• Search Research Projects
  • Search Researchers
  • How to Use
  1. Back to previous page

Genetic study on mode of tumor spread from colorectal metastasis in the liver -standardization of surgical procedure

Research Project

Project/Area Number 14571182
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionThe University of Tokyo

Principal Investigator

KOKUDO Norihiro  The University of Tokyo, Faculty of Medicine, Associate Professor, 医学部附属病院, 助教授 (00205361)

Co-Investigator(Kenkyū-buntansha) MIKI Yoshio  Cancer Institute, Department of Genetic Diagnosis, Chief (Researcher), 癌研究会研究所・遺伝子診断部, 部長(研究職) (10281594)
MIKI Kenji  The University of Tokyo, Faculty of Medicine, Asistant, 医学部附属病院, 助手 (10242059)
Project Period (FY) 2002 – 2003
Project Status Completed (Fiscal Year 2003)
Budget Amount *help
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2003: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2002: ¥2,300,000 (Direct Cost: ¥2,300,000)
Keywordscolorectal liver metastasis / genetic diagnosis / liver resection / hepatic hilar lymph node / 大腸癌 / 転移性肝癌
Research Abstract

To clarify most reasonable procedures for the surgical resection of colorectal liver metastases, we have conducted a genetic and histological study. Using a genetic diagnosis, tumor supread inside the hepatic parenchyma and Glisson's were investigated. Impact of K-ras and p-53 mutations on patient survival after liver resection was also studied. From 1996 through 2002,58 patients underwent 62 liver resections for hepatic metastasis from colorectal cancer. Tissue samples taken from the tumor, the surrounding liver parenchyma, and Glisson's pedicle near the tumor were tested for K-ras and p-53 mutations using the mutant allele-specific amplification method. This cohort was followed up until January 2004, and patient survival was analyzed. Of the 62 sets of samples from liver metastases, 39 were positive for K-ras and/or p53 gene mutations. Micrometastases in the liver parenchyma surrounding colorectal metastases were present in 2.0% (4/199) of tested samples and were located within 4 mm from the tumor border.
Micrometastases via Glisson's pedicle were more common (14.3%:3/21), but they were also confined to a short range from the tumor edge (【less than or equal】 5mm). Three-year survival rate of patients without mutations of either gene was 94% while that of patients with mutation of wither gene was 67% (p=0.177 logrank). Three-year survival rate of patients with K-ras mutation had significantly poor prognosis comapring to that of patients without mutation (p=0.045).
Micrometastases around the liver tumors are not common and most are confined to the immediate vicinity of the tumor border. Surgical margin of 2 mm appears to be a clinically acceptable minimum requirement with an approximately 5% risk of margin-related recurrence. K-ras mutation in the metastatic lesion was related to a poor patient outcome after liver resection.

Report

(3 results)
  • 2003 Annual Research Report   Final Research Report Summary
  • 2002 Annual Research Report
  • Research Products

    (29 results)

All 2004 2003 Other

All Journal Article (15 results) Book (1 results) Publications (13 results)

  • [Journal Article] Surgical Challenge for Multiple Hepatic Colorectal Netastases2004

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      J HPS Surg 11

      Pages: 84-91

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Current role of portal vein embolization / hepatic artery chemoembolization.2004

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Surg Clin N Am 84

      Pages: 643-657

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer.2004

    • Author(s)
      T Aoki, N Kokudo, et al.
    • Journal Title

      J Am Coll Surg 198

      Pages: 366-372

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Single and multiple resections of multiple hepatic metasatases of colorectal origin.2004

    • Author(s)
      H Imamura, N Kokudo, et al.
    • Journal Title

      Surgery 135

      Pages: 508-517

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] The repeated hepatectomy for frequent recurrence of hepatic metastasis from gastrointestinal stromal tumor of the stomach.2004

    • Author(s)
      T Satoi, N Kokudo, et al.
    • Journal Title

      Hepato-Gastroenterology 51

      Pages: 181-183

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Surgical Challenge for Multiple Hepatic Colorectal Metastases2004

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      J HPB Surg 11

      Pages: 84-91

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Current role of portal vein embolization/hepatic artery chemoembolozation2004

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Surg Clin N Am 84

      Pages: 643-657

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer2004

    • Author(s)
      T Aoki, N Kokudo et al.
    • Journal Title

      J Am Coll Surg 198

      Pages: 366-372

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Single and multiple resections of multiple hepatic metasatases of colorectal origin2004

    • Author(s)
      H Imamura, N Kokudo et al.
    • Journal Title

      Surgery 135

      Pages: 508-517

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] The repeated hepatectomy for frequent recurrence of hepatic metastasis from gastrointestinal stromal tumor of the stomach2004

    • Author(s)
      T Sato, N Kokudo et al.
    • Journal Title

      Hepato-Gastroenterol 51

      Pages: 181-183

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Strategies for Surgical Treatment of Gall Bladder Carcinoma Based only on Information Available before Resection.2003

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Arch Surg 138

      Pages: 741-750

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Clinical Application of TcGSA2003

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Nuclear Medicine and Biology 30

      Pages: 845-849

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Sling suspension of the liver in donor operation : a gradual tape-repositioning technique.2003

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Transplantation 76

      Pages: 803-807

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Strategies for Surgical Treatment of Gall Bladder Carcinoma Based only on Information Available before Resection2003

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Arch Surg 138

      Pages: 741-750

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Journal Article] Clinical Applicaiton of TcGSA2003

    • Author(s)
      Norihiro Kokudo, et al.
    • Journal Title

      Nucl Med & Biol 30

      Pages: 845-849

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Book] Liver Tumor in Asia2004

    • Author(s)
      N Kokudo, M Makuuchi.
    • Total Pages
      482
    • Publisher
      MALIGNANT LIVER TUMORS, P-A Clavien Ed. Pp.. 427-438, Jones & Bartlet, Sudbury, MA.
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Norihiro Kokudo, et al.: "Surgical Challenge for Multiple Hepatic Colorectal Metastases."J HPB Surg. (in press). (2004)

    • Related Report
      2003 Annual Research Report
  • [Publications] T Aoki, N Kokudo et al.: "Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer."J Am Coll Surg. 198. 366-372 (2004)

    • Related Report
      2003 Annual Research Report
  • [Publications] Norihiro Kokudo, et al.: "Strategies for Surgical Treatment of Gall Bladder Carcinoma Based only on Information Available before Resection."Arch Surg. 138. 741-750 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Norihiro Kokudo, et al.: "Clinical Application of TcGSA."Nuclear Medicine and Biology. 30. 845-849 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Norihiro Kokudo, et al.: "Sling suspension of the liver in donor operation : a gradual tape-repositioning technique."Transplantation. 76. 803-807 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Tada K, Kokudo N, et al.: "Hepatic resection for colorectal metastasis with macroscopic tumor thrombus in the portal vein."World J Surg. 27. 299-303 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] N Kokudo, M Makuuchi: "Liver Tumors in Asia"MALIGNANT LIVER TUMORS, 2nd Edition (chapter 33), P-A Clavien Ed nn 427-438 Iones & Bartlet Sudbury MA. 482 (2004)

    • Related Report
      2003 Annual Research Report
  • [Publications] Norihio Kokudo et al.: "Genetic and histologcial assesiment of surgical margersin resected liver metastuses from coloraital carinsoma"Arohives of Surgery. 137(7). 833-840 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Norihiro Kokudo et al.: "Predictors os succesoful hepitic rasection-prognartic wefulness of hopatic ASGP-R analysis"World Journal of Surgery. 26. 1642-1340 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Norikhro Kokudo et al.: "Extent of resecction and outconfollrising curative resection for inteahepatic cholaglocarcinsoma"Sing Oncol Clin N Am. 11. 969-983 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] 國土典彦他: "膵臓十二指腸欠如における膵消化舌吻合4 二期的膵空腸吻合術"外科. 64(6). 680-684 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] 國土典彦他: "J型切開法の具体的開胸開腹法と視野の展開図"臨床外科. 57(5). 601-604 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] 國土典彦: "門脈圧亢進症治療における外科医の役割"日門元会誌. 7. 197-199 (2002)

    • Related Report
      2002 Annual Research Report

URL: 

Published: 2002-04-01   Modified: 2016-04-21  

Information User Guide FAQ News Terms of Use Attribution of KAKENHI

Powered by NII kakenhi