| Project/Area Number |
26462038
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | The University of Tokyo |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
進藤 潤一 公益財団法人冲中記念成人病研究所, その他部局等, 研究員 (90701037)
大場 大 東京大学, 医学部附属病院, 助教 (10535529)
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| Project Period (FY) |
2014-04-01 – 2017-03-31
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| Project Status |
Completed (Fiscal Year 2016)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2016: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2015: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2014: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 大腸癌肝転移 / 周術期化学療法 / 分子標的治療薬 / 微小転移 / 形態学的腫瘍変化 / 病理学的微小転移 / 遺伝学的微小転移 / 形態学的奏功 / 分子標的薬 / RAS変異 / APC / 遺伝子変異 |
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| Outline of Final Research Achievements |
Micrometastases exists around 20% of colorectal liver metastases (CLM), and preoperative chemotherapy for CLM reduces its frequency. Biologic agents, both anti-VEGF and anti-EGFR antibody, are associated with a decrease in the incidence of microscopic cancer spread beyond a width of 1 mm from the main lesion. Furthermore, in predicting the frequency and distribution of micrometastases around CLM the morphologic change in preoperative computed tomography is more favorable than the traditional tumor size-based criteria.
In patients with suboptimal morphologic response to preoperative chemotherapy for CLM, taking surgical margin more than 1mm prolongs surgical outcome. However, patients with optimal morphologic response show very good prognosis regardless of whether surgical margin is over 1mm or not, and the current study suggested the hepatic surgery with histological positive surgical margin can be acceptable, where necessary, in those patients with marginally resectable disease.
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