Download Seminar

＜ Day 1 ＞　June 13（Sat.）
18：30 ～ 19：30
Akinobu Taketomi, MD, PhD
ACADEMIC DEGREE:
March 1996　MD, PhD, Kyushu University
EDUCATION:
April 1992 - March 1996
PhD, Medical Related Research Surgical Related Section,
Graduate School of Medical Sciences, Kyushu University
March 1990 Graduate, Faculty of Medicine, Kyushu University
PROFESSIONAL APPOINTMENTS AND RESEARCH EXPERIENCE:
November 2011 – Present
Professor, Department of Gastroenterological Surgery I, Hokkaido University
October 2003 – October 2011
Lecturer (joint appointment), Department of Surgery and Science, Kyushu University Faculty of Medicine
June 2003 – October 2011
Assistant, Department of Surgery II, Kyushu University Hospital
April - May 2003
Medical Staff, Department of Surgery II, Kyushu University Hospital
April 2001 - March 2003
Chief, Medical Care Department (Surgery), Nakatsu Municipal Hospital
September 1998 - March 2001
Obtained Ph.D., and Researcher, Huntsman Cancer Institute, University of Utah, USA
April 1996 -August 1998
Medical Staff, National Kyushu Cancer Center (Department of Digestive Organs)
April 1991 - March 1992
Resident, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital (Department of Surgery)
January - March 1991
Medical Staff, Kyushu University Hospital (Resident, Department of Surgery II)
October - December 1990
Resident, Fukuoka Children's Hospital and Medical Center for Infectious Diseases (Department of Surgery)
June - September 1990
Medical Staff, Kyushu University Hospital (Resident, Department of Surgery II
LICENCE AND CERTIFICATION:
December 2010 Attending Physician,
Japan Surgical Society (No.S009134)
January 2010 Certified Physician for Gastrointestinal Diseases
The Japanese Society of Gastroenterology (No.32032)
Certified Speciality,
June 2008 Japanese Society of Hepato-Biliary-Pancreatic Surgery (No.08-0185)
April 2008 Certified Physician for Cancer Therapy,
Japanese Board of Cancer Therapy (No.7101254)
March 2008 Certified Physician for Gastrointestinal Cancer Surgery,
The Japanese Society of Gastroenterological Surgery (No.2108)
Tentative Instructor, Japanese Board of Cancer Therapy (No.72193)
August 2007 April 2007 Medical Specialist(Accredited), The Japan Society of Hepatology (No.4525)
April 2006 Attending Physician, The Japanese Society of Gastroenterological Surgery (No.4126)
January 2005 Medical Specialist The Japanese Society of Gastroenterological Surgery (No.3002235)
December 2002 Medical Specialist, Japan Surgical Society (No.1904090)
December 1997 Certified Physician,
The Japanese Society of Gastroenterological Surgery (No.3918)
December 1994 Certified Physician, Japan Surgical Society (No.9752)
May 1990 Medical Licensure (Medical License No. 328849)
PROFESSIONAL SOCIETIES:
American College of Surgeons (Fellow)
International Liver Transplant Congress (active member)
Asian-Pacific Hepato-Pancreat-Biliary Association (Active member)
Japan Surgical Society (Attending Physician/Medical Specialis/Certified Physician) The Japanese Society of
Gastroenterological Surgery (Attending Physician/Medical Specialist /Certified Physician)
Japanese Society of Hepato-Biliary-Pancreatic Surgery (Councilor, Certified Speciality)
The Japan Society of Hepatology (Medical Specialist)
Japanese Liver Transplantation Society
Japanese Cancer Association
Japan Society of Clinical Oncology
The Molecular Biology Society of Japan
Japan Surgical Association
Japanese Society of Medical Oncology
HONORS AND AWARDS:
Fukuoka Prefecture Medical Association President’s Award for Faculty Physician (2006)
Japan Society of Clinical Oncology Best Investigator Award (2010)
Japanesse Liver Transplantation Society Investigator Award (2011)
─ 20 ─
Evening Seminar
Current topics in liver cancer
Akinobu Taketomi
Department of Gastroenterological Surgery I, Hokkaido University
In unresectable intermediate-stage hepatocellular carcinoma (HCC) treatment strategy,
transarterial chemoembolization (TACE) is the most widely used treatment for patients with HCC
unsuitable for radical therapies worldwide. Furthermore, at advance stage, the advent of sorafenib
as a standard of care with an improvement in survival to 10.7 months compared to 7.9 months for
placebo (0.69; 95% CI, 0.55 to 0.87; p = 0.001) was a major breakthrough in the treatment of
advanced HCC. Sorafenib remains the only approved systemic drug for the stage.
Several experimental studies have suggested potential synergies between loco-regional and
systemic therapies with antiangiogenic properties, such as sorafenib. However, the large clinical
trials such as randomized phase II SPACE Study and phase III Post-TACE study completed so far
did not provide a clinically meaningful improvement in time to progression (TTP) and Overall
survival (OS) compared with TACE alone. In adjuvant therapy, sorafenib did not show an
improvement in RFS in phase III STORM study. Therefore, benefit of sorafenib as adjuvant
therapy and combination therapy with TACE is not clear at now.
The suitable treatment after TACE failure/refractoriness is one of the clinical questions, JSHLCSGJ Criteria 2014 recommends HAIC and sorafenib therapy after TACE failure/refractoriness.
And it was recently reported that the benefits of continuous sorafenib therapy in TACE-refractory
patients with intermediate-stage HCC from retrospective analysis. The median time to disease
progression (TTDP) and OS were 22.3 and 25.4 months, respectively, in the conversion group
(conversion to sorafenib), and 7.7 and 11.5 months, respectively, in the continued group (continued
TACE) (p = 0.001 and p = 0.003, respectively). As a prospective study, non-interventional multinational OPTIMIS study is in progress, and the result is expected.
Many studies were conducted with HCC patients using sorafenib, So we review a current topics
of HCC treatment and discuss from the surgeons point of view.
─ 21 ─
＜ Day 2 ＞　June 14（Sun.）
8：00 ～ 8：45
Hirotoshi Kobayashi, MD, PhD, FACS
Main Degrees and Honors
1994 "Graduation" from Tokyo Medical and Dental University
M.D. degree
2005 “Graduation” from Graduate School, Tokyo Medical and Dental University,
Ph.D. degree
Post-academic experience
Apr 1994 - May 1995 Dept. of 2nd Surgery, Tokyo Medical and Dental University
Jun 1995 - May 1996 Dept. of Surgery, Cancer Institute Hospital, Tokyo, JAPAN.
Jun 1996 - Jun 1998 Dept. of Surgery, Musashino Red Cross Hospital, Tokyo, JAPAN
Jul 1998 - July 2003 Dept. of Surgical Oncology, Tokyo Medical and Dental University, Tokyo
Aug 2003 - Jun 2005 Dept of Surgery I, National Defense Medical College, Saitama, JAPAN
Jul 2005 - Sep 2005
Dept of Surgical Oncology, Tokyo Medical and Dental University, Tokyo
Oct 2005 - Mar 2007Dept of Biochemistry and Molecular Biology, University of Southern
California/Norris Comprehensive Cancer Center, CA, USA
Apr 2007 - Jul 2007 Dept of Surgical Oncology, Division of Colorectal Surgery,
Tokyo Medical and Dental University, Tokyo
Aug 2007 - Jan 2011 Assistant professor
Dept of Surgical Oncology, Division of Colorectal Surgery,
Tokyo Medical and Dental University, Tokyo
Feb 2011 - Mar 2015 Associate professor
Center for Minimally Invasive Surgery, Division of Colorectal Surgery
Tokyo Medical and Dental University, Tokyo
Apr 2015 - Associate professor
Dept of Gastrointestinal Surgery, Division of Colorectal Surgery
Tokyo Medical and Dental University, Tokyo
Relevant national-international memberships
Societies
Japan Surgical Society (1994-)
The Japanese Society of Gastroenterology (1994-)
The Japanese Society of Gastroenterological Surgery (1996-)
Japan Gastroenterological Endoscopy Society (1998-)
The Japan Society of Coloproctology (2002-)
Japan Society of Endoscopic Surgery (2002-)
Japan Society of Clinical Oncology (2004-)
American Association for Cancer Research (2003-)
American Society of Clinical Oncology (2004-)
Society of Surgical Oncology (2007-)
American Society of Colon and Rectal Surgeons (2007-)
American College of Surgeons (FACS) (2011-)
Board Certification
Japan Surgical Society (1998-)
The Japanese Society of Gastroenterological Surgery (2004-)
Japan Gastroenterological Endoscopy Society (2004-)
Japan Society of Coloproctology (2007-)
Japanese Society of Gastroenterology (2009-)
Fellow of American college of Surgeons (2012-)
Award
2009 Japan Society of Coloproctology Award
2010 Japanese Society for Cancer of the Colon and Rectum Award
2011 75th Japanese Society for Cancer of the Colon and Rectum meeting Best Presentation Award
2011 49th annual meeting of Japan Society of Clinical Oncology, Best Presentation Award
2014 52nd annual meeting of Japan Society of Clinical Oncology, Excellent Abstract Award
Journal Editorial Board
BioMed Research International
World Journal of Gastroenterology
Asian Journal of Surgery
Case Reports in Surgery
Journal of Solid Tumor
World Journal of Surgical Procedure
─ 22 ─
Morning Seminar
Current status of therapeutic strategy for
colorectal cancer in Japan
Hirotoshi Kobayashi
Department of Gastrointestinal Surgery, Division of Colorectal Surgery, Tokyo Medical and Dental University
Colorectal cancer is one of the increasing diseases in Japan. It is the third leading cause of cancer
death in Japan, although it is the leading cause of cancer death in Japanese women. In this
seminar, current status of therapeutic strategy for colorectal cancer in Japan will be presented.
The treatment for early colorectal cancer has progressed along with the advancement of
endoscopy. Endoscopic resection is the first choice for Tis tumor and a part of T1 tumor.
Endoscopic treatments such as polypectomy, endoscopic mucosal resection, and endoscopic
submucosal dissection are good news for many patients. As for the treatment of T1 colorectal
cancer, the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines for the
treatment of colorectal cancer indicates the criteria of bowel resection with lymphadenectomy:
depth of submucosal invasion deeper than 1mm, lymphovascular invasion, poorly differentiated
adenocarcinoma, mucinous carcinoma, signet-ring cell carcinoma, and budding grade 2/3. Only
Japanese guidelines set up the detailed criteria for bowel resection with lymphadenectomy after
endoscopic treatment.
The outcomes after curative resection for colorectal cancer in Japan are world-leading. The
characteristics of the Japanese colon surgery are resection margin of 10cm and central vascular
ligation, so-called D3 dissection. On the other hand, many Western surgeons resect longer bowel,
but dissect lymph nodes with low vascular tie. After the adoption of complete mesocolic excision
(CME), the outcomes after colon surgery in Western countries have been improved. Central
vascular ligation is common between CME and D3 dissection, but the length of resected colon is
different between two procedures.
As for rectal cancer, the treatment strategy has been different between Japan and other countries.
The JSCCR guidelines recommend tumor-specific mesorectal excision with pelvic sidewall
dissection for T3/T4 lower rectal cancer, although preoperative chemoradiotherapy followed by
total mesorectal excision is recommended in Western countries.
One of the most epoch-making techniques in this field last 20 years is a laparoscopic surgery.
Laparoscopic surgery is used not only for early cancer but also for advanced cancer. Rectal cancer
as well as colon cancer can be treated by laparoscopic approach. Today, approximately half of the
patients with colorectal cancer in Japan are treated by laparoscopic surgery.
Chemotherapy for unresectable colorectal cancer has progressed. Not only chemotherapeutic
agents but also molecular-targeted agents are available these days.
─ 23 ─
＜ Day 2 ＞　June 14（Sun.）
12：20 ～ 13：20
Takeshi Aoki, MD, PhD
POST GRADUATE TRAINING
April, 2011- present
Division of General & Gastroenterological Surgery, Showa University, School of Medicine,
Tokyo　Associate Professor
October, 2006-Mrach, 2011 present
Division of General & Gastroenterological Surgery, Showa University, School of Medicine,
Tokyo　Lecture
August, 2002-December, 2004
Division of General & Gastroenterological Surgery, Showa University, School of Medicine,
Tokyo　Assistant Professor
August, 2002-December, 2004
Division of General & Gastroenterological Surgery, Showa University, School of Medicine,
Tokyo　Medical Staff
August, 1999-July, 2002
Cedars Sinai Medical Center, UCLA, School of Medicine, LA, USA, Research fellow, (Prof. Demetriou AA, Dr. Rozga J)
July, 1998-July, 1999
Division of General & Gastroenterological Surgery, Showa University, School of Medicin Tokyo Medical Staff
July, 1997-June, 1998
Hata Hospital, Ibaraki, Medical staff
April, 1997-June, 1997
Division of General & Gastroenterological Surgery, Showa University, School of Medicine, Medical staff
Tokyo
April, 1995-March, 1996
Kameda Hospital, Chiba, Medical Staff
April, 1994– March, 1995
Shikahama Hospital, Tokyo, Medical Staff
April , 1993 –March, 1994
Division of General & Gastroenterological Surgery, Showa University, School of Medicine, Tokyo Residency,
EDUCATION
June, 2001
Department of Surgery II, School of Medicine, Showa University, Tokyo　PhD
April, 1993-March, 1997
Postgraduate School in Department of Surgery II, School of Medicine, Showa University, Tokyo
April, 1993
Department of Surgery II, School of Medicine, Showa University, Tokyo　MD
March, 1993
Graduate from School of Medicine, Showa University, Tokyo
PROFESSIONAL SOCIETIES
Board Certified Surgeon
Board Certified Surgeon in Gastroenterology
Board Certified Member, The Japan Surgical Association
Board Certified Hepatologist of the Japan Society of Hepatology
Councilor, The Japanese Society of Hepato-Biliary-Pancreatic Surgery
Member, Japanese Society of Gastroenterological Endoscopy
Councilor, The Japanese Society for Regenerative Medicine
Councilor, The Society for Low Temperature Medicine
Editorial board: ISRN Hepatology
Editorial board: World Journal of Gastroenterological Surgery
Full member of IASGO’s(International Association of Surgeons, Gastroenterologists, and Oncologists) International Medical
Faculty as an Invited Speaker and Teacher.
Nominated Editorial board: Journal of Emergency Medicine and Surgical Care (EMSC)
GRANTS
1. 2003-2004 Grant in Aid for Scientific Research, Japan Society for the Promotion of Science
2. 2005-2006 Grant in Aid for Scientific Research, Japan Society for the Promotion of Science
3. ‌2002-2011 Showa University Grant-in Aid for Innovative Collabolative Research ProjectGrants-in-Aid for Joint Research
Projects and a special research Grant-in-Aid for Development of Charactereristic Education from the Japanese Ministry of
Education, Culture, Sports, Science and Technology.
4. 2009-20011 2005-2006 Grant in Aid for Scientific Research, Japan Society for the Promotion of Science
PATENTS
US PATENT: Application no: 11/082,055
Filing date: 03/17/2005
First named inventor: Takeshi Aoki
Title of invention: Method for cryopreserving microencapsulated living animal cells enclosed in immunoisolation membranes,
such microencapsulated living animal cells in immunoisolation membranes, and biohybrid artificial organ modules using such
microencapsulated living animal cells
AWARD
2001 The Japanese society of Regenerative medicine,　Merit Award
2003 American Association for the Study of Liver Disease (AASLD)　Merit Award, Poster
2009 The Japanese Society of Gastroenterological Surgery　Merit Award
2010 The Japanese Foundation For Research and Promotion of Endoscopy, Grant for overseas posting
2011 American College of Surgeon(ACS), Exceptional Merit (Best nine)
2011 Japan Society for Endoscopic Surgery, KarL Storz Award
2012 American College of Surgeon (ACS), Exceptional Merit (Best ten)
2014-2015 The Best Doctors in Japan
─ 24 ─
Lunceon Seminar
A safe and accurate laparoscopic liver resection for hepatic
neoplasm using a novel simulation and navigation technology
Takeshi Aoki
Division of General & Gastroenterological Surgery, Showa University, School of Medicine
Laparoscopic hepatectomy (LH) is a safe and effective approach to the management of surgical
liver disease in the hands of trained surgeons with experience in hepatobiliary and laparoscopic
surgery. However, the technique of LH is substantially different compared to the open technique
in multiple aspects, as follows. The angle of parenchymal transection is caudal-cranial angle and
limited by the possibility of liver exposure and mobilization. In addition, the intraoperative
ultrasound (IOUS) interpretation to determine intraoperative diagnosis of liver lesion and also for
guidance of the parenchymal transection plane with immediate feedback of changes that occur
during surgery is more difficult. To overcome these issue, we demonstrate several efforts to
secure the safe and accurate LH with a novel simulation or navigation technology.
1) Preoperative and intraoperative assistance by 3D virtual endoscopy (3DVE): Surgical planning
was performed by the surgeons using image-processing software. This tool enables the surgeon to
review reconstructed liver structures, perform virtual hepatectomy and generate virtual
endoscopic 3D geometries that constitute the cartography of the liver. 3DVE with a “laparoscopic
eye” can efficiently display intraoperative 3D data and contribute to safer and more accurate
hepatic surgery.
2) Laparoscopic liver surgery guided by ultrasound with electromagnetic tracking navigation
and image fusion (EMT/IF-US): During operation, the surgical instrument attached to
electromagnetic tracking sensor was used for navigating the direction of accurate liver transection
under reference guidance using EMT/IF-US. After registration, MPR images of CT identical to
the current IOUS images were continuously provided by this system. MPR images, displayed sideby-side with real-time grayscale US, showed the liver tumor and hepatic vessels in different colors.
MPR images of CT provided continuous real-time feedback to the surgeon and enabled
determination of whether the surgical device tip was close to the planned resection border or to
anatomical structures of interest. Finally, the planned surgical margin was determined, and
resection was performed.
3) Determination of surgical margin in LH using preoperative tattooing or ICG fluorescent with
infrared light: The preoperative tattooing was performed using 1 cc of sterile dye injected
surrounding the anatomical landmarks (portal branches) or surrounding of the liver tumors under
the guidance of US. The Endoscopic Fluorescence Imaging System was used as an ICG fluorescent
imaging system to assess surgical margin. Preoperative tattooing or laparoscopic ICG fluorescent
imaging provides navigation assistance to the surgeon by visualize the clear staining of landmark
of vessels or tumor.
We strongly believe that these techniques can provide continuous real-time feedback to the
surgeon and enables easy and quick identification of tumor location, planned resection borders, or
anatomical structures of interest in laparoscopic hepatectomy.
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