Akinobu Taketomi, MD, PhD

Transcription

1 < Day 1 > June 13(Sat.) 18:30 ~ 19:30 Akinobu Taketomi, MD, PhD ACADEMIC DEGREE: March 1996 MD, PhD, Kyushu University EDUCATION: April 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 March 2003 Chief, Medical Care Department (Surgery), Nakatsu Municipal Hospital September March 2001 Obtained Ph.D., and Researcher, Huntsman Cancer Institute, University of Utah, USA April August 1998 Medical Staff, National Kyushu Cancer Center (Department of Digestive Organs) April 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) June 2008 Certified Speciality, Japanese Society of Hepato-Biliary-Pancreatic Surgery (No ) April 2008 Certified Physician for Cancer Therapy, Japanese Board of Cancer Therapy (No ) March 2008 Certified Physician for Gastrointestinal Cancer Surgery, The Japanese Society of Gastroenterological Surgery (No.2108) August 2007 Tentative Instructor, Japanese Board of Cancer Therapy (No.72193) 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 ) December 2002 Medical Specialist, Japan Surgical Society (No ) 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 ) 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

2 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, JSH- LCSGJ 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 = 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

3 < Day 2 > June 14(Sun.) 8:00 ~ 8:45 Hirotoshi Kobayashi, MD, PhD, FACS Main Degrees and Honors 1994 "Graduation" from Medical and Dental University M.D. degree 2005 Graduation from Graduate School, Medical and Dental University, Ph.D. degree Post-academic experience Apr May 1995 Dept. of 2 nd Surgery, Medical and Dental University Jun May 1996 Dept. of Surgery, Cancer Institute Hospital,, JAPAN. Jun Jun 1998 Dept. of Surgery, Musashino Red Cross Hospital,, JAPAN Jul July 2003 Dept. of Surgical Oncology, Medical and Dental University, Aug Jun 2005 Dept of Surgery I, National Defense Medical College, Saitama, JAPAN Jul Sep 2005 Dept of Surgical Oncology, Medical and Dental University, Oct Mar 2007 Dept of Biochemistry and Molecular Biology, University of Southern California/Norris Comprehensive Cancer Center, CA, USA Apr Jul 2007 Dept of Surgical Oncology, Division of Colorectal Surgery, Medical and Dental University, Aug Jan 2011 Assistant professor Dept of Surgical Oncology, Division of Colorectal Surgery, Medical and Dental University, Feb Mar 2015 Associate professor Center for Minimally Invasive Surgery, Division of Colorectal Surgery Medical and Dental University, Apr Associate professor Dept of Gastrointestinal Surgery, Division of Colorectal Surgery Medical and Dental University, 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 th Japanese Society for Cancer of the Colon and Rectum meeting Best Presentation Award th annual meeting of Japan Society of Clinical Oncology, Best Presentation Award nd 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

4 Morning Seminar Current status of therapeutic strategy for colorectal cancer in Japan Hirotoshi Kobayashi Department of Gastrointestinal Surgery, Division of Colorectal Surgery, 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

5 Day 2 June 14 Sun Takeshi Aoki, MD, PhD POST GRADUATE TRAINING April, present Associate Professor October, 2006-Mrach, 2011 present Lecture August, 2002-December, 2004 Assistant Professor August, 2002-December, 2004 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 Medical Staff July, 1997-June, 1998 Hata Hospital, Ibaraki, Medical staff April, 1997-June, 1997 Medical staff April, 1995-March, 1996 Kameda Hospital, Chiba, Medical Staff April, 1994 March, 1995 Shikahama Hospital,, Medical Staff April, 1993 March, 1994 Residency, EDUCATION June, 2001 Department of Surgery II, School of Medicine, Showa University, PhD April, 1993-March, 1997 Postgraduate School in Department of Surgery II, School of Medicine, Showa University, April, 1993 Department of Surgery II, School of Medicine, Showa University, MD March, 1993 Graduate from School of Medicine, Showa University, 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 Grant in Aid for Scientific Research, Japan Society for the Promotion of Science Grant in Aid for Scientific Research, Japan Society for the Promotion of Science 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 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) The Best Doctors in Japan 24

6 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. 25