The evolution of surgical treatment for gastrointestinal cancers
According to the latest Japanese nationwide estimates, over a million Japanese people are newly diagnosed with cancer each year. Since gastrointestinal cancers account for more than 40% of all cancer-related deaths, it is imperative to formulate effective strategies to control them.
Materials and methods, and results
Basic drug discovery research Our research has revealed that the abnormal expression of regulators of chromosomal stability is a cause of cancers and identified an effective compound against cancers with chromosomal instability. We revealed the molecular mechanism of peritoneal dissemination of cancer cells via the CXCR4/CXCL12 axis to CAR-like cells and identified an MEK inhibitor effective against these tumors. Residual tumor cells after chemotherapy in colorectal cancer are LGR5-positive cancer stem cells and their ability to eliminate reactive oxygen species is elevated. The development of surgical procedures and devices In cases of gastric tube reconstruction for esophageal cancer, we determined the anastomotic line for evaluating the blood flow using ICG angiography and measuring the tissue O2 metabolism. We established a novel gastric reconstruction method (book-binding technique) for gastric cancer and a new rectal reconstruction method focusing on the intra-intestinal pressure resistance for rectal cancer. We established a novel tissue fusion method, which allows contact-free local heating and retains tissue viability with very little damage, and developed an understanding of the collagen-related processes that underpin laser-induced tissue fusion. Strategy to prevent carcinogenesis We succeeded in cleaving hepatitis B virus DNA integrated into the nucleus of hepatocytes using genome editing tools. The development of HCC from non-alcoholic steatohepatitis (NASH) may be prevented by metabolic surgery.
We believe that these efforts will help to significantly improve the gastrointestinal cancer treatment and survival.
KeywordsGastrointestinal cancers Drug discovery Chromosomal instability Reconstruction after gastrointestinal surgery Biomaterial collagen Cancer odors Metabolic surgery
Twenty seven of our studies have been financially supported by these agencies. I received the grants as the representative of these studies. We would like to extend our sincere appreciation to the Ministry of Education, Culture, Sports, Science and Technology; the Ministry of Health, Labour and Welfare; and the Japan Agency for Medical Research and Development.
Compliance with ethical standards
Conflict of interest
We disclose the following conflicts of interest. We offer our heartfelt gratitude to the cooperation extended by the research institutes of these four companies: Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, and Yakult Honsha.
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