The aim of this prospective study was to evaluate the feasibility of periareolar injection of the contrast agent Sonazoid (SNZ) followed by ultrasonography (US) for the identification of sentinel lymph node (SLN) in breast cancer patients with clinically negative node. Patients (n = 100) with T1‐2N0M0 breast cancer received a periareolar injection of SNZ followed by US to identify contrast‐enhanced SLN. Each contrast‐enhanced SLN underwent fine needle aspiration cytology (FNAC) followed by SLN biopsy with a conventional method using blue dye and/or radiocolloid (B/R). In almost all cases, contrast‐enhanced lymphatic vessels were clearly visualized by US soon after the periareolar injection of SNZ and the SLNs were easily identified with an identification rate of 98% (98/100) for SNZ and 100% (100/100) for B/R. The number of SLNs identified by SNZ (SNZ‐SLN) (mean per patient, 1.52) was significantly lower than that identified by B/R (B/R‐SLN) (2.19) (P < 0.0001). Twenty‐five patients with positive SLNs had at least one positive SNZ‐SLN. On a node‐by‐node basis, sensitivity, specificity, and accuracy of FNAC for SNZ‐SLNs (n = 149) were 33.3%, 99.2%, and 85.9%, respectively. Identification of SLN by periareolar injection of SNZ is a technically simple method with an identification rate as high as 98%. SNZ‐SLN thus seems to be a good target for FNAC, but sensitivity of FNAC for SNZ‐SLNs needs to be improved.

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dissemination still have a poor prognosis [1]; most of these patients die within 6 months of diagnosis, while the 5-year survival rate is nil [2,3].The recent introduction of an oral drug, S-1, has increased the overall response rates (ORRs) to 44% and 49% and median survival time (MST) to 8 months in phase II studies [4,5].Several reports have demonstrated that S-1 was effective for undifferentiated histological types, such as poorly differentiated adenocarcinoma and signet-ring cell carcinoma, which are relevant to peritoneal dissemination [6]. S-1 has been reported to be effective in prolonging the survival of gastric cancer patients with peritoneal dissemination [4][5][6][7].Moreover, S-1 in combination with other anticancer drugs such as cisplatin (CDDP), taxanes, and irinotecan (CPT-11) increased ORRs and prolonged MST [8][9][10][11].Paclitaxel is a cytotoxic antineoplastic agent that causes excessive polymerization of tubulin and microtubule dysfunction, resulting in tumor cell death [12]. Kobayashi et al. [13] have demonstrated that paclitaxel is a promising drug for the treatment of malignant ascites in patients with gastric cancer: the concentration of paclitaxel in ascites was maintained within the optimal level for the treatment of cancer cells for up to 72 h after intravenous administration.Recent phase II studies of systemic chemotherapy with S-1 plus taxanes have demonstrated strong anticancer effects and a good MST in the treatment of advanced gastric cancer [9,10,14]. However, the effi cacy of systemic chemotherapy for peritoneal dissemination from gastric cancer has been unclear, because peritoneal metastases have not been defi ned as measurable lesions in conventional phase II studies. Therefore, few reports describing the effi cacy of chemotherapy for these lesions are available.In this pilot study, we planned therapeutic strategies to observe the effect of chemotherapy on peritoneal metastasis by second-look laparoscopy for patients Abstract Background. This pilot study was carried out to evaluate the effi cacy of chemotherapy for patients with peritoneal dissemination from gastric cancer or positive lavage cytology diagnosed by staging laparoscopy. Methods. Sixteen patients were enrolled. Paclitaxel was administered at 120 mg/m 2 on day 1 and S-1 was administered orally at 80 mg/m 2 for 14 consecutive days, followed by a 1-week rest, as one course. After fi ve courses of this therapy, the primary gastric tumors were evaluated and second-look laparoscopy was performed for patients showing partial response or stable disease with clinical benefi t. Results. Partial response or stable disease with clinical benefi t was confi rmed in seven and fi ve patients, respectively, and these patients underwent second-look laparoscopy. No viable cancer cells were detected on cytopathological investigation during second-look laparoscopy in 9 patients who underwent surgical treatment. The intent-to-treat response rate for gastric tumor was 44% and the rate of disappearance of peritoneal metastasis was 38% ...

We present a case of left subclavian artery aneurysm in a 48-year-old man with Marfan syndrome. Aneurysmectomy and interposition with an artificial graft were successfully performed through an infraclavicular incision by dividing the clavicle at its midshaft. The clavicle bone was reconstructed with a steel plate, and the postoperative course was uneventful. Because the arterial wall is fragile in cases of connective tissue disorders such as Marfan syndrome, our surgical approach was considered to be helpful for gentle maneuvering in an adequate operative field.

A case of esophageal cancer with chronic renal failure undergoing hemodialysis treatment showing long-term complete response with docetaxel chemotherapy and salvage endoscopic treatment Abstract Chemotherapy for hemodialysis patients is not yet well codifi ed, and the selection of individual patients remains diffi cult. We report the case of a 71-year-old hemodialyzed man who was successfully treated with docetaxel for squamous cell carcinoma of the esophagus. He had received radiotherapy for squamous cell carcinoma of the esophagus 6 years earlier. Metachronous esophageal cancer had developed at the upper third of the esophagus. He was treated tri-weekly with docetaxel at a dose of 60 mg/body in combination with hemodialysis three times a week. He achieved complete response after fi ve cycles of chemotherapy. A small elevated lesion was diagnosed at the anal edge of the scar 26 months after initial treatment, and endoscopic mucosal resection and ablation was performed. Chemotherapy with docetaxel was continued up to 50 months without signifi cant toxicity. The patient died of infection resulting from diabetic gangrene at 60 months after the initial chemotherapy, but no signs of recurrence have been observed until then. Docetaxel may be an effective anticancer agent for patients undergoing hemodialysis.

&lt;Purpose&gt; To evaluate therapeutic efficacy of percutaneous ultrasound (US) guided radiofrequency (RF) ablation therapy for primary breast cancer using contrast-enhanced US. &lt;Methods and Materials&gt; The study was approved by the institutional ethics committee, and written informed consent was obtained. Between January 2012 and April 2014, 25 patients with biopsy-confirmed T1 breast cancer underwent RF ablation therapy in one institution. We examined 25 patients with 25 T1 breast cancers by contrast-enhanced MRI/CT, and contrast-enhanced US before and after RF ablation therapy. US guided RF abltion was performed using a 17-gauge internally cooled electrode (Cool-TipTM, Valleylab, Boulder, CO, USA) under general anesthesia. After injection 0.015mL/kg body weight of Sonazoid®(perflubutane), contrast-enhanced US was performed at a low mechanical index (0.17-0.24). Therapeutic success was defined as a lack of contrast enhancement by contrast-enhanced MRI, US and non-viable cancer tissues by US guided vacuum assisted biopsy (VAB) or core needle biopsy (CNB). &lt;Results&gt; Contrast-enhanced US and MRI four weeks or more after RF ablation therapy showed ablation zones and adequate tumor necrosis in all 25 cancer lesions treated. Contrast-enhanced US made it possible to see that tumor vessels of treated lesions had disappeared after treatment. Contrast enhanced MRI showed a lack of stain with ring-like enhancement of ablation zone and non-viable tissues were seen by VAB and/or CNB in 25 ablation zones. &lt;Conclusion&gt; Contrast-enhanced US using Sonazoid® was useful modalities for evaluating the efficacy of RF ablation therapy in breast cancer lesions. Citation Format: Toshikazu Ito, Jyunji Okayama, Kumiko Uji, Masaaki Izukura. Contrast-enhanced ultrasound for evaluation of therapeutic efficacy of radiofrequency ablation for primary breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-02-07.

Background: The aim of this prospective study is to evaluate feasibility of the periareolar injection of contrast agent (Sonazoid (SNZ)) followed by ultrasonography (US) for identification of sentinel lymph node (SLN) in breast cancer patients with clinically negative node. Patients and Methods: Patients with T1-2N0M0 breast cancer were recruited in this study. They received the periareolar injection of SNZ followed by US to identify contrast-enhanced SLN. Fine needle aspiration biopsy (FNAB) was done for each CE-SLN. Then, they underwent SLN biopsy with the conventional method, blue dye and/or radiotracer (B/R). Results: In almost all cases, contrast-enhanced lymphatic vessels were clearly visualized US soon after the periareolar injection of SNZ, and SLN, into which lymphatic flow was draining, was easily identified. The identification rate of SLN was 98% (98/100) by SNZ and 100% (100/100) by B/R. The number of SLNs identified by SNZ (mean per patient, 1.52) was significantly (P &lt; 0.001) lower than that of those by B/R (2.22). Twenty-five patients had at least one metastasis in the SLNs identified by SNZ and/or B/R. In these patients, SLNs (n=39) identified by both SNZ and B/R showed a significantly (P &lt; 0.0001) higher positivity (74.4%) for metastases than those (n=19) identified by B/R alone (21.1%). Conclusion: Identification of SLN by periareolar injection of SNZ followed by US is a technically easy method and the identification rate of SLN was as high as 98%, being comparable to the conventional B/R. SLNs detected by SNZ seem to represent the true SLNs which first receive lymphatic flow from the tumor among the SLNs detected by B/R. Citation Format: Shimazu K, Ito T, Uji K, Miyake T, Motomura K, Noguchi S. Sentinel lymph node biopsy by contrast-enhanced ultrasonography with sonazoid in patients with breast cancer - Prospective multicenter study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-01-27.