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Thecurrentstatusandfuturedirectionofthe
researchprojectbytheJapaneseSocietyof
HBPSurgery
Wakayama Medical University
○…Hiroki…Yamaue
The… Japanese… Society… of… HBP… Surgery… has… been… conducting… the…
research…projects…for…liver,…biliary,…and…pancreatic…surgery.…In…each…
group,…several…projects…have…been…finished…including…Liver…surgery…
project…(Liver…01…study:…Impact…of…nodal…involvement…on…surgical…
outcomes…of…intrahepatic…cholangiocarcinoma;…JHBPS…2011;18:
443,…Liver…02…study:…A…nomogram…predicting…disease-free…survival…
in…patients…with…colorectal…liver…metastases;…JHBPS…2011;19:72),…
and…Pancreatic…surgery…project…(Pancreas…02…study:…Predictive…risk…
factors… after… pancreatoduodenectomy;… JHBPS… 2011;18:601).…
Other… projects… have… been… collecting… the… clinical… data… and… also…
preparing… the… manuscripts.… The… future… direction… of… the… project…
should…direct…to…the…prospective-fashioned…research,…and…one…should…
consider… a… multi-center,… prospective,… randomized,… controlled… trial…
hopefully…in…the…near…future.
Next…issue…we…are…thinking… is;…development… to…the…international…
collaborative…studies.…As…a…first…step…for…international…collaborative…
studies,…the…Japanese…Society…of…Hepato-Biliary-Pancreatic…Surgery…
and… the…Korean… Association… of…Hepato-Biliary-Pancreatic… Surgery…
work… together… to… promote… project… studies.… Both… societies… have…
discussed…together…several…times…by… closed…meeting,…and… Project…
seminars…of…the…first…international…collaborative…study…are…to…be…held…
in…this…symposium.……Moreover,…Japanese…Society…will…collaborate…the…
Taiwan…Society…to…work…together…the…HBP…Surgery.…
…Thus,…the…international…collaborative…studies…with…Japan,…Korea…and…
Taiwan…are…now…proceeding…and…bring…a…fruitful…outcomes…by…the…
this…attempt.
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HepaticsurgeryprojectsbytheJapanese
SocietyofHBPSurgery
Tokyo Women’s Medical University
○…Masakazu…Yamamoto
The… two… projects… for… hepatic… surgery… were… conducted… and… the…
results…were…published…in…JHBPS.…
01-… Liver… project… is… to… clarify… the… prognostic… factors… of…
intrahepatic…cholangiocarcinoma…(ICC)…following…hepatectomy…and…
to…examine…the…impact…of…lymph…node…metastasis…on…survival.…Three…
hundred…and… forty-one…patients…who…underwent…hepatectomy…for…
ICC… between… 1995… and… 2004… at… the… 9… institutions… of… the… Medical…
University…Hospitals…were…analyzed…retrospectively.…This…study…was…
published…on…JHBPS…2011;18:443-52.
02-Liver…project…is…to…predict…the…disease-free…survival…of…patients…
with… colorectal… liver… metastases… treated… with… hepatic… resection.…
Perioperative…factors…were…assessed…in…727…hepatectomized…patients…
with…colorectal…liver…metastases…between…2000…and…2004…at…the…11…
institutions.… A… nomogram… was… developed… as… a… graphical…
representation… of…a…stepwise…Cox…proportional…hazards…regression…
model.…
This…study…was…published…on…JHBPS…2012;…19:71-84
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BiliarySurgeryprojectsbytheJapanese
SocietyofHBPSurgery
1
Toyota Regional Medical Center、 2 Dept. of Biliarypancreatic
Surgery, Fujita Health University
○…Shuichi…Miyakawa 1 ,Akihiko…Horiguchi 2 ,Shin…Ishihara 2
In…Japan,…biliary…tract…cancer…registration…was…started…in…1987.…Case…
registration… is… performed… in… every… year.… Follow-up… survey… is…
performed… in… alternate… years.… The… 12,767… cases… which… were…
registered… on… current… Japanese… biliary… tract… cancer… classification…
(fifth… edition… of… 2003)… are… available… for… the… retrospective… study…
according…to…the…conversion…of…the…data…before…2002…in…conformity…
with…the…fifth…edition.
Now… three… retrospective… studies… based… on… registered… cases… are…
ongoing…as…the…Biliary…Surgery…projects.…
The…first…Biliary…Surgery…project…study…(BS-01)…is…“The…number…of…
lymph… node… metastases… in… extra… hepatic… bile… duct… cancer… as… a…
prognostic… factor”.… This… is… a… study… of… the… investigation… of… the…
Japanese… classification… and… also… the… UICC… classification.… This… is…
important…role…of…the…biliary…cancer…registration.…For…this…study,…we…
started…the…accumulation…of…the…number…of…the…retrieved…regional…
lymph… node… from… 2008’s… registration.… The… 2,543… cases… were…
accumulated… in… three… years.… About… 4,000… cases… are… going… to… be…
accumulated…until…the…follow-up…survey…in…2014.…
The… second… study…(BS-02)… is…“Gallbladder… bed… resection… or…
hepatectomy…of…segment…4a…+…5…for…pT2pN0…gallbladder…carcinoma”.…
The…analysis…was…performed…to…the…pT2pN0…gallbladder…85…cancers,…
gallbladder…bed… resection…55… cases,… S4a+5…hepatectomy…30… cases,…
registered…from… 1998… to… 2004,… and… then… the… follow… up… study… was…
performed…until…2011.…This…study…finished…analysis,…and…we…make…a…
thesis…now.…
The…third…study…(BS-03)…is…“Investigation…of…bile…duct…resection…for…
T2… gallbladder… carcinoma”.……We… are… analyzing… the… pT2,… pN0…
gallbladder…cancers…registered…from…1998…to…2077…for…this…study.…
We… are… considering… two… new… biliary… surgery… projects.… One… is…
“Verification…of…a…case…to…achieve…radical…resection…with…the…use…of…
bile…duct…resection…alone…in…extra…hepatic…bile…duct…cancer”.…The…
other…is…“Application…of…local…resection…in…T1…ampullary…cancer”.
As…to…the…biliary…surgery…projects,…our…stance,…in…present…situation,…is…
to…perform…retrospective…study…of…a…thesis…subjects,…which…are…raised…
by… the… project… working… group,… using… the… large… quantities… of… the…
registered…biliary…tract…cancers…at…first,…and…then,…if…necessary,…to…
plan…prospective…study…on…the…basis…of…the…results.
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PancreaticSurgeryProjectbytheJapanese
SocietyofHBPSurgery
Wakayama Medical University
○…Hiroki…Yamaue
The… Japanese… Society… of… HBP… Surgery… has… been… conducting… the…
research… projects… for… liver,… biliary,… and… pancreatic… surgery.… In…
pancreatic… surgery… group,… three… major… projects… have… been…
proceeding…as…follows;…
Pancreas…01…study;…Clinical…impact…of…adjuvant…surgery…for…patients…
with…initially…unresectable…pancreatic…cancer.…A…total…of…58…patients…
with… adjuvant… surgery… after… adequate… chemotherapy… of…
chemoradiation… were… enrolled… in… this… project,… and… compared… the…
clinical…data…to…case-matched…controlled…patients…without…surgery.…
The…median…survival…time…(MST)…in…the…surgery…group…was…39.5…
months,…showing…that…the…superior…survival…compared…to…the…control…
group.
Pancreas… 02… study;… Predictive… risk… factors… for… clinically… relevant…
pancreatic… fistula… analyzed… in… 1,239… patients… with…
pancreaticoduodenectomy:…multicenter…data…collection…as…a…project…
of… pancreatic…surgery…by…the…Japanese… Society…of… Hepato-Biliary-
Pancreatic… Surgery.… This… project… has… been… published… in… J…
Hepatobiliary…Pancreat…Sci…2011…Jul;18(4):601-8.
Pancreas… 03study;… Resection… rate… in… preoperative… treatment… for…
resectable… pancreatic… cancer… and… its… impact… on… perioperative/
postoperative…outcomes
Purposes…of…this…project…are;…to…elucidate…the…impact…of…preoperative…
treatment…for…resectable…pancreatic…cancer…on…the…resection…rate…and…
prepoperative…treatment…outcomes…and…to…conduct…a…questionnaire…
survey…for…training…facilities…accredited…by…the…system…of…physicians…
with…advanced…technique.…
…Thus,…pancreatic…surgery…group…has…already…published…the…results…
of…the…project…to…JHBPS,…and…continuing…the…two…projects.…In…the…
near… future,… the… project… should… be… proceeded… as… a… randomized…
controlled…fashion.
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