Surgical Oncology

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Email	iga-ken-d◎t.mail.nagoya-u.ac.jp (Please send a message after replacing "◎" mark with "@" mark. )
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OUTLINE

This division provides medical care mainly for tumors in the gastrointestinal system including esophagus, stomach, duodenum, small intestine, and large intestine as well as liver, biliary tract (gallbladder and bile duct), and pancreas. We perform an aggressive surgery for highly advanced hepato-biliary pancreas, esophagus, and colorectal cancers. Especially, our department has the best treatment results for hilar cholangiocarcinoma regardless in or outside of Japan. We also perform minimally invasive surgery for selected patients in esophagus, stomach, colorectal, and hepato-biliary pancreas diseases. Through these experiences as a high volume center, our surgeons continually sharpen their skills and therefore can provide better outcomes for patients.

RESEARCH PROJECTS

Multi-center Study

• An observational Multi-center Study to Evaluate Real-World Treatment Outcomes of Durvalumab-based Regimens in Hepatobiliary Cancers
• Phase II Study to evaluate the Synbiotics efficacy on reducing the incidence of postoperative infectious complications after liver resection (SYNERGI Study)
• International Retrospective Analysis of Curatively Resected Biliary Tract Cancer: Treatment Patterns and Clinical Outcomes
• A phase III trial of neoadjuvant Gemcitabine + Cisplatin + S-1 (GCS) vs. surgery first for resectable biliary tract cancer NABICAT：NeoAdjuvant chemotherapy for BIliary tract CAncer phase III Trial
• Phase III study of gemcitabine, cisplatin plus S-1 combination therapy versus gemcitabine, cisplatin plus immune checkpoint inhibitor combination therapy in advanced biliary tract cancer.
• A study of safety, feasibility, and survival outcome of surgical resection for biliary tract cancers
• Feasibility of surgical resection for clinically diagnosed T3/T4 gallbladder cancer
• Postoperative prognosis of the patients with node-positive T1/2 gallbladder cancer
• Surgical outcomes of non-benchmark PHCC
• Surgical outcomes of hepatectomy and extrahepatic bile duct resection for perihilar cholangiocarcinoma post-chemotherapy
• The Goal of intraoperative blood loss in right hepatectomy with caudate lobectomy and extrahepatic bile duct resection for biliary cancer
• A Phase III, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Global Study of Rilvegostomig in Combination With Chemotherapy as Adjuvant Treatment After Resection of Biliary Tract Cancer With Curative Intent
• A Phase III Study of Trastuzumab Deruxtecan (T-DXd) and Rilvegostomig versus Standard-of-Care Gemcitabine, Cisplatin, and Durvalumab for First Line Locally Advanced or Metastatic HER2-expressing Biliary Tract Cancer
• A prospective, multicenter, phase II trial of platinum re-introduction with gemcitabine after gemcitabine and cisplatin with durvalumab (MEDI4736) in patients with biliary tract cancer (PRIDE study)
• Optimal assessment of future liver remnant before major hepatectomy: an international multicenter retrospective cohort study
• Clinical survey of spermatic cord sarcoma in Japan： A multi-institutional study by The Japanese Association of Sarcoma Treatment and Research (JSTAR002, SPARC study)
• A randomized phase III study of neoadjuvant chemotherapy followed by surgery versus surgery alone for patients with High Risk RetroPeritoneal Sarcoma （STRASS 2）
• A multi-center, phase 3 study to evaluate superiority of total neoadjuvant t reatment of chemotherapy, capcitabine combined with oxaliplatin and irin otecan (CAPOXIRI) to short course radiotherapy followed by capecitabine combined with oxaliplatin (CAPOX) for locally advanced rectal cancer
• A pragmatic, randomized phase III trial of bi-weekly versus conventional schedule of TAS-102 plus bevacizumab for metastatic colorectal cancer
• Analysis of prognostic factors following surgical resection after treatment with mFOLFOX6 plus bevacizumab or mFOLFOX6 plus panitumumab in RAS (KRAS/NRAS) wild-type, chemotherapy-naïve patients with unresectable advanced or recurrent colorectal cancer.
• Investigation for the effects of synbiotics on the tumor microenvironment of colon cancer (SYNCLO-01 study)
• Research on genetic profiling and its clinical significance using clinical specimens from cancer patients (CONDUCTOR)
• GALAXY trial: Genetic Alterations and clinical record in radically resected colorectal cancer revealed by Liquid biopsy And whole eXome analYsis
• VEGA trial: Vanished ctDNA Evaluation for MRD-Guided Adjuvant chemotherapy for colon cancer
• The Comprehensive Multi Center Survey on Sexual Dysfunction following Conventional Laparoscopic and Modern Minimally Invasive Approaches for Rectal Cancer (the LANDMARC Study)
• Single-arm confirmatory trial of the adjuvant chemoradiation for the patients with the high-risk rectal submucosal invasive cancer after the local resection (RESCUE study)
• JCOG1805: Randomized controlled study of adjuvant chemotherapy for stag e II colorectal cancer patients at high risk of developing recurrence according to T-stage and three selected pathological factors (PanDRa-BD)
• A phase III randomized controlled trial comparing surgery plus adjuvant chemotherapy with preoperative chemoradiotherapy followed by surgery plus adjuvant chemotherapy for locally recurrent rectal cancer (RC-SURVIVE study)
• Short and long term outcomes after pelvic exenteration for pelvic malignancies: a retrospective multi-center observational study
• Diagnostic ability of MRI for rectal cancer

Single-center study

• A Study on the Safety of Not Placing a Biliary Tube During Hepatectomy with Biliary Reconstruction
• Study of safety of robotic surgery for perihilar cholangiocarcinoma and gallbladder cancer
• Randomized Controlled Trial to Investigate the Efficacy of Administration of Antithrombin in Preventing Thrombosis after Major Hepatobiliary Resection
• Interventional Study on the Preventive Effect of Bromhexine Hydrochloride on Postoperative Cholangitis After Hepatobiliary Resection for biliary cancer
• JCOG2202: Randomized phase III trial of laparoscopic versus open distal pancreatectomy for pancreatic cancer
• Nagoya University Pancreatic Tumor Board trial 07 (NUPAT 07)
• Retrograde transhepatic approach to right anterior vessels in left hepatic trisectionectomy
• Interventional Study on Bile Viscosity Decrease after Bromhexine Hydrochloride Administration
• Interventional Study on the Preventive Effect of Bromhexine Hydrochloride on Postoperative Cholangitis After Hepatobiliary Resection for biliary cancer
• Retrospective study of antibiotic therapy for cholangitis after choledochojujunostomy
• A phase II study for neoadjuvant chemotherapy (doxorubicin and ifosfamide) treatment in patients with retroperitoneal de-differentiated liposarcoma; a prospective, single-arm study.
• Impact of monitoring patients with multiprofessional collaboration on early detection and intervention of cancer cachexia
• A prospective safety and efficacy study of robotic thoracic esophagectomy for esophageal cancer
• Evaluation of clinicopathological features, efficacy and safety of the treatment of patients with gastric or esophagogastric disease.

Basic research

Clinical Application of Novel Devices Using Deep Ultraviolet LEDs for Cancer

We demonstrated that deep ultraviolet LED irradiation triggers cancer cell apoptosis and angiogenesis inhibition through the Chk1/Chk2 pathway (Yamazaki et al, 2023), and that the combination of deep ultraviolet LED irradiation with TLK1 inhibitors enhances anti-tumor effects through the MRE11-CHK1 pathway (Koike et al. 2024). In the future, we will evaluate the therapeutic devices and start the clinical trials to establish minimally invasive cancer treatment methods.

Mechanisms of Drug Resistance Induced by an Acidic Tumor Microenvironment

We found that an acidic tumor microenvironment induces FAM111B expression, which in turn confers drug resistance (Nishimura, 2025). Ongoing studies aim to determine whether FAM111B modulates cancer cell metabolism and to develop novel therapeutic approaches to improve responsiveness to pharmacological treatments.

Development of an AI-based early diagnostic system based on metabolic abnormalities associated with cancer-related cachexia

We investigate the molecular mechanisms underlying cancer-associated cachexia and aim to apply these findings to early diagnosis. Using comprehensive urinary metabolomics analyses, we are developing an AI model to predict pancreatic and biliary tract cancers (AMED 25ck0106884). In an international collaboration with Khon Kaen University in Thailand, we evaluate whether AI models developed using Japanese cohorts are applicable to non-Japanese populations.

BIBLIOGRAPHY