© 2005 Foundation for Promotion of Cancer Research
Multipoint Oncology Teleconference, Japan |
Multipoint Oncology Teleconference, Japan
This teleconference has been held on a weekly basis (on Thursday evenings) as a good opportunity for the discussion of important issues in clinical oncology. Nowadays, this plenary meeting among the major cancer centers is indispensable for maintaining the high standard of quality of cancer clinics throughout Japan.
Review (January and February 2005)
Januray 27: Salvage surgery after chemoradiotherapy for esophageal cancer (moderated by Dr Tachimori, NCC, Tokyo). Even for resectable esophageal carcinomas chemoradiotherpy is being indicated instead of surgery. Just as postoperative adjuvant chemotherapy/radiotherapy for resected esophageal cancers, salvage surgery for recurrent or residual cancers after chemoradiotherapy is indispensable. Morbidity/mortality as well as prognosis of surgery in a salvage setting was extensively discussed. Dr Nishimura (NCCE) reported on 42 cases with salvage resection after definitive chemoradiotherapy. Dr Tachimori (NCC) also reported on the outcome of 38 cases of salvage esophagectomy, in which higher morbidity and mortality was pointed out. Dr Ono (Tohoku University) showed the feasibility of salvage resection for residual or recurrent tumors after curative chemoradiotherapy despite the prolonged hospital stay in their 11 case experiences.
February 3: Multimodality treatment for pediatric brain tumors (moderated by Dr Yoshida, Niigata Cancer Center, Niigata). In the treatment of brain tumors in children, the effect of antitumor drugs and radiation on the development of the brain must always be considered. Optimal strategy for disseminated lesions is controversial. Dr Yoshida (Niigata Cancer Center) discussed the strategy for recurrent germinoma (intradural dissemination). Dr Kumabe (Tohoku University) reported on the improvement of complete remission rate owing to the multimodality approach, and the necessity of a further strategy for recurrent tumors. Dr Hara (Osaka University) mentioned their own strategy: concurrent radiotherapy with high-dose chemotherapy for high-risk medulloblastoma and radiation alone for high-grade germ cell tumor. As chemotherapeutic regimens, the combination of CDDP, CPA, VCR, and VO-16 was employed. Median survival times of 26 and 36 months were reported, respectively.
February 10: Treatment for recurrent esophageal cancer (moderated by Dr Fuji, National Kyusyu Cancer Center, Fukuoka). The optimal treatment strategy for recurrent esophageal cancer after definitive chemoradiotherapy or endoscopic mucosal resection (EMR) has not been clearly defined. Also, the management of recurrence in the regional mediastinal lymph nodes and distant organs after radical resection is an issue. Dr Shimada (Tokai University) reported on 16 cases (3.6%) of recurrence among 446 cases of EMR, for which re-EMR and surgical resection were performed in 12 and 2 cases, respectively. Dr Hatooka (Aichi Cancer Center) showed that salvage surgery comprised 5% (19 cases) of all surgical procedures (351 cases), and discussed the appropriateness of the indication in terms of morbidity/mortality and prognosis. Dr Ohga (Kyusyu Cancer Center) discussed the outcome of radiation therapy for 35 cases with recurrence after curative resection.
February 17: The management of facial defect after radical resection (moderated by Dr Ohta, Shizuoka Cancer Center, Shizuoka). The management of deformity/defect after radical resection of head and neck malignancies is still controversial. These deformities might be a mental burden in the process of social rehabilitation for patients who undergo such radical resection. Dr Hyodo (Aichi Cancer Center) discussed case problems resulting from the resection of skull base, in which only three patients used a glass eye. Dr Mukaiyama (Tokyo Medical and Dental University) and Dr Ohta (Shizuoka Cancer Center) introduced epithesis treatment for the deformity/defect, which is intended to facilitate the recovery of a patient's social life from the cosmetic viewpoint.
For Japanese readers, detailed information of these conferences, including videos and slides of the presentations, are available at http://www.ncc.go.jp/jp/ncc-cis/pro/vod/index.html
Institutions networked by a multipoint teleconference system: National Hospital Organization Hokkaido Cancer Center, Aomori Prefectural Central Hospital, Iwate Prefectural Central Hospital, Miyagi Cancer Center, Yamagata Prefectural Central Hospital, Ibaraki Prefectural Central Hospital, Niigata Cancer Center, Gunma Prefectural Cancer Center, National Cancer Center, East, National Cancer Center, Chiba Cancer Center, Saitama Cancer Center, Shizuoka Cancer Center, Aichi Cancer Center, Osaka Medical Center for Cancer and Cardiovascular Diseases, National Hospital Organization Kure Medical Center, National Hospital Organization Shikoku Cancer Center, National Hospital Organization Kyusyu Cancer Center.
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