Evidence regarding the association between oral environment and the inflammatory bowel disease (IBD), including ulcerative colitis (UC), exists. However, evidence regarding the association between oral health parameters and disease activity of UC is limited. This study aimed to evaluate the association between remaining tooth number and toothbrushing frequency and mucosal healing (MH) in Japanese UC patients. The study included 275 patients with UC. Information on lifestyle and oral health parameters was collected via self-administered questionnaires. The definition of MH was based on the Mayo endoscopic subscore (MES) of 0. The prevalence of MH in this cohort was 24.7
AIM:In the GENESECT study, no significant gemcitabine (GEM) metabolism-related germline genetic polymorphisms (GPs) were identified because approximately 70% of patients received combination therapy with nab-paclitaxel, which has metabolic pathways different from GEM. The present study was a sub-analysis including only GEM monotherapy patients. METHODS:Of 159 patients analysed in the GENESECT study, only GEM-monotherapy patients were selected. The endpoints included carbohydrate antigen 19-9 (CA19-9) response (reduction ≥ 50% from the pretreatment level at 8 weeks), progression-free survival (PFS), and overall survival (OS) in relation to GPs. Analysed genes included those encoding GEM transporters and metabolic enzymes (SLC29A1, ABCC5, CDA, DCK, RRM1/2) and a tumour cell proliferation enzyme (COX-2). Screening and significance levels were set at 10% (univariable) and 5% (multivariable), respectively. RESULTS:Data for 50 patients were analysed. Genotype AA of ABCC5 1146A>G (rs7636910) showed a higher CA19-9 response rate than AG/GG (52.9% vs. 21.2%, p = 0.023) and remained significant in multivariable analysis (odds ratio: 6.255, p = 0.014). It also tended to be associated with longer PFS, but not significantly (hazard ratio [HR]: 0.464, p = 0.074). By contrast, although CA19-9 responses were not significantly associated with DCK -1205T>C (rs4694362), the TT/TC genotype was significantly associated with prolonged PFS compared with CC (median 127 vs. 48 days, p = 0.002), and this association remained significant in multivariable analysis (HR: 0.153, p = 0.028). No GPs were significantly associated with OS. CONCLUSION:ABCC5 and DCK might be related to the efficacy of GEM treatment, but further research is needed.
BACKGROUND:Conversion therapy, which seeks to achieve curative treatment following systemic therapy, is increasingly acknowledged in the management of unresectable hepatocellular carcinoma (HCC). However, validated criteria for predicting eligibility for conversion remain unclear. We investigated the utility of the recently proposed borderline resectable (BR) classification combined with the barcelona clinic liver cancer (BCLC) staging system to identify patients most likely to benefit from conversion following atezolizumab plus bevacizumab (ATZ/BEV) therapy. METHODS:In this multicenter retrospective study, 532 patients with unresectable HCC treated with ATZ/BEV were categorized using the BR classification and stratified according to the BCLC stage. We evaluated objective response rate (ORR), conversion rate, and overall survival (OS) and carried out multivariate logistic regression analysis to identify predictors of conversion. RESULTS:Conversion therapy was performed in 5.9% of patients. Among those with BCLC-C HCC, the conversion rate was significantly higher in BR1 HCC than in BR2 HCC (15.2% vs. 2.0% and p < 0.01), and BR1 status was independently associated with conversion (odds ratio 7.0). Patients with BCLC-C/BR1 staging showed the highest ORR (45.0%) and favorable OS after conversion (p = 0.015). In contrast, the BR classification had limited predictive value in patients with BCLC-B HCC. Notably, downstaging from BR1 to resectable status was more common than from BR2, suggesting higher conversion feasibility. CONCLUSIONS:Integrating BR classification with BCLC staging identified BCLC-C/BR1 patients as optimal candidates for conversion therapy after ATZ/BEV treatment. These findings support incorporating anatomical and oncological criteria into systemic strategies to enable curative interventions in advanced HCC.
OBJECTIVES:A meta-analysis showed that serum folate concentrations, but not vitamin B12 concentrations, are lower in patients with ulcerative colitis compared to healthy controls. However, no epidemiological study has investigated the association between dietary intake of folate, vitamin B12, vitamin B6, vitamin B2, and vitamin B1 and the risk of ulcerative colitis. This study examines this association using data from a multicenter, hospital-based, case-control study. METHODS:The study included 384 cases of ulcerative colitis diagnosed within the past 3 years and 665 controls. Data were collected through a self-reported questionnaire. Dietary information was obtained using a 169-item semi-quantitative food frequency questionnaire. Adjustment was made for sex, age, pack-years of smoking, alcohol consumption, history of appendicitis, family history of ulcerative colitis, education level, and BMI. RESULTS:Higher dietary intakes of folate and vitamin B1 were independently associated with a decreased risk of ulcerative colitis after adjusting for confounding factors. The adjusted odds ratio for extreme quartiles was 0.60 [95% confidence interval (CI): 0.39 - 0.91, P for trend = 0.009) for folate and 0.54 (95% CI: 0.36 - 0.81, P for trend = 0.004) for vitamin B1. Dietary intake of vitamins B12, B6, or B2 was not independently associated with ulcerative colitis risk. CONCLUSION:This is the first study to demonstrate significant inverse relationships between dietary intake of folate and vitamin B1 and the risk of ulcerative colitis. Our results should be interpreted as exploratory and require validation through further, more focused studies.
OBJECTIVES:We aimed to evaluate the prognostic utility of subclassifying patients with intermediate-risk prostate cancer into favorable and unfavorable subgroups in a large Japanese cohort undergoing radical prostatectomy, focusing on adverse pathology and oncologic outcomes. METHODS:We retrospectively analyzed 1485 intermediate-risk patients from the MICAN (Medical Investigation Cancer Network) study registry who underwent radical prostatectomy between 2010 and 2020 in Ehime Prefecture, Japan. Patients were categorized into favorable or unfavorable intermediate-risk groups based on the National Comprehensive Cancer Network (NCCN) guideline. We examined up-grading, up-staging, and adverse pathology defined as pathological ≥T3, grade group ≥ 4, or lymph node involvement. Kaplan-Meier analysis was used to evaluate prostate-specific antigen (PSA) failure-free survival and overall survival. RESULTS:Among 1485 patients, 590 (40.2%) were classified as having favorable intermediate risk and 879 (59.8%) as having unfavorable intermediate risk. Up-grading and up-staging were observed more frequently in the unfavorable group. Adverse pathology was more frequent in the unfavorable group (64.8%) than that in the favorable group (39.4%) (p < 0.001). The 5-year PSA failure-free survival rates were 92.1% for the favorable group and 80.1% for the unfavorable group (p < 0.001). Although the 5-year overall survival rate did not reach statistical significance (98.4% vs. 97.9%, p = 0.085), the favorable group showed a trend toward better survival. CONCLUSIONS:The subclassification of intermediate-risk prostate cancer into favorable and unfavorable groups is prognostically meaningful in Japanese patients undergoing radical prostatectomy. Higher rates of adverse pathological findings and inferior PSA failure-free survival in the unfavorable group support the clinical utility of this subclassification.
