論文 - 加勢田　馨

Clinical utility of comprehensive genomic profiling versus Oncomine Dx target test in pathological stage II–III non-small cell lung cancer

Yano K., Kaseda K., Nakamura K., Okubo Y., Masai K., Hishida T., Nukaga S., Ohgino K., Terai H., Yasuda H., Kurebayashi Y., Fukunaga K., Nishihara H., Asakura K.

Scientific Reports 15 （ 1 ） 37477 2025年12月

ISSN  2045-2322

　概要を見る

The next-generation sequencing (NGS)–based Oncomine Dx Target Test (ODxTT) is the standard tool for guiding postoperative adjuvant therapy in patients with non-small cell lung cancer (NSCLC) in Japan. To advance precision oncology, we evaluated the clinical utility of an in-house comprehensive genomic profiling (CGP) assay, Rapid-Neo, as a complementary approach to ODxTT in surgically resected NSCLC. Patients with pathological stage II–III NSCLC who underwent anatomical surgical resection between December 2019 and May 2024 were included. Resected specimens underwent genomic analysis using both ODxTT and Rapid-Neo CGP. We evaluated the mutational concordance and the frequency of additional actionable alterations identified by CGP. Among 68 eligible patients, driver mutation results were concordant in 64 (94.1%) cases. Crucially, CGP rescued one patient for targeted therapy by detecting an EGFR mutation where ODxTT failed due to insufficient DNA. CGP also identified rare EGFR variants not covered by ODxTT in two cases, although it failed to detect a RET fusion in one patient. Furthermore, CGP revealed additional actionable alterations, such as tumor suppressor gene mutations, in 57 patients (83.8%). Our in-house CGP shows high concordance with ODxTT and serves as a powerful complementary tool. These findings support a strategic testing algorithm where CGP is incorporated for patients with negative or inconclusive ODxTT results, or at the time of recurrence, to maximize opportunities for individualized therapy in resected NSCLC.

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Real-World Outcomes of Limited Resection for Tumours Greater Than 20mm in Non-Small Cell Lung Cancer

Suzuki S., Asakura K., Masai K., Kaseda K., Hishida T., Kazama A., Shigenobu T., Hanawa R., Emoto K., Sato Y.

European Journal of Cardio Thoracic Surgery 67 （ 10 ）  2025年10月

ISSN  10107940

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Sublobar resection is an established surgical option for early-stage non-small cell lung cancer. However, evidence remains limited regarding its use for tumours >20 mm in real-world settings. We evaluated characteristics and outcomes of limited resection in this context and identified predictors of local recurrence. We retrospectively analysed 165 patients with clinical stage I non-small cell lung cancer with tumours >20 mm who underwent limited resection between 2007 and 2017. Clinical, pathological, and radiological data were reviewed. The primary end-point was local recurrence, assessed using competing risk analysis. Overall survival and disease-free survival were estimated using Kaplan-Meier and Cox models. We analysed 165 patients with 13 local recurrence events. Among them, 146 (88.5%) had identifiable reasons for not undergoing lobectomy. Segmentectomy and wedge resection were performed in 59% and 41% of cases, respectively. Lymph node dissection was performed in all segmentectomies and in 20% of wedge resections. The 5-year overall and disease-free survival rates were 64.0% and 62.1%. Local recurrence occurred in 8%, more frequently after wedge resection than segmentectomy (13% vs 4%, P = .04). Solidpredominant tumours with a consolidation-to-tumour ratio greater than 0.5 accounted for 76% and were independently associated with lower disease-free survival (hazard ratio, 2.65; P = .05) and higher local recurrence (hazard ratio: infinite; P < .001). No local recurrence was observed in tumours with a ground-glass opacity-predominant pattern. Limited resection showed acceptable outcomes in lung cancers >20 mm, especially with ground-glass opacity; solidpredominant CT patterns were strongly linked to recurrence.

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Lineage-specific transcription factor landscape of thymic neuroendocrine tumors

Omura S., Kurebayashi Y., Hamamoto J., Terai H., Imoto T., Suzuki M., Nakagawa K., Suzuki T., Shigenobu T., Yoshizu A., Maeda C., Kaji M., Okubo Y., Suzuki S., Masai K., Kaseda K., Fukunaga K., Yasuda H., Asakura K.

Lung Cancer 208   108731 2025年10月

ISSN  01695002

　概要を見る

Introduction: Thymic neuroendocrine tumors (TNETs) are rare malignancies characterized by aggressive clinical behavior and limited therapeutic options. In small cell lung cancer (SCLC), molecular subtypes based on the expression of lineage-defining transcription factors (TFs)—ASCL1, NEUROD1, POU2F3, and YAP1—have been proposed. However, the TF landscape of TNETs remains poorly defined. Given the pathological similarities among neuroendocrine tumors across organs, we aimed to investigate whether the TF-based classification system used in SCLC is applicable to TNETs. Methods: Sixteen pathologically confirmed TNETs—including large cell neuroendocrine carcinoma (LCNEC), thymic small cell carcinoma (TSCC), atypical carcinoid (AC), and typical carcinoid (TC)—were retrospectively analyzed. Immunohistochemistry was performed to evaluate classical neuroendocrine (NE) markers (synaptophysin, chromogranin A, CD56) and TFs (ASCL1, NEUROD1, POU2F3, YAP1). H-scores were calculated, and tumors were categorized according to TFs expression profiles. Results: Synaptophysin was strongly expressed in all cases, while chromogranin A and CD56 showed variable expression, with reduced levels in LCNEC and TSCC. The combined NE score was significantly higher in carcinoid tumors compared to LCNEC and TSCC. For TFs, ASCL1 expression was observed in 93.8 % of cases, whereas NEUROD1 and POU2F3 were rarely or not expressed. YAP1 expression was confined to LCNEC cases, all of which co-expressed ASCL1 and YAP1. Based on H-scores, TNETs were classified into three subgroups: (1) ASCL1-positive/YAP1-negative (n = 12, 75 %), (2) ASCL1/YAP1 double-positive (n = 3, 19 %), and (3) double-negative (n = 1, 6 %). Conclusion: This study reveals molecular heterogeneity among TNETs. Notably, ASCL1 and YAP1 co-expression characterizes all LCNEC cases, making a distinct TF landscape in high-grade TNETs.

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Clinical Application of In-House Comprehensive Genomic Profiling for Thoracic Cancer: Insights From a Japanese Hospital.

Takaoka H, Terai H, Nakamura K, Mizuno T, Kawano R, Emoto K, Kurebayashi Y, Takada N, Hamabe K, Horie K, Ogata A, Kinoshita K, Shigematsu L, Ito F, Okada M, Fukushima T, Nukaga S, Tani T, Ohgino K, Kaseda K, Ikemura S, Yasuda H, Asakura K, Okita H, Nishihara H, Fukunaga K

Cancer science 2025年08月

ISSN  1347-9032

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Clinical Characteristics and Indicators of Spontaneous Hemopneumothorax Comparing With Primary Spontaneous Pneumothorax.

Suzuki M, Kaseda K, Yano K, Omura S, Okubo Y, Masai K, Hishida T, Asakura K

Cureus 17 （ 8 ） e90423 2025年08月

ISSN  2168-8184

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Initial single-institutional experience with salvage surgery for stage IV non-small cell lung cancer.

Hishida T, Oka N, Yano K, Omura S, Okubo Y, Masai K, Kaseda K, Ohgino K, Terai H, Yasuda H, Asakura K

Interdisciplinary cardiovascular and thoracic surgery 2025年02月

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外科診療における医師働き方改革　これまでの対策と今後の課題　幸せ指数から考える外科医の働き方改革　労働時間削減だけで外科医は幸せになれるのか?

中井 猛斗, 朝倉 啓介, 坂本 恭子, 岡林 剛史, 大久保 祐, 政井 恭兵, 加勢田 馨, 菱田 智之, 尾原 秀明, 北川 雄光

日本外科学会雑誌 （(一社)日本外科学会）  126 （ 1 ） 101 - 103 2025年01月

ISSN  0301-4894

　概要を見る

2024年4月から医師の働き方改革が始まっているが、医師の中でも他の診療科の医師に比べ労働時間が長いことが知られている外科医の幸せな働き方の検討に資することを目的に、本学および関連病院に所属する医師を対象に、前野らが開発した「はたらく人の幸せ診断」を用いたWebアンケートを実施し、436名(男性336名、女性100名、平均卒後年数12年、うち、外科医は92名)より回答を得た(回収率16%)。「はたらく人の幸せ診断」は働くことの幸せ実感を7因子(自己成長、リフレッシュ、チームワーク、役割認識、他者承認、他者貢献、自己裁量)に分けて測定する質問票で、全7因子の平均点(7点満点:幸せ指数)により労働者の幸せを評価可能である。その結果、外科医は非外科医と比べ、労働時間が有意に長かったが、卒後3年目および9～19年目で非外科医より幸せ指数が有意に高かった。どの卒後年数の外科医の幸せ指数(4.54～5.54)も、先行研究による一般の全職種の平均(4.42)より高く、全般的に外科医の幸せ実感は高いと考えた。主に大学病院で修練を積む卒後5～8年目の外科医の幸せ指数が相対的に低いことが課題として認識され、「はたらく人の幸せの7因子」のそれぞれを高める施策が必要と考えられた。

Resection of a Giant Middle Mediastinal Tumor Using a Transaortopulmonary Arterial Approach

Yano K., Ito T., Asakura K., Tanabe Y., Matsumoto Y., Kaseda K., Kurebayashi Y., Yamada Y., Hishida T., Shimizu H.

Annals of Thoracic Surgery Short Reports 2025年

　概要を見る

Surgical approaches for giant middle mediastinal tumors are challenging owing to the surrounding great vessels and vital organs. Here, we report the resection of a giant middle mediastinal tumor with feeding vessels from the coronary artery causing exertional dyspnea. Surgical resection involved a clamshell incision and temporary transection of the ascending aorta and right pulmonary artery under cardiopulmonary bypass to achieve optimal visualization. The tumor, diagnosed as unicentric Castleman disease, was safely excised with good postoperative outcomes. This method—the transaortopulmonary arterial approach—offers a favorable surgical tool for giant mediastinal tumors.

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Thoracic posture-related morphological changes in patients with pectus excavatum versus healthy controls

Suzuki T., Asakura K., Yamada Y., Masai K., Yamada M., Yokoyama Y., Okubo Y., Kaseda K., Hishida T., Jinzaki M.

European Journal of Cardio-thoracic Surgery 66 （ 5 ）  2024年11月

ISSN  10107940

　概要を見る

OBJECTIVES. Cases of severe pectus excavatum presenting with worsening cardiopulmonary symptoms in the upright position have been reported. However, the underlying mechanism remains unclear. We evaluated posture-related morphological changes of the thorax in patients with pectus excavatum. METHODS. Chest morphology was evaluated preoperatively using upright and supine computed tomography in 21 patients with pectus excavatum and 35 healthy volunteers. The minimum anterior–posterior thoracic diameter, depression depth, and Haller index on horizontal sections, as well as the T6-12 plumb line distance on sagittal sections, were compared between the 2 positions. RESULTS. In patients with pectus excavatum (median age, 22 years; 18 males and 3 females), the minimum anterior–posterior diameter was smaller (4.5 vs 5.1 cm, P < 0.001) and the Haller index was greater (10.1 vs 6.4, P < 0.001) in the upright position than in the supine position. The T6-T12 plumb line distance was longer in the upright position (2.4 vs 0.8 cm, P < 0.001), while the depression depth showed no significant difference. Healthy volunteers exhibited similar changes. The degree of spinal curvature increased in the upright position due to the anterior shift of the lower thoracic vertebrae, resulting in a shorter anterior–posterior diameter, irrespective of chest wall deformity. One patient with dyspnoea only in the upright position exhibited compression of the right inferior pulmonary vein only on upright computed tomography. CONCLUSIONS. The minimum anterior–posterior diameter is shorter in the upright position. This may explain the worsening of cardiopulmonary symptoms in patients with severe pectus excavatum when in an upright position.

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Clinical impact of multiple pectus bars on surgical outcomes following pectus excavatum repair

Oka N., Masai K., Okubo Y., Kaseda K., Hishida T., Asakura K.

Interdisciplinary Cardiovascular and Thoracic Surgery 39 （ 4 ）  2024年10月

　概要を見る

OBJECTIVES: The Nuss procedure, a minimally invasive surgery for pectus excavatum, has undergone various improvements. However, the impact of using multiple bars on thoracic shape changes and surgical outcomes remains unclear. METHODS: We retrospectively evaluated patients who underwent the Nuss procedure for pectus excavatum between August 2014 and September 2021. We divided the patients into 2 groups based on the number of bars placed and identified differences in surgical outcomes and morphological characteristics. RESULTS: A total of 225 patients were evaluated, of whom 132 were classified into the ≤2 bar group (using 1 or 2 bars) and 93 into the ≥3 bar group (using 3 or more bars). There was no difference in the preoperative Haller index [median (interquartile range), 4.59 (3.67–6.16) vs 4.67 (4.12–6.14), P ¼ 0.227], and asymmetric excavatum was more frequently observed in the ≥3 bar group (81% vs 51%, P < 0.001). The preoperative sternal torsion angle was larger in the ≥3 bar group, but no difference was found between the 2 groups postoperatively. The incidence of postoperative complications (≥grade 3) was comparable between groups (10% vs 17%, P ¼ 0.105); however, postoperative pleurisy was more frequently observed in the ≥3 bar group (12% vs 4%, P ¼ 0.021). In univariable and multivariable analyses, ≥3 bar placement was the only risk factor for postoperative pleurisy. CONCLUSIONS: The placement of multiple bars (≥3 bars) is useful for the correction of asymmetric pectus excavatum, but attention should be paid to the potential risk of postoperative pleurisy.

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Validity of Simple Thymomectomy for Clinical Stage I Thymoma without Myasthenia Gravis: A Propensity Score-Matched Analysis

Hishida, T; Suzuki, T; Omura, S; Okubo, Y; Masai, K; Kaseda, K; Asakura, K

JOURNAL OF THORACIC ONCOLOGY 19 （ 10 ） S274 - S274 2024年10月

ISSN  1556-0864

Multiple Lung Resections for Metastases from Pheochromocytoma to Reduce Catecholamine Production.

Yano K, Okubo Y, Ishiguro Y, Masai K, Kaseda K, Emoto K, Miyashita K, Hisihida T, Asakura K

Annals of thoracic surgery short reports 2 （ 3 ） 488 - 491 2024年09月

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Surgically resected sarcomatoid carcinoma of the lung: a nationwide retrospective study in 2010

Kaseda K., Asakura K., Shintani Y., Okami J., Toyooka S., Sato Y., Watanabe S.I., Chida M., Suzuki H., Miyaoka E., Yoshino I., Date H.

BMC Cancer 24 （ 1 ） 938 2024年08月

研究論文（学術雑誌）, 共著, 筆頭著者, 査読有り,  ISSN  1471-2407

　概要を見る

Background: Sarcomatoid carcinoma of the lung is a rare histological type of non-small cell lung cancer with a poor prognosis. We aimed to investigate the clinicopathological characteristics and prognostic factors of surgically resected sarcomatoid carcinoma of the lung. Methods: We retrospectively reviewed 14999 patients who underwent surgical resection for non-small cell lung cancer accumulated by the Japanese Joint Committee of Lung Cancer Registry in 2010. Clinicopathological characteristics and survival were compared between the sarcomatoid carcinoma and other non-small cell cancer groups. The prognostic factors in the sarcomatoid carcinoma group were identified using a multivariate Cox proportional hazard model. Results: Patients with sarcomatoid carcinoma comprised 1.4% of all patients. The sarcomatoid carcinoma group demonstrated a more aggressive pathology with presentation at more advanced stages, requiring more frequent extensive surgical resections. The sarcomatoid carcinoma group had remarkably poorer overall and recurrence-free survival than the other non-small cell lung cancer group. Adjuvant chemotherapy was associated with improved survival for pathological stage II–III sarcomatoid carcinoma cases rather than for pathological stage I disease. In the multivariate analysis, larger tumor size, lymphatic permeation, and no adjuvant chemotherapy were associated with the sarcomatoid carcinoma group’s overall and recurrence-free survival. Conclusions: Surgically resected sarcomatoid carcinoma of the lung has a higher aggressive and metastatic potential and a worse prognosis than other non-small cell lung cancers. Adjuvant chemotherapy, which was associated with enhanced survival in patients with pathological stage II–III of the disease, could be considered for treating patients with pathological stage II–III sarcomatoid carcinoma of the lung.

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高度漏斗胸に対してCombined Ravitch and Nuss Procedureを施行後に側弯の進行を認めたLoeys-Dietz症候群の一例

杉野 功祐, 政井 恭兵, 大久保 祐, 加勢田 馨, 菱田 智之, 朝倉 啓介

日本呼吸器外科学会雑誌 （一般社団法人 日本呼吸器外科学会）  38 （ 5 ） 470 - 475 2024年07月

ISSN  09190945

　概要を見る

<p>Loeys-Diez症候群（LDS）はMarfan症候群類縁の先天性結合織疾患で，骨格系の異常として漏斗胸を併存することが知られている．我々は漏斗胸手術後に側弯の進行を認めたLDSの一例を経験した．患者は9歳，男児．5歳時に遺伝子検査でLDSと診断された．Haller index 9.81の高度漏斗胸とCobb角8.5度の軽度側弯があり，漏斗胸に対してRavitch法とNuss法を組み合わせた術式（Combined Ravitch and Nuss Procedure：CRN法）を施行した．左右の肋軟骨を一部分節切除した後に2本のチタンバーを挿入し胸骨挙上術を施行した．術後のHaller indexは3.57となり，漏斗胸の改善が得られたが，側弯はCobb角34.2度に増悪した．術後早期に側弯の進行を認めたため，側弯症に対して装具治療を行った．術後4ヵ月で側弯の改善がみられ，現在経過観察中である．側弯症を合併する漏斗胸の場合，漏斗胸治療により側弯の進行を認める可能性がある．本症例では結合組織の脆弱性が背景にあり，漏斗胸の矯正が過度の側弯変形を招いた可能性が示唆された．</p>

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Clinicopathological predictors of postoperative long-term myasthenic status in resected thymoma with myasthenia gravis

Suzuki T., Hishida T., Suzuki S., Okubo Y., Masai K., Kaseda K., Asakura K., Emoto K., Asamura H.

Surgery Today （Surgery Today）  54 （ 7 ） 787 - 794 2024年07月

ISSN  09411291

　概要を見る

Purpose: Surgical patients with thymoma and myasthenia gravis (MG) must have their MG status and oncological outcomes critically monitored. We aimed to identify clinicopathological predictors of the postoperative MG status. Methods: We conducted a retrospective review of 40 consecutive surgical patients with MG-related thymomas between 2002 and 2020. The quantitative myasthenia gravis score (QMGS) and Myasthenia Gravis Foundation of America post-intervention status (MGFA-PIS) were used to evaluate postoperative MG status. Results: All patients underwent extended total thymectomy. The most common WHO type was type B2 (32%), while 65% of patients had type B1–B3 and 35% had type A–AB thymomas. Eleven patients (28%) achieved controlled MG status in MGFA-PIS 6 months after surgery. This controlled status was observed more frequently in type A–AB than in B1–B3 (57% vs. 12%, p = 0.007). In a multivariate analysis, WHO type (A–AB or B1–B3) was an independent predictor of worsening episodes of MG based on the QMGS (Type B1–B3, hazard ratio: 3.23, 95% confidence interval: 1.12–9.25). At the last follow-up, 23 patients (58%) achieved controlled MG status. The 5-year overall survival rate of all patients was 93.7%. Conclusion: The WHO type of thymoma is an informative predictor of postoperative MG status in patients with MG-related thymoma.

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高度漏斗胸に対してCombined Ravitch and Nuss Procedureを施行後に側彎の進行を認めたLoeys-Dietz症候群の一例

杉野 功祐, 政井 恭兵, 大久保 祐, 加勢田 馨, 菱田 智之, 朝倉 啓介

日本呼吸器外科学会雑誌 （(一社)日本呼吸器外科学会）  38 （ 5 ） 470 - 475 2024年07月

ISSN  0919-0945

　概要を見る

Loeys-Diez症候群(LDS)はMarfan症候群類縁の先天性結合織疾患で,骨格系の異常として漏斗胸を併存することが知られている.我々は漏斗胸手術後に側彎の進行を認めたLDSの一例を経験した.患者は9歳,男児.5歳時に遺伝子検査でLDSと診断された.Haller index 9.81の高度漏斗胸とCobb角8.5度の軽度側彎があり,漏斗胸に対してRavitch法とNuss法を組み合わせた術式(Combined Ravitch and Nuss Procedure:CRN法)を施行した.左右の肋軟骨を一部分節切除した後に2本のチタンバーを挿入し胸骨挙上術を施行した.術後のHaller indexは3.57となり,漏斗胸の改善が得られたが,側彎はCobb角34.2度に増悪した.術後早期に側彎の進行を認めたため,側彎症に対して装具治療を行った.術後4ヵ月で側彎の改善がみられ,現在経過観察中である.側彎症を合併する漏斗胸の場合,漏斗胸治療により側彎の進行を認める可能性がある.本症例では結合組織の脆弱性が背景にあり,漏斗胸の矯正が過度の側彎変形を招いた可能性が示唆された.(著者抄録)

Glomus Tumor of Intrathoracic Chest Wall: a Case Report

Ishiguro Y., Masai K., Sugino K., Yano K., Nomura R., Okubo Y., Kaseda K., Hishida T., Asakura K., Kurebayashi Y., Minami Y.

Japanese Journal of Lung Cancer （Japanese Journal of Lung Cancer）  64 （ 3 ） 208 - 209 2024年06月

ISSN  03869628

　概要を見る

<p>40歳女性．左肺尖部に5.9 cm大の腫瘤影を認め，経皮的生検を行った所，カルチノイド腫瘍が疑われ，画像上は肺尖部胸壁浸潤癌を考え，手術の方針とした．胸腔内を観察すると腫瘍は胸壁から発生しており，胸壁腫瘍を切除した．病理では類円形核と好酸性の胞体を有する異型の弱い腫瘍細胞が増生し，形態像と免疫染色所見から胸壁発生のグロムス腫瘍と診断した．胸壁発生のグロムス腫瘍の報告は極めて少なく，文献的考察を加えて報告する．</p>

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Quality of life, psychological states, and personality traits in patients with pectus excavatum

Matsuda K., Fujisawa D., Masai K., Miyazaki N., Suzuki S., Okubo Y., Kaseda K., Asakura K., Hishida T., Asamura H.

JTCVS Open （JTCVS Open）  19   355 - 369 2024年06月

　概要を見る

Objective: The quality of life (QOL) and psychological states of patients with pectus excavatum (PE) have yet to be well understood. This study aimed to evaluate the health-related QOL (HRQOL), psychological states, and personality traits of patients with PE, alongside the associations of these factors with the severity of PE. Methods: A cross-sectional evaluation was prospectively performed in patients scheduled to undergo PE repair surgery between July 2019 and April 2021. The primary outcome was the patients’ HRQOL, and the secondary outcomes were depression, social anxiety, self-efficacy, and personality traits. Results: In total, 129 patients were subjected to analyses. Patients' HRQOL had a lower role component summary score (mean ± standard deviation: 41.8 ± 12.8, P < .001) than the general population controls. Patients' HRQOL had a significantly better physical component summary (54.0 ± 10.4, P < .001) and mental component summary (53.3 ± 8.8, P < .001) than that of the general population. Fourteen patients' (10.9%) and 56 patients' (43.4%) scores indicated the presence of depression and social anxiety disorder, respectively. Patients’ self-efficacy (46.1 ± 11.4, P, .001) and level of extraversion (46.5 ± 11.8, P < .001) were lower than those of the general population. No significant correlation was found between the severity of PE and these scores. Conclusions: Our study revealed that patients with PE had decreased social-role QOL, depressive tendencies, increased social anxiety, lower self-efficacy, and introversion. No correlation between the severity of PE and the patients’ psychological outcomes leads us to conclude that surgical implications of PE should not be decided solely by a physical index.

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胸壁に発生したグロムス腫瘍の1切除例

石黒 勇輝, 政井 恭兵, 杉野 功祐, 矢野 海斗, 野村 塁, 大久保 祐, 加勢田 馨, 菱田 智之, 朝倉 啓介, 紅林 泰, 南 優子

肺癌 （(NPO)日本肺癌学会）  64 （ 3 ） 208 - 209 2024年06月

ISSN  0386-9628

Nuss procedure for the treatment of pectus excavatum with dyspnea following oropharyngeal cancer surgery: a case report

Masai K., Nakai T., Okubo Y., Kaseda K., Hishida T., Asakura K.

Journal of Surgical Case Reports （Journal of Surgical Case Reports）  2024 （ 1 ） rjad714 2024年01月

ISSN  2042-8812

　概要を見る

Pectus excavatum (PE) causes cardiopulmonary dysfunction depending on the degree and form of the depression. The patient was a 74-year-old woman with a history of PE. Fourteen years ago, a total glossolaryngectomy was performed for oropharyngeal cancer. Two years later, the patient gradually experienced difficulty in breathing. Computed tomography (CT) revealed severe PE and right main bronchial stenosis. We performed a Nuss procedure for PE repair to surgically release the stenosis of the right main bronchus. Postoperative chest CT showed improvement in the sternal depression and right main bronchial stenosis. Furthermore, shortness of breath was relieved postoperatively. Oropharyngeal cancer surgery may cause tracheal support disruption, leading to leftward shift and severe stenosis of the right main bronchus due to sternum depression. This is an important report regarding respiratory distress caused by a combination of PE and post-oropharyngeal cancer surgery.

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