御子柴　卓弥 (ミコシバ　タクヤ)

Mikoshiba, Takuya

写真a

所属（所属キャンパス）

医学部 耳鼻咽喉科学教室 （信濃町）

職名

助教（有期）
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  • Utility of computed tomography findings as a predictor of carotid artery invasion by metastatic lymph nodes in head and neck squamous cell carcinoma

    Mikoshiba T., Sakamoto K., Shinden S., Shimanuki M., Nakayama R., Okada T., Ozawa H.

    European Archives of Oto-Rhino-Laryngology （European Archives of Oto-Rhino-Laryngology)  2022年

    ISSN  09374477

    　概要を見る

    Purpose: Carotid artery invasion by metastatic lymph nodes in head and neck squamous cell carcinoma (HNSCC) is one of the diagnostic criteria for unresectable tumors. However, to date, the diagnostic criteria for carotid artery invasion have not been well documented. This study investigated the utility of computed tomography (CT) findings as a predictor of carotid artery invasion by metastatic lymph nodes in HNSCC. Methods: Twenty-eight patients who had metastatic lymph nodes of HNSCC attached to the carotid artery as seen on CT images before neck dissection from January 2011 to November 2017 were included. Five imaging parameters (angle of contact [AC], length of contact [LC], haziness of the carotid artery wall [HW], size of the lymph node, and involvement of the bifurcation of the carotid artery [IB]) were assessed using CT to predict carotid artery invasion. Furthermore, the utility of the combination of these five parameters was evaluated. Results: There were significant differences in AC, LC, and IB between patients with and without carotid artery invasion. There were significant differences in all combinations of the two image findings between patients with and without carotid artery invasion. In particular, the combinations of LC and HW, and LC and IB could clearly predict carotid artery invasion. Conclusion: AC, LC, and IB were useful predictors of carotid artery invasion of metastatic lymph nodes in HNSCC. This study is the first to report that IB is a useful predictor of carotid artery invasion in HNSCC.

  • Prognostic Value of the Lymphocyte-to-Monocyte Ratio in Patients with Parotid Gland Carcinoma

    Mikoshiba T., Ozawa H., Watanabe Y., Sekimizu M., Saito S., Yoshihama K., Nakamura S., Imanishi Y., Kameyama K., Ogawa K.

    Laryngoscope （Laryngoscope)  131 （ 3 ） E864 - E869 2021年03月

    ISSN  0023852X

    　概要を見る

    Objective: Previous studies have evaluated various markers as prognostic predictors in patients with many types of cancers. However, the influence of such factors on the outcomes of patients with parotid gland carcinoma (PGC) is unknown. This study investigated the roles of alternative markers in the prognoses of patients with PGC. Methods: Overall, 101 patients who underwent curative treatment for PGC were retrospectively evaluated, and their 5-year overall and disease-free survival rates were calculated. The prognostic values of clinical and pathologic factors were determined. Results: The 5-year overall and disease-free survival rates were 73.1% and 62.8%, respectively. Multivariate analysis revealed that a low lymphocyte-to-monocyte ratio (LMR), high T classification, high N classification, and perineural invasion were independent predictors of poor prognosis. Conclusions: Thus, we identified LMR as an independent prognostic factor for patients with PGC. Patients with low LMRs who are amenable to treatment may require adjuvant treatment to improve their prognoses. Level of Evidence: 4 Laryngoscope, 131:E864–E869, 2021.

  • Pretherapeutic Predictive Factors for Histological High-Grade Parotid Gland Carcinoma

    Mikoshiba T., Ozawa H., Watanabe Y., Kawaida M., Sekimizu M., Saito S., Yoshihama K., Nakamura S., Nagai R., Imanishi Y., Kameyama K., Ogawa K.

    Laryngoscope （Laryngoscope)  132 （ 1 ） 96 - 102 2021年

    ISSN  0023852X

    　概要を見る

    Objective: The histological grade of parotid gland carcinoma (PGC) is an important prognostic factor; however, the diagnosis prior to treatment has been challenging to make. This study aimed to investigate whether the pretreatment clinical findings, including hematological inflammatory, nutritional, and immune markers, could predict the histological grade of PGC. Study Design: Retrospective study. Methods: We retrospectively enrolled 111 patients with PGC and evaluated the correlation between histological grade and pretreatment clinical findings such as age, sex, tumor staging, facial nerve paralysis, pain or tenderness, adhesion to the surrounding tissues or tumor immobility, and hematological markers. Results: Sixty patients (54%) were diagnosed with histological high-grade PGC. Univariate analysis revealed that age, T classification, N classification, TNM stage, facial nerve paralysis, adhesion/immobility, C-reactive protein (CRP), and CRP-to-albumin ratio (CAR) were significant predictors of PGC histological grade. On multivariate analysis, high T classification (T3, 4), high N classification (≥1), and elevated CRP (≥0.22 mg/dL) were independent predictors of high-grade PGC. Conclusions: Pretreatment T classification, N classification, and CRP are significant predictors of the histological grading of PGC. Our results are useful for treatment planning and obtaining appropriate informed consent from the patients before treatment. Level of Evidence: 4 Laryngoscope, 2021.

  • Usefulness of Hematological Inflammatory Markers in Predicting Severe Side-effects from Induction Chemotherapy in Head and Neck Cancer Patients

    Mikoshiba T., Saito S., Ikari Y., Nakahara N., Ito F., Watanabe Y., Sekimizu M., Imanishi Y., Ogawa K., Ozawa H.

    Anticancer Research （Anticancer Research)  39 （ 6 ） 3059 - 3065 2019年

    ISSN  02507005

    　概要を見る

    Background: Induction chemotherapy (IC) for head and neck cancer (HNC) often causes severe side-effects. However, it has still been challenging to predict the adverse events. The present study aimed to evaluate the role of hematological inflammatory markers in predicting severe side-effects caused by IC. Materials and Methods: A total of 54 HNC patients who underwent IC were enrolled. The association between severe side-effects and pre-treatment hematological inflammatory markers [the C-reactive protein (CRP) to albumin ratio (CAR), the modified Glasgow Prognostic Score (mGPS), the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR)] were evaluated. Results: In the univariate analysis, the incidence of whole severe side-effects (grade 4), febrile neutropenia (above grade 3), and hyponatremia (above grade 3) were significantly higher in the high CAR and high GPS groups. Multivariate analysis revealed that high CAR and mGPS were independent predictors of these side-effects. Conclusion: CAR and mGPS were significant predictors of severe side-effects. These data can potentially offer patients an improved quality of life during cancer therapy.

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