Kenichiro Uemura

Kenichiro Uemura, M.D, Ph.D.

Clinical Professor of Surgery
Organization: Hiroshima University
Nationality: Japan
Email: umk@hiroshima-u.ac.jp

Brief Introduction

Hepato-Pancreato-Biliary (HPB) Surgical Oncologist in Japan.

Specialty

  • Pancreato-Biliary Surgery
  • Advanced Surgery for PDAC
  • Minimally invasive surgery

Education

  • 1991 - 1992: Surgical Resident, Hiroshima University Hospital, Hiroshima, Japan
  • 1985 - 1991: MD, University of Occupational and Environmental Health, Fukuoka, Japan

Experience

  • 2025 - Present: Clinical Professor of Surgery, Hiroshima University Hospital, Hiroshima, Japan
  • 2009 - 2025: Associate Professor of Surgery, Hiroshima University Hospital, Hiroshima, Japan
  • 2004 - 2009: Assistant Professor of Surgery, Hiroshima University Hospital, Hiroshima, Japan
  • 2002 - 2004: Research Fellow, Duke University Medical Center, NC, USA

Selected Publications

  1. Seo K, Uemura K, Okada K, Nishi H, Sumiyoshi T, Shintakuya R, Murakami Y, Kawaguchi H, & Takahashi S. Independent Prognostic Value of Natural Tooth Count Versus Posterior Teeth Occlusion in Resected Pancreatic Cancer. Journal of Hepato-Biliary-Pancreatic Sciences. 2026. https://doi.org/10.1002/jhbp.70113
  2. Baba K, Uemura K, Sumiyoshi T, Shintakuya R, Okada K, Harada T, Oka S, Ishii Y, Arihiro K, Murakami Y, & Takahashi S. Evaluating C-Reactive Protein in Drainage Fluid as a Predictive Biomarker for Clinically Relevant Pancreatic Fistulas Following Pancreaticoduodenectomy. Annals of Surgical Oncology, 2026, 33(6), 5029–5037. https://doi.org/10.1245/s10434-026-19140-z
  3. Shintakuya R, Uemura K, Sumiyoshi T, Okada K, Harada T, Tazuma S, Ishii Y, Oka S, Murakami Y, & Takahashi S. Prognostic Value of Combined Carbohydrate Antigen 19-9 and Duke Pancreatic Monoclonal Assessment in Biliary Tract Cancer. Annals of Surgical Oncology, 2026, 33(7), 6041–6049. https://doi.org/10.1245/s10434-026-19488-2
  4. Sumiyoshi T, Uemura K, Seo S, Fujii T, Satoi S, Miwa T, Fukasawa M, Yamaki S, Oshita A, Abe T, Sudo T, Tazuma S, Sasaki M, Matsugu, Y, Kohashi T, Nakashima A, Kuroda S, Oishi K, Inoue M, Okano K, Matsukawa H, Ohdan H, & Takahashi S. Impact of pre-compression versus non-compression before parenchyma transection in left-sided pancreatic resection on the rate of clinically relevant pancreatic fistula: multicentre randomized clinical trial. British Journal of Surgery, 2025, 112(2), znaf008. https://doi.org/10.1093/bjs/znaf008
  5. Sumiyoshi T, Uemura K, Shintakuya R, Okada K, Baba K, Harada T, Serikawa M, Ishii Y, Nakamura S, Arihiro K, Murakami Y, & Takahashi S. Clinical Utility of the Combined Use of CA19-9 and DUPAN-2 in Pancreatic Adenocarcinoma. Annals of Surgical Oncology, 2024, 31(7), 4665–4672. https://doi.org/10.1245/s10434-024-15221-z
  6. Uemura K, Kondo N, Sudo T, Sumiyoshi T, Shintakuya R, Okada K, Baba K, Harada T, Murakami Y, & Takahashi S. Long-term outcomes of neoadjuvant gemcitabine, nab-paclitaxel, and S1 (GAS) in borderline resectable pancreatic cancer with arterial contact: Results from a phase II trial. Journal of Hepato-Biliary-Pancreatic Sciences, 2024, 31(5), 351–362. https://doi.org/10.1002/jhbp.1412
Arterial Resection and Divestment after Neoadjuvant Therapy for Locally Advanced Pancreatic Cancer
Kenichiro Uemura
Hiroshima University, Hiroshima, Japan

Background:
The optimal surgical strategy after neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer with arterial involvement (BR-A) and unresectable locally advanced pancreatic ductal adenocarcinoma (UR-LA PDAC) remains controversial. We evaluated the outcomes of arterial resection and arterial divestment following NAT and the role of preoperative CT-detected arterial adventitial irregularity in surgical decision-making.

Methods:
We retrospectively reviewed 163 consecutive patients with BR-A or UR-LA PDAC who received preoperative chemotherapy between 2009 and 2023. Patients with positive peritoneal cytology or occult metastasis were excluded before surgery. Overall survival (OS) and perioperative outcomes were compared between arterial resection and arterial divestment, and pathological findings were correlated with preoperative CT findings of arterial adventitial irregularity.

Results:
Among 163 patients, 144 (88%) underwent curative-intent resection, including arterial resection in 74 (51%) and arterial divestment in 70 (49%). R0 resection was achieved in 80%, major complications (Clavien–Dindo grade ≥IIIa) occurred in 17%, and 90-day mortality was 0.7%. Resected patients had significantly better survival than unresected patients (median OS, 30.5 vs. 13.7 months; P<0.001). Newer NAT regimens (GAS, GA, or mFOLFIRINOX) improved OS compared with conventional gemcitabine plus S-1 (41.0 vs. 27.5 months; P=0.019). OS was comparable between arterial resection and arterial divestment (35.9 vs. 28.8 months; P=0.984). Elevated CA19-9, lymph node metastasis, and incomplete adjuvant chemotherapy were independent adverse prognostic factors. Pathological adventitial invasion was identified in 59% of patients with arterial adventitial irregularity but in none without it.

Conclusions:
Both arterial resection and arterial divestment achieved favorable oncologic outcomes after effective NAT. Preoperative CT-detected arterial adventitial irregularity accurately predicted pathological adventitial invasion and may guide selection of the optimal surgical approach. Arterial resection appears appropriate for patients with arterial adventitial irregularity, whereas arterial divestment is a suitable vessel-preserving strategy when arterial adventitial irregularity is absent.