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大学院医学系研究科(医学専攻等) 医学専攻 腫瘍制御医学系 腎泌尿器科学講座 |
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2020年05月-継続中
秋田大学 大学院医学系研究科(医学専攻等) 医学専攻 腫瘍制御医学系 准教授
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2017年01月-2020年04月
秋田大学 附属病院 血液浄化療法部 准教授
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2011年01月-2016年12月
秋田大学 附属病院 泌尿器科 講師
研究等業績 【 表示 / 非表示 】
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Ryuma Tanaka, Masanao Shinohara, Yohei Kawashima, Yuya Sekine, Shintaro Narita, Shin Kobayashi, Noriyuki Abe, Hirotake Kodama, Naoki Fujita, Teppei Okamoto, Hayato Yamamoto, Kazuyuki Numakura, Satoshi Sato, Tomonori Habuchi, Chikara Ohyama, Shingo Hatakeyama
International Journal of Urology ( Wiley ) 33 ( 1 ) 2026年01月
研究論文(学術雑誌)
ABSTRACT
Objective
The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) remains controversial in the era of modern systemic therapy. We aimed to evaluate the proportion of patients undergoing deferred CN (dCN) and their oncological outcomes in a real‐world setting.
Methods
We retrospectively reviewed 651 patients with mRCC who received first‐line tyrosine kinase inhibitors (TKIs) or immune‐oncology (IO) combinations (nivolumab–ipilimumab or IO–TKI) between 2006 and 2025 at 22 Japanese institutions. Patients with prior nephrectomy or follow‐up < 3 months were excluded, leaving 278 eligible patients (TKI 101, IO–TKI 115, Nivo–Ipi 62). Patients were categorized into dCN and non‐nephrectomy groups. Outcomes assessed included the proportion of patients undergoing dCN, disease‐free survival (DFS), overall survival (OS), and perioperative morbidity. Propensity score–matching and multivariable time‐dependent Cox regression were performed.
Results
Among 278 patients, 58 (20.9%) underwent dCN (TKI: 24.8%, IO‐TKI: 15.7%, and Nivo‐Ipi: 24.2%) after a median of 6.6 months of systemic therapy. In the propensity score–matched cohort ( n = 58 per group), dCN was significantly associated with improved survival (DFS: HR 0.38; OS: HR 0.19; both p < 0.001). Perioperative complications occurred in 27.6% (grade ≥ 3 in 3.4%) with no grade 4–5 events. Notably, 34.5% were able to discontinue systemic therapy without recurrence, indicating the possibility of durable treatment‐free disease control in a subset of patients.
Conclusions
Deferred CN (dCN) was feasible and associated with prolonged survival in selected patients with mRCC. Prospective trials are warranted to confirm its role and refine patient selection. -
Fumihiko Urabe, Takafumi Yanagisawa, Wataru Fukuokaya, Naoki Fujita, Hiromi Sato, Kojiro Tashiro, Shintaro Narita, Takaya Sasaki, Tomonori Habuchi, Shingo Hatakeyama, Takahiro Kimura
Japanese Journal of Clinical Oncology ( Oxford University Press (OUP) ) 2026年01月
研究論文(学術雑誌)
Abstract
Background
Although pivotal trials have demonstrated the superiority of triplet therapy over androgen deprivation therapy (ADT)–docetaxel doublet therapy, direct comparisons between triplet and androgen receptor pathway inhibitor (ARPI)–ADT doublet therapy remain lacking in real-world practice. This study evaluated the comparative efficacy and safety of triplet versus ARPI-doublet therapy in patients with metastatic castration-sensitive prostate cancer (mCSPC).
Methods
A total of 837 patients with de novo mCSPC treated between February 2018 and April 2025 were included: 121 received triplet therapy (darolutamide plus docetaxel with ADT), and 716 received ARPI-doublet therapy (abiraterone acetate, enzalutamide, or apalutamide with ADT). The primary endpoint was castration-resistant prostate cancer–free survival (CRPC-FS), and the secondary endpoints were progression-free survival 2 (PFS2) and treatment-related adverse events (TRAEs). Propensity score–based inverse probability of treatment weighting (IPTW) and multiple sensitivity analyses adjusted for baseline imbalances.
Results
The median follow-up was 24 months. In the IPTW-adjusted analysis, triplet therapy significantly improved CRPC-FS compared with ARPI-doublet therapy (hazard ratio 0.52, 95% confidence interval 0.39–0.68; P &lt; .001). Subgroup analysis demonstrated consistent benefits in patients with high-volume disease, while no CRPC events occurred in the low-volume subgroup. Sensitivity analyses using propensity score matching and truncated IPTW confirmed the robustness of these findings. Cancer-specific and overall survival were not assessable because of limited follow-up and few events in the triplet cohort. Regarding safety, triplet therapy was associated with higher rates of grade ≥ 3 TRAEs (48.8% vs 8.7%), mainly hematologic toxicities.
Conclusion
Triplet therapy significantly prolonged CRPC-FS compared with ARPI-doublet therapy in patients with de novo mCSPC, particularly among those with high-volume disease. However, this benefit was accompanied by higher toxicity, underscoring the need to balance efficacy with safety. Longer follow-up is required to determine impacts on PFS2, cancer-specific survival, and overall survival. -
Kazuya Kimura, Kenta Watanabe, Mizuki Kobayashi, Keisuke Okubo, Hiromi Sato, Shintaro Narita, Yuki Wada, Satoshi Kumagai, Kimihiko Sato, Sho Fukuda, Tatsuki Yoshida, So Kodama, Yohei Saruta, Ryo Abe, Yosuke Shimodaira, Tamotsu Matsuhashi, Junichi Arita, Naoko Mori, Hiroshi Nanjo, Tomonori Habuchi, Katsunori Iijima
Internal Medicine ( Japanese Society of Internal Medicine ) 2026年
研究論文(学術雑誌)
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Impact of Age on Treatment Patterns and Outcomes in Patients With Non-Metastatic Castration-Resistant Prostate Cancer.
Hiroki Hagimoto, Shinichi Sakamoto, Kodai Sato, Kazuyoshi Nakamura, Hiroki Kito, Satoshi Fukasawa, Daichi Hino, Yusuke Shiraishi, Kohei Hashimoto, Yuto Matsushita, Shintaro Narita, Jun Miki, Takuma Kato, Ryuji Matsumoto, Toshihiro Saito, Ryotaro Tomida, Takahiro Kimura, Hiroshi Kitamura, Tomohiko Ichikawa, Yoshiyuki Matsui
International journal of urology : official journal of the Japanese Urological Association 2025年12月
研究論文(学術雑誌)
OBJECTIVES: To evaluate the impact of age on treatment patterns and outcomes in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). METHODS: We conducted a retrospective multicenter analysis of 428 patients with nmCRPC from 25 tertiary centers (2002-2022). Patients were divided into two age groups: < 80 and ≥ 80 years. The outcomes included cancer-specific survival (CSS), overall survival (OS), and progression-free survival (PFS). RESULTS: Among 428 patients (median follow-up, 32.5 months), performance status (PS) 0 was more frequent in < 80 vs. ≥ 80 years (78% vs. 58%, p < 0.001). Use of first-line androgen receptor signaling inhibitors (ARSIs) was similar (58% vs. 59%, p = 0.83) among all, whereas any-line docetaxel use was less common in patients aged ≥ 80 years (33% vs. 9% for < 80 vs. ≥ 80, p < 0.001). Five-year CSS was 76.5% vs. 63.7% (p = 0.002) and five-year OS 73.8% vs. 59.9% (p = 0.006) for < 80 vs. ≥ 80 years, respectively. Time-to-treatment failure was shorter in patients aged ≥ 80 years (p = 0.04). CONCLUSION: Maintaining PS and managing ARSI-related adverse events are essential in older patients with nmCRPC and may preserve their eligibility for chemotherapy and improve their prognosis.
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Shintaro Narita, Takafumi Yanagisawa, Shingo Hatakeyama, Wataru Fukuokaya, Fumihiko Urabe, Naoki Fujita, Yuya Sekine, Hiromi Sato, Shuhei Okada, Soki Kashima, Ryohei Yamamoto, Mizuki Kobayashi, Kazuyuki Numakura, Mitsuru Saito, Eiki Tsushima, Takahiro Kimura, Tomonori Habuchi
The Prostate ( Wiley ) 2025年11月
研究論文(学術雑誌)
ABSTRACT
Background
This study evaluates the impact of early modification of upfront androgen receptor signaling inhibitors (ARSI) on outcomes among patients with metastatic hormone‐sensitive prostate cancer (mHSPC).
Methods
This retrospective, multicenter cohort study included 590 patients with mHSPC who received upfront ARSI combined with androgen deprivation therapy. All had a follow‐up duration of ≥ 6 months. The impact of early modification of ARSI without progression on survival outcomes was analyzed. The inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors associated with survival outcomes, comparing patients who did and did not discontinue ARSI early.
Results
Upfront abiraterone acetate, apalutamide, and enzalutamide were used in 50.8%, 28.1%, and 21.0% of patients, respectively. The rates of withdrawal of the upfront ARSI and initial dose reduction were 21.2% and 6.1%, respectively. The highest withdrawal rate (33.1%) was with apalutamide, mainly due to adverse events (89.1%). Apalutamide use (odds ratio [OR] 2.39, 95% CI: 1.50–3.80) and a low‐risk CHAARTED status (OR 1.84, 95% CI: 1.08–3.14) were identified as independent risk factors for early ARSI withdrawal. IPTW analysis revealed early ARSI withdrawal (within 6 months) significantly correlated with poor castration‐resistant prostate cancer‐free survival (CRPC‐FS) ( p = 0.004) and second progression‐free survival (PFS2) ( p = 0.035). However, it had no significant relationship with overall survival ( p = 0.280).
Conclusions
Early withdrawal of initial upfront ARSI was associated with poor CRPC‐FS and PFS2 among mHSPC patients. Maximizing the effectiveness of first‐line treatment requires optimal management of ARSI therapy.
Trial Registration: jRCTs021180021. -
前立腺癌におけるNLRP3インフラマソームと病期分類の関連(Association between NLRP3 Inflammasome and Tumor-Node-Metastasis Staging in Prostate Cancer)
宮内 隼弥, 成田 伸太郎, 齋木 由利子, 工藤 幸紹, 堀井 明, 福重 真一, 羽渕 友則, 南條 博, 後藤 明輝
日本病理学会会誌 ( (一社)日本病理学会 ) 114 ( 1 ) 371 - 371 2025年03月
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重症心身障害を有する若年性膀胱癌の4例
奈良 健平, 沼倉 一幸, 菊池 茜恵, 関根 悠哉, 武藤 弓奈, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 70 ( 8 ) 227 - 231 2024年08月
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ニボルマブ・イピリムマブ併用療法に対して治療不応性を示す転移性腎細胞癌患者の特徴
沼倉 一幸, 畠山 真吾, 武藤 弓奈, 関根 悠哉, 蘇武 竜太, 小林 瑞貴, 笹川 甫, 嘉島 相輝, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 大山 力, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 54 ) 114 - 114 2024年07月
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年齢は転移性前立腺癌におけるアビラテロン酢酸エステル治療後の有害事象に関連する
成田 伸太郎, 高橋 佳子, 佐藤 博美, 関根 悠哉, 小林 瑞貴, 山本 竜平, 沼倉 一幸, 齋藤 満, 三浦 昌朋, 羽渕 友則
日本老年泌尿器科学会誌 ( 日本老年泌尿器科学会 ) 37 ( 1 ) 172 - 172 2024年04月
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手術または全身療法を受けた高齢泌尿器癌患者における高齢者機能評価の検討
蘇武 竜太, 成田 伸太郎, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本老年泌尿器科学会誌 ( 日本老年泌尿器科学会 ) 37 ( 1 ) 183 - 183 2024年04月
◆原著論文【 表示 / 非表示 】
◆その他【 表示 / 非表示 】
学術関係受賞 【 表示 / 非表示 】
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Best Presentation Award of the ACRLS 2022
2022年12月 Asian-Pacific Congress of Robotic Laparoscopic Surgery Best Presentation Award of the ACRLS 2022
受賞者: Shintaro Narita -
優秀演題賞
2022年10月 第60回日本癌治療学会学術集会 優秀演題賞
受賞者: 成田伸太郎
科研費(文科省・学振)獲得実績 【 表示 / 非表示 】
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FABP4を介した脂質代謝および腫瘍周囲微小環境変化による前立腺癌増殖・進展制御
基盤研究(C)
研究期間: 2024年04月 - 2027年03月 代表者: 黄 明国, 成田 伸太郎, 南條 博
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免疫チェックポイント阻害薬の治療有効性・抵抗性の要因評価~宿主腫瘍HLA環境解析
基盤研究(C)
研究期間: 2021年04月 - 2025年03月 代表者: 藤山 信弘, 成田 伸太郎, 細道 一善, 嘉島 相輝
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ファーマコゲノミクスとトランスクリプトミクスによる腎癌薬物療法の新治療体系の確立
基盤研究(C)
研究期間: 2015年04月 - 2018年03月 代表者: 土谷 順彦, 成田 伸太郎, 黄 明国, 藤山 信弘
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長鎖脂肪酸による前立腺癌進展の機序解明-パルミチン酸とMIC-1の関連-
基盤研究(C)
研究期間: 2012年04月 - 2015年03月 代表者: 黄 明国, 成田 伸太郎, 土谷 順彦
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SNPアレイを用いた前立腺癌の進展関連分子の同定とリスク予測モデルの構築
基盤研究(C)
研究期間: 2012年04月 - 2015年03月 代表者: 土谷 順彦, 羽渕 友則, 成田 伸太郎
学会等発表 【 表示 / 非表示 】
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特集 ロボット支援手術One Step Up 〈ロボット支援手術の困難症例に対するベネフィットとピットフォール-解剖および基本操作と事故予防に関して〉 腎摘除術
成田 伸太郎
臨床泌尿器科 2025年07月 - 2025年07月 株式会社医学書院
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RANUの合併症とその対策
齋藤 満, 成田 伸太郎, 沼倉 一幸, 小林 瑞貴, 佐藤 博美, 関根 悠哉, 山本 竜平, 羽渕 友則
Japanese Journal of Endourology and Robotics 2025年 - 2025年 一般社団法人 日本泌尿器内視鏡・ロボティクス学会
<p> 我が国では2022年4月にロボット支援腎尿管摘除術 (RANU) が保険収載され, 徐々に実施施設が増加している. 今回, 秋田大学泌尿器科において, 上部尿路上皮癌 (UTUC) 症例に対するRANU (19例 : RANU群) と, 同時期に実施した従来の腹腔鏡手術群 (21例) で周術期成績を比較した. 腹腔鏡手術群では有意に出血量が多く2例で輸血を実施していた. リンパ節郭清の実施頻度は両群間で有意差はなかったが, 平均郭清リンパ節数はRANU群で多い傾向にあった. 周術期合併症では全グレードおよびグレード別の頻度に有意差はなかったが, 乳糜についてはRANU群で多い傾向にあった. RANUではリンパ節郭清時のリンパ管のシーリングが不完全になりやすい可能性を考慮し, こまめなクリッピング, シーリングデバイスの積極的な使用を心掛けるべきと考えた.</p>
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奈良 健平, 沼倉 一幸, 菊池 茜恵, 関根 悠哉, 武藤 弓奈, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器科紀要 2024年08月 - 2024年08月 泌尿器科学術研究会
Recent advances in medical and nursing care have improved the prognosis of patients with severe motor and intellectual disabilities (SMID). However, there has been a proportionate increase in the incidence of malignant tumor-related deaths in this population owing to their prolonged survival. In this study, we reviewed the clinical characteristics of four bladder cancers in young SMID patients treated at our hospital. In all patients, a diagnosis of a bladder tumor was made after a referral from the family medical department to the urology department ; the median time from the first symptom to the diagnosis was 12.5 months (range : 0-17 months). In clinical staging, two patients had non-invasive cancer, while the other two had invasive bladder cancer (one patient with cN1). Radical cystectomy with ileal conduit was performed in three patients (pathological stages were pTa with CIS, pT3aN1, and pT3bN0), and transurethral bladder tumor ablation was performed in the fourth one. The median postoperative follow-up period was 134 months (range : 20-182 months). Three patients survived afterward, while one patient died due to other causes. These findings suggest that young SMID patients tend to have a more severe form of bladder cancer compared to the general young population. Therefore, complaints of gross hematuria and urinary symptoms in young patients with SMID need appropriate evaluation in cooperation with the family department for an early diagnosis.
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増刊号特集 薬の使い方がすぐわかる 泌尿器科処方ガイド 9.腫瘍《抗がん薬の副作用対策》 分子標的薬に対する副作用対策
成田 伸太郎
臨床泌尿器科 2024年04月 - 2024年04月 株式会社医学書院
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ABO血液型不適合生体腎移植後の抗体関連型拒絶と抗体価リバウンド・BAFF・B細胞関連マーカーの意義
山本 竜平, 齋藤 満, 藤山 信弘, 梶原 知佳, 森 瑞季, 青山 有, 関根 悠哉, 佐藤 博美, 小林 瑞貴, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
移植 2024年 - 2024年 一般社団法人 日本移植学会
<p>【目的】ABO血液型不適合生体腎移植(ABOi-KT)では、リツキシマブ(RIT)登場後の近代的免疫抑制療法下でも抗体関連型拒絶反応(ABMR)を発症する症例が散見される。本研究では、抗血液型抗体価(治療前、移植直前、抗体価リバウンド)、B細胞活性化因子(BAFF)値、骨盤リンパ節中のB細胞関連マーカーの発現とABMRの関連について検討した。【方法】2005年から2022年までに当院でABOi-KTを施行した81例を対象とした。血中BAFF濃度はRIT投与前、移植前日、移植翌日、移植7日目、移植28日目に測定した。移植時に採取した2次リンパ節組織は、CD20、CD79a、CD138の免疫組織化学染色で発現を評価した。ABMR群(10例:12.3%)と非ABMR群(71例:87.7%)の2群に分けて比較検討を行った。【結果】抗体価リバウンドを20例(24.7%)に認めた。ABMR群と非ABMR群で、治療前、移植直前の抗体価に有意差は認めなかった。しかし、ABMR群では、抗体価リバウンドが有意に高率であった(p = 0.002)。また、ABMR群では、移植前日のBAFF値が非ABMR群と比較して有意に高値であった(p = 0.002)。骨盤リンパ節の免疫組織化学染色では、ABMR群でCD138陽性細胞(形質細胞)の割合が有意に高かった(p = 0.038)。【結語】ABOi-KTのABMR発症には、リンパ節中の形質細胞密度の高さとそれに伴う抗体産生が抗体価リバウンドさらにはABMRに寄与している可能性がある。</p>