研究等業績 - その他 - 成田　伸太郎

Reassessment of the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer treated using radical prostatectomy.

Shintaro Narita, Koji Mitsuzuka, Norihiko Tsuchiya, Takuya Koie, Sadafumi Kawamura, Chikara Ohyama, Tatsuo Tochigi, Takuhiro Yamaguchi, Yoichi Arai, Tomonori Habuchi

International journal of urology : official journal of the Japanese Urological Association   22 ( 11 ) 1029 - 35   2015年11月

OBJECTIVES: To assess the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer patients treated using radical prostatectomy. METHODS: We retrospectively reviewed the medical records of 1268 men with prostate cancer treated using radical prostatectomy without neoadjuvant therapy. The association between various risk factors and biochemical recurrence was then statistically evaluated. The Kaplan-Meier method, log-rank tests and Cox proportional hazards models were used for statistical analysis. RESULTS: In the intermediate-risk group, 96 patients (14.5%) experienced biochemical recurrence during a median follow up of 41 months. In the intermediate-risk group, preoperative prostate-specific antigen level, prostate volume and prostate-specific antigen density were significant preoperative risk factors for biochemical recurrence, whereas other factors including age, primary Gleason 4, clinical stage >T2 and percentage of positive biopsies were not. In multivariate analysis, higher preoperative prostate-specific antigen level and density, and a smaller prostate volume were independent risk factors for biochemical recurrence in the intermediate-risk group. Biochemical recurrence-free survival of patients in the intermediate-risk group with a higher prostate-specific antigen level and density (≥15 ng/mL, ≥0.6 ng/mL/cm(3), respectively), and lower prostate volume (≤10 mL) was comparable with that of high-risk group individuals (P = 0.632, 0.494 and 0.961, respectively). CONCLUSIONS: Preoperative prostate-specific antigen, prostate volume and prostate-specific antigen density are significant risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer patients treated using radical prostatectomy. Using these variables, a subset of the intermediate-risk patients can be identified as having equivalent outcomes to high-risk patients.

DOI PubMed

Identification of a subgroup with worse prognosis among patients with poor-risk testicular germ cell tumor.

Takahiro Kojima, Koji Kawai, Kunihiko Tsuchiya, Takashige Abe, Nobuo Shinohara, Toshiaki Tanaka, Naoya Masumori, Shigeyuki Yamada, Yoichi Arai, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Hiroyuki Nishiyama

International journal of urology : official journal of the Japanese Urological Association   22 ( 10 ) 923 - 7   2015年10月

OBJECTIVES: To clarify the significance of the International Germ Cell Cancer Collaborative Group classification in the 2000s, especially in intermediate- and poor-prognosis testicular germ cell tumor in Japan. METHODS: We retrospectively analyzed 117 patients with intermediate- and poor-prognosis testicular non-seminomatous germ cell tumor treated at five university hospitals in Japan between 2000 and 2010. Data collected included age, levels of tumor markers, spread to non-pulmonary visceral metastases, treatment details and survival. RESULTS: The median follow-up period of all patients was 57 months. A total of 50 patients (43%) were classified as having intermediate prognosis, and 67 patients (57%) as poor prognosis according to the International Germ Cell Cancer Collaborative Group classification. As first-line chemotherapy, 92 patients (79%) received bleomycin, etoposide and cisplatin. Of all patients, 74 patients (63%) received second-line chemotherapy. The most commonly used second-line chemotherapy regimens were a combination of taxanes, ifosfamide and platinum in 49 cases (66%). Overall, 33 patients (28%) received third-line chemotherapy. A total of 88 patients (75%) underwent post-chemotherapy surgery. The 5-year overall survival for intermediate (n = 50) and poor prognosis (n = 67) was 89% and 83% (P = 0.21), respectively. In poor prognosis patients, patients with two or more risk factors (any of high lactic dehydrogenase, alpha-fetoprotein and human chorionic gonadotropin levels, and presence of non-pulmonary visceral metastases) had significantly worse survival than those with only one risk factor (71% and 91%, respectively, P = 0.01). CONCLUSIONS: The 5-year overall survivals of poor-prognosis testicular non-seminomatous germ cell tumor patients reached 83%. Further stratification of poor-prognosis patients based on a number of risk factors has the potential to further identify those with poorer prognosis.

DOI PubMed

Neoadjuvant luteinizing-hormone-releasing hormone agonist plus low-dose estramustine phosphate improves prostate-specific antigen-free survival in high-risk prostate cancer patients: a propensity score-matched analysis.

Takuya Koie, Koji Mitsuzuka, Takahiro Yoneyama, Shintaro Narita, Sadafumi Kawamura, Yasuhiro Kaiho, Norihiko Tsuchiya, Tatsuo Tochigi, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama, Tohru Yoneyama, Yuki Tobisawa

International journal of clinical oncology   20 ( 5 ) 1018 - 25   2015年10月

BACKGROUND: The optimal treatment for high-risk prostate cancer (Pca) remains to be established. We previously reported favorable biochemical recurrence-free survival (BRFS) in high-risk Pca patients treated with a neoadjuvant therapy comprising a luteinizing-hormone-releasing hormone (LHRH) agonist plus low dose estramustine phosphate (EMP) (LHRH+EMP) followed by radical prostatectomy (RP). In the present study, we used a retrospective design via propensity score matching to elucidate the clinical benefit of neoadjuvant LHRH+EMP for high-risk Pca. METHODS: The Michinoku Urological Cancer Study Group database contained data for 1,268 consecutive Pca patients treated with RP alone at 4 institutions between April 2000 and March 2011 (RP alone group). In the RP alone group, we identified 386 high-risk Pca patients. The neoadjuvant LHRH+EMP group included 274 patients with high-risk Pca treated between September 2005 and November 2013 at Hirosaki University. Neoadjuvant LHRH+EMP therapy included LHRH and EMP administration at a dose of 280 mg/day for 6 months before RP. The outcome measures were overall survival (OS) and BRFS. RESULTS: The propensity score-matched analysis indicated 210 matched pairs from both groups. The 5-year BRFS rates were 90.4 and 65.8 % for the neoadjuvant LHRH+EMP and RP alone groups, respectively (P < 0.0001). The 5-year OS rates were 100 and 96.1 % for the neoadjuvant LHRH+EMP and RP alone groups, respectively (P = 0.110). CONCLUSIONS: Although the present study was not randomized, neoadjuvant LHRH+EMP therapy followed by RP appeared to reduce the risk of biochemical recurrence. A prospective randomized study is warranted to determine the clinical implications of the neoadjuvant therapy described here.

DOI PubMed

前立腺がん進展の分子メカニズムと去勢抵抗性前立腺がんに対する治療戦略 前立腺癌発症・進展における高脂肪食および脂質代謝の役割

成田 伸太郎, 佐々木 雄彦, 羽渕 友則

日本癌学会総会記事 ( 日本癌学会 )  74回   SST8 - 2   2015年10月

アディポネクチンはプログラム細胞死を抑制し、腎癌増殖に関与する

伊藤 隆一, 成田 伸太郎, 黄 明国, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 土谷 順彦, 佐藤 滋, 羽渕 友則

日本癌学会総会記事 ( (一社)日本癌学会 )  74回   P - 2139   2015年10月

前立腺がん進展における脂肪酸結合分子4の役割

黄 明国, 小泉 淳, 成田 伸太郎, 土谷 順彦, 田中 正光, 羽渕 友則

日本癌学会総会記事 ( (一社)日本癌学会 )  74回   P - 3259   2015年10月

腎細胞癌進展とインスリンレセプター発現との逆関連

井上 高光, 黄 明国, 鶴田 大, 成田 伸太郎, 土谷 順彦, 羽渕 友則

日本癌学会総会記事 ( (一社)日本癌学会 )  74回   P - 2129   2015年10月

進行性腎細胞癌におけるチロシンキナーゼ阻害薬の長期服用に関連する因子の検討

土谷 順彦, 成田 伸太郎, 井上 高光, 齋藤 満, 前野 淳, 鶴田 大, 高山 孝一朗, 五十嵐 龍馬, 伊藤 隆一, 羽渕 友則

日本癌治療学会誌 ( (一社)日本癌治療学会 )  50 ( 3 ) 1877 - 1877   2015年09月

[PRIMARY MEDIASTINAL GERM CELL TUMOR ARISING IN A PATIENT WITH NEUROFIBROMATOSIS TYPE 1].

Soki Kashima, Mitsuru Saito, Norihiko Tsuchiya, Hajime Saito, Hiroshi Nanjo, Kazuyuki Numakura, Hiroshi Tsuruta, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Yoshihiro Minamiya, Shigeru Satoh, Tomonori Habuchi

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   106 ( 3 ) 178 - 84   2015年07月

Neurofibromatosis type 1 (NF1) is a distinct genetic disorder due to the NF1 gene mutation which induces the aberrant activation of the RAS-signaling. Because RAS-related proteins function as oncogenic factors, NF1 patients frequently develop malignant tumors, especially of neural crest origin, such as peripheral nerve sheath. In addition, malignant tumors of the pancreas, colorectum, and lung have been reported to frequently arise in NF1 patients. However, the association between germ cell tumor and NF1 has not been clarified yet. A 29-year-old male with dyspnea was referred to our hospital because of the large mass in the anterior mediastinum and cervical lymph node swelling. The diagnosis was extragonadal germ cell tumor with cervical lymph node metastasis, and complete remission was obtained by multidisciplinary treatment consisted of combination chemotherapy and surgical resection. To our acknowledgement, this is the first case of extragonadal germ cell tumor in NF1 patients. We discuss the relevance between activation of the RAS-signaling and the development of germ cell tumor.

PubMed

[Pazopanib for three patients with recurrence of retroperitoneal liposarcoma : initial clinical experience].

Atsushi Koizumi, Takamitsu Inoue, Koichiro Takayama, Makoto Takahashi, Kazuyuki Numakura, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi

Hinyokika kiyo. Acta urologica Japonica   61 ( 4 ) 153 - 8   2015年04月

Pazopanib, a novel tyrosine kinase inhibitor, is an effective therapeutic agent for patients with advanced soft tissue sarcoma. Here we report three patients with recurrent retroperitoneal liposarcoma who were treated with pazopanib. Case 1: A 54-year-old male received three courses of combined chemotherapy consisting of doxorubicin and ifosfamide for recurrent left retroperitoneal dedifferentiated liposarcoma and liver metastasis following tumor excision. Because of the lack of response to chemotherapy, 400 mg/day of pazopanib was subsequently administered for two weeks. The patient died 3 weeks after the initiation of pazopznib therapy. Case 2: A 78-year-old male with right retroperitoneal dedifferentiated liposarcoma underwent irradiation for a recurrent tumor 16 months after the initial tumor excision. Pazopanib (600 mg/day) was partially effective for 2 months. Pazopanib was administered for 7 months, but the patient died 8 months after the initiation of pazopanib therapy. Case 3 : An 80-year-old male with locally recurrent right retroperitoneal myxoid liposacroma was treated with 600 mg/day of pazopanib from 5 months after tumor excision. He remains alive and has had stable disease for 17 months to date. In conclusion, pazopanib may be effective in a subset of patients with recurrent retroperitoneal liposarcoma.

PubMed

A solitary positive prostate cancer biopsy does not predict a unilateral lesion in radical prostatectomy specimens.

Takuya Koie, Koji Mitsuzuka, Shintaro Narita, Takahiro Yoneyama, Sadafumi Kawamura, Yasuhiro Kaiho, Norihiko Tsuchiya, Tatsuo Tochigi, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama

Scandinavian journal of urology   49 ( 2 ) 103 - 7   2015年04月

OBJECTIVE: Prostate cancer (PCa) may be a multifocal and bilateral disease. Patients with low-risk PCa and a low number of positive biopsy cores may choose to undergo active surveillance or focal therapy. The aim of this study was to determine the correlation between a solitary positive prostate biopsy core and the pathological outcome after radical prostatectomy (RP). MATERIAL AND METHODS: The Michinoku Japan Urological Cancer Study Group database contains data, including preoperative and postoperative information, on 1268 consecutive patients with PCa treated with RP alone at four institutions. This study focused on 151 patients with a single positive biopsy core, preoperative prostate-specific antigen (PSA) level less than 10 ng/ml, biopsy Gleason score less than 8, and clinical stage T1c/T2a/T2b disease. Potential preoperative predictors of unilateral PCa were age, preoperative PSA level, biopsy Gleason score and clinical T stage. RESULTS: The median age and preoperative PSA level were 65 years (range 47-76 years) and 6.00 ng/ml (range 0.50-9.80 ng/ml), respectively. Unilateral PCa was identified in 41% of the patients. Extraprostatic extension or seminal vesicle invasion was observed in 26% of all patients. CONCLUSION: Serum PSA levels were significantly higher in the bilateral PCa group than in the unilateral PCa group in the current study. For patients with PCa having a solitary positive prostate biopsy core, definitive therapy such as RP should be considered.

DOI PubMed

Successful introduction of laparoendoscopic single-site donor nephrectomy after experience with laparoscopic single-site plus-one trocar donor nephrectomy.

Takamitsu Inoue, Norihiko Tsuchiya, Shintaro Narita, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Shigeru Satoh, Tomonori Habuchi

Journal of endourology   29 ( 4 ) 435 - 42   2015年04月

PURPOSE: To assess the feasibility, safety, and efficacy of the laparoendoscopic single-site (LESS) donor nephrectomy (LESSDN) procedure after experience with the LESS-plus-one-trocar donor nephrectomy (LEPODN) procedure. PATIENTS AND METHODS: From 2009 to 2014, 126 left laparoscopic donor nephrectomies (LDNs) were performed, including 59 Standard (Std)-LDN, 30 LEPODN, and 37 LESSDN. In the LEPODN procedure, a 5-mm trocar was added as a right-hand working trocar to the LESSDN procedure. A GelPOINT(®) platform was applied on a pararectal single incision in both LEPODN and LESSDN procedures. After performing the LEPODN procedure several times, each surgeon performed the LESSDN procedure. RESULTS: Std-LDN, LEPODN, and LESSDN procedures were performed by 10, 10, and 7 surgeons, respectively. The mean operative time, estimated blood loss, warm ischemia time, time to ambulation, and length of postoperative hospital stay were the shortest for the LESSDN procedure (P<0.012, P=0.007, P<0.001, P=0.027, and P=0.001, respectively). No significant difference in the complication rate, delayed graft function rate, and mean 7-day post-transplant serum creatinine levels was observed among the three procedures. Individual results of the operative time and estimated blood loss for the LESSDN procedure were not significantly inferior to those of Std-LDN and LEPODN procedures for each surgeon. CONCLUSIONS: The LESSDN procedure can be introduced safely and effectively without compromising the operative time, complication rate, and graft function after experience with the LEPODN procedure among multiple surgeons. The LEPODN procedure may be an effective bridge from standard multiport LDN to LESSDN.

DOI PubMed

ASSOCIATION BETWEEN PLASMA CONCENTRATION OF AXITINIB AND TREATMENT OUTCOME IN ADVANCED RENAL CELL CARCINOMA PATIENTS

Norihiko Tsuchiya, Nobuhiro Fujiyama, Ryoma Igarashi, Naoko Honma, Shintaro Narita, Takamitsu Inoue, Kazuyuki Numakura, Susumu Akihama, Mitsuru Saito, Shigeru Satoh, Masatomo Miura, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E872 - E873   2015年04月

研究発表要旨（国際会議）  

CASTRATION-INDUCED ACCELERATION OF BONE METASTASIS PREVENTED BY RANK INHIBITOR OSTEOPROTEGERIN IN MURINE CASTRATION-RESISTANT PROSTATE CANCER MODEL

Koichiro Takayama, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Yoko Mitobe, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Norihiko Tsuchiya, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E549 - E550   2015年04月

研究発表要旨（国際会議）  

CLINICAL OUTCOME OF SINGLE NUCLEOTIDE POLYMORPHISMS ON PHARMACOKINETIC GENES IN JAPANESE METASTATIC RENAL CELL CARCINOMA PATIENTS TREATED WITH SUNITINIB

Kazuyuki Numakura, Norihiko Tsuchiya, Makoto Takahashi, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Tkamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E867 - E867   2015年04月

研究発表要旨（国際会議）  

DYSLIPIDEMIA IN THE FIRST YEAR AFTER KIDNEY TRANSPLANTATION: INCIDENCE, CLINICAL CHARACTERISTICS, PHARMACOKINETICS OF IMMUNOSUPPRESSIVE DRUGS, AND RELATED GENOMIC POLYMORPHISMS

Kazuyuki Numakura, Shigeru Satoh, Norihiko Tsuchiya, Komine Naoki, Mitsuru Saito, Tkamitsu Inoue, Shintaro Narita, Hideaki Kagaya, Masatomo Miura, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E1071 - E1071   2015年04月

研究発表要旨（国際会議）  

EFFECT OF OBESITY AND ADIPONECTIN SIGNALING IN PATIENTS WITH RENAL CELL CARCINOMA TREATED WITH SURGERY

Ryuichi Itoh, Shintaro Narita, Mingguo Huang, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E457 - E458   2015年04月

研究発表要旨（国際会議）  

EXPRESSION OF ANDROGEN AND GLUCOCORTICOID RECEPTORS IN RESIDUAL CANCER CELLS AFTER NEOADJUVANT CHEMOHORMONAL THERAPY WITH DOCETAXEL FOR HIGH-RISK LOCALIZED PROSTATE CANCER

Shintaro Narita, Taketoshi Nara, Mingguo Huang, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E1053 - E1053   2015年04月

研究発表要旨（国際会議）  

INVERSE RELATIONSHIP BETWEEN INSULIN RECEPTOR EXPRESSION AND CANCER PROGRESSION IN RENAL CELL CARCINOMA: CLINICAL AND EXPERIMENTAL EVALUATION

Makoto Takahashi, Takamitsu Inoue, Mingguo Huang, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E710 - E711   2015年04月

研究発表要旨（国際会議）  

LYMPHOVASCULAR INVASION IS SIGNIFICANTLY ASSOCIATED WITH BIOCHEMICAL RELAPSE AFTER RADICAL PROSTATECTOMY EVEN IN PATIENTS WITH PT2N0 NEGATIVE RESECTION MARGIN

Koji Mitsuzuka, Shintaro Narita, Takuya Koie, Yasuhiro Kaiho, Norihiko Tsuchiya, Takahiro Yoneyama, Narihiko Kakoi, Sadafumi Kawamura, Tatsuo Tochigi, Tomonori Habuchi, Chikara Ohyama, Yoichi Arai

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  193 ( 4 ) E686 - E687   2015年04月

研究発表要旨（国際会議）