研究等業績 - その他 - 成田　伸太郎

Pathological and oncological outcomes of elderly men with clinically localized prostate cancer.

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

Japanese journal of clinical oncology   43 ( 12 ) 1238 - 42   2013年12月

OBJECTIVE: The aim of the study was to characterize pathological and oncological outcomes of elderly men with clinically localized prostate cancer treated with radical prostatectomy. METHODS: Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to whether they were of age <70 or ≥70 years at radical prostatectomy. Patient characteristics, pathological and oncological outcomes were compared among the groups. RESULTS: Of the total population, 31.4% (398 of 1268) of patients were ≥70 years of age. The median age in patients <70 and ≥70 years of age was 64 (45-69) and 72 (70-83) years. The proportion of low-risk disease was significantly lower among those ≥70 years of age than in those <70 years, while the proportion of high-risk disease was significantly higher among those ≥70 years of age than in those <70 years (P < 0.001). The proportions of pathological high-risk disease (≥T3b, GS ≥8, positive surgical margin or lymph node invasion) in patients <70 and ≥70 years of age were 42.0 and 50.0%, respectively (P = 0.008). The proportions of organ-confined disease in patients <70 and ≥70 years of age were 69.9 and 65.1%, respectively (P = 0.09). With a median follow-up of 50 months, 5-year biochemical recurrence-free and cancer-specific survival rates were not significantly different among the groups. CONCLUSIONS: Radical prostatectomy was more likely to be performed in those with higher-risk disease among patients ≥70 years of age. About half of the patients ≥70 years of age had pathological, high-risk disease. Radical prostatectomy could be considered for patients with expected long-term life expectancy, even in the setting of advanced age.

DOI PubMed

Is pelvic lymph node dissection required at radical prostatectomy for low-risk prostate cancer?

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

International journal of urology : official journal of the Japanese Urological Association   20 ( 11 ) 1092 - 6   2013年11月

OBJECTIVES: To determine the necessity of pelvic lymph node dissection for low-risk prostate cancer, we analyzed the incidence of lymph node invasion and the therapeutic value of pelvic lymph node dissection in low-risk prostate cancer patients. METHODS: Medical records for 1268 patients undergoing open radical prostatectomy between January 2000 and December 2009 who had not undergone neoadjuvant therapy were retrospectively reviewed. Patients with low-risk disease (n = 222; prostate-specific antigen <10 ng/mL, biopsy Gleason score ≤6, clinical T1c or T2a) were classified according to whether they underwent pelvic lymph node dissection (pelvic lymph node dissection group, n = 147) or did not (no pelvic lymph node dissection group, n = 75). Pelvic lymph node dissection was carried out in a limited style, which included the external iliac vein and the obturator fossa. The incidence of lymph node invasion was determined and referred to the preoperative nomogram developed for Japanese patients (Japanese nomogram), Partin and Kattan nomograms. The 5-year biochemical recurrence-free survivals in both groups were analyzed. RESULTS: Lymph node invasion in low-, intermediate- and high-risk disease was 0.7% (1/147), 1.2% (7/595) and 6.1% (23/374). The 5-year biochemical recurrence-free survival rates for patients with low-risk disease were 87.6% in the pelvic lymph node dissection group and 87.1% in the no pelvic lymph node dissection group (P = 0.65, log-rank). No patients in the pelvic lymph node dissection group exceeded 2% of lymph node invasion risk with Japanese and Partin nomograms. With the Kattan nomogram, 22.4% (33/147) of the pelvic lymph node dissection group exceeded 2% of lymph node invasion risk, and one patient had documented lymph node invasion, but none exceeded 2.5%. CONCLUSIONS: Pelvic lymph node dissection can be spared at radical prostatectomy for low-risk disease, as its diagnostic and therapeutic value is poor.

DOI PubMed

高脂肪食摂取下の前立腺癌進展におけるFatty acid synthase(FASN)の役割(Role of fatty acid synthase(FASN) on HFD induced prostate cancer progression)

黄 明国, 成田 伸太郎, 土谷 順彦, 井上 高光, 佐藤 滋, 佐々木 雄彦, 羽渕 友則

日本癌学会総会記事 ( 日本癌学会 )  72回   509 - 509   2013年10月

シスプラチン腎障害により維持透析に至った2例

山本 竜平, 井上 高光, 五十嵐 龍馬, 小泉 淳, 沼倉 一幸, 秋濱 晋, 齋藤 満, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 佐藤 滋, 羽渕 友則

秋田腎不全研究会誌 ( 秋田腎不全研究会 )  16   159 - 162   2013年10月

進行性腎細胞癌患者におけるsunitinibの血中濃度と治療アウトカムの検討

土谷 順彦, 藤山 信弘, 成田 伸太郎, 井上 高光, 斎藤 満, 沼倉 一幸, 秋濱 晋, 鶴田 大, 佐藤 滋, 三浦 昌朋, 羽渕 友則

日本癌治療学会誌 ( (一社)日本癌治療学会 )  48 ( 3 ) 1614 - 1614   2013年09月

Changes in indications and oncological outcomes of radical prostatectomy after 2000--data from 1268 Japanese patients treated with radical prostatectomy between 2000 and 2009.

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

Japanese journal of clinical oncology   43 ( 8 ) 821 - 6   2013年08月

OBJECTIVE: The aim of the study was to characterize trends in indications for and oncological outcomes of radical prostatectomy after 2000. METHODS: Data from 1268 patients undergoing radical prostatectomy without neoadjuvant therapy between 2000 and 2009 at four urological centers in Japan were retrospectively reviewed. Changes in age at radical prostatectomy, prostate-specific antigen level, biopsy Gleason score, clinical T stage, D'Amico risk classification, organ-confined disease and tumor volume in surgical specimens were analyzed over time. RESULTS: The median age at radical prostatectomy decreased from 68 years in 2000-2 to 65 years in 2009 (P < 0.001). Approximately 63.3% of patients were ≥65 years old, and 31.4% of patients were ≥70 years old during the whole study period. The median prostate-specific antigen level decreased from 8.61 ng/ml in 2000-2 to 6.90 ng/ml in 2009 (P < 0.001). The rate of organ-confined disease increased from 52.8% in 2000-2 to 72.5% in 2009 (P = 0.004). The median tumor volume decreased from 1.70 cc in 2000-2 to 1.28 cc in 2009 (P = 0.017). The proportion of biopsy Gleason score 7 increased from 40.6% in 2000-2 to 60.1% in 2009 (P < 0.001), and the proportion of the intermediate-risk group increased from 39.5% in 2000-2 to 59.5% in 2009 (P < 0.001). CONCLUSIONS: Age at radical prostatectomy for men with localized prostate cancer was higher in Japan than in the USA or Europe. Prostate-specific antigen, non-organ-confined disease and tumor volume decreased during the study period, whereas Gleason score 7 and intermediate-risk disease increased during the study period. This information enables comparison of outcomes between various treatments, between various geographic regions and between various time periods.

DOI PubMed

グラセプタのトラフ値はプログラフと同等か? 移植1年まで

佐藤 滋, 新岡 丈典, 加賀谷 英彰, 沼倉 一幸, 井上 高光, 斎藤 満, 小峰 直樹, 秋濱 晋, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 三浦 昌朋

日本臨床腎移植学会雑誌 ( (一社)日本臨床腎移植学会 )  1 ( 1 ) 78 - 81   2013年07月

タクロリムス(Tac)には1日2回服用のプログラフ(Tac-BID)と1日1回のグラセプタ(Tac-QD)があり、Tac-BIDからTac-QDへ切替えた初期報告(Allowayらの報告)では、「1日同量服用で同等の薬物動態が得られた」と報告されている。一方、同量服用ではTac-QDのトラフ値(Cmin)や24時間血中濃度時間曲線下面積(AUC0-24)が低値になるとの報告が多くなされている。また、Tacはチトクローム(CYP)3A5の基質薬剤であり、CYP3A5イントロン3のA6986Gには多型が存在し、CYP3A5 expresserはCYP3A5*1アレルを有し、non-expresserはCYP3A5*3/*3 genotypeを表す。そこで今回、CYP3A5のアレル頻度を同一にしたTac-BID群とTac-QD群の各24例を対象とし、服用直後と移植後1ヵ月および1年時の薬物動態について比較検討した。その結果、CYP3A5 non-expresserにおいてはTac-QDの目標CminがTac-BIDより低値でもTac-BIDと同等のAUC0-24を得られる可能性が示唆された。

Pathological and biochemical outcomes after radical prostatectomy in men with low-risk prostate cancer meeting the Prostate Cancer International: Active Surveillance criteria.

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

BJU international   111 ( 6 ) 914 - 20   2013年05月

UNLABELLED: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Active surveillance has been widely accepted as a treatment tool for low-risk prostate cancer, and use of the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria can select smaller and less aggressive tumours in low-risk disease. The study shows the pathological outcomes of radical prostatectomy for patients with low-risk disease who met the PRIAS criteria. It found that ~20% had unfavourable pathological features and only 30% satisfied insignificant cancer criteria with pT2 stage, a Gleason score ≤6 and tumour volume <2.5 mL. It concludes that close follow-up including repeat biopsy or MRI is necessary to minimize unexpected progression of disease. OBJECTIVE: To assess the effectiveness of the Prostate Cancer Research International Active Surveillance (PRIAS) criteria in identifying indolent cancer. PATIENTS AND METHODS: Data from 1268 patients undergoing radical prostatectomy without neoadjuvant therapy were retrospectively reviewed. Within this cohort, patients with low-risk disease (n = 211) were classified according to whether they met (Group A, n = 87) or did not meet (Group B, n = 124) the PRIAS criteria. Pathological upstaging, upgrading, tumour volume and 5-year prostate-specific antigen (PSA) recurrence-free survival were compared between the two groups, and factors that predicted upstaging, upgrading and PSA recurrence were analysed by univariate and multivariate methods. RESULTS: Pathological T3 stage was present in 10.3% of patients in Group A and in 18.5% of patients in Group B (P = 0.08). Gleason score upgrading to 4+3 or greater was seen in 19.5% of Group A and in 29.9% of Group B (P = 0.01). The mean (range) tumour volume was 0.81 (0.03-5.09) mL in Group A and 1.40 (0.04-8.21) mL in Group B (P < 0.01). The rates of insignificant cancer with total tumour volume <2.5 mL, Gleason score ≤6 and stage pT2 were 30.6% in Group A and 15.4% in Group B (P = 0.07). With a median follow-up of 44 months, the 5-year PSA recurrence-free survival rates were 91.2% in Group A and 86.4% in Group B (P = 0.47). In multivariate analysis, PSA density and the PRIAS criteria were independent factors that predicted upstaging. CONCLUSIONS: Although use of the PRIAS criteria could select more favourable tumours even in low-risk prostate cancer, about one in five men had unfavourable pathological outcomes and only three in ten had insignificant cancer. Close and careful follow-up is necessary to avoid misclassification or progression of disease, especially during the first few years of active surveillance.

DOI PubMed

進行性腎細胞癌患者におけるsunitinibの薬物動態とその臨床的意義

土谷 順彦, 藤山 信弘, 成田 伸太郎, 井上 高光, 沼倉 一幸, 秋濱 晋, 佐藤 滋, 三浦 昌朋, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  26 ( 臨増 ) 712 - 712   2013年05月

CAN BIOPSY GLEASON SCORE 3+4 BE INDICATED FOR ACTIVE SURVEILLANCE CRITERIA?

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

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  189 ( 4 ) E273 - E273   2013年04月

研究発表要旨（国際会議）  

LACK OF CLINICAL FACTORS INCREASING QUANTITATIVE INTERSTITIAL FIBROSIS AFTER RENAL TRANSPLANTATION UNDER A LOWER TARGET TROUGH STRATEGY OF TACROLIMUS

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

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  189 ( 4 ) E868 - E868   2013年04月

研究発表要旨（国際会議）  

LOW PERCENTAGE (&lt; 10%) OF POSITIVE BIOPSY CORE (PBC) IS NOT A PREDICTOR OF LOWER RISK FOR PSA RECURRENCE IN CT1C PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY IN CONTEMPORARY JAPANESE POPULATION

Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Shintaro Narita, Norihiko Tsuchiya, Koji Mitsuzuka, Sadafumi Kawamura, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  189 ( 4 ) E795 - E795   2013年04月

研究発表要旨（国際会議）  

PREDICTION OF PROGRESSION-FREE SURVIVAL IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR LOCALLY ADVANCED BLADDER CANCER USING A SNP PANEL OF CANCER-ASSOCIATED GENES

Takamitsu Inoue, Shigeyuki Matsui, Norihiko Tsuchiya, Kazuyuki Numakura, Susumu Akihama, Mitsuru Saito, Shintaro Narita, Shigeru Satoh, Wun-Jae Kim, Tomonori Habuchi

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  189 ( 4 ) E379 - E380   2013年04月

研究発表要旨（国際会議）  

SINGLE POSITIVE BIOPSY AND PSA LEVEL &lt; 10NG/ML WITH PROSTATE CANCER PATIENTS CAN NOT PREDICT UNILATERAL LESION IN RADICAL PROSTATECTOMY SPECIMENS IN CONTEMPORARY JAPANESE POPULATION

Takuya Koie, Koji Mitsuzuka, Takahiro Yoneyama, Shintaro Narita, Sadafumi Kawamura, Yuki Tobisawa, Tohru Yoneyama, Kazuyuki Mori, Akiko Okamoto, Hayato Yamamto, Atsushi Imai, Shingo Hatakeyma, Yasuhiro Hashimoto, Tatsuo Tochigi, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  189 ( 4 ) E791 - E792   2013年04月

研究発表要旨（国際会議）  

CYP3A5遺伝子多型に基づくグラセプタ個別投与による移植後早期の薬物動態と腎機能への影響

佐藤 滋, 沼倉 一幸, 斎藤 満, 井上 高光, 秋濱 晋, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 加賀谷 英彰, 新岡 丈典, 三浦 昌朋

日本腎臓学会誌 ( (一社)日本腎臓学会 )  55 ( 3 ) 323 - 323   2013年04月

Insulin-like growth factor-1 genotypes and haplotypes influence the survival of prostate cancer patients with bone metastasis at initial diagnosis.

Norihiko Tsuchiya, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Kazuyuki Numakura, Mingguo Huang, Shingo Hatakeyama, Shigeru Satoh, Seiichi Saito, Chikara Ohyama, Yoichi Arai, Osamu Ogawa, Tomonori Habuchi

BMC cancer   13   150 - 150   2013年03月

BACKGROUND: The insulin-like growth factor-1 (IGF-1) plays an important role in growth of prostate cancer (PCa) cells and facilitating the development and progression of PCa. This study aimed to evaluate the association of polymorphisms in three linkage disequilibrium (LD) blocks of the IGF-1 on the survival of metastatic PCa patients. METHODS: A total of 215 patients with bone metastases at initial presentation were included in this study. The cytosine-adenine (CA) repeat polymorphism and rs12423791 were selected as representative polymorphisms in the LD blocks 1 and 2, respectively. Haplotype in the LD block 3 was analyzed using two tag single nucleotide polymorphisms (SNPs), rs6220 and rs7136446. Cancer-specific survival rate was estimated from the Kaplan-Meier curve, and the survival data were compared using the log-rank test. RESULTS: Cancer-specific survival was significantly associated with the CA repeat polymorphism, rs12423791, and rs6220 (P = 0.013, 0.014, and 0.014, respectively). Although rs7136446 had no significant association with survival, the haplotype in the LD block 3 was significantly associated with cancer-specific survival (P = 0.0003). When the sum of the risk genetic factors in each LD block (19-repeat allele, C allele of rs12423791, or C-T haplotype) was considered, patients with all the risk factors had significantly shorter cancer specific-survival than those with 0-2 risk factors (P = 0.0003). CONCLUSIONS: Polymorphisms in the IGF-1, especially a haplotype in the LD block 3, are assumed to be genetic markers predicting the outcome of metastatic PCa.

DOI PubMed

Risk factors for sorafenib-induced high-grade skin rash in Japanese patients with advanced renal cell carcinoma.

Norihiko Tsuchiya, Shintaro Narita, Takamitsu Inoue, Naoko Hasunuma, Kazuyuki Numakura, Yohei Horikawa, Shigeru Satoh, Takeshi Notoya, Naohito Fujishima, Shingo Hatakeyama, Chikara Ohyama, Tomonori Habuchi

Anti-cancer drugs   24 ( 3 ) 310 - 4   2013年03月

The aim of this study was to evaluate the clinical factors, drug-related genetic polymorphisms, and human leukocyte antigen (HLA) types to determine the association with sorafenib-induced high-grade skin rash (HGSR) in Japanese patients with advanced renal cell carcinoma (RCC). A total of 55 patients with advanced RCC treated with sorafenib were analyzed retrospectively. Of these, 33 patients were subjected to HLA typing and polymorphism analyses of CYP3A5, ABCB1, ABCC2, and UGT1A1, which are involved in the metabolism and membrane transport of sorafenib. Grade 3 or higher SR developed in 12 (22%), and a higher incidence was observed in female patients than in male patients (40 vs. 15%, P=0.046). The initial dose, initial dose per body weight, and initial dose per body surface area in patients with HGSR were significantly higher than those in patients without HGSR. Patients with the ABCC2 -24CC genotype were at a significantly higher risk of SR than those with the CT genotype (35 vs. 0%, P=0.032). HLA-A*24 was significantly associated with the occurrence of HGSR (P=0.049). Our finding suggested that women, higher initial dose per body weight or body surface area, the ABCC2 -24CC genotype, and HLA-A*24 are associated with the risk of sorafenib-induced HGSR in Japanese RCC patients.

DOI PubMed

高脂肪食摂取下の前立腺癌増殖におけるFatty Acid Synthase(FASN)の役割

黄 明国, 成田 伸太郎, 土谷 順彦, 井上 高光, 佐藤 滋, 佐々木 雄彦, 羽渕 友則

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  104 ( 2 ) 411 - 411   2013年03月

CYP3A5遺伝子多型に基づくグラセプタ個別投与による移植後早期の薬物動態と腎機能への影響

佐藤 滋, 新岡 丈典, 加賀谷 英彰, 沼倉 一幸, 斎藤 満, 井上 高光, 小峰 直樹, 秋濱 晋, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 三浦 昌朋

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  104 ( 2 ) 242 - 242   2013年03月

進行性腎細胞癌患者におけるsunitinib薬物治療モニタリング

土谷 順彦, 藤山 信弘, 成田 伸太郎, 井上 高光, 齋藤 満, 沼倉 一幸, 秋濱 晋, 佐藤 滋, 三浦 昌朋, 羽渕 友則

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  104 ( 2 ) 240 - 240   2013年03月