研究等業績 - その他 - 成田 伸太郎
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OUTCOME OF LAPAROSCOPIC LYMPHADENECTOMY IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE UPPER URINARY TRACT
Shintaro Narita, Shuji Chiba, Souhei Kanda, Kazuyuki Numakura, Susumu Akihama, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF ENDOUROLOGY ( MARY ANN LIEBERT INC ) 26 A165 - A165 2012年09月
研究発表要旨（国際会議）
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Comparison of the clinical outcome and systemic inflammatory marker levels between retroperitoneal and transperitoneal laparoscopic donor nephrectomy.
Mitsuru Saito, Norihiko Tsuchiya, Shintaro Narita, Teruaki Kumazawa, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
Journal of endourology 26 ( 8 ) 1038 - 43 2012年08月
BACKGROUND AND PURPOSE: Whether the retroperitoneal approach (RA) or the transperitoneal approach (TA) for performing laparoscopic donor nephrectomy (LDN) in kidney transplant donors is less invasive is unclear. In this study, we compared the clinical outcome and systemic inflammatory marker levels between RA and TA to assess surgical invasiveness. PATIENTS AND METHODS: We enrolled 105 donors (RA: 41, TA: 64) who underwent LDN in our hospital. Evaluation of both approaches included comparison of conventional clinical parameters and preoperative, immediate postoperative, and 1-day postoperative levels of the following circulating inflammatory cytokines: Tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-8, IL-10, and IL-12p70. RESULTS: The frequency of right nephrectomy being performed was significantly lower in the TA than in the RA group (3/64 vs 12/41, P<0.001). Other clinical parameters in the TA group, including the frequency of surgical complications and incidence of delayed graft function, were comparable to those in the RA group. Immediate and 1-day postoperative mean serum IL-6 levels were significantly higher in the RA than in the TA group (P=0.023 and 0.044, respectively). The 1-day postoperative mean serum IL-10 level was also significantly higher in the RA than in the TA group (P=0.041). Meanwhile, the mean serum IL-6 and IL-10 levels were not associated with surgical duration or estimated intraoperative blood loss. CONCLUSIONS: Conventional clinical parameters related to surgical invasiveness were comparable in both approaches, thus indicating that both LDN approaches were similar and equally effective as minimally invasive procedures. The clinical significance of the higher postoperative mean serum IL-6 and IL-10 levels in the RA group remains to be clarified in a future study.
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Hyperuricemia at 1 year after renal transplantation, its prevalence, associated factors, and graft survival.
Kazuyuki Numakura, Shigeru Satoh, Norihiko Tsuchiya, Mitsuru Saito, Shinya Maita, Takashi Obara, Hiroshi Tsuruta, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Hideaki Kagaya, Masatomo Miura, Tomonori Habuchi
Transplantation 94 ( 2 ) 145 - 51 2012年07月
BACKGROUND: The present study investigated the prevalence and predictors for the development of hyperuricemia within 1 year after transplantation and their associations with genetic polymorphisms and graft outcome in patients taking tacrolimus and mycophenolate mofetil. METHODS: One hundred twenty-one renal allograft recipients transplanted between January 2001 and March 2009 were studied. Patients with serum uric acid concentrations above 7.0 mg/dL within 1 year after transplantation were defined as having hyperuricemia, and all were treated with allopurinol. Genetic polymorphisms of nitric oxide synthase, angiotensin-converting enzyme, methylenetetrahydrofolate reductase, and 3 uric acid transporters were examined. RESULTS: At 1 year after transplantation, 46 (38%) recipients developed hyperuricemia. Male gender, higher body mass index, long-term pretransplantation dialysis, and hypertension were associated with the development of hyperuricemia. The estimated glomerular filtration rate (eGFR) at 1 year after transplantation was lower in the patients with hyperuricemia than in those without. There were no differences in graft survival between the two groups. The pharmacokinetics of tacrolimus and mycophenolic acid and 6 polymorphisms were not associated with hyperuricemia. In the multivariate analysis, male gender, long-term pretransplantation dialysis (>36 months), and eGFR (<60 mL/min) were independently associated with the development of hyperuricemia. CONCLUSION: The incidence of hyperuricemia in our cohort was 38%. Male gender and long-term pretransplantation dialysis were predictors for the development of hyperuricemia. The eGFR was lower in patients with hyperuricemia, but graft survival did not differ between the patients with hyperuricemia treated with alloprinol and those without hyperuricemia. We could not define the significance of the pharmacokinetics of immunosuppressants and genetic risk factors for hyperuricemia.
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Outcome, clinical prognostic factors and genetic predictors of adverse reactions of intermittent combination chemotherapy with docetaxel, estramustine phosphate and carboplatin for castration-resistant prostate cancer.
Shintaro Narita, Norihiko Tsuchiya, Takeshi Yuasa, Shinya Maita, Takashi Obara, Kazuyuki Numakura, Hiroshi Tsuruta, Mitsuru Saito, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
International journal of clinical oncology 17 ( 3 ) 204 - 11 2012年06月
OBJECTIVES: Docetaxel-based chemotherapy is effective in patients with castration-resistant prostate cancer (CRPC). This phase II study assessed the outcome and predictive factors for prognosis and toxicity following intermittent chemotherapy with docetaxel, estramustine phosphate, and carboplatin (DEC) in patients with CRPC. METHODS: Thirty-five patients were treated with a DEC regimen that consisted of a 28-day cycle of drugs as follows: docetaxel (60 mg/m(2) on day 1), carboplatin (AUC 5 on day 1) and estramustine phosphate (560 mg daily). Treatment was continued intermittently. The end point was to test the effect of DEC on the response rate and overall survival (OS). Statistical correlations between the outcomes and predictive factors, including clinical parameters and 8 single-nucleotide polymorphisms (SNPs) related to drug metabolism, were assessed. RESULTS: Prostate-specific antigen levels decreased by more than 30% in 65.7% of the patients. The median OS following DEC was 17.8 months, and the median total time of chemotherapy holiday was 7.7 months (range 1.7-35.8). On multivariate analysis, serum lactate dehydrogenase (LDH) was an independent prognostic factor for OS (p = 0.007). On SNP analysis, patients carrying the TT genotype of the ABCB1 C3435T polymorphism showed a significantly more severe leukocytopenia during the first cycle of DEC therapy compared to patients with the CC + CT genotype (p = 0.036). CONCLUSION: Combination chemotherapy with DEC has a potential effect on CRPC with acceptable toxicity. Serum LDH may be a promising predictor of prognosis, and the ABCB1 C3435T polymorphism may be a genetic predictor of the severity of leukocytopenia in patients with CRPC treated with DEC.
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進行性腎癌患者におけるsunitinibの薬物動態とその臨床的意義
土谷 順彦, 堀川 洋平, 藤山 信弘, 成田 伸太郎, 井上 高光, 沼倉 一幸, 佐藤 滋, 三浦 昌朋, 羽渕 友則
日本DDS学会学術集会プログラム予稿集 ( 日本DDS学会 ) 28回 174 - 174 2012年06月
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Clinical efficacy and prognostic factors for overall survival in Japanese patients with metastatic renal cell cancer treated with sunitinib.
Takeshi Yuasa, Norihiko Tsuchiya, Shinji Urakami, Yohei Horikawa, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Shinya Yamamoto, Junji Yonese, Iwao Fukui, Kenji Nakano, Shunji Takahashi, Kiyohiko Hatake, Tomonori Habuchi
BJU international 109 ( 9 ) 1349 - 54 2012年05月
UNLABELLED: Study Type--Therapy (case series). Level of Evidence 4. What's known on the subject? and What does the study add? A randomized prospective phase III clinical trial for systemic treatment-naïve metastatic renal cell cancer (RCC) patients demonstrated the superiority of sunitinib over interferon with an acceptable safety profile. However, a commonly asked question is whether patients with RCC in clinical trials are representative of those with this disease being seen in ordinary clinical practice. To our knowledge, this is the first report of sunitinib for the Japanese patients with metastatic RCC in ordinary clinical practice. The estimated median PFS and OS in this study were 9.3 and 32.2 months, respectively. The application of the MSKCC model distinctly separated OS curves (P<0.001), suggesting that MSKCC prognostic factors might be still valid to predict survival in metastatic RCC in the era of molecular targeted therapy. OBJECTIVES: • To report the treatment efficacy and safety profile of sunitinib for patients with metastatic renal cell carcinoma (RCC) in ordinary clinical practice. • In addition, to investigate the prognostic clinicopathological factors in these patients. PATIENTS AND METHODS: • The present study consisted of native Japanese patients with metastatic RCC, comprising 29 pretreated and 34 systemic treatment-naïve patients. • Univariate and multivariate analyses were performed by the log-rank test and the Cox proportional hazards model, respectively. RESULTS: • Estimated median progression-free survival and overall survival (OS) were 9.3 months (95% confidence interval, CI, 5.0-13.7) and 32.2 months (95% CI, 24.4-40.0), respectively. • Among the patients pretreated before sunitinib, two patients were treated with initialized systemic therapy with sorafenib and the remaining 27 were initialized with interferon-α. • The OS from the initial systemic therapy of the patients in pretreated groups was 79.6 months (95% CI, 14.6-144.5). • The application of the Memorial Sloan-Kettering Cancer Center model distinctly separated the OS curves (P < 0.001). • The most common grade 3 adverse events were fatigue (53%), thrombocytopaenia (48%), hand-foot syndrome (16%), anaemia (20%), hypertension (10%) and leucopaenia (9%), although these events were manageable and reversible. CONCLUSIONS: • Sunitinib has a favourable efficacy/safety profile for Japanese metastatic RCC patients in clinical practice. • The estimated median OS was >2 years with acceptable tolerability. • The median OS from the initial systemic therapy of the pretreated patients was >6 years. • Memorial Sloan-Kettering Cancer Center prognostic factors still appear to be valid for predicting survival in metastatic RCC in the era of molecular targeted therapy.
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FUNCTIONAL GENETIC POLYMORPHISMS IN THE CYP19 GENE DECREASE THE RISK OF PROSTATE CANCER AND ALTER THE RESPONSE TO ANDROGEN DEPRIVATION THERAPY
Sohei Kanda, Norihiko Tsuchiya, Meikoku Kou, Syuji Chiba, Kiyofumi Satoyoshi, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E390 - E390 2012年04月
研究発表要旨（国際会議）
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FUNCTIONAL MONONUCLEOTIDE REPEATS IN THE HGF PROMOTER ARE ASSOCIATED WITH BLADDER CANCER PROGRESSION
Syuji Chiba, Yohei Horikawa, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E361 - E361 2012年04月
研究発表要旨（国際会議）
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IS SMALL BLADDER CAPACITY DUE TO LONG-TERM DIALYSIS ASSOCIATED WITH THE INCIDENCE OF VESICO-URETERAL REFLUX AFTER TRANSPLANTATION?
Takamitsu Inoue, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Takashi Obara, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E860 - E860 2012年04月
研究発表要旨（国際会議）
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LAPARO-ENDOSCOPIC SINGLE-SITE (LESS) PLUS ONE TROCAR DONOR NEPHRECTOMY USING GELPORT: AN INITIAL CLINICAL EXPERIENCE
Takamitsu Inoue, Norihiko Tsuchiya, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E869 - E870 2012年04月
研究発表要旨（国際会議）
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PERSONALIZED INITIAL DOSE OF TACROLIMUS BASED ON THE CYP3A5 POLYMORPHISM AND ITS IMPACT ON THE 1-MONTH GRAFT FUNCTION: A PRELIMINARY EXPERIENCE
Shigeru Satoh, Kazuyuki Numakura, Yoshiko Miura, Mitsuru Saito, Shinya Maita, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi, Hideaki Kagaya, Masatomo Miura
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E913 - E913 2012年04月
研究発表要旨（国際会議）
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POSTTRANSPLANT DIABETES MELLITUS IN ADULT RENAL TRANSPLANT RECIPIENTS: INCIDENCE, CLINICAL CHARACTERISTICS, TACROLIMUS PHARMACOKINETICS, AND RELATED GENOMIC POLYMORPHISMS
Kazuyuki Numakura, Shigeru Satoh, Norihiko Tsuchiya, Mitsuru Saito, Shinya Maita, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Hideaki Kagaya, Masatomo Miura, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 187 ( 4 ) E916 - E916 2012年04月
研究発表要旨（国際会議）
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低リスク前立腺癌に対する前立腺全摘術に骨盤内リンパ節郭清は必要か?
三塚 浩二, 成田 伸太郎, 米山 高弘, 川村 貞文, 栃木 達夫, 羽渕 友則, 大山 力, 荒井 陽一, みちのく泌尿器癌研究グループ
日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 ) 103 ( 2 ) 184 - 184 2012年03月
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日本人前立腺癌患者における全摘術後のPSA再発および臨床病理学的因子とBMIの関係
成田 伸太郎, 三塚 浩二, 米山 高弘, 川村 貞文, 荒井 陽一, 大山 力, 栃木 達夫, 羽渕 友則
日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 ) 103 ( 2 ) 182 - 182 2012年03月
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CYP3A5遺伝子多型に基づくグラセプタ個別投与設計による移植腎機能への影響と線維組織増生抑制への期待
沼倉 一幸, 佐藤 滋, 小峰 直樹, 三浦 喜子, 井上 高光, 米田 真也, 小原 崇, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 羽渕 友則, 加賀谷 英彰, 三浦 昌朋
日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 ) 103 ( 2 ) 236 - 236 2012年03月
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Antitumor effect of sunitinib against skeletal metastatic renal cell carcinoma through inhibition of osteoclast function.
Shinya Maita, Takeshi Yuasa, Norihiko Tsuchiya, Yoko Mitobe, Shintaro Narita, Yohei Horikawa, Kiyohiko Hatake, Iwao Fukui, Shinya Kimura, Taira Maekawa, Tomonori Habuchi
International journal of cancer 130 ( 3 ) 677 - 84 2012年02月
We investigated the inhibitory effect of sunitinib, a newly approved multitargeted tyrosine kinase inhibitor, against the progression of renal cell cancer (RCC) bone metastases in vivo. In vitro cell proliferation was determined using the MTS assay. To investigate the inhibitory effects of sunitinib in vivo, we established luciferase-labeled ACHN(Luc) cells derived from papillary RCC. Mice in which ACHN(Luc) cells had been transplanted into the left ventricle to establish bone metastases were treated orally with 40 mg/kg/day sunitinib or vehicle control for 3 weeks. Growth of the cancer cells was monitored using an in vivo imaging system. In addition, 16 patients with metastatic RCC were treated with sunitinib, and serum and urine levels of amino-terminal telopeptide (NTx) were measured as markers of bone resorption. Sunitinib did not inhibit the growth of RCC cells in vitro at clinically or experimentally achievable serum levels (100 nM-1 μM). To investigate the inhibitory effect of sunitinib in vivo, we established luciferase-labeled human RCC cells (ACHN(Luc) ). Sunitinib prevented the growth of ACHN(Luc) RCC cells in the bone metastatic mouse model. The number of osteoclasts in sunitinib-treated mice was significantly less than that in control mice. Serum and urine levels of NTx in patients with metastatic RCC declined significantly during the first 4 weeks of sunitinib treatment (p = 0.027). Sunitinib is a potent anticancer agent for RCC bone metastases, at least for papillary RCC.
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Short-term clinicopathological outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade, followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with high-risk localized prostate cancer.
Shintaro Narita, Norihiko Tsuchiya, Teruaki Kumazawa, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Hiroshi Nanjyo, Tomonori Habuchi
World journal of surgical oncology 10 1 - 1 2012年01月
BACKGROUND: To assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa). METHODS: Complete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) with estramustine phosphate (560 mg) were given to 18 PCa patients before radical prostatectomy. Subsequently, the clinical and pathological outcomes were analyzed. RESULTS: No patients had severe adverse events during chemohormonal therapy, and hence they were treated with radical prostatectomy. Two patients (11.1%) achieved pathological complete response. Surgical margins were negative in all patients. At a median follow-up of 18 months, 14 patients (77.8%) were disease-free without PSA recurrence. All 4 patients with PSA recurrence had pathologic T3b or T4 disease and 3 of these 4 patients had pathologic N1 disease. CONCLUSION: We found that neoadjuvant chemohormonal therapy with complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy was safe, feasible, and associated with favorable pathological outcomes in patients with a high risk of localized PCa.
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Association between various indices of obesity and intraoperative factors in laparoscopic donor nephrectomy.
Teruaki Kumazawa, Norihiko Tsuchiya, Takamitsu Inoue, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Youhei Horikawa, Shigeru Satoh, Tomonori Habuchi
Journal of laparoendoscopic & advanced surgical techniques. Part A 22 ( 6 ) 567 - 71 2012年
PURPOSE: Obesity has been considered a potential risk factor for complications during laparoscopic surgery. The purpose of this study is to retrospectively investigate the association of various obesity indices and intraoperative factors in laparoscopic donor nephrectomy. PATIENTS AND METHODS: This study included 70 and 44 patients who underwent laparoscopic donor nephrectomy by a transperitoneal approach and retroperitoneal approach, respectively. We measured fat thickness and fat areas on preoperative computerized tomography (CT) images. The median value of fat thickness or of the subcutaneous fat area, visceral fat area, perirenal fat area, or total fat area among subjects was used as a cutoff to define fatty and non-fatty groups. The operative time and estimated blood loss were then compared between the two groups. RESULTS: In the transperitoneal approach group, there was no statistically significant difference in any of the indices or intraoperative factors between the fatty and non-fatty groups defined using any of the fat parameters. In the retroperitoneal approach group, patients in the fatty group categorized by perirenal fat thickness and visceral fat area had significantly greater estimated blood loss than those in the non-fatty group. Also, in the retroperitoneal approach group, patients in the fatty group categorized by perirenal fat area had significantly greater estimated blood loss and longer operating time than those in the non-fatty group (P=.02 and P=.014, respectively). CONCLUSIONS: The results indicate that the visceral fat, and in particular the perirenal fat area measured using CT scan imaging, influences operating time and estimated blood loss after retroperitoneal approach surgery but not in transperitoneal approach surgery. In donors with a high volume of perirenal fat, the transperitoneal approach may be recommended for laparoscopic nephrectomy.
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[Primary retroperitoneal carcinoid tumor associated with multiple endcrine neoplasia (men) type 1: a case report].
Syuji Chiba, Kazuyuki Numakura, Kiyofumi Satoyoshi, Mitsuru Saito, Yohei Horikawa, Koichiro Takayama, Taketoshi Nara, Sohei Kanda, Yoshiko Miura, Shinya Maita, Hiroshi Tsuruta, Takashi Obara, Teruaki Kumazawa, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 102 ( 6 ) 735 - 9 2011年11月
We report an extremely rare case of a 69-year-old man having a retroperitoneal carcinoid tumor associated with multiple endocrine neoplasia (MEN) type 1. The patient whose son and daughter were previously diagnosed with MEN type 1 was admitted to the Department of Endocrinology at our hospital for evaluation of this disorder. Computed tomography (CT) and ultrasonography revealed a parathyroid and retroperitoneal tumor (43 mm x 34 mm). The patient did not consent to surgical management of the tumor; however three years later, a follow-up CT revealed tumor enlargement (55 mm x 50 mm). We were unable to rule out a malignancy, and subsequently resected the tumor. A pathological diagnosis of retroperitoneal carcinoid was made. No local recurrence or metastasis have been observed for 21 months.
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Overexpression of Fn14 promotes androgen-independent prostate cancer progression through MMP-9 and correlates with poor treatment outcome.
Mingguo Huang, Shintaro Narita, Norihiko Tsuchiya, Zhiyong Ma, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
Carcinogenesis 32 ( 11 ) 1589 - 96 2011年11月
Fibroblast growth factor-inducible 14 (Fn14), a transmembrane receptor binding to the multifunctional cytokine tumor necrosis factor-like weak inducer of apoptosis (TWEAK), is known to modulate many cellular activities including cancer progression. Here, we demonstrated the significant role of Fn14 in invasion, migration and proliferation of androgen-independent prostate cancer (AIPC) cells. Fn14 and its ligand TWEAK were highly expressed in two AIPC cell lines, DU 145 and PC-3, whereas expression was weak in androgen-sensitive LNCaP cells. Fn14 knockdown using small-interfering RNAs attenuated migration, invasion and proliferation and enhanced apoptosis in the AIPC cell lines. Both forced overexpression of Fn14 by stable Fn14 complementary DNA transfection to PC-3 cells (PC-3/Fn14) and ligand activation by recombinant TWEAK in PC-3 cells enhanced invasion. Fn14 was shown to modulate expression of matrix metalloproteinase (MMP)-9, and MMP-9 mediated the invasive potential influenced by Fn14 in PC-3 cells. In vivo, subcutaneous xenografts of PC-3/Fn14 grew significantly faster than xenograft of PC-3/Mock, and the invasive capacity in PC-3/Fn14 was found to be higher than that of PC-3/Mock as evaluated in an invasion model of the diaphragm. Furthermore, the messenger RNA expressions of MMP-9 in PC-3/Fn14 xenografts were significantly higher than those in PC-3/Mock xenografts. Clinically, high expression of Fn14 was significantly associated with higher prostate-specific antigen recurrence rate in patients who underwent radical prostatectomy. In conclusion, the overexpression of Fn14 may contribute to multiple malignant cellular phenotypes associated with prostate cancer (PCa) progression, in part via MMP-9. TWEAK-Fn14 signaling may be a novel therapeutic target of PCa.