研究等業績 - その他 - 成田 伸太郎
-
Matsuda Y.
Annals of Surgical Oncology ( Annals of Surgical Oncology ) 28 ( 9 ) 5341 - 5348 2021年09月
PURPOSE: This study was designed to assess the relationship between nerve-sparing (NS) status, positive surgical margin (PSM) location, and biochemical recurrence (BCR) based on a multicenter, radical prostatectomy (RP) database. METHODS: We retrospectively reviewed data from 726 patients who underwent RP without any neoadjuvant or adjuvant treatment between 2010 and 2014. We statistically assessed the impact of NS sides on PSM location and BCR. RESULTS: PSM rates were 21.9% in the 726 patients studied, 13.2% in patients with ≤pT2, and 46.8% in patients with ≥pT3. Regarding PSM locations, the anterior-apex (AA) was the most common site for PSM (43.3%). After adjusting for confounding factors, bilateral nerve sparing (BNS) had a significantly higher odds ratio of PSM than the absence of NS did (odds ratio [OR] 3.04, 95% confidence interval [CI] 1.85-4.99). In the UNS RP in patients with ≤pT2, non-AA PSM on the non-NS side was significantly higher than that on the NS side (92.9% vs. 45.5%, p = 0.009). In all patients, 5.8% experienced BCR during a median follow-up of 43.5 months. PSM was significantly associated with BCR-free survival in patients with ≤pT2 (p = 0.013), but not in patients with ≥pT3 (p = 0.185). Non-AA PSM at the non-NS side was an independent risk factor for BCR (hazard ratio [HR] 2.56, 95% confidence interval [CI] 1.12-5.85), whereas AA PSMs, including NS/non-NS sides and non-AA PSM at the NS side, were not associated with BCR-free survival. CONCLUSIONS: Avoidance of non-AA PSM on the non-NS side may be rather important for maintaining BCR-free survival after RP.
-
Shiota M.
Cancer Science ( Cancer Science ) 112 ( 9 ) 3616 - 3626 2021年09月
The metastatic burden is a critical factor for decision-making in the treatment of metastatic hormone-sensitive prostate cancer (HSPC). This study aimed to develop and validate a novel risk model for survival in patients with de novo low- and high-burden metastatic HSPC. The retrospective observational study included men with de novo metastatic prostate cancer who were treated with primary androgen-deprivation therapy at 30 institutions across Japan between 2008 and 2017. We created a risk model for overall survival (OS) in the discovery cohort (n = 1449) stratified by the metastatic burden (low vs high) and validated its predictive ability in a separate cohort (n = 951). Based on multivariate analyses, lower hemoglobin levels, higher Gleason grades, and higher clinical T-stage were associated with poor OS in low-burden disease. Meanwhile, lower hemoglobin levels, higher Gleason grade group, liver metastasis, and higher extent of disease scores in bone were associated with poor OS in patients with high-burden disease. In the discovery and validation cohorts, the risk model using the aforementioned parameters exhibited excellent discriminatory ability for progression-free survival and OS. The predictive ability of this risk model was superior to that of previous risk models. Our novel metastatic burden-stratified risk model exhibited excellent predictive ability for OS, and it is expected to have several clinical uses, such as precise prognostic estimation.
-
特集 今こそ知りたい! ロボット時代の腹腔鏡手術トレーニング-腹腔鏡技術認定を目指す泌尿器科医のために〈特別付録Web動画〉 〈腹腔鏡技術認定を目指した取り組み〉 腎移植を積極的に行う施設でのトレーニング法
齋藤 満, 成田 伸太郎, 羽渕 友則
臨床泌尿器科 ( 株式会社医学書院 ) 75 ( 10 ) 730 - 735 2021年09月
-
上部尿路上皮癌に対するロボット支援腹腔鏡下腎尿管全摘除術の経験
齋藤 満, 成田 伸太郎, 沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 羽渕 友則
Japanese Journal of Endourology ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34 ( 2 ) 318 - 322 2021年09月
今回我々はロボット支援腹腔鏡下腎尿管全摘除術(RNU)の初期経験を得た.対象は2019年7月から2020年7月にda Vinci Si(4例)またはXi(2例)サージカルシステムでRNUを受けた6症例.全例男性で患側は左4例,右2例,cT3の3例を含む4例で術前化学療法を施行した.完全側臥位,軽度ジャックナイフ体位,6または7ポート,経腹膜アプローチで手術を施行した.術中,体位変換やペイシェントカートの移動は行わなかった.手術時間の中央値は308分,推定出血量の中央値は63mLで輸血や開腹手術移行は無かった.pT3の左尿管癌症例1例で摘出標本断端が陽性であった.周術期合併症はClavien-dindo分類でGrade IIの乳糜腹水,下痢を1例ずつ認めた.RNUは手術手技の標準化とより多くの症例を対象とした長期追跡調査が必要であるが,UTUC症例に対する新たな治療選択肢となり得る.(著者抄録)
-
細胞内レチノイン酸結合蛋白2は飽和脂肪酸誘導性の前立腺癌進展を促進する
佐藤 博美, 成田 伸太郎, 石田 雅宣, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 黄 明国, 沼倉 一幸, 齋藤 満, 堂前 直, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 80回 [P14 - 4] 2021年09月
-
術前肥満が腎移植後のアウトカムに与える影響についての検討
山本 竜平, 齋藤 満, 提箸 隆一郎, 青山 有, 嘉島 相輝, 小泉 淳, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 佐藤 滋, 羽渕 友則
移植 ( (一社)日本移植学会 ) 56 ( 総会臨時 ) P1 - 47 2021年09月
-
高脂肪食摂取による前立腺癌増殖とホスファチジルイノシトールの関連
黄 明国, 佐々木 雄彦, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 80回 [P23/24/26 - 2] 2021年09月
-
【今こそ知りたい! ロボット時代の腹腔鏡手術トレーニング-腹腔鏡技術認定を目指す泌尿器科医のために】腹腔鏡技術認定を目指した取り組み 腎移植を積極的に行う施設でのトレーニング法
齋藤 満, 成田 伸太郎, 羽渕 友則
臨床泌尿器科 ( (株)医学書院 ) 75 ( 10 ) 730 - 735 2021年09月
＜文献概要＞ポイント ・生体腎移植ドナーは疾患や肥満などの影響が少ないことから,鏡視下ドナー腎採取術は腹腔鏡手術のトレーニングに適している.・鏡視下ドナー腎採取術には,通常の鏡視下腎摘除術とは異なる注意点があり,あらかじめ手術手順を決めておく.・鏡視下ドナー腎採取術が安全かつ適切にできる知識・技術を習得できれば,標準的な腹腔鏡下腎摘除術の指導は十分可能である.
-
新鮮凍結血漿の血液型は血漿交換の有害事象の発生に影響するか?
提箸 隆一郎, 齋藤 満, 齋藤 拓郎, 山本 竜平, 藤山 信弘, 嘉島 相輝, 小泉 淳, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 佐藤 滋, 羽渕 友則
移植 ( (一社)日本移植学会 ) 56 ( 総会臨時 ) P1 - 39 2021年09月
-
脂肪由来間葉系幹細胞によるPI3/AKT経路を介した腎癌の浸潤能の亢進
武藤 弓奈, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 80回 [P14 - 1] 2021年09月
-
腎細胞がんの組織型によって寄与する遺伝子が異なることを示した大規模ゲノム解析
関根 悠哉, 平田 真, 松田 浩一, 菅野 康吉, 吉田 輝彦, 村上 善則, 福井 智洋, 赤松 秀輔, 小川 修, 中川 英刀, 沼倉 一幸, 成田 伸太郎, 羽渕 友則, 桃沢 幸秀
日本癌学会総会記事 ( (一社)日本癌学会 ) 80回 [J7 - 1] 2021年09月
-
高脂肪食摂取による前立腺癌増殖とホスファチジルイノシトールの関連
黄 明国, 佐々木 雄彦, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 80回 [P23/24/26 - 2] 2021年09月
-
PD-1の遺伝子多型とニボルマブの臨床結果との関連
小林 瑞貴, 沼倉 一幸, 畠山 真吾, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 大山 力, 羽渕 友則
日本腎泌尿器疾患予防医学研究会プログラム・抄録集 ( 日本腎泌尿器疾患予防医学研究会 ) 30回 52 - 52 2021年07月
-
Takayama K.
Case Reports in Oncology ( Case Reports in Oncology ) 14 ( 2 ) 1019 - 1024 2021年06月
A 73-year-old woman with no history of disease was referred to our hospital with fatigue and joint pain. Screening blood test showed that her cancer antigen 15-3 (CA 15-3) serum level was elevated to 36.6 U/mL, and a contrast-enhanced computed tomography scan revealed a bladder tumor without metastasis. Cystoscopy showed a papillary and a small kissing tumor, and the histopathological analysis of the bladder tumor obtained by transurethral resection (TUR) showed invasive urothelial carcinoma (UC) with micropapillary variant (pT1). At 4 weeks after TUR, the CA 15-3 serum level was markedly increased to 180.6 U/mL, and radiographic examinations revealed multiple regional and nonregional lymph node metastases. The patient received systemic therapy with gemcitabine and cisplatin. After 3 cycles of chemotherapy, the size of all lymph node metastases reduced by 80% in diameter, and the CA 15-3 serum level decreased from 238.2 to 11.4 U/mL. Immunohistological analysis showed that the bladder tumor was positive for mucin 1, of which CA 15-3 is an epitope. In our patient, changes in the CA 15-3 serum levels were in congruence with the clinical course of advanced micropapillary UC (MPUC). Therefore, the CA 15-3 serum level may be a potentially valuable biomarker for MPUC.
-
武藤 弓奈, 奈良 健平, 嘉島 相輝, 山本 竜平, 小泉 淳, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 臨増 ) 798 - 798 2021年06月
-
小林 瑞貴, 成田 伸太郎, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 臨増 ) 786 - 786 2021年06月
-
転移性腎細胞癌に対する1stライン治療成績の比較検討 ニボルマブ・イピリムマブ併用療法vs.チロシンキナーゼ阻害薬(多施設共同研究)
田中 壽和, 畠山 真吾, 沼倉 一幸, 及川 真亮, 野呂 大輔, 細越 正吾, 成田 伸太郎, 井上 高光, 米山 高弘, 伊藤 弘之, 西村 祥二, 川口 俊明, 橋本 安弘, 羽渕 友則, 大山 力
泌尿器外科 ( 医学図書出版(株) ) 34 ( 臨増 ) 793 - 793 2021年06月
-
高齢腎移植レシピエントでは免疫抑制の減量は必要か?
提箸 隆一郎, 齋藤 満, 齋藤 拓郎, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則, 藤山 信弘, 佐藤 滋
泌尿器外科 ( 医学図書出版(株) ) 34 ( 臨増 ) 776 - 776 2021年06月
-
Yamamoto R.
Transplantation Proceedings ( Transplantation Proceedings ) 53 ( 4 ) 1292 - 1294 2021年05月
A 35-year-old male patient with end-stage renal disease due to vesicoureteral reflux preemptively received a renal graft from his father. The patient had a history of allergy to contrast-enhancing media. He received oral tacrolimus (TAC) and mycophenolate mofetil without any problems for 2 days before kidney transplantation. During the induction period of the surgery, his systolic blood pressure (sBP) decreased to 60 mmHg approximately 1 hour after initiating intravenous tacrolimus (TAC-IV) and intravenous piperacillin (PIPC), and the anesthesiologist suspected drug-induced anaphylaxis and stopped administration of the medications. Because TAC had been administered preoperatively without any adverse events, PIPC was suspected as the causative agent of the anaphylaxis. After the patient's hemodynamics returned to baseline, TAC-IV was restarted. However, his sBP rapidly decreased to 40 mmHg and the patient developed wheezing. He was diagnosed with drug-induced anaphylaxis due to castor oil derivatives in the TAC-IV formulation. The patient's sBP was restored with the administration of some vasopressors, and kidney transplantation was then performed without difficulty. Two days after kidney transplantation, oral TAC was administered without anaphylaxis. Clinicians should consider that not only the drug itself but also its additives or metabolites could induce anaphylaxis.
-
Huang M.
Cancer Communications ( Cancer Communications ) 41 ( 5 ) 389 - 403 2021年05月
BACKGROUND: Recent studies have indicated that a high-fat diet (HFD) and/or HFD-induced obesity may influence prostate cancer (PCa) progression, but the role of HFD in PCa microenvironment is unclear. This study aimed to delineate the molecular mechanisms of PCa progression under HFD milieus and define the stromal microenvironment focusing on macrophage inhibitory cytokine-1 (MIC-1) activation. METHODS: We investigated the effects of HFD on PCa stromal microenvironment and MIC-1 signaling activation using PC-3M-luc-C6 PCa model mice fed with HFD or control diet. Further, we explored the effect of periprostatic adipocytes derived from primary PCa patients on activation and cytokine secretion of prostate stromal fibroblasts. Expression patterns and roles of MIC-1 signaling on human PCa stroma activation and progression were also investigated. RESULTS: HFD stimulated PCa cell growth and invasion as a result of upregulated MIC-1 signaling and subsequently increased the secretion of interleukin (IL)-8 and IL-6 from prostate stromal fibroblasts in PC-3M-luc-C6 PCa mouse model. In addition, periprostatic adipocytes directly stimulated MIC-1 production from PC-3 cells and IL-8 secretion in prostate stromal fibroblasts through the upregulation of adipose lipolysis and free fatty acid release. The increased serum MIC-1 was significantly correlated with human PCa stroma activation, high serum IL-8, IL-6, and lipase activity, advanced PCa progression, and high body mass index of the patients. Glial-derived neurotrophic factor receptor α-like (GFRAL), a specific receptor of MIC-1, was highly expressed in both cytoplasm and membrane of PCa cells and surrounding stromal fibroblasts, and the expression level was decreased by androgen deprivation therapy and chemotherapy. CONCLUSION: HFD-mediated activation of the PCa stromal microenvironment through metabolically upregulated MIC-1 signaling by increased available free fatty acids may be a critical mechanism of HFD and/or obesity-induced PCa progression.