研究等業績 - その他 - 成田 伸太郎
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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 ) ( 53 ) 49 - 49 2023年07月
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当科におけるペムブロリズマブ・レンバチニブ併用療法の初期治療経験
関根 悠哉, 沼倉 一幸, 小林 瑞貴, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 53 ) 54 - 54 2023年07月
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転移性腎細胞癌に対するニボルマブ+イピリムマブ併用療法のirAEと治療効果の関連についての検討
蘇武 竜太, 沼倉 一幸, 畠山 真吾, 関根 悠哉, 武藤 弓奈, 小林 瑞貴, 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
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 53 ) 87 - 87 2023年07月
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BRAF V600E変異は副腎腫瘍からのコルチゾール産生を亢進する(BRAF V600E mutation promoted excess of cortisol secretion in adrenal cortical adenoma)
沼倉 一幸, 武藤 弓奈, 杉山 志子, 小林 瑞貴, 関根 悠哉, 嘉島 相輝, 山本 竜平, 奈良 健平, 黄 明国, 齋藤 満, 成田 伸太郎, 西本 紘嗣郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 110回 AOP08 - 03 2023年04月
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船越 佑大, 嘉島 相輝, 関根 悠哉, 小林 瑞貴, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則, 南條 博
泌尿器外科 ( 医学図書出版(株) ) 36 ( 4 ) 357 - 357 2023年04月
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日本人上部尿路上皮癌の大規模ゲノム解析(Large-scale genetic analysis of Upper Urinary Tract Urothelial Carcinoma in Japanese)
関根 悠哉, 岩崎 雄介, 遠藤 ミキ子, 佐野 剛視, 赤松 秀輔, 小林 恭, 中川 英刀, 沼倉 一幸, 成田 伸太郎, 桃沢 幸秀, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 110回 AOP06 - 07 2023年04月
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Numakura K.
World Journal of Surgical Oncology ( World Journal of Surgical Oncology ) 20 ( 1 ) 202 - 202 2022年12月
INTRODUCTION: Warm ischemia time (WIT) is a primary concern for robot-assisted laparoscopic partial nephrectomy (RALPN) patients because longer WIT is significantly associated with postoperative deteriorating kidney function. Tumor complexity, determined by the RENAL nephrometry score (RENAL score), can help predict surgical outcomes, but it is unclear what RENAL score and clinical factors affect WIT. This study explored the clinical factors predicting long WIT in experienced surgeon to RALPN. MATERIALS AND METHODS: In our institute, 174 RALPNs were performed between November 2013 and February 2021, of which 114 were performed by a single surgeon and included in this study. Clinical staging and the total RENAL score were determined based on preoperative CT scans. The cases were divided into three groups based on experience: period 1: 1-38, period 2: 39-76, and period 3: 77-114. The clinical factors associated with longer WIT were analyzed per period. RESULTS: The overall median tumor diameter was 32 mm, and one patient had a positive surgical margin, but there were no cancer-related deaths. In total, there were 18 complications (15.8%). Periods 2 and 3 had larger tumor diameters (p < 0.01) and worse preoperative kidney function (p = 0.029) than period 1. A RENAL L-component score of 3 was associated with longer WIT in period 3 (odds ratio: 3.900; 95% confidence interval: 1.004-15.276; p = 0.044), but the tumor diameter and the total RENAL score were not. CONCLUSIONS: A large tumor in the central lesion indicated by the RENAL L-component score was associated with increased WIT in RALPN.
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Kimura H.
British Journal of Cancer ( British Journal of Cancer ) 127 ( 9 ) 1680 - 1690 2022年11月
BACKGROUND: The prognostic significance of germline variants in homologous recombination repair genes in advanced prostate cancer (PCa), especially with regard to hormonal therapy, remains controversial. METHODS: Germline DNA from 549 Japanese men with metastatic and/or castration-resistant PCa was sequenced for 27 cancer-predisposing genes. The associations between pathogenic variants and clinical outcomes were examined. Further, for comparison, DNA from prostate biopsy tissue samples from 80 independent patients with metastatic PCa were analysed. RESULTS: Forty-four (8%) patients carried germline pathogenic variants in one of the analysed genes. BRCA2 was most frequently altered (n = 19), followed by HOXB13 (n = 9), PALB2 (n = 5) and ATM (n = 5). Further, the BRCA1, BRCA2, PALB2 and ATM variants showed significant association with a short time to castration resistance and overall survival (hazard ratio = 1.99 and 2.36; 95% CI, 1.15-3.44 and 1.23-4.51, respectively), independent of other clinical variables. Based on log-rank tests, the time to castration resistance was also significantly short in patients with BRCA1, BRCA2, PALB2 or ATM somatic mutations and TP53 mutations. CONCLUSIONS: Germline variants in BRCA1, BRCA2, PALB2 or ATM are independent prognostic factors of the short duration of response to hormonal therapy in advanced PCa.
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Narita S.
International Journal of Urology ( International Journal of Urology ) 29 ( 10 ) 1147 - 1154 2022年10月
OBJECTIVE: This study aimed to assess survival outcomes in older patients with de novo metastatic prostate cancer who initially received androgen deprivation therapy. METHODS: The retrospective multicenter study included 2784 men with metastatic prostate cancer who were treated with androgen deprivation therapy between 2008 and 2017. Patients were classified into <75, 75-79, and ≥80 age groups. Propensity score matching was conducted to assess the cancer-specific survival of the groups. The 5-year net overall survival of each group was derived to evaluate relative survival compared with the general population using the Pohar-Perme estimator and the 2019 Japan Life Table. RESULTS: During the follow-up (median, 34 months), 1014 patients died, of which 807 died from metastatic prostate cancer progression. Compared with the <75 group, the cancer-specific survival of the 75-79 group was similar (hazard ratio 1.07; 95% confidence interval 0.84-1.37; P = 0.580), whereas that of the ≥80 group was significantly worse (hazard ratio 1.41; 95% confidence interval 1.10-1.80; P = 0.006). The 5-year net overall survival of the <75, 75-79, and ≥80 age groups were 0.678, 0761, and 0.718, respectively. The 5-year net overall survival of patients aged ≥80 years with low- and high-volume disease were 0.893 and 0.586, respectively, which was comparable with those in patients aged <75 years (0.872 and 0.586, respectively). CONCLUSIONS: Older metastatic prostate cancer patients aged ≥80 years had poorer cancer-specific survival compared with younger patients. Conversely, 5-year net overall survival in older patients aged ≥80 years was comparable with that in younger patients aged <75 years.
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Yanagisawa T.
Prostate ( Prostate ) 82 ( 14 ) 1322 - 1330 2022年10月
BACKGROUND: Docetaxel-related adverse events (AEs) such as neutropenia and febrile neutropenia (FN) can be life-threatening. A previous in vivo study raised the hypothesis that the castration status affects the rate of hematologic AEs. We aimed to investigate the impact of castration status on the incidence of docetaxel-related AE in metastatic prostate cancer (mPCa) patients. METHODS: We retrospectively analyzed the records of 265 mPCa patients treated with docetaxel, comprising 92 patients with metastatic hormone-sensitive prostate cancer (mHSPC) and 173 patients with metastatic castration-resistant prostate cancer (mCRPC) between January 2015 and December 2021. Common terminology Criteria for Adverse Events (CTCAE) was applied to evaluate AEs. We analyzed the differential incidences between mHSPC and mCRPC, and risk factors of hematologic and nonhematologic AEs using a logistic regression model. RESULTS: The rate of patients who received primary prophylaxis against neutropenia was higher in those with the mHSPC compared with those with the mCRPC (7.5% vs. 33%, p < 0.001). Among the patients without primary prophylaxis, incidence rates of severe neutropenia (CTCAE ≥ Grade3) and FN were 89% and 16% in patients with mCRPC compared to 81% and 18% in those with mHSPC. Logistic regression analysis revealed that age ≥ 75 years and failure to provide primary prophylaxis were independent risk factors of severe neutropenia (odds ratio [OR]: 2.39, 95% confidential interval [CI]: 1.10-5.18 and OR: 15.8, 95% CI: 7.23-34.6, respectively). Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≧ 1 was an independent risk factor of FN (OR: 2.26, 95% CI: 1.13-4.54). Castration status (mHSPC vs. mCRPC) was not associated with the risks of severe neutropenia and FN. CONCLUSIONS: Castration status did not affect the risk of severe neutropenia or FN in mPCa patients treated with docetaxel regardless of the disease state. Failure to provide primary prophylaxis and advanced patient age are independent risk factors of severe neutropenia; while patients with poor PS are more likely to develop FN. These findings may help guide the clinical decision-making for proper candidate selection of docetaxel treatment.
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特集 限局性前立腺癌診療バイブル-このへんでキッチリと前立腺癌診療の"あたりまえ"を整理しよう! 〈高齢者・その他〉 高齢者限局性前立腺癌治療
成田 伸太郎
臨床泌尿器科 ( 株式会社医学書院 ) 76 ( 11 ) 844 - 850 2022年10月
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転移性腎癌におけるイピリムマブ・ニボルマブ併用療法の早期の耐性化と関連因子の検討
武藤 弓奈, 沼倉 一幸, 畠山 真吾, 関根 悠哉, 小林 瑞貴, 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
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 60回 P51 - 1 2022年10月
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転移性腎細胞癌患者におけるニボルマブ+イピリムマブ療法と免疫関連有害事象との関連
沼倉 一幸, 小林 瑞貴, 武藤 弓奈, 関根 悠哉, 嘉島 相輝, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 60回 O9 - 2 2022年10月
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Miura Y.
Prostate ( Prostate ) 82 ( 13 ) 1304 - 1312 2022年09月
BACKGROUND: The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration-sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden. METHODS: This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration-resistant prostate cancer (CRPC)-free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis. RESULTS: The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC-FS and OS compared with the conventional group, and this was also the case in the background-adjusted multivariable Cox regression analysis. CONCLUSION: Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC-FS and OS compared with similar age patients treated with conventional therapy in real-world practice. The oncological benefit may not diminish in this older population.
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Prevalence and risk estimation of cancer-predisposing genes for upper urinary tract urothelial carcinoma in Japanese.
Yuya Sekine, Yusuke Iwasaki, Nozomi Hakozaki, Mikiko Endo, Yoichiro Kamatani, Koichi Matsuda, Yoshinori Murakami, Takeshi Sano, Shusuke Akamatsu, Takashi Kobayashi, Hidewaki Nakagawa, Kazuyuki Numakura, Shintaro Narita, Tomonori Habuchi, Yukihide Momozawa
Japanese journal of clinical oncology 52 ( 12 ) 1441 - 1445 2022年09月
Upper urinary tract urothelial carcinoma is a rare cancer that has been associated with mismatch repair genes such as MLH1, MSH2, MSH6 and PMS2. In addition, patients with pathogenic variants of cancer-predisposing genes such as BRCA1 and BRCA2 have been reported. However, how cancer-predisposing genes affect the risk of upper urinary tract urothelial carcinoma in the Japanese population remains unclear. Thus, we performed a case-control sequencing study of 27 cancer-predisposing genes in 208 upper urinary tract urothelial carcinoma patients and 37 727 controls. Only MSH6 and MSH2 were observed with a value of P < 0.05. However, there was no difference in the prevalence of pathogenic variants of BRCA1/2, which does not support the use of a poly adenosine diphosphate-ribose polymerase inhibitor in patients with upper urinary tract urothelial carcinoma. Only mismatch repair genes were associated with patients with upper urinary tract urothelial carcinoma, but the prevalence of pathogenic variants in mismatch repair genes was lower than that reported in previous studies from other populations.
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Narita S.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 27 ( 9 ) 1477 - 1486 2022年09月
PURPOSE: We assessed clinical outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) treated with two upfront therapies. METHODS: The medical records of 301 patients with mCSPC treated with androgen deprivation therapy plus upfront abiraterone acetate (ABI) or docetaxel (DOC) between 2014 and 2021 were retrospectively reviewed. Propensity score matching (PSM) was performed to compare survival outcomes. Subgroup analyses of risk factors for second progression were conducted. RESULTS: A total of 95 patients received upfront DOC, whereas 206 received upfront ABI. After PSM, the ABI group had a significantly better castration-resistant prostate cancer (CRPC)-free survival than the DOC group [hazard ratio (HR), 0.53; 95% confidence interval (CI), 0.34-0.82]. Second progression-free survival (PFS2) tended to be longer in the ABI group than in the DOC group, but the difference was not statistically significant (HR, 0.64; 95% CI, 0.33-1.22). No significant difference in overall survival (OS) was found between the two groups (HR, 0.92; 95% CI, 0.42-2.03). In the subgroup analysis, upfront ABI had significantly favorable PFS2 in patients aged ≥ 75 years compared with upfront DOC (p = 0.038). Four risk factors for second progression (primary Gleason 5, liver metastasis, high serum alkaline phosphatase level, and high serum lactate dehydrogenase level) successfully stratified patients into three risk groups. CONCLUSIONS: Upfront ABI provided better CRPC-free survival than upfront DOC; however, no significant differences in PFS2 or OS were observed between the two groups. Personalized management based on prognostic risk factors may benefit patients with mCSPC treated with upfront intensified therapies.
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診断に難渋したIVC浸潤を伴う腫瘍マーカー陰性NSGCTの1例
佐々木 禎, 奈良 健平, 小泉 淳, 石田 雅則, 青山 有, 梶原 知佳, 嘉島 相輝, 山本 竜平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 9 ) 1022 - 1022 2022年09月
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Carney複合に合併した難治性性索間質性腫瘍の1例
天野 賢士, 嘉島 相輝, 小泉 淳, 南條 博, 赤井 太郎, 明円 真吾, 安達 尚宣, 川村 貞文, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 安田 純, 荒井 陽一, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 9 ) 1021 - 1021 2022年09月
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【新規保険収載ロボット支援手術手技を極める】ロボット支援腎尿管全摘除術
成田 伸太郎, 齋藤 満, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 9 ) 954 - 959 2022年09月
2022年の診療報酬改定でロボット支援腎尿管摘除術(Robot-assisted laparoscopic nephroureterectomy:RNU)が保険収載となった。当科の初期成績は良好で、膀胱カフ切除までの操作がPatient Cartのポジション変更なく可能であった。至適ポート位置、リンパ節郭清手技、後腹膜アプローチに関しては今後検討が必要である。(著者抄録)
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細胞質内におけるコネキシン43の発現が腎細胞癌の予後に与える影響(High expression of Connexin 43 in cytoplasm relates to worse clinical outcomes in patients with renal cell carcinoma)
小林 瑞貴, 大森 泰文, 沼倉 一幸, 関根 悠哉, 武藤 弓奈, 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 ) 81回 P - 3190 2022年09月
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A CASE OF RENAL ANASTOMOSING HEMANGIOMA
Sasaki Y.
Acta Urologica Japonica ( Acta Urologica Japonica ) 68 ( 8 ) 265 - 269 2022年08月
A 65-year-old man was found to have a 1.7 cm right renal mass by follow-up abdominal computed tomography for left total nephrectomy after a traffic accident. The renal mass progressed slowly to 2.2 cm in three years and enhanced magnetic resonance imaging revealed marked T2 weighting hyperintensity of the lesion. Although a radiologist (TK) suggested the diagnosis renal anastomosing hemangioma preoperatively, we could not deny the possibility of renal cell carcinoma completely. Therefore, the patient underwent robot-assisted laparoscopic partial nephrectomy. The tumor was successfully removed without any renal arterial clamping or parenchymal excision. Histopathologically, the lesion was composed of capillary-size blood vessels lined by a single layer of endothelial cells, and was diagnosed as a renal anastomosing hemangioma. There were no signs of postoperative recurrence during the 3 month follow-up.
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Kobayashi M.
BJU International ( BJU International ) 130 ( 2 ) 226 - 234 2022年08月
OBJECTIVES: To assess the impact of histological variants on survival and response to treatment with pembrolizumab in patients with chemo-resistant urothelial carcinoma (UC). PATIENTS AND METHODS: The medical records of 755 patients with advanced UC who received pembrolizumab were reviewed retrospectively. Patients were classified into pure UC (PUC) and each variant. Best overall response (BOR) and overall survival (OS) were compared between the groups using a propensity score matching (PSM). RESULTS: Overall, 147 (19.5%) patients harboured any histological variant UC (VUC). After PSM, there were no significant differences in the objective response rate (ORR, 24.5% vs 17.3%, P = 0.098) or disease control rate (DCR, 36.7% vs 30.2%, P = 0.195) when comparing patients with any VUC and PUC. Furthermore, any VUC, as compared with PUC, was associated with a similar risk of death (hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.68-1.20; P = 0.482). Squamous VUC, which was the most frequent variant in the cohort, had a comparable ORR, DCR and OS as compared with PUC or non-squamous VUC. The patients with sarcomatoid VUC (n = 19) had significantly better ORR (36.8%, P = 0.031), DCR (52.6%, P = 0.032), and OS (HR 0.37, 95% CI 0.15-0.90; P = 0.023) compared to patients with PUC. CONCLUSIONS: The presence of variant histology did not seem to affect BOR or OS after pembrolizumab administration in patients with chemo-resistant UC. The patients with sarcomatoid VUC achieved favourable responses and survival rates compared to PUC.
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Iwamura H.
Cancer Science ( Cancer Science ) 113 ( 7 ) 2434 - 2445 2022年07月
Early diagnosis of urological diseases is often difficult due to the lack of specific biomarkers. More powerful and less invasive biomarkers that can be used simultaneously to identify urological diseases could improve patient outcomes. The aim of this study was to evaluate a urological disease-specific scoring system established with a machine learning (ML) approach using Ig N-glycan signatures. Immunoglobulin N-glycan signatures were analyzed by capillary electrophoresis from 1312 serum subjects with hormone-sensitive prostate cancer (n = 234), castration-resistant prostate cancer (n = 94), renal cell carcinoma (n = 100), upper urinary tract urothelial cancer (n = 105), bladder cancer (n = 176), germ cell tumors (n = 73), benign prostatic hyperplasia (n = 95), urosepsis (n = 145), and urinary tract infection (n = 21) as well as healthy volunteers (n = 269). Immunoglobulin N-glycan signature data were used in a supervised-ML model to establish a scoring system that gave the probability of the presence of a urological disease. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC). The supervised-ML urologic disease-specific scores clearly discriminated the urological diseases (AUC 0.78-1.00) and found a distinct N-glycan pattern that contributed to detect each disease. Limitations included the retrospective and limited pathological information regarding urological diseases. The supervised-ML urological disease-specific scoring system based on Ig N-glycan signatures showed excellent diagnostic ability for nine urological diseases using a one-time serum collection and could be a promising approach for the diagnosis of urological diseases.
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Overview of clinical management for older patients with renal cell carcinoma
Numakura K.
Japanese Journal of Clinical Oncology ( Japanese Journal of Clinical Oncology ) 52 ( 7 ) 657 - 673 2022年07月
The rapidly increasing pool of older patients being diagnosed with and surviving their cancer is creating many challenges. Regarding localized renal cell carcinoma, surgery is considered as gold standard treatment options even in older men, whereas active surveillance and ablation therapy are alternative options for a proportion of these patients. With regard to advanced disease, anti-vascular endothelial growth factor tyrosine kinase inhibitors (VEGFR-TKI) and immune check point inhibitor are standard treatment modalities, although treatment choice from multiple regimens and prevention of adverse events need to be considered. Better assessment techniques, such as comprehensive geriatric assessment to meet the unique needs of older patients, are a central focus in the delivery of high-quality geriatric oncology care. Through this process, shared decision-making should be adopted in clinical care to achieve optimal goals of care that reflect patient and caregiver hopes, needs and preferences. It is necessary to continue investigating oncological outcomes and complications associated with treatment in this population to ensure appropriate cancer care. In this narrative review, we completed a literature review of the various treatments for renal cell carcinoma in older patients that aimed to identify the current evidence related to the full range of the treatments including active surveillance, surgery, ablation therapy and systemic therapy. Prospectively designed studies and studies regarding geriatric assessment were preferentially added as references. Our goals were to summarize the real-world evidence and provide a decision framework that guides better cancer practices for older patients with renal cell carcinoma.
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Shiota M.
Cancer Science ( Cancer Science ) 113 ( 7 ) 2386 - 2396 2022年07月
The treatment for lymph node involvement (LNI) after radical prostatectomy (RP) has not been established. This study aimed to reveal the outcomes of various management strategies among patients with LNI after RP. Retrospectively, 561 patients with LNI after pelvic lymph node dissection (PLND) with RP treated between 2006 and 2019 at 33 institutions participating in the Japanese Urological Oncology Group were investigated. Metastasis-free survival (MFS) was the primary outcome. Patients were stratified by prostate-specific antigen (PSA) persistence after RP. Cox regression models were used to analyze the relationships between clinicopathological characteristics and survival. Survival analyses were conducted using the Kaplan-Meier method and log-rank test with or without propensity score matching. Prognoses, including MFS and overall survival, were prominently inferior among patients with persistent PSA compared with those without persistent PSA. In multivariate analysis, androgen deprivation therapy (ADT) plus radiotherapy (RT) was associated with better MFS than ADT alone among patients with persistent PSA (hazard ratio = 0.37; 95% confidence interval = 0.15-0.93; p = 0.034). Similarly, MFS and overall survival were significantly better for ADT plus RT than for ADT alone among patients with persistent PSA after propensity score matching. This study indicated that PSA persistence in LNI prostate cancer increased the risk of poor prognoses, and intensive treatment featuring the addition of RT to ADT might improve survival.
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Kobayashi M.
Genes ( Genes ) 13 ( 7 ) 2022年07月
Single nucleotide polymorphisms (SNPs) reportedly influence the effect of nivolumab in metastatic renal cell carcinoma (mRCC). This study aimed to evaluate the relationship between the clinical outcomes of patients with mRCC and SNPs in programmed cell death protein 1 (PD-1) protein-coding gene (PDCD1) and explore any potential correlation with patient prognosis and incidence of immune-related adverse events (irAEs). In total, 106 patients with mRCC, who were treated with nivolumab alone (n = 59) or nivolumab and ipilimumab (n = 47), were enrolled in the study. Three SNPs in the PDCD1 gene, namely PD-1.3, PD-1.5, and PD-1.6, were assessed. Patients harboring the PD-1.6 G allele experienced more severe (odds ratio, 3.390; 95% confidence interval 1.517-7.756; p = 0.003) and multiple (OR, 2.778; 95% CI, 1.020-6.993 p = 0.031) irAEs than those harboring the AA genotype. Thus, the existence of the PDCD1 PD-1.6 polymorphism (G allele) was associated with the occurrence of severe and multiple irAEs in patients with mRCC. Further evaluation of PDCD1 polymorphisms might help identify patients experiencing irAE by nivolumab treatment.
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当院泌尿器科でのFoundationOneCDxがんゲノムプロファイリング施行症例の検討
石田 雅宣, 成田 伸太郎, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 臨増 ) 833 - 833 2022年07月
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山本 竜平, 齋藤 満, 提箸 隆一郎, 齋藤 拓郎, 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
泌尿器外科 ( 医学図書出版(株) ) 35 ( 臨増 ) 805 - 805 2022年07月
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蘇武 竜太, 沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 臨増 ) 814 - 814 2022年07月
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転移性腎細胞癌に対するニボルマブ+イピリムマブ併用療法のirAEと治療効果の関連についての検討
蘇武 竜太, 沼倉 一幸, 畠山 真吾, 関根 悠哉, 武藤 弓奈, 小林 瑞貴, 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
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 52 ) 34 - 34 2022年07月
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合併症軽減を目指したRARC・ICUDの術式の確立 当科における尿管トラブルを回避する術式の標準化
成田 伸太郎, 沼倉 一幸, 齋藤 満, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 臨増 ) 781 - 783 2022年07月
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Sekine Y.
Human Molecular Genetics ( Human Molecular Genetics ) 31 ( 12 ) 1962 - 1969 2022年06月
Identifying causative genes via genetic testing is useful for screening, preventing and treating cancer. Several hereditary syndromes occur in patients with renal cell carcinoma (RCC). However, the evidence is from the European population; it remains unclear how the RCC-related genes and other cancer-predisposing genes contribute to RCC development in the Japanese population. A case-control study of 14 RCC-related genes and 26 cancer-predisposing genes was performed in 1563 Japanese patients with RCC and 6016 controls. The patients were stratified into clear cell RCC (ccRCC) or non-ccRCC (nccRCC). Gene-based analysis of germline pathogenic variants in patients with each subtype and cancer-free subjects was performed. Following quality control, 1532 patients with RCC and 5996 controls were analyzed. For ccRCC, 52 of 1283 (4.05%) patients carried pathogenic variants mainly in the cancer-predisposing genes such as TP53 (P = 1.73 × 10-4; OR, 5.8; 95% CI, 2.2-15.7). Approximately 80% of patients with pathogenic variants in TP53 had p.Ala189Val that was specific in East Asian population. For nccRCC, 14 of 249 (5.62%) patients carried pathogenic variants mainly in the RCC-related genes such as BAP1 and FH (P = 6.27 × 10-5; OR, Inf; 95% CI, 10.0-Inf). The patients with the pathogenic variants in the associated genes were diagnosed 15.8 years earlier and had a higher proportion of patients with a family history of RCC (OR, 20.0; 95% CI, 1.3-237.4) than the non-carriers. We showed different and population-specific contributions of risk genes between ccRCC and nccRCC in Japanese for improved personalized medicine.
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Management of prostate cancer in older patients
Narita S.
Japanese Journal of Clinical Oncology ( Japanese Journal of Clinical Oncology ) 52 ( 6 ) 513 - 525 2022年06月
The incidence of prostate cancer among older men has increased in many countries, including Asian countries. However, older patients are ineligible for inclusion in large randomized trials, and the existing guidelines for the management of patients with prostate cancer do not provide specific treatment recommendations for older men. Therefore, generation of evidence for older patients with prostate cancer is a key imperative. The International Society of Geriatric Oncology has produced and updated several guidelines for management of prostate cancer in older men since 2010. Regarding localized prostate cancer, both surgery and radiotherapy are considered as feasible treatment options for intermediate- and high-risk prostate cancer even in older men, whereas watchful waiting and active surveillance are useful options for a proportion of these patients. With regard to advanced disease, androgen-receptor axis targets and taxane chemotherapy are standard treatment modalities, although dose modification and prevention of adverse events need to be considered. Management strategy for older patients with prostate cancer should take cognizance of not only the chronological age but also psychological and physical condition, socio-economic status and patient preferences. Geriatric assessment and patient-reported health-related quality of life are important tools for assessing health status of older patients with prostate cancer; however, there is a paucity of evidence of the impact of these tools on the clinical outcomes. Personalized management according to the patient's health status and tumour characteristics as well as socio-economic condition may be necessary for treatment of older patients with prostate cancer.
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当院における副腎癌12例の検討
青山 有, 沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内分泌外科学会雑誌 ( (一社)日本内分泌外科学会 ) 39 ( Suppl.1 ) S205 - S205 2022年06月
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未来へ向かう診断・治療 BRAF V600E変異は副腎腫瘍からのコルチゾール産生を亢進する
沼倉 一幸, 小林 瑞貴, 武藤 弓奈, 嘉島 相輝, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内分泌外科学会雑誌 ( (一社)日本内分泌外科学会 ) 39 ( Suppl.1 ) S101 - S101 2022年06月
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Narita S.
World Journal of Urology ( World Journal of Urology ) 40 ( 5 ) 1135 - 1141 2022年05月
PURPOSE: This study investigated the impact of treatment intensification with upfront docetaxel (DOC) or abiraterone (ABI) plus prednisolone on survival outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) by comparing it with androgen deprivation therapy (ADT) monotherapy or combined androgen blockade (CAB) using propensity score matching (PSM). METHODS: Outcomes from 278 CHAARTED high-volume patients receiving upfront DOC (92 patients) or upfront ABI (186 patients) were compared to those from 354 patients receiving ADT or CAB. PSM was conducted to assess castration-resistant prostate cancer-free survival (CRPCFS) and overall survival (OS). RESULTS: After PSM, patient distributions between the three groups were well balanced. After 1:1 PSM, patients receiving upfront ABI had significantly better CRPCFS than those receiving ADT/CAB or upfront DOC [hazard ratio (HR) 0.39; 95% CI 0.27-0.56 vs. HR 0.50; 95% CI 0.30-0.82, respectively]. No significant difference in CRPCFS was observed between the upfront DOC and ADT/CAB groups (HR 0.75; 95% CI 0.50-1.12). Patients receiving upfront DOC and upfront ABI had significantly better OS than those receiving ADT/CAB (HR 0.54; 95% CI 0.0.30-0.98 vs. HR 0.49; 95% CI 0.29-0.84, respectively). However, no significant difference in OS was observed between upfront ABI and upfront DOC (hazard ratio 0.84; 95% CI 0.34-2.06). CONCLUSION: The comparison of real-world retrospective cohorts showed that treatment intensification with upfront DOC or upfront ABI promoted better OS compared to ADT alone or CAB in patients with high-volume mCSPC after PSM. However, no difference in OS was observed between upfront DOC and upfront ABI.
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ロボット支援下手術の現状と展望 ロボット支援腹腔鏡下膀胱全摘+体腔内回腸新膀胱・回腸導管作成のコツと成績
沼倉 一幸, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本外科系連合学会誌 ( 日本外科系連合学会 ) 47 ( 3 ) 306 - 306 2022年05月
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高齢腎移植レシピエントの治療成績 免疫抑制薬の薬物動態解析から
提箸 隆一郎, 齋藤 満, 青山 有, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則, 藤山 信弘
日本老年泌尿器科学会誌 ( 日本老年泌尿器科学会 ) 35 ( 1 ) 155 - 155 2022年05月
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Morozumi K.
International Journal of Urology ( International Journal of Urology ) 29 ( 4 ) 324 - 331 2022年04月
OBJECTIVE: We evaluated the impact of Gleason pattern 5 presence on prognosis among de novo metastatic hormone-sensitive prostate cancer patients with a Gleason score ≥8. METHODS: The data of 559 patients diagnosed as metastatic hormone-sensitive prostate cancer with a Gleason score ≥8, who were initially treated with androgen deprivation therapy from 2008 to 2016, were retrospectively collected. Patients were divided into two groups as high and low volume based on the CHAARTED trial criteria. RESULTS: The median overall survival of the 559 metastatic hormone-sensitive prostate cancer patients with Gleason score ≥8 was 70 months, with a median follow-up period of 36 months. Gleason pattern 5 was confirmed in 341 patients (61.0%), in which primary Gleason pattern 5 was confirmed in 164 patients (29.3%). The number of patients with high metastatic volume group was 363 (64.9%). In total and high metastatic volume groups, hemoglobin and lactate dehydrogenase were significant factors for predicting overall survival, but both Gleason pattern 5 and primary Gleason pattern 5 did not show a statistically significant difference. In the low-volume metastatic group, the median overall survival in patients with or without primary Gleason pattern 5 was 40 and 78 months, respectively. In multivariate analysis, only primary Gleason pattern 5 was an independent predictive factor for overall survival in the low-volume metastatic group (hazard ratio 2.76, 95% confidence interval 1.88-8.67; P = 0.0026). CONCLUSION: The presence of Gleason pattern 5 was not associated with overall survival in metastatic hormone-sensitive prostate cancer with a Gleason score ≥8. In low-metastatic volume metastatic hormone-sensitive prostate cancer, primary Gleason pattern 5 was a poor prognostic factor, which might show a separate treatment option for this group.
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Tamura D.
Diagnostics ( Diagnostics ) 12 ( 4 ) 2022年04月
Although giant hydronephrosis (GH) associated with ureteropelvic junction obstruction (UPJO) is extremely rarely detected in pregnant women, diagnostic methods, therapeutic approaches, and perinatal management have not been established. A 31-year-old Japanese primipara had a 15 cm × 12 cm multi-cystic mass in the right abdomen detected by transabdominal ultrasound at gestational week 26. Magnetic resonance imaging revealed that the mass was right renal GH. She underwent serial ultrasound-guided transretroperitoneal drainage as conservative treatment. She delivered vaginally at gestational week 36. Since she had flank pain and a documented non-functional right kidney, laparoscopic nephrectomy was conducted 22 months after delivery. UPJO with fewer smooth muscle cells and fibrosis was histologically diagnosed in the surgical specimen. Her postpartum and postoperative courses were uneventful for 10 months. We performed a literature review of diagnostic methods, clinical characteristics, and perinatal management in pregnant women with GH due to UPJO.
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大久保 佳祐, 小泉 淳, 高橋 佳子, 提箸 隆一郎, 森 奏美, 蘇武 竜太, 佐藤 博美, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 4 ) 360 - 360 2022年04月
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IgG4関連疾患を背景に前立腺癌治療後、急速に発症したびまん性大細胞型B細胞リンパ腫の一例
森 瑞季, 山本 竜平, 中村 岳, 武藤 弓奈, 嘉島 相輝, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 4 ) 356 - 356 2022年04月
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ロボット支援膀胱前立腺尿道摘除後に生じた会陰ヘルニアによる絞扼性腸閉塞の1例
小松 夕姫, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 4 ) 357 - 357 2022年04月
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梶原 知佳, 山本 竜平, 手塚 崇文, 嘉島 相輝, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 35 ( 4 ) 361 - 361 2022年04月
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免疫抑制薬MMF併用が有効であったニボルマブ関連ステロイド抵抗性の口腔粘膜炎
中村 岳, 奈良 健平, 高橋 修平, 中島 志織, 小林 瑞貴, 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) ) 35 ( 4 ) 353 - 353 2022年04月
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Kobayashi M.
Cancer Immunology, Immunotherapy ( Cancer Immunology, Immunotherapy ) 71 ( 3 ) 727 - 736 2022年03月
The intravesical administration of bacillus Calmette-Guérin (BCG) is widely used to control the intravesical recurrence of non-muscle-invasive bladder cancer (NMIBC). This study aimed to reveal the effects of zygosity on human leukocyte antigen (HLA) genes and individual HLA genotypes on intravesical recurrence after intravesical BCG therapy for NMIBC. This study included Japanese patients who had received intravesical BCG for NMIBC. HLA genotyping of HLA-A, B, C, and DRB1 was performed. The effect of HLA zygosity and HLA genotype on intravesical recurrence was evaluated. Among 195 patients, those homozygous for the HLA-B supertype were more likely than those heterozygous for the HLA-B supertype to experience intravesical recurrence by univariate analysis (hazard ratio [HR], 95% confidence interval [CI]; 1.87, 1.14-3.05, P = 0.012) and multivariate analysis (HR, 95% CI; 2.26, 1.02-5.01, P = 0.045). Patients with B07 or B44 had a decreased risk of intravesical recurrence by univariate analysis (HR, 95% CI; 0.43, 0.24-0.78, P = 0.0056) and multivariate analysis (HR, 95% CI; 0.36, 0.16-0.82, P = 0.016). This study suggests the importance of the diversity and specificity of HLA-B loci in the antitumor effect of BCG immunotherapy for NMIBC. These findings may contribute to the delineation of risk strata for BCG therapy and improve the medical management of NMIBC.
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Management of bladder cancer in older patients
Hatakeyama S.
Japanese Journal of Clinical Oncology ( Japanese Journal of Clinical Oncology ) 52 ( 3 ) 203 - 213 2022年03月
Evidence has shown that patients with bladder cancer are diagnosed at a much older age compared with those with other cancers. Given that co-morbidities and frailty are prevalent in older patients with advanced bladder cancer, they are easily excluded from randomized controlled trials. As little evidence has been available regarding assessment tools for frailty, the management of those patients remains challenging. This weakness is strongly manifested in muscle-invasive bladder cancer. Despite radical cystectomy is the standard of care for bladder cancer, there is an extensive undertreatment of older adult patients with potentially curative muscle-invasive bladder cancer. However, it is also true that radical cystectomy is often unsuitable for vulnerable or frail patients. Bladder preservation using trimodality therapy has been utilized as an alternative option, but the appropriate selection criteria for trimodality therapy remain unclear. Cisplatin-based regimens have been the first choice for advanced disease among eligible patients. Moreover, immunotherapy appears to have similar benefits and tolerability in both older and younger patients. Furthermore, palliative or supportive interventions need to be initiated earlier in patients with metastatic disease. Accumulating evidence suggests that frailty may play a key role in the selection of treatment modalities. Older patients should be considered for standard treatment based on frailty and not chronological age. Moreover, older patients with bladder cancer need to undergo geriatric assessment for proper decision-making.
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Prognostic impact of proton pump inhibitors for immunotherapy in advanced urothelial carcinoma.
Yoshiharu Okuyama, Shingo Hatakeyama, Kazuyuki Numakura, Takuma Narita, Toshikazu Tanaka, Yuki Miura, Daichi Sasaki, Daisuke Noro, Noriko Tokui, Teppei Okamoto, Hayato Yamamoto, Shintaro Narita, Takahiro Yoneyama, Yasuhiro Hashimoto, Tomonori Habuchi, Chikara Ohyama
BJUI compass 3 ( 2 ) 154 - 161 2022年03月
OBJECTIVE: To evaluate the effects of the concomitant use of proton pump inhibitors (PPIs) and/or antibiotics (Abs) on oncological outcomes in patients with advanced urothelial carcinoma. PATIENTS AND METHODS: We retrospectively evaluated 155 patients with advanced urothelial carcinoma who were treated with immune checkpoint inhibitors (ICIs) between August 2015 and April 2021. The concomitant use of PPI or Abs was defined as any PPI or Abs administered within 30 days before ICI initiation and during ICI therapy. The primary outcomes were the effect of PPI and/or Abs use on the objective response rate (ORR) and immune-related adverse events (irAEs). The secondary outcomes were the effects of PPI and/or Abs use on progression-free survival (PFS) and overall survival (OS) after ICI therapy analyzed using the inverse probability of treatment weighting-adjusted Cox regression analysis. RESULTS: Of the 155 patients enrolled in the study, 99 (64%) were PPI users and 56 (36%) Abs users. PPI users were associated with a significantly poorer ORR than non-PPI users (41% vs. 20%, respectively), whereas Abs use was not significantly associated with changes in ORR. The rate of irAEs was not significantly associated with the use of PPIs or Abs. Multivariate inverse probability of treatment weighting-adjusted Cox regression analysis revealed significantly poorer PFS and OS in PPI users than in non-PPI users, whereas Abs use was not associated with poorer outcomes. CONCLUSION: The concomitant use of PPI may adversely affect oncological outcomes in patients with locally advanced or metastatic urothelial carcinoma treated with ICI therapy.
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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誌 ( 日本腎泌尿器疾患予防医学研究会 ) 30 ( 1 ) 60 - 62 2022年03月
抗PD-1抗体であるニボルマブは、転移性腎細胞癌(mRCC)に対する標準治療薬であるが、完全奏効例がある一方で、まったく効果なく病勢進行することもあり、また免疫関連有害事象(irAE)のため投与を中止せざるをえない例もある。PD-1タンパク質コード遺伝子(PDCD1)には幾つかの一塩基多型(SNP)が存在し、それらがPD-1の機能に関連する可能性がある。そこで今回、PDCD1のSNPとニボルマブの効果・有害事象との関連について、mRCC患者70例を対象に検討した。結果、PDCD1のSNPとニボルマブの効果との間には有意な関連は認められなかったが、有害事象についてはSNPのうちPD-1.6が複数のirAEと有意に関連していた。
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Clinical Utility of Germline Genetic Testing in Japanese Men Undergoing Prostate Biopsy
Akamatsu S.
JNCI Cancer Spectrum ( JNCI Cancer Spectrum ) 6 ( 1 ) 2022年02月
BACKGROUND: Multiple common variants and also rare variants in monogenic risk genes such as BRCA2 and HOXB13 have been reported to be associated with risk of prostate cancer (PCa); however, the clinical setting in which germline genetic testing could be used for PCa diagnosis remains obscure. Herein, we tested the clinical utility of a 16 common variant-based polygenic risk score (PRS) that has been developed previously for Japanese men and also evaluated the frequency of PCa-associated rare variants in a prospective cohort of Japanese men undergoing prostate biopsy. METHODS: A total of 1336 patients undergoing first prostate biopsy were included. PRS was calculated based on the genotype of 16 common variants, and sequencing of 8 prostate cancer-associated genes was performed by multiplex polymerase chain reaction based target sequencing. PRS was combined with clinical factors in logistic regression models to assess whether addition of PRS improves the prediction of biopsy positivity. RESULTS: The top PRS decile was associated with an odds ratio of 4.10 (95% confidence interval = 2.46 to 6.86) with reference to the patients at average risk, and the estimated lifetime absolute risk approached 20%. Among the patients with prostate specific antigen 2-10 ng/mL who had prebiopsy magnetic resonance imaging, high PRS had an equivalent impact on biopsy positivity as a positive magnetic resonance imaging finding. Rare variants were detected in 19 (2.37%) and 7 (1.31%) patients with positive and negative biopsies, respectively, with BRCA2 variants being the most prevalent. There was no association between PRS and high-risk rare variants. CONCLUSIONS: Germline genetic testing could be clinically useful in both pre- and post-PSA screening settings.
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Specific Gut Microbial Environment in Lard Diet-Induced Prostate Cancer Development and Progression
Sato H.
International Journal of Molecular Sciences ( International Journal of Molecular Sciences ) 23 ( 4 ) 2022年02月
Lard diet (LD) is a risk factor for prostate cancer (PCa) development and progression. Two immunocompetent mouse models fed with isocaloric specific fat diets (LD) enriched in saturated and monounsaturated fatty acid (SMFA), showed significanftly enhanced PCa progression with weight gain compared with a fish oil diet (FOD). High gut microbial divergency resulted from difference in diets, and the abundance of several bacterial species, such as in the orders Clostridiales and Lactobacillales, was markedly altered in the feces of LD- or FOD-fed mice. The proportion of the order Lactobacillales in the gut was negatively involved in SMFA-induced body weight gain and PCa progression. We found the modulation of lipid metabolism and cholesterol biosynthesis pathways with three and seven commonly up- and downregulated genes in PCa tissues, and some of them correlated with the abundance of the order Lactobacillales in mouse gut. The expression of sphingosine 1-phosphate receptor 2, which is associated with the order Lactobacillales and cancer progression in mouse models, was inversely associated with aggressive phenotype and weight gain in patients with PCa using the NCBI Gene Expression Omnibus database. Therefore, SMFA may promote PCa progression with the abundance of specific gut microbial species and overexpression of lipogenic genes in PCa. Therapeutics with alteration of gut microbiota and candidate genes involved in diet-induced PCa progression may be attractive in PCa.
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術前レシピエント肥満が腎移植後のアウトカムに与える影響
山本 竜平, 齋藤 満, 藤山 信弘, 齋藤 拓郎, 提箸 隆一郎, 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
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 55回 233 - 233 2022年02月
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レムデシビルが奏功した生体腎移植後患者におけるCOVID-19の一例
青山 有, 齋藤 満, 齋藤 拓郎, 提箸 隆一郎, 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
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 55回 222 - 222 2022年02月
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免疫抑制療法 mTOR阻害薬最適化 各施設のプロトコールから mTOR阻害薬を含む免疫抑制プロトコール 見えてきた効果と課題
齋藤 満, 佐藤 滋, 藤山 信弘, 青山 有, 提箸 隆一郎, 齋藤 拓郎, 山本 竜平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 55回 101 - 101 2022年02月
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Kanda S.
Asian journal of endoscopic surgery ( Asian journal of endoscopic surgery ) 15 ( 1 ) 63 - 69 2022年01月
OBJECTIVES: We retrospectively investigated if robot-assisted laparoscopic partial nephrectomy (RAPN) contributes to a decrease in resected parenchymal volume (RPV), an increase in postoperative parenchymal volume (PPV), and an improvement of postoperative renal function when compared with conventional laparoscopic partial nephrectomy (LPN) using a three-dimensional image analysis system. METHODS: Patients who underwent LPN (n = 37) and RAPN (n = 66) from November 2013 to November 2018 were included in this study. All patients had a tumor diameter of 4 cm or less. Patients with an anatomical or functional single kidney were excluded. RPV and PPV were measured using SYNAPSE VINCENT®. The surgical outcomes were compared between the two groups. RESULTS: Warm ischemic time in the RAPN group was significantly shorter than that in the LPN group (p < 0.001). The ratio of RPV to tumor volume (RPV/TV) in the RAPN group was significantly lower than that in the LPN group (p = 0.016). PPV in the RAPN group was significantly higher than that in the LPN group (p = 0.049). The decreased estimated glomerular filtration rate in the RAPN group was significantly lower than that in the LPN group on days 1, 7, 30, 90, and 180 after surgery. CONCLUSIONS: Postoperative renal function in the RAPN group was significantly better than that in the LPN group in both the short and long term. In addition to a short warm ischemia time, the decreased RPV/TV and increased PPV may have contributed to the improvement of postoperative renal function.
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Nishiyama N.
Journal of Geriatric Oncology ( Journal of Geriatric Oncology ) 13 ( 1 ) 88 - 93 2022年01月
BACKGROUND: We used real-world and large-scale data to assess the clinical efficacy and safety of pembrolizumab in older patients with advanced urothelial carcinoma (UC). METHODS: A total of 608 patients who received pembrolizumab for the treatment of chemoresistant UC were retrospectively analyzed. All patients were histologically diagnosed with pure UC. Using propensity score matching (PSM) (ECOG performance status, site of metastasis, hemoglobin level and neutrophil-to-lymphocyte ratio, 1:1 matching), the overall survival (OS) and adverse events (AEs) of patients <75 and ≥75 years old were compared. RESULTS: The median follow-up (IQR) period was 16.1 (9.9-20.5) months. After PSM, there were 215 patients each in the aged <75 years and aged ≥75-year-old groups. The median OS of all patients was estimated to be 10.4 months (95% confidence interval [CI] = 8.8-12.1). After PSM, the median OS was 7.8 months (95% CI = 5.2-10.4) in the <75-year-old group and 10.4 months (95% CI = 7.3-13.5) in the ≥75-year-old group (P = 0.186). Any-grade AEs were more frequently reported in the ≥75-year-old group in comparison to the age <75-year-old group (55.3% vs. 41.9%, P = 0.007), whereas there was no significant difference between the two groups in the incidence of grade ≥3 AEs (10.2% vs. 12.6%, P = 0.544). The objective response rate, defined as complete remission or a partial response, was 22.8% in the <75-year-old group and 25.1% in the ≥75-year-old group (P = 0.651). CONCLUSIONS: The present study demonstrates that age does not affect the efficacy and safety of pembrolizumab treatment for advanced chemoresistant UC. Pembrolizumab treatment should not be avoided based on chronological age; however, close monitoring for the development of treatment-related AE should be considered for older patients.
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Inoue T.
Urology ( Urology ) 167 158 - 164 2022年
OBJECTIVE: To compare the therapeutic effect of Bacille Calmette-Guérin (BCG) intravesical instillation in older and younger patients with high-risk non-muscle-invasive bladder cancer. The comparison was performed with propensity score matching (PSM) without terminating the death of the older patients using relatively large-scale retrospective data from multiple institutes in Japan. MATERIALS AND METHODS: Overall, 3283 patients diagnosed with non-muscle-invasive bladder cancer treated with intravesical BCG instillation during 2000-2018 in 31 institutes were examined; 1437 and 602 patients with high-grade T1 and Tis tumors were divided into those aged ≥75 and <75 years. Multivariate analysis using the Fine-Gray competing risks regression model before PSM and survival analysis using the cumulative incidence method after PSM were performed. RESULTS: In the pre-PSM series of high-grade T1 tumors, age ≥75 years was an independent prognostic factor for both recurrence and progression in multivariate analysis (P = .015 and P = .013). In the pre-PSM series with Tis tumor, no variables to predict recurrence and progression was found. In the post-PSM series of 870 high-grade T1 tumors, cumulative probability of recurrence after BCG intravesical instillation were significantly higher in patients aged ≥75 years than in those aged <75 years (P = .008). The frequency of discontinuation of BCG instillation in patients aged ≥75 years with high-grade T1 and Tis was not significantly different from those in patients aged <75 years (P = .564 and P = .869). CONCLUSION: The cumulative probability of recurrence after intravesical BCG instillation was significantly higher in older than in younger patients with high-grade T1 bladder cancer.
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Yanagisawa T.
World Journal of Urology ( World Journal of Urology ) 2022年
PURPOSE: The aim of this study was to investigate the oncologic efficacy of combining docetaxel with androgen deprivation therapy (ADT) versus nonsteroidal antiandrogen (NSAA) with ADT in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC) with focus on the effect of sequential therapy in a real-world clinical practice setting. METHODS: The records of 382 patients who harbored high-volume mHSPC, based on the CHAARTED criteria, and had received ADT with either docetaxel (n = 92) or NSAA (bicalutamide) (n = 290) were retrospectively analyzed. The cohorts were matched by one-to-one propensity scores based on patient demographics. Overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), including time to castration-resistant prostate cancer (CRPC), and time to second-line progression (PFS2) were compared. 2nd-line PFS defined as the time from CRPC diagnosis to progression after second-line therapy was also compared. RESULTS: After matching, a total of 170 patients were retained: 85 patients treated with docetaxel + ADT and 85 patients treated with NSAA + ADT. The median OS and CSS for docetaxel + ADT versus NSAA + ADT were not reached (NR) vs. 49 months (p = 0.02) and NR vs. 55 months (p = 0.02), respectively. Median time to CRPC and PFS2 in patients treated with docetaxel + ADT was significantly longer compared to those treated with NSAA (22 vs. 12 months; p = 0.003 and, NR vs. 28 months; p < 0.001, respectively). There was no significant difference in 2nd-line PFS between the two groups. CONCLUSIONS: Our analysis suggested that ADT with docetaxel significantly prolonged OS and CSS owing to a better time to CRPC and PFS2 in comparison to NSAA + ADT in high-volume mHSPC.
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Numakura K.
European Urology Focus ( European Urology Focus ) 8 ( 6 ) 1666 - 1672 2022年
BACKGROUND: Although bacillus Calmette-Guerin (BCG) is a standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), a high rate of adverse events with a variety of grades remains a difficulty. OBJECTIVE: In this randomized, prospective, multicenter study, we examined whether levofloxacin, given after each intravesical instillation of BCG, could improve its tolerance in patients with intermediate- to high-risk urothelial carcinoma of the bladder without compromising its efficacy. DESIGN, SETTING, AND PARTICIPANTS: Overall, 106 Japanese patients (85 men and 21 women; age: median, 69.5 yr) with primary or recurrent NMIBC were randomized after transurethral resection to induce treatment with intravesical BCG plus levofloxacin (group 1) or BCG alone (group 2). INTERVENTION: Patients who underwent intravesical instillation of BCG were randomized with or without levofloxacin administration. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Adverse events were assessed using the National Cancer Institute-Common Toxicity Criteria version 3.0. Cumulative incidence functions and Kaplan-Meier methods were applied to estimate survival outcomes. RESULTS AND LIMITATIONS: There was no significant difference in baseline characteristics between the groups. The completion rate of group 1 (85.5%) was not significantly lower than that of group 2 (76.5%; p = 0.321). There was no significant difference in the completion rate of patients with pollakisuria, painful micturition, gross hematuria, fever elevation, and others between the groups. The incidence of adverse events in patients with high-grade pollakisuria (7.3% vs 25.4%, p = 0.041) and fever (0% vs 9.1%, p = 0.034) was significantly lower in group 1. The 5-yr progression-free and cancer-specific survival rates were significantly better in group 1. CONCLUSIONS: Prophylactic levofloxacin administration may reduce the severity of adverse events and contribute to better outcomes from BCG intravesical therapy in patients with NMIBC. PATIENT SUMMARY: Levofloxacin administration seems to be a safe and effective therapy for non-muscle-invasive bladder cancer patients treated with bacillus Calmette-Guerin intravesical therapy.
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Takahashi S.
Cancer Science ( Cancer Science ) 113 ( 12 ) 4059 - 4069 2022年
Human leukocyte antigen class I (HLA-I) genotypes are suggested to influence the cancer response to checkpoint blockade immunotherapy. This study assessed the impact of germline HLA genotypes on clinical outcomes in patients with chemoresistant advanced urothelial cancer (UC) treated with pembrolizumab. Zygosity, supertypes, evolutionary divergency, and specific alleles of germline HLA-I and -II were evaluated using the Luminex technique in 108 patients with chemoresistant metastatic or locally advanced UC treated with pembrolizumab. Among the 108 patients, 69 died and 83 showed radiographic progression during follow-up. Homozygous for at least one HLA-I locus, absence of the HLA-A03 supertype, and high HLA-I evolutionary divergence were associated with a radiographic response, but were not associated with survival outcomes. Patients with the HLA-DQB1*03:01 allele had significantly lower disease control rates than patients without the allele (17.4% vs. 53.8%, p = 0.002); its presence was also an independent risk factor for progressive disease (hazard ratio 4.35, 95% confidence interval 1.03-18.46). Furthermore, patients with the HLA-DQB1*03:01 allele had significantly worse progression-free survival than patients without the allele (median progression-free survival 3.1 vs. 4.8 months, p = 0.035). There was no significant relationship between any HLA status and the incidence of severe adverse events. Several germline HLA genotypes, especially HLA-DQB1*03:01, may be associated with radiographic progression. However, their impact on treatment response is limited, and germline HLA genotypes was not independently associated with survival outcomes. Further prospective studies are needed to confirm the relationship between germline HLA genotypes and clinical outcomes in patients with chemoresistant advanced UC treated with pembrolizumab.
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Takahashi Y.
European Journal of Clinical Pharmacology ( European Journal of Clinical Pharmacology ) 79 ( 1 ) 89 - 98 2022年
PURPOSE: We assessed the impact of plasma trough concentrations of abiraterone (ABI) and its metabolite Δ4-abiraterone (D4A) and related polymorphisms on adverse events (AEs) in patients with metastatic prostate cancer who received abiraterone acetate (AA). METHODS: This prospective study enrolled patients with advanced prostate cancer treated with AA between 2016 and 2021. Plasma trough concentrations of ABI and D4A were measured using high-performance liquid chromatography. The impact of HSD3B1 rs1047303, SRD5A2 rs523349, and cytochrome P450 family 3A member 4 rs2242480 polymorphisms on plasma concentrations of ABI and D4A and the incidence of AEs were also assessed. RESULTS: In 68 patients treated with AA, the median ABI and D4A concentrations were 18.1 and 0.94 ng/mL, respectively. The high plasma trough concentration of ABI (≥ 20.6 ng/mL) was significantly associated with the presence of any AE and its independent risk factor based on multivariable analysis (odds ratio, 7.20; 95% confidence interval (CI): 2.20-23.49). Additionally, a high plasma trough concentration of ABI was an independent risk factor of time to withdraw AA (hazard ratio, 4.89; 95% CI: 1.66-14.38). The risk alleles of three polymorphisms were not statistically associated with the ABI and D4A concentrations and the incidence of AEs. CONCLUSIONS: The plasma trough concentration of ABI is associated with the presence of AEs and treatment failure after AA administration. ABI concentration monitoring may be useful in patients with prostate cancer who received AA.
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Terada N.
International Journal of Urology ( International Journal of Urology ) 30 ( 2 ) 227 - 234 2022年
OBJECTIVE: This study investigated the efficacy of docetaxel (DOC) and cabazitaxel (CBZ) and examined the factors associated with the prognosis of patients with castration-resistant prostate cancer (CRPC) receiving DOC-CBZ sequential treatment in Japanese real-world data. METHODS: We retrospectively evaluated data for 146 patients who received DOC followed by CBZ. The correlations of prostate specific antigen (PSA) decrease rate and time to progression between DOC and CBZ treatment were examined. Combined progression-free survival (PFS) of DOC-CBZ and overall survival (OS) from the initiation of DOC and the diagnosis of CRPC were evaluated and compared between patients with high and low PSA levels at the start of DOC and CBZ treatment. RESULTS: No correlations of PSA decrease rate and time to progression were observed between DOC and CBZ. The patients for whom DOC was started in higher PSA levels had significantly shorter combined PFS (p = 0.003) and OS from the initiation of DOC (p = 0.002). In patients who started DOC at high PSA levels, those who switched to CBZ at low PSA levels had longer OS than those who switched at high PSA levels (p = 0.048). The OS from CRPC of patients who started DOC at low PSA levels was significantly longer than those that started at high PSA levels (p = 0.030). CONCLUSIONS: For patients for whom DOC was not effective, sequential CBZ might have change to be effective. The PSA levels at the start of DOC and CBZ might be a potential prognostic biomarker.
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Hajime Sasagawa, Kazuyuki Numakura, Gaku Nakamura, Takashi Kukimoto, Akane Kikuchi, Ryuichiro Sagehashi, Ryohei Yamamoto, Atsushi Koizumi, Taketoshi Nara, Sohei Kanda, Mitsuru Saito, Shintaro Narita, Takamitsu Inoue, Shigeru Satoh, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica ( 泌尿器科紀要刊行会 ) 67 ( 12 ) 525 - 528 2021年12月
A 46-year-old woman was referred to our hospital with a left-sided renal tumor pointed out by ultrasonography at the time of a medical checkup．Computed tomography revealed a mass measuring 88×77×68 mm on the upper pole of the left kidney. She was diagnosed with cT2aN0M0 clear cell renal cell carcinoma. Laparoscopic left nephrectomy was performed uneventfully. Histopathological diagnosis was clear cell renal cell carcinoma, G2, v1, pT2. Four months after surgery, lung metastases appeared, and systemic therapy was given sequentially as follows ; sunitinib for 2 months, nivolumab for 8 months, axitinib for 17 months, and pazopanib for 2 months．However, metastases progressed, and a re-administration of nivolumab was planned. The nivolumab re-treatment resulted in a marked reduction in multiple lung metastases despite the previous failure by nivolumab treatment. There are few reports on the therapeutic effect of re-administration of nivolumab. We report a case of successful treatment by re-administration of nivolumab.
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Altering phosphoinositides in high-fat diet-associated prostate tumor xenograft growth
Huang M.
MedComm ( MedComm ) 2 ( 4 ) 756 - 764 2021年12月
The metabolic reprogramming of phospholipids may affect intracellular signal transduction pathways. A high-fat diet (HFD) is attributed to prostate cancer (PCa) progression, but the expression pattern and role of phospholipids in HFD-mediated PCa progression remains unclear. In this study, HFD enhanced LNCaP xenograft tumor growth by upregulating the phosphatidylinositol (PI) 3-kinase (PI3K)/AKT signaling pathway. A lipidomic analysis using xenograft tumors showed that phosphoinositides, especially PI (3,4,5)-trisphosphate (PIP3), including several species containing C38:4, C38:3, and C40:4 fatty acids, increased in the HFD group compared to control. Fatty acid synthase (FASN) was significantly upregulated in xenograft tumors under HFD in both gene and protein levels. PCa cell growth was significantly inhibited through the decreased AKT signaling pathway by treatment with cerulenin, a chemical FASN inhibitor, which also downregulated PIP, PIP2, and PIP3 but not PI. Thus, dietary fat influences PCa progression and alters phosphoinositides, especially PIP3, a critical player in the PI3K/AKT pathway. These results may offer appropriate targets, such as FASN, for dietary intervention and/or chemoprevention to reduce PCa incidence and progression.
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Yoneyama T.
Prostate ( Prostate ) 81 ( 16 ) 1411 - 1427 2021年12月
BACKGROUND: The presence of glycosylated isoforms of prostate-specific antigen (PSA) in prostate cancer (PC) cells is a potential marker of their aggressiveness. We characterized the origin of α2,3-sialylated prostate-specific antigen (S23PSA) by tissue-based sialylation-related gene expression and studied the performance of S23PSA density (S23PSAD) alone and in combination with multiparametric magnetic resonance imaging (MRI) for the detection of clinically significant prostate cancer in men with elevated PSA. METHODS: Tissue-based quantification of S23PSA and sialyltransferase and sialidase gene expression was evaluated in 71 radical prostatectomy specimens. The diagnostic performance of S23PSAD was studied in 1099 men retrospectively enrolled in a multicenter systematic biopsy (SBx) cohort. We correlated the S23PSAD with Prostate Imaging Reporting and Data System (PI-RADS) scores in 98 men prospectively enrolled in a single-center MRI-targeted biopsy (MRI-TBx) cohort. The primary outcome was the PC-diagnostic performance of the S23PSAD, the secondary outcome was the avoidable biopsy rate of S23PSAD combined with DRE and total PSA (tPSA), and with or without PI-RADS. RESULTS: S23PSA was significantly higher in Gleason pattern 4 and 5 compared with benign prostate tissue. In the retrospective cohort, the performance of S23PSAD for detecting PC was superior to tPSA or PSA density (PSAD) (AUC: 0.7758 vs. 0.6360 and 0.7509, respectively). In the prospective cohort, S23PSAD was superior to tPSA, PSAD, and PI-RADS (AUC: 0.7725 vs. 0.5901, 0.7439 and 0.7305, respectively), and S23PSAD + PI-RADS + DRE + tPSA was superior to DRE + tPSA+PI-RADS with avoidance rate of MRI-TBx (13% vs. 1%) at 30% risk threshold. CONCLUSIONS: The diagnostic performance of S23PSAD was superior to conventional strategies but comparable to mpMRI.
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Okamoto T.
BMC Cancer ( BMC Cancer ) 21 ( 1 ) 605 - 605 2021年12月
BACKGROUND: Anemia has been a known prognostic factor in metastatic hormone-sensitive prostate cancer (mHSPC). We therefore examined the effect of anemia on the efficacy of upfront abiraterone acetate (ABI) in patients with mHSPC. METHODS: We retrospectively evaluated 66 mHSPC patients with high tumor burden who received upfront ABI between 2018 and 2020 (upfront ABI group). We divided these patients into two groups: the anemia-ABI group (hemoglobin < 13.0 g/dL, n = 20) and the non-anemia-ABI group (n = 46). The primary objective was to examine the impact of anemia on the progression-free survival (PFS; clinical progression or PC death before development of castration resistant PC) of patients in the upfront ABI group. Secondary objectives included an evaluation of the prognostic significance of upfront ABI and a comparison with a historical cohort (131 mHSPC patients with high tumor burden who received androgen deprivation therapy (ADT/complete androgen blockade [CAB] group) between 2014 and 2019). RESULTS: We found that the anemia-ABI group had a significantly shorter PFS than the non-anemia-ABI group. A multivariate Cox regression analysis showed that anemia was an independent prognostic factor of PFS in the upfront ABI group (hazard ratio, 4.66; P = 0.014). Patients in the non-anemia-ABI group were determined to have a significantly longer PFS than those in the non-anemia-ADT/CAB group (n = 68) (P < 0.001). However, no significant difference was observed in the PFS between patients in the anemia-ABI and the anemia-ADT/CAB groups (n = 63). Multivariate analyses showed that upfront ABI could significantly prolong the PFS of patients without anemia (hazard ratio, 0.17; P < 0.001), whereas ABI did not prolong the PFS of patients with anemia. CONCLUSION: Pretreatment anemia was a prognostic factor among mHSPC patients who received upfront ABI. Although the upfront ABI significantly improved the PFS of mHSPC patients without anemia, its efficacy in patients with anemia might be limited.
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Sasagawa H.
Acta Urologica Japonica ( Acta Urologica Japonica ) 67 ( 12 ) 525 - 528 2021年12月
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cT1a/cT1b腎癌に対するロボット支援腹腔鏡下腎部分切除術の比較検討
石田 雅宣, 小泉 淳, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 OP33 - 04 2021年12月
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回腸導管造設術後の傍ストーマヘルニアの検討
奈良 健平, 沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 PP10 - 07 2021年12月
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2種の免疫応答性マウスモデルにおける飽和脂肪酸が前立腺癌発症・進展に及ぼす影響
佐藤 博美, 成田 伸太郎, 石田 雅宣, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 佐藤 滋, 吉岡 年明, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 PP13 - 01 2021年12月
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Germline HLA-B*15:01は転移性腎細胞癌の免疫チェックポイント阻害薬治療有害事象頻度に関連する
高橋 修平, 成田 伸太郎, 藤山 信弘, 小林 恭, 畠山 真吾, 内藤 整, 加藤 廉平, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 PP01 - 08 2021年12月
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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
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 OP79 - 03 2021年12月
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笹川 甫, 沼倉 一幸, 中村 岳, 久木元 隆, 菊池 茜恵, 提箸 隆一郎, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 67 ( 12 ) 525 - 528 2021年12月
46歳女性。人間ドックの超音波検査で左腎腫瘍を指摘後、近医のCT検査にて左腎癌と診断され、当科へ紹介となった。画像検査で左腎上極に88×77×68mm大の腫瘍性病変が認められ、左腎癌の診断で腹腔鏡下左腎摘除術が行われた。病理組織学的に腎細胞癌であったが、術後4ヵ月で多発肺転移が出現し、スニチニブの投与を行うも、1ヵ月半の投与で肺転移が増悪した。そこで、ニボルマブを12回投与することで、肺転移の増大は緩徐になったものの、新規に右肩甲骨、右上腕骨、左鎖骨骨転移が生じたため、アキシチニブの投与と局所放射線照射が行われた。増悪なく経過していたが、約1年半で多発肺転移が増悪し、ニボルマブを再投与したところ、転移巣は著明に縮小し、目下は抗腫瘍効果を維持している。
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ロボット支援腎部分切除術の今後の展開:腎機能温存最大化を目指して Early Unclampingによる合併症の回避と阻血短縮
沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 SY34 - 4 2021年12月
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ロボット支援膀胱全摘除術における体腔内尿路変向術 尿管合併症を回避するRARC手術手技標準化の試み
成田 伸太郎, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 26 ( 7 ) PD14 - 1 2021年12月
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大きな腎癌に対する腹腔鏡下腎摘除術のピットフォール 大きな腎腫瘍に対する腹腔鏡下腎摘除の対応とコツとピットフォール
小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 26 ( 7 ) WS18 - 3 2021年12月
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当院のロボット支援腹腔鏡下腎部分切除術における温阻血時間に影響する臨床因子の検討
高橋 佳子, 沼倉 一幸, 小林 瑞貴, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 26 ( 7 ) MO234 - 3 2021年12月
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腎盂尿管移行部通過障害に対するロボット支援腹腔鏡下腎盂形成術の検討
奈良 健平, 小泉 淳, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 26 ( 7 ) MO234 - 7 2021年12月
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長期透析患者の腎移植時の評価:外科的、循環器内科的側面 進行した動脈硬化を伴う腎移植レシピエントの術前・術中評価
齋藤 満, 佐藤 滋, 山本 竜平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 109回 SY3 - 1 2021年12月
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Mizuno K.
Clinical Cancer Research ( Clinical Cancer Research ) 27 ( 22 ) 6164 - 6173 2021年11月
PURPOSE: Although cell-free DNA (cfDNA) testing is expected to drive cancer precision medicine, little is known about the significance of detecting low-frequency variants in circulating cell-free tumor DNA (ctDNA) in castration-resistant prostate cancer (CRPC). We aimed to identify genomic profile including low-frequency variants in ctDNA from patients with CRPC and investigate the clinical utility of detecting variants with variant allele frequency (VAF) below 1%. EXPERIMENTAL DESIGN: This prospective, multicenter cohort study enrolled patients with CRPC eligible for treatment with abiraterone or enzalutamide. We performed targeted sequencing of pretreatment cfDNA and paired leukocyte DNA with molecular barcodes, and ctDNA variants with a VAF ≥0.1% were detected using an in-house pipeline. We investigated progression-free survival (PFS) and overall survival (OS) after different ctDNA fraction cutoffs were applied. RESULTS: One hundred patients were analyzed (median follow-up 10.7 months). We detected deleterious ATM, BRCA2, and TP53 variants even in samples with ctDNA fraction below 2%. When the ctDNA fraction cutoff value of 0.4% was applied, significant differences in PFS and OS were found between patients with and without defects in ATM or BRCA2 [HR, 2.52; 95% confidence interval (CI), 1.24-5.11; P = 0.0091] and TP53 (HR, 3.74; 95% CI, 1.60-8.71; P = 0.0014). However, these differences were no longer observed when the ctDNA fraction cutoff value of 2% was applied, and approximately 50% of the samples were classified as ctDNA unquantifiable. CONCLUSIONS: Detecting low-frequency ctDNA variants with a VAF <1% is important to identify clinically informative genomic alterations in CRPC.
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ロボット支援腎部分切除術における肥満と治療成績及び周術期サイトカイン変動の関連
小泉 淳, 成田 伸太郎, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 O - 5 2021年11月
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ロボット支援腹腔鏡下と後腹膜鏡下前立腺全摘除術後における急性腎障害発症の比較
佐藤 博美, 成田 伸太郎, 齋藤 満, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 O - 4 2021年11月
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ロボット支援腹腔鏡下腎部分切除で温阻結時間に影響する臨床因子の検討
沼倉 一幸, 小林 瑞貴, 小泉 淳, 嘉島 相輝, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 O - 1 2021年11月
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秋田大学でのロボット支援腹腔鏡下腎部分切除術192例の短期成績
嘉島 相輝, 沼倉 一幸, 小泉 淳, 山本 竜平, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
西日本泌尿器科学会総会抄録集 ( (一社)西日本泌尿器科学会 ) 73回 202 - 202 2021年11月
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腎盂尿管移行部通過障害に対するロボット支援腹腔鏡下腎盂形成術の検討
奈良 健平, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 小泉 淳, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 P - 6 2021年11月
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腹腔鏡下ドナー腎採取術:安全性、移植腎機能と低侵襲性のバランスを目指して 安全性、移植腎機能、低侵襲性、整容性のバランスがとれたドナー腎採取術を目指して
齋藤 満, 成田 伸太郎, 沼倉 一幸, 奈良 健平, 小泉 淳, 山本 竜平, 嘉島 相輝, 井上 高光, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 WS - 2 2021年11月
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T細胞リンパ腫に対する多剤併用化学療法後に発症した若年性浸潤性膀胱癌の1例
武藤 弓奈, 奈良 健平, 井上 高光, 岡田 脩平, 小泉 淳, 千葉 修治, 神田 壮平, 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 ( 11 ) 1293 - 1293 2021年11月
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笹川 甫, 沼倉 一幸, 菊池 茜恵, 石田 雅宣, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 11 ) 1295 - 1295 2021年11月
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保険収載を目指したロボット支援腹腔鏡手術 上部尿路上皮癌症例に対するロボット支援腹腔鏡下腎尿管全摘除術
齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 SY - 2 2021年11月
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免疫チェックポイント阻害薬が奏功した転移性mucinous tubular and spindle cell carcinomaの1例
高橋 佳子, 沼倉 一幸, 青山 有, 齋藤 拓郎, 武藤 弓奈, 小泉 淳, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 南條 博, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 11 ) 1288 - 1288 2021年11月
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尿路上皮癌に対するPembrolizumab治療中にニューモシスチス肺炎を発症し回復した1例
青山 有, 井上 高光, 高橋 佳子, 中島 志織, 佐藤 博美, 小林 瑞貴, 山本 竜平, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 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 ( 11 ) 1292 - 1292 2021年11月
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神経内分泌分化と扁平上皮癌の特徴を併せ持つ転移性去勢抵抗性前立腺癌の一例
中村 岳, 成田 伸太郎, 久木 元隆, 提箸 隆一郎, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 南條 博, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 11 ) 1297 - 1297 2021年11月
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腎移植前の貧血管理の意義
齋藤 満, 藤山 信弘, 提箸 隆一郎, 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, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 24 71 - 77 2021年11月
2004年7月〜2016年12月に生体腎移植を受けた症例を、移植後1ヵ月以内に濃厚赤血球輸血を受けた輸血有り群148例(61.4%)と輸血なし群93例(38.6%)に分け、輸血療法の危険因子、それに伴うドナー特異的新規抗体産生リスクや移植腎予後について検討した。輸血あり群は男性81例、女性67例、平均年齢49.3歳、輸血なし群は男性72例、女性21例、平均年齢48.5歳であり、多変量解析では女性、先行的腎移植症例、移植前日Hb 11g/dL未満、移植時出血300mL以上が独立した危険因子であった。腎移植前日Hb値と輸血療法施行とのROC曲線での評価では感度74.2%、特異度67.6%、カットオフ値10.4g/dLでAUC 0.747であった。輸血療法を回避するためには、腎移植術前Hb値を11g/dL程度まで上昇させておくべきである。
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岡田 脩平, 神田 壮平, 中島 志織, 佐藤 博美, 山本 竜平, 本間 直子, 奈良 健平, 千葉 修治, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 34 ( 11 ) 1289 - 1289 2021年11月
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鏡視下膀胱全摘除術の術後再発を如何に防ぐか 当院におけるRARCの拡大リンパ節郭清
成田 伸太郎, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 SY - 4 2021年11月
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高難度症例に対するロボット支援腎部分切除術:症例から学ぶ 高難度症例に対するロボット支援腎部分切除術
沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 35回 WS - 3 2021年11月
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Narita S.
Current Oncology ( Current Oncology ) 28 ( 5 ) 4109 - 4117 2021年10月
Benign ureteroenteric anastomosis strictures (UESs) are one of many critical complications that may cause irreversible disability following robot-assisted radical cystectomy (RARC). Previous studies have shown that the incidence rates of UES after RARC can reach 25.3%, with RARC having higher UES incidence rates compared to open radical cystectomy. Various known and unknown factors are involved in the occurrence of UES. To minimize the incidence of UES after RARC, our group has standardized the procedure and technique for intracorporeal urinary diversion by applying the following five strategies: (1) wide delicate dissection of the ureter and preservation of the periureteral tissues; (2) gentle handling of the ureter and security of periureteral tissues at the anastomotic site; (3) use of indocyanine green to confirm good blood supply; (4) standardization of the ample ureteral spatulation length for Wallace ureteroenteric anastomosis through objective measurements; and (5) development of an institutional standardized procedure manual. This review focused on the incidence, etiology, prevention, and management of UES after RARC to bring attention to the incidence of this complication while also proposing standardized surgical procedures to minimize its incidence after RARC.
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Prognosis of Japanese metastatic renal cell carcinoma patients in the targeted therapy era
Naito S.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 26 ( 10 ) 1947 - 1954 2021年10月
BACKGROUND: The aims of this study were to investigate prognosis and validate prognostic models [Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic Renal Cell Carcinoma Data Consortium (IMDC), and Japanese metastatic renal cancer (JMRC) models] in the targeted therapy era in Japanese patients with metastatic renal cell carcinoma. METHODS: We retrospectively analyzed 692 patients who were diagnosed with mRCC from January 2008 to August 2018 in the Michinoku Japan Urological Cancer Study Group database. Nivolumab as sequential therapy was widely used. Other immune checkpoint inhibitors were excluded from this study. RESULTS: The median overall survival (95% confident interval) in all, MSKCC favorable, intermediate, and poor risk patients was 41.0 months (33.9-46.8), not reached (63.5 to not estimable), 46.8 months (37.1-52.9), and 10.4 months (8.9-14.4), respectively. The median overall survival (95% confident interval) in IMDC favorable, intermediate, and poor risk patients was not reached (61.6 to not estimable), 47.4 months (41.4-56.5), and 11.5 (9.9-16.3), respectively. The c-index of the MSKCC, IMDC, and JMRC models calculated at mRCC diagnosis was 0.680, 0.689, and 0.700, respectively. No statistical differences were found in the c-index among the models. CONCLUSION: While the real-world overall survival in Japanese patients with mRCC in the targeted therapy era improved compared to that previously reported in the cytokine era, there was no clear difference in the survival of poor risk patients between these eras. There were no differences in the superiority among the models.
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当院泌尿器科でのFoundationOne CDxがんゲノムプロファイル施行症例の検討
石田 雅宣, 成田 伸太郎, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 齋藤 満, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 59回 P28 - 5 2021年10月
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Narita T.
International Journal of Urology ( International Journal of Urology ) 28 ( 9 ) 899 - 905 2021年09月
OBJECTIVES: To assess the clinical benefit of pembrolizumab as second-line therapy for advanced urothelial carcinoma. METHODS: We retrospectively compared the effects of pembrolizumab with those of conventional chemotherapy on the prognosis of patients with advanced urothelial carcinoma at six hospitals between January 2004 and August 2020. We compared the oncological outcomes between the patients treated with pembrolizumab and those treated with conventional chemotherapy using Kaplan-Meier curve analysis and multivariate Cox regression analysis with the inverse probability of treatment weighting method. RESULTS: The numbers of patients in the pembrolizumab and chemotherapy groups were 121 and 67, respectively. Patients in the pembrolizumab group were significantly older (median 72 vs 66 years, P = 0.001), and had poor Eastern Cooperative Oncology Group performance status (median 1 vs 0, P = 0.001). The unadjusted Kaplan-Meier curve analysis showed no significant differences in the median overall survival from the first-line chemotherapy (24.7 months vs 16.3 months, P = 0.159). Inverse probability of treatment weighting-adjusted multivariate Cox proportional hazards analyses showed a significant difference between the pembrolizumab and chemotherapy groups in overall survival (P = 0.003, hazard ratio 0.63). CONCLUSIONS: Despite the non-negligible age difference between the trial and our clinical practice, our study supports the benefit of second-line pembrolizumab over chemotherapy in real-world practice.
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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.
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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.
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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
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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)
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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
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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
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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
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【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.
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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
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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
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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
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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
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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
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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.
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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
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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
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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
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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
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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.
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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.
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褐色細胞腫におけるカテコールアミン合成酵素に関する検討
小林 瑞貴, 沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内分泌外科学会雑誌 ( (一社)日本内分泌外科学会 ) 38 ( Suppl.1 ) S98 - S98 2021年05月
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Muto Y.
Medical Oncology ( Medical Oncology ) 38 ( 4 ) 2021年04月
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Genetic Polymorphisms and Pharmacotherapy for Prostate Cancer.
Masaki Shiota, Shusuke Akamatsu, Shintaro Narita, Naoki Terada, Naohiro Fujimoto, Masatoshi Eto
JMA journal 4 ( 2 ) 99 - 111 2021年04月
The therapeutic landscape of pharmacotherapy for prostate cancer has dramatically evolved, and multiple therapeutic options have become available for prostate cancer patients. Therefore, useful biomarkers to identify suitable candidates for treatment are required to maximize the efficacy of pharmacotherapy. Genetic polymorphisms such as single-nucleotide polymorphisms (SNPs) and tandem repeats have been shown to influence the therapeutic effects of pharmacotherapy for prostate cancer patients. For example, genetic polymorphisms in the genes involved in androgen receptor signaling are reported to be associated with the therapeutic outcome of androgen-deprivation therapy as well as androgen receptor-pathway inhibitors. In addition, SNPs in genes involved in drug metabolism and efflux pumps are associated with therapeutic effects of taxane chemotherapy. Thus, genetic polymorphisms such as SNPs are promising biomarkers to realize personalized medicine. Here, we overview the current findings on the influence of genetic polymorphisms on the outcome of pharmacotherapy for prostate cancer and discuss current issues as well as future visions in this field.
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増刊号特集 泌尿器科当直医マニュアル 入院編 術後合併症 術後出血(開放手術・腹腔鏡手術後の血圧低下)
井上 高光, 成田 伸太郎
臨床泌尿器科 ( 株式会社医学書院 ) 75 ( 4 ) 195 - 198 2021年04月
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特集 前立腺癌のバイオロジーと最新の治療-いま起こりつつあるパラダイムシフト 〈転移性ホルモン感受性前立腺癌(mHSPC)とオリゴ転移前立腺癌に対する治療〉 ハイリスク転移性前立腺癌治療の現在
成田 伸太郎
臨床泌尿器科 ( 株式会社医学書院 ) 75 ( 5 ) 308 - 313 2021年04月
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ロボット支援腎部分切除術における腎実質縫合の有無による術後腎実質体積のCT volumetryを用いた比較検討
提箸 隆一郎, 井上 高光, 中島 志織, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 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 ( 1 ) 130 - 135 2021年04月
【目的】ロボット支援腎部分切除術(RAPN)における腎実質縫合の追加が術後の腎実質体積を減少させるかを画像解析ソフトにより検討した.また腎機能,合併症への影響も検討した.【対象と方法】2013年11月から2018年11月までに当科でRAPNを行ったT1a症例69例のうち,腎実質縫合を施行した26例(実質縫合群)と省略した43例(非縫合群)を後方視的に比較した.Synapse Vincent ver. 4を用いて,術前と術後6ヵ月の造影CTから腎実質減少体積を推定した.【結果】2群間の患者背景や手術成績に有意差はなかった.腎実質体積の減少量やeGFRの低下率,合併症の発生率に有意差を認めなかった.【結語】RAPNにおける腎実質縫合の追加は腎実質体積や腎機能,合併症の発生に影響しなかった.(著者抄録)
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超高齢社会におけるロボット支援手術 高齢者のロボット支援膀胱全摘徐術
沼倉 一幸, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 井上 高光, 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 ) 34 ( 1 ) 36 - 36 2021年04月
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泌尿器科における新規ロボット支援手術の展望 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
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 25 ( 7 ) SY13 - 2 2021年03月
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Narita S.
Sexual Medicine ( Sexual Medicine ) 9 ( 1 ) 2021年02月
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Validated prognostic significance of YB-1 genetic variation in metastatic prostate cancer
Shiota M.
Pharmacogenomics Journal ( Pharmacogenomics Journal ) 21 ( 1 ) 102 - 105 2021年02月
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腎移植患者におけるウイルス感染症の注意点 腎移植におけるCMV感染症は未だに要注意 長期生着との関連から
齋藤 満, 佐藤 滋, 藤山 信弘, 提箸 隆一郎, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 54回 117 - 117 2021年02月
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秋田大学での免疫学的リスク別免疫抑制プロトコールの評価
山本 竜平, 齋藤 満, 藤山 信弘, 提箸 隆一郎, 齋藤 拓郎, 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
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 54回 201 - 201 2021年02月
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Kido K.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 26 ( 1 ) 154 - 162 2021年01月
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Narita T.
Translational Andrology and Urology ( Translational Andrology and Urology ) 10 ( 1 ) 417 - 425 2021年01月
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Prognosis of metastatic castration-resistant prostate cancer in the era of the second-generation androgen receptor-targeted agents: A retrospective multicenter study.
Hiromichi Iwamura, Shingo Hatakeyama, Shintaro Narita, Yoichi Arai, Tomonori Habuchi, Chikara Ohyama
International journal of urology : official journal of the Japanese Urological Association 28 ( 1 ) 125 - 127 2021年01月
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Therapeutic effects of the combined androgen blockade therapy versus luteinizing hormone-releasing hormone analog monotherapy in patients with hormone naïve metastatic prostate cancer: a multi-institutional comparative analysis.
Takuma Narita, Shingo Hatakeyama, Shintaro Narita, Masahiro Takahashi, Toshihiko Sakurai, Sadafumi Kawamura, Senji Hoshi, Jiro Shimoda, Toshiaki Kawaguchi, Shigeto Ishidoya, Koji Mitsuzuka, Yoichi Arai, Akihiro Ito, Norihiko Tsuchiya, Tomonori Habuchi, Chikara Ohyama
Translational andrology and urology 10 ( 1 ) 417 - 425 2021年01月
BACKGROUND: The clinical benefit of the combined androgen blockade (CAB) therapy over luteinizing hormone-releasing hormone analog (LH-RHa) monotherapy for hormone naïve metastatic prostate cancer (mHNPC) is unclear. Therefore, we retrospectively compare the effectiveness of CAB with the LH-RHa monotherapy on the prognosis of Japanese patients with mHNPC. METHODS: We retrospectively evaluated the prognosis of 517 patients diagnosed with mHNPC between August 2001 and May 2017. The patients' data were obtained from the Michinoku Urological Cancer Research Group database and Hirosaki University-related hospitals. Patients were divided into the CAB and LH-RHa monotherapy groups based on primary androgen deprivation therapy (ADT). Overall survival (OS), cancer-specific survival (CSS), and castrate-resistant prostate cancer-free survival (CRPC-FS) were compared between the two groups using the Kaplan-Meier curve analysis. Inverse probability of treatment weighting (IPTW)-adjusted Cox hazard proportional analyses was performed to investigate the effect of primary ADT on oncological outcomes. RESULTS: The median age was 73 years old. The numbers of patients in the CAB and LH-RHa monotherapy groups were 447 and 70, respectively. The Kaplan-Meier curve analysis showed no significant differences in either 5-year OS (56.7% vs. 52.5%, P=0.277), CSS (61.1% vs. 56.4%, P=0.400), and CRPC-FS (33.1% vs. 31.1%, P=0.529) between the groups. IPTW-adjusted multivariate Cox hazard proportional analyses showed no significant differences in OS, CSS, and CRPC-FS between the two groups. CONCLUSIONS: No significant differences in oncological outcomes were observed between the CAB and LH-RHa monotherapy groups in patients with mHNPC.
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Iwamura H.
International Journal of Urology ( International Journal of Urology ) 28 ( 1 ) 125 - 127 2021年01月
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Shiota M.
Pharmacogenomics Journal ( Pharmacogenomics Journal ) 2021年
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ロボット支援腎部分切除術における腎実質縫合の有無による術後腎実質体積のCT volumetryを用いた比較検討
提箸 隆一郎, 井上 高光, 中島 志織, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
Japanese Journal of Endourology ( 日本泌尿器内視鏡学会 ) 34 ( 1 ) 130 - 135 2021年
<p>【目的】ロボット支援腎部分切除術 (RAPN) における腎実質縫合の追加が術後の腎実質体積を減少させるかを画像解析ソフトにより検討した. また腎機能, 合併症への影響も検討した.</p><p>【対象と方法】2013年11月から2018年11月までに当科でRAPNを行ったT1a症例69例のうち, 腎実質縫合を施行した26例 (実質縫合群) と省略した43例 (非縫合群) を後方視的に比較した. Synapse Vincent ver. 4を用いて, 術前と術後6カ月の造影CTから腎実質減少体積を推定した.</p><p>【結果】2群間の患者背景や手術成績に有意差はなかった. 腎実質体積の減少量やeGFRの低下率, 合併症の発生率に有意差を認めなかった.</p><p>【結語】RAPNにおける腎実質縫合の追加は腎実質体積や腎機能, 合併症の発生に影響しなかった.</p>
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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 ( 日本泌尿器内視鏡学会 ) 34 ( 2 ) 318 - 322 2021年
<p> 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.</p><p> 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.</p><p> 手術時間の中央値は308分, 推定出血量の中央値は63 mL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.</p><p> 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.</p>
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Tanaka T.
International Journal of Urology ( International Journal of Urology ) 27 ( 12 ) 1095 - 1100 2020年12月
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Numakura K.
Scientific Reports ( Scientific Reports ) 10 ( 1 ) 2020年12月
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Honma N.
Health Science Reports ( Health Science Reports ) 3 ( 4 ) 2020年12月
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Yamamoto R.
Transplant Immunology ( Transplant Immunology ) 63 2020年12月
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ホスホイノシタイド(PIPs)アシル基飽和度が前立腺癌進展に与える影響
小泉 淳, 成田 伸太郎, 中西 広樹, 奈良 健平, 神田 壮平, 沼倉 一幸, 黄 明国, 齋藤 満, 井上 高光, 佐藤 滋, 吉岡 年明, 羽渕 友則, 佐々木 雄彦
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 476 - 476 2020年12月
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1st-line Axitinib療法におけるIMDCリスク分類の有用性についての検討
小西 栄, 畠山 真吾, 沼倉 一幸, 成田 伸太郎, 井上 高光, 齋藤 満, 米山 高弘, 橋本 安弘, 吉川 和暁, 成田 知, 川口 俊明, 羽渕 友則, 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1416 - 1416 2020年12月
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ロボット支援膀胱全摘除術における尿路変向の標準化を目指して
成田 伸太郎, 齋藤 満, 井上 高光, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 328 - 328 2020年12月
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上部尿路上皮癌に対する腎尿管全摘術におけるリンパ節郭清が予後に与える影響
小林 瑞貴, 井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1263 - 1263 2020年12月
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内分泌単独療法で開始したCHAARTED low volume転移性前立腺癌における予後因子の検討
久木 元隆, 成田 伸太郎, 野村 恭子, 畠山 真吾, 高橋 正博, 櫻井 俊彦, 星 宣次, 三塚 浩二, 川村 貞文, 土谷 順彦, 大山 力, 荒井 陽一, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1556 - 1556 2020年12月
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当科における化学療法抵抗性尿路上皮癌に対するPembrolizumabの初期使用経験
菊池 茜恵, 神田 壮平, 井上 高光, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1849 - 1849 2020年12月
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当科における高齢者の精巣腫瘍に対する導入化学療法の成績
奈良 健平, 成田 伸太郎, 小泉 淳, 山本 竜平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1717 - 1717 2020年12月
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奈良 健平, 沼倉 一幸, 山本 竜平, 小泉 淳, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本小児泌尿器科学会雑誌 ( 日本小児泌尿器科学会 ) 29 ( 2 ) 202 - 202 2020年12月
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高リスク限局性前立腺癌におけるロボット支援腹腔鏡下根治的前立腺摘除術後のPSA再発とGleason score Global gradingとSeparate gradingの検討
佐藤 博美, 沼倉 一幸, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 南條 博, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 108回 1469 - 1469 2020年12月
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Does the Addition of Abiraterone to Castration Affect the Reduction in Bone Mineral Density?
Nakajima S.
In Vivo ( In Vivo ) 34 ( 6 ) 3291 - 3299 2020年11月
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Potential effectiveness of local radiotherapy for extending survival and reducing symptomatic local events in patients with de novo metastatic prostate cancer.
Naoki Terada, Takashi Mizowaki, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Ken-Ichi Tabata, Masaki Shiota, Atsushi Takahashi, Toru Shimazui, Takayuki Goto, Yasuhiro Hashimoto, Masato Fujii, Ryotaro Tomida, Toshihiko Sakurai, Kohei Hashimoto, Sadafumi Kawamura, Shogo Teraoka, Shinichi Sakamoto, Takahiro Kimura, Manabu Kamiyama, Shintaro Narita, Nobumichi Tanaka, Takuma Kato, Masashi Kato, Takahiro Osawa, Takahiro Kojima, Takahiro Inoue, Mikio Sugimoto, Hiroyuki Nishiyama, Toshiyuki Kamoto
BJUI compass 1 ( 5 ) 165 - 173 2020年11月
OBJECTIVES: To evaluate the association between the use of local radiotherapy (RT) with the survival of patients with de novo metastatic prostate cancer and symptomatic local events (SLEs). PATIENTS AND METHODS: Patients were initially diagnosed with metastatic prostate cancer between 2008 and 2017 at 30 institutes in Japan. Prostate-specific antigen (PSA) progression-free survival (PSA-PFS) under initial androgen deprivation therapy and overall survival (OS) was compared between patients receiving local RT (RT group) and no RT (no-RT group) by multivariate Cox proportional hazard analyses. The occurrence rate of grade ≥2 SLEs was compared by multivariate logistic regression analyses. Propensity score matching (PSM) analyses were performed to compare PSA-PFS and OS of the groups in the high and low metastatic burden cohort. RESULTS: Two hundred and five (7%) of 2829 patients received RT before PSA progression. Median PSA-PFS and OS were significantly longer in the RT group than in the no-RT group and the difference was significant in multivariate analyses (HR = 0.44, 95% CI = 0.33-0.57 and HR = 0.40, 95% CI = 0.27-0.60, respectively). The occurrence rate of grade ≥2 SLEs was significantly lower in the RT group (2%) than the no-RT group (9%) and the difference was significant in multivariate analyses (HR = 0.28, 95% CI = 0.10-0.76). Using PSM analyses, PSA-PFS and OS remained significantly different (HR = 0.64, 95% CI = 0.46-0.89 and HR = 0.47, 95% CI = 0.30-0.72, respectively), between the RT (n = 182) and the no-RT (n = 182) groups. The difference in OS was significant in the high metastatic burden cohort (HR = 0.55, 95% CI = 0.37-0.81). CONCLUSIONS: Addition of local RT to standard treatment for de novo metastatic prostate cancer patients tends to have the potential to extend survival, even in patients with high metastatic burden, and to reduce SLEs.
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ロボット支援腹腔鏡下腎部分切除における周術期血清サイトカインと臨床因子の関連検討
小泉 淳, 成田 伸太郎, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 齋藤 満, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 O - 13 2020年11月
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ロボット支援腹腔鏡下膀胱全摘における時間短縮と合併症回避のための手順標準化
沼倉 一幸, 小林 瑞貴, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 AV - 1 2020年11月
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上部尿路上皮癌症例に対するロボット支援腹腔鏡下腎尿管全摘除術の初期経験
齋藤 満, 成田 伸太郎, 山本 竜平, 小泉 淳, 奈良 健平, 沼倉 一幸, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 O - 2 2020年11月
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腹腔鏡技術認定医 実際の教育現場を紹介します! 秋田大学における腹腔鏡手術若手指導現場を紹介します
成田 伸太郎, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 SY - 2 2020年11月
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膀胱全摘における再発を減らすには? 当院におけるRARCの拡大リンパ節郭清
成田 伸太郎, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 SY - 4 2020年11月
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馬蹄腎の小径腎癌に対するロボット支援腹腔鏡下腎部分切除術の2例
山本 竜平, 沼倉 一幸, 武藤 弓奈, 蘇武 竜太, 奈良 健平, 市村 靖, 飯沼 昌宏, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 34回 O - 7 2020年11月
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Sato H.
International Journal of Medical Robotics and Computer Assisted Surgery ( International Journal of Medical Robotics and Computer Assisted Surgery ) 16 ( 5 ) 1 - 7 2020年10月
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Seminal vesicle cystadenoma with concurrent prostate cancer: A case report
Ishida M.
Acta Urologica Japonica ( Acta Urologica Japonica ) 66 ( 10 ) 351 - 355 2020年10月
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Robotic-assisted laparoscopic partial nephrectomy for renal cell carcinoma in horseshoe kidney: a hybrid technique with conventional laparoscopic surgery.
Kazuyuki Numakura, Yumina Muto, Ryohei Yamamoto, Atsushi Koizumi, Taketoshi Nara, Sohei Kanda, Mitsuru Saito, Shintaro Narita, Takamitsu Inoue, Tomonori Habuchi
International cancer conference journal 9 ( 4 ) 199 - 202 2020年10月
Robotic-assisted laparoscopic partial nephrectomies (RAPN) have come up to standard treatment for small renal tumors, with a growing indication to accomplish this procedure. Although a horseshoe kidney is one of the most common congenital renal fusion anomalies, surgical planning for tumors is considered difficult because of its poor mobility and abnormal vascular supply. We showed our experience of RAPN in combination with conventional laparoscopic kidney mobilization and dissection for a patient with renal cell carcinoma in a horseshoe kidney. The patient was an otherwise healthy 66-year-old man with 26 mm right renal mass on the lower pole of the horseshoe kidney. Robotic assistance allows for proper tissue dissection, easy to aware unconfirmed vasculatures, and meticulous fine suturing and would overcome the potential challenges involved in the minimally invasive management of such complex anomalies as shown in the patient.
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抗血液型抗体価のリバウンド現象と急性抗体関連型拒絶反応との関連性
山本 竜平, 齋藤 満, 齋藤 拓郎, 提箸 隆一郎, 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 ) 55 ( 総会臨時 ) 309 - 309 2020年10月
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泌尿器癌に対する抗PD-1抗体の治療効果とgermline HLA statusの関連検討
高橋 修平, 成田 伸太郎, 藤山 信弘, 嘉島 相輝, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 58回 P - 341 2020年10月
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2種の免疫応答性マウスモデルにおける特定の脂肪食が前立腺癌発症・進展に及ぼす影響
佐藤 博美, 成田 伸太郎, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 吉岡 年明, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 79回 PJ14 - 2 2020年10月
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BCG膀注療法におけるレボフロキサシンの効果の検討 非盲検多施設共同無作為比較試験
沼倉 一幸, 小林 瑞貴, 石田 俊哉, 岡根 克己, 鈴木 一正, 下田 直威, 鈴木 丈博, 熊澤 光明, 佐々木 隆聖, 福田 歴視, 齋藤 満, 成田 伸太郎, 井上 高光, 土谷 順彦, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 58回 O44 - 1 2020年10月
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ウサギモデルを使用した無尿および膀胱再灌流による廃用性萎縮膀胱および回復に関与する候補遺伝子の解明とそのヒト腎移植臨床検体での検証
喜早 祐介, 井上 高光, 西島 和俊, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本排尿機能学会誌 ( (一社)日本排尿機能学会 ) 31 ( 1 ) 301 - 301 2020年10月
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ロボット支援下前立腺全摘除術後の急性腎障害に関する検討
佐藤 博美, 成田 伸太郎, 齋藤 満, 奈良 健平, 神田 壮平, 千葉 修治, 沼倉 一幸, 井上 高光, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 23 102 - 106 2020年10月
ロボット支援下前立腺全摘除(RALP)後の急性腎不全(AKI)発症に関して、その頻度、リスク因子および腎予後との関連について検討した。限局性前立腺癌と診断され当院でRALPを施行し、かつ周術期の血液生化学データが取得可能であった305例(平均66歳)を対象とした。Early AKI、late AKIの発症率はそれぞれ46.9%(305例中143例)、3.9%(305例中12例)であった。多変量解析では高血圧とコンソール時間がearly AKIの独立したリスク因子であり、糖尿病がlate AKIのリスク因子であった。また、early AKI群ではnon-early AKI群と比較し、術後12ヵ月時点での術前からのeGFR低下が大きい傾向にあった。特に、術前eGFRが60mL/mm/1.73m2以上の172例においては有意にeGFRが低下していた。一方、late AKIは術後12ヵ月の腎機能と統計学的に関連しなかった。RALP術後には約半数がAKIを経験し、高血圧、糖尿病、コンソール時間延長がAKI発症のリスク因子であった。
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石田 雅宣, 井上 高光, 小泉 淳, 山本 竜平, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 66 ( 10 ) 351 - 355 2020年10月
49歳男性。肝血管腫の経過観察中に前立腺肥大を指摘された。経直腸前立腺生検、CT、MRI各所見より、精嚢原発悪性腫瘍、前立腺癌cT1cN0M0と診断された。嚢胞状悪性腫瘍の破裂と腹腔内播種の危険性、前立腺癌合併のため、精嚢腫瘍の生検を行わずに開放前立腺精嚢腫瘍摘出術で一塊に摘出した。病理学的所見より、前立腺癌は中分化型pT2cN0、精嚢腫瘍は精嚢cystadenomaと診断された。術後12日目に退院し、術後5年6ヵ月現在、再発はない。
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秋田市中通総合病院におけるMRI/US融合画像ガイド下前立腺生検の初期経験
高橋 誠, 鈴木 敏文, 小泉 淳, 成田 伸太郎, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 58回 O43 - 3 2020年10月
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転移性腎細胞癌の一次治療におけるニボルマブ・イピリムマブ併用療法とTKIの比較検討
細越 正吾, 畠山 真吾, 沼倉 一幸, 田中 壽和, 及川 真亮, 野呂 大輔, 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
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 58回 P - 289 2020年10月
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Kisou Y.
Neurourology and Urodynamics ( Neurourology and Urodynamics ) 39 ( 6 ) 1653 - 1666 2020年08月
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Numakura K.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 25 ( 8 ) 1543 - 1550 2020年08月
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内分泌単独療法で開始したCHAARTED low-volume転移性前立腺癌における予後因子の検討
久木元 隆, 成田 伸太郎, 野村 恭子, 畠山 真吾, 高橋 正博, 櫻井 俊彦, 川村 貞文, 星 宣次, 石田 雅宣, 石戸谷 滋人, 下田 次郎, 佐藤 博美, 三塚 浩二, 栃木 達夫, 土谷 順彦, 大山 力, 荒井 陽一, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 8 ) 1053 - 1056 2020年08月
本邦9施設で去勢単独療法による治療を開始した内分泌感受性転移性前立腺癌556例のうち、CHAARTED low-volumeに分類される184例の予後因子を後ろ向きに解析検討した。治療前因子の単変量解析でGleason score≧9、LDH高値、ヘモグロビン低値が無CRPC生存と全生存に有意に関連し、Gleason score≧9は独立した予後因子であった。経過中の予後関連因子の単変量解析ではPSA nadir≧0.2ng/mL、time to PSA nadir<6ヵ月が無CRPC生存と全生存に有意に関連した。治療経過中因子を含めた多変量解析ではGleason score≧9、TTN<6ヵ月、PSA nadir≧0.2ng/mLが独立した危険因子であった。(著者抄録)
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秋田大学医学部附属病院における初診時85歳以上の膀胱癌患者の治療成績
提箸 隆一郎, 沼倉 一幸, 山本 竜平, 小泉 淳, 奈良 健平, 齋藤 満, 井上 高光, 成田 伸太郎, 佐藤 滋, 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 ) 33 ( 1 ) 136 - 136 2020年08月
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Hatakeyama S.
International Journal of Urology ( International Journal of Urology ) 27 ( 7 ) 610 - 617 2020年07月
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【オリゴ転移・オリゴ再発前立腺癌を巡る諸問題】原発巣標的局所治療
沼倉 一幸, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 7 ) 946 - 952 2020年07月
本総説では、オリゴ転移前立腺癌における原発巣を標的とした局所治療について解説する。オリゴ転移の定義などまだ議論がある部分については理解を助けるための最小限の記述にとどめ、新たな疾患概念ともいえるオリゴ転移前立腺癌に対する原発巣標的局所治療(放射線療法、腫瘍減量前立腺全摘除そして凍結療法)についてのエビデンスと実際の臨床への適応を考察した。オリゴ転移の定義などの詳細な説明は割愛したので該当する他項を参照していただきたい。(著者抄録)
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【泌尿器がんのリンパ節転移とリンパ節郭清】ロボット支援腹腔鏡下前立腺全摘除術のリンパ節郭清
成田 伸太郎, 羽渕 友則
泌尿器科 ( (有)科学評論社 ) 12 ( 1 ) 67 - 70 2020年07月
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ロボット支援腹腔鏡下腎部分切除術のアウトカムを検証する RAPN手術中に苦労した症例、非典型例に対するRAPNの検討
齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 754 - 756 2020年06月
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成田 伸太郎, 齋藤 満, 井上 高光, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 760 - 763 2020年06月
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菊池 茜恵, 奈良 健平, 成田 伸太郎, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 886 - 886 2020年06月
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成田 伸太郎, 井上 高光, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 874 - 874 2020年06月
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浸潤性膀胱癌に対する術前化学療法におけるレジメン毎の治療効果に関する検討
神田 壮平, 奈良 健平, 沼倉 一幸, 齋藤 満, 井上 高光, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 906 - 906 2020年06月
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秋田大学における生体腎移植レシピエントでのエベロリムス導入プロトコールの中間成績
山本 竜平, 齋藤 満, 齋藤 拓郎, 藤山 信弘, 奈良 健平, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 915 - 915 2020年06月
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転移を有する去勢抵抗性前立腺癌(mCRPC)の一次治療が予後へ与える影響
沖田 和貴, 畠山 真吾, 成田 伸太郎, 高橋 正博, 櫻井 俊彦, 川村 貞文, 伊藤 明宏, 土谷 順彦, 荒井 陽一, 羽渕 友則, 大山 力
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 896 - 896 2020年06月
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転移性去勢抵抗性前立腺癌(mCRPC)において初期ホルモン治療に対する「PSA kinetics」は予後予測因子である
濱野 逸人, 畠山 真吾, 成田 伸太郎, 高橋 正博, 櫻井 俊彦, 川村 貞文, 三塚 浩二, 土谷 順彦, 荒井 陽一, 羽渕 友則, 大山 力
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 894 - 894 2020年06月
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高齢外国人に起こったTURBT後の高熱と尿道周囲・陰嚢の激烈な炎症
久木元 隆, 沼倉 一幸, 山本 竜平, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 臨増 ) 814 - 815 2020年06月
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Narita S.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 25 ( 5 ) 912 - 920 2020年05月
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Robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction with duplex system
Numakura K.
Urology Case Reports ( Urology Case Reports ) 30 2020年05月
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Kashima S.
iScience ( iScience ) 23 ( 4 ) 2020年04月
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Matsuda Y.
BMC Cancer ( BMC Cancer ) 20 ( 1 ) 2020年04月
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Okita K.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 18 ( 2 ) e103 - e111 2020年04月
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A patient with synchronous bilateral low-grade upper tract urothelial carcinoma who underwent nephroureterectomy and total ureterectomy with ileal ureteric replacement.
Yoshinori Matsuda, Takamitsu Inoue, Atsushi Maeno, Atsushi Koizumi, Ryohei Yamamoto, Taketoshi Nara, Sohei Kanda, Kazuyuki Numakura, Mitsuru Saito, Shintaro Narita, Shigeru Satoh, Tomonori Habuchi
International cancer conference journal 9 ( 2 ) 82 - 87 2020年04月
We present the case of a synchronous bilateral low-grade upper-tract urothelial carcinoma patient who underwent left nephroureterectomy and right total ureterectomy with ileal ureteric replacement resulting in a favorable prognosis. A 66-year-old male presented with bilateral hydronephrosis. Computed tomography revealed left pelvic and right upper-middle ureteral tumors with no lymph node swelling or distant metastasis. The patient underwent a left nephroureterectomy with a bladder cuff, and histopathology revealed a low-grade urothelial carcinoma. Considering the contralateral low-grade nature as revealed in histopathology and the right retrograde ureterography being noninvasive, he underwent a right total ureterectomy with ileal ureteric replacement. Histopathology of the right ureter revealed a low-grade urothelial carcinoma. The patient successfully avoided an anephric status without renal function deterioration for 4 years with a transurethral resection for a recurrent small papillary bladder tumor on 18 months after the total ureterectomy.
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特集 ここが変わった! 膀胱癌診療-新ガイドラインを読み解く 膀胱癌の経過観察
成田 伸太郎, 松井 喜之, 都築 豊徳, 羽渕 友則
臨床泌尿器科 ( 株式会社医学書院 ) 74 ( 5 ) 320 - 325 2020年04月
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CANDIDATE GENES INVOLVED IN A DEFUNCTIONALIZING AND REFUNCTIONALIZING URINARY BLADDER INDUCED BY ANURIA AND URINE REPERFUSION IN A RABBIT URINARY DIVERSION MODEL
Yusuke Kiso, Takamitsu Inoue, Kazutoshi Nishijima, Minguo Huang, Taketoshi Nara, Sohei Kanda, Kazuyuki Numakura, Mitsuru Saito, Shintaro Narita, Masaru Yoshizumi, Masahito Kawatani, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( LIPPINCOTT WILLIAMS & WILKINS ) 203 E796 - E796 2020年04月
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BCG膀胱内注入療法におけるレボフロキサシンの効果に関する検討 非盲検多施設共同無作為比較試験
沼倉 一幸, 小林 瑞貴, 石田 俊哉, 前野 淳, 岡根 克己, 本間 直子, 鈴木 一正, 下田 直威, 高橋 修平, 鈴木 丈博, 久保 恭平, 熊澤 光明, 高橋 佳子, 佐々木 隆聖, 福田 歴視, 武藤 弓奈, 奈良 健平, 神田 壮平, 黄 明国, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 33 ( 4 ) 374 - 377 2020年04月
筋層非浸潤性膀胱癌に対するBCG膀胱内注入療法+レボフロキサシン(LVFX)併用の有用性を検証するため、多施設共同の非盲検無作為化比較試験を行った。BCG+LVFX併用群52例とBCG単独群48例で比較した結果、BCGの完遂率は2群間で有意差を認めなかったが、Grade2以上の発熱および頻尿の発生率はBCG+LVFX併用群で有意に少なかった。副次評価項目の無再発生存期間は2群間で有意差がなかったが、無進行生存期間および癌特異的生存期間はBCG+LVFX併用群で有意に良好であった。
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PTENノックアウト前立腺癌マウスモデルにおいてラード食は全身炎症と腸内細菌叢の変化を介して前立腺癌進展を促進する
佐藤 博美, 成田 伸太郎, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 吉岡 年明, 羽渕 友則
腸内細菌学雑誌 ( (公財)腸内細菌学会 ) 34 ( 2 ) 142 - 142 2020年04月
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IgG抗A抗体価4096倍で術前脱感作療法に難渋した1例
山本 竜平, 齋藤 満, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 53回 192 - 192 2020年02月
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長期成績向上に向けたmTOR阻害薬の使用と意義 エベロリムス併用プロトコルは移植腎間質線維化を抑制できるか
齋藤 拓郎, 齋藤 満, 山本 竜平, 提箸 隆一郎, 奈良 健平, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 53回 106 - 106 2020年02月
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Kobayashi M.
Acta Urologica Japonica ( Acta Urologica Japonica ) 66 ( 1 ) 1 - 4 2020年01月
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Okamoto T.
International Journal of Urology ( International Journal of Urology ) 27 ( 1 ) 90 - 91 2020年01月
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Mizuki Kobayashi, Takamitsu Inoue, Taketoshi Nara, Shuji Chiba, Sohei Kanda, Hiroshi Tsuruta, Kazuyuki Numakura, Mitsuru Saito, Shintaro Narita, Shigeru Satoh, Norihiko Tsuchiya, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica ( 泌尿器科紀要刊行会 ) 66 ( 1 ) 1 - 4 2020年01月
The initial results robot-assisted pyeloplasty (RAP) performed on 6 patients were compared with those of laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction performed on 26 patients in a Japanese regional center. The median operating time, estimated blood loss, time to oral intake, time to start walking, and hospital stay were not significantly different between the groups. There was no difference in the rate of complications of Clavien-Dindo≥grade III between the two groups. Although the number of entered patients was small, the results indicated that RAP is feasible with favorable outcome.
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Shiota M.
Cancer Science ( Cancer Science ) 2020年
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齋藤 拓郎, 齋藤 満, 山本 竜平, 提箸 隆一郎, 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 ( 一般社団法人 日本移植学会 ) 55 ( Supplement ) 357_2 - 357_2 2020年
<p>【目的】移植腎間質線維化／尿細管萎縮（IF/TA）は移植腎廃絶の大きな要因である。当院では2013年10月から、エベロリムス（EVR）を移植2週後からadd onしTac及びMMFを減量するプロトコルを採用。移植成績やIF/TAについて従来プロトコルと比較・検討した。【対象と方法】対象は2011年1月から2017年12月までに当院で腎移植を施行した104例。画像解析装置（WinROOF2015）を用いて移植腎皮質線維化の間質占有率（IFR）を測定し、0hr生検標本でのIFRを基準として移植1年時点でのその増生率を算出。両群間で移植成績を比較・検討し、移植腎間質線維増生の危険因子について解析。【結果】移植1年時点での拒絶発症率、移植腎機能、生着率は両群で差を認めなかったが、EVR群ではウイルス感染が有意に高かった（p=0.001）。IFR増生率はリツキシマブ非投与群（p=0.037）、CYP3A5 non-expresser群（p=0.027）、ウイルス感染あり群（p=0.019）、EVR非投与群（p < 0.001）で有意に高く、多変量解析ではEVR非投与群（p< 0.001）はIFR増生率の独立した危険因子であった。【結論】EVR併用プロトコルは従来プロトコルよりIFR増生率が有意に少なく、EVRは移植腎間質の線維増生を抑制する可能性がある。</p>
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抗血液型抗体価のリバウンド現象と急性抗体関連型拒絶反応との関連性
山本 竜平, 齋藤 満, 齋藤 拓郎, 提箸 隆一郎, 嘉島 相喜, 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 ( 一般社団法人 日本移植学会 ) 55 ( Supplement ) 309_1 - 309_1 2020年
<p>【背景】Rituximab時代でのABO血液型不適合腎移植（ABOI-KT）における抗血液型抗体価のリバウンド現象の臨床的意義は明らかとされていない。【対象・方法】2005年11月から2019年3月までに当院でRituximab投与後にABOI-KTを施行した70例を対象とした。術直前の目標抗体価をIgG/IgMとも32倍以下に設定し、抗体除去療法は1～４回施行した。抗体除去療法後に抗体価がbaselineまで再上昇した場合、リバウンド現象有りと定義した。【結果】リバウンド現象は20例（29％；リバウンド群）で認められ、また移植後1ヶ月以内のABMR発症例は10例（14％）であった。リバウンド現象はbaseline抗体価64倍以上例（p = 0.001）と抗A抗体例(p = 0.016)で有意に発生頻度が高かった。Baselineや移植直前の抗体価とABMＲとの関連性は認められなかったが、リバウンド群では7例（35％）にABMRがみられ、非リバウンド群（50例）と比較して有意にその頻度が高く（p = 0.004）、多変量解析ではリバウンド現象がABMRの独立した危険因子であった（ｐ= 0.003）。【結語】リバウンド現象はABMR発症の危険因子であり、ABOI-KTでは目標抗体価の達成の可否のみならず、リバウンド現象の有無にも注目すべきと考える。</p>
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秋田大学における65歳以上のレシピエントに対する腎移植の治療成績について
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, 藤山 信弘, 佐藤 滋
移植 ( 一般社団法人 日本移植学会 ) 55 ( Supplement ) 362_1 - 362_1 2020年
<p>【緒言】高齢者では免疫応答が低下するため過剰免疫抑制に注意が必要とされる。【方法】2009年11月から2019年4月に当院で腎移植を受けたレシピエントを、移植時年齢55歳未満（若年群：97例）、55歳以上65歳未満（中年群：54例）、65歳以上（高齢群：27例）に分け、薬物動態を比較し臨床結果を後方視的に検討した。免疫抑制法はTAC、MMF、PSL、Bxで導入し2013年10月以降は移植2週後からEVRを追加した。免疫学的ハイリスク症例ではリツキシマブ投与や抗体除去を行った。高齢を理由に免疫抑制プロトコルの変更は行わなかった。【結果】夫婦間移植の割合は若年群で有意に低かった。各群間でリツキシマブ使用例や拒絶治療例の割合、移植後1年までの各免疫抑制薬の薬物動態、移植後5年までのeGFRに有意差を認めなかった。観察期間中に感染症で入院を要した症例は各群で26%、18%、14%発癌は2%、8%、11%に認められ、いずれも有意差はなかった。移植後5年正着率はそれぞれ95%、82%、87%であったがdeath censoredでは95%、96%、100%であった。【結語】65歳以上の腎移植レシピエントでは薬物動態が若年者と同等にもかかわらず、免疫抑制療法に伴う有害事象や拒絶反応の発症率が若年者と同程度であり、免疫抑制薬の過度な減量には注意が必要である。</p>
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齋藤 満, 藤山 信弘, 提箸 隆一郎, 齋藤 拓郎, 嘉島 相輝, 山本 竜平, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 佐藤 滋, 羽渕 友則
移植 ( 一般社団法人 日本移植学会 ) 55 ( Supplement ) 255_2 - 255_2 2020年
<p>生体腎移植は待機手術として行われる。設定された手術日にピークを合わせて様々なリスクを低減化し、考え得る最善の状態で手術に臨むことが基本である。しかし、先行的腎移植（PEKT）では移植までの期間が短いためリスク評価や必要に応じた治療が不十分となる恐れがある。特に貧血は短期間での治療が困難であり周術期に輸血を施行せざるを得ない症例も多い。実際、当科の症例を見てみると2004年7月から2015年12月までの期間でPEKT群（33例）では非PEKT群（171例）と比較して当科初診時のHbが有意に低値であった。ほぼ同時期の生体腎移植症例163例の検討では102例（62.6%）で濃厚赤血球製剤が輸血されていた。背景因子の比較では、輸血施行群で非施行群と比較して有意に女性が多く（p=0.03）、腎移植前日のHb値が低値（p＜0.001）であった。幸い、免疫学的ハイリスク症例を除くと両群間でde novo DSA産生やABMRの頻度に有意差は見られなかったものの、輸血は行わないに越したことはなく、術前Hb値がより高値であれば輸血を要しなかった症例も多いと思われた。周術期の輸血回避のため、腎移植、特にPEKT施行時には術前にエリスロポエチン製剤や鉄剤などを充分に投与しHb値を上昇させておく必要がある。</p>
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齋藤 拓郎, 齋藤 満, 山本 竜平, 提箸 隆一郎, 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 ( 一般社団法人 日本移植学会 ) 55 ( Supplement ) 388_1 - 388_1 2020年
<p>症例は56歳、女性。妊娠中毒症を契機として腎機能が低下し、41歳時に血液透析導入。夫婦間生体腎移植を希望し当科受診。DSA陽性でnMFI値が高く術前にRituximab 200 mg/bodyを1回投与、新鮮凍結血漿を用いた血漿交換を4回施行した。2019年7月にABO血液型適合生体腎移植術を施行。移植後は軽度の脳梗塞を発症するも後遺症無く回復。全身状態、移植腎機能とも良好で明らかな拒絶反応を認めず、当初の予定通り退院した。腎移植後8カ月が経過した2020年3月初旬から微熱が持続し、その後38度台の発熱となり近医受診。発熱以外の自覚症状は無く細菌尿を認めたため尿路感染症として抗生物質投与で解熱するも投薬終了後に再び発熱したため当科受診。細菌尿及びCMVアンチゲネミアの陽性化を認め抗生物質及びVGCV投与を開始。速やかに解熱するも抗生物質投与が終了すると再び発熱。全身CTで右肺に境界明瞭な類円形の腫瘤像を2つ認め、精査加療目的に当科入院。呼吸器内科にコンサルトするもあらゆるマーカーが陰性。気管支鏡検査でBALを行うも確定診断に至らず退院。抗生物質投与期間中のみ解熱が得られていた。フォローの胸部レントゲン写真で右肺腫瘤陰影の増大を認め再度気管支鏡検査でBALを行い、最終的に肺アスペルギルス症の診断を得た。</p>
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転移性腎細胞癌における2nd line療法のNivolumabとTKIの比較検討
小泉 淳, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 50 ) 63 - 63 2020年
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転移性腎細胞癌に対するfirst line axitinibの治療成績と効果不良因子の検討
沼倉 一幸, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 50 ) 58 - 58 2020年
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Kodama H.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 17 ( 6 ) e1091 - e1098 2019年12月
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Fujiyama N.
Clinical and Experimental Nephrology ( Clinical and Experimental Nephrology ) 23 ( 12 ) 1398 - 1406 2019年12月
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Increased fatty acyl saturation of phosphatidylinositol phosphates in prostate cancer progression
Koizumi A.
Scientific Reports ( Scientific Reports ) 9 ( 1 ) 2019年12月
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Narita S.
Scientific Reports ( Scientific Reports ) 9 ( 1 ) 2019年12月
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ドナー腎採取術における工夫 秋田大学におけるドナー腎採取術の変遷
井上 高光, 奈良 健平, 齋藤 満, 神田 壮平, 小泉 淳, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 24 ( 7 ) WS8 - 5 2019年12月
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腹腔鏡下ドナー腎採取術による生体腎移植におけるDelayed Graft Functionの検討
井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 24 ( 7 ) MO338 - 5 2019年12月
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腹腔鏡下腎部分切除術におけるロボット支援の有無による腎実質切除量と術後腎機能回復に関する検討
神田 壮平, 井上 高光, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 24 ( 7 ) MO336 - 3 2019年12月
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Fujiyama N.
International Immunopharmacology ( International Immunopharmacology ) 76 2019年11月
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Narita S.
Cancer Medicine ( Cancer Medicine ) 8 ( 15 ) 6566 - 6577 2019年11月
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Hamano I.
World Journal of Urology ( World Journal of Urology ) 37 ( 11 ) 2365 - 2373 2019年11月
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Raven P.A.
Journal of Cellular Physiology ( Journal of Cellular Physiology ) 234 ( 11 ) 20634 - 20647 2019年11月
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RAPNにおける腎実質縫合の有無による術後腎実質体積のCT volumetryを用いた検討
提箸 隆一郎, 井上 高光, 中島 志織, 神田 壮平, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 O - 6 2019年11月
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ロボット支援/腹腔鏡下膀胱全摘除術における尿路変向手順の標準化 ロボット支援下膀胱全摘除術における尿路変向の標準化
成田 伸太郎, 井上 高光, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 JWS - 3 2019年11月
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周術期合併症を防ぐための工夫(腹腔鏡手術、ロボット支援手術) ロボット支援下腎部分切除術における周術期合併症を防ぐための工夫
成田 伸太郎, 井上 高光, 齋藤 満, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 SY - 2 2019年11月
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根治的膀胱全摘除術における血清炎症性サイトカインを用いた手術侵襲の比較検討
小泉 淳, 井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 O - 4 2019年11月
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複数術者によるロボット支援前立腺全摘の断端陽性に関する検討
佐藤 博美, 成田 伸太郎, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 P - 4 2019年11月
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馬蹄腎に生じた腎細胞癌に対するロボット支援腹腔鏡下腎部分切除術
沼倉 一幸, 武藤 弓奈, 山本 竜平, 小泉 淳, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 33回 AV - 3 2019年11月
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Nakajima S.
Acta Urologica Japonica ( Acta Urologica Japonica ) 65 ( 10 ) 397 - 402 2019年10月
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Konishi S.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 17 ( 5 ) e1080 - e1089 2019年10月
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本邦初診時転移性前立腺癌におけるConditional Net Survival
成田 伸太郎, 野村 恭子, 畠山 真吾, 高橋 正博, 櫻井 俊彦, 川村 貞文, 星 宣次, 石田 雅宣, 佐藤 博美, 三塚 浩二, 土谷 順彦, 大山 力, 荒井 陽一, 長島 健悟, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 57回 P109 - 2 2019年10月
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SunitinibおよびN-desethyl-sunitinibの血中濃度の測定による治療薬物モニタリング
沼倉 一幸, 藤山 信広, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 土谷 順彦, 新岡 丈典, 三浦 昌朋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 57回 P40 - 4 2019年10月
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前立腺癌に対する密封小線源療法におけるPSA低下率の臨床的意義
小林 瑞貴, 沼倉 一幸, 武藤 弓奈, 佐藤 博美, 小泉 淳, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則, 熊谷 聡, 和田 優貴, 安倍 明
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 57回 P108 - 4 2019年10月
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当科における化学療法抵抗性尿路上皮癌に対するPembrolizumabの初期使用経験
神田 壮平, 井上 高光, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 57回 P97 - 7 2019年10月
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拡大手術と化学療法を施行した下大静脈腫瘍塞栓を伴う進行副腎皮質癌の1例
中島 志織, 成田 伸太郎, 佐藤 博美, 五十嵐 龍馬, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 山本 浩史, 山本 雄造, 羽渕 友則
泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 65 ( 10 ) 397 - 402 2019年10月
36歳女性。検診にて白血球、ALPの高値を認め近医を受診し、腹部超音波検査で右上腹部巨大腫瘤を指摘され、当科へ紹介となった。腹部造影CT、MRI、超音波ガイド下経皮的針生検の結果、下大静脈腫瘍塞栓と肺転移を伴う巨大副腎皮質癌と診断され、副腎皮質癌および下大静脈腫瘍塞栓の摘出術が施行された。術後は化学療法を施行し、術後1年で多発肺転移巣はほぼ消失したが、術後1年3ヵ月で単発肺転移を認めたため、胸腔鏡補助下右肺下葉部分切除術を施行した。だが、術後2年で再度新たな肺転移巣が出現し、術後3年9ヵ月経過現在、化学療法を継続中である。
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異所性石灰化を伴う頸部腫瘤に対しイバンドロン酸ナトリウムが著効した維持血液透析患者の1例
青山 有, 齋藤 満, 岡田 脩平, 高橋 佳子, 中島 志織, 齋藤 拓郎, 佐藤 博美, 武藤 弓奈, 小林 瑞貴, 喜早 祐介, 山本 竜平, 本間 直子, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則, 齋藤 孝喜, 笹木 てい子, 小玉 智樹, 木内 雅臣, 白井 良幸
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 22 87 - 91 2019年10月
症例は52歳男性で、糖尿病性腎症による慢性腎不全で血液透析を導入されていた。右前腕皮下に内部に石灰化を伴う無痛性腫瘤が出現し、整形外科を受診し異所性石灰化と診断とされた。その後、4年以上にわたり炭酸ランタン、クエン酸第二鉄を内服していたにもかかわらず、血液検査で高Ca血症、高iP血症、intact-PTH高値が遷延し、新たに異所性石灰化病変が出現したことから、CKD-MBD管理の厳格化が必要と判断した。エテルカルセチドを導入したもののその後もCKD-MBDコントロールは不良であり、異所性石灰化腫瘤の縮小はみられなかった。このため、イバンドロン酸ナトリウム1mg/月の投与を開始した。投与開始2ヵ月後、患者から右前腕および左後頸部腫瘤が徐々に縮小し疼痛も消失したとの報告があり、CTでも同腫瘤の縮小、石灰化の減少を認めた。現在、イバンドロン酸ナトリウム投与開始から半年以上が経過しているが特に有害事象は認めていない。
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第一選択アキシチニブで治療した転移性腎細胞癌患者におけるIMDC予後モデルの検証
小西 栄, 畠山 真吾, 沼倉 一幸, 成田 伸太郎, 井上 高光, 齋藤 満, 得居 範子, 山本 勇人, 米山 高弘, 橋本 安弘, 吉川 和暁, 成田 智, 川口 俊明, 羽渕 友則, 大山 力
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 57回 O45 - 3 2019年10月
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血液透析患者の排便状態の検討 リン吸着薬内服状況との関連について
千葉 修治, 青山 有, 岡田 脩平, 高橋 佳子, 齋藤 拓郎, 中島 志織, 小林 瑞貴, 佐藤 博美, 武藤 弓奈, 山本 竜平, 小泉 淳, 本間 直子, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 井上 高光, 伊藤 卓雄, 鈴木 丈博, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 22 130 - 134 2019年10月
血液透析患者の排便状態の実態について検討した。当院で維持透析中の患者のうち、排便に関する問診に回答することができる66例(男性43例、女性23例、平均65.4歳)を対象とした。便秘スコアに関して、各リン吸着薬で排便状態に有意差を認めなかった。ブリストル便形状スコアでは、沈降炭酸カルシウム単剤群で普通便の割合が有意に高く、リン吸着薬なし群で普通便が少ない傾向にあった。また、沈降炭酸カルシウム単剤群で軟便の割合が有意に少なく、リン吸着薬なし群で軟便が有意に多かった。日本語版便秘評価尺度LT版の評価では、リン吸着薬で排便状態に有意差を認めなかった。QOLスコアに基づくと14名(21.2%)の患者が排便状態に不満を持っており、各リン吸着薬でQOLスコアに有意差を認めなかった。クエン酸第二鉄水和物単剤群では、下剤を内服している患者の割合が有意に少なく、リン吸着薬なし群では下剤内服者の割合が有意に高かった。
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血液透析患者の服薬アドヒアランス及びリン管理の検討 リン吸着薬内服状況との関連について
千葉 修治, 青山 有, 岡田 脩平, 高橋 佳子, 齋藤 拓郎, 中島 志織, 小林 瑞貴, 佐藤 博美, 武藤 弓奈, 山本 竜平, 小泉 淳, 本間 直子, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 井上 高光, 伊藤 卓雄, 鈴木 丈博, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 22 135 - 141 2019年10月
リン吸着薬服用者の服薬アドヒアランスについて検討した。当院で維持透析中の患者のうち、リン吸着薬を内服している46名(男性28名、女性18名、平均63.0歳)を対象とした。リン吸着薬の内服錠数は1日平均5.43錠であった。リン吸着薬を「全部飲み切っている」と回答した患者は67.4%であり、「飲み忘れをしない」と回答した患者は69.6%であった。服薬アドヒアランス優良者とアドヒアランス不良者との間で、年齢や透析歴、血清リン値や補正カルシウム値の比較を行ったが有意差を認めなかった。また、リン吸着薬ごとの比較では服薬アドヒアランスに有意差を認めなかった。クエン酸第二鉄水和物錠は服用錠数が多かったが、リン吸着薬を「減らしたいと思う」と回答した患者の割合は20%であり、有意差はなかったが最も少ない結果であった。
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Numakura K.
Molecular and Clinical Oncology ( Molecular and Clinical Oncology ) 11 ( 3 ) 320 - 324 2019年09月
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Okamoto T.
World Journal of Urology ( World Journal of Urology ) 37 ( 9 ) 1827 - 1835 2019年09月
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Takahashi Y.
Acta Urologica Japonica ( Acta Urologica Japonica ) 65 ( 9 ) 363 - 367 2019年09月
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ニボルマブが奏功した転移性Mucinous tubular and spindle cell carcinomaの1例
高橋 佳子, 沼倉 一幸, 青山 有, 岡田 脩平, 齋藤 拓郎, 武藤 弓奈, 小泉 淳, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 南條 博, 羽渕 友則
泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 65 ( 9 ) 363 - 367 2019年09月
68歳男。人間ドックで右腎腫瘍を指摘され、精査にて右腎癌、臨床病期T3aN1M0と診断された。全身麻酔下に腹腔鏡下右腎摘除術および傍大動脈リンパ節郭清術を行い、病理組織学的所見よりmucinous tubular and spindle cell carcinoma(MTSCC)、G2、pT3aN0と診断したが、術後7ヵ月にMTSCCの骨転移をきたした。アキシチニブを開始するも肺腫瘍が増大し、左仙骨転移も出現したため、二次治療としてニボルマブを導入したところ、12ヵ月後のCTでは多発肺転移はほぼ消失、骨転移も硬化性変化を示し、病勢の増悪は認めなかった。MTSCCに対してニボルマブが有効な症例が存在する可能性が示唆され、本例でニボルマブが奏功した理由としてPD-L1高発現、末梢血Tリンパ球CD4/CD8比低値、末梢血中の好中球/リンパ球比低値であったことが考えられた。
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腎癌におけるイノシトールリン脂質発現プロファイル(The expression profile of phosphatidylinositol phosphates in clinical renal cell carcinoma)
成田 伸太郎, 中西 広樹, 松田 芳教, 小泉 淳, 江口 賢史, 高須賀 俊輔, 黄 明国, 井上 高光, 佐々木 純子, 南条 博, 羽渕 友則, 佐々木 雄彦
日本癌学会総会記事 ( (一社)日本癌学会 ) 78回 P - 1154 2019年09月
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腹腔鏡下ドナー腎採取術手技によるレシピエントのDelayed Graft Functionの検討
井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
移植 ( (一社)日本移植学会 ) 54 ( 総会臨時 ) 252 - 252 2019年09月
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高脂肪食による前立腺癌間質代謝変化とMIC-1シグナル(HFD leads to metabolic modification of prostate cancer promoting stroma by the upregulation of MIC-1)
黄 明国, 成田 伸太郎, 井上 高光, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 78回 E - 1031 2019年09月
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Numakura K.
Frontiers in Endocrinology ( Frontiers in Endocrinology ) 10 2019年08月
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Kawahara T.
PLoS ONE ( PLoS ONE ) 14 ( 8 ) 2019年08月
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ロボット支援下前立腺全摘除術後の急性腎障害の発症と腎予後に関する検討
佐藤 博美, 成田 伸太郎, 齋藤 満, 奈良 健平, 神田 壮平, 千葉 修治, 沼倉 一幸, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 8 ) 1049 - 1051 2019年08月
当院でロボット支援下前立腺全摘除術を施行した305例を対象に、術後急性腎不全(AKI)の発症率や予後との関連を検討した。全症例の平均血清クレアチニンは術直後で術前に比較し有意に上昇した(1.16 vs.0.82mg/dL、p<0.001)。術直後のAKI発生率は55.4%(169例)、術後1〜7日のAKI発生率は5.6%(17例)であり、それぞれ高血圧とコンソール時間の延長、糖尿病がAKI発生のリスク因子であった。また、術直後のAKI発症は術後12ヵ月の腎機能低下と関連していた。(著者抄録)
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特集 ハイリスク前立腺癌を深掘りする-その変遷とM0 CRPCの最新治療 〈オリゴ転移前立腺癌の診断と治療〉 オリゴ転移前立腺癌の診断の現状と課題
成田 伸太郎, 井上 高光, 羽渕 友則
臨床泌尿器科 ( 株式会社医学書院 ) 73 ( 8 ) 530 - 534 2019年07月
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【ハイリスク前立腺癌を深掘りする-その変遷とM0 CRPCの最新治療】オリゴ転移前立腺癌の診断と治療 オリゴ転移前立腺癌の診断の現状と課題
成田 伸太郎, 井上 高光, 羽渕 友則
臨床泌尿器科 ( (株)医学書院 ) 73 ( 8 ) 530 - 534 2019年07月
＜文献概要＞ポイント ・オリゴ転移前立腺癌は予後や治療選択の観点から,局所進行癌や高容量転移癌と区別して扱う必要がある.・オリゴ転移前立腺癌は通常5個までの転移を有する癌とすることが多いが,明確な定義は存在しない.・PSMA-PETやWhole Body-MRIによるオリゴ転移前立腺癌の新規画像診断が注目される.
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転移性腎細胞癌における2nd line療法のNivolumabとTKIの比較検討
小泉 淳, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 49 ) 57 - 57 2019年07月
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転移性腎細胞癌に対するfirst line axitinibの治療成績と効果不良因子の検討
沼倉 一幸, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 49 ) 54 - 54 2019年07月
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A case of penile pyoderma gangrenosum treated with steroid administration without penectomy
Takahashi S.
Acta Urologica Japonica ( Acta Urologica Japonica ) 65 ( 6 ) 219 - 222 2019年06月
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癌性糖鎖変異S2.3PSA検査の前立腺癌診断能および悪性度予測マーカーとしての多施設後ろ向き検討
米山 徹, 石川 友一, 飛澤 悠葵, 畠山 真吾, 成田 伸太郎, 三塚 浩二, 橋本 安弘, 古家 琢也, 羽渕 友則, 伊達 睦廣, Duivenvoorden Wilhelmina, Pinthus Jehonathan, 大山 力
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 757 - 757 2019年06月
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Stage D2前立腺癌に対する複合アンドロゲン療法(CAB)とLH-RH製剤単独療法の治療効果:多施設共同研究
成田 拓磨, 畠山 真吾, 成田 伸太郎, 櫻井 俊彦, 星 宣次, 高橋 正博, 川村 貞文, 石田 雅宣, 土谷 順彦, 荒井 陽一, 羽渕 友則, 大山 力
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 757 - 757 2019年06月
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ロボット支援下腎部分切除術の標準化 当科におけるロボット支援下腎部分切除術標準化の試み
成田 伸太郎, 井上 高光, 齋藤 満, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 645 - 648 2019年06月
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ロボット支援下膀胱全摘除術・尿路変向術の安全な導入と手術手技 テンプレートに従ったRARCにおける拡大リンパ節郭清術手技の標準化
井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 721 - 723 2019年06月
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大久保 鉄平, 三塚 浩二, 小泉 淳, 成田 伸太郎, 古家 琢也, 川村 貞文, 栃木 達夫, 大山 力, 羽渕 友則, 荒井 陽一
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 754 - 754 2019年06月
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高橋 正博, 成田 伸太郎, 三塚 浩二, 畠山 真吾, 櫻井 俊彦, 川村 貞文, 栃木 達夫, 土谷 順彦, 大山 力, 羽渕 友則, 荒井 陽一
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 757 - 757 2019年06月
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導入化学療法抵抗性転移性セミノーマに対し放射線併用救済化学療法が奏効した3例
本間 直子, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 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) ) 32 ( 臨増 ) 742 - 742 2019年06月
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奈良 健平, 成田 伸太郎, 神田 壮平, 千葉 修治, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 742 - 742 2019年06月
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当院における去勢感受性転移性前立腺癌に対する早期ドセタキセル治療の短期成績
武藤 弓奈, 成田 伸太郎, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 758 - 758 2019年06月
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齋藤 拓郎, 齋藤 満, 山本 竜平, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 臨増 ) 740 - 740 2019年06月
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Akamatsu S.
European Urology Oncology ( European Urology Oncology ) 2 ( 3 ) 320 - 328 2019年05月
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Research evidence on high-fat diet-induced prostate cancer development and progression
Narita S.
Journal of Clinical Medicine ( Journal of Clinical Medicine ) 8 ( 5 ) 2019年05月
Although recent evidence has suggested that a high-fat diet (HFD) plays an important role in prostate carcinogenesis, the underlying mechanisms have largely remained unknown. This review thus summarizes previous preclinical studies that have used prostate cancer cells and animal models to assess the impact of dietary fat on prostate cancer development and progression. Large variations in the previous studies were found during the selection of preclinical models and types of dietary intervention. Subcutaneous human prostate cancer cell xenografts, such as LNCaP, LAPC-4, and PC-3 and genetic engineered mouse models, such as TRAMP and Pten knockout, were frequently used. The dietary interventions had not been standardized, and distinct variations in the phenotype were observed in different studies using distinct HFD components. The use of different dietary components in the research models is reported to influence the effect of diet-induced metabolic disorders. The proposed underlying mechanisms for HFD-induced prostate cancer were divided into (1) growth factor signaling, (2) lipid metabolism, (3) inflammation, (4) hormonal modulation, and others. A number of preclinical studies proposed that dietary fat and/or obesity enhanced prostate cancer development and progression. However, the relationship still remains controversial, and care should be taken when interpreting the results in a human context. Future studies using more sophisticated preclinical models are imperative in order to explore deeper understanding regarding the impact of dietary fat on the development and progression of prostate cancer.
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小泉 淳, 沼倉 一幸, 堀川 洋平, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 下田 直威, 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 ) 32 ( 1 ) 116 - 116 2019年05月
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腹腔鏡下副腎摘除術を行った褐色細胞腫における糖質コルチコイドのカテコールアミンへの影響に関する検討
沼倉 一幸, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
日本内分泌外科学会雑誌 ( (一社)日本内分泌外科学会 ) 36 ( Suppl.1 ) S126 - S126 2019年05月
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小林 瑞貴, 沼倉 一幸, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 4 ) 376 - 378 2019年04月
当科で2009〜2018年に筋層非浸潤性膀胱癌に対してBCG膀注を行った149例を対象とし、年齢が80歳以上の群(38例)と80歳未満群(111例)に分け、「BCG膀注の完遂率」「無再発生存率」「非進展生存率」などを群間比較した。結果、いずれの比較項目にも有意な群間差は認めず、BCG膀注は80歳以上の高齢患者においても非高齢患者と同等の効果・安全性があると考えられた。
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Gemcitabine baseレジメン耐性後の転移性尿路上皮癌に対するHi-dose intensity MVAC療法の効果の検討
武藤 弓奈, 沼倉 一幸, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 OP - 239 2019年04月
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【腹腔鏡手術〜初心者に何をどう教えるべきか〜】腹腔鏡技術習得に必要なこと 教わる立場から
神田 壮平, 井上 高光, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 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 ) 32 ( 1 ) 21 - 24 2019年04月
独立した腹腔鏡手術の術者となるためには、術前決定事項として、アプローチ(経腹膜か経後腹膜か)、ポートの留置部位、デバイス選択、などを自ら判断、決定できることに加え、術中はさらに解剖学的な理解と判断、剥離、止血、脈管処理等を安全に実行する技術が要求される。腹腔鏡技術向上のため筆者は、(1)ドライボックスを用いた反復練習、(2)指導医の手術を真似る、(3)自らの手術を振り返る、(4)他施設の手術を見る、という4項目を実践した。一方、教わる立場から、教える側には(1)指導医間の指導内容の統一、(2)手技の言語化、(3)自ら判断し実践させる、という3項目が重要であると考える。一度、自分の型を身につけ手術を完遂できるようになると、自分の型以外にも型があることに気づき、型の違いを知ることで理解はさらに深まる。(著者抄録)
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クッシング症候群に対する腹腔鏡手術後の肥満患者における遠隔期での腎機能の回復(Delayed recovery of kidney function in patients with obesity after laparoscopic surgery for Cushing's syndrome)
沼倉 一幸, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 IS - 30 2019年04月
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ドナー腎代償性機能亢進と糸球体肥大および移植腎機能との関連性
山本 竜平, 齋藤 満, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 OP - 021 2019年04月
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ロボット支援膀胱全摘除術 骨盤リンパ節郭清の方法・成績・意義
成田 伸太郎, 井上 高光, 齋藤 満, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 SY8 - 2 2019年04月
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初回生検時の血清S2,3PSA検査によるActive surveillance適格症例およびClinical significant症例の検出に関する多施設後ろ向き検討
米山 徹, 石川 友一, 飛澤 悠葵, 畠山 真吾, 成田 伸太郎, 三塚 浩二, 橋本 安弘, 伊藤 明宏, 羽渕 友則, 伊達 睦廣, Duivenvoorden Wilhelmina, Pinthus Jehonathan H., 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 OP - 515 2019年04月
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当科における上部尿路上皮癌に対する術前化学療法の検討
小林 瑞貴, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP1 - 291 2019年04月
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当科における化学療法抵抗性尿路上皮癌に対するPembrolizumabの初期使用経験
神田 壮平, 井上 高光, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP1 - 260 2019年04月
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当院ロボット支援腹腔鏡下根治的前立腺摘除術におけるPatient Reported Outcomeの検討
佐藤 博美, 成田 伸太郎, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP2 - 102 2019年04月
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本邦初診時転移性前立腺癌におけるConditional Survival
成田 伸太郎, 野村 恭子, 畠山 真吾, 高橋 正博, 川村 貞文, 星 宣次, 櫻井 俊彦, 三塚 浩二, 土谷 順彦, 大山 力, 荒井 陽一, 長島 健悟, 羽渕 友則, みちのく泌尿器癌研究班
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP2 - 051 2019年04月
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腎移植におけるドナーから持ち込まれたレシピエント腎結石の解析
中島 志織, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP1 - 221 2019年04月
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転移性腎細胞癌における2nd line療法のNivolumabとTKIの比較検討
小泉 淳, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP3 - 151 2019年04月
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転移性腎細胞癌に対するfirst line axitinibの治療成績と効果予測因子の検討
沼倉 一幸, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 OP - 145 2019年04月
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転移性腎細胞癌逐次療法におけるNivolumab投与後のTKI療法の検討
井上 高光, 沼倉 一幸, 小泉 淳, 喜早 祐介, 千葉 修治, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP1 - 176 2019年04月
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限局性前立腺癌全摘患者における血清LH、FSH、テストステロン値と臨床因子・予後との関連
千葉 修治, 成田 伸太郎, 佐藤 博美, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 PP1 - 023 2019年04月
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症例 111In-pentetreotideにて集積を認めた前立腺癌の1例
松田 雅純, 菅原 真人, 古賀 誠, 石山 公一, 高橋 聡, 成田 伸太郎, 羽渕 友則, 橋本 学
臨床放射線 ( 金原出版 ) 64 ( 3 ) 301 - 304 2019年03月
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ドナーから持ち込まれたレシピエント移植腎結石の臨床経過と対応
中島 志織, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本尿路結石症学会誌 ( 日本尿路結石症学会 ) 17 ( 2 ) 170 - 172 2019年03月
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Shiota M.
JAMA network open ( JAMA network open ) 2 ( 2 ) 2019年02月
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Narita S.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 17 ( 1 ) e113 - e122 2019年02月
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Terada N.
BMC Cancer ( BMC Cancer ) 19 ( 1 ) 2019年02月
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【まるごと 基礎〜最新まですべてがわかる!前立腺がん Up-to-date】転移を有する前立腺がん(mHNPC)に対する初期治療(最新動向)
成田 伸太郎, 井上 高光, 羽渕 友則
Uro-Lo: 泌尿器Care & Cure ( (株)メディカ出版 ) 24 ( 1 ) 58 - 61 2019年02月
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術前ドナー腎機能評価法としてのCT volumetryの有効性
山本 竜平, 齋藤 満, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本臨床腎移植学会プログラム・抄録集 ( (一社)日本臨床腎移植学会 ) 52回 148 - 148 2019年02月
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両側精巣腫瘍に対しOnco-TESEを行い精子採取に成功した1例
久保 恭平, 成田 伸太郎, 高橋 修平, 松田 芳教, 小泉 淳, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 佐藤 滋, 熊澤 由紀代, 寺田 幸弘, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 1 ) 86 - 86 2019年01月
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再発悪性褐色細胞腫に対し131I-MIBG内照射療法を施行した一例
中村 久美子, 蘇武 竜太, 小林 瑞貴, 喜早 祐介, 小泉 淳, 成田 伸太郎, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 内山 裕子, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 32 ( 1 ) 91 - 91 2019年01月
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放射線併用のnedaplatin+irinotecan療法が奏功した治療抵抗性進行性セミノーマの一例
松田 芳教, 井上 高光, 喜早 祐介, 沼倉 一幸, 鶴田 大, 前野 淳, 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) ) 32 ( 1 ) 82 - 82 2019年01月
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神田 壮平, 井上 高光, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
Japanese Journal of Endourology ( 日本泌尿器内視鏡学会 ) 32 ( 1 ) 21 - 24 2019年
<p> 独立した腹腔鏡手術の術者となるためには, 術前決定事項として, アプローチ (経腹膜か経後腹膜か), ポートの留置部位, デバイス選択, などを自ら判断, 決定できることに加え, 術中はさらに解剖学的な理解と判断, 剥離, 止血, 脈管処理等を安全に実行する技術が要求される. 腹腔鏡技術向上のため筆者は, ①ドライボックスを用いた反復練習, ②指導医の手術を真似る, ③自らの手術を振り返る, ④他施設の手術を見る, という4項目を実践した. 一方, 教わる立場から, 教える側には①指導医間の指導内容の統一, ②手技の言語化, ③自ら判断し実践させる, という3項目が重要であると考える. 一度, 自分の型を身につけ手術を完遂できるようになると, 自分の型以外にも型があることに気づき, 型の違いを知ることで理解はさらに深まる.</p>
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ホスホイノシタイド(PIPs)プロファイルと前立腺癌の関連検討
小泉淳, 成田伸太郎, 中西広樹, 千葉修治, 神田壮平, 沼倉一幸, 黄明国, 齋藤満, 井上高光, 佐藤滋, 吉岡年明, 羽渕友則, 佐々木雄彦
日本泌尿器科学会総会(Web) ( (一社)日本泌尿器科学会総会事務局 ) 107th PP1 - 006 2019年
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ロボット支援手術の新術式への拡大(骨盤臓器脱・膵臓癌・下咽頭癌・腎盂尿管移行部狭窄・その他) 重複腎盂尿管をともなう腎盂尿管移行部狭窄症に対するロボット支援腹腔鏡下腎盂形成術
沼倉 一幸, 奈良 健平, 神田 壮平, 成田 伸太郎, 井上 高光, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 23 ( 7 ) WS18 - 4 2018年12月
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ロボット支援根治的膀胱全摘除術の新展開 ロボット支援膀胱全摘における拡大リンパ節郭清の意義、方法と成績
羽渕 友則, 井上 高光, 成田 伸太郎, 斎藤 満
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 23 ( 7 ) PD10 - 2 2018年12月
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泌尿器科領域におけるReduced Port Surgeryの現状と将来展望 秋田大学におけるLESS+1トロカードナー腎採取術の現況と今後の展望
井上 高光, 奈良 健平, 齋藤 満, 神田 壮平, 千葉 修治, 沼倉 一幸, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 23 ( 7 ) WS16 - 7 2018年12月
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秋田大学のLESSドナー腎採取術におけるレシピエント長期移植腎機能の検討
奈良 健平, 成田 伸太郎, 神田 壮平, 沼倉 一幸, 井上 高光, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 23 ( 7 ) OS46 - 2 2018年12月
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5-アミノレブリン酸による光力学診断(ALA-PDD)を併用したTURBTの初期検討
中島 志織, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 O - 5 2018年11月
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小林 瑞貴, 沼倉 一幸, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 黄 明国, 佐藤 滋, 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 ) 31 50 - 50 2018年11月
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〜Precision Endourologyを語る〜理想的なドナー腎摘除とは?〜経腹vs経後腹膜、多孔式vs単孔式、Pureラパロvsハンドアシスト〜 生体反応性、質問票調査結果から考える理想的なドナー腎摘除術とは?
齋藤 満, 井上 高光, 成田 伸太郎, 沼倉 一幸, 神田 壮平, 千葉 修治, 奈良 健平, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 MSY - 2 2018年11月
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〜エキスパートのResilienceを学ぶ〜高難度症例の腹腔鏡下腎摘除をResilience能力で対応する 大きな腎腫瘍に対する腹腔鏡下腎摘除術
神田 壮平, 井上 高光, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 VWS - 1 2018年11月
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ロボット支援腹腔下腎部分切除術における腎実質切除量と術後腎機能に関する検討
神田 壮平, 井上 高光, 中島 志織, 奈良 健平, 千葉 修治, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 O - 3 2018年11月
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ロボット支援腹腔鏡下根治的前立腺摘除術後の急性腎障害に関する検討
佐藤 博美, 成田 伸太郎, 斎藤 満, 奈良 健平, 神田 壮平, 千葉 修治, 沼倉 一幸, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 P - 10 2018年11月
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ロボット支援膀胱全摘術におけるテンプレートに従った拡大リンパ節郭清術
井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 AV - 6 2018年11月
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抗体関連型拒絶反応及びTリンパ球細胞性拒絶反応を伴ったplasma cell-rich acute rejectionの1例
山本 竜平, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 21 119 - 125 2018年11月
症例は40歳女性で、15歳時に全身性エリテマトーデスを発症し、28歳時にループス腎炎による慢性腎不全のため腹膜透析導入となった。その後、血液透析を経て34歳時に母親をドナーとする血液型適合生体腎移植術を施行した。術後、維持免疫抑制はタクロリムス(TAC)、ミコフェノール酸モフェチル(MMF)、プレドニゾロン(PSL)の3剤を併用して行った。移植2ヵ月後にサイトメガロウイルス(CMV)感染症を発症し、MMFを減量して維持していたが、移植後5年経過時に帯状疱疹による右下肢運動・感覚障害が出現したためMMFを中止し、感染症がコントロールできた後もMMFは再開せずにTACとPSLのみで維持免疫抑制とした。移植後6年目に入り、血清Crの急激な上昇を認めたため、エピソード移植腎生検を施行した。エピソード移植腎生検1回目の所見より、抗体関連型拒絶反応およびTリンパ球細胞性拒絶反応を伴ったPlasma cell-rich acute rejectionと診断した。治療としてステロイドパルス療法+血漿交換療法+low doseガンマグロブリンを行い、ステロイド治療抵抗性拒絶反応として抗ヒト胸腺細胞ウサギ免疫グロブリンを追加投与した。ボルテゾミブの使用も検討したが2回目のエピソード移植腎生検の病理所見で形質細胞浸潤が減少していたため投与を行わなかった。その後、一時TAC、MMFの中止を余儀なくされたものの最終的にはバルガンシクロビル投与でCMV感染のコンロールが可能となった。現在、TACおよびMMFは再開しており、エベロリムス、PSLの4剤併用療法を行っている。
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減点されない!腹腔鏡下副腎摘除術
成田 伸太郎, 井上 高光, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 SEP - 1 2018年11月
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秋田大学におけるロボット支援腎部分切除術の検討
小泉 淳, 井上 高光, 奈良 健平, 千葉 修司, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 O - 5 2018年11月
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腹腔鏡下ドナー腎採取術における術中血管トラブル症例の検討
千葉 修治, 井上 高光, 成田 伸太郎, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 佐藤 滋, 羽渕 友則
日本泌尿器内視鏡学会総会 ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 32回 O - 2 2018年11月
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Can single positive core prostate cancer at biopsy be considered a low-risk disease?
Yamamoto H.
International Urology and Nephrology ( International Urology and Nephrology ) 50 ( 10 ) 1829 - 1833 2018年10月
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Sunitinibの血中濃度測定による薬物モニタリングと治療効果および予測因子の検討
沼倉 一幸, 藤山 信弘, 奈良 健平, 千葉 修治, 神田 壮平, 黄 明国, 齋藤 満, 成田 伸太郎, 佐藤 滋, 新岡 丈典, 三浦 昌朋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 56回 P98 - 8 2018年10月
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抗PD-1抗体(Nivolumab)で治療した転移性腎細胞癌患者の有害事象に関する多施設研究
沼倉 一幸, 堀川 洋平, 鎌田 幸子, 小泉 淳, 奈良 健平, 千葉 修治, 神田 壮平, 齋藤 満, 成田 伸太郎, 井上 高光, 小原 崇, 下田 直威, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 56回 P100 - 1 2018年10月
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限局性前立腺癌に対するTomoTherapyOを用いた画像誘導放射線治療の治療成績
佐藤 博美, 寺井 康詞郎, 高山 孝一朗, 成田 直史, 目時 隆博, 成田 伸太郎, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 斎藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 56回 O44 - 3 2018年10月
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前立腺癌におけるホスファチジルイノシトールリン酸プロファイルの解析(Phosphatidylinositol phosphate profiles in pre-clinical and clinical prostate cancer)
小泉 淳, 成田 伸太郎, 中西 広樹, 奈良 健平, 神田 壮平, 沼倉 一幸, 黄 明国, 齋藤 満, 井上 高光, 佐藤 滋, 吉岡 年明, 羽渕 友則, 佐々木 雄彦
日本癌学会総会記事 ( 日本癌学会 ) 77回 1444 - 1444 2018年09月
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山本 竜平, 齋藤 満, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
移植 ( (一社)日本移植学会 ) 53 ( 総会臨時 ) 358 - 358 2018年09月
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ハイリスク限局性前立腺癌の全摘標本を用いた化学内分泌療法抵抗性分子の探索(Tissue biomarkers in patients with high-risk prostate cancer treated with neoadjuvant chemohormonal therapy)
成田 伸太郎, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 井上 高光, 黄 明国, 南條 博, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 77回 1689 - 1689 2018年09月
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高脂肪食下前立腺間質活性化と癌進展におけるMIC-1の役割(Reactive stromal fibroblast contribute to high-fat-associated prostate cancer by the upregulated MIC-1)
黄 明国, 成田 伸太郎, 井上 高光, 羽渕 友則
日本癌学会総会記事 ( (一社)日本癌学会 ) 77回 1489 - 1489 2018年09月
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Koizumi A.
Japanese Journal of Clinical Oncology ( Japanese Journal of Clinical Oncology ) 48 ( 8 ) 765 - 770 2018年08月
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ドナーから持ち込まれたレシピエント移植腎結石の臨床経過と対応
中島 志織, 井上 高光, 奈良 健平, 千葉 修治, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本尿路結石症学会誌 ( 日本尿路結石症学会 ) 17 ( 1 ) 55 - 55 2018年08月
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irAE 転移性腎細胞癌に対するNivolumabの治療成績とirAE
沼倉 一幸, 堀川 洋平, 井上 高光, 奈良 健平, 神田 壮平, 齋藤 満, 成田 伸太郎, 黄 明国, 佐藤 滋, 下田 直威, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 48 ) 23 - 23 2018年07月
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分子標的薬時代の転移性腎癌における一次転移臓器別の予後解析
井上 高光, 高山 孝一朗, 喜早 祐介, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 48 ) 104 - 104 2018年07月
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血管内皮関連遺伝子多型とaxitinibの臨床効果との関連
小泉 淳, 沼倉 一幸, 奈良 健平, 神田 壮平, 黄 明国, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 48 ) 32 - 32 2018年07月
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転移性腎癌患者における1st-line Sunitinib療法とAxitinib療法とのアウトカムの比較検討
喜早 祐介, 井上 高光, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 48 ) 96 - 96 2018年07月
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ロボット支援腎部分切除術(RAPN);導入から応用まで ロボット支援腹腔鏡下腎部分切除術におけるデバイスの選択
井上 高光, 齋藤 満, 神田 壮平, 奈良 健平, 沼倉 一幸, 成田 伸太郎, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 31 ( 臨増 ) 681 - 684 2018年06月
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奈良 健平, 成田 伸太郎, 沢石 由記夫, 小原 崇, 神田 壮平, 沼倉 一幸, 齋藤 満, 佐藤 滋, 羽渕 友則
日本小児泌尿器科学会雑誌 ( 日本小児泌尿器科学会 ) 27 ( 2 ) 287 - 287 2018年06月
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本間 直子, 鶴田 大, 奈良 健平, 神田 壮平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 31 ( 臨増 ) 808 - 808 2018年06月
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奈良 健平, 成田 伸太郎, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 31 ( 臨増 ) 826 - 826 2018年06月
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腎移植患者におけるタクロリムス変動係数と服薬アドヒアランス、拒絶反応との関連性
山本 竜平, 齋藤 満, 藤山 信弘, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 31 ( 臨増 ) 821 - 821 2018年06月
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膀胱全摘除術を行った75歳以上の膀胱癌患者における補助化学療法の意義
小林 瑞貴, 沼倉 一幸, 神田 壮平, 鶴田 大, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 31 ( 臨増 ) 832 - 832 2018年06月
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奈良 健平, 井上 高光, 神田 壮平, 沼倉 一幸, 鶴田 大, 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) ) 31 ( 臨増 ) 836 - 836 2018年06月
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Numakura K.
Oncotarget ( Oncotarget ) 9 ( 38 ) 25277 - 25284 2018年05月
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Sato H.
BMC Urology ( BMC Urology ) 18 ( 1 ) 2018年05月
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Komine N.
International Immunopharmacology ( International Immunopharmacology ) 58 57 - 63 2018年05月
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Intermittent chemotherapy with docetaxel for metastatic castration-resistant prostate cancer
Narita S.
Hormone Therapy and Castration Resistance of Prostate Cancer ( Hormone Therapy and Castration Resistance of Prostate Cancer ) 357 - 368 2018年05月
The optimal schedule of docetaxel chemotherapy for castration-resistant prostate cancer is unknown, although continuous administration is accepted as the standard. However, several disadvantages, including side effects, costs, and development of resistant clones, need to be considered during continuous administration of docetaxel. Intermittent docetaxel therapy represents an appealing option to address these issues. Previous studies have reported that intermittent docetaxel therapy is associated with favorable outcomes, with successful chemotherapy holidays and maintained Quality of Life (QOL). However, limitations of these studies include a wide variation in study design and schedule and a lack of randomized trials comprising a large number of patients allowing comparison of outcomes with continuous administration. This chapter summarizes current data on intermittent docetaxel therapy in androgen-independent and castration-resistant prostate cancer from previous literature and examines future directions regarding the use of this strategy as a therapeutic option for advanced prostate cancer.
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腹腔鏡下副腎摘除術を行ったクッシング症候群における術後腎機能とその予測因子の検討
松田 芳教, 沼倉 一幸, 成田 伸太郎, 井上 高光, 羽渕 友則
日本内分泌・甲状腺外科学会雑誌 ( 日本内分泌外科学会・日本甲状腺外科学会 ) 35 ( Suppl.1 ) S108 - S108 2018年05月
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Igarashi R.
Medical Oncology ( Medical Oncology ) 35 ( 4 ) 2018年04月
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Significance of Serum N-glycan Profiling as a Diagnostic Biomarker in Urothelial Carcinoma
Oikawa M.
European Urology Focus ( European Urology Focus ) 4 ( 3 ) 405 - 411 2018年04月
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ウサギを用いた萎縮膀胱機能回復の分子生物学的検討
喜早 祐介, 井上 高光, 西島 和俊, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 善積 克, 佐藤 滋, 河谷 正仁, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP2 - 203 2018年04月
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体液を用いた診断・治療マーカーの開発 PSAの糖鎖変異を利用した前立腺癌診断および悪性度評価マーカー
米山 徹, 金子 智典, 彼谷 高敏, 須田 美彦, 石川 友一, 伊達 睦廣, 成田 伸太郎, 三塚 浩二, 羽渕 友則, 荒井 陽一, 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 SY6 - 2 2018年04月
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癌性糖鎖変異S2,3PSA検査とF/TおよびPSA検査との前立腺癌診断能比較
米山 徹, 石川 友一, 飛澤 悠葵, 畠山 真吾, 成田 伸太郎, 三塚 浩二, 橋本 安弘, 古家 琢也, 羽渕 友則, 荒井 陽一, 伊達 睦廣, 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 303 2018年04月
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High risk前立腺癌に対する集学的治療(手術療法を中心に) High-risk前立腺癌に対する前立腺全摘のneoadjuvant療法
成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 SY17 - 3 2018年04月
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【前立腺癌のバイオマーカー】遺伝子多型を用いた進行前立腺癌の予後・治療反応予測
成田 伸太郎, 土谷 順彦, 羽渕 友則
Prostate Journal ( 医学図書出版(株) ) 5 ( 1 ) 41 - 47 2018年04月
遺伝子多型は、簡便・安定・非侵襲であり、進行前立腺癌の有力なバイオマーカーとなる可能性がある。多型解析は従来型の仮説研究的解析に加え、大規模な網羅的解析が行われるようになった。しかし、臨床応用のハードルは高く、生物学的機能解析、複数多型を組合せたモデルや複数コホートによる検証が重要である。本稿では進行前立腺癌と遺伝子多型の関連につき、最近の報告とわれわれのこれまでの研究結果につき概述する。(著者抄録)
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ロボット支援腹腔鏡下前立腺全摘除術における断端陽性の検討 多施設共同後ろ向き試験の成績から
成田 伸太郎, 大久保 鉄平, 三塚 浩二, 畠山 真吾, 古家 拓也, 松田 芳教, 羽渕 友則, 小泉 淳, 大山 力, 荒井 陽一
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP2 - 145 2018年04月
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上部尿路上皮癌の原発巣に対する放射線外照射の有効性に関する検討
小林 瑞貴, 沼倉 一幸, 高山 孝一朗, 奈良 健平, 神田 壮平, 鶴田 大, 黄 明国, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則, 安倍 明
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 603 2018年04月
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前立腺全摘標本における癌周囲免疫細胞と治療抵抗性および生化学的再発の関連
奈良 健平, 成田 伸太郎, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 井上 高光, 佐藤 滋, 南條 博, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP3 - 190 2018年04月
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当科での尿道狭窄に対する尿道形成術9例の検討
本間 直子, 井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 053 2018年04月
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根治的前立腺全摘における断端陽性と生化学的再発の関連 多施設共同後ろ向き試験の成績から
松田 芳教, 成田 伸太郎, 小泉 淳, 大久保 鉄平, 三塚 浩二, 畠山 真吾, 古家 琢也, 川村 貞文, 栃木 達夫, 大山 力, 荒井 陽一, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 617 2018年04月
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秋田大学における転移性腎細胞癌に対するNivolumabの初期投与経験
小泉 淳, 井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP2 - 040 2018年04月
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腎移植患者におけるタクロリムス変動係数の臨床事象への影響
山本 竜平, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 205 2018年04月
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腹腔鏡下およびロボット支援下腎部分切除術における腎部分切除体積と術後腎機能の比較検討
井上 高光, 神田 壮平, 奈良 健平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 OP - 354 2018年04月
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膀胱全摘除術を行った75歳以上の膀胱癌患者における補助化学療法の意義
神田 壮平, 沼倉 一幸, 鶴田 大, 奈良 健平, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP2 - 046 2018年04月
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高脂肪食による前立腺癌間質微小環境の活性化と前立腺癌進展
黄 明国, 井上 高光, 成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 106回 PP3 - 065 2018年04月
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Inoue T.
BMC Cancer ( BMC Cancer ) 18 ( 1 ) 2018年03月
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膀胱全摘除術を行った75歳以上の膀胱癌患者における補助化学療法の意義
神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 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 ) 30 60 - 60 2018年03月
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【前立腺がんの診断・治療2018】局所進行がん、少量転移がんの治療戦略
成田 伸太郎, 井上 高光, 羽渕 友則
Mebio ( (株)メジカルビュー社 ) 35 ( 2 ) 49 - 57 2018年02月
●局所進行前立腺がんおよび少量転移前立腺がんの定義は確立していない。●PETやMRIなどの新規画像技術を用いた診断が有用である。●局所治療と全身治療を併用した集学的治療が有効と考えられるが、標準的治療は存在しない。(著者抄録)
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抗体関連型拒絶反応及びTリンパ球細胞性拒絶反応を伴ったplasma cell rich acute rejectionの1例
山本 竜平, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
移植 ( (一社)日本移植学会 ) 52 ( 6 ) 564 - 564 2018年02月
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Matsumoto T.
Medical Oncology ( Medical Oncology ) 34 ( 12 ) 2017年12月
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ロボット支援腹腔鏡下前立腺全摘除術における断端陽性の検討 多施設共同後ろ向き試験の成績から
成田 伸太郎, 三塚 浩二, 古家 琢也, 畠山 真吾, 松田 芳教, 大山 力, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 22 ( 7 ) SF107 - 05 2017年12月
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秋田大学におけるロボット支援腹腔鏡下膀胱全摘除術の成績
松田 芳教, 井上 高光, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 22 ( 7 ) SF107 - 01 2017年12月
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腹腔鏡下副腎摘除術を行ったクッシング症候群における術後腎機能とその予測因子の検討
沼倉 一幸, 神田 壮平, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 22 ( 7 ) SF099 - 05 2017年12月
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ドナー腎採取術: 後腹膜 vs 経腹膜 腹腔鏡下ドナー腎採取術における経腹膜アプローチの利点
井上 高光, 成田 伸太郎, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 佐藤 滋, 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 ) 30 ( 3 ) 149 - 149 2017年11月
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単孔式・Reduced port腹腔鏡手術の最前線 当院における単孔式ドナー腎採取の取組み
成田 伸太郎, 井上 高光, 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 ) 30 ( 3 ) 133 - 133 2017年11月
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安全・低侵襲で腎機能を最大限温存するドナー腎採取術 安全かつ移植腎機能を温存する腹腔鏡下ドナー腎採取術への注意点
井上 高光, 成田 伸太郎, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 佐藤 滋, 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 ) 30 ( 3 ) 128 - 128 2017年11月
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当院における腎盂尿管移行部狭窄症に対するロボット支援腹腔鏡下腎盂形成術の初期成績
小林 瑞貴, 井上 高光, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 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 ) 30 ( 3 ) 196 - 196 2017年11月
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腎移植レシピエントに発症した浸潤性膀胱癌
石田 雅宣, 沼倉 一幸, 関根 悠哉, 喜早 祐介, 松田 芳教, 五十嵐 龍馬, 山本 竜平, 小泉 淳, 高山 孝一朗, 奈良 健平, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 成田 伸太郎, 佐藤 滋, 羽渕 友則
秋田腎不全研究会誌 ( 秋田腎不全研究会 ) 20 109 - 112 2017年11月
症例1は71歳女性で、20歳代から検診で尿蛋白を指摘されていたが、無治療のまま放置した。食思不振、嘔気で受診し、慢性腎不全の診断で血液透析導入となった。弟をドナーとする血液型適合生体腎移植術を施行した。尿定性検査で尿潜血を指摘され、膀胱鏡検査で膀胱両側壁に乳頭型・広基性腫瘍を認めた。尿細胞診はclass Vであった。経尿道的膀胱腫瘍切除術を施行した。術後補助化学療法を施行した。術後4年間、再発を認めなかったが、脳梗塞を発症し、寝たきり状態となり、誤嚥性肺炎で死亡した。症例2は63歳男性で、IgA腎症による慢性腎不全で腹膜透析導入となった。その後、イレウスを繰り返し、被嚢性腹膜硬化症と診断された。大腸ポリペクトミー後に腹膜炎を発症し、血液透析導入となった。妻をドナーとする血液型適合生体腎移植術を行った。肉眼的血尿を認め、膀胱鏡検査で左側壁に結節型・広基性腫瘍を認めた。尿細胞診はclass IIIであった。経尿道的膀胱腫瘍切除術を施行した。治療経過中に発熱性好中球減少症および消化管出血を発症したため、現在治療を延期中である。
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腹腔鏡下腎部分切除術におけるロボット支援による術後早期腎機能回復の検討
神田 壮平, 井上 高光, 鶴田 大, 奈良 健平, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 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 ) 30 ( 3 ) 191 - 191 2017年11月
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Inoue T.
Transplantation Proceedings ( Transplantation Proceedings ) 49 ( 8 ) 1786 - 1790 2017年10月
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ハイリスク前立腺癌に対する術前化学内分泌療法併用前立腺全摘の治療成績
成田 伸太郎, 奈良 健平, 鶴田 大, 沼倉 一幸, 神田 壮平, 齋藤 満, 井上 高光, 南條 博, 三塚 浩二, 古家 琢也, 川村 貞文, 大山 力, 荒井 陽一, 栃木 達夫, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 55回 P96 - 3 2017年10月
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【新腎・泌尿器癌(下)-基礎・臨床研究の進歩-】膀胱癌 膀胱癌の分子生物学と発癌機序 発症メカニズム 膀胱癌幹細胞を中心に
成田 伸太郎, 羽渕 友則
日本臨床 ( (株)日本臨床社 ) 75 ( 増刊7 新腎・泌尿器癌(下) ) 35 - 38 2017年10月
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前立腺癌密封小線源療法のQOLに影響する臨床因子の検討
沼倉 一幸, 古賀 誠, 高山 孝一朗, 小泉 淳, 奈良 健平, 神田 壮平, 鶴田 大, 黄 明国, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 安倍 明, 橋本 学, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 55回 P73 - 4 2017年10月
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腎盂尿管癌に対する腎尿管全摘術に伴うリンパ節郭清の有効性に関する多施設前向き研究
井上 高光, 成田 伸太郎, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 55回 P49 - 3 2017年10月
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転移性腎癌におけるアキシチニブの治療効果を予測するバイオマーカーの探索
本間 直子, 土谷 順彦, 井上 高光, 鶴田 大, 沼倉 一幸, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 55回 P3 - 6 2017年10月
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ウサギを用いた廃用性萎縮膀胱の回復モデルの作成
喜早 祐介, 井上 高光, 西島 和俊, 沼倉 一幸, 鶴田 大, 善積 克, 齋藤 満, 成田 伸太郎, 佐藤 滋, 河谷 正仁, 羽渕 友則
日本排尿機能学会誌 ( (一社)日本排尿機能学会 ) 28 ( 1 ) 207 - 207 2017年09月
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高脂肪食は前立腺癌間質微小環境を活性化し癌進展を促進する
黄 明国, 井上 高光, 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 ) 76回 P - 2418 2017年09月
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【新腎・泌尿器癌(上)-基礎・臨床研究の進歩-】腎盂尿管癌 腎盂尿管癌の特徴 腎盂尿管癌の多発進展メカニズム
成田 伸太郎, 井上 高光, 羽渕 友則
日本臨床 ( (株)日本臨床社 ) 75 ( 増刊6 新腎・泌尿器癌(上) ) 442 - 445 2017年08月
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グラフトを原因としない移植後長期合併症とその対策 遺伝子多型によるTacrolimus投与設計およびmTOR阻害剤add onプロトコールは移植腎線維化を軽減できるか?
齋藤 満, 佐藤 滋, 山本 竜平, 沼倉 一幸, 井上 高光, 成田 伸太郎, 鶴田 大, 羽渕 友則
移植 ( (一社)日本移植学会 ) 52 ( 総会臨時 ) 247 - 247 2017年08月
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当院で組織学的に神経内分泌腫瘍と診断された前立腺癌の臨床検討
奈良 健平, 成田 伸太郎, 神田 壮平, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 8 ) 1305 - 1308 2017年08月
当院で病理学的に前立腺神経内分泌腫瘍(NEPC)と診断された9例の臨床経過を検討した。全症例で経過中、血清NEPCマーカーが上昇し、免疫組織染色でNEPCマーカーのいずれかが陽性となった。プラチナ製剤を含む化学療法が半数で奏効した。NEPCマーカー陽性の腺癌に比較し、小細胞癌の予後は不良であった。NEPCの定義、診断、マーカー、治療法は確立していないため、さらなる症例を集積した検討が必要である。(著者抄録)
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Takayama K.
Cancer Letters ( Cancer Letters ) 397 103 - 110 2017年07月
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分子標的薬時代の転移性腎癌における一次転移臓器別の予後解析
井上 高光, 高山 孝一朗, 喜早 祐介, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 47 ) 42 - 42 2017年07月
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転移性腎癌患者における1st-line Sunitinib療法とAxitinib療法とのアウトカムの比較検討
喜早 祐介, 井上 高光, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 羽渕 友則
腎癌研究会会報 ( (一社)腎癌研究会 ) ( 47 ) 36 - 36 2017年07月
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奈良 健平, 成田 伸太郎, 関根 悠哉, 石田 雅宣, 五十嵐 龍馬, 沼倉 一幸, 鶴田 大, 前野 淳, 斎藤 満, 井上 高光, 羽渕 友則, 沢石 由記夫, 小原 崇
日本小児血液・がん学会雑誌 ( (一社)日本小児血液・がん学会 ) 54 ( 2 ) 184 - 185 2017年06月
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Inverse relationship between insulin receptor expression and progression in renal cell carcinoma
Takahashi M.
Oncology Reports ( Oncology Reports ) 37 ( 5 ) 2929 - 2941 2017年05月
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ロボット支援腎部分切除術 初期経験における留意点 秋田大学におけるロボット支援腎部分切除術の初期経験と留意点
井上 高光, 成田 伸太郎, 齋藤 満, 沼倉 一幸, 鶴田 大, 前野 淳, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 813 - 816 2017年05月
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前立腺癌バイオマーカーのパラダイムシフト 遺伝子多型を用いた進行前立腺癌の予後・治療反応予測
成田 伸太郎, 土谷 順彦, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 675 - 677 2017年05月
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五十嵐 龍馬, 前野 淳, 成田 伸太郎, 井上 高光, 齋藤 満, 鶴田 大, 沼倉 一幸, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 903 - 903 2017年05月
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根治術不能な上部尿路癌に対する原発巣への放射線外照射療法の検討
高山 孝一朗, 成田 伸太郎, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 926 - 926 2017年05月
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泌尿器科医の腎移植ことはじめ 生体腎移植における腹腔鏡下移植用腎採取術およびレシピエント手術の要点
井上 高光, 齋藤 満, 山本 竜平, 沼倉 一幸, 鶴田 大, 前野 淳, 成田 伸太郎, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 799 - 801 2017年05月
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秋田大学における転移性腎細胞癌に対するPazopanibの使用経験
喜早 祐介, 井上 高光, 五十嵐 龍馬, 沼倉 一幸, 鶴田 大, 齋藤 満, 前野 淳, 成田 伸太郎, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 臨増 ) 908 - 908 2017年05月
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血液透析患者の転移性腎細胞癌に対する分子標的薬治療の経験
奈良 健平, 成田 伸太郎, 関根 悠哉, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本透析医学会雑誌 ( (一社)日本透析医学会 ) 50 ( Suppl.1 ) 710 - 710 2017年05月
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Narita T.
Cancer Medicine ( Cancer Medicine ) 6 ( 4 ) 739 - 748 2017年04月
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増刊号特集 泌尿器科検査パーフェクトガイド II疾患別:実施すべき検査と典型所見 [10]腫瘍 尿膜管腫瘍
井上 高光, 成田 伸太郎
臨床泌尿器科 ( 株式会社医学書院 ) 71 ( 4 ) 296 - 299 2017年04月
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CONTRIBUTION OF GENETIC POLYMORPHISMS RELATED TO AXITINIB PHARMACOKINETICS TO THE CLINICAL SAFETY AND EFFICACY IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA
Ryoma Igarashi, Norihiko Tsuchiya, Takamitsu Inoue, Nobuhiro Fujiyama, Kazuyuki Numakura, Hiroshi Tsuruta, Hideaki Kagaya, Atsushi Maeno, Mitsuru Saito, Shintaro Narita, Takenori Nioka, Masatomo Miura, Shigeru Sato, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 197 ( 4 ) E182 - E182 2017年04月
研究発表要旨（国際会議）
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血清N-結合型糖鎖の網羅的質量解析による精巣腫瘍の診断・予後マーカーの検索
成田 拓磨, 畠山 真吾, 米山 徹, 成田 伸太郎, 山下 慎一, 櫻井 俊彦, 飛澤 悠葵, 古家 琢也, 土谷 順彦, 羽渕 友則, 荒井 陽一, 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 OP58 - 1 2017年04月
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高脂肪食下前立腺間質 癌微小環境の活性化と前立腺癌進展における脂肪酸結合分子4(FABP4)の役割
黄 明国, 小泉 淳, 井上 高光, 成田 伸太郎, 斉藤 満, 佐藤 滋, 南條 博, 佐々木 雄彦, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 OP41 - 4 2017年04月
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沼倉 一幸, 石田 雅宣, 関根 祐哉, 五十嵐 龍馬, 山本 竜平, 小泉 淳, 高山 孝一朗, 奈良 健平, 黄 明国, 鶴田 大, 前野 淳, 斎藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 30 ( 4 ) 468 - 470 2017年04月
BCG膀胱内注入療法を行った筋層非浸潤膀胱癌65例(男性46名、女性19名、52〜87歳)を対象とした。BCGの使用理由は、CIS 29例、T1 24例、頻回再発8例、G3 3例、その他1例であった。肝機能障害は13例(20.0%)で、AST、ALTのみの上昇5例、ALPのみの上昇3例、γ-GTPのみの上昇2例、複数の検査値上昇3例であった。女性に肝機能障害が多く、膀胱癌再発率が高い傾向がみられたが、抗生剤内服の有無、BCGの完遂率、癌の進展率に違いはなかった。再発率をLog-Rank testで解析し、再発率が高い傾向がみられた。
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Cisplatin unfitの進行性尿路上皮癌に対する二次化学療法としてのGemcitabine-Nedaplatin療法の有効性の検討
鶴田 大, 井上 高光, 齋藤 満, 前野 淳, 沼倉 一幸, 成田 伸太郎, 佐藤 滋, 羽渕 友則, 賀本 敏行
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 PP75 - 03 2017年04月
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分子標的薬時代の転移性腎癌における一次転移臓器別の予後解析
高山 孝一朗, 井上 高光, 喜早 祐介, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 OP49 - 4 2017年04月
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当院および関連施設における去勢抵抗性前立腺癌に対するエンザルタミド、アビラテロンの治療成績
前野 淳, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 井上 高光, 熊澤 光明, 飯沼 昌宏, 松尾 重樹, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 PP53 - 04 2017年04月
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根治的前立腺全摘患者の周術期血中サイトカイン濃度と生化学的再発の検討
奈良 健平, 成田 伸太郎, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 PP91 - 06 2017年04月
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腎移植レシピエント術後管理のコツと工夫
井上 高光, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 UB07 - UB07 2017年04月
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転移性腎癌におけるアキシチニブの治療効果を予測する血清バイオマーカーの探索
本間 直子, 土谷 順彦, 井上 高光, 鶴田 大, 前野 淳, 沼倉 一幸, 成田 伸太郎, 齋藤 満, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 PP65 - 02 2017年04月
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転移性腎癌患者における1st-line Sunitinib療法とAxitinib療法とのアウトカムの比較検討
喜早 祐介, 井上 高光, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 斎藤 満, 前野 淳, 成田 伸太郎, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 PP76 - 01 2017年04月
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高齢腎移植レシピエントの選択基準について
齋藤 満, 佐藤 滋, 井上 高光, 沼倉 一幸, 成田 伸太郎, 鶴田 大, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 105回 SKH04 - 1 2017年04月
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Kobayashi M.
Acta Urologica Japonica ( Acta Urologica Japonica ) 63 ( 3 ) 111 - 114 2017年03月
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Mizuki Kobayashi, Mitsuru Saito, Susumu Akihama, Teruaki Kumazawa, Ryoma Igarashi, Ryohei Yamamoto, Koichiro Takayama, Hiroshi Tsuruta, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica ( 泌尿器科紀要刊行会 ) 63 ( 3 ) 111 - 114 2017年03月
A woman in her 30s was admitted with abdominal pain and nausea. CT scan revealed a spontaneous rupture of the right giant renal angiomyolipoma, and trans-arterial embolization was performed successfully. With further examination, she was found to be affected with tuberous sclerosis complex (TSC) and she finally wastreated with everolimusfor prevention of recurrent spontaneous-rupture of renal angiomyolipoma.
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Kamba T.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 22 ( 1 ) 166 - 173 2017年02月
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Ishikawa T.
International Journal of Molecular Sciences ( International Journal of Molecular Sciences ) 18 ( 2 ) 2017年02月
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Ito R.
PLoS ONE ( PLoS ONE ) 12 ( 2 ) 2017年02月
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【メタボリック症候群と腎泌尿器疾患-疾患予防への挑戦-】泌尿器がんとメタボリックシンドローム
成田 伸太郎, 井上 高光, 羽渕 友則
腎臓内科・泌尿器科 ( (有)科学評論社 ) 5 ( 2 ) 133 - 139 2017年02月
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Numakura K.
Anti-Cancer Drugs ( Anti-Cancer Drugs ) 28 ( 1 ) 97 - 103 2017年01月
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Laparoendoscopic single-site surgeries: A multicenter experience of 469 cases in Japan
Sato F.
International Journal of Urology ( International Journal of Urology ) 24 ( 1 ) 69 - 74 2017年01月
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Narita T.
Medical Oncology ( Medical Oncology ) 34 ( 1 ) 2017年01月
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Clinical effects of single nucleotide polymorphisms on drug-related genes in Japanese metastatic renal cell carcinoma patients treated with sunitinib.
Kazuyuki Numakura, Norihiko Tsuchiya, Hideaki Kagaya, Makoto Takahashi, Hiroshi Tsuruta, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Takenori Niioka, Masatomo Miura, Tomonori Habuchi
Anti-cancer drugs 28 ( 1 ) 97 - 103 2017年01月
Although sunitinib is a well-established chemotherapeutic for metastatic renal cell carcinoma (mRCC), there are no robust markers that predict efficacy and toxicity. We analyzed the effect of single nucleotide polymorphisms (SNPs) in genes involved in sunitinib pharmacokinetics on clinical outcomes in Japanese patients with mRCC. We analyzed the effect of SNPs in genes involved in sunitinib pharmacokinetics on the clinical outcome in mRCC patients in a Japanese population. We evaluated seven SNPs in four candidate genes, the transport proteins ATP-binding cassette (ABC) B1 (rs1045642, rs1128503, rs2032582, and rs7779562) and ABCG2 (rs2231142), and the metabolic proteins cytochrome P450 (CYP) 3A4 (rs35599367) and CYP3A5 (rs776746) in 70 patients. No significant association was observed between the genotypes of each SNP and time to dose reduction, progression-free survival, overall survival, and best objective response. Meanwhile, the incidence of grade 2 or greater hypertension and hand-foot syndrome, and multiple adverse events (>3), was significantly higher in patients carrying the ABCB1 rs2032582 GG genotype [odds ratio (OR): 5.37, 95% confidence interval (CI) 1.02-14.63, P=0.035; OR: 3.17, 95% CI 1.06-9.52, P=0.036, OR: 3.35; 95% CI 1.14-9.84; P=0.025, respectively]. In conclusion, our data showed that the ABCB1 rs2032582 GG genotype was associated with individual adverse events' susceptibility among Japanese patients treated with sunitinib in routine clinical settings.
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The impact of extended lymph node dissection versus neoadjuvant therapy with limited lymph node dissection on biochemical recurrence in high-risk prostate cancer patients treated with radical prostatectomy: a multi-institutional analysis.
Takuma Narita, Takuya Koie, Teppei Ookubo, Koji Mitsuzuka, Shintaro Narita, Hayato Yamamoto, Takamitsu Inoue, Shingo Hatakeyama, Sadafumi Kawamura, Tatsuo Tochigi, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama
Medical oncology (Northwood, London, England) 34 ( 1 ) 1 - 1 2017年01月
The optimal treatment for high-risk prostate cancer (Pca) remains to be established. The current guidelines recommend extended pelvic lymph node dissection (e-PLND) for selected intermediate- and high-risk patients treated with RP. However, the indications, optimal extent, and therapeutic benefits of e-PLND remain unclear. The aim of this study was to assess whether e-PLND confers an oncological benefit for high-risk Pca compared to neoadjuvant luteinizing hormone-releasing hormone and estramustine (LHRH + EMP). The Michinoku Urological Cancer Study Group database contained the data of 2403 consecutive Pca patients treated with RP at four institutes between March 2000 and December 2014. In the e-PLND group, we identified 238 high-risk Pca patients who underwent RP and e-PLND, with lymphatic tissue removal around the obturator and the external iliac regions, and hypogastric lymph node dissection. The neoadjuvant therapy with limited PLND (l-PLND) group included 280 high-risk Pca patients who underwent RP and removal of the obturator node chain between September 2005 and June 2014 at Hirosaki University. The outcome measure was BRFS. The 5-year biochemical recurrence-free survival rates for the neoadjuvant therapy with l-PLND group and e-PLND group were 84.9 and 54.7%, respectively (P < 0.0001). The operative time was significantly longer in the e-PLND group compared to that of the neoadjuvant therapy with l-PLND group. Grade 3/4 surgery-related complications were not identified in both groups. Although the present study was not randomized, neoadjuvant LHRH + EMP therapy followed by RP might reduce the risk of biochemical recurrence.
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Huang M.
Oncotarget ( Oncotarget ) 8 ( 67 ) 111780 - 111794 2017年
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Narita S.
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques ( Surgical Laparoscopy, Endoscopy and Percutaneous Techniques ) 27 ( 4 ) e69 - e73 2017年
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【鏡視下腎摘出術の新展開】LESS/RPSドナー腎採取術の現況と展望
井上 高光, 成田 伸太郎, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 佐藤 滋, 羽渕 友則
腎移植・血管外科 ( 腎移植・血管外科研究会 ) 29 ( 3 ) 144 - 152 2017年
本邦の生体ドナー腎採取術の9割以上は腹腔鏡下ドナー腎採取術(laparoscopic donor nephrectomy:LDN)で行われているが、近年、一部の施設で単孔式腹腔鏡手術(Laparoendoscopic single-site surgery:LESS)に代表されるreduced port surgery(RPS)を採用したLDNが推進されてきた。従来法のLDN(Std-LDN)より更に低侵襲性や整容性を高めることは、数少ない生体腎移植ドナー候補に対して提供手術に納得していただくために重要であると考えられる。一方、LDNは健康なボランティアに対する手術であるため、安全性と採取腎の良好な機能が絶対的な要件である。従って、LESS/RPSの術式においては低侵襲性、整容性を担保しつつ同時に安全性も担保するreduced port surgery(RPS)の考え方が重要であると考えられる。腎に対するLESSでは副腎など小さな臓器の場合と異なり、腎摘出に必要な約5cmの単孔ではストレート鉗子のみでの操作で比較的容易に術式の完遂が可能である。また採取対象の腎の大きさは、腫瘍性疾患と異なり、各ドナー間でのばらつきが少ないため、ドナー腎採取術はLESSの良い適応であると考えられる。本稿では、LESSドナー腎採取術(Laparoendoscopic single-site donor nephrectomy:LESSDN)およびRPSを採用したLDNについて、国内外の過去の文献および当科の取り組みを紹介し、今後を展望する。(著者抄録)
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[A Case of Giant Prostate Carcinoma Effectively Treated with External-Beam Radiation Therapy].
Sohei Kanda, Shintaro Narita, Naoki Komine, Seiichi Kitajima, Misa Yamauchi, Akihiro Sugita, Yutaka Saito, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica 62 ( 12 ) 647 - 650 2016年12月
We present a case of gigantic prostate tumor in a patient with castration-resistant prostate cancer with successful local control by external-beam radiation therapy. A 71-year-old man was shown to have a prostate specific antigen (PSA)level of 24.5 ng/ml, Gleason 9, cT2N1M1a, prostate adenocarcinoma with an estimated prostate volume of 26.9 g. He achieved a PSA nadir at 4 months after the initial androgen deprivation therapy and was diagnosed with castration-resistant prostate cancer three years later. Eight months after the diagnosis of castration-resistant prostate cancer, he visited our hospital due to urinary retention. Abdominal computed tomography scan showed a gigantic prostatic mass occupying the whole pelvic cavity along with multiple lymph node, bone and liver metastases. The estimated volume of the prostate was 878 g. A tumor needle biopsy revealed a histological finding similar to the initial prostate biopsy which was adenocarcinoma with Gleason 9. He underwent external beam radiation therapy (60 Gy) to the prostate, which brought about excellent local control with a 96.7% shrinkage of tumor at 2 months after radiation therapy. He had no complaints of urinary symptoms and no need for urethral catheterization until he died of prostate cancer metastases.
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Altered miRNA expression in high-fat diet-induced prostate cancer progression.
Taketoshi Nara, Shintaro Narita, Huang Mingguo, Toshiaki Yoshioka, Atsushi Koizumi, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Carcinogenesis 37 ( 12 ) 1129 - 1137 2016年12月
Recent evidence suggests that a high-fat diet (HFD) plays an important role in prostate carcinogenesis; however, underlying mechanisms largely remain unknown. Here, we investigated microRNA (miRNA) expression changes in murine prostate cancer (PCa) xenografts using two different diets: HFD and control diet. We then assessed the roles and targets of altered miRNAs in HFD-induced PCa progression. We identified 38 up- and 21 downregulated miRNAs in xenografts under HFD conditions using the miRCURY LNA™ microRNA array. The differences in 10 candidate miRNAs were validated using quantitative RT-PCR. We focused on miR-130a because the expression levels were significantly lower in the three PCa cell lines in comparison with benign prostate PINT1B cells. PCa cells cultured in a medium containing HFD mouse serum were associated with significantly higher cell proliferation rates and lower miR-130a expression levels. Further, miR-130a modulated MET expression in PCa cells, and MET was overexpressed in in vitro and in vivo HFD-induced PCa progression models. Moreover, ectopic miR-130a downregulated AR in LNCaP cells and DICER1 in PC-3 and DU145 cells, respectively. In human tissues, as elucidated using laser capture microdissection, the mean miR-130a expression level in cancer epithelium was significantly lower than that in normal epithelium. Furthermore, cytoplasmic MET in PCa tissues was overexpressed in patients with higher body mass index. In conclusion, a substantial number of miRNAs was altered in HFD-induced PCa growth. Specifically, miR-130a was attenuated in HFD-induced PCa progression with MET overexpression. miRNAs thus have implications in the mechanism, prevention and treatment of HFD-induced PCa progression.
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Efficacy and safety of bladder hydrodistension for decreased bladder capacity induced by intravesical BCG therapy.
Kazuyuki Numakura, Norihiko Tsuchiya, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
Scandinavian journal of urology 50 ( 6 ) 429 - 432 2016年12月
OBJECTIVE: Intravesical BCG therapy is widely used for the treatment of high-risk, non-muscle-invasive bladder cancer. Among various reported side-effects, decreased bladder capacity is a serious side-effect that significantly worsens patients' quality of life. This article reports the efficacy and safety of bladder hydrodistension (BHD) in six patients with seriously decreased bladder capacity caused by BCG treatment. METHODS: Six patients with low bladder capacity (<100 ml in voiding diaries) and complaint of grade 3 irritative symptoms were diagnosed with decreased bladder capacity and treated with BHD. Alleviation of symptoms was defined as medication being discontinued or reduced after BHD. RESULTS: Five patients were male and one was female, and the mean age was 67.7 years. The mean interval between the last transurethral resection and BCG therapy was 26.0 days. Before BHD, all patients had been treated with antibiotics, anticholinergics and non-steroidal anti-inflammatory drugs (NSAIDs). The median bladder capacity before treatment was 40 ml (range 30-100 ml), and the median capacity increased to 200 ml (175-250 ml) within 2 weeks following BHD therapy. Four patients stopped NSAID use and three patients stopped anticholinergic use. One patient needed total cystectomy for recurrent symptoms. With a median follow-up period of 32 months, the bladder capacity remained stable without symptomatic deterioration in the remaining five patients. There was neither tumor spread nor disseminated tuberculosis infection. CONCLUSIONS: BHD appears to be an effective treatment option in patients with severely decreased bladder capacity. Its efficacy and safety were acceptable.
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von Hippel-Lindau病に合併した腫瘍性病変に対するアキシチニブによる治療経験
関根 悠哉, 成田 伸太郎, 五十嵐 龍馬, 奈良 健平, 松田 芳教, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 羽渕 友則, 佐藤 滋, 立木 裕
泌尿器外科 ( 医学図書出版(株) ) 29 ( 12 ) 1794 - 1794 2016年12月
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ロボット支援腹腔鏡下前立腺全摘除術(RALP)における神経温存が術後尿失禁に及ぼす影響
高山 孝一朗, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 成田 伸太郎, 羽渕 友則
日本排尿機能学会誌 ( (一社)日本排尿機能学会 ) 27 ( 1 ) 267 - 267 2016年12月
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石田 雅宣, 井上 高光, 前野 淳, 喜早 祐介, 高山 孝一朗, 小泉 淳, 山本 竜平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 羽渕 友則, 佐藤 滋
泌尿器外科 ( 医学図書出版(株) ) 29 ( 12 ) 1793 - 1794 2016年12月
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単一施設における根治的前立腺全摘術3術式における断端陽性率と陽性部位の比較
小泉 淳, 成田 伸太郎, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 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 ) 29 ( 3 ) 196 - 196 2016年11月
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井上 高光, 成田 伸太郎, 齋藤 満, 沼倉 一幸, 鶴田 大, 前野 淳, 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 ) 29 ( 3 ) 250 - 250 2016年11月
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沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 滿, 井上 高光, 成田 伸太郎, 黄 明国, 佐藤 滋, 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 ) 29 ( 3 ) 237 - 237 2016年11月
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腹腔鏡下腎摘除(基本編) 当科における腹腔鏡下腎摘除術手術手技習得にむけての取り組み
成田 伸太郎, 井上 高光, 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 ) 29 ( 3 ) 109 - 109 2016年11月
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Secondary bladder amyloidosis with familial Mediterranean fever in a living donor kidney transplant recipient: a case report.
Sentaro Imamura, Shintaro Narita, Ryuta Nishikomori, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Hiroshi Nanjo, Toshio Heike, Shigeru Satoh, Tomonori Habuchi
BMC research notes 9 ( 1 ) 473 - 473 2016年10月
BACKGROUND: Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation. Consequently, he was diagnosed with secondary bladder amyloidosis with FMF. CASE PRESENTATION: A 64-year-old Japanese male received a living ABO-incompatible kidney transplant from his wife. The postoperative clinical course was normal, and the patient was discharged 21 days after the transplantation with a serum creatinine level of 0.78 mg/dl. The patient frequently complained of general fatigue and fever of unknown origin. Six months later, the patient presented with continuous general fatigue, macroscopic hematuria, and fever. Cystoscopic examination of the bladder showed an edematous region with bleeding, and a transurethral biopsy revealed amyloid deposits. His wife stated that the patient had a recurrent high fever since the age of 40 years and that his younger brother was suspected to have a familial autoinflammatory syndrome; thus, the patient was also suspected to have a familial autoinflammatory syndrome. Based on his brother's medical history and the genetic tests, which showed a homozygous mutation (M694V/M694V) for the Mediterranean fever protein, he was diagnosed with FMF. Although colchicine treatment for FMF was planned, the patient had an untimely death due to heart failure. We re-evaluated the pathological findings of the various tissue biopsies obtained during the treatment after the renal transplantation. Immunohistochemistry revealed amyloid deposits in the bladder region, renal allograft, and myocardium and the condition was diagnosed as AA amyloidosis associated with FMF. CONCLUSION: We presented a case of systemic amyloidosis with FMF, involving the bladder region, myocardium, and renal allograft, diagnosed after renal transplantation. Bladder amyloidosis should be considered in patients with macroscopic hematuria, particularly in the kidney transplant recipients with idiopathic chronic renal disease. Diagnosis of secondary bladder amyloidosis may result in the early detection of underlying diseases, which may contribute to patient prognosis.
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前立腺癌間質微小環境と前立腺癌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, 井上 高光, 佐々木 雄彦, 羽渕 友則
日本癌学会総会記事 ( 日本癌学会 ) 75回 J - 2068 2016年10月
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単一施設における根治的前立腺全摘術3術式の断端陽性率と断端陽性部位の比較
小泉 淳, 成田 伸太郎, 奈良 健平, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 54回 P53 - 7 2016年10月
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転移性尿路上皮癌に対する二次化学療法としてGN療法を行った3例の検討
鶴田 大, 井上 高光, 成田 伸太郎, 齋藤 満, 前野 淳, 沼倉 一幸, 佐藤 滋, 賀本 敏行, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 54回 P46 - 1 2016年10月
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前立腺癌術後再発に対する内分泌および化学療法中に発生した小細胞癌の一例
齋藤 拓郎, 前野 淳, 井上 高光, 喜早 祐介, 提箸 隆一郎, 高山 孝一朗, 鶴田 大, 齋藤 満, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 佐藤 滋
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1494 - 1494 2016年09月
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喜早 祐介, 前野 淳, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 斎藤 満, 井上 高光, 成田 伸太郎, 土谷 順彦, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1497 - 1498 2016年09月
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肝転移破裂に対し肝動脈化学塞栓術を施行し、長期生存が得られている腎癌症例
松田 芳教, 鶴田 大, 喜早 祐介, 高山 孝一朗, 小泉 淳, 奈良 健平, 本間 直子, 前野 淳, 斉藤 満, 井上 高光, 成田 伸太郎, 秋濱 晋, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1499 - 1499 2016年09月
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腎移植後脂質代謝異常症の検討
沼倉 一幸, 加賀谷 英彰, 山本 竜平, 齋藤 滿, 鶴田 大, 前野 淳, 井上 高光, 成田 伸太郎, 黄 明国, 土谷 順彦, 羽渕 友則, 新岡 丈典, 三浦 昌朋, 佐藤 滋
移植 ( (一社)日本移植学会 ) 51 ( 総会臨時 ) 294 - 294 2016年09月
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Cystometric evaluation of recovery in hypocompliant defunctionalized bladder as a result of long-term dialysis after kidney transplantation.
Takamitsu Inoue, Shigeru Satoh, Takashi Obara, Mitsuru Saito, Kazuyuki Numakura, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
International journal of urology : official journal of the Japanese Urological Association 23 ( 8 ) 694 - 700 2016年08月
OBJECTIVES: To evaluate the functional recovery of a pretransplant hypocompliant bladder in patients without neurological disorders, and to determine its relationship with ureteral complications, including vesicoureteral reflux. METHODS: A total of 61 patients without neurogenic disorders, who underwent video water cystometry pre- and 1 year post-transplantation, were enrolled. Cystometric bladder capacity and maximum intravesical pressure were measured, and compliance was calculated by the elevation in intravesical pressure as a result of an increase in volume. The frequencies of urinary complications, including urinary leakage, pyelonephritis and vesicoureteral reflux, were also evaluated. RESULTS: Pretransplant dialysis duration correlated with pretransplant bladder capacity and compliance (R(2) = 0.421, P < 0.001 and R(2) = 0.418, P < 0.001, respectively). A total of 16 (26.2%) patients had hypocompliant bladders <10 mL/cmH2 O, whereas 10 of the 12 patients (83.3%) with pretransplant dialysis duration of more than 5 years had a pretransplant hypocompliant bladder. Bladder compliance significantly recovered to >20 mL/cmH2 O (21.1-286.0) at 1 year post-transplantation in all 16 patients with a pretransplant hypocompliant bladder. No significant differences were observed for urinary leakage, pyelonephritis or vesicoureteral reflux between patients with and without a pretransplant hypocompliant bladder. CONCLUSIONS: Bladder compliance decreases logarithmically pretransplantation according to dialysis duration. Although the ability of the patients to recover varies, dysfunctions associated with a pretransplant hypocompliant bladder recover to normal ranges after renal transplantation. A pretransplant hypocompliant bladder seems not to be associated with the post-transplant prevalence of urinary complications or vesicoureteral reflux.
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当院における去勢抵抗性前立腺癌に対する新規内分泌療法エンザルタミド・アビラテロンの初期使用成績
喜早 祐介, 成田 伸太郎, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 土谷 順彦, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 8 ) 1279 - 1282 2016年08月
去勢抵抗性前立腺癌に対し、新規内分泌療法としてエンザルタミド(Enza)およびアビラテロン酢酸エステル(Abi)を使用した26例の初期使用成績を検討した。Enza 21例、Abi 17例に投与し、PSA 50%低下率はEnza 33.3%、Abi 17.6%であり、いずれの治療も重篤な副作用は認めなかった。今後症例を重ね、最適な投与患者選択と投与タイミングの検討が必要と考えられた。(著者抄録)
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[Extrarenal Retroperitoneal Angiomyolipoma Masquerading as Retroperitoneal Liposarcoma : A Report of Two Cases].
Ryohei Yamamoto, Takamitsu Inoue, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Mitsuru Saito, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica 62 ( 6 ) 317 - 22 2016年06月
We report two patients with extrarenal retroperitoneal angiomyolipoma masquerading as perinephric liposarcoma. Patient 1 : A 66-year-old man was diagnosed with a retroperitoneal tumor near the right renal hilum on an abdominal computed tomography (CT) performed before surgery for gastric cancer. A diagnosis of extrarenal retroperitoneal angiomyolipoma was made on the basis of negative uptake of fluorine- 18 2-deoxy-2-fluoro-D-glucose positron emission tomography (18F-FDG PET)/CT. However, because the tumor was found to have gradually enlarged at 18 months afterward, he underwent resection of the extrarenal fat tissue together with the right kidney. Patient 2 : A 56-year-old man underwent abdominal ultrasound during a periodic medical examination, which revealed a right retroperitoneal tumor. Because of the findings in the contrast-enhanced CT and positive uptake of 18F-FDG PET/CT, he underwent resection of the extrarenal fat tissue together with the right kidney. The pathological examination of the two tumors confirmed extrarenal angiomyolipoma. The differential diagnosis of extrarenal retroperitoneal angiomyolipoma from retroperitoneal liposarcoma is difficult even with the use of 18F-FDG PET/CT.
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[Outcome of Resection of Inferior Vena Cava Superior to the Renal Vein in Renal Cell Carcinoma with Vena Caval Tumor Thrombus].
Soki Kashima, Shintaro Narita, Mitsuru Saito, Makoto Takahashi, Shinya Maita, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Hiroshi Yamamoto, Yuzo Yamamoto, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica 62 ( 6 ) 287 - 94 2016年06月
Surgical management with radical nephrectomy and thrombectomy has often been performed in renal cell carcinoma (RCC) with tumor thrombus infiltrating the inferior vena cava (IVC). We retrospectively reviewed the outcomes of IVC resection without venous reconstruction in patients with RCC and IVC thrombus at our institution. Eight patients with right RCC underwent radical nephrectomy and IVC resection superior to the level of the renal vein without venous reconstruction from August 2005 to February 2015. Thoracotomy, liver mobilization, and extracorporeal circulation were performed based on the IVC thrombus level. We assessed surgical outcomes, perioperative complications, and survival. At presentation, four patients had level IIIa IVC thrombus, three had level IIIb IVC thrombus, and one had level IV IVC thrombus. Perioperative imaging showed that three of the four patients who underwent neoadjuvant molecular targeting therapy achieved down-staging of the tumor thrombus level. The median operative time was 406 min, and the median estimated blood loss was 3,135 ml. With regard to IVC resectionassociated perioperative complications, one patient needed extracorporeal circulation with IVC ligation and Pringle maneuver owing to low blood pressure. Another patient underwent temporary hemodialysis for 8 days after surgery. There were no perioperative deaths, and none of the patients required permanent hemodialysis. Three patients survived the mean observation period of 25 months, including one patient with no recurrence. Three patients achieved long-term survival of more than 2 years. IVC resection without venous reconstruction may be a feasible option for patients with RCC and IVC tumor thrombus. Further study is needed to determine the most appropriate candidates for this procedure.
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A prospective multicenter study of intermittent chemotherapy with docetaxel and prednisolone for castration-resistant prostate cancer.
Shintaro Narita, Takuya Koie, Shigeyuki Yamada, Kazuhiko Orikasa, Shigeki Matsuo, Hiroshi Aoki, Shigeto Ishidoya, Senji Hoshi, Norihiko Tsuchiya, Chikara Ohyama, Yoichi Arai, Tomonori Habuchi
Japanese journal of clinical oncology 46 ( 6 ) 547 - 553 2016年06月
OBJECTIVE: The optimal schedule of docetaxel chemotherapy for castration-resistant prostate cancer is unknown, although continuous administration is accepted as the standard. We conducted a Phase II trial to evaluate the outcome of intermittent docetaxel and prednisolone therapy in castration-resistant prostate cancer. METHODS: The patients were treated using a 28-day cycle of docetaxel (70 mg/m2 on Day 1) and oral prednisolone (10 mg/day). After three consecutive administrations of docetaxel, a holiday was taken until prostate specific antigen levels returned to the baseline. The therapy was continued intermittently until the disease progressed, drug toxicity occurred, or the patients refused further treatment. The primary endpoint was overall survival. Time to treatment failure, adverse events, the duration of chemotherapy holiday and quality of life were also evaluated. RESULTS: A total of 120 patients were enrolled. The median age and pretreatment prostate specific antigen level were 72 years and 37.5 ng/ml, respectively. Sixty (50.0%) patients resumed chemotherapy after the first holiday, and a maximum of six courses were administered to four patients. The median period of the first, second and third-to-fifth holiday was 18.6, 11.0 and 4.9 weeks, respectively. Toxicity was moderate, except for two fatal adverse events. The median time to treatment failure and overall survival from the initiation of docetaxel and prednisolone therapy in all patients were 17.5 and 35.0 months, respectively. All quality-of-life scores were unchanged statistically from the start of docetaxel and prednisolone therapy to the beginning of the second course. CONCLUSIONS: Intermittent docetaxel and prednisolone therapy might be a feasible treatment option for castration-resistant prostate cancer with comparable outcome and successful chemotherapy holidays.
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進行性腎癌におけるアキシチニブの効果予測を目的とした血清バイオマーカーの探索
喜早 祐介, 本間 直子, 鶴田 大, 沼倉 一幸, 前野 淳, 齋藤 満, 成田 伸太郎, 井上 高光, 佐藤 滋, 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 ) 32回 197 - 197 2016年06月
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[Recent trend in the development of novel treatments based on the mechanisms of prostate cancer progression].
Takamitsu Inoue, Shintaro Narita, Tomonori Habuchi
Nihon rinsho. Japanese journal of clinical medicine 74 Suppl 3 211 - 20 2016年05月
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[Treatment strategy for high-risk localized prostate cancer].
Shintaro Narita, Takamitsu Inoue, Tomonori Habuchi
Nihon rinsho. Japanese journal of clinical medicine 74 Suppl 3 693 - 700 2016年05月
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【新前立腺癌学-最新の基礎研究と診断・治療-】ハイリスク限局性前立腺癌に対する治療戦略
成田 伸太郎, 井上 高光, 羽渕 友則
日本臨床 ( (株)日本臨床社 ) 74 ( 増刊3 新前立腺癌学 ) 693 - 700 2016年05月
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【新前立腺癌学-最新の基礎研究と診断・治療-】臨床応用を目指した基礎研究 新規治療開発 前立腺癌の進展機序に基づく新規治療開発の動向
井上 高光, 成田 伸太郎, 羽渕 友則
日本臨床 ( (株)日本臨床社 ) 74 ( 増刊3 新前立腺癌学 ) 211 - 220 2016年05月
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本間 直子, 井上 高光, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 土谷 順彦, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 臨増 ) 934 - 934 2016年05月
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秋田大学における肝転移を有する進行性腎癌の分子標的薬治療成績
五十嵐 龍馬, 土谷 順彦, 成田 伸太郎, 井上 高光, 齋藤 満, 鶴田 大, 前野 淳, 高山 孝一朗, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 臨増 ) 911 - 911 2016年05月
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腎移植治療の最前線 秋田大学におけるLESSドナー腎採取術への取り組み
井上 高光, 成田 伸太郎, 齋藤 満, 鶴田 大, 沼倉 一幸, 前野 淳, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 臨増 ) 871 - 874 2016年05月
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腹腔鏡下/ロボット支援膀胱全摘除術における尿路変向術の現状と問題点 腹腔鏡下/ロボット支援膀胱全摘除術における尿路変向 完全体腔内と小切開体腔外での造設法の比較
井上 高光, 成田 伸太郎, 齋藤 満, 鶴田 大, 沼倉 一幸, 前野 淳, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 臨増 ) 741 - 743 2016年05月
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EXOSOMAL MIRNAS AND SERUM CYTOKINES AS PREDICTORS FOR TREATMENT OUTCOMES IN PATIENTS WITH METASTATIC RENAL CELL CARCINOMA TREATED WITH AXITINIB
Naoko Suzuki-Honma, Norihiko Tsuchiya, Takamitsu Inoue, Shintaro Narita, Mitsuru Saito, Hiroshi Tsuruta, Atsushi Maeno, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 195 ( 4 ) E322 - E323 2016年04月
研究発表要旨（国際会議）
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EXPRESSION OF STEROID HORMONE RECEPTORS IN RESIDUAL CANCER AND STROMAL CELLS AFTER NEOADJUVANT CHEMOHORMONAL THERAPY WITH DOCETAXAL FOR HIGH-RISK LOCALIZED PROSTATE CANCER
Shintaro Narita, Taketoshi Nara, Mingguo Huang, Koichiro Takayama, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Hiroshi Nanjo, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 195 ( 4 ) E759 - E760 2016年04月
研究発表要旨（国際会議）
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PROTECTIVE EFFECTS OF REGULATORY T CELLS IN RENAL ISCHEMIA/REPERFUSION INJURY IN MICE
Ryohei Yamamoto, Mitsuru Saito, Hiroshi Tsuruta, Atsushi Maeno, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 195 ( 4 ) E383 - E383 2016年04月
研究発表要旨（国際会議）
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REASSESSMENT OF RISK FACTORS FOR BIOCHEMICAL RECURRENCE IN D'AMICO INTERMEDIATE-RISK PROSTATE CANCER TREATED BY RADICAL PROSTATECTOMY
Shintaro Narita, Koji Mitsuzuka, Norihiko Tsuchiya, Takuya Koie, Sadafumi Kawamura, Chikara Ohyama, Tatsuo Tochigi, Takuhiro Yamaguchi, Yoichi Arai, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 195 ( 4 ) E712 - E713 2016年04月
研究発表要旨（国際会議）
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Rising star report 移植腎採取術の低侵襲化への挑戦
井上 高光, 成田 伸太郎, 齋藤 満, 鶴田 大, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 SPS14 - 2 2016年04月
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Stage D2前立腺癌に対する内分泌療法前および治療早期の予後予測因子の検討
成田 伸太郎, 佐藤 博美, 鶴田 大, 前野 淳, 斉藤 満, 井上 高光, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 PP1 - 082 2016年04月
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秋田大学における転移性副腎腫瘍に対する副腎摘除術の検討
小泉 淳, 井上 高光, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本内分泌・甲状腺外科学会雑誌 ( 日本内分泌外科学会・日本甲状腺外科学会 ) 33 ( Suppl.1 ) S100 - S100 2016年04月
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秋田大学における転移性腎細胞癌に対するPazopanibの初期使用経験
喜早 祐介, 井上 高光, 五十嵐 龍馬, 鶴田 大, 斎藤 満, 前野 淳, 成田 伸太郎, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 PP3 - 026 2016年04月
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脂肪酸結合タンパク質4の過剰発現と分泌は前立腺癌進行を促進する(Overexpression and secretion of fatty acid binding protein 4 promotes prostate cancer progression)
黄 明国, 成田 伸太郎, 土谷 順彦, 田中 正光, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 PP2 - 100 2016年04月
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血清炎症性サイトカイン濃度からみた根治的膀胱全摘術における手術侵襲度の検討
鶴田 大, 齋藤 満, 井上 高光, 成田 伸太郎, 前野 淳, 土谷 順彦, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 PP3 - 218 2016年04月
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進行性前立腺癌治療におけるunmet medical needsをいかに埋めるか 若手医師意見の集約 進行性前立腺癌患者に「生活で気をつけることはありますか?」と聞かれたら
成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 104回 FS21 - 1 2016年04月
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von Recklinghausen病に合併した縦隔原発巨大胚細胞腫の一例
嘉島 相輝, 齋藤 満, 沼倉 一幸, 神田 壮平, 山本 竜平, 高山 孝一朗, 鶴田 大, 秋濱 晋, 井上 高光, 成田 伸太郎, 土谷 順彦, 佐藤 滋, 羽渕 友則, 齋藤 元, 南谷 佳弘
泌尿器外科 ( 医学図書出版(株) ) 29 ( 2 ) 186 - 186 2016年02月
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ロボット支援手術 その後の展開 秋田大学におけるロボット支援腹腔鏡下根治的膀胱全摘術・腎部分切除術の現状と工夫
齋藤 満, 土谷 順彦, 成田 伸太郎, 井上 高光, 鶴田 大, 秋濱 晋, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 2 ) 193 - 193 2016年02月
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多発肺・肝・骨転移を伴う悪性褐色細胞腫に対しCVD療法が奏功した1例
今村 専太郎, 齋藤 満, 五十嵐 龍馬, 小泉 淳, 高山 孝一朗, 鶴田 大, 秋濱 晋, 井上 高光, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 佐藤 滋, 堀川 洋平, 下田 直威
泌尿器外科 ( 医学図書出版(株) ) 29 ( 2 ) 194 - 194 2016年02月
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ロボット支援/腹腔鏡下膀胱全摘除術における問題点と対策 ロボット支援腹腔鏡下膀胱全摘術の問題点とその対策
鶴田 大, 井上 高光, 成田 伸太郎, 齋藤 満, 前野 淳, 土谷 順彦, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 20 ( 7 ) WS12 - 5 2015年12月
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ロボット支援腹腔鏡下前立腺全摘除術(RALP)における神経温存が術後尿失禁に及ぼす影響
高山 孝一朗, 土谷 順彦, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 井上 高光, 羽渕 友則
日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 ) 20 ( 7 ) OS182 - 8 2015年12月
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後期高齢者の浸潤性膀胱癌に対する少量シスプラチン併用放射線療法の効果と忍容性の検討
鶴田 大, 成田 伸太郎, 井上 高光, 齋藤 満, 秋濱 晋, 土谷 順彦, 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 ) 28 46 - 46 2015年12月
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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.
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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.
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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.
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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
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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
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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
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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
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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
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[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.
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[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.
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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.
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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.
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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）
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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）
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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）
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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）
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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）
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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）
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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）
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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）
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PREDICTIVE RISK FACTORS OF POST-TRANSPLANT HIGH-GRADE CMV REACTIVATION IN CMV-SEROPOSITIVE PATIENTS IN THE MODERN IMMUNOSUPPRESSIVE ERA
Mitsuru Saito, Shigeru Satoh, Hiroshi Tsuruta, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 193 ( 4 ) E1068 - E1068 2015年04月
研究発表要旨（国際会議）
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PROGNOSTIC FACTORS FOR OVERALL SURVIVAL IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER TREATED BY INTERMITTENT CHEMOTHERAPY WITH DOCETAXEL AND PREDNISOLONE
Shintaro Narita, Takuya Koie, Shigeyuki Yamada, Kazuhiko Orikasa, Shigeki Matsuo, Hiroshi Aoki, Shigeto Ishidoya, Senji Hoshi, Norihiko Tsuchiya, Chikara Ohyama, Yoichi Arai, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 193 ( 4 ) E1086 - E1087 2015年04月
研究発表要旨（国際会議）
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血清3分岐、4分岐N型糖鎖は去勢抵抗性前立腺癌予測マーカーとなりえる
米山 徹, 石橋 祐介, 飛澤 悠葵, 畠山 真吾, 成田 伸太郎, 古家 琢也, 羽渕 友則, 大山 力
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 493 - 493 2015年04月
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高脂肪食摂取によるマウス前立腺癌xenograftの腫瘍増大とリン脂質代謝の変化
小泉 淳, 黄 明国, 中西 広樹, 秋濱 晋, 沼倉 一幸, 鶴田 大, 齋藤 満, 井上 高光, 成田 伸太郎, 土谷 順彦, 佐藤 滋, 佐々木 雄彦, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 594 - 594 2015年04月
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マウス去勢抵抗性前立腺癌骨転移モデルにおける去勢による骨密度低下と骨転移促進効果
高山 孝一朗, 井上 高光, 成田 伸太郎, 黄 明国, 鶴田 大, 秋濱 晋, 齋藤 満, 土谷 順彦, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 527 - 527 2015年04月
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分子標的薬時代における1st-Lineインターフェロン単独療法適応の検討
井上 高光, 土谷 順彦, 鶴田 大, 秋濱 晋, 齋藤 満, 成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 775 - 775 2015年04月
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局所進行腎盂尿管癌に対する補助化学療法の意義 腎機能低下症例における薬剤選択
成田 伸太郎, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 389 - 389 2015年04月
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腎癌と肥満およびアディポネクチンシグナルの関連検討
成田 伸太郎, 伊藤 隆一, 鶴田 大, 秋濱 晋, 齋藤 満, 井上 高光, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 643 - 643 2015年04月
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腎細胞癌進展とインスリンレセプター発現との逆関連 臨床およびマウス実験での検討
高橋 誠, 井上 高光, 黄 明国, 鶴田 大, 秋濱 晋, 齋藤 満, 成田 伸太郎, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 594 - 594 2015年04月
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進行性腎癌におけるアキシチニブの効果予測を目的とした血清バイオマーカーの探索
鈴木 直子, 土谷 順彦, 成田 伸太郎, 井上 高光, 齋藤 満, 秋濱 晋, 鶴田 大, 佐藤 滋, 羽渕 友則
日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 103回 770 - 770 2015年04月
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A phase III, multicenter, randomized, controlled study of maximum androgen blockade with versus without zoledronic acid in treatment-naive prostate cancer patients with bone metastases: Results of ZAPCA study.
Tomomi Kamba, Toshiyuki Kamoto, Yousuke Shimizu, Shunichi Namiki, Kiyohide Fujimoto, Hiroaki Kawanishi, Fuminori Sato, Shintaro Narita, Takefumi Satoh, Hideo Saito, Mikio Sugimoto, Jun Teishima, Naoya Masumori, Shin Egawa, Hideki Sakai, Yusaku Okada, Toshiro Terachi, Osamu Ogawa
JOURNAL OF CLINICAL ONCOLOGY ( AMER SOC CLINICAL ONCOLOGY ) 33 ( 7 ) 2015年03月
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Association of pharmacokinetics of axitinib with treatment outcome and adverse events in advanced renal cell carcinoma patients.
Norihiko Tsuchiya, Ryoma Igarashi, Naoko Suzuki-Honma, Nobuhiro Fujiyama, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Susumu Akihama, Hiroshi Tsuruta, Masatomo Miura, Tomonori Habuchi
JOURNAL OF CLINICAL ONCOLOGY ( AMER SOC CLINICAL ONCOLOGY ) 33 ( 7 ) 2015年03月
研究発表要旨（国際会議）
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Treatment outcome of patients with intermediate- and poor-prognosis metastatic testicular cancer in the 2000s: A multicenter experience in Japan
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
JOURNAL OF CLINICAL ONCOLOGY ( AMER SOC CLINICAL ONCOLOGY ) 33 ( 7 ) 2015年03月
研究発表要旨（国際会議）
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Prostate-specific antigen density predicts extracapsular extension and increased risk of biochemical recurrence in patients with high-risk prostate cancer who underwent radical prostatectomy.
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 ( 1 ) 176 - 81 2015年02月
BACKGROUND: Patients with advanced local-stage, high-grade prostate cancer (Pca) and high pretreatment prostate-specific antigen (PSA) levels have inferior outcomes compared to their counterparts with more favorable clinical characteristics. However, some patients exhibit favorable pathological features or experience long-term PSA-free survival after radical prostatectomy (RP). We retrospectively examined the ability of preoperative characteristics to predict pathological and oncological outcomes in high-risk Pca patients who underwent RP. METHODS: We examined data of 1,268 consecutive Pca patients treated with RP alone at 4 hospitals from the Michinoku Urological Cancer Study Group database. Preoperative predictors included age, PSA level, biopsy Gleason score, clinical T stage, and PSA density (PSAD). The outcome measures pathological T stage and PSA-free survival were evaluated by multivariate analysis. RESULTS: We identified 380 high-risk Pca patients, of which 44 % patients had extracapsular extension. Logistic regression analysis indicated that PSAD was an independent predictor of adverse pathologic stage. The 5-year PSA-free survival rates were 82.9 % for patients with PSAD ≤0.468 ng mL(-1) cm(-2) and 50.7 % for those with PSAD >0.468 ng mL(-1) cm(-2) (P < 0.0001). Multivariate analyses revealed that PSAD, cT, and the number of preoperative high-risk Pca criteria were independent predictors of PSA-free survival. CONCLUSIONS: PSAD may be an independent predictor of advanced pathological features and biochemical recurrence in high-risk Pca patients treated with RP alone. PSAD may be used for further risk stratification of high-risk Pca patients.
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Effects of functional genetic polymorphisms in the CYP19A1 gene on prostate cancer risk and survival.
Sohei Kanda, Norihiko Tsuchiya, Shintaro Narita, Takamitsu Inoue, Mingguo Huang, Syuji Chiba, Susumu Akihama, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Shigeru Satoh, Seiichi Saito, Chikara Ohyama, Yoichi Arai, Osamu Ogawa, Tomonori Habuchi
International journal of cancer 136 ( 1 ) 74 - 82 2015年01月
CYP19 catalyzes the conversion of androgens to estrogens and is a critical enzyme affecting the sex hormone milieu. In this study, we investigated the functions of CYP19A1 polymorphisms and their associations with prostate cancer risk and clinical outcome. This case-control study evaluated the effects of three single nucleotide polymorphisms (SNPs) in CYP19A1 on the risk of prostate cancer in 330 prostate cancer patients and 354 normal controls. The associations between each SNP and sex hormone levels were evaluated in 164 healthy male patients. The functions of the SNPs were determined by reporter gene assays in PC3 and DU145 cell lines. Prostate-specific antigen nadir was evaluated in 142 patients with metastatic prostate cancer treated with androgen deprivation therapy. Cancer-specific survival (CSS) was determined in 166 patients with metastatic prostate cancer, to evaluate the influence of the three SNPs. Each variant allele of the three SNPs significantly decreased the risk of prostate cancer. Haplotype analysis showed that the T-A-G haplotype (corresponding to rs2470152-rs10459592-rs4775936) increased the risk of prostate cancer, while the C-C-A haplotype decreased the risk. The estrone/androstenedione ratio was significantly higher in men with the C allele of rs2470152, the C allele of rs10459592, and the A allele of rs4775936 in a gene-dosage-dependent manner. Patients with the variant allele at rs4775936 had significantly shorter CSS. These results indicate that CYP19A1 polymorphisms may influence prostate cancer risk and survival by modifying promoter activity, with subsequent effects on the sex hormone milieu.
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Efficiency of pretreatment risk stratification systems for prostate cancer in a Japanese population treated with radical prostatectomy.
Takuya Koie, Koji Mitsuzuka, Shintaro Narita, Takahiro Yoneyama, Sadafumi Kawamura, Norihiko Tsuchiya, Tatsuo Tochigi, Tomonori Habuchi, Yoichi Arai, Chikara Ohyama
International journal of urology : official journal of the Japanese Urological Association 22 ( 1 ) 70 - 3 2015年01月
OBJECTIVE: To determine whether the currently available pretreatment risk classification systems are applicable in Japanese prostate cancer patients. METHODS: Using data obtained from 1264 consecutive patients with prostate cancer treated with radical prostatectomy at four hospitals in Japan, biochemical recurrence-free survival rates were estimated and compared between the D'Amico, the National Institute for Health and Clinical Excellence, the Cancer of the Prostate Strategic Urological Research Endeavor, the National Comprehensive Cancer Network, and the European Society of Medical Oncology risk groups by using the Kaplan-Meier method and log-rank test. RESULTS: The 5-year biochemical recurrence-free survival rates in the D'Amico low-, intermediate-, and high-risk groups were 88.3%, 84.7% and 66.9%, respectively (low and intermediate risk vs high risk, P < 0.001). The 5-year biochemical recurrence-free survival rates in the National Institute for Health and Clinical Excellence, National Comprehensive Cancer Network, and European Society of Medical Oncology low-, intermediate- and high-risk groups were 88.3%, 84.3%, and 60.3%, respectively (low and intermediate risk vs high risk, P < 0.001). The 5-year biochemical recurrence-free survival rates in the Cancer of the Prostate Strategic Urological Research Endeavor low-, intermediate-, and high-risk groups were 90%, 83.5% and 60.3%, respectively (low and intermediate risk vs high risk, P < 0.001). Low- and intermediate-risk groups according to any of the risk stratification systems did not show significant differences in biochemical recurrence-free survival. CONCLUSION: Current risk stratification systems do not discriminate between low- and intermediate-risk groups in the Japanese population. A novel, pretreatment risk stratification system including other prognostic factors is necessary for an adequate prostate cancer risk assessment in the Japanese population.
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Characterization of clinical and genetic risk factors associated with dyslipidemia after kidney transplantation.
Kazuyuki Numakura, Hideaki Kagaya, Ryohei Yamamoto, Naoki Komine, Mitsuru Saito, Tsuruta Hiroshi, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Takenori Niioka, Masatomo Miura, Shigeru Satoh
Disease markers 2015 179434 - 179434 2015年
We determined the prevalence of dyslipidemia in a Japanese cohort of renal allograft recipients and investigated clinical and genetic characteristics associated with having the disease. In total, 126 patients that received renal allograft transplants between February 2002 and August 2011 were studied, of which 44 recipients (34.9%) were diagnosed with dyslipidemia at 1 year after transplantation. Three clinical factors were associated with a risk of having dyslipidemia: a higher prevalence of disease observed among female than male patients (P = 0.021) and treatment with high mycophenolate mofetil (P = 0.012) and prednisolone (P = 0.023) doses per body weight at 28 days after transplantation. The genetic association between dyslipidemia and 60 previously described genetic polymorphisms in 38 putative disease-associated genes was analyzed. The frequency of dyslipidemia was significantly higher in patients with the glucocorticoid receptor (NR3C1) Bcl1 G allele than in those with the CC genotype (P = 0.001). A multivariate analysis revealed that the NR3C1 Bcl1 G allele was a significant risk factor for the prevalence of dyslipidemia (odds ratio = 4.6; 95% confidence interval = 1.8-12.2). These findings may aid in predicting a patient's risk of developing dyslipidemia.
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Clinical benefits of tubeless umbilical cutaneous ureterostomy.
Kazuyuki Numakura, Norihiko Tsuchiya, Makoto Takahashi, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 9 ( 5-6 ) E379-83 2015年
INTRODUCTION: We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence. METHODS: This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence. RESULTS: Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period. CONCLUSION: This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved.
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齋藤 満, 鶴田 大, 井上 高光, 成田 伸太郎, 土谷 順彦, 羽渕 友則
Japanese Journal of Endourology ( Japanese Society of Endourology ) 28 ( 1 ) 68 - 72 2015年
泌尿器科領域ではロボット支援腹腔鏡下前立腺摘除術（robot-assisted laparoscopic prostatectomy：RALP）の経験をもとに，他疾患に対してもロボット支援手術が導入されつつある．当科ではこれまでに進行性膀胱癌患者に対しロボット支援膀胱全摘除術（robot-assisted radical cystectomy：RARC）を8例に施行している． <br> RARC施行時は体位ならびに機器の配置はRALPに準じ，カメラポートはRALPよりも3-4cm頭側に配置し，さらに第2助手用5mmトロカールを1本追加，計7本のトロカールを留置した．全例で下腸間膜動脈分岐部までの拡大リンパ節郭清（extended pelvic lymph node dissection：ePLND）を施行した．尿路変更は回腸導管4例（完全腹腔内と腹腔外が2例ずつ），回腸利用自然排尿型代用膀胱2例（完全腹腔内と腹腔外が1例ずつ），尿管皮膚瘻が2例であった．手術時間の中央値は511（462-763）分，出血量の中央値は418（少量‐709）mLであった．平均郭清リンパ節数は30（18-35）個であった．本術式は安全に施行でき，輸血症例ならびに術後の重篤な合併症の発生は無かった．本稿では主にRARCにおけるePLNDの意義について論述する．
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[Treatment for high-risk localized prostate cancer].
Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
Nihon rinsho. Japanese journal of clinical medicine 72 ( 12 ) 2212 - 6 2014年12月
High-risk localized prostate cancer encompasses a significant heterogeneity and the treatment strategy for this group of prostate cancer patients remains controversial. The definition of high-risk localized prostate cancer is not consistent in that which clinicopathological parameters are included as risk factors. Therefore, we need to be careful in comparing the treatment outcome of each report. Recently, there have been significant improvements in the radiotherapeutic and surgical management. High radiation dose levels, long-term androgen deprivation therapy, and the combination of brachytherapy may contribute to the improvement of radiation-based treatment. Although some patients can be cured by standard surgical approach, extended lymph node dissection and multimodal treatment with radiation and chemohormonal therapy may improve surgical outcome. This review focuses on the recent treatment strategy for high-risk localized prostate cancer.
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De novo renal cell carcinoma in an allograft kidney treated with nephron-sparing surgery: a case report.
Kazuyuki Numakura, Shigeru Satoh, Norihiko Tsuchiya, Mitsuru Saito, Taketoshi Nara, Mingguo Huang, Hiroshi Tsuruta, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Tomonori Habuchi
Progress in transplantation (Aliso Viejo, Calif.) 24 ( 4 ) 328 - 31 2014年12月
The development of primary malignant tumors is a distressing complication of organ transplant. However, the emergence of de novo renal cell carcinoma from a kidney allograft is rare. A 60-year-old man underwent living kidney transplant from a spousal donor. Six years after the transplant surgery, computed tomographic evaluation confirmed the presence of a 2.8-cm-diameter solid mass in the lower pole of the allograft. Partial allograft nephrectomy was performed, and the margin surrounding the normal parenchyma was resected. The serum level of creatinine did not decrease. Here, we report a case of renal cell carcinoma in an allograft kidney that was successfully treated with nephron-sparing surgery.
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Renal subcapsular fluid collection caused by penetration of a pancreatic pseudocyst.
Soki Kashima, Takamitsu Inoue, Mitsuru Chiba, Naoki Komine, Ryuichi Ito, Kazuyuki Numakura, Hiroshi Tsuruta, Mitsuru Saito, Susumu Akihama, Shintaro Narita, Norihiko Tsuchiya, Shigeru Satoh, Hirohide Onishi, Tomonori Habuchi
Urology 84 ( 5 ) e23-4 2014年11月
A 63-year-old man presented with left flank pain and spiked fever. Computed tomography revealed a pancreatic cyst and left renal subcapsular fluid collection that appeared to be connected to the cyst. High levels of amylase and lipase were observed in a test puncture of renal fluid collection. The cause of the fluid collection was diagnosed as penetration of the pancreatic pseudocyst. Endoscopic nasobiliary drainage was used to drain the pancreatic pseudocyst and renal subcapsular fluid collection. The present case demonstrated that renal subcapsular fluid collection may be caused by penetration of a pancreatic pseudocyst.
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Serum tri- and tetra-antennary N-glycan is a potential predictive biomarker for castration-resistant prostate cancer.
Yusuke Ishibashi, Yuki Tobisawa, Shingo Hatakeyama, Tetsu Ohashi, Masakazu Tanaka, Shintaro Narita, Takuya Koie, Tomonori Habuchi, Shin-Ichiro Nishimura, Chikara Ohyama, Tohru Yoneyama
The Prostate 74 ( 15 ) 1521 - 9 2014年11月
BACKGROUND: The U.S. FDA has approved several novel systemic agents including abiraterone acetate and taxoid cabazitaxel for metastatic castration-resistant prostate cancer (CRPC) result in a complicated decision-making while selecting an appropriate treatment. Therefore, a predictive biomarker for CRPC would provide useful information to physicians. The aim of this study is to evaluate the diagnostic potential of serum N-glycan profiling in CRPC. METHODS: Serum N-glycomics was performed in 80 healthy volunteers and 286 benign prostatic hyperplasia, 258 early-stage PC, 46 PC with androgen deprivation therapy (ADT), and 68 CRPC patients using the glycoblotting method. A total of 36 types of N-glycan levels in each patient were analyzed using logistic regression analysis and receiver operating characteristic curves. We also examined the expression of N-glycan branching enzyme genes in PC cell lines using quantitative RT-PCR. RESULTS: We observed that tri- and tetra-antennary N-glycans were significantly higher in CRPC patients than in any other groups. The longitudinal follow-up of tri- and tetra- antennary N-glycan levels revealed that one PC with ADT patient showed an increase that was more than the cut-off level and two consecutive increases in tri- and tetra-antennary N-glycan levels 3 months apart; resulted in biochemical recurrence despite the castrate level of testosterone, and the patient was defined as CRPC. Expression of N-glycan branching enzyme genes were significantly upregulated in CRPC cell lines. CONCLUSIONS: These results suggest that the overexpression of tri- and tetra-antennary N-glycan may be associated with the castration-resistant status in PC and may be a potential predictive biomarker for CRPC.
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高齢者の前立腺癌は本当に悪いのか? Matched-pair analysisによる前立腺全摘除術施行例での検討
三塚 浩二, 古家 琢也, 成田 伸太郎, 川村 貞文, 栃木 達夫, 大山 力, 羽渕 友則, 荒井 陽一
日本老年泌尿器科学会誌 ( 日本老年泌尿器科学会 ) 27 42 - 42 2014年11月
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Antiemetic efficacy and safety of a combination of palonosetron, aprepitant, and dexamethasone in patients with testicular germ cell tumor receiving 5-day cisplatin-based combination chemotherapy.
Shota Hamada, Shiro Hinotsu, Koji Kawai, Shigeyuki Yamada, Shintaro Narita, Tomomi Kamba, Hiroyuki Nishiyama, Yoichi Arai, Tomonori Habuchi, Osamu Ogawa, Koji Kawakami
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 22 ( 8 ) 2161 - 6 2014年08月
PURPOSE: This study aimed to determine the antiemetic efficacy and safety of a combination of palonosetron, aprepitant, and dexamethasone in patients with testicular germ cell tumor (TGCT) receiving 5-day cisplatin-based combination chemotherapy. METHODS: An open-label, single-arm, multicenter study was performed in patients with TGCT who were scheduled to receive 5-day cisplatin-based combination chemotherapy. The antiemetic therapy consisted of palonosetron 0.75 mg on day 1, aprepitant 125 mg on day 1 and 80 mg on days 2 to 5, and dexamethasone 9.9 mg on day 1 and 6.6 mg on days 2 to 8. The primary endpoint was complete response (CR) rate, which was defined as no vomiting and no rescue medication, in the overall period (0 to 216 h) in the first chemotherapy course. Incidence and severity of nausea were assessed based on the Common Terminology Criteria for Adverse Events (CTCAE) and a subjective rating scale completed by patients. RESULTS: Thirty patients were included in the analysis. CR was achieved in 90.0% of the patients in the first chemotherapy course, and high CR rates were also observed in the second and third courses (82.1 and 78.3%, respectively). The incidence of nausea peaked on days 4 to 6 in about 50% of the patients. The reported adverse drug reactions were hiccups (13.3%), anorexia (3.3%), and stomach pain (3.3%). None of these were unexpected and none were grade 3 or 4. CONCLUSIONS: The combination antiemetic therapy examined in this study was highly effective and well-tolerated in patients with TGCT receiving 5-day cisplatin-based combination chemotherapy.
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Pharmacokinetic and CYP3A5 pharmacogenetic differences between once- and twice-daily tacrolimus from the first dosing day to 1 year after renal transplantation.
Shigeru Satoh, Takenori Niioka, Hideaki Kagaya, Kazuyuki Numakura, Takamitsu Inoue, Mitsuru Saito, Naoki Komine, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Masatomo Miura
Pharmacogenomics 15 ( 11 ) 1495 - 506 2014年08月
UNLABELLED: Aim & patients & methods: This study investigated 24-h pharmacokinetic and CYP3A5 pharmacogenetic differences between once-daily tacrolimus (Tac-q.d.) versus twice-daily tacrolimus (Tac-b.i.d.) pretransplantation and at 1 month and 1 year post-transplantaion. RESULTS: The dose-adjusted trough level (Cmin) and area under the blood concentration-time curve from 0 to 24 h (AUC₀₋₂₄) increased twofold within 1 year post-transplantation with both formulations and the two genotypes. Good correlations were observed between the AUC₀₋₂₄ and Cmin for both formulations. However, the dose-adjusted Cmin, but not dose-adjusted AUC₀₋₂₄, was approximately 30% lower for Tac-q.d. than for Tac-b.i.d. Although the dose-adjusted Cmin was lower for Tac-q.d. than for Tac-b.i.d. in both genotypes, the dose-adjusted AUC₀₋₂₄ was approximately 25% lower for Tac-q.d. than for Tac-b.i.d. in CYP3A5 expressers, but not in nonexpressers during the study period. CONCLUSION: These results suggested that the approximately 30% lower Cmin for Tac-q.d. than for Tac-b.i.d. may have achieved the same AUC₀₋₂₄ with both formulations and may be associated with CYP3A5 pharmacogenomic differences, especially in CYP3A5 expressers, between Tac-b.i.d. and Tac-q.d.
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Successful mammalian target of rapamycin inhibitor maintenance therapy following induction chemotherapy with gemcitabine and doxorubicin for metastatic sarcomatoid renal cell carcinoma.
Kazuyuki Numakura, Norihiko Tsuchiya, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
Oncology letters 8 ( 1 ) 464 - 466 2014年07月
This study presents a case of metastatic sarcomatoid renal cell carcinoma (RCC) treated with systemic chemotherapy followed by mammalian target of rapamycin inhibitor maintenance therapy. A 63-year-old male presented with lumbago, and lumbar vertebral tumors were detected by magnetic resonance imaging. Subsequent computed tomography (CT) revealed a right renal tumor and CT-guided biopsy of the right renal and left sacroiliac tumors determined pure sarcomatoid carcinoma without a clear cell component. Two cycles of combination chemotherapy comprising of gemcitabine (1,500 mg/m2 on day one) and doxorubicin (50 mg/m2 on day one) resulted in a 20% reduction in the longest diameter of the right renal tumor. However, due to grade 3 neutropenia, the chemotherapy was discontinued and temsirolimus (25 mg once weekly), which binds to the cytoplasmic protein, FKBP-12, and inhibits mTOR, was administered. Stable disease was maintained for 19 months with temsirolimus and no major adverse events, with the exception of grade 2 nausea, were observed. The patient succumbed to their disease at 30 months following the initiation of treatment. These results suggested that systemic chemotherapy followed by temsirolimus maintenance is a feasible treatment option for patients with metastatic sarcomatoid RCC.
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Are pathological and oncological outcomes of elderly men treated with radical prostatectomy worse than those of younger men? Matched-pair analysis between patients aged <70 and ≥70 years.
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 44 ( 6 ) 587 - 92 2014年06月
OBJECTIVE: To compare oncological outcomes of patients aged ≥70 years treated with radical prostatectomy with those of a clinically matched younger cohort. METHODS: Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to age (<70 or ≥70 years) at the time of prostatectomy. After matching pre-operative factors (i.e. prostate specific antigen, positive biopsy cores, Gleason score, clinical stage and D'Amico risk group), 333 patients were chosen from each group. RESULTS: The percentage of pathological stage ≥T3 in those of age <70 and ≥70 years was 30.3 and 33.0%, respectively (P = 0.51). The percentage of pathological Gleason score ≤6, 7 and ≥8 was not significantly different between the two age groups (P = 0.08). The percentage of organ-confined disease in those of age <70 and ≥70 years was 69.4 and 67.0%, respectively (P = 0.56). With a median follow-up of 50 months, 5-year prostate specific antigen recurrence-free survival in those of age <70 and ≥70 years was 83.4 and 80.1%, respectively (log rank, P = 0.199). Five-year cancer-specific survival in those of age <70 and ≥70 years was 100 and 99.4%, respectively (log rank, P = 0.317). Five-year overall survival in those of age <70 and ≥70 years was 98.4 and 96.4%, respectively (log rank, P = 0.228). CONCLUSIONS: Pathological and oncological outcomes in elderly patients (age ≥70 years) treated with radical prostatectomy were not significantly different from those of younger patients (age <70 years). This information will help refine the indications for definitive treatment for localized prostate cancer in elderly men.
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Measurement of aberrant glycosylation of prostate specific antigen can improve specificity in early detection of prostate cancer.
Tohru Yoneyama, Chikara Ohyama, Shingo Hatakeyama, Shintaro Narita, Tomonori Habuchi, Takuya Koie, Kazuyuki Mori, Kazuya I P J Hidari, Maho Yamaguchi, Takashi Suzuki, Yuki Tobisawa
Biochemical and biophysical research communications 448 ( 4 ) 390 - 6 2014年06月
INTRODUCTION: We previously identified prostate cancer (PCa)-associated aberrant glycosylation of PSA, where α2,3-linked sialylation is an additional terminal N-glycan on free PSA (S2,3PSA). We then developed a new assay system measuring S2,3PSA using a magnetic microbead-based immunoassay. We compared the diagnostic accuracy of conventional PSA and percent-free PSA (%fPSA) tests. METHODS: We used MagPlex beads to measure serum S2,3PSA levels using anti-human fPSA monoclonal antibody (8A6) for capture and anti-α2,3-linked sialic acid monoclonal antibody (HYB4) for detection. We determined the cutoff values in a training test and measured serum S2,3PSA levels in 314 patients who underwent biopsy, including 138 PCa and 176 non-PCa patients with PSA of <10.0 ng/ml. Serum S2,3PSA levels were presented as mean fluorescence intensity (MFI). Receiver operating characteristic curves were used to evaluate the diagnostic accuracy of total PSA, %fPSA, and S2,3PSA. RESULTS: We determined an MFI cutoff value of 1130 with a sensitivity of 95.0% and specificity of 72.0% for the diagnosis of PCa in the training test. In the validation study, the area under the curve for the detection of PCa with S2,3PSA was 0.84, which was significantly higher than that with PSA or %fPSA. CONCLUSIONS: Although the present study is small and preliminary, these results suggest that the measurement of serum S2,3PSA using a magnetic microbead-based immunoassay may improve the accuracy of early detection of PCa and reduce unnecessary prostate biopsy.
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Successful local control of recurrent penile cancer treated with a combination of systemic chemotherapy, irradiation, and mohs' paste: a case report.
Naoki Komine, Shintaro Narita, Teruaki Kigure, Hiroshi Tsuruta, Kazuyuki Numakura, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Hiroshi Nanjo, Tomonori Habuchi
Case reports in oncology 7 ( 2 ) 522 - 7 2014年05月
Penile squamous cell carcinoma (pSCC) is a rare disease, making it difficult to establish a standard of care, particularly in the advanced stage. We report a case of pSCC with advanced lymph node metastasis treated with multimodal therapy consisting of combination chemotherapy, irradiation, and chemosurgery using Mohs' zinc chloride-containing paste. An 80-year-old male with a past history of local treatment for penile cancer presented with a large painful inguinal mass with an ulcer and exudates. The patient underwent multimodal treatment with combination chemotherapy, irradiation, and Mohs' paste. The combination chemotherapy consisted of cisplatin, 5-fluorouracil, and docetaxel. The patient received 50-Gy external-beam radiation therapy to the left inguinal region along with daily local treatment with Mohs' paste. After the initiation of treatment, the pain and bleeding in the inguinal region considerably ameliorated. The wound became dry and flattened 20 days after the initiation of chemotherapy. A CT scan showed that the tumor had decreased 70% in diameter 1 month after the initiation of chemotherapy. After the first course of chemotherapy, the patient and his family decided not to continue treatment because of socio-economic reasons. The patient underwent no additional treatments; nevertheless, he had no local progression of the inguinal tumors for 8 months. We report a case of successful local control of recurrent inguinal pSCC treated with multimodal therapy. Combination treatment with taxane-based chemotherapy, external-beam radiation therapy, and Mohs' paste is an option for the management of recurrent pSCC.
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ANALYSIS OF FACTORS ASSOCIATED WITH IMPROVEMENT OF METABOLIC DISORDERS FOLLOWING LAPAROSCOPIC ADRENALECTOMY IN PATIENTS WITH CUSHING'S SYNDROME
Kazuyuki Numakura, Norihiko Tsuchiya, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 191 ( 4 ) E11 - E11 2014年04月
研究発表要旨（国際会議）
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FUNCTIONAL RECOVERY OF HYPOCOMPLIANT DEFUNCTIONALIZED BLADDER DUE TO LONG-TERM DIALYSIS AFTER KIDNEY TRANSPLANTATION
Takamitsu Inoue, Shigeru Satoh, Takashi Obara, Mingguo Huang, Mitsuru Saito, Kazuyuki Numakura, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 191 ( 4 ) E389 - E389 2014年04月
研究発表要旨（国際会議）
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INVERSE RELATIONSHIP BETWEEN INSULIN RECEPTOR EXPRESSION AND FAVORABLE OUTCOMES IN PATIENTS WHO UNDERWENT RADICAL NEPHRECTOMY FOR RENAL CELL CARCINOMA
Makoto Takahashi, Takamitsu Inoue, Mingguo Huang, Mitsuru Saito, Hiroshi Tsuruta, Kazuyuki Numakura, Susumu Akihama, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 191 ( 4 ) E307 - E307 2014年04月
研究発表要旨（国際会議）
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MEASUREMENT OF PROSTATE CANCER-ASSOCIATED ABERRANT GLYCOSYLATION OF PROSTATE SPECIFIC ANTIGEN CAN IMPROVE DIAGNOSTIC ACCURACY
Tohru Yoneyama, Yuki Tobisawa, Shingo Hatakeyama, Shintaro Narita, Tomonori Habuchi, Takuya Koie, Chikara Ohyama
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 191 ( 4 ) E931 - E931 2014年04月
研究発表要旨（国際会議）
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SERUM BAFF LEVELS AND B CELL SUBSETS IN DIFFERENT LYMPHOID ORGANS AFTER RITUXIMAB ADMINISTRATION: ITS ASSOCIATION WITH CLINICAL OUTCOMES
Mitsuru Saito, Shigeru Satoh, Kazuyuki Numakura, Mingguo Huang, Hiroshi Tsuruta, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 191 ( 4 ) E824 - E824 2014年04月
研究発表要旨（国際会議）
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Functional mononucleotide repeat polymorphism in the promoter region of HGF is associated with risk and malignant aggressiveness of bladder cancer.
Syuji Chiba, Norihiko Tsuchiya, Yohei Horikawa, Shintaro Narita, Takamitsu Inoue, Susumu Akihama, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
International journal of oncology 44 ( 3 ) 678 - 84 2014年03月
Increased expression of hepatocyte growth factor (HGF) has been shown to be associated with aggressiveness in several types of cancer. Shorter variants of deoxyadenosine tract element (DATE) located in the HGF promoter region have been reported to enhance the expression of HGF. In this study, we investigated the role of HGF DATE variants in bladder cancer risk, HGF expression and clinicopathological features. The frequency of individuals with a short DATE (<28 repeats) in peripheral blood lymphocytes (PBLs) was significantly higher in bladder cancer patients compared to controls (p<0.001). Somatic mutations were observed in 37 of 70 bladder tumor (BT) tissues and the frequency of mutation to long DATE was significantly higher than that to short DATE (p=0.047). The presence of the short DATE in BT tissue was significantly associated with higher tumor grade (p=0.015). HGF mRNA levels were significantly higher in pT2 tumors than pTa or pT1 tumors (p=0.019), and in grade 3 tumors than grade 1 or 2 tumors (p=0.020). Furthermore, BT tissues with the short DATE showed significantly higher levels of HGF mRNA (p<0.001). In patients who underwent radical cystectomy, those with higher HGF expression had a significantly shorter overall survival than those with lower HGF expression (p=0.012). In conclusion, HGF may be associated with the prognosis of patients who undergo radical cystectomy, and the HGF DATE may affect the risk and aggressiveness of bladder cancer by altering HGF expression.
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Organ-specific and tumor-size-dependent responses to sunitinib in clear cell renal cell carcinoma.
Norihiko Tsuchiya, Takeshi Yuasa, Shinya Maita, Shintaro Narita, Takamitsu Inoue, Kazuyuki Numakura, Mitsuru Saito, Shigeru Satoh, Junji Yonese, Tomonori Habuchi
BMC urology 14 26 - 26 2014年03月
BACKGROUND: Tyrosine kinase inhibitors (TKIs) have been used as standard therapy for patients with advanced renal cell carcinoma (RCC). However, information on factors predicting response to treatment with TKIs is lacking. This study aimed to assess the association between initial tumor size, involved organs, pre-treatment C-reactive protein (CRP) levels, and reduction in tumor size in patients with clear cell RCC (CCRCC) treated with sunitinib. METHODS: Patients with advanced CCRCC with target lesions with a maximum diameter ≥ 10 mm treated with sunitinib were evaluated. The tumor diameter representing the best overall response was designated as the post-treatment tumor diameter. RESULTS: A total of 179 lesions in 38 patients were analyzed. Organ-specific analysis demonstrated that pre-treatment diameter of lung metastatic lesions had a moderate inverse association with percent reduction in post-treatment tumor diameter (R = 0.341). Lung lesions showed significantly greater percent reductions in diameter than liver and kidney lesions (P = 0.007 and 0.002, respectively). Furthermore, based on a CRP cut-off level of 2.0 mg/dl, mean tumor size reduction was significantly greater in patients with low CRP levels than in patients with high CRP levels in lesions with diameters < 20 mm (P = 0.002). CRP level had no effect on mean size reduction in lesions with a diameter ≥ 20 mm. CONCLUSIONS: Patients with CCRCC with smaller lung metastatic lesions and lower CRP levels may achieve greater percent reductions in tumor size with sunitinib therapy than patients with extra-pulmonary lesions, large lung lesions, and/or higher CRP levels.
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Diet-induced macrophage inhibitory cytokine 1 promotes prostate cancer progression.
Mingguo Huang, Shintaro Narita, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Hiroshi Nanjo, Takehiko Sasaki, Tomonori Habuchi
Endocrine-related cancer 21 ( 1 ) 39 - 50 2014年02月
Recent studies have indicated that a high-fat diet (HFD) plays an important role in prostate cancer (PCa) progression. Palmitic acid (PA) is one of the most abundant saturated free fatty acids (FAs) and is associated with carcinogenesis. In this study, we investigated the mechanism underlying the association of dietary fat, including PA, with PCa progression. In four PCa cell lines, in vitro PA administration stimulated the expression of macrophage inhibitory cytokine 1 (MIC1), which is a divergent member of the transforming growth factor-β family. In vivo, LNCaP xenograft tumor growth, serum MIC1 levels, and FA levels in xenograft tumors were significantly higher in mice receiving an HFD containing high amounts of PA than in those receiving a low-fat diet (LFD). In addition, tumor cells with high MIC1 expression invaded to venules and lymph vessels in the LNCaP xenograft. In vitro studies showed that proliferation and invasive capacity were significantly higher in PCa cells cultured with serum from HFD-fed mice than in those cultured with the serum from LFD-fed mice. This effect was attenuated by the addition of neutralizing antibodies against MIC1, but not by isotype control antibodies. Clinically, serum MIC1 levels were significantly higher in PCa patients than in healthy controls, and higher levels were associated with higher pathological grade and obesity. In conclusion, our results indicate that an HFD containing PA may promote growth and invasiveness of PCa cells through the upregulation of MIC1 expression.
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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.
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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.
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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
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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
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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
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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.
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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。
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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.
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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
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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）
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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）
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LOW PERCENTAGE (< 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）
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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）
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SINGLE POSITIVE BIOPSY AND PSA LEVEL < 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）
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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
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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.
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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.
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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
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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
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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
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Laparoendoscopic single-site plus one trocar donor nephrectomy using the GelPort: initial clinical experience.
Takamitsu Inoue, Norihiko Tsuchiya, Shintaro Narita, Mitsuru Saito, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
Urology 81 ( 2 ) 308 - 12 2013年02月
OBJECTIVE: To achieve better cosmesis, less invasiveness, and less morbidity in donor nephrectomy without using specialized instruments, which is usually required in the laparoendoscopic single-site (LESS) procedure, we performed laparoendoscopic plus one trocar donor nephrectomy (LEPODN). METHODS: From October 2010 to December 2011, 20 living renal transplantation donors underwent the LEPODN procedure. Their mean age, body mass index (BMI), and preoperative creatinine clearance were 55.7 years, 23.2, and 118.4 mg/min, respectively. The GelPort laparoscopic system was inserted through a 5-6 cm pararectal incision at the umbilicus level. A subcostal 5-mm right-hand working trocar was placed under the left costal arch. The graft kidney was extracted using a retrieval bag. A 5-mm diameter drain was placed via a right-hand working trocar. Operative data of LEPODN were retrospectively compared to those of standard laparoscopic donor nephrectomy (standard-LDN, n = 27) previously performed at our hospital. RESULTS: The procedure was technically successful in all 20 patients. The mean operative time in the LEPODN group was significantly shorter than that in the standard-LDN group (229.1 vs 249.8 minutes, P = .033). Mean blood loss and warm ischemic time in the LEPODN group were 39.4 mL and 272.4 seconds, respectively. The mean serum creatinine concentrations of the recipients 7 and 30 days after operation were 1.57 and 1.13 mg/dL, respectively. These results were not significantly different from those in the standard-LDN group. CONCLUSION: The LEPODN procedure was feasible and performed without specialized instruments by surgeons experienced in only standard laparoscopic nephrectomy.
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Impact of body mass index on clinicopathologic outcome and biochemical recurrence after radical prostatectomy in 1,257 Japanese patients with prostate cancer
Shintaro Narita, Koji Mitsuzuka, Takahiro Yoneyama, Sadafumi Kawamura, Yoichi Arai, Chikara Ohyama, Tatsuo Tochigi, Takuhiro Yamaguchi, Tomonori Habuchi
JOURNAL OF CLINICAL ONCOLOGY ( AMER SOC CLINICAL ONCOLOGY ) 31 ( 6 ) 2013年02月
研究発表要旨（国際会議）
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A meta-analysis of genome-wide association studies to identify prostate cancer susceptibility loci associated with aggressive and non-aggressive disease.
Ali Amin Al Olama, Zsofia Kote-Jarai, Fredrick R Schumacher, Fredrik Wiklund, Sonja I Berndt, Sara Benlloch, Graham G Giles, Gianluca Severi, David E Neal, Freddie C Hamdy, Jenny L Donovan, David J Hunter, Brian E Henderson, Michael J Thun, Michael Gaziano, Edward L Giovannucci, Afshan Siddiq, Ruth C Travis, David G Cox, Federico Canzian, Elio Riboli, Timothy J Key, Gerald Andriole, Demetrius Albanes, Richard B Hayes, Johanna Schleutker, Anssi Auvinen, Teuvo L J Tammela, Maren Weischer, Janet L Stanford, Elaine A Ostrander, Cezary Cybulski, Jan Lubinski, Stephen N Thibodeau, Daniel J Schaid, Karina D Sorensen, Jyotsna Batra, Judith A Clements, Suzanne Chambers, Joanne Aitken, Robert A Gardiner, Christiane Maier, Walther Vogel, Thilo Dörk, Hermann Brenner, Tomonori Habuchi, Sue Ingles, Esther M John, Joanne L Dickinson, Lisa Cannon-Albright, Manuel R Teixeira, Radka Kaneva, Hong-Wei Zhang, Yong-Jie Lu, Jong Y Park, Kathleen A Cooney, Kenneth R Muir, Daniel A Leongamornlert, Edward Saunders, Malgorzata Tymrakiewicz, Nadiya Mahmud, Michelle Guy, Koveela Govindasami, Lynne T O'Brien, Rosemary A Wilkinson, Amanda L Hall, Emma J Sawyer, Tokhir Dadaev, Jonathan Morrison, David P Dearnaley, Alan Horwich, Robert A Huddart, Vincent S Khoo, Christopher C Parker, Nicholas Van As, Christopher J Woodhouse, Alan Thompson, Tim Dudderidge, Chris Ogden, Colin S Cooper, Artitaya Lophatonanon, Melissa C Southey, John L Hopper, Dallas English, Jarmo Virtamo, Loic Le Marchand, Daniele Campa, Rudolf Kaaks, Sara Lindstrom, W Ryan Diver, Susan Gapstur, Meredith Yeager, Angela Cox, Mariana C Stern, Roman Corral, Markus Aly, William Isaacs, Jan Adolfsson, Jianfeng Xu, S Lilly Zheng, Tiina Wahlfors, Kimmo Taari, Paula Kujala, Peter Klarskov, Børge G Nordestgaard, M Andreas Røder, Ruth Frikke-Schmidt, Stig E Bojesen, Liesel M FitzGerald, Suzanne Kolb, Erika M Kwon, Danielle M Karyadi, Torben Falck Orntoft, Michael Borre, Antje Rinckleb, Manuel Luedeke, Kathleen Herkommer, Andreas Meyer, Jürgen Serth, James R Marthick, Briony Patterson, Dominika Wokolorczyk, Amanda Spurdle, Felicity Lose, Shannon K McDonnell, Amit D Joshi, Ahva Shahabi, Pedro Pinto, Joana Santos, Ana Ray, Thomas A Sellers, Hui-Yi Lin, Robert A Stephenson, Craig Teerlink, Heiko Muller, Dietrich Rothenbacher, Norihiko Tsuchiya, Shintaro Narita, Guang-Wen Cao, Chavdar Slavov, Vanio Mitev, Stephen Chanock, Henrik Gronberg, Christopher A Haiman, Peter Kraft, Douglas F Easton, Rosalind A Eeles
Human molecular genetics 22 ( 2 ) 408 - 15 2013年01月
Genome-wide association studies (GWAS) have identified multiple common genetic variants associated with an increased risk of prostate cancer (PrCa), but these explain less than one-third of the heritability. To identify further susceptibility alleles, we conducted a meta-analysis of four GWAS including 5953 cases of aggressive PrCa and 11 463 controls (men without PrCa). We computed association tests for approximately 2.6 million SNPs and followed up the most significant SNPs by genotyping 49 121 samples in 29 studies through the international PRACTICAL and BPC3 consortia. We not only confirmed the association of a PrCa susceptibility locus, rs11672691 on chromosome 19, but also showed an association with aggressive PrCa [odds ratio = 1.12 (95% confidence interval 1.03-1.21), P = 1.4 × 10(-8)]. This report describes a genetic variant which is associated with aggressive PrCa, which is a type of PrCa associated with a poorer prognosis.
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Comparison of surgical stress in patients undergoing open versus laparoscopic radical prostatectomy by measuring perioperative serum cytokine levels.
Shintaro Narita, Norihiko Tsuchiya, Teruaki Kumazawa, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
Journal of laparoendoscopic & advanced surgical techniques. Part A 23 ( 1 ) 33 - 7 2013年01月
PURPOSE: We evaluated the perioperative serum levels of inflammatory cytokines in patients with prostate cancer (PCa) treated with open or laparoscopic radical prostatectomy (RP) and assessed the surgical stress based on the cytokine levels in addition to conventional clinical stress markers after surgery. PATIENTS AND METHODS: One hundred sixty-five patients who received RP for clinically localized PCa were enrolled. Serum levels of interleukin (IL)-10, IL-6, tumor necrosis factor-α, IL-1β, IL-8, and IL-12p70 were quantitatively measured using a multiplex bead array at three time points (i.e., before the operation [pre-OP], immediately after the operation [post-OP], and on postoperative Day 1 [POD1]). The perioperative changes in serum stress markers, including cytokines, were compared between patients who underwent open and laparoscopic RP, and the predictors for high levels of postoperative cytokines were assessed. RESULTS: The median age and estimated blood loss were significantly lower in the laparoscopic RP group than in the open RP group (P=.003 and P<.01, respectively). In all patients, body temperature, white blood cell count, and serum IL-10 and IL-6 levels were significantly higher at post-OP and POD1 than at pre-OP. Patients who underwent laparoscopic RP had significantly lower levels of serum IL-10, IL-6, and IL-1β at post-OP and POD1 than those who underwent open RP. Multivariate regression analyses showed that the surgical group (open versus laparoscopic) was an independent influencing factor on the levels of serum IL-6 and IL-10 at POD1 (P=.031 and P<.004, respectively) among various clinical perioperative parameters. CONCLUSIONS: Several inflammatory cytokines, particularly IL-6 and IL-10, are potential surgical stress markers in patients with PCa treated with RP. Based on cytokine production, our data support the view that laparoscopic RP is less invasive than open RP.
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Distinct cancer-specific survival in metastatic prostate cancer patients classified by a panel of single nucleotide polymorphisms of cancer-associated genes.
Norihiko Tsuchiya, Shigeyuki Matsui, Shintaro Narita, Tomomi Kamba, Koji Mitsuzuka, Shingo Hatakeyama, Yohei Horikawa, Takamitsu Inoue, Seiichi Saito, Chikara Ohyama, Yoich Arai, Osamu Ogawa, Tomonori Habuchi
Genes & cancer 4 ( 1-2 ) 54 - 60 2013年01月
Individual genetic variations may have a significant influence on the survival of metastatic prostate cancer (PCa) patients. We aimed to identify target genes and their variations involved in the survival of PCa patients using a single nucleotide polymorphism (SNP) panel. A total of 185 PCa patients with bone metastasis at the initial diagnosis were analyzed. Germline DNA in each patient was genotyped using a cancer SNP panel that contained 1,421 SNPs in 408 cancer-related genes. SNPs associated with survival were screened by a log-rank test. Fourteen SNPs in 6 genes, XRCC4, PMS1, GATA3, IL13, CASP8, and IGF1, were identified to have a statistically significant association with cancer-specific survival. The cancer-specific survival times of patients grouped according to the number of risk genotypes of 6 SNPs selected from the 14 SNPs differed significantly (0-1 v. 2-3 v. 4-6 risk genotypes; P = 7.20 × 10(-8)). The high-risk group was independently associated with survival in a multivariate analysis that included conventional clinicopathological variables (P = 0.0060). We identified 14 candidate SNPs in 6 cancer-related genes, which were associated with poor survival in patients with metastatic PCa. A panel of SNPs may help predict the survival of those patients.
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A high-fat diet enhances proliferation of prostate cancer cells and activates MCP-1/CCR2 signaling.
Mingguo Huang, Shintaro Narita, Kazuyuki Numakura, Hiroshi Tsuruta, Mitsuru Saito, Takamitsu Inoue, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
The Prostate 72 ( 16 ) 1779 - 88 2012年12月
BACKGROUND: Dietary patterns including high-fat diet (HFD) and high-carbohydrate diet (HCD) play an important role in prostate cancer progression. However, which of these diets have the greatest effect on tumor progression and its underlying mechanisms remains unclear. METHODS: We investigated the effects of different diets on prostate cancer cell growth and the relevant circulating factors including serum insulin, growth factors, and inflammatory cytokines using the in vivo and ex vivo model. RESULTS: The tumor growth of prostate cancer LNCaP xenograft was significantly higher in the HFD group than in the HCD and control diet (CD) groups (P = 0.01; HFD vs. HCD, P = 0.025; HFD vs. CD, P = 0.003). The mean level of the serum monocyte chemoattractant protein-1 (MCP-1) in the HFD group was significantly higher than that in the HCD and CD groups (P = 0.024; HFD vs. HCD, P = 0.033; HFD vs. CD, P = 0.001). The mRNA levels of CC chemokine receptor 2 (CCR2), which is an MCP-1 receptor, and the expression of activated Akt were the highest in the HFD group. Furthermore, serum from HFD-fed mice enhanced the proliferation of two PCa cells and CCR2 knockdown inhibited HFD-induced proliferation of LNCaP cells. CONCLUSIONS: An HFD enhanced prostate cancer cell growth more strongly than an HCD or CD. MCP-1/CCR2 signaling may be involved in an HFD-induced prostate cancer progression.
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Comparison of pharmacokinetics and pharmacogenetics of once- and twice-daily tacrolimus in the early stage after renal transplantation.
Takenori Niioka, Shigeru Satoh, Hideaki Kagaya, Kazuyuki Numakura, Takamitsu Inoue, Mitsuru Saito, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Masatomo Miura
Transplantation 94 ( 10 ) 1013 - 9 2012年11月
BACKGROUND: This study investigated pharmacokinetic and pharmacogenetic differences between a modified-release once-daily formulation of tacrolimus (Tac-QD) and the original formulation requiring twice-daily intake (Tac-BID) in de novo renal transplant recipients. METHODS: Forty-seven and 25 patients who received Tac-BID and Tac-QD, respectively, were enrolled. The pharmacokinetics and CYP3A5 6986A>G and ABCB1 3435C>T pharmacogenetics of each formulation were analyzed on day 28 posttransplantation. RESULTS: The dose-adjusted trough level (C0) and area under the concentration-time curve (AUC0-24) of tacrolimus were approximately 25% lower for Tac-QD than Tac-BID. However, there was a good correlation between the AUC0-24 and C0 in the Tac-BID and Tac-QD groups (r=0.575, P<0.001; and r=0.638, P<0.001, respectively) and a similar coefficient in each regression equation. The dose-adjusted AUC0-24 was approximately 25% lower in carriers of the CYP3A*1 allele (CYP3A5 expressers), but not individuals with the CYP3A*3/*3 genotype (nonexpressers), for TAC-QD than Tac-BID. In the Tac-QD group, the interpatient variability for dose-adjusted parameters was small, and the interquatile ranges of dose-adjusted parameters differed between CYP3A5 expressers and nonexpressers and did not overlap. The ABCB1 polymorphism was not associated with any pharmacokinetic parameters of Tac-QD. CONCLUSIONS: C0-guided monitoring may lead to similar AUC0-24 values for both formulations. However, to maintain the same AUC0-24 value, a higher dose of Tac-QD than Tac-BID may be needed, especially for CYP3A5 expressers, in the early stage posttransplantation. The narrow interindividual variability of Tac-QD pharmacokinetics and its difference between CYP3A5 expressers and nonexpressers might contribute to a dosing strategy based on CYP3A5 genotype.
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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
日本癌治療学会誌 ( (一社)日本癌治療学会 ) 47 ( 3 ) 1942 - 1942 2012年10月
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最近10年間における限局性前立腺癌の腫瘍学的特徴の変化 前立腺全摘1268例の解析
三塚 浩二, 成田 伸太郎, 古家 琢也, 栫井 成彦, 海法 康裕, 土谷 順彦, 米山 高広, 川村 貞文, 栃木 達夫, 羽渕 友則, 大山 力, 荒井 陽一
日本癌治療学会誌 ( (一社)日本癌治療学会 ) 47 ( 3 ) 1954 - 1954 2012年10月
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薬物治療モニタリングに向けた進行性腎細胞癌患者におけるsunitinibの薬物動態の検討
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
日本癌治療学会誌 ( (一社)日本癌治療学会 ) 47 ( 3 ) 1052 - 1052 2012年10月
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LAPARO-ENDOSCOPIC SINGLE-SITE (LESS) DONOR NEPHRECTOMY USING GELPOINT (R): AN INITIAL CLINICAL EXPERIENCE
Takamitsu Inoue, Shintaro Narita, Kazuyuki Numakura, Susumu Akihama, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF ENDOUROLOGY ( MARY ANN LIEBERT INC ) 26 A64 - A65 2012年09月
研究発表要旨（国際会議）
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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.
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LAPARO-ENDOSCOPIC SINGLE-SITE (LESS) PLUS ONE TROCAR LAPAROSCOPIC DONOR NEPHRECTOMY UTILIZING GELPORT: AN INITIAL CLINICAL EXPERIENCE
Takamitsu Inoue, Norihiko Tsuchiya, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Mitsuru Saito, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF ENDOUROLOGY ( MARY ANN LIEBERT INC ) 25 A84 - A85 2011年11月
研究発表要旨（国際会議）
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A case study of metastatic Xp11.2 translocation renal cell carcinoma effectively treated with sunitinib.
Kazuyuki Numakura, Norihiko Tsuchiya, Takeshi Yuasa, Mitsuru Saito, Takashi Obara, Hiroshi Tsuruta, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
International journal of clinical oncology 16 ( 5 ) 577 - 80 2011年10月
We report a case of Xp11.2 translocation renal cell carcinoma (RCC) whose lung metastases were effectively treated with sunitinib. A 43-year-old woman presenting with upper abdominal pain was diagnosed with a left renal tumor. Laparoscopic left radical nephrectomy was performed. Histopathological examination of the surgical specimen revealed a clear-cell carcinoma of the left kidney. Two years later, multiple lung metastases were detected and the patient was treated daily with 50 mg sunitinib. A computed tomography scan performed after 2 cycles of sunitinib treatment revealed partial regression of these metastases. The partial regression has been maintained for >3 years. In retrospective evaluation of the primary RCC, tumor cells showed strong nuclear staining for transcription factor E3 (TFE3) protein and TFE3 split-fluorescence in-situ hybridization revealed translocation involving the TFE3 gene. These findings strongly support diagnosis of Xp11.2 translocation RCC.
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Combination therapy consisting of gemcitabine, carboplatin, and docetaxel as an active treatment for advanced urothelial carcinoma.
Hiroshi Tsuruta, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Mitsuru Saito, Takashi Obara, Kazuyuki Numakura, Shinya Maita, Shigeru Satoh, Norihiko Tsuchiya, Tomonori Habuchi
International journal of clinical oncology 16 ( 5 ) 533 - 8 2011年10月
BACKGROUND: To evaluate the efficacy and toxicity of a combination chemotherapy consisting of gemcitabine, carboplatin, and docetaxel (GCD) in patients with advanced urothelial carcinoma (UC) as a phase II trial. MATERIALS AND METHODS: Patients with metastatic or locally advanced unresectable UC were eligible for this trial. All enrolled patients were considered to be "unfit" for cisplatin-based chemotherapy, or to have methotrexate, vinblastine, doxorubicin, cisplatin (MVAC)-refractory UC. The chemotherapy regimen consisted of gemcitabine 1000 mg/m(2) on days 1 and 8, and carboplatin (with a target area under the curve of 5) and docetaxel 70 mg/m(2) on day 1; this was repeated every 21 days. RESULTS: Thirty-five patients were enrolled, with a median age of 68 years. A total of 89 cycles were administered (median, 2 cycles). Major toxicities were Grade 3/4 neutropenia in 28 (80.0%) patients and Grade 3/4 thrombocytopenia in 18 (51.5%). An objective response rate (ORR) was 11 of 21 patients (52.4%), including a complete response in 1 (4.8%). The median overall survival (OS) was 13.1 months (1-year survival rate, 60%) and the median progression-free survival (PFS) was 5.0 months. Among 16 patients who had previously received MVAC, the ORR, the median PFS, the median OS and 1-year survival rate was 56.3%, 5.0 months, 12.6 months and 54%, respectively. CONCLUSIONS: GCD chemotherapy is active and well tolerated as a first- or second-line therapy for patients with advanced UC. Response rate, duration and survival did not differ between those with and without a history of MVAC treatment.
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Two survivin polymorphisms are cooperatively associated with bladder cancer susceptibility.
Naoko Kawata, Norihiko Tsuchiya, Yohei Horikawa, Takamitsu Inoue, Hiroshi Tsuruta, Shinya Maita, Shigeru Satoh, Yoko Mitobe, Shintaro Narita, Tomonori Habuchi
International journal of cancer 129 ( 8 ) 1872 - 80 2011年10月
Abnormal survivin expression has been reported to be involved in many types of cancer. A single-nucleotide polymorphism (SNP), C-31G, located in the promoter region of survivin reportedly may alter the mRNA level, while the significance of the nonsynonymous SNP A9194G in exon 4 has not yet been clarified. Here, the association between the two survivin SNPs and bladder cancer susceptibility and progression was investigated in 235 patients with bladder cancer and 346 healthy controls. Regarding the C-31G SNP, subjects with the CC genotype had a significantly higher risk of bladder cancer compared to those with the GG + CG genotype [odds ratio (OR) = 1.85, p = 0.001]. Regarding the A9194G SNP, the presence of the G allele was associated with a significantly reduced risk with a gene dosage effect (OR = 0.69, p = 0.002). Using the C-A haplotype as a reference, the G-G haplotype was associated with a significantly lower risk (OR = 0.11, p = 0.00006), indicating the cooperative effect of the two SNPs. Immunohistological evaluation of surgical specimens showed that cancer cells of the C-31G CC genotype had significantly higher nuclear survivin expression than those of the C-31G GG + CG genotype. With reverse transcriptase-polymerase chain reaction analysis, a significantly higher survivin mRNA expression level was observed in surgical specimens with an increase in the number of the C-31G C allele (p = 0.016). These results indicate that the two SNPs have a significant and cooperative influence on bladder cancer susceptibility.
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癌関連遺伝子SNPパネルを用いた転移性前立腺癌の予後予測(Prediction of survival in metastatic prostate cancer patients by SNP panel of cancer-associated genes)
土谷 順彦, 松井 茂之, 成田 伸太郎, 神波 大己, 三塚 浩二, 畠山 真吾, 堀川 洋平, 井上 高光, 斎藤 誠一, 大山 力, 荒井 陽一, 小川 修, 羽渕 友則
日本癌学会総会記事 ( 日本癌学会 ) 70回 455 - 456 2011年09月
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Correlations between pretransplant dialysis duration, bladder capacity, and prevalence of vesicoureteral reflux to the graft.
Takamitsu Inoue, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Takashi Obara, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
Transplantation 92 ( 3 ) 311 - 5 2011年08月
BACKGROUND: Urinary bladder capacity is reduced in patients undergoing long-term dialysis, which may increase the risk of vesicoureteral reflux (VUR) to a transplanted kidney. This study investigated the correlations between dialysis duration, pretransplant and posttransplant bladder capacity, and prevalence of VUR to the graft. METHODS: Voiding cystography was performed in 101 adult renal transplant recipients without neurogenic disorders immediately before and 1 year after transplantation to evaluate bladder capacity and VUR. Nonstented extravesical antireflux ureteroneocystostomy was performed in all patients. RESULTS: The median dialysis duration and pretransplant bladder capacity were 32 months (range 1-426 months) and 120 mL (range 15-450 mL), and 21 patients (20.8%) underwent dialysis for more than 120 months, and 30 patients (29.7%) had a pretransplant bladder capacity of less than 80 mL. Dialysis duration was correlated with pretransplant bladder capacity (R=0.466, P<0.001). Bladder capacity expanded more than 6-fold from pretransplantation to posttransplantation, and all recipients had a bladder capacity greater than 150 mL at 1 year posttransplantation. Thirty patients had VUR to the graft. Dialysis duration longer than 60 months (P=0.021) and pretransplant bladder capacity of less than 130 mL (P=0.024) were associated with VUR. VUR was associated with lower graft function. CONCLUSIONS: Although bladder capacity decreased because of long-term dialysis, it exceeded 150 mL at 1 year posttransplantation. A small bladder can be used in renal transplantation, but it may increase the risk of VUR.
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Seven prostate cancer susceptibility loci identified by a multi-stage genome-wide association study.
Zsofia Kote-Jarai, Ali Amin Al Olama, Graham G Giles, Gianluca Severi, Johanna Schleutker, Maren Weischer, Daniele Campa, Elio Riboli, Tim Key, Henrik Gronberg, David J Hunter, Peter Kraft, Michael J Thun, Sue Ingles, Stephen Chanock, Demetrius Albanes, Richard B Hayes, David E Neal, Freddie C Hamdy, Jenny L Donovan, Paul Pharoah, Fredrick Schumacher, Brian E Henderson, Janet L Stanford, Elaine A Ostrander, Karina Dalsgaard Sorensen, Thilo Dörk, Gerald Andriole, Joanne L Dickinson, Cezary Cybulski, Jan Lubinski, Amanda Spurdle, Judith A Clements, Suzanne Chambers, Joanne Aitken, R A Frank Gardiner, Stephen N Thibodeau, Dan Schaid, Esther M John, Christiane Maier, Walther Vogel, Kathleen A Cooney, Jong Y Park, Lisa Cannon-Albright, Hermann Brenner, Tomonori Habuchi, Hong-Wei Zhang, Yong-Jie Lu, Radka Kaneva, Ken Muir, Sara Benlloch, Daniel A Leongamornlert, Edward J Saunders, Malgorzata Tymrakiewicz, Nadiya Mahmud, Michelle Guy, Lynne T O'Brien, Rosemary A Wilkinson, Amanda L Hall, Emma J Sawyer, Tokhir Dadaev, Jonathan Morrison, David P Dearnaley, Alan Horwich, Robert A Huddart, Vincent S Khoo, Christopher C Parker, Nicholas Van As, Christopher J Woodhouse, Alan Thompson, Tim Christmas, Chris Ogden, Colin S Cooper, Aritaya Lophatonanon, Melissa C Southey, John L Hopper, Dallas R English, Tiina Wahlfors, Teuvo L J Tammela, Peter Klarskov, Børge G Nordestgaard, M Andreas Røder, Anne Tybjærg-Hansen, Stig E Bojesen, Ruth Travis, Federico Canzian, Rudolf Kaaks, Fredrik Wiklund, Markus Aly, Sara Lindstrom, W Ryan Diver, Susan Gapstur, Mariana C Stern, Roman Corral, Jarmo Virtamo, Angela Cox, Christopher A Haiman, Loic Le Marchand, Liesel Fitzgerald, Suzanne Kolb, Erika M Kwon, Danielle M Karyadi, Torben Falck Orntoft, Michael Borre, Andreas Meyer, Jürgen Serth, Meredith Yeager, Sonja I Berndt, James R Marthick, Briony Patterson, Dominika Wokolorczyk, Jyotsna Batra, Felicity Lose, Shannon K McDonnell, Amit D Joshi, Ahva Shahabi, Antje E Rinckleb, Ana Ray, Thomas A Sellers, Hui-Yi Lin, Robert A Stephenson, James Farnham, Heiko Muller, Dietrich Rothenbacher, Norihiko Tsuchiya, Shintaro Narita, Guang-Wen Cao, Chavdar Slavov, Vanio Mitev, Douglas F Easton, Rosalind A Eeles
Nature genetics 43 ( 8 ) 785 - 91 2011年07月
Prostate cancer (PrCa) is the most frequently diagnosed male cancer in developed countries. We conducted a multi-stage genome-wide association study for PrCa and previously reported the results of the first two stages, which identified 16 PrCa susceptibility loci. We report here the results of stage 3, in which we evaluated 1,536 SNPs in 4,574 individuals with prostate cancer (cases) and 4,164 controls. We followed up ten new association signals through genotyping in 51,311 samples in 30 studies from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium. In addition to replicating previously reported loci, we identified seven new prostate cancer susceptibility loci on chromosomes 2p11, 3q23, 3q26, 5p12, 6p21, 12q13 and Xq12 (P = 4.0 × 10(-8) to P = 2.7 × 10(-24)). We also identified a SNP in TERT more strongly associated with PrCa than that previously reported. More than 40 PrCa susceptibility loci, explaining ∼25% of the familial risk in this disease, have now been identified.
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A case of intratesticular endometrioid papillary cystadenocarcinoma.
Kazuyuki Numakura, Norihiko Tsuchiya, Hiroshi Tsuruta, Takashi Obara, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Hiroshi Nanjyo, Tomonori Habuchi
Japanese journal of clinical oncology 41 ( 5 ) 674 - 6 2011年05月
We report a case of intratesticular endometrioid papillary cystadenocarcinoma. A 73-year-old man was admitted for a painless right scrotal swelling. Ultrasonography and computed tomography revealed a large cystic mass in the right testis. Right scrotum puncture revealed xanthochromic fluid with negative cytology. Three months later, follow-up computed tomography showed enlargement of the cystic mass. Right high orchiectomy was performed because a testicular malignancy was suspected. The pathological diagnosis was endometrioid papillary cystadenocarcinoma, and the cells were strongly positive for the estrogen and progesterone receptors. Testicular neoplasms resembling common ovarian-type epithelial tumors are very rare. This is the first report of endometrioid papillary cystadenocarcinoma of the testis.
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CLINICAL CHARACTERISTICS OF XP11.2 TRANSLOCATION RENAL CELL CARCINOMA IN ADULT JAPANESE PATIENTS
Kazuyuki Numakura, Norihiko Tsuchiya, Takeshi Yuasa, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Shingo Hatakeyama, Chikara Ohyama, Toru Inoue, Hiromitsu Mimata, Hideo Saito, Yoichi Arai, Toru Kanno, Tomomi Kamba, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E706 - E706 2011年04月
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BASILIXIMAB INDUCTION THERAPY COMBINED WITH A LOWER TARGET TROUGH LEVEL OF TACROLIMUS AND LOW DOSE OF MYCOPHENOLATE MOFETIL DECREASED INTERSTITIAL FIBROSIS AT 1-YEAR POSTTRANSPLANTATION AND IMPROVED THE 5-YEAR GRAFT SURVIVAL
Shigeru Satoh, Kazuyuki Numakura, Mitsuru Saito, Yoshiko Miura, Takashi Obara, Hiroshi Tsuruta, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi, Hideaki Kagaya, Masatomo Miura
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E905 - E905 2011年04月
研究発表要旨（国際会議）
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ELEVATED URINE LEVELS OF RANTES AND HIGH EXPRESSION LEVELS OF THE RANTES RECEPTOR (CCR5) IN BLADDER CANCER
Hiroshi Tsuruta, Yohei Horikawa, Shintaro Narita, Takamitsu Inoue, Takashi Obara, Kazuyuki Numakura, Shinya Maita, Shigeru Sato, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E496 - E496 2011年04月
研究発表要旨（国際会議）
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EXTRACELLULAR MATRIX METALLOPROTEINASE INDUCER (EMMPRIN/CD147) IS ASSOCIATED WITH MALIGNANT PHENOTYPES OF HUMAN BLADDER CANCER
Kiyofumi Satoyoshi, Noriko Yamaguchi, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E349 - E349 2011年04月
研究発表要旨（国際会議）
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FACTORS ASSOCIATED WITH QUANTITATIVE INTERSTITIAL FIBROSIS AT 0-HOUR (DONOR) BIOPSY BY COMPUTERIZED IMAGE ANALYSIS IN LIVING DONORS
Yoshiko Miura, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habichi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E903 - E903 2011年04月
研究発表要旨（国際会議）
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IMPACT OF CLINICAL CHARACTERISTICS AND PRETRANSPLANT URINARY BLADDER CAPACITY ON URODYNAMICS ONE YEAR POSTTRANSPLANTATION IN 54 ADULT RECIPIENTS
Takashi Obara, Shigeru Satoh, Kazuyuki Numakura, Hiroshi Tsuruta, Shintaro Narita, Horikawa Yohei, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E830 - E830 2011年04月
研究発表要旨（国際会議）
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POSTTRANSPLANT HYPERURICEMIA IN THE EARLY STAGE OF RENAL TRANSPLANT RECIPIENTS: INCIDENCE, CLINICAL CHARACTERISTICS, TACROLIMUS PARMACOKINETICS, AND RELATED GENOMIC POLYMORPHISMS
Kazuyuki Numakura, Shigeru Satoh, Norihiko Tsuchiya, Mitsuru Saito, Takamitsu Inoue, Takashi Obara, Hiroshi Tsuruta, Shintaro Narita, Yohei Horikawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E906 - E906 2011年04月
研究発表要旨（国際会議）
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PREDICTION OF SURVIVAL IN METASTATIC PROSTATE CANCER PATIENTS BY SNP ARRAY ANALYSIS OF CANCER-ASSOCIATED GENES
Norihiko Tsuchiya, Shigeyuki Matsui, Shintaro Narita, Takamitsu Inoue, Kazuyuki Numakura, Yohei Horikawa, Shingo Hatakeyama, Chikara Ohyama, Youichi Arai, Seiichi Saito, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E917 - E917 2011年04月
研究発表要旨（国際会議）
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PREOPERATIVE SERUM LEVELS OF INTERLEUKIN-6 AND INTERLEUKIN-12 PREDICT BIOCHEMICAL RECURRENCE IN PATIENTS WITH PROSTATE CANCER TREATED USING RADICAL PROSTATECTOMY
Shintaro Narita, Norihiko Tsuchiya, Shinya Maita, Takashi Obara, Kazuyuki Numakura, Hiroshi Tsuruta, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E937 - E937 2011年04月
研究発表要旨（国際会議）
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PROSTATE CANCER PROGRESSION UNDER HIGH-FAT DIET IS ENHANCED BY MCP-1/CCR2 SIGNALING
Mingguo Huang, Shintaro Narita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Takamitsu Inoue, Yohei Horikawa, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 185 ( 4 ) E115 - E115 2011年04月
研究発表要旨（国際会議）
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A case of ureteral malignant lymphoma diagnosed by laparoscopic needle biopsy.
Kazuyuki Numakura, Norihiko Tsuchiya, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
Japanese journal of clinical oncology 41 ( 3 ) 440 - 2 2011年03月
A pathological diagnosis of a lesion in the ureteral wall is often attended with a difficulty. We report a case of a 54-year-old man who presented a thickening of the ureteral wall and diffuse swelling of paraaortic lymph nodes diagnosed as a non-Hodgkin lymphoma by a laparoscopic needle biopsy. This is a safe and useful technique by which target tissues can be surely obtained.
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Factors increasing quantitative interstitial fibrosis from 0 hr to 1 year in living kidney transplant patients receiving tacrolimus.
Yoshiko Miura, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Takamitsu Inoue, Takashi Obara, Hiroshi Tsuruta, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Atsushi Komatsuda, Hideaki Kagaya, Masatomo Miura, Tomonori Habuchi
Transplantation 91 ( 1 ) 78 - 85 2011年01月
BACKGROUND: This study investigated the increase in interstitial fibrosis (IF) from 0 hr to 1 month and 1 year posttransplantation in biopsy sections and assessed the risk of developing IF in 118 living kidney recipients. METHODS: A quantitative analysis of IF was performed using computer-assisted imaging. The percent IF (%IF) in the cortical region at 0 hr was defined as the baseline, and the increases in %IF at 1 month and 1 year were calculated. Demographics, higher (regimen 1) and lower (regimen 2) target trough concentrations of tacrolimus, and the cytochrome P450 (CYP) 3A5 polymorphism were tested as risk factors. RESULTS: The mean %IF at 0 hr, 1 month, and 1 year was 10.3%+/-4.2%, 15.0%+/-5.8%, and 19.0%+/-7.7%, respectively. %IF increased 1.7- and 2.2-fold from 0 hr to 1 month and 1 year posttransplantation, respectively. At 1 year, the increase was higher in patients with the CYP3A5*3/*3 genotype (nonexpressers), those treated with regimen 1, and those with a lower estimated glomerular filtration rate and higher body mass index. In a multivariate analysis, CYP3A5 nonexpression correlated with the development of IF (odds ratio 2.63, P=0.018). Tacrolimus blood levels in the early stage posttransplantation were higher in nonexpressers than CYP3A5 expressers in both regimens 1 and 2, despite therapeutic drug monitoring. CONCLUSIONS: The higher concentrations of tacrolimus, especially in the nonexpressers treated with regimen 1, might influence the development of IF. This study suggested that a new regimen with lower and narrow target trough levels of tacrolimus or a dosing strategy based on the CYP3A5 genotype is needed to reduce the risk of developing IF.
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What is the most preferred wound site for laparoscopic donor nephrectomy?: a questionnaire assessment.
Mitsuru Saito, Norihiko Tsuchiya, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Teruaki Kumazawa, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Takeshi Yuasa, Shigeru Satoh, Tomonori Habuchi
Journal of laparoendoscopic & advanced surgical techniques. Part A 21 ( 6 ) 511 - 5 2011年
INTRODUCTION: Although specimen extraction site selection for laparoscopic donor nephrectomy (LDN) is relatively flexible and is mostly selected by surgeons from the patient's standpoint, the patient's request may differ from the medical worker's recommendation. The cosmetic aspect may also differ with age, gender, and the extent of medical knowledge. We performed an unsigned questionnaire assessment of individual preferences for LDN wound sites. MATERIALS AND METHODS: Between August 2007 and October 2008, we surveyed LDN wound site preferences among 148 physicians, 263 nurses, and 266 outpatients of urology at Akita University Hospital. They were questioned for their age, gender, occupation (medical worker or not), and for the most preferred surgical wound site among the following: A, lower vertical midline: B, upper vertical midline: C, anterior subcostal: D, Pfannenstiel: E, Gibson: and F, subcostal flank. The valid response rate was 93.5% (677/724). RESULTS: Wound sites preferred (ranked in descending order) were F (48.3%), D (25.6%), E (10.5%), A (9.0%), C (5.2%), and B (1.4%). The subcostal flank incision was the most preferred in almost all the categories. Second preferences were Pfannenstiel incisions in women and incisions on the lower abdomen in men. Overall, flank and lower abdominal incisions tended to be preferred, and mid and upper abdominal incisions tended to be avoided. Medical workers selected the subcostal flank and Pfannenstiel incisions more frequently than outpatients. With increasing age, the selection rates of the Gibson and the lower vertical midline incisions increased, whereas the subcostal flank and the Pfannenstiel incisions decreased. CONCLUSIONS: The subcostal flank was the most preferred LDN sites. Age, gender, and the extent of medical knowledge may influence the individual preferences for LDN wound sites.
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AL-5 サイトカインシグナルを介した高脂肪食摂取下の前立腺癌進展機序の解明(第4回ヤングリサーチグラント受賞者記念講演,第99回日本泌尿器科学会総会)
成田 伸太郎, 黄 明国, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 279 - 279 2011年
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OP-001 食事による前立腺癌xenograft増殖とMCP-1/CCR2の関与(前立腺腫瘍/基礎,一般演題口演,第99回日本泌尿器科学会総会)
黄 明国, 成田 伸太郎, 鶴田 大, 井上 高光, 堀川 洋平, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 341 - 341 2011年
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OP-073 腎盂尿管癌に対する腎尿管全摘除術の予後因子の検討(腎盂・尿管腫瘍,一般演題口演,第99回日本泌尿器科学会総会)
堀川 洋平, 千葉 修司, 米田 真也, 高橋 誠, 沼倉 一幸, 鶴田 大, 小原 崇, 井上 高光, 成田 伸太郎, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 353 - 353 2011年
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PP-206 国際前立腺症状スコア(IPSS)はPSAグレーゾーン症例の前立腺生検癌検出率と逆相関する(発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)
小原 崇, 小峰 直樹, 高橋 誠, 米田 真也, 沼倉 一幸, 鶴田 大, 井上 高光, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 438 - 438 2011年
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PP-474 BCG(Connaught株)膀注療法におけるレボフロキサシンの効果の検討(一般演題ポスター発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)
沼倉 一幸, 米田 真也, 小原 崇, 鶴田 大, 齋藤 満, 井上 高光, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 佐藤 滋, 石田 俊哉, 松尾 重樹, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 482 - 482 2011年
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PP-816 SNPアレイを用いた転移性前立腺癌の生存期間に関与する癌関連遺伝子の探索(発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)
土谷 順彦, 成田 伸太郎, 井上 高光, 鶴田 大, 沼倉 一幸, 堀川 洋平, 畠山 真吾, 大山 力, 荒井 陽一, 小川 修, 斎藤 誠一, 松井 茂之, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 102 ( 2 ) 540 - 540 2011年
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移植後1ヵ月までのグラセプタ薬物動態におよぼすCYP3A5遺伝子多型の影響
佐藤 滋, 齋藤 満, 沼倉 一幸, 小峰 直樹, 高橋 誠, 小原 崇, 鶴田 大, 井上 高光, 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
移植 ( (一社)日本移植学会 ) 45 ( 総会臨時 ) 186 - 186 2010年10月
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腎移植長期生着のために何が必要か 画像解析装置による定量的線維増生に及ぼす因子からの検討
三浦 喜子, 齋藤 満, 沼倉 一幸, 小原 崇, 鶴田 大, 井上 高光, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 羽渕 友則, 小松田 敦, 加賀谷 英彰, 三浦 昌朋, 佐藤 滋
移植 ( (一社)日本移植学会 ) 45 ( 総会臨時 ) 158 - 158 2010年10月
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Clinical significance of polymorphism and expression of chromogranin a and endothelin-1 in prostate cancer.
Zhiyong Ma, Norihiko Tsuchiya, Takeshi Yuasa, Mingguo Huang, Takashi Obara, Shintaro Narita, Yohei Horikawa, Hiroshi Tsuruta, Mitsuru Saito, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
The Journal of urology 184 ( 3 ) 1182 - 8 2010年09月
PURPOSE: We investigated the clinical significance of chromogranin A and endothelin-1 polymorphism and expression in prostate cancer. MATERIALS AND METHODS: We analyzed 2 CHGA polymorphisms by polymerase chain reaction-restriction fragment length polymorphism in DNA samples of 435 patients with prostate cancer and 316 age matched male controls. Chromogranin A and endothelin-1 expression was evaluated by immunohistochemistry in prostate specimens of 114 men with prostate cancer who underwent radical retropubic prostatectomy and in 27 with bladder cancer who underwent radical cystectomy and served as controls. RESULTS: For the CHGA Glu264Asp polymorphism men with the GG genotype were at 2.05 times higher risk for prostate cancer than men with the CC genotype (p = 0.014). In men with prostate cancer higher chromogranin A immunohistochemistry grade was associated with higher stage and higher Gleason score (p = 0.011 and 0.044, respectively). Multivariate analysis showed that chromogranin A immunohistochemistry grade was an independent variable for predicting biochemical failure after radical prostatectomy (p = 0.023). Higher endothelin-1 expression was observed in prostate cancers (p = 0.011), especially those with a higher Gleason score (p = 0.042). There was no significant relationship between chromogranin A polymorphisms, and chromogranin A and endothelin-1 expression. CONCLUSIONS: Polymorphism and expression of chromogranin A and endothelin-1 have clinical significance in prostate cancer. Chromogranin A expression was an independent predictor of biochemical failure after prostatectomy in patients with localized prostate cancer.
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Relationship between bone mineral density and androgen-deprivation therapy in Japanese prostate cancer patients.
Takeshi Yuasa, Shinya Maita, Norihiko Tsuchiya, Zhiyong Ma, Shintaro Narita, Yohei Horikawa, Shinya Yamamoto, Junji Yonese, Iwao Fukui, Shunji Takahashi, Kiyohiko Hatake, Tomonori Habuchi
Urology 75 ( 5 ) 1131 - 7 2010年05月
OBJECTIVES: To examine Japanese patients who had received androgen-deprivation therapy (ADT) for longer periods, as it is known that ADT of patients with prostate cancer reduces their bone mineral density (BMD). However, our previous cross-sectional study revealed that short-term ADT (average, 23.5 months) does not significantly increase the prevalence of osteoporosis in Japanese patients. METHODS: The subjects consisted of 201 native Japanese patients with prostate cancer. They comprised 113 ADT-treated and 88 hormone-naive patients. Lumbar spine, total hip, and femoral neck BMDs were measured by dual-energy x-ray absorptiometry and expressed in standard deviation units relative to the scores of young adult men (T-score) or age-matched men (Z-score). Serum levels of bone metabolism markers were also measured. RESULTS: The ADT-treated patients had significantly lower BMD values, T-scores, and even Z-scores than the hormone-naive patients (P <.001). For patients who were hormone-naive, ADT-treated for less than 2 years, and ADT-treated for more than 2 years, the osteoporosis prevalence was 4.5% (4/88), 12.1% (4/33), and 10.8% (4/37), respectively. The ADT-treated patients had significantly higher serum amino-terminal telopeptide levels than the hormone-naive patients (P = .014), but significantly lower serum carboxy-terminal telopeptide of type-I collagen levels than the ADT-treated patients with bone metastasis (P <.001). CONCLUSIONS: Our cross-sectional study confirmed that both ADT-treated and hormone-naive Japanese patients with prostate cancer have low rates of osteoporosis. These findings are different from those of studies in western countries. Genetic and hormonal or other environmental factors may result in population differences in the characteristics of prostate cancer and BMD.
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AN ORAL SMALL-MOLECULE MULTITARGETED RECEPTOR TYROSINE KINASE INHIBITOR, SUNITINIB, DEMONSTRATES GROWTH INHIBITION IN BONE METASTASIS OF RENAL CELL CANCER IN VIVO
Shinya Maita, Takeshi Yuasa, Norihiko Tsuchiya, Yoko Mitobe, Shintaro Narita, Yohei Horikawa, Iwao Fukui, Kiyohiko Hatake, Shinya Kimura, Taira Maekawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E30 - E30 2010年04月
研究発表要旨（国際会議）
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CLINICAL RISK FACTORS FOR INCREASED INTERSTITIAL FIBROSIS BY COMPUTERIZED IMAGE ANALYSIS AFTER RENAL TRANSPLANTATION
Yoshiko Miura, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E802 - E802 2010年04月
研究発表要旨（国際会議）
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Clinical Risk Factors for Increased Interstitial Fibrosis by Computerized Image Analysis after Renal Transplantation
Yoshiko Miura, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Shintaro Narita, Yohei Horika, Norihiko Tsuchiya, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 10 408 - 408 2010年04月
研究発表要旨（国際会議）
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COMBINATION THERAPY CONSISTING OF GEMCITABINE, CARBOPLATIN, AND DOCETAXEL (GCD) AS AN ACTIVE TREATMENT FOR ADVANCED UROTHELIAL CELL CARCINOMA
Hiroshi Tsuruta, Yohei Horikawa, Shintaro Narita, Mitsuru Saito, Takashi Obara, Kazuyuki Numakura, Shigeru Sato, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E659 - E659 2010年04月
研究発表要旨（国際会議）
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GENETIC POLYMORPHISM INFLUENCES INDIVIDUAL VARIATIONS IN SERUM TESTOSTERONE LEVELS IN PROSTATE CANCER PATIENTS TREATED WITH ANDROGEN DEPRIVATION THERAPY
Shintaro Narita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E801 - E801 2010年04月
研究発表要旨（国際会議）
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Impact of Clinical Characteristics and Pretransplant Urinary Bladder Capacity on Urodynamics One Year Posttransplantation in Adult Recipients
Takashi Obara, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 10 254 - 254 2010年04月
研究発表要旨（国際会議）
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Incidence, Clinical Risk Factors, Tacrolimus Pharmacokinetics, and Genomic Polymorphisms in Post Transplant Hyperuricemia in Early Stage Renal Transplant Recipients
Kazuyuki Numakura, Shigeru Satoh, Mitsuru Saito, Norihiko Tsuchiya, Yoshiko Miura, Takashi Obara, Hiroshi Tsuruta, Shintaro Narita, Yohei Horikawa, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 10 528 - 528 2010年04月
研究発表要旨（国際会議）
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INSULIN-LIKE GROWTH FACTOR-I (IGF-I) POLYMORPHISMS PREDICT THE SURVIVAL OF PROSTATE CANCER PATIENTS WITH BONE METASTASIS AT INITIAL PRESENTATION
Norihiko Tsuchiya, Shintaro Narita, Zhiyong Ma, Yohei Horikawa, Hiroshi Tsuruta, Kazuyuki Numakura, Mitsuru Saito, Shigeru Satoh, Takamitsu Inoue, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E797 - E798 2010年04月
研究発表要旨（国際会議）
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No Impact of Age on Dose-Adjusted Pharmacokinetics of Tacrolimus, Mycophenolic Acid and Prednisolone One Month after Renal Transplantation
Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi, Hideaki Kagaya, Masatomo Miura
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 10 322 - 322 2010年04月
研究発表要旨（国際会議）
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POLYMORPHISMS IN THE XRCC1 AND MDM2 GENES MAY BE ASSOCIATED WITH RECURRENCE IN NON-MUSCLE INVASIVE BLADDER CANCER
Yohei Horikawa, Takamitsu Inoue, Shintaro Narita, Takashi Obara, Mitsuru Saito, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E306 - E306 2010年04月
研究発表要旨（国際会議）
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TWEAK-FN14 SIGNALING REGULATES ANDROGEN-INDEPENDENT PROSTATE CANCER CELL INVASIVENESS AND CORRELATES WITH POOR PATIENT OUTCOME
Huang Mingguo, Shintaro Narita, Ma Zhiyong, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 183 ( 4 ) E213 - E213 2010年04月
研究発表要旨（国際会議）
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画像解析による移植腎線維組織の定量的測定と線維増生に関連する因子の解析
三浦 喜子, 齋藤 満, 沼倉 一幸, 鶴田 大, 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, 佐藤 滋
日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 ) 101 ( 2 ) 220 - 220 2010年02月
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AVP-010 秋田大学におけるドナー腎摘術の変遷から : 最良の術式は存在するか?(副腎・腎・尿管,総会賞応募ビデオ,第98回日本泌尿器科学総会)
土谷 龍彦, 成田 伸太郎, 井上 高光, 齋藤 満, 鶴田 大, 小原 崇, 沼倉 一幸, 堀川 洋平, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 101 ( 2 ) 169 - 169 2010年
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The novel tumor-suppressor Mel-18 in prostate cancer: its functional polymorphism, expression and clinical significance.
Wei Wang, Takeshi Yuasa, Norihiko Tsuchiya, Zhiyong Ma, Shinya Maita, Shintaro Narita, Teruaki Kumazawa, Takamitsu Inoue, Hiroshi Tsuruta, Yohei Horikawa, Mitsuru Saito, Weilie Hu, Osamu Ogawa, Tomonori Habuchi
International journal of cancer 125 ( 12 ) 2836 - 43 2009年12月
Mel-18 is a member of the polycomb group (PcG) proteins, which are chromatin regulatory factors and play important roles in development and oncogenesis. This study was designed to investigate the clinical and prognostic significance of Mel-18 in patients with prostate cancer. A total of 539 native Japanese subjects consisting of 393 prostate cancer patients and 146 controls were enrolled in this study. Mel-18 genotyping was analyzed using a PCR-RFLP method and an automated sequencer using the GENESCAN software. Immunohistochemistry revealed that Mel-18 expression was diminished in high grade and high stage prostate cancers. Moreover, patients with positive Mel-18 expression had significantly longer PSA recurrence-free survival than patients negative for Mel-18 expression (p=0.038). A Mel-18 1805A/G SNP was located in the 3' untranslated region and was predicted to alter the secondary structure of the mRNA. Mel-18 mRNA expression of the 1805A allele was clearly higher than expression of the 1805G allele by allele specific quantitative RT-PCR. In multivariate analysis, a homozygous G allele genotype and negative Mel-18 expression were independent risk factors predicting high PSA recurrence after radical prostatectomy, with HRs of 2.757 (p=0.022) and 2.271 (p=0.045), respectively. Moreover, the G allele was also an independent predictor of poor cancer-specific survival with an HR of 4.658 (p=0.019) for patients with stage D2 prostate cancer. This is the first study to provide important evidence demonstrating that Mel-18 is a tumor suppressor and possible therapeutic target, as well as a diagnostic marker for poor prognosis in prostate cancer patients.
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Laparoscopic nephrectomy in patients with renal vein and/or inferior vena cava anomalies: Video presentation.
Tomonori Habuchi, Shintaro Narita, Norihiko Tsuchiya, Teruaki Kumazawa, Yohei Horikawa, Shigeru Sato
International journal of urology : official journal of the Japanese Urological Association 16 ( 11 ) 854 - 854 2009年11月
Laparoscopic nephrectomy is a standard surgery for the treatment of many types of renal tumor, renal pelvic tumor, and benign disease. Renal vein and inferior vena cava anomalies are not uncommon, having been detected at an incidence of 2-17%. With the increasing number of patients undergoing laparoscopic nephrectomy, surgeons have more opportunities to encounter major anomalies of the renal vein and inferior vena cava. This video presents images of the management of the renal pedicle in laparoscopic nephrectomy in cases where there were anomalies of the renal vein and inferior vena cava. Patient 1 had left renal tumor with the left inferior vena cava, patient 2 had left ureteral tumor with double inferior vena cava, patient 3 had left renal tumor with double inferior vena cava and a circumaortic renal vein, patient 4 had left renal tumor with a retro-aortic renal vein, and patient 5 had left renal tumor with a circumaortic renal vein. Multiple renal arteries were present in patients 3, 4, and 5. In laparoscopic nephrectomy complicated by anomalies of the renal vein and inferior vena cava, (i) surgical staff should be alert for the potential presence of aberrant veins and multiple renal arteries that may not be visualized in preoperative imaging. (ii) An anterior transperitoneal approach is well-suited in the understanding of positional relationships of vessels and anatomical landmarks in cases of vascular anomalies. (iii) With recent advances in diagnostic imaging modalities, such as multislice computed tomography (CT) and 3-D CT, it has become easier to identify the major arterial and venous anomalies. However, intraoperative observation and assessment remain important and mandatory in the management of smaller anomalous vessels accompanied by major anomalies.
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Clinical significance of a single nucleotide polymorphism and allelic imbalance of matrix metalloproteinase-1 promoter region in prostate cancer.
Norihiko Tsuchiya, Shintaro Narita, Teruaki Kumazawa, Takamitsu Inoue, Zhiyong Ma, Hiroshi Tsuruta, Mitsuru Saito, Yohei Horikawa, Takeshi Yuasa, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
Oncology reports 22 ( 3 ) 493 - 9 2009年09月
Matrix metalloproteinase-1 (MMP-1) is associated with cancer invasion and metastasis. The 2G allele of the polymorphic site in the MMP-1 promoter was demonstrated to have a higher transcription activity than the 1G allele. Allelic imbalance (AI) at 11q22 harboring the MMP-1 is frequently observed in various cancers and may be associated with an advanced disease. We conducted a case-control study to determine the association of the MMP-1 genotype with susceptibility to prostate cancer involving 283 prostate cancer patients and 251 controls. Furthermore, AI, retention allele of the MMP-1 promoter, and MMP-1 protein expression were analyzed in 77 prostate cancer specimens. The MMP-1 promoter polymorphism was associated with neither susceptibility nor progression of prostate cancer. Tumors with 1G/2G and 2G/2G genotypes had a significantly higher MMP-1 expression level compared to those with 1G/1G genotype (P=0.006 and 0.013, respectively). AI at 11q22 was observed in 13 (40.6%) of 32 informative cases. Retention of the 1G and 2G alleles were observed in 4 and 9 cases, respectively. AI was significantly associated with the Gleason score (P=0.003) and pathological stage (P=0.022). In addition, retention of the 2G allele showed a significant association with the pathological stage (P=0.026). AI at 11q22 region, retention of the 2G allele, specifically appeared to be involved in the progression of prostate cancer. However, the presence of the 2G allele of the MMP-1 promoter polymorphism itself seems to influence neither the susceptibility nor the progression of prostate cancer.
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佐藤 滋, 齋藤 満, 三浦 嘉子, 沼倉 一幸, 小原 崇, 鶴田 大, 成田 伸太郎, 堀川 洋平, 土谷 順彦, 羽渕 友則, 三浦 昌朋
移植 ( (一社)日本移植学会 ) 44 ( 総会臨時 ) 287 - 287 2009年09月
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A GENETIC POLYMORPHISM OF THE OSTEOPROTEGERIN GENE IS ASSOCIATED WITH AN INCREASED RISK OF ADVANCED PROSTATE CANCER
Naofumi Narita, Takeshi Yuasa, Norihiko Tsuchiya, Teruaki Kumazawa, Shintaro Narita, Takamitsu Inoue, Zhiyong Ma, Mitsuru Saito, Yohei Horikawa, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 168 - 168 2009年04月
研究発表要旨（国際会議）
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EVALUATION OF OUTCOMES AND GENETIC PREDICTIVE FACTORS FOR PROGNOSIS AND TOXICITY IN HORMONE-REFRACTORY PROSTATE CANCER PATIENTS FOLLOWING COMBINATION THERAPY WITH DOCETAXEL, ESTRAMUSTINE, AND CARBOPLATIN
Shintaro Narita, Hiroshi Tsuruta, Mitsuru Saito, Teruaki Kumazawa, Yohei Horikawa, Takeshi Yuasa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 293 - 293 2009年04月
研究発表要旨（国際会議）
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INFLUENCE OF POLYMORPHISMS AND EXPRESSION OF CHROMOGRANIN A AND ENDOTHELIN-1 ON THE DEVELOPMENT AND PROGRESSION OF PROSTATE CANCER
Zhiyong Ma, Norihiko Tsuchiya, Takeshi Yuasa, Shintaro Narita, Yohei Horikawa, Teruaki Kumazawa, Mitsuru Saito, Takashi Obara, Hiroshi Tsuruta, Naoko Kawata, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 49 - 50 2009年04月
研究発表要旨（国際会議）
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MICROVASCULAR TUMOR INVASION AS A PROGNOSTIC FACTOR FOR TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA
Norihiko Tsuchiya, Takashi Obara, Kojiro Nishio, Teruaki Kumazawa, Shintaro Narita, Yohei Horikawa, Takamitsu Inoue, Mitsuru Saito, Takeshi Yuasa, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 213 - 214 2009年04月
研究発表要旨（国際会議）
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OVEREXPRESSION OF BCL-2 SEEN IN RESIDUAL PROSTATE CANCER AFTER NEOADJUVANT CHEMOHORMONAL THERAPY WITH DOCETAXEL FOR LOCALLY ADVANCED PROSTATE CANCER
Teruaki Kumazawa, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Yohei Horikawa, Takeshi Yuasa, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 97 - 97 2009年04月
研究発表要旨（国際会議）
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POLYMORPHISMS OF FIBROBLAST GROWTH FACTOR RECEPTOR 4 HAVE ASSOCIATION WITH THE DEVELOPMENT OF PROSTATE CANCER AND BENIGN PROSTATIC HYPERPLASIA AND THE PROGRESSION OF PROSTATE CANCER IN A JAPANESE POPULATION
Zhiyong Ma, Norihiko Tsuchiya, Takeshi Yuasa, Shintaro Narita, Yohei Horikawa, Teruaki Kumazawa, Mitsuru Saito, Takashi Obara, Hiroshi Tsuruta, Naoko Kawata, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 48 - 49 2009年04月
研究発表要旨（国際会議）
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SIMULTANEOUS LAPAROSCOPIC TREATMENT FOR URETEROPELVIC JUNCTION OBSTRUCTION ACCOMPANIED BY NEPHROLITHIASIS
Norihiko Tsuchiya, Takamitsu Inoue, Takeshi Yuasa, Sohei Kanda, Teruaki Kumazawa, Shintaro Narita, Mitsuru Saito, Hiroshi Tsuruta, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 736 - 736 2009年04月
研究発表要旨（国際会議）
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THE NOVEL TUMOR-SUPPRESSOR MEL-18 IN PROSTATE CANCER: ITS FUNCTIONAL POLYMORPHISM, EXPRESSION, AND CLINICAL SIGNIFICANCE
Wei Wang, Takeshi Yuasa, Norihiko Tsuchiya, Zhiyong Ma, Shinya Maita, Teruaki Kumazawa, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Hiroshi Tsuruta, Yohei Horikawa, Jian Huang, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 181 ( 4 ) 50 - 50 2009年04月
研究発表要旨（国際会議）
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移植早期の高齢者レシピエントにおけるタクロリムス(TAC)、セルセプト(MMF)、プレドニゾロン(PDS)の薬物動態
佐藤 滋, 齋藤 満, 鶴田 大, 熊澤 光明, 成田 伸太郎, 堀川 洋平, 湯浅 健, 土谷 順彦, 三浦 昌朋, 加賀谷 英彰, 鈴木 敏夫, 羽渕 友則
日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 ) 100 ( 2 ) 257 - 257 2009年02月
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Cystoprostatectomy as a treatment of prostate cancer involving the bladder neck.
Teruaki Kumazawa, Norihiko Tsuchiya, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Youhei Horikawa, Takeshi Yuasa, Shigeru Satoh, Tetsuro Kato, Hiroshi Nanjyo, Tomonori Habuchi
Urologia internationalis 83 ( 2 ) 141 - 5 2009年
OBJECTIVE: We evaluated the clinicopathological findings and short- and long-term outcomes of prostate cancer (PCa) patients with bladder neck invasion who underwent cystoprostatectomy. PATIENTS AND METHODS: Between 1989 and 2005, we performed 17 cystoprostatectomies for PCa patients having bladder neck invasion without distant visceral or distant lymph node metastasis. Of the 17 patients, 11 were treated with neoadjuvant hormone therapy and all patients were treated with adjuvant hormone therapy immediately after surgery. RESULTS: All 7 patients in whom pelvic lymph node swelling was identified by preoperative imaging studies had pathological lymph node metastasis. Of the 10 patients judged as cN0 preoperatively, 7 (70.0%) had lymph node metastasis. Although local recurrence was found in 2 (11.8%) patients, no additional urinary diversion or inconvenient urinary symptoms due to PCa progression were observed in any patients. The 5-year prostate-specific antigen recurrence-free survival rate was 62.2%. Cause-specific survival at 5 years after surgery was 87.1%. The 5-year cause-specific survival rate of node-positive patients was 92.3%. CONCLUSION: Cystoprostatectomy followed by immediate hormone therapy may be a feasible treatment option to achieve excellent local control for patients with previously untreated PCa, even in the presence of pelvic lymph node metastasis.
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APP-029-AM Survivin遺伝子多型が膀胱癌の発症リスクと予後に及ぼす影響についての検討(総会賞応募ポスター,第97回日本泌尿器科学会総会)
河田 真子, 堀川 洋平, 三浦 喜子, 米田 真也, 鶴田 大, 齋藤 満, 井上 高光, 成田 伸太郎, 熊澤 光明, 湯浅 健, 佐藤 滋, 土谷 順彦, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 100 ( 2 ) 139 - 139 2009年
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APP-050-AM 前立腺癌におけるchromogranin Aならびにendothelin-1の臨床的意義(総会賞応募ポスター,第97回日本泌尿器科学会総会)
馬 智勇, 土谷 順彦, 湯浅 健, 成田 伸太郎, 堀川 洋平, 熊澤 光明, 鶴田 大, 齋藤 満, 河田 真子, 井上 高光, 佐藤 滋, 小川 修, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 100 ( 2 ) 149 - 149 2009年
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Laparoscopic Versus Retroperitoneoscopic Living Donor Nephrectomy: Comparison of Two Procedures Regarding Clinical Outcome and Complication Rate
Mitsuru Saito, Norihiko Tsuchiya, Shintaro Narita, Hiroshi Tsuruta, Takashi Obara, Takamitsu Inoue, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 9 441 - 441 2009年
研究発表要旨（国際会議）
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Transplantation into the Long-Term Defunctionalized Bladder: Is It Cause of Vesicoureteral Reflux to the Renal Graft?
Takamitsu Inoue, Mitsuru Saito, Shigeru Satoh, Yoshiko Miura, Teruaki Kumazawa, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 9 520 - 521 2009年
研究発表要旨（国際会議）
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Where Is the Most Preferable Surgical Wound Site for Living Donor Nephrectomy? A Questionnaire Assessment
Mitsuru Saito, Norihiko Tsuchiya, Shinya Maita, Hiroshi Tsuruta, Takashi Obara, Takamitsu Inoue, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
AMERICAN JOURNAL OF TRANSPLANTATION ( WILEY-BLACKWELL PUBLISHING, INC ) 9 440 - 441 2009年
研究発表要旨（国際会議）
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Drug related genetic polymorphisms affecting adverse reactions to methotrexate, vinblastine, doxorubicin and cisplatin in patients with urothelial cancer.
Norihiko Tsuchiya, Takamitsu Inoue, Shintaro Narita, Teruaki Kumazawa, Mitsuru Saito, Takashi Obara, Hiroshi Tsuruta, Yohei Horikawa, Takeshi Yuasa, Shigeru Satoh, Tomonori Habuchi
The Journal of urology 180 ( 6 ) 2389 - 95 2008年12月
PURPOSE: There is considerable interindividual diversity in the development of adverse reactions during chemotherapy for cancers. This diversity is suggested to be attributable to differences in the disposition of chemotherapeutic agents, which is modified by genetic polymorphisms. In this study we evaluated the possible association of polymorphisms of genes involved in the metabolism, detoxification and transport of the agents with adverse reactions to methotrexate, vinblastine, doxorubicin and cisplatin therapy. MATERIALS AND METHODS: A total of 40 patients with urothelial cancer who received methotrexate, vinblastine, doxorubicin and cisplatin or high dose methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy between 1996 and 2005 at Akita University Medical Center were included in this study. Four genetic polymorphisms (ABCB1, GSTP1, CYP3A5 and MTHFR) and clinical parameters were included in the analysis to determine whether there was any association with the grade of adverse reactions at the first cycle and the worst grade of each adverse reaction throughout the chemotherapy period. RESULTS: On multivariate analysis the CYP3A5 A6986G genotype *3/*3 (OR 8.205, 95% CI 1.616-41.667, p = 0.011) and smaller number of treatment cycles (OR 0.156, 95% CI 0.037-0.659, p = 0.011) were independent factors for leukocytopenia (grade 3 or greater) throughout the period of chemotherapy. The mean white blood cell count nadir in patients with genotype *3/*3 was significantly lower than that in those with the *1 allele (1,542 +/- 903 vs 2,431 +/- 973/mm(3), p = 0.009). CONCLUSIONS: The A6986G polymorphism of CYP3A5, which is involved in the metabolism of vinblastine and doxorubicin, might be a genetic predictor of the severity of leukocytopenia induced by chemotherapy with methotrexate, vinblastine, doxorubicin and cisplatin.
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Polymorphisms of fibroblast growth factor receptor 4 have association with the development of prostate cancer and benign prostatic hyperplasia and the progression of prostate cancer in a Japanese population.
Zhiyong Ma, Norihiko Tsuchiya, Takeshi Yuasa, Takamitsu Inoue, Teruaki Kumazawa, Shintaro Narita, Yohei Horikawa, Hiroshi Tsuruta, Takashi Obara, Mitsuru Saito, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
International journal of cancer 123 ( 11 ) 2574 - 9 2008年12月
Fibroblast growth factor receptor 4 (FGFR4) is a member of a family of transmembrane receptors with ligand-induced tyrosine kinase activity. The Glycine (Gly) to Arginine (Arg) polymorphism at codon 388 (Gly388Arg), which encodes an amino acid in the transmembrane part of the FGFR4 gene, was reported to be associated with an increased risk in some carcinomas. We investigated the association between the Gly388Arg polymorphism or the G or A polymorphism at intron 11 (rs2011077) of FGFR4, which was located 1,213 base pairs apart from the Gly388Arg polymorphism, and the risk of prostate cancer or benign prostate hyperplasia (BPH), and the prostate cancer disease status in Japanese men. Genotypes of Gly388Arg and rs2011077 polymorphisms of FGFR4 were determined in 492 patients with prostate cancer, 165 patients with BPH and 179 male controls. Regarding the Gly388Arg polymorphism, individuals with the ArgArg genotype had a 2.207- and 1.958-fold increased risk of prostate cancer and BPH, and a 1.804-fold increased risk of metastatic prostate cancer compared with those with the GlyGly genotype. Regarding the rs2011077 polymorphism, individuals with the GG genotype had a 6.260- and 3.033-fold increased risk of prostate cancer and BPH, and a 5.550-fold increased risk of metastatic prostate cancer compared with those with the AA genotype. Our results indicate that the FGFR4 Arg allele of the Gly388Arg polymorphism and the G allele of the rs2011077 polymorphism have a significant impact on the development of prostate cancer and BPH, and the progression of prostate cancer in a Japanese population.
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Characterization of prostate cancer detected at repeat biopsy.
Takeshi Yuasa, Norihiko Tsuchiya, Teruaki Kumazawa, Takamitsu Inoue, Shintaro Narita, Mitsuru Saito, Yohei Horikawa, Shigeru Satoh, Tomonori Habuchi
BMC urology 8 14 - 14 2008年11月
BACKGROUND: The aim of this study was to investigate the characteristics of prostate cancer patients who were diagnosed at repeat biopsy and compare them to non-cancerous patients or patients who were diagnosed at initial biopsy. METHODS: We carried out a retrospective analysis of clinical and pathological data from 576 patients, which included data on the period of time from radical prostatectomy to biochemical failure. RESULTS: Cancer was diagnosed in 191 (33%) of 576 patients at initial biopsy and in 23 (18%) of 127 patients who underwent a repeat biopsy. Cut-off values of 0.80 and 0.30 for prostate specific antigen velocity (PSAV) and prostate specific antigen density (PSAD), respectively, were determined using ROC curve analysis. Based on these values, PSAV and PSAD were able to predict 94% (46 of 49) of negative repeat biopsies, indicating that these patients had undergone unnecessary repeat biopsies. Although the patients who were diagnosed at repeat biopsy had a higher rate of organ-confined tumor than those who were diagnosed at initial biopsy (73% and 44%, respectively; P = 0.041), there were no differences in the recurrence rate or the duration of biochemical failure-free survival between the two groups. CONCLUSION: PSAV and PSAD may be useful indicators of the results of repeat biopsies. Although prostate cancer that was diagnosed at repeat biopsy was associated with a more favorable pathological profile, it was not associated with a better outcome after radical prostatectomy.
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[Combination therapy consisting of gemcitabine, docetaxel and carboplatin as a second-line chemotherapy for patients with MVAC-treated metastatic urothelial carcinoma].
Takamitsu Inoue, Takashi Obara, Mitsuru Saito, Teruaki Kumazawa, Shintaro Narita, Yohei Horikawa, Takeshi Yuasa, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica 54 ( 9 ) 581 - 5 2008年09月
From 2001 to 2006, 11 patients with MVAC-treated metastatic urothelial carcinoma received as a second-line therapy GDC therapy consisting of gemcitabine (1,000 mg/m2) on day land 8, docetaxel (80 mg/m2) on day 1 and carboplatin (AUC 5) on day 1 in each 21-day cycle. The 11 patients received a total of 42 cycles. The median progression-free survival and the median overall survival were 3 months (range 0-51) and 10 months (range 2-51), respectively. The median overall survival from diagnosis of the metastasis was 13.0 months (range 7-55). Complete response and partial response rates were 1/11 (9%) and 5/11 (45%), respectively. One- and two-year survival rates were 36 and 9%, respectively. Grade 3 or 4 hematologic toxicity included neutropenia (69.0%), thrombocytopenia (47.6%) and anemia (45.2%). Non-hematologic toxicity of grade 3 or 4 consisted mainly of diarrhea (23.8%) and anorexia (21.4%). GDC regimen as a second-line chemotherapy was effective in 54% of patients with MVAC-treated metastatic urothelial carcinoma, although the high incidence of hematologic toxicities and short period of progression-free survival remain to be major problems.
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GLI2 knockdown using an antisense oligonucleotide induces apoptosis and chemosensitizes cells to paclitaxel in androgen-independent prostate cancer.
Shintaro Narita, Alan So, Susan Ettinger, Norihiro Hayashi, Mototsugu Muramaki, Ladan Fazli, Youngsoo Kim, Martin E Gleave
Clinical cancer research : an official journal of the American Association for Cancer Research 14 ( 18 ) 5769 - 77 2008年09月
PURPOSE: GLI transcription factors mediate hedgehog signaling and have been implicated in several human malignancies, including prostate cancer. The objectives of this study were to characterize GLI2 expression levels in human prostate cancer cell lines and tissues to test the effect of antisense oligonucleotide (ASO) targeting GLI2 on androgen-independent (AI) prostate cancer cell lines. EXPERIMENTAL DESIGN: A tissue microarray was used to characterize differences in GLI2 expression in benign prostate hyperplasia, prostate cancer treated by neoadjuvant hormonal therapy and AI prostate cancer. The effects of GLI2 ASO on PC-3 cell growth and paclitaxel chemosensitivity were assessed in vitro and in vivo. Oligonucleotide spotted microarray analysis was used to determine alteration in GLI2 coregulated genes after ASO treatment. RESULTS: The expression of GLI2 was significantly higher in prostate cancer than in benign prostate hyperplasia, decreased after androgen ablation in a time-dependent fashion, but became highly expressed again in AI prostate cancer. GLI2 ASO treatment of PC-3 cells reduced GLI2 mRNA and protein levels in a dose-dependent manner. GLI2 knockdown increased PC-3 cell apoptotic rates and significantly decreased cell growth and modulated levels of apoptosis-related genes, such as Bcl2, Bcl-xL, and clusterin. GLI2 knockdown also changed levels of several cell cycle regulators, such as cyclin D1, p27, and PKC-eta. Systematic administration of GLI2 ASO in athymic mice significantly delayed PC-3 tumor progression and enhanced paclitaxel chemosensitivity. CONCLUSIONS: These findings suggest that increased levels of GLI2 correlates with AI progression and that GLI2 may be a therapeutic target in castrate-resistant prostate cancer.
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A genetic polymorphism of the osteoprotegerin gene is associated with an increased risk of advanced prostate cancer.
Naofumi Narita, Takeshi Yuasa, Norihiko Tsuchiya, Teruaki Kumazawa, Shintaro Narita, Takamitsu Inoue, Zhiyong Ma, Mitsuru Saito, Yohei Horikawa, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
BMC cancer 8 224 - 224 2008年08月
BACKGROUND: The purpose of this study was to evaluate the role of osteoprotegerin gene (OPG) polymorphisms as genetic modifiers in the etiology of prostate cancer (PCa) and disease progression. METHODS: Three hundred and sixty one patients with PCa and 195 normal controls were enrolled in the study, and two genetic polymorphisms, 149 T/C and 950 T/C in the putative promoter region of OPG, were genotyped. RESULTS: There was no significant difference in the genotype frequencies between PCa patients and controls (P = 0.939 and 0.294 for 149 T/C and 950 T/C polymorphisms, respectively). However, those patients with TC and TT genotypes in the 950 T/C polymorphism had a significantly increased risk of extraprostatic (age-adjusted odds ratio; aOR = 1.74 and 2.03 for TC and TT genotypes compared with the CC genotype, P = 0.028) and metastatic disease (aOR = 1.72 and 2.76 for TC and TT genotypes compared with the CC genotype, P = 0.009) compared with those with the CC genotype. In addition, analysis of the metastatic PCa patients (Stage D) showed that the presence of the T allele of the OPG 950 T/C polymorphism was an independent risk factor predicting survival by Cox proportional hazard regression analyses (P = 0.031). CONCLUSION: Progression of PCa may be influenced by an intrinsic genetic factor of the host's bone metabolism. The variant C allele of 950 T/C in the OPG promoter may play a major role as a genetic safe guard against progression in patients with PCa.
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Prognostic significance of HIF-1alpha polymorphisms in transitional cell carcinoma of the bladder
Junichi Nadaoka, Yohei Horikawa, Mitsuru Saito, Teruaki Kumazawa, Takamitsu Inoue, Shintaro Narita, Takeshi Yuasa, Shigeru Satoh, Hiroyuki Nishiyama, Osamu Ogawa, Norihiko Tsuchiya, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 179 ( 4 ) 320 - 320 2008年04月
研究発表要旨（国際会議）
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Prognostic significance of HIF-1 alpha polymorphisms in transitional cell carcinoma of the bladder.
Junichi Nadaoka, Yohei Horikawa, Mitsuru Saito, Teruaki Kumazawa, Takamitsu Inoue, Shintaro Narita, Takeshi Yuasa, Shigeru Satoh, Hiroyuki Nishiyama, Osamu Ogawa, Norihiko Tsuchiya, Tomonori Habuchi
International journal of cancer 122 ( 6 ) 1297 - 302 2008年03月
Recently, two single nucleotide polymorphisms in the hypoxia-inducible factor-1 alpha (HIF-1 alpha) gene, P582S and A588T, were shown to cause significantly higher transcriptional activity than the wild type. We investigated the association between the HIF-1 alpha polymorphisms and the incidence and progression of transitional cell carcinoma of the bladder, and the relationship between the polymorphisms and the tissue vascular endothelial growth factor (VEGF) level or microvessel density (MVD). A total of 219 patients with bladder cancer and 464 healthy native Japanese control subjects were enrolled. Tissue VEGF and HIF-1 alpha expression levels and the mean MVD were evaluated in 73 radical cystectomy specimens by immunohistochemistry. The HIF-1 alpha genotype did not significantly influence the incidence or disease status of bladder cancer. Among patients who underwent radical cystectomy, those with a variant allele had significantly worse disease-free survival (p = 0.001) and disease-specific survival (p = 0.006) than those without a variant allele. Multivariate analysis using a Cox proportional hazard model revealed that the presence of a variant allele was an independent predictor of disease-free survival (HR = 3.10, 95%CI = 1.38-6.99, p = 0.006). Although not statistically significant, the moderate/high expression levels of VEGF in tumor tissues were more frequently observed in patients with a HIF-1 alpha variant allele (11/13, 84.6%) than in those without (33/60, 55%, p = 0.063). The HIF-1 alpha polymorphisms may have a significant influence on the poor prognosis of the patients undergoing radical cystectomy for bladder cancer, while they seem to have no relation to the bladder cancer occurrence.
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Candidate genes involved in enhanced growth of human prostate cancer under high fat feeding identified by microarray analysis.
Shintaro Narita, Norihiko Tsuchiya, Mitsuru Saito, Takamitsu Inoue, Teruaki Kumazawa, Takeshi Yuasa, Akira Nakamura, Tomonori Habuchi
The Prostate 68 ( 3 ) 321 - 35 2008年02月
BACKGROUND: Several studies have suggested that a high fat diet (HFD) may be a risk factor of prostate cancer (PCa). As a first step to delineate the molecular mechanisms underlying the enhanced progression of PCa under HFD, we investigated the differential gene expressions of a human PCa xenograft under HFD and a low fat diet (LFD). METHODS: LNCaP cells were subcutaneously injected in 20 nude mice, which were equally divided into two groups, the HFD group and LFD group. Oligonucleotide microarray analyses were performed using mice xenografts from HFD and LFD, and the results of candidate genes with a significant differential expression were validated by quantitative RT-PCR experiments. As for insulin-like growth factor I receptor (IGF-IR), protein expression levels were further examined by immunohistochemistry in xenograft tissues and in 78 radical prostatectomy specimens. RESULTS: Tumor volume and serum PSA levels were significantly higher in the HFD group than in the LFD group (P<0.001 and P=0.006, respectively). We found 64 up-regulated genes (0.19%) and 14 down-regulated genes (0.04%) with more than twofold differences in the HFD xenograft. IGF-IR, TNFRSF, and LPL showed striking differences in the quantitative RT-PCR experiment. Immunostaining further revealed marked enhanced IGF-IR expression in the HFD xenograft. In human PCa, the lowest IGF-IR immunoreactivity group tended to have the lowest body mass index in both normal and PCa epithelium. CONCLUSION: HFD induced remarkable up- and down-regulation of mRNA of a substantial number of genes. Furthermore, the IGF-I system may be involved in the HFD-associated enhanced progression of PCa.
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APP-085 腎細胞癌患者におけるDNAの完全性(副腎腫瘍・腎腫瘍/マーカー・臨床,総会賞応募ポスター,第96回日本泌尿器科学会総会)
土谷 順彦, 熊澤 光明, 井上 高光, 成田 伸太郎, 齋藤 満, 堀川 洋平, 小原 崇, 湯浅 健, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 99 ( 2 ) 252 - 252 2008年
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Clinical implication of vascular endothelial growth factor T-460C polymorphism in the risk and progression of prostate cancer.
Hisami Fukuda, Norihiko Tsuchiya, Shintaro Narita, Teruaki Kumazawa, Yohei Horikawa, Takamitsu Inoue, Mitsuru Saito, Takeshi Yuasa, Shinobu Matsuura, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
Oncology reports 18 ( 5 ) 1155 - 63 2007年11月
Vascular endothelial growth factor (VEGF), one of the most potent angiogenic factors, is suggested to play a crucial role in tumor neovascularization and is associated with tumor progression and metastasis in prostate cancer. This study evaluated the significance of the VEGF T-460C polymorphism in the risk and the progression of prostate cancer. In a case-control experiment, 270 patients with prostate cancer and 252 male controls were investigated to assess the association of the VEGF T-460C polymorphism with the risk of prostate cancer. Prostate-specific antigen (PSA) recurrence in 95 patients who underwent radical prostatectomy and survival in 99 patients with metastases at diagnosis were analyzed to evaluate the influence of the polymorphism in cancer progression. The CC and TC genotypes of the polymorphism were associated with significantly higher rates of PSA recurrence after radical prostatectomy than the TT genotype and were independent predictors of PSA recurrence (P=0.011) in a multivariate analysis. In contrast, metastatic prostate cancer patients with the TT genotype showed significantly worse survival as compared to the CC and TC genotypes. In a multivariate analysis, the TT genotype was an independent predictor of cancer-specific survival (P=0.006). The VEGF T-460C polymorphism may have a substantial impact on both PSA recurrence after radical prostatectomy and survival in advanced prostate cancer. The molecular mechanisms of the polymorphism on the differing status in prostate cancer should be elucidated in further studies.
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Lymphatic invasion is a prognostic factor for bladder cancer treated with radical cystectomy.
Yohei Horikawa, Teruaki Kumazawa, Shintaro Narita, Takamitsu Inoue, Takeshi Yuasa, Shinobu Matsuura, Hiroshi Nanjo, Shigeru Satoh, Norihiko Tsuchiya, Tomonori Habuchi
International journal of clinical oncology 12 ( 2 ) 131 - 6 2007年04月
BACKGROUND: We aimed to elucidate the significance of pathological prognostic factors in patients with bladder cancer treated with radical cystectomy and pelvic lymphadenectomy focusing on the association between lymphatic invasion and disease recurrence. METHODS: Ninety-one patients with ladder cancer who had undergone radical cystectomy were examined retrospectively. Clinicopathological findings and clinical outcomes were analyzed. Patients who received palliative cystectomy or neoadjuvant chemotherapy and patients who did not receive lymphadenectomy owing to a poor general condition or far advanced local disease status were excluded. RESULTS: Lymphatic invasion and lymph node involvement were present in 45.1% and 23.1% of patients, respectively. Multivariate analyses, using the Cox proportional hazards model, indicated that lymphatic invasion (hazard ratio [HR], 5.30; P = 0.007) and lymph node involvement (HR = 3.05; P = 0.016) were independent prognostic factors for disease-specific survival. Of the 91 patients, 29 (31.9%) had recurrent disease during the follow-up period. The rate of recurrence in patients with lymphatic invasion and without lymph node involvement was 50% (11/22), which was not significantly different from that in patients with both lymphatic invasion and lymph node involvement (73.7%; 14/19; P = 0.121), indicating a high risk of disease recurrence in patients with bladder cancer with lymphatic invasion even in the absence of the lymph node involvement. CONCLUSION: In patients with bladder cancer treated with radical cystectomy, lymphatic invasion is an independent prognostic factor for disease-specific and disease-free survival. Patients with lymphatic invasion have a high risk of disease recurrence after radical cystectomy even in the absence of lymph node involvement.
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Clinical implication of vascular endothelial growth factor (VEGF) T-460C polymorphism in the risk and progression of prostate cancer
Norihiko Tsuchiya, Hisami Fukuda, Shintaro Narita, Teruaki Kumazawa, Yohei Horikawa, Takamitsu Inoue, Mitsuru Saito, Takeshi Yuasa, Shinobu Matsuura, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 177 ( 4 ) 53 - 53 2007年04月
研究発表要旨（国際会議）
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Gene expression in response to high-fat feeding in human prostate cancer xenograft model
Shintaro Narita, Norihiko Tsuchiya, Mitsuru Saito, Takamitsu Inoue, Teruaki Kumazawa, Yohei Horikawa, Takeshi Yuasa, Shinobu Matsuura, Shigeru Satoh, Tomonori Habuchi
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 177 ( 4 ) 48 - 48 2007年04月
研究発表要旨（国際会議）
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Identifying genetic polymorphisms which predict adverse effects of MVAC in patients with urothelial cancers
Norihiko Tsuchiya, Takamitsu Inoue, Shintaro Narita, Teruaki Kumazawa, Mitsuru Saito, Yohei Horikawa, Takeshi Yuasa, Shinobu Matsuura, Shigeru Satoh
JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 177 ( 4 ) 81 - 81 2007年04月
研究発表要旨（国際会議）
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APP-024 前立腺癌の進展における Osteoprotegerin の役割(第95回日本泌尿器科学会総会)
成田 直史, 湯浅 健, 土谷 順彦, 熊澤 光明, 堀川 洋平, 成田 伸太郎, 齋藤 満, 井上 高光, 松浦 忍, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 98 ( 2 ) 252 - 252 2007年
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PP-618 進行性前立腺癌の予後におけるhGH, IGF-IならびにIL-6遺伝子多型の関与(第95回日本泌尿器科学会総会)
土谷 順彦, 成田 伸太郎, 熊澤 光明, 井上 高光, 馬 智勇, 齋藤 満, 堀川 洋平, 湯浅 健, 松浦 忍, 佐藤 滋, 小川 修, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 98 ( 2 ) 551 - 551 2007年
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Radical nephroureterectomy as initial treatment for carcinoma in situ of upper urinary tract.
Takeshi Yuasa, Norihiko Tsuchiya, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Teruaki Kumazawa, Yohei Horikawa, Shinobu Matsuura, Shigeru Satoh, Hiroshi Nanjo, Tomonori Habuchi
Urology 68 ( 5 ) 972 - 5 2006年11月
OBJECTIVES: Transitional cell carcinoma in situ (CIS) of the upper urinary tract is a relatively rare disease, and treatment guidelines remain to be defined. In this study, we evaluated the outcomes after radical nephroureterectomy as the initial therapy for upper urinary tract CIS. METHODS: Eight patients treated with radical nephroureterectomy after the diagnosis of upper urinary tract CIS from December 1999 to May 2004 were entered in this study. The diagnosis criteria included positive voided urinary cytology; negative multiple random biopsies of the bladder; negative radiographic studies, including retrograde pyelography and computed tomography; and serial positive cytology results in selective ipsilateral urine samples. RESULTS: The median follow-up period was 56 months. The presence of CIS was confirmed pathologically in all patients. Two patients had more invasive lesions (pT1 and pT2), although retrospective evaluation revealed no infiltrative lesions. Intravesical recurrence was found in 5 patients, whose median recurrence-free period was 16 months. These heterotopic urothelial recurrences did not affect patient survival, and all 8 patients were alive without disease at last follow-up. CONCLUSIONS: Although radical nephroureterectomy may be overtreatment for some patients with upper urinary tract CIS, excellent survival outcomes can be accomplished. In addition, the presence of concomitant invasive lesions, which cannot be identified on pretreatment examination in a substantial subset of patients with CIS, should be taken into account. Although the number of patients in this study was small, the results support the view that nephroureterectomy should remain a standard option for the initial treatment of this disease.
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Bladder acellular matrix grafting regenerates urinary bladder in the spinal cord injury rat.
Takashi Obara, Shinobu Matsuura, Shintaro Narita, Shigeru Satoh, Norihiko Tsuchiya, Tomonori Habuchi
Urology 68 ( 4 ) 892 - 7 2006年10月
OBJECTIVES: To assess the feasibility of bladder acellular matrix (BAM) grafting onto the bladder of rats with spinal cord injury (SCI). METHODS: Female Wistar rats, weighing 100 to 150 g, were divided into four groups: neurologically intact groups with sham operation or BAM grafting and SCI rats with or without BAM grafting (grafted groups, n = 15 each; nongrafted groups, n = 5 each). The BAM was prepared from other normal rat bladder tissue. During BAM surgery, the rats underwent partial cystectomy, followed by BAM grafting as a bladder augmentation. The SCI was created by compressing the spinal cord at the 10th thoracic level. BAM grafting in SCI rats was performed 2 to 3 weeks after SCI. At 2, 4, and 12 weeks after grafting, cystometry was performed with the rats under pentobarbital anesthesia, and the bladders were subsequently harvested and immunostained with anti-PGP9.5, uroplakin III, and alpha-smooth muscle actin antibodies (n = 5 each time). For comparison, similar examinations were performed in the nongrafted groups (n = 5 each). RESULTS: Regenerated urothelium, smooth muscles, and nerve fibers in the grafted BAM appeared at 2, 4, and 12 weeks, respectively, in both intact and SCI rats. Immunohistologic examination showed that these regenerated tissues inherited each characteristic of the host bladder tissue. The grafted BAM itself also showed the proper storage function of distensibility in the intact and SCI groups receiving BAM. CONCLUSIONS: Our data have indicated that BAM grafting is feasible, even in animals with spinal injury, suggesting that BAM may be one of the alternatives for patients with a neurogenic bladder who require augmentation enterocystoplasty in clinical situations.
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Association of BCL10 germ line polymorphisms on chromosome 1p with advanced stage testicular germ cell tumor patients.
Takamitsu Inoue, Takuo Ito, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Hideaki Kakinuma, Mutsuki Mishina, Eijiro Nakamura, Tetsuro Kato, Osamu Ogawa, Tomonori Habuchi
Cancer letters 240 ( 1 ) 41 - 7 2006年08月
The association between four BCL10 single nucleotide polymorphisms at codons 5, 8, 162, and intron 1 and the susceptibility or progression for germ cell tumors (GCTs) was investigated in 73 testicular GCT patients and 72 controls. GCT patients with metastatic disease were more likely to have a variant type allele of the polymorphisms at codon 5 (age-adjusted odds ratio (aOR)=6.25; 95% CI=1.09-35.83; P=0.040) and codon 8 (aOR=4.63; 95% CI=1.35-15.93; P=0.015) than those with the localized disease. Therefore, BCL10 polymorphisms at codons 5 and 8 may play a role in the progression to advanced stage GCTs.
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Association of XRCC1 gene polymorphisms with the susceptibility and chromosomal aberration of testicular germ cell tumors.
Norihiko Tsuchiya, Mutsuki Mishina, Shintaro Narita, Teruaki Kumazawa, Takamitsu Inoue, Yohei Horikawa, Hideaki Kakinuma, Takeshi Yuasa, Shinobu Matsuura, Shigeru Satoh, Osamu Ogawa, Tomonori Habuchi
International journal of oncology 28 ( 5 ) 1217 - 23 2006年05月
It is known that many genomic and genetic alterations caused by aging or environmental factors are responsible for cancer development and progression. XRCC1 is involved in the repair of DNA single-strand breaks formed by exposure to ionizing radiation and alkylating agents. The objective of this study was to investigate the association of genomic alterations and the susceptibility of testicular germ cell tumors with XRCC1 polymorphisms. Two polymorphisms of XRCC1, Arg194Trp and Arg399Gln, were genotyped in 83 patients with testicular germ cell tumors (TGCT) and 87 male controls. Allelic imbalances (AI) were evaluated using 4 microsatellite markers in a subgroup of 50 patients. Patients with at least one Gln allele of the Arg399Gln polymorphism had an increased risk of TGCT than those with the Arg/Arg genotype (aOR=1.775, 95% CI=1.045-3.016, P=0.034). Furthermore, the increased risk associated with the Gln allele against the Arg homozygote was more strongly observed in patients with pure seminoma (aOR=2.242, 95% CI=1.149-4.374, P=0.018) or with metastasis (aOR=2.481, 95% CI=1.267-4.862, P=0.008). In the Arg194Trp polymorphism, there was no significant difference in the genotype distribution between TGCT patients and the controls. In AI analysis, the frequency of AI was significantly higher in tumors with at least one Gln allele than those with the Arg/Arg genotype in D13S317 (P=0.010) and in a combination of 4 markers (0.51+/-0.32 vs 0.32+/-28, P=0.028). Our results suggest that the Gln allele of the XRCC1 Arg399Gln polymorphism may genetically modify the development and progression of TGCT through genomic instability.
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Impact of IGF-I and CYP19 gene polymorphisms on the survival of patients with metastatic prostate cancer.
Norihiko Tsuchiya, Lizhong Wang, Hiroyoshi Suzuki, Takehiko Segawa, Hisami Fukuda, Shintaro Narita, Masaki Shimbo, Toshiyuki Kamoto, Kenji Mitsumori, Tomohiko Ichikawa, Osamu Ogawa, Akira Nakamura, Tomonori Habuchi
Journal of clinical oncology : official journal of the American Society of Clinical Oncology 24 ( 13 ) 1982 - 9 2006年05月
PURPOSE: The prognosis of metastatic prostate cancer significantly differs among individuals. While various clinical and biochemical prognostic factors for survival have been suggested, the progression and response to treatment of those patients may also be defined by host genetic factors. In this study, we evaluated genetic polymorphisms as prognostic predictors of metastatic prostate cancer. PATIENTS AND METHODS: One hundred eleven prostate cancer patients with bone metastasis at the diagnosis were enrolled in this study. Thirteen genetic polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism or an automated sequencer with a genotyping software. RESULTS: Among the polymorphisms, the long allele (over 18 [CA] repeats) of insulin-like growth factor-I (IGF-I) and the long allele (over seven [TTTA] repeats) of cytochrome P450 (CYP) 19 were significantly associated with a worse cancer-specific survival (P = .016 and .025 by logrank test, respectively). The presence of the long allele of either the IGF-I or CYP19 polymorphisms was an independent risk factor for death (P = .019 or .026, respectively). Furthermore, the presence of the long allele of both the IGF-I and CYP19 polymorphisms was a stronger predictor for survival (P = .001). CONCLUSION: The prognosis of metastatic prostate cancer patients is suggested to be influenced by intrinsic genetic factors. The IGF-I (CA) repeat and CYP19 (TTTA) repeat polymorphisms may be novel predictors in prostate cancer patients with bone metastasis at the diagnosis.
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Outcome of right hand-assisted retroperitoneoscopic living donor nephrectomy.
Shintaro Narita, Takamitsu Inoue, Shinobu Matsuura, Yohei Horikawa, Hideaki Kakinuma, Mitsuru Saito, Teruaki Kumazawa, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Urology 67 ( 3 ) 496 - 500 2006年03月
OBJECTIVES: To compare the results of right and left hand-assisted retroperitoneoscopic living donor nephrectomy (HARDN) and assess the usefulness and feasibility of right HARDN. METHODS: A total of 68 HARDNs performed from July 2001 to February 2005 in Akita University Medical Center were entered into this study. Of these, 12 cases were right-sided HARDN. The reasons for selecting right HARDN were wandering right kidney in 4, multiple left renal arteries in 3, lower glomerular function presenting in the right kidney in 2 patients, and left renal stone, right renal cyst, and right renal aneurysm in 1 patient each. We compared the perioperative and postoperative results of the 12 right-sided HARDNs with those of the 56 left HARDNs. RESULTS: No significant differences were found between the two groups in the demographic data (ie, age, sex, number of renal arteries), except for the body mass index. None of the right HARDNs resulted in major complications or open conversion, but two left HARDNs required conversion to open surgery. No difference was found between the two groups regarding estimated blood loss, warm ischemia time, or time to oral intake, although the right HARDN group had a longer mean operative time. No significant differences were found in the recipient's postoperative graft function or in the frequency of delayed graft function. CONCLUSIONS: Right HARDN provided almost similar perioperative and postoperative outcomes compared with those of left HARDN. Our results indicate that right HARDN is a choice for living donor nephrectomy because of its technical feasibility, safety, and minimal invasiveness, which are comparable to those of left HARDN.
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Hand assisted retroperitoneoscopic living donor nephrectomy in elderly donors.
Norihiko Tsuchiya, Shigeru Satoh, Kazunari Sato, Masahiro Iinuma, Shintaro Narita, Takamitsu Inoue, Shinobu Matsuura, Tomonori Habuchi
The Journal of urology 175 ( 1 ) 230 - 4 2006年01月
PURPOSE: We assessed the influence of HARDN on residual donor kidney and allograft function, invasiveness and morbidity in elderly living donors. MATERIALS AND METHODS: A total of 89 living donors underwent nephrectomy before September 2004 at our institution. The 18 donors who were 65 years or older included 4 of 27 with ODN and 14 of 62 with HARDN. RESULTS: In older (65 years or older) donors mean operative time, mean blood loss and warm ischemia time in the HARDN group did not differ from those in the ODN group. None of the donors had major complications. Older donors with HARDN had a tendency toward a shorter hospital stay than those with ODN. Postoperative serum creatinine in older donors with HARDN was higher than that in younger donors with HARDN, while there was no difference in postoperative serum creatinine between older donors with HARDN and those with ODN. The frequency of allograft losses tended to be higher in older than in younger kidneys (4 of 18 vs 5 of 71, p = 0.054). However, most allograft losses did not seem to be related to surgical technique. CONCLUSIONS: Although further studies, especially with long-term followup, are necessary, HARDN is suggested to be safe and minimally invasive surgery even in elderly donors and to be comparable to open surgery in terms of morbidity, the residual donor kidney and allograft function.
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MP-712 MVACによる副作用発現の個人差における遺伝子多型の意義(一般演題ポスター,第94回日本泌尿器科学会総会)
土谷 順彦, 井上 高光, 成田 伸太郎, 熊澤 光明, 齋藤 満, 堀川 洋平, 柿沼 秀秋, 湯浅 健, 松浦 忍, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 97 ( 2 ) 544 - 544 2006年
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OP-074 長期移植腎機能におよぼすインターロイキン2遺伝子多型の影響(一般演題口演,第94回日本泌尿器科学会総会)
佐藤 滋, 沼倉 一幸, 斎藤 満, 井上 高光, 熊澤 光明, 成田 伸太郎, 堀川 洋平, 柿沼 秀秋, 湯浅 健, 松浦 忍, 土谷 順彦, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 97 ( 2 ) 299 - 299 2006年
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Successful renal transplantation in the right iliac fossa 2 years after serious deep venous thrombosis in a patient with systemic lupus erythematosus.
Norihiko Tsuchiya, Shigeru Satoh, Shintaro Narita, Naotake Shimoda, Shinobu Matsuura, Chikara Ohyama, Kazunari Sato, Tetsuro Kato, Hiroshi Ohtani, Atsushi Komatsuda, Tomonori Habuchi
International journal of urology : official journal of the Japanese Urological Association 12 ( 10 ) 912 - 6 2005年10月
Deep venous thrombosis (DVT) possibly occurs in the perioperative period, and induces serious complications such as a pulmonary embolism. On the other hand, allograft renal vein thrombosis leads to a high incidence of graft loss. We experienced a case in which a serious DVT occurred prior to renal transplantation; however, a successful renal transplantation in the right iliac fossa was performed after 2 years of anticoagulant therapy. It is suggested that the external iliac vein even after suffering from DVT can be anastomosed to an allograft vein successfully, when enough blood fl ow or a lower venous pressure is confirmed. However, one should be aware of the risk factors and the adequate management of thrombosis in renal transplantation because of the serious complications of DVT and the poor prognosis of allograft vein thrombosis.
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CYP3A5 gene polymorphism and risk of prostate cancer in a Japanese population.
Li Zhenhua, Norihiko Tsuchiya, Shintaro Narita, Takamitsu Inoue, Yohei Horikawa, Hideaki Kakinuma, Tetsuro Kato, Osamu Ogawa, Tomonori Habuchi
Cancer letters 225 ( 2 ) 237 - 43 2005年07月
The CYP3A5 gene (CYP3A5) encodes the cytochrome P450 3A5, which catalyzes the 6beta-hydroxylation of testosterone. We explored association between the CYP3A5 A6986G polymorphism and a risk of prostate cancer in 260 prostate cancer patients, 199 BPH patients and 212 male controls. The CYP3A5 gene polymorphism did not influence significantly a risk of developing of prostate cancer in general. However, compared with males with the GG genotype, those with the AA genotype had a 0.23-fold decreased risk of developing low-grade prostate cancer (P=0.023), and a 0.31-fold decreased risk of developing localized (stages A-C) prostate cancer (P=0.044). The CYP3A5 A6986G polymorphism may be specifically associated with a decreased risk of low-grade or early stage prostate cancer.
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An A/G polymorphism of core 2 branching enzyme gene is associated with prostate cancer.
Lizhong Wang, Junya Mitoma, Norihiko Tsuchiya, Shintaro Narita, Yohei Horikawa, Tomonori Habuchi, Atsushi Imai, Hirofumi Ishimura, Chikara Ohyama, Minoru Fukuda
Biochemical and biophysical research communications 331 ( 4 ) 958 - 63 2005年06月
The expression of core 2 beta1,6-N-acetylglucosaminyltransferase-1 (C2GnT) is associated with development and progression of malignancy. Sequence analysis showed that the codon 152 of C2GnT has a polymorphism having GTT encoding valine or ATT encoding isoleucine. By examining the polymorphism in prostate cancer and benign prostatic hyperplasia patients, we found that the C2GnT G allele was more frequently observed in the prostate cancer group (p=0.015) than the control group. Men with the GG genotype had a 3.60-fold increased risk of prostate cancer, and men with the AG genotype had a 1.58-fold increased risk of prostate cancer compared with those with the AA genotype. The G allele was found to have a gene dosage effect for prostate cancer risk. No such risk was associated for benign prostatic hyperplasia. These results demonstrate that C2GnT A/G polymorphism is associated with the susceptibility to prostate cancer in a Japanese population.
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[Outcome of treatment with surgical resection of the remaining tumor after modified M-VAC treatment for advanced urothelial carcinoma].
Shintaro Narita, Masahiro Nakano, Masato Matsuzaki, Jyunichi Watanabe, Hiroshi Morikawa, Hirokatsu Murata, Hiroyuki Oda, Hideki Komatsu
Hinyokika kiyo. Acta urologica Japonica 51 ( 3 ) 155 - 8 2005年03月
We retrospectively evaluated the effect of the surgical resection of the remaining tumor after modified M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) (m-M-VAC) treatment for locally advanced or metastatic urothelial carcinoma. In m-M-VAC therapy, methotrexate and vinblastine on 15 and 22 days were omitted from the classical M-VAC to avoid the discontinuation and the dose reduction, and duration of 1 course was shortened to 21 days from 28 days of the classical M-VAC. Seven patients with locally invasive or metastatic carcinoma of the renal pelvis, ureter, and bladder, 6 males and 1 female, with a median age 64.1 years, ranging from 49 to 77 years received m-M-VAC chemotherapy without severe side effects. In all patients, the residual viable carcinoma was completely resected and they achieved complete remission. The median survival time was 20 months (range, 7 to 61). Five of these 7 patients were still alive. Two patients had no recurrence and achieved long-term survival (survival duration; 61 and 39 months). Although further studies and long-term follow up are required, these results suggest that patients who present with locally advanced or metastatic urothelial carcinoma may benefit from surgical resection after m-M-VAC.
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[Comparison of radical retropubic prostatectomy under combined lumbar spinal and epidural anesthesia with that under combined general and epidural anesthesia].
Masahiro Nakano, Masato Matsuzaki, Shintaro Narita, Junichi Watanabe, Hirofumi Morikawa, Hirokatsu Murata, Hiroyuki Oda, Komatsu Hideki
Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 96 ( 1 ) 11 - 6 2005年01月
PURPOSE: To evaluate the efficacy of combined lumbar spinal and epidural (CLSE) anesthesia in retropubic radical prostatectomy. MATERIALS AND METHODS: Twenty consecutive patients who underwent radical retropubic prostatectomy by a single surgeon (H.K.) under CLSE anesthesia from July of 2003 to February of 2004 were selected as subjects. They were compared with 20 consecutive patients who underwent radical retropubic prostatectomy performed by the same surgeon under combined general and epidural (CGE) anesthesia from April to December of 2002. Both periods were carefully selected to exclude radical prostatectomies with intraoperative complications to evaluate genuine effects of anesthesia. For lumbar spinal anesthesia, 0.5% hyperbaric bupivacaine hydrochloride or 0.5% hyperbaric tetracaine hydrochloride (dissolved in a 10% glucose solution) was used. An epidural tube was inserted for both lumbar spinal anesthesia and general anesthesia mainly for the purpose of controlling a pain after operation. RESULTS: Intraoperative blood loss was significantly less in the CLSE anesthesia group compared with CGE anesthesia group (p = 0.024). Postoperative water drinking was started at 0.4 days (average) for CLSE anesthesia and at 1.1 days (average) for CGE anesthesia (p < 0.0001). Postoperative diet was begun at 0.7 days (average) for CLSE anesthesia and at 1.5 days (average) for CGE anesthesia (p < 0.0001). Compared with the CLSE anesthesia group, the mean of the highest intraoperative mean blood pressure was significantly higher in the CGE anesthesia group (p = 0.002). CONCLUSION: Intraoperative blood loss was less, intraoperative change in blood pressure was less and recovery of postoperative intestinal peristalsis was earlier in patients who underwent prostatectomy under CLSE anesthesia than in patients who underwent prostatectomy under CGE anesthesia. We believe that prostatectomy under CLSE anesthesia is more advantageous than prostatectomy under CGE anesthesia.
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Clinical evaluation of random biopsy in superficial bladder cancer
堀川 洋平, 灘岡 純一, 成田 伸太郎, 井上 高光, 柿沼 秀秋, 冨樫 寿文, 松浦 忍, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 96 ( 2 ) 322 - 322 2005年
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Hand-Assisted Retroperitoneoscopic Donor Nephrectomy(Endoscopic Live Donor Nephrectomy)
Satoh Shigeru, Tsuchiya Norihiko, Matsuura Shinobu, Narita Shintaro, Inoue Takamitsu, Horikawa Yohei, Kakinuma Hideaki, Togashi Hisafumi, Iinuma Masahiro, Ohyama Chikara, Sato Kazunari, Habuchi Tomonori
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 96 ( 2 ) 123 - 123 2005年
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XRCC1遺伝子多型と精巣腫瘍の発症・進展ならびにヘテロ接合性消失との関連に対する検討(第93回日本泌尿器科学会総会)
成田 伸太郎, 土谷 順彦, 三品 睦輝, 井上 高光, 堀川 洋平, 柿沼 秀秋, 冨樫 寿文, 松浦 忍, 佐藤 滋, 小川 修, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 96 ( 2 ) 223 - 223 2005年
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前立腺腫瘍細胞に対するHDAC阻害薬 (FK228) の抗腫瘍効果と抗癌剤増強作用(第93回日本泌尿器科学会総会)
神崎 正俊, 柿沼 秀秋, 畠山 真吾, 井上 高光, 成田 伸太郎, 堀川 洋平, 冨樫 寿文, 松浦 忍, 土谷 順彦, 佐藤 滋, 羽渕 友則
日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 ) 96 ( 2 ) 160 - 160 2005年
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Association of lipoprotein lipase gene polymorphism with risk of prostate cancer in a Japanese population.
Shintaro Narita, Norihiko Tsuchiya, Lizhong Wang, Shinobu Matsuura, Chikara Ohyama, Shigeru Satoh, Kazunari Sato, Osamu Ogawa, Tomonori Habuchi, Tetsuro Kato
International journal of cancer 112 ( 5 ) 872 - 6 2004年12月
A high fat intake has been associated with prostate cancer risk, and gene polymorphisms of lipoprotein lipase (LPL) play an important role in plasma lipoprotein metabolism. We herein analyzed the association of LPL gene polymorphisms with the risk of prostate cancer in a Japanese population. Three single nucleotide polymorphisms (SNPs) of LPL designated as Ser447stop, HindIII and PvuII were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method in 273 prostate cancer patients, 205 benign prostatic hyperplasia (BPH) patients and 230 male controls. The men with the CG + GG genotypes of the Ser447stop polymorphism had an increased risk of prostate cancer compared to those with the CC genotype [age-adjusted odds ratio (aOR) = 1.625; 95% CI = 1.068-2.471; p = 0.023]. Furthermore, the increased risk associated with the CG + GG genotypes was more strongly observed in patients with high-grade cancers (aOR = 2.843; 95% CI = 1.252-6.458; p = 0.039) or metastatic diseases (aOR = 2.300; 95% CI = 1.042-5.074; p = 0.013), whereas the risk was not significant in those with low- to intermediate-grade cancers or nonmetastatic diseases. In the HindIII and PvuII polymorphisms, there was no significant difference between the prostate cancer patients and the controls, and no significant results as for tumor grade and stage. None of the 3 polymorphisms showed any association with the risk of BPH. Our results suggest that the LPL Ser447stop polymorphism is a common genetic modifier for the development of prostate cancer, particularly that of high-grade and/or high-stage, in a Japanese population.
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Transitional cell carcinoma in an ectopic ureter.
Shintaro Narita, Toshiya Akao, Norihiko Tsuchiya, Teruaki Kumazawa, Hideaki Kakinuma, Shigeru Satoh, Kazunari Sato, Tomonori Habuchi, Tetsuro Kato
International journal of urology : official journal of the Japanese Urological Association 10 ( 5 ) 276 - 7 2003年05月
We experienced an 82-year-old man with transitional cell carcinoma in an ectopic ureter draining into the prostatic urethra. Carcinoma arising from an ectopic ureter is very rare and a differential diagnosis is difficult. To our knowledge, our case is the third male case reported in the literature.