研究等業績 - その他 - 羽渕 友則
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泌尿器腹腔鏡技術認定制度の現状と展望
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 ) PT1 - 2 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 105881 - 105881 2019年11月
The association between immunosuppressive therapy or cytomegalovirus (CMV) infection and detection of de novo donor-specific antibody (dnDSA) at 1 year after transplantation was evaluated. The impact of dnDSA positivity at 1 year after transplantation on long-term death-censored renal graft survival was also evaluated. One hundred and sixty adults receiving living renal allografts were studied. Inclusion criteria were renal graft survival for at least 1 year and a standard regimen of immunosuppressive therapy with tacrolimus, mycophenolate mofetil (MMF), steroids, and basiliximab. DSA were measured retrospectively by the Luminex assay. The coefficient of variation (CV) was calculated and receiver operating characteristic (ROC) analysis was employed to clarify the association of tacrolimus with development of dnDSA. Seven of the 160 patients (4.4%) were positive for dnDSA. The intra-patient minimum trough level of tacrolimus (cutoff value: 3.2 ng/mL) was associated with development of dnDSA. Discontinuation of MMF and treatment of CMV infection were more frequent in patients with dnDSA than in those without dnDSA. In multivariate analysis, a low trough level of tacrolimus, discontinuation of MMF, and treatment of CMV infection within 1 year after transplantation were independently associated with detection of dnDSA at 1 year. In patients with or without dnDSA at 1 year, the 10-year allograft survival rate was 51.4 versus 87.9%, respectively (P = 0.002). A lower tacrolimus trough level, discontinuation of MMF, and treatment of CMV infection were associated with dnDSA positivity. Further investigation is needed to determine whether a new immunosuppressive regimen that avoids these factors can reduce dnDSA positivity.
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Narita S.
Cancer Medicine ( Cancer Medicine ) 8 ( 15 ) 6566 - 6577 2019年11月
BACKGROUND: The purpose of this study was to identify predictive factors associated with conditional net survival in patients with metastatic hormone-naive prostate cancer (mHNPC) initially treated with androgen deprivation therapy (ADT). METHODS: At nine hospitals in Tohoku, Japan, the medical records of 605 consecutive patients with mHNPC who initially received ADT were retrospectively reviewed. The Pohar Perme estimator was used to calculate conditional net cancer-specific survival (CSS) and overall survival (OS) for up to 5 years subsequent to the diagnosis. Using multiple imputation, proportional hazard ratios for conditional CSS and OS were calculated with adjusted Cox regression models. RESULTS: During a median follow up of 2.95 years, 208 patients died, of which 169 died due to progressive prostate cancer. At baseline, the 5-year CSS and OS rates were 65.5% and 58.2%, respectively. Conditional 5-year net CSS and OS survival gradually increased for all the patients. In patients given a 5-year survivorship, the conditional 5-year net CSS and OS rates improved to 0.906 and 0.811, respectively. Only the extent of disease score (EOD) ≥2 remained a prognostic factor for CSS and OS up to 5 years; as survival time increased, other variables were no longer independent prognostic factors. CONCLUSIONS: The conditional 5-year net CSS and OS in patients with mHNPC gradually increased; thus, the risk of mortality decreased with increasing survival. The patient's risk profile changed over time. EOD remained an independent prognostic factor for CSS and OS after 5-year follow-up. Conditional net survival can play a role in clinical decision-making, providing intriguing information for cancer survivors.
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Hamano I.
World Journal of Urology ( World Journal of Urology ) 37 ( 11 ) 2365 - 2373 2019年11月
PURPOSE: We determine whether the nadir prostate-specific antigen level (PSA nadir) and time to nadir (TTN) during initial androgen deprivation therapy (ADT) are prognostic factors in metastatic castration-resistant prostate cancer (mCRPC) patients. METHODS: We reviewed the Michinoku Japan Urological Cancer Study Group database, including 321 mCRPC patients. Optimal cutoff values for PSA nadir and TTN on survival were calculated with the receiver operating characteristic (ROC) curve. Patients were stratified into unfavorable (higher PSA nadir and/or shorter TTN) and favorable (lower PSA nadir and longer TTN) groups. The inversed probability of treatment weighing (IPTW)-adjusted Cox proportional hazard model was performed to evaluate the impact of the unfavorable group on overall survival (OS) after CRPC diagnosis. RESULTS: Median age and follow-up period were 71 years and 35 months, respectively. ROC curve analysis demonstrated cutoffs of PSA nadir > 0.64 ng/mL and TTN < 7 months. The unfavorable group included 248 patients who had significantly shorter OS after mCRPC. The IPTW-adjusted multivariate model revealed that the unfavorable group had a negative impact on OS in mCRPC patients [hazards ratio (HR) 2.98, P < 0.001]. CONCLUSIONS: Higher PSA nadir and shorter TTN during the initial ADT are poor prognostic factors in patients with mCRPC.
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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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次世代の人工神経 シート状の人工神経による神経叢部の再生
鈴木 義久, 石川 奈美子, 岡野 純子, 羽渕 友則, 武田 孝輔, 武田 紘司
日本マイクロサージャリー学会学術集会プログラム・抄録集 ( (一社)日本マイクロサージャリー学会 ) 46回 103 - 103 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
A 36-year-old female was referred to our hospital for a giant abdominal mass found by ultrasound examination. A computed tomographic scan showed a large retroperitoneal mass measuring 11 cm in diameter suspected to be liver invasion, a right atrial and inferior vena cava (IVC) tumor thrombus with obstruction of hepatic vein junction of IVC, and small lung metastases. She was diagnosed with cT4N0M1 adrenocortical carcinoma (ACC) by a needle biopsy and radiographic examination. Right adrenalectomy and thrombectomy were successfully performed without cardiac arrest and without liver dissection. The operative time was 485 minutes, and the estimated blood loss was 7, 533 ml. No major peri- or postoperative complications were observed. For the residual lung mass, a first line combination chemotherapy with etoposide, doxorubicin, cisplatin and mitotane followed by a second line chemotherapy with gemcitabine and capecitabine were administered. She has been alive with disease for 45 months under mitotane treatment against residual lung metastases. In conclusion, extended surgery could be successfully performed for advanced ACC with right atrium and IVC tumor thrombus. Although careful planning is needed for successful surgery, combination therapy with extended surgery and subsequent systematic chemotherapy may provide a substantial benefit in patients with advanced ACC.
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Konishi S.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 17 ( 5 ) e1080 - e1089 2019年10月
BACKGROUND: The objective of the study was to validate the characteristics of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model in patients treated with first-line axitinib in clinical practice. PATIENTS AND METHODS: We retrospectively evaluated 143 patients with metastatic renal-cell carcinoma who were treated with axitinib as the first-line therapy between October 2008 and February 2019. Overall survival (OS) was evaluated according to the IMDC prognostic model. We investigated the intragroup heterogeneity in the intermediate-risk group and divided these patients according to abnormal C-reactive protein (CRP) levels. An inverse probability of treatment-weighted (IPTW)-adjusted Cox regression analysis was performed to evaluate the effects of the CRP-risk model of OS in the patients in the IMDC intermediate-risk group. RESULTS: A significant difference in OS was observed in patients in the IMDC intermediate- and poor-risk group, although no significant difference was observed between the IMDC favorable- and intermediate-risk group. Significantly shorter prognosis was observed in patients in the IMDC intermediate-risk group who had 2 risk factors and CRP ≥0.3 mg/dL (inter-high group) than in those with 1 risk factor or 2 risk factors with CRP <0.3 mg/dL (inter-low group). IPTW-adjusted Cox regression analysis revealed significant differences in the OS between the inter-low and inter-high groups. CONCLUSION: The IMDC prognostic model was active in patients who received first-line axitinib treatment. The combination of CRP value with the number of positive risk factors in the IMDC model might predict prognosis in patients with IMDC intermediate-risk treated with first-line axitinib.
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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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エベロリムス導入による腎移植後サイトメガロウイルス感染及び治療への影響
藤山 信弘, 齋藤 満, 山本 竜平, 沼倉 一幸, 井上 高光, 羽渕 友則, 佐藤 滋
日本腎臓病薬物療法学会誌 ( 日本腎臓病薬物療法学会 ) 8 ( 特別号 ) S148 - S148 2019年10月
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ホルモン感受性転移性前立腺癌における治療抵抗性時のPSA低値は予後不良因子である
小玉 寛健, 畠山 真吾, 星 宣次, 川口 俊明, 石戸谷 滋人, 下田 次郎, 三塚 浩二, 土谷 順彦, 荒井 陽一, 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 P109 - 1 2019年10月
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初期ホルモン治療における「PSA kinetics」は去勢抵抗性前立腺癌の予後を予測する
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, 星 宣次, 川口 俊明, 石戸谷 滋人, 下田 次郎, 三塚 浩二, 土谷 順彦, 荒井 陽一, 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 O33 - 1 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