研究等業績 - その他 - 羽渕 友則
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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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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(株) ) 64 ( 3 ) 301 - 304 2019年03月
70歳代男。前立腺癌(腺癌)cT4N0M0の診断で内分泌療法(MAB)と外照射が行われたが、治療終了後2年で再発し、CTで左腸骨リンパ節腫大を認めた。MABを再開するも治療効果は乏しく、pro-gastrin releasing peptideの上昇を認めたため、111In-pentetreotideを行ったところ、全身像では生理的集積との重なりのため異常所見を指摘できなかったが、SPECT-CTで病変部の集積がみられ、腸管の生理的集積との区別が可能であった。左腸骨リンパ節病変の生検では前立腺癌の転移を認め、synaptophysinは陽性で神経内分泌分化が確認された。前立腺癌の神経内分泌分化が疑われる場合には111In-pentetreotideの施行が有用と考えられ、本症例は病変の分布と活動性の評価に111In-pentetreotideが有用であった。
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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 ) e190115 2019年02月
IMPORTANCE: Recently, genetic polymorphism in HSD3B1 encoding 3β-hydroxysteroid dehydrogenase-1 has been shown to be associated with oncological outcome when treated with androgen-deprivation therapy (ADT) for prostate cancer. Upfront abiraterone combined with ADT has proved survival benefit. However, its effect on oncological outcome among different ethnicities and in abiraterone treatment remain unclear. OBJECTIVE: To investigate the significance of missense polymorphism in HSD3B1 gene among men treated with primary ADT or abiraterone. DESIGN, SETTING, AND PARTICIPANTS: This prognostic study included Japanese patients with metastatic hormone-sensitive prostate cancer between June 1993 and July 2005 and with castration-resistant prostate cancer between September 2014 and February 2018. Genome DNA was obtained from patient whole blood samples, and genotyping on HSD3B1 (rs1047303, 1245C) was performed by Sanger sequencing. EXPOSURES: Primary ADT for metastatic hormone-sensitive prostate cancer and abiraterone for castration-resistant prostate cancer. MAIN OUTCOMES AND MEASURES: The association of genotype in HSD3B1 with clinicopathological parameters and oncological outcome, including prostate-specific antigen response, progression-free survival, treatment failure-free survival, and overall survival was examined. RESULTS: Of 203 men, 104 were in the primary ADT cohort (median [interquartile range] age, 72 [67-76] years) and 99 men were in the abiraterone group (median [interquartile range] age, 74 [67-80] years). Most patients carried metastatic lesions in each cohort. Among the cohort of primary ADT, men carrying heterozygous and homozygous variant types in HSD3B1 gene showed higher progression risk (hazard ratio [HR], 2.34; 95% CI, 1.08-4.49; P = .03) but not any-caused death risk (HR, 1.36; 95% CI, 0.52-2.92; P = .50), compared with men carrying homozygous wild type. In contrast, among the abiraterone cohort, men carrying variant type in HSD3B1 gene showed lower progression risk (HR, 0.32; 95% CI, 0.12-0.69; P = .006) and lower all-cause mortality risk (HR, 0.40; 95% CI, 0.13-0.94; P = .04) compared with men carrying homozygous wild type. CONCLUSIONS AND RELEVANCE: This study showed that HSD3B1 genetic variant is distinctly associated with oncological outcome between primary ADT and abiraterone in Japanese men, suggesting universal significance among different ethnicities in primary ADT, as well as promise as a predictive biomarker of ADT and abiraterone.
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Narita S.
Clinical Genitourinary Cancer ( Clinical Genitourinary Cancer ) 17 ( 1 ) e113 - e122 2019年02月
BACKGROUND: To investigate the clinical outcomes in patients with high-risk prostate cancer (PCa) treated with neoadjuvant chemohormonal therapy (NCHT) before radical prostatectomy (RP). PATIENTS AND METHODS: Our NCHT protocol involved complete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) plus estramustine phosphate (560 mg). NCHT was provided to 60 patients with PCa before RP, and we compared the clinical and pathologic outcomes with those of 349 patients with high-risk PCa who underwent RP alone using propensity score matching. The data for those who underwent RP alone were obtained from the Michinoku Japan Urological Cancer Study Group database. RESULTS: In the NCHT group, 10.0% experienced pathologic complete response, 3.3% had positive surgical margins, and 13.3% developed severe complications (Clavien-Dindo grade III or higher) after RP. The median follow-up duration was 42.5 months, and the 5-year biochemical recurrence (BCR)-free survival was 60.1%. In multivariate analysis, pN+ was an independent prognostic factor for BCR (hazard ratio = 5.251, 95%CI 1.300-21.201; P = .020). In propensity score matching, the BCR rate in the NCHT group was significantly lower than that in the RP alone group (P = .021). In subgroup analyses, the BCR rate in patients with a single high-risk factor was significantly lower in the NCHT group than in the RP-alone group (P = .027). CONCLUSION: NCHT before RP can reduce the risk of BCR in patients with high-risk PCa, particularly if a single high-risk factor is present. However, the potential for perioperative complications should be considered.
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Terada N.
BMC Cancer ( BMC Cancer ) 19 ( 1 ) 156 - 156 2019年02月
BACKGROUND: We analyzed the efficacy and toxicity of cabazitaxel (CBZ) at high and low initial doses in Japanese patients with docetaxel-resistant castration-resistant prostate cancer (CRPC). METHODS: We retrospectively evaluated 118 patients who received CBZ for docetaxel-resistant CRPC in 10 university hospitals in Japan between 2014 and 2016. The rate of decrease of prostate-specific antigen (PSA), adverse events, progression-free survival (PFS), and overall survival (OS) were compared between patients receiving initially high (≥22.5 mg/m2, n = 36) and low (≤20 mg/m2, n = 80) CBZ doses. Factors associated with survival and grade 4 neutropenia were evaluated. RESULTS: PSA values decreased by > 50% in 22 patients (19%), with a higher frequency in the high-dose group than in the low-dose group (29 and 14%, P = 0.073). The median PFS time for the all-patient, high- and low-dose groups was 2.8 months (95% confidence interval [CI] 1.9-4.4), 2.1 months (1.2-5.5), and 3.0 months (2.0-4.4), respectively (P = 0.904). The median OS times were 16.3 months (95% CI 9.7-30.9), 30.9 months (11.8-47.4), and 10.2 months (8.6-20), respectively (P = 0.020). In multivariate analyses, PFS was significantly associated with existing bone metastasis at diagnosis (P = 0.005) and OS with PSA > 100 ng/ml (P = 0.007), hemoglobin < 12 g/dl (P = 0.030), and low initial CBZ dose (P = 0.030). Grade 4 neutropenia occurred in 53 patients (45%) and was associated with a low CBZ dose (hazard ratio 0.21, 95% CI 0.08-0.59, P = 0.002). CONCLUSIONS: CBZ at a higher initial dose may have similar response rate and response duration, but longer survival duration after treatment with higher toxicity than a lower initial dose for docetaxel-resistant CRPC in Japanese patients.
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Lowe症候群男児に対して生体腎移植を施行した経験
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
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 235 - 235 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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小児科病棟における生体腎移植看護の導入に向けた取り組み
巴 祐子, 大友 マキ, 相庭 結花, 佐藤 佐智子, 瀬田川 美香, 齋藤 満, 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 195 - 195 2019年02月
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腎移植後サイトメガロウイルス感染とHLAの相関性
藤山 信弘, 三浦 アヤ子, 齋藤 満, 山本 竜平, 齋藤 拓郎, 沼倉 一幸, 井上 高光, 奥山 慎, 羽渕 友則, 佐藤 滋
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 242 - 242 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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Tomita Y.
BMC Cancer ( BMC Cancer ) 19 ( 1 ) 17 - 17 2019年01月
BACKGROUND: A prospective, randomised phase II study demonstrated clinical benefit of axitinib dose titration in a subset of treatment-naïve patients treated with axitinib for metastatic renal cell carcinoma. This analysis evaluated patient baseline characteristics that may impact overall survival (OS) with axitinib dose titration. METHODS: Following a 4-week lead-in period during which all patients received axitinib 5 mg twice-daily (bid); patients meeting the predefined randomisation criteria were randomly assigned to receive axitinib 5 mg bid plus either axitinib or placebo titration. In exploratory analyses, patients were grouped into those who achieved OS ≥24 versus < 24 months, and compared their baseline characteristics with Fisher's exact test or Cochran-Armitage trend exact test, with a 5% significance level. Potential predictive baseline characteristics associated with effect of axitinib dose titration on OS were investigated using a Cox proportional hazard model. RESULTS: Overall, 112 patients were randomised. Three of 56 patients receiving axitinib titration were censored; of the remaining 53, 33 (62%) achieved OS ≥24 months versus 20 (38%) with OS < 24 months. Patients with OS ≥24 vs. < 24 months, respectively, had significantly fewer metastatic sites (≤2 metastases: 52% vs. 10%; ≥3 metastases: 48% vs. 90%), fewer lymph node (45% vs. 75%) or liver (15% vs. 45%) metastases, higher haemoglobin level (i.e., ≥ lower limit of normal: 67% vs. 25%) at baseline, lower neutrophil (≤ upper limit of normal, 97% vs. 75%) and platelet (≤ upper limit of normal, 82% vs. 50%) levels at baseline and ≥ 1 year between histopathological diagnosis and treatment (64% vs. 15%). The primary reason for treatment discontinuation in both OS groups was disease progression. The frequency of toxicity-related discontinuation was comparable between the 2 groups, indicating that it was not a factor for a shorter OS. The multivariate analysis showed that ≥1 year from histopathological diagnosis to treatment and baseline haemoglobin level equal or greater than lower limit of normal were significant covariates associated with favourable OS in patients receiving axitinib titration. CONCLUSIONS: The current analyses identified potentially predictive factors that could help selecting patients who may benefit from axitinib dose titration. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT00835978. Registered prospectively, February 4, 2009.
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高橋 修平, 沼倉 一幸, 久保 恭平, 松田 芳教, 山本 竜平, 本間 直子, 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) ) 32 ( 1 ) 92 - 92 2019年01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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大動脈炎症候群による機能的単腎の腎動脈狭窄に対し自家腎移植を施行した1例
蘇武 竜太, 齋藤 満, 中村 久美子, 小林 瑞貴, 喜早 祐介, 山本 竜平, 本間 直子, 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) ) 32 ( 1 ) 87 - 87 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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喜早 祐介, 鶴田 大, 奈良 健平, 石田 雅宣, 沼倉 一幸, 前野 淳, 斎藤 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) ) 32 ( 1 ) 81 - 81 2019年01月
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序文
松田 公志, 羽渕 友則
Japanese Journal of Endourology ( 日本泌尿器内視鏡学会 ) 32 ( 1 ) 43 - 44 2019年
<p> 2004年に創設された泌尿器腹腔鏡技術認定制度は15年が経過し, これまでに延べ2,811名が審査を受け, 1,598名が合格した (2018年度審査を除く). 合格率56.8％である. 合格者は, 日本泌尿器内視鏡学会正会員の39.2％を占めることになる.</p><p> 当初様々な議論の後に創設された本制度は, 日本泌尿器内視鏡学会の重要な業務として, 審査委員各位の膨大な努力のもとに運営され, わが国における泌尿器腹腔鏡手術の安全性を担保する根幹となる制度として機能してきた. 技術認定制度は, 若手泌尿器外科医の技術習得の大きな目標であり, 認定取得者は独り立ちの泌尿器腹腔鏡手術術者の称号となっているのである.</p><p> 1990年に始まった泌尿器腹腔鏡手術は, 年とともに広く普及し, その手術件数はFig. 1に示すように増加してきた. 当初必ずしも低くなかった腹腔鏡手術から開放手術への移行や合併症の頻度は, この間に徐々に低下してきたことが, 本学会と日本内視鏡外科学会による全国調査<sup>1)</sup>で示されている (Fig. 2). これらの改善には, 各施設各術者の努力や種々の教育体制の整備とともに, 技術認定制度がそれなりの役割を果たしてきたと想定されるのである.</p><p> 本特集では, 14年におよぶ本制度の審査結果と制度の妥当性, 審査項目の概略と求められる基本手技について解説するとともに, それぞれの術式において求められる術式上のポイントを到達法別に詳述していただき, これから認定取得を目指す先生方にとって有益なものとなることを期待している.</p>