研究者詳細 - 羽渕　友則

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.

DOI PubMed

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.

DOI PubMed

【ここまで進んだ鏡視下手術】泌尿器領域前立腺前立腺癌に対する腹腔鏡手術ロボット支援手術を中心に

小林瑞貴, 羽渕友則

臨牀と研究 ( 大道学館出版部 ) 99 ( 6 ) 713 - 719 2022年06月

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

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

Real-world survival outcomes of adding docetaxel or abiraterone in patients with high-volume metastatic castration-sensitive prostate cancer: historically controlled, propensity score matched comparison with androgen deprivation therapy

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.

DOI PubMed

<腎代替療法選択のSDGsを求めて>腎移植up to date 腎移植におけるウイルス感染症up to date(CMV、EBV、BKPyV)

齋藤満, 佐藤滋, 提箸隆一郎, 齋藤拓郎, 山本竜平, 藤山信弘, 奈良健平, 沼倉一幸, 成田伸太郎, 羽渕友則

日本透析医学会雑誌 ( (一社)日本透析医学会 ) 55 ( Suppl.1 ) 323 - 323 2022年05月

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

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

Impact of Gleason pattern 5 on prognosis for newly diagnosed metastatic hormone-sensitive prostate cancer with Gleason score ≥8

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.

DOI PubMed

BRCA2変異陽性を示した前立腺小細胞癌の一例

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

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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