論文 - 大家　基嗣

Performance of diffusion-weighted MRI post-CT urography for the diagnosis of upper tract urothelial carcinoma

Akita Hirotaka, Kikuchi Eiji, Hayakawa Nozomi, Mikami Shuji, Sugiura Hiroaki, Oya Mototsugu, Jinzaki Masahiro

Clinical Imaging 52   208 - 215 2018年11月

共著,  ISSN  0899-7071

　概要を見る

<p>Objectives: To evaluate the usefulness of adding diffusion-weighted MRI (DW-MRI) to CT urography (CTU) for diagnosing upper tract urothelial carcinoma (UTUC). Materials and methods: We retrospectively evaluated 102 high-risk patients with UTUC who underwent both CTU and DW-MRI. The diagnostic performance of CTU and DW-MRI was evaluated in all the patients. Then, the diagnostic performance of DW-MRI in the patients with positive CTU findings was assessed based on the types of CTU findings (mass formation, wall thickening, and small filling defects). The diagnostic performance of DW-MRI and selective urine cytology sampling in these patients was also compared. Results: The sensitivity of DW-MRI (92%) was less than that of CTU (98%) (P = 0.25), since DW-MRI could not detect any small papillary tumors. The specificity of DW-MRI (91%) was greater than that of CTU (78%) (P = 0.065), since DW-MRI could discriminate some benign conditions from UTUC. Among the 59 positive CTU lesions, DW-MRI correctly diagnosed all 41 mass-forming lesions and improved the accuracy from 36% using CTU alone to 79% for 14 wall-thickening lesions but could not add any additional information for 4 small filli

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Selection of patients who would not require long-term prostate-specific antigen monitoring after low-dose-rate brachytherapy

Niwa N., Matsumoto K., Nishiyama T., Yagi Y., Ozu C., Nakamura K., Saito S., Oya M.

Brachytherapy （Brachytherapy）  17 （ 6 ） 899 - 905 2018年11月

研究論文（学術雑誌）, 共著,  ISSN  15384721

　概要を見る

© 2018 American Brachytherapy Society Purpose: To identify patients at extremely low risk of biochemical recurrence (BCR) of prostate cancer after low-dose-rate brachytherapy (LDR-BT) to determine when prostate-specific antigen (PSA) monitoring can be stopped. Methods and Materials: We retrospectively reviewed clinicopathologic data of patients with prostate cancer who underwent LDR-BT between 2003 and 2011. Of 1569 patients reviewed, 689 (43.9%) received combination external beam radiotherapy, and 970 (61.8%) had neoadjuvant hormonal therapy. We stratified patients according to risk factors identified by multivariate analysis and assessed the factors for an association with BCR (defined as ≥2 ng/mL higher than the nadir). Results: The median followup was 96 months. Of 1531 patients who were BCR-free at 3 years after treatment, 76 subsequently developed BCR; of 1500 who were BCR-free at 5 years, 45 eventually had BCR. On multivariate analysis, independent risk factors for BCR were the National Comprehensive Cancer Network risk group at diagnosis and PSA levels at 3 or 5 years after radiotherapy. In the low-risk group, no patient with a PSA level ≤0.2 ng/mL at 3 years after radiotherapy subsequently developed BCR. In the intermediate-risk group, no patients with a PSA level ≤0.2 ng/mL at 5 years subsequently developed BCR. Conclusions: The National Comprehensive Cancer Network risk group at diagnosis and PSA values at 3 and 5 years after LDR-BT are independently associated with a risk of later BCR. Using these two factors may help to select patients for whom PSA monitoring could be stopped because they have an extremely low risk of later BCR.

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Performance of diffusion-weighted MRI post-CT urography for the diagnosis of upper tract urothelial carcinoma: Comparison with selective urine cytology sampling

Akita H., Kikuchi E., Hayakawa N., Mikami S., Sugiura H., Oya M., Jinzaki M.

Clinical Imaging （Clinical Imaging）  52   208 - 215 2018年11月

共著,  ISSN  08997071

　概要を見る

© 2018 Objectives: To evaluate the usefulness of adding diffusion-weighted MRI (DW-MRI) to CT urography (CTU) for diagnosing upper tract urothelial carcinoma (UTUC). Materials and methods: We retrospectively evaluated 102 high-risk patients with UTUC who underwent both CTU and DW-MRI. The diagnostic performance of CTU and DW-MRI was evaluated in all the patients. Then, the diagnostic performance of DW-MRI in the patients with positive CTU findings was assessed based on the types of CTU findings (mass formation, wall thickening, and small filling defects). The diagnostic performance of DW-MRI and selective urine cytology sampling in these patients was also compared. Results: The sensitivity of DW-MRI (92%) was less than that of CTU (98%) (P = 0.25), since DW-MRI could not detect any small papillary tumors. The specificity of DW-MRI (91%) was greater than that of CTU (78%) (P = 0.065), since DW-MRI could discriminate some benign conditions from UTUC. Among the 59 positive CTU lesions, DW-MRI correctly diagnosed all 41 mass-forming lesions and improved the accuracy from 36% using CTU alone to 79% for 14 wall-thickening lesions but could not add any additional information for 4 small filling-defect lesions. Among the 44 patients with positive CTU findings who underwent selective urine cytology sampling, the sensitivity of DW-MRI (95%) was significantly greater than that of selective urine cytology sampling (56%) (P < 0.001). Conclusions: The addition of DW-MRI would be useful for both mass-forming and wall-thickening lesions. DW-MRI has the potential to reduce the frequency of selective urine cytology sampling for such lesions.

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Particle Transport within the Pulsar Wind Nebula HESS J1825-137

H. E. S. S. Collaboration, H. Abdalla, F. Aharonian, F. Ait Benkhali, E. O. Angüner, M. Arakawa, C. Arcaro, C. Armand, M. Arrieta, M. Backes, M. Barnard, Y. Becherini, J. Becker Tjus, D. Berge, K. Bernlöhr, R. Blackwell, M. Böttcher, C. Boisson, J. Bolmont, S. Bonnefoy, P. Bordas, J. Bregeon, F. Brun, P. Brun, M. Bryan, M. Büchele, T. Bulik, T. Bylund, M. Capasso, S. Caroff, A. Carosi, S. Casanova, M. Cerruti, N. Chakraborty, T. Chand, S. Chandra, R. C. G. Chaves, A. Chen, S. Colafrancesco, B. Condon, I. D. Davids, C. Deil, J. Devin, P. deWilt, L. Dirson, A. Djannati-Ataï, A. Dmytriiev, A. Donath, V. Doroshenko, L. O'C. Drury, J. Dyks, K. Egberts, G. Emery, J. -P. Ernenwein, S. Eschbach, S. Fegan, A. Fiasson, G. Fontaine, S. Funk, M. Füßling, S. Gabici, Y. A. Gallant, F. Gaté, G. Giavitto, D. Glawion, J. F. Glicenstein, D. Gottschall, M. -H. Grondin, J. Hahn, M. Haupt, G. Heinzelmann, G. Henri, G. Hermann, J. A. Hinton, W. Hofmann, C. Hoischen, T. L. Holch, M. Holler, D. Horns, D. Huber, H. Iwasaki, A. Jacholkowska, M. Jamrozy, D. Jankowsky, F. Jankowsky, L. Jouvin, I. Jung-Richardt, M. A. Kastendieck, K. Katarzyński, M. Katsuragawa, U. Katz, D. Kerszberg, D. Khangulyan, B. Khélifi, J. King, S. Klepser, W. Kluźniak, Nu. Komin, K. Kosack, M. Kraus, G. Lamanna, J. Lau, J. Lefaucheur, A. Lemière, M. Lemoine-Goumard, J. -P. Lenain, E. Leser, T. Lohse, R. López-Coto, I. Lypova, D. Malyshev, V. Marandon, A. Marcowith, C. Mariaud, G. Martí-Devesa, R. Marx, G. Maurin, P. J. Meintjes, A. M. W. Mitchell, R. Moderski, M. Mohamed, L. Mohrmann, C. Moore, E. Moulin, T. Murach, S. Nakashima, M. de Naurois, H. Ndiyavala, F. Niederwanger, J. Niemiec, L. Oakes, P. O'Brien, H. Odaka, S. Ohm, M. Ostrowski, I. Oya, M. Panter, R. D. Parsons, C. Perennes, P. -O. Petrucci, B. Peyaud, Q. Piel, S. Pita, V. Poireau, A. Priyana Noel, D. A. Prokhorov, H. Prokoph, G. Pühlhofer, M. Punch, A. Quirrenbach, S. Raab, R. Rauth, A. Reimer, O. Reimer, M. Renaud, F. Rieger, L. Rinchiuso, C. Romoli, G. Rowell, B. Rudak, E. Ruiz-Velasco, V. Sahakian, S. Saito, D. A. Sanchez, A. Santangelo, M. Sasaki, R. Schlickeiser, F. Schüssler, A. Schulz, H. Schutte, U. Schwanke, S. Schwemmer, M. Seglar-Arroyo, M. Senniappan, A. S. Seyffert, N. Shafi, I. Shilon, K. Shiningayamwe, R. Simoni, A. Sinha, H. Sol, A. Specovius, M. Spir-Jacob, Ł. Stawarz, R. Steenkamp, C. Stegmann, C. Steppa, T. Takahashi, J. -P. Tavernet, T. Tavernier, A. M. Taylor, R. Terrier, L. Tibaldo, D. Tiziani, M. Tluczykont, C. Trichard, M. Tsirou, N. Tsuji, R. Tuffs, Y. Uchiyama, D. J. van der Walt, C. van Eldik, C. van Rensburg, B. van Soelen, G. Vasileiadis, J. Veh, C. Venter, P. Vincent, J. Vink, F. Voisin, H. J. Völk, T. Vuillaume, Z. Wadiasingh, S. J. Wagner, R. M. Wagner, R. White, A. Wierzcholska, R. Yang, H. Yoneda, D. Zaborov, M. Zacharias, R. Zanin, A. A. Zdziarski, A. Zech, F. Zefi, A. Ziegler, J. Zorn, N. Zywucka

A&A 621, A116 (2019) 2018年10月

　概要を見る

Aims: We present a detailed view of the pulsar wind nebula (PWN) HESS
J1825-137. We aim to constrain the mechanisms dominating the particle transport
within the nebula, accounting for its anomalously large size and spectral
characteristics. Methods: The nebula is studied using a deep exposure from over
12 years of H.E.S.S. I operation, together with data from H.E.S.S. II improving
the low energy sensitivity. Enhanced energy-dependent morphological and
spatially-resolved spectral analyses probe the Very High Energy (VHE, E > 0.1
TeV) gamma-ray properties of the nebula. Results: The nebula emission is
revealed to extend out to 1.5 degrees from the pulsar, ~1.5 times further than
previously seen, making HESS J1825--137, with an intrinsic diameter of ~100 pc,
potentially the largest gamma-ray PWN currently known. Characterisation of the
nebula's strongly energy-dependent morphology enables the particle transport
mechanisms to be constrained. A dependence of the nebula extent with energy of
R $\propto$ E^\alpha with \alpha = -0.29 +/- 0.04 (stat) +/- 0.05 (sys)
disfavours a pure diffusion scenario for particle transport within the nebula.
The total gamma-ray flux of the nebula above 1~TeV is found to be (1.12 +/-
0.03 (stat) +/- 0.25 (sys)) $\times 10^{-11}$ cm$^{-2}$ s$^{-1}$, corresponding
to ~64% of the flux of the Crab Nebula. Conclusions: HESS J1825-137 is a PWN
with clear energy-dependent morphology at VHE gamma-ray energies. This source
is used as a laboratory to investigate particle transport within middle-aged
PWNe. Deep observations of this highly spatially-extended PWN enable a spectral
map of the region to be produced, providing insights into the spectral
variation within the nebula.


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特集 泌尿器科医のためのゲノム腫瘍学入門─時代に取り残されるな 企画にあたって

大家 基嗣

臨床泌尿器科 （株式会社医学書院）  72 （ 11 ） 865 - 865 2018年10月

ISSN  0385-2393

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Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer: Analysis of community-based multi-institutional database across Japan using propensity score matching

Onozawa M., Akaza H., Hinotsu S., Oya M., Ogawa O., Kitamura T., Suzuki K., Naito S., Namiki M., Nishimura K., Hirao Y., Tsukamoto T.

Cancer Medicine （Cancer Medicine）  7 （ 10 ） 4893 - 4902 2018年10月

共著,  ISSN  2045-7634

　概要を見る

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were started on ADT by surgical or medical castration alone (monotherapy group, 5395 cases) or ADT in combination with a nonsteroidal anti-androgen (combined androgen blockade (CAB) group, 8379 cases). We used logistic regression analysis with background factors as independent factors to calculate propensity scores in regard to selection of CAB. Next, for 8826 cases of propensity score-matched patients, we compared the survival rates in the two groups. Results: The CAB group showed a significantly better progression-free survival (PFS) rate (65.6% vs 59.6% at 5 years; median time to progression, 11.6 vs 7.1 years; hazard ratio in the CAB group: 0.78, with a 95% confidence interval of 0.72 to 0.84; P < 0.001). In subgroup analysis based on the background factors, the PFS rate was generally better in the CAB group in all risk subgroups except for those having significant risk factors. Conclusion: Propensity score matching analysis revealed the prolongation of PFS by CAB in prostate cancer patients without significant risk factors. It would possible to decide the type of the first-line ADT according to the prostate cancer risk.

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A phase 1/2a trial of docetaxel plus ribavirin for reprogramming efficacy in patients with castration resistant prostate cancer: DRREEM trial

Kosaka Takeo, Shinojima Toshiaki, Abe Takayuki, Ueda Koji, Kikuchi Kayoko, Saito Yasuko, Hagiwara Sachiko, Kikuchi Eiji, Kojima Shinichiro, Miyake Shinji, Saya Hideyuki, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   353 - 353 2018年10月

共著,  ISSN  0919-8172

The establishment of new therapeutic strategy for metastatic urothelial carcinoma targeting against cancer stem cell

Ogihara Koichiro, Kikuchi Eiji, Hakozaki Kyohei, Okazaki Shogo, Hagiwara Masayuki, Takeda Toshikazu, Matsumoto Kazuhiro, Kosaka Takeo, Mikami Shuji, Saya Hideyuki, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   332 - 332 2018年10月

共著,  ISSN  0919-8172

The clinical impact of baseline serum C-reactive protein level in patients with metastatic renal cell carcinoma treated by targeted therapy

Takamatsu Kimiharu, Mizuno Ryuichi, Takeda Toshikazu, Morita Shinya, Matsumoto Kazuhiro, Kosaka Takeo, Shinojima Toshiaki, Kikuchi Eiji, Asanuma Hiroshi, Oyama Masafumi, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   257 - 257 2018年10月

共著,  ISSN  0919-8172

Network Medicine to Overcome Drug Resistance in CRPC or NEPC: Drug Efficacy Reprogramming

Kosaka Takeo, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   153 - 153 2018年10月

共著,  ISSN  0919-8172

Efficacy of TWIST score system for different diagnosis in acute scrotum

Teranishi Yu, Asanuma Hiroshi, Takamatsu Kimiharu, Takeda Toshikazu, Matsumoto Kazuhiro, Morita Shinya, Kosaka Takeo, Mizuno Ryuichi, Shinojima Toshiaki, Kikuchi Eiji, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   374 - 374 2018年10月

共著,  ISSN  0919-8172

Clinical Investigation of Homecare Urology in a Japanese Homecare Support Clinic

Yazawa Satoshi, Yamanaka Takashi, Kubota Kazumi, Kemei Jun, Nakahara Jin, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   201 - 201 2018年10月

共著,  ISSN  0919-8172

Nivolumab (NIVO) v everolimus (EVE) in advanced renal cell carcinoma (aRCC): 3-year follow-up in Japanese patients (pts) from Check-Mate 025

Satoshi Fukasawa, Nobuo Shinohara, Hiroshi Kitamura, Mototsugu Oya, Masatoshi Eto, Kazunari Tanabe, Mitsuru Saito, Go Kimura, Junji Yonese, Masahiro Yao, Lingfeng Yang, Elmer Berghorn, Robert J. Motzer, Yoshihiko Tomita

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   257 - 257 2018年10月

共著,  ISSN  0919-8172

Oncologic Surveillance After Radical Nephroureterectomy in Upper Tract Urothelial Carcinoma Patients: A Novel Risk-Based Approach

Shigeta Keisuke, Kikuchi Eiji, Hagiwara Masayuki, Abe Takayuki, Takeda Toshikazu, Matsumoto Kazuhiro, Shinojima Toshiaki, Nakagawa Ken, Oya Mototsugu

INTERNATIONAL JOURNAL OF UROLOGY 25   438 - 438 2018年10月

ISSN  0919-8172

Oncologic Surveillance After Radical Nephroureterectomy in Upper Tract Urothelial Carcinoma Patients: A Novel Risk-Based Approach

Keisuke Shigeta, Eiji Kikuchi, Masayuki Hagiwara, Takayuki Abe, Toshikazu Takeda, Kazuhiro Matsumoto, Toshiaki Shinojima, Ken Nakagawa, Mototsugu Oya

INTERNATIONAL JOURNAL OF UROLOGY （WILEY）  25   438 - 438 2018年10月

共著,  ISSN  0919-8172

Updated long-term outcomes after carbon-ion radiotherapy for primary renal cell carcinoma

Kasuya G., Tsuji H., Nomiya T., Makishima H., Haruyama Y., Kobashi G., Ebner D., Hayashi K., Omatsu T., Kishimoto R., Yasuda S., Igarashi T., Oya M., Akakura K., Suzuki H., Ichikawa T., Shimazaki J., Kamada T.

Cancer Science （Cancer Science）  109 （ 9 ） 2873 - 2880 2018年09月

研究論文（学術雑誌）, 共著,  ISSN  1347-9032

　概要を見る

© 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. Long-term oncological outcomes for primary renal cell carcinoma (RCC) treated with carbon-ion radiotherapy (CIRT) are poorly understood. Patients with primary RCC were treated with 12 or 16-fraction CIRT at The Hospital of the National Institute of Radiological Sciences outside of clinical trials. Outcome data were pooled and retrospectively analyzed for toxicity, local control, and disease-free, cancer-specific, and overall survival. From 1997 to 2014, 19 RCC patients (11 with T1aN0M0, 4 with T1bN0M0, and 4 with inoperable advanced stage [T4N0M0, T3aN1M0, and T1aN0M1]) were treated with CIRT and followed up for a median of 6.6 (range, 0.7-16.5) years; 9 of these patients were inoperable because of comorbidities or advanced-stage disease. Diagnoses were confirmed by imaging in 11 patients and by biopsy in the remaining 8. In 4 of 5 patients with definitive renal comorbidities, including diabetic nephropathy, sclerotic kidney or solitary kidney pre-CIRT progressed to grade 4 chronic kidney disease (CKD). In contrast, the remaining 14 patients without definitive renal comorbidities did not progress to grade 3 or higher CKD. Furthermore, although 1 case of grade 4 dermatitis was observed, there were no other grade 3 or higher non-renal adverse events. Local control rate, and disease-free, cancer-specific, and overall survival rates at 5 years of all 19 patients were 94.1%, 68.9%, 100%, and 89.2%, respectively. This updated retrospective analysis based on long-term follow-up data suggests that CIRT is a safe treatment for primary RCC patients without definitive renal comorbidities pre-CIRT, and yield favorable treatment outcomes, even in inoperable cases.

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Analysis of cabazitaxel-resistant mechanism in human castration-resistant prostate cancer

Hongo H., Kosaka T., Oya M.

Cancer Science （Cancer Science）  109 （ 9 ） 2937 - 2945 2018年09月

研究論文（学術雑誌）, 共著,  ISSN  1347-9032

　概要を見る

© 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. Cabazitaxel (CBZ) is approved for docetaxel-resistant castration-resistant prostate cancer (CRPC). However, efficacy of CBZ for CRPC is limited and there are no effective treatments for CBZ-resistant CRPC. In order to investigate the CBZ-resistant mechanism, the establishment of a CBZ-resistant cell line is urgently needed. We established CBZ-resistant CRPC cell lines DU145CR and PC3CR by incubating DU145 and PC3 cells with gradually increasing concentrations of CBZ for approximately 2 years. We analyzed the gene expression profiles and cell cycle changes using microarray and flow cytometry. Pathway analysis revealed DU145CR cells had enhanced gene clusters of cell division and mitotic nuclear division. Enhancement of ERK signaling was detected in DU145CR cells. DU145CR cells had resistance to G2/M arrest induced by CBZ through ERK signaling activation. The MEK inhibitor PD184352 significantly inhibited cell proliferation of DU145CR. In contrast to DU145CR, PC3CR cells had enhancement of PI3K/AKT signaling. The PI3K/mTOR inhibitor NVP-BEZ 235 had a significant antitumor effect in PC3CR cells. Cabazitaxel -resistant CRPC cells established in our laboratory had enhancement of cell cycle progression signals and resistance to G2/M arrest induced by CBZ. Enhancement of ERK signaling or PI3K/AKT signaling were detected in the cell lines, so ERK or PI3K/AKT could be therapeutic targets for CBZ-resistant CRPC.

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Message from the Publications Chair

Mototsugu Oya

WORLD JOURNAL OF UROLOGY （SPRINGER）  36 （ 9 ） 1504 - 1504 2018年09月

単著,  ISSN  0724-4983

Incidence and timing of inadvertent nephrostomy catheter displacement in patients with ureteral obstruction

大家 基嗣

Clinical Nephrology （Clinical Nephrology）  90 （ 2 ） 112 - 116 2018年08月

研究論文（学術雑誌）, 単著,  ISSN  0301-0430

　概要を見る

© 2018 Dustri-Verlag Dr. K. Feistle. Introduction: To evaluate nephrostomy catheter displacement, we assessed the cumulative nephrostomy catheter displacement rate in patients with percutaneous nephrostomy and compared the nephrostomy displacement rates between pigtail and balloon catheters. Materials and methods: Between 2003 and 2011, 87 patients who underwent percutaneous nephrostomy catheter placement and more than one subsequent catheter replacement were retrospectively identified. We evaluated their inadvertent nephrostomy catheter displacement. Results: 20 patients (23.0%) experienced incidental nephrostomy catheter displacement during the follow-up period. Kaplan-Meier analysis revealed that the 1-year nephrostomy catheter displacement-free survival rate was 62 ± 9%. No significant independent risk factors for predicting nephrostomy catheter displacement were identified, including the type of catheter. The median time from initial placement to displacement of pigtail catheters was shorter than that of balloon catheters. Conclusion: There were no significant differences in the nephrostomy catheter displacement-free survival rates between the two types of catheters. Regardless of the type of catheter, our results indicated that careful handling and guiding during catheter placement are important for all patients because of the high risk of inadvertent events.

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Evaluation of efficacy and safety of sorafenib in kidney cancer patients aged 75 years and older: A propensity score-matched analysis

Tatsugami K., Oya M., Kabu K., Akaza H.

British Journal of Cancer （British Journal of Cancer）  119 （ 2 ） 241 - 247 2018年07月

研究論文（学術雑誌）, 共著,  ISSN  00070920

　概要を見る

© 2018 The Author(s). Background: The average age of patients diagnosed with renal cell carcinoma (RCC) is increasing, but a limited number of reports have described therapy of tyrosine kinase inhibitor for elderly RCC patients. Hence, we analysed the efficacy and safety of sorafenib in elderly patients aged ≥75 years with advanced RCC. Methods: Data were extracted from <75-year-old and ≥75-year-old patient groups, matching those demographics considered to affect prognosis. Differences in patients' characteristics, dose modification, adverse events, tumour response, progression-free survival, and renal function (glomerular filtration) were evaluated between the groups. Results: From 2536 and 703 patients aged <75 and ≥75 years, respectively, 397 pairs were matched. Median daily dose was higher and duration of treatment longer in patients <75 years; however, progression-free survival and tumour response were similar in both age groups. Incidence of all adverse events was not significantly different between groups. The proportion of patients discontinuing treatment was higher in patients ≥75 years, but there was no significant difference between groups in the number patients discontinuing due to adverse events. Conclusions: For patients aged ≥75 years, sorafenib treatment had minimal additional negative impact compared to younger patients and showed similar efficacy and safety without reducing renal function.

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