論文 - 大家　基嗣

IN SILICO SCREENING USING RNA-SEQ DATA SETS OF NEUROENDOCRINE PROSTATE CANCER HAS IDENTIFIED CANDIDATE DRUGS FOR REPROGRAMMING NEPC-SPECIFIC SIGNATURES.

Takeo Kosaka, Hiroshi Hongo, Shuji Mikami, Kazuhiro Matsumoto, Eiji Kikuchi, Mototsugu Oya

JOURNAL OF UROLOGY （ELSEVIER SCIENCE INC）  199 （ 4 ） E853 - E853 2018年04月

共著,  ISSN  0022-5347

IMPACT OF TUMOR LOCATION ON BIOCHEMICAL RECURRENCE AFTER LAPAROSCOPIC RADICAL PROSTATECTOMY

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

JOURNAL OF UROLOGY （ELSEVIER SCIENCE INC）  199 （ 4 ） E51 - E51 2018年04月

共著,  ISSN  0022-5347

DOES NEOADJUVANT CHEMOTHERAPY WITH GEMCITABINE AND CISPLATIN IN BLADDER CANCER INCREASE THE COMPLICATIONS AT RADICAL CYSTECTOMY IN HIGH AGE PATIENTS?

Keishiro Fukumoto, Eiji Kikuchi, Suguru Shirotake, Kyohei Hakozaki, Yasumasa Miyazaki, Takahiro Maeda, Gou Kaneko, Shunsuke Yoshimine, Nobuhiro Tanaka, Kunimitsu Kanai, Masafumi Oyama, Yosuke Nakajima, Tetsuo Momma, Mototsugu Oya

JOURNAL OF UROLOGY （ELSEVIER SCIENCE INC）  199 （ 4 ） E1041 - E1042 2018年04月

共著,  ISSN  0022-5347

Preoperative sarcopenia status is associated with lymphovascular invasion in upper tract urothelial carcinoma patients treated with radical nephroureterectomy

Anno T., Kikuchi E., Fukumoto K., Ogihara K., Oya M.

Journal of the Canadian Urological Association （Journal of the Canadian Urological Association）  12 （ 3 ） E132 - E136 2018年03月

共著,  ISSN  1911-6470

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© 2018 Canadian Urological Association. Introduction: Sarcopenia is a novel concept representing skeletal muscle wasting and has been identified as a prognostic factor for several cancers. The aims of this study were to evaluate the prognostic significance of sarcopenia and the relationship between sarcopenia and poor pathological findings in upper tract urothelial carcinoma (UTUC) patients who underwent radical nephroureterectomy (RNU). Methods: We identified 123 UTUC patients who underwent RNU between 2003 and 2014. We assessed sarcopenia by measuring the area of skeletal muscle at the third lumber vertebra on preoperative computed tomography scans. Sarcopenia was classified based on a sex-specific consensus definition. We investigated whether sarcopenia predicts clinical outcomes, such as cancer death and poor pathological findings at RNU. Results: A total of 50 (40.7%) patients had sarcopenia. In a multivariate Cox regression analysis, sarcopenia was not associated with cancer-specific survival (CSS), and lymphovascular invasion (LVI) (hazard ratio 5.88; p=0.002) was the only independent risk factor for CSS. A multivariate logistic regression analysis showed that sarcopenia independently correlated with the LVI status (odds ratio 2.36; p=0.025). LVI was positive in 27 of 50 (54%) and 25 of 73 (34%) patients with and without sarcopenia, respectively (p=0.029). Conclusions: Preoperative sarcopenia predicted the LVI status, which was a strong prognostic factor for UTUC patients after RNU.

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IJU this issue

Oya Mototsugu

International Journal of Urology 25 （ 3 ） 173 - 174 2018年03月

ISSN  0919-8172

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The preoperative sarcopenia status is associated with lymphovascular invasion in upper tract urothelial carcinoma patients treated with radical nephroureterectomy

Anno T., Kikuchi E., Fukumoto K., Ogihara K., Oya M.

Canadian Urological Association Journal （Canadian Urological Association Journal）  12 （ 3 ）  2018年03月

研究論文（学術雑誌）, 共著,  ISSN  19201214

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Introduction: Sarcopenia is a novel concept representing skeletal muscle wasting and has been identified as a prognostic factor for several cancers. The aims of this study were to evaluate the prognostic significance of sarcopenia and the relationship between sarcopenia and poor pathological findings in upper tract urothelial carcinoma (UTUC) patients who underwent radical nephroureterectomy (RNU). Methods: We identified 123 UTUC patients who underwent RNU between 2003 and 2014.We assessed sarcopenia by measuring the area of skeletal muscle at the third lumber vertebra on preoperative computed tomography scans. Sarcopenia was classified based on a sex-specific consensus definition. We investigated whether sarcopenia predicts clinical outcomes such as cancer death and poor pathological findings at RNU. Results: A total of 40.7% of patients (n=50) had sarcopenia. In a multivariate Cox regression analysis, sarcopenia was not associated with cancer-specific survival (CSS), and lymphovascular invasion (LVI) (hazard ratio 5.88; p=0.002) was the only independent risk factor for CSS. A multivariate logistic regression analysis showed that sarcopenia independently correlated with the LVI status (odds ratio 2.36; p=0.025). LVI was positive in 27 out of 50 (54%) and 25 out of 73 (34%) patients with and without sarcopenia, respectively (p=0.029). Conclusions: Preoperative sarcopenia predicted the LVI status, which was a strong prognostic factor for UTUC patients after RNU.

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「2016年度前立腺がん啓発週間」の活動実績報告

五十嵐 敦, 深貝 隆志, 山中 英壽, 木村 剛, 柏原 剛, 大家 基嗣, 門間 哲雄, 中島 洋介, 森山 正敏, 井上 啓史, 斉藤 史郎

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）  26 （ 1 ） 72 - 74 2018年03月

共著,  ISSN  1347-5010

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「2016年度前立腺がん啓発週間」の活動実績を報告した。NPO法人前立腺がん啓発推進実行委員のメンバーが中心となり、日本全国19ヶ所の医療機関において、2016年9月〜10月にかけて前立腺癌に関する公開講座、情報提供、無料PSA検診、個別相談などの啓発活動を各施設に任意で行った。その結果、すべての参加施設で一般市民に前立腺癌に関する情報提供が行われ、16施設では前立腺癌に関する公開講座、11施設では無料PSA検診が行われた。全国合計でPSA検診参加者は670名であり、うち107名(16.0%)が4.0ng/mlを超える異常値を示し、精査の必要性が受診者に連絡された。尚、前年度に比べると、PSA検診の参加者の減少がみられた。

尿路上皮癌の再発・進展および治療における予測因子としてのpd-1発現の有用性の検討

早川 望, 菊地 栄次, 大家 基嗣, 三上 修治

大和証券ヘルス財団研究業績集 （(公財)大和証券ヘルス財団）  41 （ 41 ） 29 - 33 2018年03月

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上部尿路上皮癌におけるPD-1発現の役割について検討した。過去20年間に当院で上部尿路上皮癌に対して腎尿管全摘除術を施行した181例を対象に、切除検体のPD-1発現を免疫染色法にて評価した。PD-1発現は、腫瘍辺縁および腫瘍内部とそれぞれ400倍視野下で陽性細胞をカウントし、高発現群と低発現群に分類した。平均陽性個数は腫瘍内部で2個、腫瘍辺縁では11個であった。カットオフ値の設定にはX-tile softwareを使用し、腫瘍内部では10個以上を高発現、腫瘍辺縁では8個以上を高発現と定義した。PD-1発現は腫瘍辺縁において高発現群が103例(56.9%)、低発現群が78例(43.1%)、腫瘍内部において高発現群が44例(24.3%)、低発現群が137例(75.7%)であった。腫瘍内部におけるPD-1の高発現はhigh gradeおよびpT2≦と関連があり、一方腫瘍辺縁においては、high grade、pT2≦および壁内脈管侵襲陽性と関連があることが分かった。腫瘍内部のPD-1高発現は、切除可能な上部尿路上皮癌において有用な予後予測因子であることが示唆された。

A phase 1/2a trial of docetaxel plus ribavirin for reprogramming efficacy in patients with progressive metastatic castration resistant prostate cancer who have previously received docetaxel alone: DRREEM trial.

Kosaka Takeo, Shinojima Toshiaki, Kikuchi Kayoko, Hagiwara Sachiko, Kojima Shin-ichiro, Hongo Hiroshi, Ueda Koji, Miyake Shinji, Oya Mototsugu

JOURNAL OF CLINICAL ONCOLOGY （AMER SOC CLINICAL ONCOLOGY）  36 （ 6 ）  2018年02月

共著,  ISSN  0732-183X

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Efficacy and safety of abiraterone acetate (AA) and low-dose prednisone (P) in Japanese patients with newly diagnosed, metastatic, hormone-naive prostate cancer (mHNPC): Subgroup analysis of LATITUDE trial.

Fukasawa Satoshi, Suzuki Hiroyoshi, Sato Fuminori, Hashine Katsuyoshi, Hasumi Hisashi, Matsumoto Hiroaki, Tsuchiya Tomohiro, Uemura Hirotsugu, Oya Mototsugu, Kanayama Hiroomi, Kawaguchi Kazushiro, Noguchi Hidehisa, Enjo Kentaro, Tran Namphuong, Todd Mary Beth, Fizazi Karim, Matsubara Nobuaki

JOURNAL OF CLINICAL ONCOLOGY （AMER SOC CLINICAL ONCOLOGY）  36 （ 6 ）  2018年02月

共著,  ISSN  0732-183X

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Variant isoforms of CD44 involves acquisition of chemoresistance to cisplatin and has potential as a novel indicator for identifying a cisplatin-resistant population in urothelial cancer

Hagiwara M., Kikuchi E., Tanaka N., Kosaka T., Mikami S., Saya H., Oya M.

BMC Cancer （BMC Cancer）  18 （ 1 ） 113 - 113 2018年01月

研究論文（学術雑誌）, 共著,  ISSN  1471-2407

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© 2018 The Author(s). Background: Cisplatin is the most commonly used chemotherapeutic agent in the treatment of patients with metastatic and/or recurrent urothelial cancer. However, the effectiveness of these treatments is severely limited due to the development of cisplatin resistance. Cancer stem cells have been documented as one of the key hypotheses involved in chemoresistance. CD44v8-10 has been identified as one of the new cancer stem cells markers and was recently shown to enhance the antioxidant system by interaction with xCT, a subunit of the cystine transporter modulating intracellular glutathione synthesis. The aim of the present study was to investigate the clinical role of CD44v8-10 and the molecular mechanism underlying the acquisition of cisplatin resistance through CD44v8-10 in urothelial cancer. Methods: We analyzed the clinical significance of the immunohistochemical CD44v9 expression, which detects the immunogen of human CD44v8-10, in 77 urothelial cancer patients treated with cisplatin-based systemic chemotherapy for recurrence and/or metastasis. We then evaluated the biological role of CD44v8-10 in the acquisition of cisplatin resistance using the urothelial cancer cell lines, T24 and T24PR, which were generated to acquire resistance to cisplatin. Results: The 5-year cancer-specific survival rate was significantly lower in the CD44v9-positive group than in the CD44v9-negative group (P = 0.008). Multivariate analyses revealed that CD44v9 positivity was an independent risk factor of cancer-specific survival (P = 0.024, hazard ratio = 5.16) in urothelial cancer patients who had recurrence and/or metastasis and received cisplatin-based chemotherapy. The expression of CD44v8-10 and xCT was stronger in T24PR cells than in T24 cells. The amount of intracellular glutathione was significantly higher in T24PR cells than in T24 cells (p < 0.001), and intracellular reactive oxygen species production by cisplatin was lower in T24PR cells than in T24 cells. Furthermore, the knockdown of CD44v8-10 by siRNA led to the recovery of cisplatin sensitivity in T24PR cells. Conclusions: CD44v9 in tumor specimens has potential as a novel indicator for identifying a cisplatin-chemoresistant population among urothelial cancer patients. CD44v8-10 contributes to reactive oxygen species defenses, which are involved in chemoresistance, by promoting the function of xCT, which adjusts the synthesis of glutathione.

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特集 腎癌に対する薬物療法─最新エビデンスを実臨床に活かす 腎癌薬物療法におけるバイオマーカー開発の進歩

水野 隆一, 浅沼 宏, 大家 基嗣

臨床泌尿器科 （株式会社医学書院）  72 （ 1 ） 64 - 69 2018年01月

ISSN  0385-2393

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Tanaka Nobuyuki, Kanatani Shigeaki, Tomer Raju, Sahlgren Cecilia, Kronqvist Pauliina, Kaczynska Dagmara, Louhivuori Lauri, Kis Lorand, Lindh Claes, Mitura Przemysław, Stepulak Andrzej, Corvigno Sara, Hartman Johan, Micke Patrick, Mezheyeuski Artur, Strell Carina, Carlson Joseph W., Fernández Moro Carlos, Dahlstrand Hanna, Östman Arne, Matsumoto Kazuhiro, Wiklund Peter, Oya Mototsugu, Miyakawa Ayako, Deisseroth Karl, Uhlén Per

Nature Biomedical Engineering 2018年01月

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<p>In this Article originally published, owing to a technical error, author affiliations were incorrectly assigned in the HTML version; the PDF was correct. These errors have now been corrected.</p>

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Vasohibin-1 as a novel microenvironmental biomarker for patient risk reclassification in low-risk prostate cancer

Kobayashi H., Kosaka T., Mikami S., Miyazaki Y., Matsumoto K., Kikuchi E., Miyajima A., Kameyama K., Sato Y., Oya M.

Oncotarget （Oncotarget）  9 （ 12 ） 10203 - 10210 2018年01月

研究論文（学術雑誌）, 共著,  ISSN  1949-2553

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© Kobayashi et al. Background: We previously reported high expression of vasohibin-1 (VASH1), which is specifically expressed in activated vascular endothelial cells, was a prognostic indicator of disease progression in prostate cancer. The aim of this study was to assess whether VASH1 expression at the area of normal prostatic tissue as well as that of intratumoral tissue could reflect the grade of malignancy of prostate cancer. Results: Pathological upgrade of Gleason Score ≥7 by radical prostatectomy was observed in 48 patients (upgraded group). The median VASH1 densities of the intratumoral and normal areas were 9.7 ± 9.5 and 13.3 ± 11.8, respectively, and the median MVDs were 58.6 ± 20.3 and 64.1 ± 23.5, respectively. We detected a strong positive correlation with each other for both VASH1 density (ρ = 0.589, p < 0.001) and MVD (ρ = 0.342, p < 0.001). VASH1 density was significantly higher in the upgreaded group than in the non-upgraded group regardless of prostatic location (intratumoral area: p < 0.001, normal area: p < 0.001). Conclusions: Even if the tumor volume was low in biopsy samples, VASH1 density reflected the grade of malignancy throughout the prostate. These results suggested that VASH1 expression could be a novel microenvironmental biomarker for patient risk reclassification in low-risk prostate cancer. Materials and Methods: Among the 1177 patients who underwent radical prostatectomy, 104 patients diagnosed with Gleason Score ≤6 and positive cores ≤3 were included. We immunohistochemically examined the microvessels positive for anti-CD34 as microvessel density (MVD), and those with activated endothelial cells as VASH1 density using prostatic biopsy samples, and evaluated the association between their expressions and clinicopathological findings.

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Change of the 5α/5β ratio of urinary steroid metabolites in benign prostatic hyperplasia patients treated with dutasteride

Maeda Takahiro, Kikuchi Eiji, Hasegawa Masanori, Homma Keiko, Yasumizu Yota, Hattori Seiya, Kosaka Takeo, Shinoda Kazunobu, Miyajima Akira, Oya Mototsugu

Clinical Biochemistry 2018年01月

共著,  ISSN  0009-9120

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<p>Background: The effects of the administration of dutasteride (DUT) on steroid metabolite pathways in BPH patients have not been examined. Methods: Urine and blood samples as well as clinical parameters were prospectively collected after the administration of DUT to 60 BPH patients, and after its withdrawal in another set of 25 BPH patients. Urine samples were assessed using gas chromatography/mass spectrometry for the urinary steroid profile (USP), which simultaneously measures 63 steroid metabolites. We examined pharmacological changes in the 5α/5β ratio of urinary metabolites and their relationships with clinical parameters in patients treated with DUT. Results: The mean urinary androsterone/etiocholanolone (An/Et) ratio in sex-steroid pathways significantly decreased from 1.39 to 0.02 (p < 0.01). Urinary metabolites in other steroid pathways such as 5αTHF/5βTHF in the glucocorticoid pathway and 5αTHB/5βTHB in the mineralocorticoid pathway also significant decreased after the DUT treatment. As compared to baseline level, the mean An/Et ratios in patients with the withdrawal of DUT were 0.7%, 1.4%, 12.6%, and 82.4% at just before, one month, 3 months, and 6 months afte

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Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer

Onozawa Mizuki, Akaza Hideyuki, Hinotsu Shiro, Oya Mototsugu, Ogawa Osamu, Kitamura Tadaichi, Suzuki Kazuhiro, Naito Seiji, Namiki Mikio, Nishimura Kazuo, Hirao Yoshihiko, Tsukamoto Taiji

Cancer Medicine 2018年01月

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<p>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

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Does switching the bacillus Calmette-Guérin strain affect clinical outcome in patients with recurrent non-muscle-invasive bladder cancer after initial bacillus Calmette-Guérin therapy?

Niwa Naoya, Kikuchi Eiji, Matsumoto Kazuhiro, Kosaka Takeo, Mizuno Ryuichi, Oya Mototsugu

Urologic Oncology: Seminars and Original Investigations 2018年01月

共著,  ISSN  1078-1439

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<p>Purpose: It is still unknown whether switching the bacillus Calmette-Guérin (BCG) strain at the second induction course of BCG therapy has a therapeutic benefit in patients with tumor recurrence after the initial BCG therapy (BCG-relapsing tumor). Materials and methods: We retrospectively reviewed the clinicopathological features of 97 patients treated with a second induction course of BCG therapy between 1986 and 2014. Among the patients initially treated with BCG Tokyo-172, the second course was either BCG Tokyo-172 in 56 (57.8%) or BCG Connaught in 15 (15.5%). Among those who were initially treated with BCG Connaught, the corresponding numbers were 13 (13.4%) or 13 (13.4%), respectively. Twenty-eight (28.9%) patients were given a different BCG strain at the 2 BCG therapies (switching group), and 69 (71.1%) patients were given the same BCG strain (non-switching group). Result: The 5-year recurrence-free survival rate of the switching group was 64.7 ± 9.6%, which was not significantly different from that of the non-switching group (54.8 ± 6.9%, P = 0.427). Switching or not switching the BCG strain was not significantly associated with tumor recurrence after the second BCG th

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Establishment of the optimal follow-up schedule after radical prostatectomy

Matsumoto K., Niwa N., Hattori S., Takeda T., Morita S., Kosaka T., Mizuno R., Shinojima T., Kikuchi E., Asanuma H., Oya M.

Urologic Oncology: Seminars and Original Investigations （Urologic Oncology: Seminars and Original Investigations）  36 （ 7 ） 341.e9 - 341.e14 2018年01月

研究論文（学術雑誌）, 共著,  ISSN  1078-1439

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© 2018 Elsevier Inc. Purpose: Monitoring the serum level of prostate specific antigen (PSA) is indispensable for surveillance after radical therapy, and the aim of this study was to establish the optimal follow-up schedule. Materials and methods: We retrospectively reviewed the clinicopathological data of 1,010 consecutive patients who underwent radical prostatectomy. After excluding patients who received neoadjuvant or adjuvant therapy and those without a nadir PSA level<0.2 ng/ml, the remaining 779 patients were enrolled. Biochemical recurrence (BCR) was defined as elevation of PSA to >0.2 ng/ml. We investigated the PSA doubling time (PSA-DT) following BCR at various times after surgery. Results: During a mean follow-up of 8.8 years, BCR occurred in 180/779 patients. The annual BCR rate was 6% in the first year after surgery, 6% between 1 and 2 years, 3% between 2 and 3 years, 3% between 3 and 5 years, and 2% at >5 years postoperatively. During these periods, the minimum PSA-DT after BCR was 1.6, 2.4, 3.1, 6.1, and 6.4 months, respectively. These minimum PSA-DTs were used to determine the optimal follow-up interval during each period after surgery. If the baseline level is 0.1 ng/ml, PSA should be measured at approximately 3-month intervals for the first year, at 4-month intervals between 1 and 2 years, at 6-month intervals between 2 and 3 years, and annually thereafter to definitely detect BCR before the serum PSA level exceeds 0.4 ng/ml. Conclusion: The PSA-DT following BCR varies according to the time after surgery. Our data on minimum PSA-DT values after BCR are useful for setting the optimal follow-up schedule.

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History of Non–Muscle-Invasive Bladder Cancer May Have a Worse Prognostic Impact in cT2-4aN0M0 Bladder Cancer Patients Treated With Radical Cystectomy

Kayama E., Kikuchi E., Fukumoto K., Shirotake S., Miyazaki Y., Hakozaki K., Kaneko G., Yoshimine S., Tanaka N., Takahiro M., Kanai K., Oyama M., Nakajima Y., Hara S., Monma T., Oya M.

Clinical Genitourinary Cancer （Clinical Genitourinary Cancer）  16 （ 5 ） e969 - e976 2018年01月

研究論文（学術雑誌）, 共著,  ISSN  1558-7673

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© 2018 Elsevier Inc. We performed a retrospective study comparing clinical outcomes between patients with initially diagnosed muscle-invasive bladder cancer (MIBC) without a history of non-MIBC (NMIBC) and those with MIBC that progressed from NMIBC. A history of NMIBC was independently associated with cancer death in cT2-T4a MIBC patients treated with radical cystectomy and without lymph node involvement. MIBC that progresses from NMIBC may not respond to neoadjuvant chemotherapy. Purpose: To investigate whether a history of non–muscle-invasive bladder cancer (NMIBC) plays a prognostic role in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy in the era when neoadjuvant chemotherapy was established as standard therapy for MIBC. Patients and Methods: A total of 282 patients who were diagnosed with cT2-T4aN0M0 bladder cancer treated with open radical cystectomy at our institutions were included. Initially diagnosed MIBC without a history of NMIBC was defined as primary MIBC group (n = 231), and MIBC that progressed from NMIBC was defined as progressive MIBC (n = 51). Results: The rate of cT3/4a tumors was significantly higher in the primary MIBC group than in the progressive MIBC group (P =.004). Five-year recurrence-free survival and cancer-specific survival (CSS) rates for the primary MIBC group versus progressive MIBC group were 68.2% versus 55.9% (P =.039) and 76.1% versus 61.6% (P =.005), respectively. Progressive MIBC (hazard ratio, 2.170; P =.008) was independently associated with cancer death. In the primary MIBC group, the 5-year CSS rate in patients treated with neoadjuvant chemotherapy was 85.4%, which was significantly higher than that in patients without (71.5%, P =.023). In the progressive MIBC group, no significant differences were observed in CSS between patients treated with and without neoadjuvant chemotherapy. Conclusion: MIBC that progressed from NMIBC had a significantly worse clinical outcome than MIBC without a history of NMIBC and may not respond as well to neoadjuvant chemotherapy. These results are informative, even for NMIBC patients treated with conservative intravesical therapy.

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Influence of dutasteride treatment on serum hormone levels and aging male symptoms in patients with benign prostatic enlargement

Maeda T., Kikuchi E., Hasegawa M., Homma K., Ando T., Suzuki K., Kaneko G., Mizuno R., Miyajima A., Oya M.

International Journal of Urology （International Journal of Urology）  25 （ 1 ） 70 - 74 2018年01月

研究論文（学術雑誌）, 共著,  ISSN  0919-8172

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© 2017 The Japanese Urological Association Objectives: To clarify the effects of dutasteride on serum hormone levels and aging male symptoms in patients with benign prostatic enlargement. Methods: The present prospective study was carried out in 110 symptomatic benign prostatic enlargement patients treated with daily administration of 0.5 mg dutasteride. We analyzed serum hormonal levels and aging related symptoms using a validated Aging Male Symptom questionnaire at baseline and after 3 months of dutasteride treatment. Results: The mean total testosterone, free testosterone and luteinizing hormone levels after dutasteride treatment were approximately 20% higher than those at baseline. The percentage increases in total and free testosterone levels were negatively correlated with these baseline levels. Baseline age, levels of total testosterone and free testosterone, and the changes in the rate of luteinizing hormone after dutasteride treatment tended to be correlated with an increase in the rate of total testosterone and free testosterone after dutasteride treatment. In a subgroup of 26 patients with moderate-to-severe aging male symptoms, poor morning erection and free testosterone levels <8.5 pg/mL, total aging male symptoms, and somatic symptoms scores significantly decreased after dutasteride treatment with an increase of total and free testosterone. Conclusions: The increase of endogenous free testosterone and total testosterone by dutasteride might bring additional benefits of improvement of aging male-related symptoms, especially in patients with lower free testosterone baseline levels and moderate-to-poor aging-related symptoms.

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