Details of a Researcher - Oya, Mototsugu

Papers - Oya, Mototsugu

Division display 561 - 580 of about 942 ／ All the affair displays >>

METABOLIC SHIFT UNDER HYPOXIC ENVIRONMENT CAUSES RESISTANCE TO MTOR INHIBITOR IN HUMAN CASTRATION RESISTANT PROSTATE CANCER.

Yasumizu Yota, Kosaka Takeo, Miyazaki Yasumasa, Kikuchi Eiji, Miyajima Akira, Oya Mototsugu

JOURNAL OF UROLOGY 191 ( 4 ) E264 - E264 2014.04

Research paper (scientific journal), Joint Work, ISSN 0022-5347

Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy

Tanaka Nobuyuki, Kikuchi Eiji, Kanao Kent, Matsumoto Kazuhiro, Kobayashi Hiroaki, Ide Hiroki, Miyazaki Yasumasa, Obata Jun, Hoshino Katsura, Shirotake Suguru, Akita Hirotaka, Kosaka Takeo, Miyajima Akira, Momma Tetsuo, Nakagawa Ken, Hasegawa Shintaro, Nakajima Yosuke, Jinzaki Masahiro, Oya Mototsugu

Annals of Surgical Oncology 21 ( 3 ) 1038 - 1045 2014.03

ISSN 1068-9265

Purpose: To investigate the site-specific pattern of disease recurrence and/or metastasis and the associated patient outcomes after radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods: A total of 733 patients with UTUC from a retrospective multi-institutional cohort were included, with a median follow-up of 34 months. Associated patient outcomes were analyzed by multivariate analysis. To evaluate the influence of primary tumor location, we divided it into four areas: renal pelvis, and upper, middle, and lower ureter. Results: A total of 218 patients experienced disease recurrence, with the majority of relapses occurring within the first 3 years. Cumulative incidence rates of first disease recurrence at 1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients, 38.5 % developed distant recurrence; 17.4 % experienced both local and distant recurrences; and 44.0 % developed isolated local recurrence. The predominant sites of distant metastasis were lung, liver, and bone. Multivariate analysis revealed that the prevalence of local recurrence and lung metastasis was significantly associated, with primary tumor location being independent of other clinicopathological variables. Lower/middle ureter tumors had a higher rate of local recurrence in the pelvic cavity, and renal pelvic tumors had a higher prevalence of distant relapse in the lungs. Similar results were obtained when rerunning the data set by excluding patients who received adjuvant chemotherapy (n = 131). Conclusions: This multi-institutional study provided a detailed picture of metastatic behavior after RNU, and primary tumor locations were associated with unique patterns of metastatic spread in UTUC patients.

Access to Document (DOI)

Metastatic Behavior of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy: Association with Primary Tumor Location

ANNALS OF SURGICAL ONCOLOGY 21 ( 3 ) 1038 - 1045 2014.03

Research paper (scientific journal), Joint Work, ISSN 1068-9265

Access to Document (DOI)

Sunitinib versus sorafenib as first-line therapy for patients with metastatic renal cell carcinoma with favorable or intermediate MSKCC risk factors: A multicenter randomized trial, CROSS-J-RCC.

Tomita Yoshihiko, Naito Sei, Sassa Naoto, Takahashi Atsushi, Kondo Tsunenori, Koie Takuya, Obara Wataru, Kobayashi Yasuyuki, Teishima Jun, Takahashi Masayuki, Matsuyama Hideyasu, Ueda Takeshi, Yamaguchi Kenya, Kishida Ken, Shiroki Ryoichi, Saika Takashi, Nobuo Shinohara, Oya Mototsugu, Kanayama Hiro-Omi

JOURNAL OF CLINICAL ONCOLOGY 32 ( 4 ) 619 - 624 2014.02

Research paper (scientific journal), Joint Work, ISSN 0732-183X

Multicenter phase II clinical trial of everolimus in Japanese patients with unresectable or metastatic renal cell carcinoma (mRCC) after failure of treatment with first-line tyrosine kinase inhibitor (TKI) therapy

Ozono Seiichiro, Oyama Masafumi, Nozawa Masahiro, Fujimoto Kiyohide, Kishida Ken, Tokuda Noriaki, Kimura Go, Nishimura Kazuo, Matsubara Akio, Matsuyama Hideyasu, Sugiyama Takayuki, Kamba Tomomi, Kume Haruki, Masumori Naoya, Oya Mototsugu, Kanayama, Hiro-Omi, Naito, Seiji, Hinotsu, Shiro, Shimozuma, Kojiro, Akaza, Hideyuki

JOURNAL OF CLINICAL ONCOLOGY 32 ( 4 ) 853 - 863 2014.02

Research paper (scientific journal), Joint Work, ISSN 0732-183X

Long term follow-up in patients with initially diagnosed low grade Ta non-muscle invasive bladder tumors

Kobayashi Hiroaki, Kikuchi Eiji, Mikami Shuji, Maeda Takahiro, Tanaka Nobuyuki, Miyajima Akira, Nakagawa Ken, Oya Mototsugu

BMC Urology 14 ( 1 ) 2014.01

Background: We evaluated the clinical outcome of low grade Ta bladder cancer followed-up for a long period using the 2004 WHO grading system. Methods. We retrospectively reviewed 190 patients with primary, low grade Ta bladder cancer. We defined worsening progression (WP) as confirmed high grade Ta, all T1 or Tis/concomitant CIS of bladder recurrence, upper urinary tract recurrence (UTR), or progression to equal to or more than T2. The associations between clinicopathological factors and tumor recurrence as well as WP pattern were analyzed. We also evaluated the late recurrence of 76 patients who were tumor-free for more than 5 years. Results: Tumor recurrence and WP occurred in 82 (43.2%) and 21 (11.1%) patients during follow-up (median follow-up: 101.5 months), respectively. WP to high grade Ta, all T1 or Tis/concomitant CIS was seen in 17 patients, and UTR and progression to equal to or more than T2 were seen in 2 and 2 patients, respectively. Multivariate analyses demonstrated that multiple tumor (p < 0.001, HR: 2.97) and absence of intravesical instillation (IVI) (p < 0.001, HR: 2.88) were significant risk factors for tumor recurrence while multiple tumor was the only risk factor for WP (p = 0.001, HR: 5.26). After a 5-year tumor-free period, 9 patients experienced late recurrence in years 5 and 10 and were diagnosed at a follow-up cystoscopy, however, only 2 patients recurred beyond 10 years and were found by gross hematuria. There were no significant risk factors of late recurrence. Conclusions: Multiple tumor was a risk factor for both tumor recurrence and WP while IVI did not affect the occurrence of WP. Our results suggest that routine follow-up of patients with low grade Ta bladder cancer is needed up to 10 years from the initial diagnosis.

Access to Document (DOI)

The predictive value of positive urine cytology for outcomes following radical nephroureterectomy in patients with primary upper tract urothelial carcinoma

Tanaka Nobuyuki, Kikuchi Eiji, Kanao Kent, Matsumoto Kazuhiro, Shirotake Suguru, Kobayashi Hiroaki, Miyazaki Yasumasa, Ide Hiroki, Obata Jun, Hoshino Katsura, Hayakawa Nozomi, Kosaka Takeo, Oyama Masafumi, Miyajima Akira, Momma Tetsuo, Nakagawa Ken, Jinzaki Masahiro, Nakajima Yosuke, Oya Mototsugu

Urologic Oncology: Seminars and Original Investigations 32 ( 1 ) 2014.01

ISSN 1078-1439

Background and objective: Few studies have addressed the predictive value of positive urine cytology for prognosis in patients with upper tract urothelial carcinoma (UTUC). We investigated whether the status of preoperative urine cytology could provide additional prognostic information following radical nephroureterectomy (RNU). Materials and methods: The study included 474 patients with primary nonmetastatic UTUC (pTa-4N0M0) from a retrospective multi-institutional cohort. The median follow-up period was 35 months. Associations between the status of urine cytologic evaluation and outcomes were analyzed using multivariate Cox regression models. Urine cytology was evaluated preoperatively using voided samples. Disease recurrence was defined as any relapse in nonbladder lesions and was coded separately from intravesical recurrence. Results: Positive urine cytology was detected in 184 patients (38.8%) preoperatively. Disease recurrence occurred in 127 patients, while intravesical recurrence occurred in 219 patients; 83 patients died of UTUC during follow-up. Kaplan-Meier analysis revealed that only the incidence of intravesical recurrence was significantly associated with the status of urine cytologic evaluation (P = 0.024); the intravesical recurrence-free survival rates at 1 and 3 years following RNU were 61.4% and 46.2% in patients with positive urine cytology and 71.1% and 51.6% in their counterparts, respectively. Multivariate analysis showed that gender (hazard ratio [HR] = 1.74, 95% confidence interval [CI]; 1.28-2.43), tumor multifocality in RNU specimens (HR = 1.64, 95% CI; 1.09-2.47), and positive urine cytology (HR = 1.41, 95% CI; 1.08-1.85) were independent risk factors for subsequent intravesical recurrence. Conclusions: The results showed the prognostic value of positive urine cytology in patients with primary UTUC, and preoperative positive urine cytology may be associated with a significant increase in the prevalence of intravesical recurrence following RNU.

Access to Document (DOI)

Occurrence of infection following prostate biopsy procedures in Japan Japanese Research Group for Urinary Tract Infection (JRGU) - A multi-center retrospective study

Togo Yoshikazu, Kubo Tatsuhiko, Taoka Rikiya, Hiyama Yoshiki, Uehara Teruhisa, Hashimoto Jiroh, Kurimura Yuichiro, Takahashi Satoshi, Tsukamoto Taiji, Miyazaki Jun, Nishiyama Hiroyuki, Kira Shinichiro, Kiyota Hiroshi, Yazawa Satoshi, Niwa Naoya, Hongo Hiroshi, Oya Mototsugu, Kato Taku, Yasuda Mitsuru, Deguchi Takashi, Ishikawa Kiyohito, Hoshinaga Kiyotaka, Matsumoto Minort, Shigemura Katsumi, Tanaka Kazushi, Arakawa Soichi, Fujisawa Masato, Wada Koichiro, Uehara Shinya, Watanabe Toyohiko, Kumon Hiromi, Kobayashi Kanao, Matsubara Akio, Matsumoto Masahiro, Sho Takehiko, Hamasuna Ryoichi, Matsumoto Tetsuro, Hayami Hiroshi, Nakagawa Masayuki, Yamamoto Shingo

JOURNAL OF INFECTION AND CHEMOTHERAPY 20 ( 3-4 ) 232 - 237 2014.01

Research paper (scientific journal), Joint Work, ISSN 1341-321X

Access to Document (DOI)

Long term follow-up in patients with initially diagnosed low grade Ta non-muscle invasive bladder tumors: tumor recurrence and worsening progression

Kobayashi Hiroaki, Kikuchi Eiji, Mikami Shuji, Maeda Takahiro, Tanaka Nobuyuki, Miyajima Akira, Nakagawa Ken, Oya Mototsugu

BMC UROLOGY 14 619 - 624 2014.01

Research paper (scientific journal), Joint Work, ISSN 1471-2490

Access to Document (DOI)

The predictive value of C-reactive protein for prognosis in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy

Tanaka Nobuyuki, Kikuchi Eiji, Shirotake Suguru, Kanao Kent, Matsumoto Kazuhiro, Kobayashi Hiroaki, Miyazaki Yasumasa, Ide Hiroki, Obata Jun, Hoshino Katsura, Hayakawa Nozomi, Ito Yujiro, Kosaka Takeo, Kodaira Kiichiro, Oyama Masafumi, Miyajima Akira, Momma Tetsuo, Nakagawa Ken, Ueno Munehisa, Oya Mototsugu

European Urology 65 ( 1 ) 227 - 234 2014.01

ISSN 0302-2838

Background: Few studies have discussed the prognostic impact of serum C-reactive protein (CRP) level in upper tract urothelial carcinoma (UTUC). Objective: To investigate whether the perioperative level of CRP provides additional prognostic information following radical nephroureterectomy (RNU). Design, setting, and participants: A total of 564 patients with UTUC from a retrospective multi-institutional cohort were included. The median follow-up was 32 mo. Intervention: All patients underwent RNU without neoadjuvant chemotherapy, while 106 patients (18.8%) received adjuvant chemotherapy. Outcome measurements and statistical analysis: Associations between perioperative CRP level and outcome were assessed using multivariate analysis. A serum CRP level >0.50 mg/dl was defined as elevated. Results and limitations: Preoperative CRP (pre-CRP) level was elevated in 136 patients (24.1%). Multivariate analysis showed that pre-CRP elevation was an independent predictor of subsequent disease recurrence (hazard ratio [HR]: 1.47 for CRP 0.51-2.00; HR: 1.89 for CRP >2.00). Five-year recurrence-free survival rates were 69.2% in patients with pre-CRP levels ≤0.50 mg/dl, 54.3% in patients with pre-CRP levels between 0.51 and 2.00 mg/dl, and 35.4% in patients with pre-CRP levels >2.00 mg/dl (p < 0.001). Similar results were found in cancer-specific mortality, showing that pre-CRP elevation was an independent predictor of worse outcome (HR: 1.74 for CRP 0.51-2.00; HR: 2.31 for CRP >2.00). In a subgroup analysis of the elevated pre-CRP group, postoperative normalisation of CRP level was an independent predictor of better outcome. This study is limited by its retrospective nature as well as its heterogeneous group of patients and variable follow-up protocols resulting from the multi-institution design. Conclusions: Serum CRP may become a possible biomarker in UTUC, suggesting that patients with an elevated pre-CRP level could be predicted to have subsequent disease recurrence and cancer-specific mortality, while postoperative normalisation of CRP level was an independent predictor for prognosis.

Access to Document (DOI)

Dual PI3K/mTOR inhibitor NVP-BEZ235 sensitizes docetaxel in castration resistant prostate cancer

Yasumizu Yota, Miyajima Akira, Kosaka Takeo, Miyazaki Yasumasa, Kikuchi Eiji, Oya Mototsugu

Journal of Urology 191 ( 1 ) 227 - 234 2014.01

ISSN 0022-5347

Purpose: Effective therapeutic strategies that can achieve long-term improvement in patients with castration resistant prostate cancer are urgently needed. We recently reported that the activated PI3K/Akt/mTOR signaling pathway induced by docetaxel explains resistance to docetaxel in castration resistant prostate cancer. In this study we explored the efficacy of NVP-BEZ235, a dual PI3K and mTORC1/2 inhibitor, for docetaxel resistant castration resistant prostate cancer. Materials and Methods: We used the 2 human castration resistant prostate cancer cell lines C4-2 and C4-2AT6. At our laboratory C4-2AT6 cells were established from C4-2 under androgen ablated treatment for 6 months. We investigated the efficacy of NVP-BEZ235 monotherapy and NVP-BEZ235 combined with docetaxel in vitro and in vivo. Results: Increased phosphorylated Akt in C4-2AT6 cells was significantly inhibited by NVP-BEZ235 in a dose and time dependent manner. WST cell proliferation assay results in C4-2AT6 cells revealed that combined administration of NVP-BEZ235 and docetaxel had significant, synergistically greater cytotoxicity than NVP-BEZ235 or docetaxel monotherapy. Combined NVP-BEZ235 (40 mg/kg) and docetaxel (4 mg/kg) in vivo in a castrated mouse xenograft model inhibited C4-2AT6 tumor growth to a greater degree than in the monotherapy groups. Also, NVP-BEZ235 showed significant efficacy with docetaxel at a low concentration in vivo, suggesting that NVP-BEZ235 effectively decreased resistance to docetaxel. Conclusions: Results suggest that inhibition of the PI3K/Akt/mTOR signaling pathway by NVP-BEZ235 can overcome docetaxel resistance in human castration resistant prostate cancer. Our findings provide a molecular basis for the clinical use of combined administration of NVP-BEZ235 and docetaxel in patients with castration resistant prostate cancer.

Access to Document (DOI)

New year's greetings

Oya Mototsugu

International Journal of Urology 21 ( 1 ) 1 2014.01

ISSN 0919-8172

Access to Document (DOI)

Renal angiomyolipoma

Jinzaki Masahiro, Silverman Stuart G., Akita Hirotaka, Nagashima Yoji, Mikami Shuji, Oya Mototsugu

Abdominal Imaging 39 ( 3 ) 588 - 604 2014

ISSN 0942-8925

Angiomyolipoma is the most common benign solid renal neoplasm observed in clinical practice. Once thought to be a hamartoma and almost always diagnosed by the imaged-based detection of fat, angiomyolipomas are now known to consist of a heterogeneous group of neoplasms. Although all are considered perivascular epithelioid cell tumors, many display different pathology, imaging features, and clinical behavior. The importance of understanding this group of neoplasms is emphasized by the fact that many types of angiomyolipoma contain little to no fat, and despite being benign, sometimes escape a pre-operative diagnosis. These types of angiomyolipomas can all be considered when encountering a renal mass that is both hyperattenuating relative to renal parenchyma on unenhanced CT and T2-hypointense, features that reflect their predominant smooth muscle component. We review recent developments and provide a radiological classification of angiomyolipomas that helps physicians understand the various types and learn how to both diagnose and manage them.

Access to Document (DOI)

Invasion and metastasis of renal cell carcinoma

Mikami Shuji, Oya Mototsugu, Mizuno Ryuichi, Kosaka Takeo, Katsube Ken Ichi, Okada Yasunori

Medical Molecular Morphology 47 ( 2 ) 63 - 67 2014

ISSN 1860-1480

Renal cell carcinoma (RCC) represents over 80 % of kidney cancer, and about 30 % of the patients with RCC develop metastasis after the surgery. Invasion of basement membrane (BM) and extracellular matrix (ECM) is an essential event in tumor invasion and metastasis. Matrix metalloproteinases (MMPs), which digest the main components of BM and ECM, are expressed in RCC. Heparanase, which degrades heparan sulfate proteoglycans, is predominantly expressed in high-grade RCCs with a positive correlation with pathological tumor stage and poor prognosis. Bone metastasis is common among the patients with RCC, and increased osteoclastic activity was observed at metastatic sites. Receptor activator of nuclear factor κB ligand (RANKL), which plays an important role in osteoclastogenesis, is predominantly expressed in high-grade RCC and its expression level is associated with bone metastasis and prognosis. Epithelial-mesenchymal transition (EMT), a switch of epithelial cells to sarcomatoid phenotype, is considered to be critical step during metastasis, and Snail, a major regulator of EMT, is predominantly expressed in high-grade RCC, and high Snail expression is a worse prognostic factor. Accordingly, heparanase, RANKL and Snail may be targets for the development of anti-tumor therapies for RCCs.

Access to Document (DOI)

Renal arteriolar injury by salt intake contributes to salt memory for the development of hypertension

Oguchi Hideyo, Sasamura Hiroyuki, Shinoda Kazunobu, Morita Shinya, Kono Hidaka, Nakagawa Ken, Ishiguro Kimiko, Hayashi Kaori, Nakamura Mari, Azegami Tatsuhiko, Oya Mototsugu, Itoh Hiroshi

Hypertension 64 ( 4 ) 784 - 791 2014

ISSN 0194-911X

The role of salt intake in the development of hypertension is prominent, but its mechanism has not been fully elucidated. Our aim was to examine the effect of transient salt intake during the prehypertensive period in hypertensive model animals. Dahl salt-sensitive rats and spontaneously hypertensive rats were fed from 6 to 14 weeks with lowsalt (0.12% NaCl), normal-salt (0.8% NaCl), high-salt (7% NaCl), or high-sodium/normal-chloride diet and returned to normal-salt diet for 3 months. Rats in the high-salt group saw elevations in blood pressure (BP) not only during the treatment period but also for the 3 months after returning to normal-salt diet. We named this phenomenon salt memory. Renal arteriolar injury was found in the high-salt group at the end of experiment. Dahl salt-sensitive rats were fed from 6 to 14 weeks with high-salt diet with angiotensin receptor blocker, vasodilator, calcium channel blocker, and calcium channel blocker+angiotensin receptor blocker and returned to normal-salt diet. Although BP was suppressed to control levels by vasodilator or calcium channel blocker, elevated renal angiotensin II and renal arteriolar injury were observed, and salt memory did not disappear because of sustained renal arteriolar injury. Calcium channel blocker+angiotensin receptor blocker suppressed renal arteriolar injury, resulting in the disappearance of salt memory. Cross-transplantation of kidneys from Dahl salt-sensitive rats on high salt to control rats caused increase of BP, whereas control kidneys caused reduction in BP of hypertensive rats, inducing the central role of the kidney. These results suggest that renal arteriolar injury through BP and renal angiotensin II elevation plays important roles in the development of salt memory for hypertension.

Access to Document (DOI)

Individualized prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men

Kanao Kent, Komori Osamu, Nakashima Jun, Ohigashi Takashi, Kikuchi Eiji, Miyajima Akira, Nakagawa Ken, Eguchi Shinto, Oya Mototsugu

Japanese Journal of Clinical Oncology 44 ( 9 ) 852 - 859 2014

ISSN 0368-2811

Objective: To individualize prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. Methods: A total of 406 men aged over 70 years old with prostate-specific antigen levels between 4.0 and 20.0 ng/ml, normal digital rectal examination results and diagnosed by transrectal needle biopsy were retrospectively analyzed. The patients were divided into a no/favorable-risk cancer group or an unfavorable-risk cancer group based on their Gleason score and the number of positive cores. Prostate-specific antigen levels, percent free prostate specific antigen level, prostate transition zone volume and the number of previous biopsies were used to discriminate between the two groups.The optimal individualized prostate-specific antigen threshold values based on the other variables that gave a sensitivity of 95% for the detection of unfavorable-risk cancer were calculated using a boosting method for maximizing the area under the receiver operating characteristic curve. Results: A total of 66 men had favorable-risk cancer, and 139 had unfavorable-risk cancer. The area under the receiver operating characteristic curve of the combination model determined by the boosting method for maximizing the area under the receiver operating characteristic curve was 0.852. The sensitivity and specificity of the threshold values for the detection of unfavorable-risk cancer were 95 and 36%, respectively. By using the threshold values, 100 (25%) of the subjects with no/favorable-risk cancer could have avoided undergoing biopsies, with a <5% risk of missing the detection of unfavorable-risk cancer. Conclusions: These individualized prostate-specific antigen threshold values may be useful for determining an indication of prostate biopsy for elderly men to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy.

Access to Document (DOI)

Optimal timing of hormonal therapy for prostate-specific antigen recurrence after radical prostatectomy

Matsumoto Kazuhiro, Mizuno Ryuichi, Tanaka Nobuyuki, Ide Hiroki, Hasegawa Masanori, Ishida Masaru, Hayakawa Nozomi, Yasumizu Yota, Hagiwara Masayuki, Hara Satoshi, Kikuchi Eiji, Miyajima Akira, Nakagawa Ken, Nakajima Yosuke, Nakamura So, Nakashima Jun, Oya Mototsugu

Medical Oncology 31 ( 7 ) 2014

ISSN 1357-0560

The present study was undertaken to examine biochemical progression in patients who received salvage hormonal therapy (HT) for biochemical disease recurrence (BCR) after radical prostatectomy (RP), and to determine the optimal timing for the administration of HT. The study population consisted of 156 patients who underwent RP and received salvage HT for BCR. The starting point of this study was the timing of RP, and the endpoint was biochemical prostate-specific antigen (PSA) progression (castration-resistance) after HT. The mean follow-up period after surgery was 8.1 years. First, we excluded 18 patients with persistent PSA (≥0.2 ng/mL) after RP from an analysis below because their prognoses were significantly poorer compared with 138 patients whose PSA nadirs had reached <0.2 ng/mL. Multivariate analysis demonstrated that Gleason score ≥8 (p = 0.010, hazard ratio (HR) 3.02), and PSA doubling time (PSA-DT) <6 months (p = 0.001, HR 7.39) was independently associated with subsequent biochemical progression after HT. Using these two variables (Gleason score and PSA-DT), we could stratify patients into three risk groups for BCR after salvage HT. Regarding the optimal timing for HT administration for these high-risk patients with both risk factors (relative risk = 22.3), the PSA cutpoint of 1.0 ng/mL at the initiation of HT showed a significant difference in progression-free survival rates (p = 0.023). The findings indicated that for high-risk patients, salvage HT for BCR after PSA nadir (<0.2 ng/mL) should be started before the PSA level exceeds 1.0 ng/mL; otherwise, there is a significant risk of subsequent biochemical progression after HT.

Access to Document (DOI)

Clinical characteristics and outcomes of congenital midureteral stricture detected by fetal ultrasonography

Ogihara Koichiro, Yazawa Satoshi, Asanuma Hiroshi, Takamatsu Kimiharu, Masuda Aya, Yasumizu Yota, Sato Hiroyuki, Matsui Zenichi, Muramatsu Masaki, Kono Hidaka, Mizuno Ryuichi, Oya Mototsugu

Japanese Journal of Urology 105 ( 3 ) 122 - 128 2014

ISSN 0021-5287

(Objectives) Congenital midureteral stricture (CMS), which develops from obstructive lesion between pyeloureteral junction and ureterovesical junction, is relatively rare and its clinical condition and therapeutic strategy have not yet been established. We analyzed the clinical characteristics and surgical outcomes of CMS. (Patients and methods) From November 2006 to December 2012, out of 137 patients presented with congenital hy-drohephrosis, we identified 4 pediatric patients diagnosed with CMS at our institutions. We retrospectively investigated clinical characteristics and surgical outcomes in these 4 patients. (Results) Three boys and one girl were identified in this study. All patients were detected hydronephrosis by fetal ultrasonography. The median age at the diagnosis of CMS was 1 year and 11 months. Three patients had obstructive lesion in left side and 1 patient in right CMSs were located at the level of L4 in 2 patients, and at the level of L5 and SI in each 1. Split renal function was decreased less than 45% in 3 of 4 patients. Ipsilateral pyeloureteral junction obstruction and ipsilateral hypoplastic kidney were identified in 2 and 1 patient respectively. One patient developed urosepsis and underwent nephrostomy. Partial ureterectomy and ureteroureterostomy, pyeloplasty were performed in 3 and 1 patient respectively. Extrinsic obstruction was detected in just 1 patient intraoperatively. In all patients, there were no protruded lesion and atrophied, fibrotic and ischemic muscles were not detected in pathological finding. Neither urinary tract infection nor recurrence of obstructive lesion was detected in all patients at the mean follow-up period of 3 years and 1 month. (Conclusion) We analyzed the clinical characteristics of 4 pediatric patients with CMS. In order to prevent critical infection and maintain renal function, it could be considered that surgical intervention is undertaken just after making the diagnosis of CMS.

Investigation of the management and risk of febrile neutropenia associated with chemotherapy in the urological field

Wada Koichiro, Tanimoto Ryuta, Nose Hiroyuki, Uehara Shinya, Watanabe Toyohiko, Hayami Hiroshi, Nagai Shingo, Yasuda Mitsuru, Deguchi Takashi, Shigeta Keisuke, Yazawa Satoshi, Kikuchi Eiji, Oya Mototsugu, Hashimoto Jiro, Uehara Teruhisa, Kurimura Yuichiro, Hiyama Yoshiki, Takahashi Satoshi, Tsukamoto Taiji, Sho Takehiko, Hamasuna Ryoichi, Miyazaki Jun, Togo Yoshikazu, Taoka Rikiya, Nakao Atsushi, Yamamoto Shingo, Kobayashi Kanao, Matsubara Akio, Ishikawa Kiyohito, Kumon Hiromi, Matsumoto Tetsuro

Japanese Journal of Chemotherapy 62 ( 3 ) 374 - 381 2014

ISSN 1340-7007

In Japan, chemotherapy for urogenital malignant diseases is commonly performed by urologists and febrile neutropenia (FN) is one of the major adverse events associated with chemotherapy, however, few reports exist from the urological field about FN. In this present study, a total of 883 courses of chemotherapy (326 patients) performed from 2010 to 2011 at 10 University Hospitals were retrospectively reviewed. The regimens were GC (gemcitabine and cisplatin), GCP (gemcitabine, cisplatin and paclitaxel) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) for urothelial carcinoma, and EP (etoposide and cisplatin) and BEP (bleomycin, etoposide and cisplatin) for testicular cancer. In 81 courses (9.2%, 66 patients; 20.2%) including FN, antimicrobials and granulocyte-colony stimulating factor (G-CSF) were administered in 69 courses (85.2%) and in 77 courses (95.1%), respectively. The MASCC risk-index score was evaluated in no more than 51 courses (63.0%) and 1 patient with 18 points on the MASCC score died due to myelotoxicity and infections. According to statistical investigations, FN is significantly more frequent in GCP and M-VAC than in GC (p = 0.0073, <0.0001) and in a similar manner in BEP than in EP (p = 0.0405). In patients with afebrile neutropenia (AN), observed in 232 courses (26.3%), antimicrobials and G-CSF were administered in 5 courses (2.2%) and in 144 courses (62.1%), respectively. Further evidence from the urological field is required to investigate the treatment and risk of FN for management of patients with urogenital malignancies.

Prognostic value of preoperative multiparametric magnetic resonance imaging (MRI) for predicting biochemical recurrence after radical prostatectomy

Hattori Seiya, Kosaka Takeo, Mizuno Ryuichi, Kanao Kent, Miyajima Akira, Yasumizu Yota, Yazawa Satoshi, Nagata Hirohiko, Kikuchi Eiji, Mikami Shuji, Jinzaki Masahiro, Nakagawa Ken, Tanimoto Akihiro, Oya Mototsugu

BJU International 113 ( 5 ) 741 - 747 2014

ISSN 1464-4096

Objective To evaluate the suitability of preoperative multiparametric magnetic resonance imaging (MRI) positivity as a predictor of biochemical recurrence after radical prostatectomy (RP). Patients and Methods We reviewed the clinical records of patients who underwent either standard RP or laparoscopic RP between January 2005 and December 2009 at our institution. Patients who received radiotherapy or androgen deprivation therapy before surgery were excluded. A total of 314 patients met the study inclusion criteria. Cox proportional hazard regression models were used for analyses. In accordance with the criteria in the established guidelines, a radiologist scored the probability of the presence of prostate cancer using a five-point scale of diagnostic confidence level. The highest confidence level of any pulse sequence was considered as the evaluation result. Results MRI positivity was significantly associated with a high clinical stage (cT ≥ 2; P = 0.039), a high positive biopsy core rate (≥0.2; P < 0.001), a high biopsy Gleason score ([GS] ≥8; P < 0.001) and a high pathological GS (≥8; P = 0.005). Univariate analysis and multivariate analysis showed that MRI positivity was a prognostic indicator in the analysis that included only preoperative variables and also in the analysis including preoperative and pathological variables. Conclusion Multiparametric MRI positivity can independently predict biochemical recurrence after RP.

Access to Document (DOI)

　 Previous page - Next page 　