記述言語：英語   掲載種別：研究論文（学術雑誌）  

Studies have reported the relevance of immune phenotype, or presence of cluster of differentiation 8 (CD8)-positive tumour-infiltrating lymphocytes, to the anti-tumour efficacy of checkpoint inhibitors and to prognosis. The multicentre, retrospective ARCHERY study (UMIN000034131) collected tissue samples from Japanese patients with recurrent or metastatic renal cell carcinoma (RCC) who received systemic therapy between 2010 and 2015. In this exploratory analysis, the prognostic impact of immune phenotype and PD-L1 expression (separately and combined) was investigated using 770 surgical specimens and outcomes from patients enrolled in ARCHERY. A key objective was to determine overall survival (OS), defined as time from nephrectomy to death from any cause, by immune and PD-L1 subgroups. The median OS by immune phenotype was 28.8, 57.3, and 63.4 months in patients with inflamed, excluded, and desert tumours, respectively [hazard ratio (95% CI): inflamed 1.78 (1.27-2.49); excluded 1.08 (0.89-1.30); desert as reference]. PD-L1 positivity by SP142 showed a strong association with immune phenotype; 88.1%, 61.9%, and 8.7% of PD-L1-positive patients had inflamed, excluded, and desert phenotypes, respectively. PD-L1 positivity was also associated with worse OS in each phenotype, except for the inflamed phenotype (due to limited sample size in the PD-L1-negative immune inflamed subgroup; n=7). Additionally, the difference in OS by PD-L1 status was larger in the desert versus excluded phenotype [median OS in PD-L1 positive vs negative: 27.1 vs 67.2 months (desert), and 48.2 vs 78.1 months (excluded)]. Results show that PD-L1 expression was highly associated with immune phenotype, but both covariates should be evaluated when determining prognosis.

DOI： 10.1016/j.pathol.2022.07.013

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: More patients with renal cell carcinoma are now diagnosed with the disease in its early stages. Although patients with pT1a renal cell carcinoma have a good prognosis and low recurrence rate, a few patients still experience recurrence. Herein, we evaluated the clinicopathological risk factors for postoperative recurrence of pT1aN0M0 renal cell carcinoma. METHODS: An renal cell carcinoma survey was conducted by the Japanese Urological Association to register newly diagnosed cases of renal cell carcinoma. A total of 1418 patients diagnosed with pT1aN0M0 renal cell carcinoma who underwent surgery as the primary surgical treatment were included. We analyzed the recurrence-free survival using the Kaplan-Meier method and clinicopathological factors for recurrence using Cox proportional hazards models. RESULTS: Among 1418 patients, 58 (4.1%) had recurrences after a median follow-up of 62.8 months. The median time to recurrence was 31.0 months. Metastases to the lungs and the bone were observed in 20 and 10 cases, respectively. Significant differences in sex, tumor size, Eastern Cooperative Oncology Group performance status, and dialysis history, preoperative hemoglobin levels, C-reactive protein levels and creatinine levels were observed between the recurrence and non-recurrence groups. Multivariate analysis identified male sex, high C-reactive protein level and tumor size ≥3 cm as independent risk factors. The 5-year recurrence-free survival of patients with 0, 1, 2 and 3 risk factors was 99.0, 97.2, 93.1 and 80.7%, respectively. CONCLUSIONS: Male sex, tumor diameter and a high C-reactive protein level were independent recurrence risk factors for pT1a renal cell carcinoma; special attention should be paid to patients with these risk factors during postoperative follow-up.

DOI： 10.1093/jjco/hyab201

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Accurate prostate cancer screening is imperative for reducing the risk of cancer death. Ultrasound imaging, although easy, tends to have low resolution and high inter-observer variability. Here, we show that our integrated machine learning approach enabled the detection of pathological high-grade cancer by the ultrasound procedure. Our study included 772 consecutive patients and 2899 prostate ultrasound images obtained at the Nippon Medical School Hospital. We applied machine learning analyses using ultrasound imaging data and clinical data to detect high-grade prostate cancer. The area under the curve (AUC) using clinical data was 0.691. On the other hand, the AUC when using clinical data and ultrasound imaging data was 0.835 (p = 0.007). Our data-driven ultrasound approach offers an efficient tool to triage patients with high-grade prostate cancers and expands the possibility of ultrasound imaging for the prostate cancer detection pathway.

DOI： 10.1038/s41598-022-04951-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In the phase III open-label KEYNOTE-426 (NCT02853331) study, first-line pembrolizumab and axitinib improved overall survival (OS) and progression-free survival (PFS) versus sunitinib for metastatic renal cell carcinoma (mRCC). KEYNOTE-426 evaluated patients enrolled from 25 sites in Japan. METHODS: Patients enrolled in Japan were included in this post hoc subgroup analysis. Adults with clear cell mRCC were randomly assigned 1:1 to receive intravenous pembrolizumab 200 mg every 3 weeks plus oral axitinib 5 mg twice daily or oral sunitinib 50 mg once daily (4 weeks on/2 weeks off). Dual primary endpoints were OS and PFS as assessed by blinded independent central review. Objective response rate (ORR) and safety were secondary endpoints. RESULTS: The Japanese subgroup comprised 94 patients (pembrolizumab-axitinib, n = 44; sunitinib, n = 50; 11% of the intent-to-treat population). Median time from randomization to data cutoff (January 6, 2020) was 29.5 months (range 24.6-37.3). Consistent with the intent-to-treat population, the OS, PFS, and ORR suggested improvement with pembrolizumab-axitinib versus sunitinib in the Japanese subgroup. Grade ≥ 3 treatment-related adverse events (TRAEs) occurred in 70% of patients receiving pembrolizumab-axitinib versus 78% receiving sunitinib; 11 (25%) patients receiving pembrolizumab-axitinib and 13 (27%) patients receiving sunitinib discontinued the study medication due to AEs. TRAEs led to the discontinuation of pembrolizumab, axitinib, pembrolizumab-axitinib, or sunitinib in 32%, 34%, 14%, and 20%, respectively. No deaths from TRAEs occurred. CONCLUSIONS: Efficacy outcomes for the Japanese subgroup were consistent with those of the global population. Safety in Japanese patients was consistent with the results from the global population.

DOI： 10.1007/s10147-021-02014-7

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

添付ファイル： pazopanib論文.pdf

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oxford University Press (OUP)  

<title>Abstract</title>
<sec>
<title>Background</title>
We performed subgroup analyses of the AFTER I-O study to clarify the association of time-to-treatment failure (TTF) and discontinuation reason of prior immune-oncology (I-O) therapy, and molecular targeted therapy (TT) regimen with the outcomes of TT after I-O.


</sec>
<sec>
<title>Methods</title>
The data of Japanese metastatic renal cell carcinoma patients treated with TT after nivolumab (NIVO) (CheckMate 025) or NIVO + ipilimumab (IPI) (CheckMate 214) were retrospectively analyzed. The objective response rates (ORRs), progression-free survival (PFS) and overall survival (OS) of TT after I-O were analyzed by subgroups: TTF (&amp;lt;6 or ≥6 months) and discontinuation reason of prior I-O (progression or adverse events), and TT regimen (sunitinib or axitinib). We also analyzed PFS2 of prior I-O and OS from first-line therapy.


</sec>
<sec>
<title>Results</title>
The ORR and median PFS of TT after NIVO and NIVO+IPI among the subgroups was 17–36% and 20–44%, and 7.1–11.6 months and 16.3-not reached (NR), respectively. The median OS of TT after NIVO was longer in patients with longer TTF of NIVO and treated with axitinib. Conversely, median OS of TT after NIVO+IPI was similar among subgroups. The median PFS2 of NIVO and NIVO+IPI was 36.7 and 32.0 months, respectively. The median OS from first-line therapy was 70.5 months for patients treated with NIVO and NR with NIVO+IPI. The safety profile of each TT after each I-O was similar to previous reports.


</sec>
<sec>
<title>Conclusions</title>
The efficacy of TT after NIVO or NIVO+IPI was favorable regardless of the TTF and discontinuation reason of prior I-O, and TT regimen.


</sec>

添付ファイル： Subgroup analysis of the AFTER I-O study a retrospective study on the efficacy and safety of subsequent molecular targeted therapy after immune-oncology therapy in Japanese patients with metastatic renal cell carcinoma.pdf

DOI： 10.1093/jjco/hyab114

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

INTRODUCTION: TAS-115 is an oral multikinase inhibitor targeting the MET proto-oncogene, vascular endothelial growth factor receptor, and colony-stimulating factor 1 receptor. We evaluated the efficacy and safety of TAS-115 in castration-resistant prostate cancer (CRPC) patients with bone metastases. PATIENTS AND METHODS: This phase II study, conducted in Japan, comprised 2 cohorts of CRPC patients. Cohort A included patients with bone metastasis and no history of docetaxel; TAS-115 200 to 400 mg/d was administered with abiraterone and prednisone. Cohort B included patients with symptomatic multiple bone metastases, post- or unfit for docetaxel, randomized 1:1 to receive TAS-115 400 or 600 mg/d orally, once daily, in a repeated weekly schedule of 5 days on/2 days off. The primary endpoint was bone scan index (BSI) response rate at Week 12 in each dose group. RESULTS: Cohorts A and B included 24 and 26 patients, respectively. The 12-week BSI response rates for 200, 300, and 400 mg were 0%, 33.3%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 25.0% in Cohort B. The best BSI response rates for 200, 300, and 400 mg were 0%, 66.7%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 33.3% in Cohort B. A ≥ 30% reduction in BPI-SF score was shown in 57.7% of patients in Cohort B. The most frequent Grade ≥ 3 adverse drug reactions were hypophosphatemia (20.8%) in Cohort A and anemia (23.1%) in Cohort B. CONCLUSION: TAS-115 appears to demonstrate anti-tumor activity and acceptable tolerability in CRPC patients with bone metastases.

添付ファイル： A Phase 2, Randomized, Open-Label, Multi-arm Study of TAS-115 for Castration-Resistant Prostate Cancer Patients With Bone Metastases.pdf

DOI： 10.1016/j.clgc.2021.07.013

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

添付ファイル： iju.14568.pdf

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oxford University Press (OUP)  

OBJECTIVES: Guidelines for treatment of mRCC recommend nivolumab monotherapy (NIVO) for treated patients, and nivolumab plus ipilimumab combination therapy (NIVO+IPI) for untreated IMDC intermediate and poor-risk mRCC patients. Although molecular-targeted therapies (TTs) such as VEGFR-TKIs and mTORi are recommended as subsequent therapy after NIVO or NIVO+IPI, their efficacy and safety remain unclear. METHODS: Outcome of Japanese patients with mRCC who received TT after NIVO (CheckMate 025) or NIVO+IPI (CheckMate 214) were retrospectively analyzed. Primary endpoints were investigator-assessed ORR of the first TT after either NIVO or NIVO+IPI. Secondary endpoints included TFS, PFS, OS and safety of TTs. RESULTS: Twenty six patients in CheckMate 025 and 19 patients in CheckMate 214 from 20 centers in Japan were analyzed. As the first subsequent TT after NIVO or NIVO+IPI, axitinib was the most frequently treated regimen for both CheckMate 025 (54%) and CheckMate 214 (47%) patients. The ORRs of TT after NIVO and NIVO+IPI were 27 and 32% (all risks), and median PFSs were 8.9 and 16.3 months, respectively. During the treatment of first TT after either NIVO or NIVO+IPI, 98% of patients experienced treatment-related adverse events, including grade 3-4 events in 51% of patients, and no treatment-related deaths occurred. CONCLUSIONS: TTs have favorable antitumor activity in patients with mRCC after ICI, possibly via changing the mechanism of action. Safety signals of TTs after ICI were similar to previous reports. These results indicate that sequential TTs after ICI may contribute for long survival benefit.

添付ファイル： Efficacy and safety of subsequent molecular targeted therapy after immuno-checkpoint therapy, retrospective study of Japanese patients with metastatic renal cell carcinoma (AFTER I-O study).pdf

DOI： 10.1093/jjco/hyaa266

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: ERA 223 compared concurrent abiraterone acetate/prednisolone (AAP) plus radium-223 with AAP plus placebo in men with chemotherapy-naïve asymptomatic or mildly symptomatic metastatic castration-resistant prostate cancer (mCRPC) and bone metastases. We report data from a subgroup of Japanese patients in ERA 223. METHODS: Patients were randomized to radium-223 (55 kBq/kg) or placebo once every 4 weeks (max. 6 cycles), and also received oral abiraterone acetate 1000 mg once daily plus prednisone/prednisolone 5 mg twice daily during and after radium-223/placebo treatment, until a symptomatic skeletal event (SSE). The primary endpoint was SSE-free survival (SSE-FS); overall survival (OS) was a secondary endpoint. RESULTS: Of 806 patients randomized in ERA 223, 114 patients (57 per arm) were enrolled in Japan. SSE-FS was not improved significantly in the radium-223 arm [25.5 months, 95% CI 20.6-not estimated (NE)] compared with the placebo arm (28.7 months, 95% CI 19.7-NE) (HR = 0.907, 95% CI 0.501-1.642). OS and other secondary endpoints were not improved significantly in the radium-223 arm. The incidence of fracture was 23% and 11% in the radium-223 and placebo arms, respectively. The incidence of death was 32% and 36%, respectively. CONCLUSIONS: In the Japanese ERA 223 subgroup, concurrent treatment with AAP and radium-223 did not significantly improve SSE-FS and increased the incidence of fracture, similar to outcomes achieved in the overall population, while an increased incidence of death was not evident. The combination of radium-223 with AAP is not recommended in Japanese patients with asymptomatic or mildly symptomatic mCRPC and bone metastases. CLINICAL TRIAL REGISTRATION: Clinical trial registration no: NCT02043678.

DOI： 10.1007/s10147-019-01589-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Nivolumab plus ipilimumab (NIVO+IPI) demonstrated superior efficacy over sunitinib (SUN) for previously untreated advanced renal cell carcinoma (aRCC) in CheckMate 214, with a manageable safety profile. We report efficacy and safety with extended follow-up amongst Japanese patients. METHODS: CheckMate 214 patients received NIVO (3 mg/kg) plus IPI (1 mg/kg) every 3 weeks for four doses, then NIVO (3 mg/kg) every 2 weeks; or SUN (50 mg) once daily for 4 weeks (6-week cycle). This subgroup analysis assessed overall survival (OS), objective response rate (ORR) and progression-free survival (PFS) per investigator in International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) intermediate/poor-risk and intent-to-treat (ITT) patients and safety (ITT patients). RESULTS: Of 550 and 546 patients randomized to NIVO+IPI and SUN, 38 and 34, respectively, were Japanese. Of these, 31 (NIVO+IPI) and 29 (SUN) patients were IMDC intermediate/poor-risk. In IMDC intermediate/poor-risk patients with 30 months' minimum follow-up, there was a delayed trend in OS benefit with NIVO+IPI (hazard ratio [HR] 0.56; 95% confidence interval [CI]: 0.19-1.59; P = 0.2670), and 24-month OS probability favoured NIVO+IPI (84%) versus SUN (76%). The ORR was 39% with NIVO+IPI and 31% with SUN (P = 0.6968). PFS was similar in both treatment arms (HR 1.17; 95% CI: 0.62-2.20; P = 0.6220). Efficacy in ITT patients was similar to IMDC intermediate/poor-risk patients. Grade 3-4 treatment-related adverse event incidence was lower with NIVO+IPI versus SUN (58 versus 91%). CONCLUSIONS: Japanese patients with untreated aRCC in the NIVO+IPI arm had a numerically higher ORR and improved safety profile versus patients in the SUN arm. A delayed OS benefit appears to be emerging with NIVO+IPI. Longer follow-up is needed. https://clinicaltrials.gov/ct2/show/NCT02231749?term=NCT02231749&rank=1 identifier: NCT02231749.

添付ファイル： Nivolumab plus ipilimumab versus sunitinib in previously untreated advanced renal-cell carcinoma analysis of Japanese patients in CheckMate 214 with extended follow-up..pdf

DOI： 10.1093/jjco/hyz132

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Deep learning algorithms have been successfully used in medical image classification. In the next stage, the technology of acquiring explainable knowledge from medical images is highly desired. Here we show that deep learning algorithm enables automated acquisition of explainable features from diagnostic annotation-free histopathology images. We compare the prediction accuracy of prostate cancer recurrence using our algorithm-generated features with that of diagnosis by expert pathologists using established criteria on 13,188 whole-mount pathology images consisting of over 86 billion image patches. Our method not only reveals findings established by humans but also features that have not been recognized, showing higher accuracy than human in prognostic prediction. Combining both our algorithm-generated features and human-established criteria predicts the recurrence more accurately than using either method alone. We confirm robustness of our method using external validation datasets including 2276 pathology images. This study opens up fields of machine learning analysis for discovering uncharted knowledge.

DOI： 10.1038/s41467-019-13647-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

Background: Various devices for isolating and detecting circulating tumor cells (CTCs) have been developed, whereas the CellSearch® system has been clinically used in numerous prostate CTC studies. CTCs might become more useful surrogate markers of prostate cancer, and they should be measured in all settings, but a smaller, low-cost CTC capture system is required. Methods: An inexpensive and highly sensitive microfluidic CTC-capture polymeric chip, developed by the Toyama Industrial Technology Center, as described in the following text, was used to assess the number of CTCs from patients with metastatic prostate cancer. After verifying that cultured human prostate cancer cells (PC3 and LNCaP) could be captured with the chip coated with anti-epithelial cell adhesion molecule (CD326) antibody, whole blood samples of 14 patients with prostate cancer were screened. Results: The average capture efficacy of PC3 cells was 94.60% in phosphate-buffered saline (PBS) and 83.82% in whole blood. The average capture efficacy of LNCaP cells was 82.73% in PBS and 75.78% in whole blood. CTCs were detected by the chip device in all 14 patients with metastatic prostate cancer using 2-mL blood samples. Although fewer CTCs were detected in patients with oligometastases, all patients with multiple distant metastases had CTCs. The average CTC count was 48 cells/mL (range 1-81 cells/mL). Conclusion: This CTC-chip will be able to capture CTCs and be useful to check CTCs as a surrogate marker in prostate cancer with smaller samples and lower cost in any small institution.

DOI： 10.1016/j.prnil.2019.01.003

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記述言語：英語  

DOI： 10.1007/s10147-019-01518-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Deep learning algorithms have achieved great success in cancer image classification. However, it is imperative to understand the differences between the deep learning and human approaches. Using an explainable model, we aimed to compare the deep learning-focused regions of magnetic resonance (MR) images with cancerous locations identified by radiologists and pathologists. First, 307 prostate MR images were classified using a well-established deep neural network without locational information of cancers. Subsequently, we assessed whether the deep learning-focused regions overlapped the radiologist-identified targets. Furthermore, pathologists provided histopathological diagnoses on 896 pathological images, and we compared the deep learning-focused regions with the genuine cancer locations through 3D reconstruction of pathological images. The area under the curve (AUC) for MR images classification was sufficiently high (AUC = 0.90, 95% confidence interval 0.87-0.94). Deep learning-focused regions overlapped radiologist-identified targets by 70.5% and pathologist-identified cancer locations by 72.1%. Lymphocyte aggregation and dilated prostatic ducts were observed in non-cancerous regions focused by deep learning. Deep learning algorithms can achieve highly accurate image classification without necessarily identifying radiological targets or cancer locations. Deep learning may find clues that can help a clinical diagnosis even if the cancer is not visible.

DOI： 10.3390/biom9110673

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Nivolumab has demonstrated antitumor activity and manageable safety in the single-arm, phase II CheckMate 275 study in patients with unresectable locally advanced or metastatic platinum-resistant urothelial carcinoma. We report updated results of the global population and a subanalysis of Japanese patients from this study. METHODS: Patients received nivolumab 3 mg/kg intravenously every 2 weeks until progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) confirmed by blinded independent review committee (BIRC) per Response Evaluation Criteria in Solid Tumors v1.1. Secondary endpoints included progression-free survival (PFS) by BIRC and overall survival (OS). Safety was also reported. The minimum follow-up was 21 months. RESULTS: Overall, 270 patients were treated with nivolumab globally; 23 patients were Japanese. In the global and Japanese populations, respectively, ORR per BIRC was 20.4% and 21.7%; median PFS was 1.9 (95% confidence interval [CI] 1.9-2.3) and 3.8 months (95% CI 1.9-7.2); and median OS was 8.6 (95% CI 6.1-11.3) and 21.0 months (95% CI 7.2-not reached). The most common any grade treatment-related adverse events were fatigue (18.1%) and diarrhea (12.2%) in the global population; the most common in the Japanese population were diarrhea (26.1%) and pyrexia (13.0%). Grade 3 or 4 treatment-related adverse events occurred in 61 (22.6%) and seven (30.4%) of the global and Japanese patients, respectively. CONCLUSIONS: Nivolumab continues to show antitumor activity and survival in the global population of CheckMate 275. Meaningful clinical benefit was also observed in Japanese patients. No new safety signals were identified.

DOI： 10.1007/s10147-019-01450-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Nivolumab treatment resulted in superior efficacy and safety versus everolimus treatment in the 2-year follow-up of the CheckMate 025 Phase III study, with consistent results in the global population and the Japanese population. Here, we report the 3-year follow-up in both groups. METHODS: Patients were randomized 1:1 to nivolumab 3 mg/kg intravenously every 2 weeks or everolimus 10 mg orally once daily until progression/intolerable toxicity. The primary endpoint was overall survival (OS). Key secondary endpoints included objective response rate, progression-free survival, safety and patient-reported quality of life. RESULTS: Of 410 and 411 patients randomized to nivolumab and everolimus, 37 and 26 were Japanese, respectively. The median OS for the global population was 25.8 months with nivolumab and 19.7 months with everolimus (hazard ratio 0.74; 95.5% confidence interval [CI]: 0.63-0.88; P = 0.0005); in the Japanese population, median OS was 45.9 months and not reached (hazard ratio 1.08; 95% CI: 0.50-2.34; P = 0.85), respectively. The investigator-assessed objective response rate was 26% versus 5% with nivolumab versus everolimus (odds ratio [OR] 6.19; 95% CI: 3.82-10.06) in the global population and 43% versus 8% in the Japanese population (OR 6.80; 95% CI: 1.60-28.91; P = 0.0035), respectively. The incidence of any-grade treatment-related adverse events was lower with nivolumab versus everolimus in both the global patient population (80% versus 89%) and the Japanese population (81% versus 100%). CONCLUSIONS: At the 3-year follow-up, the efficacy and safety results of CheckMate 025 are generally consistent in the global and the Japanese populations.

添付ファイル： Nivolumab versus everolimus in advanced renal cell carcinoma Japanese subgroup 3-year ollow-up analysis from the Phase III CheckMate 025 study.pdf

DOI： 10.1093/jjco/hyz026

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その他リンク： http://orcid.org/0000-0003-0088-9324

DOI： 10.1016/S1470-2045(18)30860-X

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Cancer and Chemotherapy Publishers Inc.  

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

The objective of this prospective study was to identify baseline angiogenic and inflammatory markers in serum as well as the baseline levels of immune cells in whole blood to predict progression-free survival in patients with metastatic renal cell carcinoma treated with sunitinib. Blood samples were collected at baseline in all 90 patients to analyze serum angiogenic and inflammatory markers together with peripheral blood immunological marker. The association between each marker and sunitinib efficacy was analyzed. Univariate and multivariate Cox proportional model analyses were used to assess the correlation between those markers with survival. Baseline levels of interleukin-6, interleukin-8, high sensitivity C-reactive protein and myeloid-derived suppressor cells were significantly higher in patients who progressed when compared with those with clinical benefit. Analysis by the Cox regression model showed that baseline interleukin-8, high sensitivity C-reactive protein and percentage of T helper type 1 cells were significantly associated with progression-free survival in univariate analysis. Furthermore, in multivariate analysis, those three markers were independent indices to predict progression-free survival. In conclusion, angiogenic (interleukin-8), inflammatory (interleukin-6, high sensitivity C-reactive) and immunologic (myeloid-derived suppressor cells, percentage of T helper type 1 cells) markers at baseline would predict the response to sunitinib therapy and/or disease progression in patients with metastatic renal cell carcinoma.

DOI： 10.1111/cas.13320

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その他リンク： http://orcid.org/0000-0003-0088-9324

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/MD.0000000000007223

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その他リンク： http://orcid.org/0000-0003-0088-9324

担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

A post hoc analysis of interim results from PREVAIL, a Phase III, double-blind, placebo-controlled trial of men with metastatic castration-resistant prostate cancer, demonstrated that the treatment effects, safety and pharmacokinetics of enzalutamide in Japanese patients were generally consistent with those of the overall population. A recent longer term analysis of PREVAIL demonstrated continued benefit of enzalutamide treatment over placebo. Here, we report results from a post hoc analysis of Japanese patients enrolled in PREVAIL at the prespecified number of deaths for the final analysis. In Japanese patients, enzalutamide reduced the risk of death by 35% ( hazard ratio, 0.65; 95% confidence interval, 0.28-1.51) and the risk of investigator-assessed radiographic progression or death by 60% ( hazard ratio, 0.40; 95% confidence interval, 0.18-0.90). These results show that treatment effects and safety in Japanese patients in the final analysis of PREVAIL continued to be generally consistent with those of the overall population.

DOI： 10.1093/jjco/hyw187

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.eururo.2016.07.032

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: Up to a fifth of patients diagnosed with prostate cancer (PC) will develop castration-resistant prostate cancer (CRPC), which has been associated with a poor prognosis. The aim of this study was to consider the patient perspective as part of the overall treatment decision-making process for CRPC, given that an alignment between patient preference and prescribing has been shown to benefit patient outcomes. This study examines preferences of patients with CRPC in Japan for treatment features associated with treatments like RA-223, abiraterone, and docetaxel and to examine the extent to which treatment preferences may vary between symptomatic and asymptomatic patients.
Methods: A two-phase research approach was implemented. In Phase 1, N = 8 patients with CRPC were recruited from a single hospital to complete a qualitative interview to provide feedback on the draft survey. In Phase 2, N = 134 patients with CRPC were recruited from five hospitals to complete a paper survey. The survey included 6 treatment choice questions, each asking patients to choose between two hypothetical treatments for their CRPC. Each treatment alternative was defined by the following attributes: length of overall survival (OS), time to a symptomatic skeletal event (SSE), method of administration, reduction in the risk of bone pain, treatment-associated risk of fatigue and lost work days. A hierarchical Bayesian logistic regression was used to estimate relative preference weights for each attribute level and mean relative importance.
Results: A total of N = 133 patients with CRPC completed the survey and were included in the final analysis. Patients had a mean age of 75.4 years (SD = 7.4) and had been diagnosed with PC a mean of 6.5 years prior (SD = 4.4). Over the attribute levels shown, fatigue (relative importance [ RI] = 24.9 %, 95 % CI: 24.7 %, 25.1 %) was the most important attribute, followed by reduction in the risk of bone pain (RI = 23.2 %, 95 % CI: 23.0 %, 23.5 %), and OS (RI = 19.2 %, 95 % CI: 19.0 %, 19.4 %). Although symptomatic patients placed significantly more importance on delaying an SSE (p &lt; .05), no other preference differences were observed.
Conclusions: CRPC patients were more concerned about reduced quality of life from side effects of treatment rather than extension of survival, which may have implications for shared decision-making between patients and physicians.

DOI： 10.1186/s12894-016-0182-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.eururo.2016.03.017

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Background: Interstitial brachytherapy for localised prostate cancer may be followed by transient increases in prostate-specific antigen (PSA) that resolve without therapy. Such PSA bounces may be associated with an improved outcome but often cause alarm in the patient and physician, and have defied explanation.
Methods: We developed a mathematical model to capture the interactions between the tumour, radiation and anti-tumour immune response. The model was fitted to data from a large cohort of patients treated exclusively with interstitial brachytherapy. Immunohistological analysis for T-cell infiltration within the same tumours was also performed.
Results: Our minimal model captures well the dynamics of the tumour after therapy, and suggests that a strong anti-tumour immune response coupled with the therapeutic effect of radiation on the tumour is responsible for the PSA bounce. Patients who experience a PSA bounce had a higher density of CD3 and CD8 cells within the tumour that likely contribute to the PSA bounce and the overall better outcomes observed.
Conclusions: Our observations provide a novel and unifying explanation for the PSA bounce in patients with early prostate cancer and also have implications for the use of immune-based therapies in such patients to improve outcomes.

DOI： 10.1038/bjc.2016.171

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.13072

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担当区分：筆頭著者  

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担当区分：筆頭著者  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Rates of renal cell carcinoma (RCC) morbidity and mortality vary widely by geography, with increasing incidence in most countries. Interestingly, RCC incidence is significantly lower in Asian countries relative to other regions, which is attributed to environmental and genetic influences. Additionally, it has been demonstrated that different ethnic groups differ in their RCC characteristics which might lead to varied responses to therapy. In this review, physicians drawn from countries across the Asia-Pacific region--China, Japan, Taiwan, Republic of Korea, and Australia--take all available data into consideration to develop the first opinion statement on treatment of advanced RCC in the region. We have sought to determine what factors influence treatment patterns and availability of therapeutic agents in our respective countries, discussed whether these factors are fully justified or should be modified, and considered what additional efforts should be undertaken to optimize treatment outcomes in RCC. Additionally, we have addressed the limitations on treatment of RCC in the region, capturing the restrictive situations of targeted therapy use in the Asia-Pacific region, mainly because of drug availability and treatment reimbursement. Often this illustrates the gap between Western and regional or even among local guidelines, the opinions of leading physicians regarding the treatment, and the realistic access to agents for most patients. Proposals made in this document are based on clinical experience and data from clinical trials of RCC therapies in which Asian patients have been included.

DOI： 10.1016/j.clgc.2014.01.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MASSACHUSETTS MEDICAL SOC  

BACKGROUND Enzalutamide is an oral androgen-receptor inhibitor that prolongs survival in men with metastatic castration-resistant prostate cancer in whom the disease has progressed after chemotherapy. New treatment options are needed for patients with metastatic prostate cancer who have not received chemotherapy, in whom the disease has progressed despite androgen-deprivation therapy.
METHODS
In this double-blind, phase 3 study, we randomly assigned 1717 patients to receive either enzalutamide (at a dose of 160 mg) or placebo once daily. The coprimary end points were radiographic progression-free survival and overall survival.
RESULTS
The study was stopped after a planned interim analysis, conducted when 540 deaths had been reported, showed a benefit of the active treatment. The rate of radiographic progression-free survival at 12 months was 65% among patients treated with enzalutamide, as compared with 14% among patients receiving placebo (81% risk reduction; hazard ratio in the enzalutamide group, 0.19; 95% confidence interval [CI], 0.15 to 0.23; P&lt;0.001). A total of 626 patients (72%) in the enzalutamide group, as compared with 532 patients (63%) in the placebo group, were alive at the data-cutoff date (29% reduction in the risk of death; hazard ratio, 0.71; 95% CI, 0.60 to 0.84; P&lt;0.001). The benefit of enzalutamide was shown with respect to all secondary end points, including the time until the initiation of cytotoxic chemotherapy (hazard ratio, 0.35), the time until the first skeletal-related event (hazard ratio, 0.72), a complete or partial soft-tissue response (59% vs. 5%), the time until prostate-specific antigen (PSA) progression (hazard ratio, 0.17), and a rate of decline of at least 50% in PSA (78% vs. 3%) (P&lt;0.001 for all comparisons). Fatigue and hypertension were the most common clinically relevant adverse events associated with enzalutamide treatment.
CONCLUSIONS
Enzalutamide significantly decreased the risk of radiographic progression and death and delayed the initiation of chemotherapy in men with metastatic prostate cancer. (Funded by Medivation and Astellas Pharma; PREVAIL ClinicalTrials.gov number, NCT01212991.)

DOI： 10.1056/NEJMoa1405095

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Background: The purpose of this study was to investigate the usefulness of a hydrocolloid dressing containing ceramide for hand-foot skin reaction (HFSR) on the soles of the feet in metastatic renal cell carcinoma (RCC) patients treated with sorafenib.
Patients with grade 1 HFSR on the soles of the feet were randomly assigned in to two groups. One group received a hydrocolloid dressing containing ceramide (arm A) and the other received 10% urea cream (arm B). Patients in both groups applied treatment to the affected sites on the soles of the feet, but not to the hands. The primary end point was the incidence of grade 2 or 3 HFSR on the soles of the feet in the first 4 weeks.
Thirty-three patients were assessed (17 in arm A and 16 in arm B), and there were no significant differences in baseline characteristics between the two groups. During the observation period of this study, grade 2 or 3 HFSR on the soles of the feet was found in 29% of patients in arm A and was significantly less than the 69% in arm B (P = 0.03). The incidence of HFSR on the hands, however, was similar in both arms. The median time to grade 2 or 3 HFSR on the soles of the feet was also significantly longer in arm A than in arm B (P = 0.03).
These results indicate that a hydrocolloid dressing containing ceramide prevented the worsening of HFSR caused by sorafenib in metastatic RCC patients.

DOI： 10.1093/annonc/mdt541

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

The objective of this study was to evaluate the capability of C-11-methionine (MET)-PET/CT and F-18-2-deoxy-2-fluoro-d-glucose (FDG)-PET/CT to diagnose primary prostate cancer using recently developed Gemini TF PET/CT (Philips Healthcare, Cleveland, OH).
Twenty men who had been referred for a diagnostic work-up for prostate cancer were enrolled in this study. MET- and FDG-PET/CT by high-resolution mode were carried out on the same day prior to prostate biopsy and each maximum standardized uptake value (SUVmax) was compared with the pathological findings. The regions of interest (about 100 mm(2) small round) were placed at standard 6 points of the peripheral zone and 4 points in the apex of the transitional zone in cases that had undergone biopsy of the internal gland. We summed two scores if a specimen had inhomogeneous Gleason scores (e.g. GS 7; 4 + 3) and doubled the score when the Gleason score was the same (e.g. GS 8; 4 x 2). We divided the tumors into three groups. If the summed Gleason score of the specimens was 5 or less, they were grouped as NG (no grade with the Gleason score). If the summed Gleason score was 6 or 7, the tumors were defined as LG (low Gleason score group), and if the summed Gleason score was 8, 9 or 10, the tumors were classified as HG (high Gleason score group). The mean SUVmax was calculated and one-way analysis of variance or Kruskal-Wallis test and the Tukey post hoc test were performed for statistical comparisons. The capabilities of MET and FDG for diagnosing prostate cancer were evaluated through analysis of the area under the curve of the receiver operating characteristic (ROC) curve. The cut-off levels of SUVmax for the highest accuracy were determined by the results of the ROC analysis, and the sensitivity, specificity and accuracy were calculated.
The PET images, obtained with Gemini TF PET/CT, allowed visual identification of anatomical locations within the prostate gland. Among the mean SUVmax of MET, FDG early phase and FDG delayed phase, the differences between NG and HG were all statistically significant (P &lt; 0.01). With MET the difference between NG and LG was also significant (P &lt; 0.05). And for the elevation rate from FDG early to delayed phase, the difference between NG and HG was significant (P &lt; 0.05). The cut-off SUVmax, sensitivity, specificity, accuracy for distinguishing between NG and LG + HG by MET, FDG early and delayed phase were 3.15/78.7/75.6/78.3, 2.81/61.7/80.0/70.7 and 3.00/62.8/78.9/70.7, respectively. And the same factors between NG + LG and HG were 3.76/70.1/89.7/82.6, 2.88/70.1/82.9/78.3 and 3.47/62.7/86.3/77.7, respectively.
In terms of the capability to diagnose prostate cancer of high Gleason score (a parts per thousand yen8), there was no significant difference between MET and FDG. MET appears to be useful for detecting prostate cancer of both low and high Gleason score.

DOI： 10.1007/s12149-011-0551-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING LTD  

Aims: Cyclooxygenase (COX), which catalyses the synthesis of prostaglandins from arachidonic acid, has two isoforms; COX-1 and COX-2. There is ample evidence to suggest an important role for COX-2 in cancer. The aim of this study was to evaluate the clinical significance of COX-2 expression and its localization in the development and progression of human renal cell carcinoma (RCC).
Methods and results: The expression and localization of COX-2 were evaluated in human RCC tissues from 75 patients by immunohistochemistry. Immunoreactive COX-2 protein was observed in all cases of RCC, and the levels of COX-2 expression were correlated with tumour grade and pathological stage. Expression of COX-2 was higher in the granular cell subtype than in the clear cell subtype of RCC. Immunoelectron microscopy revealed that COX-2 was expressed in the nuclear membrane, rough endoplasmic reticulum, Golgi complex and mitochondrial membrane of RCC cells.
Conclusion: COX-2 overexpression within these intracellular organelles in RCC may be associated with renal cell carcinogenesis and COX-2 may be a useful biomarker in RCC.

DOI： 10.1111/j.1365-2559.2004.01853.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PHARMACEUTICAL SOC JAPAN  

Cyclooxygenase (COX), which catalyzes the synthesis of prostaglandins from arachidonic acid, has two isoforms; COX-1 and COX-2. A large body of evidence exists to suggest that COX-2 is important in gastrointestinal cancer. In order to determine whether COX-2 is expressed in transitional cell carcinoma (TCC) of the human bladder as well as in gastrointestinal cancer, we investigated COX-2 expression in human TCC by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and immunohistochemical analysis, and we found that normal bladder epithelium did not express COX-2 and that COX-2 was markedly up-regulated in human bladder TCC. In nontumor tissues, COX-2 immunostaining signals were observed only in lymphoid follicles. Furthermore, the intensity and extent of COX-2 immunostaining in the bladder cancer tissues were scored and the relationship to tumor grade and stage was investigated. The levels of COX-2 expression were correlated with the tumor grade; from grades I to 3, there was a stepwise increase in the COX-2 immunostaining score. These findings suggested that an increase in COX-2 expression may be associated with bladder carcinogenesis as well as gastrointestinal carcinogenesis, and that it may be useful as a biomarker in bladder cancer.

DOI： 10.1248/jhs.48.42

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE ASIA  

Background: Although it is an established surgical technique, transurethral resection (TUR) is associated with a certain incidence of postoperative bacteriuria. Assessment was made whether the urothelial mucosal concentration of an antibiotic administered before TUR was high enough to decrease the incidence of urinary tract infection (UTI). Also investigated were factors predicting the organ concentration.
Methods: Forty-nine patients (45 men and four women aged 51-79 years with a median age of 70 years) who underwent TUR between August 1996 and September 1997 were enrolled in the study. Each patient received 200 mg of levofloxacin (LVFX) about two hours before surgery. Blood and bladder urine were collected and urothelial mucosa was harvested at the time of TUR. Then the LVFX concentration in these samples was measured using high-performance liquid chromatography. The association between drug levels, or the ratio to the serum concentration, and factors likely to affect the vascular system that delivers the drug (age, bodyweight, blood pressure, pulse rate, total cholesterol and diabetes mellitus) were investigated.
Results: The mean serum drug level was 2.4 mug/mL, and it was 206.4 mug/mL in the urine and 5.7 mug/mL in the urothelial mucosa. The mean ratio of the mucosal to serum concentrations was 2.6. The urinary drug concentration showed no association with any of the factors assessed, while the serum concentration decreased with increasing bodyweight (P = 0.03). As the diastolic blood pressure increased, both the mucosal drug concentration and the mucosa/serum ratio decreased (P &lt; 0.01). When the relationship between the serum and mucosal concentrations was investigated, no correlation was found. However, the mucosa/serum ratio (indicating the transfer of LVFX from the blood) was positively correlated with the mucosal concentration.
Conclusion: Preoperative administration of LVFX was demonstrated to have potential value for the prophylaxis of UTI after TUR. Both the mucosal concentration and the mucosa/serum ratio were correlated with the diastolic blood pressure. As the diastolic blood pressure seems to be an indicator of the tissue concentration of LVFX, it may be possible to set the optimum dose based on the diastolic pressure.

DOI： 10.1046/j.1442-2042.2001.00276.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE ASIA  

Background: A total of 60 604 persons underwent a general health checkup at Toma Hospital, Saitama, Japan, between January 1993 and June 1997, and transabdominal ultrasonography (US) was performed on all persons. We investigated the usefulness of transabdominal US in detecting renal tumors during general health checkups.
Methods: A definite diagnosis was made in cases where the re-examination by US revealed calculus with acoustic shadow or a simple cyst. Computed tomography (CT) was conducted in patients suspected of having a renal tumor, and a diagnosis of renal angiomyolipoma (AML) was made if plain CT gave evidence of a fatty component. Patients diagnosed as having a renal cell carcinoma (RCC) with non-uniform enhancement underwent nephrectomy. If a definite diagnosis could not be made even by contrast CT, the monitoring by US and contrast CT once a year was continued.
Results: Of 97 (0.16%) patients whose transabdominal US findings indicated a diagnosis of suspected renal tumor, 58 underwent the re-examination by US; of these, CT was conducted in 47. Detailed US revealed a hyperechoic pattern in 44 patients, a mixed pattern in nine and an isohypoechoic pattern with internal echo in five. By plain CT, 24 patients were diagnosed as having AML, and two as having renal calcification. Contrast CT enabled a diagnosis; of renal cyst to be made in two patients and renal tumor in 14. All 14 patients with RCC except one underwent nephrectomy, which provided pathologic evidence supporting the diagnosis. Five patients had a tumor unidentifiable by CT, with continuing periodic follow-up by US and CT. Eleven patients underwent no CT.
Conclusion: Of the 60 604 persons who underwent a general health checkup, we found 14 cases of RCC and 24 cases of AML. As a small RCC has a favorable prognosis, patients greatly benefit from early detection; therefore, we should recognize the importance of identifying renal masses by US screening during general health checkups.

DOI： 10.1046/j.1442-2042.2000.00220.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SCI PRINTERS & PUBL INC  

OBJECTIVE: To compare the cytomorphologic features of urine obtained from two different kinds of urinary diversions constructed after fetal bladder resection.
STUDY DESIGN: The smears of urine from 11 ileal conduits and 6 Indiana pouches were evaluated. All patients underwent total bladder resection due to transitional cell carcinoma (TCC) or other kinds of cancer before urine diversion.
RESULTS: The cytologic features of Indiana pouch urine include degenerated, small, round cells without columnar cells derived from intestinal epithelium. In ileal conduit urine, well-preserved columnar cells and degenerated, small, round cells were frequently observed. The columnar cells in ileal conduit urine exhibited cytologic features that should be distinguished from TCC cells.
CONCLUSION: The method of reconstructing the urinary tract is important in urine cytology from urine diversions because the cytomorphologic features of urine are different between the two kinds of urinary diversions. Since columnar cells in ileal conduit urine might lead to misdiagnosis as TCC, special consideration is required to examine ileal conduit urine.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Objectives. To assess the feasibility and limitations of endoluminal ultrasound (ELUS) for clinical staging of bladder tumors.
Methods. From 1998 to 1999, 32 patients with transitional cell carcinoma of the bladder Were evaluated by high-frequency ELUS using miniature ultrasound transducers (20 MHz, 5.1F or 7.2F) before transurethral resection. Clinical staging using ELUS was compared with the results of pathologic staging.
Results. Seventeen (94%) of the 18 patients with superficial tumors on ELUS were confirmed by pathologic examination to have Stage pTa (n = 12) or Stage pT1 (n = 5) disease, and 11 (63%) of the 14 patients with muscle-invasive tumors on ELUS were confirmed by pathologic evaluation to have Stage pT2a (n = 2) or Stage pT2b (n = 9) disease. In all of the misdiagnosed patients, the tumor lacked a well-defined base and was larger than 2 dm in size. It was difficult to distinguish between Stage Ta and Stage fl tumors because of the limited resolution of ELUS and between Stage T2a and Stage T2b tumors because of its low penetration.
Conclusions. ELUS using a high-frequency (20 MHz), miniature ultrasound transducer is able to distinguish superficial tumors from those with muscle invasion. However, the lack of penetration of the sonographic beam places major limitations on the evaluation of the depth of the invasion in large (greater than 2 cm) tumors with a broad base. UROLOGY 56: 404-407, 2000. (C) 2000, Elsevier Science Inc.

DOI： 10.1016/S0090-4295(00)00646-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Objectives. To assess the feasibility and limitations of endoluminal ultrasound (ELUS) for clinical staging of bladder tumors.
Methods. From 1998 to 1999, 32 patients with transitional cell carcinoma of the bladder Were evaluated by high-frequency ELUS using miniature ultrasound transducers (20 MHz, 5.1F or 7.2F) before transurethral resection. Clinical staging using ELUS was compared with the results of pathologic staging.
Results. Seventeen (94%) of the 18 patients with superficial tumors on ELUS were confirmed by pathologic examination to have Stage pTa (n = 12) or Stage pT1 (n = 5) disease, and 11 (63%) of the 14 patients with muscle-invasive tumors on ELUS were confirmed by pathologic evaluation to have Stage pT2a (n = 2) or Stage pT2b (n = 9) disease. In all of the misdiagnosed patients, the tumor lacked a well-defined base and was larger than 2 dm in size. It was difficult to distinguish between Stage Ta and Stage fl tumors because of the limited resolution of ELUS and between Stage T2a and Stage T2b tumors because of its low penetration.
Conclusions. ELUS using a high-frequency (20 MHz), miniature ultrasound transducer is able to distinguish superficial tumors from those with muscle invasion. However, the lack of penetration of the sonographic beam places major limitations on the evaluation of the depth of the invasion in large (greater than 2 cm) tumors with a broad base. UROLOGY 56: 404-407, 2000. (C) 2000, Elsevier Science Inc.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE LTD  

Objective To examine the antitumour effects of the angiogenesis inhibitor AGM-1470 (TNP-470) on rat urinary bladder tumours induced by N-butyl-N(4-hydroxybutyl) nitrosamine (BBN).
Materials and methods Fischer-344 rats were allocated to one of four groups of 15 rats each; in group I, rats were administered AGM-1470 intraperitoneally, with group 2 acting as the control and given only saline; in group 3, AGM-1470 was instillation intra intravesically and group 4 acting as control (intravesical saline). All rats were given 0.05% BBN in their drinking water for 8 weeks and then given water with no BBN. AGM-1470 was administered at a dose of 30 mg/kg every other day for 6 weeks in group 1 and at 15 mg/kg once a week for 6 weeks in group 3. This treatment was commenced at 21 weeks after the start of BBN treatment, when tumorigenesis was apparent in all rat bladders; approximate to 70-80% of the tumours were carcinomas. All rats were killed in the 27th week. The antitumour effects of AGM-1470 on the BBN-induced bladder tumours were evaluated macroscopically and histologically, The inhibitory effect of AGM-1470 on endothelial cell proliferation was assessed in groups I and 2 by immunohistochemical staining for Factor VIII-related antigen and by counting the microvessels.
Results The number and volume of bladder tumours were significantly less in group 1 than group 2, In the latter, at least one bladder tumour developed in each of the 15 rats. Histologically, transitional cell carcinoma (TCC) was found in 13 rats and papilloma in two, with invasive cancer in three of the 13 TCCs. Bladder tumours developed in only four of the 15 rats in group 1. Carcinomas were found in three of these four rats and no invasive cancer was detected. The rats in group 1 had significantly fewer microvessels than the controls. The rats in group 4 also showed slightly but insignificantly less tumour growth and fewer carcinomas, In neither experiment were any major side-effects seen except for mild weight loss after AGM-1470 treatment.
Conclusion AGM-1470 inhibited the growth and malignant progression of BBN-induced bladder tumours in rats, apparently mainly by the inhibition of tumour vessel development. The intraperitoneal administration of AGM-1470 produced better results than did intravesical instillation. These results suggest that the angiogenesis inhibitor AGM-1470 is a promising agent for the treatment of human bladder cancer.

DOI： 10.1046/j.1464-410X.1999.00911.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Japan  

Background. Treatment of carcinoma in situ (CIS) of the upper urinary tract is still difficult. In this study, we assessed the efficacy and safety results of Bacillus Calmette-Guerin (BCG) instillation therapy for CIS of the upper urinary tract. Methods. Thirteen renal units with CIS in eight patients 6077 years old (median, 68 years) were treated with BCG. BCG (Tokyo 172 strain) was instilled at a dose of 160mg into each renal unit once a week for 6 consecutive weeks via nephrostomy. The follow-up period ranged from 7 to 63 months (median, 26 months). Results. Of 13 renal units in eight patients, 12 units (92.3%) in eight patients became negative by cytology. Only 1 renal unit showed recurrence. The duration of the response ranged from 7 to 63 months (median, 25 months). Few side effects were observed after BCG instillation. Fever was most frequent (6/8, 75%), followed by symptoms of irritation such as frequency (5/8, 62.5%). Conclusion. BCG instillation therapy is safe and effective for CIS of the upper urinary tract. It can be used as a first-line therapy instead of any surgical option.

DOI： 10.1007/s101470050071

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER VERLAG  

Tumor cells at the stage of tumor progression build up a high tolerance to intrinsic and extrinsic defence systems and/or therapeutic procedures, and the cells deeply infiltrate the adjacent tissue, which is followed by tumor metastasis to remote organs and tissues. This study was designed to investigate the relationship between expression of matrix metalloproteinase-2 (MMP-2) and invasiveness of human bladder cancer cells, using cell lines derived from a parental human urinary bladder tumor cell line, T24. Two subpopulations of the human bladder cancer cell line T24, Hi-T24 and Lo-T24, were selected using an invasion assay and then expression of MMP-2 mRNA and protein was analyzed by reverse-transcription polymerase chain reaction (RT-PCR) and enzyme immunoassay (EIA). The gross morphology, cell growth rate,and adhesion activity to a basement membrane extract (matrigel) of the high-invasive Hi-T24 cells were similar to those of the low-invasive Lo-T24 cells, but the Hi-T24 cells were 3.8-fold more haptotactic through matrigel than the Lo-T24 cells. The haptotactic activity of the Hi-T24 cells was suppressed by the addition of an anti-MMP-2 antibody, and the amounts of MMP-2 protein secreted into the spent medium by the Hi-T24 and Lo-T24 cells were 7.8 +/- 0.2 and 3.8 +/- 0.3 ng/ml (P &lt; 0.05), respective ly. The quantities of tissue inhibitor of metalloproteinase-2 (TIMP-2) protein secreted by Hi-T24 and Lo-T24 cells were 133.2 +/- 4.3 and 168.7 +/- 5.6 ng/ml, respectively (P &lt; 0.05). The levels of transcription of the genes encoding MMP-2 and the transmembrane MMP, MT-MMP, evaluated by RT-PCR, were higher in the Hi-T24 cells than in the Lo-T24 cells. Expression of the TIMP-2 gene was slightly lower in the Hi-T24 cells than in the Lo-T24 cells. These results indicate that expression of the metalloproteinases are imbalanced at the gene level in human urinary bladder cancer cells at the stage of tumor progression.

DOI： 10.1007/s002400050071

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER VERLAG  

Insulin-like growth factors (IGFs) are potent mitogens for a variety of cancer cells in vitro. A paracrine/autocrine role of IGF-II in the growth of breast and prostate cancer cells has been suggested. Information on cell-type-specific IGF-II expression in vivo in the breast and prostate is, however, limited. Thus, cell types expressing IGF-II mRNA and protein in tumors were identified by in situ hybridization and immunohistochemistry, Of 36 prostate, 17 breast, and 10 bladder cancers, and 9 paraganglioma tissues examined, IGF-II was expressed in more than 50% of prostate, breast, and bladder tumors, and in 100% of paraganglioma tumors. Expression levels of IGF-II were highest in the paraganglioma and bladder followed by prostate and breast tumors. In all the tumors expressing IGF-II, both mRNA and protein were localized to malignant cells, expression in the stroma being minimal. Since previous studies had indicated that an incompletely processed form of 15-kDa IGF-II exhibited higher mitogenic potency than the completely processed 7.5-kDa IGF-II form, the quantity and size of IGF-II proteins expressed in these tumors were analyzed by Western immunoblotting. Greater expression of 15-kDa IGF-II relative to the 7.5-kDa IGF-II form was clearly demonstrated in all six prostate cancers and in half of the two breast and four bladder cancers examined. The results are consistent with the hypothesis that the 15-kDa form of IGF-II expressed in cancerous cells contributes to autocrine cancer cell growth in vivo.

DOI： 10.1007/s004410051016

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CAHNERS PUBL CO  

Objectives. CVFRA 21-1 is a new tumor marker that measures cytokeratin 19 (CK-19) fragments by a sandwich enzyme-linked immunosorbent assay (ELISA). In this study, we evaluated the usefulness of serum and urine CYFRA 21-1 as a tumor marker for bladder cancers.
Methods, We measured serum and urine CVFRA 21-1 levels in a group of patients with bladder cancer (n = 58) and a group without bladder cancer (n = 220). The latter group was divided into five subgroups of patients (those with cystitis, benign prostatic hyperplasia (BPH), urolithiasis, or renal dysfunction, and a group of healthy controls). In the bladder cancer group, we measured CYFRA 21-1 levels after transurethral resection of bladder tumor (TUR-Bt), and we also analyzed the relationship between serum and urine CVFRA 21-1 levels and tumor-related factors.
Results. Serum and urine CYFRA 21-1 levels were significantly higher in the bladder cancer group than in each of the non-bladder cancer subgroups. However, urine CYFRA 21-1 levels did not differ significantly between the bladder cancer group and the cystitis subgroup. In the bladder cancer group, serum CYFRA 21-levels were significantly higher in patients with local advanced-stage tumors and in those who had metastases, Urine CYFRA 21-1 levels decreased as a function of time after TUR-Bt, These levels were strongly correlated with tumor volume and were significantly better than urine cytology for the detection of bladder cancers of grades 1 and 2.
Conclusions. These results suggest that urine CYFRA 21-1 is a useful tumor marker in screening for bladder cancer, and that serum CYFRA 21-1 may be a tumor marker for advanced bladder cancers. Copyright 1996 by Elsevier Science Inc.

DOI： 10.1016/S0090-4295(96)00253-1

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Blackwell Publishing  

Background: Evidence has been accumulating that in many tumors, insulin-like growth factors (IGFs) promote cancer cell growth in an autocrine/paracrine manner via the IGF-I receptor. In an effort to understand the role of IGFs in prostate cancer cell growth, we characterized the IGF system components produced by human prostatic cancer cell-lines, LNCaP, DU145, and PC-3, grown in serum-free medium. Methods: IGFs, their receptors, and IGF binding proteins (IGFBPs) produced by the three human prostate cell lines were characterized by reverse transcriptase-polymerase chain reaction (RT-PCR), radioimmunoassay (RIA), Western ligand blot, Western immunoblot and Northern blot analyses. Results: mRNA for IGF-II and receptors for IGF-I and IGF-II were detected in all three cell-lines by RT-PCR. In contrast to the published study, only LNCaP cells expressed a trace amount of IGF-I mRNA. RIA on conditioned media collected from these cells revealed that all three cell-lines produced measurable IGF-II but not IGF-I. Western ligand blot Western immunoblot and Northern blot analyses revealed that LNCaP, DU145, and PC-3 cells expressed IGFBP-2, IGFBP-2/-3/-4/-6, and IGFBP-2/-3/-4/-5/-6, respectively. IGF-II stimulated [3H]thymidine incorporation into DNA in DU145 and PC-3 cells significantly although the effect was small. DNA synthesis in PC-3 cells but not in LNCaP and DU145 cells was significantly inhibited by the IGF-I receptor-specific monoclonal antibody. Conclusion: These results suggest potentially important roles of IGFs and IGFBPs in prostate cancer cell growth, and that in particular, IGF-II may play a critical role in prostate cancer cell growth.

DOI： 10.1111/j.1442-2042.1996.tb00628.x

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The Vesical Imaging Reporting and Data System (VI-RADS) is widely used for predicting muscle-invasive bladder cancer (MIBC). This study aimed to determine the clinicopathological significance of the VI-RADS ≧4 (VI≧4) group. METHODS: Patients who underwent transurethral resections of bladder tumors during the study period and preoperative magnetic resonance imaging were considered. The patients were pathologically diagnosed with urothelial carcinoma (UC). We first compared the results of patients with VI-RADS scores of 3 and 4 to determine the cut-off score for MIBC; thereafter, the patients were divided into the VI≧4 and VI-RADS ≦3 (VI≦3) groups using VI-RADS. The clinicopathological significance of the VI≧4 group was examined retrospectively by comparing the characteristics of each group. RESULTS: In total, 121 cases were examined, of which 28 were pathologically diagnosed with MIBC. Of the 28 MIBC cases, three (10.7%) had a VI-RADS score of ≦3, and 25 (89.3%) had a VI-RADS score of ≧4. Of the 93 NMIBC cases, 86 (92.5%) had a VI-RADS score of ≦3, and seven (7.5%) had a VI-RADS score of ≧4. The diagnostic performance of the VI-RADS with a cut-off score of 4 was 89.3% for sensitivity, 92.5% for specificity, and an area under the curve (AUC) of 0.91. Contrastingly, for a cut-off score of 3, the sensitivity was 89.3%, specificity was 62.0%, and AUC was 0.72. A VI-RADS score of ≥ 4 could predict MIBC. In the VI≧4 group, 30 of 32 (93.8%) patients had high-grade tumors. The VI≧4 group had significantly more high-grade bladder cancers than the VI≦3 group (p < 0.001 OR = 31.77 95%CI:8.47-1119.07). In addition, the VI≧4 group had more tumor necrosis (VI≧4 vs VI≦3, p < 0.001 OR = 7.46 95%CI:2.61-21.34) and more UC variant cases (VI≧4 vs VI≦3, p = 0.034 OR = 3.28 95%CI:1.05-10.25) than the VI≦3 group. CONCLUSIONS: This study suggests that VI-RADS has a high diagnostic performance in predicting MIBC and that VI-RADS could diagnose high-grade tumors, necrosis, and UC variants.

DOI： 10.1186/s12894-024-01452-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Everolimus, a mammalian target of rapamycin inhibitor used as an antineoplastic drug, is associated with a remarkably high incidence of interstitial lung disease (ILD). The clinical and pathological characteristics of ILD caused by everolimus have not been thoroughly investigated; therefore, we aimed to elucidate the features of everolimus-associated ILD. METHODS: We retrospectively reviewed the medical records of patients who received everolimus for cancer treatment at our hospital. Patient backgrounds were compared between the ILD and non-ILD groups. Chest computed tomography (CT), changes in biomarkers, and lung histopathological features were analyzed for ILD cases. RESULTS: Sixty-six patients were reviewed, and ILD developed in 19. There were no differences in patient demographics between the ILD and non-ILD groups. The severity of ILD was grade 1 (G1) in 9 and grade 2 (G2) in 10 cases. Chest CT showed organizing pneumonia (OP) or a hypersensitive pneumonia pattern. The levels of lactate dehydrogenase, C-reactive protein, Krebs von den lungen-6, and surfactant protein-D (SP-D) at the onset of ILD were significantly higher than those at baseline. Analysis of G1 and G2 ILD subgroups showed a higher SP-D levels in the G2 subgroup. Five patients underwent lung biopsies; all specimens demonstrated alveolitis with lymphocytic infiltration and granulomatous lesions, and some had OP findings. CONCLUSIONS: Everolimus-associated ILD is mild and has a favorable prognosis. Patients with symptomatic ILD were more likely to have higher SP-D levels than those with asymptomatic ILD. Granulomatous lesions are an important pathological feature of everolimus-associated ILD.

DOI： 10.1272/jnms.JNMS.2024_91-211

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記述言語：日本語   出版者・発行元：(株)羊土社  

画像に含まれる情報は膨大である.特に科学的発見を進めていくためには,実際に目で見て観察し理解することの意義は大きい.定量化やその数理解析を通して画像を客観的な情報として扱うことができるAI技術は,生物・医学研究を行っていくうえで,今後もさらなる発展が期待される.一方で,複雑なデータ解析の背後を理解するためには,複数の分野における知識の統合が必要となる場面も多い.本稿では,これまでわれわれが行ってきた細胞組織像を用いたAI研究の中から,がんに対する発見的AIを用いた研究例と,生成AIの一つである超解像技術を電子顕微鏡像に応用した研究の方向性について紹介したい.(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Renal abscesses require prompt diagnosis and appropriate intervention, as they can be life-threatening. However, diagnosis based solely on clinical findings is often challenging. We present the case of a 69-year-old woman with left renal masses on follow-up computed tomography (CT) after surgery for pT2aN0M0 lung carcinosarcoma. The masses were localized only in the left kidney without suspected metastatic lesions at other sites. The patient was referred to our department for further evaluation and treatment under a diagnosis of suspected metastatic lung carcinosarcoma of the left kidney. On enhanced CT, the left renal masses, the largest of which had a diameter of 40×36 mm had thick irregular walls gradually enhanced by the contrast media and an internal low-attenuation area. The masses showed heterogeneous signal intensity with a pseudocapsule on T2-weighted magnetic resonance imaging. Clinical symptoms such as fever or costovertebral angle tenderness were absent, and blood and urine tests were not sufficiently inflammatory to suggest a renal abscess. Histopathological findings on CT-guided renal biopsy revealed only inflammatory tissue and no tumor cells. However, because lung carcinosarcoma metastatic nodules could not be ruled out, laparoscopic left nephrectomy was performed for a definitive diagnosis and curative intent. The pathological diagnosis was renal abscess without malignant lesions. Here, we present a case of renal abscess mimicking metastatic lesions in a patient with lung carcinosarcoma. Accurately differentiating renal abscesses from metastatic renal tumors before treatment is often difficult. Renal abscess diagnosis should be considered through a comprehensive evaluation of the clinical findings of individual cases.

DOI： 10.1272/jnms.JNMS.2024_91-609

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Introduction

We report a rare case of marked rectal stenosis due to Douglas' pouch metastasis of renal pelvic urothelial carcinoma successfully treated with enfortumab vedotin.

Case presentation

A 77‐year‐old female presented with difficulty in defecation and abdominal distension. She had received two courses of cisplatin plus gemcitabine followed by four courses of maintenance avelumab for postoperative lymph node metastasis of renal pelvic urothelial carcinoma. KL‐6 levels were elevated, and a computed tomography scan revealed an irregularly shaped large mass occupying Douglas' pouch, with marked rectal stenosis. Metastatic urothelial carcinoma was pathologically diagnosed, and enfortumab vedotin was initiated after colostomy. After 12 courses of enfortumab vedotin, metastatic lesions showed marked shrinkage and KL‐6 levels decreased.

Conclusion

Enfortumab vedotin elicited a remarkable response in treating rectal stenosis due to metastasis of renal pelvic urothelial carcinoma in Douglas' pouch. Furthermore, serum KL‐6 levels were correlated with the severity of metastatic urothelial carcinoma.

DOI： 10.1002/iju5.12645

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：(一社)腎癌研究会  

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記述言語：日本語   出版者・発行元：(一社)腎癌研究会  

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記述言語：日本語   出版者・発行元：(一社)腎癌研究会  

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記述言語：日本語   出版者・発行元：(一社)腎癌研究会  

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記述言語：英語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The optimal treatment modality for locally advanced prostate cancer has not been established. Radiotherapy, hormonal therapy, and combinations of treatments are the main strategies, although the feasibility of radical prostatectomy as a first-line therapy needs to be considered. This retrospective study evaluated the long-term oncological outcome of high-risk prostate cancer treated surgically, using pathological results of the extracted specimen. The relationship between the number of risk factors and the long-term outcome was specifically analyzed. METHODS: High-risk prostate cancer patients who underwent laparoscopic radical prostatectomy at Nippon Medical School from 2000 to 2012 without neoadjuvant therapy of any kind were identified. Risk factors were prostate-specific antigen (PSA) ≥20 ng/ml, pathological ≥T3, and pathological Gleason Score ≥8. Biological failure was defined as PSA ≥0.2 ng/ml. RESULTS: A total of 222 men were identified. One patient had positive lymph node status, and there was a significant difference in surgical margin positivity (52 men, 68.4% vs 56 men 38.4%) between patients with and without biochemical failure. For patients meeting the high risk criteria with a follow-up of up to 133 months, the biochemical recurrence (BCR) -free survival rates at 5 and 10 years were 62.8% and 58.4%, respectively, with a mean time to BCR of 14.0 months. BCR-free survival rates at 5 and 10-year were 73.6% and 71.4%, respectively, with 1 risk factor, 48.7% and 34.6%, respectively, with 2 factors, and 34.5% and 34.5%, respectively, with 3 factors. A single risk factor group had a significantly better outcome than the group with multiple risk factors. The overall survival rate at 5 and 10 years were 94.6% and 93.7%, and the cancer-specific survival rate was 100% at both 5 and 10 years. CONCLUSIONS: Reasonable long-term oncological outcomes can be achieved by surgical treatment for high-risk prostate cancer. The group with 1 risk factor had a significantly better BCR-free rate than the multiple risk factor group.

DOI： 10.1272/jnms.JNMS.2023_90-210

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The case presented is of a 47-year-old patient with an extravesical pedunculated bladder leiomyoma, which was difficult to distinguish from a retroperitoneal tumor. Preoperatively, it was suspected to be a retroperitoneal tumor and a laparotomy with tumor resection was performed. lntraoperatively, the bladder and tumor were connected by a cord-like tissue. A retrospective review of preoperative images revealed that cord-like tissue, identified intraoperatively, was also present. Bladder leiomyomas can grow as extravesical pedunculated tumors. Therefore, when the continuity between the bladder and tumor is only a cord-like object, the finding ofcontinuity is useful to diagnose with bladder leiomyoma. J. Med. Invest. 70 : 513-515, August, 2023.

DOI： 10.2152/jmi.70.513

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

Background

Nephrectomy is a curative treatment for localized renal cell carcinoma (RCC), but patients with poor prognostic features may experience relapse. Understanding the prognostic impact of programmed death-ligand 1 (PD-L1) expression in patients who underwent nephrectomy for RCC may aid in future development of adjuvant therapy.

Methods

Of 770 surgical specimens collected from Japanese patients enrolled in the ARCHERY study, only samples obtained from patients with recurrent RCC after nephrectomy were examined for this secondary analysis. Patients were categorized into low- and high-risk groups based on clinical stage and Fuhrman grade. Time to recurrence (TTR) and overall survival (OS) were analyzed.

Results

Both TTR and OS were shorter in patients with PD-L1-positive than -negative tumors (median TTR 12.1 vs. 21.9 months [HR 1.46, 95% CI 1.17, 1.81]; median OS, 75.8 vs. 97.7 months [HR 1.32, 95% CI 1.00, 1.75]). TTR and OS were shorter in high-risk patients with PD-L1-positive than -negative tumors (median TTR 7.6 vs. 15.3 months [HR 1.49, 95% CI 1.11, 2.00]; median OS, 55.2 vs. 83.5 months [HR 1.53, 95% CI 1.06, 2.21]) but not in low-risk patients.

Conclusions

This ARCHERY secondary analysis suggests that PD-L1 expression may play a role in predicting OS and risk of recurrence in high-risk patients with localized RCC.

Clinical Trial Registration: UMIN000034131.

添付ファイル： Prognostic value of PD‐L1 expression in recurrent renal cell carcinoma after nephrectomy-a secondary analysis of the ARCHERY study.pdf

DOI： 10.1007/s10147-022-02256-z

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その他リンク： https://link.springer.com/article/10.1007/s10147-022-02256-z/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The phase 3 CLEAR study demonstrated statistically significantly improved efficacy with lenvatinib plus pembrolizumab versus sunitinib, including progression-free survival and overall survival, in patients with previously untreated advanced renal cell carcinoma. This subset analysis investigated efficacy and safety in Japanese patients randomized to lenvatinib plus pembrolizumab or sunitinib in the CLEAR study. METHODS: Progression-free survival, overall survival, tumor response, and safety were assessed in Japanese patients with previously untreated advanced renal cell carcinoma randomized to receive lenvatinib plus pembrolizumab (n = 42) or sunitinib (n = 31). Efficacy outcomes were analyzed by independent imaging review per Response Evaluation Criteria in Solid Tumors, version 1.1. RESULTS: Progression-free survival was longer with lenvatinib plus pembrolizumab than with sunitinib (median, 22.1 vs. 10.9 months; hazard ratio, 0.39; 95% CI, 0.20-0.74). Median overall survival was not estimable in the lenvatinib plus pembrolizumab arm and 30.6 months in the sunitinib arm (HR, 1.20; 95% CI, 0.39-3.66). Overall survival adjusted for the imbalance of Memorial Sloan-Kettering Cancer Center prognostic risk group favored lenvatinib plus pembrolizumab (hazard ratio, 0.67; 95% CI, 0.18-2.39). Objective response rate (69.0% vs. 45.2%; odds ratio, 2.71; 95% CI, 1.03-7.10) was higher and median duration of response (20.3 vs. 9.1 months) was longer with lenvatinib plus pembrolizumab versus sunitinib. Grade ≥ 3 treatment-emergent adverse events occurred in 95.2% versus 87.1% of patients in the lenvatinib plus pembrolizumab versus sunitinib arms. CONCLUSIONS: These findings support lenvatinib plus pembrolizumab as a potential first-line treatment for Japanese patients with advanced renal cell carcinoma.

DOI： 10.1002/cam4.5483

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: We encountered an extremely rare case of a vesicocutaneous fistula due to vesical diverticulitis with stones. CASE PRESENTATION: A 78-year-old male patient presented to our department with complaints of suppurative discharge in the suprapubic area. Computed tomography revealed an enlarged prostate, a vesical diverticulum with stones located on the ventral side, and an aberrant connection between the anterior bladder wall and the external surface of the skin. The patient was diagnosed with a vesicocutaneous fistula due to vesical diverticulitis and was successfully treated with a multidisciplinary approach including vesical diverticulectomy with stone removal and nonviable tissue debridement. The patient continues to receive regular outpatient follow-ups with urinary catheter changes. CONCLUSION: Vesicocutaneous fistulas due to vesical diverticulitis with stones are extremely rare. We should be aware that a vesical diverticulum with stones located on the ventral side might pose a high-risk factor for the formation of a vesicocutaneous fistula in elderly patients.

添付ファイル： IJU Case Reports - 2022 - Akatsuka - Vesicocutaneous fistula due to vesical diverticulitis with stones A case report and.pdf

DOI： 10.1002/iju5.12546

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

Background

Active surveillance (AS) is one of the treatment methods for patients with small renal masses (SRMs; &lt; 4 cm), including renal cell carcinomas (RCCs). However, some small RCCs may exhibit aggressive neoplastic behaviors and metastasize. Little is known about imaging biomarkers capable of identifying potentially aggressive small RCCs. Contrast-enhanced computed tomography (CECT) often detects collateral vessels arising from neoplastic angiogenesis in RCCs. Therefore, this study aimed to evaluate the association between SRM differential diagnoses and prognoses, and the detection of collateral vessels using CECT.

Methods

A total of 130 consecutive patients with pathologically confirmed non-metastatic SRMs (fat-poor angiomyolipomas [fpAMLs; n = 7] and RCCs [n = 123]) were retrospectively enrolled. Between 2011 and 2019, SRM diagnoses in these patients were confirmed after biopsy or surgical resection. All RCCs were surgically resected. Regardless of diameter, a collateral vessel (CV) was defined as any blood vessel connecting the tumor from around the kidney using CECT. First, we analyzed the role of CV-detection in differentiating between fpAML and RCC. Then, we evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of RCC diagnosis based on CV-detection using CECT. We also assessed the prognostic value of CV-detection using the Fisher exact test, and Kaplan-Meier method and the log-rank test.

Results

The sensitivity, specificity, PPV, NPV, and accuracy of CV-detection for the diagnosis of small RCCs was 48.5, 45.5, 100, 100, and 9.5% respectively. Five of 123 (4.1%) patients with RCC experienced recurrence. CV-detection using CECT was the only significant factor associated with recurrence (p = 0.0177). Recurrence-free survival (RFS) was significantly lower in patients with CV compared with in those without CV (5-year RFS 92.4% versus 100%, respectively; p = 0.005). In addition, critical review of the CT images revealed the CVs to be continuous with the venous vessels around the kidney.

Conclusions

The detection of CVs using CECT is useful for differentiating between small fpAMLs and RCCs. CV-detection may also be applied as a predictive parameter for small RCCs prone to recurrence after surgical resection. Moreover, AS could be suitable for small RCCs without CVs.

DOI： 10.1186/s12885-022-09971-w

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その他リンク： https://link.springer.com/article/10.1186/s12885-022-09971-w/fulltext.html

記述言語：英語  

DOI： 10.1093/jjco/hyab161

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

INTRODUCTION: We encountered an extremely rare case of a nephrostomy catheter entering the right renal vein during an exchange procedure. CASE PRESENTATION: An 80-year-old man underwent radical cystectomy. Urinary diversion was achieved through right percutaneous nephrostomy. After the 15th nephrostomy catheter exchange, the patient bled heavily from the catheter. We clamped the catheter immediately, and the patient became hemodynamically stable. Emergency angiography showed the nephrostomy catheter entering the renal vein from outside the renal pelvis. Under fluoroscopy, we pulled the catheter until its tip was located in the previous penetration site of the renal pelvic wall and inserted the catheter over the guidewire into the renal pelvis. CONCLUSIONS: Herein, we report an extremely rare case of a nephrostomy catheter inserted into the right renal vein during an exchange procedure. Inserting a nephrostomy catheter in the appropriate position and performing exchange under imaging guidance techniques could help clinicians avoid severe complications.

DOI： 10.1002/iju5.12276

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/iju5.12276

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Transrectal ultrasonography (TRUS)-guided prostate biopsy is the conventional method of diagnosing prostate cancer. TRUS-guided prostate biopsy can occasionally be associated with severe complications. Here, we report the first case of a prostate abscess with aneurysms and spondylodiscitis as a complication of TRUS-guided prostate biopsy, and we review the relevant literature. CASE PRESENTATION: A 78-year-old man presented with back pain, sepsis, and prostate abscesses. Twenty days after TRUS-guided prostate biopsy, he was found to have a 20-mm diameter abdominal aortic aneurysm that expanded to 28.2 mm in the space of a week, despite antibiotic therapy. Therefore, he underwent transurethral resection of the prostate to control prostatic abscesses. Although his aneurysm decreased to 23 mm in size after surgery, he continued to experience back pain. He was diagnosed as having pyogenic spondylitis and this was managed using a lumbar corset. Sixty-four days after the prostate biopsy, the aneurysm had re-expanded to 30 mm; therefore, we performed endovascular aneurysm repair (EVAR) using a microcore stent graft 82 days after the biopsy. Four days after the EVAR, the patient developed acute cholecystitis, and he underwent endoscopic retrograde biliary drainage. One hundred and sixty days after the prostate biopsy, all the complications had improved, and he was discharged. A literature review identified a further six cases of spondylodiscitis that had occurred after transrectal ultrasound-guided prostate biopsy. CONCLUSIONS: We have reported the first case of a complication of TRUS-guided prostate biopsy that involved prostatic abscesses, aneurysms, and spondylodiscitis. Although such complications are uncommon, clinicians should be aware of the potential for such severe complications of this procedure to develop.

DOI： 10.1186/s12894-021-00780-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: In our multicenter study evaluating metastatic papillary renal cell carcinoma (PRCC), 29% of tumors diagnosed as PRCC in collaborative institutes were finally diagnosed as other RCCs under central review. In those tumors, mucinous tubular and spindle cell carcinoma (MTSCC) was the leading histology, followed by unclassified RCC (ucRCC). We focused on those patients with MTSCC or ucRCC. METHODS: We reviewed the processes for the pathological diagnoses of nine tumors and reviewed their clinical features. RESULTS: All of the MTSCCs and ucRCCs were positive for AMACR, which is frequently positive in PRCC. Mucin was demonstrated in 80% of the MTSCCs, and its presence is important for their diagnoses. One MTSCC was diagnosed as a mucin-poor variant. The presence of spindle cells with low-grade nuclei was suggestive of MTSCC, but the diagnosis of high-grade MTSCC was difficult. Four tumors were diagnosed as ucRCC by histological and immunohistochemical findings. Three of the four tumors were suspicious of ucRCC in the initial review due to atypical findings as PRCC. Sunitinib and interferon-α were effective for one MTSCC patient who survived for >5 years. Two MTSCC patients who were Memorial Sloan-Kettering Cancer Center poor risk had unfavorable prognoses. One patient with mucin-poor MTSCC had an indolent clinical course. Two of four ucRCC patients showed durable stable disease with targeted agents (TAs) and survived >3 years. CONCLUSION: Some MTSCC metastases progressed very slowly and poor-risk tumors progressed rapidly. Systemic therapies including TAs showed some efficacies. Some patients who have metastatic ucRCC with microscopic papillary architecture can benefit from TAs.

添付ファイル： Dfficulty inDD for renal cancer with microscopic papillary architecture overlapped @athological features among PRCC, MTSCC, unclassified RCC..pdf

DOI： 10.1093/jjco/hyaa114

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Plasmacytoid urothelial carcinoma (PUC) of the urinary bladder is a variant of urothelial carcinoma that carries a poor prognosis. The epithelial-mesenchymal transition (EMT) has been demonstrated to contribute to tumor progression. As the cause of the increased aggressiveness of PUC is unknown, we investigated PUC and EMT-related marker expression. METHODS: A total of 633 bladder carcinoma cases diagnosed from 2006 to 2015 at the Nippon Medical School Hospital were analyzed. Twelve patients were found to have plasmacytoid histology and diagnosed with PUC. Slides were evaluated for percentage of plasmacytoid variant, and stained for E-cadherin, N-cadherin, Vimentin, Fibronectin and Snail expression. RESULTS: The incidence of PUC was 1.9% (12/633). The median patient age at diagnosis was 71 years (range, 60-80 years) and the male-female ratio was 11:1. All but three patients had stage T2b or higher. The median overall survival was 10 months. In 10/12 cases, Snail and N-cadherin were positive. Vimentin was positive in 9/12 cases. Fibronectin was positive in 8/12 cases. While E-cadherin was negative in 10/12 cases. Nine cases showed > 10% plasmacytoid component. Eight of the nine patients (88.9%) with > 10% plasmacytoid component died. CONCLUSIONS: The results indicate that PUC may induce EMT and may be associated with high invasion.

DOI： 10.1186/s12894-020-00641-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In a phase III clinical trial, CheckMate 025, treatment of metastatic renal cell carcinoma (mRCC) with nivolumab demonstrated superior efficacy over everolimus. However, as the clinical trial excluded patients with specific complications and poor performance status (PS), the effectiveness and safety of nivolumab in clinical practice, in which patients with various clinical complications are treated, is unclear. This study explored real-world nivolumab treatment in Japanese mRCC patients. METHODS: This is an interim analysis of a multicenter, non-interventional, medical record review study (minimum follow-up: 9 months). All eligible Japanese mRCC patients who first received nivolumab between February and October 2017 were included; data cut-off was April 2019. We analyzed nivolumab treatment patterns, efficacy (including overall survival, progression-free survival, objective response rate, and duration of response) and safety (including immune-related adverse events). RESULTS: Of 208 evaluable patients, 31.7% received nivolumab as fourth- or later line of treatment. At data cut-off, 26.9% of patients were continuing nivolumab treatment. The major reason for discontinuation was disease progression (n = 100, 65.8%). Median overall survival was not reached; the 12-month survival rate was 75.6%. Median progression-free survival was 7.1 months, the objective response rate was 22.6%, and median duration of response was 13.3 months. Patients who were excluded or limited in number in CheckMate 025, such as those with non-clear cell RCC or poor PS, also received benefits from nivolumab treatment. Immune-related adverse events occurred in 27.4% of patients (grade ≥ 3, 10.1%). CONCLUSION: Nivolumab was effective and well-tolerated in real-world Japanese mRCC patients. TRIAL REGISTRATION: UMIN000033312.

DOI： 10.1007/s10147-020-01692-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: While high body mass index (BMI) and visceral obesity are reportedly associated with a prolonged duration of laparoscopic radical nephrectomy (LRN) via the transperitoneal approach, factors that might prolong the retroperitoneal approach remain unknown. We therefore investigated factors associated with prolonged LRN using a retroperitoneal approach applied by non-expert surgeons. METHODS: We defined surgeons who were not certified to perform laparoscopic surgery by the Japanese Society of Endourology as non-experts. We retrospectively reviewed the medical records of 59 consecutive patients with renal cell carcinoma treated with LRN using the retroperitoneal approach by non-experts at our hospital between 2014 and 2019. Relationships between surgical duration and age, sex, body mass index, visceral fat area (VFA) and subcutaneous fat area (SFA), laterality and location of the tumor, length of major tumor axis (tumor length), clinical T stage, ipsilateral adrenalectomy and specimen weight were analyzed using Spearman rank correlation coefficients. RESULTS: The surgical duration positively correlated with ipsilateral adrenalectomy (rs = 0.3162, p = 0.0147) and specimen weight (rs = 0.3103, p = 0.0168), but not with BMI (rs = 0.2016, p = 0.1257) or VFA (rs = 0.0185, p = 0.8894). CONCLUSIONS: Factors associated with prolonged LRN via the retroperitoneal approach implemented by non-expert surgeons are ipsilateral adrenalectomy and specimen weight.

DOI： 10.1272/jnms.JNMS.2021_88-302

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

The lipid cell variant of urethral carcinoma (UC) is rare and poorly understood clinicopathologically. A nodular tumor detected in the bladder of an 87-year-old man with asymptomatic gross hematuria was transurethrally resected, and high-grade UC, lipid cell variant, was diagnosed pathologically. The tumor cells resembled lipoblasts and contained numerous cytoplasmic vacuoles. Immunohistochemically, the tumor cells stained positive for the epithelial markers CK7, CK20, EMA, CAM5.2, and 34betaE12 and negative for vimentin and S100. Focal positivity for adipophilin was detected in cytoplasm but not in the vacuoles. These findings suggest that the patient had lipid-producing UC.

DOI： 10.1272/jnms.JNMS.2019_86-602

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/jjco/hyz143

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Radium-223 is a first-in-class targeted alpha therapy to prolong overall survival (OS) in castration-resistant prostate cancer with bone metastases (mCRPC). The aim of the present analysis was to assess the long-term safety with radium-223 in Japanese patients with mCRPC. METHODS: Patients with symptomatic mCRPC, ≥ 2 bone metastases and no known visceral metastases received up to 6 injections of radium-223 (55 kBq/kg), one every 4 weeks. Adverse events (AEs) considered to be related to radium-223 were reported until 3 years after the first injection. Pre-specified conditions, such as acute myelogenous leukemia, myelodysplastic syndrome, aplastic anemia, primary bone cancer, or other primary malignancies, were reported regardless of causality. RESULTS: Of the 49 patients enrolled in the study, 44 (89.8%) entered the survival follow-up period and 33 (67.3%) died. Throughout the entire study, there were no reports of second primary malignancy or other pre-specified conditions. Eight patients (16.3%) experienced post-treatment drug-related AEs, which were all hematological (anemia and decreased lymphocyte, platelet, and white blood cell counts). No serious post-treatment drug-related AEs were reported. Updated median OS was 19.3 months (95% CI: 14.2, 28.5). CONCLUSIONS: In Japanese patients with symptomatic mCRPC and bone metastases, radium-223 had a favorable long-term safety profile with no second primary malignancies reported. Taken together with median OS, which was comparable to that in the pivotal phase III ALSYMPCA study, these results support continued benefit from radium-223 in Japanese patients with mCRPC.

DOI： 10.1007/s10147-018-01389-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

添付ファイル： Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma analysis of a nation-wide registry program.pdf

DOI： 10.1093/jjco/hyz054

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その他リンク： http://orcid.org/0000-0003-0088-9324

DOI： 10.1101/539791

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To clarify treatment patterns and outcomes for patients with unresectable or metastatic renal cell carcinoma in the molecular target therapy era in Japan. METHODS: A multicenter, retrospective medical chart review study was carried out. Patients diagnosed with unresectable or metastatic renal cell carcinoma between January 2012 and August 2015 were enrolled. Data extracted from medical records included treatment duration, grade ≥3 adverse events, reason for discontinuation for each targeted therapy and survival data until August 2016. RESULTS: Of 277 eligible patients, 266, 170 and 77 received first-, second- and third-line systemic treatment, respectively. Tyrosine kinase inhibitors were the most common first-line therapy (72.2%), followed by mammalian target of rapamycin inhibitors (14.3%) and cytokines (13.5%). Among 170 patients who received second-line treatment, tyrosine kinase inhibitor-tyrosine kinase inhibitor was the most common sequence (58.8%), followed by tyrosine kinase inhibitor-mammalian target of rapamycin inhibitor (14.1%) and cytokine-tyrosine kinase inhibitor (14.1%). With a median follow-up period of 19.8 months, median overall survival was not reached at 48 months. Patients who discontinued first-line tyrosine kinase inhibitors in <6 months showed poorer overall survival compared with patients who received first-line tyrosine kinase inhibitors for ≥6 months. CONCLUSIONS: The present analysis illustrates the contemporary treatment patterns and prognosis for patients with unresectable or metastatic renal cancer in a real-world setting in Japan. Tyrosine kinase inhibitor-tyrosine kinase inhibitor represents the most commonly used sequence. Shorter treatment duration of first-line tyrosine kinase inhibitors is associated with poorer prognosis, suggesting the need for better treatment options.

DOI： 10.1111/iju.13830

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We describe a patient with thrombosis of the pampiniform plexus cured using heparin. A 40-year-old man was referred to our hospital with pain in the left scrotum. A physical examination revealed a painful, 20-mm long, beaded mass in the upper left paratesticular region. Magnetic resonance imaging and ultrasonography revealed 10-mm long thrombosis in the left pampiniform plexus, so intravenous heparin was started. The patient recovered well and was discharged on oral anticoagulation therapy after five days of hospitalization. The patient was completely asymptomatic, and ultrasonographic findings of the left testicle were normal at six months after starting treatment. We found 19 patients with thrombosis of the pampiniform plexus including the present patient, in the English and Japanese literature to date. Here, we review these 19 patients and discuss their clinical features.

DOI： 10.5980/jpnjurol.110.70

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1111/1346-8138.14601

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DOI： 10.1200/JCO.2018.36.6_suppl.142

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DOI： 10.1200/JCO.2018.36.6_suppl.487

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DOI： 10.1200/JCO.2018.36.6_suppl.628

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Radium-223 dichloride (radium-223) is the first targeted alpha therapy approved for the treatment of castration-resistant prostate cancer (CRPC) with bone metastases. This study investigated the efficacy and safety of radium-223 in Japanese patients with symptomatic CRPC and bone metastases. METHODS: In this open-label, multicenter, phase II study, patients with progressive, symptomatic CRPC and bone metastases were treated with radium-223 (55 kBq/kg, intravenously) in a 4-week cycle for six cycles. The primary endpoint was the percent change in total alkaline phosphatase (ALP) from baseline at 12 weeks. Secondary endpoints included the percent ALP change from baseline to end of treatment (EOT), ALP response rates, percent change in prostate-specific antigen (PSA) from baseline to 12 weeks and EOT, PSA response rates, overall survival (OS), and time to symptomatic skeletal events (SSEs). Adverse events were monitored throughout the study period. RESULTS: Of the 49 Japanese patients (median age 74 years), 28 completed all infusions. Mean percent change in total ALP and PSA from baseline to 12 weeks was -19.3 and +97.4%, respectively. One-year OS and SSE-free rate at the end of active follow-up were 78 and 89%, respectively. The ALP response rate was 31%, while the PSA response rate was 6%. Grade 3/4 treatment-emergent adverse events observed in ≥10% of patients included decreased lymphocyte count (14%), anemia (14%), anorexia (10%), and bone pain (10%). CONCLUSIONS: Radium-223 is effective and well tolerated in Japanese patients with CRPC and bone metastases. Results were comparable with the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT01929655.

DOI： 10.1007/s10147-017-1176-0

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語  

A 73-year-old man presented with right lower back pain and dysuria. Right hydronephrosis and a large pelvic large mass were seen on computed tomography (CT). Although his prostate-specific antigen (PSA) was 0.5 ng/mL, an irregularly enlarged, stony, hard prostate was palpable on digital rectal examination. A prostate tumor was suspected, and a transrectal prostate biopsy and right transurethral ureteral stent placement were performed. Histological and immunohistochemical studies revealed diffuse large B-cell lymphoma. Positron emission tomography-computed tomography showed abnormal uptake in the stomach, cecum, right obturator lymph nodes, para-aortic lymph nodes, and dorsal left kidney. No abnormal findings were seen on bone marrow histology. Clinical stage IVA was confirmed according to Ann Arbor criteria. The patient achieved a complete response after 8 cycles of combination chemotherapy with rituximab, pirarubicin, cyclophosphamide, vincristine, and prednisolone.

DOI： 10.1272/jnms.JNMS.2018_85-37

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Heavy active smoking was an independent prognostic factor for overall and cancer-specific survival in patients with advanced renal cell carcinoma in the multi-institutional national database of the Japanese Urological Association.The association between cigarette smoking and survival in patients with renal cell carcinoma is not well studied. We examined the impact of cigarette smoking on survival of patients with advanced renal cell carcinoma using the multi-institutional national database of the Japanese Urological Association.
From 340 Japanese institutions, 963 patients with renal cell carcinoma of clinical Stage 3 or higher were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate overall and cause-specific survival.
Median duration of follow-up was 842 days, and overall and cancer death occurred in 392 (40.7%) and 351 (36.4%) patients, respectively. In multivariate analysis, smoking 20 or more cigarettes daily at diagnosis was associated with poorer overall and cancer-specific survival, especially in Stage 3. According to a Cox proportional hazards model, heavy cigarette smoking at diagnosis and the variables of underweight, fever symptoms, serum lactic dehydrogenase value, serum C-reactive protein value, serum creatinine value, Eastern Cooperative Oncology Group performance status, nephrectomy and clinical stage were significant (P &lt; 0.05) for overall and cancer-specific survival.
We could compare the smoking status at diagnosis and the prognosis of renal cell carcinoma at national wide scale. Heavy active smoking was an independent prognostic factor for overall and cancer-specific survival in patients with advanced renal cell carcinoma, especially in Stage 3.

DOI： 10.1093/jjco/hyx129

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：日本外科系連合学会  

気腫性腎盂腎炎(Emphysematous pyelonephritis:EPN)は死亡率が高く適切な治療を迅速に行うことが求められるが,外科的処置適応の判断となる予後予測因子は諸家によってことなる.また,今回われわれの経験した5症例で上記予後予測因子と治療結果を検討した結果,少ない症例の検討ではあるものの,諸家の唱える因子は治療方針の決定に必ずしも有用とは思われなかった.以上の結果からEPNの診断がつき,かつ穿刺可能な大きさの腎および腎周囲の気腫性病変を認めれば,諸家の唱える予後予測因子に関係なく,経皮的腎瘻術によるドレナージを施行してよいと思われた.経皮的腎瘻術によるドレナージは,熟練した医師が施行すれば極めて安全な手技である.またその際に患者および家族への説明と同意はこの手技に詳しくない他科の主治医より,経皮的ドレナージが極めて安全で簡単な処置であると自信を持って説明できる熟練した泌尿器科医が行った方がよいと思われた.(著者抄録)

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記述言語：日本語   出版者・発行元：日本外科系連合学会  

比較的稀とされる転移性陰茎癌は現在本邦137例を数えるが,そのうち腎細胞癌からの転移は稀である.症例は86歳の男性で左腎細胞癌に対し左腎部分切除術を施行後15年して亀頭部に直径約15mmの乳頭状の突出した無痛性腫瘤に気づき当院泌尿器科外来を受診した.切除した腫瘍組織の免疫染色で腎細胞癌からの転移と診断された.高齢で自覚症もなかったため追加治療は行わず経過観察とし,術後3ヵ月で特に異常を認めていない.本邦における腎癌陰茎転移は自験例を含め9例のみの報告であったため,貴重な症例と思われ報告する.(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

症例は70歳の女性。健診にて胸部異常陰影を指摘され近医受診。単純CTにて左腎洞部に腫瘤性病変を認め当科紹介となった。尿検査では異常を認めず、尿細胞診はclass IIIaであった。造影CTでは左腎盂壁肥厚と両側閉鎖リンパ節腫大を認めた。尿管鏡下にて左腎盂粘膜生検を施行したが異常所見は認めなかった。その後腹腔鏡下に閉鎖リンパ節生検を施行。摘出したリンパ節に著明なリンパ球および形質細胞浸潤を認め、免疫組織学的所見において、IgG4陽性細胞は10以上/HPF、IgG4/IgG陽性細胞比は40%以上であった。術後に測定した血中IgG4は662mg/dlと高値を示し、IgG4関連腎臓病診断基準に基づき、IgG4関連腎臓病と確定診断した。その後無症状で腎機能障害ないため無治療経過観察にて40ヵ月経過したが増悪所見を認めていない。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01175&link_issn=&doc_id=20171109230011&doc_link_id=1390564238036815360&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390564238036815360&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Nivolumab improved overall survival (OS) and objective response rate (ORR) versus everolimus in previously treated patients with advanced renal cell carcinoma in the phase III CheckMate 025 study (minimum follow-up: 14 months). We report efficacy and safety in the global and Japanese populations (minimum follow-up: 26 months). Methods: Patients were randomized 1:1 to receive nivolumab 3 mg/kg intravenously every 2 weeks or everolimus 10-mg tablet orally once daily. Primary endpoint: OS, key secondary endpoints: ORR, progression-free survival and safety. Results: Of 410 (nivolumab) and 411 (everolimus) patients, 37 (9%) and 26 (6%), respectively, were Japanese. Median OS for the global population was 26.0 months (nivolumab) and 19.7 months (everolimus; hazard ratio 0.73 [95% confidence interval [CI]: 0.61-0.88]; P = 0.0006), with medians not reached for Japanese patients. ORR for the global population was 26% (nivolumab) versus 5% (everolimus; odds ratio 6.13; 95% CI: 3.77-9.95); ORR for Japanese patients: 43% versus 8% (odds ratio 9.14; 95% CI: 1.76-88.33). In Japanese patients, any-grade treatment-related adverse events (AEs) occurred in 78% (Grade 3-4, 19%; most common, anemia [5%]) treated with nivolumab and 100% (Grade 3-4, 58%; most common, hypertriglyceridemia [12%]) treated with everolimus; the most common with nivolumab was diarrhea (19%) and with everolimus was stomatitis (77%). Quality of life was stable in the nivolumab arm. Conclusions: With >2 years of follow-up, Japanese patients had a higher response rate with nivolumab versus everolimus that was more pronounced yet consistent with the global population, with median OS not reached, and a favorable safety profile.

DOI： 10.1093/jjco/hyx049

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Objective: Many studies have shown the efficacy of everolimus after pretreatment with vascular endothelial growth factor receptor-tyrosine kinase inhibitors. We investigated the efficacy and safety of everolimus as a second-line treatment after the failure of vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy in Japanese patients with advanced renal cell carcinoma.
Methods: This was an open-label, multicenter, phase II trial conducted in Japan through the central registration system. A total of 57 patients were enrolled. Patients were administered 10 mg of everolimus q.d. orally. The primary efficacy endpoint was progression-free survival achieved by administration of everolimus.
Results: The median progression-free survival of patients administered everolimus was 5.03 months (95% confidence interval: 3.70-6.20). The median overall survival was not reached. The objective response rate was 9.4% (95% confidence interval: 3.1-20.7). The progression-free survival in the group of &lt;100% relative dose intensity was 6.70 months (95% confidence interval: 4.13-11.60), and that in the group of 100% relative dose intensity was 3.77 months (hazard ratio: 2.79, 95% confidence interval: 2.77-5.63). The commonly observed adverse events and laboratory abnormalities were stomatitis (49.1%), hypertriglyceridemia (26.4%), interstitial lung disease (26.4%), anemia (22.6%) and hypercholesterolemia (22.6%).
Conclusion: The median progression-free survival was almost similar to that recorded in the RECORD-1 study, whereas prolongation of overall survival was observed in the present study compared with the RECORD-1 study. The treatment outcomes of first-line vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy and second-line everolimus treatment in Japanese patients were successfully established in the present study.

DOI： 10.1093/jjco/hyw194

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We describe renal mucinous tubular and spindle cell carcinoma (MTSCC) that metastasized to the lymph nodes seven years after radical nephrectomy. An 80-year-old man was admitted for treatment of a right renal tumor. A 6.5×6.0-cm tumor in the right kidney (cT1bN0M0) revealed by abdominal computed tomography was treated by laparoscopic radical nephrectomy. The pathological findings at that time suggested papillary renal cell carcinoma type 1. Imaging findings seven years later revealed enlarged pre-caval and right external iliac lymph nodes indicative of delayed metastasis, and these were treated by laparoscopic lymphadenectomy. The pathological findings and re-evaluation of the primary tumor suggested MTSCC. The patient remains free of metastasis at 24 months of follow-up. MTSCC has been a distinct entity in the World Health Organization classification of kidney tumors since 2004. Tumors consist of tubules and cords separated by pale mucinous material in some areas, whereas others have dense cellularity without significant mucin. They are usually of low malignant potential, and metastasis has rarely been reported. To our knowledge, this is the first report of MTSCC with retroperitoneal lymph node metastasis treated by lymphadenectomy.

DOI： 10.5980/jpnjurol.108.30

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

IgG4-related kidney disease (IgG4-RKD) is a comprehensive term for renal lesions associated with IgG4-related disease (IgG4-RD), which is a recently recognized clinical entity characterized by a dense lymphoplasmacytic infiltrate rich in IgG4+ plasma cells with fibrosis affecting several organs. A 70-year-old woman was referred to our hospital for an abnormality at the left renal hilum detected by CT scan. Urinalysis was negative, urine cytology was rated as Class IIIa, and contrast-enhanced CT revealed left renal pelvic wall thickening without an irregular lumen and swelling of bilateral obturator lymph nodes. Ureterorenoscopy and biopsy were performed, and results showed no evidence of malignancy. Then, laparoscopic pelvic lymphadenectomy was performed. Plasma cells were the predominant infiltrating inflammatory cells; immunostaining showed marked infiltration of IgG4+ plasma cells with >10 IgG4+ plasma cells per high-power field, and the IgG4+/IgG+ cell ratio was over 40%. Serum IgG4 was extremely high. We made a final diagnosis of possible IgG4-related disease according to Comprehensive diagnostic Criteria for IgG4-related disease 2011. We report a long-term (40-month) follow-up case of IgG4-related kidney disease without therapy because there are no symptoms.

DOI： 10.5980/jpnjurol.108.229

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: To improve antitumor effects against metastatic renal cell carcinoma (mRCC), use of molecular target-based drugs in sequential or combination therapy has been advocated. In combination therapy, interferon (IFN)-alpha amplified the effect of sorafenib in our murine model (J Urol 184: 2549, 2010), and cytokine-treated mRCC patients in Japan had good prognoses (Eur Urol 57: 317, 2010). We thus conducted a phase II clinical trial of sorafenib plus IFN-alpha for untreated mRCC patients in Japan.
Methods: In this multicenter, prospective study, provisionally registered patients with histologically confirmed metastatic clear cell RCC received natural IFN-alpha (3 dosages of 3 million U per week) for 2 weeks. Only IFN-alpha-tolerant patients were registered to this trial, and treated additionally with oral sorafenib (400 mg, bid). The primary end point of the study was rate of response (CR + PR) to sorafenib plus IFN-alpha treatment assessed using RECIST v1.0. The secondary end points were disease control rate (CR + PR + SD), progression free survival (PFS), overall survival (OS), and safety of the combined treatment. PFS and OS curves were plotted using the Kaplan-Meier method.
Results: From July 2009 to July 2012, a total of 53 untreated patients were provisionally registered, and 51 patients were finally registered. Rate of Response to the combined therapy of sorafenib plus IFN-alpha was 26.2 % (11/42) (CR 1, PR 10). The median PFS was 10.1 months (95 % CI, 6.4 to 18.5 months), and the median OS has not been reached yet. The combined therapy increased neither the incidence of adverse effects (AE) nor the incidence of unexpected AE. A limitation was that a relatively high number of patients (9 patients) were excluded for eligibility criteria violations.
Conclusion: Our data have demonstrated that sorafenib plus IFN-alpha treatment is safe and effective for untreated mRCC patients.

DOI： 10.1186/s12885-015-1675-1

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: To investigate associations between dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) expression and survival in T1 high-grade or T2 bladder cancer patients treated with neoadjuvant chemotherapy.
Methods: The cohort under investigation comprised 44 patients who underwent neoadjuvant chemotherapy for pT1 high-grade or pT2N0M0 bladder cancer at our institution between 2002 and 2011. Immunohistochemical analysis was used to determine expression of DYRK2 in bladder cancer specimens obtained by transurethral resection before chemotherapy. Relationships between DYRK2 expression and both response to chemotherapy and survival in these patients were analyzed.
Results: DYRK2 expression was positive in 21 of 44 patients (47.7 %) and negative in 23 patients (52.3 %). In total, 20 of 21 DYRK2-positive cases showed complete response to neoadjuvant chemotherapy, whereas 11 of 23 DYRK2-negative cases did not show complete response. Sensitivity and specificity were 62.5 % and 91.7 %, respectively (P = 0.0018). In addition, disease-specific survival rate was significantly higher for DYRK2-positive patients than for DYRK2-negative patients (P = 0.017). In multivariate analysis, DYRK2 expression level was identified as an independent prognostic factor for disease-specific survival (P = 0.029). We also showed that DYRK2 mRNA expression was significantly higher in DYRK2-positive samples by immunohistochemistry than DYRK2-negative samples (P = 0.040).
Conclusions: DYRK2 expression level may predict the efficacy of neoadjuvant chemotherapy for T1 high-grade and T2 bladder cancer.

DOI： 10.1186/s12894-015-0040-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Objective: Result of clinical trial for registration purpose is often difficult to generalize because of its limited population in number and inclusion criteria.
Methods: To understand the efficacy of sorafenib under daily medical practice, we retrospectively investigated therapeutic outcomes of 175 Japanese patients with advanced renal cell carcinoma treated with sorafenib at 15 centers.
Results: The objective response rate and disease control rate were 15.4 and 77.1%, respectively, being similar to those in the Phase II study in Japanese patients (19.4 and 73.6 months). Any tumor shrinkage was observed with 53% of patients, while tumor control without growth was in 61%. Lung lesions were more sensitive to sorafenib than other lesions, in terms of any tumor shrinkage (54%) and the extent of maximal shrinkage, while tumor control was better in lymph node metastases (77%) than in lung (69%). Liver was worse in any tumor shrinkage (35%), tumor control (55%) and the extent of tumor growth. Slightly, shorter median overall survival of 21.1 months compared with Phase II clinical trial (25.3 months) is likely to be attributable to different patient population, because median overall survival was improved to 26.4 months when the population was matched to that in Phase II trial. Univariate and multivariate analyses identified prognostic factors for worse overall survival, including intermediate and poor Memorial Sloan-Kettering Cancer Center risk, Eastern Cooperative Oncology Group performance status &gt;= 1, the presence of non-clear cell component and the presence of liver metastasis.
Conclusions: In conclusion, the present study confirmed the efficacy of sorafenib in the real-world setting on advanced renal cell carcinoma.

DOI： 10.1093/jjco/hyu200

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その他リンク： http://orcid.org/0000-0003-0088-9324

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出版者・発行元：{FapUNIFESP} ({SciELO})  

DOI： 10.1590/s1677-5538.ibju.2014.02.19

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common. CASE PRESENTATION: A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the perirenal fat, and vascular involvement was strongly positive. Thirty months after partial nephrectomy, an enhanced computed tomographic scan showed local recurrence of the renal cell carcinoma extending into the inferior vena cava without renal mass. Hence, we performed right radical nephrectomy and intracaval thrombectomy. Microscopic examination revealed a clear cell carcinoma grade 2, stage pT3a + b. The patient is still alive with no evidence of recurrence 10 months post-procedure. CONCLUSION: To our knowledge, local recurrence of renal cell carcinoma extending into the inferior vena cava after partial nephrectomy has not been reported in the literature. Our case report emphasizes the importance of strict surveillance of patients after partial nephrectomy, especially for those with renal cell carcinoma positive for microvessel involvement.

DOI： 10.1186/1756-0500-7-198

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BRAZILIAN SOC UROL  

Neither computed tomography (CT) nor intravenous pyelography (IVP) alone can diagnose tumors of renal pelvic diverticula, but magnetic resonance urography (MRU) can obtain accurate preoperative information.

DOI： 10.1590/S1677-5538.IBJU.2014.02.19

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記述言語：英語   出版者・発行元：AMER SOC CLINICAL ONCOLOGY  

DOI： 10.1200/jco.2014.32.4_suppl.455

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: Neoadjuvant chemotherapy has been shown to have benefit in T1 high-grade or T2 bladder cancer. However, neoadjuvant chemotherapy fails in some patients. Careful patient selection for neoadjuvant chemotherapy is therefore needed. Several reports show that Snail is associated with resistance to chemotherapy. We hypothesized that Snail expression could predict survival in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.
Methods: The participants were 44 patients with T1 high-grade and T2 bladder cancer receiving neoadjuvant chemotherapy. Immunohistochemical analysis was used to determine Snail expression in specimens of bladder cancer obtained by transurethral resection before neoadjuvant chemotherapy. The relationships between Snail expression and patients' outcomes were analyzed.
Results: Snail expression was positive in 15 of the 44 patients (34.1%) and negative in 29 (65.9%). Disease-free survival was significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.014). In addition, disease-specific survival was also significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.039). In multivariate analysis, Snail expression level was identified as an independent prognostic factor for disease-specific survival (p = 0.020).
Conclusions: The results indicate that Snail expression may predict poor outcome in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.

DOI： 10.1186/1471-2490-13-73

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Although the percentage of patients with renal cell carcinoma (RCC) extending into venous systems is unexpectedly high, the prognostic impact and independency of venous tumor thrombus-related factors on overall survival (OS) remain controversial. Furthermore, the prognostic impact of various clinicopathologic factors including tumor thrombus-related factors on OS may change with elapsed years after the intervention and also with follow-up duration of participants. The aim of the study is to explore independent and universal predictive preoperative and intraoperative clinicopathologic factors on OS in patients with RCC extending into venous systems using subgroup analysis in terms of restricted follow-up duration and yearly-based survivors.Methods: Between 1980 and 2009, 292 patients diagnosed with RCC with venous tumor thrombus were retrospectively registered for this study. The prognostic impacts of various clinicopathologic and surgical treatment factors including levels of venous thrombus, venous wall invasion status and likelihood of aggressive cytoreductive operation, were investigated using Kaplan-Meier method and following multivariate Cox proportional hazards model for all patients and those still alive at 1, 2, and 3 years of follow-up. To investigate the impact of follow-up duration on the statistical analyses, multivariate logistic regression analyses were used to explore prognostic factors using restricted data until 1, 2, and 3 years of follow-up.Results: The median follow-up duration was 40.4 months. The 5-year OS was 47.6%. Several independent predictive factors were identified in each subgroup analysis in terms of yearly-based survival and restricted follow-up duration. The presence of tumor thrombus invading to venous wall was independently related to OS in the full-range follow-up data and in survivors at 2 and 3 years of follow-up. Using restricted follow-up data until 1, 2, and 3 years of follow-up, many independent predictive factors changed with follow-up duration, but surgical category could be universal and independent predictive factors.Conclusion: The most universal factors affecting improvement both in short-term and long-term survivals could be cytoreductive surgery and absence of venous wall invasion. It may mean that feasible aggressive cytoreductive operation following more reliable preoperative imaging for predicting venous wall invasion status would improve OS for patients with RCC extending into venous systems. © 2013 Hirono et al.
licensee BioMed Central Ltd.

DOI： 10.1186/1471-2407-13-447

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出版者・発行元：Springer Nature  

DOI： 10.1007/s13691-013-0109-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

A 76-year-old female with advanced renal cell carcinoma had been treated with everolimus for 3 months. She visited our hospital because of a cough and fever lasting a few days. Chest X-rays showed bilateral infiltrative shadows, and a chest computed tomography scan showed homogeneous ground-glass opacities with mosaic patterns, especially in the apical region. The laboratory results revealed a decreased white blood cell count with lymphocytopenia and high levels of lactate dehydrogenase, C-reactive protein and KL-6. Pneumonitis was suspected and, therefore, everolimus therapy was interrupted. At that time, the pneumonitis was thought to be drug-induced interstitial lung disease. However, it was not possible to rule out pneumocystis pneumonia, because the patient was immunocompromised and the computed tomography findings suggested the possibility of pneumocystis pneumonia. The pneumonitis progressed rapidly and the patient developed respiratory failure, so we performed bronchoalveolar lavage to make a definitive diagnosis, and simultaneously started treatment with prednisolone and trimethoprimsulfamethoxazole to cover both interstitial lung disease and pneumocystis pneumonia. A polymerase chain reaction assay of the bronchoalveolar lavage fluid was positive for Pneumocystis carinii DNA, and the serum level of -d-glucan was significantly elevated. Thus, the patient was diagnosed with pneumocystis pneumonia, which was cured by the treatment. Interstitial lung disease is a major adverse drug reaction associated with everolimus, and interstitial lung disease is the first condition suspected when a patient presents with pneumonitis during everolimus therapy. Pneumocystis pneumonia associated with everolimus therapy is rare, but our experience suggests that pneumocystis pneumonia should be considered as a differential diagnosis when pneumonitis is encountered in patients receiving everolimus therapy.

DOI： 10.1093/jjco/hyt019

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Disseminated intravascular coagulation (DIC) is the most frequent coagulation disorder in patients with prostate cancer. However, renal involvement in DIC associated with prostate cancer has rarely been documented. Herein, we present a case of metastatic prostate cancer presenting with acute renal failure (RF) triggered by DIC. An 80 year old man with metastatic prostate cancer was treated with antihormone therapy at an outpatient clinic. He was admitted to our hospital because of severe dyspnea and progressive RF. A hemorrhagic tendency was not clinically evident. Laboratory tests exhibited a significant coagulation disorder, suggestive of DIC. Despite treatment, his RF and dyspnea worsened, and he eventually passed away. An autopsy study revealed hypertensive nephrosclerosis superimposed by fibrin rich thrombi formation involving glomerular capillaries and arterioles characteristic of DIC. Additionally, focal segmental glomerulosclerosis was identified, which was presumably secondary to the glomerular endothelial and/or podocyte injury augmented by DIC. Those findings showed that glomerular injury, which was induced and subsequently exacerbated by DIC associated with prostate cancer, highly contributed to the progression of RF in our case. A differential diagnosis of DIC should be considered when a patient with prostate cancer presents with renal dysfunction. © 2013 Ohashi et al, publisher and licensee Dove Medical Press Ltd.

DOI： 10.2147/IJNRD.S41813

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Urological Association  

We reported the experience with a case of plasmacytoid variant of urothelial carcinoma of urinary bladder. A 75year-old woman complained of gross hematuria. She was hospitalized to be diagnosed as the bladder tumor on abdominal CT. TUR-BT was performed and pathological finding was invasive urothelial carcinoma. But she refused radical cystectomy. 2 months later, she was hospitalized again with worsening hematuria. Simple cystectomy was performed. Histological examination revealed a plasmacytoid appearance of the infiltrating tumor cells. Immunohistochemical stains for lymphoid markers were negative. Those findings lead to the diagnosis of plasmacytoid variant of urothelial carcinoma. She died due to local recurrence for 1.5 months after simple cystectomy. © 2013 Japanese Urological Association.

DOI： 10.5980/jpnjurol.104.26

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN SOC INTERNAL MEDICINE  

We experienced a case of interstitial lung disease (ILD) that occurred one year after the start of everolimus therapy for renal cell carcinoma. The pathological features included interstitial pneumonia with granuloma formation. Everolimus is known to cause ILD; however, its pathology is unclear. Granuloma-forming interstitial pneumonia associated with everolimus is uncommon, although it may be one of the pathological patterns associated with everolimus-induced ILD. This is a slow-onset case of everolimus-induced ILD in a patient with renal cell carcinoma. Physicians should thus be aware of the potential for the development of ILD at any time during the administration of everolimus therapy.

DOI： 10.2169/internalmedicine.52.8588

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Background: Radical prostatectomy (RP) for localized prostate cancer after transurethral resection of the prostate (TUR-P) is technically difficult because of periprostatic adhesion and changes in the form of the prostate. The advantages of laparoscopic RP (LRP) over retropubic RP (RRP) include a less invasive operation through a small wound, a clearer field of vision, and reduced blood loss, and, therefore, LRP may represent the optimal method for RP after TUR-P. The present study compared clinical, oncological, and pathological outcomes between LRP and RRP after TUR-P at our institution.
Methods: Twenty patients underwent TUR-P for benign prostatic hyperplasia, followed by LRP (12 patients) or RRP (8 patients) after localized prostate cancer was diagnosed at our institution from November 1998 through December 2006. Median patient age was 67.5 years (range, 52-73 years). The median duration of follow-up was 96 months (range, 60-144 months). Operative time, volume of blood loss, duration of indwelling urethral catheter use, degree of urinary incontinence, pathological findings, oncological outcomes, and complications were compared between LRP and RRP.
Results: No significant difference in operative time or amount blood loss was recognized between LRP and RRP. Urinary incontinence in the early and late postoperative periods was significantly more severe after LRP than after RRP. Oncological outcomes and results of pathological examinations were comparable between LRP and RRP.
Conclusion: We found no significant differences in clinical, pathological, and oncological outcomes, except for urinary incontinence, between LRP and RRP. (J Nippon Med Sch 2012; 79: 416-421)

DOI： 10.1272/jnms.79.416

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Herein we describe our experience with a bone-anchored sling using a suture anchor and polypropylene mesh for the treatment of post-radical prostatectomy urinary incontinence. Eight patients with urinary incontinence as a result of intrinsic sphincter deficiency after radical prostatectomy were included in the analysis. The procedure involved piercing the pubic bone with a bone drill, inserting the suture anchor and fixing a soft or rigid polypropylene mesh to press firmly on the bulbar urethra. Urinary incontinence was significantly improved according to changes in the daily number of pads used at 1, 3 and 6 months postoperatively in comparison with preoperatively. However, no meaningful improvement at 6 months postoperatively was seen with the soft mesh. Complications included perineal pain in four cases, but pain control was achieved using non-steroidal anti-inflammatory drugs. The bone-anchored sling with a suture anchor and polypropylene mesh appears to be safe and effective for the treatment of post-radical prostatectomy urinary incontinence. Soft mesh appears inappropriate as material for the bone-anchored sling because of the progressive likelihood of worsened urinary incontinence.

DOI： 10.1111/j.1442-2042.2012.03073.x

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   出版者・発行元：MARY ANN LIEBERT INC  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Recurrence of urothelial cancer in an ileal conduit after radical cystectomy is rare. A 79-year-old man suffered bladder cancer (UC cTisNOMO G2 &gt
3) and underwent total cystectomy with ileal conduit. He had recurrence of the right renal pelvis carcinoma 6 years after the total cystectomy, and was treated by right radical nephroureterectomy (pT3 G2 = 3). The patient had another episode of recurrence in the ileal conduit 13 years after the initial operation. The entire ileal conduit (UC, G3, ew (-)) was resected and left cutaneous ureterostomy was performed. This case suggests that long-term follow-up is necessary after radical cystectomy and ileal conduit for urinary diversion.

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   出版者・発行元：SPRINGER  

DOI： 10.1007/s12149-012-0580-9

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Tokyo  

DOI： 10.1007/s12149-012-0580-9

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.492_6

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.349_5

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.513_6

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.558_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.567_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.379_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.560_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.563_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.387_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.356_5

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.378_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.102.471_6

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DOI： 10.1016/j.juro.2010.02.1324

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DOI： 10.1016/j.juro.2010.02.358

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 50-year-old man visited our hospital with a complaint of painful masses in bilateral scrotums for 2 months. Ultra sonography shows isoechoic mass in both scrotum. Antibiotic was treated for 2 weeks but had no effects on scrotal swelling and testicular neoplasm cannot ruled out, so we performed bilateral high orchiectomy. Pathological examination shows necrotizing vasculaitis surrounded by glanulomas and pathologically diagnosed as Polyarteritis Nodosa in bilateral epididymis. After orchiectomy, blood examination of immunity was revealed no specific findings, that made us diagnosed as isolated PN. 2 years after operation, he had no reccurence.

DOI： 10.5980/jpnjurol.101.570

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

We performed transurethral resection of the prostate (TUR-P) for a 66-year-old man with benign prostatic hyperplasia. Pathological examination diagnosed poorly differentiated urothelial carcinoma of the urethra with broad prostatic permeation. Random bladder biopsies showed no malignancy, but a second TUR-P revealed urothelial carcinoma in the prostate and bladder neck. Computed tomography (CT) showed lymph node metastases from para-aortic to right/left external iliac and left obturator nodes, so clinical stage T3N2M0 carcinoma of the prostatic urethra was diagnosed. Given the presence of lymph node metastases, neoadjuvant chemotherapy using cisplatin 70 mg/m(2), ifosfamide 1.2 g/m(2) and docetaxel 70 mg/m(2) (PIT) was considered. After chemotherapy, CT showed complete response (CR) of all lymph nodes. Local control in the bladder was considered to be good, so total prostatectomy and retroperitoneal lymph node dissection was selected instead of total cystoprostatectomy. Pathological findings of surgical specimens showed no residual carcinoma in the prostatic urethra or lymph nodes, although prostatic adenocarcinoma was recognized. No recurrences or metastases have been encountered as of 3 years and 5 months since surgery.

DOI： 10.1007/s10147-009-0006-4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.257_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.296_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.524_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.475_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.343_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.331_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.262_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.408_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.258_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

There are no guidelines regarding whether to perform either a radical transurethral resection of the bladder tumor (TUR-BT) or a total cystectomy after TUR biopsy for huge bladder cancer, and this decision is entrusted to each institution. Of 439 patients in whom TUR-BT was performed from 2005 through 2009, the weight of the total resected volume was &gt
50 g in 6 patients, and among these 6 patients the following variables were compared: operating time, weight of resected volume, transfusion volume, presence or absence of hydronephrosis, preoperative urinary cytology, serum cytokeratin 19 fragment (CYFRA) level, intraoperative bladder compliance, and histopathological findings. The median age, operating time, weight of resected volume, transfusion volume, and length of follow-up were 72 years, 300 minutes, 88 g, 202 mL, 16 months, respectively. The serum CYFRA level in patients with muscle-invasive cancer (11.8 ng/mL) was higher than that in patients with non-muscle-invasive cancer (5.06 ng/mL). All patients with non-muscle-invasive bladder cancer survived without recurrence. Although the mean length of follow-up was only 16 months (5-59 months), the 1 patient who was followed up for 59 months had no recurrence. In cases of muscle-invasive bladder cancer, all patients, except for a relatively recent patient, have died. In cases without muscle invasion, lymph node metastasis, distal metastasis, or preoperative renal dysfunction accompanied by hydronephrosis, with favorable bladder compliance, we believe that radical TUR-BT should be actively performed to preserve the bladder. A second TUR-BT should be performed in cases of non-muscle-invasive cancer without G3 components to treat the huge bladder cancer.

DOI： 10.1272/jnms.77.190

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.100.286_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.100.211_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.99.135_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.99.136_1

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記述言語：英語  

CiNii Books

J-GLOBAL

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

Objective: To investigate the incidence of renal cell carcinoma, classified by sex, age group and region in Japan, following a 5-year interval after a previous survey performed in 1997.
Methods: The survey was conducted between the beginning of January 2002 and the end of December 2002. A total of 1288 institutions in all 47 prefectures throughout Japan were requested to register cases.
Results: There were 7405 persons with renal cell carcinoma, consisting of 5063 males and 2342 females. Crude incidence rates were 8.2 and 3.6 per 100 000 population for men and women, respectively. Incidence rates in the Hokkaido region were highest followed by the Shikoku region.
Conclusions: Despite incidence of renal cell carcinoma increasing to 7405 from the 6358 persons in 1997, statistical data reported by the Ministry of Health, Labor and Welfare indicate that rising age-adjusted death rate for this tumor reached a ceiling in the past decade. Early detection may have contributed to this current trend; however, further epidemiological research is required to fully elucidate this.

DOI： 10.1111/j.1442-2042.2007.01739.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In our continuing investigation of the significance of leukocytosis in prostatic fluid (PF), the relation of leukocytosis in PF to that in selected sections of prostate with significant inflammation was studies with whole-mount specimens obtained at radical prostatectomy from 12 patients with prostate cancer. Although leukocytosis was observed both in PF and in prostate tissue in all 12 patients, there was no correlation between the leukocyte count in PF and the intensity of inflammation. However, the ratio of macrophages among leukocytes in PF correlated with the number of ducts filled with macrophages in prostate tissue (p=0.0481). This finding was consistent with our previous finding that activation of macrophages in PF reflects active inflammation in prostate tissue. Further studies are needed to clarify the roles of macrophages and whole leukocytes in PF and prostate tissue.

DOI： 10.1272/jnms.74.210

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Bilateral nephron-sparing surgery was performed on a 56-year-old man with von Hippel-Lindau disease as initial therapy for renal cell carcinoma (RCC). Two years after the surgery, an abdominal computerized tomography (CT) scan revealed local recurrence of RCC. The patient was admitted to our hospital after another CT scan three years later that indicated aggravation of the cancer. On physical examination, he complained of swelling of the scrotum. The patient was diagnosed with an intra-scrotal malignant tumor and local recurrence of RCC. We performed high orchiectomy and nephrectomy. The testicular tumor was diagnosed as testicular metastasis of RCC on pathological examination.

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.98.259_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Introduction: Characteristics of prostatic fluid (PF), which can be obtained in large amounts during screening transrectal ultrasound just before prostate biopsy to detect prostate cancer, were investigated. These characteristics include the amount of PF obtained and the number of leukocytes in PF, which would be useful for planning cell-biological or immunological studies of leukocytes in PF and for increasing the understanding of prostatitis in elderly men. Patients and Methods: The volume of PF and the number of leukocytes in PF were measured in 50 patients suspected of having prostate cancer because of elevated levels of serum prostate-specific antigen (PSA). Correlations of the volume of PF, the number of leukocytes per milliliter, the total leukocyte number with age and prostate volume and correlation of PSA levels with the number of leukocytes per milliliter and total leukocyte number were also investigated. Results: The average patient age was 67.2 years, and PF specimens were obtained from 43 of the 50 patients (86%). The mean ± SD of PF volume, number of leukocytes in PF, and total leukocyte number were 347.65 ± 305.76 μl, 4.84 ± 6.07 × 10 6 /ml, and 1.47 ± 2.10 × 10 6, respectively. A correlation was observed only between the total leukocyte number and the volume of the transitional zone (P=0.039). Conclusions: These data provide information for investigators to plan cell-biological or immunological studies of leukocytes in PF and for understanding prostatitis in elderly men.

DOI： 10.1272/jnms.73.24

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Urological Association  

A 54-year-old man with general fatigue and lumbago was admitted for further examination of hypercalcemia and leukocytosis. CT showed a huge renal tumor and extension of the tumor thrombus to the inferior vena cava (IVC). Moreover, the serum granulocyte colony-stimulating factor (G-CSF) and the C-terminal of parathyroid hormone-related protein (PTHrP) were elevated. Under the diagnosis of advanced renal tumor, we performed nephro-ureterectomy and throbectomy. Pathological examination revealed squamous cell carcinoma of the renal pelvis. To our knowledge, this is the first case in Japan that of the simultaneous production of G-CSF and PTHrP in squamous cell carcinoma of the renal pelvis accompanied with IVC thrombus.

DOI： 10.5980/jpnjurol1989.97.852

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objectives: While reassessing the value of exfoliative cytologic examination of prostatic fluid (PF) for the diagnosis of prostate cancer, we found that PF is easily obtained with transrectal ultrasonography during prostate biopsy and that cytologic examination of PF is useful for the diagnosis of prostate cancer. Methods: The cohort included 53 consecutive patients who underwent transrectal prostate biopsy from May through September 2005. Patient age was 66.7 ± 7.24 years, and the mean concentration of prostate-specific antigen (PSA) was 15.1 ± 25.8 ng-ml. The PF for cytologic examination was obtained before biopsy, and Papanicolaou-s staining was performed. The results of cytologic examination are expressed as class 1 to 5. Results of cytologic examination and prostate tissue pathologic examination were analyzed. Patient age, PSA levels, total prostate volume (TPV), and PF volume were compared with cytologic class by means of analysis of variance. Results: The mean PF volume was 378.4 ± 245.3 μl, and the mean TPV was 38.0 ± 18.8 ml. The numbers of patient in classes 1 to 5 were 1 (1.9%), 37 (69.8%), 11 (20.7%), 1 (1.9%), and 3 (5.7%), respectively. Pathologic examination showed 23 (43.4%) cases of cancer, 27 (50.9%) cases of benign prostatic hyperplasia, and 3 (5.7%) cases of high-grade prostatic intraepithelial neoplasia. All three patients with class 5 results had prostate cancer (Gleason score, 7 to 10). All 9 patients with a PSA level greater than 16 ng-ml had biopsy-proven cancer, and 3 of these 9 patients (33.3%) were in cytology class 5. Therefore, PF cytologic examination showed a specificity of 100% and a sensitivity of 33.3% in patients with PSA levels higher than 16 ng-ml. The cytologic classes differed in PSA levels (F=8.271, P=0.000) but not in patient age, TPV, or PF volume. Conclusions: Exfoliative cytologic examination of PF is a valuable, noninvasive method for detecting prostate cancer, especially in patients with high PSA levels.

DOI： 10.1272/jnms.73.129

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose: To determine the efficacy of power Doppler ultrasound (PDU) in the diagnosis of prostate cancer, the rate of detection of cancer with PDU-guided target biopsy and sextant biopsy, the clinicopathological features of cancer positive specimens, and the relation between these two findings were studied. Methods: From January 1998 through March 2000, 302 men suspected to have prostate cancer underwent sextant biopsy in association with additional PDU-guided target biopsy. Cases with positive biopsy results were divided into 9 groups as follows: T0: sextant biopsy was positive, but target biopsy was negative: S0: all sextant biopsies were negative, but target biopsy was positive: S1-S6: both sextant biopsy and target biopsy were positive (number indicates number of positive sextant biopsy): Tx: sextant biopsy was positive, but no target biopsy was performed owing to a lack of echogenic abnormalities. The Gleason score (GS) and percent organ confined disease (%OCD) were compared between these 9 groups. Results: Cancer was pathologically detected in 143 of 302 patients (47.4%). PDU detected 39 of 49 digital rectal examination-negative cancers (79.6%) and 5 of 13 transrectal ultrasound-negative isoechoic cancers (38.5%). Of 143 biopsy-positive cases, 6 were in the T0 group (4.2%), 10 in S0 (7.0%), 119 in S1-S6 (83.2%), and 8 in Tx (5.6%). Target biopsy missed 14 (sum of T0 and Tx) cancers, and sextant biopsy missed 10 (S0). The average GS in the Tx group was significantly lower than that in the other groups: consequently, the %OCD was significantly higher. Retrospective analysis revealed that the failure to obtain cancer tissue in 4 of the 6 cases in the T0 group is most likely due to technical failure in obtaining specimens. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PDU were 90.2%, 77.4%, 78.2%, 89.8% and 83.4%, respectively. Conclusion: PDU in association with sextant biopsy is a useful tool for increasing the rate of detection of prostate cancer. Further advances in ultrasound technology may enable the detection of prostate cancer by target biopsy alone and consequently may reduce the number of unnecessary biopsies. However, PDU-guided target biopsy alone is insufficient for cancer detection at the present time because of possible technical failure in obtaining specimens and the existence of PDU-negative cancer. Although more evidence is required, PDU-negative cancer is suggested to be less aggressive clinically, possibly justifying a watch and wait policy.

DOI： 10.1272/jnms.72.262

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記述言語：英語  

Background: We assessed the outcome and prognostic factors in men with prostate cancer after luteinizing hormone-releasing hormone agonist monotherapy. Methods: Between April 1998 and August 2002, 62 men with prostate cancer who were treated with monotherapy at our institution were included in this analysis. Prostate-specific antigen (PSA) failure-free (bNED) survival was calculated using Kaplan-Meier methods. Prognostic factors were evaluated using Cox proportional hazards regression model. Results: We reviewed the data of patients, with a median follow-up from the commencement of monotherapy of 26 months. The overall survival rate at 3 years was 89.9%. The bNED survival rate was 63.7% at 3 years. Of the 20 patients with clinical stage B, 2 progressed to PSA failure, whereas PSA failure was seen in 8 of 30 patients with stage C and 8 of 12 patients with stage D. The significant factors for bNED status were an initial PSA level of &lt
30 ng/ml (p = 0.0044), achievement of PSA nadir level of &lt
2.0 ng/ml (p&lt
0.001), and Gleason score of ≤6 (p&lt
0.00l). Conclusions: Patients with high clinical stage, a high initial PSA level of ≥30 ng/ml, and high Gleason score of ≥7 are at increased risk for PSA failure. Failure to achieve PSA nadir level of &lt
2.0 ng/ml is an important predictor of the progression. The use of PSA nadir can provide useful guidelines for the reconsideration of treatment in patients who have received monotherapy.

DOI： 10.1272/jnms.72.89

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.96.214_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.96.358_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.96.86_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose: We investigated whether urine survivin, an inhibitor of the apoptosis protein, is useful for diagnosing bladder tumor. Method: We measured urine survivin levels in 40 patients with bladder tumors and 9 healthy volunteers. Results: The average urine survivin levels in the 40 patients and 9 healthy controls were not significantly different (3.802 ± 8.669 and 1.127 ± 1.529, respectively (p = 0.3646)). However, significantly high urine survivin levels were observed in 3 of the 40 patients, but not in healthy volunteers. Urine Cyfra 21-1 was not elevated (1.3 ng/ml) in one patient with a significantly elevated urine survivin level (33.54 ng/ml), while in two patients with elevated Cyfra (320 ng/ ml and 240 ng/ml), the urine survivin level was not detectable. Conclusion: With improvements in the sensitivity of our Elisa system for urine survivin and combined use of urine Cyfra 21-1, it is possible that urine survivin will be a useful tumor marker in detecting both new-onset and recurrent bladder tumors.

DOI： 10.1272/jnms.71.379

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report four patients on maintenance hemodialysis (HD) with transitional cell carcinoma (TCC) of the bladder. Three patients underwent transurethral resection (TUR) of their tumors, which were grade 2 or 3, stage pT1 TCC. Among them, one patient underwent repeat TUR for recurrent superficial TCC. The remaining one patient underwent total cystectomy for grade 3, stage pT4 TCC and squamous cell carcinoma of the bladder. Subsequently, he died suddenly without evidence of local recurrence or systemic metastasis. We discuss the relationship between the duration of HD and the tumor grade and stage of primary bladder TCC in maintenance HD patients.

DOI： 10.1272/jnms.71.408

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Five- and ten-year survival rates in patients who had transurethral resection for pT2aNOMO muscle invasive transitional cell carcinoma of the bladder was studied with emphasis on the effect of adjuvant transarterial infusions of anticancer agents (TAI). A total of 17 patients out of 290 patients with bladder cancer who had initial treatment in our department between January 1991 and May 2001 were found to be pT2aNOMO and were included in the present study. Fifteen patients received intravesical instillations of BCG after transurethral resection of the bladder tumor and 8 patients received TAI which was given two weeks after bacillus Calmette-Guerin therapy, with the exception of 1 patient. Five- and ten-year overall survival rates were 76.0% and 52.1%, respectively, and both five- and ten-year cancer-specific survival rates were 76.0% with an average follow up of 71 months. Significant prognostic factor associated with survival rates was only the infiltration pattern of the tumor cells between the alpha and beta group and gamma group (P = 0.0420) in cancer-specific survival rates. The data support conservative management of transurethral resection followed by intravesical instillation of BCG and TAI in patients with pT2a bladder cancer.

DOI： 10.1272/jnms.71.263

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Objective: This study was conducted to examine the natural history of renal cell carcinoma (RCC).
Methods: Inclusion criteria were the following: (1) patients who received diagnostic imaging of the kidney (CT, MRI) at two points in time before the diagnosis of RCC or patients who were followed, without treatment, after a diagnosis of RCC; and (2) patients in whom changes in tumor size were followed by the same modality of diagnostic imaging and who did not receive any treatment which could exert anti-tumor activity on the primary or metastatic lesions. The tumor doubling time (DT) and the growth rate of maximum tumor diameter (R) were determined. DT was calculated using the equation DT = (T - T(0)) x log2/logV-1ogV(0) (where T - T(0) indicates the length of time between two measurements and V(0) and V denote the tumor volume at two points of measurement). R was calculated using the equation R = (phi - f(0))/(T - T(0)) x 100 (where 0 and f indicate the maximum diameter at two points). Fifty-six cases registered with the Japanese Society of Renal Cancer were included in the evaluation.
Results: DT was 603.1 +/- 510.1 days, which did not correlate with V0. R was 0.263 +/- 0.346 cm/day x 100. In cases where the tumor diameter was A cm, a significant correlation was noted between f(0) and R.
Conclusions: Elucidation of the natural history of RCC will contribute to facilitation of differential diagnosis and determination of optimum therapeutic strategy.

DOI： 10.1093/jjco/hyh011

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.354_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.391_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.507_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.430_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.372_3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background. We carried out this study to clarify whether the operative methods of laparoscopic prostatectomy established in France could become standard therapy. The purpose was to evaluate the technical feasibility, oncological efficacy, and intraoperative and postoperative morbidity of laparoscopic prostatectomy performed by a general urologist. Methods. Between June 2000 and August 2002, 30 patients with clinically localized prostate cancer underwent laparoscopic radical prostatectomy performed as previously reported by Guillonneau and colleagues. Oncological data were assessed by pathological examination and by postoperative prostate-specific antigen (PSA) levels. All prostatectomy specimens were processed according to the Stanford protocol. Prostate features, including tumor weight
Gleason score
and the tumor status of the capsule, seminal vesicles, and surgical margins were studied. Results. Complete laparoscopic removal of the prostate and seminal vesicles was achieved in all 30 patients. Operating time averaged 325.5min (range, 165 to 880min). The transfusion rate for the patients in the series was 50%, using own-blood transfusion (800-1200ml). No patient required an allogenic blood transfusion. Only 2 of the 30 patients had a positive surgical margin that involved the urethra. There were three complications: bladder injury, rectal injury, and ileus associated with a drainage tube. No vascular, nervous system, or urethral complications were found. Conclusion. These preliminary results demonstrated that radical prostatectomy can be performed laparoscopically by general urologists. Laparoscopy offered better luminosity and magnification than conventional procedures, permitting precise dissection. Thus, laparoscopic prostatectomy could be a standard operation for patients with clinically organ-confirmed prostate cancer.

DOI： 10.1007/s10147-003-0345-5

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.94.390_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.94.329_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.94.317_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.161_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.172_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.179_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.328_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.149_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.240_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.417_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.132

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出版者・発行元：Study Group of Microwave Surgery  

From 1999, we have performed the partial nephrectomy for the size of ≤ 4cm in diameter of renal cell carcinoma using the microwave tissue coagulator in our institution. In this study, we examined the side effect and usefulness of the microwave tissue coagulator. Total 11 patients who had been treated the partial nephrectomy for renal tumor without the renal artery cramping at our institution between 1999 and June 2001 were enrolled in this study. We underwent the open surgery in 6 patients and laparoscopic surgery in 5 patients. There were no cases that shifted to the nephrectomy and trancefused due to bleeding from the tumor resection's side. We didn't have patients who were not pathologically diagnosed for using the microwave tissue coagulator. All patients didn't have serious side effect and renal disfunction post operation.

DOI： 10.3380/jmicrowavesurg.20.93

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KLUWER ACADEMIC/PLENUM PUBL  

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.283_4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE ASIA  

Background: The present study was conducted to investigate the incidence of renal cell carcinoma by sex, age group and different regions in Japan.
Methods: The survey was conducted from the beginning of January 1997 to the end of December 1997. A total of 1306 Institutions in all 47 prefectures throughout Japan were requested to register cases.
Results: There were 6358 persons with renal cell carcinoma, consisting of 4372 men and 1986 women. The age-specific incidence rates showed a peak in the age group of 65-70 years in both men and women. The crude incidence rates per 100 000 population for men and women were 7.1 and 3.1, respectively, and age-standardized incidence rates per 100000 population for men and women were 4.9 and 1.8, respectively. The incidence rates in the Hokkaido region were significantly higher than in other regions (P&lt;0.05), among which there was no significant difference in incidence rates.
Conclusions: The present study showed that the incidence rates of renal cell carcinoma in Japan were approximately the same as among Japanese in Los Angeles. The rates were, however, lower than North American and European countries, but higher than China, Central or South American countries and African countries. The reasons for the high incidence of renal cancer in the Hokkaido region are not entirely clear. Further epidemiologic research is required.

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.210_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.173_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.167_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.380_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.277_1

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We present a case of renal cell carcinoma in the wall of a simple renal cyst. A 54-year-old man visited our hospital with a complaint of right back pain. Ultrasound study revealed right hydronephrosis, a ureteral stone, and a 9 × 8 cm renal cyst, with a tumor, 2 cm in diameter, in the cyst wall. Power Doppler Ultrasound and enhanced computed tomography demonstrated hypervascularity of the tumor. Clinically, he was diagnosed as renal cell carcinoma and nephrectomy was performed. Pathological findings of the tumor showed clear cell carcinoma in the wall of a simple renal cyst. Twelve months after the nephrectomy, he was free from recurrence.

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その他リンク： http://orcid.org/0000-0003-0088-9324

DOI： 10.1272/jnms.68.275

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.250_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.92.442_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.348_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.389_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.186_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.287_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.251_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.452_4

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.326_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.91.323_4

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記述言語：日本語   出版者・発行元：泌尿器科紀要刊行会  

症例は66歳で,頻尿と腰痛を主訴とした.直腸診で凹凸不整・板状硬の前立腺を触知し,超音波検査の所見から前立腺癌を強く疑った.MRIで前立腺周囲脂肪組織や直腸壁への腫瘍浸潤を認め,腹部CTで傍大動脈から総腸骨動脈に及ぶリンパ節腫脹を認めた.生検により前立腺小細胞癌のTNM分類T4N3M1と診断し,多剤併用療法を考慮したが,多発性肝転移と全身状態悪化のため困難と判断した.患者は初診より33日目に急性肝不全のため死亡したA 66-year-old man was referred to our hospital with a complaint of lumbago. Digital rectal examination showed an enlarged, irregular prostate with stony hardness. The serum level of prostate specific antigen (PSA) was elevated. Abdominal computed tomography showed enlarged common iliac and paraaortic lymph nodes, and multiple liver metastases. Bone scintigraphy showed multiple bone metastases. Histological and immunohistochemical examinations indicated small cell carcinoma and adenocarcinoma of the prostate. Chemotherapy could not be performed due to acute hepatic failure. The patient died 1 month after his first visit.

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：泌尿器科紀要刊行会  

症例は70歳男性で無痛性右陰嚢腫脹を主訴とした.超音波パワードプラ法(PDU)で陰嚢部腫瘤の大半は大小不同の嚢胞で,腫瘤の辺縁にやや低エコーを示す精巣上体と思われる部位を認めた.PDUにおいては血流増加は認められなかった.右精巣腫瘍が否定できなかったため右高位精巣摘除術を施行した.病理組織学的所見で精巣上体に中心壊死及びラングハンス巨細胞を含む結核結節を認めたため精巣上体結核と診断した.精巣上体結核は稀な疾患であり術前に診断することは困難なことが多いと考えられる.高齢者の再燃など結核総数の増加が報告されており,日常診療で念頭におかなければならない疾患の1つであるA 70-year-old man complaining of painless right scrotal swelling was referred to our hospital. He had a past history of left nephrectomy for renal tuberculosis at the age of 28. Power Doppler ultrasonography revealed a hypoechoic and hypovascular tumor with septa in the scrotum. We suspected a right testicular tumor and therefore, performed a right high inguinal orchiectomy. On macroscopic findings, the fluid of the tumor was yellowish and mucinous and the ipsilateral testis was remarkably atrophic. The pathological diagnosis was tuberculous epididymitis with central necrosis. In recent years, tuberculous epididymitis is rare, and this case was considered to be the first report of power Doppler ultrasonographic findings in tuberculous epididymitis.

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Objectives. Recent clinical trials have implied the cytotoxic and antiproliferative effects of combining 5-fluorouracil and interferon-alpha in the treatment of metastatic renal cell cancer. We therefore conducted an open multicenter trial to test the efficacy of such a combination on this cancer.
Methods. Human lymphoblastoid interferon (3 MIU per patient) was administered subcutaneously three times weekly for 12 weeks, while S-fluorouracil was administered (600 mg/m(2)/day) as a continuous infusion for the first 5 days, followed by an intravenous bolus infusion of 600 mg/m(2) once a week from the 3rd week until the 12th week.
Results. Of the 63 patients entered into the trial, 55 were eligible and evaluable for systemic toxicities, and 53 were evaluable for their response. All patients had undergone a prior nephrectomy, and their European Cooperative Oncology Group (ECOG) performance status ranged from 0 to 3 (median 0). Three complete and eight partial responses were induced, with an overall response rate of 20.0%. The median time to progression and the median survival time were 11 and 33 months, respectively. World Health Organization grade 3 toxicities were observed in 8 patients; however, no grade 4 toxicities or toxicity-related deaths were noted.
Conclusions. Combination therapy of interferon-alpha plus 5-fluorouracil at the above-described dosage and schedule produced no better responses than interferon monotherapies. Prolongation of survival could be attributable to the fair performance status of the patients. This regimen has limited value for the treatment of patients with advanced renal cell cancer. UROLOGY 53: 53-59, 1999. (C) 1999, Elsevier Science Inc. All rights reserved.

DOI： 10.1016/S0090-4295(98)00459-2

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Two cases of adrenal pheochromocytoma associated with renal cell carcinoma are reported. The first case was in a 56-year-old woman who had been treated for hypertension. Computerized tomography (CT) scan revealed a right renal tumor and a right adrenal mass. Endocrinological examination and 131I-MIBG scintigraphy confirmed the diagnosis of pheochromocytoma. Right radical nephrectomy was performed under stable blood pressure. The second case was in a 45-year-old man who had been treated for gastric ulcers. CT scan incidentally revealed a right renal tumor and a left adrenal mass. He was normotensive and endocrinologically normal. Right radical nephrectomy and left adrenalectomy were performed, followed by corticosteroid supplementation. In both cases, histopathological diagnosis was renal cell carcinoma and adrenal pheochromocytoma. Both patients had no clinical evidence for von Hippel-Lindau disease such as tumorous lesions of the central nervous system, spinal cord and retina, and cystic lesions of the kidney and pancreas.

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.89.333_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.89.245_2

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.89.346_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.89.172_2

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.88.283_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.88.274_2

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J-GLOBAL

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.87.197_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.87.541_1

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.86.645_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.86.793_2

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記述言語：日本語  

DOI： 10.4009/jsdt.28.197

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記述言語：日本語   出版者・発行元：(株)医学書院  

29歳男,オートバイの交通外傷にて来院.本来陰茎のある部位に陰茎を認めず,同部に陥凹をみるのみだった.手術を施行,用手的に陰茎を整復することに成功した.陰茎は包皮のほぼ全周にわたる挫創のみを認め,挫滅された包皮を切除後縫合した.尿道損傷および陰茎白膜損傷を認めなかった.左右の精巣は,それぞれ恥骨後面,右外鼠径輪に転位しており,両側精巣固定術を同時に行った.手術後経過良好である

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記述言語：日本語   出版者・発行元：西日本泌尿器科学会  

62例の前立腺肥大症に対して,術中にしばしば誘発される前立腺被膜の反射性収縮の予防を目的として,閉鎖神経ブロックを行い,semi-radical TURPを施行し,前立腺被膜の反射性収縮の有無と誘発部位と反射の強弱について検討した.閉鎖神経ブロックにより,被膜の反射性収縮は62例中9例に認められたが,9例中8例は軽度の反射性収縮で,高度の反射は1例のみであった.前立腺被膜の反射性収縮の誘発部位としては5時と7時方向の前立腺尖部の外腺領域が電気刺激を受けたときに発生を認めた.1例を除いて,ほぼ,強い前立腺被膜の反射性収縮は閉鎖神経ブロックにより予防ができた

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記述言語：日本語   出版者・発行元：西日本泌尿器科学会  

1986年11月から1990年8月までに660例の前立腺肥大症と12例の進行性前立腺癌を対象として,経尿道的前立腺剥離切除術を施行した.1) 672例全例において,剥離操作と剥離後の全切除に成功した.2)手術時間は11〜132分,平均38.4分であった.3)合計切除重量は1.5〜131.1 g,平均22.44 gであった.4)輸血は22例の3%に施行し,その輸血量は200〜800 mlで平均500 mlであった.5)術中および術後合併症として,剥離子による穿孔例は5例あったが,ドレナージは必要としなかった.死亡例は心筋梗塞の2例であった.6)再発による再手術例はなかった

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.83.925_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.83.972_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.83.1022_1

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：泌尿器科紀要刊行会  

1986年10月～1990年2月の間の19例にRaz法,1990年6月～1991年5月の間の18例にGittes法を施行した.1991年8月にRaz法施行17例及びGittes法施行全例で追跡調査を行った.Raz法施行12例及びGittes法施行16例で失禁の消失或いは著明改善を認めた.重症な合併症はみなかった.Raz法の手術結果が不十分な理由は,早期症例における手術手技の未熟,及び症例選択の誤りであると考えられたWe performed Raz procedure and Gittes procedure for female stress incontinence since October 1986. Raz procedure was performed on 19 patients between October 1986 and February 1990, and Gittes procedure was performed on 18 patients between June 1990 and May 1991. We followed up 17 patients who underwent Raz procedure and all the patients who underwent Gittes procedure at the time August 1991. Disappearance or marked improvement of incontinence was confirmed in 12 patients by Raz procedure, and 16 patients by Gittes Procedure. No serious complications were recognized. The reason why the result of Raz procedure was not sufficient was due to our immature operative technique and incorrect patient selection in our early experience. From this experience, we believe that both procedures can be very useful and minimal invasive operation for female stress incontinence.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

A medium that had been conditioned by PC-3 cells stimulated the calcification of a human osteoblastic cell line, Tak-10, in a nonmitogenic culture. The calcification of the osteoblasts was stimulated maximally at a 25% concentration of the conditioned medium. Calcification activity was markedly enhanced by the addition of both prostatic acid phosphatase (PAP) and its substrate, alpha-glycerophosphate, to the medium; however, PAP added alone did not enhance this activity. These results suggest that human prostatic carcinoma cells produce a factor that stimulates the calcification of the human osteoblasts. Results have also suggested that PAP is a requisite for osteogenesis provided that its substrates are abundant in the medium.

DOI： 10.1159/000282291

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

1987年3月までの5年間の54例について,男女比は7:2, 60歳代(平均62.15歳)に多い.腫瘍発生部位は両側尿管口周辺に集中する.病理組織学的にgrade 1&gt;2&gt;3の順に多く,stageはpTlbが多い.浸潤様式としてはINFαが多く,ly(0),V(-)が多い.腔内再発はgrade 2, stage pTlbが有意に多い

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記述言語：日本語   出版者・発行元：泌尿器科紀要刊行会  

A 71-year-old female was seen initially with the complaint of gross hematuria. Cystoscopic examination revealed non-papillary tumor at the dome of the bladder and a transurethral biopsy showed signet ring cell carcinoma. En bloc segmental resection was performed, and the patient has been well without any evidence of progression. We report a case, which we believe to be the 6th in Japan, of signet ring cell carcinoma of the urachus.

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その他リンク： http://search.jamas.or.jp/link/ui/1992058659

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

We studied subsets and cytotoxicity of recombinant interleukin-2 (rIL-2)-expanded tumor-infiltrating lymphocytes (TIL) from renal cell cancer (RCC) patients. TIL were successfully expanded in 13 of 14 RCC cases using anti-CD3 during the initial 48 h of culture. Percentages of CD8-positive cells among rIL-2-expanded TIL at 1-4 week(s) of culture were 56.2 +/- 15.1% (range 26.2-79.8%, n = 13) and not necessarily predominant over CD4-positive cells. Natural killer and lymphokine-activated killer (LAK) activities of TIL at 3-6 weeks of culture were 31.6 +/- 15.8% (range 1.4-57.4%, n = 9) and 16.6 +/- 11.6% (range 3.8-35.6%, n = 6), respectively. Autologous and allogeneic RCC cytotoxicity of TIL at 3-4 weeks of culture were 17.9 +/- 19.7% (range 0-47.6%, n = 4) and 18.9 +/- 14.8% (range 0-47.3%, n = 12), respectively. Since there was no statistical difference between them, autologous specific cytotoxicity was not demonstrated. From these result of the present study, it is unlikely that most of effector cells of rIL-2-expanded TIL in autologous RCC lysis are major histocompatibility complex-restricted cytotoxic T cells. We concluded that it is doubtful whether TIL is significantly superior over LAK cells in immunotherapy of human RCC.

DOI： 10.1159/000282260

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

1982年4月1日より1987年3月31日の5年間に日本医科大学付属病院において, 表在性膀胱腫瘍と診断された54例について検討した.<BR>1) 男女比は7: 2と男性に多く診断時年齢は60歳代が多いと判断された (平均年齢62.15歳).<BR>2) 腫瘍発生部位は両側尿管口周辺に集中する傾向を認めた.<BR>3) 病理組織学的にはgrade 1>grade 2>grade 3の順に多く, stageはpT1bが多いと判断された.<BR>4) 浸潤様式としてはINFαが多くly (0), v (-) が多い傾向を示した.<BR>5) 腔内再発はgrade 2, stage pT1bに有意に多いと判断された.

DOI： 10.1272/jnms1923.58.454

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記述言語：日本語   出版者・発行元：泌尿器科紀要刊行会  

A 71-year-old female was seen initially with the complaint of gross hematuria. Cystoscopic examination revealed non-papillary tumor at the dome of the bladder and a transurethral biopsy showed signet ring cell carcinoma. En bloc segmental resection was performed, and the patient has been well without any evidence of progression. We report a case, which we believe to be the 6th in Japan, of signet ring cell carcinoma of the urachus.

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.5980/jpnjurol1989.81.835

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その他リンク： http://orcid.org/0000-0003-0088-9324

記述言語：日本語   出版者・発行元：(株)医学書院  

CiNii Books