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Narita C, Urabe F, Fukuokaya W, Iwatani K, Imai Y, Yasue K, Mori K, Aikawa K, Yanagisawa T, Kimura S, Tashiro K, Tsuzuki S, Yamada Y, Yuen SKK, Teoh JYC, Shimomura T, Yamada H, Furuta A, Miki J, Kimura T. Site-Specific Differences of Eligibility for Adjuvant Immunotherapy Among Urothelial Carcinoma Patients Treated With Radical Surgery: Results From a Multicenter Cohort Study. Clin Genitourin Cancer 2024:102082. [PMID: 38641443 DOI: 10.1016/j.clgc.2024.102082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The CheckMate274 trial has reported enhanced disease-free survival rates in patients with stage pT3-4/ypT2-4 or pN+ urothelial carcinoma (UC) undergoing adjuvant nivolumab therapy. This study compares prognostic differences between urothelial carcinoma of the bladder (UCB) and upper tract urothelial carcinoma (UTUC). METHODS We retrospectively analyzed data from 719 patients with UC who underwent radical surgery, stratifying to patients at stage pT3-4 and/or pN+ without neoadjuvant chemotherapy (NAC) or at ypT2-4 and/or ypN+ with NAC (potential candidates for adjuvant immunotherapy), and to those who were not candidates for adjuvant immunotherapy. We used Kaplan-Meier curves to assess oncological outcomes, particularly nonurothelial tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Risk factors were identified by Cox regression analysis. RESULTS Kaplan-Meier curves showed significantly lower NUTRFS, CSS, and OS for potential adjuvant immunotherapy candidates than for noncandidates in each UCB and UTUC group. NUTRFS, CSS, and OS did not differ significantly between adjuvant immunotherapy candidates with UBC or UTUC. Trends were similar among patients ineligible for adjuvant immunotherapy. Pathological T stage (pT3-4 or ypT2-4), pathological N stage, and lymphovascular invasion (LVI) were independent predictors of oncological outcomes on multivariate analysis. CONCLUSION The criteria for adjuvant immunotherapy candidates from the CheckMate 274 trial can also effectively stratify UC patients after radical surgery. Substantial clinical significance is attached to LVI status as well as to pathological T and N status, suggesting that LVI status should be considered when selecting suitable candidates for adjuvant immunotherapy.
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Affiliation(s)
- Chisato Narita
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Wataru Fukuokaya
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosuke Iwatani
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Yu Imai
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiji Yasue
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichiro Mori
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichi Aikawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takafumi Yanagisawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shoji Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Kojiro Tashiro
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Shunsuke Tsuzuki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuta Yamada
- Department of Urology, University of Tokyo, Tokyo, Japan
| | - Steffi Kar Kei Yuen
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Tatsuya Shimomura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Akira Furuta
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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Narita C, Takubo N, Sammori M, Matsumura Y, Shimura K, Ozaki R, Haruna H, Narumi S, Ishii T, Hasegawa T, Shimizu T. A case of 46,XY complete gonadal dysgenesis with a novel missense variant in SRY. Clin Pediatr Endocrinol 2023; 32:235-238. [PMID: 37842143 PMCID: PMC10568573 DOI: 10.1297/cpe.2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/12/2023] [Indexed: 10/17/2023] Open
Abstract
Disorders of sex development (DSD) with mild external genital abnormalities may be diagnosed after puberty. Here, we report a case of 46,XY complete gonadal dysgenesis with a novel missense variant in sex-determining region Y (SRY), diagnosed after primary amenorrhea. A 15-yr-old patient presented to our gynecology department with a chief complaint of amenorrhea. The patient was diagnosed with a 46,XY karyotype, and SRY gene positivity. Gonadotropin levels were high, whereas testosterone levels were low. A pelvic magnetic resonance imaging (MRI) revealed a hypoplastic uterus; however, no gonads could be identified. Laparoscopy revealed bilateral streak gonads, fallopian tube-like structures, and the uterus. The gonads were removed based on the risk of gonadal malignancy. Comprehensive genetic analysis of DSD revealed a previously unreported SRY variant, c.271A>T, p.Ser91Cys, and in silico analysis predicted the variant to be pathogenic. The patient was diagnosed with 46,XY complete gonadal dysgenesis with a novel missense variant in SRY. The patient continued female hormone replacement therapy and experienced breast enlargement and cyclic menstruation. Determining the etiology of DSD can be difficult, causing anxiety in patients and their families. In addition to surgical scrutiny, genetic analysis is important to aid in diagnosis and reassure patients and their families.
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Affiliation(s)
- Chisato Narita
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Noriyuki Takubo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Manami Sammori
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuko Matsumura
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Shimura
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Rie Ozaki
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hidenori Haruna
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Narumi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Narita C, Nishizaki N, Takubo N, Shimura N, Shimizu T. Graves' disease following nephrotic syndrome treated by prednisolone: A case report. Pediatr Int 2023; 65:e15634. [PMID: 37804051 DOI: 10.1111/ped.15634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/03/2023] [Accepted: 07/26/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Chisato Narita
- Department of Pediatrics, Tokyo Rinkai Hospital, Tokyo, Japan
| | - Naoto Nishizaki
- Department of Pediatrics, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Noriyuki Takubo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Naoto Shimura
- Department of Pediatrics, Tokyo Rinkai Hospital, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
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Kono A, Yoshioka R, Hawke P, Iwashina K, Inoue D, Suzuki M, Narita C, Haruta K, Miyake A, Yoshida H, Tosaka N. Correction to: A case of severe interstitial lung disease after COVID-19 vaccination. QJM 2022; 115:705. [PMID: 35312768 PMCID: PMC9383578 DOI: 10.1093/qjmed/hcac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Kono
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - R Yoshioka
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - P Hawke
- School of Pharmaceutical Sciences, University of Shizuoka, 51-1 Yada Suruga ward, Shizuoka 422-8526, Japan
| | - K Iwashina
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - D Inoue
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - M Suzuki
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - C Narita
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - K Haruta
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - A Miyake
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - H Yoshida
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - N Tosaka
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
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Kono A, Yoshioka R, Hawk P, Iwashina K, Inoue D, Suzuki M, Narita C, Haruta K, Miyake A, Yoshida H, Tosaka N. A case of severe interstitial lung disease after COVID-19 vaccination. QJM 2022; 114:805-806. [PMID: 34618126 PMCID: PMC8522437 DOI: 10.1093/qjmed/hcab263] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Kono
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
- Corresponding author contact information. Akira KONO, Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881). Mail: , TEL: +81-70-6557-8674
| | - R Yoshioka
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - P Hawk
- University of Shizuoka, 51-1 Yada Suruga ward, Shizuoka, Japan (zip code 422-8526)
| | - K Iwashina
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - D Inoue
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - M Suzuki
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - C Narita
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - K Haruta
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - A Miyake
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - H Yoshida
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - N Tosaka
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
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Koyama K, Maeda D, Tamura D, Narita C, Kudo-Asabe Y, Sato T, Yamamoto Y, Sageshima M, Nanjo H, Goto A. Fetal gut-like differentiation in gallbladder cancer. Hum Pathol 2017; 70:27-34. [PMID: 28970139 DOI: 10.1016/j.humpath.2017.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/12/2017] [Accepted: 09/22/2017] [Indexed: 11/26/2022]
Abstract
Adenocarcinomas showing fetal gut-like (enteroblastic) differentiation can arise in a variety of organs and are frequently accompanied by an elevated serum α-fetoprotein (AFP) level. However, no study has investigated fetal gut-like differentiation in gallbladder cancer in detail. Herein, we performed morphological and immunohistochemical analyses of fetal gut-like differentiation in 49 consecutive gallbladder cancer cases. The expression of Sal-like protein 4 (SALL4), an embryonic stem cell marker reported to represent fetal gut-like differentiation, as well as other oncofetal proteins, including glypican-3 (GPC3) and AFP, was assessed. We found 1 case of fetal gut-like adenocarcinoma that coexisted with conventional-type adenocarcinoma. The fetal gut-like adenocarcinoma component revealed diffuse immunoreactivity for SALL4 and partial positivity for AFP, whereas the conventional-type adenocarcinoma component was negative. We also found 2 poorly differentiated adenocarcinomas with hepatoid morphology and 1 clear cell carcinoma, none of which showed SALL4 positivity. In other conventional-type adenocarcinomas, focal immunoreactivity for SALL4 and GPC3 was occasionally observed. The overall positivity rates for SALL4 and GPC3 were 12.2% (6/49) and 16.3% (8/49), respectively. SALL4 and GPC3 expression was not associated with clinicopathological factors, including T category, lymphovascular invasion, and lymph node metastases. In conclusion, fetal gut-like adenocarcinoma was found in 2% of our gallbladder cancer series. We conclude that fetal gut-like adenocarcinoma is a distinct histological subtype of gallbladder cancer, characterized by SALL4 expression.
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Affiliation(s)
- Kei Koyama
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan; Faculty of Medicine, Akita University, Akita, 010-8543, Japan
| | - Daichi Maeda
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan.
| | - Daisuke Tamura
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan; Department of Obstetrics and Gynecology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan
| | - Chisato Narita
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan; Faculty of Medicine, Akita University, Akita, 010-8543, Japan
| | - Yukitsugu Kudo-Asabe
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan
| | - Tsutomu Sato
- Department of Surgery, Akita City Hospital, Akita, 010-0933, Japan
| | - Yuzo Yamamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan
| | - Masato Sageshima
- Department of Pathology, Akita City Hospital, Akita, 010-0933, Japan
| | - Hiroshi Nanjo
- Department of Pathology, Akita University Hospital, Akita, Akita 010-8543, Japan
| | - Akiteru Goto
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan
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