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Ito H, Yanagida S, Toyonaga Y, Yamashita H, Ohori M, Isaka K. Single assistant versus dual assistant robotic surgery for robot-assisted laparoscopic hysterectomy using da Vinci Xi or X. Int J Med Robot 2021; 17:e2315. [PMID: 34312964 DOI: 10.1002/rcs.2315] [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: 05/20/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND To verify the usefulness of single assistant robotic surgery (SA-RS) using da Vinci Xi or X performed for total hysterectomy. METHODS The SA-RS group (S-group) includes surgeries in which the surgeon performed all surgical operations other than that of the uterine manipulator, while the dual assistant robotic surgery group (D-group) includes surgeries performed by the surgeon with two assistants. In S-group, the forceps and camera were replaced during surgery in cases of a large uterus with limited range of motion of the instrument. A comparative study of patient background, intraoperative and postoperative results and surgery-related cost was performed between the two groups. RESULTS No significant differences were observed between the two groups. On the contrary, S-group showed a significant reduction in preparation time and wound closure time, and a savings of $768. CONCLUSION SA-RS for total hysterectomy was possible, which is excellent in terms of cost, esthetics, and manpower.
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Affiliation(s)
- Hiroe Ito
- Department of Obstetrics and Gynecology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Satoshi Yanagida
- Robotic Surgery Center, Tokyo International Ohori Hospital, Tokyo, Japan
| | - Yoichiro Toyonaga
- Robotic Surgery Center, Tokyo International Ohori Hospital, Tokyo, Japan
| | - Hideyuki Yamashita
- Robotic Surgery Center, Tokyo International Ohori Hospital, Tokyo, Japan
| | - Makoto Ohori
- Robotic Surgery Center, Tokyo International Ohori Hospital, Tokyo, Japan
| | - Keiichi Isaka
- Department of Obstetrics and Gynecology, Tokyo Medical University Hospital, Tokyo, Japan.,Robotic Surgery Center, Tokyo International Ohori Hospital, Tokyo, Japan
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2
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Shirasuna K, Koelsch G, Seidel-Dugan C, Salmeron A, Steiner P, Winston WM, Brodkin HR, Nirschl CJ, Abbott S, Kinugasa F, Sugahara S, Ohori M, Takeuchi M, Hicklin DJ, Yoshida T. Characterization of ASP8374, a fully-human, antagonistic anti-TIGIT monoclonal antibody. Cancer Treat Res Commun 2021; 28:100433. [PMID: 34273876 DOI: 10.1016/j.ctarc.2021.100433] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
The T-cell immunoreceptor with Ig and immunoreceptor tyrosine-based inhibitory motif (ITIM) domains (TIGIT) is a validated immune checkpoint protein expressed on memory CD4+T-cellls, Tregs, CD8+T-cell and natural killer (NK) cells. ASP8374 is a fully human monoclonal immunoglobulin (Ig) G4 antibody designed to block the interaction of TIGIT with its ligands and inhibit TIGIT signaling. ASP8374 exhibited high affinity binding to TIGIT and increased interferon (IFN)-γ production of cultured peripheral blood mononuclear cells (PBMCs) in a titratable manner. When used in combination with pembrolizumab, an anti-programmed death-1 (PD-1) antibody, ASP8374 induced higher T-cell activation in vitro than either treatment alone. An anti-mouse TIGIT antibody surrogate, mSEC1, displayed anti-tumor efficacy in an MC38 syngeneic mouse tumor model alone and in combination with an anti-programmed death-ligand 1 (PD-L1) antibody. In an additional syngeneic mouse tumor model (CT26), while mSEC1 alone did not demonstrate anti-tumor efficacy, mSEC1 combined with an anti-PD-1 antibody enhanced anti-tumor efficacy above that of the anti-PD-1 antibody alone. These data provide evidence that ASP8374 has therapeutic potential for advanced malignancies.
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Affiliation(s)
- Kenna Shirasuna
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan.
| | - Gerald Koelsch
- Drug Discovery Research, Astellas Pharma Inc., 1 Astellas Way, Northbrook, IL 60062, USA
| | - Cynthia Seidel-Dugan
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Andres Salmeron
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Philipp Steiner
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - William M Winston
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Heather R Brodkin
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Christopher J Nirschl
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Sandra Abbott
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Fumitaka Kinugasa
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan
| | - Shingo Sugahara
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan
| | - Makoto Ohori
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan
| | - Masahiro Takeuchi
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan
| | - Daniel J Hicklin
- Potenza Therapeutics, 1030 Massachusetts Avenue, Suite 210, Cambridge, MA 02138, USA
| | - Taku Yoshida
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba-shi, Ibaraki, 305-8585, Japan
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Ohori M, Gondo T, Natsuyama T, Kaburaki N, Toyonaga Y, Takeuchi H, Yamashita H. [Current Status of Prostate Cancer and Its Relation to Home Medical Care]. Gan To Kagaku Ryoho 2020; 47:402-408. [PMID: 32381903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Because ofboth the indolent and aggressive nature ofprostate cancers, it is not easy to select the best treatment for patients receiving home medical care who already have many diseases. Since the growth ofprostate cancer is generally slow and all treatments adversely affect the quality of life to some degree, conservative treatment may well be the best option for these patients with prostate cancer. However, it is also true that we often encounter home medical care patients with a locally advanced cancer who had symptoms such as difficulty to urine, macrohematuria and/or lumbago. Such patients need to be diagnosed soon and treated with mainly hormonal therapy after consultation with the specialist. Thus, after a careful evaluation ofthe nature ofthe cancer and comorbidity, we need to provide the best option ofdiagnosis and treatment for home medical care patients to maintain their quality of life.
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Affiliation(s)
- Makoto Ohori
- Dept. of Urology, Tokyo International Ohori Hospital
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4
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Shimodaira K, Nakashima J, Nakagami Y, Hirasawa Y, Hashimoto T, Satake N, Gondo T, Namiki K, Ohori M, Ohno Y. Prognostic Value of Platelet Counts in Patients with Metastatic Prostate Cancer Treated with Endocrine Therapy. Urol J 2020; 17:42-49. [PMID: 30882158 DOI: 10.22037/uj.v0i0.4735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The endocrine therapy is effective for patients with advanced prostate cancer, but the disease eventually becomes refractory to treatment. The aim of this study was to investigate prognostic factors and to develop a risk stratification model for survival in patients with advanced prostate cancer undergoing endocrine therapy. MATERIALS AND METHODS This study included 197 patients with stage IV prostate cancer who were treated with endocrine therapy as primary treatment at Tokyo Medical University, Tokyo, Japan, between January 1999 and November 2012. Prognostic values including baseline clinical laboratory values before endocrine therapy for stage IV prostate cancer were examined. Patients (n = 30) who were not followed or for whom data were unavailable or who were treated with radiotherapy were excluded from the study. Excluding these patients, we retrospectively analyzed 167 patients who were treated with endocrine therapy as the primary treatment. Disease-specific survival (DSS) was evaluated using the Kaplan-Meier method, and prognostic factors were identified using the Cox proportional hazard model analysis. RESULTS In univariate analyses, patients with a performance status (PS) ? 2, platelet count ? 3.0× 105 µ/L, prostate specific antigen (PSA) > 50 ng/mL, alkaline phosphatase (ALP) > 350 U/L, lactate dehydrogenase (LDH) > 240 IU/L, and Gleason score (GS) ? 8, hemoglobin (Hb) < 12 g/dL, extent of disease (EOD) ? 3 and poorly differentiated adenocarcinoma showed significantly lower DSS than their respective counterparts. Neutrophil-to-Lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and white blood cell (WBC) count were not significantly associated with DSS. In a multivariate Cox proportional hazard model, PS and platelet count were independent prognostic factors. Based on the hazard rate (HR) calculated by the following formula: HR = exp (0.82 × PS + 1.38 × platelet count) patients were stratified into 3 risk groups. The differences in DSS rates among the 3 groups were statistically significant. CONCLUSION These results suggest that PS and platelet count are independent prognostic factors and that a combination of these factors can be used to stratify metastatic prostate cancer patients treated with endocrine therapy according to their DSS risk.
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Affiliation(s)
- Kenji Shimodaira
- Department of Urology, Tokyo Medical University, Tokyo, Japan. kenji
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Mima T, Ohori M, Hirasawa Y, Mikami R, Arai A, Hashimoto T, Satake N, Gondo T, Nakagami Y, Namiki K, Tokuuye K, Ohno Y. Salvage radiation therapy for prostate cancer patients after prostatectomy. Jpn J Clin Oncol 2019; 49:281-286. [DOI: 10.1093/jjco/hyy195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Takashi Mima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Ryuji Mikami
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Ayako Arai
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Koichi Tokuuye
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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6
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Kamoda N, Ohori M, Hirasawa Y, Inoue R, Hashimoto T, Satake N, Gondo T, Nakagami Y, Nagao T, Ohno Y. Prognostic significance of the presence of tertiary Gleason grade 5 in robot-assisted radical prostatectomy specimens in Japanese patients with clinically localized prostate cancer. Jpn J Clin Oncol 2019; 49:276-280. [PMID: 30649377 DOI: 10.1093/jjco/hyy194] [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: 08/21/2018] [Revised: 02/12/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to study the prognostic significance of tertiary Gleason grade (TGG) 5 in patients with clinically localized prostate cancer treated with robot-assisted radical prostatectomy (RARP). METHODS A total of 600 Japanese patients who underwent RARP for clinical stage T1-3N0M0 prostate cancer were evaluated. TGG5 was evaluated according to the International Society of Urological Pathology criterion. Cox hazard regression was used to evaluate the prognostic significance of prostate-specific antigen and pathological features in RARP specimens. RESULTS Of the 600 RARP specimens, 92 (15%) had TGG5. TGG5 component was found in 30 (10%) of 287 cases with Gleason score (GS) 3 + 4, 55 (37%) of 149 cases with GS 4 + 3 and 7 (17%) of 40 cases with GS 4 + 4. There were no significant differences in pathological stage and surgical margin status between GS 3 + 4 with and without TGG5, as well as between GS 4 + 4 with and without TGG5. Of the 600 patients, 92 (15%) patients had biochemical recurrence (BCR) after surgery, with a median follow-up period of 42 (3-104) months. There were no differences in 5-year BCR-free survival rates between patients with GS 3 + 4 with and without TGG5 (92 vs. 100%, P = 0.16), as well as between patients with GS 4 + 3 with and without TGG5 (79 vs. 71%, P = 0.30). Similarly, there were no differences in 3-year BCRFS rates between patients with GS 4 + 4 with and without TGG5 (80 vs. 71%, P = 0.38). CONCLUSIONS In our population, the presence of TGG5 in RARP specimens had no strong impact on pathological and prognostic outcomes.
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Affiliation(s)
- Naohiro Kamoda
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Rie Inoue
- Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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7
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Gerber GS, Thisted RA, Chodak GW, Schroder FH, Frohmuller HG, Scardino PT, Paulson DF, Middleton, Jr. AW, Rukstalis DB, Smith, Jr. JA, Ohori M, Theiss M, Schellhammer PF. Results of Radical Prostatectomy in Men with Locally Advanced Prostate Cancer: Multi-Institutional Pooled Analysis. Eur Urol 2019. [DOI: 10.1159/000480794] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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8
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Hashimoto T, Ohori M, Shimodaira K, Kaburaki N, Hirasawa Y, Satake N, Gondo T, Nakagami Y, Namiki K, Ohno Y. Prostate-specific antigen screening impacts on biochemical recurrence in patients with clinically localized prostate cancer. Int J Urol 2018; 25:561-567. [PMID: 29633374 DOI: 10.1111/iju.13563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/24/2017] [Accepted: 02/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To clarify the impact of prostate-specific antigen screening on surgical outcomes of prostate cancer. METHODS Patients who underwent radical prostatectomy were divided into two groups according to prostate-specific antigen testing opportunity (group 1, prostate-specific antigen screening; group 2, non-prostate-specific antigen screening). Perioperative clinical characteristics were compared using the Wilcoxon rank-sum and χ2 -tests. Cox proportional hazards models were used to identify independent predictors of postoperative biochemical recurrence-free survival. RESULTS In total, 798 patients (63.2%) and 464 patients (36.8%) were categorized into groups 1 and 2, respectively. Group 2 patients were more likely to have a higher prostate-specific antigen level and age at diagnosis and larger prostate volume. Clinical T stage, percentage of positive cores and pathological Gleason score did not differ between the groups. The 5-year biochemical recurrence-free survival rate was 83.9% for group 1 and 71.0% for group 2 (P < 0.001). On multivariate analysis, prostate-specific antigen testing opportunity (hazard ratio 2.530; P < 0.001) was an independent predictive factor for biochemical recurrence after surgery, as well as pathological T stage, pathological Gleason score, positive surgical margin and lymphovascular invasion. Additional analyses showed that prostate-specific antigen screening had a greater impact on biochemical recurrence in a younger patients, patients with a high prostate-specific antigen level, large prostate volume and D'Amico high risk, and patients meeting the exclusion criteria of the Prostate Cancer Research International Active Surveillance study. CONCLUSIONS Detection by screening results in favorable outcomes after surgery. Prostate-specific antigen screening might contribute to reducing biochemical recurrence in patients with localized prostate cancer.
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Affiliation(s)
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoto Kaburaki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Hirasawa Y, Ohori M, Sugihara T, Hashimoto T, Satake N, Gondo T, Nakagami Y, Namiki K, Yoshioka K, Nakashima J, Tachibana M, Ohno Y. No clinical significance of the time interval between biopsy and robotic-assisted radical prostatectomy for patients with clinically localized prostate cancer on biochemical recurrence: a propensity score matching analysis. Jpn J Clin Oncol 2018; 47:1083-1089. [PMID: 28973504 DOI: 10.1093/jjco/hyx125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 04/27/2017] [Accepted: 08/16/2017] [Indexed: 11/12/2022] Open
Abstract
Purpose To investigate the impact of the time interval (TI) between prostate biopsy and robot-assisted radical prostatectomy (RARP) on the risk of biochemical recurrence (BCR). Methods We retrospectively reviewed the medical records of 793 consecutive patients who were treated with RARP at our institution. Patients were divided into three groups, according to TI, to compare BCR-free survival (BCRFS) rates: Group 1 (n = 196), TI < 3 months; Group 2 (n = 513), 3 ≤ TI < 6 months; Group 3 (n = 84), TI ≥ 6 months. Eighty-three patients with TI ≥ 6 months were matched with an equal number of patients with TI < 6 months based on propensity scores by using four preoperative factors: prostate-specific antigen (PSA), primary (pGS) and secondary (sGS) Gleason score and positive prostate biopsy. Results The 5-year BCRFS rates for TI Groups 1, 2, and 3 were 76%, 80.7% and 82.6% (P = 0.99), respectively. The multivariate analysis revealed that PSA, pGS, sGS and a positive prostate biopsy were independent preoperative risk factors for BCR. The propensity adjusted 5-year BCRFS for patients with TI ≥ 6 months was 84.0%. This was not worse than that of patients with TI < 6 months (71.0%, P = 0.18). Conclusions In our cohorts, a delay in the time from biopsy to RARP did not significantly affect recurrence. Therefore, hasty treatment decisions are unnecessary for at least 6 months after diagnosis of early prostate cancer.
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Affiliation(s)
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo
| | - Toru Sugihara
- Department of Urology, Tokyo Medical University, Tokyo
| | | | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo
| | | | | | | | | | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo
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Sugihara T, Yasunaga H, Matsui H, Nagao G, Ishikawa A, Fujimura T, Fukuhara H, Fushimi K, Ohori M, Homma Y. Accessibility to surgical robot technology and prostate-cancer patient behavior for prostatectomy. Jpn J Clin Oncol 2017; 47:647-651. [PMID: 28419326 DOI: 10.1093/jjco/hyx052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 01/10/2017] [Accepted: 04/02/2017] [Indexed: 11/13/2022] Open
Abstract
Background To examine how surgical robot emergence affects prostate-cancer patient behavior in seeking radical prostatectomy focusing on geographical accessibility. Methods In Japan, robotic surgery was approved in April 2012. Based on data in the Japanese Diagnosis Procedure Combination database between April 2012 and March 2014, distance to nearest surgical robot and interval days to radical prostatectomy (divided by mean interval in 2011: % interval days to radical prostatectomy) were calculated for individual radical prostatectomy cases at non-robotic hospitals. Caseload changes regarding distance to nearest surgical robot and robot introduction were investigated. Change in % interval days to radical prostatectomy was evaluated by multivariate analysis including distance to nearest surgical robot, age, comorbidity, hospital volume, operation type, hospital academic status, bed volume and temporal progress. Results % Interval days to radical prostatectomy became wider for distance to nearest surgical robot <30 km. When a surgical robot emerged within 30 and 10 km, the prostatectomy caseload in non-robot hospitals reduced by 13 and 18% within 6 months, respectively, while the robot hospitals gained +101% caseload (P < 0.01 for all) Multivariate analyses including 9759 open and 5052 non-robotic minimally invasive radical prostatectomies in 483 non-robot hospitals revealed a significant inverse association between distance to nearest surgical robot and % interval days to radical prostatectomy (B = -17.3% for distance to nearest surgical robot ≥30 km and -11.7% for 10-30 km versus distance to nearest surgical robot <10 km), while younger age, high-volume hospital, open-prostatectomy provider and temporal progress were other significant factors related to % interval days to radical prostatectomy widening (P < 0.05 for all). Conclusions Robotic surgery accessibility within 30 km would make patients less likely select conventional surgery. The nearer a robot was, the faster the caseload reduction was.
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Affiliation(s)
- Toru Sugihara
- Department of Urology, Japanese Red Cross Medical Center, Tokyo.,Department of Urology, The University of Tokyo, Tokyo
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo
| | - Go Nagao
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Akira Ishikawa
- Department of Urology, Japanese Red Cross Medical Center, Tokyo
| | | | | | - Kiyohide Fushimi
- Department of Health Care Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, The University of Tokyo, Tokyo
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11
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Takeuchi H, Ohori M, Tachibana M. Clinical significance of the prostate-specific antigen doubling time prior to and following radical prostatectomy to predict the outcome of prostate cancer. Mol Clin Oncol 2016; 6:249-254. [PMID: 28357104 DOI: 10.3892/mco.2016.1116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 09/20/2016] [Accepted: 12/09/2016] [Indexed: 11/05/2022] Open
Abstract
With the advent of serum prostate-specific antigen (PSA), a larger number of prostate cancers in the early phase have been successfully detected. Although decisions to perform prostate biopsies are routinely based on PSA levels, the PSA level is easily influenced by benign prostatic hyperplasia, with poor specificity. Therefore, the aim of the present study was to assess the clinical significance of prostate-specific antigen doubling time (PSADT) prior to and following radical prostatectomy. In total, 488 patients with T1c-3N0M0 prostate cancer who underwent radical prostatectomy were included. Preoperative and postoperative PSADT were retrospectively correlated with pathological and clinical outcomes. Preoperative PSADT was measured in 204 of the 488 patients. In total, 16 out of 20 patients with a preoperative PSADT of >24 months had a cancer confined to the prostate compared with 105 of 184 patients with a PSADT of <24 months. The PSA non-recurrence rate at 5 years for patients with a preoperative PSADT of >24 months was significantly better compared with those with a preoperative PSADT of <24 months (P=0.011). Patients with a PSADT of >24 months and stable PSADT were associated with PSA recurrence following surgery, based on multivariate analysis. Postoperative PSADT was measured in 51 of 111 patients with PSA failure following surgery. Pathologically, 7 of 8 patients with a post-PSADT of >24 months had a cancer confined to the prostate compared with 14 of 43 patients with a post-PSADT of <24 months. These results suggest that patients with longer preoperative PSADTs appeared to have a favorable pathological result and a higher PSA non-recurrence rate compared with those with shorter preoperative PSADTs. A longer postoperative PSADT may facilitate the observation of patients with PSA recurrence without immediate secondary treatments.
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Affiliation(s)
- Hisashi Takeuchi
- Department of Urology, Tokyo Medical University Ibaraki Medical Center, Ibaraki 300-0395, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo 163-0023, Japan
| | - Masaaki Tachibana
- Department of Urology, Tokyo Medical University, Tokyo 163-0023, Japan
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Ono A, Hirasawa Y, Yamashina M, Kaburagi N, Mima T, Sugihara T, Hamada R, Gondo T, Ohori M, Nagao T, Ohno Y. A Case of Primary Small-Cell Carcinoma of the Bladder. Case Rep Oncol 2016; 9:574-579. [PMID: 27920687 PMCID: PMC5118827 DOI: 10.1159/000450597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 12/11/2022] Open
Abstract
Primary small-cell carcinoma arising from the bladder (SmCCB) is uncommon. It differs from urothelial carcinoma (UC), the most common type of bladder cancer, with respect to its cell of origin, biology, and prognosis. Biologically, prostatic SmCCB is much more aggressive than UC, and the prognosis for cases with distant metastasis is especially poor. We report here a case of primary SmCCB (cT3bN1M0) treated with radical cystectomy.
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Affiliation(s)
- Ashita Ono
- Department of Urology, Akabane Central General Hospital, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoto Kaburagi
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Takashi Mima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Toru Sugihara
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Riu Hamada
- Department of Urology, Akabane Central General Hospital, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Hashimoto T, Nakashima J, Kashima T, Hirasawa Y, Shimodaira K, Gondo T, Nakagami Y, Namiki K, Horiguchi Y, Ohno Y, Ohori M, Tachibana M. Clinical significance of preoperative renal function and gross hematuria for intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma. Int J Urol 2016; 24:111-116. [PMID: 27875859 DOI: 10.1111/iju.13256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 05/26/2016] [Accepted: 10/17/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the predictive values of perioperative factors and to develop a nomogram for intravesical recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma. METHODS A retrospective analysis of 144 patients who underwent radical nephroureterectomy from 1996 to 2014 was carried out. The actuarial probabilities of the intravesical recurrence-free survival rate were calculated using the Kaplan-Meier method. Prognostic indicators for intravesical recurrence were identified using competing-risks regression analyses. RESULTS Intravesical recurrence occurred in 63 patients during the follow-up period. The intravesical recurrence-free survival rates at 1, 3, and 5 years were 65.7%, 50.6% and 47.1%, respectively. In univariate analysis, the presence of gross hematuria (P = 0.028) and the preoperative serum creatinine level (P = 0.033) were significantly associated with intravesical recurrence. In multivariate analysis, the presence of gross hematuria (subdistribution hazard ratio 2.03, 95% CI 1.145-3.496; P = 0.013) and the preoperative serum creatinine level (subdistribution hazard ratio 3.15, 95% CI 1.161-3.534; P = 0.021) were independent predictors for intravesical recurrence after radical nephroureterectomy. Accordingly, a nomogram based on the model was developed. The concordance index of this model was 0.632. CONCLUSION The presence of gross hematuria and preoperative serum creatinine levels seem to be independent predictors for intravesical recurrence after radical nephroureterectomy. Our nomogram developed based on these factors might aid in appropriate patient selection for clinical trials of novel therapeutic interventions, including administration of intravesical chemotherapy.
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Affiliation(s)
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan.,Department of Urology, Sanno Hospital, Tokyo, Japan.,Clinical Medicine Research Center, International University of Health and Welfare, Tokyo, Japan
| | - Takeshi Kashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Hirasawa Y, Nakashima J, Yunaiyama D, Sugihara T, Gondo T, Nakagami Y, Horiguchi Y, Ohno Y, Namiki K, Ohori M, Tokuuye K, Tachibana M. Sarcopenia as a Novel Preoperative Prognostic Predictor for Survival in Patients with Bladder Cancer Undergoing Radical Cystectomy. Ann Surg Oncol 2016; 23:1048-1054. [PMID: 27699608 DOI: 10.1245/s10434-016-5606-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE To investigate the prognostic significance of sarcopenia on long-term outcomes in patients with bladder cancer after radical cystectomy (RC). METHODS We retrospectively reviewed 136 patients undergoing RC for urothelial carcinoma at our institution. Prognostic impact of the preoperative clinical, laboratory, and radiologic parameters were evaluated by Cox proportional hazard model analyses, and a nomogram was developed to predict cancer-specific survival (CSS) after RC. RESULTS The mean follow-up was 46.7 months. Patients with sarcopenia had a significantly shorter CSS than those without sarcopenia. On univariate Cox analysis, clinical T stage, histology of transurethral resection of bladder tumor (TURBT) specimen, pretreatment hemoglobin, pretreatment neutrophil-to-lymphocyte ratio (NLR), pretreatment serum C-reactive protein level, pretreatment serum albumin level, presence of hydronephrosis, and presence of sarcopenia were associated with significantly worse CSS. On multivariate Cox stepwise analysis, sarcopenia (hazard rate [HR] = 2.3, p = 0.015), clinical T stage (cT4: HR = 5.3; p = 0.0096), presence of hydronephrosis (HR = 2.0; p = 0.033), histology of TURBT specimen (HR = 2.2, p = 0.044), and NLR (HR = 1.3; p = 0.0048) were significant independent predictors of an unfavorable prognosis Based on the results of the multivariate analysis, we developed a nomogram to predict 1-, 3-, and 5-year CSS after RC. CONCLUSIONS Sarcopenia, clinical T stage, presence of hydronephrosis, histology of TURBT specimen, and NLR are novel preoperative prognostic factors even after adjustment for other known preoperative predictors in patients undergoing RC for bladder cancer.
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Affiliation(s)
- Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan.,Department of Urology, Sanno Hospital, Tokyo, Japan.,Clinical Medicine Research Center, International University of Health and Welfare, Tokyo, Japan
| | | | - Toru Sugihara
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Koichi Tokuuye
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
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Hamada R, Nakashima J, Ohori M, Ohno Y, Komori O, Yoshioka K, Tachibana M. Erratum to: Preoperative predictive factors and further risk stratification of biochemical recurrence in clinically localized high-risk prostate cancer. Int J Clin Oncol 2016; 21:601. [DOI: 10.1007/s10147-015-0945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hirasawa Y, Nakashima J, Sugihara T, Takizawa I, Gondo T, Nakagami Y, Horiguchi Y, Ohno Y, Namiki K, Ohori M, Tachibana M. Development of a Nomogram for Predicting Severe Neutropenia Associated With Docetaxel-Based Chemotherapy in Patients With Castration-Resistant Prostate Cancer. Clin Genitourin Cancer 2016; 15:176-181. [PMID: 27324052 DOI: 10.1016/j.clgc.2016.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 03/01/2016] [Revised: 04/28/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Neutropenia is a major adverse event of docetaxel-based chemotherapy. The present study was undertaken to evaluate the incidence of neutropenia and to develop a nomogram for predicting Grade 4 neutropenia during the first cycle of docetaxel-based chemotherapy in patients with castration-resistant prostate cancer (CRPC). PATIENTS AND METHODS This study included 112 patients with CRPC treated with docetaxel-based systemic chemotherapy. We evaluated the incidence and risk factors for Grade 4 neutropenia in the first cycle of chemotherapy. RESULTS Sixty-two of 112 patients (55.4%) developed Grade 4 neutropenia in the first cycle of docetaxel-based chemotherapy. There were significant differences in age, baseline white blood cell count, and baseline neutrophil count between patients with non-Grade 4 neutropenia and those with Grade 4 neutropenia in univariate analyses. The serum prostate-specific antigen level, hemoglobin level, creatinine, albumin, Eastern Cooperative Oncology Group performance status, metastatic sites, extent of disease, and history of external beam radiotherapy to the prostate were not significantly different between the 2 groups. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.08; P = .019) and baseline neutrophil counts (OR, 0.79; P = .045) were significant independent risk factors for severe neutropenia. A nomogram and a calibration plot on the basis of these results were developed from a multivariate logistic regression analysis to predict the probability of Grade 4 neutropenia. CONCLUSION Age and baseline neutrophil counts were significant independent risk factors for Grade 4 neutropenia. The nomogram to predict it provides useful information for the management of patients with CRPC treated with docetaxel chemotherapy.
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Affiliation(s)
- Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
| | - Toru Sugihara
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Issei Takizawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Gondo T, Ohori M. [Prediction of the prostate cancer specific outcomes based on the nomograms]. Nihon Rinsho 2016; 74 Suppl 3:176-182. [PMID: 27344725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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18
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Gondo T, Ohno Y, Hirasawa Y, Kashima T, Shimodaira K, Nakagami Y, Nakashima J, Ohori M, Tachibana M. MP49-16 FACTORS PREDICTING FAILURE TO FOLLOW PRE-SCHEDULED GEMCITABINE PLUS CISPLATIN CHEMOTHERAPY REGIMEN FOR UROTHELIAL CARCINOMA. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ohno Y, Ohori M, Nakashima J, Okubo H, Satake N, Hashimoto T, Tachibana M. Association between preoperative serum total cholesterol level and biochemical recurrence in prostate cancer patients who underwent radical prostatectomy. Mol Clin Oncol 2016; 4:1073-1077. [PMID: 27284447 DOI: 10.3892/mco.2016.831] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 09/04/2015] [Accepted: 03/07/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the association between serum total cholesterol (TC) level and biochemical recurrence (BCR) following radical prostatectomy (RP). The study included 562 patients with T1-3N0M0 prostate cancer, who underwent RP at our institution between 2002 and 2010. No patients received neoadjuvant and/or adjuvant therapy. The associations between preoperative TC level, clinicopathological factors and BCR were assessed using univariate and multivariate analyses. During follow-up (mean, 54.0 months), 168 patients (168/562, 29.9%) experienced BCR, with a 5-year BCR-free rate of 67.2%. Of the clinicopathological characteristics investigated, statin use and lymphovascular invasion (LVI) status were associated with lower TC level (P=0.003 and P=0.014, respectively). In the univariate analysis, a higher serum prostate-specific antigen (PSA) level at diagnosis, extracapsular extension, positive surgical margin, seminal vesicle invasion, LVI, perineural invasion, higher Gleason score (GS ≥8) based on the RP specimen, increased body mass index, and low preoperative TC level, were significantly associated with BCR. In the multivariate analysis, the TC level was an independent predictor of BCR (hazard ratio = 0.925 per 10 mg/dl; 95% confidence interval: 0.879-0.973; P=0.003), as was the serum PSA level, extracapsular extension, positive surgical margin and the GS. Low preoperative serum TC levels were associated with an increased risk of BCR among prostate cancer patients who underwent RP. Our findings suggest that the preoperative serum TC level may provide important clinical information that may prove to be useful in patient counseling.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Hidenori Okubo
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
| | - Masaaki Tachibana
- Department of Urology, Tokyo Medical University, Tokyo 1600023, Japan
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Hirasawa Y, Nakashima J, Tatsuo G, Shimizu Y, Tokuyama N, Shimodaira K, Nakagami Y, Horiguchi Y, Ohno Y, Namiki K, Ohori M, Tachibana M. 513 Sarcopenia as a novel preoperative prognostic predictor for survival in patients with bladder cancer undergoing radical cystectomy. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60515-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Hirasawa Y, Ohno Y, Nakashima J, Shimodaira K, Hashimoto T, Gondo T, Ohori M, Tachibana M, Yoshioka K. Impact of a preoperatively estimated prostate volume using transrectal ultrasonography on surgical and oncological outcomes in a single surgeon’s experience with robot-assisted radical prostatectomy. Surg Endosc 2015; 30:3702-8. [DOI: 10.1007/s00464-015-4664-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/02/2015] [Indexed: 11/29/2022]
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Hashimoto T, Ohno Y, Nakashima J, Gondo T, Nakagami Y, Namiki K, Horiguchi Y, Yoshioka K, Ohori M, Tachibana M. Prediction of renal function after nephroureterectomy in patients with upper tract urothelial carcinoma. Jpn J Clin Oncol 2015; 45:1064-8. [PMID: 26355160 DOI: 10.1093/jjco/hyv136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 06/01/2015] [Accepted: 08/09/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The estimated glomerular filtration rate is significantly decreased after nephroureterectomy. Deteriorating renal function likely affects the eligibility for cisplatin-based chemotherapy in patients with upper tract urothelial carcinoma. The present study was undertaken to identify preoperative factors for the prediction of postoperative renal function and develop a prediction model. METHODS Between June 1996 and January 2014, 110 patients who underwent radical nephroureterectomy at our institution were analyzed in this study. The estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease study equation. Univariate linear regression analyses were performed to investigate the correlation between postoperative estimated glomerular filtration rate and preoperative variables. A stepwise multivariate linear regression analysis was performed to identify independent predictors of postoperative estimated glomerular filtration rate. RESULTS Comparison of preoperative and postoperative estimated glomerular filtration rate for each patient showed a median difference of 13.1 ml/min/1.73 m(2). The postoperative estimated glomerular filtration rate was significantly lower than the preoperative estimated glomerular filtration rate (P < 0.001). On univariate analysis, age and preoperative estimated glomerular filtration rate were significantly correlated with postoperative estimated glomerular filtration rate. On multivariate analysis, age, preoperative estimated glomerular filtration rate and the presence of hydronephrosis were independent predictive factors of postoperative estimated glomerular filtration rate. The predicted postoperative estimated glomerular filtration rate, which was calculated using these independent factors, showed a significant correlation with the observed postoperative estimated glomerular filtration rate (correlation coefficient = 0.7533). CONCLUSIONS Age, preoperative estimated glomerular filtration rate and the presence of hydronephrosis were independent predictors of postoperative estimated glomerular filtration rate in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. The predicted postoperative estimated glomerular filtration rate based on these factors may be useful for choosing alternative management strategies such as neoadjuvant chemotherapy for patients with upper tract urothelial carcinoma.
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Affiliation(s)
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Nakagami Y, Nakashima J, Ohno Y, Ohori M, Tachibana M. Prognostic value of neutrophil-to-lymphocyte ratio and establishment of novel risk stratification model in castration-resistant prostate cancer patients treated with docetaxel chemotherapy. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Satake N, Ohno Y, Nakashima J, Ohori M, Tachibana M. Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. Int J Urol 2015; 22:645-9. [PMID: 25912166 DOI: 10.1111/iju.12788] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 10/27/2014] [Revised: 02/21/2015] [Accepted: 03/15/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. METHODS We retrospectively reviewed data from 237 patients diagnosed with non-muscle-invasive bladder cancer. Pyuria was defined as urine containing ≥5 white blood cells per high power field. The association between clinicopathological factors and recurrence was assessed by Cox univariate and multivariate analyses. RESULTS Preoperative pyuria was found in 116 (49.0%) patients. Pyuria was significantly associated with advanced age, positive cytology, multiple tumors, large tumor size, non-papillary tumors, T1 tumors and high-grade tumors. In univariate analysis of the entire patient population, pyuria, positive urine cytology, multiple tumors, pT1 tumors and no bacillus Calmette-Guérin were significantly associated with recurrence. Multivariate analysis showed that pyuria was an independent predictor of recurrence (hazard ratio 3.332, 95% confidence interval 2.052-5.410; P < 0.001), along with positive urine cytology, multiple tumors and no bacillus Calmette-Guérin therapy. Subanalysis of the patients who underwent bacillus Calmette-Guérin therapy also showed that pyuria was an independent predictor of recurrence (hazard ratio 2.062, 95% confidence interval 1.085-3.918, P = 0.027). The 2-year recurrence-free survival rate for patients with pyuria was significantly lower than for patients without pyuria (65.5% vs 80.7%; P = 0.027). CONCLUSIONS Preoperative pyuria seems to be significantly associated with recurrence in patients with non-muscle-invasive bladder cancer, and it might be a useful predictor for recurrence after bacillus Calmette-Guérin therapy.
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Affiliation(s)
- Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Gondo T, Nakashima J, Inoue R, Hashimoto T, Ohno Y, Ohori M, Nagao T, Tachibana M. PD41-06 CLINICAL VALUE OF IMMUNOHISTOCHEMICALLY DETECTED LYMPHOVASCULAR INVASION IN TRANSURETHRAL BLADDER TUMOR RESECTION SPECIMEN FOR BLADDER CANCER STAGING BEFORE RADICAL CYSTECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hirasawa Y, Nakashima J, Hashimoto T, Nakagami Y, Ohno Y, Ohori M, Yoshioka K, Tachibana M. MP62-20 IMPACT OF A PREOPERATIVELY ESTIMATED PROSTATE VOLUME USING TRANSRECTAL ULTRASONOGRAPHY ON SURGICAL AND ONCOLOGICAL OUTCOMES IN A SINGLE SURGEON'S EXPERIENCE WITH ROBOT-ASSISTED RADICAL PROSTATECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ohno Y, Ohori M, Nakashima J, Okubo H, Satake N, Takizawa I, Hashimoto T, Hamada R, Nakagami Y, Yoshioka K, Tachibana M. Associations between ABO blood groups and biochemical recurrence after radical prostatectomy. Int J Clin Exp Med 2015; 8:2642-2648. [PMID: 25932213 PMCID: PMC4402860] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 02/06/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Recent studies have demonstrated associations between ABO blood groups and prognosis in various types of cancers. The aim of this study was to investigate the association between ABO blood groups and biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS A total of 555 patients with prostate cancer who underwent RP were included in the study. No patients received neoadjuvant and/or adjuvant therapy. The effect of ABO blood groups on BCR was examined using univariate and multivariate analyses. RESULTS During the follow-up period (mean, 52.0 months), 166 patients (29.9%) experienced BCR, with a 5-year BCR-free rate of 67.3%. Although the ABO blood group was not a significantly associated with BCR in the univariate analysis, it was an independent predictor of BCR in the multivariate analysis: blood type O patients had a significantly lower risk of BCR compared to type A patients (Hazard ratio, 0.608; 95% confidence interval, 0.410-0.902; P = 0.014). Further analyses revealed that surgical margin status confounded the assessment of the association between the ABO blood group and BCR. In the analyses of patients with a negative surgical margin, the 5-year BCR-free rate in blood type O patients was a significantly higher than that in type A patients (91.2% vs. 71.0%; P = 0.026). CONCLUSION Blood type O is significantly associated with a decreased risk of biochemical recurrence after radical prostatectomy. Further studies are needed to clarify the nature of this association.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Hidenori Okubo
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Naoya Satake
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Issei Takizawa
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Riu Hamada
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | | | - Kunihiko Yoshioka
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
| | - Masaaki Tachibana
- Department of Urology, Tokyo Medical University Tokyo 1600023, Japan
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Hashimoto T, Ohno Y, Nakashima J, Gondo T, Yoshioka K, Ohori M, Tachibana M. Prediction of Multifocal Lesions in Patients With Upper Tract Urothelial Carcinoma. Urology 2014; 84:869-74. [DOI: 10.1016/j.urology.2014.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 05/17/2014] [Accepted: 05/28/2014] [Indexed: 11/17/2022]
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Ohno Y, Ohori M, Nakashima J, Okubo H, Nakagami Y, Hashimoto T, Kashima T, Hamada R, Yoshioka K, Tachibana M. MP45-17 SIGNIFICANT ASSOCIATION BETWEEN ABO BLOOD GROUP AND BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Iseki R, Ohori M, Piccorelli A, Yu C, Piccorelli A, Ohno Y, Tachibana M, Kattan MW. Development of a nomogram for predicting a positive repeat prostate biopsy. World J Clin Urol 2014; 3:47-53. [DOI: 10.5410/wjcu.v3.i1.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/19/2013] [Accepted: 12/16/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To find risk factors of cancer in patients who had a repeat biopsy and to develop the nomogram using our cohort.
METHODS: Among 3500 patients who had a prostate biopsy over 11 years between 2000 and 2010 at our hospital, we studied a total of 807 repeat biopsy sessions in 459 patients who had at least 1 initial negative biopsy. At each biopsy session, we recorded patient age, number of previous biopsy sessions, number of biopsy cores, number of previously negative biopsy cores, months from the initial biopsy, months from the previous biopsy, serum PSA, PSA slope, digital rectal examination findings, hypoechoic lesions suspicious for a cancer on transrectal ultrasonography, total prostate volume, transitional zone (TZ) volume, PSA density, PSA TZ density and history of high grade prostatic intraepithelial neoplasia (HGPIN) or atypical small acinar proliferation (ASAP). Clinical and pathological variables were correlated with the outcome of repeat biopsies. A nomogram was developed based on logistic regression analyses and calibration was performed.
RESULTS: Overall, 17% of repeat biopsies had a cancer. With receiver operating characteristics analyses, the highest area under the curve (AUC) was obtained based on all available 13 variables, which were age, PSA, digital rectal examination, PSA density, prostate volume, TZ volume, PSA TZ density, cumulative number of biopsy cores, HGPIN, ASAP, months from previous negative biopsy, initial negative biopsy and number of biopsy cores. Based on multivariable logistic regression analysis, a nomogram was constructed with an AUC of 0.74, which was greater than that of any single risk factor. The calibration plot seemed to be good.
CONCLUSION: Our nomogram for predicting a positive repeat biopsy can provide probabilities for cancer and may help clinical judgment on whether to do a repeat prostate biopsy.
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Bando E, Kattan MW, Ohori M, Tokunaga M, Tanizawa Y, Kawamura T, Terashima M. Gastric cancer new nomograms based on preoperative clinical prognostic factors. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12 Background: Nomogram has been developed and shown to be more accurate than the conventional staging systems for predicting prognosis in gastric cancer patients. Preoperative clinical staging is a primary measure with which therapeutic strategies for gastric cancer is determined. While many reports have been published on the relationship between nomogram based on pathologic factors and survival outcomes, there were no reports of developing nomogram based on preoperative clinical factors. The purpose of this study was to firstly build a specific nomograms based on preoperative clinical prognosticators for predicting overall survival (OS) and disease-specific survival (DSS) in patients with primary gastric cancer for choosing accurate therapy preoperatively. Methods: We included patients with primary 2,807 gastric cancer patients, who had not been undergone prior chemotherapy, between 2002 and 2010. The priori chosen pre-operative prognostic covariates were sex, age, tumor site, tumor size, histologic subtype obtained by endoscopy, endoscopic macroscopic appearance, tumor depth, numbers of positive nodes and distant metastases on CT scan, and serum concentration of CEA/CA19-9. Internal validation was performed by applying the nomograms to the patients of an internal cohort calculated by bootstrap re-sampling method. The model's discriminative ability was estimated by means of Harrell’s C statistics. Results: At a median follow-up of 57 months, 612 deaths and 523 cancer-related deaths were recorded. Five-year OS and DSS rates were 64.3% and 72.4%. In Cox regression, depth and nodal involvement is the most powerful independent prognostic factors. And type4 is identified negative prognosticators. Sex and serum tumor markers have little effectiveness for survival outcome. The bootstrap-corrected Harrell’s C statistics for OS and DSS of our nomograms were 0.852 and 0.880, which was higher than that of TNM seventh edition (C=0.826, 0.822) or that of sixth edition (C=0.822, 0.801). Conclusions: These nomograms accurately predict OS and DSS of Japanese gastric cancer patients pre-operatively. Worldwide external validation should be necessary for practical use of our nomograms instead of TNM classification.
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Affiliation(s)
| | | | - Makoto Ohori
- Division of Urology, Tokyo Medical University, Tokyo, Japan
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Tanaka A, Ohori M, Paul L, Yu C, Kattan MW, Ohno Y, Tachibana M. External Validation of Preoperative Nomograms Predicting Biochemical Recurrence after Radical Prostatectomy. Jpn J Clin Oncol 2013; 43:1255-1260. [DOI: 10.1093/jjco/hyt154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Okubo H, Ohori M, Ohno Y, Nakashima J, Inoue R, Nagao T, Tachibana M. Prediction of non-biochemical recurrence rate after radical prostatectomy in a Japanese cohort: Development of a postoperative nomogram. Int J Urol 2013; 21:479-83. [DOI: 10.1111/iju.12327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Hidenori Okubo
- Department of Urology; Tokyo Medical University; Tokyo Japan
| | - Makoto Ohori
- Department of Urology; Tokyo Medical University; Tokyo Japan
| | - Yoshio Ohno
- Department of Urology; Tokyo Medical University; Tokyo Japan
| | - Jun Nakashima
- Department of Urology; Tokyo Medical University; Tokyo Japan
| | - Rie Inoue
- Department of Pathology; Tokyo Medical University; Tokyo Japan
| | - Toshitaka Nagao
- Department of Pathology; Tokyo Medical University; Tokyo Japan
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Ohno Y, Nakashima J, Nakagami Y, Gondo T, Ohori M, Hatano T, Tachibana M. Clinical implications of preoperative serum total cholesterol in patients with clear cell renal cell carcinoma. Urology 2013; 83:154-8. [PMID: 24149106 DOI: 10.1016/j.urology.2013.08.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/10/2013] [Accepted: 08/26/2013] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the clinical implication of preoperative serum total cholesterol (TC) level in patients with clear cell renal cell carcinoma (RCC). METHODS The records of 364 patients with clear cell RCC who had undergone nephrectomy were retrospectively reviewed. The association among preoperative TC level, clinicopathologic factors, and oncological outcome in terms of cancer-specific survival (CSS) and recurrence-free survival period was analyzed by univariate and multivariate analyses. RESULTS As a continuous variable, lower serum TC level was found to be significantly associated with male sex, symptomatic tumor, advanced TNM stage, higher nuclear grade, microscopic venous invasion, poor Eastern Cooperative Oncology Group Performance Status, larger tumor size, elevated C-reactive protein level, and lower hemoglobin level. Univariate analysis showed that relatively lower preoperative serum TC level was associated with lower recurrence-free survival (P = .040) and CSS (P <.001) rates. Multivariate analysis indicated that in addition to pT stage, M stage, nuclear grade, and Eastern Cooperative Oncology Group Performance Status, serum TC level (hazard ratio, 0.988 per mg/dL; 95% confidence interval, 0.980-0.998; P = .019) was an independent predictor of CSS. CONCLUSION Low preoperative serum TC level is associated with worse prognosis in patients with clear cell RCC. Consideration of preoperative serum TC level might thus provide additional prognostic information for patients with clear cell RCC.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Tadashi Hatano
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Hashimoto T, Yoshioka K, Gondo T, Ozu C, Horiguchi Y, Namiki K, Ohno Y, Ohori M, Nakashima J, Tachibana M. Preoperative prognostic factors for biochemical recurrence after robot-assisted radical prostatectomy in Japan. Int J Clin Oncol 2013; 19:702-7. [DOI: 10.1007/s10147-013-0611-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
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Hashimoto T, Ohori M, Kashima T, Yamamoto H, Tachibana M. Chemical cystitis due to crystal violet dye: a case report. J Med Case Rep 2013; 7:145. [PMID: 23724934 PMCID: PMC3682877 DOI: 10.1186/1752-1947-7-145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/08/2013] [Indexed: 11/24/2022] Open
Abstract
Introduction Crystal violet was commonly used for the treatment of oral and vaginal candidiasis or for sterilization during operations up to the 1960s. Because crystal violet is potentially toxic to mucosal membranes, it has been replaced with other disinfectants, and crystal violet is rarely used. We report a case of chemical cystitis due to intravesical instillation of crystal violet dye. Case presentation Crystal violet dye was instilled into the bladder of a 47-year-old Japanese woman to confirm the presence of a vesicovaginal fistula. Our patient developed symptoms of gross hematuria, frequent urination and lower abdominal pain. Computed tomography showed thickening of her whole bladder wall with spotted high-density lesions. Cystoscopy demonstrated desquamated epithelial cells and a hemorrhagic bladder wall. We treated our patient conservatively with nonsteroidal anti-inflammatory drugs and glucocorticoids. During follow-up, magnetic resonance images showed that the detrusor muscle of her bladder was normal. Our patient’s symptoms gradually improved and she completely recovered within six months. Conclusion Considering the severe side effect of crystal violet, it would be better not to use this dye to examine conditions such as a vesicovaginal fistula. Magnetic resonance imaging may help to evaluate the level of damage in the bladder wall of patients with chemical cystitis.
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Affiliation(s)
- Takeshi Hashimoto
- Department of Urology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 1600023, Japan.
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Hamada R, Nakashima J, Hashimoto T, Satake N, Nakagami Y, Ozu C, Ohno Y, Horiguchi Y, Namiki K, Yoshioka K, Ohori M, Tachibana M. 1001 PREOPERATIVE PREDICTIVE FACTORS AND FURTHER RISK STRATIFICATION OF BIOCHEMICAL RECURRENCE IN CLINICALLY LOCALIZED HIGH RISK PROSTATE CANCER. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ohno Y, Nakashima J, Ohori M, Tanaka A, Hashimoto T, Gondo T, Hatano T, Tachibana M. Clinical variables for predicting metastatic renal cell carcinoma patients who might not benefit from cytoreductive nephrectomy: neutrophil-to-lymphocyte ratio and performance status. Int J Clin Oncol 2013; 19:139-45. [DOI: 10.1007/s10147-012-0514-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 12/20/2012] [Indexed: 12/11/2022]
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Ohno Y, Nakashima J, Izumi M, Ohori M, Hashimoto T, Tachibana M. Association of legumain expression pattern with prostate cancer invasiveness and aggressiveness. World J Urol 2012; 31:359-64. [PMID: 23124822 DOI: 10.1007/s00345-012-0977-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 10/16/2012] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To investigate the clinical implication of legumain, an asparaginyl endopeptidase that is highly expressed in several types of cancer, expression in prostate cancer. METHODS Legumain expression in prostate cancer cell lines was determined by real-time reverse transcriptase PCR and Western blot. Furthermore, legumain expression in 88 prostatectomy specimens was evaluated by immunohistochemistry. The association between legumain expression and clinicopathological factors was analyzed. RESULTS Legumain expression was confirmed at the mRNA and protein levels in all the cells. Although all the cancer tissues were positive for legumain, 2 staining patterns were observed in the cytoplasm: diffuse cytoplasmic and vesicular positivity. The rates of Gleason score ≥8, extracapsular extension, and perineural invasion in the group with vesicular staining were significantly higher than those in the diffuse cytoplasmic group (p < 0.05). The maximum size of the tumor with vesicular staining was significantly greater than that of the tumor with diffuse cytoplasmic staining (p = 0.0302). The 5-year biochemical recurrence-free rate in the patients with vesicular legumain staining was 53.2%; this rate was significantly lower than that (78.8%) in the patients with diffuse cytoplasmic staining (p = 0.0269). CONCLUSIONS Tumors that showed a vesicular staining pattern of legumain had the potential of being highly invasive and aggressive in patients with prostate cancer who were treated with radical prostatectomy. This suggests that legumain might contribute to the invasiveness and aggressiveness of prostate cancer.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
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Gondo T, Nakashima J, Ohno Y, Hashimoto T, Takizawa I, Sakamoto N, Horiguchi Y, Aoyagi T, Ohori M, Tachibana M. Preoperative prediction of malignant involvement of resected ureters in patients undergoing radical cystectomy for bladder cancer. Int J Urol 2012; 20:501-6. [PMID: 23106193 DOI: 10.1111/j.1442-2042.2012.03203.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 09/23/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate preoperative predictors of ureteral involvement of bladder malignancy and to develop a novel preoperative model for the prediction of ureteral involvement in bladder cancer patients undergoing radical cystectomy. METHODS This study included 197 consecutive bladder cancer patients treated with radical cystectomy. The correlations of preoperative factors with ureteral involvement were analyzed by univariate analysis with Pearson's χ(2-) test and multivariate logistic regression analysis with a stepwise selection procedure. RESULTS Positive ureteral involvement was observed in 38 (19.3%) patients. Tumor location (involvement of the vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥ 3), but not sex, tumor grade and histological features determined by transurethral resection of bladder tumor, tumor size, shape of tumor, concomitant presence of carcinoma in situ, preoperative intravesical therapy, number of transurethral resection of bladder tumor procedures or the presence of hydronephrosis were significantly associated with ureteral involvement in the univariate analysis. Multivariate logistic regression analysis confirmed that the aforementioned three significant factors identified in the univariate analysis were significant independent predictors of ureteral involvement. The probability of ureteral involvement estimated by a combination of these three parameters was well correlated with the real incidence (R = 0.904, P = 0.0021). CONCLUSIONS Tumor location (involvement of vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥ 3) are significant independent preoperative predictors of ureteral involvement of malignancy in bladder cancer patients undergoing radical cystectomy. Our predictive model might be useful for preoperative prediction of ureteral tumor involvement.
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Affiliation(s)
- Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
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Iseki R, Ohori M, Hatano T, Tachibana M. [Urinary incontinence in early experience with robot-assisted laparoscopic prostatectomy-comparison with radical retropubic prostatectomy]. Hinyokika Kiyo 2012; 58:409-414. [PMID: 23052264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
To compare the results of urinary incontinence in patients with clinically localized prostate cancer, T1a- 3aN0M0, treated by robot-assisted laparoscopic prostatectomy (RALP) or open radical retropubic prostatectomy (RRP), we studied 44 patients treated with RALP and 60 who received RRP by one surgeon between March 2004 and January 2011. The pad-free and safety-pad (1 pad a day) rates after surgery were calculated with Kaplan-Meyer method. All preoperative and postoperative factors were not significantly different between the two groups. Overall, 88% of the patients in the RRP group were pad-free with a mean follow-up of 54 months and 93% of the patients in the RALP group were pad-free with a mean follow up of 22.1 months. However, the pad-free rates at 3, 6 and 12 months after surgery were 33, 58.6 and 75.8%, respectively, in the RRP group compared to 44, 72 and 89.5% in the RALP group, respectively (p = 0.0393). Similarly, 97% of the patients in the RRP group and 98% of the patients in the RALP group used a safety-pad during the observation period. The rates of safety-pad at 3, 6 and 12 months after surgery were 52.7, 71.6 and 81%, respectively, in the RRP group compared to 78.9,92 and 94.7% in the RALP group, respectively (p = 0.002). In conclusion, while the follow-period is short and the number of patients is small, RALP may provide a better functional outcome after surgery in terms of early recovery of urinary incontinence than RRP. This may be one of the reasons to justify the use of robotic surgery as an alternative to the traditional RRP.
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Affiliation(s)
- Ryo Iseki
- The Department of Urology, Tokyo Medical University
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Nakashima J, Takizawa I, Ko K, Nakagami Y, Ohori M, Ohno Y, Yoshioka K, Tachibana M. 761 PREDICTION OF LEUKOPENIA AFTER DOCETAXEL CHEMOTHERAPY IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ohno Y, Nakashima J, Ohori M, Hashimoto T, Gondo T, Okubo H, Shimodaira K, Tachibana M. 1999 CLINICAL VARIABLES FOR PREDICTING METASTATIC RENAL CELL CARCINOMA PATIENTS WHO WILL NOT BENEFIT FROM CYTOREDUCTIVE NEPHRECTOMY. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gondo T, Nakashima J, Ohno Y, Choichiro O, Horiguchi Y, Namiki K, Yoshioka K, Ohori M, Hatano T, Tachibana M. Prognostic value of neutrophil-to-lymphocyte ratio and establishment of novel preoperative risk stratification model in bladder cancer patients treated with radical cystectomy. Urology 2012; 79:1085-91. [PMID: 22446338 DOI: 10.1016/j.urology.2011.11.070] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 11/03/2011] [Accepted: 11/21/2011] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Preoperative prognostic factors in bladder cancer patients have not been fully established. This study was undertaken to investigate preoperative prognostic factors, including neutrophil-to-lymphocyte ratio (NLR), and to develop a novel prognostic factors-based risk stratification model for disease-specific survival (DSS) in bladder cancer patients treated with radical cystectomy (RC). METHODS We performed a retrospective analysis of 189 consecutive bladder cancer patients treated with RC at our institution. Prognostic value of the preoperative clinical and laboratory parameters were evaluated by univariate and multivariate Cox proportional hazard model analyses, and patients were stratified according to relative risks (RRs) for DSS. RESULTS One-, 3-, and 5-year DSS rates were 86.8%, 70.8%, and 61.7%, respectively. In univariate analysis, tumor size, clinical T stage, hydronephrosis, concomitance of carcinoma in situ, and some laboratory findings (hemoglobin [Hb] level, platelet count, C-reactive protein, neutrophil count, lymphocyte count, and NLR) were significantly associated with poor prognosis. In multivariate analysis, tumor size, hydronephrosis, Hb level, and NLR were independent factors for predicting poor prognosis. Patients were stratified into 3 risk groups: low (RR = 1.000-3.717), intermediate (RR = 4.149-9.315), and high (RR = 10.397-38.646). The differences among the groups were significant. CONCLUSIONS NLR was an independent prognostic factor, as were tumor size, hydronephrosis, and Hb levels, and the combination of these factors can stratify DSS risks in bladder cancer patients treated with RC. This information may be useful for identifying patients who might be candidates for clinical trials of multimodal treatment strategies, including innovative neoadjuvant treatments.
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Affiliation(s)
- Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Tanaka A, Ohori M, Hashimoto T, Hamada R, Nomura M, Kusama H, Nagao T, Tachibana M. [A case of plasmacytoid urothelial carcinoma of the bladder: rapid progression after transurethral resection]. Hinyokika Kiyo 2012; 58:101-103. [PMID: 22450838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An 85-year-old man complained of macroscopic hematuria and painful urination. Cytoscopy revealed a non-papillary tumor at the bladder neck extending to the trigone. Abdominal computed tomography revealed thickening of the bladder wall in the same area but did not reveal lymph node swelling. Urinary cytology was class IIIb. We conducted a transurethral resection of the bladder tumor (TURBT) after which a histopathological examination showed urothelial carcinoma, G3, INFγ, pT2. From 6 days after TURBT, severe fever persisted despite the administration of various antibiotics and his general condition deteriorated. He died of acute myocardial infarction at 37 days after TURBT. Histopathological examination at autopsy revealed extensive urothelial carcinoma, a plasmacytoid variant, of the bladder which had invaded into the entire body including the lungs, liver, kidneys, adrenal glands, and veins, although tumor cells were not identified in lymph nodes. We review the literature and report this rare case of urothelial carcinoma, a plasmacytoid variant, of the bladder.
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Affiliation(s)
- Ayako Tanaka
- The Department of Urology, Tokyo Medical University
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Ohori M. What is the purpose of launching World Journal of Clinical Urology? World J Clin Urol 2011. [DOI: 10.5410/wjcu.v1.i1.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The first issue of the World Journal of Clinical Urology (WJCU), whose preparatory work was initiated on December 6, 2010, will be published on December 28, 2011. The WJCU Editorial Board has now been established and consists of 101 distinguished experts from 25 countries. Our purpose in launching the WJCU is to publish peer-reviewed, high-quality articles via an open-access online publishing model, thereby acting as a platform for communication between peers and the wider public, and maximizing the benefits to editorial board members, authors and readers.
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Ohori M. What is the purpose of launching World Journal of Clinical Urology? World J Clin Urol 2011; 1:1-2. [DOI: 10.5410/wjcu.v1.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The first issue of the World Journal of Clinical Urology (WJCU), whose preparatory work was initiated on December 6, 2010, will be published on December 28, 2011. The WJCU Editorial Board has now been established and consists of 101 distinguished experts from 25 countries. Our purpose in launching the WJCU is to publish peer-reviewed, high-quality articles via an open-access online publishing model, thereby acting as a platform for communication between peers and the wider public, and maximizing the benefits to editorial board members, authors and readers.
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Ohno Y, Nakashima J, Ohori M, Gondo T, Hatano T, Tachibana M. Followup of neutrophil-to-lymphocyte ratio and recurrence of clear cell renal cell carcinoma. J Urol 2011; 187:411-7. [PMID: 22177153 DOI: 10.1016/j.juro.2011.10.026] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Indexed: 01/07/2023]
Abstract
PURPOSE An increase in the pretreatment neutrophil-to-lymphocyte ratio is associated with poor prognosis for various cancers, including renal cell carcinoma. However, the clinical implication of a posttreatment change in the neutrophil-to-lymphocyte ratio in patients with cancer remains unclear. MATERIALS AND METHODS We reviewed the records of 250 patients with nonmetastatic clear cell renal cell carcinoma and analyzed associations among clinicopathological variables, the preoperative and postoperative neutrophil-to-lymphocyte ratio, and recurrence-free survival. RESULTS The 10-year recurrence-free survival rate for patients with a preoperative neutrophil-to-lymphocyte ratio of 2.7 or greater was significantly lower than that for those with a ratio of less than 2.7 (64.4% vs 83.7%, p = 0.0004). When combined with the postoperative ratio, patients with a preoperative ratio of 2.7 or greater could be further divided into 2 groups with a significantly different prognosis. The 10-year recurrence-free survival rate for patients with a preoperative neutrophil-to-lymphocyte ratio of 2.7 or greater and postoperative ratio of less than 2.7 was significantly lower than that for those with a preoperative and postoperative ratio of 2.7 or greater (52.0% vs 83.5%, p = 0.0487). The latter was similar to the 83.7% for patients with a preoperative ratio of less than 2.7. In patients with recurrence the ratio at recurrence was significantly increased compared with the postoperative ratio (mean ± SD 2.82 ± 1.63 vs 2.00 ± 0.90, p = 0.0090). Multivariate analysis showed that tumor size, pathological tumor stage and the neutrophil-to-lymphocyte ratio change (a combination of the preoperative and postoperative ratios) were independent predictors of recurrence. Using these 3 significant variables patients were stratified into low, intermediate and high risk groups, among which the recurrence-free survival rate significantly differed. CONCLUSIONS The posttreatment neutrophil-to-lymphocyte ratio change was a significant prognostic factor for recurrence as well as tumor size and pathological tumor stage in patients with clear cell renal cell carcinoma.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
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Gondo T, Nakashima J, Ozu C, Ohno Y, Horiguchi Y, Namiki K, Yoshioka K, Ohori M, Hatano T, Tachibana M. Risk stratification of survival by lymphovascular invasion, pathological stage, and surgical margin in patients with bladder cancer treated with radical cystectomy. Int J Clin Oncol 2011; 17:456-61. [DOI: 10.1007/s10147-011-0310-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 08/13/2011] [Indexed: 12/01/2022]
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Ohno Y, Nakashima J, Ohori M, Hashimoto T, Iseki R, Hatano T, Tachibana M. Impact of tumor size on renal function and prediction of renal insufficiency after radical nephrectomy in patients with renal cell carcinoma. J Urol 2011; 186:1242-6. [PMID: 21849191 DOI: 10.1016/j.juro.2011.05.087] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Indexed: 01/30/2023]
Abstract
PURPOSE From the perspective of oncological and functional outcomes partial nephrectomy is considered standard surgery for small renal tumors 4 cm or less. However, radical nephrectomy is commonly done for small tumors. It is important to predict postoperative renal function in patients to choose the most optimal surgical procedure. MATERIALS AND METHODS We retrospectively reviewed the records of 271 patients treated with radical nephrectomy for renal cell carcinoma. Associations of tumor size and clinical variables with renal function were analyzed. RESULTS Preoperatively the mean ± SD glomerular filtration rate was 74.38 ± 17.70 ml per minute/1.73 m(2) and 56 patients (20%) had renal insufficiency (glomerular filtration rate less than 60 ml per minute/1.73 m(2)). The mean decrease in the glomerular filtration rate after radical nephrectomy was 24.2 ± 12.40 ml per minute/1.73 m(2) (31.5% ± 15%). Of 215 patients with a preoperative glomerular filtration rate of 60 ml per minute/1.73 m(2) or greater 165 (77%) had new onset renal insufficiency. Age, tumor size, preoperative glomerular filtration rate and hypertension were significantly associated with new onset renal insufficiency. Multivariate analysis revealed that age 60 years or greater, tumor size 7 cm or less and the preoperative glomerular filtration rate were independent risk factors for new onset renal insufficiency (p <0.05). Finally, we developed a predictive model for new onset renal insufficiency after radical nephrectomy. CONCLUSIONS Tumor size 7 cm or less, age 60 years or greater and a decreased preoperative glomerular filtration rate were significant risk factors for new onset renal insufficiency in patients treated with radical nephrectomy. Partial nephrectomy might be considered an option according to the risk of postoperative renal insufficiency, especially in elderly patients with a tumor of 7 cm or less.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan.
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