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Toide M, Tanaka H, Kobayashi M, Fujiwara M, Nakamura Y, Fukuda S, Kimura K, Waseda Y, Yoshida S, Tateishi U, Fujii Y. Stepwise algorithm using computed tomography and magnetic resonance imaging for differential diagnosis of fat-poor angiomyolipoma in small renal masses: A prospective validation study. Int J Urol 2024. [PMID: 38632863 DOI: 10.1111/iju.15464] [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: 09/19/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES To validate the diagnostic accuracy of a stepwise algorithm to differentiate fat-poor angiomyolipoma (fp-AML) from renal cancer in small renal masses (SRMs). METHODS We prospectively enrolled 223 patients with solid renal masses <4 cm and no visible fat on unenhanced computed tomography (CT). Patients were assessed using an algorithm that utilized the dynamic CT and MRI findings in a stepwise manner. The diagnostic accuracy of the algorithm was evaluated in patients whose histology was confirmed through surgery or biopsy. The clinical course of the patients was further analyzed. RESULTS The algorithm classified 151 (68%)/42 (19%)/30 (13%) patients into low/intermediate/high AML probability groups, respectively. Pathological diagnosis was made for 183 patients, including 10 (5.5%) with fp-AML. Of these, 135 (74%)/36 (20%)/12 (6.6%) were classified into the low/intermediate/high AML probability groups, and each group included 1 (0.7%)/3 (8.3%)/6 (50%) fp-AMLs, respectively, leading to the area under the curve for predicting AML of 0.889. Surgery was commonly opted in the low and intermediate AML probability groups (84% and 64%, respectively) for initial management, while surveillance was selected in the high AML probability group (63%). During the 56-month follow-up, 36 (82%) of 44 patients initially surveyed, including 13 of 18 (72%), 6 of 7 (86%), and 17 of 19 (89%) in the low/intermediate/high AML probability groups, respectively, continued surveillance without any progression. CONCLUSIONS This study confirmed the high diagnostic accuracy for differentiating fp-AMLs. These findings may help in the management of patients with SRMs.
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Affiliation(s)
- Masahiro Toide
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Fujiwara M, Tanaka H, Kobayashi M, Nakamura Y, Fan B, Ishikawa Y, Fukuda S, Toda K, Yoshida S, Yokoyama M, Yoshimura R, Fujii Y. Neoadjuvant Chemoradiotherapy Followed by Radical Cystectomy for Muscle-Invasive Bladder Cancer: Analysis of Efficacy and Safety in 119 Patients. Clin Genitourin Cancer 2024; 22:193-200.e1. [PMID: 38000954 DOI: 10.1016/j.clgc.2023.10.013] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/22/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Cisplatin-based systemic chemotherapy is recommended as neoadjuvant treatment for muscle-invasive bladder cancer (MIBC) before radical cystectomy (RC). However, clinical challenges include the possibility of primary chemoresistance and limited feasibility in patients with renal impairment. This study investigated the efficacy and safety profiles of neoadjuvant chemoradiotherapy (NCRT) followed by RC. MATERIALS AND METHODS We retrospectively analyzed 119 patients with nonmetastatic MIBC, who were pathologically diagnosed with urothelial carcinoma and underwent NCRT before RC. The pathological response to NCRT was evaluated using RC specimens. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared according to pathological responses to NCRT. RESULTS Of the 119 patients, 111 (93%) underwent RC; ypT0 and downstaging to ≤ypT1 were observed in 42 (38%) and 76 (68%) patients, respectively. In the multivariable analysis, smaller tumor size was independently associated with ypT0. During a median follow-up of 5.2 years, 28 (25%) patients developed recurrence and 22 (20%) died of bladder cancer after RC. The 5-year RFS and CSS rates were 75% and 80%, respectively. The 5-year RFS rates in patients with ypT0, ypTa/is/1, and ≥ypT2 were 87%, 87%, and 46%, respectively. Similarly, patients with ypT0 and ypTa/is/1 had more favorable CSS (90% and 87% at 5 years, respectively) than those with ≥ypT2 (60%, P = .001). None of the patients experienced ≥grade 4 adverse events related to NCRT or ≥grade 4 complications of RC. CONCLUSIONS This study demonstrated sufficient efficacy and safety profile of NCRT followed by RC. Chemoradiotherapy may be a helpful alternative for neoadjuvant treatment before RC.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Bo Fan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuma Toda
- Department of Radiation Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Yoshimura
- Department of Radiation Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Kobayashi M, Matsuoka Y, Uehara S, Tanaka H, Fujiwara M, Nakamura Y, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yoshida S, Fujii Y. Utility of positive core number on MRI-ultrasound fusion targeted biopsy in combination with PI-RADS scores for predicting unexpected extracapsular extension of clinically localized prostate cancer. Int J Urol 2024. [PMID: 38468553 DOI: 10.1111/iju.15451] [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: 10/20/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES To evaluate the utility of magnetic resonance imaging (MRI) and MRI-ultrasound fusion targeted biopsy (TB) for predicting unexpected extracapsular extension (ECE) in clinically localized prostate cancer (CLPC). METHODS This study enrolled 89 prostate cancer patients with one or more lesions showing a Prostate Imaging-Reporting and Data System (PI-RADS) score ≥3 but without morphological abnormality in the prostatic capsule on pre-biopsy MRI. All patients underwent TB and systematic biopsy followed by radical prostatectomy (RP). Each lesion was examined by 3-core TB, taking cores from each third of the lesion. The preoperative variables predictive of ECE were explored by referring to RP specimens in the lesion-based analysis. RESULTS Overall, 186 lesions, including 81 (43.5%), 73 (39.2%), and 32 (17.2%) with PI-RADS 3, 4, and 5, respectively, were analyzed. One hundred and twenty-two lesions (65.6%) were diagnosed as cancer on TB, and ECE was identified in 33 (17.7%) on the RP specimens. The positive TB core number was ≤2 in 129 lesions (69.4%) and three in 57 lesions (30.6%). On the multivariate analysis, PI-RADS ≥4 (p = 0.049, odds ratio [OR] = 2.39) and three positive cores on TB (p = 0.005, OR = 3.07) were independent predictors of ECE. Lesions with PI-RADS ≥4 and a positive TB core number of 3 had a significantly higher rate of ECE than those with PI-RADS 3 and a positive TB core number ≤2 (37.5% vs. 7.8%, p < 0.001). CONCLUSIONS Positive TB core number in combination with PI-RADS scores is helpful to predict unexpected ECE in CLPC.
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Affiliation(s)
- Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Urology, Saitama Cancer Center, Ina, Japan
| | - Sho Uehara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Radiology, Ochanomizu Surugadai Clinic, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Ishikawa Y, Tanaka H, Fujiwara M, Nakamura Y, Fukuda S, Waseda Y, Yoshida S, Yokoyama M, Fujii Y. Incidence and predictors of intraoperative hypotension during transurethral bladder tumor resection with oral 5-aminolevulinic acid. Int J Urol 2024; 31:238-244. [PMID: 37986203 DOI: 10.1111/iju.15341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES To analyze the incidence and risk factors of intraoperative hypotension related to photodynamic diagnosis-assisted transurethral resection of bladder tumor (PDD-TURBT) with oral 5-aminolevulinic acid (5-ALA). METHODS We retrospectively analyzed 487 patients with bladder tumors who underwent PDD-TURBT (n = 184) or conventional TURBT (conv-TURBT) (n = 303) between 2018 and 2021. Intraoperative hypotension was defined as hypotension requiring vasopressors during TURBT, and its incidence was compared between the two groups. Potential risk factors of intraoperative hypotension, including preoperative change in mean arterial pressure (MAP), were further investigated in patients receiving PDD-TURBT. RESULTS The median age was 72 years, 392 patients (81%) were male, and 203 (42%) had hypertension. TURBT was performed under general and spinal anesthesia in 76 (16%) and 411 (84%) patients, respectively. The incidence of intraoperative hypotension was significantly higher in PDD-TURBT compared to conv-TURBT (43% vs. 17%, respectively). The median change in MAP until the induction of anesthesia was +6.5 mmHg (range: -29.0 to +46.3) in the PDD-TURBT group and +14.7 mmHg (range: -35.3 to +67.7) in the conv-TURBT group, showing a significantly smaller increase in the PDD-TURBT group (p < 0.001). In the multivariable analysis for PDD-TURBT patients, advanced age, general anesthesia, and lower MAP change (<+6.5 mmHg) until anesthesia induction were significantly associated with intraoperative hypotension (p = 0.0104, <0.001, and <0.001, respectively). CONCLUSIONS Intraoperative hypotension occurred more frequently in patients who underwent PDD-TURBT than in those who underwent conv-TURBT. Using oral 5-ALA decreases preoperative blood pressure elevation and may be responsible for intraoperative hypotension.
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Affiliation(s)
- Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Amano K, Okuzaki D, Kitaoka Y, Kato S, Fujiwara M, Tanaka S, Iida S. Pth1r in Neural Crest Cells Regulates Nasal Cartilage Differentiation. J Dent Res 2024; 103:308-317. [PMID: 38234039 DOI: 10.1177/00220345231221954] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
Neural crest cells (NCC) arise from the dorsal margin of the neural plate border and comprise a unique cell population that migrates to and creates the craniofacial region. Although factors including Shh, Fgf8, and bone morphogenetic proteins have been shown to regulate these biological events, the role of parathyroid hormone 1 receptor (Pth1r) has been less studied. We generated an NCC-specific mouse model for Pth1r and researched gene expression, function, and interaction focusing on nasal cartilage framework and midfacial development. Wnt1-Cre;Pth1rfl/fl;Tomatofl/+ mice had perinatal lethality, but we observed short snout and jaws, tongue protrusion, reduced NCC-derived cranial length, increased mineralization in nasal septum and hyoid bones, and less bone mineralization at interfrontal suture in mutants at E18.5. Importantly, the mutant nasal septum and turbinate cartilage histologically revealed gradual, premature accelerated hypertrophic differentiation. We then studied the underlying molecular mechanisms by performing RNA seq analysis and unexpectedly found that expression of Ihh and related signaling molecules was enhanced in mutant nasomaxillary tissues. To see if Pth1r and Ihh signaling are associated, we generated a Wnt1-Cre; Ihhfl/fl;Pth1rfl/fl;Tomatofl/+ (DKO) mouse and compared the phenotypes to those of each single knockout mouse: Wnt1-Cre; Ihhfl/fl;Pth1rfl/+;Tomatofl/+ (Ihh-CKO) and Wnt1-Cre;Ihhfl/+;Pth1rfl/fl;Tomatofl/+ (Pth1r-CKO). Ihh-CKO mice displayed a milder effect. Of note, the excessive hypertrophic conversion of the nasal cartilage framework observed in Pth1r-CKO was somewhat rescued DKO embryos. Further, a half cAMP responsive element and the 4 similar sequences containing 2 mismatches were identified from the promoter to the first intron in Ihh gene. Gli1-CreERT2;Pth1rfl/fl;Tomatofl/+, a Pth1r-deficient model targeted in hedgehog responsive cells, demonstrated the enlarged hypertrophic layer and significantly more Tomato-positive chondrocytes accumulated in the nasal septum and ethmoidal endochondral ossification. Collectively, the data suggest a relevant Pth1r/Ihh interaction. Our findings obtained from novel mouse models for Pth1r signaling illuminate previously unknown aspects in craniofacial biology and development.
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Affiliation(s)
- K Amano
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - D Okuzaki
- Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Y Kitaoka
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Kato
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - M Fujiwara
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - S Tanaka
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Iida
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Fan B, Yokoyama M, Kobayashi M, Nakamura Y, Fujiwara M, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yoshida S, Fujii Y. Incidence, risk factors, and significance of 20% decrease from new baseline estimated glomerular filtration rate after radical and partial nephrectomy within 2 years. Int J Urol 2024; 31:119-124. [PMID: 37828800 DOI: 10.1111/iju.15322] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES To evaluate the incidence and risk factors of a 20% decrease from new baseline (NB)-estimated glomerular filtration rate (eGFR) within 2 years after radical nephrectomy (RN) and partial nephrectomy (PN) and to examine the difference in the incidence of end-stage renal disease (ESRD) with or without the 20% decrease. METHODS This retrospective study included 238 patients undergoing RN and 369 undergoing PN for cT1a-cT3a renal cancer. The incidence of a 20% decrease from NB-eGFR within 2 years after RN/PN was examined and its potential risk factors including surgery type were assessed by multivariate logistic regression analysis. The development of ESRD was analyzed as an endpoint and its incidence was compared according to the presence or absence of the 20% decrease from NB-eGFR within 2 years. RESULTS Overall, the 20% decrease from NB-eGFR within 2 years was observed in 37 patients (6.1%), including 10 (4.2%) and 27 (7.3%) after RN and PN, respectively (p = 0.117). Diabetes mellitus, proteinuria, and perioperative complications were shown to be independent risk factors for the 20% decrease from NB-eGFR, while surgery type was not. During the median follow-up of 65 months, the ESRD-free survival rate at 6 years was 75.5% and 99.6% in patients with and without the 20% decrease from NB-eGFR, respectively (p < 0.001), while no significant difference was observed between patients undergoing RN and PN (98.1% and 98.7%, p = 0.561). CONCLUSIONS Because the incidence of ESRD after the 20% decrease from NB-eGFR within 2 years was as high as 24.5% at 6 years, these patients should be followed with utmost care.
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Affiliation(s)
- Bo Fan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Kataoka M, Yokoyama M, Waseda Y, Ito M, Kobayashi M, Fujiwara M, Nakamura Y, Ishikawa Y, Fukuda S, Tanaka H, Yoshida S, Masuda H, Fujii Y. Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy. Low Urin Tract Symptoms 2024; 16:e12507. [PMID: 37984074 DOI: 10.1111/luts.12507] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES To evaluate longitudinal changes in lower urinary tract symptoms (LUTS) after artificial urinary sphincter (AUS) implantation in patients undergoing radiation therapy (RT) in comparison to those in non-irradiated patients. METHODS This retrospective study included 20 and 51 patients with and without a history of pelvic RT (RT and non-RT group, respectively) who were treated with primary AUS implantation for post-radical prostatectomy incontinence between 2010 and 2020. Longitudinal changes in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the International Prostate Symptom Score (IPSS), and the Overactive Bladder Symptom Score (OABSS) were calculated with a linear mixed model. RESULTS In the RT and non-RT group, 18 (90%) and 48 (94%) patients achieved social continence, defined as daily pad use ≤1 at 1 month after activation of AUS, respectively (p = .555). During the mean follow-up of 38 months, ICIQ-SF, IPSS, and OABSS significantly improved after AUS implantation in both the RT and non-RT groups. In the RT group, ICIQ-SF, IPSS, and OABSS subsequently deteriorated with a slope of 0.62/year (p = .010), 0.55/year (p = .025), and 0.30/year (p = .007), respectively. In the non-RT group, no significant longitudinal changes in subsequent IPSS and OABSS were observed, although ICIQ-SF significantly deteriorated (0.43/year, p = .006). Comparing between the groups, the slopes of IPSS and OABSS were significantly greater in the RT group than in the non-RT group (p < .001, and .015, respectively). CONCLUSIONS Longitudinal deterioration in LUTS that improved immediately after AUS implantation was observed in patients with a history of pelvic RT, but not in patients without a history of pelvic RT.
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Affiliation(s)
- Madoka Kataoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaya Ito
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hitoshi Masuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Kaneko H, Fujiwara M, Tanaka H, Kimura K, Yoshida S, Fujii Y. Texture feature analysis using dynamic computed tomography for preoperative risk stratification in upper urinary tract urothelial carcinoma. Int J Urol 2023; 30:1056-1058. [PMID: 37463874 DOI: 10.1111/iju.15253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Hiroki Kaneko
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Fujiwara M, Nakayama J, Sakamoto J, Higaki A. Effect of Daikenchuto Therapy on Risk of Rectal Bleeding after IMRT for Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e384. [PMID: 37785296 DOI: 10.1016/j.ijrobp.2023.06.2499] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Rectal bleeding due to radiation proctitis after treatment in radiation therapy for prostate cancer is a typical late toxicity symptom. The rate of rectal bleeding has been reduced by using IMRT, IGRT and peri-rectal hydrogel spacer. On the other hand, few reports have attempted to reduce the rate of rectal bleeding by medication. It has been reported that Daikenchuto (DKT), a traditional Japanese herbal medicine, has the effects of accelerating gastrointestinal motility and anti-fibrosis. We retrospectively investigated the rate of rectal bleeding in patients between concurrently administered and not administered DKT for bowel control during IMRT for prostate cancer. MATERIALS/METHODS The subjects were 102 patients who underwent definitive IMRT for prostate cancer between 2014 and 2021 in our hospital. The DKT therapy concurrent use group were included 46 patients (45%), who were administered DKT per 10.0 g / day or 15.0 g / day. The irradiation was carried out, confirming the rectal volume every time by the image-guided radiotherapy using cone beam CT in all cases. The curative doses fractionation of IMRT were 78 Gy in 2 Gy per fraction (40%) or 70 Gy in 2.5 Gy per fraction (60%). We compared the rate of rectal bleeding after IMRT with and without DKT. Late rectal bleeding toxicity was scored using the Common Terminology Criteria for Adverse Events ver. 5.0 criteria. The associated factors of rectal bleeding were examined using the Cox proportional hazard model for multivariate analysis. RESULTS In the DKT therapy group, the median follow-up period was 31 months (Range: 17-84 months), and the rectal bleeding rate was Grade 1 in 2 patients (4%) and Grade ≥ 2 in none. The median observation period in the non-DKT therapy group was 48 months (Range: 17-101 months), and the rectal bleeding rate was Grade 1 in 12 patients (21%), Grade 2 in 6 patients (10%), and there were no events of Grade ≥ 3. In univariate analysis, DKT therapy, dose fractionation and planned rectal doses (V50, V55, V60, V65, V70 and V75 converted to EQD23) were significant factors for rectal bleeding. Multivariate analysis showed that the DKT therapy was a significant independent factor in reducing the rate of rectal bleeding (HR: 0.105, 95% CI: 0.01-0.50, P = 0.003). CONCLUSION It was statistically suggested in this study that the DKT therapy further reduced the rate of rectal bleeding in IMRT for prostate cancer.
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Affiliation(s)
- M Fujiwara
- Department of Radiation Oncology, Suita Tokushukai Hospital, Osaka, Japan
| | - J Nakayama
- Department of Urology, Suita Tokushukai Hospital, Osaka, Japan
| | - J Sakamoto
- Department of Urology, Suita Tokushukai Hospital, Osaka, Japan
| | - A Higaki
- Department of Urology, Suita Tokushukai Hospital, Osaka, Japan
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Amano K, Kitaoka Y, Kato S, Fujiwara M, Okuzaki D, Aikawa T, Kogo M, Iida S. Pth1r Signal in Gli1+ Cells Maintains Postnatal Cranial Base Synchondrosis. J Dent Res 2023; 102:1241-1251. [PMID: 37575041 DOI: 10.1177/00220345231184405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Cranial base synchondroses are the endochondral ossification centers for cranial base growth and thus indispensable for proper skull, brain, and midfacial development. The synchondroses are composed of mirror-image growth plates that are continuously maintained from the embryonic to postnatal stage through chondrocyte differentiation. Several factors, including Pth1r signaling, are known to control fetal synchondrosis development. However, there are currently no reports regarding any role for Pth1r signaling in postnatal cranial base and synchondrosis development. Also, the mesenchymal cells that source Pth1r signaling for synchondroses are not known. Here, we employed an inducible mouse model, a hedgehog-responsive Gli1-CreERT2 driver, focusing on the postnatal study. We performed 2 inducible protocols using Gli1-CreERT2;Tomatofl/+ mice that uncovered distinct patterning of Gli1-positive and Gli1-negative chondrocytes in the synchondrosis cartilage. Moreover, we generated Gli1-CreERT2;Pth1rfl/fl;Tomatofl/+ mice to assess their functions in postnatal synchondrosis and found that the mutants had survived postnatally. The mutant skulls morphologically presented unambiguous phenotypes where we noticed the shortened cranial base and premature synchondrosis closure. Histologically, gradual disorganization in mutant synchondroses caused an uncommon remaining central zone between hypertrophic zones on both sides while the successive differentiation of round, flat, and hypertrophic chondrocytes was observed in control sections. These mutant synchondroses disappeared and were finally replaced by bone. Of note, the mutant fusing synchondroses lost their characteristic patterning of Gli1-positive and Gli1-negative chondrocytes, suggesting that loss of Pth1r signaling alters the distribution of hedgehog-responsive chondrocytes. Moreover, we performed laser microdissection and RNA sequencing to characterize the flat proliferative and round resting chondrocytes where we found flat chondrocytes have a characteristic feature of both chondrocyte proliferation and maturation. Taken together, these data demonstrate that Pth1r signaling in Gli1-positive cells is essential for postnatal development and maintenance in cranial base synchondroses. Our findings will elucidate previously unknown aspects of Pth1r functions in cranial biology and development.
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Affiliation(s)
- K Amano
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- The first department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Kitaoka
- The first department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Kato
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - M Fujiwara
- The first department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
- The Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - D Okuzaki
- Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - T Aikawa
- The first department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - M Kogo
- The first department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Iida
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Uchida Y, Yokoyama M, Fujiwara M, Nakamura Y, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yoshida S, Fujiwara T, Fujii Y. Preservation of Erectile and Ejaculatory Functions After Tetramodal Bladder-Sparing Therapy Incorporating Consolidative Partial Cystectomy Against Muscle Invasive Bladder Cancer. Urol Res Pract 2023; 49:162-168. [PMID: 37877865 PMCID: PMC10346115 DOI: 10.5152/tud.2023.22214] [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] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/17/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE To cross-sectionally assess erectile and ejaculatory functions after tetramodal bladder-sparing therapy consisting of transurethral resection, chemoradiotherapy, and consolidative partial cystectomy in patients with muscle invasive bladder cancer. MATERIALS AND METHODS Among 72 enrolled male patients who underwent tetramodal bladder-sparing therapy from 2006 to 2019, 42 who visited the outpatient clinic from February to October 2020 received questionnaires. Erectile function, ejaculatory function, and quality of life were assessed using the International Index of Erectile Function short form, the Male Sexual Health Questionnaire Ejaculatory Dysfunction short form, and the Functional Assessment of Cancer Therapy. RESULTS Among the 42 patients, 9 were excluded because of incomplete responses and 33 were eligible for analyses. The median (range) age at survey and the time from treatment completion to responding to the questionnaires was 70 (50-87) years and 4.2 (0.4-14.0) years, respectively. The median International Index of Erectile Function short form-5 score was 11 (5-25), and 3 (9.1%) and 9 (27.3%) patients had no and mild erectile dysfunction, respectively. The Male Sexual Health Questionnaire Ejaculatory Dysfunction short form results showed that 23 (69.7%) patients responded that they could ejaculate. Patients with higher Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores had better erectile function and quality of life than those with lower Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores. CONCLUSION Preservation of erectile and ejaculatory functions was demonstrated in muscle invasive bladder cancer patients treated with tetramodal bladder-sparing therapy. In addition to lower urinary tract function, preservation of male sexual function, especially ejaculatory function, in bladder-sparing therapy can be an advantage over radical cystectomy.
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Affiliation(s)
- Yusuke Uchida
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
- Department of Insured Medical Care Management, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
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12
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Tsutsui T, Fujiwara T, Matsumoto Y, Kimura A, Kanahori M, Arisumi S, Oyamada A, Ohishi M, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Hara T, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Takasaki M, Shin K, Ninomiya K, Nakaie K, Antoku Y, Iwamoto Y, Nakashima Y. Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures. Osteoporos Int 2023:10.1007/s00198-023-06753-3. [PMID: 37067545 DOI: 10.1007/s00198-023-06753-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
This study investigated the long-term survival and incidence of secondary fractures after fragility hip fractures. The 5-year survival rate was 62%, and the mortality risk was seen in patients with GNRI < 92. The 5-year incidence of secondary fracture was 22%, which was significantly higher in patients with a BMI < 20. BACKGROUND Malnutrition negatively influences the postoperative survival of patients with fragility hip fractures (FHFs); however, little is known about their association over the long term. OBJECTIVE This study evaluated the ability of the geriatric nutritional risk index (GNRI) as a risk factor for long-term mortality after FHFs. METHODS This study included 623 Japanese patients with FHFs over the age of 60 years. We prospectively collected data on admission and during hospitalization and assessed the patients' conditions after discharge through a questionnaire. We examined the long-term mortality and the incidence of secondary FHFs and assessed the prognostic factors. RESULTS The mean observation period was 4.0 years (range 0-7 years). The average age at the time of admission was 82 years (range 60-101 years). The overall survival after FHFs (1 year, 91%; 5 years, 62%) and the incidence of secondary FHFs were high (1 year, 4%; 5 years, 22%). The multivariate Cox proportional hazard analysis revealed the risk factors for mortality as older age (hazard ratio [HR] 1.04), male sex (HR 1.96), lower GNRI score (HR 0.96), comorbidities (malignancy, HR 2.51; ischemic heart disease, HR 2.24; revised Hasegawa dementia scale ≤ 20, HR 1.64), no use of active vitamin D3 on admission (HR 0.46), and a lower Barthel index (BI) (on admission, HR 1.00; at discharge, HR 0.99). The GNRI scores were divided into four risk categories: major risk (GNRI, < 82), moderate risk (82-91), low risk (92-98), and no risk (> 98). Patients at major and moderate risks of GNRI had a significantly lower overall survival rate (p < 0.001). Lower body mass index (BMI) was also identified as a prognostic factor for secondary FHFs (HR 0.88 [p = 0.004]). CONCLUSIONS We showed that older age, male sex, a lower GNRI score, comorbidities, and a lower BI are risk factors for mortality following FHFs. GNRI is a novel and simple predictor of long-term survival after FHFs.
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Affiliation(s)
- T Tsutsui
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - T Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Y Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - A Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - M Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - S Arisumi
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - A Oyamada
- Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan
| | - M Ohishi
- Department of Orthopaedic Surgery, Chihaya Hospital, Fukuoka, Japan
| | - K Ikuta
- Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Saga, Japan
| | - K Tsuchiya
- Department of Orthopaedic Surgery, Japan Community Healthcare Organization, Kyushu Hospital, Fukuoka, Japan
| | - N Tayama
- Department of Orthopaedic Surgery, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - S Tomari
- Department of Orthopaedic Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - H Miyahara
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - T Mae
- Department of Orthopaedic Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - T Hara
- Department of Orthopaedic Surgery, Aso Iizuka Hospital, Fukuoka, Japan
| | - T Saito
- Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - T Arizono
- Department of Orthopaedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - K Kaji
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - T Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - M Fujiwara
- Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan
| | - M Takasaki
- Department of Orthopaedic Surgery, Harasanshin Hospital, Fukuoka, Japan
| | - K Shin
- Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Fukuoka, Japan
| | - K Ninomiya
- Department of Orthopaedic Surgery, Koga Hospital 21, Fukuoka, Japan
| | - K Nakaie
- Department of Orthopaedic Surgery, National Hospital Organization Fukuoka-Higashi Medical Centre, Fukuoka, Japan
| | - Y Antoku
- Faculty of Medicine, Hospital Informatic Centre, Oita University, Oita, Japan
| | - Y Iwamoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Y Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Fujiwara M, Imamura M, Matsushita K, Roszak P, Yamashino T, Hosokawa Y, Nakajima K, Fujimoto K, Miyashima S. Patterned proliferation orients tissue-wide stress to control root vascular symmetry in Arabidopsis. Curr Biol 2023; 33:886-898.e8. [PMID: 36787744 DOI: 10.1016/j.cub.2023.01.036] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/24/2022] [Accepted: 01/18/2023] [Indexed: 02/16/2023]
Abstract
Symmetric tissue alignment is pivotal to the functions of plant vascular tissue, such as long-distance molecular transport and lateral organ formation. During the vascular development of the Arabidopsis roots, cytokinins initially determine cell-type boundaries among vascular stem cells and subsequently promote cell proliferation to establish vascular tissue symmetry. Although it is unknown whether and how the symmetry of initially defined boundaries is progressively refined under tissue growth in plants, such boundary shapes in animal tissues are regulated by cell fluidity, e.g., cell migration and intercalation, lacking in plant tissues. Here, we uncover that cell proliferation during vascular development produces anisotropic compressive stress, smoothing, and symmetrizing cell arrangement of the vascular-cell-type boundary. Mechanistically, the GATA transcription factor HANABA-TARANU cooperates with the type-B Arabidopsis response regulators to form an incoherent feedforward loop in cytokinin signaling. The incoherent feedforward loop fine-tunes the position and frequency of vascular cell proliferation, which in turn restricts the source of mechanical stress to the position distal and symmetric to the boundary. By combinatorial analyses of mechanical simulations and laser cell ablation, we show that the spatially constrained environment of vascular tissue efficiently entrains the stress orientation among the cells to produce a tissue-wide stress field. Together, our data indicate that the localized proliferation regulated by the cytokinin signaling circuit is decoded into a globally oriented mechanical stress to shape the vascular tissue symmetry, representing a reasonable mechanism controlling the boundary alignment and symmetry in tissue lacking cell fluidity.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka 560-0043, Japan
| | - Miyu Imamura
- Laboratory of Molecular and Functional Genomics, Graduate School of Bioagricultural Sciences, Nagoya University, Furocho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Katsuyoshi Matsushita
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka 560-0043, Japan
| | - Pawel Roszak
- Sainsbury Laboratory, University of Cambridge, 47 Bateman Street, Cambridge CB2 1LR, United Kingdom; Faculty of Biological and Environmental Sciences, University of Helsinki 00014, Helsinki, Finland
| | - Takafumi Yamashino
- Laboratory of Molecular and Functional Genomics, Graduate School of Bioagricultural Sciences, Nagoya University, Furocho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Yoichiroh Hosokawa
- Graduate School of Science and Technology, Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma, Nara 630-0192, Japan
| | - Keiji Nakajima
- Graduate School of Science and Technology, Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma, Nara 630-0192, Japan
| | - Koichi Fujimoto
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka 560-0043, Japan.
| | - Shunsuke Miyashima
- Graduate School of Science and Technology, Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma, Nara 630-0192, Japan.
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14
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Fujiwara M, Yokoyama M, Toide M, Fujiwara R, Tanaka H, Oguchi T, Komai Y, Yoshida S, Matsuoka Y, Numao N, Yamamoto S, Fukui I, Yonese J, Fujii Y. Renal function outcome after selective bladder-preserving tetramodality therapy consisting of maximal transurethral resection, induction chemoradiotherapy and consolidative partial cystectomy in comparison with radical cystectomy for patients with muscle-invasive bladder cancer: a two-centre retrospective study. Jpn J Clin Oncol 2023; 53:263-269. [PMID: 36524369 DOI: 10.1093/jjco/hyac190] [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: 09/25/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To compare renal function (RF) outcomes after bladder-preserving tetramodal therapy against muscle-invasive bladder cancer (MIBC) to those after radical cystectomy (RC). METHODS This study included 95 patients treated with tetramodal therapy consisting of transurethral bladder tumour resection, chemoradiotherapy and partial cystectomy (PC) and 300 patients treated with RC. The annual change in the estimated glomerular filtration rate (eGFR) was compared using the linear mixed model. Renal impairment was defined as a >25% decrease from the pretreatment eGFR, and renal impairment-free survival (RIFS) was calculated. The association between treatment type and renal impairment was assessed. RESULTS The number of patients who received neoadjuvant chemotherapy was 8 (8.4%) in the tetramodal therapy group and 75 (25.0%) in the RC group. After the inverse probability of treatment weighting adjustments, the baseline characteristics were balanced between the treatment groups. The mean eGFR before treatment in tetramodal therapy and RC groups was 69.4 and 69.6 mL/min/1.73 m2 and declined with a slope of -0.7 and -1.5 mL/min/1.73 m2/year, respectively. The annual deterioration rate of post-treatment eGFR in the tetramodal therapy group was milder than in the RC group. The 5-year RIFS rate in the tetramodal therapy and the RC groups was 91.2 and 85.2%, respectively. Tetramodal therapy was an independent factor of better RIFS compared with RC. CONCLUSIONS RF was better preserved after tetramodal therapy than after radical therapy; however, even after tetramodal therapy, the eGFR decreased, and a non-negligible proportion of patients developed renal impairment.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Insured Medical Care Management, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Toide
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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15
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Fujiwara R, Yuasa T, Yamamoto S, Fujiwara M, Takemura K, Urasaki T, Oki R, Komai Y, Oguchi T, Numao N, Yonese J. Geriatric Nutritional Risk Index as a Predictor of Prognosis in Metastatic Renal Cell Carcinoma Treated with Nivolumab. Nutr Cancer 2023; 75:670-677. [PMID: 36448767 DOI: 10.1080/01635581.2022.2152061] [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: 12/05/2022]
Abstract
BACKGROUND The Geriatric Nutritional Risk Index (GNRI) has been reported as a screening tool to assess the nutrition-related risk with mortality in older patients and those with the various diseases. However, the prognostic value of GNRI in metastatic renal cell carcinoma (mRCC) patients receiving nivolumab therapy remains unclear. METHODS Fifty-six consecutive patients with mRCC receiving nivolumab between September 2013 and August 2020 at our institution were retrospectively analyzed. The survival outcomes and prognostic factors associated with overall survival (OS) were statistically analyzed. RESULTS Thirteen and forty-three patients were classified with low (GNRI < 92) and high (GNRI ≥ 92) GNRI, respectively. Patients with low GNRI demonstrated significantly shorter OS (P = 0.0002) than those with high GNRI. In multivariate analysis, GNRI at the time of nivolumab (P = 0.008) was extracted as the predictor for OS in addition to Karnofsky performance status (KPS) (P = 0.016). Integration of the GNRI into the International Metastatic Renal Cell Cancer Database Consortium (IMDC) risk classification improved the c-index from 0.761 to 0.833 (combination of GNRI with IMDC risk classification) and to 0.778 (substitution of GNRI with KPS in IMDC risk classification). CONCLUSIONS GNRI was a significant prognostic biomarker in mRCC patients receiving nivolumab.
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Affiliation(s)
- Ryo Fujiwara
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kosuke Takemura
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tetsuya Urasaki
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryosuke Oki
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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16
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Nakamura Y, Yoshida S, Arita Y, Takeshita R, Kimura K, Aida Y, Asai S, Maezawa Y, Yoshitomi K, Chen W, Soma T, Kobayashi M, Fujiwara M, Fan B, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yokoyama M, Jinzaki M, Fujii Y. Can we avoid second transurethral resection according to VI-RADS score in patients with high-risk non-muscle-invasive bladder cancer? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00645-0] [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: 02/12/2023]
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17
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Yoshida S, Takahara T, Arita Y, Toda K, Kimura K, Fujiwara M, Tanaka H, Yokoyama M, Matsuoka Y, Yoshimura R, Fujii Y. Patterns of recurrence in genuine and induced oligometastatic castration-resistant prostate cancer treated with progressive site-directed therapy. Int J Urol 2023; 30:204-210. [PMID: 36314128 DOI: 10.1111/iju.15090] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/14/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To describe oncological outcomes after progressive site-directed therapy (PSDT) in genuine and induced oligometasatic (OM)-castration-resistant prostate cancer (CRPC). METHODS Thirty-seven patients with OM-CRPC treated with PSDT were retrospectively analyzed, and oncological outcomes and recurrence patterns on whole-body diffusion-weighted MRI (WB-DWI) were evaluated. RESULTS Twenty-two (59%) were classified as genuine OM-CRPC and 15 (41%) as induced OM-CRPC. A 50% decline in PSA after PSDT was observed in 21 (95%) genuine OM-CRPCs and 7 (47%) induced OM-CRPCs (p = 0.0005). At a median observation period of 7.3 months, median PSA progression-free survival were 10.9 months in the genuine OM-CRPCs and 4.8 months in the induced OM-CRPCs (p = 0.015). Among the patients who developed PSA progression after PSDT, 11 of 15 in the genuine OM-CRPCs (73%) and 11 of 14 in the induced OM-CRPCs (79%) underwent WB-DWI at PSA progression. The median numbers of newly detected metastases were 2 (range: 1-5) in the genuine OM-CRPCs and 4 (range: 1-40) in the induced OM-CRPCs (p = 0.049). Only one new metastasis appeared in 5 patients from the genuine OM-CRPCs (46%) and 1 from the induced OM-CRPCs (9.1%, p = 0.048). In 7 of 9 patients from the genuine OM-CRPCs (78%) and 7 of 8 patients from the induced OM-CRPCs (88%) who had bone metastases alone, the newly detected metastasis limited to the bone. CONCLUSIONS Genuine OM-CRPC had better oncological outcomes after PSDT than induced OM-CRPC, and the number of lesions detected at recurrence was limited. Induced OM-CRPC might be a disseminated condition with micrometastases at OM diagnosis.
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Affiliation(s)
- Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University School of Engineering, Kanagawa, Japan.,Department of Radiology, Advanced Imaging Center, Yaesu Clinic, Tokyo, Japan
| | - Yuki Arita
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuma Toda
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Yoshimura
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Kobayashi M, Matsuoka Y, Fukuda S, Kimura K, Fujiwara M, Nakamura Y, Ishikawa Y, Waseda Y, Tanaka H, Yoshida S, Yokoyama M, Fujii Y. Significance of MRI-ultrasound fusion targeted prostate biopsy for non-index PI-RADS ≥3 lesions in combination with index lesion-targeted biopsy and systematic biopsy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00218-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: 02/12/2023]
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19
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Asai S, Kobayashi M, Fukuda S, Kimura K, Fujiwara M, Nakamura Y, Ishikawa Y, Waseda Y, Tanaka H, Yoshida S, Yokoyama M, Fujii Y. Significance of atypical nodules upgraded to category 3 in PI-RADS version 2.1 for the prostate cancer diagnosis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01026-6] [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: 02/12/2023]
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20
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Arita Y, Yoshida S, Shigeta K, Kwee TC, Edo H, Okawara N, Hashimoto M, Ishii R, Ueda R, Mikami S, Fujiwara M, Waseda Y, Kikuchi E, Fujii Y, Jinzaki M. Diagnostic Value of the Vesical Imaging-Reporting and Data System in Bladder Urothelial Carcinoma with Variant Histology. Eur Urol Oncol 2023; 6:99-102. [PMID: 35933266 DOI: 10.1016/j.euo.2022.07.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
The value of the Vesicle Imaging-Reporting and Data System (VI-RADS) in the diagnosis of muscle-invasive bladder cancer (MIBC) for urothelial carcinoma with variant histology (VUC) remains unknown. We retrospectively evaluated 360 consecutive patients with bladder cancer (255 pure urothelial carcinoma [PUC] and 69 VUC) who underwent multiparametric magnetic resonance imaging between 2011 and 2019. VI-RADS scores assigned by four readers were significantly higher for the VUC group than for the PUC group (p < 0.05). In the cohort of 122 pair-matched patients, there was no significant difference in VI-RADS score distribution between the PUC and VUC groups for all readers (p > 0.05). The area under the receiver operating characteristic curve for MIBC diagnosis via overall VI-RADS score was 0.93-0.94 for PUC and 0.89-0.92 for VUC, with no significant difference between the PUC and VUC groups (p = 0.32-0.60). These data suggests that VI-RADS scores achieved high diagnostic performance for detection of muscle invasion in both PUC and VUC. PATIENT SUMMARY: The Vesical Imaging-Reporting and Data System (VI-RADS) is a standardized system for reporting on detection of muscle-invasive bladder cancer via magnetic resonance imaging (MRI) scans. Our study shows that VI-RADS is also highly accurate for diagnosis for different variants of muscle-invasive bladder cancer, with good inter-reader agreement.
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Affiliation(s)
- Yuki Arita
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Keisuke Shigeta
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Thomas C Kwee
- Department of Radiology, Nuclear Medicine, and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Hiromi Edo
- Department of Radiology, National Defense Medical College, Tokorozawa, Japan
| | - Naoko Okawara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Hashimoto
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Ryota Ishii
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ryo Ueda
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Shuji Mikami
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Eiji Kikuchi
- Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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21
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Shimotsuma Y, Kinouchi K, Yanoshita R, Fujiwara M, Mizuochi N, Uemoto M, Shimizu M, Miura K. Formation of NV centers in diamond by a femtosecond laser single pulse. Opt Express 2023; 31:1594-1603. [PMID: 36785191 DOI: 10.1364/oe.475917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/20/2022] [Indexed: 06/18/2023]
Abstract
The NV centers in a diamond were successfully created by the femtosecond laser single pulse. We also investigated the effect on the diamond lattice induced by the different laser pulse widths from both experimental and theoretical perspectives. Interestingly, in spite of the high thermal conductivity of a diamond, we found that there is a suitable pulse repetition rate of several tens kHz for the formation of NV center ensembles by the femtosecond laser pulse irradiation.
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Nakamura Y, Fukushima H, Yoshitomi K, Soma T, Kobayashi M, Fan B, Fujiwara M, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yoshida S, Yokoyama M, Fujii Y. Significance of dorsal bladder neck involvement in predicting the progression of non-muscle-invasive bladder cancer. Int J Urol 2022; 30:381-388. [PMID: 36575910 DOI: 10.1111/iju.15136] [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: 08/13/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Accurately predicting of progression is important for patients with non-muscle-invasive bladder cancer (NMIBC). We previously reported that bladder neck involvement (BNI) was significantly associated with progression of NMIBC. In this study, we evaluated the prognostic significance of the detailed BNI location in NMIBC patients. METHODS We retrospectively reviewed 651 patients diagnosed with primary NMIBC at a single center between 2000 and 2018. Using the detailed BNI location, patients were divided into the following three groups: dorsal BNI (BNId; 4 to 8 o'clock position), ventral BNI (BNIv; 8 to 4 o'clock but not 4 to 8 o'clock position), and non-BNI group. Both time to progression to muscle-invasive disease and distant metastasis was compared among the three groups. A prognostic model was developed and its discriminative ability was evaluated. RESULTS Dorsal bladder neck involvement and BNIv were observed in 43 (6.6%) and 36 (5.5%) patients, respectively. During a median follow-up of 61 months, 35 (5.4%) patients progressed. The cumulative incidence at 5 years was 12%, 0%, and 5.0% in BNId, BNIv, and non-BNI groups, respectively. On multivariate analysis, BNId was a significant and independent risk factor for progression, tumor stage pT1, and histologic grade G3. One point was assigned to each factor, and patients were classified into four well-stratified prognostic groups based on the total score. CONCLUSION Dorsal bladder neck involvement was an independent and significant risk factor for progression in primary NMIBC. Our simple and practical prognostic model including BNId is easy to use and may help selecting the optimal treatment and its timing.
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Affiliation(s)
- Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Fukushima
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kasumi Yoshitomi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiko Soma
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Bo Fan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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23
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Fukagawa E, Yuasa T, Inamura K, Hamada K, Fujiwara M, Komai Y, Yonese J. De novo
large‐cell neuroendocrine carcinoma of the prostate: A case report and literature review. IJU Case Rep 2022; 5:505-510. [PMID: 36341182 PMCID: PMC9626356 DOI: 10.1002/iju5.12527] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/12/2022] [Indexed: 02/01/2023] Open
Abstract
Introduction Prostatic large‐cell neuroendocrine carcinoma is poorly studied. Although several case reports are available, information on the clinicopathological characteristics of this disease is limited, particularly for the de novo (hormone‐naive) type. Herein, we report an extremely rare de novo case of this disease with a good prognosis despite a multi‐metastatic status. Case presentation An 83‐year‐old male patient presented with a high serum prostate‐specific antigen level and was found to have de novo prostatic large‐cell neuroendocrine carcinoma with an adenocarcinoma component upon pathological examination. Diagnosed with stage pT4cN1cM1c, he underwent chemo‐hormonal therapy using a luteinizing hormone‐releasing hormone antagonist and combined etoposide and cisplatin, which achieved a partial response. The patient has survived for 20 months without progression. Conclusion Although prostatic large‐cell neuroendocrine carcinoma is known for its aggressive clinical behavior, the de novo type with an adenocarcinoma component may be sensitive to hormonal therapy and achieve a good prognosis.
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Affiliation(s)
- Eri Fukagawa
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
- Department of Urology St. Luke's International Hospital Tokyo Japan
| | - Takeshi Yuasa
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
| | - Kentaro Inamura
- Department of Pathology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
| | - Kosuke Hamada
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
| | - Motohiro Fujiwara
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
| | - Yoshinobu Komai
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
| | - Junji Yonese
- Department of Urology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
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Fujiwara M, Akiyama-Oda Y, Oda H. Virtual spherical-shaped multicellular platform for simulating the morphogenetic processes of spider-like body axis formation. Front Cell Dev Biol 2022; 10:932814. [PMID: 36036016 PMCID: PMC9411422 DOI: 10.3389/fcell.2022.932814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/30/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Remodeling of multicellular architecture is a critical developmental process for shaping the axis of a bilaterally symmetric animal body and involves coordinated cell–cell interactions and cell rearrangement. In arthropods, the early embryonic process that leads to the segmented body axis varies at the cellular and molecular levels depending on the species. Developmental studies using insect and spider model species have provided specific examples of these diversified mechanisms that regulate axis formation and segmentation in arthropod embryos. However, there are few theoretical models for how diversity in the early embryonic process occurred during evolution, in part because of a limited computational infrastructure. We developed a virtual spherical-shaped multicellular platform to reproduce body axis-forming processes. Each virtual cell behaves according to the cell vertex model, with the computational program organized in a hierarchical order from cells and tissues to whole embryos. Using an initial set of two different mechanical states for cell differentiation and global directional signals that are linked to the planar polarity of each cell, the virtual cell assembly exhibited morphogenetic processes similar to those observed in spider embryos. We found that the development of an elongating body axis is achieved through implementation of an interactive cell polarity parameter associated with edge tension at the cell–cell adhesion interface, with no local control of the cell division rate and direction. We also showed that modifying the settings can cause variation in morphogenetic processes. This platform also can embed a gene network that generates waves of gene expression in a virtual dynamic multicellular field. This study provides a computational platform for testing the development and evolution of animal body patterns.
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Affiliation(s)
- Motohiro Fujiwara
- Laboratory of Evolutionary Cell and Developmental Biology, JT Biohistory Research Hall, Takatsuki, Japan
- *Correspondence: Motohiro Fujiwara, ; Hiroki Oda,
| | - Yasuko Akiyama-Oda
- Laboratory of Evolutionary Cell and Developmental Biology, JT Biohistory Research Hall, Takatsuki, Japan
- PRESTO, Japan Science and Technology Agency (JST), Kawaguchi, Japan
- Department of Microbiology and Infection Control, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Oda
- Laboratory of Evolutionary Cell and Developmental Biology, JT Biohistory Research Hall, Takatsuki, Japan
- Department of Biological Science, Graduate School of Science, Osaka University, Toyonaka, Japan
- *Correspondence: Motohiro Fujiwara, ; Hiroki Oda,
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Fujiwara M, Numao N, Yamamoto S, Ishikawa Y, Fujiwara R, Oguchi T, Komai Y, Matsuoka Y, Yuasa T, Yonese J. Predictive ability of prebiopsy magnetic resonance imaging and biopsy for side-specific negative lymph node metastasis at radical prostatectomy. Prostate 2022; 82:904-910. [PMID: 35297503 DOI: 10.1002/pros.24334] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 03/02/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prostate cancer localization is reportedly associated with the laterality of lymph node metastasis. Thus, it may be feasible to predict side-specific lymph node metastasis (LNM) at radical prostatectomy (RP). To investigate whether multiparametric magnetic resonance imaging and biopsy findings can predict side-specific negative LNM and to explore the feasibility of unilateral lymph node dissection (LND) at RP. METHODS A total of 500 patients who were diagnosed with prostate cancer with prebiopsy multiparametric magnetic resonance imaging of the prostate and subsequent prostate biopsy and who underwent RP and extended LND without neoadjuvant treatment were enrolled. Multiparametric magnetic resonance imaging, biopsy findings, and LNM were assessed for each side. The negative predictive value (NPV) of multiparametric magnetic resonance imaging or biopsy or both for ipsilateral LNM was examined. RESULTS LNM was found in 9.2% (46/500) and 15.6% (28/180) of patients in the overall and high-risk cohorts, respectively. Magnetic resonance imaging and biopsy findings were negative in 408 and 262 sides, respectively, in the overall cohort and 144 and 100 sides, respectively, in the high-risk cohort. The NPVs of magnetic resonance imaging, biopsy, and both for ipsilateral LNM were 98.3%, 98.5%, and 99.1%, respectively, in the overall cohort, and 95.8%, 97.1%, and 97.6%, respectively, in the high-risk cohort. CONCLUSIONS Unilateral LND may be indicated based on side-specific LNM risk as assessed by prebiopsy multiparametric magnetic resonance imaging and biopsy.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yudai Ishikawa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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26
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Fujiwara M, Fujiwara R, Urasaki T, Oguchi T, Komai Y, Numao N, Yamamoto S, Yonese J, Yuasa T. Early Serum and Hematological Responses to Pembrolizumab Therapy as Predictors of Survival in Metastatic Urothelial Cancer. Anticancer Res 2022; 42:2045-2051. [PMID: 35347027 DOI: 10.21873/anticanres.15685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/27/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND In order to search for predictive biomarkers of efficacy of pembrolizumab therapy for metastatic urothelial cancer (UC), we investigated the relationship between treatment outcomes and early neutrophil-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), and C-reactive protein (CRP) responses. PATIENTS AND METHODS Medical records of 101 patients with metastatic UC who started pembrolizumab as a second-line or later treatment were reviewed. NLR, LDH, and CRP were recorded after 3 weeks of therapy. In addition, we investigated whether these factors had an association with prolonged progression-free (PFS) or overall (OS) survival. RESULTS The objective response rate, median PFS, and median OS were 25.7%, 6.3 months, and 15.2 months, respectively. PFS and OS were significantly shorter in patients with NLR>3, LDH>upper limit of normal (ULN), and CRP>0.5 mg/dl after 3 weeks of pembrolizumab treatment (p<0.05). A predictive model comprising these factors (favorable risk group: 0 risk factors; intermediate-risk group: 1-2 risk factors; poor-risk group: 3 risk factors) revealed distinct PFS and OS curves (p<0.001). In the favorable risk group, 12-month OS was 79.6%; in the poor-risk group, it was 12.8%. Harrell's C-indices for NLR >3, LDH >ULN, CRP >0.5 mg/dl, and all three combined for predicting OS were 0.656, 0.625, 0.633 and 0.678, respectively. Early responses were also non-significantly associated with ORR (p=0.37). CONCLUSION Pembrolizumab treatment outcomes are associated with early NLR, LDH, and CRP responses in metastatic urothelial cancer.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan;
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetsuya Urasaki
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Ishikawa Y, Uehara S, Ishihara K, Hirose K, Soma T, Fujiwara M, Kobayashi M, Fan B, Nakamura Y, Uchida Y, Fukuda S, Tanaka H, Yoshida S, Yokoyama M, Matsuoka Y, Fujii Y. Variability in diagnostic performance of non-muscle invasive bladder cancer for each region using fluorescence cystoscopy with orally administered 5-aminolevulinic acid. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00317-7] [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: 11/30/2022]
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28
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Ishikawa Y, Sho U, Ishihara K, Hirose K, Soma T, Fujiwara M, Kobayashi M, Fan B, Nakamura Y, Uchida Y, Fukuda S, Tanaka H, Yoshida S, Yokoyama M, Matsuoka Y, Fujii Y. Orally administered 5-aminolevulinic acid can cause intraoperative hypotension in patients with bladder cancer undergoing transurethral resection. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00332-3] [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: 11/28/2022]
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29
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Yoshitomi KK, Komai Y, Yamamoto T, Fukagawa E, Hamada K, Yoneoka Y, Fujiwara M, Fujiwara R, Oguchi T, Numao N, Yuasa T, Yamamoto S, Fukui I, Yonese J. Improving accuracy, reliability, and efficiency of the RENAL nephrometry score with 3D reconstructed virtual imaging. Urology 2022; 164:286-292. [PMID: 35093400 DOI: 10.1016/j.urology.2022.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/09/2021] [Revised: 12/27/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To clarify the diagnostic performance of the three-dimensional reconstructed virtual image (3D-RVI) in evaluating RENAL nephrometry score (RENAL-NS). METHODS This study included 130 patients who underwent preoperative contrast-enhanced computed tomography (CECT) followed by partial nephrectomy for renal tumors suggestive of renal cell carcinoma. RENAL-NS was calculated prior to the surgery, and tumor resection was performed referring to the score. We retrospectively reviewed preoperative CECT images. We calculated the inter-observer variability of RENAL-NS using 3D-RVI versus two-dimensional (2D) imaging and compared the ability of RENAL-NS using 3D-RVI versus 2D imaging to predict the risk of opening of the urinary collecting system. We also compared the two modalities for the time required to evaluate RENAL-NS. RESULTS RENAL-NS evaluated using 3D-RVI showed a higher inter-observer agreement compared to 2D-imaging (rs = 0.85 vs. rs = 0.65). The "nearness to sinus" score was more strongly associated with the opening of the urinary collecting system when evaluated using 3D-RVI than 2D-imaging (AUC = 0.71 vs AUC = 0.57, p = 0.016). RENAL-NS using 2D-imaging required a significantly longer time compared to 3D-RVI (p = 0.036). CONCLUSIONS Using 3D-RVI improves the accuracy, reliability and efficiency of RENAL-NS evaluation in preoperative assessment and can play an important role in preoperative assessment and intraoperative navigation.
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Affiliation(s)
- Kasumi Kaneko Yoshitomi
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Tatsuya Yamamoto
- Department of Diagnostic Radiology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Eri Fukagawa
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kosuke Hamada
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yusuke Yoneoka
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Rao BVSN, Walton J, Fujiwara M. A mathematical model to investigate the effects of fishing zone configurations and mass dependent rates on biomass yield: Application to brown shrimp in Gulf of Mexico. Ecol Modell 2022. [DOI: 10.1016/j.ecolmodel.2021.109781] [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: 11/03/2022]
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31
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Yoshitomi KK, Numao N, Umino Y, Fujiwara M, Fujiwara R, Oguchi T, Komai Y, Yuasa T, Yamamoto S, Yonese J. The utility of diffusion-weighted whole-body imaging with background body signal suppression in detecting metastatic lesion of germ cell carcinoma. IJU Case Rep 2021; 4:285-288. [PMID: 34497984 PMCID: PMC8413202 DOI: 10.1002/iju5.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Although the utility of diffusion-weighted whole-body imaging with background body signal suppression for assessing lymph node involvement or distant metastasis is renowned in many cancers, only few studies have revealed its utility for germ cell carcinoma. Some metastatic lesions of germ cell carcinomas are difficult to detect by conventional imaging. CASE PRESENTATION We report a case of a 70-year-old man with relapsed retroperitoneal germ cell tumor. Although his human chorionic gonadotropin levels increased, conventional imaging analysis showed no evidence of recurrence. Diffusion-weighted whole-body imaging with background body signal suppression was performed to search the metastatic lesion and detected metastatic sacral lesions. The patient responded well to local radiotherapy added to the steroid pulse and salvage chemotherapy and achieved long-term recurrence-free survival. CONCLUSION Diffusion-weighted whole-body imaging with background body signal suppression has the potential to detect metastatic lesions not usually detected by conventional imaging methods.
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Affiliation(s)
- Kasumi Kaneko Yoshitomi
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Noboru Numao
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yosuke Umino
- Department of UrologyShowa General HospitalTokyoJapan
| | - Motohiro Fujiwara
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Ryo Fujiwara
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Tomohiko Oguchi
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yoshinobu Komai
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Yuasa
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Shinya Yamamoto
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Junji Yonese
- Department of UrologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
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Kobayashi M, Ishioka J, Matsuoka Y, Fukuda Y, Kohno Y, Kawano K, Morimoto S, Muta R, Fujiwara M, Kawamura N, Okuno T, Yoshida S, Yokoyama M, Suda R, Saiki R, Suzuki K, Kumazawa I, Fujii Y. Computer-aided diagnosis with a convolutional neural network algorithm for automated detection of urinary tract stones on plain X-ray. BMC Urol 2021; 21:102. [PMID: 34353306 PMCID: PMC8340490 DOI: 10.1186/s12894-021-00874-9] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent increased use of medical images induces further burden of their interpretation for physicians. A plain X-ray is a low-cost examination that has low-dose radiation exposure and high availability, although diagnosing urolithiasis using this method is not always easy. Since the advent of a convolutional neural network via deep learning in the 2000s, computer-aided diagnosis (CAD) has had a great impact on automatic image analysis in the urological field. The objective of our study was to develop a CAD system with deep learning architecture to detect urinary tract stones on a plain X-ray and to evaluate the model's accuracy. METHODS We collected plain X-ray images of 1017 patients with a radio-opaque upper urinary tract stone. X-ray images (n = 827 and 190) were used as the training and test data, respectively. We used a 17-layer Residual Network as a convolutional neural network architecture for patch-wise training. The training data were repeatedly used until the best model accuracy was achieved within 300 runs. The F score, which is a harmonic mean of the sensitivity and positive predictive value (PPV) and represents the balance of the accuracy, was measured to evaluate the model's accuracy. RESULTS Using deep learning, we developed a CAD model that needed 110 ms to provide an answer for each X-ray image. The best F score was 0.752, and the sensitivity and PPV were 0.872 and 0.662, respectively. When limited to a proximal ureter stone, the sensitivity and PPV were 0.925 and 0.876, respectively, and they were the lowest at mid-ureter. CONCLUSION CAD of a plain X-ray may be a promising method to detect radio-opaque urinary tract stones with satisfactory sensitivity although the PPV could still be improved. The CAD model detects urinary tract stones quickly and automatically and has the potential to become a helpful screening modality especially for primary care physicians for diagnosing urolithiasis. Further study using a higher volume of data would improve the diagnostic performance of CAD models to detect urinary tract stones on a plain X-ray.
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Affiliation(s)
- Masaki Kobayashi
- Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Junichiro Ishioka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yuichi Fukuda
- Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Yusuke Kohno
- Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Keizo Kawano
- Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Shinji Morimoto
- Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Rie Muta
- Department of Urology, JA Toride Medical Center, Toride, Japan
| | | | - Naoko Kawamura
- Department of Urology, JA Toride Medical Center, Toride, Japan
| | - Tetsuo Okuno
- Department of Urology, JA Toride Medical Center, Toride, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Rumi Suda
- Department of Information and Communications Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Ryota Saiki
- Department of Information and Communications Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Kenji Suzuki
- Laboratory for Future, Interdisciplinary Research of Science and Technology, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
| | - Itsuo Kumazawa
- Laboratory for Future, Interdisciplinary Research of Science and Technology, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Fukagawa E, Yamamoto S, Ohde S, Yoshitomi KK, Hamada K, Yoneoka Y, Fujiwara M, Fujiwara R, Oguchi T, Komai Y, Numao N, Yuasa T, Fukui I, Yonese J. External validation of the Briganti 2019 nomogram to identify candidates for extended pelvic lymph node dissection among patients with high-risk clinically localized prostate cancer. Int J Clin Oncol 2021; 26:1736-1744. [PMID: 34117947 PMCID: PMC8364898 DOI: 10.1007/s10147-021-01954-4] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/27/2021] [Indexed: 01/14/2023]
Abstract
Background We aimed to establish an external validation of the Briganti 2019 nomogram in a Japanese cohort to preoperatively evaluate the probability of lymph node invasion in patients with high-risk, clinically localized prostate cancer. Methods The cohort consisted of 278 patients with prostate cancer diagnosed using magnetic resonance imaging-targeted biopsy who underwent radical prostatectomy and extended pelvic lymph node dissection from 2012 to 2020. Patients were rated using the Briganti 2019 nomogram, which evaluates the probability of lymph node invasion. We used the area under curve of the receiver operating characteristic analysis to quantify the accuracy of the nomogram. Results Nineteen (6.8%) patients had lymph node invasion. The median number of lymph nodes removed was 18. The area under the curve for the Briganti 2019 was 0.71. When the cutoff was set at 7%, 84 (30.2%) patients with extended pelvic lymph node dissection could be omitted, and only 1 (1.2%) patient with lymph node invasion would be missed. Sensitivity, specificity, and negative predictive values at the 7% cutoff were 94.7, 32.0, and 98.8%, respectively. Conclusion This external validation showed that the Briganti 2019 nomogram was accurate, although there may still be scope for individual adjustments.
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Affiliation(s)
- Eri Fukagawa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Sachiko Ohde
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Kasumi Kaneko Yoshitomi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kosuke Hamada
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yusuke Yoneoka
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Fujiwara M, Yuasa T, Yasuoka S, Komai Y, Oguchi T, Fujiwara R, Numao N, Yamamoto S, Yonese J. Serum and hematologic responses after three cycles of cabazitaxel therapy as predictors of survival in castration-resistant prostate cancer. Cancer Chemother Pharmacol 2021; 88:525-531. [PMID: 34110449 DOI: 10.1007/s00280-021-04304-3] [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: 11/29/2020] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In this study, we investigated the association between the early response of serum and hematological variables and the outcome of cabazitaxel therapy. PATIENTS AND METHODS The medical records of 59 consecutive patients who had previously received docetaxel chemotherapy for the treatment of metastatic castration-resistant prostate cancer (CRPC) and who received cabazitaxel at our hospital between January 2011 and March 2020 were retrospectively reviewed and statistically analyzed. RESULTS The median follow-up period after cabazitaxel initiation was 15.2 months. The 30% prostate-specific antigen (PSA) response rate, median PSA progression-free survival period, and overall survival (OS) period were 45.8%, 4.3 months, and 22.6 months, respectively. Within 1 to 2 cycles of cabazitaxel, we were unable to identify hematological or serum kinetics that had a relationship with OS. Analysis of the variables after 3 cycles of cabazitaxel, however, revealed two factors, PSA decline > 30% (p = 0.016) and neutrophil-lymphocyte ratio (NLR) decline > 30% (p = 0.044), as the predictors of favorable outcome for OS. We established a prognostic model for predicting the OS period composed of these two factors, which exhibited distinctly separated OS curves (p = 0.004). The C-index of a model incorporating these two factors was 0.703. CONCLUSIONS This is the first study to demonstrate that PSA and NLR decline 3 cycles after the initiation of cabazitaxel were associated with favorable outcome in patients with CRPC. Also, 3 cycles of cabazitaxel might be necessary to assess the efficacy of cabazitaxel therapy.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shotaro Yasuoka
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Fujiwara M, Tanaka H, Yuasa T, Komai Y, Oguchi T, Fujiwara R, Numao N, Yamamoto S, Fujii Y, Fukui I, Yonese J. First-line combination chemotherapy with etoposide, ifosfamide and cisplatin for the treatment of disseminated germ cell cancer: Efficacy and feasibility in current clinical practice. Int J Urol 2021; 28:920-926. [PMID: 34028113 DOI: 10.1111/iju.14604] [Citation(s) in RCA: 4] [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: 02/23/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety profiles of first-line etoposide, ifosfamide and cisplatin and primary prophylaxis with pegfilgrastim as first-line chemotherapy for disseminated germ cell cancer. METHODS This study reviewed 154 consecutive patients with previously untreated disseminated germ cell cancer who received first-line etoposide, ifosfamide and cisplatin between 1995 and 2020. Of these, 54 patients were managed with primary prophylaxis using pegfilgrastim (primary prophylaxis group), and 100 were managed with the therapeutic use of short-acting granulocyte colony-stimulating factor (non-primary prophylaxis group). RESULTS The International Germ Cell Cancer Collaborative Group classification identified 90 (58%)/40 (26%)/24 (16%) patients with good/intermediate/poor prognosis, respectively. Overall, 139 patients (90%) were disease free after etoposide, ifosfamide and cisplatin with/without post-chemotherapy surgery. The median relative dose intensity of etoposide, ifosfamide and cisplatin was 96%, and there was a significant difference between the primary prophylaxis and non-primary prophylaxis groups (100% vs 90%, P < 0.01). The 5-year salvage treatment-free and overall survival rates were 83% and 94%, respectively. In total, 138 patients (90%) developed grade 4 hematological toxicities, and there were no treatment-related deaths due to myelosuppression. Grade 4 neutropenia was less commonly observed in the primary prophylaxis group compared with the non-primary prophylaxis group (80% vs 95%, P < 0.01). CONCLUSIONS This is the largest study of first-line etoposide, ifosfamide and cisplatin, and its sufficient efficacy and safety profiles are confirmed in current clinical practice. Primary prophylaxis using pegfilgrastim might further improve the feasibility of etoposide, ifosfamide and cisplatin.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Fujiwara M, Yuasa T, Urasaki T, Komai Y, Fujiwara R, Numao N, Yamamoto S, Yonese J. Effectiveness and safety profile of pembrolizumab for metastatic urothelial cancer: A retrospective single-center analysis in Japan. Cancer Rep (Hoboken) 2021; 4:e1398. [PMID: 33934570 PMCID: PMC8714548 DOI: 10.1002/cnr2.1398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 01/07/2021] [Revised: 03/03/2021] [Accepted: 03/25/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The paradigm of medical treatment for metastatic urothelial carcinoma is dramatically changing through the introduction of pembrolizumab. AIM We investigated the treatment effectiveness, the safety profile, and the prognostic factors of pembrolizumab in Japanese real-world clinical practice. METHODS AND RESULTS The medical records of 74 consecutive Japanese patients with metastatic urothelial cancer (UC), who started pembrolizumab as a second- or later-line treatment at our institution between January 2018 and March 2020, were reviewed and statistically analyzed. The median follow-up period after initiation of pembrolizumab was 8.5 (interquartile range: 3.5-15.7) months. The objective response rate was 30.2%, the median progression-free survival period was 4.9 months, and the median overall survival (OS) period was 13.3 months. Evaluation revealed that 39 (52.9%) patients experienced adverse events (AEs), among whom eight patients (10.9%) had severe AEs (grade 3 or more), including grade 5 hemophagocytic syndrome. Multivariate analysis indicated that the presence of liver metastasis, worse performance status (≥2), elevated serum lactate dehydrogenase, and increased C-reactive protein were predictive of shorter OS. CONCLUSION We studied the effectiveness and safety profile of pembrolizumab therapy in Japanese UC patients. We believe that the data presented here will be useful for clinical physicians.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetsuya Urasaki
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Yasuoka S, Yuasa T, Fujiwara M, Fujisaki J, Inamura K, Komai Y, Numao N, Yamamoto S, Yonese J. Unusual metastasis from renal cell cancer after partial nephrectomy and sequential targeted therapy. IJU Case Rep 2021; 4:136-138. [PMID: 33977239 PMCID: PMC8088885 DOI: 10.1002/iju5.12261] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/26/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Metastatic renal cell carcinoma is treated with various regimens. As their outcomes are improving and follow-up periods are growing longer, the rate of unusual visceral metastases may increase. CASE PRESENTATION A 68-year-old man diagnosed with lung, pancreatic, and renal metastases 9 years after left partial nephrectomy and a diagnosis of pT1a clear cell renal cell carcinoma started molecular targeted therapy using sunitinib. Nine years after the initiation of targeted therapy, a mass lesion in the esophagus was revealed by follow-up computed tomography, and endoscopic mucosal resection of the esophageal metastatic lesion was performed. One year later, a bladder tumor was detected by follow-up computed tomography. The patient underwent transurethral resection of the bladder tumor. Histological evaluation of both resected specimens disclosed clear cell renal cell carcinoma. CONCLUSION We present a valuable case of metachronous esophagus and bladder metastases from renal cell carcinoma in a long-term follow-up.
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Affiliation(s)
- Shotaro Yasuoka
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Yuasa
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Motohiro Fujiwara
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Junko Fujisaki
- Department ofGastroenterological MedicineCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Kentaro Inamura
- Department ofPathologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Yoshinobu Komai
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Noboru Numao
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Shinya Yamamoto
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Junji Yonese
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
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Urasaki T, Ono M, Mochizuki T, Takeda K, Nishizawa A, Fukagawa E, Fujiwara M, Komai Y, Kitano S, Yuasa T, Yonese J, Takahashi S. Case Report: A Case of Trimethoprim/Sulfamethoxazole-Triggered Hypotensive Shock: Cytokine Release Syndrome Related to Immune Checkpoint Inhibitors and Drug-Induced Hypersensitivity Syndrome. Front Oncol 2021; 11:681997. [PMID: 33996612 PMCID: PMC8121494 DOI: 10.3389/fonc.2021.681997] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 12/19/2022] Open
Abstract
Currently, only a few reports exist on the cytokine release syndrome (CRS) as one of the severe immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICIs). Notably, it is very rare that grade 4 CRS related to ICI therapy overlaps with the drug-induced hypersensitivity syndrome (DiHS). A 46-year old woman with metastatic kidney cancer had grade 3 interstitial pneumonitis induced by four cycles of combination therapy of anti-programmed death-1 and anti-cytotoxic T lymphocyte-4 antibodies after right cytoreductive nephrectomy. Prophylactic administration of trimethoprim/sulfamethoxazole (TMP/SMX) was started concomitantly with prednisolone therapy to treat the interstitial pneumonitis. She developed hypotensive shock when reducing the dosage of prednisolone, and required intubation and ventilation using vasopressors at the intensive care unit. She subsequently exhibited prominent leukocytosis and an increased level of C-reactive protein, suggesting markedly increased cytokine levels. Interestingly, facial edema and erythema increased in association with pyrexia, leukocytosis, liver dysfunction, and renal failure, suggesting that she developed DiHS. She received hemodialysis three times, a plasma exchange, and anti-interleukin-6 therapy to treat severe renal dysfunction, a thrombotic thrombocytopenic purpura-suspected condition, and possible grade 4 CRS, respectively. Although these therapies did not elicit sufficient effects, high-dose administration of intravenous immunoglobulin was successful. With steroid mini-pulse therapy and the subsequent administration of prednisolone, she recovered successfully. To the best of our knowledge, this is the first report that ICIs and TMP/SMX can induce hypotensive shock accompanied with CRS and DiHS during immunosuppressive therapy for an irAE. Importantly, the prophylactic administration of TMP/SMX should be performed cautiously to avoid severe drug reactions such as CRS or DiHS.
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Affiliation(s)
- Tetsuya Urasaki
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Ono
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiaki Mochizuki
- Department of Emergency Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Koichi Takeda
- Department of Infectious Diseases, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Aya Nishizawa
- Department of Dermatology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Eri Fukagawa
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shigehisa Kitano
- Division of Cancer Immunotherapy Development, Advanced Medical Development Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Fujiwara M, Yuasa T, Komai Y, Fujiwara R, Oguchi T, Numao N, Yamamoto S, Yonese J. Switching Patients With Prostate Cancer from GnRH Antagonist to Long-acting LHRH Agonist for Androgen Deprivation: Reducing Hospital Visits During the Coronavirus Pandemic. Cancer Diagn Progn 2021; 1:1-5. [PMID: 35399697 DOI: 10.21873/cdp.10000] [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] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/22/2021] [Indexed: 11/10/2022]
Abstract
Aim To reduce the frequency of the need for hospital visits for patients with prostate cancer (PCa) taking androgen-deprivation therapy during the SARS-CoV-2 (COVID-19) pandemic, we switched them from gonadotropin-releasing hormone (GnRH) antagonist to a long-acting luteinizing hormone-releasing hormone (LH-RH) agonist. Here, we confirmed the efficacy and safety profile of this switching. Patients and Methods We analyzed the medical records of 32 patients with PCa who received ADT and switched from GnRH antagonist to a long-acting LH-RH agonist during the COVID-19 pandemic, evaluating hematological and serological variables, including serum testosterone and prostate-specific antigen. Results Before and after the switching from GnRH antagonist to LH-RH agonist, the median serum testosterone levels were 0.22 and 0.18 ng/ml, respectively, and the median serum prostate-specific antigen levels were 0.18 and 0.11 ng/ml, respectively. No changes in the rates of flare-ups of conditions or adverse events were observed. Conclusion Switching from GnRH antagonist to a long-acting LH-RH agonist appears to be a reasonable option that does not diminish efficacy or exacerbate adverse events.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Fujiwara M, Goh T, Tsugawa S, Nakajima K, Fukaki H, Fujimoto K. Tissue growth constrains root organ outlines into an isometrically scalable shape. Development 2021; 148:148/4/dev196253. [PMID: 33637613 PMCID: PMC7929931 DOI: 10.1242/dev.196253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
Organ morphologies are diverse but also conserved under shared developmental constraints among species. Any geometrical similarities in the shape behind diversity and the underlying developmental constraints remain unclear. Plant root tip outlines commonly exhibit a dome shape, which likely performs physiological functions, despite the diversity in size and cellular organization among distinct root classes and/or species. We carried out morphometric analysis of the primary roots of ten angiosperm species and of the lateral roots (LRs) of Arabidopsis, and found that each root outline was isometrically scaled onto a parameter-free catenary curve, a stable structure adopted for arch bridges. Using the physical model for bridges, we analogized that localized and spatially uniform occurrence of oriented cell division and expansion force the LR primordia (LRP) tip to form a catenary curve. These growth rules for the catenary curve were verified by tissue growth simulation of developing LRP development based on time-lapse imaging. Consistently, LRP outlines of mutants compromised in these rules were found to deviate from catenary curves. Our analyses demonstrate that physics-inspired growth rules constrain plant root tips to form isometrically scalable catenary curves. Highlighted Article: The dome-shaped outlines of plant root tips converge to a parameter-free catenary curve seen in arch bridges, owing to a constraint from anisotropic and localized tissue growth.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka 560-0043, Japan
| | - Tatsuaki Goh
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Takayama, Ikoma 630-0192, Japan
| | - Satoru Tsugawa
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Takayama, Ikoma 630-0192, Japan
| | - Keiji Nakajima
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Takayama, Ikoma 630-0192, Japan
| | - Hidehiro Fukaki
- Department of Biology, Graduate School of Science, Kobe University, Rokkodai, Kobe 657-8501, Japan
| | - Koichi Fujimoto
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka 560-0043, Japan
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Hayashi K, Fukuyasu-Matsuo S, Inoue T, Fujiwara M, Asai Y, Iwata M, Suzuki S. Effects of cyclic stretching exercise on long-lasting hyperalgesia, joint contracture, and muscle injury following cast immobilization in rats. Physiol Res 2020; 69:861-870. [PMID: 32901491 DOI: 10.33549/physiolres.934437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The effects of exercise on mechanical hyperalgesia, joint contracture, and muscle injury resulting from immobilization are not completely understood. This study aimed to investigate the effects of cyclic stretching on these parameters in a rat model of chronic post-cast pain (CPCP). Seventeen 8-week-old Wistar rats were randomly assigned to (1) control group, (2) immobilization (CPCP) group, or (3) immobilization and stretching exercise (CPCP+STR) group. In the CPCP and CPCP+STR groups, both hindlimbs of each rat were immobilized in full plantar flexion with a plaster cast for a 4-week period. In the CPCP+STR group, cyclic stretching exercise was performed 6 days/week for 2 weeks, beginning immediately after cast removal prior to reloading. Although mechanical hyperalgesia in the plantar skin and calf muscle, ankle joint contracture, and gastrocnemius muscle injury were observed in both immobilized groups, these changes were significantly less severe in the CPCP+STR group than in the CPCP group. These results clearly demonstrate the beneficial effect of cyclic stretching exercises on widespread mechanical hyperalgesia, joint contracture, and muscle injury in a rat model of CPCP.
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Affiliation(s)
- K Hayashi
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan, Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Handa, Japan.
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Fujiwara R, Takemura K, Fujiwara M, Yuasa T, Yasuoka S, Komai Y, Numao N, Yamamoto S, Yonese J. Modified Glasgow Prognostic Score as a Predictor of Prognosis in Metastatic Renal Cell Carcinoma Treated With Nivolumab. Clin Genitourin Cancer 2020; 19:e78-e83. [PMID: 33279413 DOI: 10.1016/j.clgc.2020.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/21/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The modified Glasgow prognostic score (mGPS), which incorporates serum albumin and C-reactive protein levels, reflects systemic inflammation and nutritional status. In this study, we evaluate the role of mGPS as a predictor of prognosis in metastatic renal cell carcinoma treated with nivolumab. PATIENTS AND METHODS Forty-five consecutive patients with metastatic renal cell carcinoma receiving nivolumab therapy after tyrosine kinase inhibitor therapy between September 2013 and August 2019 at our institution were retrospectively analyzed. The prognostic factors associated with overall survival were statistically analyzed. RESULTS The median follow-up period was 26.4 months. The median progression-free survival and 1- and 3-year progression-free survival rates were 11.6 months, 48.9%, and 17.1%, respectively. The median overall survival and 1- and 3-year overall survival rates were not reached, 88.7%, and 62.3%, respectively. In multivariate analysis, mGPS at the time of nivolumab administration (P < .0001; hazard ratio [HR], 95.7; P = .0004 [Score 1 vs. 0]; HR, 98.9; P = .0002 [Score 2 vs. 0]; and HR, 1.03; P = .971 [Score 2 vs. 1]) was extracted as the strongest predictor for overall survival followed by duration from diagnosis to treatment (P = .0001), lactate dehydrogenase (P = .0005), and lymphocyte count (P = .021). Overall survival curves were distinctly separated between mGPS Score 0 and mGPS Score 1 + 2, with median overall survival periods being not reached and 32.4 months, respectively (P = .0004). CONCLUSIONS mGPS was the strongest significant prognostic biomarker in patients with metastatic renal cell carcinoma treated with nivolumab. This simple classification could be useful in clinical practice.
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Affiliation(s)
- Ryo Fujiwara
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan.
| | - Kosuke Takemura
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Shotaro Yasuoka
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Noboru Numao
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
| | - Junji Yonese
- Department of Genitourinary Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan
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Fujiwara M, Yuasa T, Komai Y, Numao N, Yamamoto S, Fukui I, Yonese J. Efficacy, Prognostic Factors, and Safety Profile of Enzalutamide for Non-metastatic and Metastatic Castration-Resistant Prostate Cancer: A Retrospective Single-Center Analysis in Japan. Target Oncol 2020; 15:635-643. [PMID: 33037973 DOI: 10.1007/s11523-020-00759-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Enzalutamide is a novel, non-steroidal anti-androgen that has demonstrated excellent anti-tumor activity for both non-metastatic and metastatic castration-resistant prostate cancer (nmCRPC and mCRPC) patients, and that is being rapidly introduced into clinical practice in Japan. OBJECTIVE We retrospectively investigated the treatment efficacy, safety profile, and prognostic factors of enzalutamide over a relatively long observation period in Japanese patients with nmCRPC and mCRPC. PATIENTS AND METHODS The medical records of 184 consecutive Japanese patients with nmCRPC and mCRPC who started enzalutamide treatment in our institution between January 2012 and April 2018 were reviewed. Efficacy and safety profiles were assessed and statistically analyzed. RESULTS Among these 184 patients, 44 (23.9%) nmCRPC patients, 89 (48.4%) docetaxel-naïve mCRPC patients, and 51 docetaxel-pretreated (27.7%) mCRPC patients underwent enzalutamide therapy. The median prostate-specific antigen progression-free survival (PSA-PFS) and overall survival (OS) periods for nmCRPC patients were 39.2 months and not reached; those for docetaxel-naïve mCRPC patients were 16.5 months and 59.8 months; and those for docetaxel-pretreated mCRPC patients were 7.0 months and 30.4 months, respectively. Multivariate analysis identified performance status ≥ 2, PSA > 8.89 ng/mL (median value), hemoglobin < lower limit of normal range, neutrophil to lymphocyte ratio > 3.0, and 4-week PSA decline < 50% as the predictive factors for shorter OS. Our respective prognostic models using these factors successfully demonstrated distinctly separated survival curves (p < 0.001). In addition, among these patients, 30 (16.3%) experienced adverse events and 16 (8.7%) experienced adverse events resulting in the discontinuation of therapy. Fatigue (14%) and appetite loss (7%) were the most common such events. CONCLUSIONS Both the survival period and risk factors were extracted from a relatively long-term observation period. Since enzalutamide was approved for administration to patients with castration-sensitive prostate cancer earlier this year (2020), we believe that the data presented here will be useful for both physicians and patients in clinical practice.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Fujiwara M, Kawamura N, Okuno T. Renal function outcomes in the early and intermediate phases after radical cystectomy by ileal conduit. J Rural Med 2020; 15:178-182. [PMID: 33033538 PMCID: PMC7530600 DOI: 10.2185/jrm.2020-030] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction and Objectives: An ileal conduit (IC) is an established option
for urinary diversion, despite the fact that early renal impairment (RI) sometimes occurs
after surgery. The aim of this study was to investigate the incidence and risk factors of
early RI. Materials and Methods: Thirty-one patients diagnosed with muscle-invasive
bladder cancer who underwent RC with IC were analyzed in this study. Early RI was defined
as a greater than 25% decrease in estimated glomerular filtration rate (eGFR) over the
course of one year after surgery. The incidence and risk factors of early RI were
evaluated. Results: The mean preoperative eGFR of the patients was 69.6 mL/min/1.73
m2. Early RI was observed in 7 (22.5%) patients. Multivariate analyses
demonstrated that postoperative hydronephrosis was an independent risk factor for early RI
(P=0.018). The mean intermediate-term eGFR change was −5.1 mL/min/1.73
m2 in patients with early RI and was greater than that (−2.9) in patients
without early RI, although neither were statistically significantly different. Conclusion: Renal function after RC with IC decreased immediately over the
course of one year, and postoperative hydronephrosis was an independent risk factor for
early RI. Renal function had decreased slightly at intermediate-term follow-up with or
without early RI.
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Affiliation(s)
| | | | - Tetsuo Okuno
- Department of Urology, JA Toride Medical Center, Japan
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Ohta T, Fujiwara M, Hotta T, Ide I, Ishizaki K, Kohri H, Yanai Y, Yosoi M. Monitoring the build-up of hydrogen polarization for polarized hydrogen-deuteride (HD) targets with nuclear magnetic resonance (NMR) at 17 T. Rev Sci Instrum 2020; 91:095104. [PMID: 33003818 DOI: 10.1063/5.0005696] [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] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
We report on the frozen-spin polarized hydrogen-deuteride (HD) targets for photoproduction experiments at SPring-8/LEPS. Pure HD gas with a small amount of ortho-H2 (∼0.1%) and a very small amount of para-D2 (∼0.001%) was liquefied and solidified by liquid helium. The temperature of the produced solid HD was reduced to about 30 mK with a dilution refrigerator. A magnetic field (17 T) was applied to the HD to grow the polarization with the static method. After the aging of the HD at low temperatures in the presence of a high-magnetic field strength for three months, the polarization froze. Almost all ortho-H2 molecules were converted to para-H2 molecules. Most remaining para-D2 molecules were converted to ortho-D2 molecules. The para-H2 and ortho-D2 molecules exhibited weak spin interactions with the HD. If the concentrations of the ortho-H2 and para-D2 were reduced appropriately at the beginning of the aging process, the aging time can be shortened. We have developed a new nuclear magnetic resonance (NMR) system to measure the relaxation times (T1) of the 1H and 2H nuclei with two frequency sweeps at the respective frequencies of 726 MHz and 111 MHz and succeeded in the monitoring of the polarization build-up at decreasing temperatures from 600 mK to 30 mK at 17 T. Automatic NMR measurements with the frequency sweeps enabled us to omit the use of a manual tuning circuit and to remove magnetic field sweeps with eddy current heat. This technique enables us to optimize the concentration of the ortho-H2 and to efficiently polarize the HD target within a shortened aging time.
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Affiliation(s)
- T Ohta
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - M Fujiwara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - I Ide
- Nagoya University, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - K Ishizaki
- Nagoya University, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
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Sano Y, Fujiwara M, Yuasa T, Komai Y, Yamamoto T, Kohno A, Nakao M, Inamura K, Yonese J. Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis. IJU Case Rep 2020; 3:211-214. [PMID: 32914079 PMCID: PMC7469829 DOI: 10.1002/iju5.12191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/11/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Testicular germ cell cancer has a relatively good prognosis even if visceral and/or lymph node metastases are present thanks to chemotherapy. Yet chemotherapy can lead to various adverse events. Therefore, it is crucial to distinguish whether a suspected metastatic disease is metastasis or not. CASE PRESENTATION A 33-year-old male visited our hospital to receive subsequent therapy for suspected recurrent seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy after orchiectomy. The pathological diagnosis of needle aspiration and resected specimen of the several lesions was consistent with epithelioid cell granuloma without caseous necrosis. Based on these findings, the lung and mediastinal lymph node lesions were diagnosed as sarcoidosis. CONCLUSION In cases where the simultaneous occurrence of other benign or malignant diseases is suspected, pathological confirmation is necessary for appropriate decision-making.
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Affiliation(s)
- Yuta Sano
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Motohiro Fujiwara
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Yuasa
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Yoshinobu Komai
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Tatsuya Yamamoto
- Department ofRadiologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Atsushi Kohno
- Department ofRadiologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Masayuki Nakao
- Department ofThoracic Surgical OncologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Kentaro Inamura
- Department ofPathologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Junji Yonese
- Department ofUrologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
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Miura H, Takada M, Fujiwara M, Fujiwara S. Topical imiquimod monotherapy for a recurrent lesion of Merkel cell carcinoma. Br J Dermatol 2020; 184:e30. [PMID: 32845515 DOI: 10.1111/bjd.19402] [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] [Received: 05/26/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- H Miura
- Department of Dermatology, Osaka Minato Central Hospital, Osaka, Japan
| | - M Takada
- Department of Dermatology, Osaka Minato Central Hospital, Osaka, Japan
| | - M Fujiwara
- Department of Dermatology, Osaka Minato Central Hospital, Osaka, Japan
| | - S Fujiwara
- Department of Dermatology, Osaka Minato Central Hospital, Osaka, Japan
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Numao N, Fujiwara R, Uehara S, Yasuoka S, Fujiwara M, Komai Y, Yuasa T, Yamamoto S, Fukui I, Yonese J. Intraoperative Only versus Extended Duration Use of Antimicrobial Prophylaxis for Infectious Complications in Radical Cystectomy with Intestinal Urinary Diversion. Urol Int 2020; 104:954-959. [PMID: 32814326 DOI: 10.1159/000509881] [Citation(s) in RCA: 1] [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: 04/05/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In spite of the high incidence of infectious complications (ICs), appropriate duration of antimicrobial prophylaxis (AMP) for radical cystectomy (RC) with intestinal urinary diversion (IUD) has not been established. We compared the incidence of ICs after RC with IUD in patients using only intraoperative AMP or extended duration AMP. Risk factors for ICs were also investigated. PATIENTS AND METHODS One hundred twenty-three consecutive patients who underwent RC with IUD were divided into 2 groups based on the AMP duration (intraoperative only vs. extended duration for a median of 3 days). Between the groups, the incidence of ICs was compared. Risk factors for ICs were investigated in multivariate analysis. RESULTS The IC rate was 44%. No significant difference was found in the rate of ICs between the groups. The IC rate was significantly higher in patients with lower estimated glomerular filtration rate (eGFR). Rates of ICs were 60 and 38% in patients with eGFR of less than 60 and equal or more than 60 mL/min/1.73 m2, respectively. CONCLUSIONS Our result indicates that AMP that is administered more than intraoperatively may be excessive in RC with IUD. Patients with a lower eGFR should be particularly cared for postoperative ICs.
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Affiliation(s)
- Noboru Numao
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Ryo Fujiwara
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sho Uehara
- Department of Urology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shotaro Yasuoka
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Iwao Fukui
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of Genitourinary Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Fujiwara M, Hayashi T, Takeda H, Yuasa T, Komai Y, Numao N, Yamamoto S, Fukui I, Kouno T, Yonese J. Cisplatin, Gemcitabine, and Paclitaxel as a Salvage Second-Line Therapy for Metastatic Germ-Cell Cancer. Clin Genitourin Cancer 2020; 19:e6-e11. [PMID: 32636079 DOI: 10.1016/j.clgc.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/01/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Second-line salvage therapy for patients with metastatic germ-cell cancer (GCC) after the first-line combination of VIP (etoposide, ifosfamide, cisplatin) therapy has not been established. This study evaluated the efficacy and tolerability of the TGP (paclitaxel, gemcitabine, cisplatin) combination chemotherapy as a second-line salvage therapy. PATIENTS AND METHODS The medical records of 16 consecutive patients with metastatic GCC who had been treated with first-line VIP therapy followed by second-line TGP therapy between 2005 and 2019 were reviewed and statistically analyzed. Ten patients, excluding the 6 patients treated with TGP without unequivocal progression, were included in the efficacy analysis. All 16 patients were included in the safety analysis. RESULTS The median follow-up period from initial TGP administration was 78 months (interquartile range, 46-120 months). The estimated 5-year progression-free and overall survival rates for the 10 patients in the efficacy analysis were 70% and 100%, respectively. Grade 3/4 hematologic toxicity occurred in all 16 patients, but none developed uncontrollable infections or life-threatening bleeding. One patient died of treatment-related secondary leukemia, however. CONCLUSION The present study is to our knowledge the first to examine the therapeutic outcomes and safety profile of second-line TGP chemotherapy. VIP followed by TGP might be an alternative first- and second-line conventional regimen for patients with metastatic GCC in this granulocyte colony-stimulating factor era, especially for patients at a high risk of bleomycin-induced pulmonary toxicity.
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Affiliation(s)
- Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Tatsuro Hayashi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hayato Takeda
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tsutomu Kouno
- Department of Medical Oncology, Sasaki Foundation Kyoundo Hospital, Tokyo, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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50
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Ichinose K, Igawa T, Okamoto M, Takatani A, Yajima N, Sada KE, Yoshimi R, Shimojima Y, Ono S, Kajiyama H, Sato S, Fujiwara M, Kawakami A. FRI0172 THE INFLUENCE OF CALCINEURIN INHIBITORS ON DEVELOPMENT OF CANCER IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A RETROSPECTIVE OBSERVATIONAL STUDY IN THE LUNA REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:It has been reported that the incidence of cancer in patients with systemic lupus erythematosus (SLE) is higher than that in healthy individuals, but the findings are inconsistent1. In the transplantation field, a few studies indicated an association between the use of immunosuppressants and an increased risk of cancer2. Calcineurin inhibitors (CNIs), which include cyclosporine and tacrolimus, have been used for >30 years to treat renal and extrarenal manifestations of SLE, but the effects of exposure to CNIs among SLE patients have not been established.Objectives:We investigated the incidence of various cancers (including cervical dysplasia) among SLE patients registered in the LUpus registry of NAtionwide institution (LUNA). We also investigate whether the registrants’ exposure to CNIs increased the risk of cancer.Methods:We calculated the standardized incidence ratio (SIR) of cancer among SLE patients based on the age-standardized incidence rate of cancer reported by Japan’s Ministry of Health, Labour and Welfare. A multivariate analysis of the risk of cancer was performed using the covariates of age, smoking history, CNI treatment history, maximum steroid dose in the past, and Systemic Lupus International Collaboration Clinics/American College of Rheumatology Damage Index [SDI]) value (excluding the occurrence of cancer) at the time of the patient’s registration.Results:We studied 714 patients (663 females; 88.9%).The median age at registry was 44 [interquartile range (IQR): 35–56] years. The median past max. steroid dose was 40 mg/day (IQR: 30–60 mg/day), and the SDI at registration was 1 (IQR 0–2). Smoking history was present in 248 patients (34.9%), and 53 patients (7.4%) experienced cancer complications. Gynecologic malignancies accounted for 71% of all cancers, including 12 cervical dysplasia cases. The standardized incidence rate of cancer in these SLE patients was 1.46 (95%CI: 1.07–1.85, p<0.01). The multivariate analysis showed that a CNI treatment history was not a risk factor for the development of cancer (OR 1.76, 95%CI: 0.63–4.88, p=0.30). After the covariance was adjusted for the propensity score, the risk of cancer in the CNIs group was not increased compared to the non-CNIs group (adjusted OR 2.46, 95%CI: 0.68–8.91, p=0.20).Conclusion:The incidence of cancer in SLE was higher in the LUNA cohort than in the general population. Our results suggest that CNI treatment for individuals with SLE is not a risk factor for the development of cancer.References:[1]Ladouceur A. et.al, Expert Rev Clin Immunol. 2018 Oct;14(10):793-802.[2]Gutierrez-Dalmau A. et.al, Drugs 2007;67(8):1167-98.Disclosure of Interests:None declared
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