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Nishikawa K, Oguchi H, Hashimoto J, Mikami T, Muramatsu M, Yamaguchi Y, Shishido S, Aoki Y, Itabashi Y, Hamasaki Y, Ohashi Y, Sakai K. Vesicoureteral Reflux Causes Interstitial Inflammation in Pediatric Kidney Allograft: A Clinicopathological Analysis of 1-Year Protocol Biopsies. Nephron Clin Pract 2023; 147 Suppl 1:89-95. [PMID: 37231842 DOI: 10.1159/000530590] [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: 12/21/2022] [Accepted: 02/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION At present, there is limited evidence of the histological impact of vesicoureteral reflux (VUR) on pediatric kidney allografts. In this study, we aimed to investigate the relationship between VUR diagnosed by voiding cystourethrography (VCUG) and 1-year protocol biopsy results. METHODS One hundred thirty-eight pediatric kidney transplantations were performed in Toho University Omori Medical Center between 2009 and 2019. We included 87 pediatric transplant recipients who were evaluated for VUR by VCUG prior to or at the time of the 1-year protocol biopsy and underwent a 1-year protocol biopsy after transplantation. We evaluated the clinicopathological findings of the VUR and non-VUR groups, and histological scores were evaluated using the Banff score. Tamm-Horsfall protein (THP) within the interstitium was identified by light microscopy. RESULTS Of the 87 transplant recipients, 18 cases (20.7%) were diagnosed with VUR by VCUG. The clinical background and findings were not significantly different between the VUR and non-VUR groups. The pathological findings revealed a significantly higher Banff total interstitial inflammation (ti) score in the VUR group than in the non-VUR group. Multivariate analysis indicated a significant relationship between the Banff ti score and THP within the interstitium, and VUR. The 3-year protocol biopsy results (n = 68) revealed a significantly higher Banff interstitial fibrosis (ci) score in the VUR group than in the non-VUR group. CONCLUSION VUR caused interstitial fibrosis in the 1-year pediatric protocol biopsies, and interstitial inflammation at the 1-year protocol biopsy may affect interstitial fibrosis at the 3-year protocol biopsy.
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Affiliation(s)
- Kenta Nishikawa
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
- Department of Nephrology, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Hideyo Oguchi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Junya Hashimoto
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tetuo Mikami
- Department of Pathology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Masaki Muramatsu
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | | | - Seiichiro Shishido
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yujiro Aoki
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yoshihiro Itabashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yuko Hamasaki
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
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Kuroki A, Shimura S, Kikuchi R, Yanagida T, Tsuboi T, Inagaki K, Ohashi Y. MO806: Change in Pth Measuring Method Affects the Cost of Pth-Lowering Treatment. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac082.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
To control mineral and bone disorders in haemodialysis (HD) patients, doses of vitamin D analogues and calcimimetics are adjusted based on serum parathyroid hormone (PTH) levels. Accordingly, method-related differences in PTH results may influence the prescribed dose of those drugs and PTH-lowering treatment costs. The aim of this study was to clarify the influence of inter-method variability in PTH measurement on PTH-lowering treatment costs.
METHOD
We used data from 30 maintenance HD patients in our facility. The Intact-PTH measuring assay was changed from the Elecsys PTH to the Alinity Intact PTH Reagent Kit (Alinity PTH) in March 2021, following a 2-month transitional period when PTH levels were measured using both assays. We examined method-related differences in PTH levels, using the results obtained in the transitional period. Using prescription records from October to December 2020, when the Elecsys PTH assay was used, and those from March to May 2021, when assay system was fully changed to the Alinity PTH, we examined the influence of the PTH measuring method on medication cost by evaluating the monthly cost of vitamin D analogues and calcimimetics in our facility. We evaluated the mean levels of serum calcium, phosphorus and PTH in 30 patients in the corresponding period.
RESULTS
Inter-method variability in PTH results was evaluated using 60 specimens from 30 patients.
PTH results of 60 specimens ranged from 11 to 802 pg/mL and 8.8 to 1198 pg/mL in the Elecsys PTH and in the Alinity PTH, respectively. Compared with PTH levels obtained with the Elecsys PTH, those measured with the Alinity PTH were significantly higher (P < .001). On average, results obtained with the Alinity PTH were 1.58-fold higher than those provided by the Elecsys PTH.
When the Elecsys PTH assay was used, the average monthly cost of vitamin D analogues and calcimimetics was €44 and €1668, respectively. After the assay was changed to the Alinity PTH, the average monthly costs were €40 for vitamin D analogues and €2471 for calcimimetics (€1 = ¥130). There were no notable changes in the mean serum levels of calcium, phosphorus and PTH throughout the study period.
CONCLUSION
Inter-method variability in PTH results would have an influence on the cost-effective assessment of PTH lowering therapy. Standardization of PTH measurement is required.
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Affiliation(s)
- Aki Kuroki
- Kidney Disease Center, Yokohama General Hospital, Yokohama, Japan
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satoru Shimura
- Kidney Disease Center, Yokohama General Hospital, Yokohama, Japan
| | - Rie Kikuchi
- Department of Laboratory Medicine, Yokohama General Hospital, Yokohama, Japan
| | - Toshihiro Yanagida
- Department of Laboratory Medicine, Yokohama General Hospital, Yokohama, Japan
| | - Takahiro Tsuboi
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
- Department of Nephrology, Sakura Medical Center, Toho University, Sakura, Japan
| | - Kazuyuki Inagaki
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
- Department of Nephrology, Sakura Medical Center, Toho University, Sakura, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, Toho University, Sakura, Japan
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Mitsunobu S, Ohashi Y, Makita H, Suzuki Y, Nozaki T, Ohigashi T, Ina T, Takaki Y. One-Year In Situ Incubation of Pyrite at the Deep Seafloor and Its Microbiological and Biogeochemical Characterizations. Appl Environ Microbiol 2021; 87:e0097721. [PMID: 34550782 PMCID: PMC8592575 DOI: 10.1128/aem.00977-21] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/04/2021] [Indexed: 11/20/2022] Open
Abstract
In this study, we performed a year-long in situ incubation experiment on a common ferrous sulfide (Fe-S) mineral, pyrite, at the oxidative deep seafloor in the hydrothermal vent field in the Izu-Bonin arc, Japan, and characterized its microbiological and biogeochemical properties to understand the microbial alteration processes of the pyrite, focusing on Fe(II) oxidation. The microbial community analysis of the incubated pyrite showed that the domain Bacteria heavily dominated over Archaea compared with that of the ambient seawater, and Alphaproteobacteria and Gammaproteobacteria distinctively codominated at the class level. The mineralogical characterization by surface-sensitive Fe X-ray absorption near-edge structure (XANES) analysis revealed that specific Fe(III) hydroxides (schwertmannite and ferrihydrite) were locally formed at the pyrite surface as the pyrite alteration products. Based on the Fe(III) hydroxide species and proportion, we thermodynamically calculated the pH value at the pyrite surface to be pH 4.9 to 5.7, indicating that the acidic condition derived from pyrite alteration was locally formed at the surface against neutral ambient seawater. This acidic microenvironment at the pyrite surface might explain the distinct microbial communities found in our pyrite samples. Also, the acidity at the pyrite surface indicates that the abiotic Fe(II) oxidation rate was much limited at the pyrite surface kinetically, 3.9 × 103- to 1.6 × 105-fold lower than that in the ambient seawater. Moreover, nanoscale characterization of microbial biomolecules using carbon near-edge X-ray absorption fine-structure (NEXAFS) analysis showed that the sessile cells attached to pyrite excreted the acidic polysaccharide-rich extracellular polymeric substances at the pyrite surface, which can lead to the promotion of biogenic Fe(II) oxidation and pyrite alteration. IMPORTANCE Pyrite is one of the most common Fe-S minerals found in submarine hydrothermal environments. Previous studies demonstrated that the Fe-S mineral can be a suitable host for Fe(II)-oxidizing microbes in hydrothermal environments; however, the details of microbial Fe(II) oxidation processes with Fe-S mineral alteration are not well known. The spectroscopic and thermodynamic examination in the present study suggests that a moderately acidic pH condition was locally formed at the pyrite surface during pyrite alteration at the seafloor due to proton releases with Fe(II) and sulfidic S oxidations. Following previous studies, the abiotic Fe(II) oxidation rate significantly decreases with a decrease in pH, but the biotic (microbial) Fe(II) oxidation rate is not sensitive to the pH decrease. Thus, our findings clearly suggest that the pyrite surface is a unique microenvironment where abiotic Fe(II) oxidation is limited and biotic Fe(II) oxidation is more prominent than that in neutral ambient seawater.
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Affiliation(s)
- S. Mitsunobu
- Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Y. Ohashi
- Graduate Division of Nutritional and Environmental Sciences, University of Shizuoka, Shizuoka, Shizuoka, Japan
| | - H. Makita
- Department of Ocean Sciences, Tokyo University of Marine Science and Technology, Tokyo, Tokyo, Japan
- Institute for Extra-cutting-edge Science and Technology Avant-garde Research (X-star), Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
- Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan
| | - Y. Suzuki
- Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan
| | - T. Nozaki
- Research Institute for Marine Resources Utilization, Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
- Frontier Research Center for Energy and Resources, School of Engineering, The University of Tokyo, Tokyo, Tokyo, Japan
- Department of Planetology, Graduate School of Science, Kobe University, Kobe, Hyogo, Japan
- Ocean Resources Research Center for Next Generation, Chiba Institute of Technology, Narashino, Chiba, Japan
| | - T. Ohigashi
- UVSOR Facility, Institute for Molecular Science, Myodaiji, Okazaki, Japan
| | - T. Ina
- SPring-8, Japan Synchrotron Radiation Research Institute (JASRI), Sayo-gun, Hyogo, Japan
| | - Y. Takaki
- Institute for Extra-cutting-edge Science and Technology Avant-garde Research (X-star), Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
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Sai A, Tanaka K, Ohashi Y, Kushiyama A, Tanaka Y, Motonishi S, Sakai K, Hara S, Ozawa T. Quantitative sonographic assessment of quadriceps muscle thickness for fall injury prediction in patients undergoing maintenance hemodialysis: an observational cohort study. BMC Nephrol 2021; 22:191. [PMID: 34022848 PMCID: PMC8140437 DOI: 10.1186/s12882-021-02347-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/02/2020] [Accepted: 04/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be a primary component of fall prevention. This study investigated whether quadriceps muscle thickness measured using ultrasonography can predict fall injury among dialysis patients. Methods Using an observational cohort study design, 180 ambulatory hemodialysis patients were recruited from 2015 to 2016 from four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient’s self-report during the one-year period. Results Among the 180 hemodialysis patients, 44 (24.4%) had fall injuries during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertiles, patients in the lowest tertile were more likely to have a higher incidence of fall injury than those in the higher two tertiles (0.52 vs. 0.19 and 0.17 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor of fall injury (hazard ratio [95% confidence interval], 2.33 [1.22–4.52], P < 0.05). Receiver operating characteristic curves were constructed to determine the optimal cutoffs of quadriceps muscle thickness, thigh circumference, and handgrip strength that best predicted fall injury (quadriceps muscle thickness, 3.37 cm and 3.54 cm in men and women; thigh circumference, 44.6 cm and 37.2 cm in men and women; and handgrip strength, 23.3 kg and 16.5 kg in men and women). Using these cutoff values, the areas under the curve were 0.662 (95% CI, 0.576–0.738), 0.625 (95% CI, 0.545–0.699), and 0.701 (95% CI, 0.617–0.774), for quadriceps muscle thickness, thigh circumference, and handgrip strength, respectively. Quadriceps muscle thickness was a more precise predictor of fall injury than thigh circumference and had similar diagnostic performance as handgrip strength tests in dialysis patients. Conclusions Quadriceps muscle thickness can be measured easily at the bedside using ultrasonography and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02347-5.
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Affiliation(s)
- Asuka Sai
- Kodaira Kitaguchi Clinic, Tokyo, Japan
| | - Kentaro Tanaka
- Higashikurume Ekimae Clinic, Tokyo, Japan.,Department of Nephrology, Sakura Medical Center, Toho University, 564-1, Shimoshizu, Sakura, Chiba, 285-8741, Japan.,The Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, Toho University, 564-1, Shimoshizu, Sakura, Chiba, 285-8741, Japan.
| | - Akifumi Kushiyama
- The Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan.,Department of Pharmacotherapy, Meiji Pharmaceutical University, Tokyo, Japan
| | | | | | - Ken Sakai
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Shigeko Hara
- Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
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5
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Abstract
Background Major symptoms of progressive chronic kidney disease (CKD) are similar to those of hypothyroidism. Hidden symptoms of hypothyroidism underlying CKD are often observed in clinical practice. This study aimed to ascertain the frequency of hypothyroidism complicated by CKD, and to analyze factors impacting thyroid function. Methods During the period from April 2012 through October 2016, 510 CKD patients at our outpatient clinic were measured thyroid and kidney function for diagnosing hypothyroidism (overt hypothyroidism, OH; subclinical hypothyroidism, SH; non-thyroidal illness, NTI) and evaluating the stage of CKD. All patients were over 15 years of age. Results There were significant differences in age, estimated glomerular filtration rate (eGFR), urinary protein (UP), and serum albumin (Alb) among patients with OH, SH, and NTI compared to the normal group in univariate and multivariate analyses. UP showed the highest odds ratio of OH, SH, and NTI but no differences were recognized in gender in each group. Frequency distribution showed that the prevalence of thyroid dysfunction was greater among more severe stage of CKD with higher amount of UP. OH and SH did not show high positive ratio of anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb). NTI and normal subjects showed higher positive ratio as 50.0% and 42.9% of TgAb and TPOAb than OH and SH. Conclusions Hypothyroidism complicated by CKD exhibited a high prevalence. Age, eGFR, UP, and serum Alb were related to the prevalence of hypothyroidism, whereas gender was not and this was contradicted to the prevalence of hypothyroidism in general population. The prevalence of OH and SH was higher among patients with higher stage of CKD with increased UP. Hypothyroidism complicated by CKD may involve different onset mechanisms unrelated to antithyroid antibodies (ATAb). In CKD patients, assessments of OH and SH, as well as NTI, are needed for proper diagnosis.
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Affiliation(s)
- Rena Yuasa
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Akinobu Saito
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Kumiko Tsuboi
- Department of Internal Medicine, Division of Diabetes Metabolism and Endocrinology, Toho University School of Medicine, Tokyo, Japan
| | - Seiichiro Shishido
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
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Tomida N, Muramatsu N, Niiyama M, Ahn JK, Chang WC, Chen JY, Chu ML, Daté S, Gogami T, Goto H, Hamano H, Hashimoto T, He QH, Hicks K, Hiraiwa T, Honda Y, Hotta T, Ikuno H, Inoue Y, Ishikawa T, Jaegle I, Jo JM, Kasamatsu Y, Katsuragawa H, Kido S, Kon Y, Maruyama T, Masumoto S, Matsumura Y, Miyabe M, Mizutani K, Nagahiro H, Nakamura T, Nakano T, Nam T, Ngan TNT, Nozawa Y, Ohashi Y, Ohnishi H, Ohta T, Ozawa K, Rangacharyulu C, Ryu SY, Sada Y, Sasagawa M, Shibukawa T, Shimizu H, Shirai R, Shiraishi K, Strokovsky EA, Sugaya Y, Sumihama M, Suzuki S, Tanaka S, Tokiyasu A, Tsuchikawa Y, Ueda T, Yamazaki H, Yamazaki R, Yanai Y, Yorita T, Yoshida C, Yosoi M. Search for η^{'} Bound Nuclei in the ^{12}C(γ,p) Reaction with Simultaneous Detection of Decay Products. Phys Rev Lett 2020; 124:202501. [PMID: 32501086 DOI: 10.1103/physrevlett.124.202501] [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: 12/12/2019] [Revised: 02/11/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
We measured missing mass spectrum of the ^{12}C(γ,p) reaction for the first time in coincidence with potential decay products from η^{'} bound nuclei. We tagged an (η+p) pair associated with the η^{'}N→ηN process in a nucleus. After applying kinematical selections to reduce backgrounds, no signal events were observed in the bound-state region. An upper limit of the signal cross section in the opening angle cosθ_{lab}^{ηp}<-0.9 was obtained to be 2.2 nb/sr at the 90% confidence level. It is compared with theoretical cross sections, whose normalization ambiguity is suppressed by measuring a quasifree η^{'} production rate. Our results indicate a small branching fraction of the η^{'}N→ηN process and/or a shallow η^{'}-nucleus potential.
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Affiliation(s)
- N Tomida
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Niiyama
- Department of Physics, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J Y Chen
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - M L Chu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S Daté
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - T Gogami
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Goto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Hamano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Hashimoto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Q H He
- Department of Nuclear Science & Engineering, College of Material Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - T Hiraiwa
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - Y Honda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ikuno
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Inoue
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - I Jaegle
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J M Jo
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - Y Kasamatsu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Katsuragawa
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Kido
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Institute for Radiation Sciences, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Maruyama
- College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa 252-8510, Japan
| | - S Masumoto
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - Y Matsumura
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Mizutani
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Nagahiro
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Nara Women's University, Nara 630-8506, Japan
| | - T Nakamura
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Nam
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T N T Ngan
- Nuclear Physics Department, University of Science, Vietnam National University, Ho Chi Minh City 72711, Vietnam
| | - Y Nozawa
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Y Ohashi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ohnishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ohta
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - K Ozawa
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon SK S7N 5E2, Canada
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Sada
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Sasagawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Shibukawa
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - R Shirai
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Shiraishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Laboratory of High Energy Physics, Joint Institute for Nuclear Research, Dubna, Moscow Region 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - S Suzuki
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - S Tanaka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - A Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Tsuchikawa
- J-PARC Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ueda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - H Yamazaki
- Radiation Science Center, High Energy Accelerator Research Organization (KEK), Tokai, Ibaraki 319-1195, Japan
| | - R Yamazaki
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Yorita
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - C Yoshida
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
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Kawamura T, Hamasaki Y, Takahashi Y, Hashimoto J, Kubota M, Muramatu M, Itabashi Y, Hyodo Y, Ohashi Y, Aikawa A, Sakai K, Shishido S. ABO-incompatible pediatric kidney transplantation without antibody removal. Pediatr Nephrol 2020; 35:95-102. [PMID: 31673829 DOI: 10.1007/s00467-019-04376-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/12/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Because of the severe shortage of suitable deceased donors, ABO-incompatible living donor kidney transplantation (ABOi LDKT) is performed even in pediatric recipients in Japan. We performed pediatric ABOi LDKT using rituximab without anti-A/B antibody removal. METHODS Thirteen pediatric recipients (mean age 7.4, range 3.4-15.7, four females) whose baseline anti-A/B IgG titers were ≤ × 64 underwent ABOi LDKT without antibody removal and splenectomy between July 2013 and April 2017 at Toho University. Mycophenolate mofetil (MMF) was initiated on day - 10. Rituximab (100 mg) was administered twice. Basiliximab and triple maintenance immunosuppression (calcineurin inhibitor, MMF, and steroids) were administered. Protocol biopsy was performed at 3 months and 1 year after transplantation. We retrospectively compared the clinical outcomes between these recipients and 37 children (mean age 9.0, range 2.6-18.9, 15 female) who underwent ABO-compatible (ABOc) LDKT during the same period. RESULTS The mean follow-up periods of ABOi and ABOc groups were 31.9 ± 13.5 and 28.8 ± 14.4 months, respectively. In the ABOi group, no clinical acute rejection (AR) was noted and subclinical AR was observed in four patients without evidence of acute antibody-mediated rejection. In the ABOc group, clinical and subclinical AR developed in 3 and 10 patients, respectively. No significant difference was identified for the mean eGFR between the ABOi and ABOc groups (98.3 ± 48.8 vs. 86.9 ± 39.4, P = 0.452 at 3 months; 78.2 ± 21.2 vs. 79.7 ± 21.3, at 1 year, P = 0.830). Death-censored graft survival at follow-up was 100% in the ABOi group and 94.6% in the ABOc group. Patient survival during the follow-up period in both the groups was 100%. Late-onset neutropenia (LON) requiring granulocyte colony-stimulating factor occurred more frequently in the ABOi group than in the ABOc group (4 vs. 0 patients) (P < 0.001). CONCLUSIONS Pre- and post-transplantation antibody removal is not a prerequisite for successful pediatric ABOi LDKT, at least in patients with a low anti-A/B IgG antibody titer. However, LON caused by rituximab should be monitored.
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Affiliation(s)
- Takeshi Kawamura
- Department of Nephrology, Sakura Medical Center, Toho University, 564-1, Shimosizu, Sakura City, Chiba, 285-8741, Japan.
| | - Yuko Hamasaki
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yusuke Takahashi
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Junya Hashimoto
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Mai Kubota
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Masaki Muramatu
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yoshihiro Itabashi
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yoji Hyodo
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, Toho University, 564-1, Shimosizu, Sakura City, Chiba, 285-8741, Japan
| | - Atushi Aikawa
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Seiichiro Shishido
- Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
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Ishikawa H, Tsuji D, Miyagi T, Kawasaki Y, Yamamoto K, Nakao M, Nakagaki S, Hayashi T, Ayuhara H, Harada T, Tamaki S, Maeda A, Ohashi Y, Arakawa Y, Fujita Y, Miyamoto Y, Yano T, Tanaka R, Itou K. Irinotecan and cisplatin therapy-induced neutropenia as a prognostic factor in patients with extensive-disease small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Toyota T, Morimoto T, Iimuro S, Iwata H, Miyauchi K, Inoue T, Nakagawa Y, Daida H, Ozaki Y, Sakuma I, Furukawa Y, Ohashi Y, Matsuzaki M, Nagai R, Kimura T. P832LDL-C levels on statins and cardiovascular event risk in stable coronary artery disease: An observation from the REAL-CAD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0431] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The relation between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and the cardiovascular event risk is still unclear in patients receiving the same doses of statins.
Methods
From the REAL-CAD study comparing high-dose with low-dose pitavastatin therapy in Japanese patients with stable coronary artery disease, 11105 patients without reported non-adherence for the study drug were divided into 3 groups according to the on-treatment LDL-C level at 6-month (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL; N=1016, N=3078, and N=1665 in the pitavastatin 1 mg/day stratum; N=2431, N=2524, and N=391 in the pitavastatin 4 mg/day stratum). Primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission.
Results
In the pitavastatin 1 mg/day stratum, cumulative 4-year incidence of the primary outcome measure was not significantly different across the 3 groups (5.0%, 5.7%, and 5.2%, P=0.51), while in the 4 mg/day stratum, it was significantly higher in the LDL-C ≥100 mg/dL group than in other groups (4.5%, 3.4%, and 9.1%, P<0.001). The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) remained insignificant for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), while it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001). In the on-treatment LDL-C ≥100 mg/dL group in the 4 mg/day stratum, LDL-C increased by 6.3 mg/dL from baseline to 6-month despite dose escalation of pitavastatin from 1 mg/day to 4 mg/day, suggesting the presence of unreported poor adherence in this small subgroup.
Adjusted Effects of On-treatment LDL-C
Conclusions
Very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins. Too much emphasis on the target LDL-C strategy might mislead the clinical practice.
Acknowledgement/Funding
The Comprehensive Support Project for Clinical Research of Lifestyle-Related Disease of the Public Health Research Foundation.
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Affiliation(s)
- T Toyota
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - S Iimuro
- Teikyo University, Teikyo Academic Research Center, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Inoue
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Department of Cardiovascular Medicine, Otsu, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Department of Cardiology, Toyoake, Japan
| | - I Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - Y Ohashi
- Chuo University, Department of Integrated Science and Technology for Sustainable Society, Tokyo, Japan
| | | | - R Nagai
- Jichi Medical University, Shimotsuke, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Sakurai H, Goto Y, Yoh K, Takamochi K, Shukuya T, Hishida T, Tsuboi M, Yoshida K, Ohde Y, Okumura S, Ohashi Y, Kunitoh H. P1.17-04 Multicenter Observational Study of Node-Negative Non-Small Cell Lung Cancer Patients Who Are Excluded from a Clinical Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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11
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Iwata H, Iimuro S, Inoue A, Miyauchi K, Taguchi I, Hiro T, Nakagawa Y, Ozaki Y, Ohashi Y, Daida H, Shimokawa H, Kimura T, Nagai R. P5320Reduction in high-sensitivity C-reactive protein by pitavastatin was associated with improved outcomes in Japanese patients with stable coronary artery disease: results from REAL-CAD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0289] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The effect of statins on lowering high sensitivity C-reactive protein (hs-CRP) as well as low density lipoprotein cholesterol (LDL-C) has been associated with reduced risk for cardiovascular events in patients with elevated hs-CRP. However, it remains unclear whether this statin effect applies to low-risk patients with stable coronary artery disease (CAD). In this pre-specified sub-study within the REAL-CAD trial, we explored the association between achieved LDL-C/hs-CRP levels and cardiovascular events in Japanese patients with stable CAD who were treated with pitavastatin 1 mg or 4 mg/day.
Methods
The REAL-CAD trial randomly allocated 13,054 patients with stable CAD to pitavastatin 1 mg or 4 mg/day. LDL-C and hs-CRP were measured at baseline and at 6 months after randomization. We excluded those patients without 6-month data and those with endpoint events before 6 months (N=1915). The primary endpoint of the study was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization. Outcomes were assessed by landmark analysis beyond 6 months among 4 groups that were configured based on LDL-C (median) and hs-CRP (median) targets: achieving neither target, achieving LDL-C target only, achieving hs-CRP target only, and achieving both targets. Data were adjusted for baseline characteristics including age, gender, diabetes and baseline values of LDL-C and hs-CRP.
Results
Median LDL-C and hs-CRP levels were 88 mg/dL and 0.52 mg/L at baseline and 80 mg/dL and 0.48 mg/L after 6 months, respectively. There was no correlation between the change in LDL-C and hs-CRP levels from baseline to 6 months (correlation coefficient: 0.009, P=0.331). Of the 11,677 patients included in the study, 25.1% (N=2799) achieved both LDL-C and hs-CRP targets, 25.3% (N=2282) met neither target, 24.8% (N=2765) met only the hs-CRP target, and 24.7% (N=2753) met only the LDL-C target. Risk of primary endpoint occurrence was significantly lower in those achieving either or both targets than in those meeting neither target (Figure A). In the subgroup analysis stratified by the randomized dose of pitavastatin, the risk for the primary endpoint was significantly lower in patients achieving both targets in both the 1mg and 4 mg arms, and in patients achieving only hs-CRP target in the 1 mg arm (Figure B, C).
Figure 1
Conclusions
In this subanalysis of the REAL-CAD trial, the hs-CRP lowering effect of pitavastatin was independent from LDL-C lowering. Lower achieved hs-CRP was associated with lower risk for cardiovascular events in Japanese patients with stable CAD.
Acknowledgement/Funding
Public Health Research Foundation, The company manufacturing the study drug (Kowa Pharmaceutical Co Ltd) was one of the entities providing financial s
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Affiliation(s)
- H Iwata
- Juntendo University School of Medicine, Tokyo, Japan
| | - S Iimuro
- Teikyo University, Teikyo Academic Research Center, Tokyo, Japan
| | - A Inoue
- Dokkyo Medical University, Mibu, Japan
| | - K Miyauchi
- Juntendo University School of Medicine, Tokyo, Japan
| | - I Taguchi
- Dokkyo Medical University Koshigya Hospital, Koshigaya City, Japan
| | - T Hiro
- Nihon University, Tokyo, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Otsu, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Toyoake, Japan
| | - Y Ohashi
- Chuo University, Department of Integrated Science and Technology for Sustainable Society, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Tokyo, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - R Nagai
- Jichi Medical University, Shimotsuke, Japan
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YAMAMOTO H, Tsuruya K, Hase H, Nishi S, Yamagata K, Nangaku M, Wada T, Hayashi T, Uemura Y, Ohashi Y, Hirakata H. SUN-291 PREDICTIVE FACTORS OF ESA HYPORESPONSIVENESS IN PRE-DIALYSIS CKD PATIENTS: SECONDARY ANALYSIS OF THE RADIANCE-CKD STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.796] [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] Open
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13
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Armanyous S, Ohashi Y, Lioudis M, Schold JD, Thomas G, Poggio ED, Augustine JJ. Diagnostic Performance of Blood Pressure Measurement Modalities in Living Kidney Donor Candidates. Clin J Am Soc Nephrol 2019; 14:738-746. [PMID: 30948455 PMCID: PMC6500946 DOI: 10.2215/cjn.02780218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 02/28/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Precise BP measurement to exclude hypertension is critical in evaluating potential living kidney donors. Ambulatory BP monitoring is considered the gold standard method for diagnosing hypertension, but it is cumbersome to perform. We sought to determine whether lower BP cutoffs using office and automated BP would reduce the rate of missed hypertension in potential living donors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We measured BP in 578 prospective donors using three modalities: (1) single office BP, (2) office automated BP (average of five consecutive automated readings separated by 1 minute), and (3) ambulatory BP. Daytime ambulatory BP was considered the gold standard for diagnosing hypertension. We assessed both the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) and the American College of Cardiology/American Heart Association (ACC/AHA) definitions of hypertension in the cohort. Empirical thresholds of office BP and automated BP for the detection of ambulatory BP-diagnosed hypertension were derived using Youden index, which maximizes the sum of sensitivity and specificity and gives equal weight to false positive and false negative values. RESULTS Hypertension was diagnosed in 90 (16%) prospective donors by JNC-7 criteria and 198 (34%) prospective donors by ACC/AHA criteria. Masked hypertension was found in 3% of the total cohort by JNC-7 using the combination of office or automated BP, and it was seen in 24% by ACC/AHA guidelines. Using Youden index, cutoffs were derived for both office and automated BP using JNC-7 (<123/82 and <120/78 mm Hg) and ACC/AHA (<119/79 and <116/76 mm Hg) definitions. Using these lower cutoffs, the sensitivity for detecting hypertension improved from 79% to 87% for JNC-7 and from 32% to 87% by ACC/AHA definition, with negative predictive values of 95% and 87%, respectively. Missed (masked) hypertension was reduced to 2% and 4% of the entire cohort by JNC-7and ACC/AHA, respectively. CONCLUSIONS The prevalence of hypertension was higher in living donor candidates using ACC/AHA compared JNC-7 definitions. Lower BP cutoffs in the clinic improved sensitivity and led to a low overall prevalence of missed hypertension in prospective living kidney donors.
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Affiliation(s)
- Sherif Armanyous
- Department of Nephrology and Glickman Urological and Kidney Institute, and
| | - Yasushi Ohashi
- Department of Nephrology and Glickman Urological and Kidney Institute, and
| | - Michael Lioudis
- Department of Nephrology and Glickman Urological and Kidney Institute, and
| | - Jesse D Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - George Thomas
- Department of Nephrology and Glickman Urological and Kidney Institute, and
| | - Emilio D Poggio
- Department of Nephrology and Glickman Urological and Kidney Institute, and
| | - Joshua J Augustine
- Department of Nephrology and Glickman Urological and Kidney Institute, and
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14
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Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Abstract P2-13-02: Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The RESPECT trial compared 1-year trastuzumab monotherapy with trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients. Primary objective of this study was to verify the noninferiority of 1-year trastuzumab monotherapy to trastuzumab plus chemotherapy in terms of disease free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 years was 0.45 months (reported by Sawaki at ASCO2018). This report assesses the patients-reported outcomes and health-related quality of life (HRQoL).
PATIENTS AND METHODS: The study was done at 99 hospitals in Japan. Elderly women (70 to 80 years old) with HER2-positive, stageI-IIIA invasive breast cancer treated by surgery with clear resection margins were randomly assigned to receive either 1-year trastuzumab or 1-year trastuzumab plus standard chemotherapy, stratified by age, hormone-receptor status, pathological lymph node metastasis and institution. Patients completed questionnaires at baseline, 2 months, 1year, and 3 years after protocol treatment started. The primary outcome was global HRQoL assessed using Functional Assessment of Cancer Therapy-General (FACT-G) total score, and secondary outcomes were chemotherapy-induced peripheral neuropathy (CIPN), instrumental activities of daily living (IADL), anxiety, depression, and subjective happiness. We did the analyses by intention to treat, including patients who completed questionnaires at baseline before start of protocol treatment, and 5point or more change is meaningful in FACT-G total score. This study is registered with ClinicalTrials.gov, NCT01104935.
RESULTS: Between Oct 2009 and Oct 2014, 275 patients were enrolled in the study, of whom 9 patients were excluded: 135 assigned to trastuzumab monotherapy and 131 assigned to trastuzumab plus chemotherapy. We detected significant difference between treatment groups for: clinically meaningful HRQoL deterioration rate at 2 months (31% for trastuzumab monotherapy vs 48% for trastuzumab plus chemotherapy; p=0.016) and at 1year (19% vs 38%; p=0.009), clinically meaningful HRQoL improvement rate at 2 months (38% for trastuzumab monotherapy vs 15% for trastuzumab plus chemotherapy; p<0.01) and at 1year (43% vs 25%; p=0.021), severe sensory CIPN rate at 2months (1.9% for trastuzumab monotherapy vs 14.4% for trastuzumab plus chemotherapy; p=0.001), IADL score at 1year (11.97 for trastuzumab monotherapy vs 11.54 for trastuzumab plus chemotherapy; p<0.042), Hospital Anxiety and Depression Scale score at 2months (8.92 for trastuzumab monotherapy vs 10.79 for trastuzumab plus chemotherapy; p<0.003), and subjective happiness score at 1year (12.8 for trastuzumab monotherapy vs 11.8 for trastuzumab plus chemotherapy; p<0.024).
CONCLUSION: Given the small advantage of adjuvant trastuzumab plus chemotherapy compared to trastuzumab monotherapy for elderly HER-2 positive breast cancer women, decisions about treatment should be informed by the risk for adverse health effects associated with chemotherapy.
Citation Format: Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-02.
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Affiliation(s)
- K Kobayashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Taira
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - M Sawaki
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Sagawa
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - S Baba
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Saito
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Kawahara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Hagiwara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Uemura
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Shimozuma
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Ohashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Mukai
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Abstract P1-11-21: Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-11-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The effect of trastuzumab(Tmab) or chemotherapy on cognitive function has not been fully understood, especially in elderly breast cancer patients. The RESPECT trial compared 1-year(yr) Tmab monotherapy with Tmab plus standard chemotherapy as adjuvant therapy in elderly patients with HER2-positive breast cancer. The primary objective was to verify the noninferiority of 1-yr Tmab monotherapy compared to Tmab plus chemotherapy in terms of disease-free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 yrs was 0.45 months (Sawaki at ASCO2018). The goal of this report was to assess the impact of the treatment groups on longitudinal cognitive function.
PATIENTS AND METHODS: The study was performed with patients from 99 hospitals in Japan. Elderly women with HER2-positive, stage I-IIIA invasive breast cancer surgery treated with clear resection margins were randomly assigned to either receive 1-yr Tmab or 1-yr Tmab plus standard chemotherapy. 15 institutions participated in the cognitive sub-study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline and at 1 and 3 yrs after treatment. The primary outcome was the amount of change in the MMSE score from the baseline. A linear mixed-effects model was used for comparisons of change in the MMSE score between groups, controlling for time and baseline score. Secondary outcomes were the proportion of both suspected mild dementia (MMSE≤27) and dementia (MMSE≤23) at each time point.
RESULTS: Between October 2009 and October 2014, 275 patients were enrolled in the RESPECT trial, and 57 patients were enrolled in the cognitive function sub-study with 2 patients subsequently excluded. The 55-patient sub-study comprised 29 patients assigned to the Tmab monotherapy group and 26 patients assigned to the Tmab plus chemotherapy group. Primary analysis revealed that change in the MMSE score was not significantly different between the two groups (difference −0.6 at 1 yr and −0.9 at 3 yrs; p=0.136), whereas the baseline score was the only significant factor that had an effect on the amount of change in the MMSE score (p<0.001). The proportions of suspected mild dementia at baseline, and at 1 yr and 3 yrs were 15.4, 32.0, and 41.7% in the Tmab monotherapy group, and 45.8, 17.6, and 28.6% in the Tmab plus chemotherapy group. The proportions of suspected mild dementia at baseline were significantly higher in the Tmab plus chemotherapy group (p=0.04). The proportions of suspected dementia at baseline, and at 1 yr and 3 yrs were 0%, 0%, and 4.2% in the Tmab monotherapy group, and 4.2%, 0%, and 4.8% in the Tmab plus chemotherapy group. There were no significant differences in the proportions of suspected dementia between the treatment groups at each time point.
CONCLUSION: Postoperative chemotherapy for elderly breast cancer patients was considered to have little effect on the onset of dementia during the follow-up period of 3 yrs. Further long-term observation is necessary to obtain a significant conclusion.
Citation Format: Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-21.
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Affiliation(s)
- M Takahashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - M Sawaki
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Hagiwara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Uemura
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Kawahara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Shimozuma
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Ohashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Saito
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - S Baba
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Kobayashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - H Mukai
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - N Taira
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
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Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Abstract P1-13-09: Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer. UFT is an oral fluoropyrimidine that combines tegafur, a prodrug of 5-fluorouracil, with uracil in a 1:4 molar ratio. One study was the N-SAS-BC01 trial (Watanabe et al, J Clin Oncol 2009), which was conducted in patients with high-risk node-negative breast cancer (n=733). The other was the CUBC trial (Park et al, Br J Cancer 2009), which was performed in patients with node-positive breast cancer (n=377). We reported the pooled analysis of these two randomized control trials using individual patient data (Ohashi et al, Breast Cancer Res Treat 2010). This pooled analysis showed that UFT was non-inferior to CMF in terms of inhibiting recurrence of estrogen receptor (ER)-positive early breast cancer. In addition, an exploratory subgroup analysis showed that UFT may be more effective in ER-positive patients who were 50 years or older. The present study was conducted to investigate the long-term efficacy of UFT or CMF in patients with early breast cancer.
Methods: Long-term follow-up data for disease recurrence and survival were collected. Hazard ratios (HR) were determined using the Cox model stratified by study and adjusted for clinical characteristics, namely age, tumor size, nodal status, histological type, ER, and progesterone receptor (PgR). Survival curves were estimated by the Kaplan-Meier method. Hochberg multiplicity adjustment was applied in the previous pooled analysis, and non-inferiority of UFT versus CMF was shown in terms of relapse-free survival (RFS) in the ER-positive patient group. We investigated the non-inferiority of UFT in the same patient group with updated data. Restricted mean survival time (RMST) was calculated to consider the relative efficacy of UFT. This study is registered with JapicCTI-163321.
Results: In total, 1,057 patients were analyzed (CMF, n=528; UFT n=529). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Table 1 shows the 10-year RFS and overall survival (OS) in all patients and ER-positive patients. The difference in RMST between arms at 20 years in terms of RFS was -2.7 months in all patients and 3.4 months in ER-positive patients. Table 2 shows the HR for RFS according to ER status and age.
UFT (%)CMF (%)UFT to CMF; HR (95% CI)10-year RFSall patients74.477.11.02 (0.81–1.30)ER-positive patients75.075.10.91 (0.66–1.27)10-year OSall patients86.886.90.98 (0.72–1.34)ER-positive patients89.987.90.86 (0.54–1.37)
Age <50 yearsAge ≥50 yearsER negative1.76 (0.95–3.26)0.93 (0.58–1.51)ER positive1.29 (0.74–2.23)0.76 (0.50–1.16)
Conclusion: This study shows that UFT was shown to be non-inferior to CMF in terms of RFS in ER-positive early breast cancer. This result is similar to that of the previous pooled analysis.
Sponsor: Taiho Pharmaceutical Co., LTD
Citation Format: Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-09.
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Affiliation(s)
- K Yonemori
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Ohsumi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Takao
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Tokuda
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ito
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Nakagami
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - M Takahashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Yoshidome
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Nakayama
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Yamaguchi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ohashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - H Inaji
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Watanabe
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
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Shitara K, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Yoshino T. REVERCE: a randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for previously treated metastatic colorectal cancer patients. Ann Oncol 2019; 30:259-265. [PMID: 30508156 DOI: 10.1093/annonc/mdy526] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 12/21/2022] Open
Abstract
BACKGROUND The objective of this randomized phase II trial was to evaluate efficacy and safety of the therapeutic sequence of regorafenib followed by cetuximab, compared with cetuximab followed by regorafenib, as the current standard sequence for metastatic colorectal cancer patients. PATIENTS AND METHODS Patients with KRAS exon 2 wild-type metastatic colorectal cancer after failure of fluoropyrimidine, oxaliplatin, and irinotecan were randomized to receive sequential treatment with regorafenib followed by cetuximab ± irinotecan (R-C arm), or the reverse sequence [cetuximab ± irinotecan followed by regorafenib (C-R arm)]. The primary end point was overall survival (OS). Key secondary end points included progression-free survival (PFS) with initial treatment (PFS1), PFS with second treatment (PFS2), safety, and quality of life. Exploratory end points included serial biomarker analyses, including oncogenic alterations from circulating tumor DNA or multiple serum or plasma proteins. RESULTS One-hundred one patients were randomized and eligible for efficacy analysis. Sequential treatment was successful in 86% patients in both arms. Median OS for R-C and C-R was 17.4 and 11.6 months, respectively (P = 0.0293), with a hazard ratio (HR) of 0.61 for OS [95% confidence interval (CI) 0.39-0.96]. The HR for PFS1 (regorafenib in R-C versus cetuximab in C-R) was 0.97 (95% CI 0.61-1.54), and PFS2 (C in R-C versus R in C-R) was 0.29 (95% CI 0.17-0.50). No unexpected safety signals were observed. The quality of life scores during the entire treatment period was not significantly different between the two arms. Circulating biomarker analyses showed emerging oncogenic alterations in RAS, BRAF, EGFR, HER2, and MET, which were more commonly detected after cetuximab than after regorafenib. CONCLUSIONS The therapeutic sequence of regorafenib followed by cetuximab suggests a longer OS than the current standard sequence.
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Affiliation(s)
- K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo, Japan
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Y Komatsu
- Division of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Y Kobayashi
- Department of Medical Oncology, Kushiro Rosai Hospital, Kushiro, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - H Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - M Asayama
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - K Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Y Kagawa
- Department of Surgery, Kansai Rosa Hospital, Amagasaki, Japan
| | - T Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ando
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Ohashi Y, Walker JC, Zhang F, Prindiville FE, Hanrahan JP, Mendelson R, Corcoran T. Preoperative Gastric Residual Volumes in Fasted Patients Measured by Bedside Ultrasound: A Prospective Observational Study. Anaesth Intensive Care 2018; 46:608-613. [DOI: 10.1177/0310057x1804600612] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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]
Abstract
The purpose of this prospective observational study was to measure gastric volumes in fasted patients using bedside gastric ultrasound. Patients presenting for non-emergency surgery underwent a gastric antrum assessment, using the two-diameter and free-trace methods to determine antral cross-sectional area. Gastric residual volume (GRV) was calculated using a validated formula. Univariate and multivariable analyses were performed to examine any potential relationships between ‘at risk’ GRVs (>100 ml) and patient factors. Two hundred and twenty-two successful scans were performed; of these 110 patients (49.5%) had an empty stomach, nine patients (4.1%) had a GRV >100 ml, and a further six patients (2.7%) had a GRV >1.5 ml/kg. There was no significant relationship between ‘at risk’ GRV and obesity, diabetes mellitus, gastro-oesophageal reflux disease or opioid use, although our study had insufficient power to exclude an influence of one or more of these factors. Our results indicate that despite compliance with fasting guidelines, a small percentage of patients still have GRVs that pose a pulmonary aspiration risk. Anaesthetists should consider this background incidence when choosing anaesthesia techniques for their patients. While future observational studies are required to determine the role of preoperative bedside gastric ultrasound, it is possible that this technique may assist anaesthetists in identifying patients with ‘at risk’ GRVs.
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Affiliation(s)
- Y. Ohashi
- Department of Anaesthesia and Pain Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia
| | - J. C. Walker
- Consultant Anaesthetist, Anaesthetic Department, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - F. Zhang
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - F. E. Prindiville
- Sonographer, Department of Imaging Services, Royal Perth Hospital, Perth, Western Australia
| | - J. P. Hanrahan
- General Practitioner, Queens Park Medical Centre, Perth, Western Australia
| | - R. Mendelson
- Emeritus Consultant Radiologist, Department of Diagnostic and Interventional Radiology, Royal Perth Hospital; Clinical Professor, University of Western Australia; Adjunct Professor, Notre Dame University; Perth, Western Australia
| | - T. Corcoran
- Director of Research, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital; Clinical Professor, School of Medicine and Pharmacology, University of Western Australia; Raine Clinical Research Fellow, Raine Foundation/WA Health Department; Adjunct Clinical Professor, School of Public Health and Preventive Medicine, Monash University Australia; Perth, Western Australia
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19
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Iwata H, Masuda N, Yamamoto Y, Fujisawa T, Toyama T, Taira N, Kashiwaba M, Ohtani S, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Distant disease-free survival (DDFS) according to response category in neoadjuvant endocrine therapy (NET): 6-year analysis in phase III NEOS trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.182] [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: 11/14/2022] Open
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20
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Osawa H, Shinozaki E, Nakamura M, Ohhara Y, Shindo Y, Shiozawa M, Uetake H, Matsumoto H, Ureshino N, Satake H, Kobayashi T, Suto T, Kitano S, Ohashi Y, Uemura K, Yamaguchi K. Phase II study of cetuximab rechallenge in patients with ras wild-type metastatic colorectal cancer: E-rechallenge trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Usui K, Yokoyama T, Kisohara A, Mori Y, Takeda Y, Ishida H, Kusano N, Kishi K, Katsushima U, Kuwako T, Aono H, Shikama Y, Minato K, Matsushima H, Uemura K, Ohashi Y, Kunitoh H. The plasma ctDNA monitoring during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with EGFR mutant non-small cell lung cancer (JP-CLEAR trial). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.046] [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: 11/13/2022] Open
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22
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Tanaka K, Sakai K, Kushiyama A, Hara S, Hattori M, Ohashi Y, Muramatsu M, Kawamura T, Shishido S, Aikawa A. Serum uric acid is an independent predictor of new-onset diabetes after living-donor kidney transplantation. Ren Replace Ther 2018. [DOI: 10.1186/s41100-018-0169-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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23
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Oguchi H, Sakai K, Yamaguchi Y, Mikami T, Nemoto T, Ohashi Y, Kawamura T, Muramatsu M, Itabashi Y, Shinoda K, Hyodo Y, Takahashi Y, Kawaguchi Y, Onishi H, Hamasaki Y, Shibuya K, Shishido S. Interlobular hyaline arteriopathy reflects severe arteriolopathy in renal allografts. Nephrology (Carlton) 2018; 23 Suppl 2:58-62. [PMID: 29968404 DOI: 10.1111/nep.13275] [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] [Accepted: 03/16/2018] [Indexed: 11/30/2022]
Abstract
AIM The present study was performed to examine the clinicopathological significance of hyaline deposits in the smooth muscle of the interlobular artery (interlobular hyaline arteriopathy [IHA]) in renal allografts. METHODS Tissue specimens that included the interlobular artery from biopsies performed from January 2012 to December 2015, as well as specimens from biopsies performed ≥1 year after living kidney transplantation were analyzed. Biopsies of recipients with new-onset diabetes mellitus after transplantation were excluded, as well as those of recipients who had undergone transplantation because of diabetic nephropathy. Arteriolopathy was evaluated using the aah score determined by the Banff 2007 classification. RESULTS In total, 51 specimens with IHA lesions were identified among 381 biopsies obtained from 243 recipients performed ≥1 year after kidney transplantation. Among these 51 biopsies, 18 specimens had a score of aah3, 29 had a score of aah2, and four had a score of aah1. The incidence of IHA lesions was 3.6% at ≥1 to <4 years, 18.5% at ≥4 to <8 years, and 54.1% at ≥8 years. Older kidney grafts exhibited more IHA lesions. Among the biopsy specimens obtained ≥8 years after transplantation, no significant differences in the recipient or donor age, duration after transplantation, or prevalence of hypertension were observed between the IHA and non-IHA groups. The aah scores were significantly higher in the IHA group ≥8 years after transplantation as determined by the mean score test (P < 0.01). CONCLUSION IHA in renal allografts is associated with severe arteriolopathy.
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Affiliation(s)
- Hideyo Oguchi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | | | - Tetuo Mikami
- Department of Pathology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tetsuo Nemoto
- Department of Surgical Pathology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, Toho University, Chiba, Japan
| | - Takeshi Kawamura
- Department of Nephrology, Sakura Medical Center, Toho University, Chiba, Japan
| | - Masaki Muramatsu
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yoshihiro Itabashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Kazunobu Shinoda
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yoji Hyodo
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yusuke Takahashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yuki Kawaguchi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hiroka Onishi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yuko Hamasaki
- Department of Pediatric Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Seiichiro Shishido
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
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24
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Affiliation(s)
- Yasushi Ohashi
- Department of Nephrology; Sakura Medical Center; Toho University; Chiba Japan
| | - Ken Sakai
- Department of Nephrology; School of Medicine; Faculty of Medicine; Toho University; Tokyo Japan
| | - Hiroki Hase
- Division of Nephrology; Toho University Ohashi Medical Center; Tokyo Japan
| | - Nobuhiko Joki
- Division of Nephrology; Toho University Ohashi Medical Center; Tokyo Japan
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25
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Yoshino T, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Shitara K. REVERCE: Randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin, and irinotecan: Quality of life analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.009] [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: 11/13/2022] Open
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26
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Kohri H, Shiu SH, Chang WC, Yanai Y, Ahn DS, Ahn JK, Chen JY, Daté S, Ejiri H, Fujimura H, Fujiwara M, Fukui S, Gohn W, Hicks K, Hosaka A, Hotta T, Hwang SH, Imai K, Ishikawa T, Joo K, Kato Y, Kon Y, Lee HS, Maeda Y, Mibe T, Miyabe M, Morino Y, Muramatsu N, Nakano T, Nakatsugawa Y, Nam SI, Niiyama M, Noumi H, Ohashi Y, Ohta T, Oka M, Parker JD, Rangacharyulu C, Ryu SY, Sawada T, Shimizu H, Strokovsky EA, Sugaya Y, Sumihama M, Tsunemi T, Uchida M, Ungaro M, Wang SY, Yosoi M. Differential Cross Section and Photon-Beam Asymmetry for the γ[over →]p → π^{-}Δ^{++}(1232) Reaction at Forward π^{-} Angles for E_{γ}=1.5-2.95 GeV. Phys Rev Lett 2018; 120:202004. [PMID: 29864366 DOI: 10.1103/physrevlett.120.202004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/11/2018] [Indexed: 06/08/2023]
Abstract
Differential cross sections and photon-beam asymmetries for the γ[over →]p→π^{-}Δ^{++}(1232) reaction have been measured for 0.7<cosθ_{π}^{c.m.}<1 and E_{γ}=1.5-2.95 GeV at SPring-8/LEPS. The first-ever high statistics cross-section data are obtained in this kinematical region, and the asymmetry data for 1.5<E_{γ}(GeV)<2.8 are obtained for the first time. This reaction has a unique feature for studying the production mechanisms of a pure uu[over ¯] quark pair in the final state from the proton. Although there is no distinct peak structure in the cross sections, a non-negligible excess over the theoretical predictions is observed at E_{γ}=1.5-1.8 GeV. The asymmetries are found to be negative in most of the present kinematical regions, suggesting the dominance of π exchange in the t channel. The negative asymmetries at forward meson production angles are different from the asymmetries previously measured for the photoproduction reactions producing a dd[over ¯] or an ss[over ¯] quark pair in the final state. Advanced theoretical models introducing nucleon resonances and additional unnatural-parity exchanges are needed to reproduce the present data.
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Affiliation(s)
- H Kohri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S H Shiu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Department of Physics, National Central University, Taoyuan City 32001, Taiwan
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - D S Ahn
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - J Y Chen
- Light Source Division, National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S Daté
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ejiri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Fujimura
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - M Fujiwara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- National Institutes for Quantum and Radiological Science and Technology, Tokai, Ibaraki 319-1195, Japan
| | - S Fukui
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - W Gohn
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Hosaka
- 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
| | - S H Hwang
- Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Joo
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - Y Kato
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H S Lee
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 34047, Korea
| | - Y Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui 910-8526, Japan
| | - T Mibe
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Morino
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Nakatsugawa
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - S I Nam
- Department of Physics, Pukyong National University (PKNU), Busan 608-737, Republic of Korea
| | - M Niiyama
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Noumi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Ohashi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Ohta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Oka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - J D Parker
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E2, Canada
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Sawada
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Physics Department, University of Michigan, Michigan 48109-1040, USA
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Joint Institute for Nuclear Research, Dubna, Moscow Region 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - T Tsunemi
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Uchida
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Ungaro
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - S Y Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
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Abstract
Two studies were conducted to check the effects of β-blocker eye drops, 2% carteolol (Mikelan®) and 0.5% timolol (Timoptol®), on regeneration of corneal epithelium in rabbit eyes. For the short-term study, epithelial deficiency was artificially induced in the cornea of albino rabbits. One of the β-blocker eye drops or 0.005% benzalkonium chloride was applied in the right eye and physiological saline solution was applied to the left eye four times a day, and wound healing rate was calculated. Two weeks later, images of the surface epithelium were analyzed by scanning electron microscopy and proliferative capacity was studied, using proliferating cell nuclear antigen as a marker. The long-term study was conducted similarly except that the eye drops were applied twice a day and epithelial deficiency was re-induced every two weeks. In the short-term study, epithelial wound healing rate was slowed in β-blocker groups. Significant differences were detected between the Mikelan® and Timoptol® groups, and the benzalkonium and physiological saline groups. The β-blocker groups had severe epithelial cell desquamation, as well as detachment. In the long-term study, the Mikelan® group had significantly delayed wound healing at first induction, the benzalkonium group showed delay up to the third induction and the Timoptol® group up to the fifth induction. These studies indicate that β-blocker eye drops delay corneal epithelial wound healing and supported the concept that corneal epithelial deficiency occurs clinically after the long-term administration of β-blocker eye drops.
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Affiliation(s)
- Y Haruta
- Department of Ophthalmology, National Osaka Minami Hospital, Japan
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Ohashi Y, Joki N, Yamazaki K, Kawamura T, Tai R, Oguchi H, Yuasa R, Sakai K. Changes in the fluid volume balance between intra- and extracellular water in a sample of Japanese adults aged 15–88 yr old: a cross-sectional study. Am J Physiol Renal Physiol 2018; 314:F614-F622. [DOI: 10.1152/ajprenal.00477.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The fluid volume balance between intracellular water (ICW) and extracellular water (ECW) gradually changes with age and various medical conditions. Comprehension of these physiological changes would aid in clinical decision-making related to body fluid assessments. A total of 1,992 individuals (753 men and 1,239 women) aged ≥15 yr included in this study had their body composition measurements performed at training gyms in 2014. We developed a regression formula to assess the association of age with the ratio of ECW to ICW in these subjects. The mean ages of male and female subjects were 51.2 ± 15.2 and 57.4 ± 15.2 yr, and their mean body mass indexes were 23.4 ± 3.3 and 21.1 ± 2.8 kg/m2, respectively. The total fluid volumes of male and female subjects were 39.6 ± 4.9 and 27.7 ± 3.0 liters, whereas the percent body fat mass per kilogram of body weight were 19 and 26%, respectively. The ECW-to-ICW ratio increased with age because of the steeper decrease in the ICW content than in the ECW content, especially after the age of 70 yr. The regression formulas used for calculating the age-adjusted ECW/ICW ratio were as follows: 0.5857 + 7.4334 × 10−6 × (age)2 in men and 0.6062 + 5.5775 × 10−6 × (age)2 in women. In conclusion, the fluid imbalance between ICW and ECW contents is driven by decreased cell volume associated with aging and muscle attenuation. Therefore, our proposed formula may serve as a useful assessment tool for the calculation of body fluid composition.
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Affiliation(s)
- Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, Toho University, Chiba, Japan
| | - Nobuhiko Joki
- Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Keisuke Yamazaki
- Department of Nephrology, Sakura Medical Center, Toho University, Chiba, Japan
| | - Takeshi Kawamura
- Department of Nephrology, Sakura Medical Center, Toho University, Chiba, Japan
| | - Reibin Tai
- School of Medicine, Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Hideyo Oguchi
- School of Medicine, Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Rena Yuasa
- School of Medicine, Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Ken Sakai
- School of Medicine, Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
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Ohashi Y, Sato H, Kaihara S, Kiuchil T. Methodology for the Construction of a Disease Nomenclature and Classification System for Clinical Use. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:The nature and problems of the linguistic representation of clinical data are discussed, using the linguistic theory of Ferdinand de Saussure. Based on the conclusions, a methodology for the construction of a disease nomenclature and a classification system, suitable for use in clinical information systems, is developed using set theory.
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Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Abstract P3-13-03: NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-13-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Whether adjuvant chemotherapy is required for patients (pts) with intermediate-risk endocrine-responsive postmenopausal breast cancer (BC) remains unknown. Sufficient data have not been available about the long-term prognosis of patients with neoadjuvant endocrine therapy (ET). NEOS is a randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant ET with/without adjuvant chemotherapy.
Methods: Postmenopausal BC pts with ER +/HER2 negative, T1c-2, clinically node negative, under 76 years old were enrolled at primary registration. Pts were treated by leterozole (LET) in weeks 24-28 after primary enrollment. Pts experienced progression (PD) during neoadjuvant phase were excluded at randomization and received any systemic therapy driven by investigators before or after surgery. The long-term prognosis was followed in all registered pts including PD pts. Response to neoadjuvant ET was evaluated as complete response (CR), partial response (PR) or stable disease (SD) using calipers, ultrasound and MRI (or CT) at the baseline and end of treatment before surgery. Pts who met eligibility criteria were randomized 1:1 to LET for 4.5-5 years after chemotherapy or LET alone for 4.5-5 years without chemotherapy after surgery. Pts excluded at second registration were treated any systemic therapies driven by investigators. The primary endpoint was disease-free survival (DFS) and secondary endpoints included overall survival (OS), clinical response rate in neoadjuvant phase, pathological response, and breast-conserving surgery rate. The randomization code have been blinded to the investigators.
Results: Between May 2008 and June 2013, 904 patients were enrolled at primary registration from 100 institutions in Japan (median follow-up: 4.0 years) and 24 pts were withdrawn during neoadjuvant phase. The median age was 63 years, T1c:37%, T2:63%, and PgR+:78%. Clinical response rates (CR, PR, SD and PD) were2% (16pts), 48% (421pts), 45% (400pts) and 5% (43pts), respectively and, in each response category, 0% (0/16), 5.5% (23/421), 7.8% (31/400), and 20.9% (9/43) experienced DFS events. DFS in PD pts to neoadjuvant ET were statistically significantly worse than CR, PR, SD pts (p<0.0001, hazard ratio 4.7 (95% CI:2.3-9.5). The prognosis after surgery in 669 randomized pts was good regardless with/without chemotherapy, forty four pts (6.6%) experienced DFS events after surgery. The predictive markers of PD for neoadjuvant ET were yet unclear among evaluated clinical factors.
Conclusion: This is the first report of DFS in the largest neoadjuvant ET trial (NEOS). The DFS of postmenopausal, ER+/HER2-, PBC pts excluding PD pts to neoadjuvant ET is highly good regardless with/without chemotherapy. Neoadjuvant ET with utilization of PD response as a prognostic marker can be considered as a standard treatment option for these patients. Clinical trial information: UMIN000001090.
Citation Format: Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-13-03.
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Affiliation(s)
- H Iwata
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Masuda
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Toyama
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - S Ohtani
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Sakai
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - R Nakamura
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Akabane
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Sasano
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
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Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. Abstract PD5-03: TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd5-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant therapy for locally advanced breast cancer has the potential to improve surgical therapeutic outcomes without sacrificing the survival advantages of adjuvant therapy. However, determining whether ER+ patients (pts) will respond to neoadjuvant (NA) chemotherapy (CT) or hormone therapy (HT) can be difficult. Not all ER+ pts respond to NACT, while response to NAHT can vary across ER+ pts. Thus, the ability to select pts more likely to benefit from NAHT would represent progress in clinical management of breast cancer. NEOS is a randomized phase III study assessinglong-term prognosis of ER+ primary breast cancer with/without adjuvant CT following NAHT (UMIN 000001090, http://www.umin.ac.jp/). We used archived core biopsy tumor samples from the NEOS study to validate the RS result as a predictor of clinical response and its association with successful breast conserving surgery (BCS) in pts treated with 6 months of NAHT.
Methods: NEOS enrolled 904 postmenopausal pts with ER+, HER2-, clinically node negative (cN0) breast cancer to evaluate whether adjuvant CT was necessary for pts who responded to NAHT. In this current study, we enrolled pts with tumors ≥2cm from the NEOS study. Biopsy samples of 333 pts were assessed for the Oncotype DX assay. Response to NAHT was recorded as complete/partial response (CR/PR), or stable/progressive disease (SD/PD).
Primary endpoint of this study was to evaluate clinical response (CR/PR) to NA letrozole between pts with low (<18) and high (≥31) RS result. Secondary endpoints include evaluating the relationships between clinical response and continuous RS results, and other covariates including age, tumor size, grade, Ki67 by IHC, ER and PR single gene scores, and ER and proliferation gene group scores by RT-PCR.
Results: The analysis included 294 pts with median age of 63 yrs, median tumor size of 25mm, and 66% were nuclear grade 1. 156 (53.0%), 83 (28.6%) and 54(18.4%) cases were low, intermediate, and high RS groups by Oncotype DX, respectively. Six (2%), 126 (42.8%), 149 (50.3%), 13 (4.4%) cases experienced CR, PR, SD, PD as clinical response, respectively, similar to that of all NEOS pts. Clinical response rate was 54%, 42% and 22% in low, intermediate, and high RS groups, respectively. The proportion of pts with clinical response was significantly higher in the low RS group vs the high RS group (p<0.001). In univariate analyses, continuous RS was significantly associated with clinical response (p<0.001), along with ER (p=.02), PR (p<0.001), and ER gene group score (p<0.001). Other covariates were not associated with clinical response.
Conclusion: The Oncotype DX RS test in core biopsy samples is validated as a predictive assay for clinical response of NAHT in postmenopausal, ER+/HER2-, cN0, primary early breast cancer pts. Further results on the association of RS results with BCS outcomes following NAHT will be presented. These results when combined with previously published data on RS in NACT studies help guide pts with ER+, HER2- breast cancer with NAHT vs NACT treatment options to maximize clinical response.
Citation Format: Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD5-03.
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Affiliation(s)
- Y Yamamoto
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Iwata
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Masuda
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Toyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - S Ohtani
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Taira
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Sakai
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - R Nakamura
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Akabane
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Sasano
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - K Sakamaki
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - C Chao
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - D McCullough
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Sugiyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
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Yokoyama T, Naka G, Ishida H, Kishi K, Ohashi Y, Kunitoh H. P3.01-055 The Usefulness of Liquid Biopsy for ctDNA in Patients with EGFR-Mutant NSCLC During and After Treatment with EGFR-TKIs. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tanaka S, Kawasaki R, Tanaka-Mizuno S, Iimuro S, Matsunaga S, Moriya T, Ishibashi S, Katayama S, Ohashi Y, Akanuma Y, Sone H, Yamashita H. Severe hypoglycaemia is a major predictor of incident diabetic retinopathy in Japanese patients with type 2 diabetes. Diabetes Metab 2017; 43:424-429. [PMID: 28720342 DOI: 10.1016/j.diabet.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/16/2022]
Abstract
AIM Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR). METHODS In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan. Their history of hypoglycaemia was assessed by standardized self-reported questionnaires. Severe hypoglycaemia was defined as having at least one episode with coma requiring an outpatients visit or hospitalization. Adjusted hazard ratios (HRs) for incidence and progression of DR over 8 years of follow-up were determined. RESULTS Of 1221 patients without DR, 127 (10.4%) had experienced non-severe hypoglycaemia within the previous year, whereas 10 (0.8%) reported severe hypoglycaemia episodes. During the 8-year follow-up involving 8492 person-years, 329 patients developed DR. In 410 patients with prevalent DR, the adjusted HRs for incident DR were 4.35 (95% CI: 1.98-9.56; P<0.01) and, for progression of DR, 2.29 (95% CI: 0.45-11.78; P=0.32) with severe hypoglycaemia. CONCLUSION Having a history of severe hypoglycaemia was one of the strongest predictors of incident DR in patients with T2D, with a fourfold increased risk. Identifying patients with greater risks of DR based on their history of hypoglycaemia may help to personalize risk evaluation in patients with diabetes.
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Affiliation(s)
- S Tanaka
- Department of pharmacoepidemiology, graduate longitudinal school of medicine and public health, Kyoto university, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - R Kawasaki
- Department of public health, Yamagata university graduate school of medical science, 2-2-2 Iida-Nishi, Yamagata, Japan.
| | - S Tanaka-Mizuno
- Division of medical statistics, Shiga university of medical science, Tsukinowa Seta-cho, Ohtsu, Shiga, Japan
| | - S Iimuro
- Teikyo academic research centre, Teikyo university, Kaga, Itabashi-ku, Tokyo, Japan
| | - S Matsunaga
- Department of haematology, endocrinology and metabolism, faculty of medicine, Niigata university, 1-757 Asahi-machi, Chuo-ku, Niigata, Japan
| | - T Moriya
- Health care centre, Kitasato university, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa, Japan
| | - S Ishibashi
- Division of endocrinology and metabolism, school of medicine, Jichi medical university, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - S Katayama
- Kawagoe clinic, Saitama medical university, 21-7 Wakitahonchou, Kawagoe, Saitama, Japan
| | - Y Ohashi
- Department of integrated science and engineering for sustainable society, Chuo university, 1-13-27, Kasuga, Bunkyo-ku, Tokyo, Japan
| | - Y Akanuma
- The institute for adult diseases Asahi life foundation, 1-6-1 Marunouchi Chiyoda-ku, Tokyo, Japan
| | - H Sone
- Department of haematology, endocrinology and metabolism, faculty of medicine, Niigata university, 1-757 Asahi-machi, Chuo-ku, Niigata, Japan
| | - H Yamashita
- Department of ophthalmology and visual sciences, school of medicine, Yamagata university, 2-2-2 Iida-Nishi, Yamagata, Japan
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Watanabe T, Kamata K, Hasan S, Shibusawa S, Kamada M, Yonekura T, Yamada M, Ohashi Y. Design and Implementation of an Antagonistic Exercise Support System Using a Depth Image Sensor. EAI Endorsed Transactions on Pervasive Health and Technology 2017. [DOI: 10.4108/eai.13-7-2017.152887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Itabashi Y, Ohashi Y, Muramatsu M, Kawamura T, Hyodo Y, Hamasaki Y, Shishido S, Sakai K, Maemura T, Morita M, Aikawa A. Association Between the Fertile Period and Live Birth Post-Kidney Transplantation: A Retrospective Single-Center Cohort Study. Transplant Proc 2017; 49:1068-1072. [PMID: 28583529 DOI: 10.1016/j.transproceed.2017.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite restoration of fertility after kidney transplantation, the benefit is limited in female kidney recipients. Our objective is to determine the reasons for this discrepancy. METHODS We evaluated 315 women who underwent kidney transplantation from 1983 to 2015 (a median of age at transplantation [10th-90th percentile] of 32 years [7-55 years]); 230 recipients between the ages of 15 to 49 years old as of March 2016 were observed. RESULTS We experienced 10 abortions and 21 live births from our 23 recipients and 2 abortions and 7 live births in 7 recipients from other transplant center. The live birth rate was 8.9 per 1000 female transplant recipients of childbearing age. Seven recipients received either treatments of artificial insemination or in vitro fertilization. Average age at pregnancy was 33.2 ± 3.2 years old, and the fertile period post-transplantation was longer in recipients with live births than those without live births (14.1 ± 7.1 vs 9.9 ± 7.3 years, P < .05). In 42.9% of recipients with live birth, pregnancy-induced hypertension was observed in the last trimester. The gestational age and the average birth weight were 32.8 ± 5.0 months and 2184 ± 632 g, respectively. During follow-up of 14.5 years, there was one case of graft loss, which is a rate of 2.5 per 1000 female recipients. CONCLUSION Although pregnancy complications are often observed in kidney recipients, graft survival is less influenced by pregnancy. Importantly, kidney disease at childbearing age disrupts pregnancy even after kidney transplantation.
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Affiliation(s)
- Y Itabashi
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Ohashi
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, Chiba, Japan.
| | - M Muramatsu
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - T Kawamura
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Hyodo
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Hamasaki
- Department of Pediatric Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - S Shishido
- Department of Pediatric Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - K Sakai
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - T Maemura
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - M Morita
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - A Aikawa
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
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Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol 2017; 143:1053-1059. [PMID: 28210843 PMCID: PMC5427167 DOI: 10.1007/s00432-017-2349-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. METHODS The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. RESULTS The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79-1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75-1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. CONCLUSION Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. TRIAL REGISTRATION ClinicalTrials.gov: NCT00498225.
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Affiliation(s)
- Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - H Miyakawa
- Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - H Fujii
- Division of Clinical Oncology, Jichi Medical University, Tochigi, Japan
| | - S Nakamori
- Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - T Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Hamamoto
- Keio Cancer Center, Keio University Hospital, Tokyo, Japan
| | - T Ito
- Department of Medicine and Bioreguratory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - S Matsumoto
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - H Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - N Boku
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - S Egawa
- Department of Surgery, Tohoku University, Sendai, Japan
| | - T Hatori
- Department of Surgery and Digestive Diseases Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - K Mizumoto
- Kyushu University Hospital Cancer Center, Fukuoka, Japan
| | - S Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - T Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A Funakoshi
- Division of Pancreatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - J S Chen
- Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - M Tanaka
- Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
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Yamazaki K, Sakai K, Ohashi Y, Nihei H, Itabashi T, Muramatsu M, Kawamura T, Shishido S, Aikawa A. Similar Anemic Control Between Chronic Kidney Diseases in Patients With and Without Transplantation on Entry to Dialysis. Transplant Proc 2017; 49:57-60. [PMID: 28104159 DOI: 10.1016/j.transproceed.2016.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Transplant recipients are supposedly in a more anemic, catabolic, and even inflammatory state at re-entering hemodialysis due to chronic rejection. The goal of this study was to clarify how transplant recipients can re-enter dialysis safely by focusing on control of anemia. METHODS From 2012 to 2014, a total of 29 transplant recipients re-entered hemodialysis because of chronic rejection (ie, the chronic kidney disease with transplant [CKDT] group). At the same time, in 2014, a total of 30 patients with chronic kidney disease without transplantation entered dialysis as the control group (ie, the CKD group). CKDT recipients (mean ± standard deviation age, 41.9 ± 11.8 years; 18 male subjects, 10 female subjects; frequency of diabetes, 10%; duration of graft survival, 12.5 ± 4.3 years) were younger and fewer had diabetes compared with the CKD group (age, 53.2 ± 10.5 years; 21 male subjects, 9 female subjects; frequency of diabetes, 36%). Patient characteristics at entering dialysis in both groups were analyzed according to retrospective chart review. RESULTS At entering dialysis, there were no significant differences between the CKD and CKDT groups in terms of the following: dose of darbepoetin; concentrations of hemoglobin, albumin, and C-reactive protein; cardiothoracic ratio; blood urea nitrogen and creatinine levels; estimated glomerular filtration rate; initial ultrafiltration; and duration of hospitalization for initiation of dialysis. The only difference between groups was mean weight at entry to dialysis (CKDT group, 58.5 ± 15.1 kg; CKD group, 67.1 ± 14.8 kg; P = .03). The darbepoetin dose per kilogram of weight did not differ between groups (CKDT, 2.28 ± 2.03 μg/kg; CKD, 2.12 ± 1.6 μg/kg; P = .95) in the final month before entry to dialysis. CONCLUSIONS Safe re-initiation of dialysis is important for recipient survival. Although anemia is supposedly higher in transplant recipients due to immunosuppression, this single-center analysis found no difference in anemia in CKD with or without transplantation, caused by good use of erythropoietin-stimulating agents in both groups.
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Affiliation(s)
- K Yamazaki
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - K Sakai
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
| | - Y Ohashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - H Nihei
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - T Itabashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - M Muramatsu
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - T Kawamura
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - S Shishido
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - A Aikawa
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
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Nakashima T, Ohashi Y, Oki S, Saito R, Koido K, Ogawa C, Sato N, Seto K, Negishi Y, Kondo N, Kikuchi M, Yokoyama A, Ueno H, Koinuma M, Yachi Y, Terakado H. 349P A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem cell transplantation and rituximab-based chemotherapy. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00507-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: 11/16/2022] Open
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Ohashi Y, Okamura M, Fang S, Tsutsui S, Tamaki N, Akatsuka A, Yoshimatsu K, Shiina I, Yamori T, Dan S. M-COPA, a new Golgi disruptor, inhibited growth of RTK-addicted human cancer cells. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33051-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nakashima T, Ohashi Y, Oki S, Saito R, Koido K, Ogawa C, Sato N, Seto K, Negishi Y, Kondo N, Kikuchi M, Yokoyama A, Ueno H, Koinuma M, Yachi Y, Terakado H. 349P A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem cell transplantation and rituximab-based chemotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw586.018] [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: 11/12/2022] Open
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Kiuchi A, Ohashi Y, Tai R, Aoki T, Mizuiri S, Ogura T, Aikawa A, Sakai K. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study. Nutrients 2016; 8:E662. [PMID: 27782097 PMCID: PMC5084048 DOI: 10.3390/nu8100662] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/07/2016] [Accepted: 10/14/2016] [Indexed: 12/14/2022] Open
Abstract
Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = -0.33, p < 0.001) and those with lower glomerular filtration rate (r = 0.47, p < 0.001). The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61-15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.
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Affiliation(s)
- Aki Kiuchi
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan.
| | - Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, 564-1, Shimoshizu, Sakura, Chiba 285-8741, Japan.
| | - Reibin Tai
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan.
| | - Toshiyuki Aoki
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan.
| | - Sonoo Mizuiri
- Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan.
| | - Toyoko Ogura
- Department of Nutrition, Omori Medical Center, Toho University, Tokyo 143-8541, Japan.
| | - Atsushi Aikawa
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan.
| | - Ken Sakai
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan.
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Takii Y, Miyauchi H, Sadahiro S, Shinozaki K, Fukumoto K, Otsuji T, Kambara T, Morita S, Ando Y, Arai M, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. A nomogram for predicting overall survival (OS) in Japanese patients (pts) with advanced colorectal cancer (aCRC) treated with irinotecan (IRI)-based regimens. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Doihara H, Akabane H, Kashiwaba M, Watanabe T, Ohashi Y, Mukai H. Long-term health status as measured by EQ-5D among patients with metastatic breast cancer: comparison of first-line oral S-1 and taxane therapies in the randomized phase III SELECT BC trial. Qual Life Res 2016; 26:445-453. [PMID: 27517267 PMCID: PMC5288429 DOI: 10.1007/s11136-016-1388-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/29/2022]
Abstract
Purpose The goal of chemotherapy for metastatic breast cancer (MBC) is to prolong survival and maintain health-related quality of life. This study aimed to evaluate long-term health status of patients with MBC who participated in the phase III randomized SELECT BC trial. Methods In the SELECT BC trial, patients were randomly allocated to the S-1 or taxane (paclitaxel or docetaxel) arm. Health status was assessed by EQ-5D at pre-treatment, 3 and 6 months after randomization, and every 6 months thereafter to the extent possible. Least square mean scores were assessed to compare EQ-5D index values between groups. Time to deterioration analysis was also performed by defining the minimally important difference of EQ-5D as 0.05 or 0.1. Results The number of patients for EQ-5D analysis was 175 and 208 in the taxane and S-1 arms, respectively. Least square mean EQ-5D index values up to 60 months were 0.741 (95 % CI [0.713–0.769]) in the taxane arm and 0.748 [0.722–0.775] in the S-1 arm. The EQ-5D index value during PFS up to 12 months in the S-1 was superior to the corresponding index value in the taxane (0.812 [0.789–0.834] vs. 0.772 [0.751–0.792], P = 0.009). Time to deterioration analysis also revealed that S-1 significantly delayed the deterioration of EQ-5D index value during the period before progression (P = 0.002 and 0.003). Conclusions Our findings suggest that the EQ-5D index value was higher in patients treated with S-1 during first-line chemotherapy. Considering non-inferiority of S-1 in terms of OS, obtained quality-adjusted life years may be greater in the S-1 arm.
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Affiliation(s)
- T Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - T Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - K Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - M Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - H Doihara
- Breast and Endocrine Surgery Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - H Akabane
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 24-111 Ichijo dori, Asahikawa, Hokkaido, 078 8211, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - T Watanabe
- Department of Breast Surgery, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - H Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Shinkoda Y, Shirahata A, Fukutake K, Takamatsu J, Shima M, Hanabusa H, Mugishima H, Takedani H, Kawasugi K, Taki M, Matsushita T, Tawa A, Nogami K, Higasa S, Kosaka Y, Fujii T, Sakai M, Migita M, Uchiba M, Kawakami K, Sameshima K, Ohashi Y, Saito H. A phase III clinical trial of a mixture agent of plasma-derived factor VIIa and factor X (MC710) in haemophilia patients with inhibitors. Haemophilia 2016; 23:59-66. [DOI: 10.1111/hae.13050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Y. Shinkoda
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - A. Shirahata
- Kitakyushu Yahata Higashi Hospital; Kitakyushu Fukuoka Japan
| | - K. Fukutake
- Department of Laboratory Medicine; Tokyo Medical University; Tokyo Japan
| | - J. Takamatsu
- Japanese Red Cross Tokai-Hokuriku Block Blood Center; Seto Aichi Japan
| | - M. Shima
- Department of Paediatrics; Nara Medical University; Kashihara Nara Japan
| | - H. Hanabusa
- Department of Haematology; Ogikubo Hospital; Tokyo Japan
| | - H. Mugishima
- Department of Paediatrics; Nihon University Itabashi Hospital; Tokyo Japan
| | - H. Takedani
- Department of Joint Surgery; Research Hospital of the Institute of Medical Science; the University of Tokyo; Tokyo Japan
| | - K. Kawasugi
- Department of Internal Medicine; Teikyo University Hospital; Tokyo Japan
| | - M. Taki
- Department of Paediatrics; St. Marianna University School of Medicine; Kawasaki Kanagawa Japan
| | - T. Matsushita
- Department of Transfusion Medicine; Nagoya University Hospital; Nagoya Aichi Japan
| | - A. Tawa
- Department of Paediatrics; National Hospital Organization Osaka National Hospital; Osaka Japan
| | - K. Nogami
- Department of Paediatrics; Nara Medical University; Kashihara Nara Japan
| | - S. Higasa
- Division of Haematology; Department of Internal Medicine; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | - Y. Kosaka
- Department of Haematology and Oncology; Kobe Children's Hospital; Kobe Hyogo Japan
| | - T. Fujii
- Division of Blood Transfusion; Hiroshima University Hospital; Hiroshima Japan
| | - M. Sakai
- Department of Paediatrics; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - M. Migita
- Department of Paediatrics; Kumamoto Red Cross Hospital; Kumamoto Japan
| | - M. Uchiba
- Department of Blood Transfusion and Cell Therapy; Kumamoto University Hospital; Kumamoto Japan
| | - K. Kawakami
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - K. Sameshima
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - Y. Ohashi
- Department of Biostatistics; School of Public Health; the University of Tokyo; Tokyo Japan
| | - H. Saito
- National Hospital Organization Nagoya Medical Center; Nagoya Aichi Japan
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Ohashi Y, Saito A, Yamazaki K, Tai R, Matsukiyo T, Aikawa A, Sakai K. Brain Natriuretic Peptide and Body Fluid Composition in Patients with Chronic Kidney Disease: A Cross-Sectional Study to Evaluate the Relationship between Volume Overload and Malnutrition. Cardiorenal Med 2016; 6:337-46. [PMID: 27648015 DOI: 10.1159/000447024] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/20/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM Fluid volume overload occurs in chronic kidney disease (CKD), leading to the compensatory release of natriuretic peptides. However, the elevated cardiac peptides may also be associated with malnutrition as well as volume overload. METHODS Body fluid composition was measured in 147 patients with CKD between 2009 and 2015, and its relationship to brain natriuretic peptide (BNP) levels was examined. Body fluid composition was separated into three components: (a) a water-free mass consisting of muscle, fat, and minerals; (b) intracellular water (ICW) content, and (c) extracellular water (ECW) content. Excess fluid mass was calculated using Chamney's formula. RESULTS The measured BNP levels in the tertile groups were 10.9 ± 5.4, 36.3 ± 12.5, and 393 ± 542 pg/ml, respectively. Patients in a higher log-transformed BNP level tertile were more likely to be older, to have a higher frequency of cardiac comorbidities, pulse pressure, C-reactive protein levels, and proteinuria, and to have lower serum sodium, kidney function, and serum albumin (p < 0.05). In body fluid composition, decreased body mass was significantly associated with the ECW-to-ICW ratio in relation to the downward ICW slope (r = -0.235, p = 0.004) and was strongly correlated with excess fluid mass (r = -0.701, p < 0.001). The ECW-to-ICW ratio and excess fluid mass was independently associated with the BNP levels. CONCLUSION Fluid volume imbalance between intra- and extracellular water regulated by decreased cell mass was independently associated with BNP levels, which may explain the reserve capacity for fluid accumulation in patients with CKD.
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Affiliation(s)
- Yasushi Ohashi
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, Chiba, Japan
| | - Akinobu Saito
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - Keisuke Yamazaki
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, Chiba, Japan
| | - Reibin Tai
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - Tatsuru Matsukiyo
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - Atsushi Aikawa
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
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Ryu SY, Ahn JK, Nakano T, Ahn DS, Ajimura S, Akimune H, Asano Y, Chang WC, Chen JY, Daté S, Ejiri H, Fujimura H, Fujiwara M, Fukui S, Hasegawa S, Hicks K, Horie K, Hotta T, Hwang SH, Imai K, Ishikawa T, Iwata T, Kato Y, Kawai H, Kino K, Kohri H, Kon Y, Kumagai N, Lin PJ, Maeda Y, Makino S, Matsuda T, Matsuoka N, Mibe T, Miyabe M, Miyachi M, Morino Y, Muramatsu N, Murayama R, Nakatsugawa Y, Nam SI, Niiyama M, Nomachi M, Ohashi Y, Ohkuma H, Ohta T, Ooba T, Oshuev DS, Parker JD, Rangacharyulu C, Sakaguchi A, Sawada T, Shagin PM, Shiino Y, Shimizu H, Strokovsky EA, Sugaya Y, Sumihama M, Tokiyasu AO, Toi Y, Toyokawa H, Tsunemi T, Uchida M, Ungaro M, Wakai A, Wang CW, Wang SC, Yonehara K, Yorita T, Yoshimura M, Yosoi M, Zegers RGT. Interference Effect between ϕ and Λ(1520) Production Channels in the γp→K^{+}K^{-}p Reaction near Threshold. Phys Rev Lett 2016; 116:232001. [PMID: 27341225 DOI: 10.1103/physrevlett.116.232001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Indexed: 06/06/2023]
Abstract
The ϕ-Λ(1520) interference effect in the γp→K^{+}K^{-}p reaction has been measured for the first time in the energy range from 1.673 to 2.173 GeV. The relative phases between ϕ and Λ(1520) production amplitudes were obtained in the kinematic region where the two resonances overlap. The measurement results support strong constructive interference when K^{+}K^{-} pairs are observed at forward angles but destructive interference for proton emission at forward angles. Furthermore, the observed interference effect does not account for the sqrt[s]=2.1 GeV bump structure in forward differential cross sections for ϕ photoproduction. This fact suggests possible exotic structures such as a hidden-strangeness pentaquark state, a new Pomeron exchange, or rescattering processes via other hyperon states.
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Affiliation(s)
- S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - D S Ahn
- RIKEN, The Institute of Physical and Chemical Research, Wako, Saitama 351-0198, Japan
| | - S Ajimura
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Akimune
- Department of Physics, Konan University, Kobe, Hyogo 658-8501, Japan
| | - Y Asano
- XFEL Project Head Office, RIKEN, Sayo, Hyogo 679-5143, Japan
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J Y Chen
- Light Source Division, National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S Daté
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ejiri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Fujimura
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - M Fujiwara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Fukui
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Hasegawa
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - K Horie
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S H Hwang
- Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Iwata
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - Y Kato
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H Kawai
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - K Kino
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - N Kumagai
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - P J Lin
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Y Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui 910-8526, Japan
| | - S Makino
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - T Matsuda
- Department of Applied Physics, Miyazaki University, Miyazaki 889-2192, Japan
| | - N Matsuoka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Mibe
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Miyachi
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Morino
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - R Murayama
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Nakatsugawa
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - S I Nam
- Department of Physics, Pukyong National University, Busan 48513, Republic of Korea
| | - M Niiyama
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Nomachi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Ohashi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ohkuma
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Ohta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Ooba
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - D S Oshuev
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J D Parker
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E2, Canada
| | - A Sakaguchi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Sawada
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - P M Shagin
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Y Shiino
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Joint Institute for Nuclear Research, Dubna, Moscow Region, 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - A O Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Toi
- Department of Applied Physics, Miyazaki University, Miyazaki 889-2192, Japan
| | - H Toyokawa
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Tsunemi
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Uchida
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Ungaro
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - A Wakai
- Akita Research Institute of Brain and Blood Vessels, Akita 010-0874, Japan
| | - C W Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S C Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - K Yonehara
- Department of Physics, Konan University, Kobe, Hyogo 658-8501, Japan
| | - T Yorita
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Yoshimura
- Institute for Protein Research, Osaka University, Suita, Osaka 565-0871, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - R G T Zegers
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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Sagara Y, Sawaki M, Taira N, Saito T, Kashiwaba M, Iwata H, Kobayashi K, Nakayama T, Bando H, Mizuno T, Yamamoto Y, Tsuneizumi M, Takahashi M, Yamaguchi M, Kawashima H, Takashima T, Uemura Y, Hozumi Y, Sagawa N, Mukai H, Ohashi Y. Abstract P5-18-01: A randomized clinical trial of postoperative adjuvant therapy for elderly breast cancer patients: Conditions of obtaining informed consent and reasons for declining participation. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-18-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: There are few randomized clinical trials examining adjuvant treatment in elderly breast cancer patients. While obtaining informed consent is essential for participation in clinical studies, there is little information on the frequency of agreement to participate among elderly patients. Furthermore, elderly patients might have specific reasons to decline participation.
Patients and Method: The National Surgical Adjuvant Study of Breast Cancer 07 (N-SAS BC 07) is a randomized clinical trial in women over 70 years with HER2-positive primary breast cancer. The primary aim was to investigate the benefit of trastuzumab monotherapy compared with the combination of trastuzumab and chemotherapy. Key inclusion criteria were as follows: women between 70 and 80 years old with HER2-positive breast cancer; underwent curative operation; stage I to IIIA; with sufficient organ function. Patients were randomized to receive either trastuzumab plus chemotherapy or trastuzumab monotherapy. The primary endpoint was disease-free survival, and the secondary endpoints were overall survival, relapse-free survival, safety, health-related quality of life, and cost effectiveness (NCT01104935). It was not possible to predict the number of patients who would agree to participate. In order to comprehensively assess the effect of postoperative adjuvant therapy, we evaluated the reasons why eligible patients declined to participate. The patients were registered in a cohort study to prospectively evaluate the subsequent treatment options and prognosis (07-Cohort). This study examined the obtaining of informed consent for N-SAS BC 07 and the reasons for declining participation, and compared the clinicopathological backgrounds between the N-SAS BC 07 and 07-Cohort groups.
Results: 398 eligible patients have been recruited. Informed consent to participate in N-SAS BC 07 has been obtained from 275 patients (69%) and 123 patients (31%) who declined to participate in the RCT have been registered in the 07-Cohort. The common reasons to decline participation in the RCT were "cannot choose the treatment option (55%)", "refused chemotherapy (16%)", "wanted chemotherapy (9%)", "anxious about clinical studies (9%)" and "family opposition (8%)". The mean ages of the patients in N-SAS BC 07 and 07-Cohort were 73.9 and 74.6 years old, respectively. There were no differences in stage, surgical procedure, lymph node metastasis, or co-morbidities between the groups. ER-positive rate was higher in 07-Cohort group compared with N-SAS BC 07 group (53% vs. 37%, p=0.017, χ2 test).
Conclusion: While we expected the number of registrants to be small, since N-SAS BC 07 investigated whether elderly patients with HER2-positive breast cancer should undergo chemotherapy, almost 70% of the patients accepted informed consent. The most common reason to decline participation in N-SAS BC 07 was "cannot choose the treatment option" and the majority refused chemotherapy. Furthermore, ER-positivity was higher in the 07-Cohort group, which suggested that ER expression in the patients with HER2-positive breast cancer might influence their decision to participate in the study or to choose the treatment option.
Citation Format: Sagara Y, Sawaki M, Taira N, Saito T, Kashiwaba M, Iwata H, Kobayashi K, Nakayama T, Bando H, Mizuno T, Yamamoto Y, Tsuneizumi M, Takahashi M, Yamaguchi M, Kawashima H, Takashima T, Uemura Y, Hozumi Y, Sagawa N, Mukai H, Ohashi Y. A randomized clinical trial of postoperative adjuvant therapy for elderly breast cancer patients: Conditions of obtaining informed consent and reasons for declining participation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-18-01.
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Affiliation(s)
- Y Sagara
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Sawaki
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Saito
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Iwata
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - K Kobayashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Nakayama
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Bando
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Mizuno
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Tsuneizumi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Takahashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Yamaguchi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Kawashima
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Takashima
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Uemura
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Hozumi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - N Sagawa
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Mukai
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
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Fujisawa T, Iwata H, Sakai T, Nakamura R, Hasegawa Y, Ohtani S, Kashiwaba M, Taira N, Toyama T, Masuda N, Yamamoto Y, Kihara K, Shimozuma K, Ohashi Y, Mukai H. Abstract P4-11-02: Endocrine-related symptoms during neoadjuvant endocrine therapy for breast cancer: Agreement between patient and physician reporting in a prospective clinical trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-11-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: There is a high risk of under-reporting subjective toxicities by physicians, even when collected prospectively in clinical trials. It has been recommended to include patient reported measures regarding symptoms in prospective clinical comparative effectiveness trials. However, there have been few reports of agreement in endocrine related symptoms between patient and physician reporting.
Patients and Method: The National Surgical Adjuvant Study of Breast Cancer 06 (N-SAS BC 06) is a multicenter, randomized clinical trial of postmenopausal, hormone receptor-positive breast cancer patients, with a two-stage (preoperative and postoperative) enrollment, and intervention. The primary aim was to evaluate the need for adjuvant chemotherapy in the treatment of postmenopausal breast cancer patients who responded to neoadjuvant treatment with Letrozole (LET) for 24-28 weeks. After surgery, responders were randomized into two arms receiving either chemotherapy plus LET, or LET alone. The primary endpoint was disease-free survival, and the secondary endpoints included adverse events, quality of life and health economic evaluation. This study enrolled 497 subjects from the N-SAS BC 06 who were evaluated by Patient Reported Outcomes (PROs). The concordance rate between Clinician Reported Outcomes (CROs) and PROs in their endocrine symptoms during neoadjuvant endocrine therapy was examined. Symptoms were collected prospectively by physicians using the Common Toxicity Criteria for Adverse Events at enrollment, i.e., baseline, and 4 and 16 weeks after starting neoadjuvant LET. Patients also completed the FACT-G (General), B (Breast), ES (Endocrine Symptoms), and HADS. The endocrine symptoms according to the PROs, included nausea, hot flushes, cold sweats, headaches, and HADS-Depression score. In FACT, "Not at all" was used to express the absence of the symptoms, and "A little bit", "Some-what", "Quite a bit", and "Very much" were used to express the presence of symptoms. The HADS-Depression score threshold was 10/11. According to the CROs, grade 0 was defined as the absence of symptoms and grade 1 or more was defined as the presence of symptoms. Cohen's kappa was used to determine the concordance between CROs and PROs. The sensitivity of CROs was also calculated.
Results: The calculated point estimates of Cohen's kappa at Weeks 4 and 16 after starting neoadjuvant LET were 0.12 and 0.01 for nausea, 0.16 and 0.18 for hot flushes, 0.12 and 0.09 for cold sweats, 0.03 and 0.02 for headaches, and 0.11 and 0.11 for dysthymia/depression, respectively; the concordance was quite low. The sensitivity of CROs at Weeks 4 and 16 after starting neoadjuvant LET was 0.07 and 0.03 for nausea, 0.16 and 0.17 for hot flushes, 0.1 and 0.08 for cold sweats, 0.03 and 0.03 for headaches, and 0.11 and 0.1 for dysthymia/depression, respectively; the sensitivity was quite low.
Conclusion: This study showed that there were big differences between CROs and PROs in endocrine symptoms associated with endocrine therapy for breast cancer and that physicians could not obtain sufficient information on the endocrine symptoms. It is recommended that PROs be used to evaluate adverse events caused by endocrine therapy.
Citation Format: Fujisawa T, Iwata H, Sakai T, Nakamura R, Hasegawa Y, Ohtani S, Kashiwaba M, Taira N, Toyama T, Masuda N, Yamamoto Y, Kihara K, Shimozuma K, Ohashi Y, Mukai H. Endocrine-related symptoms during neoadjuvant endocrine therapy for breast cancer: Agreement between patient and physician reporting in a prospective clinical trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-02.
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Affiliation(s)
- T Fujisawa
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Iwata
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Sakai
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - R Nakamura
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Hasegawa
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - S Ohtani
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - M Kashiwaba
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Taira
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Toyama
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Masuda
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Yamamoto
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Kihara
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Shimozuma
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Ohashi
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Mukai
- Gunma Prefectural Cancer Center, Ota, Gunma, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Chiba Cancer Center Hospital, Chiba, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; Hiroshima City Hospital, Hiroshima, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Nagoya City University Hospital, Nagoya, Aichi, Japan; National Hospital Organization Osaka National Hospital, Osaka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Saito T, Sawaki M, Hozumi Y, Sagawa N, Iwata H, Kashiwaba M, Kawashima H, Kobayashi K, Taira N, Takashima T, Takahashi M, Tsuneizumi M, Nakayama T, Baba S, Bando H, Mizuno T, Yamaguchi M, Yamamoto Y, Uemura Y, Ohashi Y, Mukai H. Abstract P4-11-09: A randomized controlled trial of postoperative adjuvant therapy for elderly breast cancer patients: Comparison of health-related quality of life between clinical trial participants and decliners. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-11-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Health-related quality of life (HRQoL) is one of the important outcomes in cancer control trials and has increasingly become the one of the primary foci. Obtaining informed consent from participants is essential for participation in randomized controlled trials (RCTs), but the participation in these RCTs may directly influence HRQoL, because treatment options are determined according to the allocation schedule. To date, only a few studies have compared HRQoL between clinical trial participants and decliners.
Patients and Method: The National Surgical Adjuvant Study of Breast Cancer 07 (N-SAS BC 07) is a randomized controlled trial in women with HER2-positive primary breast cancer who are over 70 years of age. The primary aim was to investigate the benefit of trastuzumab monotherapy compared with combination therapy using trastuzumab and chemotherapy. The study concept and design were published in concept paper (Sawaki M. et al., Jpn J Clin Oncol. 2011). In this study, patients were randomized to receive either trastuzumab plus chemotherapy or trastuzumab monotherapy. The primary endpoint was disease-free survival, and the secondary endpoints were overall survival, relapse-free survival, safety, HRQoL, comprehensive geriatric assessment (CGA) and cost effectiveness (protocol ID; NCT01104935).
HRQoL and CGA were assessed at registration (baseline), 2 month, 1 year, and 3 years after the start of protocol treatments using the Functional Assessment of Cancer Therapy-General (FACT-G), Hospital Anxiety and Depression Scale (HADS), EuroQol 5 Dimension (EQ-5D), Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, and the Philadelphia Geriatric Center (PGC) Morale Scale.
The patients who declined to participate in N-SAS BC 07 were registered in a cohort study to prospectively evaluate the subsequent treatment options and prognosis (07-Cohort). The same questionnaire that was used in N-SAS BC 07 was used in 07-Cohort to evaluate HRQoL and CGA at entry.
Results: Patients were enrolled from October 2012 to October 2016. During this period, 275 and 123 patients were registered in N-SAS BC 07 and 07-Cohort, respectively. The mean age at entry of the patients in the N-SAS BC 07 and 07-Cohort groups was 73.9 and 74.6 years, respectively. The questionnaire response rates at baseline in the patients in N-SAS BC 07 and 07-Cohort groups were 89% and 82%, respectively. There were no significant differences in FACT-G, HADS, EQ-5D, or TMIG index of competence at baseline between the groups, but the mean (standard deviation) scores of PGC Morale Scale in N-SAS BC 07 and 07-Cohort groups were 10.8 (3.3) and 9.9 (3.7), respectively, with the scores being significantly greater in the N-SAS BC 07 group (p=0.020, t-test).
Conclusion: The PGC Morale Scale provides a multidimensional approach to assess the psychological state of older people. This study indicated that participation in the RCT did not affect the baseline QoL of elderly patients but suggested that the baseline QoL of the RCT participants was better than decliners.
Citation Format: Saito T, Sawaki M, Hozumi Y, Sagawa N, Iwata H, Kashiwaba M, Kawashima H, Kobayashi K, Taira N, Takashima T, Takahashi M, Tsuneizumi M, Nakayama T, Baba S, Bando H, Mizuno T, Yamaguchi M, Yamamoto Y, Uemura Y, Ohashi Y, Mukai H. A randomized controlled trial of postoperative adjuvant therapy for elderly breast cancer patients: Comparison of health-related quality of life between clinical trial participants and decliners. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-09.
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Affiliation(s)
- T Saito
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - M Sawaki
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - Y Hozumi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - N Sagawa
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - H Iwata
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - M Kashiwaba
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - H Kawashima
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - K Kobayashi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - N Taira
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - T Takashima
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - M Takahashi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - M Tsuneizumi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - T Nakayama
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - S Baba
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - H Bando
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - T Mizuno
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - M Yamaguchi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - Y Yamamoto
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - Y Uemura
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - Y Ohashi
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
| | - H Mukai
- Saitama Red Cross Hospital, Saitama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Iwate Medical University, Mrioka, Iwate, Japan; Aomori City Hospital, Aomori, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Shizuoka General Hospital, Shizuoka, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; JCHO Kurume General Hospital, Kurume, Fukuoka, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Tokyo University Hospital, Bunkyo-ku, Tokyo, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East,
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Ohashi Y, Tai R, Aoki T, Mizuiri S, Ogura T, Tanaka Y, Okada T, Aikawa A, Sakai K. The Associations of Malnutrition and Aging with Fluid Volume Imbalance between Intra- and Extracellular Water in Patients with Chronic Kidney Disease. J Nutr Health Aging 2015; 19:986-93. [PMID: 26624209 DOI: 10.1007/s12603-015-0658-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Fluid imbalance due to sodium retention and malnutrition can be characterized by the ratio of extracellular water (ECW) to intracellular water (ICW). We investigated whether the ECW/ICW ratio is a risk factor for adverse outcomes. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS 149 patients with chronic kidney disease from 2005 to 2009, who were followed until August 2013. MEASUREMENTS Body fluid composition was measured by bioelectrical impedance analysis. Patients were categorized according to the ECW/ICW ratio tertile. Daily nutrient intake was estimated from 24-h dietary recall and analyzed using standard food composition tables. The main outcomes were adverse renal outcomes, as defined by a decline of 50% or more from the baseline glomerular filtration rate or initiation of renal replacement therapy, cardiovascular events, and all-cause mortality. RESULTS The ECW/ICW ratio increased with downward ICW slope with age and renal dysfunction besides ECW excess with massive proteinuria. Sodium intake, protein intake, and calorie intake were negatively correlated with the ECW/ICW ratios due to the steeper decreasing ICW content with the decreased dietary intake than the decreasing ECW content. During a median 4.9-year follow up, patients in the highest tertile had the worst adverse renal outcomes (15.9 vs. 5.1 per 100 patient-years, P < 0.001), cardiovascular events (4.1 vs. 0.3 per 100 patient-years, P = 0.002), and mortality (11.2 vs. 1.3 per 100 patient-years, P < 0.001). The adjusted hazard ratio (95% confidence intervals) for adverse renal outcomes, cardiovascular events, and mortality were 1.15 (1.03 - 1.26), 1.12 (0.93 - 1.31), and 1.29 (1.11 - 1.50), respectively. CONCLUSIONS Fluid imbalance between ICW and ECW occurring in malnourished and elderly patients with chronic kidney disease may explain the reserve capacity for volume overload and is associated with adverse renal outcomes and all-cause mortality.
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Affiliation(s)
- Y Ohashi
- Yasushi Ohashi, Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-Nishi, Ota-ku, Tokyo143-8541, Japan, Tel: + 81 3 3762 4151; Fax: + 81 3 5471 3056; E-mail:
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