81 results on '"Ukimura, O."'
Search Results
2. Systematic biopsy is unnecessary for the detection of clinically significant prostate cancer in men with PIRADS 5 and PSA density greater than 15%
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Tafuri, A., primary, Iwata, A., additional, Shakir, A., additional, Iwata, T., additional, Mahdi, A.S., additional, Cacciamani, G.E., additional, Gill, K., additional, Stern, M.C., additional, Ukimura, O., additional, Gill, I.S., additional, Palmer, S.L., additional, and Abreu, A.L., additional
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- 2020
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3. Primary focal- versus whole-gland cryoablation for intermediate- and high-risk prostate cancer
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Fujihara, A., primary, Iwata, T., additional, Oishi, M., additional, Shakir, A., additional, Tafuri, A., additional, Cacciamani, G., additional, Ukimura, O., additional, Gill, I., additional, Bahn, D., additional, and Abreu, A.L., additional
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- 2020
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4. The significance of multiparametric magnetic resonance imaging in monitoring of prostate cancer patients on active surveillance
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Fujihara, A., primary, Iwata, T., additional, Shakir, A., additional, Tafuri, A., additional, Cacciamani, G., additional, Gill, K., additional, Ashrafi, A., additional, Ukimura, O., additional, Desai, M., additional, Duddalwar, V., additional, Stern, M., additional, Aron, M., additional, Palmer, S., additional, Gill, I., additional, and Abreu, A.L., additional
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- 2020
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5. Automated urine cell image analysis with a convolutional neural network
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Kaneko, M., primary, Tsuji, K., additional, Masuda, K., additional, Ueno, K., additional, Henmi, K., additional, Nakagawa, S., additional, Fujita, R., additional, Suzuki, K., additional, Inoue, Y., additional, Shindo, H., additional, Konishi, E., additional, Takamatsu, T., additional, and Ukimura, O., additional
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- 2020
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6. Beyond transrectal ultrasound-guided prostate biopsies: available techniques and approaches
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Warlick, C., Futterer, J.J., Maruf, M., George, A.K., Rastinehad, A.R., Pinto, P.A., Bosaily, A.E., Villers, A., Moore, C.M., Mendhiratta, N., Taneja, S.S., Ukimura, O., Konety, B.R., Warlick, C., Futterer, J.J., Maruf, M., George, A.K., Rastinehad, A.R., Pinto, P.A., Bosaily, A.E., Villers, A., Moore, C.M., Mendhiratta, N., Taneja, S.S., Ukimura, O., and Konety, B.R.
- Abstract
Item does not contain fulltext, OBJECTIVES: Recent advances have led to the use of magnetic resonance imaging (MRI) alone or with fusion to transrectal ultrasound (TRUS) images for guiding biopsy of the prostate. Our group sought to develop consensus recommendations regarding MRI-guided prostate biopsy based on currently available literature and expert opinion. METHODS: The published literature on the subject of MRI-guided prostate biopsy was reviewed using standard search terms and synthesized and analyzed by four different subgroups from among the authors. The literature was grouped into four categories-MRI-guided biopsy platforms, robotic MRI-TRUS fusion biopsy, template mapping biopsy and transrectal MRI-TRUS fusion biopsy. Consensus recommendations were developed using the Oxford Center for Evidence Based Medicine criteria. RESULTS: There is limited high level evidence available on the subject of MRI-guided prostate biopsy. MRI guidance with or without TRUS fusion can lead to fewer unnecessary biopsies, help identify high-risk (Gleason >/= 3 + 4) cancers that might have been missed on standard TRUS biopsy and identify cancers in the anterior prostate. There is no apparent significant difference between MRI biopsy platforms. Template mapping biopsy is perhaps the most accurate method of assessing volume and grade of tumor but is accompanied by higher incidence of side effects compared to TRUS biopsy. CONCLUSIONS: Magnetic resonance imaging-guided biopsies are feasible and better than traditional ultrasound-guided biopsies for detecting high-risk prostate cancer and anterior lesions. Judicious use of MRI-guided biopsy could enhance diagnosis of clinically significant prostate cancer while limiting diagnosis of insignificant cancer.
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- 2019
7. SC36 - Systematic biopsy is unnecessary for the detection of clinically significant prostate cancer in men with PIRADS 5 and PSA density greater than 15%
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Tafuri, A., Iwata, A., Shakir, A., Iwata, T., Mahdi, A.S., Cacciamani, G.E., Gill, K., Stern, M.C., Ukimura, O., Gill, I.S., Palmer, S.L., and Abreu, A.L.
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- 2020
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8. Standardization of definitions in focal therapy of prostate cancer: report from a Delphi consensus project
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Postema, A.W. De Reijke, T.M. Ukimura, O. Van den Bos, W. Azzouzi, A.R. Barret, E. Baumunk, D. Blana, A. Bossi, A. Brausi, M. Coleman, J.A. Crouzet, S. Dominguez-Escrig, J. Eggener, S. Ganzer, R. Ghai, S. Gill, I.S. Gupta, R.T. Henkel, T.O. Hohenfellner, M. Jones, J.S. Kahmann, F. Kastner, C. Köhrmann, K.U. Kovacs, G. Miano, R. van Moorselaar, R.J. Mottet, N. Osorio, L. Pieters, B.R. Polascik, T.J. Rastinehad, A.R. Salomon, G. Sanchez-Salas, R. Schostak, M. Sentker, L. Tay, K.J. Varkarakis, I.M. Villers, A. Walz, J. De la Rosette, J.J.
- Abstract
Purpose: To reach standardized terminology in focal therapy (FT) for prostate cancer (PCa). Methods: A four-stage modified Delphi consensus project was undertaken among a panel of international experts in the field of FT for PCa. Data on terminology in FT was collected from the panel by three rounds of online questionnaires. During a face-to-face meeting on June 21, 2015, attended by 38 experts, all data from the online rounds were reviewed and recommendations for definitions were formulated. Results: Consensus was attained on 23 of 27 topics; TargetedFT was defined as a lesion-based treatment strategy, treating all identified significant cancer foci; FT was generically defined as an anatomy-based (zonal) treatment strategy. Treatment failure due to the ablative energy inadequately destroying treated tissue is defined as ablation failure. In targeting failure the energy is not adequately applied to the tumor spatially and selection failure occurs when a patient was wrongfully selected for FT. No definition of biochemical recurrence can be recommended based on the current data. Important definitions for outcome measures are potency (minimum IIEF-5 score of 21), incontinence (new need for pads or leakage) and deterioration in urinary function (increase in IPSS >5 points). No agreement on the best quality of life tool was established, but UCLA-EPIC and EORTC-QLQ-30 were most commonly supported by the experts. A complete overview of statements is presented in the text. Conclusion: Focal therapy is an emerging field of PCa therapeutics. Standardization of definitions helps to create comparable research results and facilitate clear communication in clinical practice. © 2016, The Author(s).
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- 2016
9. Follow‐up modalities in focal therapy for prostate cancer: results from a Delphi consensus project: results from a Delphi consensus project
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Muller, B. G., van den Bos, W., Brausi, M., Fütterer, J. J., Ghai, S., Pinto, P. A., Popeneciu, I. V., de Reijke, T. M., Robertson, C., de la Rosette, J.J.M.C.H., Scionti, S., Turkbey, B., Wijkstra, H., Ukimura, O., Polascik, T. J., Signal Processing Systems, and Biomedical Diagnostics Lab
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Consensus ,Prostate cancer ,SDG 3 - Good Health and Well-being ,Focal therapy ,Follow-up - Abstract
Introduction: Focal therapy can offer the middle ground for treatment between active surveillance and radical therapy in patients with low- and intermediate-risk prostate cancer. Factors that prohibit focal therapy from being standard of care are numerous. Several consensus projects have been conducted to position the utilization of imaging and trial design in focal therapy. However, the literature is still scarce on patient follow-up after focal therapy. For these reasons, an international multidisciplinary consensus project was established in order to reach consensus about a uniform follow-up protocol after focal therapy. Objective: To standardize patient follow-up after focal therapy. Materials and methods: A literature study was performed, and a questionnaire was constructed. The questionnaire was sent out to 76 participants (70 % urologists, 28 % radiologists and 2 % biomedical engineers) in three consecutive rounds according to the Delphi method. In each round, the panelists were presented with the results of the previous round. Participants each had the opportunity to adapt, delete or add questions. The topics discussed pertaining to follow-up after focal therapy were as follows: (1) general,(2) biopsies, (3) PSA, (4) digital rectal examination (DRE), (5) imaging, (6) quality of life (QoL) and (7) registration and pooling of data. The project was concluded with a face-to-face meeting in which final conclusions were formulated. Results: The follow-up after focal therapy should be a minimum of 5 years. The following modalities should be included in assessing post-treatment outcomes: multiparametric MRI (mpMRI), biopsies, assessment of erectile function, QoL, urinary symptoms and incontinence. A systematic 12-core TRUS biopsy combined with 4–6 targeted biopsy cores of the treated area and any suspicious lesion(s) should be performed after 1 year, and thereafter only when there is suspicion on imaging. The ideal way to perform targeted biopsies is to use TRUS–MRI fusion technology. PSA should be performed for research purposes, in the first year, every 3 months, and after the first year, every 6 months. mpMRI is the optimal imaging modality for follow-up after focal therapy. On a 1.5T scanner, an endorectal coil is strongly advised by the panel, whereas on a 3T machine, it is optional, however, it will improve image quality. The following sequences should be included: T2WI, DWI including high b values of >1,000 and ADC maps of DWI, DCE and T1WI. Imaging should be performed at 6 months and at 1 year following treatment; after the first year post-treatment, it should be performed every year until 5 years following treatment. All data should ideally be pooled in a common global database. Conclusion: Focal therapy is a relatively new form of treatment for prostate cancer. In order to include focal therapy as a standard of care treatment, consistent follow-up is necessary. By implementing the results of this consensus study, focal therapy users will be able to provide important and standardized outcome data.
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- 2015
10. Follow-up modalities in focal therapy for prostate cancer: results from a Delphi consensus project
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Muller, B.G., Bos, W., Brausi, M., Futterer, J.J., Ghai, S., Pinto, P.A., Popeneciu, I.V., Reijke, T.M. de, Robertson, C., Rosette, J.J.M.H.C. de la, Scionti, S., Turkbey, B., Wijkstra, H., Ukimura, O., Polascik, T.J., Muller, B.G., Bos, W., Brausi, M., Futterer, J.J., Ghai, S., Pinto, P.A., Popeneciu, I.V., Reijke, T.M. de, Robertson, C., Rosette, J.J.M.H.C. de la, Scionti, S., Turkbey, B., Wijkstra, H., Ukimura, O., and Polascik, T.J.
- Abstract
Item does not contain fulltext, Focal therapy can offer the middle ground for treatment between active surveillance and radical therapy in patients with low- and intermediate-risk prostate cancer. Factors that prohibit focal therapy from being standard of care are numerous. Several consensus projects have been conducted to position the utilization of imaging and trial design in focal therapy. However, the literature is still scarce on patient follow-up after focal therapy. For these reasons, an international multidisciplinary consensus project was established in order to reach consensus about a uniform follow-up protocol after focal therapy.To standardize patient follow-up after focal therapy.A literature study was performed, and a questionnaire was constructed. The questionnaire was sent out to 76 participants (70 \% urologists, 28 \% radiologists and 2 \% biomedical engineers) in three consecutive rounds according to the Delphi method. In each round, the panelists were presented with the results of the previous round. Participants each had the opportunity to adapt, delete or add questions. The topics discussed pertaining to follow-up after focal therapy were as follows: (1) general,(2) biopsies, (3) PSA, (4) digital rectal examination (DRE), (5) imaging, (6) quality of life (QoL) and (7) registration and pooling of data. The project was concluded with a face-to-face meeting in which final conclusions were formulated.The follow-up after focal therapy should be a minimum of 5 years. The following modalities should be included in assessing post-treatment outcomes: multiparametric MRI (mpMRI), biopsies, assessment of erectile function, QoL, urinary symptoms and incontinence. A systematic 12-core TRUS biopsy combined with 4-6 targeted biopsy cores of the treated area and any suspicious lesion(s) should be performed after 1 year, and thereafter only when there is suspicion on imaging. The ideal way to perform targeted biopsies is to use TRUS-MRI fusion technology. PSA should be performed for research
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- 2015
11. The Role of Magnetic Resonance Imaging in Focal Therapy for Prostate Cancer: Recommendations from a Consensus Panel
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Muller, B.G., Futterer, J.J., Gupta, R.T., Katz, A., Kirkham, A., Kurhanewicz, J., Moul, J.W., Pinto, P.A., Rastinehad, A.R., Robertson, C., Rosette, J. de la, Sanchez-Salas, R., Jones, J.S., Ukimura, O., Verma, S., Wijkstra, H., Marberger, M., Muller, B.G., Futterer, J.J., Gupta, R.T., Katz, A., Kirkham, A., Kurhanewicz, J., Moul, J.W., Pinto, P.A., Rastinehad, A.R., Robertson, C., Rosette, J. de la, Sanchez-Salas, R., Jones, J.S., Ukimura, O., Verma, S., Wijkstra, H., and Marberger, M.
- Abstract
Item does not contain fulltext, To establish a consensus on the utility of multiparametric magnetic resonance imaging (mpMRI) to identify patients for focal therapy. Topics specifically not included staging of prostate cancer (PCa), but rather identifying the optimal requirements for performing MRI, and the current status of optimally performed mpMRI to a) determine focality of prostate cancer (i.e. localizing small target lesions of 0.5 cm3 and greater), b) to monitor and assess the outcome of focal ablation therapies, and c) to indentify the diagnostic advantages of new MRI methods. In addition, the need for transperineal template saturation biopsies in selecting patients for focal therapy was discussed, if a high quality mpMRI is available. In other words, can mpMRI replace the role of transperineal saturation biopsies in patient selection for focal therapy?Urological surgeons, radiologists, and basic researchers, from Europe and North America participated in a consensus meeting about the use of mpMRI in focal therapy of prostate cancer. The consensus process was face-to-face and specific clinical issues were raised and discussed with agreement sought when possible. All participants are listed among the authors.Consensus was reached on most key aspects of the meeting, however on definition of the optimal requirements for mpMRI, there was 1 dissenting voice. mpMRI is the optimum approach to achieve the objectives needed for focal therapy, if made on a high quality machine (3T with/without endorectal coil or 1.5 with endorectal coil) and judged by an experienced radiologist. Structured and standardized reporting of prostate MRI is paramount. State of the art mpMRI is capable to localize small tumors for focal therapy. State of the art mpMRI is the technique of choice for follow up of focal ablation.The present evidence for MRI in focal therapy is limited. mpMRI is not accurate enough to consistently grade tumor aggressiveness. Template guided saturation biopsies are no longer necessary when a hig
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- 2014
12. Standards of Reporting for MRI-targeted Biopsy Studies (START) of the Prostate: Recommendations from an International Working Group.
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Moore, C.M., Kasivisvanathan, V., Eggener, S., Emberton, M., Futterer, J.J., Gill, I.S., Grubb Iii, R.L., Hadaschik, B., Klotz, L., Margolis, D.J., Marks, L.S., Melamed, J., Oto, A., Palmer, S.L., Pinto, P., Puech, P., Punwani, S., Rosenkrantz, A.B., Schoots, I.G., Simon, R., Taneja, S.S., Turkbey, B., Ukimura, O., Meulen, J. van der, Villers, A., Watanabe, Y., Moore, C.M., Kasivisvanathan, V., Eggener, S., Emberton, M., Futterer, J.J., Gill, I.S., Grubb Iii, R.L., Hadaschik, B., Klotz, L., Margolis, D.J., Marks, L.S., Melamed, J., Oto, A., Palmer, S.L., Pinto, P., Puech, P., Punwani, S., Rosenkrantz, A.B., Schoots, I.G., Simon, R., Taneja, S.S., Turkbey, B., Ukimura, O., Meulen, J. van der, Villers, A., and Watanabe, Y.
- Abstract
1 oktober 2013, Item does not contain fulltext, BACKGROUND: A systematic literature review of magnetic resonance imaging (MRI)-targeted prostate biopsy demonstrates poor adherence to the Standards for the Reporting of Diagnostic Accuracy (STARD) recommendations for the full and transparent reporting of diagnostic studies. OBJECTIVE: To define and recommend Standards of Reporting for MRI-targeted Biopsy Studies (START). DESIGN, SETTING, AND PARTICIPANTS: Each member of a panel of 23 experts in urology, radiology, histopathology, and methodology used the RAND/UCLA appropriateness methodology to score a 258-statement premeeting questionnaire. The collated responses were presented at a face-to-face meeting, and each statement was rescored after group discussion. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Measures of agreement and consensus were calculated for each statement. The most important statements, based on group median score, the degree of group consensus, and the content of the group discussion, were used to create a checklist of reporting criteria (the START checklist). RESULTS AND LIMITATIONS: The strongest recommendations were to report histologic results of standard and targeted cores separately using Gleason score and maximum cancer core length. A table comparing detection rates of clinically significant and clinically insignificant disease by targeted and standard approaches should also be used. It was recommended to report the recruitment criteria for MRI-targeted biopsy, prior biopsy status of the population, a brief description of the MRI sequences, MRI reporting method, radiologist experience, and image registration technique. There was uncertainty about which histologic criteria constitute clinically significant cancer when the prostate is sampled using MRI-targeted biopsy, and it was agreed that a new definition of clinical significance in this setting needed to be derived in future studies. CONCLUSIONS: Use of the START checklist would improve the quality of reporting in MRI-targeted biopsy
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- 2013
13. A testis-specific lncRNA functions as a post-transcriptional regulator of MDM2 and stimulates apoptosis of testicular germ cell tumor cells.
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Ito S, Ueno A, Ueda T, Ogura R, Sako S, Gabata Y, Murashita J, Takahashi H, and Ukimura O
- Abstract
Germ cells preferentially induce apoptosis in response to DNA damage to avoid genomic mutations. Apoptosis of germ cells is closely related to cancer development and chemotherapy resistance; however, its regulatory mechanism is unclear. Here, we suggest that testis-specific lncRNA LINC03074 is involved in male germ cell apoptosis by regulating the expression of the proto-oncogene MDM2. LINC03074 is highly expressed in the sperm of healthy adult testes and cancer cells of testes with testicular germ cell tumors (TGCTs). LINC03074 binds to MDM2 mRNA via an Alu element, thereby reducing MDM2 protein levels. LINC03074 stimulates STAU1-mediated nuclear export of MDM2 mRNA by increasing STAU1 binding to MDM2 mRNA in the cell nucleus, thereby promoting PKR-mediated translational repression in the cytoplasm. The induction of apoptosis in TGCT cells and their responsiveness to the anticancer drug cisplatin is enhanced by LINC03074. Notably, LINC03074 increased E2F1 expression without increasing p53, the primary target of MDM2, and upregulated the apoptotic gene p73, the target gene of E2F1. LINC03074-mediated regulation of apoptosis contributes to the responsiveness of TGCTs to anticancer drug-induced DNA damage., (© 2024. The Author(s).)
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- 2024
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14. Robotic-assisted laparoscopic radical prostatectomy for treatment of a newly identified lesion revealed no viable cells in the previously treated area with microwave focal therapy.
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Tsukuda F, Shimizu T, Hagiwara K, Kawano Y, Sakamoto N, Itagaki S, Horiguchi Y, Koga S, and Ukimura O
- Abstract
Introduction: Histological outcome of the targeted focal therapy is in principle confirmed by targeted needle biopsy from the treated area in clinical trial. Herein, we report a rare case in which the MFT was followed by RARP., Case Presentation: A 68-year-old man with PSA 9.6 ng/mL and PI-RADS 4 lesion in the right transition zone on multi-parametric MRI underwent MR/ultrasound fusion-guided targeted biopsy, which revealed grade-group 1 cancer. Targeted focal therapy with microwave ablation was performed, resulting in disappearance of the PI-RADS 4 lesion at post-operative 4 months. However, PSA rose to 11.5 ng/mL, and a new PI-RADS 4 lesion, was identified in the left peripheral zone. RARP was performed to reveal new grade-group 3 cancer, and no viable cells in the previously treated area with MFT., Conclusion: RARP was safely performed even after MFT and proved the pathological complete response of microwave ablation., Competing Interests: The authors declare conflict of interest for Alfresa Pharma K.K. about support our clinical trial., (© 2024 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)
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- 2024
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15. A nomogram to predict the absence of clinically significant prostate cancer in males with negative MRI
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Kaneko M, Fujihara A, Iwata T, Ramacciotti LS, Palmer SL, Oishi M, Aron M, Cacciamani GE, Duddalwar V, Horiguchi G, Teramukai S, Ukimura O, Gill IS, and Abreu AL
- Subjects
- Female, Humans, Cystoscopy methods, Urologic Surgical Procedures methods, Endometriosis diagnostic imaging, Endometriosis surgery, Ureteral Diseases surgery, Laparoscopy methods, Urinary Bladder Diseases diagnostic imaging, Urinary Bladder Diseases surgery
- Abstract
Purpose: To create a nomogram to predict the absence of clinically significant prostate cancer (CSPCa) in males with non-suspicion multiparametric magnetic resonance imaging (mpMRI) undergoing prostate biopsy (PBx)., Materials and Methods: We identified consecutive patients who underwent 3T mpMRI followed by PBx for suspicion of PCa or surveillance follow-up. All patients had Prostate Imaging Reporting and Data System score 1-2 (negative mpMRI). CSPCa was defined as Grade Group ≥2. Multivariate logistic regression analysis was performed via backward elimination. Discrimination was evaluated with area under the receiver operating characteristic (AUROC). Internal validation with 1,000x bootstrapping for estimating the optimism corrected AUROC., Results: Total 327 patients met inclusion criteria. The median (IQR) age and PSA density (PSAD) were 64 years (58-70) and 0.10 ng/mL2 (0.07-0.15), respectively. Biopsy history was as follows: 117 (36%) males were PBx-naive, 130 (40%) had previous negative PBx and 80 (24%) had previous positive PBx. The majority were White (65%); 6% of males self-reported Black. Overall, 44 (13%) patients were diagnosed with CSPCa on PBx. Black race, history of previous negative PBx and PSAD ≥0.15ng/mL2 were independent predictors for CSPCa on PBx and were included in the nomogram. The AUROC of the nomogram was 0.78 and the optimism corrected AUROC was 0.75., Conclusions: Our nomogram facilitates evaluating individual probability of CSPCa on PBx in males with PIRADS 1-2 mpMRI and may be used to identify those in whom PBx may be safely avoided. Black males have increased risk of CSPCa on PBx, even in the setting of PIRADS 1-2 mpMRI., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)
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- 2024
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16. Apalutamide versus bicalutamide in combination with androgen deprivation therapy for metastatic hormone sensitive prostate cancer.
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Ueda T, Shiraishi T, Miyashita M, Kayukawa N, Gabata Y, Sako S, Ogura R, Fujihara A, Okihara K, and Ukimura O
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- Male, Humans, Androgens, Prostate-Specific Antigen, Retrospective Studies, Androgen Antagonists therapeutic use, Prostatic Neoplasms drug therapy
- Abstract
The objective of this study is to compare the efficacy of apalutamide and bicalutamide in combination with androgen deprivation therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC). We retrospectively collected the data of about 330 patients with metastatic hormone-sensitive prostate cancer at our hospital and affiliated hospitals between December 2013 and August 2023. Sixty-one patients were administered apalutamide (240 mg/day) with androgen deprivation therapy (group A), and 269 patients were administered bicalutamide (80 mg/day) with androgen deprivation therapy (group B). Propensity score matching was used to adjust for clinical background factors between the two groups. PSA progression-free survival and overall survival were significantly longer in group A than in group B among the matched patients. Apalutamide therapy was a significant independent factor for OS in matched patients. The second progression-free survival of group A was significantly longer than that of group B in matched patients. Patients treated with apalutamide achieved ≥ 90% PSA decline from baseline faster and in larger numbers than those with bicalutamide. Apalutamide combined with ADT may be superior to bicalutamide alone in terms of OS and PSA-PFS in patients with mHSPC., (© 2024. The Author(s).)
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- 2024
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17. Author Correction: Screening for a practical method to monitor the status of patients with metastatic bladder cancer at the circulating cell-gene level.
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Ogura R, Ito S, Ueda T, Gabata Y, Sako S, Inoue Y, Yamada T, Konishi H, Fujihara A, and Ukimura O
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- 2023
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18. Screening for a practical method to monitor the status of patients with metastatic bladder cancer at the circulating cell-gene level.
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Ogura R, Ito S, Ueda T, Gabata Y, Sako S, Inoue Y, Yamada T, Konishi H, Fujihara A, and Ukimura O
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- Humans, Promoter Regions, Genetic, Early Detection of Cancer, Mutation, Biomarkers, Tumor genetics, Urinary Bladder Neoplasms genetics, Urinary Bladder Neoplasms pathology, Cell-Free Nucleic Acids, Telomerase genetics
- Abstract
Identifying a novel method to monitor metastatic bladder cancer status at the cell-gene level could lead to earlier appropriate therapeutic intervention and better outcomes. In this study, we evaluated a practical method to monitor the cancer status at the circulating cell-gene level before and after treatment in fourteen patients with metastatic bladder cancer who were indicated for systemic drug therapy. Patients were assessed via imaging before and after drug treatment, and cell-free DNA (cfDNA) analysis was performed to detect three parameters: cfDNA level, ERRB2 gene copy numbers, and telomerase reverse transcriptase (TERT) gene mutations. We hypothesized that decreased cfDNA levels, a normal copy number of ERB-B2 receptor tyrosine kinase 2 (ERBB2), and the absence of the TERT C228T mutation indicate cancer suppression. We found that a > 1.8-fold increase in cfDNA levels, increased copy number of ERBB2, or the existence of the TERT C228T mutation indicated disease progression. Stable cfDNA levels, normal ERBB2 copy number, and the absence of TERT C228T mutations indicate a stable cancer status. Collectively, our results show that the combination of cfDNA concentration, TERT mutation, and ERBB2 copy number may be useful for determining the efficacy of drug therapy in patients with metastatic bladder cancer., (© 2023. The Author(s).)
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- 2023
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19. TGF-β inhibitor treatment of H₂O₂-induced cystitis models provides biochemical mechanism for elucidating interstitial cystitis/painful bladder syndrome patients.
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Taga H, Kishida T, Inoue Y, Yamamoto K, Kotani SI, Masashi T, Ukimura O, and Mazda O
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- Animals, Humans, Mice, Fibrosis, Hydrogen Peroxide adverse effects, Disease Models, Animal, Cystitis, Interstitial drug therapy, Cystitis, Interstitial pathology, Transforming Growth Factor beta antagonists & inhibitors
- Abstract
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic disease for which no effective treatment is available. Transforming growth factor-β (TGF-β) is thought to be involved in the pathogenesis of IC/PBS, and previous studies have suggested that administrations of a TGF-β inhibitor significantly ameliorated IC/PBS in a mouse model. However, the molecular mechanisms underlying the therapeutic effect of a TGF-b inhibitor on IC/PBS has not been comprehensively analyzed. TGF-β has a variety of actions, such as regulation of immune cells and fibrosis. In our study, we induced IC/PBS-like disease in mice by an intravesical administration of hydrogen peroxide (H₂O₂) and examined the effects of three TGF-β inhibitors, Repsox, SB431542, and SB505124, on the urinary functions as well as histological and gene expression profiles in the bladder. TGF-β inhibitor treatment improved urinary function and histological changes in the IC/PBS mouse model, and SB431542 was most effective among the TGF-β inhibitors. In our present study, TGF-β inhibitor treatment improved abnormal enhancement of nociceptive mechanisms, immunity and inflammation, fibrosis, and dysfunction of bladder urothelium. These results show that multiple mechanisms are involved in the improvement of urinary function by TGF-β inhibitor., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Taga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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20. Increasing rectum-prostate distance using a hydrogel spacer to reduce radiation exposure during proton beam therapy for prostate cancer.
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Narukawa T, Aibe N, Tsujimoto M, Shiraishi T, Kimoto T, Suzuki G, Ueda T, Fujihara A, Yamazaki H, and Ukimura O
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- Male, Humans, Prostate, Rectum, Hydrogels, Hydrogel, Polyethylene Glycol Dimethacrylate, Radiotherapy Dosage, Proton Therapy, Radiation Injuries, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms chemically induced, Radiation Exposure
- Abstract
SpaceOAR, a polyethylene-glycol hydrogel, reduces rectal radiation exposure during radiation therapy for prostate cancer. Previously, our group reported the modified technique of hydrogel insertion, which achieves greater separated distance at prostate-apex. This study aimed to investigate the impact of separated distance at prostate-apex and our modifier technique, on radiation exposure reduction during proton beam therapy (PBT). We included 330 patients undergoing PBT with the relative biological effectiveness (RBE) of 63 Gray (Gy) for localized prostate cancer, and categorized them into groups 0 (no spacer, n = 141), 1 (separated distance of spacer at the prostate-apex level < 7.5 mm, n = 81), and 2 (distance ≥ 7.5 mm, n = 108). The rectal volumes to receive 30-60 Gy (RBE), was estimated and described as Rectal V30-60 (ml) in 10 Gy increments. The Rectal V30-60 (ml) was significantly lower in group 2 than in group 1, and in group 1 than in group 0. After propensity score matching, the multivariate logistic regression analysis revealed that the most significant factor to reduce radiation exposure was our modified technique of hydrogel insertion. Therefore, using a hydrogel spacer to expand the prostate-rectum distance not only at prostate-mid to prostate-base level but also at the prostate-apex level can reduce the radiation exposure in PBT for prostate cancer., (© 2023. Springer Nature Limited.)
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- 2023
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21. Treatment impact of newly approved therapeutic agents for metastatic urothelial carcinoma in Japan: a single-center retrospective study.
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Inoue Y, Yamada T, Fujihara A, Miyashita M, Shiraishi T, Okumi M, Hongo F, and Ukimura O
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- Humans, Retrospective Studies, Japan, Carcinoma, Transitional Cell drug therapy, Urinary Bladder Neoplasms pathology
- Abstract
Although recent clinical trials of new therapeutic agents for metastatic urothelial carcinoma have shown prolonged overall survival, there are few real-world evidence. To assess the impact of new therapeutic agents, we performed retrospective analysis for consecutive 158 metastatic urothelial carcinoma patients who performed systemic therapy in our institution between May 2008 and August 2023. We defined a period from May 2008 to December 2017, when pembrolizumab was first introduced to the clinical setting in the new therapeutic agents for metastatic urothelial carcinoma in Japan, as "pre new drug era" and a period from January 2018 to August 2023 as "post new drug era". We compared overall survival between pre- and post- new drug era using Kaplan-Meier method with log rank test. Median overall survival of pre- and post- new drug era were 14.5 months (95% confidence intervals: 11.6-16.7) and 23.1 months (95% confidence intervals: 14.5-NA), respectively (p < 0.001). Five-year survival rate of pre- and post- new drug era was 7.0% (95% confidence intervals: 2.3-15.3) and 36.3% (95% confidence intervals: 21.4-51.5), respectively. Multivariable Cox proportional hazards regression analysis of factors associated with overall survival showed that enfortumab vedotin administration, administration of second-line or more systemic therapy, best overall response of SD, PR and CR in first-line systemic therapy, higher serum albumin and lower CRP were factors for overall survival prolongation. Introduction of new therapeutic agents for metastatic urothelial carcinoma contributed to the improvement of overall survival in comparison with the era without these agents., (© 2023. Springer Nature Limited.)
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- 2023
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22. Identification of c-Met as a novel target of γ-glutamylcyclotransferase.
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Saito Y, Taniguchi K, Ii H, Horinaka M, Kageyama S, Nakata S, Ukimura O, and Sakai T
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- Humans, Male, Animals, Mice, AMP-Activated Protein Kinases, gamma-Glutamylcyclotransferase, Disease Models, Animal, Prostatic Neoplasms, Retinoblastoma, Retinal Neoplasms
- Abstract
γ-Glutamylcyclotransferase (GGCT) is highly expressed in multiple types of cancer tissues and its knockdown suppresses the growth of cancer cells in vitro and in vivo. Although GGCT is a promising target for cancer therapy, the mechanisms underlying the antitumor effects remain unclear. The knockdown of GGCT inhibited the MEK-ERK pathway, and activated the tumor suppressor retinoblastoma gene (RB) at the protein level in cancer cell lines. c-Met was down-regulated by the knockdown of GGCT in cancer cells and its overexpression attenuated the dephosphorylation of RB and cell cycle arrest induced by the knockdown of GGCT in lung cancer A549 cells. STAT3 is a transcription factor that induces c-Met expression. STAT3 phosphorylation and its nuclear expression level were decreased in GGCT-depleted A549 and prostate cancer PC3 cells. The simultaneous knockdown of AMPK and GGCT restored the down-regulated expression of c-Met, and attenuated the dephosphorylation of STAT3 and MEK-ERK-RB induced by the knockdown of GGCT in PC3 cells. An intraperitoneal injection of a GGCT inhibitor decreased c-Met protein expression in a mouse xenograft model of PC3 cells. These results suggest that the knockdown of GGCT activates the RB protein by inhibiting the STAT3-c-Met-MEK-ERK pathway via AMPK activation., (© 2023. The Author(s).)
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- 2023
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23. Novel device for dividing core needle biopsy specimens to provide paired mirror image-like tissues for genetic and pathological tests.
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Nakamura Y, Tsuji K, Shiraishi T, Sako S, Ogura R, Taga H, Inoue Y, Ohashi M, Ueda S, Yamada T, Ueda T, Fujihara A, Hongo F, and Ukimura O
- Subjects
- Male, Humans, Biopsy, Large-Core Needle, Retrospective Studies, Prostate, Image-Guided Biopsy
- Abstract
In a world that seeks precision medicine, genetic testing is gaining importance in clinical decision making. We previously reported the utility of a novel tool for longitudinally dividing core needle biopsy (CNB) tissues into two filamentous tissues that can provide paired mirror image-like tissues (mirror-tissues) that spatially match each other. In this study, we investigated its application in gene panel testing in patients who underwent prostate CNB. Four hundred and forty-three biopsy cores were obtained from 40 patients. Of them, 361 biopsy cores (81.5%) were judged by a physician to be appropriate for dividing into two pieces using the new device, of which a histopathological diagnosis was successfully reached in 358 biopsy cores (99.2%). Among them, the quality and quantity of nucleic acid in 16 appropriately divided cores were assessed and found to be sufficient for gene panel testing, and histopathological diagnosis was successfully obtained from the remaining divided cores. The novel device for longitudinally-dividing CNB tissue provided mirror image-like paired-tissues for gene panel and pathology testing. The device might be a promising tool for obtaining genetic and molecular biological information, in addition to histopathological diagnosis, helping to advance personalized medicine., (© 2023. The Author(s).)
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- 2023
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24. A big data-based prediction model for prostate cancer incidence in Japanese men.
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Kato M, Horiguchi G, Ueda T, Fujihara A, Hongo F, Okihara K, Marunaka Y, Teramukai S, and Ukimura O
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- Humans, Male, Incidence, Retrospective Studies, Japan epidemiology, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over, Reference Values, Risk Assessment, Risk Factors, Biomarkers, Tumor blood, Predictive Value of Tests, Big Data, East Asian People, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms epidemiology
- Abstract
To define a normal range for PSA values (ng/mL) by age and create a prediction model for prostate cancer incidence. We conducted a retrospective analysis using 263,073 observations of PSA values in Japanese men aged 18-98 years (2007-2017), including healthy men and those diagnosed with prostate cancer. Percentiles for 262,639 PSA observations in healthy men aged 18-70 years were calculated and plotted to elucidate the normal fluctuation range for PSA values by age. Univariable and multivariable logistic regression analyses were performed to develop a predictive model for prostate cancer incidence. PSA levels and PSA velocity increased with age in healthy men. However, there was no difference in PSA velocity with age in men diagnosed with prostate cancer. Logistic regression analysis showed an increased risk of prostate cancer for PSA slopes ranging from 0.5 to 3.5 ng/mL/year. This study provides age-specific normal fluctuation ranges for PSA levels in men aged 18-75 years and presents a novel and personalized prediction model for prostate cancer incidence. We found that PSA slope values of > 3.5 ng/mL/year may indicate a rapid increase in PSA levels caused by pathological condition such as inflammation but are unlikely to indicate cancer risk., (© 2023. The Author(s).)
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- 2023
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25. Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation.
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Ghoreifi A, Kaneko M, Peretsman S, Iwata A, Brooks J, Shakir A, Sugano D, Cai J, Cacciamani G, Park D, Lebastchi AH, Ukimura O, Bahn D, Gill I, and Abreu AL
- Abstract
Background: Several reports are available regarding the treatment decision regret of patients receiving conventional treatments for localized prostate cancer (PCa); yet data on patients undergoing focal therapy (FT) are sparse., Objective: To evaluate the treatment decision satisfaction and regret among patients who underwent FT for PCa with high-intensity focused ultrasound (HIFU) or cryoablation (CRYO)., Design Setting and Participants: We identified consecutive patients who underwent HIFU or CRYO FT as the primary treatment for localized PCa at three US institutions. A survey with validated questionnaires, including the five-question Decision Regret Scale (DRS), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5), was mailed to the patients. The regret score was calculated based on the five items of the DRS, and regret was defined as a DRS score of >25., Outcome Measurements and Statistical Analysis: Multivariable logistic regression models were applied to assess the predictors of treatment decision regret., Results and Limitations: Of 236 patients, 143 (61%) responded to the survey. Baseline characteristics were similar between responders and nonresponders. During a median (interquartile range) follow-up of 43 (26-68) mo, the treatment decision regret rate was 19.6%. On a multivariable analysis, higher prostate-specific antigen (PSA) at nadir after FT (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.1-2, p = 0.009), presence of PCa on follow-up biopsy (OR 3.98, 95% CI 1.5-10.6, p = 0.006), higher post-FT IPSS (OR 1.18, 95% CI 1.01-1.37, p = 0.03), and newly diagnosed impotence (OR 6.67, 95% CI 1.57-27, p = 0.03) were independent predictors of treatment regret. The type of energy treatment (HIFU/CRYO) was not a predictor of regret/satisfaction. Limitations include retrospective abstraction., Conclusions: FT for localized PCa is well accepted by the patients, with a low regret rate. Higher PSA at nadir, presence of cancer on follow-up biopsy, bothersome postoperative urinary symptoms, and impotence after FT were independent predictors of treatment decision regret., Patient Summary: In this report, we looked at the factors affecting satisfaction and regret in patients with prostate cancer undergoing focal therapy. We found that focal therapy is well accepted by the patients, while presence of cancer on follow-up biopsy as well as bothersome urinary symptoms and sexual dysfunction can predict treatment decision regret., (© 2023 The Authors.)
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- 2023
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26. A Cortisol-Secreting Adrenal Adenoma Combined With a Micro-Pheochromocytoma: Case Report and Literature Review.
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Sakai K, Asano M, Hamaguchi M, Taniguchi H, Ukimura O, and Fukui M
- Abstract
Cushing's syndrome and pheochromocytomas (PCCs) are associated with endocrine hypertension. Cortisol-producing adrenal adenomas are a major cause of Cushing's syndrome. Simultaneous occurrence of cortisol-producing adrenal adenomas and PCCs is rare. Additionally, a PCC generally produces catecholamines in proportion to its size; therefore, micro-PCCs are rarely found in clinical practice. It is unknown whether micro-PCCs produce excess catecholamines during the pre-biochemical phase. Herein, we report the case of a 53-year-old woman who was referred to our hospital for further evaluation of left adrenal incidentaloma. She had been suffering from hypertension for 7 years. Endocrine tests indicated autonomous cortisol secretion, and she was diagnosed with cortisol-producing adrenal adenoma. A laparoscopic left adrenalectomy was performed. The final pathological examination revealed an adrenocortical adenoma measuring 26 × 24 mm. In addition, a micro-PCC measuring 3 × 2 mm was incidentally found near the cortisol-secreting adrenal adenoma in the ipsilateral adrenal gland. All catecholamine biosynthetic enzymes, tyrosine hydroxylase, aromatic l-amino acid decarboxylase, dopamine β-hydroxylase, and phenyl ethanolamine N-methyltransferase, were detected in this micro-PCC by immunohistochemical analyses. Although catecholamine levels were not biochemically elevated, the PCC expressed catecholamine biosynthetic enzymes. This is the first immunohistochemical report to show that a micro-PCC produces excess catecholamines in the pre-biochemical phase., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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27. Detection of relatively poor but definitive blood supply in prostate stromal sarcoma using transrectal ultrasonography with superb microvascular imaging.
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Ohashi M, Shiraishi T, Fujihara A, Yamada T, Ueda T, Hongo F, and Ukimura O
- Abstract
A 23-year-old man presented with complaints of macrohematuria and hematospermia and was referred to our hospital for further examination. Magnetic resonance imaging revealed a round 30 × 25 mm tumor in the right peripheral zone; hence, a rare prostate tumor was suspected. Grayscale transrectal ultrasonography (TRUS) was performed using the Aplio-i800 PVL-715RST-transducer and revealed a well-defined round tumor. Although regular color Doppler flow imaging could not detect internal blood flow, superb microvascular imaging (SMI) identified the low-velocity blood flow in the tumor. Based on the results of a TRUS-guided targeted biopsy assisted by SMI, the patient was diagnosed with stromal sarcoma. He underwent total pelvic exenteration with construction of ileal conduit and colostomy, the tumor was finally diagnosed as prostate stromal sarcoma (PSS). Since PSS is a rare malignant prostate tumor, reports on the characteristic findings in imaging tests are scarce. To the best of our knowledge, this study reports the first case in which a poor internal blood flow was detected in PSS, but not through regular color Doppler flow imaging. SMI revealed that the blood flow signal to the PSS was relatively poor; however, its definite presence was confirmed, suggesting a malignant disease with relatively poor blood supply and the findings of SMI would assist the adequate targeted biopsy-sampling from the presence site of viable cells with the blood supply., Competing Interests: Conflict of interestAll the authors declare that they have no conflict of interest., (© The Author(s) under exclusive licence to The Japan Society of Clinical Oncology 2022.)
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- 2022
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28. Bone marrow metastasis in a patient with non-seminomatous testicular germ cell tumor.
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Ueda T, Takada I, Shimizu T, Ito S, Fujihara A, Shiraishi T, Nakamura T, and Ukimura O
- Abstract
Introduction: Metastasis to the bone marrow is rare in testicular germ cell tumor patients. We report a case of a patient with a non-seminomatous testicular germ cell tumor who presented with bone marrow metastases after intensive chemotherapy., Case Presentation: A 36-year-old man was admitted to the hospital with pancytopenia. Previously, he had received intensive care for an advanced left testicular germ cell tumor. Although multidisciplinary treatments including several regimens of salvage chemotherapy, desperation retroperitoneal lymph node dissection, and focal radiotherapy were performed, the serum tumor marker alfa-fetoprotein was not normalized and there were no findings of relapse by several imaging modalities. Bone marrow aspirate, conducted to diagnose a cause of pancytopenia, revealed metastatic germ cell tumors in the bone marrow., Conclusion: Bone marrow metastasis should be considered as a differential diagnosis in patients with germ cell tumors whose serum tumor makers are not normalized without any radiographic finding of recurrence., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)
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- 2022
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29. Double renal cell carcinoma with histological type of clear cell carcinoma and papillary carcinoma in the same kidney concurrently treated with robot-assisted partial nephrectomy.
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Shimizu T, Hongo F, Takahashi H, Fujihara A, and Ukimura O
- Abstract
Introduction: The presence of two different histologic types of renal cell carcinoma in the same kidney is rare in clinical practice. This report describes a patient with ipsilateral renal cell carcinomas, consisting of a clear cell renal cell carcinoma and a papillary type 1 renal cell carcinoma, who was successfully treated by robot-assisted partial nephrectomy., Case Presentation: A 70-year man was referred to our hospital for the treatment of two right mid-pole renal tumors, measuring 51 mm and 31 mm in diameter. The two tumors, which differed in contrast enhancement on computed tomography, were removed simultaneously by robot-assisted partial nephrectomy. Histopathological and immunohistochemical findings confirmed that one tumor was a clear cell renal cell carcinoma, pT1a, and the other was a papillary type1 renal cell carcinoma, pT1b., Conclusion: This report describes a rare patient presenting with two ipsilateral renal cell carcinomas differing in histology. Robot-assisted partial nephrectomy was the safe and effective nephron-sparing surgery, even in patients with complex double renal tumors., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)
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- 2021
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30. Strategies to Improve the Antitumor Effect of γδ T Cell Immunotherapy for Clinical Application.
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Miyashita M, Shimizu T, Ashihara E, and Ukimura O
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- Animals, Humans, Neoplasms immunology, Neoplasms metabolism, Cytotoxicity, Immunologic immunology, Immunotherapy methods, Neoplasms therapy, Receptors, Antigen, T-Cell, gamma-delta immunology, T-Lymphocytes immunology, Tumor Microenvironment immunology
- Abstract
Human γδ T cells show potent cytotoxicity against various types of cancer cells in a major histocompatibility complex unrestricted manner. Phosphoantigens and nitrogen-containing bisphosphonates (N-bis) stimulate γδ T cells via interaction between the γδ T cell receptor (TCR) and butyrophilin subfamily 3 member A1 (BTN3A1) expressed on target cells. γδ T cell immunotherapy is classified as either in vivo or ex vivo according to the method of activation. Immunotherapy with activated γδ T cells is well tolerated; however, the clinical benefits are unsatisfactory. Therefore, the antitumor effects need to be increased. Administration of γδ T cells into local cavities might improve antitumor effects by increasing the effector-to-target cell ratio. Some anticancer and molecularly targeted agents increase the cytotoxicity of γδ T cells via mechanisms involving natural killer group 2 member D (NKG2D)-mediated recognition of target cells. Both the tumor microenvironment and cancer stem cells exert immunosuppressive effects via mechanisms that include inhibitory immune checkpoint molecules. Therefore, co-immunotherapy with γδ T cells plus immune checkpoint inhibitors is a strategy that may improve cytotoxicity. The use of a bispecific antibody and chimeric antigen receptor might be effective to overcome current therapeutic limitations. Such strategies should be tested in a clinical research setting.
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- 2021
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31. Gene expression profiles during tissue remodeling following bladder outlet obstruction.
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Ito S, Nomura T, Ueda T, Inui S, Morioka Y, Honjo H, Fukui A, Fujihara A, Hongo F, and Ukimura O
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- Animals, Cell Hypoxia, Cells, Cultured, DNA-Binding Proteins biosynthesis, DNA-Binding Proteins genetics, Disease Models, Animal, Female, Gene Expression Regulation, Hypertrophy, Hypoxia-Inducible Factor 1, alpha Subunit biosynthesis, Hypoxia-Inducible Factor 1, alpha Subunit genetics, Muscle, Smooth metabolism, Muscle, Smooth pathology, Nitric Oxide Synthase Type III biosynthesis, Nitric Oxide Synthase Type III genetics, RNA-Seq, Rats, Rats, Sprague-Dawley, Transcription Factors biosynthesis, Transcription Factors genetics, Urinary Bladder Neck Obstruction metabolism, Gene Expression Profiling, Urinary Bladder Neck Obstruction genetics
- Abstract
Bladder outlet obstruction (BOO) often results in lower urinary tract symptoms (LUTSs) and negatively affects quality of life. Here, we evaluated gene expression patterns in the urinary bladder during tissue remodeling due to BOO. We divided BOO model rats into two groups according to the degree of hypertrophy of smooth muscle in the bladder. The strong muscular hypertrophy group, which exhibited markedly increased bladder smooth muscle proportion and HIF1α mRNA levels compared with the control group, was considered a model for the termination of hypertrophy, whereas the mild muscular hypertrophy group was considered a model of the initiation of hypertrophy. Some genes related to urinary function showed different expression patterns between the two groups. Furthermore, we found that several genes, including D-box binding PAR bZIP transcription factor (DBP), were upregulated only in the mild muscular hypertrophy group. DBP expression levels were increased in bladder smooth muscle cells in response to hypoxic stress. DBP associated with enhancer and promoter regions of NOS3 gene locus and upregulated NOS3 gene expression under hypoxic conditions. These findings suggested that the regulatory systems of gene expression were altered during tissue remodeling following BOO. Furthermore, circadian clock components might be involved in control of urinary function via transcriptional gene regulation in response to hypoxic stimuli.
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- 2021
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32. Challenge and Outcome for the Prostate Squamous Cell Carcinoma Which Developed 8 Years after Low-Dose-Rate Brachytherapy Approached by a Combined Multimodal Treatment with High-Dose-Rate Interstitial Brachytherapy, External Beam Radiation Therapy, and Chemotherapy.
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Matsugasumi T, Masui K, Yamada K, Watanabe S, Okihara K, Kozawa N, Yamada Y, Yamazaki H, Yamada K, and Ukimura O
- Abstract
Prostate squamous cell carcinoma (pSCC) rarely develops as a secondary cancer after treatment with low-dose-rate brachytherapy (LDR-BT). There is no established effective treatment for the disease condition. Herein, we present a 78-year-old man who developed pSCC 8 years after LDR-BT. He was subsequently selected to receive a combined multimodal treatment with high-dose-rate interstitial brachytherapy (HDR-ISBT), external beam radiation therapy, and chemotherapy for his pSCC. Eleven months later, he displayed no biochemical failure nor clinical radiographic recurrence. However, MRI detected a newly developed prostatic-rectal fistula (grade 4), and a colostomy was performed to relieve pain and inflammation. To our knowledge, this is the first report to perform a combined multimodal treatment with HDR-ISBT for pSCC suspected as a secondary cancer due to LDR-BT., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 by S. Karger AG, Basel.)
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- 2021
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33. Robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction due to aberrant blood vessel with ipsilateral retrocaval ureter.
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Inoue Y, Naitoh Y, Ajiki J, Fukui A, Yamada T, Fujihara A, Yamada K, Hongo F, and Ukimura O
- Abstract
Introduction: Ureteropelvic junction obstruction is a common congenital anomaly that causes hydronephrosis but rarely accompanies ipsilateral retrocaval ureter., Case Presentation: A 39-year-old woman, who visited to our hospital complaining of worsened right low back pain and fever, was diagnosed with right hydronephrosis due to ureteropelvic junction obstruction by contrast-enhanced computed tomography. Intraoperatively before the planned robot-assisted laparoscopic pyeloplasty, retrograde pyelography was performed to reveal concomitant ipsilateral retrocaval ureter. Laparoscopically, ureteropelvic junction obstruction due to aberrant blood vessel and coexisting retrocaval ureter was confirmed. Transposition of the ureter from posterior to anterior of the inferior vena cava and following dismembered pyeloplasty was performed. Two years after surgery, her right hydronephrosis improved and she had no complain of any symptom., Conclusion: Retrocaval ureter is a rare abnormality; however, combination of preoperative retrograde pyelography and laparoscopic evaluation was important for management of this concomitant abnormality., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.)
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- 2021
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34. Abiraterone acetate versus bicalutamide in combination with gonadotropin releasing hormone antagonist therapy for high risk metastatic hormone sensitive prostate cancer.
- Author
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Ueda T, Shiraishi T, Ito S, Ohashi M, Matsugasumi T, Yamada Y, Fujihara A, Hongo F, Okihara K, and Ukimura O
- Subjects
- Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Drug Therapy, Combination, Humans, Male, Middle Aged, Neoplasm Grading, Progression-Free Survival, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology, Retrospective Studies, Treatment Outcome, Abiraterone Acetate administration & dosage, Androgen Antagonists administration & dosage, Anilides administration & dosage, Gonadotropin-Releasing Hormone antagonists & inhibitors, Nitriles administration & dosage, Oligopeptides administration & dosage, Prostatic Neoplasms drug therapy, Tosyl Compounds administration & dosage
- Abstract
The objective of this study was to compare the efficacy of abiraterone acetate with that of bicalutamide in combination with gonadotropin-releasing hormone (GnRH) antagonist treatment for patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). A total of 149 patients with mHSPC who underwent treatment at our hospital and affiliated hospitals between December 2013 and July 2020 were retrospectively identified. Fifty patients were administered abiraterone acetate (1000 mg/day) plus prednisolone (5 mg/day) with a GnRH antagonist (degarelix) (group A), and 99 patients were administered bicalutamide (80 mg/day) with a GnRH antagonist (group B). The prostate-specific antigen (PSA) progression-free survival (PSA-PFS) was significantly longer in group A than in group B. Abiraterone acetate therapy and Gleason score were significant independent factors of PSA-PFS. Using propensity score matching, 56 matched patients were obtained. The PSA-PFS (p < 0.001) and overall survival (OS) (p = 0.0071) of patients with high-risk mHSPC were significantly longer in group A of matched patients. Abiraterone acetate therapy and Gleason score were significant independent factors for PSA-PFS in matched patients. The PSA-PFS and OS of patients treated with abiraterone acetate in combination with a GnRH antagonist were significantly better than those treated with bicalutamide.
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- 2021
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35. Usefulness of bicarbonate Ringer's solution as perfusate during transurethral resection of the prostate.
- Author
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Hongo F, Narukawa T, Fujihara A, Amaya F, Sawa T, and Ukimura O
- Abstract
Transurethral resection of the prostate (TURP) is the most common standard surgical procedure used for benign prostatic hyperplasia. Transurethral resection in saline (TURis) is a bipolar electrosurgery system used to prevent TURP (or TUR) syndrome. The bicarbonate Ringer's solution is not generally used as perfusate for TURP. Hence, we compared the efficacy of the bicarbonate Ringer's solution with that of physiological saline as perfusate during TURP. This prospective, multicenter, cooperative study was conducted on 40 adult patients admitted to a medical college hospital. After obtaining informed consent from all the patients, they were divided into two groups (20 patients per group). For patients of one group, bicarbonate Ringer's solution, and for other group, physiological saline was used as perfusate. Compared to the physiological saline, the electrolyte composition of the bicarbonate Ringer's solution was closer to that of plasma. Hence, the group using bicarbonate Ringer's solution as perfusate was exhibited less variation in plasma electrolytes and blood gas data. The primary endpoints were adverse events of grade 1 or higher according to the JCOG postoperative complication criteria ver. 2.0, unintended diseases, or related signs in patients who underwent the protocol therapy. The secondary endpoints were changes in blood pH, bicarbonate ion level, anion gap (AG), base excess (BE), and chloride (C1), which occurred during and after the surgeries. Therefore, bicarbonate Ringer's solution has superior with that of physiological saline as perfusate during TURP which is directly administered into the blood vessels as an infusion solution.Bicarbonate Ringer's solution is directly administered into the blood vessels as an infusion solution., Competing Interests: The authors declare that they have no competing interests., (© 2021 Published by Elsevier Inc.)
- Published
- 2021
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36. Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis.
- Author
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Kanbayashi Y, Sakaguchi K, Hongo F, Ishikawa T, Tabuchi Y, Ukimura O, Takayama K, and Taguchi T
- Subjects
- Adult, Aged, Aged, 80 and over, Bone Density Conservation Agents pharmacology, Calcium pharmacology, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Retrospective Studies, Risk Factors, Vitamin D pharmacology, Young Adult, Bone Neoplasms pathology, Denosumab pharmacology, Hypocalcemia chemically induced, Hypocalcemia pathology
- Abstract
This retrospective study was undertaken to identify predictors for the development of hypocalcaemia even with prophylactic administration of calcium and vitamin D, and to help guide future strategies to improve the safety, efficacy, and QOL of patients receiving denosumab. Between January 2016 and February 2020, a total of 327 advanced cancer patients at our hospital who were receiving denosumab were enrolled. Variables associated with the development of hypocalcaemia were extracted from the clinical records. The level of hypocalcaemia was evaluated using CTCAE version 5. Multivariate ordered logistic regression analysis was performed to identify predictors for the development of hypocalcaemia. Optimal cut off thresholds were determined using ROC analysis. Values of P < 0.05 (2-tailed) were considered significant. 54 patients have developed hypocalcemia (≥ Grade 1). Significant factors identified included concomitant use of vonoprazan [odds ratio (OR) = 3.74, 95% confidence interval (CI) 1.14-12.26; P = 0.030], dexamethasone (OR = 2.45, 95%CI 1.14-5.42; P = 0.022), pre-treatment levels of serum calcium (OR = 0.27, 95%CI 0.13-0.54; P < 0.001), ALP/100 (OR = 1.04, 95%CI 1.01-1.07; P = 0.003), and haemoglobin (OR = 0.79, 95%CI 0.68-0.93; P = 0.004). ROC curve analysis revealed that the threshold for pre-treatment levels of serum calcium was ≤ 9.3 mg/dL, ALP was ≥ 457 U/L, and haemoglobin was ≤ 10.4 g/dL. In conclusion, concomitant use of vonoprazan or dexamethasone, and pre-treatment levels of serum calcium (low), ALP (high) and haemoglobin (low) were identified as significant predictors for the development of denosumab-induced hypocalcaemia.
- Published
- 2021
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37. Usefulness of a novel device to divide core needle biopsy specimens in a spatially matched fashion.
- Author
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Shiraishi T, Inui S, Inoue Y, Saito Y, Taga H, Kaneko M, Tsuji K, Ueda S, Ueda T, Matsugasumi T, Taniguchi H, Ueno A, Yamada T, Yamada Y, Iwata T, Fujihara A, Hongo F, and Ukimura O
- Subjects
- Animals, Biopsy, Needle methods, Cell Line, Tumor, Feasibility Studies, Genetic Testing, Humans, Mice, Mice, SCID, Neoplasm Transplantation, Neoplasms, Experimental surgery, Real-Time Polymerase Chain Reaction, Specimen Handling methods, Biopsy, Needle instrumentation, Neoplasms, Experimental pathology, Specimen Handling instrumentation
- Abstract
We developed a novel dividing device that can split needle biopsy tissues along longitude axis aiming to achieve definitive molecular-biological and genetical analysis with reference of pathological diagnosis of the side-by-side divided tissue as spatially matched information. The aim of this study was to evaluate the feasibility and potential usefulness of the novel dividing device to provide the appropriate materials for molecular diagnosis. The new device was examined using mouse xenograft tumors. Real-time quantitative PCR and genetic test were performed to evaluate the feasibility and usefulness of the device. All the samples from needle biopsy were successfully divided into two pieces. Quality and quantity from divided samples harbor high enough to perform gene expression analysis (real-time PCR) and genetic test. Using two divided samples obtained from xenograft tumor model by needle biopsy, the % length of xenograft tumor (human origin) was significantly correlated with the % human genomic DNA (p = 0.00000608, r = 0.987), indicating that these divided samples were spatially matched. The novel longitudinally dividing device of a needle biopsy tissue was useful to provide the appropriate materials for molecular-biological and genetical analysis with reference of pathological diagnosis as spatially matched information.
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- 2020
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38. Radiotherapy for elder patients aged ≥80 with clinically localized prostate cancer - Brachytherapy enhanced late GU toxicity especially in elderly.
- Author
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Yamazaki H, Masui K, Suzuki G, Shimizu D, Aibe N, Yamada K, Fujihara A, Shiraishi T, Okihara K, Ukimura O, Yoshida K, Nakamura S, and Okabe H
- Abstract
Background and Purpose: Elongation of life expectancy had led to marked increase in number of elderly patients with localized prostate cancer. However, the standard treatment for such patients is not well determined because of a high prevalence of comorbidities and slow growth of prostate cancer. The aim of this study is to examine the feasibility of radiotherapy for elderly patients aged ≥80 years., Materials and Methods: We compared 96 patients aged ≥80 years and 2333 younger patients (aged 60-79 years) using multi-institutional data included cT1-T4N0M0 prostate cancer treated with 902 external beam radiotherapy (EBRT) and 1527 brachytherapy (BT)., Results: The 5-year biochemical failure-free survival rate was similar between elderly ≥80 years and younger control (91.3% vs. 85.9%, p = 0.6171) (100%, 92.9%, 82.4% and 96.3%, 93.7%, 89% for low, intermediate and high risk group), and for the prostate cancer-specific survival rate (100% and 99.3%, p = 0.6171). The accumulated incidence of late gastrointestinal (GI) at 5 years was also similar between elderly and younger patients (3.5% vs. 2.5%, p = 0.6857). Brachytherapy improved biochemical control rate and reduced GI toxicity compared with EBRT, however, enhanced late genitourinary (GU) toxicity, especially in elderly patients. Elderly received brachytherapy showed highest rate of late GU toxicity grade ≥2 of 22.1% than the younger counterparts of 12.7% at 5 years, whereas younger patients treated with EBRT had 2.4% and elderly EBRT had 2.7% ( p < 0.0001)., Conclusion: Elderly patients aged ≥80 years showed equivalent biochemical control, prostate cancer-related survival, and gastrointestinal toxicity profiles to younger patients. Meticulous care should be required for brachytherapy enhanced late GU toxicity, especially in elderly patients aged ≥80 years., (© 2020 The Author(s).)
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- 2020
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39. Sphere-derived Prostate Cancer Stem Cells Are Resistant to γδ T Cell Cytotoxicity.
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Miyashita M, Tomogane M, Nakamura Y, Shimizu T, Fujihara A, Ukimura O, and Ashihara E
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- AC133 Antigen genetics, Cell Line, Tumor, Cell Proliferation genetics, Humans, Male, Nanog Homeobox Protein genetics, Neoplastic Stem Cells pathology, Octamer Transcription Factor-3 genetics, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology, Receptors, Antigen, T-Cell, gamma-delta immunology, SOXB1 Transcription Factors genetics, T-Lymphocytes, Intraepithelial Lymphocytes immunology, Neoplastic Stem Cells immunology, Prostatic Neoplasms immunology, Receptors, Antigen, T-Cell, gamma-delta genetics
- Abstract
Background/aim: γδ T cells mediate cytotoxicity against prostate cancer (PCa) cells in vitro; however, the clinical efficacy of γδ T cell-targeted immunotherapy for recurrent and metastatic PCa is unsatisfactory. We hypothesized that the resistance of recurrent and metastatic PCa to γδ T cells is related to the presence of prostate cancer stem cells (PCSCs), and we examined their relationship., Materials and Methods: PCa spheres (prostaspheres) were generated from five PCa cell lines, and their susceptibility to cytotoxicity by γδ T cells was investigated. Expression of stemness-related markers was evaluated by qRT-PCR., Results: Prostasphere-derived cancer cells were resistant to lysis by γδ T cells and expressed higher levels of several stemness markers, including CD133, NANOG, SOX2, and OCT4, than the parental PCa cell lines., Conclusion: Ex vivo-expanded γδ T cells are not effective against PCSCs., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
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- 2020
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40. Safety and tolerability of PD-1/PD-L1 inhibitors in elderly and frail patients with advanced malignancies.
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Sakakida T, Ishikawa T, Uchino J, Tabuchi Y, Komori S, Asai J, Arai A, Tsunezuka H, Kosuga T, Konishi H, Hongo F, Inoue M, Hirano S, Ukimura O, Taguchi T, Takayama K, and Itoh Y
- Abstract
The number of elderly patients with cancer has increased due to aging of the population. However, safety of programmed cell death-1 (PD-1) or programed cell death ligand 1 (PD-L1) inhibitors in elderly patients remains controversial, and limited information exists in frail patients. The present study retrospectively identified 197 patients treated with nivolumab, pembrolizumab or atezolizumab for unresectable advanced cancer between September 2014 and December 2018. Patients were divided into the elderly (age, ≥75 years) and non-elderly (age, <75 years) groups. The detailed immune-related adverse events (irAE) profile and development of critical complications were evaluated. To assess tolerability, the proportion of patients who continued PD-1/PD-L1 inhibitor for >6 months was analyzed. In the two groups, a three-element frailty score, including performance status, Charlson Comorbidity Index and neutrophil-lymphocyte ratio, was estimated, and patients were divided into the low-, intermediate- and high-frailty subgroups. Safety and tolerability were evaluated using the aforementioned items. A total of 58 patients (29.4%) were aged ≥75 years. No significant difference was found in the development of irAEs, hospitalization and treatment discontinuation due to irAEs between the two groups. However, the occurrence of unexpected critical complications was significantly higher in the elderly group (P=0.03). Among the elderly patients with high frailty, more critical complications and fatal irAE (hepatitis) were observed. In this population, 33.3% were able to continue treatment for >6 months without disease progression. The present analysis based on real world data showed similar safety and tolerability of PD-1/PD-L1 inhibitors in elderly patients with advanced malignancies. However, the impact of irAE in elderly patients, especially those with frailty, was occasionally greater compared with that in younger and fit patients., (Copyright: © Sakakida et al.)
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- 2020
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41. Remitting seronegative symmetrical synovitis with pitting edema syndrome in maintenance hemodialysis.
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Matsugasumi T, Nakanouchi T, Mikami K, Shiraishi T, Kadoya M, Toriyama S, Taniguchi H, Fujihara A, Hongo F, and Ukimura O
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Introduction: The remitting seronegative symmetrical synovitis with pitting edema syndrome primarily occurs in elderly individuals to represent symptoms of edema, pain, and joint swelling. It could be misdiagnosed in elderly maintenance hemodialysis patients, as hemodialysis patients often present with pain and joint swelling induced by hypervolemia, inflammation, amyloidosis, and/or chronic kidney disease. Here, we describe a maintenance hemodialysis patient with remitting seronegative symmetrical synovitis with pitting edema syndrome., Case Presentation: A 71-year-old man on maintenance hemodialysis who complained of continuous pain and swelling of joints was diagnosed with remitting seronegative symmetrical synovitis with pitting edema syndrome on his clinical findings that revealed tenosynovitis at the joint without joint erosions and no elevation of anti-cyclic citrullinated peptide antibody and rheumatoid factor. After administration of prednisolone, systemic edema, and pain improved in 2 days., Conclusion: Remitting seronegative symmetrical synovitis with pitting edema syndrome should be considered as a differential diagnosis in hemodialysis patients with edema and/or arthralgia., Competing Interests: The authors declare no conflict of interest., (© 2020 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on the behalf of the Japanese Urological Association.)
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- 2020
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42. Intratumoral and s.c. injection of inactivated hemagglutinating virus of Japan envelope (GEN0101) in metastatic castration-resistant prostate cancer.
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Fujita K, Kato T, Hatano K, Kawashima A, Ujike T, Uemura M, Imamura R, Okihara K, Ukimura O, Miki T, Nakajima T, Kaneda Y, and Nonomura N
- Subjects
- Aged, Antibodies, Viral blood, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Resistance, Neoplasm, Humans, Injections, Killer Cells, Natural immunology, Male, Middle Aged, Prostate-Specific Antigen blood, Prostatic Neoplasms, Castration-Resistant immunology, Prostatic Neoplasms, Castration-Resistant pathology, Safety, Oncolytic Virotherapy, Prostatic Neoplasms, Castration-Resistant therapy, Sendai virus immunology, Viral Envelope Proteins immunology
- Abstract
Inactivated hemagglutinating virus of Japan envelope (HVJ-E) has an antitumor effect and tumor immunity. We undertook an open-label, phase I, dose-escalation study in patients with castration-resistant prostate cancer (CRPC) to determine the safety and efficacy of intratumoral and s.c. injection of HVJ-E (GEN0101). Patients with CRPC, who were resistant to or unable to receive standard of care, were included. GEN0101 was injected directly into the prostate and s.c. in two 28-day treatment cycles. The primary end-points were to evaluate the safety and tolerability of GEN0101 and determine its recommended dose. The secondary end-points were to analyze the antitumor effect and tumor immunity. Three patients received 30 000 mNAU GEN0101 and 6 received 60 000 mNAU. There was no dose-limiting toxicity, and the recommended dose of GEN0101 was defined as 60 000 mNAU. Radiographically, 1 patient had stable disease and 2 had progressive disease in the low-dose group, whereas 5 patients had stable disease and 1 had progressive disease in the high-dose group. Three patients in the high-dose group showed reduction in lymph node metastasis. Prostate-specific antigen increase rates in the high-dose group were suppressed more than those in the low-dose group. Natural killer cell activity was enhanced in 2 patients of the low-dose group and in 5 patients in the high-dose group. In conclusion, intratumoral and s.c. injections of GEN0101 were well-tolerated and feasible to use. The study is registered with the UMIN Clinical Trials Registry (no. UMIN000017092)., (© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)
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- 2020
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43. Prostate squamous cell carcinoma developing 11 years after external radiotherapy for prostate adenocarcinoma.
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Matsugasumi T, Nakanishi H, Yokota T, Shiraishi T, and Ukimura O
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Introduction: Secondary bladder, colon, and rectal cancers are relatively common after prostate radiotherapy. However, secondary squamous cell carcinoma of the prostate is rare., Case Presentation: An 85-year-old man presented with dysuria and low-serum prostate-specific antigen levels. His medical history included localized prostate adenocarcinoma (Gleason score of 4 + 5) treated with combined three-dimensional conformal radiotherapy and androgen deprivation therapy, 11 years ago. Urethroscopy and magnetic resonance imaging showed a bulging mass around the prostatic urethra. Transurethral resection of the prostate performed for histopathological diagnosis revealed squamous cell carcinoma., Conclusion: Hereby, a rare case of secondary squamous cell carcinoma of the prostate after radiotherapy for adenocarcinoma was reported, which was found after 11 years of radiotherapy with symptom of dysuria including urinary hesitancy, difficulty, pain during urination, and low-serum prostate-specific antigen levels., Competing Interests: The authors declare no conflict of interest., (© 2020 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.)
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- 2020
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44. Pazopanib after Nivolumab-Induced Tumor Lysis Syndrome in a Patient with Metastatic Clear-Cell Renal Cell Carcinoma.
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Narukawa T, Hongo F, Fujihara A, Ueno A, Matsugasumi T, and Ukimura O
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Nivolumab, a programmed death-1 checkpoint inhibitor, is worldwide available for metastatic renal cell carcinoma (mRCC). Limited data exist on the response to vascular endothelial growth factor receptor-tyrosine kinase inhibitor (TKI) therapy after administration of nivolu-mab. In this case study, we report on a patient with tumor lysis syndrome (TLS), which was induced by pazopanib after the administration of nivolumab. A 69-year-old woman with a primary diagnosis of mRCC received pazopanib as a fourth-line therapy, after sunitinib, axitinib, and nivolumab as first-, second-, and third-line therapies, respectively. Two weeks after the administration of pazopanib, she presented to the emergency room of our institution, complaining of fatigue associated with nausea and diarrhea. Her laboratory results showed hyperphosphatemia, hyperuricemia, hypocalcemia, and possible acute kidney injury; the results were consistent with TLS. Our case report highlights TLS as a potential reaction to pazopanib following nivolumab; and we consider careful observation is necessary when administering TKI after immune checkpoint inhibitors., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2020 by S. Karger AG, Basel.)
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- 2020
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45. Step-by-Step: Fusion-guided prostate biopsy in the diagnosis and surveillance of prostate cancer.
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Nassiri N, Beeder L, Nazemi A, Asanad K, Um J, Gill I, Oishi M, Palmer SL, Aron M, Ukimura O, and Abreu ALC
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- Humans, Male, Prostate pathology, Reproducibility of Results, Ultrasound, High-Intensity Focused, Transrectal methods, Watchful Waiting methods, Image-Guided Biopsy methods, Multiparametric Magnetic Resonance Imaging methods, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology
- Abstract
Competing Interests: None declared.
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- 2019
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46. Phase I study of cancer lesion-targeted microwave coagulation therapy for localized prostate cancer: A pilot clinical study protocol.
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Yamada Y, Shiaishi T, Ueno A, Kaneko M, Inoue Y, Fujihara A, Hongo F, and Ukimura O
- Abstract
Background: Whole-gland therapy for prostate cancer, which might cause more harm than no therapy (observation or active surveillance), might be a overtreatment. In order to avoid overtreatment as well as undertreatment of localize prostate cancer, novel strategy of organ-preserving therapies have been developed to achieve both cancer control and functional preservation. For the therapeutic techniques, microwave ablation would be an option for lesion-targeted focal therapy to eradicate biopsy-proven cancer lesion with its safety margin. Following our recent pilot clinical study of lesion-targeted focal cryotherapy, prospective clinical trial was designed to investigate the safety and therapeutic effects of lesion-targeted microwave therapy for localized prostate cancer., Methods: This is a single-center, phase I, clinical study to evaluate primarily the safety of lesion-targeted focal microwave treatment for prostate cancer. Patients with a magnetic resonance imaging (MRI)-visible, MR-ultrasound image-fusion targeted biopsy-proven clinically significant cancer will be enrolled. The target sample size is 5. Transrectal ultrasound-guided focal microwave ablation will be performed under general anesthesia. The primary endpoint is adverse events after microwave focal therapy. Secondary endpoint includes to assess both cancer control and quality of life (functional preservation)., Discussion: This single-center, phase I, clinical study aims to evaluate the safety and efficacy of lesion-targeted focal microwave treatment for prostate cancer. The importance of this clinical trial is that it may establish new treatment for prostate cancer., Trial Registration: This study was registered with Japan Registry of Clinical Trials (jRCTs052190026)., (© 2019 The Authors.)
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- 2019
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47. Abscopal effect of high-dose-rate brachytherapy on pelvic bone metastases from renal cell carcinoma: a case report.
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Suzuki G, Masui K, Yamazaki H, Takenaka T, Asai S, Taniguchi H, Nakamura T, Ukimura O, and Yamada K
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Radiation therapy is considered an optimal partner for immunotherapies. Several pre-clinical studies have demonstrated that regression of distant metastases, at remote non-irradiated sites of the body, termed the "abscopal effect", can be achieved by an appropriate timing and combination of radiation with immunotherapy. However, nearly all pre-clinical and clinical studies evaluating a combination of radiation and immunotherapies have used external beam radiation therapy. We present in this case report, the abscopal effect observed in a 30-year-old Japanese woman with metastatic renal cell carcinoma after the treatment with high-dose-rate interstitial brachytherapy combined with nivolumab. This is the first published report demonstrating an abscopal effect following brachytherapy for human malignancy. Our case indicates that immuno-oncology effects are not limited to external beam irradiation regimens as they can also be attained by brachytherapy., Competing Interests: The authors report no conflict of interest., (Copyright: © 2019 Termedia Sp. z o. o.)
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- 2019
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48. Direct conversion of fibroblasts into urothelial cells that may be recruited to regenerating mucosa of injured urinary bladder.
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Inoue Y, Kishida T, Kotani SI, Akiyoshi M, Taga H, Seki M, Ukimura O, and Mazda O
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- Animals, Cell Culture Techniques, Cell Line, Cystitis, Interstitial genetics, Disease Models, Animal, Epithelial Cells metabolism, Female, Hepatocyte Nuclear Factor 3-alpha genetics, Humans, Induced Pluripotent Stem Cells cytology, Induced Pluripotent Stem Cells metabolism, Kruppel-Like Factor 4, Kruppel-Like Transcription Factors genetics, Mice, Proto-Oncogene Proteins c-myc genetics, Skin metabolism, Transduction, Genetic, Tumor Suppressor Proteins genetics, Urothelium metabolism, Cystitis, Interstitial therapy, Epithelial Cells cytology, Skin cytology, Transcription Factors genetics, Urothelium cytology, Urothelium transplantation
- Abstract
Urothelial cells play essential roles in protection of urine exudation and bacterial invasion at the urothelial mucosa, so that defect or damage of urothelial cells associated with urinary tract diseases may cause serious problems. If a sufficient number of functional urothelial cells are prepared in culture and transplanted into the damaged urothelial lesions, such technology may provide beneficial effects to patients with diseases of the urinary tract. Here we found that human adult dermal fibroblasts were converted into urothelial cells by transducing genes for four transcription factors, FOXA1, TP63, MYCL and KLF4 (FTLK). The directly converted urothelial cells (dUCs) formed cobblestone-like colonies and expressed urothelium-specific markers. dUCs were successfully expanded and enriched after serial passages using a specific medium that we optimized for the cells. The passaged dUCs showed similar genome-wide gene expression profiles to normal urothelial cells and had a barrier function. The FTLK-transduced fibroblasts were also converted into urothelial cells in vivo and recruited to the regenerating urothelial tissue after they were transplanted into the bladder of mice with interstitial cystitis. Our technology may provide a promising solution for a number of patients with urinary tract disorders.
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- 2019
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49. Clinical features of immune-related thyroid dysfunction and its association with outcomes in patients with advanced malignancies treated by PD-1 blockade.
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Sakakida T, Ishikawa T, Uchino J, Chihara Y, Komori S, Asai J, Narukawa T, Arai A, Kobayashi T, Tsunezuka H, Kosuga T, Konishi H, Hongo F, Inoue M, Hirano S, Ukimura O, Itoh Y, Taguchi T, and Takayama K
- Abstract
Programmed cell death protein-1 (PD-1) blockade therapy has improved outcomes in the treatment of advanced cancers. The therapy is well-tolerated, although it occasionally causes immune-related adverse events (irAEs). Thyroid dysfunction is one of the most common irAEs seen. Our aim was to clarify the clinical characteristics of thyroid dysfunction induced by PD-1 blockade and its association with the therapeutic effect of the treatment in advanced cancers. A total of 174 patients who received nivolumab or pembrolizumab for metastatic or unresectable advanced cancers were included in this retrospective study. The patients were divided into two groups: The thyroid dysfunction group and the euthyroid group. In the present study, the clinical characteristics, the association with anti-thyroid antibodies, as well as the progression-free survival (PFS) and overall survival (OS) were estimated. An adjusted Cox proportional hazard regression model was used to evaluate prognostic factors for OS and PFS. This study showed that 25 out of 150 patients (16.7%) developed immune-related thyroid dysfunction. Hypothyroidism occurred in the early stage of the clinical course (median: 12 weeks); subsequently, 9 of the 25 patients underwent a transient period of hyperthyroidism, all with mild symptoms. The presence of positive anti-thyroid antibodies at baseline was significantly higher in the thyroid dysfunction group (13/22) than in the euthyroid group (18/100, P=0.0002). Moreover, PFS (median: 66 vs. 27 weeks, hazard ratio (HR): 0.50, 95% CI: 0.26-0.89, P=0.02) and OS (median 156 vs. 59 weeks, HR: 0.34, 95% CI: 0.13-0.75, P=0.01) were significantly longer in the thyroid dysfunction group than in the euthyroid group. Multivariable analysis also revealed that thyroid dysfunction was an independent prognostic factor for OS (HR: 0.42, 95% CI: 0.16-0.97, P=0.04). These findings may enable the early recognition and appropriate management of thyroid dysfunction, and help in maximizing the therapeutic effect of PD-1 blockade.
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- 2019
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50. Robot-assisted laparoscopic partial nephrectomy for horseshoe kidney: A case report.
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Fujihara A, Hongo F, Narukawa T, Nomura T, Yamada Y, and Ukimura O
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Introduction: Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal cell carcinoma in a horseshoe kidney, who underwent tumor resection by robot-assisted laparoscopic partial nephrectomy based on preoperative three-dimensional computed tomography., Case Presentation: A 66-year-old man was referred to our hospital with a 2-cm enhancing mid-pole mass in the left moiety of a horseshoe kidney. The clinical diagnosis was renal cell carcinoma cT1aN0M0 (R.E.N.A.L. nephrometry score: 1 + 2 + 3 + 3 = 9p). Robot-assisted laparoscopic partial nephrectomy was performed with selective clamping based on reconstructed three-dimensional images. The warm ischemia time was 13 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 6 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact., Conclusion: Robot-assisted laparoscopic partial nephrectomy with preoperative three-dimensional computed tomography may have advantages for resection of tumors in patients with horseshoe kidney., Competing Interests: The authors declare no conflict of interest., (© 2019 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.)
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- 2019
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