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Objectives To determine the significance of molecular diagnosis of lymph node metastasis using quantitative reverse transcription polymerase chain reaction in patients with upper urinary tract urothelial cancer. Methods A total of 51 patients with upper urinary tract urothelial cancer who underwent extended lymphadenectomy were included in the present study. Retrieved lymph nodes from each patient were divided into two parts. One part was assessed by quantitative reverse transcription polymerase chain reaction assay for molecular staging, whereas the other one was assessed by routine histopathological examination. Four kinds of molecules (FXYD3, KRT19, KRT20 and UPK2) were selected as markers to detect urothelial cancer cells. Results The average number of retrieved lymph nodes was 18.3. As UPK2 showed the best discrimination ability among four markers, the patients were classified in three categories according to UPK2 expression: N(+)PCR(+) for patients who had lymph node metastasis by routine pathological diagnosis as well as quantitative reverse transcription polymerase chain reaction (n = 4); N(−)PCR(+) for patients who had lymph node metastasis by polymerase chain reaction but not by routine pathological diagnosis (n = 7); and N(−)PCR(−) for patients who showed no lymph node metastasis not only by routine pathological diagnosis but also by polymerase chain reaction (n = 40). The prognosis of the N(−)PCR(+) group was better than that of the N(+)PCR(+) group, and similar to that of the N(−)PCR(−) group. Conclusions Quantitative reverse transcription polymerase chain reaction could detect micrometastasis in patients with upper urinary tract urothelial cancer. However, the prognosis of patients with micrometastasis is better than patients with pathologically metastasized lymph nodes, and similar to patients without micrometastasis.

Objectives To identify biomarkers predicting prognosis in bladder cancer patients undergoing the gemcitabine and cisplatin regimen. Methods We studied 52 patients with metastatic bladder cancer treated with the gemcitabine and cisplatin regimen by evaluating the relationship between the expression of two biomarkers, ribonucleotide reductase subunit M1 and excision repair cross complementing 1, by immunohistochemistry and clinical outcomes. Results The patients with low expression of ribonucleotide reductase subunit M1 showed a higher objective response rate by the gemcitabine and cisplatin regimen than those with high expression of ribonucleotide reductase subunit M1 (80.0% and 45.5%, respectively). No differences were observed according to the expression level of excision repair cross complementing 1. Low expression of ribonucleotide reductase subunit M1 significantly prolonged overall survival and progression-free survival compared with the high expression group. Low expression of excision repair cross complementing 1 tended to prolong overall survival and progression-free survival, but there were no significant differences (P = 0.07 and 0.10, respectively). Multivariate analysis showed that the expression of ribonucleotide reductase subunit M1 was the only independent prognostic factor (P = 0.012). Conclusions The expressions of ribonucleotide reductase subunit M1 seem to be associated with clinical response and survival in patients with metastatic bladder cancer treated with gemcitabine and cisplatin-based chemotherapy.

A 78-year-old woman presented with macroscopic hematuria. We diagnosed giant hydronephrosis with a left ureteral stone and multiple renal pelvic carcinoma cT3N0M0 tumors.Open nephroureterectomy proceeded via a peritoneal approach, and 8,600 mL of urine were collected from the renal pelvis. The pelvic carcinoma was histologically confirmed as a rare giant cell variant with high malignant potential. The same variant was found in the upper ureter where a 15-mm stone had lodged. We considered that this was due to rapid progression of the renal pelvic giant cell carcinoma and hydronephrosis during the month before surgery.Multiple lung and bone metastases occurred after three courses of gemcitabine/cisplatin combination chemotherapy as postoperative adjuvant therapy. Therefore, radiotherapy for bone metastasis and gemcitabine/paclitaxel combination chemotherapy were performed concurrently.

Objective: It remains unclear whether lymphadenectomy alters regional node recurrence after nephroureterectomy in patients with urothelial carcinoma of the renal pelvis. The predictive factors for regional node recurrence are still unclear. In this study, we retrospectively examined how the extent of lymphadenectomy influences regional node recurrence in patients with urothelial carcinoma of the renal pelvis. Methods: From January 1988 through July 2013, we performed nephroureterectomy in 180 patients with non-metastatic (cN0M0) urothelial carcinoma of the renal pelvis at two Japanese institutes. Regional nodes were determined according to our previous mapping study: complete lymphadenectomy designates that all regional sites were dissected; incomplete lymphadenectomy that all sites were not dissected. A third group included those without lymphadenectomy. Results: The 5-year cancer-specific and recurrence-free survival was significantly higher in the complete lymphadenectomy group than in the incomplete lymphadenectomy or without lymphadenectomy groups (P ¼ 0.03). The incidence of regional node recurrence was significantly lower in the complete lymphadenectomy group at 2.9% (2/67) than in the incomplete lymphadenectomy at 18.1% (4/22) or without lymphadenectomy at 10.9% (10/91) groups (P ¼ 0.03). In patients with incomplete lymphadenectomy, 75% of regional node recurrence occurred outside of the dissected sites. Complete lymphadenectomy is shown to be a likely predictive factor of reduced risk of recurrence at the regional nodes by multivariate analysis, after adjusting for patient age, pathological T stage, and pathological nodal metastases. Conclusions: This study shows that template-based lymphadenectomy reduced the risk of regional node recurrence in patients with urothelial carcinoma of the renal pelvis and appears to result in improved survival.

Objective To validate two prediction models (European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment) for recurrence and progression of non-muscle invasive bladder cancer in Japanese patients who underwent bacillus Calmette–Guerin instillation therapy. Methods From March 1985 to April 2007, data were analyzed from 366 patients who underwent transurethral resection of bladder tumor followed by bacillus Calmette–Guerin instillation therapy. The ability of two scoring models to predict recurrence and progression was assessed by concordance index. Results For recurrence probability, the concordance index of the European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.514 and 0.576, respectively, which was lower than that (0.604) of a selected single prognostic factor (age) by our multivariate analysis. For progression probability, the concordance index of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.693 and 0.764, respectively, which was higher than that (0.633) of a selected single factor (T stage) by our multivariate analysis. The Spanish Urological Club for Oncological Treatment scoring system resulted in better stratification of tumor recurrence and progression when compared with the European Organization for Research and Treatment of Cancer model, probably because more patients underwent bacillus Calmette–Guerin treatment in the Spanish Urological Club for Oncological Treatment cohort than in the European Organization for Research and Treatment of Cancer cohort. Conclusions The Spanish Urological Club for Oncological Treatment scoring system is a good predictor of tumor recurrence and progression in Japanese patients who underwent bacillus Calmette–Guerin immunotherapy. A large prospective study is warranted to confirm the efficacy of this system.

Our previous nonrandomized prospective study showed that template-based lymphadenectomy improved survival among patients with renal pelvic cancer but not among patients with ureteral cancer. However, regional node sites vary according to the tumor’s location in relation to the ureter. Therefore, this retrospective study examined the therapeutic role of lymphadenectomy for ureteral cancer according to tumor location. Between January 1988 and September 2015, we performed nephroureterectomy for 154 patients with nonmetastatic urothelial carcinoma of the ureter at two Japanese institutions. The tumors’ locations were classified as the lower ureter or the upper/middle ureter (before the cranial crossing of the common iliac artery). The appropriate regional nodes were identified based on our previous mapping study. Dissection was classified as complete lymphadenectomy (all regional sites were dissected), incomplete lymphadenectomy (not all sites were dissected), or no lymphadenectomy. We focused the analyses on patients with ≥pT2 disease to clarify the effect of the lymphadenectomy. Among the 48 patients with upper/middle ureteral cancer, recurrence-free and cancer-specific survival were significantly higher in the complete lymphadenectomy group (vs. the incomplete or no lymphadenectomy groups). However, there were no differences in recurrence-free and cancer-specific survivals among the 56 patients with lower ureteral cancer. In the patients with upper/middle ureteral cancer, multivariate analysis revealed that template-based lymphadenectomy was independently associated with a reduced risk of cancer-specific mortality. Template-based lymphadenectomy has a therapeutic benefit for treating patients with upper/middle ureteral cancer but not for treating patients with lower ureteral cancer.

Background While novel drugs have been developed, docetaxel remains one of the standard initial systemic therapies for castration-resistant prostate cancer (CRPC) patients. Despite the excellent anti-tumor effect of docetaxel, its severe adverse effects sometimes distress patients. Therefore, it would be very helpful to predict the efficacy of docetaxel before treatment. The aims of this study were to evaluate the potential value of patient characteristics in predicting overall survival (OS) and to develop a risk classification for CRPC patients treated with docetaxel-based chemotherapy. Methods This study included 79 patients with CRPC treated with docetaxel. The variables, including patient characteristics at diagnosis and at the start of chemotherapy, were retrospectively collected. Prognostic factors predicting OS were analyzed using the Cox proportional hazard model. Risk stratification for overall survival was determined based on the results of multivariate analysis. Results PSA response ≥50 % was observed in 55 (69.6 %) of all patients, and the median OS was 22.5 months. The multivariate analysis showed that age, serum PSA level at the start of chemotherapy, and Hb were independent prognostic factors for OS. In addition, ECOG performance status (PS) and the CRP-to-albumin ratio were not significant but were considered possible predictors for OS. Risk stratification according to the number of these risk factors could effectively stratify CRPC patients treated with docetaxel in terms of OS. Conclusions Age, serum PSA level at the start of chemotherapy, and Hb were identified as independent prognostic factors of OS. ECOG PS and the CRP-to-albumin ratio were not significant, but were considered possible predictors for OS in Japanese CRPC patients treated with docetaxel. Risk stratification based on these factors could be helpful for estimating overall survival.

We extend the Hubble diagram up to $z = 5.6$ using 63 gamma-ray bursts (GRBs) via peak energy-peak luminosity relation (so called Yonetoku relation), and obtain constraints on cosmological parameters including dynamical dark energy parametrized by $P/\rho\equiv w(z) = w_0 + w_a \cdot z/(1+z)$. It is found that the current GRB data are consistent with the concordance model, ($\Omega_m = 0.28, \Omega_{\Lambda} = 0.72, w_0 = -1, w_a = 0$), within two sigma level. Although constraints from GRBs themselves are not so strong, they can improve the conventional constraints from SNeIa because GRBs have much higher redshifts. Further we estimate the constraints on the dark-energy parameters expected by future observations with GLAST (Gamma-ray Large Area Space Telescope) and \swift by Monte-Carlo simulation. Constraints would improve substantially with another 150 GRBs., Comment: 5 pages, 6 figures. Submitted tu MNRAS

We calibrated the peak energy–peak luminosity relation of gamma-ray bursts (GRBs; the so-called Yonetoku relation) using 33 events with redshift z < 1.62 without assuming any cosmological models. The luminosity distances to GRBs are estimated from those of large numbers of Type Ia supernovae with z < 1.755. This calibrated Yonetoku relation can be used as a new cosmic distance ladder towards higher redshifts. We determined the luminosity distances of 30 GRBs in 1.8 < z < 5.6 using the calibrated relation, and plotted the likelihood contour in the (Ωm, ΩΛ) plane. We obtained (Ωm, ΩΛ) = (0.37+0.14−0.11, 0.63+0.11−0.14) for a flat universe. Because our method is free from the circularity problem, we can say that our universe in 1.8 < z < 5.6 is compatible with the so-called concordance cosmological model derived for z < 1.8. This suggests that the time variation of the dark energy is small or zero up to z∼ 6.

We compared redshifts zY measured from the Yonetoku relation and zlag from the lag–luminosity relation for 565 BATSE gamma-ray bursts (GRBs) and were surprised to find that the correlation between these two redshifts is very low. Assuming that the luminosity is a function of both zY and the intrinsic spectral lag τlag, we found a new redshift-dependent lag–luminosity relation L= 7.5 × 1050 erg s−1 (1 +z)2.53τ−0.282lag with the correlation coefficient of 0.77 and the chance probability of 7.9 × 10−75. Although the spectral lag is computed from two channels of the Burst and Transient Source Experiment (BATSE), our new lag–luminosity relation suggests that a future lag–luminosity relation defined in the Swift data should also depend on the redshift.

著者人数: 42名, Accepted: 2007-08-24, 資料番号: SA1000710000

INTRODUCTION AND OBJECTIVES: In patients with upper urinary tract urothelial cancer (UTUC), the significance of lymphadenectomy not only in diagnostic aspect but also in therapeutic benefit has not been clarified yet. In order to examine its significance, we are currently conducting a prospective clinical trial of extended lymphadenectomy in patients with UTUC. Furthermore, we applied qRT-PCR technique to retrieved lymph nodes by extended lymphadenectomy in patients with UTUC for more accurate and sensitive diagnosis. In addition, We examined the association with the clinicopathologic findings and prognosis. METHODS: We included 41 patients with UTUC who underwent extended lymphadenectomy. Tissue sections of retrieved LNs from each patient were divided in two parts. One of them was assessed by qRT-PCR assay, and the other one was assessed by routine pathological examination. Four kinds of molecules (FXYD3, KRT19, KRT20, UPK2) were selected as markers to detect urothelial cancer cells. In addition, about a representative sample, We performed the immunohistological examination in order to perform a supplementary examination of the qRT-PCR result. We regarded specimen in which all marker molecules was positive as presence of micrometastasis. RESULTS: As total, 21 out of 738 LNs (2.8%) showed amplification of all marker. In 4 out of 41 patients (9.8%), LN metastasis was confirmed by not only qRT-PCR but also by histological examination. In 7 patients (17.1%), amplification of all marker genes was observed by qRT-PCR without evidence of metastasis by histological examination, indicating the presence of micrometastais. Based on this result, We divided the 41 patients into three groups and evaluated the association with conventional prognostic factors or progression free survival. qRT-PCR findings was associated with the lymphovascular invasion (p

The aim of this study was to evaluate the effect of zoledronic acid (ZA) on bone mineral density (BMD) in patients with prostate cancer receiving combined androgen blockade (CAB) as a first-line androgen deprivation therapy. Patients receiving CAB for prostate cancer without bone metastasis were candidates for this study. Forty-two patients were randomly assigned to receive either ZA or no treatment. BMD were measured at baseline and at 12 months. Bone-turnover markers, including cross-linked N-telopeptide of type I collagen (NTX), C-telopeptide of type I collagen (ICTP), and bone-specific alkaline phosphatase (BAP), were assessed during study periods. Patients on ZA maintained BMD after a year of treatment. Change in T-score from baseline differed significantly between the two groups (P=0.009). An inverse correlation was demonstrated between baseline and change in T-score in the ZA group. While ZA prevented an increase in ICTP and BAP, the increase in NTX was suppressed only in patients with low baseline T-score. ZA prevented a decrease in BMD in patients undergoing CAB, especially those with lower baseline BMD.

Recent studies showed the therapeutic benefit of lymphadenectomy in advanced stage urothelial carcinoma of the upper urinary tract, but there is still a lack of prospective studies and standardization of the extent of lymphadenectomy. The aim of this multi-institutional study was to examine the role of lymphadenectomy in urothelial carcinoma of the upper urinary tract.From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and lymphadenectomy for non-metastatic (cN0M0) urothelial carcinoma of the upper urinary tract were included in a prospective study at two Japanese institutions(lymphadenectomy group). Lymphadenectomies were carried out according to definite anatomical template. Results from this group were compared with those from a control group of 89 patients who did not receive lymphadenectomy during the study period (no lymphadenectomy group).In patients with urothelial carcinoma of the upper urinary tract in the renal pelvis of pathological stage 2 or higher, template-based lymphadenectomy resulted in significantly higher cancer-specific survival (89.8% and 51.7%, P = 0.01) and overall survival (86.1% and 48.0%, P = 0.01). Disease-free survival tended to be higher in the lymphadenectomy group(77.8% and 50.0%, P = 0.06). Template-based lymphadenectomy was a significant independent factor for reducing the risk of cancer death in patients with renal pelvic cancer of ≥ pT2 by multivariate analysis. In contrast, cancer-specific survival of patients with ureteral urothelial carcinoma of the upper urinary tract was not significantly different between the lymphadenectomy and no lymphadenectomy groups.This multi-institutional prospective study further supports the therapeutic role of template-based lymphadenectomy in patients with advanced-stage urothelial carcinoma of the upper urinary tract in the renal pelvis. This is not the case for patients with ureteral urothelial carcinoma of the upper urinary tract.

INTRODUCTION AND OBJECTIVES: We previously reported improvement of patient survival by template-based lymphadenectomy in patients with renal pelvic cancer. It remains unclear, however, whether lymphadenectomy reduces the risk of recurrence in the regional nodes. In this study, we retrospectively examined how the extent of lymphadenectomy influenced regional node recurrence in these patients. METHODS: From January 1988 through July 2013, we performed nephroureterectomy in 180 patients with non-metastatic (cN0M0) urothelial carcinoma of the renal pelvis at two Japanese institutes. Regional nodes were determined according to our previous mapping study: complete lymphadenectomy (CompLND) designates that all regional sites were dissected; incomplete lymphadenectomy (IncompLND) that all sites were not dissected. A 3rd group included those without lymphadenectomy (No-LND). Sites of recurrence were examined by imaging studies. RESULTS: Five-years recurrence-free survival was significantly higher in the CompLND group than in the IncompLND or No LND groups (84.1%, 67.5%, 66.1%, p1⁄40.04). The incidence of regional node recurrence was significantly lower in the CompLND group at 2.9% (2/ 67) than in the IncompLND at 18.1% (4/22) or No LND at 10.9% (10/91) groups (p1⁄40.03). We divided the pattern of regional node recurrence into two categories, recurrence at sites of dissection (Intra-LND recurrence) and that outside these sites (Extra-LND recurrence). The Figure here shows that 2 patients with CompLND and 1 of 4 patients with IncompLND experienced Intra-LND recurrence, but all these patients showed pathological node metastases. Extra-LND recurrence was 0% in CompLND, 3/4 (75%) in IncompLND, and 10/10 (100%) in No LND. The incidence of distant metastasis without lymph node involvement was not significantly different among the 3 groups. Cancer-specific survival was significantly higher in the CompLND group than in the IncompLND or No LND groups (90.6% versus 65.0% versus 70.2%, p1⁄40.03). CONCLUSIONS: This multi-institutional study shows that template-based lymphadenectomy reduced the risk of regional node recurrence in patients with renal pelvic cancer, which appears to result in improved survival.

In December 2003, a 32-year-old man underwent puncture for right renal cyst at a clinic. Since puncture fluid was dark red color in spite of negative cytology, he was being followed, but after a while he did not show up for further examination. In November 2007, he revisited the clinic due to low-grade fever. Computed tomographic findings showed an enlarged cystic mass with a solid component invading the liver and lymph node swelling. He underwent right radical nephrectomy combined with partial liver resection and lymphadenectomy. Histological findings showed collecting duct carcinoma associated with clear cell carcinoma directly invading the liver with lymph node metastasis (pT4N2M0). Although he underwent 4 cycles of gemcitabine-cisplatin therapy and alfa interferon injection 3 times a week thereafter as adjuvant setting, multiple liver metastasis occurred 15 months after surgery. He died of cancer 31 months after surgery in spite of molecular targeted therapy including sorafenib and sunitinib.

The small solar power sail demonstrator "IKAROS" is a Japanese engineering verification spacecraft launched by H-IIA rocket on May 21, 2010 at JAXA Tanegashima Space Center. IKAROS has a huge sail with 20 m in diameter which is made of thin polyimide membrane. This sail converts the solar radiation-pressure into the propulsion force of IKAROS and accelerates the spacecraft. The Gamma-Ray Burst Polarimeter (GAP) aboard IKAROS is the first polarimeter to observe the gamma-ray polarization of Gamma-Ray Bursts (GRBs) during the IKAROS cruising phase. GAP is a tinny detector of 3.8 kg in weight and 17 cm in size with an energy range between 50-300 keV. The GAP detector also plays a role of the interplanetary network (IPN) to determine the GRB direction. The detection principle of gamma-ray polarization is the anisotropy of the Compton scattering. GAP works as the GRB polarimeter with the full coincidence mode between the central plastic and the surrounding CsI detectors. GAP is the first instrument, devoted for the observation of gamma-ray polarization in the astronomical history. In this paper, we present the GAP detector and its ground and onboard calibrations., Submitted to Publications of the Astronomical Society of Japan (PASJ), 23 pages, 14 figures

We have performed ToO observations for three bright GRBs with the Japanese X‐ray satellite “Suzaku”. Suzaku strongly supports the follow‐up observations by Swift, especially in the late time afterglow phase, with its capabilities of larger effective area and wider energy band compared with Swift/XRT. In this presentation, mainly focusing on the X‐ray afterglow of GRB 060904A, we introduce these ToO observation results. In GRB 060904A, we found rapid spectral softening with the photon indices from 1.5 to 5.3 during the steep decay (prompt tail) phase in the BAT and XRT data. This ultra soft spectra suddenly disappeared at the transition time from the prompt tail phase to the shallow decay one. After that, typical afterglow spectra with the photon indices of 2.0 are continuously and preciously monitored by both XRT and Suzaku/XIS up to 1 day since the burst trigger time. To explain this ultra soft spectra, we introduce a spectral cutoff model instead of power‐law, and investigate the possibility of the maxi...

We consider two empirical relations using data only from the prompt emission of Gamma-Ray Bursts (GRBs), peak energy ($E_p$) - peak luminosity ($L_p$) relation (so called Yonetoku relation) and $E_p$-isotropic energy ($E_{\rm iso}$) relation (so called Amati relation). We first suggest the independence of the two relations although they have been considered similar and dependent. From this viewpoint, we compare constraints on cosmological parameters, $\Omega_m$ and $\Omega_{\Lambda}$, from the Yonetoku and Amati relations calibrated by low-redshift GRBs with $z < 1.8$. We found that they are different in 1-$\sigma$ level, although they are still consistent in 2-$\sigma$ level. This and the fact that both Amati and Yonetoku relations have systematic errors larger than statistical errors suggest the existence of a hidden parameter of GRBs. We introduce the luminosity time $T_L$ defined by $T_L\equiv E_{\rm iso}/L_p$ as a hidden parameter to obtain a generalized Yonetoku relation as $(L_p/{10^{52} \rm{erg s^{-1}}}) = 10^{-3.88\pm0.09}(E_p/{\rm{keV}})^{1.84\pm0.04} (T_L/{\rm{s}})^{-0.34\pm0.04}$. The new relation has much smaller systematic error, 30%, and can be regarded as "Fundamental plane" of GRBs. We show a possible radiation model for this new relation. Finally we apply the new relation for high-redshift GRBs with $1.8 < z < 5.6$ to obtain $(\Omega_m,\Omega_{\Lambda}) = (0.16^{+0.04}_{-0.06},1.20^{+0.03}_{-0.09})$, which is consistent with the concordance cosmological model within 2-$\sigma$ level., Comment: 5 pages, 6 figures, published in JCAP

We compared redshifts $z_Y$ from Yonetoku relation and $z_{lag}$ from the lag-luminosity relation for 565 BASTE GRBs and were surprised to find that the correlation is very low. Assuming that the luminosity is a function of both $z_Y$ and the intrinsic spectral lag $\tau_{lag}$, we found a new redshift dependent lag-luminosity relation as $L=7.5\times 10^{50}{\rm erg/s}(1+z)^{2.53}\tau_{lag}^{-0.282}$ with the correlation coefficient of 0.77 and the chance probability of $7.9\times 10^{-75}$. To check the validity of this method, we examined the other luminosity indicator, Amati relation, using $z_Y$ and the observed fluence and found the correlation coefficient of 0.92 and the chance probability of $5.2\times 10^{-106}$. Although the spectral lag is computed from two channels of BATSE, our new lag-luminosity relation suggests that a possible lag-luminosity relation in the \swift era should also depend on redshift.

A 50-year-old woman underwent surgical resection of a left adrenocortical carcinoma in April 2000. Bilateral pulmonary metastases and abdominal lymph node metastasis were detected in June 2001. After radiation therapy for the abdominal lymph node metastasis, a pulmonary metastatic lesion was thoracoscopically resected. The specimen was subjected to histoculture drug response assay (HDRA), and results revealed that this tumor was sensitive for cisplatin. We therefore performed concurrent chemoradiotherapy including cisplatin for the residual pulmonary metastatic lesion; a complete response was then obtained. Standard protocols of chemotherapy are often absent for malignant tumors, such as in this case, with low incidences. HDRA seems useful for chemotherapy agent selection in cases of rare malignant tumors.

Introduction and objective Human Equilibrative Nucleoside Transporter 1 (hENT1) and Ribonucleotide reductase M1 (RRM1) play important roles in pharmacokinetics of gemcitabine, and excision repair cross-complementing 1 (ERCC1) is related to drug resistance to CDDP. We evaluated the expression level of these molecules in patients with metastatic bladder cancer treated with gemcitabine—cisplatin (GC)-based chemotherapy. Methods Clinical data were retrieved from the databases from May 2002 to October 2011 in 40 patients (age 35–88; male 36; female 4) with advanced bladder cancer treated by GC (Gemcitabine + Cisplatin) regimen (17 patients) and GCT (GC + Paclitaxel) regimen (23 patients). Inclusion criteria for this study were clinically and/or histologically documented advanced and/or metastatic (stage 4) bladder cancer. We carried out immunohistochemical staining chemo-naive primary bladder tumor specimens with specific hENT1, RRM1 and ERCC1 antibodies. Pathologist blinded to clinical outcomes evaluated the expression level of these molecules. The clinical and histopathological data were analyzed to evaluate predictive factors. Results With regards to anti tumor response, high hENT1 expression group showed better clinical response comparing with low hENT1 expression group (90% versus 35%, P = 0.001). High hENT1 expression group and low RRM1 expression group showed significantly better survival (log-tank test P Conclusions The expression of hENT1 and RRM1 was associated with prolonged survival in patients with metastatic bladder cancer treated with GC-based chemotherapy. The combined analysis of hENT1 and RRM1 expression can be a promising biomarker which can predict the clinical response and the prognosis of patients with advanced bladder cancer treated by gemcitabine-based chemotherapy.

Objectives Recent studies showed the therapeutic benefit of lymphadenectomy in advanced stage urothelial carcinoma of the upper urinary tract, but there is still a lack of prospective studies and standardization of the extent of lymphadenectomy. The aim of this multi-institutional study was to examine the role of lymphadenectomy in urothelial carcinoma of the upper urinary tract. Methods From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and lymphadenectomy for non-metastatic (cN0M0) urothelial carcinoma of the upper urinary tract were included in a prospective study at two Japanese institutions (lymphadenectomy group). Lymphadenectomies were carried out according to definite anatomical template. Results from this group were compared with those from a control group of 89 patients who did not receive lymphadenectomy during the study period (no lymphadenectomy group). Results In patients with urothelial carcinoma of the upper urinary tract in the renal pelvis of pathological stage 2 or higher, template-based lymphadenectomy resulted in significantly higher cancer-specific survival (89.8% and 51.7%, P = 0.01) and overall survival (86.1% and 48.0%, P = 0.01). Disease-free survival tended to be higher in the lymphadenectomy group (77.8% and 50.0%, P = 0.06). Template-based lymphadenectomy was a significant independent factor for reducing the risk of cancer death in patients with renal pelvic cancer of ≥pT2 by multivariate analysis. In contrast, cancer-specific survival of patients with ureteral urothelial carcinoma of the upper urinary tract was not significantly different between the lymphadenectomy and no lymphadenectomy groups. Conclusions This multi-institutional prospective study further supports the therapeutic role of template-based lymphadenectomy in patients with advanced-stage urothelial carcinoma of the upper urinary tract in the renal pelvis. This is not the case for patients with ureteral urothelial carcinoma of the upper urinary tract.

We report polarization measurements in two prompt emissions of gamma-ray bursts, GRB 110301A and GRB 110721A, observed with the Gamma-ray burst polarimeter (GAP) aboard IKAROS solar sail mission. We detected linear polarization signals from each burst with polarization degree of $\Pi = 70 \pm 22$% with statistical significance of $3.7 \sigma$ for GRB 110301A, and $\Pi = 84^{+16}_{-28}$% with $3.3 \sigma$ confidence level for GRB 110721A. We did not detect any significant change of polarization angle. These two events had shorter durations and dimmer brightness compared with GRB 100826A, which showed a significant change of polarization angle, as reported in Yonetoku et al. (2011). Synchrotron emission model can be consistent with all the data of the three GRBs, while photospheric quasi-thermal emission model is not favorable. We suggest that magnetic field structures in the emission region are globally-ordered fields advected from the central engine., Comment: Accepted for publication to ApJL (7 pages, 3 figures)

We report the polarization measurement in prompt $\gamma$-ray emission of GRB 100826A with the Gamma-Ray Burst Polarimeter (GAP) aboard the small solar power sail demonstrator IKAROS. We detected the firm change of polarization angle (PA) during the prompt emission with 99.9% ($3.5 \sigma$) confidence level, and the average polarization degree ($\Pi$) of $27 \pm 11$% with 99.4% ($2.9 \sigma$) confidence level. Here the quoted errors are given at 1 $\sigma$ confidence level for two parameters of interest. The systematic errors have been carefully included in this analysis, unlike any previous reports. Such a high $\Pi$ can be obtained in several emission models of gamma-ray bursts (GRBs), including synchrotron and photospheric models. However, it is difficult to explain the observed significant change of PA within the framework of axisymmetric jet as considered in many theoretical works. The non-axisymmetric (e.g., patchy) structures of the magnetic fields and/or brightness inside the relativistic jet are therefore required within the observable angular scale of $\sim \Gamma^{-1}$. Our observation strongly indicates that the polarization measurement is a powerful tool to constrain the GRB production mechanism, and more theoretical works are needed to discuss the data in more details., Comment: 6 pages, 3 figures, accepted for publication in ApJL