2021/12/16 更新

写真a

カタヤマ サトシ
片山 聡
Katayama Satoshi
所属
岡山大学病院 助教(特任)
職名
助教(特任)
外部リンク

学位

  • 学士 ( 関西医科大学 )

研究キーワード

  • 泌尿器悪性腫瘍

研究分野

  • ライフサイエンス / 泌尿器科学

 

論文

  • Preoperative plasma level of endoglin as a predictor for disease outcomes after radical cystectomy for nonmetastatic urothelial carcinoma of the bladder. 国際誌

    Ekaterina Laukhtina, Victor M Schuettfort, David D'Andrea, Benjamin Pradere, Keiichiro Mori, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Satoshi Katayama, Nico С Grossmann, Pawel Rajwa, Flora Zeinler, Mohammad Abufaraj, Marco Moschini, Kristin Zimmermann, Pierre I Karakiewicz, Harun Fajkovic, Douglas Scherr, Eva Compérat, Peter Nyirady, Michael Rink, Dmitry Enikeev, Shahrokh F Shariat

    Molecular carcinogenesis   61 ( 1 )   5 - 18   2022年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Elevated preoperative plasma level of endoglin has been associated with worse oncologic outcomes in various malignancies. The present large-scale study aimed to determine the predictive and prognostic values of preoperative endoglin with regard to clinicopathologic and survival outcomes in patients treated with radical cystectomy (RC) for nonmetastatic urothelial carcinoma of the bladder (UCB). We prospectively collected preoperative blood samples from 1036 consecutive patients treated with RC for UCB. Logistic and Cox regression analyses were undertaken to assess the correlation of endoglin levels with pathologic and survival outcomes, respectively. The AUC and C-index were used to assess the discrimination. Patients with adverse pathologic features had significantly higher median preoperative endoglin plasma levels than their counterparts. Higher preoperative endoglin level was independently associated with an increased risk for lymph node metastasis, ≥pT3 disease, and nonorgan confined disease (NOCD; all p < 0.001). Plasma endoglin level was also independently associated with cancer-specific and overall survival in both pre- and postoperative models (all p < 0.05), as well as with recurrence-free survival (RFS) in the preoperative model (p < 0.001). The addition of endoglin to the preoperative standard model improved its discrimination for prediction of lymph node metastasis, ≥pT3 disease, NOCD, and RFS (differential increases in C-indices: 10%, 5%, 5.8%, and 4%, respectively). Preoperative plasma endoglin is associated with features of biologically and clinically aggressive UCB as well as survival outcomes. Therefore, it seems to hold the potential of identifying UCB patients who may benefit from intensified therapy in addition to RC such as extended lymphadenectomy or/and preoperative systemic therapy.

    DOI: 10.1002/mc.23355

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  • Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes. 国際誌

    Ekaterina Laukhtina, Reza Sari Motlagh, Keiichiro Mori, Satoshi Katayama, Pawel Rajwa, Takafumi Yanagisawa, Fahad Quhal, Hadi Mostafaei, Nico C Grossmann, Frederik König, Abdulmajeed Aydh, Benjamin Pradere, Irene Resch, Axel S Merseburger, Dmitry Enikeev, Shahrokh F Shariat

    Critical reviews in oncology/hematology   103570 - 103570   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). METHODS: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. RESULTS: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. CONCLUSION: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.

    DOI: 10.1016/j.critrevonc.2021.103570

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  • Incidence, risk factors and outcomes of urethral recurrence after radical cystectomy for bladder cancer: A systematic review and meta-analysis. 国際誌

    Ekaterina Laukhtina, Keiichiro Mori, David D Andrea, Marco Moschini, Mohammad Abufaraj, Francesco Soria, Andrea Mari, Wojciech Krajewski, Simone Albisinni, Jeremy Yuen-Chun Teoh, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Satoshi Katayama, Nico С Grossmann, Pawel Rajwa, Dmitry Enikeev, Kristin Zimmermann, Harun Fajkovic, Petr Glybochko, Shahrokh F Shariat, Benjamin Pradere

    Urologic oncology   39 ( 12 )   806 - 815   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We aimed to conduct a systematic review and meta-analysis assessing the incidence and risk factors of urethral recurrence (UR) as well as summarizing data on survival outcomes in patients with UR after radical cystectomy (RC) for bladder cancer. The MEDLINE and EMBASE databases were searched in February 2021 for studies of patients with UR after RC. Incidence and risk factors of UR were the primary endpoints. The secondary endpoint was survival outcomes in patients who experienced UR. Twenty-one studies, comprising 9,435 patients, were included in the quantitative synthesis. Orthotopic neobladder (ONB) diversion was associated with a decreased probability of UR compared to non-ONB (pooled OR: 0.44, 95% CI: 0.31-0.61, P < 0.001) and male patients had a significantly higher risk of UR compared to female patients (pooled OR: 3.16, 95% CI: 1.83-5.47, P < 0.001). Among risk factors, prostatic urethral or prostatic stromal involvement (pooled HR: 5.44, 95% CI: 3.58-8.26, P < 0.001; pooled HR: 5.90, 95% CI: 1.82-19.17, P = 0.003, respectively) and tumor multifocality (pooled HR: 2.97, 95% CI: 2.05-4.29, P < 0.001) were associated with worse urethral recurrence-free survival. Neither tumor stage (P = 0.63) nor CIS (P = 0.72) were associated with worse urethral recurrence-free survival. Patients with UR had a 5-year CSS that varied from 47% to 63% and an OS - from 40% to 74%; UR did not appear to be related to worse survival outcomes. Male patients treated with non-ONB diversion as well as patients with prostatic involvement and tumor multifocality seem to be at the highest risk of UR after RC. Risk-adjusted standardized surveillance protocols should be developed into clinical practice after RC.

    DOI: 10.1016/j.urolonc.2021.06.009

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  • Prognostic value of the systemic immune-inflammation index in non-muscle invasive bladder cancer. 国際誌

    Satoshi Katayama, Keiichiro Mori, Benjamin Pradere, Ekaterina Laukhtina, Victor M Schuettfort, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Nico C Grossmann, Pawel Rajwa, Marco Moschini, Romain Mathieu, Mohammad Abufaraj, David D'Andrea, Eva Compérat, Martin Haydter, Shin Egawa, Yasutomo Nasu, Shahrokh F Shariat

    World journal of urology   39 ( 12 )   4355 - 4361   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: We assessed the prognostic value of systemic immune-inflammation index (SII) to refine risk stratification of the heterogeneous spectrum of patients with non-muscle-invasive bladder cancer (NMIBC) METHODS: In this multi-institutional cohort, preoperative blood-based SII was retrospectively assessed in 1117 patients with NMIBC who underwent transurethral resection of bladder (TURB) between 1996 and 2007. The optimal cut-off value of SII was determined as 580 using the best Youden index. Cox regression analyses were performed. The concordance index (C-index) and decision curve analysis (DCA) were used to assess the discrimination of the predictive models. RESULTS: Overall, 309 (28%) patients had high SII. On multivariable analyses, high SII was significantly associated with worse PFS (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23-2.77; P = 0.003) and CSS (HR 2.53; 95% CI 1.42-4.48; P = 0.001). Subgroup analyses, according to the European Association of Urology guidelines, demonstrated the main prognostic impact of high SII, with regards to PFS (HR 3.39; 95%CI 1.57-7.31; P = 0.002) and CSS (HR 4.93; 95% CI 1.70-14.3; P = 0.005), in patients with intermediate-risk group; addition of SII to the standard predictive model improved its discrimination ability both on C-index (6% and 12%, respectively) and DCA. In exploratory intergroup analyses of patients with intermediate-risk, the improved discrimination ability was retained the prediction of PFS and CSS. CONCLUSION: Preoperative SII seems to identify NMIBC patients who have a worse disease and prognosis. Such easily available and cheap standard biomarkers may help refine the decision-making process regarding adjuvant treatment in patients with intermediate-risk NMIBC.

    DOI: 10.1007/s00345-021-03740-3

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  • Impact of preoperative systemic immune-inflammation Index on oncologic outcomes in bladder cancer patients treated with radical cystectomy. 国際誌

    Nico C Grossmann, Victor M Schuettfort, Benjamin Pradere, Pawel Rajwa, Fahad Quhal, Hadi Mostafaei, Ekaterina Laukhtina, Keiichiro Mori, Reza S Motlagh, Abdulmajeed Aydh, Satoshi Katayama, Marco Moschini, Christian D Fankhauser, Thomas Hermanns, Mohammad Abufaraj, Dong-Ho Mun, Kristin Zimmermann, Harun Fajkovic, Martin Haydter, Shahrokh F Shariat

    Urologic oncology   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To investigate the predictive and prognostic value of the preoperative systemic immune-inflammation index (SII) in patients undergoing radical cystectomy (RC) for clinically non-metastatic urothelial cancer of the bladder (UCB). METHODS: Overall, 4,335 patients were included, and the cohort was stratified in two groups according to SII using an optimal cut-off determined by the Youden index. Uni- and multivariable logistic and Cox regression analyses were performed, and the discriminatory ability by adding SII to a reference model based on available clinicopathologic variables was assessed by area under receiver operating characteristics curves (AUC) and concordance-indices. The additional clinical net-benefit was assessed using decision curve analysis (DCA). RESULTS: High SII was observed in 1879 (43%) patients. On multivariable preoperative logistic regression, high SII was associated with lymph node involvement (LNI; P = 0.004), pT3/4 disease (P <0.001), and non-organ confined disease (NOCD; P <0.001) with improvement of AUCs for predicting LNI (P = 0.01) and pT3/4 disease (P = 0.01). On multivariable Cox regression including preoperative available clinicopathologic values, high SII was associated with recurrence-free survival (P = 0.028), cancer-specific survival (P = 0.005), and overall survival (P = 0.006), without improvement of concordance-indices. On DCAs, the inclusion of SII did not meaningfully improve the net-benefit for clinical decision-making in all models. CONCLUSION: High preoperative SII is independently associated with pathologic features of aggressive disease and worse survival outcomes. However, it did not improve the discriminatory margin of a prediction model beyond established clinicopathologic features and failed to add clinical benefit for decision making. The implementation of SII as a part of a panel of biomarkers in future studies might improve decision-making.

    DOI: 10.1016/j.urolonc.2021.10.006

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  • Comparison of Clinicopathologic and Oncological Outcomes Between Transurethral En Bloc Resection and Conventional Transurethral Resection of Bladder Tumor: A Systematic Review, Meta-Analysis and Network Meta-Analysis with Focus on Different Energy Sources. 国際誌

    Reza Sari Motlagh, Pawel Rajwa, Keiichiro Mori, Ekaterina Laukhtina, Abdulmajeed Aydh, Satoshi Katayama, Takafumi Yanagisawa, Frederik König, Nico C Grossmann, Benjamin Pradere, Hadi Mostafai, Fahad Quhal, Pierre I Karakiewicz, Marek Babjuk, Shahrokh F Shariat

    Journal of endourology   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Introduction: It has been hypothesized that transurethral en bloc (TUEB) of bladder tumor offers benefits over conventional transurethral resection of bladder tumor (cTURBT). This study aimed to compare disease outcomes of TUEB and cTURBT with focus on the different energy sources. Methods: A systematic search was performed using PubMed and Web of Science databases in June 2021. Studies that compared the pathological (detrusor muscle presence), oncological (recurrence rates) efficacy, and safety (serious adverse events [SAEs]) of TUEB and cTURBT were included. Random- and fixed-effects meta-analytic models and Bayesian approach in the network meta-analysis was used. Results: Seven randomized clinical trials (RCTs) and seven non-RCTs (NRCT), with a total of 2092 patients. The pooled 3- and 12-month recurrence risk ratios (RR) of five and four NRCTs were 0.46 (95% CI 0.29-0.73) and 0.56 (95% CI 0.33-0.96), respectively. The pooled 3- and 12-month recurrence RRs of four and seven RCTs were 0.57 (95% CI 0.25-1.27) and 0.89 (95% CI 0.69-1.15), respectively. The pooled RR for SAEs such as prolonged hematuria and bladder perforation of seven RCTs was 0.16 (95% CI 0.06-0.41) in benefit of TUEB. Seven RCTs (n = 1077) met our eligibility criteria for network meta-analysis. There was no difference in 12-month recurrence rates between hybridknife, laser, and bipolar TUEB compared with cTURBT. Contrary, laser TUEB was significantly associated with lower SAEs compared with cTURBT. Surface under the cumulative ranking curve ranking analyses showed with high certainty that laser TUEB was the best treatment option to access all endpoints. Conclusion: While NRCTs suggested a recurrence-free benefit to TUEB compared with cTURBT, RCTs failed to confirm this. Conversely, SAEs were consistently and clinically significantly better for TUEB. Network meta-analyses suggested laser TUEB has the best performance compared with other energy sources. These early findings need to be confirmed and expanded upon.

    DOI: 10.1089/end.2021.0688

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  • Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis.

    Takafumi Yanagisawa, Keiichiro Mori, Satoshi Katayama, Hadi Mostafaei, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Reza Sari Motlagh, Abdulmajeed Aydh, Frederik König, Nico C Grossmann, Benjamin Pradere, Jun Miki, Takahiro Kimura, Shin Egawa, Shahrokh F Shariat

    International journal of clinical oncology   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pembrolizumab is the standard for the first and second lines in treating metastatic urothelial carcinoma (UC). This systematic review and meta-analysis aimed to assess the value of pretreatment clinical characteristics and hematologic biomarkers for prognosticating response to pembrolizumab in patients with metastatic UC. PUBMED®, Web of Science™, and Scopus® databases were searched for articles published before May 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they evaluated overall survival (OS) in patients with metastatic urothelial carcinoma treated with pembrolizumab and pretreatment clinical characteristics or laboratory examination. Overall, 13 studies comprising 1311 patients were eligible for the meta-analysis. Several pretreatment patients' demographics and hematologic biomarkers were significantly associated with worse OS as follows: Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥ 2 (Pooled hazard ratio [HR]: 3.24, 95% confidence interval [CI] 2.57-4.09), presence of visceral metastasis (Pooled HR: 1.84, 95% CI 1.42-2.38), presence of liver metastasis (Pooled HR: 4.23, 95% CI 2.18-8.20), higher neutrophil-lymphocyte ratio (NLR) (Pooled HR: 1.29, 95% CI 1.07-1.55) and, higher c-reactive protein (CRP) (Pooled HR: 2.49, 95% CI 1.52-4.07). Metastatic UC patients with poor PS, liver metastasis, higher pretreatment NLR and/or CRP have a worse survival despite pembrolizumab treatment. These findings might help to guide the prognostic tools for clinical decision-making; however, they should be interpreted carefully, owing to limitations regarding the retrospective nature of primary data.

    DOI: 10.1007/s10147-021-02061-0

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  • Impact of systemic Immune-inflammation Index on oncologic outcomes in patients treated with radical prostatectomy for clinically nonmetastatic prostate cancer. 国際誌

    Pawel Rajwa, Victor M Schuettfort, David D'Andrea, Fahad Quhal, Keiichiro Mori, Satoshi Katayama, Ekaterina Laukhtina, Benjamin Pradere, Reza Sari Motlagh, Hadi Mostafaei, Nico C Grossmann, Nicolai Huebner, Andreas Aulitzky, Dong-Ho Mun, Alberto Briganti, Pierre I Karakiewicz, Harun Fajkovic, Shahrokh F Shariat

    Urologic oncology   39 ( 11 )   785.e19-785.e27   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To evaluate the predictive and prognostic value of the Systemic Immune-inflammation Index (SII) in a large cohort of patients treated with radical prostatectomy (RP) for clinically non-metastatic prostate cancer (PCa). METHODS: We retrospectively analyzed our multicenter database comprising 6,039 consecutive patients. The optimal preoperative SII cut-off value was assessed with the Youden index calculated on a time-dependent receiver operating characteristic (ROC) curve. Logistic regression and Cox regression analyses were used to investigate the association of SII with pathologic features and biochemical recurrence (BCR), respectively. The discriminatory ability of the models was evaluated by calculating the concordance-indices (C-Index). The clinical benefit of the implementation of SII in clinical decision making was assessed using decision curve analysis (DCA). RESULTS: Patients with high preoperative SII (≥ 620) were more likely to have adverse clinicopathologic features. On multivariable logistic regression analysis, high preoperative SII was independently associated with extracapsular extension (odds ratio [OR] 1.16, P = 0.041), non-organ confined disease (OR 1.18, P = 0.022), and upgrading at RP (OR 1.23, P < 0.001). We built two Cox regression models including preoperative and postoperative variables. In the preoperative multivariable model, high preoperative SII was associated with BCR (hazard ratio [HR] 1.34, 95% CI 1.15-1.55, P < 0.001). In the postoperative multivariable model, SII was not associated with BCR (P = 0.078). The addition of SII to established models did not improve their discriminatory ability nor did it increase the clinical net benefit on DCA. CONCLUSION: In men treated with RP for clinically nonmetastatic PCa, high preoperative SII was statistically associated with an increased risk of adverse pathologic features at RP as well as BCR. However, it did not improve the predictive accuracy and clinical value beyond that obtained by current predictive and prognostic models. SII together with a panel of complementary biomarkers is praised to help guide decision-making in clinically nonmetastatic PCa.

    DOI: 10.1016/j.urolonc.2021.05.002

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  • Adjuvant therapy with tyrosine kinase inhibitors for localized and locally advanced renal cell carcinoma: an updated systematic review and meta-analysis. 国際誌

    Ekaterina Laukhtina, Fahad Quhal, Keiichiro Mori, Reza Sari Motlagh, Benjamin Pradere, Victor M Schuettfort, Hadi Mostafaei, Satoshi Katayama, Nico С Grossmann, Pawel Rajwa, Irene Resch, Dmitry Enikeev, Pierre I Karakiewicz, Shahrokh F Shariat, Manuela Schmidinger

    Urologic oncology   39 ( 11 )   764 - 773   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Tyrosine kinase inhibitors (TKIs) have been widely used in the management of patients with metastatic renal cell carcinoma (RCC). However, the use of systemic therapies in the adjuvant setting of localized and locally advanced RCC has shown conflicting results across the literature. Therefore, we aimed to conduct an updated systematic review and meta-analysis comparing the efficacy and safety of TKIs in the adjuvant setting for patients with localized and locally advanced RCC. MATERIALS AND METHODS: The MEDLINE and EMBASE databases were searched in December 2020 to identify phase III randomized controlled trials of patients receiving adjuvant therapies with TKI for RCC. Disease-free survival (DFS) and overall survival (OS) were the primary endpoints. The secondary endpoints included treatment-related adverse events (TRAEs) of high and any grade. RESULTS: Five trials (S-TRAC, ASSURE, PROTECT, ATLAS, and SORCE) were included in our meta-analysis comprising 6,531 patients. The forest plot revealed that TKI therapy was associated with a significantly longer DFS compared to placebo (pooled HR: 0.88, 95% CI: 0.81-0.96, P= 0.004). The Cochrane's Q test (P = 0.51) and I2 test (I2 = 0%) revealed no significant heterogeneity. Adjuvant TKI was not associated with improved OS compared to placebo (pooled HR: 0.93, 95% CI: 0.83-1.04, P= 0.23). The Cochrane's Q test (P = 0.74) and I2 test (I2 = 0%) revealed no significant heterogeneity. The forest plot revealed that TKI therapy, compared to placebo, was associated with higher rates of high grade TRAEs (OR: 5.20, 95% CI: 4.10-6.59, P< 0.00001) as well as any grade TRAEs (OR: 3.85, 95% CI: 1.22-12.17, P= 0.02). The Cochrane's Q tests (P < 0.0001 and P < 0.00001, respectively) and I2 tests (I2 = 79% and I2 = 90%, respectively) revealed significant heterogeneity. CONCLUSIONS: The findings of our analyses suggest an improved DFS in patients with localized and locally advanced RCC receiving adjuvant TKI as compared to placebo; however, this did not translate into any significant OS benefit. Additionally, TKI therapy led to significant toxicity. Adjuvant TKI does not seem to offer a satisfactory risk and/orbenefit balance for all patients. Select patients with very poor prognosis may be considered in a shared decision-making process with the patient. With the successful arrival of immune-based therapies in RCC, these may allow a more favorable risk/benefit profile.

    DOI: 10.1016/j.urolonc.2021.07.022

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  • Prognostic Impact of Preoperative Plasma Levels of Urokinase Plasminogen Activator Proteins on Disease Outcomes after Radical Cystectomy. 国際誌

    Victor M Schuettfort, Benjamin Pradere, David D'Andrea, Nico C Grossmann, Fahad Quhal, Hadi Mostafaei, Ekaterina Laukhtina, Keiichiro Mori, Michael Rink, Pierre I Karakiewicz, Reza Sari Motlagh, Satoshi Katayama, Yair Lotan, Douglas Scherr, Mohammad Abufaraj, Harun Fajkovica, Eva Compérat, Dmitry Enikeev, Shahrokh F Shariat

    The Journal of urology   206 ( 5 )   1122 - 1131   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: We sought to validate the association of plasma levels of urokinase-type plasminogen activator (uPA), its soluble receptor (SuPAR) and its inhibitor (PAI-one) with oncologic outcomes in a large cohort of patients treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS: We collected preoperative blood samples from 1,036 consecutive patients treated with RC for UCB. Plasma specimens were assessed for levels of uPA, SuPAR and PAI-one. Retrospective logistic and Cox regression analyses were performed to assess their correlation with clinical outcomes. The additional clinical net benefit provided by the biomarkers was evaluated using decision curve analysis. RESULTS: Preoperative plasma uPA, SuPAR and PAI-one levels were significantly elevated in patients harboring adverse pathological features. Higher levels of all biomarkers were independently associated with an increased risk of lymph node metastasis; uPA levels were also independently associated with ≥pT3 disease. Preoperative uPA and SuPAR were independently associated with recurrence-free and cancer-specific survival. The addition of these biomarkers to standard pre-treatment and post-treatment models improved the discriminatory power for prediction of lymph node metastasis, ≥pT3 disease, and recurrence-free and cancer-specific survival by a prognostically significant margin. CONCLUSIONS: We confirmed that elevated preoperative plasma levels of uPA, SuPAR and PAI-one are associated with features of aggressive disease and worse survival outcomes in patients treated with RC for UCB. These biomarkers hold potential in identifying patients who are likely to benefit from intensified/multimodal therapy. They also demonstrated the ability to improve the discriminatory power of predictive/prognostic models, thus refining personalized clinical decision-making.

    DOI: 10.1097/JU.0000000000001936

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  • Oncologic impact of delaying radical prostatectomy in men with intermediate- and high-risk prostate cancer: a systematic review. 国際誌

    Ekaterina Laukhtina, Reza Sari Motlagh, Keiichiro Mori, Fahad Quhal, Victor M Schuettfort, Hadi Mostafaei, Satoshi Katayama, Nico C Grossmann, Guillaume Ploussard, Pierre I Karakiewicz, Alberto Briganti, Mohammad Abufaraj, Dmitry Enikeev, Benjamin Pradere, Shahrokh F Shariat

    World journal of urology   39 ( 11 )   4085 - 4099   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To summarize the available evidence on the survival and pathologic outcomes after deferred radical prostatectomy (RP) in men with intermediate- and high-risk prostate cancer (PCa). METHODS: The PubMed database and Web of Science were searched in November 2020 according to the PRISMA statement. Studies were deemed eligible if they reported the survival and pathologic outcomes of patients treated with deferred RP for intermediate- and high-risk PCa compared to the control group including those patients treated with RP without delay. RESULTS: Overall, nineteen studies met our eligibility criteria. We found a significant heterogeneity across the studies in terms of definitions for delay and outcomes, as well as in patients' baseline clinicopathologic features. According to the currently available literature, deferred RP does not seem to affect oncological survival outcomes, such as prostate cancer-specific mortality and metastasis-free survival, in patients with intermediate- or high-risk PCa. However, the impact of deferred RP on biochemical recurrence rates remains controversial. There is no clear association of deferring RP with any of the features of aggressive disease such as pathologic upgrading, upstaging, positive surgical margins, extracapsular extension, seminal vesicle invasion, and lymph node invasion. Deferred RP was not associated with the need for secondary treatments. CONCLUSIONS: Owing to the different definitions of a delayed RP, it is hard to make a consensus regarding the safe delay time. However, the current data suggest that deferring RP in patients with intermediate- and high-risk PCa for at least around 3 months is generally safe, as it does not lead to adverse pathologic outcomes, biochemical recurrence, the need for secondary therapy, or worse oncological survival outcomes.

    DOI: 10.1007/s00345-021-03703-8

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  • Selection and evaluation of preoperative systemic inflammatory response biomarkers model prior to cytoreductive nephrectomy using a machine-learning approach. 国際誌

    Ekaterina Laukhtina, Victor M Schuettfort, David D'Andrea, Benjamin Pradere, Fahad Quhal, Keiichiro Mori, Reza Sari Motlagh, Hadi Mostafaei, Satoshi Katayama, Nico C Grossmann, Pawel Rajwa, Pierre I Karakiewicz, Manuela Schmidinger, Harun Fajkovic, Dmitry Enikeev, Shahrokh F Shariat

    World journal of urology   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: This study aimed to determine the prognostic value of a panel of SIR-biomarkers, relative to standard clinicopathological variables, to improve mRCC patient selection for cytoreductive nephrectomy (CN). MATERIAL AND METHODS: A panel of preoperative SIR-biomarkers, including the albumin-globulin ratio (AGR), De Ritis ratio (DRR), and systemic immune-inflammation index (SII), was assessed in 613 patients treated with CN for mRCC. Patients were randomly divided into training and testing cohorts (65/35%). A machine learning-based variable selection approach (LASSO regression) was used for the fitting of the most informative, yet parsimonious multivariable models with respect to prognosis of cancer-specific survival (CSS). The discriminatory ability of the model was quantified using the C-index. After validation and calibration of the model, a nomogram was created, and decision curve analysis (DCA) was used to evaluate the clinical net benefit. RESULTS: SIR-biomarkers were selected by the machine-learning process to be of high discriminatory power during the fitting of the model. Low AGR remained significantly associated with CSS in both training (HR 1.40, 95% CI 1.07-1.82, p = 0.01) and testing (HR 1.78, 95% CI 1.26-2.51, p = 0.01) cohorts. High levels of SII (HR 1.51, 95% CI 1.10-2.08, p = 0.01) and DRR (HR 1.41, 95% CI 1.01-1.96, p = 0.04) were associated with CSS only in the testing cohort. The exclusion of the SIR-biomarkers for the prognosis of CSS did not result in a significant decrease in C-index (- 0.9%) for the training cohort, while the exclusion of SIR-biomarkers led to a reduction in C-index in the testing cohort (- 5.8%). However, SIR-biomarkers only marginally increased the discriminatory ability of the respective model in comparison to the standard model. CONCLUSION: Despite the high discriminatory ability during the fitting of the model with machine-learning approach, the panel of readily available blood-based SIR-biomarkers failed to add a clinical benefit beyond the standard model.

    DOI: 10.1007/s00345-021-03844-w

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  • Discordance Between Clinical and Pathological Staging and Grading in Upper Tract Urothelial Carcinoma. 国際誌

    Keiichiro Mori, Satoshi Katayama, Ekaterina Laukhtina, Victor M Schuettfort, Benjamin Pradere, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Nico C Grossmann, Pawel Rajwa, Kristin Zimmermann, Pierre I Karakiewicz, Mohammad Abufaraj, Harun Fajkovic, Morgan Rouprêt, Vitaly Margulis, Dmitry V Enikeev, Shin Egawa, Shahrokh F Shariat

    Clinical genitourinary cancer   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: This study aimed to evaluate the concordance in tumor stage and grade between ureteroscopic (URS) biopsy and radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS: Records of 1,214 UTUC patients who had undergone URS biopsy followed by RNU were included. Univariable and multivariable logistic regression analyses were performed to identify factors contributing to the pathological upstaging. RESULTS: The concordance between URS biopsy-based clinical and RNU pathological staging was 34.5%. Clinical understaging occurred in 59.5% patients. Upstaging to muscle-invasive disease occurred in 240 (41.7%) of 575 patients diagnosed with ≤cT1 disease. Of those diagnosed with muscle-invasive disease on final pathology, 89.6% had been clinically diagnosed with ≤cT1 disease. In the univariable analyses, computed tomography urography (CTU)-based invasion, ureter location, hydronephrosis, high-grade cytology, high-grade biopsy, sessile architecture, age, and women sex were significantly associated with pathological upstaging (P < .05). In the multivariable analyses, CTU-based invasion and hydronephrosis remained associated with pathological upstaging (P < .05). URS biopsy-based clinical and pathological gradings were concordant in 634 (54.2%) patients. Clinical undergrading occurred in 496 (42.4%) patients. CONCLUSIONS: Clinical understaging/undergrading and upstaging to muscle-invasive disease occurred in a high proportion of UTUC patients undergoing RNU. Despite the inherent selection bias, these data underline the challenges of accurate UTUC staging and grading. In daily clinical practice, URS biopsy and CTU offer the most accurate preoperative information albeit with limited predictive value when used alone. These findings should be considered when utilizing preoperative, risk-adapted strategies.

    DOI: 10.1016/j.clgc.2021.10.002

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  • Role of systemic immune-inflammation index in patients treated with salvage radical prostatectomy. 国際誌

    Pawel Rajwa, Victor M Schuettfort, Fahad Quhal, Keiichiro Mori, Satoshi Katayama, Ekaterina Laukhtina, Benjamin Pradere, Reza Sari Motlagh, Hadi Mostafaei, Nico C Grossmann, Andreas Aulitzky, Andrzej Paradysz, Pierre I Karakiewicz, Harun Fajkovic, Kristin Zimmermann, Axel Heidenreich, Paolo Gontero, Shahrokh F Shariat

    World journal of urology   39 ( 10 )   3771 - 3779   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To examine the predictive and prognostic value of preoperative Systemic Immune-inflammation Index (SII) in patients with radio-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP). MATERIALS AND METHODS: This multicenter retrospective study included 214 patients with radio-recurrent PCa, treated with SRP between 2007 and 2015. SII was measured preoperatively (neutrophils × platelets/lymphocytes) and the cohort was stratified using optimal cut-off. Uni- and multivariable logistic and Cox regression analyses were performed to evaluate the predictive and prognostic value of SII as a preoperative biomarker. RESULTS: A total of 81 patients had high preoperative SII (≥ 730). On multivariable logistic regression modeling, high SII was predictive for lymph node metastases (OR 3.32, 95% CI 1.45-7.90, p = 0.005), and non-organ confined disease (OR 2.55, 95% CI 1.33-4.97, p = 0.005). In preoperative regression analysis, high preoperative SII was an independent prognostic factor for cancer-specific survival (CSS; HR 10.7, 95% CI 1.12-103, p = 0.039) and overall survival (OS; HR 8.57, 95% CI 2.70-27.2, p < 0.001). Similarly, in postoperative multivariable models, SII was associated with worse CSS (HR 22.11, 95% CI 1.23-398.12, p = 0.036) and OS (HR 5.98, 95% CI 1.67-21.44, p = 0.006). Notably, the addition of SII to preoperative reference models improved the C-index for the prognosis of CSS (89.5 vs. 80.5) and OS (85.1 vs 77.1). CONCLUSIONS: In radio-recurrent PCa patients, high SII was associated with adverse pathological features at SRP and survival after SRP. Preoperative SII could help identify patients who might benefit from novel imaging modalities, multimodal therapy or a closer posttreatment surveillance.

    DOI: 10.1007/s00345-021-03715-4

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  • Impact of paclitaxel, cisplatin, and gemcitabine as first-line chemotherapy in cisplatin-fit and -unfit patients with advanced/metastatic urothelial carcinoma. 国際誌

    Satoshi Katayama, Yasuyuki Kobayashi, Atsushi Takamoto, Kohei Edamura, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Koichiro Wada, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

    Urologic oncology   39 ( 10 )   731.e25-731.e32   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: This study aimed to clarify the efficacy and toxicity of first-line combination treatment with paclitaxel, cisplatin, and gemcitabine (PCG) for advanced/metastatic urothelial carcinoma (UC) in cisplatin-unfit patients compared with cisplatin-fit patients. METHODS: We conducted a retrospective study of patients who received first-line PCG. Using international consensus criteria, patients were classified into cisplatin-fit and -unfit groups. Cisplatin-unfit patients received PCG with adjustment of the cisplatin dose after assessing 24-hour urinary creatinine clearance, without modifying the administration interval. RESULTS: From 2008 to 2017, 50 patients received first-line PCG, of whom 30 and 20 were classified into the cisplatin-fit and -unfit groups. After a median follow-up of 15.0 months, the median overall survival (OS) and progression-free survival (PFS) were 15.0 and 9.8 months in all patients, 15.0 and 10.0 months in the cisplatin-fit group, and 13.2 and 9.3 months in the cisplatin-unfit group, respectively. There was no significant difference in OS (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 0.69-2.54) or PFS (HR: 1.38, 95% CI: 0.74-2.55) between the groups. The overall response rate and complete response rate were 58% (95% CI: 43.2-71.8) and 32% (95% CI: 19.5-46.7) in all patients, and 55% (95% CI: 31.5-76.9) and 35% (95% CI: 15.4-59.2) in the cisplatin-unfit group, respectively. The common grade 3 of 4 adverse events experienced were neutropenia (78%), followed by thrombocytopenia (56%), anemia (46%), and febrile neutropenia (16%). The 24-hour urinary creatinine clearance did not differ significantly between the groups after one, two, or three courses of PCG. CONCLUSIONS: We found no significant difference regarding OS and PFS between the cisplatin-fit patients with a full dose of cisplatin and -unfit patients with cisplatin-dose-adjusted chemotherapy. In select cisplatin-unfit patients, PCG with dose adjustment of cisplatin may be useful for treating advanced/metastatic UC without any significant adverse events or impaired renal function compared with cisplatin-fit patients with a full dose of cisplatin.

    DOI: 10.1016/j.urolonc.2021.02.029

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  • Choosing the Most Efficacious and Safe Oral Treatment for Idiopathic Overactive Bladder: A Systematic Review and Network Meta-analysis. 国際誌

    Hadi Mostafaei, Hanieh Salehi-Pourmehr, Sandra Jilch, Greta Lisa Carlin, Keiichiro Mori, Fahad Quhal, Benjamin Pradere, Nico C Grossmann, Ekaterina Laukhtina, Victor M Schuettfort, Abdulmajeed Aydh, Reza Sari Motlagh, Frederik König, Claus G Roehrborn, Satoshi Katayama, Pawel Rajwa, Sakineh Hajebrahimi, Shahrokh F Shariat

    European urology focus   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CONTEXT: The choice of the most efficacious drug for patients with idiopathic overactive bladder (IOAB) remains challenging. OBJECTIVE: The aim of this network meta-analysis was to determine the most efficacious oral antimuscarinic or β-adrenoceptor agonist accounting for adverse events for the management of IOAB. EVIDENCE ACQUISITION: A comprehensive electronic search was done in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Ovid for studies in any language in February 2021 considering the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. We included all randomized controlled trials assessing oral antimuscarinics or β-adrenoceptor agonists for the treatment of IOAB. We determined the effect of specific bothersome symptoms separately. EVIDENCE SYNTHESIS: Fifty-four articles were included in our analysis. The most efficacious agents considering the evaluated outcomes were oxybutynin 15 mg/d in reducing incontinence episodes, imidafenacin 0.5 mg/d together with solifenacin 10 and 5 mg/d in reducing micturition episodes, fesoterodine 4 and 8 mg/d as well as solifenacin 10 mg/d in reducing urgency episodes, imidafenacin 0.5 mg/d and solifenacin 10 mg/d in reducing urgency urinary incontinence episodes, and solifenacin 10 mg/d, vibegron 50 mg/d, and fesoterodine 8 mg/d in improving the voided volume. Gastrointestinal problems, especially due to antimuscarinic agents, were the most prevalent adverse events. CONCLUSIONS: Taken together, there is only minimal difference between the efficacy of oral antimuscarinics and that of β-adrenoceptor agonists. Although finding the best medication for all is impossible, finding the best treatment for every individual patient can be done by considering the efficacy of a medicine for the most bothersome symptom(s) in balance with drug-specific adverse events. PATIENT SUMMARY: This study aimed to find the most efficient oral medication to treat overactive bladder, taking into consideration the adverse events. Based on our study, there is a minimal difference in the efficacy between the two major drug classes used to treat overactive bladder. Gastrointestinal problems were the most common adverse events in medical treatment of overactive bladder. Selection of the best treatment is possible through shared decision-making between the doctor and the patient based on the patient's most bothersome symptom. We provide a framework for physicians to facilitate shared decision-making with each individual patient.

    DOI: 10.1016/j.euf.2021.08.011

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  • Prognostic role of the systemic immune-inflammation index in upper tract urothelial carcinoma treated with radical nephroureterectomy: results from a large multicenter international collaboration. 国際誌

    Keiichiro Mori, Irene Resch, Noriyoshi Miura, Ekaterina Laukhtina, Victor M Schuettfort, Benjamin Pradere, Satoshi Katayama, David D'Andrea, Mehdi Kardoust Parizi, Mohammad Abufaraj, Wataru Fukuokaya, Claudia Collà Ruvolo, Stefano Luzzago, Sophie Knipper, Carlotta Palumbo, Pierre I Karakiewicz, Alberto Briganti, Dmitry V Enikeev, Morgan Rouprêt, Vitaly Margulis, Shin Egawa, Shahrokh F Shariat

    Cancer immunology, immunotherapy : CII   70 ( 9 )   2641 - 2650   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To investigate the prognostic role of the preoperative systemic immune-inflammation index (SII) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS: We retrospectively analyzed our multi-institutional database to identify 2492 patients. SII was calculated as platelet count × neutrophil/lymphocyte count and evaluated at a cutoff of 485. Logistic regression analyses were performed to investigate the association of SII with muscle-invasive and non-organ-confined (NOC) disease. Cox regression analyses were performed to investigate the association of SII with recurrence-free, cancer-specific, and overall survival (RFS/CSS/OS). RESULTS: Overall, 986 (41.6%) patients had an SII > 485. On univariable logistic regression analyses, SII > 485 was associated with a higher risk of muscle-invasive (P = 0.004) and NOC (P = 0.03) disease at RNU. On multivariable logistic regression, SII remained independently associated with muscle-invasive disease (P = 0.01). On univariable Cox regression analyses, SII > 485 was associated with shorter RFS (P = 0.002), CSS (P = 0.002) and OS (P = 0.004). On multivariable Cox regression analyses SII remained independently associated with survival outcomes (all P < 0.05). Addition of SII to the multivariable models improved their discrimination of the models for predicting muscle-invasive disease (P = 0.02). However, all area under the curve and C-indexes increased by < 0.02 and it did not improve net benefit on decision curve analysis. CONCLUSIONS: Preoperative altered SII is significantly associated with higher pathologic stages and worse survival outcomes in patients treated with RNU for UTUC. However, the SII appears to have relatively limited incremental additive value in clinical use. Further study of SII in prognosticating UTUC is warranted before routine use in clinical algorithms.

    DOI: 10.1007/s00262-021-02884-w

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  • Differences in oncological and toxicity outcomes between programmed cell death-1 and programmed cell death ligand-1 inhibitors in metastatic renal cell carcinoma: A systematic review and meta-analysis. 国際誌

    Keiichiro Mori, Benjamin Pradere, Fahad Quhal, Satoshi Katayama, Hadi Mostafaei, Ekaterina Laukhtina, Victor M Schuettfort, David D'Andrea, Shin Egawa, Karim Bensalah, Manuela Schmidinger, Thomas Powles, Shahrokh F Shariat

    Cancer treatment reviews   99   102242 - 102242   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The programmed cell death ligand-1 (PD-L1)/programmed cell death-1 (PD-1) pathway is important in metastatic renal cell carcinoma (mRCC). However, some dissimilarities between anti-PD-1 and anti-PD-L1 inhibitors have emerged. We aimed to assess differences between anti-PD-1 and anti-PD-L1 combination immunotherapies as first-line treatments in mRCC patients. METHODS: Multiple databases (PubMed, Web of Science, and Scopus) were searched for articles published until March 2021. Studies were eligible if they compared overall survival (OS), progression-free survival (PFS), objective response rates (ORR), complete response rates (CRR), and adverse events. RESULTS: Five studies met the eligibility criteria. PD-1 combination therapy was associated with significantly better OS and PFS and higher ORR and CRR than sunitinib (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.40-0.89; HR: 0.52, 95% CI: 0.37-0.75; odds ratio [OR]: 3.20, 95% CI: 2.18-4.68; and OR: 3.05, 95% CI: 2.13-4.37, respectively; P < 0.001). For all oncological outcomes, anti-PD-1 agents were superior to anti-PD-L1 agents based on HR and OR (OS: HR = 0.88, PFS: HR = 0.76, ORR: OR = 1.85, and CRR: OR = 2.24). Conversely, anti-PD-L1 agents were superior to anti-PD-1 agents in their safety profiles. In network meta-analyses, pembrolizumab plus lenvatinib seemed the worst tolerated anti-PD-1 combination therapy. CONCLUSIONS: Our analysis indicates the superior oncologic benefits of first-line anti-PD-1 combination therapies over anti-PD-L1 combination therapies in mRCC patients. This biological difference is of vital importance for clinical treatment decision making and the design of future rational combination therapy trials in mRCC.

    DOI: 10.1016/j.ctrv.2021.102242

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  • Impact of enhanced optical techniques at time of transurethral resection of bladder tumour, with or without single immediate intravesical chemotherapy, on recurrence rate of non-muscle-invasive bladder cancer: a systematic review and network meta-analysis of randomized trials. 国際誌

    Reza Sari Motlagh, Keiichiro Mori, Ekaterina Laukhtina, Abdulmajeed Aydh, Satoshi Katayama, Nico C Grossmann, Hadi Mostafai, Benjamin Pradere, Fahad Quhal, Victor M Schuettfort, Mohammad Reza Roshandel, Pierre I Karakiewicz, Jeremy Teoh, Shahrokh F Shariat, Harun Fajkovic

    BJU international   128 ( 3 )   280 - 289   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: To assess whether single immediate intravesical chemotherapy (SIIC) adds value to bladder tumour management in combination with novel optical techniques: enhanced transurethral resection of bladder tumour (TURBT). METHODS: A systematic search was performed using the PubMed and Web of Science databases in September 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) extension statement for network meta-analyses. Studies that compared recurrence rates among intervention groups (TURBT with photodynamic diagnosis [PDD] ± SIIC, narrow-band imaging [NBI] ± SIIC, or white-light cystoscopy [WLC] + SIIC) and a control group (TURBT with WLC alone) were included. We used the Bayesian approach in the network meta-analysis. RESULTS: Twenty-two studies (n = 4519) met our eligibility criteria. Out of six different interventions including three different optical techniques, compared to WLC alone, blue-light cystoscopy (BLC) plus SIIC (odds ratio [OR] 0.349, 95% credible interval [CrI] 0.196-0.601) and BLC alone (OR 0.668, 95% CrI 0.459-0.931) were associated with a significantly lower likelihood of 12-month recurrence rate. In the sensitivity analysis, out of eight different interventions compared to WLC alone, PDD by 5-aminolevulinic acid plus SIIC (OR 0.327, 95% CrI 0.159-0.646) and by hexaminolevulinic acid plus SIIC (OR 0.376, 95% CrI 0.172-0.783) were both associated with a significantly lower likelihood of 12-month recurrence rate. NBI with and without SIIC was not associated with a significantly lower likelihood of 12-month recurrence rate (OR 0.385, 95% CrI 0.105-1.29 and OR 0.653, 95% CrI 0.343-1.15). CONCLUSION: Blue-light cystoscopy during TURBT with concomitant SIIC seems to yield superior recurrence outcomes in patients with non-muscle-invasive bladder cancer. The use of PDD was able to reduce the 12-month recurrence rate; moreover, concomitant SIIC increased this risk benefit by a 32% additional reduction in odds ratio. Although using PDD could reduce the recurrence rate, SIIC remains necessary. Moreover, ranking analysis showed that both PDD and NBI, plus SIIC, were better than these techniques alone.

    DOI: 10.1111/bju.15383

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  • Intracorporeal versus extracorporeal urinary diversion in robot-assisted radical cystectomy: a systematic review and meta-analysis.

    Satoshi Katayama, Keiichiro Mori, Benjamin Pradere, Hadi Mostafaei, Victor M Schuettfort, Fahad Quhal, Reza Sari Motlagh, Ekaterina Laukhtina, Marco Moschini, Nico C Grossmann, Yasutomo Nasu, Shahrokh F Shariat, Harun Fajkovic

    International journal of clinical oncology   26 ( 9 )   1587 - 1599   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This systematic review and meta-analysis aimed to assess and compare the perioperative and oncological outcomes of intracorporeal (ICUD) and extracorporeal (ECUD) urinary diversion following robot-assisted radical cystectomy (RARC). A systematic literature search of articles was performed in PubMed®, Web of Science®, and Scopus® databases according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. We included studies that compared patients who underwent RARC with ICUD to those with ECUD. Twelve studies including 3067 patients met the eligibility criteria. There were no significant differences between ICUD and ECUD in overall and major complications, regardless of the period (short-term [≤ 30 days] or mid-term [> 30 days]). Subgroup analyses demonstrated that ICUD performed by high-volume centers exhibited a significantly reduced risk of major complications (short-term: OR 0.57, 95% CI 0.37-0.86, p = 0.008, mid-term: OR 0.66, 95% CI 0.46-0.94, p = 0.02). Patients who underwent ICUD had lower estimated blood loss (MD -102.3 ml, 95% CI - 132.8 to - 71.8, p < 0.00001), less likely to receive blood transfusion rates (OR 0.36, 95% CI 0.20-0.62, p = 0.00003); and these findings were consistent in subgroup analyses by low-volume centers (MD-121.6 ml, 95% CI - 160.9 to - 82.3, p < 0.00001 and OR 0.36, 95% CI 0.20-0.62, p = 0.00003, respectively). ICUD had a higher lymph node yield (MD 3.68, 95% CI 0.80-6.56, p = 0.01). Patients receiving ICUD provided comparable complications, superior perioperative outcomes, and similar oncological outcomes compared with ECUD. Centralization of patients may contribute to a reduction of postoperative complications, while maintaining the advantages.

    DOI: 10.1007/s10147-021-01972-2

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  • Comparison of intracorporeal versus extracorporeal urinary diversion after robot-assisted radical cystectomy at a medium-sized facility.

    Takehiro Iwata, Yasuyuki Kobayashi, Yuki Maruyama, Tatsushi Kawada, Takuya Sadahira, Yuko Oiwa, Satoshi Katayama, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Koichiro Wada, Kohei Edamura, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

    International journal of clinical oncology   26 ( 9 )   1714 - 1721   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The aim of this study is to compare the perioperative outcomes and learning curves between intracorporeal and extracorporeal urinary diversion at our medium-sized institution. METHODS: Between January 2018 and September 2020, a single surgeon at our institution performed 46 consecutive robot-assisted radical cystectomies with ileal conduit. We compared the perioperative outcomes between patients who underwent intracorporeal versus extracorporeal urinary diversion. We also investigated learning curves for the first and last 10 patients in each group. RESULTS: The extracorporeal group had shorter overall operative time (P = 0.003) and urinary diversion time (P < 0.0001) than the intracorporeal group. The intracorporeal group had shorter length of hospital stay (P = 0.02). There was no difference in complication and readmission rates. The extracorporeal group demonstrated no difference between the first and last 10 patients for overall operative time or time for cystectomy, lymph node dissection, or urinary diversion. However, the intracorporeal group had shorter urinary diversion time for the last 10 patients compared with the first 10 patients. The first 10 patients in the extracorporeal group had shorter overall operative time than the first 10 in the intracorporeal group, but there was no difference for the last 10 patients. CONCLUSIONS: Intracorporeal urinary diversion requires longer overall operative time than extracorporeal diversion for the first 10 patients, due to longer urinary diversion time. However, there is no difference in overall operative time for the last 10 patients. The benefit of intracorporeal over extracorporeal urinary diversion was not confirmed at our medium-sized institution.

    DOI: 10.1007/s10147-021-01957-1

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  • The Value of Preoperative Plasma VEGF Levels in Urothelial Carcinoma of the Bladder Treated with Radical Cystectomy. 国際誌

    Keiichiro Mori, Victor M Schuettfort, Satoshi Katayama, Ekaterina Laukhtina, Benjamin Pradere, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Nico C Grossmann, Pawel Rajwa, Frederik König, Abdulmajeed Aydh, Francesco Soria, Marco Moschini, Pierre I Karakiewicz, Yair Lotan, Douglas Scherr, Martin Haydter, Peter Nyirady, Jeremy Y C Teoh, Shin Egawa, Eva Compérat, Shahrokh F Shariat

    European urology focus   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Elevated preoperative plasma levels of the angiogenesis-related marker VEGF have been associated with worse oncological outcomes in various malignancies. OBJECTIVE: To investigate the predictive/prognostic role of VEGF in patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: VEGF plasma levels were measured preoperatively in 1036 patients with UCB who underwent RC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The correlation between plasma VEGF levels and pathological and survival outcomes was assessed using logistic regression and Cox regression analyses. Discrimination was assessed using the concordance index (C index). The clinical net benefit was evaluated using decision curve analysis (DCA). RESULTS AND LIMITATIONS: Patients with higher pretreatment plasma VEGF levels had poorer recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) according to log-rank tests (all p < 0.001). Higher VEGF levels were not independently associated with higher risk of lymph node metastasis, ≥pT3 disease, or non-organ-confined disease (all p > 0.05). Preoperative plasma VEGF levels were independently associated with RFS, CSS, and OS in preoperative and postoperative multivariable models. However, in all cases the C index increased by <0.02 and there was no improvement in net benefit on DCA. A limitation is that none of the patients received current elements of standard of care such as neoadjuvant chemotherapy. CONCLUSIONS: Elevated plasma VEGF levels were associated with features of biologically and clinically aggressive disease such as worse survival outcomes among patients with UCB treated with RC. However, VEGF appears to have relatively limited incremental additive value in clinical use. Further study of VEGF for UCB prognostication is warranted before routine use in clinical algorithms. PATIENT SUMMARY: Currently available models for predicting outcomes in bladder cancer are less than optimal. A protein called vascular endothelial growth factor (VEGF), which is a marker of the formation of blood vessels (angiogenesis), may have a role in predicting survival outcomes in bladder cancer. TAKE HOME MESSAGE: Elevated plasma VEGF levels are associated with worse survival outcomes for patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy. VEGF could be used as a part of a biomarker panel to enhance tools currently used for risk stratification for patients with UCB.

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  • The role of lymph node dissection in salvage radical prostatectomy for patients with radiation recurrent prostate cancer. 国際誌

    Fahad Quhal, Pawel Rajwa, Keiichiro Mori, Ekaterina Laukhtina, Nico C Grossmann, Victor M Schuettfort, Frederik König, Abdulmajeed Aydh, Reza S Motlagh, Satoshi Katayama, Hadi Mostafai, Benjamin Pradere, Giancarlo Marra, Paolo Gontero, Romain Mathieu, Pierre I Karakiewicz, Alberto Briganti, Shahrokh F Shariat, Axel Heidenreich

    The Prostate   81 ( 11 )   765 - 771   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To examine the effect of lymph node dissection on the outcomes of patients who underwent salvage radical prostatectomy (SRP). MATERIAL AND METHODS: We retrospectively reviewed data from radiation-recurrent patients with prostate cancer (PCa) who underwent SRP from 2000-2016. None of the patients had clinical lymph node involvement before SRP. The effect of the number of removed lymph nodes (RLNs) and the number of positive lymph nodes (PLNs) on biochemical recurrence (BCR)-free survival, metastases free survival, and overall survival (OS) was tested in multivariable Cox regression analyses. RESULTS: About 334 patients underwent SRP and pelvic lymph node dissection (PLND). Lymph node involvement was associated with increased risk of BCR (p < .001), metastasis (p < .001), and overall mortality (p = .006). In a multivariable Cox regression analysis, an increased number of RLNs significantly lowered the risk of BCR (hazard ratio [HR] 0.96, p = .01). In patients with positive lymph nodes, a higher number of RLNs and a lower number of PLNs were associated with improved freedom from BCR (HR 0.89, p = .001 and HR 1.34, p = .008, respectively). At a median follow-up of 23.9 months (interquartile range, 4.7-37.7), neither the number of RLNs nor the number of PLNs were associated with OS (p = .69 and p = .34, respectively). CONCLUSION: Pathologic lymph node involvement increased the risk of BCR, metastasis and overall mortality in radiation-recurrent PCa patients undergoing SRP. The risk of BCR decreased steadily with a higher number of RLNs during SRP. Further research is needed to support this conclusion and develop a precise therapeutic adjuvant strategy based on the number of RLNs and PLNs.

    DOI: 10.1002/pros.24173

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  • Androgen receptor axis-targeted agents for non-metastatic castration-resistant prostate cancer impact on overall survival and safety profile: an updated systematic review and meta-analysis. 国際誌

    Keiichiro Mori, Fahad Quhal, Satoshi Katayama, Hadi Mostafaei, Ekaterina Laukhtina, Victor M Schuettfort, Reza Sari Motlagh, Nico C Grossmann, Pawel Rajwa, Guillaume Ploussard, Alberto Briganti, Takahiro Kimura, Shin Egawa, Rocco Papalia, Diego M Carrion, Cristian Fiori, Shahrokh F Shariat, Francesco Esperto, Benjamin Pradere

    Minerva urology and nephrology   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: The management of non-metastatic castration-resistant prostate cancer (nmCRPC) has undergone a paradigm shift with the development of androgen receptor axis-targeted (ARAT) agents. The updated results with final overall survival (OS) data of the phase III PROSPER, SPARTAN, and ARAMIS trials have recently been reported. Therefore, we performed an updated meta-analysis and network meta-analysis to indirectly compare the efficacy and safety of currently available treatments. EVIDENCE ACQUISITION: Multiple databases were searched for articles published before January 2021. Studies that compared OS and adverse events (AEs) in patients with nmCRPC were considered eligible. EVIDENCE SYNTHESIS: Three studies (n=4,117) met our eligibility criteria. Formal network meta-analyses were conducted. ARAT agent is associated with significantly longer OS compared to placebo (pooled hazard ratio (HR): 0.74, 95% confidence interval (CI): 0.65-0.83, P<0.001), with similar results shown for patients with both N1 and N0 disease (pooled HR 0.61 and pooled HR 0.76, respectively). In the network meta-analysis, apalutamide, darolutamide, and enzalutamide were more effective than placebo, with similar efficacies in terms of OS. For AEs (including any AEs, grade 3 or grade 4 AEs, grade 5 AEs, serious AEs, and AEs leading to treatment discontinuation), darolutamide was shown to be likely well tolerated. Quality-of-life was preserved in treatment arms irrespective of the drug. CONCLUSIONS: All three ARAT agents are efficacious options for the treatment of nmCRPC, whereas darolutamide appears to have the most favorable tolerability profile. These findings may facilitate individualized treatment strategies and inform future direct comparative trials.

    DOI: 10.23736/S2724-6051.21.04431-1

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  • The Efficacy and Safety of Relugolix Compared with Degarelix in Advanced Prostate Cancer Patients: A Network Meta-analysis of Randomized Trials. 国際誌

    Reza Sari Motlagh, Mohammad Abufaraj, Keiichiro Mori, Abdulmajeed Aydh, Pawel Rajwa, Satoshi Katayama, Nico C Grossmann, Ekaterina Laukhtina, Hadi Mostafai, Benjamin Pradere, Fahad Quhal, Pierre I Karakiewicz, Dmitry V Enikeev, Shahrokh F Shariat

    European urology oncology   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CONTEXT: Degarelix is associated with high rates of injection site reaction. The US Food and Drug Administration approved relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, for the treatment of advanced prostate cancer patients. OBJECTIVE: This systematic review and network meta-analysis aimed to compare the efficacy and safety of relugolix versus degarelix. EVIDENCE ACQUISITION: A systematic search was performed using major web databases for studies published before January 30, 2021, according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) extension statement for a network meta-analysis. Studies that compared the efficacy (12-mo castration rate with testosterone ≤50 ng/dl) and safety (adverse events [AEs]) of relugolix or degarelix and of the control group (GnRH agonists) were included. We used the Bayesian approach in the network meta-analysis. EVIDENCE SYNTHESIS: Four studies (n = 2059) met our eligibility criteria. The main efficacy analysis was conducted for two different treatments (relugolix and all doses of degarelix vs GnRH agonists); relugolix (risk ratio [RR] 1.09, 95% credible interval [CrI]: 0.95-1.23) and degarelix (RR 0.98, 95% CrI: 0.91-1.06) were not associated with different 12-mo castration rates. In the subgroup analysis, degarelix 480 mg was significantly associated with a lower castration rate (RR 0.46, 95% CrI: 0.07-0.92). In all efficacy ranking analyses, relugolix achieved the best rank. The safety analyses showed that relugolix (RR 0.99, 95% CrI: 0.6-1.6 and RR 0.72, 95% CrI: 0.4-1.3, respectively) and degarelix (RR 1.1, 95% CrI: 0.75-1.35 and RR 1.05, 95% CrI: 0.42-2.6, respectively) were not associated with either all AE or serious AE rates. In the ranking analyses, degarelix achieved the worst rank of all AEs and the best rank of serious AEs. Relugolix (RR 0.44, 95% CrI: 0.16-1.2) and degarelix (RR 0.74, 95% CrI: 0.37-1.52) were not associated with different cardiovascular event (CVE) rates; both were associated with lower CVE rates than GnRH agonists in the ranking analyses. CONCLUSIONS: We found that the efficacy and safety of relugolix are comparable with those of degarelix, albeit with no injection site reaction. Such data should be interpreted with caution until large-scale direct comparison studies with a longer follow-up are available. PATIENT SUMMARY: We found that relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, has comparable efficacy and safety with degarelix, a parenteral GnRH antagonist, for the treatment of advanced prostate cancer patients.

    DOI: 10.1016/j.euo.2021.07.002

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  • Association of Severe Microscopic Hematuria with Successful Conservative Treatment of Single Uncomplicated Ureteral Calculus: A Multicenter Cohort Study. 国際誌

    Satoshi Katayama, Takashi Yoshioka, Tomoko Sako, Wataru Murao, Motoo Araki, Toyohiko Watanabe, Tadasu Takenaka

    European urology focus   7 ( 4 )   812 - 817   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Although detection of microscopic hematuria is a well-known diagnostic method for urolithiasis, its ability to predict urolithiasis treatment outcomes in adults is unknown. OBJECTIVE: To evaluate the role of microscopic hematuria in conservative treatment of ureteral calculus. DESIGN, SETTING, AND PARTICIPANTS: This cohort study involved 482 patients who were diagnosed with a single uncomplicated ureteral calculus (≤10 mm) using computed tomography and underwent conservative therapy at two Japanese community hospitals between 2013 and 2018. Patients were divided into three groups according to the severity of microscopic hematuria (no, ≤4; mild to moderate, 5-99; and severe, ≥100 red blood cells per high-power field) and as determined during the first emergency department or urologic outpatient clinic visit. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: A multivariate logistic regression analysis was performed to estimate the odds ratio for successful conservative therapy at 28 d after the diagnosis. Statistical significance was set at p < 0.05. RESULTS AND LIMITATIONS: Of the 482 patients, 81 (16.8%), 209 (43.4%), and 192 (39.8%) had no, mild to moderate, and severe microscopic hematuria, respectively. After adjustments for six relevant confounders, severe microscopic hematuria showed a significant association with successful conservative therapy at 28 d (adjusted odds ratio, 1.91; 95% confidence interval, 1.02-3.57; p = 0.043), whereas mild to moderate microscopic hematuria did not (adjusted odds ratio, 1.05; 95% confidence interval, 0.57-1.93; p = 0.872) when compared with no microscopic hematuria. CONCLUSIONS: Severe microscopic hematuria was significantly associated with successful conservative therapy for single uncomplicated ureteral calculus. PATIENT SUMMARY: Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus. Using the presence or absence of blood in urine and other predictive factors, clinicians may lead patients with a single uncomplicated ureteral calculus to successful conservative therapy.

    DOI: 10.1016/j.euf.2020.04.004

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  • Accuracy of Frozen Section Analysis of Urethral and Ureteral Margins During Radical Cystectomy for Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis. 国際誌

    Ekaterina Laukhtina, Pawel Rajwa, Keiichiro Mori, Marco Moschini, David D'Andrea, Mohammad Abufaraj, Francesco Soria, Andrea Mari, Wojciech Krajewski, Simone Albisinni, Jeremy Yuen-Chun Teoh, Fahad Quhal, Reza Sari Motlagh, Hadi Mostafaei, Satoshi Katayama, Nico C Grossmann, Dmitry Enikeev, Kristin Zimmermann, Harun Fajkovic, Petr Glybochko, Shahrokh F Shariat, Benjamin Pradere

    European urology focus   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CONTEXT: The question of the ability of frozen section analysis (FSA) to accurately detect malignant pathology intraoperatively has been discussed for many decades. OBJECTIVE: We aimed to conduct a systematic review and meta-analysis assessing the diagnostic estimates of FSA of the urethral and ureteral margins in patients treated with radical cystectomy (RC) for bladder cancer (BCa). EVIDENCE ACQUISITION: The MEDLINE and EMBASE databases were searched in February 2021 for studies analyzing the association between FSA and the final urethral and ureteral margin status in patients treated with RC for BCa. The primary endpoint was the value of pathologic detection of urethral and ureteral malignant involvement with FSA during RC compared with the final margin status. We included studies that provided true positive, true negative, false positive, and false negative values for FSA, which allowed us to calculate the diagnostic estimates. EVIDENCE SYNTHESIS: Fourteen studies, comprising 8208 patients, were included in the quantitative synthesis. Forest plots revealed that the pooled sensitivity and specificity for FSA of urethral margins during RC were 0.83 (95% confidence interval [CI] 0.38-0.97) and 0.95 (95% CI 0.91-0.97), respectively. While for the FSA of ureteral margins, the pooled sensitivity and specificity were 0.77 (95% CI 0.67-0.84) and 0.97 (95% CI 0.95-0.98), respectively. Calculated diagnostic odds ratios indicated high FSA effectiveness, and patients with a positive urethral or ureteral margin at final pathology are over 100 times more likely to have positive FSA than patients without margin involvement at final pathology. Area under the curves of 96.6% and 96.7% were reached for FSA detection of urethral and ureteral tumor involvement, respectively. CONCLUSIONS: Intraoperative FSA demonstrated high diagnostic performance in detecting both urethral and ureteral malignant involvement at the time of RC for BCa. FSA of both urethral and ureteral margins during RC is accurate enough to be of great value in the routine management of BCa patients treated with RC. While its specificity was great to guide intraoperative decision-making, its sensitivity remains suboptimal yet. PATIENT SUMMARY: We believe that the frozen section analysis of both urethral and ureteral margins during radical cystectomy should be considered more often in urologic practice, until quality of life-based cost-effectiveness studies can identify patients within each institution who are unlikely to benefit from it.

    DOI: 10.1016/j.euf.2021.05.010

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  • Impact of the preoperative modified glasgow prognostic score on disease outcome after radical cystectomy for urothelial carcinoma of the bladder. 国際誌

    Victor M Schuettfort, Kilian Gust, David D'Andrea, Fahad Quhal, Hadi Mostafaei, Ekaterina Laukhtina, Keiichiro Mori, Michael Rink, Mohammad Abufaraj, Pierre I Karakiewicz, Stefano Luzzago, Morgan Rouprêt, Dmitry Enikeev, Kristin Zimmermann, Marina Deuker, Marco Moschini, Reza Sari Motlagh, Nico C Grossmann, Satoshi Katayama, Benjamin Pradere, Shahrokh F Shariat

    Minerva urology and nephrology   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: To investigate the predictive and prognostic value of the preoperative modified Glasgow Prognostic Score (mGPS) in patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). METHODS: We conducted a retrospective analysis of an established multicenter database consisting of 4,335 patients who were treated with RC +/- adjuvant chemotherapy for UCB between 1979 and 2012. The mGPS of each patient was calculated on the basis of preoperative serum C-reactive protein and albumin. Uni- and multivariable logistic and Cox regression analyses were performed. The discriminatory ability of the models was assessed by calculating the area under receiver operating characteristics curves (AUC) and concordance-indices (C-Index). The additional clinical net-benefit was assessed using the decision curve analysis (DCA). RESULTS: A mGPS of 0, 1, and 2 was observed in 3,158 (72.8%), 1,020 (23.5%), and 157 (3.6%) patients, respectively. On multivariable logistic regression analyses, mGPS of 1 or 2 were associated with an increased risk of pT3/4 disease at RC (OR 1.25, p=0.004 and OR 2.58, p<0.001, respectively) and/or lymph node metastasis (OR 1.7, p<0.001 and OR 3.9, p<0.001, respectively). Addition of the mGPS to a predictive model based on preoperatively available variables improved its accuracy for prediction of lymph node metastasis (change of AUC +3.7%, p<0.001). On multivariable Cox regression analyses, mGPS of 1 or 2 remained associated with worse recurrence-free survival (HR 1.14, p=0.03 and HR 1.89 p<0.001, respectively), cancer-specific survival (HR 1.16, p=0.032 and HR 2.1, p<0.001, respectively) and overall survival (HR 1.5, p=0.007 and HR 1.92 p<0.001, respectively) compared to mGPS of 0. The additional discriminatory ability of the mGPS for prognosis of survival outcomes in separate models that included either established pre- or postoperative variables did not improve the C-Index by a prognostically relevant degree (change of C-Index <2% for all models). On DCA, the inclusion of the mGPS did not meaningfully improve the net-benefit for clinical decision-making regarding survival outcomes. CONCLUSIONS: We confirmed that an elevated mGPS is an independent risk factor for non-organ confined disease and poor survival outcomes in patients with UCB undergoing RC. However, the mGPS showed little value in improving the discriminatory ability of predictive and prognostic models that relied on either pre- or postoperative clinicopathological variables. The discriminatory ability of this biomarker in the age of immunotherapy warrants further evaluation.

    DOI: 10.23736/S2724-6051.21.04216-6

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  • Accuracy and Clinical Utility of a Tumor Grade- and Stage-based Predictive Model in Localized Upper Tract Urothelial Carcinoma. 国際誌

    Satoshi Katayama, Keiichiro Mori, Victor M Schuettfort, Benjamin Pradere, Hadi Mostafaei, Fahad Quhal, Pawel Rajwa, Reza Sari Motlagh, Ekaterina Laukhtina, Marco Moschini, Nico C Grossmann, Motoo Araki, Jeremy Yuen-Chun Teoh, Morgan Rouprêt, Vitaly Margulis, Dmitry Enikeev, Pierre I Karakiewicz, Mohammad Abufaraj, Eva Compérat, Yasutomo Nasu, Shahrokh F Shariat

    European urology focus   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Among various clinicopathologic factors used to identify low-risk upper tract urothelial carcinoma (UTUC), tumor grade and stage are of utmost importance. The clinical value added by inclusion of other risk factors remains unproven. OBJECTIVE: To assess the performance of a tumor grade- and stage-based (GS) model to identify patients with UTUC for whom kidney-sparing surgery (KSS) could be attempted. DESIGN, SETTING, AND PARTICIPANTS: In this international study, we reviewed the medical records of 1240 patients with UTUC who underwent radical nephroureterectomy. Complete data needed for risk stratification according to the European Association of Urology (EAU) and National Comprehensive Cancer Network (NCCN) guidelines were available for 560 patients. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariable and multivariable logistic regression analyses were performed to determine if risk factors were associated with the presence of localized UTUC. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the GS, EAU, and NCCN models in predicting pathologic stage were calculated. RESULTS AND LIMITATIONS: Overall, 198 patients (35%) had clinically low-grade, noninvasive tumors, and 283 (51%) had ≤pT1disease. On multivariable analyses, none of the EAU and NCCN risk factors were associated with the presence of non-muscle-invasive UTUC among patients with low-grade and low-stage UTUC. The GS model exhibited the highest accuracy, sensitivity, and negative predictive value among all three models. According to the GS, EAU, and NCCN models, the proportion of patients eligible for KSS was 35%, 6%, and 4%, respectively. Decision curve analysis revealed that the net benefit of the three models was similar within the clinically reasonable range of probability thresholds. CONCLUSIONS: The GS model showed favorable predictive accuracy and identified a greater number of KSS-eligible patients than the EAU and NCCN models. A decision-making algorithm that weighs the benefits of avoiding unnecessary kidney loss against the risk of undertreatment in case of advanced carcinoma is necessary for individualized treatment for UTUC patients. PATIENT SUMMARY: We assessed the ability of three models to predict low-grade, low-stage disease in patients with cancer of the upper urinary tract. No risk factors other than grade assessed on biopsy and stage assessed from scans were associated with better prediction of localized cancer. A model based on grade and stage may help to identify patients who could benefit from kidney-sparing treatment of their cancer.

    DOI: 10.1016/j.euf.2021.05.002

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  • Photodynamic diagnostic ureteroscopy using the VISERA ELITE video system for diagnosis of upper-urinary tract urothelial carcinoma: a prospective cohort pilot study. 国際誌

    Koichiro Wada, Motoo Araki, Ryuta Tanimoto, Takuya Sadahira, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Hirochika Nakajima, Herik Acosta, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

    BMC urology   21 ( 1 )   45 - 45   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system. METHODS: We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated. RESULTS: A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS). CONCLUSIONS: Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system. TRIAL REGISTRATION: The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803-002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205).

    DOI: 10.1186/s12894-021-00819-2

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  • Intravesical Therapy in Patients with Intermediate-risk Non-muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis of Disease Recurrence. 国際誌

    Ekaterina Laukhtina, Mohammad Abufaraj, Abdallah Al-Ani, Mustafa Rami Ali, Keiichiro Mori, Marco Moschini, Fahad Quhal, Reza Sari Motlagh, Benjamin Pradere, Victor M Schuettfort, Hadi Mostafaei, Satoshi Katayama, Nico C Grossmann, Harun Fajkovic, Francesco Soria, Dmitry Enikeev, Shahrokh F Shariat

    European urology focus   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CONTEXT: Patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) may pose a clinical dilemma without an agreed evidence-based decision tree for personalized treatment. OBJECTIVE: To perform a systematic review and network meta-analysis (NMA) to summarize available evidence on the oncologic outcomes of intravesical therapy in patients with intermediate-risk NMIBC. EVIDENCE ACQUISITION: The MEDLINE, EMBASE, and ClinicalTrials.gov databases were searched in October 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they reported on oncologic outcomes in patients with intermediate-risk NMIBC treated with transurethral resection of bladder tumor with and without intravesical chemotherapy or bacillus Calmette-Guérin (BCG) immunotherapy. EVIDENCE SYNTHESIS: Twelve studies were included in a qualitative synthesis (systematic review); three were deemed eligible for a quantitative synthesis (NMA). An NMA of five different regimens was conducted for the association of treatment with the 5-yr recurrence risk. Chemotherapy with maintenance was associated with a lower likelihood of 5-yr recurrence than chemotherapy without maintenance (odds ratio [OR] 0.51, 95% credible interval [CI] 0.26-1.03). Immunotherapy, regardless of whether a full- or reduced-dose regimen, was not associated with a significantly lower likelihood of 5-yr recurrence when compared with chemotherapy without maintenance (OR 0.90, 95% CI 0.39-2.11 vs OR 0.93, 95% CI 0.40-2.19). Analysis of the treatment ranking revealed that chemotherapy with maintenance had the lowest 5-yr recurrence risk (P score 0.9666). CONCLUSIONS: Our analysis indicates that chemotherapy with a maintenance regimen confers a superior oncologic benefit in terms of 5-yr recurrence risk compared to chemotherapy without maintenance in patients with intermediate-risk NMIBC. Regardless of the dose regimen, immunotherapy with BCG does not appear to be superior to chemotherapy in patients with intermediate-risk NMIBC in term of disease recurrence. However, owing to the lack of comparative studies, there is an unmet need for well-designed, large-scale trials to validate our findings and generate robust evidence on disease recurrence and progression. PATIENT SUMMARY: A maintenance schedule of chemotherapy reduces the rate of long-term recurrence of bladder cancer that has not invaded the bladder muscle. Chemotherapy inserted directly into the bladder and immunotherapy without maintenance schedules seem to have limited benefit in preventing cancer recurrence.

    DOI: 10.1016/j.euf.2021.03.016

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  • A panel of systemic inflammatory response biomarkers for outcome prediction in patients treated with radical cystectomy for urothelial carcinoma. 国際誌

    Victor M Schuettfort, David D'Andrea, Fahad Quhal, Hadi Mostafaei, Ekaterina Laukhtina, Keiichiro Mori, Frederik König, Michael Rink, Mohammad Abufaraj, Pierre I Karakiewicz, Stefano Luzzago, Morgan Rouprêt, Dmitry Enikeev, Kristin Zimmermann, Marina Deuker, Marco Moschini, Reza Sari Motlagh, Nico C Grossmann, Satoshi Katayama, Benjamin Pradere, Shahrokh F Shariat

    BJU international   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To determine the predictive and prognostic value of a panel of systemic inflammatory response (SIR) biomarkers relative to established clinicopathological variables in order to improve patient selection and facilitate more efficient delivery of peri-operative systemic therapy. MATERIALS AND METHODS: The preoperative serum levels of a panel of SIR biomarkers, including albumin-globulin ratio, neutrophil-lymphocyte ratio, De Ritis ratio, monocyte-lymphocyte ratio and modified Glasgow prognostic score were assessed in 4199 patients treated with radical cystectomy for clinically non-metastatic urothelial carcinoma of the bladder. Patients were randomly divided into a training and a testing cohort. A machine-learning-based variable selection approach (least absolute shrinkage and selection operator regression) was used for the fitting of several multivariable predictive and prognostic models. The outcomes of interest included prediction of upstaging to carcinoma invading bladder muscle (MIBC), lymph node involvement, pT3/4 disease, cancer-specific survival (CSS) and recurrence-free survival (RFS). The discriminatory ability of each model was either quantified by area under the receiver-operating curves or by the C-index. After validation and calibration of each model, a nomogram was created and decision-curve analysis was used to evaluate the clinical net benefit. RESULTS: For all outcome variables, at least one SIR biomarker was selected by the machine-learning process to be of high discriminative power during the fitting of the models. In the testing cohort, model performance evaluation for preoperative prediction of lymph node metastasis, ≥pT3 disease and upstaging to MIBC showed a 200-fold bootstrap-corrected area under the curve of 67.3%, 73% and 65.8%, respectively. For postoperative prognosis of CSS and RFS, a 200-fold bootstrap corrected C-index of 73.3% and 72.2%, respectively, was found. However, even the most predictive combinations of SIR biomarkers only marginally increased the discriminative ability of the respective model in comparison to established clinicopathological variables. CONCLUSION: While our machine-learning approach for fitting of the models with the highest discriminative ability incorporated several previously validated SIR biomarkers, these failed to improve the discriminative ability of the models to a clinically meaningful degree. While the prognostic and predictive value of such cheap and readily available biomarkers warrants further evaluation in the age of immunotherapy, additional novel biomarkers are still needed to improve risk stratification.

    DOI: 10.1111/bju.15379

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  • Catalog of prognostic tissue-based biomarkers in patients treated with neoadjuvant systemic therapy for urothelial carcinoma of the bladder: a systematic review. 国際誌

    Ekaterina Laukhtina, Benjamin Pradere, Keiichiro Mori, Victor M Schuettfort, Fahad Quhal, Hadi Mostafaei, Reza Sari Motlangh, Satoshi Katayama, Nico C Grossmann, Marco Moschini, Dmitry Enikeev, Shahrokh F Shariat

    Urologic oncology   39 ( 3 )   180 - 190   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The present systematic review aimed to identify prognostic values of tissue-based biomarkers in patients treated with neoadjuvant systemic therapy (NAST), including chemotherapy (NAC) and checkpoint inhibitors (NAI) for urothelial carcinoma of the bladder (UCB). MATERIAL AND METHODS: The PubMed, Web of Science, and Scopus databases were searched in August 2020 according to the PRISMA statement. Studies were deemed eligible if they compared oncologic or pathologic outcomes in patients treated with NAST for UCB with and without detected pretreatment tissue-based biomarkers. RESULTS: Overall, 44 studies met our eligibility criteria. Twenty-three studies used immunohistochemistry (IHC), 19 - gene expression analysis, three - quantitative polymerase chain reaction (QT PCR), and two - next-generation sequencing (NGS). According to the currently available literature, predictive IHC-assessed biomarkers, such as receptor tyrosine kinases and DNA repair pathway alterations, do not seem to convincingly improve our prediction of pathologic response and oncologic outcomes after NAC. Luminal and basal tumor subtypes based on gene expression analysis showed better NAC response, while claudin-low and luminal-infiltrated tumor subtypes did not. In terms of NAI, PD-L1 seems to maintain value as a predictive biomarker, while the utility of both tumor mutational burden and molecular subtypes remains controversial. Specific genomic alterations in DNA repair genes have been shown to provide significant predictive value in patient treated with NAC. QT PCR quantification of specific genes selected through microarray analysis seems to classify cases regarding their NAC response. CONCLUSION: We believe that the present systematic review may offer a robust framework that will enable the testing and validation of predictive biomarkers in future prospective clinical trials. NGS has expanded the discovery of molecular markers that are reflective of the mechanisms of the NAST response.

    DOI: 10.1016/j.urolonc.2020.12.019

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  • 神経線維腫症1型に合併した後腹膜悪性末梢神経鞘腫瘍の1例

    宗田 大二郎, 岩田 健宏, 定平 卓也, 富永 悠介, 片山 聡, 西村 慎吾, 高本 篤, 佐古 智子, 枝村 康平, 小林 泰之, 荒木 元朗, 渡部 昌実, 渡邉 豊彦, 那須 保友, 中田 英二, 柳井 広之

    西日本泌尿器科   82 ( 6 )   596 - 600   2021年2月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

    症例は30代,女性。過去に左腋窩皮膚生検で神経線維腫と診断され,特徴的な皮膚所見や家族歴などから神経線維腫症1型(NF-1;von Recklinghausen病)を疑われていたが放置していた。20XX年2月に右大腿部痛,背部痛を主訴に近医を受診しMRI,造影CTで約13cm大の後腹膜腫瘤を指摘され,L2神経根からの発生と脊柱管内の浸潤も疑われ,神経線維腫の疑いとして手術目的に当科紹介された。合同での手術が必要と考えられたため,整形外科に紹介しMRIガイド下生検で悪性末梢神経鞘腫瘍の可能性を示唆された。同年6月に腫瘍の動脈塞栓術施行後に右後腹膜腫瘍摘出術を施行し,病理結果から悪性末梢神経鞘腫瘍と診断された。術後10ヵ月現在再発認めず,外来通院中である。後腹膜原発腫瘍において悪性末梢神経鞘腫瘍は極めて稀な症例であり,有効な治療法は確立されていない。今回,後腹膜原発の悪性末梢神経鞘腫瘍の1例を経験したので,若干の文献的考察を加えて報告する。(著者抄録)

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  • 神経線維腫症1型に合併した後腹膜悪性末梢神経鞘腫瘍の1例

    宗田 大二郎, 岩田 健宏, 定平 卓也, 富永 悠介, 片山 聡, 西村 慎吾, 高本 篤, 佐古 智子, 枝村 康平, 小林 泰之, 荒木 元朗, 渡部 昌実, 渡邉 豊彦, 那須 保友, 中田 英二, 柳井 広之

    西日本泌尿器科   82 ( 6 )   596 - 600   2021年2月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

    症例は30代,女性。過去に左腋窩皮膚生検で神経線維腫と診断され,特徴的な皮膚所見や家族歴などから神経線維腫症1型(NF-1;von Recklinghausen病)を疑われていたが放置していた。20XX年2月に右大腿部痛,背部痛を主訴に近医を受診しMRI,造影CTで約13cm大の後腹膜腫瘤を指摘され,L2神経根からの発生と脊柱管内の浸潤も疑われ,神経線維腫の疑いとして手術目的に当科紹介された。合同での手術が必要と考えられたため,整形外科に紹介しMRIガイド下生検で悪性末梢神経鞘腫瘍の可能性を示唆された。同年6月に腫瘍の動脈塞栓術施行後に右後腹膜腫瘍摘出術を施行し,病理結果から悪性末梢神経鞘腫瘍と診断された。術後10ヵ月現在再発認めず,外来通院中である。後腹膜原発腫瘍において悪性末梢神経鞘腫瘍は極めて稀な症例であり,有効な治療法は確立されていない。今回,後腹膜原発の悪性末梢神経鞘腫瘍の1例を経験したので,若干の文献的考察を加えて報告する。(著者抄録)

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  • Further Understanding of Urokinase Plasminogen Activator Overexpression in Urothelial Bladder Cancer Progression, Clinical Outcomes and Potential Therapeutic Targets. 国際誌

    Nico C Grossmann, Victor M Schuettfort, Benjamin Pradere, Marco Moschini, Fahad Quhal, Hadi Mostafaei, Francesco Soria, Satoshi Katayama, Ekaterina Laukhtina, Keiichiro Mori, Reza Sari Motlagh, Cédric Poyet, Mohammad Abufaraj, Pierre I Karakiewicz, Shahrokh F Shariat, David D'Andrea

    OncoTargets and therapy   14   315 - 324   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose: The Plasminogen Activation System (PAS) plays a role in tumor growth, invasion and metastasis and has been associated with oncological outcomes in urinary bladder carcinoma (UBC). The use of the different components of this system as molecular markers could improve our understanding of the heterogeneous behavior of UBC and might enable earlier disease detection, individual risk stratification, more accurate outcome prediction and be a rationale for new targeted therapies. Methods: A comprehensive literature search including relevant articles up to October 2020 was performed using the MEDLINE/PubMed database. Results: The components of the PAS axis are involved in tumor progression through their signaling processes during angiogenesis, cell migration, metastasis and adhesion. The body of evidence shows an association of PAS component overexpression with adverse pathological features and clinical outcome in UBC. Overexpressed PAS components correlate with a higher pathological tumor grade and advanced tumor stage. In non-muscle-invasive bladder cancer (NMIBC), the PAS components were associated with disease outcome while in muscle-invasive bladder cancer (MIBC), it was associated with disease outcome and pathological features. Possible therapeutic approaches in the PAS for the treatment of UBC have only been sparsely investigated in in vitro and in vivo studies. Intravesical plasminogen activator inhibitor 1 (PAI-1) instillation in animal models yielded interesting results and warrant further exploration in Phase II studies. Conclusion: The overexpression of PAS components in UBC tumor tissue is associated with adverse pathological features and worse oncological outcomes. These findings are mainly based on preclinical studies and retrospective series, which requires further prospective studies to translate the PAS into clinically useful biomarkers and therapeutic targets.

    DOI: 10.2147/OTT.S242248

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  • 当院における開腹膀胱全摘術(ORC)と腹腔鏡下膀胱全摘術(LRC)の治療成績の比較

    和田里 章悟, 小林 泰之, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 高本 篤, 佐古 智子, 枝村 康平, 荒木 元朗, 渡部 昌実, 渡邉 豊彦, 那須 保友

    日本泌尿器科学会総会   108回   1138 - 1138   2020年12月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • Combined Laparoscopic and CT Monitoring of the Ice-Ball Margin during Cryoablation for Renal Cell Carcinoma Associated with von Hippel-Lindau Disease: First Case.

    Takanori Sekito, Motoo Araki, Takao Hiraki, Mayu Uka, Toshiyuki Komaki, Yusuke Matsui, Toshihiro Iguchi, Satoshi Katayama, Kasumi Yoshinaga, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Risa Kubota, Takuya Sadahira, Shingo Nishimura, Koichiro Wada, Atsushi Takamoto, Kohei Edamura, Tomoko Sako, Yasuyuki Kobayashi, Toyohiko Watanabe, Susumu Kanazawa, Yasutomo Nasu

    Acta medica Okayama   74 ( 5 )   443 - 448   2020年10月

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    記述言語:英語  

    We report a 47-year-old Japanese female with 10 previous treatments for multiple bilateral renal cell carcinoma (RCC) associated with von Hippel-Lindau disease. The 14-mm right lower pole renal tumor was in contact with the right ureter. Laparoscopic cryoablation was performed to protect the ureter wrapped with gauze. Computed tomography (CT) monitoring was used to confirm the precise ≥ 6 mm ice-ball margin. There was no local progression at 6-months post-surgery. The serum creatinine has been stable. This is apparently the first report of combined laparoscopic and CT monitoring of an ice-ball formation and its margin during cryoablation for RCC.

    DOI: 10.18926/AMO/60806

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  • 岡山大学病院における進行性尿路上皮癌に対するpembrolizumabの治療経験

    富永 悠介, 高本 篤, 関戸 崇了, 和田里 章悟, 大岩 裕子, 窪田 理沙, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   82 ( 1 )   106 - 110   2020年4月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

    【目的】当科におけるpembrolizumabの治療成績について報告する。【対象と方法】2018年4月から2019年7月までの間に、当院で進行性尿路上皮癌に対してpembrolizumabを使用した19例を対象とした。後方視的に有効性と安全性について検討した。【結果】年齢中央値は68歳(39〜81歳)、性別は男性14例(74%)、女性5例(26%)であった。上部尿路腫瘍10例(53%)、膀胱腫瘍7例(37%)、その他2例(11%)であり、転移部位はリンパ節14例(74%)、肺9例(47%)、骨4例(21%)、肝2例(11%)であった。投与回数の中央値は3回(1〜16回)、観察期間の中央値は4ヵ月(1〜12ヵ月)であった。奏効率は24%、progression-free survival(PFS)の中央値は2.7ヵ月、overall survival(OS)の中央値は9.1ヵ月であった。PRを得られた症例(4例)では観察期間終了時点においても全例で継続可能であった。免疫関連有害事象は4例で経験した。好中球・リンパ球比とPFSは負の相関を認めた。【結論】当院におけるpembrolizumabの治療成績は他の報告と同等であった。奏効例についてはdurable responseを得られた。今後、臨床的に応用可能な効果予測因子のさらなる検討が必要である。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01004&link_issn=&doc_id=20200514090018&doc_link_id=%2Fer9niuro%2F2020%2F008201%2F018%2F0106-0110%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2020%2F008201%2F018%2F0106-0110%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 後腹膜悪性末梢神経鞘腫の1例

    宗田 大二郎, 高本 篤, 荒木 元朗, 角南 亮輔, 関戸 崇了, 佐久間 貴文, 和田里 章悟, 吉永 香澄, 丸山 雄樹, 光井 洋介, 富永 悠介, 大岩 裕子, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 石井 亜矢乃, 渡部 昌実, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   82 ( 1 )   173 - 173   2020年4月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 岡山大学病院における進行性尿路上皮癌に対するpembrolizumabの治療経験

    富永 悠介, 高本 篤, 角南 亮輔, 関戸 崇了, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 大岩 裕子, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 石井 亜矢乃, 渡部 昌実, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 6 )   656 - 656   2019年12月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 症例から学ぶ 治療変遷から読み解く腎癌治療 何を、どこまで、どのように? 下大静脈腫瘍塞栓を伴う腎腫瘍の新しい手術アプローチ

    荒木 元朗, 小林 泰之, 枝村 康平, 角南 亮輔, 関戸 崇了, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 大岩 裕子, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 高本 篤, 佐古 智子, 和田 耕一郎, 渡辺 豊彦, 渡部 昌実, 那須 保友, 楳田 佑三, 八木 孝仁

    西日本泌尿器科   81 ( 増刊 )   113 - 113   2019年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • Pulmonary Tumor Thrombotic Microangiopathy Induced by Prostate Cancer. 査読

    Katayama S, Takenaka T, Nakamura A, Sako S, Bessho A, Ohara N

    Acta medica Okayama   72 ( 3 )   309 - 313   2018年6月

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    記述言語:英語  

    DOI: 10.18926/AMO/56078

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  • Urologic diseases in the emergency department 査読

    Yusuke Tominaga, Satoshi Katayama, Eiichi Ando, Tadasu Takenaka, Katsuyoshi Kondo

    Japanese Journal of Urology   107 ( 4 )   239 - 244   2016年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Urological Association  

    (Objectives) This paper aimed to report the clinical statistics on urologic diseases treated in the emergency department (ED). (Patients and methods) We retrospectively evaluated 1,480 patients diagnosed with urologic diseases in the ED between January 2013 and December 2014. We reviewed the patients' sex, age, main complaints, emergency grade, care-seeking process, hospitalization, examination items, and diagnosis. We also reviewed the correct-diagnosis rates of patients who visited the ED for the first time and were followed up at the urology department. (Results) Of the patients, 2.6% were diagnosed as having a urologic disease, with a male-to-female ratio of 1.5:1. The age distribution ranged from 0 to 101 years, with a median age of 53 years. Patients who required hospitalization accounted for 17.8%. The diagnoses were urolithiasis (546 cases), cystitis (220 cases), and pyelonephritis (137 cases), in order of frequency. The correct-diagnosis rates of urolithiasis (91.2%), benign prostatic hyperplasia (75.0%), and pyelonephritis (71.9%) were high. However, those of testicular torsion (0%), urologic neoplasm (26.7%), prostatitis (35.7%), and epididymitis (35.7%) were low. (Conclusion) In the ED, 82.2% of cases of urologic diseases were mild and did not require hospitalization. The correct-diagnosis rate of acute scrotum was low, as it was difficult to diagnose and thus difficult to manage in the ED. Therefore, urologists should cooperate with ED staff and warn them that cases of acute scrotum should be subjected to emergency consultation.

    DOI: 10.5980/jpnjurol.107.239

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MISC

  • 経皮的腎凍結療法の困難症例における術中CTと腹腔鏡の併用の有用性

    荒木元朗, 関戸崇了, 平木隆夫, 宇賀麻由, 片山聡, 高本篤史, 枝村康平, 小林泰之, 渡邉豊彦, 那須保友

    日本泌尿器内視鏡学会(Web)   34th   2020年

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  • 岡山大学病院における進行性尿路上皮癌に対するpembrolizumabの治療経験

    富永 悠介, 高本 篤, 角南 亮輔, 関戸 崇了, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 大岩 裕子, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 石井 亜矢乃, 渡部 昌実, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 6 )   656 - 656   2019年12月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 症例から学ぶ 治療変遷から読み解く腎癌治療 何を、どこまで、どのように? 下大静脈腫瘍塞栓を伴う腎腫瘍の新しい手術アプローチ

    荒木 元朗, 小林 泰之, 枝村 康平, 角南 亮輔, 関戸 崇了, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 大岩 裕子, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 高本 篤, 佐古 智子, 和田 耕一郎, 渡辺 豊彦, 渡部 昌実, 那須 保友, 楳田 佑三, 八木 孝仁

    西日本泌尿器科   81 ( 増刊 )   113 - 113   2019年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 岡山大学病院における進行性尿路上皮腫瘍に対するpembrolizumabの治療経験

    高本 篤, 小林 泰之, 大岩 裕子, 片山 聡, 枝村 康平, 窪田 理沙, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 荒木 元朗, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 増刊 )   183 - 183   2019年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • ロボット支援腹腔鏡下腎部分切除術後の腎癌尿管再発の1例

    角南 亮輔, 大岩 裕子, 高本 篤, 関戸 崇了, 佐久間 貴文, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 4 )   482 - 482   2019年8月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院におけるニボルマブ+イピリムマブの初期経験

    片山 聡, 高本 篤, 関戸 崇了, 角南 亮輔, 佐久間 貴文, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 窪田 理沙, 大岩 裕子, 定平 卓也, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 石井 亜矢乃, 渡部 昌実, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 4 )   483 - 484   2019年8月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院におけるニボルマブ+イピリムマブの初期経験

    片山 聡, 高本 篤, 関戸 崇了, 角南 亮輔, 佐久間 貴文, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 窪田 理沙, 大岩 裕子, 定平 卓也, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 石井 亜矢乃, 渡部 昌実, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 4 )   483 - 484   2019年8月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • ロボット支援腹腔鏡下腎部分切除術後の腎癌尿管再発の1例

    角南 亮輔, 大岩 裕子, 高本 篤, 関戸 崇了, 佐久間 貴文, 和田里 章悟, 河村 香澄, 丸山 雄樹, 光井 洋介, 窪田 理沙, 定平 卓也, 片山 聡, 岩田 健宏, 西村 慎吾, 佐古 智子, 和田 耕一郎, 枝村 康平, 小林 泰之, 荒木 元朗, 渡邉 豊彦, 那須 保友

    西日本泌尿器科   81 ( 4 )   482 - 482   2019年8月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 腎全摘後における長期的な腎機能推移についての検討

    片山 聡, 山本 洋資, 中塚 浩一, 村尾 航, 村上 貴典

    西日本泌尿器科   80 ( 増刊 )   189 - 189   2018年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 岡山赤十字病院泌尿器科における転移性去勢抵抗性前立腺癌に対するカバジタキセルの治療成績

    笹岡 丈人, 竹中 皇, 甲斐 誠二, 榮枝 一磨, 安東 栄一, 佐古 智子, 片山 聡, 富永 悠介

    西日本泌尿器科   80 ( 増刊 )   202 - 202   2018年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 岡山赤十字病院泌尿器科における転移性去勢抵抗性前立腺癌に対するカバジタキセルの初期使用経験

    竹中 皇, 佐古 智子, 栄枝 一磨, 笹岡 丈人, 安東 栄一, 片山 聡, 富永 悠介

    日本泌尿器科学会総会   106回   PP3 - 264   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • 当科における光選択的前立腺レーザー蒸散術(PVP)の短期成績

    榮枝 一磨, 笹岡 丈人, 富永 悠介, 片山 聡, 佐古 智子, 安東 栄一, 竹中 皇

    Japanese Journal of Endourology   30 ( 3 )   265 - 265   2017年11月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器内視鏡学会  

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  • タバコによる尿道異物の1例

    坂本 健, 富永 悠介, 榮枝 一磨, 片山 聡, 佐古 智子, 竹中 皇

    岡山赤十字病院医学雑誌   28   96 - 96   2017年11月

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    記述言語:日本語   出版者・発行元:岡山赤十字病院医学雑誌編集委員会  

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  • 上腸間膜動脈塞栓症の治療中に両側腎梗塞を合併し救命しえた1例

    渡邊 麻衣, 楠原 英生, 渡邉 謙太, 片山 聡, 田尻 展久, 岩崎 衣津, 福家 聡一郎, 高木 章司, 中西 浩之, 實金 健

    岡山赤十字病院医学雑誌   28   93 - 93   2017年11月

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    記述言語:日本語   出版者・発行元:岡山赤十字病院医学雑誌編集委員会  

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  • 自然破裂を来した腎血管筋脂肪腫の1例

    佐野 雄芳, 富永 悠介, 片山 聡, 佐古 智子, 竹中 皇

    岡山赤十字病院医学雑誌   28   95 - 96   2017年11月

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    記述言語:日本語   出版者・発行元:岡山赤十字病院医学雑誌編集委員会  

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  • 右鼠径部に発生した黄色肉芽腫性炎症の1例

    山本 洋資, 片山 聡, 中塚 浩一, 村尾 航, 藤江 俊司, 淀谷 光子, 大前 健一, 藤井 将義

    西日本泌尿器科   79 ( 増刊 )   149 - 149   2017年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • タバコによる尿道異物の1例

    坂本 健, 富永 悠介, 榮枝 一磨, 片山 聡, 佐古 智子, 竹中 皇

    西日本泌尿器科   79 ( 6 )   197 - 197   2017年6月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 顕微鏡的血尿があると尿路結石は落下しやすいのか

    片山 聡, 和田 耕一郎, 富永 悠介, 佐古 智子, 安東 栄一, 竹中 皇

    日本泌尿器科学会総会   105回   PP30 - 04   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • 当院救急センターにおける泌尿器疾患の臨床統計

    富永 悠介, 片山 聡, 安東 栄一, 竹中 皇, 近藤 捷嘉

    日本泌尿器科学会雑誌   107 ( 4 )   239 - 244   2016年10月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会  

    (目的)救急における泌尿器疾患の臨床統計を行った。(方法)2013年1月から2014年12月までの2年間に当院救急外来を受診し、泌尿器疾患と診断された1,480例を対象とした。検討項目は、性別、年齢、主訴、救急区分、受診経路、入院の有無、検査内容、診断名とした。さらに初診患者のうち、泌尿器科でフォローアップされた症例において正診率を検討した。(結果)泌尿器疾患は全体の2.6%であり、男女比は1.5:1であった。年齢は0歳から101歳まで(中央値53歳)であり、入院を必要とした症例は17.8%であった。診断は尿路結石(546例)、膀胱炎(220例)、腎盂腎炎(137例)の順に多かった。泌尿器疾患の正診率は72.3%であった。疾患別では尿路結石(91.2%)、前立腺肥大症(75.0%)、腎盂腎炎(71.9%)の順に高く、一方で精巣捻転(0%)、泌尿器腫瘍(26.7%)、前立腺炎(35.7%)、精巣上体炎(35.7%)などは低かった。(結論)泌尿器疾患の82.2%が入院を必要としない軽症例であった。急性陰嚢症の正診率が低く、救急部での診断・対応は困難であった。我々泌尿器科医も救急部と連携を図り、急性陰嚢症の迅速なコンサルテーションを注意喚起することが必要である。(著者抄録)

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  • 当院におけるPVPの初期症例の検討

    片山 聡, 富永 悠介, 安東 栄一, 竹中 皇

    西日本泌尿器科   78 ( 5 )   260 - 260   2016年5月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 治療に苦慮した膀胱出血の3例

    片山 聡, 徳永 貴範, 富永 悠介, 安東 栄一, 竹中 皇

    西日本泌尿器科   78 ( 3 )   135 - 135   2016年3月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 膀胱尿道異物の1例

    徳永 貴範, 富永 悠介, 片山 聡, 安東 栄一, 竹中 皇

    岡山赤十字病院医学雑誌   26   44 - 47   2015年11月

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    記述言語:日本語   出版者・発行元:岡山赤十字病院医学雑誌編集委員会  

    症例は42歳、男性。尿道内へ体温計を自己挿入したところ抜去困難となり、当院救急外来を受診した。腹部X線検査および腹部超音波検査にて、膀胱から尿道にかけて挿入された異物を確認した。同日、全身麻酔下で膀胱高位切開術による膀胱異物摘出を行った。膀胱尿道異物は比較的稀な疾患であるが、挿入された異物の種類、位置等により、適切な術式を選択すべきである。(著者抄録)

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  • SIADHを合併した女性尿道癌に対して膀胱全摘及び回腸導管を行った一例

    丸山 雄樹, 富永 悠介, 片山 聡, 安東 栄一, 竹中 皇

    西日本泌尿器科   77 ( 増刊 )   160 - 160   2015年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院で入院加療を要した血尿症例の検討

    片山 聡, 富永 悠介, 中村 あや, 安東 栄一, 佐古 真一, 竹中 皇

    西日本泌尿器科   77 ( 増刊 )   136 - 136   2015年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当科におけるBONENAVIの使用経験

    富永 悠介, 片山 聡, 安東 栄一, 竹中 皇

    泌尿器外科   28 ( 臨増 )   823 - 823   2015年5月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

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  • PDE5阻害薬内服中、転倒により陰茎折症を疑われた1例

    安東 栄一, 富永 悠介, 片山 聡, 竹中 皇

    日本抗加齢医学会総会プログラム・抄録集   15回   221 - 221   2015年5月

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    記述言語:日本語   出版者・発行元:(一社)日本抗加齢医学会  

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  • 当院救急センターにおける尿路・性器感染症の検討

    安東 栄一, 富永 悠介, 片山 聡, 竹中 皇, 中村 あや, 佐古 真一, 近藤 捷嘉

    日本泌尿器科学会総会   103回   745 - 745   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • PTTMにより呼吸不全を呈した前立腺癌の一例

    片山 聡, 富永 悠介, 中村 あや, 安東 栄一, 佐古 真一, 竹中 皇, 近藤 捷嘉

    西日本泌尿器科   76 ( 増刊 )   144 - 144   2014年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 岡山赤十字病院救急外来における泌尿器科疾患の検討

    富永 悠介, 片山 聡, 安東 栄一, 竹中 皇, 近藤 捷嘉, 中村 あや, 佐古 真一, Yusuke TOMINAGA

    日赤医学 = The Japanese Red Cross Medical Journal   66 ( 1 )   235 - 235   2014年9月

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    記述言語:日本語   出版者・発行元:日本赤十字社医学会  

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  • 当院救命救急センターにおける2013年上半期の泌尿器科疾患の臨床統計

    富永 悠介, 片山 聡, 安東 栄一, 竹中 皇, 近藤 捷嘉, 中村 あや, 佐古 真一

    西日本泌尿器科   76 ( 9 )   335 - 335   2014年9月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 完全内臓逆位症に合併した腎癌の一例

    片山 聡, 富永 悠介, 安東 栄一, 佐古 真一, 竹中 皇, 大橋 輝久, 近藤 捷嘉

    Japanese Journal of Endourology   27 ( 2 )   395 - 398   2014年9月

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    記述言語:日本語   出版者・発行元:日本泌尿器内視鏡学会  

    症例は74歳男性.肺検診異常の精査にて,右腎腫瘍・多発肺転移を指摘され当科紹介受診.CT・MRIで,胸腹部の内臓が左右逆転しており,さらに右側腎臓上部に約8cm大の内部不均一な充実性腫瘤,肺には2,3cm大の結節影を認めた.以上より,完全内臓逆位症に合併した右腎癌・多発肺転移(cT2aN0M1 PUL)と診断し,腹腔鏡下根治的右腎摘除術を施行した.左側臥位で右肋骨弓下に3ポートを置き,経腹的アプローチで行った.術中所見として,内臓逆位に伴う手技の困難はあまり感じることはなかった.手術時間は4時間30分,出血量は100mlであった.完全内臓逆位症に合併した腎癌に対する腹腔鏡手術は,鏡面構造をよく理解した上で,十分なシミュレーションを行い執刀すれば操作に大きな困難はなく,安全かつ低侵襲に施行することができた.

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  • 当院での去勢抵抗性前立腺癌(CRPC)に対するドセタキセルの使用経験

    片山 聡, 富永 悠介, 野崎 邦浩, 村尾 航, 中村 あや, 安東 栄一, 佐古 真一, 竹中 皇, 近藤 捷嘉

    日本泌尿器科学会総会   102回   499 - 499   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • 当院救急センターにおける泌尿器科疾患の臨床統計

    富永 悠介, 片山 聡, 安東 栄一, 竹中 皇, 近藤 捷嘉, 中村 あや, 佐古 真一

    日本泌尿器科学会総会   102回   620 - 620   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会総会事務局  

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  • ウイルス性尿路感染症の3例

    片山 聡, 和田 耕一郎, 藤田 治

    西日本泌尿器科 = The Nishinihon journal of urology   76 ( 2 )   52 - 58   2014年2月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

    【症例1】60歳、男性。急性リンパ性白血病に対し非血縁間同種骨髄移植を施行。移植から約半年後より肉眼的血尿が出現し当科紹介。USにて両側水腎症が出現し、両側尿管ステントを留置した。尿よりHHV6およびADV陽性であった。以後、血尿は消失し尿路通過障害が改善したため両側尿管ステントを抜去し、腎機能の低下なく経過良好であったが、原疾患の悪化により永眠された。【症例2】36歳、女性。急性骨髄性白血病に対し臍帯血移植を施行。その約1ヵ月後から肉眼的血尿が出現し当科紹介受診。CTにて両側水腎症が出現し、同日両側尿管ステントを留置した。肉眼的血尿のコントロールが難しく、第5病日に両側腎瘻を造設した。尿よりCMV陽性であった。以後血尿は消失し尿路通過障害が改善したため両側腎瘻を抜去し、腎機能の低下なく経過良好であったが、原疾患の悪化により永眠された。【症例3】49歳、女性。慢性腎不全に対し献腎移植を施行。移植約2年3ヵ月後より悪寒および肉眼的血尿が出現し、当科紹介受診。CTにて移植腎水腎症が出現し、同日腎瘻を造設した。尿よりADV陽性であった。以後血尿は消失し尿路通過障害が改善したため約1ヵ月後には腎瘻を抜去し、腎機能の低下なく経過良好である。3例ともに水腎症を呈し尿管ステントあるいは腎瘻造設を行い軽快した。今回われわれは、ウイルス性尿路感染症の3例を経験したので、若干の文献的考察を加えて報告する。(著者抄録)

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  • 尿膜管遺残に対する腹腔鏡下尿膜管切除を行った4例の臨床的検討

    黒瀬 恭平, 藤田 治, 眞鍋 大輔, 武田 克治, 片山 聡, 和田 耕一郎, 三枝 道尚

    西日本泌尿器科   76 ( 1 )   31 - 32   2014年1月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 完全内臓逆位症に合併した腎癌の一例

    片山 聡, 富永 悠介, 安東 栄一, 佐古 真一, 竹中 皇

    Japanese Journal of Endourology   26 ( 3 )   275 - 275   2013年11月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器内視鏡学会  

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  • 精路と交通した尿管瘤と思われた1例

    片山 聡, 富永 悠介, 藤田 治, 眞鍋 大輔, 三枝 道尚, 武田 克治

    西日本泌尿器科   75 ( 9 )   488 - 488   2013年9月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 尿路上皮癌の肺転移に対して外科的切除を行った2例の検討

    片山 聡, 藤田 治, 眞鍋 大輔, 三枝 道尚, 武田 克治

    西日本泌尿器科   75 ( 8 )   445 - 445   2013年8月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院におけるTVM手術治療成績

    藤田 治, 片山 聡, 眞鍋 大輔, 三枝 道尚, 武田 克治

    西日本泌尿器科   75 ( 5 )   269 - 269   2013年5月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院におけるTVM手術治療成績

    藤田 治, 片山 聡, 眞鍋 大輔, 三枝 道尚, 武田 克治

    日本泌尿器科学会雑誌   104 ( 2 )   393 - 393   2013年3月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器科学会  

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  • 香川県立中央病院における腹腔鏡下前立腺全摘除術導入期の治療成績

    眞鍋 大輔, 片山 聡, 藤田 治, 三枝 道尚, 武田 克治, 雑賀 隆史, 小林 泰之

    Japanese Journal of Endourology   25 ( 3 )   303 - 303   2012年11月

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    記述言語:日本語   出版者・発行元:(一社)日本泌尿器内視鏡学会  

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  • BCG膀胱内注入療法中に急速に進行した膀胱癌の1例

    三枝 道尚, 片山 聡, 藤田 治, 真鍋 大輔, 武田 克治

    西日本泌尿器科   74 ( 増刊 )   128 - 128   2012年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • TAEにより治療した腎動静脈奇形2例

    富永 悠介, 片山 聡, 藤田 治, 眞鍋 大輔, 三枝 道尚, 武田 克治, 櫻井 淳

    西日本泌尿器科   74 ( 10 )   590 - 590   2012年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 当院におけるTVM手術治療成績

    藤田 治, 片山 聡, 眞鍋 大輔, 三枝 道尚, 武田 克治

    香川県医師会誌   65 ( 特別 )   100 - 100   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)香川県医師会  

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  • ウイルス性尿路感染症の3例

    片山 聡, 藤田 治, 眞鍋 大輔, 三枝 道尚, 武田 克治

    西日本泌尿器科   74 ( 9 )   523 - 523   2012年9月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 後腹膜脂肪肉腫の1例

    片山 聡, 西川 昌友, 山野 潤, 阪本 祐一, 中村 一郎

    泌尿器科紀要   58 ( 2 )   123 - 123   2012年2月

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    記述言語:日本語   出版者・発行元:泌尿器科紀要刊行会  

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  • 初回塞栓術(TAE)6年後に再発した腎動静脈奇形の1例

    西川 昌友, 片山 聡, 山野 潤, 阪本 祐一, 中村 一郎

    泌尿器科紀要   57 ( 11 )   661 - 662   2011年11月

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    記述言語:日本語   出版者・発行元:泌尿器科紀要刊行会  

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  • Fournier壊疽の2例

    片山 聡, 別宮 謙介, 石川 勉, 平田 武志, 佐々木 克己, 江原 伸, 上原 慎也, 渡邉 豊彦, 那須 保友, 公文 裕巳, 瀧口 徹也, 山崎 修

    西日本泌尿器科   73 ( 10 )   577 - 577   2011年10月

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    記述言語:日本語   出版者・発行元:西日本泌尿器科学会  

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  • 臥位高血圧に起立性低血圧を伴った糖尿病腎症に昇圧剤を投与し可逆性後頭葉白質脳症の発症をみた1例

    中村 武寛, 高井 智子, 山下 修司, 片山 聡, 武部 礼子, 中川 智広, 城 洋志彦, 臼杵 則朗

    糖尿病   53 ( 12 )   845 - 849   2010年12月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本糖尿病学会  

    症例は33歳男性.2型糖尿病で外来通院中であったが,血糖コントロール不良で腎症第4期など合併症が進行していた.糖尿病神経障害によると思われる起立性低血圧を繰り返すため,降圧剤を中止し昇圧剤を投与したところ,血圧の急激な上昇とともに意識レベルが低下し,痙攣を生じた.頭部MRIの所見および経過により,可逆性後頭葉白質脳症(Reversible posterior leukoencephalopathy syndrome;以下RPLS)と診断した.昇圧剤投与による急激な血圧上昇,進行した腎症,腎性貧血に対するエリスロポイエチン製剤投与,自律神経障害などの複数の要因が発症に関与したと考えられた.糖尿病合併症の進行した高血圧患者において,起立性低血圧に対して昇圧剤を投与する際には,RPLS発症の危険があり,十分な注意が必要である.&lt;br&gt;

    CiNii Article

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  • 魚骨により腸間膜穿孔をきたした一例

    片山 聡, 茅田 洋之, 諏澤 憲, 木川 雄一郎, 湯浅 一郎, 仲本 嘉彦, 原田 武尚, 竹尾 正彦, 小縣 正明, 山本 満雄

    日本腹部救急医学会雑誌   30 ( 3 )   511 - 511   2010年3月

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    記述言語:日本語   出版者・発行元:(一社)日本腹部救急医学会  

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