Faculty Profiles - ARAKI Motoo

Papers - ARAKI Motoo

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Robotic renal auto transplantation

Motoo Araki, Koichiro Wada, Shingo Nishimura, Risa Kubota, Kasumi Kawamura, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Ayano Ishii, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 81 ( 3 ) 314 - 320 2019.6

Language：Japanese Publishing type：Research paper (international conference proceedings) Publisher：The West Japan Urological Association

Renal autotransplantation (RAT) is a great surgical procedure for renal preservation, however it is underutilized due to its invasiveness. Robotic RATx has been in use since 2014. We conducted robotic RATx following a feasibility study using a porcine model. A 38-year-old woman with left ureteral stenosis was referred to us for urinary tract reconstruction. She had undergone an emergency Caesarean section for intraperitoneal bleeding secondary to left ovarian rupture four years earlier. After the surgery, she developed hypovolemic shock and disseminated intravascular coagulation (DIC) due to postoperative bleeding. Left internal iliac artery embolization saved her life. However, it resulted in a left ureteral stenosis measuring 2.7 cm that was located 5 cm from the left ureteral orifice, which required chronic ureteral stent exchange. Neither balloon dilation nor laser incision was successful. In addition, retrograde pyelography showed a possible left ureteropelvic junction obstruction. The patient was hesitant about the surgery because of its invasiveness. However, four years later, the patient elected to undergo robotic RATx. To date, only four cases of robotic RATx have been reported, including the current case. The indication of all four cases was extensive ureteral stenosis. Ileal ureter is frequently used for the treatment of extensive ureteral stenosis, but it can entail many problems including urine reabsorption resulting in metabolic acidosis. Ileal ureter is contraindicated for patients with a serum creatinine (sCr) level greater than 2 mg/dl. Even if sCr is less than 2 mg/dl, it is questionable whether sCr will remain less than 2 mg/ dl for the remainder of someone's life. Boari flap can give rise to vesicoureteral reflux causing urinary tract infection. RATx does not have those problems. Robotic RATx is a new, minimally invasive approach to renal preservation.

Contrast-enhanced Computed Tomography-Guided Percutaneous Cryoablation of Renal Cell Carcinoma in a Renal Allograft: First Case in Asia. Reviewed

Ichiro Tsuboi, Motoo Araki, Hiroyasu Fujiwara, Toshihiro Iguchi, Takao Hiraki, Naoko Arichi, Kasumi Kawamura, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Risa Kubota, Shingo Nishimura, Tomoko Sako, Atsushi Takamoto, Koichiro Wada, Yasuyuki Kobayashi, Toyohiko Watanabe, Hiroyuki Yanai, Masashi Kitagawa, Katsuyuki Tanabe, Hitoshi Sugiyama, Jun Wada, Hiroaki Shiina, Susumu Kanazawa, Yasutomo Nasu

Acta medica Okayama 73 ( 3 ) 269 - 272 2019.6

Authorship：Corresponding author Language：English Publisher：Okayama University Medical School

Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.

DOI： 10.18926/AMO/56871

Other Link： http://search.jamas.or.jp/link/ui/2020076262

Comparison of the predictive value among inflammation-based scoring systems for bleomycin pulmonary toxicity in patients with germ cell tumors. Reviewed International journal

Maruyama Y, Sadahira T, Araki M, Mitsui Y, Wada K, Edamura K, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

International journal of urology : official journal of the Japanese Urological Association 26 ( 8 ) 813 - 819 2019.5

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To compare the predictive value of pretreatment inflammation-based scoring systems in patients with germ cell tumors receiving first-line bleomycin-based chemotherapy. METHODS: Retrospectively, we evaluated 57 patients with germ cell tumors. Bleomycin pulmonary toxicity was defined as the presence of asymptomatic decline in pulmonary function tests, pulmonary symptoms or interstitial pneumonia on computed tomography in the absence of infection. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, albumin-to-globulin ratio, Prognostic Nutritional Index, Glasgow Prognostic Score and C-reactive protein were measured in all patients. To assess the predictive ability of each scoring system, the area under the receiver operating characteristic curve was calculated, and multivariate analysis was carried out to identify the predictive scores associated with bleomycin pulmonary toxicity. RESULTS: Of the 57 patients, 15 patients developed bleomycin pulmonary toxicity. The neutrophil-to-lymphocyte ratio had the highest area under the curve value (0.763) of all inflammation-based scoring systems, followed by the Prognostic Nutritional Index (0.749). In multivariate analysis, the neutrophil-to-lymphocyte ratio (odds ratio 11.5; P = 0.009) and Prognostic Nutritional Index (odds ratio 9.07; P = 0.013) were independently associated with development of bleomycin pulmonary toxicity. As these two independent markers were combined, the area under the curve achieved the highest value (0.822). CONCLUSIONS: The present study shows that the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index are independent risk factors for development of bleomycin pulmonary toxicity. The combination of the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index seems to have superior predictive value compared with other inflammation-based scoring systems.

DOI： 10.1111/iju.14017

Comparison of longitudinal health-related quality-of-life outcomes between anterior and posterior surgical approaches to robot-assisted radical prostatectomy. Reviewed International journal

Maruyama Y, Sadahira T, Araki M, Mitsui Y, Wada K, Tanimoto R, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

Journal of robotic surgery 14 ( 2 ) 255 - 260 2019.5

Language：English Publishing type：Research paper (scientific journal)

Increasingly, studies have explored health-related quality-of-life (HRQOL) outcomes after robot-assisted radical prostatectomy (RARP). Nevertheless, no study has compared differences between anterior and posterior surgical approaches. The aim of this study is to assess differences of HRQOL following these two surgical approaches. From January 2012 to September 2017, 653 patients underwent RARP at our institution. We included patients who underwent operations by three experienced surgeons with interchangeability of role as console operator, and who could evaluate preoperatively the Expanded Prostate Cancer Index Composite (EPIC) score. Patients treated with neoadjuvant hormonal therapy were excluded. HRQOL was assessed using the EPIC score, and the questionnaire was administered at 6 timepoints: the baseline survey was conducted within 3 months before the surgery, and follow-up surveys were conducted at 2 weeks, 1, 3, 6, and 12 months after surgery. We defined the minimal clinically important difference (MCID) as half the standard deviation of the baseline score for each domain. A total of 201 patients were included in this retrospective study. Of these, 146 patients underwent RARP using an anterior surgical approach and 55 patients underwent a posterior approach. The clinical characteristics had no significant differences except for median prostate volume between the anterior and posterior groups (27 ml vs 29 ml, p = 0.049). There were no significant differences between the two groups in score decline beyond the MCID in any domain at any timepoint. Our study demonstrates no significant differences in HRQOL between anterior and posterior surgical approaches to RARP.

DOI： 10.1007/s11701-019-00975-6

Experience of robot-assisted radical cystectomy in Okayama University Hospital

Yasuyuki Kobayashi, Masao Mitsui, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Koichiro Wada, Kohei Edamura, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 81 ( 2 ) 122 - 127 2019.4

Language：Japanese Publishing type：Research paper (international conference proceedings) Publisher：The West Japan Urological Association

Robot-assisted radical cystectomy became listed as being covered by insurance in 2018 and accordingly, it is expected to become a popular surgical method in Japan in the future. In this study, we examined the findings of 102 patients who underwent total cystectomy (ORC, 35 cases), laparoscopic radical cystectomy (LRC, 52 cases), and robot-assisted radical cystectomy (RARC, 15 cases). The examined items were operative time, bleeding volume, postoperative complications, length of hospital stay, postoperative walking start date, postoperative pain and postoperative fever. Operative time was the shortest for RARC and bleeding volume was the lowest for RARC. Postoperative complications comprised approximately 33% (all grades) in any group. LRC and RARC were superior to ORC regarding both the period until walking start day and the period of postoperative persistent fever. Compared to ORC, patients undergoing RARC can expect an earlier recovery after surgery. In addition, patients undergoing RARC can expect stable surgical results with little difference in the postoperative course of each case.

Gosha-jinki-gan, a herbal medicine, is effective for the treatment of female patients with overactive bladder and sensitivity to the cold

Yuko Matsumoto, Ayano Ishii, Masumi Yamamoto, Satoko Matsuo, Tomoko Sako, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu, Miyabi Inoue, Shinako Araki, Noritaka Ishito, Hitoshi Takamoto

Nishinihon Journal of Urology 81 ( 1 ) 12 - 16 2019.2

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The West Japan Urological Association

The herbal medicine "gosha-jinki-gan" is effective for the treatment of patients with overactive bladder and an increase in peripheral blood flow. We prospectively assessed the relationship between the effectiveness of gosha-jinki-gan for female patients with overactive bladder and an improvement in their sensitivity to the cold. Between December 2012 and March 2016, gosha-jinki-gan 2.5 g t.i.d. was administered to a total of 56 adult female patients with overactive bladder for a period of 4 weeks. Their symptoms were assessed using the Overactive Bladder Symptom Score (OABSS), and their sensitivity to the cold was assessed using a questionnaire about the cold, based on Terasawa's diagnostic criteria. Skin temperature (at the palmar, suprapubic and plantar locations), OABSS and answers to the questionnaire about the cold were obtained at baseline and again at 4 weeks after treatment. Average age was 64 ± 13.8 years. Total OABSS improved significantly at 4 weeks (7.57 ± 3.36 vs. 6.73 ± 3.50), however skin temperature did not increase significantly. In a subgroup analysis, total OABSS was found to have improved significantly at 4 weeks (7.94 ± 3.65 vs. 6.86 ± 3.61) in the 36 women with sensitivity to the cold. However, although it showed a trend for improvement, that improvement was not statistically significant in the 20 women without sensitivity to the cold. Our findings indicated that gosha-jinki-gan improved overactive bladder symptoms more in patients with sensitivity to the cold than in patients without sensitivity to the cold.

Clitoral Blood Flow Changes after Surgery with Tension-Free Vaginal Mesh for Pelvic Organ Prolapse Reviewed

Oiwa Yuko, Watanabe Toyohiko, Sadahira Takuya, Ishii Ayano, Sako Tomoko, Inoue Miyabi, Wada Koichiro, Kobayashi Yasuyuki, Araki Motoo, Nasu Yasutomo

Acta Medica Okayama 73 ( 1 ) 21 - 27 2019.2

Language：English Publisher：Okayama University Medical School

We measured basal clitoral blood flow by Doppler sonography to determine whether tension-free vaginal mesh(TVM) affects the clitoral blood flow and sexual function in women with pelvic organ prolapse (POP). We performed a prospective study of 22 patients who underwent TVM for POP. Clitoral blood flow was measured by Doppler ultrasound. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries were measured preoperatively and at 1, 3, and 6 months postoperatively. Female sexual function was also investigated with the Female Sexual Function Index (FSFI). The mean PI and RI were increased at 1 month and significantly decreased at 6 months postoperatively (p<0.05). In contrast, the mean PSV and EDV decreased at 1 month postoperatively and increased at 6 months postoperatively. These four parameters recovered to baseline levels at 6 months following surgery. Total FSFI scores improved significantly from 10.2±7.9 at baseline to 18.2±8.9 at 6 months postoperatively. Color Doppler ultrasonography is potentially useful in measuring clitoral blood flow in patients treated with TVM for POP. Prospective long-term studies are needed to evaluate the utility of this modality as a diagnostic and prognostic tool for female sexual dysfunction.

DOI： 10.18926/AMO/56455

Robotic-assisted renal autotransplantation: Preliminary studies and future directions

Motoo Araki, Koichiro Wada, Kasumi Kawamura, Yuuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Risa Kubota, Shingo Nishimura, Takashi Yoshioka, Yuichi Ariyoshi, Kei Fujio, Atsushi Takamoto, Morito Sugimoto, Katsumi Sasaki, Yasuyuki Kobayashi, Shin Ebara, Amano Hiroyuki, Masashi Inui, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Endourology Progress: Technique, Technology and training 143 - 148 2019.1

Language：English Publishing type：Part of collection (book) Publisher：Springer Singapore

The indications for renal autotransplantation (RATx) include renal vascular trauma, thrombosis, stenosis, aneurysm, complex ureteral injuries, renal cell carcinoma, urolithiasis, retroperitoneal fibrosis, and loin pain-hematuria syndrome. Unfortunately, RATx is underutilized because of its invasiveness. The current gold standard approach to RATx is laparoscopic nephrectomy and open autotransplantation, which requires a large pelvic incision. Robotic-assisted renal autotransplantation (robotic RATx) is a new, minimally invasive approach that has been used since 2014. The first completely intracorporeal robotic RATx, used to repair a ureteral injury, was reported in 2014. Since then, only three cases have been reported, all from North America. After an initial porcine study, we conducted the fourth robotic RATx procedure. Robotic surgery has multiple advantages, such as providing a three-dimensional magnified view, navigating in narrow spaces, and fine suturing and dissection, which are particularly helpful in cases with desmoplastic changes. Most robotic RATx procedures have been used to repair ureteral injuries. These cases tend to have desmoplastic changes due to previous surgeries. Nephrectomy and RATx are technically challenging, hence robotic surgery may be the best option in patients with complex and severe desmoplastic changes. The disadvantages of robotic RATx include the length of surgery and cost. However, with continued use, both the operative time and the cost should decrease. In conclusion, robotic RATx is a new, minimally invasive approach to renal preservation.

DOI： 10.1007/978-981-13-3465-8_18

The Novel Combination of Nitroxoline and PD-1 Blockade, Exerts a Potent Antitumor Effect in a Mouse Model of Prostate Cancer. Reviewed International journal

Naijin Xu, Linglong Huang, Xiezhao Li, Masami Watanabe, Chaoming Li, Abai Xu, Chunxiao Liu, Qiang Li, Motoo Araki, Koichiro Wada, Yasutomo Nasu, Peng Huang

International journal of biological sciences 15 ( 5 ) 919 - 928 2019

Language：English Publishing type：Research paper (scientific journal)

Programmed cell death protein 1 (PD-1) blockade is a promising therapeutic strategy against prostate cancer. Nitroxoline has been found to have effective anticancer properties in several cancer types. We investigated the efficacy of a combination therapy involving nitroxoline and PD-1 blockade in a prostate cancer mouse model. In our in vitro analysis, we found that nitroxoline inhibited the viability and proliferation of the mouse prostate cancer cell line RM9-Luc-PSA. Additionally, nitroxoline downregulated the expressions of phospho-PI3 kinase, phospho-Akt (Thr308), phospho-Akt (Ser473), phospho-GSK-3β, Bcl-2, and Bcl-xL. Nitroxoline also downregulated programmed death-ligand 1 (PD-L1) expression levels in prostate cancer cell line and tumor tissue. In our murine prostate cancer orthotopic model, nitroxoline plus PD-1 blockade synergistically suppressed tumor growth when compared with nitroxoline or PD-1 blockade alone, leading to reductions in tumor weight, bioluminescence tumor signals, and serum prostate-specific antigen levels. Furthermore, fluorescence-activated cell sorting analysis showed that the combination strategy significantly enhanced antitumor immunity by increasing CD44+CD62L+CD8+ memory T cell numbers and reducing myeloid-derived suppressor cell numbers in peripheral blood. In conclusion, our findings suggest that nitroxoline plus PD-1 blockade may be a promising treatment strategy in patients with prostate cancer.

DOI： 10.7150/ijbs.32259

Use of single-dose perioperative antimicrobial therapy is acceptable in recipients of living-donor renal transplants in the rituximab era. Reviewed International journal

Nishimura S, Wada K, Araki M, Sadahira T, Maruyama Y, Mitsui Y, Tanimoto R, Kobayashi Y, Watanabe T, Nasu Y

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 ( 4 ) 247 - 252 2018.12

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The aim of this study was to evaluate the efficacy of single-dose perioperative antimicrobial therapy as infection prophylaxis in recipients of living-donor renal transplants in the rituximab era. PATIENTS AND METHODS: Between 2009 and 2017, 84 recipients underwent living-donor renal transplantation (LDRT) at Okayama University Hospital; 3 with vascular/urinary complications requiring additional surgery were excluded from this analysis. Data including recipient characteristics, antimicrobial prophylaxis and administration of rituximab were retrospectively examined for an association with perioperative infections. Prophylactic antimicrobial agents, selected according to the Results of preoperative urine cultures, were administered just before incision. Perioperative infections, which consisted of surgical site infections, remote infections, and urinary tract infections, were defined as a positive culture indicating required administration of additional antimicrobial agents. RESULTS: Among the 81 recipients, prophylactic cefazolin, ampicillin/sulbactam, and others were administered to 66 (82%), 13 (16%), and 2 (3%) recipients, respectively. Twenty-one (26%) received single-dose antimicrobial prophylaxis, while 60 (74%) received multiple doses up to 7 days. Rituximab was used in 59 (72.8%) recipients. The incidence of urinary tract infection, surgical site infection and remote infection was 13 (16%), 1 (1%), and 0, respectively. Univariate analysis could not demonstrate any significant risk factors for postoperative urinary tract infections, including a single dose vs multiple doses of antimicrobial therapy (P = 0.069) and administration of rituximab (P = 0.717). CONCLUSIONS: Our data suggest that the use of single-dose perioperative antimicrobial therapy is acceptable for prophylaxis of infections in patients undergoing LDRT, even in the rituximab era.

DOI： 10.1016/j.jiac.2018.11.013

Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot-assisted radical prostatectomy. Reviewed International journal

Sadahira T, Mitsui Y, Araki M, Maruyama Y, Wada K, Edamura K, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

Lower urinary tract symptoms 11 ( 3 ) 122 - 126 2018.12

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. METHODS: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. RESULTS: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. CONCLUSIONS: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.

DOI： 10.1111/luts.12245

The 3-D Volumetric Measurement Including Resected Specimen for Predicting Renal Function AfterRobot-assisted Partial Nephrectomy. Reviewed International journal

Mitsui Y, Sadahira T, Araki M, Maruyama Y, Nishimura S, Wada K, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

Urology 125 104 - 110 2018.12

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To investigate the relationship between postoperative renal function and resected cortex margin volume calculated by a 3-dimensional reconstruction technique based on the resected specimen, and to determine predictors of renal function after robot-assisted partial nephrectomy. METHODS: A total of 114 patients underwent robot-assisted partial nephrectomy from 2014 to 2018. Patients without a 1 mm slice computed tomography or renal scintigraphy were excluded. We identified the margins of the tumor from each resected specimen with 2 mm margin being added as the ischemic margin. The volume of the renal cortex was calculated automatically using 3-dimensional volume analyzer software. The total margin volume was excluded from the ipsilateral cortex volume to calculate the cortex volume split. Predicted estimated glomerular filtration rate (eGFR) was calculated using the change in cortex volume and then compared with the actual eGFR. RESULTS: Eighty-two patients were included in this retrospective study. Sixty-six patients (80%) were cT1a. A strong correlation was observed between renal scintigraphy split and pre- and postoperative cortex volume split (Pearson correlation coefficient r = 0.9330 and 0.8742, respectively). The predicted eGFR correlated strongly with post 1, 3, 6, and 12 months eGFR (r = 0.8929, 0.9294, 0.9320, and 0.8952, respectively). Preoperative relative renal function and total cortex margin volume were independent risk factors for decreasing postoperative renal function. CONCLUSION: This precise volumetric assessment that includes the resected margin is an alternative to renal scintigraphy for predicting postoperative relative renal function. The healthy cortex margin volume calculated by the reconstruction technique is an independent risk factor of decreasing postoperative renal function.

DOI： 10.1016/j.urology.2018.12.020

Burned-out Prostate Cancer ? Primary Metastatic Cancer Not Detected on Repeat Biopsy Reviewed

Mitsui Yosuke, Sadahira Takuya, Maruyama Yuki, Wada Koichiro, Tanimoto Ryuta, Sugimoto Morito, Araki Motoo, Watanabe Masami, Yanai Hiroyuki, Watanabe Toyohiko, Nasu Yasutomo

Acta Medica Okayama 72 ( 6 ) 605 - 609 2018.12

Language：English Publisher：Okayama University Medical School

Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was "burned-out," demonstrating remote metastases with no apparent primary tumor in the prostate. Burned-out PCa may be difficult to diagnose and treat due to its rarity.

DOI： 10.18926/AMO/56380

Other Link： http://search.jamas.or.jp/link/ui/2019286383

Loss of psoas major muscle volume during systemic chemotherapy is related to worse prognosis in testicular cancer. Reviewed International journal

Mitsui Y, Sadahira T, Araki M, Maruyama Y, Wada K, Tanimoto R, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

Japanese journal of clinical oncology 49 ( 2 ) 183 - 189 2018.11

Language：English Publishing type：Research paper (scientific journal)

Objective: In several cancers, the loss of skeletal muscle is well associated with oncological outcome. However, its effect is unknown in testicular cancer. This study evaluated the prognostic impact of psoas major muscle volume loss during systemic chemotherapy. Methods: This was a retrospective study of patients who underwent chemotherapy from 2008 to 2017. Psoas major muscle volume was calculated by volume analyzer software, and its loss was calculated during systemic chemotherapy. The patients were divided according to muscle volume loss: Group 1 (<20%) and Group 2 (≥20%). The losses were compared with Kaplan-Meier curves, and a Cox proportional hazard model was applied to test predictors of poor prognosis. Results: Fifty patients were included. Seventeen were classified into Group 1, and 33 into Group 2. The Kaplan-Meier curves revealed that the progression-free and the overall survival of Group 1 were significantly better than those of Group 2 (P = 0.002, P = 0.03, respectively). A multivariate analysis identified psoas major muscle volume loss as a significant and independent predictor of poor prognosis. Conclusions: Patients with psoas major muscle volume loss during chemotherapy had a significantly worse prognosis than those without loss.

DOI： 10.1093/jjco/hyy166

経腹的到達法による根治的腎摘除術

小林泰之, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

日本泌尿器内視鏡学会総会 32回 SEP - 2 2018.11

Red nodular melanoma of the penile foreskin: A case report and literature review. Reviewed International journal

Maruyama Y, Sadahira T, Mitsui Y, Wada K, Tanimoto R, Kobayashi Y, Araki M, Watanabe M, Watanabe T, Nasu Y

Molecular and clinical oncology 9 ( 4 ) 449 - 452 2018.10

Language：English Publishing type：Research paper (scientific journal)

The penis is an extremely rare primary site for malignant melanomas, and the clinical presentation may vary greatly. We herein present the case of a 71-year-old male patient who presented with a 6-year history of two slow growing, asymptomatic red macules on the penile foreskin. On physical examination, the mobility of the foreskin was good, and there was no metastasis on computed tomography and magnetic resonance imaging. The patient underwent segmental circumcision for treatment and histological diagnosis, and the histological examination revealed a malignant melanoma. As cancer cells were identified at the edge of the tissue specimen and computed tomography-positron emission tomography revealed increased uptake of 18F-fluorodeoxyglucose in the penis, wider resection and a right sentinel lymph node biopsy were performed; both specimens came back negative. Two years after the surgery, there has been no evidence of locoregional recurrence or distant metastases. The aim of this report is to alert physicians to include melanoma in the differential diagnosis of red-pigmented lesions of the penile foreskin.

DOI： 10.3892/mco.2018.1697

集学的治療によって長期予後が得られている進行性尿膜管癌の一例

横山周平, 杉本盛人, 松尾聡子, 坪井一郎, 河村香澄, 窪田理沙, 岩田健宏, 小林泰之, 荒木元朗, 渡邊豊彦, 那須保友, 江原伸, 宗淳一

西日本泌尿器科 80 ( 増刊 ) 181 - 181 2018.10

当院で経験した前立腺炎症性偽腫瘍の1例

佐久間貴文, 高本篤, 河村香澄, 岩田健宏, 和田耕一郎, 谷本竜太, 杉本盛人, 小林泰之, 荒木元朗, 渡邊豊彦, 柳井広之, 那須保友

西日本泌尿器科 80 ( 増刊 ) 176 - 176 2018.10

QOL向上をめざした泌尿器がん治療ロボット支援下膀胱全摘除術

小林泰之, 三井將雄, 佐古智子, 高本篤, 西村慎悟, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 80 ( 増刊 ) 95 - 95 2018.10

Clinical impact of abdominal fat distribution measured by 3-D computed tomography volumetry on post-transplant renal function in recipients after living kidney transplantation: a retrospective study. Reviewed

Mitsui Y, Sadahira T, Araki M, Maruyama Y, Wada K, Tanimoto R, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y

Clinical and experimental nephrology 23 ( 3 ) 415 - 424 2018.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Excessive visceral fat may decrease renal function because of metabolic derangements. The aim of this study was to evaluate the impact of abdominal fat distribution on renal function of recipients after kidney transplantation using the visceral adipose tissue (VAT)/subcutaneous adipose tissue (SAT) ratio. METHODS: Seventy-nine patients underwent living kidney transplantation from 2009 to 2017. Patients without a correct measurement of VAT and SAT, follow-up of < 6 months, or with kidney transplant rejection or a virus infection were excluded. VAT and SAT were calculated automatically by 3-D volume analyzer software in recipients prior to living kidney transplantation. Our primary aim was to identify abdominal fat distribution measured by CT associated with renal dysfunction (estimate glomerular filtration rate; eGFR < 45) at 6 month post renal transplantation in recipient. RESULTS: Fifty-eight living kidney recipients were included in this retrospective study: 30 for the high VAT/SAT ratio group; 28 for the VAT/SAT low group. Multiple logistic regression analysis showed the VAT/SAT ratio and pre-donor eGFR were associated with eGFR < 45 ml/min/1.73 m2. An increase in VAT/SAT ratio was associated independently with the incidence of decreased renal function. CONCLUSION: This finding indicates that adipose tissue distribution is an important predictor of the outcome of living kidney transplantation in recipients.

DOI： 10.1007/s10157-018-1643-6

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