Faculty Profiles - ARAKI Motoo

Papers - ARAKI Motoo

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Nonintravesical Interventions for Preventing Intravesical Recurrence in Patients With Nonmuscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Robert J Schulz, Stefano Mancon, Tamás Fazekas, Marcin Miszczyk, Anna Cadenar, Ekaterina Laukhtina, Pawel Rajwa, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Takafumi Yanagisawa, Jun Miki, Takahiro Kimura, Koichiro Wada, Pierre I Karakiewicz, Piotr Chlosta, Jeremy Teoh, Motoo Araki, Shahrokh F Shariat

Clinical genitourinary cancer 23 ( 2 ) 102306 - 102306 2025.4

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

Despite currently used intravesical therapies in non-muscle-invasive bladder cancer (NMIBC), the rate of intravesical recurrence remains very high. We aimed to evaluate the effectiveness of adding nonintravesical interventions to standard intravesical therapies to prevent intravesical recurrence. In April 2024, 3 databases were queried for prospective studies evaluating nonintravesical interventions in addition to standard intravesical therapies for NMIBC (CRD42024490988). The primary outcome was intravesical recurrence-free survival (iRFS). Standard pairwise meta-analyses were performed using hazard ratios (HR) and 95% confidence intervals (95% CI) with a random-effects model. We identified 18 eligible studies (14 RCTs and 4 prospective trials) comprising 4,593 NMIBC patients, which investigated pharmacological interventions (eg, selenium, vitamins, Lactobacillus casei, celecoxib, metformin, mistletoe lectin) and lifestyle modifications (diet). The addition of Lactobacillus casei significantly improved iRFS (HR: 0.50; 95% CI: 0.34-0.73; P < .001). A high western diet pattern significantly worsened iRFS (HR:1.48, 95%CI:1.06-2.06, P = .03). The other nonintravesical interventions were not associated with iRFS. Our comprehensive review of the published literature highlights the need for further research into the efficacy of nonvesical interventions for NMIBC. While Lactobacillus was shown to improve iRFS in 2 RCTs, additional high-quality randomized studies are required to evaluate the effectiveness of other interventions.

DOI： 10.1016/j.clgc.2025.102306

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Incidence, Management, and Prevention of Gynecomastia and Breast Pain in Patients with Prostate Cancer Undergoing Antiandrogen Therapy: A Systematic Review and Meta-analysis of Randomized Controlled Trials. International journal

Ichiro Tsuboi, Robert J Schulz, Ekaterina Laukhtina, Koichiro Wada, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat

European urology open science 73 31 - 42 2025.3

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

BACKGROUND AND OBJECTIVE: In patients with prostate cancer treated with antiandrogen monotherapy, gynecomastia and breast pain are relatively common. In the setting of androgen receptor pathway inhibitors (ARPIs), the incidence of these adverse events (AEs) remains unclear. In addition, the effect of prophylactic treatment on gynecomastia remains uncertain. We aimed to evaluate the incidence of gynecomastia and breast pain in prostate cancer patients treated with ARPIs compared with androgen deprivation therapy (ADT) and the effect of prophylactic treatment for these AEs due to antiandrogen therapy. METHODS: In June 2024, we queried four databases-PubMed, Scopus, Web of Science, and Embase-for randomized controlled trials (RCTs) investigating prostate cancer treatments involving antiandrogen therapy. The endpoints of interest were the incidence of these AEs due to ARPIs and the effect of prophylactic treatment for these. KEY FINDINGS AND LIMITATIONS: Eighteen RCTs, comprising 5036 patients, were included in the systematic review and meta-analysis. ARPIs included enzalutamide, darolutamide, and apalutamide. The results indicated that patients who received ARPI monotherapy had a significantly higher incidence of gynecomastia than those who received ADT monotherapy (risk ratio [RR]: 5.19, 95% confidence interval [CI]: 3.58-7.51, p < 0.001). There was no significant difference in the incidence of gynecomastia between ARPI plus ADT therapy and ADT monotherapy (RR: 1.27, 95% CI: 0.84-1.93, p = 0.2). Prophylactic tamoxifen or radiotherapy reduced significantly the incidence of gynecomastia and breast pain caused by bicalutamide monotherapy. CONCLUSIONS AND CLINICAL IMPLICATIONS: We found that ARPI monotherapy increases the incidence of these AEs significantly compared with ADT. In contrast, ARPI plus ADT therapy did not result in a higher incidence of AEs. The use of either tamoxifen or radiotherapy was effective in reducing the incidence of these AEs due to bicalutamide monotherapy. These prophylactic treatments could reduce the incidence of AEs due to ARPI monotherapy. However, further studies are needed to clarify their efficacy. PATIENT SUMMARY: Although androgen deprivation therapy (ADT) improves overall survival in patients with prostate cancer, it is associated with several complications. Androgen receptor pathway inhibitor (ARPI) monotherapy has emerged as a promising strategy for improving oncological outcomes in these patients. However, ARPI monotherapy increases gynecomastia and breast pain in prostate cancer patients compared with ADT, while ARPI plus ADT did not result in a higher incidence of adverse events.

DOI： 10.1016/j.euros.2025.01.001

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Serum uric acid level is associated with renal arteriolar hyalinosis and predicts post-donation renal function in living kidney donors. International journal

Yuzuki Kano, Katsuyuki Tanabe, Masashi Kitagawa, Hitoshi Sugiyama, Tomoaki Yamanoi, Kasumi Yoshinaga, Kensuke Bekku, Shingo Nishimura, Motoo Araki, Jun Wada

PloS one 20 ( 3 ) e0320482 2025

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

Major guidelines for living-donor kidney transplantation underscore the need for pre-donation evaluation of renal function, hypertension, obesity, diabetes mellitus, and albuminuria to minimize the risk of donation from marginal donors. However, validity is yet to be established. We retrospectively investigated the relationship between clinical characteristics and histological indices in baseline renal biopsies (0-h biopsies) and whether these parameters could predict renal function in living kidney donors one year post-donation. Seventy-six living kidney donors were recruited for this study. In histological analyses, glomerulosclerosis, arteriosclerosis, arteriolosclerosis, arteriolar hyalinosis, and interstitial fibrosis and tubular atrophy scores/indices were evaluated. Post-donation serum creatinine levels in kidney donors with arteriolar hyalinosis were significantly higher than those in individuals without arteriolar hyalinosis. There was a significant correlation between baseline serum uric acid levels and the arteriolar hyalinosis index, with baseline uric acid level identified as an independent factor for hyalinosis in multiple regression analysis. Additionally, the serum uric acid level was a significant prognostic factor for post-donation serum creatinine after adjustment for baseline clinical parameters. These data demonstrate that pre-donation serum uric acid levels are associated with arteriolar hyalinosis in the kidney and could predict a decline in renal function during the first year after donation in living kidney donors.

DOI： 10.1371/journal.pone.0320482

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Propensity score-matched analysis comparing robot-assisted partial nephrectomy and image-guided percutaneous cryoablation for cT1 renal cell carcinoma. International journal

Tomoaki Yamanoi, Kensuke Bekku, Kasumi Yoshinaga, Yuki Maruyama, Kentaro Nagao, Tatsushi Kawada, Yusuke Tominaga, Noriyuki Umakoshi, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Mayu Uka, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Takao Hiraki, Motoo Araki

Urologic oncology 42 ( 12 ) 453.e15-453.e22 2024.12

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

OBJECTIVES: This study aimed to compare the clinical outcomes of robot-assisted partial nephrectomy (RAPN) and image-guided percutaneous cryoablation (IG-PCA) for clinical T1 renal cell carcinoma. MATERIALS AND METHODS: We conducted a retrospective analysis of 679 patients with clinical T1 renal cell carcinoma treated with RAPN or IG-PCA between 2012 and 2021. Propensity scores were calculated via logistic analysis to adjust for imbalances in baseline characteristics. We compared oncological and functional outcomes between the 2 treatment groups. RESULTS: Following the matching process, 108 patients were included in each group. No patient in the RAPN group developed local recurrence. In the IG-PCA group, three patients experienced local tumor progression. The patients underwent salvage thermal ablations by the secondary technique; 2 underwent IG-PCA and 1 underwent microwave ablation, resulting in a local control rate of 100%. The Kaplan-Meier analysis showed no statistically significant differences between the groups in terms of 5-year recurrence-free survival, metastasis-free survival, and overall survival (log-rank test; P = 0.11, P = 0.64, and P = 0.17, respectively). No significant differences were observed in the 2 treatments in major and overall complication rates (P = 0.75 and P = 0.82, respectively). Both groups showed similar rates of less than 10% estimated glomerular filtration rate decline at 12 months post-treatment and 5-year renal function preservation rates (P = 0.88 and P = 0.38, respectively). CONCLUSIONS: IG-PCA demonstrated oncological outcomes comparable to those of RAPN. RAPN addressed the disadvantages of conventional procedures and allowed for safety outcomes comparable to IG-PCA.

DOI： 10.1016/j.urolonc.2024.09.012

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The Impact of Concomitant Medications on the Overall Survival of Patients Treated with Systemic Therapy for Advanced or Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Marcin Miszczyk, Tamás Fazekas, Robert J Schulz, Stefano Mancon, Giulio Litterio, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Pawel Rajwa, Koichiro Wada, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat

Clinical genitourinary cancer 22 ( 6 ) 102237 - 102237 2024.12

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

Although immune checkpoint inhibitors (ICI) and/or tyrosine kinase inhibitors (TKI) are the standard treatment of advanced unresectable or metastatic renal cell carcinoma (RCC), the impact of concomitant medications remains unclear. We aimed to evaluate the impact of concomitant medications on survival outcomes in patients treated with systemic therapy for advanced unresectable or metastatic RCC. In August 2024, PubMed, Scopus, and Web of Science were queried for studies evaluating concomitant medications in patients with advanced unresectable or metastatic RCC (PROSPERO: CRD42024573252). The primary outcome was overall survival (OS). A fixed- or random-effects model was used for meta-analysis according to heterogeneity. We identified 22 eligible studies (5 prospective and 17 retrospective) comprising 16,072 patients. Concomitant medications included proton pump inhibitors (PPI) (n = 3959), antibiotics (n = 571), statins (n = 5466), renin-angiotensin system inhibitors (RASi) (n = 6615), and beta-blockers (n = 1964). Both concomitant PPI and antibiotics were significantly associated with worse OS in patients treated with ICI (PPI: HR: 1.22, P = .01, and antibiotics: HR: 2.09, P < .001). Concomitant statins, RASi, or beta-blocker were significantly associated with improved OS in patients treated with TKI (statins: HR: 0.81, P = .03, RASi: HR: 0.63, P < .001, beta-blocker: HR: 0.69, P < .001, respectively). In patients treated with ICI, RASi was significantly associated with improved OS (HR: 0.64, P = .02). Concomitant use of antibiotics or PPI with ICI can reduce its oncologic efficacy. Conversely, concomitant statins, RASi, or beta-blockers can enhance the oncologic efficacy of TKI. When initiating systemic therapy for metastatic RCC, it may be important for clinicians to assess baseline co-medications and recognize their possible positive or negative effects.

DOI： 10.1016/j.clgc.2024.102237

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Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk.

Risa Kubota, Kensuke Bekku, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki

Acta medica Okayama 78 ( 6 ) 429 - 437 2024.12

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

Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers.

DOI： 10.18926/AMO/67868

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First-line therapy for metastatic renal cell carcinoma: A propensity score-matched comparison of efficacy and safety. Reviewed

Yanagisawa T, Mori K, Kawada T, Katayama S, Uchimoto T, Tsujino T, Nishimura K, Adachi T, Toyoda S, Nukaya T, Fukuokaya W, Urabe F, Murakami M, Yamanoi T, Bekku K, Komura K, Takahara K, Hashimoto T, Fujita K, Azuma H, Ohno Y, Shiroki R, Uemura H, Araki M, Kimura T, JK-FOOT study group

Urol Oncol. 42 ( 11 ) e21 - e29 2024.11

What is the identity of Gerota fascia? Histological study with cadavers. International journal

Yasuyuki Kobayashi, Kohei Edamura, Takuya Sadahira, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Kobayashi, Keita Sato, Takaaki Komiyama, Ryusuke Momota, Hideyo Ohuchi, Motoo Araki

International journal of urology : official journal of the Japanese Urological Association 2024.10

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

OBJECTIVES: The advancement of laparoscopic surgery has allowed surgeons to see finer anatomical structures during surgery. As a result, several issues have arisen regarding Gerota fascia that cannot be explained by previous interpretations, such as its various forms observed during surgery. To address these issues, we histologically examined the structure of Gerota fascia. METHODS: Specimens for study were prepared from kidneys with Gerota fascia from four cadavers, and the structure was studied histologically. Its thickness and collagen fiber area ratios were measured using ImageJ and compared to those of the epimysium of the rectus abdominis muscle. RESULTS: Connective tissue that appeared to be Gerota fascia was observed in 26 specimens. Histologically, the basic structure of Gerota fascia was a sandwich-like structure with a thin layer of thick, long collagen fibers in the central layer, and small granular collagen fibers scattered at the edges. However, not all areas observed had a similar structure; eight specimens were composed only of small granular collagen fibers. The average thickness of the Gerota fascia was 466 μm, and the area ratio of collagen was 27.1%. In contrast, the epimysium was much thicker than Gerota fascia, and its collagen fibers were much thicker and denser. CONCLUSIONS: Gerota fascia, unlike the epimysium, was a very thin and fragile layer of collagen fibers, and its structure was diverse. This explains why Gerota fascia was observed in various states during surgery. It is important for surgeons to understand the properties of Gerota fascia and to treat it appropriately.

DOI： 10.1111/iju.15596

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The efficacy of adjuvant mitotane therapy and radiotherapy following adrenalectomy in patients with adrenocortical carcinoma: A systematic review and meta-analysis. International journal

Ichiro Tsuboi, Mehdi Kardoust Parizi, Akihiro Matsukawa, Stefano Mancon, Marcin Miszczyk, Robert J Schulz, Tamás Fazekas, Anna Cadenar, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Mesut Remzi, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat

Urologic oncology 2024.10

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

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a high recurrence rate after surgical therapy with curative intent. Adjuvant radiotherapy (RT) and mitotane therapy have been proposed as options following the adrenalectomy. However, the efficacy of adjuvant RT or mitotane therapy remains controversial. We aimed to evaluate the efficacy of adjuvant therapy in patients who underwent adrenalectomy for localised ACC. The PubMed, Scopus, and Web of Science databases were queried on March 2024 for studies evaluating adjuvant therapies in patients treated with surgery for localized ACC (PROSPERO: CRD42024512849). The endpoints of interest were overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) with 95% confidence intervals (95%CI) were pooled in a random-effects model meta-analysis. One randomized controlled trial (n = 91) and eleven retrospective studies (n = 4,515) were included. Adjuvant mitotane therapy was associated with improved RFS (HR: 0.63, 95%CI: 0.44-0.92, p = 0.016), while adjuvant RT did not reach conventional levels of statistical significance (HR:0.79, 95%CI:0.58-1.06, p = 0.11). Conversely, Adjuvant RT was associated with improved OS (HR:0.69, 95%CI:0.58-0.83, p<0.001), whereas adjuvant mitotane did not (HR: 0.76, 95%CI: 0.57-1.02, p = 0.07). In the subgroup analyses, adjuvant mitotane was associated with better OS (HR:0.46, 95%CI: 0.30-0.69, p < 0.001) and RFS (HR:0.56, 95%CI: 0.32-0.98, p = 0.04) in patients with negative surgical margin. Both adjuvant RT and mitotane were found to be associated with improved oncologic outcomes in patients treated with adrenalectomy for localised ACC. While adjuvant RT significantly improved OS in general population, mitotane appears as an especially promising treatment option in patients with negative surgical margin. These data can support the shared decision-making process, better understanding of the risks, benefits, and effectiveness of these therapies is still needed to guide tailored management of each individual patient.

DOI： 10.1016/j.urolonc.2024.09.014

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Correction: Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Motoo Araki, Shahrokh F Shariat

World journal of urology 42 ( 1 ) 522 - 522 2024.9

Clinical significance of tumor location for ureteroscopic tumor grading in upper tract urothelial carcinoma. Reviewed

Katayama S, Pradere B, Grossmann NC, Potretzke AM, Boorjian SJ, Ghoreifi A, Daneshmand S, Djaladat H, Sfakianos J, Mari A, Khene ZE, D'Andrea D, Hayakawa N, Fujita K, Heidenreich A, Raman JD, Roumiguie M, Abdollah F, Breda A, Fontana M, Roupret M, Margulis V, Karakiewicz PI, Araki M, Nasu Y, Shariat SF

J Endourol. 2024.9

術前栄養状態と骨格筋評価が腎移植レシピエントの腎予後に与える影響

山野井友昭, 西村慎吾, 関戸崇了, 吉永香澄, 定平卓也, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 大西康博, 竹内英実, 田邊克幸, 森永裕士, 荒木元朗

移植 59 ( 総会臨時 ) 323 - 323 2024.9

トランス男性のホルモン治療に対する期待度の調査

森分貴俊, 富永悠介, 藤澤諒多, 奥村美紗, 堀井聡, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林泰之, 荒木元朗

日本性科学会雑誌 42 ( 2 ) 63 - 63 2024.9

Differential effect of surgical technique on intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial cancer: a systematic review and Meta-analysis. Reviewed

Tsuboi I, Matsukawa A, Kardoust Parizi M, Klemm J, Schulz RJ, Cadenar A, Mancon S, Chiujdea S, Fazekas T, Miszczyk M, Laukhtina E, Kawada T, Katayama S, Iwata T, Bekku K, Wada K, Gontero P, Rouprêt M, Teoh J, Singla N, Araki M, Shariat SF

World J Urol. 42 ( 1 ) 488 2024.8

Diagnostic Accuracy of Liquid Biomarkers for Clinically Significant Prostate Cancer Detection: A Systematic Review and Diagnostic Meta-analysis of Multiple Thresholds. Reviewed

Kawada T, Shim SR, Quhal F, Rajwa P, Pradere B, Yanagisawa T, Bekku K, Laukhtina E, von Deimling M, Teoh JY, Karakiewicz PI, Araki M, Shariat SF

Eur Urol Oncol. 7 ( 4 ) 649 - 662 2024.8

Clinical outcomes and prognostic factors in metastatic nonclear cell renal cell carcinoma treated with immuno-oncology combination therapy. Reviewed

Toyoda S, Fukuokaya W, Mori K, Kawada T, Katayama S, Nishimura S, Maenosono R, Tsujino T, Adachi T, Hirasawa Y, Saruta M, Komura K, Nukaya T, Yanagisawa T, Takahara K, Hashimoto T, Azuma H, Ohno Y, Shiroki R, Araki M, Kimura T, Fujita K, JK-FOOT study group

Jpn J Clin Oncol. 108 2024.8

LOH症候群における精神症状がテストステロン補充療法に与える影響について

富永悠介, 小林知子, 森分貴俊, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林泰之, 佐古智子, 杉本盛人, 渡部昌実, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 167 - 167 2024.8

当院に受診したクラインフェルター症候群患者の性機能についての検討

森分貴俊, 富永悠介, 藤澤諒多, 奥村美紗, 堀井聡, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 杉本盛人, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 169 - 169 2024.8

男性低ゴナドトロピン性性腺機能低下症(MHH)に対するテストステロン補充療法(TRT)についての検討

藤澤諒多, 富永悠介, 奥村美紗, 堀井聡, 森分貴俊, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 杉本盛人, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 170 - 170 2024.8

The durability of filter cap for OT-Balloon catheter, a novel urethral catheter for intermittent balloon catheterization Reviewed

Tomofumi Watanabe, Motoo Araki, Takuya Sadahira

Continence Reports 10 100049 - 100049 2024.6

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