Faculty Profiles - EDAMURA Kohei

Papers - EDAMURA Kohei

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Significance of targeted antimicrobial prophylaxis using rectal-culture selective screening media prior to transrectal prostate biopsy: A multicenter, randomized controlled trial. International journal

Takuya Sadahira, Takanori Sekito, Yuki Maruyama, Takaharu Ichikawa, Yuki Kurihara, Hiromasa Shiraishi, Takafumi Sakuma, Moto Tokunaga, Yosuke Mitsui, Norihiro Kusumi, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Masami Watanabe, Yoshiki Hiyama, Hiroki Yamada, Hiroki Kurata, Tsubasa Kondo, Masao Mitsui, Tadasu Takenaka, Hiroshi Kiyota, Motoo Araki, Jun Miyazaki, Satoshi Takahashi, Shingo Yamamoto, Koichiro Wada

Urology 2024.12

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

OBJECTIVE: To examine whether antimicrobial prophylaxis based on screening rectal cultures using selective media prevented acute bacterial prostatitis following transrectal prostate biopsy (TRPB). METHODS: In this multicenter, randomized controlled trial, we enrolled 403 patients undergoing TRPB with low risks of infectious complications. Patients were randomized into a cultured group (CG) or no cultured group (NCG). In the CG, patients with positive culture results for fluoroquinolone (FQ)-resistant or extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) used piperacillin/tazobactam as prophylaxis, and those with negative culture results and in the NCG used levofloxacin. The primary endpoint was the incidence of acute prostatitis after TRPB. The secondary endpoint was the accuracy of the selective media. RESULTS: Of 373 patients (CG, 187; NCG, 186), 67 were positive, and 120 were negative for rectal culture in the CG. The overall incidence of prostatitis after TRPB was 1.1% (n=4). The incidences in the CG and the NCG were 1.6% (n=3, all negative-culture cases) and 0.5% (n=1), respectively, without significant difference (P=0.3). No prostatitis occurred in the positive-culture group. The sensitivity and specificity of the levofloxacin-insusceptible selective media were 98.1% and 94.7%, respectively. CONCLUSION: Screening with selective media before TRPB in patients with low infectious risks may provide additive value to preventing post-biopsy prostatitis. Piperacillin/tazobactam can be considered when FQ-resistant or ESBL-producing E. coli is detected.

DOI： 10.1016/j.urology.2024.12.018

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

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

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

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

Prognosis based on postoperative PSA levels and treatment in prostate cancer with lymph node involvement.

Tokiyoshi Tanegashima, Masaki Shiota, Takahiro Kimura, Dai Takamatsu, Yoshiyuki Matsui, Akira Yokomizo, Ryoichi Saito, Shuichi Morizane, Makito Miyake, Masakazu Tsutsumi, Yoshiyuki Yamamoto, Kojiro Tashiro, Ryotaro Tomida, Kohei Edamura, Shintaro Narita, Takahiro Yamaguchi, Takashi Kasahara, Kohei Hashimoto, Masashi Kato, Takayuki Yoshino, Shusuke Akamatsu, Akihiro Matsukawa, Tomoyuki Kaneko, Ryuji Matsumoto, Akira Joraku, Manabu Kato, Toshihiro Saito, Takuma Kato, Shuichi Tatarano, Shinichi Sakamoto, Hidenori Kanno, Naoki Terada, Naotaka Nishiyama, Hiroshi Kitamura, Masatoshi Eto

International journal of clinical oncology 29 ( 10 ) 1586 - 1593 2024.7

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

BACKGROUND: The therapeutic role of pelvic lymph node dissection (PLND) during radical prostatectomy (RP) for prostate cancer is not established. In clinical practice, PLND is primarily performed in cases of high-risk prostate cancer. The detection of lymph node metastasis plays a crucial role in determining the need for subsequent treatments. This study aims to evaluate the prognosis of prostate cancer patients with lymph node involvement (LNI) by stratifying them based on postoperative prostate-specific antigen (PSA) levels to identify biomarkers that can guide postoperative treatment strategies. METHODS: Analysis was conducted on 383 patients, selected from 572 initially eligible, who underwent RP with LNI across 33 Japanese Urological Oncology Group institutions from 2006 to 2019. Patients were grouped according to postoperative PSA levels and salvage treatments received. Follow-up focused on castration resistance-free survival (CRFS), metastasis-free survival (MFS), and overall survival (OS). RESULTS: In the persistent PSA group (PSA ≥ 0.1 ng/mL), CRFS and MFS were significantly shorter compared to the non-persistent PSA group (PSA < 0.1 ng/mL), and there was a tendency for shorter OS. In the persistent PSA group, patients with postoperative PSA values above the median (PSA ≥ 0.52 ng/mL) showed shorter CRFS and MFS. Furthermore, in the PSA ≥ 0.52 group, androgen deprivation therapy (ADT) plus radiotherapy (RT) combination had prolonged CRFS and MFS compared with ADT alone. CONCLUSIONS: This study provides valuable insights into stratifying patients based on postoperative PSA levels to tailor postoperative treatment strategies, potentially improving the prognosis of prostate cancer patients with LNI.

DOI： 10.1007/s10147-024-02580-6

Prognostication in Lymph Node-Positive Prostate Cancer with No PSA Persistence After Radical Prostatectomy. International journal

Masaki Shiota, Dai Takamatsu, Yoshiyuki Matsui, Akira Yokomizo, Shuichi Morizane, Ryoichi Saito, Makito Miyake, Masakazu Tsutsumi, Yoshiyuki Yamamoto, Kojiro Tashiro, Ryotaro Tomida, Shintaro Narita, Kohei Edamura, Takahiro Yamaguchi, Kohei Hashimoto, Masashi Kato, Takashi Kasahara, Takayuki Yoshino, Shusuke Akamatsu, Tomoyuki Kaneko, Akihiro Matsukawa, Ryuji Matsumoto, Akira Joraku, Toshihiro Saito, Takuma Kato, Manabu Kato, Hideki Enokida, Shinichi Sakamoto, Naoki Terada, Hidenori Kanno, Naotaka Nishiyama, Takahiro Kimura, Hiroshi Kitamura, Masatoshi Eto

Annals of surgical oncology 31 ( 6 ) 3872 - 3879 2024.6

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

BACKGROUND: This study aimed to create a prognostic model to predict disease recurrence among patients with lymph node involvement but no prostate-specific antigen (PSA) persistence and to explore its clinical utility. METHODS: The study analyzed patients with lymph node involvement after pelvic lymph node dissection with radical prostatectomy in whom no PSA persistence was observed between 2006 and 2019 at 33 institutions. Prognostic factors for recurrence-free survival (RFS) were analyzed by the Cox proportional hazards model. RESULTS: Among 231 patients, 127 experienced disease recurrence. The factors prognostic for RFS were PSA level at diagnosis (≥ 20 vs. < 20 ng/mL: hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.09-2.52; P = 0.017), International Society of Urological Pathology grade group at radical prostatectomy (RP) specimen (group ≥ 4 vs. ≤ 3: HR, 1.63; 95% CI 1.12-2.37; P = 0.010), pathologic T-stage (pT3b/4 vs. pT2/3a: HR, 1.70; 95% CI 1.20-2.42; P = 0.0031), and surgical margin status (positive vs. negative: HR, 1.60; 95% CI 1.13-2.28; P = 0.0086). The prognostic model using four parameters were associated with RFS and metastasis-free survival. CONCLUSION: The prognostic model in combination with postoperative PSA value and number of lymph nodes is clinically useful for discussing treatment choice with patients.

DOI： 10.1245/s10434-024-14999-2

Circadian Rhythms Fluctuate the Treatment Effects of Intravesical Treatments on Rat Urinary Frequency Models International journal

Tomofumi Watanabe, Takuya Sadahira, Yusuke Tominaga, Yuki Maruyama, Naoya Nagasaki, Takanori Sekito, Kohei Edamura, Toyohiko Watanabe, Motoo Araki, Masami Watanabe

Veterinary Medicine International 2024 1 - 9 2024.5

Language：English Publishing type：Research paper (scientific journal) Publisher：Hindawi Limited

Objectives. It is still not clear how the intravesical instillation of drugs affects rat urinary frequency. This study aimed to examine the dynamics of intravesical treatments’ treatment effect on rat urinary frequency models by real-time and extended monitoring using a novel continuous urination monitoring system. Methods. Nine eleven-week-old female Wistar rats were divided into three groups to receive intravesical instillation of 0.1% acetic acid (AA), 1.0% AA, or phosphate-buffered saline (PBS). Thirty minutes later, these drugs were voided, and rats were moved to a continuous urination monitoring system, UM-100. UM-100 monitored rat urination quantitatively and continuously for 24 hours. Rats were then euthanized, and histopathologic examinations using a damage score validated the severity of bladder inflammation. We used nine additional rats to determine the treatment effect of various drugs against the urinary frequency. These rats were also treated with 1.0% AA in the same way and divided into three groups (n = 3 each) to receive intravesical instillation of lidocaine, silver nitrate (AgNO₃), or dimethyl sulfoxide (DMSO), respectively. Thirty minutes later, rats were catheterized again and moved to the UM-100, and their voiding was monitored for 24 hours. Results. Intravesical instillation of AA increased the urinary frequency and decreased the mean voided volume (VV) in a concentration-dependent manner, with statistical significance at a concentration of 1.0% (urinary frequency; , mean VV; , respectively) compared with PBS. Histopathological analysis of these models demonstrated a significantly higher damage score of bladder mucosa in both 0.1% AA and 1.0% AA compared with PBS, with the severity in concordance with the clinical severity of urinary frequency (0.1% AA: , 1.0% AA: ). Moreover, intravesical instillation of lidocaine, AgNO₃, and DMSO decreased the urinary frequency. Continuous monitoring with UM-100 also demonstrated that the treatment effect of these intravesically instilled drugs occurred only at night. Conclusions. The extended monitoring of rat urination by UM-100 revealed a significant fluctuation in the treatment effect of intravesically instilled drugs between day and night. These findings may help establish novel therapies for urinary frequency.

DOI： 10.1155/2024/6505595

Other Link： http://downloads.hindawi.com/journals/vmi/2024/6505595.xml

Trans men can achieve adequate muscular development through low-dose testosterone therapy: A long-term study on body composition changes. International journal

Yusuke Tominaga, Tomoko Kobayashi, Yuko Matsumoto, Takatoshi Moriwake, Yoshitaka Oshima, Misa Okumura, Satoshi Horii, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Morito Sugimoto, Yasuyuki Kobayashi, Masami Watanabe, Yuzaburo Namba, Yosuke Matsumoto, Mikiya Nakatsuka, Motoo Araki

Andrology 2024.4

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

BACKGROUND: Transgender individuals undergo the gender-affirming hormone therapy (GAHT) to achieve physical changes consistent with their gender identity. Few studies are available on the long-term safety and efficacy of GAHT. OBJECTIVES: To investigate the long-term physical effects and the safety of the testosterone therapy for trans men and to assess the impact of differential hormone dose. MATERIALS AND METHODS: Trans men who initiated GAHT between May 2000 and December 2021 were included in this retrospective analysis. Physical findings (body mass index, body fat percentage (BFP), lean body mass (LBM), and grip strength), blood testing results (hemoglobin, hematocrit, uric acid, creatinine, total cholesterol, triglycerides, and total testosterone), and menstrual cessation were recorded. We assessed the effects of testosterone on body composition changes and laboratory parameters, comparing a low-dose group (≤ 62.5 mg/wk) to a high-dose group (> 62.5 mg/wk). RESULTS: Of 291 participants, 188 patients (64.6%) were in the low-dose group and 103 (35.4%) in the high-dose group. Cumulative menstrual cessation rates up to 12 months were not significantly different between groups. Both groups showed a decrease in BFP and an increase in LBM during the first year of therapy, followed by a slight increase in both over the long term. The high-dose group exhibited greater LBM gains during the first year. Higher hormone doses and lower initial LBM values were associated with LBM increases at 3 and 6 months (3 mo, P = 0.006, P < 0.001; 6 mo, P = 0.015, P < 0.001). There were no long-term, dose-dependent side effects such as polycythemia or dyslipidemia. CONCLUSION: Long-term GAHT for trans men is safe and effective. Low-dose testosterone administration is sufficient to increase LBM in trans men. Higher testosterone doses can lead to an earlier increase in muscle mass.

DOI： 10.1111/andr.13640

Effect of antacids on the survival of patients with metastatic urothelial carcinoma treated with pembrolizumab International journal

Takanori Sekito, Kensuke Bekku, Satoshi Katayama, Tomofumi Watanabe, Ichiro Tsuboi, Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Tatsushi Kawada, Yusuke Tominaga, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Norihiro Kusumi, Kohei Edamura, Tomoko Kobayashi, Kyohei Kurose, Takaharu Ichikawa, Yoshiyuki Miyaji, Koichiro Wada, Yasuyuki Kobayashi, Motoo Araki

Clinical Genitourinary Cancer 22 ( 4 ) 102097 - 102097 2024.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

INTRODUCTION: Concomitant medications can affect the efficacy of immune checkpoint inhibitors. The association between histamine-2 receptor antagonists (H2RAs), major antacids similar to proton pump inhibitors (PPIs), and the efficacy of pembrolizumab for metastatic urothelial carcinoma (mUC) treatment has been poorly evaluated. We evaluated the impact of PPIs and H2RAs on oncological outcomes in mUC patients treated with pembrolizumab. PATIENTS AND METHODS: This retrospective multicenter study included patients with mUC treated with pembrolizumab. Patients prescribed PPIs or H2RAs within 30 days before and after the initial administration were extracted. The overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and objective response rates (ORR) were assessed. Kaplan-Meier survival curve analysis and multivariable Cox proportional hazard models were employed to assess the association between PPIs or H2RAs and survival outcomes. RESULTS: Overall, 404 patients were eligible for this study; 121 patients (29.9%) used PPIs, and 34 (8.4%) used H2RAs. Kaplan-Meier analysis showed significantly worse OS, CSS, and PFS in patients using PPIs compared to no PPIs (P = .010, .018, and .012, respectively). In multivariable analyses, the use of PPIs was a significant prognostic factor for worse OS (HR = 1.42, 95% CI 1.08-1.87, P = .011), CSS (HR = 1.45, 95% CI 1.09-1.93, P = .011), and PFS (HR = 1.35, 95% CI 1.05-1.73, P = .020). PPIs were not associated with ORRs. The use of H2RAs was not associated with survival or ORRs. CONCLUSION: PPIs were significantly associated with worse survival of patients with mUC treated with pembrolizumab, and H2RAs could be an alternative during administration. Both the oncological and gastrointestinal implications should be carefully considered when switching these antacids.

DOI： 10.1016/j.clgc.2024.102097

脳腫瘍に対する放射線化学療法前に顕微鏡下精巣内精子採取術により精子回収が可能であったKlinefelter症候群の1例

富永悠介, 杉山星哲, 原綾英, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 羽原俊宏, 荒木元朗

日本生殖医学会雑誌 69 ( 1-2 ) 109 - 109 2024.4

Current status and future perspectives on robot-assisted kidney autotransplantation: A literature review. International journal

Takanori Sekito, Tomoaki Yamanoi, Takuya Sadahira, Kasumi Yoshinaga, Yuki Maruyama, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki

International journal of urology : official journal of the Japanese Urological Association 31 ( 6 ) 599 - 606 2024.2

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

This review presents the latest insights on robot-assisted kidney autotransplantation (RAKAT). RAKAT is a minimally invasive surgical procedure and represents a promising alternative to conventional laparoscopic nephrectomy followed by open kidney transplantation for the treatment of various complex urological and vascular conditions. RAKAT can be performed either extracorporeally or intracorporeally. Additionally, a single-port approach can be performed through one small incision without the need to reposition the patient. Of 86 patients undergoing RAKAT, 8 (9.3%) developed postoperative > Grade 2 Clavien-Dindo (CD) complications. Although the feasibility of RAKAT was established in 2014, the long-term efficacy and safety along with outcomes of this surgical approach are still being evaluated, and additional studies are needed. With improvements in the technology of RAKAT and as surgeons gain more experience, RAKAT should become increasingly used and further refined, thereby leading to improved surgical outcomes and improved patients' quality of life.

DOI： 10.1111/iju.15426

活躍する女性腎移植医女性腎移植医への期待

荒木元朗, 吉永香澄, 窪田理沙, 西村慎吾, 関戸崇了, 丸山雄樹, 定平卓也, 山野井友昭, 富永悠介, 片山聡, 岩田健宏, 別宮謙介, 枝村康平, 小林知子, 小林泰之

日本臨床腎移植学会プログラム・抄録集 57回 117 - 117 2024.2

当院における生体腎移植ドナーの術後フォローアップ状況

山野井友昭, 西村慎吾, 関戸崇了, 吉永香澄, 丸山雄樹, 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

日本臨床腎移植学会プログラム・抄録集 57回 208 - 208 2024.2

Discontinuation of Immune-oncology Combinations due to Immune-related Adverse Events in Patients With Advanced Renal Cancers. International journal

Kensuke Bekku, Manuela Schmidinger, Satoshi Katayama, Tatsushi Kawada, Takafumi Yanagisawa, Takehiro Iwata, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki, Shahrokh F Shariat

Anticancer research 44 ( 1 ) 379 - 386 2024.1

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

BACKGROUND/AIM: Patients with advanced renal cell carcinoma (aRCC) treated with immune-oncology (IO) drugs may need to discontinue the treatment when severe immune-related adverse events (irAE) occur; however, the impact of discontinuation on survival remains unknown. PATIENTS AND METHODS: This is a retrospective multicenter analysis using a database of 183 aRCC patients treated with first-line IO drugs combination. The patients were divided into two groups according to the necessity of discontinuation due to irAEs. The primary endpoint was overall survival (OS). Cox proportional hazard models determined the predictive factors on OS. RESULTS: Among a total of 135 patients who experienced irAE, 38 patients had to discontinue and 52 continued the treatment while treating irAE. When compared to patients who were able to continue treatment, discontinuation was associated with significantly higher rates of IO-IO doublet use, severe irAE (grade ≥3), steroid use, and the occurrence of immune-related pneumonitis (p=0.03, p<0.001, p<0.001, and p=0.02, respectively). The objective response rates were comparable between the two groups (discontinuation 55.6% vs. no discontinuation 56.0%, p=0.7). On univariate analysis, patients who discontinued had a significantly worse OS when compared to those who continued treatment (p=0.02). On the contrary, on multivariate analysis treatment discontinuation was not associated with poor OS (HR=1.1, p=0.9). CONCLUSION: Treatment discontinuation due to irAE was not associated with poor prognosis in aRCC patients treated with ICI-based combination therapy. Treatment discontinuation may be a reasonable treatment option for well-selected patients, specifically for those who experienced good treatment responses.

DOI： 10.21873/anticanres.16822

グラフト感染が契機と考えられる腎動脈破綻を認めた自家腎移植の一例

西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 枝木大治, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 57 - 57 2024.1

高度腸骨動脈石灰化を有するレシピエントに対する脳死献腎移植の経験

吉永香澄, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 三浦望, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 56 - 57 2024.1

腎提供後11年経過の若年ドナーに認めたT3a腎細胞癌の1例

原尚史, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 川野香, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 24 - 24 2024.1

生体腎移植レシピエントの周術期尿路感染症リスク因子の検討

西村慎吾, 長崎直也, 奥村美紗, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 56 - 56 2024.1

腎提供後11年経過の若年ドナーに認めたT3a腎細胞癌の1例

原尚史, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 川野香, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 24 - 24 2024.1

生体腎移植レシピエントの周術期尿路感染症リスク因子の検討

西村慎吾, 長崎直也, 奥村美紗, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 56 - 56 2024.1

高度腸骨動脈石灰化を有するレシピエントに対する脳死献腎移植の経験

吉永香澄, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 三浦望, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 56 - 57 2024.1

グラフト感染が契機と考えられる腎動脈破綻を認めた自家腎移植の一例

西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 枝木大治, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 57 - 57 2024.1

Prognostic impact of radiological tumor burden in patients with metastatic urothelial carcinoma treated with pembrolizumab. International journal

Satoshi Katayama, Takehiro Iwata, Tasushi Kawada, Yusuke Okamoto, Yuho Sano, Yuya Kawago, Shuji Miyake, Takatoshi Moriwake, Aya Kuinose, Yuhei Horikawa, Kazuma Tsuboi, Ichiro Tsuboi, Kazuma Sakaeda, Hirokazu Nakatsuka, Atsushi Takamoto, Takeshi Hirata, Yoshinori Shirasaki, Taku Yamasaki, Hirofumi Morinaka, Naoya Nagasaki, Takafumi Hara, Akinori Ochi, Misa Okumura, Tomofumi Watanabe, Takanori Sekito, Kaoru Kawano, Satoshi Horii, Tomoaki Yamanoi, Kentaro Nagao, Kasumi Yoshinaga, Yuki Maruyama, Yusuke Tominaga, Takuya Sadahira, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Norihiro Kusumi, Kyohei Kurose, Yasuo Yamamoto, Morito Sugimoto, Tetsuya Nakada, Katsumi Sasaki, Tadasu Takenaka, Shin Ebara, Yoshiyuki Miyaji, Koichiro Wada, Yasuyuki Kobayashi, Motoo Araki

Urologic oncology 42 ( 3 ) 70.e11-70.e18 2023.12

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

PURPOSE: Radiological tumor burden has been reported to be prognostic in many malignancies in the immunotherapy era, yet whether it is prognostic in patients with metastatic urothelial carcinoma (mUC) treated with pembrolizumab remains uninvestigated. We sought to assess the predictive and prognostic value of radiological tumor burden in patients with mUC. METHODS: We performed a retrospective analysis of 308 patients with mUC treated with pembrolizumab. Radiological tumor burden was represented by baseline tumor size (BTS) and baseline tumor number (BTN). Optimal cut-off value of BTS was determined as 50 mm using the Youden index (small BTS: n = 194, large BTS: n = 114). Overall (OS), cancer-specific (CSS), progression-free survival (PFS), and objective response rate (ORR) were compared. Non-linear associations between BTS and OS and CSS were evaluated using restricted cubic splines. RESULTS: Patients with large BTS were less likely to have undergone the surgical resection of the primary tumor (P = 0.01), and more likely to have liver metastasis (P < 0.001) and more metastatic lesions (P < 0.001). On multivariable analyses controlling for the effects of confounders (resection of primary tumor, metastatic site, number of metastases and lactate dehydrogenase level), large BTS and high BTN were independently associated with worse OS (HR 1.52; P = 0.015, and HR 1.69; P = 0.018, respectively) and CSS (HR 1.59; P = 0.01, and HR 1.66; P = 0.031, respectively), but not PFS. Restricted cubic splines revealed BTS was correlated with OS and CSS in linear relationships. Additionally, large BTS was significantly predictive of lower ORR and complete response rate on univariable analyses (P = 0.041 and P = 0.032, respectively), but its association disappeared on multivariable analyses. CONCLUSION: Radiological tumor burden has independent prognostic value with a linear relationship in pembrolizumab-treated patients with mUC and might help drive the earlier introduction of second-line pembrolizumab and/or switching to subsequent therapies.

DOI： 10.1016/j.urolonc.2023.11.009

The Diagnosis and Treatment Approach for Oligo-Recurrent and Oligo-Progressive Renal Cell Carcinoma. International journal

Kensuke Bekku, Tatsushi Kawada, Takanori Sekito, Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Yusuke Tominaga, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki, Yuzuru Niibe

Cancers 15 ( 24 ) 2023.12

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

One-third of renal cell carcinomas (RCCs) without metastases develop metastatic disease after extirpative surgery for the primary tumors. The majority of metastatic RCC cases, along with treated primary lesions, involve limited lesions termed "oligo-recurrent" disease. The role of metastasis-directed therapy (MDT), including stereotactic body radiation therapy (SBRT) and metastasectomy, in the treatment of oligo-recurrent RCC has evolved. Although the surgical resection of all lesions alone can have a curative intent, SBRT is a valuable treatment option, especially for patients concurrently receiving systemic therapy. Contemporary immune checkpoint inhibitor (ICI) combination therapies remain central to the management of metastatic RCC. However, one objective of MDT is to delay the initiation of systemic therapies, thereby sparing patients from potentially unnecessary burdens. Undertaking MDT for cases showing progression under systemic therapies, known as "oligo-progression", can be complex in considering the treatment approach. Its efficacy may be diminished compared to patients with stable disease. SBRT combined with ICI can be a promising treatment for these cases because radiation therapy has been shown to affect the tumor microenvironment and areas beyond the irradiated sites. This may enhance the efficacy of ICIs, although their efficacy has only been demonstrated in clinical trials.

DOI： 10.3390/cancers15245873

性同一性障害に対するフィナステリドの安全性の検討について:中間報告

富永悠介, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 渡部昌実, 荒木元朗

GID(性同一性障害)学会雑誌 16 ( 1 ) 165 - 167 2023.12

Language：Japanese Publisher：GID(性同一性障害)学会

ホルモン療法に伴う男性型脱毛症(AGA)を有する性同一性障害(GID-FTM)に対するフィナステリドの安全性・治療効果を前向きに検討した.選択基準はNorwood-Hamilton(N-H)分類II以上などで,性別適合手術後の症例は除外した.被験者にはフィナステリド0.2mgを3ヵ月経口投与し,継続可能であった症例については,1.0mgに増量しさらに3ヵ月投与した.登録した2例において,フィナステリドに関連した有害事象を認めず,6ヵ月間の内服継続が可能であった.2例ともに多血症の改善およびN-H分類で脱毛の改善を認めた.1例で1度の月経再開を認めた.フィナステリドはホルモン療法中の身体的男性化に影響を与える可能性がある.本試験においては,良好な安全性・有効性を示唆する結果が得られた.(著者抄録)

閉経後の反復性膀胱炎を有する女性における尿および腟内の大腸菌の相同性の比較

関戸崇了, 定平卓也, 岩田健宏, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 239 - 239 2023.11

Treg細胞の活性化CTLA-4非依存性免疫抑制によるCTLA-4遮断の不安定な抗腫瘍効果(Disturbed anti-tumor effect of CTLA-4 blockade by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 河田達志, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

西日本泌尿器科学会総会抄録集 75回 185 - 185 2023.11

超高齢膀胱癌患者に対するロボット支援膀胱全摘除術(RARC)の外科的達成評価の検討

山野井友昭, 小林泰之, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 209 - 209 2023.11

Calciphylaxisによると考えられた陰茎亀頭部潰瘍の一例

川野香, 長尾賢太郎, 岩田健宏, 富永悠介, 片山聡, 定平卓也, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平井陽至

西日本泌尿器科学会総会抄録集 75回 233 - 233 2023.11

ロボット支援下前立腺全摘除術(RARP)の周術期抗菌薬投与方法と術後感染症発生率に関する後方視的研究

長崎直也, 定平卓也, 岩田健宏, 渡部智文, 山野井友昭, 河田達志, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 236 - 236 2023.11

超高齢膀胱癌患者に対するロボット支援膀胱全摘除術(RARC)の外科的達成評価の検討

山野井友昭, 小林泰之, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 209 - 209 2023.11

Treg細胞の活性化CTLA-4非依存性免疫抑制によるCTLA-4遮断の不安定な抗腫瘍効果(Disturbed anti-tumor effect of CTLA-4 blockade by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 河田達志, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

西日本泌尿器科学会総会抄録集 75回 185 - 185 2023.11

ロボット支援下前立腺全摘除術(RARP)の周術期抗菌薬投与方法と術後感染症発生率に関する後方視的研究

長崎直也, 定平卓也, 岩田健宏, 渡部智文, 山野井友昭, 河田達志, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 236 - 236 2023.11

Calciphylaxisによると考えられた陰茎亀頭部潰瘍の一例

川野香, 長尾賢太郎, 岩田健宏, 富永悠介, 片山聡, 定平卓也, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平井陽至

西日本泌尿器科学会総会抄録集 75回 233 - 233 2023.11

当科におけるロボット支援膀胱全摘除術・体腔内尿路変向の技術継承の取り組み

山野井友昭, 小林泰之, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 6 2023.11

閉経後の反復性膀胱炎を有する女性における尿および腟内の大腸菌の相同性の比較

関戸崇了, 定平卓也, 岩田健宏, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 239 - 239 2023.11

岡山大学病院におけるRAPN再発・転移症例の検討

吉永香澄, 冨永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 3 2023.11

当科におけるロボット支援膀胱全摘除術・体腔内尿路変向の技術継承の取り組み

山野井友昭, 小林泰之, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 6 2023.11

岡山大学病院におけるRAPN再発・転移症例の検討

吉永香澄, 冨永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 3 2023.11

転移性去勢抵抗性前立腺癌におけるBRCA遺伝子バリアントの検討

岩田健宏, 吉永香澄, 丸山雄樹, 河田達志, 定平卓也, 富永悠介, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

日本癌治療学会学術集会抄録集 61回 P12 - 5 2023.10

CTLA-4の単純な阻害はTreg細胞のCTLA-4以外の免疫抑制機構の活性化を引き起こす(Anti-tumor effects of CTLA-4 blockade are distrubed by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 丸山雄樹, 河田達志, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

日本癌学会総会記事 82回 1380 - 1380 2023.9

CTLA-4の単純な阻害はTreg細胞のCTLA-4以外の免疫抑制機構の活性化を引き起こす(Anti-tumor effects of CTLA-4 blockade are distrubed by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 丸山雄樹, 河田達志, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

日本癌学会総会記事 82回 1380 - 1380 2023.9

ロボット支援腹腔鏡下膀胱全摘除術における予防的全腟閉鎖術併用の試み

小林知子, 西村慎吾, 富永悠介, 宇埜誠, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

日本女性骨盤底医学会プログラム・抄録集 25回 91 - 91 2023.8

LOH症候群における各種質問票の有用性について

富永悠介, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 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 38 ( 2 ) 182 - 182 2023.8

ロボット支援腹腔鏡下膀胱全摘除術における予防的全腟閉鎖術併用の試み

小林知子, 西村慎吾, 富永悠介, 宇埜誠, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

日本女性骨盤底医学会プログラム・抄録集 25回 91 - 91 2023.8

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗, 関戸崇之, 吉永香澄, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 526 - 526 2023.7

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗, 関戸崇之, 吉永香澄, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 526 - 526 2023.7

SEXUAL DYSFUNCTION IN MALE INFERTILITY

富永悠介, 松本裕子, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科(Web) 85 ( 5 ) 324 - 329 2023.6

Staphylococcus saprophyticusによる感染結石の1例

渡部智文, 鵜川聖也, 長崎直也, 奥村美紗, 宇埜誠, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 85 ( 増刊号2 ) 148 - 148 2023.6

RPLND後の難治性リンパ漏に対して開腹リンパ管結紮術が奏功した1例

鵜川聖也, 長崎直也, 原惇也, 松島萌希, 奥村美紗, 渡部智文, 宇埜誠, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 85 ( 増刊号2 ) 148 - 148 2023.6

Bladder tumors with multiple cardiac metastases, with elevated serum granulocyte colony-stimulating factor. International journal

Naoya Nagasaki, Tomofumi Watanabe, Kohei Edamura, Motoo Araki, Takuya Sadahira

The American journal of medicine 136 ( 8 ) e161-e162 2023.4

Laparoscopic surgery education in the robotic era

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 小林知子, 荒木元朗

Japanese Journal of Endourology and Robotics (Web) 36 ( 1 ) 57 - 60 2023.4

FOCAL THERAPY FOR LOCALIZED PROSTATE CANCER

小林泰之, 枝村康平, 西村慎吾, 岩田健宏, 片山聡, 定平卓也, 小林知子, 荒木元朗

西日本泌尿器科(Web) 85 ( 4 ) 106 - 109 2023.4

What is the identity of Gerota fascia?-Histological study using cadaver-

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 小林知子, 小見山高明, 百田龍輔, 荒木元朗

Japanese Journal of Endourology and Robotics (Web) 36 ( 1 ) 118 - 123 2023.4

転移性腎細胞がんに対する免疫チェックポイント阻害剤の有効性における転移部位腫瘍径の影響(The impact of metastatic tumor burden to the efficacy of immune checkpoint inhibitors for metastatic renal cell carcinoma)

岩田健宏, 片山聡, 吉永香澄, 丸山雄樹, 定平卓也, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 渡邉豊彦, 荒木元朗

日本泌尿器科学会総会 110回 OP25 - 05 2023.4

cT1腎癌におけるロボット支援腎部分切除(RAPN)と経皮的凍結療法(PCA)の傾向スコアマッチング解析を用いた周術期成績・術後腎機能の検討(Oncological outcomes and renal function in robot-assisted partial nephrectomy vs percutaneous cryoablation for cT1 RCC: A propensity score-matched analysis)

山野井友昭, 別宮謙介, 馬越紀行, 定平卓也, 片山聡, 岩田健宏, 宇賀麻由, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平木隆夫

日本泌尿器科学会総会 110回 PP75 - 01 2023.4

局所進行性膀胱癌に対する根治的膀胱全摘除術前化学療法としてのゲムシタビン、シスプラチン、パクリタキセル3剤併用化学療法の治療成績(Clinical Outcomes of Neoadjuvant Paclitaxel/Cisplatin/Gemcitabine compared with Gemcitabine/Cisplatin for Muscle-Invasive Bladder cancer)

河田達志, 別宮謙介, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 津川卓士, 坪井一馬, 定平卓也, 西村慎吾, 小林知子, 江原伸, 荒木元朗

日本泌尿器科学会総会 110回 OP36 - 02 2023.4

異所性腎患者に発生したmicropapillary variantを伴う筋層浸潤性膀胱癌に対して,ロボット支援下膀胱全摘除術を施行した一例

原惇也, 堀井聡, 岩田健宏, 鵜川聖也, 長崎直也, 松島萌希, 奥村美紗, 渡部智文, 関戸崇了, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 小林泰之

西日本泌尿器科 85 ( 増刊号1 ) 46 - 46 2023.1

Bladder tuberculosis with ureteral strictures after bacillus Calmette‑Guérin therapy for urinary bladder cancer: A case report International journal

Yusuke Tominaga, Masanori Fujii, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Katsuyuki Kiura, Yoshinobu Maeda, Koichiro Wada, Motoo Araki

Molecular and Clinical Oncology 18 ( 2 ) 7 - 7 2022.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Spandidos Publications

Intravesical immunotherapy using bacillus Calmette-Guérin (BCG) is recommended for patients with intermediate- to high-risk non-muscle invasive bladder cancer. Bladder tuberculosis (TB) is a rare complication of BCG therapy. The present study describes the case of a 73-year-old man who underwent intravesical BCG therapy for urothelial carcinoma in situ of the bladder. Red patches around the resection scar were first detected 1 year and 5 months after BCG treatment; these findings gradually spread to encompass more of the bladder wall. Transurethral biopsy revealed a benign lesion, but the patient developed bilateral hydronephrosis and mild voiding dysfunction. The patient was eventually diagnosed with bladder TB by mycobacterial urine culture and TB-specific polymerase chain reaction (PCR). The patient was given multidrug therapy (isoniazid, rifampicin and ethambutol) and their bladder TB was completely cured; however, their voiding dysfunction and bilateral hydronephrosis did not fully improve. Bladder TB can occur long after intravesical BCG administration and cystoscopy findings consistent with inflammation can be the key to suspecting this condition. Acid-fast examination and PCR testing of a urine sample are necessary for early diagnosis.

DOI： 10.3892/mco.2022.2603

Comparison of therapeutic features and oncologic outcome in patients with pN1 prostate cancer among robot-assisted, laparoscopic, or open radical prostatectomy.

Takahiro Kirisawa, Masaki Shiota, Takahiro Kimura, Kohei Edamura, Makito Miyake, Shuichi Morizane, Takayuki Yoshino, Akihiro Matsukawa, Ryuji Matsumoto, Takashi Kasahara, Naotaka Nishiyama, Masatoshi Eto, Hiroshi Kitamura, Eijiro Nakamura, Yoshiyuki Matsui

International journal of clinical oncology 28 ( 2 ) 306 - 313 2022.12

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

OBJECTIVES: To compare the therapeutic features and oncological outcomes of robot-assisted radical prostatectomy (RARP) with those of open radical prostatectomy (ORP) or laparoscopic radical prostatectomy (LRP) in lymph node (LN) positive prostate cancer patients in a retrospective observational multi-institutional study. PATIENTS AND METHODS: We evaluated the clinical results of 561 patients across 33 institutions who underwent RARP, LRP, or ORP and who were diagnosed with LN-positive prostate cancer during RP with pelvic LN dissection (PLND). We determined the following survival outcomes: metastasis-free survival, overall survival, cancer-specific survival, and biochemical recurrence-free survival. The Kaplan-Meier method, log-rank test, and Cox proportional hazards regression model were used to evaluate the effect of treatment on oncological outcomes. Statistical significance was set at P < 0.05. RESULTS: There was no significant difference for any of the survival outcomes between the three surgical groups. However, RARP achieved a greater LN yield compared to that of ORP or LRP. When the extent of PLND was limited to the obturator LNs, the number of removed LNs (RLNs) was comparable between the three surgical groups. However, higher numbers of RLNs were achieved with RARP compared to the number of RLNs with ORP (P < 0.001) when PLND was extended to the external and/or internal iliac LNs. CONCLUSION: RARP, LRP, and ORP provided equal surgical outcomes for pN1 prostate cancer, and the prognosis was relatively good for all procedures. Increased numbers of RLNs may not necessarily affect the oncological outcome.

DOI： 10.1007/s10147-022-02278-7

Feasibility of robot‑assisted radical cystectomy in a patient with an ectopic kidney: A case report International journal

Kohei Edamura, Takuya Sadahira, Junya Hara, Takehiro Iwata, Wataru Ando, Satoshi Horii, Kentaro Nagao, Asuyuki Kobayashi, Motoo Araki

Medicine International 3 ( 1 ) 1 - 1 2022.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Spandidos Publications

An ectopic kidney is a rare congenital defect in which the kidney does not migrate to its normal anatomical position. In the present study, a robot-assisted radical cystectomy and intracorporeal urinary diversion were performed for a patient with an ectopic kidney. The present study describes the case of a 72-year-old male patient who was diagnosed with a bladder tumor by magnetic resonance imaging and cystoscopy. A transurethral resection of the bladder tumor was performed. The pathological examination revealed an invasive urothelial carcinoma. Contrast-enhanced computed tomography revealed an ectopic left kidney in the upper pelvis. A robot-assisted radical cystectomy, extended lymph node dissection and intracorporeal urinary diversion were performed. On the whole, as demonstrated herein, a robot-assisted radical cystectomy with intracorporeal urinary diversion is a feasible approach for muscle-invasive bladder cancer complicated by an ectopic kidney.

DOI： 10.3892/mi.2022.61

Cutaneous toxicity with suprabasal blisters and dyskeratosis following administration of enfortumab vedotin. International journal

Ken-Ichi Hasui, Yoshio Kawakami, Tomoko Miyake, Yoji Hirai, Hayato Nomura, Kohei Edamura, Motoo Araki, Shin Morizane

The Journal of dermatology 50 ( 4 ) e115-e116 2022.11

横隔膜、腸腰筋、左腎に接する後腹膜脱分化型脂肪肉腫に対して横隔膜合併切除を含めた外科的治療を行った一例

松島萌希, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 190 - 190 2022.11

再三の細胞診検査で骨盤内再発が判明した膀胱癌の一例

鵜川聖也, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 227 - 227 2022.11

当院におけるProteus mirabilisの薬剤感受性の推移とESBL産生株分離状況

丸山雄樹, 定平卓也, 岩田健宏, 荒木元朗, 片山聡, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡邉豊彦, 和田耕一郎

西日本泌尿器科学会総会抄録集 74回 216 - 216 2022.11

横隔膜、腸腰筋、左腎に接する後腹膜脱分化型脂肪肉腫に対して横隔膜合併切除を含めた外科的治療を行った一例

松島萌希, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 190 - 190 2022.11

SPAREスコアと3Dモデルによるロボット支援腹腔鏡下腎部分切除術の予後予測

渡部智文, 定平卓也, 吉永香澄, 関戸崇了, 丸山雄樹, 枝村康平, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 21 2022.11

再三の細胞診検査で骨盤内再発が判明した膀胱癌の一例

鵜川聖也, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 227 - 227 2022.11

当院におけるProteus mirabilisの薬剤感受性の推移とESBL産生株分離状況

丸山雄樹, 定平卓也, 岩田健宏, 荒木元朗, 片山聡, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡邉豊彦, 和田耕一郎

西日本泌尿器科学会総会抄録集 74回 216 - 216 2022.11

ロボット支援膀胱全摘術における低分子ヘパリンによる予防的抗凝固療法の有用性

丸山雄樹, 岩田健宏, 吉永香澄, 片山聡, 小林智子, 別宮健介, 枝村康平, 小林泰之, 渡邉豊彦, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 O - 4 2022.11

腹腔鏡下手術でここまでできる～ロボット時代を生き抜く達人技～大きな腫瘍に対する腹腔鏡・後腹膜鏡併用による腫瘍摘出術の試み

吉永香澄, 小林泰之, 冨永悠介, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 WS - 4 2022.11

仙骨腟固定術後の新規腹圧性尿失禁腹腔鏡下手術とロボット支援下手術での検討

小林知子, 佐古智子, 岩田健宏, 富永悠介, 別宮謙介, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 1 2022.11

ロボット支援膀胱全摘除術(RARC)における体腔内(ICUD)・体腔外尿路変向(ECUD)の比較

山野井友昭, 小林泰之, 岩田健宏, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 渡邉豊彦, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 2 2022.11

Simplified PADUA REnal (SPARE) nephrometry system can describe the surgical difficulty of renal masses with high accuracy even without 3D renal models. International journal

Tomofumi Watanabe, Takuya Sadahira, Takanori Sekito, Yuki Maruyama, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki

Urology 170 132 - 138 2022.10

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

OBJECTIVES: To evaluate whether a 2-dimensional(2D) model describes the surgical difficulty of a renal mass accurately comparable to that obtained using a 3D model with the Simplified PADUA REnal nephrometry system (SPARE). METHODS: A total of 100 patients underwent RAPN in our hospital between October 2018 and May 2021. We excluded patients with CT images inappropriate for evaluation or for construction of 3D models, patients with multiple tumors, and those who underwent preoperative transcatheter arterial embolization. We conducted a retrospective analysis of the remaining patients using SPARE predictions from CT images (2D-SPARE) and SPARE predictions from 3D models (3D-SPARE). We evaluated the difference between the 2 nephrometry scores and compared them by their ability to predict the achievement of the desired surgical outcome: absence of positive margins, absence of ischemia, and absence of significant complications. RESULTS: A total of 87 patients were included in this study. Total score, and risk categorization using 3D-SPARE was significantly different from those using 2D-SPARE (p < 0.05), but in their areas under the curve (AUC), the scores and categorizations were not significantly different (score, 0.763 vs 0.742; p = 0.501; categorization, 0.711 vs 0.701; p = 0.755). CONCLUSION: The SPARE system can describe the surgical difficulty of renal masses with high accuracy even without the use of 3D renal models.

DOI： 10.1016/j.urology.2022.09.015

Management of patients with advanced prostate cancer in Japan: ‘real-world’ consideration of the results from the Advanced Prostate Cancer Consensus Conference International journal

Kazutoshi Fujita, Hiroyoshi Suzuki, Nobuyuki Hinata, Yuji Miura, Kohei Edamura, Ken-Ichi Tabata, Gaku Arai, Nobuaki Matsubara, Yota Yasumizu, Takeo Kosaka, Mototsugu Oya, Mikio Sugimoto

Translational Andrology and Urology 11 ( 12 ) 1771 - 1785 2022.10

Language：English Publishing type：Research paper (scientific journal) Publisher：AME Publishing Company

A multidisciplinary approach is necessary to manage advanced prostate cancer. The Advanced Prostate Cancer Consensus Conference (APCCC) in 2019 provided a practical guide to help clinicians consider therapeutic options in controversial areas, but healthcare systems vary across the world. At the 109th annual meeting of the Japanese Urological Association in December 2021, Japanese urologists voted on the questions in the APCCC 2019 guidelines regarding prostate-specific membrane antigen-positron emission tomography (PSMA-PET), management of oligometastatic prostate cancer, management of nonmetastatic castration-resistant prostate cancer (CRPC), management of a primary tumor in metastatic settings, systemic treatment of newly diagnosed metastatic castration-sensitive prostate cancer (CSPC), management of metastatic CRPC (mCRPC), and tumor genomic testing. We summarize the "real-world" status of the management of advanced prostate cancer in Japan. Several differences were noted in the management of advanced prostate cancer between Japanese urologists and the APCCC 2019 guidelines. Many Japanese urologists chose conventional imaging modalities for detecting metastasis instead of PSMA-PET. More Japanese urologists prefer androgen-deprivation therapy (ADT) alone in the management of low-volume metastatic CSPC than the APCCC panelists do, In the management of M0 CRPC, darolutamide and enzalutamide were chosen more by Japanese urologists than by the voters at the APCCC 2019. Bicalutamide remains one of the options for the management of mCRPC in Japan. More Japanese urologists do not recommend microsatellite instability (MSI) and BRCA1/2 tests than the voters at the APCCC 2019. Clinical evidence in Japan should be collected to address these discrepancies.

DOI： 10.21037/tau-22-396

当院における腎移植後コロナウイルス感染症の臨床経過

吉永香澄, 関戸崇了, 丸山雄樹, 山野井友昭, 西村慎吾, 竹内英実, 田邉克幸, 森永裕士, 内田治仁, 和田淳, 枝村康平, 小林知子, 小林泰之, 荒木元朗

移植 57 ( 総会臨時 ) 262 - 262 2022.10

A case of tape infection 19 years after insertion of a tension-free vaginal tape sling. International journal

Tomofumi Watanabe, Tomoko Sako, Yusuke Tominaga, Takuya Sadahira, Takanori Sekito, Atsushi Takamoto, Kohei Edamura, Yasuyuki Kobayashi, Koichiro Wada, Motoo Araki

IJU case reports 5 ( 4 ) 228 - 231 2022.7

Language：English

Introduction: Tape infection after insertion of tension-free vaginal tape is a well-known but rare complication. We report a patient who experienced a subcutaneous abscess 19 years after the surgery. Case presentation: A 41-year-old woman presented with fever and lower abdominal pain. She had undergone tension-free vaginal tape insertion for stress urinary incontinence 19 years prior. She had asymptomatic dysuria. After an abscess incision and 1-week treatment with antibiotics, she underwent surgery to remove the tape and the abscess without complications. Conclusion: Tension-free Vaginal Tape insertion could be a potential risk of asymptomatic dysuria, resulting in urinary tract infection. In this case, removal of tape was necessary for controlling subcutaneous abscess resulting from the presence of tension-free vaginal tape.

DOI： 10.1002/iju5.12440

Radiotherapy plus androgen deprivation therapy for prostate-specific antigen persistence in lymph node-positive prostate cancer. International journal

Masaki Shiota, Dai Takamatsu, Takahiro Kimura, Kojiro Tashiro, Yoshiyuki Matsui, Ryotaro Tomida, Ryoichi Saito, Masakazu Tsutsumi, Akira Yokomizo, Yoshiyuki Yamamoto, Kohei Edamura, Makito Miyake, Shuichi Morizane, Takayuki Yoshino, Akihiro Matsukawa, Shintaro Narita, Ryuji Matsumoto, Takashi Kasahara, Kohei Hashimoto, Hiroaki Matsumoto, Masashi Kato, Shusuke Akamatsu, Akira Joraku, Manabu Kato, Takahiro Yamaguchi, Toshihiro Saito, Tomoyuki Kaneko, Atsushi Takahashi, Takuma Kato, Shinichi Sakamoto, Hideki Enokida, Hidenori Kanno, Naoki Terada, Shigetaka Suekane, Naotaka Nishiyama, Masatoshi Eto, Hiroshi Kitamura

Cancer science 113 ( 7 ) 2386 - 2396 2022.7

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

The treatment for lymph node involvement (LNI) after radical prostatectomy (RP) has not been established. This study aimed to reveal the outcomes of various management strategies among patients with LNI after RP. Retrospectively, 561 patients with LNI after pelvic lymph node dissection (PLND) with RP treated between 2006 and 2019 at 33 institutions participating in the Japanese Urological Oncology Group were investigated. Metastasis-free survival (MFS) was the primary outcome. Patients were stratified by prostate-specific antigen (PSA) persistence after RP. Cox regression models were used to analyze the relationships between clinicopathological characteristics and survival. Survival analyses were conducted using the Kaplan-Meier method and log-rank test with or without propensity score matching. Prognoses, including MFS and overall survival, were prominently inferior among patients with persistent PSA compared with those without persistent PSA. In multivariate analysis, androgen deprivation therapy (ADT) plus radiotherapy (RT) was associated with better MFS than ADT alone among patients with persistent PSA (hazard ratio = 0.37; 95% confidence interval = 0.15-0.93; p = 0.034). Similarly, MFS and overall survival were significantly better for ADT plus RT than for ADT alone among patients with persistent PSA after propensity score matching. This study indicated that PSA persistence in LNI prostate cancer increased the risk of poor prognoses, and intensive treatment featuring the addition of RT to ADT might improve survival.

DOI： 10.1111/cas.15383

Intravesical indwelling lidocaine‑releasing devices for IC/BPS (Review)

Tomofumi Watanabe, Takuya Sadahira, Masami Watanabe, Yuki Maruyama, Koichiro Wada, Takanori Sekito, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Toyohiko Watanabe

World Academy of Sciences Journal 4 ( 4 ) 2022.6

ステント付着結石により3本尿管ステント留置し2度のECIRSによりstone freeとなった1例

堀井聡, 奥村美紗, 渡部智文, 関戸崇了, 徳永素, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 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 84 ( 増刊号2 ) 168 - 168 2022.6

【初心にかえって、TURBTの手技徹底検証!】合併症を回避するTURBTの極意

西村慎吾, 小林泰之, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

Japanese Journal of Endourology and Robotics 35 ( 1 ) 45 - 50 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

TURBTは泌尿器科医にとって必須な手技であり,その良し悪しが患者の予後を規定するといっても過言ではない.加えて,TURBTは個体差によるバリエーションに富んでおり,初心者のみならず熟練者であってもその難しさを痛感する手術である.そのため,それぞれの症例に応じた戦略(根治的・姑息的・診断的切除の判断,切除の手順・方法等)をたてることが重要であり,加えて合併症対策をしっかりと行うこと,システム化された指導法を確立することが重要である.今回,初心に立ち返り当院における『合併症を回避するためのポイント』を整理した.術中合併症には穿孔や出血が挙げられる.高齢者,複数回のTUR歴やBCG治療歴などによる膀胱壁菲薄化が術中穿孔リスクとなる.出血は,術中の不十分な止血操作だけでなく,抗血小板薬・抗凝固薬の内服もリスクとなる.これらの薬剤継続による出血のみならず,休薬に伴う血栓症リスクを術前に評価することも重要である.術後合併症には前立腺肥大症などによる尿道カテーテル抜去後尿閉による穿孔がある.これらの合併症対策として,1.術前に画像検査で筋層浸潤の有無を判断し,症例に応じた戦略作成をたてること,2.抗血小板・抗凝固薬の継続,中止の取り扱いを検討すること,3.システム化された指導を行うこと,が重要である.これらのポイントについて,当科で実践している手技,術前戦略が功を奏した症例などを提示しながら解説する.(著者抄録)

ロボット支援下前立腺全摘除術中にモノポーラシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友, 小林泰之

Japanese Journal of Endourology and Robotics 35 ( 1 ) 168 - 172 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

我々が経験したロボット支援下前立腺全摘除術におけるインシデントを報告する.症例は70歳代男性.手術はda Vinci Xiで行われた.術中,1stポートのインストゥルメントを入れ替えた際に,モノポーラシザースよりチップカバーが外れ,紛失した.腹腔内や術野内外をX線透視も用いて探索するも見つからず,Computed tomographyを施行したところ,1stポート造設部の皮下に迷入していた.その後は手術を再開し,合併症なく終了.チップカバーは画像と同部位の皮下より摘出された.手術映像を見返したところ,チップカバーが適切に装着されておらず,インストゥルメント交換の際にトロッカーが皮下まで抜けていたことが判明した.本件のようなインシデントを予防するためには,チップカバーの適切な装着と,インストゥルメントの正しい手順での交換および交換時の確認が必要である.(著者抄録)

ロボット支援下前立腺全摘除術中にモノポーラシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友, 小林泰之

Japanese Journal of Endourology and Robotics 35 ( 1 ) 168 - 172 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

我々が経験したロボット支援下前立腺全摘除術におけるインシデントを報告する.症例は70歳代男性.手術はda Vinci Xiで行われた.術中,1stポートのインストゥルメントを入れ替えた際に,モノポーラシザースよりチップカバーが外れ,紛失した.腹腔内や術野内外をX線透視も用いて探索するも見つからず,Computed tomographyを施行したところ,1stポート造設部の皮下に迷入していた.その後は手術を再開し,合併症なく終了.チップカバーは画像と同部位の皮下より摘出された.手術映像を見返したところ,チップカバーが適切に装着されておらず,インストゥルメント交換の際にトロッカーが皮下まで抜けていたことが判明した.本件のようなインシデントを予防するためには,チップカバーの適切な装着と,インストゥルメントの正しい手順での交換および交換時の確認が必要である.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07650&link_issn=&doc_id=20220531400028&doc_link_id=%2Fcs5robot%2F2022%2F003501%2F032%2F0168-0172%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5robot%2F2022%2F003501%2F032%2F0168-0172%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

テキストマイニングによる腎移植に関する症例報告論文の考察

関戸崇了, 荒木元朗, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 渡部昌実, 渡邉豊彦, 田邊克幸, 竹内英実, 喜多村真治, 杉山斉, 和田淳, 那須保友

日本臨床腎移植学会プログラム・抄録集 55回 227 - 227 2022.2

Medical uses for silver nitrate in the urinary tract (Review)

Takanori Sekito, Takuya Sadahira, Toyohiko Watanabe, Yuki Maruyama, Tomofumi Watanabe, Takehiro Iwata, Koichiro Wada, Kohei Edamura, Motoo Araki, Masami Watanabe

World Academy of Sciences Journal 4 ( 1 ) 2022.1

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検

高本篤, 河田達志, 長尾賢太郎, 富永悠介, 渡部智文, 三宅修司, 林あずさ, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 定平卓也, 岩田健宏, 西村慎吾, 和田耕一郎, 枝村康平, 佐古智子, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 48 2022.1

上部尿路上皮癌に対する尿路内視鏡的治療の成績と課題

和田耕一郎, 小川貢平, 坪井一朗, 吉岡彩織, 横山周平, 小林祐介, 中島宏親, 永見太一, 山崎清玄, 小池千明, 椎名浩昭, 荒木元朗, 枝村康平, 岩田健宏, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 89 - 89 2022.1

岡山大学におけるUTUCに対するURSの成績と課題

和田耕一郎, 丸山雄樹, 荒木元朗, 関戸崇了, 枝村康平, 定平卓也, 林あずさ, 三宅修司, 渡部智文, 吉永香澄, 和田里章悟, 長尾賢太郎, 河田達志, 富永悠介, 大岩裕子, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 49 2022.1

全身転移を来たした成人発症の胎児型前立腺横紋筋肉腫の1例

近藤崇弘, 関戸崇了, 定平卓也, 富永悠介, 高本篤, 奥村美紗, 渡部智文, 堀井聡, 竹丸絋史, 和田里章悟, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 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, 田端雅弘, 柳井広之

西日本泌尿器科 84 ( 増刊号1 ) 53 - 53 2022.1

待機日数56日で先行的脳死下献腎移植を行った17歳女性の1例

奥村美紗, 吉永香澄, 西村慎吾, 和田耕一郎, 荒木元朗, 渡部智文, 近藤崇弘, 関戸崇了, 堀井聡, 竹丸紘史, 和田里章悟, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 50 - 51 2022.1

後腹膜リンパ節郭清術後の射精障害の検討

富永悠介, 佐古智子, 奥村美紗, 渡部智文, 近藤崇弘, 関戸崇了, 竹丸紘史, 堀井聡, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 片山聡, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 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, 松本裕子, 杉本盛人, 和田耕一郎

西日本泌尿器科 84 ( 増刊号1 ) 84 - 84 2022.1

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検

高本篤, 河田達志, 長尾賢太郎, 富永悠介, 渡部智文, 三宅修司, 林あずさ, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 定平卓也, 岩田健宏, 西村慎吾, 和田耕一郎, 枝村康平, 佐古智子, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 48 2022.1

岡山大学におけるUTUCに対するURSの成績と課題

和田耕一郎, 丸山雄樹, 荒木元朗, 関戸崇了, 枝村康平, 定平卓也, 林あずさ, 三宅修司, 渡部智文, 吉永香澄, 和田里章悟, 長尾賢太郎, 河田達志, 富永悠介, 大岩裕子, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 49 2022.1

待機日数56日で先行的脳死下献腎移植を行った17歳女性の1例

奥村美紗, 吉永香澄, 西村慎吾, 和田耕一郎, 荒木元朗, 渡部智文, 近藤崇弘, 関戸崇了, 堀井聡, 竹丸紘史, 和田里章悟, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 50 - 51 2022.1

全身転移を来たした成人発症の胎児型前立腺横紋筋肉腫の1例

近藤崇弘, 関戸崇了, 定平卓也, 富永悠介, 高本篤, 奥村美紗, 渡部智文, 堀井聡, 竹丸絋史, 和田里章悟, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 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, 田端雅弘, 柳井広之

西日本泌尿器科 84 ( 増刊号1 ) 53 - 53 2022.1

後腹膜リンパ節郭清術後の射精障害の検討

富永悠介, 佐古智子, 奥村美紗, 渡部智文, 近藤崇弘, 関戸崇了, 竹丸紘史, 堀井聡, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 片山聡, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 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, 松本裕子, 杉本盛人, 和田耕一郎

西日本泌尿器科 84 ( 増刊号1 ) 84 - 84 2022.1

A Novel Technique Using Fluorescent Ureteral Catheter and Flexible Ureteroscope for Safe Laparoscopic Fenestration of Lymphocele after Kidney Transplantation. International journal

Takanori Sekito, Motoo Araki, Koichiro Wada, Kasumi Yoshinaga, Yuki Maruyama, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Toyohiko Watanabe

Case reports in transplantation 2022 9948425 - 9948425 2022

Language：English

Laparoscopic fenestration of a postrenal transplant lymphocele is associated with a risk of renal hilar vessel and ureteral injury. Consequently, determination of the incision line is difficult. We describe a case of a 73-year-old man with postrenal transplant lymphocele who underwent a laparoscopic fenestration. We report a surgical video containing a new technique of laparoscopic fenestration using a fluorescent ureteral catheter in combination with a flexible ureteroscope. The combination of a fluorescent ureteral catheter and flexible ureteroscope during surgery enabled us to determine the incision line safely and accurately. Intraoperative real-time visualization of the lymphocele and ureter using a fluorescent ureteral catheter and a flexible ureteroscope is safer than conventional methods for laparoscopic fenestration. To the best of our knowledge, this is the first report of this novel technique.

DOI： 10.1155/2022/9948425

Testosterone Recovery after Neoadjuvant Gonadotropin-Releasing Hormone Antagonist versus Agonist on Permanent Iodine-125 Seed Brachytherapy in Prostate Cancer Patients: A Propensity Score Analysis.

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

Acta medica Okayama 75 ( 6 ) 705 - 711 2021.12

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

Optimal neoadjuvant hormone therapy (NHT) for reducing prostate cancer (PC) patients' prostate volume pre-brachytherapy is controversial. We evaluated the differential impact of neoadjuvant gonadotropin-releasing hormone (GnRH) antagonist versus agonist on post-brachytherapy testosterone recovery in 112 patients treated pre-brachytherapy with NHT (GnRH antagonist, n=32; GnRH agonists, n=80) (Jan. 2007-June 2019). We assessed the effects of patient characteristics and a GnRH analogue on testosterone recovery with logistic regression and a propensity score analysis (PSA). There was no significant difference in the rate of testosterone recovery to normal levels (> 300 ng/dL) between the GnRH antagonist and agonists (p=0.07). The GnRH agonists induced a significantly more rapid testosterone recovery rate at 3 months post-brachytherapy versus the GnRH antagonist (p<0.0001); there was no difference in testosterone recovery at 12 months between the GnRH antagonist/agonists (p=0.8). In the multivariate analysis, no actor was associated with testosterone recovery. In the PSA, older age and higher body mass index (BMI) were significantly associated with longer testosterone recovery. Post-brachytherapy testosterone recovery was quicker with the neoadjuvant GnRH agonists than the antagonist, and the testosterone recovery rate was significantly associated with older age and higher BMI. Long-term follow-ups are needed to determine any differential effects of GnRH analogues on the quality of life of brachytherapy-treated PC patients.

DOI： 10.18926/AMO/62810

腎移植における悪性腫瘍とその治療法:自己腎癌、前立腺癌、PTLDなども含めて腎移植後の前立腺癌・尿路上皮癌

荒木元朗, 吉永香澄, 丸山雄樹, 定平卓也, 山野井友昭, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 渡辺豊彦, 那須保友

日本泌尿器科学会総会 109回 SY4 - 3 2021.12

腸骨下腹神経ブロックが鼠径部痛の緩和に有効であった、再発性鼠径ヘルニアを合併したミュラー管遺残症候群の1例

関戸崇了, 丸山雄樹, 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, 渡部昌実, 渡辺豊彦, 那須保友

日本泌尿器科学会総会 109回 OP05 - 06 2021.12

APCCC JAPAN:今こそ日本人泌尿器科医の常識を問う! M0CRPC診療 M0CRPCに対する新規ホルモン剤はどのような症例に有効か?

枝村康平, 河田達志, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 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

日本泌尿器科学会総会 109回 SY31 - 3 2021.12

COMPARISON OF SURGICAL OUTCOMES AND LONG-TERM PROGNOSIS BETWEEN LAPAROSCOPIC AND OPEN RADICAL CYSTECTOMY; A RETROSPECTIVE COHORT STUDY IN A SINGLE JAPANESE INSTITUTION.

和田里章悟, 小林泰之, 河田達志, 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, 枝村康平, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科(Web) 84 ( 2 ) 146 - 153 2021.12

Glasgow prognostic scoreは非セミノーマの胚細胞腫瘍患者において治療前にOS・PFSを予測できる

吉永香澄, 定平卓也, 関戸崇了, 和田里章悟, 丸山雄樹, 高本篤, 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

日本泌尿器科学会総会 109回 OP65 - 04 2021.12

Clinical Efficacy and Safety of Sitafloxacin 200 mg Once Daily for Refractory Genitourinary Tract Infections.

Takehiro Iwata, Takuya Sadahira, Yuki Maruyama, Takanori Sekito, Kasumi Yoshinaga, Shogo Watari, Kentaro Nagao, Tatsushi Kawada, Yusuke Tominaga, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Ayano Ishii, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 6 ) 763 - 766 2021.12

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

The aim of this ongoing trial is to evaluate the clinical efficacy and safety of sitafloxacin (STFX) 200 mg once daily (QD) for 7 days in patients with refractory genitourinary tract infections, which include recurrent or complicated cystitis, complicated pyelonephritis, bacterial prostatitis, and epididymitis. The primary endpoint is the microbiological efficacy at 5-9 days after the last administration of STFX. Recruitment began in February 2021, and the target total sample size is 92 participants.

DOI： 10.18926/AMO/62820

TVT手術19年後に発症したテープ感染の一例

渡部智文, 富永悠介, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器科学会総会 109回 PP16 - 07 2021.12

Tumor suppressor REIC/Dkk-3 and its co-chaperone SGTA: Two aspects of a GR inhibitor and AR activator as a modifier of the steroid signaling(和訳中)

岩田健宏, 定平卓也, 片山聡, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科学会総会抄録集 73回 175 - 175 2021.11

癌抑制因子REIC/Dkk-3とそのコシャペロンSGTA ステロイドシグナル伝達の調節因子としてのGR阻害剤とAR活性化剤の二つの側面(Tumor suppressor REIC/Dkk-3 and its co-chaperone SGTA: Two aspects of a GR inhibitor and AR activator as a modifier of the steroid signaling)

岩田健宏, 定平卓也, 片山聡, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科学会総会抄録集 73回 175 - 175 2021.11

鏡視下手術後の深部静脈血栓症早期発見を目的としたD-dimer測定の有用性

丸山雄樹, 岩田健宏, 吉永香澄, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 AP - 6 2021.11

腎移植後リンパ嚢腫の腹腔鏡下開窓術における蛍光尿管カテーテルと軟性尿管鏡の有用性

関戸崇了, 荒木元朗, 和田耕一郎, 吉永香澄, 西村慎吾, 枝村康平, 佐古智子, 小林泰之, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 V - 4 2021.11

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

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 2021.10

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

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

Feasible kidney donation with living marginal donors, including diabetes mellitus. International journal

Kasumi Yoshinaga, Motoo Araki, Koichiro Wada, Takanori Sekito, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Risa Kubota, Shingo Nishimura, Kohei Edamura, Yasuyuki Kobayashi, Katsuyuki Tanabe, Hidemi Takeuchi, Masashi Kitagawa, Shinji Kitamura, Jun Wada, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Immunity, inflammation and disease 9 ( 3 ) 1061 - 1068 2021.9

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

OBJECTIVES: To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). METHODS: MDs were defined according to Japanese guideline criteria: (a) age >70-years, (b) blood pressure ≤130/80 mmHg on hypertension medicine, (c) body mass index >25 to ≤32 kg/m2 , (d) 24-h creatinine clearance ≥70 to <80 ml/min/1.73 m2 , and (e) hemoglobin A1c > 6.2 or ≤6.5 with oral diabetic medicine. Fifty-three of 114 donors were MDs. We compared donor kidney functions until 60 months postoperatively. RESULTS: No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p = .02), 49 vs. 40 (12, p < .01), 48 vs. 42 (24, p = .04), 47 vs. 38 (36, p = .01)) and the percentage of residual eGFR (SD vs. MD + DM: 63 vs. 57 (1 (month), p < .01), 63 vs. 57 (2, p < .01), 64 vs. 56 (12, p < .01), 63 vs. 57 (24, p < .01), 63 vs. 52 (36, p = .02)). However, when MD with a single risk factor of DM was compared to SD, the difference disappeared. Nine out of 12 (75%) MD + DM had ≥2 risk factors. CONCLUSIONS: Although long-term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool.

DOI： 10.1002/iid3.470

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 2021.9

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

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

【これから始めるロボット支援下仙骨腟固定術】ロボット支援下仙骨腟固定術の導入に向けて

佐古智子, 岩田健宏, 西村慎吾, 高本篤, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友

Japanese Journal of Endourology 34 ( 2 ) 221 - 225 2021.9

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

骨盤臓器脱に対する治療として,2010年に経腟メッシュ手術が,2014年に腹腔鏡下仙骨腟固定術が保険収載され,泌尿器科医が骨盤臓器脱に対する治療を行うことも一般的になってきている.2020年4月の診療報酬改定により,新たにロボット支援腹腔鏡下仙骨腟固定術が保険収載された.腹腔鏡下仙骨腟固定術は,正確な剥離操作を要し,深部での縫合結紮操作を多用する手術であることなど,良性疾患に対する手術でありながら手技の難易度が比較的高い術式であると考えられる.これに対して手術支援ロボットを用いることで,手術の難易度が低減されること,手術成績が向上することが期待される.当院でも2020年8月よりロボット支援下仙骨腟固定術を導入した.ロボット支援下仙骨腟固定術のメリットやデメリット,導入の意義などについて,手術導入に向けた取り組みについて述べる.(著者抄録)

【これから始めるロボット支援下腎盂形成術】成人例のテクニカルポイント

小林泰之, 岩田健宏, 西村慎吾, 枝村康平, 和田耕一郎, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 34 ( 2 ) 243 - 245 2021.9

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

ロボット支援腎盂形成術(Robot-assisted Pyeloplasty 以下:RAPP)は2002年にGettmanらが報告して以来,海外を中心に広く行われている.本邦においては,2021年4月に保険適用され,今後急速に症例数が増加することが予想されている.RAPPの成否を左右するポイントは,(1)狭窄部の確実な切除,(2)余剰腎盂の切離のデザイン,そして(3)適切な腎盂尿管吻合の3点である.腎盂形成術は,術後に機能が回復,維持されて初めて成功と言える.この発表が,安全で確実なRAPPの普及に役立てば幸いである.(著者抄録)

【RARC ICUDを行う際のpit fall】RARCにおけるECUDとICUD(回腸導管)の比較検討

小林泰之, 枝村康平, 岩田健宏, 西村慎吾, 和田耕一郎, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 34 ( 2 ) 182 - 185 2021.9

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

岡山大学病院にて2018年1月より2020年9月までの期間に単一術者にて連続的に行われたロボット支援膀胱全摘(以下:RARC)46症例体腔外尿路変更(以下:ECUD)(23例),体腔内尿路変更(以下:ICUD)(23例)の比較検討を行った.検討項目は手術時間,推定出血量,輸血率,リンパ節郭清個数,入院日数,血液生化学データ,術後合併症とした.尿路変更に要した時間はICUD群の方が有意に長かったが,入院期間はICUD群が有意に短かった.他の周術期成績はECUDと同等であった.術者の視点では良好な拡大視野,尿管導管吻合の精緻性,同一視野で手術の流れが途切れることなく継続できることがICUDのメリットではないかと考える.(著者抄録)

ABO血液型不適合生体腎移植後の細菌感染症が急性抗体関連拒絶反応に与える影響についての検討

西村慎吾, 荒木元朗, 和田耕一郎, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 山野井友昭, 山下里美, 佐古智子, 枝村康平, 小林泰之, 渡邉豊彦, 那須保友

移植 56 ( 総会臨時 ) O11 - 1 2021.9

Role of PARP inhibitors and IO drugs in the treatment of metastatic castration-resistant prostate cancer Reviewed

Kohei Edamura, Yasutomo Nasu

西日本泌尿器科(Web) 83 ( 3 ) 132 - 137 2021.8

腎部分切除術を施行した巨大類上皮型腎血管筋脂肪腫の1例

横山周平, 富永悠介, 高本篤, 定平卓也, 関戸崇了, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科 83 ( 3 ) 175 - 180 2021.8

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は41歳,女性。2008年に結節性硬化症,両側腎血管筋脂肪腫およびIgA腎症と診断され,経過観察されていた。2015年に右腎血管筋脂肪腫より出血を認め緊急経カテーテル的動脈塞栓術を施行し,左腎血管筋脂肪腫に対しても待機的に経カテーテル的動脈塞栓術を施行した。2017年にCTで右腎尾側に新たに腫瘤を指摘され,2年の経過で12cmから20cm大に急速に増大したため2019年3月にCTガイド下針生検を実施し類上皮型腎血管筋脂肪腫と診断された。2019年5月に術前TAE後に開腹右腎部分切除術を施行した。2019年9月よりエベロリムスを開始したが,腎機能障害とHbA1cの上昇を認めたため中止した。その後,術後12ヵ月まで再発および転移を認めず経過している。(著者抄録)

ハイリスク腎移植 game changers DSA陽性ハイリスク腎移植

西村慎吾, 荒木元朗, 関戸崇了, 坪井一朗, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 83 ( 3 ) 152 - 160 2021.8

Language：Japanese Publisher：(一社)西日本泌尿器科学会

腎移植は末期腎不全に対する腎代替療法として理想的な治療である。生体で約94%,献腎で約88%という高い5年生着率が得られており,抗ドナー抗体(Donor-Specific Antibody:DSA)陽性のハイリスク症例に対する移植も積極的に行われつつある。2019年12月にDSA陽性腎移植における術前脱感作として免疫グロブリン大量静注療法(Intravenous Immunoglobulins:IVIG)が保険適応となった。IVIGは海外ではその有効性について多くの報告があり,日本でもGame changerとなりうる。今回,当科でDSA陽性に対し術前IVIGを行った2例を含めその有用性について文献的に検討する。症例1は69歳,3次移植の男性。原疾患不明の腎不全に対し,外国にて献腎移植を施行するも,術中に超急性拒絶反応を認め即座に移植腎を摘出,2つ目の腎が移植された。移植後約12年で当科に紹介受診。移植後約20年でgraft lossに至り,妻をドナーとしたA型(Rh+)→AB型(Rh+)の血液型不一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-DQ強陽性であった(nMFI=23,230)。TAC,PSLに加え術前6週前より中止していたMMFを再開し,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。症例2は71歳,女性。IgA腎症を原疾患とする腎不全に対して,HD導入前に当科受診。妊娠・出産歴3回,夫をドナーとしたAB型(Rh+)→AB型(Rh+)の血液型一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-C,DR,DQ陽性であった(nMFI=〜5,000)。術前脱感作はTAC,MMF,PSL,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。2症例とも術後現在まで一度も拒絶反応を起こすことなく良好な腎機能で経過している。(著者抄録)

DSA-POSITIVE HIGH RISK KIDNEY TRANSPLANTATION

西村慎吾, 荒木元朗, 関戸崇了, 坪井一朗, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科(Web) 83 ( 3 ) 152 - 160 2021.8

GIANT RENAL EPITHELIOID ANGIOMYOLIPOMA TREATED WITH PARTIAL NEPHRECTOMY: A CASE REPORT

横山周平, 富永悠介, 高本篤, 定平卓也, 関戸崇了, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科(Web) 83 ( 3 ) 175 - 180 2021.8

Successful deceased donor kidney transplantation to a recipient with a history of COVID-19 treatment. International journal

Kasumi Yoshinaga, Motoo Araki, Koichiro Wada, Kou Hasegawa, Takanori Sekito, Shuji Miyake, Shogo Watari, Yuki Maruyama, Takuya Sadahira, Shingo Nishimura, Katsuyuki Tanabe, Hidemi Takeuchi, Yuri Nakashima, Masaru Kinomura, Herik Acosta, Yosuke Mitsui, Risa Kubota, Hirochika Nakajima, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Fumio Otsuka, Jun Wada, Yasutomo Nasu

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 7 ) 1097 - 1101 2021.7

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

CASE PRESENTATION: A 49-year-old Asian male, who had undergone hemodialysis for >16 years, complained of a fever, dysgeusia and dysosmia, and was diagnosed with COVID-19 pneumonia based on severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (SARS-CoV-2 PCR) and computed tomography (CT). Treatment was started with oral favipiravir and ciclesonide inhalation. On the 10th day of treatment, the patient had a persistent high fever and a chest CT showed exacerbation of pneumonia, so dexamethasone was intravenously started. He was discharged after confirming two consecutive negative SARS-CoV-2 PCR tests. Three months after COVID-19 treatment, a SARS-CoV-2 PCR test was negative and he underwent a deceased donor kidney transplantation. Basiliximab induction with triple drug immunosuppression consisting of extended-release tacrolimus, mycophenolate mofetil and prednisolone, which is our regular immunosuppression protocol, was used. He was discharged on postoperative day 18 without the need for postoperative hemodialysis or any complications. The serum creatinine level was 1.72 mg/dL 95 days postoperatively and he had a favorable clinical course that was similar to deceased donor kidney recipients without a history of SARS-CoV-2 infection. CONCLUSION: We report the first case of a kidney transplantation after COVID-19 treatment in Japan and the fourth case globally. We would like to provide information about our successful case due to the anticipated increase in similar candidates in the near future.

DOI： 10.1016/j.jiac.2021.03.018

A Case of Metastatic Fumarate Hydratase-Deficient-like Renal Cell Carcinoma Successfully Managed by Ipilimumab plus Nivolumab.

Takanori Sekito, Atsushi Takamoto, Yasuyuki Kobayashi, Masao Mitsui, Shogo Watari, Risa Kubota, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Sako, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Rei Shibata, Daisuke Ennishi, Yasutomo Nasu

Acta medica Okayama 75 ( 3 ) 397 - 402 2021.6

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

We report a 62-year-old male with metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) without fumarate hydratase (FH) mutation (FH-deficient-like RCC). The International Metastatic RCC Database Consortium risk score was intermediate, and immunotherapy with nivolumab and ipilimumab (Ipi/ Nivo) was initiated. Four cycles of Ipi/Nivo and 5 cycles of nivolumab resulted in a complete response of the metastases. Hypophysitis occurred as an immune-related adverse event after four cycles of Ipi/Nivo. The prognosis of patients with FH-deficient RCC is generally poor. Few reports of FH-deficient RCC successfully treated with Ipi/Nivo have been published. Ipi/Nivo can be effective for treating FH-deficient RCC.

DOI： 10.18926/AMO/62237

MUCINOUS CYSTADENOCARCINOMA IN THE RENAL HILUM: A CASE REPORT AND REVIEW OF THE LITERATURE

三宅修司, 岩田健宏, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 久保寿夫, 柳井広之, 那須保友

西日本泌尿器科(Web) 83 ( 2 ) 100 - 105 2021.6

腎門部に発生した粘液嚢胞腺癌の1例

三宅修司, 岩田健宏, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 久保寿夫, 柳井広之, 那須保友

西日本泌尿器科 83 ( 1 ) 14 - 14 2021.6

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は79歳,男性。2年前に検診にて左腎嚢胞と診断され近医で経過観察となっていたが,増大傾向であったため当科紹介となった。造影CT検査でBosniak分類category IVの左嚢胞性腎癌を疑い,腹腔鏡下左腎摘除術を施行した。術後病理結果から,粘液嚢胞腺癌(Mucinous cystadenocarcinoma)と診断した。術後補助化学療法は行わずに経過観察としていたが,術後3ヵ月後に多発肺転移が出現し,化学療法(カルボプラチン+パクリタキセル)を開始した。5コース投与後の肺転移はSDであったため,一旦化学療法中止で経過観察の方針としたが,5ヵ月後に肺転移は増大傾向を認めたため術後14ヵ月目よりニボルマブの投与を開始した。ニボルマブ2コース投与後のCTで肺転移は縮小し,5コース投与後もPRを維持しているため現在も投与継続中である。(著者抄録)

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

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 2021.3

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

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

ロボット支援腹腔鏡下膀胱全摘除術〜現状の課題と今後の方向性〜岡山大学病院におけるRARC ICUD(回腸導管)

小林泰之, 西村慎吾, 岩田健宏, 枝村康平, 和田耕一郎, 荒木元朗, 渡辺豊彦, 那須保友

日本内視鏡外科学会雑誌 25 ( 7 ) SY16 - 2 2021.3

Prevention and control of perioperative complication of RAPN.

小林泰之, 荒木元朗, 枝村康平, 渡辺豊彦, 那須保友

月刊泌尿器科 13 ( 3 ) 323 - 325 2021.3

岡山大学病院における去勢抵抗性前立腺癌に対するドセタキセルの長期治療成績

河田達志, 高本篤, 横山周平, 宗田大二郎, 坪井一馬, 長尾賢太郎, 富永悠介, 岩田健宏, 西村慎吾, 佐古智子, 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 ( 6 ) 605 - 605 2021.2

RETROPERITONEAL MALIGNANT PERIPHERAL NERVE SHEATH TUMOR ASSOCIATED WITH NEUROFIBROMATOSIS TYPE 1: A CASE REPORT

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 2021.2

Long-term ureteroscopic management of upper tract urothelial carcinoma: 28-year single-centre experience. International journal

Yuki Maruyama, Motoo Araki, Koichiro Wada, Kasumi Yoshinaga, Yosuke Mitsui, Takuya Sadahira, Shingo Nishimura, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Manoj Monga, Yasutomo Nasu, Hiromi Kumon

Japanese journal of clinical oncology 51 ( 1 ) 130 - 137 2021.1

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

BACKGROUND: Long-term survival outcomes of patients who undergo endoscopic management of non-invasive upper tract urothelial carcinoma remain uncertain. The longest mean follow-up period in previous studies was 6.1 years. This study reports the long-term outcomes of patients with upper tract urothelial carcinoma who underwent ureteroscopic ablation at a single institution over a 28-year period. METHODS: We identified all patients who underwent ureteroscopic management of upper tract urothelial carcinoma as their primary treatment at our institution between January 1991 and April 2011. Survival outcomes, including overall survival, cancer-specific survival, upper-tract recurrence-free survival and renal unit survival, were estimated using Kaplan-Meier methodology. RESULTS: A total of 15 patients underwent endoscopic management, with a mean age at diagnosis of 66 years. All patients underwent ureteroscopy, and biopsy-confirmed pathology was obtained. Median (range; mean) follow-up was 11.7 (2.3-20.9, 11.9) years. Upper tract recurrence occurred in 87% (n = 13) of patients. Twenty percent (n = 3) of patients proceeded to nephroureterectomy. The estimated cancer-specific survival rate was 93% at 5, 10, 15 and 20 years. Estimated overall survival rates were 86, 80, 54 and 20% at 5, 10, 15 and 20 years. Only one patient experienced cancer-specific mortality. The estimated mean and median overall survival times were 14.5 and 16.6 years, respectively. The estimated mean cancer-specific survival time was not reached. CONCLUSIONS: Although upper tract recurrence is common, endoscopic management of non-invasive upper tract urothelial carcinoma provides a 90% cancer-specific survival rate at 20 years in selected patients.

DOI： 10.1093/jjco/hyaa132

A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial.

Takuya Sadahira, Yuki Maruyama, Yoshiki Hiyama, Hiroyuki Kitano, Hiroki Yamada, Takayuki Goto, Tsubasa Kondo, Katsumi Shigemura, Yosuke Mitsui, Takehiro Iwata, Kohei Edamura, Motoo Araki, Masami Watanabe, Tadasu Takenaka, Jun Teishima, Yasuyoshi Miyata, Kiyohito Ishikawa, Ei-Ichiro Takaoka, Jun Miyazaki, Satoshi Takahashi, Naoya Masumori, Hiroshi Kiyota, Masato Fujisawa, Shingo Yamamoto, Takafumi Sakuma, Norihiro Kusumi, Takaharu Ichikawa, Toyohiko Watanabe, Yoshitsugu Nasu, Masaya Tsugawa, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 5 ) 663 - 667 2021

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

The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants.

DOI： 10.18926/AMO/62782

Management of Groin Pain Using an Iliohypogastric Nerve Block in a Patient with Inguinal Hernia due to Persistent Müllerian Duct Syndrome. International journal

Takanori Sekito, Takuya Sadahira, Masahiro Sugihara, Kohei Edamura, Motoo Araki, Yasutomo Nasu

Case reports in urology 2021 7577632 - 7577632 2021

Language：English

Persistent Müllerian duct syndrome can cause an inguinal hernia, although this is a rare occurrence; recurrent inguinal hernias can, in turn, cause ongoing groin pain. Management of groin pain plays an important role in patients' quality of life. We present our experience with a 43-year-old man who had a 2-week history of left-sided groin pain. The patient underwent laparoscopic surgery for a left inguinal hernia via the transabdominal preperitoneal approach. Right-sided cryptorchidism was noted during surgery, with a solid structure-thought to be a uterus-extending into the left inguinal canal. The diagnosis was persistent Müllerian duct syndrome, and the groin pain was relieved after a laparoscopic right orchiectomy with a bilateral preperitoneal hernia repair using a mesh. Four years later, magnetic resonance imaging performed for new-onset left groin pain showed a left inguinal hernia caused by the uterine structure. We diagnosed the recurrent hernia as the cause of his pain. Prior to performing any invasive surgical procedures, an iliohypogastric nerve block was performed using 1% lidocaine. Short-term analgesia was provided by the block, improving his quality of life. He has been followed since then and has declined surgical neurectomy. An iliohypogastric nerve block can be an effective method of controlling groin pain caused by an inguinal hernia resulting from persistent Müllerian duct syndrome; the effectiveness of the nerve block will help determine whether surgical neurectomy is indicated for permanent pain control.

DOI： 10.1155/2021/7577632

How to establish sustainable kidney transplant program at Okayama University

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科(CD-ROM) 33 ( 2 ) 67 - 71 2021

【地方の腎移植の継続と継承-組織・指導医の取り組みと今後の展望-】岡山大学における腎移植継承の取り組み

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科 33 ( 2 ) 67 - 71 2021

Language：Japanese Publisher：腎移植・血管外科研究会

1.岡山大学の腎移植の背景・歴史岡山大学泌尿器科は2009年に新しい腎移植プログラムを立ち上げ総計144例となった.成績も1年生存・生着率100%を維持している.2.人材確保医局員の確保から始まる.3.育成腎移植は幅広いテクニックが要求される.血管縫合糸は若手医師でも縫いやすく結紮もし易いGore-tex sutureを用いている.いい雰囲気でやることを心がけている.4.腎臓内科との連携術前術後連携を取るため腎移植カンファレンスを月一回行い情報共有している.5.教室内での他の領域の医師との関係腎移植チームのメンバーも腫瘍の手術やロボット手術を担当することによって腎移植のみに偏らない配慮をしている.6.働き方改革移植前後の管理の簡略化に努めている.(著者抄録)

【ロボット手術の教育方法-それぞれの施設での試み-】岡山大学病院泌尿器科におけるロボット手術教育の現状

小林泰之, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 定平卓也, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 33 ( 2 ) 221 - 224 2020.12

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

2009年にダビンチSが薬事承認、2012年にロボット支援下腹腔鏡下前立腺全摘除術が保険収載されて以来、ロボット手術は急激に普及している。岡山大学病院関連施設においても、この数年間でダビンチが急速に普及し、13台(岡山大学病院を含む)のダビンチが稼働し45名の術者が執刀を行っている。しかしながら、各々施設での手術方法、指導方法は全く同じではない。関連施設内での人事異動にともない、岡山大学病院においても、様々な背景を有する術者が在籍するようになり、同一施設内にも関わらず複数の手術方法が乱立した。この状態に当施設のロボット手術教育はうまく対応できず、2015年頃より周術期成績も悪化の傾向を示した。この問題を解決するために、腹腔鏡手術教育にて培った"手術内容を統一し手術内容の再現性を高め、短いラーニングカーブを目指す"というコンセプトを応用し、この状況を乗り越えようと試みている。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J05817&link_issn=&doc_id=20201215380007&doc_link_id=%2Fcs5jjend%2F2020%2F003302%2F009%2F0221-0224%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5jjend%2F2020%2F003302%2F009%2F0221-0224%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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総会 34回 AV - 5 2020.11

UTUCに対するKidney-sparing surgeryの現状と課題岡山大学の手技と成績

和田耕一郎, 丸山雄樹, 荒木元朗, 小林泰之, 定平卓也, 高本篤, 佐古智子, 枝村康平, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

Comparison of intracorporeal versus extracorporeal urinary diversion after robot-assisted radical cystectomy

小林泰之, 岩田健宏, 西村慎吾, 枝村康平, 和田耕一郎, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology (Web) 34回 ( 2 ) SY - 2 2020.11

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 2020.10

Language：English

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

後腹膜SFT(Solitary fibrous tumor)の一例

坪井一馬, 高本篤, 関戸崇了, 富永悠介, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 荒木元朗, 渡部昌美, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 191 - 191 2020.10

ハイリスク腎移植game changers DSA陽性ハイリスク腎移植

西村慎吾, 荒木元朗, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 90 - 90 2020.10

尿路変向術:私の工夫 RARC ICUD失敗から学んだこと

小林泰之, 枝村康平, 西村慎吾, 岩田健宏, 定平卓也, 高本篤, 佐古智子, 荒木元朗, 渡邊豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 111 - 111 2020.10

進行腎癌に対してipilimumb、nivolumab併用療法が奏功するも重度肝機能障害を来たし死亡の転機をたどった1例

宗田大二郎, 岩田健宏, 横山周平, 大岩裕子, 窪田理沙, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邊豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 165 - 165 2020.10

Pembrolizumabが著効した進行性尿膜管癌の一例

横山周平, 長尾賢太郎, 河田達志, 富永悠介, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 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 ( 増刊 ) 184 - 184 2020.10

去勢抵抗性前立腺癌game changers mCRPC治療におけるPARP阻害剤、IOの役割

枝村康平

西日本泌尿器科 82 ( 増刊 ) 84 - 84 2020.10

生体腎移植において好中球・リンパ球比の高値の継続は腎機能低下の予後予測因子となる

丸山雄樹, 荒木元朗, 関戸崇了, 和田里章悟, 吉永香澄, 光井洋介, 窪田理沙, 西村慎吾, 山下里美, 枝村康平, 小林泰之, 渡邉豊彦, 田邊克幸, 杉山斉, 和田淳, 那須保友

移植 55 ( 総会臨時 ) 355 - 355 2020.10

長期加療を要した術中十二指腸損傷の1例

高村剛輔, 宇野誠, 三宅修司, 野田岳, 河田達志, 別宮謙介, 江原伸, 枝村康平, 平田武志, 小倉一真, 花本昌紀

泌尿器科紀要 66 ( 6 ) 191 - 191 2020.6

Indication of laparoscopic radical nephroureterectomy for pelvic and ureteral tumor

吉永香澄, 荒木元朗, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 和田耕一郎, 佐古智子, 枝村康平, 小林泰之, 渡部昌実, 渡辺豊彦, 那須保友

泌尿器外科 33 ( 5 ) 455 - 461 2020.5

Clinical experience with pembrolizumab in the treatment of advanced urothelial cancer

Yusuke Tominaga, Atsushi Takamoto, Takanori Sekito, Syogo Watari, Yuko Oiwa, Risa Kubota, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 82 ( 1 ) 106 - 110 2020.4

Language：Japanese Publisher：The West Japan Urological Association

[Introduction and objective) Pembrolizumab, a programmed death one checkpoint inhibitor, was approved as second-line treatment of advanced urothelial cancer (UC). We performed a pilot study to investigate the effect of pembrolizumab. [Methods and patients) 19 patients who were treated with pembrolizumab from April 2018 to July 2019 were retrospectively reviewed and analyzed to evaluate efficacy and safety. Pembrolizumab was administered after platinum-based chemotherapy. [Results) The median age was 68 years old
male-to-female ratio was 14:5
primary lesions were upper urinary tract, bladder and others (10, 7 and 2, respectively)
recurrence lesions were lymph nodes, lung, bone and liver (14, 9, 4 and 2, respectively). The median number of cycles was three courses (range, 1-16). The objective response rate, median progression-free survival period (PFS), and median overall survival period (OS) were 24%, 2.7 months and 9.1 months, respectively. Pembrolizumab showed a long-term effect for all responsive cases until the end of the follow-up period. Immune-related adverse events (irAE) were observed in four patients. Neutrophil-to-lymphocyte ratio was negatively correlated with PFS, but not significantly correlated with OS. [Conclusion) Pembrolizumab demonstrated a comparable efficacy and safety profile in the treatment of advanced UC. In particular, responsive cases showed a durable response. Further investigation is required to identify predictive markers that can be routinely used in clinical practice.

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 2020.4

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 2020.4

Language：Japanese Publisher：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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Robotic Renal Autotransplantation: A Feasibility Study in a Porcine Model.

Risa Kubota, Motoo Araki, Koichiro Wada, Kasumi Kawamura, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Yuichi Ariyoshi, Takehiro Iwata, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Yuzuki Kano, Masashi Kitagawa, Katsuyuki Tanabe, Hitoshi Sugiyama, Jun Wada, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Acta medica Okayama 74 ( 1 ) 53 - 58 2020.2

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

We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci® robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort® and irrigated on ice with Ringer's solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery.

DOI： 10.18926/AMO/57953

ロボット支援下腎動脈瘤修復術のfeasibility study

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

日本内視鏡外科学会雑誌 24 ( 7 ) MO336 - 7 2019.12

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 2019.12

岡山大学病院におけるロボット支援腹腔鏡下腎部分切除術の検討

窪田理沙, 小林泰之, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 33回 O - 4 2019.11

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 2019.10

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 2019.10

Fumarate hydratase(FH)欠損腎細胞癌によるリンパ節転移に対して、イピリムマブ+ニボルマブ併用療法が奏功した一例

関戸崇了, 高本篤, 小林泰之, 三井將雄, 和田里章吾, 窪田理沙, 岩田健宏, 枝村康平, 佐古智子, 荒木元朗, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科 81 ( 増刊 ) 151 - 151 2019.10

糖尿病患者は腎部分切除術後一年で腎機能が低下する Propensity Score-Matched Analysis

河村香澄, 荒木元朗, 丸山雄樹, 光井洋介, 定平卓也, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 渡辺豊彦, 那須保友

西日本泌尿器科 81 ( 増刊 ) 177 - 177 2019.10

岡山大学病院泌尿器科における腹腔鏡教育プログラムの有用性腹腔鏡下副腎摘除術

和田里章悟, 小林泰之, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

Japanese Journal of Endourology 32 ( 2 ) 225 - 229 2019.9

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

当院泌尿器科では2006年から独自の腹腔鏡手術教育プログラムを作成し手術教育を行っている。2009年3月から2017年11月までに当院で腹腔鏡技術認定医トレーニング中の泌尿器科医師が執刀した腹腔鏡下副腎摘除術76症例と、当院の腹腔鏡技術認定医が行った43症例との周術期成績の比較検討を行った。プログラム対象者は合計18人(卒後6-11年目)で、1人あたりの執刀症例数は中央値4例(range:1-9)、認定医の術者は9名で中央値2例(range:1-26)であった。患者背景には大きな差は認めなかった。手術時間は認定医群で有意に短かった(p=0.0122)ものの、両群において輸血や開腹移行症例、重篤な合併症はなかった。手術時間・出血量に急激なラーニングカーブは認めなかった。系統的な手術教育により腹腔鏡手術経験の未熟な術者の初期症例においても、安定した周術期成績を残すことが出来た。(著者抄録)

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サルコペニアが前立腺全摘除後の排尿関連QoLに与える影響 Expanded Prostate Cancer Index Compositeを用いた経時的変化

光井洋介, 渡邉豊彦, 定平卓也, 丸山雄樹, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 那須保友

日本排尿機能学会誌 30 ( 1 ) 255 - 255 2019.9

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

Yuki Maruyama, Takuya Sadahira, Motoo Araki, Yosuke Mitsui, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

International journal of urology : official journal of the Japanese Urological Association 26 ( 8 ) 813 - 819 2019.8

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

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 2019.8

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 2019.8

局所進行性前立腺癌に対するRALP(拡大リンパ節郭清、拡大摘除)の予後因子の検討

柳原豊, 芳賀俊介, 渡辺隆太, 沢田雄一郎, 野田輝乙, 浅井聖史, 福本哲也, 三浦徳宣, 宮内勇貴, 菊川忠彦, 雑賀隆史, 中島宏親, 枝村康平, 江原伸

泌尿器外科 32 ( 8 ) 1023 - 1024 2019.8

Language：Japanese Publisher：医学図書出版(株)

局所進行性前立腺癌に対する一次治療としてのロボット支援下前立腺全摘術(RALP)の成績は、限られた報告しかない。そこでわれわれは、extended RALP(拡大摘除+拡大骨盤内リンパ節郭清)を行った局所進行性前立腺癌の症例(ネオアジュバントならびにアジュバント治療を施行していない約100例)を後方視的に、手術成績、周術期合併症、術後PSA再発、予後因子などを検討し報告する。(著者抄録)

ロボット支援腹腔鏡下腎部分切除術後に再発した3症例の検討

小林泰之, 荒木元朗, 枝村康平, 西村慎吾, 高本篤, 渡辺豊彦, 那須保友

腎癌研究会会報 ( 49 ) 40 - 40 2019.7

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.

ROBOTIC RENAL AUTOTRANSPLANTATION

荒木元朗, 和田耕一郎, 西村慎吾, 窪田理沙, 河村香澄, 丸山雄樹, 光井洋介, 定平卓也, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌美, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 3 ) 314 - 320 2019.6

BCG膀胱内注入療法後に発症した感染性胸部大動脈瘤の1例

高村剛輔, 三宅修司, 小倉一真, 花本昌紀, 河田達志, 平田武志, 枝村康平, 江原伸, 甲斐誠二

泌尿器科紀要 65 ( 6 ) 229 - 229 2019.6

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

Takuya Sadahira, Yosuke Mitsui, Motoo Araki, Yuki Maruyama, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Lower urinary tract symptoms 11 ( 3 ) 122 - 126 2019.5

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

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 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.

経尿道的砕石術(TUL)を施行した小児腎結石症の1例

佐久間貴文, 和田耕一郎, 本郷智拡, 前原貴典, 高本篤, 坪井一朗, 松尾聡子, 三井將雄, 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, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 2 ) 243 - 244 2019.4

持続勃起症に対してT-shunt術を施行した1例

三宅修司, 小倉一真, 花本昌紀, 河田達志, 高村剛輔, 平田武志, 別宮謙介, 江原伸, 枝村康平

西日本泌尿器科 81 ( 2 ) 244 - 244 2019.4

難治性過活動膀胱(OAB)に対する仙骨神経刺激療法(SNM)の初期経験と今後の治療戦略について

渡邉豊彦, 大岩裕子, 佐久間貴文, 定平卓也, 石井亜矢乃, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 那須保友, 横山光彦, 井上雅, 小林知子

西日本泌尿器科 81 ( 2 ) 245 - 245 2019.4

【腹腔鏡手術〜初心者に何をどう教えるべきか〜】ロボット支援腹腔鏡下手術時代における腹腔鏡教育

小林泰之, 和田耕一郎, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 32 ( 1 ) 28 - 31 2019.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

ロボット手術導入後より、腹腔鏡手術の手術件数は減少し、全盛期の半分となっている。これからの腹腔鏡教育はこのことを念頭に考えていかなければならない。"手術教育の根幹となる手術"は腹腔鏡手術の普及に伴い開腹手術から腹腔鏡に移行したが、近年ロボット手術に移行しつつある。しかしながら、ロボット手術は腹腔鏡手術の一種であり、開腹手術から腹腔鏡手術へといった大きなシフトではなく、ロボット手術と腹腔鏡手術は並列なものと捉え、相補的な教育を行っていくことが大切だと考える。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J05817&link_issn=&doc_id=20190611290006&doc_link_id=%2Fcs5jjend%2F2019%2F003201%2F009%2F0028-0031%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5jjend%2F2019%2F003201%2F009%2F0028-0031%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

QOL向上をめざした泌尿器がん治療岡山大学病院におけるロボット支援腹腔鏡下膀胱全摘除術の経験

小林泰之, 三井将雄, 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

西日本泌尿器科 81 ( 2 ) 122 - 127 2019.4

Language：Japanese Publisher：西日本泌尿器科学会

2018年にロボット支援腹腔鏡下膀胱全摘除術が保険収載され、今後本邦においても普及していくことが予想される。今回、当院にて膀胱全摘除術を行った102例(ORC35例、LRC52例、RARC15例)を対象に後方視的に検討を行った。検討項目は、手術時間、出血量、術後合併症、入院日数、術後の歩行開始日、術後疼痛、術後発熱とした。手術時間はRARCが最も短く、出血量はRARCが最も少なかった。術後の合併症はいずれの群においても約33%(全グレード)認めた。術後の歩行開始日、発熱が持続した期間は鏡視下手術群がORCと比して優れた結果であった。入院日数においては3群に有意な差はなかった。RARCはORCに比べ術後早期に回復が期待できるだけでなく、症例ごとの術後経過に差が少なく安定した手術成績が期待できる。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01004&link_issn=&doc_id=20190507280003&doc_link_id=%2Fer9niuro%2F2019%2F008102%2F004%2F0122-0127%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2019%2F008102%2F004%2F0122-0127%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

超細径HDIGスコープを用いた直視下腎杯穿刺とPCNLの初期成績

和田耕一郎, 公文裕巳, 谷本竜太, 荒木元朗, 本郷智拡, 三井將雄, 松尾聡子, 坪井一朗, 佐久間貴文, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 前原貴典, 窪田理沙, 大岩裕子, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 杉本盛人, 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 80 ( 12 ) 700 - 700 2018.12

The Combination of Gemcitabine, Cisplatin, and Paclitaxel as Salvage Chemotherapy for Advanced Urothelial Carcinoma.

Takeshi Hirata, Masanori Hanamoto, Kazuma Ogura, Nobuki Hayashi, Kosuke Takamura, Kohei Edamura, Shin Ebara, Takashi Saika

Acta medica Okayama 72 ( 2 ) 175 - 179 2018.4

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

There is no standard second-line or salvage treatment for advanced urothelial carcinoma (UC). Here we investigated the efficacy and safety of gemcitabine, cisplatin, and paclitaxel (GCP) combination chemotherapy as salvage chemotherapy for advanced UC. We retrospectively analyzed the cases of 23 patients with advanced UC who showed progression or recurrence after cisplatin-based chemotherapy. Gemcitabine (1000 mg/m2), and paclitaxel (80 mg/m2) were administered on days 1 and 8. Cisplatin (70 mg/m2) was administered on day 1. The 3-week cycle regimen was repeated until disease progression if it had no intolerable toxicity. The overall response rate was 61% (95%CI, 41-78%). The median overall survival and progression-free survival times were 14 months and 5.5 months, respectively. Of the already known risk factors of chemotherapy for advanced UC, only the performance status was a prognostic factor for OS. Overall, 16 of the 23 patients (70%) experienced grade 3/4 toxicities, and no fatal adverse events were observed. GCP therapy was a promising option as second-line or salvage therapy for advanced UC.

DOI： 10.18926/AMO/55858

Efficacy and safety of 3 day versus 7 day cefditoren pivoxil regimens for acute uncomplicated cystitis: Multicentre, randomized, open-label trial Reviewed

Takuya Sadahira, Okayama Urological Research Group (OURG), Koichiro Wada, Motoo Araki, Ayano Ishii, Atsushi Takamoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Hiromi Kumon, Teruaki Akaeda, Nobuyuki Akazawa, Naoki Akebi, Daiji Araki, Tohru Araki, Ryoji Arata, Yuichi Ariyoshi, Eiichi Ando, Nobuyoshi Ando, Kazushi Ishii, Tsutomu Ishikawa, Noritaka Ishito, Takaharu Ichikawa, Takaaki Inoue, Miyabi Inoue, Yosuke Inoue, Shin Irie, Takehiro Iwata, Tatsuya Uesugi, Shinya Uehara, Katsutoshi Uematsu, Satoshi Uno, Kohei Edamura, Shin Ebara, Yuko Oiwa, Tadashi Oeda, Teruhisa Ohashi, Yozo Ohashi, Hideo Ozawa, Junzo Ochi, Noriaki Ono, Seiji Kai, Haruki Kaku, Satoshi Katayama, Yasuhiro Katayama, Tetuzo Kaneshige, Keiichiro Kawauchi, Masashi Kawaguchi, Tatsushi Kawada, Taiki Kanbara, Mikio Kishi, Ryo Kishimoto, Nobuyuki Kusaka, Norihiro Kusumi, Kimito Kunitomi, Risa Kubota, Hiroaki Kurahashi, Hironori Kojima, Tomoko Kobayashi, Makoto Kobuke, Katsuyoshi Kondo, Takashi Saika, Kazuma Sakaeda, Koji Sakuramoto, Shinichi Sako, Tomoko Sako, Taketo Sasaoka, Katsumi Sasaki, Yoshimasa Jo, Morito Sugimoto, Yuko Seno, Akira Takao, Kosuke Takamura, Kousuke Takamura, Hitoshi Takamoto, Katsuji Takeda, Tadasu Takenaka, Daisuke Tanaka, Ryuta Tanimoto, Masaya Tsugawa, Tomoyasu Tsushima, Hiromu Tsuboi, Syunji Tojo, Kenji Tokinaga, Yusuke Tominaga, Keisuke Doi, Atsushi Nagai, Hirochika Nakajima, Tetsuya Nakada, Hirokazu Nakatsuka, Aya Nakamura, Yasuki Nakayama, Yoshitsugu Nasu, Daisuke Nishikawa, Jun Nishiguchi, Yoshio Nishitani, Shingo Nishimura, Motoichi Nishimura, Yasuhiro Nishiyama, Hajime Nibuno, Kunihiro Nozaki, Hiroyuki Nose, Gaku Noda, Hideaki Hashimoto, Kazuhiro Hata, Toshihide Hayashi, Nobuki Hayashi, Syunji Hayata, Ryoei Hara, Takeshi Hirata, Tomohiro Fujii, Kei Fujio, Ryuji Fujita, Kensuke Bekku, Takanori Maehara, Yoshio Maki, Yuko Matsumoto, Daisuke Manabe, Yusuke Mayumi, Yuki Maruyama, Yosuke Mitsui, Sadayuki Miyaji, Syuhei Munemasa, Wataru Murao, Takanori Murakami, Tadashi Murata, Akihiro Mori, Akira Morita, Koichi Monden, Tomoya Yamasaki, Masahiro Yamashita, Daiduke Yamada, Toyoko Yamato, Toru Yamane, Tomoaki Yamanoi, Yasuo Yamamoto, Kazuaki Yukari, Teruhiko Yokoyama, Takashi Yoshioka, Yuichi Watanabe

Journal of Antimicrobial Chemotherapy 72 ( 2 ) 529 - 534 2017

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press

Background: Fluoroquinolone-non-susceptible Escherichia coli isolated from patients with acute uncomplicated cystitis are a matter of increasing concern. Cefditoren pivoxil is an oral, β-lactamase-stable, extended-spectrum cephalosporin that is effective against fluoroquinolone-non-susceptible bacteria. Objectives: To evaluate the clinical and microbiological efficacies of cefditoren pivoxil against acute uncomplicated cystitis and to determine the optimal duration of cefditoren pivoxil treatment. Methods: We compared 3 and 7 day regimens of cefditoren pivoxil in a multicentre, randomized, open-label study. Results: A total of 104 female patients with acute uncomplicated cystitis were enrolled and randomized into 3 day (n=51) or 7 day (n=53) treatment groups. At first visit, 94 bacterial strains were isolated from the 104 participants of which 81.7% (85/104) were E. coli. Clinical and microbiological efficacies were evaluated 5-9 days following administration of the final dose of cefditoren pivoxil. The clinical efficacies of the 3 and 7 day groups were 90.9% (40/44) and 93.2% (41/44), respectively (P=1.000). The microbiological efficacies of the 3 and 7 day groups were 82.5% (33/40) and 90.2% (37/41), respectively (P=0.349). There were no adverse events due to cefditoren pivoxil treatment, with the exception of a mild allergic reaction in one patient, after which the cefditoren pivoxil was exchanged for another antimicrobial. Conclusions: Cefditoren pivoxil is safe and effective for uncomplicated cystitis, with no significant differences in clinical and microbiological efficacies between 3 and 7 day regimens.

DOI： 10.1093/jac/dkw424

Feasibility of robot-assisted radical prostatectomy in elderly patients: Comparative analysis of the peri-surgical/oncological outcomes with younger patients. Reviewed

Takehiro Iwata, Takashi Saika, Kohei Edamura

JOURNAL OF CLINICAL ONCOLOGY 34 ( 2 ) 2016.1

Introduction of robot-assisted radical prostatectomy: Outcomes of a cohort comprising the initial 100 patients compared with those of patients who underwent laparoscopic radical prostatectomy

Takashi Saika, Nobuyuki Kusaka, Kohei Edamura, Kyohei Kurose, Kazuaki Yukari, Tomoya Yamasaki, Fumihito Koizumi, Keiichiro Kawauchi

Nishinihon Journal of Urology 76 ( 11 ) 408 - 413 2014.11

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

In Japan, the modalities of radical prostatectomy are changing drastically due to recent innovation of the Japanese social health insurance system regarding surgery for prostate cancer (PCa). We compared outcomes between a cohort comprising the initial 100 patients who underwent robot-assisted radical prostatectomy (RALP) and patients who had undergone laparoscopic radical prostatectomy (LRP). Between September 2012, when we initiated RALP, and September 2013, we performed this operation on 100 patients. All the surgeries were undertaken by a single surgical team conducted by the Director of the Department of Urology. Peri-surgical outcomes, pathological findings and continence status were compared with those of 141 patients who had undergone LRP. Preoperative parameters (age, PSA, Gleason score) were similar in both the RALP and LRP groups. Operative time (169 vs. 209 minutes) and estimated blood loss (minimal vs. 77 ml) were reduced in the RALP group vs. the LRP group. Peri-operative complications in the RALP group appeared to be minimal, with no cases of intra-operative open conversion. On the other hand, severe complications, including 3 rectal injuries, were observed in 6 cases in the LRP group. Although not statistically significant, there was a lower positive margin rate in organ-confined (pT2) disease (7.1%, RALP vs. 16%, LRP). Continence at 1 month was 76% following RALP as opposed to 41% after LRP. The transition to RALP from LRP has yielded superior operative, oncologic, and functional results.

Systemic GLIPR1-ΔTM protein as a novel therapeutic approach for prostate cancer. International journal

Theodoros Karantanos, Ryuta Tanimoto, Kohei Edamura, Takahiro Hirayama, Guang Yang, Alexei A Golstov, Jianxiang Wang, Shinji Kurosaka, Sanghee Park, Timothy C Thompson

International journal of cancer 134 ( 8 ) 2003 - 13 2014.4

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

GLIPR1 is a p53 target gene known to be downregulated in prostate cancer, and increased endogenous GLIPR1 expression has been associated with increased production of reactive oxygen species, increased apoptosis, decreased c-Myc protein levels and increased cell cycle arrest. Recently, we found that upregulation of GLIPR1 in prostate cancer cells increases mitotic catastrophe through interaction with heat shock cognate protein 70 (Hsc70) and downregulation of Aurora kinase A and TPX2. In this study, we evaluated the mechanisms of recombinant GLIPR1 protein (glioma pathogenesis-related protein 1-transmembrane domain deleted [GLIPR1-ΔTM]) uptake by prostate cancer cells and the efficacy of systemic GLIPR1-ΔTM administration in a prostate cancer xenograft mouse model. GLIPR1-ΔTM was selectively internalized by prostate cancer cells, leading to increased apoptosis through reactive oxygen species production and to decreased c-Myc protein levels. Interestingly, GLIPR1-ΔTM was internalized through clathrin-mediated endocytosis in association with Hsc70. Systemic administration of GLIPR1-ΔTM significantly inhibited VCaP xenograft growth. GLIPR1-ΔTM showed no evidence of toxicity following elimination from mouse models 8 hr after injection. Our results demonstrate that GLIPR1-ΔTM is selectively endocytosed by prostate cancer cells, leading to increased reactive oxygen species production and apoptosis, and that systemic GLIPR1-ΔTM significantly inhibits growth of VCaP xenografts without substantial toxicity.

DOI： 10.1002/ijc.28529

LAPAROSCOPY AND ENDOSCOPY COOPERATIVE SINGLE-SITE SURGERY (LECS) FOR BLADDER ENDOMETRIOSIS DISSECTION Reviewed

Kyouhei Kurose, Tomoya Yamasaki, Kazuaki Yukari, Kohei Edamura, Nobuyuki Kusaka, Takashi Saika

JOURNAL OF ENDOUROLOGY 26 A504 - A504 2012.9

Primary Gleason grade 4 impact on biochemical recurrence after permanent interstitial brachytherapy in Japanese patients with low- or intermediate-risk prostate cancer. International journal

Tatsuya Uesugi, Takashi Saika, Kohei Edamura, Hiroyuki Nose, Makoto Kobuke, Shin Ebara, Fernand Abarzua, Norihisa Katayama, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

International journal of radiation oncology, biology, physics 82 ( 2 ) e219-23 2012.2

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

PURPOSE: To reveal a predictive factor for biochemical recurrence (BCR) after permanent prostate brachytherapy (PPB) using iodine-125 seed implantation in patients with localized prostate cancer classified as low or intermediate risk based on National Comprehensive Cancer Network (NCCN) guidelines. METHODS AND MATERIALS: From January 2004 to December 2009, 414 consecutive Japanese patients with clinically localized prostate cancer classified as low or intermediate risk based on the NCCN guidelines were treated with PPB. The clinical factors including pathological data reviewed by a central pathologist and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with BCR. RESULTS: Median follow-up was 36.5 months. The 2-, 3-, 4-, and 5-year BCR-free rates using the Phoenix definition were 98.3%, 96.0%, 91.6%, and 87.0%, respectively. On univariate analysis, the Gleason score, especially primary Gleason grade 4 in biopsy specimens, was a strong predicting factor (p < 0.0001), while age, initial prostate-specific antigen (PSA) level, T stage, and minimal dose delivered to 90% of the prostate volume (D90) were insignificant. Multivariate analysis indicated that a primary Gleason grade 4 was the most powerful prognostic factor associated with BCR (hazard ratio = 6.576, 95% confidence interval, 2.597-16.468, p < 0.0001). CONCLUSIONS: A primary Gleason grade 4 carried a worse BCR prognosis than the primary grade 3 in patients treated with PPB. Therefore, the indication for PPB in patients with a Gleason sum of 4 + 3 deserves careful and thoughtful consideration.

DOI： 10.1016/j.ijrobp.2011.04.018

Caveolin-1 upregulation contributes to c-Myc-induced high-grade prostatic intraepithelial neoplasia and prostate cancer. International journal

Guang Yang, Alexei A Goltsov, Chengzhen Ren, Shinji Kurosaka, Kohei Edamura, Richard Logothetis, Francesco J DeMayo, Patricia Troncoso, Jorge Blando, John DiGiovanni, Timothy C Thompson

Molecular cancer research : MCR 10 ( 2 ) 218 - 29 2012.2

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

Previously we reported caveolin-1 (Cav-1) overexpression in prostate cancer cells and showed that it promotes prostate cancer progression. Here, we report that Cav-1 was overexpressed in 41.7% (15 of 36) of human high-grade prostatic intraepithelial neoplasia (HGPIN) specimens obtained during radical prostatectomies. Positive correlations exist between Cav-1-positive (Cav-1(+)) HGPIN and Cav-1(+) primary prostate cancer (rho = 0.655, P < 0.0001) and between Cav-1 and c-Myc expression in HGPIN (rho = 0.41, P = 0.032). To determine whether Cav-1 cooperates with c-Myc in development of premalignant lesions and prostate cancer in vivo, we generated transgenic mice with c-Myc overexpression driven by the ARR(2)PB promoter. In this ARR(2)PB-c-myc model, Cav-1 overexpression was found in mouse PIN (mPIN) lesions and prostate cancer cells and was associated with a significantly higher ratio of proliferative to apoptotic labeling in mPIN lesions than in the Cav-1-negative epithelia adjacent to those lesions (10.02 vs. 4.34; P = 0.007). Cav-1 overexpression was also associated with increased levels of P-Akt and VEGF-A, which were previously associated with Cav-1-induced prostate cancer cell survival and positive feedback regulation of cellular Cav-1 levels, respectively. In multiple prostate cancer cell lines, Cav-1 protein (but not mRNA) was induced by c-Myc transfection, whereas VEGF siRNA transfection abrogated c-Myc-induced Cav-1 overexpression, suggesting a c-Myc-VEGF-Cav-1 signaling axis. Overall, our results suggest that Cav-1 is associated with c-Myc in the development of HGPIN and prostate cancer. Furthermore, Cav-1 overexpression in HGPIN is potentially a biomarker for early identification of patients who tend to develop Cav-1(+) primary prostate cancer.

DOI： 10.1158/1541-7786.MCR-11-0451

Could a salvage lymphadenectomy after chemotherapy have clinical impact on cancer survival in patients with metastatic urothelial carcinoma? Reviewed

Takashi Saika, Kensuke Bekku, Ryo Kishimoto, Shin Ebara, Kohei Edamura, Kyohei Kurose, Yasutomo Nasu, Hiromi Kumon

JOURNAL OF CLINICAL ONCOLOGY 30 ( 5 ) 2012.2

Local and distant effects of caveolin-1 on prostate cancer progression

T. C. Thompson, S. A. Tahir, L. Li, M. Watanabe, K. Naruishi, G. Yang, Ken-ichi Tabata, S. Kurosaka, K. Edamura, R. Tanimoto, P. Corn, D. Kadmon, C. J. Logothetis, P. Troncoso, C. Ren, A. Goltsov, S. Park

Caveolins in Cancer Pathogenesis, Prevention and Therapy 1 - 15 2012.1

GLIPR1 tumor suppressor gene expressed by adenoviral vector as neoadjuvant intraprostatic injection for localized intermediate or high-risk prostate cancer preceding radical prostatectomy. International journal

Guru Sonpavde, Timothy C Thompson, Rajul K Jain, Gustavo E Ayala, Shinji Kurosaka, Kohei Edamura, Ken-ichi Tabata, Chengzhen Ren, Alexei A Goltsov, Martha P Mims, Teresa G Hayes, Michael M Ittmann, Thomas M Wheeler, Adrian Gee, Brian J Miles, Dov Kadmon

Clinical cancer research : an official journal of the American Association for Cancer Research 17 ( 22 ) 7174 - 82 2011.11

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

BACKGROUND: GLIPR1 is upregulated by p53 in prostate cancer cells and has preclinical antitumor activity. A phase I clinical trial was conducted to evaluate the safety and activity of the neoadjuvant intraprostatic injection of GLIPR1 expressing adenovirus for intermediate or high-risk localized prostate cancer before radical prostatectomy (RP). METHODS: Eligible men had localized prostate cancer (T1-T2c) with Gleason score greater than or equal to 7 or prostate-specific antigen 10 ng/mL or more and were candidates for RP. Patients received the adenoviral vector expressing the GLIPR1 gene by a single injection into the prostate followed four weeks later by RP. Six viral particle (vp) dose levels were evaluated: 10(10), 5 × 10(10), 10(11), 5 × 10(11), 10(12), and 5 × 10(12) vp. RESULTS: Nineteen patients with a median age of 64 years were recruited. Nine men had T1c, 4 had T2a, and 3 had T2b and T2c clinical stage. Toxicities included urinary tract infection (n = 3), flu-like syndrome (n = 3), fever (n = 1), dysuria (n = 1), and photophobia (n = 1). Laboratory toxicities were grade 1 elevated AST/ALT (n = 1) and elevations of PTT (n = 3, with 1 proven to be lupus anticoagulant). No pathologic complete remission was seen. Morphologic cytotoxic activity, induction of apoptosis, and nuclear p27(Kip1) upregulation were observed. Peripheral blood CD8(+), CD4(+), and CD3(+) T-lymphocytes were increased, with upregulation of their HLA-DR expression and elevations of serum IL-12. CONCLUSIONS: The intraprostatic administration of GLIPR1 tumor suppressor gene expressed by an adenoviral vector was safe in men, with localized intermediate or high-risk prostate cancer preceding RP. Preliminary evidence of biologic antitumor activity and systemic immune response was documented.

DOI： 10.1158/1078-0432.CCR-11-1899

Tumor growth and metastasis suppression by Glipr1 gene-modified macrophages in a metastatic prostate cancer model. International journal

K Tabata, S Kurosaka, M Watanabe, K Edamura, T Satoh, G Yang, E Abdelfattah, J Wang, A Goltsov, D Floryk, T C Thompson

Gene therapy 18 ( 10 ) 969 - 78 2011.10

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

We previously identified the mouse and human Glipr1 and GLIPR1/RTVP-1 genes, respectively, as direct p53 targets with proapoptotic activities in various cancer cell lines, including prostate cancer (PCa). Intratumoral injection of an adenoviral vector capable of efficient transduction and expression of Glipr1 (AdGlipr1) yielded promising therapeutic results in an orthotopic, metastatic mouse model of PCa. AdGlipr1-transduced macrophages (Mφ/Glipr1) generated greater surface expression of CD40, CD80 and major histocompatibility complex class II molecules and greater production of interleukin 12 (IL-12) and IL-6 in vitro than control macrophages did. Mechanistic analysis indicated that increased production of IL-12 in Mφ/Glipr1 depends on activation of the p38 signaling cascade. Mφ/Glipr1 injected into orthotopic 178-2BMA tumors in vivo resulted in significantly suppressed prostate tumor growth and spontaneous lung metastases and longer survival relative to those observed in control-treated mice. Furthermore, these preclinical data indicate the generation of systemic natural killer cell activity and tumor-specific cytotoxic T lymphocyte responses. Trafficking studies confirmed that intratumorally injected Mφ/Glipr1 could migrate to draining lymph nodes. Overall, our data suggest that this novel gene-modified cell approach is an effective treatment avenue that induces antitumor immune responses in preclinical studies.

DOI： 10.1038/gt.2011.51

PRIMARY GLEASON GRADE 4 IMPACTS ON BIOCHEMICAL RECURRENCE AFTER PERMANENT INTERSTITIAL BRACHYTHERAPY IN JAPANESE PATIENTS WITH LOW- OR INTERMEDIATE-RISK PROSTATE CANCER Reviewed

Takashi Saika, Tatsuya Uesugi, Kohei Edamura, Hiroyuki Nose, Makoto Kobuke, Shin Ebara, Norihisa Katayama, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

JOURNAL OF UROLOGY 185 ( 4 ) E523 - E523 2011.4

OP-302 開放的腎部分切除術55症例の臨床的検討(腎腫瘍/手術2,一般演題口演,第99回日本泌尿器科学会総会)

西村慎吾, 枝村康平, 黒瀬恭平, 江原伸, 三枝道尚

日本泌尿器科学会雑誌 102 ( 2 ) 391 - 391 2011

Expression pattern of REIC/Dkk-3 in various cell types and the implications of the soluble form in prostatic acinar development. International journal

Kai Zhang, Masami Watanabe, Yuji Kashiwakura, Shun-Ai Li, Kohei Edamura, Peng Huang, Ken Yamaguchi, Yasutomo Nasu, Yasuyuki Kobayashi, Masakiyo Sakaguchi, Kazuhiko Ochiai, Hiroshi Yamada, Kohji Takei, Hideo Ueki, Nam-Ho Huh, Ming Li, Haruki Kaku, Yanqun Na, Hiromi Kumon

International journal of oncology 37 ( 6 ) 1495 - 501 2010.12

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

The tumor suppressor REIC/Dkk-3 is a secretory protein which was originally identified to be downregulated in human immortalized cells. In the present study, we investigated the expression pattern of REIC/Dkk-3 in various cell types to characterize its physiological functions. We first examined the expression level of REIC/Dkk-3 in a broad range of cancer cell types and confirmed that it was significantly downregulated in all of the cell types. We also examined the tissue distribution pattern in a variety of normal mouse organs. Ubiquitous REIC/Dkk-3 protein expression was observed in the organs. The expression was abundant in the liver, heart and brain tissue, but was absent in the spleen and peripheral blood mononuclear cells. The immunohistochemical analyses revealed that the subcellular localization of REIC/Dkk-3 had a punctate pattern around the nucleus, indicating its association with secretory vesicles. In cancer cells stably transfected with REIC/Dkk-3, the protein was predominantly localized to the endoplasmic reticulum (ER) under observation with confocal microscopy. Because REIC/Dkk-3 was found to be abundantly expressed in the acinar epithelial cells of the mouse prostate, we analyzed the effects of recombinant REIC/Dkk-3 protein on the acinar morphogenesis of RWPE-1 cells, which are derived from human normal prostate epithelium. Statistically significant acinar growth was observed in the culture condition with 10 µg/ml REIC/Dkk-3 protein, implicating the soluble form in prostatic acinar development. Current results suggest that REIC/Dkk-3 may play a role in regulating the morphological process of normal tissue architecture through an autocrine and/or paracrine manner.

A PHASE I/II STUDY OF ADENOVIRUS-MEDIATED INTERLEUKIN-12 GENE THERAPY FOR HORMONE REFRACTORY PROSTATE CANCER; A REPORT OF INITIAL 6 CASES Reviewed

Katsumi Sasaki, Yasutomo Nasu, Haruki Kaku, Masami Watanabe, Kohei Edamura, Takashi Saika, Hiromi Kumon, Malcolm K. Brenner

JOURNAL OF GENE MEDICINE 12 ( 12 ) 1025 - 1025 2010.12

岡山大学における低、中リスク限局性前立腺癌に対するI-125永久密封小線源療法の成績

岸本涼, 枝村康平, 能勢宏幸, 上杉達也, 小武家誠, 小林泰之, 賀来春紀, 雑賀隆史, 那須保友, 公文裕巳

日本癌治療学会誌 45 ( 2 ) 677 - 677 2010.9

進行尿路上皮癌に対する化学療法奏功例におけるSalvage Surgeryの臨床的意義

雑賀隆史, 別宮謙介, 岸本涼, 枝村康平, 小林泰之, 賀来春紀, 那須保友, 公文裕巳

日本癌治療学会誌 45 ( 2 ) 1045 - 1045 2010.9

岡山大学において過去16年間に経験した前立腺癌1384症例の臨床的検討

枝村康平, 雑賀隆史, 小林泰之, 賀来春紀, 那須保友, 公文裕巳

西日本泌尿器科 72 ( 9 ) 546 - 546 2010.9

早期前立腺がんの治療戦略前立腺癌に対する根治療法前立腺全摘除術or密封小線源療法単一施設における検討

枝村康平, 雑賀隆史, 上杉達也, 能勢宏幸, 小林泰之, 真鍋大輔, 小武家誠, 江原伸, 那須保友, 公文裕巳

日本癌治療学会誌 45 ( 2 ) 492 - 492 2010.9

進行胚細胞癌に対する後腹膜リンパ節郭清術の検討腫瘍学的、射精機能温存のアウトカム

雑賀隆史, 枝村康平, 高尾彰, 小林泰之, 上杉達也, 那須保友, 公文裕巳, 小武家誠, 時永賢治, 橋本英昭

西日本泌尿器科 72 ( 4 ) 211 - 211 2010.4

陰茎原発epithelioid sarcomaに対し陰茎全摘除術後に尿道陰茎再建術行った1例

西村慎吾, 枝村康平, 小林泰之, アバラズア・フェルナンド, 石井和史, 雑賀隆史, 那須保友, 公文裕巳

西日本泌尿器科 71 ( 増刊 ) 132 - 132 2009.10

Functional analysis of secreted caveolin-1 in mouse models of prostate cancer progression. International journal

Masami Watanabe, Guang Yang, Guangwen Cao, Salahaldin A Tahir, Koji Naruishi, Ken-Ichi Tabata, Elmoataz Abdel Fattah, Kartik Rajagopalan, Terry L Timme, Sanghee Park, Shinji Kurosaka, Kohei Edamura, Ryuta Tanimoto, Francesco J Demayo, Alexei A Goltsov, Timothy C Thompson

Molecular cancer research : MCR 7 ( 9 ) 1446 - 55 2009.9

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

Previously, we reported that caveolin-1 (cav-1) is overexpressed in metastatic prostate cancer and that virulent prostate cancer cells secrete biologically active cav-1. We also showed that cav-1 expression leads to prosurvival activities through maintenance of activated Akt and that cav-1 is taken up by other cav-1-negative tumor cells and/or endothelial cells, leading to stimulation of angiogenic activities through PI-3-K-Akt-eNOS signaling. To analyze the functional consequences of cav-1 overexpression on the development and progression of prostate cancer in vivo, we generated PBcav-1 transgenic mice. Adult male PBcav-1 mice showed significantly increased prostatic wet weight and higher incidence of epithelial hyperplasia compared with nontransgenic littermates. Increased immunostaining for cav-1, proliferative cell nuclear antigen, P-Akt, and reduced nuclear p27(Kip1) staining occurred in PBcav-1 hyperplastic prostatic lesions. PBcav-1 mice showed increased resistance to castration-induced prostatic regression and elevated serum cav-1 levels compared with nontransgenic littermates. Intraprostatic injection of androgen-sensitive, cav-1-secreting RM-9 mouse prostate cancer cells resulted in tumors that were larger in PBcav-1 mice than in nontransgenic littermates (P = 0.04). Tail vein inoculation of RM-9 cells produced significantly more experimental lung metastases in PBcav-1 males than in nontransgenic male littermates (P = 0.001), and in cav-1(+/+) mice than in cav-1(-/-) mice (P = 0.041). Combination treatment with surgical castration and systemic cav-1 antibody dramatically reduced the number of experimental metastases. These experimental data suggest a causal association of secreted cav-1 and prostate cancer growth and progression.

DOI： 10.1158/1541-7786.MCR-09-0071

進行性尿路上皮癌に対するGCP療法の検討

枝村康平, 雑賀隆史, 谷本竜太, 高尾彰, 小林泰之, 上杉達也, 賀来春紀, 那須保友, 公文裕巳

日本癌治療学会誌 44 ( 2 ) 593 - 593 2009.9

上部尿路疾患に対する腎盂尿管鏡の有用性に関する検討

高尾彰, 雑賀隆史, 枝村康平, 小林泰之, 小武家誠, 上杉達也, 上原慎也, 賀来春紀, 門田晃一, 那須保友, 公文裕巳

日本癌治療学会誌 44 ( 2 ) 763 - 763 2009.9

進行性尿路上皮癌に対するGemcitabine(GEM)、Cisplatin(CDDP)、Paclitaxel(PAC)-GCP療法-の検討

枝村康平, 雑賀隆史, 和田耕一郎, 谷本竜太, 高尾彰, 小林泰之, 小武家誠, 上杉達也, 賀来春紀, 那須保友, 公文裕巳

西日本泌尿器科 71 ( 8 ) 435 - 435 2009.8

Therapeutic effects of gelatin matrix-embedded IL-12 gene-modified macrophages in a mouse model of residual prostate cancer. International journal

K Tabata, M Watanabe, K Naruishi, K Edamura, T Satoh, G Yang, E Abdel Fattah, J Wang, A Goltsov, D Floryk, S D Soni, D Kadmon, T C Thompson

Prostate cancer and prostatic diseases 12 ( 3 ) 301 - 9 2009

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

We evaluated the potential use of intraoperative gelatin matrix hemostatic sealant (GMHS; FloSeal; Baxter Healthcare) embedded with macrophages (Mphi) transduced with murine interleukin (IL)-12 recombinant adenoviral vector (G/Mphi/AdmIL-12) for prevention of recurrence of prostate cancer following radical prostatectomy. Application of G/Mphi/AdmIL-12 resulted in significant suppression of tumor growth and spontaneous lung metastases, a statistically significant survival advantage of the G/Mphi/AdmIL-12-treated animals, more efficient trafficking of Mphi to lymph nodes draining from the prostate and generation of systemic natural killer cell activity and tumor-specific cytolytic T lymphocyte responses compared to the controls in a preclinical mouse model of residual prostate cancer. Our data recommend this treatment as a novel adjuvant for prevention of local recurrence of prostate cancer following radical prostatectomy.

DOI： 10.1038/pcan.2008.57

JUP1-2 腎癌に対するCTガイド下経皮的ラジオ波焼灼療法(JUAアップデートセッションパネルディスカッション1「エンドユロロジー・腹腔鏡領域」,第97回日本泌尿器科学会総会)

小林泰之, 郷原英夫, 枝村康平, 小武家誠, 上杉達也, 雑賀隆史, 那須保友, 金澤右, 公文裕巳

日本泌尿器科学会雑誌 100 ( 2 ) 77 - 77 2009

PP-286 前立腺癌永久密封小線源治療に合併する排尿障害に対するα1受容体遮断薬の改善効果に関する検討(Neurourology/臨床3,一般演題ポスター,第97回日本泌尿器科学会総会)

上松克利, 佐々木克己, 渡辺豊彦, 上原慎也, 小武家誠, 上杉達也, 枝村康平, 川口正志, 雑賀隆史, 那須保友, 公文裕己

日本泌尿器科学会雑誌 100 ( 2 ) 388 - 388 2009

難治性尿路上皮癌および精巣腫瘍に対する化学療法難治性精巣腫瘍にたいする3rd line化学療法としてのGemcitabine(GEM)、Cisplatinum(CDDP)、Paclitaxel(PTX)併用療法の経験

雑賀隆史, 小武家誠, 上杉達也, 小林泰之, 谷本竜太, 枝村康平, 賀来春紀, 那須保友, 公文裕巳

西日本泌尿器科 70 ( 増刊 ) 112 - 112 2008.10

切除不能・再発尿路上皮癌に対するGemcitabine(GEM)、Cisplatin(CDDP)、Paclitaxel(PAC)-GCP療法-の検討

谷本竜太, 枝村康平, 雑賀隆史, 和田耕一郎, 小林泰之, 小武家誠, 大和豊子, 賀来春紀, 那須保友, 公文裕巳

日本癌治療学会誌 43 ( 2 ) 486 - 486 2008.10

再燃進行前立腺がんの治療の現状と展望再燃前立腺がんに対する遺伝子治療の現況と展望 Reviewed

那須保友, 賀来春紀, 渡部昌実, 枝村康平, 谷本竜太, Abaruz Fernando, 黄鵬, 佐々木克己, 雑賀隆史, 公文裕巳

泌尿器外科 21 ( 8 ) 1049 - 1051 2008.8

Language：Japanese Publisher：医学図書出版(株)

再燃前立腺がんに対する新たな治療法として遺伝子治療の基礎研究は分子生物学の進歩に伴いその成果を挙げてきた。さらにこれらの基礎研究の成果を臨床に還元するための研究(トランスレーショナルリサーチ)としてわれわれは遺伝子治療臨床研究を実施してきた。われわれが実施してきた自殺遺伝子としてのHSV-tk遺伝子、Interleukin-12遺伝子、腫瘍融解アデノウイルス、新規がん抑制遺伝子REICを用いた遺伝子治療研究の成果を概説することで再燃前立腺がんに対する遺伝子治療の現況とその展望を述べた。(著者抄録)

Iodine-125 seed implantation (permanent brachytherapy) for clinically localized prostate cancer.

Shin Ebara, Norihisa Katayama, Ryuta Tanimoto, Kohei Edamura, Hiroyuki Nose, Daisuke Manabe, Tomoko Kobayashi, Yasuyuki Kobayashi, Makoto Kobuke, Mitsuhiro Takemoto, Takashi Saika, Yasutomo Nasu, Susumu Kanazawa, Hiromi Kumon

Acta medica Okayama 62 ( 1 ) 9 - 13 2008.2

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

From January 2004 to March 2007, 308 patients with clinically localized prostate cancer were treated using iodine-125 (125I) seed implantation (permanent brachytherapy) at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. We evaluated the treatments efficacy and morbidity in 300 prostate cancer patients who were followed up for more than 1 month after brachytherapy. Based on the National Comprehensive Cancer Network (NCCN) guidelines, patients with a prostate volume of less than 40 ml in transrectal ultrasound imaging were classified as low or intermediate risk. The median patient age was 67 years (range 50 to 79 years), the median prostate-specific antigen (PSA) value before biopsy was 6.95 ng/ml (range 1.13 to 24.7 ng/ml), and the median prostate volume was 24.33 ml (range 9.3 to 41.76 ml). The median follow-up was 18 months (range 1 to 36 months) and the PSA levels decreased in almost all patients after brachytherapy. Although 194 of 300 patients (64.7%) complained of difficulty in urination, pollakisuria/urgency, miction pain, and/or urinary incontinence, all of which might be associated with radiation prostatitis during the first month after brachytherapy, these symptoms gradually improved. 125I seed implantation brachytherapy is safe and effective for localized prostate cancer within short-term follow up.

Adenovirus-mediated REIC/Dkk-3 gene transfer inhibits tumor growth and metastasis in an orthotopic prostate cancer model. International journal

K Edamura, Y Nasu, M Takaishi, T Kobayashi, F Abarzua, M Sakaguchi, Y Kashiwakura, S Ebara, T Saika, M Watanabe, N-H Huh, H Kumon

Cancer gene therapy 14 ( 9 ) 765 - 72 2007.9

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

We had previously reported that REIC/Dkk-3, a member of the Dickkopf (Dkk) gene family, works as a tumor suppressor. In this study, we evaluated the therapeutic effects of an intratumoral injection with adenoviral vector encoding REIC/Dkk-3 gene (Ad-REIC) using an orthotopic mouse prostate cancer model of RM-9 cells. We also investigated the in vivo anti-metastatic effect and in vitro anti-invasion effect of Ad-REIC gene delivery. We demonstrated that the Ad-REIC treatment inhibited prostate cancer growth and lymph node metastasis, and prolonged mice survival in the model. These therapeutic responses were consistent with the intratumoral apoptosis induction and in vitro suppression of cell invasion/migration with reduced matrix metalloprotease-2 activity. We thus concluded that in situ Ad-REIC/Dkk-3 gene transfer may be a promising therapeutic intervention modality for the treatment of prostate cancer.

Heat shock proteins play a crucial role in tumor-specific apoptosis by REIC/Dkk-3. International journal

Fernando Abarzua, Masakiyo Sakaguchi, Ryuta Tanimoto, Hiroyuki Sonegawa, Dai-Wei Li, Kohei Edamura, Tomoko Kobayashi, Masami Watanabe, Yuji Kashiwakura, Haruki Kaku, Takashi Saika, Keiichiro Nakamura, Yasutomo Nasu, Hiromi Kumon, Nam-Ho Huh

International journal of molecular medicine 20 ( 1 ) 37 - 43 2007.7

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

We recently showed that overexpression of REIC/Dickkopf-3 (Dkk-3), a tumor suppressor gene, induced apoptosis in a tumor cell-specific manner. The aim of the present study was to determine the mechanisms underlying the selective induction of apoptosis. At first, we found a mouse renal carcinoma cell line, RENCA, to be extremely sensitive to an adenovirus carrying REIC/Dkk-3 (Ad-REIC), and we showed that activation of c-Jun N-terminal kinase (JNK) was a critical step in cell death, i.e. a process similar to that in human prostate and testicular cancer observed in our previous studies. Among the proteins interfering with the activation of JNK, heat shock protein (Hsp)70/72 was reduced in expression in RENCA cells compared with that in NIH3T3 cells. An Hsp70/72 inducer protected RENCA cells from Ad-REIC-induced apoptosis, while an Hsp70/72 inhibitor sensitized NIH3T3 cells for apoptosis induction. These results indicate that functionally active Hsp70/72 is a key factor in tumor cell-specific induction of apoptotic cell death and that analyses of the expression levels of Hsp70/72 may be essential in determining the significance of Ad-REIC-based gene therapy against human cancer.

Adenovirus-mediated REIC/Dkk-3 gene transfer inhibits tumor growth and metastasis in an orthotopic prostate cancer model

K Edamura , Y Nasu , M Takaishi , T Kobayashi , F Abarzua , M Sakaguchi , Y Kashiwakura , S Ebara , T Saika , M Watanabe , N-H Huh , H Kumon

Cancer Gene Therapy 14 765 - 772 2007

S11-6 密封小線源療法を施行された前立腺癌患者のQOLに関する研究 : 恥骨後式根治的前立腺摘除術とのProspectiveな比較において(シンポジウム11「限局性前立腺癌の治療成績とQOL」,第94回日本泌尿器科学会総会)

雑賀隆史, 江原伸, 真鍋大輔, 能勢宏幸, 枝村康平, 谷本竜太, 小林知子, 津島知靖, 那須保友, 中西代志子, 公文裕巳

日本泌尿器科学会雑誌 97 ( 2 ) 165 - 165 2006

MP-453 1251シード線源による前立腺癌永久挿入密封小線源治療(一般演題ポスター,第94回日本泌尿器科学会総会)

江原伸, 真鍋大輔, 枝村康平, 谷本竜太, 小林知子, 雑賀隆史, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 97 ( 2 ) 480 - 480 2006

OP-119 進行性尿路上皮癌に対するGemcitabine (GEM)、Cisplatin (CDDP)、Paclitaxel (PAC) -GCP療法-の検討(一般演題口演,第94回日本泌尿器科学会総会)

谷本竜太, 眞鍋大輔, 和田耕一郎, 枝村康平, 小林知子, 賀来春紀, 江原伸, 大和豊子, 雑賀隆史, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 97 ( 2 ) 310 - 310 2006

Long-term clinical outcomes of 420 consecutive prostate cancer patients in a single institute.

Kohei Edamura, Takashi Saika, Takashi Senoh, Fumihito Koizumi, Daisuke Manabe, Shin Ebara, Haruki Kaku, Teruhiko Yokoyama, Fernando Abarzua, Atsushi Nagai, Yasutomo Nasu, Tomoyasu Tsushima, Hiromi Kumon

Acta medica Okayama 59 ( 5 ) 195 - 9 2005.10

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

This study was undertaken to reveal the trends of prostate cancer and the outcome of treatment modalities for each disease stage in patients in a single institute over a 10-year period. From January 1994 through December 2003, 420 consecutive patients with previously untreated and histologically confirmed prostate cancer were analyzed for annual distributions of disease stages and treatment modalities and for long-term clinical progression-free survival, prostate cancer-specific survival, and prostate-specific antigen (PSA) failure-free survival rates for each stage and treatment modality. Annual trends showed that the number of patients, especially those with clinically localized cancer, increased dramatically. The 5-year disease-specific survival rates for patients with clinically localized disease were 100 percent for all treatment modalities, including hormonal therapy alone. Patients with PSA levels less than 10 ng/ml showed an 81 percent 5-year PSA failure-free survival rate with radical prostatectomy. Stage C patients treated by surgery or radiation-based therapy with concomitant hormonal therapy obtained 93 percent and 100 percent cause-specific survival rates, respectively, and those treated by hormonal therapy alone showed a 79 percent rate. The number of patients with localized prostate cancer was increasing in this decade. While long-term hormonal therapy alone was highly efficient in controlling localized prostate cancer, radical therapies in conjunction with neo-adjuvant hormonal therapy produced better survival rates in cases of locally advanced disease.

^<125>Iシード線源による前立腺癌永久刺入密封小線源治療(第93回日本泌尿器科学会総会)

江原伸, 真鍋大輔, 能勢宏幸, 枝村康平, 雑賀隆史, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 96 ( 2 ) 426 - 426 2005

精巣腫瘍に対する後腹膜リンパ節郭清術の検討(第93回日本泌尿器科学会総会)

津島知靖, 雑賀隆史, 枝村康平, 村上貴典, 小泉文人, 小林知子, 真鍋大輔, 江原伸, 賀来春紀, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 96 ( 2 ) 270 - 270 2005

PP3-132 経会陰的および経直腸的前立腺12ヶ所生検の有用性 : 再生検施行症例の検討(一般演題(ポスター))

秋山博伸, 林俊秀, 枝村康平, 渡部昌実, 牧佳男, 入江伸, 金重哲三

日本泌尿器科学会雑誌 95 ( 2 ) 506 - 506 2004

経会陰的および経直腸的前立腺12ヵ所生検の有用性 : 前立腺全摘標本での癌mappingをふまえて

渡部昌実, 林俊秀, 枝村康平, 森末浩一, 入江伸, 金重哲三

日本泌尿器科学会雑誌 94 ( 2 ) 145 - 145 2003

前立腺全摘術後のPSA failureの定義とその妥当性について-超高感度測定法にて3ポイント連続上昇と定義した場合

妹尾孝司, 雑賀隆史, 那須保友, 津島知靖, 公文裕巳, 三宅知子, 宮地禎幸, 石戸則孝, 高本均, 小林泰之, 武田克治, 枝村康平, 林俊秀

西日本泌尿器科 64 ( 増刊 ) 179 - 179 2002.11

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