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Hisaki H, Okazaki T, Kubota M, Nakane M, Fujimaki T, Nakayama H, Nakagomi T, Tamura A, Masuda H. L-PDMP improves glucosylceramide synthesis and behavior in rats with focal ischemia. Neurol Res 2013; 30:979-84. [DOI: 10.1179/016164108x339396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kokubo K, Masuda H, Ikuma N, Mikie T, Oshima T. Synthesis and characterization of new acetalized [60]fullerenes. Tetrahedron Lett 2013. [DOI: 10.1016/j.tetlet.2013.04.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kitaoka Y, Mukai K, Aida H, Hiraga A, Masuda H, Takemasa T, Hatta H. Effects of high-intensity training on lipid metabolism in Thoroughbreds. Am J Vet Res 2013; 73:1813-8. [PMID: 23106469 DOI: 10.2460/ajvr.73.11.1813] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of high-intensity training (HIT) on carbohydrate and fat metabolism in Thoroughbreds. ANIMALS 12 Thoroughbreds (3 to 4 years old; 6 males and 6 females). PROCEDURES Horses performed HIT for 18 weeks. They ran at 90% or 110% of maximal oxygen consumption ((V)O(2max)) for 3 minutes (5 d/wk) and were subjected to incremental exercise testing (IET) before and after training. Blood samples were collected during IET, and muscle samples were obtained from the gluteus medius muscle immediately after IET. Phosphofructokinase, citrate synthase, and β-3-hydroxyacyl CoA dehydrogenase (β-HAD) activities were measured to determine glycolytic and oxidative capacities. Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) and fatty acid translocase (FAT/CD36) protein contents were detected via western blotting. Metabolome analysis was performed via capillary electrophoresis-electrospray ionization mass spectrometry to measure substrate concentrations related to carbohydrate metabolism. RESULTS Peak speed during IET and (V)O(2max) increased after HIT. Activities of citrate synthase and β-HAD increased after HIT, whereas phosphofructokinase activity remained unchanged. The PGC-1α and FAT/CD36 protein contents increased after HIT, but plasma lactate concentration and the respiratory exchange ratio decreased after HIT. The plasma free fatty acid concentration increased after HIT, whereas the glucose concentration was not altered. Fructose 1,6-diphosphate, phosphoenolpyruvate, and pyruvate concentrations decreased after HIT. CONCLUSIONS AND CLINICAL RELEVANCE HIT caused an increase in oxidative capacity in equine muscle, which suggested that there was a decreased reliance on carbohydrate utilization and a concomitant shift toward fatty acid utilization during intensive exercise.
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Schuring A, Kiesel L, Gotte M, Cao MZ, Chan RWS, Yeung WSB, Yamagata Y, Asada H, Tamura H, Sugino N, Jin X, Jiang Y, Shen X, Liu H, Zhu L, Shan H, Hu Y, Sun H, Yan G, Tapia-Pizarro A, Archiles S, Argandona F, Devoto L, Miyazaki K, Maruyama T, Masuda H, Oda H, Hida N, Uchida H, Yoshimura Y, Jiang Y, Shen X, Liu H, Zhen X, Sun H, Hu Y, Yan G. Session 59: Endometrium. Hum Reprod 2013. [DOI: 10.1093/humrep/det192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fukushima H, Masuda H, Yokoyama M, Tatokoro M, Yoshida S, Ishioka J, Matsuoka Y, Numao N, Koga F, Saito K, Fujii Y, Kihara K. Diabetes Mellitus with Obesity is a Predictor of Recurrence in Patients with Non-metastatic Renal Cell Carcinoma. Jpn J Clin Oncol 2013; 43:740-6. [DOI: 10.1093/jjco/hyt070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Matsunaga Y, Tamura Y, Masuda H, Takahashi Y, Hoshino D, Hatta H. Casein peptide supplementation enhances training effects on mitochondrial biogenesis of skeletal muscle in mice. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.713.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tamura Y, Matsunaga Y, Masuda H, Takahashi Y, Takahashi Y, Takashima S, Minagawa H, Hoshino D, Hatta H. Whole‐body heat stress increases mitochondrial enzyme activity in mice skeletal muscle. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1202.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hoshino D, Kitaoka Y, Setogawa S, Masuda H, Tamura Y, Yanagihara D, Hatta H. Acute exercise increases monocarboxylate transporter 2 expression in mouse cerebellum. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.710.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kihara K, Takeshita H, Masuda H, Koga F, Saito K, Matsuoka Y, Numao N, Fujii Y. 950 Novel three-dimensional head-mounted display system (RoboSurgeon System) – application to the initial 60 cases of gasless single-port access urologic surgeries. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/s1569-9056(13)61429-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kihara K, Fujii Y, Masuda H, Saito K, Koga F, Numao N, Matsuoka Y. V61 New 3-dimensional head-mounted display system (RoboSurgeon system) applied to gasless, single-port access adrenalectomy. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/s1569-9056(13)61644-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brewer TM, Masuda H, Iwamoto T, Liu P, Shen Y, Liu DD, Kai K, Barnett CM, Woodward WA, Reuben JM, Yang P, Hortobagyi GN, Ueno NT. Abstract PD03-08: Statin use and improved outcome in primary inflammatory breast cancer: retrospective cohort study. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-pd03-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer. HMG-CoA reductase inhibitors (statins) are cholesterol reducing agents with pleiotropic effects, including antitumorigenic and anti-inflammatory properties. We hypothesized that statins reduce the metastatic potential in primary IBC.
Methods We retrospectively reviewed 724 patients diagnosed with and treated for primary IBC at The University of Texas MD Anderson Cancer Center between Jan. 12, 1995 and Jan. 27, 2011. Patients with records indicating statin use at the time of IBC diagnosis on the electronic medical record were compared with those without. We further compared outcomes stratified by statin type (hydrophilic [H] versus lipophilic [L]). We used the Kaplan-Meier method to estimate the median disease-free survival (DFS) after surgery, overall survival (OS), and disease specific survival (DSS), followed by Cox proportional hazards regression model to test statistical significance of several potential prognostic factors.
Results For primary IBC patients who had information on their statin use status at IBC diagnosis, the median DFS time were 4.88 years, 2.47 years and 1.76 years (P= 0.04); the median OS time 5.05 years, 3.79 years and 4.32 years (P= 0.35); and the median DSS time 5.10 years, 3.79 years and 4.52 years (P= 0.37), for patients who took “ H”, “L” and no statin, respectively. In multivariable Cox model stratified by radiation therapy, ER/PR status and HER2 status, statin “H” use was associated with significantly improved DFS compared to no statin use (HR=0.49; 95% CI: 0.28–0.84; p<0.01), adjusted for lymphatic/vascular invasion. Although there is a trend that patients who used statin “H” had a longer time to death compared to patients who did not take statin, it did not reach statistical significance for OS (HR=0.80; 95% CI: 0.43–1.49; p=0.49) and DSS (HR=0.85; 95% CI: 0.46–1.57, p=0.59) after adjustment for lymphatic/vascular invasion, nuclear grade and surgery status within one year.
Conclusions Hydrophilic statin use was associated with improved DFS. There was a trend for reduced HR in OS and DSS among primary IBC patient who used hydrophilic statins. A prospective randomized study to evaluate the potential survival benefits of statins in primary IBC population is warranted.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PD03-08.
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Masuda H, Iwamoto T, Brewer T, Hsu L, Kai K, Woodward WA, Reuben JM, Valero V, Alvarez RH, Willey J, Hortobagyi GN, Ueno NT. Abstract P3-10-05: Response to neoadjuvant systemic therapy (NST) in inflammatory breast cancer (IBC) according to estrogen receptor (ER) and HER2 expression. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-10-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inflammatory breast cancer (IBC) is the most aggressive form breast cancer. NST, followed by local therapy (surgery and radiation therapy), is considered the current standard therapy for IBC. Among noninflammatory breast cancers, sensitivity to NST differs based on ER and HER2 status. However, whether the sensitivity to NST also differs in primary IBC based on ER status or other prognostic factors has not been studied in a large cohort.
Methods: We retrospectively reviewed 1078 patients (pts) newly diagnosed with IBC from April 1989 to January 2011. Of these, 838 pts met our inclusion criterion of stage III disease at diagnosis, and 713 of these pts had received NST and surgery. Among this population, 545 pts had information available on both ER and HER2 status. We compared pathological complete response (pCR) rates (defined as no evidence of invasive disease in the breast and ipsilateral axillary limph nodes) and clinical characteristics between ER and HER2-status subgroups and analyzed their clinical outcome. We used the Kaplan-Meier method to estimate the median recurrence-free survival (RFS) after surgery and overall survival (OS), and the Cox proportional hazards regression model to test the statistical significance of potential prognostic factors in each group.
Results: Overall 177 pts had ER+HER2− tumors; 75, ER+HER2+; 134, ER-HER2+; and 159, ER-HER2−. NST consisted of anthracycline-based [A] alone, a taxane [T] alone or with A+T; HER2 targeting therapies (H) were administered to 117 patients with HER2-positive breast cancer after 1998. Overall pCR rate was 14.7%. pCR rates are shown by marker subtype and NST received in the table below. pCR rate, nuclear grade, vascular invasion, clinical response to NST, adjuvant treatment, radiation therapy, and adjuvant hormonal therapy differed significantly among subgroups.
The median RFS and OS for all patients was 19.2 and 33.2 months, respectively. In multivariate analysis, BMI, ER status, lymphatic invasion, radiation therapy, and pCR rate were associated with RFS, and ER status, vascular invasion, radiation therapy, and pCR rate were associated with OS. Except in the ER+HER2− group, pCR was associated with better prognosis compared to non-pCR. Adjuvant hormonal therapy improved RFS both in ER+HER2+ and ER+HER2− groups, but did not improve OS in the ER+HER2+ group. Among 209 patients with HER2+ IBC, 134 received HER2 targeting therapies in neoadjuvant or adjuvant chemotherapy, and had a trend to improvement in RFS compared to chemotherapy alone (p = 0.082). The ER-HER2− group showed poorest outcome compared to other subgroups (P < 0.001).
Conclusions: Sensitivity to NST differs depending on the ER and HER2 status in IBC pts. pCR rates based on these subgroups appear to be low. There is a need more effective treatments in the neoadjuvant and adjuvant therapies for all subgroups of IBC.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-10-05.
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Reyes ME, Masuda H, Zhang D, Reuben JM, Woodward W, Darnay BG, Hortobagyi GN, Ueno NT. Abstract P5-03-09: Receptor Activator of Nuclear Factor Kappa B (RANK) as a potential therapeutic target in triple-negative breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p5-03-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple-negative breast cancer (TNBC) has a poorer prognosis in comparison to other breast cancer subtypes because of its high metastatic rate. There is evidence that cancer stem cells (CSCs), known to have an epithelial-to-mesenchymal (EMT) phenotype, may contribute to the metastasis of breast cancer. Denosumab (an anti-RANK ligand antibody) is currently being explored as a treatment for breast cancer in phase II and III clinical trials. RANK is thought to regulate mammary stem cells. Therefore, we hypothesized that RANK promotes tumorigenicity and metastasis of TNBC via the regulation of EMT and enrichment of CSCs. We sought to determine the effects of RANK expression on the tumorigenic and metastatic activities of TNBC cells and whether RANK is a potential therapeutic target in TNBC.
Methods: Primary breast tumor specimens from the MD Anderson Cancer Center Tumor Bank were stratified by ER/HER2 status. We analyzed RANK mRNA expression levels, obtained by Affymetrix gene chip array, in ER+/HER2-negative breast tumors (n = 22) and ER−/HER2-negative breast tumors including TNBC tumors (n = 18). To study the effects of RANK suppression in TNBC cells, we generated two stable RANK shRNA MDA-MB-231 TNBC cell lines and a negative shRNA cell line as a control and examined whether knockdown of RANK expression correlated with a decrease in mesenchymal markers, vimentin and snail, and stem cell marker, ALDH1, invasion, migration, and tumorigenicity in TNBC cells.
Results: An analysis of RANK mRNA expression levels among human primary breast cancer specimens revealed increased RANK expression in ER−/HER2-negative primary breast tumors including TNBC tumors, compared with ER+/HER2-negative primary breast tumors (p = 0.034). Knocking down RANK in MDA-MB-231 cells significantly inhibited migration (p = 0.0005) and invasion (p = 0.0006) and reduced the stem cell subpopulation, as shown by a decrease in mammospheres (p = 0.0188) and ALDH1 activity. Further, in a three-dimensional (3D) cell culture model, we observed significant inhibition of projections in MDA-MB-231 cells with knockdown of RANK (p < 0.05), which correlated with downregulation of the mesenchymal markers vimentin and snail shown by qRT PCR analysis.
Conclusion: Our data demonstrate that RANK may promote the tumorigenesis of TNBC by enriching cancer stem cells. In future studies, we will investigate the effect of RANK inhibition on metastasis in vivo using a TNBC xenograft model. Our long-term goal is to develop RANK-targeted therapy for TNBC.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-03-09.
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Kaji M, Gotoh M, Takagi Y, Masuda H. Blood lead levels in Japanese children: Effects of passive smoking. Environ Health Prev Med 2012; 2:79-81. [PMID: 21432457 DOI: 10.1007/bf02931969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/1996] [Accepted: 03/27/1997] [Indexed: 11/27/2022] Open
Abstract
Blood lead levels (BLLs) of 188 pediatric patients were measured and their parents were queried as to the smoking style in their home. Their mean BLL was 3.16 μg/dl, which was among the lowest levels in the world, and none of them had levels of over 10 μ g/dl. Preschool children ( 1 to 6 years of age) with parents who smoked in the same room had a significantly higher BLL (mean; 4.15 μ g/dl) than those with parents who never smoked (mean; 3.06 μ g/dl) (P<0.01). However, the mean BLL of school children (6 to 15 years of age) with parents who smoked in the same room was not significantly different from that of school children with parents who never smoked. Passive smoking caused an increase of the BLL only in preschool children in Japan. This is probably because preschool infants spend much more time with their parents and have much more contact with passive smoking than school children and, additionally young infants have a limited ability to excrete lead from the body.
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Honda M, Yokota K, Ichibayashi R, Yoshihara K, Masuda H, Uekusa H, Seiki Y, Nomoto J, Nagao T, Kishi T, Sase S. The study of systemic general circulation disturbance during the initiation of therapeutic hypothermia: Pit fall of hypothermia. Asian J Neurosurg 2012; 7:61-5. [PMID: 22870153 PMCID: PMC3410162 DOI: 10.4103/1793-5482.98645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aims: Neurointensive care has reduced the mortality and improved the outcome of patients for severe brain damage, over recent decades, and made it possible to perform this therapy in safety. However, we have to understand the complications of this therapy well. The purpose of our study was to determine the systemic circulation disturbance during the initiation of therapeutic hypothermia by using this continuous neurointensive monitoring system. Materials and Methods: Ten severe brain damage patients treated with hypothermia were enrolled. All patients had Glasgow Coma Scale (GCS) less than or equal to 8, on admission. Results: We verified that heart rate, cardiac output, and oxygen delivery index (DO2I) decreased with decreasing core temperature. We recognized that depressed cardiac index (CI) was attributed to bradycardia, dehydration, and increased systemic vascular resistance index (SVRI) upon initiation of hypothermia. Conclusion: Although the hypothermia has a therapeutic role in severe brain damage patients, we have to carry out this therapy while maintaining their cardiac output using multimodality monitoring devices during hypothermia period.
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Masuda H, McClay K, Steffan RJ, Zylstra GJ. Characterization of three propane-inducible oxygenases in Mycobacterium sp. strain ENV421. Lett Appl Microbiol 2012; 55:175-81. [PMID: 22803623 DOI: 10.1111/j.1472-765x.2012.03290.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS Mycobacterium sp. strain ENV421 has the ability to cometabolize a variety of chemicals following growth on propane as a sole source of carbon and energy. In this study, we used genetic and biochemical approaches to identify and characterize multiple propane-inducible oxygenase genes in ENV421. METHODS AND RESULTS Gene clusters encoding a CYP153-type cytochrome P450 oxygenase (P450), an AlkB-type alkane monooxygenase (AlkB) and a soluble diiron monooxygenase were identified and cloned using degenerate PCR primers. Reverse transcriptase PCR showed that all three gene clusters were induced by propane. Substrate specificity studies revealed that despite the fact that ENV421 does not grow on medium length alkanes, cloned versions of both the AlkB and P450 were capable of octane oxidation, forming n-octanol. Additionally, the P450 oxygenase had the ability to oxidize indole, medium-to-long-chain alkylbenzenes and a variety of para-substituted methylalkylbenzenes. Successful cloning and expression of the diiron monooxygenase was not achieved, so its substrate specificity could not be determined. CONCLUSIONS Three types of short-to-medium-chain alkane oxygenases were induced by propane in ENV421, even though the cloned AlkB and P450 oxygenases did not oxidize propane. Curiously, they both oxidized octane, which is not a growth substrate for ENV421. Furthermore, the P450, typically operating as terminal alkane hydroxylase, exhibited interesting regio- and stereoselectivity, catalysing linear alkanes, alkylbenzenes and indole. SIGNIFICANCE AND IMPACT OF THE STUDY This study describes the first example of a propane-inducible P450 with a broad substrate specificity, including linear alkanes, alkylbenzenes and a multiring compound. The induction of three distinct oxygenase classes by propane is also an interesting finding because it might explain why propane serves as an effective stimulant that promotes the biodegradation of a various environmental contaminants.
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Yamamoto S, Kawakami S, Yonese J, Fujii Y, Urakami S, Masuda H, Numao N, Ishikawa Y, Kohno A, Fukui I. Long-term Oncological Outcome and Risk Stratification in Men with High-risk Prostate Cancer Treated with Radical Prostatectomy. Jpn J Clin Oncol 2012; 42:541-7. [DOI: 10.1093/jjco/hys043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kihara K, Koga F, Masuda H, Saito K, Tatokoro M, Yokoyama M, Matsuoka Y, Numao N, Kawakami S, Fujii Y. 143 Feasibility of gasless single-port clampless partial nephrectomy for peripheral renal tumor: An experience of 118 consecutive cases. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1569-9056(12)60142-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Masuda H, Masuda T, Kitaoka Y, Takahashi Y, Hatta H. Effect of Thiamin Derivative on Carbohydrate Metabolism at Rest in Mice. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401642.77861.4f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Takahashi Y, Hanawa T, Urushibata E, Masuda H, Masuda T, Hatta H. The Effect Of Taurine Supplementation On Substrate Metabolism During Fasting And Endurance Running In Mice. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401625.42422.4f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Masuda H, Katsuoka Y. 62 A case of 47,XXY/46,XY Klinefelter syndrome. JOURNAL OF MEN'S HEALTH 2011. [DOI: 10.1016/s1875-6867(11)60095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sakura M, Kawakami S, Ishioka J, Fujii Y, Numao N, Saito K, Koga F, Masuda H, Fukui I, Kihara K. A novel repeat biopsy nomogram based on three-dimensional extended biopsy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
111 Background: There is no perfect cohort in which nomograms are developed because no biopsy method can detect all cancers. To minimize this inherent verification bias, having a cohort with fewer false negative cases is advantageous. Based on a cohort examined with three-dimensional (3D) extended biopsy protocol, we developed a novel nomogram for diagnosis of prostate cancer on repeat biopsy. Methods: Of 4,074 consecutive male patients undergoing prostate biopsy at our institutions between 2000 and 2009, 775 men with at least one previous negative biopsy underwent repeat biopsy with 3D protocol. Men with previous atypical glands or atypical small acinar proliferation and/or without available prostate-specific antigen (PSA) kinetics information were excluded. The remaining 515 men constituted the study cohort. We developed a logistic regression-based nomogram with 70% of the cohort selected randomly; we validated it with the remaining 30%. Predictive accuracy and performance characteristics were assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots, respectively. The threshold probability was evaluated with decision curve analysis. Results: We developed a novel repeat biopsy nomogram incorporating age, free to total PSA ratio, prostate volume, history of previous extended biopsy, and PSA doubling time. Validation confirmed predictive accuracy with an AUC value of 0.791. Calibration plots showed good agreement. The decision curve of the nomogram was superior to the decision curve of biopsying all men in a range of threshold probability over 0.15. At the threshold of 0.2, the number of unnecessary biopsies could be reduced by 10 per 100, without missing PCa. Conclusions: We developed a novel repeat biopsy nomogram based on a cohort examined with 3D extended biopsy. This repeat biopsy nomogram is clinically beneficial, saving a substantial number of unnecessary biopsies. No significant financial relationships to disclose.
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Masuda H, Kawakami S, Sakura M, Fujii Y, Koga F, Saito K, Numao N, Yoshida S, Komai Y, Okada Y, Ito M, Yonese J, Fukui I, Kihara K. 12 PERFORMANCE OF FREE PSA BETTER THAN TOTAL PSA FOR ESTIMATION OF PROSTATE VOLUME IN ELDERLY MEN WITHOUT PROSTATE CANCER. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1569-9056(11)60017-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fujii Y, Yoshida S, Yokoyama M, Iimura Y, Numao N, Saito K, Koga F, Masuda H, Kawakami S, Kihara K. Maintenance of the suppressed level of serum testosterone by administration of three-monthly formulations of luteinizing hormone-releasing hormone agonists at six-month intervals in Japanese patients with prostate cancer: A prospective study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
159 Background: Treatment with an LH-RH agonist is a standard alternative to surgical castration for prostate cancer patients. The serum testosterone level is kept at castrate levels continuously during LH-RH agonist therapy in almost all patients (Fujii Y, BJU Int 2008). LH- RH agonists, however, are more expensive than surgical castration, with drugs costing between US $300 and $500 per month in Japan. Recent studies suggest that 3-monthly formulations of LH-RH agonists suppress the serum testosterone levels far longer than the 3-month dosing interval. Methods: A total of 43 Japanese patients with prostate cancer who were treated with 3-monthly LH-RH agonists (23 with 11.25mg leuprolide, and 20 with 10.8 mg goserelin) for one year or longer and whose testosterone levels were kept at castrate level (defined as < 50 ng/dL) were entered into this prospective, longitudinal study. After entry, the 43 men received the same 3-monthly LH-RH agonists at 6-month intervals, and had serum LH and testosterone tests performed at 3-month intervals. Bicalutamide was combined with the LH-RH agonists in 12 of the patients. Results: At entry, median patient age was 74 years (range 59 to 89), median duration of LH-RH agonists treatment was 26 months (12 to 125), and median LH and testosterone levels were <10 ng/dL (<10 to 60) and 5 ng/dL (<5 to 18), respectively. The 43 patients received a total of 162 administrations (median 5, range 1 to 6) of the LH-RH agonists at 6-month intervals, and had a total 335 hormonal tests (median 10, range 2 to12) performed during the median followup period of 30 months. Serum LH and testosterone levels were kept suppressed during the treatment. Of the 43 patients, two had serum testosterone just above the castrate level (54 and 56 ng/dL) once each among their 12 and 8 hormonal assays, respectively. Conclusions: Administration of 3-monthly LH-RH agonists, either leuprolide or goserelin, at 6-month intervals could maintain the castrate level of serum testosterone at least in Japanese prostate cancer patients who have received LH-RH agonists treatment for one year or longer. No significant financial relationships to disclose.
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Iimura Y, Saito K, Fujii Y, Ishioka J, Iwai A, Numao N, Okada Y, Koga F, Masuda H, Kihara K. Use of C-reactive protein to predict perinephric or renal sinus fat invasion in patients with clinical T1N0M0 renal cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
385 Background: Indication of nephron sparing surgery (NSS) for renal cell carcinoma (RCC) has been extending, as NSS can be considered for not only cT1a but also cT1b tumors. However, some cT1 diseases have pathological perinephric or renal sinus fat invasion. It is useful to know the probability of the presence of fat invasion before surgery, but diagnostic ability of imaging studies such as CT for predicting pT3a disease is limited. Therefore, estimation of the risk for pT3a disease in cT1 RCC patients could be helpful. C-reactive protein (CRP) has been shown to be a strong prognostic factor in RCC patients, reflecting tumor aggressiveness. We evaluated the predictive ability of preoperative CRP for pT3a disease in cT1N0M0 RCC patients. Methods: Of consecutive 386 patients treated with radical nephrectomy for cT1a-bN0M0 RCC, 82 were excluded due to hemodialysis, inflammatory disease, bilateral synchronous renal tumors, synchronous other malignant disease or loss of each data. The remaining 304 patients constituted the current study cohort. Cut off point of CRP was 3 mg/L. Associations were analyzed between pT3a and preoperative factors including age, sex, BMI, laterality, tumor size, CRP, hemoglobin, platelet, LDH, ALP, calcium and albumin. We developed a multivariate model for predicting pT3a disease in cT1 RCC. Results: Of the 304 patients, 28 (9%) had pT3a disease. Of 43 patients with elevated CRP level, 10 (23%) had pT3a disease. In contrast, of the remaining 261 patients with non-elevated CRP level, 18 (7%) had (p=0.002). Univariate and then multivariate analyses identified age (p=0.021), tumor size (p=0.007), and CRP (p=0.024) as independent and significant predictors for pT3a disease. Incorporating these three factors, we developed a predictive model for pT3a disease with predictive accuracy of area under the ROC curve of 0.772. Conclusions: Preoperative CRP is an independent predictor for pT3a disease in cT1 RCC along with age and tumor size. The model could be useful to estimate the risk of the probability of fat invasion before surgery, especially NSS. No significant financial relationships to disclose.
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