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Kamada S, Sakamoto S, Kinoshita R, Zhao X, Kamasako T, Yamase R, Junryo R, Saito S, Sangjon P, Takei A, Yamada Y, Goto Y, Imamura Y, Iguchi T, Mizokami A, Suzuki H, Akakura K, Ichikawa T. Testosterone bounce predicts favorable prognoses for prostate cancer patients treated with degarelix. Prostate 2024; 84:636-643. [PMID: 38413843 DOI: 10.1002/pros.24679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/27/2024] [Accepted: 02/07/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND To clarify the clinical roles of changes in testosterone (T) levels with a cut-off level of 20 ng/dL as predictive factors for prostate cancer patients treated with degarelix acetate. METHODS A total of 120 prostate cancer patients who received hormone therapies with gonadotropin-releasing hormone antagonist degarelix acetate were retrospectively analyzed. The predictive values of nadir T levels, max T levels, T bounce, and other clinical factors were evaluated for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). T bounce was defined as satisfying both nadir serum T levels of <20 ng/dL and max serum T levels of ≥20 ng/dL during hormone therapies. RESULTS In 120 prostate cancer patients, 16 (13%) patients did not achieve nadir T < 20 ng/dL, and 76 (63%) patients had max T ≥ 20 ng/dL. The median times to nadir T and max T are 108 and 312 days, respectively. T bounce was shown in 60 (50%) patients and is associated with favorable prognoses both for OS (p = 0.0019) and CSS (p = 0.0013) but not for PFS (p = 0.92). While in the subgroup analyses of the patients with the progression of the first-line hormone therapies, T bounce predicts favorable OS (p = 0.0015) and CSS (p = 0.0013) after biochemical recurrence. CONCLUSIONS The present study revealed that T bounce with cut-off levels of 20 ng/dL is a promising biomarker that predicts OS and CSS for prostate cancer patients treated with degarelix acetate.
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Affiliation(s)
- Shuhei Kamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ryo Kinoshita
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Xue Zhao
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomohiko Kamasako
- Department of Urology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Ryosuke Yamase
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Rii Junryo
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinpei Saito
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Pae Sangjon
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akinori Takei
- Department of Urology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Goto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Taro Iguchi
- Department of Urology, Kanazawa Medical University, Kahoku-gun, Japan
| | - Atsushi Mizokami
- Department of Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Sakura, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Shinjuku-ku, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Kikuchi Y, Shimada H, Yamasaki F, Yamashita T, Araki K, Horimoto K, Yajima S, Yashiro M, Yokoi K, Cho H, Ehira T, Nakahara K, Yasuda H, Isobe K, Hayashida T, Hatakeyama S, Akakura K, Aoki D, Nomura H, Tada Y, Yoshimatsu Y, Miyachi H, Takebayashi C, Hanamura I, Takahashi H. Clinical practice guidelines for molecular tumor marker, 2nd edition review part 2. Int J Clin Oncol 2024; 29:512-534. [PMID: 38493447 DOI: 10.1007/s10147-024-02497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
In recent years, rapid advancement in gene/protein analysis technology has resulted in target molecule identification that may be useful in cancer treatment. Therefore, "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" was published in Japan in September 2021. These guidelines were established to align the clinical usefulness of external diagnostic products with the evaluation criteria of the Pharmaceuticals and Medical Devices Agency. The guidelines were scoped for each tumor, and a clinical questionnaire was developed based on a serious clinical problem. This guideline was based on a careful review of the evidence obtained through a literature search, and recommendations were identified following the recommended grades of the Medical Information Network Distribution Services (Minds). Therefore, this guideline can be a tool for cancer treatment in clinical practice. We have already reported the review portion of "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" as Part 1. Here, we present the English version of each part of the Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition.
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Affiliation(s)
| | - Hideaki Shimada
- Department of Clinical Oncology, Toho University, Tokyo, Japan.
- Department of Surgery, Toho University, Tokyo, Japan.
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Koji Araki
- Department of Otorhinolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | - Masakazu Yashiro
- Department of Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Keigo Yokoi
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Haruhiko Cho
- Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Takuya Ehira
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazunari Nakahara
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroshi Yasuda
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazutoshi Isobe
- Division of Respiratory Medicine, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Daisuke Aoki
- International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Hiroyuki Nomura
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yuji Tada
- Department of Pulmonology, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Yuki Yoshimatsu
- Department of Patient-Derived Cancer Model, Tochigi Cancer Center Research Institute, Tochigi, Japan
| | - Hayato Miyachi
- Faculty of Clinical Laboratory Sciences, Nitobe Bunka College, Tokyo, Japan
| | - Chiaki Takebayashi
- Division of Hematology and Oncology, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
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Akakura K, Uemura H, Kawakami S, Yokomizo A, Nakamura M, Nishimura K, Komori T, Ledesma DA. Metastatic castration resistant prostate cancer patients' experience with Radium-223 treatment in Japan. Future Oncol 2024; 20:781-798. [PMID: 38275149 DOI: 10.2217/fon-2023-0870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Aim: We aimed to determine Japanese metastatic castration resistant prostate cancer (CRPC) patients' Ra-223 treatment experience. Patients & methods: Patients answered the Cancer Therapy Satisfaction Questionnaire (CTSQ domains: Satisfaction with Therapy [SWT], Expectations of Therapy [ET], Feelings about Side Effects [FSE]), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and the FACT-Bone Pain (FACT-BP) Questionnaire at baseline, during (vists 3 and 5) and after treatment (end of observation; EOO). Results: Data from 72 patients were included. Baseline median CTSQ scores SWT: 66.1 (IQR19.7), ET: 75.0 (IQR45), and FSE 68.8 (IQR 34.4) were unchanged during vists 3 and 5, but the SWT (-3.57 [IQR17.9]) and ET (-5.0 [IQR30]) decreased while FSE was unchanged (0.0 [IQR31.25]) at EOO. The median MAX-PC (18.0 [IQR 49]) score was unchanged (0.0, IQR 6) while the median FACT BP (54.0 [IQR13]) score decreased by -1.0 (IQR 8) at EOO. Conclusion: Japanese metastatic castration resistant prostate cancer patients' experience is stable during Ra-223 treatment.
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Affiliation(s)
| | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
| | - Satoru Kawakami
- Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Sakamoto S, Ando K, Pae S, Zhao X, Sakai K, Sato K, Saito S, Yamada Y, Rii J, Goto Y, Sazuka T, Imamura Y, Anzai N, Akakura K, Nishio K, Ichikawa T. Copy Number Gain in Androgen Receptors Predicts the Poor Prognosis in Japanese Castration-resistant Prostate Cancer. Anticancer Res 2024; 44:639-647. [PMID: 38307556 DOI: 10.21873/anticanres.16853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND/AIM The prognostic significance of androgen receptor amplification (AR amp) in cell-free DNA (cfDNA) was studied in Japanese patients with castration-resistant prostate cancer (CRPC). PATIENTS AND METHODS A total of 120 serum samples were obtained from 38 patients with CRPC. Serum cfDNA was purified and the AR copy number was determined. Factors associated with progression-free survival (PFS) and overall survival (OS) were statistically investigated. RESULTS The number of patients administered enzalutamide (Enza)/abiraterone (Abi)/docetaxel (DTX) was 33/25/11, respectively. The median PSA was 16.5 ng/ml. Thirty patients (79%) had bone metastases and three patients (7.9%) had lung metastases. The median follow-up was 655 days. The median initial AR copy number was 1.27 (1.10-11.50); an AR copy number of 1.27 or higher was defined as an AR-amp. Regarding PFS, the presence of AR-amp, Gleason score (GS), and ALP were significant factors in univariate analysis. In multivariate analysis, AR amplification was an independent prognostic factor (hazard ratio=7.7, p=0.0035). For OS, PSA and AR-amp were significant factors. In multivariate analysis, AR-amp (hazard ratio=4.65, p=0.0188) was the only independent prognostic factor. CONCLUSION AR-amp was associated with high nadir PSA and low iPSA/PSA ratio. AR-amp was significantly associated with poor prognosis in Japanese patients with CRPC.
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Affiliation(s)
- Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan;
| | - Keisuke Ando
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sangjon Pae
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Pharmacology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Xue Zhao
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Kodai Sato
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinpei Saito
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Pharmacology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasutaka Yamada
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Junryo Rii
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Goto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naohiko Anzai
- Department of Pharmacology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Utsumi T, Suzuki H, Ishikawa H, Wakatsuki M, Okonogi N, Harada M, Ichikawa T, Akakura K, Murakami Y, Tsuji H, Yamada S. Identification of Early Biochemical Recurrence Predictors in High-Risk Prostate Cancer Patients Treated with Carbon-Ion Radiotherapy and Androgen Deprivation Therapy. Curr Oncol 2023; 30:8815-8825. [PMID: 37887536 PMCID: PMC10605605 DOI: 10.3390/curroncol30100636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of this retrospective study was to identify clinical predictors of early biochemical recurrence (BCR) in patients with high-risk prostate cancer (PCa) treated with carbon-ion radiotherapy (CIRT) and androgen deprivation therapy (ADT). A total of 670 high-risk PCa patients treated with CIRT and ADT were included in the study. Early BCR was defined as recurrence occurring during adjuvant ADT after CIRT or within 2 years after completion of ADT. Univariate and multivariate analyses were performed to identify clinical predictors of early BCR. Patients were also classified according to the Systemic Therapy in Advancing or Metastatic Prostate cancer (STAMPEDE) PCa classification. Early BCR was observed in 5.4% of the patients. Multivariate analysis identified clinical T3b stage and ≥75% positive biopsy cores as clinical predictors of early BCR after CIRT and ADT. The STAMPEDE PCa classification was also significantly associated with early BCR based on univariate analysis. These predictors can help clinicians identify patients who are at risk of early BCR. In the future, combination therapy of ADT with abiraterone may be an option for high-risk PCa patients who are at risk of early BCR, based on the results of the STAMPEDE study.
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Affiliation(s)
- Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (T.U.); (H.S.)
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (T.U.); (H.S.)
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Masaru Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Noriyuki Okonogi
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Masaoki Harada
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan;
| | - Koichiro Akakura
- Department of Urology, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku-ku, Tokyo 162-8543, Japan;
| | - Yoshitaka Murakami
- Department of Medical Statistics, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan;
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
| | - Shigeru Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan; (M.W.); (N.O.); (M.H.); (H.T.); (S.Y.)
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Takeshita N, Sakamoto S, Yamada Y, Sazuka T, Imamura Y, Komiya A, Akakura K, Sato N, Nakatsu H, Kato T, Sugimoto M, Tsuzuki T, Ichikawa T. Detection of intraductal carcinoma in prostate cancer patients with small tumor volume. Prostate 2023; 83:580-589. [PMID: 36762419 DOI: 10.1002/pros.24492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate intraductal carcinoma of the prostate (intraductal carcinoma) and significant cancer (SC) in patients with small tumor volume (<0.5 cm3 ) in prostatectomy specimens. METHODS Data from 639 patients undergoing radical prostatectomy between April 2006 and December 2017 at Chiba University Hospital and 2 affiliated institutions were retrospectively reviewed. Tumor volume in prostatectomy specimens was measured, and with a tumor volume of less than 0.5 cm3 , the presence of intraductal carcinoma and SC was examined. SC was defined as one that did not meet the definition of pathological insignificant cancer (organ-confined cancer, Grade Group 1, tumor volume < 0.5 cm3 ). The number of patients who met four active surveillance (AS) protocols was also examined. RESULTS A total of 83 patients with tumor volume < 0.5 cm3 were identified in this study population (SC: 43 patients [52%], intraductal carcinoma: 5 patients [6%]). The median follow-up was 34.6 months (range: 18-57 months). Four (5%) developed biochemical recurrence. The number of positive biopsy cores ≥ 2 was an independent predictor of SC in patients with tumor volume < 0.5 cm3 (hazard ratio: 4.39; 95% confidence interval: 1.67-11.56; p = 0.003). In tumor volume < 0.5 cm3 , tumor volume was significantly correlated with the International Society of Urological Pathology Grade Group (1 vs. 4-5, p = 0.002) and the presence of intraductal carcinoma (p = 0.004). In intraductal carcinoma-positive cases, four of five patients (80%) had the predictor of SC, which was two or more positive biopsy cores. Of the four AS protocols, the criteria for Prostate Cancer Research International: Active Surveillance were met most frequently in 46 cases (55%) of tumor volume less than 0.5 cm3 if targeted biopsy by magnetic resonance imaging was available. CONCLUSION The results of the present study suggest that intraductal carcinoma was present even in cases with small tumor volumes. Grade Group and intraductal carcinoma showed a positive correlation with tumor volume.
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Affiliation(s)
- Nobushige Takeshita
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo, Japan
| | - Nobuo Sato
- Department of Urology, Funabashi Municipal Medical Center, Chiba, Japan
| | | | - Takuma Kato
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Takei A, Sakamoto S, Niino J, Takeuchi N, Kanesaka M, Sazuka T, Imamura Y, Akakura K, Ichikawa T. The difference in serum testosterone recovery between Gn-RH Antagonist and LH-RH agonist among patients with prostate cancer treated with radiation therapy. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
382 Background: Only limited data exist related to the serum testosterone (TST) recovery after discontinuation of Gn-RH antagonist (Degarelix acetate). In the present study, we investigated the difference in serum testosterone (TST) recovery between LH-RH agonist and Gn-RH antagonist among prostate cancer (Pca) patients received radiation therapy in combination with androgen deprivation therapy (ADT). Methods: We analyzed the association between TST levels after the end of endocrine therapy and clinical factors in 130 patients who underwent ADT for prostate cancer at Chiba University hospital between May 2003 and May 2020. The proportional hazards model and Kaplan-Meier methods were used for the statistical analysis. Results: The median patient age and PSA were 72 years, and 16.8ng/mL, respectively. The median initial TST and nadir TST were 457 ng/dL, and 20ng/dL, respectively. The median duration of ADT was 857 days. As factors affect the speed of recovery to the castration level (TST 50 ng/dL), univariate analysis showed that Gn-RH antagonist presented the significantly shorter TST recovery compared to those of LH-RH agonist (HR 1.9, p=0.0078), together with the duration of hormone therapy (857 days) and Nadir TST level (20 ng/dL), GS8 and PSA (16.8ng/mL). Multivariate analysis showed that Nadir TST level was an independent predictor (HR 2.0, p=0.0093). As factors affect the speed of recovery to the physiological level (TST 200 ng/dL), univariate analysis showed that Gn-RH antagonist presented the significantly shorter TST recovery compared to those of LH-RH agonist (HR 2.1, p=0.0064). Multivariate analysis showed that duration was the only independent predictor (HR0.34, p=0.0029). Kaplan-Meier curve demonstrated shorter time for the TST recovery in Gn-RH antagonist compared to the LH-RH agonist for the castration level (p=0.0064) and the physiological level (p=0.0052). Conclusions: TST recoveries were significantly shorter in Pca patients treated with Gn-RH antagonist than LH-RH agonist. Nadir TST value, duration, and a type of LH-RH drug may comprehensively suggest us the dynamics of TST recovery after ADT. [Table: see text]
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Affiliation(s)
- Akinori Takei
- Funabashi Municipal Medical Center, Department of Urology, Funabashi City, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graudate School of Medicine, Chiba, Japan
| | - Jun Niino
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuyoshi Takeuchi
- Chiba University, Graduate School of Medicine, Department of Urology, Chiba, Japan
| | - Manato Kanesaka
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Graduate School of Medicine Chiba University, Japan, Chiba, Japan
| | - Koichiro Akakura
- JCHO Tokyo Shinjuku Medical Center, Department of Urology, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Sakamoto S, Baba H, Xue Z, Yamada Y, Rii J, Fujimoto A, Takeuchi N, Sazuka T, Imamura Y, Akakura K, Ichikawa T. The location of tumor volume over 2.8cc predict the prognosis among Japanese localized prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01280-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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9
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Sakamoto S, Takei A, Nino J, Takeuchi N, Kanesaka M, Shibata Y, Sazuka T, Imamura Y, Akakura K, Ichikawa T. The difference in serum testosterone recovery between Gn-RH antagonist and LH-RH agonist among prostate cancer patients treated radiation therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01155-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Baba H, Sakamoto S, Zhao X, Yamada Y, Rii J, Fujimoto A, Kanesaka M, Takeuchi N, Sazuka T, Imamura Y, Akakura K, Ichikawa T. Tumor Location and a Tumor Volume over 2.8 cc Predict the Prognosis for Japanese Localized Prostate Cancer. Cancers (Basel) 2022; 14:cancers14235823. [PMID: 36497304 PMCID: PMC9740872 DOI: 10.3390/cancers14235823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Objective: Our study investigated the prognostic value of tumor volume and location in prostate cancer patients who received radical prostatectomy (RP). (2) Methods: The prognostic significance of tumor volume and location, together with other clinical factors, was studied using 557 patients who received RP. (3) Results: The receiver operating characteristic (ROC) curve identified the optimal cutoff value of tumor volume as 2.8 cc for predicting biochemical recurrence (BCR). Cox regression analysis revealed that a tumor in the posterior area (p = 0.031), peripheral zone (p = 0.0472), and tumor volume ≥ 2.8 cc (p < 0.0001) were predictive factors in univariate analysis. After multivariate analysis, tumor volume ≥ 2.8 cc (p = 0.0225) was an independent predictive factor for BCR. Among them, a novel risk model was established using tumor volume and location in the posterior area and peripheral zone. The progression-free survival (PFS) of patients who met the three criteria (unfavorable group) was significantly worse than other groups (p ≤ 0.001). Furthermore, multivariate analysis showed that the unfavorable risk was an independent prognostic factor for BCR. The prognostic significance of our risk model was observed in low- to intermediate-risk patients, although it was not observed in high-risk patients. (4) Conclusion: Tumor volume (≥2.8 cc) and localization (posterior/peripheral zone) may be a novel prognostic factor in patients undergoing RP.
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Affiliation(s)
- Haruki Baba
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
- Correspondence: ; Tel.: +81-43-226-2134; Fax: +81-43-226-2136
| | - Xue Zhao
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Junryo Rii
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Ayumi Fujimoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Manato Kanesaka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Nobuyoshi Takeuchi
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, Tokyo 162-8543, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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Kato T, Yokomizo A, Matsumoto R, Tohi Y, Miyakawa J, Mitsuzuka K, Sasaki H, Inokuchi J, Matsumura M, Sakamoto S, Kinoshita H, Fukuhara H, Kamiya N, Kimura R, Nitta M, Okuno H, Akakura K, Kakehi Y, Sugimoto M. Comparison of the medical costs between active surveillance and other treatments for early prostate cancer in Japan using data from the PRIAS-JAPAN study. Int J Urol 2022; 29:1271-1278. [PMID: 35855586 DOI: 10.1111/iju.14977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the medical costs of active surveillance with those of robot-assisted laparoscopic prostatectomy, brachytherapy, intensity-modulated radiation therapy, and hormone therapy for low-risk prostate cancer. METHODS The costs of protocol biopsies performed in the first year of surveillance (between January 2010 and June 2020) and those of brachytherapy and radiation therapy performed between May 2019 and June 2020 at the Kagawa University Hospital were analyzed. Hormone therapy costs were assumed to be the costs of luteinizing hormone-releasing hormone analogs for over 5 years. Active surveillance-eligible patients were defined based on the following: age <74 years, ≤T2, Gleason score ≤6, prostate-specific antigen level ≤10 ng/ml, and 1-2 positive cores. We estimated the total number of active surveillance-eligible patients in Japan based on the Japan Study Group of Prostate Cancer (J-CAP) study and the 2017 cancer statistical data. We then calculated the 5-year treatment costs of active surveillance-eligible patients using the J-CAP and PRIAS-JAPAN study data. RESULTS In 2017, number of active surveillance-eligible patients in Japan was estimated to be 2808. The 5-year total costs of surveillance, prostatectomy, brachytherapy, radiation therapy, and hormone therapy were 1.65, 14.0, 4.61, 4.04, and 5.87 million United States dollar (USD), respectively. If 50% and 100% of the patients in each treatment group had opted for active surveillance as the initial treatment, the total treatment cost would have been reduced by USD 6.89 million (JPY 889 million) and USD 13.8 million (JPY 1.78 billion), respectively. CONCLUSION Expanding active surveillance to eligible patients with prostate cancer helps save medical costs.
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Affiliation(s)
- Takuma Kato
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| | - Akira Yokomizo
- Department of Urology, Harasanshin Hospital, Fukuoka, Japan
| | - Ryuji Matsumoto
- Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoichiro Tohi
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| | - Jimpei Miyakawa
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan
| | - Hiroshi Sasaki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junichi Inokuchi
- Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Masafumi Matsumura
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, Hirakata, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, Sakura, Japan
| | - Ryu Kimura
- Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Japan
| | - Masahiro Nitta
- Department of Urology, Tokai University School of Medicine, Hiratsuka, Japan
| | - Hiroshi Okuno
- Department of Urology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
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12
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Ishikawa H, Hiroshima Y, Kanematsu N, Inaniwa T, Shirai T, Imai R, Suzuki H, Akakura K, Wakatsuki M, Ichikawa T, Tsuji H. Carbon-ion radiotherapy for urological cancers. Int J Urol 2022; 29:1109-1119. [PMID: 35692124 PMCID: PMC9796467 DOI: 10.1111/iju.14950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/16/2022] [Indexed: 01/01/2023]
Abstract
Carbon-ions are charged particles with a high linear energy transfer, and therefore, they make a better dose distribution with greater biological effects on the tumors compared with photons and protons. Since prostate cancer, renal cell carcinoma, and retroperitoneal sarcomas such as liposarcoma and leiomyosarcoma are known to be radioresistant tumors, carbon-ion radiotherapy, which provides the advantageous radiobiological properties such as an increasing relative biological effectiveness toward the Bragg peak, a reduced oxygen enhancement ratio, and a reduced dependence on fractionation and cell-cycle stage, has been tested for these urological tumors at the National Institute for Radiological Sciences since 1994. To promote carbon-ion radiotherapy as a standard cancer therapy, the Japan Carbon-ion Radiation Oncology Study Group was established in 2015 to create a registry of all treated patients and conduct multi-institutional prospective studies in cooperation with all the Japanese institutes. Based on accumulating evidence of the efficacy and feasibility of carbon-ion therapy for prostate cancer and retroperitoneal sarcoma, it is now covered by the Japanese health insurance system. On the other hand, carbon-ion radiotherapy for renal cell cancer is not still covered by the insurance system, although the two previous studies showed the efficacy. In this review, we introduce the characteristics, clinical outcomes, and perspectives of carbon-ion radiotherapy and our efforts to disseminate the use of this new technology worldwide.
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Affiliation(s)
- Hitoshi Ishikawa
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Yuichi Hiroshima
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Nobuyuki Kanematsu
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Taku Inaniwa
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Toshiyuki Shirai
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Reiko Imai
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Hiroyoshi Suzuki
- Department of UrologyToho University Sakura Medical CenterChibaJapan
| | - Koichiro Akakura
- Department of UrologyJapan Community Health‐care Organization Tokyo Shinjuku Medical CenterTokyoJapan
| | - Masaru Wakatsuki
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
| | - Tomohiko Ichikawa
- Department of UrologyChiba University Graduate School of MedicineChibaJapan
| | - Hiroshi Tsuji
- QST HospitalNational Institutes for Quantum Science and TechnologyChibaJapan
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13
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Hiroshima Y, Ishikawa H, Iwai Y, Wakatsuki M, Utsumi T, Suzuki H, Akakura K, Harada M, Sakurai H, Ichikawa T, Tsuji H. Safety and Efficacy of Carbon-Ion Radiotherapy for Elderly Patients with High-Risk Prostate Cancer. Cancers (Basel) 2022; 14:cancers14164015. [PMID: 36011007 PMCID: PMC9406609 DOI: 10.3390/cancers14164015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Carbon-ion radiotherapy (CIRT) is a high-dose intensive treatment, whose safety and efficacy have been proven for prostate cancer. This study aims to evaluate the outcomes of CIRT in elderly patients with prostate cancer. Patients aged 75 years or above at the initiation of CIRT were designated as the elderly group, and younger than 75 years as the young group. The overall survival (OS), disease-specific survival (DSS), biochemical control rate (BCR), biochemical relapse-free survival (BRFS), and adverse events were compared between the elderly and young patients with high-risk prostate cancer treated with CIRT. The elderly group comprised 173 of 927 patients treated for high-risk prostate cancer between April 2000 and May 2018. The overall median age was 69 (range: 45−92) years. The median follow-up period was 91.9 (range: 12.6−232.3) months. The 10-year OS, DSS, BCR, and BRFS rates in the young and elderly groups were 86.9%/71.5%, 96.6%/96.8%, 76.8%/88.1%, and 68.6%/64.3%, respectively. The OS (p < 0.001) was longer in the younger group and the BCR was better in the elderly group (p = 0.008). The DSS and BRFS did not differ significantly between the two groups. The rates of adverse events between the two groups did not differ significantly and no patient had an adverse event of Grade 4 or higher during the study period. CIRT may be as effective and safe in elderly patients as the treatment for high-risk prostate cancer.
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Affiliation(s)
- Yuichi Hiroshima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Department of Radiation Oncology, Proton Medical Research Center, University of Tsukuba Hospital, Tsukuba 305-8576, Japan
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Department of Radiation Oncology, Proton Medical Research Center, University of Tsukuba Hospital, Tsukuba 305-8576, Japan
- Correspondence:
| | - Yuma Iwai
- Department of Radiology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Masaru Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Chiba 285-8741, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba 285-8741, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, Tokyo 162-8543, Japan
| | - Masaoki Harada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, Proton Medical Research Center, University of Tsukuba Hospital, Tsukuba 305-8576, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
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14
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Hino D, Sugano T, Kino M, Nakata T, Kito H, Inoue M, Fujie H, Akakura K. Successful radiofrequency ablation of liver metastases from prostate cancer. IJU Case Rep 2022; 5:455-458. [DOI: 10.1002/iju5.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Daichi Hino
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Takahiro Sugano
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Mika Kino
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Takako Nakata
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Hiroki Kito
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Masafumi Inoue
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Hajime Fujie
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
| | - Koichiro Akakura
- Department of Urology, Pathology, Gastroenterology Japan Community Health‐Care Organization Tokyo Shinjuku Medical Center Tokyo Japan
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15
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Utsumi T, Suzuki H, Ishikawa H, Hiroshima Y, Wakatsuki M, Harada M, Ichikawa T, Akakura K, Tsuji H. External validation of the Candiolo nomogram for high-risk prostate cancer patients treated with carbon ion radiotherapy plus androgen deprivation therapy: a retrospective cohort study. Jpn J Clin Oncol 2022; 52:950-953. [DOI: 10.1093/jjco/hyac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
The aim of this study was to reclassify high-risk prostate cancer patients treated with carbon-ion radiotherapy and androgen deprivation therapy using the Candiolo nomogram and evaluate usefulness to predict the following 10-year biochemical recurrence. Six hundred seventy-two high-risk prostate cancer patients were reclassified according to the Candiolo nomogram. The cumulative incidence curves for biochemical recurrence were compared by Gray’s test. Furthermore, five predictors of the Candiolo nomogram in our patients were evaluated by Fine and Gray regression hazards model. The higher the Candiolo risk, the worse the biochemical recurrence, especially in high- and very high-risk patients. Out of five predictors, age ≥70 years, cT3 stage, biopsy Gleason score ≥9 or the percentage of positive biopsy cores ≥50% had significant impacts on 10-year biochemical recurrence in our patients. The Candiolo nomogram can reclassify our high-risk prostate cancer patients treated with carbon-ion radiotherapy and androgen deprivation therapy and evaluate the biochemical recurrence preciously.
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Affiliation(s)
- Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Chiba 285-8741, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba 285-8741, Japan
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan, Chiba 263-8555, Japan
| | - Yuichi Hiroshima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan, Chiba 263-8555, Japan
| | - Masaru Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan, Chiba 263-8555, Japan
| | - Masaoki Harada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan, Chiba 263-8555, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan, Chiba 260-8670, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health-care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan, Tokyo 162-8543, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan, Chiba 263-8555, Japan
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16
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Akakura K, Uemura H, Miyazaki K, Stroupe A, Seo C, Uzumcu A, Ledesma DA. A qualitative research study in Japan investigating patients' experience with metastatic castration-resistant prostate cancer: from diagnosis to decision for Ra-223 treatment. Future Oncol 2021; 17:5103-5118. [PMID: 34664992 DOI: 10.2217/fon-2021-0773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This qualitative study aimed to reveal symptoms and impacts among bone metastatic castration-resistant prostate cancer (or mCRPC) Japanese patients, prior to Radium-223 (Ra-223) treatment. Materials & Methods: Twenty-three mCRPC patients designated to receive Ra-223 and three treating physicians (Ra-223 prescribers) in Japan, were interviewed. All interview data were assessed for concept frequency, themes and saturation. Results: Forty-five percent of the patients (mean age: 75.8 years) were symptomatic at the time of enrollment. Interviews with all patients revealed 47 mCRPC symptoms, including back pain and bone-specific pain, and 45 life impacts, including worry about disease progression and the impact on daily, physical activities. Conclusion: The symptoms and impacts of living with mCRPC and the associated burden of bone metastasis and skeletal-related symptoms are varied and are important considerations for treatment.
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Affiliation(s)
- Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization (JCHO) Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku, 162-8543, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Kikuko Miyazaki
- School of Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Angela Stroupe
- Patient-Centered Outcomes, Open Health, Newton, MA 02458, USA
| | - Caroline Seo
- Patient-Centered Outcomes, Open Health, Bethesda, MD 20814, USA
| | - Alyssa Uzumcu
- Patient-Centered Outcomes, Open Health, Newton, MA 02458, USA
| | - Dianne A Ledesma
- Market Access Oncology, Bayer Yakuhin, Ltd, Marunouchi 1-6-5, Chiyoda-ku, Tokyo, 100-8265, Japan
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17
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Akakura K. Editorial Comment to External beam radiotherapy and radical prostatectomy are associated with better survival in Asian prostate cancer patients. Int J Urol 2021; 29:24-25. [PMID: 34608681 DOI: 10.1111/iju.14723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Koichiro Akakura
- Department of Urology, Japan Community Health-Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
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18
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Kino M, Hayashi T, Hino D, Nakada T, Kitoh H, Akakura K. Patients' poor performance status is an independent risk factor for urosepsis induced by kidney and ureteral stones. Urolithiasis 2021; 49:477-484. [PMID: 33755744 DOI: 10.1007/s00240-021-01256-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/12/2021] [Indexed: 12/29/2022]
Abstract
This study was aimed to identify the risk factors for urosepsis caused by kidney and ureteral stones. One hundred and nine patients who had kidney or ureteral stones and who were treated with trans-ureteral lithotripsy (TUL) at our institution from 2016 to 2020 were included. We investigated the risk factors for urosepsis caused by kidney or ureteral stones that occurred prior to TUL. Thirty patients (28%) had urosepsis prior to TUL. Patients were divided into a urosepsis group (n = 30, 28%) and a non-urosepsis group (n = 79, 72%). Patients' characteristics (gender, age, performance status [PS] score, presence of diabetes mellitus, and skeletal muscle mass), as well as their stone and urine characteristics (stone size, presence of obstructive ureteral stones, stone composition, and urine and stone cultures), were compared between the two groups. When compared to the non-urosepsis group, patients with urosepsis were more likely to be older (p < 0.001), female (p < 0.001), with lower skeletal muscle mass (p < 0.001) and with poor PSs (p < 0.001). For stone and urine characteristics, infection stones (p = 0.01), positive urine (p < 0.001) and stone culture (p = 0.007) were more often detected in patients with urosepsis. A multivariate analysis showed patients' poor PS to be an independent risk factor for urosepsis due to kidney and ureteral stones (OR = 15.7; 95% CI = 2.2-115, p = 0.007). Our study revealed that the most significant risk factor for urosepsis caused by kidney and ureteral stones was the patients' poor PS.
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Affiliation(s)
- Mika Kino
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan.
| | - Takumi Hayashi
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan
| | - Daichi Hino
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan
| | - Takako Nakada
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan
| | - Hiroki Kitoh
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan
| | - Koichiro Akakura
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo - cho, Shinjuku - ku, Tokyo, 162 - 8543, Japan
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Abstract
OBJECTIVE To explore the perceptions of patients living with different stages of prostate cancer across the Asia-Pacific (APAC) region, as while extensive quantitative research has been undertaken into outcomes of treatments for prostate cancer, little in the way of qualitative research has been performed looking at subjective perceptions of patients in regard to their perceived deficits in the treatment of this condition and such research is particularly lacking in reference to the APAC region. PATIENTS AND METHODS Initial 45-min qualitative research interrogatory interviews were conducted with 12 patients from Australia, China and Japan to identify themes that were significant to patients in the management of prostate cancer. Thereafter, 150 patients with different stages of prostate cancer underwent 30-min online (Australia) or computer-assisted/personal interviews categorised on the five key themes identified, in order to more fully clarify the nature of patient perceptions of how their prostate cancer had been treated and the issues they felt could be more fully addressed in order to improve the management of this condition. RESULTS Interviews indicated common challenges and unmet needs among patients, including: (i) patients' feelings and emotional state change during their disease journey, (ii) patients lack of knowledge about prostate cancer and disease progression prior to diagnosis, (iii) patients felt shared decision-making was uncommon, (iv) patients have misperceptions about surgery, and (v) patients have unmet needs for greater information and support to manage their condition. CONCLUSIONS These patient perceptions of unmet needs in prostate cancer management stand in contrast to patient awareness of other common diseases such as heart failure and diabetes. Such unmet needs vary across disease stages and between different nationalities. Patients with prostate cancer in the APAC region appear to have gaps in knowledge about their disease and wish for greater information, support and public awareness about prostate cancer.
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Affiliation(s)
- Koichiro Akakura
- Department of Urology, Japan Community Health-care Organization (JCHO), Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Damien Bolton
- Department of Urology, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Vince Grillo
- Health Division, Kantar, Singapore City, Singapore
| | - Naomi Mermod
- The Janssen Pharmaceutical Companies of Johnson & Johnson, Asia Pacific, Beerse, Belgium
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20
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Rii J, Sakamoto S, Yamada Y, Takeshita N, Yamamoto S, Sazuka T, Imamura Y, Nakamura K, Komiya A, Komaru A, Fukasawa S, Nakatsu H, Akakura K, Ichikawa T. Prognostic factors influencing overall survival in de novo oligometastatic prostate cancer patients. Prostate 2020; 80:850-858. [PMID: 32501559 DOI: 10.1002/pros.24016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Oligometastatic cancer has been suggested as an intermediate state between localized disease and wide-ranging metastases. The clinical significance of local treatment in oligometastatic prostate cancer (PCa) has been a recent topic of interest. However, standard definitions of oligometastasis are lacking. Here we studied risk factors among Japanese de novo oligometastatic patients with PCa. METHODS We retrospectively assessed clinical data from 264 patients, including locally advanced (T3 or T4N0M0) cancer, lymph-node-positive cancer (Tany N1M0), and cancer with ≤10 bone metastases. All patients received androgen deprivation therapy only. The number of bone metastases and clinical factors were evaluated in association with overall survival (OS) and progression-free survival (PFS). The Mann-Whitney U test, Cox proportional hazard models, and Kaplan-Meier methods were used as statistical analyses. RESULTS Median age, PSA at baseline and OS were 74 years, 55.2 ng/mL, and 129.0 months, respectively. The cutoff for the number of bone metastases having the greatest impact on OS was ≥3 (hazard ratio [HR]: 2.67; P = .0001). In multivariate analysis, non-regional lymph node (LN) metastases (HR: 2.15; P = .0222), ISUP grade group (GG) 5 (HR: 2.04; P = .0186) and ≥3 bone metastases (HR: 1.82; P = .0390) were independent predictors of OS. In risk classification based on these factors, OS and PFS were significantly classifiable into poor (2-3 factors), intermediate (1 factor), and good (no factors) risk groups (P < .0001). CONCLUSION Not only the number of bone metastases, but also non-regional LN metastases predict OS in patients with de novo oligometastatic PCa.
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Affiliation(s)
- Junryo Rii
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Satoshi Yamamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazuyoshi Nakamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Komaru
- Prostate Center and Division of Urology, Chiba Cancer Center, Chiba, Japan
| | - Satoshi Fukasawa
- Prostate Center and Division of Urology, Chiba Cancer Center, Chiba, Japan
| | | | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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21
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Takei A, Sakamoto S, Tamura T, Wakai K, Maimaiti M, Imamura Y, Komiya A, Nakatsu H, Akakura K, Ichikawa T. Trends and oncological outcome of testosterone recovery after androgen deprivation therapy in prostate cancer patients who received external beam radiotherapy. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
345 Background: Although androgen deprivation therapy (ADT) combined with external beam radiation therapy (EBRT) is standard treatment for high risk prostate cancer (PC) patients, the shift of testosterone (TST) levels after ADT and the optimal duration of ADT is unclear. TST recovery and outcome were studied in PC patients who received EBRT with ADT. Methods: Eighty-two patients who underwent EBRT with ADT for PC were retrospectively analyzed. Serum TST levels after ADT terminations were studied. Cox proportional hazard models and the Kaplan-Meier method were used for statistical analysis. Results: Median age, baseline TST, nadir TST, and duration of ADT were 73 years, 456 ng/dL, 16 ng/dL, and 26 months, respectively. ADT duration of 33 months (HR 0.13; p=0.0018), nadir TST of 20 ng/dL (HR 0.35; p=0.0112), and TST >50 ng/dL at 6 months after ADT termination (HR 0.21; p=0.0075) were significantly associated with TST recovery to normal levels (200 ng/dL) on multivariate analysis. ADT duration of 33 months (HR 0.31; p=0.0023) and nadir TST of 20 ng/dL (HR 0.38; p=0.0012) were significantly associated with TST recovery to supracastrate level (50 ng/dL) on multivariate analysis. In high risk PC patients, ADT≤ 2 year group showed shorter time to TST recovery to supracastrate levels compare to those of ADT>2 year group (HR 4.21; p=0.0022) without affecting biochemical recurrence (p=0.49) and overall survival (p=0.674). Conclusions: ADT duration of 33 months and nadir TST of 20 ng/dL predicted the TST recovery to suparacastrate levels. Less than 2 year of ADT provided better TST recovery without affecting the oncological outcome in high risk patients.[Table: see text]
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Affiliation(s)
| | | | | | - Ken Wakai
- Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Yusuke Imamura
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Komiya
- Chiba University Graduate School of Medicine, Chiba, Japan
| | | | | | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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22
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Ando K, Sakamoto S, Takeshita N, Fujimoto A, Maimaiti M, Saito S, Sanjyon P, Imamura Y, Sato N, Komiya A, Akakura K, Ichikawa T. Higher serum testosterone levels predict poor prognosis in castration-resistant prostate cancer patients treated with docetaxel. Prostate 2020; 80:247-255. [PMID: 31816126 DOI: 10.1002/pros.23938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/26/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The role of testosterone as a prognostic factor for castration-resistant prostate cancer treated with docetaxel in Japan was investigated. METHODS A total of 164 patients with castration-resistant prostate cancer who received docetaxel treatment at Chiba University Hospital and an affiliated hospital were retrospectively analyzed. Testosterone and other clinical factors at the start of docetaxel treatment were evaluated with respect to overall survival and progression-free survival. RESULTS Of the 164 patients, 69 had high-volume tumors. The median prostatic-specific antigen was 27.0 ng/mL. The median testosterone was 13.0 ng/dL. The rates of bone and visceral metastases were 80.1% and 8.8%, respectively. For progression-free survival, testosterone ≥13 ng/dL was an independent prognostic factor only on univariate analysis (hazard ratio, 1.81; P = .0108). For overall survival, testosterone ≥ 1.3 ng/dL (hazard ratio, 3.37; P < .0001), high volume (hazard ratio, 3.06; P = .0009), and prostate-specific antigen ≥ 27.0 ng/mL (hazard ratio, 2.75; P = .0013) were independent prognostic factors on multivariate analysis. When assessing related clinical factors, higher serum testosterone was associated with visceral metastasis, high volume, and prostate-specific antigen. Based on three prognostic factors (testosterone, high volume, prostate-specific antigen), a risk classification was developed. The high-risk group (3 risk factors) showed a significantly shorter overall survival compared to the moderate-risk (2 risk factors) and low-risk (0-1 risk factor) groups (P < .0001). CONCLUSIONS The present study identified higher serum testosterone (≥13 ng/dL) as a significant prognostic factor in castration-resistant prostate cancer patients treated with docetaxel therapy.
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Affiliation(s)
- Keisuke Ando
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | | | | | - Ayumi Fujimoto
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | | | - Shinpei Saito
- Department of Urology, Funabashi Municipal Medical Center, Chiba, Japan
| | - Pae Sanjyon
- Department of Urology, Chiba Cancer Center, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Nobuo Sato
- Department of Urology, Funabashi Municipal Medical Center, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Chiba, Japan
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23
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Akakura K. Editorial Comment to Impact of alternative antiandrogen therapy for Japanese prostate cancer patients in the era of new hormonal therapy. Int J Urol 2019; 27:89. [PMID: 31637770 DOI: 10.1111/iju.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
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24
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Yamada Y, Sakamoto S, Amiya Y, Sasaki M, Shima T, Komiya A, Suzuki N, Akakura K, Ichikawa T, Nakatsu H. Treatment strategy for metastatic prostate cancer with extremely high PSA level: reconsidering the value of vintage therapy. Asian J Androl 2019; 20:432-437. [PMID: 29735818 PMCID: PMC6116678 DOI: 10.4103/aja.aja_24_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The prognostic significance of initial prostate-specific antigen (PSA) level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows: low (<100 ng ml−1), intermediate (100–999 ng ml−1), and high (≥1000 ng ml−1). All patients received androgen deprivation therapy (ADT) immediately. We investigated PSA progression-free survival (PFS) for first-line ADT and overall survival (OS) within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal (AW) and alternative antiandrogen (AA) therapies after development of castration-resistant prostate cancer (CRPC). No significant differences in OS were observed among the three groups (P = 0.654). Patients with high PSA levels had significantly short PFS for first-line ADT (P = 0.037). Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group (P = 0.047). Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy (P = 0.049). PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders (P = 0.011 and P < 0.001, respectively). Thus, extremely high PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.
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Affiliation(s)
- Yasutaka Yamada
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan.,Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
| | - Yoshiyasu Amiya
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan
| | - Makoto Sasaki
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan
| | - Takayuki Shima
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
| | - Noriyuki Suzuki
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo 162-8543, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
| | - Hiroomi Nakatsu
- Department of Urology, Asahi General Hospital, Asahi 289-2511, Japan
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25
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Tanaka N, Nishimura K, Okajima E, Ina K, Ogawa O, Nagata H, Akakura K, Fujimoto K, Gotoh M, Teramukai S, Hirao Y. Docetaxel‐based chemotherapy combined with dexamethasone 1 mg daily oral administration for castration‐resistant prostate cancer: Long‐term outcomes. Int J Urol 2019; 26:797-803. [DOI: 10.1111/iju.14009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/03/2019] [Indexed: 01/10/2023]
Affiliation(s)
| | - Kazuo Nishimura
- Department of Urology Osaka International Cancer Institute Osaka Japan
| | | | - Kenji Ina
- Department of Chemotherapy Nagoya Memorial Hospital Nagoya Japan
| | - Osamu Ogawa
- Department of Urology Kyoto University Kyoto Japan
| | | | - Koichiro Akakura
- Department of Urology JCHO Tokyo Shinjuku Medical Center Tokyo Japan
| | | | | | - Satoshi Teramukai
- Department of Biostatistics Kyoto Prefectural University of Medicine Kyoto Japan
| | - Yoshihiko Hirao
- Department of Urology Nara Medical University Kashihara Japan
- Department of Urology Osaka Gyoumeikan Hospital Osaka Japan
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26
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Kasuya G, Tsuji H, Nomiya T, Makishima H, Haruyama Y, Kobashi G, Hayashi K, Ebner DK, Omatsu T, Kishimoto R, Yasuda S, Igarashi T, Oya M, Akakura K, Suzuki H, Ichikawa T, Shimazaki J, Kamada T. Prospective clinical trial of 12-fraction carbon-ion radiotherapy for primary renal cell carcinoma. Oncotarget 2019; 10:76-81. [PMID: 30713604 PMCID: PMC6343760 DOI: 10.18632/oncotarget.26539] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/20/2018] [Indexed: 12/20/2022] Open
Abstract
The aims of this study were to clarify the safety and efficacy of 12-fraction carbon-ion radiotherapy (CIRT) for primary renal cell carcinoma (RCC) and to confirm the recommended dose in a prospective clinical trial. This clinical trial was planned as a non-randomized, open-label, single-center phase I/II study of CIRT monotherapy. The incidence of acute adverse events was the primary endpoint. Dose-limiting toxicities (DLTs) were defined as grade ≥3 skin, gastrointestinal tract, or urologic adverse events. Based on the eligibility criteria, 8 patients with primary RCC, including 3 medically inoperable patients and 5 patients with tumors >4 cm, were enrolled. Of the 8 patients, 5 were treated with 66 Gy (relative biological effectiveness [RBE]), and subsequently, the dose was escalated to 72 Gy (RBE) for the remaining 3 patients. The median follow-up time was 43.1 months. No DLTs were observed at any dose level though the end of follow-up. Although 1 patient died of pneumonia 3 months after CIRT, which was determined to be unrelated to CIRT, no grade 3 or higher adverse events were observed, and both local control and cancer-specific survival rates were 100%. In conclusion, the safety and efficacy of CIRT hypofractionation using 12-fractions for the treatment of eligible RCC patients, including those with inoperable or tumor size >4 cm, were confirmed in this prospective trial, and a recommended dose of 72 Gy (RBE) was established.
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Affiliation(s)
- Goro Kasuya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Takuma Nomiya
- Department of Radiology, Joban Hospital, Iwaki, Japan
| | - Hirokazu Makishima
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | | | - Daniel K Ebner
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Tokuhiko Omatsu
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Riwa Kishimoto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Shigeo Yasuda
- Department of Radiation Oncology, Chiba Rosai Hospital, Chiba, Japan
| | - Tatsuo Igarashi
- Department of Urology, Seirei Sakura Citizen Hospital, Chiba, Japan.,Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization Tokyo, Shinjuku Medical Center, Tokyo, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Jun Shimazaki
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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27
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Sakamoto S, Miyazawa K, Yasui T, Iguchi T, Fujita M, Nishimatsu H, Masaki T, Hasegawa T, Hibi H, Arakawa T, Ando R, Kato Y, Ishito N, Yamaguchi S, Takazawa R, Tsujihata M, Taguchi M, Akakura K, Hata A, Ichikawa T. Chronological changes in epidemiological characteristics of lower urinary tract urolithiasis in Japan. Int J Urol 2018; 26:96-101. [PMID: 30308705 DOI: 10.1111/iju.13817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine changes and trends in the annual incidence and epidemiological aspects of lower urinary tract stones in Japan. METHODS Data about patients who had been diagnosed by urologists in 2015 with first and recurrent lower urinary tract stones were collected from 301 hospitals approved by the Japanese Board of Urology. The estimated annual incidence according to sex, age and stone composition was compared with previous nationwide surveys between 1965 and 2005. RESULTS The incidence of lower urinary tract stones in Japan has steadily increased from 4.7 per 100 000 in 1965 to 12.0 per 100 000 in 2015. However, the age standardized annual incidence of lower urinary tract stones has remained relatively stable over the same period at 5.5 per 100 000 and 6.0 per 100 000 in 1965 and 2015, respectively. The increase in incidence was most evident among individuals aged ≥80 years. The incidence of calcium oxalate stones has steadily increased among males and females, whereas that of infection-related stones has significantly decreased from 26.2% to 14.3% among men over the past 50 years. CONCLUSIONS Nationwide surveys suggest a steady increase in the incidence of lower urinary tract stones over a 50-year period in Japan. This trend might reflect changes in the aging population and improved Japanese medical standards.
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Affiliation(s)
- Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Takahiro Yasui
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Taro Iguchi
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Misuzu Fujita
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Takuro Masaki
- Department of Urology, Harasanshin Hospital, Fukuoka, Japan
| | - Toru Hasegawa
- Department of Urology, Hasegawa Hospital, Tokyo, Japan
| | - Hatsuki Hibi
- Department of Urology, Kyoritsu General Hospital, Nagoya, Japan
| | - Takashi Arakawa
- Department of Urology, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Ryosuke Ando
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshinari Kato
- Department of Urology, Kaizuka City Hospital, Kaizuka, Japan
| | - Noritaka Ishito
- Department of Urology, Kurashiki Medical Center, Kurashiki, Japan
| | | | - Ryoji Takazawa
- Department of Urology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
| | | | - Makoto Taguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Japan
| | - Koichiro Akakura
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Akira Hata
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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28
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Kasuya G, Tsuji H, Nomiya T, Makishima H, Haruyama Y, Kobashi G, Ebner DK, Hayashi K, Omatsu T, Kishimoto R, Yasuda S, Igarashi T, Oya M, Akakura K, Suzuki H, Ichikawa T, Shimazaki J, Kamada T. Updated long-term outcomes after carbon-ion radiotherapy for primary renal cell carcinoma. Cancer Sci 2018; 109:2873-2880. [PMID: 29981249 PMCID: PMC6125442 DOI: 10.1111/cas.13727] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022] Open
Abstract
Long‐term oncological outcomes for primary renal cell carcinoma (RCC) treated with carbon‐ion radiotherapy (CIRT) are poorly understood. Patients with primary RCC were treated with 12 or 16‐fraction CIRT at The Hospital of the National Institute of Radiological Sciences outside of clinical trials. Outcome data were pooled and retrospectively analyzed for toxicity, local control, and disease‐free, cancer‐specific, and overall survival. From 1997 to 2014, 19 RCC patients (11 with T1aN0M0, 4 with T1bN0M0, and 4 with inoperable advanced stage [T4N0M0, T3aN1M0, and T1aN0M1]) were treated with CIRT and followed up for a median of 6.6 (range, 0.7‐16.5) years; 9 of these patients were inoperable because of comorbidities or advanced‐stage disease. Diagnoses were confirmed by imaging in 11 patients and by biopsy in the remaining 8. In 4 of 5 patients with definitive renal comorbidities, including diabetic nephropathy, sclerotic kidney or solitary kidney pre‐CIRT progressed to grade 4 chronic kidney disease (CKD). In contrast, the remaining 14 patients without definitive renal comorbidities did not progress to grade 3 or higher CKD. Furthermore, although 1 case of grade 4 dermatitis was observed, there were no other grade 3 or higher non‐renal adverse events. Local control rate, and disease‐free, cancer‐specific, and overall survival rates at 5 years of all 19 patients were 94.1%, 68.9%, 100%, and 89.2%, respectively. This updated retrospective analysis based on long‐term follow‐up data suggests that CIRT is a safe treatment for primary RCC patients without definitive renal comorbidities pre‐CIRT, and yield favorable treatment outcomes, even in inoperable cases.
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Affiliation(s)
- Goro Kasuya
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hiroshi Tsuji
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Takuma Nomiya
- Department of Radiology, Joban Hospital, Iwaki, Japan
| | - Hirokazu Makishima
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Daniel K Ebner
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Brown University Alpert Medical School, Providence, Rhode Island
| | - Kazuhiko Hayashi
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Tokuhiko Omatsu
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Riwa Kishimoto
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Shigeo Yasuda
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Chiba Rosai Hospital, Chiba, Japan
| | - Tatsuo Igarashi
- Department of Urology, Seirei Sakura Citizen Hospital, Chiba, Japan.,Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization Tokyo, Shinjuku Medical Center, Tokyo, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | | | - Jun Shimazaki
- Department of Urology, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Tadashi Kamada
- The Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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29
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Takeuchi N, Sakamoto S, Nishiyama A, Horikoshi T, Yamada Y, Iizuka J, Maimaiti M, Imamura Y, Kawamura K, Imamoto T, Komiya A, Ikehara Y, Akakura K, Ichikawa T. Biparametric Prostate Imaging Reporting and Data System version2 and International Society of Urological Pathology Grade Predict Biochemical Recurrence after Radical Prostatectomy. Clin Genitourin Cancer 2018; 16:e817-e829. [DOI: 10.1016/j.clgc.2018.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 02/10/2018] [Accepted: 02/18/2018] [Indexed: 11/15/2022]
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30
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Sakamoto S, Miyazawa K, Yasui T, Iguchi T, Fujita M, Nishimatsu H, Masaki T, Hasegawa T, Hibi H, Arakawa T, Ando R, Kato Y, Ishito N, Yamaguchi S, Takazawa R, Tsujihata M, Matsuda T, Akakura K, Hata A, Ichikawa T. Chronological changes in the epidemiological characteristics of upper urinary tract urolithiasis in Japan. Int J Urol 2018; 25:373-378. [DOI: 10.1111/iju.13552] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/15/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Shinichi Sakamoto
- Department of Urology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Katsuhito Miyazawa
- Department of Urology; Kanazawa Medical University; Uchinada Ishikawa Japan
| | - Takahiro Yasui
- Department of Nephro-Urology; Graduate School of Medical Sciences; Nagoya City University; Nagoya Aichi Japan
| | - Taro Iguchi
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Japan
| | - Misuzu Fujita
- Department of Public Health; Graduate School of Medicine; Chiba University; Chiba Japan
| | | | - Takuro Masaki
- Department of Urology; Harasanshin Hospital; Fukuoka Japan
| | - Toru Hasegawa
- Department of Urology; Hasegawa Hospital; Tokyo Japan
| | - Hatsuki Hibi
- Department of Urology; Kyoritsu General Hospital; Nagoya Aichi Japan
| | - Takashi Arakawa
- Department of Urology; International University of Health and Welfare Mita Hospital; Tokyo Japan
| | - Ryosuke Ando
- Department of Nephro-Urology; Graduate School of Medical Sciences; Nagoya City University; Nagoya Aichi Japan
| | - Yoshinari Kato
- Department of Urology; Kaizuka City Hospital; Osaka Japan
| | - Noritaka Ishito
- Department of Urology; Kurashiki Medical Center; Kurashiki Okayama Japan
| | - Satoshi Yamaguchi
- Department of Urology; Kitasaito Hospital; Sagamihara Kanagawa Japan
| | - Ryoji Takazawa
- Department of Urology; Tokyo Metropolitan Ohtsuka Hospital; Tokyo Japan
| | - Masao Tsujihata
- Department of Urology; Osaka Rosai Hospital; Sakai Osaka Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology; Kansai Medical University; Hirakata Osaka Japan
| | - Koichiro Akakura
- Department of Urology; JCHO Tokyo Shinjuku Medical Center; Tokyo Japan
| | - Akira Hata
- Department of Public Health; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Tomohiko Ichikawa
- Department of Urology; Graduate School of Medicine; Chiba University; Chiba Japan
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Sakamoto S, Takei A, Tamura T, Fujimura M, Shigeta Y, Imamura Y, Yano H, Naya Y, Kawamura K, Imamoto T, Komiya A, Akakura K, Ichikawa T. PD03-03 GENOTYPE CLASSIFICATION BASED ON THE MULTIPLE CYSTINE RELATED TRANSPORTERS IN JAPANESE CYSTINURIA PATIENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sakamoto S, Takei A, Tamura T, Fujimura M, Yano H, Kawamura K, Imamoto T, Komiya A, Akakura K, Ichikawa T. MP24-08 IDENTIFICATION OF A NOVEL GENOMIC MUTATIONS THROUGH A NEXT-GENERATION SEQUENCE AMONG JAPANESE CYSTINURIA PATIENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ito K, Yokomizo A, Tokunaga S, Arai G, Sugimoto M, Akakura K, Hasumi H, Sakai H, Ouraji A, Suzuki K. PD06-06 IMPORTANCE OF [-2] PROPSA MEASUREMENT IN A DIAGNOSIS OF PROSTATE CANCER: PROSTATE HEALTH INDEX TRIAL (PROPHET) - DIAGNOSTIC IMPACTS OF CLINICAL LABORATORY-BASED INDICES ON GLEASON GRADE GROUP ≥2 OR ≥3 CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hirata Y, Morino K, Akakura K, Higano CS, Aihara K. Personalizing Androgen Suppression for Prostate Cancer Using Mathematical Modeling. Sci Rep 2018; 8:2673. [PMID: 29422657 PMCID: PMC5805696 DOI: 10.1038/s41598-018-20788-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 01/24/2018] [Indexed: 01/20/2023] Open
Abstract
Using a dataset of 150 patients treated with intermittent androgen suppression (IAS) through a fixed treatment schedule, we retrospectively designed a personalized treatment schedule mathematically for each patient. We estimated 100 sets of parameter values for each patient by randomly resampling each patient’s time points to take into account the uncertainty for observations of prostate specific antigen (PSA). Then, we identified 3 types and classified patients accordingly: in type (i), the relapse, namely the divergence of PSA, can be prevented by IAS; in type (ii), the relapse can be delayed by IAS later than by continuous androgen suppression (CAS); in type (iii) IAS was not beneficial and therefore CAS would have been more appropriate in the long run. Moreover, we obtained a treatment schedule of hormone therapy by minimizing the PSA of 3 years later in the worst case scenario among the 100 parameter sets by searching exhaustively all over the possible treatment schedules. If the most frequent type among 100 sets was type (i), the maximal PSA tended to be kept less than 100 ng/ml longer in IAS than in CAS, while there was no statistical difference for the other cases. Thus, mathematically personalized IAS should be studied prospectively.
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Affiliation(s)
- Yoshito Hirata
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505, Japan. .,Department of Mathematical Informatics, The University of Tokyo, Tokyo, Japan.
| | - Kai Morino
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505, Japan.,Department of Mathematical Informatics, The University of Tokyo, Tokyo, Japan
| | - Koichiro Akakura
- Department of Urology, JCHO Tokyo Shinjuku Medical Center, Japan Community Health Care Organization, Tokyo, Japan
| | - Celestia S Higano
- Department of Medicine, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kazuyuki Aihara
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505, Japan.,Department of Mathematical Informatics, The University of Tokyo, Tokyo, Japan
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35
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Takei A, Sakamoto S, Wakai K, Tamura T, Imamura Y, Xu M, Maimaiti M, Kawamura K, Imamoto T, Komiya A, Akakura K, Ichikawa T. Duration of androgen deprivation therapy and nadir of testosterone at 20 ng/dL predict testosterone recovery to supracastrate level in prostate cancer patients who received external beam radiotherapy. Int J Urol 2018; 25:352-358. [DOI: 10.1111/iju.13521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Akinori Takei
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Shinichi Sakamoto
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Ken Wakai
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Takaaki Tamura
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Yusuke Imamura
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Minhui Xu
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Maihulan Maimaiti
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Koji Kawamura
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Takashi Imamoto
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Akira Komiya
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
| | - Koichiro Akakura
- Department of Urology; Japan Community Healthcare Organization Tokyo Shinjuku Medical Center; Tokyo Japan
| | - Tomohiko Ichikawa
- Department of Urology; Chiba University Graduate School of Medicine; Chiba Japan
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36
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Kasuya G, Ishikawa H, Tsuji H, Haruyama Y, Kobashi G, Ebner DK, Akakura K, Suzuki H, Ichikawa T, Shimazaki J, Makishima H, Nomiya T, Kamada T, Tsujii H. Cancer-specific mortality of high-risk prostate cancer after carbon-ion radiotherapy plus long-term androgen deprivation therapy. Cancer Sci 2017; 108:2422-2429. [PMID: 28921785 PMCID: PMC5715357 DOI: 10.1111/cas.13402] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 11/30/2022] Open
Abstract
The treatment outcomes of patients with high‐risk localized prostate cancer (PC) after carbon‐ion radiotherapy (CIRT) combined with long‐term androgen deprivation therapy (LTADT) were analyzed, and compared with those of other treatment modalities, focusing on PC‐specific mortality (PCSM). A total of 1247 patients were enrolled in three phase II clinical trials of fixed‐dose CIRT between 2000 and 2013. Excluding patients with T4 disease, 608 patients with high‐risk or very‐high‐risk PC, according to the National Comprehensive Cancer Network classification system, who received CIRT with LTADT were evaluated. The median follow‐up time was 88.4 months, and the 5‐/10‐year PCSM rates were 1.5%/4.3%, respectively. T3b disease, Gleason score of 9–10 and percentage of positive biopsy cores >75% were associated with significantly higher PCSM on univariate and multivariate analyses. The 10‐year PCSM rates of patients having all three (n = 16), two (n = 74) or one of these risk factors (n = 217) were 27.1, 11.6 and 5.7%, respectively. Of the 301 patients with none of these factors, only 1 PCSM occurred over the 10‐year follow‐up (10‐year PCSM rate, 0.3%), and significant differences were observed among the four stratified groups (P <0.001). CIRT combined with LTADT yielded relatively favorable treatment outcomes in patients with high‐risk PC and very favorable results in patients without any of the three abovementioned factors for PCSM. Because a significant difference in PCSM among the high‐risk PC patient groups was observed, new categorization and treatment intensity adjustment may be required for high‐risk PC patients treated with CIRT.
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Affiliation(s)
- Goro Kasuya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hitoshi Ishikawa
- Department of Radiation Oncology, Faculty of Medicine, Graduate School of Medicine, Tsukuba University, Ibaraki, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Daniel K Ebner
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Brown University Alpert Medical School, Providence, RI, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization Tokyo, Shinjuku Medical Center, Tokyo, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Jun Shimazaki
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hirokazu Makishima
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | | | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hirohiko Tsujii
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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Yamamoto S, Sakamoto S, Minhui X, Tamura T, Otsuka K, Sato K, Maimaiti M, Kamada S, Takei A, Fuse M, Kawamura K, Imamoto T, Komiya A, Akakura K, Ichikawa T. Testosterone Reduction of ≥ 480 ng/dL Predicts Favorable Prognosis of Japanese Men With Advanced Prostate Cancer Treated With Androgen-Deprivation Therapy. Clin Genitourin Cancer 2017; 15:e1107-e1115. [PMID: 28882738 DOI: 10.1016/j.clgc.2017.07.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/23/2017] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Reductions in testosterone concentration play a significant role in the treatment of prostate cancer. We studied the role of testosterone as a prognostic marker for advanced prostate cancer (stage C or higher) treated with primary androgen-deprivation therapy (ADT). PATIENTS AND METHODS A total of 348 patients were treated using ADT as first-line therapy for prostate cancer at Chiba University Hospital between 1999 and 2016. Of these, 222 patients with advanced prostate cancer (stage C or higher) were enrolled onto this study. The prognostic values of serum testosterone level and other clinical factors were evaluated in association with prostate-specific antigen (PSA), progression-free survival during first-line therapy, and overall survival. RESULTS Median age was 73 years. PSA at baseline was 86 ng/mL. Gleason scores of ≤ 6, 7, 8, and ≥ 9 were seen in 2.3%, 19.4%, 21.2%, and 41.9%, respectively. Mean follow-up was 60.5 months. Median testosterone at baseline was 482 ng/dL and nadir testosterone was 13 ng/dL. No variable associated with testosterone predicted progression-free survival. With regard to overall survival, multivariate analysis identified nadir testosterone ≤ 20 ng/dL (hazard ratio = 0.44, P = .026) and testosterone reduction ≥ 480 ng/dL (hazard ratio = 0.35, P = .030) as independent prognostic factors. With regard to progression-free survival, multivariate analysis identified nadir PSA ≤ 0.1 ng/mL (hazard ratio = 3.07, P < .001), presence of lymph node metastasis (hazard ratio = 1.67, P = .017), and time to nadir PSA (hazard ratio = 0.30, P < .001) as independent prognostic factors. CONCLUSION Our data suggested both nadir testosterone (< 20 ng/dL; P = .026) and testosterone reduction (≥ 480 ng/dL; P = .030) to be key prognostic factors for primary ADT in advanced prostate cancer in Japanese men.
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Affiliation(s)
| | | | - Xu Minhui
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Takaaki Tamura
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Kotaro Otsuka
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Kodai Sato
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | | | - Shuhei Kamada
- Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan
| | - Akinori Takei
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Miki Fuse
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Kouji Kawamura
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Takashi Imamoto
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Hospital, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
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Tanaka N, Nishimura K, Okajima E, Ina K, Ogawa O, Nagata H, Akakura K, Fujimoto K, Gotoh M, Teramukai S, Hirao Y. The efficacy and safety of docetaxel-based chemotherapy combined with dexamethasone 1 mg daily oral administration: JMTO Pca 10-01 phase II trial. Jpn J Clin Oncol 2017; 47:247-251. [PMID: 28042138 DOI: 10.1093/jjco/hyw193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 12/08/2016] [Indexed: 11/12/2022] Open
Abstract
Objectives Previously, one randomized control trial (TAX327) revealed the efficacy of docetaxel-based chemotherapy combined with prednisone. On the other hand, several studies showed a high prostate specific antigen (PSA) response with low-dose dexamethasone in castration-resistant prostate cancer (CRPC) patients. The objective of this study was to evaluate the efficacy and safety of docetaxel-based chemotherapy combined with dexamethasone in CRPC patients. Materials and methods This study was a single-arm multi-institutional phase II trial. Patients received 75 mg/m2 of docetaxel, and 0.5 mg of dexamethasone orally twice a day continuing throughout the treatment period. Treatment was planned for 10 cycles, and continued for at least four cycles depending on the observation of PSA flare. The primary endpoint was PSA response defined as a reduction from baseline of at least 50% that continued for at least 3 weeks. Secondary endpoints were safety, PSA flare, time to PSA failure and adherence rate to protocol treatment (10 cycles). Results Between January 2011 and February 2014, a total of 76 chemotherapy-naïve CRPC patients were enrolled. Seventy-five patients received docetaxel-based chemotherapy combined with dexamethasone. The median age and PSA level at enrollment were 71 years (53-85) and 23.2 ng/mL (2.9-852), respectively. PSA response rate was 76.8% (90% confidence interval (CI): 66.9-84.9). Of all patients, 30 patients completed 10 cycles of chemotherapy (40%). The incidence rate of PSA flare was 10.7% (eight patients). The median time to PSA failure was 369 days (95% CI: 245-369). The most frequently observed adverse event was hematotoxicity (neutropenia of G2 or greater: 100%). Conclusions The present study showed a significantly high PSA response compared with previous reports. Most patients tolerated the protocol treatment well, whereas hematotoxicity was often observed.
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Affiliation(s)
| | - Kazuo Nishimura
- Osaka Medical Center for Cancer and Cardiovascular Diseases, Department of Urology, Osaka
| | | | - Kenji Ina
- Nagoya Memorial Hospital, Department of Chemotherapy , Nagoya
| | - Osamu Ogawa
- Kyoto University, Department of Urology , Kyoto
| | | | - Koichiro Akakura
- JCHO Tokyo Shinjuku Medical Center, Department of Urology , Tokyo
| | | | | | - Satoshi Teramukai
- Kyoto Prefectural University of Medicine, Department of Biostatistics, Kyoto
| | - Yoshihiko Hirao
- Nara Medical University, Department of Urology, Kashihara.,Osaka Gyoumeikan Hospital, Department of Urology, Osaka, Japan
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39
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Yamada Y, Sakamoto S, Shimazaki J, Sugiura M, Amiya Y, Sasaki M, Shima T, Komiya A, Suzuki N, Akakura K, Ichikawa T, Nakatsu H. Significant prognostic difference between Grade Group 4 and 5 in the 2014 International Society of Urological Pathology Grading System for High Grade Prostate Cancer with Bone Metastasis. Prostate Int 2017; 5:143-148. [PMID: 29188201 PMCID: PMC5693457 DOI: 10.1016/j.prnil.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 03/07/2017] [Indexed: 02/03/2023] Open
Abstract
Background To investigate prognostic difference between Gleason Score (GS) 8 and 9–10, as the 2014 International Society of Urological Pathology Gleason Grading Systems proposed, in patients with prostate cancer (PCa) with bone metastasis. Materials and methods We retrospectively reviewed data on 106 patients with GS 8–10 between 2006 and 2016. All patients received androgen deprivation therapy immediately. We validated biochemical recurrence, PCa-specific survival, and overall survival, and analyzed the predictive value for overall survival. Results Patients with GS 9–10 had significantly lower PCa-specific survival (50.5% vs. 83.4%, P = 0.01) and overall survival (38.8% vs. 66.3%, P = 0.04) at 5 years than those with GS 8, while biochemical recurrence rate was not significantly different (P = 0.26). Furthermore, these significant differences between GS 8 and 9–10 were also observed among high-risk groups proposed in Japan Cancer of the Prostate Risk Assessment Stratification (prostate cancer-specific survival: P = 0.03, overall survival: P = 0.04, respectively). Pathological GS 9–10 was an independent prognostic factor for overall survival (hazard ratio = 1.97, P = 0.04) in multivariable cox proportional hazard regression analysis. Among patients with GS 9–10, albumin level was an only prognostic factor for overall survival (hazard ratio = 0.33, P < 0.01). Conclusion Pathological GS 9–10 predicts significantly worse outcomes than GS 8 in Japanese PCa patients with bone metastasis. Our data indicated clinical significance of discriminating the 2014 International Society of Urological Pathology Gleason Grading Group 4 and 5 among high-risk PCa patients with bone metastasis.
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Affiliation(s)
- Yasutaka Yamada
- Department of Urology, Asahi General Hospital, Chiba, Japan.,Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Jun Shimazaki
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masahiro Sugiura
- Department of Urology, Asahi General Hospital, Chiba, Japan.,Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Makoto Sasaki
- Department of Urology, Asahi General Hospital, Chiba, Japan
| | - Takayuki Shima
- Department of Urology, Asahi General Hospital, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Koichiro Akakura
- Department of Urology, Japan Community Healthcare Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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40
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Maruyama K, Tsuji H, Nomiya T, Katoh H, Ishikawa H, Kamada T, Wakatsuki M, Akakura K, Shimazaki J, Aoyama H, Tsujii H. Five-year quality of life assessment after carbon ion radiotherapy for prostate cancer. J Radiat Res 2017; 58:260-266. [PMID: 28043947 PMCID: PMC5439371 DOI: 10.1093/jrr/rrw122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/11/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to prospectively assess 5-year health-related quality of life (HRQOL) of patients treated with carbon ion radiotherapy (C-ion RT) for clinically localized prostate cancer. A total of 417 patients received carbon ion radiotherapy at a total dose of 63-66 Gray-equivalents (GyE) in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy (ADT) were administered for intermediate and high-risk patients. A HRQOL assessment was performed at five time points (immediately before the initiation of C-ion RT, immediately after, and at 12, 36 and 60 months after completion of C-ion RT) using Functional Assessment of Cancer Therapy (FACT) questionnaires. FACT-G and FACT-P scores were significantly decreased; however, the absolute change after 60 months was minimal. The transient decreases in the Trial Outcome Index (TOI) score returned to their baseline levels. Use of ADT, presence of adverse events, and biochemical failure were related to lower scores. Scores of subdomains of FACT instruments indicated characteristic changes. The pattern of HRQOL change after C-ion RT was similar to that of other modalities. Further controlled studies focusing on a HRQOL in patients with prostate cancer are warranted.
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Affiliation(s)
- Katsuya Maruyama
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Tsuji
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Takuma Nomiya
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Gunma Heavy-ion Medical Center, Gunma University, Gunma, Japan
| | - Hitoshi Ishikawa
- Department of Radiation Oncology, University of Tsukuba Faculty of Medicine, Ibaraki, Japan
| | - Tadashi Kamada
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Masaru Wakatsuki
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Koichiro Akakura
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Jun Shimazaki
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hirohiko Tsujii
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
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41
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Kasuya G, Ishikawa H, Tsuji H, Nomiya T, Makishima H, Kamada T, Akakura K, Suzuki H, Shimazaki J, Haruyama Y, Kobashi G, Tsujii H. Significant impact of biochemical recurrence on overall mortality in patients with high-risk prostate cancer after carbon-ion radiotherapy combined with androgen deprivation therapy. Cancer 2016; 122:3225-3231. [PMID: 27351298 PMCID: PMC5094521 DOI: 10.1002/cncr.30050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/18/2016] [Accepted: 04/04/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Whether biochemical recurrence (BR) is a significant predictive factor of mortality after definitive radiation therapy for prostate cancer remains unknown. The aim of the current study was to investigate the relation between BR and overall mortality (OAM) in high‐risk prostate cancer patients who were treated with carbon‐ion radiotherapy (CIRT) and had long‐term follow‐up in 2 prospective trials. METHODS In the 2 phase 2 clinical trials, which involved 466 prostate cancer patients who received 63.0 to 66.0 Gy of CIRT (relative biological effect) in 20 fractions between 2000 and 2007, 324 patients who were deemed to be at high risk on the basis of the modified D'Amico classification criteria and received CIRT along with androgen‐deprivation therapy (ADT) were examined. The OAM rate was adjusted for the ADT duration, and multivariate analyses using a Cox proportional hazards model were performed for OAM with BR as a time‐dependent covariate. RESULTS The median follow‐up period was 107.4 months, and the 5‐ and 10‐year OAM rates after adjustments for the ADT duration were 7.0% (95% confidence interval [CI], 4.0%‐9.4%) and 23.9% (95% CI, 16.4%‐26.2%), respectively. A multivariate analysis revealed that the presence of BR (hazard ratio, 2.82; 95% Cl, 1.57‐5.08; P = .001) was one of the predictive factors for OAM. On the other hand, the duration of ADT had no impact on OAM. CONCLUSIONS BR after CIRT combined with ADT is an independent predictive factor for OAM in high‐risk prostate cancer patients. The results of this study could be applied to other high‐dose radiation therapies. Cancer 2016;122:3225–31. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. Two prospective phase 2 studies involving 324 high‐risk prostate cancer patients treated with carbon‐ion radiotherapy have revealed that the presence of biochemical recurrence is an independent predictive factor for overall mortality (hazard ratio, 2.82; 95% confidence interval, 1.57‐5.08; P = .001) in patients with high‐risk prostate cancer after carbon‐ion radiotherapy according to a multivariate analysis.
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Affiliation(s)
- Goro Kasuya
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Hitoshi Ishikawa
- Department of Radiation Oncology, Graduate School of Medicine, Tsukuba University Faculty of Medicine, Ibaraki, Japan
| | - Hiroshi Tsuji
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
| | | | - Hirokazu Makishima
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Tadashi Kamada
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - Jun Shimazaki
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Hirohiko Tsujii
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
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Akakura K. [Intermittent hormone therapy]. Nihon Rinsho 2016; 74 Suppl 3:595-599. [PMID: 27344800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Akakura K. [Hormonal therapy for advanced prostate cancer: current status and issues]. Nihon Rinsho 2016; 74:124-128. [PMID: 26793892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
For advanced prostate cancer, hormonal therapy has been utilized as the first choice of treatment. In general, initial hormonal therapy consists of androgen deprivation therapy by means of bilateral orchiectomy, LHRH agonist or LHRH antagonist. It has been attempted to improve efficacy of hormonal therapy by several methods including combined androgen blockade (CAB: castration+antiandrogen), intermittent hormonal therapy, or chemohormonal therapy using docetaxel. The results of clinical trials demonstrated benefit of each hormonal therapy in the selected patients with advanced prostate cancer. In future, it is expected that personalized hormonal therapy would be established based on understanding of characteristics and selection of good candidates for several types of hormonal therapies.
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Yamada Y, Sakamoto S, Sazuka T, Goto Y, Kawamura K, Imamoto T, Nihei N, Suzuki H, Akakura K, Ichikawa T. Validation of active surveillance criteria for pathologically insignificant prostate cancer in Asian men. Int J Urol 2015; 23:49-54. [PMID: 26450768 DOI: 10.1111/iju.12952] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/26/2015] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To validate the ability of contemporary active surveillance protocols to predict pathologically insignificant prostate cancer among Asian men undergoing radical prostatectomy. METHODS We retrospectively reviewed data on 132 patients eligible for any active surveillance criteria out of 450 patients that underwent radical prostatectomy at several institutions between 2006 and 2013. We validated the ability of seven contemporary active surveillance protocols to predict pathologically insignificant prostate cancer. Traditional and updated criteria to define pathologically insignificant prostate cancer were used. Predictive factors for pathologically insignificant prostate cancer were determined by logistic regression analysis. RESULTS The predictive rate for updated pathologically insignificant prostate cancer of respective active surveillance criteria was 51% for Johns Hopkins Medical Institution, 41% for Prostate Cancer Research International: Active Surveillance Study, 39% for University of Miami, 32% for University of California, San Francisco, 32% for Memorial Sloan-Kettering Cancer Center, 31% for Kakehi and 27% for University of Toronto. Predictive rates for pathologically insignificant prostate cancer in Asian men were far lower than in USA men. On multivariate analysis, predictive factors of updated pathologically insignificant cancer was prostate volume (odds ratio 1.07, P = 0.004). By adding prostate volume to Prostate Cancer Research International: Active Surveillance Study criteria, the predictive rate for updated insignificant prostate cancer was improved up to 66.7%. CONCLUSIONS Active surveillance can be carried out considering the clinical characteristics of prostate cancers depending on ethnicity, as current active surveillance criteria seem to have a lower predictive ability value of insignificant prostate cancer in Asian men compared with men in Western countries.
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Affiliation(s)
- Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Goto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koji Kawamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takashi Imamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoki Nihei
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Koike M, Natsuyama T, Matsuzaki K, Yokota E, Shiozawa S, Chiba K, Akakura K. [REITER'S SYNDROME FOLLOWING INTRAVASICAL BCG THERAPY FOR UROTHELIAL CARCINOMA. SUMMARY OF CASE REPORTS OVER THE PAST 13 YEARS IN JAPAN, INCLUDING OUR CURRENT 6 CASES]. Nihon Hinyokika Gakkai Zasshi 2015; 106:238-242. [PMID: 26717781 DOI: 10.5980/jpnjurol.106.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Reiter's syndrome is one of the rare complications following intravesical bovis Bacillus Calmette-Guerin (BCG) treatment. In this study we have reviewed and discussed 101 cases including our own 6 cases over the past 13 years in Japan (2000-2013). The patients comprised 70 males and 25 females (6 cases were unknown), mean age of 63.1 (range 42 - 91). Arthritis occured 4-5 days after conjunctivitis. Thirty five (55%) of 68 patients needed corticosteroid treatment to control their arthritis. HLA-B27 is known as a risk factor of Reiter's syndrome, however, positive rate was only 2.4% (n = 41).
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Sakamoto S, Kamada S, Kawamura K, Nihei N, Imamoto T, Naya Y, Akakura K, Suzuki H, Ichikawa T. The prognostic value of nadir testosterone levels in prostate cancer patients treated with combined androgen blockade in Japanese men. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Koji Kawamura
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoki Nihei
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Yukio Naya
- Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | | | | | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Namekawa T, Fukasawa S, Komaru A, Kobayashi M, Imamura Y, Ohzeki T, Takagi K, Sato Y, Akakura K, Ichikawa T, Ueda T. Prospective evaluation of the safety of transrectal ultrasound-guided transperineal prostate biopsy based on adverse events. Int J Clin Oncol 2015; 20:1185-91. [DOI: 10.1007/s10147-015-0831-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/14/2015] [Indexed: 12/01/2022]
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Kamada S, Sakamoto S, Ando K, Muroi A, Fuse M, Kawamura K, Imamoto T, Suzuki H, Nagata M, Nihei N, Akakura K, Ichikawa T. Nadir Testosterone after Long-Term Followup Predicts Prognosis in Patients with Prostate Cancer Treated with Combined Androgen Blockade. J Urol 2015; 194:1264-70. [PMID: 25861958 DOI: 10.1016/j.juro.2015.03.120] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We examined the clinical significance of long-term serum testosterone monitoring to predict the prognosis of patients with prostate cancer treated with combined androgen blockade. MATERIALS AND METHODS We retrospectively analyzed the records of 225 patients who underwent combined androgen blockade as first line therapy for prostate cancer. The prognostic values of testosterone and other clinical factors were evaluated with respect to prostate specific antigen progression-free and overall survival. RESULTS Median patient age was 73.0 years, median prostate specific antigen was 42.6 ng/ml and median followup was 45.8 months. No variable associated with testosterone was predictive of progression-free survival. With regard to overall survival on univariate analysis nadir testosterone less than 16 ng/dl (p = 0.0190), less than 20 ng/dl (p = 0.0020) and less than 32 ng/dl (p = 0.0146) were significant together with other clinical factors. In contrast, nadir testosterone less than 8 and less than 12 ng/dl were not significant. Multivariate analysis showed that nadir testosterone less than 20 ng/dl was the significant prognostic factor (p = 0.0048). In addition, time to nadir testosterone was about 1 year (11.3 months). Patients were divided into rapid and slow types based on time to testosterone less than 20 ng/dl before and after 6 months, respectively. No significant difference in overall survival was observed between the 2 types. The current results suggest that the critical factor for prognosis was not a rapid decrease but whether nadir testosterone achieved a level of less than 20 ng/dl. CONCLUSIONS Nadir testosterone 20 ng/dl was the most significant cutoff level for overall survival in Japanese patients with prostate cancer treated with combined androgen blockade.
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Affiliation(s)
- Shuhei Kamada
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan.
| | - Keisuke Ando
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Ayumi Muroi
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Miki Fuse
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Koji Kawamura
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Takashi Imamoto
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Maki Nagata
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Naoki Nihei
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Koichiro Akakura
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Hospital, Chiba-city, Japan; Department of Urology, Toho University Medical Center Sakura Hospital, Sakura, Japan; Department of Urology, Yokohama Rosai Hospital, Yokohama City, Japan; Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku, Tokyo, Japan
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Kamada S, Sakamoto S, Ando K, Muroi A, Fuse M, Kawamura K, Imamoto T, Suzuki H, Nagata M, Nihei N, Akakura K, Ichikawa T. MP87-06 NADIR TESTOSTERONE AFTER LONG-TERM FOLLOW-UP PREDICTS PROGNOSIS OF PROSTATE CANCER PATIENTS TREATED WITH COMBINED ANDROGEN BLOCKADE. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Akakura K. Editorial Comment from Dr Akakura to Early radiotherapy after radical prostatectomy improves cancer-specific survival only in patients with highly aggressive prostate cancer: validation of recently released criteria. Int J Urol 2014; 22:97. [PMID: 25187069 DOI: 10.1111/iju.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan.
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