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Kitamura K, Sato N, Nakamura M, Iwawaki Y, Matsui T, Takasato Y, Sugiura S, Matsunaga K, Ito K. Identification of Allergens in Azuki (Adzuki) Bean Allergy. J Investig Allergol Clin Immunol 2024; 34:139-140. [PMID: 37669086 DOI: 10.18176/jiaci.0930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Affiliation(s)
- K Kitamura
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
| | - N Sato
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
- General Research and Development Institute, Hoyu Co, Ltd, Nagakute, Japan
| | - M Nakamura
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
- General Research and Development Institute, Hoyu Co, Ltd, Nagakute, Japan
| | - Y Iwawaki
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
| | - T Matsui
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
| | - Y Takasato
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
| | - S Sugiura
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
| | - K Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
| | - K Ito
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, Obu, Japan
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
- Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Kawamura H, Imuta N, Ooka T, Shigemi A, Nakamura M, Mougi K, Obama Y, Fukuyama R, Arimura S, Murata N, Tominaga H, Sasaki H, Nagano S, Taniguchi N, Nishi J. Impact of control measures including decolonization and hand hygiene for orthopaedic surgical site infection caused by MRSA at a Japanese tertiary-care hospital. J Hosp Infect 2024; 146:151-159. [PMID: 37516280 DOI: 10.1016/j.jhin.2023.07.011] [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: 04/22/2023] [Revised: 06/16/2023] [Accepted: 07/01/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Meticillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen in orthopaedic surgical site infections (SSIs). However, few studies have investigated the transmission process of orthopaedic MRSA SSI. AIM To investigate the transmission process of orthopaedic MRSA SSI using epidemiological and molecular analyses and to determine a method to prevent MRSA SSI in nosocomial orthopaedic surgery. METHODS Active MRSA surveillance, preoperative decolonization and contact precautions for MRSA-positive cases was performed at our institution. Changes in epidemic strains were evaluated and the possibility of transmission from patients in an orthopaedic ward of a Japanese tertiary-care hospital was assessed by genotyping stored MRSA strains. In addition, data on the prevalence of MRSA SSI, MRSA colonization, and use of an alcohol antiseptic agent (mL/patient-days) during 2005-2022 were retrospectively assessed. FINDINGS SCCmec type II strain in the SSI group decreased over time, associated with fewer outbreaks. Even during a period of high infection rates, no cases of transmission-induced SSI from nasal MRSA carriers were identified. The infection rate correlated negatively with the use of an alcohol antiseptic agent (r = -0.82; P < 0.0001). Two cases among five nasal carriers developed MRSA SSI caused by strains different from those related to nasal colonization. CONCLUSION The infection control measures for transmission from the hospital reservoirs including strict adherence to hand hygiene and decolonization of carriers is likely to be important for the prevention of orthopaedic MRSA SSI. However, the need for contact precautions for decolonized nasal carriers might be low.
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Affiliation(s)
- H Kawamura
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan; Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - N Imuta
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - T Ooka
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - A Shigemi
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan
| | - M Nakamura
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan; Clinical Laboratory, Kagoshima University Hospital, Kagoshima, Japan
| | - K Mougi
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan; Clinical Laboratory, Kagoshima University Hospital, Kagoshima, Japan
| | - Y Obama
- Clinical Laboratory, Kagoshima University Hospital, Kagoshima, Japan
| | - R Fukuyama
- Clinical Laboratory, Kagoshima University Hospital, Kagoshima, Japan
| | - S Arimura
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan
| | - N Murata
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan
| | - H Tominaga
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - H Sasaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - S Nagano
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - N Taniguchi
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - J Nishi
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan; Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Yamada Y, Fujii Y, Kakutani S, Kimura N, Sugimoto K, Hakozaki Y, Sugihara T, Takeshima Y, Kawai T, Nakamura M, Kamei J, Taguchi S, Akiyama Y, Sato Y, Yamada D, Urabe F, Miyazaki H, Enomoto Y, Fukuhara H, Nakagawa T, Fujimura T, Kume H. Development of risk-score model in patients with negative surgical margin after robot-assisted radical prostatectomy. Sci Rep 2024; 14:7607. [PMID: 38556562 PMCID: PMC10982299 DOI: 10.1038/s41598-024-58279-1] [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: 10/08/2023] [Accepted: 03/27/2024] [Indexed: 04/02/2024] Open
Abstract
A total of 739 patients underwent RARP as initial treatment for PCa from November 2011 to October 2018. Data on BCR status, clinical and pathological parameters were collected from the clinical records. After excluding cases with neoadjuvant and/or adjuvant therapies, presence of lymph node or distant metastasis, and positive SM, a total of 537 cases were eligible for the final analysis. The median follow-up of experimental cohort was 28.0 (interquartile: 18.0-43.0) months. We identified the presence of International Society of Urological Pathology grade group (ISUP-GG) ≥ 4 (Hazard ratio (HR) 3.20, 95% Confidence Interval (95% CI) 1.70-6.03, P < 0.001), lymphovascular invasion (HR 2.03, 95% CI 1.00-4.12, P = 0.049), perineural invasion (HR 10.7, 95% CI 1.45-79.9, P = 0.020), and maximum tumor diameter (MTD) > 20 mm (HR 1.9, 95% CI 1.01-3.70, P = 0.047) as significant factors of BCR in the multivariate analysis. We further developed a risk model according to these factors. Based on this model, 1-year, 3-year, and 5-year BCR-free survival were 100%, 98.9%, 98.9% in the low-risk group; 99.1%, 94.1%, 86.5% in the intermediate-risk group; 93.9%, 84.6%, 58.1% in the high-risk group. Internal validation using the bootstrap method showed a c-index of 0.742 and an optimism-corrected c-index level of 0.731. External validation was also carried out using an integrated database derived from 3 other independent institutions including a total of 387 patients for the final analysis. External validation showed a c-index of 0.655. In conclusion, we identified risk factors of biochemical failure in patients showing negative surgical margin after RARP and further developed a risk model using these risk factors.
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Affiliation(s)
- Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Yoichi Fujii
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shigenori Kakutani
- Department of Urology, Chiba Tokushukai Hospital, Funabashi-Shi, Chiba, Japan
| | - Naoki Kimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Kazuma Sugimoto
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Yuji Hakozaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Toru Sugihara
- Department of Urology, Jichi Medical University, Shimotsuke-Shi, Tochigi-Ken, Japan
| | - Yuta Takeshima
- Division of Innovative Cancer Therapy, Advanced Research Center, The Institute of Medical Science, The University of Tokyo, Minato-Ku, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Shinagawa-Ku, Tokyo, Japan
| | - Jun Kamei
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideyo Miyazaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Yutaka Enomoto
- Department of Urology, Mitsui Memorial Hospital, Chiyoda-Ku, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Jichi Medical University, Shimotsuke-Shi, Tochigi-Ken, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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Fujisawa T, Motegi A, Hirata H, Zenda S, Hojo H, Nakamura M, Oyoshi H, Tomizawa K, Zhou Y, Fukushi K, Kageyama SI, Enokida T, Okano S, Tahara M, Shinozaki T, Hayashi R, Matsuura K, Akimoto T. Long-term outcomes of patients with oral cavity cancer receiving postoperative radiotherapy after salvage neck dissection for cervical lymph node recurrence. Head Neck 2024; 46:541-551. [PMID: 38108511 DOI: 10.1002/hed.27609] [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] [Received: 08/03/2023] [Revised: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUNDS We aimed to clarify the outcomes of postoperative radiotherapy (PORT) after salvage neck dissection for cervical lymph node (LN) recurrence in oral cavity cancer. METHODS We retrospectively evaluated overall survival (OS), recurrence-free survival (RFS), recurrence patterns, and adverse events of 51 patients with high-risk features receiving PORT after salvage neck dissection between 2009 and 2019. RESULTS After a median follow-up of 7.4 years from PORT initiation, the 7-year OS and RFS rates were 66.3% (95% CI: 54.0-81.3) and 54.6% (95% CI: 42.1-70.9), respectively. Age <70 years and isolated LN recurrence were significantly associated with longer OS and RFS. Among the 22 patients who experienced recurrence, 14 experienced recurrence within the radiation field. PORT-related grade 3 acute mucositis (35%) and late adverse events (osteoradionecrosis [4%] and laryngeal stenosis [2%]) were observed. CONCLUSIONS PORT after salvage neck dissection for cervical LN recurrence achieved good survival with acceptable toxicity.
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Affiliation(s)
- Takeshi Fujisawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Hidekazu Oyoshi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kento Tomizawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuzheng Zhou
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Keiko Fukushi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
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Ono A, Nakamura M, Takada T, Miura S, Tsuru I, Izumi T, Kusakabe M, Mitarai S, Nagashima Y, Kume H, Morikawa T, Shiga Y. Bilateral fumarate hydratase deficient renal cell carcinoma in a patient with hereditary leiomyomatosis and renal cell cancer syndrome. IJU Case Rep 2024; 7:144-147. [PMID: 38440695 PMCID: PMC10909150 DOI: 10.1002/iju5.12688] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/17/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Patients with hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome have high risks of uterine and cutaneous leiomyomas and renal cell carcinoma (RCC), which are caused by germline mutation of the fumarate hydratase (FH) gene. RCC lesions are mostly high-grade tumors with a poor prognosis. Case presentation A 37-year-old man who had previously undergone treatment for a left RCC was referred to our hospital with a diagnosis of right RCC. Robot-assisted partial nephrectomy was performed, and the pathological diagnosis revealed fumarate hydratase (FH)-deficient RCC. The left RCC, which was originally diagnosed as mucinous tubular and spindle cell carcinoma, was reviewed and diagnosed as FH-deficient RCC. The patient's father and uncle both died of RCC, and the father's tumor was also immunohistochemically proven to be FH-deficient RCC. Conclusion HLRCC-related RCC should be considered in a differential diagnosis of young patients with a family history of RCC.
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Affiliation(s)
- Akihiro Ono
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | - Takuya Takada
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Sakiko Miura
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Ibuki Tsuru
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Taro Izumi
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | | | - Yoji Nagashima
- Department of Surgical PathologyTokyo Women's Medical UniversityTokyoJapan
| | - Haruki Kume
- Department of Urology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Teppei Morikawa
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
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Tomizawa K, Motegi A, Oyoshi H, Fujisawa T, Zenda S, Zhou Y, Nakamura M, Hirata H, Hojo H, Kageyama SI, Hirotaki K, Matsuura K, Akimoto T. Accelerated three-dimensional conformal radiotherapy for early-stage glottic cancer in reducing dose to the internal carotid artery and pharyngeal constrictor muscles. Head Neck 2024; 46:239-248. [PMID: 37933710 DOI: 10.1002/hed.27568] [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] [Received: 06/06/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND We evaluated clinical and dosimetric outcomes of radiotherapy using two anterior oblique portals (AOP), to reduce the dose to the bilateral internal carotid arteries (CAs) and pharyngeal constrictor muscle (PCM) during early-stage glottic cancer (ESGC) treatment. METHODS We identified patients with ESGC who underwent definitive radiotherapy between June 2014 and May 2020. RESULTS Among the 66 patients, 32 (48%) underwent radiotherapy using AOP, and the remaining underwent typical radiotherapy using parallel opposed lateral portals (POLP). The median follow-up duration was 53 months. No significant differences were observed in the 5-year local failure (0%/9.4%), progression-free survival (90.6%/90.8%), and overall survival (90.6%/91.0%) rates between the two groups. The grade ≥2 acute mucositis incidence rate was significantly lower in the AOP group (44%/85%). Radiotherapy using AOP maintained an adequate dose coverage to the target while markedly reducing the CAs and PCM doses. CONCLUSION Radiotherapy with AOP resulted in favorable clinical and dosimetric outcomes.
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Affiliation(s)
- Kento Tomizawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hidekazu Oyoshi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Fujisawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuzheng Zhou
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kouta Hirotaki
- Department of Radiological Technology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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7
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Tsuru I, Nakamura M, Izumi T, Ono A, Miura S, Morikawa T, Shigehara K, Kitamura T, Kume H, Shiga Y. A case of condyloma acuminatum of the bladder concurrently diagnosed with urothelial carcinoma. IJU Case Rep 2024; 7:42-45. [PMID: 38173455 PMCID: PMC10758899 DOI: 10.1002/iju5.12664] [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: 07/20/2023] [Accepted: 10/21/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Condyloma acuminatum usually occurs in the external genitalia and rarely in the bladder mucosa. Here, we report a case of condyloma acuminatum of the bladder that was detected concurrently with urothelial carcinoma. Case presentation A 42-year-old man was referred to our urology department with positive urine cytology for urothelial carcinoma. Cystoscopy revealed a broad-base nonpapillary bladder tumor. The patient underwent a transurethral resection of the bladder tumor. Pathological examination revealed urothelial carcinoma, high-grade pT1, and concurrent resection of condyloma acuminatum. DNA was extracted from the paraffin-embedded transurethral resection of the bladder tumor tissue specimens. HPV11 was detected in condylomas by PCR and in situ hybridization, whereas HPV was not detected in urothelial carcinomas. Conclusion We report a rare case of condyloma acuminatum of the bladder that was concurrently diagnosed with urothelial carcinoma from the same site.
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Affiliation(s)
- Ibuki Tsuru
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | - Taro Izumi
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Akihiro Ono
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Sakiko Miura
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Teppei Morikawa
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and UrologyKanazawa University Graduate School of Medical ScienceKanazawaJapan
| | | | - Haruki Kume
- Department of UrologyThe University of Tokyo hospitalTokyoJapan
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Shiratori T, Nakamura M, Naito A, Yamamoto M, Okura Y, Yamakawa J, Kume H, Suzuki M. Clinical features and treatment outcomes of Fournier's gangrene in a single tertiary emergency hospital: Simplified Fournier's Gangrene Severity Index score is a predictor for death. Glob Health Med 2023; 5:362-365. [PMID: 38162432 PMCID: PMC10730922 DOI: 10.35772/ghm.2023.01051] [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: 04/15/2023] [Revised: 10/08/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024]
Abstract
To assess the predictive reliability of the Simplified Fournier's Gangrene Severity Index Score (SFGSI) for mortality in Japanese patients with Fournier's gangrene (FG), we compared the clinical features and outcomes of a patient sample with the SFGSI. The medical records of 36 patients diagnosed with FG at our hospital between October 2007 and September 2022 were reviewed retrospectively. Clinical and laboratory variables, including SFGSI, were evaluated and predictive factors for fatality were investigated using multivariate logistic regression analysis. The median age and body mass index were 65 and 24.2, respectively. Eight patients had cooccurring chronic kidney disease and 23 had diabetes. None were taking sodium-glucose co-transporter-2 (SGLT-2) inhibitors. The causative organisms were diverse, and no specific trends in causative organisms were observed. 26 patients underwent debridement of necrotic tissue including eight colostomies, two orchiectomies, and one cystectomy. Multivariate logistic regression analysis revealed that SFGSI alone was an independent predictor of case fatality, with an odds ratio of 20.167 (95% CI: 1.66-245.53). In conclusion, the fatality rate was 19.4%, which was comparable to that reported in other studies. The SFGSI was an independent predictor of mortality in this study.
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Affiliation(s)
- Taichi Shiratori
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Akihiro Naito
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Masahiro Yamamoto
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Yoshihiro Okura
- Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Jun Yamakawa
- Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, The University of Tokyo Hospital, Tokyo, Japan
| | - Motofumi Suzuki
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
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9
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Oyoshi H, Du J, Sakai SA, Yamashita R, Okumura M, Motegi A, Hojo H, Nakamura M, Hirata H, Sunakawa H, Kotani D, Yano T, Kojima T, Nakamura Y, Kojima M, Suzuki A, Zenkoh J, Tsuchihara K, Akimoto T, Shibata A, Suzuki Y, Kageyama SI. Comprehensive single-cell analysis demonstrates radiotherapy-induced infiltration of macrophages expressing immunosuppressive genes into tumor in esophageal squamous cell carcinoma. Sci Adv 2023; 9:eadh9069. [PMID: 38091397 PMCID: PMC10848745 DOI: 10.1126/sciadv.adh9069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023]
Abstract
Radiotherapy (RT) combined with immunotherapy is promising; however, the immune response signature in the clinical setting after RT remains unclear. Here, by integrative spatial and single-cell analyses using multiplex immunostaining (CODEX), spatial transcriptome (VISIUM), and single-cell RNA sequencing, we substantiated the infiltration of immune cells into tumors with dynamic changes in immunostimulatory and immunosuppressive gene expression after RT. In addition, our comprehensive analysis uncovered time- and cell type-dependent alterations in the gene expression profile after RT. Furthermore, myeloid cells showed prominent up-regulation of immune response-associated genes after RT. Notably, a subset of infiltrating tumor-associated myeloid cells showing PD-L1 positivity exhibited significant up-regulation of immunostimulatory (HMGB1 and ISG15), immunosuppressive (SIRPA and IDO1), and protumor genes (CXCL8, CCL3, IL-6, and IL-1AB), which can be targets of immunotherapy in combination with PD-L1. These datasets will provide information on the RT-induced gene signature to seek an appropriate target for personalized immunotherapy combined with RT and guide the timing of combination therapy.
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Affiliation(s)
- Hidekazu Oyoshi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Junyan Du
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8568, Japan
| | - Shunsuke A. Sakai
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8568, Japan
| | - Riu Yamashita
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Division of Cancer Immunology, Research Institute/ Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8562, Japan
| | - Masayuki Okumura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Hironori Sunakawa
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Yuka Nakamura
- Pathology Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
| | - Motohiro Kojima
- Pathology Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
| | - Ayako Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8562, Japan
| | - Junko Zenkoh
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8562, Japan
| | - Katsuya Tsuchihara
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8568, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Atsushi Shibata
- Division of Molecular Oncological Pharmacy, Faculty of Pharmacy, Keio University, Shibakouen, Minato-ku, Tokyo, 105-8512, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8562, Japan
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
- Division of Cancer Immunology, Research Institute/ Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba 277-8577, Japan
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
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10
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Shibuki T, Sasaki M, Yamaguchi S, Inoue K, Taira T, Satake T, Watanabe K, Imaoka H, Mitsunaga S, Fujisawa T, Tomizawa K, Oyoshi H, Nakamura M, Hojo H, Ikeda M. Correction: Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study. Radiat Oncol 2023; 18:199. [PMID: 38111062 PMCID: PMC10717781 DOI: 10.1186/s13014-023-02377-3] [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: 12/20/2023] Open
Affiliation(s)
- Taro Shibuki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan.
| | - Mitsuhito Sasaki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Shota Yamaguchi
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kanae Inoue
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Tomonao Taira
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Tomoyuki Satake
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kazuo Watanabe
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hiroshi Imaoka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Shuichi Mitsunaga
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Takeshi Fujisawa
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kento Tomizawa
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hidekazu Oyoshi
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
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11
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Maezawa M, Inoue M, Satake R, Wakabayashi W, Oura K, Goto F, Miyasaka K, Hirofuji S, Iwata M, Suzuki T, Tanaka H, Nishida S, Shimizu S, Suzuki A, Iguchi K, Nakamura M. Effect of acid suppressant medications on the laxative action of magnesium preparations in patients with opioid-induced constipation: A pharmacovigilance analysis of the FDA Adverse Event Reporting System. Pharmazie 2023; 78:245-250. [PMID: 38178284 DOI: 10.1691/ph.2023.3624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Objective: Magnesium oxide is widely used for treating opioid-induced constipation, a serious analgesic-associated problem. Opioid analgesic users are often prescribed non-steroidal anti-inflammatory drugs, which are sometimes combined with acid suppressants to prevent gastrointestinal adverse events. Magnesium preparations combined with acid suppressants may diminish magnesium preparations' laxative effect. This study was aimed at evaluating the effect of magnesium preparations combined with acid suppressants on the incidence of opioid-induced constipation by using the Food and Drug Administration Adverse Event Reporting System. Methods: Adverse events were defined per the Medical Dictionary for Regulatory Activities; the term 'constipation (preferred term code: 10010774)' was used for analysis. After adjusting for patient background factors using propensity score matching, acid suppressants' effect on constipation incidence was evaluated in opioid users prescribed magnesium preparations alone as laxatives by using a test for independence. Key Findings: The Food and Drug Administration Adverse Event Reporting System contains 14,475,614 reports for January 2004 to December 2021. Significantly increased constipation incidence was related to magnesium preparations combined with acid suppressants, especially proton pump inhibitors (P < 0.0001, McNemar's test). Conclusion: Magnesium preparations combined with acid suppressants may diminish magnesium preparations' laxative effect; healthcare professionals should pay attention to this issue.
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Affiliation(s)
- M Maezawa
- Laboratory of Drug Informatics, Gifu Pharmaceutical Universit
| | - M Inoue
- Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - R Satake
- Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - W Wakabayashi
- Laboratory of Drug Informatics , Gifu Pharmaceutical University
| | - K Oura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - F Goto
- Laboratory of Drug Informatics, Gics, Gifu Pharmaceutical University
| | - K Miyasaka
- Laboratory of Drug Informatics, Gics, Gifu Pharmaceutical University
| | - S Hirofuji
- Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - M Iwata
- Laboratory of Drug Informatics, Gifu Pharmaceutical University; Kifune Pharmacy
| | - T Suzuki
- Laboratory of Drug Informatics, Gifu Pharmaceutical University; Gifu Prefectural Government
| | - H Tanaka
- Laboratory of Drug Informatics, Gifu Pharmaceutical University; Chubu Yakuhin Co. Ltd
| | - S Nishida
- Department of Pharmacy, Gifu University Hospital
| | - S Shimizu
- Department of Pharmacy, Gifu University Hospital
| | - A Suzuki
- Department of Pharmacy, Gifu University Hospital
| | - K Iguchi
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - M Nakamura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University; Corresponding author: Mitsuhiro Nakamura, Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4 Daigaku-nishi, Gifu, 501-1196, Japan mnakamura@gifu-pu. ac. jp
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12
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Narita Y, Matsushima T, Sakamoto Y, Matsuoka H, Tanioka H, Kawakami T, Shoji H, Mizukami T, Izawa N, Nishina T, Yamamoto Y, Mitani S, Nakamura M, Misumi T, Muro K. Chemotherapy after nivolumab for advanced gastric cancer (REVIVE): a prospective observational study. ESMO Open 2023; 8:102071. [PMID: 38016249 PMCID: PMC10774960 DOI: 10.1016/j.esmoop.2023.102071] [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: 07/04/2023] [Revised: 09/25/2023] [Accepted: 10/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Nivolumab therapy is a standard-of-care treatment for heavily pretreated patients with advanced gastric cancer (AGC). Previous studies have reported improvement in the objective response rate to chemotherapy after nivolumab therapy for other types of cancer. This study evaluated the efficacy and safety of chemotherapy after nivolumab therapy in AGC. PATIENTS AND METHODS We conducted a prospective, multicenter, observational study in pretreated patients with nivolumab-refractory or -intolerant AGC. Patients received irinotecan, oxaliplatin-containing regimens, or trifluridine/tipiracil. The primary endpoint was overall survival. RESULTS A total of 199 patients were included (median age: 69 years; male: 70%; female: 30%). Median overall survival and progression-free survival were 7.5 months [95% confidence interval (CI): 6.7-9.7 months] and 2.9 months (95% CI: 2.2-3.5 months), respectively. Objective response and disease control rates were 16.8% (95% CI: 11.6% to 23.6%) and 18.9% (95% CI: 38.9% to 54.6%), respectively. A prognostic index using alkaline phosphatase and the Glasgow Prognostic Score was generated to classify patients into three risk groups (good, moderate, and poor). The hazard ratios of the moderate and poor groups to the good group were 1.88 (95% CI: 1.22-2.92) and 3.29 (95% CI: 1.92-5.63), respectively. At the initiation of chemotherapy, 42 patients had experienced immune-related adverse events due to prior nivolumab therapy. The most common grade 3-4 adverse events were neutropenia (7.5%), anemia (8.0%), and anorexia (7.5%). CONCLUSIONS The administration of cytotoxic chemotherapy after nivolumab therapy may give rise to a synergistic antitumor effect in AGC. Further investigation is warranted to confirm these findings.
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Affiliation(s)
- Y Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya
| | - T Matsushima
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - Y Sakamoto
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki
| | - H Matsuoka
- Department of Gastrointestinal Surgery School of Medicine, Fujita Health University Hospital, Toyoake
| | - H Tanioka
- Department of Clinical Oncology, Kawasaki Medical School, Kurashiki
| | - T Kawakami
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - H Shoji
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Mizukami
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki; Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo
| | - N Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama
| | - Y Yamamoto
- Department of Gastroenterology, University of Tsukuba Hospital, Tsukuba
| | - S Mitani
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama
| | - M Nakamura
- Department of Gastroenterology, Sapporo City General Hospital, Sapporo
| | - T Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya.
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13
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Tsuru I, Nakamura M, Izumi T, Ono A, Masuda Y, Kusakabe M, Morikawa T, Kume H, Shiga Y. Asymptomatic renal granuloma diagnosed 3 years after Bacillus Calmette-Guérin intravesical injection: A case report and a literature review. IJU Case Rep 2023; 6:377-381. [PMID: 37928297 PMCID: PMC10622208 DOI: 10.1002/iju5.12627] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/03/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Intravesical Bacillus Calmette-Guérin immunotherapy is an effective treatment for non-muscle-invasive bladder cancer, which is occasionally associated with side effects and complications. The incidence of significant renal complications after intravesical Bacillus Calmette-Guérin immunotherapy is less than 2%. We report a case of renal granuloma after intravesical Bacillus Calmette-Guérin immunotherapy for bladder cancer, which radiologically resembled a papillary renal cell carcinoma. Case presentation A 65-year-old man, who had a medical history of urothelial carcinoma and received intravesical Bacillus Calmette-Guérin therapy, was referred to our Urology Department with a right renal tumor. Imaging findings suggested papillary renal cell carcinoma. Robot-assisted partial nephrectomy was performed, and the histopathological examination revealed epithelioid cell granuloma, which were considered to be Bacillus Calmette-Guérin-related renal granuloma. Conclusion Bacillus Calmette-Guérin-related renal granuloma mimicking papillary renal cell carcinoma have been reported. We should consider the possibility of renal granulomas when encountering image abnormalities for patients treated with intravesical Bacillus Calmette-Guérin therapy.
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Affiliation(s)
- Ibuki Tsuru
- Department of Urology NTT Medical Center Tokyo Tokyo Japan
| | | | - Taro Izumi
- Department of Urology NTT Medical Center Tokyo Tokyo Japan
| | - Akihiro Ono
- Department of Urology NTT Medical Center Tokyo Tokyo Japan
| | - Yoshio Masuda
- Department of Diagnostic Pathology NTT Medical Center Tokyo Tokyo Japan
| | | | - Teppei Morikawa
- Department of Diagnostic Pathology NTT Medical Center Tokyo Tokyo Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine The University of Tokyo Tokyo Japan
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14
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Ono A, Nakamura M, Hayashi T, Tsuru I, Izumi T, Kusakabe M, Nakao K, Kashiwagi M, Kume H, Shiga Y. Broad subcutaneous emphysema with airway obstruction during robot-assisted partial nephrectomy: A case report and literature review. IJU Case Rep 2023; 6:461-464. [PMID: 37928293 PMCID: PMC10622212 DOI: 10.1002/iju5.12648] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/16/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Subcutaneous emphysema is a relatively common complication in laparoscopic surgery. However, airway obstruction secondary to subcutaneous emphysema is rare. Case presentation A 63-year-old woman with a 56-mm left renal tumor underwent a robot-assisted partial nephrectomy. The operative time was 155 min, the insufflation time was 108 min, and the estimated blood loss was 70 mL. The pneumoperitoneum pressure was maintained at 12 mmHg, except at 15 mmHg for 19 min during tumor resection. The end-tidal CO2 was <47 mmHg throughout the procedure. Postoperatively, broad subcutaneous emphysema from the thigh to the eyelid was observed. Computed tomography revealed airway obstruction, and extubation was aborted. On postoperative day 1, emphysema around the trachea and neck improved and the intubation tube was successfully removed. Conclusion Both laryngeal emphysema and physical compression secondary to emphysema can cause airway obstruction. To reduce gas-related complications, the risk of developing subcutaneous emphysema should be properly assessed during robot-assisted laparoscopic surgery.
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Affiliation(s)
- Akihiro Ono
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | - Tomoe Hayashi
- Department of AnesthesiologyNTT Medical Center TokyoTokyoJapan
| | - Ibuki Tsuru
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Taro Izumi
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | - Kazunari Nakao
- Department of Otorhinolaryngology – Head & Neck SurgeryNTT Medical Center TokyoTokyoJapan
| | | | - Haruki Kume
- Department of Urology, Graduate School of MedicineThe University of TokyoTokyoJapan
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15
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Shibuki T, Sasaki M, Yamaguchi S, Inoue K, Taira T, Satake T, Watanabe K, Imaoka H, Mitsunaga S, Fujisawa T, Tomizawa K, Oyoshi H, Nakamura M, Hojo H, Ikeda M. Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study. Radiat Oncol 2023; 18:178. [PMID: 37907912 PMCID: PMC10617159 DOI: 10.1186/s13014-023-02367-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/20/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. METHODS We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. RESULTS During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7-14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280-3360 mL) to 280 mL (range 0-5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39-317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76-not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. CONCLUSION This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.
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Affiliation(s)
- Taro Shibuki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan.
| | - Mitsuhito Sasaki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Shota Yamaguchi
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kanae Inoue
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Tomonao Taira
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Tomoyuki Satake
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kazuo Watanabe
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hiroshi Imaoka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Shuichi Mitsunaga
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Takeshi Fujisawa
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Kento Tomizawa
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hidekazu Oyoshi
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan
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16
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Harada H, Suefuji H, Mori K, Ishikawa H, Nakamura M, Tokumaru S, Murakami M, Ogino T, Iwata H, Tatebe H, Kubo N, Waki T, Yoshida D, Nakamura M, Aoyama H, Araya M, Nakajima M, Nakayama H, Satouchi M, Shioyama Y. Proton and Carbon Ion Radiotherapy for Operable Early-Stage Lung Cancer: 3-Year Results of a Prospective Nationwide Registry. Int J Radiat Oncol Biol Phys 2023; 117:e23. [PMID: 37784924 DOI: 10.1016/j.ijrobp.2023.06.698] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this analysis was to report subset analysis as to progression-free survival (PFS) and overall survival (OS) of particle-beam radiation therapy for operable early-stage lung cancer. MATERIALS/METHODS Patients of early-stage lung cancer (T1-T2aN0) who were eligible for radical surgery but did not wish to undergo surgery were treated by proton-ion (PT) or carbon-ion (CT) radiation therapy and enrolled in Japanese prospective registry. In this analysis, PFS and OS by clinical stage, tumor location, pathological confirmation and particle-ion type were evaluated. RESULTS A total of 274 patients were enrolled and included in efficacy and safety analyses. Most tumors were adenocarcinoma (44%), and 105 (38%) were not histologically confirmed and diagnosed clinically. 250 (91%) of 274 patients had tumors that were peripherally situated. 138 (50%) and 136 (50%) patients were treated by PT and CT, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7 - 49.0). No grade 3 or severe treatment-related toxicity was observed. 3-year PFS was 81% (95% CI;76-86) and OS was 93% (95% CI;89-96), respectively. As to particle-ion type, 3-year PFS were 79.0% and 81.9% in PT and CT (p = 0.19), and 3-year OS were 93.9% and 91.1% in PT and CT (P = 0.72), respectively. For PFS, pathological confirmation, clinical stage was significant factors but there were no significant differences by tumor location or particle-ion type; for OS, clinical stage was significant factor but there was no significant difference on pathological confirmation, tumor location or particle-ion type (Table1). Table 1. 3-year PFS and OS CONCLUSION: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS on each subset.
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Affiliation(s)
- H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - H Suefuji
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
| | - K Mori
- Shizuoka Cancer Center, Nagaizumi, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - M Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Koriyama, Japan
| | - T Ogino
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - H Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Japan
| | - H Tatebe
- Fukui Prefectural Hospital Proton Therapy Center, Fukui, Japan
| | - N Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Waki
- Tsuyama Chuo Hospital, Tsuyama, Japan
| | - D Yoshida
- Kanagawa Cancer Center, Yokohama, Japan
| | - M Nakamura
- University of Tsukuba, Tsukuba City 305-8575, Japan
| | - H Aoyama
- Department of Radiation oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Japan
| | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Nakayama
- Kanagawa Prefectural Hospital Organization, Yokohama, Japan
| | | | - Y Shioyama
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
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17
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Yasui H, Okita Y, Nakamura M, Sagawa T, Watanabe T, Kataoka K, Manaka D, Shiraishi K, Akazawa N, Okuno T, Shimura T, Shiozawa M, Sunakawa Y, Ota H, Kotaka M, Okuyama H, Takeuchi M, Ichikawa W, Fujii M, Tsuji A. Ramucirumab plus FOLFIRI as second-line treatment for patients with RAS wild-type metastatic colorectal cancer previously treated with anti-EGFR antibody: JACCRO CC-16. ESMO Open 2023; 8:101636. [PMID: 37703596 PMCID: PMC10594013 DOI: 10.1016/j.esmoop.2023.101636] [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: 04/14/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Chemotherapy in combination with anti-epidermal growth factor receptor (EGFR) antibody is considered a first-line treatment regimen for RAS wild-type and left-sided metastatic colorectal cancer (mCRC), whereas second-line treatment regimens have not yet been established. Few studies have prospectively evaluated second-line treatment with anti-vascular endothelial growth factor antibody after first-line anti-EGFR antibody therapy for RAS wild-type mCRC. PATIENTS AND METHODS This non-randomized phase II trial investigated the clinical outcomes of second-line ramucirumab (RAM) plus fluorouracil, levofolinate, and irinotecan (FOLFIRI) after first-line anti-EGFR antibody in combination with doublet or triplet regimen in patients with RAS wild-type mCRC. The primary endpoint was the 6-month progression-free survival (PFS) rate. The secondary endpoints were PFS, overall survival (OS), objective response rate (ORR), rate of early tumor shrinkage (ETS), and safety. We hypothesized a threshold 6-month PFS rate of 30% and an expected 6-month PFS rate of 45%. Treatment was considered effective if the lower limit of the 90% confidence interval (CI) of the 6-month PFS rate was >0.30. RESULTS Ninety-two patients were enrolled in the study. The primary tumor was located on the left side in 86 (95.6%) patients. Twenty (22.0%) patients had received triplet plus cetuximab as previous therapy. Six-month PFS rate was 58.2% (90% CI 49.3% to 66.2%) with a median PFS of 7.0 months (95% CI 5.7-7.6 months). Median OS was 23.6 months (95% CI 16.5-26.3 months). The ORR and ETS rate were 10.7% and 16.9%, respectively, in 83 patients with measurable lesions. The 6-month PFS rate was comparable between patients previously treated with doublet and triplet regimens; however, median PFS was longer for the doublet regimen (7.4 versus 6.4 months, P = 0.036). CONCLUSIONS Our study demonstrated prospectively that RAM plus FOLFIRI is an effective second-line treatment after anti-EGFR antibody-containing first-line therapy in RAS wild-type and left-sided mCRC. Furthermore, the results were similar for patients who were previously treated with triplet regimen.
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Affiliation(s)
- H Yasui
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe
| | - Y Okita
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun
| | - M Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto
| | - T Sagawa
- Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Sapporo
| | - T Watanabe
- Department of Surgery, Japanese Red Cross Society Himeji Hospital, Himeji
| | - K Kataoka
- Division of Lower GI, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya
| | - D Manaka
- Department of Surgery, Gastro-Intestinal Center, Kyoto Katsura Hospital, Kyoto
| | - K Shiraishi
- Department of Medical Oncology, National Hospital Organization Nagoya Medical Center, Nagoya
| | - N Akazawa
- Department of Gastroenterological Surgery, Sendai City Medical Center Sendai Open Hospital, Sendai
| | - T Okuno
- Department of Medical Oncology, Osaka Rosai Hospital, Sakai
| | - T Shimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - M Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama
| | - Y Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - H Ota
- Department of Gastroenterological Surgery, Ikeda City Hospital, Ikeda
| | - M Kotaka
- Gastrointestinal Cancer Center, Sano Hospital, Kobe
| | - H Okuyama
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun
| | - M Takeuchi
- Graduate School of Mathematical Sciences, The University of Tokyo, Meguro-ku
| | - W Ichikawa
- Division of Medical Oncology, Showa University Fujigaoka Hospital, Yokohama
| | - M Fujii
- Department of Digestive Surgery, Nihon University School of Medicine, Itabashi-ku, Japan
| | - A Tsuji
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun.
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18
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Tomizawa K, Hojo H, Zhou Y, Oyoshi H, Fujisawa T, Kageyama SI, Nakamura M, Hirata H, Motegi A, Zenda S, Akimoto T. Compensatory Enlargement of the Liver after Proton Beam Therapy for Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e346. [PMID: 37785203 DOI: 10.1016/j.ijrobp.2023.06.2414] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Charged particle therapy (CPT) has been applied as a safe and effective treatment option for hepatocellular carcinoma (HCC). Although most HCC patients have cirrhosis, favorable treatment outcome has been achieved with CPT preserving liver function. After proton beam therapy (PBT) for patients with HCC, the liver volume in the non-irradiated area is often enlarged. Here, we evaluated whether enlargement of the non-irradiated liver affects preserving hepatic function and prognosis in HCC patients treated with PBT. MATERIALS/METHODS Among consecutive patients with HCC treated with PBT between April 2011 and July 2017, we retrospectively identified patients who fulfilled the following criteria: (i) receiving PBT to the right hepatic lobe, (ii) the left lateral segment was not irradiated, (iii) no local treatment was performed for liver within 12 months after PBT, and (iv) the albumin-bilirubin (ALBI) score was evaluable at 12 months after PBT. The left lateral segment was defined as the non-irradiated region and measured by contrast-enhanced CT just before and 3 months after PBT. ALBI scores just before and 12 months after PBT were compared to evaluate changes of hepatic function. Overall survival rate was estimated using the Kaplan-Meier method, and differences in survival between subgroups were examined using the log-rank test. The ALBI scores were compared using the Wilcoxon signed-rank test. RESULTS We identified 40 patients (male/female = 32/8). The median age at the start date of PBT was 72 (range, 54-87) years. The prescribed dose was 66.0-76.0 Gy (relative biological effectiveness) delivered in 10-38 fractions. The median follow-up was 61 (range, 12-126) months. The 5-year overall survival rates were 79.0% (95% CI: 60.4-100.0%) in the larger enlargement group (n = 16, enlarged volume of non-irradiated region 3 months after PBT ≥75 cm3) and 53.7% (95% CI: 36.0-79.9%) in the smaller enlargement group (n = 24, as above, <75 cm3), respectively (p = 0.21). The median ALBI scores just before and 12 months after PBT were -3.14 (95% CI: -3.22- (-2.53)) and -2.74 (95% CI: -3.07- (-2.42)) in the larger enlargement group (p = 0.09), and -2.91 (95% CI: -3.15- (-2.40)) and -2.59 (95% CI: -2.74- (-2.12)) in the smaller enlargement group (p = 0.006), respectively. CONCLUSION Our study suggests that larger enlargement of the non-irradiated liver after PBT is related to well-preserved liver function at 1 year and modestly associated with a favorable prognosis.
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Affiliation(s)
- K Tomizawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - H Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Y Zhou
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - H Oyoshi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - T Fujisawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S I Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - M Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - H Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - A Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - T Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
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19
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Oyoshi H, Hirata H, Hirano Y, Zenda S, Zhou Y, Tomizawa K, Fujisawa T, Nakamura M, Hojo H, Motegi A, Kageyama SI, Zenke Y, Goto K, Ishihara S, Naganawa S, Akimoto T. Prognostic impact of EGFR/ALK alterations in leptomeningeal metastasis from lung adenocarcinoma treated with whole-brain radiotherapy. Clin Exp Metastasis 2023; 40:407-413. [PMID: 37468822 DOI: 10.1007/s10585-023-10225-7] [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: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Abstract
The prognosis and prognostic factors of patients receiving whole-brain radiotherapy (WBRT) for leptomeningeal metastasis (LM) from lung adenocarcinoma have not been established. Particularly, the impact of EGFR mutations and ALK rearrangements on survival remains unclear. This retrospective study evaluated the prognosis and prognostic factors of patients receiving WBRT for LM. We evaluated overall survival (OS) from WBRT initiation and clinical variables in 80 consecutive patients receiving WBRT for LM from lung adenocarcinoma at our institution between June 2013 and June 2021. After a median follow-up of 5.2 (range 0.5-56.5) months, the median OS was 6.2 months (95% CI 4.4-12.4). Of the 80 patients, 51 were classified as EGFR/ALK mutant (EGFR: 44; ALK: 6; both: 1) and 29 as wild-type. The median OS was 10.4 (95% CI 5.9-20.9) versus 3.8 (95% CI 2.5-7.7) months in the EGFR/ALK-mutant versus wild-type patients (HR = 0.49, P = 0.0063). Multivariate analysis indicated that EGFR/ALK alterations (HR = 0.54, P = 0.021) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1 (HR = 0.25, P < 0.001) were independent factors associated with favorable OS. Among the patients who underwent brain MRI before and after WBRT, intracranial progression-free survival was longer in the 26 EGFR/ALK-mutant than 13 wild-type patients (HR = 0.31, P = 0.0039). Although the prognosis of patients receiving WBRT for LM remains poor, EGFR/ALK alterations and good ECOG PS may positively impact OS in those eligible for WBRT.
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Affiliation(s)
- Hidekazu Oyoshi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan.
| | - Yasuhiro Hirano
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Yuzheng Zhou
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kento Tomizawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Fujisawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Yoshitaka Zenke
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shunichi Ishihara
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Radiation Oncology and Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
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20
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Matsuo Y, Murofushi K, Kokubo M, Sakamoto T, Morita S, Hiraoka M, Nakamura M, Mizowaki T. Long-Term Results of a Multi-Institutional Study of Dynamic Tumor Tracking-Stereotactic Body Radiotherapy for Lung Tumors. Int J Radiat Oncol Biol Phys 2023; 117:S31. [PMID: 37784474 DOI: 10.1016/j.ijrobp.2023.06.294] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We had conducted a multi-institutional phase II study to evaluate the safety and efficacy of dynamic tumor tracking-stereotactic body radiotherapy (DTT-SBRT) for lung tumors. The primary endpoint was 2-year local control, which was reported to be 95.2%. After the initial evaluation of the primary endpoint, the study was extended as an observational study which was designed to evaluate 5-year survival and late toxicities. We present the long-term results of DTT-SBRT for lung tumors. MATERIALS/METHODS The main eligibility criteria for the study were as follows: (1) primary or metastatic lung cancer with a diameter of 5 cm or less, and up to 3 lesions without any extrapulmonary lesions; (2) ineligibility to standard surgery, or patient's refusal of surgery; (3) ECOG-PS of 0 to 2; and (4) expected range of respiratory motion of 10 mm or more. The study included 48 patients from four institutions with the median age of 80 years (range, 49-90 years). Forty-two patients had primary non-small-cell lung cancer, and 6 patients had metastatic lung tumors. Forty-eight tumors (median diameter, 23.5 mm; range, 5-47 mm) in 48 patients were targeted for DTT-SBRT using a gimbal-mounted linear accelerator. Prior to treatment planning, spherical gold markers were placed around the tumor to detect internal tumor motion using fluoroscopy. The prescribed dose was 50 Gy in four fractions. Treatment beams were delivered with DTT according to a 4D model that predicts internal tumor motion with abdominal wall motion. DTT-SBRT was successfully delivered to all but one patient who had poor correlation between abdominal wall and tumor motion. RESULTS Median follow-up period at data cutoff was 5.0 years (interquartile range, 3.1-6.3 years). Twenty-nine patients died; the causes of death were cancer-specific in 10 patients, comorbidity in 14 patients (pulmonary disease, renal failure, cerebral infarction, other malignancies, etc.), and unknown in 5 patients without cancer recurrence. Overall survival at 5 years was 51.5% (95% confidence interval [CI], 36.5-64.6%). Progression-free survival and local control at 5 years were 41.0% (95% CI, 27.0-54.5%) and 92.6% (95% CI, 78.7-97.6%), respectively. There were no grade 4-5 toxicities. One patient (2%) developed grade 3 radiation pneumonitis at 3 months. Grade 2 toxicities were observed in 9 patients (19%), including dyspnea, radiation pneumonitis, pleural effusion, rib fracture, and dermatitis. CONCLUSION Dynamic tumor tracking SBRT achieved the long-term efficacy with low incidence of severe toxicities in lung tumors with respiratory motion. In this elderly patient cohort, non-cancer deaths were observed more than cancer-specific deaths.
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Affiliation(s)
- Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Murofushi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Hiraoka
- Department of Radiation Oncology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - M Nakamura
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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21
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Nakamura M, Tsuru I, Izumi T, Ono A, Inoue Y, Muraki Y, Yamada Y, Tsuji Y, Watanabe J, Fujimura M, Kihara S, Naito A, Shiratori T, Amakawa R, Inatsu H, Yoshimatsu T, Kashiwagi M, Fukuda A, Morikawa T, Kusakabe M, Suzuki M, Kameyama S, Kume H, Shiga Y. Advantages of enhanced recovery after surgery program in robot-assisted radical cystectomy. Sci Rep 2023; 13:16237. [PMID: 37758782 PMCID: PMC10533885 DOI: 10.1038/s41598-023-43489-w] [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: 06/29/2023] [Accepted: 09/25/2023] [Indexed: 09/29/2023] Open
Abstract
Radical cystectomy is a gold-standard treatment for muscle-invasive bladder cancer. We recently introduced robot-assisted radical cystectomy (RARC) with perioperative enhanced recovery after surgery (ERAS). The medical records of patients with bladder cancer who underwent open radical cystectomy (ORC) or RARC/ERAS at NTT Medical Center Tokyo were retrospectively reviewed to compare the surgical outcomes, hospital stay, and medical costs between groups. Multidisciplinary full ERAS items were provided for the RARC/ERAS group. The median estimated blood losses in the ORC and RARC/ERAS groups were 650 and 100 mL, and the median operative times were 312 and 445 min, respectively. In addition, the median times to liquid food intake in these groups were 6 and 0 days, the median times to first flatus and first defecation were 2 and 1 day, and 3 and 1.5 days, respectively. The rates of postoperative ileus in the ORC and RARC/ERAS groups were 27.5% and 4.5%, and the median postoperative hospital stays was 26.5 and 12 days, respectively. Medical costs excluding surgery were significantly lower in the RARC/ERAS group. In conclusion, RARC/ERAS represents a safe treatment option for muscle-invasive bladder cancer with decreased perioperative complications and lower medical costs.
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Affiliation(s)
- Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
| | - Ibuki Tsuru
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Taro Izumi
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Akihiro Ono
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Yasushi Inoue
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Yasuko Muraki
- Information System Group, NTT Medical Center Tokyo, Tokyo, Japan
- Critical Pathway Committee, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yumi Yamada
- Critical Pathway Committee, NTT Medical Center Tokyo, Tokyo, Japan
- Nursing Department, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yuko Tsuji
- Nutrition Department, NTT Medical Center Tokyo, Tokyo, Japan
| | - Junko Watanabe
- Department of Rehabilitation, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Shunsuke Kihara
- Operating Department, NTT Medical Center Tokyo, Tokyo, Japan
| | - Akihiro Naito
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Taichi Shiratori
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Ryo Amakawa
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Hiroki Inatsu
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | - Tadashi Yoshimatsu
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
| | | | - Akira Fukuda
- Department of Rehabilitation, NTT Medical Center Tokyo, Tokyo, Japan
| | - Teppei Morikawa
- Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Motofumi Suzuki
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | | | - Haruki Kume
- Department of Urology, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshiyuki Shiga
- Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan
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22
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Katsurahara M, Umeda Y, Yukimoto H, Shigefuku A, Nakamura M, Hamada Y, Tanaka K, Horiki N, Hayashi A, Nakagawa H. Gastrointestinal: Small bowel hemangioma with unusual endoscopic findings and complicated with obscure gastrointestinal bleeding. J Gastroenterol Hepatol 2023; 38:1455. [PMID: 36751046 DOI: 10.1111/jgh.16109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/17/2022] [Accepted: 01/07/2023] [Indexed: 02/09/2023]
Affiliation(s)
- M Katsurahara
- Department of Endoscopic Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Y Umeda
- Department of Endoscopic Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - H Yukimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - A Shigefuku
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - M Nakamura
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Y Hamada
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - K Tanaka
- Department of Endoscopic Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - N Horiki
- Department of Endoscopic Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - A Hayashi
- Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Japan
| | - H Nakagawa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
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Nakamura M. Feasibility of robot-assisted partial nephrectomy in morbidly obese patients. Transl Androl Urol 2023; 12:1211-1212. [PMID: 37680232 PMCID: PMC10481193 DOI: 10.21037/tau-23-312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/12/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
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24
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Du J, Kageyama SI, Yamashita R, Tanaka K, Okumura M, Motegi A, Hojo H, Nakamura M, Hirata H, Sunakawa H, Kotani D, Yano T, Kojima T, Hamaya Y, Kojima M, Nakamura Y, Suzuki A, Suzuki Y, Tsuchihara K, Akimoto T. Transposable elements potentiate radiotherapy-induced cellular immune reactions via RIG-I-mediated virus-sensing pathways. Commun Biol 2023; 6:818. [PMID: 37543704 PMCID: PMC10404237 DOI: 10.1038/s42003-023-05080-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 08/01/2022] [Accepted: 06/28/2023] [Indexed: 08/07/2023] Open
Abstract
Radiotherapy (RT) plus immunotherapy is a promising modality; however, the therapeutic effects are insufficient, and the molecular mechanism requires clarification to further develop combination therapies. Here, we found that the RNA virus sensor pathway dominantly regulates the cellular immune response in NSCLC and ESCC cell lines. Notably, transposable elements (TEs), especially long terminal repeats (LTRs), functioned as key ligands for the RNA virus sensor RIG-I, and the mTOR-LTR-RIG-I axis induced the cellular immune response and dendritic cell and macrophage infiltration after irradiation. Moreover, RIG-I-dependent immune activation was observed in ESCC patient tissue. scRNA sequencing and spatial transcriptome analysis revealed that radiotherapy induced the expression of LTRs, and the RNA virus sensor pathway in immune and cancer cells; this pathway was also found to mediate tumour conversion to an immunological hot state. Here, we report the upstream and ligand of the RNA virus sensor pathway functions in irradiated cancer tissues.
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Affiliation(s)
- Junyan Du
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Shun-Ichiro Kageyama
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan.
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan.
| | - Riu Yamashita
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Kosuke Tanaka
- Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Masayuki Okumura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
| | - Atsushi Motegi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
| | - Hidehiro Hojo
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
| | - Masaki Nakamura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
| | - Hidenari Hirata
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
| | - Hironori Sunakawa
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Yamato Hamaya
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Motohiro Kojima
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Yuka Nakamura
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Ayako Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Katsuya Tsuchihara
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Tetsuo Akimoto
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
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25
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Amano H, Eshima K, Ito Y, Nakamura M, Kitasato H, Ogawa F, Hosono K, Iwabuchi K, Uematsu S, Akira S, Narumiya S, Majima M. The microsomal prostaglandin E synthase-1/prostaglandin E2 axis induces recovery from ischaemia via recruitment of regulatory T cells. Cardiovasc Res 2023; 119:1218-1233. [PMID: 35986688 PMCID: PMC10411941 DOI: 10.1093/cvr/cvac137] [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: 01/29/2021] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Microsomal prostaglandin E synthase-1 (mPGES-1)/prostaglandin E2 (PGE2) induces angiogenesis through the prostaglandin E2 receptor (EP1-4). Among immune cells, regulatory T cells (Tregs), which inhibit immune responses, have been implicated in angiogenesis, and PGE2 is known to modulate the function and differentiation of Tregs. We hypothesized that mPGES-1/PGE2-EP signalling could contribute to recovery from ischaemic conditions by promoting the accumulation of Tregs. METHODS AND RESULTS Wild-type (WT), mPGES-1-deficient (mPges-1-/-), and EP4 receptor-deficient (Ep4-/-) male mice, 6-8 weeks old, were used. Hindlimb ischaemia was induced by femoral artery ligation. Recovery from ischaemia was suppressed in mPges-1-/- mice and compared with WT mice. The number of accumulated forkhead box protein P3 (FoxP3)+ cells in ischaemic muscle tissue was decreased in mPges-1-/- mice compared with that in WT mice. Expression levels of transforming growth factor-β (TGF-β) and stromal cell derived factor-1 (SDF-1) in ischaemic tissue were also suppressed in mPges-1-/- mice. The number of accumulated FoxP3+ cells and blood flow recovery were suppressed when Tregs were depleted by injecting antibody against folate receptor 4 in WT mice but not in mPges-1-/- mice. Recovery from ischaemia was significantly suppressed in Ep4-/- mice compared with that in WT mice. Furthermore, mRNA levels of Foxp3 and Tgf-β were suppressed in Ep4-/- mice. Moreover, the number of accumulated FoxP3+ cells in ischaemic tissue was diminished in Ep4-/- mice compared with that in Ep4+/+ mice. CONCLUSION These findings suggested that mPGES-1/PGE2 induced neovascularization from ischaemia via EP4 by promoting the accumulation of Tregs. Highly selective EP4 agonists could be useful for the treatment of peripheral artery disease.
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Affiliation(s)
- Hideki Amano
- Department of Pharmacology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Koji Eshima
- Department of Immunology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yoshiya Ito
- Department of Pharmacology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Masaki Nakamura
- Department of Microbiology, Kitasato University School of Allied Health Science, Kanagawa, Japan
| | - Hidero Kitasato
- Department of Microbiology, Kitasato University School of Allied Health Science, Kanagawa, Japan
| | - Fumihiro Ogawa
- Department of Pharmacology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Kanako Hosono
- Department of Pharmacology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Kazuya Iwabuchi
- Department of Immunology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Satoshi Uematsu
- Department of Immunology and Genomics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shizuo Akira
- Laboratory of Host Defense, WPI Immunology Frontier Research Center (IFReC), Osaka University, Osaka, Japan
| | - Shuh Narumiya
- Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masataka Majima
- Department of Pharmacology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Department of Medical Therapeutics, Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan
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26
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Inoue T, Nakamura M, Masuyama S, Azuma T, Ichihara T. [Endovascular Treatment of a Ruptured Mediastinal Bronchial Artery Aneurysm]. Kyobu Geka 2023; 76:358-361. [PMID: 37150914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Case 1:A 73-year-old man was transported to our hospital for evaluation of sudden onset of chest pain, back pain, and dyspnea. We initially misdiagnosed him with advanced esophageal cancer accompanied by mediastinal metastasis;however, subsequent multi-detector row computed tomography (MDR-CT) confirmed the diagnosis. We performed coil embolization of a bronchial artery aneurysm and thoracic endovascular aortic repair( TEVAR) to seal the root of the bronchial artery. Case 2:An 81-year-old woman with a one-week history of fever and cervical pain was diagnosed with a ruptured infected thoracic aneurysm. She underwent the same treatment as described in Case 1. Physicians should consider it as a differential diagnosis of mediastinal hematoma.
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Affiliation(s)
- Takehiko Inoue
- Department of Cardiovascular Surgery, Otakanomori Hospital, Kashiwa, Japan
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27
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Mutoh N, Kakiuchi I, Hiraku A, Iwabuchi N, Kiyosawa K, Igarashi K, Tanaka M, Nakamura M, Miyasaka M. Heat-killed Lactobacillus helveticus improves mood states: a randomised, double-blind, placebo-controlled study. Benef Microbes 2023; 14:109-118. [PMID: 37026368 DOI: 10.3920/bm2022.0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 04/08/2023]
Abstract
We investigated the effects of heat-killed Lactobacillus helveticus MCC1848 on daily mood states in healthy young adults. Participants (n=58) were randomised to receive heat-killed L. helveticus MCC1848 powder or placebo powder for 4 weeks. During the study period, adverse events were recorded in the participant diary. Mood states were assessed before and 2 and 4 weeks after initiation of the intervention. The primary outcomes were the shortened version of the Profile of Mood States 2 (POMS 2) scores. Secondary outcomes included other mood state (State-Trait Anxiety Inventory (STAI); visual analogue scale (VAS)), quality of life (acute form of the SF-36v2), sleep (Athens Insomnia Scale (AIS)) and fatigue (Chalder Fatigue Scale (CFS)) scores. Four weeks of heat-killed L. helveticus MCC1848 intake, compared to placebo, significantly improved the shortened version of the POMS 2 'friendliness' and the VAS 'relaxed' scores, which are two indicators of positive mood states. On the other hand, heat-killed L. helveticus MCC1848 intake had no significant effects on negative mood state items (e.g. anger, nervousness, confusion) assessed by the shortened version of the POMS 2, STAI and VAS. AIS and CFS scores also showed no significant differences. No adverse effects were observed with 4 weeks of heat-killed L. helveticus MCC1848 intake. These results suggest that daily consumption of heat-killed L. helveticus MCC1848 is safe and has the potential to improve positive mood states. UMIN Clinical Trial Registry: UMIN000043697.
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Affiliation(s)
- N Mutoh
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, 2528583 Zama-city, Kanagawa, Japan
| | - I Kakiuchi
- Department of Nursing, Matsumoto Junior College, 3118, Sasaga, 399-0033, Matsumoto-city, Nagano, Japan
| | - A Hiraku
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, 2528583 Zama-city, Kanagawa, Japan
| | - N Iwabuchi
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, 2528583 Zama-city, Kanagawa, Japan
| | - K Kiyosawa
- Department of Nursing, Matsumoto Junior College, 3118, Sasaga, 399-0033, Matsumoto-city, Nagano, Japan
| | - K Igarashi
- Department of Nursing, Matsumoto Junior College, 3118, Sasaga, 399-0033, Matsumoto-city, Nagano, Japan
| | - M Tanaka
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, 2528583 Zama-city, Kanagawa, Japan
| | - M Nakamura
- Matsumoto City Hospital, 4417-180 Hata, 390-1401 Matsumoto-city, Nagano, Japan
| | - M Miyasaka
- Department of Nursing, Matsumoto Junior College, 3118, Sasaga, 399-0033, Matsumoto-city, Nagano, Japan
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28
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Tamura K, Nakamori M, Matsuda K, Hotta T, Nakamura M, Yokoyama S, Iwahashi M, Yamade N, Yamaue H. Elective colorectal cancer surgery in nonagenarians and postoperative outcomes. Updates Surg 2023:10.1007/s13304-023-01498-4. [PMID: 36997824 DOI: 10.1007/s13304-023-01498-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 03/22/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVES The population of very elderly patients is increasing, and nonagenarians have significantly higher mortality rates and poorer rates of survival than younger patients. Meanwhile, recent studies have shown colorectal cancer surgery in nonagenarian patients to be feasible regarding postoperative outcomes. This retrospective study aims to evaluate the postoperative outcomes of nonagenarians in the latest clinical settings. METHODS Consecutive nonagenarian patients who underwent elective colorectal cancer surgery between 2018 and 2020 retrospectively enrolled (Trial registration number: UMIN000046296 on December 7th, 2021). Clinicopathological data and short-term postoperative outcomes were collected for statistical analysis. RESULTS This study included 81 nonagenarian patients (31 males, 50 females). Postoperative complications occurred in 21 patients (25.9%), and 3 patients died within 90 days (3.7%). Multivariate analysis revealed prognostic nutritional index was a significant predictor of postoperative complications (OR 2.99, 95% CI 0.78-9.10, P = 0.048), and performance status ≥ 3 could be an independent risk factor of 90-day mortality (HR 32.30, 95% CI 3.20-326.10, P = 0.032). CONCLUSIONS Short-term outcomes after surgical treatment for nonagenarian patients with colorectal cancer were acceptable. Low prognostic nutritional index was closely related to postoperative complications and poor performance status could also lead to 90-day mortality. In aging populations, risk stratification to prevent poorer postoperative outcomes in nonagenarian patients is needed.
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Affiliation(s)
- Koichi Tamura
- Department of Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1, Kidohigashicho, Kawachinagano, Osaka, 586-8521, Japan.
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
| | - Mikihito Nakamori
- Department of Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1, Kidohigashicho, Kawachinagano, Osaka, 586-8521, Japan
| | - Kenji Matsuda
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Tsukasa Hotta
- Department of Surgery, Naga Municipal Hospital, Kinokawa, Wakayama, Japan
| | - Masaki Nakamura
- Department of Surgery, Hashimoto Municipal Hospital, Hashimoto, Wakayama, Japan
| | - Shozo Yokoyama
- Department of Surgery, National Hospital Organization Minami Wakayama Medical Center, Tanabe, Wakayama, Japan
| | - Makoto Iwahashi
- Department of Surgery, Wakayama Rosai Hospital, Wakayama, Wakayama, Japan
| | - Naohisa Yamade
- Department of Surgery, Shingu Municipal Medical Center, Shingu, Wakayama, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan
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29
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Suzuki M, Yamamoto M, Shiratori T, Naito A, Nakamura M. Evaluation of trends in prescription drugs for overactive bladder in Japanese patients. Int J Urol 2023; 30:331-333. [PMID: 36479727 DOI: 10.1111/iju.15117] [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: 12/12/2022]
Affiliation(s)
- Motofumi Suzuki
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
| | - Masahiro Yamamoto
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
| | - Taichi Shiratori
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
| | - Akihiro Naito
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
| | - Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
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30
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Sekita T, Asano N, Kubo T, Mitani S, Hattori N, Yoshida A, Kobayashi E, Komiyama M, Toshikazu U, Nakayama R, Kawai A, Nakamura M, Ichikawa H. 45O Clonal evolution of dedifferentiated liposarcoma. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101082] [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: 04/05/2023] Open
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31
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Tanaka A, Nguyen H, Dhillon JS, Nakamura M, Zhou SF, Sandhu HK, Miller CC, Safi HJ, Estrera AL. Reappraisal of the role of motor and somatosensory evoked potentials during open distal aortic repair. J Thorac Cardiovasc Surg 2023; 165:944-953. [PMID: 34517983 DOI: 10.1016/j.jtcvs.2021.08.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/14/2020] [Revised: 07/14/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Intraoperative motor and somatosensory evoked potentials have been applied to monitor spinal cord ischemia during repair. However, their predictive values remain controversial. The purpose of this study was to evaluate the impact of motor evoked potentials and somatosensory evoked potentials on spinal cord ischemia during open distal aortic repair. METHODS Our group began routine use of both somatosensory evoked potentials and motor evoked potentials at the end of 2004. This study used a historical cohort design, using risk factor and outcome data from our department's prospective registry. Univariate and multivariable statistics for risk-adjusted effects of motor evoked potentials and somatosensory evoked potentials on neurologic outcome and model discrimination were assessed with receiver operating characteristic curves. RESULTS Both somatosensory evoked potentials and motor evoked potentials were measured in 822 patients undergoing open distal aortic repair between December 2004 and December 2019. Both motor evoked potentials and somatosensory evoked potentials were intact for the duration of surgery in 348 patients (42%). Isolated motor evoked potential loss was observed in 283 patients (34%), isolated somatosensory evoked potential loss was observed in 18 patients (3%), and both motor evoked potential and somatosensory evoked potential loss were observed in 173 patients (21%). No spinal cord ischemia occurred in the 18 cases with isolated somatosensory evoked potential loss. When both signals were lost, signal loss happened in the order of motor evoked potentials and then somatosensory evoked potentials. Immediate spinal cord ischemia occurred in none of those without signal loss, 4 of 283 (1%) with isolated motor evoked potential loss, and 15 of 173 (9%) with motor evoked potential plus somatosensory evoked potential loss. Delayed spinal cord ischemia occurred in 12 of 348 patients (3%) with intact evoked potentials, 24 of 283 patients (8%) with isolated motor evoked potentials loss, and 27 of 173 patients (15%) with motor evoked potentials + somatosensory evoked potentials loss (P < .001). Motor evoked potentials and somatosensory evoked potentials loss were each independently associated with spinal cord ischemia. For immediate spinal cord ischemia, no return of motor evoked potential signals at the conclusion of the surgery had the highest odds ratio of 15.87, with a receiver operating characteristic area under the curve of 0.936, whereas motor evoked potential loss had the highest odds ratio of 3.72 with an area under the curve of 0.638 for delayed spinal cord ischemia. CONCLUSIONS Somatosensory evoked potentials and motor evoked potentials are both important monitoring measures to predict and prevent spinal cord ischemia during and after open distal aortic repairs. Intraoperative motor evoked potential loss is a risk for immediate and delayed spinal cord ischemia after open distal aortic repair, and somatosensory evoked potential loss further adds predictive value to the motor evoked potential.
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Affiliation(s)
- Akiko Tanaka
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Hung Nguyen
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Jaydeep S Dhillon
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Masaki Nakamura
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Shao-Feng Zhou
- Department of Anesthesiology, McGovern Medical School at UTHealth, Houston, Tex
| | - Harleen K Sandhu
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Charles C Miller
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Hazim J Safi
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex
| | - Anthony L Estrera
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth, Houston, Tex.
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32
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Inoue T, Ichihara T, Masuyama S, Nakamura M. [Optimal Management of Stanford Type A Acute Aortic Dissection with Mesenteric Malperfusion]. Kyobu Geka 2023; 76:179-187. [PMID: 36861272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The optimal management of Stanford type A accute aortic dissection (TAAAD) with mesenteric malperfusion (TAAADwM) is controversial. Our strategy of TAAADwM is open superior mesenteric artery (SMA) bypass prior to aortic repair, if we suspect TAAADwM on computed tomography (CT) scan, whatever other findings might be or not. The need of treatment of mesenteric malperfusion prior to aortic repair is not always linked with digestive symptom, lactate, intraoperative finding. The mortality of 14 patients with TAAADwM was 21.4%, which was an allowable result. Our strategy might be proper at instances of, allowable time for management of open SMA bypass, unnecessarily of endovascular treatment, confirming an enteric property and ability to respond to a rapid hemodynamic change.
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Affiliation(s)
- Takehiko Inoue
- Department of Cardiovascular Surgery, Otakanomori Hospital, Kashiwa, Japan
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33
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Nakamura M, Suzuki M, Izumi T, Tsuru I, Muraki Y, Kume H. Trends in surgical treatment for prostate cancer: Analysis of National Database Open Data in Japan. Glob Health Med 2023; 5:62-63. [PMID: 36865896 PMCID: PMC9974222 DOI: 10.35772/ghm.2022.01065] [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: 11/14/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023]
Abstract
We conducted a study to clarify the trends in surgical treatments for prostate cancer in Japan between 2014 and 2020 by analyzing the National Database (NDB) Open Data in Japan. Intriguingly, the number of patients over 70 years old who underwent robotic-assisted radical prostatectomy (RARP) nearly doubled from 2015 to 2019, while that in those 69 years old and younger remained almost constant during the same period. The increase in the number of patients over 70 years of age may reflect the fact that RARP can be safely applied to elderly patients. With the new development and spread of surgery-assisting robots, we can foresee a further increase in the number of RARPs performed for elderly patients in the future.
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Affiliation(s)
- Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan;,Address correspondence to:Masaki Nakamura, Department of Urology, NTT Medical Center Tokyo 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan. E-mail:
| | - Motofumi Suzuki
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Taro Izumi
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ibuki Tsuru
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yasuko Muraki
- Nursing Department, NTT Medical Center Tokyo, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, The University of Tokyo Hospital, Tokyo, Japan
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34
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Nakamura M, Kageyama SI, Hirata H, Tochinai T, Hojo H, Motegi A, Kanai A, Suzuki Y, Tsuchihara K, Akimoto T. Detection of Pretreatment Circulating Tumor DNA Predicts Recurrence after High-Dose Proton Beam Therapy for Early-Stage Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)00166-9. [PMID: 36822372 DOI: 10.1016/j.ijrobp.2023.02.021] [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: 08/22/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Taku Tochinai
- Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Akinori Kanai
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan
| | - Katsuya Tsuchihara
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
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Habu T, Kumanishi R, Ogata T, Fujisawa T, Mishima S, Kotani D, Kadowaki S, Nakamura M, Hojo H, Fujiwara H, Kumagai S, Koyama S, Fujita T, Kinoshita T, Nishikawa H, Yano T, Tajika M, Muro K, Mitsunaga S, Kojima T, Bando H. Complete response to definitive chemoradiotherapy in unresectable locally advanced esophageal squamous cell carcinoma. Esophagus 2023:10.1007/s10388-023-00987-0. [PMID: 36750480 DOI: 10.1007/s10388-023-00987-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Although definitive chemoradiotherapy (CRT) is the standard therapy for patients with unresectable locally advanced esophageal squamous cell carcinoma (ESCC), poor survival has been reported. Although the complete response (CR) rate is strongly correlated with good prognosis, the predictive factors for CR have not been elucidated. METHODS This registry study aimed to identify predictors of CR to definitive CRT in patients with unresectable locally advanced ESCC. "Unresectable" was defined as the primary lesion invading unresectable adjacent structures such as the aorta, vertebral body, and trachea (T4b), or the regional and/or supraclavicular lymph nodes invading unresectable adjacent structures (LNT4b). RESULTS Overall, 175 patients who started definitive CRT between January 2013 and March 2020 were included. The confirmed CR (cCR) rate was 24% (42/175). The 2-year progression-free survival (PFS) and overall survival (OS) rates of cCR cases vs. non-cCR cases were 59% vs. 2% (log-rank p < 0.001) and 90% vs. 31% (log-rank p < 0.001), with a median follow-up period of 18.5 and 40.5 months, respectively. Multivariate analysis of clinicopathological factors revealed that tumor length ≥ 6 cm [odds ratio (OR) 0.446; 95% CI 0.220-0.905; p = 0.025] was a predictor of cCR. CONCLUSIONS Favorable PFS and OS rates were observed in patients with cCR. Tumor length was a predictive factor for cCR.
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Affiliation(s)
- Takumi Habu
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
- Division of Cancer Immunology, Research Institute/Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center, Kashiwa, Japan
- Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryosuke Kumanishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takatsugu Ogata
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takeshi Fujisawa
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Saori Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masaki Nakamura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hidehiro Hojo
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hisashi Fujiwara
- Division of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shogo Kumagai
- Division of Cancer Immunology, Research Institute/Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center, Kashiwa, Japan
| | - Shohei Koyama
- Division of Cancer Immunology, Research Institute/Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center, Kashiwa, Japan
| | - Takeo Fujita
- Division of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takahiro Kinoshita
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroyoshi Nishikawa
- Division of Cancer Immunology, Research Institute/Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center, Kashiwa, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shuichi Mitsunaga
- Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hideaki Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Bando H, Kumagai S, Kotani D, Mishima S, Habu T, Tsushima T, Hara H, Kadowaki S, Kato K, Chin K, Yamaguchi K, Kageyama SI, Hojo H, Nakamura M, Hidenobu T, Wakabayashi M, Fukui M, Fuse N, Nishikawa H, Kojima T. Investigation of predictive biomarkers in patients treated with atezolizumab monotherapy following definitive chemoradiotherapy for unresectable locally advanced esophageal squamous cell carcinoma (EPOC1802). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.416] [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: 01/25/2023] Open
Abstract
416 Background: Platinum-based definitive chemoradiotherapy (dCRT) is the standard treatment for patients (pts) with unresectable locally advanced esophageal squamous cell carcinoma (ESCC), invading the aorta, vertebral body, or trachea. However, complete response (CR) rates are low (11–25%), with a median overall survival (OS) of 9–10 months. We previously reported atezolizumab following dCRT indicated promising 42.1% of confirmed CR (cCR) rate and 65.8% of 12-months OS (Bando H, et al., ESMO Congress 2022 ). Methods: We investigated predictive biomarkers for cCR in this multicenter phase II study. PD-L1 tumor proportion score (TPS) was examined with VENTANA PD-L1. Immunological phenotypes of tumor microenvironments were assessed with multiplex immunohistochemistry (mIHC) and multi-color flow cytometry (FCM). Cancer gene aberrations and gene expression were investigated with whole exome and whole transcriptome sequencing (WES/WTS), respectively. Results: In 35 pts with an evaluable PD-L1 TPS, the cCR rates of <1% and ≥1% were 44.4% and 41.2%, respectively. In mIHC analysis of 28 pts, the number of CD3+CD8+PD-1+ T cells and CD3+CD8-FOXP3+ T cells prior to CRT in tumor tissue were significantly correlated with cCR and non-cCR, respectively (both are P<0.05). In FCM analysis of 19 pts, tumor-infiltrating PD-1+CD8+ T cells prior to CRT, after CRT, and after atezolizumab were significantly correlated with cCR (P<0.05). On the other hand, CTLA-4+FOXP3highCD45RA-CD4+ regulatory T cells (Treg cells) after CRT were significantly correlated with non-cCR (P<0.05). In WES of 27 pts, MYC amplification, EGFR mutation, PIK3CA mutation, PTEN mutation, and KEAP1 mutation were detected in pts with non-cCR. In WTS of 27 pts, gene expression signatures of IFN-γ response and inflammatory response were enhanced after CRT. Gene expression signatures of epithelial mesenchymal transition (EMT) and TGF-β signalings prior to CRT were significantly enriched in pts with cCR. Conclusions: Our biomarker analysis suggests that tumor-infiltrating PD-1+CD8+ T cells prior to CRT may be a predictive biomarker for cCR of CRT followed by atezolizumab, and that several driver gene abnormalities, cancer intrinsic signatures and tumor-infiltrating Treg cells are associated with treatment resistance. These findings could enable subsequent biomarker-selected clinical trials and lead to the development of novel cancer immunotherapeutic strategies. Clinical trial information: UMIN000034373 .
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Affiliation(s)
- Hideaki Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shogo Kumagai
- Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Saori Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takumi Habu
- National Cancer Center Hospital Japan East, Kashiwa, Japan
| | - Takahiro Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Ken Kato
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Keisho Chin
- Department of Gastroenterological Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterological Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shun-ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tachibana Hidenobu
- Radiation Safety and Quality Assurance division, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masashi Wakabayashi
- Division for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Fukui
- Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nozomu Fuse
- Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroyoshi Nishikawa
- Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Noda T, Nochioka K, Kaikita K, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H, Yasuda S. Antithrombotic monotherapy for stable coronary artery disease and atrial fibrillation patients with and without prior coronary artery revascularization: Insights from the AFIRE trial. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Japan Cardiovascular Research Foundation under a contract with Bayer Yakuhin
Background
The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial demonstrated that rivaroxaban monotherapy was noninferior to combination therapy with rivaroxaban plus a single antiplatelet therapy regarding efficacy and superior for safety endpoints in patients with atrial fibrillation and stable coronary artery disease including patients not requiring revascularization [prior percutaneous coronary intervention (PCI) or bypass grafting (CABG)].
Purpose
The aim of this post-hoc subgroup analysis was to investigate the efficacy and safety of rivaroxaban monotherapy compared to combination therapy in patients with and without prior revascularization.
Methods
Among 2,215 patients included in the modified intention-to-treat analysis in the AFIRE trial, 1445 patients (65.2%) had undergone previous PCI alone, and 252 (11.4%) had undergone previous CABG. The remaining 518 patients (23.4%) was categorized as a group without prior revascularization and then compared with a group with prior revascularization (PCI or CABG). The primary efficacy end point was a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death from any cause. The primary safety end point was major bleeding, according to the criteria of the International Society on Thrombosis and Hemostasis.
Results
In 1697 patients with prior revascularization, efficacy and safety endpoints of rivaroxaban monotherapy were superior to combination therapy (efficacy: HR 0.62, 95%CI 0.45-0.85, p=0.003; safety: HR 0.62, 95%CI 0.39-0.98, p=0.040), whereas there were no significant differences in efficacy and safety endpoints among 518 patients without prior revascularization (efficacy: HR 1.19, 95%CI 0.67-2.11, p=0.553; safety: HR 0.47, 95%CI 0.18-1.26, p=0.125). There was a borderline interaction of efficacy endpoint (P for interaction=0.055) by randomized treatment assignment (Figure 1 and Figure 2). Compared with combination therapy, the safety benefit of rivaroxaban monotherapy on any bleeding was significant in patients without prior revascularization (HR 0.59, 95%CI 0.38-0.93, p=0.022).
Conclusions
In patients with prior PCI or CABG, rivaroxaban monotherapy resulted in more favorable safety and efficacy outcomes than combination therapy. There was a borderline interaction for primary efficacy outcome between prior revascularization and anti-thrombotic therapy.
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Affiliation(s)
- T Noda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Kaikita
- University of Miyazaki, Faculty of Medicine, Division of Cardiovascular Medicine and Nephrology, Department of Internal Medi , Miyazaki , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - T Matoba
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
| | - M Nakamura
- Toho University Ohashi Medical Center, Division of Cardiovascular Medicine , Tokyo , Japan
| | - K Miyauchi
- Juntendo Tokyo Koto Geriatric Medical Center, Department of Cardiovascular Medicine , Tokyo , Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology , Tokyo , Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center , Yokohama , Japan
| | - A Hirayama
- Osaka Police Hospital, Department of Cardiology , Osaka , Japan
| | - K Matsui
- Kumamoto University, Department of General Medicine and Primary Care , Kumamoto , Japan
| | - H Ogawa
- Kumamoto University , Kumamoto , Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
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Sakakibara M, Sumida H, Yanagida K, Miyasato S, Nakamura M, Sato S. 338 Bitter taste receptor T2R38 expressed on skin-infiltrating lymphocytes regulates lymphocyte migration. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.351] [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: 11/19/2022]
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Nakamura M, Magara T, Yoshimitsu M, Kano S, Matsubara A, Kato H, Morita A. 458 Tertiary lymphoid structures improve survival in virus-negative Merkel cell carcinoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.472] [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: 11/19/2022]
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Noda‐Narita S, Naito T, Udagawa H, Goto K, Miyawaki T, Mamesaya N, Nakashima K, Kenmotsu H, Shimokawaji T, Kato T, Hakozaki T, Okuma Y, Nakamura M, Nakayama Y, Watanabe H, Kusumoto M, Ohe Y, Horinouchi H. Nivolumab-induced radiation recall pneumonitis in non-small-cell lung cancer patients with thoracic radiation therapy. Cancer Sci 2022; 114:630-639. [PMID: 36285515 PMCID: PMC9899626 DOI: 10.1111/cas.15621] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 11/30/2022] Open
Abstract
The role of previous thoracic radiation therapy as a risk factor of immune-related pneumonitis is unclear. Furthermore, some patients develop radiation recall pneumonitis, which is characterized by a radiation pneumonitis-like imaging pattern with consolidation progressing within a previous radiation field. In this multicenter retrospective study, we analyzed the relationship of previous thoracic radiation therapy with immune-related pneumonitis and the characteristics of radiation recall pneumonitis. The medical records of patients with non-small-cell lung cancer who had received nivolumab between December 2015 and March 2017 at five institutions were retrospectively reviewed. Incidence, imaging patterns, clinical course, and risk factors of immune-related pneumonitis and radiation recall pneumonitis were evaluated. A total of 669 patients were evaluated, and the incidences of all-grade and grade 3 or higher immune-related pneumonitis were 8.8% and 2.6%, respectively. The incidences of immune-related pneumonitis were 13.2% (34/257) and 6.1% (25/412) in patients with and those without previous thoracic radiation therapy, respectively. A history of previous thoracic radiation therapy was associated with immune-related pneumonitis (odds ratio, 2.11; 95% confidence interval, 1.21-3.69 in multivariate analysis). Among the patients with previous thoracic radiation therapy, 6.2% (16/257) showed radiation recall pattern. This study found an increased risk of nivolumab-induced immune-related pneumonitis associated with a history of thoracic radiation therapy. Radiation recall pattern was one of the major patterns of immune-related pneumonitis among the patients with previous thoracic radiation therapy. Incidence, risk factors, and clinical outcome of radiation recall pneumonitis were elucidated.
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Affiliation(s)
- Shoko Noda‐Narita
- Department of Thoracic OncologyNational Cancer Center HospitalTokyoJapan
| | - Tomoyuki Naito
- Department of Thoracic OncologyNational Cancer Center Hospital EastKashiwaJapan
| | - Hibiki Udagawa
- Department of Thoracic OncologyNational Cancer Center Hospital EastKashiwaJapan
| | - Koichi Goto
- Department of Thoracic OncologyNational Cancer Center Hospital EastKashiwaJapan
| | - Taichi Miyawaki
- Department of Thoracic OncologyShizuoka Cancer CenterShizuokaJapan
| | - Nobuaki Mamesaya
- Department of Thoracic OncologyShizuoka Cancer CenterShizuokaJapan
| | | | | | | | - Terufumi Kato
- Department of Thoracic OncologyKanagawa Cancer CenterYokohamaJapan
| | - Taiki Hakozaki
- Department of Thoracic Oncology and Respiratory MedicineTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory MedicineTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
| | - Masaki Nakamura
- Department of Radiation OncologyNational Cancer Center Hospital EastKashiwaJapan
| | - Yuko Nakayama
- Department of Radiation OncologyNational Cancer Center HospitalTokyoJapan
| | - Hirokazu Watanabe
- Department of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
| | - Masahiko Kusumoto
- Department of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
| | - Yuichiro Ohe
- Department of Thoracic OncologyNational Cancer Center HospitalTokyoJapan
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Awaya T, Koizumi T, Enomoto Y, Moroi M, Nakamura M. Response to: T2 mapping should be utilized in cases of suspected myocarditis to confirm an acute inflammatory process. QJM 2022; 115:782. [PMID: 34931679 DOI: 10.1093/qjmed/hcab327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Awaya
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - T Koizumi
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Y Enomoto
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - M Moroi
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - M Nakamura
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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Oyoshi H, Hirata H, Hirano Y, Zenda S, Fujisawa T, Nakamura M, Hojo H, Motegi A, Kageyama S, Akimoto T. Prognosis after Whole-Brain Radiotherapy for Leptomeningeal Metastasis in Patients with Lung Adenocarcinoma with or without EGFR/ALK Alterations. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.806] [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: 11/30/2022]
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Awaya T, Koizumi T, Enomoto Y, Moroi M, Nakamura M. Response to: Note the distinction between myocarditis, novel coronavirus myocarditis and COVID-19 vaccine-associated myocarditis. QJM 2022; 115:696. [PMID: 34791457 PMCID: PMC9619480 DOI: 10.1093/qjmed/hcab281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- T Awaya
- Address correspondence to Dr T. Awaya, Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
| | - T Koizumi
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
| | - Y Enomoto
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
| | - M Moroi
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
| | - M Nakamura
- From the Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
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Nakamura M, Yamada Y, Sato Y, Honda K, Yamada D, Kawai T, Akiyama Y, Suzuki M, Kume H. Preservation of pelvic floor muscles contributes to early continence recovery after robot-assisted radical prostatectomy. PLoS One 2022; 17:e0275792. [PMID: 36206288 PMCID: PMC9543982 DOI: 10.1371/journal.pone.0275792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Postoperative recovery of urinary continence has a great impact on quality of life for patients undergoing robot-assisted radical prostatectomy (RARP). A variety of surgical techniques including reconstruction of the periurethral structure have been introduced, and yet there are no effective methods that promote early urinary continence recovery after surgery. We hypothesized that the preservation of pelvic floor muscle structure could be responsible for early recovery of urinary continence after surgery. METHODS A total of 94 consecutive patients who underwent RARP at our hospital were enrolled in this study. Operative video records were reviewed and the severity of pelvic floor muscle injury was classified according to the scoring system that we devised in this study. Briefly, damage of pelvic floor muscles was classified into 4 categories; intact, fascial injury, unilateral muscle injury, and bilateral muscle injury. The volume of urinary incontinence was measured for 2 days after removal of the urethral catheter, and the incontinence ratio (amount of incontinence/total volume of urine per day) was calculated. Predictive factors for immediate incontinence after catheter removal were identified by multivariate regression analysis. RESULTS The severity of puboperineal muscle injury was significantly associated with the early incontinence ratio after catheter removal (p < 0.001). Age at surgery and severity of puboperineal muscle injury were independent predictors for early incontinence after catheter removal. CONCLUSION Preservation of the pelvic floor muscle, particularly the puboperineal muscle is an important factor for early continence recovery after RARP.
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Affiliation(s)
- Masaki Nakamura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
- * E-mail:
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuki Honda
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motofumi Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Ishii M, Kaikita K, Yasuda S, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H, Tsujita K. Effect of rivaroxaban monotherapy vs. combination with anti-platelet therapy in patients with atrial fibrillation and stable coronary artery disease across different body mass index categories. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1223] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial showed both noninferiority for efficacy and superiority for safety endpoints of rivaroxaban monotherapy compared to rivaroxaban plus antiplatelet therapy (combination therapy) in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD). However, no accumulating evidence regarding efficacy and safety of these fixed-dose direct oral anticoagulant therapy was available in underweight and obese patients.
Purpose
The aim of this post-hoc analysis of the AFIRE trial was to evaluate outcomes of rivaroxaban monotherapy (vs. combination therapy) in patients with AF and stable CAD across body mass index (BMI) categories.
Methods
Patients were categorized into groups 1 (underweight: BMI of <18.5 kg/m2), 2 (normal: BMI of 18.5 to <25 kg/m2), 3 (overweight: BMI of 25 to <30 kg/m2), and 4 (obesity: BMI of ≥30 kg/m2). Efficacy (a composite of all-cause death, myocardial infarction, unstable angina requiring revascularization, stroke, or systemic embolism) and safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria) were compared between rivaroxaban monotherapy and combination therapy across BMI categories.
Results
We analyzed 2,054 patients with a median age of 75.0 (interquartile range [IQR], 69 to 80)) years old and CHA2DS2-VASc of 4 (IQR, 3 to 5). Group 1 through 4 included 72 (3.5%), 1,158 (56.4%), 680 (33.1%), 144 (7.0%) patients and 62.3%, 52.3%, 36.2%, and 30.3% were received reduced dose of rivaroxaban, respectively. Although the sample sizes for group 1 and 4 were limited, monotherapy was superior to combination therapy for efficacy in group 2 (hazard ratio [HR], 0.64; 95% CI, 0.44 to 0.95) and safety in group 3 (HR, 0.25; 95% CI, 0.10 to 0.62), whereas a significant difference in the endpoints was not observed in the other BMI categories. Impact of monotherapy on endpoints did not have a significant interaction in BMI.
Conclusions
Rivaroxaban monotherapy had similar effect on prognosis across all BMI categories in patients with AF and stable CAD.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Japan Cardiovascular Research Foundation based on a contract with Bayer Yakuhin, Ltd
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Affiliation(s)
- M Ishii
- Kumamoto University Hospital , Kumamoto , Japan
| | - K Kaikita
- University of Miyazaki , Miyazaki , Japan
| | - S Yasuda
- Tohoku University , Sendai , Japan
| | - M Akao
- Kyoto Medical Centre , Kyoto , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
| | - T Matoba
- Kyushu University , Fukuoka , Japan
| | - M Nakamura
- Toho University Ohashi Medical Center , Tokyo , Japan
| | - K Miyauchi
- Juntendo University School of Medicine , Tokyo , Japan
| | - N Hagiwara
- Tokyo Women's Medical University , Tokyo , Japan
| | - K Kimura
- Yokohama City University Medical Center , Yokohama , Japan
| | | | - K Matsui
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Ogawa
- Kumamoto University , Kumamoto , Japan
| | - K Tsujita
- Kumamoto University Hospital , Kumamoto , Japan
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Bando H, Kumagai S, Kotani D, Saori M, Habu T, Tsushima T, Hara H, Kadowaki S, Kato K, Chin K, Yamaguchi K, Kageyama SI, Hojo H, Nakamura M, Tachibana H, Wakabayashi M, Fukutani M, Fuse N, Nishikawa H, Kojima T. 1211P A multicenter phase II study of atezolizumab monotherapy following definitive chemoradiotherapy for unresectable locally advanced esophageal squamous cell carcinoma (EPOC1802). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1329] [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: 11/01/2022] Open
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Fujimori M, Nakamura M. Association between seasonal influenza vaccines and the increased risk of acute disseminated encephalomyelitis, estimated using the Vaccine Adverse Event Reporting System. Pharmazie 2022; 77:262-269. [PMID: 36199182 DOI: 10.1691/ph.2022.2354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Acute disseminated encephalomyelitis (ADEM) is a rare and immune-mediated inflammatory disorder of the central nervous system (CNS) that can be triggered by infections and vaccinations. To date, only anecdotal case studies have reported the association between ADEM incidence and seasonal influenza vaccines, and multiple studies have found no association. This study aimed to investigate the association between the incidence of ADEM and seasonal influenza vaccines in a real-world setting using data from the United States Vaccine Adverse Event Reporting System (VAERS). Further, propensity score matching and disproportionality analysis was performed by calculating the adjusted reporting odds ratio (ROR) of reported ADEM cases associated with seasonal influenza vaccines using multiple logistic regression. Additionally, we analysed the time-to-onset using Weibull shape parameters (WSPs). The VAERS database contained 390,352 adverse events reported from January 2011 to December 2020. The ROR of seasonal influenza vaccines for ADEM was 3.02 (95% confidence interval: 1.72-5.33). The median duration (interquartile range) of ADEM was 11.0 (5.0-33.0) days. The median duration of ADEM induced by egg culture-based influenza vaccine (Egg-based vaccine) and cell culture-based influenza vaccine (Cell-based vaccine) was 10.0 (5.0-24.0) and 91.0 (79.0-125.0) days (P < 0.001), respectively. Only Cell-based cases had WSP β > 1, indicating a wear-out failure type. The incidence of ADEM within 30 days after administration of egg- and Cell-based vaccines was 78.6% and 0.0%, respectively. Our findings indicate that ADEM incidence is associated with seasonal influenza vaccines; thus, careful monitoring of ADEM is required within the first month of Egg-based vaccination and after two months of Cell-based vaccination. Neurologists and general practitioners should exercise caution, as the timing for careful monitoring varies depending on the vaccine type.
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Affiliation(s)
- M Fujimori
- General Affairs Team, Marumori-machi National Health Insurance Marumori Hospital, Miyagi, Japan;,
| | - M Nakamura
- Laboratory of Drug informatics, Gifu Pharmaceutical University, Gifu, Japan
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48
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Nakamura M, Kameyama S, Ambe Y, Teshima T, Izumi T, Tsuru I, Inoue Y, Yoshimatsu T, Inatsu H, Amakawa R, Kusakabe M, Morikawa T, Shiga Y. Predictive factors for postoperative renal function after off-clamp, non-renorrhaphy partial nephrectomy. Transl Androl Urol 2022; 11:1226-1233. [PMID: 36217403 PMCID: PMC9547154 DOI: 10.21037/tau-22-321] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background There is limited information on perioperative renal function during off-clamp, non-renorrhaphy open partial nephrectomy. Therefore, this retrospective study aimed to identify predictive factors of perioperative decline in renal function after off-clamp, non-renorrhaphy open partial nephrectomy. Methods Clinical records of 138 patients with renal tumors who underwent off-clamp, non-renorrhaphy open partial nephrectomy at our institution were reviewed. Off-clamp, non-renorrhaphy partial nephrectomy was performed using a soft coagulation system. Perioperative estimated glomerular filtration rate (eGFR) preservation was calculated, and predictors were identified using multivariate regression analysis at 5 days, 1 month, and 3 months after surgery. Results The median operation time was 122 minutes, and the median volume of estimated blood loss was 155 mL. The mean eGFR preservation at 5 days, 1 month, and 3 months after surgery was 95.3%, 91.0%, and 90.7%, respectively. Estimated blood loss was an independent predictor of perioperative decline in eGFR 5 days after surgery [odds ratio (OR): 0.97; 95% confidence interval (CI): 0.96, 0.98; P<0.001]. Preoperative eGFR and estimated blood loss were independent predictors of perioperative decline in eGFR 1 month after surgery (OR: 0.86; 95% CI: 0.77, 0.95; P=0.007 and OR: 0.98; 95% CI: 0.97, 0.99; P<0.001, respectively). Age, preoperative eGFR, and estimated blood loss were independent predictors of perioperative decline in eGFR 3 months after surgery (OR: 0.64; 95% CI: 0.54, 0.81; P<0.001, OR: 0.72; 95% CI: 0.61, 0.85; P<0.001; and OR: 0.98; 95% CI: 0.97, 0.99; P=0.004, respectively). Conclusions Estimated blood loss during surgery was a predictor of perioperative decline in eGFR within 3 months after off-clamp, non-renorrhaphy open partial nephrectomy. Age was a predictor of perioperative decline in eGFR 3 months after surgery.
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Affiliation(s)
- Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Shuji Kameyama
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yoshiki Ambe
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Taro Teshima
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Taro Izumi
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ibuki Tsuru
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yasushi Inoue
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Hiroki Inatsu
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ryo Amakawa
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Teppei Morikawa
- Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yoshiyuki Shiga
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
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49
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Yajima A, Tsuchiya K, Kuro-O M, Urena P, Tominaga Y, Okada M, Ichimori T, Tomosugi T, Hiramitsu T, Murata T, Nakamura M, Sasaki M, Ito A, Nitta K. Renal hyperparathyroidism. Vitam Horm 2022; 120:305-343. [PMID: 35953115 DOI: 10.1016/bs.vh.2022.04.010] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The number of the patients with chronic kidney disease is now increasing in the world. The pathophysiology of renal hyperparathyroidism is closely associated with Klotho-FGF-endocrine axes, which must be solved definitively as early as possible. It was revealed that the expression of fgf23 is activated by calciprotein particles, which induces vascular ossification. And it is well known that phosphorus overload directly increases parathyroid hormone and hyperparathyroid bone disease develops in those subjects. On the other hand, low turnover bone disease is often recently. Both the patients with chronic kidney disease suffering from hyperparathyroid bone disease or low turnover bone disease are associated with increased fracture risk. Micropetrosis may be one of the causes of increased fracture risk in the subjects with low turnover bone disease. In this chapter, we now describe the diagnosis, pathophysiology and treatments of renal hyperparathyroidism.
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Affiliation(s)
- Aiji Yajima
- Department of Anatomy, Cell Biology and Physiology, Indiana University, School of Medicine, Indianapolis, IN, United States; Department of Urology, Tokyo, Teishin Hospital, Tokyo, Japan; Department Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
| | - Ken Tsuchiya
- Department Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Makoto Kuro-O
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Pablo Urena
- Division of Nephrology, Clinique du Landy, Saint Ouen, France
| | - Yoshihiro Tominaga
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Manabu Okada
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Toshihiro Ichimori
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Toshihide Tomosugi
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Takahisa Hiramitsu
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Taro Murata
- Department of Urology, Tokyo, Teishin Hospital, Tokyo, Japan
| | - Masaki Nakamura
- Department of Nephrology and Urology, NTT East Kanto Hospital, Tokyo, Japan
| | - Masahiko Sasaki
- Department of Urology, Tokyo, Teishin Hospital, Tokyo, Japan
| | - Akemi Ito
- Ito Bone Histomorphometry Institute, Niigata, Japan
| | - Kosaku Nitta
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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50
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Sawada K, Kotani D, Yukami H, Mishima S, Fujiwara H, Kadota T, Nakajo K, Yoda Y, Nakamura M, Hojo H, Yano T, Fujita T, Kojima T. Definitive chemoradiotherapy has comparable survival outcomes to esophagectomy in patients with clinical T1N0M0 esophageal squamous cell carcinoma: real-world data. Int J Clin Oncol 2022; 27:1279-1288. [PMID: 35779118 DOI: 10.1007/s10147-022-02185-x] [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: 12/27/2021] [Accepted: 05/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recently, the JCOG0502 has shown a comparable efficacy of chemoradiotherapy and esophagectomy in patients with clinical T1N0M0 esophageal squamous cell carcinoma. However, few studies have compared the clinical outcomes of these treatments in esophageal squamous cell carcinoma patients (including elderly patients) based on real-world data. METHODS This retrospective study determined real-world outcomes in patients who underwent chemoradiotherapy or esophagectomy, including those with clinical T1N0M0 esophageal squamous cell carcinoma, between 2009 and 2017 at the National Cancer Center Hospital East. RESULTS Among a total of 156 patients, 120 and 36 patients underwent esophagectomy and chemoradiotherapy, respectively; 138, 12 and 6 patients had Eastern Cooperative Oncology Group performance status 0, 1, and 2, respectively; and 33 and 123 patients had clinical tumor depth MM-SM1 and SM2-SM3, respectively. In a median follow-up of 72 months, 5-year progression-free survival and overall survival were respectively 77.0% and 81.5% in the esophagectomy group and 74.4% and 82.6% in the chemoradiotherapy group (P = 0.48 and, P = 0.89). Moreover, no treatment-related death was detected in both groups. In elderly patients (75 years or older), 5-year progression-free survival and overall survival were not significantly different between esophagectomy and chemoradiotherapy groups (5-year progression-free survival: 72.3% vs. 81.8%, P = 0.38; 5-year overall survival: 76.9% vs. 81.8%, P = 0.59). CONCLUSIONS This real-world study confirms the results of a previous clinical trial, and the present findings support chemoradiotherapy as one of the standard treatment options in patients of all ages with clinical T1N0M0 esophageal squamous cell carcinoma.
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Affiliation(s)
- Kentaro Sawada
- Department of Medical Oncology, Kushiro Rosai Hospital, 13-23 Nakazono-cho, Kushiro, Hokkaido, 085-8533, Japan
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Hiroki Yukami
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Saori Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hisashi Fujiwara
- Department of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomohiro Kadota
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Keiichiro Nakajo
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yusuke Yoda
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Masaki Nakamura
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takeo Fujita
- Department of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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