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Last Updated :2024/10/16

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Master

Affiliation (Master)

  • Faculty of Medicine　Surgery　Surgery

Affiliation (Master)

  • Faculty of Medicine　Surgery　Surgery

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Profile and Settings

Profile and Settings

  • Name (Japanese)

    Abe

  • Name (Kana)

    Takashige

  • Name

    201001097776442677

Achievement

Research Areas

  • Life sciences / Urology / urologic cancer, minimum invasive surgery, surgical education

Awards

  • 2016/09 三井生命厚生財団医学研究助成
     
    受賞者: 安部 崇重
  • 2016/04 公益財団法人 伊藤医薬学術交流財団 海外交流助成
     
    受賞者: 安部 崇重
  • 2010 日本泌尿器科学会 JUA/AUA academic exchange program
     
    受賞者: 安部 崇重
  • 2009 内視鏡医学研究振興財団 研究助成B
     
    受賞者: 安部 崇重
  • 2007/04 日本泌尿器科学会 坂口賞
     
    受賞者: 安部 崇重
  • 2007 内視鏡医学研究振興財団 研究助成B
     
    受賞者: 安部 崇重

Published Papers

  • Naoto Wakabayashi, Shiro Watanabe, Takashige Abe, Junki Takenaka, Kenji Hirata, Rina Kimura, Keita Sakamoto, Nobuo Shinohara, Kohsuke Kudo
    Annals of nuclear medicine 38 (7) 553 - 562 2024/07 
    OBJECTIVE: To investigate the incidence of adverse events (AEs) following single and multiple administrations of I-131 metaiodobenzylguanidine (MIBG) therapy for inoperable pheochromocytomas and paragangliomas (PPGLs). METHODS: A single-center retrospective study was conducted on patients with inoperable PPGLs who underwent I-131 MIBG therapy between January 2000 and December 2020. A total of 28 patients with available electronic medical records were included. The treatment consisted of a single intravenous administration of 150 mCi (5.55 GBq) of I-131 MIBG. We evaluated the first MIBG treatment and repeated MIBG treatments performed within 200 days of the previous treatment. AEs for each treatment were evaluated using CTCAE version 4.0, and the statistical analysis was conducted at a significance level of p < 0.05. Objective response based on RECIST 1.1 criteria and biochemical response based on urinary catecholamines were assessed. RESULTS: The study included a total of 63 administrations, consisting of 28 single administrations (SAs), including the first administration for all 28 cases, and 35 multiple administrations (MAs), which included the second or later administrations. Hematological AEs were evaluable for 23 SAs and 29 MAs. Grade 3 or higher leukopenia occurred in 9.8% of all administrations, and Grade 3 or higher lymphopenia in 23.5%; both were manageable through observation. There were no significant differences in clinical AE Grades 1-2 (p = 0.32), hematological AE Grades 1-2 (p = 0.22), or hematological AE Grades 3-4 (p = 0.12) between MAs and SAs. Statistical analysis for each type of AE revealed significant increases in leukopenia (p < 0.01) and lymphopenia (p = 0.04). No significant difference in anemia, thrombocytopenia, or neutropenia was observed between MAs and SAs. There was no significant increase in the incidence rate of Grade 3 or higher hematological AEs for any of the parameters. The objective response rate was 0% for SAs and 36% for MAs. Biochemical response rates were 18% for SAs and 67% for MAs. CONCLUSION: In I-131 MIBG therapy for PPGLs, multiple administrations significantly increased only Grade 1 or 2 lymphopenia and leukopenia compared to single administration.
  • Shigeru Harada, Takashige Abe, Jun Furumido, Keita Takahashi, Kanta Hori, Noriyuki Abe, Masafumi Kon, Sachiyo Murai, Haruka Miyata, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    Scientific reports 14 (1) 9741 - 9741 2024/04/28 
    New technologies such as laparoscopic and robotic surgery are spreading, and there is a demand for physicians to keep up with novel methods. In contrast to the recent focus on healthcare professional burnout, the mental and physical costs during surgery are not well-understood. We aimed to quantify surgeons' workloads in daily urological surgical practice and clarify potential background factors associated with such workloads. Urologists in Hokkaido, Japan, were invited to this study. Between December 2020 and December 2021, participants repeatedly reported workloads, which were assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), after each surgery in conjunction with participants' names, patients' backgrounds, their roles (independent operator, operator under supervision, instructor, and 1st or 2nd assistant), and surgical outcomes, via SurveyMonkey®. Because of the heterogeneity among individuals, a linear mixed-effects model was utilized to analyze factors associated with NASA-TLX, calculating the parameter estimates (PE) of regression coefficients for each factor and their 95% confidence interval (CI). Sixty-five urologists (5 women) joined the study, and 2169 data were collected within 7 days after surgeries. A linear mixed-effects model revealed that female surgeons (PE + 15.56, 95% CI 2.36-28.77), urgent/emergency surgery (PE + 6.65, 95% CI 4.59-8.70), intraoperative complications (PE + 9.26, 95% CI 6.76-11.76), and near-miss incidents (PE + 3.81, 95% CI 2.27-5.36) were associated with higher workloads. Regarding the surgeons' role, operator under supervision (PE + 12.46, 95% CI 9.86-15.06) showed the highest workloads. Surgeons' workloads decreased as the number of previous cases of the same procedure increased. Surgeons' workloads were associated with various factors. Given that the highest workloads were for operators under supervision, instructors should be aware of trainees' high workloads and devise appropriate instructional interventions.
  • Mifuka Ouchi, Takeya Kitta, Hiroki Chiba, Madoka Higuchi, Yui Abe-Takahashi, Mio Togo, Naohisa Kusakabe, Sachiyo Murai, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Takashige Abe, Nobuo Shinohara
    BJU international 2024/04/24 
    OBJECTIVE: To assess the effectiveness of pre- and postoperative supervised pelvic floor muscle training (PFMT) on the recovery of continence and pelvic floor muscle (PFM) function after robot-assisted laparoscopic radical prostatectomy (RARP). PATIENTS AND METHODS: We carried out a single-blind randomised controlled trial involving 54 male patients scheduled to undergo RARP. The intervention group started supervised PFMT 2 months before RARP and continued for 12 months after surgery with a physiotherapist. The control group was given verbal instructions, a brochure about PFMT, and lifestyle advice. The primary outcome was 24-h pad weight (g) at 3 months after RARP. The secondary outcomes were continence status (assessed by pad use), PFM function, and the Expanded Prostate Cancer Index Composite (EPIC) score. RESULTS: Patients who participated in supervised PFMT showed significantly improved postoperative urinary incontinence (UI) compared with the control group (5.0 [0.0-908.0] g vs 21.0 [0.0-750.0] g; effect size: 0.34, P = 0.022) at 3 months after RARP based on 24-h pad weight. A significant improvement was seen in the intervention compared with the control group (65.2% continence [no pad use] vs 31.6% continence, respectively) at 12 months after surgery (effect size: 0.34, P = 0.030). Peak pressure during a maximum voluntary contraction was higher in the intervention group immediately after catheter removal and at 6 months, and a longer duration of sustained contraction was found in the intervention group compared with the control group. We were unable to demonstrate a difference between groups in EPIC scores. CONCLUSION: Supervised PFMT can improve postoperative UI and PFM function after RARP. Further studies are needed to confirm whether intra-anal pressure reflects PFM function and affects continence status in UI in men who have undergone RARP.
  • Taku Murakami, Keita Minami, Toru Harabayashi, Satoru Maruyama, Norikata Takada, Akira Kashiwagi, Haruka Miyata, Yasuyuki Sato, Ryuji Matsumoto, Hiroshi Kikuchi, Takashige Abe, Yoichi M Ito, Sachiyo Murai, Nobuo Shinohara, Hiroshi Harada, Takahiro Osawa
    Scientific reports 14 (1) 6801 - 6801 2024/03/21 
    We designed this multi-center prospective study with the following objectives: (1) the cross-sectional validation of extracellular vesicles (EV) mRNA markers to detect urothelial bladder cancer (UBC) before transurethral resection of bladder cancer (TURBT), and (2) the longitudinal validation of EV mRNA markers to monitor non-muscle invasive bladder cancer (NMIBC) recurrence after TURBT. EV mRNA markers evaluated in this study were KRT17, GPRC5A, and SLC2A1 in addition to two additional markers from literatures, MDK and CXCR2, and measured by quantitative RT-PCR with normalization by a reference gene (ALDOB). Diagnostic performances of EV mRNA markers were compared to conventional markers. Regarding the first objective, we confirmed that EV mRNA biomarkers in urine were higher in UBC patients, particularly those with higher stage/grade tumors, than in those without UBC (n = 278 in total) and the diagnostic performance of EV mRNA MDK and KRT17 outperformed conventional biomarkers with AUC 0.760 and 0.730, respectively. Concerning the second objective, we prospectively analyzed the time courses of EV mRNA markers while NMIBC patients (n = 189) (median follow-up 19 months). The expression of EV mRNA KRT17 was significantly high in patients with recurrence, while it gradually decreased over time in those without recurrence (p < 0.01).
  • Kanta Hori, Takashige Abe, Noriyuki Abe, Junya Abe, Kazufumi Okada, Keita Takahashi, Shigeru Harada, Jun Furumido, Sachiyo Murai, Masafumi Kon, Kohei Hashimoto, Naoya Masumori, Hidehiro Kakizaki, Nobuo Shinohara
    International Journal of Urology 0919-8172 2024/02/17 
    Objective According to the rapid progress in surgical techniques, a growing number of procedures should be learned during postgraduate training periods. This study aimed to clarify the current situation regarding urological surgical training and identify the perception gap between trainees' competency and the competency expected by instructors in Japan. Methods Regarding the 40 urological surgical procedures selected via the Delphi method, we collected data on previous caseloads, current subjective autonomy, and confidence for future skill acquisition from trainees (<15 post‐graduate years [PGY]), and the competencies when trainees became attending doctors expected by instructors (>15 PGY), according to a 5‐point Likert scale. In total, 174 urologists in Hokkaido Prefecture, Japan were enrolled in this study. Results The response rate was 96% (165/174). In a large proportion of the procedures, caseloads grew with accumulation of years of clinical practice. However, trainees had limited caseloads of robotic and reconstructive surgeries even after 15 PGY. Trainees showed low subjective competencies at present and low confidence for future skill acquisition in several procedures, such as open cystectomy, ureteroureterostomy, and ureterocystostomy, while instructors expected trainees to be able to perform these procedures independently when they became attending doctors. Conclusion Trainees showed low subjective competencies and low confidence for future skill acquisition in several open and reconstructive procedures, while instructors considered that these procedures should be independently performable by attending doctors. We believe that knowledge of these perception gaps is helpful to develop a practical training program.
  • Hiroshi Kikuchi, Takashige Abe, Makito Miyake, Haruka Miyata, Ryuji Matsumoto, Takahiro Osawa, Nobutaka Nishimura, Kiyohide Fujimoto, Junichi Inokuchi, Takahiro Yoneyama, Ryotaro Tomida, Kazuyuki Numakura, Yuto Matsushita, Kazumasa Matsumoto, Takuma Sato, Rikiya Taoka, Takashi Kobayashi, Takahiro Kojima, Yoshiyuki Matsui, Naotaka Nishiyama, Hiroshi Kitamura, Hiroyuki Nishiyama, Nobuo Shinohara
    Japanese Journal of Clinical Oncology 54 (2) 192 - 200 0368-2811 2024/02/01 
    Objective: Several guidelines recommended that second transurethral resection should be performed in patients with diagnosis of high-risk non-muscle-invasive bladder cancer. However, therapeutic benefits of second transurethral resection before bacillus Calmette-Guérin intravesical instillation were conflicting amongst previous studies. We investigated the prognostic impact of second transurethral resection before bacillus Calmette-Guérin instillation in high-risk non-muscle-invasive bladder cancer patients. Methods: This retrospective study included 3104 non-muscle-invasive bladder cancer patients who received bacillus Calmette-Guérin instillations between 2000 and 2019 at 31 collaborative institutions. Univariate and multivariate Cox proportional hazards models were used to assess the risk factors of intravesical recurrence, disease progression, cancer-specific mortality and overall mortality. Results: In the entire population, patients undergoing second transurethral resection (33%, 1026/3104) had a lower risk of intravesical recurrence on univariate analysis (hazard ratio 0.85, 95% confidence interval 0.73-0.98, P = 0.027), although it did not remain significant on multivariate analysis (hazard ratio 0.90, 95% confidence interval 0.76-1.07, P = 0.24). Subgroup analysis revealed that, in pT1 patients (n = 1487), second transurethral resection was significantly correlated with a lower risk of intravesical recurrence on multivariate analysis (hazard ratio 0.80, 95% confidence interval 0.64-1.00, P = 0.048), but lower risks of disease progression (hazard ratio 0.75, 95% confidence interval 0.56-1.00, P = 0.049), cancer-specific mortality (hazard ratio 0.54, 95% confidence interval 0.35-0.85, P = 0.007) and overall mortality (hazard ratio 0.73, 95% confidence interval 0.55-0.97, P = 0.027) on univariate analysis. Conclusions: Second transurethral resection confers accurate pathological staging and could be used to safely select good candidates for intravesical bacillus Calmette-Guérin instillation. We further confirm that second transurethral resection could confer an oncological benefit in pT1 bladder cancer patients treated by bacillus Calmette-Guérin instillation, and so strongly recommend second transurethral resection in this patient population.
  • High complexity tumorを含む片側多発腎腫瘍に対する冷却併用ロボット支援腎部分切除術
    松本 隆児, 安部 崇重, 篠原 信雄
    日本内視鏡外科学会雑誌 (一社)日本内視鏡外科学会 28 (7) 1167 - 1167 1344-6703 2023/12
  • 客観的フィードバックが得られる腹腔鏡手術トレーニングモデル構築の試み
    安部 崇重, 松本 隆児, 堀田 記世彦, 七戸 俊明, 倉島 庸, 篠原 信雄
    日本内視鏡外科学会雑誌 (一社)日本内視鏡外科学会 28 (7) 2919 - 2919 1344-6703 2023/12
  • 免疫複合療法後に鏡視下腫瘍減量腎摘除術を行った4例
    大澤 崇宏, 東海林 旺次朗, 永森 聖人, 上條 千太, 森口 卓哉, 堀 寛太, 宮田 遥, 松本 隆児, 安部 崇重, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 37回 O - 3 2023/11
  • ロボット支援下膀胱全摘術後に閉鎖神経による内ヘルニアをきたした一例
    吉田 あゆ, 大澤 崇宏, 宮田 遥, 松本 隆児, 安部 崇重, 内藤 善, 和田 雅孝, 村上 壮一, 平野 聡, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 37回 O - 5 2023/11
  • カダバートレーニング時の鉗子動態計測による手術技量の数値化の試み
    安部 崇重, 今 雅史, 堀田 記世彦, 樋口 まどか, 菊地 央, 上條 千太, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 37回 O - 6 2023/11
  • 精巣腫瘍に対する腹腔鏡下神経温存両側後腹膜リンパ節郭清術の経験
    松本 隆児, 宮田 遥, 上條 千太, 東海林 旺次朗, 森口 卓哉, 堀 寛太, 永森 聖人, 大澤 崇宏, 安部 崇重, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 37回 O - 1 2023/11
  • 安部 崇重, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (10) 1091 - 1095 0914-6180 2023/10 
    転移性尿路上皮癌においても,症状緩和目的や,転移巣が全身化学療法でコントロールされている状況で原発巣切除が考慮される場合がある。主に所属リンパ節転移のみを認める症例では,全身化学療法が有効で,かつ原発巣と転移巣を含め完全切除が可能であった場合には長期生存が期待される。近年注目されている遠隔転移を有する症例での予後改善効果に関しては,転移性尿路上皮癌に関しては無作為化前向き試験で観察された結果ではない点を強調したい。その実施にあたって個々の症例ごとにそのベネフィット・リスクを十分吟味する必要がある。(著者抄録)
  • 増やそう未来の外科医!働き方改革における外科系教育 泌尿器科手術に関するシミュレーショントレーニング 当科での経験
    安部 崇重, 今 雅史, 樋口 まどか, 堀田 記世彦, 菊地 央, 古御堂 純, 岩原 直也, 山田 修平, 原田 茂, 上條 千太, 村井 祥代, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本癌治療学会学術集会抄録集 61回 SWS7 - 1 2023/10
  • Hajime Miyata, Takashige Abe, Naoya Iwahara, Hiroshi Kikuchi, Hiroki Chiba, Ryuji Matsumoto, Takahiro Osawa, Hiroshi Tanaka, Ken Morita, Tomoko Mitsuhashi, Nobuo Shinohara
    Hinyokika kiyo. Acta urologica Japonica 69 (9) 259 - 264 2023/09 
    A 23-year-old male was aware of pain around his left hip joint and visited a nearby orthopedic clinic. Swelling of the right testis was pointed out, and a testicular tumor was suspected. He was referred to the urology department of a local hospital. Blood analysis showed an increase of α-fetoprotein (AFP) (3,620 ng/ml). Computed tomographic (CT) -scan revealed a left iliac bone metastasis and morbid fracture. Right radical inguinal orchiectomy was performed. The pathological examination revealed mixed germ cell tumor (embryonic carcinoma and immature teratoma: 70%, seminoma: 30%). The diagnosis was non-seminomatous germ cell tumor, stage IIIc, and poor risk on the International Germ Cell Consensus Classification. After one cycle of a bleomycin, etoposide and cisplatinum (BEP) regimen, he was referred to our hospital. After a total of 4 cycles of BEP, AFP was normalized. Denosumab was also administered monthly. The CT-scan showed a reduction of bone metastasis and recovery of ossification. Bone biopsy did not show viable tumor cells. Because extirpation of the remaining mass would require resection of the left part of the pelvic bone with significant functional loss of the left limb, we performed close follow-up after an additional 2 courses of the etoposide and cisplatin regimen. The patient is currently alive without recurrence at 45 months after the last systemic chemotherapy.
  • 大澤 崇宏, 山田 修平, 宮田 遥, 松本 隆児, 安部 崇重, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (臨増) 704 - 704 0914-6180 2023/08
  • 大澤 崇宏, 菊地 央, 山田 修平, 宮田 遥, 松本 隆児, 安部 崇重, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (臨増) 788 - 789 0914-6180 2023/08
  • 樋口 まどか, 佐藤 三穂, 大澤 崇宏, 山田 修平, 宮田 遥, 松本 隆児, 田中 博, 佐々木 芳浩, 森田 研, 原林 透, 柏木 明, 村井 祥代, 安部 崇重, 小笠原 克彦, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (臨増) 886 - 886 0914-6180 2023/08
  • Takashige Abe, Shuhei Yamada, Hiroshi Kikuchi, Ataru Sazawa, Hidenori Katano, Hidetaka Suzuki, Ichiro Takeuchi, Keita Minami, Ken Morita, Kunihiko Tsuchiya, Norikata Takada, Shintaro Maru, Soshu Sato, Takanori Yamashita, Tango Mochizuki, Tomoshige Akino, Yoshihiro Sasaki, Yuichiro Shinno, Norihiro Murahashi, Takafumi Kawazu, Jun Furumido, Haruka Miyata, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Nobuo Shinohara
    Japanese journal of clinical oncology 2023/07/17 
    OBJECTIVE: To determine the impact of postoperative complications on long-term survival outcomes in patients with bladder cancer undergoing radical cystectomy. METHODS: This retrospective multi-institutional study included 766 bladder cancer patients who underwent radical cystectomy between 2011 and 2017. Patient characteristics, perioperative outcomes, all complications within 90 days after surgery and survival outcomes were collected. Each complication was graded based on the Clavien-Dindo system, and grouped using a standardized grouping method. The Comprehensive Complication Index, which incorporates all complications into a single formula weighted by their severity, was utilized. Overall survival and recurrence-free survival (local, distant or urothelial recurrences) were stratified by Comprehensive Complication Index (high: ≥26.2; low: <26.2). A multivariate model was utilized to identify independent prognostic factors. RESULTS: The incidence of any and major complications (≥Clavien-Dindo grade III) was 70 and 24%, respectively. In terms of Comprehensive Complication Index, 34% (261/766) of the patients had ≥26.2. Patients with Comprehensive Complication Index ≥ 26.2 had shorter overall survival (4-year, 59.5 vs. 69.8%, respectively, log-rank test, P = 0.0037) and recurrence free survival (51.9 vs. 60.1%, respectively, P = 0.0234), than those with Comprehensive Complication Index < 26.2. The Cox multivariate model identified the age, performance status, pT-stage, pN-stage and higher CCI (overall survival: HR = 1.35, P = 0.0174, recurrence-free survival: HR = 1.26, P = 0.0443) as independent predictors of both overall survivial and recurrence-free survival. CONCLUSIONS: Postoperative complications assessed by Comprehensive Complication Index had adverse effects on long-term survival outcomes. Physicians should be aware that major postoperative complications can adversely affect long-term disease control.
  • 樋口 まどか, 佐藤 三穂, 大澤 崇宏, 山田 修平, 宮田 遥, 菊地 央, 松本 隆児, 三浪 圭太, 田中 博, 佐々木 芳浩, 森田 研, 高田 徳容, 原林 透, 古御堂 純, 柏木 明, 村井 祥代, 安部 崇重, 小笠原 克彦, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 417 - 417 0914-6180 2023/05
  • 山田 修平, 安部 崇重, 佐澤 陽, 片野 英典, 鈴木 英孝, 竹内 一郎, 石崎 淳司, 三浪 圭太, 森田 研, 土屋 邦彦, 高田 徳容, 丸 晋太朗, 石川 修平, 佐藤 聡秋, 河津 隆文, 山下 孝典, 小野 武紀, 望月 端吾, 秋野 文臣, 佐々木 芳浩, 信野 祐一郎, 古御堂 純, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 420 - 420 0914-6180 2023/05
  • 細川 智加, 安部 崇重, 菊地 央, 森田 研, 山田 修平, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 423 - 423 0914-6180 2023/05
  • 原田 茂, 古御堂 純, 安部 崇重, 高橋 圭太, 今 雅史, 村井 祥代, 菊地 央, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 427 - 427 0914-6180 2023/05
  • 宮田 遥, 大澤 崇宏, 山田 修平, 細川 智加, 星 達也, 坪内 駿, 松本 隆児, 安部 崇重, 中里 信一, 岩崎 沙理, 谷口 浩二, 谷川 聖, 田中 伸哉, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 428 - 428 0914-6180 2023/05
  • 安部 崇重, 山田 修平, 菊地 央, 佐澤 陽, 片野 英典, 鈴木 英孝, 竹内 一郎, 森 達也, 三浪 圭太, 森田 研, 土屋 邦彦, 高田 徳容, 丸 晋太郎, 河津 隆文, 石川 修平, 佐藤 聡秋, 山下 孝典, 望月 端吾, 秋野 文臣, 佐々木 芳浩, 信野 祐一郎, 古御堂 純, 松田 博幸, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    泌尿器外科 医学図書出版(株) 36 (5) 429 - 429 0914-6180 2023/05
  • 透析腎癌の最新の知見 透析腎癌の疫学
    大澤 崇宏, 宮田 遥, 松本 隆児, 安部 崇重, 篠原 信雄
    日本透析医学会雑誌 (一社)日本透析医学会 56 (Suppl.1) 299 - 299 1340-3451 2023/05
  • Noriko Nishioka, Noriyuki Fujima, Satonori Tsuneta, Masami Yoneyama, Ryuji Matsumoto, Takashige Abe, Rina Kimura, Keita Sakamoto, Fumi Kato, Kohsuke Kudo
    Medicine 102 (17) e33639  2023/04/25 
    We investigated the ability of echo-planar imaging with L1-regularized iterative sensitivity encoding-based diffusion-weighted imaging (DWI) to improve the image quality and reduce the scanning time in prostate magnetic resonance imaging. We retrospectively analyzed 109 cases of prostate magnetic resonance imaging. We compared variables in the quantitative and qualitative assessments among 3 imaging groups: conventional parallel imaging-based DWI (PI-DWI) with an acquisition time of 3 minutes 15 seconds; echo-planar imaging with L1-regularized iterative sensitivity encoding-based DWI (L1-DWI) with a normal acquisition time (L1-DWINEX12) of 3 minutes 15 seconds; and L1-DWI with a half acquisition time (L1-DWINEX6) of 1 minute 45 seconds. As a quantitative assessment, the signal-to-noise ratio (SNR) of DWI (SNR-DWI), the contrast-to-noise ratio (CNR) of DWI (CNR-DWI), and the CNR of apparent diffusion coefficient were measured. As a qualitative assessment, the image quality and visual detectability of prostate carcinoma were evaluated. In the quantitative analysis, L1-DWINEX12 showed significantly higher SNR-DWI than PI-DWI (P = .0058) and L1-DWINEX6 (P < .0001). In the qualitative analysis, the image quality score for L1-DWINEX12 was significantly higher than those of PI-DWI and L1-DWINEX6. A non-inferiority assessment demonstrated that L1-DWINEX6 was non-inferior to PI-DWI in terms of both quantitative CNR-DWI and qualitative grading of image quality with a <20% inferior margin. L1-DWI successfully demonstrated a reduced scanning time while maintaining good image quality.
  • 高齢者のがん治療:薬物療法 膀胱がんに対する薬物療法
    安部 崇重, 宮田 遥, 松本 隆児, 大澤 崇宏, 菊地 央, 篠原 信雄
    日本老年泌尿器科学会誌 日本老年泌尿器科学会 36 (1) 37 - 37 2187-3682 2023/04
  • 泌尿器科医師が手術時に感じるメンタルワークロードに関する前向き観察研究(Mental workloads of surgeons in urology: A prospective observational study)
    原田 茂, 古御堂 純, 安部 崇重, 高橋 圭太, 今 雅史, 村井 祥代, 菊地 央, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器科学会総会 110回 AOP12 - 07 2023/04
  • 泌尿器科医師における手術時に感じるメンタルワークロードのクラスター解析について(Cluster analysis of mental workloads of urologists: A prospective observational study)
    古御堂 純, 原田 茂, 安部 崇重, 高橋 圭太, 今 雅史, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 村井 祥代, 篠原 信雄
    日本泌尿器科学会総会 110回 OP10 - 03 2023/04
  • 回腸導管造設後の尿管導管吻合狭窄発症のリスク因子(Risk factors of ureteroenteric anastomotic stricture after ileal conduit urinary diversion)
    菊地 央, 安部 崇重, 山田 修平, 佐澤 陽, 三浪 圭太, 森田 研, 高田 徳容, 大石 悠一郎, 古御堂 純, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器科学会総会 110回 OP43 - 05 2023/04
  • 膀胱全摘後術後合併症の長期予後への影響(Impact of postoperative complications on longterm survival after radical cystectomy)
    安部 崇重, 山田 修平, 菊地 央, 佐澤 陽, 三浪 圭太, 森田 研, 高田 徳容, 秋野 文臣, 古御堂 純, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器科学会総会 110回 OP59 - 01 2023/04
  • 尿管癌への放射線治療後に転移による直腸狭窄を来した1例
    服部 敬寛, 西岡 健太郎, 橋本 孝之, 大塚 愛美, 木下 留美子, 青山 英史, 安部 崇重, 大澤 崇宏, 松本 隆児, 菊地 央, 篠原 信雄, 高桑 恵美
    Japanese Journal of Radiology (公社)日本医学放射線学会 41 (Suppl.) 4 - 4 1867-1071 2023/02
  • 褐色細胞腫・傍神経節腫に対するI-131MIBG治療の単回投与と複数回投与での有害事象発生率の検討
    若林 直人, 渡邊 史郎, 安部 崇重, 竹中 淳規, 平田 健司, 篠原 信雄, 工藤 與亮
    核医学 (一社)日本核医学会 60 (Suppl.) S216 - S216 0022-7854 2023
  • Koki Ebina, Takashige Abe, Kiyohiko Hotta, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Masafumi Kon, Shunsuke Komizunai, Yo Kurashima, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Teppei Tsujita, Kazuya Sase, XiaoShuai Chen, Nobuo Shinohara, Atsushi Konno
    IEEE/SICE International Symposium on System Integration(SII) 1 - 6 2023 [Refereed]
  • Miho Sato, Takahiro Osawa, Takashige Abe, Michitaka Honda, Madoka Higuchi, Shuhei Yamada, Jun Furumido, Hiroshi Kikuchi, Ryuji Matsumoto, Yasuyuki Sato, Yoshihiro Sasaki, Toru Harabayashi, Satoru Maruyama, Norikata Takada, Keita Minami, Hiroshi Tanaka, Ken Morita, Akira Kashiwagi, Sachiyo Murai, Yoichi M Ito, Katsuhiko Ogasawara, Nobuo Shinohara
    Scientific reports 12 (1) 21544 - 21544 2022/12/13 
    The Body Image Scale (BIS) is a 10-item tool that measures the body images of cancer patients. This study aims to validate the Japanese version of the BIS for bladder cancer patients. A multicenter cross-sectional survey was used to identify the participants, which included Japanese bladder cancer patients. The percentage of missing responses, internal consistency, and known-group validity were evaluated. The correlations between the BIS and two HRQOL instruments (the Bladder Cancer Index and the SF-12) were assessed to determine convergent validity. Among 397 patients, 221 patients were treated by transurethral resection of bladder tumor (TURBT) endoscopically, 49 patients underwent cystectomy with neobladder, and 127 patients underwent cystectomy involving stoma. The percentage of missing responses in the BIS ranged from 8.1 to 15.6%. Cronbach's α coefficient was 0.924. Higher BIS scores indicate negative body image, and the median BIS score for patients with native bladders after TURBT (0.5) was significantly lower than those of the patients with neobladder (4.0) and stoma formation (7.0), which indicated the discriminatory ability of the BIS. Each domain of the Bladder Cancer Index and the role summary score of the SF-12 correlated to the BIS scores, which confirmed the convergent validity. A range of BIS scores were identified among patients who reported similar physical summary scores and mental summary scores of the SF-12. This study confirmed the reliability and validity of the Japanese version of the BIS for bladder cancer patients.
  • Taigo Kato, Nobuaki Matsubara, Masaki Shiota, Masatoshi Eto, Takahiro Osawa, Takashige Abe, Nobuo Shinohara, Yota Yasumizu, Nobuyuki Tanaka, Mototsugu Oya, Koshiro Nishimoto, Takuji Hayashi, Masashi Nakayama, Takahiro Kojima, Kenjiro Namikawa, Takao Fujisawa, Susumu Okano, Eisuke Hida, Yoshiaki Nakamura, Hideaki Bando, Takayuki Yoshino, Norio Nonomura
    BMC cancer 22 (1) 1292 - 1292 2022/12/09 
    BACKGROUND: Previous clinical trials have demonstrated the potential efficacy of poly (ADP-ribose) polymerase (PARP) inhibitors (PARPis) in patients with cancer involving homologous recombination repair (HRR) gene-mutation. Moreover, HRR gene-mutated cancers are effectively treated with immune checkpoint inhibitors (ICIs) with the increase in tumor mutation burden. We have proposed to conduct a multicenter, single-arm phase II trial (IMAGENE trial) for evaluating the efficacy and safety of niraparib (PARPi) plus programmed cell death-1 inhibitor combination therapy in patients with HRR gene-mutated cancers who are refractory to ICIs therapy using a next generation sequencing-based circulating tumor DNA (ctDNA) and tumor tissue analysis. METHODS: Key eligibility criteria for this trial includes HRR gene-mutated tumor determined by any cancer gene tests; progression after previous ICI treatment; and Eastern Cooperative Oncology Group Performance Status ≤ 1. The primary endpoint is the confirmed objective response rate (ORR) in all patients. The secondary endpoints include the confirmed ORR in patients with HRR gene-mutation of ctDNA using the Caris Assure (CARIS, USA). The target sample size of the IMAGENE trial is 57 patients. Biomarker analyses will be performed in parallel using the Caris Assure, proteome analysis, and T cell repertoire analysis to reveal tumor immunosurveillance in peripheral blood. EXPECTED OUTCOME: Our trial aims to confirm the clinical benefit of PARPi plus ICI combination therapy in ICI-resistant patients. Furthermore, through translational research, our trial will shed light on which patients would benefit from the targeted combination therapy for patients with HRR gene-mutated tumor even after the failure of ICIs. TRIAL REGISTRATION: The IMAGENE trial: jRCT, Clinical trial no.: jRCT2051210120, Registered date: November 9, 2021.
  • 鉗子動態計測を用いた腹腔鏡手術基本手技の技量評価・客観的フィードバックの試み
    安部 崇重, 堀田 記世彦, 松本 隆児, 倉島 庸, 篠原 信雄
    日本内視鏡外科学会雑誌 (一社)日本内視鏡外科学会 27 (7) 1418 - 1418 1344-6703 2022/12
  • RAPN アプローチ別、機種別 RAPN 経腹アプローチ Da Vinci Xi
    安部 崇重, 山田 修平, 宮田 遥, 松本 隆児, 大澤 崇宏, 菊地 央, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 SY - 2 2022/11
  • 鉗子動態計測を用いた腹腔鏡手術基本手技の技量評価・客観的フィードバックの試み
    安部 崇重, 堀田 記世彦, 古御堂 純, 岩原 直也, 今 雅史, 樋口 まどか, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 AP - 7 2022/11
  • 妊娠中に発見されたパラガングリオーマに対して腹腔鏡下腫瘍摘除術を施行した一例
    細川 智加, 安部 崇重, 菊地 央, 森田 研, 山田 修平, 宮田 遥, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 V - 4 2022/11
  • 腎部分切除術後同側腎に再発した腎門部腎腫瘍に対するロボット支援腎部分切除術の経験
    松本 隆児, 山田 修平, 宮田 遥, 大澤 崇宏, 安部 崇重, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 V - 3 2022/11
  • 膀胱全摘+回腸導管造設後の上部尿路再発にたいする後腹膜鏡下腎尿管全摘の2例
    菊地 央, 安部 崇重, 大澤 崇宏, 山田 修平, 古御堂 純, 宮田 遥, 松本 隆児, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 V - 7 2022/11
  • 前立腺癌に対し動体追尾強度変調放射線療法後にロボット支援膀胱全摘術を施行した2例
    保坂 雪野, 大澤 崇宏, 山田 修平, 宮田 遥, 松本 隆児, 安部 崇重, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 O - 3 2022/11
  • TURBTチェックリスト(CL)を導入前後での治療成績の比較
    大澤 崇宏, 菊地 央, 山田 修平, 宮田 遥, 松本 隆児, 安部 崇重, 村井 祥代, 篠原 信雄
    日本泌尿器内視鏡・ロボティクス学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 36回 O - 7 2022/11
  • Jun Furumido, Nako Maishi, Aya Yanagawa‐Matsuda, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Takashige Abe, Yoshihiro Matsuno, Nobuo Shinohara, Yasuhiro Hida, Kyoko Hida
    International Journal of Urology 30 (2) 147 - 154 0919-8172 2022/10/28 [Refereed]
     
    OBJECTIVES: This study analyzes the relationship between biglycan expression in prostate cancer and clinicopathological parameters to clarify the potential link between biglycan and prognosis and progression to castration-resistant prostate cancer (CRPC). METHODS: We retrospectively analyzed 60 cases of prostate cancer patients who underwent robot-assisted laparoscopic radical prostatectomy in Hokkaido University Hospital. RESULTS: Biglycan was expressed in the tumor stroma but not in tumor cells. There was no significant relationship with biochemical recurrence (p = 0.5237), but the expression of biglycan was 36.1% in the group with progression to CRPC. This indicates a significant relationship with progression to CRPC (p = 0.0182). Furthermore, the expression of biglycan-positive blood vessels was significantly higher (15.9%) in the group with biochemical recurrence than in the group without biochemical recurrence (8.5%) (p = 0.0169). The biglycan-positive vessels were 28.6% in the group with progression to CRPC, which was significantly higher than that in the group without progression to CRPC (p < 0.0001). CONCLUSION: This is the first study to show that stroma biglycan is a useful prognostic factor for prostate cancer.
  • Junki Takenaka, Shiro Watanabe, Takashige Abe, Kenji Hirata, Yuko Uchiyama, Rina Kimura, Nobuo Shinohara, Kohsuke Kudo
    Annals of nuclear medicine 2022/10/27 [Refereed][Not invited]
     
    OBJECTIVE: Pheochromocytomas and paragangliomas (PPGLs) are rare tumors arising from the neural crest cells that form the sympathetic and parasympathetic nervous systems. Radiotherapy with [131I]metaiodobenzylguanidine (MIBG) is recommended for unresectable PPGLs. We investigated the usefulness of the metabolic tumor volume (MTV) and total lesion glycolysis (TLG) derived from [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting the prognosis of patients with unresectable PPGL(s) before receiving [131I]MIBG therapy. PATIENTS AND METHODS: We retrospectively analyzed the cases of 25 patients with unresectable PPGLs treated with [131I]MIBG at our hospital between 2001 and 2020. The MTV and TLG were measured in reference to liver accumulation. We divided the patients into two groups based on median values for the maximum standardized uptake value (SUVmax), MTV, and TLG, and evaluated between-group differences using log-rank tests. Cox proportional hazards models were used to determine whether there were significant differences in prognosis with respect to tumor type (pheochromocytoma vs. paraganglioma), site of metastasis, age, past treatment (chemotherapy, external radiation or [131I]MIBG treatment before the current [131I]MIBG treatment), urinary catecholamine, SUVmax, MTV, and TLG. RESULTS: The median follow-up time was 42 months (range 2-136 months). The median overall survival was 63 months. The overall survival (OS) was significantly shorter in the high-MTV group (log-rank test, p = 0.049) and the high-TLG group (p = 0.049), with no significant difference between the high- and low-SUVmax groups (p = 0.19). Likewise, there was no significant difference in prognosis according to pheochromocytoma or paraganglioma, metastasis location, age, or prior chemotherapy. A history of external radiation before [131I]MIBG treatment was associated with a significantly worse prognosis (hazard ration [HR] = 7.95, p = 0.0018). Urinary adrenaline and noradrenaline were not significant prognostic factors (p = 0.70, p = 0.25, respectively), but urinary dopamine did predict a worse outcome (p = 0.022). There was no increased risk of death for higher SUVmax or TLG (p = 0.63 and 0.057, respectively), but higher MTV did predict a worse outcome (HR = 7.27, p = 0.029). CONCLUSION: High MTV and high TLG were significantly associated with a poor prognosis after [131I]MIBG therapy for PPGLs. Other treatment strategies for such patients may need to be explored.
  • Yurie Hirata, Madoka Higuchi, Takahiro Osawa, Shiro Hinotsu, Toru Harabayashi, Tango Mochizuki, Nobuyasu Enami, Osamu Nounaka, Yuichiro Shinno, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Sachiyo Murai, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 29 (10) 1140 - 1146 2022/10 
    OBJECTIVES: There is no consensus about the follow-up schedule after 5-year cancer-free periods. In this study, we aimed to elucidate the risk factors for the recurrence in patients with non-muscle-invasive bladder cancer who remained cancer free for more than 5 years. METHODS: Data from six Japanese institutions were retrospectively reviewed. Among the patients with non-muscle-invasive bladder cancer who were treated with transurethral resection of bladder tumor between 1990 and 2013, those who had no recurrence for more than 5 years were included in this study. The Kaplan-Meier method and Cox hazards model were used to estimate recurrence-free survival and to determine the pathologic and clinical factors affecting late recurrence. RESULTS: In total, 434 patients were enrolled in this study. Of these patients, 55 patients (12.7%) experienced late recurrence. The median follow-up time was 8.9 years (interquartile range 6.9-11.3 years). Prior history of bladder cancer before the most recent transurethral resection was a significant predictor for late recurrence (hazard ratio 1.99 [95% confidence interval 1.13-3.47], P = 0.019), although other clinical factors including tumor grade, pathologic stage, tumor multiplicity, and current risk classification systems were not associated with late recurrence. CONCLUSIONS: Late recurrence after a long tumor-free period is not rare and it was not predicted by current risk classification systems. Only prior history of bladder cancer was a significant predictor for late recurrence in this study.
  • Koki Ebina, Takashige Abe, Kiyohiko Hotta, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Masafumi Kon, Kou Miyaji, Sayaka Shibuya, Yan Lingbo, Shunsuke Komizunai, Yo Kurashima, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Teppei Tsujita, Kazuya Sase, Xiaoshuai Chen, Atsushi Konno, Nobuo Shinohara
    Langenbeck's Archives of Surgery 407 (5) 2123 - 2132 1435-2443 2022/08 [Refereed]
     
    Background: Our aim was to build a skill assessment system, providing objective feedback to trainees based on the motion metrics of laparoscopic surgical instruments. Methods: Participants performed tissue dissection around the aorta (tissue dissection task) and renal parenchymal closure (parenchymal-suturing task), using swine organs in a box trainer under a motion capture (Mocap) system. Two experts assessed the recorded movies, according to the formula of global operative assessment of laparoscopic skills (GOALS: score range, 5–25), and the mean scores were utilized as objective variables in the regression analyses. The correlations between mean GOALS scores and Mocap metrics were evaluated, and potential Mocap metrics with a Spearman’s rank correlation coefficient value exceeding 0.4 were selected for each GOALS item estimation. Four regression algorithms, support vector regression (SVR), principal component analysis (PCA)-SVR, ridge regression, and partial least squares regression, were utilized for automatic GOALS estimation. Model validation was conducted by nested and repeated k-fold cross validation, and the mean absolute error (MAE) was calculated to evaluate the accuracy of each regression model. Results: Forty-five urologic, 9 gastroenterological, and 3 gynecologic surgeons, 4 junior residents, and 9 medical students participated in the training. In both tasks, a positive correlation was observed between the speed-related parameters (e.g., velocity, velocity range, acceleration, jerk) and mean GOALS scores, with a negative correlation between the efficiency-related parameters (e.g., task time, path length, number of opening/closing operations) and mean GOALS scores. Among the 4 algorithms, SVR showed the highest accuracy in the tissue dissection task (MAE median= 2.2352), and PCA-SVR in the parenchymal-suturing task (MAE median= 1.2714), based on 100 iterations of the validation process of automatic GOALS estimation. Conclusion: We developed a machine learning–based GOALS scoring system in wet lab training, with an error of approximately 1–2 points for the total score, and motion metrics that were explainable to trainees. Our future challenges are the further improvement of onsite GOALS feedback, exploring the educational benefit of our model and building an efficient training program.
  • Yusuke Yamagata, Takashige Abe, Naoya Iwahara, Kohichi Takada, Yasuhiro Hida, Emi Takakuwa, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    IJU Case Reports 2577-171X 2022/07/29
  • EBINA KOKI, ABE TAKASHIGE, HOTTA KIYOHIKO, HIGUCHI MADOKA, FURUMIDO JUN, IWAHARA NAOYA, KON MASAFUMI, KOMIZUNAI SHUNSUKE, KURASHIMA YO, KIKUCHI HIROSHI, MATSUMOTO RYUJI, OSAWA TAKAHIRO, MURAI SACHIYO, TSUJITA TEPPEI, SASE KAZUYA, CHEN XIAOSHUAI, SHINOHARA NOBUO, KONNO ATSUSHI
    Proceedings of Jc-IFToMM International Symposium 5 73 - 79 2022/07/16 
    This paper describes details of the development of skill evaluation system for laparoscopic surgical procedure. The measurement experiment was conducted for 70 surgeons, and the participants perform 2 tasks: tissue dissection around the aorta and renal parenchymal suturing/knotting using porcine cadaver. In the experiments, the movement of surgical instruments were recorded by motion capture (MoCap) system, and the motion indices were calculated. The participants grouped into three classes (novices, intermediates, and experts) according to their level of experience. Three classification algorithms: support vector machine (SVM), principal component based SVM (PCA-SVM), gradient boosting decision tree (GBDT) were utilized for developing the model of classifier. The accuracy of each model was assessed by nested and repeated k-fold cross validation. Regarding 3-class classification, the GBDT method resulted highest accuracy (the median of the accuracy is A_med = 68.6 %) in the dissection tasks. In the suturing/knotting tasks, PCA-SVM resulted highest accuracy (A_med = 58.4 %). Regarding 2-class classification (experts vs. intermediates/novices), the GBDT method resulted A_med = 72.9 % in the dissection task, and the PCA-SVM method resulted A_med = 69.2 % in the suturing task. This result shows the MoCap based skill evaluation system in wet-lab training could be a practical way to objectively assess trainees' surgical competence.
  • Ayumi Takayanagi, Fumi Kato, Ayako Nozaki, Ryuji Matsumoto, Takahiro Osawa, Ken Kuwahara, Yoshihiro Matsuno, Hiroshi Asano, Tatsuya Kato, Hidemichi Watari, Takashige Abe, Nobuo Shinohara, Kohsuke Kudo
    Radiology case reports 17 (7) 2320 - 2327 2022/07 
    A 62-year-old woman presented with a tumor in the right kidney. A right partial nephrectomy was performed, and the tumor was diagnosed as clear cell renal cell carcinoma (RCC) on histopathological examination. A right ovarian tumor was detected on follow-up computed tomography (CT) 5 years after partial nephrectomy and pathology proved RCC metastasis. RCC rarely metastasizes to the ovaries. There is limited information on the radiological features of ovarian metastasis in RCC. In this case report, we presented the CT and magnetic resonance images of ovarian metastasis of RCC. In addition, we also presented a literature review with special emphasis on the imaging features of ovarian metastasis of RCC.
  • Haruka Miyata, Yoshihiko Hirohashi, Shuhei Yamada, Junko Yanagawa, Aiko Murai, Shinichi Hashimoto, Serina Tokita, Kanta Hori, Takashige Abe, Terufumi Kubo, Tomohide Tsukahara, Takayuki Kanaseki, Nobuo Shinohara, Toshihiko Torigoe
    Cancer immunology, immunotherapy : CII 71 (4) 795 - 806 2022/04 [Refereed]
     
    Recent studies have revealed that treatment-resistant cancer stem-like cells (CSCs)/cancer-initiating cells (CICs) can be targeted by cytotoxic T lymphocytes (CTLs). CTLs recognize antigenic peptides derived from tumor-associated antigens; thus, the identification of tumor-associated antigens expressed by CSCs/CICs is essential. Human leucocyte antigen (HLA) ligandome analysis using mass spectrometry enables the analysis of naturally expressed antigenic peptides; however, HLA ligandome analysis requires a large number of cells and is challenging for CSCs/CICs. In this study, we established a novel bladder CSC/CIC model from a bladder cancer cell line (UM-UC-3 cells) using an ALDEFLUOR assay. CSCs/CICs were isolated as aldehyde dehydrogenase (ALDH)-high cells and several ALDHhigh clone cells were established. ALDHhigh clone cells were enriched with CSCs/CICs by sphere formation and tumorigenicity in immunodeficient mice. HLA ligandome analysis and cap analysis of gene expression using ALDHhigh clone cells revealed a distinctive antigenic peptide repertoire in bladder CSCs/CICs, and we found that a glutamate receptor, ionotropic, kainite 2 (GRIK2)-derived antigenic peptide (LMYDAVHVV) was specifically expressed by CSCs/CICs. A GRIK2 peptide-specific CTL clone recognized GRIK2-overexpressing UM-UC-3 cells and ALDHhigh clone cells, indicating that GRIK2 peptide can be a novel target for bladder CSC/CIC-targeting immunotherapy.
  • 家坂 光, 亀田 啓, 宮 愛香, 野本 博司, ちょう 圭龍, 中村 昭伸, 安部 崇重, 篠原 信雄, 三好 秀明, 渥美 達也
    日本内分泌学会雑誌 (一社)日本内分泌学会 97 (5) 1253 - 1253 0029-0661 2022/03
  • Hiroki Takeda, Ryuji Matsumoto, Emi Takakuwa, Kanta Hori, Takuya Moriguchi, Shuhei Yamada, Hiroshi Kikuchi, Takahiro Osawa, Takashige Abe, Nobuo Shinohara
    IJU case reports 5 (2) 108 - 112 2022/03 
    INTRODUCTION: Granulocyte colony-stimulating factor-producing upper urinary tract urothelial carcinoma is rare, with a poor prognosis. Advanced urothelial carcinoma is currently treated with immune checkpoint inhibitors, whose efficacy for granulocyte colony-stimulating factor-producing upper urinary tract urothelial carcinoma remains unclear. CASE PRESENTATION: A 66-year-old male diagnosed with clinical stage T3N1M0 urothelial carcinoma of the right ureter with giant hydronephrosis underwent right radical nephroureterectomy. Local recurrence, leukocytosis, and elevated serum granulocyte colony-stimulating factor levels were observed approximately 3 months after surgery. Chemotherapy was started but failed to control the disease. Therefore, pembrolizumab was chosen as the second-line treatment. After this treatment, the blood leukocyte count rapidly normalized, and a clinically favorable response was achieved. There was no recurrence 10 months after the beginning of pembrolizumab treatment, which is still ongoing. CONCLUSION: Pembrolizumab may be a treatment option for advanced granulocyte colony-stimulating factor-producing upper urinary tract urothelial carcinoma.
  • Hiroshi Kikuchi, Takashige Abe, Ryuji Matsumoto, Takahiro Osawa, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 29 (3) 251 - 258 2022/03 
    OBJECTIVES: We examined the outcomes of eight weekly bacillus Calmette-Guérin induction therapy after second transurethral resection, and investigated risk factors for intravesical recurrence or disease progression in high-risk non-muscle-invasive bladder cancer patients. METHODS: This retrospective study included 146 high-risk non-muscle-invasive bladder cancer patients who received eight weekly bacillus Calmette-Guérin instillations without a maintenance schedule between 2000 and 2019. Intravesical recurrence-free and progression-free survival rates were evaluated using the Kaplan-Meier method. The Cox proportional hazards model was used to identify risk factors. RESULTS: Pathological T staging in the first transurethral resection was pTa in 56 patients (38.4%), pT1 in 75 (51.4%) and primary carcinoma in situ in 15 (10.2%). A total of 109 (83.2%) with pTa-1 disease underwent second transurethral resection before bacillus Calmette-Guérin induction therapy, and residual disease was detected in 54 (49.5%). The completion rate of eight instillations was 82.2%. The 2- and 5-year intravesical recurrence-free survival rates were 80.7% and 75.2%, whereas the 2- and 5-year progression-free survival rates were 85.7% and 82.0%. Recurrent tumors (hazard ratio 6.5830, P = 0.0007) and residual tumors at the second transurethral resection (hazard ratio 4.0337, P = 0.0021) were risk factors for intravesical recurrence. Multiple tumors (hazard ratio 5.8056, P = 0.0302), pT1 disease (hazard ratio 3.7351, P = 0.0447) and residual tumors at second transurethral resection (hazard ratio 3.2552, P = 0.0448) were associated with disease progression. CONCLUSIONS: Accurate disease staging and disease elimination by second transurethral resection followed by eight weekly bacillus Calmette-Guérin instillations achieved good disease control. Our protocol (without a maintenance schedule) after thorough surgical resection has potential as a treatment option in the current bacillus Calmette-Guérin shortage.
  • Shogo Aizawa, Takahiro Osawa, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Souichi Shiratori, Tomoko Mitsuhashi, Nobuo Shinohara
    Hinyokika kiyo. Acta urologica Japonica 68 (2) 63 - 66 2022/02 
    A 57-year-old man visited the urology department with a painful mass on the dorsal side of the penis. Magnetic resonance imaging sagittal image showed a small nodule. Leukemia recurrence was suspected due to his history of treatment for acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation. No recurrence was identified by bone marrow biopsy ; however, two months later, the recurrence of leukemia was strongly suspected because the tumor grew over time and blasts were found in the peripheral blood. A biopsy of the penile tumor and bone marrow was performed, leading to the diagnosis of granulocytic sarcoma. Patients with a history of leukemia may be preceded by a single recurrence to extramedullary organs, even if blood and bone marrow findings suggest remission.
  • Tatsu Tanabe, Takahiro Osawa, Kiyohiko Hotta, Daiki Iwami, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Nobuo Shinohara
    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 113 (1) 37 - 41 2022 
    We report a case of bladder cancer in a 54-year-old woman who underwent renal transplantation for chronic renal failure. Six years after the transplantation, she was diagnosed with muscle-invasive bladder cancer with multiple lung metastases. She received gemcitabine/cisplatin therapy for Stage IV bladder cancer, and the dose of the immunosuppressants was reduced to prevent adverse effects. Since lung metastatic lesions disappeared after four courses of chemotherapy and no new lesions were found, we performed radical cystectomy and right nephroureterectomy with ileal conduit construction. Although she was followed closely without therapy, multiple lung metastases appeared 6 months after the radical cystectomy. Gemcitabine/carboplatin therapy was administered, and the lung metastasis improved slightly until the end of the 4th course, but aggressive growth was observed after the 5th course. She switched to palliative treatment without requesting additional treatment and died of cancer 1 year and 9 months after total cystectomy.There is no evidence-based treatment strategy for advanced bladder cancer after kidney transplantation. It is necessary to recognize that the patient had renal dysfunction and was in an immunosuppressed state. Thus, it is crucial to select appropriate drug and surgical treatments for each patient.
  • Hiroshi Kikuchi, Takahiro Osawa, Takashige Abe, Ryuji Matsumoto, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    PloS one 17 (10) e0276816  2022 
    BACKGROUND: The quality of transurethral resection of bladder tumor (TURBT) markedly varies among surgeons and may have a considerable impact on treatment outcomes. The importance of a surgical checklist for TURBT has been suggested in order to standardize the procedure and improve surgical and oncological outcomes. In the present study, we verified the usefulness of a checklist for managing patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: This retrospective study included 201 NMIBC patients diagnosed with Ta, T1, or Tis between October 2011 and February 2021. After September 2016, TURBT was performed with a checklist. We analyzed the intravesical recurrence-free survival (RFS) rate and the presence or absence of the detrusor muscle in resected specimens before and after the introduction of the checklist. Survival rates were compared using the Log-rank test. A multivariate analysis with Cox proportional hazards modeling was performed to verify risk factors for intravesical recurrence. RESULTS: Ninety-nine patients who underwent TURBT with the checklist (checklist group) were compared with 102 patients who underwent TURBT without the checklist (non-checklist group). When the analysis was narrowed down to 9 critical items, we observed a mean number of 9 documented items per operative report (98.0% completion) after implementation of the checklist. Two-year intravesical RFS rates in the checklist and non-checklist groups were 76.7 and 69.5%, respectively (p = 0.1059). The Cox proportional multivariate analysis showed that the rate of intravesical recurrence was slightly lower in the checklist group (hazard ratio 0.7376, 95% CI 0.4064-1.3388, P = 0.3170). CONCLUSION: The introduction of a checklist is recommended for the standardization of TURBT and increasing the quality of operative reporting, and it may also improve oncological outcomes.
  • Mikio Konno, Takahiro Osawa, Kiyohiko Hotta, Ai Shimizu, Takashige Abe, Ryuji Matsumoto, Hiroshi Kikuchi, Nobuo Shinohara
    IJU case reports 5 (1) 66 - 69 2022/01 
    INTRODUCTION: We report a rare case of primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava. CASE PRESENTATION: A 54-year-old woman presented with right flank pain and abdominal distension. Physical examination findings were unremarkable. Abdominal computed tomography revealed a heterogeneously enhancing right solid renal mass with a thrombus in the renal vein extending into the inferior vena cava. Magnetic resonance imaging demonstrated a renal tumor with a thrombus about 4 cm below the hepatic vein. Chest computed tomography and bone scintigraphy were negative. The patient underwent right radical nephrectomy and vena cava thrombectomy. Histophathologic evaluation of the resected tumor confirmed the diagnosis of leiomyosarcoma. She underwent no adjuvant therapy. Seven months after surgery, the patient died following a 2-month history of multiple pulmonary and hepatic metastases. CONCLUSION: This report highlights the importance of considering the possibility of renal leiomyosarcoma invasion to the inferior vena cava, similar to renal cell carcinoma.
  • Takahiro Osawa, Takashige Abe, Hiroshi Kikuchi, Ryuji Matsumoto, Sachiyo Murai, Takafumi Nakao, Shinji Tanaka, Ayu Watanabe, Nobuo Shinohara
    PloS one 17 (3) e0265230  2022 
    BACKGROUND: Immune checkpoint inhibitors (ICIs) are increasingly being used to treat malignancies. Some patients experience immune-related adverse events (irAEs), which may affect any organ/tissue. IrAEs are occasionally fatal and usually have nonspecific symptoms. We developed a three-step application (https://irae-search.com/) to provide healthcare professionals with information on the diagnosis, treatment options, and published reports for 38 categories of irAEs encountered in clinical practice. METHODS: IrAEs reported in ≥5 cases were identified from articles published between October 2018 and August 2020 by searching Japanese (SELIMIC, JAPIC-Q Service, and JMED Plus) and international (MEDLINE, EMBASE, Derwent Drug File) databases. The cases' symptoms were entered into the application to identify irAEs, which were verified using the reported diagnosis, to evaluate the application's sensitivity and specificity. RESULTS: Overall, 1209 cases (1067 reports) were analyzed. The three most common categories of irAEs were pituitary or adrenal disorders (14% of cases), skin disorders (13%), and diabetes mellitus (10%). The top three primary diseases were lung cancer (364 cases), melanoma (286 cases), and renal cell carcinoma (218 cases). The average sensitivity was 90.8% (range 44.4%-100.0%) initially, and improved to 94.8% (range 83.3%-100.0%) after incorporating the symptoms reported in published cases into the application's logic for two irAE categories. The average specificity was 79.3% (range 59.1% [thyroid disorders]-98.2% [arthritis]). CONCLUSION: irAE Search is an easy-to-use application designed to help healthcare professionals identify potential irAEs in ICI-treated patients in a timely manner to facilitate prompt management/treatment. The application showed high sensitivity and moderate-to-high specificity for detecting irAEs.
  • Shuhei Yamada, Takashige Abe, Ataru Sazawa, Hidenori Katano, Hidetaka Suzuki, Ichiro Takeuchi, Junji Ishizaki, Keita Minami, Ken Morita, Kunihiko Tsuchiya, Norikata Takada, Shintaro Maru, Shuhei Ishikawa, Soshu Sato, Takafumi Kawazu, Takanori Yamashita, Takenori Ono, Tango Mochizuki, Tomoshige Akino, Yoshihiro Sasaki, Yuichiro Shinno, Jun Furumido, Haruka Miyata, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    Urologic oncology 40 (1) 11.e17-11.e25  2022/01 
    OBJECTIVES: During the past 2 decades, in order to improve perioperative and oncological outcomes, a minimally invasive approach, neoadjuvant chemotherapy (NAC), and an enhanced postoperative recovery program after surgery have been introduced into routine clinical practice of radical cystectomy (RC). Our aim was to examine the differences in clinical practice and postoperative complications after RC by comparing our previous and current cohorts. MATERIALS AND METHODS: A retrospective multi-institutional study. We collected all complications within 90 days after surgery between 2011 and 2017 (current cohort), and categorized them according to a standardized methodology. Then, we compared the outcomes with those in our previous study (previous cohort, 1997-2010). A multivariate logistic regression model was utilized to determine predictors of complications in the current cohort. RESULTS: A total of 838 patients were newly collected (current cohort), and 919 from the previous cohort were included in the subsequent analyses. In the current cohort, the rate of performing NAC was significantly higher (13% vs. 4%, respectively, P < 0.0001), and 26% (222/838) underwent laparoscopic RC (LRC, without robotic assistance: n = 210, with robotic assistance: n = 12). There was no significant difference in the overall complication [69% (580/838) vs. 68% (629/919), respectively, P = 0.7284] or major complication (Grades 3-5) [25% (211/838) vs. 22% (201/919), respectively, P = 0.1022] rates between the 2 cohorts. In both cohorts, the most frequent categories were infectious, gastrointestinal, wound-related, and genitourinary. In the current cohort, the performance status (odds ratio, OR = 2.11, P = 0.0013) and operative time (OR = 1.003, P = 0.0016) remained significant predictors of major complications. NAC was not associated with any or major complications. CONCLUSIONS: Surgical complications related to RC still remain significant problems, despite the recent improvements in surgical techniques and perioperative care. NAC did not increase the complications.
  • 加藤 大悟, 松原 伸晃, 塩田 真己, 江藤 正俊, 大澤 崇宏, 安部 崇重, 篠原 信雄, 安水 洋太, 田中 伸之, 大家 基嗣, 西本 紘嗣郎, 林 拓自, 中山 雅志, 吉野 孝之, 野々村 祝夫
    泌尿器科 (有)科学評論社 15 (1) 77 - 82 2435-192X 2022/01
  • MONSTAR-SCREEN試験におけるリキッドバイオプシー研究
    加藤 大悟, 松原 伸晃, 塩田 真己, 江藤 正俊, 大澤 崇宏, 安部 崇重, 篠原 信雄, 安水 洋太, 田中 伸之, 大家 基嗣, 西本 紘嗣郎, 林 拓自, 中山 雅志, 吉野 孝之, 野々村 祝夫
    泌尿器科 (有)科学評論社 15 (1) 77 - 82 2435-192X 2022/01
  • Hiroshi Kikuchi, Takahiro Osawa, Ryuji Matsumoto, Takashige Abe, Satoru Maruyama, Toru Harabayashi, Haruka Miyata, Akira Kashiwagi, Suguru Ikeshiro, Ataru Sazawa, Riyo Fukui, Ken Morita, Ichiro Takeuchi, Kanta Hori, Noboru Yamashita, Keita Minami, Tango Mochizuki, Sachiyo Murai, Nobuo Shinohara
    Urologic oncology 40 (1) 13.e19-13.e27  2022/01 
    OBJECTIVES: With the emergence of several effective combination therapies, information on their effects at the primary site will be crucial for planning future cytoreductive nephrectomy (CN). The present study focused exclusively on changes in primary tumor sizes following treatment with nivolumab plus ipilimumab and investigated the clinical factors associated with a good response in primary tumors. METHODS AND MATERIALS: We retrospectively assessed 27 patients diagnosed with advanced renal cell carcinoma (RCC) who started treatment with nivolumab plus ipilimumab. Changes in tumor sizes at the primary site were described using waterfall and spider plots, respectively. We analyzed the correlation of tumor shrinkage between primary and metastatic site. The parameters analyzed between responders and non-responders according to primary tumor sizes were International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk scores, peripheral blood markers, and CRP. RESULTS: The median age and follow-up period were 66 years and 9.3 months, respectively. The median IMDC risk score was 3 (range: 1-6). Nineteen patients were diagnosed with clear-cell RCC (ccRCC) and 8 patients with non-ccRCC. Among ccRCC patients, 9 (47.4%) achieved a significant response with a maximum reduction of 30% or more in the size of the primary tumor from baseline within 4 months, while 3 (37.5%) out of 8 patients with non-ccRCC achieved a significant response. Shrinkage of the primary tumor correlated with the metastatic tumors in both ccRCC and non-ccRCC cases. Of note, 6 patients underwent CN and no viable tumor cells were detected in the surgical specimens of 3 patients whose primary tumors shrank by approximately 50%-60% with a reduction to 4 cm or less. Among ccRCC patients, the neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio were slightly lower in responders than in non-responders (P = 0.0944 and P = 0.0691). The platelet-to-lymphocyte ratio was significantly lower in responders than in non-responder (P = 0.0391). CONCLUSIONS: Significant responses in primary tumors to nivolumab plus ipilimumab were observed in 50% of ccRCC patients, while responses varied among non-ccRCC patients. Inflammation markers may be predictive factors of treatment responses in primary tumors. Although further studies are needed, the present results suggest the importance of considering CN from radiological and pathological viewpoints.
  • Koki Ebina, Takashige Abe, Kiyohiko Hotta, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Masafumi Kon, Kou Miyaji, Sayaka Shibuya, Yan Lingbo, Shunsuke Komizunai, Yo Kurashima, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Teppei Tsujita, Kazuya Sase, Xiaoshuai Chen, Atsushi Konno, Nobuo Shinohara
    PloS one 17 (11) e0277105  2022 [Refereed]
     
    The purpose of this study was to characterize the motion features of surgical devices associated with laparoscopic surgical competency and build an automatic skill-credential system in porcine cadaver organ simulation training. Participants performed tissue dissection around the aorta, dividing vascular pedicles after applying Hem-o-lok (tissue dissection task) and parenchymal closure of the kidney (suturing task). Movements of surgical devices were tracked by a motion capture (Mocap) system, and Mocap-metrics were compared according to the level of surgical experience (experts: ≥50 laparoscopic surgeries, intermediates: 10-49, novices: 0-9), using the Kruskal-Wallis test and principal component analysis (PCA). Three machine-learning algorithms: support vector machine (SVM), PCA-SVM, and gradient boosting decision tree (GBDT), were utilized for discrimination of the surgical experience level. The accuracy of each model was evaluated by nested and repeated k-fold cross-validation. A total of 32 experts, 18 intermediates, and 20 novices participated in the present study. PCA revealed that efficiency-related metrics (e.g., path length) significantly contributed to PC 1 in both tasks. Regarding PC 2, speed-related metrics (e.g., velocity, acceleration, jerk) of right-hand devices largely contributed to the tissue dissection task, while those of left-hand devices did in the suturing task. Regarding the three-group discrimination, in the tissue dissection task, the GBDT method was superior to the other methods (median accuracy: 68.6%). In the suturing task, SVM and PCA-SVM methods were superior to the GBDT method (57.4 and 58.4%, respectively). Regarding the two-group discrimination (experts vs. intermediates/novices), the GBDT method resulted in a median accuracy of 72.9% in the tissue dissection task, and, in the suturing task, the PCA-SVM method resulted in a median accuracy of 69.2%. Overall, the mocap-based credential system using machine-learning classifiers provides a correct judgment rate of around 70% (two-group discrimination). Together with motion analysis and wet-lab training, simulation training could be a practical method for objectively assessing the surgical competence of trainees.
  • Nicholas Raison, Patrick Harrison, Takashige Abe, Abdullatif Aydin, Kamran Ahmed, Prokar Dasgupta
    Surgical Endoscopy 35 (12) 6897 - 6902 1432-2218 2021/12/01 
    Background: Virtual reality (VR) training is widely used for surgical training, supported by comprehensive, high-quality validation. Technological advances have enabled the development of procedural-based VR training. This study assesses the effectiveness of procedural VR compared to basic skills VR in minimally invasive surgery. Methods: 26 novice participants were randomised to either procedural VR (n = 13) or basic VR simulation (n = 13). Both cohorts completed a structured training programme. Simulator metric data were used to plot learning curves. All participants then performed parts of a robotic radical prostatectomy (RARP) on a fresh frozen cadaver. Performances were compared against a cohort of 9 control participants without any training experience. Performances were video recorded and assessed blindly using GEARS post hoc. Results: Learning curve analysis demonstrated improvements in technical skill for both training modalities although procedural training was associated with greater training effects. Any VR training resulted in significantly higher GEARS scores than no training (GEARS score 11.3 ± 0.58 vs. 8.8 ± 2.9, p = 0.002). Procedural VR training was found to be more effective than both basic VR training and no training (GEARS 11.9 ± 2.9 vs. 10.7 ± 2.8 vs. 8.8 ± 1.4, respectively, p = 0.03). Conclusions: This trial has shown that a structured programme of procedural VR simulation is effective for robotic training with technical skills successfully transferred to a clinical task in cadavers. Further work to evaluate the role of procedural-based VR for more advanced surgical skills training is required.
  • Naoya Iwahara, Takashige Abe, So Nagai, Masanao Yoshino, Hitoshi Saito, Hiromi Okada, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    IJU case reports 4 (5) 330 - 332 2021/09 
    Introduction: Thyroid storm is a rare life-threating condition. We report a case of thyroid storm after radical nephrectomy for renal cell carcinoma with inferior vena cava tumor thrombus. Case presentation: A 76-year-old man with a left renal tumor and tumor thrombus extending into the inferior vena cava underwent left radical nephrectomy and thrombectomy. After the surgery, his postoperative course rapidly deteriorated, including central nervous system disturbance, fever, tachycardia, congestive heart failure, and hepatic manifestation. Thyroid function test revealed perioperative hyperthyroidism. Corticosteroids and inorganic iodide improved his condition, suggesting that he developed thyroid storm after surgery. He was discharged 5 months after surgery and has been free from disease recurrence for more than 2 years. Conclusion: Thyroid storm after surgery is rare. However, this postoperative complication is important because it is fatal if not diagnosed and treated properly.
  • Yoichiro Tohi, Takuma Kato, Akira Yokomizo, Koji Mitsuzuka, Ryotaro Tomida, Junichi Inokuchi, Ryuji Matsumoto, Toshihiro Saito, Hiroshi Sasaki, Koji Inoue, Hidefumi Kinoshita, Hiroshi Fukuhara, Satoru Maruyama, Shinichi Sakamoto, Toshiki Tanikawa, Shin Egawa, Haruhiko Ichikura, Takashige Abe, Masaki Nakamura, Yoshiyuki Kakehi, Mikio Sugimoto
    Urologic oncology 40 (2) 56.e9-56.e15  2021/06/08 
    OBJECTIVES: This study aimed to evaluate how health-related quality of life (HRQOL) is related to repeat protocol biopsy compliance. MATERIALS AND METHODS: We conducted a retrospective analysis using data from a prospective cohort in the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study between January 2010 and August 2019. We used the Short Form 8 Health Survey (SF-8), as patient-reported outcomes, to assess HRQOL at AS enrollment and the first year of the protocol. The physical component summary (PCS) and mental component summary (MCS) were calculated from SF-8 questionnaires. The primary outcome was the evaluation of the association of HRQOL at enrollment on the first repeat biopsy compliance. The secondary outcome was the comparison of SF-8 scores during AS, stratified by repeat protocol biopsy compliance. RESULTS: Of 805 patients who proceeded to the first year of the protocol, the non-compliance rate was 15% (121 patients). In the adjusted model, lower MCS at enrollment was significantly associated with the first repeat protocol biopsy non-compliance (odds ratio [OR], 2.134; 95% confidence interval [CI], 1.031-4.42; P = 0.041) but not in lower PCS (OR, 0.667; 95% CI, 0.294-1.514; P = 0.333). All subscales of SF-8 were lower in the non-compliance group than in the compliance group at any point. MCS in the non-compliance group improved over time from the time of AS enrollment (2.34 increased, P = 0.152). CONCLUSION: Our data suggest that lower MCS at AS enrollment using patient-reported outcomes was negatively associated with the first repeat protocol biopsy compliance. Our study may support the availability of a simple questionnaire to extract non-compliance.
  • Makito Miyake, Nobutaka Nishimura, Kota Iida, Tomomi Fujii, Ryoma Nishikawa, Shogo Teraoka, Atsushi Takenaka, Hiroshi Kikuchi, Takashige Abe, Nobuo Shinohara, Eijiro Okajima, Takuto Shimizu, Shunta Hori, Norihiko Tsuchiya, Takuya Owari, Yasukiyo Murakami, Rikiya Taoka, Takashi Kobayashi, Takahiro Kojima, Naotaka Nishiyama, Hiroshi Kitamura, Hiroyuki Nishiyama, Kiyohide Fujimoto
    Cancers 13 (11) 2021/05/26 
    The 2016 World Health Organization classification newly described infiltrating urothelial carcinoma (UC) with divergent differentiation (DD) or variant morphologies (VMs). Data comparing oncological outcomes after bladder-preservation therapy using intravesical Bacillus Calmette-Guérin (BCG) treatment among T1 bladder pure UC (pUC), UC with DD (UC-DD), and UC with VMs (UC-VM) are limited. We evaluated 1490 patients with T1 high-grade bladder UC who received intravesical BCG during 2000-2019. They were classified into three groups: 93.6% with pUC, 4.4% with UC-DD, and 2.0% with UC-VM. Recurrence-free, progression-free, and cancer-specific survival following intravesical BCG were compared among the groups using multivariate Cox regression analysis, also used to estimate inverse probability of treatment weighting-adjusted hazard ratio and 95% confidence interval for the outcomes. Glandular differentiation and micropapillary variant were the most common forms in the UC-DD and UC-VM groups, respectively. Of 1490 patients, 31% and 13% experienced recurrence and progression, respectively, and 5.0% died of bladder cancer. Survival analyses revealed the impact of concomitant VMs was significant for cancer-specific survival, but not recurrence-free and progression-free survival compared with that of pUC. Our analysis clearly demonstrated that concomitant VMs were associated with aggressive behavior in contrast to concomitant DD in patients treated with intravesical BCG.
  • Keiichiro Yoshinaga, Takashige Abe, Shozo Okamoto, Yuko Uchiyama, Osamu Manabe, Yoichi M Ito, Naomi Tamura, Natsue Ito, Naho Yoshioka, Komei Washino, Nobuo Shinohara, Nagara Tamaki, Tohru Shiga
    Journal of nuclear medicine : official publication, Society of Nuclear Medicine 62 (5) 685 - 694 2021/05/10 
    131I-meta-iodobenzylguanidine (131I-MIBG) radiotherapy has shown some survival benefits in metastatic neuroendocrine tumors (NETs). European Association of Nuclear Medicine clinical guidelines for 131I-MIBG radiotherapy suggest a repeated treatment protocol, although none currently exists. The existing single-high-dose 131I-MIBG radiotherapy (444 MBq/kg) has been shown to have some benefits for patients with metastatic NETs. However, this protocol increases adverse effects and requires alternative therapeutic approaches. Therefore, the aim of this study was to evaluate the effects of repeated 131I-MIBG therapy on tumor size and tumor metabolic response in patients with metastatic NETs. Methods: Eleven patients with metastatic NETs (aged 49.2 ± 16.3 y) prospectively received repeated 5,550-MBq doses of 131I-MIBG therapy at 6-mo intervals. In total, 31 treatments were performed. The mean number of treatments was 2.8 ± 0.4, and the cumulative 131I-MIBG dose was 15,640.9 ± 2,245.1 MBq (286.01 MBq/kg). Tumor response was observed by CT and 18F-FDG PET or by 18F-FDG PET/CT before and 3-6 mo after the final 131I-MIBG treatment. Results: On the basis of the CT findings with RECIST, 3 patients showed a partial response and 6 patients showed stable disease. The remaining 2 patients showed progressive disease. Although there were 2 progressive-disease patients, analysis of all patients showed no increase in summed length diameter (median, 228.7 mm [interquartile range (IQR), 37.0-336.0 mm] to 171.0 mm [IQR, 38.0-270.0 mm]; P = 0.563). In tumor region-based analysis with partial-response and stable-disease patients (n = 9), 131I-MIBG therapy significantly reduced tumor diameter (79 lesions; median, 16 mm [IQR, 12-22 mm] to 11 mm [IQR, 6-16 mm]; P < 0.001). Among 5 patients with hypertension, there was a strong trend toward systolic blood pressure reduction (P = 0.058), and diastolic blood pressure was significantly reduced (P = 0.006). Conclusion: Eighty-two percent of metastatic NET patients effectively achieved inhibition of disease progression, with reduced tumor size and reduced metabolic activity, through repeated 131I-MIBG therapy. Therefore, this relatively short-term repeated 131I-MIBG treatment may have potential as one option in the therapeutic protocol for metastatic NETs. Larger prospective studies with control groups are warranted.
  • ウエットラボにおける腹腔鏡手術熟練課程の数値化の試み
    安部 崇重, 海老名 光希, 樋口 まどか, 古御堂 純, 岩原 直也, 今 雅史, 堀田 紀世彦, 小水内 俊介, 倉島 庸, 村井 祥代, 近野 敦, 篠原 信雄
    泌尿器外科 医学図書出版(株) 34 (3) 327 - 327 0914-6180 2021/03
  • Abdullatif Aydın, Kamran Ahmed, Takashige Abe, Nicholas Raison, Mieke Van Hemelrijck, Hans Garmo, Hashim U. Ahmed, Furhan Mukhtar, Ahmed Al-Jabir, Oliver Brunckhorst, Nobuo Shinohara, Wei Zhu, Guohua Zeng, John P. Sfakianos, Mantu Gupta, Ashutosh Tewari, Ali Serdar Gözen, Jens Rassweiler, Andreas Skolarikos, Thomas Kunit, Thomas Knoll, Felix Moltzahn, George N. Thalmann, Andrea G. Lantz Powers, Ben H. Chew, Kemal Sarica, Muhammad Shamim Khan, Prokar Dasgupta, SIMULATE Trial Group
    European Urology 1873-7560 2021 
    Background: It is hypothesised that simulation enhances progression along the initial phase of the surgical learning curve. Objective: To evaluate whether residents undergoing additional simulation, compared to conventional training, are able to achieve proficiency sooner with better patient outcomes. Design, setting, and participants: This international, multicentre, randomised controlled trial recruited 94 urology residents with experience of zero to ten procedures and no prior exposure to simulation in ureterorenoscopy, selected as an index procedure. Intervention: Participants were randomised to simulation or conventional operating room training, as is the current standard globally, and followed for 25 procedures or over 18 mo. Outcome measurements and statistical analysis: The number of procedures required to achieve proficiency, defined as achieving a score of ≥28 on the Objective Structured Assessment of Technical Skill (OSATS) scale over three consecutive operations, was measured. Surgical complications were evaluated as a key secondary outcome. This trial is registered at www.isrctn.com as ISCRTN 12260261. Results and limitations: A total of 1140 cases were performed by 65 participants, with proficiency achieved by 21 simulation and 18 conventional participants over a median of eight and nine procedures, respectively (hazard ratio [HR] 1.41, 95% confidence interval [CI] 0.72–2.75). More participants reached proficiency in the simulation arm in flexible ureterorenoscopy, requiring a lower number of procedures (HR 0.89, 95% CI 0.39–2.02). Significant differences were observed in overall comparison of OSATS scores between the groups (mean difference 1.42, 95% CI 0.91–1.92 p < 0.001), with fewer total complications (15 vs 37 p = 0.003) and ureteric injuries (3 vs 9 p < 0.001) in the simulation group. Conclusions: Although the number of procedures required to reach proficiency was similar, simulation-based training led to higher overall proficiency scores than for conventional training. Fewer procedures were required to achieve proficiency in the complex form of the index procedure, with fewer serious complications overall. Patient summary: This study investigated the effect of simulation training in junior surgeons and found that it may improve performance in real operating settings and reduce surgical complications for complex procedures.
  • 桑原 咲, 亀田 啓, 家坂 光, 泉原 里美, 大江 悠希, 上垣 里紗, 千葉 幸輝, 宮 愛華, 野本 博司, 曹 圭龍, 中村 昭伸, 安部 崇重, 篠原 信雄, 三好 秀明, 渥美 達也
    日本内分泌学会雑誌 (一社)日本内分泌学会 96 (3) 598 - 598 0029-0661 2021/01
  • Kentaro Nishioka, Kento Gotoh, Takayuki Hashimoto, Takashige Abe, Takahiro Osawa, Ryuji Matsumoto, Isao Yokota, Norio Katoh, Rumiko Kinoshita, Koichi Yasuda, Toshiaki Yakabe, Takaaki Yoshimura, Seishin Takao, Nobuo Shinohara, Hidefumi Aoyama, Shinichi Shimizu, Hiroki Shirato
    BJR|Open 3 (1) 2021/01 [Refereed]
     
    Objectives: The purpose of this study is to investigate whether verbal instructions are sufficient for bladder volume (BV) control not to deteriorate prostate position reproducibility in image-guided spot scanning proton therapy (SSPT) for localized prostate cancer. Methods: A total of 268 treatment sessions in 12 consecutive prostate cancer patients who were treated with image-guided SSPT with fiducial markers were retrospectively analyzed. In addition to strict rectal volume control procedures, simple verbal instructions to void urine one hour before the treatment were used here. The BV was measured by a Bladder Scan just before the treatment, and the prostate motion was measured by intraprostatic fiducial markers and two sets of X-ray fluoroscopy images. The correlation between the BV change and prostate motion was assessed by linear mixed-effects models and systematic and random errors according to the reproducibility of the BV. Results: The mean absolute BV change during treatment was from −98.7 to 86.3 ml (median 7.1 ml). The mean absolute prostate motion of the patients in the left-right direction was −1.46 to 1.85 mm; in the cranial-caudal direction it was −6.10 to 3.65 mm, and in the anteroposterior direction −1.90 to 5.23 mm. There was no significant relationship between the BV change and prostate motion during SSPT. The early and late genitourinary and gastrointestinal toxicity was minimal with a minimum follow up of 4.57 years. Conclusions: Simple verbal instructions about urination was suggested to be sufficient to control the BV not to impact on the prostate motion and clinical outcomes in image-guided SSPT. Careful attention to BV change is still needed when the seminal vesicle is to be treated. Advances in knowledge: Our data demonstrated that there was no apparent relationship between BV changes and prostate position reproducibility and simple verbal instruction about urination could be sufficient for image-guided SSPT.
  • Takahiro Osawa, John T. Wei, Takashige Abe, Michitaka Honda, Karl T. Rew, Rod Dunn, Shuhei Yamada, Jun Furumido, Hiroshi Kikuchi, Ryuji Matsumoto, Yasuyuki Sato, Toni Harabayashi, Norikata Takada, Keita Minami, Ken Morita, Akira Kashiwagi, Shunichi Fukuhara, Sachiyo Murai, Yoichi M. Ito, Katsuhiko Ogasawara, Nobuo Shinohara
    BLADDER CANCER 7 (1) 61 - 69 2352-3727 2021 
    INTRODUCTION: The aim of this study is to characterize health related quality of life (HRQOL) in Japanese patients after bladder cancer surgery and to perform cross-cultural comparison between Japanese and American patients.METHODS: Firstly, we cross-sectionally assessed HRQOL of 371 patients in Japan using the Bladder Cancer Index (BCI- Japanese). HRQOL of the four groups of patients (native bladder without intravesical therapy, native bladder with intravesical therapy, cystectomy with ileal conduit, and cystectomy with neobladder) were assessed. Secondly, we compared the Japanese with the American cohort (n = 315) from the original BCI paper. After adjusting for age and gender, the differences in each BCI subdomain score was analyzed.RESULTS: Among Japanese patients, the urinary domain function score was significantly lower among the cystectomy with neobladder group, compared to the cystectomy with ileal conduit group (p < 0. 01). Despite this, the urinary bother was comparable between the two groups. Although there were apparent differences between Japanese and American patients, there were few differences in Urinary and Bowel HRQOL. In three of the four treatment groups (other than native bladder with intravesical therapy), Japanese patients were more likely than Americans to report poor sexual function (p < 0.05). However, Japanese patients were less likely than Americans to be bothered by their lower sexual function, regardless of treatment (p <0.05).CONCLUSIONS: HRQOL outcomes following treatment of bladder cancer in Japan are comparable to those in the USA, except for sexual functioning and sexual bother. The BCI can be used for cross-cultural assessments of HRQOL in bladder cancer patients.
  • モーションキャプチャー装置を用いた腹腔鏡手術手技の熟練過程の分析
    安部 崇重, 海老名 光希, 樋口 まどか, 古御堂 純, 岩原 直也, 今 雅史, 堀田 記世彦, 小水内 俊介, 倉島 庸, 村井 祥代, 近野 敦, 篠原 信雄
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 108回 899 - 899 2020/12
  • Takahiro Osawa, John T. Wei, Takashige Abe, Michitaka Honda, Shuhei Yamada, Jun Furumido, Hiroshi Kikuchi, Ryuji Matsumoto, Kazushi Hirakawa, Yasuyuki Sato, Yoshihiro Sasaki, Toru Harabayashi, Norikata Takada, Keita Minami, Hiroshi Tanaka, Ken Morita, Akira Kashiwagi, Naoto Miyajima, Tomoshige Akino, Sachiyo Murai, Yoichi M. Ito, Shunichi Fukuhara, Katsuhiko Ogasawara, Nobuo Shinohara
    International Journal of Clinical Oncology 25 (12) 2090 - 2098 1341-9625 2020/12 [Refereed]
     
    Abstract Introduction We validated a Japanese version of the Bladder Cancer Index (BCI) as a tool for measuring health-related quality of life (HRQOL) in bladder cancer patients treated with various surgical procedures. Methods The reliability and validity of the Japanese BCI were examined in 397 Japanese patients with bladder cancer via cross-sectional analysis. The patients simultaneously completed the Short Form (SF)-12, EQ-5D, and the Functional Assessment of Cancer Therapy-General and Bladder (FACT-G and FACT-BL). The differences in BCI subscales among various treatment groups were analyzed. Results This study involved 397 patients (301 males and 96 females), with a mean age of 70 years and a median disease duration of 29 months (IQR: 12–66 months). Of these patients, 221 underwent transurethral resection of a bladder tumor, and 176 patients underwent radical cystectomy (ileal conduit: 101 patients, ileal neobladder: 49, and ureterostomy: 26). Cronbach’s alpha coefficient was ≥ 0.78 for all subscales, except the bowel bother subscale. Despite moderate correlations being detected between the function and bother score in urinary and bowel domains, the sexual function score was inversely correlated with the sexual bother score (r = − 0.19). A missing value percentage of > 15% was associated with old age (p < 0.05). The mean domain scores differed significantly among distinct clinically relevant treatment groups. Conclusions Although revisions are needed to make it easier for elderly patients to comprehend, we confirmed the reliability and validity of the Japanese BCI. The Japanese BCI could be used for cross-cultural assessments of HRQOL in bladder cancer patients.
  • Koki Ebina, Takashige Abe, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Masafumi Kon, Kiyohiko Hotta, Shunsuke Komizunai, Yo Kurashima, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Teppei Tsujita, Kazuya Sase, Xiaoshuai Chen, Atsushi Konno, Nobuo Shinohara
    Surgical endoscopy 35 (8) 4399 - 4416 0930-2794 2020/09/09 [Refereed][Not invited]
     
    BACKGROUND: Our aim was to characterize the motions of multiple laparoscopic surgical instruments among participants with different levels of surgical experience in a series of wet-lab training drills, in which participants need to perform a range of surgical procedures including grasping tissue, tissue traction and dissection, applying a Hem-o-lok clip, and suturing/knotting, and digitize the level of surgical competency. METHODS: Participants performed tissue dissection around the aorta, dividing encountered vessels after applying a Hem-o-lok (Task 1), and renal parenchymal closure (Task 2: suturing, Task 3: suturing and knot-tying), using swine cadaveric organs placed in a box trainer under a motion capture (Mocap) system. Motion-related metrics were compared according to participants' level of surgical experience (experts: 50 ≤ laparoscopic surgeries, intermediates: 10-49, novices: 0-9), using the Kruskal-Wallis test, and significant metrics were subjected to principal component analysis (PCA). RESULTS: A total of 15 experts, 12 intermediates, and 18 novices participated in the training. In Task 1, a shorter path length and faster velocity/acceleration/jerk were observed using both scissors and a Hem-o-lok applier in the experts, and Hem-o-lok-related metrics markedly contributed to the 1st principal component on PCA analysis, followed by scissors-related metrics. Higher-level skills including a shorter path length and faster velocity were observed in both hands of the experts also in tasks 2 and 3. Sub-analysis showed that, in experts with 100 ≤  cases, scissors moved more frequently in the "close zone (0  ≤ to < 2.0 cm from aorta)" than those with 50-99 cases. CONCLUSION: Our novel Mocap system recognized significant differences in several metrics in multiple instruments according to the level of surgical experience. "Applying a Hem-o-lok clip on a pedicle" strongly reflected the level of surgical experience, and zone-metrics may be a promising tool to assess surgical expertise. Our next challenge is to give completely objective feedback to trainees on-site in the wet-lab.
  • Madoka Higuchi, Takashige Abe, Kiyohiko Hotta, Ken Morita, Haruka Miyata, Jun Furumido, Naoya Iwahara, Masafumi Kon, Takahiro Osawa, Ryuji Matsumoto, Hiroshi Kikuchi, Yo Kurashima, Sachiyo Murai, Abdullatif Aydin, Nicholas Raison, Kamran Ahmed, Muhammad Shamim Khan, Prokar Dasgupta, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 2020/08/03 [Refereed][Not invited]
     
    OBJECTIVES: To develop a wet laboratory training model for learning core laparoscopic surgical skills and evaluating learners' competency level outside the operating room. METHODS: Participants completed three tasks (task 1: tissue dissection around the aorta; task 2: tissue dissection and division of the renal artery; task 3: renal parenchymal closure). Each performance was video recorded and subsequently evaluated by two experts, according to the Global Operative Assessment of Laparoscopic Skills and task-specific metrics that we developed (Assessment Sheet of Laparoscopic Skills in Wet Lab score). Mean scores were used for analyses. The subjective mental workload was also assessed (NASA Task Load Index). RESULTS: The 54 participants included 32 urologists, eight young trainees and 14 medical students. A total of 13 participants were categorized as experts (≥50 laparoscopic surgeries), eight as intermediates (10-49) and 33 as novices (0-9). There were significant differences in the Global Operative Assessment of Laparoscopic Skills and Assessment Sheet of Laparoscopic Skills in Wet Lab scores among the three groups in all three tasks. Higher NASA Task Load Index scores were observed in novices, and there were significant differences in tasks 1 (Kruskal-Wallis test, P = 0.0004) and 2 (P = 0.0002), and marginal differences in task 3 (P = 0.0745) among the three groups. CONCLUSIONS: Our training model has good construct validity, and differences in the NASA Task Load Index score reflect previous laparoscopic surgical experiences. Our findings show the ability to assess both laparoscopic surgical skills and mental workloads, which could help educators comprehend trainees' level outside the operating room. Given the decreasing opportunity to carry out pure laparoscopic surgeries because of the dissemination of robotic surgery, especially in urology, our model can offer practical training opportunities.
  • 転移性腎癌に対するニボルマブとイピリムマブの併用療法により破壊性甲状腺炎に続いて劇症1型糖尿病を発症した1例
    家坂 光, 亀田 啓, 安部 崇重, 亀田 玲奈, 宮 愛香, 野本 博司, 曹 圭龍, 中村 昭伸, 篠原 信雄, 三好 秀明, 渥美 達也
    糖尿病 (一社)日本糖尿病学会 63 (Suppl.1) S - 173 0021-437X 2020/08
  • Koki Ebina, Takashige Abe, Shunsuke Komizunai, Teppei Tsujita, Kazuya Sase, Xiaoshuai Chen, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Yo Kurashima, Nobuo Shinohara, Atsushi Konno
    SICE Journal of Control, Measurement, and System Integration 13 (4) 191 - 200 1882-4889 2020/07 [Refereed][Invited]
  • Hiroshi Kikuchi, Nako Maishi, Dorcas A. Annan, Mohammad Towfik Alam, Randa Ibrahim Hassan Dawood, Masumi Sato, Masahiro Morimoto, Ryo Takeda, Keita Ishizuka, Ryuji Matsumoto, Tomoshige Akino, Kunihiko Tsuchiya, Takashige Abe, Takahiro Osawa, Naoto Miyajima, Satoru Maruyama, Toru Harabayashi, Manabu Azuma, Katsushige Yamashiro, Kaname Ameda, Akira Kashiwagi, Yoshihiro Matsuno, Yasuhiro Hida, Nobu Shinohara, Kyoko Hida
    Cancer Research canres.3791.2019 - canres.3791.2019 0008-5472 2020/06/14 [Refereed][Not invited]
  • Takashige Abe, Keita Minami, Toru Harabayashi, Ataru Sazawa, Hiroki Chiba, Hiroshi Kikuchi, Haruka Miyata, Jun Frumido, Ryuji Matsumoto, Takahiro Osawa, Ishizaki Junji, Mochizuki Tango, Chiba Satoshi, Akino Tomoshige, Murakumo Masashi, Miyajima Naoto, Tsuchiya Kunihiko, Maruyama Satoru, Sachiyo Murai, Nobuo Shinohara
    Japanese journal of clinical oncology 50 (6) 727 - 727 2020/06/10 [Refereed][Not invited]
  • Ryuji Matsumoto, Takashige Abe, Norikata Takada, Keita Minami, Toru Harabayashi, Satoshi Nagamori, Kanako C Hatanaka, Katsushige Yamashiro, Hiroshi Kikuchi, Takahiro Osawa, Satoru Maruyama, Nobuo Shinohara
    Urologic oncology 2020/06/10 [Refereed][Not invited]
     
    OBJECTIVES: This study investigated the relapse pattern and oncologic outcomes after laparoscopic nephroureterectomy with template-based lymph node dissection (LND) in patients with clinically node-negative (cN0) upper urinary tract urothelial carcinoma. The frequency of lymph node metastasis, including micrometastases, was also evaluated. METHODS AND MATERIALS: A total of 105 patients with cTa-3N0M0 upper urinary tract urothelial carcinoma were analyzed, all of whom underwent regional LND during laparoscopic nephroureterectomy. Of those patients, 96 (91%) underwent complete LND in accordance with an anatomical template-based rule. We collected patient characteristics, pathological data, and follow-up data from medical charts. Micrometastases were assessed by pan-cytokeratin immunohistochemistry. Nonurothelial recurrence-free survival and cancer-specific survival were estimated using the Kaplan-Meier method. RESULTS: The median number of lymph nodes removed was 12 (range, 1-59). Lymph node metastasis was identified by routine pathological examination in 7 (7/105, 6.7%) patients. Pan-cytokeratin immunohistochemistry revealed micrometastases in 5 additional patients (pNmicro +: 5/105, 4.8%). Nonurothelial disease recurrence was observed in 21 (20%) patients at a median of 10 months (range: 1-33) after surgery. Distant metastasis was dominant (15/105, 14.3%), followed by locoregional recurrence (5/105, 4.8%) and both (1/105, 0.95%). The 5-year nonurothelial recurrence-free survival rates were 84.8% for pN0, 53.3% for pNmicro+, and 19.1% for pN+ (3-sample log-rank test, P < 0.0001). The 5-year cancer-specific survival rates were 95.0% for pN0, 53.3% for pNmicro+, and 23.8% for pN+ (P < 0.0001). CONCLUSIONS: Our observation showed that template-based LND could contribute to precise disease staging and better local disease control probably by eliminating nodal disease, compared with previous studies. The survival impact and ideal management of pNmicro+ disease should be evaluated in a larger cohort.
  • Nicholas Raison, Andrea Gavazzi, Takashige Abe, Kamran Ahmed, Prokar Dasgupta
    Journal of Endourology 34 (3) 379 - 384 1557-900X 2020/03/01 
    Background: Virtual reality (VR) and dry-lab simulation have been widely validated for robotic surgical training. Both modalities are used during the early stages of the learning curve, yet, no comparative analysis of the two modalities has been undertaken. This study compares the effectiveness of VR and dry-lab simulation for basic robotic surgical skill training. Methods: A comparative study of 43 robotic novices was undertaken at two centers in the United Kingdom and Italy. Participants were allocated to either VR or dry-lab simulation and completed a robotic simulation training program. On completion, all participants were assessed by performing a urethrovesical anastomosis on a synthetic model. Technical proficiency was measured by two trained raters using the Global Evaluative Assessment of Robotic Skills (GEARS) tool. All participants completed a qualitative posttraining assessment questionnaire. Results: Baseline characteristics were equal between the two groups. Both VR and dry-lab training led to a significant improvement in technical proficiency. Overall mean GEARS scores increased by 5.6 and 2.5 following dry-lab and VR simulation training, respectively (p = 0.034). Dry-lab training showed significantly greater improvements than VR simulation, but only after the third training session. Both techniques were highly rated by participants. Conclusions: Both VR and dry-lab simulation were effective in improving robotic surgical skill but were not equal. For more advanced skill training, dry-lab training was found to be superior to VR simulation. Dry-lab training offers specific benefits to robotic surgical training and should remain a principal component of the simulation curriculum.
  • Kanta Hori, Yoshihiko Hirohashi, Toshiki Aoyagi, Narumi Taniguchi, Masashi Murakumo, Haruka Miyata, Toshihiko Torigoe, Takashige Abe, Nobuo Shinohara, Ken Morita
    Experimental and therapeutic medicine 19 (3) 1903 - 1907 2020/03 
    The case of a patient with metastatic renal cell carcinoma who exhibited the abscopal effect following treatment by anti-programmed death-1 (PD-1) antibody is presented. A 40-year-old woman was diagnosed with an 8.2-cm renal tumor without distant metastases, and radical nephrectomy was subsequently performed. Pathological examination revealed a clear cell renal cell carcinoma. At 3 months after surgery, the patient developed one lung metastasis. Following treatment with interferon and three types of tyrosine kinase inhibitors, anti-PD1 antibody (nivolumab) was started. During the treatment, para-aortic/supraclavicular lymph nodes and several lung lesions remained, although other lesions decreased markedly. The patient was subsequently treated by palliative radiotherapy to the para-aortic and supraclavicular lymph nodes for pain control. After the radiotherapy, the lung lesions previously refractory to nivolumab started to decrease, probably due to an abscopal effect. Additionally, the laboratory data and Karnofsky Performance Status improved. Histological re-examination of the primary lesion revealed heterogeneity of the immunological microenvironment, which may be associated with the heterogeneity of treatment sensitivity.
  • Haruka Miyata, Takahiro Osawa, Takashige Abe, Hiroshi Kikuchi, Ryuji Matsumoto, Satoru Maruyama, Kentaro Nishioka, Shinichi Shimizu, Takayuki Hashimoto, Hiroki Shirato, Nobuo Shinohara
    Japanese journal of clinical oncology 2020/01/19 [Refereed][Not invited]
     
    OBJECTIVE: Bladder-preserving trimodal therapy is recognized as a promising alternative treatment for muscle-invasive bladder cancer. We report the updated outcomes of muscle-invasive bladder cancer patients that were treated using our treatment protocol, which involves radiotherapy delivered with a real-time tumor-tracking radiotherapy system. METHODS: Thirty-eight patients who were diagnosed with T2-T4N0M0 bladder cancer between 1998 and 2016 and had clinically inoperable disease or refused to undergo surgery were enrolled. The treatment protocol included maximal transurethral resection followed by whole-bladder radiotherapy (40 Gy). Concurrent nedaplatin-based chemotherapy was administered to patients with adequate renal function. At the time of the first evaluation (via transurethral resection of the tumor bed), fiducial markers were endoscopically inserted into the bladder wall around the tumor. A boost of 25 Gy was administered using the real-time tumor-tracking radiotherapy system. The second evaluation (via transurethral resection of the tumor bed) was performed 6 months after the start of treatment. The Kaplan-Meier method and Cox hazards analysis were used to analyze overall survival and cancer-specific survival. RESULTS: The median duration of the follow-up period was 28 months (range: 3-161 months). The 5- and 10-year overall survival rates were 54.9 and 41.2%, respectively. Twenty-five (65.8%) and twenty (74.1%) patients had achieved complete responses to chemoradiation at the first and second evaluations, respectively. In univariate and multivariate analyses, performance status was found to be significantly associated with overall survival [P = 0.03, hazard ratio: 3.48, 95% confidence interval: 1.15-10.6] and cancer-specific survival [P = 0.02, hazard ratio: 4.57, 95% confidence interval: 1.32-16.9], and sex was shown to be significantly associated with cancer-specific survival [P = 0.03, hazard ratio: 3.07, 95% confidence interval: 1.09-8.30]. CONCLUSIONS: Our bladder-preserving trimodal therapy protocol, which involves the use of a real-time tumor-tracking radiotherapy system, produced an acceptable overall survival rate. This therapy is a reasonable alternative for patients that are medically unfit for or do not want to undergo cystectomy.
  • Haruka Miyata, Takashige Abe, Kiyohiko Hotta, Madoka Higuchi, Takahiro Osawa, Ryuji Matsumoto, Hiroshi Kikuchi, Yo Kurashima, Sachiyo Murai, Nobuo Shinohara
    Surgery open science 2 (1) 51 - 56 2020/01 
    Background: Virtual reality simulators allow trainees to perform repeated practice and provide objective dexterity metrics regarding their performance, which means that virtual reality-based surgical training is becoming a vital part of initial learning of basic laparoscopic surgical skills. However, its educational role in learning advanced procedures remains undetermined. We evaluated the validity of the laparoscopic radical nephrectomy module of the LapVision virtual reality simulator. Methods: Urologists, medical students, and a junior resident voluntarily participated in the present study, and they performed training with a laparoscopic left radical nephrectomy module. For construct validation, dexterity metrics calculated in the simulator and the mean score of Global Operative Assessment of Laparoscopic Skills evaluated by 2 experts' video review were compared according to the certification of Japanese Endoscopic Surgical Skill Qualification or previous surgical experience. Results: Ten experts (≥ 50 laparoscopic surgeries), 9 intermediates (11-49), and 14 novices (0-10) voluntarily participated in the present study. Regarding the construct validity, there was a significant difference in the total number of errors, blood loss, and Global Operative Assessment of Laparoscopic Skills score among the groups for both the Endoscopic Surgical Skill Qualification status and previous surgical experience. Conclusion: The present study demonstrated good construct validity for the LapVision nephrectomy module. Furthermore, global skill assessment was possible by experts' reviews, which indicates the usefulness of the virtual reality procedural module as a skill assessment tool. Virtual reality-based procedural simulation has marked potential to become a vital part of integrated laparoscopic training programs.
  • Jun Furumido, Takahiro Osawa, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Emi Takakuwa, Nobuo Shinohara
    International cancer conference journal 9 (1) 5 - 8 2020/01 [Refereed][Not invited]
     
    A 66-year-old man was referred to our hospital for an incidentally detected 40-mm mass located at the inter-aortocaval area around the renal hilum. Positron emission tomography CT revealed high accumulation (SUVmax 12.382) without distant metastasis. Bilateral testes were normal by ultrasonography and physical examination, but the serum AFP level was increased to 1161 ng/mL. The pathology based on trans-duodenal needle biopsy demonstrated a yolk sac tumor; therefore, we diagnosed him with retroperitoneal primary germ cell tumor. Due to old age, the potential toxicity of systemic chemotherapy, and no significant signs of invasion to adjacent organs, we performed surgical resection. Although the AFP level decreased to 13.2 ng/mL postoperatively, it increased to 553 ng/mL 2 months after surgery without clinical recurrence on imaging studies. Four cycles of a VIP regimen (VP-16, ifosfamide, and CDDP) were performed, and the AFP level normalized to 2.4 ng/mL. The patient is now disease-free 1 year and 6 months after surgery.
  • Yasuhiro Dekura, Kentaro Nishioka, Takayuki Hashimoto, Naoki Miyamoto, Ryusuke Suzuki, Takaaki Yoshimura, Ryuji Matsumoto, Takahiro Osawa, Takashige Abe, Yoichi M Ito, Nobuo Shinohara, Hiroki Shirato, Shinichi Shimizu
    Radiation oncology (London, England) 14 (1) 226 - 226 2019/12/12 [Refereed][Not invited]
     
    PURPOSE: To determine the best method to contour the planning organ at risk volume (PRV) for the urethra, this study aimed to investigate the displacement of a Foley catheter in the urethra with a soft and thin guide-wire. METHODS: For each patient, the study used two sets of computed tomography (CT) images for radiation treatment planning (RT-CT): (1) set with a Foley urethral catheter (4.0 mm diameter) plus a guide-wire (0.46 mm diameter) in the first RT-CT and (2) set with a guide-wire alone in the second CT recorded 2 min after the first RT-CT. Using three fiducial markers in the prostate for image fusion, the displacement between the catheter and the guide-wire in the prostatic urethra was calculated. In 155 consecutive patients treated between 2011 and 2017, 5531 slices of RT-CT were evaluated. RESULTS: Assuming that ≥3.0 mm of difference between the catheter and the guide-wire position was a significant displacement, the urethra with the catheter was displaced significantly from the urethra with the guide-wire alone in > 20% of the RT-CT slices in 23.2% (36/155) of the patients. The number of patients who showed ≥3.0 mm anterior displacement with the catheter in ≥20% RT-CT slices was significantly larger at the superior segment (38/155) than at the middle (14/155) and inferior segments (18/155) of the prostatic urethra (p < 0.0167). CONCLUSIONS: The urethral position with a Foley catheter is different from the urethral position with a thin and soft guide-wire in a significant proportion of the patients. This should be taken into account for the PRV of the urethra to ensure precise radiotherapy such as in urethra-sparing radiotherapy.
  • Shuhei Yamada, Takahiro Osawa, Takashige Abe, Norikata Takada, Ryuji Matsumoto, YoichiM Ito, Hiroshi Kikuchi, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    Hinyokika kiyo. Acta urologica Japonica 65 (12) 495 - 499 2019/12 [Refereed][Not invited]
     
    Radical cystectomy (RC) is the gold standard for managing muscle-invasive and high-risknon-muscleinvasive bladder cancer, but is accompanied by non-negligible operative risk. The aim of this study is to identify preoperative variables to predict major perioperative complications after RC and to develop a nomogram using the cohort from multiple institutions in Japan. We retrospectively reviewed 668 patients who underwent open RC with ileal conduit or neobladder at Hokkaido University hospital and 20 affiliated institutions between 1997 and 2010. Complications occurring within 90 days of surgery were graded using modified Clavien classification system. We defined modified Clavien grade 3 or more as major complications and performed univariate and multivariate logistic regression analyses. Predictive accuracy of the nomogram was evaluated with the area under the receiver operating characteristics curve (AUC). A total of 528 men and 140 women were included in this study. There were a total of 160/668 patients (24%) with major perioperative complications. A multivariate model identified gender (OR : 1. 63, p=0. 04), cardiovascular comorbidity (OR : 1.48, p=0.03) and simultaneous nephroureterectomy (OR : 2.81, p=0. 01) as independent predictors. Using these 3 variables, a nomogram was developed with the AUC of 0.58. Predictive performance of our nomogram showed only fair performance ; but at least, we identified male, cardiovascular comorbidity and simultaneous nephroureterectomy as independent predictors of perioperative major complications.
  • Takashige Abe, Keita Minami, Toru Harabayashi, Ataru Sazawa, Hiroki Chiba, Hiroshi Kikuchi, Haruka Miyata, Jun Frumido, Ryuji Matsumoto, Takahiro Osawa, Ishizaki Junji, Mochizuki Tango, Chiba Satoshi, Akino Tomoshige, Murakumo Masashi, Miyajima Naoto, Tsuchiya Kunihiko, Maruyama Satoru, Sachiyo Murai, Nobuo Shinohara
    Japanese journal of clinical oncology 0368-2811 2019/10/28 [Refereed][Not invited]
     
    OBJECTIVE: To clarify the prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients treated by systemic chemotherapy. METHODS: Of the 228 metastatic urothelial carcinoma patients treated with systemic chemotherapy, 97 received radiotherapy mainly to metastatic sites. In patients for whom the purpose of radiotherapy was not specified, more than 50 Gy irradiation was considered to be for disease consolidation for survival analysis, while less than 50 Gy was categorized as palliation. According to the Kaplan-Meier method, we analysed overall survival from the initiation of treatment for metastatic urothelial carcinoma until death or the last follow-up, using the log-rank test to assess the significance of differences. The Cox model was applied for prognostic factor analysis. RESULTS: Overall, there was no significant difference in survival between patients with and those without radiotherapy (P = 0.1532). When analysing the patients undergoing consolidative radiotherapy separately, these 25 patients showed significantly longer survival than the 72 patients with palliative radiotherapy (P = 0.0047), with a 3-year overall survival of 43.3%. Of the present cohort, 22 underwent metastasectomy for disease consolidation, and there was no overlapping case between the metastasectomy cohort and cohort receiving consolidative radiotherapy. After controlling for four independent prognostic factors (sex, performance status, haemoglobin level and number of organs with metastasis) in our previous study, radiotherapy for disease consolidation showed a marginal value (hazard ratio = 0.666, P = 0.0966), while metastasectomy remained significant (hazard ratio = 0.358, P = 0.0006). CONCLUSIONS: In the selected patients, long-term disease control could be achieved after consolidative radiotherapy for metastatic urothelial carcinoma disease. Our observations suggest that local ablative therapy (surgery or radiotherapy) could facilitate long-term disease control. However, the treatment decision should be individualized because of the lack of randomized control trials.
  • Takahiro Osawa, John T Wei, Takashige Abe, Yuki Kako, Sachiyo Murai, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 26 (10) 1016 - 1017 0919-8172 2019/10 [Refereed][Not invited]
  • Abe T, Dar F, Amnattrakul P, Aydin A, Raison N, Shinohara N, Khan MS, Ahmed K, Dasgupta P
    BMC medical education 19 (1) 318  2019/08 [Refereed][Not invited]
  • Hiroshi Kikuchi, Takashige Abe, Ryuji Matsumoto, Takahiro Osawa, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    Urologic oncology 37 (5) 301.e19-301.e25 - 301.e25 1078-1439 2019/05 [Refereed][Not invited]
     
    OBJECTIVE: To evaluate the association between the RENAL nephrometry score (RNS) and tumor proliferative activity assessed by immunohistochemistry in patients with localized renal cell carcinoma. METHODS: The current study included 145 pathological T1 (pT1) clear cell renal cell carcinomas (ccRCC). Tumor proliferative activity was assessed with the Ki67 index and microvessel density (MVD). RNS was retrospectively assessed in the present study. We divided patients into 3 groups according to RNS (RNS 4-6: low-complexity, 7-9: moderate complexity, and 10-12: high-complexity tumors) and compared the Ki67 index as well as MVD among the 3 groups. The association between the Ki67index/MVD and each component (R, E, N, A, L, h) was also evaluated. RESULTS: There were 56 low, 84 moderate, and 5 high-complexity tumors. The median Ki67 index of all tumors was 5.34% (interquartile range: 3.28-8.57). The median Ki67 index of low, moderate, and high-complexity tumors was 3.97%, 6.39%, and 11.27%, respectively, with a significant difference among the 3 groups (Kruskal-Wallis test, P = 0.0004). On the other hand, the median MVD of low, moderate, and high-complexity tumors was 14.11%, 14.42%, and 21.22%, respectively, and there were no significant differences among the 3 groups. In terms of each RNS component, there were significant differences in the Ki67 index among the 3 groups in N (P = 0.0101) and L (P = 0.0280) components, respectively. CONCLUSIONS: The revealed association between RNS and the Ki67 index in pT1 clear cell renal cell carcinomas further supports the previous findings that the anatomy of renal cell carcinoma is associated with the malignant potential of localized clear cell renal cell carcinoma, which may provide additional information for treatment decision.
  • Koki Ebina, Takashige Abe, Shunsuke Komizunai, Teppei Tsujita, Kazuya Sase, XiaoShuai Chen, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Yo Kurashima, Nobuo Shinohara, Atsushi Konno
    58th Annual Conference of the Society of Instrument and Control Engineers of Japan, SICE 2019, Hiroshima, Japan, September 10-13, 2019 1099 - 1106 2019 [Refereed][Not invited]
  • Raison N, Ahmed K, Abe T, Brunckhorst O, Novara G, Buffi N, McIlhenny C, van der Poel H, van Hemelrijck M, Gavazzi A, Dasgupta P
    BJU international 122 (6) 1075 - 1081 1464-4096 2018/12 [Refereed][Not invited]
  • Takashige Abe, Tsunenori Kondo, Toru Harabayashi, Norikata Takada, Ryuji Matsumoto, Takahiro Osawa, Keita Minami, Satoshi Nagamori, Satoru Maruyama, Sachiyo Murai, Kazunari Tanabe, Nobuo Shinohara
    Japanese journal of clinical oncology 48 (11) 1001 - 1011 0368-2811 2018/11/01 [Refereed][Not invited]
     
    Objective: To assess the number of lymph nodes removed as a surrogate marker of the extent of lymph node dissection, and compare survival outcomes between laparoscopic radical nephroureterectomy (LRNU) and open radical nephroureterectomy (ORNU) in patients undergoing standardized lymph node dissection. Methods: We retrospectively analyzed the data of 214 cTanyN0M0 patients undergoing radical NU with regional lymph node dissection according to the tumor location. The Kaplan-Meier method and Cox hazards model were utilized for survival analyses, including recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Results: A total of 114 patients underwent LRNU and 100 underwent ORNU. There was no significant difference in the pT stage, pN stage, or tumor grade, but distal ureteral tumors were more frequent in the LRNU group. The number of lymph nodes removed did not differ between the two groups [LRNU: 12 (median), ORNU: 11.5, P = 0.3852]. Lymph node metastasis was pathologically identified in 19 patients (8.9%). The 5-year RFS (ORNU: 71.7%, LRNU: 74%, P = 0.7829), CSS (77.8 and, 80%, P = 0.8441) and OS (72.8, and 75.9%, P = 0.3456) did not differ between the two groups. In the sub-analysis of pT3/4 patients (n = 83), there were no significant differences in RFS, CSS, or OS between the two groups, although Kaplan-Meier survival curves were slightly better for those receiving ORNU. In the multivariate model, LRNU was not significantly correlated with a poorer RFS, CSS or OS. Conclusion: Our data support the feasibility of lymph node dissection with a laparoscopic approach and the equivalent oncological outcome of LRNU compared with ORNU when regional lymph node dissection is performed. However, LRNU should be performed after careful patient selection for advanced disease.
  • Dekura Yasuhiro, Nishioka Kentaro, Hashimoto Takayuki, Miyamoto Naoki, Suzuki Ryusuke, Matsumoto Ryuji, Osawa Takahiro, Abe Takashige, Maruyama Satoru, Shinohara Nobuo, Shirato Hiroki, Shimizu Shinichi
    INTERNATIONAL JOURNAL OF UROLOGY 25 445 - 445 0919-8172 2018/10 [Refereed][Not invited]
  • Abe Takashige, Ishizaki Junji, Minami Keita, Harabayashi Toru, Sazawa Ataru, Mochizuki Tango, Akino Tomoshige, Chiba Satoshi, Chiba Hiroshi, Murakumo Masashi, Matsumoto Ryuji, Shinohara Nobuo
    INTERNATIONAL JOURNAL OF UROLOGY 25 200  0919-8172 2018/10 [Refereed][Not invited]
  • Miyata Haruka, Osawa Takahiro, Matsumoto Ryuji, Abe Takashige, Maruyama Satoru, Nishioka Kentaro, Shimizu Shinichi, Hashimoto Takayuki, Shirato Hiroki, Shinohara Nobuo
    INTERNATIONAL JOURNAL OF UROLOGY 25 321  0919-8172 2018/10 [Refereed][Not invited]
  • Abe T
    Journal of investigative surgery : the official journal of the Academy of Surgical Research 1  0894-1939 2018/10 [Refereed][Not invited]
  • Muranishi Y, Fukuzawa N, Wada Y, Abe T, Shinohara N, Harada H
    Hinyokika kiyo. Acta urologica Japonica 64 (10) 409 - 413 0018-1994 2018/10 [Refereed][Not invited]
  • Naohisa Kusakabe, Takahiro Osawa, Haruka Miyata, Hiroshi Kikuchi, Ryuji Matsumoto, Satoru Maruyama, Takashige Abe, Nobuo Shinohara
    Hinyokika kiyo. Acta urologica Japonica 64 (9) 353 - 358 0018-1994 2018/09 [Refereed][Not invited]
     
    Axitinib was approved for use in Japan as a salvage therapy for patients with metastatic renal cell carcinoma (RCC) in 2012. We retrospectively evaluated the cases of 32 RCC patients that were treated with Axitinib as a 2nd- or further-line therapy between November 2012 and March 2017. Overall survival (OS), progression-free survival (PFS), and adverse events were assessed. The median OS and PFS from the initiation of Axitinib were 29 and 11 months, respectively. Nineteen patients received Axitinib as a 2nd-line treatment, in whom the median OS and median PFS were 22 and 10 months, respectively, while the median OS and PFS were 29 and 15.5 months, respectively, amongthe 13 patients who received Axitinib as a 3rd- or further-line treatment, which suggested that Axitinib is effective in the 3rd-line and further-line settings. A Cox multivariate model revealed that bone metastasis was a significant adverse factor for OS. Common grade 3 or higher adverse events included hypertension (28%), diarrhea (7%), and proteinuria (7%). Although the present study demonstrated the efficacy and safety of salvage Axitinib treatment in patients who had recurrent disease after the initial systemic therapy, further large-scale studies should be warranted to make clear its clinical effectiveness in these patients.
  • Ryuji Matsumoto, Takashige Abe, Junji Ishizaki, Hiroshi Kikuchi, Toru Harabayashi, Keita Minami, Ataru Sazawa, Tango Mochizuki, Tomoshige Akino, Masashi Murakumo, Takahiro Osawa, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    Japanese journal of clinical oncology 48 (8) 771 - 776 0368-2811 2018/08/01 [Refereed][Not invited]
     
    Objectives: The objective of the present study was to investigate the survival outcome and prognostic factors of metastatic urothelial carcinoma patients treated with second-line systemic chemotherapy in real-world clinical practice. Methods: Overall, 114 patients with metastatic urothelial carcinoma undergoing second-line systemic chemotherapy were included in this retrospective analysis. The dominant second-line chemotherapy was a paclitaxel-based combination regimen (60%, 68/114). We assessed the progression-free survival and overall survival times using the Kaplan-Meier method. The Cox proportional hazards model was applied to identify the factors affecting overall survival. Results: The median progression-free survival and overall survival times were 4 and 9 months, respectively. In the multivariate analysis, an Eastern Cooperative Oncology Group performance status score greater than 0 at presentation, C-reactive protein level ≧1 mg/dl and poor response to prior chemotherapy were adverse prognostic indicators. Patients with 0, 1, 2 and 3 of those risk factors had a median overall survival of 17, 12, 7 and 3 months, respectively. Conclusions: The Eastern Cooperative Oncology Group performance status at presentation, C-reactive protein level and response to prior chemotherapy were prognostic factors for metastatic urothelial carcinoma patients undergoing second-line chemotherapy. In the future, this information might help guide the choice of salvage treatment, such as second-line chemotherapy or immune checkpoint inhibitors, after the failure of first-line chemotherapy.
  • Osawa T, Abe T, Takada N, Ito YM, Murai S, Shinohara N
    International journal of urology : official journal of the Japanese Urological Association 25 (7) 699 - 700 0919-8172 2018/07 [Refereed][Not invited]
  • Patrick Harrison, Nicholas Raison, Takashige Abe, William Watkinson, Faizan Dar, Ben Challacombe, Henk Van Der Poel, Muhammad Shamim Khan, Prokar Dasgupa, Kamran Ahmed
    Journal of Surgical Education 75 (3) 758 - 766 1878-7452 2018/05/01 [Refereed][Not invited]
     
    Objective: To perform the first validation of a full procedural virtual reality robotic training module and analysis of novice surgeon's learning curves. Design: Participants completed the bladder neck dissection task and urethrovesical anastomosis task (UVA) as part of the prostatectomy module. Surgeons completed feedback questionnaires assessing the realism, content, acceptability and feasibility of the module. Novice surgeons completed a 5.5-hour training programme using both tasks. Setting: King's College London, London. Participants: 13 novice, 24 intermediate and 8 expert surgeons completed the validation study. Results: Realism was scored highly for BDN (mean 3.4/5) and UVA (3.74/5), as was importance of BDN (4.32/5) and UVA (4.6/5) for training. It was rated as a feasible (3.95/5) and acceptable (4/5) tool for training. Experts performed significantly better than novice group in 6 metrics in the UVA including time (p = 0.0005), distance by camera (p = 0.0010) and instrument collisions (p = 0.0033), as well as task-specific metrics such as number of unnecessary needle piercing points (p = 0.0463). In novice surgeons, a significant improvement in performance after training was seen in many metrics for both tasks. For bladder neck dissection task, this included time (p < 0.0001), instrument collisions (p = 0.0013) and total time instruments are out of view (p = 0.0251). For UVA, this included time (p = 0.0135), instrument collisions (p = 0.0066) and task-specific metrics such as injury to the urethra (p = 0.0032) and bladder (p = 0.0189). Conclusions: Surgeons found this full procedural VR training module to be a realistic, feasible and acceptable component for a robotic surgical training programme. Construct validity was proven between expert and novice surgeons. Novice surgeons have shown a significant learning curve over 5.5 hours of training, suggesting this module could be used in a surgical curriculum for acquisition of technical skills. Further implementation of this module into the curriculum and continued analysis would be beneficial to gauge how it can be fully utilised.
  • Watkinson W, Raison N, Abe T, Harrison P, Khan S, Van der Poel H, Dasgupta P, Ahmed K
    Postgraduate medical journal 94 (1111) 270 - 277 0032-5473 2018/05 [Refereed][Not invited]
  • Matsumoto Ryuji, Abe Takashige, Takada Norikata, Minami Keita, Harabayashi Toru, Kikuchi Hiroshi, Osawa Takahiro, Maruyama Satoru, Shinohara Nobuo
    JOURNAL OF UROLOGY 199 (4) E220  0022-5347 2018/04 [Refereed][Not invited]
  • Matsumoto Ryuji, Abe Takashige, Ishizaki Junji, Minami Keita, Harabayashi Toru, Sazawa Ataru, Mochizuki Tango, Akino Tomoshige, Murakumo Masashi, Miyajima Naoto, Tsuchiya Kunihiko, Kikuchi Hiroshi, Miyata Haruka, Osawa Takahiro, Maruyama Satoru, Murai Sachiyo, Shinohara Nobuo
    JOURNAL OF UROLOGY 199 (4) E1045  0022-5347 2018/04 [Refereed][Not invited]
  • Abe Takashige, Ishizaki Junji, Minami Keita, Harabayashi Toru, Sazawa Ataru, Mochizuki Tango, Chiba Satoshi, Chiba Hiroki, Akino Tomoshige, Murakumo Masashi, Miyajima Naoto, Tsuchiya Kunihiko, Kikuchi Hiroshi, Miyata Haruka, Matsumoto Ryuji, Osawa Takahiro, Maruyama Satoru, Murai Sachiyo, Shinohara Nobuo
    JOURNAL OF UROLOGY 199 (4) E1042  0022-5347 2018/04 [Refereed][Not invited]
  • Takashige Abe, Nicholas Raison, Nobuo Shinohara, M. Shamim Khan, Kamran Ahmed, Prokar Dasgupta
    Journal of Surgical Education 75 (2) 458 - 464 1878-7452 2018/03/01 [Refereed][Not invited]
     
    Background: The aim of this study was to determine the correlation of visual-spatial ability with progression along the learning curve for robotic surgical skills training. Methods: A total of 21 novice participants were recruited. All participants completed a training program consisting of 5 training sessions of 30 minutes of virtual reality (VR) simulation and 30 minutes of dry laboratory training. The VR simulation part was the subject of the present study. During VR simulation training, participants performed the basic skill exercises of Camera Targeting 1, Pick and Place, and Peg Board 1 followed by advanced skill exercises of Suture Sponge 1 and Thread the Rings. The visual-spatial ability was assessed using a mental rotation test (MRT). Pearson correlation coefficients were used to assess the relationship between the MRT score and simulator score for the aforementioned 5 tasks. Student t test was used to compare the simulator score between high- and low-MRT score groups. Results: A median MRT score of 26/40 (range: 13-38) was observed. Approximately 19 participants completed the full curriculum but 2 did not complete “Thread the Rings” during the study period. A significant correlation was observed between the MRT score and simulator score only in “Suture Sponge 1” over the first 3 attempts (first: r = 0.584, p = 0.0054 second: r = 0.443, p = 0.0443 third: r = 0.4458, p = 0.0428). After the third attempt, this significant correlation was lost. Comparison of the score for “Suture Sponge 1” between the high-MRT and low-MRT scoring participants divided by a median MRT score of 26 also showed a significant difference in the score until the third trial. Conclusion: Our observations suggest that the spatial cognitive ability influences the initial learning of robotic suturing skills. Further studies are necessary to verify the usefulness of an individual's spatial ability to tailor the surgical training program.
  • Maishi Nako, Kikuchi Hiroshi, Morimoto Hirofumi, Tsuchiya Kunihiko, Abe Takashige, Hida Yasuhiro, Harabayashi Toru, Matsuno Yoshihiro, Shinohara Nobuo, Hida Kyoko
    CANCER SCIENCE 109 873  1349-7006 2018/01 [Refereed][Not invited]
  • Lovegrove CE, Abe T, Aydin A, Veneziano D, Sarica K, Khan MS, Dasgupta P, Ahmed K
    Minerva urologica e nefrologica = The Italian journal of urology and nephrology 69 (6) 579 - 588 0393-2249 2017/12 [Refereed][Not invited]
  • Nicholas Raison, Thomas Wood, Oliver Brunckhorst, Takashige Abe, Talisa Ross, Ben Challacombe, Mohammed Shamim Khan, Giacomo Novara, Nicolo Buffi, Henk Van Der Poel, Craig McIlhenny, Prokar Dasgupta, Kamran Ahmed
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 31 (12) 5403 - 5410 0930-2794 2017/12 [Refereed][Not invited]
     
    Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons. Using a Delphi methodology, a panel of 16 expert surgeons was consulted to identify behaviours important to NTS assessment. These behaviours were organised into an appropriate assessment template. Experts were consulted on the feasibility, applicability and educational impact of ICARS. An observational trial was used to validate ICARS. 73 novice, intermediate and expert robotic surgeons completed a urethrovesical anastomosis within a simulated operating room. NTS were tested using four scripted scenarios of increasing difficulty. Performances were video recorded. Robotic and NTS experts assessed the videos post hoc using ICARS and the standard behavioural rating system, NOn-Technical Skills for Surgeons (NOTSS). 28 key non-technical behaviours were identified by the expert panel. The finalised behavioural rating system was organised into four principle domains and seven categories. Expert opinion strongly supported its implementation. ICARS was found to be equivalent to NOTSS on Bland-Altman analysis and accurately differentiated between novice, intermediate and expert participants, p = 0.01. Moderate agreement was found between raters, Krippendorff's alpha = 0.4. The internal structure of ICARS was shown to be consistent and reliable (median Cronbach alpha = 0.92, range 0.85-0.94). ICARS is the first NTS behavioural rating system developed for robotic surgery. Initial validation has shown it to be an effective and reliable tool. Implementation of ICARS will supported structured training and assessment of NTS within the robotic surgical curriculum.
  • Ahmed Al-Jabir, Abdullatif Aydin, Takashige Abe, Nicholas Raison, M. Shamim Khan, Prokar Dasgupta, Kamran Ahmed
    UROLOGY 110 45 - 50 0090-4295 2017/12 [Refereed][Not invited]
     
    OBJECTIVE To validate the Advanced Scope Trainer (AST; Mediskills, Northampton, UK). The AST is a currently unvalidated simulator, developed for flexible ureterorenoscopy (fURS) training. This study aims to assess the face, content, construct, and concurrent validity to assess the level of transferability of skills to the operating room. MATERIALS AND METHODS This prospective, observational, and comparative study recruited novices (n = 19) and trainees (n = 34), with participants performing a diagnostic fURS, followed by removal of a lower pole stone, on the AST. Fifteen participants performed a fURS on fresh frozen cadavers to assess concurrent validity. Trainees were supervised by expert urologists (n = 7) during each procedure. Performance was evaluated using the validated Objective Structured Assessment of Technical Skills (OSATS) assessment. Face and content validity were demonstrated by anonymous surveys from participants and faculty. RESULTS Face validity assessment revealed that trainees found the simulator was 76% realistic (3.8/5 on a Likert scale). Laser stone fragmentation (4.11 +/- 0.85) and manual stone extraction (4.03 +/- 0.85) were thought to be the most realistic components and guidewire insertion (3.14 +/- 1.35) the least. Participants also believed the simulator to be useful, giving transferrable skills to take into the operating room, demonstrating content validity. Using an OSATS assessment, concurrent validity was demonstrated in "respect for tissue" (P = .0105) and "time and motion" (P = .0196). Construct validity was also demonstrated when comparing novices to trainees (mean OSATS 10.11 +/- 2.28 vs 23.89 +/- 5.38). CONCLUSION This study has demonstrated face, content, construct, and concurrent validity of the AST for fURS training. Further evaluation is necessary to demonstrate construct and predictive validity of skills gained using the model. (C) 2017 Elsevier Inc.
  • Abe T, Murai S, Nasuhara Y, Shinohara N
    Journal of patient safety 15 (4) 343 - 351 1549-8417 2017/09 [Refereed][Not invited]
     
    OBJECTIVES: The aim of this study was to clarify the characteristics of adverse events/near misses during laparoscopic/thoracoscopic surgery. METHODS: Using relevant key words for minimally invasive surgeries, 540 records were identified in the database of the Japan Council for Quality Health Care. After data review and the classification of adverse events, 746 events associated with laparoscopic (laparo group) and/or thoracoscopic (thoraco group) surgery were identified. We calculated the frequency of each event, compared the frequency regarding recurrent events, and evaluated the types of event that had resulted in deaths between the 2 groups. RESULTS: There were 582 events in the laparo group, 159 in the thoraco group, and 5 in those undergoing combined surgery. Overall, injury of other organs (11.4%, 85/746), retention of a foreign body (9.1%, 68/746), breakage/failure of medical equipment or devices (6.2%, 46/746), massive bleeding (5.9%, 44/746), misperception of anatomy (5.6%, 42/746), and vascular injury (4.8%, 36/746) were frequently reported. There were marked differences in the frequency of injury of other organs (laparo group: 13.4%, 78/582; thoraco group: 4.4%, 7/159), massive bleeding (laparo group: 3.4%, 20/582; thoraco group: 14.5%, 23/159), and vascular injury (laparo group: 2.6%, 15/582; thoraco group: 12.6%, 20/159) between the 2 groups. Among the 56 patient-death reports, 132 adverse events were identified. In the thoraco group, bleeding events were frequently observed, whereas in the laparo group, various categories of events were noted. CONCLUSIONS: We observed recurrent incidents and differences in the frequency between the 2 groups. Surgeons should keep in mind these characteristics. Retention of a foreign body and the breakage/malfunctioning of instruments might be reduced by the introduction of specialized checklists.
  • Takashige Abe, Norikata Takada, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Naoto Miyajima, Satoru Maruyama, Nobuo Shinohara
    Japanese journal of clinical oncology 47 (8) 755 - 761 0368-2811 2017/08/01 [Refereed][Not invited]
     
    Objective: To determine the characteristics of 90-day morbidity and mortality after radical cystectomy in Japanese octogenarians. Methods: A retrospective multi-institutional study. We reviewed the records of 834 patients treated by open radical cystectomy between 1997 and 2010. All complications within 90 days after surgery were sorted into the 11 categories proposed by the Memorial Sloan-Kettering Cancer Center and graded according to the modified Clavien-Dindo system. We compared the characteristics of complications between ≥80-year (n = 86) and <80-year (n = 748) groups. Multivariate regression models were used to determine the predictors of complications. Results: American Society of Anesthesiologists score III-IV was more frequent (14% vs. 6%, respectively, P < 0.0001), and ureterocutaneostomy was more frequently performed (30% vs. 21%, respectively, P = 0.0148) in the ≥80-year group compared with <80-year group. There were no significant differences in the rates of any complication, major (Grade 3-5) complication, or 90-day mortality between the two groups (≥80-year group: 70%, 21%, 3.5%, respectively, <80-year group: 68%, 22%, 2%, respectively). The ≥80-year group had fewer genitourinary complications (7% vs. 16%, respectively, P = 0.0131). Multivariate regression analyses revealed that bowel-using urinary diversion (P = 0.0031) and the operative time (P = 0.0269) were significant predictors of any grade of complications, and a male sex (P = 0.0167), annual cystectomy volume (P = 0.0284) and prior cardiovascular comorbidity (P = 0.0034) were significant predictors of major complications. Conclusions: In our experience, radical cystectomy in Japanese octogenarians caused similar perioperative comorbidities. Old age as a single criterion should not be used to abandon radical cystectomy; careful preoperative assessment is mandatory.
  • Kikuchi Hiroshi, Maishi Nako, Akiyama Kosuke, Morimoto Masahiro, Yanagiya Misa, Miyajima Naoto, Tsuchiya Kunihiko, Maruyama Satoshi, Abe Takashige, Hida Yasuhiro, Harabayashi Toru, Ameda Kaname, Matsumoto Ryuji, Kashiwagi Akira, Matsuno Yoshihiro, Shinohara Nobuo, Hida Kyoko
    JOURNAL OF CLINICAL ONCOLOGY 35 0732-183X 2017/05/20 [Refereed][Not invited]
  • Takashige Abe, Tsunenori Kondo, Toru Harabayashi, Norikata Takada, Ryuji Matsumoto, Ataru Sazawa, Takahiro Osawa, Keita Minami, Satoshi Nagamori, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Sachiyo Murai, Kazunari Tanabe, Nobuo Shinohara
    JOURNAL OF UROLOGY 197 (4) E952 - E952 0022-5347 2017/04 [Refereed][Not invited]
  • Takeya Kitta, Yukiko Kanno, Hiroki Chiba, Kimihiko Moriya, Satoru Maruyama, Takashige Abe, Nobuo Shinohara
    INTERNATIONAL JOURNAL OF UROLOGY 24 (4) 301 - 307 0919-8172 2017/04 [Refereed][Not invited]
     
    ObjectivesPressure flow studies are regarded as the gold standard for evaluating both bladder outlet obstruction and detrusor contractility, but none of the current methods for evaluating bladder contraction patterns are well validated. Impaired bladder contraction results in a lower peak Watts factor and poorly sustained detrusor contractions. From this viewpoint, the maximum Watts factor and its pattern should be considered separately. To examine detrusor contraction pattern in patients after radical prostatectomy by using multiple parameters. MethodsA total of 37 patients with clinically localized prostate cancer underwent both pre- and post-radical prostatectomy urodynamic evaluations. The examined urodynamic parameters included the maximum flow rate, post-void residual volume, detrusor pressure at maximum flow, maximum Watts factor and relative volume (maximum Watts factor). Some parameters were defined from the Watts factor curve throughout micturition. Relative volume (maximum Watts factor) was the relative bladder volume at the maximum Watts factor. A normal detrusor contractility pattern involves an increase in Watts factor at the initiation followed by further gradual increases until the end of micturition. ResultsMaximum flow rate increased significantly after radical prostatectomy (pre: 13.06.5, post: 17.3 +/- 7.7mL/min; P<0.01), whereas detrusor pressure at maximum flow and post-void residual volume decreased significantly (pre: 49.6 +/- 21.6 and 31.4 +/- 18.2cmH(2)O; post: 48.6 +/- 66.1 and 10.1 +/- 28.5mL; P<0.05). Maximum Watts factor did not change significantly after radical prostatectomy (pre: 10.5 +/- 3.1W/m(2), post: 11.0 +/- 3.2W/m(2)), but relative volume (maximum Watts factor) decreased significantly (pre: 0.48 +/- 0.3, post: 0.20 +/- 0.20; P<0.001). Maximum Watts factor represents the maximum power of bladder contraction at a particular point in time, whereas relative volume (maximum Watts factor) can be used to detect changes in detrusor contraction pattern. ConclusionsEvaluation of relative volume (maximum Watts factor) confirms that radical prostatectomy restores the normal detrusor contractility pattern in prostate cancer patients.
  • Kentaro Nishioka, Shinichi Shimizu, Nobuo Shinohara, Yoichi M. Ito, Takashige Abe, Satoru Maruyama, Norio Katoh, Rumiko Kinoshita, Takayuki Hashimoto, Naoki Miyamoto, Rikiya Onimaru, Hiroki Shirato
    RADIATION ONCOLOGY 12 (1) 44  1748-717X 2017/03 [Refereed][Not invited]
     
    Background: Current adaptive and dose escalating radiotherapy for muscle invasive bladder cancer requires knowledge of both inter-fractional and intra-fractional motion of the bladder wall involved. The purpose of this study is to characterize inter-and intra-fractional movement of the partial bladder wall using implanted fiducial markers and a real-time tumor-tracking radiotherapy system. Methods: Two hundred fifty one sessions with 29 patients were analysed. After maximal transurethral bladder tumor resection and 40 Gy of whole bladder irradiation, up to six gold markers were implanted transurethrally into the bladder wall around the tumor bed and used for positional registration. We compared the systematic and random uncertainty of positions between cranial vs. caudal, left vs. right, and anterior vs. posterior tumor groups. The variance in intrafractional movement and the percentage of sessions where 3 mm and 5 mm or more of intrafractional wall movement occurring at 2, 4, 6, 8, 10, and at more than 10 min until the end of a session were determined. Results: The cranial and anterior tumor group showed larger interfractional uncertainties in the position than the opposite side tumor group in the CC and AP directions respectively, but these differences did not reach significance. Among the intrafractional uncertainty of position, the cranial and anterior tumor group showed significantly larger systematic uncertainty of position than the groups on the opposite side in the CC direction. The variance of intrafractional movement increased over time; the percentage of sessions where intrafractional wall movement was larger than 3 mm within 2 min of the start of a radiation session or larger than 5 mm within 10 min was less than 5%, but this percentage was increasing further during the session, especially in the cranial and anterior tumor group. Conclusions: More attention for intrafractional uncertainty of position is required in the treatment of cranial and anterior bladder tumors especially in the CC direction. The optimal internal margins in each direction should be chosen or a precise intrafractional target localization system is required depending on the tumor location and treatment delivery time in the setting of partial bladder radiotherapy.
  • Takashige Abe, Junji Ishizaki, Hiroshi Kikuchi, Keita Minami, Ryuji Matsumoto, Toru Harabayashi, Ataru Sazawa, Tango Mochizuki, Satoshi Chiba, Tomoshige Akino, Masashi Murakumo, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    Urologic oncology 35 (2) 38.e1-38.e8 - 38.e8 1078-1439 2017/02 [Refereed][Not invited]
     
    AIM: To clarify prognostic factors of metatstatic urothelial carcinoma treated by systemic chemotherapy in real-world clinical practice in the Japanese population. MATERIALS AND METHODS: A total of 228 patients with metastatic urothelial carcinoma undergoing systemic chemotherapy between 2000 and 2013 were included in the present multi-institutional study. The gemcitabine plus cisplatin regimen was administered as first-line chemotherapy to 131 patients, whereas methotrexate, vinblastine, doxorubicin, and cisplatin or its modified regimen was given to 71 patients. Of the 228 patients, 119 received at least 2 different regimens and 22 underwent resection of metastases (metastasectomy). Multivariate survival analysis was performed using the Cox proportional hazards model. The characteristics included were age, sex, Eastern Cooperative Oncology Group performance status (PS), primary site, pathology of primary site, hemoglobin levels, lactate dehydrogenase levels, C-reactive protein levels, corrected calcium levels, estimated glomerular filtration rate levels, history of prior chemotherapy, metastatic sites, resection of primary site, number of metastatic organs, and metastasectomy. RESULTS: The median overall survival (OS) time was 17 months. On multivariate analysis, female sex, good Eastern Cooperative Oncology Group PS at presentation, hemoglobin level≥10g/dl, and single organ metastasis were significant independent predictors of prolonged OS. For the survival effect of metastasectomy, the median OS time of the 22 patients with metastasectomy was 53 months, which was significantly longer when compared with patients not undergoing metastasectomy (15mo). After adjustment for the 4 aforementioned prognostic factors, metastasectomy still remained significant (hazard ratio: 0.364, P = 0.0008). CONCLUSIONS: Female sex, more favorable PS at presentation, hemoglobin level>10g/dl, and single organ metastasis were favorable prognostic factors. In addition, metastasectomy was associated with long-term disease control.
  • Takashige Abe
    INTERNATIONAL JOURNAL OF UROLOGY 23 (12) 990 - 990 0919-8172 2016/12 [Refereed][Not invited]
  • Takashige Abe, Ryuji Matsumoto, Nobuo Shinohara
    Current opinion in urology 26 (6) 573 - 80 0963-0643 2016/11 [Refereed][Not invited]
     
    PURPOSE OF REVIEW: Since the development of systemic combination chemotherapy, postchemotherapy extirpation has been performed in selected patients mainly with locally advanced and/or initially unresectable bladder cancer, and, in very selected patients, surgical consolidation for visceral metastases has also been performed. The purpose of this article was to review and summarize the current evidence for the role of surgical consolidation in metastatic urothelial carcinoma. RECENT FINDINGS: The role of metastasectomy has not yet been examined in a randomized setting. In terms of locally advanced and/or node-positive bladder cancer, studies further support the benefit of surgical consolidation, especially after a favorable response to systemic chemotherapy. Regarding metastasectomy for visceral metastasis, recent evidence suggested that lung metastases (ideally small solitary lesions) are a good indication. SUMMARY: Patients with a good response to chemotherapy, limited nodal/pulmonary disease, and a favorable performance status are good candidates for surgical consolidation. Careful patient selection is mandatory.
  • Takahiro Osawa, Daniela Wittmann, Masahito Jimbo, Evan T. Keller, Shunichi Namiki, Takashige Abe, Nobuo Shinohara, Ted A. Skolarus
    INTERNATIONAL JOURNAL OF UROLOGY 23 (11) 906 - 915 0919-8172 2016/11 [Refereed][Not invited]
     
    Despite an increasing number of prostate cancer survivors in Japan, the current delivery of prostate cancer survivorship care is insufficient and lacks a multidisciplinary approach. We carried out a study to characterize prostate cancer survivorship care in Japan, examine the Japanese workforce available to deliver survivorship care, introduce a conceptual framework for survivorship and identify opportunities to improve Japanese survivorship care. We systematically searched PubMed for prostate cancer survivorship care studies, including those from Japan. We also searched the internet for prostate cancer guidelines relevant to survivorship care. We found 392 articles, of which 71 were relevant, read in detail and reported here. In Japan, survivorship care is mostly provided by urologists. Primary care as a specialty does not exist in Japan, and there are no independent nurse practitioners or physician assistants to assist with survivorship care. Japanese quality of life studies characterize the long-term effects of prostate cancer treatment, but routine use of patient-reported outcomes is not common in Japan. In the USA, in light of a growing comprehensive awareness of challenges facing survivors and their providers, the American Cancer Society prostate cancer survivorship care guidelines serve as a tool for optimizing the management of long-term treatment effects and coordination of care. In order to deliver high-quality survivorship care in Japan, urologists need to establish collaborations with other disciplines within the delivery system. A multidisciplinary guideline for prostate cancer survivorship care in Japan appears warranted.
  • Ryuji Matsumoto, Masumi Tsuda, Kazuhiko Yoshida, Mishie Tanino, Taichi Kimura, Hiroshi Nishihara, Takashige Abe, Nobuo Shinohara, Katsuya Nonomura, Shinya Tanaka
    Scientific reports 6 34625 - 34625 2016/10/04 [Refereed][Not invited]
     
    In treating bladder cancer, determining the molecular mechanisms of tumor invasion, metastasis, and drug resistance are urgent to improving long-term patient survival. One of the metabolic enzymes, aldo-keto reductase 1C1 (AKR1C1), plays an essential role in cancer invasion/metastasis and chemoresistance. In orthotopic xenograft models of a human bladder cancer cell line, UM-UC-3, metastatic sublines were established from tumors in the liver, lung, and bone. These cells possessed elevated levels of EMT-associated markers, such as Snail, Slug, or CD44, and exhibited enhanced invasion. By microarray analysis, AKR1C1 was found to be up-regulated in metastatic lesions, which was verified in metastatic human bladder cancer specimens. Decreased invasion caused by AKR1C1 knockdown suggests a novel role of AKR1C1 in cancer invasion, which is probably due to the regulation of Rac1, Src, or Akt. An inflammatory cytokine, interleukin-1β, was found to increase AKR1C1 in bladder cancer cell lines. One particular non-steroidal anti-inflammatory drug, flufenamic acid, antagonized AKR1C1 and decreased the cisplatin-resistance and invasion potential of metastatic sublines. These data uncover the crucial role of AKR1C1 in regulating both metastasis and drug resistance; as a result, AKR1C1 should be a potent molecular target in invasive bladder cancer treatment.
  • Abe T, Sazawa A, Harabayashi T, Oishi Y, Miyajima N, Tsuchiya K, Maruyama S, Okada H, Shinohara N
    Surgical endoscopy 30 (10) 4640 - 4645 0930-2794 2016/10 [Refereed][Not invited]
  • Takashige Abe, Ataru Sazawa, Toru Harabayashi, Yuichiro Oishi, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Hiromi Okada, Nobuo Shinohara
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 30 (10) 4646 - 4646 0930-2794 2016/10 [Refereed][Not invited]
  • Jun Furumido, Takashige Abe, Hiroshi Kikuchi, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Nobuo Shinohara
    Acta Urologica Japonica 62 (7) 377 - 381 0018-1994 2016/07/01 [Refereed][Not invited]
     
    A 79-year-old male was referred to the Department of Gastroenterology in our hospital due to a large palpable abdominal mass, with the suspicion of a gastrointestinal stromal tumor. An abdominal computed tomographic (CT) scan revealed a huge mass of 270 × 208 × 144 mm which occupied the entire pelvic cavity. Since the specimens obtained by an endoscopic ultrasound-guided fine-needle aspiration via lower intestinal tract revealed a Glcason score 4 + 4 prostate adenocarcinoma, he was then referred to our department. Prostate specific antigen (PSA) was elevated to 3, 087 ng/ml, and positron emission tomography-CT revealed right obturator lymph node metastasis and bone metastasis of the left 5th rib. Degarelix was administered as an androgen deprivation therapy, and the PSA level had decreased to 62.4 ng/ml one month later. At the last follow-up, the PSA level was 0.67 ng/ml and the tumor size had decreased to 88 × 83 × 110 mm. Next, we conducted a follow-up survey by mail of 20 reported Japanese cases of a giant prostate carcinoma, and data on 17 cases were available for analysis. In the total of 18 cases, including the present case, with a median follow-up time of 26 months, the 2-year overall survival rate was 85.7% for patients without metastasis, and 65.6% for those with metastasis.
  • Osawa T, Lee CT, Abe T, Takada N, Hafez KS, Montgomery JS, Weizer AZ, Hollenbeck BK, Skolarus TA, Murai S, Shinohara N, Morgan TM
    Bladder cancer (Amsterdam, Netherlands) 2 (2) 251 - 261 2352-3727 2016/04 [Refereed][Not invited]
     
    Background: To identify potential avenues for quality improvement, we compared the variations in clinical practice and their association with perioperative morbidity and mortality following radical cystectomy (RC) for bladder cancer in the United States (US) and Japan. Methods: We reviewed our retrospectively collected database of 2240 patients who underwent RC for bladder cancer at the University of Michigan (n = 1427) and in 21 Japanese institutions (n = 813) between 1997 and 2014. We performed a systematic comparison of clinical and perioperative factors and assessed predictors of perioperative morbidity and mortality. Death within 90 days of surgery was the primary outcome. Results: There were apparent differences between the two study populations. Notably, US patients had a significantly greater BMI and higher ASA score. In Japanese institutions, median postoperative hospital stay was significantly higher (40 days vs. 7 days, p <  0.001) and 90-day readmission rates were significantly lower (0.6% vs. 26.8% , p <  0.001). There was a total of 1372/2240 (61.2%) patients with complications within 90 days and 66/2240 (2.9%) patient deaths. Significant predictors of 90-day mortality were older age (OR 1.04, CI 1.01-1.07), higher body mass index (OR 1.07, CI 1.02-1.12), node-positive disease (OR 3.14, CI 1.78-5.47), increased blood loss (OR 1.02, CI 1.01-1.03), and major (Clavien-grade 3 or greater) complication (OR 3.29, CI 1.88-5.71). Conclusion: Despite major differences in baseline characteristics and care of cystectomy patients between the two study populations, peri-operative mortality rates proved to be comparable. This data supports an exploration of non-traditional factors that may influence mortality after cystectomy.
  • Shinohara N, Abe T, Maruyama S
    Nihon rinsho. Japanese journal of clinical medicine 日本臨床社 74 (1) 27 - 33 0047-1852 2016/01 [Refereed][Not invited]
  • Nobuo Shinohara, Takashige Abe
    INTERNATIONAL JOURNAL OF UROLOGY 22 (10) 888 - 897 0919-8172 2015/10 [Refereed][Not invited]
     
    The introduction of molecular-targeted therapy has made dramatical changes to treatment for metastatic renal cell carcinoma. Currently, there are four vascular endothelial growth factor receptor-tyrosine kinase inhibitors and two mammalian target of rapamycin inhibitors in Japan. For the appropriate clinical use of these molecular-targeted drugs, the identification of prognostic and/or predictive factors in patients who received these drugs is required. Although molecular biological and genetic factors that determine the prognosis of patients with metastatic renal cell carcinoma have been reported, most of these factors are problematic in that the number of patients analyzed was small. In contrast, clinicopathological prognostic factors, including the practice of cytoreductive nephrectomy, pathological findings, metastatic sites and metastasectomy, and abnormal inflammatory response, have been identified by analyzing a relatively large number of patients. Several prognostic classification models that were developed by combining these clinicopathological factors are widely used in not only clinical trials, but also routine clinical practice. However, the quality of these prognostic models is considered to be insufficient regarding prognostic prediction of metastatic renal cell carcinoma patients and, thus, requires further improvements. Recently, basic and clinical studies have been extensively carried out for the identification of promising informative markers and for understanding molecular mechanisms of resistance to molecular-targeted drugs in metastatic renal cell carcinoma patients. The present review considers ongoing translational research efforts on clinicopathological, molecular biological, and genetic prognostic and/or predictive factors for metastatic renal cell carcinoma patients in the era of molecular-targeted therapy, and discusses the clinical implications of these findings.
  • Takahiro Kojima, Koji Kawai, Kunihiko Tsuchiya, Takashige Abe, Nobuo Shinohara, Toshiaki Tanaka, Naoya Masumori, Shigeyuki Yamada, Yoichi Arai, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Hiroyuki Nishiyama
    INTERNATIONAL JOURNAL OF UROLOGY 22 (10) 923 - 927 0919-8172 2015/10 [Refereed][Not invited]
     
    ObjectivesTo clarify the significance of the International Germ Cell Cancer Collaborative Group classification in the 2000s, especially in intermediate- and poor-prognosis testicular germ cell tumor in Japan. MethodsWe retrospectively analyzed 117 patients with intermediate- and poor-prognosis testicular non-seminomatous germ cell tumor treated at five university hospitals in Japan between 2000 and 2010. Data collected included age, levels of tumor markers, spread to non-pulmonary visceral metastases, treatment details and survival. ResultsThe median follow-up period of all patients was 57months. A total of 50 patients (43%) were classified as having intermediate prognosis, and 67 patients (57%) as poor prognosis according to the International Germ Cell Cancer Collaborative Group classification. As first-line chemotherapy, 92 patients (79%) received bleomycin, etoposide and cisplatin. Of all patients, 74 patients (63%) received second-line chemotherapy. The most commonly used second-line chemotherapy regimens were a combination of taxanes, ifosfamide and platinum in 49 cases (66%). Overall, 33 patients (28%) received third-line chemotherapy. A total of 88 patients (75%) underwent post-chemotherapy surgery. The 5-year overall survival for intermediate (n=50) and poor prognosis (n=67) was 89% and 83% (P=0.21), respectively. In poor prognosis patients, patients with two or more risk factors (any of high lactic dehydrogenase, alpha-fetoprotein and human chorionic gonadotropin levels, and presence of non-pulmonary visceral metastases) had significantly worse survival than those with only one risk factor (71% and 91%, respectively, P=0.01). ConclusionsThe 5-year overall survivals of poor-prognosis testicular non-seminomatous germ cell tumor patients reached 83%. Further stratification of poor-prognosis patients based on a number of risk factors has the potential to further identify those with poorer prognosis.
  • Taisuke Harada, Takashige Abe, Fumi Kato, Ryuji Matsumoto, Hiromi Fujita, Sachiyo Murai, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Kohsuke Kudo, Nobuo Shinohara
    BMC urology 15 91 - 91 2015/09/04 [Refereed][Not invited]
     
    BACKGROUND: To clarify the relationship between the probability of prostate cancer scaled using a 5-point Likert system and the biological characteristics of corresponding tumor foci. METHODS: The present study involved 44 patients undergoing 3.0-Tesla multiparametric MRI before laparoscopic radical prostatectomy. Tracing based on pathological and MRI findings was performed. The relationship between the probability of cancer scaled using the 5-point Likert system and the biological characteristics of corresponding tumor foci was evaluated. RESULTS: A total of 102 tumor foci were identified histologically from the 44 specimens. Of the 102 tumors, 55 were assigned a score based on MRI findings (score 1: n = 3; score 2: n = 3; score 3: n = 16; score 4: n = 11 score 5: n = 22), while 47 were not pointed out on MRI. The tracing study revealed that the proportion of >0.5 cm(3) tumors increased according to the upgrade of Likert scores (score 1 or 2: 33%; score 3: 68.8%; score 4 or 5: 90.9%, χ(2) test, p < 0.0001). The proportion with a Gleason score >7 also increased from scale 2 to scale 5 (scale 2: 0%; scale 3: 56.3%; scale 4: 72.7%; 5: 90.9%, χ(2) test, p = 0.0001). On using score 3 or higher as the threshold of cancer detection on MRI, the detection rate markedly improved if the tumor volume exceeded 0.5 cm(3) (<0.2 cm(3): 10.3%; 0.2-0.5 cm(3): 25%; 0.5-1.0 cm(3): 66.7%; 1.0 < cm(3): 92.1%). CONCLUSIONS: Each Likert scale favobably reflected the corresponding tumor's volume and Gleason score. Our observations show that "score 3 or higher" could be a useful threshold to predict clinically significant carcinoma when considering treatment options.
  • 腎部分切除術後出血・仮性動脈瘤に対するTAE症例の検討
    阿保 大介, 作原 祐介, 曽山 武士, 高橋 文也, 工藤 與亮, 安部 崇重, 丸山 覚, 森田 研, 篠原 信雄, 野々村 克也
    IVR: Interventional Radiology (一社)日本インターベンショナルラジオロジー学会 30 (3) 270 - 270 1340-4520 2015/09
  • Ryuji Matsumoto, Norikata Takada, Takashige Abe, Keita Minami, Toru Harabayashi, Satoshi Nagamori, Kanako C Hatanaka, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Sachiyo Murai, Nobuo Shinohara
    Japanese journal of clinical oncology 45 (9) 874 - 80 0368-2811 2015/09 [Refereed][Not invited]
     
    OBJECTIVE: To investigate node-disease prevalence including micrometastases and its survival impact on bladder cancer patients. METHODS: A total of 60 patients participated in this study, in which extended lymph node dissection was carried out according to the prospective rule (below aortic bifurcation). Radical cystectomy and extended lymph node dissection were performed by open surgery (n = 23) or laparoscopically (n = 37). Perioperative, pathological and follow-up data were collected. Micrometastasis in lymph nodes was investigated by pan-cytokeratin immunohistochemistry. Recurrence-free survival was estimated with the Kaplan-Meier method. RESULTS: The median number of lymph nodes removed was 29 (range: 10-103) and there was no significant difference between the two groups (open group: median 30, laparoscopic group: median 29). Routine pathological examination revealed that 10 patients had lymph node metastases. Immunohistochemistry revealed micrometastases in four additional patients (pNmicro+), who had been diagnosed with pN0 on routine pathological examination. After excluding the three patients with pure nonurothelial carcinoma on the final pathology (small cell carcinoma: n = 2, adenocarcinoma: n = 1), 10 out of the 57 urothelial carcinoma patients (17.5%) had node metastasis, and an additional 4 out of the 47 pN0 patients (4/47, 8.5%) had micrometastasis. The 2-year recurrence-free survival rates divided by pN stage were 82.4% for pN0, 66.7% for pNmicro+ and 12.5% for pN+ (three-sample log-rank test, P < 0.0001). Three out of the four patients with pNmicro+ were disease free at the last follow-up. CONCLUSIONS: We confirmed under extended lymph node dissection that a substantial proportion of the patients had node metastasis (pN+: n = 10 and pNmicro+: n = 4), and the pN stage influenced patient survival. Our observations of micrometastasis yielded additional evidence for the potential survival benefit of extended lymphadenectomy by eliminating microdisease.
  • Norihiro Murahashi, Takashige Abe, Nobuo Shinohara, Sachiyo Murai, Toru Harabayashi, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Naoto Miyajima, Kanako Hatanaka, Katsuya Nonomura
    BMC UROLOGY 15 92  1471-2490 2015/09 [Refereed][Not invited]
     
    Background: To determine the incidence of later cancer detection and its risk factors after the first diagnostic ureteroscopy. Methods: One hundred and sixty-six patients undergoing diagnostic ureteroscopy based on the suspicion of urothelial carcinoma of the upper urinary tract (UC of the UUT) between 1995 and 2012 were included. We examined the diagnostic outcome of the initial ureteroscopy. Thereafter, we collected follow-up data on patients who had not been diagnosed with UC of the UUT at the first examination, and evaluated the incidence of later cancer detection and its risk factors using Cox hazard models. Results: Of the 166 patients, 76 (45.8 %) were diagnosed with UC of the UUT at the first diagnostic ureteroscopy. The remaining 90 (54.2 %) were diagnosed with other malignancies (n = 22), non-malignant disorders (n = 18), or without disorders (n = 50). Of these 90 patients, follow-up data were available in 65 patients (median: 41 months, range: 3-170). During the follow-up, carcinoma was detected in 6 patients (6/65, 9.2 %) at a median of 43.5 months (range: 10-59). Episodes of gross hematuria (p = 0.0048) and abnormal cytological findings (p = 0.0335) during the follow-up and a male sex (p = 0.0316) were adverse risk factors. Conclusion: Later cancer detection of UC of the UUT was not uncommon after the first examination. The risk analysis revealed the aforementioned characteristics.
  • Abe T
    International journal of urology : official journal of the Japanese Urological Association 22 (7) 656  0919-8172 2015/07 [Refereed][Not invited]
  • Ryuji Matsumoto, Masumi Tsuda, Lei Wang, Nako Maishi, Takashige Abe, Taichi Kimura, Mishie Tanino, Hiroshi Nishihara, Kyoko Hida, Yusuke Ohba, Nobuo Shinohara, Katsuya Nonomura, Shinya Tanaka
    Cancer science 106 (6) 709 - 17 1347-9032 2015/06 [Refereed][Not invited]
     
    We have previously reported that an adaptor protein CRK, including CRK-I and CRK-II, plays essential roles in the malignant potential of various aggressive human cancers, suggesting the validity of targeting CRK in molecular targeted therapy of a wide range of cancers. Nevertheless, the role of CRK in human bladder cancer with marked invasion, characterized by distant metastasis and poor prognosis, remains obscure. In the present study, immunohistochemistry indicated a striking enhancement of CRK-I/-II, but not CRK-like, in human bladder cancer tissues compared to normal urothelium. We established CRK-knockdown bladder cancer cells using 5637 and UM-UC-3, which showed a significant decline in cell migration, invasion, and proliferation. It is noteworthy that an elimination of CRK conferred suppressed phosphorylation of c-Met and the downstream scaffold protein Gab1 in a hepatocyte growth factor-dependent and -independent manner. In epithelial-mesenchymal transition-related molecules, E-cadherin was upregulated by CRK elimination, whereas N-cadherin, vimentin, and Zeb1 were downregulated. A similar effect was observed following treatment with c-Met inhibitor SU11274. Depletion of CRK significantly decreased cell proliferation of 5637 and UM-UC-3, consistent with reduced activity of ERK. An orthotopic xenograft model with bioluminescent imaging revealed that CRK knockdown significantly attenuated not only tumor volume but also the number of circulating tumor cells, resulted in a complete abrogation of metastasis. Taken together, this evidence uncovered essential roles of CRK in invasive bladder cancer through the hepatocyte growth factor/c-Met/CRK feedback loop for epithelial-mesenchymal transition induction. Thus, CRK might be a potent molecular target in bladder cancer, particularly for preventing metastasis, leading to the resolution of clinically longstanding critical issues.
  • Shinohara Nobuo, Obara Wataru, Tatsugami Katsunori, Naito Sei, Kamba Tomomi, Takahashi Masayuki, Abe Takashige, Oba Koji, Naito Seiji
    JOURNAL OF CLINICAL ONCOLOGY 33 (15) 0732-183X 2015/05/20 [Not refereed][Not invited]
  • Nobuo Shinohara, Wataru Obara, Katsunori Tatsugami, Sei Naito, Tomomi Kamba, Masayuki Takahashi, Sachiyo Murai, Takashige Abe, Koji Oba, Seiji Naito
    Cancer science 106 (5) 618 - 26 1347-9032 2015/05 [Refereed][Not invited]
     
    A multicenter cooperative study was conducted to clarify the prognosis of Japanese patients with metastatic renal cell carcinoma in the era of molecular-targeted therapy and the clinical usefulness of the Japanese metastatic renal cancer (JMRC) prognostic classification. Of 389 consecutive patients for whom treatment was started between 2008 and 2010 at 23 hospitals in Japan, 357 patients who received vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) or cytokine as initial systemic therapy were the subject of the present study. Patients were classified into three prognostic groups according to the JMRC prognostic classification. The endpoints were progression-free survival (PFS) and overall survival (OS) after the start of the initial treatment. The median PFS and OS for the entire cohort of 357 patients were 9.1 and 27.2 months, respectively. VEGFR-TKI were selected for patients with multiple organ metastases, those with liver metastasis, and those with bone metastasis. The median PFS and OS were 11.0 and 23.2 months and 5.4 and 38.2 months in the VEGFR-TKI group and the cytokines group, respectively. The JMRC prognostic classification was useful as a prognostic model for PFS and OS (c-indexes: 0.613 and 0.630 in patients who initially received VEGFR-TKI and 0.647 and 0.642 in patients who received cytokines, respectively). The present study showed for the first time the prognosis of Japanese patients with metastatic renal cell carcinoma in the era of molecular-targeted therapy. The JMRC prognostic classification may be clinically useful as a prognostic model.
  • Abe T, Maruyama S, Shichinohe T, Honma S, Kudo M, Shinohara N
    [Hokkaido igaku zasshi] The Hokkaido journal of medical science 90 (1) 13 - 16 0367-6102 2015/05 [Refereed][Not invited]
  • Matsumoto Ryuji, Tsuda Masumi, Abe Takashige, Maruyama Satoru, Tsuchiya Kunihiko, Miyajima Naoto, Shinohara Nobuo, Tanaka Shinya
    JOURNAL OF UROLOGY 193 (4) E535  0022-5347 2015/04 [Refereed][Not invited]
  • Ishizaki Junji, Abe Takashige, Minami Keita, Matsumoto Ryuji, Harabayashi Toru, Sazawa Ataru, Mochizuki Tango, Chiba Satoshi, Akino Tomoshige, Murakumo Masahi, Miyajima Naoto, Tsuchiya Kunihiko, Maruyama Satoru, Shinohara Nobuo
    JOURNAL OF UROLOGY 193 (4) E728  0022-5347 2015/04 [Refereed][Not invited]
  • Abe Takashige, Takada Norikata, Matsumoto Ryuji, Osawa Takahiro, Sazawa Ataru, Maruyama Satoru, Tsuchiya Kunihiko, Harabayashi Toru, Minami Keita, Nagamori Satoshi, Hatanaka Kanako C, Tanaka Yuka, Shinohara Nobuo, Nonomura Katsuya
    JOURNAL OF ENDOUROLOGY 29 (3) 304 - 309 0892-7790 2015/03/01 [Refereed][Not invited]
  • Takashige Abe, Norikata Takada, Ryuji Matsumoto, Takahiro Osawa, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Toru Harabayashi, Keita Minami, Satoshi Nagamori, Kanako C Hatanaka, Yuka Tanaka, Nobuo Shinohara, Katsuya Nonomura
    Journal of endourology 29 (3) 304 - 9 0892-7790 2015/03 [Refereed][Not invited]
     
    PURPOSE: To determine the appropriate template of regional lymph node dissection (LND) at the time of laparoscopic nephroureterectomy (LNU) for patients with clinically node- negative urothelial carcinoma of the upper urinary tract. PATIENTS AND METHODS: This prospective study included 45 patients undergoing LND with LNU in accordance with our prospective rules regarding the area of LND. Perioperative, pathologic, and follow-up data were collected. Micrometastasis in lymph nodes (LNs) was later evaluated by immunohistochemistry (IHC). Recurrence-free survival (RFS) was calculated with the Kaplan-Meier method. RESULTS: The median number of LNs removed was 14 (range 1-33). One patient with pT3 disease had node metastasis based on routine pathologic examination, and IHC revealed micrometastases in two additional patients (pT2 in one and pT3 in one). Therefore, 15% (3/20) of patients with ≥pT2 disease had node disease. After surgery, six patients experienced minor complications (Grade 1 or 2), and Grade 5 gastrointestinal bleeding after aspiration pneumonia developed in one elderly male patient on the 45th postoperative day, which was not considered to be associated with LND. At the last follow-up, lung metastasis developed in four patients (pT1 in one, pT2 in one, and pT3 in two), and presacral lymph node metastasis developed in one patient with a lower ureteral tumor (pT2), which was not included in our prospective template for a lower ureteral tumor. LN recurrence within/ near the LND area was not observed in patients with pelvic/upper ureteral carcinoma. The 2-year nonurothelial RFS rate was 84%. CONCLUSIONS: We consider that the present template represents regional LNs for patients with clinically node-negative pelvic/upper ureteral carcinoma, while presacral LNs may be incorporated into the regional LND template for patients with clinically node-negative lower ureteral carcinoma.
  • Haruka Miyata, Nobuo Shinohara, Norihiro Murahashi, Kunihiko Tsuchiya, Naoto Miyajima, Satoru Maruyama, Takashige Abe, Kichizo Kaga, Satoshi Hirano, Katsuya Nonomura
    Acta Urologica Japonica 61 (2) 49 - 54 0018-1994 2015/02/01 [Refereed][Not invited]
     
    We conducted a retrospective study to clarify the clinical significance of metastasectomy in patients with metastatic renal cell carcinoma (mRCC). Of 83 mRCC patients who were treated at our hospital between 2005 and 2010, 19 patients who underwent metastasectomy during the treatment course were the subjects of the present study. By the purpose and timing of metastasectomy, we classified the 19 patients into three groups: (1) patients who immediately underwent metastasectomy at diagnosis of metastasis (primary group), (2) patients who underwent resection of clinically problematic metastatic lesions for the relief of their symptoms (palliative group), and (3) patients who underwent complete resection of all metastatic lesions after sufficient systemic therapies (consolidation group). In the primary group (n = 5), four patients had lung metastasis and one had metastases to limbs and the adrenal gland. Overall survival at 3 years was 100%. In the palliative group (n = 4), 3 patients underwent resection of brain metastasis and one underwent resection of skin metastasis. The symptoms associated with metastasis clearly improved. In the consolidation group (n= 10), the metastasized organ was the lung in 5 patients, pancreas in 4, and liver in one. Preoperative systemic therapy included sunitinib or sorafenib in 5 patients, interferon-α in 4, and S-l in one. After metastasectomy, systemic therapies were discontinued in 9 patients, 4 of whom did not experience RCG recurrence, with a median follow-up of 35 months. Overall survival at 3 years was 60%. Metastasectomy would be a good treatment option in patients with mRCC.
  • Ryuji Matsumoto, Nobuo Shinohara, Kanako C-Hatanaka, Naoto Kuroda, Kunihiko Tsuchiya, Satoru Maruyama, Takashige Abe, Katsuya Nonomura
    BMC research notes 8 3 - 3 2015/01/15 [Refereed][Not invited]
     
    BACKGROUND: Renal cell carcinoma (RCC) with rhabdoid features is a rare histology and exhibits clinically aggressive behavior. We report a case of a married couple in whom RCC with rhabdoid features concurrently occurred. The rarity of this event suggests that environmental factors may contribute to the etiology of RCC with rhabdoid features. CASE PRESENTATION: A 76-year-old Japanese woman was diagnosed with a hypervascular mass in the right kidney and tumor thrombus extending into the right atrium by enhanced computed tomography (CT). She underwent radical nephrectomy and tumor thrombectomy following systemic therapy with the tyrosine kinase inhibitor sunitinib. The histological evaluation denoted clear cell RCC with rhabdoid features. The patient died of cancer 12 months postoperatively. A 76-year-old man, her husband, presented with gross hematuria 2 weeks after his wife had undergone surgery. He had a long history of asbestos exposure. An abdominal CT scan revealed a hypervascular mass in the right kidney and tumor thrombus extending into the inferior vena cava. He also underwent radical nephrectomy and tumor thrombectomy. The histological evaluation also showed clear cell RCC with rhabdoid features. Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery. CONCLUSION: Concurrent occurrence of RCC with rhabdoid features may not to be coincidental. Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.
  • Takashige Abe, Norikata Takada, Nobuo Shinohara, Ryuji Matsumoto, Sachiyo Murai, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Shino Kanzaki, Katsuya Nonomura
    International journal of urology : official journal of the Japanese Urological Association 21 (6) 554 - 9 0919-8172 2014/06 [Refereed][Not invited]
     
    OBJECTIVE: To determine the differences in the type, incidence, and severity of 90-day morbidity after radical cystectomy between two different methods of urinary diversion, ileal conduit and neobladder. METHODS: We carried out a retrospective multi-institutional study by reviewing the records of 668 patients treated with open radical cystectomy, and ileal conduit (n = 493) or neobladder substitution (n = 175) between 1997 and 2010. All complications within 90 days after surgery were divided into 11 specific categories as reported by the Memorial-Sloan Kettering Cancer Center, and graded according to the modified Clavien system. Type, incidence and severity of the 90-day morbidity between the two different types of urinary diversions were compared. RESULTS: There was no significant difference in the overall complication rates between the two groups (ileal conduit: 72% [353/493], neobladder: 74% [129/175], P = 0.5909), whereas the neobladder group had fewer major (grade 3 or more) complications (13 vs 20%, respectively, P = 0.0271). The neobladder group had more infectious complications (43 vs 31%, respectively, P = 0.0037), mainly as a result of urinary tract infection, whereas the ileal conduit group had more wound-related complications (24 vs 14%, respectively, P = 0.0068), mainly as a result of surgical site infection. The 90-day mortality rates were 1.1% (2/175) in the neobladder group and 1.6% (8/493) in the ileal conduit group (P = 0.6441). CONCLUSIONS: There was no significant difference in the overall complication rates between the two methods, and patients with neobladder had fewer major complications. The neobladder group had more infectious complications, whereas the ileal conduit group had more wound-related complications.
  • Ryuji Matsumoto, Takashige Abe, Nobuo Shinohara, Sachiyo Murai, Satoru Maruyama, Kunihiko Tsuchiya, Katsuya Nonomura
    International journal of urology : official journal of the Japanese Urological Association 21 (6) 549 - 52 0919-8172 2014/06 [Refereed][Not invited]
     
    OBJECTIVE: To evaluate the association between the RENAL nephrometry score and annual growth rates of renal masses presumed to be renal cell carcinoma. METHODS: The current study included 47 renal tumors followed up for at least 12 months, of which 26 tumors were found to be pathologically proven renal cell carcinomas. Annual tumor growth rates were calculated from changes in the maximal diameter on computed tomography, and RENAL nephrometry scores were recorded on initial imaging by two senior urologists. The associations between clinical characteristics including the RENAL nephrometry score and annual growth rates were analyzed using a linear regression model. RESULTS: The median tumor size at diagnosis was 1.7 cm (range 0.6-5.8). The median nephrometry score at diagnosis was 7 (range 4-10). Overall, the median tumor growth rate was 0.34 cm per year (range -0.19-2.0). Linear regression analysis showed that the annual tumor growth rate was associated with the RENAL nephrometry score (P < 0.0001), but it was independent of the age at diagnosis, sex and initial tumor size. In addition, the correlation between the RENAL nephrometry score and annual growth rate remained significant in the 26 pathologically proven renal cell carcinomas. CONCLUSIONS: The RENAL nephrometry score is associated with the annual growth rate of renal masses. Our findings further support the association between the RENAL nephrometry score and tumor biology.
  • Shinichi Shimizu, Kentaro Nishioka, Ryusuke Suzuki, Nobuo Shinohara, Satoru Maruyama, Takashige Abe, Rumiko Kinoshita, Norio Katoh, Rikiya Onimaru, Hiroki Shirato
    RADIATION ONCOLOGY 9 118  1748-717X 2014/05 [Refereed][Not invited]
     
    Background: We prospectively assessed the utility of intensity-modulated radiation therapy (IMRT) with urethral dose reduction and a small margin between the clinical target volume (CTV) and the planning target volume (PTV) for patients with localized prostate cancer. Methods: The study population was 110 patients in low- (14.5%), intermediate- (41.8%), and high-risk (43.6%) categories. Three gold fiducial markers were inserted into the prostate. A soft guide-wire was used to identify the urethra when computed tomography (CT) scan for treatment planning was performed. A dose constraint of V70 < 10% was applied to the urethral region. Margins between the CTV-PTV were set at 3 mm in all directions. Patients were treated with 70 Gy IMRT in 30 fractions (D95 of PTV) over 7.5 weeks. The patient couch was adjusted to keep the gold markers within 2.0 mm from their planned positions with the use of frequent on-line verification. Results: The median follow-up period was 31.3 (3.2 to 82.1) months. The biochemical relapse-free survival (bRFS) rates at 3 years were 100%, 93.8% and 89.5% for the low-, intermediate-, and high-risk patients, respectively. The incidences of acute adverse events (AEs) were 45.5% and 0.9% for grades 1 and 2, respectively. The late AEs were grade 1 cystitis in 10.0% of the patients, rectal bleeding in 7.3%, and urinary urgency in 6.4%. Only three patients (2.7%) developed grade 2 late AEs. Conclusions: On-line image guidance with precise correction of the table position during radiotherapy achieved one of the lowest AEs rates with a bRFS equal to the highest in the literature.
  • Takashige Abe, Hiroshi Kitamura, Wataru Obara, Nagahide Matsumura, Taiji Tsukamoto, Tomoaki Fujioka, Isao Hara, Sachiyo Murai, Nobuo Shinohara, Katsuya Nonomura
    JOURNAL OF UROLOGY 191 (4) 932 - 936 0022-5347 2014/04 [Refereed][Not invited]
     
    Purpose: We determined prognostic factors associated with prolonged survival after metastasectomy for urothelial carcinoma. Materials and Methods: A total of 42 patients who underwent resection of urothelial carcinoma metastases with curative intent at 4 Japanese university hospitals were included in analysis. Of the patients 41 of 42 underwent systemic chemotherapy before and/or after metastasectomy. Overall survival was analyzed using the Kaplan-Meier method. The relationship between clinical characteristics and survival was analyzed using the log rank test. Results: Metastasectomy included lymph node dissection in 20 cases, pulmonary resection in 12, pelvic exenteration in 3, resection of local recurrence in 2, resection of subcutaneous metastasis in 2, liver resection in 1 and other in 2. Median overall survival was 29 months (IQR 19-80) from the initiation of treatment for metastases and 26 months (IQR 11-90) from metastasectomy. The overall 5-year survival rate after metastasectomy was 31%. On univariate analysis patients treated with metastasectomy for a solitary lung or solitary lymph node metastasis had significantly longer survival than the others who underwent metastasectomy (81 vs 19 months, log rank test p = 0.0296). Conclusions: Long-term cancer control could be achieved in a subgroup of patients who undergo metastasectomy, especially those with a solitary lung or solitary lymph node metastasis.
  • Maruyama Satoru, Shinohara Nobuo, Murahashi Norihiro, Suzuki Hidetaka, Matsumoto Ryuji, Akino Tomoshige, Miyajima Naoto, Tsuchiya Kunihiko, Abe Takashige, Nonomura Katsuya
    JOURNAL OF CLINICAL ONCOLOGY 32 (4) 0732-183X 2014/02/01 [Refereed][Not invited]
  • Kentaro Nishioka, Shinichi Shimizu, Nobuo Shinohara, Yoichi M. Ito, Takashige Abe, Satoru Maruyama, Rumiko Kinoshita, Keiichi Harada, Noboru Nishikawa, Naoki Miyamoto, Rikiya Onimaru, Hiroki Shirato
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 44 (1) 28 - 35 0368-2811 2014/01 [Refereed][Not invited]
     
    The real-time tumor-tracking radiotherapy system with fiducial markers has the advantage that it can be used to verify the localization of the markers during radiation delivery in real-time. We conducted a prospective Phase II study of image-guided local-boost radiotherapy for locally advanced bladder cancer using a real-time tumor-tracking radiotherapy system for positioning, and here we report the results regarding the safety and efficacy of the technique. Twenty patients with a T2-T4N0M0 urothelial carcinoma of the bladder who were clinically inoperable or refused surgery were enrolled. Transurethral tumor resection and 40 Gy irradiation to the whole bladder was followed by the transurethral endoscopic implantation of gold markers in the bladder wall around the primary tumor. A boost of 25 Gy in 10 fractions was made to the primary tumor while maintaining the displacement from the planned position at less than 2 mm during radiation delivery using a real-time tumor-tracking radiotherapy system. The toxicity, local control and survival were evaluated. Among the 20 patients, 14 were treated with concurrent chemoradiotherapy. The median follow-up period was 55.5 months. Urethral and bowel late toxicity (Grade 3) were each observed in one patient. The local-control rate, overall survival and cause-specific survival with the native bladder after 5 years were 64, 61 and 65. Image-guided local-boost radiotherapy using a real-time tumor-tracking radiotherapy system can be safely accomplished, and the clinical outcome is encouraging. A larger prospective multi-institutional study is warranted for more precise evaluations of the technological efficacy and patients quality of life.
  • Nobuo Shinohara, Satoru Maruyama, Shinichi Shimizu, Kentaro Nishioka, Takashige Abe, Kanako C-Hatanaka, Koji Oba, Katsuya Nonomura, Hiroki Shirato
    Journal of radiation research 54 (6) 1095 - 101 0449-3060 2013/11/01 [Refereed][Not invited]
     
    The purpose of this study was to compare the quality of life (QOL) in patients with localized prostate cancer (PC) after intensity-modulated radiation therapy assisted with a fluoroscopic real-time intensity-modulated radiation therapy (RT-IMRT) tumor-tracking system versus the QOL after radical prostatectomy (RP). Between 2003 and 2006, 71 patients were enrolled in this longitudinal prospective study. Each patient was allowed to decide which treatment modality they would receive. Of the 71 patients, 23 patients underwent RT-IMRT, while 48 opted for RP. No patient received neo-adjuvant or adjuvant hormone therapy. The global QOL and disease-specific-QOL were evaluated before treatment and again at 1, 3 and 5 years after treatment. There was no significant difference in the background characteristics between the two groups. The 5-year biochemical progression-free survival was 90% in the RT-IMRT and 79% in the RP group. In the RT-IMRT group, there was no significant deterioration of the global QOL or disease-specific QOL through 5 years post-treatment. In the RP group, the urinary function, sexual function, and sexual bother indicators significantly deteriorated after treatment. Urinary and sexual function was significantly better in the RT-IMRT group at 1, 3 and 5 years post-treatment compared to the RP group. RT-IMRT may be a preferable treatment for localized PC because of similar efficacy to RP but better post-treatment QOL.
  • Masanori Hirono, Mikio Kobayashi, Tomoyasu Tsushima, Wataru Obara, Nobuo Shinohara, Keiichi Ito, Masatoshi Eto, Tatsuya Takayama, Yasuhisa Fujii, Masaharu Nishikido, Go Kimura, Takeshi Kishida, Masayuki Takahashi, Noriomi Miyao, Yukio Naya, Takashige Abe, Tomoaki Fujioka, Kazuto Ito, Seiji Naito
    BMC Cancer 13 447  1471-2407 2013/10/02 [Refereed][Not invited]
     
    Background: Although the percentage of patients with renal cell carcinoma (RCC) extending into venous systems is unexpectedly high, the prognostic impact and independency of venous tumor thrombus-related factors on overall survival (OS) remain controversial. Furthermore, the prognostic impact of various clinicopathologic factors including tumor thrombus-related factors on OS may change with elapsed years after the intervention and also with follow-up duration of participants. The aim of the study is to explore independent and universal predictive preoperative and intraoperative clinicopathologic factors on OS in patients with RCC extending into venous systems using subgroup analysis in terms of restricted follow-up duration and yearly-based survivors.Methods: Between 1980 and 2009, 292 patients diagnosed with RCC with venous tumor thrombus were retrospectively registered for this study. The prognostic impacts of various clinicopathologic and surgical treatment factors including levels of venous thrombus, venous wall invasion status and likelihood of aggressive cytoreductive operation, were investigated using Kaplan-Meier method and following multivariate Cox proportional hazards model for all patients and those still alive at 1, 2, and 3 years of follow-up. To investigate the impact of follow-up duration on the statistical analyses, multivariate logistic regression analyses were used to explore prognostic factors using restricted data until 1, 2, and 3 years of follow-up.Results: The median follow-up duration was 40.4 months. The 5-year OS was 47.6%. Several independent predictive factors were identified in each subgroup analysis in terms of yearly-based survival and restricted follow-up duration. The presence of tumor thrombus invading to venous wall was independently related to OS in the full-range follow-up data and in survivors at 2 and 3 years of follow-up. Using restricted follow-up data until 1, 2, and 3 years of follow-up, many independent predictive factors changed with follow-up duration, but surgical category could be universal and independent predictive factors.Conclusion: The most universal factors affecting improvement both in short-term and long-term survivals could be cytoreductive surgery and absence of venous wall invasion. It may mean that feasible aggressive cytoreductive operation following more reliable preoperative imaging for predicting venous wall invasion status would improve OS for patients with RCC extending into venous systems. © 2013 Hirono et al. licensee BioMed Central Ltd.
  • K. Nishioka, S. Shimizu, R. Onimaru, R. Kinoshita, N. Kato, K. Harada, T. Abe, S. Maruyama, N. Shinohara, H. Shirato
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 87 (2) S397 - S397 0360-3016 2013/10 [Refereed][Not invited]
  • Nobuo Shinohara, Takashige Abe, Tango Mochizuki, Akira Kashiwagi, Kouichi Kanagawa, Satoru Maruyama, Ataru Sazawa, Koji Oba, Katsuya Nonomura
    Urologic oncology 31 (7) 1276 - 82 1078-1439 2013/10 [Refereed][Not invited]
     
    OBJECTIVES: We investigated the prognosis of Japanese patients with metastatic renal cell carcinoma (RCC), and analyzed the validity of Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification. MATERIALS AND METHODS: The endpoint of the present study was overall survival. Relationships between overall survival and potential prognostic factors were assessed using the Cox proportional hazard model with a step-wise procedure. Prognostic assessment was also performed according to the MSKCC risk classification. The predictive accuracy of the MSKCC risk classification was measured employing the concordance index. RESULTS: The median survival for all patients was 22 months (95% CI, 19-28 months). The eight factors were identified as independent prognostic factor; time from initial diagnosis to metastasis, low hemoglobin (Hb), lactate dehydrogenase (LDH), corrected serum calcium (cCa), C-reactive protein (CRP), and the presence or absence of liver metastasis, bone metastasis, and lymph node metastasis. When the MSKCC risk classification was applied to patients, the median overall survival was not reached and 26 and 10 months in the patients classified as favorable, intermediate, and poor risk, respectively. The c-index was 0.73. CONCLUSIONS: The prognosis of Japanese metastatic renal cell carcinoma patients may be better than that of previous studies from North America or Europe. Although there are some differences in the rate of patients in the risk groups and survival time by risk group between these patients, the MSKCC risk classification may be applicable for Japanese patients with metastatic renal cell carcinoma.
  • Takahiro Osawa, Nobuo Shinohara, Satoru Maruyama, Koji Oba, Takashige Abe, Shintaro Maru, Norikata Takada, Ataru Sazawa, Katsuya Nonomura
    Urology journal 10 (1) 784 - 9 1735-1308 2013 [Refereed][Not invited]
     
    PURPOSE: To evaluate postoperative renal function and risk factors for the loss of renal function in patients who had undergone radical cystectomy. MATERIALS AND METHODS: A retrospective single institutional study evaluated 70 patients, including 54 men and 16 women who underwent radical cystectomy. The median follow-up period was 34.5 months (range, 12 to 228 months). In this cohort, four types of urinary diversions were studied, including ileal neobladder (n = 24), ileocecal neobladder (n = 12), ileal conduit (n = 25), and cutaneous ureterostomy (n = 9). Postoperative changes in renal function were reviewed, and the estimated serum creatinine-based glomerular filtration rate (eGFR) was calculated. The variables analyzed were age, a prior history of hypertension or diabetes mellitus, pre-operative renal function, type of urinary diversion, the postoperative occurrence of acute pyelonephritis, and the presence of chemotherapy. RESULTS: The mean eGFR was 74.6 (range, 15.2 to 155.1) mL/min/1.73 m² before surgery and 63.6 (range, 8.7 to 111.5) mL/min/1.73 m² at the last follow-up. The 10-year renal deterioration-free interval was 63.8%. Multivariate analysis showed that a postoperative episode of acute pyelonephritis [Odds Ratio (OR), 3.21; 95% Confidence Interval (CI), 1.14 to 9.02; P = .03] and the presence of chemotherapy (OR, 3.27; 95% CI, 1.33 to 8.01; P = .01) were significant adverse factors. CONCLUSION: Twenty-four (34.2%) patients demonstrated reduced renal function during the follow-up period. Postoperative episodes of acute pyelonephritis and the presence of chemotherapy were found to be significant adverse factors.
  • Norikata Takada, Takashige Abe, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Yuichiro Shinno, Soshu Sato, Kimiyoshi Mitsuhashi, Takuya Sato, Keiji Sugishita, Shinji Kamota, Takanori Yamashita, Junji Ishizaki, Takaya Hioka, Gaku Mouri, Takenori Ono, Naoto Miyajima, Takanori Sakuta, Tango Mochizuki, Toshiki Aoyagi, Hidenori Katano, Tomoshige Akino, Kazushi Hirakawa, Keita Minami, Akira Kumagai, Toshimori Seki, Masaki Togashi, Katsuya Nonomura
    BJU INTERNATIONAL 110 (11B) E756 - E764 1464-4096 2012/12 [Refereed][Not invited]
     
    OBJECTIVE To determine the type, incidence and severity of 90-day morbidity after radical cystectomy in our institution and our affiliated hospitals in accordance with a standard reporting methodology. At present, most studies on complications associated with open radical cystectomy are derived from Western academic high-volume centres and data from Japan and other Asian countries remain very limited. PATIENTS AND METHODS The study comprised a retrospective multi-institutional study. The records were reviewed of 928 patients who underwent open radical cystectomy between 1997 and 2010. All complications within 90 days of surgery were categorized into 11 specific categories and graded in accordance with the modified Clavien system. Multivariate regression models were used to determine predictors of complications. RESULTS At least one complication was observed in 635 (68%) patients and a major (grade 3-5) complication was observed in 156 (17%) patients. The most common complication categories were infectious (30%), gastrointestinal (26%), wound-related (21%) and genitourinary (15%). The 30-day mortality rate was 0.8% and the 90-day mortality rate was 2%. A multivariate regression model showed that previous cardiovascular comorbidity and type of urinary diversion (i.e. ileal conduit or neobladder) were significant factors for any and major complications. CONCLUSIONS Surgical complication-related radical cystectomy is significant and both previous cardiovascular comorbidity and the type of urinary diversion were found to be significant factors for any and major complications. The 90-day mortality rate was 2%, which is compatible with reports from Western high-volume centres.
  • K. Nishioka, S. Shimizu, R. Onimaru, R. Kinoshita, K. Harada, N. Nishikawa, T. Abe, S. Maruyama, N. Shinohara, H. Shirato
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 84 (3) S769 - S769 0360-3016 2012/11 [Refereed][Not invited]
  • Takashige Abe, Ataru Sazawa, Toru Harabayashi, Nobuo Shinohara, Satoru Maruyama, Ken Morita, Ryuji Matsumoto, Toshiki Aoyagi, Katsuya Nonomura
    Journal of endourology 26 (11) 1483 - 8 0892-7790 2012/11 [Refereed][Not invited]
     
    PURPOSE: To investigate changes in renal function after retroperitoneal laparoscopic partial nephrectomy (LPN) with renal hypothermia induced by ice-slush cooling. PATIENTS AND METHODS: Seventy-one patients undergoing retroperitoneal LPN with renal hypothermia were included. Perioperative outcomes were reviewed retrospectively. The total renal function was evaluated by an estimated glomerular filtration rate (eGFR) preoperatively and 6 months postoperatively in 69 patients. Split renal function (SRF) was also evaluated by 99mTc-mercaptoacetyltriglycine scintigraphy preoperatively and 6 months postoperatively in 61 patients. RESULTS: The median operative time was 246 minutes (range, 155-424). The median cold ischemic time, including the initial 15 minutes of hypothermia, was 57 minutes (range, 34-112). In the 21 patients whose renal temperature was monitored, median lowest renal temperature was 20.7°C (range, 12.1-27.6). The median baseline eGFR and 6-month postoperative eGFR were 77.2 mL/min/1.73 m(2) (range, 36.1-121.3) and 68.3 mL/min/1.73 m(2) (range, 33.2-103.4), and the median baseline SRF and 6-month postoperative SRF of the affected kidney were 49.3% (range, 40.3-57.6) and 40.7% (range, 13.8-54.5). Using multivariate analysis, the baseline eGFR (p<0.0001) and the ischemic time (p=0.0073) were associated with the 6-month postoperative eGFR, and the 6-month postoperative SRF was only associated with a baseline SRF (p=0.0185). CONCLUSIONS: Ice-slush cooling could provide renal hypothermia also under LPN. The decrease in renal function was small, whereas our ischemic time was longer than experts' warm ischemic series. These observations suggested the protective effect of our cooling methods against ischemic injury.
  • Nobuo Shinohara, Katsuya Nonomura, Takashige Abe, Satoru Maruyama, Takao Kamai, Masayuki Takahashi, Katsunori Tatsugami, Shigeaki Yokoi, Takashi Deguchi, Hiroomi Kanayama, Koji Oba, Seiji Naito
    Cancer science 103 (9) 1695 - 700 1347-9032 2012/09 [Refereed][Not invited]
     
    The aims of the present study were to: (i) develop a clinically useful prognostic classification in Asian patients with metastatic renal cell carcinoma (RCC) by combining metastatic features with several pretreatment parameters; and (ii) evaluate the validity of this prognostic classification. Baseline characteristics and outcomes were collected for 361 patients who underwent interferon-α-based therapy between 1995 and 2005. Relationships between overall survival (OS) and potential prognostic factors were assessed using Cox's proportional hazard model. The predictive performance of the model was evaluated using bootstrap resampling procedures and by using an independent dataset obtained from randomly selected institutions. The predictive accuracy was measured using the concordance index (c-index). Four factors were identified as independent prognostic factors: time from initial diagnosis to treatment, anemia, elevated lactate dehydrogenase (LDH), and poor prognostic metastatic group (liver only, bone only, or multiple organ metastases). Each patient was assigned to one of three risk groups: favorable risk (none or one factor; n = 120), in which median OS was 51 months; intermediate risk (two factors; n = 101), in which median OS was 21 months; and poor risk (three or four factors; n = 102), in which median OS was 10 months. The c-index was 0.72 in the original dataset and 0.72 in 500 random bootstrap samples. In the independent dataset for external validation, the c-index was 0.73. Thus, the new prognostic classification is easily applicable for Asian patients with previously untreated metastatic RCC and should be incorporated into patient care, as well as clinical trials performed in Asia.
  • 広瀬 貴行, 原林 透, 安部 崇重, 丸山 覚, 三浦 正義, 佐澤 陽, 篠原 信雄, 野々村 克也
    泌尿器外科 医学図書出版(株) 25 (7) 1573 - 1573 0914-6180 2012/07
  • Takahiko Mitsui, Hiroshi Tanaka, Toru Harabayashi, Kimihiko Moriya, Satoru Maruyama, Takashige Abe, Ataru Sazawa, Nobuo Shinohara, Katsuya Nonomura
    LUTS-LOWER URINARY TRACT SYMPTOMS 4 (2) 82 - 86 1757-5664 2012/05 [Refereed][Not invited]
     
    Objectives: Our goal was to identify changes in urodynamic parameters and lower urinary tract symptoms (LUTS) in men followed for1 year after radical prostatectomy (RP) compared to the preoperative measures with a specific focus on detrusor contractility. Methods: This study enrolled 43 patients who received RP (laparoscopic 27, retropubic: 16) and pressure flow studies (PFS) pre- RP as well as 12 months (M) after RP. No patients complained of urinary incontinence preoperatively. Urodynamic studies and questionnaires regarding LUTS and urinary continence were conducted before and 12 M after RP. Detrusor underactivity (DU) was defined as < 10 (W/m(2)) in preoperative maximum watts factor value. Results: Urodynamics demonstrated that RP improved urodynamic parameters by releasing bladder outlet obstruction without affecting overall detrusor contractility. Meanwhile, RP did not affect bladder capacity, bladder compliance, or detrusor contractility. LUTS in the International Prostate Symptom Score (IPSS), including the IPSS subscore, was not improved. The quality of life score was significantly better at 12 M after RP and continence rates were gradually improved to be at a satisfactory level in more than 80% of patients by 12 M after RP. DU was preoperatively identified in 21(49%) patients, influencing urodynamic parameters and LUTS preoperatively. However, DU did not affect urodynamic parameters and LUTS after RP. Conclusion: Although RP improves urodynamic parameters, it does not significantly affect LUTS. Urinary continence gradually improves and is satisfactory within 1 year after RP. The status of preoperative detrusor contractility did not affect urodynamic parameters or LUTS after RP.
  • Nobuo Shinohara, Takashige Abe, Ataru Sazawa, Satoru Maruyama, Junri Shindo, Soshu Sato, Shin Suzuki, Katsuya Nonomura
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 42 (2) 113 - 119 0368-2811 2012/02 [Refereed][Not invited]
     
    Objective: We reviewed the outcomes of metastatic renal cell carcinoma patients with the primary tumor in situ who initially underwent interferon-alpha-based immunotherapy to evaluate the effect of this therapy on metastatic sites as well as primary kidney tumor and survival. Methods: Thirty-one patients, for whom upfront cytoreductive nephrectomy was considered to be inappropriate because of poor performance status and far-advanced disease, were the subject of the present study. Tumor response and reduction in the size of metastatic sites and primary kidney tumor were assessed. Overall survival distributions were estimated using the Kaplan-Meier method with the significance determined using the log-rank test. Results: Partial response was observed in 11 patients, yielding an overall response rate of 35%. Seventeen patients had regression or stabilization of metastatic sites, while progression of metastatic sites was observed in the remaining 14 patients. Regarding the maximum response of primary kidney tumor, a reduction in kidney primary tumor size was observed in 42% of the patients and the mean reduction rate in these patients was 18.2% (range: 3-36%). Furthermore, the reduction in the size of metastatic sites was significantly associated with that in the size of primary kidney tumor (R-2 = 0.432, P < 0.0001). The median survival for the 31 patients was 17 months. The median survival was 42 months in patients with regression or stabilization of metastatic sites and 7 months in those without (P < 0.001). Conclusions: The present study suggests that metastatic sites as well as primary kidney tumor respond to interferon-alpha-based immunotherapy in metastatic renal cell carcinoma patients with primary tumor in situ.
  • Shintaro Maru, Takashige Abe, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Toru Harabayashi, Shin Suzuki, Katsuya Nonomura
    INTERNATIONAL JOURNAL OF UROLOGY 19 (2) 110 - 116 0919-8172 2012/02 [Refereed][Not invited]
     
    Objectives: To investigate the influence of baseline renal function and dose reduction of chemotherapeutic agents on the outcome of metastatic urothelial carcinoma patients with renal impairment. Methods: A total of 57 patients with metastatic urothelial carcinoma treated by systemic chemotherapy were included in the present study. The 24 h-creatinine clearance was measured before each cycle and dose reduction was carried out according to our guidelines. Patients were divided into two groups according to baseline 24 h-creatinine clearance: fit group (60 mL/min/1.48 m(2)<=) and unfit group (60 mL/min/1.48 m(2)>). Clinical characteristics and final outcomes were compared between the two groups. Results: There was no significant difference in the total number of chemotherapy cycles of each patient between the two groups (fit group: median 5; unfit group: median 4; P = 0.7466), although dose reduction was carried out significantly more often in the unfit group than in the fit group during treatment (fit group: median 0 cycles; unfit group: median 3.5 cycles; P = 0.0016). Overall, the median survival was 16 months. There was a significant survival difference between the two groups (fit group: median 17 months; unfit group: median 10 months; P = 0.0419). On multivariate analyses, impaired renal function at the baseline remained an adverse factor (HR 2.27, P = 0.01). Conclusions: "Unfit" was a poor prognostic factor for metastatic urothelial carcinoma. The dose reduction strategy contributed to continuous treatment in the unfit group. However, its contribution to the prognosis of unfit patients is uncertain.
  • Abe Takashige, Sazawa Ataru, Harabayashi Toru, Matsumoto Ryuji, Aoyagi Toshiki, Maruyama Satoru, Shinohara Nobuo, Nonomura Katsuya
    JOURNAL OF ENDOUROLOGY 25 A186  0892-7790 2011/11 [Refereed][Not invited]
  • Takashige Abe, Toru Harabayashi, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Hajime Sasaki, Katsuya Nonomura
    JOURNAL OF ENDOUROLOGY 25 (5) 803 - 807 0892-7790 2011/05 [Refereed][Not invited]
     
    Objective: To obtain accurate disease staging, we routinely perform regional lymph node dissection (LND) in conjunction with laparoscopic nephroureterectomy (NU) to treat urothelial carcinoma of the upper urinary tract. The present study evaluated the feasibility and usefulness of LND in laparoscopic NU. Patients and Methods: Thirty-nine patients undergoing laparoscopic NU with regional LND were included in the present study. We evaluated the number of lymph nodes (LNs) resected, pathological node status, adverse events, and survival data. Node count was compared with that of 41 patients who underwent open NU between 1990 and 2008. Results: The median number of LNs removed was 10 (range, 2-59) in the laparoscopic NU group and 10 (range, 1-65) in the open NU group (Mann-Whitney U-test, p = 0.82). Pathological examination demonstrated positive LNs in four patients (10.3%) and three of the four patients received adjuvant chemotherapy. Although chylous drain discharge was detected just after resuming dietary intake in eight patients, it resolved without significant problem. Five-year overall survival by stage was 100% for pT2 >= disease, 55% for pT3 disease, and 0% for pT4 disease. Conclusions: LND can be performed safely and effectively during laparoscopic nephroureterectmy. We consider that accurate node staging and subsequent stratification are mandatory for disease management.
  • Shuhei Ishikawa, Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Satoru Maruyama, Kanako Kubota, Yoshihiro Matsuno, Takahiro Osawa, Yuichiro Shinno, Akira Kumagai, Masaki Togashi, Hiroyuki Matsuda, Tatsuya Mori, Katsuya Nonomura
    JOURNAL OF UROLOGY 184 (3) 883 - 887 0022-5347 2010/09 [Refereed][Not invited]
     
    Purpose: We determined whether diagnostic ureteroscopy for upper urinary tract cancer affects intravesical recurrence and cancer specific mortality. Materials and Methods: In a retrospective, multi-institutional study we evaluated 208 patients undergoing nephroureterectomy for upper urinary tract cancer who had no perioperative systemic chemotherapy, history of invasive bladder cancer, distant metastasis or incomplete followup data. Of these 208 patients 55 who composed the study group underwent diagnostic ureteroscopy before nephroureterectomy while 153 serving as controls did not. We analyzed intravesical recurrence and cancer specific survival using the Kaplan-Meier method with the log rank test used to assess significance. Results: There was no significant difference between the 2 groups in patient characteristics or upper urinary tract cancer stage and grade while followup, and the proportion of multiple tumors and lymphovascular invasion positive tumors were significantly greater in controls. The 2-year bladder recurrence-free survival rate was 60.0% in the study group and 58.7% in controls. There was no significant difference in the intravesical recurrence rate between the 2 groups (log rank test p = 0.972). Estimated Kaplan-Meier cancer specific survival was 88.3% and 78.1% at 5 years in the study and control groups, respectively (log rank test p = 0.0687). Conclusions: Diagnostic ureteroscopy did not affect intravesical recurrence or cancer specific survival in patients with upper urinary tract cancer undergoing nephroureterectomy.
  • Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Tomoshige Akino, Shuhei Ishikawa, Kanako Kubota, Yoshihiro Matsuno, Takahiro Osawa, Takeshi Shibata, Yutaka Toyoda, Yuichiro Shinno, Shinji Kamota, Keita Minami, Shigeo Sakashita, Akira Kumagai, Norikata Takada, Masaki Togashi, Hiroshi Sano, Tatsuya Mori, Katsuya Nonomura
    BJU INTERNATIONAL 105 (8) 1102 - 1106 1464-4096 2010/04 [Refereed][Not invited]
     
    OBJECTIVES To determine the pathological features and clinical course of intravesical recurrence after nephroureterectomy (NU) for upper urinary tract (UUT) cancer. PATIENTS AND METHODS Among 325 patients undergoing NU with bladder cuff excision for UUT cancer, in this retrospective multi-institutional study we evaluated 113 who developed bladder tumour after NU. Excluding patients with (i) perioperative systemic chemotherapy or radiotherapy for UUT cancer; (ii) a history of previous or synchronous bladder cancer at the time of NU; (iii) distant metastasis at the time of NU; (iv) a follow-up of < 1 year after the initial bladder cancer recurrence; or (v) missing data, 74 patients were included in this study. We compared the pathology between UUT cancer and the first bladder cancer recurrence, using Fisher's exact test. Further intravesical recurrence and bladder cancer progression was analysed using the Kaplan-Meier method, with the log-rank test used to assess significance. A Cox proportional hazard model was used for multivariate analysis. RESULTS The grade of the first bladder cancer recurrence strongly correlated with that of the UUT tumour (P < 0.001) and the carcinoma in situ (CIS) lesion with the first bladder cancer recurrence correlated with high grade (grade 3) UUT tumour (P < 0.001). In all, 56 of the assessable 70 patients further developed intravesical recurrence at a median interval of 7 months after the first bladder cancer recurrence. There were no clinicopathological factors that predicted the second recurrence. Progression occurred in 14 patients, at a median interval of 25 months. A CIS lesion with the first bladder cancer recurrence was a risk factor for progression on multivariate analysis. CONCLUSIONS A large proportion of the patients who developed bladder tumour after NU had further intravesical recurrence, which indicated its refractory nature. Especially when a CIS lesion is detected in the initial intravesical recurrence, a careful follow-up is mandatory to detect bladder cancer progression.
  • Nobuo Shinohara, Akira Kumagai, Kouichi Kanagawa, Satoru Maruyama, Takashige Abe, Ataru Sazawa, Katsuya Nonomura
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 39 (11) 720 - 726 0368-2811 2009/11 [Refereed][Not invited]
     
    We conducted a Phase II trial to investigate the efficacy of combined therapy with meloxicam, a cyclooxygenase-2 inhibitor and natural interferon (IFN)-alpha in renal cell carcinoma patients with distant metastasis. The subjects of this study were patients with untreated renal cell carcinoma who were diagnosed from the results of imaging or pathological studies and who had measurable lesions according to the Response Evaluation Criteria in Solid Tumors (RECIST). Patients could be enrolled in the study irrespective of whether nephrectomy had been performed. Treatment involved the subcutaneous injection of natural IFN-alpha at 3 x 10(6) or 5 x 10(6) U three times weekly plus oral administration of meloxicam at 10 mg once daily. A total of 43 patients were enrolled in the present study, included 11 patients without nephrectomy, 23 patients with a high C-reactive protein (CRP) level and 23 patients with extrapulmonary metastasis. Four patients of complete response and 12 patients of partial response were confirmed, given an overall response rate of 37.2% (95% confidence interval, 23.0-53.3%). Stable disease for 6 months or longer was also obtained in 14 patients. The median time to progression was 14 months. Adverse events (AEs) observed were mainly flu-like symptoms due to cytokine. Although the Grade 3 or 4 AEs were fatigue, hepatic dysfunction, arthritis and gastric ulcer, all but one (gastric ulcer) were immediately improved by discontinuation of this combined therapy. The combination of meloxicam and natural IFN-alpha is considered to be an active regimen with tolerable toxicities as a first-line treatment of metastatic renal cell carcinoma.
  • Ataru Sazawa, Nobuo Shinohara, Toru Harabayashi, Takashige Abe, Hiroki Shirato, Katsuya Nonomura
    INTERNATIONAL JOURNAL OF UROLOGY 16 (4) 410 - 412 0919-8172 2009/04 [Refereed][Not invited]
     
    Patients with an adrenal tumor usually undergo laparoscopic adrenalectomy. However, an alternative treatment approach might be needed in some patients with adrenal metastasis from malignancy or with severe complications. Real-time tracking radiotherapy (RTRT) with a gold marker is considered one of the feasible treatment options because this system can reduce the adverse effects of organ movement such as that in the adrenal gland or kidney. A 64-year-old patient with hormone refractory prostate cancer presented with clinically isolated adrenal metastasis. The patient underwent RTRT treatment with an implanted gold marker in the right adrenal metastasis. There were no adverse events. Although disease progression with elevated prostate-specific antigen occurred 8 months later, there was no further growth of the right adrenal metastasis before he died. From our experience, RTRT with an implanted gold marker might be feasible for the treatment of isolated adrenal metastasis from malignancies including prostate cancer.
  • Takahiro Osawa, Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Kanako Kubota, Yoshihiro Matsuno, Takeshi Shibata, Yuichiro Shinno, Shinji Kamota, Keita Minami, Shigeo Sakashita, Akira Kumagai, Tatsuya Mori, Katsuya Nonomura
    INTERNATIONAL JOURNAL OF UROLOGY 16 (3) 274 - 278 0919-8172 2009/03 [Refereed][Not invited]
     
    To evaluate the prognostic role of different clinico-pathological parameters in node-positive patients treated by radical cystectomy. A retrospective multi-institutional study of 435 patients who underwent radical cystectomy between 1990 and 2005 was carried out. Of them, pathological lymph node (LN) metastases were found in 83 patients. Sixty of these 83 patients, whose clinical information and follow-up data were available, were included in the analysis. Twenty-five patients had undergone adjuvant chemotherapy, whereas 35 had not. A Cox proportional hazards model was used to determine the impact of the following clinico-pathological parameters on patient survival: number of resected LNs, number of positive LNs, LN density (defined as the ratio of the number of positive LNs divided by the total number of resected LNs) and adjuvant chemotherapy. Median follow-up for surviving patients was 41 months (range 4-138) after surgery. The median survival time for all patients was 22 months (95% confidence interval, 15-42 months). At multivariate analysis, LN density of 25% or less, adjuvant chemotherapy and pure urothelial carcinoma were independently significant predictors of survival. Lymph node density predicts survival in patients with node-positive bladder cancer.
  • Tatsuhiro Suzuki, Toru Harabayashi, Takashige Abe, Ataru Sazawa, Nobuo Shinohara, Katsuya Nonomura
    Japanese Journal of Urology 100 (7) 703 - 706 0021-5287 2009 [Refereed][Not invited]
     
    A 72-years-old male visited our hospital with a complaint of perineal and voiding pain. An elastic hard mass was palpated by rectal examination in the cranial lesion of prostate. On CT scan and MRI it was located at the site of the right seminal vesicle. Trans-rectal needle biopsy specimen showed leiomyosarcoma. Radical cystoprostatectomy with pelvic lymph node dissection was performed at Hokkaido University Hospital. Microscopic examination of the resected specimen revealed the tumor arose from the right seminal vesicle without involvement of the bladder and the prostate gland. Three months after the operation the tumor recurred at lung and pelvic lymph node. He died 10 month postoperatively. Autopsy finding showed many visceral organs metastases without local recurrence. In the past, nine cases of leiomyosarcoma of seminal vesicle were published in the literature. Including our case, pathological diagnosis by core needle biopsy was attempted in five cases, though accurate diagnosis was made in only two cases. In our case, Immunohistological study by SMA and desmin was useful for histological diagnosis preoperatively.
  • Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Shuhei Ishikawa, Kanako Kubota, Yoshihiro Matsuno, Takahiro Osawa, Takeshi Shibata, Yuichiro Shinno, Shinji Kamota, Keita Minami, Shigeo Sakashita, Ichiro Takeuchi, Akira Kumagai, Tatsuya Mori, Masaki Togashi, Katsuya Nonomura
    BJU INTERNATIONAL 102 (5) 576 - 579 1464-4096 2008/09 [Refereed][Not invited]
     
    To determine the role of lymph-node (LN) dissection in patients undergoing surgery for upper urinary tract (UUT) cancer. We reviewed the clinicopathological data from 312 patients with UUT cancer treated predominantly by nephroureterectomy. The relationship between clinical characteristics and cancer-specific survival (CSS) was analysed, focusing on node-related information. In all, 166 patients had LN dissection while 146 did not (pNx). Multivariate analysis showed that T stage, grade and pN status were significant variables for CSS. The difference in survival between the pN0 and pNx groups remained significant in a multivariate analysis. The median (range) number of LNs removed was 6 (1-65). There was no significant difference in CSS between the 72 patients with fewer than six LNs removed and the 78 with six or more removed. LN dissection is important for postoperative stratification of patients with UUT cancer because node-positive disease was one of the variables with a significant adverse effect on survival. In addition, the significant difference in survival between the pN0 and pNx groups might indicate a therapeutic benefit of LN dissection, although removing more LNs did not uniformly increase the probability of CSS.
  • Takashige Abe, Nobuo Shinohara, Mitsuhiro Tada, Toru Harabayashi, Ataru Sazawa, Satoru Maruyama, Tetsuya Moriuchi, Kenzo Takada, Katsuya Nonomura
    INTERNATIONAL JOURNAL OF UROLOGY 15 (5) 429 - 434 0919-8172 2008/05 [Refereed][Not invited]
     
    Objective: Epstein-Barr virus (EBV) has been implicated in the genesis of a variety of human cancers. We aimed to confirm the presence and define the role of EBV in bladder cancer. Methods: A total of 39 bladder cancer specimens were analyzed. Ten urinary bladder tissues obtained at autopsy were used as a normal control. EBV-encoded RNA (EBER) was evaluated by in situ hybridization (ISH). Frozen material available from 18 EBER-positive cases was analyzed by using reverse transcription-polymerase chain reaction for BZLF1, an early lytic gene product. The expression of CD20, CD3, ZEBRA (BZLF1 product) and transforming growth factor beta 1 (TGF beta-1) was assessed using an immunohistochemical technique. Results: Infiltration of EBER-expressing lymphocytes was detected in 26 of 39 bladder cancer cases (66.7%). A small fraction of the tumor cells as well as the infiltrating lymphocytes were positive in two cases. All normal urinary bladder specimens showed negative results. The incidence of EBV-positive lymphocyte infiltration was significantly higher for advanced stage cancers than those in earlier stages (Ta-152% vs T2-4 93%, P = 0.013). The presence of BZLF1 mRNA was demonstrated in seven out of the 18 EBER-positive cases. Conclusions: Infiltration of EBV-harboring lymphocytes occurs in a large subset of bladder cancers cases. It is more frequently associated with advanced stages. EBV infection in tumor cells is very limited. Our findings suggest that EBV-positive lymphocytes might play a role in bladder cancer progression.
  • Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Satoru Maruyama, Shin Suzuki, Katsuya Nonomura
    EUROPEAN UROLOGY 52 (4) 1106 - 1114 0302-2838 2007/10 [Refereed][Not invited]
     
    Objectives: Systemic combination chemotherapy remains the mainstay of treatment for metastatic urothelial cancer. Although initial response rates are 50-70%, these responses are usually transient. The present study investigated the impact of multimodal treatment including metastasectomy on survival in patients with metastatic urothelial cancer. Methods: Between 1989 and 2005, 48 patients with metastatic urothelial cancer underwent systemic chemotherapy at our institution. The majority received conventional cisplatin-based chemotherapy, whereas some patients underwent novel chemotherapeutic regimens mainly as salvage therapy with or without resection of metastases, aiming to improve the outcome. The relationship between clinical characteristics and survival was analyzed using the Cox proportional hazards model. The characteristics analyzed were sex, age, primary site, prior systemic chemotherapy, histology of primary lesion, white blood cell counts, hemoglobin levels, metastatic sites, total number of chemotherapy courses, and resection of the primary lesion and metastasis. Results: Median survival-time was 17 mo (95% confidence interval, 9-27 mo) for all 48 patients. Using a multivariate model, five or more chemotherapy cycles (p = 0.0022), absence of liver, bone, and local recurrence (p = 0.0146), and resection of metastasis (p = 0.0006) were independent significant predictors of prolonged survival. Median survival time in the 12 patients with metastasectomy was 42 mo, which was significantly longer than that of patients who did not undergo metastasectomy (10 mo). Conclusions: The number of chemotherapy cycles, sites of metastasis, and metastasectomy had an impact on survival. In selected patients, a multimodal approach including metastasectomy may contribute to long-term disease control. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.
  • Yutaka Toyoda, Nobuo Shinohara, Toru Harabayashi, Takashige Abe, Tomoshige Akino, Ataru Sazawa, Katsuya Nonomura
    EUROPEAN UROLOGY 52 (1) 163 - 169 0302-2838 2007/07 [Refereed][Not invited]
     
    Objectives: We retrospectively analyzed the survival of renal cell carcinoma patients with bone metastases, and identified prognostic factors and a model predictive for survival in these patients. Methods: Fifty patients with renal cell carcinoma with osseous metastases were treated at Hokkaido University Hospital between 1980 and 2004. The relationship between several clinical features and survival was examined univariately. The Cox proportional hazards model was then used to form a multivariate model. Results: The median survival time from the diagnosis of bone metastasis was 12 mo, and overall survival at 2 yr was 37%. Clinical features correlated with longer survival in the multivariate analysis were a long interval (24 mo or more) between the diagnosis of kidney cancer and that of osseous metastasis (hazard ratio [HR]: 2.608; 95% confidence inter-Val [CI], 1.031-6.S99) and the absence of extraosseous metastases (HR: 2.523; 95%CI, 1.023-6.220). By combining these two favorable factors, renal cell carcinoma patients with osseous metastases could be categorized into two different groups. The median time to death in 20 patients with zero favorable factors (poor prognosis) was S mo. On the other hand, 30 patients had one or two favorable factors (good prognosis); the median survival time in this group was 30 mo. There was a significant difference in survival duration between the two groups (p < 0.001). Conclusions: Two prognostic factors predicting survival were identified and used to categorize renal cell carcinoma patients with bone metastasis into two prognostic groups. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.
  • Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Shin Suzuki, You Kawarada, Katsuya Nonomura
    UROLOGY 69 (2) 326 - 329 0090-4295 2007/02 [Refereed][Not invited]
     
    OBJECTIVES To determine the incidence of inguinal hernia after radical prostatectomy and compare it with the incidence in patients with prostate cancer treated with radiotherapy. We also analyzed the effect of potential risk factors for inguinal hernia after radical prostatectomy. METHODS We investigated the medical records of 53, 43, and 74 men who underwent open radical retropubic prostatectomy (RRP), laparoscopic radical prostatectomy (LRP), or radiotherapy with or without laparoscopic pelvic lymph node dissection, respectively, and evaluated the respective incidence of inguinal hernia after these therapies. The risk factors were analyzed using a Cox proportional hazards model. RESULTS The incidence of inguinat hernia was 17% (9 of 53), 14.0% (6 of 43), and 1.4% (1 of 74) in open RRP, LRP, and radiotherapy groups, respectively. Multivariate Cox proportional hazards analysis demonstrated that open RRP and LRP were significant risk factors for the development of inguinal hernia. CONCLUSIONS Urologists should be aware that inguinal hernia is an important postoperative complication of open RRP. More interestingly, even LRP could promote the development of postoperative inguinal hernia.
  • T Abe, M Tada, N Shinohara, F Okada, T Itoh, JI Hamada, T Harabayashi, QZ Chen, T Moriuchi, K Nonomura
    INTERNATIONAL JOURNAL OF UROLOGY 13 (1) 47 - 57 0919-8172 2006/01 [Refereed][Not invited]
     
    Aim: To establish and characterize a murine xenograft model of human urothelial cancer in severe combined immunodeficient (SCID) mice for therapeutic simulation. Methods: Pieces of 30 freshly resected urothelial tumors (24 obtained from bladder and 6 from ureter or pelvis) were implanted subcutaneously into SCID mice, and xenograft tumors were passed in tumorigenic cases. At each passage, histopathology, TP53 mutational status assessed by yeast p53 functional assay, and the Ki-67 labeling index (LI) were examined to evaluate the preservation of original features. A growth delay assay after single-dose irradiation was performed in four representative xenografts. Results: Tumor growth was observed in 18 mice (60%, 18/30). Histologically, 15 of the 18 were epithelial carcinomas similar to the original tumors, whereas the other 3 were Epstein-Barr virus-associated lymphoproliferative disease, resulting in a 50% (15/30) take rate. No correlation was found between the tumor take rate and the clinicopathologic features, TP53 mutational status, or Ki-67 LI of the patients' tumors. Of these 15 xenografts, 11 xenografts were passed from 3 to 10 generations. TP53 mutational status remained stable during the passages, and the Ki-67 LI of eight xenografts was within a range of 50% of the LI of the original tumors, although the other three xenografts increased by over 50%. Specific growth delay after irradiation, independent of the original tumor growth speed and Ki-67 LI, was observed in four xenografts. Conclusions: SCID mice are useful recipients for investigations of human urothelial cancer with a wide biological range. This easy-to-handle xenograft system can help to develop a better in vivo preclinical evaluation system for therapeutic agents as well as the investigation of tumor pathophysiology.
  • QZ Chen, N Shinohara, T Abe, T Harabayashi, K Nonomura
    JOURNAL OF UROLOGY 172 (6) 2153 - 2157 0022-5347 2004/12 [Refereed][Not invited]
     
    Purpose: We have previously confirmed that cyclooxygenase-2 (COX-2) is expressed in a human renal cell carcinoma (RCC) cell line and it has an important role in cell tumorigenesis and angiogenesis. In the current study we evaluated the impact on cell adhesion and tumor invasiveness in human RCC cell lines by transfection of COX-2 sense and antisense cDNAs. Materials and Methods: A human RCC cell line that expresses COX-2 was transfected with COX-2 sense or antisense cDNA. E-cadherin expression in parental cells of OS-RC-2 and transfectants was detected by real-time polymerase chain reaction and Western blotting. The expression of beta-catenin was detected by Western blotting. Zymography was used to detect gelatinase activity. CD44 expression in parental cells and transfectants was detected by fluorescence activated cell sorting. Cell adhesion was detected by adhesion assay and cell invasive ability was detected by invasion assay. Results: E-cadherin expression was increased in antisense transfectants and decreased in sense transfectants compared with parental cells at the mRNA and protein levels. However, obvious consistent changes in beta-catenin expression could not be confirmed in parental cells and transfectants, nor were there any significant differences in gelatinase activity in parental cells and transfectants. CD44 expression was increased in sense transfectants and decreased in antisense transfectants compared with parental cells. Adhesion to hyaluronan coated wells was significantly enhanced in sense transfectants and inhibited in antisense transfectants compared with parental cells. Compared with parental cells invasive ability was significantly increased in sense transfectants and decreased in antisense transfectants. Conclusions: The results demonstrate that COX-2 expression has a crucial role in cell invasion ability and the suppression of COX-2 expression might regulate adhesion molecule expression and inhibit invasive ability in the RCC cell line OS-RC-2.
  • S Suzuki, N Shinohara, T Harabayashi, S Sato, T Abe, T Koyanagi
    INTERNATIONAL JOURNAL OF UROLOGY 11 (7) 456 - 460 0919-8172 2004/07 [Refereed][Not invited]
     
    Background: The objective of this study was to retrospectively investigate the effectiveness of adjuvant combination chemotherapy for locally advanced urothelial cancer. Methods: Between 1987 and 1998, 56 patients with locally advanced bladder (n = 27) or upper urinary tract (n = 29) cancer (pathological stage T3, T4 or N1, N2 and M0) were treated by radical cystectomy or radical nephroureterectomy and regional lymphadenectomy. Thirty-one patients had lymph node-positive disease and 25 patients did not. Twenty patients underwent adjuvant chemotherapy and 36 patients were observed after surgery. Cox proportional hazards models were used to determine the impact of numerous clinicopathological findings on survival. A subgroup analysis of patients with lymph node-positive disease was conducted to evaluate disease-free survival and overall survival rates. Results: In this series, the median follow-up period was 39 months (range, 4-163) after surgery. Disease-free and overall survival rates of all 56 patients were 45% and 58%, respectively, at 3 years. Only lymph node status was significantly associated with disease-free and overall survival in the multivariate analyses. In a subgroup analysis of patients with lymph node-positive disease, 16 patients who underwent adjuvant chemotherapy had superior disease-free survival compared to 15 patients with no adjuvant chemotherapy (P = 0.0376). Conclusion: These findings show that the prognosis of advanced urothelial cancer is significantly associated with nodal status. Furthermore, adjuvant combination chemotherapy has a positive impact on survival in patients with lymph node-positive disease.
  • QZ Chen, N Shinohara, T Abe, T Watanabe, K Nonomura, T Koyanagi
    INTERNATIONAL JOURNAL OF CANCER 108 (6) 825 - 832 0020-7136 2004/03 [Refereed][Not invited]
     
    Accumulating evidences indicate that cyclooxygenase (COX)-2 plays an important role in tumorigenesis in many human cancers. Yet the relationship between COX-2 and human renal cell carcinoma (RCC) remains unclear. The aim of our study was to evaluate COX-2 expression in human RCC cell lines and its role in tumorigenesis of human RCC. Among the human RCC cell lines (SMKT-R4, OS-RC-2, ACHN) and normal renal cell line RPTEC, COX-2 overexpression was found in OS-RC-2 cells both at mRNA and protein levels. COX-2 sense- and antisense-orientated vectors were constructed and transferred into RCC cells. Significant suppression of cellular proliferation was demonstrated in OS-RC-2 antisense transfectants, whereas promotion was found in SMKT-R4 sense transfectants by colony-forming assay despite the observation that COX-2 specific inhibitor NS398 exhibited similar IC50 among RCC cell lines by MTT assay. In comparison with parent cells and sense transfectants, significant suppression of COX-2 expression and PGE2 production and increase in butyrate-induced apoptosis were observed in OS-RC-2 antisense transfectants by Western blot, ELISA assay and FACS analysis, respectively. Furthermore, tumor growth and angiogenesis of OS-RC-2 antisense transfectants in nude mice was significantly suppressed and the survival time of these mice was significantly prolonged. Our study demonstrates that COX-2 is overexpressed in OS-RC-2 RCC cell line and plays an important role in tumorigenesis of the cells in vivo, which implies that COX-2 may be a therapeutic target for COX-2-expressing RCC, and that suppression of COX-2 expression by antisense-based strategy may have potential utility in treatment of COX-2-expressing RCC. (C) 2003 Wiley-Liss, Inc.
  • T Abe, N Shinohara, T Harabayashi, K Tsuchiya, S Suzuki, T Itoh, T Seki, M Togashi, K Nonomura, T Koyanagi
    INTERNATIONAL JOURNAL OF UROLOGY 11 (3) 184 - 186 0919-8172 2004/03 [Refereed][Not invited]
     
    Intraperitoneal metastasis from a testicular germ cell tumor is very rare. We report a case in a 33-year-old man who was referred to Hokkaido University Hospital, Hokkaido, Japan, for further therapy for refractory seminoma. Physical examination revealed abdominal distension as a result of ascites, and cytology of the ascites showed seminoma cells. Although the ascites completely disappeared after treatment with a novel regimen of irinotecan-based chemotherapy, the patient had a recurrence of ascites and died of progressive disease 5 months after the start of the therapy.
  • Kikuo Okamura, Katsushi Nagahama, Takatoshi Usami, Hirohiko Nagata, Takashige Abe, Satoshi Katsuno, Keizo Kawano, Shigenori Sato, Masaki Harada
    Japanese Journal of Geriatrics 40 (4) 352 - 359 0300-9173 2003 [Refereed][Not invited]
     
    Criteria for general practitioners to assess treatment efficacy are needed to efficiently treat urination problems in the elderly. Recently, criteria have been developed for urologists to assess the efficacy of benign prostatic hyperplasia treatment using the International Prostate Symptom Score (I-PSS), QoL index and maximal flow rates. We examined whether these criteria can be applied to the general urination problems of the elderly men and women, with 85 male and 16 female subjects aged 50 and over. Furthermore, we set Level I criteria using the I-PSS and QoL indices, Level II criteria using I-PSS, QoL index and post-void residual urine in addition to Level III criteria using I-PSS, QoL index and maximal urine flow rate. Correspondence rates among assessments by these criteria of treatment efficacy were investigated. Ninety-nine of 101 patients (98.0%) were assessed properly using the Level III criteria but the efficacy graded as "fair" and "unchanged" in Level III in each patient should be "poor" and "fair" in reality. Our findings suggest that Level III criteria should be useful for assessing the treatment efficacy of urination problems of elderly men and women besides benign prostatic hyperplasia. All of the patients, whose treatment efficacy was graded as "excellent" or "good", and those with efficacy graded as "unchanged" or "poor", according to the Level I criteria, were appropriately assessed by the Level III criteria. Of 35 patients whose treatment efficacy was graded as "fair" at Level I, the efficacy of 6 patients was graded as "unchanged" according to Level III. All of the patients, whose treatment efficacy was graded as "excellent" or "good", and those with efficacy graded as "poor", according to the Level II, were also appropriately assessed by the Level III criteria. However, the efficacy of 11 and 4 patients of 38 and 35 patients, respectively, whose efficacy was graded as "fair" and "unchanged" at Level II, was graded as "unchanged" and "fair" according to Level III, respectively. We believe that simple criteria including only I-PSS and QoL index are useful for general practitioners to assess treatment efficacy of urination problems in the elderly. It is suggested that patients with efficacy graded as "unchanged", or "poor" should be referred to a urologist but those with efficacy graded as "exellent", "good" and "fair" should be treated continuously. However, 17% of the patients with efficacy graded as "fair" by Level I criteria might be judged "unchanged" from the viewpoint of urologists.
  • Kikuo Okamura, Katsushi Nagahama, Takatoshi Usami, Hirohiko Nagata, Takashige Abe, Satoshi Katsuno, Keizo Kawano, Shigenori Sato, Masaki Harada
    Japanese Journal of Geriatrics 40 (4) 360 - 367 0300-9173 2003 [Refereed][Not invited]
     
    As the population ages rapidly, we need to establish a cost-effective system to assess and treat urination problems of the elderly. Recently, criteria have been developed for urologists to assess benign prostatic hyperplasia using the International Prostate Symptom Score (I-PSS), QoL index, urination function (maximal flow rates and residual urine volume) and prostate volume. It is suggested that patients with moderate to severe urination problems as measured by these criteria need to be treated but those with mild problems have no need for treatment. We examined whether these criteria can be applied to the general urination problems of elderly men and women, with 112 men and 21 women aged 50 and over as subjects. Furthermore, we set Level I criteria for the elderly themselves, their families or nurses taking care of them, using I-PSS and QoL index, and Level II criteria for general practitioners, using I-PSS, QoL index and residual urine volume, in addition to Level III criteria for urologists (omitting prostate volume in women). Correspondence rates among severities of urination problems at Level I, II and III, and sensitivities and specificities of Level I and II criteria were investigated. One hundred twenty-one patients of 124 with moderate to severe urination problems at Level III needed to be treated and eight of nine with mild urination problems did not. As a whole, our findings suggested that 129 of 133 patients (97.0%) were correctly assessed at Level III. We found that Level III criteria were valid for general urination problems of the elderly, not just benign prostalic hyperplasia. While 102 and 111 patients were judged as having moderate or severe urination problems, respectively, at Level I and Level II, and all of these were diagnosed as having moderate or severe problems at Level III, 22 (71.0%) of 31 and 13 (59.1%) of 22 patients judged as having mild urination problems at Level I and Level II were diagnosed as having moderate problems at Level III. Although specificities of Level I and Level II criteria were 100%, sensitivities improved from 82.3% (102/124) to 89.5% (111/124), adding residual urine measurement to the I-PSS and QoL scores. Polyuria of more than 2,000ml per day was noted in 33 patients (24.8%). At Level I, residual urine of 50 ml or more was noted in 9 (29.0%) patients with mild urination problems, in 22 (24.2%) with moderate problems and in 4 (36.4%) with severe problems. Assessment criteria for general practitioners should include a frequency-volume chart and measurement of residual urine. When the elderly are judged as having moderate or severe urination problems according to either Level I or II criteria, they need treatment. However, more than half of the elderly, judged as having mild problems according to those criteria, need treatment from the standpoint of urologists.
  • Takashige Abe, Hiroyuki Matsuda, Junri Shindo, Katsuya Nonomura, Tomohiko Koyanagi
    International Journal of Urology 7 (3) 110 - 111 0919-8172 2000/03 
    A patient with ectopic pheochromocytoma that developed in the spermatic cord about 5 years after successive resections of bilateral carotid body tumors and bilateral adrenal pheochromocytomas is reported. This is thought to be the first case of pheochromocytoma of the spermatic cord in a setting of multiplicity.
  • Takashige Abe, Yuichiro Shinno, Koichi Kawakura, Kimihiko Moriya
    International Journal of Urology 7 (2) 69 - 71 0919-8172 2000/02 
    A patient with a mullerian duct cyst, which caused acute renal failure secondary to urinary retention, is reported. The case was treated successfully by transurethral unroofing of the cyst.

MISC

  • 大澤崇宏, 宮田遥, 松本隆児, 安部崇重, 篠原信雄  日本泌尿器科学会総会(Web)  111th-  2024
  • 安部崇重, 宮田遥, 松本隆児, 大澤崇宏, 菊地央, 篠原信雄  泌尿器外科  37-  2024
  • 安部崇重, 宮田遥, 松本隆児, 大澤崇宏, 菊地央, 篠原信雄  泌尿器外科  37-  2024
  • 佐々木 佑菜, 三田村 卓, 松本 隆児, 桑谷 将城, 細田 充主, 安部 崇重, 柴田 有花, 松島 理明, 矢部 一郎, 山田 崇弘  日本遺伝カウンセリング学会誌  44-  (2)  137  -137  2023/06
  • 安部崇重, 宮田遥, 菊地央, 松本隆児, 大澤崇宏, 篠原信雄  日本泌尿器科学会東部総会プログラム・抄録集  88th (CD-ROM)-  2023
  • 安部崇重, 宮田遥, 菊地央, 松本隆児, 大澤崇宏, 篠原信雄  日本泌尿器科学会東部総会プログラム・抄録集  88th (CD-ROM)-  2023
  • 松本隆児, 宮田遥, 大澤崇宏, 安部崇重, 篠原信雄  日本泌尿器科学会東部総会プログラム・抄録集  88th (CD-ROM)-  2023
  • 海老名光希, 安部崇重, YAN Lingbo, 堀田記世彦, 今雅史, 樋口まどか, 古御堂純, 岩原直也, 小水内俊介, 倉島庸, 菊地央, 松本隆児, 大澤崇宏, 村井祥代, 辻田哲平, 佐瀬一弥, CHEN Xiaoshuai, 妹尾拓, 篠原信雄, 近野敦  日本機械学会ロボティクス・メカトロニクス講演会講演論文集(CD-ROM)  2023-  2023
  • ステントグラフト内挿術後に外科的治療を要した尿管動脈瘻の1例
    杉戸 悠紀, 堀田 記世彦, 山田 修平, 千葉 博基, 松本 隆児, 大澤 崇宏, 安部 崇重, 阿保 大介, 佐藤 公治, 若狭 哲, 篠原 信雄  日本泌尿器科学会雑誌  113-  (4)  134  -138  2022/10  
    症例は36歳,女性.29歳時,子宮頸癌に対する広汎子宮全摘術の際に,両側尿管ステントが留置され,その後術後放射線療法として全骨盤照射,傍大動脈リンパ節照射が施行された.術後4年間は尿管ステント交換のために通院していたが,以後通院を自己中断した.術後7年目に肉眼的血尿を主訴に前医を受診した.右尿管ステント抜去直後に大量出血し,右尿管動脈瘻の疑いで当院に転院となった.血管造影検査および血管内超音波検査では右総腸骨動脈遠位端に仮性動脈瘤を認めたため,右総腸骨動脈内にステントグラフトを留置し,その後血尿の再燃なく退院となった.退院1ヵ月後に右水腎症と右腎盂腎炎を発症したため,右腎瘻が造設された.半年後発熱と腎瘻からの出血を来し,CTでは右総腸骨動脈に仮性瘤の形成とステントグラフト滑脱の所見を認めた.血管内治療は困難と判断し,手術にてステントグラフトの抜去と仮性動脈瘤の切除を行った.また大腿動脈-大腿動脈バイパス術を行い右下肢の血流を確保した.現在右腎瘻を定期交換しているが,感染や血尿の再燃なく,下肢の血流障害も認めず,安定して経過している.近年は尿管動脈瘻に対して低侵襲な血管内治療が第一選択となることが多いが,感染を合併した例では血管壁が脆弱化し,仮性瘤の形成やステントの滑脱が起こる場合がある.(著者抄録)
  • 海老名光希, 安部崇重, 堀田記世彦, 樋口まどか, 古御堂純, 岩原直也, 今雅史, 小水内俊介, 倉島庸, 菊地央, 松本隆児, 大澤崇宏, 村井祥代, 辻田哲平, 佐瀬一弥, CHEN Xiaoshuai, 妹尾拓, 篠原信雄, 近野敦  計測自動制御学会システムインテグレーション部門講演会(CD-ROM)  23rd-  2022
  • 黒沢瞭, 堀田記世彦, 阿保大介, 岩見大基, 安部崇重, 田邉起, 大澤崇宏, 松本隆児, 篠原信雄  泌尿器外科  34-  (3)  2021
  • 岩原直也, 安部崇重, 山田修平, 古御堂純, 菊地央, 松本隆児, 大澤隆宏, 篠原信雄  泌尿器外科  34-  (3)  2021
  • Takashige Abe, Koki Ebina, Madoka Higuchi, Jun Furumido, Naoya Iwahara, Masafumi Kon, Kiyohiko Hotta, Shunsuke Komizunai, Yo Kurashima, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Sachiyo Murai, Atsushi Konno, Nobuo Shinohara  JOURNAL OF UROLOGY  203-  E686  -E686  2020/04  [Not refereed][Not invited]
  • Yurie Hirata, Takahiro Osawa, Madoka Higuchi, Shiro Hinotsu, Toru Harabayashi, Tango Mochizuki, Nobuyasu Enami, Osamu Nounaka, Yuichiro Shinno, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Sachiyo Murai, Nobuo Shinohara  JOURNAL OF UROLOGY  203-  E1079  -E1080  2020/04  [Not refereed][Not invited]
  • Ryuji Matsumoto, Takashige Abe, Noritaka Takada, Keita Minami, Toru Harabayashi, Satoru Maruyama, Hiroshi Kikuchi, Takahiro Osawa, Nobuo Shinohara  JOURNAL OF UROLOGY  203-  E375  -E376  2020/04  [Not refereed][Not invited]
  • Keita Minami, Takahiro Osawa, Taku Murakami, Hiroshi Harada, Toru Harabayashi, Norikata Takada, Akira Kashiwagi, Kazushi Hirakawa, Yasuyuki Sato, Ryuji Matsumoto, Hiroshi Kikuchi, Takashige Abe, Sachiyo Murai, Nobuo Shinohara  JOURNAL OF UROLOGY  203-  E1008  -E1009  2020/04  [Not refereed][Not invited]
  • Takahiro Osawa, John T. Wei, Takashige Abe, Shuhei Yamada, Jun Furumido, Hiroshi Kikuchi, Ryuji Matsumoto, Yoshihiro Sasaki, Kazushi Hirakawa, Akira Kashiwagi, Ken Morita, Hiroshi Tanaka, Keita Minami, Norikata Takada, Toru Harabayashi, Sachiyo Murai, Nobuo Shinohara  JOURNAL OF UROLOGY  203-  E355  -E355  2020/04  [Not refereed][Not invited]
  • 尿管ステント抜去による総腸骨動脈尿管瘻に対しVIABAHN留置を施行した1例
    木野田 直也, 阿保 大介, 曽山 武士, 森田 亮, 吉野 裕紀, 工藤 與亮, 松本 隆児, 安部 崇重, 篠原 信雄  日本インターベンショナルラジオロジー学会雑誌  34-  (4)  297  -297  2020/04
  • Takahiro Osawa, John Wei, Takashige Abe, Shuhei Yamada, Jun Frumido, Haruka Miyata, Hiroshi Kikuchi, Ryuji Matsumoto, Yasuyuki Sato, Kazushi Hirakawa, Yoshihiro Sasaki, Hiroshi Tanaka, Akira Kashiwagi, Ken Morita, Norikata Takada, Keita Minami, Toru Harabayashi, Sachiyo Murai, Nobuo Shinohara  JOURNAL OF CLINICAL ONCOLOGY  38-  (6)  2020/02  [Not refereed][Not invited]
  • 今雅史, 安部崇重, 黒沢瞭, 守田卓人, 堀寛太, 樋口まどか, 古御堂純, 岩原直也, 菊地央, 松本隆児, 篠原信雄  日本泌尿器科学会総会(Web)  108th-  2020
  • 安部崇重, 菊地央, 松本隆児, 大澤崇宏, 篠原信雄  日本泌尿器内視鏡学会(Web)  34th-  2020
  • 加藤諒, 安部崇重, 菊地央, 松本隆児, 大澤崇宏, 篠原信雄  日本泌尿器内視鏡学会(Web)  34th-  2020
  • 山形優友, 安部崇重, 菊池央, 松本隆児, 大澤崇宏, 篠原信雄  日本泌尿器内視鏡学会(Web)  34th-  2020
  • 松本隆児, 山田修平, 古御堂純, 森口卓哉, 菊地央, 大澤崇宏, 安部崇重, 篠原信雄  日本泌尿器内視鏡学会(Web)  34th-  2020
  • 大澤崇宏, 安部崇重, 西岡健太郎, 菊地央, 松本隆児, 橋本孝之, 清水伸一, 青山英史, 村井祥代, 篠原信雄  日本泌尿器内視鏡学会(Web)  34th-  2020
  • 腎神経内分泌腫瘍による異所性ACTH症候群の一例
    柴山 惟, 亀田 啓, 中村 昭伸, 三好 秀明, 秋川 和聖, 安部 崇重, 坪内 駿, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄, 土井 和尚, 高桑 恵美, 笹野 公伸, 渥美 達也  日本内分泌学会雑誌  95-  (2)  765  -765  2019/10  [Not refereed][Not invited]
  • 二分脊椎症の定期検査で早期発見し得た腎腫瘍の一例
    築山 真由子, 橘田 岳也, 千葉 博基, 樋口 まどか, 中村 美智子, 今 雅史, 安部 崇重, 大澤 崇宏, 松本 隆児, 菊地 央, 篠原 信雄  日本排尿機能学会誌  30-  (1)  257  -257  2019/09  [Not refereed][Not invited]
  • 丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 永森 聡, 篠原 信雄  泌尿器外科  32-  (8)  1019  -1021  2019/08  [Not refereed][Not invited]
     
    低リスク前立腺癌で前立腺全摘除術をした症例を対象として、遺伝子アッセイにより監視療法を行うのに適切な患者をスクリーニングできるかを検討した。全例、10年以内の癌死リスクは1%未満、10年以内の遠隔転移リスクは1〜2%であり、悪性病理所見となるリスクは9〜38%と予想された。実際には遠隔転移、癌死例はおらず、悪性病理所見が認められた症例もなかった。以上より、遺伝子アッセイにより監視療法に適した症例を予測できたと考えられた。(著者抄録)
  • ニボルマブが奏功したSarcomatoid changeを伴う淡明腎細胞癌の1症例
    菊地 央, 古御堂 純, 宮田 遥, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  腎癌研究会会報  (49)  60  -60  2019/07  [Not refereed][Not invited]
  • 外科的治療を先行した高齢者性腺外胚細胞腫瘍の1例
    古御堂 純, 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  975  -975  2019/07  [Not refereed][Not invited]
  • 当院におけるロボット支援腎部分切除術の臨床的検討
    松本 隆児, 古御堂 純, 菊地 央, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  980  -980  2019/07  [Not refereed][Not invited]
  • 膀胱悪性腫瘍に対して腹腔鏡下膀胱部分切除術を施行した2例
    前田 啓介, 古御堂 純, 安部 崇重, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  泌尿器外科  32-  (7)  981  -981  2019/07  [Not refereed][Not invited]
  • アビラテロン投与症例における効果予測因子の検討
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄, 永森 聡  泌尿器外科  32-  (7)  982  -982  2019/07  [Not refereed][Not invited]
  • 筋層非浸潤膀胱癌の晩期再発リスク因子の検討
    樋口 まどか, 大澤 崇宏, 平田 由里絵, 宮田 遥, 菊池 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  983  -983  2019/07  [Not refereed][Not invited]
  • cT1腎癌に対する開腹腎部分切除術と鏡視下腎部分切除術後のSF-36を用いたQOLの比較
    大澤 崇宏, 安部 崇重, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 伊藤 陽一, 村井 祥代, 篠原 信雄  泌尿器外科  32-  (7)  985  -986  2019/07  [Not refereed][Not invited]
  • 80歳以上の腎部分切除術の検討
    古御堂 純, 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  986  -986  2019/07  [Not refereed][Not invited]
  • カバジタキセルの治療成績
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 永森 聡, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  990  -990  2019/07  [Not refereed][Not invited]
  • Bladder Cancer Index(BCI)日本語版の妥当性検証
    古御堂 純, 大澤 崇宏, 伊藤 陽一, 菊地 央, 松本 隆児, 平川 和志, 佐藤 泰之, 佐々木 芳浩, 高田 徳容, 原林 透, 柏木 明, 田中 博, 三浪 圭太, 森田 研, 山田 修平, 村井 祥代, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  991  -991  2019/07  [Not refereed][Not invited]
  • 当科で行っているブタ臓器を用いた腹腔鏡手術トレーニングの紹介
    安部 崇重, 樋口 まどか, 宮田 遥, 今 雅史, 堀田 記世彦, 森田 研, 菊池 央, 松本 隆児, 大澤 崇宏, 倉島 庸, 篠原 信雄  泌尿器外科  32-  (7)  992  -992  2019/07  [Not refereed][Not invited]
  • ニボルマブが奏功したSarcomatoid changeを伴う淡明腎細胞癌の1症例
    菊地 央, 古御堂 純, 宮田 遥, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  腎癌研究会会報  (49)  60  -60  2019/07  [Not refereed][Not invited]
  • 後腹膜パラガングリオーマに対する集学的治療後、WDHA症候群(Water diarrhea,Hypokalemia,Achlorhydria)を呈した1例
    村橋 範浩, 安部 崇重, 松本 隆児, 大澤 崇宏, 吉永 恵一郎, 志賀 哲, 畑中 佳奈子, 松野 吉宏, 篠原 信雄  泌尿器科紀要  65-  (7)  277  -282  2019/07  [Not refereed][Not invited]
  • 外科的治療を先行した高齢者性腺外胚細胞腫瘍の1例
    古御堂 純, 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  975  -975  2019/07  [Not refereed][Not invited]
  • 当院におけるロボット支援腎部分切除術の臨床的検討
    松本 隆児, 古御堂 純, 菊地 央, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  980  -980  2019/07  [Not refereed][Not invited]
  • 膀胱悪性腫瘍に対して腹腔鏡下膀胱部分切除術を施行した2例
    前田 啓介, 古御堂 純, 安部 崇重, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  泌尿器外科  32-  (7)  981  -981  2019/07  [Not refereed][Not invited]
  • アビラテロン投与症例における効果予測因子の検討
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄, 永森 聡  泌尿器外科  32-  (7)  982  -982  2019/07  [Not refereed][Not invited]
  • 筋層非浸潤膀胱癌の晩期再発リスク因子の検討
    樋口 まどか, 大澤 崇宏, 平田 由里絵, 宮田 遥, 菊池 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  983  -983  2019/07  [Not refereed][Not invited]
  • cT1腎癌に対する開腹腎部分切除術と鏡視下腎部分切除術後のSF-36を用いたQOLの比較
    大澤 崇宏, 安部 崇重, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 伊藤 陽一, 村井 祥代, 篠原 信雄  泌尿器外科  32-  (7)  985  -986  2019/07  [Not refereed][Not invited]
  • 80歳以上の腎部分切除術の検討
    古御堂 純, 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  986  -986  2019/07  [Not refereed][Not invited]
  • カバジタキセルの治療成績
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 永森 聡, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  990  -990  2019/07  [Not refereed][Not invited]
  • Bladder Cancer Index(BCI)日本語版の妥当性検証
    古御堂 純, 大澤 崇宏, 伊藤 陽一, 菊地 央, 松本 隆児, 平川 和志, 佐藤 泰之, 佐々木 芳浩, 高田 徳容, 原林 透, 柏木 明, 田中 博, 三浪 圭太, 森田 研, 山田 修平, 村井 祥代, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (7)  991  -991  2019/07  [Not refereed][Not invited]
  • 当科で行っているブタ臓器を用いた腹腔鏡手術トレーニングの紹介
    安部 崇重, 樋口 まどか, 宮田 遥, 今 雅史, 堀田 記世彦, 森田 研, 菊池 央, 松本 隆児, 大澤 崇宏, 倉島 庸, 篠原 信雄  泌尿器外科  32-  (7)  992  -992  2019/07  [Not refereed][Not invited]
  • 大澤 崇宏, 安部 崇重, 松本 隆児, 篠原 信雄  泌尿器外科  32-  (臨増)  612  -612  2019/06  [Not refereed][Not invited]
  • 安部 崇重, 松本 隆児, 高田 徳容, 三浪 圭太, 原林 透, 菊地 央, 大澤 崇宏, 丸山 覚, 永森 聡, 近藤 恒徳, 田邉 一成, 篠原 信雄  泌尿器外科  32-  (臨増)  656  -657  2019/06  [Not refereed][Not invited]
  • 筋層非浸潤膀胱癌の晩期再発の検討
    樋口 まどか, 大澤 崇宏, 宮田 遥, 菊池 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (臨増)  746  -746  2019/06  [Not refereed][Not invited]
  • 風雲!膀胱がんの診断・治療の最前線 筋層非浸潤性膀胱癌の治療成績向上のために
    大澤 崇宏, 安部 崇重, 松本 隆児, 篠原 信雄  泌尿器外科  32-  (臨増)  612  -612  2019/06  [Not refereed][Not invited]
  • 上部尿路上皮がんにおけるリンパ節郭清の意義 上部尿路上皮癌におけるリンパ節郭清の意義 腹腔鏡によるリンパ節郭清の妥当性
    安部 崇重, 松本 隆児, 高田 徳容, 三浪 圭太, 原林 透, 菊地 央, 大澤 崇宏, 丸山 覚, 永森 聡, 近藤 恒徳, 田邉 一成, 篠原 信雄  泌尿器外科  32-  (臨増)  656  -657  2019/06  [Not refereed][Not invited]
  • 筋層非浸潤膀胱癌の晩期再発の検討
    樋口 まどか, 大澤 崇宏, 宮田 遥, 菊池 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (臨増)  746  -746  2019/06  [Not refereed][Not invited]
  • 安部 崇重, 近藤 恒徳, 原林 透, 高田 徳容, 松本 隆児, 佐澤 陽, 大澤 崇宏, 三浪 圭太, 永森 聡, 宮島 直人, 土屋 邦彦, 丸山 覚, 村井 祥代, 田邊 一成, 篠原 信雄  泌尿器外科  32-  (5)  508  -508  2019/05  [Not refereed][Not invited]
  • 丸山 覚, 宮田 遙, 菊地 央, 大澤 崇宏, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (5)  508  -508  2019/05  [Not refereed][Not invited]
  • 大澤 崇宏, 宮田 遙, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 村井 祥代, 篠原 信雄  泌尿器外科  32-  (5)  513  -513  2019/05  [Not refereed][Not invited]
  • 大澤 崇宏, Wei John T, 伊藤 陽一, 成田 学, 賀古 勇輝, 宮田 遙, 菊地 央, 松本 隆児, 宮島 直人, 丸山 覚, 安部 崇重, 村井 祥代, 篠原 信雄  泌尿器外科  32-  (5)  518  -518  2019/05  [Not refereed][Not invited]
  • 大堀 加奈子, 大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (5)  519  -519  2019/05  [Not refereed][Not invited]
  • 当院における前立腺癌監視療法の成績
    丸山 覚, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (5)  520  -520  2019/05  [Not refereed][Not invited]
  • 前立腺癌監視療法におけるゲノムアッセイの有用性
    丸山 覚, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  32-  (5)  520  -520  2019/05  [Not refereed][Not invited]
  • Hiroshi Kikuchi, Takashige Abe, Ryuji Matsumoto, Jun Furumido, Haruka Miyata, Takahiro Osawa, Sachiyo Murai, Nobuo Shinohara  JOURNAL OF UROLOGY  201-  (4)  E274  -E275  2019/04  [Not refereed][Not invited]
  • Ryuji Matsumoto, Satoru Maruyama, Jun Furumido, Haruka Miyata, Hiroshi Kikuchi, Takahiro Osawa, Takashige Abe, Nobuo Shinohara  JOURNAL OF UROLOGY  201-  (4)  E1059  -E1060  2019/04  [Not refereed][Not invited]
  • 進行性腎細胞癌における治療の現状と今後の展望 免疫チェックポイント阻害療法時代における分子標的療法の役割とは?
    大澤 崇宏, 古御堂 純, 宮田 遥, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  SY16  -2  2019/04  [Not refereed][Not invited]
  • 尿路上皮癌におけるリンパ郭清の意義 腹腔鏡下・ロボット支援下のリンパ節郭清の現状
    安部 崇重, 古御堂 純, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  日本泌尿器科学会総会  107回-  SY25  -4  2019/04  [Not refereed][Not invited]
  • ブタティッシュを用いた腹腔鏡手術トレーニングのアセスメントツールとしての有用性の報告
    安部 崇重, 樋口 まどか, 宮田 遙, 今 雅史, 堀田 記世彦, 森田 研, 菊地 央, 松本 隆児, 大澤 崇宏, 倉島 庸, 村井 祥代, 篠原 信雄  日本泌尿器科学会総会  107回-  AOP  -025  2019/04  [Not refereed][Not invited]
  • Bladder Cancer Index(BCI)日本語版の妥当性検証
    大澤 崇宏, 伊藤 陽一, 古御堂 純, 菊地 央, 松本 隆児, 平川 和志, 佐々木 芳浩, 高田 徳容, 三浪 圭太, 原林 透, 村井 祥代, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  AOP  -071  2019/04  [Not refereed][Not invited]
  • T1淡明細胞型腎細胞癌におけるRENAL nephrometry scoreと腫瘍増殖能の関連
    菊地 央, 安部 崇重, 松本 隆児, 古御堂 純, 宮田 遥, 大澤 崇宏, 篠原 信雄  日本泌尿器科学会総会  107回-  OP  -038  2019/04  [Not refereed][Not invited]
  • 高リスク限局性前立腺癌に対する前立腺全摘除術と放射線療法の長期治療成績の比較検討
    松本 隆児, 丸山 覚, 古御堂 純, 菊地 央, 宮田 遥, 大澤 崇宏, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  OP  -102  2019/04  [Not refereed][Not invited]
  • アビラテロン治療効果に与える前治療の影響
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 永森 聡, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  OP  -341  2019/04  [Not refereed][Not invited]
  • 進行性腎癌に対するニボルマブの使用経験
    丸山 覚, 森口 卓哉, 高田 徳容, 原林 透, 永森 聡, 日下部 直久, 佐澤 陽, 宮田 遙, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  OP  -458  2019/04  [Not refereed][Not invited]
  • 当院におけるニボルマブの初期治療成績
    古御堂 純, 大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  107回-  OP  -463  2019/04  [Not refereed][Not invited]
  • 前立腺癌治療の新たな展開:ハイリスク前立腺癌に対する拡大手術、粒子線治療、ネオアジュバント治療 ハイリスク前立腺がんに対する強度変調放射線治療・陽子線治療 現状と可能性
    清水 伸一, 橋本 孝之, 西岡 健太郎, 安部 崇重, 大澤 崇宏, 松本 隆児, 松浦 妙子, 宮本 直樹, 高尾 聖心, 鈴木 隆介, 梅垣 菊男, 篠原 信雄, 白土 博樹  日本癌治療学会学術集会抄録集  56回-  SY5  -2  2018/10  [Not refereed][Not invited]
  • ハイリスク筋層非浸潤性膀胱癌の治療戦略 ハイリスクNMIBCに対するBCG膀注療法
    安部 崇重, 菊地 央, 松本 隆児, 大澤 崇弘, 篠原 信雄  日本癌治療学会学術集会抄録集  56回-  PD16  -2  2018/10  [Not refereed][Not invited]
  • 尿路上皮癌における抗癌剤治療後の腫瘍血管ABCB1発現亢進と薬剤耐性
    菊地 央, 間石 奈湖, 宮田 遥, 松本 隆児, 大澤 孝宏, 安部 崇重, 樋田 泰浩, 丸山 覚, 原林 透, 飴田 要, 柏木 明, 松野 吉宏, 篠原 信雄, 樋田 京子  日本癌治療学会学術集会抄録集  56回-  O22  -3  2018/10  [Not refereed][Not invited]
  • 腎全摘除術と腎部分切除術が施行された限局性腎癌(cT1)患者の術後QOL比較前向き研究
    大澤 崇宏, 安部 崇重, 古御堂 純, 宮田 遥, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 伊藤 陽一, 村井 幸代, 篠原 信雄  日本癌治療学会学術集会抄録集  56回-  O42  -6  2018/10  [Not refereed][Not invited]
  • 前立腺癌監視療法における不安と抑うつの評価
    丸山 覚, 松本 隆児, 大澤 崇宏, 安部 崇重, 森口 卓哉, 高田 徳容, 原林 透, 永森 聡, 篠原 信雄  日本癌治療学会学術集会抄録集  56回-  O44  -5  2018/10  [Not refereed][Not invited]
  • 腹腔鏡下およびロボット支援下腎部分切除術におけるtrifecta、pentafecta達成率の検討
    松本 隆児, 古御堂 純, 宮田 遥, 菊地 央, 大澤 崇宏, 丸山 覚, 安部 崇重, 篠原 信雄  日本癌治療学会学術集会抄録集  56回-  P33  -6  2018/10  [Not refereed][Not invited]
  • 当院における転移性腎細胞癌に対するアキシチニブの治療成績
    日下部 直久, 大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  泌尿器科紀要  64-  (9)  353  -358  2018/09  [Not refereed][Not invited]
     
    対象は2012年12月〜2017年3月の32例(男性24例、女性8例、年齢中央値61歳)であった。アキシチニブ導入後の全生存率(OS)中央値は29ヵ月、無増悪生存率(PFS)中央値は11ヵ月であった。2nd-lineでアキシチニブを使用した19例におけるOS中央値は22ヵ月、PFS中央値は10ヵ月であり、3rd-line以降でアキシチニブを使用した13例におけるOS中央値は29ヵ月、PFS中央値は15.5ヵ月であった。多変量解析では骨転移ありの症例でOSが有意に短かった。アキシチニブ内服中に認めたG3以上の有害事象は高血圧9例(28%)、下痢7例(22%)、蛋白尿7例(22%)であるが、死亡症例はなく、アキシチニブは比較的安全に投与できた。後ろ向きの検討ではあるが、3rd-line以降のアキシチニブ投与でも有効性があることが示唆された。
  • 【老年医学(下)-基礎・臨床研究の最新動向-】高齢者の臓器別疾患 泌尿器疾患 腎癌
    大澤 崇宏, 安部 崇重, 菊地 央, 松本 隆児, 宮島 直人, 篠原 信雄  日本臨床  76-  (増刊7 老年医学(下))  463  -467  2018/08  [Not refereed][Not invited]
  • irAE Nivolumab使用中に免疫関連有害事象(irAE)を経験した転移性腎癌の2例
    宮田 遥, 大澤 崇宏, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (48)  28  -28  2018/07  [Not refereed][Not invited]
  • 北海道大学病院での腎細胞癌患者に対するAxitinibの治療成績の検討
    日下部 直久, 大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (48)  58  -58  2018/07  [Not refereed][Not invited]
  • 進行腎細胞がん患者におけるS-1の使用経験
    大澤 崇宏, 松本 隆児, 宮島 直人, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (48)  109  -109  2018/07  [Not refereed][Not invited]
  • mRCCに対する治療戦略 転移巣に対する手術療法
    丸山 覚, 宮田 遥, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  31-  (臨増)  694  -695  2018/06  [Not refereed][Not invited]
  • 非セミノーマ精巣腫瘍に対するゲムシタビン/オキサリプラチン療法中に肝静脈閉塞症を発症した1例
    氏橋 一紘, 宮島 直人, 森口 卓哉, 西村 陽子, 菊地 央, 広瀬 貴行, 松本 隆児, 大澤 崇宏, 丸山 覚, 安部 崇重, 篠原 信雄  泌尿器外科  31-  (臨増)  845  -845  2018/06  [Not refereed][Not invited]
  • 前立腺癌監視療法におけるゲノムアッセイの有用性(第1報)
    丸山 覚, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  106回-  OP  -247  2018/04  [Not refereed][Not invited]
  • 前立腺癌監視療法における不安と抑うつの評価
    丸山 覚, 宮田 遥, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  106回-  OP  -248  2018/04  [Not refereed][Not invited]
  • 北海道大学病院での腎癌に対するAxitinibの治療成績
    日下部 直久, 大澤 崇宏, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  106回-  OP  -464  2018/04  [Not refereed][Not invited]
  • 上部尿路癌に対する腹腔鏡下腎尿管全摘除術によるリンパ節転移陽性症例の検討
    松本 隆児, 安部 崇重, 高田 徳容, 三浪 圭太, 原林 透, 永森 聡, 宮田 遥, 菊地 央, 大澤 崇宏, 丸山 覚, 篠原 信雄  日本泌尿器科学会総会  106回-  PP1  -102  2018/04  [Not refereed][Not invited]
  • Bladder Cancer Index(BCI)日本語版の開発におけるPilot Study
    大澤 崇宏, ウェイ・ジョン, 伊藤 陽一, 成田 学, 賀古 勇輝, 宮田 遙, 菊地 央, 松本 隆児, 宮島 直人, 丸山 覚, 安部 崇重, 村井 祥代, 篠原 信雄  日本泌尿器科学会総会  106回-  PP1  -201  2018/04  [Not refereed][Not invited]
  • 筋層非浸潤性膀胱癌ガイドラインに対する日常診療のアドヒアランスに関する調査研究
    大堀 加奈子, 大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  106回-  PP1  -202  2018/04  [Not refereed][Not invited]
  • 小径腎腫瘍に対して病理はどのように対峙すべきか 小径腎腫瘍の画像診断
    大澤 崇宏, 宮田 遥, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  日本病理学会会誌  107-  (1)  244  -244  2018/04  [Not refereed][Not invited]
  • 上部尿路癌に対する腹腔鏡下腎尿管全摘除術+所属リンパ節郭清の治療成績
    松本 隆児, 安部 崇重, 高田 徳容, 三浪 圭太, 原林 透, 菊地 央, 大澤 崇宏, 丸山 覚, 篠原 信雄  Japanese Journal of Endourology  30-  (3)  198  -198  2017/11  [Not refereed][Not invited]
  • チェックリスト導入によるTURBTの詳細な術中記録の試み
    大澤 崇宏, 宮田 遥, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 村井 祥代, 篠原 信雄  Japanese Journal of Endourology  30-  (3)  201  -201  2017/11  [Not refereed][Not invited]
  • 転移性尿路上皮癌二次化学療法における予後因子の検討
    松本 隆児, 安部 崇重, 石崎 淳司, 菊地 央, 原林 透, 三浪 圭太, 佐澤 陽, 望月 端吾, 秋野 文臣, 村雲 雅志, 大澤 崇宏, 丸山 覚, 宮田 遥, 村井 祥代, 篠原 信雄  日本癌治療学会学術集会抄録集  55回-  P13  -3  2017/10  [Not refereed][Not invited]
  • 転移性腎癌に対するニボルマブの初期治療成績
    宮田 遥, 大澤 崇宏, 菊地 央, 松本 隆児, 丸山 覚, 安部 崇重, 篠原 信雄  日本癌治療学会学術集会抄録集  55回-  P33  -7  2017/10  [Not refereed][Not invited]
  • アビラテロン投与後に血清テストステロン値が上昇した症例の検討
    丸山 覚, 宮田 遥, 菊地 央, 大澤 崇宏, 松本 隆児, 安部 崇重, 篠原 信雄  日本癌治療学会学術集会抄録集  55回-  P80  -5  2017/10  [Not refereed][Not invited]
  • 抗癌剤治療前後における腫瘍血管内皮のP-glycoprotein発現変化
    間石 奈湖, 菊地 央, 森本 浩史, 土屋 邦彦, 安部 崇重, 樋田 泰浩, 原林 透, 松野 吉宏, 篠原 信雄, 樋田 京子  日本癌学会総会記事  76回-  J  -3103  2017/09  [Not refereed][Not invited]
  • M. Higuchi, T. Kitta, Y. Kanno, M. Ouchi, M. Tsukiyama, M. Togo, S. Maruyama, T. Abe, K. Moriya, N. Shinohara  NEUROUROLOGY AND URODYNAMICS  36-  S108  -S110  2017/07  [Not refereed][Not invited]
  • 進行腎細胞がん患者におけるS-1の使用経験
    大澤 崇宏, 松本 隆児, 宮島 直人, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (47)  46  -46  2017/07  [Not refereed][Not invited]
  • Takeya Kitta, Yukiko Kanno, Mifuka Ouchi, Kimihiko Moriya, Satoru Maruyama, Takashige Abe, Nobuo Shinohara  JOURNAL OF UROLOGY  197-  (4)  E404  -E404  2017/04  [Not refereed][Not invited]
  • 初回治療としてVEGFR-TKIが投与された有転移腎細胞がん症例に対する治療選択 ニボルマブの位置づけは?
    大澤 崇宏, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  105回-  UP18  -2  2017/04  [Not refereed][Not invited]
  • 菊地央, 菊地央, 間石奈湖, 秋山廣輔, 森本真弘, 土屋邦彦, 丸山覚, 安部崇重, 樋田泰浩, 原林透, 飴田要, 松本隆児, 松本隆児, 柏木明, 松野吉宏, 篠原信雄, 樋田京子  日本がん転移学会学術集会・総会プログラム抄録集  26th-  134  2017  [Not refereed][Not invited]
  • Takahiro Osawa, Cheryl T. Lee, Takashige Abe, Norikata Takada, Khaled S. Hafez, Jeffrey S. Montgomery, Alon Z. Weizer, Brent K. Hollenbeck, Ted A. Skolarus, Sachiyo Murai, Nobuo Shinohara, Todd M. Morgan  JOURNAL OF UROLOGY  195-  (4)  E74  -E75  2016/04  [Not refereed][Not invited]
  • pT1淡明型腎細胞癌におけるRENAL nephrometry scoreとMIB-1 indexの関連
    菊地 央, 安部 崇重, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 篠原 信雄  日本泌尿器科学会総会  104回-  PP1  -010  2016/04  [Not refereed][Not invited]
  • 膀胱全摘術 アウトカムの改善に何が必要か? 膀胱全摘術における拡大リンパ節郭清の意義
    松本 隆児, 安部 崇重, 高田 徳容, 三浪 圭太, 原林 透, 永森 聡, 宮島 直人, 土屋 邦彦, 篠原 信雄  日本泌尿器科学会総会  104回-  FS17  -3  2016/04  [Not refereed][Not invited]
  • 進行尿路上皮癌に対する集学的治療戦略 進行性尿路上皮癌の治療戦略 Oligometastasisに対する転移巣切除術
    松本 隆児, 安部 崇重, 石崎 淳司, 大澤 崇宏, 菊地 央, 丸山 覚, 土屋 邦彦, 宮島 直人, 篠原 信雄  日本泌尿器科学会総会  104回-  FS23  -6  2016/04  [Not refereed][Not invited]
  • CRKアダプター蛋白質はHGF/c-Metフィードバックループを介して膀胱癌のEMTと転移を誘導する
    王 磊, 松本 隆児, 津田 真寿美, 間石 奈湖, 安部 崇重, 木村 太一, 谷野 美智枝, 西原 広史, 樋田 京子, 大場 雄介, 篠原 信雄, 田中 伸哉  日本癌学会総会記事  74回-  J  -1142  2015/10  [Not refereed][Not invited]
  • Keiichiro Yoshinaga, Shozo Okamoto, Tohru Shiga, Nobuo Shinohara, Takashige Abe, Yuko Uchiyama, Nagara Tamaki  JOURNAL OF NUCLEAR MEDICINE  56-  (3)  2015/05  [Not refereed][Not invited]
  • 泌尿器科疾患治療中に生じた敗血症性肺塞栓症の2例
    菊地 央, 宮島 直人, 大石 悠一郎, 池城 卓, 西村 陽子, 村橋 範浩, 広瀬 貴行, 鈴木 英孝, 今 雅史, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄, 長岡 健太郎  泌尿器外科  28-  (5)  1005  -1005  2015/05  [Not refereed][Not invited]
  • 泌尿器科疾患治療中に生じた敗血症性肺塞栓症の2例
    菊地 央, 宮島 直人, 大石 悠一郎, 池城 卓, 西村 陽子, 村橋 範浩, 広瀬 貴行, 鈴木 英孝, 今 雅史, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄  泌尿器外科  28-  (臨増)  849  -849  2015/05  [Not refereed][Not invited]
  • 膀胱癌拡大リンパ節郭清に関する前向き観察研究 微小リンパ節転移の特徴
    松本 隆児, 高田 徳容, 安部 崇重, 原林 透, 三浪 圭太, 永森 聡, 宮島 直人, 土屋 邦彦, 丸山 覚, 篠原 信雄  泌尿器外科  28-  (5)  1008  -1008  2015/05  [Not refereed][Not invited]
  • Takashige Abe, Ataru Sazawa, Toru Harabayashi, Naoto Miyajima, Kunihiko Tsuchiya, Satoru Maruyama, Nobuo Shinohara  JOURNAL OF UROLOGY  193-  (4)  E908  -E909  2015/04  [Not refereed][Not invited]
  • 膀胱癌転移巣におけるAldo-keto reductase(AKR)1C1の発現亢進は浸潤能と抗癌剤耐性能を反映する
    松本 隆児, 津田 真寿美, 安部 崇重, 篠原 信雄, 田中 伸哉, 野々村 克也  日本泌尿器科学会総会  103回-  471  -471  2015/04  [Not refereed][Not invited]
  • 3-Tesla MRIの前立腺癌検出能に関する検討
    安部 崇重, 原田 太以佑, 加藤 扶美, 松本 隆児, 藤田 裕美, 丸山 覚, 土屋 邦彦, 宮島 直人, 篠原 信雄  日本泌尿器科学会総会  103回-  575  -575  2015/04  [Not refereed][Not invited]
  • Takahiro Kojima, Koji Kawai, Kunihiko Tsuchiya, Takashige Abe, Nobuo Shinohara, Toshiaki Tanaka, Naoya Masumori, Shigeyuki Yamada, Yoichi Arai, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi, Hiroyuki Nishiyama  JOURNAL OF CLINICAL ONCOLOGY  33-  (7)  2015/03  [Not refereed][Not invited]
  • R.E.N.A.L.nephrometry scoreは腎腫瘍無治療経過観察時における腫瘍径増大の予測因子となる
    松本 隆児, 安部 崇重, 村井 祥代, 丸山 覚, 土屋 邦彦, 篠原 信雄, 野々村 克也  泌尿器外科  27-  (12)  1968  -1968  2014/12  [Not refereed][Not invited]
  • 結節性硬化症に伴う腎血管筋脂肪腫に対する治療成績
    宮島 直人, 鈴木 英孝, 村橋 範浩, 松本 隆児, 秋野 文臣, 土屋 邦彦, 丸山 覚, 安部 崇重, 原林 透, 篠原 信雄, 野々村 克也  泌尿器外科  27-  (12)  1982  -1982  2014/12  [Not refereed][Not invited]
  • Naoto Miyajima, Tomoshige Akino, Kunihiko Tsuchiya, Satoru Maruyama, Takashige Abe, Nobuo Shinohara, Katsuya Nonomura, Len Neckers  CANCER RESEARCH  74-  (19)  2014/10  [Not refereed][Not invited]
  • 篠原信雄, 小原航, 立神勝則, 内藤整, 神波大己, 高橋正幸, 村井祥代, 大庭幸治, 安部崇重, 内藤誠二  日本癌治療学会学術集会(CD-ROM)  49-  (3)  985  -985  2014/06  [Not refereed][Not invited]
  • High grade筋層非浸潤性膀胱癌に対する2nd TURの有用性
    土屋 邦彦, 篠原 信雄, 鈴木 英孝, 村橋 範浩, 松本 隆児, 秋野 文臣, 宮島 直人, 丸山 覚, 安部 崇重, 野々村 克也  日本癌治療学会誌  49-  (3)  1228  -1228  2014/06  [Not refereed][Not invited]
  • 去勢抵抗性前立腺癌骨転移例に対するゾレドロン酸の抗腫瘍効果
    丸山 覚, 篠原 信雄, 鈴木 英孝, 村橋 範浩, 松本 隆児, 秋野 文臣, 宮島 直人, 土屋 邦彦, 安部 崇重, 野々村 克也  日本癌治療学会誌  49-  (3)  2235  -2235  2014/06  [Not refereed][Not invited]
  • 結節性硬化症に伴う腎血管筋脂肪腫の長期治療成績
    宮島 直人, 篠原 信雄, 原林 透, 鈴木 英孝, 村橋 範浩, 松本 隆児, 秋野 文臣, 土屋 邦彦, 丸山 覚, 安部 崇重, 野々村 克也  日本癌治療学会誌  49-  (3)  2591  -2591  2014/06  [Not refereed][Not invited]
  • 村橋範浩, 安部崇重, 吉永恵一郎, 丸山覚, 篠原信雄, 野々村克也  泌尿器外科  27-  773  2014/05/15  [Not refereed][Not invited]
  • Keiichiro Yoshinaga, Shozo Okamoto, Tohru Shiga, Nobuo Shinohara, Takashige Abe, Nagara Tamaki  JOURNAL OF NUCLEAR MEDICINE  55-  2014/05  [Not refereed][Not invited]
  • Naoto Miyajima, Tomoshige Akino, Kunihiko Tsuchiya, Satoru Maruyama, Takashige Abe, Nobuo Shinohara, Katsuya Nonomura, Len Neckers  JOURNAL OF UROLOGY  191-  (4)  E374  -E375  2014/04  [Not refereed][Not invited]
  • 検証:R.E.N.A.L Nephrometry score R.E.N.AL. scoreおよびPADUA分類は本当に臨床的に有用か? R.E.N.A.L nephrometry score その"実用性"に関して
    松本 隆児, 安部 崇重, 丸山 覚, 土屋 邦彦, 宮島 直人, 篠原 信雄, 野々村 克也  日本泌尿器科学会総会  102回-  373  -373  2014/04  [Not refereed][Not invited]
  • 腎盂尿管癌における至適リンパ節郭清範囲の確立を目指した前向き観察研究
    安部 崇重, 高田 徳容, 松本 隆児, 大澤 崇宏, 佐澤 陽, 丸山 覚, 土屋 邦彦, 宮島 直人, 原林 透, 三浪 圭太, 永森 聡, 篠原 信雄, 野々村 克也  日本泌尿器科学会総会  102回-  406  -406  2014/04  [Not refereed][Not invited]
  • 当院において経験した副腎hemangiomaの一例
    今 雅史, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄, 三井 貴彦, 山田 洋介, 野々村 克也  泌尿器外科  27-  (2)  247  -247  2014/02  [Not refereed][Not invited]
  • 横紋筋肉腫様変化を伴う腎細胞癌を発症した夫婦例の経験
    松本 隆児, 篠原 信雄, 土屋 邦彦, 安部 崇重, 丸山 覚, 久保田 佳奈子, 黒田 直人, 野々村 克也  泌尿器外科  27-  (2)  255  -255  2014/02  [Not refereed][Not invited]
  • 大澤崇宏, 丸山覚, 大庭幸治, 安部崇重, 丸晋太郎, 秋野文臣, 佐澤陽, 篠原信雄, 野々村克也  泌尿器外科  26-  (12)  1857  -1857  2013/12  [Not refereed][Not invited]
  • 前立腺癌骨転移患者における骨関連事象(SRE)の検討
    丸山 覚, 篠原 信雄, 鈴木 英孝, 村橋 範浩, 松本 隆児, 宮島 直人, 土屋 邦彦, 安部 崇重, 佐澤 陽, 野々村 克也  日本癌治療学会誌  48-  (3)  1488  -1488  2013/09  [Not refereed][Not invited]
  • 当院における非機能性副腎腫瘍の検討
    今 雅史, 丸山 覚, 土屋 邦彦, 安部 崇重, 森田 研, 篠原 信雄, 野々村 克也  泌尿器外科  26-  (臨増)  724  -724  2013/05  [Not refereed][Not invited]
  • 横紋筋肉腫様変化を伴う腎細胞癌を発症した夫婦例の報告
    松本 隆児, 篠原 信雄, 土屋 邦彦, 安部 崇重, 丸山 覚, 久保田 佳奈子, 黒田 直人, 野々村 克也  泌尿器外科  26-  (臨増)  732  -732  2013/05  [Not refereed][Not invited]
  • Takashige Abe, Norikata Takada, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Shino Kanzaki, Yuichiro Shinno, Soushu Sato, Kimiyoshi Mitsuhashi, Takuya Sato, Keiji Sugishita, Shinji Kamota, Takanori Yamashita, Junji Ishizaki, Takaya Hioka, Gaku Mouri, Takenori Ono, Naoto Miyajima, Takanori Sakuta, Tango Mochizuki, Toshiki Aoyagi, Hidenori Katano, Tomoshige Akino, Kazushi Hirakawa, Keita Minami, Akira Kumagai, Masaki Togashi, Toshimori Seki, Katsuya Nonomura  JOURNAL OF UROLOGY  189-  (4)  E664  -E664  2013/04  [Not refereed][Not invited]
  • 高齢泌尿器癌患者の治療戦略 高齢者の小径腎腫瘍に対する治療戦略
    安部 崇重, 篠原 信雄, 松本 隆児, 丸山 覚, 土屋 邦彦, 野々村 克也  尿路悪性腫瘍研究会記録  39-  22  -26  2013/04  [Not refereed][Not invited]
  • ダイオキシン受容体内因性リガンドによる前立腺癌細胞におけるアンドロゲンレセプター発現低下と増殖抑制
    丸山覚, 築山忠維, 宮島直人, 土屋邦彦, 安部崇重, 佐澤陽, 篠原信雄, 畠山鎮次, 野々村克也  日本泌尿器科学会雑誌  104-  (2)  415  2013/03  [Not refereed][Not invited]
  • 篠原 信雄, 宮田 遥, 安部 崇重  Year book of RCC  79  -86  2013
  • SUZUKI HIDETAKA, MIYAJIMA NAOTO, TSUCHIYA KUNIHIKO, MARUYAMA SATORU, ABE TAKASHIGE, SHINOHARA NOBUO, YABUSAKI TETSUSHI, MANABE TOKUKO, KATO FUMI, NISHIDA MUTSUMI, NONOMURA KATSUYA  泌尿器画像診断・治療技術研究会プログラム・抄録  1st-  64  2013  [Not refereed][Not invited]
  • S. Shimizu, K. Nishioka, R. Onimaru, R. Kinoshita, K. Harada, N. Nishikawa, T. Abe, S. Maruyama, N. Shinohara, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  84-  (3)  S181  -S181  2012/11  [Not refereed][Not invited]
  • N. Shinohara, K. Nonomura, T. Abe, S. Maruyama, T. Kamai, M. Takahashi, K. Tatsugami, S. Yokoi, T. Deguchi, H. Kanayama, K. Oba, S. Naito  CANCER SCIENCE  103-  (10)  1905  -1905  2012/10  [Not refereed][Not invited]
  • 異時性両側性精巣腫瘍に対して一側精巣摘除術および対側精巣部分切除術を施行した1例
    宮本 秀一, 篠原 信雄, 松本 隆児, 山田 洋介, 橘田 岳也, 丸山 覚, 安部 崇重, 佐澤 陽, 野々村 克也  泌尿器外科  25-  (10)  2067  -2067  2012/10  [Not refereed][Not invited]
  • 当科における鏡視下前立腺全摘除術の成績
    佐澤 陽, 安部 崇重, 篠原 信雄, 丸山 覚, 宮島 直人, 大澤 崇宏, 松本 隆児, 佐々木 元, 原林 透, 野々村 克也  泌尿器外科  25-  (10)  2069  -2069  2012/10  [Not refereed][Not invited]
  • 鏡視下腎部分切除術 周術期合併症症例を振り返る
    松本 隆児, 安部 崇重, 原林 透, 佐々木 元, 丸山 覚, 佐澤 陽, 篠原 信雄, 野々村 克也  泌尿器外科  25-  (10)  2078  -2078  2012/10  [Not refereed][Not invited]
  • 精巣癌化学療法後に正常化しないβ-hCGは疑陽性の可能性がある
    丸山 覚, 安部 崇重, 橘田 岳也, 宮島 直人, 岩見 大基, 松本 隆児, 佐々木 元, 菅野 由起子, 佐澤 陽, 篠原 信雄, 野々村 克也  泌尿器外科  25-  (10)  2085  -2085  2012/10  [Not refereed][Not invited]
  • 池城卓, 佐澤陽, 安部崇重, 丸山覚, 丸晋太郎, 大澤崇宏, 青柳俊紀, 篠原信雄, 吉永恵一郎, 玉木長良, 野々村克也  泌尿器外科  25-  (9)  1910  2012/09/15  [Not refereed][Not invited]
  • Takafumi Kawazu, Takashige Abe, Hiroki Chiba, Ataru Sazawa, Satoru Maruyama, Nobuo Shinohara, Katsuya Nonomura  JOURNAL OF ENDOUROLOGY  26-  A390  -A390  2012/09  [Not refereed][Not invited]
  • Takashige Abe, Ataru Sazawa, Satoru Maruyama, Nobuo Shinohara, Katsuya Nonomura  JOURNAL OF ENDOUROLOGY  26-  A516  -A516  2012/09  [Not refereed][Not invited]
  • Hiroki Chiba, Takashige Abe, Takahumi Kawatsu, Ataru Sazawa, Satoru Maruyama, Nobuo Shinohara, Katsuya Nonomura  JOURNAL OF ENDOUROLOGY  26-  A88  -A89  2012/09  [Not refereed][Not invited]
  • Nobuo Shinohara, Takashige Abe, Satoru Maruyama, Ataru Sazawa, Katsuya Nonomura  JOURNAL OF UROLOGY  187-  (4)  E723  -E723  2012/04  [Not refereed][Not invited]
  • Shintaro Maru, Yasuhito Ishigaki, Nobuo Shinohara, Takanobu Takata, Takashige Abe, Satoru Maruyama, Ataru Sazawa, Naohisa Tomosugi, Katsuya Nonomura  JOURNAL OF UROLOGY  187-  (4)  E58  -E58  2012/04  [Not refereed][Not invited]
  • 大澤崇宏, 樋田京子, 大賀則孝, 秋山廣輔, 樋田泰浩, 丸山覚, 安部崇重, 佐澤陽, 篠原信雄, 進藤正信, 野々村克也  日本泌尿器科学会雑誌  103-  (2)  356  2012/03/20  [Not refereed][Not invited]
  • Satoru Maruyama, Nobuo Shinohara, Takashige Abe, Ataru Sazawa, Katsuya Nonomura  JOURNAL OF CLINICAL ONCOLOGY  30-  (5)  2012/02  [Not refereed][Not invited]
  • Nobuo Shinohara, Takashige Abe, Satoru Maruyama, Ataru Sazawa, Katsuya Nonomura  JOURNAL OF CLINICAL ONCOLOGY  30-  (5)  2012/02  [Not refereed][Not invited]
  • Ataru Sazawa, Takashige Abe, Nobuo Shinohara, Satoru Maruyama, Toru Harabayashi, Katsuya Nonomura  JOURNAL OF ENDOUROLOGY  25-  A316  -A316  2011/11  [Not refereed][Not invited]
  • 【腹腔鏡下腎部分切除】冷却併用腹腔鏡下腎部分切除術
    安部 崇重, 佐澤 陽, 原林 透, 松本 隆児, 丸山 覚, 篠原 信雄, 野々村 克也  Japanese Journal of Endourology  24-  (3)  66  -66  2011/10  [Not refereed][Not invited]
  • 大澤崇宏, 丸山覚, 大庭幸治, 安部崇重, 丸晋太郎, 秋野文臣, 佐澤陽, 篠原信雄, 野々村克也  日本癌治療学会誌  46-  (2)  933  -933  2011/09/13  [Not refereed][Not invited]
  • 篠原信雄, 丸山覚, 清水伸一, 安部崇重, 佐澤陽, 大庭幸治, 白土博樹, 野々村克也  日本癌治療学会誌  46-  (2)  422  2011/09/13  [Not refereed][Not invited]
  • 進行性精巣癌化学療法後に正常化しないβ-hCGは疑陽性の可能性がある
    丸山 覚, 安部 崇重, 橘田 岳也, 宮島 直人, 岩見 大基, 松本 隆児, 佐々木 元, 菅野 由起子, 佐澤 陽, 篠原 信雄, 野々村 克也  日本癌治療学会誌  46-  (2)  712  -712  2011/09  [Not refereed][Not invited]
  • 【"長期成績"〜V."腎部分切除"〜】冷却併用腹腔鏡下腎部分切除術
    安部 崇重, 佐澤 陽, 原林 透, 松本 隆児, 丸山 覚, 篠原 信雄, 野々村 克也  Japanese Journal of Endourology  24-  (2)  228  -232  2011/09  [Not refereed][Not invited]
  • Norihiro Murahashi, Takashige Abe, Toru Harabayashi, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Katsuya Nonomura  JOURNAL OF UROLOGY  185-  (4)  E556  -E556  2011/04  [Not refereed][Not invited]
  • 佐澤 陽, 篠原 信雄, 安部 崇重  臨床泌尿器科  65-  (5)  297  -302  2011/04
  • 異時性両側性精巣腫瘍に対して一側精巣摘除術および対側精巣部分切除術を施行した1例
    宮本 秀一, 篠原 信雄, 松本 隆児, 橘田 岳也, 丸山 覚, 安部 崇重, 佐澤 陽, 野々村 克也  泌尿器外科  24-  (臨増)  514  -514  2011/04  [Not refereed][Not invited]
  • 経直腸的前立腺生検後の再生検における経会陰的アプローチの意義
    佐々木 元, 安部 崇重, 丸山 覚, 松本 隆児, 宮島 直人, 佐澤 陽, 篠原 信雄, 野々村 克也  泌尿器外科  24-  (臨増)  535  -535  2011/04  [Not refereed][Not invited]
  • N. Shinohara, S. Maruyama, T. Abe, A. Sazawa, K. Nonomura  JOURNAL OF CLINICAL ONCOLOGY  29-  (7)  2011/03  [Not refereed][Not invited]
  • Low risk前立腺癌に対するPSA監視療法におけるPSA doubling timeの意義
    丸山 覚, 篠原 信雄, 佐々木 元, 松本 隆児, 大澤 崇宏, 宮島 直人, 安部 崇重, 佐澤 陽, 原林 透, 野々村 克也  日本泌尿器科学会雑誌  102-  (2)  314  -314  2011/03  [Not refereed][Not invited]
  • 進行性前立腺癌に対するドセタキセルの効果と有害事象
    佐澤 陽, 篠原 信雄, 安部 崇重, 丸山 覚, 宮島 直人, 大澤 崇宏, 松本 隆児, 野々村 克也  日本泌尿器科学会雑誌  102-  (2)  371  -371  2011/03  [Not refereed][Not invited]
  • 膀胱全摘後の遅発性再発について
    安部 崇重, 篠原 信雄, 佐澤 陽, 丸山 覚, 松本 隆児, 山下 登, 信野 祐一郎, 内野 秀紀, 岡 応樹, 坂下 茂夫, 熊谷 章, 森 達也, 野々村 克也  日本泌尿器科学会雑誌  102-  (2)  382  -382  2011/03  [Not refereed][Not invited]
  • PSA監視療法の適応基準と治療開始基準 PSA kineticsは有用か?
    丸山 覚, 篠原 信雄, 佐々木 元, 松本 隆児, 大澤 崇宏, 宮島 直人, 安部 崇重, 佐澤 陽, 野々村 克也  日本腎泌尿器疾患予防医学研究会誌  19-  (1)  89  -92  2011/03  [Not refereed][Not invited]
  • 膀胱癌術後再発にて直腸輪状狭窄を呈した1例
    加藤 健太郎, 七戸 俊明, 新田 建雄, 寺村 紘一, 那須 裕也, 楢崎 肇, 川村 武史, 中山 智英, 三浦 巧, 高田 実, 田本 英司, 寺本 賢一, 村上 壮一, 松本 譲, 土川 貴裕, 田中 栄一, 平野 聡, 近藤 哲, 安部 崇重, 佐澤 陽, 野々村 克也, 小野 尚子  日本大腸肛門病学会雑誌  64-  (2)  100  -100  2011/02  [Not refereed][Not invited]
  • 鏡視下腎部分切除術 周術期合併症症例を振り返る
    松本 隆児, 安部 崇重, 原林 透, 佐々木 元, 丸山 覚, 佐澤 陽, 篠原 信雄, 野々村 克也  Japanese Journal of Endourology and ESWL  23-  (3)  154  -154  2010/10  [Not refereed][Not invited]
  • 鏡視下手術におけるポートサイト合併症
    佐澤 陽, 安部 崇重, 篠原 信雄, 丸山 覚, 宮島 直人, 大澤 崇宏, 松本 隆児, 佐々木 元, 原林 透, 野々村 克也  Japanese Journal of Endourology and ESWL  23-  (3)  198  -198  2010/10  [Not refereed][Not invited]
  • Nephrometry Scoring Systemを用いた腹腔鏡下腎部分切除術のリスク評価
    安部 崇重, 篠原 信雄, 佐澤 陽, 原林 透, 森田 研, 松本 隆児, 佐々木 元, 丸山 覚, 野々村 克也  Japanese Journal of Endourology and ESWL  23-  (3)  207  -207  2010/10  [Not refereed][Not invited]
  • N. Murahashi, T. Abe, N. Shinohara, A. Sazawa, S. Maruyama, T. Osawa, K. Nonomura  JOURNAL OF ENDOUROLOGY  24-  A322  -A322  2010/09  [Not refereed][Not invited]
  • H. Sasaki, T. Abe, S. Maruyama, N. Fukuzawa, A. Sazawa, T. Harabayashi, N. Shinohara, K. Nonomura  JOURNAL OF ENDOUROLOGY  24-  A373  -A373  2010/09  [Not refereed][Not invited]
  • R. Matsumoto, T. Abe, T. Harabayashi, S. Maruyama, A. Sazawa, N. Shinohara, K. Nonomura  JOURNAL OF ENDOUROLOGY  24-  A386  -A387  2010/09  [Not refereed][Not invited]
  • 早期前立腺がんの治療戦略 PSA監視療法の適応基準と治療開始基準 PSA kineticsの検討
    丸山 覚, 篠原 信雄, 佐々木 元, 松本 隆児, 大澤 崇宏, 宮島 直人, 安部 崇重, 佐澤 陽, 野々村 克也  日本癌治療学会誌  45-  (2)  491  -491  2010/09  [Not refereed][Not invited]
  • 経直腸的前立腺生検後の再生検における経会陰的アプローチの意義
    佐々木 元, 安部 崇重, 松本 隆児, 宮島 直人, 丸山 覚, 佐澤 陽, 篠原 信雄, 野々村 克也  日本癌治療学会誌  45-  (2)  837  -837  2010/09  [Not refereed][Not invited]
  • 鏡視下前立腺全摘除術後のPSA再発に関する因子の検討
    佐澤 陽, 篠原 信雄, 安部 崇重, 丸山 覚, 宮島 直人, 大澤 崇宏, 佐々木 元, 松本 隆児, 原林 透, 野々村 克也  日本癌治療学会誌  45-  (2)  940  -940  2010/09  [Not refereed][Not invited]
  • S. Maruyama, T. Mitsui, M. Tsukiyama, K. Moriya, H. Tanaka, T. Abe, A. Sazawa, T. Harabayashi, N. Shinohara, K. Nonomura  INTERNATIONAL UROGYNECOLOGY JOURNAL  21-  S123  -S124  2010/08  [Not refereed][Not invited]
  • Takahiro Osawa, Satoru Maruyama, Takashige Abe, Shintaro Maru, Toshiki Aoyagi, Ataru Sazawa, Nobuo Shinohara, Katsuya Nonomura  JOURNAL OF UROLOGY  183-  (4)  E369  -E369  2010/04  [Not refereed][Not invited]
  • 佐澤 陽, 篠原 信雄, 安部 崇重, 丸山 覚, 新藤 純理, 佐藤 聡秋, 野々村 克也  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • 大澤 崇宏, 丸 晋太郎, 青柳 俊紀, 丸山 覚, 安部 崇重, 佐澤 陽, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • 安部 崇重, 篠原 信雄, 佐澤 陽, 丸山 覚, 原林 透, 鈴木 信, 大澤 崇宏, 丸 晋太郎, 青柳 俊紀, 石川 修平, 野々村 克也  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • 丸山 覚, 守屋 仁彦, 丸 晋太朗, 大澤 崇宏, 青柳 俊紀, 安部 崇重, 森田 研, 佐澤 陽, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • 佐澤 陽, 篠原 信雄, 安部 崇重, 丸山 覚, 青柳 俊紀, 大澤 崇宏, 丸 晋太郎, 野々村 克也  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • 菊地 央, 丸山 覚, 村橋 範浩, 丸 晋太朗, 大澤 崇宏, 青柳 俊紀, 田邉 起, 安部 崇重, 三浦 正義, 佐澤 陽, 篠原 信雄, 野々村 克也, 清水 康  日本泌尿器科學會雜誌  101-  (2)  2010/02/20  [Not refereed][Not invited]
  • S. Maruyama, T. Mitsui, M. Tsukiyama, K. Moriya, H. Tanaka, T. Abe, A. Sazawa, T. Harabayashi, N. Shinohara, K. Nonomura  NEUROUROLOGY AND URODYNAMICS  29-  (6)  927  -928  2010  [Not refereed][Not invited]
  • ABE T, SHINOHARA N, MURANAKA M, SAZAWA A, MARUYAMA S, OSAWA T, NONOMURA K, HARABAYASHI T, SHIBATA T, TOYADA Y, SHINNO Y, MINAMI K, SAKASHITA S, KUMAGAI A, TAKADA N, TOGASHI M, SANO H, MORI T, KUBOTA K, MATSUNO Y  EJSO  36-  (11)  1085  -1091  2010  [Not refereed][Not invited]
  • 腎癌患者へのSunitinib投与が引き起こす甲状腺機能障害の発症機序
    篠原 信雄, 高橋 正幸, 神島 保, 生島 仁史, 大塚 紀幸, 石津 明洋, 丸山 覚, 安部 崇重, 佐澤 陽, 金山 博臣, 野々村 克也  日本癌治療学会誌  44-  (2)  456  -456  2009/09  [Not refereed][Not invited]
  • 佐澤 陽, 安部 崇重, 篠原 信雄, 丸山 覚, 原林 透, 野々村 克也  Jpn J Endourol ESWL  22-  (2)  234  -238  2009/09/01  [Not refereed][Not invited]
  • Naoto Miyajima, Satoru Maruyama, Takashige Abe, Ataru Sazawa, Nobuo Shinohara, Shigetsugu Hatakeyama, Katsuya Nonomura  JOURNAL OF UROLOGY  181-  (4)  398  -398  2009/04  [Not refereed][Not invited]
  • Takashige Abe, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Toru Harabayashi, Kanako Kubota, Yoshihiro Matsuno, Takeshi Shibata, Yutaka Toyoda, Yuichiro Shinno, Keita Minami, Shigeo Sakashita, Akira Kumagai, Norikata Takada, Masaki Togashi, Hiroshi Sano, Tatsuya Mori, Katsuya Nonomura  JOURNAL OF UROLOGY  181-  (4)  134  -134  2009/04  [Not refereed][Not invited]
  • T. Abe, N. Shinohara, A. Sazawa, S. Maruyama, T. Harabayashi, K. Kubota, Y. Matsuno, T. Shibata, Y. Toyada, Y. Shinno, K. Minami, S. Sakashita, A. Kumagai, N. Takada, M. Togashi, H. Sano, T. Mori, K. Nonomura  EUROPEAN UROLOGY SUPPLEMENTS  8-  (4)  149  -149  2009/03  [Not refereed][Not invited]
  • 丸山 覚, 安部 崇重, 三井 貴彦, 守屋 仁彦, 田中 博, 佐澤 陽, 原林 透, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  100-  (2)  2009/02/20  [Not refereed][Not invited]
  • 広瀬 貴行, 原林 透, 安部 崇重, 丸山 覚, 三浦 正義, 佐澤 陽, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  100-  (2)  2009/02/20  [Not refereed][Not invited]
  • 安部 崇重, 篠原 信雄, 原林 透, 佐澤 陽, 丸山 覚, 柴田 武, 豊田 裕, 鴨田 慎二, 三浪 圭太, 熊谷 章, 佐野 洋, 高田 徳容, 野々村 克也  日本泌尿器科學會雜誌  100-  (2)  2009/02/20  [Not refereed][Not invited]
  • N. Shinohara, T. Abe, A. Sazawa, K. Nonomura  JOURNAL OF CLINICAL ONCOLOGY  26-  (15)  16003  2008/05  [Not refereed][Not invited]
  • Tomoshige Akino, Kyoko Hida, Kunihiko Tsuchiya, Yasuhiro Hida, Michael Klagsbrun, Kohei Matsuda, Noritaka Ohga, Takashige Abe, Ataru Sazawa, Toru Harabayashi, Nobuo Shinohara, Masanobu Shindoh, Katsuya Nonormura  JOURNAL OF UROLOGY  179-  (4)  133  -133  2008/04  [Not refereed][Not invited]
  • Takashige Abe, Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Shuhei Ishikawa, Takahiro Osawa, Kanako Kubota, Yoshihiro Matsuno, Yuichiro Shinno, Shinji Kamota, Keita Minami, Shigeo Sakashita, Akira Kumagai, Tatsuya Mori, Masaki Togashi, Katsuya Nonomura  JOURNAL OF UROLOGY  179-  (4)  72  -72  2008/04  [Not refereed][Not invited]
  • T. Mitsui, H. Tanaka, T. Harabayashi, K. Moriya, M. Matsuda, T. Abe, A. Sazawa, N. Shinohara, T. Kitta, K. Nonomura  EUROPEAN UROLOGY SUPPLEMENTS  7-  (3)  87  -87  2008/03  [Not refereed][Not invited]
  • Nobuo Shinohara, Toru Harabayashi, Ataru Sazawa, Takashige Abe, Ichiro Takeuchi, Akira Kumagai, Akira Kashiwagi, Satoshi Nagamori, Katsuya Nonomura  JOURNAL OF UROLOGY  177-  (4)  412  -412  2007/04  [Not refereed][Not invited]
  • T. Harabayashi, T. Abe, T. Akino, K. Morita, A. Sazawa, N. Shinohara, K. Nonomura  EUROPEAN UROLOGY SUPPLEMENTS  6-  (2)  236  -236  2007/03  [Not refereed][Not invited]
  • 丸山 覚, 宮島 直人, 安部 崇重, 佐澤 陽, 原林 透, 篠原 信雄, 佐藤 択矢, 柏木 明, 永森 聡, 畠山 鎮次, 野々村 克也  日本泌尿器科學會雜誌  98-  (2)  2007/02/20  [Not refereed][Not invited]
  • 望月 端吾, 安部 崇重, 佐澤 陽, 原林 透, 篠原 信雄, 鐘ヶ江 香久子, 玉木 長良, 野々村 克也  日本泌尿器科學會雜誌  98-  (2)  2007/02/20  [Not refereed][Not invited]
  • T Harabayashi, K Morita, T Abe, M Miura, A Sazawa, N Shinohara, K Nonomura  JOURNAL OF UROLOGY  175-  (4)  506  -506  2006/04  [Not refereed][Not invited]
  • 丸山 覚, 佐澤 陽, 安部 崇重, 原林 透, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  97-  (2)  2006/03/10  [Not refereed][Not invited]
  • N Shinohara, S Suzuki, T Abe, A Sazawa, T Harabayashi, K Nonomura  JOURNAL OF UROLOGY  173-  (4)  358  -358  2005/04  [Not refereed][Not invited]
  • 土屋 邦彦, 鈴木 信, 原林 透, 佐澤 陽, 安部 崇重, 三浪 圭太, 丸山 覚, 宮島 直人, 篠原 信雄, 野々村 克也  日本泌尿器科學會雜誌  96-  (2)  2005/03/05  [Not refereed][Not invited]
  • 安部 崇重, 多田 光宏, 篠原 信雄, 原林 透, 佐澤 陽, 三浪 圭太, 丸山 覚, 野々村 克也  日本泌尿器科學會雜誌  96-  (2)  2005/03/05  [Not refereed][Not invited]
  • SCIDマウスを利用したヒト尿路上皮癌xenograft modelの樹立(Establishment and characteristics of human urotherial cancer xenografts in SCID mice)
    安部 崇重, 多田 光宏, 篠原 信雄, 岡田 太, 原林 透, 浜田 淳一, 守内 哲也, 野々村 克也  日本癌学会総会記事  63回-  364  -364  2004/09  [Not refereed][Not invited]
  • QZ Chen, N Shinohara, T Abe, T Harabayashi, K Nonomura  JOURNAL OF UROLOGY  171-  (4)  267  -267  2004/04  [Not refereed][Not invited]
  • 杉下 圭治, 篠原 信雄, 三浪 圭太, 古野 剛史, 丸山 覚, 安部 崇重, 谷口 明久, 鈴木 信, 原林 透, 野々村 克也  日本泌尿器科學會雜誌  95-  (2)  2004/03/15  [Not refereed][Not invited]
  • 鈴木 信, 篠原 信雄, 白土 博樹, 原林 透, 大坂 康信, 安部 崇重, 丸山 覚, 出村 孝義, 小柳 知彦, 野々村 克也  日本泌尿器科學會雜誌  95-  (2)  2004/03/15  [Not refereed][Not invited]
  • 安部 崇重, 多田 光宏, 篠原 信雄, 岡田 太, 伊藤 智雄, 原林 透, 浜田 淳一, 鈴木 信, 三浪 圭太, 丸山 覚, 守内 哲也, 野々村 克也  日本泌尿器科學會雜誌  95-  (2)  2004/03/15  [Not refereed][Not invited]
  • 原林 透, 鈴木 信, 篠原 信雄, 安部 崇重, 三浪 圭太, 土屋 邦彦, 佐澤 陽, 森田 研, 柿崎 秀宏, 野々村 克也  J. Microwave Surg.  22-  133  -136  2004  [Not refereed][Not invited]
  • 後腹膜パラガングリオーマに対する腹腔鏡下摘除術の経験
    岩見 大基, 原林 透, 柿崎 秀宏, 安部 崇重, 小柳 知彦  泌尿器外科  15-  (3)  272  -272  2002/03

Research Projects

  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2023/04 -2026/03 
    Author : 近野 敦, 安部 崇重, 妹尾 拓, 小水内 俊介, 安孫子 聡子, 辻田 哲平, 陳 暁帥, 佐瀬 一弥
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2022/04 -2025/03 
    Author : 大澤 崇宏, 伊藤 陽一, 安部 崇重, 樋田 京子, 篠原 信雄
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2021/04 -2024/03 
    Author : 安部 崇重, 渡辺 雅彦, 七戸 俊明, 篠原 信雄, 近野 敦
     
    鉗子動態に基づく手術技量評価法の開発 これまでのウエットラボ参加者70名の鉗子動態計測データを用いて、手術経験数を熟練度の指標として用い、サポートベクターマシン等を用いて、鉗子動態に基づく手術技量分析能を評価した。良好な弁別能を観察しており、現在論文投稿中である。また、これまでのウェットラボ記録ビデオに関して、腹腔鏡手術技術評価表であるGOALS評価表を使用し、2名の腹腔鏡技術認定医による技術評価を修了した。GOALS評価表は、1. Depth perception, 2. Bimanual dexterity, 3. Efficiency, 4.Tissu handling, 5. Autonomy の5項目を、それぞれ1-5段階で評価を行う形式で、5-25点の点数が割り付けられる。R3年度は、鉗子動態計測値とGOALSスコアの相関評価を行い、鉗子動態に基づく機械学習を用いたGOALSスコアの自動計算法を開発した。現在、論文投稿中である。
    カダバーを用いた腹腔鏡下腎摘除術トレーニングプログラムの開発と鉗子動態の計測・解析 使用するカダバーは、シール法と呼ばれる固定方法の献体で、生体と比較し良好な組織類似性が特徴である。2020年9月末より腹腔鏡下腎摘除術トレーニングにおいて、三眼カメラOptiTrack V 120 Trioを用いて鉗子動態計測を開始している。R3年度は、18名の参加者に関して、カダバー腹腔鏡下腎摘除術の鉗子動態の測定を行った。
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2018/04 -2021/03 
    Author : Osawa Takahiro
     
    We validated a Japanese version of the bladder cancer index (BCI) as a tool for measuring health-related quality of life (HRQOL) in bladder cancer patients treated with various surgical procedures. In addition, we characterized health related quality of life (HRQOL) in Japanese patients after bladder cancer surgery and to perform cross-cultural comparison between Japanese and American patients. Although revisions are needed to make it easier for elderly patients to comprehend, we confirmed the reliability and validity of the Japanese BCI. The Japanese BCI could be used for cross-cultural assessments of HRQOL in bladder cancer patients. HRQOL outcomes following treatment of bladder cancer in Japan are comparable to those in the USA, except for sexual functioning and sexual bother. The BCI can be used for cross-cultural assessments of HRQOL in bladder cancer patients.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2017/04 -2020/03 
    Author : Abe Takashige
     
    We develop a wet-lab training model for learning laparoscopic surgical skills and evaluating learners’ competency level outside the operating room, using swine organs. 45 participants (experts [≧50 laparoscopic surgeries]: n=13, intermediates [11-49]: n=8, novices [0-10]: n=33) completed 3 tasks (Task 1: tissue dissection around aorta, Task 2: tissue dissection and divide renal artery, Task 3: renal parenchymal closure). Each performance was video-recorded and later evaluated by two experts, according to Global Operative Assessment of Laparoscopic Skills. We observed good construct validity in all 3 tasks. The subjective mental workload was also assessed (NASA Task Load Index [NASA-TLX]), and higher NASA-TLX scores were observed in novices. We also evaluated the validity of the laparoscopic radical nephrectomy module of the LapVision virtual reality simulator. 33 subjects performed training, and we observed good construct validities for the nephrectomy module.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2014/04 -2017/03 
    Author : Abe Takashige
     
    Using the relevant key words with minimum invasive surgeries, 540 records were identified in the database of the Japan Council for Quality Health Care. After data review and the classification of adverse events, 746 events associated with laparoscopic (laparo-group) and/or thoracoscopic (thoraco-group) surgery were identified. There were 582 events in the laparo-group, 159 in the thoraco-group, and 5 in those undergoing a combined surgery. Overall, injury of other organs, retention of a foreign body, breakage/failure of medical equipment or devices, massive bleeding, misperception of anatomy, and vascular injurywere frequently reported. There were marked differences in the frequency of injury of other organs, massive bleeding, and vascular injury.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2010 -2011 
    Author : ABE Takashige
     
    Study 1 : Fifty-one patients treated by nephroureterectomy were included. All had lymph nodes(LNs) and all LNs were negative on hematoxylin and eosin staining. We re-evaluated the presence of micrometastasis in LNs specimens by anti-cytokeratin immunohistochemistory. Immunohistochemistry identified micrometastases in 7(14%) of 51 patients. Study 2 : We prospectively evaluated the presence of micrometastasis in LNs in patients undergoing radical cystectomy or nephroureterectomy. Micrometastasis was detected in 9%(2/22) of patients undergoing radical cystectomy. Study 3 : We evaluated the association between the expression of VEGFC mRNA, VEGFD mRNA, or VEGF3R mRNA and pathological characteristic in primary tumors. We subsequently evaluated the lymph vascular density(LVD) in marginal zone of regional lymph nodes. The expression of VEGFC mRNA was higher in> pT2 disease than

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