Researcher Database

Takahiro Osawa
Hokkaido University Hospital Surgery
Lecturer

Researcher Profile and Settings

Affiliation

  • Hokkaido University Hospital Surgery

Job Title

  • Lecturer

J-Global ID

Research Areas

  • Life sciences / Urology

Educational Organization

Association Memberships

  • JAPAN SOCIETY OF CLINICAL ONCOLOGY   JAPANESE SOCIETY OF ENDOUROLOGY   THE JAPANESE UROLOGICAL ASSOCIATION   

Research Activities

Published Papers

  • Yuto Matsushita, Takahiro Kojima, Takahiro Osawa, Tomokazu Sazuka, Shingo Hatakeyama, Keisuke Goto, Kazuyuki Numakura, Kazutoshi Yamana, Shuya Kandori, Kazutoshi Fujita, Kosuke Ueda, Hajime Tanaka, Ryotaro Tomida, Toshifumi Kurahashi, Yukari Bando, Naotaka Nishiyama, Takahiro Kimura, Shimpei Yamashita, Hiroshi Kitamura, Hideaki Miyake
    International journal of urology : official journal of the Japanese Urological Association 31 (5) 526 - 533 2024/05 
    OBJECTIVES: This study aimed to assess the prognostic outcomes in mRCC patients receiving second-line TKI following first-line IO combination therapy. METHODS: This study retrospectively included 243 mRCC patients receiving second-line TKI after first-line IO combination therapy: nivolumab plus ipilimumab (n = 189, IO-IO group) and either pembrolizumab plus axitinib or avelumab plus axitinib (n = 54, IO-TKI group). Oncological outcomes between the two groups were compared, and prognostication systems were developed for these patients. RESULTS: In the IO-IO and IO-TKI groups, the objective response rates to second-line TKI were 34.4% and 25.9% (p = 0.26), the median PFS periods were 9.7 and 7.1 months (p = 0.79), and the median OS periods after the introduction of second-line TKI were 23.1 and 33.5 months (p = 0.93), respectively. Among the several factors examined, non-CCRCC, high CRP, and low albumin levels were identified as independent predictors of both poor PFS and OS by multivariate analyses. It was possible to precisely classify the patients into 3 risk groups regarding both PFS and OS according to the positive numbers of the independent prognostic factors. Furthermore, the c-indices of this study were superior to those of previous systems as follows: 0.75, 0.64, and 0.61 for PFS prediction and 0.76, 0.70, and 0.65 for OS prediction by the present, IMDC, and MSKCC systems, respectively. CONCLUSIONS: There were no significant differences in the prognostic outcomes after introducing second-line TKI between the IO-IO and IO-TKI groups, and the histopathology, CRP and albumin levels had independent impacts on the prognosis in mRCC patients receiving second-line TKI, irrespective of first-line IO combination therapies.
  • 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).
  • Takayuki Hirose, Kiyohiko Hotta, Takahiro Osawa, Isao Yokota, Tasuku Inao, Tatsu Tanabe, Naoya Iwahara, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 31 (5) 519 - 524 2024/01/19 
    OBJECTIVES: Previous studies suggested that living kidney donors do not have a higher risk of death or kidney failure than the general population. However, living kidney donor risk is controversial. Furthermore, only a few studies have evaluated long-term kidney function after kidney donation. METHODS: This study evaluated Japanese kidney donor' long-term outcomes, including mortality and kidney function. From 1965 to 2015, 230 donors (76 males, 154 females, and a median age of 54) were enrolled in this study. The median observation period was 11.0 (range, 0.3-41.0) years. RESULTS: In total, 215 donors were still alive, and 15 had died. Causes of death included malignancies, cardiovascular disease, pneumonia, suicide, gastrointestinal bleeding, and kidney failure. Actual donor survival rates at 10, 20, and 30 years were 95.3%, 90.7%, and 80.9%, respectively. These values were comparable to age- and gender-matched expected survival. Long-term kidney function after donation was evaluated in 211 donors with serum creatinine data. Two donors developed kidney failure 24 and 26 years post-donation, respectively. The percentage of donors whose estimated glomerular filtration rate (eGFR) remained ≥45 mL/min/1.73 m2 at 10, 20, and 30 years after donation were 84.2%, 73.0%, and 63.9%, respectively. Survival rates of donors with eGFR <45 mL/min/1.73 m2 were comparable to those in persons with eGFR >45 mL/min/1.73 m2 . CONCLUSION: Our findings revealed that kidney donors did not have a higher long-term risk of death than the general population. Although some donors showed decreased kidney function after donation, kidney function did not impact their survival.
  • Tomokazu Sazuka, Yuto Matsushita, Hiroaki Sato, Takahiro Osawa, Nobuyuki Hinata, Shingo Hatakeyama, Kazuyuki Numakura, Kosuke Ueda, Takahiro Kimura, Masayuki Takahashi, Hajime Tanaka, Yoshihide Kawasaki, Toshifumi Kurahashi, Takuma Kato, Kazutoshi Fujita, Makito Miyake, Takahiro Kojima, Hiroshi Kitamura, Hideaki Miyake, Tomohiko Ichikawa
    Scientific reports 13 (1) 20629 - 20629 2023/11/23 
    Immuno-oncology (IO) combination therapy is utilized as a first-line systemic treatment for advanced renal cell carcinoma. However, evidence supporting the use of cabozantinib after IO combination therapy is lacking. We retrospectively analyzed patients who received second-line cabozantinib after IO combination therapy using the Japanese Urological Oncology Group (JUOG) database. In total, 254 patients were enrolled in the JUOG global study, and 118 patients who received second-line cabozantinib comprised the study cohort. The objective response rate, disease control rate, second-line cabozantinib progression-free survival (PFS), and overall survival from second-line for overall were 32%, 75%, 10.5 months, and not reached, respectively, for first-line IO-IO therapy were 37%, 77%, 11.1 months, and not reached, respectively, versus 24%, 71%, 8.3 months, and not reached, respectively, for first-line IO-tyrosine kinase inhibitor therapy. In univariate and multivariate analyses, discontinuation of first-line treatment because of progressive disease and liver metastasis were independent risk factors for PFS. All-grade adverse events occurred in 72% of patients, and grade 3 or higher adverse events occurred in 28% of patients. Second line-cabozantinib after first-line IO combination therapy for advanced renal cell carcinoma was expected to be effective after either IO-IO or IO-TKI treatment and feasible in real-world practice.
  • 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 2023/11/16 
    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.
  • Juntaro Koyama, Shinichi Yamashita, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Kazuo Nishimura, Norio Nonomura, Hiroyuki Nishiyama, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Yoshimi Suzukamo, Akihiro Ito, Yoichi Arai
    International journal of urology : official journal of the Japanese Urological Association 30 (11) 1044 - 1050 2023/11 
    OBJECTIVE: To evaluate sexual function after treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 (EORTC QLQ-TC26) questionnaire in Japanese testicular cancer (TC) survivors in a multi-institutional, cross-sectional study. METHODS: This study enrolled TC survivors who visited any of eight high-volume institutions in Japan from 2018 to 2019. After obtaining informed consent, participants completed the EORTC QLQ-TC26 questionnaires. We evaluated sexual function after treatment for TC using the EORTC QLQ-TC26 and analyzed the impact of treatment on sexual function in TC survivors. RESULTS: A total of 567 TC survivors responded to the EORTC QLQ-TC26. Median age at the time of response was 43 years (interquartile range [IQR] 35-51 years), and median follow-up period after treatment was 5.2 years (IQR 2.2-10.0 years). Sexual function, particularly ejaculatory function, was significantly lower after post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) than after Surveillance or Chemotherapy groups (p < 0.05). In the PC-RPLND group, nerve-sparing procedure preserved postoperative ejaculatory function after RPLND compared with the non-nerve-sparing and offered improved ejaculatory function with time. On multivariate analysis, RPLND was a significant predictor of post-treatment ejaculatory dysfunction, particularly without nerve-sparing (odds ratio 3.0, 95% CI 1.2-7.7, p < 0.05). In addition, TC survivors with nerve-sparing RPLND had higher sexual activity than those without. CONCLUSION: This survey of the EORTC QLQ-TC26 showed that sexual function and activity in TC survivors after RPLND was reduced in the absence of nerve-sparing techniques.
  • Keita Minami, Takahiro Osawa, Takahiro Kojima, Tomohiko Hara, Masatoshi Eto, Ario Takeuchi, Yasutomo Nakai, Kosuke Ueda, Michinobu Ozawa, Motohide Uemura, Kojiro Ohba, Keita Tamura, Tetsuya Shindo, Hiroshi Nakagomi, Atsushi Takahashi, Satoshi Anai, Akira Yokomizo, Shuichi Morizane, Takahiro Kimura, Toru Shimazui, Yasuyuki Miyauchi, Koji Mitsuzuka, Hiroaki Hara, Koji Yoshimura, Hiroaki Shiina, Youichi M Ito, Sachiyo Murai, Hiroyuki Nishiyama, Nobuo Shinohara, Hiroshi Kitamura
    Urologic oncology 41 (11) 458.e9-458.e19  2023/11 
    OBJECTIVES: Limited information is currently available on the efficacy and safety of axitinib for metastatic renal cell carcinoma (mRCC) patients with renal impairment. Therefore, the present study investigated the efficacy and toxicity of axitinib in patients with chronic kidney disease. METHODS: Post-hoc analyses were performed on a Japanese multicenter cohort study of 477 mRCC patients who received axitinib followed by 1 or 2 regimens of systemic antiangiogenic therapy between January 2012 and December 2016. Differences in clinical characteristics and the efficacy and safety of axitinib were assessed based on pretreatment renal function. RESULTS: Patients were categorized into the following 5 renal function groups according to baseline renal function: estimated glomerular filtration rate (eGFR) ≥60 ml/min (n = 133), 45 ml/min ≤eGFR <60 ml/min (n = 153), 30 ml/min ≤eGFR< 45 ml/min (n = 130), eGFR <30 ml/min (n = 45), and dialysis (n = 16). Median progression-free survival (PFS) (95% confidence interval [CI]) in the 5 groups was 11 (8-16), 14 (11-19), 14 (10-19), 12 (8-24), and 6 (3-NR) months, respectively (p = 0.781). After adjustments for treatment-related confounders, the renal function group was not a significant prognostic factor for PFS. Objective response rates in the 5 groups were 22%, 23%, 23%, 18%, 20%, and 38%, respectively (p = 0.468). Regarding adverse events of all grades, hypertension (p = 0.0006) and renal and urinary disorders (p < 0.0001) were more frequently observed in the eGFR <30 ml/min group than in the other groups. CONCLUSIONS: Since renal function at the initiation of treatment with axitinib does not adversely affect the efficacy of VEGF-TKI therapy, clinicians do not need to avoid its administration to mRCC patients with impaired renal function in consideration of the risk of progression to end-stage renal disease.
  • 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
  • Takahiro Osawa, Yasuhisa Fujii, Go Kimura, Hiroshi Kitamura, Yoji Nagashima, Sakura Iizumi, Tsuyoshi Osaka, Ryoichi Tsubouchi, Nobuo Shinohara
    BMJ open 13 (7) e070275  2023/07/26 
    INTRODUCTION: Cabozantinib monotherapy is an option for treatment of advanced renal cell carcinoma (RCC). However, cabozantinib dose modification and discontinuation due to symptomatic adverse events (AEs) remains a challenge. The use of patient-reported outcomes (PROs) may help manage symptomatic AEs, which is reported to lead to improved quality of life (QOL), avoidance of drug discontinuation and better survival. This study aims to investigate the clinical benefits of PROs in patients with RCC receiving cabozantinib and the most appropriate medium for PRO monitoring (electronic [e]-PRO or paper-PRO). METHODS AND ANALYSIS: This study is being conducted at about 35 sites in Japan. Patients aged ≥18 years with unresectable or metastatic RCC initiating treatment with cabozantinib monotherapy are eligible and will be randomised to: (1) e-PRO monitoring, (2) paper-PRO monitoring or (3) usual care without PRO monitoring. Recruitment began in December 2021 (target sample size, 105). Patients start treatment with cabozantinib 60 mg once daily, and in the PRO groups, will record daily medication intake, weight, temperature, blood pressure and AEs. Endpoints include the proportion of patients with a ≥5-point deterioration on the Functional Assessment of Cancer Therapy-Kidney Cancer Symptom Index (FKSI-19; primary endpoint), progression-free survival, QOL, dose adjustments, relative dose intensity, treatment-emergent AEs and frequency of interventions for AEs outside of the scheduled visits. Patient and physician opinions of the PRO monitoring systems and patient compliance with e-PRO/paper-PRO input are also being measured. ETHICS AND DISSEMINATION: The study is being conducted in compliance with the Declaration of Helsinki, the International Council for Harmonisation guidelines for Good Clinical Practice and the Clinical Trials Act. Written informed consent is being obtained from all patients, and the protocol has been approved by the Hokkaido University Hospital Certified Review Board (approval number, CRB021-005). The results will be presented at conferences and submitted to a peer-reviewed journal. TRIAL REGISTRATION NUMBER: jRCTs011210055.
  • 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.
  • Kojiro Ohba, Keisuke Monji, Takahiro Osawa, Kazutoshi Yamana, Yosuke Yasuda, Hajime Tanaka, Yuki Nakagawa, Tamaki Fukuyama, Nobuaki Matsubara, Hirotsugu Uemura, Hideki Sakai, Masatoshi Eto
    International journal of urology : official journal of the Japanese Urological Association 2023/07/11 
    OBJECTIVES: Current prognostic models for metastatic renal cell carcinoma (mRCC) are likely inaccurate due to recent treatment advances and improved survival outcomes. The JEWEL study used a data set from patients who received tyrosine kinase inhibitors (TKIs) to explore the prognostic impact of the tumor immune environment in the absence of immune checkpoint inhibitor intervention. METHODS: The primary analysis population comprised 569 of the 770 Japanese patients enrolled in the ARCHERY study who received first-line TKIs. Multivariable Cox proportional hazard models were used to identify factors associated with the primary (overall survival [OS]) and secondary outcomes (treatment duration) using 34 candidate explanatory variables. RESULTS: Median OS was 34.1 months (95% CI, 30.4-37.6) in the primary analysis population. A considerable negative prognostic impact (descriptive p ≤ 0.0005) on OS was seen with lactate dehydrogenase (LDH) >1.5 × upper limit of normal (adjusted HR [aHR], 3.30; 95% CI, 2.19-4.98), Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 (aHR, 2.14; 95% CI, 1.56-2.94), World Health Organization (WHO)/International Society of Urological Pathology (ISUP) Grade 4 (aHR, 1.89; 95% CI, 1.43-2.51), C-reactive protein (CRP) level ≥0.3 (aHR, 1.78; 95% CI, 1.40-2.26), and age ≥75 years (aHR, 1.65; 95% CI, 1.24-2.18) in the multivariable analysis. PD-L1 and immunophenotype affected OS in univariable analyses but were not selected in the multivariable model as explanatory variables. CONCLUSIONS: JEWEL identified sex, age, ECOG PS, liver and bone metastases, CRP levels, WHO/ISUP grade, LDH, and albumin levels as key prognostic factors for OS after first-line TKI therapy for mRCC.
  • Takahiro Osawa, Mototsugu Oya, Tohru Okanishi, Ryohei Kuwatsuru, Haruna Kawano, Yoshihiko Tomita, Yo Niida, Norio Nonomura, Takashi Hatano, Yasuhisa Fujii, Masashi Mizuguchi, Nobuo Shinohara
    International journal of urology : official journal of the Japanese Urological Association 2023/06/06 
    New clinical issues have been raised through an interval of 7 years from the previous version (2016). In this study, we update the "Clinical Practice Guidelines for tuberous sclerosis complex-associated renal angiomyolipoma" as a 2023 version under guidance by the Japanese Urological Association. The present guidelines were cooperatively prepared by the Japanese Urological Association and Japanese Society of Tuberous Sclerosis Complex; committee members belonging to one of the two societies or specializing in the treatment of this disease were selected to prepare the guidelines in accordance with the "Guidance for preparing treatment guidelines" published by Minds (2020 version). The "Introduction" consisted of four sections, "Background Questions (BQ)" consisted of four sections, "Clinical Questions (CQ)" consisted of three sections, and "Future Questions (FQ)" consisted of three sections (total: 14 sections). Concerning CQ, an agreement was confirmed through voting by the committee members based on the direction and strength of recommendation, accuracy of evidence, and recommendation comments. The present guidelines were updated based on the current evidence. We hope that the guidelines will provide guiding principles for the treatment of tuberous sclerosis complex-associated renal angiomyolipoma to many urologists, becoming a foundation for subsequent updating.
  • Sumanta Kumar Pal, Laurence Albiges, Piotr Tomczak, Cristina Suárez, Martin H Voss, Guillermo de Velasco, Jad Chahoud, Anastasia Mochalova, Giuseppe Procopio, Hakim Mahammedi, Friedemann Zengerling, Chan Kim, Takahiro Osawa, Martín Angel, Suyasha Gupta, Omara Khan, Guillaume Bergthold, Bo Liu, Melania Kalaitzidou, Mahrukh Huseni, Christian Scheffold, Thomas Powles, Toni K Choueiri
    Lancet (London, England) 2023/06/02 
    BACKGROUND: Immune checkpoint inhibitors are the standard of care for first-line treatment of patients with metastatic renal cell carcinoma, yet optimised treatment of patients whose disease progresses after these therapies is unknown. The aim of this study was to determine whether adding atezolizumab to cabozantinib delayed disease progression and prolonged survival in patients with disease progression on or after previous immune checkpoint inhibitor treatment. METHODS: CONTACT-03 was a multicentre, randomised, open-label, phase 3 trial, done in 135 study sites in 15 countries in Asia, Europe, North America, and South America. Patients aged 18 years or older with locally advanced or metastatic renal cell carcinoma whose disease had progressed with immune checkpoint inhibitors were randomly assigned (1:1) to receive atezolizumab (1200 mg intravenously every 3 weeks) plus cabozantinib (60 mg orally once daily) or cabozantinib alone. Randomisation was done through an interactive voice-response or web-response system in permuted blocks (block size four) and stratified by International Metastatic Renal Cell Carcinoma Database Consortium risk group, line of previous immune checkpoint inhibitor therapy, and renal cell carcinoma histology. The two primary endpoints were progression-free survival per blinded independent central review and overall survival. The primary endpoints were assessed in the intention-to-treat population and safety was assessed in all patients who received at least one dose of study drug. The trial is registered with ClinicalTrials.gov, NCT04338269, and is closed to further accrual. FINDINGS: From July 28, 2020, to Dec 27, 2021, 692 patients were screened for eligibility, 522 of whom were assigned to receive atezolizumab-cabozantinib (263 patients) or cabozantinib (259 patients). 401 (77%) patients were male and 121 (23%) patients were female. At data cutoff (Jan 3, 2023), median follow-up was 15·2 months (IQR 10·7-19·3). 171 (65%) patients receiving atezolizumab-cabozantinib and 166 (64%) patients receiving cabozantinib had disease progression per central review or died. Median progression-free survival was 10·6 months (95% CI 9·8-12·3) with atezolizumab-cabozantinib and 10·8 months (10·0-12·5) with cabozantinib (hazard ratio [HR] for disease progression or death 1·03 [95% CI 0·83-1·28]; p=0·78). 89 (34%) patients in the atezolizumab-cabozantinib group and 87 (34%) in the cabozantinib group died. Median overall survival was 25·7 months (95% CI 21·5-not evaluable) with atezolizumab-cabozantinib and was not evaluable (21·1-not evaluable) with cabozantinib (HR for death 0·94 [95% CI 0·70-1·27]; p=0·69). Serious adverse events occurred in 126 (48%) of 262 patients treated with atezolizumab-cabozantinib and 84 (33%) of 256 patients treated with cabozantinib; adverse events leading to death occurred in 17 (6%) patients in the atezolizumab-cabozantinib group and nine (4%) in the cabozantinib group. INTERPRETATION: The addition of atezolizumab to cabozantinib did not improve clinical outcomes and led to increased toxicity. These results should discourage sequential use of immune checkpoint inhibitors in patients with renal cell carcinoma outside of clinical trials. FUNDING: F Hoffmann-La Roche and Exelixis.
  • Junji Yonese, Nobuyuki Hinata, Satoru Masui, Yasutomo Nakai, Suguru Shirotake, Ario Takeuchi, Teruo Inamoto, Masahiro Nozawa, Kosuke Ueda, Toru Etsunaga, Takahiro Osawa, Motohide Uemura, Go Kimura, Kazuyuki Numakura, Kazutoshi Yamana, Hideaki Miyake, Satoshi Fukasawa, Naoto Morishima, Hiroaki Ito, Hirotsugu Uemura
    International journal of urology : official journal of the Japanese Urological Association 30 (9) 762 - 771 2023/05/29 
    OBJECTIVES: To examine the long-term effectiveness of nivolumab monotherapy and following subsequent therapies for metastatic renal cell carcinoma (mRCC) in Japanese real-world settings. METHODS: This was a multicenter, retrospective, observational study, with a 36-month follow-up, and conducted in Japanese patients with mRCC who initiated nivolumab monotherapy between 1 Feb 2017 and 31 Oct 2017. Endpoints included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). RESULTS: Of the 208 patients, 36.5% received nivolumab monotherapy as second-line, 30.8% as third-line, and 31.7% as fourth- or later-line therapy. By 36 months, 12.0% of patients continued nivolumab monotherapy; 88.0% discontinued, mainly because of disease progression (66.7%). The median (m) OS was not reached irrespective of treatment line, with a 36-month OS rate of 54.3% (second-line, 57.4%; third-line, 52.6%; fourth- or later-line, 52.9%). The ORR was 24.2% and five patients achieved complete response. The OS from first-line therapy was 8.9 years. In the 95 patients receiving therapy after nivolumab, 87.4% received vascular endothelial growth factor receptor-tyrosine kinase inhibitors, with mOS and mPFS of 27.4 and 8.1 months, respectively. Irrespective of treatment line, the mOS was not reached in patients with International Metastatic RCC Database Consortium (IMDC) favorable or intermediate risk at mRCC diagnosis. CONCLUSIONS: This 36-month real-world follow-up analysis showed a survival benefit of nivolumab monotherapy for patients with mRCC. The long-term effectiveness of sequential therapy from first-line therapy to therapy after nivolumab was also demonstrated. Additionally, nivolumab monotherapy was beneficial for patients with favorable IMDC risk at the time of mRCC diagnosis.
  • Kanako Hagio, Junko Kikuchi, Kohichi Takada, Hiroki Tanabe, Minako Sugiyama, Yoshihito Ohhara, Toraji Amano, Satoshi Yuki, Yoshito Komatsu, Takahiro Osawa, Kanako C Hatanaka, Yutaka Hatanaka, Takashi Mitamura, Ichiro Yabe, Yoshihiro Matsuno, Atsushi Manabe, Akihiro Sakurai, Atsushi Ishiguro, Masato Takahashi, Hiroshi Yokouchi, Hirohito Naruse, Yusuke Mizukami, Hirotoshi Dosaka-Akita, Ichiro Kinoshita
    Cancer science 114 (8) 3385 - 3395 2023/05/19 
    Comprehensive genomic profiling (CGP) tests have been covered by public insurance in Japan for patients with advanced solid tumors who have completed or are completing standard treatments or do not have them. Therefore, genotype-matched drug candidates are often unapproved or off-label, and improving clinical trial access is critical, involving the appropriate timing of CGP tests. To address this issue, we analyzed the previous treatment data for 441 patients from an observational study on CGP tests discussed by the expert panel at Hokkaido University Hospital between August 2019 and May 2021. The median number of previous treatment lines was two; three or more lines accounted for 49%. Information on genotype-matched therapies was provided to 277 (63%). Genotype-matched clinical trials were ineligible because of an excess number of previous treatment lines or use of specific agents were found in 66 (15%) patients, with the highest proportion in breast and prostate cancers. Many patients met the exclusion criteria of one to two or more treatment lines across cancer types. In addition, previous use of specific agents was a frequent exclusion criterion for breast, prostate, colorectal, and ovarian cancers. The patients with tumor types with a low median number (two or fewer) of previous treatment lines, including most rare cancers, primary unknown cancers, and pancreatic cancers, had significantly fewer ineligible clinical trials. The earlier timing of CGP tests may improve access to genotype-matched clinical trials, with their proportion varying by cancer type. Each relevant society needs to advocate the desirable timing of CGP testing nationwide.
  • 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
  • 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
  • 免疫チェックポイント阻害薬併用放射線治療による膀胱温存療法の奏功性におけるPD-L1発現の意義 多施設単群第II相試験(The impact of PD-L1 status on treatment response to bladder preservation with immunoradio-therapy for bladder cancer: A single-arm, multicenter, phase II trial)
    松岡 陽, 影山 幸雄, 木村 友和, 南雲 義之, 川合 剛人, 東 治人, 内木 拓, 小林 泰之, 猪口 淳一, 大澤 崇宏, 北 悠希, 都築 豊徳, 西山 博之
    日本泌尿器科学会総会 110回 OP30 - 05 2023/04
  • Noboru Nakaigawa, Yoshihiko Tomita, Satoshi Tamada, Katsunori Tatsugami, Takahiro Osawa, Mototsugu Oya, Hiroomi Kanayama, Yuji Miura, Naoto Sassa, Kazuo Nishimura, Masahiro Nozawa, Naoya Masumori, Yasuhide Miyoshi, Shingo Kuroda, Akiko Kimura
    International journal of clinical oncology 28 (3) 416 - 426 2023/01/03 
    BACKGROUND: Cabozantinib was established as the standard of care for the treatment of patients with renal cell carcinoma (RCC) whose disease had progressed after vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) therapy in the global randomized trial METEOR. A phase 2 study was conducted to bridge the findings in METEOR to Japanese patients. Here, we report a biomarker analysis and update the efficacy and safety results of cabozantinib treatment. METHODS: Japanese patients with RCC who received at least one prior VEGFR-TKI were enrolled and received cabozantinib 60 mg orally once daily. The primary endpoint was objective response rate. Secondary endpoints included progression-free survival, overall survival, and safety. Exploratory analyses included the relationship between plasma protein hepatocyte growth factor (HGF) levels and treatment responses. RESULTS: In total, 35 patients were enrolled. The median treatment duration was 58.3 (range 5.1-131.4) weeks. The objective response rate was 25.7% (90% confidence interval [CI] 14.1-40.6). Kaplan-Meier estimate of median progression-free survival was 11.1 months (95% CI 7.4-18.4). The estimated progression-free survival proportion was 73.1% (95% CI 54.6-85.0) at 6 months. Median overall survival was not reached. Adverse events were consistent with those in METEOR and the safety profile was acceptable. Nonresponders to cabozantinib showed relatively higher HGF levels than responders at baseline. CONCLUSIONS: Updated analyses demonstrate the long-term efficacy and safety of cabozantinib in Japanese patients with advanced RCC after at least one VEGFR-TKI therapy. Responders tended to show lower baseline HGF levels ClinicalTrials.gov Identifier: NCT03339219.
  • Conor Chandler, Heather Burnett, Kassandra Schaible, Vishnu Senthil, Masafumi Kato, Yuji Miura, Takahiro Osawa, Hiroji Uemura, Hiroyo Kuwabara
    Journal of medical economics 26 (1) 1009 - 1018 2023 
    AIMS: The treatment landscape of renal cell carcinoma has changed with the introduction of targeted therapies. While the clinical benefit of cabozantinib is well-established for Japanese patients who have received prior treatment, the economic benefit remains unclear. The objective of this study was to assess the cost-effectiveness of cabozantinib compared with everolimus, axitinib, and nivolumab in patients with advanced renal cell carcinoma who have failed at least one prior therapy in Japan. METHODS: A cost-effectiveness model was developed using a partitioned survival approach and a public healthcare payer's perspective. Over a lifetime horizon, clinical and economic implications were estimated according to a three-health-state structure: progression-free, post-progression, and death. Key clinical inputs and utilities were derived from the METEOR trial, and a de novo network meta-analysis and cost data were obtained from publicly available Japanese data sources. Costs, quality-adjusted life-years, and incremental cost-effectiveness ratios were estimated. Costs and health benefits were discounted annually at 2%. RESULTS: Cabozantinib was more costly and effective compared with everolimus and axitinib, with deterministic incremental cost-effectiveness ratios of \5,375,559 and \2,223,138, respectively. Compared to nivolumab, cabozantinib was predicted to be less costly and more effective. Sensitivity and scenario analyses demonstrated that the key drivers of cost-effectiveness results were the estimation of overall survival and treatment duration, relative efficacy, drug costs, and subsequent treatment costs. LIMITATIONS: METEOR was an international trial but did not enroll any patients from Japan. Efficacy and safety data from METEOR were used as a proxy for the Japanese population following validation by clinical experts, and alternative assumptions specific to clinical practice in Japan were evaluated in scenario analyses. CONCLUSIONS: In Japan, cabozantinib is a cost-effective alternative to everolimus, axitinib, and nivolumab for the treatment of patients with advanced renal cell carcinoma who have received at least one prior line of therapy.
  • 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
  • Yuki Munekata, Saki Yamamoto, Shun Kato, Yutaro Kitagawa, Ken Enda, Nanase Okazaki, Satoshi Tanikawa, Zen Ichi Tanei, Yohei Ikebe, Takahiro Osawa, Soichiro Takamiya, Hideki Ujiie, Masahiro Onozawa, Satoshi Hirano, Miki Fujimura, Shinya Tanaka
    Autopsy and Case Reports 13 2023 
    We report a fatal subdural empyema caused by Campylobacter rectus in a 66-year-old female who developed acute onset of confusion, dysarthria, and paresis in her left extremities. A CT scan showed hypodensity in a crescentic formation with a mild mid-line shift. She had a bruise on her forehead caused by a fall several days before admission, which initially raised subdural hematoma (SDH) diagnosis, and a burr hole procedure was planned. However, her condition deteriorated on the admission night, and she died before dawn. An autopsy revealed that she had subdural empyema (SDE) caused by Campylobacter rectus and Slackia exigua. Both microorganisms are oral microorganisms that rarely cause extra-oral infection. In our case, head trauma caused a skull bone fracture, and sinus infection might have expanded to the subdural space causing SDE. CT/MRI findings were not typical for either SDH or SDE. Early recognition of subdural empyema and prompt initiation of treatment with antibiotics and surgical drainage is essential for cases of SDE. We present our case and a review of four reported cases.
  • 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 [Refereed]
     
    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.
  • Kunihisa Nezu, Shinichi Yamashita, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Kazuo Nishimura, Norio Nonomura, Hiromitsu Negoro, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Yoshimi Suzukamo, Akihiro Ito, Yoichi Arai
    International journal of urology : official journal of the Japanese Urological Association 29 (12) 1526 - 1534 2022/12 
    OBJECTIVES: Most testicular cancer (TC) survivors have long-term survival. However, the association between financial toxicity (FT), which is an economic side effect of cancer treatment, and the quality of life (QOL) of TC survivors is still unclear. Thus, the impact of FT on the QOL of TC survivors was examined in a multi-institutional cross-sectional study. METHODS: We recruited TC survivors from eight high-volume institutions in Japan between January 2018 and March 2019. A total of 562 participants completed the EORTC QLQ-C30, EORTC QLQ-TC26 and the questionnaires on demographics, including annual income. Financial difficulty in the EORTC QLQ-C30 and low income were used to assess financial distress (FD) and financial burden (FB), respectively. FT was defined as FD and FB. The QOL scores were compared, and a multivariate logistic regression analysis for FT was performed. RESULTS: With severe FD, TC survivors had more treatment side effects, physical limitations, and anxiety concerning employment and future. The TC survivors who reported low income were worried about their jobs and the future. The QOL of the survivors with FT exhibited high impairment, except for sexual activity. In particular, the TC survivors with FT were physically limited and anxious concerning the future. The multivariate logistic regression analysis revealed that four or more chemotherapy cycles were substantial risk factors for FT (4 cycles, odds ratio (OR) = 4.17; ≥5 cycles, OR = 6.96). CONCLUSIONS: TC survivors who received multi-cycle chemotherapy were prone to experience FT, resulting in a decline in their health-related QOL.
  • 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 : official journal of the Japanese Urological Association 30 (2) 147 - 154 2022/10/28 
    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.
  • 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 (一社)日本泌尿器科学会 113 (4) 134 - 138 0021-5287 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)
  • 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 (一社)日本泌尿器科学会 113 (4) 134 - 138 0021-5287 2022/10
  • Toyonori Tsuzuki, Chisato Ohe, Takahiro Osawa, Yosuke Yasuda, Toshiaki Tanaka, Satoshi Anai, Go Kimura, Kazutoshi Yamana, Shingo Hatakeyama, Takuya Yoshimoto, Yuki Nakagawa, Tamaki Fukuyama, Nobuaki Matsubara, Hirotsugu Uemura
    Pathology 55 (1) 31 - 39 2022/09 [Refereed]
     
    Studies have reported the relevance of immune phenotype, or presence of cluster of differentiation 8 (CD8)-positive tumour-infiltrating lymphocytes, to the anti-tumour efficacy of checkpoint inhibitors and to prognosis. The multicentre, retrospective ARCHERY study (UMIN000034131) collected tissue samples from Japanese patients with recurrent or metastatic renal cell carcinoma (RCC) who received systemic therapy between 2010 and 2015. In this exploratory analysis, the prognostic impact of immune phenotype and PD-L1 expression (separately and combined) was investigated using 770 surgical specimens and outcomes from patients enrolled in ARCHERY. A key objective was to determine overall survival (OS), defined as time from nephrectomy to death from any cause, by immune and PD-L1 subgroups. The median OS by immune phenotype was 28.8, 57.3, and 63.4 months in patients with inflamed, excluded, and desert tumours, respectively [hazard ratio (95% CI): inflamed 1.78 (1.27-2.49); excluded 1.08 (0.89-1.30); desert as reference]. PD-L1 positivity by SP142 showed a strong association with immune phenotype; 88.1%, 61.9%, and 8.7% of PD-L1-positive patients had inflamed, excluded, and desert phenotypes, respectively. PD-L1 positivity was also associated with worse OS in each phenotype, except for the inflamed phenotype (due to limited sample size in the PD-L1-negative immune inflamed subgroup; n=7). Additionally, the difference in OS by PD-L1 status was larger in the desert versus excluded phenotype [median OS in PD-L1 positive vs negative: 27.1 vs 67.2 months (desert), and 48.2 vs 78.1 months (excluded)]. Results show that PD-L1 expression was highly associated with immune phenotype, but both covariates should be evaluated when determining prognosis.
  • Yusuke Yamagata, Takashige Abe, Naoya Iwahara, Kohichi Takada, Yasuhiro Hida, Emi Takakuwa, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    IJU Case Reports 5 (6) 446 - 450 2577-171X 2022/07/29 
    INTRODUCTION: We report a case of laparoscopic adrenalectomy in a salvage setting after multiple chemotherapies for neuroendocrine carcinoma. CASE PRESENTATION: A 49-year-old man was diagnosed with unknown primary carcinoma with single brain metastasis, and right supraclavicular and mediastinal lymph node metastases. After stereotactic radiotherapy of the brain metastasis and systemic chemotherapy, lymphadanectomy was performed. The pathologic diagnosis was neuroendocrine carcinoma. At 11 months after surgery, computed tomography revealed right adrenal metastasis. Local radiotherapy initially resulted in complete remission. However, adrenal recurrence was noted 10 months later. Laparoscopic adrenalectomy was performed with curative intent. The patient is currently alive without recurrence at 20 months after the operation. CONCLUSION: Adrenalectomy can become a treatment option if other metastases are well-controlled with systemic therapy. Surgical elimination of oligometastases can offer long-term disease control in selected patients as part of a multimodal approach.
  • 外科教育の実践とキャリア 当科で行ってきた手術シミュレーショントレーニングの経験
    安部 崇重, 今 雅史, 樋口 まどか, 菊地 央, 岩原 直也, 古御堂 純, 堀田 記世彦, 松本 隆児, 大澤 崇宏, 篠原 信雄
    医学教育 (一社)日本医学教育学会 53 (Suppl.) 26 - 26 0386-9644 2022/07
  • 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄
    泌尿器外科 医学図書出版(株) 35 (臨増) 670 - 671 0914-6180 2022/07
  • 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄
    泌尿器外科 医学図書出版(株) 35 (臨増) 716 - 716 0914-6180 2022/07
  • 安部 崇重, 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) 35 (臨増) 749 - 750 0914-6180 2022/07
  • 武田 浩貴, 松本 隆児, 堀 寛太, 森口 卓哉, 菊池 央, 大澤 崇宏, 安部 崇重, 高桑 恵美, 篠原 信雄
    泌尿器外科 医学図書出版(株) 35 (臨増) 829 - 829 0914-6180 2022/07
  • 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.
  • 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 2022/05/21 
    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.
  • Kazuyuki Numakura, Yasutomo Nakai, Takahiro Kojima, Takahiro Osawa, Shintaro Narita, Masashi Nakayama, Hiroshi Kitamura, Hiroyuki Nishiyama, Nobuo Shinohara
    Japanese journal of clinical oncology 52 (7) 657 - 673 2022/04/10 
    The rapidly increasing pool of older patients being diagnosed with and surviving their cancer is creating many challenges. Regarding localized renal cell carcinoma, surgery is considered as gold standard treatment options even in older men, whereas active surveillance and ablation therapy are alternative options for a proportion of these patients. With regard to advanced disease, anti-vascular endothelial growth factor tyrosine kinase inhibitors (VEGFR-TKI) and immune check point inhibitor are standard treatment modalities, although treatment choice from multiple regimens and prevention of adverse events need to be considered. Better assessment techniques, such as comprehensive geriatric assessment to meet the unique needs of older patients, are a central focus in the delivery of high-quality geriatric oncology care. Through this process, shared decision-making should be adopted in clinical care to achieve optimal goals of care that reflect patient and caregiver hopes, needs and preferences. It is necessary to continue investigating oncological outcomes and complications associated with treatment in this population to ensure appropriate cancer care. In this narrative review, we completed a literature review of the various treatments for renal cell carcinoma in older patients that aimed to identify the current evidence related to the full range of the treatments including active surveillance, surgery, ablation therapy and systemic therapy. Prospectively designed studies and studies regarding geriatric assessment were preferentially added as references. Our goals were to summarize the real-world evidence and provide a decision framework that guides better cancer practices for older patients with renal cell carcinoma.
  • 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 2022/04/08 
    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 ([Formula: see text]), and PCA-SVR in the parenchymal-suturing task ([Formula: see text]), 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.
  • 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.
  • 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.
  • 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.
  • Yoshiyuki Nagumo, Mizuki Onozawa, Takahiro Kojima, Naoki Terada, Masaki Shiota, Koji Mitsuzuka, Hiroaki Yasumoto, Hiroaki Matsumoto, Hideki Enokida, Takayuki Sugiyama, Kentaro Kuroiwa, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Ken‐ichi Tabata, Atsushi Takahashi, Mikio Sugimoto, Hiroshi Kitamura, Toshiyuki Kamoto, Hiroyuki Nishiyama, Toru Shimazui, Takahiro Inoue, Takayuki Goto, Yasuhiro Hashimoto, Ryotaro Tomida, Toshihiko Sakurai, Kohei Hashimoto, Sadafumi Kawamura, Shogo Teraoka, Shinichi Sakamoto, Takahiro Kimura, Manabu Kamiyama, Shintaro Narita, Nobumichi Tanaka, Takuma Kato, Masashi Kato, Takahiro Osawa
    International Journal of Urology 29 (5) 398 - 405 2022/01/25 
    OBJECTIVE: To determine the effect of combined androgen blockade with a first-generation anti-androgen on the prognoses of metastatic hormone-sensitive prostate cancer patients stratified by tumor burden. METHODS: We retrospectively analyzed the cases of metastatic hormone-sensitive prostate cancer patients who were treated with androgen deprivation therapy in 2008-2017 at 30 institutions in Japan. To compare the overall survival and progression-free survival rates of the patients treated with castration monotherapy and combined androgen blockade, we carried out a Cox proportional hazards regression analysis using both inverse probability of treatment weighting and instrumental variables methods. High-burden disease was defined as the presence of four or more bone metastases and/or visceral metastasis. RESULTS: Of 2048 patients, 702 (34.3%) and 1346 (65.7%) patients were classified as the low- and high-burden groups, respectively. In each group, >80% of the patients were treated with combined androgen blockade. Although there was no significant between-group difference in the overall survival according to the androgen deprivation therapy method, in the high-burden group the progression-free survival of the combined androgen blockade-treated patients was significantly better than that of patients treated with castration monotherapy: inverse probability of treatment weighting method, hazard ratio 0.49, 95% confidence interval 0.34-0.71; instrumental variables method, hazard ratio 0.80, 95% confidence interval 0.60-0.98. CONCLUSION: In the high-burden group, combined androgen blockade with a first-generation anti-androgen resulted in superior progression-free survival compared with castration monotherapy. For well-selected metastatic hormone-sensitive prostate cancer patients, the use of combined androgen blockade might still have some suitable scenarios.
  • 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.
  • 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
  • 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.
  • 腎移植後6年で発症した転移性膀胱癌の治療経験
    田邉 起, 大澤 崇宏, 堀田 記世彦, 岩見 大基, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄
    日本泌尿器科学会雑誌 (一社)日本泌尿器科学会 113 (1) 37 - 41 0021-5287 2022/01 
    症例は54歳女性,原疾患不明の慢性腎不全に対して献腎移植を施行され腎機能は安定していた.移植後6年で膀胱刺激症状を契機に膀胱右側の筋層浸潤性膀胱癌が判明し肺転移も伴っていた.StageIV膀胱癌として免疫抑制剤を減量しゲムシタビン・シスプラチン療法を開始したところ,4コース後に転移巣が消失した.新規病変を認めなかったため開放手術にて右腎尿管膀胱全摘術および回腸導管造設を行った.摘出標本で左尿管断端に上皮内癌病変を認めたため,2ヵ月後に残存した左固有腎尿管に対して鏡視下で腎尿管全摘術を施行したが,悪性所見は認めなかった.Surgical CRとして無治療経過観察としたが,術後半年で多発肺転移が出現した.ゲムシタビン・カルボプラチン療法を導入し,4コース終了までは肺転移がやや縮小したが,5コース終了後は増悪を認めていた.追加治療を希望せず緩和治療へ移行となり膀胱全摘後1年9ヵ月で癌死した.腎移植後であっても膀胱全摘および尿路変向手術は可能で,免疫抑制剤の調整により化学療法も完遂できた.腎移植後の進行性膀胱癌にエビデンスのある治療方針はなく,腎機能障害を有し免疫抑制状態であることを認識し,個々の症例で適切な薬物治療や外科的治療の選択をする必要がある.(著者抄録)
  • 腎移植後6年で発症した転移性膀胱癌の治療経験
    田邉 起, 大澤 崇宏, 堀田 記世彦, 岩見 大基, 菊地 央, 松本 隆児, 安部 崇重, 篠原 信雄
    日本泌尿器科学会雑誌 (一社)日本泌尿器科学会 113 (1) 37 - 41 0021-5287 2022/01 
    症例は54歳女性,原疾患不明の慢性腎不全に対して献腎移植を施行され腎機能は安定していた.移植後6年で膀胱刺激症状を契機に膀胱右側の筋層浸潤性膀胱癌が判明し肺転移も伴っていた.StageIV膀胱癌として免疫抑制剤を減量しゲムシタビン・シスプラチン療法を開始したところ,4コース後に転移巣が消失した.新規病変を認めなかったため開放手術にて右腎尿管膀胱全摘術および回腸導管造設を行った.摘出標本で左尿管断端に上皮内癌病変を認めたため,2ヵ月後に残存した左固有腎尿管に対して鏡視下で腎尿管全摘術を施行したが,悪性所見は認めなかった.Surgical CRとして無治療経過観察としたが,術後半年で多発肺転移が出現した.ゲムシタビン・カルボプラチン療法を導入し,4コース終了までは肺転移がやや縮小したが,5コース終了後は増悪を認めていた.追加治療を希望せず緩和治療へ移行となり膀胱全摘後1年9ヵ月で癌死した.腎移植後であっても膀胱全摘および尿路変向手術は可能で,免疫抑制剤の調整により化学療法も完遂できた.腎移植後の進行性膀胱癌にエビデンスのある治療方針はなく,腎機能障害を有し免疫抑制状態であることを認識し,個々の症例で適切な薬物治療や外科的治療の選択をする必要がある.(著者抄録)
  • 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.
  • 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.
  • 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.
  • 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.
  • 生体腎移植ドナーの長期生命予後と腎機能推移の検討
    堀田 記世彦, 大澤 崇宏, 横田 勲, 稲尾 翼, 田邉 起, 岩原 直也, 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 109回 OP56 - 07 2021/12
  • 篤志献体を用いた腹腔鏡下根治的腎摘除術トレーニングの経験
    安部 崇重, 今 雅史, 岩原 直也, 古御堂 純, 樋口 まどか, 菊地 央, 堀田 記世彦, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 35回 V - 5 2021/11
  • ロボット支援腹腔鏡下前立腺全摘除術における神経温存症例の治療成績
    宮田 孟, 松本 隆児, 山形 優友, 武田 浩貴, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 35回 O - 10 2021/11
  • 篤志献体を用いた腹腔鏡下根治的腎摘除術トレーニングの経験
    安部 崇重, 今 雅史, 岩原 直也, 古御堂 純, 樋口 まどか, 菊地 央, 堀田 記世彦, 松本 隆児, 大澤 崇宏, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 35回 V - 5 2021/11
  • ロボット支援腹腔鏡下前立腺全摘除術における神経温存症例の治療成績
    宮田 孟, 松本 隆児, 山形 優友, 武田 浩貴, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 35回 O - 10 2021/11
  • Shinichi Yamashita, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Shigeyuki Yamada, Kazuo Nishimura, Norio Nonomura, Kosuke Kojo, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Yoshimi Suzukamo, Akihiro Ito, Yoichi Arai
    International journal of urology : official journal of the Japanese Urological Association 28 (10) 1047 - 1052 2021/10 
    OBJECTIVE: To evaluate fertility and use of reproductive technology of testicular cancer survivors in a multi-institutional, cross-sectional study. METHODS: This study recruited testicular cancer survivors who were followed after treatment for testicular cancer at eight high-volume institutions between 2018 and 2019. The participants completed the questionnaires on marital status, fertility and use of reproductive technology. RESULTS: A total of 567 testicular cancer survivors, with a median age of 43 years, responded to the questionnaire. Chemotherapy was given to 398 survivors, including three cycles of cisplatin-based chemotherapy in 106 patients and four cycles in 147 patients. Among 153 survivors who attempted sperm cryopreservation, 133 (87%) could preserve sperm. Of the 28 survivors whose cryopreserved sperm was used, 17 (61%) fathered children. Of the 72 survivors who fathered children without the use of cryopreserved sperm, 59 (82%) fathered naturally. Whereas 33 (20%) of 169 survivors treated without chemotherapy fathered children without using cryopreserved sperm, 39 (10%) of 398 treated with chemotherapy fathered children (P < 0.05). Furthermore, the paternity rate was 12% and 5% in testicular cancer survivors with three and four cycles of cisplatin-based chemotherapy, respectively (P < 0.05). However, of 121 survivors who wanted to have children, 14 (12%) received counseling about infertility treatment. CONCLUSIONS: Testicular cancer survivors preserving their sperm have a higher paternity rate after chemotherapy, especially after four cycles, than those not using cryopreserved sperm. Physicians who give chemotherapy for testicular cancer need to take particular care not only with respect to recurrence of testicular cancer, but also to post-treatment fertility.
  • 生体腎移植ドナーの腎機能と透析導入リスク 生体腎移植ドナーの長期生命予後と腎機能推移の検討
    堀田 記世彦, 大澤 崇宏, 横田 勲, 稲尾 翼, 田邉 起, 岩原 直也, 篠原 信雄
    移植 (一社)日本移植学会 56 (総会臨時) SSY2 - 4 0578-7947 2021/09
  • 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.
  • 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 2021/08 
    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.
  • 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) 4417 - 4417 2021/08
  • Masaki Shiota, Naoki Terada, Hiroshi Kitamura, Takahiro Kojima, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Takayuki Goto, Sadafumi Kawamura, Yasuhiro Hashimoto, Atsushi Takahashi, Takahiro Kimura, Ken-Ichi Tabata, Ryotaro Tomida, Kohei Hashimoto, Toshihiko Sakurai, Toru Shimazui, Shinichi Sakamoto, Manabu Kamiyama, Nobumichi Tanaka, Koji Mitsuzuka, Takuma Kato, Shintaro Narita, Hiroaki Yasumoto, Shogo Teraoka, Masashi Kato, Takahiro Osawa, Yoshiyuki Nagumo, Hiroaki Matsumoto, Hideki Enokida, Takayuki Sugiyama, Kentaro Kuroiwa, Takahiro Inoue, Mikio Sugimoto, Takashi Mizowaki, Toshiyuki Kamoto, Hiroyuki Nishiyama, Masatoshi Eto
    Cancer science 112 (9) 3616 - 3626 2021/06/19 
    The metastatic burden is a critical factor for decision-making in the treatment of metastatic hormone-sensitive prostate cancer (HSPC). This study aimed to develop and validate a novel risk model for survival in patients with de novo low- and high-burden metastatic HSPC. The retrospective observational study included men with de novo metastatic prostate cancer who were treated with primary androgen-deprivation therapy at 30 institutions across Japan between 2008 and 2017. We created a risk model for overall survival (OS) in the discovery cohort (n = 1449) stratified by the metastatic burden (low vs high) and validated its predictive ability in a separate cohort (n = 951). Based on multivariate analyses, lower hemoglobin levels, higher Gleason grades, and higher clinical T-stage were associated with poor OS in low-burden disease. Meanwhile, lower hemoglobin levels, higher Gleason grade group, liver metastasis, and higher extent of disease scores in bone were associated with poor OS in patients with high-burden disease. In the discovery and validation cohorts, the risk model using the aforementioned parameters exhibited excellent discriminatory ability for progression-free survival and OS. The predictive ability of this risk model was superior to that of previous risk models. Our novel metastatic burden-stratified risk model exhibited excellent predictive ability for OS, and it is expected to have several clinical uses, such as precise prognostic estimation.
  • Yasutomo Nakai, Ario Takeuchi, Takahiro Osawa, Takahiro Kojima, Tomohiko Hara, Mikio Sugimoto, Masatoshi Eto, Keita Minami, Kosuke Ueda, Michinobu Ozawa, Motohide Uemura, Yasuyuki Miyauchi, Kojiro Ohba, Akira Kashiwagi, Masaya Murakami, Tomokazu Sazuka, Hiroaki Yasumoto, Shuichi Morizane, Yoshihide Kawasaki, Daichi Morooka, Toru Shimazui, Yoshiaki Yamamoto, Hiroshi Nakagomi, Ryotaro Tomida, Yoichi M Ito, Sachiyo Murai, Hiroshi Kitamura, Hiroyuki Nishiyama, Nobuo Shinohara
    Journal of geriatric oncology 12 (5) 834 - 837 2021/06
  • Keita Tamura, Takahiro Osawa, Ario Takeuchi, Keita Minami, Yasutomo Nakai, Kosuke Ueda, Michinobu Ozawa, Motohide Uemura, Mikio Sugimoto, Kojiro Ohba, Toshihiro Suzuki, Satoshi Anai, Tetsuya Shindo, Naohisa Kusakabe, Motokiyo Komiyama, Ken Tanaka, Akira Yokomizo, Naoki Kohei, Nobuo Shinohara, Hideaki Miyake
    Japanese journal of clinical oncology 51 (5) 810 - 818 2021/04/30 
    PURPOSE: To externally validate the utility of the albumin, C-reactive protein and lactate dehydrogenase model to predict the overall survival of previously treated metastatic renal cell carcinoma patients. PATIENTS AND METHODS: The ability of the albumin, C-reactive protein and lactate dehydrogenase model to predict overall survival was validated and compared with those of other prognostication models using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib therapy at 36 hospitals belonging to the Japan Urologic Oncology Group. RESULTS: The following factors in this cohort were independently associated with poor overall survival in a multivariate analysis: a low Karnofsky performance status, <1 year from diagnosis to targeted therapy, a high neutrophil count, and low albumin, elevated C-reactive protein, and elevated lactate dehydrogenase, and the Japan Urologic Oncology Group model was newly developed based on the presence/absence of these independent factors. In this cohort, 151 (35.9%), 125 (27.7%) and 145 (34.4%) patients were classified into the favorable, intermediate and poor risk groups, respectively, according to the albumin, C-reactive protein and lactate dehydrogenase model; however, the proportions of patients in the intermediate risk group stratified by the Japan Urologic Oncology Group, Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models were >50%. The superiority of the albumin, C-reactive protein and lactate dehydrogenase model to the Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models, but not the Japan Urologic Oncology Group model, was demonstrated by multiple statistical analyses. CONCLUSIONS: The utility of the albumin, C-reactive protein and lactate dehydrogenase model as a simple and objective prognostication tool was successfully validated using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib.
  • Masaki Shiota, Naoki Terada, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Takayuki Goto, Sadafumi Kawamura, Yasuhiro Hashimoto, Atsushi Takahashi, Takahiro Kimura, Ken-Ichi Tabata, Ryotaro Tomida, Kohei Hashimoto, Toshihiko Sakurai, Toru Shimazui, Shinichi Sakamoto, Manabu Kamiyama, Nobumichi Tanaka, Koji Mitsuzuka, Takuma Kato, Shintaro Narita, Hiroaki Yasumoto, Shogo Teraoka, Masashi Kato, Takahiro Osawa, Yoshiyuki Nagumo, Hiroaki Matsumoto, Hideki Enokida, Takayuki Sugiyama, Kentaro Kuroiwa, Takahiro Inoue, Takashi Mizowaki, Toshiyuki Kamoto, Takahiro Kojima, Hiroshi Kitamura, Mikio Sugimoto, Hiroyuki Nishiyama, Masatoshi Eto
    Cancer science 112 (4) 1524 - 1533 2021/04 
    Metastatic burden is a critical factor for therapy decision-making in metastatic hormone-sensitive prostate cancer. The present study aimed to identify prognostic factors in men with high- or low-metastatic burden treated with primary androgen-deprivation therapy. The study included 2450 men with de novo metastatic prostate cancer who were treated with primary androgen-deprivation therapy at 30 institutions across Japan between 2008 and 2017. We investigated the prognostic value of various clinicopathological parameters for progression-free survival (PFS) and overall survival (OS) in patients stratified by low- or high-metastatic burden. Among the 2450 men, 841 (34.3%) and 1609 (65.7%) were classified as having low- and high-metastatic burden, respectively. Median PFS of the low- and high-burden groups were 44.5 and 16.1 months, respectively, and the median OS was 103.2 and 62.7 months, respectively. Percentage of biopsy-positive core, biopsy Gleason grade group, T-stage, and N-stage were identified to be differentially prognostic. M1a was associated with worse PFS than was M1b in the low-burden group, whereas lung metastasis was associated with better PFS and OS than was M1b in the high-burden group. Differential prognostic factors were identified for patients with low- and high-burden metastatic prostate cancer. These results may assist in decision-making to select the optimal therapeutic strategies for patients with different metastatic burdens.
  • Shinichi Yamashita, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Shigeyuki Yamada, Kazuo Nishimura, Norio Nonomura, Hiroyuki Nishiyama, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Yoshimi Suzukamo, Akihiro Ito, Yoichi Arai
    Urology 156 173 - 180 2021/03/27 
    OBJECTIVE: To evaluate the health-related quality of life (QOL) of testicular cancer (TC) survivors using the Japanese version of the EORTC QLQ-TC26 questionnaire in a multi-institutional, cross-sectional study. METHODS: This study recruited TC survivors who were followed after treatment for TC at eight high-volume institutions between January, 2018 and March, 2019. The participants completed the EORTC QLQ-TC26 questionnaire and mailed the completed questionnaires to a central institution. The QOL scores were assessed according to therapeutic modality (watchful waiting, WW; chemotherapy, CT; and CT followed by retroperitoneal lymph node dissection, CT+RPLND) and follow-up period and compared using analysis of variance and Student's t-test. RESULTS: A total of 567 TC survivors responded to the questionnaire. The median age at response was 43 years (IQR 35-51 years), and the median follow-up was 5.2 years (IQR 2.2-10.0 years). As for treatment side effects and physical limitations, the scores of the CT+RPLND group were significantly higher than those of the WW group, especially within one year after treatment. In addition, TC survivors in the CT+RPLND group reported high impairment related to job and education problems and future perspective less than 5 years after treatment. Even TC survivors in the WW group were anxious about job and education issues within one year after treatment. CONCLUSION: TC survivors were anxious about not only cancer recurrence, but also their jobs and education. TC patients should be given appropriate information on QOL after treatment for TC to attenuate post-treatment anxiety and improve their health-related QOL.
  • Shinichi Yamashita, Yoshimi Suzukamo, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Shigeyuki Yamada, Kazuo Nishimura, Norio Nonomura, Hiroyuki Nishiyama, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Akihiro Ito, Yoichi Arai
    International journal of urology : official journal of the Japanese Urological Association 28 (2) 176 - 182 2021/02 
    OBJECTIVE: To validate the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 in Japanese-speaking testicular cancer survivors. METHODS: A total of 200 testicular cancer survivors were recruited at eight high-volume institutions in Japan. The participants completed the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and the International Index of Erectile Function 15 questionnaires. A total of 40 participants completed a retest of the questionnaires 2 weeks after the first response. The psychometric properties of the Japanese version including test-retest reliability, internal consistency and concurrent validity were evaluated. RESULTS: The mean age at response was 43 years (range 22-74 years), and the mean period after treatment was 77 months (range 0-416 months). The response rate for each item, except sexual function, was high, and the percentage of missing values was less than 3.5%. For test-retest reliability, seven of 12 scales met the criteria (intraclass correlation 0.70-0.86). For internal consistency, four of seven scales met the criteria (Cronbach's alpha 0.62-0.91). For concurrent validity, treatment side effects of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 were related to some domains of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. The sex-related subscales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 were moderately correlated with some International Index of Erectile Function 15 domains. CONCLUSIONS: The psychometric properties of the Japanese version are equivalent to the properties of the original European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26. The Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 questionnaire is a useful tool to assess the health-related quality of life of testicular cancer patients.
  • 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) 20210064 - 20210064 2021/01 
    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.
  • Tetsuaki Shoji, Yo Niida, Takahiro Osawa, Ryuji Matsumoto, Kotaro Sakurai, Masaru Suzuki, Yoshihiro Matsuno, Satoshi Konno
    Respiratory medicine case reports 34 101526 - 101526 2021 
    A woman with a diagnosis of tuberous sclerosis complex (TSC) presented with TSC2 gene mutation and various manifestations, including epilepsy, renal angiomyolipomas (AML), and pathologically confirmed multifocal micronodular pneumocyte hyperplasia (MMPH). With oral administration of everolimus, a mammalian target of rapamycin (mTOR) inhibitor, MMPH and AML were markedly reduced. Further, after starting treatment with everolimus, serum levels of surfactant protein (SP)-A and SP-D, which reflect type II pneumocyte hyperplasia, decreased to the normal range. At the time of writing of this manuscript, 6 years after starting everolimus, MMPH lesions did not relapse and SP-A/D remained the low levels. This is the first case of everolimus efficacy shown for histologically confirmed MMPH in genetically determined TSC patient, with time course of serum SP-A and SP-D.
  • 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.
  • 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 2020/12 
    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.
  • 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 38 (12) 933.e13-933.e18  2020/12 [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.
  • Naoki Terada, Takashi Mizowaki, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Ken-Ichi Tabata, Masaki Shiota, Atsushi Takahashi, Toru Shimazui, Takayuki Goto, Yasuhiro Hashimoto, Masato Fujii, Ryotaro Tomida, Toshihiko Sakurai, Kohei Hashimoto, Sadafumi Kawamura, Shogo Teraoka, Shinichi Sakamoto, Takahiro Kimura, Manabu Kamiyama, Shintaro Narita, Nobumichi Tanaka, Takuma Kato, Masashi Kato, Takahiro Osawa, Takahiro Kojima, Takahiro Inoue, Mikio Sugimoto, Hiroyuki Nishiyama, Toshiyuki Kamoto
    BJUI compass 1 (5) 165 - 173 2020/11 
    Objectives: To evaluate the association between the use of local radiotherapy (RT) with the survival of patients with de novo metastatic prostate cancer and symptomatic local events (SLEs). Patients and methods: Patients were initially diagnosed with metastatic prostate cancer between 2008 and 2017 at 30 institutes in Japan. Prostate-specific antigen (PSA) progression-free survival (PSA-PFS) under initial androgen deprivation therapy and overall survival (OS) was compared between patients receiving local RT (RT group) and no RT (no-RT group) by multivariate Cox proportional hazard analyses. The occurrence rate of grade ≥2 SLEs was compared by multivariate logistic regression analyses. Propensity score matching (PSM) analyses were performed to compare PSA-PFS and OS of the groups in the high and low metastatic burden cohort. Results: Two hundred and five (7%) of 2829 patients received RT before PSA progression. Median PSA-PFS and OS were significantly longer in the RT group than in the no-RT group and the difference was significant in multivariate analyses (HR = 0.44, 95% CI = 0.33-0.57 and HR = 0.40, 95% CI = 0.27-0.60, respectively). The occurrence rate of grade ≥2 SLEs was significantly lower in the RT group (2%) than the no-RT group (9%) and the difference was significant in multivariate analyses (HR = 0.28, 95% CI = 0.10-0.76). Using PSM analyses, PSA-PFS and OS remained significantly different (HR = 0.64, 95% CI = 0.46-0.89 and HR = 0.47, 95% CI = 0.30-0.72, respectively), between the RT (n = 182) and the no-RT (n = 182) groups. The difference in OS was significant in the high metastatic burden cohort (HR = 0.55, 95% CI = 0.37-0.81). Conclusions: Addition of local RT to standard treatment for de novo metastatic prostate cancer patients tends to have the potential to extend survival, even in patients with high metastatic burden, and to reduce SLEs.
  • 片側多発腎腫瘍に対するロボット支援腎部分切除術の経験
    永森 聖人, 松本 隆児, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 34回 O - 6 2020/11
  • 片側多発腎腫瘍に対するロボット支援腎部分切除術の経験
    永森 聖人, 松本 隆児, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 34回 O - 6 2020/11
  • Amir H Lebastchi, Christopher M Russell, Yashar S Niknafs, Nicholas W Eyrich, Zoey Chopra, Rachel Botbyl, Rana Kabeer, Takahiro Osawa, Javed Siddiqui, Rabia Siddiqui, Matthew S Davenport, Rohit Mehra, Scott A Tomlins, Lakshimi P Kunju, Arul M Chinnaiyan, John T Wei, Jeffrey J Tosoian, Todd M Morgan
    Urology 145 204 - 210 2020/11 
    OBJECTIVE: To evaluate the association of the MyProstateScore (MPS) urine test on the decision to undergo biopsy in men referred for prostate biopsy in urology practice. METHODS: MPS testing was offered as an alternative to immediate biopsy in men referred to the University of Michigan for prostate biopsy from October 2013 through October 2016. The primary endpoint was the decision to perform biopsy. The proportion of patients undergoing biopsy was compared to predicted risk scores from the Prostate Cancer Prevention Trial risk calculator (PCPTrc). Analyses were stratified by the use of multiparametric magnetic resonance imaging (mpMRI). The associations of PCPTrc, MPS, and mpMRI with the decision to undergo biopsy were explored in a multivariable logistic regression model. RESULTS: Of 248 patients, 134 (54%) proceeded to prostate biopsy. MPS was significantly higher in biopsied patients (median 29 vs14, P < .001). The use of biopsy was strongly associated with MPS, with biopsy rates of 26%, 38%, 58%, 90%, and 85% in the first through fifth quintiles, respectively (P < .001). MPS association with biopsy persisted upon stratification by mpMRI. On multivariable analysis, MPS was strongly associated with the decision to undergo biopsy when modeled as both a continuous (odds ratio [OR] 1.05, 95%; confidence interval [CI] 1.04-1.08; <.001) and binary (OR 7.76, 95%; CI 4.14-14.5; P < .001) variable. CONCLUSION: Many patients (46%) undergoing clinical MPS testing as an alternative to immediate prostate biopsy were able to avoid biopsy. Increasing MPS was strongly associated with biopsy rates. These findings were robust to use of mpMRI.
  • Yoshihiko Tomita, Katsunori Tatsugami, Noboru Nakaigawa, Takahiro Osawa, Mototsugu Oya, Hiroomi Kanayama, Chihiro Nakayama Kondoh, Naoto Sassa, Kazuo Nishimura, Masahiro Nozawa, Naoya Masumori, Yasuhide Miyoshi, Shingo Kuroda, Shingo Tanaka, Akiko Kimura, Satoshi Tamada
    International journal of urology : official journal of the Japanese Urological Association 27 (11) 952 - 959 2020/11 
    OBJECTIVES: To evaluate the efficacy and safety of cabozantinib, through a bridging study to METEOR, in Japanese patients with advanced renal cell carcinoma who had progressed after prior tyrosine kinase inhibitor therapy. METHODS: This phase II, open-label, single-arm study (ClinicalTrials.gov registration number: NCT03339219) included adult Japanese patients with advanced renal cell carcinoma and measurable disease who had received one or more tyrosine kinase inhibitors. Patients received cabozantinib 60 mg orally once daily while there was clinical benefit, or until unacceptable toxicity or disease progression. The primary end-point was objective response rate per Response Evaluation Criteria in Solid Tumors Version 1.1. Secondary end-points included clinical benefit rate (complete or partial response, or ≥8-week stable disease), progression-free survival, overall survival and safety. RESULTS: Of the 35 patients enrolled, 68.6%, 22.9% and 8.6% had previously received one, two and three prior tyrosine kinase inhibitors, respectively. The median duration of cabozantinib exposure was 27.0 weeks (range 5.1-43.0 weeks). The objective response rate was 20.0% (90% confidence interval 9.8-34.3%), and the clinical benefit rate was 85.7% (95% confidence interval 69.7-95.2%). The 6-month estimated progression-free survival was 72.3% (95% confidence interval 53.3-84.6%); the median progression-free survival and overall survival were not reached. All patients reported adverse events, which were manageable by supportive treatment or dose modification; two patients (5.7%) discontinued therapy due to adverse events. CONCLUSIONS: The results showed that findings from METEOR can be extrapolated, and that cabozantinib 60 mg/day is a viable treatment option in Japanese patients with advanced renal cell carcinoma who had progressed after prior tyrosine kinase inhibitor therapy.
  • Hiromi Hirama, Mikio Sugimoto, Nobuyuki Miyatake, Takuma Kato, Lionne D F Venderbos, Sebastiaan Remmers, Kenichiro Shiga, Akira Yokomizo, Koji Mitsuzuka, Ryuji Matsumoto, Takahiro Osawa, Takashige Abe, Hiroshi Sasaki, Shin Egawa, Iku Ninomiya, Katsuyoshi Hashine, Monique J Roobol, Yoshiyuki Kakehi
    World journal of urology 39 (7) 2491 - 2497 2020/10/20 
    PURPOSE: To evaluate the health-related quality of life (HRQoL) of Japanese men on active surveillance (AS) in the Prostate cancer Research International Active Surveillance study in Japan (PRIAS-JAPAN). METHODS: Participants were included in the PRIAS-JAPAN HRQoL study between January 2010 and March 2016. Their general HRQoL was assessed using a validated Japanese version of the Short-Form 8 Health Survey (SF-8) at enrolment and annually thereafter until discontinuation of AS. The SF-8 mental component summary (MCS) and physical component summary (PCS) of men on AS were compared with scores of the general population (norm-based score [NBS]: 50) and MCS and PCS scores for men following AS were analysed over time. We tested whether MCS and PCS scores over time explained discontinuation of AS. RESULTS: Five hundred and twenty-five patients enrolled, and the median age at baseline was 68 years. At enrolment and after 1-, 2-, and 3-year follow-ups, the PCS and MCS scores were significantly higher than the NBS of the general Japanese population except for the median PCS at 3 years. We found that age at diagnosis and time on AS negatively affected the PCS score of men on AS, while every additional year on AS led to a 0.27 point increase in MCS scores. Neither PCS nor MCS were predictors for discontinuation of AS. CONCLUSION: Japanese men following an AS strategy for 3 years reported better HRQoL compared with the general population, indicating that monitoring Japanese low-risk prostate cancer patients can be an effective treatment strategy. STUDY REGISTRATION: Clinical trial registry-UMIN (University Hospital Medical Information Network); UMIN000002874 (2009/12/11).
  • 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 27 (10) 929 - 938 2020/10 [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.
  • Nobuyuki Hinata, Junji Yonese, Satoru Masui, Yasutomo Nakai, Suguru Shirotake, Katsunori Tatsugami, Teruo Inamoto, Masahiro Nozawa, Kosuke Ueda, Toru Etsunaga, Takahiro Osawa, Motohide Uemura, Go Kimura, Kazuyuki Numakura, Kazutoshi Yamana, Hideaki Miyake, Satoshi Fukasawa, Kenya Ochi, Hirokazu Kaneko, Hirotsugu Uemura
    International journal of clinical oncology 25 (8) 1533 - 1542 2020/08 [Refereed][Not invited]
     
    BACKGROUND: In a phase III clinical trial, CheckMate 025, treatment of metastatic renal cell carcinoma (mRCC) with nivolumab demonstrated superior efficacy over everolimus. However, as the clinical trial excluded patients with specific complications and poor performance status (PS), the effectiveness and safety of nivolumab in clinical practice, in which patients with various clinical complications are treated, is unclear. This study explored real-world nivolumab treatment in Japanese mRCC patients. METHODS: This is an interim analysis of a multicenter, non-interventional, medical record review study (minimum follow-up: 9 months). All eligible Japanese mRCC patients who first received nivolumab between February and October 2017 were included; data cut-off was April 2019. We analyzed nivolumab treatment patterns, efficacy (including overall survival, progression-free survival, objective response rate, and duration of response) and safety (including immune-related adverse events). RESULTS: Of 208 evaluable patients, 31.7% received nivolumab as fourth- or later line of treatment. At data cut-off, 26.9% of patients were continuing nivolumab treatment. The major reason for discontinuation was disease progression (n = 100, 65.8%). Median overall survival was not reached; the 12-month survival rate was 75.6%. Median progression-free survival was 7.1 months, the objective response rate was 22.6%, and median duration of response was 13.3 months. Patients who were excluded or limited in number in CheckMate 025, such as those with non-clear cell RCC or poor PS, also received benefits from nivolumab treatment. Immune-related adverse events occurred in 27.4% of patients (grade ≥ 3, 10.1%). CONCLUSION: Nivolumab was effective and well-tolerated in real-world Japanese mRCC patients. TRIAL REGISTRATION: UMIN000033312.
  • 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, Nobuo Shinohara, Kyoko Hida
    Cancer research 80 (14) 2996 - 3008 0008-5472 2020/07/15 [Refereed][Not invited]
     
    Tumor endothelial cells (TEC) lining tumor blood vessels actively contribute to tumor progression and metastasis. In addition to tumor cells, TEC may develop drug resistance during cancer treatment, allowing the tumor cells to survive chemotherapy and metastasize. We previously reported that TECs resist paclitaxel treatment via upregulation of ABCB1. However, whether TEC phenotypes are altered by anticancer drugs remains to be clarified. Here, we show that ABCB1 expression increases after chemotherapy in urothelial carcinoma cases. The ratio of ABCB1-positive TEC before and after first-line chemotherapy in urothelial carcinoma tissues (n = 66) was analyzed by ABCB1 and CD31 immunostaining. In 42 cases (64%), this ratio increased after first-line chemotherapy. Chemotherapy elevated ABCB1 expression in endothelial cells by increasing tumor IL8 secretion. In clinical cases, ABCB1 expression in TEC correlated with IL8 expression in tumor cells after first-line chemotherapy, leading to poor prognosis. In vivo, the ABCB1 inhibitor combined with paclitaxel reduced tumor growth and metastasis compared with paclitaxel alone. Chemotherapy is suggested to cause inflammatory changes in tumors, inducing ABCB1 expression in TEC and conferring drug resistance. Overall, these findings indicate that TEC can survive during chemotherapy and provide a gateway for cancer metastasis. Targeting ABCB1 in TEC represents a novel strategy to overcome cancer drug resistance. SIGNIFICANCE: These findings show that inhibition of ABCB1 in tumor endothelial cells may improve clinical outcome, where ABCB1 expression contributes to drug resistance and metastasis following first-line chemotherapy.
  • Takahiro Osawa, Takahiro Kojima, Tomohiko Hara, Mikio Sugimoto, Masatoshi Eto, Ario Takeuchi, Keita Minami, Yasutomo Nakai, Kosuke Ueda, Michinobu Ozawa, Motohide Uemura, Yasuyuki Miyauchi, Kojiro Ohba, Toshiro Suzuki, Satoshi Anai, Tetsuya Shindo, Naohisa Kusakabe, Keita Tamura, Motokiyo Komiyama, Takayuki Goto, Akira Yokomizo, Naoki Kohei, Akira Kashiwagi, Masaya Murakami, Tomokazu Sazuka, Hiroaki Yasumoto, Hideto Iwamoto, Koji Mitsuzuka, Daichi Morooka, Toru Shimazui, Yoshiaki Yamamoto, Suguru Ikeshiro, Hiroshi Nakagomi, Ken Morita, Ryotaro Tomida, Tango Mochizuki, Takamitsu Inoue, Hiroshi Kitamura, Shuhei Yamada, Yoichi M Ito, Sachiyo Murai, Hiroyuki Nishiyama, Nobuo Shinohara
    Cancer science 111 (7) 2460 - 2471 2020/07 [Refereed][Not invited]
     
    The present study aimed to evaluate the efficacy of the real-world use of axitinib and to develop a prognostic model for stratifying patients who could derive long-term benefit from axitinib. This was a retrospective, descriptive study evaluating the efficacy of axitinib in patients with metastatic renal cell carcinoma that had been treated with 1 or 2 systemic antiangiogenic therapy regimens at 1 of 36 hospitals belonging to the Japan Urologic Oncology Group between January 2012 and February 2019. The primary outcome was overall survival (OS). Using a split-sample method, candidate variables that exhibited significant relationships with OS were chosen to create a model. The new model was validated using the rest of the cohort. In total, 485 patients were enrolled. The median OS was 34 months in the entire study population, whereas it was not reached, 27 months, and 14 months in the favorable, intermediate, and poor risk groups, respectively, according to the new risk classification model. The following 4 variables were included in the final risk model: the disease stage at diagnosis, number of metastatic sites at the start of axitinib therapy, serum albumin level, and neutrophil : lymphocyte ratio. The adjusted area under the curve values of the new model at 12, 36, and 60 months were 0.77, 0.82, and 0.82, respectively. The efficacy of axitinib in routine practice is comparable or even superior to that reported previously. The patients in the new model's favorable risk group might derive a long-term survival benefit from axitinib treatment.
  • 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
  • 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 50 (5) 609 - 616 2020/05/05 [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.
  • Mototsugu Oya, Satoshi Tamada, Katsunori Tatsugami, Noboru Nakaigawa, Takahiro Osawa, Hiro-Omi Kanayama, Chihiro Kondoh, Naoto Sassa, Kazuo Nishimura, Masahiro Nozawa, Naoya Masumori, Yasuhide Miyoshi, Akiko Kimura, Shingo Kuroda, Robert J. Motzer, Toni K. Choueiri, Yoshihiko Tomita
    JOURNAL OF CLINICAL ONCOLOGY 38 (15) 0732-183X 2020/05
  • 大澤 崇宏, 安部 崇重, 山田 修平, 宮田 遥, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 篠原 信雄
    Japanese Journal of Endourology (一社)日本泌尿器内視鏡学会 33 (1) 89 - 94 2186-1889 2020/04 [Refereed][Not invited]
     
    【目的】cT1腎癌に対して行われた開腹腎部分切除術(OPN)と鏡視下腎部分切除術(LPN)の術後QOLについて前向き観察研究を行った。【対象・方法】62名(OPN群:8例、LPN群:54例)を対象とした。2群において36-Item Short Formを用いて測定したQOL(術前、術後6ヵ月、術後1年)を比較検討した。有意水準をp<0.05とした。【結果】体の痛み(BP)においてLPN群は、国民標準値と比べて全時点において有意に良好なQOLスコアを示し、術後12ヵ月時点では、OPN群と比較してQOLが有意に良好であった。また、心の健康(MH)は、LPN群において、術後12ヵ月にかけて有意に回復していた。【結論】OPN群とLPN群の術後、QOLの回復過程において異なるプロファイルが認められた。(著者抄録)
  • 【高齢者の安全な泌尿器科診療を目指して】(chapter 3)高齢者の泌尿器がん 高齢者に対する分子標的薬、免疫チェックポイント阻害治療の考え方
    菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄
    Uro-Lo: 泌尿器Care & Cure (株)メディカ出版 25 (2) 215 - 217 2189-8545 2020/04 [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 (2) 206 - 213 2020/02/17 [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.
  • 安部 崇重, 菊池 央, 松本 隆児, 大澤 崇宏, 篠原 信雄
    Uro-Lo: 泌尿器Care & Cure (株)メディカ出版 25 (1) 42 - 47 2189-8545 2020/02 [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 (一社)腎癌研究会 (50) 66 - 66 2020
  • 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.
  • 安部 崇重, 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) 33 (1) 33 - 36 0914-6180 2020/01 [Refereed][Not invited]
     
    正確な病期診断の観点、微小リンパ節転移摘除による潜在的治療効果の観点から、根治的膀胱全摘除術時には骨盤内リンパ節郭清が積極的に施行される。当科では、総腸骨動脈分岐部以下の骨盤内リンパ節郭清を行っている。いわゆる拡大郭清の範囲で、具体的には総腸骨領域、仙骨前面領域、外腸骨領域、内腸骨領域、閉鎖領域のリンパ節に該当する。正確な病期診断、微小リンパ節転移摘除による潜在的治療効果の面から、リンパ節郭清においては丁寧な手術操作を心がけることが肝要である。(著者抄録)
  • 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.
  • 山田 修平, 大澤 崇宏, 安部 崇重, 高田 徳容, 松本 隆児, 伊藤 陽一, 菊地 央, 宮島 直人, 土屋 邦彦, 丸山 覚, 村井 祥代, 篠原 信雄
    泌尿器科紀要 泌尿器科紀要刊行会 65 (12) 495 - 499 0018-1994 2019/12 [Refereed][Not invited]
     
    1997〜2010年までの間に20施設で膀胱癌に対して腸管利用尿路変向の開腹膀胱全摘除術(開腹RC)を施行した668例(男性528例、女性140例、年齢中央値65歳)を対象に、周術期重度合併症の術前予測因子を検討した。その結果、男性、心血管疾患既往、同時NUx(同時腎尿管全摘除術)が周術期重度合併症の有意な予測因子となったものの、この3つの因子を用いたモノグラムではAUC 0.58と十分な予測精度を持つには至らなかった。
  • 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.
  • Nobuhiro Tanaka, Masataka Yamamoto, Takashige Abe, Takahiro Osawa, Ryuji Matsumoto, Nobuo Shinohara, Hitoshi Saito, Yosuke Uchida, Yuji Morimoto
    Journal of endourology 33 (12) 995 - 1001 0892-7790 2019/12 [Refereed][Not invited]
     
    Purpose: Robot-assisted laparoscopic radical prostatectomy (RARP) requires a steep head-down tilt and pneumoperitoneum, which may cause an increase in cerebral blood volume (CBV). With a new near-infrared time-resolved spectroscopy device, the tNIRS-1, we can measure the absolute value of the cerebral hemoglobin concentration and hence calculate CBV and cerebral oxygen saturation (rSO2). Using this device, we evaluated the time course of CBV during surgery and also evaluated the changes in rSO2 simultaneously. Materials and Methods: We performed a prospective observational study of 21 patients scheduled for RARP. We evaluated CBV and rSO2 by using the tNIRS-1 at 10 time points during surgery. Results: The CBV was 2.92 ± 0.38 mL ·100 g-1 after the end of anesthetic preparation. It significantly increased to 3.05 ± 0.44 mL ·100 g-1 after the head-down tilt and was around 3.1 mL ·100 g-1 until 120 minutes after the head-down tilt. However, just before the return to the horizontal position, it decreased to 2.93 ± 0.46 mL ·100 g-1 and then decreased more after the return to the horizontal position. Changes in rSO2 over time were within only 3%, and no significant differences from the control value were observed. Conclusions: The increase in CBV was <10% despite the steep head-down tilt and pneumoperitoneum, and it was compensated for at around the end of surgery. Clinically significant changes in rSO2 were not observed during the surgery.
  • Yasuhiro Morii, Takahiro Osawa, Teppei Suzuki, Nobuo Shinohara, Toru Harabayashi, Tomoki Ishikawa, Takumi Tanikawa, Hiroko Yamashina, Katsuhiko Ogasawara
    BMC urology 19 (1) 110 - 110 2019/11/08 [Refereed][Not invited]
     
    BACKGROUND: Robot-assisted radical cystectomy is becoming a common treatment for bladder carcinoma. However, in comparison with open radical cystectomy, its cost-effectiveness has not been confirmed. Although few published reviews have compared total costs between the two surgical procedures, no study has compared segmental costs and explained their impact on total costs. METHODS: A systematic review was conducted based on studies on the segmental costs of open, laparoscopic, and robot-assisted radical cystectomy using PubMed, Web of Science, and Cochrane Library databases to provide insight into cost-effective management methods for radical cystectomy. The segmental costs included operating, robot-related, complication, and length of stay costs. A sensitivity analysis was conducted to determine the impact of the annual number of cases on the per-case robot-related costs. RESULTS: We identified two studies that compared open and laparoscopic surgeries and nine that compared open and robotic surgeries. Open radical cystectomy costs were higher than those of robotic surgeries in two retrospective single-institution studies, while robot-assisted radical cystectomy costs were higher in 1 retrospective single-institution study, 1 randomized controlled trial, and 4 large database studies. Operating costs were higher for robotic surgery, and accounted for 63.1-70.5% of the total robotic surgery cost. Sensitivity analysis revealed that robot-related costs were not a large proportion of total surgery costs in institutions with a large number of cases but accounted for a large proportion of total costs in centers with a small number of cases. CONCLUSIONS: The results show that robot-assisted radical cystectomy is more expensive than open radical cystectomy. The most effective methods to decrease costs associated with robotic surgery include a decrease in operating time and an increase in the number of cases. Further research is required on the cost-effectiveness of surgeries, including quality measures such as quality of life and quality-adjusted life years.
  • 腎尿管全摘除術における新展開 腎尿管全摘除術におけるリンパ節郭清 腹腔鏡vs開腹?
    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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 SF - 2 2019/11
  • 腹腔鏡下腎摘除術時のヘモロック関連アクシデントとその予防の考察
    安部 崇重, 菊地 央, 松本 隆児, 大澤 崇宏, 佐澤 陽, 田中 博, 岩見 大基, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 V - 5 2019/11
  • ロボット支援腎部分切除後の患側腎機能に影響する因子の検討
    山田 修平, 松本 隆児, 古御堂 純, 宮田 遥, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 O - 4 2019/11
  • ロボット支援腹腔鏡下前立腺全摘除術における神経温存が健康関連QOLに及ぼす影響
    大澤 崇宏, 安部 崇重, 松本 隆児, 菊地 央, 山田 修平, 古御堂 純, 宮田 遥, 村井 祥代, 伊藤 陽一, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 O - 2 2019/11
  • 高リスク前立腺癌に対するロボット支援前立腺全摘除術と放射線療法の臨床的比較検討
    松本 隆児, 古御堂 純, 宮田 遥, 菊地 央, 大澤 崇宏, 安部 崇重, 西岡 健太郎, 橋本 孝之, 清水 伸一, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 P - 1 2019/11
  • 腎尿管全摘除術における新展開 腎尿管全摘除術におけるリンパ節郭清 腹腔鏡vs開腹?
    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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 SF - 2 2019/11
  • 腹腔鏡下腎摘除術時のヘモロック関連アクシデントとその予防の考察
    安部 崇重, 菊地 央, 松本 隆児, 大澤 崇宏, 佐澤 陽, 田中 博, 岩見 大基, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 V - 5 2019/11
  • ロボット支援腎部分切除後の患側腎機能に影響する因子の検討
    山田 修平, 松本 隆児, 古御堂 純, 宮田 遥, 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総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 O - 4 2019/11
  • ロボット支援腹腔鏡下前立腺全摘除術における神経温存が健康関連QOLに及ぼす影響
    大澤 崇宏, 安部 崇重, 松本 隆児, 菊地 央, 山田 修平, 古御堂 純, 宮田 遥, 村井 祥代, 伊藤 陽一, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 O - 2 2019/11
  • 高リスク前立腺癌に対するロボット支援前立腺全摘除術と放射線療法の臨床的比較検討
    松本 隆児, 古御堂 純, 宮田 遥, 菊地 央, 大澤 崇宏, 安部 崇重, 西岡 健太郎, 橋本 孝之, 清水 伸一, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 33回 P - 1 2019/11
  • Tomonori Sekizaki, Hiraku Kameda, Chiho Oba, Kyu Yong Cho, Akinobu Nakamura, Hideaki Miyoshi, Takahiro Osawa, Nobuo Shinohara, Tatsuya Atsumi
    Endocrine journal 66 (10) 937 - 941 0918-8959 2019/10/28 [Refereed][Not invited]
     
    A 62-year-old man was referred to our department for elevation of plasma ACTH and cortisol levels during nivolumab administration for renal cell carcinoma. Although his ACTH and cortisol levels had been maintained within their reference ranges, they were elevated to 232.7 pg/mL and 21.9 μg/dL, respectively, after eight courses of nivolumab without any subjective symptoms or Cushing's sign. He was hospitalized for endocrinological investigation. ACTH and cortisol returned to their normal ranges (29.18 pg/mL and 11.4 μg/dL, respectively) in the early morning on day 1, but fell down sharply to 3.7 pg/mL and 1.6 μg/dL, respectively, in the early morning on day 2 without subjective symptoms or vital sign changes. Brain magnetic resonance imaging showed no abnormality in his pituitary gland. ACTH response to CRH was apparently normal, but cortisol did not respond to increased ACTH. A rapid ACTH stimulation test showed slightly reduced response of cortisol to exogenous ACTH (1-24). These findings and his clinical course suggested secondary adrenal insufficiency arising from nivolumab-induced hypophysitis. In previous reports, most cases of immune checkpoint inhibitor (ICI)-induced hypophysitis were diagnosed based on adrenal insufficiency symptoms or hyponatremia with low ACTH and cortisol. The ACTH elevation observed in the present case may reflect destruction of the pituitary gland, suggesting that this finding may be important for early detection of ICI-induced hypophysitis. Our case underlines the necessity of close monitoring for subsequent onset of adrenal insufficiency when ACTH elevation is observed during ICI administration.
  • 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 (一社)日本内分泌学会 95 (2) 765 - 765 0029-0661 2019/10 [Refereed][Not invited]
  • 難治性尿路上皮癌Up to Date 転移性尿路上皮癌に対する治療戦略 実臨床データ解析からみえてくる今後の展望
    松本 隆児, 安部 崇重, 古御堂 純, 宮田 遥, 菊地 央, 大澤 崇宏, 篠原 信雄
    日本癌治療学会学術集会抄録集 57回 SY14 - 5 2019/10 [Refereed][Not invited]
  • 遺伝子アッセイは前立腺癌監視療法の導入選択基準となりうるか?
    丸山 覚, 黒沢 瞭, 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
    日本癌治療学会学術集会抄録集 57回 O33 - 5 2019/10 [Refereed][Not invited]
  • ロボット支援腹腔鏡下前立腺全摘術後患者におけるEPICを用いたQOL調査
    浦川 梨里子, 志賀 桜, 熊原 綾子, 菊池 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 笠松 美紀, 篠原 信雄
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 57回 P120 - 1 2019/10 [Refereed][Not invited]
  • ロボット支援腹腔鏡下前立腺全摘術後の前立腺がん患者におけるSF-8を用いたQOL調査
    志賀 桜, 浦川 梨里子, 熊原 綾子, 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 笠松 美紀, 篠原 信雄
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 57回 P120 - 2 2019/10 [Refereed][Not invited]
  • 泌尿器癌患者におけるキャンサーサバイバーシップケア向上のために
    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
    日本癌治療学会学術集会抄録集 57回 P167 - 2 2019/10 [Refereed][Not invited]
  • 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 2019/10 [Refereed][Not invited]
  • Takahiro Osawa, Wenchu Wang, Jinlu Dai, Evan T. Keller
    SCIENTIFIC REPORTS 9 (1) 14979 - 14979 2045-2322 2019/10 [Refereed][Not invited]
     
    While microfluidic systems model aspects of metastasis, they are limited to artificially created tissues of limited complexity. We set out to develop an in vitro model of tumor cell migration from a primary tumor to a distant site that allows use of tissue. Accordingly, we created a macrofluidic model using culture plate wells connected with type I collagen-coated large bore tubing and has recirculating media. Green fluorescent protein-positive prostate carcinoma cells in a hydrogel or excised tumor xenografts from mice were placed into primary tumor sites and either human bone stromal cells (HS-5) in a hydrogel or human-derived bone chips were seeded into metastatic sites. Cells from the primary sites migrated to and grew in metastatic sites. Bone enhanced growth at metastatic sites and established a CXCL12 gradient that was higher in metastatic versus primary sites. AMD3100-mediated inhibition of CXCL12 function reduced the number of cells targeting the bone at the metastatic sites. In summary, we have developed a macrofluidic metastasis model that allows incorporation of tumor and metastatic microenvironment tissues and models chemotaxis. This system allows for incorporation of tumor heterogeneity and inclusion of an intact microenvironment. These features will facilitate identification of mechanisms and therapeutics for bone metastasis.
  • 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 (一社)日本排尿機能学会 30 (1) 257 - 257 1347-6513 2019/09 [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 医学図書出版(株) 32 (8) 1019 - 1021 0914-6180 2019/08 [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)
  • Norihiro Murahashi, Takashige Abe, Ryuji Matsumoto, Takahiro Oosawa, Keiichiro Yoshinaga, Tohru Shiga, KanakoC Hatanaka, Yoshihiro Matsuno, Nobuo Shinohara
    Hinyokika kiyo. Acta urologica Japonica 泌尿器科紀要刊行会 65 (7) 277 - 282 0018-1994 2019/07 [Not refereed][Not invited]
     
    A 45-year-old woman visited a local clinic with left-flank abdominal pain. Abdominal computed tomography (CT) revealed a tumor 20 cm in diameter in the left adrenal gland. She was referred to our hospital for further treatment. No endocrinological abnormality was detected on either serum or urine examination. CT and haematology findings led to a preoperative diagnosis of primary adrenal carcinoma, and we performed a left adrenalectomy. Histopathological examination revealed a paraganglioma with intact adrenal gland. Therefore we diagnosed this case as primary retroperitoneal paraganglioma. Six months after the surgery, she developed peritoneal dissemination including bilateral ovarian metastases. After cytoreductive metastasectomy, she received 131I-meta-iodobenzylguanidine (MIBG) radiotherapy. During the following five-year follow-up, MIBG radiotherapy in conjunction with cytoreductive metastasectomy (3 surgeries and 6 sessions of 131I-MIBG radiotherapy) was performed, aiming at disease control. Five years after the initial surgery, liver, lung, and intra-peritoneal dissemination progressed. Thereafter, she developed severe diarrhea, hypokalemia, and metabolic acidosis with an elevated level of vasoactive intestional peptide, which was consistent with water diarrhea, hypokalemia, achlorhydria (WDHA) syndrome. Despite intensive treatments such as with a somatostatin analogue, she died two months after the onset of this syndrome.
  • 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.
  • Takahiro Osawa, Ario Takeuchi, Takahiro Kojima, Nobuo Shinohara, Masatoshi Eto, Hiroyuki Nishiyama
    Japanese journal of clinical oncology 49 (5) 395 - 403 0368-2811 2019/05/01 [Refereed][Not invited]
     
    Since the 2000s, there have been dramatic advances in the treatment of metastatic renal cell carcinoma (mRCC), including drugs targeting vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways. The first VEGF inhibitors approved for mRCC were sorafenib and sunitinib. Subsequently, two mTOR inhibitors (everolimus and temsirolimus) and other VEGF inhibitors (pazopanib and axitinib) were approved. Overall survival (OS) of mRCC patients has significantly increased during this period. Two novel VEGF inhibitors have recently been approved overseas, including cabozantinib and lenvatinib. Additionally, the recent advent of immunotherapy with checkpoint inhibitors has led to significant changes in the treatment of mRCC. The PD-1 inhibitor nivolumab improved the OS rate of patients with mRCC following VEGF inhibitors. Moreover, the CheckMate 214 trial demonstrated the benefit of nivolumab plus ipilimumab combination therapy in OS and objective response rate in treatment-naive intermediate- and poor-risk mRCC. In this review, current evidence related to the clinical use of targeted therapies and checkpoint inhibitors for the treatment of patients with mRCC is discussed. In addition, we review ongoing trials investigating combinations of checkpoint inhibitors with targeted agents and the identification of biomarkers to guide patient selection and enable individualization of therapy.
  • Takahiro Osawa, Hiroshi Harada, Keita Minami, Nobuo Shinohara, Taku Murakami, Cindy M. Yamamoto, Hiroshi Tanaka, Toshimori Seki
    JOURNAL OF UROLOGY 201 (4) E228 - E228 0022-5347 2019/04
  • Kenichi Harada, Masahiro Nozawa, Motohide Uemura, Katsunori Tatsugami, Takahiro Osawa, Kazutoshi Yamana, Go Kimura, Masato Fujisawa, Norio Nonomura, Masatoshi Eto, Nobuo Shinohara, Yoshihiko Tomita, Yukihiro Kondo, Kenya Ochi, Yoshio Anazawa, Hirotsugu Uemura
    International journal of urology : official journal of the Japanese Urological Association 26 (2) 202 - 210 0919-8172 2019/02 [Refereed][Not invited]
     
    OBJECTIVES: To clarify treatment patterns and outcomes for patients with unresectable or metastatic renal cell carcinoma in the molecular target therapy era in Japan. METHODS: A multicenter, retrospective medical chart review study was carried out. Patients diagnosed with unresectable or metastatic renal cell carcinoma between January 2012 and August 2015 were enrolled. Data extracted from medical records included treatment duration, grade ≥3 adverse events, reason for discontinuation for each targeted therapy and survival data until August 2016. RESULTS: Of 277 eligible patients, 266, 170 and 77 received first-, second- and third-line systemic treatment, respectively. Tyrosine kinase inhibitors were the most common first-line therapy (72.2%), followed by mammalian target of rapamycin inhibitors (14.3%) and cytokines (13.5%). Among 170 patients who received second-line treatment, tyrosine kinase inhibitor-tyrosine kinase inhibitor was the most common sequence (58.8%), followed by tyrosine kinase inhibitor-mammalian target of rapamycin inhibitor (14.1%) and cytokine-tyrosine kinase inhibitor (14.1%). With a median follow-up period of 19.8 months, median overall survival was not reached at 48 months. Patients who discontinued first-line tyrosine kinase inhibitors in <6 months showed poorer overall survival compared with patients who received first-line tyrosine kinase inhibitors for ≥6 months. CONCLUSIONS: The present analysis illustrates the contemporary treatment patterns and prognosis for patients with unresectable or metastatic renal cancer in a real-world setting in Japan. Tyrosine kinase inhibitor-tyrosine kinase inhibitor represents the most commonly used sequence. Shorter treatment duration of first-line tyrosine kinase inhibitors is associated with poorer prognosis, suggesting the need for better treatment options.
  • Thiel法献体における尿管鏡カダバートレーニングの初期経験 ドライボックスとの比較
    今 雅史, 安部 崇重, 石川 修平, 大澤 崇宏, 松本 隆児, 菊地 央, 七戸 俊明, 村井 祥代, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 1 2018/11
  • ブタ臓器を用いた簡便な腹腔鏡トレーニングモデルの開発
    樋口 まどか, 安部 崇重, 堀田 記世彦, 森田 研, 宮田 遥, 菊池 央, 松本 隆児, 大澤 崇宏, 倉島 庸, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 6 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 7 2018/11
  • バーチャルリアリティーシミュレーター腹腔鏡下腎摘除術の妥当性の検証
    宮田 遥, 安部 崇重, 樋口 まどか, 堀田 記世彦, 大澤 崇宏, 松本 隆児, 菊地 央, 倉島 庸, 村井 祥代, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 DP - 5 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 P - 4 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 P - 10 2018/11
  • Second TUR
    松本 隆児, 大澤 崇宏, 菊地 央, 安部 崇重, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 J - 3 2018/11
  • Thiel法献体における尿管鏡カダバートレーニングの初期経験 ドライボックスとの比較
    今 雅史, 安部 崇重, 石川 修平, 大澤 崇宏, 松本 隆児, 菊地 央, 七戸 俊明, 村井 祥代, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 1 2018/11
  • ブタ臓器を用いた簡便な腹腔鏡トレーニングモデルの開発
    樋口 まどか, 安部 崇重, 堀田 記世彦, 森田 研, 宮田 遥, 菊池 央, 松本 隆児, 大澤 崇宏, 倉島 庸, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 6 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 O - 7 2018/11
  • バーチャルリアリティーシミュレーター腹腔鏡下腎摘除術の妥当性の検証
    宮田 遥, 安部 崇重, 樋口 まどか, 堀田 記世彦, 大澤 崇宏, 松本 隆児, 菊地 央, 倉島 庸, 村井 祥代, 篠原 信雄
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 DP - 5 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 P - 4 2018/11
  • 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
    日本泌尿器内視鏡学会総会 (一社)日本泌尿器内視鏡・ロボティクス学会 32回 P - 10 2018/11
  • 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.
  • 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]
  • 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]
  • 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.
  • Taku Murakami, Cindy M Yamamoto, Tomoshige Akino, Hiroshi Tanaka, Nobuyuki Fukuzawa, Hidetaka Suzuki, Takahiro Osawa, Takahiro Tsuji, Toshimori Seki, Hiroshi Harada
    Oncotarget 9 (67) 32810 - 32821 2018/08/28 [Refereed][Not invited]
     
    Objective: Urinary extracellular vesicles (EV) could be promising biomarkers for urological diseases. In this retrospective feasibility study, we conducted biomarker screening for early stage bladder cancer using EV mRNA analysis. Methods: Biomarker candidates were identified through RNA-seq analysis of urinary EV from patients with non-muscle invasive bladder cancer (N=3), advanced urothelial cancer (N=3), no residual tumor after TURBT (N=2), and healthy and disease controls (N=4). Diagnostic performance was evaluated by RT-qPCR in a larger patient group including bladder cancer (N=173), renal pelvis and ureter cancer (N=33), no residual tumor and non-cancer disease control (N=36). Results: Urinary EV SLC2A1, GPRC5A and KRT17 were overexpressed in pT1 and higher stage bladder cancer by 20.6-fold, 18.2-fold and 29.5-fold, respectively. These genes allowed detection of non-muscle invasive bladder cancer (AUC: 0.56 to 0.64 for pTa, 0.62 to 0.80 for pTis, and 0.82 to 0.86 for pT1) as well as pT2 and higher muscle invasive bladder cancer (AUC: 0.72 to 0.90). Subgroup analysis indicated that these markers could be useful for the detection of cytology-negative/-suspicious and recurrent bladder cancers. Conclusion: Three urinary EV mRNA were discovered to be elevated in bladder cancer. Urinary EV mRNA are promising biomarkers of urothelial cancer and worth further investigation.
  • 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.
  • Takahiro Osawa, Takashige Abe, Norikata Takada, Yoichi M. Ito, Sachiyo Murai, Nobuo Shinohara
    INTERNATIONAL JOURNAL OF UROLOGY 25 (7) 699 - 700 0919-8172 2018/07 [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]
  • Daniel E Spratt, Krithika Suresh, Takahiro Osawa, Matthew Schipper, William C Jackson, Ahmed Abugharib, Amir Lebastchi, David Smith, Jeffrey S Montgomery, Ganesh S Palapattu, L Priya Kunju, Angela Wu, Madelyn Lew, Scott A Tomlins, Arul M Chinnaiyan, Alon Z Weizer, Khaled S Hafez, Samuel D Kaffenberger, Aaron Udager, Rohit Mehra
    Medical oncology (Northwood, London, England) 35 (3) 21 - 21 1559-131X 2018/01/31 [Refereed][Not invited]
     
    The frequency of co-occurrence between germ cell tumor (GCT) components in non-seminomatous germ cell tumor (NSGCT) orchiectomy specimens and their correlation with histologic findings in subsequent retroperitoneal lymph node dissection (RPLND) specimens have not been well characterized. The objective of the study was to report the first detailed clinicopathologic analysis of NSGCT orchiectomy and RPLND samples to determine the likelihood and agreement of the co-occurrence of GCT components. A total of 118 consecutive patients with NSGCT treated between 1988 and 2012 who underwent both orchiectomy and RPLND at a single academic tertiary care center were analyzed. Statistical analysis of co-occurrence likelihood and agreement of GCT components was performed, both within and between orchiectomy and RPLND specimens. Embryonal carcinoma was the most frequent component present in orchiectomy specimens, and there were multiple significant associations between orchiectomy GCT components; seminoma occurred less frequently with embryonal carcinoma (OR 0.29 [95% confidence interval (CI) 0.11-0.75]; p < 0.01), and teratoma more frequently occurred with choriocarcinoma (OR 9.64 [95% CI 1.22-76.12]; p = 0.01). Presence of teratoma in the orchiectomy specimen predicted for a fourfold increase in distant metastasis on multivariate analysis (HR 4.92 [1.14-18.9]; p = 0.02). The only significant association of co-occurrence in the RPLND specimen was between embryonal carcinoma and teratoma (OR 0.01 [95% CI 0-0.07]; p < 0.001), where it was significantly less likely for them to occur together. Our findings are limited by their retrospective nature. The co-occurrence of GCT components within orchiectomy specimens does not appear to be a completely random process. However, there is less agreement and more randomness between the occurrence of the GCT components in matched orchiectomy and RPLND samples. In this report, we look at the co-occurrence of different GCT components within matched orchiectomy and RPLND pathology specimens and show that co-occurrence is not a completely random process.
  • Shintaro Maru, Hideki Uchino, Takahiro Osawa, Satoshi Chiba, Gaku Mouri, Ataru Sazawa
    PloS one 13 (5) e0197252  1932-6203 2018 [Refereed][Not invited]
     
    PURPOSE: Intermittent androgen deprivation therapy is an effective treatment for metastatic prostate cancer. However, no study to date has evaluated the long-term outcomes of this treatment among patients with prostate cancer after radical prostatectomy. We retrospectively examined the treatment outcomes of patients with prostate-specific antigen recurrence who underwent radical prostatectomy at our department. MATERIALS AND METHODS: Of the 690 patients who underwent radical prostatectomy for local prostate cancer between 1988 and 2011, 129 patients who received androgen deprivation therapy for prostate-specific antigen recurrence were included in this study. Patient characteristics, luteinizing hormone-releasing hormone agonist administration, and outcomes were compared between the intermittent androgen deprivation group (n = 66) and the continuous androgen deprivation therapy group (n = 63). The non-recurrence and overall survival rates were compared between groups. RESULTS: Thirty-six patients (27.9%) experienced recurrence after luteinizing hormone-releasing hormone agonist administration. The 5-year non-recurrence rate and 10-year overall survival rate were higher in the intermittent group (92.9%) than in the continuous group (92.9 vs 57.9%, P < 0.001; and 95.9% vs 84.3%, P = 0.047, respectively). Furthermore, 63 patients (48.8%) showed a PSA nadir of less than 0.01 ng/mL after initiation of luteinizing hormone-releasing hormone agonist; among these patients, the non-recurrence rate was significantly higher in the intermittent androgen deprivation group (P = 0.003). CONCLUSIONS: Intermittent androgen deprivation therapy for prostate specific antigen recurrence after radical prostatectomy contributed to improvement of the non-recurrence rate and overall survival, and can be considered an effective therapy for better prognosis.
  • Daniel P. Petrylak, Ronald de Wit, Kim N. Chi, Alexandra Drakaki, Cora N. Sternberg, Hiroyuki Nishiyama, Daniel Castellano, Syed Hussain, Aude Fléchon, Aristotelis Bamias, Evan Y. Yu, Michiel S. van der Heijden, Nobuaki Matsubara, Boris Alekseev, Andrea Necchi, Lajos Géczi, Yen Chuan Ou, Hasan Senol Coskun, Wen Pin Su, Miriam Hegemann, Ivor J. Percent, Jae Lyun Lee, Marcello Tucci, Andrey Semenov, Fredrik Laestadius, Avivit Peer, Giampaolo Tortora, Sufia Safina, Xavier Garcia del Muro, Alejo Rodriguez-Vida, Irfan Cicin, Hakan Harputluoglu, Ryan C. Widau, Astra M. Liepa, Richard A. Walgren, Oday Hamid, Annamaria H. Zimmermann, Katherine M. Bell-McGuinn, Thomas Powles, Suet Lai Shirley Wong, Thean Hsiang Tan, Elizabeth Jane Hovey, Timothy Dudley Clay, Siobhan Su Wan Ng, Annemie Rutten, Jean Pascal Machiels, Herlinde Dumez, Susanna Yee Shan Cheng, Cristiano Ferrario, Lisa Sengeloev, Niels Viggo Jensen, Constance Thibault, Brigitte Laguerre, Florence Joly, Aude Fléchon, Stéphane Culine, Catherine Becht, Günter Niegisch, Michael Stöckle, Marc Oliver Grimm, Georgios Gakis, Wolfgang Schultze-Seemann, Haralambos Kalofonos, Dimitrios Mavroudis, Christos Papandreou, Vasilis Karavasilis, Janos Révész, Lajos Géczi, Eli Rosenbaum, Raya Leibowitz-Amit, Daniel Kejzman, David Sarid, Giorgio Vittorio Scagliotti, Sergio Bracarda, Francesco Massari, Takahiro Osawa, Naoto Miyajima, Nobuo Shinohara, Fumimasa Fukuta, Chikara Ohyama, Wataru Obara, Shinichi Yamashita, Yoshihiko Tomita, Koji Kawai, Satoshi Fukasawa, Masafumi Oyama, Junji Yonese, Masayoshi Nagata, Motohide Uemura, Kazuo Nishimura, Mutsushi Kawakita, Hiroyuki Tsunemori, Katsuyoshi Hashine, Junichi Inokuchi, Akira Yokomizo, Satoshi Nagamori, Hyo Jin Lee, Se Hoon Park, Sun Young Rha, Yu Jung Kim
    The Lancet 390 (10109) 2266 - 2277 0140-6736 2017/11/18 
    Background Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab—a human IgG1 VEGFR-2 antagonist—or placebo in this patient population. Methods We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy. Patients were enrolled from 124 sites in 23 countries. Previous treatment with one immune-checkpoint inhibitor was permitted. Patients were randomised (1:1) using an interactive web response system to receive intravenous docetaxel 75 mg/m2 plus either intravenous ramucirumab 10 mg/kg or matching placebo on day 1 of repeating 21-day cycles, until disease progression or other discontinuation criteria were met. The primary endpoint was investigator-assessed progression-free survival, analysed by intention-to-treat in the first 437 randomised patients. This study is registered with ClinicalTrials.gov, number NCT02426125. Findings Between July, 2015, and April, 2017, 530 patients were randomly allocated either ramucirumab plus docetaxel (n=263) or placebo plus docetaxel (n=267). Progression-free survival was prolonged significantly in patients allocated ramucirumab plus docetaxel versus placebo plus docetaxel (median 4·07 months [95% CI 2·96–4·47] vs 2·76 months [2·60–2·96]; hazard ratio [HR] 0·757, 95% CI 0·607–0·943; p=0·0118). A blinded independent central analysis was consistent with these results. An objective response was achieved by 53 (24·5%, 95% CI 18·8–30·3) of 216 patients allocated ramucirumab and 31 (14·0%, 9·4–18·6) of 221 assigned placebo. The most frequently reported treatment-emergent adverse events, regardless of causality, in either treatment group (any grade) were fatigue, alopecia, diarrhoea, decreased appetite, and nausea. These events occurred predominantly at grade 1–2 severity. The frequency of grade 3 or worse adverse events was similar for patients allocated ramucirumab and placebo (156 [60%] of 258 vs 163 [62%] of 265 had an adverse event), with no unexpected toxic effects. 63 (24%) of 258 patients allocated ramucirumab and 54 (20%) of 265 assigned placebo had a serious adverse event that was judged by the investigator to be related to treatment. 38 (15%) of 258 patients allocated ramucirumab and 43 (16%) of 265 assigned placebo died on treatment or within 30 days of discontinuation, of which eight (3%) and five (2%) deaths were deemed related to treatment by the investigator. Sepsis was the most common adverse event leading to death on treatment (four [2%] vs none [0%]). One fatal event of neutropenic sepsis was reported in a patient allocated ramucirumab. Interpretation To the best of our knowledge, ramucirumab plus docetaxel is the first regimen in a phase 3 study to show superior progression-free survival over chemotherapy in patients with platinum-refractory advanced urothelial carcinoma. These data validate inhibition of VEGFR-2 signalling as a potential new therapeutic treatment option for patients with urothelial carcinoma. Funding Eli Lilly and Company.
  • Kyoko Hida, Nako Maishi, Kosuke Akiyama, Hitomi Ohmura-Kakutani, Chisaho Torii, Noritaka Ohga, Takahiro Osawa, Hiroshi Kikuchi, Hirofumi Morimoto, Masahiro Morimoto, Masanobu Shindoh, Nobuo Shinohara, Yasuhiro Hida
    CANCER SCIENCE 108 (11) 2195 - 2203 1349-7006 2017/11 [Refereed][Not invited]
     
    Tumor blood vessels play an important role in tumor progression and metastasis. We previously reported that tumor endothelial cells (TEC) exhibit several altered phenotypes compared with normal endothelial cells (NEC). For example, TEC have chromosomal abnormalities and are resistant to several anticancer drugs. Furthermore, TEC contain stem cell-like populations with high aldehyde dehydrogenase (ALDH) activity (ALDH(high)TEC). ALDH(high) TEC have proangiogenic properties compared with ALDH(low) TEC. However, the association between ALDH(high) TEC and drug resistance remains unclear. In the present study, we found that ALDH mRNA expression and activity were higher in both human and mouse TEC than in NEC. Human NEC:human microvascular endothelial cells (HMVEC) were treated with tumor-conditioned medium (tumor CM). The ALDH(high) population increased along with upregulation of stem-related genes such as multidrug resistance 1, CD90, ALP, and Oct-4. Tumor CM also induced sphere-forming ability in HMVEC. Platelet-derived growth factor (PDGF)-A in tumor CM was shown to induce ALDH expression in HMVEC. Finally, ALDH(high) TEC were resistant to fluorouracil (5-FU) invitro and invivo. ALDH(high) TEC showed a higher grade of aneuploidy compared with that in ALDH(low) TEC. These results suggested that tumor-secreting factor increases ALDH(high) TEC populations that are resistant to 5-FU. Therefore, ALDH(high) TEC in tumor blood vessels might be an important target to overcome or prevent drug resistance.
  • Kyoko Hida, Nako Maishi, Kosuke Akiyama, Hitomi Ohmura-Kakutani, Chisaho Torii, Noritaka Ohga, Takahiro Osawa, Hiroshi Kikuchi, Hirofumi Morimoto, Masahiro Morimoto, Masanobu Shindoh, Nobuo Shinohara, Yasuhiro Hida
    Cancer science 108 (11) 2195 - 2203 1347-9032 2017/11 [Refereed][Not invited]
     
    Tumor blood vessels play an important role in tumor progression and metastasis. We previously reported that tumor endothelial cells (TEC) exhibit several altered phenotypes compared with normal endothelial cells (NEC). For example, TEC have chromosomal abnormalities and are resistant to several anticancer drugs. Furthermore, TEC contain stem cell-like populations with high aldehyde dehydrogenase (ALDH) activity (ALDHhigh TEC). ALDHhigh TEC have proangiogenic properties compared with ALDHlow TEC. However, the association between ALDHhigh TEC and drug resistance remains unclear. In the present study, we found that ALDH mRNA expression and activity were higher in both human and mouse TEC than in NEC. Human NEC:human microvascular endothelial cells (HMVEC) were treated with tumor-conditioned medium (tumor CM). The ALDHhigh population increased along with upregulation of stem-related genes such as multidrug resistance 1, CD90, ALP, and Oct-4. Tumor CM also induced sphere-forming ability in HMVEC. Platelet-derived growth factor (PDGF)-A in tumor CM was shown to induce ALDH expression in HMVEC. Finally, ALDHhigh TEC were resistant to fluorouracil (5-FU) in vitro and in vivo. ALDHhigh TEC showed a higher grade of aneuploidy compared with that in ALDHlow TEC. These results suggested that tumor-secreting factor increases ALDHhigh TEC populations that are resistant to 5-FU. Therefore, ALDHhigh TEC in tumor blood vessels might be an important target to overcome or prevent drug resistance.
  • 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.
  • 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]
  • Amir H. Lebastchi, Christopher M. Russell, Alexander M. Helfand, Takahiro Osawa, Javed Siddiqui, Rabia Siddiqui, Arul M. Chinnaiyan, Priya Kunju, Rohit Mehra, Debbie Snyder, Scott A. Tomlins, Jont T. Wei, Todd M. Morgan
    JOURNAL OF UROLOGY 197 (4) E128 - E128 0022-5347 2017/04 [Refereed][Not invited]
  • Takahiro Osawa, Sapan N. Ambani, Kola Olugbade, Ted A. Skolarus, Alon Z. Weizer, Jeffrey S. Montgomery, Chang He, Khaled S. Hafez, Brent K. Hollenbeck, Cheryl T. Lee, James E. Montie, Ganesh S. Palapattu, Todd M. Morgan
    UROLOGY 102 92 - 98 0090-4295 2017/04 [Refereed][Not invited]
     
    OBJECTIVE To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge.MATERIALS AND METHODS The analytic cohort comprised 484 consecutive patients with 90-day follow-up who underwent RC at our institution from 2005 to 2012 and with LOS <= 9 days. Patients were categorized according to LOS as short (s-LOS; <= 5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grades 3-5) occurring within 90 days after discharge. A Cox proportional hazards model was used to determine the association between LOS and post-discharge major complications. Hospital readmission was a secondary outcome.RESULTS Patients in the s-LOS cohort had fewer comorbidities (P < .01), less frequently received neoadjuvant chemotherapy (P = .02), and more often underwent robotic RC (P < .01). Major outpatient complications occurred in 18.1% of s-LOS patients vs 11.2% of r-LOS patients, and s-LOS was associated with a significant independent increase in the risk of major outpatient complications (hazard ratio 1.91, 95% confidence interval 1.03-3.56, P = .04). There was also a statistically significant association between s-LOS and readmission (hazard ratio 1.60, 95% confidence interval 1.01-2.44, P = .048).CONCLUSION Early discharge post RC appears to be associated with an increased risk of major outpatient complications, suggesting that attempts to reduce LOS may need to be supplemented by additional outpatient services to diminish this effect. Further attention should be given to understanding how to better support patients discharged after a short LOS. (C) 2016 Elsevier Inc.
  • Takahiro Osawa, Sapan N Ambani, Ted A Skolarus, Todd M Morgan
    Urology 102 99 - 99 0090-4295 2017/04 [Refereed][Not invited]
  • Takahiro Osawa, Daniela Wittmann, Masahito Jimbo, Evan T Keller, Shunichi Namiki, Takashige Abe, Nobuo Shinohara, Ted A Skolarus
    International journal of urology : official journal of the Japanese Urological Association 23 (11) 906 - 915 2016/11 
    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.
  • Takahiro Osawa, Khaled S. Hafez, David C. Miller, Jeffrey S. Montgomery, Todd M. Morgan, Ganesh S. Palapattu, Alon Z. Weizer, Elaine M. Caoili, James H. Ellis, Lakshmi P. Kunju, J. Stuart Wolf
    UROLOGY 96 87 - 92 0090-4295 2016/10 [Refereed][Not invited]
     
    OBJECTIVE To compare the accuracies of renal mass biopsy (RMB) and R. E. N. A. L. nephrometry score (RNS) nomograms for predicting benign vs malignant disease, and low-vs high-risk renal tumors.MATERIALS AND METHODS We included 281 renal masses in 277 patients who had complete RNS, preoperative RMB, and final pathology from renal surgery for clinically localized renal tumors. RMB and final pathology were determined to be benign or malignant, and malignancies were classified as low-risk (Fuhrman grade I/II) or high-risk (Fuhrman grade III/IV) (benign included in low-risk group). Previously published RNS nomograms were used to determine probabilities of any cancer and high-risk cancer. The gamma statistic was used to assess strength of association between RMB or RNS with final pathology.RESULTS Of the 281 masses, 13 (5%) and 268 (95%) were confirmed benign and malignant, respectively, and 155 (55%) and 126 (45%) were confirmed low-risk and high-risk, respectively, on final pathology. The areas under the curve of the RNS nomograms for benign vs malignant disease and for low-risk vs high-risk renal tumors were 0.56 and 0.64, respectively. Concordances for predicting benign vs malignant disease were 99% for RMB (P <.01, gamma 0.99) and 29% for RNS nomogram (P =.16, gamma 0.38). Concordances for predicting low-risk vs high-risk renal tumors were 67% for RMB (P <.01, gamma 0.97) and 61% for RNS nomogram (P <.01, gamma 0.47), respectively.CONCLUSION Although RNS nomograms are useful for discriminating between benign vs malignant renal masses, and low-risk vs high-risk renal tumors, they are outperformed by RMB. (C) 2016 Elsevier Inc.
  • 大澤 崇宏, 安部 崇重, 丸山 覚, ダニエラ・ウィットマン, スコラルス・テッド, 菊地 央, 宮島 直人, 土屋 邦彦, 並木 俊一, 篠原 信雄
    日本癌治療学会学術集会抄録集 54回 (11) P51 - 3 0919-8172 2016/10 [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.
  • James Tracey, Sapan Ambani, Takahiro Osawa, Ted Skolarus, Chang He, Tudor Borza, Alon Weizer, Jeffrey Montgomery, Khaled Hafez, Brent Hollenbeck, Cheryl Lee, Todd Morgan
    JOURNAL OF UROLOGY 195 (4) E828 - E828 0022-5347 2016/04 [Refereed][Not invited]
  • Takahiro Osawa, Khaled S. Hafez, David C. Miller, Jeffrey S. Montgomery, Todd M. Morgan, Ganesh S. Palapattu, Alon Z. Weizer, Elaine M. Caoili, James H. Ellis, Lakshmi P. Kunju, J. Stuart Wolf
    JOURNAL OF UROLOGY 195 (3) 574 - 580 0022-5347 2016/03 [Refereed][Not invited]
     
    Purpose: A previously published risk stratification algorithm based on renal mass biopsy and radiographic mass size was useful to designate surveillance vs the need for immediate treatment of small renal masses. Nonetheless, there were some incorrect assignments, most notably when renal mass biopsy indicated low risk malignancy but final pathology revealed high risk malignancy. We studied other factors that might improve the accuracy of this algorithm.Materials and Methods: For 202 clinically localized small renal masses in a total of 200 patients with available R.E.N.A.L. (radius, exophytic/endophytic, nearness of tumor to collecting system or sinus, anterior/posterior, hilar tumor touching main renal artery or vein and location relative to polar lines) nephrometry score, preoperative renal mass biopsy and final pathology we assessed the accuracy of management assignment (surveillance vs treatment) based on the previously published risk stratification algorithm as confirmed by final pathology. Logistic regression was used to determine whether other factors (age, gender, R.E.N.A.L. score, R.E.N.A.L. score components and nomograms based on R.E.N.A.L. score) could improve assignment.Results: Of the 202 small renal masses 53 (26%) were assigned to surveillance and 149 (74%) were assigned to treatment by the risk stratification algorithm. Of the 53 lesions assigned to surveillance 25 (47%) had benign/favorable renal mass biopsy histology while in 28 (53%) intermediate renal mass biopsy histology showed a mass size less than 2 cm. Nine of these 53 masses (17%) were incorrectly assigned to surveillance in that final pathology indicated the need for treatment (ie intermediate histology and a mass greater than 2 cm or unfavorable histology). Final pathology confirmed a correct assignment in all 149 masses assigned to treatment. None of the additional parameters assessed improved assignment with statistical significance.Conclusions: Age, gender, R.E.N.A.L. nephrometry score, R.E.N.A.L. score components and nomograms or combinations of these factors do not improve the predictive performance of a small renal mass management risk stratification algorithm based on renal mass biopsy and radiographic mass size.
  • 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
    BLADDER CANCER 2 (2) 251 - 261 2352-3727 2016 [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.
  • 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 - 309 0892-7790 2015/03 [Refereed][Not invited]
     
    Purpose: This study was to evaluate the effect of intraoperative continuous infusion of dexmedetomidine on intraocular pressure (IOP) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) in the steep Trendelenburg (ST). Materials and Methods: Sixty-eight patients were randomly divided into two groups. The dexmedetomidine group (Group D, n=34) received a continuous infusion of dexmedetomidine at a rate of 0.4 mu g kg(-1) hour(-1) from the induction of anesthesia until the end of the ST position, while the control group (Group C, n=34) received an equal volume of physiologic saline at the same rate under conventional general anesthesia with sevoflurane and remifentanil. IOP was measured at 11 predefined time points for all patients. Results: Significant differences in IOP were detected between the two groups by a linear mixed model analysis (p<0.001). The highest mean IOP was 19.9 +/- 5.0 mm Hg in Group D and 25.7 +/- 5.0 mm Hg in Group C; both were measured 60 minutes after the patients had been placed in the ST position. No significant between-group differences in ocular perfusion pressure, mean blood pressure, or heart rate were observed between the two groups. No ocular or other complications were noted. Conclusion: Intraoperative continuous infusion of dexmedetomidine may help alleviate IOP increase in patients undergoing RALRP in the ST position.
  • 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.
  • Kawai Y, Osawa T, Kobayashi K, Inoue R, Yamamoto Y, Matsumoto H, Nagao K, Hara T, Sakano S, Nagamori S, Matsuyama H
    Asian Pacific journal of cancer prevention : APJCP 16 (14) 5687 - 5690 1513-7368 2015 [Refereed][Not invited]
  • T. Osawa, N. Ohga, K. Akiyama, Y. Hida, K. Kitayama, T. Kawamoto, K. Yamamoto, N. Maishi, M. Kondoh, Y. Onodera, M. Fujie, N. Shinohara, K. Nonomura, M. Shindoh, K. Hida
    BRITISH JOURNAL OF CANCER 109 (8) 2237 - 2247 0007-0920 2013/10 [Refereed][Not invited]
     
    Background: Molecules that are highly expressed in tumour endothelial cells (TECs) may be candidates for specifically targeting TECs. Using DNA microarray analysis, we found that the lysyl oxidase (LOX) gene was upregulated in TECs compared with its expression in normal endothelial cells (NECs). LOX is an enzyme that enhances invasion and metastasis of tumour cells. However, there are no reports on the function of LOX in isolated TECs. Methods: TECs and NECs were isolated to investigate LOX function in TECs. LOX inhibition of in vivo tumour growth was also assessed using beta-aminopropionitrile (BAPN). Results: LOX expression was higher in TECs than in NECs. LOX knockdown inhibited cell migration and tube formation by TECs, which was associated with decreased phosphorylation of focal adhesion kinase (Tyr 397). Immunostaining showed high LOX expression in human tumour vessels in vivo. Tumour angiogenesis and micrometastasis were inhibited by BAPN in an in vivo tumour model. Conclusion: LOX may be a TEC marker and a possible therapeutic target for novel antiangiogenic therapy.
  • Nako Maishi, Taisuke Kawamoto, Noritaka Ohga, Koji Yamada, Kosuke Akiyama, Kazuyuki Yamamoto, Takahiro Osawa, Yasuhiro Hida, Kyoko Hida
    Oncology reports 30 (4) 1695 - 700 1021-335X 2013/10 [Refereed][Not invited]
     
    Fluorescent and luminescent tools are commonly used to study the dynamics of cancer progression and metastases in real-time. Fluorophores have become essential tools to study biological events. However, few can sustain fluorescence long enough during long-term studies. In the present study, we focused on a series of new amphiphilic fluorophores known as POLARIC™, which emit strong fluorescence in lipid bilayers and can be readily modified using the Suzuki-Miyaura cross-coupling reaction. Appropriate chemical modifications of substituent groups can improve target-site specificity, reduce cytotoxicity and prolong emission. Therefore, in contrast to conventional fluorescent probes, these fluorophores show promise for long-term monitoring of biological processes. In the present study, we conducted long-term observations of tumor growth and metastasis using a POLARIC derivative as a novel fluorescent probe. For this purpose, we studied the metastatic melanoma cell line A375-SM, which proliferates at a high rate. We compared the characteristics of the POLARIC probe with the commercially available fluorescent dye PKH26 and fluorescent protein mRFP1. A375-SM cells were labeled with these fluorescent probes and orthotopically implanted into nude mice. The fluorescence emitted by POLARIC was detected more than five weeks after implantation without causing detectable harmful effects on tumor growth. By contrast, fluorescence of cells labeled with PKH26 could not be detected at this same time. Furthermore, POLARIC-, but not PKH26-labeled cells, were also detected in lung metastases. These results indicate that labeling cells with POLARIC fluorophores can significantly extend the time course of in vivo studies on tumor cell growth.
  • Kosuke Akiyama, Noritaka Ohga, Nako Maishi, Yasuhiro Hida, Kazuko Kitayama, Taisuke Kawamoto, Takahiro Osawa, Yuko Suzuki, Nobuo Shinohara, Katsuya Nonomura, Masanobu Shindoh, Kyoko Hida
    Pathology international 63 (1) 37 - 44 1320-5463 2013/01 [Refereed][Not invited]
     
    Tumor angiogenesis is necessary for tumor progression and metastasis; therefore, tumor blood vessels are potential therapeutic targets in anticancer therapy. We previously reported that tumor endothelial cells (TECs) exhibit different phenotypes compared with normal endothelial cells (NECs), and microarray analyses of mouse TECs and NECs have shown that several genes are upregulated in TECs compared with NECs. Among these genes, the expression levels of prostaglandin F receptor (PTGFR) mRNA, which encodes the prostaglandin F receptor (FP), were higher in TECs than in NECs. It has been reported that FP and its ligand, prostaglandin F(2α) , are involved in tumor angiogenesis. However, there have been no reports of the expression of PTGFR in the tumor vessels of renal cell carcinoma (RCC). Thus, we isolated human TECs (hTECs) from RCCs. The expression levels of PTGFR mRNA were also upregulated in hTECs. In addition, immunostaining showed that the PTGFR was expressed in human tumor blood vessels in vivo. These findings suggested that PTGFR is a novel TEC marker and that it may be a novel target for antiangiogenic therapy for RCC.
  • Takahiro Osawa, Hiroshi Harada, Koji Oba, Toshimori Seki, Masaki Togashi
    [Hokkaido igaku zasshi] The Hokkaido journal of medical science 88 (1) 15 - 20 0367-6102 2013/01 [Refereed][Not invited]
     
    INTRODUCTION: Nephron-sparing surgery (NSS) has become the standard treatment for small renal cell carcinoma because of its comparable oncological outcome and superior patient survival compared to total nephrectomy. However, the precise chronological course of recovery from initial kidney damage and the factors responsible for it remain unknown. MATERIALS AND METHODS: Seventy-one patients who underwent NSS were enrolled. To elucidate the chronological changes in kidney function that occur after NSS, the estimated glomerular filtration rate (eGFR) was calculated at different two points, the early (7 days after surgery) and late time points (more than 12 months after surgery), and compared with the preoperative eGFR. Perioperative factors were applied to a multivariate regression model to investigate the factors that most affect patient recovery from nephron damage. RESULTS: eGFR was decreased at the early time point but had partially recovered at the late time point. Male gender, ischemic time, and tumor size were found to be significant predictors of the initial drop in eGFR. The only significant factor that prevented later functional recovery was the presence of DM. CONCLUSION: Several perioperative factors significantly influence early kidney damage; however, the presence of DM is the only factor affecting the risk of long-term chronic kidney damage.
  • 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.
  • ALDH陽性活性腫瘍血管内皮細胞の特性解析(Characterization of Aldehyde dehydrogenase (ALDH) positive tumor endothelial cells)
    大村 瞳, 秋山 廣輔, 大賀 則孝, 間石 奈湖, 樋田 泰浩, 川本 泰輔, 近藤 美弥子, 大澤 崇宏, 山本 和幸, 飯田 順一, 進藤 正信, 樋田 京子
    日本癌学会総会記事 71回 85 - 85 0546-0476 2012/08 [Refereed][Not invited]
  • 川本 泰輔, 大賀 則孝, 秋山 廣輔, 平田 尚也, 北原 秀治, 間石 奈湖, 大澤 崇宏, 山本 和幸, 近藤 美弥子, 進藤 正信, 樋田 泰浩, 樋田 京子
    日本癌学会総会記事 71回 (3) 293 - 293 0546-0476 2012/08 [Refereed][Not invited]
     
    BACKGROUND: Increasing evidence indicates that tumor endothelial cells (TEC) differ from normal endothelial cells (NEC). Our previous reports also showed that TEC were different from NEC. For example, TEC have chromosomal abnormality and proangiogenic properties such as high motility and proliferative activity. However, the mechanism by which TEC acquire a specific character remains unclear. To investigate this mechanism, we focused on tumor-derived microvesicles (TMV). Recent studies have shown that TMV contain numerous types of bioactive molecules and affect normal stromal cells in the tumor microenvironment. However, most of the functional mechanisms of TMV remain unclear. METHODOLOGY/PRINCIPAL FINDINGS: Here we showed that TMV isolated from tumor cells were taken up by NEC through endocytosis. In addition, we found that TMV promoted random motility and tube formation through the activation of the phosphoinositide 3-kinase/Akt pathway in NEC. Moreover, the effects induced by TMV were inhibited by the endocytosis inhibitor dynasore. Our results indicate that TMV could confer proangiogenic properties to NEC partly via endocytosis. CONCLUSION: We for the first time showed that endocytosis of TMV contributes to tumor angiogenesis. These findings offer new insights into cancer therapies and the crosstalk between tumor and endothelial cells mediated by TMV in the tumor microenvironment.
  • Takahiro Osawa, Noritaka Ohga, Yasuhiro Hida, Kazuko Kitayama, Kosuke Akiyama, Yuichiro Onodera, Manabu Fujie, Nobuo Shinohara, Masanobu Shindoh, Katsuya Nonomura, Kyoko Hida
    CANCER SCIENCE 103 (6) 1038 - 1044 1347-9032 2012/06 [Refereed][Not invited]
     
    Molecules highly expressed in tumor endothelial cells (TEC) are important for specific targeting of these cells. Previously, using DNA microarray analysis, we found that the prostacyclin receptor (IP receptor) gene was upregulated in TEC compared with normal endothelial cells (NEC). Although prostacyclin is implicated in re-endothelialization and angiogenesis, its role remains largely unknown in TEC. Moreover, the effect of the IP receptor on TEC has not been reported. In the present study we investigated the function of the IP receptor in TEC. The TEC were isolated from two types of human tumor xenografts in nude mice, while NEC were isolated from normal counterparts. Prostacyclin secretion levels in TEC were significantly higher than those in NEC, as shown using ELISA. Real-time RT-PCR showed that the IP receptor was upregulated in TEC compared with NEC. Furthermore, migration and tube formation of TEC were suppressed by the IP receptor antagonist RO1138452. Immunohistostaining showed that the IP receptor was specifically expressed in blood vessels of renal cell carcinoma specimens, but not in glomerular vessels of normal renal tissue. These findings suggest that the IP receptor is a TEC-specific marker and might be a useful therapeutic target. (Cancer Sci 2012; 103: 10381044)
  • Nako Maishi, Noritaka Ohga, Yasuhiro Hida, Kosuke Akiyama, Kazuko Kitayama, Takahiro Osawa, Yuichiro Onodera, Nobuo Shinohara, Katsuya Nonomura, Masanobu Shindoh, Kyoko Hida
    Pathology international 62 (5) 309 - 17 1320-5463 2012/05 [Refereed][Not invited]
     
    Tumor angiogenesis is necessary for progression and metastasis of solid tumor. Tumor blood vessels are morphologically different from their normal counterparts. In this study, we isolated tumor endothelial cells (TECs) and revealed their abnormalities. We have compared the gene expression profiles of TECs and normal endothelial cells (NECs) by microarray analysis and found that several genes were upregulated in TECs. Expression of the chemokine receptor CXCR7 mRNA was higher in TECs than in NECs. However, information regarding the expression of CXCR7 in the tumor vessels of renal cell carcinoma is limited. CXCR7 and its ligand CXCL12 have been implicated in tumor cell survival. In this study, the expression of CXCR7 in the tumor vessels of renal cell carcinoma (RCC) was investigated. Real-time PCR revealed higher expression level of CXCR7 in cultured TECs than in cultured NECs. Furthermore, similar to mouse TECs, immunostaining revealed strong expression of CXCR7 in vivo in human tumor vessels. These findings suggest that CXCR7 is a novel TEC marker and a target for antiangiogenic therapy for RCC.
  • K. Yamamoto, N. Ohga, Y. Hida, N. Maishi, T. Kawamoto, K. Kitayama, K. Akiyama, T. Osawa, M. Kondoh, K. Matsuda, Y. Onodera, M. Fujie, K. Kaga, S. Hirano, N. Shinohara, M. Shindoh, K. Hida
    BRITISH JOURNAL OF CANCER 106 (6) 1214 - 1223 0007-0920 2012/03 [Refereed][Not invited]
     
    BACKGROUND: We isolated tumour endothelial cells (TECs), demonstrated their abnormalities, compared gene expression profiles of TECs and normal endothelial cells (NECs) by microarray analysis and identified several genes upregulated in TECs. We focused on the gene encoding biglycan, a small leucine-rich repeat proteoglycan. No report is available on biglycan expression or function in TECs. METHODS: The NEC and TEC were isolated. We investigated the biglycan expression and function in TECs. Western blotting analysis of biglycan was performed on sera from cancer patients. RESULTS: Biglycan expression levels were higher in TECs than in NECs. Biglycan knockdown inhibited cell migration and caused morphological changes in TECs. Furthermore, immunostaining revealed strong biglycan expression in vivo in human tumour vessels, as in mouse TECs. Biglycan was detected in the sera of cancer patients but was hardly detected in those of healthy volunteers. CONCLUSION: These findings suggested that biglycan is a novel TEC marker and a target for anti-angiogenic therapy. British Journal of Cancer (2012) 106, 1214-1223. doi: 10.1038/bjc.2012.59 www.bjcancer.com Published online 28 February 2012 (C) 2012 Cancer Research UK
  • Noritaka Ohga, Shuhei Ishikawa, Nako Maishi, Kosuke Akiyama, Yasuhiro Hida, Taisuke Kawamoto, Yoshihiro Sadamoto, Takahiro Osawa, Kazuyuki Yamamoto, Miyako Kondoh, Hitomi Ohmura, Nobuo Shinohara, Katsuya Nonomura, Masanobu Shindoh, Kyoko Hida
    The American journal of pathology 180 (3) 1294 - 1307 0002-9440 2012/03 [Refereed][Not invited]
     
    An important concept in tumor angiogenesis is that tumor endothelial cells (TECs) are genetically normal and homogeneous. However, we previously reported that TECs differ from normal ECs. Whether the characteristics of TECs derived from different tumors differ remains unknown. To elucidate this, in this study, we isolated two types of TECs from high-metastatic (HM) and low-metastatic (LM) tumors and compared their characteristics. HM tumor-derived TECs (HM-TECs) showed higher proliferative activity and invasive activity than LM tumor-derived TECs (LM-TECs). Moreover, the mRNA expression levels of pro-angiogenic genes, such as vascular endothelial growth factor (VEGF) receptors 1 and 2, VEGF, and hypoxia-inducible factor-1α, were higher in HM-TECs than in LM-TECs. The tumor blood vessels themselves and the surrounding area in HM tumors were exposed to hypoxia. Furthermore, HM-TECs showed higher mRNA expression levels of the stemness-related gene stem cell antigen and the mesenchymal marker CD90 compared with LM-TECs. HM-TECs were spheroid, with a smoother surface and higher circularity in the stem cell spheroid assay. HM-TECs differentiated into osteogenic cells, expressing activated alkaline phosphatase in an osteogenic medium at a higher rate than either LM-TECs or normal ECs. Furthermore, HM-TECs contained more aneuploid cells than LM-TECs. These results indicate that TECs from HM tumors have a more pro-angiogenic phenotype than those from LM tumors.
  • 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
    The Journal of urology 184 (3) 883 - 7 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 - 6 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.
  • Takahiro Osawa, Hiroshi Harada, Masayoshi Miura, Yayoi Ogawa, Kanako Morooka, Michiko Nakamura, Tatsu Tanabe, Norikata Takada, Toshimori Seki, Masaki Togashi, Toshinao Takenouchi, Tetsuo Hirano
    Clinical transplantation 23 Suppl 20 31 - 3 0902-0063 2009/08 [Refereed][Not invited]
     
    Japan A 56-yr-old Japanese male with a history of diabetic nephropathy underwent a HLA 5/6 mismatch and ABO-compatible living-related kidney transplantation (donor: his 49-yr-old wife). A pre-transplant standard NIH complement-dependent cytotoxicity cross-match (Xm) test, a flow-cytometric T-cell Xm, and a FlowPRA test were totally negative. Inductionimmunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil, methylprednisolone, and basiliximab (BAS). The patient's post-operative course was almost uneventful, and the graft was functioning well (sCr 1.1 mg/dL). He developed general fatigue, and his sCr was elevated to 2.2 mg/dL 792 d after transplant. A graft biopsy showed acute T-cell mediated rejection Banff grade IB (i3, t3, g0, v0, ptc0, C4d staining negative). The conventional anti-rejection therapy could not improve his graft function; therefore, we added BAS to eliminate activated graft-infiltrating T-cells. He responded to the rescue therapy, and the improvement in graft function was confirmed by a subsequent graft biopsy. He enjoyed his health without any opportunistic infections.
  • Takahiro Osawa, Hiroshi Harada, Hitoki Uno, Ryuji Matsumoto, Michiko Nakamura, Norikata Takada, Toshimori Seki, Masaki Togashi, Tetsuo Hirano
    JOURNAL OF UROLOGY 181 (4) 440 - 440 0022-5347 2009/04 [Refereed][Not invited]
  • 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 : official journal of the Japanese Urological Association 16 (3) 274 - 8 0919-8172 2009/03 [Refereed][Not invited]
     
    OBJECTIVES: To evaluate the prognostic role of different clinico-pathological parameters in node-positive patients treated by radical cystectomy. METHODS: 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. RESULTS: 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. CONCLUSIONS: Lymph node density predicts survival in patients with node-positive bladder cancer.
  • Michiko Nakamura, Hiroshi Harada, Masayoshi Miura, Hitoki Uno, Ryuji Matsumoto, Takahiro Osawa, Norikata Takada, Toshimori Seki, Masaki Togashi, Tetsuo Hirano
    AMERICAN JOURNAL OF TRANSPLANTATION 9 599 - 599 1600-6135 2009 [Refereed][Not invited]
  • Takahiro Osawa, Keiji Sugishita, Masashi Murakumo, Tomohiko Koyanagi
    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology (一社)日本泌尿器科学会 100 (1) 12 - 5 0021-5287 2009/01 [Refereed][Not invited]
     
    A 31-year-oldman presented with a 6-month history of right testicular enlargement. The patient underwent a right inguinal orchiectomy. Histopathological examination showed nonseminomatous germ cell tumor (choriocarcinoma>seminoma) which was confined to the tunica albuginea. The postoperative serum level of alpha-fetoprotein (AFP) and lactate dehydrogenase were normal. Serum level of human chorionic gonadotrophin(HCG), however, was 23,000 mIU/ml (normal, < 0.7 mIU/ml). A thoracic computed tomography (CT) at that time showed bilateral and multiple metastases to the lungs but the abdominal CT was normal. After the surgery, the patient was treated with conventional doses of cisplatin, etoposide, and bleomycin. On day 11 of the second chemotherapy course, the patient developed confusion and right sided weakness. Brain magnetic resonance imaging (MRI) showed an ischemic lesion in the left middle cerebral artery area. An echocardiogram showed normal left ventricular function and no valvular vegetations. Finally, the patient completed one additional course of chemotherapy with considerable measures to prevent side effects. A thoracic CT at the end of the third cycle showed no evidence of tumor. At 3 months followup after chemotherapy, he suffered from partial paralysis of right-sided upper and lower limbs but due to intensive rehabilitation he overcame the paralysis and is able to walk by himself. There was no evidence of tumor recurrence.
  • 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 - 80 1464-4096 2008/08/05 [Refereed][Not invited]
     
    OBJECTIVES: To determine the role of lymph-node (LN) dissection in patients undergoing surgery for upper urinary tract (UUT) cancer. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
  • Takahiro Osawa, Yoshihiko Watarai, Ken Morita, Hidehiro Kakizaki, Katsuya Nonomura
    BJU international 97 (4) 794 - 8 1464-4096 2006/04 [Refereed][Not invited]
     
    OBJECTIVE: To present five cases of renal arteriovenous fistula (RAVF) seen at our institution, with an emphasis on surgical treatment. PATIENTS AND METHODS: We assessed five patients with giant high-flow RAVF. The affected kidney was evaluated functionally using (99m)Tc-diethylenetriamine pentaacetic acid renal scintigraphy. The size, location, involvement of branched arteries, and renal function dictated the choice of operative method. Four patients were treated with in situ ligation of the feeding artery for extrarenal RAVF, and the remaining patient had a nephrectomy of the nonfunctioning kidney. The clinical outcome was analysed by renal function, blood pressure control, radiographic cardiothoracic ratio (CTR), occlusion of RAVF, and renal artery patency. RESULTS: Of two patients with hypertension, the blood pressure was normalized in one. The renal function of the affected side was preserved in four patients. CTR was normalized or improved in all four patients with preoperative cardiomegaly. There was no recurrence of RAVF in any of the five patients and there was no major morbidity after surgery. CONCLUSIONS: Surgery for giant high-flow RAVF is safe and feasible from the perspective of complications and recurrence, even though transarterial embolization has become the first line of therapy for RAVF.
  • Takahiro Osawa, Nobuo Shinohara, Satoru Maruyama, Koji Oba, Takashige Abe, Shintaro Maru, Norikata Takada, Ataru Sazawa, Katsuya Nonomura
    UROLOGY JOURNAL 10 (1) 784 - 789 1735-1308 1970/01 
    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 m(2) before surgery and 63.6 (range, 8.7 to 111.5) mL/min/1.73 m(2) 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.

MISC

  • 山田修平, 山田修平, 廣橋良彦, 宮田遥, 宮田遥, 柳川純子, 村井愛子, 時田芹奈, 金関貴幸, 菊地央, 松本隆児, 大澤崇宏, 安部崇重, 鳥越俊彦, 篠原信雄  日本泌尿器科学会総会(Web)  110th-  2023
  • 外科教育の実践とキャリア 当科で行ってきた手術シミュレーショントレーニングの経験
    安部 崇重, 今 雅史, 樋口 まどか, 菊地 央, 岩原 直也, 古御堂 純, 堀田 記世彦, 松本 隆児, 大澤 崇宏, 篠原 信雄  医学教育  53-  (Suppl.)  26  -26  2022/07
  • 森井 康博, 原林 透, 大澤 崇宏, 谷川 琢海, 山品 博子, 篠原 信雄, 小笠原 克彦  泌尿器外科  35-  (6)  516  -521  2022/06  
    北海道がんセンターで腹腔鏡下膀胱全摘除術を受けた48名を対象として、症例のDPCデータより合併症治療費用をClavien-Dindo分類に基づいて症状・重症度別に推計した。1症例あたり合併症治療費用は11万円(四分位範囲:0〜32万円)であり、総費用(257万円)の4.3%を占めた。また、Clavien-Dindo分類でGrade III以上、および再入院を伴う合併症には大きな費用が発生していた。本結果より、合併症治療費用は重症度や再入院の有無により大きく異なることが示された。(著者抄録)
  • Psammomatous meningioma周囲に脳実質石灰化を認めた一例
    岡崎 ななせ, 谷川 聖, 種井 善一, 津田 真寿美, 大澤 崇宏, 松野 吉宏, 田中 伸哉  Brain Tumor Pathology  39-  (Suppl.)  124  -124  2022/05
  • 進行性腎癌の治療
    大澤 崇宏  日本泌尿器科学会雑誌  113-  (2)  np4  -np4  2022/04
  • 相澤 翔吾, 大澤 崇宏, 菊地 央, 松本 隆児, 安部 崇重, 白鳥 聡一, 三橋 智子, 篠原 信雄  泌尿器科紀要  68-  (2)  63  -66  2022/02  
    症例は57歳男性で、陰茎腫瘍を主訴に当科を受診した。初診時MRIでは硬化性リンパ管炎やペロニー病などの良性疾患が考えられたが、2ヵ月後に腫瘤は25×15×8mmから27×15×8mmに増大し、PET-CTで悪性疾患が強く疑われ手術を予定した。既往歴に急性骨髄性白血病(AML)があり、術前検査でAML再燃が疑われたため、陰茎腫瘍生検および骨髄生検を行ったところ、陰茎発生顆粒球性肉腫(GS)が先行したAML再燃の診断に至った。診断後はDNR+AraC療法を行い、陰茎腫瘍の縮小とAMLの寛解が得られた。その後は2回目の同種骨髄幹細胞移植が施行され、現在まで8ヵ月間再発を認めていない。
  • 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, 陳暁帥, 篠原信雄, 近野敦  日本ロボット学会学術講演会予稿集(CD-ROM)  40th-  2022
  • 【泌尿器がんにおけるリキッドバイオプシーの現状と展望】腎がんにおけるリキッドバイオプシー
    大澤 崇宏  泌尿器科  15-  (1)  29  -33  2022/01
  • 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  15-  (1)  77  -82  2022/01
  • ED治療における新しい選択肢 前立腺がん患者のcancer survivorshipと性機能 米国でのがんサバイバー診療から学ぶこと
    大澤 崇宏, 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  109回-  WS4  -5  2021/12
  • 精巣がんサバイバーの妊孕性とQOL
    山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 鈴鴨 よしみ, 荒井 陽一  日本泌尿器科学会総会  109回-  AOP01  -10  2021/12
  • HLAリガンドーム解析を用いた膀胱癌Cancer stem-like cells/Cancer initiating cells(CSCs)に発現する癌抗原の研究
    宮田 遥, 廣橋 良彦, 柳川 純子, 村井 愛子, 時田 芹奈, 金関 貴幸, 山田 修平, 安部 崇重, 大澤 崇宏, 松本 隆児, 菊地 央, 鳥越 俊彦, 篠原 信雄  日本泌尿器科学会総会  109回-  AOP07  -04  2021/12
  • 精巣がんサバイバーにおけるEORTC QLQ-TC26日本語版を用いた性機能評価 多施設共同横断研究
    小山 淳太朗, 山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 鈴鴨 よしみ, 荒井 陽一  日本泌尿器科学会総会  109回-  AOP14  -06  2021/12
  • アキシチニブを投与した転移性腎細胞癌の腫瘍学的成績と予後因子の多施設共同コホート研究による解析(Oncologic outcome and prognostic factor analysis in a multi-center cohort treated with axitinib for metastatic renal cell carcinoma)
    大澤 崇宏, 小島 崇宏, 武内 在雄, 杉元 幹史, 江藤 正俊, 三浪 圭太, 中井 康友, 植田 浩介, 伊藤 陽一, 村井 祥代, 北村 寛, 西山 博之, 篠原 信雄  日本泌尿器科学会総会  109回-  ISP01  -03  2021/12
  • 長期間無再発で経過した筋層非浸潤性膀胱癌術後患者における再発リスクの解析
    平田 由里絵, 大澤 崇宏, 樋口 まどか, 樋之津 史郎, 原林 透, 望月 端吾, 榎並 宣裕, 能中 修, 信野 祐一郎, 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  109回-  OP45  -01  2021/12
  • 進行性腎癌に対するニボルマブ+イピリムマブ療法の原発巣縮小効果
    菊地 央, 大澤 崇宏, 松本 隆児, 安部 崇重, 丸山 覚, 原林 透, 宮田 遥, 柏木 明, 佐澤 陽, 森田 研, 竹内 一郎, 三浪 圭太, 篠原 信雄  日本泌尿器科学会総会  109回-  OP77  -05  2021/12
  • 当院におけるMRI/US fusion biopsyの初期成績
    杉戸 悠紀, 大澤 崇宏, 山田 修平, 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  109回-  PP29  -06  2021/12
  • ED治療における新しい選択肢 前立腺がん患者のcancer survivorshipと性機能 米国でのがんサバイバー診療から学ぶこと
    大澤 崇宏, 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  109回-  WS4  -5  2021/12
  • 精巣がんサバイバーの妊孕性とQOL
    山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 鈴鴨 よしみ, 荒井 陽一  日本泌尿器科学会総会  109回-  AOP01  -10  2021/12
  • HLAリガンドーム解析を用いた膀胱癌Cancer stem-like cells/Cancer initiating cells(CSCs)に発現する癌抗原の研究
    宮田 遥, 廣橋 良彦, 柳川 純子, 村井 愛子, 時田 芹奈, 金関 貴幸, 山田 修平, 安部 崇重, 大澤 崇宏, 松本 隆児, 菊地 央, 鳥越 俊彦, 篠原 信雄  日本泌尿器科学会総会  109回-  AOP07  -04  2021/12
  • 精巣がんサバイバーにおけるEORTC QLQ-TC26日本語版を用いた性機能評価 多施設共同横断研究
    小山 淳太朗, 山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 鈴鴨 よしみ, 荒井 陽一  日本泌尿器科学会総会  109回-  AOP14  -06  2021/12
  • Oncologic outcome and prognostic factor analysis in a multi-center cohort treated with axitinib for metastatic renal cell carcinoma(和訳中)
    大澤 崇宏, 小島 崇宏, 武内 在雄, 杉元 幹史, 江藤 正俊, 三浪 圭太, 中井 康友, 植田 浩介, 伊藤 陽一, 村井 祥代, 北村 寛, 西山 博之, 篠原 信雄  日本泌尿器科学会総会  109回-  ISP01  -03  2021/12
  • 長期間無再発で経過した筋層非浸潤性膀胱癌術後患者における再発リスクの解析
    平田 由里絵, 大澤 崇宏, 樋口 まどか, 樋之津 史郎, 原林 透, 望月 端吾, 榎並 宣裕, 能中 修, 信野 祐一郎, 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  109回-  OP45  -01  2021/12
  • 生体腎移植ドナーの長期生命予後と腎機能推移の検討
    堀田 記世彦, 大澤 崇宏, 横田 勲, 稲尾 翼, 田邉 起, 岩原 直也, 篠原 信雄  日本泌尿器科学会総会  109回-  OP56  -07  2021/12
  • 進行性腎癌に対するニボルマブ+イピリムマブ療法の原発巣縮小効果
    菊地 央, 大澤 崇宏, 松本 隆児, 安部 崇重, 丸山 覚, 原林 透, 宮田 遥, 柏木 明, 佐澤 陽, 森田 研, 竹内 一郎, 三浪 圭太, 篠原 信雄  日本泌尿器科学会総会  109回-  OP77  -05  2021/12
  • 当院におけるMRI/US fusion biopsyの初期成績
    杉戸 悠紀, 大澤 崇宏, 山田 修平, 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  109回-  PP29  -06  2021/12
  • 転移性腎細胞癌患者に対するニボルマブの有効性 日本人臨床カルテレビュー最終調査
    舛井 覚, 日向 信之, 米瀬 淳二, 中井 康友, 城武 卓, 武内 在雄, 稲元 輝生, 野澤 昌弘, 植田 浩介, 悦永 徹, 大澤 崇宏, 植村 元秀, 森島 直士, 伊藤 寛明, 植村 天受  日本癌治療学会学術集会抄録集  59回-  ☆O54  -2  2021/10
  • 転移性腎細胞癌患者に対するニボルマブの有効性 日本人臨床カルテレビュー最終調査
    舛井 覚, 日向 信之, 米瀬 淳二, 中井 康友, 城武 卓, 武内 在雄, 稲元 輝生, 野澤 昌弘, 植田 浩介, 悦永 徹, 大澤 崇宏, 植村 元秀, 森島 直士, 伊藤 寛明, 植村 天受  日本癌治療学会学術集会抄録集  59回-  ☆O54  -2  2021/10
  • 生体腎移植ドナーの腎機能と透析導入リスク 生体腎移植ドナーの長期生命予後と腎機能推移の検討
    堀田 記世彦, 大澤 崇宏, 横田 勲, 稲尾 翼, 田邉 起, 岩原 直也, 篠原 信雄  移植  56-  (総会臨時)  SSY2  -4  2021/09
  • 大澤 崇宏, 篠原 信雄  日本臨床  79-  (5)  662  -666  2021/05
  • 山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 伊藤 明宏, 荒井 陽一  日本内分泌学会雑誌  96-  (4)  1079  -1079  2021/04
  • 安部 崇重, 宮田 遥, 山田 修平, 菊地 央, 松本 隆児, 大澤 崇宏, 西岡 健太郎, 橋本 孝之, 清水 伸一, 篠原 信雄  日本老年泌尿器科学会誌  34-  (1)  50  -50  2021/04
  • 精巣がんサバイバーにおける生殖医療の現状
    山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 伊藤 明宏, 荒井 陽一  日本内分泌学会雑誌  96-  (4)  1079  -1079  2021/04
  • 大澤 崇宏, 篠原 信雄  泌尿器外科  34-  (3)  224  -227  2021/03  
    どのような場面で転移巣切除が行われるべきかについて高いエビデンスの前向き無作為比較試験の報告は存在しない。したがって、実臨床では後ろ向きの報告を手がかりに患者個々の病態を考慮して、最善と判断される場合に転移巣切除が実施されている。本稿では、全身薬物治療と転移巣切除の組み合わせにより、長期生存が得られた膵・肝転移を認めた患者の治療経過を供覧し、膵および肝に対する転移巣切除の後ろ向きの観察研究についての諸家の報告を紹介する。(著者抄録)
  • 岩原 直也, 堀田 記世彦, 岩見 大基, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  34-  (3)  315  -315  2021/03
  • 山田 修平, 松野 吉宏, 大澤 崇宏, 古御堂 純, 宮田 遥, 菊池 央, 松本 隆児, 安部 崇重, 篠原 信雄  泌尿器外科  34-  (3)  315  -315  2021/03
  • 丸山 覚, 黒沢 瞭, 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  34-  (3)  320  -320  2021/03
  • 大澤 崇宏, 安部 崇重, 松本 隆児, 菊地 央, 山田 修平, 古御堂 純, 宮田 遥, 村井 祥代, 伊藤 陽一, 篠原 信雄  泌尿器外科  34-  (3)  321  -321  2021/03
  • 宮田 孟, 安部 崇重, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  泌尿器外科  34-  (3)  329  -329  2021/03
  • 永森 聖人, 松本 隆児, 菊地 央, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  34-  (3)  330  -330  2021/03
  • 平田 由里絵, 大澤 崇宏, 樋口 まどか, 樋之津 史郎, 原林 透, 望月 端吾, 榎並 宣裕, 能中 修, 信野 祐一郎, 菊地 央, 松本 隆児, 安部 崇重, 村井 祥代, 篠原 信雄  泌尿器外科  34-  (3)  331  -331  2021/03
  • 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)  331  -331  2021/03
  • 武田 浩貴, 松本 隆児, 堀 寛太, 森口 卓哉, 菊地 央, 大澤 崇宏, 安部 崇重, 篠原 信雄  泌尿器外科  34-  (3)  334  -335  2021/03
  • 篠原 信雄, 大澤 崇宏  臨床泌尿器科  75-  (2)  110  -115  2021/02  
    <文献概要>ポイント ・ペムブロリズマブ+アキシチニブ併用療法は,がん免疫療法と血管新生阻害療法を組み合わせることで抗腫瘍効果が増強するとされる.・ペムブロリズマブ+アキシチニブ併用療法では,それぞれの薬剤に特徴的な有害事象と重複した有害事象がみられる.・ペムブロリズマブ+アキシチニブ併用療法は,各種ガイドラインにおいてリスク分類にかかわらず未治療腎細胞癌の推奨治療となっている.
  • 大江 悠希, 亀田 啓, 野本 博司, 曹 圭龍, 松本 隆児, 大澤 崇宏, 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  96-  (3)  598  -598  2021/01
  • 泌尿器癌における免疫チェックポイント阻害薬の位置づけと将来展望 腎がんにおける現状と展望
    大澤 崇宏  日本泌尿器科学会総会  108回-  350  -350  2020/12
  • 膀胱癌サバイバーの患者立脚型アウトカムを適切に測定できるQOL評価法の確立
    大澤 崇宏  日本泌尿器科学会総会  108回-  452  -452  2020/12
  • 泌尿器癌における腫瘍血管内皮細胞の役割
    菊地 央, 山田 修平, 古御堂 純, 宮田 遥, 松本 隆児, 大澤 崇宏, 秋野 文臣, 土屋 邦彦, 安部 崇重, 間石 奈湖, 樋田 京子, 篠原 信雄  日本泌尿器科学会総会  108回-  500  -500  2020/12
  • EORTC QLQ-TC26日本語版を用いた精巣癌サバイバーのQOLに関する横断的多施設共同研究
    山下 慎一, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 山田 成幸, 鈴鴨 よしみ, 荒井 陽一  日本泌尿器科学会総会  108回-  807  -807  2020/12
  • 精巣癌患者に対するEORTC QLQ-TC26日本語版の妥当性検証
    山下 慎一, 鈴鴨 よしみ, 垣本 健一, 植村 元秀, 岸田 健, 河合 弘二, 中村 晃和, 後藤 崇之, 大澤 崇宏, 山田 成幸, 荒井 陽一  日本泌尿器科学会総会  108回-  1718  -1718  2020/12
  • 根治的膀胱全摘除術後の周術期合併症に関する多施設後ろ向き研究
    山田 修平, 安部 崇重, 松本 隆児, 古御堂 純, 宮田 遥, 菊地 央, 大澤 崇宏, 篠原 信雄  日本泌尿器科学会総会  108回-  1751  -1751  2020/12
  • 菊地 央, 大澤 崇宏, 松本 隆児, 安部 崇重, 篠原 信雄  腫瘍内科  26-  (4)  384  -390  2020/10
  • 進行・転移性膀胱癌治療のup-to-date 転移性膀胱癌治療における外科治療の位置づけ
    安部 崇重, 山田 修平, 古御堂 純, 菊地 央, 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  58回-  WS14  -3  2020/10
  • 【症例で学ぶ!腎泌尿器診療ガイドラインの使い方】(第3章)腎泌尿器関連疾患 腎癌
    菊地 央, 大澤 崇宏, 篠原 信雄  腎と透析  88-  (増刊)  110  -114  2020/06
  • 安部 崇重, 山田 修平, 古御堂 純, 宮田 遙, 菊地 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  泌尿器外科  33-  (臨増)  732  -733  2020/06
  • 大澤 崇宏, 安部 崇重, 山田 修平, 菊地 央, 松本 隆児, 篠原 信雄  泌尿器外科  33-  (臨増)  772  -772  2020/06
  • 【疾患別 泌尿器科の薬物療法と患者管理 医師・看護師・薬剤師でつくる治療戦略】(第1章)泌尿器がん・腫瘍 腎細胞がん
    山田 修平, 大澤 崇宏, 栗原 尚美, 志賀 桜  Uro-Lo: 泌尿器Care & Cure  別冊-  (疾患別泌尿器科の薬物療法と患者管理)  10  -26  2020/05
  • 安部 崇重, 菊池 央, 松本 隆児, 大澤 崇宏, 篠原 信雄  泌尿器外科  33-  (5)  462  -465  2020/05  
    腎盂尿管癌におけるリンパ節郭清の治療的意義に関して、郭清・非郭清を比較した無作為化試験の結果は存在せずコンセンサスは存在しない。これまでの後ろ向き研究の結果も予後改善効果ありとする報告と、なしとする報告の両方が混在する。ただし、郭清範囲に関しては、Kondoらの腫瘍部位とリンパ節転移部位に関するマッピング研究にはじまり、腫瘍部位別の至適郭清範囲の知見が集積されてきた。今後、臨床病期診断の精度を上げていく試みも、リンパ節郭清の意義を明確にするうえで重要なアプローチであると考えている。(著者抄録)
  • 菊地 央, 松本 隆児, 大澤 崇宏, 安部 崇重, 篠原 信雄  Uro-Lo: 泌尿器Care & Cure  25-  (2)  215  -217  2020/04
  • 大澤 崇宏, 安部 崇重, 山田 修平, 宮田 遥, 菊地 央, 松本 隆児, 宮島 直人, 土屋 邦彦, 丸山 覚, 篠原 信雄  Japanese Journal of Endourology  33-  (1)  89  -94  2020/04  
    【目的】cT1腎癌に対して行われた開腹腎部分切除術(OPN)と鏡視下腎部分切除術(LPN)の術後QOLについて前向き観察研究を行った。【対象・方法】62名(OPN群:8例、LPN群:54例)を対象とした。2群において36-Item Short Formを用いて測定したQOL(術前、術後6ヵ月、術後1年)を比較検討した。有意水準をp<0.05とした。【結果】体の痛み(BP)においてLPN群は、国民標準値と比べて全時点において有意に良好なQOLスコアを示し、術後12ヵ月時点では、OPN群と比較してQOLが有意に良好であった。また、心の健康(MH)は、LPN群において、術後12ヵ月にかけて有意に回復していた。【結論】OPN群とLPN群の術後、QOLの回復過程において異なるプロファイルが認められた。(著者抄録)
  • 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]
  • 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]
  • 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]
  • 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-  JWS  -4  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-  V  -6  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-  AV  -1  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-  O  -2  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-  P  -1  2020
  • 日本人進行性腎細胞癌を対象としたCabozantinibの第II相試験 サブグループ解析
    立神 勝則, 玉田 聡, 中井川 昇, 大澤 崇宏, 大家 基嗣, 金山 博臣, 近藤 千紘, 佐々 直人, 西村 和郎, 野澤 昌弘, 舛森 直哉, 三好 康秀, 木村 丹香子, 黒田 晋吾, 冨田 善彦  日本癌治療学会学術集会抄録集  57回-  P40  -3  2019/10
  • 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)
  • 大澤 崇宏, 篠原 信雄  日本医事新報  (4970)  40  -41  2019/07
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • 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]
  • Norihiro Murahashi, Takashige Abe, Ryuji Matsumoto, Takahiro Oosawa, Keiichiro Yoshinaga, Tohru Shiga, KanakoC Hatanaka, Yoshihiro Matsuno, Nobuo Shinohara  Hinyokika kiyo. Acta urologica Japonica  65-  (7)  277  -282  2019/07  [Not refereed][Not invited]
     
    A 45-year-old woman visited a local clinic with left-flank abdominal pain. Abdominal computed tomography (CT) revealed a tumor 20 cm in diameter in the left adrenal gland. She was referred to our hospital for further treatment. No endocrinological abnormality was detected on either serum or urine examination. CT and haematology findings led to a preoperative diagnosis of primary adrenal carcinoma, and we performed a left adrenalectomy. Histopathological examination revealed a paraganglioma with intact adrenal gland. Therefore we diagnosed this case as primary retroperitoneal paraganglioma. Six months after the surgery, she developed peritoneal dissemination including bilateral ovarian metastases. After cytoreductive metastasectomy, she received 131I-meta-iodobenzylguanidine (MIBG) radiotherapy. During the following five-year follow-up, MIBG radiotherapy in conjunction with cytoreductive metastasectomy (3 surgeries and 6 sessions of 131I-MIBG radiotherapy) was performed, aiming at disease control. Five years after the initial surgery, liver, lung, and intra-peritoneal dissemination progressed. Thereafter, she developed severe diarrhea, hypokalemia, and metabolic acidosis with an elevated level of vasoactive intestional peptide, which was consistent with water diarrhea, hypokalemia, achlorhydria (WDHA) syndrome. Despite intensive treatments such as with a somatostatin analogue, she died two months after the onset of this syndrome.
  • 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]
  • 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]
  • 関崎 知紀, 亀田 啓, 馬場 菜月, 山内 裕貴, 平田 恵里奈, 柴山 惟, 宮野 有希恵, 高瀬 崇宏, 亀田 玲奈, 大場 知穂, 曹 圭龍, 中村 昭伸, 三好 秀明, 大澤 崇宏, 篠原 信雄, 渥美 達也  日本内分泌学会雑誌  95-  (1)  477  -477  2019/04
  • 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]
  • 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-  (4)  OP  -463  2019/04  [Not refereed][Not invited]
  • Haruka Miyata, Takahiro Osawa, Jun Frumido, Hiroshi Kikuchi, Ryuji Matsumoto, Takashige Abe, Satoru Maruyama, Kentaro Nishioka, Shinichi Shimizu, Takayuki Hashimoto, Hiroki Shirato, Nobuo Shinohara  JOURNAL OF CLINICAL ONCOLOGY  37-  (7)  2019/03  [Not refereed][Not invited]
  • 上部尿路上皮癌と精巣癌のリンパ節郭清のPrecision Endourology 上部尿路癌に対する腹腔鏡下リンパ節郭清と開腹郭清との比較
    安部 崇重, 松本 隆児, 高田 徳容, 三浪 圭太, 原林 透, 丸山 覚, 大澤 崇宏, 近藤 恒徳, 田邉 一成, 篠原 信雄  日本泌尿器内視鏡学会総会  32回-  SY  -2  2018/11
  • Second TUR
    松本 隆児, 大澤 崇宏, 菊地 央, 安部 崇重, 篠原 信雄  日本泌尿器内視鏡学会総会  32回-  J  -3  2018/11
  • 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]
  • 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]
  • 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。
  • 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]
  • 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]
  • 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]
  • 転移性腎細胞がん患者を対象とした薬物治療の後方視的観察研究
    野澤 昌弘, 植村 元秀, 大澤 崇宏, 原田 健一, 山名 一寿, 木村 剛, 立神 勝則, 野々村 祝夫, 篠原 信雄, 藤澤 正人, 冨田 善彦, 近藤 幸尋, 江藤 正俊, 越智 研也, 穴澤 嘉雄, 植村 天受, RCC retrospective chart review study group  日本泌尿器科学会総会  106回-  OP  -471  2018/04  [Not refereed][Not invited]
  • 転移性腎細胞がん患者を対象とした薬物治療の後方視的観察研究
    野澤 昌弘, 植村 元秀, 大澤 崇宏, 原田 健一, 山名 一寿, 木村 剛, 立神 勝則, 野々村 祝夫, 篠原 信雄, 藤澤 正人, 冨田 善彦, 近藤 幸尋, 江藤 正俊, 越智 研也, 穴澤 嘉雄, 植村 天受, RCC retrospective chart review study group  日本泌尿器科学会総会  106回-  OP  -471  2018/04  [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]
  • 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]
  • 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]
  • 「それぞれの癌」診断・治療の現状と展望 腎癌 腎癌薬物療法の現状と展望
    篠原 信雄, 大澤 崇宏  日本癌治療学会学術集会抄録集  55回-  OSY12  -3  2017/10
  • 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]
  • 結節性硬化症に伴うてんかんにeverolimusを使用した一症例
    櫻井 高太郎, 大澤 崇宏, 堀之内 徹, 栗田 紹子, 武田 洋司, 久住 一郎  てんかん研究  35-  (2)  594  -594  2017/09
  • 丸山 覚, 菊地 央, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄  泌尿器外科  30-  (8)  1281  -1283  2017/08  
    【目的】手術治療の断端陽性例を少なくするため、局所限局癌における切除断端陽性(pT2RM1)症例を術前MRIで予測可能か検討した。【対象と方法】pT2RM1であった症例12例を対象とし術前MRIと病理標本を比較検討した。【結果】術前MRIにおいて癌が被膜に近いと指摘していたのは11例中6例であり、5例の被膜近傍の癌は指摘できなかった。【結語】術前MRIの診断能は限定的であり、体積の小さい癌は指摘できなかった。(著者抄録)
  • 大澤 崇宏, 篠原 信雄  日本性機能学会雑誌  32-  (2)  156  -156  2017/08
  • 大澤 崇宏, 安部 崇重, 篠原 信雄  日本臨床  75-  (増刊6 新腎・泌尿器癌(上))  59  -62  2017/08
  • 安部 崇重, 大澤 崇宏, 篠原 信雄  日本臨床  75-  (増刊6 新腎・泌尿器癌(上))  412  -416  2017/08
  • 宮崎 将也, 土屋 邦彦, 大澤 崇宏, 宮島 直人, 丸山 覚, 安部 崇重, 阿保 大介, 篠原 信雄  泌尿器外科  30-  (7)  1194  -1194  2017/07
  • 大澤 崇宏, 安部 崇重, 高田 徳容, 宮島 直人, 土屋 邦彦, 丸山 覚, 村井 祥代, Lee Cheryl T., Morgan Todd M., 篠原 信雄  泌尿器外科  30-  (7)  1197  -1197  2017/07
  • 山田 修平, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄  泌尿器外科  30-  (7)  1198  -1198  2017/07
  • 森口 卓哉, 丸山 覚, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄  泌尿器外科  30-  (7)  1203  -1203  2017/07
  • 大澤 崇宏, 安部 崇重, 高田 徳容, 伊藤 陽一, 菊地 央, 宮島 直人, 土屋 邦彦, 丸山 覚, Lee Cheryl T., Morgan Todd M., 村井 祥代, 篠原 信雄  泌尿器外科  30-  (7)  1207  -1207  2017/07
  • 腫瘍径と腎生検に基づく小径腎腫瘍診断アルゴリズムの精度を更に改善させることは可能か? 年齢、性別、およびR.E.N.A.L.Nephrometry Score(RNS)を加えた検討
    大澤 崇宏, Wolf Jr. J. Stuart, 菊地 央, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (47)  76  -76  2017/07
  • 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]
  • 大澤 崇宏  泌尿器外科  30-  (臨増)  898  -898  2017/05
  • 宮崎 将也, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 阿保 大介, 篠原 信雄  泌尿器外科  30-  (臨増)  924  -924  2017/05
  • 日本人および米国人患者に対する膀胱全摘除術後周術期死亡予測ノモグラムの外的妥当性の検証
    大澤 崇宏, 安部 崇重, 高田 徳容, 伊藤 陽一, 菊地 央, 宮島 直人, 土屋 邦彦, 丸山 覚, 村井 祥代, りー・しぇりる, もるがん・とっど, 篠原 信雄  日本泌尿器科学会総会  105回-  OP14  -3  2017/04
  • 術前MRIで局所限局性前立腺癌pT2症例における切除断端陽性部位を予測できるか
    丸山 覚, 菊地 央, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  105回-  OP24  -1  2017/04
  • ロボット支援前立腺全摘除術における腓腹部障害と圧モニタリングの有用性
    丸山 覚, 菊地 央, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  105回-  OP73  -6  2017/04
  • 腸管利用尿路変更膀胱全摘除術における術前因子と周術期重度合併症の関連
    山田 修平, 大澤 崇宏, 安部 崇重, 高田 徳容, 伊藤 陽一, 菊池 央, 宮島 直人, 丸山 覚, 土屋 邦彦, 村井 祥代, 篠原 信雄  日本泌尿器科学会総会  105回-  PP11  -08  2017/04
  • 80歳以上の高齢者腎癌に対する手術治療成績
    宮島 直人, 菊池 央, 大澤 崇宏, 土屋 邦彦, 丸山 覚, 篠原 信雄  日本泌尿器科学会総会  105回-  PP43  -01  2017/04
  • 精巣腫瘍脳転移例に対する治療
    森口 卓哉, 丸山 覚, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄  日本泌尿器科学会総会  105回-  PP93  -03  2017/04
  • 精巣に発生した原始神経外胚葉性腫瘍の1例
    宮崎 将也, 大澤 崇宏, 宮島 直人, 土屋 邦彦, 丸山 覚, 畑中 佳奈子, 谷口 明久, 平川 和志, 清水 康, 秋田 弘俊, 篠原 信雄  日本泌尿器科学会総会  105回-  PP93  -07  2017/04
  • Takahiro Osawa, Sapan N. Ambani, Ted A. Skolarus, Todd M. Morgan  UROLOGY  102-  99  -99  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]
  • 大澤 崇宏, Montgomery Jeffrey S., 丸山 覚, 菊地 央, 宮島 直人, 土屋 邦彦, 安部 崇重, 篠原 信雄, Weizer Alon S.  Japanese Journal of Endourology  29-  (3)  332  -332  2016/11
  • 前立腺全摘除術における術中操作が術後尿失禁に与える影響
    丸山 覚, 菊地 央, 大澤 崇宏, 宮島 直人, 安部 崇重, 篠原 信雄  日本癌治療学会学術集会抄録集  54回-  P53  -10  2016/10
  • 腫瘍径と腎生検に基づく小径腎腫瘍診断アルゴリズムの精度を更に改善させることは可能か? 年齢、性別、およびR.E.N.A.L.Nephrometry Score(RNS)を加えた検討
    大澤 崇宏, Wolf Jr. J. Stuart, 菊地 央, 宮島 直人, 土屋 邦彦, 丸山 覚, 安部 崇重, 篠原 信雄  腎癌研究会会報  (46)  29  -29  2016/07
  • 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]
  • Takahiro Osawa, Khaled S. Hafez, David C. Miller, Jeffrey S. Montgomery, Todd M. Morgan, Ganesh S. Palapattu, Alon Z. Weizer, Elaine M. Caoili, James H. Ellis, Lakshmi P. Kunju, J. Stuart Wolf  JOURNAL OF UROLOGY  195-  (4)  E961  -E961  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]
  • 三浪 圭太, 大澤 崇宏, 原林 透, 永森 聡  Japanese Journal of Endourology  28-  (1)  96  -99  2015/04  
    【目的】下腹部手術の既往がある腹腔鏡下膀胱全摘術症例を検討した。【対象と方法】2009年12月より2013年6月まで腹腔鏡下膀胱全摘術を45例に施行した。5ポートで行い骨盤リンパ節郭清後、膀胱摘出、臍とポート間を5cm切開し膀胱回収、回腸を創外に誘導し腸管処理、回腸導管・新膀胱造設した。新膀胱では再気腹の後に腹腔鏡下に尿道と連続縫合した。10例で下腹部手術の既往を認め、既往のない症例と手術時間、周術期合併症につき比較検討した。【結果】下腹部手術既往の内訳は虫垂炎6例、S状結腸癌術後2例、回盲部癌術後1例、Yグラフト置換術後1例であった。尿路変向は回腸導管7例で新膀胱3例であった。全手術時間・出血量・同種血輸血の頻度・開腹移行の頻度・飲水、摂食開始日・在院日数では手術既往の有無で有意な差は認めなかった。しかし、手術既往症例ではポート設置からリンパ節郭清開始までに中央値22分と有意に時間を要し(既往なしでは10.5分)、術後イレウス発症が5例(50%)と有意に頻度が高かった(既往なしでは11.4%)。【結論】十分な注意を要するが骨盤内手術の既往がある場合でも腹腔鏡下膀胱全摘術は施行可能な術式である。(著者抄録)
  • 原林 透, 三浪 圭太, 大澤 崇宏, 永森 聡  泌尿器外科  27-  (12)  1970  -1970  2014/12
  • 前立腺全摘術後のPSA再発に対する救済放射線治療の検討
    大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  泌尿器外科  27-  (12)  1976  -1976  2014/12
  • 大澤 崇宏  泌尿器外科  27-  (12)  1976  -1977  2014/12
  • 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  泌尿器外科  27-  (12)  1978  -1979  2014/12
  • 去勢抵抗性前立腺癌患者に対するDP療法による骨髄抑制の予測因子の検討
    高田 慎也, 玉木 慎也, 高崎 雅彦, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  日本癌治療学会誌  49-  (3)  2237  -2237  2014/06
  • 進行性膀胱癌に対する放射線単独療法の成績
    原林 透, 三浪 圭太, 大澤 崇宏, 永森 聡, 西山 典明, 沖本 智昭  日本癌治療学会誌  49-  (3)  2612  -2612  2014/06
  • 大石 悠一郎, 大澤 崇宏, 安住 誠, 三浪 圭太, 原林 透, 永森 聡, 武田 広子, 鈴木 宏明, 山城 勝重  泌尿器外科  27-  (臨増)  783  -783  2014/05
  • Sunitinibの治療効果予測因子と治療効果予測モデル
    川井 禎久, 小林 圭太, 西嶋 淳, 大澤 崇宏, 山本 義明, 松本 洋明, 長尾 一公, 原 貴彦, 坂野 滋, 永森 聡, 松山 豪泰  日本泌尿器科学会総会  102回-  608  -608  2014/04
  • 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]
  • 三浪 圭太, 大澤 崇宏, 安住 誠, 原林 透, 永森 聡  泌尿器外科  27-  (2)  250  -250  2014/02
  • 安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  泌尿器外科  27-  (2)  255  -255  2014/02
  • 大澤 崇宏, 安住 誠, 三浪 圭太, 原林 透, 永森 聡  泌尿器外科  27-  (2)  263  -263  2014/02
  • 間石奈湖, 大場雄介, 樋田泰浩, 浜田淳一, 山本和幸, 大賀則孝, 秋山廣輔, 川本泰輔, 大澤崇宏, 近藤美弥子, 大村瞳, 井上農夫男, 進藤正信, 樋田京子  日本口腔科学会雑誌  63-  (1)  135  -135  2014/01  [Not refereed][Not invited]
  • 大村瞳, 秋山廣輔, 大賀則孝, 間石奈湖, TOWFIK Alam Mohammad, 樋田泰浩, 川本泰輔, 近藤美弥子, 大澤崇宏, 飯田順一郎, 進藤正信, 樋田京子  日本口腔科学会雑誌  63-  (1)  133  -133  2014/01  [Not refereed][Not invited]
  • 秋山廣輔, 川本泰輔, 大賀則孝, 樋田泰浩, 近藤美弥子, 間石奈湖, 大澤崇宏, 山本和幸, 進藤正信, 樋田京子  日本口腔科学会雑誌  63-  (1)  170  -170  2014/01  [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]
  • 原林 透, 三浪 圭太, 大澤 崇宏, 永森 聡  Japanese Journal of Endourology  26-  (3)  221  -221  2013/11
  • 三浪 圭太, 大澤 崇宏, 原林 透, 永森 聡  Japanese Journal of Endourology  26-  (3)  299  -299  2013/11
  • 原林 透, 三浪 圭太, 大澤 崇宏, 大石 悠一郎, 永森 聡, 篠原 信雄, 野々村 克也  泌尿器外科  26-  (10)  1509  -1515  2013/10  
    上部尿路上皮腫瘍の標準的治療は腎尿管全摘除術であるが、内視鏡治療は低侵襲かつ機能温存的である。適応はLow grade、小径、単発の筋層非浸性潤腫瘍であるが、単腎症例などではその限りではない。画像と内視鏡検査をあわせることでより正確な病期診断を術前に行うことが重要である。内視鏡治療後の再発率は高いことが問題ではあるが、症例を選べば、経皮的治療は経尿道的アプローチで治療困難な腫瘍の治療に有効である。(著者抄録)
  • 転移性尿路上皮癌における維持化学療法の治療成績
    三浪 圭太, 大澤 崇宏, 安住 誠, 原林 透, 永森 聡  泌尿器科紀要  59-  (9)  609  -609  2013/09
  • 当院における前立腺がん死症例の検討
    大澤 崇宏, 安住 誠, 三浪 圭太, 原林 透, 永森 聡  日本癌治療学会誌  48-  (3)  1494  -1494  2013/09
  • 前立腺MRIとエコーを併用した狙い撃ち生検の検討
    大石 悠一郎, 大澤 崇宏, 安住 誠, 三浪 圭太, 原林 透, 永森 聡, 武田 広子, 鈴木 宏明, 山城 勝重  日本癌治療学会誌  48-  (3)  2916  -2916  2013/09
  • 安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  泌尿器外科  26-  (別冊号)  99  -100  2013/07
  • 大澤 崇宏, 樋田 京子, 篠原 信雄, 野々村 克也  泌尿器外科  26-  (臨増)  659  -660  2013/05  
    泌尿器科癌における血管新生について検討した。ヒトメラノーマ細胞(A375SM)のマウス皮下移植腫瘍からmTEC、正常皮膚からmNECを分離した。次に、ヒト腎細胞癌ならびに非癌部腎組織の血管におけるLOXの発現を解析した。A375SMのヌードマウス皮下移植モデルにおいて、LOX阻害剤BAPNを用いた治療実験を行った。LOX siRNAを用いたLOXの抑制により、mTECの遊走能、管腔形成能は有意に抑制された。また、mTECは接着斑の増加を伴いより広がった細胞へと形態変化した。さらに、LOXの抑制によりFAK tyr397のリン酸化が抑制された。BAPNを用いたヒト腫瘍のヌードマウス皮下移植モデルでは、腫瘍血管新生と肺転移が抑制された。ヒト腎癌組織と非癌部腎組織より分離培養した血管内皮において、TECにおいてLOXの高いmRNA発現レベルを認めた。
  • 原林 透, 三浪 圭太, 大澤 崇宏, 大石 悠一郎, 安住 誠, 永森 聡  Japanese Journal of Endourology  26-  (1)  93  -97  2013/04  
    侵襲度の高い膀胱全摘除術が腹腔鏡手術の導入により周術期の侵襲を低減できたか否かを検討した。【対象】2009/12以降腹腔鏡下膀胱全摘除術を施行した34例を対象とし、それ以前の開腹症例30例と比較検討した。尿路変向法は新膀胱19例、回腸導管13例、尿管皮膚瘻2例であった。【結果】34例の手術時間は345分、出血量516mLと開放手術よりも有意に少なく76%で無輸血手術が遂行できた。2例で開放移行を要した。術後飲水開始3日、食事5日、在院期間32日は開放手術に比して有意に短かった。G3以上の周術期合併症は15%にみられた。病理は、pT3≦26%、pN+18%、断端陽性9%であり、摘出リンパ節個数は22個であった。【結語】腹腔鏡下手術は、術後合併症発生頻度に差はなかったが、出血が少なく、飲水食事開始が早く、術後回復は良好であった。(著者抄録)
  • 山本 和幸, 大賀 則孝, 樋田 泰浩, 間石 奈湖, 川本 泰輔, 秋山 廣輔, 大澤 崇宏, 近藤 美弥子, 加賀 基知三, 平野 聡, 篠原 信雄, 進藤 正信, 樋田 京子  北海道醫學雜誌 = Acta medica Hokkaidonensia  88-  (2)  103  -103  2013/04/01  [Not refereed][Not invited]
  • 間石奈湖, 大場雄介, 山本和幸, 大賀則孝, 浜田淳一, 秋山廣輔, 川本泰輔, 大澤崇宏, 大村瞳, 樋田泰浩, 進藤正信, 樋田京子  日本病理学会会誌  102-  (1)  437  -437  2013/04  [Not refereed][Not invited]
  • 大村瞳, 秋山廣輔, 大賀則孝, 間石奈湖, TOWFIK Alam Mohammad, 樋田泰浩, 川本泰輔, 近藤美弥子, 大澤崇宏, 飯田順一郎, 進藤正信, 樋田京子  日本病理学会会誌  102-  (1)  435  -435  2013/04  [Not refereed][Not invited]
  • 非筋層浸潤膀胱癌の晩期再発例の検討
    安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  日本泌尿器科学会雑誌  104-  (2)  261  -261  2013/03
  • 中高年齢者における精巣腫瘍に対する化学療法の検討
    三浪 圭太, 大澤 崇宏, 安住 誠, 原林 透, 永森 聡  日本泌尿器科学会雑誌  104-  (2)  471  -471  2013/03
  • 原林 透, 三浪 圭太, 大澤 崇宏, 安住 誠, 永森 聡  Japanese Journal of Endourology  25-  (3)  151  -151  2012/11  
    膀胱全摘除術は、浸潤性膀胱癌に対する治療のgoldstandardであり、尿路変向法の選択が重要な要素である。膀胱全摘後に行われる尿路変向術は、回腸導管から新膀胱へとシフトしつつあるが、各人の併存症、生活様式、病状理解に応じて選択されるべきである。現時点では、腹腔鏡手術におけるいずれの尿路変向でも、腸管セグメントの処理は小切開から小腸を引き出し体外で行うのが妥当である。本邦では尿管皮膚瘻の施行頻度が高いが尿管狭窄を防ぐ工夫が欠かせない。腹腔鏡手術の導入により、手術時間は延長するが、出血量と術後合併症の有意な減少が示されている。いまだ確立したとはいえないが、ロボットを含む器具の改良と技術の進歩により、泌尿器科領域で最も複雑な手術も腹腔鏡手術が標準オプションの一つとなるものと思われる。(著者抄録)
  • 大澤 崇宏, 原林 透, 安住 誠, 三浪 圭太, 永森 聡  Japanese Journal of Endourology  25-  (3)  266  -266  2012/11
  • 安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  Japanese Journal of Endourology  25-  (3)  327  -327  2012/11
  • 去勢抵抗性前立腺癌におけるドセタキセル間欠療法の検討
    原林 透, 安住 誠, 大澤 崇宏, 三浪 圭太, 永森 聡  日本癌治療学会誌  47-  (3)  1907  -1907  2012/10
  • PSA低値のCRPC症例の検討
    安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  日本癌治療学会誌  47-  (3)  1940  -1940  2012/10
  • 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]
  • 菊地 央, 丸山 覚, 大堀 加奈子, 鴨田 慎二, 村橋 範浩, 大澤 崇宏, 丸 晋太郎, 青柳 俊紀, 安部 崇重, 佐澤 陽, 原林 透, 篠原 信雄, 野々村 克也  泌尿器外科  25-  (9)  1904  -1904  2012/09
  • 青柳 俊紀, 佐澤 陽, 原林 透, 安部 崇重, 丸 晋太郎, 大澤 崇宏, 丸山 覚, 篠原 信雄, 野々村 克也  泌尿器外科  25-  (9)  1904  -1904  2012/09
  • 岡 応樹, 篠原 信雄, 大澤 崇宏, 青柳 俊紀, 山下 孝典, 北原 学, 丸山 覚, 安部 崇重, 佐澤 陽, 執印 太郎, 野々村 克也  泌尿器外科  25-  (9)  1910  -1910  2012/09
  • 大澤 崇宏, 丸山 覚, 安部 崇重, 岡 応樹, 池城 卓, 丸 晋太郎, 青柳 俊紀, 佐澤 陽, 篠原 信雄, 野々村 克也  泌尿器外科  25-  (9)  1911  -1911  2012/09
  • 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, 秋田 弘俊, 関 利盛, 富樫 正樹, 倉 達彦  泌尿器外科  25-  (9)  1913  -1913  2012/09
  • 原林 透, 三浪 圭太, 大澤 崇宏, 安住 誠, 永森 聡  Japanese Journal of Endourology  25-  (2)  292  -298  2012/09  
    膀胱全摘除術は、浸潤性膀胱癌に対する治療のgoldstandardであり、尿路変向法の選択が重要な要素である。膀胱全摘後に行われる尿路変向術は、回腸導管から新膀胱へとシフトしつつあるが、各人の併存症、生活様式、病状理解に応じて選択されるべきである。現時点では、腹腔鏡手術におけるいずれの尿路変向でも、腸管セグメントの処理は小切開から小腸を引き出し体外で行うのが妥当である。本邦では尿管皮膚瘻の施行頻度が高いが尿管狭窄を防ぐ工夫が欠かせない。腹腔鏡手術の導入により、手術時間は延長するが、出血量と術後合併症の有意な減少が示されている。いまだ確立したとはいえないが、ロボットを含む器具の改良と技術の進歩により、泌尿器科領域で最も複雑な手術も腹腔鏡手術が標準オプションの一つとなるものと思われる。(著者抄録)
  • Toru Harabayashi, Yuichiro Oishi, Makoto Azumi, Takahiro Osawa, Keita Minami, Satoshi Nagamori  JOURNAL OF ENDOUROLOGY  26-  A440  -A440  2012/09  [Not refereed][Not invited]
  • 池城 卓, 佐澤 陽, 安部 崇重, 丸山 覚, 丸 晋太朗, 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  -1910  2012/09  [Not refereed][Not invited]
  • がん転移における腫瘍血管内皮細胞の役割(The role of tumor endothelial cells in tumor metastasis)
    間石 奈湖, 大場 雄介, 大賀 則孝, 秋山 廣輔, 山本 和幸, 浜田 淳一, 川本 泰輔, 大澤 崇宏, 近藤 美弥子, 大村 瞳, 進藤 正信, 樋田 泰浩, 樋田 京子  日本癌学会総会記事  71回-  85  -85  2012/08
  • 腫瘍血管内皮の血管新生におけるLysyl oxidaseの役割(The role of Lysyl oxidase on proangiogenic phenotypes of tumor endothelial cells)
    秋山 廣輔, 大澤 崇宏, 大賀 則孝, 樋田 泰浩, 北山 和子, 川本 泰輔, 山本 和幸, 間石 奈湖, 近藤 美弥子, 篠原 信雄, 野々村 克也, 進藤 正信, 樋田 京子  日本癌学会総会記事  71回-  85  -85  2012/08
  • 腫瘍血管内皮におけるBiglycanの機能解析(Biglycan is a specific marker and an autocrine angiogenic factor of tumor endothelial cells)
    大賀 則孝, 山本 和幸, 樋田 泰浩, 秋山 廣輔, 間石 奈湖, 川本 泰輔, 北山 和子, 大澤 崇宏, 平野 聡, 篠原 信雄, 近藤 正信, 樋田 京子  日本癌学会総会記事  71回-  86  -86  2012/08
  • 腫瘍血管内皮細胞のプロスタサイクリン受容体は血管新生をオートクラインに促進する(Prostacyclin receptor in tumor endothelial cells promotes angiogenesis in an autocrine manner)
    土屋 邦彦, 大澤 崇宏, 大賀 則孝, 樋田 泰浩, 北山 和子, 秋山 廣輔, 小野寺 雄一郎, 篠原 信雄, 藤江 学, 進藤 正信, 野々村 克也, 樋田 京子  日本癌学会総会記事  71回-  251  -251  2012/08
  • 腫瘍細胞由来のmicrovesiclesがエンドサイトーシスを介して血管内皮細胞に血管新生能を獲得させる(Tumor-derived microvesicles induce proangiogenic phenotype in endothelial cells via endocytosis)
    川本 泰輔, 大賀 則孝, 秋山 廣輔, 平田 尚也, 北原 秀治, 間石 奈湖, 大澤 崇宏, 山本 和幸, 近藤 美弥子, 進藤 正信, 樋田 泰浩, 樋田 京子  日本癌学会総会記事  71回-  293  -293  2012/08  [Not refereed][Not invited]
  • 高田 徳容, 三浦 正義, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 中村 美智子, 原田 浩, 関 利盛, 平野 哲夫, 富樫 正樹  泌尿器外科  25-  (7)  1574  -1574  2012/07  [Not refereed][Not invited]
  • 松本 隆児, 原田 浩, 中村 美智子, 宇野 仁輝, 大澤 崇宏, 高田 徳容, 関 利盛, 富樫 正樹, 平野 哲夫  泌尿器外科  25-  (7)  1575  -1575  2012/07  [Not refereed][Not invited]
  • 高橋 俊行, 高田 徳容, 松本 隆児, 宇野 仁輝, 大澤 崇宏, 中村 美智子, 原田 浩, 関 利盛, 富樫 正樹, 平野 哲夫  泌尿器外科  25-  (7)  1575  -1575  2012/07  [Not refereed][Not invited]
  • 分子標的薬再投与を行った転移性腎細胞癌の2例
    安住 誠, 大澤 崇宏, 三浪 圭太, 原林 透, 永森 聡  腎癌研究会会報  (42)  57  -57  2012/06
  • Takahiro Osawa, Kyoko Hida, Noritaka Ohga, Yasuhiro Hida, Kazuko Kitayama, Kazuyuki Yamamoto, Taisuke Kawamoto, Nako Maishi, Miyako Kondo, Kosuke Akiyama, Yuichiro Onodera, Nobuo Shinohara, Masanobu Shindoh, Katsuya Nonomura  JOURNAL OF UROLOGY  187-  (4)  E57  -E58  2012/04  [Not refereed][Not invited]
  • Takahiro Osawa, Noritaka Ohga, Yasuhiro Hida, Kazuko Kitayama, Kazuyuki Yamamoto, Taisuke Kawamoto, Nako Maishi, Miyako Kondo, Kosuke Akiyama, Yuichiro Onodera, Nobuo Shinohara, Katsuya Nonomura, Masanobu Shindoh, Kyoko Hida  CANCER RESEARCH  72-  2012/04  [Not refereed][Not invited]
  • Taisuke Kawamoto, Noritaka Ohga, Kosuke Akiyama, Naoya Hirata, Nako Maishi, Takahiro Osawa, Kazuyuki Yamamoto, Miyako Kondoh, Masanobu Shindoh, Yasuhiro Hida, Kyoko Hida  CANCER RESEARCH  72-  2012/04  [Not refereed][Not invited]
  • Kazuyuki Yamamoto, Noritaka Ohga, Yasuhiro Hida, Nako Maishi, Taisuke Kawamoto, Kazuko Kitayama, Kosuke Akiyama, Takahiro Osawa, Miyako Kondoh, Kichizo Kaga, Satoshi Hirano, Nobuo Shinohara, Masanobu Shindoh, Kyoko Hida  CANCER RESEARCH  72-  2012/04  [Not refereed][Not invited]
  • Takahiro Osawa, Kyoko Hida, Noritaka Ohga, Yasuhiro Hida, Kazuko Kitayama, Kazuyuki Yamamoto, Taisuke Kawamoto, Nako Maishi, Miyako Kondo, Kosuke Akiyama, Yuichiro Onodera, Nobuo Shinohara, Masanobu Shindoh, Katsuya Nonomura  JOURNAL OF UROLOGY  187-  (4)  E57  -E57  2012/04  [Not refereed][Not invited]
  • TNM分類第7版での腎癌pT3症例の予後に関する解析
    安部 崇重, 篠原 信雄, 佐澤 陽, 丸山 覚, 大澤 崇宏, 河津 隆文, 千葉 博基, 佐藤 拓矢, 野々村 克也  日本泌尿器科学会雑誌  103-  (2)  267  -267  2012/03
  • 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  -356  2012/03  [Not refereed][Not invited]
  • 大村瞳, 大村瞳, 大賀則孝, 樋田泰浩, 秋山廣輔, 間石奈湖, 近藤美弥子, 大澤崇宏, 山本和幸, 川本泰輔, 飯田順一郎, 進藤正信, 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  21st-  91  2012  [Not refereed][Not invited]
  • 間石奈湖, 大場雄介, 山本和幸, 大賀則孝, 浜田淳一, 秋山廣輔, 川本泰輔, 大澤崇宏, 近藤美弥子, 大村瞳, 樋田泰浩, 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  21st-  104  2012  [Not refereed][Not invited]
  • 宇野 仁揮, 関 利盛, 早崎 貴洋, 松本 隆児, 大澤 崇宏, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  泌尿器外科  24-  (10)  1692  -1692  2011/10  [Not refereed][Not invited]
  • 高田 徳容, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 関 利盛, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫, 三浦 正義  泌尿器外科  24-  (10)  1693  -1693  2011/10  [Not refereed][Not invited]
  • 大澤 崇宏, 関 利盛, 早崎 貴洋, 宇野 仁揮, 松本 隆児, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  泌尿器外科  24-  (10)  1693  -1693  2011/10  [Not refereed][Not invited]
  • 高田 徳容, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 中村 美智子, 原田 浩, 関 利盛, 平野 哲夫, 富樫 正樹  泌尿器外科  24-  (10)  1695  -1695  2011/10  [Not refereed][Not invited]
  • 大澤 崇宏, 関 利盛, 宇野 仁揮, 松本 隆児, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  泌尿器外科  24-  (10)  1700  -1700  2011/10  [Not refereed][Not invited]
  • 中村 美智子, 原田 浩, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 関 利盛, 富樫 正樹, 平野 哲夫  泌尿器外科  24-  (10)  1700  -1700  2011/10  [Not refereed][Not invited]
  • 癌細胞培養上清による正常血管内皮の薬剤抵抗性の獲得(Endothelial cells acquire drug resistance by factors from tumor cells)
    秋山 廣輔, 大賀 則孝, 樋田 泰浩, 川本 泰輔, 定本 圭弘, 石川 修平, 近藤 美弥子, 間石 奈湖, 大澤 崇宏, 山本 和幸, 進藤 正信, 樋田 京子  日本癌学会総会記事  70回-  107  -107  2011/09
  • 低酸素環境が血管内皮細胞に及ぼす影響(Hypoxia is a key factor to acquisition of tumor endothelial cells abnormalities)
    近藤 美弥子, 大賀 則孝, 秋山 廣輔, 間石 奈湖, 川本 泰輔, 大澤 崇宏, 山本 和幸, 大村 瞳, 樋田 泰浩, 進藤 正信, 樋田 京子  日本癌学会総会記事  70回-  124  -124  2011/09
  • 腫瘍由来microvesiclesが血管内皮細胞の運動能と管腔形成能を亢進させる(Tumor-derived microvesicles promote cell motility and tube formation in endothelial cells)
    川本 泰輔, 大賀 則孝, 秋山 廣輔, 間石 奈湖, 大澤 崇宏, 山本 和幸, 近藤 美弥子, 進藤 正信, 樋田 泰浩, 樋田 京子  日本癌学会総会記事  70回-  125  -125  2011/09
  • 腫瘍血管内皮におけるBiglycanの機能解析(Biglycan is angiogenic factor stimulating cell migration of tumor endothelium)
    山本 和幸, 大賀 則孝, 樋田 泰浩, 北山 和子, 間石 奈湖, 大澤 崇宏, 川本 泰輔, 近藤 美弥子, 秋山 広輔, 加賀 基知三, 平野 聡, 進藤 正信, 樋田 京子  日本癌学会総会記事  70回-  125  -126  2011/09
  • 腫瘍血管内皮細胞とがん転移との相互作用解析(Analysis of interaction between tumor endothelial cells and tumor metastasis)
    間石 奈湖, 大賀 則孝, 樋田 泰浩, 大場 雄介, 浜田 淳一, 秋山 廣輔, 山本 和幸, 大澤 崇宏, 近藤 美弥子, 川本 泰輔, 進藤 正信, 井上 農夫男, 樋田 京子  日本癌学会総会記事  70回-  430  -430  2011/09
  • 腫瘍血管内皮におけるLysyl oxidaseの機能解析(The role of Lysyl oxidase on abnormal phenotypes of tumor endothelial cells)
    大澤 崇宏, 大賀 則孝, 北山 和子, 樋田 泰浩, 川本 泰輔, 近藤 美弥子, 間石 奈湖, 山本 和幸, 秋山 廣輔, 篠原 信雄, 野々村 克也, 進藤 正信, 樋田 京子  日本癌学会総会記事  70回-  430  -430  2011/09
  • 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  [Not refereed][Not invited]
  • Nako Maishi, Noritaka Ohga, Yasuhiro Hida, Yusuke Ohba, Taisuke Kawamoto, Kosuke Akiyama, Kazuko Kitayama, Miyako Kondoh, Takahiro Osawa, Kazuyuki Yamamoto, Nobuo Inoue, Masanobu Shindoh, Kyoko Hida  CANCER RESEARCH  71-  2011/04  [Not refereed][Not invited]
  • 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]
  • 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]
  • 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]
  • 大澤 崇宏, 杉下 圭治, 羽場 知己, 村雲 雅志, 松本 隆治, 小柳 知彦, 足立 祐二  泌尿器外科  24-  (1)  101  -101  2011/01
  • 石川 修平, 安部 崇重, 佐澤 陽, 原林 透, 篠原 信雄, 大澤 崇宏, 三浪 圭太, 坂下 茂夫, 信野 祐一郎, 熊谷 章, 森 達也, 富樫 正樹, 野々村 克也  泌尿器外科  24-  (1)  102  -102  2011/01
  • 安部 崇重, 篠原 信雄, 原林 透, 佐澤 陽, 三浪 圭太, 大澤 崇宏, 鴨田 慎二, 石川 修平, 柴田 武, 秋野 文臣, 坂下 茂夫, 信野 祐一郎, 熊谷 章, 森 達也, 富樫 正樹, 久保田 佳奈子, 野々村 克也  泌尿器外科  24-  (1)  109  -109  2011/01
  • 菅野 由岐子, 橋本 晃佳, 柴田 武, 信野 祐一郎, 大澤 崇宏  泌尿器外科  24-  (1)  111  -111  2011/01
  • 杉下 圭治, 大澤 崇宏, 村雲 雅志, 小柳 知彦  泌尿器外科  24-  (1)  112  -112  2011/01
  • 大澤 崇宏, 杉下 圭治, 村雲 雅志, 小柳 知彦, 高橋 達郎  泌尿器外科  24-  (1)  114  -114  2011/01
  • T. Abe, N. Shinohara, M. Muranaka, A. Sazawa, S. Maruyama, T. Osawa, 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  EJSO  36-  (11)  1085  -1091  2010/11  [Not refereed][Not invited]
     
    Aim: To determine the role of lymph node dissection (LND) in the treatment of urothelial carcinoma (UC) of the upper urinary tract (UUT). Patients and methods: [Study-1] A retrospective multi-institutional study evaluated 293 patients undergoing predominantly nephroureterectomy for UC of the UUT. Of 293 patients, 267 patients had pure UC and 26 demonstrated other histological components. Regarding the pathological node status, 130 patients had pN0 disease, 141 patients had pNx disease and 22 patients had pN+ disease. The sites of initial recurrence and time to first recurrence were reviewed. The sites of recurrence were classified as locoregional or distant recurrence. The relationship between node status and future recurrence was analyzed. [Study-2] Fifty-one patients treated by nephroureterectomy at Hokkaido University Hospital were included. All had LND and all LNs were negative on hematoxylin and eosin staining. We re-evaluated the presence of micrometastasis in LND specimens by anti-cytokeratin immunohistochemistory. Results: [Study-1] Of 293 patients, 76 developed disease relapse. Regional lymph node recurrence was the most common site (34 patients). On multivariate analyses that adjusted for the effect of tumor stage and tumor grade, pNx (skipping LND) was an adverse factor not only for locoregional recurrence, but also for distant relapse. [Study-2] Immunohistochemistry identified micrometastases in 7 (14%) of 51 patients. Regarding survival, 5 of these 7 patients with micrometastases were alive at last follow-up. Conclusions: On relapse analysis, skipping LND was an adverse factor not only for locoregional recurrence, but also for distant relapse. Immunohistochemistry detected micrometastases in about 14% of patients previously diagnosed as pN0. These findings further support a potential therapeutic benefit of LND by eliminating micrometastases. (C) 2010 Elsevier Ltd. All rights reserved.
  • 村橋 範浩, 安部 崇重, 原林 透, 篠原 信雄, 佐澤 陽, 丸山 覚, 大澤 崇宏, 野々村 克也  Japanese Journal of Endourology and ESWL  23-  (3)  164  -164  2010/10
  • 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]
  • 当科における転移性尿路上皮癌の治療成績 dose modificationの影響
    丸 晋太朗, 安部 崇重, 大澤 崇宏, 丸山 覚, 佐澤 陽, 鈴木 信, 原林 透, 篠原 信雄, 野々村 克也  日本癌治療学会誌  45-  (2)  1049  -1049  2010/09
  • 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]
  • 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]
  • 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]
  • 腫瘍血管内皮細胞と腫瘍細胞との相互作用解析(Analysis of interaction between tumor endothelial cells and tumor cells)
    間石 奈湖, 大賀 則孝, 秋山 廣輔, 北山 和子, 近藤 美弥子, 川本 泰輔, 大澤 崇宏, 山本 和幸, 樋田 泰浩, 大場 雄介, 進藤 正信, 樋田 京子  日本癌学会総会記事  69回-  103  -103  2010/08
  • 癌細胞培養上清による正常血管内皮の薬剤抵抗性の獲得(Emdothelial cells acquire drug resistance by factors from tumor cells)
    秋山 廣輔, 大賀 則孝, 樋田 泰浩, 黒須 拓郎, 北山 和子, 石川 修平, 近藤 美弥子, 間石 奈湖, 川本 泰介, 大澤 崇宏, 山本 和幸, 進藤 正信, 樋田 京子  日本癌学会総会記事  69回-  103  -103  2010/08
  • がん患者末梢循環血管内皮細胞における遺伝子発現解析(Gene expression analysis of circulating endothelial cells in cancer patients)
    近藤 美弥子, 大賀 則孝, 黒須 拓郎, 北山 和子, 秋山 廣輔, 間石 奈湖, 川本 泰輔, 大澤 崇宏, 山本 和幸, 樋田 泰浩, 進藤 正信, 樋田 京子  日本癌学会総会記事  69回-  130  -131  2010/08
  • 転移能の異なる腫瘍から分離された腫瘍血管内皮細胞の特性解析(Comparative characterization of tumor endothelial cells isolated from highly and low metastatic tumors)
    大賀 則孝, 石川 修平, 樋田 泰浩, 秋山 広輔, 北山 和子, 近藤 美弥子, 間石 奈湖, 川本 泰輔, 大澤 崇宏, 山本 和幸, 進藤 正信, 樋田 京子  日本癌学会総会記事  69回-  270  -270  2010/08
  • 癌が分泌する小胞は内皮細胞の遺伝子発現を変化させる(Tumor-derived microvesicles cause gene changes in endothelial cells)
    川本 泰輔, 大賀 則孝, 北山 和子, 秋山 廣輔, 近藤 美弥子, 間石 奈湖, 大澤 崇宏, 山本 和幸, 樋田 泰浩, 進藤 正信, 樋田 京子  日本癌学会総会記事  69回-  497  -498  2010/08
  • 非機能性副腎腫瘍のアウトカム 術後に併存症の改善はみられるか?
    丸山 覚, 守屋 仁彦, 丸 晋太朗, 大澤 崇宏, 青柳 俊紀, 安部 崇重, 佐澤 陽, 篠原 信雄, 野々村 克也  泌尿器科紀要  56-  (7)  412  -412  2010/07
  • 大澤 崇宏, 柴田 武, 信野 祐一郎  泌尿器外科  23-  (4)  631  -631  2010/04
  • 柴田 武, 大澤 崇宏, 信野 祐一郎, 上野 洋男  泌尿器外科  23-  (4)  641  -641  2010/04
  • 悪性褐色細胞腫に対する131Imetaiodobenzylguanidine(MIBG)内照射療法
    池城 卓, 佐澤 陽, 安部 崇重, 丸山 覚, 青柳 俊紀, 大澤 崇宏, 丸 晋太朗, 原林 透, 篠原 信雄, 吉永 恵一郎, 玉木 長良, 野々村 克也  日本内分泌外科学会総会プログラム・抄録集  22回-  96  -96  2010/04
  • 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]
  • 村雲 雅志, 小野 武紀, 今 雅史, 小柳 知彦, 杉下 圭治, 川口 愛, 大澤 崇宏, 松本 隆児, 青柳 俊紀, 中村 美智子, 豊田 裕, 堀田 記世彦, 佐澤 陽  泌尿器外科  23-  (臨増)  481  -481  2010/03  [Not refereed][Not invited]
  • 中村 美智子, 原田 浩, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 関 利盛, 富樫 正樹, 平野 哲夫  腎移植・血管外科  21-  (2)  199  -203  2010/03  [Not refereed][Not invited]
     
    症例は30歳女性。12年の血液透析の後、献腎移植を行った。術後無尿であったが、ドップラーエコーやMAG3シンチグラフィーで移植腎血流は良好であり、急性尿細管壊死と診断した。その後腎生検で急性拒絶反応を認め、抗拒絶療法を行ったが、術後33日目に体重増加・腹部膨満が著明となり腹水穿刺により、腹水が尿であることが判明した。再開腹手術を行い、移植尿管が膀胱頭側の腹膜へ吻合されていたことが判明し、固有尿管尿管吻合を行った。その後経過は良好である。(著者抄録)
  • 村橋 範浩, 田中 博, 大澤 崇宏, 菊地 央, 鴨田 慎二, 千葉 博基, 三井 貴彦, 篠原 信雄, 野々村 克也  日本泌尿器科学会雑誌  101-  (2)  492  -492  2010/02
  • 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  日本泌尿器科学会雑誌  101-  (2)  206  -206  2010/02  [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  日本泌尿器科学会雑誌  101-  (2)  270  -270  2010/02  [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  日本泌尿器科学会雑誌  101-  (2)  350  -350  2010/02  [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  日本泌尿器科学会雑誌  101-  (2)  356  -356  2010/02  [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  日本泌尿器科学会雑誌  101-  (2)  431  -431  2010/02  [Not refereed][Not invited]
  • 佐澤 陽, 安部 崇重, 篠原 信雄, 丸山 覚, 原林 透, 青柳 俊紀, 大澤 崇宏, 丸 晋太朗, 野々村 克也  Japanese Journal of Endourology and ESWL  22-  (3)  157  -157  2009/11
  • 原田 浩, 関 利盛, 工藤 大輔, 山内 崇生, 中村 美智子, 岩見 大基, 大澤 崇宏, 高田 徳容, 富樫 正樹, 三浦 浩康  Japanese Journal of Endourology and ESWL  22-  (3)  174  -174  2009/11
  • 大澤 崇宏, 原田 浩, 宇野 仁揮, 松本 隆児, 中村 美智子, 高田 徳容, 関 利盛, 平野 哲夫, 富樫 正樹  Japanese Journal of Endourology and ESWL  22-  (3)  164  -164  2009/11  [Not refereed][Not invited]
  • 精巣腫瘍セミノーマ症例に対するFDG-PETの有用性
    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, 原林 透, 永森 聡, 野々村 克也  日本癌治療学会誌  44-  (2)  541  -541  2009/09
  • 膀胱扁平上皮癌の臨床的検討 予後は改善したか?
    丸山 覚, 篠原 信雄, 丸 晋太朗, 大澤 崇宏, 青柳 俊紀, 安部 崇重, 佐澤 陽, 野々村 克也  日本癌治療学会誌  44-  (2)  594  -594  2009/09
  • 当院における膀胱全摘除周術期合併症の検討
    青柳 俊紀, 安部 崇重, 大澤 崇宏, 丸 晋太朗, 丸山 覚, 佐澤 陽, 篠原 信雄, 野々村 克也  日本癌治療学会誌  44-  (2)  623  -623  2009/09
  • 当科における転移性尿路上皮癌の治療成績 新規抗がん剤の併用は予後を改善したか
    丸 晋太朗, 安部 崇重, 大澤 崇宏, 丸山 覚, 佐澤 陽, 鈴木 信, 原林 透, 篠原 信雄, 野々村 克也  日本癌治療学会誌  44-  (2)  624  -624  2009/09
  • 高橋 俊行, 原田 浩, 高田 徳容, 松本 隆児, 宇野 仁揮, 大澤 崇宏, 中村 美智子, 藤田 裕美, 小川 弥生, 武内 利直, 平野 哲夫, 富樫 正樹, 関 利盛  市立札幌病院医誌  68-  (2)  191  -195  2009/03  [Not refereed][Not invited]
     
    症例は66歳、男性。他院より紹介され、浸潤性膀胱癌に対して腹腔鏡下膀胱全摘除+尿道摘除+回腸導管造設術を施行した。術後4日目より38℃台の発熱あり、尿路感染あるいはカテーテル感染を考え抗生剤投与を開始したが、改善を認めなかった。各種細菌・真菌培養は陰性、画像上も明らかな感染巣を指摘でなかった。尿管カテーテル抜去時に予防的にCFPN(塩酸セフカペン)の内服を開始したところ発熱とともに急性腎不全となり、一時的に血液透析を導入した。透析導入と同時に腎生検を試行したところ、腎の間質への好酸球も含む、強い炎症細胞浸潤を認めたため、この時点で間質性腎炎として、ステロイド治療を開始した。ステロイド投与後は、解熱し炎症反応も陰性化、腎機能も改善し、透析も離脱した。原因薬剤の検索目的に薬剤負荷リンパ球幼若化試験を施行したところ、CFPNおよびMEPM(メロペネム)が陽性を示し、経過からはCFPNが原因薬剤と考えられた。術後に頻用される抗生剤や非ステロイド性抗炎症剤等の薬剤は腎障害をきたすことが知られており、使用の際には間質性腎炎の発症も念頭に置き、有症時には早期に対応することが必要である。(著者抄録)
  • 松本 隆児, 原田 浩, 中村 美智子, 早崎 貴洋, 宇野 仁輝, 大澤 崇宏, 高田 徳容, 関 利盛, 平野 哲夫, 富樫 正樹  泌尿器外科  22-  (臨増)  344  -344  2009/03  [Not refereed][Not invited]
  • 高田 徳容, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 中村 美智子, 原田 浩, 関 利盛, 平野 哲夫, 富樫 正樹  日本泌尿器科学会雑誌  100-  (2)  130  -130  2009/02  [Not refereed][Not invited]
  • 大澤 崇宏, 宇野 仁揮, 松本 隆児, 中村 美智子, 高田 徳容, 原田 浩, 関 利盛, 平野 哲夫, 富樫 正樹  日本泌尿器科学会雑誌  100-  (2)  253  -253  2009/02  [Not refereed][Not invited]
  • 関 利盛, 高橋 俊行, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 三浦 正義, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  日本泌尿器科学会雑誌  100-  (2)  311  -311  2009/02  [Not refereed][Not invited]
  • 大澤 崇宏, 杉下 圭治, 村雲 雅志, 小柳 知彦  日本泌尿器科学会雑誌  100-  (1)  12  -15  2009/01  
    精巣腫瘍の化学療法中に脳梗塞をきたした症例を経験したので文献的考察を加え報告する。31歳男性。半年前より右陰嚢の腫脹を自覚、増大したため近医を受診し高位除睾術施行。病理は混合型胚細胞腫(絨毛上皮癌>精上皮腫)、pT1。多発性肺転移を認め当科紹介。術後LDH231IU/l(200〜400IU/l)、AFP1.9ng/ml(10ng/ml以下)、HCG23000mIU/ml(0.7mIU/ml以下)。International Germ Cell Consensus Classification(IGCCC)のintermediate riskとしてBEP療法開始。2コース目第11病日に軽度の意識障害(JCS1)と左片麻痺が出現。MRIにて左中大脳動脈領域の梗塞巣を確認したため、ただちに治療を開始した。海外での報告では精巣癌患者の化学療法中に血栓塞栓症をきたした例は8.4%、脳梗塞については1.1%という報告があり、発生の危険因子がいくつか指摘されている。自験例では病状の回復を待ち3コース目を終了、肺転移巣の消失を確認し化学療法後3ヵ月現在、再発を認めていない。また、脳梗塞による麻痺症状はリハビリを施行して3ヵ月には右上肢はMMT2度、右下肢はMMT4度まで改善し自力歩行可能となっている。化学療法中に神経学的異常を認めた時には若年者であっても脳血栓塞栓症を鑑別に入れ治療開始することが必要である。(著者抄録)
  • 高田 徳容, 三浦 正義, 大澤 崇宏, 中村 美智子, 原田 浩, 関 利盛  Japanese Journal of Endourology and ESWL  21-  (4)  144  -144  2008/11
  • 大澤 崇宏, 三浦 正義, 宇野 仁揮, 松本 隆児, 中村 美智子, 高田 徳容, 原田 浩, 関 利盛, 平野 哲夫, 富樫 正樹  Japanese Journal of Endourology and ESWL  21-  (4)  157  -157  2008/11  [Not refereed][Not invited]
  • 関 利盛, 早崎 貴洋, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  Japanese Journal of Endourology and ESWL  21-  (4)  176  -176  2008/11  [Not refereed][Not invited]
  • 関 利盛, 早崎 貴洋, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  西日本泌尿器科  70-  (増刊)  202  -202  2008/10  [Not refereed][Not invited]
  • 宇野 仁揮, 関 利盛, 早崎 貴洋, 松本 隆児, 大澤 崇宏, 中村 美智子, 高田 徳容, 原田 浩, 平野 哲夫, 富樫 正樹  西日本泌尿器科  70-  (増刊)  231  -231  2008/10  [Not refereed][Not invited]
  • 膀胱上皮内癌におけるBCG膀胱内注入療法(治療後ランダム生検には意味があるか)
    大澤 崇宏, 関 利盛, 早崎 貴洋, 宇野 仁揮, 松本 隆児, 高田 徳容, 富樫 正樹, 中村 美智子, 原田 浩, 平野 哲夫  日本癌治療学会誌  43-  (2)  828  -828  2008/10  [Not refereed][Not invited]
  • 原田 浩, 中村 美智子, 関 利盛, 宇野 仁揮, 松本 隆児, 大澤 崇宏, 高田 徳容, 富樫 正樹, 平野 哲夫  移植  43-  (総会臨時)  232  -232  2008/09  [Not refereed][Not invited]
  • 中村 美智子, 原田 浩, 早崎 貴洋, 宇野 仁輝, 松本 隆児, 大澤 崇宏, 高田 徳容, 関 利盛, 富樫 正樹, 平野 哲夫  移植  43-  (総会臨時)  321  -321  2008/09  [Not refereed][Not invited]
  • 大澤 崇宏, 原田 浩, 中村 美智子, 早崎 貴洋, 宇野 仁揮, 松本 隆児, 高田 徳容, 関 利盛, 富樫 正樹, 平野 哲夫  移植  43-  (総会臨時)  412  -412  2008/09  [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]
  • 安部 崇重, 篠原 信雄, 三浪 圭太, 佐澤 陽, 原林 透, 鴨田 慎二, 坂下 茂夫, 森 達也, 大澤 崇宏, 信野 祐一郎, 熊谷 章, 富樫 正樹, 野々村 克也  泌尿器外科  21-  (臨増)  389  -389  2008/03
  • 安部 崇重, 篠原 信雄, 原林 透, 佐澤 陽, 鴨田 慎二, 三浪 圭太, 大澤 崇宏, 石川 修平, 信野 祐一郎, 熊谷 章, 森 達也, 富樫 正樹, 野々村 克也  日本泌尿器科学会雑誌  99-  (2)  227  -227  2008/02
  • 大澤 崇宏, 杉下 圭治, 村雲 雅志, 小柳 知彦, 高橋 達郎  日本泌尿器科学会雑誌  99-  (2)  415  -415  2008/02
  • 佐々木 芳浩, 大澤 崇宏, 石川 修平, 篠島 弘和, 坂下 茂夫, 佐藤 幸彦  泌尿器外科  20-  (10)  1345  -1345  2007/10
  • 石川 修平, 大澤 崇宏, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫, 菊池 慶介  泌尿器外科  20-  (10)  1349  -1349  2007/10
  • 大澤 崇宏, 石川 修平, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫  泌尿器外科  20-  (10)  1356  -1356  2007/10
  • 石川 修平, 大澤 崇宏, 篠島 弘和, 佐々木 芳浩, 菊池 慶介, 坂下 茂夫  泌尿器外科  20-  (10)  1357  -1357  2007/10
  • 大澤 崇宏, 石川 修平, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫  泌尿器外科  20-  (10)  1365  -1365  2007/10
  • T. Abe, N. Shinohara, T. Osawa, T. Harabayashi, A. Sazawa, T. Akino, K. Kubota, T. Shibata, H. Ueno, Y. Shinno, K. Shinji, K. Minami, S. Sakashita, T. Mori, I. Takeuchi, A. Kumagai, S. S. Ishikawa, M. Togashi, K. Nonomura  EUROPEAN UROLOGY SUPPLEMENTS  6-  (2)  112  -112  2007/03  [Not refereed][Not invited]
  • 大澤 崇宏, 原林 透, 篠原 信雄, 鴨田 慎二, 坂下 茂夫, 秋野 文臣, 森 達也, 信野 祐一郎, 上野 洋男, 熊谷 章, 竹内 一郎, 富樫 正樹, 野々村 克也  日本泌尿器科学会雑誌  98-  (2)  304  -304  2007/02
  • 大澤 崇宏, 渡井 至彦, 橘田 岳也, 片野 英典, 森田 研, 野々村 克也  泌尿器外科  19-  (11)  1367  -1367  2006/11
  • 三浦 克紀, 大澤 崇宏, 飴田 要, 関 晴夫, 奥山 みどり, 松野 正, 谷口 光太郎, 南谷 正水  泌尿器外科  19-  (11)  1376  -1376  2006/11
  • 大澤 崇宏, 小山 敏樹, 熊谷 章, 竹内 一郎  泌尿器外科  19-  (9)  1158  -1158  2006/09
  • 進行性膀胱尿路上皮癌に対するMVAC/MVEC療法についての検討
    大澤 崇宏, 石川 修平, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫  帯広厚生病院医誌  9-  27  -33  2006/06  
    1994〜2002年に膀胱尿路上皮癌で膀胱全摘出術を受けた84症例(上部尿路癌合併例を除く)を対象に長期成績を検討した.更にあわせて周術期化学療法併用治療の成績と,それに伴う副作用も検討した.年齢中央値は68歳,術後観察期間の中央値は44ヵ月であった.2例にneoadjuvant chemotherapyを,12例にadjuvant chemotherapyを行い,化学療法施行回数は平均2.46コースであった.1)全症例の5年疾患特異生存率は70.7%で,5年全生存率は57.5%であった.2)pT stage,pN stageが高くなるにつれて生存期間が短くなる傾向を認めた.3)化学療法群,非施行群との間にpT3,pT3b,pT4以上,またはpN1,pN2以上の症例に対象を限定しても,無病生存期間に有意差はみられなかった.4)Grade 3以上の副作用は全体で11例みられ,骨髄抑制5例,消化器症状4例,G-CSFを用いてもなおGrade 4の顆粒球減少を2例に認め,輸血を要する貧血症例が3例みられた.また化学療法中の敗血症による死亡例が1例みられた
  • 複数回の生検で見つかった前立腺癌の検討
    石川 修平, 大澤 崇宏, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫, 菊地 慶介  帯広厚生病院医誌  9-  34  -37  2006/06  
    2004年4月から1年間に根治的前立腺全摘術を受けた前立腺癌症例85例(平均年齢67歳)の摘出標本を用いて前立腺癌組織の局在様式を調べ,診断に至った前立腺針生検との相互の関係を検討した.1)主病巣は辺縁領域(PZ)に59例,移行領域(TZ)に26例存在した.2)術前癌診断に要した針生検回数は,1回57例,2回17例,3-6回11例で,平均1.6回であった.3)複数回の生検を要した症例は腫瘍容積が小さく,主病変がTZに多く存在し,全摘Gleason scoreは有意に低く,生検陽性本数が有意に少なかった.4)生検回数と癌病巣の数,重量,術前のPSA値,針生検標本のGleason scoreには有意差は認めなかった.以上,これらの結果から,前立腺癌を強く疑いながらも複数回の生検で癌が検出されない症例では,生検本数を増やしたり,癌発生が少ないとされるTZも針生検の標的に加える必要があると思われた
  • 石川 修平, 大澤 崇宏, 篠島 弘和, 佐々木 芳浩, 菊池 慶介, 坂下 茂夫  泌尿器外科  19-  (臨増)  436  -436  2006/04
  • 佐々木 芳浩, 大澤 崇宏, 石川 修平, 篠島 弘和, 佐藤 幸彦, 坂下 茂夫  泌尿器外科  19-  (臨増)  439  -439  2006/04
  • 三浦 克紀, 大澤 崇宏, 飴田 要, 関 晴夫, 奥山 みどり, 谷口 光太郎, 松野 正, 南谷 正水  泌尿器外科  19-  (臨増)  465  -465  2006/04
  • 大澤 崇宏, 石川 修平, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫  日本泌尿器科学会雑誌  97-  (2)  290  -290  2006/03
  • 石川 修平, 大澤 崇宏, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫, 菊池 慶介  日本泌尿器科学会雑誌  97-  (2)  304  -304  2006/03
  • 大澤 崇宏, 石川 修平, 篠島 弘和, 佐々木 芳浩, 坂下 茂夫  西日本泌尿器科  67-  (増刊)  96  -96  2005/10
  • 上極発生の癌に対する腹腔鏡補助下腎部分切除術(LAPN)の経験
    篠島 弘和, 大澤 崇宏, 石川 修平, 佐々木 芳浩, 坂下 茂夫  日本癌治療学会誌  40-  (2)  620  -620  2005/09
  • 大澤 崇宏, 渡井 至彦, 橘田 岳也, 片野 英典, 森田 研, 福澤 信之, 柿崎 秀宏, 野々村 克也  日本泌尿器科学会雑誌  96-  (2)  210  -210  2005/03

Research Grants & Projects

  • Japan Society for the Promotion of Science:Grants-in-Aid for Scientific Research
    Date (from‐to) : 2022/04 -2025/03 
    Author : 丸山 覚, 伊藤 陽一, 大澤 崇宏, 小笠原 克彦
  • 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) : 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 : Shinohara Nobuo
     
    P-glycoprotein (P-gp), ATP binding cassette transporter, causes drug resistance. We have reported that tumor endothelial cells (TECs) are resistant to paclitaxel (PTX) with P-gp upregulation. PTX is often selected in salvage chemotherapy for urothelial carcinoma (UC), however its outcomes are limited. We hypothesized that TEC P-gp is the cause of this situation. We demonstrated that the number of P-gp positive TECs increased after chemotherapy in UC. High P-gp expression in TECs was correlated with poor prognosis in patients with UC. As the mechanism, chemotherapy elevated P-gp expression in ECs via increasing tumor IL-8 secretion. When the P-gp inhibitor was combined with PTX, tumor growth and metastasis were more reduced with anti-angiogenic effect compared to PTX alone. It was suggested that chemotherapy causes inflammatory changes in tumors, which induce P-gp expression in TECs and cause drug resistance. Targeting P-gp in TECs can be a novel strategy to overcome drug resistance.
  • Japan Society for the Promotion of Science:Grants-in-Aid for Scientific Research
    Date (from‐to) : 2016/08 -2018/03 
    Author : Osawa Takahiro
     
    Metastasis is a complex cascade that involves both intravasation and extravasation. In this study, we developed the 3D in vitro metastasis model for creating primary tumor site and metastatic sites. The primary tumor and metastatic sites were connected with a blood vessel-mimicking channel or tube and cell culture media was circulated among the sites using a peristaltic pump. Prostate carcinoma cells (PC3-GFP) were seeded into primary tumor site containing biomimetic collagen extracellular matrix within 6-well tissue culture plate. Bone stromal cells (HS-5) were seeded into metastatic site. We observed intravasation and circulation of the tumor cells and found tumor cells at the metastatic site. In summary, we have developed the 3D systems that mimic key steps of the metastatic cascade. Such systems will allow both exploration of mechanisms of metastasis and development of therapeutics.

Educational Activities

Teaching Experience

  • Master's Thesis Research in Medical Sciences
    開講年度 : 2021
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 尿路性器腫瘍、腎移植、腎血管外科、神経泌尿器、小児泌尿器、臨床研究、基礎研究
  • Basic Principles of Medicine
    開講年度 : 2021
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 尿路性器腫瘍、腎移植、腎血管外科、神経泌尿器、小児泌尿器、臨床研究、基礎研究
  • Principles of Medicine
    開講年度 : 2021
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 先天性尿路異常、性分化疾患、泌尿器癌、発癌、進展メカニズム
  • Dissertation Research in Medical Sciences
    開講年度 : 2021
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 先天性尿路異常、性分化疾患、泌尿器癌、発癌、進展メカニズム
  • Dissertation Research in Clinical Medicine
    開講年度 : 2021
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 腎移植、拒絶反応、泌尿器科癌、QOL研究、予後、神経因性膀胱、小児泌尿器


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