JaLCDOI 10.18926/AMO/56069
FullText URL 72_3_241.pdf
Author Kambara, Taiki| Tanimoto, Ryuta| Araki, Motoo| Saika, Takashi| Hashimoto, Hideaki| Oeda, Tadashi| Tsushima, Tomoyasu| Hayata, Shunji| Nasu, Yasutomo| Kobayashi, Yasuyuki|
Abstract We retrospectively analyzed the factors related to postoperative cardiovascular (CV) events in patients undergoing partial nephrectomy (PN) or radical nephrectomy (RN) for clinical T1 renal cell carcinoma (RCC). We identified 570 patients who underwent PN or RN for T1 renal cell carcinoma between January 1998 and December 2009 at our institution and related hospitals. We determined the cumulative incidence rate of CV events and overall survival (OS) using Kaplan-Meier survival curves with a log-rank test, and we evaluated the risk for an increase in CV events and OS using Cox proportional hazard regression. Of the 570 patients, 171 underwent PN and 399 underwent RN. The type of surgery was not significantly related with CV events. The only factor that significantly increased the risk of CV events in both the univariate (HR 2.67, p=0.006) and multivariate analyses (HR 2.14, p=0.044) was a postoperative estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m2. Postoperative eGFR was also a significant risk factor for OS in the univariate analysis (HR 2.38, p=0.0104), but not in the multivariate model. Postoperative renal function was a significant independent predictor of the incidence of subsequent CV events.
Keywords renal cell carcinoma nephrectomy partial nephrectomy renal function
Amo Type Original Article
Published Date 2018-06
Publication Title Acta Medica Okayama
Volume volume72
Issue issue3
Publisher Okayama University Medical School
Start Page 241
End Page 247
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29926001
JaLCDOI 10.18926/AMO/48338
FullText URL 61_4_199.pdf
Author Saika, Takashi| Arata, Ryoji| Tsushima, Tomoyasu| Nasu, Yasutomo| Suyama, Bunzo| Takeda, Katsuji| Ebara, Shin| Manabe, Daisuke| Kobayashi, Tomoko| Tanimoto, Ryuta| Kumon, Hiromi|
Abstract To compare the health-related quality of life of elderly patients after radical cystectomy for bladder cancer in urinary diversion groups: ileal conduit, ureterocutaneostomy, or orthotopic urinary reservoir. The 109 participating elderly patients aged 75 or older completed self-reporting questionnaires: the QLQ-C30, and on satisfaction with urinary diversion methods. Fifty-six patients had undergone constructions for ileal conduit diversion, 31 for ureterocutaneostomy, and 22 for orthotopic urinary reservoir (OUR). The median follow-up period for each group was 4.0 years (range 0.3-11.2), 4.5 years (range 0.3-18.0), and 3.3 years (range 0.3-6.7), respectively. Regardless of the type of urinary diversion, the majority of patients reported having good overall quality of life, although with some problem of pain. No significant differences among urinary diversion subgroups were found in any quality of life area in the QLQ-C30 questionnaire. More patients in the OUR sub-group felt disappointment than those in the ileal conduit or cutaneostomy sub-groups. However, a questionnaire which asked which diversion method would be preferable showed a trend that more patients in the OUR subgroup would have chosen the same one. Health-related quality of life appeared relatively good in these 3 groups. Patient demands and expectations may be so different from the results that the details of each urinary diversion method should be explained thoroughly. OUR construction could be a candidate even for elderly patients.
Keywords bladder cancer cystectomy neo-bladder urinary diversion QOL
Amo Type Original Article
Published Date 2007-08
Publication Title Acta Medica Okayama
Volume volume61
Issue issue4
Publisher Okayama University Medical School
Start Page 199
End Page 203
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 17853939
Web of Science KeyUT 000248957100003
JaLCDOI 10.18926/AMO/32881
FullText URL fulltext.pdf
Author Murakami, Takanori| Ebara, Shin| Saika, Takashi| Irie, Shin| Takeda, Katsuji| Maki, Yoshio| Miyaji, Sadayuki| Manabe, Daisuke| Kaku, Haruki| Nasu, Yasutomo| Tsushima, Tomoyasu| Kumon, Hiromi|
Abstract <p>We evaluated the need for transurethral biopsy at first follow-up after intravesical bacillus Calmette-Guerin (BCG) therapy for superficial bladder cancer. The records of 84 patients with superficial bladder cancer who received a 6- or 8-week course of BCG were reviewed. Pathological results before BCG, cystoscopic findings, urinary cytology, and biopsy results for evaluation of BCG therapy were reviewed. All 19 patients with positive urinary cytology had evidence of positive bladder biopsy results. Fifty-three of 54 patients (98.1%) with no visible recurrent tumor and negative urinary cytology demonstrated negative pathological results on bladder biopsy. When not found in conjunction with positive urinary cytology, erythematous mucosa on cystoscopy was not an indicator of tumor recurrence or residual cancer. In conclusion, routine transurethral biopsy of the bladder for evaluating the response to BCG intravesical therapy is not necessary in patients who have no visible tumor on cystoscopy and negative urinary cytology./</p>
Keywords bladder cancer BCG therapy transurethral biopsy cystoscopy urinary cytology
Amo Type Original Article
Published Date 2007-12
Publication Title Acta Medica Okayama
Volume volume61
Issue issue6
Publisher Okayama University Medical School
Start Page 341
End Page 344
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 18183079
JaLCDOI 10.18926/AMO/32868
FullText URL fulltext.pdf
Author Arata, Ryoji| Saika, Takashi| Tsushima, Tomoyasu| Abarzua, Fernando| Nasu, Yasutomo| Kumon, Hiromi|
Abstract To compare the quality of life (QOL) in patients with ileal neobladder and sigmoidal neobladder, a retrospective survey was conducted using a formulated questionnaire. Between January and March 1999, a QOL survey was conducted using self-administered questionnaires (EORTC QLQ-C30, IPSS, supplemented with detailed questionnaires about continence, sexual function, and patient’s satisfaction with the selected urinary diversion method) for 78 patients with orthotopic urinary reservoir (OUR) who were followed-up for more than 3 months after cystectomy. Among 78 patients, 63 had OUR using an ileal segment (male/female&#65309;59/4, median age: 70.8 years old, median follow-up: 1.7 years). Fifteen patients had OUR using a sigmoidal segment (male/female&#65309;13/2, median age: 71.9, median follow-up: 3.9). The QLQ-C30 functional evaluation and the items in relation to sexual function showed no diff erences between the 2 groups. Concerning the voiding condition, bladder emptying, frequency, and urgency, scores in the sigmoidal OUR group were signifi cantly higher. The QOL score concerning voiding conditions, daytime, and nighttime continence and quantity of pad showed a better score in the ileal OUR group. Concerning the satisfaction with methods of urinary diversion, patients in the sigmoidal OUR group expressed less satisfaction than their preoperative expectations. Considering several postoperative voiding conditions, ileal OUR seems superior to sigmoidal OUR.
Keywords urinary diversion orthotopic urinary reservoirs bladder cancer quality of life
Amo Type Original Article
Published Date 2007-08
Publication Title Acta Medica Okayama
Volume volume61
Issue issue4
Publisher Okayama University Medical School
Start Page 229
End Page 234
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 17726512
Web of Science KeyUT 000248957100007
JaLCDOI 10.18926/AMO/32815
FullText URL fulltext.pdf
Author Saika, Takashi| Tsushima, Tomoyasu| Nasu, Yasutomo| Arata, Ryoji| Kaku, Haruki| Akebi, Naoki| Kusaka, Nobuyuki| Kumon, Hiromi|
Abstract <p>The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6%) had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9%) had tumor progression and 149 (49.2%) had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.</p>
Keywords superficial bladder cancer anterior urehral recurrence prognosis predictor
Amo Type Article
Published Date 2003-12
Publication Title Acta Medica Okayama
Volume volume57
Issue issue6
Publisher Okayama University Medical School
Start Page 293
End Page 297
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 14726966
Web of Science KeyUT 000187556500004
JaLCDOI 10.18926/AMO/32806
FullText URL fulltext.pdf
Author Yabuki, Takayuki| Togami, Izumi| Kitagawa, Takahiro| Sasai, Nobuya| Tsushima, Tomoyasu| Shirasaki, Yoshinori| Hiraki, Yoshio|
Abstract <p>The purpose of this study was to compare the MR characteristics of renal cell carcinomas against histologic findings and to assess the correlations among signal intensity, tumor enhancement, and pathologic findings. Fifty-four patients (56 lesions) were examined by MR imaging and then underwent partial or radical nephrectomy. The pathologic diagnosis of all lesions was renal cell carcinoma. All MR examinations were performed as dynamic studies using the same 1.5-T scanner. MR characteristics were compared against pathologic findings after resection, and the correlations among signal intensity, tumor enhancement, and pathologic findings were then assessed. A significant correlation was observed between tumor grade and tumor enhancement, with G3 lesions tending to show little enhancement. Regardless of the histologic classification, G3 tumors were found to contain highly heterotypic cancer cells and very few vessels by histopathologic examination. No significant correlations were noted between the other MR characteristics and pathologic findings. Renal cell carcinomas showing little enhancement tend to be highly malignant lesions based on the pathologic findings. Special consideration is required for these tumors with regard to the selection of surgical intervention and follow-up observation.</p>
Keywords kidney kidney neoplasms MR diagnosis grade
Amo Type Article
Published Date 2003-08
Publication Title Acta Medica Okayama
Volume volume57
Issue issue4
Publisher Okayama University Medical School
Start Page 179
End Page 186
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 14627069
Web of Science KeyUT 000184987100003
JaLCDOI 10.18926/AMO/31973
FullText URL fulltext.pdf
Author Edamura, Kohei| Saika, Takashi| Senoh, Takashi| Koizumi, Fumihito| Manabe, Daisuke| Ebara, Shin| Kaku, Haruki| Yokoyama, Teruhiko| Abarzua, Fernando| Nagai, Atsushi| Nasu, Yasutomo| Tsushima, Tomoyasu| Kumon, Hiromi|
Abstract <p>This study was undertaken to reveal the trends of prostate cancer and the outcome of treatment modalities for each disease stage in patients in a single institute over a 10-year period. From January 1994 through December 2003, 420 consecutive patients with previously untreated and histologically confirmed prostate cancer were analyzed for annual distributions of disease stages and treatment modalities and for long-term clinical progression-free survival, prostate cancer-specific survival, and prostate-specific antigen (PSA) failure-free survival rates for each stage and treatment modality. Annual trends showed that the number of patients, especially those with clinically localized cancer, increased dramatically. The 5-year disease-specific survival rates for patients with clinically localized disease were 100 percent for all treatment modalities, including hormonal therapy alone. Patients with PSA levels less than 10 ng/ml showed an 81 percent 5-year PSA failure-free survival rate with radical prostatectomy. Stage C patients treated by surgery or radiation-based therapy with concomitant hormonal therapy obtained 93 percent and 100 percent cause-specific survival rates, respectively, and those treated by hormonal therapy alone showed a 79 percent rate. The number of patients with localized prostate cancer was increasing in this decade. While long-term hormonal therapy alone was highly efficient in controlling localized prostate cancer, radical therapies in conjunction with neo-adjuvant hormonal therapy produced better survival rates in cases of locally advanced disease.</p>
Keywords prostate carcinoma long-term cohort retrospective outcome
Amo Type Article
Published Date 2005-10
Publication Title Acta Medica Okayama
Volume volume59
Issue issue5
Publisher Okayama University Medical School
Start Page 195
End Page 199
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16286958
Web of Science KeyUT 000232835600003
JaLCDOI 10.18926/AMO/31847
FullText URL fulltext.pdf
Author Kobuke, Makoto| Saika, Takashi| Nakanishi, Yoshiko| Ebara, Shin| Manabe, Daisuke| Uesugi, Tatsuya| Nose, Hiroyuki| Arata, Ryoji| Tsushima, Tomoyasu| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>To determine health-related quality of life (HRQOL) after radical retropubic prostatectomy (RRP) or permanent prostate brachytherapy (BT), third party-conducted QOL surveys were prospectively compared. Between 2004 and 2005, 37 patients underwent RRP and 36 were treated with BT. A QOL survey consisting of the Medical Outcomes Study 36-Item Short Form (SF-36), the University of California, Los Angeles, Prostate Cancer Index (UCLA-PCI) and the International Prostate Symptoms Score (IPSS) was completed prospectively by a research coordinator at baseline, and at 1, 3, 6 and 12 months after treatment. The RRP patients scored well in general QOL except at 1 month after surgery, with their mental health better than at baseline by 6 months after surgery. Disease-specific QOL in RRP patients received a low score at 1 month for both urinary and sexual function, though urinary function rapidly recovered to baseline levels. BT patient QOL was not affected by the therapy except in the IPSS score. However, general and mental health scores in BT patients were inferior to those in RRP patients. This prospective study revealed differences in QOL after RRP and BT. These results will be helpful in making treatment decisions.</p>
Keywords prostate cancer radical prostatectomy QOL brachytherapy
Amo Type Original Article
Published Date 2009-06
Publication Title Acta Medica Okayama
Volume volume63
Issue issue3
Publisher Okayama University Medical School
Start Page 129
End Page 135
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 19571899
Web of Science KeyUT 000267388200002
JaLCDOI 10.18926/AMO/31722
FullText URL fulltext.pdf
Author Nagai, Atsushi| Nasu, Yasutomo| Shirasaki, Yoshinori| Iguchi, Hiroki| Arata, Ryouji| Tsugawa, Masaya| Tsushima, Tomoyasu| Kumon, Hiromi|
Abstract <p>We performed laparoscopic prostatectomy in seven cases with organ-confined prostate cancer. In 6 cases, the surgery was completed successfully and the mean operative time was 424 min. Volume of blood loss was 200 to 3,200 ml and catheterization lasted 6 to 37 days. No major complications were observed in 6 of the cases. In one case, open surgical conversion was necessary mainly due to a bladder injury. Although these were the first cases of laparoscopic prostatectomy in our institution, the technical difficulty and complexity of the surgery were moderate. We believe that laparoscopic radical prostatectomy will become a standard option for the treatment of organ-confined prostate cancer.</p>
Keywords prosatatic cancer laparoscopy prostatectomy
Amo Type Article
Published Date 2002-02
Publication Title Acta Medica Okayama
Volume volume56
Issue issue1
Publisher Okayama University Medical School
Start Page 51
End Page 52
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 11873945
Web of Science KeyUT 000174031300009
JaLCDOI 10.18926/AMO/31599
FullText URL fulltext.pdf
Author Kuroda, Masahiro| Tsushima, Tomoyasu| Nasu, Yasutomo| Asaumi, Junichi| Nishikawa, Koji| Gao, Xian Shu| Joja, Ikuo| Takeda, Yoshihiro| Togami, Izumi| Makihata, Eiichi| Kawasaki, Shoji| Ohmori, Hiroyuki| Hiraki, Yoshio|
Abstract <p>We performed a long-term follow-up of 4 patients with penile cancer who underwent hyperthermotherapy from August 1985 until August 1992. Hyperthermia was applied using a frequency of 350 MHz with a waveguide applicator twice a week for 60 min each for an average of 9.5 times (varying from 6 to 13 times). The total heating time that the temperature of urethra could be kept above 42 degrees C, was 166 min on the average (ranging from 0 to 463 min). Two patients classified as stage I according to the Jackson classification and 1 patient classified as stage IV underwent combined radiotherapy and received an average radiation dose of 53 Gy (range, 40-70 Gy). Among these patients 2 underwent combined chemotherapy with bleomycin or peplomycin. Malignant cells disappeared posttherapeutically and in August 1992, after an average of 5 years and 9 months (varying from 4 years 6 months to 6 years 10 months), the patients were free of recurrences. The one patient on stage IV had extensive invasion of the abdominal wall, but still recovered completely. One patient on stage III underwent combined chemotherapy and hyperthermotherapy, but heating had obviously been insufficient. There was a residue of malignant cells after the treatment and we performed a penectomy. Regarding functional preservation of the penis a multidisciplinary therapy incorporating hyperthermotherapy can be expected to increase the curativity. This indicates that it could induce in an advanced case, where an operation would be difficult, complete remission.</p>
Keywords penile cancer hyperthermia radiotherapy chemotherapy
Amo Type Article
Published Date 1993-06
Publication Title Acta Medica Okayama
Volume volume47
Issue issue3
Publisher Okayama University Medical School
Start Page 169
End Page 174
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 8379345
Web of Science KeyUT A1993LL12400005
JaLCDOI 10.18926/AMO/30759
FullText URL fulltext.pdf
Author Kaku, Haruki| Saika, Takashi| Tsushima, Tomoyasu| Nagai, Atsushi| Yokoyama, Teruhiko| Abarzua, Fernando| Ebara, Shin| Manabe, Daisuke| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>We evaluated the efficiency and toxicity of estramustine phosphate (ECT), ifosfamide (IFM) and cisplatin (CDDP) combination chemotherapy in twenty-one patients with hormone-refractory prostate cancer (HRPC), for which there is currently no effective treatment. Patients received a daily dose of 560 mg ECT in combination with 1.2 g/m2 IFM on days 1 to 5 and 70 mg/m2 CDDP on day 1. This combination therapy was given every 3 to 4 weeks. An objective response of more than 50% reduction in prostate-specific antigen was observed in 9 of 18 patients (50%), and a more than 50% reduction in bi-dimensionally measurable soft-tissue lesions was observed in 2 of 7 patients (29%). The median duration of response among the cases showing partial response was 40 weeks, while the median duration of response of overall partial-response plus stable cases was 30 weeks. The median survival duration of all cases was 47 weeks. Toxicity was modest and acceptable. In conclusion, the ECT, IFM and CDDP combination chemotherapy regimen is a viable treatment option for HRPC. However, in comparison with our previous chemotherapy regimen of IFM and CDDP, no additional long-lasting effects resulting from the inclusion of ECT could be affirmed.</p>
Keywords hormone-refractory prostate cancer chemotherapy estramustine phosphate ifosfamide cisplatin
Amo Type Article
Published Date 2006-02
Publication Title Acta Medica Okayama
Volume volume60
Issue issue1
Publisher Okayama University Medical School
Start Page 43
End Page 49
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16508688
Web of Science KeyUT 000235538900005