Publications by authors named "Fumitaka Koga"

Article Synopsis
  • - The study aimed to compare the effectiveness and safety of neoadjuvant chemohormonal therapy (NCHT) versus radical prostatectomy (RP) alone in patients with high-risk prostate cancer undergoing robot-assisted surgery.
  • - Data from 1,023 patients were analyzed, with results showing that those who received NCHT had a lower rate of biochemical recurrence (15.8% vs. 29.5%) and better pathology outcomes compared to the RP-only group.
  • - The findings indicate that NCHT could be a beneficial pre-surgery treatment for high-risk prostate cancer, improving outcomes without significant safety concerns, although some adverse events were noted.
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Introduction: Systemic and local therapies for patients with metastatic renal cell carcinoma (mRCC) are often challenging despite the evolution of multimodal cancer therapies in the last decade. In this review, we will focus on recent multidisciplinary approaches for patients with mRCC.

Areas Covered: Systemic therapies for patients with mRCC have been garnering attention particularly after the approval of immuno-oncology (IO) agents, including anti-programmed death 1/programmed death-ligand 1.

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Article Synopsis
  • This study investigates prognostic factors for patients with pathological Grade Group 5 prostate cancer after robot-assisted radical prostatectomy, focusing on a cohort of 217 men from ten Japanese medical centers.
  • The research found that the rates of biochemical recurrence-free survival (BCRFS) at 3 and 5 years were 66.1% and 57.7%, respectively, with positive surgical margins (PSMs) and the percentage of positive cancer cores (PPCC) identified as key independent predictors of survival outcomes.
  • Ultimately, the study suggests that monitoring PSMs and PPCC could significantly aid in predicting overall survival and disease progression in this high-risk patient group.
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To investigate the incidence and risk factors of inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) using a multicentric database. The present study used a multicentric database (the MSUG94) containing data on 3,195 Japanese patients undergoing RARP between 2012 and 2021. Surgical procedures utilized for IH prevention were as follows: isolation of the vas deferens, transection of the vas deferens, isolation of the spermatic vessels, and separation of the peritoneum from the internal inguinal ring.

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Article Synopsis
  • The study explored the link between lymphovascular invasion (LVI) and oncological outcomes in prostate cancer patients who underwent robotic-assisted radical prostatectomy (RARP).
  • Out of 3195 patients, 2608 met the criteria, with 11.9% experiencing biochemical recurrence (BCR), showing that LVI adversely affects BCR-free survival and metastasis-free survival in certain patient groups.
  • The findings indicate that LVI is a significant independent prognostic factor for recurrence and metastasis, especially in patients with locally advanced disease, highlighting the need for close monitoring in these cases.
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: We aimed to examine the relationship between the inflammation-related parameters, such as the neutrophil-to-lymphocyte ratio (NLR), and the pathological findings and biochemical recurrence (BCR) in patients with prostate cancer (PCa) undergoing robot-assisted radical prostatectomy (RARP). : A retrospective multicenter cohort study of patients with PCa who underwent RARP at 10 institutes in Japan was conducted. This study enrolled 3195 patients.

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Background: The impact of unilateral and bilateral nerve-sparing robot-assisted laparoscopic radical prostatectomy (NS-RARP) procedures on continence and the time to continence recovery have not been established.

Material And Methods: We retrospectively reviewed a total of 2801 patients who underwent RARP in 9 institutions. Procedures were classified as NS or non-NS; NS procedures were further classified as unilateral or bilateral.

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Translocation and transcription factor E3 (TFE3)-rearranged renal cell carcinoma (RCC) is a rare subtype of RCCs characterised by the fusion of the TFE3 transcription factor genes on chromosome Xp11.2 with one of the multiple genes. TFE3-rearranged RCC occurs mainly in children and adolescents, although middle-aged cases are also observed.

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Introduction: Despite the lack of level 1 evidence, selective bladder-sparing therapy using trimodal therapy is currently recommended by guidelines as a standard of care in patients with non-metastatic, muscle-invasive bladder cancer who are eligible for the treatment.

Areas Covered: This article reviews major studies of selective, bladder-sparing therapy utilizing multiple modalities for muscle-invasive bladder cancer and those comparing the oncological outcomes between bladder-sparing therapy and radical cystectomy. Also discussed are predictive biomarkers potentially capable of guiding treatment decisions by patients with muscle-invasive bladder cancer and a novel strategy for boosting the antitumor immune response in bladder-sparing therapy.

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Background: The BioJet system allows the fusion of magnetic resonance imaging (MRI) images with real-time transrectal ultrasonography to accurately direct biopsy needles to the target lesions. To date, the superiority of targeted biopsy using the BioJet system over cognitive registration remains unknown.

Methods: This retrospective study included 171 biopsy-naïve men with elevated prostate-specific antigen (2.

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Background & Aims: Recently, the strength, assistance with walking, rise from a chair, climb stairs, and falls (SARC-F) questionnaire has been developed to screen patients with signs of sarcopenia. However, its clinical benefit remains uncertain in elderly patients undergoing elective major surgeries. This study aimed to explore the role of the SARC-F questionnaire as a screening tool for patients who plan to undergo elective major surgery for urologic cancer and to also evaluate correlations of SARC-F scores with established indicators of sarcopenia.

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Article Synopsis
  • * Factors like prostate-specific antigen levels, prostate volume, and biopsy results were identified as key predictors in our multivariable analysis.
  • * The nomogram showed good predictive ability, correctly diagnosing 39.9% of patients with advanced cancer and helping 91.6% of cases avoid being underdiagnosed.
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Purpose: To investigate whether even a minimally invasive diagnostic procedure for the upper tract such as ureteral catheterization (UCath) may substantially increase the risk of intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

Methods: The present, retrospective study enrolled 163 patients undergoing RNU for UTUC between 2010 and 2021 at two, tertiary care hospitals. The primary endpoint was the association between UCath and IVR-free survival (IVRFS).

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Objectives: To examine the clinical significance of the Vesical Imaging-Reporting and Data System (VI-RADS) in predicting outcome of multimodal treatment (MMT) in muscle-invasive bladder cancer (MIBC) patients.

Methods: We reviewed 78 pathologically proven MIBC patients who underwent MMT including transurethral resection and chemoradiotherapy, followed by partial or radical cystectomy. Treatment response was assessed through histologic evaluation of cystectomy specimens.

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Locally advanced prostate cancer (PCa) with pathological seminal vesicle invasion (pT3b) is a very-high-risk disease associated with biochemical recurrence (BCR), local recurrence, distant metastases, or mortality following definitive therapies. This study aimed to evaluate the risk factors associated with BCR following robot-assisted radical prostatectomy (RARP) in PCa patients with pT3b. A retrospective multicenter cohort study was conducted on 3,195 patients with PCa who underwent RARP at nine domestic centers between September 2011 and August 2021.

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Background: The significance of metastasis-directed therapy for oligometastatic prostate cancer has been widely discussed, and targeted therapy for progressive sites is a feasible option as a multidisciplinary treatment for castration-resistant prostate cancer (CRPC). When oligometastatic CRPC with only bone metastases progresses after targeted therapy, it tends to progress as multiple bone metastases. The progression of oligometastatic CRPC after targeted therapy may be due in part to the presence of micrometastatic lesions that, though undetected on imaging, were present prior to targeted therapy.

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Background: This retrospective multicenter cohort study investigated the association of hospital volume with perioperative and oncological outcomes in patients treated with robot-assisted radical prostatectomy (RARP).

Methods: We collected the clinical data of patients who underwent RARP at eight institutions in Japan between September 2012 and August 2021. The patients were divided into two groups based on the treatment site-high- and non-high-volume hospitals.

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Article Synopsis
  • The study aimed to determine if prostate cancer patients with different locations of positive surgical margins experience varying outcomes after robot-assisted radical prostatectomy.
  • Conducted in Japan with 3,195 participants, the research analyzed data from 2,667 patients, contrasting those with negative vs. positive surgical margins over a median follow-up of 25 months.
  • Results indicated that patients with multifocal and seminal-vesicle-only positive surgical margins had poorer biochemical recurrence-free survival, while those with apex-only positive margins experienced better outcomes compared to other margin locations.
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In this multicenter retrospective cohort study, we aimed to evaluate whether pelvic lymph node dissection (PLND) improved biochemical recurrence (BCR) in patients with prostate cancer (PCa) who underwent robot-assisted radical prostatectomy (RARP) in Japan. A multicenter retrospective cohort study of 3195 PCa patients undergoing RARP at nine institutions in Japan was conducted. Enrolled patients were divided into two groups: those who underwent RARP without PLND (non-PLND group) and those who underwent PLND (PLND group).

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Background And Objective: Muscle-invasive bladder cancer (MIBC) is a biologically aggressive disease and its prognosis is poor. Radical cystectomy (RC) with urinary diversion and lymph node dissection is the gold standard treatment for MIBC patients. Accumulating evidence indicates that sarcopenia, the degenerative and systemic loss of skeletal muscle mass, is a significant predictor of higher rates of mortality and perioperative complications following RC.

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Article Synopsis
  • - A study was conducted on 3195 prostate cancer patients who underwent robot-assisted surgery to create a nomogram for predicting lymph node involvement (LNI).
  • - Analyzing data from 1855 patients, the study identified key predictors like prostate-specific antigen levels and biopsy results, yielding a prediction accuracy with an AUC of 84%.
  • - The nomogram allows for a cutoff of 6%, enabling 26.5% of patients to avoid unnecessary lymph node removal, with only a minimal risk of missing LNI cases.
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Background: While the controlling nutritional status (CONUT) score and sarcopenia are objective indices of different aspects of a patient’s general condition, few studies have comprehensively examined their mutual relationship in patients with advanced cancer. Methods: This retrospective study included 200 Japanese patients with advanced urothelial carcinoma (aUC). Sarcopenia was diagnosed using Prado’s definition.

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Background: We hypothesized that diagnostic ureterorenoscopy (URS) may adversely affect prognosis in a subset of patients with high-risk upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). Methods: The present retrospective study included 143 patients with UTUC treated between 2010 and 2021 at two tertiary care hospitals, of whom 79 received URS prior to RNU. Subgroups were stratified by clinicopathological variables relevant to prognosis.

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Article Synopsis
  • The study aimed to determine if subgroups within the International Society of Urological Pathology Grade Group 4 (GG 4) of prostate cancer patients exhibit different oncological outcomes after robotic-assisted radical prostatectomy (RARP) in Japan.
  • A total of 3195 patients were analyzed, with 298 having GG 4 tumors; results showed varied 3-year biochemical recurrence-free survival rates among the subgroups, with the GS 3+5 group having the best outcomes.
  • The findings suggest that patients with pathological Gleason scores (GSs) of 4+4 and 5+3 face higher risks of recurrence compared to those with GS 3+5, indicating that the latter may be overestimated in severity among
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: This study's objective was to examine patients treated with robot-assisted radical prostatectomy (RARP) for intermediate-risk prostate cancer (IR-PCa), and to identify preoperative risk factors for biochemical recurrence (BCR) in these patients in Japan. : We conducted a retrospective multicenter cohort study of patients with PCa who underwent RARP at 10 institutions in Japan. A total of 3195 patients were enrolled in this study.

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