Objectives: This study aimed to assess the treatment preferences of Japanese patients with muscle-invasive bladder cancer (MIBC) by quantifying their trade-offs between treatment attributes using a discrete choice experiment (DCE).
Methods: A DCE was conducted among MIBC patients post-radical cystectomy. Participants were presented with hypothetical treatment options differing in attributes such as efficacy Disease-free survival (DFS), side effects, administration, and cost.
In patients previously treated with immune checkpoint inhibitors (ICIs) for malignancies, the efficacy and safety of re-challenging with the same or another type of ICI remain unclear. We experienced a case in which a patient responded to pembrolizumab as a salvage treatment despite primary resistance to avelumab as a maintenance treatment for metastatic upper urinary tract urothelial carcinoma (mUTUC). A 69-year-old female presented with anemia and microscopic hematuria, diagnosed as mUTUC with lymph node metastases.
View Article and Find Full Text PDFCombination therapy with nivolumab and ipilimumab for advanced renal cell carcinoma (RCC) may cause immune-related myocarditis; however, its incidence in this cancer type and regimen remains unknown. At our institution, we measure biomarkers, such as high-sensitivity Troponin (hsTn), and perform electrocardiograms (ECGs) and echocardiography before and every month after the initiation of this therapy, and the findings obtained and patients' symptoms are continuously monitored by physicians and pharmacists. A retrospective survey was conducted on physiological and biochemical test findings and immune-related adverse events in patients with advanced RCC who received combination therapy with nivolumab and ipilimumab between October 1, 2018 and December 31, 2023.
View Article and Find Full Text PDFBackground/aim: Measures to control adverse events (AEs) in the use of oral multi-kinase inhibitors (OMI) are important for the continuation of treatment.
Patients And Methods: In this study, oncology pharmacists monitored symptoms of patients receiving outpatient therapy with OMIs in real-time using a smartphone Web app for the early detection/early treatment of AEs. This feasibility study evaluated the effects of using the app in 10 patients compared with data from 10 patients who did not use the app.
The Senhance robotic system (Asensus Surgical, Durham, NC, USA) is an innovative platform for minimally invasive surgery. It enables surgeons to perform precise and cost-effective procedures using reusable instruments and has advanced features such as haptic feedback and eye-tracking camera control. Herein, we present the first application of the "double bipolar method" (DBM) in a Senhance-assisted laparoscopic partial cystectomy utilizing 3 mm Maryland bipolar instruments.
View Article and Find Full Text PDFWe report our initial experience and the utility of 3 mm bipolar forceps in laparoscopic renal surgery using the Senhance robotic system. We performed laparoscopic nephroureterectomy for upper tract urothelial carcinoma in two patients: an 80-year-old female with a left renal pelvic tumor and an 80-year-old male with a right ureteral tumor. Both surgeries were successfully completed without conversion to conventional laparoscopic surgery or laparotomy.
View Article and Find Full Text PDFThe "double bipolar method" (DBM) in robotic surgery has been widely used in Japanese general surgery and gynecology; however, it is not commonly used in the field of urology. A 55-year-old female was diagnosed with stage IA endometrial cancer. A 2-cm cystic lesion was incidentally observed at the dome of the bladder on magnetic resonance imaging.
View Article and Find Full Text PDFBackground: Enfortumab vedotin (EV) was approved for patients with metastatic urothelial carcinoma (mUC) who progressed after anticancer therapy on September 2021 in Japan. The association between the occurrence of EV-related side effects and clinical outcome remains to be elucidated.
Methods: We identified 97 mUC patients treated with EV therapy at our five institutions from the date of approval to March 2023.
Choroidal metastasis originating from renal cell carcinomas (RCCs) is rare. To the best of our knowledge, 31 cases of choroidal metastasis from RCC have been reported in the English literature as of January 31, 2024. Nevertheless, physicians need to be vigilant in recognizing this condition, as its progression impacts the quality of life (QOL) of affected patients.
View Article and Find Full Text PDFObjectives: We aim to evaluate the risk of recurrence after neoadjuvant chemotherapy followed by radical cystectomy, particularly in ypT2 disease in patients with urothelial carcinoma, because it is not clear if all eligible patients with high-risk muscle-invasive urothelial carcinoma should be treated with adjuvant nivolumab.
Materials And Methods: We analysed the radiological and clinicopathological features, including cT and ypT stages, of 197 patients who had undergone two to four cycles of cisplatin-based neoadjuvant chemotherapy and radical cystectomy without adjuvant chemotherapy. We stratified the risk of postoperative recurrence by these factors.
Background: The treatment landscape for men with metastatic hormone-naïve prostate cancer (mHNPC) has dramatically changed with the approval of next-generation anti-androgen drugs. We compared the treatment efficacy of abiraterone with that of combined androgen blockade (CAB) therapy and androgen deprivation therapy (ADT) alone in men with high-risk mHNPC.
Methods: In total, 146 Japanese men with high-risk mHNPC were retrospectively analyzed.
Objective: Novel androgen receptor axis-targeted agents (ARATAs) have been developed for mCRPC and improved overall survival (OS). Here, we aimed to find predictors who will receive the greatest benefits from ARATAs.
Methods: We previously performed a multicenter study to identify prognostic factors for metastatic hormone-sensitive prostate cancer (mHSPC, n = 148) and mCRPC (n = 99), and showed that the bone scan index (BSI) was one of the significant prognostic factors for 3-year OS (PROSTAT-BSI study).
Background: Immune checkpoint inhibitors (ICIs) are effective in some cancer patients; however, they may show no efficacy in others. Predictive biomarkers are crucial for appropriately selecting the patients who receive ICI therapy. This study aimed to clarify the predictors of disease progression in urothelial carcinoma (UC) patients treated with an ICI, pembrolizumab.
View Article and Find Full Text PDFIntroduction: Our patient treated with pembrolizumab and axitinib is one of the longest survivors in Japan on KEYNOTE 426, despite adverse events, including delayed-onset hepatitis. We herein present a detailed clinical course and short discussion on the case.
Case Presentation: This was a 49-year-old male with clear cell renal cell carcinoma and lung metastases.
Unlabelled: The Senhance robotic system (TransEnterix, Morrisville, NC, USA), previously called the TELELAP Alf-X system, is a novel robotic system with a telesurgical concept. We herein describe our initial experience of Senhance assisted laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) with detailed figures and videos. Case 1: A left renal tumor was incidentally detected in a 52-year-old female on ultrasonography.
View Article and Find Full Text PDFObjective: To determine prognostic factors including the Bone Scan Index in prostate cancer patients receiving standard hormonal therapy and chemotherapy.
Methods: This multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index study involved 30 hospitals and enrolled 247 patients (age 71 ± 8 years) with metastatic hormone-sensitive prostate cancer (n = 148) under hormone therapy and metastatic castration-resistant prostate cancer (n = 99) under chemotherapy. The Bone Scan Index (%) was determined by whole-body bone scintigraphy using Tc-methylenediphosphonate.
Introduction: To describe laparoendoscopic single-site simple nephrectomy and reduced port simple nephrectomy for inflammatory nonfunctioning kidney.
Case Presentation: Case 1: a 58-year-old female with fever was referred to our hospital. Computed tomography demonstrated a markedly atrophic right kidney and mild hydronephrosis.
Reduced port laparoscopic radical nephrectomy (RPLRN) is an equivalent approach to conventional laparoscopic radical nephrectomy (LRN). In LRN, one wound generally needs to be extended for specimen extraction; therefore, some ingenuity is needed to achieve a good cosmetic outcome. We herein describe our initial experience of RPLRN using an umbilical zigzag skin incision for renal cell carcinoma (RCC).
View Article and Find Full Text PDFIntroduction: To describe laparoscopic surgery for psoas abscess caused by migrated urolithiasis.
Case Presentation: A 64-year-old female had renal stones in the right kidney for 5 years. She developed right back pain.
Introduction: Pazopanib, a tyrosine kinase inhibitor, and nivolumab, an immune checkpoint inhibitor, are both considered to cause hepatotoxicity with different pathophysiology. We report a case in which a patient died of severe hepatotoxicity who was presumed to have been caused by the administration of nivolumab followed by pazopanib for metastatic renal cell carcinoma.
Case Presentation: A 74-year-old male with metastatic renal cell carcinoma was treated with nivolumab as a third-line treatment.
Castration-resistant prostate cancer (CRPC) patients with liver metastases have an extremely poor prognosis. Herein, we report a rare patient who achieved a complete response by docetaxel chemotherapy for this aggressive disease. A 67-year-old Japanese male diagnosed with local prostate cancer [initial prostate specific antigen (PSA) of 10.
View Article and Find Full Text PDFBackground/aim: Patients with metastatic renal cell carcinoma (RCC) with cardiac metastasis have had poor outcomes in the era of molecular targeted therapy. There are few reported outcomes for patients with cardiac metastasis of RCC treated with immune checkpoint inhibitors (ICIs).
Case Report: A 32-year-old female presented with metastatic RCC (unclassified type) with contralateral renal and cardiac metastases, as well as renal hilar lymph node metastases (cT4N2M1).