Novel anatomical apical dissection utilizing puboprostatic "open-collar" technique: Impact on apical surgical margin and early continence recovery.

Purpose: To evaluate the impact of modifications to anatomical apical dissection including a puboprostatic open-collar technique, which visualizes the lateral aspect of the apex and dorsal vein complex (DVC) covering the rhabdosphincter while preserving the puboprostatic collar, on positive surgical margin (PSM) and continence recovery.

Methods: One-hundred-and-sixty-seven patients underwent gasless single-port retroperitoneoscopic radical prostatectomy using a three-dimensional head-mounted display system. Sequentially modified surgical techniques comprised puboprostatic open-collar technique, sutureless transection of the DVC, retrograde urethral dissection, and anterior reconstruction.

Who Can Avoid Biopsy of Magnetic Resonance Imaging-Negative Lobes without Compromising Significant Cancer Detection among Men with Unilateral Magnetic Resonance Imaging-Positive Lobes?

Objectives: To assess whether biopsy of multiparametric magnetic resonance imaging (MRI)-negative lobes can be avoided without compromising significant cancer (SC) detection among men with unilateral MRI-positive lobes.

Methods: From April 2013 to April 2019, 322 men with elevated prostate-specific antigen (PSA <20 ng/mL) and unilateral MRI-positive lobes underwent targeted 4-core and systematic 14-core biopsy. MRI findings were prospectively collected and evaluated according to the Prostate Imaging-Reporting and Data System (PI-RADS) version 2, and scores ≥3 were considered positive.

Clinically node-positive micropapillary bladder cancer in a young female desiring to spare functional bladder and fertility.

A 38-year-old female developing pelvic lymph node recurrence (cN2) of bladder cancer was referred to our hospital. Eighteen months earlier, she had received complete transurethral resection of bladder tumor and pathological diagnosis of muscle-invasive urothelial carcinoma with micropapillary variant had been made. She had declined radical cystectomy or chemoradiation because of a strong desire to spare the bladder and fertility.

Salvage Radiotherapy Versus Hormone Therapy for Prostate-specific Antigen Failure After Radical Prostatectomy: A Randomised, Multicentre, Open-label, Phase 3 Trial (JCOG0401).

Background: No standard therapy has been established for localised prostate cancer patients with prostate-specific antigen (PSA) failure after radical prostatectomy (RP).

Objective: To determine whether radiotherapy ± hormone therapy is superior to hormone therapy alone in such patients.

Design, Setting, And Participants: This study is a multicentre, randomised, open-label, phase 3 trial.

Prognostic significance of the controlling nutritional status (CONUT) score in advanced urothelial carcinoma patients.

Introduction & Objectives: The controlling nutritional status (CONUT) score, consisting of serum albumin, total lymphocyte count, and total cholesterol, is a validated and objective tool for nutritional assessment. Cancer-bearing patients often suffer from malnutrition in association with cachexia. We explored the prognostic role of malnutrition evaluated by the CONUT score in advanced urothelial carcinoma (aUC) patients.

Serum γ-Glutamyltransferase as a Prognostic Biomarker in Metastatic Castration-resistant Prostate Cancer Treated With Enzalutamide.

Background/aim: Serum γ-glutamyltransferase (GGT) is reportedly associated with survival and therapeutic response in various malignancies; however, as far as we are aware its impact on metastatic castration-resistant prostate cancer (mCRPC) has never been assessed.

Patients And Methods: Fifty consecutive men with mCRPC receiving enzalutamide at a single cancer center were retrospectively evaluated. The primary endpoint was overall survival (OS) and the secondary endpoints were prostate-specific antigen (PSA) response, maximal PSA change, and PSA progression-free survival (PSA-PFS).

Who Can Avoid Systematic Biopsy Without Missing Clinically Significant Prostate Cancer in Men Who Undergo Magnetic Resonance Imaging-Targeted Biopsy?

Background: The objective of the study was to identify a subset of men who can avoid systematic multisite biopsy (SyB) among those undergoing magnetic resonance imaging (MRI)-targeted transperineal 4-core biopsy (TgB) without missing clinically significant cancer (SC).

Patients And Methods: From April 2013 to December 2017, 304 men with elevated prostate-specific antigen levels (< 20 ng/mL) or abnormal digital rectal examination and positive MRI findings underwent transrecta ultrasound and MRI-targeted transperineal 4-core with 14-core systematic biopsy. MRI findings were prospectively collected and evaluated using Prostate Imaging-Reporting and Data System version 2 (PI-RADS), and scores ≥3 were considered positive.

Multifocal Synchronous Upper Urinary Tract Carcinosarcoma (Sarcomatoid Carcinoma) With Rhabdomyoblastic Differentiation.

Carcinosarcoma of the upper urinary tract is very rare. In this article, we report a case of upper urinary tract carcinosarcoma with rhabdomyoblastic differentiation showing distinct transition between the epithelial and mesenchymal components confirmed by morphology and immunohistochemistry. An 81-year-old female underwent radical nephroureterectomy under the diagnosis of left ureteral urothelial carcinoma (UC).

Prognostic significance of serum γ-glutamyltransferase in patients with advanced urothelial carcinoma.

Objectives: Serum γ-glutamyltransferase (GGT) is reportedly associated with prognosis in patients with various malignancies. However, the prognostic role of GGT is unknown among patients with advanced urothelial carcinoma (aUC). This study was designed to examine the prognostic role of serum GGT in patients with aUC.

A Case of Renal Pelvic Cancer Complicated by Horseshoe Kidney Treated with RoboSurgeon Gasless Single-Port Retroperitoneoscopic Nephroureterectomy.

A 78-year-old man who had a horseshoe kidney (HSK) visited us because of gross hematuria and suspicious urine cytology. CT and MRI revealed a right renal pelvic tumor of 28 mm in diameter. He underwent gasless single-port retroperitoneoscopic nephroureterectomy with division of the isthmus via the right pararectal small incision using the RoboSurgeon system.

Posttherapeutic skeletal muscle mass recovery predicts favorable prognosis in patients with advanced urothelial carcinoma receiving first-line platinum-based chemotherapy.

Objectives: Sarcopenia, decreased skeletal muscle mass (SMM), is an adverse prognostic factor in patients with advanced urothelial carcinoma (aUC). Given that SMM is variable depending on disease and patient conditions, changes in SMM over the course of treatments may be also prognostic. We investigated the prognostic role of posttherapeutic SMM recovery (PSR) in patients with aUC receiving first-line platinum-based chemotherapy.

Retroperitoneal Teratoma in an Adult: A Potential Pitfall in the Differential Diagnosis of Adrenal Myelolipoma.

We report a 32-year-old female case of a right adrenal gland mass detected on CT scan at medical checkup. CT and MRI showed a mass of 5.1 cm made of fat and calcification in the right adrenal gland, leading to the clinical diagnosis of adrenal myelolipoma.

Postoperative Changes in Skeletal Muscle Mass Predict Survival of Patients With Metastatic Renal Cell Carcinoma Undergoing Cytoreductive Nephrectomy.

Background: Sarcopenia, or the degenerative loss of skeletal muscle mass, develops as a consequence of cancer-host interactions, including systemic inflammation and poor nutritional status, and is associated with a poor prognosis in patients with metastatic renal cell carcinoma (mRCC). We explored whether postoperative changes in skeletal muscle mass after cytoreductive nephrectomy (CN) can predict the prognosis of patients with mRCC.

Patients And Methods: The present retrospective study included 37 mRCC patients undergoing CN at a single cancer center.

Prognostic significance of sarcopenia in upper tract urothelial carcinoma patients treated with radical nephroureterectomy.

We investigated the prognostic significance of sarcopenia in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU). The skeletal muscle index (SMI) was calculated from computed tomography images. Sarcopenia was defined as SMI <43 cm(2) /m(2) for males with body mass index <25 kg/m(2) , <53 cm(2) /m(2) for males with BMI ≥25 kg/m(2) , and <41 cm(2) /m(2) for females.

Prognostic significance of intensive local therapy to bone lesions in renal cell carcinoma patients with bone metastasis.

We evaluated the prognostic roles of local therapy to bone metastasis (BM) in metastatic renal cell carcinoma (mRCC) patients with BM. This retrospective study included 71 mRCC patients with BM. Local therapy to BM included en bloc resection, curettage, and radiotherapy (RT).

Prognostic Significance of Sarcopenia in Patients with Metastatic Renal Cell Carcinoma.

Purpose: Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is a critical physiological change during the development of cancer cachexia. We retrospectively investigated the prognostic role of sarcopenia in patients with metastatic renal cell carcinoma.

Materials And Methods: Skeletal muscle index was calculated using computerized tomography performed at the diagnosis of metastatic renal cell carcinoma.

Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma.

Objectives: Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is an objective indicator of cancer cachexia. We investigated its role as a prognostic biomarker in advanced urothelial carcinoma (UC) patients.

Methods: This retrospective study consisted of 88 UC patients with cT4 and/or metastases to lymph nodes/distant organs.

[Tubulocystic carcinoma of the kidney].

A 55-year-old man who presented himself with gross hematuria and right back pain was found to have a right renal mass with evidence of metastasis to the lymph nodes, bone and lung (cT1bN1M1). He underwent a transperitoneal right nephrectomy. Tumor expressed markers of CD10, P504S and CK19 immunohistochemically, so histopathological examination revealed tubulocystic carcinoma of the right kidney (pT3a).

Prospective evaluation of selection criteria for active surveillance in Japanese patients with stage T1cN0M0 prostate cancer.

Objective: Selection criteria for active surveillance (AS) program of localized prostate cancer remain to be standardized. The purpose was to evaluate the validity of selection criteria and investigate the feasibility of this AS program.

Methods: Patients meeting the criteria (i) stage T1cN0M0, (ii) age 50-80, (iii) serum prostate-specific antigen (PSA) View Article and Find Full Text PDF

Percentage of positive biopsy cores, preoperative prostate-specific antigen (PSA) level, pT and Gleason score as predictors of PSA recurrence after radical prostatectomy: a multi-institutional outcome study in Japan.

Objective: To evaluate the clinical outcome of radical prostatectomy (RP) in Japan, by retrospectively analysing the clinicopathological data in patients with clinical T1-T2 prostate cancer treated by RP, as there can be prostate-specific antigen (PSA) recurrence after RP in substantially many patients, and its character can differ according to ethnic group and/or country.

Patients And Methods: We reviewed 1192 patients who had a RP from 1993 to 2002 with no neoadjuvant/adjuvant therapy and whose PSA level after RP decreased at least once to undetectable levels (<0.2 ng/mL).

[Clinical and pathological staging of prostate cancer].

In Japan, UICC TNM staging system is widely accepted and used for clinical and pathological classification of prostate cancer. "General rule for clinical and pathological studies on prostate cancer" was also edited by Japanese urological association and the Japanese society of pathology. In this book, clinical staging system modified from Jewett staging system is demonstrated.

Randomized controlled trial to evaluate radiotherapy +/- endocrine therapy versus endocrine therapy alone for PSA failure after radical prostatectomy: Japan Clinical Oncology Group Study JCOG 0401.

A randomized controlled trial has started in Japan to evaluate radiotherapy and endocrine therapy for prostate-specific antigen (PSA) failure after radical prostatectomy. Patients who have PSA failure after radical prostatectomy for localized prostate cancer (T1-2N0M0) are randomized into treatment groups of either radiotherapy +/- endocrine therapy or endocrine therapy alone. The Urologic Oncology Study Group (UOSG) in the Japan Clinical Oncology Group (JCOG) composed of 36 specialized institutions will recruit 200 patients.

Allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen for treatment of metastatic renal cell carcinoma: single institution experience with a minimum 1-year follow-up.

Objective: The aim of this study was to evaluate the safety and efficacy of allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen (RIST) for interferon-alpha-refractory metastatic renal cell carcinoma (RCC).

Patients And Methods: Of 26 patients referred to the National Cancer Center Hospital for possible RIST between June 2000 and April 2002, an HLA-identical relative was identified for 12 patients. Nine patients underwent RIST.

[Introduction of information technology in the field of cancer therapy].

The introduction of information technology in the field of cancer therapy will realize not only better mutual communication among staff and patients, but also standardize the care process. Secondary utilization of medical information, such as cost-income analyses, will also be possible, though there will still be some limitations due to immaturity of the present systems.

Dynamic computed tomography and color Doppler ultrasound of renal parenchymal neoplasms: correlations with histopathological findings.

Background: We evaluated whether color Doppler ultrasound (US) had diagnostic accuracy equal to dynamic computed tomography (CT) and whether performing dynamic CT and Doppler US together would be more informative in preoperative diagnosis of renal solid tumors.

Methods: A total of 110 renal solid tumors smaller than 7 cm were evaluated with dynamic CT and Doppler US. We compared the enhancement and the color flow patterns with the histopathological subtypes.