Publications by authors named "Koichiro Akakura"

Objectives: To evaluate the success rate of shock wave lithotripsy and identify predictors of stone-free status after shock wave lithotripsy for ureteral stones, focusing on the impact of stones remaining in the same location for 2 months (SSL2).

Methods: A retrospective analysis was conducted on 501 patients with ureteral stones treated with shock wave lithotripsy by expert surgeons (each with over 1000 shock wave lithotripsy operations) at a single Japanese institution in 2020. Logistic regression analysis identified predictors of stone-free status, including stone length, skin-to-stone distance, stone density (Hounsfield Unit), Hounsfield Unit above/below the stone, stone position, and duration of stone at the same location (SSL2).

View Article and Find Full Text PDF
Article Synopsis
  • Recent advancements in gene and protein analysis technologies have improved the identification of target molecules for cancer treatment.
  • In September 2021, Japan published the "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" to ensure external diagnostic products are clinically useful and in line with evaluation criteria.
  • These guidelines include a clinical questionnaire addressing serious issues, are based on comprehensive literature reviews, and serve as a practical tool for cancer treatment in clinical settings.
View Article and Find Full Text PDF

Background: To clarify the clinical roles of changes in testosterone (T) levels with a cut-off level of 20 ng/dL as predictive factors for prostate cancer patients treated with degarelix acetate.

Methods: A total of 120 prostate cancer patients who received hormone therapies with gonadotropin-releasing hormone antagonist degarelix acetate were retrospectively analyzed. The predictive values of nadir T levels, max T levels, T bounce, and other clinical factors were evaluated for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS).

View Article and Find Full Text PDF

Background/aim: The prognostic significance of androgen receptor amplification (AR amp) in cell-free DNA (cfDNA) was studied in Japanese patients with castration-resistant prostate cancer (CRPC).

Patients And Methods: A total of 120 serum samples were obtained from 38 patients with CRPC. Serum cfDNA was purified and the AR copy number was determined.

View Article and Find Full Text PDF

We aimed to determine Japanese metastatic castration resistant prostate cancer (CRPC) patients' Ra-223 treatment experience. Patients answered the Cancer Therapy Satisfaction Questionnaire (CTSQ domains: Satisfaction with Therapy [SWT], Expectations of Therapy [ET], Feelings about Side Effects [FSE]), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and the FACT-Bone Pain (FACT-BP) Questionnaire at baseline, during (vists 3 and 5) and after treatment (end of observation; EOO). Data from 72 patients were included.

View Article and Find Full Text PDF

The aim of this retrospective study was to identify clinical predictors of early biochemical recurrence (BCR) in patients with high-risk prostate cancer (PCa) treated with carbon-ion radiotherapy (CIRT) and androgen deprivation therapy (ADT). A total of 670 high-risk PCa patients treated with CIRT and ADT were included in the study. Early BCR was defined as recurrence occurring during adjuvant ADT after CIRT or within 2 years after completion of ADT.

View Article and Find Full Text PDF

Objectives: The purpose of this study was to investigate intraductal carcinoma of the prostate (intraductal carcinoma) and significant cancer (SC) in patients with small tumor volume (<0.5 cm ) in prostatectomy specimens.

Methods: Data from 639 patients undergoing radical prostatectomy between April 2006 and December 2017 at Chiba University Hospital and 2 affiliated institutions were retrospectively reviewed.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess how tumor volume and location impact the prognosis of prostate cancer patients following radical prostatectomy.
  • Researchers analyzed data from 557 patients and found that a tumor volume of 2.8 cc or greater, along with tumors located in the posterior area or peripheral zone, were significant predictors of biochemical recurrence (BCR).
  • A new risk model was developed based on these findings, indicating that patients with high-risk factors had worse progression-free survival compared to others, particularly in low- to intermediate-risk groups.
View Article and Find Full Text PDF

Introduction: Patients with liver metastases from prostate cancer show poor prognosis. We performed metastases-directed therapy using radiofrequency ablation of liver metastases in an attempt to improve the prognosis in a patient with metastatic prostate cancer.

Case Presentation: We present the case of a 66-year-old man who was treated for metastatic castration-resistant prostate cancer.

View Article and Find Full Text PDF

Carbon-ion radiotherapy (CIRT) is a high-dose intensive treatment, whose safety and efficacy have been proven for prostate cancer. This study aims to evaluate the outcomes of CIRT in elderly patients with prostate cancer. Patients aged 75 years or above at the initiation of CIRT were designated as the elderly group, and younger than 75 years as the young group.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aims to compare the medical costs associated with active surveillance versus treatments like robot-assisted laparoscopic prostatectomy, brachytherapy, radiation therapy, and hormone therapy for low-risk prostate cancer.
  • - An analysis of costs over the first five years for various therapies showed that active surveillance is significantly cheaper, with total costs coming to $1.65 million compared to much higher costs for other treatments (e.g., $14 million for surgery).
  • - The findings suggest that if more patients (50% or 100%) chose active surveillance initially, up to $13.8 million could be saved in total treatment costs, highlighting the potential for cost savings in expanding this approach.
View Article and Find Full Text PDF

Carbon-ions are charged particles with a high linear energy transfer, and therefore, they make a better dose distribution with greater biological effects on the tumors compared with photons and protons. Since prostate cancer, renal cell carcinoma, and retroperitoneal sarcomas such as liposarcoma and leiomyosarcoma are known to be radioresistant tumors, carbon-ion radiotherapy, which provides the advantageous radiobiological properties such as an increasing relative biological effectiveness toward the Bragg peak, a reduced oxygen enhancement ratio, and a reduced dependence on fractionation and cell-cycle stage, has been tested for these urological tumors at the National Institute for Radiological Sciences since 1994. To promote carbon-ion radiotherapy as a standard cancer therapy, the Japan Carbon-ion Radiation Oncology Study Group was established in 2015 to create a registry of all treated patients and conduct multi-institutional prospective studies in cooperation with all the Japanese institutes.

View Article and Find Full Text PDF

The aim of this study was to reclassify high-risk prostate cancer patients treated with carbon-ion radiotherapy and androgen deprivation therapy using the Candiolo nomogram and evaluate usefulness to predict the following 10-year biochemical recurrence. Six hundred seventy-two high-risk prostate cancer patients were reclassified according to the Candiolo nomogram. The cumulative incidence curves for biochemical recurrence were compared by Gray's test.

View Article and Find Full Text PDF

Background: To identify the real high-risk group among Japanese de novo metastatic prostate cancer patients who fit CHAARTED or LATITUDE criteria.

Methods: We retrospectively studied patients who fitted CHAARTED (292 patients) and LATITUDE (294 patients) criteria from Japanese multi-institutions. All patients received androgen deprivation therapy with bicalutamide as an initial treatment.

View Article and Find Full Text PDF

This qualitative study aimed to reveal symptoms and impacts among bone metastatic castration-resistant prostate cancer (or mCRPC) Japanese patients, prior to Radium-223 (Ra-223) treatment. Twenty-three mCRPC patients designated to receive Ra-223 and three treating physicians (Ra-223 prescribers) in Japan, were interviewed. All interview data were assessed for concept frequency, themes and saturation.

View Article and Find Full Text PDF

This study was aimed to identify the risk factors for urosepsis caused by kidney and ureteral stones. One hundred and nine patients who had kidney or ureteral stones and who were treated with trans-ureteral lithotripsy (TUL) at our institution from 2016 to 2020 were included. We investigated the risk factors for urosepsis caused by kidney or ureteral stones that occurred prior to TUL.

View Article and Find Full Text PDF

The aim of this study was to review our initial experience of using radium 223 (Ra-223) for metastatic castration-resistant prostate cancer (CRPC) and to evaluate whether pretreatment PSA levels correlate with completion of Ra-223 treatment. In addition, we examined change ratios of PSA, ALP and BAP after the third administration to evaluate the correlation of these change ratios with completion of the subsequent Ra-223 treatment. Forty patients were enrolled in this retrospective study.

View Article and Find Full Text PDF

Objective: To explore the perceptions of patients living with different stages of prostate cancer across the Asia-Pacific (APAC) region, as while extensive quantitative research has been undertaken into outcomes of treatments for prostate cancer, little in the way of qualitative research has been performed looking at subjective perceptions of patients in regard to their perceived deficits in the treatment of this condition and such research is particularly lacking in reference to the APAC region.

Patients And Methods: Initial 45-min qualitative research interrogatory interviews were conducted with 12 patients from Australia, China and Japan to identify themes that were significant to patients in the management of prostate cancer. Thereafter, 150 patients with different stages of prostate cancer underwent 30-min online (Australia) or computer-assisted/personal interviews categorised on the five key themes identified, in order to more fully clarify the nature of patient perceptions of how their prostate cancer had been treated and the issues they felt could be more fully addressed in order to improve the management of this condition.

View Article and Find Full Text PDF

Background: Oligometastatic cancer has been suggested as an intermediate state between localized disease and wide-ranging metastases. The clinical significance of local treatment in oligometastatic prostate cancer (PCa) has been a recent topic of interest. However, standard definitions of oligometastasis are lacking.

View Article and Find Full Text PDF

Background: The role of testosterone as a prognostic factor for castration-resistant prostate cancer treated with docetaxel in Japan was investigated.

Methods: A total of 164 patients with castration-resistant prostate cancer who received docetaxel treatment at Chiba University Hospital and an affiliated hospital were retrospectively analyzed. Testosterone and other clinical factors at the start of docetaxel treatment were evaluated with respect to overall survival and progression-free survival.

View Article and Find Full Text PDF
Article Synopsis
  • The PROPHET study aims to assess the effectiveness of p2PSA-related indexes in diagnosing prostate cancer in men with PSA levels under 10 ng/ml.
  • Between April 2015 and March 2017, 421 men were evaluated, with substantial findings related to Gleason Grade Group prostate cancer diagnoses.
  • The results indicate that p2PSA-related indexes are more effective than traditional PSA tests at detecting clinically significant prostate cancer and could prevent unnecessary biopsies in 35% to 42% of men without aggressive forms of the disease.
View Article and Find Full Text PDF

We report an extremely rare case of an alpha-fetoprotein- (AFP-) producing female primary urethral adenocarcinoma with neuroendocrine differentiation (NED). The patient was a 65-year-old woman with a 2-year history of urinary frequency and voiding difficulty. Enhanced computed tomography showed an approximately 3.

View Article and Find Full Text PDF