Publications by authors named "Shusuke Akamatsu"
Purpose: To evaluate functional and oncological outcomes in patients who underwent unilateral or bilateral nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) for high-risk prostate cancer.
Methods: The cohort comprised 2683 patients with clinical stage T1-4, N0M0 high-risk prostate cancer who underwent RARP in Japanese tertiary care centers from August 2011 to April 2023. High risk was defined using the European Association of Urology risk stratification criteria.
Background: Treatment-related skin reactions (TRSRs) induced by enfortumab vedotin (EV) targeting nectin-4 are among the most common adverse events. However, their association with survival and treatment response is poorly understood.
Methods: We retrospectively identified patients who received EV from December 2021 to April 2023 at Nagoya University Hospital and its affiliated facilities and extracted clinical data from their medical records.
Prostate cancer (PC) growth is hormone-dependent and it frequently develops distant metastases as disease progresses. Patients with metastatic castration-sensitive prostate cancer (mCSPC) initially respond to androgen deprivation therapy (ADT) but eventually become refractory and develop metastatic castration-resistant prostate cancer (mCRPC). Castration-resistance is associated with high lethality and metastases confer poor prognosis, therefore unmet needs in treatment for mCSPC remain high.
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- The study examined postoperative complication rates in elderly prostate cancer patients undergoing robot-assisted radical prostatectomy (RARP) across various age groups.
- A total of 8,055 patients were analyzed, revealing similar complication rates for those under 70 and those aged 75 or older.
- The conclusion indicated that age alone does not significantly increase the risk of complications after RARP in well-selected elderly patients, suggesting that surgery can be safely performed on older populations.
Introduction: In Japan, transgender individuals have historically had limited therapeutic options, prompting many to seek gender-affirming surgeries in private or foreign clinics because of restricted access to public hospitals. This has led to challenges for patients undergoing surgery.
Case Presentation: A transgender man underwent surgery at a private clinic and experienced recurrent complications.
Article Synopsis
- - Neuroendocrine prostate cancer (NEPC) is an aggressive form of prostate cancer that arises after advanced treatments, marked by the loss of androgen receptor signaling and rapid progression.
- - The third symposium on NEPC, held in June 2024 in Canada, brought together leading researchers and clinicians to discuss recent advancements, molecular pathways, and innovative treatment strategies.
- - Experts emphasized the need for early detection and personalized medicine to tackle NEPC, highlighting the importance of global collaboration to improve understanding and treatment of this complex disease.
Article Synopsis
- - This study analyzed the effectiveness of combined androgen blockade (CAB) using bicalutamide (Bic-CAB) as a first-line treatment for metastatic hormone-sensitive prostate cancer (mHSPC) in Japan, evaluating patient data from 2007 to 2017.
- - From 159 patients reviewed, nearly half had prostate-specific antigen (PSA) progression, with a median overall survival of about 72.9 months; a significant number achieved low PSA levels quickly.
- - The research suggests that patients with low initial PSA and minimal changes had excellent long-term survival rates, indicating that Bic-CAB treatment adjusted based on PSA results could be beneficial for low-risk mHSPC patients.
Article Synopsis
- - A new prognostic model was developed to predict cancer-specific survival (CSS) for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC) using data from 1,092 Japanese patients treated between 2014 and 2020.
- - Key factors for predicting CSS included disease severity, liver metastasis, certain lab results, and primary tumor characteristics, leading to significant differences in 5-year CSS rates among low-risk (86%) and high-risk (22%) groups.
- - This model displayed high accuracy and reproducibility, and it may help tailor treatment approaches for patients with mHSPC, especially in determining the intensity of therapies needed.
Article Synopsis
- * A total of 383 patients were analyzed, revealing that those with persistent PSA levels post-surgery had significantly shorter castration resistance-free survival (CRFS) and metastasis-free survival (MFS) compared to those with non-persistent levels.
- * The findings suggest that stratifying patients by PSA levels can help tailor postoperative treatment, with patients experiencing better outcomes when receiving a combination of androgen deprivation therapy and radiotherapy if their PSA levels are high.
Article Synopsis
- Combo treatments with androgen receptor inhibitors and hormone therapy are now the main way to treat advanced prostate cancer, but some patients still need better options.
- For patients with fewer tumors, using local radiation may help improve their survival chances, and sometimes they can take a break from other treatments.
- Future plans involve using detailed genetic information to help doctors decide the best treatment for patients based on their specific risks.
Article Synopsis
- The study examines the effectiveness of salvage radiotherapy in patients with biochemical recurrence after prostatectomy, focusing on factors that influence patient outcomes.
- It evaluated 67 patients from 2005 to 2019, finding a 5-year biochemical recurrence-free survival (bRFS) rate of 47.1%, with key factors like PSA doubling time and surgical margins impacting survival rates.
- The research concludes that a PSA doubling time of less than 6 months and positive surgical margins predict worse outcomes for salvage radiotherapy, while no serious side effects were reported.
Background: The proliferation of cancer-associated fibroblasts (CAFs) hampers drug delivery and anti-tumor immunity, inducing tumor resistance to immune checkpoint blockade (ICB) therapy. However, it has remained a challenge to develop therapeutics that specifically target or modulate CAFs.
Methods: We investigated the involvement of Meflin cancer-restraining CAFs (rCAFs) in ICB efficacy in patients with clear cell renal cell carcinoma (ccRCC) and urothelial carcinoma (UC).
Background: Anti-programmed cell death-1 (ligand-1) antibody [PD-(L)1-Ab] can cause destructive thyroiditis and/or hypothyroidism. In addition, tyrosine kinase inhibitors (TKIs) frequently induce hypothyroidism. The aim of this prospective study is to examine the incidence and clinical characteristics of thyroid dysfunction induced by combination therapy of a PD-(L)1-Ab and TKI [PD-(L)1-Ab/TKI].
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- The study aimed to examine the spatial relationship between primary and recurrent prostate tumors after patients underwent external-beam radiation therapy using PSMA-targeted PET/CT scans.
- Researchers analyzed data from a previous trial focusing on recurrent prostate cancer detected through PET/CT and divided the prostate into 14 sections to assess overlap between tumors.
- Results showed that 25% of recurrent tumors were found at the same site as the primary tumor, while 41.7% had partial overlap, suggesting that recurrent tumors often arise near the original tumor location.
Importance: Although the cognitive components of behavioral therapy for overactive bladder (OAB) are widely recognized, there is a lack of studies evaluating the effectiveness of multicomponent interventions that include cognitive components as a treatment for OAB.
Objective: To examine the efficacy of a multicomponent intervention in improving health-related quality of life (HRQOL) for women with moderate to severe OAB.
Design, Setting, And Participants: This multicenter, open-label, randomized clinical trial was conducted in Japan among women aged 20 to 80 years who had moderate to severe OAB.
Key Clinical Message: Maintaining a disease-free status for a long time in cases of renal cell carcinoma with multiple bone metastases and repeated recurrences is challenging. What matters most in the multidisciplinary approach is the treatment strategy. Although this is a case where multidisciplinary treatment resulted in long-term CR during the TKI era, the treatment strategy is still relevant now that treatment options have increased.
View Article and Find Full Text PDFValidation study on the 2 mm diameter cutoff in lymph node-positive cases following radical prostatectomy in accordance with the AJCC/UICC TNM 8th edition: Real-world data analysis from a Japanese cohort.
Int J Urol
June 2024
Objectives: The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) 8th edition has proposed micrometastasis as a lymph node metastasis (LN+) of diameter ≤2 mm in prostate cancer. However, supporting evidence has not described. We evaluated LN+ patients' survival after radical prostatectomy (RP) based on the LN maximum tumor diameter (MTD).
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- This study created a prognostic model to predict disease recurrence in patients with lymph node involvement but no ongoing PSA levels.
- Researchers analyzed data from 231 patients who underwent surgery between 2006 and 2019, identifying key factors affecting recurrence-free survival (RFS).
- The model, which includes parameters like initial PSA level and surgical margin status, is said to aid in treatment discussions with patients.
Aims: To investigate the usefulness of novel clinical diagnostic criteria based on noninvasive examination findings to diagnose urodynamic detrusor underactivity (DU) in men.
Methods: We developed clinical diagnostic criteria to predict the presence of urodynamic DU in men as follows: (a) bladder voiding efficiency <70% on uroflowmetry, (b) existence of "sawtooth and interrupted waveforms" on uroflowmetry, and (c) ultrasonography-documented intravesical prostatic protrusion <10 mm. We analyzed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these clinical criteria for diagnosing urodynamic DU in men aged 50 years or above with lower urinary tract symptoms who underwent urodynamic studies.
Article Synopsis
- The study investigates the long-term effects of prostate position-based image-guided radiotherapy (P-IGRT) on patients with localized prostate cancer compared to traditional intensity-modulated radiation therapy (IMRT) without P-IGRT.
- A total of 222 patients were analyzed, and the results showed that the P-IGRT group had a higher biochemical failure-free rate (94.9% vs 82.7%) and lower rates of rectal bleeding requiring intervention.
- The findings suggest that using P-IGRT with higher doses and smaller margins may lead to better disease control and fewer side effects, highlighting its potential benefits in treating intermediate-risk prostate cancer.
Nicotinamide phosphoribosyltransferase (NAMPT) plays a major role in NAD biosynthesis in many cancers and is an attractive potential cancer target. However, factors dictating therapeutic efficacy of NAMPT inhibitors (NAMPTi) are unclear. We report that neuroendocrine phenotypes predict lung and prostate carcinoma vulnerability to NAMPTi, and that NAMPTi therapy against those cancers is enhanced by dietary modification.
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- Androgen-deprivation therapy is commonly used to treat advanced prostate cancer, but many patients develop castration-resistant prostate cancer (CRPC), which is harder to treat.
- Researchers created new CRPC cell lines (AILNCaP14 and AILNCaP15) that show high androgen receptor activity and resistance to enzalutamide, a common drug used for CRPC.
- They discovered that flavopiridol, a CDK inhibitor, effectively reduced tumor growth in both laboratory conditions and a living model, suggesting it could be a promising treatment option for CRPC patients who resist other therapies.
Background: Overactive bladder (OAB) is a common chronic and bothersome condition. Bladder training is widely prescribed as a first-line treatment for OAB, but the efficacy has been systematically evaluated for urinary incontinence rather than OAB alone.
Objectives: To evaluate the benefits and harms of bladder training for treating adults with OAB compared to no treatment, anticholinergics, β3-adrenoceptor agonists, or pelvic floor muscle training (PFMT) alone or in combination.