Publications by authors named "Shutaro Yamamoto"
Background: Despite the availability of advanced imaging technologies, it remains difficult to achieve sufficient staging accuracy to ensure a tailored treatment strategy for patients with upper tract urothelial carcinoma (UTUC). The aim of the study was to identify preoperative risk factors for tumor upstaging in patients with UTUC initially staged as clinical T2 or lower and to analyze these factors separately for renal pelvic cancer and ureteral cancer.
Methods: This retrospective study included data from patients with UTUC who underwent nephroureterectomy.
Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane.
Am J Ophthalmol Case Rep
December 2024
Purpose: To describe two cases of extramacular paracentral acute middle maculopathy (PAMM)-like retinal ischemia after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM).
Observations: Case 1 involved a 78-year-old woman with a history of hyperlipidemia and preoperative visual acuity (VA) of 20/20. Case 2 involved a 72-year-old man with a history of hypertension and hyperlipidemia, and preoperative VA of 20/32.
Background: Androgen-receptor signaling inhibitors (ARSIs) become the new standard of care for metastatic hormone-sensitive prostate cancer (mHSPC). It is unknown whether time to castration resistance (TTCR), when using the first-line ARSIs, offers predictive value in mHSPC. We sought to assess the clinical outcomes for mHSPC patients treated with first-line ARSIs focusing on the TTCR.
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- Secondary extramammary Paget's disease is a rare condition that occurs when tumor cells spread from nearby tissues, often linked to underlying cancers of the skin, genitourinary, or gastrointestinal tracts.
- An 80-year-old woman with a 7-year history of urothelial carcinoma developed a lesion on her labia majora, diagnosed as pagetoid spread of her carcinoma, but she chose not to have it surgically removed.
- After receiving several treatments, including platinum-based chemotherapy and pembrolizumab, her condition improved significantly with enfortumab vedotin, leading to a successful complete resection of the tumor.
Background: Two randomized trials demonstrated that the survival benefits afforded by triplet therapy were greater than those of doublet therapy, thus changing the treatment paradigm for metastatic castration-sensitive prostate cancer (mCSPC). This is the first study to assess the real-world use, performance, and safety of triplet therapy in Japanese patients.
Methods: This retrospective multicenter study included 45 consecutive mCSPC patients who received triplet therapy composed of androgen deprivation therapy (ADT), docetaxel, and darolutamide between January 2023 and June 2024.
Article Synopsis
- This study investigates the impact of age on outcomes for very elderly patients (85+) undergoing nephroureterectomy for upper tract urothelial carcinoma (UTUC), utilizing data from 847 patients across various age groups.
- The results revealed that, while older patients experienced worse overall survival (OS), age was not a significant predictor of postoperative complications or cancer recurrence, suggesting surgical outcomes are largely consistent across ages.
- The findings support considering surgery for UTUC in fit patients aged 85 and older, highlighting that age alone should not deter treatment options.
Background: Enfortumab vedotin (EV), an antibody-drug conjugate that targets Nectin-4, is used for patients with metastatic urothelial carcinoma who have experienced progression on platinum-based chemotherapy and checkpoint inhibitors. Despite the widespread use of the drug, evidence remains scarce regarding clinical indicators that can predict the response to EV treatment.
Objective: We aimed to explore the predictive value of clinical indicators derived from peripheral blood tests for treatment responses to EV.
Article Synopsis
- * This study developed methods for obtaining pig fetal kidneys through cesarean sections and long-term cryopreservation, ensuring the health of the mother pig.
- * Results showed that cryopreserved pig fetal kidneys could grow and form organoids after being grafted into mice, indicating a promising approach for advancing xenotransplantation research.
Background: The effect of radical nephroureterectomy (RNUx) on postoperative renal function in patients diagnosed with upper tract urothelial carcinoma (UTUC) has not been thoroughly explored.
Methods: We conducted a retrospective analysis including 785 patients who underwent RNUx for UTUC. We assessed the preoperative and postoperative estimated glomerular filtration rates (eGFRs) and factors related to the decline in eGFR.
Article Synopsis
- - Prostate cancer (PCa) is the second most prevalent cancer among men in the U.S., facing challenges with drug resistance and detection, prompting a focus on extracellular vesicles (EVs) that may play important roles in cancer biology.
- - EVs contain various biological materials like proteins and RNA that influence tumor behavior, immune responses, and cancer progression, highlighting their potential as stable biomarkers for liquid biopsies in PCa.
- - The review emphasizes that while current knowledge on EVs in PCa management is limited, ongoing research may lead to innovative therapies and improved outcomes for patients.
Article Synopsis
- - Enfortumab vedotin (EV) is an antibody-drug conjugate used for patients with metastatic urothelial carcinoma (mUC) who have progressed on checkpoint inhibitors (CPIs); however, there's limited evidence comparing EV directly with re-challenging chemotherapy in real-world settings.
- - In a study of 350 mUC patients, those treated with EV showed an objective response rate (ORR) of 48% and a median overall survival (OS) of 29 months, compared to 14 months for re-challenging chemotherapy and 8 months for continuing CPIs beyond progression.
- - While there was no significant difference in overall survival or progression-free survival between EV and re-challenging chemotherapy, the duration
Background: This study aims to investigate the relationship between comorbidities and survival in patients with mUC treated with pembrolizumab as a second-line treatment.
Methods: From February 2018 to October 2021, we analyzed the data of 185 consecutive patients with metastatic UC who received pembrolizumab as second-line therapy at The Jikei University Hospital and five affiliated hospitals. We used the Charlson Comorbidity Index (CCI) to assess the comorbidities.
Article Synopsis
- Human pluripotent stem cells are used to create organoids, but they pose challenges due to their immaturity and limited cell types compared to fetal organs.
- The study investigates preservation methods for porcine fetal kidneys, hearts, and livers, focusing on their potential use in regeneration and xenotransplantation.
- Results show that while kidney cells can differentiate effectively after freezing, heart cells perform better when frozen post-dissociation, and liver cells can be preserved using a new perfusion technique, enhancing their viability for research.
Background: Immune checkpoint inhibitors can cause various immune-related adverse events (irAEs). This study aimed to evaluate the association between the incidence of irAEs and oncological outcomes of metastatic renal cell carcinoma (mRCC) treated with nivolumab plus ipilimumab as first-line therapy.
Patients And Methods: We retrospectively analyzed data from 69 patients with mRCC treated with nivolumab plus ipilimumab as first-line therapy between September 2018 and September 2021 at 4 institutions.
Article Synopsis
- Ureteral injuries necessitate surgical repair to prevent renal function loss, and current techniques for long ureteral defects have significant issues, prompting this study on using autologous collagen tubes in a rat model.
- In the experiment, various reconstruction methods were tested, including use of Biotubes alone and those wrapped with cardiomyocyte or stem cell sheets, while assessing the impact of urine flow on the success of the reconstructions.
- The study found that urinary flow promoted urothelial regeneration in some cases, particularly with the cardiomyocyte sheet, while other groups experienced occlusion and complications, underscoring the importance of urine flow in the healing process.
Article Synopsis
- The study aimed to assess pediatric renal trauma cases at a medical center in Japan, using the Japanese Association for the Surgery of Trauma (JAST) classification from 2008.
- Researchers reviewed medical records of 45 children under 18 diagnosed with renal trauma between 2004 and 2021, focusing on injury causes, treatment methods, and JAST classification details.
- The results revealed that most injuries were due to blunt trauma, primarily from falls and accidents, with a significant portion of cases not fitting the JAST classification, indicating a need for a new pediatric renal injury scale for better diagnosis and treatment.
Article Synopsis
- The study aimed to identify simple indicators from daily clinical practice that can predict the objective response to pembrolizumab in metastatic urothelial carcinoma patients, which is known for leading to better survival outcomes.
- The analysis of 220 patients revealed that changes in the neutrophil-lymphocyte ratio (NLR) and the presence of liver metastasis were significant predictors of treatment response.
- The risk model created categorized patients into favorable, intermediate, and poor risk groups, correlating with different objective response rates and overall survival outcomes, suggesting that those in the "poor risk" category might benefit from alternative therapies.
Background: There is little evidence of abiraterone acetate (AA) plus prednisone for patients with non-metastatic castration-resistant prostate cancer (nmCRPC). In this study, we conducted a comparative analysis of real-world survival outcomes between AA plus prednisone and enzalutamide (Enz) in patients with nmCRPC, utilizing our consortium dataset.
Materials And Methods: The clinical records of 133 nmCRPC patients treated with first-line Enz or AA plus prednisone were analyzed.
Article Synopsis
- Extramammary Paget's disease is a rare skin condition affecting the vulva and perineum, often requiring surgical treatment, especially when associated with urothelial carcinoma.
- An 80-year-old woman with a history of urothelial carcinoma presented with skin lesions that were diagnosed as extramammary Paget's disease, but she refused surgery and opted for chemotherapy instead.
- The treatment involved nine cycles of platinum-based chemotherapy, and as residual disease remained, the plan is to administer pembrolizumab to further address the condition.
Article Synopsis
- Pembrolizumab is a key treatment for metastatic urothelial carcinoma (mUC) but its effectiveness varies among patients; this study aims to explore how palliative radiation may enhance its survival benefits.
- A review of a dataset involving 235 mUC patients showed that those who received concurrent palliative radiation with pembrolizumab had significantly longer overall survival (OS) compared to those who did not or those who had radiation before starting pembrolizumab.
- After adjusting for potential biases, patients treated with concurrent radiation had a median OS of 29 months versus 13 months for those without it, suggesting that combining these treatments might improve outcomes for mUC patients.
Serum C-reactive protein (CRP) is known to be a biomarker for systemic inflammatory reactions. In the present study, we sought to measure the predictive value of serum CRP level for metastatic renal cell carcinoma (mRCC) treated with first-line ipilimumab and nivolumab using our real-world clinical dataset including non-clear cell RCC (nccRCC). The clinical record of patients who underwent the first-line ipilimumab plus nivolumab treatment for mRCC including ccRCC and nccRCC from 2018 to 2021 was retrospectively analyzed.
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- The KEYNOTE-045 trial showed pembrolizumab improves survival in patients with advanced urothelial carcinoma (UC), but its effectiveness in those not eligible for the trial was uncertain.
- A retrospective study analyzed data from 164 metastatic UC patients treated with pembrolizumab, assessing trial eligibility based on KEYNOTE-045 criteria and using statistical methods to evaluate survival outcomes.
- The results indicated that ineligible patients had similar progression-free and overall survival outcomes compared to eligible patients, suggesting that pembrolizumab may still be effective for them, highlighting the potential benefit of broadening trial eligibility criteria.
Article Synopsis
- The study aimed to evaluate the clinical benefits of administering chemotherapy after pembrolizumab treatment in patients with metastatic urothelial carcinoma, focusing on whether it can restore sensitivity to platinum-based drugs.
- Out of 236 patients who received pembrolizumab, 105 were analyzed for their survival outcomes, comparing those who continued with pembrolizumab versus those who received re-challenging chemotherapy after showing disease progression.
- Results indicated that patients who received re-challenging chemotherapy had a significantly longer median overall survival (13.9 months) compared to those who continued with pembrolizumab (5.8 months), suggesting the potential effectiveness of this treatment strategy.
The coronavirus disease 2019 (COVID-19) pandemic is disturbing and overwhelming a regular medical care in the world. We evaluated the clinical characteristics of patients with primary rhegmatogenous retinal detachment (RRD) during the state of emergency for COVID-19 pandemic in Japan. We also reviewed measures against the COVID-19 pandemic in our institute with a focus on RRD treatment.
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