Publications by authors named "Yoichiro Tohi"
Background And Objective: There is no consensus on de-escalation of monitoring during active surveillance (AS) for prostate cancer (PCa). Our objective was to determine clinical criteria that can be used in decisions to reduce the intensity of AS monitoring.
Methods: The global prospective AS cohort from the Global Action Plan prostate cancer AS consortium was retrospectively analyzed.
Introduction: Small tumors may be difficult to identify visually and require preoperative effort to locate. Recent advancements in mixed reality technology have improved surgical accuracy in various departments. Here, we present the application of mixed reality-assisted surgery and a guiding marker in the case of small retroperitoneal metastasis of uterine cancer.
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- - The study aimed to assess the effectiveness and safety of a chemotherapy regimen, dose-dense gemcitabine and cisplatin (ddGC), in treating muscle-invasive bladder cancer (MIBC) before surgery.
- - Out of 45 patients treated, 92.7% completed the planned chemotherapy cycles, achieving a pathological complete response in 29.3% and an objective response in 41.5%.
- - The results indicated that ddGC was well-tolerated, with severe adverse effects in only 17.8% of patients, and showed promising 2-year disease-free and overall survival rates of 70.8% and 89.2%, respectively.
Objective: To report the outcomes of repeat biopsies, metastasis and survival in the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study, a prospective observational study for Japanese patients, initiated in 2010.
Patients And Methods: At the beginning, inclusion criteria were initially low-risk patients, prostate-specific antigen (PSA) density (PSAD) <0.2, and ≤2 positive biopsy cores.
Article Synopsis
- The study aimed to evaluate how the COVID-19 pandemic influenced the outcomes of robot-assisted radical prostatectomy (RARP) and urologists' treatment practices.
- Researchers analyzed medical records of 208 patients who underwent RARP between 2017 and 2022, comparing data from pre-pandemic and pandemic periods, focusing on factors like preoperative hormone therapy, waiting times, and cancer pathology.
- Results showed a significant increase in preoperative androgen deprivation therapy during the pandemic, shorter waiting periods for surgery, and a shift towards treating more high-risk patients, but no overall negative impact on cancer outcomes or patients' quality of life.
Article Synopsis
- * The surgery performed was a retroperitoneal scopic ureteral resection along with a partial cystectomy, which involved the innovative use of a fluorescent ureteral catheter for better identification of the ureter during the procedure.
- * The conclusion highlights that the fluorescent ureteral catheter is a valuable tool in laparoscopic surgeries, particularly for cases where locating the ureter is challenging, as demonstrated in this patient's case.
Article Synopsis
- - The study investigates the effects of enfortumab vedotin, a new treatment for urothelial cancer, focusing on how peripheral neuropathy impacts its effectiveness and if early nerve changes are linked to neuropathy onset.
- - In a trial involving 34 patients with advanced bladder cancer who had not responded to previous therapies, the treatment showed promising results with a 52.9% overall response rate and significant survival benefits.
- - Peripheral neuropathy was present in 12.5% of patients, but interestingly, those affected had better response rates compared to those without neuropathy; nerve studies showed that sensory nerves were more impacted, particularly the sural nerve.
Article Synopsis
- The study aimed to explore how frailty impacts cancer-related fatigue and quality of life in prostate cancer patients, analyzing 108 out of 254 outpatients.
- Results showed a 63% prevalence of frailty, with older age linked to greater frailty severity but not to the levels of fatigue.
- Patients with frailty experienced significantly higher fatigue and poorer quality of life compared to those without frailty, emphasizing the need to consider frailty in treatment decisions, especially for older patients.
Background: Japanese men receiving apalutamide often experience skin-adverse events (AEs), possibly requiring treatment interruption or dose reduction. However, concerns have arisen regarding the impact of these adjustments on the efficacy of apalutamide. Our study evaluated the efficacy, safety, and persistence of apalutamide in men with metastatic castration-sensitive prostate cancer (mCSPC).
View Article and Find Full Text PDFPurpose: We developed a simple self-checkable screening tool for chronic prostatitis (S-CP) and internally validated it to encourage men (in the general population) with possible chronic prostatitis to consult urologists.
Methods: The expert panel proposed the S-CP, which comprises three domains: Area of pain or discomfort (6 components), accompanying Symptom (6 components), and Trigger for symptom flares (4 components). We employed logistic regression to predict chronic prostatitis prevalence with the S-CP.
Aggressive Prostate Cancer in Patients Treated with Active Surveillance.
Cancers (Basel)
August 2023
Active surveillance has emerged as a promising approach for managing low-risk and favorable intermediate-risk prostate cancer (PC), with the aim of minimizing overtreatment and maintaining the quality of life. However, concerns remain about identifying "aggressive prostate cancer" within the active surveillance cohort, which refers to cancers with a higher potential for progression. Previous studies are predictors of aggressive PC during active surveillance.
View Article and Find Full Text PDFBackground: In men undergoing upfront active surveillance, predictors of adverse pathology in radical prostatectomy specimens, including intraductal carcinoma of the prostate and cribriform patterns, remain unknown. Therefore, we aimed to examine whether adverse pathology in radical prostatectomy specimens could be predicted using preoperative patient characteristics.
Methods: We re-reviewed available radical prostatectomy specimens from 1035 men prospectively enrolled in the PRIAS-JAPAN cohort between January 2010 and September 2020.
Background: The efficacy of photodynamic diagnosis using 5-aminolevulinic acid during transurethral resection of bladder tumors has been demonstrated, albeit with limited information regarding its side effects. This study aimed to clarify the impact of oral 5-aminolevulinic acid on perioperative nausea and vomiting (NV) for the first time in a real-world clinical practice setting.
Methods: Patients who underwent transurethral surgery at Kagawa University between April 2017 and March 2020 were included.
Objective: This study conducted a national questionnaire survey of Japanese urologists from a treatment perspective for older patients with prostate cancer.
Methods: A questionnaire was distributed to 922 teaching hospitals of the Japanese Urological Association. Questionnaire items included years of urologist experience, gender, workplace, treatment equipment owned, daily specialty practice area, urological cancer specialty, treatment reference items for older adults, upper age limit for radical treatment, medication, and two hypothetical cases of Gleason grade group 2 prostate cancer with or without oligometastasis.
Objective: this study aimed to evaluate the active surveillance continuation period, treatment intervention rate and health-related quality of life in younger patients.
Methods: we prospectively conducted a health-related quality of life survey of patients enrolled in the Prostate Cancer Research International: Active Surveillance-JAPAN study at Kagawa University between January 2010 and December 2020. Health-related quality of life was assessed by mail using a validated Japanese version of the Short-Form 8 Health Survey and Expanded Prostate Cancer Index at active surveillance enrolment and annually thereafter until discontinuation of active surveillance.
Background: Among early stage prostate cancer patients, intraductal carcinoma of the prostate (IDC-P) and invasive cribriform are key prognostic factors; however, their presence and clinical significance following active surveillance (AS) are unknown. In men who opted for AS, we aimed to examine the presence and impact of IDC-P or cribriform, utilizing radical prostatectomy (RP) specimens.
Methods: We re-reviewed 137 RP specimens available in the PRIAS-JAPAN prospective cohort between January 2010 and September 2020.
Background: The purpose of the present study was to elucidate the correlation between standardized uptake value (SUV) and volume-based parameters measured by quantitative [Tc]Tc-methylene diphosphonate (MDP) single photon emission computed tomography (SPECT)/CT and [F]-sodium fluoride ([F]NaF) positron emission tomography (PET)/CT in the assessment of bone metastases in patients with prostate cancer.
Methods: The study included 26 male prostate cancer patients with confirmed or suspected bone metastases who underwent both [Tc]Tc-MDP SPECT/CT and [F]NaF PET/CT studies. Skeletal lesions visible on both SPECT/CT and PET/CT were classified as benign or metastases.
Objective: To conduct a national questionnaire survey of Japanese urologists on active surveillance (AS) for low- and intermediate-risk prostate cancer (PCa).
Methods: A questionnaire was sent to 922 Japanese Urological Association Teaching Base Hospitals. The items included were years of experience as a urologist, sex, workplace, treatment equipment owned, specialty area of daily practice, specialty area of urological cancer, and six hypothetical cases of AS.
Objective: This study investigated the efficacy of docetaxel (DOC) and cabazitaxel (CBZ) and examined the factors associated with the prognosis of patients with castration-resistant prostate cancer (CRPC) receiving DOC-CBZ sequential treatment in Japanese real-world data.
Methods: We retrospectively evaluated data for 146 patients who received DOC followed by CBZ. The correlations of prostate specific antigen (PSA) decrease rate and time to progression between DOC and CBZ treatment were examined.
Article Synopsis
- Acute generalized exanthematous pustulosis is a severe skin reaction to drugs, and its connection to apalutamide, a prostate cancer treatment, is unclear.
- A 72-year-old man developed a rash after 41 days on apalutamide, leading to severe symptoms and hospitalization after discontinuation of the drug.
- A skin biopsy confirmed the diagnosis of acute generalized exanthematous pustulosis, which improved with corticosteroid treatment, marking the first reported case linked to apalutamide.
Background: The effect of enzalutamide in patients with non-metastatic castration-resistant prostate cancer after combined androgen blockade, which represents a patient profile similar to real-world clinical practice in Japan, remains unknown. Therefore, we investigate the efficacy and safety of enzalutamide after combined androgen blockade for recurrence following radical treatment in Japanese patients with non-metastatic castration-resistant prostate cancer.
Methods: We analyzed 66 patients with non-metastatic castration-resistant prostate cancer after combined androgen blockade for recurrence following radical prostatectomy or radiation therapy who were prospectively enrolled from October 2015 to March 2018.
Article Synopsis
- The study compares robot-assisted (CRO-RAPN) and laparoscopic (CRO-LPN) techniques in partial nephrectomy for patients with localized renal masses from July 2012 to June 2020.! -
- Results showed that CRO-RAPN had significantly better outcomes, including shorter operation and warm ischemic times, less blood loss, and lower complication rates compared to CRO-LPN.! -
- Overall, CRO-RAPN also demonstrated a higher preservation rate of kidney function and a greater trifecta achievement rate, indicating its superiority in surgical performance and patient recovery.!
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.
Article Synopsis
- The study assessed the effects of continuing antithrombotic therapy during surgery on bleeding and complications in patients undergoing laparoscopic radical nephrectomy and nephroureterectomy.
- It was conducted as a retrospective observational analysis, comparing outcomes between patients who continued their antithrombotic medications and those who did not, focusing on bleeding complications and other surgical markers.
- The findings suggest that perioperative antithrombotic therapy does not significantly increase bleeding risk, indicating it is safe to continue during these surgical procedures.