20 research outputs found
What Affects the Visualization of Prostate Cancer Using MRI in Patients Treated with RARP?
Aimļ¼To assess the index lesionsļ¼the largest and clinically significant onesļ¼in cases of surgically confirmed prostate cancerļ¼PCaļ¼using a multi-parametric MRI at 3 tesla and to evaluate the relationships between the clinical-pathological features of index PCas and cancer visualization. Materials and Methodsļ¼This retrospective study included 67 patients who had undergone roboticassisted radical prostatectomy. Two radiologists reviewed the MRIsļ¼axial and coronal T2-weighted imaging, diffusion-weighted imagingļ¼DWIļ¼with apparent diffusion coefficient mapping and dynamic contrast enhancement MRIļ¼DCEIļ¼ļ¼. The patients were divided into 4 groups as followsļ¼detected on all 3 sequencesļ¼Aļ¼, on 2 of 3 sequencesļ¼Bļ¼, on 1 of 3 sequencesļ¼Cļ¼, and on none of themļ¼Dļ¼. In all groups, all PCa characteristics were assessed, including the PSA level, Grade Groupļ¼GGļ¼based on the Gleason scoreļ¼GSļ¼, the DāAmico criteria, and the maximum tumour lengthļ¼TLļ¼of the biopsy specimen. Resultsļ¼Of the 67 patients, 16 were high-risk according to the DāAmico criteria, and 15 of these 16 high-risk patientsļ¼94ļ¼
ļ¼belonged to either Group A or Group B. In addition, the mean TL and GG were longer and higher, respectively, in Group A than in the other groupsļ¼pļ¼0.05ļ¼. Furthermore, in Group B, 3 of the 4 high-risk patientsļ¼75ļ¼
ļ¼were detected using DWI and DCEI. The lesions detected using DWI and DCEI had higher GSs and were in a higher GG. Conclusionļ¼PCas of pathologically higher grades and clinically higher risk were more readily detectableusing multiple parameters
Clinical Significance of Serum Soluble T Cell Regulatory Molecules in Clear Cell Renal Cell Carcinoma
To clarify the role of serum soluble T cell regulatory molecules in clear cell renal cell carcinoma (CCRCC), we measured the serum levels of soluble interleukin-2 receptor (sIL-2R), soluble B7-H3 (sB7-H3), and soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) in 70 CCRCC patients and 35 healthy controls. We investigated correlations between the serum levels of these soluble T cell regulatory molecules and the pathological grade, clinical stage, and prognosis of CCRCC. We also assessed the relations among each of these soluble molecules. As a result, the serum level of sIL-2R was significantly higher in CCRCC patients than in healthy controls ( < 0.05). In addition, elevation of serum sIL-2R was significantly correlated with the clinical stage ( < 0.001), and the survival of patients with high sIL-2R levels was shorter than that of patients with low sIL-2R levels ( < 0.05). Furthermore, the serum level of sB7-H3 was also significantly correlated with the clinical stage ( < 0.05), while the sIL-2R and sB7-H3 levels showed a positive correlation with each other ( = 0.550, < 0.0001). These results indicate that the serum level of sIL-2R reflects tumor progression in CCRCC patients. In addition, the possibility was suggested that the IL-2/IL-2R and B7-H3 pathways may be involved in the progression of CCRCC
Prostate volume and biopsy tumor length are significant predictors for classical and redefined insignificant cancer on prostatectomy specimens in Japanese men with favorable pathologic features on biopsy
What Affects the Visualization of Prostate Cancer Using MRI in Patients Treated with RARP?
Multiparametric MRI Detectable Prostate Cancerļ¼What is the Additional Value of T2-mapping
Association between Immune Checkpoint Inhibitor Treatment Outcomes and Body Composition Factors in Metastatic Renal Cell Carcinoma Patients
Introduction: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of metastatic renal cell carcinoma (mRCC); however, validating body composition-related biomarkers for their efficacy remains incomplete. We evaluated the association between body composition-related markers and the prognosis of patients with mRCC who received ICI-based first-line therapies. Patients and Methods: We retrospectively investigated 60 patients with mRCC who underwent ICI-based therapy as their first-line treatment between 2019 and 2023. Body composition variables, including skeletal muscle, subcutaneous fat, and visceral fat indices, were calculated using baseline computed tomography scans. Sarcopenia was defined according to sex-specific cut-off values of the skeletal mass index. The associations between body composition indices and objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were evaluated. Results: Patients with sarcopenia had lower ORR and DCR than those without sarcopenia (33.3% vs. 61.1%, p = 0.0436 and 52.4% vs. 94.4%, p = 0.0024, respectively). Patients with sarcopenia had a significantly shorter median PFS (14 months vs. not reached, p = 0.0020) and OS (21 months vs. not reached, p = 0.0023) than patients without sarcopenia did. Sarcopenia was a significant predictor of PFS (hazard ratio [HR], 4.31; 95% confidence interval [CI], 1.65ā14.8; p = 0.0018) and OS (HR, 5.44; 95% CI, 1.83ā23.4; p = 0.0013) along with poor IMDC risk. No association was found between the subcutaneous, visceral, and total fat indices and the therapeutic effect of ICI-based therapy. Conclusions: Sarcopenia was associated with a lower response and shorter survival rates in patients with mRCC who received first-line ICI-based therapy
Transperitoneal laparoscopic umbilical resection of urachal remnants: a feasible surgical method
Abstract Background To date, there is no standard established laparoscopic surgical method for managing urachal remnants because of their rarity, and several questions remain unanswered. Are there any problems for considering the operative indications about patientsā factors for example, body mass index and so on? This study aimed to determine the feasible surgical method for managing urachal remnants and presents the operative outcomes of our cases in relation to the findings from the existing literature. Methods We analyzed the data of 16 patients (7 women and 9 men; age range, 19ā48Ā years) who underwent surgery for urachal remnants between January 2013 and March 2019 at our institution. Results In our cases, all urachal remnants were urachal sinuses, and the primary complaints were umbilical pain and pus discharge. Most of these symptoms were controlled using umbilical drainage and oral antibiotic intake; however, incisional drainage was required in two cases. In all cases, we performed a laparoscopic resection of the urachal remnants; one patient underwent an open conversion due to a very thick abdominal wall. Therefore, āperi-umbilical distanseā was proposed as an index to verify the periumbilical abdominal wall thickness. This index may clear the difficulties of the laparoscopic resection of the urachal remnunts. A postoperative complicationālocal infection that was treated using re-suturingāwas observed in one patient. No adverse events occurred in the other cases. Our method was appropriate because it allowed for complete urachal resection with good cosmetic results, i.e., a small and natural scar appearance. Additionally, if bladder injury occurred, bladder re-suturing was easily possible because of the laparoscopic portās position. Conclusions We present an feasible method for laparoscopic urachal resection. This method may be recommended for young patients with an peri-umbilical distanse ofā<ā2Ā cm
Plasma progastrināreleasing peptide level shows different predictive profiles for treatment response by androgen receptor axisātargeted agents in patients with metastatic castrationāresistant prostate cancer
Abstract Background The neuroendocrine (NE) pathway cannot be ignored as a mechanism for castrationāresistant prostate cancer (CRPC) progression. The neuromediator, gastrināreleasing peptide (GRP) may be involved in the aberrant activation of the normal androgen receptor (AR) and increased AR variants. This study focused on plasma levels of progastrināreleasing peptide (ProGRP) and examined the treatment outcomes with androgen receptor axisātargeted (ARAT) agents. Methods One hundred patients with metastatic CRPC were enrolled. Enzalutamide (ENZ) or abiraterone acetate/prednisone (AA/P) were administered to 50 patients each in a nonrandomized manner as a firstāline or later choice. Plasma ProGRP levels were determined using a chemiluminescent enzyme immunoassay, and data were collected prospectively. The study endpoints were prostateāspecific antigen (PSA) response and survival estimates. Results In the ENZ series, ProGRP levels correlated with the maximum PSA change from baseline (high ProGRP: ā34.5% vs. low ProGRP: ā85.7% pĀ =ā.033). PSA progressionāfree survival (PFS), radiographic/symptomatic (r/s) PFS, and overall survival (OS) in patients with high ProGRP were significantly worse than those in patients with low ProGRP (median PSAāPFS: 3.3 vs. 10.0Ā months, pā=Ā .001, r/s PFS: 5.0 vs. 15.0Ā months, pĀ <ā0.001, and OS 17.5 vs. 49.0Ā months, pĀ <ā.001, respectively). In addition, ProGRP showed an independent predictive value for all survival estimates in multivariate analyses. In the AA/P series, ProGRP levels did not correlate with the PSA change or predict PSAāPFS and r/s PFS, but they maintained a significant difference in OS (19.0 vs. 48.0Ā months, pĀ =ā.003). Conclusions Plasma ProGRP provides a consistent predictive value for OS in metastatic CRPC patients who underwent therapy with ARAT agents. Meanwhile, ProGRP showed different predictive profiles for PSAā and r/s PFS between ENZ and AA/P. These findings clinically suggest a mechanism for CRPC progression involving the NE pathway via the GRP. The underlying mechanism of different predictive profiles by the ARAT agent should be explored in future research
Clinical Significance of Serum Soluble T Cell Regulatory Molecules in Clear Cell Renal Cell Carcinoma
To clarify the role of serum soluble T cell regulatory molecules in clear cell renal cell carcinoma (CCRCC), we measured the serum levels of soluble interleukin-2 receptor (sIL-2R), soluble B7-H3 (sB7-H3), and soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) in 70 CCRCC patients and 35 healthy controls. We investigated correlations between the serum levels of these soluble T cell regulatory molecules and the pathological grade, clinical stage, and prognosis of CCRCC. We also assessed the relations among each of these soluble molecules. As a result, the serum level of sIL-2R was significantly higher in CCRCC patients than in healthy controls (P<0.05). In addition, elevation of serum sIL-2R was significantly correlated with the clinical stage (P<0.001), and the survival of patients with high sIL-2R levels was shorter than that of patients with low sIL-2R levels (P<0.05). Furthermore, the serum level of sB7-H3 was also significantly correlated with the clinical stage (P<0.05), while the sIL-2R and sB7-H3 levels showed a positive correlation with each other (R=0.550, P<0.0001). These results indicate that the serum level of sIL-2R reflects tumor progression in CCRCC patients. In addition, the possibility was suggested that the IL-2/IL-2R and B7-H3 pathways may be involved in the progression of CCRCC
Increased expression of system large amino acid transporter (LAT)-1 mRNA is associated with invasive potential and unfavorable prognosis of human clear cell renal cell carcinoma
BACKGROUND: The system L amino acid transporter (LAT) has an important role in the transport of various amino acids, and there have been reports about the relation of this system to cancer. Although LATs are highly expressed in the kidneys, little is known about their influence on human renal cancer. METHODS: To clarify the role of LATs in human clear cell renal cell carcinoma (RCC), we investigated the expression of mRNAs for LAT1, LAT2, LAT3, LAT4, and 4F2hc in clear cell RCC tissues. The mRNAs of these five genes were analyzed by the real-time reverse transcription polymerase chain reaction in matched sets of tumor and non-tumor tissues obtained at operation from 82 Japanese patients with clear cell RCC. We also measured phosphorylated S6 ribosomal protein (Ser-235/236) proteins levels in 18 paired tumor and non-tumor tissues of the patients by Western blotting. RESULTS: Expression of LAT1 mRNA was significantly increased in tumor tissue compared with non-tumor tissue, while expression of LAT2 and LAT3 mRNAs was reduced. There was no difference in the expression of LAT4 and 4F2hc mRNAs between tumor and non-tumor tissues. Increased expression of LAT1 mRNA was associated with less differentiated tumors, local invasion, microscopic vascular invasion, and metastasis. Kaplan-Meier survival analysis showed that a higher serum LAT1 mRNA level was associated with a shorter overall survival time. Phosphorylated S6 ribosomal protein levels were associated with metastatic potential. LAT1 mRNA levels positively correlated with phosphorylated S6 ribosomal protein proteins levels in primary tumors. CONCLUSIONS: These findings suggest that LAT1 mRNA is related to the invasive and progressive potential of clear cell RCC