Laparoscopic Evaluation and the Management of the Nonpalpable Testis

From June 1992 to December 1996, we performed laparoscopic evaluation for 28 nonpalpable testes in 22 patients (1–21, median 3 years old)

Anti-tumor effects of interferon-beta cell therapy in murine model of melanoma

Purpose: Recombinant interferon beta (IFN-β) has been used for a treatment of cancers. However, the efficacy of recombinant IFN-β is limited because of its short half-life and side effects. To overcome these problems, we focused on the efficacy of cell-based therapy (cell therapy) using IFN-β-producing cells in the treatment of melanoma.Methods: IFN-β-producing therapeutic cells were constructed by gene transduction using retrovirus vector. Anti-tumor effects of the cell therapy were investigated by a murine melanoma model.Results: IFN-β cell therapy significantly suppressed the proliferation of B16 melanoma in vitro and the growth of B16-derived tumor in vivo, accompanied with the activation of natural killer (NK) cells. IFN-β cell therapy did not show any systemic side-effects concerning hepatic dysfunction and bone marrow suppression.Conclusion: IFN-β cell therapy could be a candidate as a novel cancer treatment.

Outcome and prognostic factors in metastatic urothelial carcinoma patients receiving second-line chemotherapy : an analysis of real-world clinical practice data in Japan

Objectives: The objective of the present study was to investigate the survival outcome and prognostic factors of metastatic urothelial carcinoma patients treated with second-line systemic chemotherapy in real-world clinical practice. Methods: Overall, 114 patients with metastatic urothelial carcinoma undergoing second-line systemic chemotherapy were included in this retrospective analysis. The dominant second-line chemotherapy was a paclitaxel-based combination regimen (60%, 68/114). We assessed the progression-free survival and overall survival times using the Kaplan-Meier method. The Cox proportional hazards model was applied to identify the factors affecting overall survival. Results: The median progression-free survival and overall survival times were 4 and 9 months, respectively. In the multivariate analysis, an Eastern Cooperative Oncology Group performance status score greater than 0 at presentation, C-reactive protein level ≧1 mg/dl and poor response to prior chemotherapy were adverse prognostic indicators. Patients with 0, 1, 2 and 3 of those risk factors had a median overall survival of 17, 12, 7 and 3 months, respectively. Conclusions: The Eastern Cooperative Oncology Group performance status at presentation, C-reactive protein level and response to prior chemotherapy were prognostic factors for metastatic urothelial carcinoma patients undergoing second-line chemotherapy. In the future, this information might help guide the choice of salvage treatment, such as second-line chemotherapy or immune checkpoint inhibitors, after the failure of first-line chemotherapy

Prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients receiving systemic chemotherapy

Objective To clarify the prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients treated by systemic chemotherapy. Methods Of the 228 metastatic urothelial carcinoma patients treated with systemic chemotherapy, 97 received radiotherapy mainly to metastatic sites. In patients for whom the purpose of radiotherapy was not specified, more than 50 Gy irradiation was considered to be for disease consolidation for survival analysis, while less than 50 Gy was categorized as palliation. According to the Kaplan-Meier method, we analysed overall survival from the initiation of treatment for metastatic urothelial carcinoma until death or the last follow-up, using the log-rank test to assess the significance of differences. The Cox model was applied for prognostic factor analysis. Results Overall, there was no significant difference in survival between patients with and those without radiotherapy (P = 0.1532). When analysing the patients undergoing consolidative radiotherapy separately, these 25 patients showed significantly longer survival than the 72 patients with palliative radiotherapy (P = 0.0047), with a 3-year overall survival of 43.3%. Of the present cohort, 22 underwent metastasectomy for disease consolidation, and there was no overlapping case between the metastasectomy cohort and cohort receiving consolidative radiotherapy. After controlling for four independent prognostic factors (sex, performance status, haemoglobin level and number of organs with metastasis) in our previous study, radiotherapy for disease consolidation showed a marginal value (hazard ratio = 0.666, P = 0.0966), while metastasectomy remained significant (hazard ratio = 0.358, P = 0.0006). Conclusions In the selected patients, long-term disease control could be achieved after consolidative radiotherapy for metastatic urothelial carcinoma disease. Our observations suggest that local ablative therapy (surgery or radiotherapy) could facilitate long-term disease control. However, the treatment decision should be individualized because of the lack of randomized control trials