Akihiko Furuhata

Postoperative prophylactic use of progesterone in renal cell carcinoma.

Medroxyprogesterone acetate has been used prophylactically in 35 patients with stages I and IIIA renal cell carcinoma who had undergone radical nephrectomy. Metastasis was noted in 26 per cent (9 of 35) of the patients who had received the drug and in 44 per cent (20 of 45) of those who had not (controls). The incidence of metastasis in patients who had undergone nephrectomy more than 3 years previously was 10 per cent (3 of 31) for patients who received medroxyprogesterone acetate and 35 per cent (15 of 43) for the control group, the difference being statistically significant. Prognosis tended to be better in patients who had received medroxyprogesterone acetate than in the controls, and relative 3 and 5-year survival rates being 99.3 and 87.2 per cent, respectively, in the former group, and 86.8 and 75.0 per cent, respectively, in the latter group. There was no significant difference between these 2 groups. However, it may be concluded that prophylactic medroxyprogesterone acetate seems to be beneficial in the prevention of postoperative metastasis of renal cell carcinoma.

A phase II study of prophylactic intravesical chemotherapy with 4′-epirubicin in recurrent superficial bladder cancer: comparison of 4′-epirubicin and Adriamycin

Since intravesical recurrence of superficial bladder cancer (Ta, T1) after transurethral resection (TUR) is frequent, adjuvant therapy to reduce the recurrence rate has been extensively investigated. Although intravesical chemotherapy has been employed for 30 years or more, neither the exact effect on the bladder epithelium nor the optimal dose and administration schedule has yet been clarified. In recent years, several derivatives of Adriamycin (ADR) have been developed, and 4′-epirubicin (FARM) is one of them. This drug has been shown to have antitumor effects almost equal to those of ADR and to produce less toxicity when given systemically as chemotherapy. In an attempt to clarify the effect of intravesical FARM in the prevention of recurrence of superficial bladder cancer, we conducted a prospective randomized trial to compare the effects of equal doses of FARM and ADR given by intravesical instillation after TUR in cases of highly recurrent superficial bladder cancer. A total of 73 patients with recurrent superficial bladder cancer were randomized to receive TUR and either 30 mg FARM or 30 mg ADR by intravesical instillation every 2–4 weeks for 1 year. The prophylactic effect on recurrence and the toxic effects of these drugs were investigated. The current results show that FARM provides efficacy almost equal to that of ADR in the prevention of recurrence in these patients. However, FARM also caused almost the same local toxic effects (bladder irritation, among others) as ADR. On the basis of these preliminary results, FARM is surmised to be one of the agents as beneficial as ADR in the prevention of recurrence of superficial bladder cancer.

Clinical outcomes of prostate cancer patients in Yokosuka City, Japan: A comparative study between cases detected by prostate-specific antigen-based screening in Yokosuka and those detected by other means

To investigate whether prostate‐specific antigen‐based screening reduced the prostate cancer mortality rate in Yokosuka, Japan.