Iori Sakai

A comparison of the biological features between prostate cancers arising in the transition and peripheral zones

To investigate differences in the biological features of prostate cancer according to the zonal origin.

Microscopic venous invasion in renal cell carcinoma as a predictor of recurrence after radical surgery

Background: The objective of the present study was to investigate the significance of microscopic venous invasion (MVI) as a prognostic factor for patients with renal cell carcinoma (RCC) who underwent radical surgery.

Expression profile of E-cadherin and N-cadherin in non-muscle-invasive bladder cancer as a novel predictor of intravesical recurrence following transurethral resection

The objective of this study was to investigate the impact of the expression profile of E-cadherin and N-cadherin in newly diagnosed non-muscle-invasive bladder cancer (NMIBC) on the probability of intravesical recurrence in patients undergoing transurethral resection (TUR). This study included 115 consecutive patients diagnosed as having NMIBC following TUR. Expression levels of E-cadherin and N-cadherin in TUR specimens from these patients were measured by immunohistochemical staining. In this series, intravesical recurrence occurred in 35 of 115 patients (30.4%). Immunohistochemical study showed that positive expression of E-cadherin and N-cadherin were noted in 62 (53.9%) and 48 (41.7%) specimens, respectively. Intravesical recurrence was detected in only 7 of 62 patients (11.3%) with positive E-cadherin expression, while 33 of 48 patients (68.8%) with positive N-cadherin expression developed intravesical recurrence. When patients were divided into 4 groups according to the positivities of E-cadherin and N-cadherin expression, intravesical recurrence was detected in 27 of 30 patients (90.0%) with negative E-cadherin as well as positive N-cadherin expression, and the intravesical recurrence-free survival of this group was significantly poorer than those of the remaining 3 groups. Furthermore, negative E-cadherin as well as positive N-cadherin expression was identified as the most powerful independent predictor for intravesical recurrence following TUR on multivariate analysis. These findings suggest that the loss of E-cadherin and gain of N-cadherin expression in on NMIBC appeared to be significantly associated with postoperative recurrence; therefore, the switch from E-cadherin to N-cadherin expression might be involved in the mechanism underlying intravesical recurrence of on NMIBC.

Acquired resistance to sunitinib in human renal cell carcinoma cells is mediated by constitutive activation of signal transduction pathways associated with tumour cell proliferation.

Although there have been a few studies investigating the molecular mechanism mediating the acquisition of resistance to molecular‐targeted agents, including sunitinib, by renal cell carcinoma (RCC) cells, this mechanism remains largely unclear. The maintenance of protein kinase activation during sunitinib treatment may be involved in the acquisition of a phenotype resistant to sunitinib in RCC, and additional treatment with agents targeting activated protein kinases could be a promising approach for overcoming resistance to sunitinib in RCC.

Expression of potential molecular markers in renal cell carcinoma: impact on clinicopathological outcomes in patients undergoing radical nephrectomy

To evaluate the expression levels of several potential molecular markers in renal cell carcinoma (RCC), to clarify the significance of these markers as prognostic predictors in patients undergoing radical nephrectomy (RN).

Analysis of differences in clinicopathological features between prostate cancers located in the transition and peripheral zones

Background:  The objective of this study was to retrospectively characterize differences in the clinicopathological features of prostate cancer according to the zonal origin.

Prediction of potentially insignificant prostate cancer in men undergoing radical prostatectomy for clinically organ-confined disease.

Abstract  Background:  The objectives of the present study were to characterize, according to tumor significance, the clinicopathological features of patients with prostate cancer who underwent radical prostatectomy, and to determine useful parameters for predicting insignificant disease before surgery.

Influence of Nerve-Sparing Procedure on Early Recovery of Urinary Continence After Laparoscopic Radical Prostatectomy

PURPOSE This study considered the influence of the nerve-sparing procedure on early recovery of urinary continence after laparoscopic radical prostatectomy according to preoperative erectile function. PATIENTS AND METHODS There were 135 patients eligible for assessment of the status of urinary continence after surgery. The patients were divided into two groups according to the International Index of Erectile Function (IIEF)-5 score: Group 1, >or=14 (56 patients); group 2, <14 (79 patients). The correlation between urinary continence and patient age at surgery, body mass index, preoperative prostate-specific antigen level, preoperative IIEF-5 score, and an attempted nerve-sparing procedure was investigated. RESULTS Overall continence rates were 13%, 41%, 63%, and 79% at 1, 3, 6, and 12 months, respectively. The rate in group 2 was significantly lower than that in group 1 6 months after surgery (P = 0.0286), and the rate in patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at 3 months (P = 0.0084). The rate in group 2 of patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at both 3 months (P = 0.0046) and 6 months postoperatively (P = 0.0356). CONCLUSIONS Preoperative erectile function and the nerve-sparing procedure were predictors of early recovery of urinary continence after laparoscopic radical prostatectomy. If each case fulfills the oncologic criteria for nerve sparing, we should attempt nerve sparing to facilitate the early recovery of urinary continence despite the degree of preoperative erectile function.

Significance of cancer detection in the anterior lateral horn on systematic prostate biopsy: the effect on pathological findings of radical prostatectomy specimens

To clarify the significance of cancer detection in the anterior lateral horn (ALH) on systematic prostate biopsy in relation to its effect on the pathological findings from retropubic radical prostatectomy (RRP) specimens.

Intraoperative Fluorescence Imaging for Detection of Sentinel Lymph Nodes and Lymphatic Vessels during Open Prostatectomy using Indocyanine Green

PURPOSE We investigated the feasibility and validity of intraoperative fluorescence imaging using indocyanine green for the detection of sentinel lymph nodes and lymphatic vessels during open prostatectomy. MATERIALS AND METHODS Indocyanine green was injected into the prostate under transrectal ultrasound guidance just before surgery. Intraoperative fluorescence imaging was performed using a near-infrared camera system in 66 consecutive patients with clinically localized prostate cancer after a 10-patient pilot test to optimize indocyanine green dosing, observation timing and injection method. Lymphatic vessels were visualized and followed to identify the sentinel lymph nodes. Confirmatory pelvic lymph node dissection including all fluorescent nodes and open radical prostatectomy were performed in all patients. RESULTS Lymphatic vessels were successfully visualized in 65 patients (98%) and sentinel lymph nodes in 64 patients (97%). Sentinel lymph nodes were located in the obturator fossa, internal and external iliac regions, and rarely in the common iliac and presacral regions. A median of 4 sentinel lymph nodes per patient was detected. Three lymphatic pathways, the paravesical, internal and lateral routes, were identified. Pathological examination revealed metastases to 9 sentinel lymph nodes in 6 patients (9%). All pathologically positive lymph nodes were detected as sentinel lymph nodes using this imaging. No adverse reactions due to the use of indocyanine green were observed. CONCLUSIONS Intraoperative fluorescence imaging using indocyanine green during open prostatectomy enables the detection of lymphatic vessels and sentinel lymph nodes with high sensitivity. This novel method is technically feasible, safe and easy to apply with minimal additional operative time.