Kazuhiko Nagakura

Anterior perirectal fat tissue thickness is a strong predictor of recurrence after high‐intensity focused ultrasound for prostate cancer

Objective:  To evaluate if and why obesity affects the clinical outcome in patients undergoing high‐intensity focused ultrasound (HIFU) treatment for prostate cancer (CaP).

Transurethral resection of the prostate immediately after high-intensity focused ultrasound treatment for prostate cancer

Objectives:  To evaluate the long‐term outcomes of transurethral resection of the prostate (TURP) immediately after high‐intensity focused ultrasound (HIFU) treatment for prostate cancer (CaP).

Efficacy of Short-Term Androgen Deprivation With High-Intensity Focused Ultrasound in the Treatment of Prostate Cancer in Japan

OBJECTIVES To determine whether combining short-term neoadjuvant androgen deprivation therapy (NADT) with high-intensity focused ultrasound (HIFU) had a significant benefit in a large population of men with nonmetastatic prostate cancer (CaP). METHODS We evaluated the records of 530 patients whose prostate-specific antigen (PSA) level at diagnosis was 30 ng/mL or less and whose follow-up period was not less than 12 months, at seven investigational sites. Two hundred seventy patients had received NADT (within 6 months), and 260 had not. The primary outcome measure was disease-free survival according to the combined criteria satisfying the Phoenix definition (less than nadir + 2), negative prostate biopsy, and no findings of distant metastasis after the last HIFU treatment. The significance of the differences of values or the distributions of each parameter between two groups was evaluated with a Mann-Whitney U test, unpaired t test, or chi-square test, and a multivariate Cox proportional hazards model was used to evaluate the prognostic relevance of preoperative parameters. RESULTS Statistical analyses showed that the NADT group had worse disease (higher PSA and risk group) than the HIFU-only group. Variables shown by multivariate analyses to be significant prognostic parameters were pretreatment PSA level, clinical stage, and no use of NADT. Short-term NADT significantly improved the 3-year disease-free survival rate of patients with intermediate-risk and high-risk CaP. During follow-up the frequencies of complications did not differ significantly with or without NADT. CONCLUSIONS Our retrospective study suggests that combining short-term NADT with HIFU treatment is of significant clinical benefit to intermediate-risk and high-risk CaP patients without increasing the likelihood of complications.

1,25-Dihydroxyvitamin D3 Receptors and their Relationship to Histological Features in Renal Cell Carcinoma

The present studies were carried out in 11 human renal cell carcinomas to determine the presence of a receptor specific for an active form of vitamin D, 1,25-dihydroxyvitamin D3. Saturation and Scatchard analyses of the cytosol receptor for 1,25-dihydroxyvitamin D3 showed that nine tumors had a detectable level of the receptor (two fmol/mg. protein). The equilibrium dissociation constant of these receptors ranged between 46 and 380 pM and the binding capacity also ranged between 3.5 and 12.7 femtomol/mg. protein. Sucrose density gradient analysis of the specific binders revealed that the tumors had a receptor protein appearing as a single 3.6S peak. Two tumors which had only a trace of the receptor were high grade solid tumors consisting mainly of spindle or pleomorphic cells. Nine tumors possessing 1,25-dihydroxyvitamin D3 receptor consisted of clear and/or granular cells. Thus, the absence of the receptor was only accompanied by low differentiated sarcomatoid tumors with poor prognosis. However, so far, the amount of the receptor in the receptor-positive tumor did not relate to the other clinical and pathological features of the patients.