Kiyohide Fujimoto

Insignificant role of bacillus Calmette-Guérin maintenance therapy after complete transurethral resection of bladder tumor for intermediate- and high-risk non-muscle-invasive bladder cancer: Results from a randomized trial.

To investigate the effect of bacillus Calmette–Guérin maintenance therapy on patients with intermediate‐ and high‐risk non‐muscle‐invasive bladder cancer receiving aggressive complete transurethral resection of bladder tumors standardized by well‐trained surgeons.

Microfluidic cell sorter for photodynamic urine diagnosis

We report a new microfluidic cell sorting system for early diagnosis of genitourinary cancer based on photodynamic analysis of urine. In the developed system, genitourinary cancer cells are detected using 5-aminolevulinic acid (5-ALA)-induced fluorescence and then sorted for gene alteration analysis. The unique characteristic of this cell sorter is that the microchannels microstructure is fabricated using one-step UV photolithography, to create a disposable, low-cost device that has low autofluorescence. In this paper, we examine the performance of the microfluidic cell sorting system for diagnosing genitourinary cancer, and evaluate the accuracy of cancer cell separation when using the 5-ALA treatment, and also when using fluorescent beads.

Risk Stratification Model to Predict High-Risk Patients for AdjuvantChemotherapy in Upper Urinary Tract Urothelial Cancer

Objective: Optimal patient selection for adjuvant chemotherapy has not been clarified in upper urinary tract n urothelial cancer (UTUC). We aimed to develop a risk model to select candidates for adjuvant chemotherapy after n radical nephroureterectomy (RNU). nMethods: A retrospective review of 936 patients with UTUC between 1995 and 2015 who received ≥ 2 cycles of n platinum-based adjuvant chemotherapy after RNU (n=213) or surgery alone (n=723) was conducted in collaborative n institutions. Risk factors for cancer-specific mortality were extracted using the proportional hazard model. The n survival benefit in high-risk patients was compared between the groups. nResults: At a median follow-up of 1006 days (34 months), disease recurrence, cancer-specific mortality, and allcause n mortality were noted in 253 (27.5%), 206 (22.0%), and 285 (30.4%) patients, respectively. On multivariate n analysis, baseline serum C-reactive protein (CRP) ≥ 0.32 mg/dL (HR: 1.74, 95% CI: 1.09–2.75, p=0.0201), n pathologic T stage ≥ 3 (pT>3) (HR: 2.17, 95% CI: 1.28–3.76, (p=0.0033), cN+ (HR: 2.84, 95% CI: 1.50–5.01, n p=0.0021), and lymphovascular invasion (LVI) (HR: 3.94, 95% CI: 2.23–7.17, p<0.0001) were independent n predictors of cancer-specific mortality (CSM) in the training set. When they were used to categorize patients into low n (0-1 factor) and high-risk groups (2-4 factors), high-risk patients had significantly worse CSM than those with low-risk. n In the high-risk patients, 42.3% who received adjuvant chemotherapy had significantly better CSM and all-cause n mortality than those who underwent surgery alone. In high-risk patients, multivariate analysis showed n adjuvant chemotherapy as an independent prognostic factor for CSM (HR: 0.52) and all-cause mortality (HR: 0.57). nConclusion: CRP, pT>3, cN+, and LVI was useful for identifying high-risk patients.