Maki Nagata

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

Objective:  We evaluated the efficacy of low dose tamsulosin after extracorporeal shock wave lithotripsy (ESWL) in Japanese male patients with ureteral stone.

Laparoscopic adrenalectomy in patients with large adrenal tumors

Objectives: The maximum size of adrenal tumors that should be removed by laparoscopic adrenalectomy is controversial. We conducted a retrospective comparison of the results of laparoscopic adrenalectomy between patients with adrenal tumors ≥6 cm (‘large tumors’) and patients with adrenal tumors <6 cm (‘small tumors’).

Efficacy and safety of laparoscopic surgery for pheochromocytoma

Objective: Laparoscopic surgery for primary aldosteronoma and Cushings syndrome is well established. We report on our experiences with laparoscopic adrenalectomy for pheochromocytoma, and assess the efficacy and safety of the laparoscopic approach.

Evaluation of docetaxel plus estramustine in the treatment of patients with hormone‐refractory prostate cancer

Objectives:  To investigate the feasibility and efficacy of docetaxel‐based chemotherapy in patients with hormone‐refractory prostate cancer (HRPC).

Somatic KCNJ5 mutation occurring early in adrenal development may cause a novel form of juvenile primary aldosteronism.

We report a case of non-familial juvenile primary aldosteronism (PA). Super-selective adrenal venous sampling identified less aldosterone production in the right inferior adrenal segment than others. Bilateral adrenalectomy sparing the segment normalized blood pressure and improved PA. Both adrenals had similar histologies, consisting of a normal adrenal cortex and aldosterone synthase-positive hyperplasia/adenoma. An aldosterone-driving KCNJ5 mutation was detected in the lesions, but not in the histologically normal cortex. After taking into account that the two adrenal glands displayed a similar histological profile, as well as the fact that hyperplastic lesions in both glands exhibited a common KCNJ5 mutation, we conclude that the specific mutation may have occurred at an adrenal precursor mesodermal cell, at an early stage of development; its daughter cells were mixed with non-mutant cells and dispersed into both adrenal glands, resulting into a form of the condition known as genetic mosaicism.

Active surveillance criteria for prostate cancer: Can they be applied to Japanese patients?

Prostate‐specific antigen screening has significantly increased the percentage of men who are diagnosed with low‐risk prostate cancer. All men undergoing retropubic radical prostatectomy for primary treatment of prostate cancer from April 2004 to September 2010 in our hospital were examined in order to determine whether active surveillance criteria could be applied to Japanese men. From pathological data of prostate biopsies, whether these men met five published criteria for active surveillance (Johns Hopkins Medical Institution, Prostate Cancer Research International: Active Surveillance Study, University of California, San Francisco, Toronto and Kakehi criteria) was evaluated. Men who met any of the criteria had a statistically significant lower extracapsular extension rate and organ‐confinement rate. From the view of the possibility of Gleason upgrading and organ‐confinement rate, the Johns Hopkins Medical Institution and Prostate Cancer Research International: Active Surveillance Study criteria showed to be appropriate for Japanese patients. However, the present study had limitations of selection bias and a limited number of cases.

MP78-05 INTRAVESICAL IRRIGATION PREVENTS BLADDER CARCINOMA RECURRENCE AFTER NEPHROURETERECTOMY

Shinichi Yamashita*, Akihiro Ito, Koji Mitsuzuka, Masataka Aizawa, Naomasa Ioritani, Sendai, Japan; Shigeto Ishidoya, Sendai, Japan; Yoshihiro Ikeda, Osaki, Japan; Kenji Numahata, Yamagata, Japan; Kazuhiko Orikasa, Kesennuma, Japan; Tatsuo Tochigi, Natori, Japan; Fumihiko Soma, Hachinohe, Japan; Takashige Namima, Hideo Saito, Sendai, Japan; Makoto Sato, Rifu, Japan; Shinnosuke Katoh, Yuzawa, Japan; Shozo Ota, Sendai, Japan; Atsushi Kyan, Shirakawa, Japan; Atsushi Takeda, Ichinoseki, Japan; Yasuhiro Kaiho, Yoichi Arai, Sendai, Japan

THE RISK AND MANAGEMENT OF RADIATION INDUCED CYSTITIS AFTER RADIOTHERAPY FOR PROSTATE CANCER

(Objectives) Radiation induced cystitis (RC) is one of the toxicities we must often treat after radiation therapy for prostate cancer.Some patients require urinary diversion with or without cystectomy.We evaluated the clinical risks and management of RC. (Patients and methods) The clinical records of 303 patients who underwent radiation therapy for prostate cancer (199 only radiation therapy; 104 adjuvant or salvage radiation therapy after radical prostatectomy) between 2005 and 2015 in our institute, were reviewed.We defined RC based on the presence of macrohematuria, not caused by reccurence of prostate cancer or occurrence of bladder cancer. (Results) The median follow up time was 37 months (range 1-132).Thirty patients (9.9%) developed RC.Compared to radiation therapy alone, adjuvant/salvage radiation therapy was found to be a risk for RC (4.5% vs. 20.1%, p< 0.01).Ten out of 30 RC patients needed hospitalization and 6 patients underwent urinary diversion with or without cystectomy.Two patients who underwent urinary diversion without cystectomy were hospitalized for a longer period compared with 4 patients with cystectomy. (Conclusion) Adjuvant/salvage therapy is a risk factor of RC after radiation therapy for prostate cancer.About 2% of the patients needed urinary diversion and cystectomy improved their prognosis.

LAPAROSCOPIC RADICAL NEPHRECTOMY FOR LARGE RENAL CELL CARCINOMA: RETROSPECTIVE ANALYSIS OF SAFETY AND ONCOLOGICAL OUTCOME

(Objectives) To evaluate the safety and oncologic efficacy of laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) >7 cm, we retrospectively reviewed the clinical outcome and long-term cancer control of patients who underwent LRN in comparison to open radical nephrectomy (ORN). (Patients and methods) The clinical records of 79 patients with RCC >7 cm, who underwent radical nephrectomy (37 LRN; 42 ORN) between 1993 and 2014, were reviewed. (Results) The 2 groups (LRN and ORN) were comparable regarding age, body mass index and mean tumor size (86.5 mm vs. 94.6 mm).The operative time was significantly longer in the LRN group than ORN group (204 min vs. 168 min; p<0.05) and blood loss was significantly lower in the LRN group than in the ORN group (144 ml vs. 930 ml; p<0.05).No statistically significant difference was found in complication rate (10.8% vs. 23.8%) and the 2-year recurrence-free survival rate (85.6% vs. 83.8%). (Conclusion) Despite the longer operative time, LRN for large RCC was associated with lower blood loss. This study provides evidence of the safety and efficacy of LRN for large RCC.