Shigeyoshi Kamata

Risk stratification for bladder recurrence of upper urinary tract urothelial carcinoma after radical nephroureterectomy

To identify risk factors and develop a model for predicting recurrence of upper urinary tract urothelial carcinoma (UTUC) in the bladder in patients without a history of bladder cancer after radical nephroureterectomy (RNU).

Telomere length and telomerase activity in bladder and prostate cancer cell lines.

Background: Specific repeats of oligonucleotides at the ends of chromosomes (telomeres) are shortened by cell division in somatic cells and are thought to be related to aging. Immortal cells such as germ‐line cells or cancer cells have demonstrated increased activity of the telomere‐elongating enzyme (telomerase). The length of the telomeres of these cells is stable regardless of cell division. We examined the telomere length and telomerase activity in 3 bladder (JTC30, JTC32, and T24) and 2 prostate cancer (LNCaP and DU145) cell lines.

Sympathetic efferent pathways projecting to the prostate in the dog

The laterality of the signals passing through the splanchnic nerves to each lobe of the prostate has not been studied.

Equivalent survival and improved preservation of renal function after distal ureterectomy compared with nephroureterectomy in patients with urothelial carcinoma of the distal ureter: A propensity score-matched multicenter study

To investigate the oncological and functional outcome of distal ureterectomy compared with nephroureterectomy in the management of distal ureteral urothelial carcinoma.

Ureteral Involvement Is Associated with Poor Prognosis in Upper Urinary Tract Urothelial Carcinoma Patients Treated by Nephroureterectomy: A Multicenter Database Study

BACKGROUND The prognostic significance of tumor location for patients with upper urinary tract urothelial carcinoma (UUT-UC) has been disputed. Several papers have reported that ureteral cancer is associated with worse prognosis. OBJECTIVE To investigate the prognostic significance of the presence of ureteral tumors in UUT-UC patients who underwent radical nephroureterectomy (RNU). DESIGN, SETTING, AND PARTICIPANTS In this multicenter retrospective study, 1068 eligible patients (median follow-up: 40 mo [interquartile range: 17-77 mo]) were divided into three groups based on tumor location: renal pelvic, ureteral, and both-regional (having both renal pelvic and ureteral tumors). The ureteral and both-regional groups were subsequently integrated into the ureteral involvement group to evaluate its prognostic impact. INTERVENTION All patients underwent RNU. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The prognostic impact of tumor location on survival was analyzed. RESULTS AND LIMITATIONS The renal pelvic, ureteral, and both-regional groups consisted of 507 (47.5%), 430 (40.3%), and 131 (12.3%) patients, respectively. The ureteral and both-regional groups had a higher rate of lymphovascular invasion and lymph node metastasis compared with the renal pelvic group. The renal pelvic and both-regional tumors presented more frequently with locally advanced stages (pT3/T4) compared with the ureteral tumors. The 5-yr cancer-specific survival (CSS) and progression-free survival (PFS) rates of patients in the ureteral (70.5% and 66.7%, respectively) and both-regional groups (64.8% and 57.8%, respectively) were significantly worse than those in the renal pelvic group (81.9% and 78.1%, respectively). In a multivariate analysis, the presence of ureteral involvement was a significant prognostic factor for CSS (hazard ratio [HR]: 1.50; p=0.006) and PFS (HR: 1.35; p=0.023). This study is inherently limited by the biases associated with its retrospective and multicenter design. CONCLUSIONS The presence of ureteral involvement had a significant impact on the survival of surgically treated UUT-UC patients associated with a poor prognosis. PATIENT SUMMARY We demonstrated that the ureteral involvement was associated with poor survival compared with patients with renal pelvic tumor only in upper urinary tract urothelial patients treated by nephroureterectomy.

687 BIMODAL PATTERN OF THE IMPACT OF BODY MASS INDEX ON CANCER-SPECIFIC SURVIVAL OF UPPER URINARY TRACT UROTHELIAL CARCINOMA PATIENTS: MULTI-CENTER STUDY IN A 1114-CASE TOKYO METROPOLITAN DATABASE OF UROLOGIC DISEASE (TMDU) COHORT

UTUC database and the UTUC collaboration (n 4137). After excluding the nine patients who we previously reported on [5], 28 patients (0.7%) with pT0 tumor were included in this report. All patients had undergone cystoscopy, urine cytology, intravenous urography and/or abdominalpelvic CT-scans, and diagnostic ureteroscopy prior to RNU. None of the patients underwent preoperative radiotherapy and none of the patients had metastasis at time of RNU. Due to the low number of patients, only descriptive results are shown. RESULTS: The median age at diagnosis was 68 years (IQR: 57-74) and the male-to-female ratio was 2:1. Six patients had evidence of non-organ confined UTUC on pre-RNU imaging and received neoadjuvant cisplatin-based combination chemotherapy. Regional lymphadenectomy was performed in the six patients who had received neoadjuvant chemotherapy (median: 10 lymph nodes, IQR 6-14). On final pathology, all patients had pT0N0 except one patient who had two positive renal hilar lymph nodes (pT0 N1). Overall, 4 patients experienced disease recurrence (median time to recurrence : 38 months, IQR: 24-48). Three of these patients developed metastatic disease and one had a relapse in the operative field. The three patients with metastasis died from UTUC within a median time of 10 months from their disease recurrence. Within a median follow-up of 40 months (IQR: 22-64), nine patients developped intravesical recurrence (median time: 35 months, IQR: 14-54). The 5-year recurrence-free and cancer-specific survival rates were 77% (95% CI, 72-81.3) and 78% (95% CI, 69-83.8), respectively. CONCLUSIONS: pT0 UTUC may be the result from effective neoadjuvant chemotherapy, complete endoscopic treatment, misinterpretation of the pathologic specimen (i.e, false pT0), or overtreatment. Our limited data shows that post-RNU prognosis of pT0 patients is highly variable as some patients experience disease progression needing more stringent follow-up.