Yoshihiro Nagata

Transrectal high-intensity focused ultrasound for the treatment of localized prostate cancer: eight-year experience.

Objective:  To report on the long‐term results of high‐intensity focused ultrasound in the treatment of localized prostate cancer.

Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer

Background:  High‐intensity focused ultrasound (HIFU) is a minimally invasive technique used in achieve coagulation necrosis. We evaluated biochemical disease‐free survival rates, predictors of clinical outcome and morbidity in patients with localized prostate cancer treated with HIFU.

High‐intensity focused ultrasound as salvage therapy for patients with recurrent prostate cancer after external beam radiation, brachytherapy or proton therapy

Study Type – Therapy (case series)
Level of Evidence 4

Quality of life following high-intensity focused ultrasound for the treatment of localized prostate cancer: a prospective study.

Objectives:  To report our health‐related quality of life (QOL) and functional outcomes following high‐intensity focused ultrasound (HIFU) for localized prostate cancer.

Improved Outcomes with Advancements in High Intensity Focused Ultrasound Devices for the Treatment of Localized Prostate Cancer

PURPOSE We evaluated the association between long-term clinical outcomes and morbidity with high intensity focused ultrasound. MATERIALS AND METHODS We included patients with stage T1c-T3N0M0 prostate cancer who were treated with Sonablate® (SB) devices during 1999 to 2012 and followed for more than 2 years. Risk stratification and complication rates were compared among the treatment groups (ie SB200/500 group, SB500 version 4 group and SB500 tissue change monitor group). Primary study outcomes included overall, cancer specific and biochemical disease-free survival rates determined using Kaplan-Meier analysis (Phoenix definition). Secondary outcomes included predictors of biochemical disease-free survival using Cox models. RESULTS A total of 918 patients were included in the study. Median followup in the SB200/500, SB500 version 4 and the SB500 tissue change monitor groups was 108, 83 and 47 months, respectively. The 10-year overall and cancer specific survival rates were 89.6% and 97.4%, respectively. The 5-year biochemical disease-free survival rate in the SB200/500, SB500 version 4 and SB500 tissue change monitor group was 48.3%, 62.3% and 82.0%, respectively (p < 0.0001). The overall negative biopsy rate was 87.3%. On multivariate analysis pretreatment prostate specific antigen, Gleason score, stage, neoadjuvant androgen deprivation therapy and high intensity focused ultrasound devices were significant predictors of biochemical disease-free survival. Urethral stricture, epididymitis, urinary incontinence and rectourethral fistula were observed in 19.7%, 6.2%, 2.3% and 0.1% of cases, respectively. CONCLUSIONS Long-term followup of patients with high intensity focused ultrasound demonstrated improved clinical outcomes due to technical, imaging and technological advancements.

Metastin Inhibits Migration and Invasion of Renal Cell Carcinoma with Overexpression of Metastin Receptor

BACKGROUND Metastin, the final peptide of the KiSS-1 gene, has been proposed to suppress cell motility. OBJECTIVE This study investigated whether renal cell carcinoma (RCC) tissue expresses metastin or its receptor, and clarified whether metastin can suppress migration and/or invasion and/or proliferation of RCC cells in vitro. DESIGN, SETTING, AND PARTICIPANTS Twenty-five RCC samples were submitted. Fresh RCC tissues were prepared for real-time RT-PCR, and formalin-fixed and paraffin-embedded tissues blocks were examined by immunohistochemistry. RCC cell lines Caki-1 and ACHN were supplied for cell migration, invasion, and proliferation assays. MEASUREMENTS Real-time RT-PCR was performed by using Taq Man gene expression system. ENVISION system was used in immunohistochemistry. Wound-healing assay and matrigel assays were used to identify migration and invasion abilities of RCC cell lines. Cell Counting Kit-8 was applied to measure the cell proliferation. Cell morphology was examined under a META system. Statistical analysis was performed with SPSS15.0J. RESULTS AND LIMITATIONS In twenty-five RCC samples, the mRNA level of metastin receptor was identified to be significantly higher than non-neoplastic renal cortex by real-time RT-PCR (p=0.011). Immunohistochemical study also detected metastin receptor protein in all RCC tumors. In vitro, this study showed that metastin inhibited migration and invasion of Caki-1 and ACHN cells. In contrast, it had no effects on cell proliferation. Metastin (10 micromol/l) induced excessive formation of focal adhesions and stress fibers in Caki-1 and ACHN cells; this phenomenon was inhibited by pretreating pharmacological Rho-kinase inhibitor (Y-27632) to those cells. CONCLUSION This is the first report regarding overexpression of the metastin receptor hOT7T175 in human RCC. We demonstrate that metastin can inhibit migration and invasion of the RCC cell line, which is regulated by a Rho-kinase inhibitor. Metastin and its receptor are therefore probable targets for suppressing RCC.

Salvage high-intensity focused ultrasound for biopsy-confirmed local recurrence of prostate cancer after radical prostatectomy

Study Type – Therapy (case series)
 Level of Evidence 4

OVER-EXPRESSION OF METASTIN RECEPTOR IN RENAL CELL CARCINOMA: METASTIN AND ITS RECEPTOR ARE A POSSIBLE INHIBITOR OF THE INVASION OF RENAL CELL CARCINOMA

245 OVER-EXPRESSION OF METASTIN RECEPTOR IN RENAL CELL CARCINOMA: METASTIN AND ITS RECEPTOR ARE A POSSIBLE INHIBITOR OF THE INVASION OF RENAL CELL CARCINOMA Sunao Shoji*, Xian Yan Tang, Shinobu Umemura, Masanori Shima, Yukio Usui, Yoshihiro Nagata, Toyoaki Uchida, Robert Y Osamura, Toshiro Terachi. Isehara, Kanagawa, Japan. INTRODUCTION AND OBJECTIVE: KiSS-1 is a tumor suppressor gene, which can prevent breast cancer and melanoma KiSS-1 gene encodes a 145-amino acid

High‐Intensity Focused Ultrasound (HIFU) for the Treatment of Localized Prostate Cancer using Sonablate‐500

We evaluated 181 patients with localized prostate cancer treated with high‐intensity focused ultrasound (HIFU) for biochemical disease‐free rate, safety, morbidity and predictors of biochemical outcome. A total of 181 patients underwent HIFU with the Sonablate‐500 and with at least 12 months of follow‐up. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The biochemical disease‐free rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease‐free rates at 3 years for patients with pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml and more than 20.0 ng/ml were 94%, 75% and 35%, respectively (p<0.0001). According to multivariate analysis preoperative PSA (p<0.0001) was a significant independent predictor of time to biochemical recurrence. HIFU therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, e...

Twelve years’ experience with high-intensity focused ultrasound (HIFU) using sonablate™ devices for the treatment of localized prostate cancer

To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Patients with clinical Stage T1c-T3N0M0, biopsy proven, localized prostate cancer, with a serum prostate specific antigen (PSA) level of <30 ng/ml, any Gleason score were included. All patients underwent HIFU using the Sonablate™ (S) device and were required to have a minimal follow-up of 2 years after the last HIFU session to be included in this analysis. Four different generation HIFU devices, S200, S500, S500 version 4 and S500 TCM, have been used for this study. Biochemical failure was defined according to the Phoenix definition (PSA nadir+2ng/ml). Seven hundred and fifty-three men with prostate cancer were included. The patients were divided into two groups: in the Former group, 421 patients were treated with S200 and 500 from 1990 to 2005; in the Latter group, 332 patients were treated with S500 ver. 4 and TCM from 2005 to 2009. The mean age, PSA, Gleason score, operation time, and follow-up period in the Former and Latter groups were 68 and 67 years, 11.3 and 9.7 ng/ml, 6.2 and 6.6, 167 and 101 min, and 49 and 38 months, respectively. The biochemical disease-free rate (BDFR) in the groups at 5 years was, respectively, 67% and 53%, and was 50% at 10 years in the Former group (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Former group at 5 and 10 years were 68% and 65%, 52% and 48%, and 43% and 40%, respectively (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Latter group at 5 years were 83%, 76%, and 42% (p<0.0001). The negative prostate biopsy rate in the Former and Latter groups was 81% and 93%, respectively. Postoperative erectile dysfunction was noted in 45%, 38%, and 24% of patients at 6 months, 12 months, and 2 years after HIFU. The results after long-term follow-up have indicated that HIFU is an efficient and safe treatment for patients with localized prostate cancer, especially low-and intermediate-risk patients.