1.Eosinophilic Cystitis Coexisting with Superficial Bladder Cancer
Noriyasu Kawai ; Daisuke Nagata ; Akihiro Nakane
Journal of Rural Medicine 2008;4(1):38-40
Eosinophilic cystitis is a rare form of allergic cystitis. We reported a case of eosinophilic cystitis coexisting with superficial bladder cancer, which seemed to be invasive bladder cancer on imaging. We performed total cystectomy in this case. When invasive bladder cancer is diagnosed by imaging, coexistence of eosinophilic cystitis with superficial bladder cancer should be considered if biopsy does not show invasive bladder cancer.
Cancer of Bladder
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Cystitis
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Eosinophilic
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Superficial
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Diagnostic Imaging
2.Carcinosarcoma of the Urinary Bladder with Rapid Growth: A Case Report
Taku Naiki ; Noriyasu Kawai ; Daisuke Nagata ; Yutaka Andoh ; Hideyuki Kamisawa ; Toshiki Katoh ; Hidetoshi Akita ; Takehiko Okamura
Journal of Rural Medicine 2008;4(1):27-31
Carcinosarcoma of the bladder is a rare malignancy characterized by an intimate admixture of malignant epithelial elements (carcinoma) and malignant soft tissue elements (sarcoma). Patients with carcinosarcoma usually present with high-stage malignancy. Cystectomy or transurethral resection of the bladder tumor (TUR-Bt) is the preferred treatment, often followed by radiation therapy, but the prognosis is very poor1-7). To our knowledge, almost 80 cases have been reported in Japan, usually as case reports or small series6, 7). In almost all cases, the chief complaint was gross hematuria. We herein report a case of carcinosarcoma of the urinary bladder in a patient whose chief complaint was abdominal pain. His pain worsened, and the occurrence of hydronephrosis indicated that extremely rapid tumor growth may have occurred. No evidence of recurrence was noted 30 months after the performance of cystectomy.
Carcinosarcoma
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Bladder
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Malignant Neoplasms
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Rapid
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Case Report
3.Effect of Neoadjuvant Hormonal Therapy of Surgical Margin Status in Patients with Prostate Cancer Treated by Radical Prostatectomy
Yasuyuki Yamada ; Yoshihiro Hashimoto ; Noriyasu Kawai ; Keiji Fujita ; Keiichi Tozawa ; Takehiko Okamura ; Hiroshi Sakagami ; Kenjiro Kohri
Journal of Rural Medicine 2006;2(2):98-104
(Objective) Neoadjuvant hormonal therapy (NHT) before radical prostatectomy promotes the downstaging of primary lesions. A retrospective analysis was conducted of the relationship between NHT durations and positive surgical margin rates, as well as between positive surgical margin rates and three types of prostatectomy (antegrade radical prostatectomy, retrograde radical prostatectomy, and laparoscopic radical prostatectomy (LRP)).;(Materials and Methods) This study was a retrospective analysis of 257 patients treated with radical prostatectomy during the three years between April 2002 and March 2005. Of the 257 patients, 190 were treated by NHT. NHT durations were classified into “not conducted,” “<1 month,” “1-3 month,” “3-6 month” and “>6 month,” and the relationship between positive surgical margin rates and NHT durations was investigated. Seventy-four patients underwent antegrade radical prostatectomy, 131 were treated with retrograde radical prostatectomy, and 52 underwent LRP. Positive surgical margin rates were investigated according to the types of prostatectomy, as well as according to prostate-specific antigen (PSA) levels upon diagnosis.;(Results) Positive surgical margin rates were 53.8% in the “not conducted” and “<1 month” groups, 38.8% in the “1-3 month” group, 32.4% in the “3-6 month” group, and 10.7% in the >6 month” group. Positive surgical margin rates after open surgery (antegrade and retrograde) tended to decrease when NHT durations were longer, while those after LRP tended to increase inversely. No correlation was observed between PSA levels upon diagnosis and positive surgical margin rates or between presurgical PSA levels and NHT durations.;(Conclusion) Positive surgical margin rates were not significantly different when patients were treated with NHT for 1-3 months, but they tended to decrease when NHT was for >6 months. However, positive surgical margin rates after LRP increased when NHT continued for longer periods of time. This may the result of fibrous adhesion in the vicinity of the prostate due to long-term NHT which made the surgical margins unclear.
Prostatectomy
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month
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Positive
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LDL-Receptor Related Protein 1
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public service announcement
4.Feasibility of metronomic chemotherapy with tegafur-uracil, cisplatin, and dexamethasone for docetaxel-refractory prostate cancer
Hiroki Kubota ; Katsuhiro Fukuta ; Kenji Yamada ; Masahito Hirose ; Hiromichi Naruyama ; Yoshimasa Yanai ; Yasuyuki Yamada ; Hideki Watase ; Noriyasu Kawai ; Keiichi Tozawa ; Takahiro Yasui
Journal of Rural Medicine 2017;12(2):112-119
Objectives: To evaluate the efficacy of tegafur–uracil (UFT), a prodrug of 5-fluorouracil, plus cisplatin and dexamethasone in patients with docetaxel-refractory prostate cancers.
Methods: Twenty-five patients with docetaxel-refractory prostate cancer were administered oral UFT plus intravenous cisplatin (UFT-P therapy) and dexamethasone. Treatment responses were assessed monthly via prostate-specific antigen (PSA) level measurements. Treatment-related adverse events and overall survival were also assessed.
Results: UFT-P therapy resulted in decreased PSA levels in 14 (56%) patients and increased PSA levels in 11 (44%). In patients with increased PSA levels, 7 (64%) of the 11 patients displayed decreased PSA doubling times. The UFT-P therapy response rate was 84% (21/25 patients). Imaging studies revealed that tumor shrinkage during UFT-P therapy occurred in 1 patient in whom bilateral hydronephrosis caused by lymph node metastasis improved. The median survival time from docetaxel initiation was 36 months. In UFT-P-treated patients, the median PSA progression and overall survival times were 6 and 14 months, respectively. UFT-P treatment-related adverse events were mild diarrhea, general fatigue, and anorexia. Treatment was not discontinued for any of the patients. UFT-P therapy did not cause serious hepatic or renal dysfunction or pancytopenia.
Conclusions: UFT-P therapy is a safe and effective treatment for patients with docetaxel-refractory prostate cancer, although large-scale, multicenter, prospective studies are needed to validate these findings.
5.A pilot study of gemcitabine and paclitaxel as third-line chemotherapy in metastatic urothelial carcinoma
Taku Naiki ; Keitaro Iida ; Noriyasu Kawai ; Toshiki Etani ; Ryosuke Ando ; Takashi Nagai ; Yutaro Tanaka ; Shuzo Hamamoto ; Takashi Hamakawa ; Hidetoshi Akita ; Yosuke Sugiyama ; Takahiro Yasui
Journal of Rural Medicine 2017;12(2):105-111
Background: We evaluated the effectiveness of gemcitabine and paclitaxel therapy in patients with metastatic urothelial carcinoma for whom two lines of sequential chemotherapy had been unsuccessful.
Methods: A total number of 105 patients who had previously received first-line chemotherapy consisting of gemcitabine and cisplatin or carboplatin, were treated with second-line gemcitabine and docetaxel therapy between June 2006 and May 2015. Of these patients, 15 with an Eastern Cooperative Oncology Group Performance Status of 0 or 1 were administered gemcitabine and paclitaxel as third-line treatment from 2013 after failure of the second-line therapy. For each 21-day cycle, gemcitabine (1000 mg/m2) was administered on days 1, 8, and 15, and paclitaxel (200 mg/m2) on day 1. Patients were assessed for each cycle and any adverse events were noted. Furthermore, a Short Form Health Survey questionnaire was used to assess each patient’s quality of life.
Results: Third-line gemcitabine and paclitaxel treatment cycles were undertaken for a median of four times (range 2–9). The disease control rate was 80.0%. After second-line gemcitabine and docetaxel therapy was completed, median progression-free survival and median overall survival were determined as 9.8 and 13.0 months, respectively. The only prognostic factor for overall survival, as determined by univariate and multivariate analyses, was third-line gemcitabine and paclitaxel therapy. Neutropenia (66.7%) and thrombocytopenia (53.3%) were noted as the grade 3 treatment-related toxicities. After two cycles of third-line gemcitabine and paclitaxel therapy, the pre- and post-treatment quality of life scores did not differ significantly.
Conclusions: Results demonstrate that third-line combination therapy using gemcitabine and paclitaxel is a feasible option for metastatic urothelial carcinoma patients.