Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objectives: To determine the effect of preoperative chemotherapy on survival in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes. Methods: We retrospectively analyzed 55 consecutive patients who received radical nephroureterectomy with or without preoperative chemotherapy for upper urinary tract urothelial carcinoma clinically involving regional lymph nodes at a single institution between January 1991 and December 2013. Results: Median follow up was 18 months (range 2-193). Of 55 patients, 24 (43.6%) received preoperative chemotherapy (study group) and 31 (56.4%) underwent primary surgery (control group). Preoperative chemotherapy consisted of two to four cycles (median 3) of cisplatin-containing regimens. The fraction of patients with lower pathological T stage and N stage than clinical T stage and N stage was higher in the study group (29.2% and 54.2%) compared with the control group (3.2% and 16.1%; P = 0.013 and 0.010, respectively). The 5-year overall survival rate was significantly higher in the study group than in the control group (44.0% vs 12.9%, log-rank, P = 0.003). In multivariate analysis incorporating age at diagnosis, Eastern Cooperative Oncology Group Performance Status, clinical N stage and the number of removed lymph nodes, preoperative chemotherapy was a predictor of better overall survival (P = 0.047, HR 0.47, 95% CI 0.22-0.99). Conclusions: Preoperative chemotherapy might provide better survival outcomes in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes.

DOI： 10.1111/iju.13010

Web of Science

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Objectives: To characterize patients experiencing late recurrence after primary radical surgery for renal cell carcinoma and to approach the mechanism of late recurrence. Methods: We retrospectively analyzed 657 consecutive patients who underwent radical surgery for pathologically confirmed ≤stage III renal cell carcinoma in a single institution between January 1981 and December 2008. Early or late recurrence was defined as a recurrence occurring before or after 60 months after primary surgery. Results: Of 657 patients, 96 (14.6%) experienced early recurrence, and 41 (6.2%) developed late recurrence. Patients with late recurrence had smaller diameter of primary tumor (median 5 cm vs 8 cm, P < 0.001), lower pathological stage (P < 0.001) and lower nuclear grade (P = 0.004) at primary surgery than those with early recurrence. On multivariate analysis, vascular invasion (including microscopic and gross invasion) was the predictor of late recurrence (P < 0.01, HR 3.79). Overall survival and disease-specific survival after recurrence were longer in patients with late recurrence (median 64 and 76 months, respectively) than in those with early recurrence (34.5 and 35 months, respectively; P = 0.008 and 0.002). Conclusions: These results suggest that micrometastasis at the time of surgery associated with vascular invasion at primary tumor site and their relatively lower malignant potential could lead to late recurrence. Further studies are warranted for better understanding and managing late recurrence of renal cell carcinoma.

DOI： 10.1111/iju.12996

Web of Science

Scopus

PubMed

researchmap

Language：Japanese  

A 71-year-old woman complaining of fever and left flank pain was referred to our hospital. She had no history of taking any silicate-containing antiacids. She was diagnosed with left staghorn renal stone and repeated extracorporeal shock wave lithotripsy was performed. Analysis of the stones revealed silica calculi. Forty-nine cases of silica calculi have been reported in Japan, but this is the first case of nearly pure staghorn silicate calculi.

Scopus

PubMed

CiNii Article

CiNii Books

J-GLOBAL

researchmap

Other Link： http://hdl.handle.net/2433/159086

Language：Japanese   Publisher：(一社)日本臨床腎移植学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本泌尿器科学会総会事務局  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本泌尿器科学会総会事務局  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本臨床腎移植学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本泌尿器科学会総会事務局  

J-GLOBAL

researchmap