DSpace コレクション: 2010-022010-02http://hdl.handle.net/2433/980152024-03-29T08:27:55Z2024-03-29T08:27:55Z転移性腎癌症例の予後因子の検討井上, 隆太高橋, 敦高杉, 尚吾舛森, 直哉塚本, 泰司長谷川, 匡http://hdl.handle.net/2433/980342021-09-15T10:11:55Z2010-02-01T00:00:00Zタイトル: 転移性腎癌症例の予後因子の検討
著者: 井上, 隆太; 高橋, 敦; 高杉, 尚吾; 舛森, 直哉; 塚本, 泰司; 長谷川, 匡
抄録: To identify prognostic factors for survival and risk classification in Japanese patients, we studied clinical parameters in 79 patients with metastatic renal cell carcinoma (mRCC) treatedat our institution from 1988 to 2004. Univariate andmultivariate analyses were performedto identify prognostic factors for survival. In univariate analysis, the absence of nephrectomy, metastasis at first visit, ECOG performance status (PS) 2 or more, liver metastasis, brain metastasis, low hemoglobin (<lower limit of normal), C-reactive protein (CRP) >0.3, and serum lactate dehydrogenase (LDH) higher than 1.5 times the upper normal limit were significantly associatedwith poor outcome. Multivariate analysis demonstratedthat two variables remained significant : hepatic metastasis andhigh LDH. Hepatic metastasis, high LDH, nephrectomy, metastasis at first visit, poor ECOG PS andCRP >0.3 were usedto categorize patients into three groups. The 2-year survival rate was 72.9% for the patients with no or one risk factor, 40.2% for those with two and15.1% for those with three or more. According to Motzer's criteria, the 2-year survival rates for patients with favorable risk, intermediate risk, andpoor risk were 85.1, 33.0, and13.1 % respectively. Our prognostic criteria are simple, andcan be usedto categorize Japanese patients with mRCC into three risk groups.2010-02-01T00:00:00ZModulith SLX-F2における焦点領域と破砕成績の検討鈴木, 康太郎山下, 雄三吉田, 実松崎, 純一http://hdl.handle.net/2433/980332021-09-15T10:11:56Z2010-02-01T00:00:00Zタイトル: Modulith SLX-F2における焦点領域と破砕成績の検討
著者: 鈴木, 康太郎; 山下, 雄三; 吉田, 実; 松崎, 純一
抄録: We evaluated the usefulness of a new shock-wave lithotripsy machine with a dual focus system (large focus : 9×50 mm, standard focus : 6×28 mm), "Modulith SLX-F2" on 361 patients. In the first period, 210 patients, were treated with the large focus, and in the second period, 151 patients were treated with the standard focus. Complications, efficacy and subsequent auxiliary procedures were compared between the first and second periods. The efficacy was evaluated with efficiency quotient (EQ). Administered total energy was displayed with stortz medical lithotripsy index (SMLI). After treatment, we performed ultrasonography to evaluate renal hematoma in all cases. Average size of renal stones and ureteral stones was 14.25 and 11.0 mm, respectivery, in the first period, and 13.80 and 8.97 mm, respectivery, in the second period. EQ of renal and ureteral stones was 0.565 and 0.626, respectivery, in the first stage, and 0.553 and 0.798, respectivery, in the second period. The total EQ was 0.646. This value was good and particularly the result obtained on ureteral stones in the second period was thought to be excellent compared with other reports. In this series, 6 renal hematomas were confirmed. A statistically significant risk factor was SMLI, but the severity of hematoma was not correlated with SMLI. In hematoma patients, 2 patients had no notable risk factor, but they were thin or were small. Dual focus has a potential to improve ESWL results on ureteral stones. Excessive SMLI may be a risk factor of renal hematoma in thin or small patients.2010-02-01T00:00:00Z膀胱全摘後の上部尿路再発の臨床的検討杉, 素彦福井, 勝也吉田, 健志乾, 秀和川喜多, 繁誠室田, 卓之木下, 秀文松田, 公志http://hdl.handle.net/2433/980322021-09-15T10:11:56Z2010-02-01T00:00:00Zタイトル: 膀胱全摘後の上部尿路再発の臨床的検討
著者: 杉, 素彦; 福井, 勝也; 吉田, 健志; 乾, 秀和; 川喜多, 繁誠; 室田, 卓之; 木下, 秀文; 松田, 公志
抄録: Transitional cell carcinoma of the urothelium is often multifocal, and subsequent tumors may occur anywhere in the urinary tract afer treating the initial carcinoma. The risk of an upper urinary tract recurrence following a radical cystectomy has been reported to be approximately 2 to 8%, but there are few reports with regard to the pattern and predictive factors of upper tract recurrence. We report here the incidence and pattern of upper tract recurrence following a radical cystectomy. Of the 166 patients 5 (3%) had upper tract recurrence. The prognosis of upper urinary tract recurrence is significantly better than other site of recurrence.2010-02-01T00:00:00Z前立腺全摘除術標本における腫瘍体積とPSA再発との関連について橋本, 安弘百瀬, 昭志岡本, 亜希子山本, 勇人畠山, 真吾岩渕, 郁哉米山, 高弘古家, 琢也神村, 典孝大山, 力http://hdl.handle.net/2433/980312021-09-15T10:11:56Z2010-02-01T00:00:00Zタイトル: 前立腺全摘除術標本における腫瘍体積とPSA再発との関連について
著者: 橋本, 安弘; 百瀬, 昭志; 岡本, 亜希子; 山本, 勇人; 畠山, 真吾; 岩渕, 郁哉; 米山, 高弘; 古家, 琢也; 神村, 典孝; 大山, 力
抄録: We examined whether the tumor volume (TV) is a good predictor of PSA recurrence after radical prostatectomy. Data were collected for 158 patients with clinically localized prostate cancer undergoing radical prostatectomy without neoadjuvant hormonal therapy in our hospital since April 2005 to September 2007. Along with the routine pathological assessment, TV was assessed in all prostatectomy specimens. PSA recurrence was defined as PSA levels of greater than 0.2 ng/ml. The TVs were 1.81±1.66 ml (mean ±SD) ranging from 0.02 to 8.20 ml. The TV in cT1c was 1.77±1.64, and 1.89±1.72 ml in cT2 (not significant). Significant differences were observed between TV and pT. The TVs in pT2a, pT2b and pT3/4 were 0.54±0.54, 1.63±1.47 and 2.67±1.80 ml, respectively. The median follow-up period was 32.3 months (range from 15 to 45) after radical prostatectomy, and PSA recurrence was observed in 32 cases. Patients with smaller TV (TV <1.3 ml) had a higher PSA-free survival rate (89.5%) than those with a larger TV (TV >− 1.3 ml, 66.7%) with a significantdifference atp <0.001 (log-rank test). A multivariate analysis was performed for PSA, TV, pT, Gleason Score (GS), and surgical margins. Significantdifferences were observed for GS, and surgical margins, butnotfor TV. Clinically organ-confined disease in Japanese patients with prostate cancer included various cancers from clinically insignificant to locally advanced ones. In our series, TV was not regarded as a predictor of PSA recurrence after radical prostatectomy.2010-02-01T00:00:00Z