PubMed Health⌕ Search

Biomedical subjects

S Isaka

Publications and source records attributed to S Isaka.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Changes in prostatic acid phosphatase, gamma-seminoprotein and prostate specific antigen after endocrine therapy for stage D2 prostate cancer].

Prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PSA) were examined on 120 cases of stage D2 prostate cancer between 1979 and 1989. All patients received endocrine therapy as the first treatment; castration and immediate administration of estrogen or antiandrogen (101), LH-RH analogs (13), estrogen (3) and antiandrogen (3). The actuarial survival rates were calculated by the cause-specific survival method. Pretreatment levels of PAP, gamma-Sm and PSA did not influence prognosis. After start of treatment, the relationship between the changes of the markers and prognosis were examined. At 1 month after the start of the treatment, normalization of PAP or gamma-Sm was not reflected in the following course. On the contrary, at 3 and 6 months, groups with normalization of PAP or gamma-Sm showed better prognosis than those with elevated levels. The same tendency of PSA was obtained at 6 months after start of treatment. In patients with normalized PAP at 3 months, abnormal gamma-Sm showed worse prognosis than normalized gamma-Sm. Therefore, the significance of determination on the two markers was manifested. As histological grade influenced the following course, poorly differentiated adenocarcinoma with normalized PAP at 3 months showed better prognosis than those with elevated levels. In conclusion, it is worthwhile to measure multiple markers for predicting the prognosis of stage D2 prostate cancer treated with endocrine therapy.

Acid Phosphatase↗
PubMed1990

[Prognosis of the patients with prostate cancer clinically confined within the pelvis].

Between 1975 and 1989, 90 patients with prostate cancer in clinical stage A2 to C underwent pelvic lymphadenectomy. Median follow-up period was 38 months. Almost all of the patients with pN0-1 (49) and 4 of pN2 were treated by curative treatment, such as radical prostatectomy (7) or radiation therapy (45). The remaining pN2 (26), pN3 (4) and pM1 LYM (6) received endocrine therapy. Pelvic lymph node metastasis were noticed in 50 cases (56%). Rates of positive node and degree of nodal extension were related to clinical stage and histological grade. Disease-free survival of the patients with pN0-1 was better than that of the patients with more than pN2. There was no difference in disease-free survival between the patients with pN0 and pN1. We concluded that the patients with pN0 and pN1 were the candidates for curative therapy and recommend that the patients with more than pN2 be treated with endocrine therapy.

Adenocarcinoma↗
PubMed1989

[Recurrence and prognosis of renal pelvic and ureteral carcinoma].

Eighty-three patients with renal pelvic and ureteral carcinoma operated in Chiba University Hospital were followed. Age ranged between 23 and 79 years old (average 61.8 years) with the male-to-female ratio of approximately 2:1. Localization of tumors was in renal pelvis in 41 (49.4%), ureter in 29 (34.9%) and both in 13 (15.7%). Significant correlation in prognosis was obtained with macroscopic hematuria, histological classification, grade, stage and regional lymph node involvement. Recurrence was found on 49 cases (59%), 21 had intra-vesical tumor and 28 showed retroperitoneal recurrence or distant metastasis. In the former the mean tumor free interval was 14.8 months and 5 year survival rate was 62.1%. In the later the mean tumor free interval was 6.5 months and 3 year survival rate was 5%. 8 (38.1%) in 21 cases with low stage papillary transitional cell carcinoma showed recurrence and it was all intra-vesical tumor. 25 (56.8%) in 44 cases with high stage papillary transitional cell carcinoma showed recurrence. Retroperitoneal recurrence or distant metastasis was recognized in 12 cases. On the other hand 14 (87.5%) in 16 cases with non-papillary transitional cell carcinoma showed recurrence, which was all retroperitoneal recurrence or distant metastasis.

Adult↗
PubMed1989

[Survivals of incidental renal cell carcinoma].

Between January 1987 and July 1988, 151 cases of renal cell carcinoma were nephrectomized at out institutions. Among them 41 cases (27.2%) were diagnosed incidentally. The ratio of incidental carcinoma has been increasing steadily in the past decade. Thirty-four of these cases (82.9%) were detected by ultrasound, 4 by computerized tomography, and three by excretory urography. Twenty-eight of these cases were found serendipitously during examination for other diseases, while others had no symptoms at all. Only 8 of these cases (19.5%) showed microscopic hematuria. The stage and the grade of these incidental carcinoma were significantly lower than those of symptomatic carcinoma (p less than 0.001). The survival rate of the former was better than that of the latter (p less than 0.01), especially in patients with pT1-2b tumors (p less than 0.05) or with tumors smaller than 10 cm in diameter (p less than 0.05).

Adult↗
PubMed1989

[Magnetic resonance imaging in the diagnosis of prostatic carcinoma and benign hyperplasia].

Using a 0.5 tesla superconducting magnetic system, magnetic resonance imaging (MRI) studies were performed in 42 patients (27 prostatic carcinoma and 15 benign prostatic hyperplasia) and 2 healthy volunteers. Spin echo images were produced in the transverse, coronal and sagittal directions. T1 and T2 relaxation times were calculated from these images. The images of 2 normal prostates showed 2 separate zones: an internal zone and an external zone. The images of 8 of the 15 prostates with benign prostatic hyperplasia showed 3 zones: an internal zone, a band of low intensity and an external zone. Most of the cases of prostatic carcinoma showed extracapsular extension, so we could not detect zonal distinction of the images in 25 cases out of the 27 prostates with prostatic carcinoma. Most of the images of prostates with prostatic carcinoma showed irregular and asymmetric shape and inhomogeneous signal intensity. MRI had an accuracy of 85.7% in differentiating prostatic carcinoma from benign prostatic hyperplasia. A good correlation (r = 0.936) was observed between the weight of the whole prostate as predicted by MRI and the actual weight of the adenoma enucleated by retropubic prostatectomy. The change in volume of the prostate after hormone therapy was well evaluated by MRI. We were not able to differentiate prostatic carcinoma from benign prostatic hyperplasia on the basis of the T1 and T2 relaxation times alone. The serial measurements of the T1 and T2 relaxation times might be value in following therapeutic response of prostatic carcinoma.

Adult↗
PubMed1989

[Conservative surgery of upper urinary tract urothelial carcinomas].

In the last ten years 19 patients with urothelial cancer of the upper urinary tract underwent excision of the tumor with preservation of the ipsilateral kidney. Renal function was preserved well in all cases in 31 months of the mean follow up term. In the presence of a normal contralateral kidney, local tumor excision was done electively in 12 patients (5 lower portion of ureter, 5 low grade lesions, 2 high age), local recurrence developed 6-63 months after operation in 2 patients, and they underwent nephroureterectomy. 11 cases are alive with no evidence of disease and one is alive with contralateral renal pelvic cancer. Absolute indications for conservative surgery were solitary kidneys/non functioning contralateral kidney in 3 patients and bilateral tumor in 4 patients. Most tumors were high grade or high stage (6: grade 2,4: PT2). No one had local recurrence, but one had a metastasis to a lung, 4 were suffering from bladder cancer post-operatively. Three patients died from cancer 20-30 months after operation. Local excision of urothelial cancer should be considered not only for cases of contralateral damaged kidneys but also for low grade, low stage localized tumors. Precise preoperative evaluation of tumors using a ureteroenoscope should be made for the indication of the renal preservative operation.

Adult↗
PubMed1989

[Factors influencing the prognosis of grade 1 renal cell carcinoma].

Between 1960 and 1988, 65 patients with grade 1 renal cell carcinoma were nephrectomized in our institutions. To delineate potentially curable cancer, the host and tumor factors influencing the prognosis were analyzed. Factors that had unfavorable effects were the presence of tumor thrombi in renal veins, fever, and elevation of erythrocyte sedimentation rate (ESR), serum alpha 2-globulin and C-reactive protein (CRP). Patients who were under 39-years-old or with pT1-2a tumor had excellent prognosis. The ratio of tumor thrombi, pT, fever, ESR, serum alpha 2-globulin and CRP levels all increased with age. In conclusion, patients with normal levels of fever, ESR, serum alpha 2-globulin, CRP and no tumor thrombi and/or with pT1-2a tumor were considered to be the potentially curable cancer patients.

Adolescent↗
PubMed1989

[Pelvic lymph node dissection for invasive bladder cancer].

From 1979 through 1988, 64 men and 16 women (age range 36-82; mean 63 years) with bladder cancer underwent pelvic lymph node dissection and radical cystectomy with urinary diversion. Bilateral common iliac, external iliac, internal iliac, obturator and presacral nodes were removed and examined. The frequency of involvement of each nodal group was the highest at the common iliac and the external iliac nodes followed by the obturator, presacral and internal iliac nodes. The incidence of lymph node metastasis increased with the tumor grade and pathological stage. The incidence of positive nodes is 3.7% in patients with P1 tumors, 10% in P2, and 17% in P3 tumors. Of these patients, 9 were with nodal metastasis; seven died of metastatic cancer 3 to 37 months post-operatively, two were alive for 4 to 41 months without evidence of recurrence. The mean survival time was significantly longer than that of the historical control group (1975-1978 total cystectomy without node dissection).

Adult↗
PubMed1989

[Histological effect of preoperative irradiation in bladder cancer].

Forty-seven patients with high grade invasive bladder cancer were treated with preoperative radiation therapy (910 rad by fast neutron or 3000 rad by X-ray for two weeks) followed by radical cystectomy and urinary diversion. Stage down effect was observed in 32% of patients when comparison was made between the clinical and pathological stages. Those who showed stage down effect had better prognosis when compared those without it. Histopathological effect of Grade 2B or Grade 3, according to the criteria described by Ohboshi and Shimosato, was noticed in 49% of the patients. Five year survival was as follows: 100% (PT0, PTis), 75% (PT1), 100% (PT2), 47% (PT3), 0% (PT4). These results clearly showed the improvement of prognosis compared to the historical control.

Adult↗
PubMed1989

[A case of refractory testicular cancer showing complete response to high-dose chemotherapy with autologous bone marrow transplantation].

A patient with stage III testicular cancer was treated by 3 courses of BEP therapy and a partial response was obtained. Afterwards he underwent resection of pulmonary residual tumors and was treated by 2 courses of PE therapy immediately after operation. However, a new pulmonary tumor appeared after the first course of PE therapy was completed. He was treated by high-dose chemotherapy (etoposide 1200 mg/m2, cyclophosphamide 120 mg/kg, CDDP 60 mg/m2) with autologous bone marrow transplantation. Three weeks after high-dose chemotherapy his metastatic pulmonary tumor showed cavity formation which disappeared after 3 months. Fifteen months after the high-dose chemotherapy, no evidence of disease has been seen even without maintenance therapy.

Adult↗
PubMed1989

Histological effects of endocrine therapy for prostatic cancer in relation to clinical course.

In order to evaluate histological changes in cases of prostatic cancer following endocrine therapy, 25 extensive specimens were removed from prostates during periods of local control, and were examined with respect to prognosis. Shortly after the commencement of the endocrine therapy, there were noticeable degenerative changes in the cancer cells as well as structural changes such as desquamation of cells and loss of cancer nests. Later than two months from the start of therapy, stromal changes such as fibrosis and scar formation appeared. Coagulation necrosis of tumor tissue, inflammatory cell infiltration and granulomatous reactions were not as prominent. Within the first two months of treatment, the endocrine therapy uniformly affected the cancer tissues to some extent. After then, some showed relapsing viable cells in a part of the tumor, being judged to be no response. The others continued to respond to the therapy. The response was estimated as marked when such therapeutic changes appeared diffusely and profoundly over the tissues removed. Patients with a marked response had a good prognosis, indicating histological evaluation after endocrine therapy to provide a prognostic factor.

Aged↗
PubMed1988

[Trends in patterns of care for prostatic cancer in Japan: statistics of 9 institutions for 5 years].

Five hundred and sixty-five patients with prostatic cancer, who first visited 9 institutions in Japan between 1981 and 1985, were analyzed. The peak of age distribution was in the seventies. As clinical symptoms, disturbance on micturition was the most frequent and pain caused by metastasis was a complaint in approximately one tenth of the cases. Alkaline phosphatase measurement, prostatic biopsy, intravenous pyelography, bone scintigraphy, cystourethrography, and measurements of serum prostatic acid phosphatase and serum acid phosphatase were performed on more than 80% of the patients. The clinical stage was stage A1 in 6.2%, A2 in 3.7%, B in 14.9%, C in 20.7%, D1 in 7.4%, and D2 in 43.7%. According to the histological grade, well, moderately and poorly differentiated adenocarcinoma were observed in 20.4, 33.3 and 32.7%, respectively. Increased ratio of high grade to low grade was noticed in the lower age group as well as in the advanced stage. In this series, endocrine therapy was still accepted in most of the patients. Almost all were treated with hormonal medication and half of them had undergone bilateral orchiectomy. Surgery, radiation, chemotherapy or multidisciplinary therapy were attempted judging from the clinical stage and histological grade. However, old age restricted the therapeutic modality. Actuarial survival rate at 5 years for stage A1, A2, B, C, D1 and D2 was 89.2, 66.1, 72.7, 51.0, 47.5 and 28.0%, respectively. In the patients with stage D2, the 5-year actuarial rate of poorly differentiated adenocarcinoma was lower than that of well or moderately differentiated adenocarcinoma, even though more intensive therapy was given to the former.

Adenocarcinoma↗
PubMed1988

[Lectin-binding sugar chain in bladder tumors].

We studied the lectin binding patterns of 40 initial superficial and 10 subsequent invasive bladder tumors by the avidin-biotin-peroxidase complex (ABC) method using the following biotin-labeled lectins: PNA, DBA, UEA-I, BS-I, ConA and WGA. We observed the relationship between lectin binding and subsequent course of initial superficial tumors, grade and stage (T). DBA or WGA staining tumors and Con A negative tumors revealed no recurrence or superficial recurrence. Low grade tumors were DBA or BS-I positive and high grade tumors were ConA positive. Low staging tumors possessed DBA or WGA positiveness and high staging tumors had ConA positiveness. From these results we considered that negative staining of WGA or DBA, or positive staining of ConA was a change accompanying the malignant potentiality.

Adult↗
PubMed1987

Phase III trial of the Japanese Urological Cancer Research Group for Adriamycin: cyclophosphamide, adriamycin and cisplatinum versus cyclophosphamide, adriamycin and 5-fluorouracil in patients with advanced transitional cell carcinoma of the urinary bladder.

A non-randomized clinical study on systemic combination chemotherapy was conducted by the Japanese Urological Cancer Research Group for Adriamycin to compare the effectiveness of CAP (cyclophosphamide 200-500 mg/m2, adriamycin 30-50 mg/m2 and cisplatin 30-50 mg/m2) and CAF (cyclophosphamide 200-500 mg/m2, adriamycin 30-50 mg/m2 and 5-fluorouracil 250 mg/m2) in 123 patients (104 evaluable) with advanced and/or metastatic cancer of the urinary bladder. Among 96 patients who were non-randomly selected to receive CAP, 4 achieved complete remission, 12 achieved partial remission, 7 achieved minor response, 30 had stable disease, and 43 had disease progression. The response in the 8 patients who received CAF were: partial remission in 1 and progressive disease in 7. The overall response rate to CAP therapy was 17%, as against 13% for CAF therapy. The median duration of survival with CAP was 29 weeks and with CAF, 22 weeks. The differences between the two groups in duration of survival and response rate were not statistically significant. Complete and/or partial remissions were observed in the lymph nodes, lung and liver in 32%, 24%, and 57% of cases, respectively. There was no objective response in bone metastasis. The main side effects of CAP were anorexia (88%), nausea and/or vomiting (81%), alopecia (65%), leukopenia (72%), anemia (48%), and renal dysfunction (17%). No patients died as a result of toxicity of these combination chemotherapy modalities.

Adult↗
PubMed1987

Prophylaxis of superficial bladder cancer with instillation of adriamycin or mitomycin C.

A multicenter trial for postoperative prophylaxis of superficial Ta-T1, G1-G2 bladder cancer was performed. Intravesical instillation using either 20-30 mg adriamycin or 20 mg mitomycin C per dose was carried out for 4 weeks or 2 years. Patients without instillation served as controls. A total of 259 patients was considered eligible for the evaluation. The instillation group showed a better disease free survival rate than the control group. Better prophylactic effects of instillation therapy were observed when one of following factors was present: multiple tumors, large tumors, T1 and G2 bladder cancer. The total dose of drug instilled seemed to correlate with the effects, but there were no differences between adriamycin and mitomycin C. The side effects were minimal and temporary.

Administration, Intravesical↗