PubMed Health⌕ Search

Biomedical subjects

Tetsuo Momma

Publications and source records attributed to Tetsuo Momma.

9 recordsLinked to original sources
PubMed2006

Predictive factors of acute urinary retention requiring catheterization following 125I prostate brachytherapy.

OBJECTIVE: To analyze predictive factors of acute urinary retention requiring catheterization after (125)I prostate brachytherapy. METHODS: A group of 227 consecutive patients with localized prostate cancer were treated with (125)I prostate brachytherapy between September 2003 and December 2004. The clinical, treatment-related and dosimetric factors were evaluated for the need for catheterization owing to urinary retention. RESULTS: Twelve patients (5.3%) required catheterization. The median time to onset was 2 days after implantation (range 1-7 days). Univariate analysis demonstrated that pre-implant ultrasound prostate volume, number of seeds, number of needles and neoadjuvant hormonal manipulation were predictive for catheterization. In multivariate analysis, the number of needles and neoadjuvant hormonal manipulation were significant independent predictive factors for catheterization (P = 0.002 and 0.025, respectively). The risk of catheterization in the cluster in which the number of needles was >24 was 4.07 times as high as that in the cluster in which the number of needles was < or =24 [11.3% versus 3.0%, P = 0.020; 95% confidence interval (CI) 1.24-13.36], and the risk in the hormonally manipulated patients was 7.05 times as high as that in the hormone-naïve patients (7.7% versus 1.2%, P = 0.034; 95% CI 0.89-55.64). CONCLUSION: Our data suggest that the number of needles and hormonal manipulation might be the strongest predictors for catheterization.

Aged↗
PubMed2006

Serial changes of international prostate symptom score following I-125 prostate brachytherapy.

BACKGROUND: This study was conducted to assess serial changes in the International Prostate Symptom Score (IPSS) within the first 12 months after iodine-125 (I-125) prostate brachytherapy. METHODS: Between September 2003 and June 2004, a group of 103 patients with localized prostate cancer was treated with I-125 prostate brachytherapy, either alone (monotherapy; 60 patients) or in combination with external-beam radiotherapy (combined therapy; 43 patients). The IPSS was obtained at preimplant, and at 1, 6, and 12 months after treatment. The minimum IPSS follow-up for this study was 12 months. Dosimetry was based on computed tomography (CT) scan 1 month postimplant. Clinical, treatment-related, and dosimetric factors were assessed for correlations with the maximum IPSS increase (the peak IPSS minus the preimplant IPSS). RESULTS: The median preimplant IPSS was 7.0, with a median peak of 16 at 1 month. The IPSS returned to baseline in 42 patients (40.8%) and it returned to within 3 points of the baseline in 64 (62.1%) at 1-year follow-up. On univariate and multivariate analyses, the maximum IPSS increase was best predicted by lower preimplant IPSS, in both the monotherapy and combined therapy groups. CONCLUSION: In our series, IPSS after prostate brachytherapy peaked at 1 month and gradually returned to approximately baseline at 12 months.

Aged↗
PubMed2006

Three-year results of treatment for prostate cancer with low-dose rate temporary iridium-192 brachytherapy.

AIM: To report the 3-year treatment results of definitive irradiation by using a temporary interstitial implant with low-dose rate iridium-192 with or without external beam radiotherapy in the treatment of localized prostate cancer. METHODS: One-hundred and forty-three patients with pathologically defined prostate carcinoma were treated from December 1997 to April 2003. The patients were classified into a low-risk group (T2, PSA 20 ng/mL or Gleason score>or=7). Low-risk patients were treated with low-dose-rate iridium brachytherapy as monotherapy delivering 70 Gy. High-risk patients were treated with the combination of brachytherapy and external beam radiotherapy delivering 40 Gy and 36 Gy, respectively. Kaplan-Meier estimates of prostate-specific antigen (PSA) progression-free survival rate were analysed. To assess the treatment quality in different periods, PSA progression-free survival rates in late era (year of 2000 and after) and in early era (before 2000) were compared. Morbidity was graded according to the Radiation Therapy Oncology Group grading scale. RESULTS: One hundred and nineteen patients were analysed, of which 86 patients underwent monotherapy with an iridium implant, and 33 were treated with the combination of external beam radiotherapy. Twenty-four patients were excluded from the analysis because the classification of risk group did not suit the criteria. The total (n=119) PSA progression-free survival rate at 3 years was 80.3%. The PSA progression-free survival rate at 3 years for the monotherapy group (n=86) and the combination therapy group (n=33) were 78.2% and 86.9%, respectively. There were 23 patients who were followed for more than 36 to 63 months, and, during this period, only 1 patient who received the monotherapy was diagnosed as PSA failure at 50 months. The 3-year PSA progression-free survival rate of monotherapy in late era was significantly higher than that in early era; however, no significant difference was seen in the combination treatment. Morbidity for the combination treatment was low; however, for the monotherapy, three patients developed severe rectal ulcers, and colostomies were made. CONCLUSIONS: The PSA progression-free survival rate after low-dose rate iridium-192 brachytherapy with or without external beam radiotherapy can be satisfactory and longer follow up is necessary to compare the efficacy of other treatments.

Adenocarcinoma↗
PubMed2006

[Brachytherapy for prostate cancer].

This review article aims to overview modern prostate brachytherapy in Japan. Permanent transperineal prostate brachytherapy with I-125 started in September, 2003 in Japan. Brachytherapy has several advantages: the dose is adapted precisely to the tumor shape and size, and the long-lived isotope gives a higher tumor dose with less damage to normal tissue; less-time consuming for patients and staff: long-term results comparable to surgery or external beam series in the USA; and quality of life after brachytherapy also appealing. These advantages have brought about increasing use in Japan as well. Patients with a high probability of organ-confined disease and a low-risk group are appropriately treated with brachytherapy. Brachytherapy candidates with a significant risk of extraprostatic extension should be treated with supplemental external beam radiation therapy. High-dose-rate (HDR) brachytherapy with Ir-192 has preceded seed implants in Japan. HDR has some theoretical advantages. Long-term results of brachytherapy in the USA are comparable with surgery or external beam irradiation so far. We should develop more sophisticated brachytherapy techniques in Japan.

Brachytherapy↗
PubMed2005

Acute urinary morbidity following I-125 prostate brachytherapy.

BACKGROUND: In Japan, iodine-125 (I-125) prostate brachytherapy has been legally approved since July 2003, and this method is becoming more popular. The purpose of the present study was to assess acute urinary morbidity within the first 6 months after I-125 prostate brachytherapy. METHODS: A group of 130 consecutive patients with localized prostate cancer was treated with I-125 prostate brachytherapy between September 2003 and June 2004,either alone (monotherapy; 66 patients) or in combination with external-beam radiotherapy (combined therapy; 64 patients). Urinary morbidity was evaluated using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. RESULTS: During the follow-up, 111 patients (85.4%) developed some degree of urinary symptoms such as frequency, retention, dysuria, incontinence, or hematuria. Urinary frequency (73.1%) and retention (66.9%) were the most common, and showed no significant differences between the monotherapy group and combined therapy group (P = 0.352 and P = 0.630, respectively). Six patients (4.6%) required catheterization for urinary obstruction; the median time to onset was 1.5 days (range, 1-192 days). Five of these 6 patients received monotherapy and the other received combined therapy. CONCLUSION: Manifestations of acute urinary morbidity, especially frequency and retention, are relatively common but acceptable events after I-125 prostate brachytherapy.

Aged↗
PubMed2004

Metanephric adenoma treated with laparoscopic nephrectomy.

A 31-year-old-female presented with a left renal mass detected incidentally during an abdominal ultrasound examination. Computed tomography and angiography revealed a hypovascular solid tumor 4.5 cm in diameter at the middle portion of the left kidney. Laparoscopic left nephrectomy was performed and macroscopic examination of the specimen revealed encapsulated tumor with grayish yellow cut surface. Histological examination demonstrated that the tumor cells were small scant cytoplasms, containing round and regular nuclei, forming a glomerular-like structure. There was no mitosis nor cellular atypia indicating a malignant structure. The histological diagnosis was metanephric adenoma.

Adenoma↗
PubMed2003

[Neuroendocrine differentiation in adenocarcinoma of the prostate with progression of disease during hormonal treatment: a report of two cases].

Prostatic neuroendocrine (NE) carcinoma is a rare situation and the NE differentiation in the prostate adenocarcinoma appears to be characterized as poor prognosis, rapid tumor progression and the androgen-independent state, for which there is currently no successful therapy. We report two cases of NE differentiated prostatic carcinoma, which were diagnosed adenocarcinoma initially and the tumors progressed universally with NE differentiation during androgen suppression therapy.

Adenocarcinoma↗
PubMed2003

[A case of synchronous triple primary carcinomas of the kidney, bladder and prostate].

A case of synchronous triple carcinomas arising in the kidney, bladder and prostate is reported. An 82-year-old man had gross hematuria. Urine cytology was positive and intravenous pyelography showed right hydronephrosis with a filling defect in the bladder. Computed tomography revealed a 4 cm mass in the bladder, enlarged prostate and 6 cm renal mass at the left kidney. Cystoscopy demonstrated a papillary broadbased tumor with some small satellite tumors in the bladder, and magnetic resonance imaging revealed muscle invasion of the bladder tumor. This patient underwent left radical nephrectomy and total cystoprostatectomy with ileal conduit urinary diversion as radical treatment. Histological diagnosis was renal cell carcinoma, transitional cell carcinoma of the bladder. Furthermore, well-differentiated adenocarcinoma was found incidentally in the prostate. Immunohistochemical staining with anti-p53 antibody for the three tumors showed positive staining only for the bladder cancer.

Adenocarcinoma↗