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Toshihiro Saito

Publications and source records attributed to Toshihiro Saito.

17 recordsLinked to original sources
PubMed2006

Total and free prostate-specific antigen indexes in prostate cancer screening: value and limitation for Japanese populations.

AIM: To assess the efficacy and limitation of free/total prostate-specific antigen ratio (f/tPSA) at a single institution in Japan, focusing on the avoidance of pointless prostate biopsies. METHODS: In total, 631 men between 44 and 93 years old (mean 69.8 years) with elevated PSA underwent power-Doppler ultrasoundgraphy-guided transrectal 10-core prostate biopsies at Niigata Cancer Center Hospital, and their histological features were investigated with total PSA (tPSA) and f/tPSA. RESULTS: PCa was detected in 126 of 134 patients (94.3%) with tPSA of 26 ng/mL or higher. The detection rate was 59.4% for tPSA of 21-25 ng/mL, followed by 39.2% for 16-20 ng/mL, 30.0% for 11-15 ng/mL, 20.0% for 4.1-10 ng/mL and 7.6% for = or <4.0 ng/mL. f/tPSA of the PCa group was significantly lower than that of non-malignamt disorders in any tPSA ranges (mean 0.122 vs. 0.160, P<0.001). Receiver-operating characteristics analyses showed that f/tPSA (AUC:0.664) performed more valuably than tPSA (AUC:0.559) in patients with tPSA between 3.0-10 ng/mL (P<0.01). Although f/tPSA of 0.250 for the cut-off value might miss 1.8% PCa patients, it potentially spares 9.2% of unnecessary biopsies. CONCLUSION: f/tPSA is more valuable compared with tPSA alone for the prediction of the occurrence of PCa. We recommend 0.250 as the cut-off value for f/tPSA in PCa screening for Asian men having so-called grey-zone tPSA.

Adult↗
PubMed2006

Outcomes of locally advanced prostate cancer: a single institution study of 209 patients in Japan.

AIM: To investigate the outcomes for Asian populations with locally advanced/clinical stage III prostate cancer (PCa) treated with currently prevailing modalities. METHODS: We reviewed the record of 209 patients with clinical stage III PCa, who were treated at Niigata Cancer Center Hospital between 1992 and 2003. Treatment options included hormone therapy-combined radical prostatectomy (RP+HT), hormone therapy-combined external beam irradiation (EBRT+HT) and primary hormone therapy (PHT). RESULTS: The 5- and 10-year overall survival rates were 80.3% and 46.1% in all cohorts, respectively. The survival rates were 87.3% and 66.5% in the RP+HT group, 94.9% and 70.0% in the EBRT+HT group and 66.1% and 17.2% in the PHT group, respectively. A significant survival advantage was found in the EBRT+HT group compared with that in the PHT group (P < 0.0001). Also, the RP+HT group had better survival than the PHT group (P = 0.0107). The 5- and 10-year disease-specific survival rates for all cases were 92.5% and 80.0%, respectively. They were 93.8% and 71.4% in the RP+HT group, 96.6% and 93.6% in the EBRT+HT group and 88.6% and 62.3% in the PHT group, respectively. A survival advantage was found in the EBRT+HT group compared with the PHT group (P = 0.029). No significant difference was found in disease-specific survival between the EBRT+HT and RP+HT groups or between the RP+HT and PHT groups. CONCLUSION: Although our findings indicate that radiotherapy plus HT has a survival advantage in this stage of PCa, we recommend therapies that take into account the patients'social and medical conditions for Asian men with clinical stage III PCa.

Aged↗
PubMed2006

[Clinical analysis of 1,000 patients with prostate cancer].

OBJECTIVES: Treatment outcomes for prostate cancer in our hospital were reported. MATERIALS AND METHODS: We analyzed 1,009 patients with prostate cancer treated at Niigata Cancer Hospital between 1983 and 2003. RESULTS: As for the clinical stage, 20 cases belonged to Stage I, 367 cases to Stage II, 269 cases to Stage III and 353 cases to Stage IV. The overall 5-year survival rate of the all 1,009 cases was 59.0%, comprising 78.2% for stage I, 82.0% for Stage II, 76.0% for Stage III and 30.0% for Stage IV cases. Disease-specific 5-year survival rates for Stage I, II, III and IV were 100%, 96.8%, 89.3% and 41.1% respectively. In Stage III patients, the radiotherapy (with endocrine therapy) group showed longer cause-specific survival than the endocrine therapy group (p = 0.0056). CONCLUSIONS: Our result suggest that the radiotherapy with endocrine therapy is useful for Stage III prostate cancer.

Aged↗
PubMed2006

[Prognosis of prostate cancer with elevated prostatic acid phosphatase].

To evaluate the significance of prostatic acid phosphatase (PAP), we analyzed 1,029 prostate cancer patients who were treated at the Niigata Cancer Center. We classified clinically localized prostate cancer with elevated PAP as stage DO. When stage DO was not taken into acount, the 5-year cause-specific survival rate for stage A, B, C and D was 94.7, 97.9, 87.7 and 42.4%, respectively. Taking stage DO into account, the cause-specific survival curve for stage DO patients was similar to those for stage B,C patients. The 5-year cause-specific survival rate for stage DO was 92.2% considering above 3 ng/ml as elevated PAP. A significant correlation was found between PAP and cause-specific survival for all cases but no correlation was found for non-metastatic disease patients. The significance of PAP in the staging of prostate cancer is limited.

Acid Phosphatase↗
PubMed2006

[Significance of re-measurement of prostate specific antigen before prostate biopsy].

To examine the natural change of prostate-specific antigen (PSA), we compared two PSA values, the first value with which we decided to perform prostate biopsy and the value obtained by remeasurement just before biopsy. To exclude cases with extremely high PSA, we examined 288 cases in which PSA was less than 50 ng/ml for comparison. Of the 288 cases, 93 were diagnosed with prostate cancer (CaP). The interval between the two PSA measurements was 1-90 days (average of 31.4 days). The first and second values were an average of 13.0 and 11.7 ng/ml, respectively, and the second value was significantly lower than the first value. When we divided them into CaP cases and non-CaPthe two cases, a significant difference between PSA values was found only in the non-CaP cases. Moreover, in the non-CaP cases with some clinical symptoms, the difference in PSA was marked between the first and second values, which averaged 11.2 and 9.2 ng/ml, respectively. When we decide to perform a biopsy, we should recognize that PSA sometimes is lower on re-measurement. Particularly in symptomatic cases, it is worth re-measuring PSA, which may save unnecessary biopsies.

Biopsy↗
PubMed2005

[Chemo-endocrine therapy for newly diagnosed stage D2 prostate cancer].

We evaluated 175 patients with newly diagnosed stage D2 prostate cancer who had been treated in our hospital between 1992 and 2003 to compare chemo-endocrine therapy with endocrine therapy alone. One hundred and thirty seven patients were treated with endocrine therapy alone. The other 38 patients received chemo-endocrine therapy, which included medical or surgical castration with/without antiandrogen plus VIP (Vincristine, Ifosfamide, Peplomycin) regimen or other cytotoxic agents. The patients treated with chemo-endocrine therapy had a significantly better prognosis than the patients treated with endocrine therapy alone (p<0.05), although treatment was not randomized. The cause-specific survival rates at 5 years for the chemo-endocrine therapy group and the endocrine therapy group were 61.6% and 34.8%, respectively. These data suggest that chemo-endocrine therapy is a potentially effective treatment for newly diagnosed stage D2 prostate cancer.

Aged↗
PubMed2003

Treatment strategy of limited surgery in the treatment guidelines for gastric cancer in Japan.

Surgical practice for gastric cancer in Japan is based on the Gastric Cancer Treatment Guidelines issued in 2001 by the Japanese Gastric Cancer Association. These recommendations list options for treatment of each stage of cancer, with clear distinctions between interventions recommended for routine use and those that should be confined to trial settings until further evidence for their curative potential becomes available. In this review, we discuss standard surgery, local resection, segmental resection, and pylorus-preserving gastrectomy (PPG) as examples of limited resection and describe in detail the indications for limited lymph-node dissection in cases of early-stage gastric cancer. At present, evidence does not support the conclusion that limited surgery is effective for local resection or for improving quality of life. Thus, use of limited surgery should be considered an experimental approach both in Japan and the West. We conclude that surgeons who are familiar with the criteria for selecting surgical procedures should decide on a case-by-case basis which technique is most appropriate. Choices should be made with consideration of the stage of the cancer, invasiveness of the surgical procedure, and the patient's history. For all procedures, the patient must give informed consent and the surgeons must accurately assess the success of the operation after surgery.

Gastrectomy↗
PubMed2003

[Intermittent oral hormonal chemotherapy using estramustine phosphate and etoposide for the treatment of hormone-refractory prostate cancer].

Seventeen patients were given lower dose and intermittent oral administration of estramustine phosphate (6 mg/kg/day) and etoposide (30 mg/m2/day) for 7 days. Then administration was discontinued for 7 days. This administration cycle was repeated. Therapy was continued until evidence of disease progression or unacceptable toxicity occurred. Fifteen of the 17 patients were finally evaluated for PSA response. Overall, the pretreatment PSA levels were lowered at least 50% from baseline in 7 (47%) of the 15 patients. The median survival was 65 weeks. Five of the 17 patients complained of anorexia or nausea during the treatment, but none of them showed over grade 2 anorexia, none requiring transfusion or hospitalization. None of the patients showed edema, deep venous thrombosis, thrombocytopenia, anemia or myocardial infarction. Because of its rare and mild adverse effects, this intermittent administration of oral estramustine and oral etoposide may be a useful and secure regimen for hormone refractory prostate cancer.

Administration, Oral↗
PubMed2002

Peroxisome proliferator-activated receptor gamma plays a critical role in inhibition of cardiac hypertrophy in vitro and in vivo.

BACKGROUND: Peroxisome proliferator-activated receptors (PPARs) are transcription factors of the nuclear receptor superfamily. It has been reported that the thiazolidinediones, which are antidiabetic agents and high-affinity ligands for PPARgamma, regulate growth of vascular cells. In the present study, we examined the role of PPARgamma in angiotensin II (Ang II)-induced hypertrophy of neonatal rat cardiac myocytes and in pressure overload-induced cardiac hypertrophy of mice. METHODS AND RESULTS: Treatment of cultured cardiac myocytes with PPARgamma ligands such as troglitazone, pioglitazone, and rosiglitazone inhibited Ang II-induced upregulation of skeletal alpha-actin and atrial natriuretic peptide genes and an increase in cell surface area. Treatment of mice with a PPARgamma ligand, pioglitazone, inhibited pressure overload-induced increases in the heart weight-to-body weight ratio, wall thickness, and myocyte diameter in wild-type mice and an increase in the heart weight-to-body weight ratio in heterozygous PPARgamma-deficient mice. In contrast, pressure overload-induced increases in the heart weight-to-body weight ratio and wall thickness were more prominent in heterozygous PPARgamma-deficient mice than in wild-type mice. CONCLUSIONS: These results suggest that the PPARgamma-dependent pathway is critically involved in the inhibition of cardiac hypertrophy.

Actins↗
PubMed2002

Antibody binding to fas ligand attenuates inflammatory cell infiltration and cytokine secretion, leading to reduction of myocardial infarct areas and reperfusion injury.

Fas ligand (FasL) induces apoptotic cell death when bound to Fas antigen. The engagement of FasL has anti-inflammatory effects through the prevention of cell proliferation and cytokine secretion. However, the role of FasL in myocardial ischemia/reperfusion (MI/R) injury is unclear. We examined the expression of FasL mRNA in the myocardium of MI/R rats by ligating the left coronary artery for 30 minutes and allowing reperfusion to occur for 0, 1, 3, and 24 hours. The expression of FasL mRNA was enhanced 1 hour after reperfusion, and enhanced levels were consistently seen after 24 hours of reperfusion. FasL immunostaining was observed on neutrophils, macrophages, T cells, and vascular endothelial cells. We then assessed the potential role of FasL in the cell proliferation and cytokine production seen in MI/R injury after 24 hours of reperfusion. Rats were divided into three groups; Group A, without treatment; Group B, treated with nonspecific rabbit IgG; and Group C, treated with anti-FasL antibody. Anti-FasL antibody or rabbit IgG were administered intravenously before coronary artery occlusion. In Group C, interleukin-1beta and interleukin-2 mRNA levels were decreased, and neutrophil and T cell accumulation was attenuated. The infarct area determined by triphenyltetrazolium chloride staining was significantly smaller in Group C (18 +/- 4%) than in Group A (34 +/- 2%) or Group B (33 +/- 4%) (p< 0.0001). However, there was no significant difference in the prevalence of terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end-labeling-positive cardiomyocytes among the three groups. These findings suggest that the cardioprotective effect of anti-FasL antibody is due to its anti-inflammatory action, rather than antiapoptotic action. The Fas/FasL system may be involved in the development of MI/R injury.

Animals↗
PubMed2002

Subsequent activation of mitogen-activated protein kinase after adhesion of transitional cell cancer cells to fibronectin.

INTRODUCTION: In the process of tumor invasion and metastasis, interactions between tumor cells and extracellular matrix play a crucial role. Recently, it was shown that fibronectin binding to fibronectin receptor promotes mitogen-activated protein kinase (MAPK) activation after tyrosine phosphorylation of focal adhesion kinase (FAK). We investigated these signal transduction events in transitional cell cancer (TCC) cells. MATERIALS AND METHODS: (1) The adhesion of T24 cells, a fibronectin-receptor-positive TCC cell line, to fibronectin was investigated; (2) the MAPK activation after fibronectin stimulation in bladder cancer cell lines was examined by Western blotting using an antiactive MAPK antibody, and (3) FAK, Sos, and Grb-2 were also examined by Western blot analysis. RESULTS AND CONCLUSIONS: T24 cells adhered to fibronectin-coated dishes more quickly than to the noncoated dishes. Fibronectin stimulation induced activation of MAPK in T24, SCaBER, and HT1376 cells. However, activated MAPK was not detected in RT4 cells which do not express alpha(5)beta(1) integrin (major fibronectin receptor) after fibronectin stimulation. T24, SCaBER, and HT1376 expressed FAK and Sos. RT4 showed little FAK and Sos expression. Grb-2 was expressed in all cell lines. Adhesion of fibronectin-receptor-positive TCC cells to fibronectin activates the MAPK cascade, possibly resulting in activation of tumor cells.

Carcinoma, Transitional Cell↗
PubMed2002

Clinicopathological study for gastric cancer with liver metastasis.

Clinicopathological characteristics, stromal volume (Vvf), nuclear DNA content and cell protein were retrospectively analyzed in order to scrutinize the risk factors of hepatic metastasis from carcinoma of the stomach. We conducted a clinicopathological study of 327 patients with gastric cancer, including 34 patients with liver metastasis (synchronous, 22; metachronous, 12) and 294 patients without liver metastasis. Univariate analysis revealed significant inter-group differences in tumor size (p<0.001), depth of invasion (p<0.001), lymph node metastasis (p<0.001), vascular involvement (p<0.001), lymphatic involvement (p<0.001), peritoneal dissemination (p<0.05), Vvf (p<0.01) and DNA content (p<0.01). Vvf and DNA content were estimated in the liver metastasis group (n=20) and in the group of patients with stage III-IVa carcinoma but without liver metastasis (n=11). In multivariate analysis, only Vvf and DNA content showed significant correlations with liver metastasis (p<0.01). A comparison of Vvf and expression of the amount of interstitial connective tissue showed that there as a significant correlation between them. Our results indicate that gastric cancer with low Vvf and high DNA content carries a high risk of hepatic metastasis. Therefore, mean DNA content and Vvf are useful indices for predicting liver metastasis from gastric carcinoma.

Aged↗
PubMed2002

Early and late recurrences after gastrectomy for gastric cancer: a multiple logistic regression analysis.

PURPOSE: Although many studies have focused on clinical risk factors for prognosis of patients with surgically treated gastric cancer, little information is available regarding the timing of recurrent malignant disease. The purpose of this study was to determine the factors that are predictive of early and late recurrences after gastrectomy. PATIENTS AND METHODS: We reviewed the hospital records of patients with hisotological proof of gastric cancer who were admitted to Sendai National Hospital during the period from 1985 to 1995. A total of 923 records were examined, and 251 patients with recurrent disease were identified. The patients were divided into an "early recurrence group" consisting of 195 patients (died within one year after surgery) and a "late recurrence group" of 56 patients (died two years or more after surgery). Clinicopathological characteristics were examined, and independent risk factors influencing the timing of recurrence were determined by a multiple logistic regression analysis. RESULTS: The mean tumor size of early recurrence cases was larger than that of late recurrence cases (p=0.0294). Tumors penetrating the serosa with direct invasion to continuous structures were found more frequently in the early recurrence group than in the late recurrence group. The patients with early recurrence showed a higher tendency to have nodal involvement, lymphatic invasion and vascular invasion. The relative risks of early and late recurrences associated with different variables were estimated by a multiple logistic regression method. The following variables were found to be significant risk factors for early recurrence: male gender (p=0.0382), lymph node metastasis (p=0.0016), and vascular invasion (p=0.0006). CONCLUSION: Male patients who have node-positive gastric cancer with vascular invasion have a high risk of early recurrence.

Female↗
PubMed2002

[Carcinoma in situ of the urinary tract--in patients with positive cytologies of upper urinary tract samples].

PURPOSE: The present two-tiered study demonstrates first, the value of upper urinary tract sampling in cytological diagnoses, and multiple cold punch biopsies of bladder, in the cases of carcinoma in situ (CIS) of the urinary tract. The second segment assesses the value of Double-J catheter-based BCG treatment, in the case of positive upper urinary-tract sampling. MATERIALS AND METHODS: We tested a total thirty three patients (26 man, 7 woman, median age: 67.8 years) who demonstrated two serial positive voiding cytologies. Cystoscopic investigations of bladder tumors, as well as radiologic studies of the upper urinary tract both yielded negative findings. Cytological samples obtained from upper urinary tract of all 33 individuals were next to subjected to multiple cold punch biopsies of bladder. RESULTS: Among the seven patients whose bladders displayed no abnormalities, cytological tests of the upper urinary tract samples determined that 2 of subjects fell into class III, while the other five were diagnosed class V. In 7 other cases diagnosed as suffering from dysplasia of bladder, cytological findings for two upper urinary tract were class I and II, while one case was class III, and 4 others fell within class V. Of the 19 patients suffering from bladder CIS, eight were diagnosed class I or II, three cases as class III and eight other cases, class V, in upper urinary tract cytologies. At the original site of the urinary CIS, the bladder was affected in 11 cases, the upper urinary tract in 9 patients, and a combined attack on the bladder and upper urinary tract, in 8 others. Of seventeen patients whose upper urinary tract samples produced positive reading, thirteen had had double-J catheter run from bladders to renal pelves as well as treatment consisting of the intravesical instillation of BCG. From thorough cytological evaluations, we learned that the urine of eleven of these 13 individuals, which initially tested positive, had turned negative following intravesical instillation of BCG. Although bladder vesicles proved susceptible to certain minor irritations and slight fevers were not uncommon on treatment-days, such side effects disappeared, once BCG treatment ended. CONCLUSIONS: From painstaking observations, it was concluded that cytological investigations of the upper urinary tract were indispensable to the proper diagnosis of urinary tract CIS, and that intravesical BCG treatment with Double-J catheter is both safe and effective when treating the patients suffering from upper urinary tract CIS.

Aged↗
PubMedDate not supplied

Is tumor size a prognostic indicator for gastric carcinoma?

BACKGROUND: Retrospective studies using multivariate analysis of clinical and pathological features in gastric cancer have identified a number of high-risk, independent prognostic factors. In these clinical features, tumor size can be measured easily before or during the operation without the requirement of any special equipment, but its prognostic value in patients with gastric cancer is unclear. The aim of this study was to review the experience at our institution of gastric adenocarcinoma to determine the influence of tumor size on outcome. PATIENTS AND METHODS: Between January 1985 and December 1995, 697 patients with gastric adenocarcinoma underwent resection of the stomach at the Department of Surgery, Sendai National Hospital, Japan. Data on age, gender, tumor location, structure and size, evidence of local invasion, and type of operation performed for each patient were obtained. The sizes of tumors were derived from measurements made in fresh resected specimens. The patients were divided into three groups: 102 patients with tumors of less than 2 cm in diameter, 392 patients with tumors of 2-7 cm in diameter, and 203 patients with tumors of more than 7 cm in diameter. RESULTS: In these three groups, there were statistical differences in tumor location, macroscopic type, depth of invasion, lymph node metastasis, histological type, lymphatic invasion, vascular invasion and cancer-stromal relationship. Patients with larger tumors had more invasion into the gastric wall in terms of depth of invasion and more frequent lymph node metastasis than did patients with smaller tumors. Histologically, diffuse, scirrhous-type was more common in the larger tumor group. The frequency of lymphatic and vascular permeation in the larger tumor group was higher than that in the other groups. The 5-year survival rates according to tumor size were 94.3% in cases of tumors of less than 2 cm, 75.1% in cases of tumors of 2-7 cm, and 26.3% in cases of tumors of more than 7 cm. Multivariate analysis revealed that the prognosis of gastric cancer patients was affected most by depth of invasion, followed by lymph node metastasis and tumor location. Tumor size is not an independent prognostic factor. CONCLUSION: In conclusion, according to the results of univariate analysis, tumor size is clinically a predictor of survival of patients with gastric cancer. In multivariate analysis, however, it is not an independent factor, and the presence of lymph node metastasis, depth of invasion and tumor location are more important than tumor size.

Adenocarcinoma↗