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  • 1
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    Geriatric 8 screening of frailty in patients with prostate cancer
    Wiley ; 2020
    In:  International Journal of Urology Vol. 27, No. 8 ( 2020-08), p. 642-648
    Details
    In: International Journal of Urology, Wiley, Vol. 27, No. 8 ( 2020-08), p. 642-648
    Abstract: To evaluate the association between the score of the Geriatric 8 screening tool and treatment by disease stages in patients with prostate cancer. Methods Between January 2017 and June 2019, we prospectively evaluated the Geriatric 8 in 540 prostate cancer patients who were treated with robot‐assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and standard of care for metastatic hormone‐naïve prostate cancer or castration‐resistant prostate cancer. The primary purpose was the association between frailty (Geriatric 8 ≤14) and robot‐assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone, and metastatic diseases. Secondary purposes included a comparison of the Geriatric 8 scores among the disease status and the influence of Geriatric 8 score on overall survival. Results The median age was 75 years. Geriatric 8 scores ≤14 were seen in 36% of robot‐assisted radical prostatectomy ( n  = 78/214), 57% of radiotherapy ( n  = 119/209), 91% of androgen deprivation therapy alone ( n  = 19/21) and 70% of metastatic diseases ( n  = 67/96). The median Geriatric 8 score in patients treated with robot‐assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and metastatic diseases was 15.0, 14.0, 12.0 and 12.8, respectively. The median Geriatric 8 score was significantly higher in the metastatic disease than that in localized disease (14.5 vs 12.8, respectively). Robot‐assisted radical prostatectomy patients had a significantly higher Geriatric 8 score than radiotherapy patients, with the cut‐off value of 〈 14.5. The overall survival was significantly different between Geriatric 8 scores ≤13 and 〉 13 in metastatic hormone‐naïve prostate cancer patients, and between Geriatric 8 scores ≤12 and 〉 12 in castration‐resistant prostate cancer patients. Conclusion The Geriatric 8 score is significantly associated with treatment by disease stages in patients with prostate cancer.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.v27.8
    DOI: 10.1111/iju.14256
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2009793-1
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  • 2
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    C‐reactive protein/albumin ratio is a predictive factor for prognosis in patients with metastatic renal cell carcinoma
    Wiley ; 2019
    In:  International Journal of Urology Vol. 26, No. 10 ( 2019-10), p. 992-998
    Details
    In: International Journal of Urology, Wiley, Vol. 26, No. 10 ( 2019-10), p. 992-998
    Abstract: To evaluate the effect of pretreatment C‐reactive protein/albumin ratio and modified Glasgow prognostic score on the prognosis in patients with metastatic renal cell carcinoma. Methods A retrospective study was carried out in 176 patients with metastatic renal cell carcinoma who received first‐line tyrosine kinase inhibitors. The effect of adding inflammatory prognostic scores to the International Metastatic Renal Cell Carcinoma Database Consortium model (International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio and International Metastatic Renal Cell Carcinoma Database Consortium‐Glasgow prognostic score models) on overall survival was evaluated using receiver operating characteristic curves. The prognostic value of inflammatory prognostic scores (C‐reactive protein/albumin ratio‐modified Glasgow prognostic score) was tested using the Kaplan–Meier method and Cox proportional regression models. Results Patients were stratified into two groups using the cut‐off value of 0.05: C‐reactive protein/albumin ratio‐low ( 〈 0.05) and C‐reactive protein/albumin ratio‐high (≥0.05). The area under the curve was significantly higher in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio model (0.720) than that of the International Metastatic Renal Cell Carcinoma Database Consortium model (0.689) and the International Metastatic Renal Cell Carcinoma Database Consortium‐modified Glasgow prognostic score model (0.703). Significant differences were observed in overall survival stratified by the number of risk factors in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio risk model between one or two and three or four factors ( P  〈   0.001), and three or four and five or more factors ( P  =   0.001). For the patients in the International Metastatic Renal Cell Carcinoma Database Consortium intermediate‐risk group, overall survival was significantly different between the C‐reactive protein/albumin ratio‐low and ‐high groups ( P  =   0.001), whereas it was not significantly different between the patients with one and two International Metastatic Renal Cell Carcinoma Database Consortium risk factors ( P  =   0.106). Conclusion The C‐reactive protein/albumin ratio is a simple and independent predictor of overall survival in patients with metastatic renal cell carcinoma. The predictive activity was significantly improved in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio model compared with the International Metastatic Renal Cell Carcinoma Database Consortium/International Metastatic Renal Cell Carcinoma Database Consortium‐modified Glasgow prognostic score models.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.v26.10
    DOI: 10.1111/iju.14078
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 3
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    Frailty is significantly associated with the type of urinary diversion in patients with muscle‐invasive bladder cancer
    Wiley ; 2020
    In:  International Journal of Urology Vol. 27, No. 8 ( 2020-08), p. 649-654
    Details
    In: International Journal of Urology, Wiley, Vol. 27, No. 8 ( 2020-08), p. 649-654
    Abstract: To investigate the effect of frailty on the type of urinary diversion after radical cystectomy in patients with muscle‐invasive bladder cancer. Methods Between January 2014 and January 2020, we prospectively evaluated frailty in 88 patients with localized muscle‐invasive bladder cancer, who had received radical cystectomy and urinary diversion. The selection of the type of urinary diversion was determined by the operating surgeon based on performance status, comorbidities, tumor status and the patient’s preference. The frailty evaluation included the Fried phenotype criteria, the modified frailty index and the frailty discriminant score. We investigated the association between frailty and type of urinary diversion, the effect of frailty on postoperative complications and the effect of frailty on overall survival. Results The median age of the selected participants was 68 years. The number of patients with an orthotopic neobladder and any postoperative complications was 54 (61%) and 46 (52%), respectively. Of the frailty assessment tools that were used, Fried phenotype criteria and frailty discriminant score were significantly associated with the selection of non‐orthotopic neobladder urinary diversion. Occurrences of postoperative complications in participants were significantly associated with modified frailty index, but not with Fried phenotype criteria and frailty discriminant score. Multivariate Cox regression analysis showed that a higher frailty discriminant score was significantly associated with poor overall survival, whereas higher Fried phenotype criteria and modified frailty index were not. Conclusion Frailty is significantly associated with the type of urinary diversion, and it should be considered for the selection of urinary diversion in muscle‐invasive bladder cancer patients undergoing radical cystectomy.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.v27.8
    DOI: 10.1111/iju.14263
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 4
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    Trends in the use of neoadjuvant chemotherapy and oncological outcomes for high‐risk upper tract urothelial carcinoma: a multicentre retrospective study
    Wiley ; 2021
    In:  BJU International Vol. 128, No. 4 ( 2021-10), p. 468-476
    Details
    In: BJU International, Wiley, Vol. 128, No. 4 ( 2021-10), p. 468-476
    Abstract: To evaluate temporal trends in neoadjuvant chemotherapy (NAC) utilisation and outcomes in patients with locally advanced upper tract urothelial carcinoma (UTUC). Patients and Methods We included 289 patients from seven hospitals who underwent radical nephroureterectomy (RNU) for locally advanced UTUC (≥cT3 or cN+) between 2000 and 2020. These patients received RNU alone or two to four courses of NAC with either a cisplatin‐ or carboplatin‐based regimen. We evaluated the temporal changes in NAC use and compared the visceral recurrence‐free, cancer‐specific, and overall survival rates. The effect of NAC on oncological outcomes was examined using multivariate Cox regression analysis with inverse probability of treatment weighting (IPTW) models. Results Of 289 patients, 144 underwent NAC followed by RNU (NAC group) and 145 underwent RNU alone (Control [Ctrl] group). NAC use increased significantly from 19% (2006–2010), 58% (2011–2015), to 79% (2016–2020). Pathological downstaging was significantly higher in the NAC group than in the Ctrl group. The IPTW‐adjusted multivariable analyses showed that NAC significantly improved the oncological outcomes in the NAC group compared with the Ctrl group. Moreover, carboplatin‐based NAC significantly improved the oncological outcomes in the NAC group compared with the Ctrl group among patients with chronic kidney disease Stage ≥3. There were no significant differences in oncological outcomes between the cisplatin‐ and carboplatin‐based regimens. Conclusions The use of NAC for high‐risk UTUC increased significantly after 2010. Platinum‐based short‐term NAC followed by immediate RNU may not impede and potentially improves oncological outcomes.
    Type of Medium: Online Resource
    ISSN: 1464-4096 , 1464-410X
    URL: Issue
    URL: Article
    DOI: 10.1111/bju.v128.4
    DOI: 10.1111/bju.15346
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2019983-1
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  • 5
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    Prognostic impact of eligibility for adjuvant immunotherapy in locally advanced urothelial cancer
    Wiley ; 2022
    In:  BJUI Compass Vol. 3, No. 2 ( 2022-03), p. 146-153
    Details
    In: BJUI Compass, Wiley, Vol. 3, No. 2 ( 2022-03), p. 146-153
    Abstract: To evaluate the effect of postoperative pathological findings related to the eligibility of adjuvant immunotherapy on oncologic outcomes in patients with localized and locally advanced muscle‐invasive bladder carcinoma (MIBC) and upper tract urothelial carcinoma (UTUC). Patients and methods We retrospectively evaluated 1082 patients treated with radical cystectomy ( n  = 597) and nephroureterectomy ( n  = 485) between January 2000 and April 2021. Patients were divided into two groups: pT3‐4 or pN+ without neoadjuvant chemotherapy and ypT2‐4 or pN+ treated with neoadjuvant chemotherapy (trial‐eligible group) or others (trial‐ineligible group). The primary outcome was the effect of trial eligibility for adjuvant immunotherapy on disease‐free survival (DFS) and overall survival (OS). Secondary outcomes included the additional effect of lymphovascular invasion (LVI) status to the clinical trial criteria on prognosis and a risk model development. Results The median ages of the patients were 69 and 72 years in the MIBC and UTUC groups, respectively. Fifty‐two percent of patients met the trial inclusion criteria. Trial eligibility was significantly associated with poor DFS and OS among patients with MIBC and UTUC. LVI‐positive status was significantly associated with poor prognosis among patients in the trial‐eligible group. A very high risk (LVI+ or pN+ among the pT3‐4 or ypT2‐4) was significantly associated with poor prognosis. Conclusion A total of 52% of patients were eligible for adjuvant immunotherapy. Trial eligibility was significantly associated with a poor prognosis. LVI+ and pN+ may play a key role in candidate selection for adjuvant immunotherapy.
    Type of Medium: Online Resource
    ISSN: 2688-4526 , 2688-4526
    URL: Issue
    URL: Article
    DOI: 10.1002/bco2.v3.2
    DOI: 10.1002/bco2.117
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 3015455-8
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  • 6
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    Effect of active anticancer therapy on serologic response to SARS‐CoV‐2 BNT162b2 vaccine in patients with urothelial and renal cell carcinoma
    Wiley ; 2022
    In:  International Journal of Urology Vol. 29, No. 7 ( 2022-07), p. 733-739
    Details
    In: International Journal of Urology, Wiley, Vol. 29, No. 7 ( 2022-07), p. 733-739
    Abstract: To evaluate the serologic response to the BNT162b2 messenger ribonucleic acid vaccine in patients with urothelial carcinoma and renal cell carcinoma. Methods Between June 2021 and November 2021, we retrospectively evaluated blood samples from 60 healthy controls (control group), 57 patients with urothelial carcinoma, and 28 patients with renal cell carcinoma who had received two doses of the BNT162b2 vaccine at Hirosaki University Hospital. We determined the immunoglobulin G antibody titers against the severe acute respiratory syndrome coronavirus 2 spike receptor‐binding domain. Seropositivity was defined as ≥15 U/mL. We investigate factors associated with antibody titers and seropositivity in the patients with urothelial carcinoma and renal cell carcinoma. Results Antibody titers in the control, urothelial carcinoma, and renal cell carcinoma groups were 813, 431, and 500 U/mL, respectively. Seropositivity was 100%, 90%, and 96% in the control, urothelial carcinoma, and renal cell carcinoma groups, respectively. Of the 85 patients, 37 of 57 (65%) and 21 of 28 (75%) were actively undergoing anticancer treatment for urothelial carcinoma and renal cell carcinoma, respectively. Anti‐severe acute respiratory syndrome coronavirus 2 spike immunoglobulin G antibody titers and seropositivity was not significantly different between the patients with urothelial carcinoma and renal cell carcinoma. Anti‐severe acute respiratory syndrome coronavirus 2 spike immunoglobulin G antibody titers were not significantly associated with active anticancer therapy or steroid treatment for immune‐related adverse events. Univariable logistic regression analysis revealed that older age and metastatic disease were significantly and negatively associated with seropositivity. Conclusions Patients with urothelial carcinoma or renal cell carcinoma exhibited an adequate antibody response to the BNT162b2 vaccine. Active anticancer therapy was not significantly associated with seropositivity following vaccination with severe acute respiratory syndrome coronavirus 2 BNT162b2 in patients with urothelial carcinoma and renal cell carcinoma.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.v29.7
    DOI: 10.1111/iju.14882
    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 7
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    Relationship between lower urinary tract symptoms and frailty
    Wiley ; 2023
    In:  International Journal of Urology Vol. 30, No. 7 ( 2023-07), p. 606-613
    Details
    In: International Journal of Urology, Wiley, Vol. 30, No. 7 ( 2023-07), p. 606-613
    Abstract: To elucidate the relationship between frailty and lower urinary tract symptoms (LUTS). Methods We longitudinally evaluated the temporal changes and the relationships between frailty and LUTS in 247 community‐dwelling adults (45 years or older) at baseline and at a 5‐year follow‐up. We used the Fried phenotype (phenotype‐based frailty), 5‐item modified frailty index (5i‐mFI; comorbidity‐based frailty), and frailty discriminant score (comprehensive frailty assessment) to evaluate frailty. LUTS were evaluated using the international prostate symptom score (IPSS) and overactive bladder symptom score (OABSS). Results We analyzed 247 participants with a median age of 60 years. The median IPSS and OABSS were significantly increased over the 5 years. The proportion of frail individuals did not increase significantly over the 5 years. Of the three frailty assessment tools, the 5i‐mFI score significantly increased between 2014 and 2019. Multiple linear regression analyses showed that the 5i‐mFI score was significantly associated with the severity of LUTS in 2014 to 5i‐mFI in 2019 but not with 5i‐mFI in 2014 to the severity of LUTS in 2019. Conclusion The effect of LUTS on frailty might be greater than the effect of frailty on LUTS. Further large‐scale studies are needed to elucidate the relationship between LUTS and frailty.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.v30.7
    DOI: 10.1111/iju.15187
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 8
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    Implication of aortic calcification on persistent hypertension after laparoscopic adrenalectomy in patients with primary aldosteronism
    Wiley ; 2016
    In:  International Journal of Urology Vol. 23, No. 5 ( 2016-05), p. 412-417
    Details
    In: International Journal of Urology, Wiley, Vol. 23, No. 5 ( 2016-05), p. 412-417
    Abstract: To identify risk factors, including aortic calcification, for persistent hypertension in primary aldosteronism patients undergoing laparoscopic adrenalectomy. Methods Between October 2000 and October 2015, we carried out 101 consecutive laparoscopic adrenalectomies for unilateral primary aldosteronism. Of these, 95 cases with at least 1 year of postoperative follow up were included. These were divided into two study groups based on whether they had normal blood pressure without antihypertensive medications (resolved group) or still required medications (unresolved group) at 1 year after surgery. Variables included age, sex, body mass index, history of hypertension, dosage of antihypertensive medication score, presence of type 2 diabetes, subclinical Cushing syndrome, preoperative renal function, aldosteronoma resolution score and abdominal calcification index. Univariate and multivariate logistic regression analyses were used to assess independent risk factors for persistent hypertension 1 year after surgery. Results The complete resolution of hypertension without antihypertensive medication 1 year after adrenalectomy was 36 out of 95 (38%). The preoperative antihypertensive medication score, systolic blood pressure and abdominal calcification index were significantly higher, and the aldosteronoma resolution score were significantly lower in the unresolved group than in the resolved group. Using multivariate logistic regression analysis, independent risk factors significantly correlating with persistent hypertension 1 year after surgery were aldosteronoma resolution score and abdominal calcification index . Conclusions Laparoscopic adrenalectomy for primary aldosteronism is effective in improving blood pressure and reducing the need for antihypertensive medications. Aldosteronoma resolution score and abdominal calcification index represent potential independent risk factors for persistent hypertension 1 year after surgery.
    Type of Medium: Online Resource
    ISSN: 0919-8172 , 1442-2042
    URL: Issue
    URL: Article
    DOI: 10.1111/iju.2016.23.issue-5
    DOI: 10.1111/iju.13060
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 9
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    The impact of microalbuminuria on overactive bladders: Results from a community‐based four‐year longitudinal study in Japan
    Wiley ; 2020
    In:  Neurourology and Urodynamics Vol. 39, No. 5 ( 2020-06), p. 1567-1575
    Details
    In: Neurourology and Urodynamics, Wiley, Vol. 39, No. 5 ( 2020-06), p. 1567-1575
    Abstract: To investigate the longitudinal association of microalbuminuria with overactive bladder (OAB). Methods This longitudinal study investigated 561 participants of the Iwaki Health Promotion Project in both 2015 and 2019 in Japan. Microalbuminuria and OAB symptoms were assessed using the urine albuminuria creatinine ratio (ACR) and the overactive bladder symptom score (OABSS), respectively. Urine ACR was defined as high if ≥9.3 mg/gCr. Differences in OABSS between 2015 and 2019 were evaluated as ∆OABSS. Participants were divided into two groups according to ΔOABSS: high (ΔOABSS  〉  1) and control (≤1). We used baseline data acquired in 2015, such as urine ACR, the Pittsburgh Sleep Quality Index (PSQI), and arterial stiffness expressed by brachial‐ankle pulse wave velocity (baPWV). Predictive factors of a ΔOABSS  〉  1 were assessed by multivariable logistic regression analysis. Results This study included 332 women and 229 men. Of those, 86 (34 males and 52 females) were classified into the ΔOABSS  〉  1 group. There were significant group differences in age, renal function, and hemoglobin A1c. Participants in the ΔOABSS  〉  1 had a higher prevalence of PSQI  〉  5, baPWV ≥ 1400 seconds/cm, and urine ACR ≥ 9.3 mg/gCr (49% vs 20%, P  = .001) than those in the control group. Multivariable analysis revealed that PSQI  〉  5 (odds ratio [OR], 2.57; 95% confidence interval [CI] , 1.15‐4.60; P  = .002) and urine ACR ≥ 9.3 mg/gCr (OR, 1.93; 95% CI, 1.15‐3.23; P  = .013) were independent risk factors for ΔOABSS  〉  1. Conclusions Microalbuminuria may be an independent risk indicator for OAB symptom exacerbation.
    Type of Medium: Online Resource
    ISSN: 0733-2467 , 1520-6777
    URL: Issue
    URL: Article
    DOI: 10.1002/nau.v39.5
    DOI: 10.1002/nau.24405
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1500793-5
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  • 10
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    Relationships of low‐grade systemic inflammation and nutritional status with erectile dysfunction severity in men on dialysis
    Wiley ; 2022
    In:  Andrology Vol. 10, No. 8 ( 2022-11), p. 1548-1555
    Details
    In: Andrology, Wiley, Vol. 10, No. 8 ( 2022-11), p. 1548-1555
    Abstract: Low‐grade systemic inflammation and malnutrition are frequently observed in patients on dialysis and contribute to the development of endothelial dysfunction; however, the role of these conditions in erectile dysfunction (ED) severity remains to be elucidated. Objectives To investigate the relationships of low‐grade systemic inflammation and nutritional status with ED severity in men on dialysis. Materials and methods The present study included 71 men on dialysis. The sexual health inventory for men (SHIM) was used to assess ED. Men were classified as the mild/moderate (SHIM score ≥ 8) and severe ED (SHIM score ≤ 7) groups. C‐reactive protein/albumin ratio (CAR) and Geriatric Nutritional Risk Index (GNRI) were used to evaluate low‐grade systemic inflammation and nutritional status, respectively. We performed multivariate analysis to assess the relationships of CAR and GNRI with severe ED. Results The median age of the included men was 64 years old. All men had any degree of ED with 65% having severe ED. In the univariate analyses, a significant association was observed between elevated CAR (≥0.09) and severe ED (odds ratio [OR]: 4.038, p  = 0.025), whereas no significant association was observed between lower GNRI ( 〈 92) and severe ED (OR: 2.357, p  = 0.109). In the multivariate analysis, an association between elevated CAR and severe ED was still significant (OR: 5.985, p  = 0.010). Discussion and conclusion Low‐grade systemic inflammation was significantly associated with ED severity, whereas lower GNRI was not. These results may be helpful for further research to identify the optimal treatment for men suffering from severe ED.
    Type of Medium: Online Resource
    ISSN: 2047-2919 , 2047-2927
    URL: Issue
    URL: Article
    DOI: 10.1111/andr.v10.8
    DOI: 10.1111/andr.13259
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2693844-3
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