Renal cell carcinoma with synchronous bilateral adrenal metastases.
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Adrenal Gland Neoplasms↗
Biomedical subjects
T Kotake
Publications and source records attributed to T Kotake.
The current TNM-classification of bladder carcinoma--is it as good as we need it to be?
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Carcinoma, Transitional Cell↗
Effect of dietary intake on urinary oxalate excretion in calcium renal stone formers.
OBJECTIVE: To investigate the influence of dietary intake on urinary oxalate excretion in calcium renal-stone formers. PATIENTS AND METHODS: Dietary intake was monitored by using the dietary-record method in 60 idiopathic stone formers. The patients collected their urine for 24 h at home and their urinary oxalate excretion rate was determined. The relationship between the daily intake of various nutrients and urinary oxalate excretion was examined by both monovariate and multivariate analyses. RESULTS: By monovariate analysis, the intake of carbohydrate, total protein and fat were significantly correlated with urinary oxalate excretion, but the intake of calcium and body surface area were not. In addition, the intake of total protein was highly correlated with that of fat. By multivariate analysis, the intake of carbohydrate and fat were significantly related to urinary oxalate excretion, and the intake of calcium was inversely correlated with urinary oxalate excretion, but the intake of total protein showed no significant correlation. CONCLUSION: The intake of carbohydrate and fat was positively and the intake of calcium was inversely correlated with urinary oxalate excretion in stone formers and, taken together, these findings suggested that fat plays an important role in urinary oxalate excretion and that protein has a minimal effect.
Body Surface Area↗
Effect of ethyl icosapentate on urinary calcium excretion in calcium oxalate stone formers.
Buck and co-workers presented the hypothesis that the initiating factor of stone formation triggers the mechanisms for prostaglandin synthesis, resulting in the biochemical abnormalities associated with stone disease. In order to test this hypothesis, we undertook a clinical study with the use of a highly purified preparation of ethyl icosapentate. Ethyl icosapentate (1,800 mg/day) was administered to 57 patients with urinary stones chiefly composed of calcium oxalate for 6 weeks. Urinary calcium in the hypercalciuric patients reduced significantly, but the calcium level in the normocalciuric group did not decrease. Oxalate values did not reduce either in the hypercalciuric patients or in the normocalciuric subjects. No serious side effects were observed.
Adult↗
Preventive effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer in a double-blind trial. The BLP Study Group.
A double-blind trial was conducted in 138 patients with superficial transitional cell carcinoma of the bladder following transurethral resection to evaluate the prophylaxis of recurrence by an oral Lactobacillus casei preparation (BLP). Patients were stratified into the following 3 subgroups: (A) with primary multiple tumors; (B) with recurrent single tumors, and (C) with recurrent multiple tumors. In each group, patients were randomly allocated to receive BLP or placebo. BLP showed a better prophylactic effect in subgroups A and B than placebo, whereas no significant difference was observed in subgroup C. Cox multivariate analysis showed that the outcome with BLP was significantly better than with placebo (p = 0.01). Slight and tolerable adverse reactions occurred in 3 patients receiving BLP and in 3 of the placebo-treated patients. Oral administration of BLP was thus safe and effective for preventing recurrence of superficial bladder cancer.
Administration, Oral↗
Clinical and biochemical features of uric acid nephrolithiasis.
A clinical investigation was carried out on patients with uric acid stones in order to study the frequency and pathogenesis of uric acid nephrolithiasis. Of 652 patients with stones in the upper urinary tract in whom the stone composition could be examined, 36 patients and uric acid stones (5.5%). The male to female ratio was 11:1. The average age of the 33 male subjects was 49 +/- 11 years (mean +/- SD), and the 3 females were 22, 37 and 42 years old, respectively. Two of the females showed hypouricemia. With regard to stone composition, pure uric acid stones were present in 26 cases (72%), a mixed uric acid and calcium oxalate stones were found in 6 cases (17%), both pure uric acid and mixed uric acid and calcium oxalate stones were observed in 3 cases (8%), and a mixed uric acid and sodium acid urate stone in 1 (3%). Biochemical studies on male patients showed that the blood uric acid level was higher in the uric acid stone group and the pure uric acid stone group compared to the calcium stone group. The blood uric acid levels of the former 2 groups did not differ from the control group. With respect to urine chemistry, the excretion of calcium in the uric acid stone group was significantly lower than that in the control group. In the uric acid stone group and the pure uric acid stone group the excretion of calcium tended to be lower than that in the calcium stone group. The amounts of oxalic acid excreted in the uric acid stone group and in the pure uric acid stone group were low compared to the calcium stone group. Oxalic acid elimination in these 2 groups did not differ from the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Clinical assessment for prognostic factors related to recurrence and progression in superficial bladder cancer].
PURPOSE: The objective of this assessment is to identify prognostic factors of recurrence and disease progression of primary superficial transitional cell carcinoma of the bladder. PATIENTS AND METHODS: TUR-Bt was performed in 150 patients with initial superficial bladder cancer, of which pathological diagnosis was pTa or pT1 transitional cell carcinoma. The recurrence and progression free survival was examined. The clinicopathological factors analyzed were as follows: grade, pT, tumor size, tumor number and tumor form. RESULTS: Median follow-up period was 39 months (range 3-184). The age distribution was from 25 to 98 years old with the average of 67. The patients were 122 males and 28 females. Recurrence was observed in 72 patients. The 5-year recurrence free rate for all cases were 41.6%. The factors found to be of significance for the prognosis for recurrence were tumor size (1 cm <) and tumor multiplicity (p < 0.01). Progression was seen in 15 patients; 8 invasive tumors, 2 lymph node metastases and 5 distant metastases. Twelve cases of those died of cancer. The 5-year progression free rate for all cases were 87.0%. The prognostic factors related to progression found in this study were G3, pT1 and sessile form (p < 0.01). There was no significant difference in recurrence free rate between cases with and without postoperative therapy; UFT p.o., ADM i.i. (intravesical instillation), ADM + Ara-C i.i. and PEP + 5-FU + Ara-C i.i. CONCLUSION: Tumor size more than 1 cm and tumor multiplicity were the high risk factors about recurrence. So were G3, pT1 and sessile form about progression.
Adult↗
[Multicentricity and concomitant tumors in renal cell carcinoma: analysis by serial section of resected kidneys].
Nephron-sparing surgery was initially limited to the patients with localized renal cancer (RCC) present bilaterally or in a solitary kidney. Recently there is controversy in the indication for partial nephrectomy or enucleation to incidentally defined small RCC with normal opposite kidney. We examined the incidence of multicentricity in 43 kidneys removed for RCC with a diameter of less than 80 mm. The mean diameter of the predominant tumors was 45 mm (range 12 to 80 mm). The kidneys were serially sectioned at 5 mm intervals. Three of 43 kidneys (7%) had multiple RCC. The size of the concomitant tumors ranged from 2 to 15 mm. The multicentricity had no relation to pathological grade, stage, vascular invasion or infiltration pattern. In addition, the other 4 kidneys had 2 adenomas, 1 angiomyolipoma and 1 fibroma. Therefore we observed a 16% incidence of small renal nodules and a 7% multicentricity of RCC in the nephrectomized kidneys with normal opposite kidney.
Adenoma↗
Preoperative endocrine therapy in patients with locally advanced prostate cancer.
Recently, there has been increased interest in the application of preoperative endocrine therapy prior to radical prostatectomy for locally advanced cancer in order to enhance surgical curability and increase survival. Between 1986 and 1993, 40 patients with prostate cancer were given endocrine therapy before radical prostatectomy. Fifteen patients had stage B2 disease and 25 stage C. The median duration of preoperative endocrine therapy was 3.8 months, and all the patients subsequently underwent radical prostatectomy, pelvic lymphadenectomy and castration. There was an average 25.5% (0-71.8%) decreases in the maximal cross-sectional area of the prostate gland as determined by transrectal ultrasonography. Twenty-four of 25 patients with elevated levels of serum prostate-specific antigen (PSA) showed normal values after preoperative endocrine therapy. Evaluation of treatment-related histological effects, divided into three grades, revealed that 17 patients had pronounced, 11 moderate and 12 poor or no regression. Thirteen of the 40 patients (33%) demonstrated pathological downstaging of disease status from the diagnosis made at the initial clinical examination. After a median follow-up period of 36 months (3-100 months), 36 of the 40 patients are disease-free; two died of cancer 43 and 50 months after surgery, respectively. These results suggest that preoperative endocrine therapy may play an important role in the management of locally advanced prostatic cancer.
Adenocarcinoma↗
[A case of a ureteral polyp resected transurethrally].
We report a case of fibroepithelial polyp of right ureter. The patient was a 36-year-old man, complaining of macrohematuria. An excretory urogram and retrograde pyelogram revealed a filling defect of the middle third of ureter, but it did not show hydronephrosis. We observed the ureter by transurethral ureteroscopy and found a ureter polyp with a slender stalk. We resected the polyp transurethrally. The pathological diagnosis was a fibroepithelial polyp. This suggests that the endourological technique is a useful method for diagnosis and treatment in patients with a urinary tract filling defect.
Adult↗
Reactivities of mouse monoclonal antibody K2.7 to renal cancers in complement dependent cytotoxicity and antibody dependent cell-mediated cytotoxicity.
Immunohistochemical analysis by indirect immunoperoxidase staining demonstrated that monoclonal antibody (mAb) K2.7, derived from a mouse immunized with a renal cell carcinoma (RCC) cell line OS-RC-2, reacted with 89 of 95 renal cancer tissues (94%). Only 1 gastric and uterine cancer tissue showed positive staining among 87 cancer specimens from 9 different organs. Among normal human tissues, the renal tubule, testis, epithelium of the uterine endometrial gland and Fallopian tube, grey matter of cerebrum and cerebellum, and foreskin showed positive staining. Serological analysis by protein A mixed hemadsorption (PA) assay demonstrated that mAb K2.7 reacted with 25 of 31 RCC cell lines (81%), but with only 2 of 50 other cell lines from different organs. The specific antitumor activities of mAb K2.7 against RCC cell lines were investigated in vitro by complement dependent cytotoxicity (CDC) and antibody dependent cell-mediated cytotoxicity (ADCC) assays. In the CDC assay, all of the 9 RCC cell lines reactive serologically with mAb K2.7 were killed by mAb K2.7 with normal human serum, and the killing activity of mAb K2.7 correlated well with the reactivity of mAb K2.7 in the PA assay. mAb K2.7 showed the same killing activity against each of 3 RCC cell lines with sera from 9 patients with low and high stage renal cancers, as well as with normal human serum. In the ADCC assay, mAb K2.7 with peripheral blood leukocytes (PBLs) from 4 healthy donors showed cytotoxic activity against RCC cell lines. Peripheral blood leukocytes from the same 9 renal cancer patients also showed significant killing activity against the 3 RCC cell lines. These findings suggest the potential utility of mAb K2.7 for specific immunotherapy of renal cancer.
Animals↗
Ossified cystic metastasis of bladder tumor to abdominal wound after partial cystectomy.
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Abdominal Muscles↗
[A case of leiomyosarcoma of the diverticulum of urinary bladder].
A 77-year-old man was admitted to our hospital complaining of gross hematuria. Cystoscopy showed an approximately 4-cm non-papillary tumor in and out of the diverticulum of the left posterior wall. Total cystectomy was performed. Histopathological diagnosis was pleomorphic leiomyosarcoma. According to TNM classification of bladder cancer, the stage of this tumor was pT3bpN0M0. The patient had local recurrence two months after the operation, and died a month later. This is the second case of leiomyosarcoma of the diverticulum of urinary bladder reported in Japan.
Aged↗
[Prognostic factors in bladder cancer].
Prognostic factors in bladder cancer are used to determine the prognosis of patients and select the method of treatment. Clinical stage, the number of tumors, size of the main tumor, mode of proliferation, cell type, histological grade, histological stage, mode of spread, and intramural lymphatic and venous invasion are well-known prognostic factors. They are closely related to survival or the disease-free interval. Most prognostic factors are histopathological findings. Now, study of new prognostic factors in bladder cancer related to molecular biological or immunohistochemical technique is ongoing.
Disease-Free Survival↗
Adjuvant and neoadjuvant chemotherapy for invasive bladder cancer.
A total of 20 patients with primary invasive bladder cancer who underwent radical cystectomy received postoperative adjuvant chemotherapy using a CAP (cyclophosphamide, doxorubicin, and cisplatin) or modified M-VAC (methotrexate, vinblastine, pirarubicin, and cisplatin) regimen. In all, 16 of the patients were treated with CAP and 4 received the modified M-VAC regimen. Of the 20 patients, 17 had transitional-cell carcinoma with or without non-transitional-cell elements. All of the patients had tumors with a histological grade of G2 (6 cases) or G3 (14 cases). As for lymph-node metastasis, there were ten N0 cases, three N1 cases, six N2 cases, and one N3 case. Adjuvant chemotherapy was usually commenced 2 weeks after the surgery and was given every 3-4 weeks for two or three cycles. The 5-year survival rate of these 20 patients was 65.9%, whereas that of 49 patients who did not receive any adjuvant chemotherapy was 30.2%. Regarding toxicity, both of the adjuvant chemotherapy regimens used in this study were generally well tolerated. The most common toxic effects were gastrointestinal symptoms, alopecia, and myelosuppression. Another 19 patients with invasive transitional-cell carcinoma of the bladder received 2 or 3 cycles of neoadjuvant chemotherapy using the modified M-VAC or MEC (methotrexate, epirubicin, and cisplatin) regimen. Of 18 pathologically evaluable patients who underwent radical cystectomy or partial cystectomy, the stage was pT0 in 3 cases (17%), pTis in 3 (17%), pT1 in 3 (17%), and pT2 or higher in 9 (50%). The 4-year survival rate of 18 patients who received neoadjuvant chemotherapy was 71.5%. Regarding toxicity, one patient died of a bowel complication after surgery, and the complication was suggested to be drug-induced.
Adenocarcinoma↗
Prophylactic chemotherapy with intravesical instillation of adriamycin and oral administration of 5-fluorouracil after surgery for superficial bladder cancer. The Japanese Urological Cancer Research Group for Adriamycin.
The Japanese Urological Cancer Research Group for Adriamycin has conducted a series of clinical trials to investigate the efficacy and safety of prophylactic intravesical chemotherapy for superficial bladder cancer. In the third trial, reported herein, patients with recurrent bladder cancer or multiple primary cancer were selected and randomized to one of four groups using the envelope method after complete resection of the original tumors. Group A was given Adriamycin alone, group B received oral 5-fluorouracil (5-FU), group C was given Adriamycin and oral 5-FU, and group D served as the control group. Of the 544 patients registered, 331 were evaluable for the purpose of this study. The administration of 5-FU (group B) failed to prevent the recurrence of bladder tumors. Although group C (both Adriamycin and 5-FU) did not fare better than group A (Adriamycin only), Adriamycin was effective in preventing the recurrence of tumors, especially in high-risk patients with recurrent and multiple tumors. The risk of recurrence was reduced to 0.21 (95% confidence interval, 0.10-0.44) relative to the control group. There was no indication of a synergistic effect between 5-FU and Adriamycin. As side effects, cystitis syndrome was observed in 23%-30% of the patients in the Adriamycin groups and mild myelosuppression was observed in the 5-FU groups.
Administration, Intravesical↗
Characterization of mouse monoclonal antibody B1.4 reactive with human invasive bladder cancer and some other malignant tumors but not with normal urinary epithelium.
Immunohistochemical analysis by indirect immunoperoxidase staining demonstrated that monoclonal antibody (mAb) B1.4 derived from a mouse immunized with a bladder cancer cell line EJ-1 was reactive with a high proportion of high-grade and invasive bladder tumors, but not with the majority of low-grade and superficial bladder tumors, or normal urinary epithelium. Among 71 primary bladder tumors classified by pathological grading, positive stainings were observed in 1 of 34 tumors (3%) of grade 1, 8 of 20 tumors (40%) of grade 2 and 14 of 17 tumors (82%) of grade 3. When the tumors were classified by pathological staging, positive stainings were observed in only 8 of 54 (15%) superficial tumors of stages Ta and T1, but in 15 of 17 (88%) invasive tumors of stages T2 and T3. mAb B1.4 showed restricted positive stainings with normal tissues including renal glomerulus, vascular endothelium, squamous epithelium of esophagus, glandular epithelium of prostate, and epithelium of pancreatic acinar gland and minute duct, while positive stainings were observed in a range of tumor tissues other than bladder tumor. Mixed hemadsorption assays with a panel of cell cultures showed also that the antigen recognized by mAb B1.4 was expressed on a range of tumor cell lines. These findings suggest that the antigen recognized by mAb B1.4 may appear after malignant transformation, and be an indicator of malignant potential of bladder cancer.
Animals↗