Prostatic Neoplasms: Arai Y

Kamidono S, Ohshima S, Hirao Y, Suzuki K, Arai Y, Fujimoto H, Egawa S, Akaza H, Hara I, Hinotsu S, Kakehi Y, Hasegawa T, Anonymous00384. · No affiliation provided · Int J Urol. · Pubmed #18184166 No free full text.

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Arai Y, Saito S, Namiki S, Ishidoya S, Satoh M. · Department of Urology, Tohoku University Graduate School of Medicine. · Nippon Rinsho. · Pubmed #15714976 No free full text.

Abstract: With widespread use of PSA screening, radical prostatectomy has gained popularity among Japanese urologists over the last decade. Recent understanding of pelvic anatomy and improvement in surgical technique have substantially reduced its morbidity. Early recovery of urinary continence is possible and improvement of sexual function after surgery may be enhanced by use of sildenafil and nerve reconstructive surgery. As prostate cancer is increasingly diagnosed at early stages and therefore with more favorable survival outcomes, the basis on which patients select primary therapy has shifted toward considerations of health-related quality of life. Accordingly, QOL assessment has become an important form of outcomes based research that may weigh heavily on the treatment selection by patients.

Arai Y, Namiki S, Ichioka K, Yoshimura K. · Department of Urology, Tohoku University Graduate School of Medicine. · Nippon Rinsho. · Pubmed #12599574 No free full text.

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Kurokawa K, Yamanaka H, Ishibashi M, Kano S, Arai Y. · Department of Urology, Gunma University School of Medicine. · Nippon Rinsho. · Pubmed #12599556 No free full text.

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Nishimura K, Nakai Y, Shimizu K, Tokizane T, Arai Y, Inoue H, Takaha N, Nonomura N, Okuyama A, Kamoi K, Ukimura O, Miki T, Koide T, Ichikawa Y, Nishimura K, Sugao H, Yamaguchi S, Takatera H, Uchida K, Miura H. · Department of Urology, Graduate School of Medicine, Osaka University. · Hinyokika Kiyo. · Pubmed #12512147 No free full text.

Abstract: To our knowledge, no standard chemotherapy for patients with hormone-refractory prostate cancer (HRPC) has been established. Since most patients with HRPC are elderly and have bone metastasis, cytotoxic chemotherapy causes them to be at high risk for myelosuppression. Therefore, chemotherapeutic agents with low toxicity and good compliance should be elected. We conducted three regimens for HRPC on an outpatient basis. Eligibility criteria were defined as serial rising PSA values on 3 or more occasions at least 2 weeks apart or radiological new or extensive lesions under hormonal therapy. The first regimen is comprised of cyclophosphamide (CPM), 100 mg/day, UFT, 400 mg/day, and estramustine phosphate (EMP), 560 mg/day in two daily fractions. The second regimen is comprised of an oral administration of dexamethasone (DEX) (0.5-2 mg/day). The third regimen is comprised of DEX, 1 mg/day, cyclophosphamide, 100 mg/day and UFT, 400 mg/day in two daily fractions. Post-therapy prostate-specific antigen (PSA) level in serum, objective response on bone scan or measurable disease, and symptomatic response on bone pain were assessed. All regimens showed clinical efficacy with mild toxicity. Indications and limitations of these regimens are discussed. Further, the combination trials of taxane and EMP in patients with HRPC are reviewed.

Arai Y. · Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan. · Int J Urol. · Pubmed #11442671 No free full text.

Abstract: In recent years, increased screening for prostate cancer, primarily with prostate-specific antigen testing, has led to an apparent increase in the incidence of prostate cancer and resulted in a shift to an earlier patient age and tumor stage at diagnosis. From the early 1980s, there have been great advances in surgical technique. In the 1990s, radical prostatectomy gained popularity among Japanese urologists. Time trends and morbidity of contemporary anatomical radical prostatectomy in Japan are reported here. In addition, the quality of life in men undergoing radical prostatectomy is discussed.

Arai Y, Okubo K. · Department of Urology, Kurashiki Central Hospital. · Nippon Rinsho. · Pubmed #11022749 No free full text.

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Ogura K, Arai Y. · Department of Urology, Hamamatsu Rosai Hospital. · Nippon Rinsho. · Pubmed #11022722 No free full text.

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Maeda H, Aoki Y, Arai Y. · Department of Urology, Faculty of Medicine, Kyoto University. · Nippon Rinsho. · Pubmed #11022695 No free full text.

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Arai Y, Akaza H, Deguchi T, Fujisawa M, Hayashi M, Hirao Y, Kanetake H, Naito S, Namiki M, Tachibana M, Usami M, Ohashi Y. · Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. · J Cancer Res Clin Oncol. · Pubmed #18491137 No free full text.

Abstract: PURPOSE: To assess quality of life (QOL) data from a double-blind Phase III study evaluating bicalutamide (Casodex) 80 mg as part of maximum androgen blockade (MAB) in patients with previously untreated advanced prostate cancer. METHODS: Patients with untreated stage C/D prostate cancer were randomized to MAB with bicalutamide plus a luteinizing hormone-releasing hormone agonist (LHRHa) or LHRHa monotherapy. QOL was evaluated at baseline and at weeks 1, 5, and 24 using the Japanese version of the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. RESULTS: A total of 203 patients were assessed for QOL. The MAB group had more rapid and greater improvements in "emotional well-being" and "prostate cancer-specific issues" domain scores than the monotherapy group. Further analysis of "prostate cancer-specific issues" revealed that, compared with monotherapy, MAB provided a greater improvement in "micturition disorder"-related QOL. Complete improvement rates for items related to "pain and micturition disorder" were also higher with MAB. Item scores of "pain and micturition disorder" did not correlate strongly with prostate-specific antigen levels or tumor size. Fewer patients who had deterioration in their "pain and micturition disorder" item scores at week 1 in the MAB group than the monotherapy group. CONCLUSIONS: Maximum androgen blockade with bicalutamide plus LHRHa did not reduce the overall QOL of patients with previously untreated advanced prostate cancer. MAB was superior to monotherapy in achieving early improvement of QOL related to micturition disorder and pain.

Usami M, Akaza H, Arai Y, Hirano Y, Kagawa S, Kanetake H, Naito S, Sumiyoshi Y, Takimoto Y, Terai A, Yoshida H, Ohashi Y. · Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. · Prostate Cancer Prostatic Dis. · Pubmed #17199134 No free full text.

Abstract: To compare combination therapy with bicalutamide 80 mg and a luteinizing hormone-releasing hormone agonist (LHRH-A) versus LHRH-A alone in Japanese men with untreated advanced prostate cancer. A total of 205 patients with stage C/D prostate cancer were randomized to either LHRH-A+once-daily oral bicalutamide 80 mg or placebo. Primary study variables have been reported previously. Secondary variables included: time to achieve prostate-specific antigen < or = 4 ng/ml, time-to-treatment failure (TTTF), time-to-disease progression (TTP), overall survival (OS), adverse events and adverse drug reactions. Following combination therapy with bicalutamide 80 mg, there were significant (P<0.001) advantages over LHRH-A alone in terms of TTTF and TTP, but the difference in the interim OS was not statistically significant. First-line combination therapy with bicalutamide 80 mg in Japanese patients with advanced prostate cancer offers significant benefits over LHRH-A alone, with respect to TTTF and TTP. Follow-up for OS continues.

Akaza H, Yamaguchi A, Matsuda T, Igawa M, Kumon H, Soeda A, Arai Y, Usami M, Naito S, Kanetake H, Ohashi Y. · Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba City, Ibaraki, Japan. · Jpn J Clin Oncol. · Pubmed #15020659 links to  free full text

Abstract: OBJECTIVES: To evaluate bicalutamide (Casodex) 80 mg as a component of maximum androgen blockade (MAB) in Japanese patients with previously untreated advanced prostate cancer. METHODS: 205 patients with previously untreated stage C/D prostate cancer were randomized (1:1) to receive once-daily bicalutamide 80 mg or placebo, each combined with a luteinizing hormone-releasing hormone (LHRH) agonist. Primary study variables were the 12 week prostate-specific antigen (PSA) normalization (i.e. PSA level <or=4 ng/ml) rate, the 12 week overall tumor response rate (proportion with a partial response or better) and the proportion of withdrawals due to adverse drug reactions (ADRs) at follow-up. This interim analysis was undertaken after a minimum of 6 months' follow-up (median 15 months). RESULTS: The 12 week PSA normalization rate was 79.4% for MAB and 38.6% for LHRH agonist monotherapy (P < 0.001). The 12 week overall tumor response rate was 77.5 and 65.3%, respectively (P = 0.063). The withdrawal rate due to ADRs was 8.8% and 10.9%, respectively. There were differences in favor of MAB over monotherapy with respect to time to treatment failure (TTTF) (P = 0.038) and time to progression (TTP) (P = 0.016). There have been too few deaths (n = 10) to analyze survival. The profiles of adverse events and ADRs were broadly similar in the two treatment groups. CONCLUSION: In Japanese patients with advanced prostate cancer, first-line treatment with bicalutamide 80 mg in combination with an LHRH agonist is superior to LHRH agonist monotherapy in terms of the antitumor response at 12 weeks, and also time to treatment failure and progression, and does not compromise treatment safety. The study is ongoing.

Yoshimura K, Sumiyoshi Y, Hashimura T, Ueda T, Kamiryo Y, Yamamoto A, Arai Y. · Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan. · Int J Urol. · Pubmed #12657097 No free full text.

Abstract: BACKGROUND: We compared the clinical effects and impact on quality of life (QOL) of patients who received a 3-month course of flutamide monotherapy before radical prostatectomy with those who received a 3-month course of luteinizing hormone-releasing hormone (LHRH) agonist monotherapy. METHODS: Thirty-seven patients with non-metastatic prostate cancer were enrolled in this study (19, flutamide; 18, LHRH agonist). The rates of change of serum prostate-specific antigen (PSA) and testosterone levels, downsizing of prostate volume, the rate of organ confined disease, adverse effects and perioperative scores measured using the European Organization for Research and Treatment of Cancer Prostate Cancer Quality of Life Questionnaire (EORTC-P) and the Sapporo Medical University Sexual Function Questionnaire (SMUF) were analyzed. RESULTS: At radical prostatectomy, pathological variables were not significantly different in the two groups. Serum testosterone level was significantly higher (mean 359.2 compared to 10.5, P < 0.001), complete response rate of PSA (13% compared to 57%, P = 0.028) and rate of downsizing of prostate volume (mean, -17.7% compared to -35.4%, P = 0.038) were significantly lower in the flutamide group than in the LHRH group. After neoadjuvant hormone therapy, the scores on the sexual problem domain of EORTC-P (P = 0.033) and sexual desire score of SMUF (P = 0.021) were significantly higher in the flutamide group than in the LHRH group. At a median follow-up of 34 months after prostatectomy, biochemical failure-free survival rate in the flutamide group did not differ from that in the LHRH group. CONCLUSION: This study suggests that flutamide monotherapy can be an acceptable modality as an option for neoadjuvant hormone therapy.

Matsui Y, Egawa S, Tsukayama C, Terai A, Kuwao S, Baba S, Arai Y. · Department of Urology, Kurashiki Central Hospital, Okayama, Japan. · Jpn J Clin Oncol. · Pubmed #12578902 links to  free full text

Abstract: BACKGROUND: Although prostate cancer has been prevalent in Japan, there has been no particular model for predicting the pathological stage in the Japanese population. We examined whether artificial neural network analysis (ANNA), which is a relatively new diagnostic tool in prostate cancer, can be one of the predictive methods for predicting organ confinement, compared with the traditional logistic regression model, in the Japanese population for the first time. METHODS: The study population comprised 178 men who underwent radical prostatectomy at our institutions between October 1992 and May 1999. As additional pretreatment parameters to the preoperative serum PSA level, clinical TNM classification and biopsy Gleason score, the percentage of number of cores exhibiting traces of tumor, maximum tumor length in biopsy cores, PSA density and patient age were used. The predictive ability of ANNA with several parameters for a set of 36 randomly selected test data was compared with those of logistic regression analysis and 'Partin Tables' by area under the receiver operating characteristics (ROC) curve analysis. RESULTS: Of 178 patients, 97 (54.5%) had organ-confined disease but 81 (45.5%) had locally advanced disease. With three parameters, the area under the ROC curve of ANNA (0.825 +/- 0.071) was larger than those for logistic regression (0.782 +/- 0.079) and Partin Tables (0.756 +/- 0.087), but not to a significant extent (P = 0.690 and 0.541). Although the expansion of the parameters did not increase the difference in area under the ROC curve between the best ANNA and logistic regression (0.899 +/- 0.053 and 0.873 +/- 0.065, respectively), the difference between the best ANNA and Partin Tables did not reach but approached statistical significance (P = 0.157). CONCLUSION: Although more modeling optimization is necessary to improve the predictive accuracy and generalizability of ANNA, we suggest that there is the possibility for this new predictive method to evolve in the analysis of clinical staging of prostate cancer.

Egawa S, Suyama K, Arai Y, Tsukayama C, Matsumoto K, Kuwao S, Baba S. · Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. · Int J Urol. · Pubmed #11389745 No free full text.

Abstract: BACKGROUND: North American investigators have suggested the usefulness of risk-group stratification based on prostate-specific antigen (PSA), clinical stage and biopsy Gleason score for predicting the biochemical outcome of prostate cancer after radical prostatectomy. There have been no reports of the application of this stratification to early biochemical outcome after radical surgery in Japanese men. METHODS: The study population consisted of 178 men treated with radical retropubic prostatectomy and bilateral pelvic lymph node dissection at Kitasato University Hospital (n = 110) and Kurashiki Central Hospital (n = 68) between October 1992 and May 1999. Pathologic and biochemical outcomes after radical prostatectomy were analyzed based on risk-group stratification. Risk groups were further analyzed according to detailed pathologic findings at biopsy. RESULTS: The median follow-up period for the 178 patients after radical surgery was 41.5 months (range, 2.0--82.0 months; mean, 40.9 months). Fifty-eight patients experienced PSA failure at a median of 8.0 months following surgery (range, 0.0--58.0). Risk-group stratification distinctly defined groups of pathologic findings in the radical prostatectomy specimens. The proportion of patients with PSA failure for low, intermediate and high-risk groups were 9.5%, 23.9% and 56.9%, respectively (P < 0.0001). Use of the number of cores with cancer and maximum cancer length in biopsy cores failed to improve risk stratification for PSA outcome in all risk groups. CONCLUSIONS: Risk-group stratification based on preoperative variables may significantly improve a physician's ability to counsel patients about PSA outcome after radical prostatectomy. Further improvement in risk stratification may call for use of variables other than the pathologic information in biopsy cores.

Akakura K, Isaka S, Akimoto S, Ito H, Okada K, Hachiya T, Yoshida O, Arai Y, Usami M, Kotake T, Tobisu K, Ohashi Y, Sumiyoshi Y, Kakizoe T, Shimazaki J. · Department of Urology, School of Medicine, Chiba University, Japan. · Urology. · Pubmed #10443731 No free full text.

Abstract: OBJECTIVES: To improve the treatment of locally advanced prostate cancer (Stages B2 and C), a prospective randomized trial was conducted to compare radical prostatectomy versus external beam radiotherapy with the combination of endocrine therapy in both modalities. METHODS: One hundred patients were enrolled and 95 were evaluated. Forty-six patients underwent radical prostatectomy with pelvic lymph node dissection, and 49 were treated with radiation by linear accelerator with 40 to 50 Gy to the whole pelvis and a 20-Gy boost to the prostatic area. For all patients, endocrine therapy was initiated 8 weeks before surgery or radiation, and continued thereafter. The living patients were asked to respond to a quality-of-life questionnaire. RESULTS: The follow-up period ranged from 6.0 to 94.4 months (median 58.5). The progression-free and cause-specific survival rates at 5 years were 90.5% and 96.6% in the surgery group and 81.2% and 84.6% in the radiation group, respectively. The surgery group had better progression-free and cause-specific survival rates (P = 0.044 and 0.024, respectively). More patients in the surgery group complained of urinary incontinence. The questionnaire revealed that quality of life was less disturbed in the radiation group. CONCLUSIONS: Radical prostatectomy combined with endocrine therapy may contribute to the survival benefit of patients with locally advanced prostate cancer. External beam radiotherapy in combination with endocrine therapy can be used in selected patients because of its low morbidity.

Nakamura Y, Suzuki T, Sugawara A, Arai Y, Sasano H. · Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Pathol Int. · Pubmed #19432669 No free full text.

Abstract: Peroxisome proliferator-activated receptor (PPAR) is a member of the nuclear hormone receptor superfamily of transcription factors. Peroxisome proliferator-activated receptor gamma (PPARgamma) plays an important role in the regulation of lipid homeostasis, adipogenesis, insulin resistance, and development of various organs. Agonists of PPARgamma have been also reported to inhibit proliferation of prostate carcinoma cells as in other human malignancies, and these synthetic ligands have been used in differentiation-mediated therapy of various human carcinomas associated with high levels of PPARgamma. The significance of PPARgamma expression, however, was unknown in human prostate carcinoma tissues. The purpose of the present study was therefore to examine the immunolocalization of PPARgamma in human prostate cancer tissues (40 cases) and correlate the findings with clinicopathological features of the patients in order to evaluate its possible biological significance. Twenty-nine patients were positive for PPARgamma immunoreactivity (73%) and a significant inverse correlation was detected between PPARgamma immunoreactivity, pT stage (P = 0.036), and serum concentration of prostate-specific antigen (P = 0.0004). In conclusion, PPARgamma immunoreactivity is considered to be a new clinicopathological parameter of human prostate cancer.

Matsushita M, Nakagawa H, Namiki S, Ikeda Y, Kaiho Y, Kawamorita N, Ito A, Ishidoya S, Saito S, Arai Y. · Department of Urology, Tohoku University Graduate School of Medicine. · Nippon Hinyokika Gakkai Zasshi. · Pubmed #19198223 No free full text.

Abstract: PURPOSE: Mecobalamin has been reported to be useful for peripheral nerve disorder. There have been no previous reports of the effects of mecobalamin on urinary and sexual function after nerve sparing radical prostatectomy. We examined the effects of the use of mecobalamin on urinary and erectile functions after nerve sparing radical prostatectomy. MATERIALS AND METHODS: A total of 54 patients with localized prostatic cancer were prospectively randomized into 2 groups. The 27 patients in group A were treated with nerve sparing prostatectomy and mecobalamin 1,500 microg/day for 6 months. The 27 patients in group B were treated with nerve sparing prostatectomy alone. Urinary function (URF), urinary bother (URB), sexual function (SXF) and sexual bother (SXB) were evaluated using the University of California at Los Angeles Prostate Cancer Index (UCLA-PCI) before surgery, and 3, 6 and 12 months after surgery. RESULTS: There were no significant differences in URF, URB, SXF or SXB between the two groups at any postoperative period. At 3 months after surgery, however, group A tended to have a better URF than group B (85.7 +/- 4.7 (mean +/- standard error) vs. 66.9 +/- 10.2) and URB (85.7 +/- 7.4 vs. 63.9 +/- 11.8) (p = 0.121, p = 0.168). At 12 months after surgery, both groups showed similar URF (86.4 +/- 7.4 vs. 81.8 +/- 4.2) and URB (86.5 +/- 8.3 vs. 84.5 +/- 4.7). Although the two groups had similar recovery phase of SXF, group A tended to report better SXB throughout the postoperative period. CONCLUSION: This study did not demonstrate any significant effect of the use of mecobalamin on the recovery of urinary or sexual function after nerve sparing prostatectomy, although an early recovery effect on urinary function was suggested. A randomized controlled study with a larger population is warranted to fully elucidate the role of mecobalamin in the improvement of functional outcome after radical prostatectomy.

Namiki S, Ishidoya S, Ito A, Kawamura S, Tochigi T, Saito S, Arai Y. · Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. · Int J Urol. · Pubmed #19054169 No free full text.

Abstract: OBJECTIVES: To measure health-related quality of life (HRQOL) after radical prostatectomy (RP) in Japanese men with localized prostate cancer. METHODS: A total of 154 patients who underwent RP were included in this 5-year longitudinal survey. The Short Form 36-Item Health Survey, the University of California, Los Angeles, Prostate Cancer Index and the International Prostate Symptom Score questionnaires were administered at diagnosis and nine times afterwards. RESULTS: Patients undergoing RP showed problems in some physical domains of general HRQOL, but these problems diminished over time. Mental health and social functions significantly improved during the follow-up period. The urinary function substantially declined at 3 months and continued to recover gradually but never returned to baseline. Most patients (95%) recovered to their baseline urinary bother score within 60 months. The overall mean total International Prostate Symptom Score progressively improved with time. On the other hand, at 60 months after RP, only 34% of subjects had fully returned to baseline sexual function. By 5 years postoperatively, 78% of the men had reached baseline sexual bother and the mean recovery time was 8.6 months. Adverse effects of RP on sexual function and bother were mitigated by bilateral nerve-sparing procedures up to 5 years after the operation. CONCLUSIONS: Despite reported problems with sexuality and urinary continence, general HRQOL was mostly unaffected by RP after 6 months in our survey with functional outcomes remaining relatively stable in the majority of patients.

Ishidoya S, Ito A, Orikasa K, Kawamura S, Tochigi T, Kuwahara M, Yamanobe T, Tomita Y, Masumori N, Tsukamoto T, Shibuya D, Arai Y. · Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Jpn J Clin Oncol. · Pubmed #18941125 links to  free full text

Abstract: OBJECTIVE: No previous study has reported the numbers of prostate cancer (PC) patients existing among a normal Japanese population with prostate-specific antigen (PSA) < 4 ng/ml. The aim of this study was to elucidate the performance of %free PSA as a screening tool for a normal Japanese population with PSA of 2-4 ng/ml and to examine the characteristics of cancer detected using this criterion. METHODS: We conducted a prospective, multi-center study to evaluate the performance of %free PSA among a normal Japanese population. We decided on a %free PSA cutoff value of 12% according to the preliminary results. A total of 5548 consecutive screening volunteers aged 50-79 years were enrolled in the project. Men with total PSA > 4 ng/ml, or men with total PSA of 2-4 ng/ml and %free PSA of < or =12% were indicated to undergo 12 core biopsies. RESULTS: There were 826 (14.9%) men with PSA of 2-4 ng/ml. Among them, those with %free PSA of < or =12% numbered 100 (12.1%). Forty-nine out of 100 men (49%) received biopsy, and 16 PC patients were detected. Among 10 patients undergoing radical prostatectomy, seven were associated with extra-prostatic extension (pT3) or high-grade cancer (Gleason score > or = 8). CONCLUSIONS: We confirmed the ability of %free PSA and demonstrated that there are considerable numbers of PC patients among the normal Japanese population with PSA of 2-4 ng/ml. We ascertained that cancers detected in this study had a variety of tumor characteristics, including those of an aggressive nature.

Nakamura Y, Suzuki T, Arai Y, Sasano H. · Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Endocr J. · Pubmed #18827407 links to  free full text

Abstract: The orphan nuclear receptor DAX1 (dosage-sensitive sex reversal-AHC critical region on the X chromosome gene 1; NR0B1) has been known for its various roles in human development, specifically sex determination and steroidogenesis. Its expression has been reported in endocrine and sex steroid-dependent neoplasms such as human adrenocortical, pituitary, endometrial, and ovarian tumors. Prostate cancer is also sex steroid-dependent tumor in which androgens play important roles in the pathogenesis and development via androgen receptor (AR). DAX1 is also reported to repress AR activity in human prostate cancer cell line (LNCaP) but its biological roles have remained unclear in the human prostate cancer. The aim of this study is to examine the expression of DAX1 in human prostate cancer using immunohistochemistry in order to evaluate its possible biological and/or clinical significance. In this study, we examined the DAX1 immunoreactivity in human prostate cancer obtained from surgery (n = 40), and correlated the findings with clinicopathological features of the patients. Twenty-one cases were defined as positive cases for DAX1 immunoreactivity (53%). Immunoreactivity for DAX1 was inversely and significantly correlated with Gleason score (P<0.05). However, DAX1 immunoreactivity was not significantly correlated with the status of sex steroid receptors we examined. DAX1 immunoreactivity is considered a new biological modulator of human prostate cancer, but independent to the status of sex steroid receptors in human prostate cancer tissues.

Namiki S, Ishidoya S, Saito S, Mitsukawa S, Suzuki Y, Numata I, Arai Y. · Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Nippon Hinyokika Gakkai Zasshi. · Pubmed #18697469 No free full text.

Abstract: PURPOSE: There were few studies which reported the longitudinal quality of life (QOL) for Japanese men who received endocrine therapy for advanced or metastatic prostate cancer. A pilot randomized trial was conducted to assess QOL and the incidence of hot flash following endocrine therapy using luteinizing hormone-releasing hormone (LH-RH) agonist goserelin acetate 1-month or 3-month depot alone in patients with advanced or metastatic prostate cancer. MATERIAL AND METHODS: A total of 28 patients with advanced or metastatic prostate cancer who received LH-RH analogue goserelin acetate depot alone for 12 months were randomized (1:1) to two different formulations. Fifteen patients received the 1-month depot and thirteen patients received 3-month depot, namely Zoladex 3.6 mg depot and Zoladex LA 10.8 mg depot, respectively. We measured health related QOL using European Organization for Research and Treatment of Cancer (EORTC) and EuroQol (EQ-5D) questionnaire and evaluated the incidence of hot flashes between the two groups for one year after diagnosis. Moreover, we evaluated the incidence of hot flashes between the 1M and 3M depot. A baseline interview was conducted before treatment. Follow-up interviews were conducted in person at scheduled study visits of 3, 6, 9 and 12 months after treatment. RESULTS: Five (18%) patients dropped out of the study. Thus, we analyzed 23 eligible patients (11 in the 1M arms and 12 in the 3M arms). No significant differences between the two treatment arms were detected in categories of age, average pre- PSA values, Gleason scores and clinical T stage. According to EORTC, each treatment group showed similar QOL scores in all domains before and after treatment. With regard to EQ-5D, the 1M-treatnent arm reported better utility scores than 3M treatment arm, which was no significant statistically. The overall incidence of hot flash was 61% (58% in 1M group and 64% in 3M group). CONCLUSION: There were no differences with regard to general and disease specific HRQOL between the both formulations of goserelin acetate. Hot flashes are the major adverse effects of endocrine therapy for Japanese patients with prostate cancer.

Orikasa K, Ito A, Ishidoya S, Saito S, Endo M, Arai Y. · Department of Urology, Tohoku University, Sendai, Miyagi, Japan. · Int J Urol. · Pubmed #18657203 No free full text.

Abstract: OBJECTIVES: To evaluate the utility of a 12-core prostate biopsy protocol including apical anterior peripheral zone (AAPZ) cores. METHODS: Between February 2002 and October 2006, 10-core and 12-core initial transrectal prostate biopsies were performed on 164 and 549 men, respectively. Two AAPZ-directed biopsies were included in the 12-core biopsy. During the same period, 12-core repeat biopsies including six AAPZ sites were performed on 118 men. RESULTS: Cancer was found in 66 cases (40.2%) in the 10-core biopsy group and in 252 (45.9%) in the 12-core biopsy group. In this latter group, 13 (5.2%) of the 252 men with positive biopsy had cancer exclusively in the AAPZ cores. When the cancer detection rate at initial biopsy in AAPZ alone was compared according to the digital rectal examination (DRE) findings, it was significantly higher in men with normal rather than abnormal DRE: 12/250 (3.4%) vs 1/185 (0.5%) (P < 0.01). In repeat 12-core biopsies, cancer was detected in 25 (21.2%) men and 9 of them (36.0%) had cancer exclusively in the AAPZ cores. The cancer detection rate from AAPZ sites was significantly higher in repeat biopsy than that in initial biopsy (P < 0.01). CONCLUSIONS: Addition of the AAPZ site-directed biopsy had greater utility in men with normal DRE and particularly in patients with a prior negative biopsy.

Saito S, Murayama Y, Pan Y, Taima T, Fujimura T, Murayama K, Sadilek M, Egawa S, Ueno S, Ito A, Ishidoya S, Nakagawa H, Kato M, Satoh M, Endoh M, Arai Y. · Department of Urology, Tohoku University, Graduate School of Medicine, Aoba-ku, Sendai, Japan. · Int J Cancer. · Pubmed #18464263 No free full text.

Abstract: In our previous study, monoclonal antibody RM2, established toward the glycosyl epitope, reflected grade of malignancy of prostate cancer cells whereas RM2 reactivity to benign glands was negative or weak. RM2 reactivity was also detected in stroma, suggesting the glycoprotein RM2 recognizes could be released into the bloodstream. Then, we explored RM2 reactivity to sera of early prostate cancer. We compared RM2 reactivity to sera between 62 patients with early prostate cancer and 43 subjects with benign prostatic disease, and examined RM2 reactivity before and after radical prostatectomy in 15 patients by Western blotting. We also examined RM2 reactivity to sera of the other urogenital cancers. RM2 reactivity was significantly enhanced on a serum glycoprotein with molecular mass approximately 40 kDa, hereby termed GPX, in the patients with early prostate cancer when compared with those with benign prostatic disease (p < 0.0001). Setting an appropriate cutoff level, RM2 reactivity to GPX for detection of prostate cancer had sensitivity of 87% and specificity of 84%, respectively. Furthermore, the level of RM2 reactivity significantly decreased after radical prostatectomy (p = 0.006). However, increased RM2 reactivity to GPX was also observed in the other urogenital cancers. The proteomics approach identified GPX as haptoglobin-beta chain and RM2 showed preferential reactivity toward haptoglobin-beta chain derived from prostate cancer when compared with polyclonal anti-haptoglobin antibody. Haptoglobin-beta chain defined by RM2 is a novel serum marker that may be useful for detection of early prostate cancer when coupled with prostate-specific antigen because it is not specific to prostate cancer.

Namiki S, Kwan L, Kagawa-Singer M, Terai A, Arai Y, Litwin MS. · Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California 90095-1738, USA. · Urology. · Pubmed #18407337 No free full text.

Abstract: OBJECTIVES: To compare the evolution of urinary dysfunction and associated distress (bother) during the first 2 years after radical prostatectomy (RP) or external beam radiation therapy (EBRT) between Japanese and U.S. men with localized prostate cancer. METHODS: A total of 477 Japanese men and 385 U.S. men with localized prostate cancer who underwent RP or EBRT participated in paired longitudinal outcomes studies. We evaluated urinary control and distress using the University of California-Los Angeles, Prostate Cancer Index and urinary irritation/obstruction using the American Urological Association Symptom Index (AUASI) before and 1, 2 to 3, 4 to 6, 8, 12, 18, and 24 months after treatment. We used general linear mixed modeling adjusting for subject characteristics to assess changes in these domains. RESULTS: Multivariate analyses revealed a nonlinear trend of recovery and an interaction between this trend and country with regard to urinary function (control) and bother after RP (both P <0.0001). Among the men who received EBRT, the recovery trend of AUASI and urinary bother also differed significantly by country (both P <0.0001). CONCLUSIONS: Japanese and U.S. men differed in their patterns of urinary recovery up to 24 months after curative therapy for localized prostate cancer.