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  • 1
    Electronic Resource
    Electronic Resource
    Evidence-based meta-analysis of pharmacotherapy for benign prostatic hypertrophy (2002)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 9 (2002), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Evidence-based diagnosis and treatment have been proposed recently in various medical fields. Evidence-based diagnostic and therapeutic guidelines for benign prostatic hypertrophy (BPH), one of the most common urological diseases, have been proposed in foreign countries. This paper examines common therapeutic drugs for BPH in Japan from the viewpoint of evidence-based medicine (EBM).The term ‘BPH’ and drugs indicated for BPH were used as key words to search related articles in the PubMed website. A total of 813 articles extracted as of October 2001 were examined. The articles were ranked in levels ranging from I–V, where Level I indicated a large randomized controlled trial and Level V indicated a non-controlled case accumulation study.Among the 813 articles extracted, 132 clinical articles were suitable for evaluation. There were many reliable articles on the effectiveness of α-blockers. However, it seemed necessary to examine further how to choose the optimum α-blocker for each clinical case and the combination of antiandrogen drugs with α-blockers. It was also considered necessary to evaluate the effectiveness of drugs, such as eviprostat and hachimi-jio-gan, that are available only in Japan.The present study evaluated the effectiveness of commonly available therapeutic drugs for BPH in Japan from a viewpoint of EBM.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.2002.00539.x
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  • 2
    Electronic Resource
    Electronic Resource
    Endocrine therapy with or without radical prostatectomy for T1b-T3N0M0 prostate cancer (2004)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 11 (2004), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: We retrospectively compared the 5-year survival rates of T1b-T3N0M0 prostate cancer patients treated either by endocrine therapy plus radical prostatectomy or endocrine therapy alone.Methods: Clinical T1b-T3N0M0 prostate cancer patients were enrolled at 104 institutions in Japan. They were assigned to study 1 (n = 176), if they were indicated to prostatectomy, if not indicated, they were assigned to study 2 (n = 151). The indication of prostatectomy was based on the clinical judgement of physicians and/or patients. Those assigned to study 1 underwent prostatectomy and adjuvant endocrine therapy with or without preoperative androgen deprivation. Those assigned to study 2 were treated with leuprorelin acetate with or without chlormadinone acetate. They were followed-up every 3 months until death or for 5 years and over.Results: Those assigned to study 1 were younger (mean age 67.2 vs 75.7 years), less advanced in clinical stage, and had lower prostate specific antigen levels (mean 43.8 vs 103.6 ng/mL). Death for any reason was observed less frequently in study 1 (n = 29, 16%) than study 2 (n = 50, 33%), and the 5-year overall survival rate was higher in study 1 (87 vs. 68%). However, prostate cancer deaths were comparatively seldom (9% in study 1 and 7% in study 2), resulting in the identical 5-year cause specific survival rate in both study groups (91%). In both study groups the overall survival was almost equal to the natural survival of age-matched men.Conclusions: Endocrine therapy offers a reasonable survival rate in T1b-T3 prostate cancer patients within a 5-year follow-up. Observation will be extended to determine 10-year outcomes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2003.00781.x
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  • 3
    Electronic Resource
    Electronic Resource
    Preoperative Endocrine Therapy for Clinical Stage A2, B, and C Prostate Cancer: An Interim Report on Short-Term Effects (1997)
    Oxford, UK : Blackwell Publishing Ltd
    International journal of urology 4 (1997), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Preoperative endocrine therapy has been suggested to improve surgical radicality and/or patient prognosis in prostate cancer. Methods Patients with clinical stage A2, B, and C prostate cancer were randomized to either group I (n = 113) or group II (n = 111). Croup I patients were to receive preoperative endocrine therapy consisting of leuprolide and chlormadinone for 3 months, followed by radical prostatectomy with lymph node dissection. Group II patients were to undergo the surgery before endocrine therapy. Results: Group I patients showed a remarkable decrease in prostate-specific antigen (PSA) (mean ± SE: 41.8 ± 8.6ng/mL to 2.7 ± 0.7 ng/mt) and prostate volume (29.8 ± 1.7 mL to 21.2 ± 1.6 mL) during the preoperative therapy. Histopathologic analysis showed a significant difference in the rates of down-staging (19.1 % in group I versus 3.3% in group II), positive surgical margins (63.8% versus 81.3%) and positive lymph node metastasis (20.7% versus 36.5%). No significant difference was detected in operating features. Subgroup analyses indicated that beneficial effects were correlated positively with degree of histologic differentiation and negatively with the basal PSA level. Conclusions Preoperative endocrine therapy reduced local extention of prostate cancer, and the effects depended on histologic differentiation and PSA level. Long-term follow-up data are needed to determine the effects on the patient prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.1997.tb00161.x
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  • 4
    Electronic Resource
    Electronic Resource
    Early results of radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation (1999)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 6 (1999), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The effects of preoperative androgen deprivation were explored in the patients who received radical prostatectomy and subsequent adjuvant endocrine therapy for prostate cancer. Methods: Stage A2, B or C prostate cancers were randomized to one of two groups: (i) group I (n = 90), who received androgen deprivation (leuploride and chlormadinone acetate) for 3 months preoperatively followed by radical prostatectomy and adjuvant endocrine therapy (leuploride only); and (ii) group II (n = 86), who underwent the surgery followed by 3 month androgen deprivation and subsequent adjuvant endocrine therapy. The effects of preoperative androgen deprivation on clinical relapse (serum prostate specific antigen (PSA) 〉 1.98 ng/mL, local recurrence or distant metastasis) and PSA relapse (PSA 〉 0.2 ng/mL) were evaluated at 2 years after randomization. Results: There was no significant difference in clinical or PSA relapse-free survival and quality of life measures between the two groups, although relapses occurred significantly more frequently in patients who had more advanced stages, higher pretreatment PSA values or lower histologic differentiation in either group. Subgroup analysis indicated that clinical relapse-free survival in stage C cancer tended to be better in patients with preoperative androgen deprivation than in those patients without it (P 〈 0.1). Conclusions: Preoperative androgen deprivation may be beneficial for stage C prostate cancer patients receiving radical prostatectomy and adjuvant endocrine therapy over the 2 year observation period. A longer follow up is needed to clarify the exact extent of benefit in terms of survival and quality of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.1999.00050.x
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  • 5
    Electronic Resource
    Electronic Resource
    Chromophobe cell renal carcinoma with acquired cystic disease of the kidney in a long-term hemodialysis patient (2003)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 10 (2003), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract We report a rare case of chromophobe cell renal carcinoma found in a 52-year-old female who had received hemodialysis therapy for 13 years. She was diagnosed as having a left renal tumor 7.5 cm in diameter with acquired cystic disease of the kidney (ACDK) by ultrasonographic examination during periodical systemic screening. As abdominal computed tomography scanning and enhanced color Doppler ultrasonography suspected that the hypervascular tumor was renal cell carcinoma, she underwent translumbar nephrectomy in July 2000. The histopathological diagnosis was chromophobe cell carcinoma with pT2 and grade 2 malignancy. Chromophobe cell carcinoma is uncommon among renal tumors with ACDK found in long-term hemodialysis patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.2003.00573.x
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  • 6
    Electronic Resource
    Electronic Resource
    Transurethral needle ablation of the prostate: An initial Japanese clinical trial (2001)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 8 (2001), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Objectives: Transurethral needle ablation of the prostate is a new alternative endoscopic thermal therapy that uses a low-energy radio frequency delivered into the prostatic adenoma. Herein is reported the initial clinical experience by multiple institutes in Japan of transurethral needle ablation of the prostate for the treatment of symptomatic benign prostatic hyperplasia.Methods: A total of 93 patients were treated with this technique. Transurethral needle ablation of the prostate was generally performed under low-spinal anesthesia. Before and after the procedure, international symptom score (IPSS), quality of life (QOL) score, peak urinary flow rate (Qmax), postvoid residual urine volume and prostate size were evaluated.Results: There was a reduction of IPSS of more than 50% when compared with that of pretreatment, being 51.3% (57/93 patients) and 60.2% (56/93 patients) at 3 months and 6 months after the procedure, respectively. Sixty-seven patients who were available for a 12-month follow-up period demonstrated a markedly decreased mean IPSS when compared with that measured before the treatment for a statistically significant difference (P 〈 0.01). Fifty-eight patients who were available for uroflowmetric study at 12 months exhibited a notably increased mean Qmax of 11.2 ± 4.5 mL/s, which was a statistically significant increase when compared with that found before treatment (P 〈 0.05). Although all patients suffered some degree of gross hematuria after the procedure, none of them required any specific treatment for complications.Conclusion: Transurethral needle ablation technique for the treatment of symptomatic benign prostatic hyperplasia is safe and effective. However, a much longer follow-up study is essential for fully evaluating the extended effectiveness of this technique.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.2001.00260.x
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  • 7
    Electronic Resource
    Electronic Resource
    Intrarenal pelvic papillary Wilms’ tumor associated with aniridia: A case report (1999)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 6 (1999), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Intrarenal pelvic Wilms’ tumor in a papillary growth is rare in children. A case of a two-year-old infant with Wilms’ tumor associated with congenital aniridia is reported. Results: A chromosomal abnormality (11p13 deletion) was found in this patient. The tumor was well evaluated by ultrasonography, computed tomography and magnetic resonance imaging. Discussion: Previous case reports are briefly reviewed and the clinical characteristics disclosed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.1999.00075.x
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  • 8
    Electronic Resource
    Electronic Resource
    Urinary nuclear matrix protein 22 as a new marker for the screening of urothelial cancer in patients with microscopic hematuria (1999)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 6 (1999), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Purpose: The aim of the present study was to determine the clinical usefulness of nuclear matrix protein 22 (NMP22) as a new urinary marker for the screening of urothelial cancer in patients with microscopic hematuria, especially in comparison with that of voided urine cytology.Methods: Patients with microscopic hematuria detected at a health examination, who were advised by a consulted urologist to have a cystoscopical examination, were asked to enter this study. Urine samples were collected before cystoscopy and divided into two portions for a NMP22 test and voided urine cytology.Results: Of the 309 patients with microscopic hematuria, 22 cases (7.1%) of urothelial cancer and one case of prostate cancer were detected. For the other cases, 128 (41.4%) were of benign diseases and 158 (51.1%) were designated as having no evidence of disease (NED). The median NMP22 values for urothelial cancer, other diseases and NED were 35.5, 6.7 and 6.0 U/mL, respectively, with 95% confidence intervals of 19.9–228.2, 5.1–9.3 and 5.4–7.2, respectively. The sensitivity of the NMP22 test for urothelial cancer was 90.9% (20/22), whereas the sensitivity of voided urine cytology was only 54.5% (12/22).Conclusions: The present study indicates that urinary NMP22 is a useful tool for the screening of urothelial cancer in patients with microscopic hematuria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.1999.06437.x
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  • 9
    Electronic Resource
    Electronic Resource
    Radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation: Five-year results (2004)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 11 (2004), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The effects of preoperative androgen deprivation on the outcomes of prostate cancer patients who received radical prostatectomy and subsequent adjuvant endocrine therapy have not yet been fully evaluated.Methods: Patients with stage A2, B or C prostate cancers were randomized to one of two groups: group I (n = 90), who received androgen deprivation (leuprolide and chlormadinone acetate) for 3 months followed by radical prostatectomy and subsequent adjuvant endocrine therapy (leuprolide alone), and group II (n = 86), who underwent the surgery followed by 3-month androgen deprivation (leuprolide and chlormadinone acetate) and subsequent adjuvant endocrine therapy (leuprolide alone). The effects of preoperative androgen deprivation on survival, clinical relapse (serum prostate specific antigen, PSA, above the normal level, local recurrence, or distant metastases), and PSA relapse (PSA above the detectable level) were evaluated at 5 years or later after treatment.Results: There were no significant differences in overall, cause-specific, clinical relapse-free, or PSA relapse-free survival rates between the two groups. In a subanalysis, no prostate cancer deaths or clinical relapses were noted in 29 patients with organ-confined disease (OCD: negativity of capsular invasion, seminal vesicle invasion, surgical margins or nodal involvement). The odds ratio for OCD depending on group assignment was 2.44 (95% confidence interval, CI 1.04–5.72), for group I, demonstrating a higher probability of having OCD. This ratio was increased to 4.00 (95% CI 1.06–15.16) if the analysis was conducted in a subpopulation with prostate specific antigen levels less than 35.6 ng/mL and with clinical stage B or C cancers.Conclusion: Preoperative androgen deprivation has no demonstrable benefit in 5-year outcomes for patients undergoing radical prostatectomy and adjuvant endocrine therapy. However, it did increase the probability of OCD, which was associated with no clinical relapse during the follow-up. A longer observation is needed to clarify the exact extent of the benefits in terms of survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2004.00795.x
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  • 10
    Electronic Resource
    Electronic Resource
    Alpha-blocker test: Alternative to pressure–flow study of bladder outlet obstruction and detrusor contractility in patients without an enlarged prostate (2004)
    Melbourne, Australia : Blackwell Publishing Ltd.
    International journal of urology 11 (2004), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Objectives:  We investigated whether the cause of urinary disturbance in men with a prostate volume ≤20 mL can be determined by analyzing the efficacy of α1-adrenoceptor antagonist (alpha-blocker) treatment.Methods:  Thirty-five men who were 〉50 years of age, with an International Prostate Symptom Score (IPSS) ≥8 points, a quality of life (QOL) index ≥2 points and a prostate volume ≤20 mL were enrolled in the non-enlarged prostate group. Twenty-six men who met the above conditions but who had a prostate volume 〉20 mL served as controls. The α1-adrenoceptor antagonist tamsulosin was administered at a dose of 0.2 mg/day for 4 weeks. Results for the IPSS, QOL index, free flowmetry and pressure–flow studies were obtained before and after tamsulosin administration.Results:  In both groups, tamsulosin improved the IPSS and QOL index and the bladder outlet obstruction index (BOOI) was lowered without reducing the bladder contractility index (BCI). No parameter showed a significant difference in treatment efficacy between the two groups. In the non-enlarged prostate group, both the pretreatment BOOI and BCI correlated with the efficacy of treatment in improving maximum flow rate (Qmax). In the enlarged prostate group, BOOI and BCI did not correlate with Qmax. When Qmax was improved by ≥3.5 mL/s, the positive predictive value for both pretreatment BOOI 〉40 and BCI 〉100 was 100% in the non-enlarged prostate group.Conclusions:  The alpha-blocker test is one method to assess the presence of bladder outlet obstruction and the state of detrusor contractility in men without an enlarged prostate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2004.00737.x
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