Annual Report 2023
Department of Urology
Hitoshi Masuda, Yasukazu Nakanishi, Shugo Yajima, Madoka Kataoka, Kohei Hirose, Sao Katsumura, Ken Sekiya, Naoki Imasato
Introduction
The Department of Urological Surgery has existed as part of the Department of Pelvic Surgery at the National Cancer Center Hospital East since 2003. This department primarily treats all urogenital malignant diseases, including kidney cancer, urothelial cancer, prostate cancer, testicular germ cell tumors, and retroperitoneal sarcomas. We usually perform minimally invasive surgeries such as robotic, laparoscopic and minimum incision endoscopic surgery, while preserving the sexual and/or voiding functions in prostate cancer and organ function, especially in kidney cancer.
The Team and What We Do
1. Outpatient activities: Our outpatient clinic is open four days a week, performing flexible cystoscopy, abdominal ultrasonography, retrograde pyelography and prostate biopsy. Superficial bladder cancer (G3, cis, or recurrent tumor) after TUR-Bt is treated by instillation of BCG into the bladder. Cases of advanced urogenital cancers including metastatic prostate cancer are referred to the medical oncology division for chemotherapy or hormonal therapy. Extrinsic upper urinary tract obstructions that directly result from invasion of an adjacent malignancy or peritoneal metastasis are also treated in our department. The selection of internal stenting or percutaneous nephrostomy depends on the malignancy type and degree of obstruction. In 2023, 128 patients newly received ureteral stents and 47 underwent nephrostomy for obstructive uropathy. Moreover, 341 patients newly received insertion of markers or spacers for radiation therapy for localized prostate cancer in 2023.
2. Inpatient activities: A daily conference is held for diagnosis and treatment of patients with urological cancer. Surgeries, especially all robotic surgeries, have consistently increased over time. This year, 886 surgeries were performed in the Department of Urology. Moreover, we performed 43 combination surgeries with colorectal surgeons in 2023.
3. Other: We have a conference on urogenital cancers every other week among medical oncologists, radiation oncologists, and pathologists. Neoadjuvant chemotherapy for muscle-invasive bladder cancer, combination hormone and radiation therapy for prostate cancer, treatment strategies for metastatic renal cell carcinoma and testicular cancer, and so on are determined in the meeting.
Research Activities
1. We investigated the risk factors for the progression of high-risk superficial bladder cancer. Additionally, we investigated the resistant mechanisms of BCG therapy for high-risk superficial bladder cancer.
2. We investigated the usefulness of novel techniques in robot surgeries including radical prostatectomy and nephro-ureterctomy.
3. We are proceeding with clinical trials, including fat-derived stem cell therapy for urinary incontinence after radical prostatectomy and mobile health intervention for robot-assisted radical prostatectomy.
4. We investigated the risk factors of complications after urinary sphincter implantation.
5. We investigated the geriatric assessment in urological cancer patients.
Clinical Trials
1. A phase III study: Pirarubicin instillation after nephroureterectomy for upper tract urothelial carcinoma (JCOG1403)
2. A phase II clinical study: Pembrolizumab in high risk NMIBC unresponsive to BCG (MK-3475-057)
3. A phase III clinical study: Pembrolizumab in MIBC (MK-3475-866)
4. A phase III clinical study: Enfortumab Vedotin and Pembrolizumab in MIBC (MK-3475-905)
5. A phase III clinical study: Belzutifan and Pembrolizumab in ccRCC post nephrectomy (MK-6482-022)
6. A prospective observational study: QOL using a wearable device for SUI after radical prostatectomy
7. A prospective clinical study: Fat derived stem cell therapy for SUI after radical prostatectomy
8. A prospective clinical study: Preventive effect of drug for postoperative delirium
Education
We accepted four voluntary residents of urology in 2023 and taught urological surgery and clinical study.
Future Prospects
1. We will develop new and useful techniques for robot-assisted surgeries of the prostate, bladder and kidney.
2. We will start a multicenter clinical trial of stem cell therapy for urinary incontinence after radical prostatectomy.
3. We will develop a new two-arm transurethral surgical system for en bloc resection of bladder tumor.
4. We will develop transurethral probe of photo-immunotherapy for bladder cancer.
List of papers published in 2023
Journal
1. Nishimura N, Miyake M, Iida K, Miyamoto T, Tomida R, Numakura K, Inokuchi J, Yoneyama T, Okajima E, Yajima S, Masuda H, Terada N, Taoka R, Kobayashi T, Kojima T, Matsui Y, Nishiyama N, Kitamura H, Nishiyama H, Fujimoto K. Treatment patterns and prognosis in patients with Bacillus Calmette-Guérin-exposed high-risk non-muscle invasive bladder cancer: a real-world data analysis. World journal of urology, 42:185, 2024
2. Ogasawara RA, Okubo N, Nakanishi Y, Imasato N, Hirose K, Kataoka M, Yajima S, Ikeda K, Ito M, Masuda H. Laparoscopic total pelvic exenteration combined with transanal total mesorectal excision for locally advanced prostate cancer with rectal infiltration. IJU case reports, 7:83-86, 2024
3. Kataoka M, Yokoyama M, Waseda Y, Ito M, Kobayashi M, Fujiwara M, Nakamura Y, Ishikawa Y, Fukuda S, Tanaka H, Yoshida S, Masuda H, Fujii Y. Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy. Lower urinary tract symptoms, 16:e12507, 2024
4. Yajima S, Masuda H. The significance of G8 and other geriatric assessments in urologic cancer management: A comprehensive review . International journal of urology, 31:607-615 , 2024
5. Yajima S, Nakanishi Y, Ogasawara RA, Imasato N, Hirose K, Katsumura S, Kataoka M, Masuda H. Housework participation and mortality in Japanese male patients undergoing cancer surgery: A propensity score-matched study . Preventive medicine, 180:107896 , 2024
6. Tanabe K, Nakanishi Y, Okubo N, Matsumoto S, Umino Y, Kataoka M, Yajima S, Yoshida T, Miyazaki S, Kuwata T, Ishii G, Watanabe R, Masuda H. Prevalence and characteristics of patients with upper urinary tract urothelial carcinoma having potential Lynch syndrome identified by immunohistochemical universal screening and Amsterdam criteria II. BMC cancer, 23:940, 2023
7. Chung E, Liao L, Kim JH, Wang Z, Kitta T, Lin AT, Lee KS, Ye L, Chu P, Kaiho Y, Takei M, Jiang H, Lee J, Masuda H, Tse V. The Asia-Pacific AMS800 artificial urinary sphincter consensus statement. International journal of urology, 30:128-138, 2023
8. Nakanishi Y, Hirose K, Yasujima R, Umino Y, Okubo N, Kataoka M, Yajima S, Masuda H. Impact of perinephric fat volume and the Mayo Adhesive Probability score on time to clamping in robot-assisted partial nephrectomy. Journal of robotic surgery, 17:1485-1491, 2023
9. Yajima S, Nakanishi Y, Takenaka S, Koike Y, Odajima S, Okubo N, Umino Y, Kataoka M, Tanabe H, Masuda H. A case report of simultaneous robot-assisted nephroureterectomy and robot-assisted total laparoscopic hysterectomy. IJU case reports, 6:190-193, 2023
10. Yajima S, Fukushima H, Oda S, Yasujima R, Hirose K, Okubo N, Umino Y, Kataoka M, Nakanishi Y, Koga F, Masuda H. The significance of SARC-F scores in predicting postoperative outcomes of older adults undergoing elective major surgery for urologic cancer. Clinical nutrition (Edinburgh, Scotland), 42:1537-1544, 2023
11. Yajima S, Nakanishi Y, Hirose K, Katsumura S, Kataoka M, Masuda H. Simultaneous robot-assisted laparoscopic radical prostatectomy and inguinal hernia repair using a polypropylene mesh: Report of two cases. IJU case reports, 6:318-320, 2023
12. Tanabe K, Nakanishi Y, Okubo N, Umino Y, Kataoka M, Yajima S, Masuda H. Association of the Controlling Nutritional Status Score with the Development of Postoperative Paralytic Ileus After Radical Cystectomy: Retrospective Cohort Study. Urology research & practice, 49:184-190, 2023
13. Yasujima R, Nakanishi Y, Hirose K, Umino Y, Okubo N, Kataoka M, Yajima S, Masuda H. Control of bleeding from a recurrent tumor at a uretero-ileal anastomosis by electrocoagulation via an ileal conduit. IJU case reports, 6:334-336, 2023
14. Yajima S, Nakanishi Y, Hirose K, Kataoka M, Masuda H. Use of a lockable pigtail catheter (Cook Dawson-Mueller Multipurpose Drainage Catheter) for nephrostomy reduces the risk of slippage of the catheter. Surgical Practice, 28:27-31, 2023
15. Yajima S, Nakanishi Y, Matsumoto S, Okubo N. Ability of clock drawing errors on Mini-Cog test to predict development of delirium after major urological cancer surgery. Current Urology, 30:2023
16. Yajima S, Nakanishi Y, Matsumoto S, Okubo N, Tanabe K, Kataoka M, Masuda H. Repair Technique of Indirect Inguinal Hernia Without Mesh Concomitant with Radical Retropubic Prostatectomy: a Report of Three Cases. Indian Journal of Surgery, 2023