Publications by authors named "Ryotaro Tomida"

Introduction: Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.

Case Presentation: A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass.

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Objectives: To evaluate the effects of renal impairment at the time of second-line tyrosine kinase inhibitor (TKI) therapy initiation and rapid renal function decline during first-line immuno-oncology (IO) combination therapy on metastatic renal cell carcinoma (mRCC) patients treated with second-line TKIs.

Methods: This multicenter retrospective study included 243 mRCC patients treated with first-line IO combination therapy, followed by second-line TKI therapy. Patients were divided into three groups using the estimated glomerular filtration rate (eGFR; mL/min/1.

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Background: Looping blood vessels in robot-assisted surgery remains challenging because of limitations in instrument articulation, joint length, and the lack of tactile feedback. To address this critical issue, we developed the Vas Guide, a novel device, for safe blood vessel handling. This study aims to establish the efficacy, safety, and durability of the Vas Guide.

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Radical surgery is effective for localized renal cell carcinoma (RCC). However, recurrence occurs in up to 40% of patients, underscoring the need for adjuvant therapy to improve the prognosis. Historically, adjuvant treatments, including tyrosine kinase inhibitors, have shown limited success, failing to improve overall survival.

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Introduction: Effectiveness and safety of second-line tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC) for whom first-line immuno-oncology (I-O) combination therapy was discontinued because of adverse events (AEs) remain to be determined.

Patients And Methods: Clinicopathological data were retrospectively collected from 34 institutions between August 2018 and January 2022 for 243 patients with mRCC who received second-line TKIs after first-line I-O combination therapy. Two patients who requested discontinuation of first-line I-O combination therapy were excluded.

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Objective: To evaluate the real-world clinical usage and effectiveness of apalutamide in men with nonmetastatic castration-resistant prostate cancer (nmCRPC).

Methods: We retrospectively reviewed the data of 186 men who received apalutamide across 17 institutions. The primary outcomes were the clinical usage of apalutamide for nmCRPC: prior usage of other androgen receptor signaling inhibitors (ARSIs), prior radical treatment, and the distribution of the prostate-specific antigen (PSA) doubling time (PSA-DT) at the initial administration of apalutamide.

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Introduction: Immune-related adverse events (irAEs) induced by immune checkpoint inhibitors are difficult to predict and can lead to severe events. Although it is important to develop strategies for the early detection of severe irAEs, there is a lack of evidence on irAEs associated with ipilimumab plus nivolumab therapy for metastatic renal cell carcinoma (RCC). Therefore, this study aimed to investigate the association between eosinophil and severe irAEs in patients receiving ipilimumab plus nivolumab therapy for RCC.

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Background: In Japan, since 2014, new treatments such as androgen receptor signaling inhibitors and cabazitaxel have become applicable for metastatic castration-resistant prostate cancer (mCRPC), leading to dramatic changes in treatment options.

Objective: This study aims to evaluate the impact of recent advancements in treatment options on the overall survival (OS) of patients diagnosed with de novo metastatic castration-sensitive prostate cancer (mCSPC) in Japan.

Methods: A retrospective analysis was conducted on 2450 Japanese men diagnosed with de novo mCSPC between 2008 and 2018.

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Nivolumab plus ipilimumab (NIVO+IPI) has a long-term response rate of 30% for patients with metastatic renal cell carcinoma (mRCC). However, 20% of patients develop primary resistant disease (PRD) to NIVO+IPI and show poor survival outcomes. In this study, we aimed to evaluate the effect of PRD as a second-line treatment in patients with mRCC.

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Background: The aim of this study was to evaluate the differences in perioperative outcomes between transperitoneal and retroperitoneal techniques in cutaneous ureterostomy (CUS).

Methods: Between 2018 and 2023, 55 patients underwent CUS following robot-assisted radical cystectomy. Among the 55 patients, we compared 33 patients who underwent transperitoneal CUS (t-CUS) and 22 who underwent retroperitoneal CUS (r-CUS).

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Introduction: One of the factors that makes robot-assisted nephroureterectomy difficult is that the optimal port position differs between nephrectomy and bladder cuff excision. In addition, how best to retrieve the specimen after resection while minimizing the size of the wound is a challenge in robot-assisted surgery. To solve these problems, we designed a surgical technique for robot-assisted nephroureterectomy using the GelPoint Platform with a focus on port position optimization and specimen retrieval.

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Introduction: Pretreatment hemoglobin and neutrophil levels were previously reported to be important indicators for predicting the effectiveness of ipilimumab plus nivolumab (IPI + NIVO) therapy for renal cell carcinoma (RCC). Therefore, we aimed to validate this in a large external cohort.

Methods: In total, 172 patients with RCC who underwent IPI + NIVO treatment at a multicenter setting were divided into three groups according to their pretreatment hemoglobin and neutrophil levels (group 1: non-anemia; group 2: anemia and low-neutrophil; and group 3: anemia and high-neutrophil).

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Introduction: The aim of this study was to evaluate the differences in perioperative outcomes of cutaneous ureterostomy (CUS) between open surgery (open radical cystectomy, ORC) and robot-assisted surgery (robot-assisted radical cystectomy, RARC), including the stent-free rate, readmission rates due to urinary tract infection (UTI), and changes in renal function.

Methods: Between 2005 and 2023, a total of 37 patients underwent CUS following ORC, while 24 patients underwent CUS following RARC. Perioperative outcomes were compared between these two groups.

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Article Synopsis
  • * A total of 383 patients were analyzed, revealing that those with persistent PSA levels post-surgery had significantly shorter castration resistance-free survival (CRFS) and metastasis-free survival (MFS) compared to those with non-persistent levels.
  • * The findings suggest that stratifying patients by PSA levels can help tailor postoperative treatment, with patients experiencing better outcomes when receiving a combination of androgen deprivation therapy and radiotherapy if their PSA levels are high.
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  • A multicenter study in Japan analyzed 515 patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) to determine the best PSA doubling time (PSADT) cut-off for prognosis.
  • The study found that a PSADT of less than 4.65 months is a significant predictor for overall survival (OS) and cancer-specific survival (CSS), indicating worse outcomes.
  • Patients receiving novel hormonal therapy (NHT) had better progression-free survival (PFS) compared to those on older treatments, highlighting the benefits of newer treatment options.
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  • The Hinotori surgical robotic system, known for its docking-free design, aims to reduce abdominal wall stress during robotic-assisted radical prostatectomy (RARP).
  • A study compared 94 patients, with 48 using Hinotori and 46 using the da Vinci Xi, finding that the Hinotori group experienced longer surgery times but similar complication rates.
  • Postoperative pain reduction may be linked to the Hinotori's design, as indicated by a marginally significant decline in pain scores four days post-surgery.
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Purpose: Our study aimed to compare the surgical outcomes of robot-assisted partial nephrectomy (RAPN) between younger and older patients after adjusting for their background differences. We particularly assessed RAPN outcomes and safety in older patients.

Methods: We retrospectively evaluated 559 patients clinically diagnosed with T1 renal cell carcinoma (RCC) and treated with RAPN between 2013 and 2022 at five institutions in Japan.

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Article Synopsis
  • This study compared the effectiveness of two second-line treatments, cabozantinib and axitinib, for patients with metastatic clear cell renal cell carcinoma (ccRCC) who previously received nivolumab-ipilimumab therapy.
  • A total of 48 patients were treated with cabozantinib and 60 with axitinib, revealing a median progression-free survival (PFS) of 11.0 months for cabozantinib and 9.5 months for axitinib, with overall response rates being quite similar (37.5% vs. 38.3%).
  • Although both treatments had comparable safety profiles, cabozantinib showed improved efficacy in patients considered to have poor-risk characteristics, suggesting it
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Introduction: This study was performed to evaluate the differences in the perioperative results, renal function, and incidence of hydronephrosis over time between the use of Bricker anastomosis and Wallace anastomosis for robot-assisted intracorporeal ileal conduit urinary diversion (RICIC).

Methods: Fifty-five patients who underwent RICIC at two institutions were evaluated (Bricker, n = 23; Wallace, n = 32). We investigated changes in estimated glomerular filtration rate and hydronephrosis before surgery and at 3, 6, and 12 months after surgery.

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This study was performed to clarify the therapeutic and diagnostic roles of lymph node dissection (LND) by examining the impact of LND and lymph node yield (LNY) on oncological outcomes in patients undergoing robot-assisted radical cystectomy (RARC). Between 2014 and 2021, 216 patients underwent LND during RARC at Tokushima University Hospital and affiliated hospitals. Among the 216 patients, we compared 115 patients with an LNY of ≥ 20 and 101 with an LNY of < 20 to investigate the impact of LNY on surgical and oncological outcomes.

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Purpose: The International Bladder Cancer Group designated the subgroup that is resistant to Bacillus Calmette-Guérin (BCG) but does not meet the criteria for BCG-unresponsive NMIBC as "BCG-exposed high-risk NMIBC" to guide optimal trial design. We aimed to investigate the treatment patterns and prognoses of patients with BCG-exposed NMIBC.

Methods: We conducted a retrospective chart review of 3283 patients who received intravesical BCG therapy for NMIBC at 14 participating institutions between January 2000 and December 2019.

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Article Synopsis
  • This study created a prognostic model to predict disease recurrence in patients with lymph node involvement but no ongoing PSA levels.
  • Researchers analyzed data from 231 patients who underwent surgery between 2006 and 2019, identifying key factors affecting recurrence-free survival (RFS).
  • The model, which includes parameters like initial PSA level and surgical margin status, is said to aid in treatment discussions with patients.
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  • The study evaluated the outcomes for patients with metastatic renal cell carcinoma (mRCC) who received second-line targeted kinase inhibitors (TKIs) after first-line immunotherapy (IO), comparing different therapy groups.
  • A total of 243 mRCC patients were analyzed, revealing similar response rates and progression-free survival (PFS) periods between the two therapy groups, indicating no significant differences in outcomes.
  • Non-clear cell renal cell carcinoma (non-CCRCC), high C-reactive protein (CRP), and low albumin levels were identified as key independent prognostic factors for poor PFS and overall survival (OS), allowing for the development of a more accurate risk classification system for these patients.
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Objective: Several guidelines recommended that second transurethral resection should be performed in patients with diagnosis of high-risk non-muscle-invasive bladder cancer. However, therapeutic benefits of second transurethral resection before bacillus Calmette-Guérin intravesical instillation were conflicting amongst previous studies. We investigated the prognostic impact of second transurethral resection before bacillus Calmette-Guérin instillation in high-risk non-muscle-invasive bladder cancer patients.

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Objective: The aim of the present study was to identify factors related to the success of trial without catheter (TWOC) in patients with stroke and to examine the effect of the timing of urinary catheter removal on the course of stroke.

Methods: Patients who were admitted to the Stroke Care Unit of our institution between March 2018 and October 2021 were included. To identify factors related to success of TWOC, a multivariate analysis was performed on the patient's condition at admission and catheter indwelling time.

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