Japanese Journal of Clinical Oncology

Lin, Che; Chien, Su-Yu; Kuo, Shou-Jen; Chen, Li-Sheng; Chen, Shou-Tung; Lai, Hung-Wen; Chang, Tsai-Wang; Chen, Dar-Ren

doi: 10.1093/jjco/hyr196pmid: 22287721

ObjectiveThis study aimed to investigate whether triple-negative breast cancer has a worse prognosis; here, we present the 10-year follow-up results of triple-negative breast cancer patients in Taiwan.MethodsWe identified 2858 breast cancer patients in Taiwan, of whom 416 (14.6%) had triple-negative breast cancer. Data used for analysis were derived from those breast cancer patients who were diagnosed between January 1996 and December 2006.ResultsIn the Kaplan–Meier analysis, tumor subgroup (triple-negative breast cancer vs. non-triple-negative breast cancer) was a prognostic factor related to 10-year breast cancer death-specific survival and disease-free survival. The results of univariate analysis showed that tumor subgroup was a significant factor related to 10-year disease-free survival and breast cancer death-specific survival, as well as menopausal status, tumor size, lymph node, metastasis, grade, stage, estrogen receptor status, progesterone receptor status and her2/neu gene expression status. Similarly, the multivariate analysis also revealed that tumor subgroup was a significant factor related to 10-year breast cancer death-specific survival and disease-free survival, in addition to tumor size, lymph node, metastasis and grade.ConclusionsIt was suggested that triple-negative breast cancer patients in Taiwan have worse 10-year survival. Notably, in node-positive patients, triple-negative breast cancer played a prognostic role in 10-year breast cancer death-specific survival.

Tamaki, Kentaro; Ishida, Takanori; Miyashita, Minoru; Amari, Masakazu; Ohuchi, Noriaki; Kamada, Yoshihiko; Uehara, Kano; Tamaki, Nobumitsu; Sasano, Hironobu

doi: 10.1093/jjco/hyr197pmid: 22217577

ObjectiveWe evaluated ultrasonographic findings and the corresponding histopathological characteristics of breast cancer patients with Breast Imaging Reporting and Data System (BI-RADS) category 1 mammogram.MethodsWe retrospectively reviewed the ultrasonographic findings and the corresponding histopathological features of 45 breast cancer patients with BI-RADS category 1 mammogram and 537 controls with mammographic abnormalities. We evaluated the ultrasonographic findings including mass shape, periphery, internal and posterior echo pattern, interruption of mammary borders and the distribution of low-echoic lesions, and the corresponding histopathological characteristics including histological classification, hormone receptor and human epidermal growth factor receptor 2 status of invasive ductal carcinoma and ductal carcinoma in situ, histological grade, mitotic counts and lymphovascular invasion in individual cases of BI-RADS category 1 mammograms and compared with those of the control group.ResultsThe ultrasonographic characteristics of the BI-RADS category 1 group were characterized by a higher ratio of round shape (P< 0.001), non-spiculated periphery (P= 0.021), non-interruption of mammary borders (P< 0.001) and non-attenuation (P= 0.011) compared with the control group. A total of 52.6% of low-echoic lesions were associated with spotted distribution in the BI-RADS 1 group, whereas 25.8% of low-echoic lesions were associated with spotted distribution in the control group (P= 0.012). As for histopathological characteristics, there was a statistically higher ratio of triple-negative subtype (P= 0.021), and this particular tendency was detected in histological grade 3 in the BI-RADS category 1 group (P= 0.094).ConclusionWe evaluated ultrasonographic findings and the corresponding histopathological characteristics for BI-RADS category 1 mammograms and noted significant differences among these findings in this study. Evaluation of these ultrasonographic and histopathological characteristics may provide a more accurate ultrasonographic screening system for breast cancer in Japanese women.

Tada, Yukio; Matsubara, Mei; Kawada, Satoshi; Ishida, Mayumi; Wada, Makoto; Wada, Tomomi; Onishi, Hideki

doi: 10.1093/jjco/hyr200pmid: 22259217

ObjectiveIn cancer patients, adjustment disorders, delirium and depression have been identified as common psychiatric disorders. Although a comparable result was reported in the National Cancer Center in Japan, the nature of patients in that hospital may differ from that in local hospitals. There is a possibility to expand the findings of psycho-oncology by evaluation of the data from a local university hospital and comparison with the National Cancer Center data.MethodsWe retrospectively reviewed the medical records of cancer patients who were referred to the Department of Psycho-Oncology at Saitama Medical University International Medical Center. We identified their characteristics and psychiatric diagnoses and compared these with the National Cancer Center data.ResultsDuring the study period, 765 cancer patients were referred. The numbers of inpatients and outpatients were almost the same. The most common psychiatric diagnosis was adjustment disorders (24%), followed by delirium (16%) and then major depressive disorder (12%). The rank of these three was the same as that at the National Cancer Center. Outpatients constituted more than 80% of the patients with major depressive disorder. The proportion of cancer patients with schizophrenia in this study (4.3%) was higher than that in the National Cancer Center (1.6%).ConclusionsThis study revealed basic information about the consultation data of cancer patients at a local university hospital in Japan. The importance of communication with outpatients was suggested. It seems that cancer treatment for patients with schizophrenia in a local hospital is also important.

He, Shiming; Deng, Jianping; Li, Gang; Wang, Boliang; Cao, Yizhan; Tu, Yanyang

doi: 10.1093/jjco/hyr195pmid: 22217575

ObjectiveHuman neural precursor cell-expressed developmentally down-regulated 4 like (Nedd4L), a ubiquitin protein ligase, is expressed by various cancer cells and might have an oncogenic property. Its expression pattern in glioma tissues is unknown. Therefore, the aim of this study was to investigate whether Nedd4L is present in glioma and to evaluate the correlation of Nedd4L expression with the progression and prognosis of the disease.MethodsImmunohistochemistry and western blot were used to investigate the expression of Nedd4L protein in 128 patients with gliomas.ResultsImmunohistochemistry showed a strong-to-weak range of Nedd4L staining with increasing pathologic grade of glioma (P < 0.001), which was in line with the results from western blot analysis. In addition, a non-parametric analysis revealed that the attenuated Nedd4L expression was significantly correlated with a large tumor diameter (P = 0.02), low Karnofsky performance score (P = 0.008), frequent intra-tumor necrosis (P = 0.01) and worse overall survival (P = 0.009). Furthermore, multivariate analysis showed that Nedd4L expression (P = 0.02) and intra-tumor necrosis (P = 0.03) were two important independent prognostic factors identified by the Cox proportional hazards model.ConclusionsOur results provide convincing evidence for the first time that the expression of Nedd4L is down-regulated in human gliomas. The glioma patients with lower Nedd4L expression have a worse prognosis.

Hoshino, Katsura; Kikuchi, Eiji; Tanaka, Nobuyuki; Akita, Hirotaka; Ito, Yujiro; Miyajima, Akira; Jinzaki, Masahiro; Oya, Mototsugu

doi: 10.1093/jjco/hyr199pmid: 22246718

ObjectivePartial or complete urinary obstruction caused by a tumor itself may affect renal function and the eligibility for perioperative cisplatin-based chemotherapy in patients with upper tract urothelial carcinoma. We investigated whether the status of preoperative hydronephrosis provides additional predictive information concerning changes in perioperative renal function.MethodsA total of 155 patients who underwent nephroureterectomy for upper tract urothelial carcinoma from 1997 to 2010 were identified. The association between preoperative parameters including the grade of hydronephrosis and perioperative renal function was analyzed.ResultsHydronephrosis was observed in 104 patients. The grade of hydronephrosis was 1, 2, 3 and 4 in 6 (3.9%), 25 (16.1%), 42 (27.1%) and 31 (20.0%) cases. Using a defined cut-off creatinine clearance value of ≥50 ml/min indicating eligibility for cisplatin-based chemotherapy, only 94 patients (60.6%) were eligible in the neoadjuvant setting. Of these 94 patients, 30 (31.9%) were judged to be ineligible in the adjuvant setting. Multivariate analysis demonstrated that patient age ≥70 years [P < 0.001, hazard ratio (HR) 27.9] and the absence of a higher grade hydronephrosis (P = 0.013, HR 7.40) were independent risk factors for predicting patients ineligible to receive adjuvant cisplatin-based chemotherapy. The proportion of patients ineligible to receive cisplatin-based chemotherapy changed from 40.9 to 88.6% following nephroureterectomy in patients aged ≥70 years and those with no or a lower grade hydronephrosis.ConclusionsThe status of hydronephrosis is an independent predictor of eligibility to receive adjuvant cisplatin-based chemotherapy. The information on preoperative hydronephrosis and patient age may assist in part of the decision-making when considering neoadjuvant cisplatin-based chemotherapy.

Tanaka, Keitaro; Tsuji, Ichiro; Tamakoshi, Akiko; Matsuo, Keitaro; Ito, Hidemi; Wakai, Kenji; Nagata, Chisato; Mizoue, Tetsuya; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; , ; Tsugane, Shoichiro; Inoue, Manami; Sasazuki, Shizuka; Iwasaki, Motoki; Otani, Tetsuya; Sawada, Norie; Shimazu, Taichi; Tsuji, Ichiro; Tsubono, Yoshitaka; Nishino, Yoshikazu; Tamakoshi, Akiko; Matsuo, Keitaro; Ito, Hidemi; Wakai, Kenji; Nagata, Chisato; Mizoue, Tetsuya; Tanaka, Keitaro

doi: 10.1093/jjco/hyr198pmid: 22241822

ObjectiveWith increased interest in non-alcoholic steatohepatitis, its common co-morbid condition, obesity, has recently attracted much attention as a risk factor for liver cancer. Recent studies also suggest that obesity may play a role in the development of liver cancer in alcoholic cirrhosis or viral hepatitis and in the general population.MethodsWe systematically reviewed epidemiologic studies on overweight/obesity and liver cancer among Japanese populations. Original data were obtained by searching the MEDLINE (PubMed) and Ichushi databases, complemented by manual searches. The evaluation was performed in terms of the magnitude of association in each study and the strength of evidence (‘convincing’, ‘probable’, ‘possible’ or ‘insufficient’), together with biologic plausibility.ResultsAmong nine cohort studies identified, five (four on patients with chronic liver disease and one on local residents) reported a weak to strong positive association, while four (one on patients with hepatitis B and three on local residents) found no association [summary relative risk for one unit increase in body mass index (kg/m2) 1.07, 95% confidence interval 1.03–1.10]. All three case–control studies identified (two on cirrhotic patients and one on atomic bomb survivors) reported a strong positive association (summary relative risk 1.31, 95% confidence interval 1.12–1.53). Overall, the summary relative risk was estimated at 1.13 (95% confidence interval 1.07–1.20), and overweight/obese individuals had a relative risk of 1.74 (95% confidence interval 1.33–2.28) compared with those who had normal/low weight.ConclusionsWe conclude that overweight or obesity ‘probably’ increases the risk of primary liver cancer, to a moderate degree, among the Japanese population.

Matsumoto, Koji; Katsumata, Noriyuki; Saito, Isamu; Shibata, Taro; Konishi, Ikuo; Fukuda, Haruhiko; Kamura, Toshiharu

doi: 10.1093/jjco/hyr201pmid: 22323553

A single-arm Phase II study evaluating combination chemotherapy utilizing oral etoposide and irinotecan for platinum-resistant and taxane-pretreated ovarian cancer has started. The aim of this study is to evaluate the efficacy and safety of this regimen as a test arm regimen in a subsequent Phase III trial. Patients with platinum-resistant and taxane-pretreated ovarian cancer are given etoposide at 50 mg/m2 p.o. from days 1 to 21 and irinotecan 70 mg/m2 i.v. at days 1 and 15, repeated every 28 days, up to six cycles. A total of 60 patients will be enrolled at 36 institutions. The primary endpoint is response rate. The secondary endpoints include adverse events and progression-free and overall survival.

Akaza, Hideyuki; Carroll, Peter; Cooperberg, Matthew R.; Hinotsu, Shiro

doi: 10.1093/jjco/hyr194pmid: 22217576

This report summarizes the presentations and discussions that took place at the Fifth Joint Meeting of J-CaP and CaPSURE held in Tokyo, Japan, in July 2011. The J-CaP and CaPSURE Joint Initiative was established in 2007 with the objective of analyzing, reviewing, comparing and contrasting data on prostate cancer patients from Japan and the USA within the two important large-scale, longitudinal, observational databases—J-CaP and CaPSURE. Since its inception, the initiative has reviewed a wide range of topics and generated valuable data on the patterns of prostate cancer treatment and patient outcomes in the two geographical regions. The objectives of this 5th Joint Meeting were to provide an update on the current status of the J-CaP and CaPSURE databases, and also to discuss perspectives from a range of other Asian countries—Japan, China, Indonesia and Korea—on the use of androgen deprivation therapy for prostate cancer. The collaborators recognize that large databases, such as J-CaP and CaPSURE, provide valuable ‘real-world’ information, to complement data from clinical trials, which can help to advance the clinical management of prostate cancer patients worldwide. It is anticipated that in the near future, the Joint Initiative will expand globally to include patient registries from other countries so that best practice can be shared and regional differences in patients, treatments and outcomes can be explored.