Japanese journal of clinical oncology最新文献

{"title":"Impact of treatment volume on outcomes for patients with penile cancer at relatively low-volume centers in Japan.","authors":"Yoji Murakami, Takahiro Yamaguchi, Masato Goya, Katsuyoshi Higashijima, Shohei Tobu, Ryuta Sato, Shuichi Tatarano, Shoichiro Mukai, Kei-Ichiro Uemura, Katsunori Tatsugami, Kazuna Tsubouchi, Yohei Shida, Tatsu Ishii, Hideki Sakai, Hirofumi Matsuoka, Nobuhiro Haga, Masatoshi Eto, Tsukasa Igawa, Toshiyuki Kamoto, Hideki Enokida, Toshitaka Shin, Mitsuru Noguchi, Naohiro Fujimoto, Seiichi Saito, Tomomi Kamba","doi":"10.1093/jjco/hyag070","DOIUrl":"10.1093/jjco/hyag070","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether there are differences in treatment approaches, including complications according to the volume of treatment experience for penile cancer, and whether such differences affect patient prognosis.</p><p><strong>Methods: </strong>We retrospectively analyzed 196 patients with penile cancer treated at 12 university hospitals and affiliated institutions (total of 32 institutions) in the Kyushu-Okinawa region from 2009 to 2020. Cancer-specific survival (CSS) was compared between patients treated at lower-volume centers (defined as institutions with fewer than five cases during the study period) and higher-volume centers (five or more cases). The underlying factors contributing to differences in CSS were also analyzed.</p><p><strong>Results: </strong>Groups treated at lower-volume and higher-volume centers comprised 39 and 157 patients, respectively. No significant differences were observed in patient backgrounds. However, among patients with clinical stage 3 disease, CSS was significantly worse in the lower-volume center group. In that subgroup, significantly fewer patients underwent lymph node dissection. There were no notable differences in other treatments or complications between the two groups.</p><p><strong>Conclusion: </strong>A disparity in CSS was observed specifically in patients with clinical stage 3 disease. The lower rate of lymph node dissection in lower-volume centers appears to be a contributing factor to the inferior prognosis in this group. No other differences were found in treatment or complication rates, suggesting that lower-volume centers can deliver care that is comparable to that in higher-volume centers, apart from lymph node dissection.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1007-1014"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world outcomes of definitive chemoradiotherapy for bladder cancer: a multi-institutional retrospective study in Japan.","authors":"Daichi Sugahara, Keiko Nemoto Murofushi, Hideomi Yamashita, Etsuyo Ogo, Koyo Kikuchi, Anneyuko I Saito, Takafumi Komiyama, Nobuki Imano, Ataru Igarashi, Sayaka Ohno, Hiroshi Onishi","doi":"10.1093/jjco/hyag063","DOIUrl":"10.1093/jjco/hyag063","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate real-world clinical outcomes and prognostic factors of definitive chemoradiotherapy (CRT) for bladder cancer in Japan.</p><p><strong>Methods: </strong>Patients with bladder cancer treated with definitive CRT between 2010 and 2023 at seven Japanese institutions were retrospectively analyzed. Overall survival (OS) was estimated using the Kaplan-Meier method, whereas cause-specific survival (CSS) and bladder preservation were analyzed using competing risk methods. Univariable analyses were performed using the log-rank and Gray's tests, and multivariable analyses were performed using Cox and Fine-Gray models with Bayesian Information Criterion-based stepwise selection.</p><p><strong>Results: </strong>A total of 175 patients were included. Maximal transurethral resection of the bladder tumor (TUR-Bt) was performed in 55% of patients, and 49% were deemed ineligible for radical cystectomy (RC). The 5-year OS, CSS, and bladder preservation rate were 52% (95% CI, 42-60%), 73% (95% CI, 66-80%), and 69% (95% CI, 61-77%), respectively. In multivariable analyses, poorer performance status remained associated with worse OS (P = .003), whereas advanced clinical T stage was associated with worse CSS (P = .018) and maximal TUR-Bt was associated with improved bladder preservation (P = .024). Although patients ineligible for RC demonstrated inferior OS (P < .001) and CSS (P = .007) in univariable analyses, bladder preservation was comparable to those treated by patient preference.</p><p><strong>Conclusions: </strong>This multi-institutional retrospective study demonstrates acceptable real-world outcomes of definitive CRT for bladder cancer in Japan. Patient-related factors influenced OS, whereas tumor burden and local tumor control were associated with CSS and bladder preservation.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"984-992"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply to 'Bayesian interpretation of febrile neutropenia risk and primary G-CSF prophylaxis during darolutamide triplet therapy'.","authors":"Taizo Uchimoto, Kensuke Hirosuna, Heima Niigawa, Taisuke Jo, Hirofumi Morinaka, Wataru Fukuokaya, Atsuhiko Yoshizawa, Masanobu Saruta, Tsuyoshi Morita, Saizo Fujimoto, Yutaka Yamamoto, Moritoshi Sakamoto, Kazuki Nishimura, Ryoichi Maenosono, Takuya Tsujino, Kyosuke Nishio, Yuki Yoshikawa, Atsushi Ichihashi, Fumihiko Urabe, Keiichiro Mori, Takafumi Yanagisawa, Shunsuke Tsuzuki, Kiyoshi Takahara, Teruo Inamoto, Kazutoshi Fujita, Haruhito Azuma, Takahiro Kimura, Kazumasa Komura","doi":"10.1093/jjco/hyag059","DOIUrl":"10.1093/jjco/hyag059","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1024"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple enteric fistulas in primary small-intestinal diffuse large B-cell lymphoma.","authors":"Taichiro Tokura, Reina Saga, Hiroko Hidai, Sayuri Motomura","doi":"10.1093/jjco/hyag068","DOIUrl":"10.1093/jjco/hyag068","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1025-1026"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a visualization tool to estimate out-of-pocket costs for systemic cancer therapy in Japan and claims-based agreement evaluation: the VEST-Ca study.","authors":"Kazunori Honda, Kazuhiro Shimomura, Hiroya Taniguchi, Shigenori Kadowaki, Toshiki Masuishi, Yukiya Narita, Taro Mizuno, Taiju Ando, Yasunobu Ishizuka, Sho Umegaki, Masashi Ando, Kei Muro","doi":"10.1093/jjco/hyag061","DOIUrl":"10.1093/jjco/hyag061","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity is increasingly recognized as a major barrier to high-quality cancer care. However, regimen-specific estimates of out-of-pocket (OOP) costs are rarely available at treatment planning. We developed VEST-Ca (Visualization of Estimated Self-pay Treatment Costs for Cancer), a rule-based visualization tool to estimate OOP expenditures for systemic anticancer therapy under Japan's universal health coverage system, and evaluated its agreement with claims-derived expenditures.</p><p><strong>Methods: </strong>We conducted a single-center retrospective agreement study including adults with solid tumors who received outpatient systemic therapy for at least 4 months. Actual 4-month OOP expenditures were extracted from claims data. VEST-Ca simulated OOP costs using drug prices, dosing schedules, and patient-specific reimbursement ceilings under the high-cost medical expense benefit system. Accuracy was defined as (simulated OOP/actual OOP) × 100 (%). Agreement was assessed using Bland-Altman analysis. A prespecified sensitivity analysis excluded computed tomography (CT) and medical certificate-related charges.</p><p><strong>Results: </strong>Among 41 enrolled patients, 21 were included after excluding those with indeterminate ceiling categories. Median actual 4-month OOP expenditure was JPY 160 930, compared with a median simulated cost of JPY 121 068. Median accuracy was 93.1% and improved to 100% after excluding CT and certificate-related charges. Bland-Altman analysis showed a small negative bias (-11 705 JPY), which decreased in sensitivity analysis.</p><p><strong>Conclusions: </strong>VEST-Ca demonstrated high claims-based agreement across diverse systemic regimens. A simple rule-based cost estimation tool may facilitate financial counseling and support shared decision-making in oncology.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"961-967"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of high-dose-rate brachytherapy combined with moderately hypofractionated external beam radiotherapy for high-risk localized prostate cancer.","authors":"Kenta Ohmatsu, Yaichiro Hashimoto, Mirei Kamori, Takashi Mikuni, Shiho Wada, Yuka Kaizu, Miki Tsujii, Sawa Kono, Junpei Iizuka","doi":"10.1093/jjco/hyag071","DOIUrl":"10.1093/jjco/hyag071","url":null,"abstract":"<p><strong>Background: </strong>High-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) is an established dose-escalation strategy for high-risk localized prostate cancer; however, long-term outcomes using a streamlined schedule with moderately hypofractionated EBRT and single-day HDR-BT remain insufficiently reported.</p><p><strong>Methods: </strong>We retrospectively reviewed 110 patients with high-risk localized prostate cancer treated between 2008 and 2012 with EBRT (45 Gy in 15 fractions; 3 fractions/week) followed by single-day HDR-BT (9 Gy × 2 fractions). Most patients received 12 months of combined androgen blockade. Toxicity was graded using Radiation Therapy Oncology Group criteria. Biochemical relapse-free survival (bRFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox regression was performed to identify predictors of biochemical recurrence.</p><p><strong>Results: </strong>After a median follow-up of 127 months, the 10-year OS and bRFS rates were 92.7% and 74.0%, respectively. Late grade ≥ 3 genitourinary toxicity occurred in 1.8% of patients, and no grade ≥ 3 gastrointestinal toxicity was observed. Most adverse events were managed conservatively. In multivariate analysis, pretreatment PSA was significantly associated with biochemical recurrence (P = 0.012).</p><p><strong>Conclusions: </strong>Moderately hypofractionated EBRT combined with single-day HDR-BT produced durable long-term biochemical control with a favorable late-toxicity profile in high-risk localized prostate cancer. This streamlined schedule may be a practical combined-modality option and merits confirmation in broader, multi-institutional cohorts.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"993-997"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian interpretation of febrile neutropenia risk and primary granulocyte colony-stimulating factor prophylaxis during darolutamide triplet therapy.","authors":"Hiroshi Fukushima, Soichiro Yoshida, Akihiro Hirakawa, Yosuke Yasuda, Yuji Miura, Yasuhisa Fujii","doi":"10.1093/jjco/hyag058","DOIUrl":"10.1093/jjco/hyag058","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1022-1023"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global evidence and clinical implications of spontaneous tumor lysis syndrome in older adults with solid tumors: a systematic review of reported cases.","authors":"Samuel M Pettit, Na Liu","doi":"10.1093/jjco/hyag062","DOIUrl":"10.1093/jjco/hyag062","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous tumor lysis syndrome (STLS) is rare in solid tumors but highly lethal. Older adults may be especially vulnerable due to comorbidity and homeostenosis. Our objective was to synthesize reported cases among older adults with solid tumors and describe clinical features, prognostic factors, and outcomes.</p><p><strong>Methods: </strong>We systematically reviewed reports of patients ≥65 years with STLS from solid tumors, excluding hematologic malignancies or recent cytotoxic therapy. PubMed and Embase were searched through 16 September 2025, plus one hand-identified case. Data extracted included demographics, tumor type, metastatic activity, laboratory results, renal failure, and mortality. Hypothesis-generating analysis included Fisher's exact, Mann-Whitney U tests, and the area under the curve (AUC) with a Youden's J-derived cutoff (to summarize phosphate's discrimination for death).</p><p><strong>Results: </strong>Eighteen publications (20 patients) met criteria; no Japanese cases, highlighting a potential regional data gap. Overall mortality was 74%. Renal failure (14 of 20) strongly predicted death (13/14 vs 0/4, P < .002). Phosphate was higher in non-survivors (median 7.1 vs 5.25 mg/dL; P = .040) and discriminated death well (AUC = 0.865); a Youden-optimal phosphate threshold ≈6.0 mg/dL signaled high mortality risk. Tumors were almost exclusively metastatic; 88% involved the liver.</p><p><strong>Conclusions: </strong>Although rare, with evidence limited to case reports inherently at high risk for publication bias and imprecision, STLS is almost exclusively associated with metastatic disease, usually with hepatic involvement. It is lethal, particularly when accompanied by renal failure and/or hyperphosphatemia (>6 mg/dL) in older adults with solid tumors. Early recognition and management are critical.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"968-975"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing management of small renal masses: a patient-centered approach to minimize overtreatment.","authors":"Goshi Kitano, Takahiro Kojima, Takahiro Osawa, Haruka Miyata, Kazuyuki Numakura, Hiroshi Kitamura","doi":"10.1093/jjco/hyag069","DOIUrl":"10.1093/jjco/hyag069","url":null,"abstract":"<p><p>Small renal masses (SRMs) usually have a favorable prognosis. Many studies have shown that cancer-specific survival (CSS) is comparable among various treatment options, such as partial nephrectomy, percutaneous thermal ablation, stereotactic body radiotherapy, and active surveillance (AS). Therefore, the choice of treatment should be based on patient background and tumor characteristics rather than on oncologic concerns alone. Important patient factors include age, comorbidities, renal function, and life expectancy. Tumor size, growth rate, and anatomical location also influence this decision. In older or frail patients, immediate intervention may represent overtreatment, as the risk of periprocedural complications and renal function loss may outweigh the limited oncological benefit. Recent AS studies have demonstrated excellent CSS and very low metastatic rates; however, many of these prospective cohorts included patients with limited life expectancies and relatively short follow-up periods, which limit their generalizability. This review summarizes the current evidence regarding local treatment options and surveillance strategies for SRMs, focusing on oncologic outcomes, renal function, and patient selection. Finally, we highlight the rationale and design of the ongoing JCOG2409 prospective comparative study in medically operable adults aged ≥75 years with a solitary renal mass that evaluates standardized AS versus upfront interventions.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"931-939"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cellular plasticity of cancer: roles of biomolecular condensates and ecDNA.","authors":"Yohei Sugimoto, Yihao Zhang, Takeru Kachi, Koichi Ogami, Hiroshi I Suzuki","doi":"10.1093/jjco/hyag065","DOIUrl":"10.1093/jjco/hyag065","url":null,"abstract":"<p><p>Cancer is characterized not only by malignant transformation driven by genomic alterations but also by remarkable cellular plasticity that enables adaptation to environmental and therapeutic stress. Cancer cell plasticity frequently involves extensive remodeling of gene regulatory and transcriptional networks arising from complex interactions between genetic alterations and nongenetic regulatory mechanisms. The regulatory sources of cancer cell plasticity include changes in RNA molecules, such as microRNAs, alterations in RNA processing, epigenetic reprogramming, and higher-order cellular organization. In particular, biomolecular condensates-membraneless organelles formed through phase separation-and extrachromosomal DNA (ecDNA) have gained attention as important regulators of gene expression and cellular heterogeneity in cancer. Alterations in biomolecular condensates in cancer cells are frequently associated with dysregulated gene regulation and cell signaling. In addition, ecDNA represents an emerging mechanism that mediates high-level oncogene transcription, tumor heterogeneity, and drug resistance in cancer. This review summarizes recent advances in understanding how biomolecular condensates and ecDNA contribute to the regulation of cancer cell plasticity and discusses their implications for tumor evolution and therapeutic resistance. We also outline the usefulness of several CRISPR-based methods to test the roles of ecDNA, including generation of ecDNA-like circular DNA as model systems, optimization of Cas9 activity for prevention of Cas9-induced ecDNA loss and efficient ecDNA knock-in, and CRISPR interference-based perturbations.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"919-930"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}