Japanese journal of clinical oncology最新文献

{"title":"Multicenter phase II trial of trastuzumab and docetaxel for HER2-positive salivary gland cancer.","authors":"Satoshi Kano, Naomi Kiyota, Ichiro Kinoshita, Yuichiro Tada, Kei Ijichi, Tomoko Yamazaki, Yasushi Shimizu, Yutaka Hatanaka, Hitoshi Tsuda, Shojiroh Morinaga, Yoshihiro Matsuno, Yoichi M Ito, Naoki Nishimoto, Keiko Kobayashi, Toshiyuki Isoe, Takuro Noguchi, Akihiro Homma, Hirotoshi Dosaka-Akita","doi":"10.1093/jjco/hyaf106","DOIUrl":"10.1093/jjco/hyaf106","url":null,"abstract":"<p><strong>Backgrounds: </strong>Standard systemic chemotherapy remains unestablished for recurrent or metastatic (RM) salivary gland cancer (SGC) due to its rarity. A single institute phase II trial of trastuzumab and docetaxel previously showed efficacy with human epidermal growth factor receptor 2 (HER2)-positive SGC.</p><p><strong>Methods: </strong>We conducted a multicenter, single-arm, open-label phase II trial of trastuzumab and docetaxel for HER2-positive RM SGC. Patients received trastuzumab 6 mg/kg (loading dose 8 mg/kg) and docetaxel 70 mg/m2 every 3 weeks up to eight cycles. The primary endpoint was the objective response rate (ORR) by a blinded independent review committee. Secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and safety. Forty-eight patients were screened for HER2 status; 23 were HER2-positive.</p><p><strong>Results: </strong>Eighteen patients were enrolled, with 16 receiving the protocol treatment. Fourteen patients were diagnosed with salivary duct carcinoma. The ORR was 60.0% (95% confidence interval [CI], 32.3 to 83.7). The median PFS was 8.5 months (95% CI, 6.0 to 12.7), the median OS, 33.8 months (95% CI, 16.9 to not estimable), and the DCR, 93.3% (95% CI, 68.1 to 99.8). The most frequent grade ≥3 treatment-emerged adverse events were neutropenia (100%), leukopenia (93.8%), lymphopenia (18.8%), and febrile neutropenia (12.5%). One treatment-related death occurred (6.3%) due to hypoalbuminemia.</p><p><strong>Conclusions: </strong>These results demonstrate the significant efficacy and predictable toxicities of trastuzumab and docetaxel in patients with HER2-positive RM SGC, leading to the simultaneous approval of trastuzumab and HER2 companion diagnostics assay for this setting in Japan.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1131-1140"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496684","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":"Comparison of hysterectomy using four different robotic surgical systems; a retrospective cohort study.","authors":"Hiroki Nagata, Hiroaki Komatsu, Koji Yamamoto, Masayo Okawa, Kohei Hikino, Yuki Iida, Ikumi Wada, Mayumi Sawada, Shinya Sato, Fuminori Taniguchi","doi":"10.1093/jjco/hyaf109","DOIUrl":"10.1093/jjco/hyaf109","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted surgery has become a cornerstone of minimally invasive gynecologic procedures. While the da Vinci system has long dominated the field, new robotic platforms, such as hinotori™ and Hugo™, have recently been introduced, expanding surgical options. However, no previous study has directly compared surgical outcomes across these four systems. This study aimed to evaluate and compare the perioperative outcomes of four robotic systems-da Vinci X, da Vinci Xi, hinotori™, and Hugo™-in total hysterectomies.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent robotic-assisted total hysterectomy at Tottori University Hospital between April 2019 and January 2025. Patients were categorized into four groups based on the robotic system used.</p><p><strong>Results: </strong>Key surgical parameters, including operative time, blood loss, complication rates, and hospital stay, were analyzed. Subgroup analyses were also performed, including comparisons limited to robot-assisted total laparoscopic hysterectomy without lymphadenectomy and the first 10 cases following the introduction of each system. A total of 293 patients were included. No significant differences were observed among the four systems in terms of operative time, blood loss, or complication rates in the overall cohort analysis or the robot-assisted total laparoscopic hysterectomy subgroups. In the early-case subgroup, Hugo showed a significantly shorter pre-console time, while hinotori demonstrated a significantly shorter console time, both compared to Xi.</p><p><strong>Conclusion: </strong>Total hysterectomy can be safely and effectively performed using all four robotic platforms.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1112-1116"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583882","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":"Comparison of standard and biweekly trifluridine/tipiracil plus bevacizumab regimens in advanced or recurrent colorectal cancer: a retrospective study.","authors":"Yosuke Ando, Hiroshi Matsuoka, Hanaho Orito, Takuma Ishihara, Tomohiro Mizuno, Nanaho Hiraga, Hidetoshi Katsuno, Zenichi Morise, Akihiko Horiguchi, Koichi Suda, Takahiro Hayashi, Shigeki Yamada","doi":"10.1093/jjco/hyaf108","DOIUrl":"10.1093/jjco/hyaf108","url":null,"abstract":"<p><strong>Background: </strong>Trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) is a standard third-line therapy for unresectable advanced or recurrent colorectal cancer. The standard dosing schedule (5 days of administration followed by 2 days off) is associated with a high incidence of severe neutropenia. Conversely, a biweekly dosing schedule (5 days of administration followed by 9 days off) reportedly reduces this incidence. However, no direct comparison of these regimens has been made. In this study, we retrospectively compared the efficacy and safety of these two dosing schedules.</p><p><strong>Methods: </strong>We analyzed data from patients who received FTD/TPI + BEV treatment between June 2016 and January 2024 at three hospitals affiliated with Fujita Health University. The effects of the dosing schedules on hematological toxicity, overall survival (OS), and time to treatment failure (TTF) were assessed.</p><p><strong>Results: </strong>Among the 125 patients, 26 and 99 were classified into the standard and biweekly groups, respectively. Grade ≥ 3 neutropenia occurred in 50.0% of patients in the standard group and 29.3% of those in the biweekly group (P = .062), with multivariable analysis confirming the dosing schedule impact (P = .048). Median TTF was 5.4 and 7.0 months, while median OS was 16.4 and 14.5 months (P = .908, 0.947) in the standard and biweekly groups, respectively.</p><p><strong>Conclusion: </strong>The biweekly regimen of FTD/TPI + BEV resulted in a lower tendency for severe neutropenia than that in the standard regimen, while maintaining comparable OS and TTF in patients with unresectable advanced or recurrent colorectal cancer.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1105-1111"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583883","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":"Factors affecting the success of peripheral pulmonary lesion diagnosis via transbronchial needle aspiration and transbronchial biopsy when the probe is adjacent to the lesion on radial endobronchial ultrasound: a multicenter retrospective observational study.","authors":"Tomoya Baba, Takayasu Ito, Tadasuke Ikenouchi, Yasushi Makino, Fumie Kinoshita, Shunsaku Hayai, Junji Koyama, Ichidai Tanaka, Tetsunari Hase, Koji Sakamoto, Yuichiro Shindo, Masahiro Morise, Makoto Ishii","doi":"10.1093/jjco/hyaf103","DOIUrl":"10.1093/jjco/hyaf103","url":null,"abstract":"<p><strong>Background: </strong>Radial endobronchial ultrasound (R-EBUS)-guided transbronchial biopsy (TBB) is a useful method for diagnosing peripheral pulmonary lesions (PPLs). However, the diagnostic yield of this method for PPLs is unsatisfactory as the R-EBUS probe is not always located within the lesion. Nevertheless, R-EBUS-guided transbronchial needle aspiration (TBNA) followed by TBB (TBNA/TBB) has the potential to increase the diagnostic yield for lesions with adjacent orientation on R-EBUS. However, data on the diagnostic yield, safety, and success factors associated with the diagnosis using this technique for such lesions are limited.</p><p><strong>Methods: </strong>Consecutive patients who underwent R-EBUS-guided TBNA/TBB for lesions with adjacent orientation on R-EBUS between 1 April 2019, and 31 March 2022, at three institutions (Nagoya University Hospital, Toyohashi Municipal Hospital, and Handa City Hospital) were retrospectively analyzed. The diagnostic yield, factors affecting the success of the diagnosis, and complications associated with R-EBUS-guided TBNA/TBB for the aforementioned lesions were investigated.</p><p><strong>Results: </strong>Lesions from 75 patients were analyzed. The overall diagnostic yield of the lesions was 56/75 (74.7%). Multivariate analysis revealed that the close proximity of the probe to the edge of the PPL on an R-EBUS image before sampling (P = 0.012) and the visibility on chest radiography (P = 0.023) significantly affected the diagnostic yield via R-EBUS-guided TBNA/TBB. No major complications occurred.</p><p><strong>Conclusions: </strong>R-EBUS-guided TBNA/TBB might be safe and effective in improving the diagnostic yield for lesions with adjacent orientation on R-EBUS, particularly when the lesion is in close proximity to the probe and is visible on chest radiography.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1162-1169"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954671","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":"Newly formed adrenergic nerve fibers and perineural invasion in head and neck squamous cell carcinoma: a multicohort study.","authors":"Toshihiko Sakai, Yuki Saito, Koji Yamamura, Osamu Fukuoka, Masafumi Yoshida, Mizuo Ando, Yasuhiro Ebihara, Hironobu Nishijima, Kenji Kondo, Tatsuya Yamasoba","doi":"10.1093/jjco/hyaf098","DOIUrl":"10.1093/jjco/hyaf098","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the role of newly formed adrenergic nerve fibers in the tumor microenvironment in promoting tumor growth, focusing on the relationship between perineural invasion and adrenergic axonogenesis in oral cavity cancer.</p><p><strong>Methods: </strong>We analyzed 70 and 14 patients with oral tongue squamous cell carcinoma and oral cavity squamous cell carcinoma, respectively, from our institution and 465 patients with head and neck cancer from The Cancer Genome Atlas (TCGA). In the oral tongue squamous cell carcinoma cohort, the extent of tyrosine hydroxylase (TH) and growth-associated protein 43 (GAP43) immunostaining in peritumoral nerves were evaluated and compared with perineural invasion. In the oral cavity squamous cell carcinoma and TCGA cohorts, TH and GAP43 expressions were compared with perineural invasion. Survival was analyzed based on gene expression levels in TCGA cohort.</p><p><strong>Results: </strong>In the oral tongue squamous cell carcinoma cohort, TH positivity was associated with perineural invasion (P = .01). A positive correlation was observed between wild-type p53 immunostaining and TH negativity (P = .03). Double immunostaining for TH and GAP43 showed a 76% concordance rate. In the oral cavity squamous cell carcinoma cohort, a positive association between GAP43 expression and perineural invasion was suggested. TCGA cohort showed a positive association between TH expression and perineural invasion (P < .001). High GAP43 expression was associated with poor prognosis (P = .04).</p><p><strong>Conclusions: </strong>TH expression may play a role in adrenergic axonogenesis in the tumor microenvironment and may participate in the pathogenesis of perineural invasion in oral cavity squamous cell carcinoma.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1117-1130"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234111","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":"A questionnaire-based cross-sectional study on neuropathic pain in patients with cancer in Japan.","authors":"Saori Hashiguchi, Hiroshi Takahashi, Shuhei Yamamoto, Haruhiko Seki, Yaoki Sonohara, Yuko Tanabe","doi":"10.1093/jjco/hyaf116","DOIUrl":"10.1093/jjco/hyaf116","url":null,"abstract":"<p><strong>Background: </strong>Some patients with cancer experience cancer-related neuropathic pain. This study investigated the prevalence of possible neuropathic pain in patients with cancer.</p><p><strong>Methods: </strong>This observational, cross-sectional, questionnaire-based study recruited adult participants with stage ≥II cancer in Japan between June and November 2024. The primary endpoint was the proportion of participants with suspected neuropathic pain (Self-Reported Leeds Assessment of Neuropathic Symptoms and Signs pain scale [S-LANSS] score ≥ 12 points). Secondary endpoints included pain scores (11-point numeric rating scale [NRS]), communication with healthcare professionals, impact on daily activities, and quality of life (QoL) per the EQ-5D-5L.</p><p><strong>Results: </strong>Responses from 713 participants were analyzed. Of those, 230 participants (32.3%) reported cancer-related pain and 53 (7.4%) had suspected neuropathic pain. Among participants with suspected neuropathic pain, the mean ± standard deviation (SD) pain intensity (NRS) was 5.1 ± 2.7. Over one-third of participants (37.7% [20/53]) with suspected neuropathic pain reported that no healthcare provider had asked about cancer pain before they sought a consultation, 60.4% (32/53) wished their healthcare provider had noticed their pain sooner, 69.8% (37/53) could no longer perform some daily activities due to cancer pain, and 98.1% (52/53) thought their pain needed to be adequately treated for them to live their life going forward. QoL was lower among participants with suspected neuropathic pain versus the overall population (EQ-5D-L mean ± SD: 0.6065 ± 0.2518 vs 0.8204 ± 0.1788).</p><p><strong>Conclusions: </strong>These findings suggest that pain assessment earlier in the cancer treatment process than standard may improve pain management for patients with cancer.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1141-1151"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760079","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":"A multi-institutional randomized phase III trial of lobectomy versus segmentectomy for radiologically solid-predominant non-small cell lung cancer with a ground-glass opacity and tumor diameter > 2 cm and ≤ 3 cm: JCOG2217 (STRONG).","authors":"Noriko Mitome, Aritoshi Hattori, Kenji Suzuki, Masashi Wakabayashi, Yuta Sekino, Tetsuya Isaka, Masaya Yotsukura, Keiju Aokage, Haruhiko Fukuda, Shun-Ichi Watanabe","doi":"10.1093/jjco/hyaf104","DOIUrl":"10.1093/jjco/hyaf104","url":null,"abstract":"<p><p>Lobectomy has been the standard surgical procedure for clinical stage IA non-small cell lung cancer (NSCLC) since the results of a randomized trial in 1995. However, recent phase III trials have demonstrated the efficacy of segmentectomy for small NSCLC. Segmentectomy has become one of the standard treatments for peripheral lung cancers with a tumor diameter of ≤2 cm and further expansion of the indication for segmentectomy is considered. We planned this trial to confirm the non-inferiority of segmentectomy to lobectomy in terms of overall survival in patients with solid-predominant NSCLC with ground-glass opacity and > 2 cm and ≤ 3 cm in tumor diameter. Pure-solid tumors will be excluded because of their highly malignant characteristics. The primary endpoint is overall survival. A total of 515 patients from 53 institutions will be enrolled over 5 years. The trial has been registered in the Japan Registry of Clinical Trials (study number: jRCTs1030240027).</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1184-1188"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511947","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":"The optimal conversion ratio of tacrolimus switching from intravenous to oral tacrolimus administration in hematopoietic cell transplantation patients receiving posaconazole prophylaxis with and without letermovir.","authors":"Toshihisa Nakashima, Azusa Kawasaki, Yoshihiro Inamoto, Ayumu Ito, Takahiro Fukuda, Hironobu Hashimoto","doi":"10.1093/jjco/hyaf101","DOIUrl":"10.1093/jjco/hyaf101","url":null,"abstract":"<p><p>Letermovir, a moderate inhibitor of CYP3A4 and inducer of CYP2C9 and CYP2C19, is used for cytomegalovirus prophylaxis following allogeneic hematopoietic stem cell transplantation (HCT). Posaconazole also inhibits CYP3A4, affecting tacrolimus metabolism. This study aimed to examine tacrolimus conversion ratios when switching from continuous intravenous to oral administration in HCT patients receiving posaconazole with and without letermovir. Tacrolimus concentration-to-dose (C/D) ratios before (C/Dciv) and after (C/Dpo) conversion were compared. The median C/Dciv ratios were 20.1 and 22.5 (ng/mL)/(mg/day) for patients with and without letermovir, respectively (P = 0.31). The median C/Dpo ratios were 5.1 and 5.9 (ng/mL)/(mg/day), respectively (P = 0.43). The median (C/Dpo)/(C/Dciv) ratios were 0.25 and 0.24, respectively (P = 0.77), indicating no significant difference in tacrolimus conversion ratios with and without letermovir. Based on these findings, the tacrolimus conversion ratio in patients receiving posaconazole was estimated to be approximately 1:2, regardless of concomitant letermovir use.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1189-1193"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266238","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":"Age-standardized mortality-to-incidence ratio for ovarian cancer in the world.","authors":"Sumiyo Okawa, Kumiko Saika","doi":"10.1093/jjco/hyaf144","DOIUrl":"https://doi.org/10.1093/jjco/hyaf144","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":"55 10","pages":"1198-1199"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238710","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":"Temporal changes in the urologist's practice behaviour of active surveillance for prostate cancer: analysis of prospective observational study cohort.","authors":"Yoichiro Tohi, Akira Yokomizo, Ryuji Matsumoto, Keiichiro Mori, Shinichi Sakamoto, Masaki Shiota, Yoshitaka Sekine, Toru Kanno, Takuma Kato, Hiroshi Fukuhara, Yasuyuki Sakai, Yasuo Kohjimoto, Iori Matsuda, Takayuki Goto, Norihiko Kawamura, Yoshito Kusuhara, Katsuyoshi Hashine, Hideyasu Tsumura, Yushi Naito, Mikio Sugimoto","doi":"10.1093/jjco/hyaf102","DOIUrl":"10.1093/jjco/hyaf102","url":null,"abstract":"<p><strong>Background: </strong>To analyse temporal trends and variations in the use of active surveillance (AS) for low- and intermediate-risk prostate cancer in Japan.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of data from the Prostate Cancer Research International: AS-JAPAN study, a multi-institutional prospective observational cohort study, collected between January 2010 and February 2024. The primary outcomes of interest were temporal trends in characteristics of patients undergoing AS, including risk classification, age at enrollment, patterns of treatment interventions during AS, and reasons for discontinuation of AS.</p><p><strong>Results: </strong>A total of 1263 patients were included, with a median follow-up period of 30 months (interquartile range: 11-59). The proportion of patients with D'Amico intermediate-risk prostate cancer significantly increased over time (R2 = 0.7139), reaching 24.7% in 2023. No significant trend was observed for younger patients aged ≤60 years, but the proportion of patients aged ≥75 years increased over time (R2 = 0.5133). Among treatment interventions during AS, no significant trends were noted in the use of prostatectomy, external beam radiation therapy, hormone therapy, or watchful waiting; however, the use of brachytherapy significantly decreased (R2 = 0.5604). Reasons for discontinuing AS revealed a slight increase in off-protocol cases over time, reaching 59.6% in 2023 (R2 = 0.3869).</p><p><strong>Conclusion: </strong>These findings highlight a notable shift in the adoption of AS in Japan, with an increasing proportion of intermediate-risk and older patients. The rise in off protocol AS discontinuation underscores the complexities of clinical decision-making in the context of AS.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1170-1176"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511950","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}