Japanese journal of clinical oncology最新文献

{"title":"Nationwide retrospective survey on healthcare professionals' perceptions of suicide-related behaviors among people with head and neck cancer in Japan.","authors":"Kohtaro Eguchi, Seiichi Yoshimoto, Maiko Fujimori, Yosuke Uchitomi","doi":"10.1093/jjco/hyaf125","DOIUrl":"https://doi.org/10.1093/jjco/hyaf125","url":null,"abstract":"<p><strong>Objective: </strong>To investigate healthcare professionals' perceptions of suicide-related behaviors among people with head and neck cancers in Japan.</p><p><strong>Methods: </strong>A two-phase, multicenter retrospective study was conducted. First, head and neck cancer specialists completed a survey on their experience with suicide-related behaviors and institutional prevention efforts. Second, a medical record review explored associations between suicide-related behaviors and treatment factors.</p><p><strong>Results: </strong>There were 152 respondents, of whom 82 (53.9%) had encountered suicide-related behaviors, and 69 (45.4%) had experienced patient suicides. A total of 110 cases of suicide were reported. Only 4.6% of respondents had attended lectures on preventing suicide, although 37.5% had implemented preventive measures. Overall, 27 cases were analyzed, including 18 suicides, and nine attempts. The majority of these involved men who were either smokers or drinkers. Behaviors often occurred when people were post-treatment without any recurrence. Common preceding factors were eating difficulties, speech impairment, and psychological decline.</p><p><strong>Conclusions: </strong>Suicide risk among people with head and neck cancer extends well beyond diagnosis and remains under-addressed. Increased awareness and education among healthcare professionals, and provision of multidisciplinary support, are essential for comprehensive prevention.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760080","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":"Utility of ultrasound-guided transbronchial needle biopsy using an acquire needle in the diagnosis of chest and mediastinal diseases.","authors":"Daisuke Minami, Nagio Takigawa, Tatsuyuki Kawahara, Akichika Nagano, Yasuhiro Nakajima, Nobuaki Ochi, Hiromichi Yamane, Arihiko Kanehiro","doi":"10.1093/jjco/hyaf124","DOIUrl":"https://doi.org/10.1093/jjco/hyaf124","url":null,"abstract":"<p><strong>Background: </strong>Recently, a transbronchial needle biopsy (TBNB) method using a three-plane symmetric Acquire needle with Franseen geometry was developed to improve diagnostic yield. This study describes our experience with Endobronchial ultrasound (EBUS)-TBNB for pulmonary and mediastinal diseases.</p><p><strong>Methods: </strong>A retrospective review was conducted involving 37 patients who underwent EBUS-TBNB with an Acquire 22G needle between July 2021 and September 2024. Enlarged lymph nodes were sampled, and medical records were analyzed to evaluate diagnostic outcomes, including histological core tissue acquisition, programmed death-ligand 1 (PD-L1) expression testing, and next-generation sequencing (NGS).</p><p><strong>Results: </strong>We sampled a total of 48 lymph nodes (26 subcarinal [#7], 12 right lower paratracheal [#4R], and 10 right hilar [#11]) with a median longest diameter of 23.1 mm (range, 9.3-44.6 mm). Definitive diagnoses were achieved in 36 patients, including 25 cases of lung cancer, one large-cell neuroendocrine carcinoma, one renal cell carcinoma, five cases of sarcoidosis, and four cases of unspecified lymphadenopathy. The overall diagnostic yield was 97.3% (95% confidence interval: 85.8%-99.5%). Both PD-L1 expression testing and NGS were successfully performed in all lung adenocarcinoma cases (nine using the Oncomine Dx Target Test and four using the AmoyDx Pan Lung Cancer polymerase chain reaction (PCR) Panel). Histological samples were successfully obtained from 35 patients, whereas only two cases of lung squamous cell carcinoma were cytologically diagnosed due to necrotic and calcified samples. The nucleic acid yield from a single puncture was sufficient for analysis using the Lung Cancer Compact Panel.</p><p><strong>Conclusions: </strong>EBUS-TBNB demonstrated high efficacy for diagnosing lung cancer, including PD-L1 testing and NGS, and for obtaining histological core tissue.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730980","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":"Cross-organ examination of hematologic toxicities from immune checkpoint inhibitors: insights from real-world data.","authors":"Sayako Yuda, Yuma Tada, Yasuhiro Shingai, Hidenori Kasahara, Shigeo Fuji, Hiroaki Masaie, Takafumi Yokota, Jun Ishikawa","doi":"10.1093/jjco/hyaf118","DOIUrl":"https://doi.org/10.1093/jjco/hyaf118","url":null,"abstract":"<p><strong>Objective: </strong>Immune checkpoint inhibitors (ICPis) are widely used clinically to improve the prognosis of various cancers. However, little is known about their hematologic immune-related adverse events (irAEs). This study aimed to comprehensively investigate the incidence and clinical characteristics of irAEs induced by ICPis through a cross-organ research approach.</p><p><strong>Methods: </strong>Patients who received at least one ICPi dose at the Osaka International Cancer Institute between January 2014 and September 2021 were reviewed, irrespective of their tumor type. We analyzed the cumulative incidence of hematological irAEs and investigated the clinical course of patients who underwent bone marrow examination owing to suspected hematological irAEs.</p><p><strong>Results: </strong>During the study period, 1500 patients in total received ICPis. Based on clinical data and the histopathological evaluation of bone marrow samples, we identified seven cases of hematologic irAEs (four of immune thrombocytopenia, two of hemophagocytic lymphohistiocytosis, and one of agranulocytosis). Additionally, we observed six cases of primary hematologic disease, four of bone marrow findings consistent with cytopenia and subsequent recovery secondary to infections or cytotoxic agents, two of bone marrow involvement by primary cancer, and one of an unknown cause. With the median follow-up of 297 days (0-2087 days), the cumulative incidence rates of hematologic irAEs at 90 days and 1 year were 0.1% (95% CI, 0.0-0.4) and 0.4% (95% CI, 0.2-1.0), respectively. None of the patients with hematological irAEs died.</p><p><strong>Conclusion: </strong>Severe hematological irAEs are rare but can be life-threatening. When hematological abnormalities are detected during ICPi therapy, it is important to explore the possibility of irAEs, including bone marrow abnormalities.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707499","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":"Regional disparities in lymphedema treatment and access to complex decongestive therapy: a nationwide survey in Japan.","authors":"Mariko Masujima, Shinsuke Akita, Makiko Tazaki, Akane Tsujimoto, Ryoko Katagiri, Chikao Yasuda, Tetsuya Tsuji","doi":"10.1093/jjco/hyaf120","DOIUrl":"https://doi.org/10.1093/jjco/hyaf120","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema has a significant impact on patient quality of life. However, it remains unclear whether the provision of lymphedema treatment in Japan is uniform across regions. This study aimed to clarify the current situation regarding lymphedema treatment with emphasis on complex decongestive therapies (CDT) availability and implementation in Japan.</p><p><strong>Methods: </strong>A nationwide web-based survey was conducted. Respondents included healthcare professionals from designated cancer care hospitals and other medical institutions treating lymphedema in Japan. The distribution of variables, including the implementation of lymphedema treatment, was compared between designated cancer care hospitals and other facilities using the chi-square test. Japan was divided into nine regions to compare and analyze access to medical institutions providing CDT for lymphedema on both inpatient and outpatient bases.</p><p><strong>Results: </strong>Of the 372 facility responses analyzed, ˃95% reported treating secondary lymphedema of the extremities, whereas ˂30% treated head and neck lymphedema. The number of CDT inpatients per 100 000 people in the region with the lowest patient volume was approximately 2% of that in the region with the highest volume. Similarly, the number of CDT outpatients per 100 000 people in the lowest-volume region was one-third of that in the highest-volume region. There was no significant correlation between facilities with high outpatient numbers and those with low outpatient numbers (ρ =0.57, P-value = 0.11).</p><p><strong>Conclusion: </strong>Eliminating regional disparities in access to lymphedema treatment facilities, particularly for inpatient CDT, would improve quality of life and enable patients to manage the condition regardless of where they live.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698568","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":"Clinical outcome of patients with soft tissue sarcoma after bone metastases: Tokai musculoskeletal oncology consortium study.","authors":"Tomohito Hagi, Tomoki Nakamura, Satoshi Tsukushi, Hiroshi Koike, Hiroaki Kimura, Akihito Nagano, Kozo Hosono, Yoji Shido, Eiji Kozawa, Katsuhisa Kawanami, Kunihiro Asanuma, Yumi Matsuyama, Masahiro Hasegawa, Yoshihiro Nishida","doi":"10.1093/jjco/hyaf121","DOIUrl":"https://doi.org/10.1093/jjco/hyaf121","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue sarcomas (STSs) are a diverse group of rare malignant tumors accounting for <1% of all human tumors. Almost 50% of patients with STS develop metastatic disease, mainly within 3 years of initial diagnosis. Lung metastasis occurs in 20%-30% of STS cases, while bone metastasis is rare.</p><p><strong>Patients and methods: </strong>We investigated tumor characteristics and clinical outcomes in 59 patients with STS who developed bone metastases.</p><p><strong>Results: </strong>A total of 21 patients had solitary bone metastasis: two in the extremity, 11 in the vertebral body, and eight in the trunk. Around 38 patients had multiple bone metastases: 18 with extremity bone involvement and 20 with no extremity bone involvement. Fourteen patients developed complicated bone metastases with distant extrapulmonary metastases. Seven patients had no distant metastases other than bone; that is, the bone was the first distant metastasis. The 5-year disease-specific survival (DSS) rate after primary treatment was 45.1%. The median 5-year DSS after bone metastasis was 28.1 months. The 5-year DSS rate was 55.6% in nine patients who underwent radical local treatment for solitary bone metastases. The 5-year DSS rate was 14.7% in 50 patients who did not undergo local radical treatment for bone metastases, with a significant correlation.</p><p><strong>Conclusion: </strong>Patients with bone metastases from STS had a relatively good prognosis after bone metastases. Solitary bone metastases can be aggressively treated. Although nearly half of the patients received bone-modifying agents, the effectiveness of these therapeutics warrants further investigation.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690307","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":"Biliary stenting implantation with 125I seed strand followed by chemotherapy plus PD-1 inhibitor in cholangiocarcinoma with malignant obstructive jaundice: a retrospective comparative study.","authors":"Tianhua Yue, Wenlong Gu, You Lu","doi":"10.1093/jjco/hyaf123","DOIUrl":"https://doi.org/10.1093/jjco/hyaf123","url":null,"abstract":"<p><strong>Background: </strong>Owing to the nonspecific symptoms in early stage and the propensity for secondary obstructive jaundice, cholangiocarcinoma (CCA) is frequently diagnosed at an advanced stage, thereby missing the optimal window for surgical intervention. The aim of this study was to evaluate the efficacy and safety of biliary stenting implantation with 125I seed strand (SI) plus chemotherapy with PD-1inhibitor for patients with CCA and malignant obstructive jaundice (MOJ).</p><p><strong>Methods: </strong>Between January 2015 and December 2023, 88 patients diagnosed with CCA and MOJ were enrolled for this retrospective study. Then, 36 patients (observation group) received SI plus chemotherapy with PD-1inhibitor, whereas 52 patients (control group) received biliary stenting implantation plus chemotherapy. The response to therapy and adverse effect were compared between both groups. The data of stent patency time, progression-free survival (PFS) and overall survival (OS) obtained through clinical follow-up, were performed using the Kaplan-Meier method and analysed with the log-rank test. Prognostic risk factors were evaluated using Cox regression analysis.</p><p><strong>Results: </strong>After the 6-month follow-up, the DCR (86.11% vs 67.31%) was statistically different (P = 0.045), while ORR (33.33% vs 23.08%) not (P = 0.288) between both groups. There were no serious interventional treatment-related adverse events and the differences of severe toxicities of chemotherapy between both groups were not statistically significant (P > 0.05). The median stent patency time, PFS and OS were 300 days (95%CI 260-330) vs 215 days (95%CI 194-240), 360 days (95%CI 260-372) vs 230 days (95%CI 200-248) and 420 days (95%CI 330-452) vs 309 days (95%CI 252-340) between both groups, respectively and the differences between both groups were statistically significant (P < 0.05). Staging of CCA and subsequent therapy method were independent risk factors that affected the prognosis for survival.</p><p><strong>Conclusions: </strong>SI plus chemotherapy with PD-1inhibitor is an effective and safe therapy and shows promising results compared to biliary stenting implantation plus chemotherapy for CCA patients with MOJ.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690306","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":"Consecutive real-world treatment experience with a reduced starting dose of lenvatinib (14 mg) plus pembrolizumab for metastatic renal cell carcinoma.","authors":"Tomokazu Sazuka, Kentaro Murakami, Hidetaka Nihei, Yuki Iida, Kosuke Mikami, Sangjon Pae, Shinpei Saito, Keisuke Ando, Manato Kanesaka, Kodai Sato, Yasutaka Yamada, Yusuke Imamura, Shinichi Sakamoto, Tomohiko Ichikawa","doi":"10.1093/jjco/hyaf122","DOIUrl":"https://doi.org/10.1093/jjco/hyaf122","url":null,"abstract":"<p><strong>Objective: </strong>In the CLEAR trials, the starting dose of lenvatinib in lenvatinib+pembrolizumab (L + P) was set at 20 mg for renal cell carcinoma (RCC). The incidence of adverse events is not low with L + P compared with other combination immunotherapies. There have been no reports of initiating treatment at 14 mg lenvatinib in (L + P) combination treatment for metastatic RCC (mRCC).</p><p><strong>Methods: </strong>Patients who initiated L + P for mRCC between January 2022 and 2024 in our institution were included. Clinical data were collected retrospectively. Patients' backgrounds and adverse events were summarized, and the maximum tumor shrinkage rate and treatment progress were analyzed.</p><p><strong>Results: </strong>Eleven patients were enrolled in this study; median age: 69 years, median body weight: 63.0 kg. Two patients were female. The International Metastatic Renal Cell Database Consortium risk score was favorable in two cases, intermediate in six cases, and poor in three cases. Adverse events led to drug interruption or discontinuation of treatment in four cases, 2 months after initiating L + P. Partial response was achieved in 10 (91%) cases; stable disease was achieved in only 1 case. Almost all patients experienced some type of adverse event (AE). Only one patient discontinued treatment due to AEs.</p><p><strong>Conclusions: </strong>Although management of AEs was essential, early drug interruption was less frequent in our study compared with the CLEAR trial Japanese cohort. The response of a reduced starting dose of 14 mg lenvatinib for mRCC was almost the same as that in the CLEAR trial.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667661","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":"Recent advances in understanding and management of intravascular large B-cell lymphoma.","authors":"Kazuyuki Shimada","doi":"10.1093/jjco/hyaf112","DOIUrl":"https://doi.org/10.1093/jjco/hyaf112","url":null,"abstract":"<p><p>Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma characterized by the proliferation of tumor cells within the lumina of small vessels in systemic organs. Diagnosis remains challenging due to the frequent presentation of non-specific symptoms such as fever and general malaise. Since its listing as a distinct disease entity in the 4th edition of the World Health Organization classification, awareness of IVLBCL has increased, leading to improvements in diagnostic accuracy. Nevertheless, patients with delayed or difficult diagnosis continue to be reported. Recent genetic studies have identified recurrent genetic abnormalities associated with IVLBCL, and the potential utility of liquid biopsy for diagnosis and treatment monitoring has been suggested. However, despite these advances, a gap remains between translational research and clinical application, particularly regarding how liquid biopsy can be incorporated into clinical practice. Regarding treatment, although standard chemotherapy with central-nervous-system-directed therapy has demonstrated favorable outcomes in initial management, the efficacy and safety of emerging immune cell therapies in IVLBCL remain largely unknown. This article aims to review recent advances in the understanding and management of IVLBCL, with the ultimate goal of improving clinical outcomes and advancing therapeutic management of IVLBCL.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591266","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":"Current status and perspective of ctDNA-based MRD testing in breast cancer: a systematic review.","authors":"Yukinori Ozaki, Hiroji Iwata","doi":"10.1093/jjco/hyaf113","DOIUrl":"https://doi.org/10.1093/jjco/hyaf113","url":null,"abstract":"<p><p>Treatment strategies for breast cancer have become increasingly complex over the years, requiring a deep understanding of disease pathology and the individualization of treatments on the basis of biomarkers. Circulating tumor DNA (ctDNA) enables non-invasive evaluation of the entire tumor, and its potential is being explored for treatment development. Numerous studies have evaluated ctDNA in various breast cancer subtypes during postoperative follow-up or after neoadjuvant chemotherapy, consistently showing that ctDNA positivity is associated with a higher risk of recurrence. Clinical trials evaluating therapeutic interventions on the basis of ctDNA status are also underway. Moving forward, the development of more sensitive assays and appropriate treatment strategies will be required. As the clinical application of ctDNA advances, the individualization of breast cancer treatment is expected to be further refined.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591265","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":"Comparing oncological outcomes and safety between photodynamic diagnosis-assisted and white-light transurethral resection in elderly patients with non-muscle invasive bladder cancer.","authors":"Yuto Matsushita, Yoshihiro Tsuchiya, Gaku Ishikawa, Asuka Sano, Ayana Takemura, Shunsuke Watanabe, Kyohei Watanabe, Hiromitsu Watanabe, Keita Tamura, Daisuke Motoyama, Atsushi Otsuka, Teruo Inamoto","doi":"10.1093/jjco/hyaf047","DOIUrl":"10.1093/jjco/hyaf047","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the prognostic outcomes and risk of adverse events in elderly non-muscle invasive bladder cancer (NMIBC) patients receiving photodynamic diagnosis-assisted transurethral resection of bladder cancer (PDD-TURBT).</p><p><strong>Methods: </strong>This study retrospectively included 326 patients who were over 70 years old and received either PDD-TURBT (n = 114, PDD group) or white-light TURBT (n = 212, WL group). Oncological outcomes, namely recurrence-free survival (RFS) and progression-free survival (PFS), and adverse event profiles were compared between the two groups.</p><p><strong>Results: </strong>In the PDD and WL groups, the median RFS periods were not reached and 41.7 months (P < 0.001), and the median PFS periods were not reached and 160.2 months (P = 0.057), respectively. The Grey test which take account to overall death as a competing risk event revealed recurrence tended to decrease in PDD group (P = 0.050). The independent prognostic factors were determined by multivariate Cox regression analyses: WL-TURBT in RFS. After propensity score matching, statistically favorable RFS in the PDD group were shown (P = 0.018). The incidence of AST/ALT elevation and intraoperative hypotension (defined as systolic blood pressure ≤ 80 mmHg) were significantly higher in the PDD group than in the WL group (P = 0.003 and 0.003, respectively).</p><p><strong>Conclusions: </strong>Prolonged RFS are expected for PDD-TURBT using oral 5-aminolevulinic acid in elderly NMIBC patients. However, the risks of liver injury and intraoperative hypotension are higher for PDD-TURBT.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"784-790"},"PeriodicalIF":1.9,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585687","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}