研究者情報

キクチ　エイジ   KIKUCHI EIJI   菊地栄次    所属   医学部医学科 腎泌尿器外科学    職種   主任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	A novel risk-based approach simulating oncological surveillance after radical nephroureterectomy in patients with upper tract urothelial carcinoma.
掲載誌名	正式名：European Urology Oncology 略　 称：Eur Urol Oncol ISSNコード：2588931125889311
掲載区分	国外
巻・号・頁	3(6),756-763頁
著者・共著者	Shigeta Keisuke, Kikuchi Eiji, Abe Takayuki, Hagiwara Masayuki, Ogihara Koichiro, Anno Tadatsugu, Umeda Kota, Baba Yuto, Sanjo Tansei, Shojo Kazunori, Mikami Shuji, Mizuno Ryuichi, Oya Mototsugu
担当区分	2nd著者
発行年月	2020/12
概要	OBJECTIVE:To create a novel risk model and to simulate individualized surveillance duration that dynamically illustrates the changing risk relationship of UTUC-related death and non-UTUC death, considering the impact of cigarette smoking.DESIGN, SETTING, AND PARTICIPANTS:This multicenter cohort study comprised 714 pTa-T4N0M0 UTUC patients, with a median follow-up duration of 65mo. There were 279 (39.1%) nonsmokers, 260 (36.4%) current smokers, and 175 (24.5%) ex-smokers.INTERVENTION:All patients underwent RNU.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:The risks of UTUC death and non-UTUC death over time were estimated using parametric models for time to failure with Weibull distributions. Age-specific, stage-specific, and smoking status-specific surveillance durations were simulated based upon Weibull estimates.RESULTS AND LIMITATIONS:The hazard rate (HR) of non-UTUC death gradually increased over time in all age groups regardless of the smoking status, whereas that of UTUC-related death decreased markedly according to the pathological T (pT) stage and was affected by the smoking status. Among current smokers, the baseline HR of UTUC-related death in pT3/4 was higher than that of pT ≤2 and remained high even 10yr after RNU. Among heavy smokers, the HR of UTUC-related death in all pT stages was highest at baseline and remained high after RNU, compared with nonsmokers, current smokers, or ex-smokers. We simulated specific time points when the risk of non-UTUC death was greater than that of UTUC-related death. Among patients ≥80yr of with pT3N0M0, the risk of non-UTUC death was greater than that of UTUC-related death 1yr after RNU in nonsmokers, but 7yr for heavy smokers.CONCLUSIONS:Our result revealed that smokers bear a long-term risk burden of UTUC-related death more than th
DOI	10.1016/j.euo.2019.06.021
PMID	31395480