Impact of health-related quality of life on repeat protocol biopsy compliance on active surveillance for favorable prostate cancer: results from a prospective cohort in the PRIAS-JAPAN study.

OBJECTIVES: This study aimed to evaluate how health-related quality of life (HRQOL) is related to repeat protocol biopsy compliance. MATERIALS AND METHODS: We conducted a retrospective analysis using data from a prospective cohort in the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study between January 2010 and August 2019. We used the Short Form 8 Health Survey (SF-8), as patient-reported outcomes, to assess HRQOL at AS enrollment and the first year of the protocol. The physical component summary (PCS) and mental component summary (MCS) were calculated from SF-8 questionnaires. The primary outcome was the evaluation of the association of HRQOL at enrollment on the first repeat biopsy compliance. The secondary outcome was the comparison of SF-8 scores during AS, stratified by repeat protocol biopsy compliance. RESULTS: Of 805 patients who proceeded to the first year of the protocol, the non-compliance rate was 15% (121 patients). In the adjusted model, lower MCS at enrollment was significantly associated with the first repeat protocol biopsy non-compliance (odds ratio [OR], 2.134; 95% confidence interval [CI], 1.031-4.42; P = 0.041) but not in lower PCS (OR, 0.667; 95% CI, 0.294-1.514; P = 0.333). All subscales of SF-8 were lower in the non-compliance group than in the compliance group at any point. MCS in the non-compliance group improved over time from the time of AS enrollment (2.34 increased, P = 0.152). CONCLUSION: Our data suggest that lower MCS at AS enrollment using patient-reported outcomes was negatively associated with the first repeat protocol biopsy compliance. Our study may support the availability of a simple questionnaire to extract non-compliance.

In vivo growth of transitional and renal cell carcinoma cell lines can be suppressed by the adenovirus-mediated expression of a soluble form of vascular endothelial growth factor receptor.

Antiangiogenic therapy is a promising strategy for the treatment of cancer since tumor development and metastases require angiogenesis. Vascular endothelial growth factor (VEGF) is one of the most important factors in tumor angiogenesis. In the present study, we investigated the antitumor effect of an adenovirus (AdVEGF-ExR) expressing the extracellular domain of the human VEGF receptor (flt-1) using two different urological tumor/mouse systems. RENCA, a renal cell carcinoma of BALB/c origin, and MBT-2, a poorly differentiated transitional carcinoma of C3H/He origin, were used. Both types of tumor were in vitro infected with AdVEGF-ExR and inoculated subcutaneously into the abdomens of syngenenic mice, and tumor growth was measured twice weekly. In some experiments, BALB/c mice with established RENCA tumors were injected intramuscularly with AdVEGF-ExR as a therapeutic model. The cytotoxicity of spleen cells from the tumor-rejected mice was assessed by 51Cr-release assay. Although the in vitro cell growth of either MBT-2 or RENCA was not affected by infection with AdVEGF-ExR, the in vivo growth of both AdVEGF-ExR-infected tumors was significantly suppressed in the syngeneic mice. In addition, although 2 of 5 mice rejected the AdVEGF-ExR-infected RENCA, tumor-specific cytotoxic T lymphocytes were not generated from their spleen cells, thus suggesting no cellular immune response. In a therapeutic model, intramuscular injections of AdVEGF-ExR at a remote site also significantly suppressed the growth of the subcutaneously established RENCA. These results indicate that the adenovirus-mediated expression of a soluble VEGF receptor can be an effective therapy for urological cancer treatment; however, such VEGF-targeted gene therapy is not necessarily accompanied by subsequent antitumor T cell immunity.

The change of the split renal function before and after a nephrectomy using Tc-mercaptoacetyltriglycine (MAG3).

OBJECTIVE: We examined the change in the renal function in the normal side kidney before and after a nephrectomy, by means of a newly developed diuretic renography technique utilizing Tc 99m-mercaptoacetyltriglycine (MAG3). MATERIALS AND METHODS: Forty patients who underwent a nephrectomy were evaluated using MAG3 diuretic renography. We measured the effective renal plasma flow (ERPF) and Tmax time before and after a nephrectomy. The effects of the patient age and the preoperative ERPF of ill side kidney on the post operative ERPF were then assessed statistically. RESULTS: The ERPF increased by an average of 44.8 ml/min at 2 weeks after a nephrectomy, but it decreased by an average of 24.3 ml/min at 3 months after a nephrectomy. The Tmax time decreased by an average of 0.58 min at 2 weeks, but thereafter increased by an average of 0.58 min at 3 months after a nephrectomy. The correlation coefficient between the rate of increase in the ERPF and the patient age was 0.197. CONCLUSIONS: The rise of renal function in terms of ERPF and the Tmax time was observed at 2 weeks post-nephrectomy. However, this effect disappeared at 3 months post-nephrectomy. These data demonstrated that the rise in the renal function of the normal-side kidney in such patients was only temporary.