Objective. This study evaluated the 5-year failure rate of naftopidil (NAF) or tamsulosin hydrochloride (TAM) in lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH/LUTS) and compared the prognostic factor of two α₁-blockers. Material and methods. A total of 131 patients with International Prostate Symptom Score (IPSS) ≥ 8 or IPSS quality of life (IPSS-QOL) ≥ 3 with BPH/LUTS receiving treatment with α₁-blockers had been administered NAF or TAM, and failure rates were calculated for 5 years. Age, prostate volume (PV), acute urinary retention (AUR), overactive bladder (OAB), IPSS, IPSS-QOL and postvoiding residual volume (PVR) were evaluated as prognostic factors. Results. No significant differences in failure rate were observed between the drugs. The failure rate was significantly high for patients with a PV ≥ 35 ml, PVR ≥ 30 ml, a history of AUR or complications of OAB symptoms. The failure rate for patients with a history of AUR was significantly higher than in those without AUR in the NAF group. By contrast, in the TAM group, it was significantly higher in patients who had OAB symptoms than in those without OAB. Conclusions. No significant differences were observed between the drugs for the failure rate. Each treatment had a unique factor for prognosis, such as history of AUR for NAF and complications of OAB for TAM. Therefore, it will be necessary to use the two α₁-blockers properly, considering the patient's background.

Background: Recently, robot-assisted minimally invasive esophagectomy (RAMIE) has gained popularity worldwide. Some studies have compared the long-term results of RAMIE and minimally invasive esophagectomy (MIE). However, there are no reports on the long-term outcomes of RAMIE in Japan. This study compared the long-term outcomes of RAMIE and MIE. Methods: This retrospective study included 86 patients with thoracic esophageal cancer who underwent RAMIE or MIE at our hospital from June 2010 to December 2016. Propensity score matching (PSM) was employed, incorporating co-variables such as confounders or risk factors derived from the literature and clinical practice. These variables included age, sex, body mass index, alcohol consumption, smoking history, American Society of Anesthesiologists stage, comorbidities, tumor location, histology, clinical TNM stage, and preoperative therapy. The primary endpoint was 5-year overall survival (OS), and the secondary endpoints were 5-year disease-free survival (DFS) and recurrence rates. Results: Before PSM, the RAMIE group had a longer operation time (min) than the MIE group (P = 0.019). RAMIE also exhibited significantly lower blood loss volume (mL) (P < 0.001) and fewer three-field lymph node dissections (P = 0.028). Postoperative complications (Clavien–Dindo: CD ≥ 2) were significantly lower in the RAMIE group (P = 0.04), and postoperative hospital stay was significantly shorter than the MIE group (P < 0.001). After PSM, the RAMIE and MIE groups consisted of 26 patients each. Blood loss volume was significantly smaller (P = 0.012), postoperative complications (Clavien–Dindo ≥ 2) were significantly lower (P = 0.021), and postoperative hospital stay was significantly shorter (P < 0.001) in the RAMIE group than those in the MIE group. The median observation period was 63 months. The 5-year OS rates were 73.1% and 80.8% in the RAMIE and MIE groups, respectively (P = 0.360); the 5-year DFS rates were 76.9% and 76.9% in the RAMIE and MIE groups, respectively (P = 0.749). Six of 26 patients (23.1%) in each group experienced recurrence, with a median recurrence period of 41.5 months in the RAMIE group and 22.5 months in the MIE group. Conclusions: Compared with MIE, RAMIE led to no differences in long-term results, suggesting that RAMIE is a comparable technique.

This study aimed to validate and reanalyze urinary biomarkers for detecting colorectal cancers (CRCs). We previously conducted urinary metabolomic analyses using capillary electrophoresis-mass spectrometry and found a significant difference in various metabolites, especially polyamines, between patients with CRC and healthy controls (HC). We analyzed additional samples and confirmed consistency between the newly and previously analyzed data. In total, we included 36 HC, 34 adenoma (AD), and 214 CRC samples, which were used for subsequent analyses. Among the 132 quantified metabolites, 16 exhibited consistent differences in both datasets, which included polyamines, etc. Pathway analyses of the integrated data revealed significant differences in many metabolites, such as glutamine, and metabolites of the TCA (tricarboxylic acid cycle) and urea cycles. The discrimination ability of the combination of multiple metabolites among the three groups was evaluated, which yielded higher sensitivity than tumor markers. The Mann–Whitney test was employed to evaluate the prognosis predictivity of the assessed metabolites and the difference between the patients with or without recurrence, which yielded 16 significantly different metabolites. Among these 16 metabolites, 11 presented significant prognosis predictivity. These data indicated the potential of metabolite-based discrimination of patients with CRC and AD from HC and prognosis predictivity of the monitored metabolites.

Postgastrectomy disorders decrease the quality of life of patients because of poor oral intake and nutritional status. Rikkunshito is a Japanese herbal medicine that alleviates anorexia and prevents upper gastrointestinal disorders, particularly in the perioperative period. Herein, we investigated whether Rikkunshito administration in the early perioperative period alleviates weight loss and improves the nutritional status after undergoing minimally invasive distal gastrectomy for gastric cancer. We conducted a retrospective cohort study involving 139 consecutive gastric cancer patients who underwent laparoscopic or robot-assisted distal gastrectomy for potentially curable gastric cancer between January 2018 and May 2023 at our institution. We divided the patients into 2 groups based on Rikkunshito administration time: Rikkunshito administered on postoperative day 4 (RPOD4 group) and on postoperative day 1 (RPOD1 group). We performed one-to-one propensity score matching to balance the baseline characteristics. We examined the postoperative body weight changes and nutritional status at 1 month. One month postoperatively, the RPOD1 group showed a significantly smaller body weight change rate (7.12% [RPOD4] vs 5.35% [RPOD1], P < .05). For nutritional status, the RPOD1 group showed significantly higher prognostic nutritional index score (47.21 ± 16.45 [RPOD4] vs 49.45 ± 5.50 [RPOD1], P < .05) and geriatric nutritional risk index score (97.22 ± 20.49 [RPOD4] vs 100.97 ± 7.96 [RPOD1], P < .05). Initiating rikkunshito in the early perioperative period alleviates weight loss and improves the nutritional status after minimal invasive distal gastrectomy for gastric cancer.