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The primary objective of this study was to identify predictors for biochemical recurrence (BCR) within 2 years following robot-assisted radical prostatectomy (RARP). Identifying predictors will enable insights that enhance personalized patient management and facilitate the ongoing refinement of postoperative therapy strategies. This retrospective study included patients undergoing RARP from September 2014 to January 2021. Exclusion criteria were preoperative endocrine therapy, BCR beyond 2 years post-surgery, and incomplete postoperative data. Multivariate analyses were conducted to evaluate predictors of BCR, focusing on preoperative prostate-specific antigen (PSA) level, pathological tumor (pT) stage, Gleason score (GS), extraprostatic extension (EPE), and surgical margin status. Among 374 patients, 40 experienced BCR within 2 years. Significant predictors of early BCR included initial PSA level ≥10 ng/ml, pT3 or greater, GS ≥8, EPE, and positive surgical margins (RM1). Multivariate analysis identified pT3 or higher, GS ≥8, and RM1 as independent risk factors for early BCR. Early BCR after RARP is significantly associated with advanced pathological stage, high GS, and positive surgical margins. These findings emphasize the need for tailored postoperative management strategies and highlight the importance of precision in surgical technique to improve patient outcomes.

Benign prostatic hyperplasia (BPH) is arguably the most common benign disease among men. This disease is often associated with lower urinary tract symptoms (LUTS) in men and significantly decreases the quality of life. Polyphenol consumption reportedly plays an important role in the prevention of many diseases, including BPH. In recent years, in addition to disease prevention, many studies have reported the efficacy and safety of polyphenol treatment against various pathological conditions in vivo and in vitro. Furthermore, numerous studies have also revealed the molecular mechanisms of the antioxidant and anti-inflammatory effects of polyphenols. We believe that an improved understanding of the detailed pharmacological roles of polyphenol-induced activities at a molecular level is important for the prevention and treatment of BPH. Polyphenols are composed of many members, and their biological roles differ. In this review, we first provide information regarding the pathological roles of oxidative stress and inflammation in BPH. Next, the antioxidant and anti-inflammatory effects of polyphenols, including those of flavonoids and non-flavonoids, are discussed. Finally, we talk about the results and limitations of previous clinical trials that have used polyphenols in BPH, with particular focus on their molecular mechanisms of action.

Background and Objectives: Gamma-glutamyltransferase-to-lymphocyte ratio (GLR) is a prognostic biomarker reflecting oxidative stress and host immune status. However, its prognostic value in patients with bladder cancer undergoing radical cystectomy (RC) remains unclear. This study aimed to investigate whether preoperative GLR predicts survival outcomes following RC. Materials and Methods: We retrospectively reviewed 110 patients with urothelial carcinoma of the bladder (pure urothelial carcinoma or urothelial carcinoma with variant histology) who underwent RC at a single tertiary center between 2008 and 2022. GLR was calculated as serum gamma-glutamyltransferase (U/L) divided by absolute lymphocyte count (×109/L) using routine preoperative blood samples. Patients were categorized into low-GLR (≤17.0; n = 54) and high-GLR (>17.0; n = 56) groups based on the cohort median cut-off (17.0). Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) were assessed using Kaplan–Meier analysis and compared by log-rank tests. Cox proportional hazards models were used, including a preoperative model (Model 1) and a pathology-adjusted model incorporating postoperative variables (Model 2). Results: High GLR was associated with significantly worse OS, RFS, and CSS (log-rank: p = 0.020, p = 0.043, and p = 0.003, respectively). In multivariate analyses, high GLR was independently associated with inferior outcomes in both models. In Model 2, high GLR predicted worse OS (hazard ratio [HR] = 2.38; 95% confidence interval [CI] = 1.32–4.28; p = 0.003), RFS (HR = 2.37; 95% CI = 1.13–4.99; p = 0.020), and CSS (HR = 3.45; 95% CI = 1.56–8.52; p = 0.001). Conclusions: Preoperative GLR is a simple, inexpensive biomarker independently associated with survival after RC for bladder cancer, even after adjustment for established clinicopathological and pathological factors. GLR may support risk stratification and postoperative management, warranting prospective multicenter validation.

This study aimed to investigate the efficacy of salt intake restriction on overactive bladder (OAB) symptoms in patients with excessive salt intake. Patients received a brochure on nutritional guidance regarding salt intake reduction and received health education every 4 weeks for 12 weeks. Data from overactive bladder symptom score (OABSS) questionnaires and frequency volume charts (FVCs) were evaluated. The daily salt intake was estimated by determining the urinary sodium and creatinine concentrations using spot urine samples. Of the 98 patients included, 71 (72.4%) successfully restricted their daily salt intake after 12 weeks (salt restricted [R] group), while 27 (27.6%) did not (salt non-restricted [N-R] group). The scores to each OABSS question and the resulting total score improved significantly in the R group; however, the individual scores remained unchanged and the total score increased in the N-R group. The FVC data indicated improved voided volumes in the R group as compared to in the N-R group. Ultimately, 17 (23.9%) patients in the R group no longer fulfilled the OAB diagnostic criteria after salt intake reduction. Thus, salt intake reduction improved urinary symptoms in patients with OAB and may be a therapeutic option for OAB in patients with excessive daily salt intakes.

The effectiveness of cardiac rehabilitation (CR) in patients with cardiovascular disease requiring continuous CR from an acute care hospital to a convalescent rehabilitation hospital is unknown. Therefore, we compared the effect of CR in a rehabilitation hospital for patients with cardiovascular disease with that of those who underwent cardiovascular surgery. Sixty-nine consecutive patients were admitted to two rehabilitation hospitals for CR. Patients were classified by primary disease into two groups: patients with cardiovascular disease (cardiology group, 26 patients) and patients who underwent cardiovascular surgery (surgery group, 43 patients). Clinical information, physical function, cognitive function, activities of daily living (ADL), quality of life (QOL), amount of CR, and length of hospital stay were compared between the two groups. Compared with clinical features, age was significantly higher in the cardiology group ( P  < 0.001), and the preadmission Barthel index was significantly lower in the cardiology group ( P  = 0.025). Physical function at the time of transfer was significantly lower in the cardiology group than in the surgery group for the short physical performance battery ( P  < 0.001), gait speed ( P  = 0.005), and 6-min walking distance ( P  = 0.042). No significant difference was found in the amount of CR performed or the length of hospital stay, and no interaction effects were observed in improvements in physical function, exercise tolerance, or QOL. In conclusion, in rehabilitation hospitals, patients with cardiovascular disease were older, had lower preadmission ADL, and had lower a physical function at transfer than those who underwent cardiovascular surgery, but CR improved physical function and QOL to the same extent. The results suggest that the recovery of patients with cardiovascular disease may be similar to those who undergo cardiovascular surgery.

Background The recurrence rate after robot-assisted laparoscopic partial nephrectomy (RAPN) for renal cell carcinoma varies, and few established risk factors have been identified. We investigated recurrence rate and its risk factors following RAPN. Methods Among 221 patients who underwent RAPN at our institution from 2016 to 2024, we analyzed 205 patients diagnosed with renal cell carcinoma (excluding benign diseases). We retrospectively examined recurrence rates and risk factors. Results Postoperative recurrence was observed in 11 cases: 3 local recurrences and 8 non-local recurrences. The postoperative recurrence rate was 5.3%. The overall median follow-up duration for the full cohort was 63.5 months and the median time to postoperative recurrence was 15 months. Regarding perioperative findings, sex, lateral perirenal fat thickness, dorsal perirenal fat thickness, tumor size, operative time, warm ischemia time, pathological tumor (pT) stage ≥ 3a, and Fuhrman grade ≥ 3 were associated with postoperative recurrence status. A Cox regression analysis for recurrence-free survival was performed on factors associated with postoperative recurrence in the univariate analysis, and hazard ratios (HRs) were calculated. In particular, it was indicated that pT stage ≥ 3a (HR: 8.2, 95% confidence interval (CI): 2.0–33.8; p  < 0.01) and Fuhrman grade ≥ 3 (HR: 9.2, 95% CI: 2.5–33.8; p  < 0.01) might be associated with recurrence. However, postoperative recurrence occurred in only one of the seven cases with positive surgical margins, suggesting that no significant association was detected between positive surgical margins and recurrence in this cohort. Thirty-seven (18%) patients had either pT stage ≥ 3a or Fuhrman grade ≥ 3 (high-risk group). Compared with the 169 patients in the low-risk group (i.e., neither pT stage ≥ 3a nor Fuhrman grade ≥ 3), RFS was significantly shorter in patients meeting either criterion (HR: 15.6; 95% CI: 4.1–59.9; p  < 0.01). Conclusion Positive surgical margin was not significantly associated with recurrence after RAPN for renal cell carcinoma, whereas pT stage ≥ 3a and Fuhrman grade ≥ 3 may be associated with recurrence. These findings should be interpreted with caution due to the limited number of events and require validation in larger studies.

Prostaglandin E2 plays an important role in carcinogenesis and malignant potential of prostate cancer (PC) cells by binding to its specific receptors, E-type prostanoid (EP) receptors. However, anti-carcinogenic effects of the EP receptor antagonist are unclear. In this study, we used a mouse model of PC. The mice were provided standard feed (control) or feed containing the EP1 receptor antagonist and were sacrificed at 10, 15, 30, and 52 weeks of age. Apoptosis was evaluated by immunohistochemical analysis using a cleaved caspase-3 assay. The incidence of cancer in the experimental group was significantly lower than that in the control group at 15, 30, and 52 weeks of age. The percentage of poorly differentiated PC cells was significantly lower in the experimental group than in the control group at 30 and 52 weeks of age. The percentage of apoptotic cells in the experimental group was significantly higher than that in the control group at 15, 30, and 52 weeks of age. These findings indicate that feeding with the addition of EP1 receptor antagonist delayed PC progression via the upregulation of apoptosis. We suggest that the EP1 receptor antagonist may be a novel chemopreventive agent for PC.

Green tea polyphenol (GTP) suppresses carcinogenesis and aggressiveness in many types of malignancies including bladder cancer. However, the mechanistic basis of these effects is not well understood. This was investigated in the present study using a mouse model of chemically induced bladder cancer. C3H/He mice (8 weeks old; n = 46) were treated with 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) solution for 14-24 weeks. Mice in the BBN + GTP group (n = 47) were also treated with 0.5% GTP solution over the same period. Tumor cell proliferation and microvessel density were evaluated along with immunohistochemical analysis of human antigen (Hu)R, vascular endothelial growth factor (VEGF)-A, cyclooxygenase (COX)-2, and hemeoxygenase (HO)-1 expression. Cytoplasmic HuR expression in cancer cells was higher at 14 and 24 weeks in the BBN than in the control group and was associated with increased invasion of tumor cells in muscle. However, these effects were not observed in the BBN + GTP group. A multivariate analysis of GTP intake and cytoplasmic HuR expression revealed that GTP was independently associated with COX-2 and HO-1 expression, while cytoplasmic HuR expression was associated with COX-2 and VEGF-A levels. Expression of COX-2 and HO-1 was associated with cell proliferation and that of VEGF-A and HO-1 was associated with angiogenesis. Nuclear HuR expression was not associated with any parameters such as carcinogenesis, muscle invasion, and GTP intake. These results indicate that GTP intake can suppress tumor progression and malignant behavior in an animal model of bladder cancer. We also speculate that GTP directly and indirectly suppresses tumor cell proliferation and angiogenesis via HuR-related pathways in bladder cancer.

Kidney and brain expressed protein (KIBRA), a member of the WW domain-containing protein family, has an important role in tumour growth and progression in various cancers. However, the pathological significance of KIBRA expression in clear cell renal cell carcinoma (ccRCC) tissues is not fully understood. The aim of this study was to clarify the pathological significance and prognostic roles of KIBRA expression in patients with ccRCC. KIBRA immunoreactivity, proliferation index (PI; with anti-Ki-67 antibody), apoptotic index (AI; using anti-cleaved caspase-3), and large tumour suppressor kinases (LATS-2) were evaluated in 157 ccRCC specimens by immunohistochemistry. Fifty normal kidney tissues were also evaluated as controls. The relationships between KIBRA expression and these cancer-related variables as well as clinicopathological features and survival were analysed. Moderate to strong immunoreactivity of KIBRA was identified in all normal kidney tissues; however, ccRCC cells with strong KIBRA expression was rare. The immunoreactivity score (IRS) of KIBRA was negatively associated with grade, T stage, tumour diameter, and metastasis. Kaplan-Meier survival curves showed that high KIBRA expression was a favourite predictor for overall survival. KIBRA IRS was negatively associated with PI and positively associated with the IRS of LATS-2 by univariate analysis. In addition, multivariate analysis showed that KIBRA was significantly associated with PI. KIBRA demonstrated important roles as a tumour suppressor in ccRCC. In addition, its expression was significantly associated with survival in these patients. Several such KIBRA-related functions were speculated to be modulated by cancer cell proliferation and LATS-2.

During the developmental processes of embryos, cells undergo massive deformation and division that are regulated by mechanical cues. However, little is known about how embryonic cells change their mechanical properties during different cleavage stages. Here, using atomic force microscopy, we investigated the stiffness of cells in ascidian embryos from the fertilised egg to the stage before gastrulation. In both animal and vegetal hemispheres, we observed a Rho kinase (ROCK)-independent cell stiffening that the cell stiffness exhibited a remarkable increase at the timing of cell division where cortical actin filaments were organized. Furthermore, in the vegetal hemisphere, we observed another mechanical behaviour, i.e., a ROCK-associated cell stiffening, which was retained even after cell division or occurred without division and propagated sequentially toward adjacent cells, displaying a characteristic cell-to-cell mechanical variation. The results indicate that the mechanical properties of embryonic cells are regulated at the single cell level in different germ layers.Fujii et al. investigate the stiffness of cells in ascidian embryos from the fertilised egg to the stage before gastrulation. They find two types of cell stiffening, occurring during cell division and in the interphase, the latter of which is associated with the Rho kinase pathway. They conclude that the mechanical properties of early embryonic cells are regulated specifically at the single cell level.