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• W4252321619 abstract "There are regional differences in how positron-emission tomography (PET) is routinely used in clinical practices. Compared with other fields of cancer clinics, urological cancer clinics have limitations in the efficacy of diagnostics, because the most commonly used fluorodeoxyglucose-PET is physiologically excreted into the urinary system. Furthermore, urological cancers, including renal cell carcinoma, bladder cancer and prostate cancer, require less glucose in comparison with other cancers whose proliferation depends on glucose uptake. Indeed, we use PET-computed tomography in the evaluation of seminoma patients to detect residual viable cells post-chemotherapy. However, these are few in number. A paradigm shift is coming in the field of prostate cancer staging. In Europe, prostate-specific membrane antigen-PET is routinely used in decision-making in regard to prostate cancer. Rauscher et al. (Munich, Germany) have written a comprehensive review of the use of PET-computed tomography for urological cancers. We often see patients with rising prostate-specific antigen whose computed tomography and bone scan cannot identify any recurrent lesions. Prostate-specific membrane antigen-PET can visualize local recurrence or lymph node metastases. Prostate-specific membrane antigen-PET can provide higher efficacy in the initial staging evaluation of prostate cancer and can change our ordinary practices. “Pure” or “dirty,” which is better? This is about molecular targeted therapy for renal cell carcinoma. Tyrosine kinase inhibitors, including sunitinib, pazopanib, axitinib and sorafenib, are widely used in Japan. Cabozantinib and lenvatinib are also used in the USA and Europe. Specificity to vascular endothelial growth factor receptor is different among the tyrosine kinase inhibitors. Axitinib is the “purest” drug in terms of low IC50 to vascular endothelial growth factor receptor, followed by lenvatinib, which is commonly used for the treatment of thyroid cancer. Interestingly, lenvatinib can target fibroblast growth factor receptor, as well as vascular endothelial growth factor receptor. Matsubara et al. (Kashiwa, Japan) described the Japanese phase I study of combination therapy of lenvatinib and everolimus. Many publications have shown that adverse events observed in the Japanese population are more often and severe in the use of tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors, including everolimus. Contrary to the expectations, the study has shown that Japanese patients can tolerate the combination therapy. Interstitial pneumonitis is the major adverse event in Japanese patients taking 10 mg.1 The combination is 5 mg, and fine dose reduction is possible with lenvatinib use. Combination therapy is promising for weak Japanese patients. Is race related with biological aggressiveness of prostate cancer? Do African American (AA) patients have worse survival because of limited access to radical prostatectomy than non-Hispanic white (NHW) patients? Several publications have shown that racial disparities exist in the prognosis of prostate cancer. Is this related to the quality of care for localized prostate cancer? Preisser et al. (Hamburg, Germany) investigated racial disparities using the Surveillance, Epidemiology and End Results database (2010–2014) among patients who have chosen definitive treatment of radical prostatectomy in terms of lymph node dissection (LND) rates, LND extent, lymph node invasion rate and cancer-specific mortality. Although the extent of LND was lower, lymph node invasion and cancer-specific mortality were the same between AA patients and NHW patients. This result suggests that there are still racial disparities in LND that do not prove a benefit in cancer-specific mortality. In a previous report using the Surveillance, Epidemiology and End Results database (1991–2009), Schmid et al. showed that AA patients were more likely to experience adverse events, but their results did not translate into cancer-specific mortality.2 The current study reconfirmed the same trend. It seems that there are no racial disparities in cancer aggressiveness, but the quality of the operations are different between AA patients and NHW patients. Schmid, the author of reference 2, stated in the Editorial Comment that true convergence to equal care seems to be far from over. None declared." @default.
• W4252321619 created "2022-05-12" @default.
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• W4252321619 date "2018-11-01" @default.
• W4252321619 modified "2023-09-30" @default.
• W4252321619 title "IJU this issue" @default.
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• W4252321619 doi "https://doi.org/10.1111/iju.13835" @default.
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