Overall, our results show that intravesical BCG instillation for variant histology in NMIBC leads to a better prognosis with regard to progression and cause-specific survival than other intravesical treatments or no additional treatment. BCG treatment may also have a clinical benefit for variant histology in non-muscle invasive bladder cancer patients.

Objectives To clarify Japanese real‐world clinical data on the use of desmopressin 25 and 50 μg orally disintegrating tablets (ODT) for male patients with nocturia and evaluate the predictive factors to improve nighttime frequency. Methods We retrospectively accumulated real‐world clinical data from 27 institutions in Japan. Male patients with two or more episodes of nocturia who received desmopressin ODT for nocturnal polyuria (NP) from 2019 through 2021 were included. The primary endpoint was the change of nighttime frequency until 3 months after desmopressin administration. The secondary endpoints were to clarify the persistence rate, adverse events, and predictive factors of decreasing nighttime frequency. Results A total of 118 patients were eligible to participate in this study. The persistence rate of desmopressin on the Kaplan‐Meier curve at week 12 was 51.3. The reason for discontinuation was mainly the occurrence of adverse events in 67 patients (56.8%), particularly hyponatremia in 7 patients (5.9%). Nighttime frequencies at baseline, ‐ 1 month and 1 ‐ 3 months after desmopressin administration were 4.1 ± 1.3, 2.9 ± 1.4 (P < .01), and 2.6 ± 1.3 (P < .01), respectively. The mean nighttime urine volume voided at baseline was significantly larger in patients whose nighttime frequency decreased by two or more times than in those with a decrease of less than two times. Conclusions Desmopressin 25 and 50 μg ODT treatments are feasible for male patients with NP in Japanese real‐world clinical practice. Patients with higher voided volumes, particularly in the nighttime, may have great benefit from desmopressin.

岡部 洸 1) 梶 智人 2) 高木 良雄 1) 要旨： (目的)尿路上皮癌患者の転移診断における PET/CT の有用性について検討を行った． (対象と方法) 当科で新規に尿路上皮癌と診断し，転移検索目的に CT および PET/CT を行った症例を対象 とした． (結果) 対象患者 92 例の年齢は中央値 71 歳，原疾患は膀胱癌が 41 例 (46%) ，腎盂尿管癌が 51 例 (54%) で あった．92 例中 66 例(72%)では CT で転移を認めなかったが，うち 9 例(14%)には PET/CT で転移が認 められた．CT，PET/CT ともに転移を認めなかった 57 例(86%)は根治手術を行い，2 例(4%)に病理学的 なリンパ節転移が認められた． CT で転移を認めた 26 例中，3 例 (12%) は PET/CT では転移を認めず，全例で病理学的に転移がないこと が確認された．CT，PET/CT ともに転移を認めた 23 例のうち，10 例 (43%) では PET/CT を行うことで CT では同定出来ない転移が発見された． CT のみ行った場合に比べ，CT および PET/CT を行った場合の方が，有意に診断精度が高い結果であった (p＜0.01) ．

INTRODUCTION AND OBJECTIVES: Single immediate intravesical instillation of chemotherapy after transurethral resection of bladder tumor (TURBT) has been the gold standard treatment for patients with low-and intermediate-risk non-muscle invasive bladder cancer (NMIBC). Herein, we conducted a multicenter prospective randomized controlled trial in Japan, comparing recurrence-free survival between single and two-time instillation of pirarubicin (THP) for solitary NMIBC.METHODS: Between 2005 and 2009, 257 patients with solitary NMIBC were enrolled and randomized to single instillation of THP (30 mg/50 mL) immediately after TURBT (Group A) or two-time instillation of THP immediately after and 1 day after TURBT (Group B). The primary endpoint was recurrence-free survival. Secondary endpoints included rates of recurrence and adverse effects, including hematuria, micturition pain, difficult urination, pollakiuria, systemic symptoms, and other complications. This study was registered as UMIN C000000266.RESULTS: Of 257 patients, 99 in Group A and 102 in Group B could be evaluated for recurrence. Median follow-up was 71 months. The overall recurrence rate was 39% and 31%, respectively (p¼0.2704). Although the 5-year recurrence-free survival rates were 55.9% and 67.7% in groups A and B, respectively, the difference between groups was not significant (p¼0.2031). No significant differences in adverse effects were observed between groups, except for pollakiuria (7% vs 22%, p¼0.0031). Multivariate analyses did not show that the treatment group was a significant risk factor for bladder cancer recurrence.CONCLUSIONS: Postoperative two-time intravesical instillation of THP was not superior to single immediate instillation for preventing recurrence after complete resection of a solitary NMIBC.