Welcome
Dear friends and APPS members,
It is our great privilege and honor to host the Annual Congress of Asian Pacific Prostate Society (APPS)
2022 in Tokyo, Japan from December 8th to 10th, 2022.
On behalf of the member of APPS and as the Congress Chairperson, I would like to welcome all participants from Asian Pacific Countries and Communities to the meeting in Tokyo. This will be the second
time that the event has been held in Japan since Professor Shigeo Horie of Juntendo University held thefourth event in Okinawa in 2014.
APPS is an academic meeting held every year for the purpose of contributing to the progress and development of Urological medical care. But due to the pandemic of COVID-19, the annual meeting for the
past two years has been cancelled, and it will be the first time in three years since the meeting inShanghai in 2019. We believe that an academic meeting where many urologists from Asian countries
gather and exchange clinical experiences and research results with each other will be of great significance, and we would like to make the academic meeting we hold fruitful. The organizing committee
and the scientific committee are planning to have several symposia and panel discussions about recent
hot topics for prostatic disease. We encourage expert and young urologists in the Asian-Pacific region
to discuss about the latest progress in the clinical and translational research.
The status of the epidemic of COVID-19 at the end of this year is unpredictable. But we believe that we
can have a face-to-face discussion with you in Tokyo.
Sincerely,

Takashi Fukagai, MD., PhD.
Congress Chair of Asian Pacific Prostate Society 2022

DAY1 / THURSDAY DECEMBER 8, 2022
TIME
8:35-9:00

PROGRAM
Session 1: Opening Lecture: Epidemiology of prostate cancer in Asian countries

Takashi Fukagai [Japan]

Epidemiology of prostate cancer in Asian countries
Takahiro Kimura [Japan]
9:00-10:00

Session 2: Current Status of PSA Screening in Asian Countries

Koichiro Akakura [Japan], Byung Ha Chung [Korea]

Current Status of PSA Screening in China

Dingwei Ye [China]

Current status of PSA screening in KOREA

Jae Young Joung [Korea]

Prostate Cancer Screening in Indonesia
Lukman Hakim [Indonesia]
10:00-10:40

Session 3: Topics of Active Surveillance and PSA screening in Japan

Kazuhiro Suzuki [Japan]

PSA screening in Japan
Kazuto Ito [Japan]
Active Surveillance for early Prostate Cancer―PRIAS-JAPAN―
Mikio Sugimoto [Japan]
Co-sponsored by Takeda Pharmaceutical Company Limited
10:50-11:50

Session 4: Treatment for Localized Prostate Cancer 1 Radiation therapy

Jun Hyuk Hong [Korea], Osamu Ogawa [Japan]

IMRT for prostate cancer
John Lederer [USA]
Permanent seed implantation prostate brachytherapy in Japan
Shiro Saito [Japan]
Experience of Proton Beam Therapy for Localized Prostate cancer in Tsukuba University
Hiroyuki Nishiyama [Japan]
12:05-12:55

Session 5: Luncheon Seminar: Topics of RARP

Yukihiro Kondo [Japan], Tomohiko Ichikawa [Japan]

Key anatomical structures and points of surgical procedure in robot-assisted radical prostatectomy―Achieving early recovery ofurinary continence―
Yuta Yamada [Japan]
Usefulness of Retzius-sparing technique to prevent postoperative urinary incontinence after robot-assisted radical prostatectomy(RARP)
Atsushi Okada [Japan]
Co-sponsored by Intuitive Surgical
13:10-13:50

Session 6: Treatment for Localized Prostate Cancer 2 RARP: New Platform

Levent Türkeri [Turkey], Yasutomo Nasu [Japan]

Robot-assisted radical prostatectomy using hinotori
Nobuyuki Hinata [Japan]
Robotic Prostatectomy 2022: SP Retzius-Sparing & Perineal.
Koon Ho Rha [Korea]
13:50-14:30

Session 7: Treatment for Localized Prostate Cancer 3 RARP: Tips and Tricks
Dennis Serrano [Philippines], Takeshi Shichijo [Japan]
Application of dehydrated human amnion/chorion membrane on patients undergoing Robotic Assisted Radical Prostatectomy(RARP)
Yen Chuan Ou [Taiwan]
Robot Assisted Radical Prostatectomy(RARP): Techniques to Preserve Potency and Continence
Choung-Soo Kim [Korea]

14:40-15:20

Session 8: Target biopsy and Focal therapy

Go Kimura [Japan], Seong Il Seo [Korea]

Robot-assisted Magnetic Resonance Imaging-ultrasound Fusion Transperineal Targeted Biopsy
Henry Ho [Singapore]
Focal therapy with high-intensity focused ultrasound for the localized prostate cancer based on magnetic resonance imagingtransrectal ultrasound fusion image-guided target biopsy in Japan
Sunao Shoji [Japan]
15:20-16:00

Session 9: Ablation therapy for prostate cancer

Robert G. Carlile [USA], Yoshiyuki Kakehi [Japan]

Irreversible electroporation (IRE) for prostate cancer using PSMA PET-CT
Ji Youl Lee [Korea]
The routine use of high intensity focused ultrasound for the treatment of localized prostate cancer
Po Hui Chiang [Taiwan]
16:15-16:55

Session 10: Topics of the managements of mHSPC

Mototsugu Oya [Japan]

Current status and future perspectives of the managements of metastatic prostate cancer
Kazutoshi Fujita [Japan]
Co-sponsored by Astellas Pharma Inc.
17:05-18:35
MP1-1

Moderated Poster Presentation 1

Kazuhiko Oshinomi [Japan], Jacob ST Pang [Taiwan], Thomas S Namiki [USA]A mitochondria-targeted drug induces apoptosis in prostate cancer xenografts
Seiji Arai [Japan]

MP1-2

Hyperforin Induces Extrinsic/Intrinsic Apoptosis Signaling and Inhibits NF-кB for Metastasis Suppression in Prostate Cancer
Cells
Cheng-Hsi Liao [Taiwan]

MP1-3

Combination therapy with novel androgen receptor antagonists and statin for castration-resistant prostate cancer
Yoshitaka Sekine [Japan]

MP1-4

Lipopolysaccharide from dysbiotic gut microbiome promotes prostate cancer growth through histamine H1 receptor signaling
Kazutoshi Fujita [Japan]

MP1-5

GDF15 propeptide is a novel and useful biomarker for bone metastases in prostate cance
Gaku Yamamichi [Japan]

MP1-6

Withdrawn

MP1-7

Is 12 Systemic Cores in Transperineal Biopsy Sufficient for Detecting Clinically Significant Prostate Cancer?
Chang Eil Yoon [Korea]

MP1-8

The Impact of mpMRI on Treatment Strategy for Incidental Prostate Cancer after HoLEP
Chung Un Lee [Korea]

MP1-9

Clinicopathological analysis of prostate cancer with lymph node metastasis in the prostatic anterior fat pad
Junichi Ikeda [Japan]

MP1-10

Robotic-Assisted Simple Prostatectomy using the da Vinci SP system, pilot study
ByungHoon Kim [Korea]

MP1-11

Ealry outcomes of Single port robotic radical prostatectomy: 1 year followed up
Seokhwan Bang [Korea]

MP1-12Comparison of longitudinal health-related QOL outcomes between anterior and posterior approaches to robot-assisted radical
prostatectomy
Naoya Nagasaki [Japan]

MP1-13Novel Nomogram Predicting Biochemical Recurrence-Free Survival After Radical Prostatectomy
leandro blas [Japan]

MP1-14

Carbon-ion radiotherapy for high-risk prostate cancer in Gunma University Heavy Ion Medical Center
Hiroshi Matsui [Japan]

MP1-15

Salvage low-dose rate brachytherapy for local recurrence of prostate cancer after radical radiotherapy
Takahiro Nakamoto [Japan]

DAY2 / FRIDAY DECEMBER 9, 2022
TIME
8:30-9:10

PROGRAM
Session 11: Topics of RCC

Tohru Nakagawa [Japan]

Practice of clinical approaches to first-line treatment for metastatic renal cell carcinoma.〜A new era of immune checkpoint
inhibitors (ICI) -based combination therapy〜
Jun Morita [Japan]
Co-sponsored by Pfizer
9:10-9:40

Session 12: Medication for BPH & LUTS

Hiroyuki Nishiyama [Japan]

Treatment strategy for OAB with BPH
Naoya Masumori [Japan]
Co-sponsored by KYORIN Pharmaceutical Co., Ltd.
9:50-10:50

Session 13: New Surgical Techniques & New treatment Strategies for BPH
Bannakij Lojanapiwat [Thailand], Satoru Takahashi [Japan]
Water Vapor Therapy for Benign Prostatic Hyperplasia―the Hong Kong Experience
Anthony C.F. Ng [Hong Kong]
Prostatic Urethral Life (Urolift) for the treatment of LUTS in 2022
Henrry Woo [Australia]
Effects of Transoral Robotic Surgery (TORS)- Obstructive Sleep Apnea (OSA) Surgery on Lower Urinary Tract Symptoms in Male
Patients with OSA/Hypopnea Syndrome
Yao-Chi Chuang [Taiwan]

11:00-12:00
MP2-1

Moderated Poster Presentation 2

Kyung Seop Lee [Korea], Robert G. Carlile [USA]

Changes of resistance indices after medication in benign prostatic hyperplasia: a prospective study
Kyung Seop Lee [Korea]

MP2-2

The Association between Human Gut Microbiota and Benign Prostatic Hyperplasia
Kentaro Takezawa [Japan]

MP2-3

PSA doubling time predicts the efficiency of site-directed therapy for non-metastatic or oligometastatic CRPC
Taketo Kawai [Japan]

MP2-4

Switching to darolutamide for M0CRPC resistant to enzalutamide or apalutamide
Saizo Fujimoto [Japan]

MP2-5

Efficacy and Safety of Enzalutamide and Apalutamide in the Treatment of Patients with nmCRPC: A retrospective analysis
Shuhei Hara [Japan]

MP2-6

How I recruit the suitable nmCRPC patients for taking insurance-reimbursed Darolutamide in Taiwan
Kuan-Chou Chen [Taiwan]

MP2-7

Cisplatin and Etoposide for treatment-related Neuroendocrine Prostate Cancer: avorable early Response with short Duration
Yuto Tsubonuma [Japan]

MP2-8Biology and usefulness of [-2] proPSA as a prognostic marker in CRPC patients
Yoshiyuki Miyazawa [Japan]

MP2-9

The Effects of Personal and Family Cancer History on the Diagnosis of Prostate Cancer in a Multi-Institutional Prostate Biopsy
Registry
Jeong Woo Yoo [Korea]

MP2-10Withdrawn

12:15-13:15

Session 14: Luncheon Seminar Topics of M0CRPC

Hideki Sakai [Japan]

Non-metastatic CRPC or Early CRPC?
Challenges in CRPC treatment in the era of next-generation imaging.
Shusuke Akamatsu [Japan]

Changes in treatment landscape for non-metastatic CRPC: what has novel hormonal therapy brought about?
Kohei Hashimoto [Japan]
Co-sponsored by Bayer Yakuhin, Ltd./Nippon Kayaku Co., Ltd.
13:30-14:00

Session 15: Topics of Bone Scan

Takahiro Kimura [Japan]

Importance of Imaging Follow-up for Advanced Prostate Cancer
Kazuki Sudo [Japan]
Co-sponsored by Nihon Medi-physics Co., Ltd.
14:00-14:40

Session 16: Treatment strategy for mCSPC

Hirotsugu Uemura [Japan]

Treatment strategy for mCSPC
Declan G. Murphy [Australia]
Co-sponsored by Janssen Pharmaceutical K.K./Nippon Shinyaku Co., Ltd.
14:50-15:30

Session 17: Topics of BRCA &CRPC

Naohiro Fujimoto [Japan]

The role of olaparib in the treatment of mCRPC
Hiroshi Kitamura [Japan]
Co-sponsored by AstraZeneca
15:30-16:20

Session 18: What is the best treatment sequence of metastatic Pca?
Hiroyoshi Suzuki [Japan], Edmund Chiong [Singapore]
Panelist: Jae il Chung [Korea], Teng Aik Ong [Malaysia], Hiroshi Kitamura [Japan], Kuan Chou Chen [Taiwan]
Metastatic Prostate Cancer Treatment―Considerations in Asia
Edmund Chiong [Singapore]

16:20-16:50

Session 19: Advance in PSMA theranostics

Norio Nonomura [Japan]

A single dose of novel PSMA-targeting radiopharmaceutical agent [177Lu] Ludotadipep for patients with metastatic castrationresistant prostate cancer: Phase I clinical trial
Ji Youl Lee [Korea]
Co-sponsored by Future Chem
17:00-18:15

APPS & ACaP Joint Symosium (7th A-Cap meeting)Opening Remarks
Haruki Kume [Japan]
Special Lecture

Takashi Fukagai [Japan]

The utilization of the Japan Study Group of Prostate Cancer registry data
Masaki Shiota [Japan]
Changes in the trends of initial treatment for newly diagnosed prostate cancer in Japan: A nationwide multi-institutional study
Taketo Kawai [Japan]
Reports from participating countries

Tohru Nakagawa [Japan]

1. Malaysia
Teng Aik Ong [Malaysia]
2. Turkey
Levent Turkeri [Turkey]
3. Japan
Mizuki Onozawa [Japan]
Closing Remarks
Teng Aik Ong [Malaysia]
18:30-19:00

Best Poster Award at Foyer

Hidefumi Kinoshita [Japan]

DAY3 / SATURDAY DECEMBER 10, 2022
TIME

PROGRAMAPPS & Prostate Cancer Symposium joint session
8:30-9:00

Session 20: Liquid Biopsy

Kazuhiro Suzuki [Japan]

Liquid Biopsy for Prostate Cancer
Yeong-Shiau Pu [Taiwan]
9:00-10:00

Session 21: Topics of New Diagnostic Methods p2PSA

Rainy Umbas [Indonesia], Yoshihiko Hirao [Japan]

Current update on prostate health index (phi ) in Japan
Kazuto Ito [Japan]
Effectiveness of [-2]proPSA measurement in the diagnosis of significant prostate cancer compared to MRI and PSA
Hiroji Uemura [Japan]
Co-sponsored by Beckman CoulterSession 1: Opening Lecture: Epidemiology of prostate cancer in Asian countries

Moderator

Takashi Fukagai
Department of Urology, Showa University School of Medicine, Tokyo, Japan
Education:
1980-1986
1986-1990
1997-1999

Showa University, School of Medicine, Tokyo, Japan
Degree: Doctor of Medicine
Showa University Graduate School Department of Urology
Research Fellow, Department of Surgery,John A. Burns School of Medicine, University of Hawaii.

Professional experience:
1990-1991
Instructor, Showa University School of Medicine.
1991-1993
Medical Staff in Urology
Tokyo Seamen’s Insurance Hospital, Tokyo.
1993-1996
Medical Staff in Urology
Tokyo Metropolitan Hiroo General Hospital, Tokyo.
1996-1998
Instructor, Showa University School of Medicine.
1998-2003
Assistant Professor of Urology.
Showa University School of Medicine.
2003-2014
Associate Professor of Urology.
Showa University School of Medicine
2014 March
Professor of Urology,
Showa University Koto Toyosu Hospital
2016 April
Vice Director, Professor of Urology,
Showa University Koto Toyosu Hospital
2021 April
Professor and chairman of Urology,
Showa University School of Medicine

Session 1: Opening Lecture: Epidemiology of prostate cancer in Asian countries

Epidemiology of prostate cancer in Asian countries

Takahiro Kimura
Department of Urology, The Jikei University School of Medicine
Educational History
2002
Ph.D. (Dr. of Medical Science), The Jikei University School of Medicine
1996
M.D., The Jikei University School of Medicine
Professional BackgroundApr/2022-present
Jan/2018-Mar/2022
Aug/2011-Dec/2017
Aug/2003-Sep/2006
Apr/2001-Aug/2003
May/1996-Dec/1999

Professor, Department of Urology, The Jikei University School of Medicine
Associate Professor, Department of Urology, The Jikei University School of Medicine
Assistant Professor, Department of Urology, The Jikei University School of Medicine
Postdoctoral Researcher, Department of Medicine, Division of Digestive Disease, UCLA
Clinical Associate, Department of Urology, The Jikei University School of Medicine
Resident in Department of Urology, The Jikei University School of Medicine

Consultants/Committees/Editorial Boards
2013-2017
Editorial Board, International Journal of Urology
2013-2015
International Committee, Japanese Urological Association
2015-present
Representative, Japanese Society of Endourology
2019-present
Website Chairman, Urological Association of Asia
2020-present
Representative, Japan Society of Urologic Oncology

Abstract
The incidence of prostate cancer has been increasing worldwide in recent years. The GLOBOCAN project showed thatprostate cancer was the second most frequently diagnosed cancer and the fifth leading cause of cancer mortality among
men worldwide in 2020. This trend has been growing even in Asian countries, where the incidence had previously been
low. However, the accuracy of data about incidence and mortality as a result of prostate cancer in some Asian countries
is limited. The cause of this increasing trend is multifactorial. One possible explanation is changes in lifestyles due tomore Westernized diets. The incidence is also statistically biased by the wide implementation of early detection systems
and the accuracy of national cancer registration systems, which are still immature in most Asian countries. Mortality
rate decreases in Australia, New Zealand and Japan since the 1990s are possibly due to the improvements in treatment
and/or early detection efforts employed. However, this rate is increasing in the majority of other Asian countries. Studies of latent and incidental prostate cancer provide less biased information. The prevalence of latent and incidental prostate cancer in contemporary Japan and Korea is similar to those in Western countries, suggesting the influence of lifestyle changes on carcinogenesis. Many studies reported evidence of both congenital and acquired risk factors for carcinogenesis of prostate cancer. Recent changes in the acquired risk factors might be associated with the increasing occurrence of prostate cancer in Asian countries. This trend could continue, especially in developing Asian countries.

Session 2: Current Status of PSA Screening in Asian Countries

Moderator

Koichiro Akakura
Department of Urology, JCHO Tokyo Shinjuku Medical Center
EDUCATION:
Graduated from School of Medicine, Chiba University, Japan, 1984 (M.D.)
Graduated from Graduated School of Medicine, Chiba University, Japan, 1990 (Ph.D.)
PROFESSION:
Clinical Resident, Department of Urology, Chiba University Hospital and National Kohnodai Hospital, Japan, 1984-1986
Post-doctoral Fellow, Department of Cancer Endocrinology, British Columbia Cancer Agency, Canada, 1990-1993
Faculty Member, Assistant Professor and Associate Professor, Department of Urology, Chiba University Hospital, Japan, 1994-2002
Head, Department of Urology, Tokyo Kosei Nenkin Hospital, Japan, 2002-2014
Assistant to the President, Tokyo Kosei Nenkin Hospital, Japan, 2007-2014
Assistant to the President, Japan Community Health-care Organization (JCHO) Tokyo Shinjuku Medical Center, Japan, 2014-2015
Head, Department of Urology, Japan Community Health-care Organization (JCHO) Tokyo Shinjuku Medical Center, Japan, 2014Vice President, Japan Community Health-care Organization (JCHO) Tokyo Shinjuku Medical Center, Japan, 2015AWARDS:First Award in Prostate Cancer Meeting in Japan, Tokyo, Japan, 1990
Fellowship of Urological Oncology from Berlex Canada, 1990-1992
Sakaguchi Award, Japanese Urological Association, 2000
Dr. Akakura graduated from School of Medicine, Chiba University, Japan (M.D.), and obtained Ph.D. from Chiba University. Dr. Akakura completed Clinical Resident at Department of Urology, Chiba University Hospital and National
Kohnodai Hospital, Japan, and spent 2.5 years as a Post-doctoral Fellow at Department of Cancer Endocrinology, British Columbia Cancer Agency, Canada. Currently He is a Vice President of Japan Community Health-care Organization(JCHO) Tokyo Shinjuku Medical Center. He has been studying clinical and basic research on urological diseases, especially on prostate cancer, and published more than 210 original articles, 210 reviews and 60 chapters of books.

Moderator

Byung Ha Chung
Dept of Urology, Yonsei medical college, Gangnam Severance Hospital
Academic or Medical Associations Position:
The Korean Urological Oncology Society, Executive member (current)
Prostate Cancer Clinic, Gangnam Severance Hospital, Chairperson (current)
The Korean Prostate Society Korean Urological Association, Advisor (current)
Korean Medical Association, Member (current)
Korean Urological Association, Member (current)
Korean Cancer Association, Member (current)
Korean Urologic Oncology Society, Member (current)
Korea Prostate Society, Member (current)
American Urological Association, Member (current)
Asian-Pacific Prostate Society, Member (current)Session 2: Current Status of PSA Screening in Asian Countries
Educational background & professional experience (in sequence of the latest year):
2014〜
Executive member, The Korean Urological Oncology Society
2012〜
Chairperson, Prostate Cancer Clinic, Gangnam Severance Hospital
2006〜
Professor, Department of Urology, Yonsei University College of Medicine
2010-2020
Chairperson, Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine
2014-2018
Chairperson, Department of Urology, Yonsei University College of Medicine
2012-2014
President, Asian-Pacific Prostate Society
2011-2013
President, Severance Urology Oncology Group (SUOG)
2010-2012
Chairperson, Urologic Cancer Clinic, Gangnam Severance Hospital
2008-2009
President, The Korean Prostate Society
2001-2006
Associate Professor, Department of Urology, Yonsei University College of Medicine
1999-2000
Research Fellow, Mayo Clinic, Rochester, MN, USA
1995-2001
Assistant Professor, Department of Urology, Yonsei University College of Medicine
1994-1995
Visiting Clinician, Mayo Clinic, Rochester, MN, USA
1994-1995
Assistant professor, Department of Urology, Gyeongsang National University College of Medicine
1991-1994
Full time Instructor, Department of Urology, Gyeongsang National University College of Medicine
Research Interests: Oncology, Benign Prostatic Hypertrophy (BPH)Session 2: Current Status of PSA Screening in Asian Countries

Current Status of PSA Screening in China

Dingwei Ye
Department of Urology, Fudan University Shanghai Cancer Center
Prof. Dingwei Ye, Vice President of the Fudan University Shanghai Cancer Center, Director of the Multi-disciplinary
Team for GU cancer, Director of Fudan University Prostate Cancer Institute, President of Chinese Society of ClinicalOncology Prostate Cancer Committee (CSCO-PC), President of China Primary Health Care Foundation Urology Committee, Former President of Genitourinary Cancer Committee of Chinese Anti-Cancer Association (CACA-GU), Vice
Chair of Chinese Urology Association (CUA) Oncology Group, President of Chinese Prostate Cancer Consortium(CPCC), Vice chair of Urothelial Carcinoma Committee, Renal Cell Carcinoma Committee and Immunotherapy Committee of CSCO, President of Genitourinary Cancer Committee of Shanghai Anti-Cancer Association, deputy leader ofwriting group of NCCN Guidelines for diagnosis and treatment of prostate cancer, renal cancer and urothelial carcinoma(Chinese edition), Committee member of NCCN Asia Consensus of prostate cancer and bladder cancer, Committee
member of Advanced Prostate Cancer Consensus Conference, President-elect of Asian Pacific Prostate Society (APPS),
Vice President of Asia Cryo-surgery Society.
Prof. Ye presided over more than 50 national, provincial and ministerial scientific research funds. Prof. Ye had 622 papers published in peer review journals as the first author or corresponding author (360 SCI), edited 9 monographs, obtained 25 patents. He has led 74 international or national multicenter clinical trials and studies for GU cancer as leading
PI. As the first accomplisher, Prof. Ye won the first prize of Shanghai Science and Technology Progress, First Prize of
Science and Technology Achievement of Ministry of Education, Shanghai Medical Science and Technology Award
first prize, Second prize of Chinese Medicine Award. As the third accomplisher, Prof. Ye won First Prize of National
Science and Technology Progress in 2012. Prof. Ye awarded as Young and middle-aged experts with outstanding contributions by the National Health and Family Planning Commission, Wu Jieping Urology Award, Shanghai Leading
Talents, Shanghai medical leading talents, Excellent Academic Leader of Shanghai, Advanced Worker in National
Health and Family Planning Commission, and enjoyed special government allowance of The State Council.

Abstract
Introduction
In China, the incidence of prostate cancer (PCa) has been increased rapidly in recent years. Moreover, the mortality of
PCa in China is much higher than that in Western countries. In addition to differences in ethnicity and lifestyle, different
PSA screening pattern may also be an important factor.
Methods
We reviewed the epidemiology of PCa in China and compared the recommendations of Chinese Society of Clinical Oncology (CSCO) Prostate Cancer Guideline with the EAU, AUA, NCCN guidelines. Finally, we conducted a health economic evaluation of PSA screening and introduced some PSA screening models in China.
Results
In Shanghai, the incidence of PCa has risen to 3rd place. The proportion of newly diagnosed metastatic PCa patients accounted for nearly 1/3, much higher than 5% in the United States. In China, PSA screening is not a national health recommendation program. However, CSCO Prostate Cancer Guideline also recommends PSA screening for Chinese men(life expectancy > 10 years) over 50 years, over 45 years with PCa family history, and over 40 years with BRCA2 genemutation. In addition, results based on Chinese population suggest that Chinese men with BRCA1 , MSH2 , or ATM
mutation should also receive PSA screening. In health economic evaluation, PSA-based PCa screening appears to becost-effective, especially in men aged 50 to 65 years.
Conclusion
Currently, PSA screening is not a national health recommendation in China. However, with the update of epidemiological data and health economics data, PSA screening may have broader application prospects.

Session 2: Current Status of PSA Screening in Asian Countries

Current Status of PSA Screening in KOREA
Jae Young Joung 1 , Young Hwii Ko 2 , Byung Hoon Kim 3
1
2
3

National Cancer Center,
Yeungnam University,
Keimyung University, Korea

Dr. Joung, Jae Young graduated from Gyeongsang National University College of Medicine in 1998. He finished aurological residency at Asan Medical Center. He has been working for the department of urology, National Cancer Center since 2003
He is a uro-oncologist who cares for patients with prostate cancer. He has performed more than 1,500 robotic-assisted
radical prostatectomy. He has published over 130 peer-reviewed articles. His clinical interest also lies in medical carefor patients with advanced prostate cancer and he is now actively involved in several international clinical trials using
new investigative drugs for advanced prostate cancer. A Senior Scientist in the Division of Precision Medicine at the
National Cancer Center, his main translation research activity is focused on genetic characteristics and liquid biopsy of
prostate cancer and Dr Joung has also served as the Secretary General of the Korean Prostate Society and Asian Pacific
Prostate Society since 2022.

Abstract
The incidence of prostate cancer has grown gradually in recent years in Korean men and prostate cancer is the fourthmost commonly diagnosed cancer and the tenth leading cause of cancer related death, with an estimated 16,803 newcases diagnosed and 2,047 deaths in 2019. Prostate cancer is the 3rd most prevalent cancer among Korean men, and 2nd
most common among men over 65 years old. Notably, the incidence of prostate cancer in Korea has risen rapidly overthe past two decades, and due to the rapid demographic shifts, the burden of prostate cancer in Korea is expected to increase markedly in the future. With prior projection study of prostate cancer in Korea, the incidence and mortality of
prostate cancer is expected to increase markedly in the period until 2034, due primarily to estimated increases in theaged population. Based on the recent study by Ko and Kim et al. using data of National Health Insurance Service of Korea, I present national-wide trends of serum PSA testing over a recent decade and investigated the impact of testing on
prostate cancer detection rates at the meeting of APPS 2022.
References
Jung KW, Won YJ, Kong HJ, Lee ES. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2016.
Cancer Res Treat 2019;51:417-430
Kang MJ, Won YJ, Lee JJ, Jung KW, Kim HJ, Kong HJ, Im JS, Seo HG; Community of Population-Based Regional
Cancer Registries. Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019. Cancer Res Treat
2022;54(2):330-344
Ko YH, Roh KC, Kim BH. The national-wide incidence of prostate-specific antigen testing trend for a decade in Korea
by age group. Investig Clin Urol. 2022;63(2):184-191
Ko YH, Kim BH. Should Contemporary Western Guidelines Based on Studies Conducted in the 2000s Be Adopted for
the Prostate-Specific Antigen Screening Policy for Asian Men in the 2020s? World J Mens Health. 2022;40(4):543-550
Pak S, Jung KW, Park EH, Ko YH, Won YJ, Joung JY. Incidence and mortality projections for major cancers among
Korean men until 2034, with a focus on prostate cancer. Investig Clin Urol. 2022;63(2):175-183

Session 2: Current Status of PSA Screening in Asian Countries

Prostate Cancer Screening in Indonesia

Lukman Hakim
Department of Urology, Soetomo Hospital, Airlangga University School of Medicine
EDUCATION
September 2011 - 20152017

Ph.D at KU Leuven, Belgium
Consultant Uro-oncology

PROFESSIONAL EXPERIENCE
2008 - now Staff member at the Department of Urology, Airlangga University, Surabaya, Indonesia
2010 - now Reviewer of Journal of Medical Case Reports
2010 - now Vice-editor of the Indonesian Journal of Urology (JURI)2014 - now Reviewer of British Journal of Urology International (BJUI)
2013 - now Reviewer of Journal of Urology
2014 - now Reviewer of Urologia Internasionalis Journal
2012 - now Reviewer of BMC Journal
2014 - now Reviewer for JMED Research Journal
2017 - now Editorial Board of the Journal of Men’s Health (JOMH)
2017 - now Assistant Editor of the Urological Science Journal
ACADEMIC POSITIONS
2021 - now Head of Urology, Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
2021 - now Head of Clinical Research Unit (CRU), Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
2021 - now Member of Research Ethic Committee, Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
PROFESSIONAL POSITIONS
Nov 2015 - now
Executive Board Member of the Asia Pacific Prostate Society (APPS)
Nov 2015 - now
Executive Board Member of the Asia Pacific Society of Uro-oncology (APSU)
January 2017 - now
Treasurer of the Asia Pacific Society of Uro-oncology (APSU)
October 2017 - now
Research Council Member (Indonesian Representative) of the Societe Internationale D’ Urologie (SIU)
March 2018 - now
Faculty member of the Asian Urological Surgical Training & Education (AUSTEG)
2008 - now
Executive Board Member of The Asian Society of Men’s Health and Aging (ASMHA)
2020 - now
Member of the Academic Ethic Commission, Indonesian College of Urology (KUI)
2021 - now
Chair of Scientific Comiittee, Indonesian Urological Association (IAUI)
2021 - now
Chair of Scientific Committee, Indonesian Society of Urological Oncology (InaSOU)SCIENTIFIC MEMBERSHIP
Indonesian Association of Urology (IAUI)European Associaton of Urology (EAU)International Continence Society (ICS)International Society of Stem Cell Research (ISSCR)
American Urological Associaton (AUA)
Indonesian Physicians Association (IDI)
Asia Pacific Prostate Society (APPS), Executive Board Member
Asia Pacific Society of Uro-oncology (APSU), Treasurer
Asian Urological Surgery Training and Education (AUSTEG), Faculty Representing Indonesia
Asia Society of Men’s Health and Aging (ASMHA), Executive Board Member
Indonesian Society of Oncological Urology (InaSOU), Chair of Scientific Committee
Indonesian Urological Association, Chair of Scientific Committee

Session 2: Current Status of PSA Screening in Asian Countries
Abstract
Prostate cancer (PCa) is currently ranked 5th among all cancer among Men in Indonesia. Despite the much lower incidence compared to the western-world, PCa in Indonesia is considered at later stage during the first consultation. The national PCa registry recently obtained from 2 multi-institutional databases (n=1695) have shown an average total PSA of
347.67 ng/ml at first presentation. Among these cohorts, > 50% were considered as metastatic disease at their initialconsultation. These characteristics were similar to some other Asian countries.
The high total PSA at first presentation were related to multi-factors, i.e health-seeking behaviour, educational background, level of awareness for PSA screening,, average household income and pattern of expenditure, national healthinsurance policy and lifestyle contributing to risk factors. Efforts have been introduced continuously to increase awareness among the society and advocacy to the ministry of health authorities. More frequent PCa campaign to emphasize
the importance of PSA screening have been organised, as well as to propose PSA total screening cost to be part of thenational health insurance coverage among any level of the public healthcare facilities. These efforts will of course needtime to take significant effect.
Despite the high-value of total PSA at first presentation at this moment, a slow but increasing trend of patients with earlier stage showing less PSA total value have been observed. These are sub-population of PCa patients who started to beaware about the importance of PSA total screening and prostate biopsy.
Keyword : PSA total, PSA screening, Prostate Cancer, Health InsuranceSession 3: Topics of Active Surveillance and PSA screening in Japan

Moderator

Kazuhiro Suzuki
Department of Urology, Gunma University Graduate School of Medicine
Kazuhiro Suzuki, MD. PhD
MD. 1988 Gunma University, Faculty of Medicine
Ph. D. 1996 Gunma University, Graduate School of Medicine
1997-1999 Post-doctoral fellow, Department of Hematology/Oncology, Professor Micheal Caligiuri
2004 Professor and Chairman, Department of Urology, Gunma University Graduate School of Medicine

Session 3: Topics of Active Surveillance and PSA screening in Japan

PSA screening in Japan

Kazuto Ito
Kurosawa Hospital
Kazuto Ito, MD, PhD, is currently Director of Kurosawa Hospital and Research Professor of Advanced Medical Science
Research Center, Gunma Paz University, Takasaki, Japan. Previously, Dr. Ito was an Associate Professor in the Department of Urology at Gunma University Graduate School of Medicine between 2005 and 2018.
Dr. Ito graduated medical school in Gunma University, Japan in 1990 and got Ph.D. (Urology), Gunma University
School of Medicine (Thesis: The Evidence of Estrogen Production in the Prostate) in 1997.
Dr. Ito conducted research at Erasmus Medical Centre, Rotterdam, Netherlands, between 2002 and 2003. His researchinterests include prostate cancer epidemiology, screening and biomarkers, including PSA and related indices.
Society: Japanese Urological Association/AUA/EAU/SIU/Japan Society of Clinical Oncology/Japanese Society of Endourology, etc.
Editorial Board: European Urology since 2008.

Abstract
The exposure rate of screening for prostate cancer in Japan is still low compared with that in the USA or western
Europe. In Japan, Prostate cancer has been the most frequent male cancer in Japan since 2015 and the incidence was
92,021 in 2018. The mortality of prostate cancer has increased since 1970. It is estimated that 12,759 men died due toprostate cancer in 2020. Therefore, there is an urgent need to provide the best available countermeasures to decrease
death due to prostate cancer. The benefit of prostate-specific antigen (PSA)-based screening is mortality reduction. On
the other hand, screened men may still have risks of overdetection, overtreatment and a decrease in quality of life after
treatment. According to the latest Japanese Urological Association (JUA) guidelines on screening for prostate cancer
published in 2018, PSA screening should be offered for men at risk of prostate cancer, based on fact sheets indicating
the merits and drawbacks of screening for prostate cancer. The JUA has an important role to provide the best available
screening system not only 1st line screening, but also 2nd line diagnostic tool including prostate health index (phi ) and
MRI, and subsequent appropriate treatment strategies, including an active surveillance and minimally invasive modalities, for men who want to be screened.

Session 3: Topics of Active Surveillance and PSA screening in Japan

Active Surveillance for early Prostate Cancer―PRIASJAPAN―
Mikio Sugimoto
Department of Urology, Faculty of Medicine, Kagawa University
Education:
Ph.D: Kagawa University Graduate School of Medicine, 1992
M.D.: Kagawa University Faculty of Medicine, 1988
Appointments:
Jul. 2018-present
Jan. 2006 -Jun. 2018
1997-2006
1992-1997
Mar. 1988

Professor & Chairman, Department of Urology, Kagawa University Hospital
Associate Professor, Department of Urology, Kagawa University Hospital
Chief of Urology, Sakaide Municipal Hospital, Japan
Assistant Professor, Department of Urology, Kagawa University Hospital
Kagawa University, Medical School

Member of academic societies
Japanese Urological Association (Member of a delegation)
The Japanese society of Endourology (Qualified Surgeon for Laparoscopic G-U Surgery & Member of a delegation)
West Japan Urological Association (voting member)
Japan society of Clinical Oncology (Member of a delegation)
Japanese Society of Urologic Oncology (JSUO: Member of a delegation)
Japanese Society of Medical Oncology (JCS: Member of a delegation)

Abstract
Prostate cancer (PC) is one of the most prevalent male cancer worldwide. Especially, early PC is increasing rapidly alsoin Japan. Early detection by PSA test has led the reduction of mortality. On the other hand, overdiagnosis followed byovertreatment has emerged as a big problem. One of the realistic solutions of this is active surveillance (AS).
The Prostate Cancer Research International: Active Surveillance (PRIAS) study is the largest international prospective
observational AS study that commenced in 2006. Japan has participated into the study as PRIAS-JAPAN (P-J) since2010, and recruitment remains ongoing at 42 Japanese institutions. Enrollment to P-J have been steadily increasing andthe number of patients has exceeded 1,000 by 2020.
Herein, we will present the interim results of P-J; the result of re-biopsy, the roll of pro-PSA, QOL and pathologicalfindings of deferred prostatectomy and so on.
In PRIAS, as the long-term results of AS have proven to be quite safe, the inclusion criteria and follow-up protocol have
gradually changed with time. For example, Gleason pattern 4 without cribriform and intra-ductal carcinoma of the prostate (IDC-P) is allowed, MRI and targeted biopsy is recommended to skip periodical biopsy and to reduce the number ofneedle biopsy cores etc. In near future, more precise biomarker, maybe gene marker to correctly select patients isneeded.
AS strategy is a standard treatment for favorable prostate cancer in the world. Unfortunately, however, it is not yet fully
used in Japan. One of the most important problems with AS is the lack of incentives in carrying out it. Assistancethrough the insurance system is desirable to make more effective use of AS in Japan.
AS is a logical and safe way to avoid overtreatment. We will need to work hard to increase the number of patients who
benefit from it.

Session 4: Treatment for Localized Prostate Cancer 1 Radiation therapy

Moderator

Jun Hyuk Hong
University of Ulsan, Asan Medical Center, Seoul
Professor
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center
Seoul, Republic of Korea
Education and Training
1984.3 - 1990.2 Seoul National University, Medical College. M.D. (1990)
1996.3 - 1998.2 Graduate School, University of Ulsan. M.S. (1998)
1998.3 - 2000.2 Graduate School, University of Ulsan. Ph.D. (2000)
Professional Experience
2001. 3 - 2002. 2, Instructor, Department of Urology, Asan Medical Center
2002. 3 - 2006. 2, Assistant Professor, Asan Medical Center, University of Ulsan
2005. 8 - 2007. 6, Visiting Professor, University of Medicine and Dentistry of New Jersey, USA
2006. 3 - 2014. 8, Associate Professor, Asan Medical Center, University of Ulsan
2014. 9 - Present, Professor, Asan Medical Center, University of Ulsan
2013. 7 - 2018. 2, Chief, Center for Robot Surgery Training, Asan Medical Center2018. 3 - 2020. 2, Chief, Center for Robot Surgery, Asan Medical Center2018. 3 - Present, Chief, Center for Prostate Diseases, Asan Medical Center
2019. 1 - Present, Director, Physician Education and Training Department, Asan Medical Center2016. 9 - 2021. 12, Secretary General, the APPS (Asia-Pacific Prostate Society)2018. 3 - 2019. 9, Secretary General, the 36th KJUC 2019 Meeting (Seoul)
2019. 1 - 2020. 12, Secretary General, the KUA (Korean Urological Association)
2019. 3 - 2021. 2, President, the KPS (Korean Prostate Society)2022. 1 - Present, President-elect, the KUA (Korean Urological Association)

Moderator

Osamu Ogawa
Japanese Red Cross Otsu Hospital
Education:

1993: D. Med. Sci., Faculty of Medicine, Kyoto University
1982: M.D., Faculty of Medicine, Kyoto University

Professional Training and Employment
2018-2019:
President of Urological Association of Asia (UAA)
2010-2014:
Secretary General of UAA
2010-2013:
Director of Science of UAA
2021-present:
Director, Japanese Red Cross Otsu Hospital
1998-2021:
Professor and Chairman, Dept. of Urology
Kyoto University Graduate School of Medicine
1996-1998:
Associate professor, Dept. of Urology, Akita Univ.
1993-1996:
Assistant professor, Dept. of Urology, Kyoto University
1991-1993:
Postdoctoral fellow, Dept. of Biochemistry
Otago University, New Zealand
1982-1983:
Resident in Dept. of Urology, Kyoto University

Session 4: Treatment for Localized Prostate Cancer 1 Radiation therapy

IMRT for prostate cancer

John Lederer
Department of Surgery, University of Hawaii
EDUCATION
Rice University B.A.
Baylor College M.D.
Internal Medicine Internship, Baylor College of Medicine Affiliated Hospitals
Internal Medicine 2nd Year Resident, Baylor College of Medicine
Internal Medicine Senior Resident, University of Utah Health Sciences Center
Radiation Oncology Resident, University of Utah Health Sciences Center
PROFESSIONAL EXPERIENCE
Board Chairman
The Cancer Center of Hawaii
Medical Director, Programs and Technology
The Cancer Center of Hawaii
Manager, Radiation Oncologist, Pacific Radiation Oncology
Honolulu, Hawaii
Medical Director
The Cancer Center of Hawaii 1991-Present
Assistant Professor, Department of Surgery
University of Hawaii
Assistant Professor, Department of Surgery,
Univ ersity of Hawaii
Radiation Oncologist, Pacific Radiation Oncology, Honolulu, Hawaii
President, OnCare, Hawai
Senior Vice-President, AmMed International
Medical Director, Radiation Oncology
The Queen’s Medical Center, Honolulu, Hawaii
President, Island Radiation Oncology
Chairman, Cancer Committee
The Queen’s Medical Center, Honolulu, HawaiiInternist, Kelsey-Seybold Clinic, Houston, Texas
Instructor, Advanced Cardiac Life Support,
University of Utah, Salt Lake City, Utah
Clinical Instructor, Department of Medicine,
University of Utah School of Medicine,
Salt Lake City, Utah

1976
1980
1980-1981
1981-1982
1982-1983
1986-1989

2014-20192016-Present
2012-Present
2009-2016
1989-Present
1991-Present
1989-Present
1997-2002
1997-2006
1996-2005
1996-2009
1993-2000
1984-1986
1983-1984
1983-1984

Abstract
Intensity modulated radiation therapy (IMRT) has been utilized for prostate cancer over the last two decades. Initially, it
was utilized predominantly for prostate radiotherapy for curative intent. Standard fractionation was utilized, usually requiring 8-9 weeks of daily treatments.
More recently investigations have been made into the utilization of IMRT for hypofractionated regimens requiring lesstreatments. Results have been favorable both with so-called moderate hypofractionation and extreme hypofractionation.
Moderate hypofractionation usually requires 20-28 daily visits as opposed to 40-45 required for standard fractionation.
Extreme hypofractionation, also known as SBRT or SABR, require approximately five treatments. Results have shown
moderate hypofractionation to be non-inferior to standard fractionation therapy in terms of progression-free survival.
Both GU and GI late toxicities have been similar. Early studies with SBRT indicate that it may approach the efficacy ofSession 4: Treatment for Localized Prostate Cancer 1 Radiation therapy
brachytherapy in terms of progression-free survival. Studies have produced conflicting results regarding late toxicity.
IMRT has been utilized for SBRT for oligometastatic prostate cancer. Oligometastatic is usually diagnosed as four orless non-visceral metastases. Studies such as the STAMPEDE trial have indicated good results and potential cure for thepatients with oligometastatic disease receiving SBRT treatments to their metastatic lesions and moderate hypofractionation radiation to the prostate.
This presentation will review the current data for moderate hypofractionation and severe hypofractionation in the treatment of carcinoma of the prostate in addition to the treatment of oligometastatic disease utilizing IMRT based SBRT.

Session 4: Treatment for Localized Prostate Cancer 1 Radiation therapy

Permanent seed implantation prostate brachytherapy inJapan
Shiro Saito 1 , Yasuto Yagi 2 , Ken Nakamura 2 , Tomohiro Eriguchi 1 ,Hiroyuki Yamanaka 1 , Tomohiko Matsushita 1 , Tetsuo Monma 2
1

Department of Urology and Prostate Cancer Center, Ofuna Chuo Hospital, Kanagawa,Japan,
2
Department of Urology, NHO Tokyo Medical Center, Tokyo, JapanPRESENT POSITION
・Chief of Prostate Cancer Center, Ofuna Chuo Hospital・Visiting Assistant Professor of the Department of Urology,
School of Medicine Keio University, Tokyo Japan・Visiting Assistant Professor of the Department of Urology
University of Ryukyus, Okinawa JapanEDUCATION
・Keio University Premedical School, Yokohama Japan
April, 1976 to March, 1978
・Keio University School of Medicine, Tokyo Japan
April, 1978 to March 1982
PROFESSIONAL TRAINING AND PAST POSITIONSRESIDENCY: ・Department of Surgery, Keio University, Tokyo, Japan (1982-1984)
TRAINING: ・Kasumigaura National Hospital, Tsuchiura, Japan (1985-1986)
・University of Ryukyus, Okinawa, Japan (1986-1987)
・Keio University, Tokyo, Japan (1987-1988)
POSITIONS: ・Tachikawa Kyosai Hospital, Tachikawa, Japan (1988-1991)
・Keio University, Tokyo, Japan (1991-1992)
・Research Fellow of Memorial Sloan-Kettering Cancer Center
New York, USA (1992-1994)
・Chief staff of Department of Urology, Keio University
Tokyo, Japan (1994-1997)
・Chief of Department of Urology, NHO Tokyo Medical Center,
Tokyo, Japan (1997-2021)
・Chief of “Japanese Permanent Seed Implantation Study Group (JPSS)”(2016 - present)
・Chief of Prostate Cancer Center, Ofuna Chuo Hospital
Kanagawa, Japan (2021-present)

Abstract
Introduction: Permanent seed implantation prostate brachytherapy (BT) started in 2003 in Japan. During the past 19
years, 120 institutes performed BT and more than 52,000 cases were treated around the country. NHO Tokyo Medical
Center (NTMC) initially performed this treatment and 4,222 cases were treated until end of 2021.
Material and Methods: Between September 2003 and August 2010, 1,427 patients underwent BT for cT1-3N0M0
prostate cancer at NTMC. Among those patients, 514 were low risk, 751 were intermediate risk and 162 were high risk
with basic NCCN risk classification. Prescription dose was 144 or 160Gy for cases treated with BT alone, and 110Gy
boost of BT followed by 45Gy of EBRT for the combined cases. Neo-adjuvant hormone therapy was performed for 3-6
months only for those cases that need size reduction to avoid pubic arch interference or not to exceed maximum dose
(1,300 MBq) originally established in Japan. None of the cases received adjuvant hormone therapy. Median follow up
period was 12.3 years. Phoenix definition was used to determine biochemical failure and Kaplan-Meier analysis was
performed to evaluate overall survival (OS), disease specific survival (DSS) and biochemical progression free survival(BPFS).
Results: Fifteen-year OS was 75.9%, DSS was 98.6% and BPFS was 88.5%. BPFS in low-, intermediate- and high-riskcases were 95.4%, 87.2% and 72.3%, respectively. Grade 3 or 4 (CTCAE v4.0) acute and late GU toxicity were seen in
0.5% and 1.5%, respectively. Acute and late GI toxicity were seen in 0% and 0.2%, respectively.
Conclusion: Effectiveness and safety of BT for localized prostate cancer have been shown in Japan.

Session 4: Treatment for Localized Prostate Cancer 1 Radiation therapy

Experience of Proton Beam Therapy for Localized
Prostate cancer in Tsukuba University
Hiroyuki Nishiyama
Department of Urology, Faculty of Medicine, Tsukuba University
Professor and Chairman, Department of Urology, Tsukuba University
Vice president, Tsukuba University Hospital
Project Leader, Tsukuba International Center for Digital Biotechnology
Vice Director, Research and Development Center for Precision Medicine
Chairman, Department of Urological Oncology, Japan Clinical Oncology Group (JCOG)
After graduating from Kyoto University School of Medicine in 1989, I trained in the Department of Urology and studied at the Imeprial Cancer Reserch Fund in the U.K. from 1998 to 2000 as a research fellow to study the carcinogenesis
mechanism of bladder cancer. In 2011, I became a professor at the Department of Urology, University of Tsukuba,
Tsukuba, Japan. Currently, I am in charge of basic research and clinical practice related to urothelial carcinoma andother urologic cancers. In particular, he is leading a novel bladder-sparing therapy using immune checkpoint inhibitors
in combination with radiotherapy and an investigator-oriented clinical trial for testicular tumors. I also serves on theadvisory-board for global clinical trials and as chairman of the Japan-clinical Oncology group in the field of urologic
oncology.

Abstract
Although prostate cancer control using radiotherapy is dose-dependent, dose-volume effects on late toxicities in organs
at risk, such as the rectum and bladder, have been observed. Both protons and carbon ions offer advantageous physicalproperties for radiotherapy, and create favorable dose distributions using fewer portals compared with photon-based radiotherapy. Thus, particle beam therapy using protons and carbon ions theoretically seems suitable for dose escalation
and reduced risk of toxicity. However, it is difficult to evaluate the superiority of particle beam radiotherapy over photon beam radiotherapy for prostate cancer, as no clinical trials have directly compared the outcomes between the two
types of therapy due to the limited number of facilities using particle beam therapy. As particle beam therapy for prostate cancer is covered by the Japanese national health insurance system as of April 2018, and the number of facilities
practicing particle beam therapy has increased recently, the number of prostate cancer patients treated with particle
beam therapy in Japan is expected to increase drastically. Here, we presented some data experienced in Tsukuba University about Chronoradiation therapy approach and hypofractionated approach. As for chronoradiation therapy, interestingly morning PBT for localized prostate cancer significantly ameliorated worsening LUTS and improved QoL compared with treatment around noon or late afternoon.

Session 5: Luncheon Seminar: Topics of RARP

Moderator

Yukihiro Kondo
Professor & Chairman, Department of Urology, Nippon Medical School【Academic history】
1985, Graduated from Nippon Medical School【Work history】
2000, Nippon Medical School, Department of Urology, Associate Professor
2009, Nippon Medical School, Department of Urology, Professor & Chairman【Affiliated society】
The Japanese Urology Association
Japanese Society of Endourology and Robotics
American Urological Association
European Association of Urology【Qualification】
Japanese Urology Association Specialist
Japanese Urology Association Preceptor
Japanese Society of Endourology and Robotics Technically Certified Doctor

Moderator
Tomohiko Ichikawa, M.D., Ph.D
Professor and Chairman, Department of Urology, Graduate School of Medicine, Chiba
University/ Director, Division of Clinical Genetics, Chiba University Hospital
1984
1989
1989-1991
1992-1997
1997-1998
1998-2001
2001-2004
2004-current
2017-current

M.D., Chiba University, Chiba, Japan
Ph.D. (Doctor of Medical Science), Chiba University
Postdoctoral Fellow, Johns Hopkins Oncology Center, Baltimore, MD
Assistant Professor, Department of Urology, School of Medicine, Chiba University
Assistant Professor, Department of Urology, Teikyo University School of Medicine, Ichihara Hospital,
Ichihara, Japan
Assistant Professor, Department of Urology, School of Medicine, Chiba University
Associate Professor, Department of Urology, Graduate School of Medicine, Chiba University
Professor and Chairman, Department of Urology, Graduate School of Medicine, Chiba University
Director, Division of Clinical Genetics, Chiba University HospitalSession 5: Luncheon Seminar: Topics of RARPKey anatomical structures and points of surgicalprocedure in robot-assisted radical prostatectomy―Achieving early recovery of urinary continence―
Yuta Yamada
The University of Tokyo Hospital
2008, Graduated from Tsukuba University
2009, The University of Tokyo Hospital, Department of Urology, Assistant Professor
2019, Chiba Tokushukai Hospital, Department of Urology, Director
2021, The University of Tokyo Hospital, Department of Urology, Lecturer
Membership of The Japanese Urological Association, Japanese Society of Endourology and Robotics, Japan Society ofClinical Oncology
Specialized in Urology, Urologic Oncology, Robotic Surgery, Laparoscopic Surgery

Abstract
We all know that urinary incontinence (UI) is still a common complication after robot-assisted radical prostatectomy(RARP). However, there are so many predictors of UI that are reported including age, prostate volume, cT stage, surgeon experience, and so on. Evaluating these predictors by linking them to anatomical structures may be importantsince these key structures may be preserved during the RARP procedure. I would like to present some predictors and thelinked key anatomy of UI and also surgical procedures that may contribute to early urinary continence.

Session 5: Luncheon Seminar: Topics of RARP

Usefulness of Retzius-sparing technique to prevent
postoperative urinary incontinence after robot-assisted
radical prostatectomy (RARP)
Atsushi Okada , Shuzo Hamamoto , Teruaki Sugino , Shoichiro Iwatsuki ,Toshiki Etani , Kazumi Taguchi , Taku Naiki , Noriyasu Kawai ,Keiichi Tozawa , Takahiro Yasui
Department of Nephro-urology, Nagoya City Universtiy Graduate School of Medical Sciences
Atsushi Okada
Associate professor, Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences,
Nagoya, Japan1998
M.D. Nagoya City University, Nagoya, Japan2009
Ph.D. Nagoya City University, Nagoya, Japan
2011 to Now
Associate Professor, Department of Nephro-urology,
Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
2008 to 2011 Instructor, Department of Nephro-urology,
Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
2005 to 2008 Department of Urology, Kainan Hospital, Yatomi, Japan
2000 to 2004 Department of Urology, Higashi Municipal Hospital, Nagoya, Japan
1998 to 2000 Resident in Nagoya City University Hospital, Nagoya, Japan
Membership of The Japanese Urological Association, Japanese Society of Endourology and Robotics, Japan Society in
Urolithiasis Research, American Urological Association etc.
Specialized in Urology, Robotic Surgery, Laparoscopic Surgery, Kidney Stone Surgery and Research

Abstract
RARP for localized prostate cancer requires management of perioperative complications as well as cancer control andfunctional preservation. RARP mainly uses an anterior transperitoneal approach via the anterior bladder space (Retzius
space), however, postoperative urinary incontinence may be prolonged depending on the patient’s body shape and anatomical features. On the other hand, the recently developed Retzius sparing (RS)-RARP is performed only from the
Douglas pouch on the posterior surface of the bladder, the technique is considered effective in preventing urinary incontinence by preserving the Retzius space structure. However, it is said that the cancer-positive rate at the resection margin
is high, and there is concern that the surgical procedure is more difficult for Japanese patients with narrow pelvises.
We have introduced RS-RARP since 2017. With this technique, regardless of the number of cases experienced by theoperator, the achievement rate of urinary continence (disappearance of incontinence) was high from the beginning of theintroduction and was 92% at 3 months after the operation. RS-RARP is highly effective in preventing urinary incontinence because the structure of the bladder neck is preserved, the position of the entire bladder is maintained at a highposition after prostatectomy, and it was thought that the length of the membranous urethra is extended. In addition, RSRARP did not detect any postoperative inguinal hernia development, which is likely to occur with conventional RARP.
However, this procedure requires relatively advanced techniques to peel off the correct layers around the prostate while
avoiding interference from the robot arm in the narrow pelvic cavity and perform the urethral anastomosis upside down.
It was characterized by a high margin positive rate on the anterior surface. For this reason, at present, the indication of
RS-RARP is decided after obtaining information on the local diagnosis of cancer by performing targeted biopsy using
MRI images.
In this presentation, regarding the usefulness of RS-RARP, which exerts a high urinary incontinence suppression effectregardless of the operator’s experience, ideal surgical indications based on biopsy results, points to be noted in the earlystages of introduction, and common problems outline about.

Session 6: Treatment for Localized Prostate Cancer 2 RARP: New Platform

Moderator

Levent Türkeri
Department of Urology, Acibadem University Altunizade Hospital, Istanbul, Turkey
Dr. Türkeri is a Professor of Urology and his main area of expertise is Uro-oncology involving robotic, laparoscopic
and open surgery. Currently, he is the chief of the Department of Urology at Acıbadem M.A. Aydınlar University Altunizade Hospital. He was one of the founding members of EAU Section of Oncological Urology (ESOU and involved
with many national and international societies such as AUA, EAU, AAEU, URS and APPS.

Moderator

Yasutomo Nasu
Okayama University
Field of Researchuro-oncology, minimally invasive treatments including brachytherapy and robotic surgery, translational research.
Education
Okayama University Medical School
Okayama, Japan, 1975-1981
Okayama University Medical School
Okayama, Japan, 1981-1986

M. D.

Medicine

Ph. D.

Urology

Professional Experience
1981-1986
Resident, Department of Urology, Okayama University Hospital, Japan
1991-1996
Assistant Professor, Department of Urology, Okayama University Hospital, Japan
2004-2009
Associate Professor, Department of Urology, Okayama University Hospital, Japan
2010-2015
Professor and Vice Director at Center for Advanced Clinical Medicine, Okayama University Hospital,Japan
2013-2016
Vice Director, Okayama University Hospital, Japan
2015-2022
Professor &Chairman, Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
2016-2019
Dean, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
2019-present
Executive Director for Research/Vice President, Okayama University

Session 6: Treatment for Localized Prostate Cancer 2 RARP: New Platform

Robot-assisted radical prostatectomy using hinotori
Nobuyuki Hinata
Department of Urology, Hiroshima University Graduate School of Biomedical and Health
Sciences
1998
2006
2010
2012
2015
2016
2021

Resident, Kobe University Hospital
Attending surgeon, Shinko Hospital
Assistant professor, Tottori University
Assistant professor, Kobe University
Research fellow, Roswell Park Cancer Institute
Associate Professor, Kobe University
Professor and Chairman, Hiroshima University

Abstract
To evaluate the safety and efficacy of the hinotori Surgical Robot System in preclinical and clinical studies, preclinical studies were conducted in ten living female porcines and four fresh male cadavers. Different types of urologic surgical procedure were performed by experienced urological surgeons using the hinotori system: partial nephrectomy, vesicourethral anastomosis, and pelvic lymph node dissection in porcines, and partial nephrectomy, radical prostatectomy,
and pelvic lymph node dissection in cadavers. In a clinical study, radical prostatectomy was performed in ten patientswith localized prostate cancer, to evaluate safety and efficacy. The primary endpoint was completion of the procedure,
and the secondary endpoints were operation time, warm ischemic time, blood loss, and safety profiles including device
errors and extracorporeal arm collisions.
The preclinical results were similar to those reported for the da Vinci surgical system. The performance of the hinotori
was equivalent to that of the da Vinci Xi, based on global assessment by the surgeons. Safety and efficacy were confirmed in a first-in-human clinical study of hinotori-assisted radical prostatectomy in ten patients with prostate cancer.
In all cases, the procedures were successfully completed as planned, and no perioperative adverse events were observed.
Safety and efficacy of the newly developed, robot-assisted hinotori surgical system were shown in the present preclinical and clinical studies. Further studies are required to confirm its clinical efficacy.

Session 6: Treatment for Localized Prostate Cancer 2 RARP: New Platform

Robotic Prostatectomy 2022: SP Retzius-Sparing &Perineal.
Koon Ho Rha
NAVER Healthcare Lab
EDUCATION
2016 Harvard School of Public Health Healthcare Executives Leadership Strategies
2015 Yonsei University School of Public Health Globalization of Healthcare2010 Harvard School of Public Health Leadership in Academic Medicine
2002-2003 Johns Hopkins University, School of Business/Medicine: Business in Medicine Certificate Program , Baltimore, MD, USA(courses in managed care, accounting, health care finance, and leadership)
1993-1999 Yonsei University, Graduate School, Seoul, Korea; PhD
1988-1992 Yonsei University, Seoul, Korea; MD (Graduated with Honors)
1980-1984 South Pasadena High School, South Pasadena, CA, USA
POSTDOCTORAL TRAINING
2002-2003 Society for Urology and Engineering Fellow
Johns Hopkins Hospital, Baltimore, Maryland, USA
1995 Visiting Resident; Urology, Mayo Clinic, Rochester, Minnesota, USA
1993-1997 Resident, Urology, Severance Hospital, Yonsei University, Seoul, Korea
HOSPITAL/ACADEMIC APPOINTMENTS
2021.1- present: Director, NAVER Healthcare Lab
2016.11- 2020.12: Chief Strategy Officer, Yonsei University Health System
2014.9. - 2016.8: Chief Operating Officer, Severance Hospital, Yonsei University
2012.9 - 2014.8: Associate Dean, Academic Affairs, Yonsei University
2002.4. - present: Professor; Department of Urology, Yonsei University
2002 - 2003 Faculty (Visiting Assistant Professor); Johns Hopkins University, USA
2000 - 2002.3.: Instructor in Urology, Yonsei University, College of Medicine
1998 - 2000: Urologist in Chief, Capital Armed Forced Hospital, Seoul, Korea
CERTIFICATION AND LICENSURE
2003 DaVinci Certification 2003 Zeus Certification
1997 Korean Board of Urology (#1108)
1992 ECFGM Certification (#0-457-651-8)
PATENTS
Rha KH and Yang SC. (2002), Surgical instruments and method for creating anatomic working space in minilaparotomy procedure , US Patent No. 6,878,110
MEMBERSHIP IN PROFESSIONAL SOCIETIESFellow, American College of Surgeons (FACS)
Past President, Engineering and Urology Society, USA
Expert, International Healthcare Subject Matter Experts (US Department of Army)
SCI PEER-REVIEWED SCI PUBLICATIONS (350)
CLINCIAL EXPERIENCE : > 3500 robotic cases (3000 prostatectomies)
Live Surgery/Proctorship in 15 different countries including USA, France, Italy
Korean Robot (REVO-i) Prostatectomy (2016)

Session 6: Treatment for Localized Prostate Cancer 2 RARP: New Platform
Abstract
Since early 2000’s robotic prostatectomy has revolutionized how prostate cancer is treated. With advent of daVinci SP
single port platform, now another avenue of new ways how we perform the procedure is explored.
As first described in 2010 by Bocciardi and Galfano in Milan, retzius sparing has became a minimally invasive way ofremoving prostate. Perineal prostatectomy was the first surgical treatment of localized prostate cancer described by
Hugh Hampton Young of Johns Hopkins Hospital in early 1900’s.
Now both procedures are explored by SP plaform and surgical technique will be discussed in this presentation.

Session 7: Treatment for Localized Prostate Cancer 3 RARP: Tips and Tricks

Moderator

Dennis Serrano
University of The Philippines, College of Medicine
DENNIS P. SERRANO MD, MHA
Urology/Oncology, Robotic Surgery, Kidney Transplantation
Associate Professor VII, University of the Philippines College of Medicine
Executive Vice President, St. Luke’s Medical Center, Global City
Past President, Foundation for the Advancement of Surgical Education
Past President, Philippine Urological Association (2009), Philippine Society of Urologic Oncologists (2017) and Philippine Society for Transplant Surgeons (2017).
Former Chairman, Philippine Board of Urology (2015)
Chief of Urology and the Integrated Organ Transplant Unit, Philippine General Hospital
DR, SERRANO is an Associate Professor of Urology and Kidney Transplantation at the University of the Philippines
College of Medicine.
CHAIR of the DIVISION OF UROLOGY at the DEPARTMENT OF SURGERY in the UNIVERSITY OF THE PHILIPPINES COLLEGE OF MEDICINE- PHILIPPINE GENERAL HOSPITAL.
He is also the former CHIEF of the INSTITUTE OF UROLOGY, at the ST. LUKE’S MEDICAL CENTER GLOBAL
CITY, and and is now Executive Vice President of the same.
He is the Past President of the PHILIPPINE SOCIETY OF UROLOGIC ONCOLOGISTS and also the Past President of
the PHILIPPINE SOCIETY FOR TRANSPLANT SURGEONS from 2017-2018.
He was President of the PHILIPPINE UROLOGICAL ASSOCIATION in 2009 and Chairman of the PHILIPPINEBOARD OF UROLOGY IN 2015. He is Board Member of the Philippine Board of Transplant Surgeons. He likewisesits in the Board of the ASIAN-PACIFIC PROSTATE SOCIETY and the ASIAN TRANSPLANT SOCIETY. He is an
International Member of the AMERICAN UROLOGICAL ASSOCIATION as well as the EUROPEAN ASSOCIATION OF UROLOGY.
He was member of the ASIAN CONSENSUS PANEL OF THE NATIONAL CANCER CARE NETWORK, 2015.
He is an Intuitive-Certified Robotic Surgeon at the St Luke’s Medical Center Global City where he heads the Section
for Robotic Urologic surgery. In 2010, he pioneered the use of Robotics in Radical Prostatectomy for the treatment of
Prostate cancer in St. Luke’s Medical Center. In 2018, he launched the robotic urology program at the Philippine General Hospital. He has done hundreds of robotic radial prostatectomy during his career.
He graduated from the UP College of Medicine (UPCM) Integrated Arts and Medicine (INTARMED) program and attained his Medical Degree in 1989.
He took his residency training in UROLOGY at the PHILIPPINE GENERAL HOSPITAL where he finished in 1994.
In 1995-1996, he pursued and completed his subspecialty Fellowship Training in UROLOGY/RENAL TRANSPLANTATION at the CLEVELAND CLINIC FOUNDATION in Cleveland, Ohio, USA.
In 2005, he attained a MASTERS DEGREE in HOSPITAL ADMINISTRATION from the College of Public Health,
University of the Philippines, Manila. His research interests and publications include urologic oncology, prostate diseases and renal transplantation.

Session 7: Treatment for Localized Prostate Cancer 3 RARP: Tips and Tricks

Moderator

Takeshi Shichijo
Department of Urology, Showa University School of Medicine, Tokyo, Japan
Education:
1996-2000

Showa University, School of Medicine, Tokyo, Japan
Degree: Doctor of Medicine

Professional experience:
2000-2001 Instructor, Showa University School of Medicine.
2001-2003 Medical Staff in Urology
National Tokyo Organization Disaster Medical Center, Tokyo.
2003-2004 Instructor, Showa University Northern Yokohama Hospital.
2004-2006 Instructor, Showa University School of Medicine.
2006-2008 Instructor, Showa University Fujigaoka Hospital.
2008-2010 Instructor, Showa University School of Medicine.
2010-2014 Medical Staff in Urology
Tokyo Metropolitan Ebara Hospital
2014-2016 Medical Staff in Urology
National Tokyo Organization Disaster Medical Center, Tokyo.
2016-2017 Assistant Professor of Urology.
Showa University School of Medicine.
2017-2019 Assistant Professor of Urology.
Showa University Northern Yokohama Hospital.
2019Associate Professor of Urology.
Showa University School of Medicine.

Session 7: Treatment for Localized Prostate Cancer 3 RARP: Tips and Tricks

Application of dehydrated human amnion/chorion
membrane on patients undergoing Robotic Assisted
Radical Prostatectomy (RARP)Yen Chuan Ou MD, PhD
Tungs’ Taichung MetroHarbor, Hospital (TTMHH), Taichung, Taiwan
Dr. Yen-chuan Aaron Ou is Dean of R&D and Innovation Center, Tung’s Taichung MetroHabor, Taichung, Taiwan.
He is Secretary General of Asian Robotic Urological Society (ARUS) since 2019.
Dr. Ou is the Professor of Department of Urology at the National Chi-Nan University, National Chung-Hsing University and Chung Sang Medical University. He got his medical degree at National Defense Medical University in 1986.
From 1986 through 1991, he finished the residency training and served as a visiting surgeon at Taichung Veterans General Hospital. From 1997 to 1999, he received his basic science training as Research Associate at Leland WK Chung
PhD’s Lab of Department of Urology of University of Virginia, USA. He obtained Ph.D degree at Institute of Medicine
of Chung Sang Medical University in 2004.
Dr. Ou is a renowned urological oncology scientist and a famous international speaker. His research interest is to
study signal transduction pathway of renal cell carcinoma, precision medicine of urological cancer and translational research. He is founder of Prostate Disease Center in 2005 and Taiwan Urological Cancer Association in 2008. He received robotic surgical training under Mentors Dr. Patel in 2005, Dr. Tewari in 2009 and Dr. Wiklund in 2013. He already did robotic urologic surgeries more than 3300 cases including radical prostatectomy, partial nephrectomy radical
cystectomy and reconstruction surgery. He got Global Award of best paper of British Journal Urology International in2012 and Asian Journal of Andrology (AJA) Outstanding Paper Award of 2016.
Dr. Ou acquired da Vinci Distinguish Robotic Surgeon Award for achievement in Urological Surgery from Intuitive
Surgical in 2014, 2016 and 2018.
Prof. Ou published more than 300 peer-review papers and is a reviewer of many journal for example, European Urology, Journal of Urology, British journal of Cancer, Urology and European Journal of Surgical Oncology, Urology.

Abstract
Introduction: The use of dehydrated human amnion/chorion membrane (dHACM) allograft wrapped around the NVB(neurovascular bundle) is adopted during a robotic-assisted radical prostatectomy (RARP). We analyze the efficacy ofdHACM for the urinary continence and potency postoperatively.
Materials & Methods:
Totally, 37 men was enrolled from Oct. 2020- Oct. 2022. The mean age was 66 years. Mean PSA level was 8.28 ng/ml.
The clinical stage was cT1c (N=2), cT2a (N=11), cT2b (N=14) and cT2c (N=10). The Gleason score was group 1 (N=14), group 2 (N=15), group 3 (N=5), group 4 (N=1), group 5 (N=2). Bilateral and unilateral neurovascular bundle(NVB) preservation was done in 9 and 27 patients respectively. The dHACM 3x2 cm was applied in unilateral side was
18 patient and bilateral side in 19 patients. Urinary continence was defined as no wearing of pad. Potency was definedas the ability to achieve and maintain satisfactory erections firm enough for sexual intercourse, with or without the useof PDE-5 inhibitors.
Results: The pathology stage was pT2a (N=7), pT2b (N=4), pT2c (N=13) and pT3a (N=13). Postoperatively, urinary
continence rate was 82% at one month and 100% at 3-month. Potency rate was 47%, 67%, 80% and 93% at 3-, 6-, 9and 12- month respectively. No patients were noted biochemical recurrence during mean follow-up 10 months.
Conclusion: Application of dehydrated human amnion/chorion membrane during patients undergoing Robotic Assisted
Radical Prostatectomy (RARP) is simple and feasible. We demonstrated that dHACM can enhance return to urinary
continence and potency. More cases and controlled cohort study is need to prove efficacy of return of sex function andinfluence of biochemical recurrence after RALP.

Session 7: Treatment for Localized Prostate Cancer 3 RARP: Tips and Tricks

Robot Assisted Radical Prostatectomy(RARP):
Techniques to Preserve Potency and Continence
Choung-Soo Kim, MD.
Ewha Womans University Mokdong HospitalPresent Position: March 2022-present, Professor
Ewha Womans University Mokdong Hospital
Academic or Medical Associations Position:
Chairman, Society of Antiaging & Urological Integrative Medicine
Mediator : Seoul High Court of Justice
Educational backgroundFebruary 26, 1983
MD, Bachelor, College of Medicine, Seoul National University, Seoul, Korea
September 30, 1993 PhD. College of Medicine, Seoul National University, Seoul, Korea
Professional background1990-2022
Professor, Asan Medical Center, University of Ulsan College of Medicine
2011-2015
Chairman, Asan Life Science Research Institute2011-2012
President, Asian Pacific Prostate Society
2008-2009
Chairman, Department of Urology, Asan Medical Center, University of Ulsan College of Medicine
2006-2007
President, The Korean Prostate Society
Research Interests: Urologic Oncology with robot sutgery,
Prostate disease
Urological Integrative Medicine
Antiaging

Abstract
Prostate cancer can be managed with active surveillance, radical prostatectomy, radiotherapy or focal treatment according to life expectancy, overall health, tumor characteristics. Radical prostatectomy is performed to cure the localized
prostate cancer patients or the patient with surgical indications.
Minimally invasive radical prostatectomy, especially RARP is the main surgery in prostate cancer treatment as compared with open surgery. The ideal procedure of radical prostatectomy is to achieve maximum oncological efficacy
while minimizing associated side effects, such as erectile dysfunction and urinary incontinence. RARP is considered as
surgery with consistent oncological outcome and low complication rates. Surgeon experience and surgical technique affect RARP outcomes.
Urologic oncologists developed their own techniques to achieve good oncological outcomes and to minimize main complications such as impotence and incontinence.
I also modified my RARP technique to increase the effectiveness and to decrease complications.
Avoiding or minimizing injury to the neurovascular bundle (NVB) during robot-assisted radical prostatectomy (RARP)
is critical for preservation of erectile function. I start to dissect NVB at bladder neck 2 and 10 O’clock sites after bladderis open and separate NVB from prostate base. I do not use electrical coagulator but use the metal surgical clips during
nerve-sparing RARP not to injure nerve fibers. I think that it is important to preserve NVB by dissecting it along theprostate base contour. The small arteries and veins that supply prostate are clipped and divided. The whole vessels of
NVB just lateral to prostate base is dissected and preserved except the ventral area from 10 to 2 O’clock. The lateral upper base of prostate can be exposed with this dissection. NVB is incised at 2 O’clock site at right side and at 10 O’clock
site, at left side. NVBs are dissected distally down to apex area with medial traction of prostate. NVB can be peeled offfrom prostate with pushing it after medial traction of prostate. Bleeding points are controlled with metal clips.
After dissection of NVB, dorsal vascular complex is incised with monopolar scissors to expose the urethra. The prostate
apex is dissected. Prostatourethral junction can be better exposed with traction of prostate. Urethra is incised at prostatourethral junction to maximize the preservation of urethral stump.
DVC is sutured with 2-0 vicryl transversely from 10 to 2 O’clock sparing both lateral edges.
Posterior reconstruction of rhabdosphincter is carried out with 3-0 V-lock. Vesicourethral anastomosis is performed
continuously with 3-0 monocryl. Simplified anterior reconstruction is done with 3-0 V-lock.
My technique of RARP is to maximize the potency and the continence by preserving NVB and increasing the length ofurethral stump. It seems that this technique is easy to follow, safe and effective for recovery of potency and continence.

Session 8: Target biopsy and Focal therapy

Moderator

Go Kimura
Department of Urology Nippon Medical School
MEDICAL LICENSE/LICENSE
Medical License: 1984year; Number: 283208
Japanese Board Certified Urologist 1990 year: Number: 900080
Japanese Board Certified Instructor 1995 year: Number: 950083
EDUCATION AND PROFESSIONAL EXPERIENCE
1984
Graduate from Nippon Medical School (NMS); MD
1984
Teaching associate of 1st Department of Pathology, NMS
1985
Clinical fellow, Department of Urology, NMS
1991
Graduate from NMS, Graduate School of Medicine; PhD
Teaching Associate of Department of Urology, NMS
1992-1994
Research fellow, Department of Biology, City of Hope National Medical Center, Duarte, CA. USA
1995-2000
Assistant Professor, Department of Urology, NMS
1996-1997
Head of Urology Department, Kitamurayama Public Hospital
1997-2001
Department of Urology, NMS Hospital
2000-2022
Associate Professor, Department of Urology, NMS
2001-2002
Department Manager, Department of Urology, NMS Chiba-Hokusoh Hospital
2002-present Department of Urology, NMS Hospital
2002-2007
Department Manager, Department of Urology, NMS Hospital
Oct., 2022Professor, Department of Urology, NMS
SPECIALITIE
Genitourinary oncology, urologic clinical pathology, Artificial intelligence
PROFESSIONAL SOCIETIESJapanese Urological Association, American Urological Association, European Association of Urology, American Society of Clinical Oncology, Japan Society of Clinical Oncology, European society of Medical Oncology, Japanese Societyof Medical Oncology, Japanese Society of Pathology, Japanese Society of Endourology, Japanese Society of Dialysis
Therapy, Japanese Society of Nephrology, Japanese Society for Palliative Medicine, Japanese Association for Medical
Artificial Intelligence, Japanese Society of Renal Cancer
BOARD
President, Medical Association of Nippon Medical School, Vice President, Japanese Society of Renal Cancer, Director,
Prostate Cancer Education Council in Japan, Delegate, Japan Society of Clinical Oncology, Delegate, Japan Society of
Urologic Oncology, Delegate, Japan Medical Association, Delegate, Tokyo Medical Association

Session 8: Target biopsy and Focal therapy

Moderator

Seong Il Seo
Samsung Medical Center
Present Position:: Professor, Department of Urology, Sungkyunkwan University, Samsung Medical Center
Academic or Medical Associations Position:: President, Korean Prostate Society (present)
Director of Academic Committee, Korean Urological Association (present)
Korean Urologic Oncology Society, Director (present)
Educational background & professional experience (in sequence of the latest year):
EDUCATION- 2002. 08 - Ph.D. Postgraduate School, The Catholic University of Korea- 1998. 02 - Master Degree, Postgraduate School, Seoul National University- 1992. 02 - M.D. Seoul National University College of Medicine,
Professional experience- Sungkyunkwan University, Samsung Medical Center2016. 04 - present: Professor, Department of Urology
2007. 09 - 2016. 03: Associate professor, Department of Urology- The Catholic University of Korea
2004. 04 - 2007. 08: Assistant Professor, Department of Urology
2002. 03 - 2004. 03: Instructor, Department of Urology
2005. 09 - 2006. 19: Visiting professor, Emory University (USA) Winship Cancer InstituteResearch Interests:: Kidney cancer, Prostate cancer, Robotic surgery

Session 8: Target biopsy and Focal therapy

Robot-assisted Magnetic Resonance Imaging-ultrasoundFusion Transperineal Targeted Biopsy
Henry Ho
Department of Urology in Singapore General Hospital
Assoc Prof Henry Ho is a senior consultant with the Department of Urology and the current Chairman, Division of Surgery & Surgical Oncology, Singapore General Hospital (SGH) & National Cancer Centre Singapore (NCCS). Dr Ho received his MBBS and Master of Medicine (Surgery) from the National University of Singapore, and was subsequently
elected a Member of the Royal College of Surgeons of Edinburgh. Dr Ho was the first doctor in SGH/SingHealth to beawarded the Singapore-Stanford Biodesign (SSB) Fellowship Award by A*STAR in 2011.
A passionate medical device innovator, he contributed significantly to the successful set-up of the Device Development
Office - now the Medical Technological Office (MTO) SingHealth - where he held the Director appointment since2012. He is the Vice-Chair ((Research) of the Surgery Academic Clinical Program and also serves as the Chairman of
the Prostate Cancer Awareness and Survivorship Program Advisor Panel of the Singapore Cancer Society.
Dr Ho also holds appointments as Adjunct Associate Professor with Duke-NUS Medical School and Clinical SeniorLecturer with NUS-Yong Loo Lin School of Medicine.
Professional Appointments and Committee Memberships
Chairman, Division of Surgery & Surgical Oncology, SGH & NCCS
Adjunct Associate Professor, Duke-NUS Medical School
Adjunct Associate Professor, NUS Yong Loo Lin School of Medicine
Singapore Urological Association
European Association of Urology

Session 8: Target biopsy and Focal therapy

Focal therapy with high-intensity focused ultrasound forthe localized prostate cancer based on magnetic
resonance imaging-transrectal ultrasound fusion imageguided target biopsy in Japan
Sunao Shoji, MD., PhD., MBA.
Department of Urology, Tokai University School of Medicine
1996-2002: Medical School: Tokyo Medical University, School of Medicine
2002-2004: Residency: Department of Surgery, St. Luke’s International Hospital Tokyo
2004-2008: Postgraduate Course in Department of Urology, Tokai University School of Medicine
2008-2010: Assistant Professor, Department of Urology, Tokai University School of Medicine
2011-2013: Department of Urology, University of Southern California, Los Angeles, USA
2018-2020: Master’s Course in Health Master of Business Administration, International University of Health and Welfare
Present Position: Associate Professor, Department of Urology, Tokai University School of Medicine
Academic and Professional Awards:
2008: 11th World Congress of Endoscopic Surgery Best Poster Prize
2013: Best Poster Winner, American Urological Association Annual Meeting 20132016: Top 10 Abstract Award: Engineering and Urology Society 32nd Annual Meeting
2019: Aso Prize (Japanese Society of Endourology), Sakaguchi Prize (Japanese Urological Association)

Abstract
Introduction: Focal therapy is a diagnosis-based investigational treatment option for localized prostate cancer (PC) thatcures clinically significant PC (csPC) while preserving the anatomical structures related to urinary and sexual function.
Objectives: The objective is to evaluate clinical outcomes of focal therapy with high-intensity focused ultrasound(HIFU) for the localized PC for Japanese. Patients and Methods: Focal therapy with HIFU was performed in patientswith serum prostate-specific antigen (PSA) levels 侑 20 ng/mL, and csPC was detected using magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion image-guided target biopsy and 12-core transperineal template-assisted
systematic biopsy. Patients’ oncological and functional outcomes were analyzed prospectively. Results: Two hundred
three patients were included in the study. Their median age was 69 years old; and median PSA level was 6.34 ng/mL.
Patients’ risk classifications were low: n= 54, intermediate: n=71, and high: n=78. Catheterization and hospitalization
times were within 24 hours after treatment in all patients. Biochemical disease-free rate was 88.7% during 36 months
follow-up when use of Phoenix ASTRO definition. Urinary functions, including IPSS (P=0.012), OABSS (P=0.010),
maximum urinary flow rate (P=0.017), and IIEF-5 (P=0.022), had significantly deteriorated at 1 month after treatment,
but improved to preoperative levels at 3 or 6 months. Rates of severe erectile dysfunction who had the functions were
24% at 12 months after treatment. Conclusions: This clinical outcome focal therapy for localized PC for Japanese waspromising for long-term results. Further large studies are required to verify oncological and functional outcomes fromthis treatment for patients with localized PC.

Session 9: Ablation therapy for prostate cancer

Moderator

Robert G. Carlile
Department of Surgery, University of Hawaii
1992 - 2020
Urology Practice at Queens Medical Center
Honolulu, Hawaii
Clinical Assistant Professor of Surgery, John A Burns School of Medicine
University of Hawaii, Honolulu, Hawaii
1987 - 1992
Surgery and Urology Residency
University of Utah School of Medicine, Salt Lake City, Utah
1987
Doctor of Medicine
John A Burns School of Medicine,
University of Hawaii, Honolulu, Hawaii

Moderator

Yoshiyuki Kakehi
Kagawa University
Current job
President, Kagawa University
Education
Graduated from Kyoto University Faculty of Medicine in 1981(M.D.)
Graduated from Kyoto University Graduate School of Medicine in 1989 (Ph.D.)
Employment
2000: Associate Professor, Department of Urology, Kyoto University Graduate School of Medicine
2001-2017.9: Professor and Chairman, Department of Urology, Kagawa University Faculty of Medicine
2017.10-present: President, Kagawa University
Academic activities
1) President of the Japan Society of Urologic Oncology (2015-2017)2) Group leader of JCOG (Japan Clinical Oncology Group) GU-cancer group (2011-2018)3) Principal investigator of PRIAS-Japan (studies on active surveillance for low risk prostate cancer in Japan)
4) Chief editor of the 3rd edition of clinical guideline for prostate cancer (Japanese Urological Association)
Memberships
1) The Japanese Urological Association
2) Japan Society of Clinical Oncology
3) Japanese Society of Clinical Oncology4) American Urological Association
5) European Association of Urology

Session 9: Ablation therapy for prostate cancer

Irreversible electroporation (IRE) for prostate cancer
using PSMA PET-CT
Ji Youl Lee , Dongho Shin , Seung ah Rhe , Chang Eil Yoon ,Hyeok Jae Kwon , Hyong Woo Moon , Yong Hyun Park
Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic
University of Korea, Seoul, Korea
Name: Ji Youl Lee, M.D. & PhD.
Education & Degree
1989: Graduated from Medical College, The Catholic University of Korea
1990 - 1992: Master of Medical Science, Catholic University Graduate School
1997 - 2000: Doctor of Medical Science, Catholic University Graduate School
Experience
In hospital
2009 - 2017: Director, Urology Oncology Team, Seoul St. Mary’s Hospital2013 - 2017: Director, Outpatient Clinics, Seoul St. Mary’s Hospital2014 - 2021: Director, Department of Urology, Seoul St. Mary’s Hospital2017 - 2021: President of Smart Hospital (Vice-president of Seoul St. Mary’s Hospital)
Academic Position2020 - present: Chairman of Department of Urology
2006 - present: President, Korea Prostate Bank
2014 - present: Director, Catholic Prostate Institute, The Catholic University of Korea
2015 - 2017: President, Catholic Central Bio-Bank
2015 - 2019: Director, Catholic Cancer Research InstituteSocial Position2017 - Present: President Asia Pacific Society of Uro-oncology (APSU)
2018 - 2020: President, Asian Pacific Prostate Society (APPS)
2017 - 2019: President, Korean Prostate Society (KPS)
2020 - 2022: President, Korean Society of Urological Research (KSUR)

Abstract
Background: To demonstrate the clinical usefulness of Prostate-specific membrane antigen (PSMA) positron emission
tomography (PET) computerized tomography (CT) for Irreversible electroporation (IRE) in prostate cancer patients.
Methods: From January to May 2021, 17 men were diagonized with localized prostate cancer through preoperative
mpMRI and [18F] florastamin PSMA PET-CT imaging, followed by transperineal MRI-ultrasound fusion guided biopsy.
The patients underwent IRE focal therapy at the target lesions under general anesthesia. To evaluate the treatment outcome, serum PSA levels were followed up in the 1st, 3rd, 6th, 9th, 12th months, and mpMRI was taken in the 1st and 12thmonths, followed by MR fusion biopsy in the 12th month post IRE.
Results: The mean age of the patients was 66.1±9.3 with a median PSA of 7.5ng/ml. After the treatment, PSA nadir
was 4.06±3.4 and 11 (64.7%) achieved decline of PSA more than 50% from the baseline. Rate of negative biopsy forprostate cancer is 88%(15/17) at 12 months MR fusion biopsy after the IRE treatment. Among the relapsed cases, 1(6.9%) patient recurred at margin of treated area and 1 (6.9%) patient was from outfield recurrence. When excluding initial four patients, none of the patients had cancer recur.
Conclusions: When treating with IRE focal therapy, PSMA-PET CT is a potentially valuable diagnostic approach for
localizing prostate cancer; it supports the detection of lesions with conventional mpMRI, enabling to perform the procedure more completely.

Session 9: Ablation therapy for prostate cancer

The routine use of high intensity focused ultrasound forthe treatment of localized prostate cancer
Po Hui Chiang, M.D., Ph.D., E.M.S.
Jhong Siao Urological Hospital
Po Hui Chiang is director of the Jhong Siao Urological Hospital and honorary president of Taiwan Urological Oncology
Association. Professor Chiang received his medical degree (1986) and his doctorate of philosophy (1995) from Kaohsiung Medical University, Taiwan. He received his executive master of science (E.M.S.) degree from the National Taiwan
University in 2015. He is an author of more than 167 publications in peer-reviewed journal, mainly in the areas ofurothelial carcinoma, prostate cancer, BPH and pharmacology. He served as the president of Taiwan Urological Oncology Association from 2008 to 2014 and 2018 to 2020, respectively. Professor Chiang has been the director of Taiwan
Urological Association Council from 2006 to 2018 and director of interventional ultrasound society since 2015. Heserved as the chief of department of urology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiungfrom 2005 to 2009. He also served as visiting scientist at Kyoto Prefectural University of Medicine, Kyoto, Japan in
1994 and visiting professor at University of Texas Medical School, Houston, USA in 2000. He completed postdoctoral
research at University of Pittsburgh, Pennsylvania, USA (2000-2001). He got the best reviewer award from the Journalof Urology in 2014 and best article in British Journal of Urology international in 2013. His recent research interests include minimally invasive treatments of prostatic diseases (laser treatment of BPH, PCNL, cryotherapy of renal tumorand HIFU of prostate cancer) and signal pathway of urological cancer (target therapy and immunotherapy). The Hindex of Prof. Chiang is 32.
Current Appointment:
President of the Jhong Siao Urological Hospital
Professor, Chang Gung Memorial Hospital
Professor, Kaohsiung Medical University
Honorary President, Taiwan Urological Oncology Association
President of Chin Pei Medical Foundation

Abstract
I have performed edap Albatherm HIFU for the treatment of localized prostate cancer since 2009. More than 600 patients have been treated. In comparison with radical prostatectomy, brachytherapy and cryotherapy, we have shown the
oncological outcomes of HIFU are not inferior to those of other treatments. However, the complications such as incontinence and erectile dysfunction are much less than other treatments.
Sonablate HIFU for the treatment of prostate cancer has also been introduced since 2021. More than 60 patients havebeen treated at Jhong Siao hospital. In comparison with the previous Albatherm HIFU, it has the feedback sensor for thetreated area. It is more delicate and precise, but is more time-comsuming. The oncological control for the low and intermediate risk patients are excellent. Besides, HIFU with salvage radiotherapy can also rescue the cancer control for thehigh risk patients.
As further long term follow up data mature, we anticipate broader acceptance of HIFU and routine application in thenear future.

Session 10: Topics of the managements of mHSPC

Moderator

Mototsugu Oya
Department of Urology, Keio University School of Medicine
EDUCATIONAL HISTORY
1994 Sep/ Doctor of Medical Science. Keio University, School of Medicine, Tokyo, Japan
1987 Mar/ M.D. Keio University, School of Medicine, Tokyo, Japan
PROFESSIONAL BACKGROUND (EMPLOYMENT HISTORY)
Oct/2013 -present
Vice Director, Keio University Hospital
Aug/2007Professor and Chairman, Department of Urology, Keio University School of Medicine
Apr/2001-Jul/2007 Assistant Professor, Department of Urology, Keio University School of Medicine(Aug/2004-Jul/2006 Program Officer, Ministry of Education, Culture, Sports, Science and Technology)
Oct/1998-Mar/2001 Medical Staff, Department of Urology, Keio University Hospital
Jan/1997-Sep/1998 Postdoctoral fellow, Department of Urology, Duesseldorf University, Germany
Apr/1996-Oct/1996 Medical Staff, Division of Urology, Ogikubo Hospital, Tokyo
Jan/1995-Mar/1996 Postdoctoral fellow, Department of Urology, New York Medical College, USA
Jun/1993-Nov/1994 Medical Staff, Division of Urology, Saiseikai Chuou Hospital, Tokyo
Jun/1987-May/1993 Resident at Department of Urology, Keio University Hospital
Jun/1987
passed the Examination of National Board
MEMBERSHIP (selected)
Japanese Urological Association (councilor), Past President (2019-2021), Congress Chairman of the 109th Annual
Meeting (2021)
Japanese Cancer Association (councilor)
Japan Society of Clinical Oncology (director)
Japanese Society of Endourology and Robotics (councilor)
Japanese Society of Nephrology (councilor), Past director (2014-2020)
Japanese Society for Dialysis Therapy (councilor)
American Urological Association
European Association of Urology
Urological Association of Asia (director of research)
Société Internationale d’Urologie (SIU): Board of Directors (Publication chief): 2017-2021

Session 10: Topics of the managements of mHSPC

Current status and future perspectives ofthe managements of metastatic prostate cancer
Kazutoshi Fujita
Department of Urology, Kindai University Faculty of Medicine
Education:

2006
1999
1995

Ph.D. (Doctor of Medical Science) Osaka University
M.D., Osaka University School of Medicine
Phar.B., Kyoto University School of Pharmacology

Employments:
2020-present Associate professor in Urology, Kindai University Faculty of Medicine
2016-2020
Associate professor in Urology, Osaka University Graduate School of Medicine
2012-2015
Assistant professor in Urology, Osaka University Graduate School of Medicine
2009-2012
Medical staff in Urology, Osaka General Medical Center
2006-2008
Postdoctoral fellowship, The Brady Urological Institute, Johns Hopkins Medical Intstitutions.
Society: The Japanese Urological Association, Japanese Cancer Association, Japanese Society of Clinical Oncology,
Japanese Society of Medical Oncology, Japanese Society of Endourology and Robotics, The Japan Society ofAndrology, The Japanese Society for Sexual Medicine, Japanese Society of Fertility and Sterility, JapaneseSociety of Clinical Renal Transplantation

Abstract
The mortality rates of prostate cancer are rising in Japan as well as in the United States. The management of metastatic
hormone-sensitive prostate cancer (mHSPC) is becoming increasingly important. Prostate cancer cell growth is regulated by androgen through activation of androgen receptor signaling pathway. Patients with metastatic prostate cancer
are basically treated with androgen deprivation therapy (ADT) as systemic therapy. Recently, the therapeutic landscapefor mHSPC has changed dramatically. Upfront androgen receptor signaling inhibitor (ARSi), such as enzalutamide, or
docetaxel in addition to ADT has improved survival in mHSPC patients and has become the new standard of care. The
inclusion of risk factors or the genetic biomarkers will provide the optimal treatment for individual mHSPC patients.
Furthermore, the mutation or amplification of androgen receptor is critical for the development of the castrationresistant prostate cancer (CRPC). Recent studies showed that gut microbiome was the source of androgens for the prostate cancer growth. The gut-prostate axis could be the new target of the treatment of prostate cancer. The understandingof the mechanisms of CRPC would lead to the development of the new strategy for mHSPC.

Session 11: Topics of RCC

Moderator

Tohru Nakagawa
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
1994/3
1997/6
2000/4
2002/4
2004/4
2006/3
2006/122010/6
2012/72017/42018/4

M.D., The University of Tokyo Faculty of Medicine
Resident, Urology Division, National Cancer Center Hospital
Chief Resident, Urology Division, National Cancer Center Hospital
Research Resident, Pathology Division, National Cancer Center Research InstituteResearch Fellow, Department of Urology, Mayo Clinic, U.S.A.
Ph.D., The University of Tokyo Graduate school of Medicine
Staff physician, Urology Division, National Cancer Center Hospital
Chief physician, Urology Division, National Cancer Center Hospital
Lecturer/Assistant Professor, Department of Urology, The University of Tokyo Graduate School of Medicine
Professor, Department of Urology, Teikyo University School of Medicine
Professor and Chairman, Department of Urology, Teikyo University School of Medicine

Session 11: Topics of RCC

Practice of clinical approaches to first-line treatment formetastatic renal cell carcinoma.〜A new era of immune
checkpoint inhibitors (ICI) -based combination therapy〜
Jun Morita, M.D. , Takashi Fukagai, M.D.
Department of Urology, Showa University, School of Medicine, Tokyo, Japan.
Jun Morita M.D., Ph.D.
Associate Professor Department of Urology, Showa University School of Medicine【Education/Career】
2001/3 M.D. Faculty of Medicine, Showa University
2003/4 Staff physician, Urology Division, Tokyo Metropolitan Hiroo Hospital
2008/4 Assistant Professor, Department of Urology, Showa University School of Medicine
2010/4 Staff physician, Urology Division, Showa University Fujigaoka Hospital
2010/9 Staff physician, Urology Division, National Hospital Organization Disaster Medical Center
2014/4 Deputy Chief, Urology Division, Yamanashi Red Cross Hospital
2015/4 Lecturer, Department of Urology, Showa University School of Medicine
2020/4 Associate Professor, Department of Urology, Showa University School of Medicine【Affiliated society】
Advising Doctor, The Japanese Urological Association
Approved Doctor, Japanese of Board of Cancer Therapy
Representative and Approved Doctor, Urology Robot-assisted Surgery Proctor Certification System, Japanese Societyof End urology and Robotics
Technical Approved Doctor, (Urology) The Japan Society for Endoscopic Surgery
Laparoscope Small Incision Surgery Facility Standards Physician, Japanese Society of Minimum Incision Endoscopic
Urological Surgery
Representative and Specialist, The Japanese Society for Sexual Medicine

Abstract
The treatment of patients with metastatic renal cell carcinoma (mRCC) is evolving rapidly, new frontline combination
therapy of immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKIs) promote response rate and increase
prognosis for mRCC. The four ICI-based TKIs combination regimens (Pembrolizumab/Axitinib, Avelumab/Axitinib,
Nivolumab/Cabozantinib, Pembrolizumab/Lenvatinib) are currently available as first-line treatment for mRCC for all
IMDC risk groups, and ICI-ICI combination (Ipilimumab/Nivolumab) are available for IMDC intermediate or poor risk
patients, in Japan.
The ipilimumab/nivolumab combination is notable for durable response after extended 5-year follow-up. Furthermore,
ICI/TKIs combinations have clinical efficacy across all IMDC risk groups with higher response rates and longer
progression-free survival (PFS). However, there is no definitive regimen, there are not a few cases to be possible formetastatic lesions to progress in a few months. Choosing among the available drug combination depends on treating
physician’s interpretation of several existing data of each clinical trial. While always keeping in mind the latest drug
characteristics, toxicity profiles, and each trial results, we need to ultimately determine the regimen that can be surely
administered effectively, in front of each patient, with considering each patients characteristics, risk factors.
In this session of novel approaches for first-line treatment of mRCC, we present an overview of current treatment strategies, the basis behind emerging treatment approaches, a summary of key results from the pivotal studies using ICI/TKIs
and ICI/ICI combination therapy, and discuss treatment strategies of practical clinical cases.

Session 12: Medication for BPH & LUTS

Moderator

Hiroyuki Nishiyama
Dept. of Urology, Faculty of Medicine, University of Tsukuba
After graduating from Kyoto University School of Medicine in 1989, I trained in the Department of Urology and studied at the Imeprial Cancer Reserch Fund in the U.K. from 1998 to 2000 as a research fellow to study the carcinogenesis
mechanism of bladder cancer. In 2011, I became a professor at the Department of Urology, University of Tsukuba,
Tsukuba, Japan. Currently, I am in charge of basic research and clinical practice related to urothelial carcinoma andother urologic cancers. In particular, he is leading a novel bladder-sparing therapy using immune checkpoint inhibitors
in combination with radiotherapy and an investigator-oriented clinical trial for testicular tumors. I also serves on theadvisory-board for global clinical trials and as chairman of the Japan-clinical Oncology group in the field of urologic
oncology.

Session 12: Medication for BPH & LUTS

Treatment strategy for OAB with BPH

Naoya Masumori, M.D.
Dept. of Urology, Sapporo Medical University
Subspecialty: Urologic oncology, Benign prostatic hyperplasia, Laparoscopic surgery, Robotic surgery, Gender identity
disorderBrief sketch
MEDICAL SCHOOL:
1988
Sapporo Medical University School of Medicine, Japan
POST GRADUATE:
1988-1993
Resident and Clinical Fellow in Urology, Sapporo Medical University School of Medicine
ACADEMIC CAREER:
1994
Received D.MSc from Sapporo Medical University
1994-1998
Instructor, Department of Urology, Sapporo Medical University School of Medicine
1998-2001
Research Fellow, Department of Urologic Surgery, Vanderbilt University, Nashville TN, USA
2001
Assistant Professor, Department of Urology, Sapporo Medical University School of Medicine
2002
Exchange visitor, Department of Urology, Helsinki University, Helsinki, Finland
2006
Associate Professor, Department of Urology, Sapporo Medical University School of Medicine
2013-present
Professor and Chair, Department of Urology, Sapporo Medical University School of Medicine
2018-present
Deputy-Chief of the Sapporo Medical University Hospital

Abstract
Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms (LUTS) in middle-aged
men. In addition to bladder outlet obstruction due to adenoma, bladder dysfunction secondary or concomitant to BPH
modulates LUTS caused by BPH in various ways. In particular, detrusor overactivity secondary to bladder outlet obstruction cause overactive bladder (OAB) and impair quality of life.
Pharmacologic treatment of OAB associated with BPH includes alpha 1-blockers alone, PDE5 inhibitors alone, 5-alphareductase inhibitors alone, anticholinergics alone, and beta 3-agonists alone. On the other hand, the higher grade recommended is the combination of alpha 1-blockers and anticholinergics or beta 3-agonists. In this presentation, medical
treatment of OAB associated with BPH will be presented based on the Overactive Bladder Clinical Guidelines, 3rd Edition.

Session 13: New Surgical Techniques & New treatment Strategies for BPH

Moderator

Bannakij Lojanapiwat
President of Thai Urologic Association and Dean of Faculty of Medicine
Present Position: Special Expert Professor of Urology, Chiang Mai University, Thailand: Dean of Faculty of Medicine, Chiang Mai University, Thailand
Academic or Medical Associations Position:: President of Thai Urologic Association: Chairman :Scientific Committee of the Urological Association of Asia
Educational background & professional experience
1988: Medicine from Chiang Mai University
1992: Fellowship in Organ transplantation, Albert Einstein Medical Center, Philadelphia, USA
2001: Fellowship in Endourology, University of Miami, USA
Research Interests
Prostate Cancer, Stone Disease, Endourology
In addition to being widely published, Professor Lojanapiwat sits on many editorial boards, including the Prostate International, the International Journal of Urology, the Official Journal of the Brazilian Society of Urology, and the Journalof Medical Association of Thailand. He is also reviewer for the Journal of Endourology, Urology, and the International
Journal of Urology, Singapore Medical Journal, Indian Journal of Urology, Urol Journal and other.

Moderator

Satoru Takahashi
Director, Nihon University Itabashi Hospital
Education:
1979-1985
Gunma University School of Medicine
1993
Awarded the degree of PhD, The University of Tokyo
Research and Professional experience:
1985-1987
Residency of Surgery (Neurosurgery), Gunma University
1987-1992
Residency of Urology, The University of Tokyo
1993-1995
Postdoctoral research fellow, Department of Urology, Mayo Clinic, USA
1996-2002
Assistant Professor, Department of Urology, The University of Tokyo
2003-2005
Associate Professor, Department of Urology, The University of Tokyo
2006-present Professor and Chairman, Department of Urology, Nihon University School of Medicine
2014-2021
Vice Director, Nihon University Itabashi Hospital
2021-present Director, Nihon University Itabashi Hospital
Membership of academic societies:
American Urological Association (AUA), European Urological Association (EAU), International Continence
Society (ICS), International Urogynecological Association (IUGA)Japanese Urological Association (JUA): Board of Director (2017-2021, Chief of Health insurance section)(2015-2017, 2021-present, Chief of BPH & Geriatric Urology section) (2010-2014, Chief of Female Urology
section)Session 13: New Surgical Techniques & New treatment Strategies for BPH
Japanese Continence Society: Board of Director (President)
Japanese Geriatric Urological Association: Board of Director (President)
Japanese Society of Female Pelvic Floor Medicine: Board of Director (Vice President)
Japanese Association for Cancer Detection and Diagnosis: Board of Director
Japanese Clinical Oncology Association: Delegate
Research Fields:
1. Voiding dysfunction (BPH, overactive bladder, female LUTS)
2. Urogynecology (pelvic floor reconstruction)
3. Urologic Oncology (molecular cancer biology and laparoscopic/Robotic surgery)
Publications:
Original articles: 241, Review: 193, Case-report: 78, Book: 106

Session 13: New Surgical Techniques & New treatment Strategies for BPH

Water Vapor Therapy for Benign Prostatic
Hyperplasia―the Hong Kong Experience
Professor Anthony C.F. Ng
SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong
Kong, China
Dr NG Chi Fai, Anthony, Tze Leung Ho Professor of Urology , graduated in the Chinese University of Hong Kong in
1993. He then joined Department of Surgery, Prince of Wales Hospital, as surgical trainee. After his basic training, hedecided to become a urologist and became a specialist in 2001. Attracted by the rapid development in minimally invasive surgery, he spent one year in Scotland, worked under Mr. David Tolley, and gained extensive experience in endolaparoscopic surgery and stone management.
After completion of his training, Dr Ng decided to join the Chinese University of Hong Kong in 2006 and is currently
Tsu Leung Ho Professor of Urology & Chief of the Division of Urology, Department of Surgery, the Chinese University of Hong Kong. He is also the Director of the CUHK Hong Kong Jockey Club Minimally Invasive Surgical Skill
Centre . He has a wide range of clinical and research interests, in particular in prostate diseases, minimally invasive surgery, robotic surgery and urolithiasis. He was honoured with Outstanding Young Urologist Award in 2010 by the AsianCongress of Urology, International Guest Scholar 2012 of the American College of Surgeons, Achievement Award
from the World Chinese Urology Association of the American Urological Association in 2014 and Outstanding Contribution Award by the International Alliance of Urolithiasis in 2017. He and his clinical team was awarded Merit Awardin the Hospital Authority Outstanding Team Award in 2019 to recognize their excellence in clinical service. Moreover,he was the first surgeon to perform da Vinci SP urological surgery in Asia.
Besides clinical and research work, Professor Ng has strong commitment in education and teaching. He has been
awarded Best Teacher Awards of the Faculty of Medicine, the Chinese University of Hong Kong, for his contributionin undergraduate teaching. He serves as Council member of the College of Surgeons of Hong Kong since 2014 andHonorary Secretary of the Urology Board of the College of Surgeons of Hong Kong. He is actively involved in planning of the urological training in Hong Kong. He was the Course Director of the Robotic Surgery Training Programme ,CUHK Hong Kong Jockey Club Minimally Invasive Surgical Skill Centre and contributed to the rapid development ofrobotic surgery in Hong Kong and Asia. He is also the founding Chairman of Asian Urological Surgery Training and
Education Group (AUSTEG) and leads a team of Asian urologists in providing training for young urologists for whole
Asia.
Lastly, he is also the co-Director of the Youth Urological Treatment Centre in Prince of Wales Hospital since 2010.
The centre is the first multidisciplinary centre in the territories to help young substance abusers with urological problems, in both physical and psychosocial domains. He also serves as member of the Action Committee Against Narcotics
since 2019 to provide advice and support to the fight against drug abuse in Hong Kong.

Abstract
With increasing aging population and also demand of better quality of life, there is a rising demand for better treatment
for benign prostatic hyperplasia (BPH). Traditional medical therapy might provide mild to moderate symptom improve,but standard transurethral resection of prostate has certain limitation and morbidities. Therefore, there is need for treatment that are both effective and also minimally invasive to patients.
Water vapor therapy (REZUMⓇ) is an emerging therapy for BPH with proven durable efficacy. In Hong Kong, the technology was introduced in 2020. In the beginning, it was first applied to patients with lower urinary tract symptom secondary to BPH. In our initial cohort, 50 patients was treated and There were significant differences of pre-operative and3-month post-operative parameters, including post-void residual urine (p = 0.038), maximal uroflow rate (p < 0.001),
symptom score (p < 0.001) and quality of life assessment (P < 0.001).
Later, due to COVID and so we tried to apply the technology under local anaethesia and also in patients with retentionof urine. Between June 2020 and July 2022, a total of 55 Asian patients with AROU secondary to BPH were treatedwith REZUM with an office setting under pure LA without sedation. All patients were able to be discharged on thesame day with Foley catheter after the operation. All patients were able to have successful trial without catheter

Session 13: New Surgical Techniques & New treatment Strategies for BPH(TWOC); 47 patients (85.5%) had successful TWOC within 30 days. The median TWOC time were 14 days (IQR: 1030). Eight patients (14.5%) had unplanned hospital admission within 30 days post-operatively due to grade I ClavienDindo complications, including five cases (9.0%) of haematuria and three cases (5.5%) of recurrent AROU. The threecases of recurrent AROU all weaned off Foley within the next two weeks.
Therefore, from our limited experience, water vapour therapy is a safe and effective procedure that could be done underlocal anesthesia in day care setting. This could help to decrease hospital stay and anesthesia demand in clinical management.

Session 13: New Surgical Techniques & New treatment Strategies for BPH

Prostatic Urethral Life (Urolift) for the treatment of
LUTS in 2022
Henrry Woo
Sydney Adventist Hospital Clinical School of the University of Sydney
Professor Henry Woo

MBBS DMedSc

FRACS(Urol) FACS

Henry Woo is a urological surgeon with a subspecialty practice in BPH and prostate cancer. He is Professor Urology at
the Australian National University since 2021 and previously was Professor of Surgery at the University of Sydney. He
is the Director of Uro-Oncology at the Chris O’Brien Lifehouse Comprehensive Cancer Centre and is the Director of
the SAN Prostate Centre of Excellence at the Sydney Adventist Hospital.
He has published widely and has approximately 200 peer reviewed publications and several book chapters. He is currently an Associate Editor with the SIU Journal and a Consulting Editor of Journal of Urology Open Plus. He also
serves on the journal editorial boards of Prostate Cancer and Prostatic Diseases, Asian Journal of Urology, World Journal of Urology, World Journal of Men’s Health and Prostate International. He has recently completed terms of service
on the editorial boards of European Urology, BJUI and PLOS One. He has reviewed for numerous journals including
high impact journals such as the New England Journal of Medicine, The Lancet, European Urology, Medical Journal ofAustralia and the Journal of Urology.
His research interests particularly include minimally invasive surgical treatment options for male LUTS, robotic assisted
simple prostatectomy, prostate cancer imaging and diagnostics and systemic treatments for prostate cancer. He is actively involved in clinical trials and has been a site PI for numerous international multicentre clinical trials.
He is a Fellowship Elected Councillor of the Royal Australasian College of Surgeons where he holds the role of Chairof the Research and Academic Surgery portfolio of the college and is also the Chair of the RACS Robotic Assisted Surgery Working Party. He is also the Chair of the Australian and New Zealand Association of Urological Surgeons(ANZAUS) and serves on the Board of Directors of the Urological Society of Australian and New Zealand (USANZ). He
also serves on the Board of Directors of the Australian and New Zealand Urogential and Prostate Cancer Trials Group(ANZUP) and the charitable Australasian Urological Foundation (AUF). He is currently the USANZ Delegate to theSociete Internationale Urologie (SIU).

Abstract
The prostatic urethral lift (PUL) has become an established minimally invasive surgical treatment option for male lower
urinary tract symptoms (LUTS). The clinical trials methodology for PUL has established a research pathway followedby subsequently developed MISTs. The use of randomised controlled trials including a sham procedure with cross overtreatment as well as the use of patient centred PROM and PREM instruments have now become common place for devices used to treat male LUTS. High level evidence of efficacy and safety of PUL has been established in randomised
controlled trials and supported by real world registry outcomes. Consistent features of clinical outcomes following PUL
are early improvement in symptoms, a low morbidity profile and in particular, the preservation of both erectile andejaculatory function. Initially, the treatment of glands with a prominent middle lobes were not recommended as suitablefor PUL but with the development of a technique to place an implant across the middle lobe has been reported with outcomes similar to subjects without a middle lobe component to obstruction. PUL is currently a recognised part of the armamentarium for the surgical treatment of male LUTS in all major clinical practice guidelines for male LUTS.

Session 13: New Surgical Techniques & New treatment Strategies for BPH

Effects of Transoral Robotic Surgery (TORS)Obstructive Sleep Apnea (OSA) Surgery on Lower
Urinary Tract Symptoms in Male Patients with OSA/
Hypopnea Syndrome
Yao-Chi Chuang
Professor of Urology, Kaohsiung Chang Gung Memorial Hospital
Yao-Chi Chuang is a Professor in the Division of Urology at the Kaohsiung Chang Gung Memorial Hospital, Taiwan.
After graduating from the National Yang-Ming University School of Medicine in 1988, Dr Chuang completed his residency in urology at Veterans General Hospital, Taipei. He was awarded a research Fellowship in the Department ofPharmacology and Urology at the University of Pittsburgh in 1999-2000, where he worked with Professor deGroat,
Chancellor, and Yoshimura on the study of physiology and pharmacology of lower urinary tract.
Dr Chuang is a member of both the Surgical and Urology Associations of Taiwan. He is immediate past president of
Taiwanese Continence Society.
He has a particular interest in neuro-urology, female urology, and minimal invasive treatment for prostate disease. Dr
Chuang is continuous working on the research of IC/PBS, OAB, UAB, DM related lower urinary tract dysfunction(LUTD), and use of low energy shock wave, botulinum toxin, and liposome for the treatment of LUTD.
Dr Chuang has published over 150 peer-reviewed articles, and he also serves as reviewers for many scientific journals.
He has been invited to give lectures more than 100 times in the national and international meeting.
Dr Chuang has won awards from Lapides Essay Contest for 6 times, and Taiwan Urological Association for 9 times. Dr
Chuang has received research grant from Ministry of Science and Technology, Taiwan since 2001, and NIH from 2003
to 2005.
Dr Chuang is an editorial member of International Urology and Nephrology, Asia Journal of Urology, and LUTS. Dr
Chuang is the chief editor of Urological Science, official journal of Taiwan Urological Association.

Abstract
Obstructive sleep apnea/hypopnea syndrome (OSA) is a common disease. It affects approximately 4% to 5% of all
middle-aged men. Previous studies have shown a relationship between OSA and nocturia and polyuria, which are related to lower urinary tract symptoms (LUTS).
The tongue base/hypopharyngeal obstruction is one of the major causes of OSA, of which obstructive condition(s) areusually challenging for the majority of sleep surgeons and could be more suitably relieved by transoral robotic surgery(TORS). In the present study, we firstly evaluated the effect of TORS-assisted OSA surgery on LUTS and OAB symptoms in 123 male OSA patients by one single surgeon (Lin HS), as well as further analyzed the relations between severity of OSA and the improvement of LUTS and OAB after TORS-assisted OSA surgery.
We found that there were significant differences in IPSS, and OABSS according to OSA severity. After TORS-OSA
surgery, significant improvements on OSA severity, daytime quality of life (QoL) and nighttime sleep quality were observed. TORS-OSA surgery was also associated with a statistically significant improvement of LUTS, LUTS QoLscore, and OAB symptoms at post-operative 3 months’ follow-up.
TORS upper airway surgery could improve LUTS and OAB symptoms on male patients with OSA in addition to improvement of major parameters of sleep study and sleep-related QoL.
Reference:
Effects of TORS-OSA Surgery on Lower Urinary Tract Symptoms, Overactive Bladder Symptoms, and Nocturia in
Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome. Nat Sci Sleep. 2022;14:547-556 (Chuang YC & Lin
HC* et al).

Session 14: Luncheon Seminar Topics of M0CRPC

Moderator

Hideki Sakai
Hospital Director, Nagasaki Rosai Hospital
EDUCATION
1983
M.D., Nagasaki University, School of Medicine
1992
Ph.D. (Doctor of Medical Science), Nagasaki University
PROFESSIONAL TRAINING AND EMPLOYMENT
1983
Passed the Examination of National Board
1983-1984
Resident, Nagasaki University Hospital
1984-1985
Resident, Sasebo General Hospital and Nagasaki Red Cross Hospital
1985-1986
Medical Staff in Urology, Ureshino National Hospital
1986-1987
Medical Staff in Urology, Isahaya Genaral Hospital
1987-1991
Medical Staff in Urology, Nagasaki University Hospital
1991-2000
Instructor, Department of Urology, Nagasaki University School of Medicine
2000-2007
Assistant Professor, Department of Urology, Nagasaki University School of Medicine
2007-2009
Associate Professor, Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
2009-2022
Professor and Chairman, Department of Urology, Nagasaki University Graduate School of Biomedical
Sciences2022-Present Director, Nagasaki Rosai Hospital
MEMBERSHIP
Japanese Urological Association
Japan Society of Clinical Oncology
Japan Association of Endocrine Surgeons
Japan Society of Trasplantation
American Urological Association
Asian Pacific Prostate Society

Session 14: Luncheon Seminar Topics of M0CRPC

Non-metastatic CRPC or Early CRPC?
Challenges in CRPC treatment in the era of nextgeneration imaging.
Shusuke Akamatsu
Associate Professor, Department of Urology Kyoto University Graduate School of Medicine
2001/3
2009/5
2012/7
2013/3
2014/7
2015/7
2016/7
2019/122022/1

M.D. Faculty of Medicine, Kyoto University
Research fellow, Center for Genomic Medicine, RIKEN
Postdoctoral fellow, Vancouver Prostate Centre, BC, Canada
Ph.D. Graduate School of Medicine, Kyoto University
Uro-oncology clinical fellow, Department of Urology, British Columbia, Canada
Assistant Professor, Kyoto University Graduate School of Medicine
Visiting researcher, Center for Integrative Medical Sciences (until present)
Senior Lecturer, Kyoto University Graduate School of Medicine
Associate Professor, Kyoto University Graduate School of Medicine

Abstract
Treatment of castration resistant prostate cancer (CRPC) has improved significantly by the emergence of potent androgen receptor pathway inhibitors (ARPIs). However, study designs of clinical trials that led to approval of these ARPIs
have created a clinical disease status called non-metastatic CRPC , whereby the site of tumor is not detectable byconventional imaging including CT and bone scans. For CRPC, among the currently available ARPIs, darolutamide andapalutamide are only indicated in non-metastatic cases. More recently, novel imaging techniques such as PSMA-PET
and whole-body MRI have revealed that in many of these non-metastatic CRPC cases, tumors are indeed detectableusing these techniques. Hence, early CRPC may be a more suitable term than non-metastatic CRPC. When there
are only a small number of metastasis sites (oligo-metastasis or oligo-progression), local control of these tumors bystereotactic radiotherapy may be a reasonable option, although there are currently no robust data supporting this treatment strategy. With the emerging role of next-generation imaging, treatment of this disease status has become very
complex, and data from more clinical trials are necessary to guide treatment.

Session 14: Luncheon Seminar Topics of M0CRPC

Changes in treatment landscape for non-metastatic
CRPC: what has novel hormonal therapy brought about?
Kohei Hashimoto
Department of Urology, Sapporo Medical University School of Medicine
2000
2002
2008-2012
2013
2016
2020

Resident in Urology, Sapporo Medical University Hospital, Sapporo
Clinical fellow in Urology, Sapporo Medical University Hospital, Sapporo
Ph.D. in Molecular Biology, Sapporo Medical University Postgraduate School of Medicine (Sapporo)
Postdoctoral Research fellow, Department of Anatomy and Developmental Biology, Monash University,
Melbourne, Australia
Instructor in Urology, Sapporo Medical University School of Medicine
Assistant professor in Urology, Sapporo Medical University School of Medicine

Abstract
Non-metastatic castration-resistant prostate cancer (nmCRPC) is defined by prostate specific antigen (PSA) progression
in the absence of metastases on conventional imaging including computed tomography (CT) and bone scan despite acastrate level of serum testosterone by androgen deprivation therapy (ADT). Recently, the randomized-controlled studies support the efficacy of androgen receptor pathway inhibitors (ARPIs) plus ADT in nmCRPC patients. The ARAMIS
study showed a median MFS (the primary endpoint) of 40.4 months with darolutamide versus 18.4 months with placebo(hazard ratio for metastasis or death in the darolutamide group, 0.41; 95% confidence interval, 0.34 to 0.50; P<0.001),
which represented a 59% reduction in metastases or death.
However, some questions to be answered have yet remained. First of all, what about less biological heterogeneity in
nmCRPC? Another question is: when to diagnose nmCRPC and start ARPIs? Then, is there any significance of MFS in
the real-world practice? Another one is: what could be the best treatment sequence for metastatic disease after ARPIs?
In this part, we review the literature and consider the rationale of the possible therapeutic choices in nmCRPC patients.

Session 15: Topics of Bone Scan

Moderator

Takahiro Kimura
Department of Urology, The Jikei University School of Medicine
Apr/2022
Jan/2018
Aug/2011
Oct/2006
Aug/2003
Apr/2001
Jan/2000
May/1998
May/1996
May/1996

Professor, Department of Urology, The Jikei University School of Medicine
Associate Professor, Department of Urology, The Jikei University School of Medicine
Assistant Professor, Department of Urology, The Jikei University School of Medicine
Clinical Associate, Department of Urology, The Jikei University School of Medicine
Postdoctoral Researcher, Department of Medicine, Division of Digestive Disease, UCLA
Clinical Associate, Department of Urology, The Jikei University School of Medicine
Research fellow, Department of Gene Therapy, Institute of DNA Medicine, The Jikei University Schoolof Medicine
Senior Resident in Department of Urology, The Jikei University School of Medicine
Junior Resident in Department of Urology, The Jikei University School of Medicine
Graduated from The Jikei University School of Medicine

Session 15: Topics of Bone Scan

Importance of Imaging Follow-up for Advanced Prostate
CancerKazuki Sudo
Department of Medical Oncology, National Cancer Center Hospital[Education]
2006 Niigata University, M.D., Medicine
2019 Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Ph.D., Medicine[Biography]
2006-12
2012-142014-1720172019Nov. 2020-

Resident and Chief resident, GI surgery, St. Luke’s International Hospital
Postdoctoral fellow, Dept. of GI Medical Oncology, MD Anderson Cancer Center
Resident for medical oncology program, National Cancer Center Hospital (NCCH)
Staff physician, Dept. of Medical Oncology at NCCH and Rare Cancer Center
Concurrent appointment in the Dept. of Experimental Therapeutics, NCCH
Concurrent appointment as Director of TR Promotion Section, Dept. of International Clinical Development, NCCH

[Specialists, etc.]
・Board Certifications: Board of surgery, 2011
・Board Certified Member of the Japanese Society of Internal Medicine, 2016
・Board of Medical Oncology, JSMO, 2017

Abstract
Recent advances in the treatment of metastatic prostate cancer have been quite remarkable, and we are facing new challenges in making decisions about the timing and selection of therapies. Strategies for follow-up of advanced prostatecancer are more important today because they lead to treatment changes.
PSA is important test for prostate cancer follow-up, but disease progression without an elevated PSA is sometimes observed. The lack of PSA progression may indicate that these tumors have become less reliant on the AR for their
growth. Treatment-emergent neuroendocrine prostate cancer is also related to low PSA level. Recent studies suggestthat HRR mutated metastatic prostate cancers may present with Low PSA. Uncoupling of PSA levels from the diseaseprogression was known in castrate-resistant prostate cancer, and has being recognised in the hormone-sensitive state as
well.
Recent studies have shown that mHSPC, M0CRPC, and mCRPC cases show clinical progression inconsistent with PSA(about 10%, about 25%, and about 25%, respectively). It is important to know how to develop an image-based followup strategy in addition to PSA. For advanced prostate cancer, CT scans and bone scintigraphy are important imaging
studies. In addition to these conventional imaging techniques, new generation imaging, like PSMA PET, have emergedin recent years. The use of PSMA PET, has been shown to be superior compared with conventional imaging, but The
usefulness of PSMA PET for periodic follow- up of advanced prostate cancer is unknown. In this presentation, appropriate imaging follow- up strategies will be discussed and proposed based on the literature, the Reports of the Advanced
Prostate Cancer Consensus Conferences, and various guidelines.

Session 16: Treatment strategy for mCSPC

Moderator

Hirotsugu Uemura
Department of Urology, Kindai University Faculty of Medicine
Name:
Institute:
Degree:Hirotsugu Uemura, MD. PhD.
Department of Urology, Kindai University Faculty of Medicine, Osaka
Professor and Chairman

1983.4 MD.
1983.4-1985.12
1986.1-1991.6
1991.7-1993.12
1994.11 PhD
1994.1-1997.2
1997.3-2003.6
2003.7-2004.3
2004.4-present
2010.10-2016.9
2013.4-2017.3
2015.4-2019.3
2016.11-present

Nara Medical University
Resident, Nara Medical University Hospital and Saiseikai Hospital
Staff in Urology, Kaisei Hospital and Nara Medical Univ. Hospital
Research fellow in Urology, Nijmegen University, The Netherlands
University Hospital Nijmegen, The Netherlands
Staff in Urology, Nara Medical University
Assistant Professor in Urology, Nara Medical University
Associate Professor in Urology, Nara Medical University
Professor and Chair in Urology, Kindai Univ. Faculty of Medicine
Vice president of Kindai University Hospital
Executive member of Japanese Urological Association(JUA) (Chair of Scientific Committee)
JUA Chair of Urologic Oncology Section
Executive member of Japanese Society of Endourology

Topics: Urologic Surgery, Urologic Oncology, Endourology,
License and Certification:
1983
MD, Japanese license No.277783
1989
Urologist, JUA license No.890240
1994
PhD, University Nijmegen, The Netherlands

Session 16: Treatment strategy for mCSPC

Treatment strategy for mCSPC
Dr. Declan G. Murphy
Consultant Urologist Director of Genitourinary Oncology, professor at the Peter MacCallum
Cancer Centre, Melbourne, Australia
Employment History:
April 2010 - present: Consultant Urologist, Director of Genitourinary Oncology & Director of Robotic Surgery Peter
MacCallum Cancer Centre, Melbourne, VIC 3000
Leadership and other positions held:
Director of Genitourinary Oncology, Peter MacCallum Cancer Centre: 2014-present
Associate Board Member, EAU Robotic Urology Section (ERUS): 2014-present
Scientific journal activity:
Associate Editor, British Journal of Urology International: 2013 - 2020
Consulting Editor/Editorial Board, European Urology: 2012-present
Expert Advisory Board, Nature Reviews Urology: 2012 - present
Faculty Member (Convenor/Scientific Director roles highlighted in bold):
16th Annual Meeting of the EAU Robotic Urology Section (ERUS), Lisbon, Sept 2019
3rd Advanced Prostate Cancer Consensus Conference, Basel, Aug 2019
Funded research activity:
Successful in attracting more than $20m in competitive grant funding as Principal or Chief Investigator since 2010
Awards:Paper of the Year 2022 - Awarded by European Urology for the PRIMARY trial
Clinical Trial of the Year - Australian Clinical Trial Alliance Annual Awards, Melbourne, May 2021
Membership of Learned Societies:
Association of Academic European Urologists
European Association of Urology
Urological Society of Australia & New ZealandSession 17: Topics of BRCA &CRPC

Moderator
Naohiro Fujimoto, M.D, Ph.D.
Professor and Chairman, Department of Urology, University of Occupational andEnvironmental Health (UOEH),
President of UOEH Wakamatsu hospital
Vice-president of UOEH University hospital
Educational background & professional experience
2015-present Department of Urology, UOEH, Professor and Chairman
1997-1998:
George Whipple laboratory for Cancer Research, University of Rochester, Research Associate
1996-1997:
Comprehensive Cancer Center, University of Wisconsin,
Research Associate
1984-1986;
Resident in UOEH
Research Interests
Urologic Oncology, Hormone Action in Cancer, Retroperitoneal tumor

Session 17: Topics of BRCA &CRPC

The role of olaparib in the treatment of mCRPC

Hiroshi Kitamura
Department of Urology, Faculty of Medicine, University of Toyama, JapanEMPLOYMENT
1994-1995
Resident
Sapporo Medical University Hospital, Sapporo, JAPAN
1996-1997
Clinical Fellow
Sapporo Medical University Hospital, Sapporo, JAPAN
1998-2001
Oncologic Surgery Fellow
National Cancer Center Hospital, Tokyo, JAPAN
2003-2005
PhD student
Sapporo Medical University Graduate School of Medicine, Sapporo, JAPAN
2006-2009
Postdoctoral Fellow
Le Centre d’Immunothérapie des Cancers
Institut Curie, Paris, FRANCE
2009-2015
Assistant Professor
Department of Urology
Sapporo Medical University School of Medicine, Sapporo, JAPAN2015Professor and Chairman
Department of Urology
Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, JAPAN

Abstract
Poly-ADP-ribose polymerase (PARP) inhibitors have shown encouraging efficacy in metastatic castration-resistant
prostate cancer (mCRPC) patients with DNA repair mutations. Somatic or germline mutations in genes regulating DNA
damage repair have been noted in around 20% of patients with advanced prostate cancer. Results of phase 3 PROfoundtrial showed that olaparib reduced the risk of disease progression or death vs abiraterone acetate or enzalutamide (HR,0.49; 95% CI, 0.38-0.63; P <.0001). In USA, two PARP inhibitors, olaparib and rucaparib, have received FDA approval for treatment of mCRPC patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated mCRPC who progressed following prior antiandrogen agents, while only olaparib has been approved for mCRPC patients with BRCA1 or BRCA2 mutation in Japan.
Here, I briefly summarize the current data supporting the efficacy of PARP inhibitors in mCRPC and introduce someon-going trials.

Session 18: What is the best treatment sequence of metastatic Pca?

Moderator

Hiroyoshi Suzuki
Department of Urology, Toho University Sakura Medical Center
Education:
M.D., Chiba University School of Medicine, 1990
Ph.D., Chiba University Graduate School of Medicine 1996
Professional:
1996-1998, Postdoctoral fellow, Johns Hopkins University Hospital Oncology Center (Prof. John T. Isaacs and Prof.
William B. Isaacs) Baltimore, Maryland, USA
1998-2006, Assistant Professor of Urology, Chiba University Hospital
2006-2010, Associate Professor of Urology, Chiba University, Graduate School of Medicine
2010- present, Professor & Chief of Urology, Toho University Sakura Medical Center
2021- present, Deputy Director of Toho University Sakura Medical Center
Research Focus:
Urologic Oncology (especially Prostate cancer)/Minimum invasive surgery (Laparoscopic surgery/Endourology)/Andrology/Endocrinology/R&D of novel agents for urologic cancers (involved in >80 clinical trials).
Awards:5th Inohana Alumini Association Academic Award, 2000
Excellent Award of International Andrology Society meeting, 2001
Excellent Award of Japan Urological Association (Clinical research), 2004
Academic Activity (Affiliated Associations):
Consensus Panel member of Advanced Prostate Cancer Consensus Conference (APCCC) 2015/2017/2019/2021/2022
Board of Directors (2017-2019) and Delegate of Japan Urological Association/President of Japanese Society of
Urologic Pathology/Board of Directors of The Japan Society of Andrology/Delegate of The Japan Society ofJapanese Society of Endourology/Delegate of Japan Society of Urologic Oncology/Delegate of The JapaneseContinence Society etc.
Editorial Board member of World Journal of Urology/International Journal of Urology/International Journal of
Clinical Oncology/Japanese Journal of Clinical Oncology/Acta Urologica Japonica/Japanese Journal of Endourology&ESWL

Moderator

Edmund Chiong
Head & Senior Consultant, Department of Urology, National University Hospital
Assoc. Prof. Edmund Chiong, is presently the Head and Senior Consultant of the Department of Urology, National University Hospital, Singapore. He is also an Associate Professor at the National University of Singapore (NUS) and the
Urologic Oncology Tumour Programme Lead, National University Cancer Institute, Singapore. Assoc. Prof. Chiong
graduated with the degrees of Bachelor of Medicine and Surgery from the National University of Singapore in 1995. He
obtained postgraduate qualifications in Surgery (FRCS) and completed of his Urology specialist training in Singapore.
Assoc. Prof. Chiong subsequently underwent a 2-year clinical fellowship program in Urologic Oncology at the University of Texas MD Anderson Cancer Center in Houston, Texas, USA. His sub-specialty interest is in Urologic Oncology
and performing DaVinci robotic surgery. His research interests include investigating new therapies and diagnostic modalities for urologic malignancies. He was conferred a PhD (NUS) for his thesis on targeted therapy for bladder cancer.
He also runs a number of clinical trials in bladder and prostate cancer. He has minor interests in investigating urinary
tract infections, and medical device innovation. Assoc. Prof. Chiong is currently Chairman of the Chapter of Urologists(College of Surgeons), Academy of Medicine, Singapore, is Past President (2016-2018) and current Board of Trustees

Session 18: What is the best treatment sequence of metastatic Pca?
member of the Singapore Urological Association, and Chairman of the Examinations Committee for Urology and Board
member, Residency Advisory Committee/Joint Committee on Specialist Training (JCST), Ministry of Health, Singapore. He is also the Deputy Chairman, Scientific Committee, Urological Association of Asia (UAA), a member of theAmerican Urological Association, European Association of Urology and the American Society of Clinical Oncology.

Session 18: What is the best treatment sequence of metastatic Pca?

Panelist

Jae il Chung
Professor and Head of Dept. of urology, Inje University, Busan Paik Hospital
Education
Feb. 17, 2001
February 26, 1988
Training
1997 - 1998

Graduate Postgraduate School Kosin University, Busan,
Korea (Doctor of Philosophy in Medicine)
Graduate College of Medicine Inje University, Busan,
Korea (Doctor of Medicine)

Fellowship in the Department of Urology
Inje University Busan Paik Hospital, Busan, Korea
1992 - 1996 Residency in the Department of Urology
Inje University Busan Paik Hospital, Busan, Korea
1988 - 1989 Internship,
Inje University Busan Paik Hospital, Busan, Korea
Certifications and License
1997
Korean Board of Urology
1988
Korean License of Medical Doctor
Academic Positions
1997. 3 - 1998. 3 Instructor
1999. 3 - 2003. 8 Assistant Professor
2003 8 - 2010
Associate professor
2010 3 - Now
Professor and Director of Department of Urology
Inje University Busan Paik Hospital, Busan, Korea
2001. 8 - 2002. 8 postdoc:immunogenetherapy of prostate cancer
Department of Urology, University of Iowa, IA U. S. A.
Memberships
Korean Medical Association
Korean Urological Association
Korean Urological Cancer Society
Korean Prostate Society―vice president
American Urologic Association
Academic Activities
2005 10 - 2009 03: The Korean Prostate Society Information Director
2009 03 - 2011 03: The Korean Prostate Society Instruction Director
2011 03 - 2013 03: The Korean Prostate Society Academic Director
2013 03 - 2015 03: The Korean Prostate Society Vice president
2015 03 - 2017 03: The Korean Prostate Society President
2005 08 - present: The Korean Urological Oncology Society Board Member
Hospital Positon
2006 01 - 2007 12: QI (Quality Improvement) team leader
2010 03 - 2014 02: IRB (Institution Review Board) Chairman
2015 01 - 2018 12: Research Vice President of Busan Paik Hospital
ArticlesAbout 50 papers include SCI journal
Cinical Trials
More than 20 cases of clinical trial

Session 18: What is the best treatment sequence of metastatic Pca?

Panelist
Teng Aik Ong
Professor & Consultant Urologist, Deputy Dean, Faculty of Medicine, University of Malaya,
Kuala Lumpur
Prof Teng Aik Ong served as the President of the Malaysian Urological Association (MUA) from 2021-2022. He is currently the Deputy Dean (Value Creation & Enterprise) of the Faculty of Medicine, University of Malaya, Kuala Lumpur.
Prof Ong was the BJUI Scholar in 2005-2007 during his training period in urology. Since then, he has been active inpromoting international collaboration in education and research. He served as a board member of the Urological Association of Asia (UAA) and Societe Internationale d’Urologie (SIU).
Uro-oncology is the focus of the clinical and research activities of Prof Ong. He was instrumental in establishing thefirst uro-onco clinic in Malaysia, in collaboration with the oncologists. He championed the M-CaP prostate cancer registry for Malaysia (working together with the A-CaP group). His group had recently published the survival data of patients with prostate cancer in Malaysia.

Panelist

Hiroshi Kitamura
Department of Urology, Faculty of Medicine, University of Toyama
EMPLOYMENT
1994-1995
Resident
Sapporo Medical University Hospital, Sapporo, JAPAN
1996-1997
Clinical Fellow
Sapporo Medical University Hospital, Sapporo, JAPAN
1998-2001
Oncologic Surgery Fellow
National Cancer Center Hospital, Tokyo, JAPAN
2003-2005
PhD student
Sapporo Medical University Graduate School of Medicine, Sapporo, JAPAN
2006-2009
Postdoctoral Fellow
Le Centre d’Immunothérapie des Cancers
Institut Curie, Paris, FRANCE
2009-2015
Assistant Professor
Department of Urology
Sapporo Medical University School of Medicine, Sapporo, JAPAN2015Professor and Chairman
Department of Urology
Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, JAPANSession 18: What is the best treatment sequence of metastatic Pca?

Panelist

Kuan Chou Chen
Department of Urology, Taipei Medical University Shuang-Ho Hospital
Education
1983-1990
1995-1998
2001-2007

Bachelor of Medicine, Taipei Medical University
Master, Graduate institute of Medical Sciences, Taipei Medical University
Ph. D., Graduate Institute of Medical Sciences, Taipei Medical University

Work Experiences
1990-1994
Resident, Department of Urology, Taipei Medical University Hospital
1994-1995
Clinical Researcher, Department of Urology, Taipei Medical University Hospital
1996-1996
Clinical Researcher, Tokyo National Cancer Center, Japan
1998-2007
Lecturer, Department of Urology, Taipei Medical University
1995-2008
Visiting Staff, Department of Urology, Taipei Medical University Hospital
2008-2020
Chief, Department of Urology, Taipei Medical University Shuang-Ho Hospital
2007-2010
Assistant Professor, Department of Urology, Taipei Medical University
2010-2014
Associate Professor, Department of Urology, Taipei Medical University
2014-present Professor, Department of Urology, Taipei Medical University
2014-2016
Chairman, Department of Urology, Taipei Medical University
2016-2022
Director, Graduate Institute of Clinical Medicine, Taipei Medical University
Board and Certification
1990
M.D. License Registration
1994
Board of Urology
1994
Board of General Surgery
Membership of Academic Society
Executive committee member of APPS
European Association of Urology
Taiwan Urology Association
Taiwan Surgical Association
The Taiwanese Association of Andrology
Taiwanese Continence Society

Session 18: What is the best treatment sequence of metastatic Pca?

Metastatic Prostate Cancer Treatment―Considerationsin Asia
Edmund Chiong
Head & Senior Consultant, Department of Urology, National University Hospital
Assoc. Prof. Edmund Chiong, is presently the Head and Senior Consultant of the Department of Urology, National University Hospital, Singapore. He is also an Associate Professor at the National University of Singapore (NUS) and the
Urologic Oncology Tumour Programme Lead, National University Cancer Institute, Singapore. Assoc. Prof. Chiong
graduated with the degrees of Bachelor of Medicine and Surgery from the National University of Singapore in 1995. He
obtained postgraduate qualifications in Surgery (FRCS) and completed of his Urology specialist training in Singapore.
Assoc. Prof. Chiong subsequently underwent a 2-year clinical fellowship program in Urologic Oncology at the University of Texas MD Anderson Cancer Center in Houston, Texas, USA. His sub-specialty interest is in Urologic Oncology
and performing DaVinci robotic surgery. His research interests include investigating new therapies and diagnostic modalities for urologic malignancies. He was conferred a PhD (NUS) for his thesis on targeted therapy for bladder cancer.
He also runs a number of clinical trials in bladder and prostate cancer. He has minor interests in investigating urinary
tract infections, and medical device innovation. Assoc. Prof. Chiong is currently Chairman of the Chapter of Urologists(College of Surgeons), Academy of Medicine, Singapore, is Past President (2016-2018) and current Board of Trustees
member of the Singapore Urological Association, and Chairman of the Examinations Committee for Urology and Board
member, Residency Advisory Committee/Joint Committee on Specialist Training (JCST), Ministry of Health, Singapore. He is also the Deputy Chairman, Scientific Committee, Urological Association of Asia (UAA), a member of theAmerican Urological Association, European Association of Urology and the American Society of Clinical Oncology.

Abstract
The management landscape of metastatic Prostate Cancer has been rapidly evolving, with many advances and life prolonging treatment options being introduced in the last decade. In metastatic castrate sensitive prostate cancer (mCSPC)
patients, the combination of Androgen Deprivation Therapy (ADT) plus either Docetaxel or Novel AR agents, has replaced ADT alone as standard of care. More recently, based on recent trials (PEACE-1 and ARASENS), further intensifying treatment (ADT plus Docetaxel plus Abiraterone/Darolutamide) was shown to confer overall survival (OS) benefit compared to ADT plus Docetaxel for mCSPC patients. However, it is uncertain whether the triplet combination has
any clinical outcome advantage over ADT plus Novel AR agents. In metastatic castrate resistant prostate cancer(mCRPC) patients, several lines of therapies (many with overall survival benefit) are now available, including Novel
hormonal therapies, Chemotherapy, Radium-223, PARP inhibitors, Lu-177 PSMA and immune check-point inhibitors.
A number of novel therapies and combination therapies are also being investigated for mCRPC. Treatment selection formetastatic Prostate Cancer patients should include clinical disease criteria, prior therapy, patient characteristics, genomics, and may also be affected by patient preference, access, affordability considerations. In the Asia-Pacific region, anumber of management considerations, such as differential adverse event incidence (eg. Docetaxel), access, cost andregulatory restrictions of therapies, have been informed to influence treatment decisions and sequencing.

Session 19: Advance in PSMA theranostics

Moderator

Norio Nonomura
Department of Urology, Osaka University Graduate School of Medicine
Professional background and research experience
1981.4 - 1986.3
Osaka University Medical School
1986.4 - 1991.3
Department of Urology, Osaka University (Postgraduate course)
1991.11 - 1993.12 National Institutes of Health/Bethesda (Visiting Fellow)
1994.1 - 1998.7
Assistant professor, Department of Urology, Osaka University
1998.8 - 2010.9
Associate professor, Department of Urology, Osaka University
2019.4 - present
Chief, Cancer Genomic Medicine, Osaka University Hospital
2010.10 - present
Professor and Chairman, Department of Urology, Osaka University
2020.4 - present
Vice president, Osaka University Hospital
Research interests(Urological malignancies (Prostate cancer, Testicular cancer, Renal cell carcinoma)
Memberships
The Japanese Urological Association (President)
The Japan Society of Urological Oncology (President)
The Japan Society of Clinical Oncology (Auditor)
The Japanese Cancer Association (Council member)
The Japanese Association of Andrology (Board of director)
The Japanese Society of Endocrine Surgery (Board of member)
American Urological Association (AUA)
Society for Basic Urology Research (Executive member)
European Association of Urology (EAU)
The American Association of Cancer Research

Session 19: Advance in PSMA theranostics

A single dose of novel PSMA-targeting
radiopharmaceutical agent [177Lu] Ludotadipep for
patients with metastatic castration-resistant prostatecancer: Phase I clinical trial
Ji Youl Lee 1 , Dongho Shin 1 , Seung ah Rhew 1 , Chang Eil Yoon 1 ,Hyeok Jae Kwon 1 , Joo Hyun O 2 , Chansoo Park 3 , Dae Yoon Chi 3
1

Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic
University of Korea, Seoul, Republic of Korea,
2
Department of Nuclear Medicine, Seoul St. Mary’s Hospital, College of Medicine, The
Catholic University of Korea, Seoul, Republic of Korea,
3
Research Institute of Labeling, FutureChem Co., Ltd, Seoul, Korea
Name: Ji Youl Lee, M.D. & PhD.
Education & Degree
1989: Graduated from Medical College, The Catholic University of Korea
1990 - 1992: Master of Medical Science, Catholic University Graduate School
1997 - 2000: Doctor of Medical Science, Catholic University Graduate School
Experience
In hospital.
2009 - 2017: Director, Urology Oncology Team, Seoul St. Mary’s Hospital2013 - 2017: Director, Outpatient Clinics, Seoul St. Mary’s Hospital2014 - 2021: Director, Department of Urology, Seoul St. Mary’s Hospital2017 - 2021: President of Smart Hospital (Vice-president of Seoul St. Mary’s Hospital)
Academic Position2020 - present: Chairman of Department of Urology
2006 - present: President, Korea Prostate Bank
2014 - present: Director, Catholic Prostate Institute, The Catholic University of Korea
2015 - 2017: President, Catholic Central Bio-Bank
2015 - 2019: Director, Catholic Cancer Research InstituteSocial Position2017 - Present: President Asia Pacific Society of Uro-oncology (APSU)
2018 - 2020: President, Asian Pacific Prostate Society (APPS)
2017 - 2019: President, Korean Prostate Society (KPS)
2020 - 2022: President, Korean Society of Urological Research (KSUR)

Abstract[177Lu] Ludotadipep, which enables targeted delivery of beta-particle radiation to prostate tumors, has been suggested asa promising novel systemic radionuclide therapy for patients with mCRPC. From November 2020 to March 2022, 25
patients were able to finish the study protocol fully and they were treated in groups of 50 mCi, 75 mCi, 100 mCi, 125mCi, or 150 mCi. [177Lu] Ludotadipep was injected via venous injection, and patients were hospitalized for 3 days after
the injection to monitor for any adverse effects. Serum PSA levels were followed up at weeks 1, 2, 3, 4, 6, 8, and 12,
and [18F] PSMA PET CT was taken at week 0 and again at weeks 4 and 8. All patients were [18F] PSMA PET CT positive in pre-[177Lu] Ludotadipep treatment. Among the 29 subjects in the Safety Set, 36 TEAEs occurred in 17 subjects(58.62%) with 4 ADRs in 3 subjects (10.34%). Of the total 25 patients (full analysis set), 15 (60%) showed any decrease in PSA, 11 (44%) showed a decrease of PSA by more than 30%, and 10 (40%) showed a decrease in PSA by
more than 50%. Waterfall plots were created for percentage change of each patient’s best PSA response. Only six of the
25 patients (24%) showed disease progression (25% increase in PSA from the baseline) at end of the study (12th week).
The current study is in the early stages of [177Lu] Ludotadipep treatment, with a final target capacity of 150 mCi. Therefore, we suggest that [177Lu] Ludotadipep treatment could be promising with low toxicity in mCRPC patients who havenot been responsive to conventional treatments.

APPS & ACaP Joint Symosium (7th A-Cap meeting)Opening Remarks

Haruki Kume
Chair and Professor, Department of Urology, the University of Tokyo
WORK EXPERIENCE:
December 2017 - Present: Chair and Professor, Department of Urology, the University of Tokyo
March 2016 - November 2017: Chief, Department of Urology, National Center for Global Health and Medicine
July 2008 - February 2016: Associate Professor, Department of Urology, the University of Tokyo
April 2003 - June 2008: Lecturer, Department of Urology, the University of Tokyo
April 2000 - March: Associate Professor, International University of Health and Welfare
June 1992 - May 1995: National Cancer Center Central Hospital
July 1990 - May 1992: Department of Urology, the University of Tokyo
July 1989 - June 1990: Department of Urology, Japanese Red Cross Medical Center
EDUCATION:
April 1996 - March 2000: Graduate School of Medicine, the University of Tokyo
April 1983 - March 1989: School of Medicine, the University of TokyoSKILLS & QUALIFICATIONS:Skills in laparoscopic surgery qualified by Laparoscopic Surgical Skill Qualification System (the Japanese Society ofEndourology and ESWL)APPS & ACaP Joint Symosium (7th A-Cap meeting): Special Lecture

Moderator

Takashi Fukagai
Department of Urology, Showa University School of Medicine, Tokyo, Japan
Education:
1980-1986
1986-1990
1997-1999

Showa University, School of Medicine, Tokyo, Japan
Degree: Doctor of Medicine
Showa University Graduate School Department of Urology
Research Fellow, Department of Surgery,John A. Burns School of Medicine, University of Hawaii.

Professional experience:
1990-1991
Instructor, Showa University School of Medicine.
1991-1993
Medical Staff in Urology
Tokyo Seamen’s Insurance Hospital, Tokyo.
1993-1996
Medical Staff in Urology
Tokyo Metropolitan Hiroo General Hospital, Tokyo.
1996-1998
Instructor, Showa University School of Medicine.
1998-2003
Assistant Professor of Urology.
Showa University School of Medicine.
2003-2014
Associate Professor of Urology.
Showa University School of Medicine
2014 March
Professor of Urology,
Showa University Koto Toyosu Hospital
2016 April
Vice Director, Professor of Urology,
Showa University Koto Toyosu Hospital
2021 April
Professor and chairman of Urology,
Showa University School of Medicine

APPS & ACaP Joint Symosium (7th A-Cap meeting): Special Lecture

The utilization of the Japan Study Group of Prostate
Cancer registry data
Masaki Shiota
Department of Urology, Kyushu University
EDUCATION:
1995-2001
School of Medicine, Kyushu University
M.D.
2006-2010
Graduate School of Medical Sciences, Kyushu University

Ph.D.

PROFESSIONAL TRAINING;
2001-2002
Resident, Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka,
Japan
2002-2003
Resident, Department of Urology, National Beppu Hospital, Beppu, Japan
2003-2005
Department of Urology, Harasanshin Hospital, Fukuoka, Japan
2005-2006
Department of Urology, Saga Prefectural Hospital, Koseikan, Saga, Japan
POSTDOCTORAL TRAINING:
2010-2012
Postdoctoral Fellow

University of British Columbia

ACADEMIC APPOINTMENTS: (In reverse chronological order)
2012-2018
Assistant Professor
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2018-2020
Lecturer
Department of Urology, Graduate School of Medical Sciences, Kyushu University,
Fukuoka, Japan
2020-Present Clinical Associate Professor
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
AWARDS/HONORS:
2009
Second prize in Young Urologist Research Contest, the 61st Western Section Meeting of Japanese Urological
Association
2011
Incitement Award of the Japanese Cancer Association
2017
EAU Prostate Cancer Research Award2017
Society Award from the Japanese Urological Association
2018
IJU Reviewers of the Year 20172019
IJU Top Cited Article Award 20182019
Medical Research Incitement Award of the Japan Medical Association
2020
IJU Reviewers of the Year 2019
2021
Annual Meeting Award from the Japanese Urological Association

Abstract
The Japanese Urological Association authorized the establishment of the Japan Study Group of Prostate Cancer (J-CaP)
registry in 2001 as a large, multicenter, population-based database of men undergoing primary androgen deprivation
therapy (PADT). Then, the valuable registry data of approximately 20,000 cases of PADT administered at major
urological facilities in Japan from 2001 to 2003 was created by J-CaP study group.
So far, we have conducted the following studies using this database; (1) prostate cancer family history and prognosis in
PADT, (2) risks and risk factors for cancer and noncancer deaths among men over 80 years of age treated with PADT,(3) conditional survival and prognostic factors in PADT, and (4) The impact of regional and institutional differences on
the prognosis in PADT. Accordingly, I would introduce the results of these studies using the valuable J-Cap registrydata and explore the potential of J-Cap registry data.

APPS & ACaP Joint Symosium (7th A-Cap meeting): Special Lecture

Changes in the trends of initial treatment for newly
diagnosed prostate cancer in Japan: A nationwide multiinstitutional study
Taketo Kawai
Department of Urology, Teikyo University School of Medicine
Education
1994-2000
2008-2012

MD
PhD

Employment
2001-2002
2002-2003
2003-2006
2006-20082012-20132013-20162016-20182019-2021
2022-

The University of Tokyo
Tokyo Metropolitan Tama Medical CenterTokyo Metropolitan Ebara HospitalTokyo Metropolitan Bokutoh Hospital
The University of TokyoJapanese Red Cross Musashino Hospital
The University of Tokyo
The University of Tokyo
Teikyo University School of Medicine

The University of Tokyo
The University of Tokyo

Research Associate
Resident physician
Full-time physician
Full-time physician
Assistant Professor
Full-time physician
Assistant Professor
Lecturer
LecturerAwards/Honors/Fellowships
2012
The 27th Annual EAU Congress: The Best Poster Award2012
UAA Youth Section Fellowship
2013
Advancements in Urology
Society Memberships:
The Japanese Urological Association, Japanese Cancer Association, Japan Society of Clinical Oncology, Japanese Society of Endourology and Robotics, Japanese Society of Geriatric Urology, Japan Society of Urologic Oncology, The
Japanese Continence Society, Japan Society for Endoscopic Surgery, Japan Study Group of Prostate Cancer, JapaneseSociety of Renal Cancer, Japan Urological Photodynamic Society

Abstract
Background: We examined changes in the trends of initial treatment for newly diagnosed prostate cancer in Japanthrough two nationwide surveys.
Methods: Two Japan-wide multi-institutional surveys, J-CaP2010 and J-CaP2016-18, were conducted and enrolled patients newly histologically diagnosed with prostate cancer in 2010 and 2016-2018, respectively. Both surveys included
age at diagnosis, initial PSA, ISUP Grade Group, TNM classification, and initial treatment for prostate cancer.
Results: Data were collected for 8,192 patients at 140 institutions in J-CaP2010 and 21,841 patients at 186 institutionsin J-CaP2016-18. Compared to 2010, the proportion of radical prostatectomy (RP) and radiation therapy (RT) in initial
treatment increased (32% to 36% and 21% to 26%, respectively), while the proportion of androgen deprivation therapy
decreased (40% to 29%) in 2016-2018. The increase of RP or RT was noticeable in patients aged 侒75 years (20% to38%) and patients with high-risk localized cancer (58% to 74%) or locally-advanced cancer; cT3-4N0M0 (43% to 64%)
and cN1M0 (11% to 26%). The proportion of robot-assisted radical prostatectomy (RARP) in RP and intensity modulated radiation therapy (IMRT) in RT increased remarkably (2.3% to 78% and 20% to 50%, respectively).
Conclusions: Compared to 2010, the proportion of RP and RT increased in 2016-18 as an initial treatment for prostatecancer, especially in patients aged 侒75 years and patients with high-risk localized or locally-advanced cancer. The
spread of RARP and IMRT in Japan may have expanded the target of curative treatment to patients who previously had
difficulty in curative treatment.

APPS & ACaP Joint Symosium (7th A-Cap meeting): Reports from participating countries

Moderator

Tohru Nakagawa
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
1994/3
1997/6
2000/4
2002/4
2004/4
2006/3
2006/122010/6
2012/72017/42018/4

M.D., The University of Tokyo Faculty of Medicine
Resident, Urology Division, National Cancer Center Hospital
Chief Resident, Urology Division, National Cancer Center Hospital
Research Resident, Pathology Division, National Cancer Center Research InstituteResearch Fellow, Department of Urology, Mayo Clinic, U.S.A.
Ph.D., The University of Tokyo Graduate school of Medicine
Staff physician, Urology Division, National Cancer Center Hospital
Chief physician, Urology Division, National Cancer Center Hospital
Lecturer/Assistant Professor, Department of Urology, The University of Tokyo Graduate School of Medicine
Professor, Department of Urology, Teikyo University School of Medicine
Professor and Chairman, Department of Urology, Teikyo University School of Medicine

APPS & ACaP Joint Symosium (7th A-Cap meeting): Reports from participating countries

1. Malaysia
Teng Aik Ong
Professor & Consultant Urologist, Deputy Dean, Faculty of Medicine, University of Malaya,
Kuala Lumpur
Prof Teng Aik Ong served as the President of the Malaysian Urological Association (MUA) from 2021-2022. He is currently the Deputy Dean (Value Creation & Enterprise) of the Faculty of Medicine, University of Malaya, Kuala Lumpur.
Prof Ong was the BJUI Scholar in 2005-2007 during his training period in urology. Since then, he has been active inpromoting international collaboration in education and research. He served as a board member of the Urological Association of Asia (UAA) and Societe Internationale d’Urologie (SIU).
Uro-oncology is the focus of the clinical and research activities of Prof Ong. He was instrumental in establishing thefirst uro-onco clinic in Malaysia, in collaboration with the oncologists. He championed the M-CaP prostate cancer registry for Malaysia (working together with the A-CaP group). His group had recently published the survival data of patients with prostate cancer in Malaysia.

APPS & ACaP Joint Symosium (7th A-Cap meeting): Reports from participating countries

2. Turkey

Levent Turkeri
Department of Urology, Acibadem University Altunizade Hospital, Istanbul, Turkey
Dr. Türkeri is a Professor of Urology and his main area of expertise is Uro-oncology involving robotic, laparoscopic
and open surgery. Currently, he is the chief of the Department of Urology at Acıbadem M.A. Aydınlar University Altunizade Hospital. He was one of the founding members of EAU Section of Oncological Urology (ESOU and involved
with many national and international societies such as AUA, EAU, AAEU, URS and APPS.

APPS & ACaP Joint Symosium (7th A-Cap meeting): Reports from participating countries

3. Japan
Mizuki Onozawa
Associate Professor, Department of Urology, International University of Health and Welfare,
Narita, JapanEDUCATION:
1993, Graduated from University of Tsukuba, Japan
1999, Completed doctoral program, University of Tsukuba, Japan
PROFESSION:
1993, Tsukuba University Hospital, Japan, Resident
1995, National Cancer Center Research Institute, Japan, Research resident
1999, Department of Urology, Kasukabe Chuo General Hospital, Japan
2003, Department of Urology, International University of Health and Welfare Hospital, Japan
2005, Department of Urology, Kasukabe Chuo General Hospital, Japan
2007, Department of Urology, International University of Health and Welfare Mita Hospital, Japan
2008, Department of Urology, University of Tsukuba, Japan
2013, Department of Urology, Tokyo-kita medical center, Japan
2018, Department of Urology, International University of Health and Welfare

APPS & ACaP Joint Symosium (7th A-Cap meeting)

Closing Remarks
Teng Aik Ong
Professor & Consultant Urologist, Deputy Dean, Faculty of Medicine, University of Malaya,
Kuala Lumpur
Prof Teng Aik Ong served as the President of the Malaysian Urological Association (MUA) from 2021-2022. He is currently the Deputy Dean (Value Creation & Enterprise) of the Faculty of Medicine, University of Malaya, Kuala Lumpur.
Prof Ong was the BJUI Scholar in 2005-2007 during his training period in urology. Since then, he has been active inpromoting international collaboration in education and research. He served as a board member of the Urological Association of Asia (UAA) and Societe Internationale d’Urologie (SIU).
Uro-oncology is the focus of the clinical and research activities of Prof Ong. He was instrumental in establishing thefirst uro-onco clinic in Malaysia, in collaboration with the oncologists. He championed the M-CaP prostate cancer registry for Malaysia (working together with the A-CaP group). His group had recently published the survival data of patients with prostate cancer in Malaysia.

Best Poster Award at Foyer

Moderator

Hidefumi Kinoshita
Department of Urology and Andrology, Kansai Medical University
2020
2016
2004
2000
1999
1996
1993
1990
1988
1988

Chair Pearson, Department of Urology and Andrology, Kansai Medical University
Professor, Kansai Medical University
Associate Professor, Kansai Medical University
Assistant Professor, Kyoto University
Clinical Fellow in Osaka Red-Cross Hospital
Associate Researcher, University Wisconsin, Madison
Graduate School of Medicine, Kyoto University
Clinical Fellow in Kurashiki Central Hospital
Resident in Kyoto University Hospital
Graduated from School of Medicine, Kyoto University

Session 20: Liquid Biopsy

Moderator

Kazuhiro Suzuki
Department of Urology, Gunma University Graduate School of Medicine
MD. 1988 Gunma University, Faculty of Medicine
Ph. D. 1996 Gunma University, Graduate School of Medicine
1997-1999 Post-doctoral fellow, Department of Hematology/Oncology, Professor Micheal Caligiuri
2004 Professor and Chairman, Department of Urology, Gunma University Graduate School of Medicine

Session 20: Liquid Biopsy

Liquid Biopsy for Prostate Cancer
Yeong-Shiau Pu
NTUH GU Cancer Group, Decipher Study Team, and BigUro Study Team,
Professor and senior urologist, Department of Urology, National Taiwan University Collegeof Medicine
TRAINING:
・ MD 1987. PhD 1995. EMBA 2007 at National Taiwan University (NTU)
CURRENT APPOINTMENT:・ Professor, Dept. Urology and Institute Clinical Medicine, NTU College of Medicine
・ Senior Urologist, NTU Hospital
PAST APPOINTMENT:・ Chairman, Dept of Urology, NTU College of Medicine and Hospital (2012 - 2018)
・ President, Taiwan Urological Association (2018 - 2020)
・ President and Founder, Taiwan Maple Urological Association (2014 - 2021)
HONORS AND FUNDING:
・ Honorary Membership of Japanese Urological Association (Japan, 2019)
・ US FDA Phase III Trial Global Lead Principal Investigator (Taiwan and US, 2009 - 2018)
・ Research Grant Funding > 400 million USD in the past 30 years
PUBLICATIONS:・ Published > 200 SCI papers (80 papers as first/Corresp authors). H-index 38.
RESEARCH FOCUS:
・ Prostate Cancer, Urological Oncology

Abstract
My talk focuses on predicting prostate cancer (PC), especially to differentiate clinically significant PC (sPC) from insignificant PC (isPC) using urine or blood biomarkers. Serum PSA is useful in screening but it is associated with low
specificity, high false-negative and false-positive rates. Moreover, it poorly differentiates sPC from isPC before biopsy.
For men with elevated PSA, biopsy is necessary to confirm cancer and obtain Gleason score to assign risk groups. Ideal
biomarkers that inform risk groups before biopsy is urgently needed to avoid unnecessary biopsies.
Serum biomarkers. Two serum biomarkers have been approved by both USFDA and EMA, i.e., 4K score and Prostate
Health Index (PHI). Both adopt a mixed algorithm of PSA isoforms and predict PC and high-grade PC (Gleason score侒7) better than PSA. A study on 1,012 men showed that 4K score predicted sPC well (AUC 0.82) and 30% biopsy could
be avoided but missed only 1.3% of sPC. PHI improves the detection rates of PC and sPC by 4.7 and 8.6 folds in Asianmen based on the PHI cutoff of 35, where 71% of biopsy would have been avoided.
Urine biomarkers. Urinary PCA3 detects PCA-3 non-coding RNA with an AUC of 0.64 and sensitivity and specificity
between 52-58% and 72-87%, respectively. Mi Prostate Score, SelectMDx, urinary exosome, and others also showed
improved AUCs in detecting PC or sPC. Recently, studies on urine metabolomics generated promising results, which,however, mostly involves small sample size, suboptimal control groups, and imprecise risk group stratification.
Through urine GS-MS metabolomics profiling, we have obtained good AUCs in predicting PC and sPC. Details will bepresented in the meeting.

Session 21: Topics of New Diagnostic Methods p2PSA

Moderator
Rainy Umbas
Department of Urology, “CiptoMangunkusumo” Hospital/Faculty of Medicine, University ofIndonesia
Prof. Rainy Umbas is a oncological-urology consultant at Department of Urology, Faculty of Medicine, University ofIndonesia/ Dr.Cipto Mangunkusumo General Hospital. He achieved his medical and urologist degree from the same
University in 1975 and 1987 respectively.
Between 1990 and 1993 he was a clinical and research fellow at the Department of Urology and Urology ResearchLaboratory, Catholic University of Nijmegen, the Netherlands. In 1994 he obtained his PhD degree with dissertation entitled E-cadherin and alpha-catenin expression of prostate and bladder cancer . Promotor: Prof. F.M.J. Debruyne, copromotor: Prof. J.A. Schalken.
He was the Chairman of Urology Training Program as well as Chairman of the Board of Professor, Faculty of Medicine, University of Indonesia, and Chairman of the Indonesian College of Urology.
Served as consulting editor for British Journal of Urology International (2012-2020), Prostate International, Investigative and Clinical Urology (Korean Journal of Urology), Asian Journal of Urology, and several Indonesian medical journals. He is also a voluntary reviewer for Turkish Journal of Urology, World Journal of Urology, Indian Journal of Medical Research, Urology Journal, Contemporary Clinical Trials Communications, and The Lancet Oncology.
Had been a principal country investigator for several phase 2, 3, and post-marketing multinational clinical studies on
new drugs for urological cancer. He also served as NCCN Asia Consensus Panel member for Prostate, Kidney, andBladder Cancer, and Panel member for several Indonesian Urological Association Guidelines. Has authored/coauthored over 100 peer-reviewed articles, mainly on oncological-urology.
He was the President of Indonesian Urological Association (2000-2003), President of Urological Association of Asia
(2006-2008), and Director of Asian School of Urology (2010-2014), and currently Chairman of Indonesia Society of
Oncological Urology (Ina-SOU), Honorary Consultant for Asian School of Urology, and Elected Council member in
Urological Association of Asia.
He is an Honorary Member of European Association of Urology & Chinese Urological Association, and he received theLife Time Achievement Award from Indonesian Urological Association in 2021.

Moderator

Yoshihiko Hirao
Osaka Gyoumeikan Hospital, Osaka, Japan
Professional Training and Employment:
1972
Nara Medical University, Resident (Urology)
1974
Nara Prefectural Hospital, Chief (Urology)
1977
Nara Medical University, Fellow (Urology)[1977-79 Northwestern Univ. Medical School, research fellow (Pathology)]
1983
Nara Medical University, Lecturer (Urology)
1983
Nara Medical University, Associate Professor (Urology)
1996
Nara Medical University, Professor (Urology)
2012〜 Nara Medical University, Emeritus and Research Professor
2012〜 Osaka Gyoumeikan Hospital, Honorary Director
2022〜 Japan Foundation for Prostate Research, President
Major interests in Research:
・ UroOncology
・ Voiding function
・ Endourology
・ Medical engineering

Session 21: Topics of New Diagnostic Methods p2PSA

Current update on prostate health index (phi ) in Japan

Kazuto Ito
Kurosawa Hospital
Kazuto Ito, MD, PhD, is currently Director of Kurosawa Hospital and Research Professor of Advanced Medical Science
Research Center, Gunma Paz University, Takasaki, Japan. Previously, Dr. Ito was an Associate Professor in the Department of Urology at Gunma University Graduate School of Medicine between 2005 and 2018.
Dr. Ito graduated medical school in Gunma University, Japan in 1990 and got Ph.D. (Urology), Gunma University
School of Medicine (Thesis: The Evidence of Estrogen Production in the Prostate) in 1997.
Dr. Ito conducted research at Erasmus Medical Centre, Rotterdam, Netherlands, between 2002 and 2003. His researchinterests include prostate cancer epidemiology, screening and biomarkers, including PSA and related indices.
Society: Japanese Urological Association/AUA/EAU/SIU/Japan Society of Clinical Oncology/Japanese Society of Endourology, etc.
Editorial Board: European Urology since 2008.

Abstract
In order to improve diagnostic accuracy of clinically significant prostate cancer, the most promising new biomarker may
be proenzyme PSA (proPSA). Previous studies demonstrated that [−2]proPSA could be more useful not only to distinguish men with prostate cancer from those without, but also tumors with aggressive features from those without compared to other classical PSA-related indices including ratio of free PSA to total PSA (%f-PSA) and PSA density. Prostate health index (phi) is calculated by the equation, [−2]proPSA/free PSA×√PSA, was approved in Japan by the
PMDA (Pharmaceuticals and Medical Devices Agency) in January 2021 and has been able to use in clinical practicesince November 2021 based on the significant results in multicenter prospective clinical study, PROPHET (Prostate
Cancer: Prostate Health Index Trial). According to the PROPHET data, laboratory based [−2]proPSA related indexes
were significantly superior for detecting clinically significant prostate cancer compared to %f-PSA. The indexes thosewould avoid up to 42% of prostate biopsies in men without aggressive cancer while maintaining 90% sensitivity. Furthermore, baseline [−2]proPSA-related indices immediately before starting active surveillance (AS) were independent
factors to predict pathological reclassification at one year after entering AS. In the future, based on data from a ongoing
preliminary study, prostate volume- adjusted [−2]proPSA-related indices would be a more useful tools to distinguish aclinically significant prostate cancer from non-aggressive prostate cancer while saving unnecessary biopsy.

Session 21: Topics of New Diagnostic Methods p2PSA

Effectiveness of [-2]proPSA measurement in the
diagnosis of significant prostate cancer compared to MRI
and PSA
Hiroji Uemura, MD. PhD.
Department of Urology and Renal Transplantation, Yokohama City University Medical Center
EDUCATION
DegreeMarch 1996 PhD, Yokohama City University School of Medicine
March 1985 MD, Yokohama City University School of Medicine
APPOINTMENTS
June 1985 - May 1987, Yokohama City University Hospital, Resident
June 1987 - May 1990, Staff of Urology, Yokosuka Kyousai Hospital
June 1990 - May 1992, Staff of Urology, Yokosuka Hokubu Kyousai Hospital,
October 1992 - February 1995, Associate Researcher, University of Wisconsin, Comprehensive Cancer Center, USA
March 1995 - Instructor, March 1998, Yokohama City University School of Medicine
April 1998 - March 2003, Assistant Professor, Yokohama City University Hospital
April 2003 - Associate Professor, Yokohama City University Graduate School of Medicine
April 2015 - Director, Associate Professor, Department of Urology and Renal Transplantation, Yokohama City University Medical Center
April 2016 - Director, Clinical Professor, Department of Urology and Renal Transplantation, Yokohama City University Medical Center
Society activity
Japanese urology association (executive board member), Japanese cancer association (board member), Japanese societyof clinical oncology (board member), Ethics committee of Tokyo University, AACR, ASCO, AUA, ESMO, Panelmember of APCCC2021, 2022

Abstract
In the early stages of prostate cancer (PCa), it is important to prevent the overdiagnosis and overtreatment. Prostate specific antigen (PSA) has been used to detect PCa. In order to avoid unnecessary prostate biopsy, more accurate diagnostic procedures for PCa are needed. Recent studies showed that the percentage of serum isoform [-2]proPSA (p2PSA) to
free PSA (%p2PSA), the Prostate Health Index (PHI) and magnetic resonance imaging (MRI) were more accurate than
PSA. Our study aimed to test the accuracy of %p2PSA, PHI and MRI in discriminating patients with and without PCa.
The subjects were 50 consecutive men with a PSA level of 2.0-10.0 ng/ml, who underwent prostate biopsy. These patients underwent multiparametric MRI before biopsy, and their serum samples were measured for PSA, free PSA andp2PSA. The sensitivity, specificity and accuracy of PHI, %p2PSA and MRI were compared with PSA in the diagnosisof biopsy-confirmed PCa. The results showed that %p2PSA and PHI were more accurate than MRI and PSA for PCa
detection. For significant cancer detection, %p2PSA, PHI and MRI were marginally more accurate than PSA. In conclusion, PHI and %p2PSA can be used for screening the general population and MRI can be used for detection of significant cancer in patients suspected, from screening tests, of having PCa. Although MRI PIRADS scoring score was not
used in this study, the combination of PIRADS scoring and PHI would be more useful to detect significant localizedPCa.

Moderated Poster Presentation 1

Moderator

Kazuhiko Oshinomi
Department of Urology, Showa University School of Medicine, Tokyo Japan
Education: 1998-2004 MD, Showa University School of Medicine
2006-2010 PhD, Showa University Graduate School Department of Urology
Professional:
2004-2006 Resident, Tokyo Metropolitan Otsuka Hospital
2010-2015 Instructor, Showa University School of Medicine
2016-present Assistant Professor of Urology, Showa University School of Medicine

Moderator

Jacob ST Pang
President of Taiwan Urological Association, Chung Shan Medical University
Current Appointment
・ Professor, Ministry of Education, Taiwan (Aug. 2015)
・ Vice-Superintendent, CGMH Linkou, Taiwan (Jul. 2017〜)
・ President, Taiwan Urological Association (Aug. 2022〜)
Education
・ Medical School: Chung Shan Medical University, Tai-Chung, Taiwan (Sep. 1983 - Jun. 1990)
・ PhD: Karolinska Institute, Stockholm, Sweden (Aug. 1999 - Oct. 2003)
・ Head, Section of Urooncology, Dept. of Urology, CGMH Linkou, Taiwan (Aug. 2007 - Jul. 2014)
・ Chief, Operating Room, CGMH Linkou, Taiwan (Feb. 2012 - Jun. 2016)
・ Director, Department of Medical Research and Development Linkou Branch, CGMH Taiwan (Jul. 2016 - June 2017)
・ President, Taiwan Urological Oncology Association (Jan. 2016 - Jan. 2018)
・ Vice-President, Taiwan Urological Association (Sep. 2018 - Aug. 2022)
Major Research・ Cancer genomics, Molecular biology
Specialization
・ Robotic Surgery, Urological Cancer

Moderated Poster Presentation 1

Moderator

Thomas S Namiki, MD
University of Hawaii, USA
EDUCATION:
Undergraduate: Yale University, New Haven, CT (BA Biochemistry)
Medical School: John A Burns School of Medicine, University of HawaiiInternship: UCLA Medical Center, General Surgery
Residency: LA County - University of Southern California Medical Center, Pathology
Fellowship: Surgical pathology, LAC-USC Medical Center
Chief Resident/Surgical Pathology, UCLA Medical Center.
CLINICAL POSITIONS:
1989-90 Associate Director, Dept of Surgical Pathology, LAC-USC Medical Center,
1989-90 Staff Pathologist, The Orthopaedic Hospital, Los Angeles,
1990-1994 Director of Cytopathology, Dept. of Pathology, The Queen’s Medical Center, Honolulu, HI,
2002-2003 Medical director, Johnston Atoll Medical Clinic Laboratory
1990-2020 Department of Pathology, The Queen’s Medical Center (1992-2012 Director of Anatomic Pathology).
TEACHING APPOINTMENTS:
1985-1988 Clinical Instructor, Dept of Pathology, USC School of Medicine.
1988-1989 Adjunct Clinical Assistant Professor, Dept of Pathology, UCLA School of Medicine.
1989-1990 Assistant Professor of Pathology, USC School of Medicine.
1990-Present Associate Clinical Professor of Pathology, John A Burns Schoold of Medicien, University of Hawaii.

INDEX
No.

Title

First Author

Institute

CountryMP1-1

A mitochondria-targeted drug induces apoptosis in prostate cancer xenografts

Seiji Arai

Gunma University

Japan

MP1-2

Hyperforin Induces Extrinsic/Intrinsic Apoptosis Signaling and Inhibits NF-кB for Metastasis
Suppression in Prostate Cancer Cells

Cheng-Hsi Liao

China Medical
University

Taiwan

MP1-3

Combination therapy with novel androgen receptor antagonists and statin for castration-resistant
prostate cancer

Yoshitaka Sekine

Gunma University

Japan

MP1-4

Lipopolysaccharide from dysbiotic gut microbiome promotes prostate cancer growth through histamine
H1 receptor signaling

Kazutoshi Fujita

Kindai University

Japan

MP1-5

GDF15 propeptide is a novel and useful biomarker for bone metastases in prostate cance

Gaku Yamamichi

Osaka University

Japan

MP1-6

Withdrawn

MP1-7

Is 12 Systemic Cores in Transperineal Biopsy Sufficient for Detecting Clinically Significant Prostate
Cancer?

Chang Eil Yoon

The Catholic
University Of
Korea

Korea

MP1-8

The Impact of mpMRI on Treatment Strategy for Incidental Prostate Cancer after HoLEP

Chung Un Lee

Sungkyunkwan
University

Korea

MP1-9

Clinicopathological analysis of prostate cancer with lymph node metastasis in the prostatic anterior fat
pad

Junichi Ikeda

Kansai Medical
University

Japan

MP1-10

Robotic-Assisted Simple Prostatectomy using the da Vinci SP system, pilot study

ByungHoon Kim

keimyung
university

Korea

MP1-11

Ealry outcomes of Single port robotic radical prostatectomy: 1 year followed up

Seokhwan Bang

The Catholic
University of
Korea

Korea

MP1-12Comparison of longitudinal health-related QOL outcomes between anterior and posterior approaches
to robot-assisted radical prostatectomy

Naoya Nagasaki

Okayama
University

Japan

MP1-13Novel Nomogram Predicting Biochemical Recurrence-Free Survival After Radical Prostatectomy

leandro blas

kyushu university

Japan

MP1-14

Carbon-ion radiotherapy for high-risk prostate cancer in Gunma University Heavy Ion Medical Center

Hiroshi Matsui

Gunma University

Japan

Takahiro Nakamoto

Kansai Medical
University

Japan

MP1-15

Salvage low-dose rate brachytherapy for local recurrence of prostate cancer after radical radiotherapy

MP1-1 A mitochondria-targeted drug induces
apoptosis in prostate cancer
xenografts
Seiji Arai , Akira Ohtsu , Tatsuhiro Sawada , Mai Kato ,Yuta Maeno , Yoshiyuki Miyazawa , Yoshitaka Sekine ,Kazuhiro Suzuki

nificantly diminish the expression of NF-кB p65 (Ser276),
anti-apoptotic and tumor progression-associated proteins.
Conclusions: All our finding may of academic value in revealing the intracellular signaling network triggered by hyperforin in prostate cancer cells.

Gunma University Graduate School of Medicine

Introduction: We have previously shown that prostate cancer
is primed to undergo apoptosis with BH3 mimetics targetinganti-apoptotic proteins, including BCL2, BCLXL, and MCL
1 (Clinical Cancer Res 2018). We have also revealed that receptor tyrosine kinase inhibitors induced MCL1 degradation
through integrated stress response and mitochondrial E3
ubiquitin ligase MARCH5 (eLife 2020). We hypothesizedthat drugs targeting mitochondria might induce apoptosis inprostate cancer.
Methods: In this study, we have conducted small-scale
screening of drugs that are supposed to target mitochondria
in prostate cancer cells.
Results: Drug A decreased prostate cancer cell growthwithin nM levels in vitro. Drug A rapidly reduced several
proteins (MCL1, AR, AR-V7, and c-MYC proteins) and significantly induced apoptosis in prostate cancer cells in vitro
and in vivo.
Conclusions: Targeting mitochondria might be a novel strategy to treat prostate cancer.

MP1-2 Hyperforin Induces Extrinsic/Intrinsic
Apoptosis Signaling and Inhibits NFкB for Metastasis Suppression in
Prostate Cancer Cells

MP1-3 Combination therapy with novel
androgen receptor antagonists andstatin for castration-resistant prostatecancerYoshitaka Sekine , Hiroshi Nakayama , Daisuke Oka ,Yoshiyuki Miyazawa , Seiji Arai , Hidekazu Koike ,Hiroshi Matsui , Yasuhiro Shibata , Kazuhiro Suzuki
Department of Urology, Gunma University Graduate School of Medicine

We investigated whether the combination therapy with novel
androgen receptor antagonists and statin could inhibit
castration-resistant prostate cancer cell growth. In androgen
independent LNCaP-LA cells, AR protein expression was
suppressed by simvastatin, but not in 22Rv1 cells, The combination with darolutamide and simvastatin suppressed cellproliferation of both LNCaP-LA and 22Rv1 cells. The same
applied to mouse xenograft model in 22Rv1 cells. In
LNCaP-LA cells, the combination therapy decreased gene
expressions regulated by androgen, but not in 22Rv1 cells.
Ingenuity Pathway Analysis under the combination therapy
in 22Rv1 cells showed the number of differentially expressed genes was the biggest in the pathway of Role ofcell cycle . In conclusion, the combination of novel AR antagonists and simvastatin can potentially affect castrationresistant prostate cancer growth in both androgen dependentand independent mechanisms.

Cheng-Hsi Liao 1,2,3,4 , Wen-Shin Chang 2,3 , Pei-Shin Hu 2,3 ,
Chia-Wen Tsai 2,3 , Hsi-Chin Wu 5 , Da-Tian Bau 2,3
1

Division of Urology, Department of Surgery, Taichung Armed Forces
General Hospital, Taichung, Taiwan
2
Graduate Institute of Biomedical Sciences, China Medical University,
Taichung, Taiwan
3
Terry Fox Cancer Research Laboratory
4
Graduate Institute of Medical Sciences, National Defense Medical Center,
Taipei, Taiwan
5Department of Urology, China Medical University Hospital, Taichung,TaiwanPurpose: Prostate ca is the second most prevalent cancer for
men and the fifth leading cause of death in the world. It isurgently needed to figure out novel and practical antiprostate cancer drugs. In this study, we have some data
showing that hyperforin can be the potential one.
Materials and Methods: The alterations in cell viability, production of reactive oxygen species (ROS), and pro- and antiapoptotic signaling will be measured via typical MTT assay,
flow cytometry, ELISA and Western blot analyzing modules.
Results: Our results show that hyperforin significantly induces apoptosis, extrinsic/intrinsic apoptotic signaling, accumulation of cytosol ROS, and calcium signaling. It can sig-

MP1-4 Lipopolysaccharide from dysbiotic gut
microbiome promotes prostate cancer
growth through histamine H1 receptor
signaling
Kazutoshi Fujita 1 , Makoto Matsushita 2 ,Daisuke Motooka 3 , Hiroaki Hase 4 , Koji Hatano 2 ,Takafumi Minami 1 , Marco De Velasco 1 ,Kazuhiro Yoshimura 1 , Norio Nonomura 2 ,Hirotsugu Uemura 1
1

Department of Urology Kindai University Faculty of Medicine
Department of Urology Osaka University Graduate School of Medicine
Department of Infection Metagenomics, Research Institute for Microbial
Diseases
4
Laboratory of Cell Biology and Physiology, Osaka University, Graduate
School of Pharmaceutical Sciences2
3

We investigated the etiology of high-fat diets (HFD)induced prostate cancer growth and the involvement of thegut microbiome. The expression of Hdc and histamine level
was upregulated in prostate tumor of HFD-fed mice, and thenumber of mast cells was increased in tumor. Administration

of fexofenadine, a histamine H1 receptor antagonist, suppressed tumor growth in HFD-fed mice by reducing thenumber of myeloid-derived suppressor cells and suppressing
IL6/STAT3 signaling. HFD intake induced gut dysbiosis, resulting in the elevation of serum lipopolysaccharide (LPS)
levels. Injection of LPS increased Hdc expression in PCa.
LPS/Toll-like receptor 4 signal inhibition suppressed HFDinduced tumor growth. In humans, mast cells were increased
in total prostatectomy specimens from severely obese patients. In conclusion, HFD promotes PCa growth throughhistamine signaling via mast cells. Dietary high-fat induced
gut dysbiosis might be involved in the inflammatory cancer
growth.

MP1-5 GDF15 propeptide is a novel anduseful biomarker for bone metastases
in prostate cance
Gaku Yamamichi 1 , Taigo Kato 1 , Shohei Myoba 2 ,Yu Ishizuya 1 , Yoshiyuki Yamamoto 1 , Koji Hatano 1 ,Atsunari Kawashima 1 , Motohide Uemura 1,3,4 ,Norio Nonomura 1
1

Department of Urology, Osaka University Graduate School of Medicine,
Osaka, Japan
Bioscience Division, Research and Development Department, Tosoh
Corporation, Kanagawa, Japan3
Department of Urology, Iwase General Hospital, Fukushima, Japan
4
Department of Urology, Fukushima Medical University, Fukushima, Japan
2

Background
GDF15 is a protein secreted by cancer cells. We found GDF
15 propeptide (GDPP) was also secreted in various types of
prostate cancer (PCa) cell lines and might be associated withbone metastases (BM). In this study, we aimed to investigate
the efficacy of GDPP as a blood biomarker for BM in PCa
patients.
Materials and Methods
We collected plasma from 107 patients with BM and 102
patients with distant metastases except bone in advanced
PCa, urothelial cancer (UC) and renal cell carcinoma (RCC).
We examined the correlation between GDPP and bone scan
index (BSI) of bone scintigraphy.
Results
We found that the area under the curves of detecting BM for
PCa, UC, and RCC was 0.90, 0.87 and 0.81. Interestingly,
we confirmed that GDPP was significantly correlated with
BSI in PCa patients (r = 0.81, p < 0.01), and its correlation
factor was significantly higher than PSA and ALP (both p <0.01).
Conclusion
Plasma GDPP was useful for the diagnosis of BM and correlated with BSI in PCa.

MP1-6 Withdrawn

MP1-7 Is 12 Systemic Cores in Transperineal
Biopsy Sufficient for Detecting
Clinically Significant Prostate
Cancer?
Chang Eil Yoon , Seung Ah Rhew , Hyeok Jae Kwon ,Dongho Shin , Hyoung Woo Moon , Yong Hyun Park ,Ji Youl Lee
Department of Urology, Seoul St. Mary’s Hospital, College Of Medicine, The
Catholic University Of Korea, Seoul, Korea

Introduction: For transperineal (TP) prostate biopsy, target
biopsy for visible lesion on MRI is essential, but the systemic biopsy is also important for detection of non-visible
lesion on MRI. This study aims to confirm the diagnostic efficiency of 20-core systemic biopsy by comparison with 12core systemic biopsy.
Methods: The 494 patients who were conducted the naive
TP biopsy were retrospectively analyzed. 293 patients for
12-core biopsy and 201 patients for 20-core biopsy was analyzed by using propensity score matching analysis for minimizing confounding variables.
Results: At 12-core biopsy, there were 97 cases of csPCa
and 63 cases for 20-core biopsy. For index negative csPCa,
the odds ratio was 4.03 (p = 0.0128), but for index positive
csPCa, the odds ratio was 0.98 (p = 0.9308)
Conclusion: If there is a suspicious lesion in MRI, 20-core
biopsy is excessive and 12-core biopsy is sufficient.
Whereas if there is no suspicious lesion in MRI, 20-core biopsy is better.

MP1-8 The Impact of mpMRI on Treatment
Strategy for Incidental Prostate
Cancer after HoLEP
Chung Un Lee , Ji Hwan Lee , Jae Hoon Chung ,Minyong Kang , Hwang Hyun Jeon , Byong Chang Jeong ,Seong Il Seo , Seong Soo Jeon , Hyun Moo Lee , Wan SongDepartment of Urology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea

Introduction: We investigated the impact of mpMRI on
treatment strategy for incidental prostate cancer (iPCa) after
HoLEP.
Methods : We retrospectively reviewed patients who underwent HoLEP and identified iPCa between Sep 2009 and Mar
2022. The treatment pattern of iPCa according to Gleason
grade(GG) and those according to combination of GG and
mpMRI were analyzed.
Results : A total of 62 patients was analyzed. In patients with
GG1 and GG2, active surveillance (AS) was performed in
78.6% and 53.8% of patients. However, in patients with GG
1, AS was performed in 88.9% when PI-RADSv2 score was
2 and, in 66.7% of patients when PI-RADSv2 score was 3.
For patients with GG2, AS was performed in 80.0% when
PI-RADSv2 score was 2 and, in 40.0% of patients when PIRADSv2 score was 3. For patients with GG 3-5, all patients
had a PI-RADSv2 score 4 or 5, thus active treatment wasperformed.
Conclusions : For management of iPCa after HoLEP,
mpMRI plays an important role in risk stratification.

MP1-9 Clinicopathological analysis of
prostate cancer with lymph nodemetastasis in the prostatic anterior fat
padprovement in maximum flow rate (7.4 to 20.1 mL/sec).
Conclusions: In our initial series, SP RASP allows for favorable perioperative and early postoperative outcomes including low complication, short Foley catheter stay, immediatecontinence and quick recovery.

MP1-11 Ealry outcomes of Single port robotic
radical prostatectomy: 1 year followedup

Junichi Ikeda , Takahiro Nakamoto , Hidefumi Kinoshita
Department of Urology and Andrology, Kansai Medical University

Seokhwan Bang , Hyuk Jin Cho , U-Syn Ha ,Sung-Hoo Hong , Ji Youl Lee

Background: Several reports have described the presence oflymph nodes (LNs) within the prostatic anterior fat pad(PAFP). Although metastatic LNs in the PAFP affect pathologic staging, the need for routine pathologic analysis is
unclear.
Purpose: This study aims to evaluate the presence of PAFP
LNs and risk factors for PAFP LN metastases.
Methods: We included 251 patients who underwent PAFP
resection during prostatectomy between January 2019 andDecember 2021 at Kansai Medical University Hospital. The
association between clinicopathologic factors and the presence of LNs or LN metastasis within the PAFP was examined.
Results: LNs were found in the PAFP in 17 (6.8%) cases,
and metastatic LNs in the PAFP were found in 2 (0.8%)
cases. PAFP LNs were not associated with clinicopathologic
factors. Two cases with LN metastasis in the PAFP wereboth high-risk cases.
Conclusion: Our results suggest that patients with high-riskfactors might benefit from pathologic analysis of the PAFP.

Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The
Catholic University of Korea, Seoul

MP1-10 Robotic-Assisted Simple
Prostatectomy using the da Vinci SP
system, pilot study
ByungHoon Kim , Haejin Byun , Jiyong Ha ,WonHo Jung , Taekjun shin , hyunchan Jang
keimyung university, school of medicine

Introduction: To present the updated technique and evaluate
the perioperative and postoperative outcomes of Roboticassisted single port simple prostatectomy (SP RASP)
Methods: Seven consecutive patients with BPH indicated forsurgery underwent SP RASP in a single institution. Demographics, perioperative and postoperative data were prospectively collected.
Results: The median age was 69 years, prostatic volume was
80cc and transitional zone volume was 42cc. median operation time was 102 minutes. Foley catheter was removed 5days later. The Median IPSS score decreased from 21.1 before the surgery to 5.6 after the surgery. All patients had a
immediate continence and significant postoperative im-

Introduction
To describe the early outcomes after induction of single port(SP) robot-assisted radical prostatectomy(RARP).
Materials and Methods
We reviewed 78 consecutive patients diagnosed with prostate adenocarcinoma who underwent SP RARP for 1 year
from September 2021 when new robotic platform was introduced. The surgery was performed by 5 experts.
Results
A total of 78 patients underwent surgery during one year,
and the mean age was 66.04±7.914 years. The mean tumor
size was 1.32±0.536 cm in preoperative MRI and the mean
PIRADS score was 4.14±0.726. The patients’ preoperative
PSA was 8.86±8.076ng/dl. The average console time was
74.00±14.562 minutes, and the expected blood loss was
110.91±100.42 ml. (Table 1) Postoperative pathological results and the postoperative Gleason score is summarized inTable 2. The mean PSA after 3 months was 0.040±0.16 ng/
dl and the mean PSA after 6 months was 0.021±0.038 ng/
dl. (Table 2)
Conclusion
SP RARP demonstrates technical safety and feasibility.

MP1-12 Comparison of longitudinal healthrelated QOL outcomes between
anterior and posterior approaches torobot-assisted radical prostatectomy
Naoya Nagasaki , Yuki Maruyama , Takuya Sadahira ,Satoshi Katayama , Takehiro Iwata , Kensuke Bekku ,Kohei Edamura , Tomoko Kobayashi ,Yasuyuki Kobayashi , Motoo Araki
Department of Urology, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, JapanThe aim of this study is to assess differences of healthrelated QOL (HRQOL) following these two surgical approaches at our institution. We included 270 patients in thisretrospective who underwent RARP using an anterior orposterior surgical approach at our institution by three skillfulsurgeons from January 2012 to July 2021, and who could
evaluate preoperatively the Expanded Prostate Cancer Index
Composite (EPIC) score. Patients treated with neoadjuvant
hormonal therapy were excluded. HRQOL was assessed using the EPIC score at 6 timepoints. We defined the minimal
clinically important difference (MCID) as half the standard
deviation of the baseline score for each domain. The propensity score matching was used to balance the preoperative
characteristics. The analysis of MCID revealed there is no
significant impact in surgical approaches. Our study demonstrates no significant differences in HRQOL between anterior and posterior surgical approaches to RARP.

MP1-13 Novel Nomogram Predicting
Biochemical Recurrence-Free Survival
After Radical Prostatectomy
leandro blas , Masaki Shiota , Dai Takamatsu ,Fumio Kinoshita , Takashi Matsumoto , Ken Lee ,Keisuke Monji , Eiji Kashiwagi , Junichi Inokuchi ,Masatoshi Eto
kyushu university hospitalObjective: To analyze biochemical recurrence (BCR)-freesurvival (FS) evolution and develop a nomogram to predict
BCR-FS including postoperative (PO) prostate-specific antigen (PSA).
Method: We included 718 men treated with robotic-assisted
radical prostatectomy (RARP). Cox model and decision
curve analyses were used to compare to the Cancer of theProstate Risk Assessment post-Surgical (CAPRA-S) score.
Results: The 5-year BCR-FS rates increased to 82.6%,
85.2%, and 91.6% for men surviving at 1, 3, and 5 years
without BCR, respectively. Pathological Gleason, T-stage,surgical margin, PSA 侒0.05 ng/mL at 1 year, and lymphnode involvement were independent risk factors for BCR after 1 year PO. Our nomogram had a higher c-index (0.89 vs0.78) than the CAPRA-S (0.78, p=0.001), and positive net
benefit at 3 and 5 years PO.
Conclusion: 5-year conditional BCR-FS increased with survivorship without BCR. The nomogram significantly improved the accuracy in predicting BCR-FS after RARP.

MP1-14 Carbon-ion radiotherapy for high-risk
prostate cancer in Gunma University
Heavy Ion Medical Center
Hiroshi Matsui 1,2 , Hidemasa Kawamura 1,3 ,Masahiro Ohnishi 1,3 , Akiko Adachi 1,3 , Naoko Okano 1,3 ,Yoshiyuki Miyazawa 2 , Yoshitaka Sekine 2 ,Hidekazu Koike 2 , Kazuhiro Suzuki 1,2 , Tatsuya Ohno 1,3
1
23

Gunma University Heavy Ion Medical Center
Department of Urology, Gunma University Graduate School of Medicine
Department of Radiation Oncology, Gunma University Graduate School of
Medicine

Objectives: We evaluated the efficacy and toxicity ofcarbon-ion radiotherapy (CIRT) for high-risk PC in Gunma
University Heavy Ion Medical Center.
Materials/Methods: Patients were classified as having highrisk disease with clinical stage T3a or T3b, a Gleason score
8 or greater, or a pretreatment PSA more than 20 ng/mL.
Neoadjuvant androgen deprivation therapy (ADT) for 6
months and adjuvant ADT for 1.5 years were given to thepatients with high-risk disease. We evaluated the efficacy
and toxicity of CIRT for 278 high-risk PC patients.
Results: Late grade 2 gastrointestinal toxicity was seen in
0.7%. Late grade 2 and 3 genitourinary toxicity was seen in
18.1 and 0.4%. The proportion of patients who were biochemical failure (Phoenix definition) free at 5 years was
91.4%. The 5-year overall survival was 96.7%. There were 4
deaths from PC.
Conclusions: Our findings demonstrated that CIRT for highrisk PC seemed effective and safety for Japanese patients.

MP1-15 Salvage low-dose rate brachytherapy
for local recurrence of prostate cancer
after radical radiotherapy
Takahiro Nakamoto , Junichi Ikeda , Hidefumi Kinoshita
Urology and Andrology, Kansai Medical University

Background
When patients show biochemical PSA recurrence (BPR) after radiotherapy, one of the therapeutic options is salvage
low-dose rate brachytherapy (sLDR-BT). Several studies
have reported the safety and efficacy of sLDR-BT. However, there is no clear evidence of the risk factors for BPR
after sLDR-BT.
PurposeThis study aims to describe the risk factors for BPR aftersLDR-BT.
Methods
17 patients underwent sLDR-BT from 2012 to 2021. The
clinicopathological data from these patients were retrospectively analyzed.
Results
9 patients developed BPR in a median follow-up of 68.8
months. Recurrence-free survival rates at 3 years and 5 years
were 70.5% and 56.1%. A univariate analysis showed that
the PSA level before sLDR-BT and MRI stage 侒T3 before
the first radiotherapy treatment were the risk factors associated with BPR after sLDR-BT.
Conclusion
The risk factors for BPR after sLDR-BT may be the PSAlevel before sLDR-BT and MRI stage 侒T3 before the firstradiotherapy treatment.

Moderated Poster Presentation 2

Moderator

Kyung Seop Lee
Keimyung University Dongsan Hospital
EDUCATION
1979-1981 Premedical Keimyung University, Daegu, Korea
1981-1985 Medical School, Keimyung University, Daegu, Korea
1987-1989 Master Keimyung University, Daegu, Korea
1995-1997 PhD Yeongnam University, Daegu, Korea
POST DOCTORAL TRAINING
2000-2001
Visiting Scholar University of Michigan, Ann Arbor, MI
1993-2020.8.31
Head of Department, Professor Dongguk University
2020.9.1-present President of Keimyung University Gyeongju Dongsan Hospital
PROFESSIONAL ORGANIZATION: MEMBERSHIPS
President, Korea Prostate Society (2011.3-2013.3)
President, Korea Urology Ultrasound Society (2012.10-2015.5)
President, Dongguk University Gyeongju Hospital (2009.2-2012.2)
President, Korea Prostate Laser Association (2014.1-2016.1)
Faculty, APPS
Faculty, (Medical Policy Treatment Committee) Korea Urologic Association (2012-2013)
Research & Planning, Korea Urologic Association (2008.11-2010.11)
Korean Foundation for Cancer Research (2011-2016)
Korea Urologic Association
Korea Andrology Association
Korea Urologic Oncology

Moderator

Robert G. Carlile
Department of Surgery, University of Hawaii
1992 - 2020
Urology Practice at Queens Medical Center
Honolulu, Hawaii
Clinical Assistant Professor of Surgery, John A Burns School of Medicine
University of Hawaii, Honolulu, Hawaii
1987 - 1992
Surgery and Urology Residency
University of Utah School of Medicine, Salt Lake City, Utah
1987
Doctor of Medicine
John A Burns School of Medicine,
University of Hawaii, Honolulu, Hawaii

INDEX
No.

Title

First Author

Institute

Country

MP2-1

Changes of resistance indices after medication in benign prostatic hyperplasia: a prospective study

Kyung Seop Lee

Keimyung
University

Korea

MP2-2

The Association between Human Gut Microbiota and Benign Prostatic Hyperplasia

Kentaro Takezawa

Osaka University

Japan

MP2-3

PSA doubling time predicts the efficiency of site-directed therapy for non-metastatic or oligometastatic
CRPC

Taketo Kawai

The University of
Tokyo

Japan

MP2-4

Switching to darolutamide for M0CRPC resistant to enzalutamide or apalutamide

Saizo Fujimoto

Kindai University

Japan

MP2-5

Efficacy and Safety of Enzalutamide and Apalutamide in the Treatment of Patients with nmCRPC: A
retrospective analysis

Shuhei Hara

The Jikei
University

Japan

MP2-6

How I recruit the suitable nmCRPC patients for taking insurance-reimbursed Darolutamide in Taiwan

Kuan-Chou Chen

Taipei Medical
University

TaiwanMP2-7

Cisplatin and Etoposide for treatment-related Neuroendocrine Prostate Cancer: avorable early
Response with short Duration

Yuto Tsubonuma

University ofOccupational andEnvironmental
Health

Japan

MP2-8

Biology and usefulness of [-2] proPSA as a prognostic marker in CRPC patients

Yoshiyuki Miyazawa

Gunma University

Japan

MP2-9

The Effects of Personal and Family Cancer History on the Diagnosis of Prostate Cancer in a MultiInstitutional Prostate Biopsy Registry

Jeong Woo Yoo

Yonsei University

Korea

MP2-10WithdrawnMP2-1 Changes of resistance indices after
medication in benign prostatic
hyperplasia: a prospective study
Kyung Seop Lee 1 , Dong Jin Park 2 , Se Yun Kwon 2 ,Young Jin Seo 2
1

Department of Urology, Keimyung University School of Medicine, Daegu,
South Korea
2
Department of Urology, Dongguk University College of Medicine, Gyeongju,
South Korea

Objectives: To determine the relationship between resistive
indices (RIs) and changes in prostate size after medical treatment in patients with benign prostatic hyperplasia (BPH).
Materials and Methods: A total of 63 patients with BPH
were included in the study. All patients were treated with α1-adrenergic blockers and 5α-reductase inhibitors (5ARIs),
RIs of the urethral artery, and left and right capsular arteries.
These variables were assessed at baseline and after 3- and 6
months of treatment.
Results: Mean RI of the urethral artery, left capsular artery,and right capsular artery decreased after 3- and 6 months oftreatment (p = 0.011, p = 0.015, p < 0.001, respectively).
Conclusion: In patients with BPH, α1-adrenergic blocker
and 5ARI medications for 3- and 6 months significantly reduced the RI of the urethral artery and both capsular arteries.
Larger scale, prospective studies are needed to confirm therelationship between TPV and RI reductions.

MP2-2 The Association between Human Gut
Microbiota and Benign Prostatic
Hyperplasia
Kentaro Takezawa 1 , Kazutoshi Fujita 2 , Koji Hatano 1 ,Go Tsujimura 1 , Takahiro Imanaka 1 ,Sohei Kuribayashi 1 , Koichi Okada 1 , Norichika Ueda 1 ,Shinichiro Fukuhara 1 , Norio Nonomura 1
1
2

Department of Urology, Osaka University
Department of Urology, Kindai University

Objectives
The pathophysiology of BPH is unknown. We hypothesizedthat the gut microbiota is involved in BPH and analyzed theassociation between gut microbiota and prostate volume.
Methods
A total of 128 patients who underwent prostate biopsy were
included. Patients with a prostate volume 侒30 mL were defined as the prostate enlargement (PE) group and those witha prostate volume <30 mL as the non-PE group. Gut microbiota was analyzed by 16S rRNA metagenomic analysis ofrectal swab and compared between the two groups.
Results
The PE group included 66 patients and the non-PE group included 62 patients. LEfSe analysis showed a higher propotion of Firmicutes and Actinobacteria in the PE group and ahigher proportion of Bacteroidetes in the non-PE group. We
focused on the Firmicutes/Bacteroidetes (F/B) ratio, which
has been reported to be associated with various diseases. The
F/B ratio was significantly higher in the PE group.

Conclusion
The F/B ratio of the gut microbiota is associated with BPH.

MP2-3 PSA doubling time predicts theefficiency of site-directed therapy fornon-metastatic or oligometastatic
CRPC
Taketo Kawai 1,2 , Keina Nozaki 3 , Satoru Taguchi 1 ,Yoshiyuki Akiyama 1 , Yuta Yamada 1 , Yusuke Sato 1 ,Daisuke Yamada 1 , Hideomi Yamashita 4 ,Tohru Nakagawa 2 , Haruki Kume 1
1

Department of Urology, Graduate School of Medicine, The University ofTokyo
Department of Urology, Teikyo University School of Medicine
3
Department of Urology, Center Hospital of National Center for Global
Health and Medicine
4
Department of Radiology, Graduate School of Medicine, The University ofTokyo
2Background: We investigated the efficiency and related
clinical factors of site-directed therapy for non-metastatic or
oligometastatic CRPC.
Methods: We reviewed 59 patients with non-metastatic or
oligometastatic CRPC who underwent site-directed therapy
targeting primary prostate lesions or metastatic lesions between April 2014 and March 2022. We evaluated the associations between clinical variables with PSA response rate,
progression-free survival (PFS), and time to next treatment(TTNT).
Results: PSA response rate of >50% was observed in 66% of
patients. The median PFS and TTNT were 8.0 months and9.9 months, respectively. Multivariate analyses revealed that
PSA doubling time of 6 months or longer was an independent factor to predict favorable PSA response rate, PFS, and
TTNT (P = 0.024, 0.025, and 0.015, respectively).
Conclusions: PSA doubling time may be a key factor to predict the efficiency of site-directed therapy for non-metastaticor oligometastatic CRPC.

MP2-4 Switching to darolutamide for M0
CRPC resistant to enzalutamide or
apalutamide
Saizo Fujimoto 1 , Kazutoshi Fujita 1 ,Mitsuhisa Nishimoto 1 , Ken Kuwahara 1 ,Mamoru Hamaguchi 2 , Shogo Adomi 1 ,Takafumi Minami 1 , Masahiro Nozawa 1 ,Kazuhiro Yoshimura 1 , Hirotsugu Uemura 1
1

2

Department of Urology, Kindai University Faculty of Medicine,
Osakasayama, Osaka, Japan
Department of Urology, Mimihara General Hospital, Sakai, Osaka, Japan

Background ⁄ Objectives
Enzalutamide, apalutamide, and darolutamide are recommended for patients with non-metastatic castration-resistant
prostate cancer (M0CRPC). However, no standard treatment

after 1st line therapy for M0CRPC. Darolutamide has a distinct chemical structure to other non-steroidal antiandrogens
and may avoid cross resistance.
Methods
We retrospectively evaluated the efficacy of switching todarolutamide in patients with M0CRPC. We included nine
M0CRPC patients who experienced biochemical progression
on enzalutamide or apalutamide and were switched over todarolutamide.
Results
Five patients (55.5%) had a PSA response >50% decline after starting darolutamide. Median progression-free survival
was six months. There were no significant differences in thepatients’ characteristics between responders and nonresponders.
Conclusions
Switching to darolutamide may be effective for M0CRPC
resistant to enzalutamide or apalutamide.

MP2-5 Efficacy and Safety of Enzalutamide
and Apalutamide in the Treatment ofPatients with nmCRPC: A
retrospective analysis
Shuhei Hara , Keiichiro Mori , Wataru Fukuokaya ,Kosuke Iwatani , Fumihiko Urabe ,Takafumi Yanagisawa , Kojiro Tashiro ,Shunsuke Tsuzuki , Tatsuya Shimomura ,Takahiro Kimura
Department of Urology, The Jikei University School of Medicine

Objective: Phase III clinical trials demonstrated the efficacy
of enzalutamide and apalutamide in nmCRPC. While thesedrugs are shown to vary in their adverse event (AE) profiles,
they remain yet to be evaluated for differences in their efficacy profile. Thus, a retrospective study was conducted toevaluate their efficacy in nmCRPC.
Methods: This study evaluated a total of 120 nmCRPC patients treated with enzalutamide (n=82) or apalutamide (n=28) in the first line setting at our facilities between May
2014 and September 2021, with the endpoints defined as oncological outcomes and AEs.
Results: Maximum PSA response of >50% and >90% was
not significanty different between the groups. No significant
difference was shown in The median PSA-PFS, CSS and OS
between the groups. The most common AE was fatigue inthe enzalutamide group and skin rash in the apalutamidegroup.
Conclusion: These drugs were shown to exhibit comparable
oncological outcomes but quite different AE profiles.

MP2-6 How I recruit the suitable nmCRPC
patients for taking insurancereimbursed Darolutamide in Taiwan

Kuan-Chou Chen 1,2
12

Department of Urology, Shuang Ho Hospital, Taipei Medical University
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical
University

Background: Darolutamide is covered by Taiwan national
health insurance when used in the high risk nmCRPC patients. Follow the results of ARAMIS trial, The national criteria for this high risk nmCRPC including:1.PSA doublingtime侑10 months 2.Undetectable testosterone level 3.Negative images (both CT and bone scan) finding of metastatic
disease 4.ECOG侑1.
Objectives: 2 group of patients will be eligible for these criteria. The first group is the standard high risk nmCRPC cohort with 1.Metastatic HSPC with initial Gleason score侒8and 2.After ADT, HSPC shifts to nmCRPC with PSA doubling time侑10 months. Another one is the converting highrisk nmCRPC cohort with 1.Metastatic HSPC with initial
Gleason score侑3+4 and 2.The HSPC can be controlled by
ADT for several years, yet the duration of stable PSA getting shorter post consecutively variant ADT regimens while
PSA doubling time侑10 months eventually.
Conclusions: We will present our real-world experiences forpatient recruitment.

MP2-7 Cisplatin and Etoposide for treatmentrelated Neuroendocrine Prostate
Cancer: avorable early Response withshort Duration
Yuto Tsubonuma 1 , Tomohisa Takaba 1 , Akinori Minato 1 ,Syuki Watanabe 1 , Ikko Tomisaki 1 , Michikazu Terado 2 ,Naohiro Fujimoto 1
1

Department of Urology, University of Occupational and Environmental
Health2
Department of Urology, Munakata suikoukai general hospitalObjectives: To evaluate the treatment outcomes of the combination therapy with cisplatin and etoposide (PE) for metastatic treatment-related neuroendocrine prostate cancer (tNEPC).
Methods: We reviewed treatment outcome data of patientswith histologically proven metastatic t-NEPC who underwent PE (cisplatin 80mg/m 2, day1, etoposide 80mg/m 2,
day1-3, q4w).
Results: We identified 14 patients between 2006 and 2022.
Median cycle of PE was 3 (range 1-7). CR and PR were observed in one (7.1%) and 9 patients (64.2%), respectively. In
responders, decline in serum NSE and tumor shrinkage werenoted after a few cycles. Median progression-free and overall survival were 4.5 months and 7 months, respectively,
with the median follow-up of 35 months. Adverse events(grade >2) were neutropenia (92.8%), anemia (42%), thrombocytopenia (28.5%), and febrile neutropenia (28.5%).
Conclusions: Metastatic t-NEPC showed favorable early response to EP.
However, duration of response was limited.

MP2-8 Biology and usefulness of [-2] proPSA
as a prognostic marker in CRPC
patients
Yoshiyuki Miyazawa 1 , Yoshitaka Sekine 1 , Seiji Arai 1 ,Yusuke Tsuji 1 , Yuta Suto 1 , Yuji Fujizuka 1 ,Hidekazu Koike 1 , Hiroshi Matsui 1 , Kazuto Ito 2 ,Kazuhiro Suzuki 1
1
2

tory was available for 283 men. Adjusted odds of the diagnosis of PCa was 1.93 times greater in brother with PCa. For
predicting the diagnosis of PCa, significant differences in
AUCs were showed in the presence of cancer types with themain histologic type of adenocarcinoma in family adding toconventional variables (p=0.019 ).
Conclusions: This study proposed a rationale to evaluate thepotency of familial cancers in men.

Gunma University Graduate School of Medicine, Department of Urology
Kurosawa Hospital, Department of Urology

Background; We retrospectively investigated the biology ofp2PSA and its usefulness as a marker using CRPC patients.
Methods; The study was performed using samples from aprospective study of CRPC patients treated with enzalutamide. We also examined the correlation between the measurement results of p2PSA and the prognosis of phi and
CRPC patients calculated accordingly. This study was approved by the IRB of Gunma University Hospital (IRB
2021-092, 1983).
Results; In the OS study, the median OS of the PSA low
group was NYR(not yet reached), the high group was 26.8
months, the p2PSA low group was NYR, the high group was
26.8 months, the phi low group was NYR, and the highgroup was 26.8 months. The OS was significantly better inthe low- value group for each parameter(p-values 0.024,
0.034, 0.018, respectively). Conclusions;The biology of p2
PSA in CRPC patients has been clarified. Although we
couldn’t find a clear advantage over PSA.

MP2-9 The Effects of Personal and Family
Cancer History on the Diagnosis of
Prostate Cancer in a MultiInstitutional Prostate Biopsy Registry
Jeong Woo Yoo 1 , Kwang Suk Lee 1 , Eu Chang Hwang 2 ,Jae Hung Jung 3 , Sang Hyub Lee 4 , Hak min Lee 5 ,Woong Kyu Han 6 , Byung Ha Chung 1
1

Department of Urology, Gangnam Severance hospital, Yonsei University
College of Medicine, Seoul, Korea
2
Department of Urology, Chonnam National University Hwasun Hospital,
Hwasun, Korea
3
Department of Urology, Yonsei University Wonju College of Medicine,
Wonju, Korea
4
Department of Urology, Kyung Hee University Medical Center, School of
Medicine, Kyung Hee University, Seoul, Korea
5
Department of Urology, Seoul National University Bundang Hospital,
Seongnam, Korea
6
Department of Urology, Shinchon Severance hospital, Yonsei University
College of Medicine, Seoul, Korea

Objectives: We estimate the risk of the diagnosis of prostatecancer (PCa) based on a cancer history.
Methods: This is a multicenter study of men undergoing initial prostate biopsy. All sites collected detailed data on thenumber of affected relatives, first-degree relatives with personal and family cancer history. Separate models were fit forcancer history definitions, including first-degree PCa andbreast cancer family histories and the presence of cancer
types with adenocarcinoma in family.
Results: Of 17,534 patients, a first-degree PCa family his-MP2-10 Withdrawn

INDEX
No.

Title

First Author

Institute

Country

UP1

The Association of Anatomical Structural with Voiding Functions in Men with Benign Prostatic
Hyperplasia/Lower Urinary Tract Symptoms

Jeong Woo Yoo

Yonsei University

Korea

UP2

Clinical Utility of Confirmatory Transperineal Template-Guided Saturation Prostate Biopsy after TRUSBx on Treatment Outcome of Focal HIFU

Chung Un Lee

Sungkyunkwan
University

Korea

UP3

MRI-TRUS Fusion Biopsies: 30 cases of primary experience

Hirotaka Kishi

Showa University

Japan

UP4

How to deal with PI-RADS category3 cases?

Eiji Matsubara

Showa University

Japan

UP5

Role of the Elastography Strain Ratio using Transrectal Ultrasonography in the Diagnosis of ClinicallySignificant Prostate Cancer

Jeong Woo Yoo

Yonsei University

Korea

UP6

Withdrawn

UP7

the characteristics of patients with prostate specific antigen persistence after Robot Assisted Radical
Prostatectomy

Motoki Yamagishi

Showa University

Japan

UP8

Robot-assisted laparoscopic radical prostatectomy (RARP) induction results and comparison with open
radical orostatectomy (ORR)

Hideaki Shimoyama

Showa University

Japan

UP9

Clinical Analysis of Intensity modulated radiation therapy (IMRT) for localized prostate cancer at
Showa University

Kazuhiko Oshinomi

Showa University

Japan

UP10

Periprocedural adverse events and distribution of the SpaceOAR hydrogel for radiothrapy for prostatecancerMasashi Morita

Showa University

Japan

UP1

The Association of Anatomical
Structural with Voiding Functions in
Men with Benign Prostatic Hyperplasia/
Lower Urinary Tract Symptoms

plan was changed in 13.5% patients from unilateral focal
HIFU to bilateral focal HIFU.
Conclusions : Confirmatory TPB plays an important role toanalyze the location and extent of PCa before focal HIFU.

Jeong Woo Yoo , Kwang Suk Lee , Kyo Chul Koo ,Byung Ha Chung
Department of Urology, Gangnam Severance hospital, Yonsei University
College of Medicine, Seoul, Korea

Objective: We investigated the effects of prostatic urethrallength (PUL), prostatic urethral angle (PUA), prostatic apex
shape or intravesical prostatic protrusion (IPP) on voiding
functions in men.
Methods: This observational study was based on data from
263 men without benign prostatic hyperplasia/lower urinary
tract symptoms treatment. A multivariate analysis was performed to determine the variables affecting international
prostate symptoms score (IPSS), max flow rate (Qmax) andvoiding efficacy (postvoid residual volume to total bladdervolume).
Results: Of 263 patients, decreasing PUA are increasing severity of voiding symptoms (p<0.001 ). Multivariable analysis reported that total IPSS was correlated with age, PUA
and Qmax, which was negatively associated with IPP. Voiding efficacy was only related with PUL.
Conclusion: This study presented that individual anatomical
stricture variations influenced the voiding functions in prostate volume.

UP2

Clinical Utility of Confirmatory
Transperineal Template-Guided
Saturation Prostate Biopsy after
TRUS-Bx on Treatment Outcome of
Focal HIFU

Chung Un Lee , Ji Hwan Lee , Jae Hoon Chung ,Minyong Kang , Hwang Hyun Jeon , Byong Chang Jeong ,Seong Il Seo , Seong Soo Jeon , Hyun Moo Lee , Wan SongDepartment of Urology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea

Introduction: We investigated the clinical utility of confirmatory transperineal template-guided saturation biopsy(TPB) after TRUS-Bx (TRB) on treatment outcome of focal
HIFU.
Methods : The study included patients underwent focal
HIFU for prostate cancer (PCa) between Oct 2019 and May
2021. All patients with suspicious for PCa received mpMRI
and diagnostic biopsy was performed as 12 core TRB. For
patients eligible for focal HIFU, confirmatory TPB was additionally performed. The change of treatment plan of focal
HIFU was analyzed after confirmatory TPB.
Results : A total of 52 patients was analyzed. PCa was foundon one side in 96.2% patients. When combined the results of
TRB and TPB, PCa was confirmed on the contralateral sidein 5 patients and on both side in 2 patients. The treatment

UP3

MRI-TRUS Fusion Biopsies: 30 casesof primary experience

Hirotaka Kishi 1 , Masashi Morita 1 , Shota Kikuchi 1 ,Saori Nakamura 1 , Sho Okada 1 , Aya Hiramatsu 1 ,Tetsuo Noguchi 1 , Yu Ogawa 1 , Takashi Fukagai 2
1
2

Showa University Koto Toyosu Hospital
Showa University Hospital

Background:
The fusion of MRI with transrectal ultrasound allows that
we can find clinically significant prostate cancers, which has
already been reported and is expected to become more widespread.
We started to use Vari Seed ver. 8.02 for MRI-TRUS fusion
biopsies and will report our primary experience.
Materials and Methods:
30 MRI-TRUS fusion biopsy cases are performed in our department from November 2018 to March 2022.
First, the T2-wighted images obtained during a previous
mpMRI are merged with the real-time ones of the TRUS.
Second, targeted biopsies in 3-6 locations and systematic biopsies in 12 locations were performed by a urologist.
Results:
MRI-TRUS fusion biopsy diagnosed 12 prostate cancer
cases in 30 men, and their median age was 64 years, median
PSA was 9.8 ng/mL, and median prostate volume was 29.2
mL.
In the 12 cases, 66.6% is higher than 3 of Gleason gradegroup (4+4 in one case, 4+3 in six cases, 3+4 in one case,and 3+3 in four cases), which is clinically significant cancer.

UP4

How to deal with PI-RADS category3cases?

Eiji Matsubara 1 , Masahiro Kurokawa 1 , Satoshi Amano 1 ,Shintarou Koizumi 1 , Ippei Kurokawa 1 ,Katsuyuki Saitou 1 , Kouzou Fuji 1 , Keiichirou Hayashi 2 ,Aya Hiramatsu 3 , Takashi Fukagai 4
1

Showa University Northern Yokohama Hospital
Tsuzuki Hayashi Urology Clinic
Showa university Koto Toyosu Hospital
4
Showa University
2
3

Purpose: PI-RADS v2 is used as a basis for judging prostatebiopsy indications. Consider whether category 3 cases
should be biopsied.
Patients and Methods: From 2017 to 2021, 353 patients who
underwent prostate biopsy at our department and were
evaluated by PI-RADS v2 were extracted. Systematic 12 locations biopsy was performed and visual registration wasadded. We examined PSA level, positive rate, PSA density(PSAD), and clinically significant prostate cancer(csPCa).
csPCa was defined as prostate cancer with a Gleason scoreof 7 or higher.
Results: Biopsy positive rate and csPCa rate (percentage ofcsPCa among biopsy positive cases) are shown. Overall,
64.9% and 79.4%, category 3: 30.9% and 56.0%, category
4: 69.7% and 78.2%, category 5: 93.8% and 90.5%.
Discussion: The positive rate was low in the group withPSAD of less than 0.18, and no csPCa was detected. It suggests that PSA density may be useful when considering biopsy indications for PI-RADS category 3 cases.

UP5

Role of the Elastography Strain Ratio
using Transrectal Ultrasonography in
the Diagnosis of Clinically Significant
Prostate Cancer

Jeong Woo Yoo , Kwang Suk Lee , Kyo Chul Koo ,Byung Ha Chung
Department of Urology, Gangnam Severance hospital, Yonsei University
College of Medicine, Seoul, Korea

Objectives: The authors investigated the efficacy of elastography strain ratio (ESR) as predictors clinically significant
prostate cancer (csPC) in targeted prostate biopsy.
Methods: A total of 257 patients who underwent magnetic
resonance imaging fusion biopsy were enrolled. Before biopsy, we put regions of interest (zone A) in target lesion,and then another regions of interest (zone B) in levator ani
muscle. ESR is measured as (zone A/zone B). Multivariable
analyses were performed to predict csPC.
Results: Patients who were diagnosed of prostate cancer
were 207 (80.5%) and number of positive prostate cancer
target lesions were 206 (71.5%). For predicting csPC, theESR 侒6.8 was significantly associated with in prostate cancer (+) group (p<0.001 ). The area under the curve (AUC) inconventional variables (Model 1) plus ESR was significantly
higher than the AUC in Model 1 (p=0.001 ).
Conclusion: The study suggests a potential role of ESR in
predicting csPC.

UP6

Withdrawn

UP7

the characteristics of patients withprostate specific antigen persistence
after Robot Assisted Radical
Prostatectomy

Motoki Yamagishi , Yoojin Chung , Toshiki Mugita ,Kota Nishimura , Yoshihiro Nakagami ,Kazuhiko Oshinomi , Yoshiko Maeda , Jun Morita ,Takeshi Shichijo , Takashi FukagaiShowa University school of medicine, Department of Urology

Robot Assisted Radical Prostatectomy(RARP) is a widely
performed procedure for localized prostate cancer in Japan.
All of our surgical total prostatectomies are performed by
RARP.
In the past, we have performed RARP in 372 patients.
Among them, there were 17 cases of Prostate Specific Antigen(PSA) Persistence after RARP without sufficient PSA reduction, although there were a certain number of patientswith post-operative recurrence. The median iPSA was 12.0
(4.28-31.20), and postoperative pathology was GleasonScore (GS) 9 in 2 cases, GS8 in 4 cases, GS7 in 10 cases,
and unknown in 1 case. pTstage was pT2b; 2 EPE(+): 8, RM(+): 10, ly(+): 5, v(+): 6, pn(+): 15, sv(+): 4.
In Japan, PSA blood sampling and imaging diagnosis areused to determine recurrence of prostate cancer after surgery. In Japan, we defined recurrence on the date of surgery
as a case in which the PSA did not fall below 0.2 ng/ml. The
characteristics of this group will be analyzed and reported,
including a discussion.

UP8

Robot-assisted laparoscopic radical
prostatectomy (RARP) induction
results and comparison with open
radical orostatectomy (ORR)

Hideaki Shimoyama 1 , Haruaki Sasaki 1 , Yuta Ogushi 1 ,Ayana Niikura 1 , Yuuki Ichimura 1 , Hiroo Sugishita 1 ,Satoru Tanifuji 1 , Yuuichiro Imamura 1 , Michiya Ota 1 ,Takashi Fukagai 2
1
2

Showa University Fujigaoka Hospital
Showa University

We reported the results of surgery early in the introductionof RARP and compared it with ORR. We report 16 cases inthe early stages of RARP that have been performed at our
hospital. We perform open radical prostatectomy and lymph
node dissection (the basic surgical procedure is only for obturatory lymph nodes, and external, internal, common iliac
lymph node dissection are added depending on the case)mainly for lymph node metastasis cases and high-risk cases.
RARP patients performed significantly better in terms ofblood loss, length of hospital stay, and vesicourethral anastomosis suture failure. There are currently few significant
differences in operative time, surgical margin positivity,
postoperative urinary continence, and postoperative complications, and it is necessary to continued observation.

UP9

Clinical Analysis of Intensity
modulated radiation therapy (IMRT)
for localized prostate cancer at Showa
University

Kazuhiko Oshinomi , Takashi Fukagai , Anju Kawamura ,Yoojin Chung , Yoshiki Tsunokawa , Jin Yamatoya ,Motoki Yamagishi , Yoshihiro Nakagami ,Yoshiko Maeda , Jun Morita , Takeshi Shichijo
Showa University School of Medicine, Department of Urology

Objective: In 2011, our hospital switched from conventional
external irradiation to IMRT. We clinically examined casesof IMRT for localized prostate cancer in our hospital.
Methods: We retrospectively evaluated the outcome and adverse events of IMRT performed for localized prostate cancer in our hospital.
Results: A total of 188 patients who underwent IMRT between November 2011 and December 2021 were included.
Median age at initiation of irradiation was 73 years, and
PSA at diagnosis (median) was 11.8 ng/ml. The NCCN risk
groups were very high/high/intermediate/low 41/70/61/16.
Median follow-up was 41 months, with 10 biochemical recurrences and 2 prostate cancer deaths. The 5-year PSA
progression-free survival was 80.4% only in the very highrisk group, but 95-100% in the other groups. Grade 3 rectal
bleeding was observed in 2 cases (1%).
Conclusion: The biochemical recurrence-free rate was goodin localized cancer, but the recurrence rate was high in very
high- risk group.

UP10 Periprocedural adverse events anddistribution of the SpaceOAR
hydrogel for radiothrapy for prostatecancerMasashi Morita 1 , Hirotaka Kishi 1 , Shota Kikuchi 1 ,Saori Nakamura 1 , Sho Okada 1 , Aya Hiramatsu 1 ,Tetsuo Noguchi 1 , Yu Ogawa 1 , Takashi Fukagai 2 ,John Lederer 3
1
2
3

Department of Urology, Showa University Koto Toyosu Hospital
Department of Urology, Showa Univerisity School of Medicine
Department of Surgery, University of Hawaii at Manoa

PURPOSE: We investigated the frequency of perioperative
adverse events of SpaceOAR procedure, and also evaluated
the gel symmetry.
MATERIALS and METHODS: Four hundred and one patients received placement of SpaceOAR. We investigatedadverse events associated with the procedure in the perioperative period. Physical findings were examined, and
MRI was used to evaluate the symmetry of the gel.
Results: Eight patients experienced perineal pain and discomfort. Urinary retention was observed in 3 patients. Gelcontamination in the prostatic capsule and seminal vesicle
was observed in 1 case each, but there were no symptoms.
No rectal wall placement was observed. Gel was symmetrically placed for 312 patients, remaining 89 patients had

some level of asymmetry, with 5 having far lateral distribution.
Conclusions: Although the placement of the spacer is simple, serious procedure-related adverse events are reported in
the FDA MAUDE database. However, no severe adverse
event were seen in this study.

LigaSure™ は、
一歩先へ
Nano-Coated Jaw は、
シーリング後の組織とアゴ内部のくっつきを抑えます。

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