Predictors of positive surgical margins after radical perineal prostatectomy.

Introduction/objective: Margin positivity has been a well described adverse prognostic factor in patients undergoing radical prostatectomy. Previous studies with regards to predictors of margin positivity after prostatectomy have primarily focused on the retropubic or robotic approach. We sought to examine the predictors of margin positivity in a contemporary series of men undergoing radical perineal prostatectomy (RPP).

Digital fecal occult blood testing in the ambulatory urology clinic.

Background: This study was designed to evaluate the use and yield of fecal occult blood testing (FOBT) in an ambulatory urology clinic.

Study Design: Patients seen in the ambulatory urology clinic were prospectively evaluated with FOBT. The test was performed only on patients when a rectal examination was indicated as part of their urologic evaluation.

Finasteride as a chemopreventive agent in prostate cancer: impact of the PCPT on urologic practice.

Prostate cancer chemoprevention involves the use of natural and/or synthetic agents that inhibit or reverse the development of precancerous lesions or delay progression of these lesions to invasive disease. The recent completion of the first Phase III trial for prostate cancer prevention, the Prostate Cancer Prevention Trial (PCPT) using the drug finasteride, has provided the urologic community with the first evidence that a chemopreventive agent can reduce the risk of developing prostate cancer. The enthusiasm for the clear relative risk reduction in the finasteride arm of the trial has been tempered by the observation that the incidence of high-grade tumors was higher in men receiving finasteride compared to those on placebo.

Phase I trial of intravesical docetaxel in the management of superficial bladder cancer refractory to standard intravesical therapy.

Purpose: Up to 50% of patients treated with intravesical agents for superficial bladder cancer will experience recurrence. Response rates to second-line intravesical therapies range from 20% to 40%. For these high-risk patients, novel agents are necessary to prevent recurrence.

A postoperative prognostic nomogram predicting recurrence for patients with conventional clear cell renal cell carcinoma.

Purpose: Few published studies have simultaneously analyzed multiple prognostic factors to predict recurrence after surgery for conventional clear cell renal cortical carcinomas. We developed and performed external validation of a postoperative nomogram for this purpose. We used a prospectively updated database of more than 1,400 patients treated at a single institution.

A contemporary evaluation of cytoreductive nephrectomy with tumor thrombus: Morbidity and long-term survival.

Background: Metastatic renal cell carcinoma (RCC) is an aggressive entity that frequently invades the venous system. We evaluated the morbidity and survival of patients with tumor thrombus who undergo cytoreductive nephrectomy.

Materials And Methods: We identified 56 patients from our institution's database who had a primary renal tumor in place and documented metastases at the time of surgery.

Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult.

Objectives: To determine the natural history of patients younger than 40 years (young patient [YP] group) who are diagnosed with a sporadic renal cortical tumor (RCT) and to compare the natural history of these patients with the more typical older patient (OP) with RCT.

Methods: We reviewed our database and identified 34 patients (younger than 40 years old, median age 35) who underwent surgery for a sporadic RCT. The YP group outcomes were compared with 100 patients between 41 and 85 years (median 65).

Partial nephrectomy: the rationale for expanding the indications.

Background: We report preliminary results of partial nephrectomy for renal tumors of > or =4 cm in 39 patients with the intent of extending the indications for kidney-sparing surgery.

Methods: From July 1989 to October 2001, 39 patients underwent a partial nephrectomy for renal cortical tumors >4 cm in maximum diameter. Fourteen (36%) had the procedure performed for essential reasons, and 25 (64%) had an elective kidney-sparing operation.