Tumor-Infiltrating Myeloid Cells Co-Express TREM1 and TREM2 and Elevated TREM-1 Associates With Disease Progression in Renal Cell Carcinoma.

Myeloid-derived suppressor cells (MDSC) and tumor-associated macrophages (TAM) contribute to cancer-related inflammation and tumor progression. While several myeloid molecules have been ascribed a regulatory function in these processes, the triggering receptors expressed on myeloid cells (TREMs) have emerged as potent modulators of the innate immune response. While various TREMs amplify inflammation, others dampen it and are emerging as important players in modulating tumor progression-for instance, soluble TREM-1 (sTREM-1), which is detected during inflammation, associates with disease progression, while TREM-2 expression is associated with tumor-promoting macrophages.

Patient Disposition Patterns following Transurethral Resection of Bladder Tumor Vary Widely: SEER-Medicare Analyses of Postoperative Discharge Practices.

Introduction: Following transurethral resection of bladder tumor, patients can be discharged home, observed for 24 hours or admitted to the hospital. While disposition can impact care delivery value, little is known about postoperative management patterns. We examined national trends and predictors of disposition following transurethral resection of bladder tumor.

Prediction of significant estimated glomerular filtration rate decline after renal unit removal to aid in the clinical choice between radical and partial nephrectomy in patients with a renal mass and normal renal function.

Objectives: To develop a clinically applicable predictive model to quantitate the risk of estimated glomerular filtration rate (eGFR) decline to ≤45 mL/min/1.73 m after radical nephrectomy (RN) to better inform decisions between RN and partial nephrectomy (PN).

Patients And Methods: Our prospectively maintained kidney cancer registry was reviewed for patients with a preoperative eGFR >60 mL/min/1.

Neoadjuvant Dose-dense Gemcitabine and Cisplatin in Muscle-invasive Bladder Cancer: Results of a Phase 2 Trial.

Background: Accelerated (also termed dose-dense, DD) chemotherapy regimens such as accelerated methotrexate, vinblastine, doxorubicin, and cisplatin have shown better efficacy and tolerability in the metastatic setting, and shortened the time to surgery in the neoadjuvant setting compared to standard-schedule regimens. We hypothesized that a DD schedule of gemcitabine and cisplatin (GC) would shorten the time to surgery and yield similar pathologic complete response rates (pT0) in patients with muscle-invasive bladder cancer (MIBC) compared with historical controls with standard GC.

Objective: To determine the safety and efficacy of neoadjuvant DDGC in MIBC.

WBC Associates with Readmission Following Cystectomy.

Radical cystectomy is associated with perioperative complication rates exceeding 50% in some series. Readmission rates are increasingly used as a surgical quality metric. White blood cell count is a crude surrogate for physiologic processes which may reflect postoperative complications leading to readmission.

Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery.

Purpose: We aimed to determine incidence, pathologic findings, prognostic factors and clinical outcomes for patients with clinically localized papillary RCC.

Methods: Demographic, clinical and pathologic findings were collected on all patients with PRCC undergoing surgery at four academic medical centers. The primary endpoint was cancer-specific survival (CSS).

Treatment of localized prostate cancer in elderly patients.

Prostate cancer is a disease of the elderly. According to National Cancer Institute, more than 56.7% of incident cases are diagnosed and more than 90% of cancer specific deaths occur in men greater than 65 years of age.

Endoscopic management of genitourinary foreign bodies.

Retrieval of foreign bodies from the genitourinary system, most commonly inserted for sexual satisfaction or as a result of a psychiatric illness, can pose a significant surgical challenge. Due to their breadth of size, shape, and location within the genitourinary system, endoscopic management can be difficult. Here, we review the management of four cases of foreign object insertion into the genitourinary system and their outcomes and management.

11C-acetate PET/CT before radical prostatectomy: nodal staging and treatment failure prediction.

Unlabelled: Despite early detection programs, many patients with prostate cancer present with intermediate- or high-risk disease. We prospectively investigated whether (11)C-acetate PET/CT predicts lymph node (LN) metastasis and treatment failure in men for whom radical prostatectomy is planned.

Methods: 107 men with intermediate- or high-risk localized prostate cancer and negative conventional imaging findings underwent PET/CT with (11)C-acetate.

Surgical cyst decortication in autosomal dominant polycystic kidney disease.

Purpose: To provide a summary of the relevant literature regarding the impact of surgical cyst decortication on hypertension, renal function, and pain management in patients with autosomal dominant polycystic kidney disease (ADPKD).

Methods: Data collection was conducted via a Medline search using the subject headings autosomal dominant polycystic kidney disease, surgery, decortication, and marsupialization. Additional reports were derived from references included within these articles.

Long-term impact of laparoscopic cyst decortication on renal function, hypertension and pain control in patients with autosomal dominant polycystic kidney disease.

Purpose: Cyst proliferation in patients with autosomal dominant polycystic kidney disease is associated with renal failure, hypertension and pain. We examined the long-term impact of laparoscopic cyst decortication on renal function, hypertension and pain control in patients with adult dominant polycystic kidney disease presenting with refractory pain.

Materials And Methods: Between 1994 and 2003, 37 patients with adult dominant polycystic kidney disease underwent laparoscopic cyst decortication at Barnes-Jewish Hospital.

Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience.

Introduction: Robotic Pyeloplasty (RAP) is a technique for management of ureteropelvic junction obstruction (UPJO).

Purpose: To report outcomes of RAP for primary and secondary (after failed primary treatment) UPJO.

Materials And Methods: Single institution data of adult RAP performed from 2007 to 2009 was collected retrospectively following approval by our IRB.

Robot-assisted partial nephrectomy: evaluation of learning curve for an experienced renal surgeon.

Purpose: The learning curve for robot-assisted partial nephrectomy (RAPN) has not been extensively studied. We therefore evaluated the learning curve of RAPN for a fellowship-trained laparoscopic surgeon with extensive prior experience with laparoscopic partial nephrectomy (LPN). We also examined the potential effect of tumor size on the learning curve.

The prepuce: preservation and reconstruction.

Purpose Of Review: To analyze the role of prepuce preservation in various disorders and discuss options available to reconstruct the prepuce.

Recent Findings: The prepuce can be preserved in selected cases of penile degloving procedures, phimosis or hypospadias repair, and penile cancer resection. There is no clear evidence that debilitating and persistent preputial lymphedema develops after a prepuce-sparing penile degloving procedure.

Suppression of p65 phosphorylation coincides with inhibition of IkappaBalpha polyubiquitination and degradation.

Transcription factor nuclear factor-kappaB (NF-kappaB) is held in the cytoplasm in an inactive state by IkappaB inhibitors. Oncogenic activation of NF-kappaB is achieved by stimulus-induced ubiquitination and subsequent proteasome-mediated degradation of IkappaBalpha. Once released from the inhibitor, NF-kappaB/p65 enters the nucleus.