Intravenous cyclophosphamide in patients with chronic systemic inflammatory diseases: morbidity and mortality.

Background: Few data exist concerning the development of malignancies and haemorrhagic cystitis in patients with systemic autoimmune diseases previously treated with intravenous (iv) cyclophosphamide (CYC). The use of mesna prophylaxis is also controversial.

Methods: The medical records of all patients with chronic systemic inflammatory diseases treated with iv or oral CYC at Stavanger University Hospital from 1985 to 1999 were reviewed.

Radiation dose escalation combined with hormone therapy improves outcome in localised prostate cancer.

We present the impact of systematic radiation dose escalation from 64 Gy to 66 Gy to 70 Gy on the outcome after radiation therapy (RT) alone or combined with hormonal treatment (HT) in a series of 494 consecutive localised prostate cancer patients treated during 1990-1999. Prognostic factors for prostate-specific antigen (PSA) failure, overall survival (OS) and prostate cancer specific survival (CSS) were investigated using multivariate analysis. T stage, pre-treatment PSA, grade, radiation dose and HT were found to be independent predictors of PSA failure.

[Scrotal pain and Henoch-Schönlein purpura].

An acute scrotum is a potential urologic emergency and requires urgent evaluation in order to rule out conditions that need immediate surgical management. The most important condition to rule out is torsion of the testis. In cases of less emergency, a wide variety of differentials may be considered.

DNA cytometric features in biopsies of TaT1 urothelial cell cancer predict recurrence and stage progression more accurately than stage, grade, or treatment modality.

Objectives: To compare retrospectively the predictive value for recurrence and stage progression of DNA ploidy and S-phase fraction by flow cytometry and highly automated ultrafast image cytometry (ICM) in biopsies of TaT1 urothelial cell carcinomas (UCCs) of the urinary bladder with stage, grade, other pathologic features, and treatment.

Methods: Three experienced pathologists reviewed the stage and grade of 228 UCCs; 193 (85%) consensus cases were analyzed further. We had enough material for single-cell suspensions for both flow cytometry and ICM in 183 cases (94.

Proliferation markers and DNA content analysis in urinary bladder TaT1 urothelial cell carcinomas: identification of subgroups with low and high stage progression risks.

Aims: To evaluate whether in situ biomarkers Ki67, mitotic activity index (MAI), p53, mean area of the 10 largest nuclei (MNA10), and whole genome DNA ploidy by flow and image cytometry (FCM and ICM, respectively) have independent prognostic value in urinary bladder urothelial cell carcinomas (UCs).

Methods: Ki67 and p53 immunoquantitation was performed in TaT1 consensus diagnosis UCs. MAI and MNA10 were also determined.

Reproducibility and prognostic variability of grade and lamina propria invasion in stages Ta, T1 urothelial carcinoma of the bladder.

Purpose: We assessed the reproducibility and prognostic variability of grade and lamina propria invasion in stages Ta, T1 urothelial carcinoma of the bladder.

Materials And Methods: A total of 130 consecutive stages Ta, T1 urothelial carcinomas routinely diagnosed by 15 pathologists (original diagnosis) were reviewed by 3 independent experienced pathologists using 1999 WHO criteria (diagnoses 1 to 3 and reviewer consensus diagnosis). Interreviewer disagreement cases were blindly reviewed again.

Tissue prostate-specific antigen and androgen receptor immunoreactivity in prostate cancer biopsies before, during and after neo-adjuvant androgen deprivation followed by radiotherapy.

Objective: The purpose of the study was to examine the immunohistochemical stainability of prostate-specific antigen (PSA) and androgen receptor (AR) in biopsies from localised prostate cancers before treatment, after androgen deprivation and after radiation therapy.

Patients And Methods: Biopsies were taken from 16 men with prostate cancer (T1-3,Nx,M0) before the start (START) of androgen deprivation with LHRH analogue, during the following pelvic lymph node dissection (PLND), and twice after radiotherapy (POSTRAD and FINAL).

Results: Malignant cells were observed in all START, PLND and POSTRAD biopsies and in 6 of 7 FINAL specimens.

[Normal tissue radiation toxicity in radiotherapy of localized prostatic cancer].

Radical radiotherapy of prostate cancer has to balance tumour control against the risk of radiation injury of normal tissue. The normal tissue toxicity is the main dose-limiting factor, and consequently a limiting factor of the curative potential of prostate cancer by irradiation. The SOMA scale is a new toxicity scoring system that registers late side effects from the most important anatomical sites.

[Urogenital tuberculosis].

Urogenital tuberculosis has unspecific clinical symptomatology. This is often a result of the complications of the disease. Clinical symptoms, X-ray examinations, urinary microscopy, cultures and cytological and histological examinations may reveal the diagnosis.

[Laser treatment of benign prostatic hyperplasia].

Transurethral resection of the prostate (TURP) has been the gold standard for BPH for over 50 years. For the last five years laser treatment of BPH has been developed as a new modality. The principles of laser surgery and the options available in clinical practice today are outlined.

Epirubicin combined with estramustine phosphate in hormone-resistant prostate cancer: a phase II study.

Twenty-four assessable patients with hormone-resistant prostate cancer (HRPC) were to receive daily doses of oral estramustine phosphate (EMP), 10 mg kg(-1), and intravenous epirubicin (EPR) infusions, 100 mg m(-2), every third week up to a cumulative dose of 500 mg m(-2). Biochemical response [> or = 50% reduction in pretreatment serum prostate-specific antigen (PSA) after three cycles of > or = 3 weeks' duration] was demonstrated in 13 of 24 patients included (54%). No objective response (WHO criteria) was observed, although seven of nine evaluable patients achieved a > or = 50% serum PSA reduction.

How safe is surveillance in patients with histologically low-risk non-seminomatous testicular cancer in a geographically extended country with limited computerised tomographic resources?

In patients with clinical stage I non-seminomatous testicular cancer only limited information is available about the administrative problems with the surveillance programme, in particular if this policy is to be implemented in a geographically extended country with limited computerised tomography (CT) resources. One hundred and two patients with non-seminomatous testicular cancer clinical stage I and low-risk histology (MRC criteria, UK) were followed by the surveillance policy for at least 1 year after orchiectomy (median 47 months, range 21-81 months). Twenty-two patients (22%) relapsed after a median time of 5 months (range 2-18 months), 14 of them in the retroperitoneal space.

A bladder cancer multi-institutional experience with total cystectomy for muscle-invasive bladder cancer.

Background: The role of total cystectomy was to be assessed in the curative treatment of muscle-invasive bladder cancer.

Methods: Two hundred and fifty-three patients with T2-T4a transitional cell carcinoma of the urinary bladder were referred to precystectomy radiation therapy (46 Gy, 66 patients; 20 Gy, 187 patients). These patients represented approximately 20% of all patients developing muscle-invasive bladder cancer in Southern Norway from 1980-1990.

Clinical significance of DNA ploidy and S-phase fraction and their relation to p53 protein, c-erbB-2 protein and HCG in operable muscle-invasive bladder cancer.

DNA ploidy and S-phase fraction (SPF), determined by flow cytometry were studied in 118 patients with muscle-invasive transitional cell carcinoma (TCC) of the urinary bladder, scheduled for cystectomy after pre-operative radiotherapy (20 Gy/1 week) with or without systemic cisplatin-based neo-adjuvant chemotherapy. The correlation between these parameters and immunohistochemically demonstrated p53, c-erbB-2 and HCG was also investigated. There were 16 DNA diploid and 102 DNA non-diploid tumours.

[Synchronous bilateral testicular cancer with different histologies].

Synchronous appearance of bilateral testicular germ cell tumours is a rare clinicopathologic entity. The incidence is estimated to be approximately 1% of all testicular tumours. Synchronous cases of different cell types on each side are extremely uncommon.

Testicular histology after treatment with LH-RH analogue for carcinoma of the prostate.

Orchiectomy was performed in 16 patients because of progression of prostatic cancer despite adequate medical castration with goserelin (Zoladex, ICI) over a mean period of 17.6 months. Severe tubular atrophy was seen in the testes.

Digital rectal examination to screen for prostatic cancer.

In a prospectively designed study 480 men, aged 45-67 years of age having routine medical examinations as part of the Occupational Health Service Program, underwent digital rectal examination to screen for early prostatic cancer. 26 men were referred to the Urology Service of the Aust-Agder Central Hospital for repeat examinations and further diagnostic procedures. Biopsies were performed on 16 patients, and transrectal ultrasound examination on 9.

Noninvasive evaluation of the enlarged prostate preliminary results.

The choice between a conventional endoscopic examination of the prostate and a noninvasive technique with ultrasound raises a basic question: Which method is most reliable and informative yet has an acceptable costbenefit ratio? One hundred patients selected on the basis of fixed criteria were examined by ultrasonography and so far 50 have been operated on. Pathologic conditions were observed in the upper urinary tract at ultrasonography in 18% of the cases. The method was found reliable as a basis for the choice between open prostatectomy and transurethral resection.

Pre-cystectomy chemotherapy in patients with muscle infiltrating bladder carcinoma. A multicentre feasibility study.

Fourteen patients with muscle infiltrating bladder cancer in whom total cystectomy was planned, received 3 cycles of cis-platinum (70 mg/m2 Day 1) and Methotrexate (40 mg/m2 Day 1) with 3-week intervals before pelvic radiotherapy (20 Gy). Thirteen patients underwent cystectomy whereas the remaining patient finally was found to be inoperable. The subjective toxicity (nausea, vomiting, decrease of performance status), the hematological side effects and the nephrotoxicity of this pre-cystectomy treatment were acceptable.