Accuracy in staging of renal cell carcinoma involving vena cava.

Accurate preoperative staging of renal cell carcinoma is necessary to determine patient prognosis and surgical approach, particularly when tumor thrombus invades the vena cava. The pathologically-confirmed tumor stage was compared with the radiographic preoperative stage in 44 patients undergoing surgery for renal cell carcinoma invading the vena cava (T3cNxMx). Nine patients (20%) were upstaged as the result of extracapsular tumor extension.

Cardiovascular abnormalities associated with human and rodent obesity.

Obesity is a major risk factor for cardiovascular disease. However, a direct link between these two states is difficult to establish, since obesity frequently occurs with other disease states such as diabetes, hypertension and atherosclerosis. Clinical studies have clearly shown that uncorrected obesity is associated with cardiac hypertrophy and compromised ventricular function.

Reappraisal of radical perineal prostatectomy.

Radical prostatectomy is frequently the treatment of choice for localized adenocarcinoma of the prostate. The procedure can be accomplished through either a perineal or a retropubic approach; both have their advantages and disadvantages. Recently, concerns over transmission of blood-borne viruses during transfusions and the advent of laparoscopic pelvic lymphadenectomy have resulted in a rejuvenation of interest in perineal prostatectomy.

Immunoreactive prostatic specific antigen in male periurethral glands.

Prostatic specific antigen (PSA) is considered an antigen unique to benign and malignant prostatic tissue. Recent evidence in the literature has raised serious doubts about the specificity of this antigen. In this study twenty male urethral specimens were evaluated for PSA and prostatic acid phosphatase (PAP) from patients without evidence of prostatic cancer.

The role of radical surgery in the management of radiation recurrent and large volume prostate cancer.

Twenty-two patients seen between 1975 and 1988 were analyzed who had surgical attempts to cure locally advanced prostate cancer by exenterative procedures or salvage surgery for radiation recurrent disease. Twelve patients (Group I) underwent either a salvage cystoprostatectomy or perineal prostatectomy for radiorecurrent disease, including three patients with a Kock continent urinary diversion done in combination with the salvage operation. Five of the 12 (41.

Staging relationships and outcome in early stage testicular cancer: a report from the Testicular Cancer Intergroup Study.

The Testicular Cancer Center Intergroup Study entered surgically staged patients with nonseminomatous tumor and metastases limited to the regional lymph nodes into a previously reported cooperative trial of immediate versus delayed therapy for positive retroperitoneal node disease. Patients with negative nodes (stage I) were placed in an observation registry with specified treatment strategy upon relapse. Of 264 stage I cancer patients 27 (10.

Protective effects of propionyl-L-carnitine during ischemia and reperfusion.

When cardiac function in isolated rat hearts was impaired by subjecting them to ischemia, subsequent perfusion with propionyl-L-carnitine and related compounds increased their rate of recovery. Thus at 11 mM, both propionyl-L-carnitine and, to a lesser extent, its taurine amide, and also acetyl-L-carnitine, significantly restored cardiac function in 15 minutes after 90 minutes of either low-flow or intermittent no-flow ischemia. Carnitine itself was ineffective.

Positive margins: is adjunctive radiation therapy indicated?

Patients with margin positive disease after radical prostatectomy are prognostically disadvantaged. The question of postoperative adjunctive radiotherapy in these patients is controversial. A retrospective study suggested that adjunctive radiation therapy reduced the local recurrence rate but did not alter survival.

Radical surgery versus radiation therapy in early prostatic carcinoma.

Patients with organ-confined prostatic cancer, as determined by digital examination, bone scans and serum acid phosphatase determination, were randomized to radical prostatectomy or external-beam radiation therapy. With respect to first evidence of treatment failure, there was a significant difference in favor of the patients who had surgical treatment. In the patients given radiotherapy there was no essential difference in time to failure as compared with comparable patients in two recent observation-only trials on record.

The relevance of stage A malignancy in prostatic cancer.

Patients with T1 (stage A) prostatic cancer detected on transurethral resection and patients with T2 (stage B) cancer, identified by palpation and needle biopsy, had similar time to failure and survival following radical prostatectomy. Transurethral resection was not associated with a higher degree of failure. The volume of the tumor and the biology of the disease were decisive of the outcome.

DNA in radical prostatectomy specimens. Prognostic value of tumor ploidy.

In a series of 94 patients with prostatic adenocarcinoma the prognostic significance of some factors was studied after radical prostatectomy. DNA ploidy was assessed by flow cytometry of cells from deparaffinized specimens. Gleason sum, seminal vesicle status and ploidy turned all out to be important predictors of disease progression.

Surgical management and prognosis of renal cell carcinoma invading the vena cava.

A total of 44 patients with renal cell carcinoma and vena caval tumor thrombus underwent surgical resection. Of these patients 27 had primary tumor confined within Gerota's fascia, negative lymph nodes and no distant metastases (stage T3cN0M0). Patients who underwent extraction of a mobile tumor thrombus from the vena cava had a 69% 5-year survival rate (median 9.

Radical prostatectomy for clinical stage T1-2N0M0 prostatic adenocarcinoma: long-term results.

A total of 441 stage T1-2N0M0 and 11 stage T1-2N0M0 cancer patients with an elevated acid phosphatase level only, and 18 stage T1-2N+M0 cancer patients underwent radical prostatectomy. Analysis of the 441 stage T1-2N0M0 cancer patients demonstrated that failure and survival were a function of the disease being organ-confined, specimen-confined or margin-positive, with 10-year failure rates of 12, 30 and 60%, respectively. Of the patients with positive margins 44 were and 79 were not irradiated postoperatively.

Primary carcinoma of the upper urinary tract. Effect of primary and secondary therapy on survival.

The pathologic material and medical records of 76 patients with primary upper urinary tract carcinomas were reviewed to identify the role of grade and stage in predicting survival; to determine any differences in survival between ureteral and renal pelvic carcinoma; to understand the role of local therapy in low grade, low stage tumors; and to establish the usefulness of adjuvant therapies in metastatic disease. Kaplan-Meier survival curves with Cox-Mantel analysis for statistical significance revealed both grade and stage to be excellent predictors of survival. No differences in survival were noted between renal pelvic and ureteral carcinomas for equivalent stage tumors.

Effect of somatostatin analogs on gastric acid secretion in dogs and rats.

The effects of several superactive analogs of somatostatin on gastric acid response to various exogenous and endogenous stimulants were investigated in conscious dogs and rats with gastric fistulae (GF). The inhibition was compared to that induced by somatostatin-14 (S-S-14) at two dose levels. Several octapeptide analogs of somatostatin including D-Phe-Cys-Tyr-D-Trp-Lys-Val-Cys-Trp-NH2 (RC-160) and D-Phe-Cys-Tyr-D-Trp-Lys-Val-Cys-Thr-NH2 (RC-121), which were superactive in tests on suppression of GH levels, were 4-5 times more potent than S-S-14 in inhibiting desglugastrin-stimulated gastric acid secretion in GF dogs.

Postoperative radiotherapy of the prostate for patients undergoing radical prostatectomy with positive margins, seminal vesicle involvement and/or penetration through the capsule.

A group of 159 patients previously reported as having margins positive for disease after radical prostatectomy with or without adjunctive postoperative radiation was reanalyzed to determine whether the reported benefit did indeed exist. Upon re-examination of the 159 patients 15 were identified who did not receive radical prostatectomy but who were analyzed as if they had received this therapy. An updated review of the total pool of 159 patients with analysis as to failure, death of any cause or death of prostatic cancer demonstrated no benefit of postoperative radiation therapy for margin positive disease.

Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years.

In an effort to determine the impact of a delayed diagnosis in testicular cancer the records of 148 patients with a known interval of delay were reviewed. The over-all mean symptomatic interval of this population was 21.1 weeks and did not change significantly during an 18-year review period.

Complications of therapy for testicular cancer.

Of 244 patients with testis cancer seen between January 1970 and December 1987 (mean followup 70 months) 88 (36.1%) experienced 1 or more early complications (within 1 year), while 16 (6.6%) had a late (greater than 1 year) complication.

Prostate cancer with solitary parotid metastasis correctly diagnosed with immunohistochemical stains.

A case of prostate cancer in which the parotid gland was the sole site of metastatic disease is presented. Special immunohistochemical stains of the excisional biopsy allowed for rapid, accurate diagnosis and appropriately directed successful therapy.

Is grade or stage of primary importance in determining the outcome after radical prostatectomy for disease clinically confined to the prostate?

A series of 145 patients with T1-2NOMO prostatic carcinoma underwent radical prostatectomy. Specimens were analysed by Gleason sum and categorised according to whether the disease was organ-confined, specimen-confined or margin-positive. The failure of treatment was indicated by elevation of acid phosphatase, by the appearance of biopsy proven local disease or distant nodal disease, or by parenchymal or nodal disease by any imaging modality.