Impact of FTO SNPs and in Prostate Cancer Severity in a Cohort of Puerto Rican Men.

Background: Obesity is prevalent in PR and has been associated with prostate cancer (PCa) mortality and aggressiveness. Polymorphisms (SNPs) and in the FTO gene have been associated with both obesity and PCa. The aim of this work was to ascertain whether the presence of these SNPs is associated with PCa risk and severity in a cohort of Puerto Rican men.

Genetic ancestry and prostate cancer susceptibility SNPs in Puerto Rican and African American men.

Background: The Puerto Rican (PR) population is a racially admixed population that has a high prostate cancer (PCa) mortality rate. We hypothesized in this pilot study that West African Ancestry (WAA) was associated with PCa in this heterogeneous (PR) population.

Methods: A case/case and case/control study was performed.

Outcomes of Minimally Invasive Inguinal Hernia Repair at the Time of Robotic Radical Prostatectomy.

Abdominal straining associated with voiding dysfunction or constipation has traditionally been associated with the development of abdominal wall hernias. Thus, classic general surgery dictum recommends that any coexistent bladder outlet obstruction should be addressed by the urologist before patients undergo surgical repair of a hernia. While organ-confined prostate cancer is usually not associated with the development of lower urinary tract symptoms, a modest proportion of patients treated with radical prostatectomy may have coexisting benign prostatic hyperplasia with elevated symptom scores and hernias may be incidentally detected at the time of surgery.

Preoperative International Prostate Symptom Score Predictive of Inguinal Hernia in Patients Undergoing Robotic Prostatectomy.

Purpose: Studies have shown that encountering an inguinal hernia during robotic radical prostatectomy is not uncommon. We reviewed our experience with simultaneous robotic prostatectomy and mesh hernia repair to identify variables predictive of a hernia.

Materials And Methods: Our cohort consisted of 693 consecutive men who underwent robotic radical prostatectomy as performed by 1 surgeon.

Association of serum lipid levels and prostate cancer severity among Hispanic Puerto Rican men.

Background: While obesity and fat intake have been associated with an increased risk of prostate cancer (PCa) aggressiveness and mortality, the association between lipid levels and PCa phenotype remains unclear. Previous reports evaluating this association are inconsistent and highly variable when considering different racial/ethnic groups. There are scarce data regarding this association among Hispanics, and specifically Puerto Rico's Hispanic men, a population with a higher burden of PCa, metabolic syndrome and overweight.

The ratio of matrix metalloproteinase to E-cadherin expression: a pilot study to assess mRNA and protein expression among African American prostate cancer patients.

Background: We assessed the expression of Matrix Metalloproteinase (MMP) to E-cadherin (M/E ratio) to determine the correlation of gene expression with pathologic variables and outcome in a cohort of African American (AA) prostate cancer patients.

Methods: Tumors from formalin-fixed, paraffin embedded RP specimens were examined. Gleason scores were 6, 7, and >or=8 in 7, 16, 13 tumors, respectively.

Cytoreductive nephrectomy for metastatic renal cell carcinoma with nonclear cell histology.

Purpose: To our knowledge the benefit of cytoreductive surgery for patients with metastatic renal cell carcinoma with nonclear cell histology is unknown. In this retrospective study we report our experience with cytoreductive nephrectomy for nonclear cell metastatic renal cell carcinoma at M. D.

Cytoreductive nephrectomy for T4NxM1 renal cell carcinoma: the M.D. Anderson Cancer Center experience.

Objectives: Although cytoreductive nephrectomy may provide a survival benefit in metastatic renal cell carcinoma, patients with locally advanced lesions may be denied cytoreduction because of a perceived worse outcome and increased morbidity. We reviewed our experience with cytoreductive nephrectomy in patients with contiguous organ involvement (Stage T4NxM1) to evaluate the outcome and morbidity.

Methods: From 1993 to 2004, 498 patients underwent cytoreductive nephrectomy for renal cell carcinoma.

Renal cell carcinoma clinically involving adjacent organs: experience with aggressive surgical management.

Background: Historically, patients with nonmetastatic renal cell carcinoma (RCC) involving adjacent organs have been considered inoperable and incurable. The oncologic efficacy of an aggressive surgical approach was evaluated in a selected subpopulation of RCC patients. Further, an attempt was made to define the clinical and pathologic characteristics predictive of surgical failure.

African-American men with nonpalpable prostate cancer exhibit greater tumor volume than matched white men.

Background: Although prostate cancer (PC) mortality disproportionately affects African-American (AA) men, limited data exist comparing the pathologic characteristics of white and AA patients with nonpalpable PC (clinical stage T1c).

Methods: The authors reviewed the radical prostatectomy (RP) specimens from 37 consecutive AA men with clinical stage T1c PC and 35 white men who were matched for age, clinical stage, serum prostate-specific antigen (PSA) level, year of surgery, prostate weight, and prostate biopsy strategy. Pathologic characteristics were compared after mapping tumor foci and calculating tumor volumes by using computer software.

Renal cell carcinoma with nodal metastases in the absence of distant metastatic disease (clinical stage TxN1-2M0): the impact of aggressive surgical resection on patient outcome.

Purpose: Nodal disease in the setting of metastatic renal cell carcinoma is associated with poor prognosis. However, to our knowledge the biology of nodal metastases in the absence of metastatic disease is unknown. We reviewed our experience with treating this subset of patients with aggressive surgical resection.

Is patient age a factor in the occurrence of prostate-specific antigen bounce phenomenon after external beam radiotherapy for prostate cancer?

Objectives: To evaluate the effect of patient age on the occurrence of prostate-specific antigen (PSA) "bounce" after external beam radiotherapy (EBRT) for prostate cancer.

Methods: In this study, 964 patients received EBRT alone for prostate cancer between April 1987 and January 1998 who had been followed for at least 12 months. Prostate-specific antigen values were obtained every 3 to 6 months after radiotherapy.

Melanoma of the penis, scrotum and male urethra: a 40-year single institution experience.

Purpose: Genitourinary melanoma is rare and classically associated with a poor prognosis. We describe our experience with 10 patients with penile or urethral involvement. In addition, we present what is to our knowledge the largest reported series of melanoma of the scrotum (6 cases).

Prognostic factors for survival among Caucasian, African-American and Hispanic men with androgen-independent prostate cancer.

Background: African-American men suffer disproportionately with respect to the incidence and mortality from prostate cancer. The objective of the current study was to define if race was an independent prognostic factor among other variables assessed for survival among men treated for androgen independent prostate cancer.

Methods: Between 1988 and 1995, 379 patients with AIPC and clinical progression were referred for novel protocol therapies.

A renal mass in the setting of a nonrenal malignancy: When is a renal tumor biopsy appropriate?

Background: Frequently, a renal mass is identified when patients with cancer undergo studies for staging or surveillance. In determining whether it represents a metastasis, patients are frequently subjected to percutaneous renal biopsies. The authors evaluated their experience with this dilemma to formulate management guidelines.

The role of lymphadenectomy in penile cancer.

In patients with squamous carcinoma of the penis, the presence and extent of metastases involving the inguinal nodes are the most important factors predictive of survival. Favorable prognostic indicators of cure in surgically treated patients in whom metastases develop include: (1) minimal nodal disease, (2) unilateral involvement, (3) no evidence of extranodal extension of cancer, and (4) absence of pelvic nodal metastases. Prophylactic lymphadenectomy in select patients at high risk for metastasis seems reasonable in lieu of prospective randomized trials because novel procedures have significantly decreased the morbidity of surgical staging.

Racial influence on biochemical disease-free survival in men treated with external-beam radiotherapy for localized prostate cancer.

Background: We retrospectively analyzed the clinical characteristics and outcomes of various racial and ethnic groups who underwent radiotherapy alone for localized or locally advanced prostate cancer.

Methods: From April 1987 to January 1998, 964 patients underwent full-dose, external-beam radiotherapy alone for localized or locally advanced prostate cancer and were included in the study. The patients' medical records were reviewed for pertinent information.

Young age is an independent prognostic factor for survival of sporadic renal cell carcinoma.

Purpose: Compared to older adults with renal cell carcinoma (RCC) our subjective impression has been that younger adults present with more unfavorable histological features and yet respond more favorably to aggressive therapies. We reviewed our experience to validate these observations.

Materials And Methods: We reviewed the medical records of 106 consecutive patients 40 years or younger and 145 consecutive 58 to 61-year-old patients referred for the surgical management of sporadic RCC between 1992 and 2002.

Natural history, management, and surveillance of recurrent squamous cell penile carcinoma: a risk-based approach.

For men with penile carcinoma, surveillance strategies may be tailored to the risks of local and regional recurrence, which vary according to the pathologic characteristics of the primary tumor and the modalities employed for local therapy (phallus sparing or extirpative) and regional therapy (surveillance or lymphadenectomy). Men at a higher risk for local or regional recurrence who should have more rigorous follow-up include those (1) treated with phallus-sparing strategies such as laser ablation, topical therapies, or radiotherapy; (2) patients with clinically negative inguinal lymph nodes who are managed without lymphadenectomy despite high-risk primary tumors (pT2-3, grade 3, vascular invasion); and (3) those with lymph node metastases after lymphadenectomy. Good candidates for less-stringent surveillance include patients with low-risk primary tumors (pTis, pTa, pT1, grades 1-2) and those with negative inguinal nodes after lymphadenectomy whose primary tumors were managed with partial or total penectomy.

Closed suction or penrose drainage after partial nephrectomy: does it matter?

Purpose: Prospective studies in the general surgery literature have shown fewer wound related complications with closed suction drainage than with open passive drainage. Nevertheless, some urologists avoid closed suction drains after partial nephrectomy mainly because of a theoretical increased risk of a prolonged urinary leak or delayed hemorrhage.

Materials And Methods: We reviewed the records of 184 patients who underwent 197 consecutive partial nephrectomies at our institution.

Clinical features and treatment outcome of Hispanic men with prostate cancer following external beam radiotherapy.

Purpose: We retrospectively analyzed the clinical characteristics and outcomes of Hispanic men compared with other groups who underwent radiotherapy alone for localized or locally advanced prostate cancer.

Materials And Methods: Between April 1987 and January 1998, 964 men who underwent full dose external beam radiotherapy alone for localized or locally advanced prostate cancer were included in the study. Patient medical records were reviewed for pertinent information.

An interval longer than 12 weeks between the diagnosis of muscle invasion and cystectomy is associated with worse outcome in bladder carcinoma.

Purpose: The standard of care for muscle invasive transitional cell carcinoma of the bladder is radical cystectomy. Definitive therapy may often be delayed for various reasons. We assessed whether pathological stage and survival correlated with the length of time between diagnosis of muscle invasion and cystectomy.