Long responders to estramustine monophosphate. Report of two cases and literature review.

Objective: Estramustine is an stable estradiol and nitrogenated mustard conjugatewith antymicotic properties. Currently, with the appearance of chemotherapy and new molecules, estramustin acetate is not a drug of choice for castration resistant prostate cancer.

Methods: We describe two patients with castration resistant prostate cancer under treatment with estramustine acetate and complete biochemical response and stable disease.

Comparison of permanent (125)I seeds implants with two different techniques in 500 cases of prostate cancer.

Purpose: To perform a comparative study of 500 consecutive (125)I seeds implants for intracapsular prostate carcinoma with two techniques differing in terms of both strand implantation and planning.

Material And Methods: From 2002 to 2007 we performed 250 implants with fixed stranded seeds (RapidStrand™) and a preplanning system and from 2007 to 2010, 250 with real-time and ProLink™ system. Mean age was 68 and 66, respectively, median PSA (prostate-specific antigen) 7.

[Dynamic sentinel node biopsy in penile cancer. Indications, technique and results in a Spanish oncological center].

Objective: Penile cancer has a predominantly lymphatic dissemination. Lymph nodes metastatic involvement conditions disease prognosis and inguinal lymph node dissection has both prognostic and therapeutic value. High and intermediate risk patients with non-palpable lymph nodes will benefit of a precise diagnosis by means of selective sentinel node biopsy with minimal surgical aggressiveness.

Obligatory information that a patient diagnosed of prostate cancer and candidate for an active surveillance protocol must know.

Objectives: To know the necessary information to reproduce the results found in the literature on active surveillance (AS) in prostate cancer (PCa) in our own center so that the information would be objective and correctly given to the patients. We have aimed to study the percentage of candidates for AS chosen in our setting, and the data on infrastaging, subgrading and prediction of insignificant PCa, debugging the predictive value of clinical variables to improve our selection criteria and finally to analyze the results of our patients enrolled in AS.

Materials And Methods: A retro- and prospective review of our data bases was performed.

Optimizing prostate cancer screening; prospective randomized controlled study of the role of PSA and PCA3 testing in a sequential manner in an opportunistic screening program.

Objectives: To reduce unnecessary biopsies (Bx) in an opportunistic screening programme of prostate cancer.

Material And Methods: We perform a prospective evaluation of PCA3 as a second line biomarker in an opportunistic screening for prostate cancer (PCa). From September-2010 until September-2012, 2,366 men, aged 40-74 years and with >10 years life expectancy, were initially screened with PSA/digital rectal examination (DRE).

Radical prostatectomy is a reasonable treatment for patients over 70 years of age.

Objective: To compare the tumor nature and oncological course of patients operated on by radical prostatectomy in three age groups.

Material And Method: From the prospective completion of the data base of our department, we analyzed 1012 patients operated on between 1986 and December 2009. Patients with neo- or adjuvant treatment and those with pre-operative PSA over 50 were excluded.

Margin status is a very important prognostic factor for patients with pT3b prostate cancer.

Objective: Despite early diagnosis of prostate cancer, seminal vesicle invasion is still a common clinical scenario nowadays. The objective of this study is to evaluate clinical and pathological prognostic factors in that subgroup of patients.

Material And Methods: After approval of our Ethical Committee, we selected all pT3b prostate cancer patients operated between 1987 and 2010.

[Outcomes of expanded use of PCA3 testing in a Spanish population with clinical suspicion of prostate cancer].

Objectives: DD3(PCA3) (PCA3) gene expression is prostate cancer-specific. Routine use of this biomarker has resulted in a 35-67% reduction in the number of required biopsies. The aim of this study is to evaluate our outcomes in its routine use and to establish in which group of patients this is the most efficient, depending on the number of previous PCA3 biopsies.

[Results of 125-iodine seed implant with preplanning system in 250 patients with prostate cancer].

Introduction: We review the experience with prostate carcinoma patients treated with permanent implants of 125-I seeds and the outcome eight years after the beginning of this technique.

Material And Methods: From 2002 to 2007 we have performed 250 implants with LDR brachytherapy with RapidStrand(®) and preplanning system. Mean age was 68 (49-78).

[Reconstruction of the glans with free-skin graft applying the Bracka technique].

Introduction: We analyse our experience in the conservative surgical management of penile cancer and/or penile skin pathologies at our institution.

Material And Methods: We have retrospectively reviewed all the skin grafting procedures performed in penile surgery in the last eight years. We show the indications and results of these surgical procedures and the detailed surgical technique originally described by Bracka.

[Metastatic progression, cancer-specific mortality and need for secondary treatments in patients with clinically high-risk prostate cancer treated initially with radical prostatectomy].

Purpose: To determine our results in high risk (HR) prostate cancer (PCa) patients treated with radical prostatectomy (RP) and to establish preoperative prognosis factors.

Material And Methods: Retrospective study of 925 RP. Mean follow-up for the HR group was 89.

Bladder preservation in selected patients with muscle-invasive bladder cancer by complete transurethral resection of the bladder plus systemic chemotherapy: long-term follow-up of a phase 2 nonrandomized comparative trial with radical cystectomy.

Background: Many phase 2 bladder-sparing programmes using transurethral resection of the bladder (TURB) plus chemotherapy or radio-chemotherapy have been undertaken, but some controversies remain.

Objective: To determine the efficacy of complete TURB plus three cycles of cisplatin-based chemotherapy in selected patients with muscle-invasive bladder cancer (MIBC).

Design, Setting, And Participants: A phase 2 nonrandomized trial was designed that included patients with MIBC who underwent complete TURB with positive biopsies of the tumour bed.

Secondary effects and biochemical control in patients with early prostate cancer treated with (125)-I seeds.

Objective: To retrospectively evaluate the toxicity of low-dose-rate brachytherapy and to relate it to the dose-volume to organs at risk.

Material And Methods: We study 160 patients with early prostate cancer, treated with (125)-I implants. Most of them were T1c (63.

Conservative elective treatment of upper urinary tract tumors: a multivariate analysis of prognostic factors for recurrence and progression.

Purpose: We evaluate the safety and efficacy of conservative elective treatment of upper urinary tract tumors, and determine predictive factors for recurrence and progression to optimize indications of this type of treatment.

Materials And Methods: Since 1984 we have performed a prospective study of conservative treatment of single, low grade and stage, less than 3 cm. upper tract tumors.

Clinical panurothelial disease in patients with superficial bladder tumors: therapeutic implications.

Purpose: We established the prognostic and therapeutic implications of panurothelial involvement in patients with superficial bladder tumors for optimizing therapeutic approaches in those at risk for panurothelial involvement.

Materials And Methods: We studied the records of 35 patients with clinical panurothelial disease. Since all of these patients presented with high risk superficial bladder cancer during followup, they were included in specific therapeutic and followup regimens.

Prospective validation of the association of local tumor stage and grade as a predictive factor for occult lymph node micrometastasis in patients with penile carcinoma and clinically negative inguinal lymph nodes.

Purpose: We prospectively validated the association of local tumor stage and grade as a predictive factor for occult lymph node micrometastasis in patients with penile carcinoma and clinically negative lymph nodes.

Materials And Methods: In a retrospective study of 66 patients we demonstrated the predictive value of the association of local tumor stage and grade for occult micrometastasis, identifying 3 risk groups. A therapy strategy was designed according to these risk groups.

Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup.

Purpose: We analyze the impact of a single mitomycin C instillation in patients with low risk superficial bladder cancer with short and long-term followup.

Materials And Methods: A total of 131 patients with low risk superficial bladder cancer were included in a prospective randomized controlled trial. All patients had a 3 cm or less single, papillary, primary or recurrent tumor and were disease-free for more than 1 year.

Feasibility of transurethral resection for muscle infiltrating carcinoma of the bladder: long-term followup of a prospective study.

Purpose: We analyzed the long-term results of radical transurethral resection for the treatment of a large series of patients with muscle infiltrating bladder cancer entered into a prospective study to determine progression predictive factors.

Materials And Methods: The study included 133 patients with invasive bladder cancer treated by radical transurethral resection who had negative biopsies of the muscle layer of the tumor bed. Followup was more than 5 years for all subjects and more than 10 years in 59 (44.

Upper urinary tract involvement in patients with bladder carcinoma in situ (Tis): its impact on management.

Objectives: To analyze the biologic behavior and etiologic mechanism of upper-tract involvement in patients with bladder cancer in situ (Tis) and its impact on management of these patients.

Methods: One hundred thirty-eight patients with bladder Tis, 786 with superficial bladder cancer, and 179 patients with invasive bladder cancer treated by cystectomy were studied: 34 (24.6%), 18 (2.

Extravesical involvement in patients with bladder carcinoma in situ: biological and therapy implications.

Purpose: The biological and therapeutic implications of extravesical involvement in patients with bladder carcinoma in situ were analyzed.

Materials And Methods: Of 138 patients with bladder carcinoma in situ 87 (63%) had extravesical involvement, including the prostate in 53, the upper urinary tract in 11 and both structures in 23 (pan-urothelial involvement). With survival free of disease as an end point, univariate and multivariate analyses were done.

The prostate involvement as prognostic factor in patients with superficial bladder tumors.

Purpose: The prognostic value of prostate involvement in patients with superficial bladder cancer was analyzed.

Materials And Methods: We studied 96 patients with prostate involvement. Taking progression-free survival rate as an end point, univariate and multivariate analyses were done.

Preservation of antegrade ejaculation in retroperitoneal lymphadenectomy due to residual masses after primary chemotherapy for testicular carcinoma.

We report 18 consecutive patients with testis cancer and retroperitoneal residual masses with normal tumor markers, who underwent lymphadenectomy. Aiming to preserve the antegrade ejaculation, we carried out surgical modifications which basically attempt to preserve: (1) both sympathetic lumbar trunks, (2) the superior hypogastric plexus and (3) some of the postganglionic branches. With a mean follow-up of 28.

Feasibility of transurethral resection for muscle-infiltrating carcinoma of the bladder: prospective study.

A prospective study was done to evaluate treatment of patients with muscle-infiltrating bladder cancer by transurethral resection exclusively. Inclusion criteria for this study were histological confirmation of muscular bladder infiltration, endoscopic radical transurethral resection, disappearance of hardened areas after transurethral resection, and negative biopsies of the depth and periphery of the tumor bed. The study began in April 1981.

Corpus cavernosum invasion and tumor grade in the prediction of lymph node condition in penile carcinoma.

Of the 101 patients with penile cancer, we have analyzed 66 from whom we had enough information: 42 (63.3%) patients with corpora cavernosa invasion (T2-3) and 24 (36.6%) without (T1).

Carcinoma in situ associated with superficial bladder tumor.

In a sample of 306 patients with superficial bladder tumors (Ta, Tl), 48 were affected by associated carcinoma in situ (TIS). We included 40 of them in a random program with Mitomycin C or Adriamycin, administered endovesically. We found that those patients with associated TIS whose progression rate had increased to 37.