Conditional survival predictions after nephrectomy for renal cell carcinoma.

Purpose: Conditional survival implies that on average long-term cancer survivors have a better prognosis than do newly diagnosed individuals. We explored the effect of conditional survival in renal cell carcinoma.

Materials And Methods: We studied 3,560 patients with renal cell carcinoma of all stages treated with nephrectomy.

Prediction of delayed graft function after renal transplantation.

Introduction: Delayed graft function (DGF), defined as the need for dialysis during the first week after renal transplantation, is an important adverse clinical outcome. A previous model relied on 16 variables to quantify the risk of DGF, thereby undermining its clinical usefulness. We explored the possibility of developing a simpler, equally accurate and more user-friendly paradigm for renal transplant recipients from deceased donors.

Open prostatectomy and the evolution of HoLEP in the management of benign prostatic hyperplasia.

Trans-urethral resection of the prostate (TURP) and other minimally invasive therapies are the most common surgical procedures used to treat benign prostatic hyperplasia today. However, many patients with a markedly enlarged prostate are often not amenable to these treatment options. In these patients open prostatectomy has been representing a viable and preferred treatment.

Unsuccessful investigation of preoperative sexual health issues in the prostate cancer "couple": results of a real-life psychometric survey at a major tertiary academic center.

Introduction: Investigating preoperative sexual function of patients with prostate cancer (PCa) and their partners is needed for realistic functional outcome analyses after radical prostatectomy (RP).

Aim: To assess pre-RP sexual health issues of PCa patients and their partners in a stable heterosexual relationship.

Methods: Data were analyzed from 3,282 consecutive patients who underwent RP over a three-period survey.

Is sperm banking of interest to patients with nongerm cell urological cancer before potentially fertility damaging treatments?

Purpose: We assessed the opinions of patients with nongerm cell urological cancer on sperm banking before undergoing surgical or nonsurgical therapy that could potentially endanger subsequent fertility.

Materials And Methods: Between April 2007 and July 2008, 753 patients visited a urological office and were invited to complete a brief self-administered questionnaire to assess opinions on sperm banking before undergoing any eventual therapy potentially dangerous for male fertility. Logistic regression models tested the association between predictors (age, educational level, relationship status, previous fatherhood and benign disorder vs nongerm cell urological cancer) and patient wishes for sperm banking.

Obesity does not increase the risk of lymph node metastases in patients with clinically localized prostate cancer undergoing radical prostatectomy and extended pelvic lymph node dissection.

Objectives: Several studies have shown that obesity is associated with more aggressive prostate cancer (PCa) variants. We hypothesized that obesity, quantified as body mass index (BMI), is associated with a higher risk of lymph node invasion (LNI) in patients undergoing extended pelvic lymph node dissection (ePLND).

Methods: Clinical and pathological data were available for 994 consecutive men with PCa treated with radical prostatectomy (RP) and ePLND at a single European tertiary academic centre.

Baseline renal function, ischaemia time and blood loss predict the rate of renal failure after partial nephrectomy.

Objective: To identify independent predictors of renal failure after partial nephrectomy (PN) in patients with renal cell carcinoma (RCC).

Patients And Methods: Data were available for 166 patients with pathological T1-3 N0M0 RCC treated with PN. Renal failure after PN was defined as a decrease in glomerular filtration rate (GFR) of >25% (RIFLE criteria).

The probability of Gleason score upgrading between biopsy and radical prostatectomy can be accurately predicted.

The objective of this study was to test the external validity of a previously developed nomogram for the prediction of Gleason score upgrading (GSU) between biopsy and radical prostatectomy (RP). The study population consisted of 973 assessable patients treated with RP at a tertiary care institution. The accuracy of the nomogram was quantified with the receiver operating characteristics curve-derived area under the curve.

Partial versus radical nephrectomy in patients with adverse clinical or pathologic characteristics.

Objectives: To assess cancer-specific survival of partial nephrectomy (PN) patients with >or= 7-cm lesions or unfavorable pathology (stage T3a or Fuhrman grades III-IV).

Material And Methods: At 13 participation centers, 4072 partial or radical nephrectomies (RN) were performed for RCC between 1984 and 2001. Of all procedures, 925 (22.

Population-based analysis of normal Total PSA and percentage of free/Total PSA values: results from screening cohort.

Objectives: To examine the distribution of total prostate-specific antigen (tPSA) and percentage of free/total PSA (%f/tPSA) values in patients undergoing prostate cancer screening in Canada.

Methods: The data from 4 consecutive annual prostate cancer screening events held in Montreal, Canada were examined with respect to age, tPSA, and %f/tPSA in 3222 men.

Results: Within the entire cohort, the median PSA level was 1.

Impact of lymph node dissection on cancer specific survival in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy.

Purpose: We examined the impact of lymphadenectomy on the clinical outcomes of patients with upper tract urothelial cancer treated with radical nephroureterectomy.

Materials And Methods: Data were collected on 1,130 consecutive patients with pT1-4 upper tract urothelial cancer treated with radical nephroureterectomy at 13 centers worldwide. Patients were grouped according to nodal status (pN0 vs pNx vs pN+).

Are infertile men less healthy than fertile men? Results of a prospective case-control survey.

Background: An association between either subfertility or infertility and an elevated risk of certain male cancers has been previously reported. Nothing is known about abnormalities in infertility and general health conditions.

Objective: To assess whether men with male factor infertility (MFI) are overall less healthy than fertile men, regardless of the reasons for infertility.

Survival after radical prostatectomy and radiotherapy for prostate cancer: a population-based study.

Objective: Based on the natural history of localized prostate cancer, the life expectancy (LE) of men treated with either radical prostatectomy (RP) or definitive external-beam radiotherapy (EBRT) should exceed 10 years. To test this hypothesis, we examined overall survival rates after RP or EBRT in a contemporary population-based cohort.

Methods: Within a population-based cohort we assessed crude survival in 17 570 men diagnosed with prostate cancer who were either treated with RP (n = 9678) or definitive EBRT (n = 7892) between 1989 and 2000.

Pre-treatment biomarker levels improve the accuracy of post-prostatectomy nomogram for prediction of biochemical recurrence.

Purpose: We tested the ability of several pre-operative blood-based biomarkers to enhance the accuracy of standard post-operative features for the prediction of biochemical recurrence (BCR) after radical prostatectomy (RP).

Methods: Pre-operative plasma levels of Endoglin, interleukin-6 (IL-6), interleukin-6 soluble receptor (IL-6sR), transforming growth factor-beta1 (TGF-beta1), urokinase plasminogen activator (uPA), urokinase plasminogen inhibitor-1 (PAI-1), urokinase plasminogen receptor (uPAR), vascular cell adhesion molecule-1 (VCAM1), and vascular endothelial growth factor (VEGF) were measured using commercially available enzyme immunoassays in 423 consecutive patients treated with RP for clinically localized prostate cancer. Standard post-operative features consisted of surgical margin status, extracapsular extension, seminal vesicle invasion, lymph node involvement, and pathologic Gleason sum.

Long-term follow-up of patients with prostate cancer and nodal metastases treated by pelvic lymphadenectomy and radical prostatectomy: the positive impact of adjuvant radiotherapy.

Background: Recent large, prospective, randomised studies have demonstrated that adjuvant radiotherapy (RT) is a safe and effective procedure for preventing disease recurrence in locally advanced prostate cancer (PCa) patients. However, no study has ever tested the role of adjuvant RT in node-positive patients after radical prostatectomy (RP).

Objective: We hypothesised that adjuvant RT with early hormone therapy (HT) might improve long-term outcomes of patients with PCa and nodal metastases treated with RP and extended pelvic lymph node dissection (ePLND).

Biopsy core number represents one of foremost predictors of clinically significant gleason sum upgrading in patients with low-risk prostate cancer.

Objectives: To examine the effect the number of biopsy cores taken has on the rate of clinically significant Gleason sum upgrading (GSU) in patients with low-risk prostate cancer.

Methods: We analyzed the data from 301 patients with low-risk prostate cancer (clinical Stage T1c-T2a, prostate-specific antigen or=10-core) prostate biopsy. Prostate-specific antigen level, clinical stage, biopsy Gleason sum, prostate volume, year of diagnosis, number of biopsy cores taken, and number of positive cores were used as predictors in logistic regression models addressing the rate of clinically significant GSU (defined as upgrading from biopsy Gleason sum 5-6 to radical prostatectomy Gleason sum of >or=7).

Assessing the minimum number of lymph nodes needed at radical cystectomy in patients with bladder cancer.

Objective: To identify the likelihood of finding one or more positive lymph nodes (LNs) according to the number of LNs removed at radical cystectomy (RC), as the number of LNs removed affects disease progression and survival after RC.

Patients And Methods: Between 1984 and 2003, 731 assessable patients had RC and bilateral pelvic lymphadenectomy at three different institutions. ROC curve coordinates were used to determine the probability of identifying one or more positive LNs according to the total number of removed LNs.

Lymphovascular invasion predicts clinical outcomes in patients with node-negative upper tract urothelial carcinoma.

Purpose: To assess the association of lymphovascular invasion (LVI) with cancer recurrence and survival in a large international series of patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC).

Patients And Methods: Data were collected on 1,453 patients treated with RNU at 13 academic centers and combined into a relational database. Pathologic slides were rereviewed by genitourinary pathologists according to strict criteria.

Age at diagnosis is a determinant factor of renal cell carcinoma-specific survival in patients treated with nephrectomy.

Objective: Based on combined data for 4880 patients, 2 previous studies reported that advanced age is a predictor of increased renal cell carcinoma-specific mortality (RCC-SM). We explored the effect of age in cubic spline analyses to identify the age groups with the most elevated risk for renal cell carcinoma (RCC).

Methods: Our study included 3595 patients from 14 European centres who had partial or radical nephrectomies.

Holmium laser enucleation of the prostate and holmium laser ablation of the prostate: indications and outcome.

Purpose Of Review: Holmium laser enucleation of the prostate (HoLEP) has been proposed as an alternative to transurethral resection of the prostate and to open prostatectomy for patients with lower urinary tract symptoms because of large benign prostatic enlargement. The aim of this review is to critically analyze currently available evidence-based reports regarding HoLEP, with particular interest in long-term follow-up results.

Recent Findings: The use of holmium laser for the treatment of benign prostatic hyperplasia was first reported in 1996.

Effect of body mass index on prostate-specific antigen and percentage free prostate-specific antigen: results from a prostate cancer screening cohort of 1490 men.

Objectives: Several studies have reported an effect of obesity, defined as elevated body mass index (BMI), on prostate cancer biology. We examined the relationship between BMI and total prostate-specific antigen (tPSA) as well as percent free tPSA (%f/tPSA) in a large prostate cancer screening cohort.

Methods: Height, weight, tPSA and %f/tPSA were assessed in 1490 consecutively screened Canadian men without known prostate cancer.

External validation of the updated partin tables in a cohort of French and Italian men.

Purpose: To test the discrimination and calibration properties of the newly developed 2007 Partin Tables in two European cohorts with localized prostate cancer.

Methods: Data on clinical and pathologic characteristics were obtained for 1,064 men treated with radical prostatectomy at the Creteil University Health Center in France (n = 839) and at the Milan University Vita-Salute in Italy (n = 225). Overall discrimination was assessed with receiver operating characteristic curve analysis, which quantified the accuracy of stage predictions for each center.

Leydig cell tumour of the testis: presentation, therapy, long-term follow-up and the role of organ-sparing surgery in a single-institution experience.

Objective: To report our single-centre experience of patients with Leydig cell tumour (LCT) of the testis, which represents the most frequent interstitial neoplasm of the testis, and for which the natural history and therapy are debated.

Patients And Methods: Between 1990 and 2006, 37 patients were treated for LCT of the testis. All patients had testicular markers assessed and 21 (57%) had their hormonal profile assessed (total testosterone, follicle-stimulating hormone, luteinizing hormone and oestradiol).

Tumour architecture is an independent predictor of outcomes after nephroureterectomy: a multi-institutional analysis of 1363 patients.

Objective: To assess whether tumour architecture can help to refine the prognosis of patients treated with nephroureterectomy (NU) for urothelial carcinoma (UC) of the upper urinary tract (UT), as the prognostic value of tumour architecture (papillary vs sessile) in UTUC remains elusive.

Patients And Methods: The study included 1363 patients with UTUC and treated with radical NU at 12 centres worldwide. All slides were re-reviewed according to strict criteria by genitourinary pathologists who were unaware of the findings of the original pathology slides and clinical outcomes.