Introduction: Gleason score biopsy undergrading (GSBU) can have an impact on the management and prognosis of patients with prostate cancer. We analyze the possible impact of time and other clinical and analytical factors in the appearance of GSBU in our series.
Patients And Method: Ambispective, multicenter study of 1955 patients with localized prostate cancer undergoing radical prostatectomy between 2005 and 2018. Descriptive statistics and hypothesis testing are reported by univariate and multivariate analyses.
Results: Mean age 63.69 (44-80) years, median PSA 8.70 ng / ml (1.23-99). GSBU was observed in 34.7% of the entire cohort. In 72.8% of the cases, the GSBU occurred in one consecutive Gleason score, with the progression from 3 + 3 to 3 + 4 being the most frequent (289 patients, 47.6%). Performing radical prostatectomy 90-180 days before or after the biopsy does not have an impact on its undergrading in any of the groups. In the univariate and multivariate analysis, the presence of tumor or pathological rectal examination in both lobes, the tumor load ≥50% of cylinders and a DPSA ≥0.20, showed independent discriminative capacity to select patients who presented GSBU.
Conclusions: The time from biopsy to radical prostatectomy did not show impact on GSBU. The number of affected cylinders, bilateral tumor and DPSA are easily accessible parameters that can help us select patients with greater probability of presenting GSBU.
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http://dx.doi.org/10.1016/j.acuro.2019.08.004 | DOI Listing |
Prostate Int
September 2024
Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Japan.
Background: Despite providing valuable staging and prognostic information, the therapeutic benefit of pelvic lymph node dissection (PLND) remains uncertain. We sought to assess the effect of extended PLND (ePLND) on the biochemical recurrence (BCR) of patients with National Comprehensive Cancer Net (NCCN) high- or very high-risk prostate cancer treated via robot-assisted radical prostatectomy (RARP).
Methods: We used a multi-institutional database (six centers) to assess 989 patients who underwent RARP from 2014 to 2022 with or without ePLND, among which 699 patients underwent BCR analysis.
Prostate Int
September 2024
Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan.
Pelvic lymph node dissection (PLND) is important for accurate staging and prognosis of prostate cancer. Several guidelines recommend extended pelvic lymph node dissection (ePLND) for patients with non-low-risk prostate cancer. However, the therapeutic benefits of ePLND are unclear.
View Article and Find Full Text PDFTransl Androl Urol
December 2024
Department of Urology, Peking University First Hospital Miyun Hospital, Beijing, China.
Background: The Toumai MT-1000 Endoscopic Surgical System is a newly developed surgical robot from China. This study evaluates its feasibility, safety, and effectiveness for various urologic procedures based on our single-center experience.
Methods: From October 2023 to January 2024, 20 urologic procedures were performed at Peking University First Hospital using the Toumai MT-1000 system.
Transl Androl Urol
December 2024
Department of Urology, Peking University People's Hospital, Beijing, China.
Background: Aggressive angiomyxoma (AAM) is a rare benign mesenchymal tumor known for its aggressive behavior and high recurrence rates, with male cases of AAM being less frequently reported. This study presents a rare case of primary prostatic AAM characterized by a prostatic urethral mass obstructing the bladder outlet, resulting in acute renal dysfunction.
Case Description: The 51-year-old male patient presented with lumbar pain, nausea, frequent urination, urgency, and incomplete urination.
Transl Androl Urol
December 2024
Department of Urology & The Institute of Applied Lithotripsy Technology, Peking University People's Hospital, Beijing, China.
Background: Bladder cancer (BCa) is one of the most common tumors of the urinary system, imposing a significant societal burden. BCa is categorized into muscle-invasive BCa (MIBC) and non-MIBC (NMIBC) types. Radical cystoprostatectomy (RCP) is the standard treatment for MIBC and refractory NMIBC, but it can lead to serious side effects.
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