Influence of thermodisinfection and duration of cryopreservation at different temperatures on pull out strength of cancellous bone.

Thermodisinfection of human femoral heads from living donors harvested during hip joint replacement is an established processing procedure. This study was designed to examine the influence of heat sterilization on pull out strength of cancellous bone and storage at different temperatures up to 2 years since we had previously studied the storage of unprocessed cancellous bone. Porcine cancellous bone resembling human bone structure was obtained from 140 proximal humerus of 6-8 months old piglets.

Urinary collecting system invasion in renal cell carcinoma: incidence and long-term prognosis.

Objectives: Current data on the prognostic impact of urinary collecting system (UCS) invasion by renal cell carcinoma (RCC) are highly conflicting. The aim of the present study was to assess incidence and long-term prognosis of RCC patients with and without UCS involvement.

Methods: We evaluated 780 patients who had undergone renal surgery between 1990 and 2005.

Comparison of a 20-min pad test with the 1-hour pad test of the international continence society to evaluate post-prostatectomy incontinence.

Objectives: Urinary incontinence is a hygienic and socially distressing problem for affected people and causes high healthcare costs. Objective standardized noninvasive quantification of urinary incontinence is highly important and, in addition, enables control of therapeutic efficacy. The aim of this prospective study was to evaluate the feasibility, accuracy and reproducibility of a standardized 20-min pad test to measure urinary incontinence after radical prostatectomy in comparison to the 1-hour pad-weighing test recommended by the International Continence Society (ICS).

Overweight is associated with improved cancer-specific survival in patients with organ-confined renal cell carcinoma.

Objectives: Overweight/obesity is known to increase the risk of developing renal cell carcinoma (RCC). However, data on the prognostic impact of overweight in RCC is still conflicting. We assessed whether different body mass index (BMI) levels at the time of surgery had an effect on the long-term prognosis of RCC patients.

Incidence and long-term prognosis of papillary renal cell carcinoma.

Objectives: Papillary renal cell carcinoma (pRCC) represents the largest subgroup of non-clear-cell kidney cancer. In this study, we assessed tumour characteristics and long-term prognosis of patients with pRCC in comparison with conventional clear-cell cancer (ccRCC).

Methods: We evaluated 744 patients who had undergone renal surgery for RCC between 1990 and 2005.

Metastatic renal cell carcinoma: recent advances and current therapeutic options.

For many years immuno(chemo)therapy has been the only therapeutic option for patients with metastatic renal cell carcinoma. Few patients, however, experienced long-term disease control and toxicity was considerable. Recent advances in understanding the biology and genetics of this malignancy have led to novel-targeted therapeutic approaches.

Clinical impact of MDR1-expression in testicular germ cell cancer.

Aim: The multidrug resistance protein 1 (MDR1, P-gp, p-170) is a membrane glycoprotein that acts as an energy-dependent drug efflux pump. In various malignancies its expression is associated with resistance to diverse cytostatic drugs, and therefore predicts resistance to systemic treatment. The aim of this study was to investigate the prognostic value of MDR1 expression in primary tumor tissue to predict necrosis or viable cancer in residual tumor masses after systemic chemotherapy for advanced testicular germ cell cancer.

Pre- and perioperative predictors of short-term clinical outcomes in patients undergoing percutaneous nephrolitholapaxy.

Percutaneous nephrolitholapaxy (PCNL) with modern stone disintegration technologies is the treatment of choice for patients with extensive stone burden or stones refractory to extracorporeal shock wave lithotripsy. However, little is known about factors predicting unfavourable outcome in terms of perioperative complications, residual stone burden or prolonged hospitalization. The aim of this study was to evaluate preoperative, patient- and stone-related parameters that might influence the perioperative course and short-term clinical outcomes.

Clinical significance of a prostate-specific antigen flare phenomenon in patients with hormone-refractory prostate cancer receiving docetaxel.

Docetaxel has shown promise for the treatment of hormone-refractory prostate cancer and has become the standard of care. The flare phenomenon is a known entity in androgen-deprivation therapy of advanced prostate cancer and it has also been described in palliative chemotherapy of hormone-refractory prostate cancer. The aim of this study was to evaluate the clinical impact of a prostate-specific antigen flare phenomenon in docetaxel-treated hormone-refractory prostate cancer patients.

Laparoscopic peritoneal drainage of symptomatic lymphoceles after pelvic lymph node dissection using methylene blue instillation.

Background: Lymphoceles are frequent complications of pelvic lymph node dissection. While small lymphoceles often remain undetected, larger ones can cause complications and require further treatment, e.g.

Impact of evidence-based interdisciplinary guidelines on testis cancer management.

Background: In 1999, interdisciplinary evidence-based guidelines were elaborated for treatment of germ cell tumors in Germany. The aims of the current study were to analyze failures in diagnosis and therapy and to demonstrate the influence of guidelines on individual therapeutic approaches and clinical outcome. Therefore, patient collectives treated before the introduction of guidelines (Group A, 1990-1999, n = 234) and those thereafter (Group B, 2000-2002, n = 84) were compared for recurrence and survival.

Second-line strategies for metastatic renal cell carcinoma: classics and novel approaches.

Objectives: Renal cell carcinoma is an aggressive malignancy with a high propensity for both early and metachronous regional and distant metastasis. While surgical resection is the mainstay of therapy for patients with localized disease, the prognosis for patients with distant metastasis is poor with a 5-year survival rate of less than 10%. Response rates to first-line immunotherapy or immunochemotherapy range from 10-35%; responses achieved are predominantly partial remissions of short duration.

Application of thalidomide/interleukin-2 in immunochemotherapy-refractory metastatic renal cell carcinoma.

Thalidomide has been reported to yield anti-tumor activity in advanced renal cell carcinoma (RCC). We evaluated safety and efficacy of a combination therapy comprising interleukin (IL)-2 and thalidomide in patients with metastatic RCC refractory to both immuno- and chemotherapy. Twelve patients with progressive metastatic RCC who had failed prior treatment with immunochemotherapy and desired further active therapy were enrolled in this study.

Application of retinoids in the treatment of renal cell carcinoma--a futile effort?

The therapeutic benefit of adding retinoids such as all-trans retinoic acid (RA), 9-cis-RA or 13-cis-RA to established single-agent or combination immuno/chemotherapy regimens for the treatment of metastatic renal cell carcinoma (RCC) has been extensively investigated during the last decade. However, at present results are contradictory and their application controversial. Moreover, recent studies indicated a significantly higher incidence of toxic side-effects in patients treated with retinoids in addition to established bio/chemotherapy.

Giant hydronephrosis mimicking progressive malignancy.

Background: Cases of giant hydronephroses are rare and usually contain no more than 1-2 litres of fluid in the collecting system. We report a remarkable case of giant hydronephrosis mimicking a progressive malignant abdominal tumour.

Case Presentation: A 78-year-old cachectic woman presented with an enormous abdominal tumour, which, according to the patient, had slowly increased in diameter.

Pitfalls in endosonographic imaging of suspected insulinomas: pancreatic nodules of unknown dignity.

Objective: Endosonography enables localization and characterization of gastroenteropancreatic neuroendocrine tumors. We have studied the problem of misleading abnormalities of pancreatic morphology as obtained by endosonographic imaging.

Design And Methods: A total of 438 endosonographies performed for known or suspected diseases of the adrenal glands and/or the pancreas and/or suspected metastases in the neighboring tissues were analyzed.

An FGF-binding protein (FGF-BP) exerts its biological function by parallel paracrine stimulation of tumor cell and endothelial cell proliferation through FGF-2 release.

Fibroblast growth factors FGF-1 (aFGF) and FGF-2 (bFGF) are found in most embryonic and adult normal and tumor tissues, where they are immobilized in the extracellular matrix (ECM). Mobilization of these FGFs is part of a tightly controlled process resulting in the activation of high-affinity FGF receptors. Recently, we have shown that a secreted FGF-binding protein (FGF-BP) binds non-covalently to FGF-2 and is able to release it from the ECM.

The influence of lymph node counts on the detection of pelvic lymph node metastasis in prostate cancer.

The present study was done to determine the influence of tumor stage and the patients' age on the number of pelvic lymph nodes obtained during standard pelvic lymphadenectomy before radical retropubic prostatectomy. Furthermore, we assessed whether the number of pelvic lymph nodes examined affects the sensitivity of pN-classification. The data of 283 consecutive patients who had undergone standardized open pelvic lymphadenectomy and radical retropubic prostatectomy for clinically organ-confined prostate cancer were reviewed retrospectively.

Radical nephrectomy for renal cell carcinoma: Is adrenalectomy necessary?

Objectives: The role of simultaneous adrenalectomy in combination with radical nephrectomy in the treatment for renal cell carcinoma (RCC) remains controversial. With nephron-sparing surgery being commonly applied, the indication for adrenalectomy has to be critically assessed.

Patients And Methods: In a retrospective analysis the outcome of 589 patients, who underwent ipsilateral adrenalectomy along with radical nephrectomy in the treatment for RCC between 1985 and 1997 at our institution, was evaluated.

Complications related to different continence mechanisms in ileocecal reservoirs.

Purpose: We compared the incidence, treatment and outcome of complications related to different continence mechanisms in a single institutional series of continent urinary diversions using an ileocecal reservoir.

Materials And Methods: From November 1990 through October 1996 in 193 consecutive cases an ileocecal pouch (Mainz I) was used as a low pressure, high capacity reservoir. A submucosally embedded in situ appendix was used in 96 patients (mean age 57.

Quality of life after cystectomy and urinary diversion: results of a retrospective interdisciplinary study.

Purpose: Now that creation of continent urinary reservoirs has become a standardized and clinically well established surgical technique with known morbidity and mortality rates, we reassessed the psychological and social aspects of this treatment compared with wet urostomy.

Materials And Methods: We developed a questionnaire (102 items) addressing general aspects of quality of life, disease related social support, coping strategies and stoma related issues. It was mailed to 600 patients with ileal conduits and 130 with continent reservoirs.