Expression of the cancer-testis antigen BORIS correlates with prostate cancer.

BACKGROUND: BORIS, a paralogue of the transcription factor CTCF, is a member of the cancer-testis antigen (CT) family. BORIS is normally present at high levels in the testis; however it is aberrantly expressed in various tumors and cancer cell lines. The main objectives of this study were to investigate BORIS expression together with sub-cellular localization in both prostate cell lines and tumor tissues, and assess correlations between BORIS and clinical/pathological characteristics. METHODS: We examined BORIS mRNA expression, protein levels and cellular localization in a panel of human prostate tissues, cancer and benign, together with a panel prostate cell lines. We also compared BORIS levels and localization with clinical/pathological characteristics in prostate tumors. RESULTS: BORIS was detected in all inspected prostate cancer cell lines and tumors, but was absent in benign prostatic hyperplasia. Increased levels of BORIS protein positively correlated with Gleason score, T-stage and androgen receptor (AR) protein levels in prostate tumors. The relationship between BORIS and AR was further highlighted in prostate cell lines by the ability of ectopically expressed BORIS to activate the endogenous AR mRNA and protein. BORIS localization in the nucleus plus cytoplasm was also associated with higher BORIS levels and Gleason score. CONCLUSIONS: Detection of BORIS in prostate tumors suggests potential applications of BORIS as a biomarker for prostate cancer diagnosis, as an immunotherapy target and, potentially, a prognostic marker of more aggressive prostate cancer. The ability of BORIS to activate the AR gene indicates BORIS involvement in the growth and development of prostate tumors.

A single United Kingdom center experience of open partial nephrectomy using regional ischemia.

INTRODUCTION: Different techniques are used in open partial nephrectomy (OPN) for localized renal cancer, with variable impact on renal function. Regional renal ischemia technique by using different clamps and without the need to occlude renal vessels is gaining popularity. In our study, we present the largest international series; and the first in the United Kingdom; describing OPN using soft bowel clamp. We study the impact of this regional ischemia innovative technique on renal function, postoperative complications and oncological outcomes. MATERIALS AND METHODS: We retrospectively analyzed the first 100 OPN cases done between 2001 and 2011. All available data on the hospital databases were analyzed; recording patient demographics, tumor characteristics, operative procedure details, histopathology results and long term follow up. RESULTS: A direct comparison with other studies that have used different clamps to achieve regional ischemia was performed. Our technique has the advantage of being used for interpolar and hilar/central tumors. Our mean tumor size was higher at 4.1 cm. Our positive margin rate for malignant tumors was comparable with other studies, same for mean operative time and hospital stay. None had significant deterioration in renal function that required renal replacement therapy. Median blood loss was 400 mL. Our series has the advantage of showing the long term follow up data. CONCLUSION: We believe the technique we have developed using soft bowel clamp to produce regional renal ischemia is practical and successful. It can be applied safely in all OPN cases, with excellent oncological outcome and clinically acceptable renal function preservation.

Nurse-led renal cancer follow-up is safe and associated with high patient satisfaction-an audit from the East of England.

BACKGROUND: With more people diagnosed and dying from renal cancers in England than ever before, treatment and follow-up post-surgery is of paramount importance. We have instituted a nurse-led follow-up service for renal cancers as a way to improve efficiency and make better use of clinic time. This is our first attempt to audit our service. OBJECTIVES: One of the main objectives of this project was to measure compliance of a nurse-led renal surveillance clinic against an established institutional follow-up protocol which was based on current European Association of Urology guidelines. We also aimed to assess patient satisfaction with nurse-led care. PATIENTS AND METHODS: A total of 89 patients with low/intermediate-risk kidney cancers who were on the nurse-led renal surveillance database following nephrectomy or partial nephrectomy were placed on a database. This was then audited for adherence to the clinic protocol. These same patients were subsequently sent patient satisfaction questionnaires. RESULTS: The audit revealed high levels of compliance against the renal clinic protocol as well as positive feedback from the patient satisfaction questionnaire. Ninety-five percent said they felt either at ease or very at ease speaking to the nurse specialist. No one was dissatisfied with their consultations with 86% being very satisfied and 14% fairly satisfied. This was reinforced further by 100% of patients feeling that they could discuss all aspects of their condition with the Uro-oncology Clinical Nurse Specialist (UOCNS). Ninety-seven percent felt that they had adequate time with the nurse. CONCLUSION: Nurse-led follow-up, in our setting, was noted to be safe and effective and was associated with high levels of patient satisfaction. This study adds to the growing body of work on the efficacy of nurse-led care.

Nurse-led active surveillance for prostate cancer is safe, effective and associated with high rates of patient satisfaction-results of an audit in the East of England.

INTRODUCTION: Active surveillance (AS) is an option in the management of men with low-stage, low-risk prostate cancer. These patients, who often require prolonged follow-up, can put a strain on outpatient resources. Nurses are ideally placed to develop advanced roles to help meet this increased demand-a model we have utilised since 2014. We set about to comprehensively evaluate our nurse-led AS (NLAS) programme. PATIENTS AND METHODS: An audit of patient notes was carried out to assess compliance with trust and national guidelines. A questionnaire was designed to capture patients' experiences of NLAS. This was piloted and then distributed to all patients in our NLAS programme. A second questionnaire was designed to assess the views of stakeholders within the department. RESULTS: Compliance with various aspects of local guidelines ranged from 88.8% to 100%. 143 patients are currently in the programme with a mean duration of AS of 37.03 months. 104 questionnaires were returned. Most of the patients were aware of the role of the nurse prior to their visit, and all were happy to meet with a nurse. All of the patients indicated their confidence in the nurse monitoring their prostate-specific antigen. Among those requiring further investigations, 85.3% were happy with the information they received prior to their tests. Overall, 96.2% were either very satisfied or satisfied with NLAS. All stakeholders held positive views about NLAS. CONCLUSIONS: NLAS is safe and effective. Patients and stakeholders alike held positive views of the programme.

An unusual groin mass. Seminal vesicle abscess: a case report.

The rare pathology of seminal vesicle abscess is usually diagnosed with computerised tomography scan and confirmed with transrectal ultrasound. We report a recently encountered case where diagnosis proved difficult owing to the non-specific clinical presentation.