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1.
Urologe A ; 47(9): 1199-204, 2008 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-18682911

RESUMO

Much prostate cancer research is based on cell culture results. Recent genomic studies found major differences between primary prostate cancer tissue and established prostate cancer cell lines, which calls into question the clinical relevance of study results based on cell cultures.Using primary cultures of prostate cancer cells from prostatectomy specimens seems to be a reasonable solution, but primary cell cultures are much more difficult to establish. In this study, a primary cell culture model was combined with an invasion assay. With this combination it was possible not only to select invasive cell clones from the primary culture but also to culture these cells in a three-dimensional model, forming spheroids. A further characterization of this cell population was done by comparative genomic hybridization, showing numerous genetic alterations. The presented cell culture model offers, for the first time, an opportunity to isolate invasive growing cells from primary prostate cancer tissue and cultivate these cells for further analyses.


Assuntos
Técnicas de Cultura de Células , Neoplasias da Próstata/patologia , Divisão Celular/fisiologia , Meios de Cultivo Condicionados , Análise Mutacional de DNA , Humanos , Masculino , Invasividade Neoplásica , Hibridização de Ácido Nucleico/genética , Neoplasias da Próstata/genética , Células Tumorais Cultivadas/patologia
2.
Urologe A ; 57(2): 164-171, 2018 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-29209755

RESUMO

BACKGROUND: Due to the multitude of therapy options, the treatment decision after diagnosis of localized prostate cancer is challenging. Compared to printed booklets, web-based information technology offers more possibilities to tailor information to patients' individual needs. OBJECTIVES: To support the decision-making process as well as the communication with patients, we developed an online tutorial in a systematic process in the German-speaking part of Switzerland and then tested it in a pilot study. The study investigated users' satisfaction, the coverage of information needs, the preparation for decision making, and the subjective quality of the decision. MATERIALS AND METHODS: Based on already existing information material, the online tutorial was developed in an iterative process using focus groups with patients and urologists. For the following evaluation in eight clinics a total of 87 patients were invited to access the platform and participate in the study. Of these patients, 56 used the tutorial and 48 answered both surveys (the first one 4 weeks after the first login and the second one 3 months after treatment decision). The surveys used the Preparation for Decision Making Scale (PDMS), the Decisional Conflict Scale (DCS), and the Decisional Regret Scale (DRS). RESULTS AND CONCLUSION: Satisfaction with the tutorial is very high among patients with newly diagnosed localized prostate cancer. Users find their information needs sufficiently covered. Three months after the decision they felt that they were well prepared for the decision making (mean PDMS 75, standard deviation [SD] 23), they had low decisional conflict (mean DCS 9.6, SD 11), and almost no decisional regret (mean DRS 6.4, SD 9.6). Based on these findings, further use of the tutorial can be recommended.


Assuntos
Tomada de Decisões , Educação de Pacientes como Assunto/métodos , Participação do Paciente , Neoplasias da Próstata/terapia , Telemedicina , Comunicação , Técnicas de Apoio para a Decisão , Humanos , Masculino , Projetos Piloto , Neoplasias da Próstata/diagnóstico , Suíça
3.
Semin Oncol ; 26(2): 234-43, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10597734

RESUMO

The treatment options available for advanced prostate cancer are increasing. These improved therapies are the result of research involving cellular targets other than DNA proliferation. For example, therapy directed against the intracellular matrix has yielded clinical responses in patients. Other novel targets are being investigated. This review examines both laboratory and clinical advances using cell structure, growth factors, differentiating agents, angiogenesis, metastasis, and the cell cycle in the treatment of prostate cancer.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Antineoplásicos/farmacologia , Ciclo Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , DNA de Neoplasias/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Substâncias de Crescimento/uso terapêutico , Humanos , Masculino , Biologia Molecular , Metástase Neoplásica/prevenção & controle , Neoplasias da Próstata/patologia
4.
J Histochem Cytochem ; 44(12): 1415-20, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8985133

RESUMO

We analyzed immunohistochemically the expression of RAR proteins in basal cell carcinomas (BCCs; n = 15) in situ. The labeling pattern for the different types of RARs was compared with the staining pattern of the proliferation marker Ki-67 in the same tumors. We found strong immunoreactivity for RAR-alpha and moderate immunoreactivity for RAR-gamma in all BCCs analyzed, whereas no or very weak staining for RAR-beta protein was detected. In contrast to RAR-gamma, which revealed no or only marginal differences in staining intensities, RAR-alpha immunoreactivity was consistently stronger in BCCs compared to adjacent unaffected epidermis. In general, labeling of BCCs for RAR-alpha and RAR-gamma was pronounced in cells of the palisade and peripheral cells, whereas staining in the center of the tumors was heterogeneous. Eleven of the 15 BCCs analyzed revealed no visual correlation in comparing labeling patterns for RAR-alpha and RAR-gamma with the labeling pattern for Ki-67. In four specimens, expression of RAR-alpha, RAR-gamma, and Ki-67 proteins was confined to peripheral tumor cells. Our findings indicate that (a) RAR-alpha and RAR-gamma proteins are, in contrast to RAR-beta, strongly expressed in BCCs; (b) expression of RAR-alpha is upregulated in BCCs compared to keratinocytes of uninvolved epidermis; and (c) BCCs may be targets for potentially preventive or therapeutic treatment with RAR-alpha- or RAR-gamma-selective retinoic acid metabolites.


Assuntos
Carcinoma Basocelular/metabolismo , Receptores do Ácido Retinoico/metabolismo , Neoplasias Cutâneas/metabolismo , Humanos , Imuno-Histoquímica , Antígeno Ki-67/metabolismo
5.
Drugs ; 58 Suppl 3: 127-31, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10711851

RESUMO

Oral chemotherapy has become a major component of the treatment of advanced prostate cancer. The recognition that prostate cancer grows very slowly and must be treated continuously with active agents has led to the development of several therapeutic regimens. These regimens employ oral agents such as estramustine, cyclophosphamide, and etoposide, as they can be taken on a daily basis at home by the patients. These regimens have demonstrated activity in patients with hormone-refractory prostate cancer; declines in both prostate specific antigen and soft tissue lesions have been demonstrated.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Administração Oral , Animais , Antineoplásicos Hormonais/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Masculino
6.
Urol Clin North Am ; 26(2): 275-9, vii, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10361550

RESUMO

The role of chemotherapy in the management of advanced prostate cancer is expanding. Multiple regimens that use a variety of drugs have been developed. A chemotherapy regimen may appear to be a collection of randomly chosen agents. This article presents the theoretic foundation for the development of combination chemotherapy.


Assuntos
Antineoplásicos/uso terapêutico , Animais , Sobrevivência Celular/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos , Humanos , Leucemia L1210/tratamento farmacológico , Leucemia L1210/patologia , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Ratos
7.
Urol Clin North Am ; 26(2): 333-40, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10361556

RESUMO

The use of oral chemotherapy for the treatment of malignant disease is expanding. The authors' experience with oral chemotherapy for hormone-refractory prostate cancer continues to grow. These therapies are well-tolerated and effective. Already, these regimens are being improved by hybridizing them with intravenous agents such as paclitaxel. Also, oral novel agents are being tested that may offer new options for the treatment of hormone-refractory prostate cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Próstata/tratamento farmacológico , Administração Oral , Idoso , Ciclofosfamida/administração & dosagem , Dietilestilbestrol/administração & dosagem , Humanos , Masculino , Prednisona/administração & dosagem , Neoplasias da Próstata/mortalidade , Taxa de Sobrevida
8.
Oncol Rep ; 5(4): 919-21, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9625846

RESUMO

Prostate cancer remains the most commonly diagnosed cancer in American males and is the second leading cause of cancer death in this group. Hydrazine sulfate, an inhibitor of gluconeogenesis, has been proposed as a means to improve nutritional status and improve survival in patients with solid tumors. We investigated the effects of hydrazine sulfate on both in vitro and in vivo models of prostate cancer. We examined the cytotoxicity of hydrazine sulfate in both human (LNCaP and PC-3) and animal (MAT-LyLu) prostate cancer cell lines. No growth inhibition was observed. In vivo, hydrazine sulfate did not suppress the growth of implanted Dunning rat prostate MAT-LyLu cells. Hydrazine sulfate does not have activity in these models of prostate cancer and may not be an appropriate therapy for patients with prostate cancer.


Assuntos
Antineoplásicos/uso terapêutico , Gluconeogênese/efeitos dos fármacos , Hidrazinas/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Animais , Divisão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Masculino , Neoplasias da Próstata/patologia , Ratos , Ratos Sprague-Dawley , Células Tumorais Cultivadas
9.
Anticancer Res ; 18(6A): 4475-82, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9891512

RESUMO

BACKGROUND: Many chemotherapeutic agents are believed to kill cancer cells by inflicting cellular damage which triggers the cell to enter apoptosis (programmed cell death). We investigated the means by which carboplatin induces cell death in three model cancer systems: the human prostate carcinoma cell lines PC-3 and LNCaP and the human cervical carcinoma cell line HeLa. MATERIALS AND METHODS: Drug cytotoxicity, cell cycle effects, bcl-2 deactivation, and multiple markers for apoptosis were utilized to examine carboplatin activity within these cell lines. RESULTS: In HeLa cells, carboplatin appears to induce an S-phase block followed by apoptosis. In contrast, PC-3 and LNCaP cells show no cell cycle phase block and die from necrosis rather than apoptosis. The effects of carboplatin contrast sharply with the effects of paclitaxel, which induces an M-phase block and apoptosis in all three cell lines. CONCLUSIONS: These results show that PC-3 and LNCaP cells are relatively resistant to carboplatin and suggest two causes of resistance: bypassing the cell cycle checkpoints which serve as points of entry into apoptosis, and incomplete execution of the effector mechanisms of apoptosis. Carboplatin resistance in the prostate cancer cell lines fits into the developing scheme of apoptosis-necrosis and raises valuable questions about the root causes of cancer resistance to chemotherapeutic agents.


Assuntos
Carboplatina/toxicidade , Ciclo Celular/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Feminino , Células HeLa , Humanos , Masculino , Necrose , Paclitaxel/toxicidade , Neoplasias da Próstata , Fase S , Células Tumorais Cultivadas , Neoplasias do Colo do Útero
10.
Expert Opin Pharmacother ; 1(2): 271-5, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11249548

RESUMO

Hormone refractory prostate cancer is a disease that kills approximately 39,000 people per year. No single chemotherapeutic agent or regimen has been demonstrated to provide a survival advantage in this disease. Etoposide as a single agent, both in i.v. and oral formulations has not proven to be effective. In the 1990s, however, etoposide has been combined with several agents to create novel treatment regiments for patients with hormone refractory disease. Several of these regimens, all involving oral etoposide, have demonstrated promising results in Phase II trials and early results suggest that they may increase survival for hormone refractory patients, although this remains to be tested in a Phase III trial setting.


Assuntos
Etoposídeo/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Antraciclinas/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Ensaios Clínicos Fase II como Assunto , Ciclofosfamida/administração & dosagem , Estramustina/administração & dosagem , Estramustina/uso terapêutico , Etoposídeo/administração & dosagem , Humanos , Masculino
11.
Urologe A ; 42(5): 641-9, 2003 May.
Artigo em Alemão | MEDLINE | ID: mdl-12750799

RESUMO

Although a number of studies have identified molecular markers for prostate cancer, their clinical utility remains mainly unclear. Markers, which allow improved determination of the biological aggressiveness of individual prostate cancers, may help to optimize therapeutic management of this heterogeneous tumor type. Here, a subset of molecular markers, which are intensively discussed in the literature or which are supposed to gain clinical utility in the future, are described in more detail. For a better survey, the markers are divided into (a) susceptibility markers, (b) malignancy markers, and (c) aggressiveness markers. The number of markers described as well as the inconsistency across studies in assessing their clinical utility reflect the heterogeneity of prostate cancer also on a genetic level so that it is unlikely that a single marker will gain clinical relevance. Future research must include systematic analysis of the clinical utility of not only single markers but rather of marker profiles in appropriate studies.


Assuntos
Marcadores Genéticos/genética , Técnicas de Diagnóstico Molecular , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Humanos , Masculino , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Neoplasias da Próstata/patologia
12.
J Fam Pract ; 33(6): 609-13, 1991 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1744606

RESUMO

BACKGROUND: Projects that are currently under way in Indiana to improve access to obstetrical care have not addressed the availability of these services in nonmetropolitan areas. This study was designed to identify all physicians who were providing obstetrical services in every county throughout the state to determine if there is a correlation between the availability of these services and the infant mortality rate in nonmetropolitan counties. METHODS: A state-wide physician profile maintained by the Indiana Academy of Family Physicians was cross-referenced with a telephone survey of all hospitals in the state to identify those physicians providing obstetrical services within each county in Indiana. The number of physicians in each county was then compared with the number of births per year by mothers from that county to determine whether nonmetropolitan counties had sufficient physicians to provide obstetrical services. Finally, these findings were compared with the most recent infant mortality rate for each nonmetropolitan county. RESULTS: A total of 610 family physicians, 311 obstetricians, and 75 general practitioners were providing obstetrical care in Indiana. There were 10 counties that did not have a physician who delivered babies practicing in that county. Thirty-two counties had more women who needed obstetrical care than the current number of physicians could serve. There was a negative correlation between physician availability and infant mortality in Indiana's nonmetropolitan counties (r = -.38; P less than .02). CONCLUSIONS: Access to care for pregnant patients is a major problem in rural Indiana and hampers Indiana's ability to reduce its current infant mortality rate.


Assuntos
Acessibilidade aos Serviços de Saúde , Mortalidade Infantil , Obstetrícia , Médicos de Família/provisão & distribuição , Saúde da População Rural , Área Programática de Saúde/estatística & dados numéricos , Feminino , Humanos , Indiana/epidemiologia , Recém-Nascido , Área Carente de Assistência Médica , Gravidez , Recursos Humanos
13.
Actas Urol Esp ; 37(1): 54-9, 2013 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-22520041

RESUMO

OBJECTIVES: We present our initial experience using robotic-assisted laparoscopic adrenalectomy in the surgical treatment of adrenal masses. MATERIAL AND METHODS: A total of 18 patients (11 women and 7 men) diagnosed of a functioning or non-functioning adrenal tumor mass were operated on in our facilities between October 2009 and October 2011. Surgical variables, intra-hospital recovery time, pathological findings and peri- and post-operatory findings were evaluated. RESULTS: Mean age of the population intervened was 51.2 years (range 18-81), average ASA score 2.11 (range 1-4) and BMI 27.0 (range 18.8-36.1). Of the 18 patients, 11 were operated on the left side and 7 on the right. Mean surgery time was 150 (range 84-329) min and intra-operatory bleeding 121 (range 10-1500) ml, with a mean loss of hemoglobin and hematocrits of 2.11g/dl and 6.33%, respectively. Two patients were converted to conventional surgery. The factors influencing surgical conversion were: normal size (>10cm), tumor weight (>100g.), active pheochromocytoma and left localization of the tumor. Seven functioning cortical adenomas, 6 metastatic adrenal tumors, 3 pheochromocytoma and 2 incidental tumors were excised. Mean tumor size was 5.39 (range 3-15) cm. Median hospital stay was 6 days (range 4-14). Five patients had peri-operatory complication. Of these, only one (5%) had major complications (Clavien III). Mean follow-up was 6 months (range 2-24). CONCLUSIONS: Robotic technology for laparoscopic adrenalectomies is a valid option for adrenal tumor treatment. In our experience with a relatively short learning curve, it makes it possible to reduce hospital treatment times and the intra- and post-operatory complications, without affecting the oncological and post-operatory functional results.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/métodos , Laparoscopia , Feocromocitoma/cirurgia , Robótica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
14.
Urologe A ; 51(4): 522-6, 2012 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-22113551

RESUMO

The identification of intracellular androgen synthesis by prostate cancer cells has led to the identification of new targets and the development of third generation drugs for the therapy of castration-resistant prostate cancer. Inhibitors of androgen synthesis and more potent androgen receptor antagonists, such as abiraterone acetate, MDV3100, TAK-700 and TOK-001, will improve treatment by prolongation of survival and palliation. A significant reduction of tumor-associated pain and a survival advantage of 4.6 months compared to placebo following docetaxel-based chemotherapy has already been shown for abiraterone in a phase III study. Further phase III studies with abiraterone, MDV3100 and TAK-700 before and after docetaxel-based chemotherapy are currently running. TOK-001 is the first of the new drugs which combines the therapeutic use of androgen synthesis inhibition and androgen receptor antagonism in a single drug. The first clinical studies with this therapy are currently being carried out and it remains to be seen whether this combination leads to increased effectiveness. With an increase in therapy options for prostate-resistant cancer, one of the projects in the coming years will be to integrate the present therapies into therapy concepts. In addition to an effective sequence of the individual medications, a combination with already established therapies, such as cytostatic agents, could also prove to be useful. Altogether, the development of new antihormonal therapies is a considerable expansion of the therapy options for patients which could contribute to an improvement of the quality of life and the prognosis of patients.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Antineoplásicos/uso terapêutico , Medicina Baseada em Evidências , Cuidados Paliativos/métodos , Neoplasias da Próstata/tratamento farmacológico , Humanos , Masculino
15.
Urologe A ; 51(5): 679-81, 2012 May.
Artigo em Alemão | MEDLINE | ID: mdl-22526187

RESUMO

The standard therapy for muscle invasive bladder cancer is radical cystectomy and urinary diversion. For open surgery this procedure has notable perioperative morbidity. Performing laparoscopic cystectomy can reduce this morbidity. So far it remains unclear, whether the oncologic outcome of the laparoscopic approach is comparable to open surgery or not due to a lack of long-term follow-up data. Important surgical steps, such as extended lymphadenectomy, sparing of the neurovascular bundle for preservation of potency, preparation of the urethra for orthotopic neobladder and intracorporeal construction of a urinary diversion can be achieved much more easily with a robot-assisted approach than with conventional laparoscopy. Furthermore, the learning curve for robot-assisted cystectomy is much steeper. Therefore, if a laparoscopic cystectomy is performed, it should be performed using a robot-assisted approach.


Assuntos
Cistectomia/tendências , Laparoscopia/tendências , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Procedimentos de Cirurgia Plástica/tendências , Robótica/tendências , Cirurgia Assistida por Computador/tendências , Humanos
16.
Urologe A ; 51(12): 1656-62, 2012 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-22996421

RESUMO

In Germany misteltoe extract is one of the most commonly used complementary therapeutic strategies in oncology. There are anthroposophical as well as phytotherapeutic concepts to explain the potential mechanism of action; however, the oncological and uro-oncological literature lacks definitive proof to support recommendations on which is the most effective drug, the optimal dose, a clear indication or its efficacy. Weighting the current data, potential side effects and contraindications, the application of mistletoe extract in daily uro-oncological practice requires careful consideration of the indications in the context of a detailed patient informed consent and request for this unique therapeutic modality.


Assuntos
Medicina Baseada em Evidências , Erva-de-Passarinho/química , Fitoterapia/tendências , Extratos Vegetais/uso terapêutico , Neoplasias Urológicas/tratamento farmacológico , Antineoplásicos/uso terapêutico , Humanos , Resultado do Tratamento
17.
Aktuelle Urol ; 43(6): 399-402, 2012 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-23196778

RESUMO

Nephron-sparing surgery is considered to be the standard surgery for small renal masses. There is a large socioeconomic and oncological relevance in such a decision, especially since tumour incidence as well as average life expectancy increases, also triggered by better diagnostic quality. The present review highlights the current state of nephron sparing-surgery, evaluates different surgical approaches and gives perspectives on the future developments and scientific investigations required. In conclusion, nephron-sparing surgery has been well studied and different approaches have shown high safety profiles with oncological results comparable to those of radical nephrectomy. Nephron -sparing surgery provides decisive advantages in long-term survival and patient morbidity, especially concerning chronic renal failure rates. Therefore, whenever feasible, a renal mass should be considered for nephron-sparing surgery.


Assuntos
Neoplasias Renais/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Nefrectomia/métodos , Néfrons/cirurgia , Tratamentos com Preservação do Órgão/métodos , Medicina Baseada em Evidências/normas , Seguimentos , Alemanha , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/prevenção & controle , Testes de Função Renal/normas , Neoplasias Renais/mortalidade , Neoplasias Renais/patologia , Procedimentos Cirúrgicos Minimamente Invasivos/normas , Nefrectomia/normas , Néfrons/patologia , Tratamentos com Preservação do Órgão/normas , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/prevenção & controle , Análise de Sobrevida
18.
Urologe A ; 50 Suppl 1: 179-83, 2011 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-21863408

RESUMO

Considerable progress has been made in nearly all clinical scenarios of bladder carcinoma. Nevertheless early detection of bladder carcinoma using urine markers is still difficult so that none of the available tests can be recommended as a screening test. Photodynamic diagnostics and resection has now been shown for the first time to improve recurrence-free survival of patients but this impact on survival has to be confirmed in a phase III clinical trial before being regarded as standard of care. In pT1G3 tumors early cystectomy seems to improve the prognosis compared to organ preserving strategies. The value of adjuvant chemotherapy is becoming more and more evident, as, apart from several retrospective analyses it has been shown to improve survival in a clinical phase III trial. Furthermore, molecular markers are gaining importance and in the future can be used for identifying patients who may benefit from systemic chemotherapy of bladder carcinoma.


Assuntos
Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/terapia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapia , Ácido Aminolevulínico/uso terapêutico , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/mortalidade , Carcinoma in Situ/patologia , Carcinoma in Situ/terapia , Carcinoma de Células de Transição/mortalidade , Carcinoma de Células de Transição/patologia , Quimioterapia Adjuvante , Terapia Combinada , Cistoscopia/métodos , Intervalo Livre de Doença , Diagnóstico Precoce , Humanos , Programas de Rastreamento , Estadiamento de Neoplasias , Fármacos Fotossensibilizantes/uso terapêutico , Prognóstico , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia
19.
Actas Urol Esp ; 35(3): 152-7, 2011 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-21345519

RESUMO

PURPOSE: radical cystectomy remains the most effective treatment for patients with localized, invasive bladder cancer and recurrent noninvasive disease. We report our experience with 84 consecutive cases of robotic assisted laparoscopic radical cystectomy with regard to perioperative results, pathological outcomes and surgical complications. MATERIALS AND METHODS: a total of 84 consecutive patients (70 male and 14 female) underwent robotic radical cystectomy and urinary diversion at our institution from January 2007 to August 2010 for clinically localized bladder cancer. Outcome measures evaluated included operative variables, hospital recovery, pathological outcomes and complication rate. RESULTS: mean age of this cohort was 65.5 years (range 28 to 82). Of the patients 62 underwent ileal conduit diversion, 22 received a neobladder. Mean operating room time for all patients was 261min. (range: 243-618min.) and mean surgical blood loss was 298ml (range: 50-2000ml). 29% of the cases were pT1 or less disease, 38% were pT2, 26% and 7% were pT3 and T4 disease respectively, 15% were node positive. Mean number of lymph nodes removed was 15 (range 1 to 33). In 2 cases (2.4%) there was a positive surgical margin. Mean days to flatus were 2.12, bowel movement 2.87 and discharge home 17.7 (range: 10-33). There were 45 postoperative complications with 11.9% having a major complication (Clavien grade 3 or higher). At a mean followup of 16.7 months 10 patients (11%) had disease recurrence and 2 died of disease. CONCLUSIONS: our experience with robotic radical cystectomy for the treatment of bladder cancer suggests that in proper hands this procedure provides acceptable surgical and pathological outcomes.


Assuntos
Cistectomia/métodos , Laparoscopia , Robótica , Neoplasias da Bexiga Urinária/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento
20.
Urologe A ; 50(8): 961-7, 2011 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-21728008

RESUMO

The clinical course of prostate cancer, the most common cancer in men, is very variable. Despite intense research activities over the years and besides histopathological criteria, prognostic markers that reliably predict tumor behavior and the necessity for treatment are still missing. A likely explanation for this fact is the lack of good tumor models, mimicking the in vivo situation. These models are not only essential for a better understanding of the pathogenesis of prostate cancer but also play an important role in the development of new therapeutic strategies. Since results of permanent cell culture experiments reflect only in part real tumor behavior and primary cultures from patient material cannot be grown indefinitely, novel approaches need to be developed to achieve reliable and clinically relevant prostate cancer research.In this work the development of several approaches for culturing primary prostate cancer tissue is illustrated and a forecast of future research plans utilizing xenograft models in mice is made.


Assuntos
Técnicas de Cultura de Células , Modelos Animais de Doenças , Neoplasias da Próstata/patologia , Técnicas de Cultura de Tecidos , Transplante Heterólogo , Células Tumorais Cultivadas/patologia , Animais , Previsões , Humanos , Masculino , Camundongos , Invasividade Neoplásica , Neoplasias da Próstata/terapia , Pesquisa Translacional Biomédica/tendências
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