Recent Advances in Diagnosing and Treating Post-Prostatectomy Urinary Incontinence.

Radical prostatectomy and radiotherapy are common first-line treatments for clinically localized prostate cancer. Despite advances in surgical technology and multidisciplinary management, post-prostatectomy urinary incontinence (PPI) remains a common clinical complication. The incidence and duration of PPI are highly heterogeneous, varying considerably between individuals. Post-prostatectomy urinary incontinence may result from a combination of factors, including patient characteristics, lower urinary tract function, and surgical procedures. Physicians often rely on detailed medical history, physical examinations, voiding diaries, pad tests, and questionnaires-based symptoms to identify critical factors and select appropriate treatment options. Post-prostatectomy urinary incontinence treatment can be divided into conservative treatment and surgical interventions, depending on the severity and type of incontinence. Pelvic floor muscle training and lifestyle interventions are commonly conservative strategies. When conservative treatment fails, surgery is frequently recommended, and the artificial urethral sphincter remains the "gold standard" surgical intervention for PPI. This review focuses on the diagnosis and treatment of PPI, based on the most recent clinical research and recommendations of guidelines, including epidemiology and risk factors, diagnostic methods, and treatment strategies, aimed at presenting a comprehensive overview of the latest advances in this field and assisting doctors in providing personalized treatment options for patients with PPI.

Apolipoprotein A1 -75 G/A and +83 C/T polymorphisms and renal cancer risk.

BACKGROUND: Apolipoprotein A1 (ApoA1) is the major apoprotein constituent of high-density lipoprotein that can play important roles in tumor invasion and metastasis. The objective of the present study was to evaluate the association of two genetic variants (-75 G/A and +83 C/T) of APOA1 with predisposition to renal cancer. METHODS: A total of 432 subjects, including 216 pathologically-proven renal cancer cases and 216 age- and gender-matched healthy controls, were recruited into this hospital-based case-control study. Genotyping of the APOA1 was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) combined with gel electrophoresis, and then confirmed by direct sequencing. RESULTS: Patients with renal cancer had a significantly higher frequency of APOA1 -75 AA genotype [odds ratio (OR) = 2.10, 95% confidence interval (CI) = 1.18, 3.75; P = 0.01] and APOA1 -75 A allele (OR =1.40, 95% CI = 1.05, 1.87; P = 0.02) than controls. When stratifying by the distant metastasis status, patients with distant metastasis had a significantly higher frequency of APOA1 -75 AA genotype genotype (OR =2.20, 95% CI = 1.04, 4.68; P = 0.04). CONCLUSION: This study is, to our knowledge, the first to examine prospectively an increased risk role of APOA1 -75 AA genotype and APOA1 -75 A allele in renal cancer susceptibility.

[Insertion/deletion polymorphism of IL1A 3'-UTR associated with the susceptibility of prostate cancer ].

OBJECTIVE: To identify the association between the insertion/deletion polymorphism of interleukin- 1A gene (IL1A) and the susceptibility of prostate cancer (PCA). METHODS: We performed a case-control study enrolling 131 PCA patients and 229 healthy control subjects in a Chinese Han population. The TTCA insertion/ deletion polymorphism (rs3783553) in 3'-UTR of IL1A gene was genotyped by PCR-RFLP method. RESULTS: The genotype distribution of rs3783553 in both groups met the requirements of Hardy-Weinberg equilibrium. Significantly reduced PCA risk was associated with D/I and I/I genotype compared to D/D genotype (P<0. 001, OR=O. 48, 95%CI: 0.31-0.74), and allele I is associated with the reduced PCA risk (P=0. 001,OR=0. 56,95% CI: 0. 40-0. 79). CONCLUSION: TTCA insertion allele of rs3783553 contributes to the reduction of the susceptibility to prostate cancer.

Retroperitoneal laparoscopic partial nephrectomy for unilateral synchronous multifocal renal carcinoma with different pathological types: A case report.

BACKGROUND: The majority of renal cell carcinomas are single lesions; unilateral synchronous multifocal renal carcinoma (USMRC) is rarely reported and poses a treatment challenge for urological oncologists. CASE SUMMARY: A 56-year-old man was hospitalized for pain and discomfort in the right kidney area for 6 d. Contrast-enhanced computed tomography demonstrated cT1a renal tumors at the lower pole of the right kidney and a cT1b renal tumor at the middle dorsal portion of the right kidney. The patient underwent retroperitoneal laparoscopic partial nephrectomy (RLPN). There were no complications peri-operatively. Histopathology revealed a low-grade, pathologic stage T1a (pT1a), clear cell renal cell carcinoma at the lower pole of the right kidney and a pT1b, chromophobe renal cell carcinoma at the middle dorsal portion of the right kidney. No tumor bed recurrence or metastasis was observed on imaging and his renal function remained stable during the 12-mo follow-up period. CONCLUSION: RLPN is a safe, effective, and feasible for the management of USMRC, which can obtain equivalent oncological results with optimal renal function preservation.

Clinicopathological and Prognostic Characteristics of CD276 (B7-H3) Expression in Adrenocortical Carcinoma.

BACKGROUND: Adrenocortical carcinoma (ACC) is a rare malignant endocrine tumor with a high tumor recurrence rate and poor postoperative survival. Recent studies suggest that CD276- (B7-H3) targeted therapy represents a promising therapeutic option for solid tumors. However, little is known about the expression status of CD276 or its association with progression and prognosis of ACC. METHODS: Clinical data were retrospectively analyzed from patients who underwent resection of ACC at our institution (n = 48). Archived, formalin-fixed, and paraffin-embedded samples were collected for immunohistochemical analysis, and the correlation between CD276 expression and clinicopathological parameters was evaluated. Kaplan-Meier and univariate/multivariate Cox regression methods were implemented to identify any prognostic effects. Data from The Cancer Genome Atlas (TCGA) ACC cohort (n = 48). Archived, formalin-fixed, and paraffin-embedded samples were collected for immunohistochemical analysis, and the correlation between CD276 expression and clinicopathological parameters was evaluated. Kaplan-Meier and univariate/multivariate Cox regression methods were implemented to identify any prognostic effects. Data from The Cancer Genome Atlas (TCGA) ACC cohort (. RESULTS: Positive expression of CD276 was detected on the cell membrane and in the cytoplasm of cancer cells or tumor-associated vascular cells in 91.67% (44/48) of ACCs. Vascular expression of CD276 was associated with local aggression (higher T stage, P = 0.029) and advanced ENSAT stage (P = 0.029) and advanced ENSAT stage (P = 0.029) and advanced ENSAT stage (P = 0.029) and advanced ENSAT stage (P = 0.029) and advanced ENSAT stage (P = 0.029) and advanced ENSAT stage (. CONCLUSION: These findings highlight the immune checkpoint factor CD276 as an independent prognostic factor and a potential therapeutic target in ACC.

A modified clinicopathological tumor staging system for survival prediction of patients with penile cancer.

BACKGROUND: The 8th American Joint Committee on Cancer tumor-node-metastasis (AJCC-TNM) staging system is based on a few retrospective single-center studies. We aimed to test the prognostic validity of the staging system and to determine whether a modified clinicopathological tumor staging system that includes lymphovascular embolization could increase the accuracy of prognostic prediction for patients with stage T2-3 penile cancer. METHODS: A training cohort of 411 patients who were treated at 2 centers in China and Brazil between 2000 and 2015 were staged according to the 8th AJCC-TNM staging system. The internal validation was analyzed by bootstrap-corrected C-indexes (resampled 1000 times). Data from 436 patients who were treated at 15 centers over four continents were used for external validation. RESULTS: A survivorship overlap was observed between T2 and T3 patients (P = 0.587) classified according to the 8th AJCC-TNM staging system. Lymphovascular embolization was a significant prognostic factor for metastasis and survival (all P < 0.001). Based on the multivariate analysis, only lymphovascular embolization showed a significant influence on cancer-specific survival (CSS) (hazard ratio = 1.587, 95% confidence interval = 1.253-2.011; P = 0.001). T2 and T3 patients with lymphovascular embolization showed significantly shorter CSS than did those without lymphovascular embolization (P < 0.001). Therefore, a modified clinicopathological staging system was proposed, with the T2 and T3 categories of the 8th AJCC-TNM staging system being subdivided into two new categories as follows: t2 tumors invade the corpus spongiosum and/or corpora cavernosa and/or urethra without lymphovascular invasion, and t3 tumors invade the corpus spongiosum and/or corpora cavernosa and/or urethra with lymphovascular invasion. The modified staging system involving lymphovascular embolization showed improved prognostic stratification with significant differences in CSS among all categories (all P < 0.005) and exhibited higher accuracy in predicting patient prognoses than did the 8th AJCC-TNM staging system (C-index, 0.739 vs. 0.696). These results were confirmed in the external validation cohort. CONCLUSIONS: T2-3 penile cancers are heterogeneous, and a modified clinicopathological staging system that incorporates lymphovascular embolization may better predict the prognosis of patients with penile cancer than does the 8th AJCC-TNM staging system. Trial registration This study was retrospectively registered on Chinese Clinical Trail Registry: ChiCTR16008041 (2016-03-02). http://www.chictr.org.cn.

Clinicopathological Characteristics, Treatment, and Prognosis of Rarely Primary Epididymal Adenocarcinoma: A Review and Update.

Primary epididymal adenocarcinoma (PEA) is exceedingly rare. Only 22 cases had been published worldwide by 2008; nearly 80% of these cases were reported before 2007. In order to investigate the current clinical status of PEA, we search for relevant literatures with "epididymis and adenocarcinoma" and "epididymal and adenocarcinoma" as keywords published between January 1997 and November 2017 in PubMed. As a result, 17 cases are identified. We review these cases and summarize new and important perspectives about the clinicopathological characteristics, diagnosis, treatment, and prognosis of PEA in the present review.

Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study.

BACKGROUND: Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients. METHODS: Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis. RESULTS: In this study, the Kaplan-Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2 patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3 patients (P = 0.417) with comparable DSS. CONCLUSION: Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.

Association between the interleukin-6 gene polymorphisms and renal cancer risk.

INTRODUCTION: Interleukin-6 (IL-6), a central proinflammatory cytokine, may be involved in the host response to cancer. We therefore aimed to evaluate the association of the IL-6 gene polymorphisms at positions -174 and -572 with predisposition to renal cancer. MATERIALS AND METHODS: We conducted a hospital-based case-control study. A total of 432 subjects, including 216 pathologically-proven renal cancer cases and 216 age- and gender-matched healthy controls, were recruited in this study. Polymorphism for the IL-6 gene was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Patients with renal cancer had a significantly higher frequency of IL-6 -174 CC genotype [odds ratio (OR)=2.08, 95% confidence interval (CI)=1.05, 4.13; P=0.04] than healthy controls. When stratifying by the grade, patients with higher grade (grade 3 or 4) renal cancer had a significantly higher frequency of IL-6 -174 CC genotype (OR=2.33, 95% CI=1.04, 5.23; P=0.04). CONCLUSION: This study is, to our knowledge, the first to examine prospectively an increased risk role of IL-6 -174 CC genotype in renal cancer susceptibility.