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1.
BJU Int ; 123(5): 877-884, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30216623

RESUMEN

OBJECTIVE: To investigate the relationship between oxidative stress and lower urinary tract symptoms (LUTS) in a community-dwelling population. MATERIALS AND METHODS: The cross-sectional study included 1 113 people who participated in the Iwaki Health Promotion Project of 2015 in Hirosaki, Japan. LUTS were assessed using structured questionnaires, including the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS). IPSS > 7, OABSS > 5, nocturia score > 1, or urge incontinence score > 1 were defined as moderate to severe symptoms. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) and advanced glycation end products (AGEs) were measured by urine analysis and skin autofluorescence, respectively. The relationship between oxidative stress and LUTS was investigated using logistic regression analyses. RESULTS: This study included 431 men and 682 women. AGEs and 8-OHdG levels were significantly higher in severe forms of LUTS. Multivariate logistic regression analyses showed that AGE levels were significantly associated with a higher frequency of nocturia but were not associated with IPSS, OABSS or urge incontinence. No significant association was observed between LUTS and 8-OHdG levels. CONCLUSIONS: We observed a significant association between AGE levels and nocturia score > 1. Further research is necessary to clarify a possible causal relationship between oxidative stress and nocturia.


Asunto(s)
Síntomas del Sistema Urinario Inferior/fisiopatología , Estrés Oxidativo/fisiología , Vejiga Urinaria Hiperactiva/fisiopatología , Incontinencia Urinaria de Urgencia/fisiopatología , Adulto , Estudios Transversales , Encuestas Epidemiológicas , Humanos , Japón/epidemiología , Síntomas del Sistema Urinario Inferior/complicaciones , Síntomas del Sistema Urinario Inferior/epidemiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Vejiga Urinaria Hiperactiva/epidemiología , Incontinencia Urinaria de Urgencia/epidemiología
2.
Int J Mol Sci ; 18(2)2017 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-28134773

RESUMEN

Wisteria floribunda agglutinin (WFA) preferably binds to LacdiNAc glycans, and its reactivity is associated with tumor progression. The aim of this study to examine whether the serum LacdiNAc carrying prostate-specific antigen-glycosylation isomer (PSA-Gi) and WFA-reactivity of tumor tissue can be applied as a diagnostic and prognostic marker of prostate cancer (PCa). Between 2007 and 2016, serum PSA-Gi levels before prostate biopsy (Pbx) were measured in 184 biopsy-proven benign prostatic hyperplasia patients and 244 PCa patients using an automated lectin-antibody immunoassay. WFA-reactivity on tumor was analyzed in 260 radical prostatectomy (RP) patients. Diagnostic and prognostic performance of serum PSA-Gi was evaluated using area under the receiver-operator characteristic curve (AUC). Prognostic performance of WFA-reactivity on tumor was evaluated via Cox proportional hazards regression analysis and nomogram. The AUC of serum PSA-Gi detecting PCa and predicting Pbx Grade Group (GG) 3 and GG ≥ 3 after RP was much higher than those of conventional PSA. Multivariate analysis showed that WFA-reactivity on prostate tumor was an independent risk factor of PSA recurrence. The nomogram was a strong model for predicting PSA-free survival provability with a c-index ≥0.7. Serum PSA-Gi levels and WFA-reactivity on prostate tumor may be a novel diagnostic and pre- and post-operative prognostic biomarkers of PCa, respectively.


Asunto(s)
Biomarcadores de Tumor/sangre , Lectinas de Plantas/metabolismo , Polisacáridos/metabolismo , Antígeno Prostático Específico/metabolismo , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/diagnóstico , Receptores N-Acetilglucosamina/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Biopsia , Glicosilación , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Análisis Multivariante , Clasificación del Tumor , Recurrencia Local de Neoplasia/patología , Pronóstico , Próstata/patología , Próstata/cirugía , Antígeno Prostático Específico/sangre , Prostatectomía , Hiperplasia Prostática/sangre , Hiperplasia Prostática/patología , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/cirugía , Curva ROC , Factores de Riesgo
3.
Hinyokika Kiyo ; 60(11): 579-82, 2014 Nov.
Artículo en Japonés | MEDLINE | ID: mdl-25511947

RESUMEN

A 34-year-old man presented with left inguinal discomfort. Digital rectal examination revealed an enlarged nodular prostate. Computed tomography showed an enlarged prostate invading the bladder and rectum. A histological examination of transrectal prostatic needle biopsy specimens revealed sarcoma of the prostate. He received three courses of neoadjuvant arterial injection chemotherapy consisting of adriamycin (30 mg/m2) and cisplatin (70 mg/m2). Total pelvic excenteration was perfomed. Histopathological examination of the tumor revealed leiomyosarcoma of the prostate. He remains alive 11 months after the operation without recurrence.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leiomiosarcoma/terapia , Terapia Neoadyuvante , Exenteración Pélvica , Neoplasias de la Próstata/terapia , Adulto , Biopsia , Cisplatino/administración & dosificación , Tacto Rectal , Doxorrubicina/administración & dosificación , Humanos , Inyecciones Intraarteriales , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/patología , Masculino , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
4.
Hinyokika Kiyo ; 60(1): 33-7, 2014 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-24594771

RESUMEN

A 76-year-old woman with a capillary hemangioma in renal hilum is reported. She was referred to our hospital with left cystic renal tumor detected by ultrasonography during the hepatitis C follow-up. Computed tomography revealed a retroperitoneal tumor in the left renal hilum with contrast effect. A hypervascular tumor in the renal hilum with severe fibrous adhesion was observed with laparoscopy and open tumorectomy was indicated. However, left radical nephrectomy was required because of severe adhesion. Histopathologic examination revealed capillary hemangioma without malignancy. Because preoperative diagnosis of capillary hemangioma was challenging, surgical excision was selected as a treatment for this rare entity.


Asunto(s)
Hemangioma Capilar/diagnóstico por imagen , Hemangioma Capilar/cirugía , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/cirugía , Anciano , Femenino , Fibrosis , Hemangioma Capilar/irrigación sanguínea , Hemangioma Capilar/patología , Humanos , Neoplasias Renales/irrigación sanguínea , Neoplasias Renales/patología , Laparoscopía , Nefrectomía , Tomografía Computarizada por Rayos X
5.
BMC Urol ; 13: 47, 2013 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-24125174

RESUMEN

BACKGROUND: Management of renal cell carcinoma (RCC) with tumor thrombus extending to the renal vein and inferior vena cava (IVC) is challenging. The aim of this study was to evaluate the benefit of surgical management in such patients. METHODS: From February 1995 to February 2013, 520 patients were treated for RCC at Hirosaki University Hospital, Hirosaki, Japan. The RCC patients with tumor thrombus extending to the renal vein (n = 42) and IVC (n = 43) were included in this study. The records of these 85 patients were retrospectively reviewed to assess the relevant clinical and pathological variables and survival. Prognostic factors were identified by multivariate analysis. The benefit of surgical management was evaluated using propensity score matching to compare overall survival between patients who received surgical management and those who did not. RESULTS: RCC was confirmed by pathological examination of surgical or biopsy specimens in 74 of the 85 patients (87%). Sixty-five patients (76%) received surgical management (radical nephrectomy with thrombectomy). Distant metastasis was identified in 45 patients (53%). The proportion of patients with tumor thrombus level 0 (renal vein only), I, II, III, and IV was 49%, 13%, 18%, 14%, and 5%, respectively. The estimated 5-year overall survival rate was 70% in patients with thrombus extending to the renal vein and 23% in patients with thrombus extending to the IVC. Multivariate analysis identified thrombus extending to the IVC, presence of distant metastasis, surgical management, serum albumin concentration, serum choline esterase concentration, neutrophil-lymphocyte ratio, and Carlson comorbidity index as independent prognostic factors. In propensity score-matched patients, overall survival was significantly longer in those who received surgical management than those who did not. CONCLUSIONS: Surgical management may improve the prognosis of RCC patients with thrombus extending to the renal vein and IVC.


Asunto(s)
Carcinoma de Células Renales/cirugía , Neoplasias Renales/cirugía , Nefrectomía/mortalidad , Venas Renales/cirugía , Trombectomía/mortalidad , Vena Cava Inferior/cirugía , Trombosis de la Vena/cirugía , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/mortalidad , Terapia Combinada/mortalidad , Comorbilidad , Femenino , Humanos , Japón/epidemiología , Neoplasias Renales/mortalidad , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento , Trombosis de la Vena/mortalidad
6.
ScientificWorldJournal ; 2013: 693514, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24228012

RESUMEN

Although the number of elderly patients requiring dialysis has increased, data regarding the prognosis of elderly patients undergoing hemodialysis are limited. In the present study, prognosis in Japanese hemodialysis patients aged ≥80 years was evaluated. From January 1988 to July 2013, 1144 consecutive patients with end-stage renal disease required renal replacement therapy at our institution; of these, 141 were aged ≥80 years. These patients' charts were retrospectively reviewed for relevant clinical variables and survival time. The life expectancies table from the National Vital Statistics database was used, and prognostic factors were assessed by multivariate analysis. In total, 107 deaths (76%) were recorded during the study period. The median survival time and estimated life-shortening period in the patients were 2.6 years and -5.3 years, respectively. Eastern Cooperative Oncology Group Performance Status and hemoglobin level were revealed as prognostic factors in the multivariate analysis. Estimates of prognosis and prognostic factors may provide useful information for physicians as well as elderly patients with end-stage kidney disease.


Asunto(s)
Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/rehabilitación , Esperanza de Vida , Diálisis Renal/mortalidad , Diálisis Renal/estadística & datos numéricos , Distribución por Edad , Anciano de 80 o más Años , Femenino , Anciano Frágil , Humanos , Japón/epidemiología , Masculino , Prevalencia , Pronóstico , Medición de Riesgo , Distribución por Sexo , Tasa de Supervivencia
7.
Nihon Hinyokika Gakkai Zasshi ; 113(3): 96-102, 2022.
Artículo en Japonés | MEDLINE | ID: mdl-37468279

RESUMEN

(Objectives) This study aimed to evaluate the surgical outcomes and functional parameters of lower urinary tract and bowel symptoms in patients who have undergone robot-assisted sacrocolpopexy (RASC) due to pelvic organ prolapse. (Patients and methods) This retrospective study included 110 consecutive RASC cases in the urology department of Ageo Central General Hospital, Japan, from November 2020 to October 2021. The medical records of these patients were retrieved. Data on uroflowmetry, post-void residual urine test, and self-administered questionnaires on urination and defecation were assessed. (Results) The mean operating time was 146 min, and the estimated blood loss was 14.8 ml. The intraoperative, postoperative, and severe complication rates of cases classified as Clavien-Dindo grade IIIa or higher were 0%, 9.1%, and 0%, respectively. The maximum flow rate and post-void residual volume of urine significantly improved after the operation. Similarly, the quality of life (QOL) scores and overactive bladder symptom score (OABSS), as well as the responses for the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Urinary Distress Inventory-6 (UDI-6), significantly improved one month after the operation and were sustained for six months. On the other hand, the total scores from the Constipation Scoring System (CSS) and the subscales of the Patient Assessment of Constipation (PAC) -QOL worsened. These scores, except for those of the PAC-QOL satisfaction subscale recovered to the preoperative levels; the PAC-QOL satisfaction subscale scores significantly improved six months postoperatively. The rates of de novo overactive bladder (OAB), stress urinary incontinence (SUI), and constipation one month postoperatively were 8%, 33%, and 10%, respectively. (Conclusions) RASC was performed safely in our institution with acceptable postoperative lower urinary tract and bowel outcomes.

8.
Urol Oncol ; 39(12): 832.e17-832.e23, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33865689

RESUMEN

OBJECTIVE: The number of cycles of platinum-based first-line chemotherapy associated with the maximum tumor response in patients with advanced urothelial carcinoma is not yet established. We investigated the association between the number of cycles and the maximum radiological response of first-line chemotherapy. METHODS: We retrospectively evaluated 167 patients with advanced urothelial carcinoma treated with platinum-based first-line chemotherapy between May 2003 and December 2020. The primary outcome was estimating the number of cycles associated with the maximum radiological response and progression disease rate within the 6 cycles. The radiological response was evaluated by the RECIST v1.1. The secondary outcomes included the difference in radiological response rate and the impact on overall survival between the cisplatin-based and carboplatin-based regimens. RESULTS: The maximum radiological response was -22% at Cycles 2. It was significantly decreased at Cycles 4 (-15%) compared with Cycles 2 (P < 0.001). The progression disease rate within the first 2, 4, and 6 cycles were 21% and 63%, and 84%, respectively. Radiological response was no significant difference between the cisplatin-based and carboplatin-based regimens. However, it was significantly decreased in the carboplatin-based regimen at Cycles 4 (-17%) compared with Cycles 2 (-22%; P = 0.004). Background-adjusted overall survival was not significantly different in between the cisplatin-based and carboplatin-based regimens (hazard rate 1.27; P = 0.337). CONCLUSION: The maximum radiological response was -22% at Cycles 2. The radiological response was significantly different between Cycle 2 and 4. More than half of patients had disease progression within the first 4 cycles.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Platino (Metal)/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/radioterapia , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Platino (Metal)/farmacología , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento
9.
Int Urol Nephrol ; 50(11): 1999-2005, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30229466

RESUMEN

PURPOSE: Optimal management strategies for patients with high-risk prostate cancer (PCa) have not been established. This study aimed to estimate the impact of surgical procedures on perioperative and oncological outcomes in patients with high-risk PCa who received neoadjuvant chemohormonal therapy (CHT) prior to radical prostatectomy (RP). METHODS: In this retrospective study, we focused on patients with high-risk PCa who received neoadjuvant CHT followed by RP. The enrolled patients were divided into the following two groups according to surgical procedure: the robot-assisted RP (RARP) group and minimum incision endoscopic RP (MIE-RP) group. The primary endpoint was biochemical recurrence-free survival (BRFS). RESULTS: A total of 522 high-risk PCa patients were enrolled in this study. The median operating time was significantly shorter in the MIE-RP group than in the RARP group. The median estimated blood loss was significantly lower in the RARP group than in the MIE-RP group. The rates of positive surgical margins (PSMs) were not statistically significant in either group. During the follow-up period, biochemical recurrence (BCR) without clinical recurrence occurred in 60 (23.9%) patients in the MIE-RP group and 5 (1.8%) in the RARP group. The 5-year BRFS rate was 76.5% in the MIE-RP group and 97.6% in the RARP group (P < 0.001). On multivariate analysis, RARP, PSM, pathological T stage, and initial prostate-specific antigen were significantly associated with BCR. CONCLUSIONS: Neoadjuvant CHT with subsequent RARP may decrease the risk of BCR when compared to MIE-RP.


Asunto(s)
Antineoplásicos/uso terapéutico , Endoscopía , Terapia Neoadyuvante , Prostatectomía , Neoplasias de la Próstata/terapia , Procedimientos Quirúrgicos Robotizados , Anciano , Supervivencia sin Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Resultado del Tratamiento
10.
Int Urol Nephrol ; 49(5): 811-816, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28213801

RESUMEN

PURPOSE: The optimal treatment for high-risk prostate cancer (Pca) remains to be established. We previously reported favorable biochemical recurrence-free survival (BRFS) for high-risk Pca patients treated with neoadjuvant therapy comprising a luteinizing hormone-releasing hormone agonist plus low-dose estramustine (LHRH + EMP) prior to radical prostatectomy (RP). In the present study, we evaluated the efficacy of neoadjuvant therapy comprising a gonadotropin-releasing hormone antagonist plus low-dose estramustine phosphate (GnRH + EMP) in patients with high-risk Pca. METHODS: Between September 2005 and March 2016, we identified 406 high-risk Pca patients of whom 136 received neoadjuvant GnRH + EMP (GnRH group) and 270 received LHRH + EMP (LHRH group) before RP. We retrospectively evaluated the clinical and pathological covariates between the two groups. The endpoint was the rate of pathological T0 status. RESULTS: The rates of pathological T0 status were 11.0 and 8.9% in the GnRH group and LHRH group, respectively (P = 0.490). The 2-year BRFS rates were 97.8% in the GnRH group and 87.8% in the LHRH group (P = 0.027). CONCLUSION: Our findings suggest that neoadjuvant GnRH antagonist + EMP followed by RP may improve the pathological outcomes and reduce the risk of biochemical recurrence in patients with high-risk Pca. Further prospective studies to confirm these findings are warranted.


Asunto(s)
Estramustina/administración & dosificación , Hormona Liberadora de Gonadotropina/antagonistas & inhibidores , Terapia Neoadyuvante/métodos , Oligopéptidos/administración & dosificación , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/terapia , Centros Médicos Académicos , Anciano , Antineoplásicos Hormonales/administración & dosificación , Estudios de Cohortes , Supervivencia sin Enfermedad , Quimioterapia Combinada , Hormona Liberadora de Gonadotropina/administración & dosificación , Humanos , Japón , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Prostatectomía/métodos , Neoplasias de la Próstata/mortalidad , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento
11.
Oncotarget ; 8(30): 49749-49756, 2017 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-28572534

RESUMEN

BACKGROUND AND OBJECTIVE: A quantitative tumor response evaluation to molecular-targeting agents in advanced renal cell carcinoma (RCC) is debatable. We aimed to evaluate the relationship between radiologic tumor response and pathological response in patients with advanced RCC who underwent presurgical therapy. RESULTS: Of 34 patients, 31 underwent scheduled radical nephrectomy. Presurgical therapy agents included axitinib (n = 26), everolimus (n = 3), sunitinib (n = 1), and axitinib followed by temsirolimus (n = 1). The major presurgical treatment-related adverse event was grade 2 or 3 hypertension (44%). The median radiologic tumor response by RECIST, Choi, and CMER were -19%, -24%, and -49%, respectively. Among the radiologic tumor response tests, CMER showed a higher association with tumor necrosis in surgical specimens than others. Ki67/MIB1 status was significantly decreased in surgical specimens than in biopsy specimens. The magnitude of the slope of the regression line associated with the tumor necrosis percentage was greater in CMER than in Choi and RECIST. MATERIALS AND METHODS: Between March 2012 and December 2016, we prospectively enrolled 34 locally advanced and/or metastatic RCC who underwent presurgical molecular-targeting therapy followed by radical nephrectomy. Primary endpoint was comparison of radiologic tumor response among Response Evaluation Criteria in Solid Tumors (RECIST), Choi, and contrast media enhancement reduction (CMER). Secondary endpoint included pathological downstaging, treatment related adverse events, postoperative complications, Ki67/MIB1 status, and tumor necrosis. CONCLUSIONS: CMER may predict tumor response after presurgical molecular-targeting therapy. Larger prospective studies are needed to develop an optimal tumor response evaluation for molecular-targeting therapy.


Asunto(s)
Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/tratamiento farmacológico , Neoplasias Renales/diagnóstico , Neoplasias Renales/tratamiento farmacológico , Terapia Molecular Dirigida , Cuidados Preoperatorios , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X , Anciano , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Medios de Contraste , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia Molecular Dirigida/efectos adversos , Terapia Molecular Dirigida/métodos , Necrosis , Estadificación de Neoplasias , Nefrectomía , Inhibidores de Proteínas Quinasas/administración & dosificación , Inhibidores de Proteínas Quinasas/efectos adversos , Inhibidores de Proteínas Quinasas/uso terapéutico , Criterios de Evaluación de Respuesta en Tumores Sólidos , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
12.
Oncotarget ; 8(39): 65492-65505, 2017 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-29029448

RESUMEN

BACKGROUND: The recurrence risk stratification and the cost effectiveness of oncological surveillance after radical cystectomy are not clear. We aimed to develop a risk stratification and a surveillance protocol with improved cost effectiveness after radical cystectomy. RESULTS: Of 581 enrolled patients, 175 experienced disease recurrences. The pathology-based protocol presented significant differences in recurrence-free survival between normal- and high-risk patients, but the medical expense was high, especially in normal-risk (≤pT2pN0) patients. Cox regression analysis identified six factors associated with recurrence-free survival. Risk score-based 5-year follow-up was significantly more cost effective than the pathology-based protocol. MATERIALS AND METHODS: We retrospectively evaluated 581 patients with radical cystectomy for muscle-invasive bladder cancer at 4 hospitals. Patients with routine oncological follow-up were stratified into normal- and high-risk groups by a pathology-based protocol utilizing pT, pN, lymphovascular invasion, and histology. Cost effectiveness of the pathology-based protocol was evaluated and a risk-score-based protocol was developed to optimize cost effectiveness. Risk-scores were calculated by summing risk factors independently associated with recurrence-free survival. Patients were stratified by low-, intermediate-, and high-risk score. Estimated cost per one recurrence detection by the pathology and by risk-scores were compared. CONCLUSIONS: Risk-score-stratified surveillance protocol has potential to reduce over-evaluation after radical cystectomy without adverse effects on medical cost.

13.
Oncotarget ; 8(37): 61404-61414, 2017 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-28977873

RESUMEN

OBJECTIVE: To evaluate the impact of preoperative chronic kidney disease (CKD) on oncologic outcomes in muscle-invasive bladder cancer patients who underwent radical cystectomy. METHODS: A total of 581 patients who underwent radical cystectomy at four medical centers between January 1995 and February 2017 were examined retrospectively. We investigated oncologic outcomes, including progression-free, cancer-specific, and overall survival (PFS, CSS, and OS, respectively) stratified by preoperative CKD status (pre-CKD vs. non-CKD). We performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) to evaluate the impact of preoperative CKD on prognosis and developed the prognostic factor-based risk stratification nomogram. RESULTS: Of the 581 patients, 215 (37%) were diagnosed with CKD before radical cystectomy. Before the background adjustment, PFS, CSS, and OS after radical cystectomy were significantly lower in the pre-CKD group compared to the non-CKD group. Background-adjusted IPTW analysis showed that preoperative CKD was significantly associated with poor PFS, CSS, and OS after radical cystectomy. The nomogram for predicting 5-year PFS and OS probability showed significant correlation with actual PFS and OS (c-index = 0.73 and 0.77, respectively). CONCLUSIONS: Muscle-invasive bladder cancer patients with preoperative CKD had a significantly lower survival probability than those without CKD.

14.
Biomed Res Int ; 2016: 4975851, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27195288

RESUMEN

This study aimed to assess the efficacy of combination therapy with dutasteride and silodosin in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH). Eighty consecutive patients with a first episode of AUR were enrolled in this study. All patients received silodosin 8 mg and dutasteride 0.5 mg daily. Trial without catheter (TWOC) was attempted every 2 weeks until 12 weeks after the initiation of medication. The primary endpoint was the rate of catheter-free status at 12 weeks. Voided volume (VV), postvoid residual urine (PVR), uroflowmetry, International Prostatic Symptoms Score (IPSS), and quality of life due to urinary symptoms (IPSS-QOL) were also measured. All patients were followed up for more than 12 weeks and were included in this analysis. The success rate of TWOC at 12 weeks was 88.8%. VV and maximum urinary flow rate were significantly higher at 2, 4, 8, and 12 weeks compared with the time of AUR (P < 0.001). IPSS and IPSS-QOL were significantly lower at 2, 4, 8, and 12 weeks compared with the time of AUR (P < 0.001). In conclusion, a combination of dutasteride and silodosin therapy may be effective and safe for patients with AUR due to BPH.


Asunto(s)
Dutasterida/efectos adversos , Dutasterida/uso terapéutico , Indoles/efectos adversos , Indoles/uso terapéutico , Hiperplasia Prostática/complicaciones , Retención Urinaria/tratamiento farmacológico , Retención Urinaria/etiología , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Quimioterapia Combinada , Humanos , Estimación de Kaplan-Meier , Masculino , Estudios Prospectivos , Hiperplasia Prostática/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Retención Urinaria/fisiopatología , Micción
15.
Case Rep Urol ; 2014: 646743, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24653857

RESUMEN

We report a case of malignant pheochromocytoma in a 35-year-old Japanese woman during fertility treatment, successfully treated with surgical excision. The patient recovered without any postoperative problems, and plasma catecholamine levels normalized. At present, 18 months after the operation, there are no signs of relapse.

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