Successful radiofrequency ablation of liver metastases from prostate cancer.

Introduction: Patients with liver metastases from prostate cancer show poor prognosis. We performed metastases-directed therapy using radiofrequency ablation of liver metastases in an attempt to improve the prognosis in a patient with metastatic prostate cancer. Case presentation: We present the case of a 66-year-old man who was treated for metastatic castration-resistant prostate cancer. Evaluation showed isolated liver metastases together with elevated serum prostate-specific antigen levels. We performed metastases-directed therapy using radiofrequency ablation of the liver tumor. The patient showed no recurrent liver metastases for 42 months and survived for 66 months after diagnosis of metastatic prostate cancer. Conclusion: To our knowledge, this is the first report that describes radiofrequency ablation of liver metastases from prostate cancer. This procedure may be a useful therapeutic option for metastases-directed therapy in patients with liver metastases from prostate cancer.

Patients' poor performance status is an independent risk factor for urosepsis induced by kidney and ureteral stones.

This study was aimed to identify the risk factors for urosepsis caused by kidney and ureteral stones. One hundred and nine patients who had kidney or ureteral stones and who were treated with trans-ureteral lithotripsy (TUL) at our institution from 2016 to 2020 were included. We investigated the risk factors for urosepsis caused by kidney or ureteral stones that occurred prior to TUL. Thirty patients (28%) had urosepsis prior to TUL. Patients were divided into a urosepsis group (n = 30, 28%) and a non-urosepsis group (n = 79, 72%). Patients' characteristics (gender, age, performance status [PS] score, presence of diabetes mellitus, and skeletal muscle mass), as well as their stone and urine characteristics (stone size, presence of obstructive ureteral stones, stone composition, and urine and stone cultures), were compared between the two groups. When compared to the non-urosepsis group, patients with urosepsis were more likely to be older (p < 0.001), female (p < 0.001), with lower skeletal muscle mass (p < 0.001) and with poor PSs (p < 0.001). For stone and urine characteristics, infection stones (p = 0.01), positive urine (p < 0.001) and stone culture (p = 0.007) were more often detected in patients with urosepsis. A multivariate analysis showed patients' poor PS to be an independent risk factor for urosepsis due to kidney and ureteral stones (OR = 15.7; 95% CI = 2.2-115, p = 0.007). Our study revealed that the most significant risk factor for urosepsis caused by kidney and ureteral stones was the patients' poor PS.

Molecular analysis of multifocal prostate cancer by comparative genomic hybridization.

BACKGROUND: Prostate cancer is often multifocal and shows histological heterogeneity among different tumor foci within the same prostate. We analyzed the origin and molecular basis of multifocal prostate cancer and genomic alterations associated with tumor progression. METHODS: We examined 45 multifocal prostate cancer foci from 22 radical prostatectomy specimens by comparative genomic hybridization (CGH). Laser capture microdissection (LCM) was used to gather cancer cells from frozen prostate specimens. RESULTS: Frequent chromosomal alternations were losses of 2q21-24 (22.2%), 6q14-22 (60.0%), 8p12-22 (35.6%), 13q14-31 (44.4%) and 16q13-24 (24.4%) and gains of 8q21.3-24.3 (37.8%) and 7q21-33 (20.0%). Frequency of losses of 8p12-22 and 16q13-24 and gains of 8q21.3-24.3 were significantly higher in tumors with high Gleason score (GS) than in those with low GS (P < 0.01, P < 0.05, and P < 0.01, respectively). Tumors with losses of 8p12-22 or 13q14-31 displayed larger volume than those without such losses (P < 0.05 and P < 0.01, respectively). In comparison between different tumor foci within the same prostate, chromosomal alterations did not show completely the same pattern between any tumor foci, except for one case in which two of the three foci displayed no chromosomal abnormalities. More malignant tumors (high GS or extracapsular invasion) displayed significantly higher frequency of losses of 8p12-22 (P < 0.05). CONCLUSIONS: These results suggest that tumor foci within the same prostate represent independent tumors with differing clonal origin and that loss of 8p12-22 represents an important determinant of prostate cancer progression.

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: efficacy in Japanese male patients with ureteral stone.

OBJECTIVE: We evaluated the efficacy of low dose tamsulosin after extracorporeal shock wave lithotripsy (ESWL) in Japanese male patients with ureteral stone. METHODS: One hundred and two Japanese male patients with ureteral stones who underwent ESWL were randomly divided into three groups. Group A (38 patients) was given tamsulosin (0.2 mg/day); group B (30 patients) was given c horeito, a herbal medicine (7.5 g/day); and group C (34 patients) received no medication. Stone clearance was assessed at 1, 7, 14, and 28 days after ESWL using plain abdominal radiography and abdominal ultrasonography. After 28 days, stone delivery was checked every 2 weeks. RESULTS: The stone-free rate was 84.21%, 90%, and 88.24% for groups A, B, and C, respectively (P = 0.3425). The mean expulsion time was 15.66 +/- 6.14 days in group A, 27.74 +/- 25.36 days in group B, and 35.47 +/- 53.70 days in group C. The expulsion time of group A was significantly shorter than that of groups B (P = 0.0116) and C (P = 0.0424). CONCLUSIONS: The addition of tamsulosin to conservative treatment appeared to be effective in shortening the stone expulsion time.