A retrospective feasibility study of biweekly docetaxel in patients with high-risk metastatic castration-naïve prostate cancer.

BACKGROUND: Results from randomized phase III trials have shown that thrice-weekly docetaxel added to androgen-deprivation therapy (ADT) has a significant impact on the survival of patients with metastatic castration-naïve prostate cancer (mCNPC) and established early chemotherapy as part of the standard of care for high-risk disease. Controversy remains, however, because some patients experience critical toxicities related to docetaxel. The purpose of the current study was to evaluate the feasibility and adverse events of biweekly-administered docetaxel in patients with previously-untreated, high-risk mCNPC. METHODS: The study included 35 consecutive patients with high-risk mCNPC who received ADT plus docetaxel 40 mg/m2. Oral prednisone 5 mg twice daily was also given. Treatment was repeated every two weeks for up to 12 cycles or until disease progression or unacceptable toxicity occurred. High-risk was defined as bone metastases beyond axial skeleton and/or visceral disease. RESULTS: The included patients' median age was 68 years (range: 31-86 years) and 17 (49%) had visceral metastases. Biweekly docetaxel was generally well-tolerated; the most commonly observed adverse events, considering those of all grades, included alopecia (74%), nail changes (42%), and constipation (31%). Hematologic adverse events were infrequent, and no patient received hematopoietic growth factors. One patient died after the fourth cycle due to respiratory failure, which occurred as a complication of pneumonia. Among the 35 patients, 28 completed the planned 12 cycles of biweekly docetaxel. Prostate-specific antigen response (> 50% decrease from baseline) was recorded in 33 patients (94%), and the radiologic response rate was 49%. Median progression-free survival was 13.6 months (95% confidence interval: 6.7-20.4). CONCLUSION: ADT plus biweekly-administered docetaxel appeared to be tolerated and effective in patients with high-risk mCNPC.

Urothelial Tumors of the Urinary Bladder in Two Adolescent Patients: Emphasis on Follow-up Methods.

Here we describe two cases of papillary urothelial neoplasm of low malignant potential in adolescent boys. One case was a 16-year-old boy with a polypoid mass beside the right ureteral orifice and the other case was a 13-year-old boy with a papillary mass beside the left ureteral orifice. The initial presentation was hematuria in both cases and the bladder mass was detected by ultrasonography. Complete resection of the bladder tumor was performed by using an 11-Fr pediatric resectoscope. Follow-up has been performed with urine analysis, urine cytology, and bladder ultrasonography or cystoscopy every 3 months with no evidence of recurrence.

Laparoendoscopic single-site nephrectomy for single-system ectopic ureters with dysplastic kidneys in children: early experience.

BACKGROUND AND AIM: Single-system ectopic ureter with dysplastic kidney is a rare urologic anomaly. We report our early experience in 4 children who underwent laparoendoscopic single-site (LESS) nephrectomy for single-system ectopic ureters with dysplastic kidney. PATIENTS AND METHODS: We diagnosed 4 consecutive children (aged 18-59 months; mean: 3.2 years) with single-system ectopic ureter with dysplastic kidney. A single, experienced surgeon performed LESS nephrectomy using a homemade single-port device in all patients. RESULTS: LESS nephrectomy was completed successfully in all 4 patients without complications, insertion of an additional port, or open conversion. Blood loss was minimal. Mean operation time was 83.3 minutes (range: 55-125 minutes), and patients began oral intake on the first postoperative day. Mean postoperative hospital stay was 1.3 days (range: 1-2 days). Urine dribbling and wetting resolved immediately after surgery, and no patient has developed a urinary tract infection to date. CONCLUSIONS: LESS nephrectomy for an ectopic ureter with dysplastic kidney is a safe and feasible method with better cosmesis, compared with classic nephrectomy. LESS nephrectomy is a promising method in pediatrics.