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1.
Zhonghua Er Ke Za Zhi ; 57(10): 767-773, 2019 Oct 02.
Artigo em Chinês | MEDLINE | ID: mdl-31594063

RESUMO

Objective: To summarize the clinical characteristics, treatment response and prognostic factors of rhabdomyosarcoma (RMS) in children. Methods: The clinical characteristics such as age at diagnosis, primary tumor site, tumor size, pathological type, clinical stage, and risk grouping of 213 RMS patients (140 males and 73 females) treated in Hematology Oncology Center of Beijing Children's Hospital, Capital Medical University, from May 2006 to June 2018 were analyzed retrospectively. The clinical characteristics, overall survival (OS), event free survival (EFS) and prognostic factors of children treated with the Beijing Children's Hospital-Rhabdomyosarcoma (BCH-RMS) regimen were analyzed. Survival data were analyzed by Kaplan-Meier survival analysis, and single factor analysis was performed by Log-Rank test. Results: The diagnostic age of 213 cases was 48.0 months (ranged 3.0-187.5 months), of which 136 cases (63.8%) were younger than 10 years old. The head and neck region was the most common primary site of tumor (30%, 64 cases), followed by the genitourinary tract (26.8%, 57 cases). Among pathological subtypes, embryonal RMS accounted for 71.4% (152 cases), while alveolar RMS and anaplastic RMS accounted for only 26.8% (57 cases) and 1.9% (4 cases), respectively. According to the Intergroup Rhabdomyosarcoma Study Group (IRS), IRS-Ⅲ and Ⅳ accounted for 85.0% (181 cases) of all RMS patients. In all patients, 9.4% (20 cases) patients were divided in to low-risk group, 52.1% (111 cases) patients in to intermediate -risk group, 25.8% (55 cases) patients in to high-risk group, and 12.7% (27 cases) patients in to the central nervous system invasion group, respectively. All patients with RMS received chemotherapy. The cycles of chemotherapy were 13.5 (ranged 5.0-18.0) for patients without event occurrence, while 14.2 (ranged 3.0-30.0) for patients with event occurrence. Among the 213 patients, 200 patients had surgical operation, of whom 103 patients underwent surgery before chemotherapy and 97 patients at the end of chemotherapy, 21 patients had secondary surgical resection. Radiotherapy was performed in 114 patients. The follow-up time was 23.0 months (ranged 0.5-151.0 months) . There were 98 patients with relapsed or progressed disease and 67 patients with death. The median time to progression was 10 months, of which 67 (68.4%) relapse occurred within 1 year and no recurrence occurred after follow-up for more than 5 years. The 3-year EFS and 5-year EFS were (52±4) % and (48±4) %, while the 3-year OS and 5-year OS were (65±4) % and (64±4) % by survival analysis. The 5-year OS of the low-risk, intermediate-risk, the high-risk were 100%, (74±5) %, (48±8) %, and the 2-year OS of the central nervous system invasion group was (36±11) % (χ(2)=33.52, P<0.01). The 5-year EFS of the low-risk, intermediate-risk, the high-risk were (93±6) %, (51±5) %, (36±7) % and the 2-year EFS of the central nervous system invasion group was (31±10) % (χ(2)=24.73, P<0.01) . Survival factor analysis suggested that the OS of children was correlated with age(χ(2)=4.16, P=0.038), tumor TNM stage (χ(2)=22.02, P=0.001), IRS group (χ(2)=4.49, P<0.01) and the risk group (χ(2)=33.52, P<0.01). Conclusions: This study showed that the median age of newly diagnosed RMS patients was 4 years. The head and neck and the genitourinary tract were the most common primary origin of RMS. The OS was low in single-center RMS children. The median time to recurrence was 10 months, and recurrence was rare 3 years later.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Rabdomiossarcoma/diagnóstico , Rabdomiossarcoma/terapia , Neoplasias Urogenitais/diagnóstico , Neoplasias Urogenitais/terapia , Adolescente , Criança , Pré-Escolar , Terapia Combinada , Intervalo Livre de Doença , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Recidiva Local de Neoplasia/terapia , Prognóstico , Estudos Retrospectivos , Rabdomiossarcoma/mortalidade , Rabdomiossarcoma/patologia , Rabdomiossarcoma Alveolar , Rabdomiossarcoma Embrionário , Análise de Sobrevida , Neoplasias Urogenitais/mortalidade , Neoplasias Urogenitais/patologia
2.
Urology ; 134: 24-31, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31302137

RESUMO

Lynch Syndrome (LS) entails a defective DNA mismatch repair system, which is the postreplicative proofreading and editing system, ensuring our genome's integrity. LS predisposes to several cancers, most commonly colorectal and endometrial cancers. LS occurs in approximately 1 in 250-1000 people. LS is associated with urological malignancies with upper tract urothelial carcinoma the most common, although still clinically underestimated. Other urologic malignancies possibly associated with LS include bladder, prostate, testis, and renal cell carcinoma. Ascertaining their true prevalence in LS is mandatory for their and their relatives' diagnosis and treatment. Awareness regarding identifying patients at risk for LS through assessment of personal and familial oncologic history is critical among urologists.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose , Neoplasias Urogenitais , Neoplasias Colorretais Hereditárias sem Polipose/genética , Neoplasias Colorretais Hereditárias sem Polipose/terapia , Reparo de Erro de Pareamento de DNA/genética , Humanos , Administração dos Cuidados ao Paciente , Medição de Risco , Neoplasias Urogenitais/genética , Neoplasias Urogenitais/patologia , Neoplasias Urogenitais/terapia
3.
Eur J Cancer Care (Engl) ; 28(5): e13102, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31184786

RESUMO

INTRODUCTION: This study aims to assess the impact of paediatric benign and malignant solid tumours and its treatment on the health-related quality of life of children and adolescents who were followed up in a Reference Center in Pediatric Oncology in Rio de Janeiro. METHODS: It is a prospective cohort study. Quality of life assessment was performed using the PedsQL™ 4.0 Generic Core Scales and PedsQL™ 3.0 Cancer Module protocols three times: during hospital admission (T1), 6 months after admission (T2) and 1 year after admission (T3). RESULTS: We evaluated 132 patients, 59 men and 73 women, aged 2-17 years. In PedsQL™4.0, the Emotional Functioning scale was the one with the worst scores, while the scores on the Social Functioning scale was the best. In PedsQL™ 3.0, the worst domains were Procedural Anxiety and Worry. Patients with malignant bone tumours had the worst health-related quality of life. The group who received only surgery had better results. Total scores of PedsQL™4.0 and PedsQL™ 3.0 improved between T1 and T3. CONCLUSION: Children and adolescents with malignant and benign neoplasms undergo changes in quality of life as a result of the disease and treatment, but an improvement has been observed over time.


Assuntos
Saúde Mental , Neoplasias/fisiopatologia , Qualidade de Vida , Participação Social , Adolescente , Neoplasias Ósseas/fisiopatologia , Neoplasias Ósseas/psicologia , Neoplasias Ósseas/terapia , Brasil , Neoplasias do Sistema Nervoso Central/fisiopatologia , Neoplasias do Sistema Nervoso Central/psicologia , Neoplasias do Sistema Nervoso Central/terapia , Criança , Pré-Escolar , Estudos de Coortes , Emoções , Feminino , Humanos , Neoplasias Renais/fisiopatologia , Neoplasias Renais/psicologia , Neoplasias Renais/terapia , Neoplasias Hepáticas/fisiopatologia , Neoplasias Hepáticas/psicologia , Neoplasias Hepáticas/terapia , Masculino , Neoplasias/psicologia , Neoplasias/terapia , Neoplasias Embrionárias de Células Germinativas/fisiopatologia , Neoplasias Embrionárias de Células Germinativas/psicologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neuroblastoma/fisiopatologia , Neuroblastoma/psicologia , Neuroblastoma/terapia , Pais , Estudos Prospectivos , Retinoblastoma/fisiopatologia , Retinoblastoma/psicologia , Retinoblastoma/terapia , Sarcoma/fisiopatologia , Sarcoma/psicologia , Sarcoma/terapia , Instituições Acadêmicas , Neoplasias de Tecidos Moles/fisiopatologia , Neoplasias de Tecidos Moles/psicologia , Neoplasias de Tecidos Moles/terapia , Neoplasias Urogenitais/fisiopatologia , Neoplasias Urogenitais/psicologia , Neoplasias Urogenitais/terapia
4.
Nat Rev Urol ; 16(5): 318-328, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30914802

RESUMO

Genitourinary cancers encompass some of the most common solid tumours and have high rates of morbidity and mortality. Inflammation is associated with enhanced tumorigenesis, and a number of pro-inflammatory mediators, such as macrophage migration inhibitory factor (MIF), also promote tumorigenesis. Studies of the role of MIF (which largely functions via the type II transmembrane receptor CD74) in prostate, bladder and kidney cancers suggest that it is a pro-tumorigenic factor in genitourinary malignancy. Inhibiting MIF activity in cell culture and in preclinical animal models of genitourinary cancers reduces the phenotypic hallmarks of cancer, such as proliferation, angiogenesis and tumour aggressiveness, by downregulating signalling pathways such as those regulated by extracellular signal-regulated kinase (ERK), protein kinase B and p53, and MIF may also reverse immunosuppression. Progress has been made in our understanding of the role of MIF (and its family member D-dopachrome tautomerase (DDT)) in genitourinary cancers and how it can be therapeutically targeted.


Assuntos
Carcinogênese , Fatores Inibidores da Migração de Macrófagos/fisiologia , Neoplasias Urogenitais/patologia , Neoplasias Urogenitais/terapia , Humanos
5.
Zhonghua Wai Ke Za Zhi ; 57(1): 34-38, 2019 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-30612392

RESUMO

In recent years, the field of medical treatment of genitourinary tract tumors has made rapid progress. Precision medicine has provided important role in selecting the potential patients. Immunotherapy is a new choice for metastatic disease. The combination therapy has also brought the light for better tumor control. This article briefly introduces these progresses and provides new conception and research directions for treatment of genitourinary tract tumors.


Assuntos
Imunoterapia , Medicina de Precisão , Neoplasias Urogenitais , Terapia Combinada , Humanos , Neoplasias Urogenitais/terapia
7.
J Pediatr Urol ; 15(1): 5-11, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30467017

RESUMO

INTRODUCTION: The long-term survival of a patient with childhood cancer now exceeds 80%. Unfortunately, as survivorship improves, the long-term consequences of the treatments used have become manifest. Specifically, the finding that development of a subsequent malignant neoplasm (SMN) is the leading cause of late mortality is concerning. In cancer survivors who are at high risk for developing an SMN, cancer screening protocols have well-documented survivorship benefits. Regrettably, 50% of these high-risk patients are non-compliant with these protocols, with studies revealing that inadequate patient compliance is in part because of insufficient knowledge of the physician regarding its need. DISCUSSION: Urologists are in a unique position to correct this deficiency. Characteristically, survivors of childhood cancer present to urologists as an adult with complaints of infertility, erectile dysfunction, androgen deprivation, lower urinary tract symptoms or for follow-up of a urinary diversion. The urologist because of their specialty should be able to treat the patients presenting complaint, identify the high-risk patient, and re-establish them on their surveillance protocol. SCREENING RECOMMENDATIONS FOR HIGH-RISK PATIENTS: The risk for developing an SMN is unequally expressed and is temporally biphasic. A minimal 10-year follow-up time span is recommended for patients who received alkylating agents or topoisomerase inhibitors. These agents can induce hematologic malignancies classically within the first 3-5 years after chemotherapy completion, with minimal risk existing after 10 years. Lifelong follow-up for SMN development is recommended under five distinct circumstances; if a genetic predisposition to tumor formation exists, a persistent post-treatment non-malignant mass is present if chemotherapy was received before 2 years of age, if the initial type of tumor predisposes to SMN, or if the patient received radiation therapy. CONCLUSION: The urologists ability to identify the patient at high risk for developing an SMN and return them to a surveillance protocol is crucial for appropriate patient management.


Assuntos
Detecção Precoce de Câncer , Neoplasias Urogenitais/diagnóstico , Urologia , Criança , Humanos , Medição de Risco , Neoplasias Urogenitais/terapia
8.
Surg Pathol Clin ; 11(4): 877-891, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30447846

RESUMO

Pathologic variables play an important role in prognostication in urologic malignancies. Histologic subtype, histologic grade, and anatomic extent of disease (pathologic tumor and nodal staging) influence treatment decisions in both the adjuvant and metastatic settings. This article discusses treatment paradigms for the most common urologic malignancies, followed by the evidence base to support the relationship between pathologic assessment and decision making by the medical oncologist.


Assuntos
Tomada de Decisão Clínica , Neoplasias Urogenitais/patologia , Neoplasias Urogenitais/terapia , Humanos , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Oncologistas , Medição de Risco , Neoplasias Urogenitais/classificação
9.
Crit Rev Oncol Hematol ; 131: 1-6, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30293699

RESUMO

Telomerase activity and telomere length are essential for the pathogenesis of several human diseases, including genitourinary tumors. Telomerase constitutes a complex system that includes human telomerase reverse transcriptase (hTERT), human telomerase RNA component (hTR) and telomerase associated protein 1 (TEP1), which are overexpressed in tumor cells compared to normal cells and are involved in the carcinogenesis and progression of renal cell carcinoma (RCC), bladder (BC) and prostate cancer (PCa). In addition, telomerase degraded peptide fragments expressed on the surface of tumor cells lead to their recognition by immune cells. On this scenario, in vitro and in vivo studies have shown effective anti-tumor activity of hTERT-tailored strategies in genitourinary tumors, including active immunotherapy with hTERT-peptide vaccines and passive immunotherapy with hTERT-transduced T cell infusion. This review emphasizes the role of telomerase in the carcinogenesis and progression of genitourinary tumors, thus underlying the potential of emerging telomerase-tailored immunotherapies in these patients.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Imunoterapia , Telomerase/antagonistas & inibidores , Neoplasias Urogenitais/terapia , Animais , Humanos , Telomerase/imunologia , Neoplasias Urogenitais/imunologia
12.
Urology ; 119: 55-61, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29935265

RESUMO

OBJECTIVE: To report a case of pelvic angiosarcoma in a 27-year-old man with Li-Fraumeni Syndrome (LFS) and evaluate the presentation and timeline of genitourinary (GU) tract involvement in LFS patients. METHODS: We retrospectively identified 39 LFS patients treated at our institution between 2000 and 2014; 7 (18%) had experienced a GU malignancy or an LFS-related malignancy involving the GU tract. Clinical characteristics, including dates of onset of first GU tract malignancies; pathologic findings; multimodal management; and familial history of LFS were reviewed. RESULTS: Median age at first malignancy was 14.0 years (interquartile range [IQR] 5.5-24.0). There was a slight male predominance (4 of 7). Median time between first malignancy and the malignancy involving the GU tract was 10.1 years (IQR 8.0-19.5). Six of the 7 patients (86%) had a form of sarcoma involving the GU tract; 1 developed adrenocortical carcinoma. The cancer pedigree of all patients showed LFS-associated malignancies in family members. Multimodal management included surgical resection in 6 patients with adjuvant chemotherapy or radiotherapy in 1 patient each. One patient received chemotherapy only. Following diagnosis of malignancy involving the GU tract, 5 of the 7 patients developed additional primary malignancies. At a median follow-up of 4.7 years (IQR 3.0-12.1), 2 patients are alive, 3 died of disease, and 1 died of unknown cause. One patient was lost at follow-up. CONCLUSION: Continued follow-up of LFS cancer patients aimed at the determination of optimal screening, management, and surveillance protocols is recommended and may result in longer survival expectations.


Assuntos
Síndrome de Li-Fraumeni , Neoplasias Urogenitais , Adulto , Evolução Fatal , Humanos , Síndrome de Li-Fraumeni/diagnóstico , Síndrome de Li-Fraumeni/terapia , Masculino , Estudos Retrospectivos , Neoplasias Urogenitais/diagnóstico , Neoplasias Urogenitais/terapia
13.
Am J Case Rep ; 19: 710-723, 2018 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-29915166

RESUMO

BACKGROUND Neuroendocrine tumors (NETs) encompass a diverse group of varying clinicopathological entities arising from cells of the endocrine and nervous systems. The presentation of these unique tumors can range from occult disease discovered incidentally to hyperactive, metastatic secretory tumors. NETs most commonly originate in the gastrointestinal and respiratory tract, although they may occur at any site in the body due to the wide distribution of neuroendocrine cells. Their classification system is complex and continues to evolve, and the current system uses histological grade in defining these subtypes. Neuroendocrine carcinomas (NECs), or high-grade, poorly-differentiated NETs, are the most aggressive subtype. Surgical resection remains the primary treatment modality and may be curative, thus early diagnosis is paramount. Management of advanced NETs remains both a diagnostic and therapeutic challenge; however, advances in our understanding of these unique neoplasms as well as an evolving classification system has led to the development of adjunctive therapeutic approaches aimed to minimize morbidity and improve patient outcomes. CASE REPORT We present 6 cases of unusual sites of high-grade neuroendocrine carcinomas involving the cervix, gallbladder, oesophagus, ovary, prostate, and urinary bladder. CONCLUSIONS Our case series highlights the heterogenous and aggressive nature of this subtype of NETs as well as their diagnostic and therapeutic difficulties. We also review the evolution of the NET classification system and its impact on the management of these malignancies.


Assuntos
Carcinoma Neuroendócrino/diagnóstico , Neoplasias do Sistema Digestório/diagnóstico , Neoplasias Urogenitais/diagnóstico , Adulto , Carcinoma Neuroendócrino/classificação , Carcinoma Neuroendócrino/terapia , Neoplasias do Sistema Digestório/classificação , Neoplasias do Sistema Digestório/terapia , Feminino , Humanos , Masculino , Tumores Neuroendócrinos/classificação , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/terapia , Gravidez , Neoplasias Urogenitais/classificação , Neoplasias Urogenitais/terapia
14.
Int Braz J Urol ; 44(5): 874-881, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29757570

RESUMO

PURPOSE: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. MATERIALS AND METHODS: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. RESULTS: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45% of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow up. CONCLUSIONS: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.


Assuntos
Transplante de Rim/efeitos adversos , Neoplasias Urogenitais/epidemiologia , Neoplasias Urogenitais/terapia , Adolescente , Adulto , Idoso , Feminino , Humanos , Incidência , Transplante de Rim/estatística & dados numéricos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Adulto Jovem
15.
Aktuelle Urol ; 49(2): 171-177, 2018 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-29587322

RESUMO

In recent years, fundamental research has yielded new insights into tumour biology, and new treatments have been developed. This review highlights the role of the pathologist and how he can support clinicians to find the right treatment for each patient. We explain the problems of the molecular subgroups of bladder cancer, the role of neo-adjuvant chemotherapy in the context of these findings, and show the important role of checkpoint inhibitors. Furthermore we focus on kidney cancer, with the clear cell carcinoma as the most frequent tumour type. We briefly consider prostate cancer, which as a hormone-dependent tumour probably requires different therapies. We also try to show the feasibility and the limits of pathology with the emerging tumour markers.


Assuntos
Imunoterapia/métodos , Neoplasias Urogenitais/imunologia , Neoplasias Urogenitais/terapia , Biomarcadores Tumorais , Feminino , Humanos , Masculino , Prognóstico
16.
Expert Rev Anticancer Ther ; 18(6): 543-553, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29575944

RESUMO

INTRODUCTION: Extramammary Paget's disease (EMPD) is a rare neoplastic condition that commonly affects the anogenital area in the elderly. Owing to its low incidence, limited data regarding EMPD's diagnosis and treatment have been available. This review article aims to explore the current knowledge of EMPD to improve the management of this disease. Areas covered: This review outlines the diagnosis and management of EMPD. Articles on this issue that had been published in PubMed were identified and surveyed. We provide an overview of the reported studies, focusing on the recent advances in this field. Expert commentary: A new TNM staging system specific for EMPD has been proposed in Japan; the T category was classified by tumor thickness and lymphovascular invasion, the N category by the number of metastatic lymph nodes, and the M category by systemic metastases. As new diagnostic tools for EMPD, dermoscopy and reflectance confocal microscopy have emerged. Recent reports about Mohs micrographic surgery, mapping biopsy, radiation therapy, photodynamic therapy, topical imiquimod, conventional chemotherapy, and targeted therapy are also discussed. Despite the increasing publications of EMPD, limited information on this condition is available and the accumulation of more data is required.


Assuntos
Neoplasias do Ânus/terapia , Doença de Paget Extramamária/terapia , Neoplasias Urogenitais/terapia , Idoso , Antineoplásicos/administração & dosagem , Neoplasias do Ânus/patologia , Dermoscopia/métodos , Humanos , Metástase Linfática , Microscopia Confocal/métodos , Doença de Paget Extramamária/diagnóstico , Doença de Paget Extramamária/patologia , Fotoquimioterapia/métodos , Neoplasias Urogenitais/diagnóstico , Neoplasias Urogenitais/patologia
17.
J Pediatr Adolesc Gynecol ; 31(5): 522-525, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29421342

RESUMO

STUDY OBJECTIVE: To review our local experience with urogenital rhabdomyosarcoma (RMS) to determine the most common clinical presentation(s). DESIGN: Retrospective case series of all female patients with urogenital RMS who presented to a tertiary pediatric hospital between 1996 and 2016. All institutional electronic pathology reports were screened for RMS and those that were pelvic in origin and occurred in female patients were included for further analysis. Seventeen cases of urogenital RMS in female patients were identified and reviewed. SETTING: This study was conducted at The Royal Children's Hospital in Melbourne, Australia. This is a tertiary referral center for the state of Victoria and surrounding areas, which services more than 1.5 million pediatric patients. PARTICIPANTS: Female pediatric patients (ages 0-18 years) who presented to The Royal Children's Hospital with eventual pathologic tissue diagnosis of urogenital RMS. MAIN OUTCOME MEASURES: The cases were reviewed for clinical presentation, duration of symptoms before initial presentation, time to tissue diagnosis, and outcomes of treatment. RESULTS: Of the 17 cases reviewed, 5 (29%) presented with perineal mass, 4 (24%) presented with each of abdominal mass and grape-like lesions/hemorrhagic mass at the introitus, 3 (18%) with nonspecific symptoms only, and 1 (6%) with vulvar inflammation. CONCLUSION: The clinical presentation of urogenital RMS in women is heterogeneous, and the classically described presentation of grape-like lesions at the introitus and vaginal bleeding represents only a small proportion of clinical presentations. Awareness of other presentations, which appear to be more common than previously recognized, needs to be increased to ensure timely diagnosis and treatment.


Assuntos
Rabdomiossarcoma/diagnóstico , Neoplasias Urogenitais/diagnóstico , Adolescente , Austrália , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Retrospectivos , Rabdomiossarcoma/terapia , Resultado do Tratamento , Neoplasias Urogenitais/terapia
18.
Cancer J ; 24(1): 20-30, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29360724

RESUMO

Genitourinary malignancies represent a diverse biologic and immunologic landscape. Recently, checkpoint blockade has transformed the treatment paradigms for bladder and kidney cancer. However, continued progress will be essential in bladder and kidney cancer, given response to inhibition of the PD-1/PD-L1 (PD-1/PD-L1) axis remains variable and only a minority of patients respond. In contrast with the clinical trial results in bladder and kidney cancer, studies of anti-PD-1/PD-L1 therapy in prostate cancer have generally been disappointing. Nevertheless, an exciting array of studies is underway that are translating lessons learned from tumor biology into promising clinical trials. Here we highlight important features of the immune tumor microenvironment of bladder, kidney, and prostate cancer and review key completed and ongoing clinical trials of anti-PD-1/PD-L1 therapy in these tumor types.


Assuntos
Antígeno B7-H1/antagonistas & inibidores , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Neoplasias Urogenitais/imunologia , Animais , Anticorpos Monoclonais/farmacologia , Anticorpos Monoclonais/uso terapêutico , Biomarcadores Tumorais/metabolismo , Ensaios Clínicos como Assunto , Humanos , Imunoterapia/métodos , Microambiente Tumoral/efeitos dos fármacos , Neoplasias Urogenitais/metabolismo , Neoplasias Urogenitais/terapia
19.
Semin Cancer Biol ; 52(Pt 2): 216-227, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29032188

RESUMO

Immunotherapy is gradually becoming a key factor in the therapeutic algorithm for patients with genito-urinary (GU) cancers at different stages of disease. Robust and reliable biomarkers are crucial for an appropriate inclusion of patients in clinical trials and for a reliable patient selection for treatments with immunomodulatory drugs. The increasing knowledge on the genomic landscape of GU cancers supports stratification of patients for targeted therapies. This review focusses on emerging biomarkers and the role of genomics in predicting clinical benefit to immunomodulatory agents in GU cancers. Based on cancer incidences and available data we restricted this overview to bladder, prostate and renal cancer.


Assuntos
Biomarcadores Tumorais/genética , Biomarcadores Tumorais/imunologia , Imunomodulação/efeitos dos fármacos , Imunomodulação/genética , Neoplasias Urogenitais/genética , Neoplasias Urogenitais/terapia , Genômica/métodos , Humanos , Imunoterapia/métodos , Neoplasias Urogenitais/imunologia
20.
Urol Oncol ; 36(4): 193-212, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28867432

RESUMO

Comparative effectiveness research (CER) is imperative for objective and balanced assessment of treatment outcomes. CER that uses administrative databases (AD-CER) affords unique opportunities for large scale data analyses that potentially transcend limitations of small institutional datasets. Prostate cancer has received much attention from the AD-CER research community, whereas non-prostate genitourinary malignancies are less well-studied. The objective of this article is to review the currently available AD-CER that has been published in the non-prostate genitourinary malignancies space.


Assuntos
Pesquisa Comparativa da Efetividade/métodos , Conjuntos de Dados como Assunto , Sistema de Registros/estatística & dados numéricos , Neoplasias Urogenitais/terapia , Humanos , Masculino , Resultado do Tratamento , Neoplasias Urogenitais/mortalidade
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