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1.
Int J Mol Sci ; 22(10)2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34069970

RESUMO

Prostate cancer (PCa) is the second most leading cause of death in males. Our previous studies have demonstrated that δ-catenin plays an important role in prostate cancer progression. However, the molecular mechanism underlying the regulation of δ-catenin has not been fully explored yet. In the present study, we found that δ-catenin could induce phosphorylation of p21Waf and stabilize p21 in the cytoplasm, thus blocking its nuclear accumulation for the first time. We also found that δ-catenin could regulate the interaction between AKT and p21, leading to phosphorylation of p21 at Thr-145 residue. Finally, EGF was found to be a key factor upstream of AKT/δ-catenin/p21 for promoting proliferation and metastasis in prostate cancer. Our findings provide new insights into molecular controls of EGF and the development of potential therapeutics targeting δ-catenin to control prostate cancer progression.


Assuntos
Cateninas/metabolismo , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Fator de Crescimento Epidérmico/metabolismo , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transporte Ativo do Núcleo Celular , Sítios de Ligação/genética , Linhagem Celular Tumoral , Proliferação de Células/fisiologia , Inibidor de Quinase Dependente de Ciclina p21/química , Inibidor de Quinase Dependente de Ciclina p21/genética , Humanos , Ligantes , Masculino , Modelos Biológicos , Mutagênese Sítio-Dirigida , Invasividade Neoplásica/patologia , Invasividade Neoplásica/fisiopatologia , Células PC-3 , Fosforilação , Neoplasias da Próstata/genética , Domínios e Motivos de Interação entre Proteínas , Estabilidade Proteica , Proteínas Proto-Oncogênicas c-akt/química , Transdução de Sinais , Treonina/química
2.
Sensors (Basel) ; 21(11)2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34070290

RESUMO

Background and Objective: The use of computer-aided detection (CAD) systems can help radiologists make objective decisions and reduce the dependence on invasive techniques. In this study, a CAD system that detects and identifies prostate cancer from diffusion-weighted imaging (DWI) is developed. Methods: The proposed system first uses non-negative matrix factorization (NMF) to integrate three different types of features for the accurate segmentation of prostate regions. Then, discriminatory features in the form of apparent diffusion coefficient (ADC) volumes are estimated from the segmented regions. The ADC maps that constitute these volumes are labeled by a radiologist to identify the ADC maps with malignant or benign tumors. Finally, transfer learning is used to fine-tune two different previously-trained convolutional neural network (CNN) models (AlexNet and VGGNet) for detecting and identifying prostate cancer. Results: Multiple experiments were conducted to evaluate the accuracy of different CNN models using DWI datasets acquired at nine distinct b-values that included both high and low b-values. The average accuracy of AlexNet at the nine b-values was 89.2±1.5% with average sensitivity and specificity of 87.5±2.3% and 90.9±1.9%. These results improved with the use of the deeper CNN model (VGGNet). The average accuracy of VGGNet was 91.2±1.3% with sensitivity and specificity of 91.7±1.7% and 90.1±2.8%. Conclusions: The results of the conducted experiments emphasize the feasibility and accuracy of the developed system and the improvement of this accuracy using the deeper CNN.


Assuntos
Imagem de Difusão por Ressonância Magnética , Neoplasias da Próstata , Algoritmos , Humanos , Aprendizado de Máquina , Masculino , Redes Neurais de Computação , Neoplasias da Próstata/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
3.
Int J Nanomedicine ; 16: 3679-3694, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34093012

RESUMO

Introduction: Photodynamic therapy (PDT) has been widely researched by cancer therapists in recent years. This study aims to establish a drug delivery system combining PDT and chemotherapy to show that chemotherapeutic drugs provide oxygen to PDT, while PDT promotes the release of chemotherapeutic drug. Methods: Firstly, poly(ethylene glycol)-lysine(Ce6)-block-poly(L-glutamate)-imidazole (mPEG-lys(Ce6)-PGA-AIM) was synthesized and self-assembled into micelles that exhibited pH- and ROS-responsiveness and buffering capacity. Perfluorohexanoate-modified cisplatin (FCP), as oxygen carriers, was encapsulated into mPEG-lys(Ce6)-PGA-AIM micelles. Then, the properties of micelles and their biological functions in vivo and in vitro were investigated. Results: The micelles exhibited remarkabe stability, pH regulated drug release, good biocompatibility and effective tumor penetration. Cellular uptake demonstrated the efficient endosome/lysosome escape of CFMs, which facilitates the intracellular drug release. Both in vitro and in vivo experiments reflected that CFMs with laser irradiation showed significantly improved therapeutic activity compared with single PDT or chemotherapy. Conclusion: Chemotherapy and PDT were combined in the form of mutual assistance to provide a promising strategy for clinical treatment.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/farmacocinética , Sistemas de Liberação de Medicamentos/métodos , Fotoquimioterapia/métodos , Animais , Caproatos/química , Linhagem Celular Tumoral , Cisplatino/administração & dosagem , Cisplatino/química , Cisplatino/farmacocinética , Liberação Controlada de Fármacos , Fluorcarbonetos/química , Humanos , Interações Hidrofóbicas e Hidrofílicas , Terapia a Laser , Masculino , Camundongos Nus , Micelas , Oxigênio/administração & dosagem , Polímeros/química , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Espécies Reativas de Oxigênio , Ensaios Antitumorais Modelo de Xenoenxerto
4.
Arch Esp Urol ; 74(5): 477-487, 2021 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-34080567

RESUMO

OBJECTIVE: VA is currently considered the treatment of choice for patients with low and very low risk prostate cancer. We analyzed the evolution of this treatment strategy in our series and adherence to the protocol. MATERIAL AND METHODS: Ambispective study of patients in VA in our center between 2014- 2019. 237 meet inclusion criteria, of which 142 (60%) have a minimum of 12 months of follow- up. Mean age: 68.5 (4678), median PSA 6.37 ng / ml (1-33). 229 (96.6%) are ISUP 1 and 8 (3.4%) ISUP 2. Objectives are proposed to assess our adherence to the protocol. Descriptive statistics are used to communicate the results. RESULTS: According to the classification by risk groups of the NCCN, 145 (61.2%), 49 (20.7%) and 42 (17.7%) were very low risk, low risk and favorable intermediate risk patients, respectively. The median of follow-up is 14 months (0-66). Of the patients with a minimum follow-up of 12 months, 107 (75.4%) were re-biopsied. 80 (33.8%) leave the protocol in these 5 years, 31.3% (25) by their own decision, 55% (44) due to medical criteria, and 11.3% (9) go to WW. After 5 years of follow-up, 99.2% of patients are still alive, 0.8% died of specific non-cancer causes. Of the objectives to assess adherence, 8 are achieved, 1 partially and 1 is not evaluable. CONCLUSIONS: VA in our center is already the treatment of choice for very low-risk patients, with a constant increase from year to year. Adherence to the protocol has been favorable during the period of time studied.


Assuntos
Neoplasias da Próstata , Conduta Expectante , Idoso , Biópsia , Humanos , Masculino , Antígeno Prostático Específico , Fatores de Risco
5.
J Int Med Res ; 49(6): 3000605211016624, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34082608

RESUMO

OBJECTIVE: Prostate cancer (PCa) is a malignant neoplasm of the urinary system. This study aimed to use bioinformatics to screen for core genes and biological pathways related to PCa. METHODS: The GSE5957 gene expression profiles were obtained from the Gene Expression Omnibus (GEO) database to identify differentially expressed genes (DEGs). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the DEGs were constructed by R language. Furthermore, protein-protein interaction (PPI) networks were generated to predict core genes. The expression levels of core genes were examined in the Tumor Immune Estimation Resource (TIMER) and Oncomine databases. The cBioPortal tool was used to study the co-expression and prognostic factors of the core genes. Finally, the core genes of signaling pathways were determined using gene set enrichment analysis (GSEA). RESULTS: Overall, 874 DEGs were identified. Hierarchical clustering analysis revealed that these 24 core genes have significant association with carcinogenesis and development. LONRF1, CDK1, RPS18, GNB2L1 (RACK1), RPL30, and SEC61A1 directly related to the recurrence and prognosis of PCa. CONCLUSIONS: This study identified the core genes and pathways in PCa and provides candidate targets for diagnosis, prognosis, and treatment.


Assuntos
Redes Reguladoras de Genes , Neoplasias da Próstata , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Ontologia Genética , Humanos , Masculino , Proteínas de Neoplasias/genética , Recidiva Local de Neoplasia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Receptores de Quinase C Ativada
6.
BMC Res Notes ; 14(1): 227, 2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34082809

RESUMO

OBJECTIVE: To date, there are no useful markers for predicting the prognosis of metastatic hormone-sensitive prostate cancer (mHSPC). We evaluated the effect of early changes in prostate-specific antigen (PSA) levels after androgen deprivation therapy (ADT) on castration-resistant prostate cancer (CRPC) progression and overall survival (OS) in mHSPC patients. RESULTS: In 71 primary mHSPC patients treated with ADT, the median times to CRPC and OS were 15 months and 92 months, respectively. In multivariate analysis, a Gleason score of ≥ 8 (p = 0.004), an extent of disease value (EOD) of ≥ 2 (p = 0.004), and a 3-month PSA level > 1% of the pretreatment level (p = 0.017) were independent predictors of shorter time to CRPC. The area under the receiver operating characteristic curve was feasible at 0.822. A 3-month PSA level > 1% of the pretreatment level was an independent predictor of OS (p = 0.004). Three factors were independent predictors of shorter time to CRPC. A 3-month PSA level > 1% of the pretreatment level correlated with a poor prognosis.


Assuntos
Neoplasias de Próstata Resistentes à Castração , Neoplasias da Próstata , Antagonistas de Androgênios/uso terapêutico , Hormônios , Humanos , Masculino , Gradação de Tumores , Antígeno Prostático Específico , Neoplasias da Próstata/tratamento farmacológico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Estudos Retrospectivos
7.
Anticancer Res ; 41(6): 3127-3130, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34083306

RESUMO

BACKGROUND/AIM: To evaluate the diagnosis and treatment of prostate cancer (PCa) during 1 year of the COVID-19 pandemic. PATIENTS AND METHODS: The management of men with PCa during COVID-19 pandemic (March 2020-2021) was compared with the clinical activity of the 12 months before the COVID-19 pandemic (March 2019-2020). RESULTS: The number of clinical visits, prostate biopsy, and men enrolled in active surveillance was significantly lower during the COVID-19 pandemic (p<0.05); on the contrary, the number of cases with advanced (pT3b: 11.2 vs. 25.6%; nodal positive: 14.8 vs. 46.1%) and metastatic (5.9 vs. 9.3%) PCa increased. The number of open radical prostatectomies increased compared with the ones using a laparoscopic approach; moreover, more men were treated with external radiotherapy (25.1 vs. 54.2%). CONCLUSION: The guideline recommendations in the management of PCa should constantly adapt to the epidemiological evolution, but the overall cost of delayed diagnosis will increase in the near future.


Assuntos
COVID-19/epidemiologia , Pandemias , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , COVID-19/virologia , Humanos , Masculino , Neoplasias da Próstata/patologia , SARS-CoV-2/isolamento & purificação
8.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 37(6): 513-519, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34060446

RESUMO

Objective To investigate the inhibitory effect of betaine (BET) on the proliferation of C4-2B prostate cancer cells and its possible mechanism. Methods C4-2B cells were treated with 0, 100, 200, 400, 600, 800 mmol/L BET. CCK-8 assay was used to assess the cell proliferation, plate cloning formation assay to detect clone formation ability and flow cytometry to evaluate cell apoptosis, and the cell morphological alteration was observed by microscopy. The protein expression of BAX, Bcl2, cleaved caspase 3 (c-caspase-3), phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT), and NF-κB p65 were detected by Western blotting, and the changes of BAX, Bcl2, c-caspase-3, and NF-κB p65 proteins were further verified after the cells were treated with NF-κB pathway inhibitor BAY11-7082. Results BET inhibited the proliferation of C4-2B cells in a dose-dependent manner. The 50% inhibitory concentration (IC50) was 422.7 mmol/L after the cells were treated with BET for 48 hours. Compared with the control group (0 mmol/L BET treatment), the proliferation of C4-2B cells was inhibited along with morphological changes, decreased clone formation ability and increased apoptosis rate in 200, 300, 400 mmol/L BET treated groups. Meanwhile, the protein expression of BAX and c-caspase-3 were up-regulated and Bcl2, PI3K, AKT and NF-κB p65 were down-regulated in 300, 400 mmol/L BET groups as compared with the control group. After BAY11-7082 treatment alone, Bcl2, BAX, c-caspase-3, NF-κB p65 protein expression trend was consistent with that of the 300 mmol/L BET treated group, and Bcl2, NF-κB p65 protein expression levels were lower and BAX and c-caspase-3 protein expression levels were higher in BET combined with BAY11-7082 treated group. Conclusion BET can inhibit C4-2B cell proliferation and induce its apoptosis by blocking PI3K/AKT/NF-κB signaling pathway.


Assuntos
Neoplasias da Próstata , Proteínas Proto-Oncogênicas c-akt , Apoptose , Betaína , Humanos , Masculino , NF-kappa B/genética , NF-kappa B/metabolismo , Fosfatidilinositol 3-Quinase , Fosfatidilinositol 3-Quinases/genética , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/genética , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais
9.
Int J Mol Sci ; 22(11)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064250

RESUMO

The members of the Lemur Tyrosine Kinases (LMTK1-3) subfamily constitute a group of three membrane-anchored kinases. They are known to influence a wide variety of key cellular events, often affecting cell proliferation and apoptosis. They have been discovered to be involved in cancer, in that they impact various signalling pathways that influence cell proliferation, migration, and invasiveness. Notably, in the context of genome-wide association studies, one member of the LMTK family has been identified as a candidate gene which could contribute to the development of prostate cancer. In this review, of published literature, we present evidence on the role of LMTKs in human prostate cancer and model systems, focusing on the complex network of interacting partners involved in signalling cascades that are frequently activated in prostate cancer malignancy. We speculate that the modulators of LMTK enzyme expression and activity would be of high clinical relevance for the design of innovative prostate cancer treatment.


Assuntos
Lemur/genética , Neoplasias da Próstata/genética , Proteínas Tirosina Quinases/genética , Animais , Humanos , Masculino , Transdução de Sinais/genética
10.
Int J Mol Sci ; 22(10)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064859

RESUMO

Tumor metastasis to bone is a common event in multiple forms of malignancy. Inflammation holds essential functions in homeostasis as a defense mechanism against infections and is a strategy to repair injured tissue and to adapt to stress conditions. However, exaggerated and/or persistent (chronic) inflammation may eventually become maladaptive and evoke diseases such as autoimmunity, diabetes, inflammatory tissue damage, fibrosis, and cancer. In fact, inflammation is now considered a hallmark of malignancy with prognostic relevance. Emerging studies have revealed a central involvement of inflammation in several steps of the metastatic cascade of bone-homing tumor cells through supporting their survival, migration, invasion, and growth. The mechanisms by which inflammation favors these steps involve activation of epithelial-to-mesenchymal transition (EMT), chemokine-mediated homing of tumor cells, local activation of osteoclastogenesis, and a positive feedback amplification of the protumorigenic inflammation loop between tumor and resident cells. In this review, we summarize established and evolving concepts of inflammation-driven tumorigenesis, with a special focus on bone metastasis.


Assuntos
Neoplasias Ósseas/secundário , Neoplasias da Mama/patologia , Inflamação/complicações , Neoplasias da Próstata/patologia , Animais , Neoplasias Ósseas/etiologia , Neoplasias da Mama/imunologia , Feminino , Humanos , Masculino , Neoplasias da Próstata/imunologia , Transdução de Sinais
12.
Medicina (Kaunas) ; 57(6)2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34067302

RESUMO

Background and objectives: Systematic prostate biopsy (SB) has a low Gleason group (GG) accuracy when compared to final pathology. This may negatively impact the inclusion of patients into specific risk groups and treatment choice. The aim of our study was to assess the GG accuracy of magnetic resonance imaging-ultrasound (MRI-US) fusion prostate biopsy. Materials and Methods: Of a cohort of minimally invasive radical prostatectomy (RP), we selected all patients who were diagnosed with prostate cancer (PCa) via MRI-US fusion biopsy (n = 115). Results: Combined biopsy had the highest rate for GG concordance (61.7% vs. 60.4% for SB vs. 45.3% for MRI-US fusion biopsy) and the lowest for upgrading (20.9% vs. 24.5% for SB vs. 34.9% for MRI-US fusion biopsy), p < 0.0001. No clinical data were predictive for upgrading or downgrading at final pathology. Locally advanced PCa was associated with a high Prostate Imaging-Reporting and Data System (PIRADS) score (p = 0.0014) and higher percentages of positive biopsy cores (PBC)/targeted (p = 0.0002) and PBC/total (p = 0.01). Positive surgical margins were correlated with higher percentages of PBC/systematic (p = 0.003) and PBC/total (p = 0.009). Conclusions: Pre-biopsy prostate MRI improves GG concordance between biopsy and RP. Combined biopsy provides the highest grading accuracy when compared to final pathology. Targeted and systematic biopsy data are predictive for adverse pathologic outcomes.


Assuntos
Próstata , Neoplasias da Próstata , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Masculino , Gradação de Tumores , Próstata/diagnóstico por imagem , Próstata/cirurgia , Prostatectomia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia
13.
Hinyokika Kiyo ; 67(4): 163-166, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-34107613

RESUMO

While robot-assisted radical cystoprostatectomy (RARC) for locally advanced prostate cancer (LAPC) may sometimes prove to be excessive treatment, it can significantly reduce the risk of positive surgical margins and lower urinary tract obstruction in some cases. Here, we report a case of LAPC treated with RARC in a patient with right hydronephrosis due to bladder infiltration and left hypoplastic kidney. A 71-year-old man presented with frequent urination in August 2019. Prostate-specific antigen (PSA) level was 8.633 ng/ml, and magnetic resonance imaging led to the suspicion that the prostate cancer extended beyond the prostate capsule without distant metastasis. Prostatic biopsy revealed Gleason score 10 (5+5) adenocarcinoma in 8 out of 8 specimens. We diagnosed left hypoplastic kidney and LAPC with right hydronephrosis due to bladder infiltration. We performed percutaneous right nephrostomy and started neoadjuvant hormone therapy. RARC and intracorporeal ileal conduit were performed in March 2020. The prostate was adherent to the anterior surface of the rectum and was difficult to remove. At present, five months after the surgery, the patient remains free of recurrence and metastasis with PSA level <0.003 ng/ml. RARC for LAPC with bladder infiltration can be an effective therapeutic strategy in some cases.


Assuntos
Neoplasias da Próstata , Robótica , Neoplasias da Bexiga Urinária , Idoso , Cistectomia , Humanos , Masculino , Recidiva Local de Neoplasia , Prostatectomia , Neoplasias da Próstata/cirurgia , Bexiga Urinária , Neoplasias da Bexiga Urinária/cirurgia
14.
Hinyokika Kiyo ; 67(4): 171-176, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-34107615

RESUMO

Ureteral metastasis from prostate cancer is rare. The present case report describes an 83-year-old patient with distant metastasis of prostate cancer to the right ureter that caused hydronephrosis. Upon initial examination at our hospital, he presented with a high prostate-specific antigen (PSA) level of 10.0 ng/ml. He was diagnosed with prostate adenocarcinoma, with Gleason score of 10 (5+5) and clinical staging of cT2aN0M0. Intensity-modulated radiation therapy (IMRT) was performed after 1 year and 7 months of androgen depriation therapy. At 1 year and 4 months after IMRT, PSA increased to 3.068 ng/ml. Computed tomography scan revealed right hydronephrosis and thickening of the right ureter. We could not identify obvious malignant cells on ureteroscopic biopsy, and right nephroureterectomy was performed. Pathological examination revealed ureteral metastasis of prostate cancer. Six months after nephroureterectomy, PSA increased to 3.037 ng/ml. He was diagnosed with castration-resistant prostate cancer and has been treated with enzalutamide.


Assuntos
Neoplasias da Próstata , Ureter , Idoso de 80 Anos ou mais , Humanos , Masculino , Gradação de Tumores , Nefroureterectomia , Antígeno Prostático Específico
15.
Int. braz. j. urol ; 47(3): 484-494, May-June 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1154488

RESUMO

ABSTRACT Prostate cancer is the most common invasive cancer in men. Radical prostatectomy (RP) is a definitive treatment option, but biochemical recurrence can reach 40%. Salvage lymphadenectomy is a relatively recent approach to oligometasis and has been rapidly diffused primarily due to improvement in imaging diagnosis and results showing possibly promising therapy. A systematic literature review was performed in March 2020, according to the PRISMA statement. We excluded studies with patients with suspicion or confirmation of visceral and / or bone metastases. A total of 27 articles were included in the study. All studies evaluated were single arm, and there were no randomized studies in the literature. A total of 1,714 patients received salvage lymphadenectomy after previous treatment for localized prostate cancer. RP was the most used initial therapeutic approach, and relapses were based on PET / CT diagnosis, with Coline-11C being the most widely used radiopharmaceutical. Biochemical response rates ranged from 0% to 80%. The 5 years - Free Survival Biochemical recurrence was analyzed in 16 studies with rates of 0% up to 56.1%. The articles do not present high levels of evidence to draw strong conclusions. However, even if significant rates of biochemical recurrence are not evident in all studies, therapy directed to lymph node metastases may present good oncological results and postpone the onset of systemic therapy. The long-term impact in overall survival and quality of life, as well as the best strategies for case selection remains to be determined.


Assuntos
Humanos , Masculino , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Prostatectomia , Terapia de Salvação , Excisão de Linfonodo , Linfonodos , Recidiva Local de Neoplasia/cirurgia
16.
BMJ Case Rep ; 14(5)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020991

RESUMO

An 88-year-old male patient presented with left ptosis, diplopia, muscle weakness of the lower limbs, dysphagia for solids, dysphonia and constipation. On investigation, he was found to have myasthenia gravis (MG). Further evaluation for the possible cause of MG, with CT scan, revealed that the patient had concomitant prostatic cancer. The patient was given steroids and pyridostigmine, with consequent resolution of his neurological symptoms. This is a rare case of MG associated with prostatic cancer.


Assuntos
Blefaroptose , Miastenia Gravis , Neoplasias da Próstata , Idoso de 80 Anos ou mais , Diplopia , Humanos , Masculino , Miastenia Gravis/complicações , Miastenia Gravis/diagnóstico , Miastenia Gravis/tratamento farmacológico , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Brometo de Piridostigmina/uso terapêutico
17.
Hinyokika Kiyo ; 67(3): 83-90, 2021 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-33957027

RESUMO

From April 2007 to April 2018, we performed lymph node dissection in 305 cases of laparoscopic radical prostatectomy and 202 cases of robot-assisted radical prostatectomy at our hospital, and there were 68 cases with positive lymph node metastasis (pN1). Of these 68 cases, we examined retrospectively 62 cases in which extended lymph node dissection (ELND) was performed. The median number of removed lymph nodes was 25 (interquartile range [IQR] ; 18-34) and the median number of metastatic lymph nodes was 1 (IQR ; 1-3). Postoperative prostate-specific antigen (PSA) recurrence was observed in 40 of the 62 patients. The median time to PSA recurrence was 24 months. After univariate analysis, PSA at initial diagnosis (iPSA) of 10 ng/ml or more, pathological Gleason score (pGS) of 8 or more, total number of lymph node metastases of 2 or more, and positive surgical margin (RM+) were found to be riskfactors of PSA recurrence. In multivariate analysis, iPSA of 10 ng/ml or more, pGS of 8 or more and RM+ were independent riskfactors of PSA recurrence (p<0.05). In the cases without riskfactors such as iPSA≥10, pGS≥8, and RM+, immediate postoperative adjuvant therapy may be avoided even with pN1.


Assuntos
Laparoscopia , Neoplasias da Próstata , Procedimentos Cirúrgicos Robóticos , Humanos , Excisão de Linfonodo , Linfonodos/cirurgia , Masculino , Recidiva Local de Neoplasia/epidemiologia , Antígeno Prostático Específico , Prostatectomia , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos , Fatores de Risco
18.
Hinyokika Kiyo ; 67(3): 91-95, 2021 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-33957028

RESUMO

We retrospectivelyevaluated postoperative inguinal hernias (PIHs) after robot-assisted radical prostatectomy(RARP) with a technique for preventing hernias byspermatic cord isolation. Among the RARPs performed from 2016 to 2018, 191 cases were evaluated 12 or more months after surgery. In all the cases, the peritoneum was isolated from the spermatic cord by5 cm or more as a hernia prevention technique during RARP. We compared the background factors between PIH-positive and PIH-negative groups. The PIH-positive group had a significantlylower bodymass index (BMI) than the PIH-negative group (20.6 kg/m2 vs 23.8 kg/m2, p=0.0079), but there were no significant differences in other background factors. When patients were classified into three groups byBMI, low (<21.9 kg/m2), intermediate (21.9 to 25.5 kg/m2), and high (>25.5 kg/m2), the rate of PIH was 8.5% for the low group, 2.1% for the intermediate group, and 0% for the high group. Our findings suggest that incidences of inguinal hernias after the preventive technique of spermatic cord isolation in RARP, and the BMIs tended to be low in the hernia cases.


Assuntos
Hérnia Inguinal , Neoplasias da Próstata , Robótica , Cordão Espermático , Hérnia Inguinal/cirurgia , Humanos , Masculino , Complicações Pós-Operatórias/prevenção & controle , Prostatectomia , Neoplasias da Próstata/cirurgia , Cordão Espermático/cirurgia
19.
Hinyokika Kiyo ; 67(3): 113-118, 2021 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-33957032

RESUMO

A 56-year-old man visited our hospital with a chief complaint of worsening urinary pain after a treatment by another doctor. Prostate specific antigen (PSA) was 429.66 ng/ml, and computed tomography (CT) revealed multiple lymph node enlargement and multiple bone metastases. Prostatic adenocarcinoma (Gleason score 4+5) was detected on the first prostate biopsy. Based on these results, the clinical stage was determined to be cT4N1M1b Androgen deprivation therapy (ADT) was started, and PSA decreased to 0.03 ng/ml at 3 months, but micturition and perineal pain tended to worsen, and multiple liver metastases were confirmed on CT. The second biopsy examination was performed and a diagnosis of neuroendocrine prostate cancer (NEPC) was made. Chemotherapy for small cell lung cancer was immediately performed, but no response was seen, and he died 8 months after the first visit. Immunostaining of prostate tissue of the first biopsy revealed that de novo NEPC expressed both PSA and synaptophysin in tumor cells.


Assuntos
Adenocarcinoma , Neoplasias da Próstata , Antagonistas de Androgênios , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico
20.
Urologiia ; (2): 57-61, 2021 May.
Artigo em Russo | MEDLINE | ID: mdl-33960158

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of radical prostatectomy (RP) with nerve-saving technique (NST) in patients more or equal 65 years of age compared with a younger group of patients. MATERIALS AND METHODS: The study group comprised 117 patients more or equal 65 years old, the control group - 333 patients <65 years old, who underwent RP with unilateral or bilateral NST from January 2012 to December 2019. The analysis of pathomorphological results, complications rate, recurrence free survival (RFS) and the restoration of erectile function (EF) in both groups was performed. RESULTS: The majority of older patients belonged to intermediate and high risk groups of biochemical recurrence. Extracapsular tumor extension was significantly more often observed in the group more or equal 65 years of age: 16.2% and 6.9%, p=0.028. There were no differences between the two groups in the frequency of serious postoperative complications ( more or equal III class according to the Clavien-Dindo classification): 2.55% and 2.7%; p=0.94. The five-year RFS after RP was 95.4% in the group <65 years old and 92.1% in the group more or equal 65 years old (p=0.31). There was a moderate tendency to a slower recovery of EF in older patients: sufficient EF after 6 and 12 months was observed in 21.9% and 59.4% versus 33.3% and 73% in the group <65 years old (p=0.12). Minimal differences in EF were observed 24 months after RP with bilateral NST (84.2% and 87.9%), and more relevant differences with unilateral NST: 53.8% and 66.7% in the study and control group (p=0.033). CONCLUSIONS: The performance of RP with NST in elderly patients is not associated with additional oncological risks, while the restoration of EF is somewhat slowed down in comparison with a group of patients <65 years of age. Bilateral NST provides high potency recovery results regardless of age.


Assuntos
Disfunção Erétil , Neoplasias da Próstata , Adolescente , Idoso , Disfunção Erétil/etiologia , Estudos de Viabilidade , Humanos , Masculino , Ereção Peniana , Prostatectomia , Neoplasias da Próstata/cirurgia
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