Protocol description and initial experience in kidney graft perfusion using infrared thermography.

PURPOSE: Protocol description for renal perfusion study using thermographic technology and description of the thermographic and clinical behavior of the transplanted kidneys before and after unclamping. METHODS: Infrared thermographic images of renal grafts are obtained before kidney reperfusion, 10 min after and just before closing the surgical wound. Thermographic data is evaluated together with the type of graft and donor, cold ischemia time, hypovascularized areas determined by the surgeon during surgical intervention, alterations in vascular flow in postoperative echo-Doppler, time at the beginning of graft function and serum creatinine monitoring during postoperative follow-up. RESULTS: 17 grafts were studied. The mean temperature of the grafts before reperfusion, 10 min after and at the end of the surgery were 18.7 °C (SD 6.27), 32.36 °C (SD1.47) and 32.07 °C (SD1.78) respectively. 4 grafts presented hypoperfused areas after reperfusion. These areas presented a lower temperature compared to the well perfused parenchyma surface using thermographic images. CONCLUSION: The study of the usefulness and applicability of thermography can allow the development of tools that provide additional objective information on organ perfusion in real time and non-invasive manner. Our protocol and initial results can contribute to provide new evidence. Further analyses should be developed to shed light on the role of this technology.

Other radiological lesions of the Lower Urinary Tract in patients after isolated pelvic radiotherapy and combined with surgery. / Otras lesiones radiológicas del tracto urinario inferior (TUI) en pacientes sometidos a radioterapia pélvica en monoterapia y combinada con cirugía.

INTRODUCTION: The cystographic study of patients who have undergone radiotherapy (RT) and pelvic surgeries is uncommon in the literature, not described in patients without complications, and mostly related to urinary fistulae. OBJECTIVE: The study of the lower urinary tract (LUT) by cystography in these patients, with a description of some other types of radiation lesions. METHODS: 127 cystographies have been performed (88 men and 39 women) in consecutive patients undergoing radiotherapy (RT) (48 monotherapy and 79 cases combined with surgery), with a mean age of 69.6 years, and a mean time from radiation of 215 months (17 years). A General Electric X ray equipment has been used. We studied: behavior of the bladder neck at rest and during micturition, assessment of vesicoureteral reflux (VUR), bladder morphology (BM), urethral strictures (UE) and fistulas (F). RESULTS: We observed: Filling phase bladder neck incompetence (BNI) (37.8%), bladder smooth morphology (60.6%), coughing urinary incontinence (UI) (26.4%), basal cystocele (64.7%) and Valsalva cystocele (96.6%), a normal opening bladder neck (96,1%), reduction of the urethral diameter during voiding (41.3%), and vesicoureteral reflux (VUR) (13.2%). Five cases of filling BNI, were all related to prostate cancer (PC) (one of them with colon cancer as well). There were six cases of fistulae (4.14%), five of them women. Forty two patients (28.96%) had reduced urethral lumen, thirty five of them affecting the posterior urethra (83%), five (11.9%) the anterior and, finally, two cases of mixed lesion (5%). 95% were patients with PC without concurrent interventions (67%). Significant differences were found regarding the gender and the background of pelvic surgery. The filling BNI (p=0.007), the irregular bladder morphology (p=0.004) and the reduction of the urethral lumen (p<0.001) have been found to be more common in male patients, while the coughing UI was more common in women (p=0.007). The study shows that BNI (p=0.046), VUR (p=0.02) and the IU due to cough (p=0.03) were more frequent in operated patients, while reduced urethral lumen was less common (p<0.01). Patients with VUR present more time from radiotherapy, but not in other cystography variables. There was a relationship between RT and the BNI, stress urinary incontinence, anterior urethral stricture and VUR. The risk factor was increased by surgery. CONCLUSIONS: Bladder neck incompetence, stress UI, anterior urethral stricture and VUR have been related to radiotherapy. Surgery increased the risk factor in operated patients.

[Evaluation of testicular growth after varicocele treatment in early childhood and adolescence based on the technique used (Palomo, Ivanissevich and embolization)]. / Valoración del crecimiento testicular tras el tratamiento del varicocele en la infancia y adolescencia en función de la técnica empleada (Palomo, Ivanissevich y embolización).

OBJECTIVES: To analyze, depending on the technique employed, recurrence, symptomatic improvement and testicular growth following treatment of testicular varicocele. MATERIAL AND METHODS: Descriptive retrospective study of 69 pediatric and adolescent males diagnosed with varicocele treated in our center by open technique according Ivanissevich technique (IT), Palomo (PT) and percutaneous embolization (PE) between 2000-2014. Variables analyzed were age, symptoms, differential testicular volume (RV), employed technique, recurrence, symptomatic improvement and RV after treatment. Association between qualitative variables was evaluated (chi-square test or Fisher's exact test). RESULTS: 69 patients with a median age of 14 years (7-19) were studied. PE was performed in 37 patients (53,6%), PT in 23 (33,3%) and IT in 9 (13%). Recurrence occurred in 16 patients (23,2%), 80% of them had been treated with PE. Eleven patients had pain (15.9%), there was improvement in 100% of patients treated with PE, but none of those treated by PT or IT improved. At diagnosis, 37 patients (53.6%) had decreased testicular volume (left testicular hypotrophy), in 28 cases the RV was >20%. After treatment, the RV was normalized in 11 cases (39,2%). CONCLUSIONS: The choice of therapeutic technique in pediatric varicocele should be based on patient characteristics, symptoms, experience center for embolization and previous recurrence. Regardless of the chosen technique, 39,2% of testicular hypotrophy with VD >20% present at diagnosis normalized after treatment.

OBJETIVOS: Analizar en función de la técnica empleada para tratamiento de varicocele, la recurrencia, alivio sintomático y crecimiento testicular en pacientes pediátricos y adolescentes. MATERIAL Y METODOS: Estudio descriptivo retrospectivo de 69 pacientes pediátricos y adolescentes diagnosticados de varicocele tratados en nuestro centro mediante abordaje abierto según técnica de Ivanissevich (TI), Palomo (TP) y embolización percutánea (EP) entre 2000-2014. Las variables fueron edad, síntomas, volumen testicular diferencial (VD), técnica empleada, recurrencia, mejoría sintomática y VD tras el tratamiento. Se evaluó la asociación entre variables cualitativas (test de Chi cuadrado o prueba exacta de Fisher). RESULTADOS: Se estudiaron 69 pacientes con mediana de edad de 14 años (7-19). Se realizó EP a 37 pacientes (53,6%), TP a 23 (33,3%) y TI a 9 (13%). Presentaron recurrencia 16 (23,2%), de ellos el 80% habían sido tratados mediante EP. Once pacientes tenían dolor al diagnóstico (15,9%), tras el tratamiento 100% de los tratados mediante EP presentaron alivio, mientras que en ninguno de los tratados mediante TI o TP mejoró el dolor. Al diagnóstico 37 pacientes (53,6%) presentaron hipotrofia testicular izquierda, en 28 casos el VD fue >20%. Tras el tratamiento, el VD se normalizó en 11 casos (39,2%). CONCLUSIONES: La elección de la técnica terapéutica de varicocele en pacientes pediátricos y adolescentes debería depender de las características del paciente, presencia de síntomas, experiencia del centro y recurrencia previa. Independientemente de la técnica elegida el 39,2% de hipotrofias testiculares con DV >20% al diagnóstico alcanzaron la normalización del volumen testicular tras el tratamiento.

Bladder cancer in Spain 2011: population based study.

PURPOSE: We estimate the annual incidence of bladder cancer in Spain and describe the clinical profile of patients with bladder cancer enrolled in a population based study. MATERIALS AND METHODS: Using the structure of the Spanish National Health System as a basis, in 2011 the AEU (Spanish Association of Urology) conducted this study with a representative sample from 26 public hospitals and a reference population of 10,146,534 inhabitants, comprising 21.5% of the Spanish population. RESULTS: A total of 4,285 episodes of bladder cancer were diagnosed, of which 2,476 (57.8%) were new cases and 1,809 (42.2%) were cases of recurrence, representing an estimated 11,539 new diagnoses annually in Spain. The incidence of bladder cancer in Spain, age adjusted to the standard European population, was 20.08 cases per 100,000 inhabitants (95% CI 13.9, 26.3). Of patients diagnosed with a first episode of bladder cancer 84.3% were male, generally older than 59 years (81.7%) with a mean ± SD age of 70.5 ± 11.4 years. Of these patients 87.5% presented with some type of clinical symptom, with macroscopic hematuria (90.8%) being the most commonly detected. The majority of primary tumors were nonmuscle invasive (76.7%) but included a high proportion of high grade tumors (43.7%). According to the ISUP (International Society of Urologic Pathology)/WHO (2004) classification 51.1% was papillary high grade carcinoma. Carcinoma in situ was found in 2.2% of primary and 5.8% of recurrent cases. CONCLUSIONS: The incidence of bladder cancer in Spain, age adjusted to the standard European population, confirms that Spain has one of the highest incidences in Europe. Most primary nonmuscle invasive bladder cancer corresponded to high risk patients but with a low detected incidence of carcinoma in situ.

Androgen deprivation therapy in localized prostate cancer. Current status and future trends.

INTRODUCTION: Prostate cancer (PCa) has been recognized as an androgen-sensitive disease since the investigations from Huggins and Hodges in 1941. Thanks to these findings, they received the Nobel Prize in 1966. This was the beginning of the development of androgen deprivation therapy (ADT) as treatment for patients with PCa. OBJECTIVE: To summarize the current indications of ADT in localized PCa. EVIDENCE ACQUISITION: We conducted a comprehensive English and Spanish language literature research, focused on the main indications for ADT in localized PCa. EVIDENCE SYNTHESIS: Nowadays, the indications for ADT as monotherapy in localized PCa have been limited to specific situations, to patients unwilling or unable to receive any form of local treatment if they have a PSA-DT < 12 months, and either a PSA > 50 ng/mL, a poorly differentiated tumor, or troublesome local disease-related symptoms. ADT can be used in combination with local treatment in different scenarios. Although neoadjuvant treatment with ADT prior to surgery with curative intent has no clear oncological impact, as a future sight, PCa is a heterogeneous disease, and there could be a group of patients with high-risk localized disease that could benefit. CONCLUSIONS: We need to optimize the treatment with ADT in localized PCa, selecting the patients accordingly to their disease characteristics. Given that the therapeutic armamentarium evolves day by day, there is a need for the development of new clinical trials, as well as a molecular studies of patients to identify those who might benefit from an early multimodal treatment.

Biomarkers and intermediate-high risk non-muscle invasive bladder cancer: a multivariate analysis of three different cellular pathways with pronostic implications.

PURPOSE: To determine the presence of a group of mutations, and establish the prognostic value for recurrence and progression. MATERIALS AND METHODS: Prospective observational study. Intermediate-to-high-risk non-muscle invasive bladder cancer (NMIBC) was evaluated. Data from genetic analyses were included in a database along with clinicopathological variables of interest. RESULTS: Seventy-four patients. Twenty-five (33.8%) recurred and 3 (4.1%) progressed. Median time to recurrence: 8 months (5.7-12.7). Median time to progression: 14 months (P75: 12). Mutation distribution: KRAS codon 12: one patient (1.4%), BAT25: five patients (6.8%), BAT-26: four patients (5.4%), and D2S123: 6 patients (8.1%). Arg72Pro polymorphism: 50 patients (67.6%) exhibited homozygous mutations, 23 (31.1%) were heterozygous, and 1 patient (1.4%) did not present the mutation. We found an association between presence of MSI at BAT26 and female sex (p < 0.05) and tumor stage and the TP53 Arg72Pro polymorphism. Recurrence-free survival (RFS) was significantly associated with presence of MSI at D2S123, with a HR of 5.44 for patients presenting the mutation (95% CI 1.83-16.16). On multivariate analysis, we found a statistically significant increase in risk of recurrence among patients with MSI at D2S123 (HR 5.15; p < 0.05) and more than 2 previous transurethral bladder resections (TURBs) (HR 5.07; p < 0.05) adjusted for tumor stage and grade. Harrell's concordance index revealed an accuracy of 0.74 (p < 0.05). CONCLUSION: An association was found between presence BAT26 MSI and female sex, Arg72Pro polymorphism with tumor stage and D2S123 and more than 2 TUR procedures were associated with RFS adjusted to tumor stage and grade.

The role of clean intermittent catheterization in the treatment for detrusor underactivity. / El cateterismo vesical intermitente en la insuficiencia contráctil del detrusor.

OBJECTIVE: To study the influence of clean intermittent catheterization (CIC) on the lower urinary tract function in patients with urinary retention (UR) due to detrusor underactivity (DU). MATERIAL AND METHODS: A longitudinal study was carried out on 49 patients (28 men, 21 women) of mean age 55years, who underwent CIC for UR secondary to DU. The mean CIC frequency was 3.15 times/day. Patients' clinical data were collected, and they underwent urodynamic study before and after CIC, with a mean interval of 4years. Fisher's exact test was used for the analysis of categorical variables and Student's t test for parametric variables. The level of significance was set at 0.05 for a two-tailed test. RESULTS: The second urodynamic study showed a significantly increased bladder compliance, the Bladder Outlet Obstruction Index (BOOI) and the Bladder Contractility Index (BCI) also increased but without reaching statistical significance. There was a significantly higher percentage of benign prostatic hyperplasia (BPH) and acontractile detrusor cases among the group of patients whose BCI improved after CIC, with significantly lower CIC time. CONCLUSIONS: CIC improved bladder compliance in the patients of our series. The BCI improved in BPH patients and in patients with acontractile detrusor.

Oncologic outcomes in 408 consecutive patient cohort treated with da Vinci robot-assisted radical prostatectomy. / Resultados oncológicos de un programa de prostatectomía radical asistida por robot «da Vinci¼ en una cohorte de 408 pacientes consecutivos.

The objective of this study is to evaluate the general characteristics and oncological results in a cohort of 408 cases submitted to da Vinci Standard 4-armed robot-assisted radical prostatectomy (RARP), performed between October 2006 and February 2015 at Clínico San Carlos hospital. Statistical analysis was performed with the SPSS 20.0 program. Qualitative variables are presented with their frequency distribution and quantitative variables with their mean and standard deviation or median and interquartile range. The χ2 test was used to analyze the association of qualitative variables. The disease-free survival outcome variable was evaluated with a Kaplan-Meier curve analysis, and the differences were contrasted with the Breslow test. A Cox regression model was adjusted. Among the results, we highlight the follow-up of 47 months (32-68.75m), recurrence-free survival of 90 months (95% CI, 86-94), median time to recurrence of 23 months (10.5-37 m), recurrence 16'6% (68/408), biochemical recurrence (62/498, 15'2%) and 22% of complications, mostly Clavien I-II. The results are summarized in Tables 1 to 7 and Figure 1. CONCLUSIONS: 1) RARP is a safe technique with an acceptable percentage of complications, mostly minor (Clavien grades iandii), 2) We found a higher probability of remaining recurrence-free in the lower grades of the ISUP classification and a higher probability of recurrence in high-risk cases, and 3) The multivariate model showed that the ISUP grade was significantly related to survival and the ISUP and PSM classification grades were independent prognostic variables.

Comparative analysis of the incidence of bladder cancer in the communities of Andalusia, Catalonia and Madrid in 2011.

OBJECTIVES: To determine the incidence of bladder cancer (BC) in the autonomous communities that include the largest number of cases in the national hospital BC registry (Andalusia, Catalonia and Madrid) and report the clinical, pathological and diagnostic differences and similarities of BC in these regions. MATERIAL AND METHODS: An observational epidemiological study was performed in 2011 in 12 public hospitals with reference population areas according to the National Health System (Spain). Demographic and clinical variables were collected from new cases and relapses, with histopathologic confirmation of BC. The raw incidence rate was calculated using the number of diagnosed cases in all the participating centers compared with the aggregate total population assigned to each center. The raw rates by age and sex were obtained from the National Institute of Statistics (2011) by weighting the assigned population with the distribution by age and sex. RESULTS: The 3 autonomous communities recorded 51% of the 4285 cases included in the national registration, with relapses corresponding to 42.8% of these cases. The raw annual incidence rate for new episodes was 22.6 (95% CI: 20.7; 24.6) in Andalusia, 23.5 (95% CI: 20.9; 26.0) in Catalonia and 22.0 (95% CI: 19.9; 24.1) in Madrid. CONCLUSIONS: Except for the larger proportion of smokers and lower tumor grade of lesions in Andalusia, the 3 autonomous communities studied are similar in terms of clinical characteristics, comorbidities, patient symptoms and diagnostic processes for BC.

[Tumor markers in liver metastases of colorectal carcinoma]. / Marcadores tumorales en metástasis hepáticas del carcinoma colorrectal.

Colorectal cancer is a potentially curable tumour when diagnosed in the early stages. In order to improve the results obtained up to now, we propose application of a diagnostic program among patients who undergo curative resection for colorectal adenocarcinoma, which would consist of using a panel of tumor markers, in combination with endoscopic, histologic and ultrasonographic diagnostic methods. For this study we studied 105 patients, divided into two groups: A) Group 1: 30 control patients. B) Group 2: 75 patients diagnosed as having colorectal cancer. We performed the preoperative determination of a series of tumor markers (CEA, CA 19.9, GGT and PHI), endoscopy/biopsy and hepatic ultrasonography on these patients. Our results suggest that the design of the preoperative diagnostic program makes early detection of hepatic metastases possible. The tumor marker panel combination provided a visible increase in sensitivity for detecting hepatic metastases.

[Urologic neoplasms in patients with renal transplantation. Experience and review of the literature]. / Neoplasias urológicas en pacientes con trasplante renal. Experiencia y revisión de la literatura.

The presence of neoplasms in patients with renal transplant in a higher frequency than in general people is known since a long time. The most frequent tumours were the skin tumours, followed by other tumours common in immunosuppressed patients. The ain of this work has been study the frequency, type, diagnosis, treatment and evolution of the urinary system tumours in patients with renal transplant and an exhaustive review of literature. We have found 11 tumours of the urinary system over 57 tumours in 41 patients, with a frequency 26.8%. 6 were kidney tumours, 3 of prostate and 3 of the bladder. We have analyzed the incidence, diagnosis, treatment and evolution of tumour and its effects on the graft. We believe that the posttransplant follow-up of the patient, overcoat in males, who have tumours in more frequency, is important for the early diagnosis.

[Quantitative determination of epidermal growth factor urothelial receptor (EGFR) in superficial and invasive bladder carcinoma]. / Dosificación cuantitativa del receptor urotelial del factor de crecimiento epidérmico (EGFR) en carcinomas vesicales superficiales e invasivos.

The epidermic growth factor (EGF) is a polypeptide which stimulates tissue proliferation. The mechanism of action takes place through an specific membrane receptor, known as the EGFR. Recent scientific contributions have allowed to know its implication in various tumoral processes (breast, ovary, bladder, etc), so that its expression may be used as a major prognostic factor. The objective of this work is to quantify and analyze the epidermic growth factor receptor (EGFR) in surface and invasive vesical carcinoma. To this end, 43 tissular samples divided in two groups were studied. The groups were: 1) Group 1 or control group, comprising 14 samples of "control" vesico-urothelial tissue, and 2) Group 2, assembling 29 patients with vesical carcinoma (17 surface and 12 infiltrant). All tissue samples underwent a process of homogenization and subsequent determination of membrane EGFR by means of radioimmunoassay (EGFR-Receptor Assay, Vienna Lab, Labordiagnostika GmbH). Our results demonstrate the expression of EGFR in both control and tumoral vesico-urothelial tissue in 100% of cases, with detection of significantly higher concentrations (p) in samples from vesical carcinoma than in those from control specimens (15.24 vs. 5.02 fmol/mg protein) and higher levels in infiltrant rather than in surface vesical carcinomas (18.92 vs. 11.4 fmol/mg protein).

[Neoadjuvant chemotherapy MVAC in the treatment of infiltrating bladder carcinoma]. / Quimioterapia neoadyuvante MVAC en el tratamiento del carcinoma vesical infiltrante.

INTRODUCTION: Aiming to preserve the bladder in patients with infiltrative carcinoma of the bladder and to offer patients improved quality of life with no detriment for survival, a therapeutical protocol was set up. MATERIAL AND METHODS: Between August 1988 and January 1997 63 patients with stage T2 and T3a infiltrative carcinoma of the bladder, with no metastasis or node extension detectable with imaging techniques were treated in our unit. 45 of these patients met all protocol criteria and were given 3 neoadjuvant chemotherapy courses with MVAC (methotrexate, vincristine, adriamycin, cisplatin). INCLUSION CRITERIA: age under 75 years, Karnofsky greater than 50%, leucocytes greater than 2,500 cell/mL and platelet greater than 100,000/mL. Following chemotherapy, re-assessment was performed through lab tests, chest X-rays, abdomino-pelvic CT, bone scanning, cystoscopy, multiple randomized biopsies, tumoral bed scar resection and resection of relapsed urothelioma. Patients with complete remission were given radiotherapy. Those showing stabilisation of progression were proposed to undergo cystectomy. Fisher's test or chi 2 test were used for the comparison of qualitative variables. The survival analysis was performed using the Kaplan-Meier method. The curves comparison was done with Breslow's exact test. A Cox's proportional risk method allowed to calculate the relative risks together with their 95% confidence interval. RESULTS: 53.7% patients included in this protocol showed complete remission, 41.5% stable disease and 4.9% progression. 62.2% of patients were given radiotherapy versus 17.8% who underwent cystectomy. 20% received other therapies after rejecting both cystectomy or radiotherapy. Median follow-up was 43.38 months. Overall median survival was 96 months. The accumulate probability of survival at 4 years was 79%. 50% patients with complete clinical response relapsed during follow-up. Tumoral stage of those who relapsed was lower than the initial one in 63.7% cases, remained the same in 18.2%, and higher in 18.2%. With regards to grading, 66.7% patients had lower grading at relapse if tumour was initially grade 2. For those with initial tumour grade 3, only 20% had a lower grade. CONCLUSION: 64.4% patients retained their bladder. In 26.7% there was demonstrable metastatic disease. No differences were seen in the distribution or survival time based on the different treatment given after chemotherapy (p = 0.22). Patients with complete remission after chemotherapy have greater actuarial survival which is statistically significant (p = 0.04).

[Role of growth factors in the etiopathogenesis of benign prostatic hyperplasia]. / Implicaciones de los factores de crecimiento en la etiopatogenia de la hiperplasia prostática benigna.

A comment is made on the role growth factors play on the regulation of prostate growth. These factors require the mediation of an specific membrane receptor to which they have to bind in order to exercise their action correctly. The objective of the present job is to carry out a comprehensive review of each and every growth factor involved in prostate growth: family of the epidermal growth factor, family of the beta-transforming growth factor, and family of the fibroblast growth factor. As a final conclusion, it should be mentioned that the two prostate growth-regulating factors more extensively studied and with greater etiopathogenic relevance in benign prostate hyperplasia, are the epidermal growth factor and, more particularly, the fibroblast growth factor.

[Endoscopic myocapsulotomy. Evaluation of the short-term clinical and urodynamic results]. / Miocapsulotomía endoscopia (MC). Evaluación de los resultados clínicos y urodinámicos a corto plazo.

Clinical and urodynamic evaluation of a series of 35 patients aged between 49 and 85 years. Clinical symptoms presented post-miocapsulotomy reduction both in obstructive and irritative signs and symptoms in 97.2% and 91.6% cases, respectively. Likewise, a decrease in peak flow and peak flow percentile was shown in 80.5% and 80% of cases, respectively. Vesical instability was seen in 90.9% and 55.5% of cases in pre- and post-operative studies respectively. An statistically significant post-operative drop (p < 0.05) in the detrusor's peak pressure during miction, (76.6 vs. 56 cm H2O), was confirmed. From our results it may be concluded that MC is a useful surgical technique in the treatment of prostatic obstruction, with the advantage versus other techniques that very frequently it preserves the proximal urinary continence mechanism and the sexual sphincter.

[Advances regarding tumor markers in bladder cancer]. / Avances en marcadores tumorales en cáncer vesical.

INTRODUCTION: Currently, there is not known tumoral marker for vesical carcinoma that would allow to distinguish when a surface tumour may become invasive. OBJECTIVE: To analyze the functionality of a series of biological substances (CEA, CA 50, CA 19.9 and TPS) in vesical carcinoma. MATERIAL AND METHODS: Between September 1992 and June 1994, a total of 385 biological specimens divided into two groups were analyzed. The first group comprised 271 serum samples from 81 control subjects and 190 patients with vesical carcinoma. The second group included 114 urothelial tissue samples (56 controls and 58 vesical carcinoma). Serum and tissue levels of CA, CA 50, CA 19.1 and TPS were determined in both groups by fluoroimmunoassay, RIA and IRMA, respectively. An statistical evaluation was done using Student's 't' and/or Mann-Whitney tests depending on whether data distribution adjusted to normal or not. RESULTS: Patients with vesical carcinoma, ana within this group those with infiltrant tumours, showed higher CEA serum levels. Also CEA tissue levels found in neoplastic vesical urothelium were higher than those in the control group (p < 0.05). Tissue levels were higher in infiltrant tumours. Higher TPS serum and tissue levels were found in the vesical tumours group. Same as with CEA, CA 50 also exhibited higher serum levels in the group with vesical Ca than in the controls (p < 0.01). Likewise, CA 50 tissue values were higher in the group with vesical Ca, more specifically in the infiltrant tumours group (p < 0.001). Statistically significant differences become apparent when the above values were compared to tissue samples from the control group (p < 0.001). On the other hand, serum CA 19.9 levels were lower in the vesical carcinoma group although tissue levels were higher in the vesical Ca group (p < 0.001). CONCLUSIONS: Transitional cell vesical carcinoma is a tumour that produces and secretes CEA, CA 50, CA 19.1 and TPS. CEA and CA 50 levels could be used as prognostic factors.

[Determination of serum SCC antigen in transitional cell carcinoma of the bladder]. / Dosificación sérica de antígeno SCC en el carcinoma vesical de células transicionales.

The SCC antigen expresses in the squamous epithelium during the process of a neoplastic transformation. This paper's objective is to evaluate the biological behaviour of SCC antigen in surface, deep, localized and spread malignant vesical carcinoma. To this end, 100 patients divided in two groups were studied. The first group consisted in 30 healthy subjects strictly selected and the second group comprised 70 patients diagnosed with transitional cell vesical carcinoma. SCC Antigen measurement was made by Radioimmunoassay (RIA, Abbott). Our results suggest that this tumoral antigen has no use as a prognostic factor in patients diagnosed with transitional cells vesical carcinoma, since serum concentrations suffer no change in relation to size, extent and degree of tumoral differentiation.

[Prostate cancer in the Community of Madrid in the year 2000. III. Study of tumor extent]. / El cáncer de próstata en la Comunidad de Madrid en el año 2000. III--Estudio de extensión tumoral.

OBJECTIVE: To identify a potential relationship between two variables, risk of metastasis and use of imaging techniques, in an extension study in prostate cancer patients diagnosed in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: 1,127 patients with available data on the tumour extension study were analysed. Performance and non performance of bone scans and CTs were correlated to risk variables for developing metastasis as described in the literature (PSA, Gleason and stage) and to therapy administered. RESULTS: The proportion of patients with risk variables for metastasis when bone scans were performed was between 7% to 14% greater than in patients with no variables. No differences were seen for CTs based on risk variables. With matching risk variables, more imaging techniques were used in patients receiving radiotherapy that in those managed with prostatectomy. CONCLUSION: Based on current recommendations imaging techniques were used in excess in the extension study in patients with no risk variables for metastasis. Conduct of a further study in the Autonomous Community seems advisable to confirm the likelihood of implementing such recommendations considering our prevalence of metastatic disease.

[Prostate cancer in the Community of Madrid in the year 2000. IV. Treatment]. / El cáncer de próstata en la Comunidad de Madrid en el año 2000. IV Tratamiento.

OBJECTIVE: To know the therapeutic options used in patients diagnosed with prostate cancer in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: The study was conducted on 1,745 patients referred by hospitals taking part in the study. Data on treatment used was available for 1,104 (63%) patients. Treatment modality was correlated to clinical stage and patient age. RESULTS: Most frequent choice was hormone therapy (35%) followed by radical prostatectomy (34%) and radiotherapy (25%). Prostatectomy was most commonly used in patients with localised (42.3%) disease while hormone therapy was preferred for locally advanced (45.6%) or disseminated (94%) disease. There are significant differences in therapeutic indications between the various Health areas participating in the survey. Median age of patients with localised and locally advanced disease was lower in patients managed with prostatectomy (65 and 64 years, respectively) than in those managed with radiotherapy (70 and 69 years, respectively). CONCLUSION: The therapeutic modality indicated by urologists in the Madrid Autonomous Community for managing patients with prostate cancer generally meets with literature recommendations.