68 results on '"Robles García JE"'
Search Results
2. Cirugía con circulación extracorpórea e hipotermia en tumores con extensión a vena cava: 20 años de experiencia de la Clínica Universitaria de Navarra
- Author
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G. Rábago, Zudaire Bergera Jj, Rioja Zuazu J, Robles García Je, Rodríguez-Rubio Cortadillas F, Rosell Costa D, Saiz Sansi A, and Berián Polo Jm
- Subjects
medicine.medical_specialty ,Vena cava ,business.industry ,Urology ,Extracorporeal circulation ,Wilms' tumor ,Hypothermia ,medicine.disease ,Surgery ,Embolism ,Circulatory system ,cardiovascular system ,medicine ,cardiovascular diseases ,Lymph ,medicine.symptom ,Thrombus ,business - Abstract
Objective We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection. Material and methods From 1985 to 2005 a total of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study. Results Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1+/-10% at three years and 17.5+/-8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50.9+/-16.3% and 32.2+/-16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20.8+/-12% and 10.4+/-9% respectively. Conclusions The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.
- Published
- 2008
3. Comparison of surgical approaches to radical prostatectomy in our series beyond oncological and functional outcomes.
- Author
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García Cortés Á, Colombás Vives J, Gutiérrez Castañé C, Chiva San Román S, Doménech López P, Ancizu Marckert FJ, Hevia Suárez M, Merino Narro I, Velis Campillo JM, Guillén Grima F, Torres Roca M, Diez-Caballero Y Alonso F, Rosell Costa D, Villacampa Aubá F, de Fata Chillón FR, Andrés Boville G, Barbas Bernardos G, Miñana López B, Robles García JE, and Pascual Piédrola JI
- Subjects
- Humans, Male, Prostatectomy methods, Quality of Life, Treatment Outcome, Erectile Dysfunction etiology, Robotic Surgical Procedures methods
- Abstract
Objectives: To evaluate the outcomes of robot-assisted radical prostatectomy (RARP) compared to those of open (ORP) and laparoscopic (LRP) surgery. The interest lies fundamentally in the quality-of-life (QoL) evaluation, postoperative recovery, and personal satisfaction of patients with the intervention (PS) beyond oncological and functional outcomes., Methods: Six hundred eighty-five RPs were performed in our center between 2011-2018 (17,8% ORP, 22,2% LRP and 60% RARP). Patients were prospectively assessed through follow-up until April 2020 and a multiple questionnaire at 12-months post-RP that included ICIQ-SF, SHIM, IPSS, IQL and questions about pain, postoperative recovery and PS. Also baseline and postoperative patient- and treatment-related data were collected, and binomial logistic regressions were performed for the 1 vs.1 comparisons (ORP vs. RARP and LRP vs. RARP)., Results: RARP patients have overall fewer comorbidities, less tumor aggressiveness, more operative time requirements and more positive surgical margins than ORP and LRP patients. Nevertheless, RARP outperforms ORP in: hospital stay (days) (OR 0,86; 95% CI: 0,80-0,94), hemoglobin loss (OR 0,38; 95% CI: 0,30-0,47), transfusion rate (OR 0,18; 95% CI: 0,09-0,34), early complications (p = 0,001), IQL (OR 0,82; 95% CI: 0,69-0,98), erectile function (OR 0,41; 95% CI: 0,21-0,79), pain control (OR 0,82; 95% CI: 0,75-0,89), postoperative recovery (p < 0,001) and choice of a different approach (OR 5,55; 95% CI: 3,14-9,80). RARP is superior to LRP in: urinary continence (OR 0,55; 95% CI: 0,37-0,82), IPSS (OR 0,96; 95% CI: 0,93-0,98), IQL (OR 0,76; 95% CI: 0,66-0,88), erectile function (OR 0,52; 95% CI: 0,29-0,93), postoperative recovery (p = 0,02 and 0,004), PS (p = 0,005; 0,002; and 0,03) and choice of a different approach (OR 7,79; 95% CI: 4,63-13,13)., Conclusions: The findings of our study globally endorse a positive effectiveness of RARP over ORP and/or LRP, both on functional issues, postoperative recovery, QoL and PS. Oncologic results should still be improved., (Copyright © 2021. Published by Elsevier España, S.L.U.)
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- 2022
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4. Surgical thromboprophylaxis in daily urologic surgery: Beyond bridge therapy.
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Doménech López P, Robles García JE, Gutiérrez Castañé C, Chiva San Román S, García Cortés A, Ancizu Marckert FJ, Tamariz Amador LE, Andrés Boville G, Villacampa Aubá F, de Fata Chillón FR, Diez-Caballero Alonso F, Torres Roca M, Rosell Costa D, Miñana López B, Pascual Piedrola JI, and Páramo Fernández JA
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- Humans, Practice Guidelines as Topic, Anticoagulants therapeutic use, Postoperative Complications prevention & control, Thromboembolism prevention & control, Urologic Surgical Procedures methods
- Abstract
Introduction: With the advanced laparoscopic and robotic surgery, thromboembolic prophylaxis in urologic procedures has traditionally been based on the experience of other surgical specialties. This paper aims to analyze the current recommendations, through a detailed study of the European clinical guidelines and bibliography, applying the recommendations of thromboprophylaxis to the daily urological practice., Objectives: To elaborate general recommendations to surgical patients in Urology, avoiding the risk of perioperative thromboembolic events. Optimize medication in chronic patients and accurately classify who are eligible for bridge therapy., Material and Methods: A review of the available literature and the European clinical guidelines was carried out. We analyzed the most recent consensus articles by studying the available bibliography, trials and reviews on which the European guidelines for thromboprophylaxis in urology are based., Results: Thromboembolic prophylaxis should be targeted towards surgeries that require abdominal approaches, prolonged bed rest or oncological pathologies. Bridge therapies with low molecular weight heparins should be limited. Patients undergoing treatment for chronic conditions can benefit from bridge therapies in specific cases., Conclusions: According to the current guidelines, there might be an overuse of heparins in the daily clinical practice. The development of -direct oral- anticoagulants have shown to reduce the time to reintroduction of medication for chronic conditions as well as a more effective bleeding management., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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5. Simulators help improve student confidence to acquire skills in urology.
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Rodríguez-Díez MC, Díez N, Merino I, Velis JM, Tienza A, and Robles-García JE
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- Female, Humans, Male, Self Efficacy, Clinical Competence, Digital Rectal Examination, Simulation Training, Urinary Catheterization, Urology education
- Abstract
Objective: To know the level of confidence of fifth year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method., Material and Methods: The study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique., Results: All the evaluations made on the different abilities were significantly higher after training (P<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (P<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47 ± 0.9 to a maximum score of 5., Conclusions: Simulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)
- Published
- 2014
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6. [Lung cancer metastasizing to the prostate: case report and literature review].
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Barba Abad J, Robles García JE, Tolosa Eizaguirre E, Panizo Santos A, and Zudaire Bergera JJ
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- Aged, 80 and over, Humans, Male, Carcinoma, Non-Small-Cell Lung secondary, Lung Neoplasms pathology, Prostatic Neoplasms secondary
- Published
- 2010
7. [Influence of donor age on graft survival].
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Barba Abad J, Tolosa Eizaguirre E, Rincón Mayans A, Rosell Costa D, Robles García JE, Zudaire Bergera J, Berián Polo JM, and Pascual Piedrola I
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- Age Factors, Humans, Middle Aged, Retrospective Studies, Graft Survival, Kidney Transplantation statistics & numerical data, Tissue Donors statistics & numerical data
- Abstract
Introduction: In 2007 in Spain 43% of donors were older than 60 years. This produces a worse graft quality and probably a worse survival., Objective: Our objective is to analyze the influence of donor age on graft survival., Material and Methods: We analyze retrospectively 216 renal consecutive transplants realized between 2000 and 2008. A univaried and multivaried study (Cox regression) was performed and Kaplan-Meyer test with log rank for graft survival., Results: Follow-up mean of 40 months (+/-33,4 SD). The univaried analysis of graft survival showed that donor age had a significative influence on graft survival. (OR=1,03; 95% CI 1,01-1,05) (p: 0,009). Studying the relation between donor and recipient age we find an inverse correlation (Pearson's Correlation: 0,55. p<0,0001), but there are significative differences after the adjustment for recipient age. (OR: 1,02; 95% CI 1,01-1,04) (p: 0,04). Optimal cut-point value determined by the ROC analysis was 60 years. The graft survival of donors over 60 years is 79% (95% CI; 74-84%) and 71% (95% CI; 65-77%) at 3 and 5 years in contrast with 94% (95% CI; 94-96%) and 90% (95% CI; 88-92 in donors under 60. (p: 0,002). The multivaried study of the influential factors on graft survival reveals that donor age dichotomized in older or younger than 60, the presence of a surgical immediate reintervention and a delayed graft function were independent influence factors., Conclusions: Donor age over 60 years has a negative and independent prognostic influence on graft survival.
- Published
- 2010
8. [Delayed scrotal trauma consultation].
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Tolosa Eizaguirre E, Robles García JE, Lorente Pérez J, and Rincón Mayans A
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- Adult, Delayed Diagnosis, Humans, Male, Time Factors, Scrotum injuries, Wounds, Nonpenetrating diagnosis
- Published
- 2010
9. [Surgical complications in kidney transplantation and their influence on graft survival].
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Barba Abad J, Rincón Mayans A, Tolosa Eizaguirre E, Romero Vargas L, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, Berián Polo JM, and Piédrola IP
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- Humans, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Graft Survival, Kidney Transplantation adverse effects
- Abstract
Objectives: To analyze surgical complications in kidney transplantation and their influence on graft survival., Materials and Methods: A retrospective analysis was made of the early and late surgical complications occurring in 216 consecutive kidney transplants performed at our institution and their influence on graft survival., Results: At least one surgical complication occurred in 82 (38%) of the 216 transplantations, and 68 (31%) required some type of repeat surgery, 23 in the early postoperative period and 45 more than 3 months after surgery. Mean follow-up was 48 months (SD +/-33.4), and median follow-up 48 months (range, 0-166 months). No recipient or donor factors predisposing to surgical complications were found. Graft survival was significantly shorter in patients with surgical complications [3- and 5-year survival rates of 86% (95% CI 83-89) and 78% (95% CI 73-82) as compared to 92% (95% CI 90-94) and 88% (95% CI 85-91), p=0.004]. Early repeat surgery, venous thrombosis, and wound infection were among the complications having an independent influence on graft survival. A multivariate analysis of graft survival in the whole group showed early repeat surgery to be a factor with an independent prognostic value (OR: 4.7; 95% CI 2.2-10, p<0.0001). Delayed function and donor age older than 60 years were the other independent influential factors. CONCLUSION Surgical complications have an influence on graft survival. The need for early repeat surgery, delayed function, and donor age older than 60 years are independent predictors of graft survival.
- Published
- 2010
10. Bilateral obstructive uropathy by lithiasis in a pregnant patient.
- Author
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Arraiza Sarasa M, Zudaire Díaz-Tejeiro B, Rincón Mayans A, Arias Fernández J, Benito Boillos A, and Robles García JE
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- Adult, Female, Humans, Pregnancy, Pregnancy Complications diagnostic imaging, Ultrasonography, Ureteral Calculi diagnostic imaging, Ureteral Obstruction diagnostic imaging, Pregnancy Complications etiology, Ureteral Calculi complications, Ureteral Obstruction etiology
- Published
- 2009
11. [Extracorporeal circulation and hypothermy surgery in tumors with vena cava extension: 20 years experience at the University Clinic of Navarra].
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Rioja Zuazu J, Rodríguez-Rubio Cortadillas F, Zudaire Bergera JJ, Saiz Sansi A, Rosell Costa D, Robles García JE, Rábago G, and Berián Polo JM
- Subjects
- Humans, Kidney Neoplasms pathology, Neoplasm Staging, Spain, Time Factors, Extracorporeal Circulation, Hypothermia, Induced, Kidney Neoplasms surgery, Neoplastic Cells, Circulating, Vena Cava, Inferior
- Abstract
Objective: We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection., Material and Methods: From 1985 to 2005 a total of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study., Results: Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1+/-10% at three years and 17.5+/-8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50.9+/-16.3% and 32.2+/-16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20.8+/-12% and 10.4+/-9% respectively., Conclusions: The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.
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- 2008
- Full Text
- View/download PDF
12. [A Spanish multicenter trial of TVT for female urinary incontinence].
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Sanz Pérez G, Rodríguez-Rubio Cortadellas FI, Garrido Insua S, Concepción Masip T, Robles García JE, Gómez Velázquez M, Bachiller Burgos J, and Cabrera A
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- Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Postoperative Complications, Retrospective Studies, Spain, Treatment Outcome, Urinary Incontinence, Stress diagnosis, Urologic Surgical Procedures adverse effects, Vagina surgery, Urinary Incontinence, Stress surgery, Urologic Surgical Procedures methods
- Abstract
Objective: The purpose of this study was to evaluate results and complications of TVT in a large series from different hospital centers in Spain., Method: We retrospectively studied the results of TVT placement from 6 centers with 272 consecutive patients (median follow-up was 636 days). All types of stress urinary incontinence with a surgical indication were included and no previous conditions were established regarding the indication. No protocol was used for either the intervention or postoperative support measures. Data collection was protocolized and carried out using a common questionnaire that was completed by an urologist at each center from 3 to 6 months after the intervention and then annually. All patients who underwent intervention were asked about their satisfaction with the outcome. Multivariate studies were made to identify the factors that influenced the recovery of continence and the occurrence of complications., Results: 92.1% of patients were continent and 2.4% have not shown any improvement. 91.6% of the patients claimed to be satisfied whereas only 2.7% were dissatisfied. After four years only 2.8% of patients showed mild incontinence with time and 0.4% had moderate incontinence. Only previous surgery for incontinence was found to be significantly unfavorable factor for achieving postoperative continence., Conclusion: We have reproduced a scenario closer to daily clinical reality than the results of series from a single institution or analyses using stricter selection criteria. This multicenter study verifies the viability and reproducibility of TVT with minimal complications in centers where patients are not selected and where not all urologists are specialized in urinary incontinence.
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- 2005
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13. [Surgical treatment of penile lymphedema associated with hidradenitis suppurativa].
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García-Tutor E, Botellé del Hierro J, San Martín Maya A, Castro García J, España A, Fernández Montero J, and Robles García JE
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- Adult, Hidradenitis Suppurativa pathology, Hidradenitis Suppurativa surgery, Humans, Lymphedema pathology, Lymphedema surgery, Male, Penile Diseases pathology, Penile Diseases surgery, Penis pathology, Penis surgery, Scrotum pathology, Scrotum surgery, Surgical Flaps, Treatment Outcome, Urologic Surgical Procedures, Male methods, Hidradenitis Suppurativa complications, Lymphedema etiology, Penile Diseases etiology
- Abstract
Penoscrotal lymphedema is a rare disease in the developed countries, although it is relatively frequent in tropical countries. The most common cause is filariasis, although in our practice usually is associate to neoplasic and inflammatory processes, surgery, radiotherapy, hidroelectrolitic disbalances and idiopathic. We present a 22 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa. After unsuccessful medical treatment, was performed a total excision of the penile skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. Even medical management of penoscrotal lymphedema is not effective for most patients, surgery is a safe and effective procedure that gives excellent functional and cosmetic results.
- Published
- 2005
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14. [Evaluation and prognostic of cystic renal tumors].
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López Ferrandis J, Rioja Zuazu J, Saiz Sansi A, Regojo Balboa JM, Fernández Montero JM, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
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- Adult, Aged, Female, Humans, Kidney Diseases, Cystic diagnosis, Kidney Diseases, Cystic mortality, Kidney Diseases, Cystic surgery, Male, Middle Aged, Neoplasm Staging, Nephrectomy, Prognosis, Retrospective Studies, Survival Rate, Kidney Diseases, Cystic pathology
- Abstract
Objective: To evaluate the clinical and pathological characteristics of cystic renal tumors in our center., Material and Methods: A retrospective review of 239 nephrectomies is performed comparing the clinical and pathological variables of cystic tumors with those of solid renal tumors. Survival outcomes are analyzed in both groups., Results: Our experience shows that cystic renal tumors behave like solid renal tumors, with no differences in survival shown. The variables studied show statistically significant differences in histological grade and number of tumors, with cystic tumors having a lower histological grade and being more often multiple in number., Conclusions: The behavior of cystic renal tumors is no different than that of solid renal tumors.
- Published
- 2005
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15. [Incidentally detected renal cancer. Prognostic factors].
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López Ferrandis J, Sánchez Zalabardo D, Rioja Zuazu J, Arocena García-Tapia J, Regojo Balboa JM, Fernández Montero JM, Berían Polo JM, Zudaire Bergera JJ, Robles García JE, and Rosell Costa D
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- Adult, Aged, Aged, 80 and over, Female, Humans, Incidental Findings, Male, Middle Aged, Prognosis, Retrospective Studies, Kidney Neoplasms diagnosis, Kidney Neoplasms surgery
- Abstract
Objective: To study the clinical and pathological characteristics of incidental renal tumors treated in our center., Material and Methods: A retrospective review is conducted of 318 nephrectomies comparing the clinico-pathological variables of renal tumors diagnosed incidentally with those of symptomatic renal tumors. The factors influencing disease-free survival are analyzed in both groups., Results: In our experience, although incidental renal tumors presented better survival than symptomatic ones owing to their better pathological state and tumor grade, incidental diagnosis was not an independent influencing factor in the multivariate study. Only when patients were studied who did not present metastases on diagnosis did incidental diagnosis become an influencing factor very close to statistical significance., Conclusions: Incidental diagnosis is not an independent prognostic factor.
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- 2004
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16. [Follicular carcinoma of the thyroid manifested initially as asymptomatic primary renal neoplasm].
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Regojo Balboa JM, Sánchez Zalabardo D, Rioja Zuazu J, Fernández Montero JM, López Ferrandis J, Zudaire Bergera JJ, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Aged, Female, Humans, Thyroid Neoplasms pathology, Adenocarcinoma, Follicular secondary, Kidney Neoplasms secondary, Thyroid Neoplasms diagnosis
- Abstract
Metastases in the kidney are rare, evenmore if primary source is thyroid. We report the tenth case of metastases in the kidney from thyroid, and it is the first to be follicular type and absolutely asymptom. Sonography and computerized tomography with suspicion of renal tumour are showed in a asymtom female 75 years old. Left partial nephrectomy was perfomed, initially it has been pathologically diagnosed as renal clear cells tumour, however the definitive pathologic report showed follicular tumour of thyroid. Local and systemic stage was discovered with complementary techniques. Sources of metastases in kidney and diagnoses techniques are discussed.
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- 2004
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17. [Mutations of the androgen receptor gene in patients with clinically localized adenocarcinoma of the prostate].
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Sánchez Zalabardo D, Rosell Costa D, Honorato Cia B, Rioja Zuazu J, Regojo Balboa JM, Fernández Montero JM, López Ferrandis J, Robles García JE, Zudaire Bergera JJ, García Foncillas J, and Berián Polo JM
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- Adenocarcinoma pathology, Aged, Humans, Male, Middle Aged, Prostatic Neoplasms pathology, Adenocarcinoma genetics, Mutation, Prostatic Neoplasms genetics, Receptors, Androgen genetics
- Abstract
Unlabelled: The aim of this study was to detect mutations in the human androgen receptor gene in radical prostatectomy specimens., Material and Methods: The genomic sequence was realized in 67 radical prostatectomy specimens. The mean age was 64 years old. The PSA median was 15 ng/ml. TNM 1997: 34.3% were T1 and 65.7% T2. Genomic sequence: 1. Radical prostatectomy specimens desparaffitation. 2. Extraction of the DNA 3. DNA amplification. 4. Automatic genome sequence. 5. Comparison with Gene-Bank., Results: 16.7% of the specimens were mutated. The most frequent mutation was the punctual mutation. The exon most frequent mutated was exon 1.
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- 2004
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18. [Usefulness of PET in the diagnosis and response to treatment of extragonadal germinal tumor with atypical presentation].
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Fernández Montero JM, Zudaire Bergera JJ, Rioja J, Regojo Balboa J, López Ferrandis J, Sánchez Zalabardo D, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adult, Germinoma drug therapy, Humans, Male, Retroperitoneal Neoplasms drug therapy, Teratoma drug therapy, Germinoma diagnostic imaging, Retroperitoneal Neoplasms diagnostic imaging, Teratoma diagnostic imaging, Tomography, Emission-Computed
- Abstract
Primary tumors of extragonadal origin are rare, with fewer than 1000 cases described in the literature. Although the exact incidence of EGTs is unknown, clinical data suggest that roughly 3% to 5% of all germ cell tumors. We expose a case report of EGT with unusually clinic presentation. We present our diagnostic and therapeutic experience in this injuries.
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- 2003
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19. [Solitary lung metastasis after radical prostatectomy].
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López Ferrandis J, Boán García J, Rioja Zuazu J, Regojo Balboa JM, Fernández Montero JM, Sánchez Zalabardo D, Berián Polo JM, Zudaire Bergera JJ, Rosell Costa D, and Robles García JE
- Subjects
- Adenocarcinoma blood, Adenocarcinoma diagnostic imaging, Adenocarcinoma surgery, Aged, Biomarkers, Tumor blood, Humans, Lung Neoplasms blood, Lung Neoplasms diagnostic imaging, Lung Neoplasms surgery, Male, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Time Factors, Tomography, Emission-Computed, Adenocarcinoma secondary, Lung Neoplasms secondary, Prostatectomy, Prostatic Neoplasms surgery
- Abstract
Prostate carcinoma is diagnosed in earlier phases of its evolution, but this carcinoma may have an unpredictible evolution. Radical treatment (surgery and radiotherapy) is the best treatment in clinically localized tumors. The biochemical failure over 5 years from the surgery is 20-50% of the patients; the biochemical failure over 10 years from the surgery is less frequent because of prognostic factors from the biologic nature of the tumor. We report a case with biochemical and clinical failure over 10 years from the surgery.
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- 2003
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20. [Prognosis factors in pT3 renal carcinoma].
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Sánchez Zalabardo D, Arocena García-Tapia J, Regojo Balboa JM, Fernández Montero JM, López Ferrandis J, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berían Polo JM
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- Adult, Aged, Aged, 80 and over, Disease Progression, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prognosis, Risk Factors, Survival Rate, Carcinoma, Renal Cell mortality, Carcinoma, Renal Cell pathology, Kidney Neoplasms mortality, Kidney Neoplasms pathology
- Abstract
Objectives: To identify independent predictors of progression and global survival in patients affected by pT3 renal cell carcinoma. To make risk groups by risk factors., Material and Methods: We evaluated 117 patients with pT3 renal cell carcinoma. 88 was M0 and 29 M1. Most frequent clinical feature: asintomatic patients. 80 males (69%) and 37 females (31%). Mean age 59 (24-82). Median follow up 34 months (mean 44 +/- 39 months)., Results: Pathological stage (TNM 1997) was pT3a in 52 patients (43.6%), pT3b 63 patients (53.6%) and pT3c 2 patients., Histology: clear cell carcinoma 106 patients (90.6%), papillary 5 patients (4.3%) an dchromophobe 4 patients (3.4%). Nuclear grading according Fuhrman's classification: G1 13 patients, G2 45 patients, G3 32 and G4 12 patients. Size > 4 cm (p = 0.005/p = 0.0019), grade 3-4 (p = 0.006/p = 0.0007), N+ (p = 0.034/p = 0.009) and M+ (p = 0.035/p = 0.042) were independent prognosis factors for progression and global survival of the pT3 renal cell carcinoma. Patients M0 with 0 or 1 risk factor have better global survival tanh patients M0 with 3 or 4 risk factors and patients M1., Conclusions: Size, grade, N+ and M+ were independent prognosis factors for progression and global survival of the pT3 renal cell carcinoma. Tera are no differencies in global survival between patients M0 with 2 or 3 risk factors and patients M1.
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- 2003
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21. [Treatment of renal carcinoma].
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Arocena García-Tapia J, López Ferrandis J, Sánchez Zalabardo D, Regojo Balboa JM, Fernández Montero JM, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Combined Modality Therapy, Humans, Kidney Neoplasms therapy
- Abstract
The standard therapy for renal carcinoma is radical surgery. When dealing with single, under 4 cm tumors and in the case of renal tumors in single-kidney patients, the choice therapy is nephrectomy or partial nephrectomy. Response rates in metastatic renal carcinoma using the various immune therapy approaches available range from 15 to 35%, responses being short-lasting.
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- 2002
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22. [Clinical features, diagnosis, and prognosis of renal carcinoma].
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Sánchez Zalabardo D, López Ferrandis J, Arocena García-Tapia J, Rogojo Balboa JM, Fernández Montero JM, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Carcinoma genetics, Humans, Kidney Neoplasms genetics, Neoplasm Staging, Prognosis, Carcinoma diagnosis, Kidney Neoplasms diagnosis
- Abstract
Significant conceptual changes have taken place in renal tumoral diseases over the last few years. As a result of the authors' broad institutional experience, this overall revision describes the most up-to-date clinical and diagnostic aspects of this condition. Emphasis is made on molecular staging and two variables that guide the prognosis of the disease, a decisive feature to establish treatment and to contribute to change current survival rates.
- Published
- 2002
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23. [Prognostic value of P53, Ki67, and Rb protein in infiltrating bladder tumors].
- Author
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Sánchez Zalabardo D, Rosell Costa D, Fernández Montero JM, López Ferrandis J, Arocena García-Tapia J, Jiménez Garín S, de Alava Casado E, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prognosis, Ki-67 Antigen metabolism, Retinoblastoma Protein metabolism, Tumor Suppressor Protein p53 metabolism, Urinary Bladder Neoplasms metabolism
- Abstract
Objectives: To determinate whether increased expression of the p53 and Ki67 and the of the tumour suppressor gene retinoblastoma (prot Rb), in an immunohistochemistry study, were associated with relapse in invasive bladder cancer., Materials and Methods: 47 patients with invasive bladder cancer. 42 men and 5 women. Mean age 63 years old. Relapse in 19 patients (40%). Mean time until recurrence 8.5 months. p53 and Ki67 were study in 47 patients and prot Rb in 40 patients., Results: p53: Mean expression 41%. There were significant differences in the increased expression of p53 between patients with and without relapse (p = 0.03). A statistically significant association was then observed between patients with p53 > 20% (vs p53 < 20%) and adverse outcome of the disease (p = 0.04). Ki67 and prot Rb: There were no significant differences in relapse and progression free survival between Ki67 > 40% (vs Ki67 < 40%) and prot Rb < 10% (vs prot Rb > 10%). p53 expression showed a statistically significant correlation with Ki67 and prot Rb., Conclusion: p53 is a good prognostic marker for the relapse and progression free survival in invasive bladder cancer.
- Published
- 2002
- Full Text
- View/download PDF
24. [Determining factors in the presence of carcinoma in prostate biopsies].
- Author
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Sanz Pérez G, Zudaire Bergera JJ, Maalik A, López Ferrandis J, Sánchez Zalabardo D, Arocena García-Tapia J, Diez-Caballero Alonso F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma blood, Biopsy statistics & numerical data, Humans, Male, Middle Aged, Multivariate Analysis, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Adenocarcinoma pathology, Prostatic Neoplasms pathology
- Abstract
Purpose: Prostate biopsy is the diagnostic method to detect prostate carcinoma. We try to identify the optimal PSA cut-off, biopsy indication and the clinico-pathological characteristics in order to differentiate those patients with negative biopsy in which we should repeat the proceeding., Method: We study 344 biopsies in 292 patients for 16 months. An univariate and multivariate study to identify the influent factors in the existence of prostate cancer in the first biopsy and in the patients with a second one was taken place., Results: Patients in the first biopsy Univariate study: Out of these variables (PSA, PSA ratio, digital rectal examination and prostate volume) just the PSA has statistical significance. Multivariate study: Only the the PSA is an indepent influence factor. Receiving Operated Curve: The optimal cut-off is 10.5 ng/ml. Patients with a second biopsy Univariate study: None of the variables is related with the existence of prostate cancer. Groups comparison: A comparison between the patients in the first biopsy and the patients with a second biopsy is performance with no statistical differences in the variables already mentioned., Conclusion: The patient with a PSA greater than 4 ng/ml should be perform a prostate biopsy, mostly if his PSA is over 10 ng/ml. In our experience we do not related the need of a second biopsy with any factor in particular, therefore in our opinion and because of the high rate of negative false, all of the patients should be controlled and undergo a second biopsy if any change in PSA or clinics modification takes place.
- Published
- 2000
- Full Text
- View/download PDF
25. [N1 prostatic adenocarcinoma treated with radical surgery and immediate hormonal management].
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Arocena García-Tapia J, Zudaire Bergera JJ, López Ferrandis J, Sánchez Zalabardo D, Sanz Pérez G, Diez-Caballero Alonso F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma pathology, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Prostatic Neoplasms pathology, Adenocarcinoma surgery, Orchiectomy, Prostatectomy, Prostatic Neoplasms surgery
- Abstract
Objectives: To study the survival in patients with prostate adenocarcinoma, lymph nodes involvement in the intraoperative pathological examination, evaluating both radical surgery and early ablation as treatment. Identification of clinical factors that can predict node involvement., Method: 20 patients who underwent radical prostatectomy between 1988-1998 were included in the study. All patients clinically diagnosed with T1-2N0Mx prostate adenocarcinoma (T.N.M. 1992), single metastatic node involvement in the pathological study and early sub-albuginea orchidectomy. This group was compared to a 200-patient control group also with T1-2N0Mx prostate adenocarcinoma but with no pathologic nodular involvement. Statistical study: contingency 2Xb tables (Pearson's chi 2 or Fisher's exact test) to compare qualitative variables; Student's t test for means comparison; Kaplan-Meier for actuarial survival calculations and comparison of Log-rank survival curves. For the study of clinical variants with influence in node involvement a logistic regression model was used., Results: Mean age was 63 +/- 0.8 years. Median follow up 56 months. Mean PSA 33 +/- 4.4 ng/mL and 55% had Gleason 5-7. 16 patients were stage pT3. Specific 5-year survival was 90 +/- 8% and biochemical progression free survival 63 +/- 12%. Clinical variables with statistical significance for node involvement are: pre-surgical PSA greater than 20 ng/mL (RR = 4.6), and Gleason higher than 4 (RR = 3). The remaining variables showed no statistical significance., Conclusions: Gleason and PSA are the only clinical values that predict node involvement. The procedure performed obtains good results and a survival comparable to that of the control group.
- Published
- 2000
- Full Text
- View/download PDF
26. [Radical prostatectomy in stage pT3C stage prostatic adenocarcinoma].
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Zudaire Bergera JJ, López Ferrándiz J, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez Caballero F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma pathology, Aged, Humans, Male, Middle Aged, Neoplasm Staging, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology, Survival Rate, Adenocarcinoma surgery, Prostatectomy, Prostatic Neoplasms surgery
- Abstract
Objectives: To assess the efficacy of surgery in pT3c patients; to discern whether this is an independent influential factor for survival and clinical factor for diagnostic prediction., Material and Methods: Forty-five pT3c (TNM 1982) patients from a cohort of 220 subjects with T1-T2 prostate cancer who underwent radical prostatectomy. Mean and median follow-up: 42 and 36 months, respectively., Results: pT3 stage accounts for 20% (45/220) patients. They display a significantly higher mean PSA (25 +/- 2 ng/ml) (0.001), worse Gleason (0.0002) and clinical stage (0.0003), greater margins involvement (0.0007), and biochemical (0.02), local (0.05) and metastatic (0.001) progression. Independent influential factors are: PSA > 20 ng/ml; T2bc and Gleason 7-10. From these values patients can be divided into 3 risk groups: a) Group I (0-1 unfavourable variables): risk of seminal vesicle involvement 7%; Group II (2 unfavourable variables): risk 47%; Group III (3 unfavourable variables): risk 61%. Progression-free survival: significantly lower than patients with pT2 (58 +/- 8% vs 66 +/- 6% at 5 years) (0.002), but similar to those with pT3ab (0.91). Seminal vesicle involvement is not an independent influential factor (Cox's multivariate study). Influential factors are PSA, Gleason and clinical stage., Conclusions: pT3c tumours are not an independently influential group in progression-free survival. Progression-free survival is lower than pT2 but similar to pT3ab. Their poor prognosis is dependent on association to negatively influential clinico-pathological factors.
- Published
- 2000
- Full Text
- View/download PDF
27. [Prostatic carcinoma. Radical prostatectomy. Impact of neoadjuvant hormonal treatment].
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Zudaire Bergera JJ, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez Caballero F, López Ferrandis J, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma pathology, Combined Modality Therapy, Humans, Male, Middle Aged, Neoplasm Staging, Prostatectomy, Prostatic Neoplasms pathology, Adenocarcinoma therapy, Antineoplastic Agents, Hormonal therapeutic use, Prostatic Neoplasms therapy
- Abstract
Objective: To assess the influence of neo-adjuvant hormone therapy on the pathologic stage, margins and disease-free survival in patients with T1-T2 prostate cancer after radical prostatectomy., Material and Methods: Forty-two non-randomised, T1-T2 patients who underwent complete neo-adjuvant blockade and radical prostatectomy between 1988-1998 were included in the study. This group is part of a larger cohort of 220 T1-T2 patients treated with radical surgery. The group is compared to: a) the remaining patients (178) (Group I) and b) a selected group (54 patients) of consistent characteristics relative to clinical variables (Group II). Mean follow-up: 35 months; median: 32 months., Results: Compared to Group I patients with neo-adjuvant therapy show worse Gleason (p: 0.01), worse clinical stage (p: 0.02), higher rate of patients with high clinical risk (p: 0.03), and higher PSA (though not statistically different). No differences were seen relative to pathological status or margins. Compared to Group II (54 patients) no differences are found in clinical or pathological variables. Groups are comparable in terms of progression-free survival., Conclusions: Neo-adjuvant hormone therapy in high clinical risk, T1-T2 patients does not involve improvement in pathological stage, margins or progression-free survival.
- Published
- 2000
- Full Text
- View/download PDF
28. [Pyeloureteral junction stenosis: our experience and review of the literature].
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Sánchez Zalabardo D, López Ferrandis J, Arocena García-Tapia J, Sanz Pérez G, Diez-Caballero Alonso F, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Constriction, Pathologic, Female, Humans, Infant, Male, Middle Aged, Kidney Pelvis surgery, Ureteral Obstruction surgery
- Abstract
Objectives: To study patients with ureteropelvic junction obstruction treated in our department and a retrospective study of this pathology, focus our attention in the diagnosis and treatment., Material and Methods: 62 patients from 7 weeks to 68 years old (mean 29 +/- 1.9). Half of the patients were men and the other half women. In 30 patients the UPJ obstruction was on the right side and 32 patients was on the left side., Results: The most frequent symptom was the flank pain (46.8%). To confirm the diagnosis, we had IVU in the 61.3% of the patients and ultrasound in the 38.7%. The treatment was the Anderson-Hynes pyeloplasty in the 96.8% of the patients. In 33 patients we used a ureteral catheter. The overall success rate was 90.3%. The 29% of the patients presented postoperative complications., Conclusions: Open pyeloplasty is the gold standard treatment of the UPJ obstruction in selected cases, mainly in children.
- Published
- 2000
- Full Text
- View/download PDF
29. [p53 and Ki67 expression in specimens of radical prostatectomy. Relationship with clinico-pathologic data and survival].
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Zudaire Bergera JJ, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez Caballero F, López Ferrandis J, Rosell Costa D, Robles García JE, de Alava E, and Berián Polo JM
- Subjects
- Humans, Male, Middle Aged, Prognosis, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology, Survival Rate, Ki-67 Antigen biosynthesis, Prostatectomy, Prostatic Neoplasms metabolism, Prostatic Neoplasms surgery, Tumor Suppressor Protein p53 biosynthesis
- Abstract
Objectives: Analysis in T1-T2 prostate cancer of the following: a) Whether there is a relationship between Ki67 and p53 over-expression, and clinico-pathological variables. b) Whether that expression influences on progression free survival., Material and Methods: The study included 68 patients diagnosed with T1-T2 prostate cancer undergoing radical prostatectomy and immunohistochemical testing of Ki67 and p53 in the prostatectomy specimen, indicating in each case the percentage of stained cells. The study was carried out by: a) Comparison of means between percentage groups of stained cells. b) Grouping patients according to expression percentage. In Ki67, a comparison is made between those expressing 0-5% vs > 5%. In p53, those expressing (0%) vs > 1%. Mean follow-up: 20 months; median: 16 months., Results: Mean expression of Ki67 is 7.2% (57% cases > 5%). 60% do not over-express p53; mean 3.65; only 15% is higher than 5%. There is a correlation between Ki67 and p53 (p: 0.002), but not to PSA. Ki67 expression is related with a poorer pathological stage (p: 0.07) and greater biochemical progression (p: 0.07), and it has a significant influence on progression free survival in both the univariate (at three years 76% vs 48%; p: 0.04) and the multivariate studies (RR: 5.7; p: 0.005). Over-expression of p53 is not related to any clinico-pathological variable, and does not influence progression free survival.
- Published
- 2000
- Full Text
- View/download PDF
30. [Radical prostatectomy in clinically localized prostatic adenocarcinoma. Study of patients with positive margins and their impact on survival free from biochemical progression].
- Author
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Zudaire Bergera JJ, Martín-Marquina Aspiunza A, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Diez Caballero F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma blood, Adenocarcinoma mortality, Disease Progression, Disease-Free Survival, Humans, Male, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms mortality, Adenocarcinoma pathology, Adenocarcinoma surgery, Prostatectomy, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery
- Abstract
Objectives: Margins involvement in T1-T2 patients undergoing radical prostatectomy is a negative prognostic factor. We aimed to: a) Study the clinical and pathological features of patients with surgical margins involvement; b) Elucidate the influence of margins involvement on the progression-free survival., Material and Method: The study included the group with "positive margins" out of a series of 160 patients with localised prostate adenocarcinoma who underwent radical prostatectomy at the Clínica Universitaria de Navarra between 1988-1997. statistics used: Fisher's or Pearson's test for qualitative variables. Kaplan-Meyer, Log-rank and Cox's multivariate tests for the survival study., Results: The group accounts for 28% (45/158) of all patients undergoing radical prostatectomy. Mean PSA (22 +/- 14 ng/ml) is similar to the remaining group although there is greater significant rates of PSA > 15 ng/ml (p: 0.006), worse Gleason (p: 0.01), higher proportion of T2bc (p: 0.003) and node involvement (0.001). Progression-free survival (BPFS) is significantly lower in this group (32 +/- 12% vs 61 +/- 6% at 5 years). Margins are the single factor with higher influence (RR:5) in the multivariate study. Influence is clear in patients with Gleason < 5 (0% vs 87%) and PSA < 30 ng/ml (33 +/- 14 vs 70 +/- 7%), but has no influence on BPFS of patients with PSA > 30 ng/ml or Gleason 5-10., Conclusions: Positive margins in patients undergoing radical prostatectomy is associated to higher PSA, worse Gleason and higher stage. They are the most significant independent risk factor (except for PSA > 30 ng/ml) for biochemical progression-free survival as evidenced in the multivariate study, although it is likely this influence is diluted in patients with PSA > 30 ng/ml and/or Gleason 5-10.
- Published
- 1999
- Full Text
- View/download PDF
31. [Upper tract urothelial tumor. Factors that influence survival].
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Arocena García-Tapia J, Zudaire Bergera JJ, Sanz Pérez G, Sánchez Zalabardo D, Diez-Caballero Alonso F, Martín-Marquina Aspiunza A, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Aged, Female, Humans, Kidney Neoplasms surgery, Kidney Pelvis surgery, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Survival Analysis, Ureteral Neoplasms mortality, Ureteral Neoplasms pathology, Ureteral Neoplasms surgery, Urinary Bladder Neoplasms secondary, Urinary Bladder Neoplasms surgery, Urothelium, Kidney Neoplasms mortality, Kidney Neoplasms pathology
- Abstract
Material and Methods: Study of the pathoanatomical features and influential factors on survival of 59 patients diagnosed with a tumour of the upper tract urothelium managed with radical surgery., Results: Mean age 65 years, 83% male, and tumour located in the renal pelvis in 64% cases. 54% was pT1-2, 73% G1-2. 10% had node involvement and 15% metastasis. 44% presented concomitant vesical tumour. No surgery-related deaths were reported. 60% was still alive at study completion. Five-year overall actuarial survival was 60 +/- 7%. Mean survival was 134 months, and median survival 156(101-168 months. 95% CI). Gender, site, morphology, type, concomitant vesical tumour, nodes number and involvement do not significantly influence survival. Only tumour differentiation (p = 0.006) and pathological stage (p = 0.005) are significant in the univariate analysis. The multivariate study showed that pathological stage is the only factor that influences survival., Conclusions: The most influential independent factor on survival of patients with upper tract endothelium tumour is the pathological stage. Grade is influential in the univariate analysis, and is likely to be a subsidiary factor. Due to the small number of cases, it can not be ruled out that node involvement and type of tumour have an influence on survival.
- Published
- 1999
- Full Text
- View/download PDF
32. [Radical prostatectomy in prostate adenocarcinoma. Clinical factors influencing the pathological stage. Diagnostic model].
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Zudaire Bergera JJ, Martín-Marquina Aspiunza A, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez-Caballero Alonso F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Humans, Logistic Models, Male, Neoplasm Staging, Prostatectomy, Risk, Adenocarcinoma pathology, Adenocarcinoma surgery, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery
- Abstract
Material and Methods: Study on the efficacy of stage diagnosis, how to support it based on clinical objective data and description of a prognostic model. Analysis of 160 patients diagnosed with localized prostate adenocarcinoma undergoing radical prostatectomy in the Clínica Universitaria de Navarra between 1988-1997. The statistical study used Fisher's or Pearson's tests for the comparison of qualitative variables. A logistic regression multivariate analysis was run to avoid confounding factors in the pathological stage., Results: 85/160 (53%) were correctly staged. Incorrect staging occurred in patients with higher clinical stage (T1-T2a: 25%; T2bc: 65%). The univariate study shows that the pathological stage is significantly correlated to: a) serum PSA levels (15 ng/mL in P2 vr. 25 ng/mL in P3-4), the most suitable cutoff value being 15 ng/mL. b) digital rectal examination and Gleason. Negatively influencing factors in the multivariate study were: PSA greater than 15 ng/mL, Gleason greater than 5 and a T2bc clinical stage. Risk groups: 4 risk groups are established based on the above factors (inclusion in group 1 involves an 8% risk of having P3, 30% in group 2, 56% in group 3 and 84% in group 4)., Conclusions: The clinical factors with influence in the pathological stage are PSA, Gleason and clinical stage. The reliability of the risk groups established based on these factors is remarkable.
- Published
- 1999
- Full Text
- View/download PDF
33. [Radical prostatectomy in clinically localized prostatic adenocarcinoma. Factors influencing biochemical progression free survival].
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Zudaire Bergera JJ, Martín-Marquina Aspiunza A, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez Caballero F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma blood, Adenocarcinoma mortality, Disease-Free Survival, Humans, Male, Multivariate Analysis, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms mortality, Survival Rate, Adenocarcinoma surgery, Prostatectomy, Prostatic Neoplasms surgery
- Abstract
Material and Method: Study of biochemical progression (PSA > 0.5 ng/ml) and biochemical progression-free survival in 160 patients diagnosed with clinically localized prostate adenocarcinoma who underwent radical prostatectomy at the University Clinic in Navarra between 1988-1997., Results: At the end of the study, 120 patients (75%) are alive and free of progression, 33 (20%) are alive and in progression, 3 (1.9%) died of cancer, and 4 (2.5%) died for other causes. Biochemical progression occurred in 43/160 (27%) patients. Progression is related to previous PSA, both in absolute terms and divided into greater or smaller than 15 ng/ml; to Gleason grade greater or smaller than 7 or divided into 2-4, 5-7, 8-10; to pathological stage and to urethro-vesical junction stenosis. Biochemical progression-free survival (BPFS) in the univariate study is related to PSA (the ideal prognostic cut-off value being 15 ng/ml); to Gleason, specially when divided into 2-4, 5-7, 8-10; to the pathological stage and to margins. The multivariate study evidences that the single most influential factors are PSA (divided as greater or smaller than 15 ng/ml), Gleason grade (divided into: 2-4, 5-7, 8-10) and margins involvement. There are 3 highly reliable risk groups based on PSA, Gleason and clinical stage. When these are introduced as variables in the multivariate study, they appear as the strongest predictive variables., Conclusions: The influential factors on progression-free survival are PSA (15 ng/ml being the best prognostic cut-off value), Gleason grade (divided into 2-4, 5-7, 8-10) and margins' positivity, which are the single most significant pathological factor ahead of clinical stage. Serum PSA, clinical stage and Gleason grade allow to define three reliable risk groups.
- Published
- 1999
34. [Radical prostatectomy. The surgical complications].
- Author
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Martín-Marquina Aspiunza A, Zudaire Bergera JJ, Sánchez Zalabardo D, Arocena García-Tapia J, Sanz Pérez G, Díez-Caballero Alonso F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Humans, Lymph Node Excision, Male, Middle Aged, Neoplasm Staging, Prostatectomy methods, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Time Factors, Postoperative Complications epidemiology, Prostatectomy adverse effects
- Abstract
Study of 165 patients with prostate adenocarcinoma who underwent radical prostatectomy using a retropubic approach. Mean PSA is 19 ng/ml, mean age 63 years and median follow-up 26 months. 22 patients (13.2%) reported complications during the first month post-surgery, primarily urinary fistula of more than 5 days long in 5 patients and rectal injury in 3.49 patients (29%) reported complications after the first month, mainly urinary incontinence in 26 cases and stenosis of the urethrovesical juncture in 15. The group with early complications showed no significant differences compared to those who had none, neither in PSA (p = 0.3) or a worse pathological stage (p = 0.1), and no evidence is shown in terms of biochemical progression or in disease free progression (p = 1). Patients with urethrovesical juncture stenosis have higher mean PSA (p = 0.01), greater biochemical progression (p = 0.006), worse Gleason (p = 0.03 = and worse progression free survival (p = 0.01). Patients with stress incontinence showed no differences compared to the other groups relative to the studied factors.
- Published
- 1999
35. [Paratesticular rhabdomyosarcoma].
- Author
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Martín-Marquina Aspiunza A, Arocena García-Tapia J, Sanz Pérez G, Díez-Caballero Alonso F, Díaz Fernández L, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Child, Preschool, Humans, Male, Rhabdomyosarcoma pathology, Testicular Neoplasms pathology
- Abstract
Contribution of one case of right paratesticular rhabdomyosarcoma in a 3-year and 4-month old male patient. Following radical orchiectomy and clinical staging, grading is IRS Group I (fully resected localized disease). Subsequently, the patient received 7 polychemotherapy courses and was found to be asymptomatic 4 years after treatment.
- Published
- 1998
36. [Influence of neoadjuvant treatment on bladder infiltrating tumors treated with radical cystectomy].
- Author
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Martín-Marquina Aspiunza A, Zudaire Bergera JJ, Arocena García-Tapia J, Sanz Pérez G, Díaz-Caballero Alonso F, Rodríguez-Rubio Cortadellas F, Rosell Costa D, Robles García JE, and Berián Polo JM
- Subjects
- Actuarial Analysis, Combined Modality Therapy, Humans, Retrospective Studies, Survival Rate, Urinary Bladder Neoplasms mortality, Cystectomy, Urinary Bladder Neoplasms therapy
- Abstract
Retrospective study of 107 patients diagnosed with infiltrant tumour of the bladder in stage T3-T4 N0-N1, treated with radical surgery. Eighty-four (84) received neoadjuvant therapy with radio- and/or chemotherapy. The neoadjuvant treatment was seen to provide significantly better survival, but the specific type of neoadjuvant treatment appears to have no influence. The multivariate study evidenced that the two most influential variables for survival are the complementary treatment and the clinical stage.
- Published
- 1998
37. [Gene sequence analysis of suppressor oncogene p53 in bladder carcinoma].
- Author
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Rosell Costa D, García-Foncillas Lopez J, Díez-Caballero Vivas-Pérez JI, Garcia-Tapia JA, Sanz Pérez G, Abad Alonso FD, Martín-Marquina Aspiunza A, Rodríguez-Rubio Cortadellas FI, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Carcinoma, Transitional Cell genetics, Carcinoma, Transitional Cell pathology, Humans, Prospective Studies, Sequence Analysis, DNA, Urinary Bladder Neoplasms pathology, Genes, p53 genetics, Urinary Bladder Neoplasms genetics
- Abstract
A prospective study which analyzes the presence of mutations in the suppressor oncogene p53 through automated genome sequentiation in 75 specimens of transitional cell carcinoma. The presence of mutations correlated to the pathological stage and cellular grade. Also, both the different types of mutations detected and the diversity of their location indicate the heterogeneity of bladder transitional cells carcinoma. The automated genome sequentiation method allows to detect both the type of mutation and the exact location. The detection of suppressor oncogene p53 mutations allows to identify those patients who may be at higher risk of disease progression and therefore those who should undergo a more intense follow-up.
- Published
- 1998
38. [Retroperitoneal sarcomas].
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Martín-Marquina Aspiunza A, Sanz Pérez G, Díez-Caballero Alonso F, Rodríguez-Rubio Cortadellas FI, López-Picazo Jiménez J, Rosell Costa D, Robles García JE, Zudaire Berjera JJ, and Berián Polo JM
- Subjects
- Female, Follow-Up Studies, Humans, Male, Retroperitoneal Neoplasms diagnosis, Retroperitoneal Neoplasms surgery, Sarcoma diagnosis, Sarcoma surgery
- Abstract
Presentation of 11 cases of retroperitoneal sarcoma. Mean time from the beginning of symptoms to diagnosis is 6 months. The primary complementary study is CT. Surgery was performed in all cases, using complete resection in 6 cases, and partial resection in 5. Ten patients relapsed. 9 of which were treated with surgical rescue, in one or more occasions; chemotherapy was added in 6 cases and radiotherapy in 7. Survival at five years is 68%, with a mean follow-up of 66 months.
- Published
- 1997
39. [Pheochromocytoma].
- Author
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Martín-Marquina Aspiunza A, Sanz Pérez G, Díez-Caballero Alonso F, Robles García JE, Zudaire Berjera JJ, Rodríguez-Rubio Cortadellas FI, Abad Vivas-Pérez JI, Rosell Costa D, and Berián Polo JM
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Adrenal Gland Neoplasms diagnosis, Pheochromocytoma diagnosis
- Abstract
Presentation of 7 case reports of pheochromocytome, diagnosed and treated in our Centre between 1981 and 1995. Clinically all patients had hypertension. Three presented the triple condition of hypertension, pulsatile headache and palpitations. The most useful analytical studies were urine vainillylmandelic acid (VMA) and catecholamines. The main radiologic method was the scanner (CT). Pre-surgical preparation was with alpha-blockers in 5 patients, adding beta-blockers in 3. Treatment was surgical in all cases, and the approach was selected based on the tumour's size and location. One patient with severe rheumatic heart disease died on day 3 post-surgery. Mean follow-up is 19 months, and only one patient requires anti-hypertensive medication following surgery.
- Published
- 1997
40. [The complications of retropubic radical prostatectomy].
- Author
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Abad Vivas-Pérez JI, Rodríguez-Rubio Cortadellas FI, Martín-Marquina Aspiunza A, Díez-Caballero Alonso F, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Aged, Follow-Up Studies, Humans, Incidence, Lymph Node Excision methods, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Prostatectomy methods, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Time Factors, Lymph Node Excision adverse effects, Postoperative Complications epidemiology, Prostatectomy adverse effects
- Abstract
Between January 1989 and October 1995, 104 prostatectomies were performed in patients with prostate carcinoma in our centre. Mean follow-up 22 months, range 3-84 months. Overall frequency of complications was 33%. No fatal complications were reported. Complications in the early post-operative occurred in 17 patients (16%); late complications in 18 patients (17%), the most frequent one was stenosis of urethrovesical by-pass. No case of total incontinence has been recorded. The rate of stress incontinence at 3 months was 36% and 15% at 9 months.
- Published
- 1997
41. [Bladder metastasis of lung adenocarcinoma].
- Author
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Martín-Marquina Aspiunza A, Díez-Caballero Alonso F, Rodríguez-Rubio Cortadellas FI, Díez Fernández L, Abad Vivas-Pérez JI, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Aged, Carcinoma, Signet Ring Cell diagnosis, Carcinoma, Signet Ring Cell pathology, Carcinoma, Signet Ring Cell surgery, Fatal Outcome, Humans, Lung Neoplasms surgery, Male, Pneumonectomy, Time Factors, Urinary Bladder pathology, Urinary Bladder Neoplasms diagnosis, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms surgery, Carcinoma, Signet Ring Cell secondary, Lung Neoplasms pathology, Urinary Bladder Neoplasms secondary
- Abstract
Secondary or metastatic vesical tumours are a very uncommon condition (less than 1% of vesical tumours). Dissemination routes are usually through blood and lymph, and diagnosis occurs typically in advanced stages. This paper presents one case of metastatic vesical neoplasia that developed 5 years after diagnosis of the primary lung tumour.
- Published
- 1997
42. [Infiltrating bladder carcinoma: influence of complementary treatment on local control and survival].
- Author
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Berián Polo JM, Zudaire Bergera JJ, Robles García JE, and de Castro Barbosa F
- Subjects
- Carcinoma, Transitional Cell pathology, Combined Modality Therapy, Female, Humans, Male, Multivariate Analysis, Neoplasm Staging, Survival Rate, Urinary Bladder Neoplasms pathology, Carcinoma, Transitional Cell mortality, Carcinoma, Transitional Cell therapy, Urinary Bladder Neoplasms mortality, Urinary Bladder Neoplasms therapy
- Abstract
We analyzed 82 patients with transitional bladder cancer stages (T2-T4) M0. According to treatment, 3 different groups were considered: Group 1: 25 patients treated with TUR and radical cystectomy. Group 2: 33 patients also received external beam radiotherapy (45-60 Gy/5 weeks) prior cystectomy. Group 3: 24 patients were also treated with intraoperative radiotherapy (15 Gy) and 3 courses of neoadjuvant chemotherapy. Our results suggest that local control rate increases significantly with the intensity of treatment (Group 3: 62% patients were PT0). Similar results were achieved in multivariate analysis. Univariate analysis of survival shows ganglionar status, vascular embolism and treatment intensity as covariates associated. Multivariate analysis demonstrate that renal function and type of complementary treatment were the covariates associated with survival. Taking both groups 2 and 3, survival was related to pathologic stage, vascular embolism and renal function. In conclusion, the significant influence of complementary treatment on the local control and survival suggest strongly their systematic utilization in infiltrating bladder cancer.
- Published
- 1994
43. [Clinico-pathologic correlation in patients undergoing surgical staging and radical prostatectomy for prostatic cancer].
- Author
-
Isa Kroon WA, De Castro Barbosa F, Abad Vivas-Perez JI, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Aged, Humans, Lymph Node Excision, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prostate-Specific Antigen blood, Prostatectomy, Prostatic Neoplasms blood, Prostatic Neoplasms surgery, Prostatic Neoplasms pathology
- Abstract
Presentation of our experience on the clinico-pathological staging of clinically localized prostate cancer (PCa) in 38 patients undergoing staging lymphadenectomy, 34 of which were treated with radical prostatectomy. From total number of patients, 37% were correctly staged, 60% were under-staged and only 3% were over-staged. A total of 11 patients (29%) presented nodular metastasis at the time of lymphadenectomy. Out of the 34 patients undergoing radical prostatectomy, 10 (29%) had microscopical invasion of prostatic capsule and seminal vesicles infiltration. The likelihood of nodes affectation in patients with prostatic capsule invasion and seminal vesicles infiltration was 60% and 70%, respectively. Mean PSA was significantly higher in patients with advanced disease as compared to those with disease localized in the prostatic gland. Also, mean PSA was significantly higher in patients with prostatic capsule invasion and seminal vesicles infiltration. The analysis by logistic regression identified pre-operative PSA as the only variable significantly correlated to the patient's final pathological stage.
- Published
- 1993
44. [Tumor thrombosis in inferior vena cava: diagnostic imaging and therapeutic approximation].
- Author
-
De Castro Barbosa F, Robles García JE, Rosell Costa D, Agüera Fernández L, Isa Kroon W, Sánchez de la Muela P, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Humans, Magnetic Resonance Imaging, Neoplasms diagnostic imaging, Neoplasms therapy, Retrospective Studies, Tomography, X-Ray Computed, Ultrasonography, Neoplastic Cells, Circulating, Vena Cava, Inferior diagnostic imaging
- Abstract
Review of our experience in the diagnosis and treatment of 44 patients with inferior vena cava tumoral thrombosis (IVCTT), associated or not to other neoplastic processes: 34 hypernephroma, 2 cava leiomyosarcoma, 1 paratesticular rhabdomyosarcoma and 1 biphasic synovial sarcoma. Twenty-five patients with hypernephroma and tumor thrombi in the ipsilateral renal vein only were excluded from the analysis since this fact did not change the usual therapeutic approach. In the 19 remaining patients, concomitantly to the primary tumour exeresis a thrombectomy was performed, using cavotomy with proximal and distal clamping in 11 patients and cardiopulmonary by-pass, deep hypothermia and cardiocirculatory arrest in 8 patients. The paper analyzes the radiological investigations performed in order to reach a IVCTT diagnosis, and reviews the related literature.
- Published
- 1992
45. [Kidney pelvis tumor in ectopic kidney. Report of a case].
- Author
-
Isa Kroon WA, de Castro Barbosa F, Sánchez de la Muela PL, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Humans, Kidney diagnostic imaging, Kidney Neoplasms diagnostic imaging, Male, Middle Aged, Tomography, X-Ray Computed, Kidney abnormalities, Kidney Neoplasms complications, Kidney Pelvis
- Abstract
A case of urothelial carcinoma in pelvic ectopic kidney is described. The low incidence of both pathologies and their rare association justifies the description.
- Published
- 1992
46. [Infiltrating bladder carcinoma with metastatic lymph node involvement: radical treatment and survival].
- Author
-
de Castro Barbosa F, Sánchez de la Muela P, Rosell Costa D, Aguera Fernández L, Isa Kroon W, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Actuarial Analysis, Carcinoma, Transitional Cell mortality, Carcinoma, Transitional Cell pathology, Carcinoma, Transitional Cell therapy, Combined Modality Therapy, Follow-Up Studies, Humans, Lymphatic Metastasis, Survival Rate, Urinary Bladder Neoplasms mortality, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms therapy, Carcinoma, Transitional Cell surgery, Urinary Bladder Neoplasms surgery
- Abstract
Presentation of the results obtained from the study of 64 patients with T2-4 stage vesical carcinoma, treated with radical cystectomy, local lymphadenectomy, with and without complementary radiotherapy, with and without neoadjuvant chemotherapy. The univariate study of 19/64 patients with microscopic nodular disease revealed a significant relationship with the pathological stage but not with the clinical stage. The multivariate study demonstrated that the most relevant prognostic factors are a decrease in tumoral stage (P) and the presence of vascular and/or lymphatic involvement in the TUR-biopsy. The analysis of survival confirms the poor prognosis of patients with metastatic nodular involvement, in spite of the association of pelvic radiotherapy or neoadjuvant chemotherapy to the treatment.
- Published
- 1992
47. [Hyperammonemia and transient blindness after transurethral resection of the prostate. Review of a case].
- Author
-
Isa Kroon WA, Aguera Fernández LG, Rosell Costa D, de Castro Barbosa F, Sánchez de la Muela PL, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Aged, Glycine blood, Humans, Male, Prostatectomy methods, Ammonia blood, Blindness etiology, Prostatectomy adverse effects
- Abstract
We report a case of hyperammonemia and transient blindness following transurethral prostatic resectin. Glicine and ammonia metabolism are reviewed. Water intoxication may not account for these symptoms.
- Published
- 1991
48. [Uretero-iliac fistula: presentation of a case and review of the literature].
- Author
-
Isa Kroon WA, Agüera Fernández LG, Rosell Costa D, de Castro Barbosa F, Sánchez de la Muela P, Robles García JE, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Aged, Humans, Male, Fistula etiology, Iliac Artery, Ureteral Diseases etiology, Urinary Fistula etiology, Vascular Diseases etiology
- Abstract
We report a case of right common iliac artery fistula to the left ureter in a patient affected by an invasive bladder tumour treated with radical surgery, radiotherapy and neo-adjuvant chemotherapy. At the time of manifestation, our patient had indwelling catheters and presented an urinary tract infection. Diagnosis was established during autopsy. We feel that the cause of this complication is multifactorial.
- Published
- 1991
49. [Neoadjuvant immunotherapy in non-metastatic renal adenocarcinoma].
- Author
-
Sánchez de la Muela P, Zudaire Bergera JJ, Robles García JE, Isa Kroon W, de Castro Barbosa F, Aguera Fernández L, Rosell Costa D, and Berián Polo JM
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma pathology, Adult, Aged, Combined Modality Therapy, Female, Humans, Kidney Neoplasms mortality, Kidney Neoplasms pathology, Male, Middle Aged, Neoplasm Staging, Survival Rate, Adenocarcinoma therapy, Immunotherapy, Kidney Neoplasms therapy
- Abstract
Prognostic factors were studied in 91 patients with diagnosed renal adenocarcinoma in stages pT1-4/N0-3/V0-2/M0. All patients had been treated with radical surgery, extended nephrectomy with or without cardiopulmonary by-pass and extracorporeal circulation in those cases with suprahepatic tumoral thrombosis. The tumoral features which have a significant incidence on the patient's survival rate are the degree of cellular anaplasia, GI 72% vs GII 42% vs GIII 22% (p less than 0.0001); pathological stage, pT1-2 86% vs pT3 30% (p = 0.0000), perirenal fat invasion, pT1-2 86% vs pT3a 61% (p = 0.01); renal vein or cava vein invasion, V0 72% vs V1-2 30% (p less than 0.01) and gangliar affection. N0 69% vs N1-3 11% (p = 0.0000). Development of systemic disease is significantly high in pT3 stages (p = 0.0001), mainly in pT3a (p = 0.01), N1-3 (p less than 0.05) and/or V1-2 (p = 0.01). There is premature development of metastasis conditioning death before the second year o study in 90% of patients. In our opinion, patients with renal adenocarcinoma in stages pT3a/N0/M0, pT3b/N0/M0 and pT2-4/N1-3/M0 present a high potential risk of developing metastatic disease following radical surgery. These patients, as well as those with high degree tumours and presumably minimum residual disease, are candidates for supplementary therapy with lymphokine immunotherapy (rIL-2,FNT, alpha or gamma IF, etc) with or without adoptive cellular immunotherapy (LAK or TIL) following radical surgery, and extended nephrectomy plus tumoral thrombectomy, if required, with or without cardiopulmonary bypass.
- Published
- 1990
50. [Extracorporeal shockwave lithotripsy (ESWL) for the treatment of bladder lithiasis. A new therapeutic option].
- Author
-
Robles García JE, Rosell Costa D, Longo Areso J, Aguera Fernández LG, Isa Kroon W, Sánchez de la Muela P, Zudaire Bergera JJ, and Berián Polo JM
- Subjects
- Humans, Male, Middle Aged, Ultrasonography, Urinary Bladder Calculi diagnostic imaging, Lithotripsy, Urinary Bladder Calculi therapy
- Abstract
A case is presented on the use of extracorporeal lithotrity by shock waves to treat vesical lithiasis, using the desk module of a Lithostar-PlusR (Siemens) lithotripter. This is an effective method without morbidity an adequate for ambulatory use, specially valuable in patients where the use of more invasive methods, or surgery can be contraindicated or when the patient refuses such methods.
- Published
- 1990
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