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Purpose: Tumor volume has been thought to be an important predictive factor for significant prostate cancer. We assessed the impact of the tumor volume (TV) and the tumor percentage (TP) of radical prostatectomy specimens on the pathological variables and the oncological outcome. Materials and Methods: The tumor percentage and tumor volume were calculated for 525 cases by a single pathologist who determined the volume based on the surface area of the slides involved by tumor of the prostate. Univariate and multivariate logistic regression analyses were used to characterize the association of TP categories (＜5%, 5-10%, 11-20% and ＞20%) and TV (＜1.8cc, 1.8-3.7cc, 3.8-7.5cc, ＞7.5cc) with the clinicopathological variables. Biochemical recurrence (BCR) was estimated using Kaplan-Meier analysis and Cox’s hazard regression model. Results: The mean prostate cancer volume was 6.5±8.5cc (median: 3.8, range: 0.04-73.8) and the mean percent tumor composition was 0.17±0.19

Purpose: To investigate clinicopathologic characteristics of unilateral, low risk prostate cancers detected via multi (≥12)-core prostate biopsy. Materials and Methods: One hundred four patients who underwent radical retropubic prostatectomy (RRP) for unilateral, low risk prostate cancer (clinical stage ≤T2a, biopsy Gleason sum ≤6, PSA ≤10ng/ml, and ipsilateral positive cores ≤2) detected via multi (≥12)-core prostate biopsy were enrolled. In this retrospective study, we reviewed the patients’ preoperative and pathologic data to assess potential predictors of pT2c or greater disease at the time of RRP, as well as characteristics of such disease. Results: Of the 104 subjects, only 34 (32.7%) were pathologically-proven to have unilateral disease, while the others showed pathologically-bilateral or worse disease from analysis of the RRP specimens. Subjects pathologically found to have uniand bi-lateral disease showed no significant differences regarding age, prostate-specific antigen (PSA), free-to-total PSA ratio, prostate volume, clinical stage, number of positive cores, biopsy Gleason score, number of total biopsy sites, and highest percentage of tumor at any biopsy site. Multivariate logistic regression analysis revealed no significant preoperative predictors of pT2c or greater disease at RRP. Conclusions: Most patients with unilateral, low risk prostate cancer detected on multi (≥12)-core prostate biopsy actually had pathologicallyworse disease. For clinically-localized prostate cancer, a more accurate method to identify appropriate candidates for unilateral or focal ablative therapy should be developed. (Korean J Urol 2008;49:874-878) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: The National Cancer Institute (NCI)'s Hollow Fiber Assay (HFA) is currently used as an in vivo screening model to quantitatively define anticancer activity. To investigate the use of HFA in a bladder cancer model, we conducted in vitro and in vivo experiments with several anticancer drugs in nude mice. Materials and Methods: The human bladder cancer cell lines (CRL2742, 253JP, SW1710, HTB9) were cultured both in vitro and in vivo in polyvinylidene fluoride (PVDF) hollow fibers. The fibers were implanted intraperitoneally (ip) and subcutaneously (sc) into female athymic nude mice (C57BL/6), and the mice were then treated with gemcitabine 120 mg/kg (bolus), cisplatin (3mg/kg), paclitaxel (15mg/kg) or vehicle only (control) for 4-consecutive days. After 6 days, the fibers were retrieved and the viable cell density was analyzed by MTT assay. Results: The difference between in vitro and in vivo growth was not significant for the CRL2742, 253J-P and SW1710 cell lines; the difference between the ip and sc fibers was also not significant in the CRL2742, SW1710 and HTB9 cell lines. After drug treatment, the percent of growth inhibition revealed constant and effective anticancer activities for the 3 individual drugs. Conclusions: This study demonstrates the possibility of measuring and quantifying the anticancer effect with using in vivo hollow fiber assay in a bladder cancer model. (Korean J Urol 2008;49:392-397) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Data was collected from 525 patients who un-derwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extra-capsular extension (ECE) was tested by logistic regression models, whereas bioche-mical recurrence (BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen (PSA) of 0.2ng/ml or greater on consecutive evaluations.

Results: In total, 84 (67.7%) and 40 (32.3%) of patients had final GS of 3+4 and 4+3, respectively. A final GS of 4+3 was associated with a higher pre-biopsy level of prostate-specific antigen (p

Purpose: We retrospectively reviewed the clinicopathological characteristics ofpatients who underwent radical retropubic prostatectomy (RRP), and these patients had clinically localized prostate cancer and a preoperative serum prostate-specific antigen (PSA) level ≥20ng/ml. Materials and Methods: Among the 266 patients who underwent RRP without any prior neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a preoperative serum PSA level ≥20ng/ml. We analyzed several clinicopathologic factors that might predict organ-confined disease. Results: Of the 29 patients, 11 (37.9%) had organ-confined cancer. The level of serum PSA, the PSA density (PSAD), the Gleason score (3+4 or less), the prostate volume, tumor volume and the tumor percentage were significant factors for predicting organ-confined cancer (p

Purpose: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, overweight, abdominal fat distribution, dyslipidemia, and hypertension, has been reported to have some association with prostate cancer. Here, we assessed the relationship between metabolic syndrome and prostate cancer. Materials and Methods: We assessed a total of 261 men who underwent radical retropubic prostatectomy between January 2004 and May 2005. The patients were stratified into two groups, with metabolic syndrome (n=75) or without (n=186). Metabolic syndrome was defined by the criteria of National Cholesterol Education Program Adult Treatment Panel III. We compared the clinical and pathologic features of specimens between the groups. Results: There was no significant difference between the two groups in terms of mean age, serum prostate specific antigen level, prostate size, Gleason score, and pathologic stage. The tumor volume of prostate cancer was significantly higher in the metabolic syndrome group (6.6±5.5cc vs 5.0±4.5cc, p=0.010). No significant differences were observed in extracapsular extension, seminal vesicle invasion, bladder neck invasion, angiolymphatic invasion, perineural invasion, and multicentricity of cancer between the two groups. As the component of metabolic syndrome increased, the tumor volume was also found to increase (p-value=0.025). Conclusions: The data from our study support that metabolic syndrome is closely associated with the development and progression of prostate cancer. (Korean J Urol 2007;48:585-591) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: We retrospectively reviewed clinicopathological characteristics in patients who underwent radical retropubic prostatectomy (RRP) with clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. Materials and Methods: Among 266 patients who underwent RRP without prior any neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. We analyzed several clinicopathologic factors that predict organ-confined disease, and also investigated the impact on postoperative changes of the biopsy Gleason score. Results: Of 29 patients, 12 (41.4%) had organ-confined cancer. Serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), tumor volume, and tumor percentage were significant factors for predicting organ-confined cancer (p

Purpose: Since its introduction into clinical practice, a laparoscopic radical prostatectomy (LRP) has been performed at a growing number of centers. LRP can be performed by either a transperitoneal or extraperitoneal approach. The perioperative morbidities were evaluated in two groups of patients; retropubic radical prostatectomy (RRP) or extraperitoneal laparoscopic radical prostatectomy (ELRP). Materials and Methods: Between December 2003 and March 2006, 45 patients were treated with a RRP, and between September 2005 and May 2006, 30 patients underwent an ELRP. The same surgeon performed both types of operation. The perioperative data, including operative time, transfusion rates, hospitalization length and duration of catheterization were analyzed. The pathological parameters, including Gleason score, pathological stage and positive surgical margin rates were also analyzed. Results: There were no significant differences in the preoperative characteristics between the two groups, with the exception of the mean age. The average operative time was significantly shorter in the RRP group (p 0.05). After gaining experience of 15 cases, the ELRP group showed significantly shorter catheterization time (p< 0.005) and hospital stay (p=0.098). The pathological parameters of the two groups were comparable. RRP group were more likely to larger amount of postoperative analgesia (p=0.072). Conclusions: The ELRP procedure showed comparable perioperative results to those of a RRP, with the exception of operative time. After our initial experience, the ELRP showed favorable outcomes with regard to catheterization time and hospital stay. Considering our results, ELRP can be recommended as one of the primary options for managing localized prostate cancer. (Korean J Urol 2007;48:131-137)

Ji Hyeong Yu, Jeong Woo Lee, In Ho Chang, Jun Hyun Han, Byoung Kyu Han, Seong-Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, Gheeyoung Choe, Sang Eun Lee From the Department of Urology, Inje University Sanggye Paik Hospital, Seoul, Departments of Urology and Pathology, Seoul National University Bundang Hospital, Seongnam, Department of Urology, Seoul National University Hospital, KEPCO Medical Foundation Hanil General Hospital, Seoul, Korea

Purpose: Simple renal cysts are common in older patients and they are usually left untreated, yet only a few studies have been done on the natural history of simple renal cysts. We investigated the sequential changes in their size and number in 103 patients. Materials and Methods: From January 1993 to August 2003, we followed 103 patients who were suffering with simple renal cysts. Their mean age was 55.8±18.72 years old (M:F=58:51). Using Abdominal USG and CT, the annual changes in renal cysts were analyzed through the follow-up period, and the mean follow-up period was 52.3±17.58 months. The values of the parameters were compared with using a 2-tailed Student's t-test, multivariate logistic regression analysis and the chi-square test. Results: At the time of diagnosis, the mean number and size of simple renal cyst were 1.5±1.31 cysts per each kidney and 25.3±12.42mm, respectively. On the consecutive imaging study, the size of the renal cysts was increased 4.4±1.54mm per year. The average size increase was significantly greater in the individuals younger than 50 versus the patients 50 years or older (5.7±2.14mm/year vs 3.7±1.45mm/year, respectively). The multiple cysts showed a significantly larger size increase than did the single cysts (8.1±3.27mm/year vs 3.6±1.64mm/year, respectively). The size increase of the bilateral renal cysts was significantly larger than that of the unilateral renal cysts (5.6±1.48mm/year vs 4.1±1.02mm/year, respectively). No significant difference was observed for the average size increase with regard to gender or the initial cyst size. Only the number of cysts was a significant predictor of aggressiveness on the multivariate logistic regression analysis. Conclusions: The simple renal cysts progress in size and they appear to grow with aging. They seem to grow more rapidly in patients with a younger age, and for multiple and bilateral renal cysts. (Korean J Urol 2006;47:80-84) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ