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PURPOSE: We aim to examine the long-term outcomes of patients who underwent multiparametric prostate magnetic resonance imaging (mp-MRI) for suspected prostate cancer (PCa), specifically based on their initial Prostate Imaging Reporting and Data System (PI-RADS) categories and various clinical factors. Our secondary aim is to evaluate the prognostic value of the PI-RADS through the National Comprehensive Cancer Network (NCCN) risk group distribution. METHODS: This research was conducted as a single-center retrospective cohort study in a tertiary care hospital. A total of 1,359 cases having at least one histopathological examination after the initial mp-MRI and/or adequate clinical/radiological follow-up data were included in the clinically significant PCa (cs-PCa) diagnosis-free survival analysis. Initial mp-MRI dates were accepted as the start of follow-up for the time-to-event analysis. The event was defined as cs-PCa diagnosis (International Society of Urological Pathology =2). Patients who were not diagnosed with cs-PCa during follow-up were censored according to predefined literature-based criteria at the end of the maximum follow-up duration with no reasonable suspicion of PCa and no biopsy indication. The impact of various factors on survival was assessed using a log-rank test and multivariable Cox regression. Subsequently, 394 cases diagnosed with PCa during follow-up were evaluated, based on initial PI-RADS categories and NCCN risk groups. RESULTS: Three main risk factors for cs-PCa diagnosis during follow-up were an initial PI-RADS 5 category, initial PI-RADS 4 category, and high MRI-defined PSA density (mPSAD), with average hazard ratios of 29.52, 14.46, and 3.12, respectively. The PI-RADS 3 category, advanced age group, and biopsy-naïve status were identified as additional risk factors (hazard ratios: 2.03, 1.54-1.98, and 1.79, respectively). In the PI-RADS 1-2 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 99.1%, 96.5%, and 93.8%, respectively. For the PI-RADS 3 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 94.9%, 90.9%, and 89.1%, respectively. For the PI-RADS 4 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 56.6%, 55.1%, and 55.1%, respectively. These rates were found to all be 24.2% in the PI-RADS 5 cohort. Considering the 394 cases diagnosed with PCa during follow-up, PI-RADS =4 cases were more likely to harbor unfavorable PCa compared to PI-RADS =3 cases (P < 0.001). In the PI-RADS 3 subgroup analysis, a low mPSAD (<0.15 ng/mL2) was found to be a protective prognostic factor against unfavorable PCa (P = 0.005). CONCLUSION: The PI-RADS category has a significant impact on patient management and provides important diagnostic and prognostic information. Higher initial PI-RADS categories are associated with decreased follow-up losses, a shorter time to PCa diagnosis, increased biopsy rates, a higher likelihood of developing cs-PCa during follow-up, and a worse PCa prognosis. Combining mPSAD with PIRADS categories could enhance diagnostic stratification in the identification of cs-PCa. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of variant histology (VH) of urothelial carcinoma (UC) of the bladder on oncologic outcomes after radical cystectomy (RC). Materials and Methods: We identified 125 patients with cT2-T4N0M0 UC who underwent RC without perioperative systemic therapy between 2014 and 2019 at a single tertiary care referral center. The Mann-Whitney U test and chi-square test were used to compare the statistically significant differences in medians and proportions, respectively. The Kaplan-Meier method and Cox regression analyses tested the effect of different VH on cancer-specific survival (CSS) and overall survival (OS). Results: Of 125 patients, 70 (56%) had pure UC, whereas 55 (44%) had VH. The mean patient age and the median follow-up were 63.6±9.7 years and 12.5 (3-72) months. The female to male ratio was 13/112. The presence of lymphovascular invasion, locally advanced stage (=pT3), and recurrence status were significantly higher in patients with VH than those with pure UC. In all patients, the presence of VH was not significantly associated with the presence of lymph node (LN) metastasis. In the multivariable Cox regression analyses, the type of UC [hazard ratio (HR) 1.80, 95% confidence interval (CI) 1.00-3.24, p=0.050] and age (HR=1.050, 95% CI 1.016-1.086, p=0.004) was associated with the OS, whereas the LN metastases was associated the CSS (HR=2.962, 95% CI 1.456-6.027, p=0.003) and OS (HR=3.211, 95% CI 1.778-5.799, p<0.001). Conclusion: Our study demonstrated that VH in bladder cancer was associated with unfavorable clinicopathological features and a poorer OS prognosis. However, VH is not independently significant with the CSS. In addition, this study confirms that the LN metastasis represents a robust and independent predictor of inferior CSS and OS. [ABSTRACT FROM AUTHOR]

Among males aged between 15 and 35 years, testicular cancer is the most commonly diagnosed cancer. Testicular germ cell tumours are generally considered curable and respond dramatically to adjuvant treatment. Cisplatin-based chemotherapy regimens are used ubiquitously, inevitably leading to iatrogenic morbidity. Herein, we represent a case of a patient diagnosed with a non-seminomatous germ cell tumour, who underwent adjuvant cisplatin-based chemotherapy treatment and subsequently developed an acute ischemic stroke. In cancer patients, a malignancy-induced hypercoagulability state can cause thromboembolic events. Nonetheless, anti-cancer therapy may dramatically increase the risk of thromboembolic events, by analogue mechanisms, such as the release of pro-coagulant mediators, direct endothelial injury or stimulation of tissue factor production by host cells. Among various chemotherapy agents correlated with thromboembolism, cisplatin is expected to carry a higher risk for thromboembolic complications. Acute cerebrovascular events secondary to anti-neoplastic agents require an interdisciplinary approach, including referral to more experienced centres when needed. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Üroonkoloji Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Üroonkoloji Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bladder cancer is the most common malignancy of the urinary tract in Europe. 70% of all muscle invasive is bladder cancer (MIBC) at the time of diagnosis whereas remaining 30% is non-muscle invasive bladder cancer (NMIBC). NMIBC patients with low-risk can be treated with complete transurethral resection of bladder tumor (TUR-BT) and perioperative single-dose adjuvant chemotherapeutic instillation; whilst TUR-BT and bacille calmette guerin (or mitomycin) treatment are usually used in patient management with high-risk tumor. Radical cystectomy may be the choice of treatment in high-risk NMIBC. Although radical cystectomy is the definitive treatment of MIBC, its role and timing in NMIBC is still remains unclear. Early and deferred cystectomy refers two different cystectomy concepts in NMIBC without a definitive time threshold. Early cystectomy defines cystectomy in a short time span following pathologic diagnosis, whereas cystectomy performed after bladder-sparing surgery is a deferred cystectomy. Despite the difference between these studies in regard to design and outcomes, most of the conducted studies have shown immediate cystectomy to be superior to deferred cystectomy with favorable survival rates. According to previous studies and a meta-analysis, depth of invasion in lamina propria and presence of carcinoma in situ have shown to be the most significant factors supporting immediate cystectomy. Increased knowledge and surgical experience, the advantages of robotic surgery as well as orthotopic urinary diversions being used more common are some factors which may encourage clinicians and patients in decision making for an early cystectomy with functional and aesthetic advantages. [ABSTRACT FROM AUTHOR]

Seminal vesicle (SV) cystic masses are rarely encountered entities in daily clinical practice. They are mostly asymptomatic and require no treatment; however, surgical removal of the cyst is highly effective treatment in symptomatic cases. Due to embryological mesonephric duct abnormality, surgical SV cysts most often present as a part of Zinner’s syndrome (renal agenesis, ipsilateral SV cyst and ejaculatory duct obstruction). In this video article, we summarise our minimally invasive surgical approach to two consecutive cases of symptomatic SV cyst at our institution. [ABSTRACT FROM AUTHOR]

Objective: To compare the demographics and the results of patients who underwent percutaneous nephrolithotomy (PCNL) with solitary and bilateral kidneys.Materials and Methods: Between January 1998 and August 2014, 2268 patients underwent PCNL at Hacettepe University Hospital. We retrospectively analyzed the data of 91 patients with a solitary kidney and 2177 patients with bilateral kidneys treated by PCNL. We compared the success and complication rates between patients with solitary and bilateral kidneys. Additionally, we determined the factors affecting success and serious complications for patients with a solitary kidney. All statistical analyses were performed using SPSS 17.0 for Windows. The threshold for statistical significance was set at P <.05.Results: The median age was 48 years and 61 patients (67%) were male. The median stone burden was 400 mm2. The stones were located in the renal pelvis in 27 patients (30%), in calices in 50 patients (55%), and in the staghorn in 14 patients (15%). A total of 57 patients (62%) underwent a left-side surgery. The comparison between solitary and nonsolitary patients showed that stone free, transfusion, and postoperative urinary tissue infection rates were similar. Complication rates, postoperative JJ stent requirements, and length of hospital stay were statistically higher in patients with a solitary kidney. The presence of a staghorn stone, the stone number (single-multiple), and male gender were found to have a negative impact on success. The existence of upper-pole stones was found to be the only factor that led to serious complications (Clavien 3-4).Conclusion: PCNL is an effective but more complicated option in patients with a solitary kidney, with stone-free rates similar to patients with bilateral kidneys. [ABSTRACT FROM AUTHOR]