Search

Purpose To assess the diagnostic accuracy of iXip, a novel biomarker for prostate cancer detection at initial biopsy based on an algorithm including patient age, prostate volume, PSA and PSA-IgM levels,. Materials and methods This was a prospective multicenter study involving 426 consecutive men undergoing initial prostate biopsy with at least 12 cores in a real-life clinical setting. Diagnostic accuracy of iXip for prostate cancer detection was calculated with AUC and compared to that of prostate volume, PSA and PSA-IgM levels. The correlation of iXip with tumor aggressiveness, defined as any cancer with Gleason score ≥7, was evaluated by Spearman ρ coefficient analysis. Results Prostate cancer was diagnosed in 193/426 patients (45%), of which 65 (35%) had Gleason score ≥7. iXip values were significantly higher in patients with cancer than in those without cancer (median value 55% vs. 39%, p Conclusions Our prospective multicenter study suggests that the novel biomarker iXip may be used with a 20% cut-off value in order to reduce the proportion of prostate biopsies by approximately 5%, without missing a single case of cancer. Moreover, higher iXip values are significantly correlated with tumor aggressiveness.

Aim of the Study: To evaluate clinical, urodynamic efficacy and safety of TURP and TVP in patients with symptoms due to obstructive benign prostatic hypertrophy with a prospective m

Leydig Cell Tumours (LCT) account for 3% of all testicular tumours; 10% are malignant and are refractory to radio- and chemotherapy. The role of Retroperitoneal Lymph Node Dissection in clinical stage I LCT is therefore a particularly debated one. From March ‘83 to December ‘95, 10 patients with LCT were subjected to orchiectomy (1 of them bilaterally because of a metachronous tumour). In 10 out of 11 specimens the following pathological features – a) size larger than 50 mm, b) infiltration of spermatic cord, c) lymphatics and veins, d) capsule, e) necrosis, f) cellular pleomorphism, g) numerous mitoses, h) nuclear atypia – were absent. The only patient in which b) and d) were present was subjected to RPLND. After a follow-up ranging from 17 to 157 months all patients are disease-free. Abstention from RPLND in clinical stage I LCT therefore seems the more rational choice when the above- listed pathologic features are absent.

After having outlined the approaches for radical nephrectomy and after some critical considerations, the authors dwell upon the current indications for conservative surgery of renal cell carcinoma. They discuss the problems related to such therapy, emphasizing the advantages and possible risks. In particular, the problems connected with multifocal lesions and peritumoral spread are examined, the real clinical meaning of which is at present unknown, as shown by the discrepancy between experimental and clinical data. Then the authors present their own experience concerning 11 cases of renal carcinoma who underwent conservative surgical treatment between January 89 and September 92. None had relapses nor further progression. The conclusion is that, although the results of such surgery are very encouraging, nonetheless prospective studies and a wider selection of cases are required in order to define its role in the treatment of renal carcinoma.

Several different parameters, both clinical and pathological are used to prognosticate renal parenchymal carcinoma (RPC). In the present report we have analyzed prognosis according to our experience, based upon the pathological staging of disease performed at the time of nephrectomy, early diagnosis, nuclear grading, the infiltration of blood vessels and metastases.

Sixty-nine patients with localised prostatic cancer, who could not undergo radical prostatectomy due to loco-regional lymph node metastasis or anaesthesiological counter-indications, were subjected to a combined treatment, radiation therapy and androgen deprivation. All patients underwent pelvio-lymphadenectomy and those with cervico-urethral obstruction, endoscopic resection of the prostate. There was a progression of the disease in 33% of patients with lymph node metastasis (median time of progression 33 months) and in 27% of those without (median time of progression 22 months). Stable disease in 67% of patients (median follow-up over 3 years).

The 980 nm Ceralas D50 diode laser, produces homogeneous lesions on tissues of different nature. In our endourological tests we used the Ceralas D50 coupled with Comeg 24 ch laser resectoscope, and we treated 22 patients: n.5 bladder cancers, n.3 uretero pelvic junction obstructions, with hydronephrosis, n.3 urethra stenosis, n1 ureter stenosis, n.4 multiple upper tract transitional cell carcinomas, n.6 BPH treatments with VLAP modalities. Using the 1000 micrometers delivery fibers with different shaped tips, we obtained a bloodless sharp cut and easily vaporizations with minimum carbonizations, with power output in the range of 8-12 W, and 18-24W for VLAP.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

There are several diagnostic procedures that can identify patients with recurrent or primary transitional cell carcinoma (TCC) of the bladder. Cystoscopy is the best tool and the golden standard against which the other tools have to be compared. In our experience the BTA test has proved more accurate than urinary cytology, above all in diagnosing low-grade, low-stage TCC of the bladder.

Experience with Octoson water-path echotomography in examining 21 testicular masses is reported. Sonographic results were confirmed by surgical and pathologic findings in all cases. We believe this procedure to be of value in differential diagnosis of intrascrotal swellings.

From January 1979 to June 1982, 141 consecutive patients with bladder transitional cell carcinoma were treated with a single stage lymphadenectomy plus radical cystectomy. The survival rate observed in our patients, based on the TNM classification, was comparable with that reported for other groups employing contemporary surgery. Survivorship for patients with deep invasive tumors was also estimated by breaking down the pT3 stage, and patients with tumor confined to the bladder wall (pT3a) were separately evaluated from those with tumor extended outside (pT3b). The results obtained with this subdivision showed that pT3a patients have almost the same survival rate as pT2 patients. From these results it is concluded that radical cystectomy is a satisfactory curative treatment of bladder cancer confined to the bladder wall, whatever the extension of the muscular involvement. Such considerations suggest that, in order to achieve a more objective analysis of the results after radical cystectomy for invasive bladder cancer, a modification of clinical staging is necessary. Moreover, a simplification of the classification methods should provide a better identification of the elements required to assess the prognosis and to improve treatment planning.

The level of antisperm antibodies using the enzyme-linked immunosorbent assay (ELISA) in the serum of 48 patients with testicular cancer before and after therapy is reviewed. This is not a linear study of each patient, but some conclusions can be drawn: (I) In a high percentage of testicular cancer patients serum antisperm antibodies can be detected: 73.3 per cent before orchiectomy and 43.7 per cent overall. (2) The percentage of patients with antibodies decreases with adequate therapy. (3) In patients with advanced disease there is a higher percentage of positivity (50 %) for serum antisperm antibodies than in patients with low-stage disease (30 %). (4) The higher percentage of antibodies-positive patients among those with infertility patterns could be an important argument that supports the hypothesis that autoimmune pathology can play a role in oligo/azoospermia in testicular cancer patients.