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Background: Positron emission tomography (PET) with 18F-FDG is being used more frequently to evaluate primary pelvic tumors (PTs). However, a standardized hydration protocol is essential for an optimal diuretic effect and constant results. Methods: We reviewed 109 patients with PTs who had undergone 18F-FDG PET/CT examinations between November 2006 and April 2013. Four different protocols were used: (a) no hydration (group 1); (b) oral hydration (800 mL) after an early scan (group 2); (c) intravenous (IV) hydration (500 mL) during an early scan followed by oral hydration (800 mL) and IV furosemide (20 mg) after an early scan (group 3); and (d) oral hydration (800 mL) before an FDG injection followed by the protocol from group 3 (group 4). The maximum standardized uptake (SUVmax) of the urinary bladder (UB) and PTs and the PT/UB SUVmax ratios were examined. Results: The UB SUVmax of group 4 was significantly lower in the early scan compared to that in the other three groups. Group 4 had a significantly higher PT/UB SUVmax ratio in the early scan than the other three groups, and it also had a 52.5% positivity rate for PTs. Conclusions: The pre-hydration plus forced diuresis protocol yielded the optimal effect of UB radiotracer washout and had the best PT/UB SUVmax ratio in both scans. [ABSTRACT FROM AUTHOR]

Urinary 8-hydroxydeoxyguanosine (8-OHdG) level is an oxidative stress marker in patients with cancer; however, little is currently known about the clinical relevance of urinary 8-OHdG levels in patients with prostate cancer at diagnosis. Voided urine samples were collected from patients at the time of prostate biopsy and stored at -80˚C after centrifugation. All of the patients were classified according to histology of the biopsy. Once the patients were diagnosed with prostate cancer, the standard of care and treatments were administered according to the standard guidelines. The association between clinicopathological parameters and urinary 8-OHdG and N-terminal telopeptide (NTx) levels were explored. A total of 409 patients received prostate biopsy, of which 190 were benign, 41 were diagnosed with prostatitis and 178 were diagnosed with prostate cancer. The urinary 8-OHdG/creatinine ratio was marginally associated with prostate size (P=0.052) but not with serum prostate-specific antigen levels (P=0.707). With correction for prostate size, the ratio of urinary 8-OHdG/creatinine was significantly higher in patients with prostate cancer than those without malignancy (P=0.004). Moreover, urinary 8-OHdG levels were weakly associated with urinary NTx levels (r2=0.04, P=0.009). In conclusion, urinary 8-OHdG levels normalized for prostate volume may reflect prostate cancer risk and could be used to predict prostate cancer aggressiveness. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the prognostic significance of a novel marker, the red cell distribution width to lymphocyte percentage (RDW-to-LYM%) ratio, in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). The clinical and follow-up data of 625 patients with UTUC receiving RNU were retrospectively analyzed. The optimal cut-off value of the pre-treatment RDW-to-LYM% ratio was determined as 0.80 using receiver operating characteristic (ROC) analysis according to cancer-specific death. The associations between low (≤0.80) and high (>0.8) RDW-to-LYM% ratio and other clinicopathological parameters were evaluated using the χ2 test and logistic regression analysis. The impact of the RDW-to-LYM% ratio on overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) rates was assessed using the Kaplan-Meier method and Cox regression analysis. A high RDW-to-LYM% ratio (>0.80) was significantly associated with impaired kidney function, previous/concurrent bladder cancer, tumors involving both the pelvis and ureter, advanced pathological T stage, lymph node involvement and lymphovascular invasion (LVI). Kaplan-Meier analysis revealed that a high RDW-to-LYM% ratio was associated with poorer OS, CSS and PFS than a low RDW-to-LYM% ratio (all P<0.001). The multiple logistic regression analysis revealed that high RDW-to-LYM% ratio was associated with non-organ-confined (NOC) disease [odd ratio (OR), 2.107; 95% confidence interval (CI), 1.446-3.069; P<0.001] and positive LVI (OR, 1.978; 95% CI, 1.338-2.916; P<0.001). Furthermore, the multivariate analysis showed that the RDW-to-LYM% ratio was an independent factor for predicting OS [hazard ratio (HR), 2.046; P<0.001], CSS (HR, 2.041; P<0.001) and PFS (HR, 1.502; P=0.009). In conclusion, the pre-treatment RDW-to-LYM% ratio was found to be a significant predictor of both NOC and the presence of LVI in patients with UTUC. Moreover, an elevated pre-treatment RDW-to-LYM% ratio was identified as an independent factor for unfavorable survival outcomes in patients with UTUC undergoing RNU. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the prognostic significance of a novel marker, the red cell distribution width to lymphocyte percentage (RDW-to-LYM%) ratio, in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). The clinical and follow-up data of 625 patients with UTUC receiving RNU were retrospectively analyzed. The optimal cut-off value of the pre-treatment RDW-to-LYM% ratio was determined as 0.80 using receiver operating characteristic (ROC) analysis according to cancer-specific death. The associations between low (≤0.80) and high (>0.8) RDW-to-LYM% ratio and other clinicopathological parameters were evaluated using the χ 2 test and logistic regression analysis. The impact of the RDW-to-LYM% ratio on overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) rates was assessed using the Kaplan-Meier method and Cox regression analysis. A high RDW-to-LYM% ratio (>0.80) was significantly associated with impaired kidney function, previous/concurrent bladder cancer, tumors involving both the pelvis and ureter, advanced pathological T stage, lymph node involvement and lymphovascular invasion (LVI). Kaplan-Meier analysis revealed that a high RDW-to-LYM% ratio was associated with poorer OS, CSS and PFS than a low RDW-to-LYM% ratio (all P<0.001). The multiple logistic regression analysis revealed that high RDW-to-LYM% ratio was associated with non-organ-confined (NOC) disease [odd ratio (OR), 2.107; 95% confidence interval (CI), 1.446-3.069; P<0.001] and positive LVI (OR, 1.978; 95% CI, 1.338-2.916; P<0.001). Furthermore, the multivariate analysis showed that the RDW-to-LYM% ratio was an independent factor for predicting OS [hazard ratio (HR), 2.046; P<0.001], CSS (HR, 2.041; P<0.001) and PFS (HR, 1.502; P=0.009). In conclusion, the pre-treatment RDW-to-LYM% ratio was found to be a significant predictor of both NOC and the presence of LVI in patients with UTUC. Moreover, an elevated pre-treatment RDW-to-LYM% ratio was identified as an independent factor for unfavorable survival outcomes in patients with UTUC undergoing RNU., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Hsieh et al.)