Surgical Treatment for Renal Cell Carcinoma

Despite recent advances in chemotherapy, radiation therapy and immunology, renal cell carcinoma can best be treated by early detection and radical surgery. Today, radical nephrectomy is the standard surgery of choice for removing malignant renal tumors. Of the surgical procedures that have been used in the past, the transabdominal incision offers the best exposure of retroperitoneal structures at the diaphragmatic level and the contralateral renal vasculature. Occasionally, supraradical procedures are recommended if tumor size and location require this approach

Palliative Urinary Diversion in Adenocarcinoma of the Prostate

Ten patients with inoperable prostatic carcinoma, producing ureteral obstruction and azotemia, underwent palliative urinary diversion. Good quality survivals of two months to three years were obtained. These results compare favorably with the good results seer) In gynecologic neoplasm of the bladder, colon and breast. In selected cases of carcinoma of the prostate, palliative urinary diversion is indicated when the prospects exist for further benefit from chemotherapy or radiotherapy

Lymphangiography in Staging Carcinoma of the Prostate. A Comparison with Operative Findings

Pedal lymphangiography was performed In 30 patients who subsequently underwent radical retropubic prostatectomy, and radical pelvic lymphadenectomy. In 24 of 30 patients, lymphangiograms correctly predicted the presence or absence of nodal Involvement. In spite of certain limitations of the technique. It is considered an essential diagnostic study in patients considered for possible radical prostatic surgery, or in patients who may be candidates for external megavoltage radiotherapy to the prostate gland and its lymphatic drainage

Bone Marrow Acid Phosphatase in the Evaluation of Patients with Carcinoma of the Prostate

Based on experience with 30 men having clinical stage A and B adenocarcinoma of the prostate, the authors conclude that elevation of bone marrow acid phosphatase (BMAP) is a sensitive indicator of the disease state. BMAP revealed periprostatic or nodal Involvement when osseous metastases seemed absent. BMAP is considered essential in the evaluation of all patients with prostatic carcinoma. Patients who have false negative BMAP (and are not candidates for radical prostatectomy), should undergo lymphangiography and bone scan before radiation therapy or hormonal treatment is planned

Changes in Serum Testosterone after Bilateral Orchiectomy in Patients with Metastatic Carcinoma of the Prostate

From a study of 38 patients, it may be concluded that, first, changes in serum testosterone levels of patients undergoing orchiectomy for metastatic carcinoma of the prostate are unrelated to the clinical course of the patient; second, no clear correlation exists between quantitative Leydig cell counts and levels of plasma testosterone; and, third, exacerbation of metastatic disease is observed while plasma testosterone remains in the castrate range. These observations question the exact function of the Leydig cell and its role in androgen production, and indicate that prostatic neoplasms have varying degrees of response to reduced androgen levels and/or androgen-Iike substances following castration