7 research outputs found
The prognostic irnportance of the morphological su bdivision of the grade II superficial bladder cancer
In this study a morphological subdivision of
grade (g)ll superficial bladder cancer is proposed and
correlated with recurrence and progression rate.
Forty patients, 33 males and 7 females, of 70
years mean age, with initial gII superficial transitional
bladder cancer were treated with transurethral resection
between January and December 1987 with followup
for a mean period of 4 years. Recurrences were
observed in 24 patients. All histological specimens
were reviewed and reclassified to gIIa and gIIb
mainly according to the variation in nuclear size.
the degree of nuclear atypia and the number of
mitoses. 42.1 % (8119) of the gIIa and 76.2% (16121)
of the gIIb tumors recurred. The observed difference
in recurrence rate was statistically significant (s.s) -
p< 0.05. The disease-free interval after the initial
presentation was over two years in 50% (418) of gIIa
and in 6.25% (1116) of gIIb patients (s.s. difference -
p< 0.05). None of the patients with gIIa, but 37.5%
(6116) with gIIb urothelial cancer had more than
two recurrences (s.s. difference - p< 0.05). All gIIa
recurred as gIIa superficial cancers, 62.5% (10116)
of gIIb as gIIb (5 superficial and 5 invasive) and
the remainder 37.5% (6116) as invasive gIII tumors.
Only one patient with repeated recurrences died
two years after the initial presentation. 3 patients died
from other causes.
In conclusion: 1. The morphological subdivision
of gIl urothelial cancer into gIIa and gIIb has a
prognostic significance, as it is related to the recurrence
rate, the disease-free interval after the initial resection,
the number of recurrences and the progression rate.
2. As gIIb urothelial cancer identifies patients at a
higher recurrence risk. it is evident that this
group requires an adjuvant treatment and a closer
follow-up
Free/Total PSA (F/T ratio) kinetics in patients with clinically localized prostate cancer undergoing radical prostatectomy
Background: In this paper we study the Free/Total PSA kinetics in patients with clinically localized prostate cancer undergoing radical prostatectomy. Methods: Serum PSA, Free PSA and Free/Total Ratio were determined preoperatively, at the time of prostate removal (0 time) and then at 3, 6, 12, 24, 48, 72 and 168 h, from 9 patients with clinically localized prostate cancer who underwent radical retropubic prostatectomy. The elimination rates and half-lives of Total, Free PSA and F/T Ratio were studied applying one and two compartment models for pharmacokinetic analysis. Results: Surgical manipulations of the prostate caused a mean 2.16-fold increase of PSA, 12-fold increase of free PSA and 4.2-fold increase of F/T PSA ratio. Removal of the prostate caused a rapid biphasic, biexponential elimination of Free PSA with a mean half-life of 0.8 h for the alpha (a) phase and 32.6 h for the beta (b) phase. PSA was eliminated following a rapid exponential (a) phase with a half-life of 1.15 h and a non-exponential (b) phase with a half-life of 71.96 h. Free/Total PSA followed a biphasic kinetic, with an initial exponential elimination phase and a mean half-life of 2.6 h and a second non-exponential increase phase with a doubling time of 130.8 h. Free/Total PSA reached its nadir very soon, at the first postoperative 24 h. Conclusions: Free/Total PSA kinetic after radical prostatectomy reflects the differences of Free and Total PSA elimination kinetics. Free/Total Ratio follows a biphasic kinetic, with an initial rapid exponential elimination phase, which is affected mainly by the rapid exponential (a) phase of Free PSA elimination and a second slow increase, which is affected mainly by the terminal non-exponential (b) phase of PSA elimination. © 2005 Elsevier B.V. All rights reserved
Total and free PSA kinetics in patients without prostate cancer undergoing radical cystoprostatectomy
BACKGROUND. Radical cystoprostatectomy and radical prostatectomy are the two major operations where prostate is totally and radically removed. Radical cystoprostatectomy is usually performed in patients with invasive bladder cancer. The aim of the study was to examine Total PSA, Free PSA, and Free/Total Ratio elimination kinetics after radical cystoprostatectomy. METHODS. Serum PSA, Free PSA, and Free/Total Ratio were determined preoperatively, at the time of cystoprostatectomy specimen removal and then at 3, 6, 12, 24, 48, 72, and 168 hr, from seven patients with muscle invasive bladder cancer, who underwent radical cystoprostatectomy. Free and Total PSA concentrations were measured with non-competitive immunological procedures. The elimination rates and half-lives of Total, Free PSA and Free/Total Ratio were studied using a nonlinear regression analysis. RESULTS. Surgical manipulations caused about 1.5-fold increase of PSA, 5-fold increase in Free PSA and 3-fold increase in Free/Total Ratio. PSA and Free PSA followed a biphasic elimination pattern of a rapid exponential (a) phase with a half-life of 4.27 and 2.14 hr and a terminal, nonexponential (b) phase with a half-life of 63 and 173.2 hr, respectively. Free/Total PSA Ratio followed, also, a biphasic kinetic pattern of a rapid exponential decline with a half-life of 3.34 and a terminal non-exponential increase with a doubling time of 43 hr. CONCLUSIONS. Comparing PSA kinetics after radical cystoprostatectomy with those of radical prostatectomy, it appears that PSA follows the same elimination pattern in both models. In contrast, Free PSA and Free/Total Ratio elimination kinetics' patterns differ between the two surgical models. © 2008 Wiley-Liss, Inc
The contribution of cavernous body biopsy in the diagnosis and treatment of male impotence
This study concerns the results of penile
biopsies in 50 patients aged 27 to 80, with secondary
impotence removed with a biopty gun or during penile
surgery. The biopty gun specimens were equally
representative as the open biopsy ones. The cause and
the degree of erectile dysfunction were determined by
clinical and laboratorial investigation. The histological
study of the cavernous bodies in the patients with
psychogenic impotence revealed normal erectile tissue.
In patients with organic impotence, histological lesions
were graded as mild, moderate or severe. The most
severe lesions were observed in the erectile tissue and in
particular in the smooth muscle of the trabeculae and the
helicine arteries, which had been reduced and replaced
by connective tissue. Histological lesions were found not
only in the arterial but also in the venous leak cases.
There was a correlation between their severity and the
degree of impotence, although of no statistical
significance. The penile biopsy determines the condition
(state) of the functional cavernous smooth muscle tissue,
the integrity of which is essential for the erectile
mechanism as well as for the action of the vasoactive
drugs and the results of vascular surgery. Its important
role is evident as it contributes not only to the diagnosis
of the cause, but also to the choice of treatment of male
impotence