Immunotherapy of Genitourinary Malignancies

Most cancer patients are treated with some combination of surgery, radiation, and chemotherapy. Despite recent advances in local therapy with curative intent, chemotherapeutic treatments for metastatic disease often remain unsatisfying due to severe side effects and incomplete long-term remission. Therefore, the evaluation of novel therapeutic options is of great interest. Conventional, along with newer treatment strategies target the immune system that suppresses genitourinary (GU) malignancies. Metastatic renal cell carcinoma and non-muscle-invasive bladder caner represent the most immune-responsive types of all human cancer. This review examines the rationale and emerging evidence supporting the anticancer activity of immunotherapy, against GU malignancies

Rapid Increase of the Serum PSA Level in Response to High-Intensity Focused Ultrasound Therapy may be a Potential Indicator of Biochemical Recurrence of Low- and Intermediate-Risk Prostate Cancer

Objectives To determine the incidence and magnitude of the rapid increase in the serum PSA (riPSA) level after high-intensity focused ultrasound (HIFU) therapy for prostate cancer, and its correlation with clinical factors. Methods A total of 176 patients with localized prostate cancer underwent HIFU therapy. Serum riPSA was determined on the basis of the same criteria as those for “PSA bounce”, ie, an increase of ≥0.2 ng/ml with a spontaneous return to the prebounce level or lower. Patients were stratified according to neoadjuvant PSA level, T stage, risk group, age, Gleason score, pretreatment PSA level, post-treatment PSA nadir, and number of HIFU sessions. Results riPSA was seen in 53% of patients during a median follow-up period of 43 months. A PSA nadir was achieved within 3 months for 85.1% of the treatments. In all cases, onset of riPSA was seen two days after HIFU therapy, and the median magnitude was 23.69 ng/ml. A magnitude of >2 ng/ml was seen in 89.4% of cases. Univariate analysis revealed that patients with riPSA were associated with usage of hormonal therapy and the post-treatment PSA nadir level. Multivariate Cox regression analysis revealed that riPSA and the number of HIFU sessions were predictors of biochemical recurrence. A significant statistical association was found between the presence of riPSA and the risk of biochemical failure only in the low- and intermediate-risk group. Conclusion Patients treated with HIFU who experience post-treatment riPSA may have an increased risk of biochemical recurrence, especially in non-high-risk patients

Surgical correction of buried penis after traffic accident – a case report

BACKGROUND: Buried penis, most commonly seen in children, is particularly debilitating in adults, resulting in inability to void while standing and it also affects vaginal penetration. We report a case of buried penis due to a traffic accident, which caused dislocation of the fractured pubic bone that shifted inside and pulled the penis by its suspensory ligament. CASE PRESENTATION: A 55-year-old man was admitted to our hospital with a chief complaint of hidden penis while in the sitting position. He had suffered a pelvic fracture in a traffic accident four years previously, and his penis was covered with suprapubic fat when he was in a sitting position. He was unable to have sexual intercourse. We performed a penile lengthening procedure, including inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy and fat removal, under general anesthesia. There was a good cosmetic result with satisfactory penile erection, which allowed successful sexual intercourse after surgery. CONCULSION: We performed penile elongation surgery with inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy, and fat removal. Surgical treatment of buried penis achieves marked aesthetic and functional improvement, and benefits the majority of patients, resulting in satisfactory erection and successful sexual intercourse

Her yol Roma'ya varmaz!

Taha Toros Arşivi, Dosya Adı: Taha Torosİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

持続性勃起症を伴う精巣腫瘍の陰茎転移の稀な1症例

持続勃起症の原因は主として, 動脈性持続勃起症と静脈性持続勃起症とに分類される.これらの分類によって治療法が異なるため, その分類は重要である.しかし, 今回, 分類不能な持続勃起症として経過し, 治療途中で精巣腫瘍からの陰茎転移による持続勃起症であると診断されたきわめて稀な症例(86歳男)を著者らが経験したので, それを報告したPriapism is thought as a condition of penile erection that persists beyond or is unrelated to sexual stimulation. Commonly two different entities of priapism are known, one is low-flow priapism and the other is high-flow priapism. It is important to distinguish these two conditions for the subsequent different treatments. We report a rare case of an indistinguishable priapism caused by penile metastasis of testicular cancer

CRISPR Screen Contributes to Novel Target Discovery in Prostate Cancer

Prostate cancer (PCa) is one of the common malignancies in male adults. Recent advances in omics technology, especially in next-generation sequencing, have increased the opportunity to identify genes that correlate with cancer diseases, including PCa. In addition, a genetic screen based on CRISPR/Cas9 technology has elucidated the mechanisms of cancer progression and drug resistance, which in turn has enabled the discovery of new targets as potential genes for new therapeutic targets. In the era of precision medicine, such knowledge is crucial for clinicians in their decision-making regarding patient treatment. In this review, we focus on how CRISPR screen for PCa performed to date has contributed to the identification of biologically critical and clinically relevant target genes

Clinical Evaluation of Minimum-incision Endoscopic Radical Prostatectomy in Initial 50 Patients

To assess the feasibility of minimum-incision endoscopic radical prostatectomy (MIERP) in the management of localized prostate cancer. Methods: We conducted clinical evaluations of mean blood loss, operation time, and postoperative course in 50 cases of MIERP performed at Osaka Medical College Hospital from June 2006 to October 2009. The operations were performed according to the MIERP development protocol at our department, with incisions of 10 cm or less in the early cases and 6-7 cm in later cases. Results: In all 50 cases, average bleeding was significantly shortened compared with 19 cases by the conventional method at our institution. The postoperative start of oral intake, start of ambulation, use of analgesics, timing of catheter removal, and duration of hospitalization were all significantly improved with MIERP compared with the conventional method. MIERP patients were divided into 3 consecutive groups (initial 16 cases, midterm 17 cases, and latest 17 cases); mean operation time/mean blood loss were 253 min/1,485 mL, 253.4 min/2,340.9 mL, and 177 min/1,274 mL, respectively. Conclusion: Surgical experience involving approximately 30 cases was required to achieve stable clinical results. MIERP is less invasive than conventional retropubic radical prostatectomy and may be safely introduced to resident urologists