Correlation between Bladder Neck Preservation, Positive Surgical Margins, and Biochemical Recurrence in Laparoscopic and Open Radical Prostatectomy: A Prospective Cohort Study

Background: Bladder neck preservation (BNP) has been adopted in open (ORP), laparoscopic (LRP), and robot-assisted radical prostatectomy (RARP). However, there are concerns that this technique can compromise oncological outcome and increase positive surgical margins (PSM). The aim was to evaluate the outcome of BNP, focusing on surgical and pathological outcomes, as well as biochemical recurrence (BCR). Methods: We prospectively collected demographic and clinical data from 170 consecutive patients who underwent ORP and LRP between 2014 and 2020. ORP was performed in 63 patients, and the rest underwent LRP. BNP was performed in 85 patients. Results: PSM were found in 24.7% of patients. Of patients with BNP, 22.4% had PSM. There was no significant statistical difference between patients with or without BNP in the form of PSM. Base-positive margins were detected in 9.4% of patients with BNP and in 5.9% of patients without BNP with no statistical significance. Bioptic Gleason score, clinical stage, and preoperative PSA were statistically significantly correlated with PSM. BCR was more common in patients without BNP (23.5%) vs. non-BNP (21.2%). The only statistically significant predictor of BCR was PSM. Conclusion: This study suggests that BNP in RP is not associated with an increased level of PSM. Preoperative PSA, bioptic Gleason score, and clinical T stage of disease were identified as predictors of PSM occurrence

Clinicopathological characteristics and survival in Serbian patients with renal cell carcinoma: a retrospective analysis

Purpose: Indications of kidney cancer outcome in lower-income countries are based on an incidence/mortality ratio due to lack of survival information. This study was conducted to provide outcome data in Serbian patients with renal cell carcinoma (RCC) and to identify prognostic factors that could affect their overall survival (OS). Methods: This retrospective study included 185 patients who underwent nephrectomy. We assessed certain clinicopathological data including age, gender, tumor size, grade, stage and histological subtypes for their possible impact on OS. Results: The 5-year OS was 63.2%. Significant association was found between OS and age (log-rank 12.455, p=0.006), tumor size (log-rank 26.425, p=0.000), grade (log-rank 13.249, p=0.000) and stage (log-rank 43.235, p=0.000). Univariate analysis indicated size (p=0.000), grade (p=0.001) and stage (p=0.000) as prognostic factors for OS. In multivariate analysis, grade (p=0.014) and stage (p=0.000) remained significant predictors of OS. Conclusion: Tumor grade and stage were identified as independent prognostic factors of OS survival in Serbian patients with RCC

Clinicopathological characteristics and survival in Serbian patients with renal cell carcinoma: a retrospective analysis

Purpose: Indications of kidney cancer outcome in lower-income countries are based on an incidence/mortality ratio due to lack of survival information. This study was conducted to provide outcome data in Serbian patients with renal cell carcinoma (RCC) and to identify prognostic factors that could affect their overall survival (OS). Methods: This retrospective study included 185 patients who underwent nephrectomy. We assessed certain clinicopathological data including age, gender, tumor size, grade, stage and histological subtypes for their possible impact on OS. Results: The 5-year OS was 63.2%. Significant association was found between OS and age (log-rank 12.455, p=0.006), tumor size (log-rank 26.425, p=0.000), grade (log-rank 13.249, p=0.000) and stage (log-rank 43.235, p=0.000). Univariate analysis indicated size (p=0.000), grade (p=0.001) and stage (p=0.000) as prognostic factors for OS. In multivariate analysis, grade (p=0.014) and stage (p=0.000) remained significant predictors of OS. Conclusion: Tumor grade and stage were identified as independent prognostic factors of OS survival in Serbian patients with RCC

Combined GSTM1-Null, GSTT1-Active, GSTA1 Low-Activity and GSTP1-Variant Genotype Is Associated with Increased Risk of Clear Cell Renal Cell Carcinoma.

The aim of this study was to evaluate specific glutathione S-transferase (GST) gene variants as determinants of risk in patients with clear cell renal cell carcinoma (cRCC), independently or simultaneously with established RCC risk factors, as well as to discern whether phenotype changes reflect genotype-associated risk. GSTA1, GSTM1, GSTP1 and GSTT1 genotypes were determined in 199 cRCC patients and 274 matched controls. Benzo(a)pyrene diolepoxide (BPDE)-DNA adducts were determined in DNA samples obtained from cRCC patients by ELISA method. Significant association between GST genotype and risk of cRCC development was found for the GSTM1-null and GSTP1-variant genotype (p = 0.02 and p<0.001, respectively). Furthermore, 22% of all recruited cRCC patients were carriers of combined GSTM1-null, GSTT1-active, GSTA1-low activity and GSTP1-variant genotype, exhibiting 9.32-fold elevated cRCC risk compared to the reference genotype combination (p = 0.04). Significant association between GST genotype and cRCC risk in smokers was found only for the GSTP1 genotype, while GSTM1-null/GSTP1-variant/GSTA1 low-activity genotype combination was present in 94% of smokers with cRCC, increasing the risk of cRCC up to 7.57 (p = 0.02). Furthermore, cRCC smokers with GSTM1-null genotype had significantly higher concentration of BPDE-DNA adducts in comparison with GSTM1-active cRCC smokers (p = 0.05). GSTM1, GSTT1, GSTA1 and GSTP1 polymorphisms might be associated with the risk of cRCC, with special emphasis on GSTM1-null and GSTP1-variant genotypes. Combined GSTM1-null, GSTT1-active, GSTA1 low activity and GSTP1-variant genotypes might be considered as "risk-carrying genotype combination" in cRCC

<i>GST</i> genotypes in relation to the risk of cRCC.

<p><i>GST</i> genotypes in relation to the risk of cRCC.</p

The association between <i>GST</i> genotypes and the levels of BPDE-DNA adducts in cRCC smokers.

<p>The association between <i>GST</i> genotypes and the levels of BPDE-DNA adducts in cRCC smokers.</p

Combined <i>GSTM1-Null</i>, <i>GSTT1-Active</i>, <i>GSTA1 Low-Activity</i> and <i>GSTP1-Variant</i> Genotype Is Associated with Increased Risk of Clear Cell Renal Cell Carcinoma

<div><p>The aim of this study was to evaluate specific glutathione S-transferase (GST) gene variants as determinants of risk in patients with clear cell renal cell carcinoma (cRCC), independently or simultaneously with established RCC risk factors, as well as to discern whether phenotype changes reflect genotype-associated risk. <i>GSTA1</i>, <i>GSTM1</i>, <i>GSTP1</i> and <i>GSTT1</i> genotypes were determined in 199 cRCC patients and 274 matched controls. Benzo(a)pyrene diolepoxide (BPDE)-DNA adducts were determined in DNA samples obtained from cRCC patients by ELISA method. Significant association between <i>GST</i> genotype and risk of cRCC development was found for the <i>GSTM1-null</i> and <i>GSTP1-variant</i> genotype (p = 0.02 and p<0.001, respectively). Furthermore, 22% of all recruited cRCC patients were carriers of combined <i>GSTM1-null</i>, <i>GSTT1-active</i>, <i>GSTA1-low activity</i> and <i>GSTP1-variant</i> genotype, exhibiting 9.32-fold elevated cRCC risk compared to the reference genotype combination (p = 0.04). Significant association between <i>GST</i> genotype and cRCC risk in smokers was found only for the <i>GSTP1</i> genotype, while <i>GSTM1-null/GSTP1-variant/GSTA1 low-activity</i> genotype combination was present in 94% of smokers with cRCC, increasing the risk of cRCC up to 7.57 (p = 0.02). Furthermore, cRCC smokers with <i>GSTM1-null</i> genotype had significantly higher concentration of BPDE-DNA adducts in comparison with <i>GSTM1-active</i> cRCC smokers (p = 0.05). <i>GSTM1</i>, <i>GSTT1</i>, <i>GSTA1</i> and <i>GSTP1</i> polymorphisms might be associated with the risk of cRCC, with special emphasis on <i>GSTM1-null</i> and <i>GSTP1-variant</i> genotypes. Combined <i>GSTM1-null</i>, <i>GSTT1-active</i>, <i>GSTA1 low activity</i> and <i>GSTP1-variant</i> genotypes might be considered as “risk-carrying genotype combination” in cRCC.</p></div

Combined effect of <i>GST</i> genotypes on risk of cRCC.

<p>Combined effect of <i>GST</i> genotypes on risk of cRCC.</p