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prostate surgery for debulking

Christoph Hohenberger, Corinna Schmidt, Julius Höhne, Alexander Brawanski, Florian Zeman, Karl-Michael Schebesch
OBJECTIVE: Space-occupying spinal metastases (SM), commonly diagnosed because of acute neurological deterioration, consequently lead to immediate decompression with tumor removal or debulking. In this study, we analyzed a series of patients with surgically treated spinal metastases and explicitly sought to determine individual predictors of functional outcome. PATIENTS AND METHODS: 94 patients (26 women, 68 men; mean age 64.0 years) with spinal metastases, who had been surgically treated at our department, were included retrospectively...
June 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Justin A Reddington, Gustavo A Mendez, Alex Ching, Charlotte Dai Kubicky, Paul Klimo, Brian T Ragel
BACKGROUND: Surgeons treating metastatic spine disease can use computed tomography (CT) imaging to determine whether lesions are osteolytic, osteoblastic, or mixed. This enables treatment that considers the structural integrity of the vertebral body (VB), which is impaired with lytic lesions but not blastic lesions. The authors analyzed CT imaging characteristics of spine metastasis from breast, lung, prostate, and renal cell carcinomas (RCCs) to determine the metastasis patterns of each of these common tumors...
2016: Surgical Neurology International
I H Kunkler, R Audisio, Y Belkacemi, M Betz, E Gore, S Hoffe, Y Kirova, P Koper, J-L Lagrange, A Markouizou, R Pfeffer, S Villa
Radiotherapy (RT) is a key component of the management of older cancer patients. Level I evidence in older patients is limited. The International Society of Geriatric Oncology (SIOG) established a task force to make recommendations for curative RT in older patients and to identify future research priorities. Evidence-based guidelines are provided for breast, lung, endometrial, prostate, rectal, pancreatic, oesophageal, head and neck, central nervous system malignancies and lymphomas. Patient selection should include comorbidity and geriatric evaluation...
November 2014: Annals of Oncology: Official Journal of the European Society for Medical Oncology
F Lugnani, G Simone, P M Biava, R J Ablin
UNLABELLED: Neuroendocrine prostate carcinoma (NE-PCa) is a heterogeneous disease. Due to a high prevalence of NE (neuroendocrine) differentiation in patients who receive prolonged androgen deprivation treatment, the real incidence of NE-PCa remains unknown. Similarly, the biological steps from prostate carcinoma (PCa) toward NE differentiation are far less than definitive and, consequently, there is a lack of evidence to support any of the treatments as the "gold standard". MATERIALS AND METHODS: A systematic literature search was conducted using the PubMed, Scopus, and Embase databases to identify original articles and review articles regarding NE-PCa ...
2014: Current Medicinal Chemistry
Kevin G Phillips, Carmen Ruiz Velasco, Julia Li, Anand Kolatkar, Madelyn Luttgen, Kelly Bethel, Bridgette Duggan, Peter Kuhn, Owen J T McCarty
Clinical studies have demonstrated that circulating tumor cells (CTCs) are present in the blood of cancer patients with known metastatic disease across the major types of epithelial malignancies. Recent studies have shown that the concentration of CTCs in the blood is prognostic of overall survival in breast, prostate, colorectal, and non-small cell lung cancer. This study characterizes CTCs identified using the high-definition (HD)-CTC assay in an ovarian cancer patient with stage IIIC disease. We characterized the physical properties of 31 HD-CTCs and 50 normal leukocytes from a single blood draw taken just prior to the initial debulking surgery...
2012: Frontiers in Oncology
Robert E Lieberson, Anand Veeravagu, Jan M Eckermann, James R Doty, Bowen Jiang, Russell Andrews, Steven D Chang
INTRODUCTION: Although vertebral and epidural metastases are common, intradural metastases and intramedullary spinal cord metastases are rare. The indications for the treatment of intramedullary spinal cord metastases remain controversial. We present the first biopsy-proven case of an intramedullary spinal cord metastasis from adenocarcinoma of the prostate. CASE PRESENTATION: Our patient was a 68-year-old right-handed Caucasian man with a Gleason grade 4 + 3 prostate adenocarcinoma who had previously undergone a prostatectomy, androgen blockade and transurethral debulking...
2012: Journal of Medical Case Reports
Marco Oderda, Steven Joniau, Martin Spahn, Paolo Gontero
UNLABELLED: What's known on the subject? and What does the study add? Nowadays radical prostatectomy (RP) is considered an effective treatment in high-risk prostate cancer (PCa) and the indications for a surgical approach are expanding, even in cases of very high PSA or node-positive disease. We explored the outcomes of debulking surgery in the setting of these very high-risk PCa patients, in order to assess its feasibility. This review confirms the important role achieved by surgery in the complex setting of patients with very high-risk PCA...
September 2012: BJU International
Canan Akyüz, Neriman Sari, Bilgehan Yalçin, Ali Varan, Tezer Kutluk, Münevver Büyükpamukçu
The characteristics and clinical outcomes of 409 children with rhabdomyosarcoma, treated in a single center between 1972 and 2003, were evaluated to identify those characteristics that may have improved the outcome. Retrospective analysis was performed on 409 children for variables such as age, sex, primary tumor site, TNM (Tumor, Node, Metastasis) stage, Intergroup Rhabdomyosarcoma Studies (IRS) clinical group, histological subtypes, treatment. The mean age was 5.4 years and the male/female ratio was 1.6/1...
February 2012: Pediatric Hematology and Oncology
Qiang Shao, Jun Ouyang, Youzhang Fan, Jianjun Xie, Jundong Zhou, Jingchang Wu, A Karim Kader, Jianfeng Xu, Guihua Liu, Yuxi Shan, Duangai Wen, Yuanyuan Zhang
OBJECTIVE: Prostate cancer is an underreported and emerging problem in China. Here we summarize the data for Chinese patients with prostate cancer (PCa), describe available treatment options, and report 5-year outcomes at multiple tertiary care institutions. PATIENTS AND METHODS: A series of 1611 patients (mean age 76.51 years) diagnosed with PCa were enrolled. Survival rates for patients were analyzed using the Kaplan-Meier method. Prognostic factors for disease-specific survival were analyzed using the log-rank test and Cox proportional hazards model...
February 28, 2012: Cancer Letters
R A Badalament, D K Bahn, F Lee
Radical prostatectomy has been considered the gold standard for the curative treatment of clinically localized prostate cancer. After an extensive review of the literature, we concluded that surgery probably functions primarily as a tumor debulking procedure rather than a curative one. Morphometric studies suggest that the majority of patients undergoing surgery have tumors too large for cure. Histologic studies demonstrate that 55% of radical prostatectomy specimens show evidence of extraprostatic disease and approximately 15% have tumors so small that a clinical impact on longevity is unlikely...
May 1996: Urologic Oncology
H Patel, J V Joseph, A Amodeo, K Kothari
Indications for total pelvic exenteration in a male (removal of the bladder, prostate and rectum) and in a woman (removal bladder, uterus, vagina, ovaries and rectum) are rare. The advanced stage generally dictates that the patient has some form of chemotherapy or radiotherapy, or a combination of two to shrink/debulk the tumour. We report the first two cases of a salvage laparoscopic total pelvic exenteration in a male for rectal adenocarcinoma invading into the bladder and prostate, post-chemo-radiotherapy and in a woman for squamous cell carcinoma of cervix invading the bladder and rectum post-chemo-radiotherapy...
October 2009: Journal of Minimal Access Surgery
Cosimo De Nunzio, Roberto Miano, Alberto Trucchi, Lucio Miano, Giorgio Franco, Stefano Squillacciotti, Andrea Tubaro
PURPOSE: We evaluated voiding and storage symptom evolution in patients treated with prostate photoselective vaporization by a KTP laser. MATERIALS AND METHODS: Enrolled in the study were 150 consecutive patients with lower urinary tract symptoms due to benign prostatic hyperplasia and a diagnosis of bladder outlet obstruction. Patients underwent prostate photoselective vaporization with the 80 W KTP laser. Baseline parameters included prostate volume, International Prostate Symptom Score with voiding and storage symptom subscores, uroflowmetry, pressure flow study and serum prostate specific antigen...
March 2010: Journal of Urology
S Thüroff, C Chaussy
The growing interest in high-intensity focused ultrasound (HIFU) technology is mainly due to its many potential applications as a new energy source and as noninvasive therapy. It has been introduced to urological oncology as a transrectal treatment for prostate cancer and as extracorporeal treatment for kidney cancer. Although its application in the kidney is still at the clinical feasibility phase, HIFU technology is currently being used in daily practice in Europe for the treatment of prostate cancer. Reports in the literature describing results of HIFU for prostate cancer are mainly based on monocentric, prospective clinical studies...
April 2008: Der Urologe. Ausg. A
Ahmed Ibrahim, Alan Crockard, Pierre Antonietti, Stefano Boriani, Cody Bünger, Alessandro Gasbarrini, Anders Grejs, Jürgen Harms, Norio Kawahara, Christian Mazel, Robert Melcher, Katsuro Tomita
OBJECT: Opinions vary widely as to the role of surgery (from none to wide margin excision) in the management of spinal metastases. In this study the authors set out to ascertain if surgery improves the quality of remaining life in patients with spinal metastatic and tumor-related systemic disease. METHODS: The authors included 223 patients in this study who were referred by oncologists and physicians over a 2-year period. All underwent surgery. Surgery was classified according to extent of excision ranging from en bloc excision or debulking to palliative surgery...
March 2008: Journal of Neurosurgery. Spine
Alexander Bachmann, Robin Ruszat
The most recent advance in laser technology for transurethral prostatectomy is represented by the KTP laser. A potassium-titanyl-phosphate-(KTP-) crystal doubles the frequency of pulsed Neodymium: Yttrium-Aluminum-Garnet (Nd:YAG) laser energy to a 532 nm wavelength, which is in the green electromagnetic spectrum (Greenlight-laser) and is selectively absorbed by hemoglobin and not at all by water. Reducing the wavelength leads to a completely different interaction between laser beam and prostatic tissue. In contrast to the early clinical experiences with the Nd:YAG lasers in which vaporization was observed as a side-effect during the procedure, the new KTP laser offers an immediate and efficient vaporization, leading to real tissue ablation...
2007: Minimally Invasive Therapy & Allied Technologies: MITAT
G Siva Prasad, K N Chacko, D Antony, G Lionel, N S Kekre, G Gopalakrishnan
INTRODUCTION: The urinary bladder is commonly involved in pelvic malignancy. The incidence of apparent extension into adjacent organs in locally advanced colorectal malignancy is 5-12%. It is not known with other pelvic malignancy. No guidelines are available for its management. Often a dilemma exists between cystectomy and a bladder-sparing procedure. We studied the validity of bladder-sparing surgery (BSS) in locally advanced nonurological pelvic malignancy. METHODS: Hospital records of patients who underwent BSS along with other surgeries (abdomino-perineal resection, anterior resection, anterior exenteration, debulking surgery and total pelvic exenteration) from January 1992 to May 2003 were reviewed...
2006: Urologia Internationalis
M Jim Yen, Chih-Yi Hsu, Tsui-Lien Mao, T-C Wu, Richard Roden, Tian-Li Wang, Ie-Ming Shih
PURPOSE: Mesothelin is an emerging marker for cancer diagnosis and target-based therapy, yet relatively little is known about the clinical significance of mesothelin expression in tumors. In this study, we correlate mesothelin immunoreactivity to clinicopathologic features in ovarian serous carcinoma. EXPERIMENTAL DESIGN: Mesothelin expression levels were compared among 81 publicly available serial analysis of gene expression (SAGE) libraries of various carcinoma and normal tissue types...
February 1, 2006: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Ferenc A Jolesz, Kullervo Hynynen, Nathan McDannold, Clare Tempany
The history of MR-guided FUS demonstrates the need for merging advanced therapy technology with advanced imaging. Without the ability of MR imaging to localize the tumor margins and without the temperature-sensitive imaging that provides the closed-loop control of energy deposition, this method is inadequate for most clinical applications. Given these limitations,high-intensity focused ultrasound initially appeared to have a narrow application area and was not able to compete with other surgical or ablation methods...
August 2005: Magnetic Resonance Imaging Clinics of North America
Edmund Chun Yu Lee, Martin P R Tenniswood
The anti-androgens used in prostate cancer therapy have been designed to interfere with the normal androgen receptor (AR)-mediated processes that ensure prostate cell survival, triggering tumor cells to undergo programmed cell death. While anti-androgens were originally designed to treat advanced disease, they have recently been used to debulk organ-confined prostate tumors, to improve positive margins prior to surgery, and for chemoprevention in patients at high risk for prostate cancer. However, tumors treated with anti-androgens frequently become hormone refractory and acquire a more aggressive phenotype...
March 1, 2004: Journal of Cellular Biochemistry
Marcela G del Carmen, Brian Eisner, Christopher G Willet, Arlan F Fuller
Women with locally advanced primary or recurrent gynecologic malignancies have a poor prognosis. The doses of external radiation necessary to treat gross or microscopic recurrent disease in patients previously irradiated exceed the doses tolerated by normal tissue [1,3-5]. IORT has been added to the treatment armamentarium in this group of patients to maximize local control and minimize the radiation exposure to dose-limiting surrounding structures. In addition, IORT may improve the long-term local control and the overall survival rates in women with pelvic sidewall or para-aortic nodal recurrence [1,4,5]...
October 2003: Surgical Oncology Clinics of North America
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