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Lymphadenectomy in urology

X Durand, A Fléchon, T Murez, L Rocher, P Camparo, N Morel-Journel, P-H Savoie, L Ferretti, P Sèbe, A Méjean
INTRODUCTION: The purpose of the oncologic comitee of the french association of urology was to establish guidelines proposed by the external genital organ group, for the diagnosis, treatment and follow-up of the germ cell tumours of the testis. MATERIAL AND METHODS: The multidisciplinary working group studied 2013 guidelines, exhaustively reviewed the literature, and evaluated references and their level of proof in order to attribute grades of recommandation. RESULTS: The initial workup of testicular cancer is based on clinical, laboratory (AFP, total hCG, LDH) and imaging assessment (scrotal ultrasound and chest, abdomen and pelvis computed tomography)...
November 2016: Progrès en Urologie
Giovannalberto Pini, Surena F Matin, Nazareno Suardi, Mihir Desai, Inderbir Gill, James Porter, Robert J Stein, Rene Sotelo, Franco Gaboardi, Francesco Porpiglia
Lymph node dissection represents an essential surgical step in the treatment of the most commonly treated urological cancers. The introduction of robotic surgery has lead to the possibility of treating these diseases with a minimally invasive surgical approach, but the surgical principles of open surgery need to be carefully respected in order to achieve comparable oncological results. Therefore, the robotic approach to urological cancers must include a carefully performed lymph node dissection when indicated...
November 8, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Robert Foerster, Lara Schnetzke, Thomas Bruckner, Nathalie Arians, Harald Rief, Juergen Debus, Katja Lindel
BACKGROUND: Adjuvant radiotherapy (RT) for endometrial cancer (EC) may affect patients' quality of life (QoL). There is a paucity of data on prognostic factors for long-term QoL and sexual functioning. This study aimed to investigate such factors and assess the role of the vaginal dilator (VD). METHODS: QoL was assessed in 112 EC patients 6 years (median) after RT. QoL was compared to normative data, and the influence of age, tumor characteristics, lymphadenectomy, RT, and acute toxicities was assessed...
September 7, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Luca Luzzi, Giuseppe Marulli, Piero Solli, Giuseppe Cardillo, Marco Ghisalberti, Marco Mammana, Francesco Carleo, Lorenzo Spaggiari, Federico Rea
Objective We wanted to assess the prognostic factors and the efficacy of the treatment in patients who underwent lung resections for transitional cell carcinoma metastases. Materials and Methods This is a retrospective, multicenter study. Between January 1995 and May 2014, 69 patients underwent lung metastasectomy with curative intent. We evaluated primary site of the tumor, the role of adjuvant chemotherapy after urological operation, disease-free interval (DFI; lower or higher than 24 months), type of lung resection, number of lung metastases, presence of metastatic lymph nodes, and diameter of the metastasis (less or more than 3 cm)...
May 5, 2016: Thoracic and Cardiovascular Surgeon
Daniele Minardi, Guendalina Lucarini, Giulio Milanese, Roberto Di Primio, Rodolfo Montironi, Giovanni Muzzonigro
INTRODUCTION: BRCA1-associated protein 1 (BAP1) is a gene situated on chromosome 3p in a region that is deleted in more than 90% of renal cell carcinomas (RCCs). In the present study, we studied BAP1 immunohistochemical expression in a large series of conventional clear cell RCCs (ccRCCs) treated with radical nephrectomy; we assessed the prognostic value of their expression in terms of patients׳ survival at long-term follow-up. MATERIALS AND METHODS: A total of 154 consecutive patients with ccRCC were selected from a prospective database and considered for the study purpose; all patients were treated with radical nephrectomy and lymphadenectomy at our Institute of Urology between 1983 and 1985...
August 2016: Urologic Oncology
Amine Slaoui, Youness Jabbour, Anouar El Ghazoui, Tarik Karmouni, Khalid Elkhader, Abdelatif Koutani, Ahmed Ibn Attaya
UNLABELLED: The aim of our study was to report the status of penile cancer sites in the urology department at the University Hospital of Rabat and evaluate long-term results of surgical treatment of this cancer. PATIENTS AND METHODS: Between 1989 and 2015, 10 patients were treated for penile cancer. 10 cases were retrospectively reviewed and the following data were recorded: mode of revelation, seat, staging, TNM stage, treatment, evolution and survival. The mean age of patients was 58,1 years (48-81 years)...
2015: Pan African Medical Journal
V I Vtorenko, R N Trushkin, A E Lubennikov, O L Podkorytova, P I Motin
The article introduces a clinical example of a patient who was first diagnosed with bladder cancer, which contributed to the development of end-stage renal failure. Initially, given the significant upper urinary tract retention and post renal acute renal failure, the patient underwent bilateral percutaneous nephrostomy. Taking into account periodic gross hematuria, cystoscopy and transurethral electrocoagulation and biopsy of bladder tumor were performed and bladder cancer was identified. Despite adequate functioning of nephrostome drainage and daily urine output up to 3000 ml, kidney failure was not resolved...
March 2015: Urologii︠a︡
Thomas Kunit, Günter Janetschek
Although the standard approach of retroperitoneal lymphadnectomy (RLA) is open surgery, laparoscopy is an emerging technique in urology and reports of laparoscopic RLA are increasing. This article presents the indications, technique, and outcome of RLA as primary treatment and post-cisplatin-based chemotherapy by means of laparoscopy. In expert hands RLA is minimally invasive and reduces morbidity in comparison with open surgery, with the same oncologic outcome. However, patient selection is crucial.
August 2015: Urologic Clinics of North America
Brent Hollenbeck
BACKGROUND: Differences in quality of care may contribute to racial variation in outcomes of bladder cancer (BCa). Quality indicators in patients undergoing surgery for BCa include the use of high-volume surgeons and high-volume hospitals, and, when clinically indicated, receipt of pelvic lymphadenectomy, receipt of continent urinary diversion, and undergoing radical cystectomy instead of partial cystectomy. The authors compared these quality indicators as well as adverse perioperative outcomes in black patients and white patients with BCa...
May 2016: Urologic Oncology
F Herranz Amo, C Hernández Fernández, J M Cózar Olmo, B Miñana López, F Gómez-Veiga, A Rodríguez-Antolín, E Pedrosa
OBJECTIVE: To assess the adherence to the recommendations of the 2009 clinical guidelines in the implementation of lymphadenectomy during radical prostatectomy and analysis of the variables that influence this decision in the 2010 National Prostate Cancer Registry. MATERIAL AND METHOD: Analysis of 1,272 patients who underwent prostatectomy in 25 national hospitals. Patient classification according to the pathological node-positive (pN+) risk criteria included in the clinical guidelines of the European Association of Urology (EAU) and National Comprehensive Cancer Network (NCCN)...
November 2015: Actas Urologicas Españolas
Christofer Adding, Justin W Collins, Oscar Laurin, Abolfazl Hosseini, N Peter Wiklund
Open radical cystectomy with pelvic lymphadenectomy and urinary diversion is associated with a high complication rate. Robotic-assisted laparoscopic radical cystectomy is increasingly performed in many urologic surgical departments in an effort to reduce surgical stress and decrease perioperative morbidity. Robotic cystectomy survival studies demonstrate similar oncologic outcomes compared to the open procedure. Enhanced recovery protocols (ERP) after major surgery are multimodal perioperative interventions to reduce surgical stress, complications, and patient convalescence...
May 2015: Current Urology Reports
Alarick Picardo, Justin Vivian
BACKGROUND: The role and type of pelvic lymph node dissection for clinically localized prostate cancer is controversial in Australia. Our study aims to determine the incidence of pelvic lymph node involvement and the complication rate of extended lymphadenectomy in a group of West Australian patients who underwent a robotic assisted radical prostatectomy plus extended pelvic lymph node dissection. METHOD: Forty-nine patients underwent a robotic assisted radical prostatectomy with extended pelvic lymph node dissection between 2008 and 2012 by a single private urological surgeon...
December 2015: ANZ Journal of Surgery
Brian Hu, Hooman Djaladat
PURPOSE OF REVIEW: The lymph node dissection (LND) is an integral component of many oncologic surgeries. Better understanding of each cancer's behaviour and improvements in surgical techniques necessitate a critical analysis of lymph node disease and the optimal LND template. This review will focus on updates in managing lymph node disease in testicular, penile, upper tract urothelial and urethral cancer. RECENT FINDINGS: For testicular and penile cancer, advances have focused on reducing the morbidity associated with the standard templates of dissection while maintaining oncologic efficacy...
March 2015: Current Opinion in Urology
Cora N Sternberg, Iwona Skoneczna, J Martijn Kerst, Peter Albers, Sophie D Fossa, Mads Agerbaek, Herlinde Dumez, Maria de Santis, Christine Théodore, Michael G Leahy, John D Chester, Antony Verbaeys, Gedske Daugaard, Lori Wood, J Alfred Witjes, Ronald de Wit, Lionel Geoffrois, Lisa Sengelov, George Thalmann, Danielle Charpentier, Frédéric Rolland, Laurent Mignot, Santhanam Sundar, Paul Symonds, John Graham, Florence Joly, Sandrine Marreaud, Laurence Collette, Richard Sylvester
BACKGROUND: Patients with muscle-invasive urothelial carcinoma of the bladder have poor survival after cystectomy. The EORTC 30994 trial aimed to compare immediate versus deferred cisplatin-based combination chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder. METHODS: This intergroup, open-label, randomised, phase 3 trial recruited patients from hospitals across Europe and Canada. Eligible patients had histologically proven urothelial carcinoma of the bladder, pT3-pT4 disease or node positive (pN1-3) M0 disease after radical cystectomy and bilateral lymphadenectomy, with no evidence of any microscopic residual disease...
January 2015: Lancet Oncology
T Bschleipfer, A Hackethal, S Tacke, P Collet
BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) in urology is becoming more and more interesting due to technical innovations. One of those innovations is the HybridKnife®, a multifunctional sonde that combines high-frequency electrosurgery and water jet surgery. The aim of this study was to establish a transrectal, flexible endoscopic retroperitoneoscopy in a porcine model by means of the HybridKnife® for further development of a transrectal retroperitoneal NOTES lymphadenectomy (NOTES-RLA)...
December 2014: Der Urologe. Ausg. A
Octavio A Castillo, Vincenzo Borgna
OBJECTIVES: Chylous ascites and high-output chylous fistula are rare complications following abdominal or pelvic surgery. We report a series of five cases that occurred after pelvic lymph node dissection for urological cancer, in addition to their clinical presentation, diagnosis, and treatment. METHODS: The series comprises five patients; four men in whom robotic radical prostatectomy and extended pelvic lymphadenectomy were performed, and one woman with an infiltrating bladder cancer that underwent robotic anterior pelvic exenteration and extended pelvic lymphadenectomy...
November 2014: Archivos Españoles de Urología
M Maek, M Musch, G Arnold, D Kröpfl
BACKGROUND: Primary urethral cancer in males is a rare entity with only approximately 800 cases described, which is why it is difficult to formulate evidence-based guidelines for treatment. For tumors in the pT2 stage with a localization distal to the membranous urethra, a penis-preserving operation can be carried out. METHODS: In the period from November 2006 to February 2014 a total of 4 patients with primary urethral cancer underwent a penis-preserving urethral resection...
December 2014: Der Urologe. Ausg. A
Travis Pagliara, Andrew Nguyen, Badrinath Konety
Upper tract malignancies represent an estimated 5 %-10 % of urothelial cancers, with roughly 3,000 new cases per year in the United States. These tumors often present at an advanced stage, with invasion and lymph node metastases. There are no large randomized prospective studies demonstrating the benefit of lymph node dissection in upper tract urothelial cancer, and as such, definitive guidelines on the surgical template and timing are lacking. Laparoscopic and robotic-assisted surgical techniques are well-established for nephroureterectomy, but are also emerging for retroperitoneal lymph node dissection...
November 2014: Current Urology Reports
Charlotte Peeters, Diederik Ponette, Hendrik van Poppel
Prostate cancer is the most common male malignancy. Radiation therapy and radical prostatectomy are the main curative treatment options for organ confined disease. Despite the good long-term oncologic outcomes, roughly 40% of patients undergoing surgery develop biochemical recurrence, manifested as a rising prostate-specific antigen (PSA). Those patients are at higher risk of developing a local or distant recurrence. The diagnosis of a nodal recurrence is challenging. This report is about a 66-year-old male, who had a radical prostatectomy in 2006...
September 6, 2014: Urologia Internationalis
Zhiqiang Zhang, Jie Min, Dexin Yu, Haoqiang Shi, Dongdong Xie
The simultaneous occurrence of different histological types of adjacent neoplasms in the same organ is called a collision tumour, and rarely occurs in the kidney. A 63-year-old female presented to the urology department with a 1-month history of a painless hematuria. The computed tomography scans of the abdomen revealed 2 heterogeneous incidental right renal masses. The patient underwent radical nephrectomy including lymphadenectomy without adjuvant therapy. Histopathological examination showed a type 2 renal collision tumour of the papillary renal cell carcinoma with eosinophilic cytoplasm and pseudostratified nuclei on papillary cores, and chromophobe renal cell carcinoma characterized by large polygonal cells with transparent reticulated cytoplasm and prominent cell membranes, which exhibited sarcomatoid transformation in the local area...
July 2014: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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