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Lymphadenectomy in urology

Benjamin T Ristau, Judi Manola, Naomi B Haas, Daniel Y C Heng, Edward M Messing, Christopher G Wood, Christopher J Kane, Robert S DiPaola, Robert G Uzzo
PURPOSE: Lymphadenectomy (LND) is a well-established practice in many urologic malignancies; however, its role in renal cell carcinoma (RCC) is less clear. Our primary objective was to determine whether LND impacted survival in patients with fully resected high-risk RCC. PATIENTS AND METHODS: Patients with fully resected high-risk, non-metastatic RCC were randomized to adjuvant sorafenib, sunitinib, or placebo in the Adjuvant Sorafenib and Sunitinib for Unfavorable Renal Carcinoma (ASSURE) trial...
July 17, 2017: Journal of Urology
F Gómez-Veiga, A Rodríguez-Antolín, B Miñana, C Hernández, J F Suárez, J M Fernández-Gómez, M Unda, J Burgos, A Alcaraz, P Rodríguez, R Medina, J Castiñeiras, C Moreno, E Pedrosa, J M Cózar
OBJECTIVE: To assess the adherence to European Association of Urology (EAU) guidelines in the management of prostate cancer (PCa) in Spain. PATIENTS AND METHODS: Epidemiological, population-based, study including a national representative sample of 3,918 incident patients with histopathological confirmation during 2010; 95% of the patient's sample was followed up for at least one year. Diagnosis along with treatment related variables (for localized PCa -low, intermediate, high and locally-advanced by D'Amico risk stratification) was recorded...
March 9, 2017: Actas Urologicas Españolas
C Chahwan, A Doerfler, N Brichart, S Bouyé, T Culty, C Iselin, C Pfister, F Sallusto, L Salomon, G Verhoest, L Viart, X Tillou
INTRODUCTION: The surgical issues of renal transplantation (RT) after localized prostate cancer (PC) treatment and oncological outcomes after transplantation in patients on the waiting list with a history of PC were unknown. We conducted a retrospective multicentre study including all patients with PC diagnosed before the kidney transplantation. METHODS: Fifty-two patients were included from December 1993 to December 2015. The median age at diagnosis of PC was 59...
March 2017: Progrès en Urologie
Carla L Ellis, Lara R Harik, Cynthia Cohen, Adeboye O Osunkoya
Urologic pathology is evolving rapidly. Emerging trends include the expanded diagnostic utility of biomarkers and molecular testing, as well as adapting to the plethora of technical advances occurring in genitourinary oncology, surgical practice, and imaging. We illustrate those trends by highlighting our approach to the diagnostic workup of a few selected disease entities that pathologists may encounter, including newly recognized subtypes of renal cell carcinoma, pheochromocytoma, and prostate cancer, some of which harbor a distinctive chromosomal translocation, gene loss, or mutation...
April 2017: Archives of Pathology & Laboratory Medicine
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...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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...
December 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
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