ABSTRACT
PURPOSE: The incidence of flutamide-related liver toxicity was studied in 56 korean patients, treated for advanced prostate cancer with flutamide combined with a LHRH agonist or orchiectomy. MATERIALS AND METHODS: Serum glutamic oxaloacetic transaminase(SGOT), serum glutamic pyruvic transaminase(SGPT), total bilirubin and alkaline phosphatase were measured to assess liver function at baseline, 1, 2 and 3 months and every 3 months thereafter. When they were elevated three-fold or more than upper normal levels, we regarded it as a presence of liver toxicity. Viral marker studies (Hepatitis B, C) were performed in patients with elevated SGOT and/or SGPT after flutamide administration. RESULTS: Ten patients(17.9%) showed elevated SGOT and/or SGPT at an average of 3 months after flutamide administration. All patients who performed viral marker studies revealed negative results. Total serum bilirubin was elevated in three(5.4%) patients and clinical jaundice appeared in one(1.8%). All clinical and biochemical manifestations of liver toxicity disappeared within two months after discontinuation of flutamide and no sequelae was observed for 15 months. CONCLUSIONS: The Incidence of flutamide-Induced hepatotoxicity seems to be higher In Korea than in North America. But this might not be due to the fact that Korea is an endemic area of viral hepatitis. Further study will be necessary for the verification of dose-related toxicity of flutamide in Korean prostate cancer patients. We recommend liver function test periodically to patients treated with flutamide.
Subject(s)
Humans , Alanine Transaminase , Alkaline Phosphatase , Aspartate Aminotransferases , Bilirubin , Biomarkers , Flutamide , Gonadotropin-Releasing Hormone , Hepatitis , Incidence , Jaundice , Korea , Liver Function Tests , Liver , North America , Orchiectomy , Prostate , Prostatic NeoplasmsABSTRACT
PURPOSE: The incidence of lymph node metastases in patients undergoing radical cystectomy varies between 15% and 25%, and is related to the depth of invasion of primary tumor. Pelvic lymphadenectomy provides accurate staging information as well as therapeutic benefit in a selected group of patients without increased morbidity. We analyzed the incidence of lymph node metastases and survival rates in the patients with pathologically proven lymph node metastases to reassess the role of pelvic lymphadenectomy in the patients with transitional cell carcinoma of urinary bladder. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 215 patients with transitional cell carcinoma treated by radical cystectomy and pelvic lymphadenectomy from 1976 to 1996 who were followed for a mean 31.7 months and analyzed the incidence of pathologically proven lymph node metastases and survival rates according to pathological stage, histologic grade and cell morphology. RESULTS: Patient distribution according to pathological stage was 18 for pTa, 51 pT1, 44 pT2 36 pT3a, 42 pT3b, and 24 pT4. Mean follow up was 31.7 months. The overall 5-year survival rate was 67.9%. The 5-year survival rates according to pathological stage were 93.6% for pTa and pT1, 72.4% pT2, 47.2% pT3a, 52.2% pT3b, 49.6% pT4 The 5-year survival rates according to histologic grade were 100.0% for grade l, 80.1% grade ll, 57.0% grade lll. The overall incidence of lymph node metastases was 14%(30/215). The 5-year survival rates according to lymph nodes metastases were 72.5% for pN0, 30.3% pN1 and the 2-year survival rate was 41.5% for pN2. The incidence of lymph node metastases was 0% for pTa and pT1, 2.3% pT2, 11.1% pT3a, 38.1% pT3b, 37.5% pT4 and 0% for grade l, 7.2% grade ll, 19.0% grade lll. The 5-year survival rates according to pathological stage and lymph nodes metastases were 75.9% for pT3a or less with pN0,58.4% for pT3b or more with pN0, 26.7% for pT3b or more with pN1 or pN2. CONCLUSIONS: Lymph node metastases was a significant prognostic factor for transitional cell carcinoma of the urinary bladder. The incidence of lymph node metastases increased as pathological stage and histologic grade increased. Radical cystectomy with pelvic lymphadenectomy might be beneficial for a few patients with bladder confined tumor with lymph node metastases. Adjuvant therapy is recommended for transitional cell carcinoma of the urinary bladder with lymph node metastases for improved survival.
Subject(s)
Humans , Carcinoma, Transitional Cell , Cystectomy , Follow-Up Studies , Incidence , Lymph Node Excision , Lymph Nodes , Medical Records , Neoplasm Metastasis , Retrospective Studies , Survival Rate , Urinary BladderABSTRACT
On psychological aspect, premature ejaculation in psychosexual dysfunction is generally associated with anxiety. Psychiatrists consider that the treatment of choice for premature ejaculation is directive sextherapy with psychotherapy. We screened psychopathology according to the Symptom Checklist-90-Revision (SCL-90-R) in premature ejaculation group (n=120) and control group (n=92). The rate of abnormal RESULTS of both groups were similar as 5 (4.1%) in patient group and 4 (4.3%) in control group. And there was statistical significance in T scores on 5 symptom dimensions of Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety and Psychoticism, but all of the T scores of those dimensions were with in the normal range. The psychological personality test does not reflect all of the psychosexual factors. But with the psychological screening, we could find that the psychological factors are not absolutely associated with premature ejaculation.