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<p><b>OBJECTIVE</b>To investigate the role of transurethral resection of the prostate (TURP) in the treatment of lower urinary tract obstruction due to advanced prostate cancer.</p><p><b>METHODS</b>A retrospective analysis was made of the clinical materials of 26 patients with advanced prostate cancer treated by TURP from May, 2002 to November, 2003.</p><p><b>RESULTS</b>Of the 26 patients, aged 56 - 92 years (75 on average), 3 were at Stage C and 23 at Stage D, and 9 had a history of urine retention, of whom 1 with renal function insufficiency received TURP after 1 month suprapubic drainage. There was little blood loss and no need for blood transfusion. Incontinence was temporary and no retention occurred after surgery. The international prostate symptom score (IPSS) and Karnofsky score improved significantly (29.7 +/- 4.6 versus 8.6 +/- 3.4 and 55 +/- 20 versus 77 +/- 32 respectively, P < 0.05).</p><p><b>CONCLUSION</b>TURP is a safe and efficient therapeutic option to relieve lower urinary tract obstruction due to advanced prostate cancer.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostatic Neoplasms , General Surgery , Quality of Life , Retrospective Studies , Transurethral Resection of Prostate , Urethral Obstruction , General SurgeryABSTRACT
Objective To explore the diagnosis and treatment of penile verrucous carcinoma,a distinctive variant of squamous cell carcinoma. Methods The clinical data of 8 patients (mean age,46 years) with penile verrucous carcinoma were analyzed retrospectively.All the tumors showed exophytic,papillary lesions,ranging from 2 to 6 cm in the greatest dimension.The tumors were located at glans in 5 patients and invaded to shafts in the other 3.The diagnosis was established by biopsy of the lesion.Three patients with tumor invading to shafts and 1 patient with large tumor at glans underwent partial penectomy, while the other 4 with the tumors localized at glans were treated by local excision. Results Histopathologic examination of the specimens confirmed tumors-free surgical margins in all the cases.The tumor cells were mostly well-differentiated.Fourteen months postoperatively,local recurrence occurred in 1 patient with local excision and partial penectomy was performed; postoperative follow-up of 9 years showed no recurrence and metastasis. During a follow-up of 4 to 13 years,the other 7 patients were disease-free.The patients with local excision of the tumors reported satisfaction of their sexual lives. Conclusions Verrucous carcinoma of penis is characterized by slow growth and a locally aggressive nature.It seldom develops metastasis to regional lymph nodes or distant areas.The prognosis is favorable after appropriate treatment.
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Objective To investigate the role of retroperitoneal lymph node dissection (RPLND) in the treatment of testicular cancer. Methods The clinical data of 39 cases (age range,20-58 years;median age,29 years) of germ cell tumor who underwent RPLND were retrospectively analyzed.Of the 39 cases,17 had the tumors on the left side and 22,on the right.One case was of seminoma,and the other 38 were of non-seminomatous germ cell tumor (NSGCT).According to the clinical examinations and radiology, 20 cases were of stage Ⅰ,15 of stage Ⅱ,and the rest 4 could not be staged. Results Of the 39 cases,10 with stage I tumors underwent nerve-sparing modified RPLND and the other 29 underwent bilateral RPLND.No metastasis was found in the dissected tissues in 22 cases,while metastasis,in 17 (including 4 of clinical stage I).All the patients with pathological metastases or elevation of blood tumor markers received postoperative chemotherapy.Follow-up was carried out for 1-149 months.The disease-free survival rate was 97.4%(38/39).Of the 10 cases receiving modified RPLND,8 regained their ejaculation function. Conclusions The probability of presence of the non-seminomatous components must be considered in the diagnosis and follow-up of seminoma cases,and the RPLND should be done if necessary.Nerve-sparing modified RPLND should be performed for clinical stage Ⅰ patients;while postoperative chemotherapy should be chosen for pathological stage Ⅱ patients.
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Objective To investigate the role of bisphosphates in the treatment of advanced prostatic cancer patients complaining of bone pain due to metastasis. Methods The clinical data of 40 cases of prostatic cancer with skeletal complications were retrospectively analyzed.Based on the post castrating conditions and therapeutic approaches,the 40 cases were divided into 3 groups.12 cases in Group A received oral androgen blockade plus bonefos,a type of bisphosphonates,following orchectomy;17 cases in Group B received oral androgen blockade following orchectomy;11 cases in Group C who had hormone refractory prostatic cancer receives oral bonefos.The severity of bone pain and quality of life before treatment and 2, 4 weeks after treatment were compared among the 3 groups using visual analogue score (VAS) and Karnofsky score of quality of life. Results Compared with the state of pre treatment,the patients got bone pain relief after 4 weeks’ treatment (VAS:7.3 vs 2.5 in Group A;7.6 vs 2.3 in Group B;7.9 vs 4.6 in Group C,respectively, P
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ObjectiveTo evaluate the therapeutic effect and toxicities of gemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma (TCC) of urinary tract. Methods Eighteen patients with advanced or metastatic TCC of urinary tract (15 cases of bladder TCC,2 of renal pelvic TCC,and 1 of ureteral TCC),who were pathologically confirmed,were treated with GC regimen (gemcitabine 1000 mg/m 2,iv infusion on day 1 and day 8;cisplatin 30 mg/m 2,iv infusion on day 2,day 8 and day 9).Before treatment, Karnofsy score for each patient was evaluated with a result of ≥60;liver and renal functions and blood routine test were normal.GC regimen was repeated for 2-3 cycles every 3-4 weeks and the response rate was evaluated.ResultsThree patients (16.7%) had complete response; 7(38.9%), partial response;5(27.8%),no response;and 3(16.7%) had progression.The overall response rate was 55.6%. The main toxic effects included decrease in white cell count (10 cases),anemia (7),nausea and vomiting (10) and constipation (8),which were mild or moderate and disappeared after stopping treatment.No chemotherapy-associated death occurred.ConclusionsGemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma of urinary tract is effective,and the toxicity is mild and tolerated. It is suggested that GC regimen can be used as the first line chemotherapy.
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Objective To investigate the protective effects of calcium channel blockade and oxygen free radical catalase on ESWL-induced kidney damage. Methods 120 female uninephrectomized rat models were randomizedly divided into six groups.After verapamil and(or) SOD injection,the kidneys were shocked 1 000 times at 14kV by ESW.Then ET level in kidney tissue,levels of NAG,MDA,ET in urine,variation of creatinine clearance (Ccr) and the kidney histopathological changes were evaluated. Results The variation of NAG and MDA level in urine and the Ccr in the therapeutic groups were significantly lower and the histopathological changes were also much slight than those in the control group. There was no significant difference of the biochemical and pathological changes when the dose of SOD increased from 20 thousand units to 40 thousand units per kg body weight. If verapamil was used, the levels of ET in kidney tissue and in urine both decreased.Combined use of SOD and verapamil can induce better protective effects. Conclusions Calcium channel blokade could decrease not only the degree of lipid overoxidation, but also the level of ET-relieve,so it can induce a marked protective effect on ESW-induced kidney damage and the effect could be much enhanced if combined with SOD.