The Frequency of Perirenal Fat Invasion according to Size and Protrusion Shape of Renal Cell Carcinomas / 대한비뇨기과학회지

Purpose: The perirenal fat surrounding a renal cell carcinoma (RCC) must be preserved during a surgical operation. However, the perirenal fat is often injured during an operation. In such cases, there is the possibility of cancer metastasis. The frequency of perirenal fat invasion and pathological features, according to the size and protrusion shape of RCCs were investigated. Materials and Methods: A retrospective reviewed 93 consecutive RCCs, resected at our institution, between January 1995 and June 2005, was conducted. The frequency of perirenal fat invasion, the pathologic T stage and nuclear grade, according to the size and protrusion shape of RCCs after a radical nephrectomy were also investigated. Eighty three out of 93 lesions were sub classified based on the percentage of the tumor extending from the normal parenchymal border; endophytic-less than 40%, mesophytic-40 to 60% and exophytic-greater than 60%. Results: Of the 93 lesions, 15 (16.1%) had perirenal fat invasion. Of the 38 lesions equal or smaller than 4cm, 2 (5.3%) had perirenal fat invasion, 4 (10.5%) a high T stage and 11 (28.9%) a high nuclear grade. Of the 33 lesions larger than 4cm, but equal or smaller than 7cm, 4 (12.1%) had perirenal fat invasion, 4 (12.1%) a high T stage and 12 (36.4%) a high nuclear grade. Of the 22 lesions larger than 7cm, 9 (40.9%) had perirenal fat invasion, 12 (54.5%) a high T stage and 17 (77.3%) a high nuclear grade. There were statistical differences in perirenal fat invasion, T stage and nuclear grade between lesions equal or smaller than 7cm and those larger than 7cm. The frequencies of perirenal fat invasion for endophytic, mesophytic and exophytic tumors were 12.2, 21.1 and 13.3% (6/49, 4/19 and 2/15), respectively, but there were no statistical differences in the percentages of perirenal fat invasion. The 5-year survival rates for patients without and with perirenal fat invasion were 91.9 and 72.7%, respectively (p=0.039). Conclusions: RCCs with a size of 4cm or smaller have a tendency for low perirenal fat invasion, but 5.3% of small RCCs had perirenal fat invasion. Therefore, an effort should be made to prevent possible metastasis by cautiously preserving the perirenal fat surrounding a renal mass during nephron sparing or minimally invasive surgery.

Prognostic Significance of E2F3 Expression in Bladder Cancer / 대한비뇨기과학회지

PURPOSE: E2F3 is important for cell cycle regulation and DNA replication. Recent studies have reported that members of the E2F family can play specific and diverse roles in the tumorigenesis of human malignancies, and the E2F3 expression appears to provide a growth advantage to tumor cells by activating cell proliferation in bladder tumors. We studied the prognostic significance of E2F3 expression in bladder cancer. MATERIALS AND METHODS: We examined the expression of E2F3 with using immunohistochemical staining in the tumor samples from 109 patients suffering with bladder cancer, and we analyzed the prognostic significance of E2F3 according to the grade, stage, recurrence and progression of bladder cancer. RESULTS: We found positive staining for E2F3 in 23 cases (21.1%). The E2F3 expression was correlated with the tumor stage (superficial vs. invasive, p<0.001) and the tumor grade (p=0.001). The E2F3 expression was not correlated with the recurrence and progression of superficial bladder cancer. CONCLUSIONS: In this study, our results showed that the E2F3 expression was observed in a portion of the bladder cancer specimens. These results suggest that E2F3 may contribute to the development of bladder cancer, but it may not play a role as a prognostic factor of bladder cancer.

Calcifying Fibrous Pseudotumor of the Spermatic Cord / 대한비뇨기과학회지

Calcifying fibrous pseudotumor is an uncommon benign soft tissue lesion that is newly recognized in the literature. It predominately occurs in young adults and it is mainly located in the extremities, trunk and neck. The pathologic features of calcifying fibrous pseudotumor are characterized by a hyalinized fibrous stroma, psammomatous or dystrophic calcifications and chronic inflammatory cells. The pathogenesis of calcifying fibrous pseudotumor is uncertain. Total excision of the lesion is curative and recurrence is rare. We report here on a case of calcifying fibrous pseudotumor of the spermatic cord that was discovered as a palpable inguinal mass in a 24-year-old man.

Long-term Follow-up Comparison between Intravaginal Slingplasty(IVS) and Tension-free Vaginal Tape(TVT) Procedure for Female Stress Urinary Incontinence

PURPOSE: Intravaginal slingplasty(IVS) is a alternative technique in the treatment of stress urinary incontinence in women. The author reports the long-term results of IVS procedure and compares to the long-term results of tension-free vaginal tape(TVT) procedure. MATERIALS AND METHODS: 25 women treated with IVS were compared to 25 women treated with TVT. The follow up period of all patients was mean of 30 months. All patients were preoperatively evaluated with detailed history, physical exam, 1 hour pad test and urodynamic study. Operation was carried out under general anesthesia. Operation time, hospitalization time, perioperative complication, cure rate and long-term follow-up data were evaluated. Long-term follow-up data was obtained from questionnaires on whether or not continuation of stress incontinence and subjective satisfaction. RESULTS: Two groups were similar in their mean ages, body mass index and mean parities. No patient demonstrated uninhibited detrusor contraction in cystometry. Mean operation time were 29.4 minutes(20~40), 31.6 minutes(25~40), and mean hopitalized duration were 3.3 days, 4.0 days for IVS and TVT, respectively. Perioperative bladder injury were 0 case(0%) and 2 cases(8%) and hemoglobin decrease were 1.5 gm/dl and 1.7 gm/dl for IVS and TVT, respectively. Vaginal erosion and infection were 1 case(4%) and 0 cases(0%) for IVS and TVT, respectively. Objectively, 3 months postoperative cured/improved/failed rates were 88%/12%/0%, 84%/16%/0% for IVS and TVT, long-term follow-up cured/improved/failed rates were 76%/20%/4%, 80%/12%/8% for IVS and TVT, respectively. Subjective satisfaction rates with the procedure were 80% and 88%, respectively. CONCLUSION: Both procedures had equally high rate of long-term cure, satisfaction and perioperative complication in the surgical treatment of stress urinary incontinence. IVS is simple, safe and effective treatment.