The Comparison of the Efficacy and Side Effects between M-VAC and GC Chemotherapy for Advanced or Metastatic Urothelial Carcinoma Patients with a Good Performance Status / 대한비뇨기과학회지

PURPOSE: We wanted to compare the efficacy and toxicity of chemotherapy with methotrexate, vinblastine, adriamycin, cisplatin(M-VAC) versus gemcitabine and cisplatin(GC) for patients with advanced or metastatic urothelial carcinoma. MATERIALS AND METHODS: Forty-nine patients diagnosed with advanced urothelial cell carcinoma and who were started on chemotherapy were divided into two groups. All of them had a 0-1 Eastern Cooperative Oncology Group performance status. 19 patients received M-VAC chemotherapy and 30 patients received the GC regimen. Among them, the subjects who completed more than 3 cycles of their recommended formula (13/19 for M-VAC, 28/30 for GC) were included in this study. They were evaluated for their overall response rate, the 5-year survival rate, toxicities and the drop-out rate. RESULTS: The overall response rate and median survival period of the M-VAC and G-C groups were 38%(5/13 cases) and 46%(13/28 cases), and 16.7 months and 43.9 months, respectively. The 5-year survival rates in the two groups were 10% in the M-VAC group and 46% in the G-C treated group(p=0.013). The main hematologic complication was leukopenia and this occurred in 10/19 patients and more than grade 3 leukopenia was noted in 4/10 patients in the M-VAC group and in 19/30 patients and more than grade 3 was noted in 10/19 patients in the GC group.The common non-hematologic side effects between the two groups were nausea/vomiting(84.2% vs 47.7%), alopecia(47.4% vs 26.7%), diarrhea(15.8% vs 16.7%), and nephrotoxicity(15.8% vs 6.7%), respectively. The drop-out rates were 31.6% in the M-VAC group and 6.7% with the GC group. CONCLUSIONS: For patients with a good performance status with advanced or metastatic urothelial carcinoma, GC chemotherapy is more effective and it has more tolerable toxicities than does the M-VAC regimen.

Adenomatoid Tumor of the Testis with Infiltration to the Seminiferous Tubules / 대한비뇨기과학회지

A 41-year-old man presented a bean sized, solid, painless left scrotal mass he'd had for 10 years. The mass was well demarcated and it showed homogeneous echogenecity on ultrasonography. Simple mass excision was performed and the specimen revealed a relatively well circumscribed mass lesion composed of dilated tubules with flattened lining cells. A focal infiltration to the seminiferous tubule and involvement of the biopsy margins were observed. The tubules had a positive reaction to the calretinin and anti-mesothelial antibody on immunohistochemical stain. Therefore, the tumor was diagnosed as adenomatoid tumor of the testis. Adenomatoid tumors of testis are rare benign neoplasms that are thought to originate from mesothelum. Most cases were reported in the epididymis, spermatic cord and testicular tunica, and rare cases were from the ejaculatory duct, prostate and adrenal gland. The findings of adenomatoid tumor infiltrating through the testis parenchyme and seminiferous tubule, like for our case, have not been previously reported in Korea.