Research progress of sarcopenia as a prognostic marker of genitourinary tumors / 中华泌尿外科杂志

Sarcopenia is observed to have age-related loss of skeletal muscle mass, muscle strength and physical performance, which can be an effective prognostic indicator for postoperative complications and poor survival outcomes in tumor patients. Sarcopenia could reflect tumor-host interactions and has the advantages in accuracy and generality compared with traditional predictors. This paper reviews the research progress of sarcopenia in predicting the prognosis of genitourinary tumors.

Advances in the study of urinary exosomes as biomarkers of genitourinary tumors / 中华泌尿外科杂志

Exosomes are membranous vesicles secreted by a variety of cells,including tumor cells,with stable characters,which can reflect the physiological/pathological state of the source cells,indicating good sources of biomarkers for early diagnosis and prognosis of tumors.Urine exosomes are directly derived from the urinary system and play a more direct role in the diagnosis and prognosis of urinary system tumors.This paper reviews the recent advances in urinary exosomes as molecular markers for the early diagnosis of genitourinary tumors.

Advances in the study of urinary exosomes as biomarkers of genitourinary tumors / 中华泌尿外科杂志

Exosomes are membranous vesicles secreted by a variety of cells, including tumor cells, with stable characters, which can reflect the physiological/pathological state of the source cells, indicating good sources of biomarkers for early diagnosis and prognosis of tumors. Urine exosomes are directly derived from the urinary system and play a more direct role in the diagnosis and prognosis of urinary system tumors. This paper reviews the recent advances in urinary exosomes as molecular markers for the early diagnosis of genitourinary tumors.

Male Genitourinary Tumors : 14 Years Experience in Garhwal Region of India.

Genitourinary tumors may show varied clinical presentation and frequency in different regions of the world. The present study was therefore conducted to analyze the frequency, clinical presentation and the histopathological types of the various male genitourinary tumors diagnosed over a period of 14 years in a major teaching institute of north Himalayan region of India. Material and Methods: Retrospective study was undertaken in the Pathology department of the Institute which included all the cases of male genitourinary tumors which were diagnosed on histopathology from the time period between 1 Jan 1997 till 31st Dec. 2010. Results: The study showed that prostate was the most common site for male genitourinary tumors with prostatic adenocarcinoma as the most common histopathological type of tumor. Testicular Non- Hodgkin’s lymphoma constituted about 8% of total tumors in testes which mostly presented in elderly age group. Renal cell carcinoma (66.2%) was the most common tumor in kidney with much lower frequency of Wilm’s tumor (16.9%). Occasional rare tumors such as hemangioma of urinary bladder and schwannoma of penis were also seen over 14 years. Conclusion: The study concludes clinically patients were associated with more severe symptoms as they presented late to the hospital from the remote areas of this Himalayan region leading to late detection of tumors. Prostatic adenocarcinoma was the most common tumor while renal cell carcinoma was most common tumor in kidney. The present study provides valuable information to clinicians and pathologists regarding frequency, clinical presentation and histopathological types of male genitourinary tumors in this region which can be further used to formulate strategies for better management of these tumors.

Evaluación urodinámica en pacientes sometidos a braquiterapia por rabdomiosarcomas genitourinarios / Urodynamic evaluation in patients undergoing brachytherapy for genitourinary rhabdomyosarcoma

Introducción: El rabdomiosarcoma (RMS) es uno de los tumores sólidos pediátricos más frecuentes. Se ha descrito que la braquiterapia es una herramienta prometedora para tratar esta patología, presentando menos secuelas en los tejidos vecinos. Este estudio tiene como propósito objetivar las secuelas de la dinámica vesical, a través de evaluación con estudios urodinámicos (EUD) a pacientes pediátricos sometidos a cirugía conservadora más braquiterapia por RMS de origen uroginecológico.P acientes y Métodos: Revisión de casos de RMS uroginecológicos desde 2004 a 2011, manejados con braquiterapia pre y/o post operatoria, más quimioterapia preoperatoria. Se realiza estudio urodinámico invasivo y/o no invasivo para evaluar secuelas en función miccional. Resultados: Serie de 4 casos de pacientes con RMS genitourinarios sometidos a braquiterapia sola o asociada a cirugía resectiva: 2 de próstata, 1 vaginal y 1 vesical. Los estudios urodinámicos muestran una capacidad vesical disminuida en 1 paciente, mínima disminución en otro y 2 presentan capacidad normal para la edad. La acomodación del detrusor es adecuada en los 4 pacientes y no hay alteraciones en la función esfinteriana. Clínicamente todos los pacientes son continentes y no presentan sintomatología de disfunción miccional. Conclusiones: El RMS genitourinario es un tumor altamente invasivo y secuelante. La braquiterapia ha logrado un nivel de radiación óptimo que se enfoca en el área tumoral sin afectar mayormente tejidos vecinos. Esto implicaría menos probabilidades de producir efectos secundarios en la dinámica vesical. Hemos demostrado en esta serie, con evaluación urodinámica, que estos pacientes con RMS presentan mínimas alteraciones en la evaluación urodinámica y no tienen repercusión clínica post tratamiento. Trabajos futuros están orientados a evaluación urodinámica pre y post braquiterapia.

Introduction: Rhabdomyosarcoma (RMS) is one of the most common pediatric solid tumors. It has been described that brachytherapy is a promising tool to treat this pathology, presenting less sequelae in neighboring tissues. This study aims to objectify alterations in bladder function through evaluation with urodynamic studies (UDS) in pediatric patients undergoing conservative surgery plus brachytherapy due to urogynecological RMS. Patients and Methods: A review of cases of RMS urogynecological from 2004-2011, managed with pre and / or post-operative brachytherapy, and preoperative chemotherapy. Invasive and / or noninvasive Urodynamic Studies are performed to assess sequelae in voiding function. Results: A series of 4 cases of genitourinary RMS patients undergoing brachytherapy alone or combined with resection surgery: 2 prostate cases, 1 vaginal and 1 bladder case. Urodynamic studies show a decreased bladder in 1 patient, minimal decrease in another and 2 show normal capacity for the patients age. Detrusor compliance is adequate in the 4 patients and there are no alterations in sphincter function. Clinically all patients are continent and show no symptoms of voiding dysfunction. Conclusions: Genitourinary RMS are a highly invasive and invalidating tumor. Brachytherapy achieves optimal radiation level that focuses on the tumor area without greatly affecting neighboring tissues.This could imply less likelyhood to cause side effects in bladder dynamics. We have shown in this series, with urodynamic evaluation, that these patients with RMS have minimal alterations in urodynamic Studies and have no post-treatment clinical impact. Future work is aimed at evaluating urodynamics before and after brachytherapy.

Clinical Manifestations of Multiple Primary Neoplasms in Urologic Patients / 대한비뇨기과학회지

PURPOSE: Since the first description of multiple primary malignant neoplasms(MPNs) by Billroth, numerous studies concerning MPNs have been reported. We analyzed variable characteristics of MPNs in urologic tumor patients and try to offer useful clinical informations. MATERIALS AND METHODS: From January 1994 to September 1998, we have treated 1,230 patients who had at least one primary urologic cancer; 459 transitional cell carcinomas, 366 renal cell carcinomas, 325 prostatic cancers, 128 others. Among those patients, 99 patients(8.0%) had genitourinary multiple primary neoplasms(GU-MPNs). We reviewed the medical and pathologic records of these 99 patients with GU-MPNs. RESULTS: The incidence of MPNs was especially high in patients with renal cell carcinoma and bladder cancer than any other GU tract cancers. Renal cell carcinoma plus gastrointestinal malignancy and urothelial cancer plus cervix cancer were common combinations of MPNs in this study. Incidences of counterpart cancers were similar to the ranks of relative frequency of cancers in Korea except genitourinary cancers that were more common than the relative frequency of their own. 55 cases were synchronous and mean diagnostic interval was one month and eleven days. 36 cases of 44 metachronous MPNs developed within 5 years after the diagnosis of the first tumor. In synchronous MPNs, 29 second tumors(52.7%) were diagnosed by staging workup or during operation of the first tumor and 34 second tumors(77.3%) of metachronous MPNs were diagnosed by their own symptoms. CONCLUSIONS: Due to the improvements in the techniques for diagnosis and treatment of cancer and the prolonged average life span, occurrence of MPNs is no longer rare. Therefore importance of early diagnosis of MPNs is increasing. We recommend to keep in mind the possibility of MPNs especially in RCC and bladder cancers. We think further study is needed to delimitate the risk factors of MPNs.

The Urine Cytology on the Genitourinary Tumors / 대한비뇨기과학회지

Urinary cytology is rather simple diagnostic procedure for the detection of the urinary tract tumors, but has not yet been fully accepted by urologists. Since publication of the work in urinary cytology by Papanicolaou and Marshall in 1945, many studies with urine sediment smears have been reported. To evaluate the results of cytologic examination of the genitourinary tumors, we have compared with the results of biopsies which were performed at the Department of Urology, Korea University Hospital, during the period from April 1972 to September 1979. One hundred fifty patients were subjected to this examination, of which 81 cases were diagnosed as the genitourinary tumors histopathologically, while 69 cases were negative histologically. In 81 cases, 50 cases (61.7%) were negative in urinary, 9 cases (11.1%) doubtful and 22 cases(27.2%) positive.