Incidence and treatment of malignant tumors of the genitourinary tract in renal transplant recipients

ABSTRACT Purpose: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. Materials and Methods: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. Results: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45 % of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow-up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow-up. Conclusions: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.

Prostate cancer / Cáncer de próstata

Abstract Prostate cancer is the most frequent tumor found in men worldwide and in Mexico in particular. Age and family history are the main risk factors. The diagnosis is made by prostate biopsy in patients with abnormalities detected in their prostate-specific antigen (PSA) levels or digital rectal exam (DRE). This article reviews screening and diagnostic methods as well as treatment options for patients diagnosed with prostate cancer.

Resumen El cáncer de próstata es el tumor más frecuente en hombres a nivel mundial, y de manera específica en México. Los principales factores de riesgo son la edad y la historia familiar. El diagnóstico se obtiene por medio de biopsia prostática en pacientes detectados por anormalidades en el antígeno prostático o tacto rectal. En este artículo se hace una discusión de los métodos de tamizaje, diagnóstico y opciones de tratamiento en pacientes con diagnóstico de cáncer de próstata.

Estenosis ureteropiélica, tratamiento quirúrgico / Surgical treatment of ureteropelvic junction obstruction

Introducción: En la actualidad existen múltiples opciones de tratamiento para la estenosis ureteropiélica (EUP). La pieloplastia abierta es el estándar de oro, con una tasa de éxito mayor a 90%. El objetivo de este estudio es describir nuestra experiencia en el manejo quirúrgico de la EUP. Material y Métodos: Estudio retrospectivo y descriptivo de los casos de EUP manejados quirúrgicamente en el periodo comprendido entre 1970 y 2002. Resultados: Se diagnosticaron 126 EUP en 114 pacientes. Los principales síntomas fueron: dolor en 105 pacientes (92.1%), infección de vías urinarias en 37 (32.4%) y hematuria en 24 (21%). Las patologías asociadas con mayor frecuencia fueron: urolitiasis en 34 casos, cruce vascular en 10, y riñón en herradura en 5. Se realizaron 123 procedimientos: 92 (74.8%) pieloplastias desmembradas, 13 (10.7%) pieloplastias tipo Foley Y-V, en 8 (6.5%) sólo liberación de vasos anómalos o bridas, 5 (4%) endopielotomías, 2 pieloplastias tipo Scardino-Prince (1.6%), 2 pacientes transplantados (1.6%), con anastomosis de la pelvis del injerto al uréter nativo y una anastomosis ureteroileal (0.8%) en un paciente con fibrosis retroperitoneal. El tiempo promedio de seguimiento fue de 33.2 meses. En 114 pacientes (92.7%) el procedimiento fue exitoso. Se documentó 17.9% de complicaciones globales, 2.4% correspondió a reestenosis asociadas a cruce vascular. Conclusión: La pieloplastia desmembrada es el procedimiento más utilizado en pacientes con EUP con adecuados resultados, preservación de la función renal, mejoría de los síntomas y baja morbilidad.

INTRODUCTION: Currently there are many therapeutic options for ureteropelvic junction obstruction (UPJO). Open pyeloplasty is the gold standard with a success rate of approximately 90%. We describe our experience in the treatment of UPJO. MATERIAL AND METHODS: We conducted a retrospective and descriptive study among our patients with UPJO surgically treated at the Department of Urology of our institution from 1970 to 2002. RESULTS: 126 UPJO were diagnosed in 114 patients. The most common symptoms at diagnosis were: pain in 105 patients (92.1), urinary tract infection (UTI) in 37 (32.4%) and hematuria in 24 (21%). The most common associated diseases were urolithiasis in 34 cases, crossing vessels in 10 and horseshoe kidney in 5. 123 procedures were undertaken: 92 (74.8%) dismembered pyeloplasties, 13 (10.7%) Foley Y-V pyeloplasties, in 8 (6.5%) release of crossing vessel, 5 (4%) endopyelotomies, 2 (1.6%) pyeloplasties Scardino-Prince, 2 patients with renal allograft in whom an anastomosis of renal pelvis to native ureter was performed and 1 (0.8%) ureter-ileal anastomosis in a patient with retroperitoneal fibrosis. The mean follow-up time was of 33.2 months. In 114 (92.7%) patients the procedure was successful. The overall complication rate was of 17.9% of which 2.4% were stricture recurrence associated with crossing vessels. CONCLUSION: Open dismembered pyeloplasty is the most common treatment procedure for UPJO at our institution. We report successful results, low morbidity, preservation of renal function and improving symptoms.