Prognostic Factors and Clinical Outcomes of Urological Soft Tissue Sarcomas

PURPOSE: The purpose of this study was to elucidate prognostic factors for survival and clinical outcomes of rological soft tissue sarcomas (STSs). MATERIALS AND METHODS: This was a retrospective review of the medical records of 48 patients with urological STS treated from January 1982 to July 2009. Demographic and pathological characteristics were compared. Patients' demographics, clinico-pathological parameters, overall survival, and the factors expected to predict survival, such as sex, age at diagnosis, primary organ, surgical resection, metastasis, and mass size, were analyzed. We evaluated differences in survival on the basis of histological subtype by Kaplan-Meier analysis and multivariate Cox proportional hazards regression. RESULTS: The study included 34 males (70.8%) and 14 females (29.1%). The mean age at diagnosis was 47.1 years (range, 3 to 80). The most common site was the retroperitoneum (n=16), followed by the kidney (n=12), prostate (n=10), bladder (n=7), ureter (n=1), and paratesticular region (n=1). Nineteen patients (39.5%) had other organ metastases at diagnosis. The most common subtypes of sarcoma were leiomyosarcoma (50%), rhabdomyosarcoma (18.7%), and liposarcoma (8%). The remaining 11 cases had other histological subtypes (22.9%). Mean tumor size was 9.5 cm (range, 2.2 to 24). Thirty-three patients (68.7%) underwent surgical resection. The overall survival rate at 5 years was 51.4%. In the univariate and multivariate analysis, surgical resection, primary tumor site, and metastasis at diagnosis remained significant predictors of prognosis. Patients with retroperitoneal sarcoma had a higher overall survival rate by 5 years compared with patients with other organ sarcoma. CONCLUSIONS: The overall survival rate at 5 years was 51.4%. Surgical resection, primary tumor site, and metastasis at diagnosis remained significant predictors of prognosis.

Prognostic Significance of Methylation Profiles in Urothelial Carcinomas of the Bladder

BACKGROUND: Study on epigenetics of urothelial carcinomas has expanded and allowed better understanding of their correlation with clinicopathologic features. The aim of this study was to determine reliable predictive epigenetic markers for patients with urothelial carcinoma of urinary bladder. METHODS: In 64 urothelial carcinomas of the urinary bladder, methylationspecific polymerase chain reaction with RAS association domain family 1A (RASSF1A), adenomatous polyposis coli (APC), death-associated protein-kinase (DAPK), runt-related transcription factor 3 (RUNX3), p14, p16 and MGMT was performed and correlated the results with p53 mutations, DNA ploidy, clinicopathologic parameters and recurrences. RESULTS: Hypermethyation of RASSF1A, APC, DAPK, RUNX3, p14, p16 and MGMT promoters was observed in 35 (54.7%), 29 (45.3%), 18 (28.1%), 18 (28.1%), 9 (14.1%), 2 (3.1%), and 6 (9.4%) cases, respectively. Hypermethylation of RUNX3 and APC was significantly associated with high histologic grades and aneuploidy. Methylation of DAPK was significantly associated with muscle invasion. Methylation of DAPK and RUNX3 genes was significantly associated with recurrence. In survival analyses, methylation of RUNX3 gene and methylation-high (methylation at two or more loci) phenotype was significantly associated with poor recurrence-free survival. CONCLUSIONS: Methylation of RUNX3 gene and methylation-high phenotype are significant indicator of recurrence.

Effects of Androgen on Expression of Androgen Receptor mRNA and Penile Erection in the Rat / 대한비뇨기과학회지

PURPOSE: Although it is well known that androgens have beneficial effects on erectile dysfunction, their precise roles have been contentious. Recently it has been shown in the rat that castration induces loss of penile reflexes and considerable reduction in the erectile response to electrical stimulation(ES) of the cavernosal nerve. Both of these effects can be reversed by testosterone replacement. In this study, we have investigated the effects of androgen on the expressions of androgen receptor(AR), penile reflex(glans engorgement, cup, flip), erectile response to electrical stimulation, and penile NOS activity. MATERIALS AND METHODS: Male Sprague-Dawly rats(300-35Og) were castrated and implanted with silastic brand silicone tube containing dihydrotestosterone (DHT) or testosterone with or without daily injections of the 5a-reductase inhibitor(MK434). Animals of control groups were either sham operated or castrated with no androgen supplementation. All animals were maintained for 7 days under normal animal house conditions. Penile tissues were removed and processed either for Northern hybridization using [a-32P]UTP-labelled cKNAs and for measurement of NOS activities. In penile reflex, number of glans engorgement. flip and cup were measured in each group and compared with control. And, ES-induced intracarvenosal pressure(ICP)/systolic blood pressure(SBP) ratio and penile NOS activities of each groups were compared with control. RESULTS: Penile AR mRNA expressions were down-regulated by androgen Penile reflex erection was significantly reduced in castrated group and restored to the control level by androgen supplementation. However, the reflex erection was decreased in MK434-treated group. Erectile response to ES and penile NOS activity of each group showed similar patterns. CONCLUSIONS: These results showed that androgen might play a important role in regulation of penile erection and its actions were mediated by AR. Androgens, especially DHT, were essential modulators of the normal penile function including erectile relaxation of the cavernous smooth muscle, their effects being mediated, at least partially, by changes in nitric oxide synthase levels.