Impact of Visceral Fat on Survival and Metastasis of Stage III Colorectal Cancer

Background/Aims@#Previous studies have investigated the relationship between visceral obesity and the risk of colorectal tumors. Visceral obesity may affect the outcome of colorectal cancer (CRC), including survival and metastasis. We investigated the associations between visceral adipose tissue and oncologic outcomes in stage III CRC. @*Methods@#Four hundred seventy-two patients with stage III CRC were identified. Subcutaneous and visceral adipose tissue areas were measured volumetrically via computed tomography for each patient at different levels of the lumbar spine. After adjusting for age, sex, and other clinical factors, the effects of visceral adipose tissue area on mortality and recurrence were assessed using Cox proportional hazard regression. @*Results@#In univariate and multivariate analyses, a higher visceral adipose tissue to total adipose tissue (VT) ratio (hazard ratio [HR], 1.041; 95% CI, 1.008 to 1.075; p=0.015) and higher visceral adipose tissue to subcutaneous adipose tissue (VS) ratio (HR, 1.016; 95% CI, 1.005 to 1.028; p=0.006) were both associated with poor CRC-specific survival. Interestingly, in the evaluation of each site of recurrence, a higher VT ratio (HR, 1.069; 95% CI, 1.010 to 1.131; p=0.020) and higher VS ratio (HR, 1.024; 95% CI, 1.003 to 1.045; p=0.023) were both related to a higher risk of peritoneal seeding and tumor recurrence. The VT ratio at the L3–L4 level was significantly associated with a higher risk of peritoneal seeding and tumor recurrence (HR, 4.969; 95% CI, 1.303 to 18.949; p=0.019), while other levels showed no such relationship. @*Conclusions@#Visceral obesity is closely related to increased risks of CRC-specific mortality and peritoneal seeding metastasis in stage III CRC patients.

Comparison of the Efficacy of Urine Cytology and Fluorescence in Situ Hybridization (FISH) for the Detection of Bladder Urothelial Carcinoma / 대한비뇨기과학회지

PURPOSE: We compared the relative sensitivity and specificity between the urine cytology and fluorescence in situ hybridization (FISH) for the detection of urothelial carcinoma. MATERIALS AND METHODS: FISH was used a mixture of fluorescent labeled probes to the centromeres of chromosomes 3, 7 and 17, and band 9p21 (P16/CDKN2A gene). Washing urine specimens were analyzed from 37 patients, including 27 with a known bladder urothelial carcinoma and 10 without a history of urothelial carcinoma. The sensitivity and specificity of the FISH was compared to that of urine cytology. FISH positivity was defined as more than 2 urothelial cells with an abnormal signal copy number of any one out of 4 probes. RESULTS: In the bladder urothelial cancer group (n=27), the overall sensitivity of the urine cytology was 59.3% versus 88.9% for FISH (p=0.046). The sensitivity of urine cytology for pTa-1 (6 cases), and pT2-pT4 (11 cases) tumors were 37.5%, and 90.9%, respectively, and the sensitivity of FISH for pTa-1 (13 cases), and pT2-pT4 (11 cases) tumors were 81.3%, and 100%, respectively. The sensitivity of urine cytology were 33.3% (5 cases) for low grade tumors, and 91.7% (11 cases) for high grade tumors. The sensitivities of FISH were 80.0% (12 cases) for low grade tumors, and 100% (12 cases) for high grade tumors. FISH was significantly more sensitive than urine cytology for pTa-1 (p=0.021), low grade tumors (p=0.023) and all tumors (p=0.046). In the control group (n=10), the specificity of urine cytology and FISH was 90.0% and 100%, respectively (p=0.056). CONCLUSIONS: With these results, the sensitivity of FISH for the detection of urothelial carcinoma is superior to that of urine cytology, and the specificity of FISH and urine cytology for urothelial carcinoma are not significantly different. FISH, in particular, is more sensitive in the detection of low grade, low stage bladder tumors. Further prospective studies are required but FISH can successfully be used as supplementary methods to detect low grade, low stage urothelial tumors.

Two Cases of Duplicated Collecting System with Lower Pole Ureteropelvic Juncton Obstruction

Ureteropelvic junction obstruction and duplicated collecting system are common urologic anomalies in upper urinary system, but they seldom occur in combination. These obstruction can occur in both partial or complete duplicated collecting system. Complete duplication of the ureter may be asymptomatic or recognized when complications develop as a result of reflux into the lower pole ureter or obstruction of the upper pole with an ectopic ureterocele. It is difficult to choose an optimal therapy due to the high variability in function, degree of obsturction, damage and potential for regeneration in growing kidney. We report our experience of successful surgical interventions in the ureteropelvic junction obstruction of the lower pole with complete duplicated collecting system.