RESUMO
We aimed to evaluate the current nationwide trend, efficacy, safety, and quality of life (QoL) profiles of hormone treatment in real-world practice settings for prostate cancer (PCa) patients in Korea. A total of 292 men with any biopsy-proven PCa (TanyNanyMany) from 12 institutions in Korea were included in this multi-institutional, observational study of prospectively collected data. All luteinizing hormone-releasing hormone (LHRH) agonists were allowed to be investigational drugs. Efficacy was defined as (1) the rate of castration (serum testosterone ≤50 ng dl-1) at 4-week visit and (2) breakthrough (serum testosterone >50 ng dl-1 after castration). Safety assessments included routine examinations for potential adverse events, laboratory tests, blood pressure, body weight, and bone mineral density (BMD, at baseline and at the last follow-up visit). QoL was assessed using the Expanded Prostate Cancer Index Composite-26 (EPIC-26). The most common initial therapeutic regimen was LHRH agonist with anti-androgen (78.0%), and the most commonly used LHRH agonist for combination and monotherapy was leuprolide (64.0% for combination and 58.0% for monotherapy). The castration and breakthrough rates were 78.4% and 6.6%, respectively. The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment. In addition, the mean BMD T-score was significantly lower at the last follow-up (mean: -1.950) compared to baseline (mean: -0.195). The mean total EPIC-26 score decreased from 84.8 (standard deviation [s.d.]: 12.2) to 78.3 (s.d.: 8.1), with significant deterioration only in the urinary domain (mean: 23.5 at baseline and 21.9 at the 4-week visit). These findings demonstrate the nationwide trend of current practice settings in hormone treatment for PCa in Korea.
Assuntos
Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Colesterol/sangue , Quimioterapia Combinada , Leuprolida/uso terapêutico , Neoplasias da Próstata/patologia , Qualidade de Vida , Receptores LHRH/agonistas , República da Coreia , Testosterona/sangue , Resultado do Tratamento , Triglicerídeos/sangueRESUMO
PURPOSE: While the safety and efficacy of laparoscopic adrenalectomy are relatively well documented, this procedure remains challenging for pheochromocytoma. The purpose of our investigation was to assess the perioperative profiles of laparoscopic adrenalectomy (LA) with those of open adrenalectomy (OA) in patients with pheochromocytoma. MATERIALS AND METHODS: Between January 1997 and October 2005, 31 patients with pheochromocytoma underwent surgical removal, including 15 LA and 16 OA. The LA was performed via a lateral decubitus transperitoneal approach. The mean tumor size was similar in both groups (LA 6.0cm vs. OA 5.7cm). All patients underwent extensive preoperative medical preparation with alpha-blockers. The intraoperative hemodynamic instabilities and perioperative profiles were retrospectively analyzed. RESULTS: No conversion to open surgery was required with either procedure and no mortality was observed. Hypertensive crisis (systolic blood pressure>200mmHg) and severe tachycardia (heart rate>100/min) were more common in the OA group (LA 13.3 and 26.7% vs. OA 56.3 and 62.5%). The mean operating times for both groups were similar (LA 182.0+/-47.0 min vs. OA 183.1+/-66.5 min), but the duration of hospitalization was shorter in the LA group (LA 5.3+/-2.2 days vs. OA 6.8+/-1.0 days). The estimated blood loss was greater in the OA group (LA 103.3+/-44.2ml vs. OA 159.4+/-66.8ml). Intravenous morphine was needed in 56.3% of the OA, but in only 13.3% of the LA group. There were no significant differences in the postoperative complications between the two groups. CONCLUSIONS: The laparoscopic resection of pheochromocytomas can be accomplished safely and effectively. A short hospital stay, with minimal perioperative morbidity and the eradication of endocrinopathy, support the minimally invasive approach for adrenalectomy in patients with pheochromocytoma.
Assuntos
Humanos , Adrenalectomia , Conversão para Cirurgia Aberta , Hemodinâmica , Hospitalização , Laparoscopia , Tempo de Internação , Morfina , Mortalidade , Feocromocitoma , Complicações Pós-Operatórias , Estudos Retrospectivos , TaquicardiaRESUMO
PURPOSE: Laparoscopic Burch colposuspension (LBC) is a feasible surgical procedure for stress urinary incontinence (SUI). Initially, transperitoneal laparoscopic Burch (TLBC) operation was performed, but lately, extraperitoneal laparoscopic Burch colposus pension (ELBC) has been developed as a minimally invasive procedure. The aim of this study is to compare the safety and efficacy of TLBC versus the ELBC in treating the women with SUI. MATERIALS AND METHODS: We retrospectively compared 13 cases TLBC with 30 cases ELBC performed between April 1995 and September 1998. Parameters of evaluation included operation time, length of postoperative hospital stay, postoperative catheter ization days, complications, and cure rate. RESULTS: There were no statistically significant differences between the two approaches in operation time and postoperative catheterization days. The postoperative hospital stay of ELBC was statistically shorter than that of TLBC. The mean times to follow-up were 51.2 months (TLBC) and 32.3 months (ELBC). At last follow-up, success rate were 11 of 13 (84.6%) of TLBC and 27 of 30 (90%) of ELBC. The postoperative complication rate were 8 of 13 of TLBC and 14 of 30 of ELBC. As results, ELBC and TLBC are considered as effective surgical method for stress urinary incontinence due to hypermobility. CONCLUSIONS: ELBC and TLBC are considered as effective surgical method for stress urinary incontinence due to hypermobility.