The effect of metabolic syndrome on prostate cancer final pathology.

AIM OF STUDY: Metabolic syndrome (MetS) is an abnormality that increases the risk of cardiovascular disease and diabetes. In the recent years, studies showed that MetS is associated with increased risk of incidence, aggressiveness, and mortality of prostate cancer (PCa). We examined the influence of MetS at final pathology in Turkish patients with PCa. MATERIALS AND METHODS: MetS was defined according to the American Heart Association, National Heart, Lung, Blood Institute, and International Diabetes Federation and requires any three of five components. The patients without and with MetS were in Group 1 and 2, respectively. Data were compared with independent sample t-test and Chi-squared test. RESULTS: There were 117 patients in the study. The patients' age was between 51 and 77 years with a median of 64.87 ± 5.65 and 62.29 ± 5.57, and prostate-specific antigen (PSA) level of the patients was 8.19 ± 5.35 and 8.68 ± 2.22 ng/ml in Group 1 and 2. Of these patients; Group 1 and 2 had 86 and 31 patients. High-grade PCa (Gleason >7) and advanced PCa (T3, T4) at final pathology were reported in 44.18-18.60% and 38.70-32.25% in Group 1 and 2. CONCLUSION: The patients with MetS are diagnosed significantly younger and had higher PSA levels than the other patients. Advanced disease of PCa is seen much more in patients with MetS.

Neutrophil-to-Lymphocyte Ratio in Renal Cell Carcinoma Patients.

BACKGROUND: Renal cell carcinoma is the third most common cancer after prostate and bladder tumors in urological malignancies. Recently, because of the widespread use of ultrasound and computed tomography, incidental and early stage renal tumors have been encountered more frequently. AIM: In this study, we evaluated the diagnostic efficacy of neutrophil-to-lymphocyte ratio for the diagnosis of renal cell carcinoma in patients who underwent nephrectomy operation. MATERIALS AND METHODS: The patients who underwent open surgery nephrectomy for the last eleven years were reviewed retrospectively. Patients diagnosed with other carcinomas (transitional cell carcinomas and other carcinomas) and had no complete blood count were excluded from the study. The patients were divided into two groups; Group 1 included the patients with benign renal tumor and chronic pyelonephritis, patients with renal cell carcinoma were in Group 2. RESULTS: There were 256 patients and 250 patients were in group 1 and 2. The median age of the patients and neutrophil lymphocyte ratio in the groups was 55 and 59 years and 1.97 and 2.35 respectively. There was statistically significant difference between the groups for age and neutrophil lymphocyte ratio (p<0.0001). The leukocyte values of the patients were calculated as 7600 and 8155 in groups, respectively and no significant difference was detected between the groups (0.1172). CONCLUSION: Neutrophil lymphocyte ratio is an easily accessible parameter which is used for prognosis in renal cell carcinoma. In this study, we found that neutro-phil lymphocyte ratio can be one of the diagnostic parameters for renal cell carcinoma in preoperative period.

Does Small Prostate Predict High Grade Prostate Cancer?

OBJECTIVE: The current is study aimed to assess the patients who underwent radical prostatectomy for prostate cancer and investigate the association between prostate size and adverse outcomes at final pathology. STUDY DESIGN: Comparative, descriptive study. PLACE AND DURATION OF STUDY: Haydarpasa Numune Training and Research Hospital, Turkey, from January 2008 to January 2016. METHODOLOGY: The patients treated with open radical prostatectomy for prostate cancer were reviewed. Patient characteristics including prostate specific antigen (PSA), free PSA levels, age, biopsy, and radical prostatectomy results were recorded. The patients whose data were complete or prostate weight was equal to or less than 80 gm, were included in the study. Patients with <40 gm prostate weight was in group 1 and the patients in group 2 had a prostate weight from 40 to 80 gm. High grade prostate cancer was defined to have a Gleason score between 7 or higher at biopsy and final pathology. Pathology and biopsy results were compared within groups. MedCalc Statistical Software demo version was used for statistical analyses. RESULTS: There were 162 patients in this study. Of these, 71 (43.82%) patients were in group 1 and 91 (56.17%) patients were in group 2. The age ranged from 49 to 76 years. Mean value of 62.70 ±6.82 and 65.82 ±5.66 years in group 1 and 2, respectively. Fifty (70.42%) and 68 patients (74.74%) had a Gleason score of 6 in group 1 and 2, respectively. Organconfined disease was reported in 53 patients (74.64%) in group 1 and in 78 patients (85.71%) in group 2. Gleason score concordance between biopsy and prostatectomy was reported in 61 patients (67.03%) and downgrading was detected in 4 patients (4.4%) in group 2. The median tumor volume of the patients was 4.47 cm3 in group 1 and 6 cm3 in group 2 (p=0.502). High grade prostate cancer was reported in 52.11% and 45.05% of the patients in groups 1 and 2, respectively at final pathology (p=0.373). CONCLUSION: The present study demonstrated that smaller prostates are more likely to compose higher percentage of the high grade prostate cancer, local advanced disease, and the Gleason upgrading. The positive surgical margin rate is higher in patients with small prostates when it is compared with the other patients.

Xanthogranulomatous Pyelonephritis.

INTRODUCTION: Xanthogranulomatous pyelonephritis is a chronic destructive granulomatous inflammation of the kidney. This pathology was firstly described in 1916 and a small number of patient series were reported in the literature. In this study, we aimed to report the patients with xanthogranulomatous pyelonephritis in our nephrectomy cases. METHODS: The patients who underwent nephrectomy and were diagnosed with xanthogranulomatous pyelonephritis in our hospital database were reviewed retrospectively. Preoperative laboratory results, radiological imaging findings, patients' age and history of predisposing diseases were recorded. RESULTS: A total of 13 cases of xanthogranulomatous pyelonephritis treated in our hospital from January 2003 to December 2015 were included in the study, consisting of 7 male and 6 female patients with a mean age of 56 ± 16.09 years. In urine analyse, pyuria was positive in 6 patients (46.15%) and leukocytosis was detected in one patient (7.7%). The disease site was the right kidney in 4 patients (30.7%) and the left kidney in 9 patients (69.23%). Radiological findings of the patients were pyonephrosis, renal ectasia, pyelonephritis, hydronephrosis, renal tumor, xanthogranulomatous pyelonephritis and non-functioning kidney with renal calculi. All patients were treated by open surgical techniques and perioperative and postoperative complications did not occur. Partial and radical nephrectomy was performed in one patient and the other patients were treated with simple nephrectomy. CONCLUSION: Xanthogranulomatous pyelonephritis is an uncommon histologic variant of the kidney for patients who are surgically treated for pyelonephritis. Early diagnosis and treatment is very important for decreasing morbidity and mortality. Although radical surgery is the main treatment of choice for patients with diffuse xanthogranulomatous pyelonephritis, nephron sparing surgery is an alternative for patients who have the focal form, if technically possible.