ABSTRACT
Background: The study aimed to assess predictors and to identify patients at increased risk of prostate-cancer-specific mortality (CSM) after radical prostatectomy (RP). Methods: A total of 2421 men with localized and locally advanced PCa who underwent RP in 2001−2017 were included in the study. CSM predictors were assessed using multivariate competing risk analysis. Death from other causes was considered a competing event. Cumulative CSM and other-cause mortality (OCM) were calculated in various combinations of predictors. Results: During the median 8 years (interquartile range 4.4−11.7) follow-up, 56 (2.3%) of registered deaths were due to PCa. Cumulative 10 years CSM and OCM was 3.6% (95% CI 2.7−4.7) and 15.9% (95% CI 14.2−17.9), respectively. The strongest predictors of CSM were Grade Group 5 (GG5) (hazard ratio (HR) 19.9, p < 0.0001), lymph node invasion (HR 3.4, p = 0.001), stage pT3b-4 (HR 3.1, p = 0.009), and age (HR 1.1, p = 0.0007). In groups created regarding age, stage, and GG, cumulative 10 years CSM ranged from 0.4−84.9%, whereas OCM varied from 0−43.2%. Conclusions: CSM after RP is related to GGs, pathological stage, age, and combinations of these factors, whereas other-cause mortality is only associated with age. Created CSM and OCM plots can help clinicians identify patients with the most aggressive PCa who could benefit from more intensive or novel multimodal treatment strategies.
ABSTRACT
Horseshoe kidney is a challenge for vascular surgeon performing abdominal aortic aneurysm repair. First case of successful surgical treatment and positive remote result is described in Lithuanian medical press. Literature review of world surgical treatment experience is given. Operative technique depends upon anomalous kidney vascularization. Three types of vascularization are described. Rational operative approach and necessity of isthmotomy are discussed, investigation methods and treatment algorithm is presented.
Subject(s)
Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/surgery , Kidney/abnormalities , Aged , Algorithms , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography , Blood Vessel Prosthesis Implantation , Follow-Up Studies , Humans , Male , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
OBJECTIVE: We compared the efficacy of transurethral resection alone or transurethral resection followed by bladder instillations of Doxorubicin for 1 year in patients with superficial bladder carcinoma, and followed them long term for the incidence of recurrence and progression to muscle invasion. MATERIALS AND METHODS: Between December 1998 and December 2000 a total of 69 patients with superficial transitional cell carcinoma of bladder participated in this prospective study. Final analysis of treatment results included 64 patients. Doxorubicin was administered to 25 patients, 39 patients were treated only by TUR. Patients were followed by control cystoscopy. RESULTS: The mean follow-up was 22.95 months; SD 7.79. Mean time to first recurrence in Doxorubicin group was 14.14 months; SD 7.84, in TUR alone group - 7.61 months; SD 4.4; p>0.05. Disease free survival was significantly prolonged in Doxorubicin group; p<0.05. There are no significant difference to comparison recurrence rate and progression rate between two groups. CONCLUSIONS: In regard to time of first recurrence and disease free survival this study indicates that adjuvant chemotherapy with Doxorubicin is superior to transurethral resection alone. However, progression in stage or recurrence rate was not influenced by the treatment regimen.
