ABSTRACT
PURPOSE: We evaluated the outcome of stage T1 transitional cell carcinoma of the bladder treated with local tumor resection and intravesical therapies. MATERIALS AND METHODS: Of 42 patients with stage T1 bladder cancer seen at our clinic during a 10-year period 38 were treated conservatively with local tumor resection, intravesical therapy and long-term followup. Bacillus Calmette-Guerin (BCG) was used as the primary intravesical agent since 1986. RESULTS: Of the 38 patients 15 had initial grade 2 or 2 to 3 tumors, including 9 (60%) who had at least 1 or more local recurrences but without disease progression. The remaining 23 patients had grade 3 or grades 3 to 4 stage T1 tumors, with local recurrence in 17 (74%) and disease progression in 8 (35%). Furthermore, 5 patients (22%) died of the metastasis despite salvage therapies. CONCLUSIONS: For patients with initial grade 2 or grades 2 to 3, stage T1 disease the risk of disease progression is low. Current management with local tumor resection and intravesical BCG is appropriate and should be continued. Patients with high grade, stage T1 disease are at particularly high risk for disease progression and BCG does not seem to decrease this risk effectively. Therefore, immediate cystectomy is appropriate and should be recommended.
Subject(s)
Adjuvants, Immunologic/administration & dosage , BCG Vaccine/administration & dosage , Carcinoma, Transitional Cell/therapy , Cystectomy , Urinary Bladder Neoplasms/therapy , Adjuvants, Immunologic/therapeutic use , Administration, Intravesical , Aged , BCG Vaccine/therapeutic use , Carcinoma, Transitional Cell/mortality , Carcinoma, Transitional Cell/surgery , Combined Modality Therapy , Follow-Up Studies , Humans , Neoplasm Recurrence, Local/epidemiology , Neoplasm Staging , Risk Factors , Survival Rate , Time Factors , Treatment Outcome , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/surgerySubject(s)
Genital Diseases, Male , Scrotum , Acute Disease , Adult , Age Factors , Analgesics/therapeutic use , Epididymitis/diagnosis , Epididymitis/etiology , Genital Diseases, Male/diagnosis , Genital Diseases, Male/surgery , Genital Diseases, Male/therapy , Gonorrhea/complications , Humans , Male , Radionuclide Imaging , Scrotum/pathology , Sodium Pertechnetate Tc 99m , Spermatic Cord Torsion/diagnosis , Spermatic Cord Torsion/diagnostic imaging , Spermatic Cord Torsion/surgery , Technetium , Testicular Neoplasms/diagnosis , Testis/diagnostic imaging , Testis/injuries , Testis/surgery , Tetracycline/therapeutic use , Trachoma/complications , UltrasonographyABSTRACT
Historically chronic bacterial prostatitis in the male human has been relatively resistant to antimicrobial chemotherapy. The pharmacokinetic theory of drug diffusion into the prostate is reviewed. A brief description of the various canine models utilized to quantitate antimicrobial drug diffusion is presented. Specific data concerning the diffusion of various antimicrobial agents are abstracted followed by a brief discussion of mechanistic explanations for the success or failure of drug therapy.
Subject(s)
Anti-Bacterial Agents/metabolism , Bacterial Infections/metabolism , Prostatitis/metabolism , Aminoglycosides/metabolism , Animals , Anti-Infective Agents, Urinary/metabolism , Cephalosporins/metabolism , Chronic Disease , Dogs , Kinetics , Male , Penicillins/metabolism , Prostatitis/etiology , Sulfonamides/metabolism , Tetracycline/metabolism , Trimethoprim/metabolismABSTRACT
The effect of chloroquine phosphate, a membrane stabilizing agent, on castration-induced involution in the prostate was investigated in adult Sprague-Dawley rats. Chloroquine phosphate (75 mg per kg of body weight) was administered daily by gastric tube on 4 consecutive days beginning 1 day before castration. Control rats received water. All animals were sacrificed 7 days after castration and the ventral prostates were analyzed. The chloroquine group had a mean prostatic weight 17 per cent greater than that of the water-fed control group (P less than 0.01) despite a modest loss in body weight. The activity of cathepsin D, a lysosomal enzyme, in the prostate of treated rats was double that measured in control rats. Histologically, prostates from chloroquine treated rats contained more lysosomal particles that were larger than those from control rats. Serum testosterone reached castrate levels in both groups of animals within 24 hr of castration. These results indicate that it is possible to reduce the rate of prostatic regression by chloroquine, although at a small magnitude, probably through the action of membrane stabilization.
