Using three-dimensional model-based tumour volume change to predict the symptom improvement in patients with renal cell cancer.

In our recent study, we explored the efficacy of three-dimensional (3D) measurement of tumor volume in predicting the improvement of quality of life (QoL) in patients suffering from renal cell cancer (RCC), who were treated with axitinib and anti-PD-L1 antibodies. This study encompassed 18 RCC patients, including 10 men and 8 women, with an average age of 56.83 ± 9.94 years. By utilizing 3D Slicer software, we analyzed pre- and post-treatment CT scans to assess changes in tumor volume. Patients' QoL was evaluated through the FKSI-DRS questionnaire. Our findings revealed that 3D models for all patients were successfully created, and there was a moderate agreement between treatment response classifications based on RECIST 1.1 criteria and volumetric analysis (kappa = 0.556, p = 0.001). Notably, nine patients reported a clinically meaningful improvement in QoL following the treatment. Interestingly, the change in tumor volume as indicated by the 3D model showed a higher area under the curve in predicting QoL improvement compared to the change in diameter measured by CT, although this difference was not statistically significant (z = 0.593, p = 0.553). Furthermore, a multivariable analysis identified the change in tumor volume based on the 3D model as an independent predictor of QoL improvement (odds ratio = 1.073, 95% CI 1.002-1.149, p = 0.045).In conclusion, our study suggests that the change in tumor volume measured by a 3D model may be a more effective predictor of symptom improvement in RCC patients than traditional CT-based diameter measurements. This offers a novel approach for assessing treatment response and patient well-being, presenting a significant advancement in the field of RCC treatment.

[Diagnosis and treatment of prostatic abscess: Report of 11 cases and review of the literature].

OBJECTIVE: To analyze the clinical features, imaging characteristics, treatment options and prognosis of prostatic abscess (PA), and provide some new ideas for the diagnosis and treatment of the disease. METHODS: This retrospective study included 11 cases of confirmed PA treated in the Fifth Medical Center of PLA General Hospital. We analyzed the clinical data obtained from the electronic medical records, including basic demographic statistics, risk factors, clinical symptoms, laboratory results, imaging findings, treatment methods, treatment-related complications and outcomes. RESULTS: The 11 patients diagnosed with PA between May 2016 and August 2022 were aged (64.18 ± 7.19) years and all had at least 1 comorbidity, including 5 cases of diabetes mellitus (45.5%) and 8 cases of dysuria (72.8%). PA was confirmed in 3 cases by CT and in 8 cases by MRI, 6 (54.5%) multifocal and 10 (90.9%) >2 cm in diameter, with a median size of 3.84 cm. After admission, positive urine culture was found in 3 cases, positive blood culture in 1, Klebsiella pneumoniae in 2 and Enterococcus Faecalis in 1. Three of the patients were treated by intravenous administration of antibiotics alone, and the other 8 by transurethral PA unroofing in addition. Antibiotics medication lasted for a median of (12.9 ± 3.88) d and hospital stay averaged (19.18 ± 8.20) d. The patients were followed up for 3 months, which revealed the presence of PA in 2 of the cases treated with antibiotics alone, but not in any of the cases treated by surgery. CONCLUSION: PA is relatively rare and has no specific symptoms clinically. Imaging examination is very important for accurate diagnosis, and transurethral PA unroofing plus antibiotics administration could be considered as an optimal management of the disease.

Discovery of bladder cancer biomarkers in paired pre- and postoperative urine samples.

BACKGROUND: Bladder cancer (BC), a common cancer of the urinary system, has a low mortality but an extremely high recurrence rate. Patients who have undergone initial surgical treatment often undergo frequent prognostic examinations with a substantial burden of discomfort and costs. Urine samples can reflect early disease processes in the urinary system and may be an excellent source of biomarkers. METHODS: In the present study, we used the liquid chromatography with tandem mass spectrometry (LC-MS/MS) to perform proteomic analysis of pre- and postoperative urine samples from patients with stage III BC to identify biomarkers of cancer prognosis. Candidate biomarkers from proteomic analysis were simultaneously validated using western blotting in an independent cohort and immunohistochemical (IHC) staining, combined with gene expression data of BC samples in The Cancer Genome Atlas (TCGA). RESULTS: The comparison of pre- and postoperative urine samples from the same patients led to the discovery of several significantly differentially expressed proteins, whose functions could be closely related to the occurrence and development of BC. We confirmed a representative group of candidate biomarker molecules, such as cadherin-related family member 2 (CDHR2), heat shock protein beta-1 (HSP27), and heterogeneous nuclear ribonucleoproteins A2/B1 (HNRNPA2B1). CONCLUSIONS: The candidate biomarker molecules can distinguish between pre- and postoperative urine samples, and alterations in their expression levels are significantly associated with recurrence rates in patients with BC. Therefore, these molecules may become useful biomarkers for the monitoring and prognosis of BC.

A Risk Signature with Autophagy-Related Long Noncoding RNAs for Predicting the Prognosis of Clear Cell Renal Cell Carcinoma: Based on the TCGA Database and Bioinformatics.

BACKGROUND: Disorders of autophagic processes have been reported to affect the survival outcome of clear cell renal cell carcinoma (ccRCC) patients. The purpose of our study was to identify and validate the candidate prognostic long noncoding RNA signature of autophagy. METHODS: Transcriptome profiles were obtained from The Cancer Genome Atlas. The autophagy gene list was obtained from the Human Autophagy Database. Based on coexpression analysis, we obtained a list of autophagy-related lncRNAs (ARlncRNAs). GO enrichment analysis and KEGG pathway analysis were conducted to explore the functional annotation of these ARlncRNAs. Univariate and multivariate Cox regression analyses were conducted to elucidate the correlation between overall survival and the expression level of each ARlncRNAs. We then established a prognostic signature that was a linear combination of the regression coefficients from the multivariate Cox regression model (ß) multiplied by the expression levels of the respective ARlncRNAs in the training cohort. The predictive performance was tested in the validation cohort. Additionally, the independence of the risk signature was assessed, and the relationship between the risk signature and conventional clinicopathological features was explored. RESULTS: Seven autophagy-related lncRNAs with prognostic value (SNHG3, SNHG17, MELTF-AS1, HOTAIRM1, EPB41L4A-DT, AP003352.1, and AC145423.2) were identified and integrated into a risk signature, dividing patients into low-risk and high-risk groups. The risk signature was independent of conventional clinical characteristics as a prognostic indicator of ccRCC (HR, 1.074, 95% confidence interval: 1.036-1.113, p < 0.001) and was valuable in the prediction of ccRCC progression. CONCLUSION: Our risk signature has potential prognostic value in ccRCC, and these ARlncRNAs may play a significant role in ccRCC tumor biology.

An early experience of the robot-assisted laparoscopic nephroureterectomy without re-docking in a single position.

OBJECTIVE: This study aims to evaluate the execution of robot-assisted laparoscopic nephroureterectomy without repositioning the patient. METHODS: The clinical data of 9 patients who underwent robot-assisted laparoscopic nephroureterectomy between May 2017 and November 2018 were analyzed, proceeding in a single position, without repositioning the patient. This involved 5 men and 4 women, with an average age of 61.67 ± 10.37 years and an average body mass index (BMI) of 24.78 ± 3.84. We considered the duration of the intervention, the blood loss, the duration of the hospital stay, the duration of maintenance of the drainage and the follow-up on all patients, with or without complications and recurrence of the tumor. RESULTS: The intervention was completed in all 9 cases. The average duration of the intervention was 242.89 ± 13.37 minutes, the average blood loss was 166.67 ± 70.71 ml, the average hospitalization time was 2 ± 0.71 days, the average time drainage maintenance was 5.11 ± 1.05 days and the average follow-up times without complications and tumor recurrence were 12.56 ± 6.19 months. CONCLUSION: Robot-assisted laparoscopic nephroureterectomy without repositioning the patient during the procedure simplifies the procedure and shortens the duration of the procedure. It is also a safe, effective and feasible minimally invasive treatment method. KEY WORDS: Nephroureterectomy, Robot-assisted laparoscopic, Tumor recurrence, Single position, Upper tract urothelial carcinoma.