Correlación entre el índice neutrófilo/linfocito y las puntuaciones de riesgo en el cáncer de vejiga no músculo-invasivo / Correlation of neutrophil-lymphocyte ratio and risk scores in non-muscle invasive bladder cancer

Objetivos: El objetivo del presente estudio es evaluar la correlación entre la puntuación de riesgo de la Organización Europea para la Investigación y Tratamiento del Cáncer (EORTC, por sus siglas en inglés) y el índice neutrófilo/linfocito (INL) en pacientes con cáncer de vejiga no músculo-invasivo, y la relación entre el INL y los grupos de riesgo. Métodos: Se revisaron retrospectivamente los datos de 212 pacientes con cáncer de vejiga no músculo-invasivo incluidos en el estudio. Los tumores se clasificaron de acuerdo con el sistema de la Organización Mundial de la Salud de 1973 y el sistema TNM de estadificación (tumor, ganglio y metástasis) de 2002. Siguiendo las directrices de la Asociación Europea de Urología, se llevó a cabo la estratificación de los pacientes en grupos de bajo, intermedio y alto riesgo para recidiva y progresión. El día previo a la operación se midieron y analizaron los valores séricos del INL para determinar el valor basal de neutrófilos y linfocitos. Resultados: De los 212 pacientes, 193 eran hombres y 19 mujeres. La media de edad fue 66,7. La puntuación media de INL fue de 3,04 ± 2,11. Se encontró una mayoría de tumores T1, tumores G3, tumores múltiples y tumores > 3 cm en pacientes con INL > 2,41. Tras comparar los 3 grupos de riesgo, se obtuvieron tasas de INL significativamente mayores en los pacientes del grupo de alto riesgo (p < 0,001). Al evaluar la correlación entre las puntuaciones de recidiva y progresión del INL y la EORTC, se observó que un valor elevado del INL se asocia a un aumento significativo en la puntuación de recidiva (r = 0,252; p < 0,001) y progresión (r = 0,145; p = 0,034). Conclusiones: Este estudio demostró la asociación entre un INL alto con los tumores T1, de grado alto, tumores múltiples, tumores > 3 cm y con el grupo de alto riesgo EORTC en pacientes con cáncer de vejiga no músculo-invasivo. También hubo una correlación positiva de la recidiva y progresión entre INL y EORTC

Objectives: Aim of this study is to evaluate the correlation between European Organization for Research and Treatment of Cancer (EORTC) risk score and neutrophil-lymphocyte ratio (NLR) in patients with non-muscle invasive bladder cancer and the relationship between NLR and risk groups. Methods: We retrospectively reviewed data of 212 patients with non-muscle invasive bladder cancer were included in the study. The tumors were graded according to the 1973 World Health Organization grading system and the tumor node metastasis (TNM) 2012 staging system. Patients were categorized low, intermediate and high risk for recurrence and progression, according to European Association of Urology guidelines. Serum values for the NLR were measured on the day before the operation to ascertain the baseline value for neutrophil and lymphocyte counts and statistically analyzed. Results: Of the 212 patients, 193 were male and 19 were female. Mean age was 66.7. Mean NLR score was 3.04 ± 2.11. T1 tumors, G3 tumors, multiple tumors and > 3 cm tumors seen mostly in patients with NLR > 2.41. Low, intermediate and high risk groups compared and NLR rates were significantly higher in high risk group patients (P < .001). When the correlation between NLR and EORTC recurrence and progression scores was evaluated, it was observed that as NLR value increased, recurrence (r = 0.252, P < .001) and progression (r = 0.145, P = .034) scores increased significantly. Conclusions: This study demonstrated the association of high NLR value with T1 tumor, high grade, multiple tumor, > 3 cm tumor and EORTC high risk group in non-muscle invasive bladder cancer patients. There was also a positive correlation between NLR and EORTC recurrence and progression scores

Correlation of neutrophil-lymphocyte ratio and risk scores in non-muscle invasive bladder cancer. / Correlación entre el índice neutrófilo/linfocito y las puntuaciones de riesgo en el cáncer de vejiga no músculo-invasivo.

OBJECTIVES: Aim of this study is to evaluate the correlation between European Organization for Research and Treatment of Cancer (EORTC) risk score and neutrophil-lymphocyte ratio (NLR) in patients with non-muscle invasive bladder cancer and the relationship between NLR and risk groups. METHODS: We retrospectively reviewed data of 212 patients with non-muscle invasive bladder cancer were included in the study. The tumors were graded according to the 1973 World Health Organization grading system and the tumor node metastasis (TNM) 2012 staging system. Patients were categorized low, intermediate and high risk for recurrence and progression, according to European Association of Urology guidelines. Serum values for the NLR were measured on the day before the operation to ascertain the baseline value for neutrophil and lymphocyte counts and statistically analyzed. RESULTS: Of the 212 patients, 193 were male and 19 were female. Mean age was 66.7. Mean NLR score was 3.04±2.11. T1 tumors, G3 tumors, multiple tumors and>3cm tumors seen mostly in patients with NLR>2.41. Low, intermediate and high risk groups compared and NLR rates were significantly higher in high risk group patients (P<.001). When the correlation between NLR and EORTC recurrence and progression scores was evaluated, it was observed that as NLR value increased, recurrence (r=0.252, P<.001) and progression (r=0.145, P=.034) scores increased significantly. CONCLUSIONS: This study demonstrated the association of high NLR value with T1 tumor, high grade, multiple tumor,>3cm tumor and EORTC high risk group in non-muscle invasive bladder cancer patients. There was also a positive correlation between NLR and EORTC recurrence and progression scores.

Can haematologic parameters be used for differential diagnosis of testicular torsion and epididymitis?

A differential diagnosis of testicular torsion and epididymitis has serious importance for testicular health. In emergency conditions, if testicular torsion goes unnoticed and epididymo-orchitis is diagnosed, organ loss may occur. This study aimed to evaluate the usefulness of haematologic parameters for the diagnosis of both testicular torsion and epididymo-orchitis and for differential diagnosis of these two diseases. Patients were divided into three groups as those undergoing surgery for testicular torsion, those receiving medical treatment for epididymitis and a healthy control group. All patients had complete blood counts taken with determinations of mean platelet volume (MPV), platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR) and leucocyte counts. These were then compared between groups. Leucocyte, MPV and NLR values were higher in both the epididymitis and torsion groups compared to the controls (p < .001). Platelet counts and PLR were significantly higher in the epididymitis group compared to the other two groups (p < .001). Leucocyte, MPV and NLR values may be used in the diagnosis of epididymitis and testicular torsion. Platelet counts and PLR appear to be useful in differentiating epididymitis from testicular torsion. However, there is a need for prospective studies with larger numbers of patients.

Cellular Angiofibroma of the Spermatic Cord.

Cellular angiofibromas are rare, slow-growing mesenchymal tumours, most often localised in the vulva and perineum of women. We present a case of a 60-year-old male with a 7-cm large cellular angiofibroma in the inguinal canal extending toward the testis, detected after inguinal herniorraphy. Inguinal orchiectomy was performed and the pathology report revealed a cellular angiofibroma containing a lot of mast cells in the stroma, which was collagenised with spindle-shaped cells and characterised by hyalinised vascular structures. The localisation and nature of this type of mass makes initial diagnosis difficult. Differential diagnosis is important to rule out histologically malignant aggressive angiomyxomas and other solitary fibrous tumours. As local recurrence may occur after resection, long-term follow-up is necessary.

Oncologic results, functional outcomes, and complication rates of transperitoneal robotic assisted radical prostatectomy: single centre's experience.

BACKGROUND: We report the operative details and short term oncologic and functional outcome of the first 334 Robotic-assisted radical prostatectomy experiences for organ confined prostate cancer METHODS: From August 2009 to December 2012, details of 334 consecutive patients were retrospectively analyzed. The analyzed parameters included: preoperative, per-operative characteristics, postoperative minor and major complications, positive surgical margin continence, potency, and biochemical progression at the follow-up period. RESULTS: The classical extrafascial, interfascial, intrafascial and fascia sparing radical prostatectomy were performed in 31, 41, 200, and 62 cases, respectively. The mean operation time was 213.8±90.1minutes, and the mean estimated blood loss was 116.1±58.9cc during operation. A nerve-sparing procedure was performed bilaterally in 198 (59.3%) cases and unilaterally in 126 (37.7%) cases. The catheter was removed on postoperative day 9, 1±1.9. Surgical margin was positive in 36 (10.7%) patients. The overall, pT2, pT3a and pT3b PSM rates were 8 (2.4%), 12 (3.6%), 16 (4.8%) respectively and PSM and BCR rates were not statistically different among four approach (P>.05). At the follow-up period, the continence rates were 74.4%, 80.4%, 80.5%, and 96.7% (P<.001), and previously potent patients' potency rates were 64.3%, 66.6%, 68.1%, and 74.5% (P>.05), in classic extrafascial, interfascial, intrafascial, and fascia sparing intrafascial prostatectomy, respectively. CONCLUSION: RARP is a safe and feasible technique in treatment of localized prostate cancer. Fascia sparing approach has better continence rate. This results need to be supported by new prospective, randomized studies.

Hemorragia de la pared abdominal después de prostatectomía radical asistida por robot: ¿es una complicación de la cirugía robótica? / Abdominal Wall Haemorrhage After Robotic-Assisted Radical Prostatectomy: Is it a Complication of Robotic Surgery?

Objetivo: La prostatectomía radical asistida por robot (PRAR) es el tratamiento quirúrgico mínimamente invasivo para los pacientes con cáncer de próstata localizado. Se han notificado complicaciones perioperatorias o postoperatorias después de PRAR en algunos estudios, y el sangrado postoperatorio severo después de PRAR es poco común, pero puede ser que la inestabilidad hemodinámica requiera exploración quirúrgica abierta y se asocie con una morbilidad considerable. Informamos de casos de sangrado postoperatorio, que es una especie de complicación asociada con la cirugía robótica, y la necesidad de transfusión masiva después de PRAR. Pacientes y métodos: Desde agosto de 2009 hasta mayo de 2012 317 pacientes consecutivos sometidos a PRAR en nuestra institución fueron analizados. Los pacientes con hemorragia postoperatoria grave, que causó inestabilidad hemodinámica después de la cirugía, fueron estudiados. Resultados: Un total de 5 de entre 317 (1,6%) pacientes tuvieron hemorragia que requería transfusión postoperatoria. En estos casos la media de tiempo operatorio fue de 114 min. La media de pérdida estimada de sangre fue de 110 ml durante la operación. En estos pacientes los niveles de hematocrito (Hct) gradualmente disminuyeron después de la cirugía, y se detectó equimosis en las paredes laterales y posteriores del abdomen en el segundo día. El Hct preoperatorio medio fue de 44,3% y el Hct medio más bajo fue de 23,1%. Todos los pacientes fueron tratados exitosamente sin exploración quirúrgica. Conclusiones: La prostatectomía radical robótica ha demostrado ser un tratamiento quirúrgico seguro con baja morbilidad. Sin embargo, el sangrado postoperatorio puede llegar a problemas serios. Este es el primer estudio para explicar la hemorragia asociada con el posible riesgo de la cirugía robótica (AU)

Objective: Robotic-assisted radical prostatectomy (RARP) is the minimally invasive surgical treatment for patients with localized prostate cancer. Perioperative or postoperative complications following RARP have been reported in some studies and severe postoperative bleeding after RARP is rare, but haemodynamic instability may necessitate open surgical exploration and be associated with considerable morbidity. We reported postoperative bleeding cases, which is a kind of complication associated with robotic surgery and requiring massive transfusion after RARP. Patients and methods: From August 2009 to May 2012, 317 consecutive patients who underwent RARP performed at our institution were analyzed. Patients with serious postoperative bleeding that caused haemodynamic instability after surgery were enrolled. Results: A total of 5 among 317 (1.6%) patients had bleeding requiring postoperative transfusion. In these cases, mean operative time was 114 min. The mean estimated blood loss was 110 ml during operation. In these patients, hematocrit (Hct) levels gradually fell after surgery and ecchymosis was detected on the side and posterior walls of the abdomen on the second day. The mean preoperative Hct was 44.3% and mean lowest Hct was 23.1%. All patients were successfully treated without surgical exploration. Conclusions: Robotic radical prostatectomy has proven to be a safe surgical treatment with low morbidity. However, postoperative bleeding can reach serious problems. This is the first study to explain haemorrhage, associated with possible risk of robotic surgery (AU)

Abdominal wall haemorrhage after robotic-assisted radical prostatectomy: is it a complication of robotic surgery?

OBJECTIVE: Robotic-assisted radical prostatectomy (RARP) is the minimally invasive surgical treatment for patients with localized prostate cancer. Perioperative or postoperative complications following RARP have been reported in some studies and severe postoperative bleeding after RARP is rare, but hemodynamic instability may necessitate open surgical exploration and be associated with considerable morbidity. We reported postoperative bleeding cases, which is a kind of complication associated with robotic surgery and requiring massive transfusion after RARP. PATIENTS AND METHODS: From August 2009 to May 2012, 317 consecutive patients who underwent RARP performed at our institution were analyzed. Patients with serious postoperative bleeding that caused hemodynamic instability after surgery were enrolled. RESULTS: A total of 5 among 317 (1.6%) patients had bleeding requiring postoperative transfusion. In these cases, mean operative time was 114 min. The mean estimated blood loss was 110 ml during operation. In these patients, hematocrit (Hct) levels gradually fell after surgery and ecchymosis was detected on the side and posterior walls of the abdomen on the second day. The mean preoperative Hct was 44.3% and mean lowest Hct was 23.1%. All patients were successfully treatment without surgical exploration. CONCLUSIONS: Robotic radical prostatectomy has proven to be a safe surgical treatment with low morbidity. However, postoperative bleeding can reach serious problems. This is the first study to explain haemorrhage, associated with possible risk of robotic surgery.