Impacto del tiempo desde la biopsia a la prostatectomía radical en la infragradación del grado de Gleason y análisis de factores relacionados / The impact of time from biopsy to radical prostatectomy on Gleason score undergrading and other related factors

INTRODUCCIÓN: La infragradación del grado de Gleason de la biopsia (IGGB) puede impactar en el manejo y pronóstico de los pacientes con cáncer de próstata. Se analiza el posible impacto del tiempo y otros factores clínico-analíticos y la aparición de IGBB en nuestra serie. PACIENTES Y MÉTODO: Estudio multicéntrico ambispectivo de 1.955 pacientes con cáncer de próstata localizado intervenidos mediante prostatectomía radical entre 2005 y 2018. Se utiliza estadística descriptiva y pruebas de contraste de hipótesis con análisis uni- y multivariado para comunicar los RESULTADOS: RESULTADOS: Edad media 63,69 años (44-80), mediana de PSA 8,70 ng/ml (1,23-99). Se observa IGGB en el 34,7% de toda la muestra. En el 72,8% de los casos la IGGB fue en un único punto consecutivo del grado de Gleason: el paso de 3 + 3 a 3 + 4 fue el más frecuente (289 pacientes, 47,6%). La realización de prostatectomía radical antes o después de 90-180 días desde la biopsia no impactó en su infragradación en ninguno de los grupos. En los análisis uni- y multivariante, la presencia de tumor o tacto rectal patológico en ambos lóbulos, la carga tumoral ≥ 50% de los cilindros totales y una DPSA ≥ 0,20 mostraron capacidad discriminativa independiente para seleccionar pacientes que presentaron IGGB. CONCLUSIONES: El tiempo desde la biopsia hasta la prostatectomía radical no mostró impacto en IGGB. El número de cilindros afectados, la DPSA y presentar tumor bilateral fueron parámetros de fácil acceso que pueden ayudarnos a seleccionar pacientes con mayor probabilidad de presentar IGGB

INTRODUCTION: Gleason score biopsy undergrading (GSBU) can have an impact on the management and prognosis of patients with prostate cancer. We analyze the possible impact of time and other clinical and analytical factors in the appearance of GSBU in our series. PATIENTS AND METHOD: Ambispective, multicenter study of 1955 patients with localized prostate cancer undergoing radical prostatectomy between 2005 and 2018. Descriptive statistics and hypothesis testing are reported by univariate and multivariate analyses. RESULTS: Mean age 63.69 (44-80) years, median PSA 8.70 ng / ml (1.23-99). GSBU was observed in 34.7% of the entire cohort. In 72.8% of the cases, the GSBU occurred in one consecutive Gleason score, with the progression from 3 + 3 to 3 + 4 being the most frequent (289 patients, 47.6%). Performing radical prostatectomy 90-180 days before or after the biopsy does not have an impact on its undergrading in any of the groups. In the univariate and multivariate analysis, the presence of tumor or pathological rectal examination in both lobes, the tumor load ≥ 50% of cylinders and a DPSA ≥ 0.20, showed independent discriminative capacity to select patients who presented GSBU. CONCLUSIONS: The time from biopsy to radical prostatectomy did not show impact on GSBU. The number of affected cylinders, bilateral tumor and DPSA are easily accessible parameters that can help us select patients with greater probability of presenting GSBU

The impact of time from biopsy to radical prostatectomy on Gleason score undergrading and other related factors. / Impacto del tiempo desde la biopsia a la prostatectomía radical en la infragradación del grado de Gleason y análisis de factores relacionados.

INTRODUCTION: Gleason score biopsy undergrading (GSBU) can have an impact on the management and prognosis of patients with prostate cancer. We analyze the possible impact of time and other clinical and analytical factors in the appearance of GSBU in our series. PATIENTS AND METHOD: Ambispective, multicenter study of 1955 patients with localized prostate cancer undergoing radical prostatectomy between 2005 and 2018. Descriptive statistics and hypothesis testing are reported by univariate and multivariate analyses. RESULTS: Mean age 63.69 (44-80) years, median PSA 8.70 ng / ml (1.23-99). GSBU was observed in 34.7% of the entire cohort. In 72.8% of the cases, the GSBU occurred in one consecutive Gleason score, with the progression from 3 + 3 to 3 + 4 being the most frequent (289 patients, 47.6%). Performing radical prostatectomy 90-180 days before or after the biopsy does not have an impact on its undergrading in any of the groups. In the univariate and multivariate analysis, the presence of tumor or pathological rectal examination in both lobes, the tumor load ≥50% of cylinders and a DPSA ≥0.20, showed independent discriminative capacity to select patients who presented GSBU. CONCLUSIONS: The time from biopsy to radical prostatectomy did not show impact on GSBU. The number of affected cylinders, bilateral tumor and DPSA are easily accessible parameters that can help us select patients with greater probability of presenting GSBU.

Gluon fusion into Higgs pairs at NLO QCD and the top mass scheme.

We present the calculation of the full next-to-leading order (NLO) QCD corrections to Higgs boson pair production via gluon fusion at the LHC, including the exact top-mass dependence in the two-loop virtual and one-loop real corrections. This is the first independent cross-check of the NLO QCD corrections presented in the literature before. Our calculation relies on numerical integrations of Feynman integrals, stabilised with integration-by-parts and a Richardson extrapolation to the narrow width approximation. We present results for the total cross section as well as for the invariant Higgs-pair-mass distribution at the LHC, including for the first time a study of the uncertainty due to the scheme and scale choice for the top mass in the loops.

Tendencia y distribución municipal de la incidencia de cáncer de vejiga en el área de salud de León (1996-2010) / Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-201

Objetivo: España presenta unas de las tasas más elevadas de incidencia y mortalidad por cáncer de vejiga del mundo. El presente estudio tiene por objeto conocer la incidencia, tendencia y distribución geográfica del cáncer de vejiga en el área de salud de León. Material y métodos: Fueron incluidos los casos nuevos de cáncer de vejiga (CIE-188) del registro hospitalario de tumores del Centro Asistencial Universitario de León, entre 1996-2010 con residencia en el ASL. Se calcularon las incidencias brutas trienales y ajustadas a población mundial y europea. Como denominador se utilizaron los datos del INE de población desagregada por sexo y grupos quinquenales de edad de residentes en municipios del ASL. Para el análisis de la distribución espacial se estimaron los riesgos relativos (RR) municipales suavizados mediante el ajuste del modelo de Besag, York y Mollié y sus probabilidades posteriores de que los RR fuesen > 1 (PP), utilizando métodos bayesianos. Resultados: Se incluyeron 1.573 casos. Las tasas estandarizadas a población europea ascendieron de 20,8 (1996-98) a 33,1 (2006-2008) casos nuevos por 100.000 hombres y de 1,9 a 5,9 en las mujeres. No se observaron diferencias de interés en la distribución municipal de las incidencias. Conclusiones: Las tasas de incidencia observadas son elevadas en el contexto europeo. Se observan tendencias ascendentes en hombres y especialmente relevantes en mujeres

Objective: Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León. Material and methods: the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one. Results: 1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences. Conclusions: bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed

Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-2010).

OBJECTIVE: Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León. MATERIAL AND METHODS: the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one. RESULTS: 1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences. CONCLUSIONS: bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed.

["Post micturition residual; urodynamic"]. / <>

OBJECTIVES: To study the possible correlation between the existence of postmicturition residual (PR), both in men as in women, with other urodynamic parameters. MATERIAL AND METHODS: A retrospective study in a series of 121 patients (33 male, 88 female), age X=68.22 and SD=12.904 (16-90 years), with a significative PR had been underwent a videourodynamic study. All cases of neurogenic vesicourethral dysfunctions and post pelvic radiotherapy were excluded. Statistical study was performed between the PR and the presence of urinary symptoms, urodynamic data, and findings of physical examination. The study was conducted, both descriptive and with statistical correlations. We used the Spearman Rho and compared with the median chi-square. RESULTS: We found a positive correlation (men and women), between the PR and bladder capacity (p=0.001) and between the PR free flowmetry and PR test pdet/flow (r=0.450 p=0.001). In women, a positive correlation was found between the PR and the urethral resistance (URA) (p=0.001), and between PR and voiding by abdominal pressure (p<0,05). We found a negative correlation in men between the PR and the parameters of detrusor contraction (W80-W20) (p<0.05). Not found statistically significant correlation between the PR and cystometry, nor with the urodynamic diagnosis of obstruction, associated radiological semiology, hyperactive bladder and emptying symptoms in men. CONCLUSIONS: The PR behaved more as a parameter measurement of detrusor contractility, than a parameter of the lower urinary tract obstruction. The PR was not associated with any clinic or associated radiologic semiology.

«Correlaciones urodinámicas del residuo posmiccional» / ''Post micturition residual; Urodynamic''

Objetivos: Estudiar la correlación entre la existencia de residuo posmiccional (rp) con otros parámetros urodinámicos. Material y métodos: Estudio retrospectivo. 121 pacientes (33V, 88M). Edad=68,22 y S=12,904 (16–90 años) que presentaban rp realizándose estudio videourodinámico completo. Se excluyeron disfunciones neurógenas vésicouretrales y posradioterapia pélvica. Se estudiaron correlaciones estadísticas entre residuo y síntomas, parámetros urodinámicos y hallazgos de la exploración física. Se ha realizado estadística descriptiva y correlaciones (rho de Spearman y comparación de medianas [chi cuadrado]). Resultados: Se encontró correlación positiva (hombres y mujeres) entre rp y capacidad vesical (p=0,001), entre rp (flujometría libre) y el rp (test pdet/flujo) (r=0,450 p=0,001). En mujeres entre rp y resistencia uretral (p=0,001) y entre rp y micción con prensa abdominal (p<0,05) Se encontró correlación negativa (hombres) entre rp y parámetros de contracción istotónica del detrusor (W80–W20) (p<0,05). No se ha encontrado correlación entre rp y parámetros cistomanométricos, ni con el diagnóstico urodinámico de obstrucción, semiología radiológica asociada, vejiga hiperactiva, ni síntomas funcionales de vaciamiento en el hombre. Conclusiones: El rp urodinámicamente se comportó más como un parámetro de medida de contractilidad del detrusor que como un parámetro de obstrucción del tracto urinario inferior. El rp no presentó ninguna semiología clínica ni radiológica asociada específica (AU)

Objectives: To study the possible correlation between the existence of postmicturition residual (PR), both in men as in women, with other urodynamic parameters. Material and methods: A retrospective study in a series of 121 patients (33 male, 88 female), age X=68.22 and SD=12.904 (16–90 years), with a significative PR had been underwent a videourodynamic study. All cases of neurogenic vesicourethral dysfunctions and post pelvic radiotherapy were excluded. Statistical study was performed between the PR and the presence of urinary symptoms, urodynamic data, and findings of physical examination. The study was conducted, both descriptive and with statistical correlations. We used the Spearman Rho and compared with the median chi-square. Results: We found a positive correlation (men and women), between the PR and bladder capacity (p=0.001) and between the PR free flowmetry and PR test pdet/flow (r=0.450 p=0.001). In women, a positive correlation was found between the PR and the urethral resistance (URA) (p=0.001), and between PR and voiding by abdominal pressure (p<0,05). We found a negative correlation in men between the PR and the parameters of detrusor contraction (W80–W20) (p<0.05). Not found statistically significant correlation between the PR and cystometry, nor with the urodynamic diagnosis of obstruction, associated radiological semiology, hyperactive bladder and emptying symptoms in men. Conclusions: The PR behaved more as a parameter measurement of detrusor contractility, than a parameter of the lower urinary tract obstruction. The PR was not associated with any clinic or associated radiologic semiology (AU)