Validation study of urinary metabolites as potential biomarkers for prostate cancer detection.

BACKGROUND: Urinary metabolomic profiles have recently drawn a lot of attention owing to a debate regarding their possible role as potential clinical markers for prostate cancer. In this study, levels of proline, kynurenine, uracil and glycerol-3-phosphate in 126 patients with genitourinary malignancies were analyzed using a validated method and compared with no evidence of malignancy. RESULTS: The statistical results showed that these biomarkers cannot differentiate prostate cancer from no evidence of malignancy or from other related cancer types, such as bladder cancer. In addition, there was no significant difference in biomarker levels for T1 stages, T2 stages and Gleason scores <7, ≥7. From the correlation study, results showed/demonstrated that age or serum prostate-specific antigen levels do not influence these metabolite concentrations in urine. However, the strong correlation between these metabolites and urinary creatinine concentrations implies that their occurrence is mainly due to renal excretion. CONCLUSION: This detailed study shows that the aforementioned urinary metabolites are not reliable biomarkers for prostate cancer detection or for differentiating the aggressiveness of prostate cancer.

Maneuver to improve exposure during radical perineal prostatectomy.

OBJECTIVES: Radical perineal prostatectomy (RPP) has an important place as a management option for prostate cancer. Herein we describe an adaptation that we found to significantly help the exposure during this procedure. METHODS: After opening the urethra, the long Lowsley tractor is changed to the short tractor. Caudal traction facilitates the dissection up to the bladder neck, which is opened. Classically, at this point an umbilical tape or Penrose drain substitutes the short tractor. Because of the limitation in the amount of traction that can be applied without fracturing through the tissue, we have utilized traction sutures placed in both right and left lobes of the prostate instead of the Penrose drain. RESULTS: Traction on these sutures resulted in excellent exposure and greatly facilitated the posterior dissection of the prostate as well as seminal vesicles dissection. CONCLUSIONS: This small addition to the standard technique of RPP helps with complete dissection of the prostate and seminal vesicles. We recommend replacing the traditional Penrose traction with these sutures placed in the lateral lobes of the prostate.