[A clinicopathological evaluation of prognostic factors of urothelial tumors of the renal pelvis and ureter].

We investigated the clinicopathological features of 109 patients with urothelial tumors of the renal pelvis and ureter who underwent surgery at four institute from April, 1975 to September, 1997. The patients consisted of 71 males and 38 females, and the mean age was 66.8 years, ranging from 41 to 92 years. Mean followup period was 43 months. The prognostic significance of the pathological factors; pT, Grade, INF, tumor size, pL, pV and pN were evaluated. All these factors affected the survival rates significantly in univariate analysis. Multivariate analysis showed the most influential prognostic factors to be pT and pN.

Experience with ureteral stone management in 1,082 patients using semirigid ureteroscopes.

OBJECTIVES: To assess the efficacy and complications of ureteroscopic lithotripsy (URS) using semirigid ureteroscopes. METHODS: We retrospectively analyzed the records of 1,082 consecutive patients with ureteral stones who were treated with URS with or without auxiliary extracorporeal shock wave lithotripsy for stone fragments. The efficacy was estimated using the stone-free rate and efficiency quotient (EQ). RESULTS: The stone-free rates were 79.0, 90.4 and 93.2% for upper, middle and lower ureteral stones, respectively. The EQ was 0.49 for upper, 0.79 for middle and 0.87 for lower ureteral stones. Ureteral perforation occurred in 54 cases (5.0%), of which 13 cases (1.2%) required nephrostomy (n = 11, 1.0%) or open surgery (n = 2, 0.2%). CONCLUSIONS: URS is a reasonable procedure with minor complications for stones located in the lower and middle ureter, but cannot be recommended as a first-line treatment for upper ureteral stones.

[Primary testicular carcinoid tumor: a case report].

This report describes a primary testicular carcinoid. A 41-year-old male was hospitalized with an asymptomatic right testicular mass. A high inguinal orchiectomy was done after the diagnosis of the testicular tumor. Pathologically, the tumor showed the typical appearance of a carcinoid tumor. A computed tomographic scan and other studies could not demonstrate any metastasis elsewhere. He has remained well and without any evidence of recurrence.

[Endocrine therapy of stage D2 prostate cancer--comparison of drugs used for total androgen blockade].

Patients with Stage D2 prostate cancer were treated with surgical or medical (LHRH analog) castration combined with either estrogen, chlormadinone acetate or flutamide as initial therapy. The effect of each medication was compared. The overall survival, cause-specific survival and relapse-free survival were not different among the three medications. Patients given each medication were divided into two groups each according to grade, extent of diseases on bone metastases, and levels of tumor marker. Survivals of the corresponding two groups were compared with each other among different medications. No differences were revealed with any medication. There were no serious side effects in whole patients, except that grade 2 liver dysfunction was accompanied in 12% of flutamide-treated group. It is concluded that the three drugs used with castration did not make any difference in the survival of stage D2 patients, and differences between medications were seen in the frequency of side effects.

[Electroconductive lithotripsy: clinical results of the Sonolith sigma].

The electroconductive lithotripter (ECL) is a new concept for shockwave generation in which a highly conductive solution channels the discharge between the anode and cathode. Out of 152 patients treated, complete follow up data were available on 151 patients. The average number of shocks per treatment was 2,138. At 3 months the overall stone-free rate was 73.5%. Success rate, defined as stone-free or asymptomatic residual fragments measuring 4 mm or less, was 84.9% for renal and 94.9% for ureteral calculi. The overall success rate for all calculi was 89%.

[Trends of prostate cancer: comparison between 1986-90 and 1991-95 at Asahi General Hospital].

Patients with prostate cancer treated during 1986-95 were divided into two groups: the first five years as early period and the recent five years as late period. Background factors, therapeutic modality and prognosis were compared between these two groups. The number of patients during the late period (245) was about 1.5 fold that during the early period (161). The average age for each stage are similar within the same period, and also similar between early and late periods. Almost the same ratios were noticed on stage distribution and on histological grade between early and late periods. Therefore, the increase in the number of patients in recent years was due mainly to expansion with the same proportion of background factors. Patients with T2 and T3 during the late period received more aggressive treatments with/without endocrine therapy. Subsequently these patients seemed to show better prognosis than the patients during the early period. No differences in survival of patients with metastosis was revealed between these two periods. Therefore, the outcome was not improved by recent endocrine therapy.