High tumor stage and grade, and ureteral location were significantly associated with worse disease specific and recurrence-free survival in patients with upper urinary tract transitional cell carcinoma. Our results may help define the patient groups that need adjuvant therapy and they may form a basis for further controlled studies.
In patients whose preoperative urine cultures are sterile, short-term prophylaxis has no advantage over single-dose prophylaxis as a means of preventing infection. The duration of surgery and the amount of irrigation fluid are significant risk factors for postoperative fever.
In this systematic review, we looked at the impact of smoking, sexual activity, and sports and exercise on prostate cancer risk and outcome after treatment. While the evidence for sexual activity is not overall clear, we found that smoking might lead to more aggressive cancers and result in worse treatment outcome. Physical activity might prevent prostate cancer and improve cancer-related outcomes as well. Hence, it is certainly reasonable to advocate an active lifestyle and advise men to quit smoking.
In light of our results we suggest that all patients with vascular invasion should receive chemotherapy. However, patients with no risk factors and those with more than 50% embryonal carcinoma but without vascular invasion should be on surveillance after orchiectomy since the relapse rate is less than 30%. Although strict followup in the first year is justified, followup schemas may be reassessed for the frequency of radiological investigations.
Both antibiotic prophylaxis methods were similar in terms of preventing septic complications. Therefore, we think that a single-dose antibiotic prophylaxis protocol may be safely recommended to patients undergoing PCNL.
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