We report a case of a 56-year-old woman who simultaneously presented adrenal and spleen tumors. Computed tomography imaging revealed a 7-cm enhancing adrenal and 2-cm solitary spleen masses. The patient simultaneously underwent left adrenalectomy and splenectomy. The pathological findings revealed the presence of synchronous adrenal and spleen angiosarcomas. Remarkably, she is disease-free since postoperative 18 months.
Objectives: The aim of this study was to investigate the relationship between quality of life (QOL) and residual urine volume in patients undergoing bacille Calmette-Guérin (BCG) therapy. Methods: Patients requiring BCG therapy, including those with carcinoma in situ, were enrolled prospectively. The urine volume collected through urethral catheterization was measured as post-voiding residual volume (PVR) during BCG therapy. Patients were divided into two groups: small PVR (SPVR), with PVR less than 30 ml, and large PVR (LPVR), with PVR greater than or equal to 30 ml. QOL status was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 system before and after BCG therapy. Moreover, some patients were assessed by International Prostate Symptom Score (IPSS) at the same time as assessment with the EORTC QLQ-C30 system. The primary end point was the evaluation of QOL during BCG therapy. Results: Among the 69 patients with non–muscle-invasive bladder cancer included in this study, 43 were in the SPVR group and 26 were in the LPVR group. The proportions of women and analgesic use in the SPVR group were higher than that in the LPVR group; however, medication use for dysuria in the SPVR group was less than that in the LPVR group. In the QOL analyses, cognitive function and emotional function in the functional scale and fatigue, nausea/vomiting, and dyspnoea in the symptomatic scale were worse in the SPVR group than in the LPVR group. In the multivariate analysis, fatigue was worse in the SPVR group than in the LPVR group. Conclusions: During BCG therapy, patients in the SPVR group had worse QOL, especially fatigue, than those in the LPVR group. Level of evidence: Not applicable for this multicentre audit.
Objective To investigate if the use of therapeutic agents for dysuria is a risk factor for the primary recurrence of non-muscle invasive bladder cancer (NMIBC). Methods First, patients with NMIBC were divided into two groups: the non-recurrence group and the recurrence group. Patient characteristics were compared between both groups. The risk factors of recurrence that were statistically different between the two groups were identified by multivariate analysis. Second, we divided the patients into risk and non-risk groups, and differences in the recurrence-free survival (RFS) between the two groups were analyzed before and after propensity score matching (PSM). Results A total of 162 patients were included, with 84 patients in the non-recurrence group and 78 patients in the recurrence group. In the multivariate analysis, the intake of dysuria agents and bacillus Calmette–Guérin (BCG) therapy were independent factors. The RFS results in terms of the intake of dysuria agents were statistically significant before and after PSM analysis, but no factors were significantly different between the BCG and non-BCG groups after PSM. Conclusions Therapeutic agents for dysuria might be at an independent risk factor for NMIBC recurrence. This trial is registered with the UMIN Clinical Trials Registry under the number UMIN000036097 ( https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno = R000041122 ).
Although the role of laparoscopic nephrectomy (LN) has been established, few studies have reported cases of LN in individuals with scoliosis. Here we report a case of right LN in a patient with severe right convex scoliosis. A 26-year-old man presented with a fever. His medical history comprised severe right convex lumbar scoliosis. CT revealed right hydronephrosis and right kidney stones. Pyelonephritis requiring nephrectomy was diagnosed. Right LN was feasible with elaborate perioperative care. The postoperative course was uneventful with no relapse of urinary tract infection.
cancer after at least two courses of intravesical therapy or one course of BCG treatment followed by one course of maintenance BCG received treatment. Six doses of pembrolizumab (100 vs 200 mg) were given every 3 weeks over 16 weeks given concurrently with 6 weekly doses of BCG beginning at week 7. Patient safety was evaluated during and for 30 days following pembrolizumab treatment. Preliminary combination efficacy was determined at 19 weeks using cystoscopy. Bladder biopsy was performed in patients with suspicious lesions.RESULTS: The combination of BCG and pembrolizumab was well tolerated at both 100mg and 200mg fixed doses. Fatigue and dysuria, spasm, urgency, sensitivity, and frequency were the most common adverse events reported. All AE were grade 1 or 2. Two patients died during the trial period. One patient died due to progression of upper urinary tract urethelial carcinoma. The second patient died after cystectomy (for progressive disease) from a cardiovascular event. Of the first 9 patients, 7 (78%) had no evidence of disease in the bladder at 19 weeks, end of treatment. The tenth patient is still in treatment.CONCLUSIONS: The combination of BCG and Pembrolizumab was well tolerated. Intravesical BCG and pembrolizumab may have clinical activity in non-muscle invasive bladder cancer recurring after repeated intravesical therapy. A phase III trial will soon open to test the clinical activity of this combination (KEYNOTE-676).
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