No abstract

clinicaltrials.gov Identifier: NCT00091637.

No abstract

It is over 10 years since the first ACPGBI Position Statement on the management of anal fistula was published in 2007. This second edition is the result of scrutiny of the literature published during this time; it updates the original Position Statement and reviews the published evidence surrounding treatments for anal fistula that have been developed since the original publication.

The nutcracker syndrome is a rare cause of haematuria which responds successfully to surgical treatment. Successful treatment does not appear to be related to lowering of the renal vein pressure.

Of 171 patients consecutively presenting with newly diagnosed transitional cell cancer (TCC) of the bladder, 107 were "superficial"; 98 have been followed up for 2 years and 84 for 3 years. No patient with pTa TCC developed muscle infiltrating recurrences, although 15% progressed to pT1 category by 3 years. At 2 and 3 years respectively, 33 and 46% of the pT1 TCC had progressed to infiltrate muscle. The use of the term "superficial" to describe pTa and pT1 category TCC together in one grouping should be reconsidered.

The UICC pT category for transitional cell cancer (TCC) of the bladder was recorded as assigned from the routine service of a pathology laboratory. All reports had been passed for release after review by pathologists of the status of senior registrar or above. After 99 cases had been collected, the slides available to the original pathologist were reviewed by one dedicated pathologist in continuous session who was ignorant of the original report. No new sections were cut. There was disagreement with the original report of pT category in 14 cases: 13 were downstaged (including 6 from invasive to superficial) and 1 upstaged. There was disagreement with the original differentiation grade in 13 cases: 10 TCC were considered to be more differentiated and 3 less differentiated than the original report. A second pathologist reviewed the pT category only of 13 of the 14 cases, disagreeing with the original pT category on 8 occasions and with the pT category assigned by the dedicated pathologist on 7 occasions. These findings have important implications for advising patients on prognosis and clinical management and in the design and reporting of therapeutic trials.

Prostate tissue containing either primary adenocarcinoma (45 patients) or benign hyperplasia (15 patients) was immunostained with the monoclonal antibody Ki-67, which recognises a human nuclear antigen expressed by human cycling cells. The percentage of cells staining positive was considered a measure of proliferation. This derived Ki-67 index was higher for carcinomas than for hyperplastic glands. Within the group of carcinomas, Ki-67 indices in patients with metastatic disease were significantly higher than in those without and there was a trend towards increasing Ki-67 indices with increasing Gleason grade. When patients with prostate cancer were prospectively followed up, the Ki-67 index did not predict either disease progression or hormone responsiveness. Ki-67 immunostaining may define a group of patients with prostate cancer of poor prognosis.