Pelvis and ureteral TCC are not the same disease in terms of invasion and prognosis. Ureteral TCC is associated with a higher local or distant failure rate than renal pelvis TCC. A radical surgical approach including meticulous lymphadenectomy may be therapeutic in patients with invasive ureteral TCC.
Sunitinib administered with a 2/1 schedule is associated with less toxicity and higher FFS at 6 months than a 4/2 schedule, without compromising the efficacy in terms of ORR and TTP (NCT00570882).
Pelvic diaphragm thickness and the ratio of levator ani thickness to prostate volume are independent factors predictive of post-prostatectomy incontinence. Patients with better developed pelvic floor muscles, especially in relation to the size of the prostate, can be expected to achieve earlier recovery of continence after radical prostatectomy.
Purpose:To evaluate the usefulness of the wash-in rate based on dynamic contrast-enhanced (DCE) MRI for the detection and localization of prostate cancer.
Materials and Methods:In 53 patients, the wash-in rate was measured in the cancer area and in three normal areas (the peripheral zone, inner portion of the transitional zone, and outer portion of the transitional zone). On the basis of these data, parametric imaging was generated and then its accuracy for cancer detection and location was evaluated compared to that of T2-weighted imaging without the use of an endorectal coil. For that purpose the entire prostate was divided into 18 segments.
Results:The wash-in rate value was greater in cancer tissue (9.2/second) than in three normal tissues (3.3/second, 6.7/second, and 3.2/second, respectively; P Ͻ 0.001). The sensitivity and specificity were greater on parametric imaging of the wash-in rate compared to T2-weighted imaging in the entire prostate (96% and 82% vs. 65% and 60%, respectively) and the peripheral zone (96% and 97% vs. 75% and 53%; P Ͻ 0.05). In the transitional zone, the sensitivity was greater on parametric imaging (96%) than on T2-weighted imaging (45%; P ϭ 0.016), but the specificity was similar (51% vs. 73%; P ϭ 0.102).
Conclusion:The wash-in rate based on DCE-MRI is a useful parameter for prostate cancer detection and localization.
contraction and storage function after RP were compared for changes in subjective symptoms.
RESULTSOn serial UDS, there were reductions in maximum cystometric capacity, maximum detrusor pressure and maximum urethral closure pressure (MUCP) at 3 months, after which all remained relatively unchanged. On the questionnaire, the voiding symptom domain score improved (8.04 to 4.82, P < 0.001) while the storage domain score significantly and progressively worsened, beginning from 3 months (2.25 to 3.78, P = 0.04), resulting in an unchanged overall urinary symptom-related quality of life at 3 years. The incidence of detrusor overactivity increased from 37.5% before RP, to 45.8% at 3 months and 51.4% at 3 years. At 3 years, a recurring postvoid residual urine volume was the cause of the deterioration in the voiding symptom domain score, while a prominent reduction in MUCP resulted in a deterioration in the storage symptom score.
Renal volume reduction, tumor location and patient age determine renal function after partial nephrectomy. In appropriate cases the laparoscopic method can show surgical and functional outcomes equivalent to those of the open method.
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