The incidence of renal deterioration was comparatively high following radical cystectomy, irrespective of the type of UD. Special attention should be paid to the long-term preservation of renal function in these patients, particularly those with hypertension and/or episodes of acute pyelonephritis.

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Abbreviations & Acronyms BMI = body mass index CCI = Charlson Comorbidity Index CIS = carcinoma in situ CSS = cancer-specific survival eGFR = estimated glomerular filtration rate HR = hazard ratio IQR = interquartile range KPS = Karnofsky Performance Status LVI = lymphovascular invasion OS = overall survival PS = performance status RC = radical cystectomy RFS = recurrence-free survival Objectives: To assess the significance of performance status as a prognostic factor after radical cystectomy for urothelial carcinoma of the bladder. Methods: The present study included 730 consecutive patients with urothelial carcinoma of the bladder who underwent radical cystectomy. Clinicopathological outcomes in these patients were analyzed focusing on the impact of performance status, which was assessed using the Karnofsky Performance Status scale before surgery. Patients were classified into groups with Karnofsky Performance Status 90 and 80. Results: A total of 561 (76.8%) and 169 (23.2%) patients were judged to have Karnofsky Performance Status 90 and 80, respectively. During a mean of 52.0 months, disease recurrence and mortality occurred in 257 (35.2%) and 249 (34.1%) patients, respectively, and the 5-year recurrence-free and overall survival rates were 64.1 and 65.3%, respectively. There were significant differences in age, hemoglobin, albumin, estimated glomerular filtration rate, pathological T stage and nodal involvement between the Karnofsky Performance Status 90 and 80 groups. Multivariate analysis showed independent impacts of Karnofsky Performance Status, pathological T stage, nodal involvement and lymphovascular invasion on recurrence-free survival, as well as independent impacts of Karnofsky Performance Status, age, body mass index, hemoglobin, pathological T stage, nodal involvement and lymphovascular invasion on overall survival. Conclusions: The results suggest a significant association between impaired performance status and unfavorable prognosis in patients with urothelial carcinoma of the bladder undergoing radical cystectomy.

These findings suggest that the combined assessment of expression levels of autophagy-associated markers, particularly Beclin 1, in radical nephrectomy specimens with conventional prognostic parameters, would contribute to the precise prediction of postoperative disease recurrence in patients with non-metastatic CCRCC.

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BackgroundThe objective of this study was to assess the effects of 25-degree and 30-degree Trendelenburg positions on intraocular pressure (IOP) changes during robot-assisted radical prostatectomy (RARP).Materials and methodsThis prospective study involved a total of 30 consecutive patients undergoing RARP. All participants were randomly divided into two groups: Trendelenburg position with the head down at 25 degrees or 30 degrees. In addition to representative operative outcomes, IOP was measured at six discrete time points; Time 1 (T1): before induction of general anesthesia, patients in a horizontal supine position; T2: after induction of general anesthesia, patients in a horizontal supine position; T3: 1 hour after adopting the Trendelenburg position; T4: 2 hours after adopting the Trendelenburg position; T5: after pneumoperitoneum resolution in the Trendelenburg position; T6: anesthetized before awakening in a supine position.ResultsThe total and console operative times, estimated blood loss, and intravenous fluid intake during RARP did not significantly differ between the two groups. While the IOP values measured at the same time points were similar between the two groups, the 25-degree Trendelenburg position significantly attenuated the IOP change from T1 to T3, T4, and T5 compared with those at 30 degrees.ConclusionsThese findings suggest that RARP in the 25-degree Trendelenburg position may reduce the risks of position-related ophthalmic complications without increasing the difficulty of the surgical procedure.

The proportion of patients with benign tumors was comparatively high in those with CT findings atypical for CCRCC; therefore, other clinical parameters, such as age and BMI, should be considered when determining therapeutic strategies for patients with such SRMs.