Early experience with laparoscopic partial nephrectomy is promising. Laparoscopic partial nephrectomy offered the advantages of less operative time, decreased operative blood loss and a shorter hospital stay. When applied to patients with a single renal tumor 7 cm or less, laparoscopic partial nephrectomy was associated with additional postoperative morbidity compared to open partial nephrectomy. However, equivalent functional and early oncological outcomes were achieved.

Renal carcinoid is the second most prevalent genitourinary carcinoid in each sex, following testicular carcinoids in men and ovarian tumors in women. Significant adverse prognostic factors include age greater than 40 years, tumor size greater than 4 cm, purely solid tumors on the cut surface, mitotic rate higher than 1/10 high power fields, metastasis at initial diagnosis and tumors extending throughout the renal capsule.

The data presented here help define the complication rates for laparoscopic urological procedures in experienced hands at a high volume institution.

Laparoscopic partial nephrectomy is an alternative technique with mid-range oncological results comparable to open partial nephrectomy in patients with localized pathological stage T1N0M0 renal cell carcinoma.

No abstract

Despite the high frequency of prostate cancer, therapeutic options for advanced disease are limited to chemotherapy, radiation or hormonal therapy and eventually fail in all patients. Therefore, alternative approaches need to be developed. We previously reported that FTY720, a metabolite from Isaria sinclarii, is a unique antitumor agent for an androgen-independent prostate cancer cell line and requires caspase-3 activation in apoptosis. In our study, we have evaluated the effect of FTY720 on a family of mitogen-activated protein kinases (MAPKs), focal adhesion kinase (FAK), mitochondrial transmembrane potential, caspase-9 and caspase-8 and analyzed the expression of some cell-cycle regulator proteins in DU145 cells in order to understand the various antitumor effects of FTY720. Apoptosis was quantified by phosphatidylserine exposure. Activation of MAPKs, cleavage of caspase-9 and caspase-8, status of cyclin-dependent kinases (CDKs) and Cip1/p21, a cyclin-dependent kinase inhibitor, were evaluated by Western blot analysis, in addition to FAK and phospho-FAK immunoprecipitation and cell-cycle analysis by FACScan. We found that in DU145 cells, 40 M FTY720 caused activation of p38 MAPK and the upstream kinase MKK3/MKK6 but not SAPK/JNK. Mitochondrial transmembrane potential, FAK and ERK1/2 were reduced while caspase-9 and caspase-8 were cleaved. The p38-specific inhibitor had no effect on apoptosis induced by FTY720, whereas z-VAD.FMK, a broad-spectrum caspase inhibitor, did not inhibit the p38 MAPK activation. An amount of 20 M FTY720 resulted in G 1 arrest and a decrease of CDK2 as well as CDK4, whereas it induced Cip1/p21. FTY720 may exert anticarcinogenic effects against prostate cancer cells possibly involving modulation of mitogenic signaling, cell-cycle regulators, induction of G 1 arrest and apoptotic death in DU145 cells. © 2002 Wiley-Liss, Inc. Key words: FTY720; apoptosis; MAPKs; FAK; caspase-9; CDKsProstate cancer (PCA) is the most common nonskin malignancy and the second-leading cause of cancer deaths in United States males. 1 Unfortunately, after radical prostectomy, chemotherapy, radiation therapy or androgen ablation treatments, a portion of patients will suffer from recurrent or residual cancer. The awareness of the limitations of current therapies is increasing, and alternative approaches need to be developed. One practical and translational approach to control PCA is to develop a mechanismbased anticarcinogenic agent(s). Recently, we have shown that FTY720, a metabolite from Isaria sinclairi, is a unique and potential strong antitumor agent for cell line DU145 and provided the first evidence for involvement of caspase-3 in a dose-related apoptosis of an androgen-independent prostate cancer cell line. 2 But the cellular mechanisms of the action of FTY720 on cancer cells are not completely understood.Apoptosis, or programmed cell death, is a regulated physiologic process leading to cell death characterized by cell shrinkage, membrane blebbing and DNA fragmentation. Caspases, a family of cysteine pr...

Based on long-term followup, our evaluation confirmed for clinical tumor stage T1/2 N0M0 that laparoscopic radical nephrectomy is oncologically equivalent to open radical nephrectomy.

A positive margin following laparoscopic partial nephrectomy does not necessarily indicate residual disease. However, vigilant monitoring is mandatory. While midterm outcomes parallel those of patients with a negative margin, longer followup is necessary to determine the ultimate oncological outcomes in this subgroup of patients.