Retrospective study on the frequency of associated bladder cancer and the influence on the prognosis was carried out in 170 cases of renal pelvic and ureteral cancer. The number of cases of associated bladder cancer coexistent with renal pelvic and ureteral cancer was 31 (18.2%), and the number of subsequent cases 3 (19.4%). The frequency of occurrence of the primary tumor site was 27.2% in the renal pelvis, 45.6% in the ureter and 58.3% in both renal pelvis and ureter. Multiple tumors occurring in the renal pelvis and ureter occupy a high percentage. As for the degree of differentiation, many cases were subsequent to G1. As for the stage, a few cases with bladder cancer were subsequent to T4, but there was no definite tendency in the occurrence of bladder cancer. The prognosis of renal pelvic and ureteral cancer: the 10-year survival rate was 93.3% for G1, 66.6% for G2 and 12.4% for G3. As can be seen, there was good correlation with the pathological gradings. It must be remembered, however, that 5-year survival rates in cases of associated bladder cancer of coexistent type, in cases of subsequent type and in cases without associated bladder cancer were 56.2%, 72.7% and 64.8%, respectively: there was no significant difference. Bladder cancer associated with renal pelvic and ureteral cancer makes the therapy troublesome, but no influence on the prognosis was observed. Therapy in conformity with the pathological grading and stage is regarded as particularly important in cases of associated bladder cancer.
CT scans were carried out on 25 patients with transitional cell carcinoma of the renal pelvis. Of the 25 patients, tumors were identified in 24 patients (96%) and not in one patient on CT scan. Of the 24 patients the tumor was delineated as a solid mass in the renal pelvis and/or calyx in 15 and as an infiltrating mass in the renal parenchyma in 8 on CT scan. The depth of invasion was correctly estimated by CT in 18 of the 25 patients (72%). Whereas the tunica muscularis of the renal pelvis or the renal parenchyma was found involved in 3 of 10 patients (30%) in whom the diagnosis was made that the tumor was limited to the renal pelvic mucosa, the correct diagnosis was possible in 22 of 25 patients (88%) in whom the tumor was confined to the renal pelvic wall (pTa-pT2) or more invasive (pT3-pT4). In 6 of 7 patients with lymph nodes matastases enlarged lymph nodes were seen on the CT scan. In all 7 cases the primary tumor was classified as a pT3 or pT4 invasive disease. Based on the results presented above, it may be concluded that CT scan is valuable in making the diagnosis of transitional cell carcinoma of the renal pelvis and also in determining whether the tumor has invaded beyond the renal pelvic wall, thereby providing guidelines for the adequate treatment.
Hypogonadism induced LHRH-a also reduce bone density, so there is a risk of iatrogenic osteoporosis caused by therapy for CaP with LHRH-a. Patients with osteoporosis easily suffer from a much complicated and pernicious bone fracture, so we should measure bone density of male patients same as female treated with LHRH-a for a long-term.
This study confirmed the need for multimodality detection using DRE, TRUS and PSA as complementary methods in order to minimize decrease in cancer detection. In particular, impalbable cancers not detectable by DRE were detected and were revealed to be more likely to be localized and amenable to curative therapy. These results therefore underscore the importance of multimodality detection for early diagnosis of prostate cancer in urological practice.
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