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Conquering new battlegrounds:Successful management of isolated giant retrovesical hydatid cyst with robotic assistance

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Asian Journal of urology 2021年第3期8卷 327-331页

作者： Santosh Kumar Abhishek Chandna Vignesh Manoharan Kalpesh M.Parmar Subhajit Mandal department of urology Postgraduate Institute of Medical Education and ResearchChandigarhIndia

Hydatid disease(HD)is an accidental human parasitic infestation by cestodes and is most commonly caused by Echinococcus *** happens to be the most common site of involvement,although involvement of other organ symptoms is not *** of the retrovesical pouch by hydatidosis is generally secondary in nature with an incidence of 0.1%-0.5%*** retrovesical hydatid cyst(RVHC)is extremely rare with only few cases in existing *** can present with a wide gamut of symptoms ranging from asymptomatic to obstructive uropathy.A 38-year-old male presented to us with complaints of lower urinary tract symptoms(LUTS)and was found to have an isolated primary retrovesical hydatid cyst on *** RVHC had compressed the right ureter leading to a grossly hydronephrotic non-functional right *** patient was started on albendazole therapy and underwent robot assisted right nephroureterectomy and partial pericystectomy for the *** postoperative period was uneventful with resolution of *** report highlights the various clinical presentations of RVHC as well as the minimal invasive management of this rare entity.

关键词： Retrovesical hydatid cyst Robotic pericystectomy Hydatid disease

Surgical Treatment of the Upper Urinary Tract Lithiasis at the urology department of the Hopital General Idrissa Pouye

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Open Journal of urology 2024年第5期14卷 290-300页

作者： Mouhamadou Moustapha Mbodji Mohamed Jalloh Medina Ndoye Abdou Fall Cheikh Gassama Babou Sakho Serigne Mbacké Ndiaye Moussa Sene Abdourahmane Diallo Issa Labou Lamine Niang department of urology and Andrology Hopital General Idrissa Pouye Dakar Senegal

Upper urinary tract lithiasis is a condition characterized by the presence of stones which is a stony concretion of crystallized substances in the kidney and/or ureter. Objective: The objective of this work is to study the epidemiological, clinical and therapeutic aspects of upper urinary tract stones on the one hand, then to compare the different types of surgical treatments and their results. Materials and Methods: This is a retrospective and descriptive study focusing on the surgical management of upper urinary tract stones, between January 2017 and December 2020, at the urology department of the Hopital General Idrissa Pouye. Results: During the study period, 7.59% of surgical interventions performed were related to the treatment of upper urinary tract stones. Average age was 45.20 ± 16.4 years, the age group [41 - 60] years was more affected with 42.68%. A history of urolithiasis was present in 25.52% of cases. Lower back pain was present in 97.48% of cases. On URO-CT scan, the stone was located more at the level of the ureter (49.57%). The size between 10 to 15 mm was more frequent (30.96%) and the density greater than 1000 HU was more frequent (33.47%). The most used therapeutic procedure was ureteroscopy (52.08%), followed by PCNL (40.83%) and open surgery (7.08%). The success rate (stone free) was 93.68% for the URS, 89.36% for the PCNL. The length of hospital stay for open surgery was 6.76 ± 4.25, for PCNL 2.62 ± 2 days and for URS 1.75 ± 1.62 days. Postoperative complications were present in 23.52% for open surgery, 11.22% for PCNL and 8% for URS. Conclusion: Urolithiasis is constantly growing in our regions. Effective endourological treatment is increasingly replacing open surgery. However, global access to these new techniques in our regions is slow to be effective.

关键词： Endo-urology Open Surgery Renal Lithiasis Ureteral Lithiasis URO-CT Scan

Treatment-induced neuroendocrine prostate cancer and de novo neuroendocrine prostate cancer:Identification,prognosis and survival,genetic and epigenetic factors

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World Journal of Clinical Cases 2024年第13期12卷 2143-2146页

作者： Mohamed Wishahi department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Neuroendocrine prostate cancer(NEPC)shows an aggressive behavior compared to prostate cancer(PCa),also known as prostate *** foci in PCa can harbor genetic alternation that can arise in a heterogeneity of prostate *** may arise de novo or develop following androgen deprivation therapy(ADT).NEPC that arise following ADT has the nomenclature“treatmentemerging/induced NEPC(t-NEPC)”.t-NEPC would be anticipated in castration resistant prostate cancer(CRPC)and metastatic PCa.t-NEPC is characterized by low or absent androgen receptor(AR)expression,independence of AR signaling,and gain of neuroendocrine phenotype.t-NEPC is an aggressive metastatic tumor,develops from PCa in response to drug induced ADT,and shows very short response to conventional therapy.t-NEPC occurs in 10%-17%of patients with *** novo NEPC is rare and is accounting for less than 2%of all *** molecular mechanisms underlying the trans-differentiation from CRPC to t-NEPC are not fully *** kinase 1 plays a significant role in t-NEPC *** neuroendocrine markers:Synaptophysin,chromogranin A,and insulinoma associated protein 1(INSM1)are expressed in t-NEPC,they are non-specific for diagnosis,prognosis,and follow-up of therapy.t-NEPC shows enriched genomic alteration in tumor protein P53(TP53)and retinoblastoma 1(RB1).There are evidences suggest that t-NEPC might develop through epigenetic *** are genomic,epigenetic,and transcriptional alterations that are reported to be involved in development of ***-outs of TP53 and RB1 were found to contribute in development of *** is resistant to immunotherapy,and at present there are running trials to approach immunotherapy for PCa,CRPC,and t-NEPC.

关键词： Prostate cancer Neuroendocrine carcinoma Treatment induced neuroendocrine prostate cancer Androgen deprivation therapy Genetic and epigenetic factors Castration resistant prostate cancer De novo neuroendocrine prostate cancer

Circadian rhythm in prostate cancer: time to take notice of the clock

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Asian Journal of Andrology 2023年第2期25卷 184-191页

作者： Wei-Zhen Zhu Qi-Ying He De-Chao Feng Qiang Wei Lu Yang department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

The circadian clock is an evolutionary molecular product that is associated with better adaptation to changes in the external *** of the circadian rhythm plays a critical role in tumorigenesis of many kinds of cancers,including prostate cancer(PCa).Integrating circadian rhythm into PCa research not only brings a closer understanding of the mechanisms of PCa but also provides new and effective options for the precise treatment of patients with *** review begins with patterns of the circadian clock,highlights the role of the disruption of circadian rhythms in PCa at the epidemiological and molecular levels,and discusses possible new approaches to PCa therapy that target the circadian clock.

关键词： chronotherapy circadian clock circadian rhythm prostate cancer

Regional location of lymph node metastases predicts survival in patients with de novo metastatic prostate cancer

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Asian Journal of Andrology 2023年第4期25卷 462-467页

作者： Zhi-Peng Wang Jun-Ru Chen Jin-Ge Zhao Sha Zhu Xing-Ming Zhang Jia-Yu Liang Ben He Yu-Chao Ni Guang-Xi Sun Peng-Fei Shen Hao Zeng department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China department of urology The Third People’s Hospital of ChengduChengdu 610031China

To report the regional locations of metastases and to estimate the prognostic value of the pattern of regional metastases inmen with metastatic hormone-sensitive prostate cancer (mHSPC), we retrospectively analyzed 870 mHSPC patients betweenNovember 28, 2009, and February 4, 2021, from West China Hospital in Chengdu, China. The patients were initially classifiedinto 5 subgroups according to metastatic patterns as follows: simple bone metastases (G1), concomitant bone and regional lymphnode (LN) metastases (G2), concomitant bone and nonregional LN (NRLN) metastases (G3), lung metastases (G4), and livermetastases (G5). In addition, patients in the G3 group were subclassified as G3a and G3b based on the LN metastatic plane(below or above the diaphragm, respectively). The associations of different metastatic patterns with castration-resistant prostatecancer-free survival (CFS) and overall survival (OS) were analyzed by univariate and multivariate analyses. The results showedthat patients in G1 and G2 had relatively favorable clinical outcomes, patients in G3a and G4 had intermediate prognoses, andpatients in G3b and G5 had the worst survival outcomes. We observed that patients in G3b had outcomes comparable to those inG5 but had a significantly worse prognosis than patients in G3a (median CFS: 8.2 months vs 14.3 months, P = 0.015;medianOS: 38.1 months vs 45.8 months, P = 0.038). In conclusion, metastatic site can predict the prognosis of patients with mHSPC,and the presence of concomitant bone and NRLN metastases is a valuable prognostic factor. Furthermore, our findings indicatethat the farther the NRLNs are located, the more aggressive the disease is.

关键词： lymph node metastases metastatic hormone-sensitive prostate cancer metastatic pattern metastatic site nonregional lymph node metastases staging

Upgrading and upstaging of low-risk prostate cancer among Korean patients： a multicenter study

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Asian Journal of Andrology 2015年第5期17卷 811-814,I0009页

作者： Insang Hwang Donghoon Lim Young Beom Jeong Seung Chol Park Jun Hwa Noh Dong Deuk Kwon Taek Won Kang department of urology Chonnam National University Medical School Gwangju Korea department of urology Chosun University Medical School Gwangju Korea department of urology Chonbuk National University Medical School Jeonju Korea department of urology Wonkwang University School of Medicine Iksan Korea department of urology Kwangju Christian Hospital Gwangju Korea

Only 54% of prostate cancer cases in Korea are localized compared with 82% of cases in the US. Furthermore, half of Korean patients are upgraded after radical prostatectomy （41.6%-50.6%）. We investigated the risk factors for upgrading and/or upstaging of low-risk prostate cancer after radical prostatectomy. We retrospectively reviewed the medical records of 1159 patients who underwent radical prostatectomy at five hospitals in Honam Province. Preoperative data on standard clinicopathological parameters were collected. The radical prostatectomy specimens were graded and staged and we defined a ＂worsening prognosis＂ as a Gleason score ≥ 7 or upstaging to ≥ pT3. Multivariate logistic regression models were used to assess factors associated with postoperative pathological upstaging. Among the 1159 patients, 324 were classified into the clinically low-risk group, and 154 （47.5%） patients were either upgraded or upstaged. The multivariable analysis revealed that the preoperative serum prostate-specific antigen level （odds ratio [OR], 1.131; 95% confidence interval [CI], 1.007-1.271; P = 0.037）, percent positive biopsy core （OR： 1.018; 95% CI： 1.002-1.035; P = 0.032）, and small prostate volume （≤30 ml）（OR： 2.280; 95% CI： 1.351-3.848; P = 0.002） were predictive of a worsening prognosis. Overall, 47.5% of patients with low-risk disease were upstaged postoperatively. The current risk stratification criteria may be too relaxed for our study cohort.

关键词： prostate cancer prostatectomy risk factors

Pretreatment elevated fibrinogen level predicts worse oncologic outcomes in upper tract urothelial carcinoma

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Asian Journal of Andrology 2020年第2期22卷 177-183页

作者： Hang Xu Jian-Zhong Ai Ping Tan Tian-Hai Lin Xi Jin Li-Na Gong Hao-Ran Lei Lu Yang Qiang Wei department of urology and Institute of urology West China HospitalSichuan UniversityChengdu 610041China

This study aimed to further validate the prognostic role of fibrinogen in upper tract urothelial carcinoma(UTUC)in a large Chinese cohort.A total of 703 patients who underwent radical nephroureterectomy were retrospectively *** levels of≥4.025 g l?1 were defined as *** regression analysis was performed to determine the association between fibrinogen and adverse pathological ***–Meier analysis and Cox regression models were used to assess the associations of fibrinogen with cancer-specific survival(CSS),disease recurrence-free survival(RFS),and overall survival(OS).Harrell c-index and decision curve analysis were used to assess the clinical utility of multivariate *** median follow-up duration was 42(range:1–168)*** regression analysis revealed that elevated fibrinogen was associated with higher tumor stage and grade,lymph node involvement,lymphovascular invasion,sessile carcinoma,concomitant variant histology,and positive surgical margins(all P<0.05).Multivariate Cox regression analysis demonstrated that elevated fibrinogen was independently associated with decreased CSS(hazard ratio[HR]:2.33;P<0.001),RFS(HR:2.09;P<0.001),and OS(HR:2.09;P<0.001).The predictive accuracies of the multivariate models were improved by 3.2%,2.0%,and 2.8%for CSS,RFS,and OS,respectively,when fibrinogen was *** curve analysis showed an added benefit for CSS prediction when fibrinogen was added to the *** fibrinogen may be a strong independent predictor of worse oncologic outcomes in UTUC;therefore,it may be valuable to apply this marker to the current risk stratification in UTUC.

关键词： fibrinogen prognosis radical nephroureterectomy upper tract urothelial carcinoma

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Asian Journal of Andrology 2023年第2期25卷 208-216页

作者： Wei-Zhen Zhu De-Chao Feng Qiao Xiong Xu Shi Fa-Cai Zhang Qiang Wei Lu Yang department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

Given the dual role of autophagy presenting in tumorigenesis and inhibition,we established an autophagy-related gene prognostic index(ARGPI)with validation to well predict the biochemical recurrence(BCR),metastasis,as well as chemoresistance for patients with prostate cancer(PCa)who underwent radical radiotherapy or ***,Lasso and COX regression was used to develop the *** performed the whole analyses through R packages(version 3.6.3).Secreted phosphoprotein 1(SPP1),single-minded 2(SIM2),serine protease inhibitor b5(SERPINB5),aldehyde dehydrogenase 2(ALDH2),and acyl-CoA synthetase long-chain 3(ACSL3)were eventually used to establish the ARGPI *** were divided into two different-risk groups based on the median ARGPI score,high-risk patients with a higher risk of BCR than low-risk patients(hazard ratio[HR]:5.46,95%confidence interval[CI]:3.23–9.24).The risk of metastasis of high-risk patients was higher than low-risk patients(HR:11.31,95%CI:4.89–26.12).In The Cancer Genome Atlas(TCGA)dataset,we observed similar prognostic value of ARGPI in terms of BCR-free survival(HR:1.79,95%CI:1.07–2.99)and metastasis-free survival(HR:1.80,95%CI:1.16–2.78).ARGPI score showed a diagnostic accuracy of 0.703 for drug *** of gene set enrichment analysis(GSEA)indicated that patients in the high-risk group were significantly positively related to interleukin(IL)-18 signaling ***,ARGPI score was significantly related to cancer-related fibroblasts(CAFs;r=0.36),macrophages(r=0.28),stromal score(r=0.38),immune score(r=0.35),estimate score(r=0.39),as well as tumor purity(r=−0.39;all P<0.05).Drug analysis showed that PI-103 was the common sensitive drug and cell line analysis indicated that PC3 was the common cell line of PI-103 and the definitive *** conclusion,we found that ARGPI could predict BCR,metastasis,and chemoresistance in PCa patients who underwent radical radiotherapy or prostatectomy.

关键词： autophagy biochemical recurrence immune checkpoint metastasis-free survival prostate cancer tumor immune microenvironment

Usefulness and limitation of punched-out orchidometer in testicular volume measurement

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Asian Journal of Andrology 2005年第1期7卷 77-80,页

作者： Koji Shiraishi Hiroshi Takihara Yoriaki Kamiryo Katsusuke Naito department of urology Saiseikai Shimonoseki General Hospital Yamaguchi Japan department of urology Onoda City Hospital Yamaguchi Japan department of urology Yamaguchi University School of Medicine Yamaguchi Japan

Aim: To determine the limitations of a punched-out orchidometer in practical use, we compared with a scrotal ultrasound (USG). Methods: A total of 281 testes from 142 males were examined using both a punched-out orchidometer and a USG. The volume differential between both methods was calculated and expressed as orchidometer/ USG volume (OAJ ratio). Distribution of the O/U ratio was determined and subdivided by clinical or pathological diagnosis. The correlations between the O/U ratio and patient age or orchidometer results were assessed. Results: There was a significant linear relationship between the results of orchidometer and USG (r = 0.94, P < 0.0001). The relationship between the O/U ratio and age or testicular volumes showed significant inverse correlations (r = 0.22, P = 0.0002, r = 0.45, P < 0.0001, respectively). Klinefelter's syndrome, ipsilateral detorted testes and hypogonadotropic hypogonadism comparatively showed a high O/U ratio. No incidental lesion was detected by USG necessitating treatment. Conclusion: The punched-out orchidometer gives estimates that correlated well with the USG measurements and provides enough information for routine andrological evaluation. We should be aware that the orchidometer often overestimates the testicular volume, especially for the patients with small testis or adolescents.

关键词： orchidometer testis ultrasonography