Abstract Context Benign prostatic hyperplasia (BPH) is one of the most common diseases associated with the aging process in men, particularly men aged >50 yr, yet only a few predictive factors have ...been identified. In recent years, attention has focused on the role of prostatic inflammation in the pathogenesis and progression of BPH. Objective This article reviews recent findings related to the potential link between local and systemic inflammation and BPH. Evidence acquisition In March 2013, at the annual meeting of the European Association of Urology in Milan, Italy, a satellite symposium entitled “Benign Prostatic Hypertrophy (BPH) and Inflammation, from Lab to Clinic,” was held with the goal of reviewing the latest data relating to the link between inflammation and BPH. This paper is based on one of the presentations at this symposium. A structured PubMed literature search was performed, and emphasis was placed on results from the past 10 yr. Evidence synthesis BPH is characterized by progressive hyperplasia of stromal and glandular cells, and clinically it is defined by lower urinary tract symptoms. In recent years, there has been accumulating evidence linking prostatic inflammation with BPH. The inflammatory infiltrates observed in patients with BPH are composed primarily of chronically activated T-lymphocytes. Cytokines and growth factors released from inflammatory cells create a proinflammatory environment that may support the fibromuscular growth seen in BPH and may also be responsible for inducing a state of relative hypoxia as a result of the increased oxygen demand of the proliferating cells. A number of clinical studies have confirmed the presence of inflammatory infiltrate in men with BPH, and this infiltrate has been shown to be involved in the pathogenesis, clinical appearance, and progression of this disorder. There is evidence emerging that systemic inflammation may also play a role in BPH, since in men with metabolic syndrome there was a significant correlation between prostate diameter/volume and the number of metabolic syndrome components. Conclusions It is clear that a number of different mechanisms are involved in the development and progression of BPH. Prostatic inflammation is an important feature, since it appears to be involved in the pathogenesis, symptomatology, and progression of the disease.
Purpose We estimate the annual incidence of bladder cancer in Spain and describe the clinical profile of patients with bladder cancer enrolled in a population based study. Materials and Methods Using ...the structure of the Spanish National Health System as a basis, in 2011 the AEU (Spanish Association of Urology) conducted this study with a representative sample from 26 public hospitals and a reference population of 10,146,534 inhabitants, comprising 21.5% of the Spanish population. Results A total of 4,285 episodes of bladder cancer were diagnosed, of which 2,476 (57.8%) were new cases and 1,809 (42.2%) were cases of recurrence, representing an estimated 11,539 new diagnoses annually in Spain. The incidence of bladder cancer in Spain, age adjusted to the standard European population, was 20.08 cases per 100,000 inhabitants (95% CI 13.9, 26.3). Of patients diagnosed with a first episode of bladder cancer 84.3% were male, generally older than 59 years (81.7%) with a mean ± SD age of 70.5 ± 11.4 years. Of these patients 87.5% presented with some type of clinical symptom, with macroscopic hematuria (90.8%) being the most commonly detected. The majority of primary tumors were nonmuscle invasive (76.7%) but included a high proportion of high grade tumors (43.7%). According to the ISUP (International Society of Urologic Pathology)/WHO (2004) classification 51.1% was papillary high grade carcinoma. Carcinoma in situ was found in 2.2% of primary and 5.8% of recurrent cases. Conclusions The incidence of bladder cancer in Spain, age adjusted to the standard European population, confirms that Spain has one of the highest incidences in Europe. Most primary nonmuscle invasive bladder cancer corresponded to high risk patients but with a low detected incidence of carcinoma in situ.
BACKGROUND: Despite recent drug development for non-muscle invasive bladder cancer (NMIBC), few therapies have been approved by the US Food and Drug Administration (FDA), and there remains an unmet ...clinical need. Bacillus Calmette-Guerin (BCG) supply issues underscore the importance of developing safe and effective drugs for NMIBC. OBJECTIVE: On November 18–19, 2021, the FDA held a public virtual workshop to discuss NMIBC research needs and potential trial designs for future development of effective therapies. METHODS: Representatives from various disciplines including urologists, oncologists, pathologists, statisticians, basic and translational scientists, and the patient advocacy community participated. The workshop format included invited lectures, panel discussions, and opportunity for audience discussion and comment. RESULTS: In a pre-workshop survey, 92% of urologists surveyed considered the development of alternatives to BCG as a high drug development priority for BCG-naïve high-risk patients. Key topics discussed included definitions of disease states; trial design for BCG-naïve NMIBC, BCG-unresponsive carcinoma in situ, and BCG-unresponsive papillary carcinoma; strengths and limitations of single-arm trial designs; assessing patient-reported outcomes; and considerations for assessing avoidance of cystectomy as an efficacy measure. CONCLUSIONS: The workshop discussed several important opportunities for trial design refinement in NMIBC. FDA encourages sponsors to meet with the appropriate review division to discuss trial design proposals for NMIBC early in drug development.
We report a case of metachronous solitary metastasis of renal cell carcinoma to the contralateral adrenal gland treated by laparoscopic transperitoneal adrenalectomy.
A 58-year-old man presented to ...our institution for regular follow up, 2 years after a right radical nephrectomy with preservation of the ipsilateral adrenal gland, for a primary renal cell carcinoma. The patient remained asymptomatic but an abdominal computed tomography scan on follow up revealed a 6.5 x 4 cm2 mass in the left adrenal gland. A positron emission tomography scan was also performed to rule out other possible metastases, and a magnetic resonance imaging scan was used for accurate localization and determination of resectability of the adrenal tumour. A bone scan, metabolic screen, liver and renal function tests were all within normal limits. A laparoscopic transperitoneal adrenalectomy was then performed. The postoperative period was uneventful, and the patient was discharged on postoperative day two. The patient remains in satisfactory condition and no recurrence or adrenal insufficiency has been observed during 12 months follow up.
Metachronous contra lateral adrenal metastases from primary renal cell carcinoma are very rare but should always be suspected in any nephrectomised patient presenting with an adrenal tumour. Regular follow up in these patients accompanied with computed tomography imaging may help the surgeon to detect early lesions. Laparoscopic transperitoneal adrenalectomy is feasible, safe and effective, with minimal trauma to the patient.
B2B: Prostate Cancer Loeb, Stacy; Black, Peter C.; Wyatt, Alexander W. ...
Société internationale d'urologie journal,
7/2021, Letnik:
2, Številka:
Supplement 1
Journal Article
B2B: Prostate Cancer Summary Stacy Loeb, Peter C. Black, Alexander W. Wyatt, Yaw A. Nyame, Neal Shore, Derya Tilki, Elena Castro, Matthew Cooperberg, Veda Giri, Maria J. Ribal, Giovanni Lughezzani, Rafael Sánchez-Salas, Caroline M. Moore, Art Rastinehad, Linda Kerkmeijer, Hashim U. Ahmed, Shusuke Akamatsu, Alexandre de la Taille, Martin Gleave, Simon Tanguay
Société internationale d'urologie journal,
07/2021, Letnik:
2, Številka:
Suppl. 1
Journal Article
PDF
