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ABSTRACT: Neuroendocrine small cell carcinoma of the urinary tract is rarely encountered and very few cases have been reported in the literature. Herein we describe a case of small cell malignancy located contemporarily in the ureter and the bladder.
Cases Journal 01/2009; 2:7743.
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ABSTRACT: Radical cystoprostatectomy and radical prostatectomy are the two major operations where prostate is totally and radically removed. Radical cystoprostatectomy is usually performed in patients with invasive bladder cancer. The aim of the study was to examine Total PSA, Free PSA, and Free/Total Ratio elimination kinetics after radical cystoprostatectomy.
Serum PSA, Free PSA, and Free/Total Ratio were determined preoperatively, at the time of cystoprostatectomy specimen removal and then at 3, 6, 12, 24, 48, 72, and 168 hr, from seven patients with muscle invasive bladder cancer, who underwent radical cystoprostatectomy. Free and Total PSA concentrations were measured with non-competitive immunological procedures. The elimination rates and half-lives of Total, Free PSA and Free/Total Ratio were studied using a nonlinear regression analysis.
Surgical manipulations caused about 1.5-fold increase of PSA, 5-fold increase in Free PSA and 3-fold increase in Free/Total Ratio. PSA and Free PSA followed a biphasic elimination pattern of a rapid exponential (a) phase with a half-life of 4.27 and 2.14 hr and a terminal, nonexponential (b) phase with a half-life of 63 and 173.2 hr, respectively. Free/Total PSA Ratio followed, also, a biphasic kinetic pattern of a rapid exponential decline with a half-life of 3.34 and a terminal non-exponential increase with a doubling time of 43 hr.
Comparing PSA kinetics after radical cystoprostatectomy with those of radical prostatectomy, it appears that PSA follows the same elimination pattern in both models. In contrast, Free PSA and Free/Total Ratio elimination kinetics' patterns differ between the two surgical models.
The Prostate 06/2008; 68(7):759-65. · 3.48 Impact Factor
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ABSTRACT: In this paper we study the Free/Total PSA kinetics in patients with clinically localized prostate cancer undergoing radical prostatectomy.
Serum PSA, Free PSA and Free/Total Ratio were determined preoperatively, at the time of prostate removal (0 time) and then at 3, 6, 12, 24, 48, 72 and 168 h, from 9 patients with clinically localized prostate cancer who underwent radical retropubic prostatectomy. The elimination rates and half-lives of Total, Free PSA and F/T Ratio were studied applying one and two compartment models for pharmacokinetic analysis.
Surgical manipulations of the prostate caused a mean 2.16-fold increase of PSA, 12-fold increase of free PSA and 4.2-fold increase of F/T PSA ratio. Removal of the prostate caused a rapid biphasic, biexponential elimination of Free PSA with a mean half-life of 0.8 h for the alpha (a) phase and 32.6 h for the beta (b) phase. PSA was eliminated following a rapid exponential (a) phase with a half-life of 1.15 h and a non-exponential (b) phase with a half-life of 71.96 h. Free/Total PSA followed a biphasic kinetic, with an initial exponential elimination phase and a mean half-life of 2.6 h and a second non-exponential increase phase with a doubling time of 130.8 h. Free/Total PSA reached its nadir very soon, at the first postoperative 24 h.
Free/Total PSA kinetic after radical prostatectomy reflects the differences of Free and Total PSA elimination kinetics. Free/Total Ratio follows a biphasic kinetic, with an initial rapid exponential elimination phase, which is affected mainly by the rapid exponential (a) phase of Free PSA elimination and a second slow increase, which is affected mainly by the terminal non-exponential (b) phase of PSA elimination.
Clinica Chimica Acta 08/2005; 357(2):196-201. · 2.54 Impact Factor
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ABSTRACT: The aim of this study was to elucidate the prognostic value of the immunohistochemical detection of the androgen receptor (AR) status, the chromogranin A assessment of neuroendocrine differentiation (NED) and the CD34 assessment of microvessel density (MVD) with time-to-biochemical failure among surgically treated patients with clinically localized prostate cancer. Patients and
Surgical specimens from 130 patients with clinically localized prostate cancer, treated with radical prostatectomy, were analyzed by immunohistochemistry on paraffin tissue sections. Full-length follow-up records were available for 94 patients.
Biochemical failure was observed in 37% of these patients. A statistically significant inverse relationship was observed between AR status and: (i) seminal vesicle invasion and (ii) surgical margin infiltration. Positive association was also detected between NED and: (i) Gleason's score, (ii) extracapsular extension, (iii) seminal vesicle invasion, (iv) surgical margin infiltration and (v) tumour volume. In addition, MVD was related to: (i) Gleason score, (ii) extracapsular extension, (iii) seminal vesicle invasion, (iv) pelvic lymph node metastasis and (v) tumour volume. Kaplan-Meier survival curves confirmed that Gleason score, extracapsular extension, seminal vesicle invasion, pelvic lymph node metastasis, tumour volume, NED, MVD and coexistence of increased NED and MVD may be potential biochemical failure predictors. However, in the multivariate analysis, MVD was the only independent prognostic factor for biochemical failure.
A high MVD index can estimate the risk for biochemical failure in clinically localized prostate cancer after radical prostatectomy.
Anticancer research 27(5B):3651-60. · 1.73 Impact Factor
