Browsing by Subject "cystectomy"

Now showing 1 - 8 of 8
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    Nested variant of transitional cell carcinoma with osseous metaplasia of the urinary bladder: A case report and review of published reports
    (2007) Neşe N.; Kandiloǧlu A.R.; Atesçi Y.Z.
    Nested variant of transitional cell carcinoma (NV-TCC) of the bladder is a rare and relatively new entity. The tumor is aggressive contrasted by its benign histopathologic appearance, and characterized by irregular urothelial nests and/or tubules. Herewith, a case with exceptional osseous metaplasia is presented emphasizing its diagnostic difficulties, because it can be confused with benign diseases or conventional TCC. © 2007 The Japanese Urological Association.
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    Carcinoma in situ of the urinary bladder: Review of clinicopathologic characteristics with an emphasis on aspects related to molecular diagnostic techniques and prognosis
    (Jones and Bartlett Publishers, 2009) Nese N.; Gupta R.; Bui M.H.T.; Amin M.B.
    Carcinoma in situ (CIS) of the urinary bladder is defined as a flat lesion comprising of cytologically malignant cells which may involve either full or partial thickness of the urothelium. De novo CIS constitutes less than 3% of all urothelial neoplasms; however, CIS detected concurrently or secondarily during follow-up of urothelial carcinoma constitutes 45% and 90%, respectively, of bladder cancer. CIS is noted predominantly in male smokers in the sixth or seventh decade. Patients may present with dysuria, nocturia, and urinary frequency and urgency with microscopic hematuria. Cystoscopic findings may range from unremarkable to erythema or edema. Urine cytology is an important diagnostic tool. Cellular anaplasia, loss of polarity discohesion, nuclear enlargement, hyperchromasia, pleomorphism, and atypical mitoses are the histopathologic hallmarks of CIS. Extensive denudation of the urothelium, monomorphic appearance of the neoplastic cells, inflammatory atypia, radiation induced nuclear smudging, multinucleation, and pagetoid spread of CIS may cause diagnostic difficulties. Together with clinical and morphologic correlation, immunostaining with CK 20, p53 (full thickness), and CD44 (absence of staining) may help accurately diagnose CIS. Fluorescent in situ hybridization analysis of voided urine for amplification of chromosomes 3, 7, and 17 and deletion of 9p has high sensitivity and specificity for diagnosing CIS in surveillance cases. Several other molecular markers, such as NMP 22 and BTA, are under evaluation or used variably in clinical pathology. Intravesical bacillus Calmette-Guerin (BCG) instillation is considered the preferred treatment, with radical cystectomy being offered to refractory cases. Chemotherapy, α-interferon, and photodynamic therapy are other modalities that can be considered in BCG-refractory cases. Multifocality, involvement of prostatic urethra, and response to BCG remain the most important prognostic factors, although newer molecular markers are being evaluated for this entity. Patient outcome varies based on whether it is de novo development or diagnosed secondary to prior or concomitant papillary bladder cancer. From a clinical perspective, the principal determinants of outcome are extent of disease, involvement of prostatic urethra, response to therapy, and time to recurrence. © Journal of the National Comprehensive Cancer Network.
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    Urachal urothelial carcinoma diagnosed at a radical prostatectomy operation: A case report
    (2010) Nese N.; Kesici G.; Lekili M.; Isisag A.
    BACKGROUND: Urachal carcinomas are rare tumors, and the majority of them are adenocarcinomas. Up to now, only 21 urachal urothelial carcinomas (UCas) have been reported. Here, we describe a case of high grade UCa arising from the urachal remnants. CASE: A 66-year-old man presented with voiding difficulties. Prostate specific antigen (PSA) was 5.46 ng/mL. Prostatic adenocarcinoma (PCa) (Gleason score 6) was diagnosed by needle biopsies. After the diagnosis of high grade, muscle invasive UCa with intact mucosa on frozen examination of the dome of bladder wall during the radical prostatectomy operation (RPO), partial cystectomy was performed. Microscopically, among the tumoral islands, cystic structures lined by cells with a benign appearance, which are considered urachal remnants, were noted. Cytokeratin 7 and high-molecular-weight cytokeratin were strongly positive, PSA and carcinoembryonic antigen were negative. Radiotherapy was given for both UCa and PCa. Six months after the diagnosis, an undifferentiated tumor was detected in a bladder transurethral resection specimen; thus, chemotherapy was given. After 1 course of chemotherapy, the patient was doing well. CONCLUSION: The origin of urachal carcinomas is usually obscured as it is a highly invasive carcinoma. The patient presented here was diagnosed incidentally during RPO. Although the stage was advanced, the tumor was detected before urachal remnants were destroyed. The treatment choice for urachal carcinomas is cystectomy. Adjuvant chemotherapy and radiotherapy are controversial. © Science Printers and Publishers, Inc.
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    Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study
    (2013) Guvenal T.; Dursun P.; Hasdemir P.S.; Hanhan M.; Guven S.; Yetimalar H.; Goksedef B.P.; Sakarya D.K.; Doruk A.; Terek M.C.; Saatli B.; Guzin K.; Corakci A.; Deger E.; Celik H.; Cetin A.; Ozsaran A.; Ozbakkaloglu A.; Kolusari A.; Celik C.; Keles R.; Sagir F.G.; Dilek S.; Uslu T.; Dikmen Y.; Altundag O.; Ayhan A.
    Objective The objectives of this study were to examine demographic and clinicopathologic characteristics and to determine the effects of primary surgery, surgical staging and the extensiveness of staging. Methods In a retrospective Turkish multicenter study, 539 patients, from 14 institutions, with borderline ovarian tumors were investigated. Some of the demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging on survival rates were calculated by using Kaplan-Meier method. Results The median age at diagnosis was 40 years (range 15-84) and 71.1% of patients were premenopausal. The most common histologic types were serous and mucinous. Majority of the staged cases were in Stage IA (73.5%). 242 patients underwent conservative surgery. Recurrence rates were significantly higher in conservative surgery group (8.3% vs. 3%). Of all patients in this study, 294 (54.5%) have undergone surgical staging procedures. Of the patients who underwent surgical staging, 228 (77.6%) had comprehensive staging including lymphadenectomy. Appendectomy was performed on 204 (37.8%) of the patients. The median follow-up time was 36 months (range 1-120 months). Five-year survival rate was 100% and median survival time was 120 months. Surgical staging, lymph node sampling or dissection and appendectomy didn't cause any difference on survival. Conclusion Comprehensive surgical staging, lymph node sampling or dissection and appendectomy are not beneficial in borderline ovarian tumors surgical management. © 2013 Elsevier Inc.
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    The rate of neoadjuvant chemotherapy use in muscle invasive bladder cancer and the approach of urologists in Turkey
    (Urology and Nephrology Research Centre, 2016) Ucer O.; Albaz A.C.; Atağ E.; Karaoğlu A.; Muezzinoglu T.
    Purpose: To investigate the proportion of neoadjuvant chemotherapy (NAC) use in patients with muscle invasive bladder cancer before radical cystectomy and the approach of urologists to this subject. Materials and Methods: We invited 242 urologists during the 12th International Urooncology Congress in Turkey to answer a self-administered questionnaire. The questionnaire included questions related to radical cystectomy, lymph node dissection and neoadjuvant chemotherapy that had been performed in patients with muscle invasive bladder cancer by the urologist. Results: The median number of radical cystectomy operations was 20 per year. 122 (50.5 %) of 242 urologists had used neoadjuvant chemotherapy for the treatment of muscle invasive bladder cancer before radical cystectomy. The mean rate of neoadjuvant chemotherapy use by these urologists (n=122) was 28.46 %. The most common reasons for not using neoadjuvant chemotherapy by urologists in Turkey were as follows: (i) neoadjuvant chemotherapy might lead to a decrease in the cure rate of radical cystectomy due to delayed surgery (ii) complication rate of radical cystectomy might be elevated and the surgery might be complicated by NAC use. Conclusion: Although the European Association of Urology (EAU) guidelines panel on muscle invasive bladder cancer recommends using NAC in T2-T4a bladder, the rate of neoadjuvant chemotherapy use was still found to be low in our country because urologists have concerns about adverse effects NAC on radical cystectomy.
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    Borderline ovarian tumors: A contemporary review of clinicopathological characteristics, diagnostic methods and therapeutic options
    (Zerbinis Publications, 2016) Hasdemir P.S.; Guvenal T.
    Borderline ovarian tumors (BOTs) differ from the epithelial ovarian malignancies with their excellent prognosis, curability with surgery, and being seen in relatively young ages. Thus, fertility sparing and conservative surgical approaches are currently recommended. Preoperative diagnosis of BOTs can be challenging because, clinical and ultrasonographic features might overlap with invasive carcinomas and sometimes with benign adnexal masses. Certain characteristics such as stage at diagnosis, age of the patient and histologic features are important while deciding the extensiveness and the type of surgery. Detailed evaluation of the entire abdominal cavity and sampling all suspected areas are imperative during operation. Frozen section is essential for the intraoperative diagnosis, despite the fact that the diagnostic value of frozen section is not as high as in invasive ovarian carcinomas. Routine appendectomy and/or contralateral ovarian biopsy in cases of isolated tumor with normal appearing appendix and/or contralateral ovary are not recommended. Conservative approach might improve the recurrence rate without worsening the overall survival. The exact role of laparoscopic surgery with its advantages and disadvantages in the treatment of BOTs needs to be confirmed with further studies.
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    Predictive value of cyclooxygenase-2 over expression for identifying prostate cancer from benign prostatic hyperplasia in prostate biopsy specimens
    (Edizioni Minerva Medica, 2016) Ceylan Y.; Lekili M.; Muezzinoglu T.; Nese N.; Isisag A.
    BACKGROUND: We studied cyclooxygenase-2 (COX-2) immunohistochemical staining intensity both in prostatic biopsy and surgical samples of patients with prostate cancer to determine if it might provide prognostic information for the decision of re-biopsy indication. METHODS: Twenty-eight patients undergone radical prostatectomy whose final pathologic examination revealed prostatic adenocarcinoma were included in the study. Twelve patients with BPH in their pathological examination of both prostatic biopsy and open prostatectomy were considered as a control group. Intensity of COX-2 receptor was examined with immunohistochemical staining according to standard techniques. RESULTS: Positive COX-2 receptor staining was obtained 89.3% of biopsy samples and 93% of surgical samples in all cancer patients. The rate of agreement in COX-2 receptor staining of biopsy samples and radical prostatectomy samples was 76% in same patients (P=0.54). Similarly, the COX-2 receptor levels in biopsy specimens of patients with BPH open surgery compared with samples of the agreement still rate was 41% (P=0.41). Prostate cancer exchanging COX-2 receptor levels in patients with biopsy specimens in patients with BPH were found significantly more (P=0.008). CONCLUSIONS: In this study the feasibility of presence of COX-2 receptor staining in biopsy samples was shown. We have also demonstrated that COX-2 staining intensity was higher in prostatic biopsy samples of patients with prostatic cancer than patients with BPH. This leads a conclusion that, higher COX-2 expression levels in biopsy specimens may be used to decide re-biopsy in borderline preoperative PSA levels as well as in the cases with suspicious pathological findings for cancer. © 2014 EDIZIONI MINERVA MEDICA.
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    Atezolizumab in Patients with Metastatic Urothelial Carcinoma Who Have Progressed After First-line Chemotherapy: Results of Real-life Experiences
    (Elsevier B.V., 2021) Tural D.; Ölmez Ö.F.; Sümbül A.T.; Artaç M.; Özhan N.; Akar E.; Çakar B.; Köstek O.; Ekenel M.; Erman M.; Coşkun H.Ş.; Selçukbiricik F.; Keskin Ö.; Türköz F.P.; Oruç K.; Bayram S.; Yılmaz U.; Bilgetekin İ.; Yıldız B.; Şendur M.A.N.; Paksoy N.; Dirican A.; Erdem D.; Selam M.; Tanrıverdi Ö.; Paydaş S.; Urakçı Z.; Atağ E.; Güncan S.; Ürün Y.; Alkan A.; Kaya A.O.; Özyükseler D.T.; Taşkaynatan H.; Yıldırım M.; Sönmez M.; Başoğlu T.; Gündüz Ş.; Kılıçkap S.
    Background: Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies in patients with locally advanced or metastatic platinum-resistant urothelial carcinoma. Objective: To compare the real-life experience and data of clinical trials on ATZ treatment in metastatic urothelial carcinoma. Design, setting, and participants: Patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy from an expanded access program were retrospectively studied. Data of patients were obtained from their files and hospital records. Safety was evaluated for patients treated with at least one cycle of ATZ. Outcome measurements and statistical analysis: The primary endpoint was objective response rate (ORR). The secondary endpoints are overall survival (OS), progression-free survival (PFS), duration of response, and safety profile of patients. Kaplan-Meier methods were used to calculate median follow-up and estimate PFS and OS. Results and limitations: Data of 115 enrolled patients were analyzed. Most of the patients (92.3%, n = 106) had received chemotherapy regimen only once prior to ATZ. The median follow-up duration was 23.5 mo. The complete response rate, partial response rate, and ORR were 8.7% (n = 10), 20.0% (n = 23), and 28.7% (n = 33), respectively. The median duration of response was 20.4 mo (95% confidence interval [CI], 6.47–28.8). Of the 33 patients who responded to treatment, 60% (n = 20) had an ongoing response at the time of the analysis. PFS and OS with ATZ were 3.8 mo (95% CI, 2.25–5.49) and 9.8 mo (95% CI, 6.7–12.9), respectively. All-cause and any-grade adverse events were observed in 113 (98%) patients. Of the patients, 64% experienced a treatment-related adverse event of any grade and 24 (21.2%) had a grade 3–4 treatment-related adverse event. Limitations of the study included its retrospective design, and determination of treatment response based on clinical notes and local radiographic studies. Conclusions: In these real-life data, ATZ was effective and well tolerated in patients with metastatic urothelial carcinoma who have progressed with platinum-based first-line chemotherapy. ATZ is an effective and tolerable treatment for patients with locally advanced or metastatic platinum-resistant urothelial carcinoma in our study, similar to previously reported trials. Patient summary: Atezolizumab is effective and well-tolerated in patients with metastatic urothelial cancer who progressed with first-line chemotherapy, consistent with the outcomes of the previous clinical trials in this setting. © 2020 European Association of Urology