Biomedical subjects

M Arrizabalaga Moreno

Publications and source records attributed to M Arrizabalaga Moreno.

At least 19 recordsLinked to original sources

PubMed2004

[Therapeutic options for patients with localized prostatic carcinoma: our experience with 454 patients].

OBJECTIVES: To evaluate the influence of different therapeutic options on progression-free survival (PFS), overall survival (OS) and specific survival (SS) in a cohort of 454 patients with localized prostatic carcinoma, taking into account different prognostic factors, and to compare our results to those reported in the world literature. MATERIAL AND METHODS: Between 1983 and 2000 we have diagnosed 706 new cases of prostatic carcinoma and 454 were clinically localized tumors. The different therapeutic options employed in our series of patients have been: follow-up (FU) (103 patients); radical prostatectomy (RP) (108 patients); radiotherapy without hormonal blockade (RT) (148 patients); and hormonal blockade (HB) (95 patients). We have determined the PFS, the OS and the SS for each group of patients and compared them in patients with different prognostic factors at the time of diagnosis, including age, PSA levels, Gleason's grading and TNM staging. We have also analysed the influence of the tumor progression on the OS. The mean follow-up time has been 5.6 years (range: 0.1-19.2; median: 5.2). RESULTS: For PFS: the disease progressed in 145 patients (32%) and the PFS at 5 and 10 years has been 77% and 67% for FU; 61% and 50% for RP; 63% and 25% for RT; and 73% and 67% for HB, respectively. The differences between RT and RP were not statistically significant. For the subgroup of patients with PSA levels <10 and Gleason <8 the differences between FU, RP and RT did not reach statistical significance. For OS: 126 patients of our series died (28%) and the OS at 5 and 10 years has been 80% and 61% for FU; 90% and 76% for RP; 85% and 67% for RT; and 64% and 32% for HB, respectively. We have found no significant differences between FU, RP and RT. For SS: 31 patients of our series died of disease (6.8%). The SS at 5 and 10 years has been 100% and 94% for FU; 98% and 98% for RP; 97% and 88% for RT; and 83% and 77% for HB, respectively. We have found no significant differences in the OS between patients with disease progression and without disease progression treated with FU, RP and RT. CONCLUSIONS: Determination of PSA levels has allowed diagnosis of prostatic carcinomas in early stages of disease; however, our results and those reported in the literature cannot define which is the best therapeutic option in these patients. We should offer the patients individualized information both in the phase of early diagnosis and of therapeutic decisions.

Adenocarcinoma↗

PubMed2003

[The prostate cancer in the community of Madrid in 2000 I.- Incidence].

OBJECTIVE: To know the incidence in the year 2000 of prostate cancer in the Autonomous Community of Madrid and its breakdown by Health Areas. MATERIAL AND METHOD: Study of histologically confirmed prostate cancer case reports and retrospective data acquisition for 2000 in the Autonomous Community of Madrid, both from Public and Private Health Care hospitals. RESULTS: Gross incidence of prostate cancer in the Autonomous Community of Madrid was 100.4 cases per 100,000 males. The incidence adjusted for the Spanish, European and Worldwide population was 120.1, 103.5 and 68.6 cases per 100,000 males, respectively. Mean age at diagnosis was 70 +/- 7.8 (40-94) years, median of 70 years. The age group with higher incidence was 70 to 79 years. CONCLUSIONS: The incidence of prostate cancer in the Autonomous Community of Madrid is lower than that in the US but higher than in most countries or regions in the EU. The different way of using PSA testing in the Health Areas of the Autonomous Community may explain the differences seen in terms of incidence by Area.

Adult↗

PubMed2003

[The prostate cancer in the community of Madrid in 2000. II Presentation and diagnosis].

OBJECTIVE: To know the presentation form, diagnostic method and clinical stage at the time of diagnosis in subjects with prostate cancer (PC) in the Autonomous Community of Madrid in 2000. MATERIAL AND METHOD: Data from 1745 patients with histologically confirmed prostate cancer obtained from 15 Hospitals participating in the study was analysed. The variables studied were: associated disease, reason for visiting the hospital, digital rectal examination (DRE), PSA, diagnostic method, graded Gleason score, tests performed in the tumoral extension study and tumour staging. The qualitative variables are given in percentages of the overall number and the quantitative variables are expressed as the median, standard deviation, maximum and minimum values and 25%, 50% (median) and 75% percentiles. RESULTS: 67% cases had an associated disease. In most (75%) patients the reason for visiting the hospital was prostatic syndrome. DRE revealed that 42.7% has no tumour. At the time of diagnosis half the patients had PSA levels lower than or equal to 11 ng/ml. Transrectal ultrasound-guided biopsy was used for diagnosis in 93% subjects. The most commonly reported Gleason scores were 6 (31.3%) and 7 (28.7%). In 75% subjects the disease was considered to be clinically limited to the prostate, in 12.5% locally advanced and in 12.5% metastatic. CONCLUSIONS: Most patients came to the hospital because of symptoms not related to PC. Transrectal ultrasound-guided biopsy is confirmed as the choice technique for PC diagnosis. When a comparison is made to historical series in our Autonomous Community a pattern of earlier diagnosis can be seen.

Adult↗

PubMed2003

[Prostate cancer in the Community of Madrid in the year 2000. III. Study of tumor extent].

OBJECTIVE: To identify a potential relationship between two variables, risk of metastasis and use of imaging techniques, in an extension study in prostate cancer patients diagnosed in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: 1,127 patients with available data on the tumour extension study were analysed. Performance and non performance of bone scans and CTs were correlated to risk variables for developing metastasis as described in the literature (PSA, Gleason and stage) and to therapy administered. RESULTS: The proportion of patients with risk variables for metastasis when bone scans were performed was between 7% to 14% greater than in patients with no variables. No differences were seen for CTs based on risk variables. With matching risk variables, more imaging techniques were used in patients receiving radiotherapy that in those managed with prostatectomy. CONCLUSION: Based on current recommendations imaging techniques were used in excess in the extension study in patients with no risk variables for metastasis. Conduct of a further study in the Autonomous Community seems advisable to confirm the likelihood of implementing such recommendations considering our prevalence of metastatic disease.

Adenocarcinoma↗

PubMed2003

[Prostate cancer in the Community of Madrid in the year 2000. IV. Treatment].

OBJECTIVE: To know the therapeutic options used in patients diagnosed with prostate cancer in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: The study was conducted on 1,745 patients referred by hospitals taking part in the study. Data on treatment used was available for 1,104 (63%) patients. Treatment modality was correlated to clinical stage and patient age. RESULTS: Most frequent choice was hormone therapy (35%) followed by radical prostatectomy (34%) and radiotherapy (25%). Prostatectomy was most commonly used in patients with localised (42.3%) disease while hormone therapy was preferred for locally advanced (45.6%) or disseminated (94%) disease. There are significant differences in therapeutic indications between the various Health areas participating in the survey. Median age of patients with localised and locally advanced disease was lower in patients managed with prostatectomy (65 and 64 years, respectively) than in those managed with radiotherapy (70 and 69 years, respectively). CONCLUSION: The therapeutic modality indicated by urologists in the Madrid Autonomous Community for managing patients with prostate cancer generally meets with literature recommendations.

Adenocarcinoma↗

PubMed1999

[Progression and prognosis of in situ carcinoma of the bladder treated with BCG].

OBJECTIVES: In situ carcinoma (isT) of the bladder is a poor prognostic tumour with a natural progressive evolution. Treatment with BCG achieves a significant improvement in survival. This paper analyses our experience in the management of isT patients with endovesical BCG. MATERIAL AND METHODS: Between 1983 and 1997 the Urology Unit in the Móstoles Hospital saw 636 patients with transitional carcinoma of the bladder. Of these, 498 (78%) were surface tumours, and 138 (22%) were infiltrant. isT: 80 patients (13%), 14 of which were primary (17%), 37 associated to a surface tumour (46%), and 29 to infiltrant tumours (36%). All surface tumours: isT was present in 51 patients (10%) 44 of which were managed with 2 courses of BCG Connaught (81 mg), for 6 weeks each followed by vesical reassessment. Quarterly follow-up was conducted during a 2-year period. Patients not managed with BCG were treated with radical cystectomy. An analysis was made of patients without complete response to BCG, as well as actuarial analysis of disease-free survival (DFS), survival until progression (SUP) and specific survival (SS). All possible prognostic factors are analyzed: sex, focal isT (a single focus) or diffuse isT (more than one focus). Primary or secondary isT and association to G1, G2 or G3 tumours. RESULTS: In all 44 patients managed with BCG: males 37 (84%), females 7 (16%), primary 14 (32%), focal 22 (50%), diffuse 22 (50%). Six patients died (5 because of the tumour). Mean follow-up of living patients: 3.7 years (0.5-7.5 years). After the 2 BCG courses, 36 (82%) showed complete response. Thirteen patients (30%) had no complete response during follow-up, and 11 (85%) continued to progression. In total 7 patients underwent cystectomy. Of 5 patients directly cystectomized due to persistence of isT or T1G3 tumour at monitoring after BCG, 2 (40%) had infiltrant tumour and one (20%) nodular metastasis. Three patients with persistent isT or T1G3 after BCG were not initially cystectomized: two that were treated with other endovesical therapies because of their age progressed, and the third one underwent a third BCG course and required cystectomy due to tumour persistency. 5-year DFS: 56%, being diffuse isT vs. focal isT (p = 0.0206) was an unfavourable prognostic factor. 5-year SUP: 63%, no significant prognostic factor. 5-year SS: 79%, being a female was an unfavourable prognostic factor (p = 0.0201). CONCLUSIONS: Based on our results and the analysis of the literature we recommend treatment with 2 BCG courses of all isTs of the bladder that present some of the following factors: Diffuse cancer associated to T1G3, involvement of prostatic urethra or overexpression of p53 over 20%. In the rest of vesical tumours, one BCG course followed by a second one if lack of response to the first. After failure of both BCG courses, cystectomy must be performed in both groups.

Adult↗

PubMed1998

[Urothelial carcinoma of the upper urinary tract. Survival and prognostic factors].

OBJECTIVE: To analyze the survival and the main prognostic factors in patients with transitional cell carcinoma of the upper urinary tract. METHODS: From 1983 to 1996, we treated 50 patients with transitional cell carcinoma of the upper urinary tract. Treatment was basically conservative except in those cases whose tumor stage or grade required a radical approach. Grading and staging were performed according to the 1992 TNM classification. Eighteen patients had died at one year mean follow-up., At the time the study was completed (June, 1997), 32 patients were alive with a mean follow-up of 4.9 years. Disease-free survival, overall and specific survival were analyzed according to sex, age, association with bladder tumors, localization, type of treatment, tumor size, number, histological grade and stage. RESULTS: The male-to-female ratio was 5:1. Patient mean age was 65.7 years. Association with bladder tumors was observed in 50%. Treatment was conservative in 40% and radical in 60%. The five- and ten-year disease-free survival rates were 69%, overall survival 61% and specific survival 71%. The univariate analysis showed the following to be unfavorable prognostic factors for survival: renal vs ureteral tumors, radical vs conservative treatment, high grade and stage tumors. The association of carcinoma in situ with other tumors of the upper urinary tract was also found to be an unfavorable factor for disease-free survival. The multivariate analysis associated T4 and G3 tumors with poor prognosis. CONCLUSIONS: Transitional cell carcinoma of the upper urinary tract was associated with bladder tumors in 50% of the cases. Low grade stage tumors demonstrated a high survival rate, therefore conservative treatment should be the first approach. High grade/ stage tumors were found to be unfavorable prognostic factors for survival.

Adult↗

PubMed1997

[Meconial hydrocele].

Presentation of one case of meconial hydrocele, a very infrequent disease that should be taken into account in all newborns presenting intrascrotal mass. Ultrasonography performed to a 29 year-old female during the 36th week of pregnancy, demonstrated in the fetus the presence of an enlarged right hemiscrotum with homogenous material inside, which was diagnosed as an intrascrotal haematoma due to a likely intrauterine spermatic cord torsion. After eutocic delivery, within one month from birth the newborn developed signs and symptoms which were compatible with acute scrotum and the emergency surgical exploration showed meconial hydrocele secondary to patency of peritoneal-vaginal duct with associated inguinal hernia. The causes, forms of presentation, differential diagnoses and therapeutical options of meconial peritonitis, a rare condition with favourable evolution in most cases, are analyzed showing that, under certain circumstances, treatment is controversial.

Female↗

PubMed1997

[Clinical course of superficial transitional carcinoma of the bladder without poor prognostic factors].

OBJECTIVES: Surface carcinoma of the bladder shows a high incidence of tumour recurrence that require frequent examinations associated to potential morbidity. This paper analyses our series of patients with vesical tumours with no known unfavourable clinical prognostic factors, aiming to detect low risk groups where it may be feasible to change the usual follow-up criteria. MATERIAL AND METHODS: Between 1983 and 1996, 503 patients with vesical cancer, 388 of which 388 were primarily surface tumours, were monitored. The study analyzed 24 patients with surface transitional carcinoma with no unfavourable prognostic factor, i.e. Ta tumours, grade 1, single, under 1 cm, negative urine cytology and multiple negative vesical biopsies. This group was then compared to a control group comprising all other patients with surface tumours in our series (364 patients), and the prognostic factors were assessed based on the disease-free interval, progression-free interval, and overall and tumour-specific survival. Also the recurrence-free interval from the first endoscopic control at 3 months after transurethral resection, were studied according to Parmar's criteria. RESULTS: With a mean follow-up of 53 months, 37% patients in the study group have relapsed versus 41% in the control group (n = 0.9), after 2 years on average. Actuarial curves in the control group reveal statistical significance for higher degree tumours recurrence. No grade progression has occurred in the study group versus 9% in the control group. No patient evolved to T2 versus 5% in the control group; also in this group, 5% patients died because of their tumour versus none in the study group. The 24 patients in the study belong to group 1 in Parmar's low risk, while the remainder of patients in the control group ranked according to these criteria have demonstrated an unfavourable statistical significance (p < 0.01) in patients with early relapse. CONCLUSIONS: Good results obtained in the evolution of patients with surface tumours with no unfavourable prognostic factors are due to the strict monitoring they undergo in order to detect early relapses. However, 37% of recurrences in this group does not allow to modify the usual follow-up schedule. In our experience, Parmar's criteria does not contribute any benefit over classical criteria to evaluate prognostic factors in surface vesical cancer.

Actuarial Analysis↗

PubMed1997

[Evolution and prognostic factors of adenocarcinomas of the prostate metastasizing at diagnosis].

OBJECTIVES: In 30-40% patients, prostate adenocarcinoma is diagnosed already in the metastatic phase, a percentage that will depend on the number of patients with localized cancer that we are unable to detect. Hormonal suppression is the most widely accepted therapeutical option, although there are doubts on the value of rescue treatment after the hormone-refractive stage. This paper analyses those parameters as well as the main prognostic factors in a series of 135 patients with metastatic prostate cancer at diagnosis. MATERIAL AND METHODS: Between 1983 and 1996, 414 patients were diagnosed with prostate adenocarcinoma in the Urology Unit. Móstoles Hospital, 135 of which (32.6%) were metastatic at the time of diagnosis and were managed as follows: 113 (84%) were treated with maximum androgenic blockade (MAB). 13 (9.6%) with orchiectomy and antiandrogens, 5 (3.7%) with various treatments, and only 4 received symptomatic treatment. Of those treated with MAB, 97 (72%) continued treatment after the hormone-refractive stage and 16 (12%) were given stramustine phosphate instead of the antiandrogen. Response monitoring was done basically by means of serial PSA determination. The parameters analyzed included survival and the following potential prognostic factors: age, performance status, metastatic bone pain, tumour diagnosis based on number of metastasis, prior PSA level, Gleason, local stage, M1 type at diagnosis based on the 1992 TNM classification, and response to the various treatment applied. RESULTS: Mean age: 72 years. Over an average of 25 (0-127) months, 80 (59%) patients have died; mean follow-up of patients alive at end of study: 24 months (3-111). Lost to follow-up: 6 patients (4.4%). Up to 1991, the proportion of patients with metastasis was 48%; since 1992, 24%. Percentage of patients diagnosed due to clinical manifestations of the metastasis (25 patients) over these two periods increased, mean age decreased and the proportion of patients with highly aggressive tumours increased. Mean overall survival, 26 months: influential prognostic factors: diagnosis due to metastasis and Gleason greater than 7; very poor prognosis for those receiving no hormonal therapy, with no differences between drug versus surgical treatment. Tumour-dependent mean survival, 32 months; influential prognostic factors: performance status, metastatic bone pain, diagnosis due to metastasis and Gleason greater than 7; very poor prognosis for those receiving no hormonal therapy. Progression-free interval, 19 months; influential prognostic factors: metastatic bone pain, PSA higher or lower than 90. Gleason greater than 7 and local stage: no differences between treatments. Mean survival after progression, 6 months; influential prognostic factors: diagnosis due to metastasis, M1b versus M1c patients: increased survival in patients rescued with stramustine phosphate. CONCLUSIONS: The proportion of prostate adenocarcinomas with metastasis at diagnosis shows a trend to decrease, although the percentage of patients who are diagnosed by the sings and symptoms of their metastasis is increasing. These patients should be treated with pharmacological or surgical hormone-suppression. Rescue treatment with stramustine phosphate prolongs survival. Influential prognostic factors: Gleason greater than 7, metastatic bone pain, tumour extent and previous PSA.

Adenocarcinoma↗

PubMed1997

[Vesical endometriosis after cesarean section: diagnostico-therapeutic aspects].

Endometriosis is a benign condition with an aggressive behaviour defined by the presence of ectopic endometrial tissue, outside the uterus. It occurs in 15-20% women with child bearing potential. Most commonly it affects organs such as the ovaries, uterine ligaments, fallopian tubes, rectum and the cervico-vaginal region. Involvement of the urinary tract, however, is rare. It can be seen in just about 1% cases, vesical location being the most frequent of these presentations (84% cases). We describe one case of vesical endometriosis that developed after a cesarean section. The intra-operative findings confirmed the existence of infiltration of the detrusor muscle and the vesical mucosa by endometrial tissue from the area of the uterine incision. A discussion of the different diagnostic and therapeutic options is also included.

Adult↗

PubMed1997

[Epidemiologic indicators of adenocarcinoma of the prostate. Results on 436 patients].

OBJECTIVE: To conduct a populational study by analyzing the major epidemiological indicators in a group of 436 patients with prostate adenocarcinoma. MATERIAL AND METHODS: The population reference for the study involves a total of 396,294 people, of which 197,500 are male. Between 1983 and 1996, 436 patients were diagnosed with prostate adenocarcinoma in the Urology Service of Mostoles Hospital. Gleason Index has been used to determine the histological grade, while the 1992 TNM rating was used for staging purposes. Gleason rating is known for 395 patients, distribution being as follows: 26.6% with Gleason 2, 3 or 4; 44.6% with 5, 6 or 7 and 28.9% with 8, 9 or 10. T1 tumours accounted for 21.1% cases; T2: 45.6%; T3: 22.2% and T4: 11%. There were 58.3% M0: 32.8% M1 and 8.9% Mx tumours. Approach for local disease: radical prostatectomy or radiotherapy. Approach for disseminated disease; hormonal blockade. Deaths: 130 (29.8%); cancer related deaths: 91 (70%). Mean follow-up of survivors: 3.4 years (0.25-14 years). Major variables analyzed: age, incidence, prevalence, mortality, Gleason's evolution and overall and specific survival. RESULTS: Mean age: 71.3 years. Prior to 1990 there were 55.5% patients under 70 years old; in 1995-96 there are 39.4%. Incidence has increased up to 36.5% per 100,000 people/year in 1996. Mean mortality in 1993-1996: 5.6 per 100,000 people/year. Prevalence in 1996: 155 per 100,000 people/year. Family background for prostate cancer: 8%. Incidence of second tumours: 10.5%. Increased proportion of patients with moderate to high versus low Gleason grades. Overall survival at 5 years: 53%, at 10 years: 33%. Tumour related survival at 5 years: 65%; at 10 years: 48%. Older age, higher PSA, higher Gleason, advanced stages and metastasis are all unfavourable prognostic factors for both overall and specific survival (p = 0.000). Significant prognostic factors in multivariate analysis have been a higher Gleason grade and non metastatic tumour at diagnosis. CONCLUSIONS: Incidence of prostate adenocarcinoma has increased in our milieu, reaching 36.5 per 100,000 people/year in 1996, far from the figures in the US. Actual mortality in our series is somehow lower than data published in other national series. This condition shows very high prevalence rates which results in increasingly growing and highly significant economic costs.

Adenocarcinoma↗

PubMed1997

[Bladder pseudosarcoma in pediatrics: clinico-pathological features and treatment].

OBJECTIVES: To review the most common clinical signs and symptoms of inflammatory pseudotumor of the bladder in children and to distinguish this benign lesion from malignant neoplasms such as rhabdomyosarcoma and leiomyosarcoma. METHODS: Two cases os pseudosarcomatous tumor of the bladder in children are described. In the first patient, the tumor had appeared spontaneously in a 9-year-old boy. The second had developed in a 6-year-old girl and was considered to be reactive to prior surgery. The literature is reviewed and data from 16 cases of inflammatory pseudotumor of the bladder in patients under 16 years of age are also presented. RESULTS: The mean age at presentation was 8 years. The male-to-female ratio was 3:1. Hematuria (56%), dysuria (37%) and abdominal pain with a palpable mass (18%) were the most commonly described clinical manifestations. Tumor size ranged from 3 to 10 cm and they were frequently located in the lateral walls and base of the bladder. Histological analysis showed an inflammatory pseudosarcomatous reaction. Immunohistochemical analysis showed moderate staining for vimentin, mild staining for focal muscle actin and negative for keratin and S-100 protein. Patients were treated by local resection (7 pts), partial cystectomy (5 pts), radical cystectomy (2 pts) and pelvic exenteration (2 pts). The mean follow-up was 34 months. All patients that had been followed (14/16) were reported to be free of disease with no evidence of recurrences or metastases. CONCLUSIONS: Inflammatory pseudotumor of the bladder is an unusual benign tumor that is very rare in children. Long-term follow-up confirms the benign nature of the lesion and conservative management is therefore advocated. However, given its histological similarity to malignant tumors, a close follow-up is recommended.

Child↗

PubMed1995

[Transurethral resection of prostate cancer: efficacy and morbidity].

OBJECTIVES: The efficacy and morbidity of transurethral resection of the prostate (TURP) were evaluated in patients with urinary retention and prostatic carcinoma. METHODS: From 1990 to 1993, 30 patients with infravesical obstruction secondary to prostate cancer were treated by TURP. The results were considered good when patients were able to void and were completely continent following the procedure, whereas poor results were defined as incontinence or no relief of urethral obstruction 21 days following catheter removal. RESULTS: Patient mean age was 72 years and the average weight of resected tissue ranged from 8 to 105 gms (mean 19.5 gms). The median postoperative follow-up period was 20.5 months (range 6-36 months). During this time, there were no deaths and 72.5% of the patients showed normal post-TURP micturition. Eight patients (27.5%) developed the following complications: 3 were incontinent, 6 had persistent obstruction and 1 patient had both complications. Presurgical hormone therapy, high-grade tumors and patient age under 70 years appear to be statistically related to poor outcome following TURP. CONCLUSIONS: TURP is an effective treatment with a relatively low morbidity and offers a viable option for patients with symptomatic urethral obstruction due to prostate cancer.

Aged↗

PubMed1995

[Flubiprofen vs dipyrone combined with hyoscine: the analgesic efficacy in renal colic].

OBJECTIVE: We compared the efficacy of flurbiprofen (NSAID) versus dipirone + hyoscine N-butylbromide in the treatment of nephric colic. METHODS: The study comprised 135 patients, aged 18 to 75 yrs, with intense nephric colic. The patients were observed 60 min after a single IM dose of 150 mg flurbiprofen (n = 67) or 2 gm dipirone + 20 mg hyoscine N-butylbromide. RESULTS: Both treatment modalities were well-tolerated and afforded significant pain relief. Flurbiprofen, however, was faster-acting and superior to dipirone + hyoscine in the overall evaluation of good and excellent therapeutic response rates. CONCLUSION: The results of the study show that IM flurbiprofen is a useful alternative to dipirone + hyoscine N-butylbromide in the treatment of nephric colic.

Adolescent↗

PubMed1990

[Early diagnosis of cancer of the prostate. Is is useful?].

Endorectal sonography (ES) + fine needle aspiration biopsy (FNAB) constitute a considerable advancement in the diagnosis of prostate cancer (PC). With ES we can detect lesions less than 0.5 cm, and FNAB permits us to know its histologic nature. Both techniques complement each other and together permit accuracy and early diagnosis while other available methods do not. Cure of this tumor type, the second most frequent in men, is based on early diagnosis. Since early tumor staging is mandatory for adequate treatment, this can only be achieved if the tumor is diagnosed in the asymptomatic phase. The present study reviews the scant epidemiologic studies available reporting a prevalence of up to 30% in males over 50 years old. In our own study, our statistical data reveal a prevalence of 9.97/1000 which is no doubt lower than the true prevalence of this disease. We discuss the ultrasound features of prostate disease with a special focus on prostate cancer. Hypothetically, we compare the cost of screening or not screening for early diagnosis and conclude that this method is of the highest diagnostic value in early, correct treatment of this disease entity.

Adult↗

PubMed1989

[Incrusted alkaline cystitis. Physiopathological basis for treatment with acetohydroxamic acid].

Alkaline incrusting cystitis is an uncommon clinical condition that usually presents in the course of bladder disease. It has characteristic presenting features and is difficult to treat despite currently available therapeutic measures. Three such cases that had been diagnosed and treated at our department is described herein. The literature is reviewed and the pathologic mechanisms of this condition are analyzed.

Aged↗

PubMedDate not supplied

[Clinical course and mid- and long-term prognosis of superficial bladder tumors].

OBJECTIVES: To evaluate the outcome of 551 patients with superficial transitional cell carcinomas of the bladder. To determine prognostic factors in these patients by means of the log-rank analysis of the Kaplan-Meier curves and a multivariate analysis with Cox regression model for the disease free survival (DFS), time to progression to infiltrating lesions (TTP) and overall survival (OS). MATERIAL AND METHODS: Between 1983 and 1998 we have seen 551 patients with superficial transitional cell carcinomas of the bladder in our Hospital. Fifteen patients included in this series had been diagnosed in other hospitals before 1983. The clinical records were actualized between 1998 and 2000 and only 21 patients were lost to follow-up (3.8%). The mean follow-up time was 6.2 years (median time: 5.3). One hundred and eleven patients (20%) died with a mean of 4.5 years (median time 3.4). Four hundred and forty patients were still alive on completion of the study with a mean follow-up time of 6.6 years (range 2-24 years; median 5.7). RESULTS: Four hundred and fifty-nine patients were men (83%) with a mean age of 64 years and 92 were women (17%) with a mean age of 70 years. In 347 patients there was only one tumour (63%). The tumours were stage Ta in 79 cases (14%). T1 in 431 (78%) and Tis in 41 (7%). The histological grade was G1 in 406 cases (74%), G2 in 96 (17%) and G3 in 33 (6%). There were recurrences in 253 patients (46%) with a mean time of 2.2 years. The DFS was 55% at 5 years, 44% at 10 years and 38% at 15 years. The multivariate analysis has shown a negative prognostic influence on DFS of the presence of multiple tumours (RR 1.4 CI 1.19-1.69), increasing age (analysed as a continuous variable) and the sex (being worse for females; RR 1.2 CI 0.98-1.52). In 40 patients (7.3%) the tumour became infiltrative in a mean of 3.3 years. The TTP was 93% at 5 years, 91% at 10 years and 90% at 15 years. The negative prognosticators in the multivariate analysis were G3 tumour (RR: 5.1 CI 2.7-9.6), the group of tumours Ta-T1G3 or multiple T1G2 or Tis (RR 4.6 CI 2.6-7.9) and the age > 70 years (RR 2.14 CI 1.2-3.7). Thirty-one patients (5.6%) died of the tumour in a mean time of 4.6 years. The OS was 95% at 5 years, 93% at 10 years and 91% at 15 years. Significant prognosticators in the multivariate analysis for OS were the group of risk tumours Ta-T1G3 and multiple Tis or T1G2 (RR 5 CI 2.7-9) and age > 70 years (RR 4.56 CI 2.2-8.8). CONCLUSIONS: The recurrence rate is very high in all the patients, but the risk is highest when the tumours are multiple. The risk of progression is low, but still exits even in patients with tumours of low malignant potential. The highest risk is associated with Ta-T1G3 of Tis or multiple T1G2.

Adult↗