PubMed Health⌕ Search

Biomedical subjects

W A Isa Kroon

Publications and source records attributed to W A Isa Kroon.

15 recordsLinked to original sources
PubMed1993

[Clinico-pathologic correlation in patients undergoing surgical staging and radical prostatectomy for prostatic cancer].

Presentation of our experience on the clinico-pathological staging of clinically localized prostate cancer (PCa) in 38 patients undergoing staging lymphadenectomy, 34 of which were treated with radical prostatectomy. From total number of patients, 37% were correctly staged, 60% were under-staged and only 3% were over-staged. A total of 11 patients (29%) presented nodular metastasis at the time of lymphadenectomy. Out of the 34 patients undergoing radical prostatectomy, 10 (29%) had microscopical invasion of prostatic capsule and seminal vesicles infiltration. The likelihood of nodes affectation in patients with prostatic capsule invasion and seminal vesicles infiltration was 60% and 70%, respectively. Mean PSA was significantly higher in patients with advanced disease as compared to those with disease localized in the prostatic gland. Also, mean PSA was significantly higher in patients with prostatic capsule invasion and seminal vesicles infiltration. The analysis by logistic regression identified pre-operative PSA as the only variable significantly correlated to the patient's final pathological stage.

Aged↗
PubMed1993

[Diagnosis of cancer of the prostate by determining the blood levels of specific prostatic antigen, rectal examination, and transrectal echography].

The usefulness of Prostate Specific Antigen (PSA), tactile rectal examination (TRE) and transrectal ultrasound (TRU) for the diagnosis of prostate cancer (PCa) was studied in 114 patients who came in for an evaluation of their mictional symptoms. Patients underwent random ultrasound-guided transrectal biopsies following findings of abnormal TRE and/or serum PSA concentrations > 5 ng/ml. Of the total series, 71% presented TRE abnormalities and 52% presented hypoechoic areas in the TRU (only ones to be considered suspicious). Also, 26%, 23% and 51% of patients presented normal (0-5 ng/ml), intermediate (5-10 ng/ml), and high (> 10 ng/ml) concentrations of serum PSA. Incidence of PCa was 31%. Based on the individual tests, both positive and negative predictive values were higher for serum PSA concentrations > 10 ng/ml. By combining the tests results, the diagnosis percentage was also higher with PSA levels > 10 ng/ml. Positive predictive value was 81% in patients with all three tests positive, 73% with suspicious TRE and high PSA and 70% with suspicious TRU and high PSA. Our results corroborate the superiority and efficacy of random biopsies over selective biopsies of hyperechoic areas. Nevertheless, of 21 patients with negative prostate biopsies who underwent TUR or retropubical adenomectomy, 28% had PCa. These findings indicate that random biopsies are associated with a percentage of false negatives which varies depending on the features of the sample being studied. In conclusion, PSA is the ideal complement to TRE, and the association of these two tests constitutes the best indication for an ultrasound-guided random prostate biopsy, with independence of any TRU findings.

Aged↗
PubMed1991

[Tumors of the upper urothelium and cyclophosphamide: presentation of a case and review of the literature].

We report a case of upper urothelial tumor in a patient who had previously received prolonged cyclophosphamide therapy for Waldeström's macroglobulinemia. Although bladder tumors in cyclophosphamide-treated patients are relatively frequent, upper urothelial tumors are rare. Only 5 cases of this latter tumor type have been reported as of 1987. The literature on this disease entity is reviewed. Patients who have received prolonged therapy with cyclophosphamide or similar drugs must be followed very closely.

BCG Vaccine↗
PubMedDate not supplied

[Effect of time of vascular anastomosis and of hot and cold ischemia, on survival of cadaver renal graft].

A retrospective study was performed on our series of 240 primary cadaveric renal transplant recipients to dissect the influence of vascular anastomosis time, warm ischemia time and cold ischemia time on ultimate graft survival. 177 patients received conventional immunosuppression with Azatioprine and steroids, and 63 patients received Cyclosporine A therapy. The data was analyzed for sub-groups of ischemia time and comparisons were performed using the method of Tarone-Ware. The present study fails to demonstrate a detrimental effect of ischemic insults on graft survival. The use of Cyclosporine A in the pre and post-transplant, monitoring periodically serum cyclosporine levels and the use of renal allograft biopsy, allows the use of this agent without a high incidence of nefrotoxicity.

Adult↗
PubMedDate not supplied

[Uretero-iliac fistula: presentation of a case and review of the literature].

We report a case of right common iliac artery fistula to the left ureter in a patient affected by an invasive bladder tumour treated with radical surgery, radiotherapy and neo-adjuvant chemotherapy. At the time of manifestation, our patient had indwelling catheters and presented an urinary tract infection. Diagnosis was established during autopsy. We feel that the cause of this complication is multifactorial.

Aged↗
PubMedDate not supplied

[Stage Ta/T2 bladder tumors: prognostic and clinical course factors].

One hundred and twenty-three patients with a Ta/T2 stage vesical tumour were studied in order to identify the histological aspects associated to a tumoral behaviour particularly aggressive. The multivariate study demonstrates that those patients with a infiltrating tumour (T1-T2) or diffused urothelial dysplasia, have specially high possibilities to progress with regard to the degree of cell anaplasia (p less than 0.05); very close follow-up is needed in those patients. Likewise, patients presenting disseminated dysplastic lesions and with a history of previous urothelial tumours, progress to a new tumour stage with a significantly higher frequency (p less than 0.01); in those cases, radical surgery is the choice treatment.

Aged↗
PubMedDate not supplied

[Prognostic value of initial function in graft and patient survival in cadaveric renal transplant; impact of cyclosporin A].

This paper presents our experience with 237 primary renal cadaveric transplants and analyzes related factors to Initial Non-Function, its influence on graft and patient survival as well as the impact of cyclosporin A on graft survival. Our study shows better graft survival rates in patients treated with cyclosporin A and in patients with Immediate Initial Function.

Adolescent↗
PubMedDate not supplied

[Superficial tumors of the bladder: prognostic value of the free of disease period].

We study retrospectively 123 cases of patients suffering from Ta/T1/T2 vesical tumour so as to evaluate the Disease Free Period as a predictive factor of relapse potential, capability of progression and survival. This parameter has no influence over the variables that define the progression of the tumour, but it has a close correlation with relapse potential; Annual Relapse Rate (p less than 0.001) and Mean Interval between Relapses (p less than 0.0001). We were not able to show any relationship between Disease-Free Period and Survival, however it defines those tumours which relapse due to tumoural persistence. These tumours progress in stage in 80% of cases and 75% of these do so with deep tumours.

Aged↗
PubMedDate not supplied

[Effect of complementary treatment (radiotherapy, chemotherapy) on the survival of patients with T3 tumors of the bladder treated with radical surgery].

We present the results obtained from the study of 65 patients with vesical carcinoma stage T3 treated with radical surgery with or without supplementary radiotherapy, with or without supplementary chemotherapy. The multivaried study of survival (Cox's model) shows that it depends significantly on the surgical complications and on the pathological state at the time of the cystectomy. Univaried analysis indicates that patients with descent from post-radiotherapy stage and those subjected to IOR (intraoperative radiotherapy) have a significantly better survival than the rest and suggests that radiotherapy improves overall survival. Influence of supplementary treatment (radiotherapy, chemotherapy) in the survival of T3 bladder tumours subjected to radical surgery.

Combined Modality Therapy↗