1.Coexistence of phaeochromocytoma and renal cell carcinoma
Enci XU ; Shiping CHEN ; Zipu CHEN
Chinese Journal of Urology 2000;0(12):-
Objectives To evaluate the relationship between phaeochromocytoma and renal cell carcinoma,and to present 2 cases of coexisting phaeochromocytoma and renal cell carcinoma. Methods 2 cases of coexisting phaeochromocytoma and renal cell carcinoma diagnosed and treated were reviewed and studied. A case of left adrenal phaeochromocytoma was disdiagnosed as metastatic carcinoma from the left kidney.Nephrectomy and adrenalectomy were carried out without preoperative preparation crisis occurred in the operation and was managed in time.The another is a case of coexising right adrenal phaeochromocytoma and right renal cell carcinoma.After adequate preoperative preparation,the operation was carried out safely.The postoperative course of both the patients has been uneventful. Conclusions An adrenal growth on the same side of a renal cases may not be a metestatic carcinoma.The possibility of an coexisting phaeochromocytoma shuld be kept in mind.Surgical management was the only means for cure and preoperative preparation was extremely important.
2.Assessment of risk factors for prostatic tumor invasion in patients undergoing radical cystectomy
Mengqiang LI ; Shaoqin JIANG ; Weizhong CAI ; Wei JIANG ; Song ZHENG ; Yongsheng LI ; Enci XU
Chinese Journal of Urology 2016;37(3):169-173
Objective To identify the risk factors for prostate-sparing cystectomy by evaluating the risk of prostatic invasion or incidental prostatic adenocarcinoma (PCa) in bladder cancer (BCa) patients undergoing radical cystectomy.Methods The patients undergoing radical cystectomy from 2009 to 2014 in Fujian Medical University Union Hospital were enrolled to analyze the risk factors of prostatic tumor invasion.These factors included age,tumor size,location,quantity,histologic grade and pathologic stage.Results In the 123 male patients,the mean age was 60 years (range,31-78 years);23 (18.7%) patients had BCa or PCa in the prostate;14 (11.4%) had prostatic Bca;11 (8.9%) had PCa.The risk factors of prostatic BCa included multifocal bladder tumors (OR =26.70,P =0.032),tumor in the bladder neck and trigone(OR =17.13,P =0.013),pathological stage (OR =26.70,P < 0.001).Among the 11 patients with PCa,3(27.3%) patients had Gleason score of ≥7,8(72.7%) patients ≤6 and 2(18.2%) patients had extracapsular extension.Three patients had clinically significant PCa.The factor of advanced age was associated with incidental PCa (P =0.003).Conclusion The risk factors of prostatic tumor invasion in patients undergoing radical cystectomy included advanced age,bladder tumor in bladder neck and trigone,muhifocal bladder tumors,and advanced pathological stage.
3.Risk factors analysis for the progression to castration-resistant prostate cancer
Shaoqin JIANG ; Mengqiang LI ; Enci XU ; Weizhong CAI ; Wei JIANG ; Yongsheng LI ; Song ZHENG
Chinese Journal of Urology 2018;39(11):847-851
Objective To explore risk factors of the progression to castration-resistant prostate cancer(CRPC)after hormone therapy (HT).Methods A total of 178 patients with prostate cancer from February 2009 to February 2018 were enrolled to analyze the risk factors of the progression to castrationresistant prostate cancer after androgen deprivation therapy in Fujian Medical University Union Hospital.The mean age was72 years (range,49-91 years);the middle Gleason score was 7 (range,4-10);the middle PSA at the initiation of HT was 24.45 ng/ml (range,0.16-100.0 ng/ml);the middle time to PSA nadir was 9 months (range,0.5-69.0 months);the middle PSA nadir after HT was 0.030 ng/ml (range,0.003-78.670 ng/ml);the mean hemoglobin level was 131 g/L (range,64-184 g/L);the mean alkaline phosphatase level was 98 U/L (range,35-734 U/L);39 patients were diabetes mellitus (21.9%);82 patients were bone metastasis/visceral metastasis (46.1%);85 patients (47.8 %) were in clinical T1 + T2;93 patients(52.2%)were in clinical T3 + T4.We studied the relationship between CRPC and these risk factors including age,Gleason score,PSA at the initiation of HT,PSA nadir after HT,the time to PSA nadir,hemoglobin level,alkaline phosphatase,bone metastasis/visceral metastasis,clinical T stage,diabetes mellitus by x2 test,univariate and multivariate Cox regression analysis methods.Results The middle follow-up time was 30 months (range,6-92 months).There were 74 of 178 patients progressed to CRPC after HT.The median time of progression to CRPC in this cohort was 15 months (range,4-47 months).On x2 test analysis,there were statistically significant differences between the progression to CRPC group after HT and the rest group in Gleason score (P <0.001),PSA nadir after HT (P <0.001),PSA at the initiation of HT (P =0.042),alkaline phosphatase (P =0.002),bone metastasis/visceral metastasis (P<0.001) and clinical T stage (P <0.001).Additionally,on multivariate Cox regression analysis,Gleason score (OR =6.152,P < 0.001),PSA nadir after HT (OR =3.022,P < 0.004) and the time to PSA nadir (OR =0.375,P <0.001) were found to be significantly associated with the rapid progression to CRPC.Conelusions Gleason score,PSA nadir after HT and the time to PSA nadir were significantly associated with the progression to CRPC.Patients with higher PSA nadir or the shorter time to PSA nadir were more likely to progress to CRPC.