Bladder urothelial carcinoma typically occurs in individuals in their sixties or seventies: it rarely occurs in persons <20 years old. Moreover, in young patients, bladder urothelial carcinoma lesions are reported to be solitary and nonmuscle invasive, with low malignant potential. However, 13% of lesions in this age group are reported to be noninvasive high-grade papillary urothelial carcinoma but these are extremely rare in children <15 years. There is no specific consensus regarding treatment of bladder urothelial carcinoma in children and adolescent. In particular, method has been suggested for follow-up of high-grade bladder urothelial carcinoma. Therefore we report our experience of one case the, discuss surveillance methods, and provide a brief review of the literature.
Adolescent ; Child* ; Consensus ; Follow-Up Studies ; Humans ; Methods ; Pediatrics ; Urinary Bladder*

Splenosis refers to the heterotropic autotransplantation of splenic tissue. Sometimes splenosis after surgical resection is difficult to differentiate from recurrence or metastasis of cancer. A 49-year-old male patient was diagnosed with clear cell renal cell carcinoma of left kidney. As there was no evidence of metastasis, he underwent radical nephrectomy with splenectomy. On surveillance computed tomography, masses at nephrectomy site and pleura were found and both were initially considered to be recurrence. After several cycle of pazopanib administration, pleural mass decreased in size while mass at nephrectomy site did not respond at all. Spleen scan showed increased uptake of the mass and therefore the mass was revealed to be splenosis. To avoid unnecessary treatment and planning optimal treatment, considering the possibility of splenosis is important and spleen scan can be helpful.
Autografts ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Male ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy* ; Pleura ; Radionuclide Imaging ; Recurrence* ; Spleen ; Splenectomy ; Splenosis* ; Transplantation, Autologous

Metastasis of choroid from prostate cancer is not common and has not been reported before in Korea. We report a case of decreased vision in a patient with prostate cancer. After external beam radiotherapy, patient had complete response in the choroidal metastasis. Metastasis of choroid secondary to prostate is not common. There have been only 8 cases reported. In this case, we demonstrated that external beam radiotherapy showed a therapeutic effect.
Choroid* ; Humans ; Korea ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms* ; Radiotherapy

PURPOSE: To investigate the percentage of pathologic tumor volume (pTPV) among patients who underwent radical prostatectomy (RP). MATERIALS AND METHODS: We reviewed 3,080 patients who underwent RP between September 2003 and March 2015 and with a postoperative follow-up for more than 1 year. The patient population was stratified into 4 disease risk groups according to tumor stage and pTPV (T2 low volume [T2LV], T2 high volume [T2HV], T3 low volume [T3LV], and T3 high volume [T3HV]). Probability of biochemical recurrence (BCR)-free survival was determined using Kaplan-Meier curves. pTPV was evaluated by Multivariate Cox proportional hazard analysis for predicting BCR. Subgroup analyses were performed according to preoperative risk. RESULTS: The median prostate-specific antigen (PSA) was 7.87 ng/mL, and pTPV was 10%. Among a total of 2,964 patients, T2LV had 1,473 (49.7%), T2HV was 598 (20.2%), T3LV with 199 (6.7%), and T3HV was 694 (23.4%). When comparing T2HV and T3LV, Gleason score and positive surgical margin rate was higher in T3LV. During a 50-month follow-up, BCR-free survival rate was higher in the T2HV group (p<0.001). pTPV was a significant factor to predict BCR in multivariate Cox analysis. In subgroup analyses, T2HV group had similar BCR-free survival rates to T3LV group in the preoperative high risk group while pTPV was significant in the high risk group. CONCLUSIONS: pTPV was a significant predictor of BCR among prostate cancer patients after RP, however T2HV had favorable BCR results. Among patients with a preoperative high PSA and Gleason score, T2HV had similar BCR results to T3LV.
Classification* ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Recurrence ; Survival Rate ; Tumor Burden

PURPOSE: The purpose of this study was to investigate the positive surgical margin (PSM) as a predictive factor of biochemical recurrence (BCR) in prostate cancer (PCa) patients after radical prostatectomy (RP) according to each pathological stage. MATERIALS AND METHODS: The records of 3,037 patients receiving RP were retrospectively reviewed. All patients were divided into 6 groups depending on pathological stage and presence of PSM. Cox proportional hazard analyses were performed to show the significance of PSM in all patients and in subgroup patients (T2, T3a, and T3b). The Kaplan-Meier analysis showed BCR-free survival rate of each group. RESULTS: Among total 3.307 patients, the mean age was 65.89 years and PSM rate was 18.7%. During the 47.1 months, 550 patients had experienced BCR (26.2%). According to groups, prostate-specific antigen, Gleason score, and BCR were significantly different. Ten-year BCR-free survival rate was 87.1% (T2R0), 65.9% (T2R1), 60.1% (T3aR0), 43.0% (T3aR1), 20.8% (T3bR0), and 5.8% (T3bR1). Each group had statistical differences with BCR-free survival except T2R1 and T3aR0 (p=0.090). PSM was significant in multivariate Cox analyses in total patients (hazard ratio, 2.091; 95% confidence interval, 1.724–2.536; p<0.001) and in all subgroup with each stages. CONCLUSIONS: PSM is a significant predictor to BCR after RP in all PCa patients and in each stage. T2R1 PCa had a similar BCR-free survival rate to T3R0 patients during long-term follow-up, therefore careful management to T2R1 PCa as T3 should be necessary.
Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Neoplasm Grading ; Passive Cutaneous Anaphylaxis ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: The study was aimed to determine the correlations of tissue-based biomarker expressions between primary and metastatic specimens of renal cell carcinoma and with several well-known prognostic clinicopathological parameters. MATERIALS AND METHODS: The immunohistochemistry (IHC) was used to determine the expression levels of 9 tissue-based markers calculated in H-score expressed by percentage of expression multiplied by the intensity score (0, 1, 2, and 3 points). Using 17 patients' 38 specimens paired with primary renal lesion and its metastatic lesions collected between 2004 and 2015, Tissue microarray with IHC was performed with BAP1, PBRM1, pS6, PTEN, TGase2, PD-L1, CA9, PSMA, and Ki-67 on formalin-fixed paraffin-embedded sections. Pearson correlation and accuracy test were performed to analyze the correlation between primary and metastatic tissues. RESULTS: The 17 patients' mean age was 56.9 years old, mean tumor size was 7.9 cm, and the male to female ratio was 13:4 (76.5%:23.5%), respectively. Three patients had 2, 3, and 3 metastatic tissues, and the rest of 14 patients had only one metastatic tissue. The H-score (PSMA and Ki67) and intensity score (pS6 and PSMA) showed that some differential significant markers were identified which had statistical correlations of expression levels between primary and metastatic lesions among 9 markers. However, no real correlation of PSMA, Ki67, and pS6 markers were found their expressions of between primary and metastatic tissues because of their skewed expressions. CONCLUSIONS: Tissue markers failed to correlate their expression levels in primary lesions with those of metastatic lesions.
Biomarkers* ; Carcinoma, Renal Cell* ; Female ; Humans ; Immunohistochemistry ; Male ; Neoplasm Metastasis

PURPOSE: To evaluate oncologic, functional outcomes and complications in patients with prostate cancer (PCa) who underwent radical perineal prostatectomy (RPP). MATERIALS AND METHODS: A retrospective review of patients who underwent RPP by a single surgeon between 1995 and 2014 was performed. We analyze clinicopathologic characteristics and postoperative complications including urinary continence and erectile function. Kaplan-Meier survival analysis was used to access biochemical recurrence (BCR)-free survival (BFS) and cancer-specific survival (CSS) and log-rank test was applied. Complications were stratified by the Clavien-Dindo classification system. RESULTS: A total of 816 patients were included in this study. The mean prostate-specific antigen and prostate volume was 8.89 ng/mL and 30.8 mL. Positive surgical margin was identified in 174 patients (21.3%) after RPP. During a mean follow-up of 58.7 months, 173 patients (21.2%) experienced BCR. Overall, 44 patients (5.4%) died, of which 15 (1.8%) died from PCa. The 5-year BFS in patients with T2, T3a, and T3b were 84.8%, 69.7%, and 46.7% (p<0.001), respectively. The 10-year CSS in patients with same groups were 98.9%, 98.2%, and 79.5% (p<0.001), respectively. At 12 months after RPP, recovery of urinary continence and erectile function was identified in 88.3% and 63.7% of patients. Wound dehiscence (8.9%) was the most common complication. However, approximately 78% of complications were grade I or II. CONCLUSIONS: Our study indicates that RPP shows acceptable outcomes in terms of oncologic results and complications in patients with PCa. Careful attention is required to prevent wound dehiscence.
Classification ; Follow-Up Studies ; Humans ; Passive Cutaneous Anaphylaxis ; Postoperative Complications ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies ; Wounds and Injuries

PURPOSE: To determine the malignant potential in clinically localised small renal cell carcinoma (RCC) (≤4cm) in patients using postoperative pathologic outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of 2,085 patients in 7 urology centres with clinical T1a RCC who underwent nephrectomy. The pathologic upstaging group (PUG) was defined by pathologic T3a after the operation. Multivariate analyses were used to examine predicting factors for the risk of PUG. Next, Kaplan-Meier analysis was used to examine the PUG for worse recurrence-free survival during the follow-up period. RESULTS: The PUG had 73 patients (3.5%); they were older and had a larger tumour size than the other patients (all p<0.001). After adjusting for clinical characteristics, age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02–1.06) and tumour size greater than 3 cm (OR, 1.94; 95% CI, 1.21–3.11) were found to be independent predictors for the PUG after nephrectomy. Furthermore, the PUG had worse recurrence-free survival during the follow-up period. CONCLUSIONS: In this multi-institution analysis, RCC 3 cm or greater in older patients had a high malignant potential compared to relatively small tumours in younger patients. These results may be helpful for stratifying patients to manage small renal masses.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Nephrectomy ; Retrospective Studies ; Urology

PURPOSE: Although the influence of Notch signaling on several types of malignancies has been studied, the role of Notch signaling in clear cell renal cell carcinoma (ccRCC) remains unclear. In this study, we evaluated the levels of Notch1 and Jagged1 and their significance in ccRCC. MATERIALS AND METHODS: Tumor tissue and matched normal adjacent kidney tissue from 49 ccRCC cases were obtained. The expression of Notch1 and Jagged1 was analyzed using real-time polymerase chain reaction (PCR) and Western blotting. Tissue samples were divided into several groups according to clinicopathological features, and the relative expression of Notch1 and Jagged1 was assessed. RESULTS: Real-time PCR revealed increased Notch1 expression in tumor tissues compared with that in adjacent normal tissues (p=0.044). Based on the pathological stage, a significant difference in Notch1 expression was observed between tumor and normal kidney tissues in pT2 and pT3 ccRCC (pT2, p=0.041; pT3, p=0.001). Notch1 expression in ccRCC relative to that in normal tissue was higher in later-stage ccRCC and larger ccRCC. Notch1 expression showed significant positive correlation with the maximal diameter of the primary renal tumor (mRNA, p<0.001; protein, p=0.001). High Notch1 expression was associated with recurrence and disease-specific death, although the difference was not significant. Jagged1 level was not significantly correlated with any of the factors examined. CONCLUSIONS: Notch1 may play a significant role in the tumorigenesis and progression of ccRCC. Notch signaling may be a potential target for chemopreventive or adjuvant therapeutics for ccRCC.
Biomarkers ; Blotting, Western ; Carcinogenesis ; Carcinoma, Renal Cell* ; Kidney ; Real-Time Polymerase Chain Reaction ; Recurrence ; Tissue Array Analysis

PURPOSE: We compared the staging ability and early complications of standard and extended pelvic lymph node dissection (sPLND and ePLND, respectively) in patients with localized bladder cancer during radical cystectomy. MATERIALS AND METHODS: We prospectively collected and analyzed the data of 261 patients who underwent radical cystectomy for localized bladder cancer. The resected lymph nodes were categorized according to anatomic locations and were carefully inspected by an experienced pathologist. The perioperative complications were classified using the Clavien-Dindo classification system. RESULTS: The 2 groups showed no significant differences in preoperative characteristics except for preoperative clinical stage (p=0.015). There were no significant differences in pathologic outcomes including pathologic stage, positive surgical margin, and lymphovascular invasion (all p>0.05), but the sPLND group showed a significantly higher cellular grade (p<0.001). The ePLND group showed a higher number of removed lymph nodes than the sPLND group (p=0.015) and a higher rate of positive lymph node invasion (35.8% vs. 28.9%). There were no significant differences in complication rates according to the extent of lymph dissection and urinary diversion type, respectively (p=0.063 and p=0.486). CONCLUSIONS: The ePLND showed more accurate nodal staging ability with comparable complication rates when compared to sPLND in patients who underwent radical cystectomy for localized bladder cancer. A further, larger prospective study is needed to confirm the result of the present study.
Classification ; Cystectomy* ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Prospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion