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Idiopathic Calcinosis Cutis of the Scrotum: A Case Report.

In Chang CHO ; Soon Ki KIM ; Kwi Bok CHOI ; Seung Ki MIN ; Ji Yoon BAE ; Jin Soo KO

Korean Journal of Urological Oncology.2017;15(2):88-91. doi:10.22465/kjuo.2017.15.2.88

Calcinosis cutis-calcification in soft tissue-is a rare benign disease that is separated into the following subtypes: dystrophic, iatrogenic, metastatic, calciphylaxis, and idiopathic. One of common site of calcinosis cutis is the scrotum. The nodules slowly grow for years or decades. The characteristic of calcinosis cutis of the scrotum is generally asymptomatic, yellowish marble-like, hard, polypoidal, solitary, or multiple. However, the pathogenesis of this nodule remains ambiguous and controversial. Thus, we reviewed possible causes and therapeutic consideration of calcinosis cutis of the scrotum.
Calcinosis* ; Calciphylaxis ; Scrotum* ; Skin

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Treatment Case of Asymptomatic Prostate Tuberculosis That Developed After Bacillus Calmette-Guerin Intravesical Therapy in a Patient With Nonmuscle Invasive Bladder Cancer.

Jong Won KIM ; Suk Young LEE ; Yee Jeong KIM ; Sang Hee CHOI

Korean Journal of Urological Oncology.2017;15(2):85-87. doi:10.22465/kjuo.2017.15.2.85

Intravesical Bacillus Calmette-Guerin (BCG) therapy after transurethral resection of bladder tumor is considered the most effective treatment for prophylaxis against the recurrence of high risk nonmuscle invasive bladder cancer, and generally well tolerated and infectious complication are rare. We reported a case of granulomatous prostatitis is a patient who had undergone intravesical BCG therapy due to nonmuscle invasive bladder cancer. This patient was diagnosed by prostate biopsy because of prostate-specific antigen elevation without any other voiding symptoms and abnormal abscess pocket in transrectal ultrasonography.
Abscess ; Bacillus* ; Biopsy ; Humans ; Mycobacterium bovis ; Prostate* ; Prostate-Specific Antigen ; Prostatitis ; Recurrence ; Tuberculosis* ; Ultrasonography ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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Incidence of Pathological Downgrading and Treatment Outcome After Radical Prostatectomy in Patients With Biopsy Confirmed High Gleason Score Prostate Cancer.

Jun Phil NA ; Jae Ho YOO ; Tae Heon KIM ; Min Yong KANG ; Hyun Hwan SUNG ; Hwang Gyun JEON ; Byong Chang JEONG ; Seong Il SEO ; Hyun Moo LEE ; Han Yong CHOI ; Seong Soo JEON

Korean Journal of Urological Oncology.2017;15(2):79-84. doi:10.22465/kjuo.2017.15.2.79

PURPOSE: High Gleason score (8 to 10) is a poor prognostic factor regardless of treatment. Pathological downgrading sometimes occurs in high grade prostate cancer. The aim of this study is to evaluate treatment outcomes in patients with high grade prostate cancer on biopsy who were pathological downgrading after radical prostatectomy (RP). The impact on outcomes according to changes in the Gleason score after RP was evaluated. MATERIALS AND METHODS: Of 3,236 men who underwent RP between September 1995 and December 2014, 541 patients with biopsy Gleason score 8 to 10 were retrospectively reviewed. We analyzed incidence and biochemical recurrence (BCR) free probability in this downgraded group according to the Gleason grade of cancer in the RP specimen. RESULTS: Of 541 patients had a prostate biopsy Gleason score of 8 to 10. Two hundred ten patients showed pathological downgrading after RP (38.8%). Five-year BCR-free probability of patients who had Gleason score of 7 or less after RP was 46.8%. However, 5-year BCR-free probability of patients who remained Gleason scores 8 to 10 after RP was 28.5%. There was a significantly higher BCR-free probability in pathological downgrading group (p<0.001). On multivariate analysis, biopsy Gleason 8, lower PSA, clinical T2 stage was a significant predictor of downgrading. CONCLUSIONS: In this study, 38.8% of patients with high grade prostate cancer had a Gleason score of 7 or less in the RP specimen. Downgraded prostate cancer had more favorable treatment outcome. Serum PSA, clinical stage and biopsy Gleason score were the predictive factors for pathological downgrading.
Biopsy* ; Humans ; Incidence* ; Male ; Multivariate Analysis ; Neoplasm Grading* ; Prostate* ; Prostatectomy* ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies ; Treatment Outcome*

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Comparison of Biopsy Results and Surgical Outcomes of Magnetic Resonance Imaging-Guided and Transrectal Ultrasonography-Guided Repeat Biopsy.

Hyunwoo CHUNG ; Wan SONG ; Jae Ho YOO ; Min Yong KANG ; Hwang Gyun JEON ; Byong Chang JEONG ; Seong Il SEO ; Seong Soo JEON ; Han Yong CHOI ; Chan Kyo KIM ; Byung Kwan PARK ; Hyun Moo LEE

Korean Journal of Urological Oncology.2017;15(2):72-78. doi:10.22465/kjuo.2017.15.2.72

PURPOSE: We compared biopsy results and surgical outcomes of magnetic resonance imaging (MRI)-guided biopsy with transrectal ultrasonography (TRUS)-guided biopsy to demonstrate efficacy of MRI-guided biopsy on previous biopsy negative patients. MATERIALS AND METHODS: We retrospectively reviewed data of 120 patients who were categorized into MRI-guided biopsy groups (n=20) and TRUS-guided biopsy groups (n=100). All patients were diagnosed with prostate cancer (PCa) and had undergone radical prostatectomy (RP) after MRI-guided or TRUS-guided repeat biopsy between January 2010 and March 2016. Detection rate of significant cancer and Gleason score upgrading and downgrading were examined, in addition to biopsy results and subsequent RP outcomes. RESULTS: Median values for prostate-specific antigen level of the TRUS-guided biopsy group and the MRI-guided biopsy group were 6.67 and 5.86 ng/mL (p=0.303), respectively. Median prostate volume of each group (34.1 mL vs. 23.5 mL, p=0.007), number of positive cores (2.0 vs. 3.0, p=0.001) and maximum cancer/core rate (30.0% vs. 60.0%, p<0.001) were statistically different. Positive core rates of each group were 21.9% and 87.1%, respectively. Pathologic T stage was the only variable that showed difference in surgical outcomes (p=0.002). Most of PCa was confirmed as clinically significant PCa after RP in MRI-guided biopsy group (95%). CONCLUSIONS: MRI-guided biopsy showed higher positive core rate and detection rate of clinically significant PCa than TRUS-guided biopsy in repeat biopsy setting. Prospective multicenter large-scale study and accumulation of data is expected to further define superiority of the MRI-guided biopsy.
Biopsy* ; Humans ; Magnetic Resonance Imaging ; Neoplasm Grading ; Passive Cutaneous Anaphylaxis ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Ultrasonography

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Role of Magnetic Resonance Imaging Using Prostate Imaging-Reporting and Data System Version 2 to Predict Clinically Significant Cancer After Radical Prostatectomy in Very Low-Risk or Low-Risk Prostate Cancer.

Jae Ho YOO ; Wan SONG ; Tae Heon KIM ; Chan Kyo KIM ; Byung Kwan PARK ; Byong Chang JEONG ; Seong Il SEO ; Seong Soo JEON ; Hyun Moo LEE ; Han Yong CHOI ; Hwang Gyun JEON

Korean Journal of Urological Oncology.2017;15(2):66-71. doi:10.22465/kjuo.2017.15.2.66

PURPOSE: To determine the negative predictive value (NPV) of multiparametric magnetic resonance imaging (mp-MRI) for clinically significant cancer (CSC) based on the Prostate Imaging-Reporting and Data System (PI-RADS) version 2 in very low-risk or low-risk prostate cancer patients. MATERIALS AND METHODS: We retrospectively analyzed 380 patients with low risk of prostate cancer who underwent mp-MRI before radical prostatectomy (RP) from 2011 to 2013. Of the 380 patients, 142 patients were in the very low risk group. CSC at RP was defined as follows: any T3−4, G3+4 with tumor volume>15%, G4+3 or higher. In the very low risk and low risk groups, we analyzed the rate of CSC according to PI-RADS score and calculated the NPV of mp-MRI for detection of CSC. RESULTS: In the low risk group, 20.8% (n=79) of patients had PI-RADS version 2 score 1–2 and 17.4% (n=66) of patients had PI-RADS version 2 score 3. In the very low risk group, 26.8% (n=38) of patients had PI-RADS version 2 score 1–2 and 17.6% (n=25) of patients had PI-RADS version 2 score 3 in the very low risk group. Rates of CSC were 33.7% (n=128) and 16.9% (n=24) in the low risk and very low risk groups, respectively. The NPV of MRI was 93.7% in the very low risk group and 78.6% in the low risk group. CONCLUSIONS: The NPV of PI-RADS for CSC is high in the very low risk group, but not in the low risk group. Further multicenter studies are needed to investigate the utility of PI-RADS version 2 for NPV.
Humans ; Information Systems* ; Magnetic Resonance Imaging* ; Prostate* ; Prostatectomy* ; Prostatic Neoplasms* ; Retrospective Studies

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Clinical Outcomes of Continuous Addition of Androgen Deprivation Therapy During Docetaxel Chemotherapy for Patients With Castration-Resistant Prostate Cancer.

Dong Hoon LEE ; Jung Ho KIM ; Won Ik SEO ; Jong Kil NAM ; Tae Nam KIM ; Cheol Kyu OH ; Soo Dong KIM ; Sung Woo PARK ; Jae Sung CHUNG ; Sang Hyun PARK ; Wan LEE ; Gyung Tak SUNG ; Moon Kee CHUNG ; Jae Il CHUNG

Korean Journal of Urological Oncology.2017;15(2):59-65. doi:10.22465/kjuo.2017.15.2.59

PURPOSE: This study compared the oncologic results of docetaxel chemotherapy (DOC) in castration-resistant prostate cancer (CRPC) according to continuous addition of androgen deprivation therapy (ADT) during chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 106 patients who received DOC in 6 medical institutes. Among them, 72 patients had a complete medical record: 28 patients with ADT (DOC+continuous ADT group) and 44 without ADT (DOC only group). We compared the progression-free survival of these groups after DOC. RESULTS: Docetaxel was administered an average of 28 months after primary ADT as the first treatment. A median number of 6 cycles of DOC was administered in both groups. In the DOC+continuous ADT group, orchiectomy was performed in 18 patients and luteinizing hormone-releasing hormone agonist was injected in 10 patients. During DOC treatment, prostate-specific antigen (PSA) progression-free survival was statistically different (6.0±4.75 months in DOC+continuous ADT group vs. 4.8±3.2 months in DOC only group, p=0.024), whereas radiologic progression-free survival was not statistically different (5.0±3.12 months in DOC+continuous ADT group vs. 5.0±2.79 months in DOC only group, p=0.387). CONCLUSIONS: In our cohort, continuous addition of ADT showed a significant benefit in PSA progression-free survival during DOC in CRPC patients. Further prospective studies are needed to confirm these observations.
Academies and Institutes ; Cohort Studies ; Disease-Free Survival ; Drug Therapy* ; Gonadotropin-Releasing Hormone ; Humans ; Medical Records ; Orchiectomy ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Retrospective Studies

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Vascularization Methods for Tissue Engineers.

Myeong Joo KIM ; Byung Hoon CHI ; Min Ji CHO ; Young Mi WHANG ; In Ho CHANG

Korean Journal of Urological Oncology.2017;15(2):51-58. doi:10.22465/kjuo.2017.15.2.51

Tissue engineering is limited by our inability to adequately vascularize tissues post implantation because all tissue-engineered substitutes (with the exception of cornea and cartilage) require a vascular network to provide the nutrient and oxygen supply needed for their survival. This review gives a brief overview of the processes and factors involved in the vascularization and angiogenesis and summarizes the different strategies to overcome the issue of slow vascularization and angiogenesis in a range of tissue-engineered substitutes. Moreover, we will announce some potential future plans.
Cornea ; Methods* ; Oxygen ; Tissue Engineering

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Comparison of Perioperative Outcomes in Patients Undergoing Robotic and Laparoscopic Adrenalectomy.

Ha Rim KOOK ; Jung Keun LEE ; Jong Jin OH ; Sangchul LEE ; Sung Kyu HONG ; Seok Soo BYUN ; Sang Eun LEE

Korean Journal of Urological Oncology.2016;14(3):118-123. doi:10.22465/kjuo.2016.14.3.118

PURPOSE: To compare outcomes of robotic adrenalectomy with conventional laparoscopic adrenalectomy. MATERIALS AND METHODS: This retrospective study included 63 patients who underwent robotic or laparoscopic adrenalectomy between March 2005 and April 2016, with all operations performed using a transperitoneal approach. Outcomes were compared in the 29 patients who underwent robotic adrenalectomy and the 34 who underwent conventional laparoscopic adrenalectomy. RESULTS: Mean age (53.1±12.2 years vs. 51.4±15.1 years, p=0.631) and body mass index (25.9±3.8 kg/m2 vs. 25.2±3.5 kg/m2, p=0.461) were similar in the robotic and laparoscopic groups. A significant percentage of patients in the robotic group had undergone prior abdominal surgery (38% vs. 12%, p=0.015). Mean tumor sizes (3.0±1.5 cm vs. 3.7±2.7 cm, p=0.134) and the percentage of incidentalomas (75.9% vs. 73.5%, p=0.354) were similar in the robotic and laparoscopic groups. There were no statistical significance between-group differences in tumor size, operative time, estimated blood loss, perioperative hemoglobin change, length of hospital stay, and complication rates. Pathologic diagnosis showed that pheochromocytoma (21% vs. 3%) and metastatic tumor (24% vs. 6%) were more frequent in the robotic than in the laparoscopic group (p=0.019). Subgroup analysis of patients with low tumor volume (≤6.8 cm3) showed that operation time was significantly shorter in the robotic than in the laparoscopic group (p=0.045). CONCLUSIONS: Robotic adrenalectomy is feasible, with outcomes comparable to those of laparoscopic adrenalectomy.
Adrenal Glands ; Adrenalectomy* ; Body Mass Index ; Diagnosis ; Humans ; Length of Stay ; Operative Time ; Pheochromocytoma ; Retrospective Studies ; Tumor Burden

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Recombinant Bacille Calmette–Guérin for Immunotherapy in Nonmuscle Invasive Bladder Cancer.

Subin JIN ; Young Mi WHANG ; In Ho CHANG

Korean Journal of Urological Oncology.2016;14(3):109-117. doi:10.22465/kjuo.2016.14.3.109

Intravesical instillation of Mycobacterium bovis bacille Calmette–Guérin (BCG) has been used for treating nonmuscle invasive bladder cancer as the forefront of immunotherapy, but BCG is ineffective in approximately 30–40% of cases and disease recurs in up to 50% of patients. Recently BCG is considered an effective vehicle for delivery of antigens due to its unique characteristics, and the genetic control of these mycobacteria is advanced in the search for less toxic and more potent therapeutic agents for bladder cancer immunotherapy. We will discuss current advances in recombinant BCG construction, research, and future directions.
Administration, Intravesical ; BCG Vaccine ; Humans ; Immunotherapy* ; Mycobacterium bovis ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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Rationale of Surgery in Locally Advanced and Oligometastatic Prostate Cancer.

Kyong Tae MOON ; Tag Keun YOO

Korean Journal of Urological Oncology.2016;14(3):97-108. doi:10.22465/kjuo.2016.14.3.97

There is no clear consensus for the best treatment of men with locally advanced prostate cancer. As a first step, radiation therapy or primary hormone therapy or radical prostatectomy with extended pelvic lymph node dissection is used. But it seems impossible to have a good oncologic result with single treatment modality. Traditionally, external beam radiation therapy with adjuvant hormone therapy is most preferred treatment method in locally advanced prostate cancer and radical prostatectomy has not been routinely used because of high rates of margin positive and lymph node metastasis. But, recently published articles showed that surgery in multimodal setting is effective treatment modality and not inferior to radiation therapy in oncologic outcomes. Perioperative morbidities of surgery and incontinence rates are similar to surgery of organ confined diseases, and patients with primary radiotherapy seem to have high rate of lower urinary tract symptoms and radiation related complications compared with radical prostatectomy with adjuvant radiotherapy. There is still controversy in regard to performing surgery for locally advanced prostate cancer. We review the studies with surgery in locally advanced prostate cancer and compare with radiation therapy in multimodal setting, and review the studies with surgery in oligometastatic prostate cancer.
Consensus ; Humans ; Lower Urinary Tract Symptoms ; Lymph Node Excision ; Lymph Nodes ; Male ; Methods ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Radiotherapy ; Radiotherapy, Adjuvant

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