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Extra-gastrointestinal Stromal Tumor on the Inner Urinary Bladder Wall.

Jun Nyung LEE ; Se Yun KWON ; Jeongshik KIM ; Ghil Suk YOON ; Eun Sang YOO ; Hyun Tae KIM

Korean Journal of Urological Oncology.2016;14(1):43-46.

A gastrointestinal stromal tumor is the most common mesenchymal tumor of the gastrointestinal tract, and is diagnosed on the basis of the combined expression of CD34 and CD117 (C-kit protein). An extragastrointestinal stromal tumor of the urinary bladder is a very rare neoplasm. In this report, we describe a case of an extragastrointestinal stromal tumor originating from the inner surface of the urinary bladder. A 46-year-old man presented with an incident bladder mass, and he was diagnosed with an extragastrointestinal stromal tumor after transurethral resection of the bladder tumor. A tumor on the inner urinary bladder wall is an unusual presentation of an extragastrointestinal stromal tumor. The patient is doing well with no recurrence at 18 months after surgery.
Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Middle Aged ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

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Routine Use of Single Instillation of Epirubicin after Transurethral Resection of Bladder Tumor - Should It Be Done in Korean Patients?.

Yu Seob SHIN ; Myung Ki KIM ; Young Beom JEONG ; Hyung Jin KIM

Korean Journal of Urological Oncology.2016;14(1):39-42.

To study the impact of single instillation of epirubicin (SIE) on the cancer recurrence of non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT) in Korean patients. The major inclusion criteria were NMIBC patients. The major exclusion criteria were muscle invasive bladder cancer, metastatic bladder cancer, combined urinary upper tract tumor, and carcinoma in situ. SIE group received 50 mg epirubicin within 6 hours after TURBT. Non-SIE group did not receive epirubicin. This study enrolled a total of 214 patients diagnosed as having NMIBC during the period from October 2003 through January 2010 at the single institutions. Follow-up of the patients was conducted through January 2012. The median age of patients was 63.4 years. Of 112 evaluable patients in the SIE group, cancer recurrence rate was 33.9% and in non-SIE group, cancer recurrence rate was 62.7% (p<0.001). The recurrence-free survival duration was longer in Group SIE compared with Group non-SIE (p<0.001). Multivariate analysis revealed that SIE was significantly associated with cancer recurrence (HR 0.213, p<0.001). We confirmed the impact of SIE on the cancer recurrence in the Korean patients who underwent TURBT for NMIBC. Single instillation of chemo-agent after TUR-B might be recommended in Korean patients for reduce bladder cancer recurrence and provide longer recurrence-free survival duration.
Carcinoma in Situ ; Epirubicin* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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Anti-tumor Immune Response after Cryoablation in Renal Cell Carcinoma Murine Model.

Jeong Kyun YEO ; Dae Yeon CHO ; Min Gu PARK

Korean Journal of Urological Oncology.2016;14(1):32-38.

PURPOSE: Cryoablation has been used successfully for the local treatment of renal cell carcinoma. Besides local destruction, Cryoablation has an immunogenic nature. In this study, we evaluated the anti-tumor immune response induced by cryoablation in renal cell carcinoma murine model. MATERIALS AND METHODS: Renal cell carcinoma was produced in BALB/c mice by the subcutaneous inoculation of Renca cells in the thigh. After 7 days, the tumors were removed using liquid nitrogen in cryoablation group and bipolar electrocoagulation in electrocautery group. For twelve days after re-inoculation of Renca cells at contralateral thigh, tumor volumes were measured daily to assess the effect against the growth of tumor. The immunocyte levels (T4, T8, B and NK cell) were determined to evaluate immune activity by FACS (Fluorescence activated cell sorter) analysis. The effect of cryoablation to induce apoptosis of tumor was evaluated by TUNEL (Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labeling) assay. RESULTS: The tumor volume of cryoablation group was significantly smaller than that of electrocautery group and control (p<0.05). Comparing with control, T cell level was significantly increased after cryoablation (p<0.05), but no group had a significant difference in the levels of B cell and NK cell by FACS analysis. The apoptosis index % of cryoablation group was significantly increased than that of control group (p<0.05) by TUNEL. CONCLUSIONS: Cryoablation could result in the inhibition of re-inoculated tumor growth and induce T cell mediated immune response. The active immune response may be attributed to the apoptosis of tumor after cryoablation.
Allergy and Immunology ; Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Cryosurgery* ; DNA Nucleotidylexotransferase ; Electrocoagulation ; Immunity, Active ; In Situ Nick-End Labeling ; Killer Cells, Natural ; Mice ; Nitrogen ; Thigh ; Tumor Burden

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Trends in Urogenital Cancer Incidence in Jeju (1999-2012).

Kyung Kgi PARK ; Sung Dae KIM ; Young Joo KIM ; Hyeon Ju KIM ; Jung Sik HUH

Korean Journal of Urological Oncology.2016;14(1):27-31.

PURPOSE: Incidence of cancer has been increasing each years. The incidence of genitourinary cancer are also being increased. We aim to describe the time trends in genitourinary cancer incidence in Jeju province. MATERIALS AND METHODS: Age-standardized rates for incidence of genitourinary tract cancer in Korea and world standard population were calculated using the databases from the Jeju Cancer Rigistry from 1999 to 2012. RESULTS: Cancer incidence in Jeju was increased approximately 2-fold from 1217 cases 1999 to 2376 cases in 1999. Prostate cancer occurred most frequently followed by bladder tumor, and kidney cancer in 2012. In the prostate cancer, incidence was increasing every year from 18 cases in 1999 to 110 cases in 2012. Age-standardized incidence rate (ASR) was approximately four time increased, from 3.0 cases in 1999 and 11.2 cases in 2012. Incidence of bladder cancer were 43 cases in 1999 and 27 cases in 2012, ASR of bladder cancer was increased from 5.0 cases in 1999 to 7.5 cases in 2012. Kidney cancer showed constantly reducing the incidence. Peak is 60 cases in 2009 and recent incidence was 37 cases in 2012. There was no significant change in the incidence of testicular cancer, ureter cancer, renal pelvis cancer from 1999 to 2012. CONCLUSIONS: Incidence of cancer has been increasing in Jeju, similar to other area In Korea. Prostate cancer is the most common urological cancer in Jeju province, and kidney cancer incidence is recently decreasing. We should try to prevent genitourinary tract cancer caused obesity and smoking.
Incidence* ; Kidney Neoplasms ; Kidney Pelvis ; Korea ; Obesity ; Prostatic Neoplasms ; Smoke ; Smoking ; Testicular Neoplasms ; Ureteral Neoplasms ; Urinary Bladder Neoplasms ; Urogenital Neoplasms* ; Urologic Neoplasms

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Differences in Prostate Cancer between Korean Patients, the European Randomized Study of Screening for Prostate Cancer/Rotterdam Group, and a Dutch Clinical Cohort.

Ji Sung SHIM ; Jae Heon KIM ; Hoon CHOI ; Jae Hyun BAE ; Hong Seok PARK ; Du Geon MOON ; Jun CHEON ; Jae Young PARK

Korean Journal of Urological Oncology.2016;14(1):18-26.

PURPOSE: We evaluated differences in biopsy-detected prostate cancer (PC) between a newly defined Korean clinical cohort (KCC) and two Western populations. MATERIALS AND METHODS: The records of 723 Korean men aged 55 to 75 years who underwent an initial transrectal ultrasound-guided biopsy from 2004 to 2010 were retrospectively reviewed. Prostate biopsies were performed due to prostate-specific antigen (PSA) levels greater than 4.0ng/ml, or suspicious findings on rectal examination or transrectal ultrasonography. Characteristics of PC were compared between the KCC and Western groups (the Rotterdam group of the European Randomized Study of Screening for Prostate Cancer: ERSPC and Dutch Clinical Cohort: DCC). RESULTS: The cancer detection rate was 26.4% (191/723) in the KCC, 20.9% (473/2268) in the ERSPC/Rotterdam group and 43.1% (138/320) in the DCC. The median PSA in patients with PC was 11.8ng/ml, 5.7ng/ml and 7.5ng/ml in the KCC, ERSPC/Rotterdam group, and DCC, respectively. The proportion of patients with a Gleason score of 7 or more was 57.1% (109/191) in the KCC, 37.5% (174/464) in the ERSPC/Rotterdam group and 37.0% (51/138) in the DCC. CONCLUSIONS: We found large differences in cancer detection rate, PSA, and Gleason score distribution between the KCC and Western cohorts. PC detected in Korean patients had more advanced clinical factors than in Western populations due to low availability of PSA screening programs.
Asian Continental Ancestry Group ; Biopsy ; Cohort Studies* ; Humans ; Male ; Mass Screening* ; Neoplasm Grading ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Retrospective Studies ; Ultrasonography

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Quality of Life in Prostate Cancer Patient Undergoing Androgen Deprivation Therapy.

Bosung SHIN ; Taek Won KANG

Korean Journal of Urological Oncology.2016;14(1):10-17.

Androgen deprivation therapy (ADT) has been one of the standard protocol for treating prostate cancer. The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Although ADT can improve survival, it can also cause significant morbidity and a decrement in quality of life (QOL). In this article, we discuss QOL problem caused by ADT and suggest for mitigating harm of ADT.
Gonadotropin-Releasing Hormone ; Humans ; Male ; Prostate* ; Prostatic Neoplasms* ; Quality of Life* ; Radiotherapy ; Recurrence

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Methylation Markers in Renal Cell Carcinoma.

Sung Pil SEO ; Yong June KIM

Korean Journal of Urological Oncology.2016;14(1):1-9.

Many tumor markers in relation to renal cell carcinoma (RCC) have been evaluated for detecting and monitoring diseases outcomes. However, none of these biomarkers reported to date has shown sufficient sensitivity and specificity for as a detector and prognosticator of the whole spectrum of RCC in routine clinical practice. The limited value of the established prognostic markers requires analysis of new molecular parameters of interest in predicting the prognosis of RCC patients; in particular, the high-risk patient groups at risk of recurrence and progression. Abnormal methylation of CpG islands can efficiently repress transcription of the associated gene in a manner akin to mutations and deletions. Recent progress in the understanding of epigenetic modification and gene silencing has provided new opportunities for the detection, treatment, and prevention of cancer. Methylation is an important molecular mechanism in RCC and could be used as a diagnostic and prognostic marker. Aberrant patterns of epigenetic modification would be, in near future, crucial parameters in cancer diagnosis, prognosis and a good target for developing novel therapies while maintaining the quality of life. This review discusses the epigenetic issues involved in the detection and prediction of prognosis in RCC.
Biomarkers ; Carcinoma, Renal Cell* ; CpG Islands ; Diagnosis ; Epigenomics ; Gene Silencing ; Humans ; Methylation* ; Prognosis ; Quality of Life ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor

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Very Late Onset of Radiation-induced Complicated Vesicocutaneous Fistula.

Jeong Hee HONG

Korean Journal of Urological Oncology.2015;13(2):101-104.

Vesicocutaneous fistula (VCF) secondary to radiation therapy is a rare event. There are difficulties in establishing the early diagnosis and choosing the proper management option. We present a very unusual case of postradiotherapy vesicocutaneous fistula which developed more than 30 years later. Temporary urinary diversion was performed because of poor performance status and anatomical condition. However, it failed to achieve spontaneous closure of VCF. It is important to recognize that late onset of radiation induced VCF could develop even after a substantial period of time has lapsed. In addition, conservative treatment appears to be unsuccessful in patient with complicated VCF. Therefore, it must be counselled carefully after a making synthetic judgment based on different individual situation.
Cutaneous Fistula ; Early Diagnosis ; Fistula* ; Humans ; Judgment ; Urinary Diversion

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Silencing of Heat Shock Protein 27 Expression Accelerates Doxazosin-induced Apoptosis in Prostate Cancer Cell Line PC-3.

Soon Cheol SHIN ; Jeong Man CHO ; Jung Yoon KANG ; Tag Keun YOO ; Heeju CHO

Korean Journal of Urological Oncology.2015;13(2):93-100.

PURPOSE: Heat shock proteins (HSPs) are highly expressed during stress responses and cellular adaptation to environmental changes. One such protein is HSP27, a 27kDa protein that prevents cell death induced by many pro-apoptotic agents. Therefore, the aim of this study was to investigate the correlation between HSP27 expression and apoptosis induced by doxazosin treatment in prostate cancer cell line PC-3. MATERIALS AND METHODS: RT-PCR, Western blotting, and immunocytochemical staining were performed to determine whether HSP27 mRNA and protein are expressed in PC-3 cells. Next, to investigate the effects of doxazosin on apoptosis and HSP27 protein expression in PC-3 cells, the cells were stained using a TUNEL kit (to detect apoptotic cells) and with HSP27 antibody (to assess HSP27 protein expression) 6, 12, 24, and 48h after treatment with 25microM doxazosin. In addition, to determine whether HSP27 mRNA interference accelerates doxazosin-induced apoptosis of PC-3, we knocked down HSP27 with siRNA and then evaluated the rate of apoptosis after doxazosin treatment. RESULTS: HSP27 mRNA and protein were expressed in PC-3 cells. Furthermore, HSP27 mRNA and protein levels increased until 12 hours after 25microM doxazosin treatment, whereas the rate of apoptosis did not increased dramatically. After 12 hours, HSP27 expression decreased and then apoptosis was accelerated. In addition, siRNA-mediated knockdown of HSP27 induce higher apoptosis rate of PC-3 cells even before 12hrs after doxazosin treatment. CONCLUSIONS: By inhibiting apoptosis, HSP27 expression might play an important role in inhibiting progression to castration-refractory prostate cancer and resistance to anti-cancer treatment.
Apoptosis* ; Blotting, Western ; Cell Death ; Cell Line* ; Doxazosin ; Heat-Shock Proteins* ; Hot Temperature* ; HSP27 Heat-Shock Proteins* ; In Situ Nick-End Labeling ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger ; RNA, Small Interfering

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Climacturia (Orgasm-associated Incontinence) Following Radical Prostatectomy.

Yun Beom KIM ; Jae Hyun RYU ; Tae Young JUNG ; Duk Yoon KIM ; Hee Ju CHO ; Tag Keun YOO

Korean Journal of Urological Oncology.2015;13(2):85-92.

PURPOSE: Climacturia is involuntary loss of urine during orgasm. The mechanism of climacturia in men who undergo radical prostatectomy (RP) is not fully understood, while deficiency in bladder neck coaptation during orgasm may be the cause. We evaluated the prevalence and risk factors of climacturia after RP. MATERIALS AND METHODS: We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from 2002 to 2013 and was able to have a vaginal intercourse postoperatively. RP was conducted using open or robot-assisted approach. We analysed the symptoms of climacturia, relationship between climacturia and several clinical factors. Also, we tried to find factors to predict the presence of climacturia. RESULTS: Total of 123 patients were analyzed in this study. The median age of the men was 65 year and postoperative follow-up period for the interview was 37 months. Of the total 123 patients, 29 (23.6%) complained of the climacturia. In climacturia group, robot-assisted RP (p=0.018), nerve-sparing (p=0.046) and penile rehabilitation (p=0.012) were significantly less frequent, and more pad were comsumed (p=0.001) compared to non-climacturia group. On multivariable analysis, post-prostatectomy incontinence (PPI) (OR 6.49, p=0.004) and penile rehabilitation (OR 0.22, p=0.036) were significant factors to predict the presence of climacturia. CONCLUSIONS: Climacturia occurs in more than 20% patients who were potent enough after RP in our study. PPI and penile rehabilitation were positive and negative factor to predict an occurrence of climacturia, respectively. Therefore, in addition to PPI and erectile dysfunction, patients must be informed of this complication before undergoing RP.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Neck ; Orgasm ; Prevalence ; Prostatectomy* ; Prostatic Neoplasms ; Rehabilitation ; Retrospective Studies ; Risk Factors ; Urinary Bladder ; Urinary Incontinence

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