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Biomedical subjects

Antonio Rosales Bordes

Publications and source records attributed to Antonio Rosales Bordes.

9 recordsLinked to original sources

Intravesical instillations with bacillus calmette-guérin for the treatment of carcinoma in situ involving prostatic ducts.

OBJECTIVES: Bacillus Calmette-Guérin (BCG) has proven its efficacy in the treatment of carcinoma in situ (CIS) of the prostatic urethra. We performed a retrospective study to evaluate the use of intravesical instillations of BCG in patients with carcinoma in situ involving prostatic ducts after complete transurethral resection (TUR). MATERIAL AND METHODS: Eligibility for the study was CIS of the prostatic urethra involving prostatic ducts. Previous instillation with BCG was an exclusion criterion. Patients were treated with intravesical BCG Connaught (81 mg) administered once a week, over a 6-wk period. TUR loop biopsies of the prostate were performed only when a macroscopic tumor was present. RESULTS: In this retrospective study of 11 patients, 8 (73%) presented with macroscopic tumor in the prostatic urethra. Ten patients (91%) had a simultaneous superficial bladder carcinoma. Eight patients (73%) had tumoral involvement of the bladder neck region. After a median follow-up of 27 mo (n=10 patients), the response in the prostatic urethra was 82%, and the response in the bladder due to superficial tumor recurrence was 64%. Two patients with residual ductal disease in the prostatic urethra were subsequently treated with cystoprostatectomy and are currently free of disease. In one of those patients, the cystoprostatectomy specimen did show prostatic stromal invasion. Another patient developed distant metastatic disease and died a few months after diagnosis. Thus, progression was encountered in two patients (18%). Currently, 90% of patients are alive without evidence of disease and 72.7% have benefitted from this bladder preservation strategy. CONCLUSION: Intravesical BCG is a feasible treatment option for patients with CIS involving prostatic ducts. In this retrospective study, bladder preservation was successful in 8 of 11 patients (70%) and there was only one oncologic death. Obviously, these patients need a careful follow-up with cystoscopy and cytology to detect either recurrence or progression and in those with persistent disease after the initial BCG induction therapy, prompt cystectomy is indicated.

Adjuvants, Immunologic↗

[Radical prostatectomy in patients with history of transurethral resection of the prostate].

OBJECTIVES: To perform a retrospective evaluation of surgical complications and morbidity in patients undergoing radical retropubic prostatectomy (RRP) as elective treatment for organ-confined prostate cancer in our center with previous transurethral resection of the prostate (TURP). METHODS: Between 1980-2004 we performed 59 radical prostatectomies in patients with previous TURP. We analyze the morbidity and mortality of the RRP, its functional outcomes, and the accordance between clinical and pathological stage. RESULTS: Mean time between TURP and RRP was 16 months. Mean patient age at the time of diagnosis was 63 years. Clinical stage: 16 T1a, 18T1b, 20T1c, 3T2a, 2T2b. Average surgical time was 180 minutes. Intraoperative events: technical difficulties in the dissection of the gland 57%, bladder neck preservation 27%, neuro vascular bundles preservation 3.39%, ureter ligation 1.69%, rectal laceration 1.69, urethrorrhagia 1.69%, urinary leak 5%, and blood transfusions 11.8%. Postoperative complications: urinary tract infection 10.17%, wound infection 10.17%, pelvic hematoma 5.08%, deep vein thrombosis 1.69%, and one sudden death of unknown cause one month after surgery. Pathologic report: 49pT2b, 8 pT3 and 2pT4. Late complications: erectile dysfunction 85.7%, vesicourethral anastomosis stenosis 10.3%, and complete urinary incontinence 3%. CONCLUSIONS: Radical retropubic prostatectomy in patients with previous TURP is technically more difficult and has comparable outcomes to RRP patients without previous TURP.

Adenocarcinoma↗

[Renal cell carcinoma associated with contralateral metacronous renal oncocytoma].

OBJECTIVES: To report one case of renal cell carcinoma and contralateral metacronous oncocytoma, and to perform a bibliographic review on the topic. METHODS: 52-year-old male patient with history of right radical nephrectomy for renal cell carcinoma. On his ten-year follow-up multiple lesions appeared in the left kidney. Partial nephrectomy was performed. Pathological study showed three oncocytomas. CONCLUSIONS: The presence of metacronous lesions in the contralateral kidney of a patient with history of renal cell carcinoma is rare. The presence of the same histological type of tumor should always be suspected and the management should follow this suspicion. Contralateral metacronous oncocytoma is a rare pathology which has not been reported in the literature so far.

Adenoma, Oxyphilic↗

Quality of life in prostate cancer patients and controls: psychometric validation of the FACTP-4 in Spanish, and relation to urinary symptoms.

OBJECTIVES: To assess the feasibility and a validity of the Spanish version of the FACT-P and its relation to urinary symptoms. METHODS: The Spanish version of the FACT-P was self-administered to 60 Prostate Cancer patients (pts) waiting to undergo radical treatment and 20 age-matched controls (con) with a negative biopsy. Clinical stage for patients was T1c in 34 and T2 in 26. FACT-P was analysed for internal consistency (Chronbach's a) and relation to symptom scales (IPSS, IPSS bother score and incontinence questionnaire (ICI-SF)). RESULTS: Feasibility (evaluable questionnaires) was 80.9 for con and 95% for pts. Internal consistency was high for all sub-scales (alpha > 0.7). Emotional well-being subscale and IPSS were significantly higher in pts. (worse emotional wellbeing and more lower urinary tract symptoms). There were no statistically significant differences between pts and con. in any of the other FACT-P sub-scores nor in symptom scores. Correlations were found between some FACT-P sub-scores and bother score. CONCLUSIONS: The Spanish version of the FACTP is feasible and psychometrically valid. Pts undergoing treatment for localized disease have similar QoL that a control group, but higher scores for emotional distress and IPSS.

Adenocarcinoma↗

[Laparoscopic adrenalectomy].

OBJECTIVES: To review indications, techniques and results of laparoscopic adrenalectomy. METHODS: We retrospectively review our experience with 8 cases of transperitoneal laparoscopic adrenalectomy (2 pheochromocytomas, 4 aldosteromas, 1 myelolipoma and 1 non functioning adenoma). RESULTS: Mean operative time was about 3 hours, with an mean estimated blood loss of 200 cc. Mean Hospital stay was 2.5 days, complication rate was 10%, being conversion to open surgery between 5 and 10%. CONCLUSIONS: Laparoscopic adrenalectomy is the operation of choice for functioning adrenal tumours and for incidentally diagnosed tumours < or = 6 cm that have increased in size in successive radiographic examinations.

Adenoma↗