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R J Correa

Publications and source records attributed to R J Correa.

At least 37 records · Page 2Linked to original sources
PubMed1983

Carcinoma of the prostate: clinical and pathological staging and prognosis.

Clinical and pathological staging furnishes valuable information upon which the clinician can base his treatment and compare results. Staging refinements occur as we learn more about the natural history of the disease and the efficacy of our treatment. We observed that clinical stage B patients with minimal (less than twice normal) elevation of the serum acid phosphatase have similar pathologic stage B (75%) and disease-free survival rates following total prostatectomy as stage B patients with normal acid phosphatases. Intraglandular crystalloids were found in 26% of clinical stage B patients treated by total prostatectomy, and none of this subgroup of patients has had a recurrence of disease. Pathologic staging frequently confirms the presence of a greater extent of tumor than was clinically anticipated. In general, prognosis for patients with a small tumor mass will be more favorable than that for patients with a large tumor mass. Staging permits the estimation of prognosis of groups of patients with similar tumor burdens; however, the survival of an individual within any such group is unpredictable.

Acid Phosphatase↗
PubMed1983

Small center kidney transplantation.

We herein present the results of our first 100 kidney transplants. The 1-year patient and graft survivals were 94 and 74 per cent, respectively, for living related grafts, and 85 and 57 per cent, respectively, for cadaver grafts. These results compare favorably to the recent standards set by the American Society of Transplant Surgeons Standards Committee (95.1, 78.6, 88.6 and 55 per cent). Initial hospitalization averaged 21 plus or minus 7 days, while hospitalization during the first year after transplantation averaged 35 plus or minus 21 days. Average expenses (Medicare reimbursed) during the first 12 months after kidney placement were $29,572 plus or minus $6,468 for 15 successive patients. A total of 22 complications occurred within 1 year of transplantation and 11 required surgical management. Of 24 patients who survived 1 year with loss of graft function 15 (62 per cent) required transplant nephrectomy. Causes of death and types of complications are presented. Our results suggest that high quality kidney transplantation may be available to patients in small transplant centers.

Actuarial Analysis↗
PubMed1983

Renal cell carcinoma in solitary kidneys.

We report 10 cases of renal tumors in a solitary kidney that were treated surgically with efforts to spare renal function. Three patients were rendered anephric to excise completely the renal cancer and 2 remain without disease. The remaining 7 patients had complete tumor excision with the aid of partial nephrectomy. One patient had bilateral oncocytomas. Of the 6 partial nephrectomy patients with cancer 1 (18 per cent) remains free of metastatic disease. Concern is expressed for the role of partial nephrectomy as curative surgery for renal cancer.

Adenocarcinoma↗
PubMed1982

Microvascular management of multiple renal arteries in transplantation.

We transplanted 8 kidneys with multiple vessels into 8 recipients using microvascular techniques to reconstruct renal arteries. Three living related combinations underwent implantation of small polar vessels (end-to-side) into the main renal artery and 1 underwent conjoined (side-to-side) anastomosis of 2 equal-sized renal arteries to form a common ostium. Additional techniques were used to manage 4 cadaver kidneys with multiple renal vessels. These included anastomosis of the lower pole artery to the inferior epigastric artery, end-to-end reanastomosis of the severed branch renal artery, separate anastomoses of 2 renal arteries to 2 branches of the hypogastric artery, and placement of 2 pediatric cadaver kidneys en bloc by anastomosis of the infrahilar aorta into the external iliac artery, and anastomosis of the infrahilar vena cava to the external iliac vein. Vascular patency (confirmed by angiography) was uniform for all anastomotic vessels. No hypertensive problems developed. In 2 cases ureteral leakage occurred, which leads us to advise caution when contemplating intrahilar vascular reconstruction of short left multiple renal arteries. Recent advances in technology of microvascular surgery have enabled dependable reconstruction of multiple renal vessels in living related and cadaver donor kidneys.

Adult↗
PubMed1981

Percutaneous pelvic lymph node aspiration in carcinoma of the prostate.

We report on 121 patients with adenocarcinoma of the prostate who underwent lymphangiography and, when indicated, subsequent fine needle aspiration biopsy of lymph nodes. The clinical staging correlation with this procedure reveals an assumed falsely negative rate of 5 to 15 per cent. The falsely positive rate is 0. This procedure is essentially without morbidity and has allowed us to stage more confidently prostatic cancer and make appropriate therapeutic recommendations.

Adenocarcinoma↗
PubMed1980

Primary adenocarcinoma of bladder.

Since 1959, 10 patients with primary adenocarcinoma of the bladder were treated at the Virginia Mason Medical Center for an incidence of 1.5 per cent of all bladder cancers. This retrospective study shows that histologic grade and tumor location had a variable influence on survival whereas clinical stage appeared to have a direct effect on survival. The only long-term survivors were the 4 low-stage patients who underwent radical cystectomy.

Adenocarcinoma↗
PubMed1979

Urolithiasis associated with pregnancy.

Of 34,081 deliveries in a 12-year period 20 were complicated by urinary calculi during the pregnancy. Of the 20 deliveries 3 required intervention either during pregnancy or immediately postpartum. There were no maternal deaths and only 1 stillborn secondary to erythroblastosis. Analysis of symptoms, findings, procedures and outcome is presented in this uncommon but serious problem.

Adolescent↗
PubMed1979

Carcinoma of the prostate: local control with external beam radiation therapy.

Local clinical control of the primary disease was evaluated in 209 patients with stage C adenocarcinoma of the prostate treated with definitive external beam radiation therapy and followed for a minimum of 2 years. Of these patients 92 per cent required no further prostatic operations for obstruction. Prostatectomy before therapy did not necessarily prevent later prostatic obstruction from occurring. Of 129 patients who had only a needle biopsy before irradiation 90 per cent had improvement of the obstructive and/or irritative symptoms as tumor regression occurred with therapy and these patients did not require a later prostatic operation for obstruction. Stricture formation occurred in 8 per cent of the patients and was not influenced by the type of preirradiation prostatic operation done. If transurethral resection was reuqired after irradiation it was technically more difficult but the morbidity was acceptable. The incidence of hematuria and incontinence was far less than that reported in non-irradiated patients with this disease. Most tumors exhibited a down-grading effect after irradiation. There were no deaths attributable to the treatment. Over-all, 83 per cent of the 209 patients had no urinary complaints after completion of therapy. From a urological viewpoint, good clinical local control is achieved in the patient with stage C adenocarcinoma of the prostate treated with external beam radiation therapy.

Adenocarcinoma↗
PubMed1978

Segmental resection in the management of bladder carcinoma.

Segmental resection for bladder carcinoma was performed on 144 patients at our medical center between 1945 and 1971. Of these 144 cases 101 had sufficient documentation to provide meaningful data for a retrospective study. The 5-year survival rates for patients with invasive bladder carcinoma, expressed as a function of the stage of disease, were stage A--79 per cent, stage B1--80 per cent, stage B2--45 per cent and stage C--6 per cent. The combined survival rates for patients with stages O, A and B1 tumors and for those with B2 and C disease were 83 and 27 per cent, respectively. A significant observation was that of the patients with stages O, A and B1 disease only 7 per cent had a history of antecedent tumor. In contrast, 59 per cent of the patients with stage B2 and C disease had antecedent tumor.

Adult↗
PubMed1978

The prophylactic use--or misuse--of antibiotics in transurethral prostatectomy.

One hundred non-infected patients undergoing transurethral prostatectomy were randomized prospectively into a controlled study to determine the influence of a prophylactic aminoglycoside (kanamycin) on the clinical course. In the non-risk patient prophylactic kanamycin had no beneficial influence on the incidence of bacteriuria, fever or length of hospitalization. Its use was associated with the development of a resistant Pseudomonas super infection in 1 patient. Prophylactic kanamycin did not protect the patient with carcinoma of the prostate from bacteriuria. There was no identifiable advantage in the use of routine prophylactic kanamycin in the uninfected, non-risk patient who was undergoing elective transurethral prostatectomy.

Aged↗
PubMed1977

Experience with adrenal cortical carcinoma.

Eight cases of histologically proved cortical carcinoma are reviewed and compared with several series from the literature. Emphasis is given to defining endocrinologic function in these tumors and to the role of nonoperative treatments. Whereas surgical therapy offered significant demonstrated in any of the patients.

Adrenal Cortex↗
PubMed1977

Random mucosal biopsies in the evaluation of patients with carcinoma of the bladder.

The management of patients with recurrent transitional cell carcinoma of the bladder has posed a constant dilemma to the practicing urologist. Previously, urine cytologies have been used and have been of value only in those instances in which they have been classified as diagnostic. Cytologies that reveal atypia or a high degree of suspicion have offered little help in the management of these patients. The current procedure of doing random mucosal biopsies using the cold cup biopsy forceps provides the pathologist with a sampling of the mucosa of the involved bladder so that a tissue diagnosis of sufficient magnitude, ranging from atypia to carcinoma in situ to frank carcinoma, may be established. This information may become valuable in determining alternate forms of management in these patients and may have a greater predictive value than customary urine cytology.

Aged↗
PubMed1977

Granulomatous prostatitis: confusion clinically with carcinoma of the prostate.

Non-specific granulomatous prostatitis is an inflammatory response of a foreign body type to extravasated prostatic fluid. Its significance is incident to its frequent confusion with carcinoma of the prostate. Noteworthy is the rapidity of onset of irritative and obstructive symptoms in a relatively younger age group than one generally sees in carcinoma of the prostate. Tissue diagnosis in those suspected of carcinoma of the prostate should be established by needle biopsy and conservative measures used for at least 4 weeks in the treatment of obstructive symptoms to allow the inflammatory response to subside before intervening surgically . Most patients frequently have associated benign prostatic hyperplasia with persistent obstructive symptoms and significant residual urine. Transurethral resection of the prostate has been performed in this study without postoperative complications.

Adult↗
PubMed1977

Total prostatectomy for stage B carcinoma of the prostate.

We reviewed 67 cases of total prostatectomy for localized stage B carcinoma of the prostate. There were no operative deaths. Significant morbidity was limited to the well known complications of impotence and incontinence. The over-all survival rates were 92 per cent for 5 years (42 of 46 cases), 79 per cent for 10 years (19 of 24) and 62 per cent for 15 years (8 of 13). Total prostatectomy continues to be the preferred method of therapy for this stage of prostatic cancer.

Adult↗
PubMed1976

Manifestations of renal cell carcinoma.

Patients with renal cell carcinoma often have no specific localizing symptoms or signs, and their presentation will often involve many organ systems. Since 40 per cent of these patients do not have genitourinary symptoms, care must be taken to avoid being misled by normal findings on urinalysis. More than 50 per cent of patients with renal cell carcinoma have vague symptoms suggesting a gastrointestinal origin; thus if primary gastrointestinal studies do not disclose a cause for these symptoms, excretory urography must be included as a screening procedure.

Adenocarcinoma↗