RESUMEN
OBJECTIVES: To determine the efficacy in the prevention of tumor recurrence, disease free interval and side effects of intravesical epirrubicin post-TUR of superficial bladder tumor. METHODS: From February 1993 to November 1997, 57 patients with stage Ta, T1, grade I, II and III tumor of the bladder were studied. These patients were treated with 50 mg epirrubicin in 50 ml saline solution administered intravesically on 15 occasions for one year after surgery. The mean follow-up was 18 months. The follow-up protocol included clinical, analytical, cytological, US and cystoscopic control evaluations every 3 months for the first year, every 6 months for the second and third year, and yearly thereafter. RESULTS: At a mean follow-up of 30.2 months, 31.5% (18/55) of the patients showed tumor recurrence; the disease free interval was 17 months for the remaining 18 patients and 43 months for the overall group. Cystitis was observed as an adverse effect in 5 of 57 patients (8.8%). CONCLUSIONS: The study shows that prophylactic treatment with intravesical epirrubicin for the prevention of recurrence in superficial bladder tumor has few side effects and its efficacy is similar to that reported in other studies.
Asunto(s)
Antibióticos Antineoplásicos/uso terapéutico , Epirrubicina/uso terapéutico , Recurrencia Local de Neoplasia/prevención & control , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Administración Intravesical , Anciano , Anciano de 80 o más Años , Antibióticos Antineoplásicos/administración & dosificación , Epirrubicina/administración & dosificación , Humanos , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
Our centre took part in an international, multicentre, Phase III trial with Finasteride (MK-906) in the treatment of BPH. In the first year, this was a double-blind, randomised, placebo-controlled study which included 25 patients who were randomly assigned: 9 to treatment with placebo, 8 to finasteride 1 mg and 8 to finasteride 5 mg. After the first year, all patients were assigned to finasteride 5 mg as a single daily dose taken before breakfast. Of the 25 patients who started the trial, 7 have completed 7 years treatment (28%): 1 from the placebo group. 1 from finasteride 1 mg, and 5 who took finasteride 5 mg throughout the study. Total symptoms score, assessed by the modified Boyarsky questionnaire, improved during the first year 4.97 points (51%) and remained unchanged up to year 7 with a final reduction of 6.2 points (64%). Percentual increase in peak urinary flow during follow-up ranged between 21 and 45.9% with an absolute increase at 7 years of 4.2 mL/seg (47.5%) and a reduction in prostate volume of 26%. Finasteride tolerance was excellent at all times, and no serious clinical reaction was seen in laboratory parameters. Two patients reported decreased libido and sexual potency and 1 decreased libido. In summary, since after 7 years of treatment efficacy is maintained in at least 30% of patients with an excellent safety profile, finasteride can be considered an alternative in the medical treatment of BPH.
Asunto(s)
Finasterida/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Método Doble Ciego , Estudios de Seguimiento , Humanos , MasculinoRESUMEN
Leiomyosarcoma of the prostate is a very uncommon malignant tumor arising from the smooth muscle cells of the prostate gland. We report on a 72-year-old patient who underwent surgery for benign prostatic hyperplasia. The pathological analysis following retropubic resection, however, revealed a leiomyosarcoma and an extended cystectomy and pelvic tumorectomy were performed after preoperative radiotherapy. The patient is alive with local recurrence at four years follow up.
Asunto(s)
Leiomiosarcoma/diagnóstico , Neoplasias de la Próstata/diagnóstico , Anciano , Terapia Combinada , Cistectomía , Diagnóstico Diferencial , Humanos , Leiomiosarcoma/patología , Leiomiosarcoma/cirugía , Masculino , Recurrencia Local de Neoplasia/epidemiología , Próstata/patología , Prostatectomía , Hiperplasia Prostática/diagnóstico , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/cirugía , Reoperación , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/secundario , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
Among 322 cases of primary malignant renal tumours reviewed between 1969 and 1991, six were renal sarcoma (1.85%). They all presented earlier symptomatology which was not different from other renal tumours, and nephrectomy was performed in all cases, 5 of which died before 14 months. The histopathological diagnose showed two liposarcoma, two carcinosarcomas, all the others being fibrosarcomas.
Asunto(s)
Neoplasias Renales , Sarcoma , Adulto , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/terapia , Masculino , Persona de Mediana Edad , Sarcoma/diagnóstico , Sarcoma/terapiaRESUMEN
We reviewed 680 cases of colorectal neoplasms with an incidence of 18 synchronous multiple carcinomas (2.7%). We describe the predominance in females (11/7), the late age of presentation (maximal incidence between 60 and 80 years) and the main symptoms of these patients. We remark the diagnostic difficulty of these tumors, despite all the methods used; the diagnosis of the second mass was intraoperative in 50% of the cases in our series. As treatment, we suggest partial colectomy, except when there is massive colonic affectation, in which we practice a total colectomy. The prognosis in these patients is similar to that of those who have a single carcinoma. We must carry out a rigorous follow-up of these patients to make an early diagnosis of any new metachronous tumors.
Asunto(s)
Carcinoma , Neoplasias del Colon , Neoplasias Primarias Múltiples , Neoplasias del Recto , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/epidemiología , Carcinoma/cirugía , Estudios de Cohortes , Colectomía , Neoplasias del Colon/epidemiología , Neoplasias del Colon/cirugía , Pólipos del Colon/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/epidemiología , Neoplasias Primarias Múltiples/cirugía , Pronóstico , Neoplasias del Recto/epidemiología , Neoplasias del Recto/cirugía , España/epidemiologíaRESUMEN
We reviewed cancers of the rectum and rectosigmoid operated from 1970 to 1980 in the General Surgery Service of the Hospital La Fe of Valencia (Spain). Of a total of 588 patients, only 370 were resectable (62.9%), which reflects the advanced stage of the disease when these patients are seen. Of the 370 resections, 210 corresponded to lower rectum, 97 to middle rectum and 63 to upper rectum and rectosigmoid. In 80%, abdominoperineal amputation was practiced and in 20%, anterior resection; this was due to the predominance of lower tumors and the fact that at this time mechanical sutures were not in use, since these permit anterior resections that cannot be performed with normal sutures. The 5-year survival was 197 patients, 53.2%. Postoperative mortality affected 4.2%. We found complications and morbidity in 17.1%. The mean hospital stay was 18 days. In no case of anterior resection was discharge colostomy performed.