RESUMEN
PURPOSE: To evaluate the association between body mass index (BMI) and oncological outcomes in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: We retrospectively reviewed 237 consecutive patients treated with RNU for UTUC at our institution between 1990 and 2012. Univariable and multivariable cox regression models investigated the association of BMI with disease recurrence, cancer-specific mortality, and overall mortality. RESULTS: From the 237 patients, 104 (44%) had a BMI < 25 kg/m2, 88 (37%) had a BMI between 25 and 29.9 kg/m2, and 45 (19%) had a BMI ≥ 30 kg/m2 at the time of surgery. Within a median follow-up of 44 months (IQR: 24-79), 53 patients (22.4%) experienced a disease recurrence, 85 patients (35.9%) had bladder recurrence, and 44 patients (18.6%) died from the disease. The 5 year recurrence-free and cancer-specific survival rates were, respectively, 32 and 56% for BMI ≥ 30 kg/m2, 45 and 74% for patients with BMI 25-29.9 kg/m2, and 69 and 81% for patients with BMI < 25 kg/m2. In multivariable analyses that adjusted for the effects of the standard clinico-pathological features, BMI ≥ 30 kg/m2 was associated with a higher risk of disease recurrence (HR 3.23; 95% CI 2.3-6.6, p < 0.001) and cancer-specific mortality (HR 3.84; 95% CI 2.8-6.5; p < 0.001). CONCLUSIONS: Obesity was independently associated with higher risks of disease recurrence and cancer-specific mortality in patients treated with RNU for UTUC.
Asunto(s)
Índice de Masa Corporal , Carcinoma de Células Transicionales/cirugía , Neoplasias Renales/cirugía , Nefroureterectomía , Neoplasias Ureterales/cirugía , Anciano , Humanos , Nefroureterectomía/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
In a 60-year-old man admitted for right epididymo-orchitis with scrotal fistula and urine leak via the rectum, the diagnosis of tuberculosis was based on histological examination of a tissue sample of the scrotal fistula. The fistula was successfully treated with tuberculostatic drugs and cystostomy.
Asunto(s)
Enfermedades de la Próstata/diagnóstico por imagen , Enfermedades de la Próstata/cirugía , Enfermedades del Recto/diagnóstico por imagen , Enfermedades del Recto/cirugía , Tuberculosis/diagnóstico por imagen , Antituberculosos/uso terapéutico , Fístula , Humanos , Masculino , Persona de Mediana Edad , Orquitis/etiología , Enfermedades de la Próstata/patología , Radiografía , Enfermedades del Recto/patología , Tuberculosis/tratamiento farmacológico , Tuberculosis/patologíaRESUMEN
Chronic irritation induced by stones and urinary stasis can be responsible for squamous and sometimes glandular metaplasia of the urothelial epithelium with secondary carcinomatous transformation. The authors report two cases of tumour of the renal pelvis associated with stone pyonephrosis in one case and ureteropelvic junction syndrome in the other.