Purpose: We postulate that the number of lymph nodes examined in cystectomy specimens can have an impact on the outcome of patients with bladder cancer. Materials and Methods: We analyzed data on 322 patients with muscle invasive bladder cancer who underwent radical cystectomy and bilateral pelvic lymphadenectomy. We evaluated the associations of the number of lymph nodes identified by the pathologist in the surgical specimen with the local recurrence rate and survival outcome. Results: Patients were divided into groups by lymph node status and the distribution of the number of lymph nodes examined. In stages pN 0 and pN + cases improved survival was associated with a greater number of lymph nodes examined. We determined that at least nine lymph nodes should be studied to define lymph node status accurately. Conclusions: These results indicate that surgical resection and pathological assessment of an adequate number of lymph nodes in cystectomy specimens increases the likelihood of proper staging and impacts patient outcome. Such information is important not only for the therapy and prognosis of individuals, but also for identifying those who may benefit from adjuvant chemotherapy.

Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer.

https://www.europeanurology.com/article/S0302-2838(14)01263-9/pdf/systematic-review-and-cumulative-analysis-of-oncologic-and-functional-outcomes-after-robot-assisted-radical-cystectomy

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

https://www.europeanurology.com/article/S0302-2838(10)00756-6/pdf/influence-of-modified-posterior-reconstruction-of-the-rhabdosphincter-on-early-recovery-of-continence-and-anastomotic-leakage-rates-after-robot-assisted-radical-prostatectomy

Influence of Modified Posterior Reconstruction of the Rhabdosphincter on Early Recovery of Continence and Anastomotic Leakage Rates after Robot-Assisted Radical Prostatectomy

Following curative treatment for localised renal cell carcinoma (RCC), up to 30% of patients develop tumour recurrence. Prognostic scores are essential to guide individualised surveillance protocols, patient counselling and potentially in the future to guide adjuvant therapy. In metastatic RCC, prognostic scores are routinely used for treatment selection in clinical practice as well as in all major trials. We performed a literature review on the current evidence based on prognostic factors and models for localised and metastatic RCC. A number of prognostic factors have been identified, of which tumour node metastasis classification remains the most important. Multiple prognostic models and nomograms have been developed for localised disease, based on a combination of tumour stage, grade, subtype, clinical features, and performance status. However, there is poor level of evidence for their routine use. Prognostic scores for patients with metastatic RCC receiving targeted treatments are used routinely, but have limited accuracy. Molecular markers can improve the accuracy of established prognostic models, but frequently lack external, independent validation. Several factors and models predict prognosis of localised and metastatic RCC. They represent valuable tools to provide estimates of clinically important endpoints, but their accuracy should be improved further. Validation of molecular markers is a future research priority.

Prognostic factors and prognostic models for renal cell carcinoma: a literature review.

This review summarizes all studies that compare the effect of a MBSR program to a control group intervention, in which the participants had been randomly allocated to be in either the MBSR group or a control group. The review summarizes the results in two categories. First, where the effect of the MBSR program was compared to an inactive group (either a wait list group or one receiving ordinary care also received by the MBSR group). Second, where MBSR was compared with an alternative active group intervention.

Based on this review it is reasonable to consider MBSR a moderately well-documented method for helping adults improve their health and cope better with the challenges and stress that life brings. New research should improve the way the trials are conducted addressing the pitfalls in research on mind-body interventions.

https://onlinelibrary.wiley.com/doi/pdf/10.4073/csr.2017.11

Mindfulness‐based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: a systematic review and meta‐analysis

Introduction The majority of patients presenting with renal and/or peri-renal hemorrhage are diagnosed with an underlying etiology. Non-traumatic spontaneous idiopathic renal hemorrhage is an infrequently reported entity. Management of these patients is critical; diagnosis is established only once any surgically correctable etiology is excluded. Case presentation A 57 year old Caucasian female with no significant past medical history presented to an outside emergency department with a one day history of right lower back pain and fatigue. An abdominal and pelvic computed tomography (CT) at the time revealed a grade IV right renal laceration. We present this unusual case of a previously healthy woman with a low probability for a spontaneous idiopathic non traumatic grade IV renal laceration with perirenal hemorrhage. Conclusion Though most renal and perirenal hemorrhages are associated with an underlying etiology, in rare circumstances idiopathic non traumatic spontaneous renal laceration manifests with insignificant symptomatology. It is critical for clinicians in the Emergency Department to be aware of this entity to avoid diagnostic error. Prior to categorizing an injury as idiopathic, appropriate evaluation to rule out rare etiologic basis is crucial.

Idiopathic non-traumatic spontaneous renal hemorrhage/laceration: a case report and review of the literature

Hemagiomas are most common tumors in infancy; however, scrotal septum hemangiomas are very rare with only 45 cases reported in the literature. We report a case of a 6-month-old child who presented with a scrotal mass at birth which had increased in size with age. A scrotal ultrasound with color doppler analysis, revealed a soft tissue mass with diffusely increased blood flow. Scrotal mass excision was performed and the pathology confirmed a capillary hemangioma.

Hemangioma of the scrotal septum: a rare entity in infants with review of the literature.

A 50-year-old woman presented with microscopic hematuria. Initial radiological investigations suggested the diagnosis of renal calculi in the left kidney. However, further assessment confirmed a renal artery aneurysm. We discuss the differential diagnosis of radio-opaque densities in the renal area. Une femme de 50 ans presente une hematurie microscopique. Les examens radiologiques initiaux portent a croire a la presence de calculs au rein gauche, mais les examens subsequents revelent un anevrisme de l’artere renale. Nous discutons ici du diagnostic differentiel en presence de zones de haute densite opaques aux rayons X dans la region renale.

/pdf/painless-hematuria-and-radio-opaque-densities-in-the-left-4lmhoq2176.pdf

Painless hematuria and radio-opaque densities in the left renal area

384 mindfulness based stress reduction decreases fear of progression over time for men with prostate cancer on active surveillance results from a randomized clinical trial

Pankaj P. Dangle

Papers

Idiopathic non-traumatic spontaneous renal hemorrhage/laceration: a case report and review of the literature

Hemangioma of the scrotal septum: a rare entity in infants with review of the literature.

Painless hematuria and radio-opaque densities in the left renal area

384 mindfulness based stress reduction decreases fear of progression over time for men with prostate cancer on active surveillance results from a randomized clinical trial

A radio-pathological correlation for prostate cancer detection – a study using dce-mri at 3t without an endorectal coil