Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present their experience about the accuracy of staging and the results of radical prostatectomy in prostatic cancer. From january 1978 to september 1988, 47 patients with clinically localized prostatic carcinoma underwent staging pelvic lymphadenectomy, of whom 36 had proven negative pelvic lymph nodes and 1 had only a micrometastasis in the obturatory nodes. We reviewed the surgical results and survival of these 37 patients who underwent radical prostatectomy. The postoperative complications were compared to those reported in Literature: partial incontinence occurred in 3 patients and there were no symptomatic urethral strictrues. 1 patient died in the early postoperative period by DIC. 35 patients are alive, 27 free of disease, with average follow-up of 36 months. The over-all accuracy of staging was 87%. Our experience suggests that radical prostatectomy with staging bilateral pelvic lymphadenectomy can be performed in a safe manner with minimal postoperative morbidity.
 ...
PMID:[Cancer of the prostate. Clinical estimation and results of radical prostatectomy]. 268 97

The morbidity of radical retropubic prostatectomy for prostate cancer has been reduced through improved understanding of the surgical anatomy of the prostate. Delineation of the anatomy of the dorsal vein complex has led to modifications in the surgical technique that have reduced blood loss and improved surgical exposure. The addition of epidural anesthesia and presurgical donation of autologous blood has limited the need for the homologous transfusion of blood to 2% of the patients and has reduced the frequency of serious perioperative complications such as pulmonary emboli to 0.3%. Delineation of the anatomy of the pelvic plexus and identification of the neurovascular bundles as the macroscopic landmark of the microscopic cavernous nerves have made it possible for the surgeon to make an informed decision at the time of surgery whether the neurovascular bundles can be preserved safely or excised widely with the specimen. In all surgical approaches to prostate cancer, the primary goal must be excision of all tumor; preservation of sexual function should be of secondary concern. These considerations were addressed in the treatment of 320 consecutive patients; 74% of the men are potent postoperatively. It was necessary to excise one neurovascular bundle widely in 49 patients; 69% are potent. In addition to improvements in postoperative sexual function, the incidence of incontinence following surgery has been reduced. The total medical expenses for patients undergoing radical prostatectomy range from $8,500 to $9,500 and are similar to those for external-beam radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Radical retropubic prostatectomy with reduced morbidity: an anatomic approach. 317 99

A total of 30 patients underwent an operation (radical prostatectomy in 27 and cystoprostatectomy in 3) for prostate cancer. In 17 patients radiotherapy with curative intent (range 5,700 to 7,500 cGy., mean 6,130 cGy.) had failed locally at 7 to 150 months (mean 48.8 months) later; 13 underwent the operation 2 months or less after planned radiotherapy (4,000 to 7,000 cGy., mean 5,431 cGy.). Followup was 1 to 16 years (mean 6.7 years). There was no perioperative death. The most significant complications were vesical neck contracture (17 per cent), lymphedema (10 per cent) and incontinence (10 per cent). Pathological staging revealed 8 patients with stage D1 disease. Of tumor grade, stage, adjuvant hormonal treatment and ploidy pattern only the last was associated with progression and survival. An increasing number of patients with local, albeit often symptomatic, radiation failure may present during the next years and they must be treated. Salvage prostatectomy is feasible and its associated morbidity seems to be acceptable; alternative (nonoperative) treatment modalities have proved not to be effective. Deoxyribonucleic acid ploidy pattern can provide valuable prognostic information in this difficult patient population for decision-making regarding radical surgery and adjuvant hormonal treatment.
 ...
PMID:Radical prostatectomy after radiation therapy for cancer of the prostate: feasibility and prognosis. 319 15

A total of 18 patients underwent nerve-sparing radical prostatectomy for clinical stage B1 or B2 prostatic cancer. An operation was performed according to the modified technique originally described by Walsh and associates. The operative technique involved three steps: 1) accurate ligation of dorsal vein complex, which makes a relatively bloodless field and makes it possible to dissect the lateral pelvic fascia from the prostate; 2) the incision in the lateral pelvic fascia is made anterior to the neurovascular bundle; 3) the lateral pedicle is divided close to the prostate. There were no major intraoperative complications such as rectal perforation or ureteral injury. The mean blood loss was 802 g (340-1600 g) and the average duration of surgery was 173 minutes. Eleven patients had no blood transfusions. Postoperatively, there was a wound infection in one case. Mild bladder neck contracture in one case responded to single dilatation. Sexual function was evaluated in 16 of the patients who have been followed for more than three months and who had not received hormone therapy postoperatively. Of 16 patients 6 (37%) had return of erectile function. Return of erections required 3-15 months (average 9 months). Patients under 70 years old had a higher incidence (80%) of return of erections than those over 70 years old. Four of the 6 patients had tumor involvement confined to the prostate. Initially most patients had significant amounts of stress incontinence. This resolved within the first or second postoperative month. Finally 4 had slight stress urinary incontinence but no patients had total incontinence. The results suggest that nerve-sparing radical prostatectomy is an anatomically safe approach. It can contribute to the quality of life in men at a stage when it is still curable.
 ...
PMID:[Clinical experience of nerve-sparing radical prostatectomy]. 319 8

Three hundred and thirteen patients with UICC T-1 N-0 M-0 prostate cancer were treated with external beam irradiation in 1973 and 1974 or in 1978, and their outcome determined 3-10 years after treatment. Survival over the first 5 years was comparable to that expected for a group of age matched normal males (77% vs. 81%), but during the second 5-year interval, there was a decrease in survival below that expected (51% vs 62%), a reflection of death in patients who developed metastasis as a first recurrence (18%). Overall, 72% of patients were free of any recurrence at 5 years and, 88% free of infield recurrence. The development of metastatic recurrence was significantly related to grade; at 5 years 87% of grade I, 79% of grade II and 69% of grade III patients were free of metastasis. There was a trend for increased local recurrence with increasing grade, but it was not statistically significant. There was a dose/response relation for complications, and radiation doses above 6500 cGy are associated with an increase in complication from 6% to 11% (p = .09). Complications requiring hospitalization for evaluation or management occurred in 30 (10%) of 313 patients. There were no deaths from complications and less than 2% of patients required surgical correction of complications. External beam radiation offers the patient with early prostate cancer a favorable opportunity for cure without the morbidity of impotence, incontinence, and occasional death experienced following LND and radical prostatectomy. Lymph node dissection does not seem necessary for most patients with T-1 prostate cancer as the positive yield in those with Grades I and II cancers is less than the complications of the procedure, and extensive involvement can be detected by non-invasive means.
 ...
PMID:The outcome of treatment of 313 patients with T-1 (UICC) prostate cancer treated with external beam irradiation. 327 53

This paper presents a report on 49 patients with prostatic cancer stages A-C (pT1NxMo-pT3Nx-1Mo) treated by radical prostatectomy. 32 patients were operated on perineally without preliminary lymph staging and 17 patients by the transpubic method after pelvic lymph staging. No death occurred perioperationaly in either group. Early complications were seen in 22% of cases after the perineal method and in 12% after the transpubic method; the incidence of late complications was virtually the same in both groups (22% and 23%) and the rate of incontinence was also similar (22% and 18%). The 5 year survival rate was 92% and the 10 year survival rate was 67%. On the basis of these results we feel that radical prostatectomy, especially incorporating the most recent modifications to retain continence and potency, represents the treatment of choice in early stages of prostatic cancer and, indeed, even in stage C cases.
 ...
PMID:[Radical prostatectomy in the treatment of prostatic cancer. Perineal and transpubic methods]. 340 Feb 41

The authors report their experience of retropubic radical prostatectomy for prostatic cancer. They have performed 55 prostatectomies over a period of 3 years. Their indications are essentially stage B (35 cases) and stage C1 (20 cases). The post-operative morbidity was low and no cases of incontinence were observed. Post-operative impotence generally occurs when the cavernous nerves are interrupted. However, erection was preserved in two cases when Walsh's technique was used.
 ...
PMID:[Radical prostatectomy in cancer of the prostate. Our experience apropos of 55 cases with 3-year follow-up]. 356 99

We analyzed the operative experience and postoperative and late complications of pelvic lymphadenectomy and radical retropubic prostatectomy in 27 consecutive cases in which the modifications of prostatectomy described by Walsh were employed, and compared the results with those of 29 cases performed in the preceding three years when the Campbell technique of prostatectomy was employed. The mean operative time, mean blood loss, and incidences of early postoperative complications and incontinence were less for patients treated with the Walsh technique than with the Campbell technique. After surgery 85 per cent of evaluable patients remained potent with the Walsh technique compared with 16 per cent of patients treated with the Campbell technique. Although other factors besides operative approach may have biased our results, we are persuaded that the innovations of radical retropubic prostatectomy detailed by Walsh constitute important advances in surgical technique, and we now use this procedure in all suitable patients electing treatment by radical prostatectomy for localized prostatic cancer.
 ...
PMID:Early experience with Walsh technique of radical retropubic prostatectomy. 382 17

Optimal management of men with diffuse incidental prostatic cancer (Stage A2) is an unresolved issue. Current forms of therapy include radical prostatectomy, external beam radiation therapy, and no treatment. Long-term results with curative therapy have been unreported because of the relatively recent substaging of Stage A into incidental and diffuse disease. The results of radical prostatectomy in 25 patients with Stage A2 prostatic cancer were reviewed. Incontinence was the most serious complication and occurred in four patients (16%). Pathologically, 24 patients (96%) had residual carcinoma present in the radical prostatectomy specimen. In 22 men (88%) the tumor was entirely confined to the prostate. Two patients (8%) demonstrated seminal vesicle invasion, and one (4%) had capsular penetration. In follow-up metastatic disease has developed in one patient, and another died without evidence of cancer. The remaining patients are alive without evidence of disease. Since 88% of men with Stage A2 disease have their tumor entirely confined to the prostate, radical prostatectomy offers an excellent chance of long-term cure, as in Stage B prostatic cancer.
 ...
PMID:Efficacy of radical prostatectomy for stage A2 carcinoma of the prostate. 405 63

22 patients had urinary incontinence plastic surgery according to Kaufman. Good and satisfactory results (n = 14) are to be expected only in cases of genuine stress incontinence following iatrogenic lesion of the sphincteral mechanism. Preoperative urodynamic clarification is obligatory for excluding neurogenic micturition disorders, detrusor-sphincter dyssynergia and bladder instability. Because of the clearly increased complication rate in prostatic cancer, Kaufman-incontinence-plastic surgery should only be carried out when over a period of 12 months tumour progression is not to be expected or when radical prostatectomy was done. Complications with necessary prosthesis removal (n = 9) occurred without exception within 8 weeks after surgery. Among them were two cases of decubital necrosis of the urethra, five cases of secondary wound healing and one case of detrusor-sphincter dyssynergia. General contraindications are: chronically recurrent urinary tract infection, urethral stricture, urethral diverticulum, vesico-urethral reflux with dilated upper urinary tract and the so-called "scarred-rigid urethra".
 ...
PMID:[Experience with the Kaufman prosthesis in the treatment of postoperative urinary incontinence in the male]. 668 25


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>