The Journal of urology
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The Journal of urology · Jan 2003
Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials.
We assessed the impact of race on survival in men treated with external beam radiotherapy with or without hormonal therapy for localized prostate cancer in Radiation Therapy Oncology Group randomized trials. ⋯ As previously reported, tumor grade (Gleason score), palpation T stage, lymph node status, pretreatment PSA and treatment type are major predictors of overall and disease specific survival. We noted no evidence that race has independent prognostic significance in patients treated for prostate cancer in Radiation Therapy Oncology Group prospective randomized trials.
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The Journal of urology · Jan 2003
Primary skin closure of large groin defects after inguinal lymphadenectomy for penile cancer using an abdominal cutaneous advancement flap.
PURPOSE Large groin defects may be created after inguinal lymphadenectomy for bulky metastatic penile cancer. We describe a new method of primary closure of a large groin skin defect. MATERIALS AND METHODS In 3 patients with large volume inguinal lymph node metastases with skin breakdown and secondary infection extensive inguinal lymphadenectomy was done with wide surgical excision of skin and subcutaneous tissue. ⋯ CONCLUSIONS Large groin skin defects can be closed primarily using an abdominal advancement flap. This technique may also be used for bilateral groin defects. Compared with other types of flaps advocated for this purpose the main advantages of the procedure are simplicity, lower morbidity and superior cosmetic results.
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The Journal of urology · Jan 2003
Comparative StudyLong-term results of renal transplantation using kidneys harvested from non-heartbeating donors: a 15-year experience.
To expand the pool of suitable organ donors we developed an organ procurement program of non-heartbeating donors during the last 15 years. We compare graft survival in patients receiving renal transplants procured from non-heartbeating with recipients of kidneys from heartbeating donors. ⋯ Despite a high rate of acute tubular necrosis, kidneys harvested from non-heartbeating donors had the same graft survival rates as those procured from heartbeating donors. Surgical complications were not different. Transplantation of selected kidneys procured from non-heartbeating donors should be promoted as a response to organ shortage.
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The Journal of urology · Jan 2003
Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy.
We examined the concordance of Gleason scores in prostate needle biopsy specimens and the corresponding radical retropubic prostatectomy specimens in a cohort of patients grouped according to the number of cores obtained during diagnostic needle biopsy. ⋯ Prostate cancer grading by extended needle biopsy is a better predictor of the final Gleason score than nonextended needle biopsy, as determined by radical prostatectomy histological evaluation. Therefore, extended prostate needle biopsy provides better guidance to determine the appropriate treatment in patients with prostate cancer.
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The Journal of urology · Jan 2003
Transperitoneal laparoscopy into the previously operated abdomen: effect on operative time, length of stay and complications.
We evaluated the effect of previous abdominal surgery on perioperative outcomes in patients undergoing a renal/adrenal laparoscopic procedure via a transperitoneal approach. ⋯ Previous open abdominal operation increased the risk of operative and major complications, which most likely resulted in increased length of stay. The location of the scar impacted the access complication rate. Patients who have undergone previous open surgical procedures should be counseled on the greater risk of complications if the transperitoneal route is elected. Alternatively a retroperitoneal approach may be used.