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Introduction: Prostatic intraepithelial neoplasia (PIN) and atypical small acinar proliferation (ASAP) in the setting of prostatic needle biopsies are considered premalignant although questions still remain., Objectives: In this paper, we have studied the clinical relevance of these histologic findings., Material and Methods: We collected 138 subjects (108 PIN, 30 ASAP); in 67% we performed a second biopsy and the rate of cancer in this late biopsy were 19% and 27% respectively. We cannot identify any clinical factor to predict the finding of cancer in the re-biopsy (PSA, age, digital rectal examination, prostatic volume)., Results: In the follow-up, we observed higher rates of cancer for the ASAP; the finding of ASAP was the single clinical or histopathological factor that was an independent predictor of cancer., Conclusions: We observed that the finding of ASAP was an indication for re-biopsy because of the higher rates of cancer; on the contrary, the paper of PIN in the prostatic needle biopsy still requires further investigation.

Objective: To describe the features and the time trends of the testicular cancer in a spanish population., Materials and Methods: Data on incident cases of testicular germ cell cancer diagnosed in our population were extracted from the Cancer Registry of our Department. We calculed annual incidence rates of testicular cancer, the Spanish population-adjusted annual percent change (APC), age of diagnosis and the different histologic types frequencies., Results: The overall incidence rate rose from 0.84 per 100,000 males to 1.91 per 100,000 males from 1991 till 2005, with a peak of 6.77 per 100,000 males in 2003. The Spanish population-adjusted APC was 2.39%. By histologic subgroup, for seminomas: the incidence rate varied from 0.84 per 100,000 males to 0.64 per 100,000 (1991-2005), with a peak of 5.41 per 100,000 in 2003 and the Spanish population-adjusted APC was 6.06. For nonseminomas, the incidence rate varied from 1.66 per 100,000 to 1.28 per 100,000 (1992-2005), with a peak of 3.65 per 100.000 in 2001 and the Spanish population-adjusted APC was 12.74. Mean ages were 31.23 years (median 30, SD 8.56) for seminomas, and 23.68 years (median 25, SD 6.85) for nonseminomas, with statistic significance (p < 0.0001)., Discussion: The increasing testicular cancer incidence observed for this population follows the time trends showed in other European countries.

Objective: to analyze metastatic prostate cancer progression in patients treated with hormonal blockade as well as second line hormonal treatments outcomes., Patients and Methods: 199 metastatic patients were selected from a 455 hormonal treated patients pool. Time to biochemical progression was studied with Kaplan Meier analysis and patients were stratified according to pathological differentiation. Second line treatment lasting and efficacy were also assessed., Results: 74 patients out of 192 metastatic patients (56.1%) progressed in terms of PSA. Median time to biochemical progression was 1.7 years (1.2-2.3, CI 95%). We did not find stadistical differences on pathological differentiation (p = 0.238). Second line treatment's efficacy, applied to 41 patients was 34.1%, without any stadistical differences among these treatments. Response treatment median time was 6.8 months without stadistical differences among different treatments (p = 0.220)., Conclusions: hormonal blockade efficacy in metastatic prostate cancer has a limited value in time in our experience. One third of these patients have a limited response to a second line treatment although this response is even shorter in duration.

Objectives: To disclose the features of bladder cancer in current smokers at diagnosis and to study the differences in recurrence and progression between smokers and non-smokers., Patients & Methods: 786 consecutive patients with bladder cancer from 1991 to 2004 were studied in a retrospective manner and characteristics of smokers tumours were compared to non smokers., Results: 377 (48%) patients were smokers at diagnosis. There were no differences in terms of age and T stage between smokers and non smokers (t student and Chi square). We found statistical differences in tumours grade, size and multiplicity ( Chi square, p=0.046, p=0.001 and p=0.12 respectly). No differences were found between smokers and non smokers according to recurrence. (Log Rank, Breslow y Tarone-Ware N.S.). We did find differences according to progression (Log Rank p=0.03, Breslow p=0.05 y Tarone-Ware p=0.03) although it did not support multivariate study., Conclusions: Currents smokers present bigger and higher grade tumors and, more frequently in a multiple fashion at diagnosis than non-smokers.

Objectives: To report our findings regarding to the natural history of prostate cancer (PCa) that shows recurrence after radical prostatectomy (RP), in terms of time to development of metastatic disease and death from PCa. To identify independent predictors of PSA recurrence., Material and Methods: Retrospective analysis of 227 patients with clinically localized PCa who underwent RP. The event PSA recurrence was defined as the presence of a postoperative PSA level of 0,2 ng/ml or higher at least 3 months after surgery. Hence, cases with shorter follow-up time were excluded from analysis. No adjuvant therapy (radiotherapy or hormonal therapy) was performed in the included population. Recurrence free survival was calculated during the follow-up period (Kaplan-Meier analysis). Uni and multivariate study was performed in order to assess the ability of factors as preoperative PSA level, Gleason score in surgical specimen, capsular penetration, positive surgical margins (excluding urethral), extracapsular extension, positive pelvic lymph nodes, and seminal vesicle invasion, to predict PSA recurrence. Finally, we selected the group of patients with PSA recurrence and calculated the probability of being free from distant metastatic disease during the follow-up period. Also, function of disease-specific survival was calculated., Results: A total of 208 records were finally included in the study. Median age was 61 years. A total of 47 (22.6%) presented with extracapsular extension. Median follow-up time was 35.8 months, and 49 (23.6%) developed PSA recurrence. Recurrence free survival was 79.9% and 67.4% at 2 and 5 years, respectively. Only three factors were identified with the aid of multivariate analysis as independent predictors of recurrence: preoperative PSA >= 10 ng/ml (hazard ratio--HR--3.03), Gleason score in surgical specimen 8 or higher (HR 3.42), and the finding of capsular penetration (HR 2.17). When only patients with PSA recurrence were considered, 16.3% developed distant metastasis. Probabilities of being free from distant disease after PSA recurrence were 97.7% and 86.9% at 2 and 5 years respectively (actuarial median time 110.8 months). Only 2 patients died from PCa, therefore disease-specific mortality analysis was not performed., Conclusions: Although an important proportion of patients present with PSA recurrence after RP in our setting, the prognosis in term of development of metastatic disease is acceptable in the short-medium term. Anyway, further analysis will be needed to ascertain the evolution of these patients in the long term.

We presented a case of inferior vena cava on the left side diagnosed by abdominal CT scan during the study of a renal cell carcinoma in the right side. This anomaly is very rare but it may suppose a more difficult approach to the nephrectomy.

Renal cell carcinoma have a great capacity of dissemination and have a great variety of clinical presentation. We exposed a clinical note of a patient diagnosed of renal cell carcinoma who developed hematuria and acute urinary retention due to a penis metastasis. Next we review the literature about this topic.