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Objectives: To evaluate recurrence after penile‐sparing surgery (PSS) in the management of carcinoma in situ (CIS) of the penis in a large multicentre cohort of patients. Patients and Methods: We identified consecutive patients from five major academic centres, treated between June 1986 and November 2014, who underwent PSS for pathologically proven penile CIS. The primary outcome was local recurrence‐free survival (RFS), which was estimated using the Kaplan–Meier method. Results: A total of 205 patients were identified. Treatment methods included circumcision, glansectomy, wide local excision, laser therapy and total glans resurfacing. Over a median (interquartile range [IQR]) follow‐up of 40 (26–65.6) months, there were 48 local recurrences, with 45.8% occurring in the first year and 81.3% occurring by year 5. The majority of recurrences were observed in the laser group (58.3%). The median (IQR) time to local recurrence was 15.9 (5.66–26.14) months. The 1‐ 2‐ and 5‐year RFS rates were 88.4, 85.6 and 75%, respectively, and the median (IQR) RFS time was 106.5 (80.2–132.2) months. Conclusions: Among patients with penile CIS selected for surgical management, durable responses at intermediate‐ to long‐term follow‐up were noted. For those with glandular CIS, glans resurfacing offered the best outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort. Patients and Methods: The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan–Meier, Cox regression and competing‐risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW). Results: Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri‐operative blood loss: median (interquartile range [IQR]) 1000 (600–1500) mL vs 500 (400–800) mL (P < 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62–9.71; P < 0.001), body mass index (OR 0.91, 95% CI 0.87–0.95; P < 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18–0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23–1.40; P < 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37–5.00; P = 0.004), and ≥pT3 tumours (OR 1.59, 95% CI 1.02–2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer‐specific mortality and other‐cause mortality rates for patients receiving PBT(P < 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence‐free survival (hazard ratio [HR] 0.92, 95% CI 0.53–1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55–2.05; P = 0.9), cancer‐specific mortality (sub‐HR 1.09, 95% CI 0.62–1.92; P = 0.8) and other‐cause mortality (sub‐HR 1.00, 95% CI 0.26–3.85; P > 0.9) in IPTW‐adjusted Cox regression and competing‐risks analyses. The same held true in conventional multivariable Cox and competing‐risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values >0.05). Conclusion: The present results did not show an adverse effect of PBT on oncological outcomes after adjusting for baseline differences in patient characteristics. [ABSTRACT FROM AUTHOR]

Objectives To assess the potential complications associated with inguinal lymph node dissection ( ILND) across international tertiary care referral centres, and to determine the prognostic factors that best predict the development of these complications. Materials and Methods A retrospective chart review was conducted across four international cancer centres. The study population of 327 patients underwent diagnostic/therapeutic ILND. The endpoint was the overall incidence of complications and their respective severity (major/minor). The Clavien-Dindo classification system was used to standardize the reporting of complications. Results A total of 181 patients (55.4%) had a postoperative complication, with minor complications in 119 cases (65.7%) and major in 62 (34.3%). The total number of lymph nodes removed was an independent predictor of experiencing any complication, while the median number of lymph nodes removed was an independent predictor of major complications. The American Joint Committee on Cancer stage was an independent predictor of all wound infections, while the patient's age, ILND with Sartorius flap transposition, and surgery performed before the year 2008 were independent predictors of major wound infections. Conclusions This is the largest report of complication rates after ILND for squamous cell carcinoma of the penis and it shows that the majority of complications associated with ILND are minor and resolve without prolonged morbidity. Variables pertaining to the extent of disease burden have been found to be prognostic of increased postoperative morbidity. [ABSTRACT FROM AUTHOR]

Objectives To analyze the effect of adenosine on detrusor smooth muscle contraction and to assess age-related changes of adenosine function. Methods Sustained contractions were induced in young (10-30 days) and old (>60 days) rat detrusor muscle strips by application of 30 mmol/L K+ and adenosine (0.1-400 µmol/L), which was either applied before raising the K+ concentration or added to the precontracted muscle strip. Quantitative polymerase chain reaction analyses were used to study adenosine receptor expression in rat and human detrusor specimens. Results Pretreatment with adenosine dose-dependently reduced subsequent K+-induced contraction in detrusor muscle strips from young rats (half-maximal effect = 40 µmol/L). The residual depolarization-induced contraction strength in young tissue was significantly smaller than in tissue from old animals, showing a greater potency of adenosine in young detrusor samples. Likewise, the relaxing effect of adenosine on precontracted detrusor muscle was also significantly more pronounced in young compared with older detrusor. Quantitative polymerase chain reaction showed an age-related downregulation of the adenosine A2B receptor in rat detrusor tissues, which could be confirmed in human detrusor samples. Furthermore, relaxation of both K+-induced as well as carbachol-induced contraction by the specific A2B receptor agonist BAY 60-6583 was significantly more pronounced in young than in old rats. Conclusions Adenosine powerfully counteracts contraction of detrusor smooth muscle, which is lost in the aging bladder. This is paralleled by an age-dependent transcriptional downregulation of the low-affinity A2B receptor. Hence, this might be pathophysiologically relevant in conditions of raised adenosine concentrations, such as hyperactive bladder contractility. [ABSTRACT FROM AUTHOR]

To identify tumour-related enzyme alterations we have used 2D-gels to analyse the proteome from dissected malignant and benign kidney areas from patients with clear-cell-type renal carcinoma. The expression of 12 proteins was diminished in tumour. Four proteins were characterized by mass spectrometry and were identified as enoyl-CoA hydratase, α-glycerol-3-phosphate dehydrogenase, aldehyde dehydrogenase 1 and aminoacylase-I. [ABSTRACT FROM AUTHOR]