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Purpose: The purpose of this study was to report the feasibility, safety, and benefits of laparoscopic radical cystectomy (LRC) for patients with bladder cancer (BC) who are older than 75 years and with marginal cardiopulmonary function in a regional teaching hospital. Materials and Methods: The charts of thirty patients who underwent LRC between 2013 and 2016 in a community teaching hospital were reviewed. The patients were subgrouped into the age groups ≥75 years and

Diabetes is usually asymptomatic in its early stage. Early diagnosis may improve outcomes by enabling initiation of treatment before end organ damage has progressed. The aim of this study was to determine whether the clinical sign of phimosis with preputial fissures is predictive of type 2 diabetes in patients not previously diagnosed with diabetes. Twenty-eight patients with acquired phimosis and preputial fissures were collected prospectively. Twenty-eight controls with acquired phimosis without preputial fissures were selected. Statistically significant differences were found in body mass index, random plasma glucose, glucosuria and glycosylated haemoglobin levels, but not in age, family history of diabetes, hypertension and classical hyperglycaemic symptoms. Diabetes was confirmed in all 28 patients in the preputial fissures group, but only 2 (7.1%) patients in the non-preputial fissures group (p < 0.0001). In conclusion, phimosis with preputial fissures may be a specific sign of undiagnosed diabetes mellitus.

Objective The purpose of this study was to report the feasibility, safety, and benefits of laparoscopic radical cystectomy (LRC) for patients with bladder cancer who are older than 75 years and with marginal cardiopulmonary function in a regional teaching hospital. Materials and methods The charts of 30 patients who underwent LRC between 2013 and 2016 in a community teaching hospital were reviewed. The patients were sub-grouped into the age groups ≥75 years and Results A significant difference was observed in the data of the group ≥75 years group compared with the p = 0.0007) and higher rate of marginal cardiopulmonary function (80% vs. 26.7%, p = 0.0092). No significant difference was observed in sex, CCI score (3.93 vs. 3.27), Body Mass Index (BMI) (24.8 vs. 24.4), ejection fraction (69% vs. 70.97%), operation time (473 vs. 465 min), blood loss (503 vs. 380 mL), urinary diversion type, intensive care unit care (1.13 vs. 0.6 days), interval to ambulation (2 vs. 1.8 days), interval to oral food intake (3.2 vs. 2.6 days), interval to normal bowel function (4.6 vs. 3.6 days), post-op hospitalization (15.67 vs. 11.67 days), and blood transfusion rate (33.3% vs. 26.7%) between the two groups. No conversion to open surgery or mortality was observed. Surgical complications occurred in 15 patients, with a complication rate of 50%. No surgical mortality was noted in 30 or 90 days. Most pathological cases revealed urothelial carcinoma. Conclusions LRC is a safe option with favorable outcomes in bladder cancer patients older than 75 years with marginal cardiopulmonary function in a regional teaching hospital.

There is relatively little literature on adjuvant radiotherapy after radical nephroureterectomy with bladder cuff excision (RNU) for patients with upper tract urothelial carcinoma (UTUC). This study was designed to determine the efficacy of adjuvant radiotherapy for patients with pT3N0M0 UTUC. We retrospectively reviewed 198 patients treated with RNU between December 2001 and January 2015. Postoperative radiotherapy was administered in 40 (20.2%) of patients. Patients who received radiotherapy were younger than those that did not (65.2 vs. 70.5 years, p = 0.023). With median follow up of 29.1 months, Kaplan-Meier analysis with the log-rank test demonstrated no significant differences between those omitting vs receiving adjuvant radiotherapy in regards to 2-year rates of overall survival (72.0% vs. 73.4%, p = 0.979), cancer-specific survival (73.2% vs. 75.3%, p = 0.844), and recurrence-free survival (61.2% vs. 66.3%, p = 0.742). However, in multivariable analysis with Cox regression, young age, absence of chronic kidney disease, negative lymphovascular invasion, negative surgical margin, and adjuvant chemotherapy were also associated with better cancer-specific survival. In conclusion, adjuvant radiotherapy did not offer any significant benefit in terms of overall, cancer-specific, and recurrence-free survivals in patients with pT3N0M0 UTUC after RNU. More effective systemic adjuvant chemotherapy is necessary to improve the outcome of these patients.