To compare the outcomes of open pyeloplasty (OP), laparoscopy-assisted extracorporeal (LEXP), and robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction in pediatric patients. We retrospectively reviewed the age-matched cohort of 30 children who underwent OP, 30 who underwent LEXP, and 10 who underwent RALP at a single institution, from 1996 to 2014. Pre- and post-operative variables including success rate were compared among surgical groups. The mean age of the patients was 120.2 months, the Society for Fetal Urology grade was 3.6, the anteroposterior diameter was 3.1 cm, and the renal relative function was 44.0%. The distribution of laterality, mean body mass index, and preoperative anteroposterior pelvic diameter on ultrasound did not differ among groups. The mean length of hospital stay was significantly shorter in the RALP group (3.2 days) than in the OP (6.6 days) and LEXP (5.8 days) groups (p<0.001). The duration of analgesics use was shorter in the RALP group (1.1 days) than in the other groups (p<0.001). During the mean follow-up period of 49.0, 20.1, and 16.6 months, the success rate was 96.7%, 89.7%, and 100% in the OP, LEXP, and RALP groups, respectively, although this difference was not statistically different (p = 0.499). In multivariate regression analysis, the presence of crossing vessels was the only factor that decreased the success rate (hazard ratio: 46.09, 95% confidence interval: 2.41–879.6, p = 0.011). Patients who undergo RALP have a reduced hospital stay and lower use of pain medication; however, there is no difference in the success rates for OP, LP, and RALP surgeries. The presence of crossing vessels is a negative prognostic indicator for surgical outcome regardless of the surgical method.

This review systematically addresses the correlation between the microbiome and prostate cancer and explores its diagnostic and therapeutic implications. Recent research has indicated an association between the urinary and gut microbiome composition and prostate cancer incidence and progression. Specifically, the urinary microbiome is a potential non-invasive biomarker for early detection and risk evaluation, with altered microbial profiles in prostate cancer patients. This represents an advancement in non-invasive diagnostic approaches to prostate cancer. The role of the gut microbiome in the efficacy of various cancer therapies has recently gained attention. Gut microbiota variations can affect the metabolism and effectiveness of standard treatment modalities, including chemotherapy, immunotherapy, and hormone therapy. This review explores the potential of gut microbiome modification through dietary interventions, prebiotics, probiotics, and fecal microbiota transplantation for improving the treatment response and mitigating adverse effects. Moreover, this review discusses the potential of microbiome profiling for patient stratification and personalized treatment strategies. While the current research identifies the pivotal role of the microbiome in prostate cancer, it also highlights the necessity for further investigations to fully understand these complex interactions and their practical applications in improving patient outcomes in prostate cancer management.

Park H, et al. J Korean Med Sci. 2018 Jan;33(11):e94. https://doi.org/10.3346/jkms.2018.33.e94

Introduction: Human epidermal growth factor receptor type 2 (HER2) overexpression is a prognostic factor and a therapeutic target for breast cancer; however, anti-HER2 therapies are ineffective in patients with bladder cancer. The authors investigated the effect of HER2 overexpression (HER2⁺) on the prognosis of muscle-invasive bladder cancer (MIBC). Materials and methods: This retrospective cohort study included patients who underwent initial transurethral resection of bladder tumors between 2005 and 2013 and were registered in the Korea National Health Insurance Database, which provides data on overall survival (OS). Sixty-one patients with clinically nonmetastatic de novo MIBC were included in this study. As a subgroup, 33 patients who underwent immediate radical cystectomy (RC) were analyzed. Univariate and multivariate Cox proportional hazards models were used to identify prognostic factors for survival. A multivariable binary logistic regression model was used to identify the favorable T stage. Results: Among the 61 patients with d-MIBC, 14 were HER2⁺ and 47 HER2^-. Age less than 70 years [hazard ratio (HR): 0.312, CI: 0.16–0.59, P<0.001] and HER2⁺ status (HR: 0.40, CI: 0.19–0.85, P=0.02) were favorable prognostic factors for OS after adjusting for clinical variables. In the RC subgroup, HER2⁺ status was a significant predictive factor for the pT2 stage (HR): 36.8, CI: 4.83–797.41, P<0.01). Age less than 70 years (HR: 0.15, CI: 0.05–0.42, P<0.001) and HER2⁺ status (HR: 0.11, CI: 0.02–0.54, P=0.01) were favorable prognostic factors for OS after adjusting for RC pathological variables. Conclusions: HER2⁺ status could be a marker for an indolent subset of MIBC and could predict favorable survival regardless of RC status. Moreover, HER2⁺ status not only consistently predicted a favorable T stage after RC, but also predicted better survival than pathological outcomes.

Introduction: Primary carcinoma in situ (P-CIS) of the bladder is rare and its clinical behavior and predictive features have not been well described. The purpose of this study was to evaluate the effects of various factors including angiotensin-2 converting enzyme inhibitors/angiotensin II receptor blockers (ACEIs/ARBs) on recurrence-free survival (RFS)-related prognosis in patients with P-CIS. Materials and Methods: In our medical center, 5,945 patients were diagnosed with bladder cancer from January 1999 to January 2014. Of these, 64 patients were diagnosed with CIS and were treated with at least 6 cycles of Bacillus Calmette-Guérin (BCG). We accessed variables including patient age, sex, initial presenting symptoms, smoking history, P-CIS descriptions, urine cytology, and medication history related to hypertension. Results and Conclusions: We evaluated the use of anti-hypertensive medications (ACEIs/ARBs, p = 0.028), the symptom of non-gross hematuria (p = 0.028), and older age (p = 0.015) as significant factors related to RFS. Older age was also a significant factor for influencing the RFS rate. We found that the use of anti-hypertensive medications (ACEIs/ARBs) improves RFS in patients with P-CIS after BCG therapy. The prognosis was poor when there was no gross hematuria and if patients were at older ages at the time of diagnosis of P-CIS.