Our aim is to evaluate the influence of clinical and histopathological parameters, including age, gender, tumor stage, grade, tumor differentiation, necrosis, lymphovascular/perineural invasion (LVI/PNI) and concomitant carcinoma in situ (CIS), on outcomes of patients with urothelial carcinoma of the bladder (UCB). A total of 84 patients who underwent radical cystectomy (RC) (n = 11) and radical cystoprostatectomy (n = 73) for muscle-invasive bladder cancer at our hospital between 2007-2013, were included in the study. The mean age of patients at diagnosis was 66.1, of whom 75 were males and 9 were females. Of the 84 patients, 38 were ≤65 years and 46 were >65 years. Mean tumor diameter was 3.66 cm. There were 38 cases which showed divergent differentiations. Concomitant CIS was observed in 30 tumors, 41 cases showed tumor necrosis, 44 PNI and 61 LVI. The rate of overall survival (OS) in patients aged ≤65 years was statistically significantly higher than in those aged >65 years. A negative statistical relationship was found between OS with lymph node metastasis (LNM) and tumor differentiation. On the other hand, necrosis did not remain significant on multivariate analysis. No statistically significant relationship was found between smoking, tumor stage, PNI, LVI and concomitant CIS and OS. In this study, advanced age, LNM, tumor differentiation were found to be independent prognostic risk factors associated with OS after RC. These additional factors, which may explain the different clinical course in patients with similar tumor stage and lymph node status, should be taken into consideration in treatment planning.

Background : The aim of this study was to evaluate the prognostic significance of clinical, demographic and detailed histopathological parameters in renal cell carcinoma (RCC). Methods : A total of 102 patients who underwent partial or radical nephrectomy for a renal mass between 2008 and 2013 were evaluated retrospectively. Fuhrman grade, TNM stage, macroscopic satellite tumor nodule formation, histopatho-logical subtype, renal vein invasion (RVI), necrosis, microvessel invasion (MVI), sarcomatoid differentiation and overall survival (OS) were evaluated to determine prognostic factors. Results : The 102 patients consisted of 73 with clear cell tumor, 15 with papillary tumor, 12 with chromophobe tumor and 2 collecting duct RCC cases. A statistically negative relationship was observed between increasing age and OS when the patients were grouped as above and under 40 years of age. There was no statistical relationship between OS and his-topathological subtype, adrenal gland invasion, and lymph node metastasis. The risk of death was 10-fold increased in patients with stage 4 tumor compared to patients with stage 1 tumor. Statistically significant macroscopical parameters for OS were satellite tumor nodule presence, Fuhrman grade, tumor size, renal sinus and perinephric fat invasion, distant metastasis, and RVI. The risk of death was 13-fold higher in cases with sarcomatoid differentiation. There was a strong correlation between the presence of a satellite tumor nodule, necrosis, sarcomatoid differentiation and the tumor stage. A statistically negative correlation was observed between OS and the MVI, sarcomatoid differentiation, and necrosis. Conclusion : We found the Fuhrman grade, tumor size, renal sinus and perinephric fat invasion, distant metastasis, RVI, MVI, sarcomatoid differentiation, necrosis and satellite tumor nodule to be all statistically significant parameters for OS. The addition of other variables to the TNM stage and grade may improve the prediction of outcomes for RCC patients.

Objective: The aim of this study was to evaluate the prognostic significance of tumor budding in muscle invasive urothelial carcinoma of bladder (MIBC). Material and methods: A total of 60 patients who underwent radical cystectomy and cystoprostatectomy for MIBC were included in the study. The correlations between tumor budding, and tumor necrosis, lymphovascular invasion (LVI), perineural invasion (PNI) and histopathological data with distant metastasis were evaluated. The correlation between progression free (PFS) and overall survival (OS) rates and the presence, and grade of tumor budding was investigated. Results: A statistically significant correlation was not seen between tumor budding, necrosis, LVI, and PNI. There was a strong correlation between distant organ metastasis, and presence of tumor necrosis. There was no statistically significant correlation between PFS, OS and tumor budding. A statistically significant relationship was observed between OS and tumor stage, lymph node metastasis, and distant organ metastasis. Conclusion: In our study, statistically significant effect of tumor budding on survival rates in MIBCs was not observed. Also, no significant correlation was observed between tumor budding and tumor necrosis, LVI, and PNI. Cite this article as: Küçük Ü, Ekmekçi S, Çakır E, Ekin Z, Ergani B, Ekin GR. Prognostic significance of tumor budding in muscle invasive urothelial carcinomas of the bladder. Turk J Urol 2019; 45(4): 273-8.

Objective: Paratesticular tumors, which comprise a heterogeneous group of entities, are often described in case reports in the literature. In this study, we present the histomorphological, immunohistochemical and clinical features of six paratesticular sarcoma cases. Material and methods: Six paratesticular sarcoma cases diagnosed in our hospital between 1997 and 2012 were included in this study. Information regarding treatment modalities, tumor recurrence, metastasis, and survival data were obtained from archival patient records. Hematoxylin-eosin sections were examined, and immunohistochemical analyses were performed for smooth muscle actin, desmin, Ki67, CD34, S100 and myogenin. Five high-power fields were counted to document Ki67 and p53 nuclear positivity rates. Results: Of the 6 paratesticular sarcoma cases, 3 were rhabdomyosarcomas, 2 were leiomyosarcomas and 1 was liposarcoma. The sclerotic-type liposarcoma case showed two recurrences in the 15-year follow-up period. The two leiomyosarcoma cases presented with lung metastases at the time of diagnosis, and 1 patient died of the disease at 7th month. Of the 3 rhabdomyosarcoma cases, 2 patients did not follow up after their operations. The other patient presented with liver and pre¬vertebral metastasis in the 3rd month and died of the disease in the 14th month. The Ki67 proliferation index was significantly higher for 1 rhabdomyosarcoma case and 2 leiomyosarcoma cases. Differences in p53 expression were not statistically significant between the cases. Conclusion: Paratesticular tumors are a heterogeneous group of tumors that can follow different clinical courses. This study showed that the most important features in determining prognosis are histopathological subtype and tumor grade.

Background/aim: This study was designed to determine the characteristic features of upper urinary system urothelial carcinomas (UUSUCs) and to evaluate the clinicopathological parameters associated with prognosis. Materials and methods: A total of 74 cases of UUSUC were included, from three different centers. Demographic data and histopathological features such as tumor localization, concomitant tumor in the urinary system, distant metastasis with overall survival and disease-free survival obtained from the hospital records were evaluated retrospectively. Histopathologic prognostic features such as grade, perineural invasion, lymphovascular invasion, tumor necrosis, and surgical margin status were also evaluated. Results: Seventy cases (94.6%) underwent open nephroureterectomy whereas 4 cases (5.4%) had laparoscopic nefroureterectomy. Thirty-eight (51.4%) cases were located in the pelvis, 7 (9.5%) in the ureter, 29 (39.2%) both in the pelvis and ureter. Fifty-six (75.7%) cases were alive; however, 18 (24.3%) patients were found to be dead. pTa, pT1, pT2, pT3, and pT4 tumors were reported in 16 (21.6%), 13 (17.6%), 4 (5.4%), 28 (37.8%), and 13 (17.6%) patients, respectively. Histopathologically, 17 cases (23%) were low-grade, 57 cases (77%) were high-grade. Statistically significant correlation was observed between overall survival and lymph node metastasis, distant metastasis, tumor necrosis, and differentiation by univariate analysis. Only distant metastasis was statistically associated with overall survival by multivariate analysis. We found no significant relationship between disease-free survival and all parameters. Conclusions: Differentiation and necrosis of tumor, lymph node involvement, and presence of distant metastasis is associated with the overall survival of urothelial carcinoma of the upper urinary system.