Biochemical recurrence (BCR) occurs in up to 27% of patients after radical prostatectomy (RP) and often compromises oncologic survival. To determine whether imaging signatures on clinical prostate magnetic resonance imaging (MRI) could noninvasively characterize biochemical recurrence and optimize treatment. We retrospectively enrolled 485 patients underwent RP from 2010 to 2017 in three institutions. Quantitative and interpretable features were extracted from T2 delineated tumors. Deep learning-based survival analysis was then applied to develop the deep-radiomic signature (DRS-BCR). The model’s performance was further evaluated, in comparison with conventional clinical models. The model achieved C-index of 0.802 in both primary and validating cohorts, outweighed the CAPRA-S score (0.677), NCCN model (0.586) and Gleason grade group systems (0.583). With application analysis, DRS-BCR model can significantly reduce false-positive predictions, so that nearly one-third of patients could benefit from the model by avoiding overtreatments. The deep learning-based survival analysis assisted quantitative image features from MRI performed well in prediction for BCR and has significant potential in optimizing systemic neoadjuvant or adjuvant therapies for prostate cancer patients.

Purpose: The objective of the study was to evaluate the important role played by androgen and insulin in the development of endometrial carcinoma (EC), and their combined effect on EC risk.

Purpose. To evaluate the long-term oncologic outcomes of renal cell carcinoma (RCC) patients with venous thrombus after radical nephrectomy and venous thrombectomy (RN-VT) and to determine the prognostic factors. Methods and Materials. We reported our follow-up data of RCC patients with venous thrombus from January 2014 to September 2020. We used the Kaplan-Meier method to assess the overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). The Cox proportional hazards regression model and competing risk model were used. Results. After a median follow-up of 31 mon, eight-five patients (31.5%) died, and cancer-specific deaths occurred in 60 patients (22.2%). The 1 yr and 3 yr CSS were 89.3% and 72.7%, respectively. The median OS was 56.0 mon (95% CI 47.6-64.3 mon), and the 1 yr, 3 yr, and 5 yr OS were 87.0%, 62.1%, and 44.8%, respectively. For M1 patients, the median OS was 27.0 mon (95% CI 22.0-42.0 mon), and the 1 yr, 3 yr, and 5 yr OS were 78.0%, 41.5%, and 23.3%, respectively. For M0 patients, the median RFS was 38.0 mon (95% CI 32.5-43.5 mon), and the 1 yr and 3 yr RFS were 81.2% and 52.3%, respectively. Multivariate analyses showed that papillary RCC (HR 2.95, 95% CI 1.80-4.82, ) or other RCC (HR 3.88, 95% CI 2.03-7.41, ), perinephric fat invasion (HR 1.53, 95% CI 1.03-2.26, ), sarcomatoid differentiation (HR 2.85, 95% CI 1.64-4.95, ), Fuhrman grade 3 (HR 2.10, 95% CI 1.28-3.44, ) or 4 (HR 3.55, 95% CI 2.09-6.03, ), and distant metastasis (HR 1.76, 95% CI 1.18-2.63, ) were associated with a worse CSS. Adjuvant therapy (HR 0.63, 95% CI 0.43-0.92, ) was associated with a better CSS. Conclusions. RCC patients can have an acceptable long-term survival after RN-VT. Prognostic factors influencing CSS included nonclear cell RCC histology, higher Fuhrman grade, sarcomatoid differentiation, perinephric fat invasion, distant metastasis, and adjuvant therapy.

Background: Renal angiomyolipoma (AML) without local invasion is generally considered benign. However, it may extend to the renal sinus, even the renal vein, or the inferior vena cava (IVC). In patients with non-tuberous sclerosis complex, coexistence of renal cell carcinoma (RCC) and renal AML is uncommon. Case presentation: A 72-year-old woman was incidentally found to have a solitary right renal mass with an IVC thrombus extending into the right atrium during a routine health checkup. Robot-assisted laparoscopic radical nephrectomy and thrombectomy were successfully performed through adequate preoperative examination and preparation. Two tumor lesions were found and pathologically confirmed as renal AML and RCC, and the tumor thrombus was derived from the renal AML. During the one-year follow-up period, no signs of recurrence or metastatic disease were observed. Conclusions: Renal AML with a tumor thrombus in the IVC and right atrium accompanied by RCC may occur, although rarely. In clinical practice, if preoperative manifestations differ from those of common diseases, rare diseases must be considered to avoid missed diagnoses. In addition, adequate examination and multidisciplinary discussions before making a diagnosis are necessary. For a level 4 tumor thrombus with no infringement of the venous wall, adoption of robot-assisted minimally invasive surgery, without extracorporeal circulation technology, is feasible.