Early releases for November 2, 2011 (about CUAJ early releases)

Early immune outcome of retroperitoneal laparoscopic radical nephrectomy for localized renal cell carcinoma: a prospective, randomized study
Cite as: Can Urol Assoc J 2011. http://dx.doi.org/10.5489/cuaj.11003
Yang Lu, Fan Tianyong, Wei Qiang, Cui Xiaobo, Bu Siyuan, Han Ping
Abstract

Prostate cancer survival in Trinidad: Is PSA a prognostic factor?
Cite as: Can Urol Assoc J 2011. http://dx.doi.org/10.5489/cuaj.11006
Kameel Mungrue, Suresh Moonan, Maryam Mohammed, Saara Hyatali
Abstract

Influence of concurrent medications on outcomes of men with prostate cancer included in the TAX 327 study
Cite as: Can Urol Assoc J 2011. http://dx.doi.org/10.5489/cuaj.11013
Saroj Niraula, Greg Pond, Ronald de Wit, Mario Eisenberger, Ian F. Tannock, Anthony M. Joshua
Abstract

Efficacy and tolerability of combined medication of two different antimuscarinics for treatment of adults with idiopathic overactive bladder in whom a single agent antimuscarinic therapy failed
Cite as: Can Urol Assoc J 2011. http://dx.doi.org/10.5489/cuaj.11059
Junseok Yi, Seong Jin Jeong, Min Soo Chung, Hongzoo Park, Sang Wook Lee, Seung Hwan Doo, Cheol Yong Yoon, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee
Abstract

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates
Cite as: Can Urol Assoc J 2011. http://dx.doi.org/10.5489/cuaj.11101
Stavros Sfoungaristos, Petros Perimenis
Abstract

Early immune outcome of retroperitoneal laparoscopic radical nephrectomy for localized renal cell carcinoma: a prospective, randomized study
Abstract
Objective: We evaluated differences in cytokine responses and T-lymphocyte subsets following retroperitoneal laparoscopic and conventional open radical nephrectomies for localized renal cell carcinoma (RCC).
Methods: A total of 62 patients with T1N0M0 staged RCC were randomized to either retro-laparoscopic (n = 31) or open (n = 31) radical nephrectomy. Plasma levels of interleukin-1ß (IL-1ß), IL-6, and tumour necrosis factor-alpha (TNF-a) were measured separately by enzyme linked immunosorbent assay (ELISA) preoperatively and on postoperative days 1 and 5. Levels of CD3+, CD4+ and CD8+ as well as the CD4+:CD8+ ratio were acquired by flow cytometry at the same time points.
Results: Levels of IL-1ß, IL-6 and TNF-a increased significantly compared to preoperative values in both groups (p < 0.05) on postoperative day 1, and all the parameters in the open group were significantly higher than those in the retro-laparoscopy group (p < 0.05). On postoperative day 1, the levels of CD3+ and CD4+ and the CD4+:CD8+ ratio decreased markedly compared to preoperative values for both groups (p < 0.05). Elevations of the CD4+:CD8+ ratio in the retro-laparoscopy group (p < 0.05) and the CD8+ level in the open group (p < 0.05) were observed when compared with the other group. On postoperative day 5, the levels of CD3+ and CD4+ and the CD4+:CD8+ ratio in the retro-laparoscopy group, as well as the level of CD8+ in the open group, returned to about preoperative levels (p < 0.05). Follow-up ranged from 4 to 14 months postoperatively in all 62 patients with a 100% cancerspecific survival rate in both groups.
Conclusions: Retroperitoneal laparoscopic radical nephrectomy is associated with the milder cytokine responses caused by trauma and inflammation and the better preserved distribution of T-lymphocytes.

Prostate cancer survival in Trinidad: Is PSA a prognostic factor?
Abstract
Background: Prostate cancer is the most common malignancy among men in the western hemisphere, including Trinidad and Tobago. The aim of this study is to describe the epidemiological features of prostate cancer among patients admitted to a tertiary level teaching hospital during 2002 to 2005. We assessed the longterm survival of patients with prostate cancer and the epidemiology of the disease.
Methods: We reviewed the admissions data for the period 2002- 2005. Demographic, clinical and outcomes (survival or death) data were collected and analysed, using SPSS version 16. Statistical analysis included Kaplan-Mier survival analysis, Cox regression models and the log-rank test. A p value of <0.05 was considered statistically significant.
Results: Of the 1250 cases reviewed, 242 participants were selected. Patients of African ancestry, older than 60 years and a Gleason score greater than 7 had an increased risk of mortality. Patients with prostate-specific antigen (PSA) = 100 ng/L had a 3-fold increased risk of mortality. Survival rates declined between 2002 and 2005.
Conclusion: This is the first study of its kind to demonstrate survival rates among patients with prostate cancer in Trinidad. The following epidemiological features were identified: average age of occurrence of 71 years, ethnic disparity with higher occurrence in African men than all other ethnic groups and a PSA of >100 ng/dL. These features were associated with a 3-fold higher risk of death. A Gleason score of 8 to 10 was also associated with lower survival rates.

Influence of concurrent medications on outcomes of men with prostate cancer included in the TAX 327 study
Abstract
Objectives: The TAX 327 trial was pivotal in establishing docetaxel in castration refractory metastatic prostate cancer. Various commonly prescribed and over-the-counter co-administered medications are thought to exhibit anti-neoplastic properties and/or could potentially have pharmacokinectic interactions with docetaxel lessening the effectiveness of chemotherapy.
Methods: To examine the effect of on prostate cancer outcomes within this trial, we examined overall survival, prostate-specific antigen (PSA) response, percent PSA reduction, pain response and QOL responses for 14 families of medications including metformin, digoxin, verapamil, proton pump inhibitors, nitrates, statins, cox-2 inhibitors, warfarin, heparins, ascorbic acid, selenium, tocopherol, antidepressants and erythropoietin.
Results: Our findings did not reveal any medication that had a significant additive or synergistic effect with docetaxel. We did note, however, that patients on digoxin or verapamil had poorer overall survival, possibly due to a trend of fewer cycles of administered chemotherapy being administered to the verapamil group, consistent with a pharmacokinectic interaction.
Conclusions: These data are only hypothesis-generating given the statistical limitations, but may form a basis for similar future analysis in other malignancies. The data suggest the need to be aware of pharmacokinectic interactions with medications that may interact with docetaxel.

Efficacy and tolerability of combined medication of two different antimuscarinics for treatment of adults with idiopathic overactive bladder in whom a single agent antimuscarinic therapy failed
Abstract
Objective: Recent studies have investigated a combination of two antimuscarinics for adult neurogenic bladder managed with clean intermittent catheterization or pediatric refractory overactive bladder (OAB). We assessed the efficacy and tolerability of this strategy in adults with idiopathic OAB.
Methods: We reviewed 49 patients with idiopathic OAB who received combined antimuscarinic medication. Patients had serially received different kinds of antimuscarinics as monotherapy, but wished to take combined medication due to a lack of sufficient subjective improvement in urgency, even with dosage escalation. Efficacy was measured by changes of episodes of urgency, daytime voiding, nocturia and mean voided volume before and after the addition of the second antimuscarinic.
Results: The mean duration of combined medication was 9.3 months. After adding the second antimuscarinic, urgency per day decreased from 3.8 to 1.9 (p < 0.001) and daytime voiding decreased from 10.4 to 7.4 (p < 0.001). The number of nocturia episodes and the mean voided volume also improved, although there was no statistical significance. Efficacy did not differ between the 29 cases, with non-selective and non-selective drugs and 20 cases with non-selective and M3 selective drugs. Thirty-three (67.3%) patients reported to have benefited from combined medication. Maximal flow rate and post-void residual volume did not change in either of the sexes. Eleven (22.4%) patients discontinued the combination due to continued ineffectiveness and dry mouth.
Conclusion: This retrospective study suggests that combined medication can help adults with refractory idiopathic OAB. Combined medication was tolerated in most of our patients.

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates
Abstract
Background: Focal hemiablative therapy for prostate cancer is a new treatment alternative. Unilateral and unifocal disease are its main limitations. The aim of this study was to identify the epidemiological, clinical and pathological parameters that may predict unilateral disease in patients diagnosed with prostate cancer.
Methods: We performed a retrospective analysis of patients at our institution between January 2005 and January 2011. Only patients with unilateral disease in prostate biopsy were part of the study. The analysis included age, preoperative prostate-specific antigen (PSA) and its density, prostate volume, biopsy first and second Gleason pattern and Gleason summary, number of biopsy cores, percentage of cancer in biopsy material and the presence of highgrade prostatic intraepithelial neoplasia. Their role as potential predictors was evaluated by univariate and multivariate analysis.
Results: A total of 161 patients had unilateral disease after prostate biopsy. A significant correlation was found between prostate volume, PSA density and percentage of cancer in biopsy material and the presence of unilateral disease in the surgical specimen. These are the same factors significant in the univariate analysis. The results of the multivariate analysis demonstrated that PSA density (p = 0.015) and percentage of cancer in biopsy material (p = 0.028) are the most significant predictors.
Interpretation: Our results demonstrate that PSA density and the percentage of cancer in biopsy cores are significant predictors for prostate cancer unilaterality and should be considered for the selection of hemiablative focal therapy candidates.

About CUAJ early releases

CUAJ has adopted an early release model, in which papers are published online in advance of their print publication. The print publication schedule remains the same: February, April, June, August, October, December; however, CUAJ is now posting new early release articles on its website (www.cuaj.ca) every other month (January, March, May, July, September, November). CUAJ early releases articles only apply to research articles.