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To calibrate a 12-mm high-intensity focused ultrasound (HIFU) probe to produce histologically verifiable complete tissue necrosis through thermal energy delivery while maintaining safety in ablation of porcine renal tissue.The study was approved by the animal research committee at our institution. A HIFU probe on a fixed arm was introduced, and ablation was subsequently carried out robotically (under...
To examine differences in disease progression and nature of tumor invasion that may lead to more accurate expectations of tumor behavior and improved management options for plasmacytoid variant (PCV) histology urothelial bladder cancer patients.Using the Indiana University Bladder Cancer Database, we conducted a retrospective analysis of patients undergoing radical cystectomy from 2008 to June 2013...
To evaluate the possibility of using α-methylacyl-CoA racemase (AMACR) variants to improve the specificity of prostate cancer (CaP) detection. AMACR has been used as a diagnostic biomarker for CaP and is now a standard biomarker for needle biopsy specimens with ambiguous lesions.We used in silico analysis and molecular cloning to discover new AMACR variants and quantitative reverse transcription–polymerase...
To establish the contribution of the anterior fibromuscular stroma to the urethral resistance in an ex vivo human prostate model. The anterior fibromuscular stroma constitutes the anterior portion of the prostatic surgical capsule.An intact bladder and prostate were obtained from 10 patients who had undergone cystoprostatectomy. The bladder was filled at a predetermined flow rate through a catheter...
To ascertain which variables of bladder urothelial carcinoma (UC) might be useful in predicting either UC involving the prostate (UCP) or incidental prostate adenocarcinoma in radical cystoprostatectomy specimens.The bladder and whole-mount prostate sections of 248 radical cystoprostatectomy specimens were reviewed. Stepwise discriminant analysis was used to predict UCP or incidental prostate adenocarcinoma...
To explore whether mini-margin nephron-sparing surgery (NSS) is clinically safe and effective for renal cell carcinoma (RCC) of 4 cm or less with a normal contralateral kidney.A total of 115 patients with sporadic, pathologically confirmed RCC of 4 cm or less (Stage T1a), with a normal contralateral kidney, were treated by NSS using a mini-margin of less than 5 mm from 1998 to 2006. The surgical margin...
Bladder cancer is a heterogeneous disease with a variable natural history. At one end of the spectrum, low-grade Ta tumors have a low progression rate and require initial endoscopic treatment and surveillance but rarely present a threat to the patient. At the other extreme, high-grade tumors have a high malignant potential associated with significant progression and cancer death rates. In the Western...
The aim of this article is to evaluate wide primary perirectal dissection (WR) during the course of radical prostatectomy as a technique to decrease positive surgical margin rates and improve subsequent biochemical outcomes. A retrospective review of a single surgeon’s series of 320 patients, including 61 who underwent WR, from 1998 to the present was performed. Patients were stratified into risk...
Objectives. The delivery of thermotherapy, cryotherapy, and interstitial radiation with minimal morbidity is dependent on the preservation of the prostatic urethra. Our aim was to determine the distribution of the distance between the urethra and the nearest prostate cancer.Methods. We determined the location of cancer in 350 prostate cancers treated by radical prostatectomy between 1991 and 1993...
Objectives. To determine the patient tolerance and thermal ablation pattern in human prostatic tissue after treatment with a hot water, catheter-based system.Methods. Twenty-seven men scheduled for surgery for symptomatic benign prostatic hyperplasia or adenocarcinoma of the prostate underwent water-induced thermotherapy. The patients were randomly assigned to one of four treatment groups. Lidocaine...
Objectives. Patients with bladder cancer and extravesical extension (Stage T3 or greater) have worse survival than those with organ-confined cancer. We sought to determine whether the depth of invasion in transurethral resection of the bladder (TURB) specimens will predict extravesical extension in patients treated by radical cystectomy. Methods. We studied 90 patients diagnosed with invasive bladder...
Objectives. Transurethral microwave thermotherapy is useful for the treatment of benign prostatic hyperplasia, but its effect on cancer is not documented. We analyzed the pathologic changes occurring after microwave thermotherapy in whole mount radical prostatectomy specimens from patients with cancer.Methods. Nine patients scheduled for radical prostatectomy for clinically localized prostate cancer...
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