Scandinavian Journal of Urology and Nephrology最新文献

{"title":"The chronic prostatitis/chronic pelvic pain syndrome and pain catastrophizing: a vicious combination.","authors":"Hans Hedelin","doi":"10.3109/00365599.2012.669403","DOIUrl":"https://doi.org/10.3109/00365599.2012.669403","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the presence and importance of pain catastrophizing among men diagnosed with chronic abacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) in a routine clinical setting.</p><p><strong>Material and methods: </strong>61 men, mean age 46 ± 11 years, with a mean CP/CPPS history of 11 ± 11 years, completed the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), Short-Form McGill Pain Questionnaire (SF-MPQ) and Coping Strategies Questionnaire (CSQ) to evaluate pain catastrophizing, and the International Index of Erectile Function (IIEF-5). They were also scored according to the UPOINT system.</p><p><strong>Results: </strong>The patients' mean scores were: IEEF-5 17.6 ± 7.3, NIH-CPSI pain subscale 11.1 ± 4.4, quality of life question 2.7 ± 1.6, quality of life impact subscale 6.9 ± 2.7 and CSQ catastrophizing score 15.3 ± 9.1. Patients with a high tendency for catastrophizing (CSQ score ≥20) (28%) had higher UPOINT and pain scores, worse quality of life and quality of life impact, but did not stand out regarding voiding dysfunction and ejaculatory pain.</p><p><strong>Conclusions: </strong>Two distinctly different cohorts could be identified: a smaller cohort with a high degree of catastrophizing, severe pain and poor quality of life, and a larger one with a low degree of catastrophizing, less severe pain and moderately reduced quality of life. It is important in clinical practice to distinguish between the two groups since they require different therapeutic approaches.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"273-8"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.669403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30532375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain associated with the chronic pelvic pain syndrome is strongly related to the ambient temperature.","authors":"Hans Hedelin,&nbsp;Karin Jonsson,&nbsp;Dan Lundh","doi":"10.3109/00365599.2012.669404","DOIUrl":"https://doi.org/10.3109/00365599.2012.669404","url":null,"abstract":"<p><strong>Objective: </strong>There are indications suggesting that the pain associated with the chronic pelvic pain syndrome (CPPS) may be related to cold. The purpose of the present study was to evaluate how the symptom intensity reported by the patient relates to the time of the year in a temperate climate, i.e. to the ambient temperature and to weather changes.</p><p><strong>Material and methods: </strong>Thirty-one patients, mean age 51 years (range 35-66 years), with CPPS for 17 ± 10 years (3-42 years) were asked to complete a set of questionnaires including questions concerning how they experienced their symptom intensity during the different seasons using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire.</p><p><strong>Results: </strong>The total NIH-CPSI score was 22.2 ± 8.2. There was a highly marked relationship between season and pain intensity as reported by the informants: it was experienced to be three times more intense during the winter months. All subjects reported that a temperature drop was associated with deterioration.</p><p><strong>Conclusion: </strong>The strong relationship between the ambient temperature, a drop in temperature and the pain experienced by men with CPPS confirms the association between cold and symptom intensity in the Scandinavian countries, where the seasonal temperature variation spans a long range and the winters are long. The cause of this relationship is still to be established. Muscular spasm/stiffness is a possibility that remains to be explored.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"279-83"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.669404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30532123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low endoglin vascular density and Ki67 index in Gleason score 6 tumours may identify prostate cancer patients suitable for surveillance.","authors":"Andreas Josefsson,&nbsp;Pernilla Wikström,&nbsp;Lars Egevad,&nbsp;Torvald Granfors,&nbsp;Lars Karlberg,&nbsp;Pär Stattin,&nbsp;Anders Bergh","doi":"10.3109/00365599.2012.669791","DOIUrl":"https://doi.org/10.3109/00365599.2012.669791","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore whether vascular density and tumour cell proliferation are related to the risk of prostate cancer death in patients managed by watchful waiting.</p><p><strong>Material and methods: </strong>From a consecutive series of men diagnosed with prostate cancer at transurethral resection in 1975-1990, tissue microarrays (TMAs) were constructed. A majority of men had no metastases at diagnosis and were followed by watchful waiting (n = 295). The TMAs were stained for Ki67, endoglin and factor VIII-related antigen (vWf).</p><p><strong>Results: </strong>In univariate Cox analyses, increased Ki67 index, endoglin vascular density and vWf vascular density were associated with shorter cancer-specific survival. Ki67 index and endoglin vascular density added independent prognostic information to clinical stage, estimated tumour size and Gleason score (GS) in multivariate Cox analysis. In GS 6 tumours, high Ki67 index and high endoglin vascular density identified patients with poor outcome. After 15 years of follow-up not a single man out of 34 men with low staining for both markers (35% of all GS 6 tumours) had died of prostate cancer, in contrast to 15 prostate cancer deaths among the remaining 63 men with GS 6 tumours (65% cumulative risk of prostate cancer death). vWf vascular density in benign areas was a prognostic marker in GS 6 and 7 tumours.</p><p><strong>Conclusions: </strong>Men with GS 6 tumours with both low Ki67 index and endoglin vascular density staining scores have a low risk of progression. Additional studies are needed to test whether these two markers can be applied to core biopsies to select patients suitable for surveillance.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"247-57"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.669791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30532752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A presentation of glandular penile metastases from prostate adenocarcinoma.","authors":"Gregory J Nason,&nbsp;Michael K O'Reilly,&nbsp;Ronan M Long,&nbsp;Helen Ingoldsby,&nbsp;Ciara Barrett,&nbsp;Kiaran J O'malley","doi":"10.3109/00365599.2012.675587","DOIUrl":"https://doi.org/10.3109/00365599.2012.675587","url":null,"abstract":"<p><p>Secondary tumours of the penis are rare; they most commonly arise from the prostate and the bladder. These lesions are often associated with disseminated malignancy and have a poor prognosis, with a 6-month mortality of up to 80% reported. Penile metastases have a variety of clinical manifestations including incidental penile nodules, cutaneous findings, urinary symptoms, pain and malignant priapism. Treatment options are mainly targeted at improving the patients' quality of life and are tailored to their clinical condition, but are primarily palliative. This study reports a case of a 92-year-old man with a presentation of glandular penile metastases from prostate adenocarcinoma treated conservatively.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"306-9"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.675587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30561575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very late prostate cancer local recurrence 23 years after radical prostatectomy.","authors":"Fredrik Liedberg,&nbsp;Hans Olsson,&nbsp;Pernilla Sundqvist","doi":"10.3109/00365599.2012.663406","DOIUrl":"https://doi.org/10.3109/00365599.2012.663406","url":null,"abstract":"<p><p>Recurrence after radical prostatectomy occurs most frequently during the first 5 years after surgery. Later recurrences have, however, been described. This report describes a case with local recurrence 23 years after radical prostatectomy.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"304-5"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.663406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30495159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term experience with surgical treatment of selected patients with bladder pain syndrome/interstitial cystitis.","authors":"Aage Valdemar Andersen,&nbsp;Petter Granlund,&nbsp;Alexander Schultz,&nbsp;Trygve Talseth,&nbsp;Hans Hedlund,&nbsp;Lars Frich","doi":"10.3109/00365599.2012.669789","DOIUrl":"https://doi.org/10.3109/00365599.2012.669789","url":null,"abstract":"<p><strong>Objective: </strong>The role of major surgery in patients with bladder pain syndrome/interstitial cystitis (BPS/IC) is not fully established. This report presents a single-institution experience with major surgery in patients with disabling BPS/IC where conservative treatment had failed.</p><p><strong>Material and methods: </strong>Forty-one patients (34 women, seven men) with BPS/IC refractory to conservative treatment underwent major surgery from 1983 to 2004. Surgical approach was determined on a case-by-case basis. Postoperative pain and satisfaction were assessed by a questionnaire.</p><p><strong>Results: </strong>Cystectomy was the primary procedure in five patients. The remaining 36 patients were primarily operated on with subtotal cystectomy and bladder augmentation (n = 16) or supravesical urinary diversion with intact bladder (n = 20). Thirteen of these patients were later operated on with cystectomy due to persisting pain 12 (6-146) months after the primary procedure. The questionnaire was answered by 38 of 41 patients after a median follow-up of 66 (6-238) months. In total, 28 patients (74%) were free of pain, and 26 patients (68%) were satisfied with the end result. There was no difference in reported pain between cystectomized and non-cystectomized patients. When comparing patients who reported pain at follow-up with those who did not report pain, preoperative length of symptoms was significantly increased, with 12.1 compared to 5.4 years (p = 0.02).</p><p><strong>Conclusions: </strong>Major surgery is associated with good symptom relief in strictly selected patients with disabling BPS/IC, where conservative treatment has failed. Extended preoperative duration of symptoms may be a predictor for persisting pain after major surgery for BPS/IC.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 4","pages":"284-9"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.669789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30532050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved differentiation between ductal and acinar prostate cancer using three-dimensional histology and biomarkers.","authors":"Miklós Tarján,&nbsp;Hsiu-Hsi Chen,&nbsp;Tibor Tot,&nbsp;Wendy Wu,&nbsp;Anna Lenngren,&nbsp;Peter B Dean,&nbsp;László Tabár","doi":"10.3109/00365599.2012.675586","DOIUrl":"https://doi.org/10.3109/00365599.2012.675586","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to refine the methodology for discriminating the ductal (DAP) and acinar adenocarcinomas (AAP) of the prostate and confirm that prostate carcinoma of ductal origin is a more aggressive subtype.</p><p><strong>Material and methods: </strong>A retrospective analysis of 110 consecutive radical prostatectomy cases operated on between 2000 and 2006 and worked up using large-format \"two-dimensional\" (2D; 4 μm thick) and \"three-dimensional\" (3D; 1500 μm thick) histology sections was carried out, with an average follow-up of 5.1 years. The same material was also analysed for selected biomarkers in tissue microarray blocks. The most discriminatory biomarkers were then tested on preoperative core biopsy specimens from 24 of these patients.</p><p><strong>Results: </strong>3D histology classified 97/110 (88%) cases of AAP and 13/110 (12%) DAP, which was then confirmed in 2D specimens. The DAP cases had a significantly greater frequency of pT3a and more advanced cancers, > 20 mm tumour focus, high-grade prostatic intraepithelial neoplasia, Gleason score ≥ 7, positive margin, extracapsular extension, vascular invasion, seminal vesicle infiltration, biochemical/local recurrence, regional lymph-node metastases and distant metastases. Three biomarkers in combination (chromogranin A, epidermal growth factor receptor and p53] distinguished DAP from AAP with an accuracy of 94% (area under the curve 0.94, 95% confidence interval 0.88-0.99). The same high accuracy was achieved using these three biomarkers on the preoperative specimens.</p><p><strong>Conclusions: </strong>Both 3D histology and the three selected biomarkers can help in accurately distinguishing DAP from AAP. The clear-cut distinction of two forms of prostate cancers by the approach advocated in this paper would allow AAP patients to undergo less radical treatment and would segregate DAP patients into a subset requiring more effective treatment regimens.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":" ","pages":"258-66"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.675586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40171030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of laminarin on the expression of GRP78 and GRP94 in rat after unilateral ureteral obstruction.","authors":"Cui Zhang,&nbsp;Jing Gao,&nbsp;Lan Zhang","doi":"10.3109/00365599.2012.663405","DOIUrl":"https://doi.org/10.3109/00365599.2012.663405","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine the effect of laminarin on the expression of kidney endoplasmic reticulum molecular chaperones (GRP78 and GRP94) in rats with renal interstitial fibrosis.</p><p><strong>Material and methods: </strong>A renal interstitial fibrosis model in rats was developed by unilateral ureteral obstruction (UUO). Rats were randomly divided into control group, model group, enalapril group, laminarin high-dosage group, laminarin median-dosage group and laminarin low-dosage group. The rats were killed 7 days after surgery and blood samples were collected. Serum creatinine (SCr) and blood urea nitrogen (BUN) levels were determined. Renal tubular damage index was determined by hematoxylin and eosin staining. The percentage of areas with renal interstitial fibrosis collagen was determined by the Masson staining method. Expression of kidney tissue endoplasmic reticulum stress (ERS) protein GRP78 and molecular chaperone GRP94 was determined by Western blotting.</p><p><strong>Results: </strong>Tubulointerstitial injury index, renal interstitial fibrosis, SCr level, BUN level and expressions of GRP78 and GRP94 were significantly different between the model group and treatment groups (p < 0.01). Expressions of GRP78 and GRP94 in rat nephridial tissue was increased (p < 0. 05), tubulointerstitial injury and renal interstitial fibrosis degree were decreased (p < 0.05) and renal function, SCr and BUN were decreased (p < 0.05) compared to those in the laminarin medium-dosage group.</p><p><strong>Conclusions: </strong>The results demonstrate that UUO activated the reaction of ERS and increased the expression of GRP78 and GRP94 in the early period after laminarin was applied, which helped the refolding, assembling and membrane transportation of denatured proteins. Consequently, the ERS signal transduction pathway was blocked, apoptosis was prevented and the development of renal interstitial fibrosis was reduced.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":" ","pages":"267-72"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2012.663405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40144616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Lund-Malmö, Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations to estimate glomerular filtration rate in a large Swedish clinical population.","authors":"Jonas Björk,&nbsp;Ian Jones,&nbsp;Ulf Nyman,&nbsp;Per Sjöström","doi":"10.3109/00365599.2011.644859","DOIUrl":"https://doi.org/10.3109/00365599.2011.644859","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to validate externally the Swedish Lund-Malmö revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations.</p><p><strong>Material and methods: </strong>The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m(2)] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m(2)). Bias, precision [interquartile range (IQR)], accuracy expressed as percentage of estimates ± 10% (P(10)) and ± 30% (P(30)) of measured GFR, and classification ability for five GFR stages (<15, 15-29, 30-59, 60-89 and ≥90 ml/min/1.73 m(2)) were compared.</p><p><strong>Results: </strong>Overall, all three equations performed satisfactorily: LM Revised, MDRD, CKD-EPI showed, respectively, a median bias of -5.8%, -2.2% and 1.7%, IQR 11.9, 12.3 and 11.7 ml/min/1.73 m(2), P(10) 35%, 34% and 38%, P(30) 84%, 79% and 79% and correctly classified GFR stages 68%, 65% and 69%. LM Revised was at least as accurate in terms of P(30) as the other equations at GFR intervals <90, while CKD-EPI was the only unbiased and the most accurate equation at ≥90 ml/min/1.73 m(2). LM Revised was more stable in terms of bias and accuracy across age and BMI groups than MDRD and CKD-EPI. Both MDRD and CKD-EPI overestimated measured GFR among elderly patients and in the small group of underweight men.</p><p><strong>Conclusion: </strong>The ideal all-purpose GFR prediction equation does not exist. LM Revised should be preferred in patients with suspected or known renal insufficiency, while CKD-EPI is most useful in settings where patients with no a priori suspicion of renal impairment are evaluated. Differences in creatinine measurements between laboratories may limit the generalizability of the present validation.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 3","pages":"212-22"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2011.644859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30390938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical prostatectomy in very high-risk localized prostate cancer: long-term outcomes and outcome predictors.","authors":"Steven Joniau,&nbsp;Chao-Yu Hsu,&nbsp;Paolo Gontero,&nbsp;Martin Spahn,&nbsp;Hein Van Poppel","doi":"10.3109/00365599.2011.637956","DOIUrl":"https://doi.org/10.3109/00365599.2011.637956","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to present the long-term outcomes and determine outcome predictors in very high-risk (cT3b-T4) prostate cancer (PCa) after radical prostatectomy (RP).</p><p><strong>Material and methods: </strong>Between January 1989 and December 2004, 51 patients with cT3b-T4 PCa underwent RP. Kaplan-Meier survival analysis was used to calculate the biochemical progression-free survival (BPFS), clinical progression-free survival (CPFS), cancer-specific survival (CSS) and overall survival (OS) rate. Multivariate Cox proportional hazard models were used to determine the predictive power of clinical and pathological variables in BPFS and CPFS.</p><p><strong>Results: </strong>Median follow-up was 108 months [interquartile range (IQR) 73.5-144.5]. The median serum prostate-specific antigen (PSA) was 16.9 ng/ml (IQR 7-37.2). Median biopsy and pathological Gleason (pGS) score were both scored as 7 (range 4-10 and 5-9, respectively). Overstaging was frequent (37.2%); four patients (7.8%) had organ-confined stage pT2, while 15 (29.4%) had extracapsular extension only (pT3a). Another 23 (45.1%) were confirmed with seminal vesicle invasion (pT3b) and nine (17.7%) had adjacent structure invasion (pT4). Eleven patients (21.6%) had lymph-node involvement. Thirty-two patients (62.7%) had positive surgical margins. The BPFS, CPFS, CSS and OS at 5 and 10 years were 52.7%, 45.8%;78.0%, 72.5%; 91.9%, 91.9% and 88.0%, 70.7%. In the multivariate Cox proportional hazard models, pathological stage was an independent predictor of BPFS while preoperative PSA and pGS was an independent predictor of CPFS.</p><p><strong>Conclusions: </strong>The management of cT3b-T4 PCa typically consists of a multimodality treatment in which RP is a valuable first step. Overstaging was frequent (37.2%), and almost one-quarter of the patients remained free of additional treatments. Long-term cancer-related outcomes were very satisfactory.</p>","PeriodicalId":21543,"journal":{"name":"Scandinavian Journal of Urology and Nephrology","volume":"46 3","pages":"164-71"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365599.2011.637956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30486291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}