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Progres En Urologie : Journal de... Nov 2014To review current knowledge about techniques of radical nephroureterectomy (RNU) for the treatment of the upper urinary tract cancer (UTUC). (Review)
Review
[Surgical treatment of upper tract urothelial carcinomas by nephroureterectomy: state of the art review for the yearly scientific report of the French National Association of Urology].
PURPOSE
To review current knowledge about techniques of radical nephroureterectomy (RNU) for the treatment of the upper urinary tract cancer (UTUC).
MATERIAL AND METHOD
A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following key-words; nephroureterectomy; renal pelvis; ureter; bladder-cuff excision; urothelial carcinoma; surgery; lymph-node dissection; laparoscopy.
RESULTS
The removal of a bladder-cuff during RNU is mandatory. After the surgical procedure, intravesical instillation of ametycine reduces significantly the risk of recurrence into the bladder. Ureteral stripping should not be practiced and continuity of the bladder wall must be restored to avoid compromising the post-operative instillation. Lymphadenectomy during RNU is of prognostic and therapeutic interests. However, the anatomic sites of lymphadenectomy and the number of nodes to be analyzed are not consensual. The oncological results of laparoscopic approach are similar to those of open surgery.
CONCLUSION
The RNU must include a lymphadenectomy and an excision of a bladder-cuff and restore the sealing of the bladder to allow practicing of a EPOI. Laparoscopic or open surgery may be used equally, and must respect these rules to avoid compromising the oncological outcome.
Topics: Carcinoma, Transitional Cell; Humans; Laparoscopy; Lymph Node Excision; Nephrectomy; Ureter; Ureteroscopy; Urologic Neoplasms; Urothelium
PubMed: 25158323
DOI: 10.1016/j.purol.2014.07.008 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2020Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations that are frequently characterized as architectural and cytological...
BACKGROUND
Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations that are frequently characterized as architectural and cytological derangements upon histological analysis. Epithelial-mesenchymal transition (EMT) has been proposed as a critical mechanism for the acquisition of the malignant phenotype in neoplastic epithelial processes. This study aims to systematically review the current findings on the immunohistochemical expression of epithelial-mesenchymal transition markers in oral potentially malignant disorders and to evaluate their possible application as biomarkers associated with the progression of oral epithelial dysplasias.
MATERIAL AND METHODS
A systematic search was performed in the following databases: PubMed, EMBASE, Chinese BioMedical Literature Database, and Cochrane Library. Articles that evaluated the relationship between the expression of EMT markers and the degree of oral epithelial dysplasia were selected for the systematic review. The quality of each eligible study was evaluated by independent reviewers that used operationalized prognostic biomarker reporting guidelines (REMARK).
RESULTS
Seventeen articles met all inclusion criteria and were selected. The EMT markers analyzed exhibited an important association with the prognosis of the cases evaluated. The results showed a progressive increase in the expression of nuclear transcription factors and markers of mesenchymal differentiation, as well as negative regulation of epithelial and cell adhesion markers, according to the stage of oral epithelial dysplasia.
CONCLUSIONS
The dysregulation of expression of important EMT components in oral dysplastic epithelium is a potential prognostic marker in OPMDs.
Topics: Biomarkers; Biomarkers, Tumor; Epithelial-Mesenchymal Transition; Prognosis
PubMed: 31967982
DOI: 10.4317/medoral.23305 -
Progres En Urologie : Journal de... Nov 2014To assess techniques, indications and results of conservative surgical management in upper tract urothelial carcinomas (UTUCs). (Review)
Review
PURPOSE
To assess techniques, indications and results of conservative surgical management in upper tract urothelial carcinomas (UTUCs).
MATERIAL AND METHODS
A systematic review of the scientific literature was performed in the Medline database (PubMed) using different associations of the following key words alone or in combination: ureter; renal pelvis; urothelial carcinoma; cancer; survival; renal insufficiency; ureteroscopy; kidney; grade; stage; surveillance.
RESULTS
Conservative management is indicated in imperative cases (solitary kidney) or in elective cases to preserve renal function as much as possible. When a patient has two kidneys, indications of conservative treatment are dedicated to UTUC with the following characteristics: less than 1cm, low grade, unique contingent upon the fact that the patient has understood that stringent follow-up was mandatory. Current technique of reference is flexible ureteroscopy but open segmental ureterectomy is still indicated in isolated tumor of distal ureter. Oncologic outcomes after conservative management are equivalent to those obtained after nephroureterectomy in low grade/volume UTUCs.
CONCLUSION
Indications of conservative management in UTUCs have been expanded in the past years in relationship with the development of new and sophisticated endourological ureteroscopes to obtain good oncologic outcomes contingent upon a stringent follow-up and even a systematic second look procedure in certain cases.
Topics: Carcinoma, Transitional Cell; Endoscopy; Humans; Neoplasm Grading; Neoplasm Staging; Urologic Neoplasms; Urologic Surgical Procedures; Urothelium
PubMed: 25205341
DOI: 10.1016/j.purol.2014.07.007