Erol O. Gursel

Radical retropubic prostatectomy for cancer: a 20-year experience.

A review of 159 patients treated by radical retropubic prostatovesiculectomy from 1951 through 1970 has reinforced our belief that this is a satisfactory method of treatment for prostatic cancer confined to the prostate. A 10-year survival of 55 per cent and a 15-year survival of 45 per cent compare well to the results reported for perineal prostatectomy. The postoperative mortality rate was 2.5 per cent and total incontinence was 12.5 per cent after radical retropubic prostatectomy. Completely normal voiding occurred in 108 of the 159 patients. Stress incontinence but no need for an incontinence device occurred in 31 patients. Improved methods for preoperative staging of the disease give promise for even higher cure rates in the future.

Penile cancer Clinicopathologic study of 64 cases

Abstract The clinical records of 64 patients with penile cancer admitted to the urologic services at the Presbyterian and Francis Delafield Hospitals from 1947 through 1969 have been reviewed. The pertinent data are analyzed and included in this report. The relationship between cancer of the penis and phimosis, and age and race are discussed. The treatment of choice was partial or total penectomy followed by external radiotherapy. Radical dissection of the inguinal lymph nodes did not seem to improve results while it contributed to increased morbidity. Survival rates were evaluated according to the types and stages of penile cancer, as well as to the methods of treatment. The over-all five-year survival rate was 49 per cent. Autopsy studies in 9 patients who died of penile cancer revealed the inguinal and pelvic lymph nodes were involved in 8 patients.

Bone Marrow Acid Phosphatase: Prognostic Value in Patients Undergoing Radical Prostatectomy

Preoperative bone marrow acid phosphatase determinations were elevated in 18 of 31 patients who underwent radical prostatectomies. A review of the surgical pathology and clinical followup demonstrated a higher incidence of metastasis in these patients.

External radiotherapy in ureteralobstruction secondary to locally invasive prostatic cancer

Sixteen patients with unilateral or bilateral hydroureteronephrosis due to ureteral obstruction secondary to locally invasive prostatic cancer (Stage III) were given 5,000 to 6,000 rads of external radiotherapy to the prostate utilizing Cobalt-60. External radiotherapy was used in 10 patients after they either refused to undergo orchiectomy or had been refractory to orchiectomy and hormone therapy for at least three months. Unilateral nephrostomy was required in 3 patients prior to radiotherapy. Within six months 9 of 10 patients showed a response. The encouraging effects of external radiotherapy on ureteral obstruction secondary to locally invasive prostatic cancer are discussed.

Positive random iliac bone biopsy in advanced prostatic cancer

Abstract Forty-one patients with biopsy proved prostatic cancer and with biopsy proved bone metastases were retrospectively evaluated. In 16 per cent of the patients, bone biopsy was positive in spite of negative skeletal survey. Positive skeletal survey and increased serum acid phosphatase levels were found in 78 per cent of the patients, although bone marrow acid phosphatase was elevated in all patients. The determination of bone marrow acid phosphatase was found to be the most sensitive parameter in detection of bone metastases in patients with advanced prostatic cancer.

Urinary ionized calcium in urolithiasis. Effect of cranberry juice.

Abstract Urinary ionized calcium was determined by a calcium activity electrode in 32 normal persons and in 54 patients with calcium-containing renal stones and without urinary tract infection. It was found to be 38 per cent higher in patients with calcium-containing renal stone in comparison to normal persons. However, this was not statistically significant. No consistant change in total or ionized calcium excretion was produced in normal volunteers by the administration of as much as 5 pints of cranberry juice. In patients with renal stones, the urinary ionized calcium was reduced during the cranberry juice ingestion by 50 per cent, which was statistically highly significant.

Increased serum amylase levels in prostatic diseases

Abstract Serum amylase levels were found to be increased in 95 per cent of patients with benign prostatic hypertrophy and in 70 per cent of patients with prostatic cancer. No known causes for high serum amylase levels were present in these patients. Investigation of a possible relationship between amylase activity and prostatic diseases suggested that benign prostatic hypertrophy and prostatic cancer should be considered in the differential diagnosis of disorders associated with increased serum amylase levels.

Serum immunoglobulins in patients with prostate cancer

SummaryImmunoelectrophoresis of serum proteins was performed on 16 patients with locally invasive (Stage III) and 20 patients with advanced (Stage IV) prostate cancer. Mean values of Immunoglobulin-G (IgG) was higher in Stage III than in Stage IV prostate cancer, although no remarkable changes were observed in the mean values of Immunoglobulin-A (IgA) and Immunoglobulin-M (IgM). — The percentage of the patients with decreased IgM was found to be higher in Stage IV (12 out of 20) than Stage III (3 out of 16) prostate cancer. Determination of serum immunoglobulins may be a useful, additional parameter in the evaluation of therapetuic responses in patients with prostate cancer.

Simplifed bone marrow biopsy needle For staging of carcinoma of prostate

Abstract Bone marrow biopsy and bone marrow aspiration for acid phosphatase determination are simple adjuncts to the staging of carcinoma of the prostate. The Vim-Silverman needle has been modified to a double-sheath needle to obtain a bone marrow biopsy and bone marrow aspirate with a single puncture of the bone.

BONE MARROW CALCIUM IN CANCER OF PROSTATE AND BLADDER

Abstract A comparative evaluation of bone marrow and serum calcium levels and their relation to the bone marrow and serum acid phosphatases were studied in 10 patients with benign prostatic hypertrophy and 23 patients with inoperable prostate cancer. None of the 33 patients had hypercalcemia at the time of the study. Calcium metabolism at the metastatic foci was discussed, and the marrow/serum calcium ratio is suggested as helpful in the staging of prostate and bladder cancer as an additional parameter.