Giuseppe Voria

Neuroendocrine differentiation in human prostate tissue: is it detectable and treatable?

which is present in the normal, hyperplastic and dysplastic prostate. NE cells are located in all regions of the human prostate at birth, but rapidly decrease in the peripheral prostate after birth and then reappear at puberty [4]. After puberty, the number of NE cells seems to increase until an apparently optimum level is reached, which persists from 25 to 54 years old [5]. The relationship of age beyond puberty to the number and distribution of these endocrine-paracrine cells has not been definitively assessed, but in the guinea pig these cells in the peripheral prostate increase markedly with adult age [6]. Studies on adult human prostates indicate that NE cells are more frequent in the periurethral ducts than in the peripheral parts of the gland [7]. Others [8,9] also described the presence of NE cells in the stroma of fetal and infantile prostates.

Role of Radical Retropubic Prostatectomy in Patients with Locally Advanced Prostate Cancer: The Influence of Gleason Score 8–10

Background: To define whether in locally advanced prostate cancer submitted to radical retropubic prostatectomy (RRP) the presence of a Gleason score 8–10 represents an index of high risk for progression and cancer-specific death. Methods: Finally, a total of 130 men with pathologically confirmed T3 cancer were included in this analysis. On the basis of the histological grade obtained at RRP, patients were divided into two groups: patients with a Gleason score 8–10 (group 1) and patients with a Gleason score <8 (group 2). Postoperative follow-up ranged from 24 to 120 months (median 60). After RRP no patients received additional treatments until a biochemical or clinical disease progression was found. Kaplan-Meier projections were used in each group. Results: After RRP, 41 patients (31.5%) had a Gleason score 8–10 tumor. The incidence of positive lymph nodes was significantly higher (p = 0.0030) in group 1 (36.6%) when compared with group 2 (12.3%). Significant differences between the two groups were also found with respect to seminal vesicle involvement (p = 0.0045) and positive surgical margins (p = 0.0040). The actuarial cumulative disease-specific survival for group 1 and group 2 was, respectively, 69 and 82% at 10 years. A Kaplan-Meier analysis demonstrated a 100% disease-specific survival, a 92% clinical progression-free survival and a 38% biochemical progression-free survival 10 years postoperatively if patients in group 1 had negative surgical margins and negative lymph nodes (48.8%). Conclusions: Our data indicate a significant association between Gleason score 8–10 and disease-specific survival, only if patients in group 1 are stratified on the basis of surgical margins and/or lymph node involvement.

Histopathological aspects of transitional cell carcinoma of the bladder: Analysis of 20 years experience

Abstract  Background:  In this study we used histopathological examinations performed over a 20‐year period to describe the characteristics of newly diagnosed transitional cell carcinoma (TCC) of the bladder in relation to patient age, and to verify changes in the TCC over different periods of observation or in relation to patient age.

Benign prostatic hyperplasia: what about a campaign for prevention?

Objectives: In an era when prevention is considered better than cure, is there a rationale for benign prostatic hyperplasia (BPH) prevention? Materials and Methods: Medline and Current Content databases were searched for studies conduced in the last 10 years on BPH and the feasibility of prevention program. Results: Some important criteria for promoting prevention can be found in BPH disease. The significant impact of BPH on the male population and on its quality of life is well established. Knowledge of the etiopathogenesis of this disease is rapidly improving. However, the use of PSA or other markers to select a population at higher risk for developing BPH and its clinical manifestations needs to be better established. More data are available for secondary prevention against BPH progression. Although the action of some natural and nutritional agents on BPH tissue has been demonstrated experimentally, data from prospective clinical trials are not available. Synthetic agents such as 5α-reductase inhibitors or COX-2 inhibitors may be effective, but clinical results for primary prevention of BPH have not been reported. Conclusion: At present, we propose a BPH prevention program as a basis for discussion and future work.

Large bowel infarct following antegrade scrotal sclerotherapy for varicocele: A case report.

Varicocele is the main cause of male infertility. Treatment stops continuous damage to spermatogenesis, thereby potentially improving fertility. Among all the available procedures, the ante-grade scrotal sclerotherapy (ASS), a combined radiological-surgical approach first introduced by Tauber, is gaining more popularity due to its minimal invasiveness. We report the case of a 35-year old man who was subjected to a colonic resection after antegrade scrotal sclerotherapy for varicocele. The procedure was necessary due to the embolization of venous anastomosis between the spermatic and mesenteric veins, which were not detectable at the preoperative phlebography.

Histopathological aspects associated with the diagnosis of benign prostatic hyperplasia: Clinical implications

The histopathological diagnosis of benign prostatic hyperplasia (BPH) is very complex. We considered different histological aspects that may be included or associated with the diagnosis of BPH and which may be able to condition this disease: specifically, the stroma-epithelium ratio, the different expression of the neuroendocrine system and angiogenesis, inflammatory aspects, or other modifications considered preneoplastic lesions which may be present in tissue specimens obtained during BPH surgery. Both the Medline and Current Contents databases were used for this review. The searches were limited to reports published in the English literature from 1980 to 2001. Moreover four historical articles were referred to (see text). The description of all these variables, rather than just a simple diagnosis of BPH, helps the clinician in the management of the patient. A second important aspect is the effect of medical therapies on the different histological compartments of the prostate in BPH, particularly on the stroma-epithelium ratio. Several authors have analyzed the effects of α 1 -adrenoceptor blockers and 5a-reductase inhibitors on BPH tissue. Regarding preneoplastic lesions, there are at least three possible findings in the prostate that can also be found in association with BPH specimens: focal acinar atrophy, atypical adenomatous hyperplasia, and prostatic intraepithelial neoplasia. The last step is represented by the development of an incidental carcinoma. All these data confirm that there is a maintained interest in the histopathological analysis of BPH which needs to be kept in continuous consideration.