Robotic Radical Prostatectomy and Nerve Grafting: Does it Actually Work?

Robotic radical prostatectomy is now the gold standard for patients with localised prostate cancer. In the setting of unfavourable prostate pathology, some men may require resection of one or both cavernous nerves at the time of prostatectomy. Potency rates in this subset of men are expectedly dismal.

With increasing numbers of younger men being diagnosed with prostate cancer and subsequently undergoing radical prostatectomy, there is an increasing focus on quality of life postoperatively, especially potency. Nerve-grafting surgery after resection of neuro-vascular bundles during radical prostatectomy is one of the promising resolutions for dilemma between cancer control and functional preservation.

There have been a number of articles recently on nerve grafting for robotic radical prostatectomy. We aim to review the evidence for whether this actually works and gives a good degree of erectile function.

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Chloroma- Myelosarcoma or Leukemic Nerve Tumor?

Following our review on leukemia and the nervous system we would like to draw your attention to a rare manifestation of leukemia termed historically chloroma (CH) or myelosarcoma, which can rarely affect the cranial nerves and the peripheral nerves.

These rare associations of leukemia and the peripheral nervous system, can occur in all stages of leukemia, as the first manifestation, as recurrence and post bone marrow transplant. Most frequently CH are seen in AML, less frequent CML, but also in OMF.

They can also appear isolated, and leave room for speculations why leukemia can covert from a liquid into a solid tumor, and why the presentation can be in peripheral nerves. Chloromas, myelosarcomas or leukemic tumors are rare and present at many sites of the body. Compared to lymphomas focal nerve lesion in leukemia are rare.

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p53 R72P Alone and in Combination with MDM2 SNP T309G is Associated with Colon Carcinoma Incidence and Survival

Protein p53 is encoded by tumor suppressor TP53, which regulates key cellular functions such as transcription, cell cycle arrest, DNA repair and apoptosis. Murine double minute 2 homolog (MDM2), a p53 transcribed protein, negatively regulates p53.

A single nucleotide polymorphism (SNP) at codon 72 of TP53 (R72P, rs rs1042522) alters an amino acid, while an SNP T309G (rs2279744) polymorphism (SNPT309G) in the promoter region of MDM2 has been reported to modulate its transcription. p53 R72P and MDM2 SNPT309G have been reported to associate alone and or in combination with various carcinomas.

In this study, we aimed to determine if p53 R72P and MDM2 SNPT309G polymorphism alone or in combination are associated with colon carcinoma incidence, tumor progression and/or patient survival in Swedish population.

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Lymphangioma in Patients with Pulmonary Lymphangioleiomyomatosis: Results of Sirolimus Treatment

Lymphangioleiomyomatosis (LAM) is a rare disease caused by abnormal proliferation of smooth muscle-like cells mainly in lungs and axial lymph nodes, that belongs to the group of PEComa tumours.

Chylous pleural and abdominal effusions, lymhangioleiomiomas, angiomyolipomas are noticed in disease course. Sirolimus has been approved for LAM treatment, and also it has been reported to decrease the size of angiomyolipomas, lymphangiooedma, pleural and peritoneal chylous effusion.

The aim of the study was to assess the significance of sirolimus therapy in patients with LAM and lymphangioma in retroperitoneal space. Method: Fourteen women with confirmed diagnosis of LAM (13 with sporadic LAM, and one TSC/LAM) and presence of lymphangioma in abdominal cavity were retrospectively reviewed. Seven patients displayed chyloperitoneum and chylothorax. Mean time of sirolimus exposure was 19 ± 12.99 months.

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Breast-Conserving Therapy Versus Radical Mastectomy for Early Breast Cancer

The aim of this clinical study was to compare breast-conserving therapy (BCT) and radical mastectomy (RM) in the treatment of early breast cancer. Materials and methods: From March 1986 to the end of 1989, 117 women with a breast tumor of up to 2 cm in size were included in this study; 66 women had a quadrantectomy, while 51 had a radical mastectomy.

Full axillary dissection was performed in all patients, while adjuvant chemotherapy with cyclophosphamide, methotrexate and fluorouracil was conducted in node-positive patients. Radiation to the remaining breast parenchyma consisted of external-beam therapy, with or without regional irradiation, without boost to the tumor bed. Results: The follow-up of patients in the two treatment groups was limited to 240 months.

The mean period of observation (SD±) was 201.34 months (54.12 ± 226.5) for the patients with breast-conserving therapy (BCT) and 195.84 months (35.1 ± 226.5) for the patients with radical mastectomy.

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