Background: Multidisciplinary team (MDT) approach is a major requirement to guarantee a fair access to treatment to heterogeneous patients with liver neoplasms and to improve the quality of care provided. This work retrospectively analyzes the impact of MDT experience at our tertiary center.

Advanced urothelial cancer (AUCa) is associated with poor long-term survival. Two major concerns are related to nonexposure to cisplatin-based chemotherapy and poor outcome after relapse. Our purpose was to record patterns of practice in AUCa in Greece, focusing on first-line treatment and management of relapsed disease.Patients with AUCa treated from 2011 to 2013 were included in the analysis. Fitness for cisplatin was assessed by recently established criteria.Of 327 patients treated with first-line chemotherapy, 179 (55%) did not receive cisplatin. Criteria for unfitness for cisplatin were: Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2, 21%; creatinine clearance ≤ 60 mL/min, 55%; hearing impairment, 8%; neuropathy, 1%; and cardiac failure, 5%. Forty-six patients (27%) did not fulfill any criterion for unfitness for cisplatin. The main reasons for these deviations were comorbidities (28%) and advanced age (32%). Seventy-four (68%) of 109 patients who experienced a relapse received second-line chemotherapy. The most frequent reason for not offering second-line chemotherapy was poor PS or limited life expectancy (66%).In line with international data, approximately 50% of Greek patients with AUCa do not receive cisplatin-based chemotherapy, although 27% of them were suitable for such treatment. In addition, about one third of patients with relapse did not receive second-line chemotherapy because of poor PS or short life expectancy. Enforcing criteria for fitness for cisplatin and earlier diagnosis of relapse represent 2 targets for improvement in current treatment practice for AUCa.

INTRODUCTION AND OBJECTIVES. The role of maintenance regimen following early intravesical chemotherapy after TUR of intermediate risk non-muscle invasive bladder cancer (NMI-BC) is still debated. Only few studies have been published on this topic, rarely dealing with patients receiving an early treatment. The aim of the present study is to evaluate the efficacy of one-year maintenance after a 6-week cycle of early intravesical chemotherapy.METHODS. Between May 2002 and August 2003, 482 patients with intermediate risk NMI-BC after TUR and early intravesical chemotherapy (epirubicin, 80mg/50mL) were randomized between 6-week induction cycle and induction plus maintenance with 10 monthly instillations. A written informed consent was obtained. All patients underwent cytology and cystoscopy 3-monthly for 2 years and 6-monthly thereafter.RESULTS. Treatment interruption for toxicity was required in 39 patients. Median follow-up was 48 months. Ten patients (2.5%) progressed and 117 patients (29.6%) recurred. The tumor characteristics were equally distributed between the two arms. No statistically significant difference in recurrence free survival (RFS) was detected between the two arms (p=0.43). An advantage in terms of recurrence free rate (RFR) in favor of the maintenance arm was evident only until 18 months after TUR (p=0.03). A trend for a higher benefit from maintenance in primary and multiple tumors was detected.CONCLUSIONS. The risk of tumor recurrence is significantly reduced by one-year maintenance only for 18 months after TUR in comparison with patients receiving a 6-week cycle of early intravesical chemotherapy. The disadvantages of prolonged intravesical chemotherapy should be taken into account.

Fibroepithelial polyps are benign epithelial tumours which are rare in adults. In females they usually arise from the distal part of the urethra and protrude through the external meatus. We report a case of a twenty-seven-year-old woman, presenting with painless terminal gross haematuria, affected by a neoplasm located in the proximal urethra near the bladder neck. Transurethral resection was performed. Endoscopic image of the tumour and histopatological details are shown.

A 3G network is a magnificently complex object embedded in a highly heterogeneous and ever-changing usage environment. It combines the functional complexity of the wireless cellular paradigm with the protocol dynamics of TCP/IP networks. Understanding such an environment is more urgent and at the same time more difficult than for legacy 2G networks. Continuous traffic monitoring by means of an advanced system, coupled with routine expert-driven traffic analysis, provides an in-depth understanding of the status and performances of the network as well as of the statistical behaviour of the user population. Such knowledge allows for a better engineering and operation practice of the whole network, and specifically the early detection of hidden risks and emerging troubles. Furthermore, the exploitation of certain TCP/IP dynamic behaviour, particularly the TCP control-loop, coupled with information extracted from the 3GPP layers, provides a cost-effective means to monitor the status of the whole network without requiring access to all network elements. In this article the main lessons are summarized learned from a two-year research activity on traffic monitoring and analysis on top of an operational 3G network.

This paper evaluates TCP spurious retransmission timeouts in a large operational GPRS network by post-processing traffic traces captured at Gi interfaces. Applying a novel algorithm to identify spurious retransmission timeouts, the frequency of spurious timeouts as well as the spurious timeout probability dependent on the flow size, the round trip time, and the network load is analyzed. Among other findings, this investigation shows that spurious timeouts are infrequent events in the considered GPRS network. In addition to the evaluation of data from an operational network, testbed measurements are performed to investigate the effect of round trip time variations as seen in the GPRS network on several flavors of TCP. Comparing TCP Newreno, SACK, TCP with Time Stamp enabled, and TCP F-RTO, we can not find major performance improvements in case of advanced TCP derivates. This observation can be addressed to the infrequency of spurious timeouts in scenarios with GPRS-like RTT variations.

Wireless mesh networks are quickly emerging as a solution for broadband wireless connectivity. The physic al layer technology is making remarkable progress allowing hi gher bandwidth and longer distance coverage than before. While standardization efforts are going on to define new standardsand paradigms for Wireless Mesh Networks, many vendors sell mes h solutions based on the 802.11b technology. This standard ha s been originally designed for Wireless Local Area Networks i n indoor scenarios with a maximum distance between nodes up to few hundred meters. As a consequence, there are many technic al challenges for adapting 802.11 to multihop networks and out door environments. This paper shows some guidelines to set the 802.11b MAC parameters in order to extend the coverage of 802.11 to long distance networks. Simulation results show that a fine tuning of MAC parameters can allow a satisfactory multi-hop wireless communication in mesh network scenario using 802.11.

In this paper we present some observations about TCP RTT as captured in the live traffic of an operational GPRS/UMTS network. RTT samples are extracted from traces collected by passive monitoring the Gn interfaces of one of the major providers in Austria, EU. We compare results for GPRS and UMTS, and expose some methodological issues involved in performing this type of analysis, for instance the potential bias introduced by heavy users. We also explore the correlation of RTT with time-of-day. The primary motivation for this research is to gain a better understanding of the dominant causes that shape the behaviour and the distribution of RTT across the TCP connections that populate a GPRS/UMTS network. The results presented here are useful for the scientific community, for instance to set more realistic simulation scenarios for other research activities. In addition, RTT measurements as obtained by large-scale passive monitoring can be used in combination with other indicators to build a summary indicator of the performances experienced by the TCP users at the scale of the whole network, i.e. a global RTT-based KPI (key performance indicator).

You have accessJournal of UrologyDiscussed Poster, Sunday, May 9, 2004, 8:00 am - 12:00 pm1 Apr 2004377: Distribution of Smoking, Water Resource and Other Environmental Factors in Patients Affected by Superficial Bladder Cancer Vincenzo Serretta, Vincenzo Altieri, Giuseppe Morgia, Rosalinda Allegro, Alessandra Di Lallo, Luca Cindolo, Darwin Melloni, Mario Motta, Francesco P. Selvaggi, Gianfranco Testa, Vincenzo Cosentino, D. Sblendorio, Leonardo Borruso, Francesco Vacirca, Michele Pavone-Macaluso, Gruppo Uro-Oncologico Campano, and Gruppo Studi Tumori Urologici Vincenzo SerrettaVincenzo Serretta More articles by this author , Vincenzo AltieriVincenzo Altieri More articles by this author , Giuseppe MorgiaGiuseppe Morgia More articles by this author , Rosalinda AllegroRosalinda Allegro More articles by this author , Alessandra Di LalloAlessandra Di Lallo More articles by this author , Luca CindoloLuca Cindolo More articles by this author , Darwin MelloniDarwin Melloni More articles by this author , Mario MottaMario Motta More articles by this author , Francesco P. SelvaggiFrancesco P. Selvaggi More articles by this author , Gianfranco TestaGianfranco Testa More articles by this author , Vincenzo CosentinoVincenzo Cosentino More articles by this author , D. SblendorioD. Sblendorio More articles by this author , Leonardo BorrusoLeonardo Borruso More articles by this author , Francesco VacircaFrancesco Vacirca More articles by this author , Michele Pavone-MacalusoMichele Pavone-Macaluso More articles by this author , Gruppo Uro-Oncologico CampanoGruppo Uro-Oncologico Campano More articles by this author , and Gruppo Studi Tumori UrologiciGruppo Studi Tumori Urologici More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)37639-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "377: Distribution of Smoking, Water Resource and Other Environmental Factors in Patients Affected by Superficial Bladder Cancer." The Journal of Urology, 171(4S), p. 99 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171 Issue 4S April 2004 Page: 99 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetrics Author Information Vincenzo Serretta More articles by this author Vincenzo Altieri More articles by this author Giuseppe Morgia More articles by this author Rosalinda Allegro More articles by this author Alessandra Di Lallo More articles by this author Luca Cindolo More articles by this author Darwin Melloni More articles by this author Mario Motta More articles by this author Francesco P. Selvaggi More articles by this author Gianfranco Testa More articles by this author Vincenzo Cosentino More articles by this author D. Sblendorio More articles by this author Leonardo Borruso More articles by this author Francesco Vacirca More articles by this author Michele Pavone-Macaluso More articles by this author Gruppo Uro-Oncologico Campano More articles by this author Gruppo Studi Tumori Urologici More articles by this author Expand All Advertisement PDF downloadLoading ...

As a preliminary approach to define the object of larger case-control studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been analyzed. Material e Methods. The analysis included only patients affected by medium risk superficial TCCB. Forty Italian urological centres joined the study. Detailed information about age, sex, residency, employment, active and passive cigarette smoking, water resource, hair-dye use were centralized. All patients underwent TUR and early intravesical chemotherapy. The distribution of the above mentioned environmental factors was related to tumor characteristics such as multiplicity and previous natural history. Results. Until today 474 patients have been recruited, 182 (38.4%) with primary tumors and 293 (61.8%) with multiple lesions. Over 80% of the patients lived in urban areas, 20% were employed in industry at risk for bladder cancer and 8% used hair dye. Forty percent of the patients were smokers, with a median smoking period of 30 years. Bottled water was the only water resource in 42% of cases. At multivariate statistical analysis a significant correlation between tumor multiplicity and employment in industry (p<0.01) and between past natural history and period of cigarette smoking (p<0.05) was found. Preliminar/y, an interesting trend was detected for a correlation between water resource and bladder cancer in non-smoking patients. The municipal water system was the main water resource more frequently in non-smokers (75% vs 53%). This might imply a pathogenic role of water pollution and chlorination.

The diagnosis of prostate carcinoma has been monitored in Sicily and Calabria for one year. Material e Methods Twenty-seven urological centres of Sicily and Calabria joined the study. Detailed informations about age, familiarity, PSA, Gleason score and TNM stage at diagnosis were centralized between november 2001 and november 2002. Results 721 patients have been recruited. The median age was 73 years. More than 80% of the patients were older than 65 years. Median PSA was 14 ng/ml. The clinical stage at diagnosis was T1c in 33% of patients and 67% had an organ confined prostate cancer (T1-T2). Familiarity was detected in 8% of cases. Age and PSA at diagnosis in these patients were similar to those of the remaining population. However, only 18% of them had a T1 tumor, emphasizing the delay in diagnosis in these patients. Although only 10% of the patients shows at diagnosis a metastatic tumor, 29% only are fit for radical prostatectomy in according to age, PSA and stage.

Urological involvement by a non-Hodgkin lymphoma, once rare, is becoming more frequent. A clinical case is described where the urological onset was a volumetric increase in the lumbar-aortic lymph nodes and functional exclusion of the left kidney. Having ascertained the lymphomatous nature of the mass, chemotherapy cycles were carried out (CVP) and ureteral stenting to conserve renal function.

The Authors’ aim is to report on their experience in treating superficial bladder cancer with Bacillus Calmette-Guerin, comparing the results with other kinds of therapy.