BACKGROUND:A novel urine test for early detection of prostate cancer (PCA), distributed and marketed by the company DiaPat, is advertised by the statement "correct analysis in 9 of 10 cases."PATIENTS AND METHODS:The test separates urinary polypeptides by means of capillary electrophoresis and characterizes the peptides in a time-of-flight mass spectrometer. The DiaPat test was performed on the urine of 18 men prior to multiple ultrasound-guided prostate biopsies.RESULTS:Sixteen of the 18 samples met the requirements for sample quality as established by the manufacturer. Eight of these 16 urine samples had been collected from patients in whom biopsies consecutively detected PCA; the remaining eight patients had benign biopsy results. Among the eight patients with detected PCA, the urine test yielded a low probability for PCA in three cases and a high probability in five. Within the group of eight patients with benign biopsy results, the urine test predicted a high probability for PCA in five men and a low probability in three. For the given PCA incidence of 50% within the investigated population, the DiaPat test correctly predicted biopsy results in one half of the population, whereas prediction in the remaining half was incorrect.CONCLUSION:Unless reliable validation of the DiaPat urine test for PCA is available, no clinical consequences should be drawn from the test results.

Introduction: The aim of this retrospective study was to evaluate various factors that may influence post-prostatectomy incontinence (PPI). Patients and Methods: 1,088 men with prostate cancer underwent radical retropubic prostatectomy. 742 patients were evaluable for analysis. Continence was defined as usage of no or one pad daily. Mean follow-up was 45 months (12–143). Results: Based on protective pad requirement 100% and 76% of men were continent at baseline and at the time of questionnaire evaluation (at least 12 months), respectively. Univariate analysis was performed to identify factors that may influence the return of continence. Age, body mass index (BMI), previous TUR-P, smoking, hypertension, diabetes and attempted nerve sparing did not predict postoperative continence status. Conclusions: In contrast to several reports, our analysis revealed that age, BMI, previous TUR-P, smoking, hypertension and diabetes do not have a statistically significant impact on continence after radical retropubic prostatectomy and are therefore not useful as predictors for PPI.

OBJECTIVES:To evaluate the impact of intussusception of the bladder neck on post-radical prostatectomy incontinence.METHODS:A total of 272 men with organ-confined prostate cancer who had undergone radical retropubic prostatectomy were studied. Of the 272 men, 139 underwent bladder neck intussusception and 133 did not. Patients completed validated questionnaires IIQ-7 and a symptom inventory. Continence was defined as the use of no or only one pad daily.RESULTS:Of the 272 men, 100%, 98.5%, and 96% answered the questionnaire and urinary symptom inventory at baseline and 3 and 12 months postoperatively, respectively. According to the protective pad requirement, 100%, 60%, and 86% of patients without intussusception and 100%, 77%, and 83% of the patients with intussusception were continent at baseline and 3 and 12 months postoperatively, respectively. Univariate logistic regression analysis revealed a statistically significant impact of intussusception on postprostatectomy incontinence at 3 months (P = 0.009), although continence at 12 months did not differ significantly (P = 0.5).CONCLUSIONS:Intussusception of the bladder neck had a significant effect on regaining continence at 3 months, although continence at 12 months was not affected.

Thalidomide has been reported to yield anti-tumor activity in advanced renal cell carcinoma (RCC). We evaluated safety and efficacy of a combination therapy comprising interleukin (IL)-2 and thalidomide in patients with metastatic RCC refractory to both immuno- and chemotherapy. Twelve patients with progressive metastatic RCC who had failed prior treatment with immunochemotherapy and desired further active therapy were enrolled in this study. Oral thalidomide was started at 200 mg/day and escalated after 2 days to 400 mg/day at week 0. IL-2 at 7 MIU/m was given by s.c. injection, starting at week 1, days 1-5, weeks 1-4, with rest from IL-2 at weeks 5 and 6. Response was assessed every two therapy cycles. Ten patients were evaluable for response. There was no objective response; four patients showed stable disease for 14+, 11+, 10+ and 9 months, respectively. Toxicities were predominantly grade I-II, and included somnolence and constipation, as well as flu-like symptoms associated with IL-2. However, one patient developed serious constipation which led to a paralytic ileus and discontinuation of treatment. Another patient left the study after 7 weeks due to increasing disorientation/confusion. Eight patients required IL-2 dose reduction. Time on therapy ranged from 3 to 44 weeks (median 20 weeks). Median overall survival was 12+ months. At present, all patients have discontinued treatment. We conclude that outpatient administration of thalidomide/IL-2 is feasible in patients with heavily pretreated and progressive RCC who desire further active treatment. However, toxicity and costs are considerable, and clinical benefit is uncertain. Therefore, thalidomide/IL-2 might not represent a promising therapeutic approach for this subgroup of patients.

You have accessJournal of UrologyModerated Poster, Tuesday, May 24, 2005, 1:00 - 3:00 pm1 Apr 20051310: Minimal Invasive Cough Leak Point Pressure (CLPP) Measurements Differentiates Between Patients with Pure Stress, Pure Urge or Mixed Incontinence Sebastian Wille, Rolf von Knobloch, and Rainer Hofmann Sebastian WilleSebastian Wille More articles by this author , Rolf von KnoblochRolf von Knobloch More articles by this author , and Rainer HofmannRainer Hofmann More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)35455-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1310: Minimal Invasive Cough Leak Point Pressure (CLPP) Measurements Differentiates Between Patients with Pure Stress, Pure Urge or Mixed Incontinence." The Journal of Urology, 173(4S), p. 356 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 356 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Sebastian Wille More articles by this author Rolf von Knobloch More articles by this author Rainer Hofmann More articles by this author Expand All Advertisement PDF downloadLoading ...

You have accessJournal of UrologyDiscussed Poster, Sunday, May 22, 2005 8:00 am - 12:00 pm1 Apr 2005202: Postoperative Pad Usage Predicts Post Prostatectomy Incontinence Sebastian Wille, Verena Koch, Rolf von Knobloch, and Rainer Hofmann Sebastian WilleSebastian Wille More articles by this author , Verena KochVerena Koch More articles by this author , Rolf von KnoblochRolf von Knobloch More articles by this author , and Rainer HofmannRainer Hofmann More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)34467-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "202: Postoperative Pad Usage Predicts Post Prostatectomy Incontinence." The Journal of Urology, 173(4S), p. 55 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 55 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Sebastian Wille More articles by this author Verena Koch More articles by this author Rolf von Knobloch More articles by this author Rainer Hofmann More articles by this author Expand All Advertisement Loading ...

Introduction: Retinoic acid (RA) and its derivates possess antiproliferative and tumor-suppressive abilities and are successfully used in the treatment of various malignancies. However, in metastatic renal cell carcinoma (RCC), its application did not meet first expectations. As the exact mechanisms of RA action and especially the role of the cellular retinoic acid-binding proteins (CRABP) still remain unclear, we studied the expression of CRABP-II and its potential influence on RA response in RCC. Materials and Methods: We used the real-time RT-PCR methodology to investigate CRABP-II expression in 12 RCC samples and corresponding normal kidney tissue. Moreover, CRABP-II was cloned and overexpressed in CAKI-2 RCC cells. CRABP-II (un)transfected CAKI-2 cells were stimulated with all-trans RA (ATRA) and 9-cis RA, and their antiproliferative effects were evaluated using 3H-thymidine-proliferation assays. Results: Using RPS9 and RPLP0 to normalize its expression, the median tumor/kidney ratio for CRABP-II expression was 0.16 and 0.12, respectively. Using proliferation assays, CRABP-II overexpressing CAKI-2 cells did not exhibit a significant change in RA sensitivity, but appeared to be less sensitive toward RA-stimulation compared to CAKI-2 cells expressing naturally low levels of CRABP-II (maximum difference, 59% at 3 µM ATRA). Conclusions: We were able to demonstrate a downregulation of CRABP-II expression in primary RCC tumor samples compared to the corresponding normal kidney tissue. However, CRABP-II overexpression in CAKI-2 RCC cells did not significantly influence RA associated antiproliferative actions. Further experiments are necessary to define the exact role of CRABP-II and its downregulation in RCC including its influence and dependence on other molecules involved in RA signalling and metabolism.

Despite the known anti-proliferative and tumor-suppressive effects seen with retinoic acid (RA), treatment of metastatic renal cell carcinoma (RCC) failed to meet the initial expectations. As the exact mechanisms of action of RA and especially the role of the cellular RA binding proteins (CRABP) have not been elucidated yet, we investigated the expression of CRABP-I and its potential influence on RA response in RCC. Real-time RT-PCR analysis disclosed a significant lack of CRABP-I expression in four RCC cell lines and 12 primary RCC samples; in contrast, high expression levels were found in the respective adjacent normal kidney tissue. To further investigate the impact of CRABP-I on RA response in RCC, A-498 RCC cells were employed as a cellular model system. CRABP-I was stably transfected into A-498 cells which consequently displayed substantial resistance to all-trans (ATRA) and 9-cis RA compared to vector controls lacking CRABP-I. Comparison of gene expression profiles of ATRA-treated CRABP-I-expressing A-498 cells and vector controls revealed specific regulation of 54 of ∼20,000 genes tested on a selected human CodeLinkTM UniSet Bioarray, with a prominent modulation of genes involved in transcriptional control, signaling, apoptosis, cell cycle regulation and metabolism. The genetic changes reported here contribute to a better understanding of the role of RA in RCC. They also provide new insights into CRABP-I-mediated signaling and gene expression.

You have accessJournal of UrologyDiscussed Poster, Saturday, May 8, 2004, 1:00 - 5:00 pm1 Apr 200415: All Patients with Adrenal Metastasis from RCC will Eventually Die in Tumor Progression: There is no Cure or Benefit From Simultaneous Adrenalectomy Rolf von Knobloch, Zoltan Varga, Andres J. Schrader, and Rainer Hofmann Rolf von KnoblochRolf von Knobloch More articles by this author , Zoltan VargaZoltan Varga More articles by this author , Andres J. SchraderAndres J. Schrader More articles by this author , and Rainer HofmannRainer Hofmann More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)37277-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "15: All Patients with Adrenal Metastasis from RCC will Eventually Die in Tumor Progression: There is no Cure or Benefit From Simultaneous Adrenalectomy." The Journal of Urology, 171(4S), p. 4 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 4 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Rolf von Knobloch More articles by this author Zoltan Varga More articles by this author Andres J. Schrader More articles by this author Rainer Hofmann More articles by this author Expand All Advertisement Loading ...

4612 Background: Lymph node dissection (LND) in PCA is considered as a mere staging procedure and limited to obturator and external iliac nodes. Since the prostate drains into the external iliac, hypogastric, lateral and subaortic sacral nodes, metastases might be missed by the standard approach. We performed a radical pelvic lymphadectomy (RLND) in pts with PCA to assess frequency and location of lymph node metastases and to evaluate the reliability of current prediction models for lymph node involvement. METHODS 311 pts underwent RLND at time of radical retropubic prostatectomy via an extraperitoneal approach. RLND comprised 8 selective fields: external, internal and common iliac nodes, obturator nodes bilaterally. Nodes from each location and side were submitted separately for pathohistologic evaluation. Pathohistology of lymph nodes was compared to serum PSA, preoperative clinical stage and biopsy Gleason sum, pathohistological stage and Gleason sum of the prostatectomy specimen. Reliability of Partin tables, CART analysis and clinical parameters in terms of accurate prediction of lymph nodes metastases was evaluated. RESULTS Lymph node metastases were diagnosed in 19.8%; mean number of dissected lymph nodes was 28 (21-42). 22% of lymph node metastases were located in the internal and common iliac region only. 23/58 pts had 1 positive lymph node, 18 pts had 2, 7 pts had 3 and 8 pts had > 3 lymph nodes involved. Preoperative PSA serum levels were 26.8 (3.5-133)ng/ml and 16.5 (2.5-125)ng/ml in pts with and without lymph node metastases, resp. (p<0.05). CART nomograms did not accurately predict lymph node metastases with 58% of pN+ having been understaged. 27% and 58% of pN+ pts had serum PSA levels <10ng/ml and a biopsy Gleason sum <7, resp. The Partin tables understaged 33.5% of pts with positive lymph nodes. CONCLUSIONS 47% of pts demonstrate positive lymph nodes around the internal and common iliac artery making this area essential for adequate staging LND. Current clinical staging systems (Partin, CART) miss up to 50% of all pN+ pts. Radical pelvic lymphadenectomy represents the standard lymphadenectomy technique of choice in surgical management of PCA. No significant financial relationships to disclose.

You have accessJournal of UrologyDiscussed Poster, Monday, May 10, 2004, 8:00 am - 12:00 pm1 Apr 2004766: Loss of Chromosome 14Q is a Strong Predictor of Progression in Conventional Renal Cell Carcinoma Rolf von Knobloch, Heidrun Brandt, Kristofina Kolb, Andres J. Schrader, and Rainer Hofmann Rolf von KnoblochRolf von Knobloch More articles by this author , Heidrun BrandtHeidrun Brandt More articles by this author , Kristofina KolbKristofina Kolb More articles by this author , Andres J. SchraderAndres J. Schrader More articles by this author , and Rainer HofmannRainer Hofmann More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38015-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "766: Loss of Chromosome 14Q is a Strong Predictor of Progression in Conventional Renal Cell Carcinoma." The Journal of Urology, 171(4S), p. 203 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 203 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Rolf von Knobloch More articles by this author Heidrun Brandt More articles by this author Kristofina Kolb More articles by this author Andres J. Schrader More articles by this author Rainer Hofmann More articles by this author Expand All Advertisement PDF downloadLoading ...