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Ha JS, Jeon J, Ko JC, Lee HS, Yang J, Kim D, Kim JS, Ham WS, Choi YD, Cho KS. Intravesical Recurrence after Radical Nephroureterectomy in Patients with Upper Tract Urothelial Carcinoma Is Associated with Flexible Diagnostic Ureteroscopy, but Not with Rigid Diagnostic Ureteroscopy. Cancers (Basel) 2022; 14:cancers14225629. [PMID: 36428721 PMCID: PMC9688462 DOI: 10.3390/cancers14225629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/12/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
(1) Background: We assessed the impact of diagnostic ureteroscopy (URS) on intravesical recurrence (IVR) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma according to the type of URS. (2) Methods: Data on 491 consecutive patients who underwent RNU at two institutions between 2016 and 2019 were retrospectively reviewed. The study population was classified according to the type of URS performed before RNU as follows: non-URS, rigid URS, and flexible URS. The study outcome was IVR occurring within 1 year of RNU. Univariable and multivariable Cox proportional hazards models were used to estimate the risk of IVR. (3) Results: Altogether, 396 patients were included for analysis. Rigid and flexible URS were performed in 178 (45%) and 111 (28%) patients, respectively, while 107 (27%) patients did not undergo URS. IVR was identified in 99 (25%) patients. Multivariable Cox regression analysis revealed that the flexible URS group was significantly associated with increased IVR, compared to the non-URS group (HR = 1.807, p = 0.0416). No significant difference in IVR was observed between the non-URS and rigid URS groups (HR = 1.301, p = 0.3388). (4) Conclusions: In patients with UTUC undergoing RNU, rigid URS may not increase the risk of IVR, whereas flexible URS appears to be associated with a higher risk of IVR.
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Affiliation(s)
- Jee Soo Ha
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Jinhyung Jeon
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Jong Cheol Ko
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Daeho Kim
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - June Seok Kim
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Won Sik Ham
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Kang Su Cho
- Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
- Correspondence: ; Tel.: +82-2-2019-3471
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Watari J, Chen N, Amenta PS, Fukui H, Oshima T, Tomita T, Miwa H, Lim KJ, Das KM. Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development. World J Gastroenterol 2014; 20:5461-73. [PMID: 24833876 PMCID: PMC4017061 DOI: 10.3748/wjg.v20.i18.5461] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/12/2013] [Accepted: 03/07/2014] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis (AG), or gastric intestinal metaplasia (GIM), and cancer. Various molecular alterations are identified not only in gastric cancer (GC) but also in precancerous lesions. H. pylori treatment seems to improve AG and GIM, but still remains controversial. In contrast, many studies, including meta-analysis, show that H. pylori eradication reduces GC. Molecular markers detected by genetic and epigenetic alterations related to carcinogenesis reverse following H. pylori eradication. This indicates that these changes may be an important factor in the identification of high risk patients for cancer development. Patients who underwent endoscopic treatment of GC are at high risk for development of metachronous GC. A randomized controlled trial from Japan concluded that prophylactic eradication of H. pylori after endoscopic resection should be used to prevent the development of metachronous GC, but recent retrospective studies did not show the tendency. Patients with precancerous lesions (molecular alterations) that do not reverse after H. pylori treatment, represent the "point of no return" and may be at high risk for the development of GC. Therefore, earlier H. pylori eradication should be considered for preventing GC development prior to the appearance of precancerous lesions.
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Stopper H, Garcia SB, Waaga-Gasser AM, Kannen V. Antidepressant fluoxetine and its potential against colon tumors. World J Gastrointest Oncol 2014; 6:11-21. [PMID: 24578784 PMCID: PMC3936192 DOI: 10.4251/wjgo.v6.i1.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 10/21/2013] [Accepted: 12/11/2013] [Indexed: 02/05/2023] Open
Abstract
Colon cancer is one of the most common tumors worldwide, with increasing incidence in developing countries. Patients treated with fluoxetine (FLX) have a reduced incidence of colon cancer, although there still remains great controversy about the nature of its effects. Here we explore the latest achievements related to FLX treatment and colon cancer. Moreover, we discuss new ideas about the mechanisms of the effects of FLX treatment in colon cancer. This leads to the hypothesis of FLX arresting colon tumor cells at the at G1 cell-cycle phase through a control of the tumor-related energy generation machinery. We believe that the potential of FLX to act against tumor metabolism warrants further investigation.
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