The commonest tumor reported in kidney fusion anomalies is renal cell carcinoma, although its reported incidence is no higher than that in the normal population. In the case of transitional cell carcinomas, diagnosis is usually made at an advanced stage. The value of thorough urologic and radiological investigations is stressed. Angiography, whether classical or in combination with multi-slice CT, is considered essential in order to confirm renal anomalies and the tumor situation and to plan the surgical approach. In our experience, radical nephrectomy with isthmus division via a transperitoneal approach is the treatment of choice.
Intensity of stromal changes could serve as an independent prognostic factor in the assessment of biochemical recurrence-free survival. Among prostate cancer patients with an identical Gleason score, it could identify patients with a higher risk of biochemical recurrence. Thus, stromal changes and their intensity could serve as a novel marker for the recognition of patients with an increased risk of disease recurrence.
Syndecans are a four-member family of transmembrane heparan sulphate proteoglycans that have different functions in cell signalling, adhesion, cytoskeleton organization, migration, proliferation, and angiogenesis. Several studies investigated the role of syndecan-2 (SDC2) in different carcinomas; however, only one being focused on SDC2 in prostate cancer. SDC2 expression and relationship with established prognostic features were assessed in a cohort of 86 patients treated with radical prostatectomy for clinically localized prostate adenocarcinoma. SDC2 expression was present in the majority of prostate cancers and absent in only 11.6% of cases. SDC2 expression was also recorded in cells of prostatic intraepithelial neoplasia, whereas normal prostatic epithelial tissue and stroma did not express SDC2. SDC2 overexpression in prostate cancer was significantly associated with established features indicative of worse prognosis such as higher preoperative PSA (P ¼ 0.011), higher Gleason score (Po0.001), positive surgical margins (Po0.003), and extraprostatic extension of disease (Po0.003). Moreover, expression of SDC2 was also associated with biochemical disease progression on univariate analysis (Po0.001). Study results supported the potential role of SDC2 in prostatic carcinogenesis and cancer progression. Moreover, SDC2 could serve as an additional prognostic marker that might help in further stratifying the risk of disease progression in patients with prostate cancer.
Connexins (Cxs) are a family of transmembrane proteins that build cell-to-cell channels in gap junctions. Gap junctions composed of Cxs have an essential role in intercellular communication, adhesion and cell differentiation. Several studies investigated the role of connexin43 (Cx43) in different carcinomas; however, none investigated its prognostic role in prostate cancer. Cx43 expression and relationship with established prognostic features were assessed in a cohort of 102 patients treated with radical prostatectomy for clinically localized prostate adenocarcinoma. Cx43 expression in prostate cancer was significantly associated with established features indicative of worse prognosis, such as follow-up time (Po0.001) and preoperative PSA (Po0.007). Patients with lower Cx43 expressions in tumours have shorter follow-up time, which indicated shorter diseasefree survival and higher preoperative PSA values. Furthermore, tumours with positive surgical margins (Po0.001) showed significantly lower Cx43 expression compared with tumours without this feature. In univariate (Po0.001) and multivariate (P ¼ 0.014) analyses, decreased Cx43 expression was found to be a significant predictor of biochemical recurrence free-survival. Study results show the association of decreased Cx43 expression with prostate cancer progression. Moreover, Cx43 could serve as an additional prognostic marker and used together with traditional prognostic markers might help in further stratifying the risk of disease progression in patients with prostate cancer.
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