Purpose: Squamous cell carcinoma (SCC) of the penis is a rare disease in developed countries but is associated with signifi cant morbidity and mortality. A crucial prognostic factor is the presence of inguinal lymph node metastases (ILNM) at the time of diagnosis. At least 25% of cases have micrometastases at the time of diagnosis. Therefore, we performed a literature review of studies evaluating factors, both clinical and pathological, predictive of lymph node metastases in penile SCC. Materials and methods: Studies were identifi ed using PubMed and search terms included the following: penile cancer, penile tumor, penile neoplasm, penile squamous cell carcinoma, inguinal lymph node metastasis, lymph node metastases, nodal metastasis, inguinal node metastasis, inguinal lymph node involvement, predictors, and predictive factor. The number of patients and predictive factors were identifi ed for each study based on OR, HR, or RR in multivariate analyses, as well as their respective signifi cance values. These were compiled to generate a single body of evidence supportive of factors predictive of ILNM in penile SCC. Results: We identifi ed 31 studies, both original articles and meta-analyses, which identifi ed factors predictive of metastases in penile SCC. The following clinical factors were predictive of ILNM in penile SCC: lymphovascular invasion (LVI), increased grade, increased stage (both clinical and pathological), infi ltrative and reticular invasion, increased depth of invasion, perineural invasion, and younger patient age at diagnosis. Biochemically, overexpression of p53, SOD2, Ki-67, and ID1 were associated with spread of SCC to inguinal lymph nodes. Diffuse PD-L1 expression, increased SCC-Ag expression, increased NLR, and CRP >20 were also associated with increased ILNM. Conclusions: A multitude of factors are associated with metastasis of SCC of the penis to inguinal lymph nodes, which is associated with poor clinical outcomes. The above factors, most strongly LVI, grade, and node positivity, may be considered when constructing a nomogram to risk-stratify patients and determine eligibility for prophylactic inguinal lymphadenectomy.

Regardless of PPI dosage or concomitant diuretics prescribed, magnesium levels were unaffected. Routine screening of serum magnesium in PPI patients appears unnecessary.

The use of SPY Elite Fluorescence Imaging has recently grown popular among multiple surgical specialties, including colorectal, plastic, endocrine, ophthalmologic, and vascular surgery, due to its ability to quickly and accurately assess tissue perfusion and guide intraoperative decision making. To our knowledge, the use of SPY imaging in urologic reconstructive surgery has yet to be reported. We present a case in which SPY imaging was used intraoperatively to assess perfusion of an ileocecal anastomosis and a segment of bowel prior to creation of a continent urinary diversion following radical cystectomy.

Background: The majority of bladder cancer patients experience recurrence. Cisplatin is the standard chemotherapy for muscle-invasive bladder cancer though adverse effects are often severe. Case Report: Intravenous (IV) dicycloplatin (DCP) sustained remission in an American bladder cancer patient for five years. A recurrent mass was observed in July 2021. The patient received DCP capsules for seven weeks with no significant side-effects. Complete blood count with differential and a basic metabolic panel showed no adverse effects of DCP capsules on the bone marrow, liver or renal parameters. Cystoscopy after oral DCP found no evident bladder tumors; cytology was negative for high-grade urothelial carcinoma. Conclusion: In this patient, DCP-capsules appeared to be as effective as DCP-IV for achieving bladder cancer remission. Both forms of DCP chemotherapy are convenient, active against several cancer types, with decreased adverse effects compared to cisplatin. Both have been available for treating cancer patients in China. A USA clinical trial of DCP in bladder and other cancers appears warranted.Bladder cancer (BC) cases steadily declined by about 1% per year from 2008 to 2017. Still, 17,200 deaths are expected in 2021. An estimated 83,730 adults in the United States will be diagnosed with BC this year. Men are about 4 times more likely than women to develop this malignancy. Among men, BC is the fourth most common cancer and the eighth most common cause of cancer death (1).The main type of BC is non-muscle invasive tumors (T1, Ta), treated with complete transurethral resection, followed by BCG (Bacillus Calmette-Guérin) intravesical immunotherapy. The vast majority of patients with high-risk BC endure recurrence, progression of disease, or die within ten years (2-7). In England, among those diagnosed with BC, 75% survive for 1 year or more, 55% for 5 years, and around 45% for 10 years after diagnosis (8-10).Recurrence and survival depend on initial tumor stage and grade, with 5-year recurrence rates in about 65% of patients with non-invasive or in situ tumors, and 73% of patients with slightly more advanced disease. Blute et al noted that the high recurrence rate in the first two years after diagnosis warrants an intense surveillance schedule (11). According to Cambier and colleagues, patients at high risk of recurrence and progression do poorly on current BCG maintenance schedules. Alternative treatments are needed (12, 13).