The purpose of this study was to assess the predictive value of prostate specific antigen density (PSAD) for detection of clinically significant prostate cancer in men undergoing systematic transrectal ultrasound (TRUS)-guided prostate biopsy. We retrospectively analyzed data of men who underwent TRUS-guided prostate biopsy because of elevated PSA (≤ 20 ng/ml) or abnormal digital rectal examination. Receiver operating characteristic curve analysis to compare PSA and PSAD performance and chi-square automatic interaction detector methodologies were used to identify predictors of clinically significant cancer (Gleason score ≥ 7 or international society of urological pathology grade group ≥ 2). Nine-hundred and ninety-two consecutive men with a median age of 66 years (IQR 61–71) were included in the study. Median PSAD was 0.10 ng/ml2 (IQR 0.10–0.22). Prostate adenocarcinoma was diagnosed in 338 men (34%). Clinically significant prostate adenocarcinoma was diagnosed in 167 patients (50% of all cancers and 17% of the whole cohort). The AUC to predict clinically significant prostate cancer was 0.64 for PSA and 0.78 for PSAD (P < 0.001). The highest Youden's index for PSAD was at 0.20 ng/ml2 with 70% sensitivity and 79% specificity for the diagnosis of clinically significant cancer. Men with PSAD < 0.09 ng/ml2 had only 4% chance of having clinically significant disease. The detection rate of clinically significant prostate cancer in patients with PSAD between 0.09 and 0.19 ng/ml2 was significantly higher when prostate volume was less than 33 ml. In conclusion, PSAD was a better predictor than PSA alone of clinically significant prostate cancer in patients undergoing TRUS-guided biopsy. Patients with PSAD below 0.09 ng/ml2 were unlikely to harbor clinically significant prostate cancer. Combining PSAD in the gray zone (0.09–0.19) with prostate volume below 33 ml adds diagnostic value of clinically significant prostate cancer.

Objective: Aim of this study was to analyze the prognostic value of age in patients with renal cell carcinoma (RCC). Patients and Methods: A group of 15 patients (age ≤ 40 years, group I) and a group of 103 patients (age ≧ 50 years, group II) with sporadic RCC who underwent radical nephrectomy between 1985 and 1997 were compared. The two groups were analyzed with respect to histologic cell type, tumor grade, stage and outcome. Results: In group I low-stage tumors (stage I and II) were diagnosed in 93% of patients and in group II in 65% of the patients (p = 0.017). High-grade tumors (stage III and IV) were diagnosed in 7% and 35% of patients in group I and group II, respectively (p < 0.01). In group I only one patient (7%) with stage II disease died of cancer. In group II the distribution of cancer-specific mortality was as follows: 6 patients (100%) with stage IV, 13 patients (42%) with stage III, and 12 patients (17%) with stage I and II died of disease. The 5-year-survival in group I was 93% and in group II was 77% (p = 0.05). Conclusion: According to our data we conclude that RCC is diagnosed at a lower stage in young patients than in the older patient group. RCC may exhibit a more favorable prognosis in young patients, possible due to the lower stage at time of diagnosis.

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PF-HPMC can be considered as an appropriate target for gene therapy since these cells can be efficiently isolated, modified, and transplanted. Nevertheless, implantation techniques in the peritoneum should be directed at obtaining longer duration of transgene expression in vivo, and means should be developed for enabling regulated expression of the gene.

A review of our records between 1971 and 1995 identified 6 patients (4 male and 2 female) with transitional cell carcinoma of the bladder who were less than 25 years of age (mean age 18.6, range 10-22). Five patients presented with gross haematuria, one with microscopic haematuria, and two presented with recurrent urinary tract infection. All tumours were low grade and low stage and were associated with excellent prognosis. Transurethral resection or fulguration was the treatment of choice. This study supports the contention that transitional cell carcinoma of the bladder is a less aggressive disease in patients under 25 years of age.