Introduction: Metabolic syndrome (MS) is linked to hormone-dependent cancers. Its prognostic implication in prostate cancer (PCa) is unclear. We analyzed the impact of MS in the survival of men with PCa treated surgically. Patients and Methods: We studied patients with PCa, treated surgically between 1990 and 2007, and compared the survival of men with MS (group 1) and without MS (group 2). A subgroup analysis of those in stage pT2 was also performed. We calculated biochemical progression-free survival (bPFS) and cancer-specific survival, and the relation of clinical and pathological variables with these end-points. Results: 65 men had MS. The 5- and 10-year bPFS in group 1 was 36 and 32% vs. 72 and 68% in group 2 (p < 0.0001). In multivariate analysis, prostate-specific antigen (p = 0.001) and MS (p < 0.0001) predicted biochemical progression/recurrence (BP/R). There was no difference in cancer-specific survival between groups (p = 0.40). Of 146 men in stage pT2, 38 had MS; group 1 men had worse 5- and 10-year bPFS (55 and 48%) than group 2 (80 and 73%; p = 0.001). In multivariate analysis, MS was the strongest predictor of BP/R (p = 0.0007). Conclusions: MS is related to adverse characteristics in PCa and confers poor bPFS after radical prostatectomy. MS is independently associated to the risk of BP/R.

Objective: To evaluate the prognostic impact of early recurrence (within 12 months) after surgery on cancer-specific survival (CSS) of patients with localized clear-cell renal cell carcinoma (ccRCC). Methods: Patients with surgically treated localized ccRCC were studied. Using the Kaplan-Meier method, we calculated CSS; by univariate and multivariate models we analyzed the association of early recurrence with cancer-related mortality. Results: We identified 259 patients with pT1–4/NX/0M0 ccRCC treated between February 1981 and September 2009; of 66 (25.5%) with disease recurrence, 29 (43.9%) had early relapse. Overall, 43 patients (16.6%) died from ccRCC. The 5- and 10-year CSS for those without, late and early recurrence was 98.5 and 96.5%, 53 and 39.8%, and 23 and 23%, respectively (p < 0.0001). In the multivariate Cox model, pT stage (p = 0.01) and early recurrence (p < 0.0001) independently predicted CSS. Conclusions: Recurrent disease after localized ccRCC confers a poor prognosis, especially if detected within 12 months after surgery. Thus, this criterion should be included as an independent risk factor for cancer-related mortality.

Introduction: The application of current prognosticators in locally advanced nonmetastatic renal cell carcinoma (RCC) is controversial. We analyzed the impact of clinical and pathological variables on the survival of this subset of patients. Patients and Methods: We studied patients with RCC in stages III and IV without metastases, treated surgically between 1980 and 2009. We calculated disease-free (DFS) and cancer-specific survival (CSS), and the relation of clinical and pathological variables with these end-points. Results: We identified 126 patients with locally advanced RCC; 8.7% had sarcomatoid differentiation. Tumor stage was pT3a in 48% and pT3b in 42%; 11.9% had lymph node invasion (N+). Patients with N– and N+ had a 10-year DFS of 49.0 and 23.4%, respectively (p = 0.0001). In multivariate analysis N+ (p = 0.0002) was the strongest predictor of DFS. The 10-year CSS of patients without sarcomatoid differentiation was 53.1% while those with sarcomatoid differentiation did not reach the median time to death (p < 0.0001). In multivariate analysis, sarcomatoid differentiation (p = 0.01) was the strongest predictor of CSS. Conclusions: Locally advanced RCC portends poor prognosis. Preoperatively, weight loss and Eastern Cooperative Oncology Group performance status are predictors of recurrence and mortality, respectively. However, the most powerful predictors of DFS and CSS in our cohort were lymph node status and sarcomatoid differentiation.

Lower enhancement of the entire tumor at the point where hypodense tumor areas are more predominant on tomography is associated with higher nuclear grade and more advanced stage.

Objetivo: Conocer el impacto que ha generado la pandemia por COVID-19 en la práctica urólogica en México. Material y Métodos:  Se realizó una encuesta a urólogos mexicanos con la aplicación SURVIO® via web del 16 al 22 de marzo 2020, la cual consistió en 8 preguntas dicotómicas y de opción múltiple, sobre la práctica urológica y su afectación por la pandemia de COVID-19. Resultados: Se recibieron un total de 374 respuestas, 66% respondió que la institución en la que laboran ya había emitido un protocolo de manejo para pacientes con COVID-19, el 80% negó que la consulta de urología hubiese sido reprogramada o cancelada en sus centros de trabajo, el 42% desconocía qué cirugías tendrían que ser diferidas y las herramientas que más ocuparán para sustituir la consulta presencial incluyen aplicaciones digitales. Limitante: Se trata de una encuesta con las limitaciones inherentes. Originalidad: Trabajo original el cual nos presenta un panorama de cómo ha impactado la pandemia por COVID-19 la práctica urológica diaria. Conclusiones: La Pandemia de COVID-19 representa un reto para todo nuestro sistema de salud. La práctica urológica enfrentará en este momento y en el futuro cambios sin precedentes.