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  1. Lim NK, Aik OT, Meng LL, Htun TH, Razack AH
    J Coll Physicians Surg Pak, 2014 Mar;24 Suppl 1:S68-70.
    PMID: 24718014 DOI: 03.2014/JCPSP.S68S70
    Superior vena caval syndrome (SVCS) is a debilitating condition attributed to malignancy in more than 70% of cases. However, solitary head and neck metastases arising from renal cell carcinomas without evidence of disease elsewhere are rare. We report a case of renal cell carcinoma presenting as a rapidly growing right cervical lymph node with compression on the subclavian vein causing superior vena caval syndrome (SVCS). There was pulmonary embolism as well. Biopsy of the neck mass confirmed metastatic clear cell carcinoma with primary found in the (L) kidney. The patient had partial response to focussed radiotherapy to neck mass and Sunitinib (tyrosine kinase inhibitor) before succumbing to the disease.
  2. Ye D, Kanesvaran R, Chiong E, Lojanapiwat B, Pu YS, Rawal SK, et al.
    Ther Adv Med Oncol, 2024;16:17588359241293393.
    PMID: 39583953 DOI: 10.1177/17588359241293393
    BACKGROUND: The incidence of prostate cancer (PC) is increasing in Asian countries. The epidemiology of PC, its treatment including the use of novel therapeutic options, impacts on quality of life, and clinical outcomes of patients with PC in Asia, are not well documented.

    OBJECTIVES: To describe the demographic and disease features of the full cohort of patients enrolled in the United in Fight against prOstate cancer (UFO) registry.

    DESIGN: The UFO registry was a multi-national, longitudinal, observational study of patients with PC presenting to participating tertiary care hospitals in eight Asian countries/regions.

    METHODS: Patients with high-risk localized PC (HRL), non-metastatic biochemically recurrent, or metastatic PC were consecutively enrolled from September 14, 2015 until September 1, 2020 and followed for up to 5 years.

    RESULTS: Among the full cohort of 3635 patients, 425 had HRL, 389 had non-metastatic biochemically recurrent, and 2821 had metastatic PC. Median follow-up time was 4.2, 4.2, and 2.6 years, respectively. At first diagnosis, the mean age ranged from 65.7 to 69.1 years, 38.5% had extra-capsular tumor extension, 34.0% had regional lymph node metastases, and 65.1% had distant metastases. Quality-of-life scores at enrollment were significantly worse in patients with metastatic disease. Decisions to start therapy were mainly driven by treatment guidelines and disease progression. The decision to discontinue hormonal therapy was often due to disease progression. Few patients received novel hormonal therapies despite their availability.

    CONCLUSION: The UFO registry provides a detailed, contemporary picture of the characteristics, treatment, and outcomes of patients with PC in Asia. There is an unmet medical need to improve access to novel agents in Asia, aiming to improve quality of life and clinical outcomes.

    TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT02546908, Registry Identifier: NOPRODPCR4001.

  3. Trujillo-Santamaría H, Robles-Torres JI, Teoh JY, Tanidir Y, Campos-Salcedo JG, Bravo-Castro EI, et al.
    Curr Urol, 2024 Mar;18(1):55-60.
    PMID: 38505163 DOI: 10.1097/CU9.0000000000000163
    BACKGROUND: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.

    MATERIALS AND METHODS: Patients diagnosed with EPN between 2013 and 2020 were retrospectively included. Data from 15 centers (70%) were used to develop the scoring system, and data from 7 centers (30%) were used to validate it. Univariable and multivariable logistic regression analyses were performed to identify independent factors related to mortality. Receiver operating characteristic curve analysis was performed to construct the scoring system and calculate the risk of mortality. A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points. The area under the curve was used to quantify the scoring system performance. An 8-point scoring system for the mortality risk was created (range, 0-7).

    RESULTS: In total, 570 patients were included (400 in the test group and 170 in the validation group). Independent predictors of mortality in the multivariable logistic regression were included in the scoring system: quick Sepsis-related Organ Failure Assessment score ≥2 (2 points), anemia, paranephric gas extension, leukocyte count >22,000/μL, thrombocytopenia, and hyperglycemia (1 point each). The mortality rate was <5% for scores ≤3, 83.3% for scores 6, and 100% for scores 7. The area under the curve was 0.90 (95% confidence interval, 0.84-0.95) for test and 0.91 (95% confidence interval, 0.84-0.97) for the validation group.

    CONCLUSIONS: Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.

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