sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
B. anatomic location and extent of the tumor
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
radical cysto-prostatectomy
anterior pelvic exenteration
bilateral pelvic lymphadenectomy
creation of a urinary diversion
rarely diagnosed at autopsy
the peak incidence occurs between ages 70 and 80
they occur twice as frequently in men as in women
none of the above
immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
obstructive LUTS are common presentations and occur in association with carcinoma in situ
might present as perineal abscesses and fistulae
could be asymptomatic
venereal diseases increase the risk of urethral cancers
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
tumor stage
tumor grade
lymphovascular invasion
lymph node spread
working with organic chemicals and dyes
abuse of pain-control medications especially phenacetin
exposure to arsenic and aromatic amines
schistosomiasis
upper ureter
middle ureter
lower ureter
comparable
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
comparable
history of pulmonary TB
total incontinence
immunosuppression
impaired renal function
multifocality
high tumor grade and advanced stage
presence of CIS
all of the above
mid prostate to the verumontanum at the 5 and 7 oclock positions
lateral margins of the prostate at the 10 and 2 oclock positions
entire area distal to the urethral crest
area between ejaculatory duct openings and prostatic utricle
well-differentiated tumor with broad-based invasive font
marked atypia distributed on wide areas of superficial urothelium
atypia is present
no atypia but marked degenerative epithelial changes
urine cytology
CT urography
cystoscopy
renal function tests
nodular or sessile lesions usually invade muscle
papillary bladder tumors are typical of low stage and grade
carcinoma in situ appears as a flat, velvety patch
sarcomas commonly invade bladder base and ureteral orifices causing obstructions
frequently found in association with high-grade or extensive TCC
has a rate of progression to muscle invasion of 10-25%
significant areas of CIS are easily missed by routine cystoscopy
treatment begins with TURBT
leiomyoma
hemangioma
fibroepithelial polyp
lymphangioma
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
high specificity
high sensitivity
high reliability
strong validity
the anterior urethra drains into the inguinal and pelvic nodes
the posterior urethra drains into the pelvic nodes
the proximal two-thirds drain into the external and internal iliac nodes
the distal one-third drains into the obturator nodes
30%
40%
50%
60%
cisplatin
BCG
mitomycin C
5-fluorouracil
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
small cell carcinoma
en bloc resection involving total penectomy, cystoprostatectomy, resection of the pubic rami and urogenital diaphragm, with pelvic lymphadenectomy. In addition, creating a urinary diversion.
total penectomy involving removal of the penis, urethra, and penile root
partial penectomy involving excision of the malignant lesion with 2-cm margins
transurethral resection or fulguration