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Verhoest G.,Rennes University Hospital Center | Shariat S.F.,Cornell University | Shariat S.F.,Penn State College of Medicine | Chromecki T.F.,Cornell University | And 9 more authors.
World Journal of Urology | Year: 2011

Objective: UTUCC is a rare tumor, and most reports on prognostic factors come from small single-center series. The objective of this article was to provide an updated overview of current clinical, pathological and biological prognostic factors of UTUC. Methods: PubMed was searched for records from 2002 to 2010 using the terms "prognostic factors", "recurrence", "survival", and "upper tract urothelial carcinoma". Among identified citations, papers were selected based on their clinical relevance. Results: Classical clinical factors that influence UTUC prognosis include age, presence of symptoms, hydronephrosis, and interval from diagnosis. Many biomarkers have shown promises to better appraise the natural course of UTUC although none is currently used in clinical practice. Stage, grade, lymph node metastases, lymphovascular invasion, tumor necrosis, and tumor architecture are strong pathological parameters. RNU is the standard treatment of localized UTUC. Both laparoscopic and open approaches seem to offer similar cancer control. Lymph node dissection increases staging accuracy and might confer a survival benefit. Conclusion: RNU is the standard treatment for most patients with UTUC. Recent multicenter studies confirmed the prognostic value of classical prognostic parameters. Better survival prediction might be obtained with prognostic systems including clinical data and new biomarkers. © 2011 Springer-Verlag.

Dirnberger G.,Medical University of Vienna | Dirnberger G.,Weizmann Institute of Science | Lang W.,Hospital Barmherzige Bruder Vienna | Lindinger G.,Medical University of Vienna
Age | Year: 2010

The "frontal aging theory" assumes the deterioration of executive/inhibitory functions as causal factors for the cognitive decline in human aging. The contingent negative variation resolution (CNV-R) is an electroencephalographic potential elicited after the second (informative) stimulus in warned Go/NoGo tasks requiring a response to one type of stimulus (Go) but not to the other (NoGo). Whereas the CNV-R across conditions is a measure of executive functions, the augmented potential in the NoGo condition is a specific measure of inhibitory processes. The aim was to examine the presumed linkage between executive processes and the CNV-R with special regard to inhibition in the NoGo condition, and to test whether any effects of age on this potential can be explained by a failure of (inhibitory) executive functions. Nineteen young and 15 elderly non-demented healthy volunteers were examined in a Go/NoGo CNV-R paradigm and on a test of executive functions focussed on set shifting (Trail Making test). Results showed: (1) Better executive functions are associated with higher amplitudes of the CNV-R across conditions. (2) The CNV-R is higher for elderly than younger subjects; this increment is much stronger in the NoGo condition. In conclusion, the CNV-R across conditions reflects executive processes such as the shift of motor set. A higher CNV-R for elderly subjects (particularly of the inhibition-related NoGo CNV-R) indicates that this group is not impaired in the available amount of executive control but may exert such control for task demands where young subjects do not require it. © 2010 American Aging Association, Media.

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