The status,limitation and improvement of adoptive cellular immunotherapy in advanced urologic malignancies

In recent years, immunotherapy has been gradually established as the fourth frequently adopted antitumor therapy, following surgery, chemotherapy and radiotherapy, for advanced urologic malignancies with an improved understanding of theoretical basis, such as molecular biology and immunology. Thereinto, adoptive cellular immunotherapy （ACI） has become one of the hotspots, which comprises a variety of treatment approaches, such as TIL, CIK cell, ~＇~ T cell, CAR-engineered T cell and Allogeneie stem cell transplantation （alloSCT）. Although preclinical efficacy has been demonstrated remarkably, clinical trials could not consistently show the benefit due to multi-factors in complex immnnosuppressive microenvironment in vivo compared to that of in vitro. Here we review some timely aspects of ACI for advanced urologic malignancies, and describe the current status and limitation of immunotherapy from the cellular level. It＇s our expectation to provide prompting consideration of novel combinatorial ACI strategies and a resurgence of interest in ACI for advanced urologic malignancies.

Primary urachal adenocarcinoma: a rare case report

Primary urachal carcinoma is a very rare cancer with a poor prognosis.It generally presents as a highgrade,high-stage tumor,and in most cases the patient has developed regional or distant metastasis at the time of presentation.Here,we report a very interesting case of primary urachal adenocarcinoma with signet ring cell carcinoma in a 58-year-old male who presented with a lower abdominal mass and discomfort.In this case,urachal carcinoma was successfully treated with surgery using an extended partial bladder cystectomy approach with excision of the urachal mass and umbilicus.The patient also underwent systematic chemotherapy with 5-fluorourical and cisplatin.During the 12-month follow-up period,the patient did not experience recurrence or metastasis.Overall,we found that an organ preserving extended partial cystectomy along with chemotherapy was an optimal treatment method that helped improve the patient's quality of the life with no recurrence of cancer so far.

The Effect of Prostate Volume on Robotic-assisted Radical Prostatectomy

Objective:To investigate the effect of prostate volume on robot-assisted radical prostatectomy.Methods:Clinical data of 75 patients underwent RARP in the Affiliated Hospital of Qingdao University were retrospectively analyzed.The patients were divided into 3 groups according to size of prostate.A total of 35 cases with prostate volume less than 30ml were recorded as group 1,27 cases with volume of 30 to 50 ml were recorded as group 2,and 13 cases with volume greater than 50ml were recorded as group 3.Age,BMI,preoperative PSA,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,indwelling time of drainage tube,total hospitalization time,pathological stage,surgical margin,urine control and biochemical recurrence were observed.Results:All operations were performed under Da Vinci robot assistance,and no patient was transferred to open surgery.There was no significant difference in age,preoperative PSA,BMI,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,total hospitalization time,pathological stage,rate of positive surgical margin and recovery of urinary continence between the groups.Indwelling time of drainage tube was longer in group with larger prostate,6.4(±4.5)days in group 1,6.3(±2.9)days in group 2 and 7.1(±2.5)days in group 3.Gleason score was lower in group with larger prostate,with statistical difference.Conclusion:Prostate volume had no significant effect on urinary control,rate of positive surgical margin and recurrence after RARP.Gleason score of pathological tissue was lower and indwelling time of drainage tube was longer in patients with larger prostate after RARP.Operation time and intraoperative bleeding volume of large prostate patients underwent RARP need to be further studied.RARP has certain advantages for patients with large prostate.