Masayuki Nakagawa M.D., Ph.D. Associate Editor

In this issue there are three reviews, four original articles, three short communications, two letters to the editor and a meeting report. Among the three reviews, two relate to renal tumors. Samplaski et al. (Cleveland, USA) reviewed renal mass sampling from an enlightened perspective. Renal mass sampling has been performed to make a differential diagnosis, however the technique was not standardized and terminology remains ambiguous. In this review, they proposed a new classification in which all biopsies are categorized as non-informative versus informative, with the latter being subclassified as confirmed accurate, presumed accurate or confirmed inaccurate in order to stratify biological aggressiveness and guide management of renal masses. There are currently several nomograms for renal cell carcinoma (RCC). Flanigan et al. (Maywood, USA) reviewed prognostic variables of RCC by focusing on various clinicopathological parameters and nomograms. They described how to use the nomograms properly in order to choose suitable treatment options for each individual patient. Tong et al. (Kuala Lumpur, Malaysia) reviewed and compared the variations in disorders and health care of aging men in different Asian countries. They emphasized the poor understanding of the health care needs of men and recommended that a framework for a movement to advance men's health in each Asian country be set up.

The prognosis of urothelial cancer (UC) in the upper urinary tract (UUT) has been reported to be poorer than bladder UC. Suyama et al. (Tokyo, Japan) reported that measurement of preoperative serum CYPRA 21-1 levels provides a prognostic value of UC in UUT. They showed that patients with high (≥2.7 ng/mL) CYFRA 21-1 levels had a statistically worse prognosis than those with low (<2.7 ng/mL) levels. Another study on micropapillary UC of the bladder, which is uncommon but aggressive, was carried out by Edgerton et al. (Atlanta, USA). They retrospectively analyzed 24 cases and found that a high percentage of this entity was significantly associated with male sex, regional lymph node metastasis and pathological stage. Therefore, they recommended that the micropapillary component in each specimen be quantified. Baek et al. (Seoul, South Korea) reported the results of a nationwide survey to evaluate the prevalence of varicoceles in middle school boys. They found that 16.5% of middle school boys had varicoceles and the presence was associated with a negative effect on testicular growth. Developing new biomarkers and drug targets for RCC is desirable, because there is no useful biomarker for detecting RCC. Minamida et al. (Sagamihara, Japan) attempted to identify overexpressed antigens in RCC using a proteomics technique. They reported that profilin 1 overexpressed not in normal kidney tissue but in RCC, might play a key role in the pathological process of RCC. Further study is necessary to confirm its significance as a biomarker for RCC.

In the short communications, there are three interesting papers on prostate cancer and vesicoureteral reflux (VUR). The first short communication studies the relationship between prostate-specific antigen and obesity in prostate cancer screening. Kubota et al. (Toyota, Japan) analyzed 19 294 male subjects and found an inverse, but weak, relationship between prostate-specific antigen and body mass index. According to their results, we should be aware that the hemodilution effect might reduce prostate-specific antigen levels in obese men. Continence is a critical issue regarding quality of life in prostatectomy patients. Naselli et al. (Genoa, Italy) examined the incidence and risk factors of late-onset incontinence in 235 subjects who underwent radical prostatectomy. The result showed that 26 (11%) patients had incontinence, whereas the other 209 (89%) patients maintained continence. Aging (≥65 years) seems to be related to late-onset incontinence, although the difference was not statistically significant. Since the 1990s, new onset contralateral VUR has been reported in 7–21% of patients who received unilateral anti-reflux surgery for primary VUR. Matsumoto et al. (Izumi, Japan) investigated 34 patients with unilateral VUR and found that 16 (47%) patients had contralateral VUR detected by the positioning the instillation of contrast (PIC) method under general anesthesia. Therefore, they recommended the use of PIC at the ureteral orifice to predict new onset of contralateral VUR.