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Urologic Oncology

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https://www.readbyqxmd.com/read/28803701/contemporary-practice-patterns-and-survival-outcomes-for-locally-advanced-urethral-malignancies-a-national-cancer-database-analysis
#1
David B Cahn, Elizabeth Handorf, Benjamin T Ristau, Daniel M Geynisman, Jay Simhan, Alexander Kutikov, Richard E Greenberg, Rosalia Viterbo, David Y T Chen, Robert G Uzzo, Marc C Smaldone
PURPOSE: Primary urethral carcinoma (PUC) has an aggressive natural history; however, controversy exists regarding the role of multimodal therapy for its treatment. Our objective was to examine practice patterns and survival outcomes for locally advanced urethral cancers. METHODS: The National Cancer Database was queried for patients with T2-4 or N1-2M0 PUC with urothelial, squamous, or adenocarcinoma histology from 2004 to 2013. Temporal trends for receipt of local or definitive surgery, radiotherapy (XRT), and systemic therapy were assessed...
August 10, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28803700/association-of-androgen-deprivation-therapy-and-depression-in-the-treatment-of-prostate-cancer-a-systematic-review-and-meta-analysis
#2
Kevin T Nead, Sumi Sinha, David D Yang, Paul L Nguyen
BACKGROUND: There is increasing evidence that androgen deprivation therapy (ADT) may be associated with depression. Existing studies have shown conflicting results. METHODS: PubMed, Web of Science, Embase, and PsycINFO were queried on April 5, 2017. Eligible studies were in English and reported depression among individuals with prostate cancer exposed to a course of ADT vs. a lesser-exposed group (e.g., any-ADT vs. no ADT and continuous ADT vs. intermittent ADT)...
August 10, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28802883/neoadjuvant-therapy-for-localized-and-locally-advanced-renal-cell-carcinoma
#3
REVIEW
Ahmet Bindayi, Zachary A Hamilton, Michelle L McDonald, Kendrick Yim, Frederick Millard, Rana R McKay, Steven C Campbell, Brian I Rini, Ithaar H Derweesh
Neoadjuvant Targeted Molecular Therapy in the setting of localized and locally advanced renal cell carcinoma has emerged as a strategy to render primary renal tumors amenable to planned surgical resection in settings where radical resection or nephron-sparing surgery was not thought to be safe or feasible. Presurgical tumor reduction has been demonstrated in a number of studies including a recently published randomized double-blind placebo-controlled study, and an expanding body of literature suggests benefit in select patients...
August 9, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28801027/lymph-node-dissection-should-not-be-dismissed-in-case-of-localized-renal-cell-carcinoma-in-the-presence-of-larger-diseases
#4
Paolo Dell'Oglio, Alessandro Larcher, Fabio Muttin, Ettore Di Trapani, Francesco Trevisani, Francesco Ripa, Cristina Carenzi, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Roberto Bertini, Umberto Capitanio
OBJECTIVE: To assess whether even in the group of localized renal cell carcinoma (RCC), some patients might harbor a disease with a predilection for lymph node invasion (LNI) and/or lymph node (LN) progression and might deserve lymph node dissection (LND) at the time of surgery. MATERIALS AND METHODS: Between 1990 and 2014, 2,010 patients with clinically defined T1-T2N0M0 RCC were treated with nephrectomy and standardized LND at a single tertiary care referral center...
August 8, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28801026/quadruple-immunotherapy-of-bacillus-calmette-gu%C3%A3-rin-interferon-interleukin-2-and-granulocyte-macrophage-colony-stimulating-factor-as-salvage-therapy-for-non-muscle-invasive-bladder-cancer
#5
Ryan L Steinberg, Kenneth G Nepple, Kyla N Velaer, Lewis J Thomas, Michael A O'Donnell
BACKGROUND: Bacillus Calmette-Guérin (BCG) is the most effective initial intravesical therapy for high-grade non-muscle invasive bladder cancer, but many patients still fail. Combination intravesical BCG and interferon (IFN) will salvage some patients but results remain suboptimal. OBJECTIVE: We hypothesized that further immunostimulation with intravesical interleukin-2 and subcutaneous granulocyte-macrophage colony-stimulating factor may improve response to intravesical BCG and IFN in patient with prior BCG failure(s)...
August 8, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28801025/toward-an-mri-based-nomogram-for-the-prediction-of-transperineal-prostate-biopsy-outcome-a-physician-and-patient-decision-tool
#6
Su-Min Lee, Sidath H Liyanage, Wahyu Wulaningsih, Konrad Wolfe, Thomas Carr, Choudhry Younis, Mieke Van Hemelrijck, Rick Popert, Peter Acher
PURPOSE: To develop and internally validate a nomogram using biparametric magnetic resonance imaging (B-MRI)-derived variables for the prediction of prostate cancer at transperineal sector-guided prostate biopsy (TPSB). SUBJECTS/PATIENTS AND METHODS: Consecutive patients referred to our institution with raised prostate-specific antigen (PSA), abnormal prostate examination, or persistent suspicion of prostate cancer after previous transrectal biopsy between July 2012 and November 2015 were reviewed from a prospective database...
August 8, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28797587/subcutaneous-adipose-tissue-characteristics-and-the-risk-of-biochemical-recurrence-in-men-with-high-risk-prostate-cancer
#7
Andrew M McDonald, John B Fiveash, Robert S Kirkland, Rex A Cardan, Rojymon Jacob, Robert Y Kim, Michael C Dobelbower, Eddy S Yang
PURPOSE/OBJECTIVE(S): To assess subcutaneous adipose tissue characteristics by computed tomography (CT) as potential imaging biomarkers predictive of biochemical recurrence in men with high-risk prostate cancer receiving radiotherapy (RT). MATERIALS AND METHODS: This retrospective study included men with high-risk prostate cancer (PSA>20ng/ml, Gleason score ≥8, or clinical extraprostatic extension) treated between 2001 and 2012. All patients received definitive, dose-escalated external beam RT along with a course of neoadjuvant, concurrent, and adjuvant androgen deprivation therapy (ADT)...
August 7, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28797586/obesity-as-defined-by-waist-circumference-but-not-body-mass-index-is-associated-with-higher-renal-mass-complexity
#8
Laura A Bertrand, Lewis J Thomas, Peng Li, Claire M Buchta, Shannon K Boi, Rachael M Orlandella, James A Brown, Kenneth G Nepple, Lyse A Norian
OBJECTIVES: Obesity, typically defined as a body mass index (BMI)≥30kg/m(2), is an established risk factor for renal cell carcinoma (RCC) but is paradoxically linked to less advanced disease at diagnosis and improved outcomes. However, BMI has inherent flaws, and alternate obesity-defining metrics that emphasize abdominal fat are available. We investigated 3 obesity-defining metrics, to better examine the associations of abdominal fat vs. generalized obesity with renal tumor stage, grade, or R...
August 7, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28789930/commentary-on-an-integrated-metabolic-atlas-of-clear-cell-renal-cell-carcinoma-hakimi-aa-reznik-e-lee-ch-creighton-cj-brannon-ar-luna-a-aksoy-ba-liu-em-shen-r-lee-w-chen-y-stirdivant-sm-russo-p-chen-yb-tickoo-sk-reuter-ve-cheng-eh-sander-c-hsieh-jj-cancer-cell
#9
Byron H Lee
Dysregulated metabolism is a hallmark of cancer, manifested through alterations in metabolites. We performed metabolomic profiling on 138 matched clear cell renal cell carcinoma (ccRCC)/normal tissue pairs and found that ccRCC is characterized by broad shifts in central carbon metabolism, one-carbon metabolism, and antioxidant response. Tumor progression and metastasis were associated with metabolite increases in glutathione and cysteine/methionine metabolism pathways. We develop an analytic pipeline and visualization tool (metabolograms) to bridge the gap between TCGA transcriptomic profiling and our metabolomic data, which enables us to assemble an integrated pathway-level metabolic atlas and to demonstrate discordance between transcriptome and metabolome...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28789929/commentary-on-comprehensive-transcriptional-analysis-of-early-stage-urothelial-carcinoma-hedegaard-j-lamy-p-nordentoft-i-algaba-f-h%C3%A3-yer-s-ulh%C3%A3-i-bp-vang-s-reinert-t-hermann-gg-mogensen-k-thomsen-mb-nielsen-mm-marquez-m-segersten-u-aine-m-h%C3%A3-glund-m-birkenkamp
#10
Byron H Lee
Non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease with widely different outcomes. We performed a comprehensive transcriptional analysis of 460 early-stage urothelial carcinomas and showed that NMIBC can be subgrouped into 3 major classes with basal- and luminal-like characteristics and different clinical outcomes. Large differences in biological processes such as the cell cycle, epithelial-mesenchymal transition, and differentiation were observed. Analysis of transcript variants revealed frequent mutations in genes encoding proteins involved in chromatin organization and cytoskeletal functions...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#11
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28789927/commentary-on-inherited-dna-repair-gene-mutations-in-men-with-metastatic-prostate-cancer-pritchard-cc-mateo-j-walsh-mf-de-sarkar-n-abida-w-beltran-h-garofalo-a-gulati-r-carreira-s-eeles-r-elemento-o-rubin-ma-robinson-d-lonigro-r-hussain-m-chinnaiyan-a-vinson
#12
Byron H Lee
BACKGROUND: Inherited mutations in DNA-repair genes such as BRCA2 are associated with increased risks of lethal prostate cancer. Although the prevalence of germline mutations in DNA-repair genes among men with localized prostate cancer who are unselected for family predisposition is insufficient to warrant routine testing, the frequency of such mutations in patients with metastatic prostate cancer has not been established. METHODS: We recruited 692 men with documented metastatic prostate cancer who were unselected for family history of cancer or age at diagnosis...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28789926/commentary-on-redirecting-abiraterone-metabolism-to-fine-tune-prostate-cancer-anti-androgen-therapy-li-z-alyamani-m-li-j-rogacki-k-abazeed-m-upadhyay-sk-balk-sp-taplin-me-auchus-rj-sharifi-n-nature-2016-may-25-533-7604-547-51
#13
Byron H Lee
Abiraterone blocks androgen synthesis and prolongs survival in patients with castration-resistant prostate cancer, which is otherwise driven by intratumoral androgen synthesis. Abiraterone is metabolized in patients to Δ(4)-abiraterone (D4A), which has even greater antitumour activity and is structurally similar to endogenous steroidal 5α-reductase substrates, such as testosterone. Here, we show that D4A is converted to at least three 5α-reduced and three 5β-reduced metabolites in human serum. The initial 5α-reduced metabolite, 3-keto-5α-abiraterone, is present at higher concentrations than D4A in patients with prostate cancer taking abiraterone, and is an androgen receptor agonist, which promotes prostate cancer progression...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28781111/creation-and-internal-validation-of-a-biopsy-avoidance-prediction-tool-to-aid-in-the-choice-of-diagnostic-approach-in-patients-with-prostate-cancer-suspicion
#14
Bimal Bhindi, Haiyan Jiang, Cedric Poyet, Thomas Hermanns, Robert J Hamilton, Kathy Li, Ants Toi, Antonio Finelli, Alexandre R Zlotta, Theodorus H van der Kwast, Andrew Evans, Neil E Fleshner, Girish S Kulkarni
INTRODUCTION: To reduce unnecessary prostate biopsies while using novel tests judiciously, we created a tool to predict the probability of clinically significant prostate cancer (CSPC) vs. low-risk prostate cancer or negative biopsy (i.e., when intervention is likely not needed) among men undergoing initial or repeat biopsy. METHODS: Separate models were created for men undergoing initial and repeat biopsy, identified from our institutional biopsy database and the placebo arm of the REDUCE trial, respectively, to predict the presence of CSPC (Gleason≥7 or>33% of cores involved)...
August 3, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28781110/association-of-race-and-margin-status-among-patients-undergoing-robotic-partial-nephrectomy-for-t1-renal-cell-carcinoma-results-from-a-population-based-cohort
#15
Victor S Chen, Robert Abouassaly, Christopher M Gonzalez, Alexander Kutikov, Marc C Smaldone, Neal J Meropol, Sarah P Psutka, Stephen B Williams, Rebecca O'Malley, Hillary M Sedlacek, Simon P Kim
OBJECTIVE: To assess the relationship of race and margin status among patients undergoing robotic partial nephrectomy (RPN) for T1 renal tumors from a contemporary population-based cohort. METHODS: Using the National Cancer Database, we identified patients with localized renal cell carcinoma (RCC) (clinical T1N0M0) who underwent RPN from 2010 to 2013. The primary outcome was positive surgical margins (PSM). Multivariable logistic regression analyses were used to assess the association between race and PSM adjusting for patient clinicopathologic and hospital factors...
August 3, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28780132/commentary-on-comprehensive-molecular-characterization-of-papillary-renal-cell-carcinoma-cancer-genome-atlas-research-network-n-engl-j-med-2016-jan-14-374-2-135-45
#16
Byron H Lee
BACKGROUND: Papillary renal-cell carcinoma, which accounts for 15%-20% of renal-cell carcinomas, is a heterogeneous disease that consists of various types of renal cancer, including tumors with indolent, multifocal presentation, and solitary tumors with an aggressive, highly lethal phenotype. Little is known about the genetic basis of sporadic papillary renal-cell carcinoma, and no effective forms of therapy for advanced disease exist. METHODS: We performed comprehensive molecular characterization of 161 primary papillary renal-cell carcinomas, using whole-exome sequencing, copy-number analysis, messenger RNA and microRNA sequencing, DNA-methylation analysis, and proteomic analysis...
August 2, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28780131/commentary-on-clonal-evolution-of-chemotherapy-resistant-urothelial-carcinoma-faltas-bm-prandi-d-tagawa-st-molina-am-nanus-dm-sternberg-c-rosenberg-j-mosquera-jm-robinson-b-elemento-o-sboner-a-beltran-h-demichelis-f-rubin-ma-nat-genet-2016-oct-17-http-dx-doi
#17
Byron H Lee
Chemotherapy-resistant urothelial carcinoma has no uniformly curative therapy. Understanding how selective pressure from chemotherapy directs the evolution of urothelial carcinoma and shapes its clonal architecture is a central biological question with clinical implications. To address this question, we performed whole-exome sequencing and clonality analysis of 72 urothelial carcinoma samples, including 16 matched sets of primary and advanced tumors prospectively collected before and after chemotherapy. Our analysis provided several insights that are as follows: (1) chemotherapy-treated urothelial carcinoma is characterized by intrapatient mutational heterogeneity, and most mutations are not shared; (2) both branching evolution and metastatic spread are very early events in the natural history of urothelial carcinoma; (3) chemotherapy-treated urothelial carcinoma is enriched with clonal mutations involving L1 cell-adhesion molecule and integrin signaling pathways; and (4) APOBEC-induced mutagenesis is clonally enriched in chemotherapy-treated urothelial carcinoma and continues to shape the evolution of urothelial carcinoma throughout its lifetime...
August 2, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28778585/the-effect-of-kinetics-of-c-reactive-protein-in-the-prediction-of-overall-survival-in-patients-with-metastatic-renal-cell-carcinoma-treated-with-tyrosine-kinase-inhibitor
#18
Jun Teishima, Kohei Kobatake, Shunsuke Shinmei, Shogo Inoue, Tetsutaro Hayashi, Shinya Ohara, Koji Mita, Yasuhisa Hasegawa, Satoshi Maruyama, Mitsuru Kajiwara, Masanobu Shigeta, Hideki Mochizuki, Hiroyuki Moriyama, Seiji Fujiwara, Akio Matsubara
INTRODUCTION AND OBJECTIVES: The aim of this study was to investigate the effect of kinetics of C-reactive protein (CRP) in the prediction of overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) treated with a tyrosine kinase inhibitor. MATERIALS AND METHODS: The CRP in 118 cases of molecular-targeted therapy for mRCC was measured before starting the prescription of the first-line targeted agents and at the first time a CT scan was conducted during treatments...
August 1, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28778584/temporal-trends-in-perioperative-morbidity-for-radical-cystectomy-using-the-national-surgical-quality-improvement-program-database
#19
Scott C Johnson, Zachary L Smith, Shay Golan, Joseph F Rodriguez, Norm D Smith, Gary D Steinberg
INTRODUCTION: Radical cystectomy (RC) is the standard of care for invasive nonmetastatic bladder cancer. Unfortunately, it is a complex procedure and more than half of patients experience a complication. A number of efforts to reduce perioperative morbidity have been made, including alterations in pain management, antibiotics, diet advancement, and anticoagulation. Many of these changes in management have been studied with favorable results; however, it is not clear whether complication rates following RC have improved in recent years...
August 1, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28774722/targeting-mtor-in-urothelial-cancer-beating-a-dead-horse-or-ready-for-prime-time
#20
Günter Niegisch, Peter Albers
No abstract text is available yet for this article.
July 31, 2017: Urologic Oncology
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