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Urologic Oncology

Abhinav Sidana, Meet Kadakia, Julia C Friend, Louis S Krane, Daniel Su, Maria J Merino, Ramaprasad Srinivasan
OBJECTIVE: To describe the incidence of ascites in metastatic papillary renal cell cancer (pRCC), identify the factors associated with its development and evaluate its prognostic effect on the survival of these patients. METHODS: A retrospective evaluation of the medical records of patients with metastatic pRCC seen at National Cancer Institute (2000-2014) was undertaken. Logistic regression to identify predictors of the development of malignant ascites and Kaplan-Meier analysis to estimate survival was done...
November 30, 2016: Urologic Oncology
Francesco Soria, Marco Moschini, Mohammad Abufaraj, Gregory J Wirth, Beat Foerster, Kilian M Gust, Mehmet Özsoy, Alberto Briganti, Paolo Gontero, Romain Mathieu, Morgan Rouprêt, Pierre I Karakiewicz, Shahrokh F Shariat
PURPOSE: To evaluate the effect of preoperative anemia (PA) on oncological outcomes in a multicenter cohort of patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB) and adjuvant intravesical therapies. We hypothesize that PA represents a marker of disease aggressiveness and could be used to improve the discrimination of prognostic tools for the prediction of disease recurrence and progression. METHODS: This multicenter retrospective study included 1,117 patients from 4 different centers...
November 28, 2016: Urologic Oncology
Wan Song, Hyun Hwan Sung, Deok Hyun Han, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Hwang Gyun Jeon
PURPOSE: We investigated the effect of preoperative contralateral kidney (CK) volume on renal function after radical nephroureterectomy (RNU). METHODS: We reviewed 630 patients who underwent RNU between September 1994 and December 2013. Of these 630 patients, 135 patients with advanced upper tract urothelial cancer were ultimately included. Preoperative CK volume was measured from computed tomography images of the venous phase using a specialized volumetric program...
November 28, 2016: Urologic Oncology
Kamla Kant Shukla, Sanjeev Misra, Puneet Pareek, Vivek Mishra, Barkha Singhal, Praveen Sharma
Prostate cancer (CaP) is a leading cause of cancer death and displays a broad range of clinical behavior from relatively indolent to aggressive metastatic disease. Due to the alteration and incomplete characterization of the CaP genomic markers, the quest for novel cellular metabolic regulatory molecules like micro RNA (miRNA) as a biomarker could be considered for the prognosis and treatment of CaP in future. In this article, we review the existing literature pertaining to CaP. Study provides a comprehensive miRNA profile expressed in CaP...
November 24, 2016: Urologic Oncology
Tyler A Wittmann, E Jason Abel
INTRODUCTION: The role of percutaneous biopsy to characterize large, locally advanced and metastatic primary renal tumors has not been well described. The goal of this article is to describe the potential advantages of biopsy for preoperative evaluation of patients with large renal tumors and advanced disease. METHODS: Literature was reviewed for percutaneous biopsy and for locally advanced and metastatic renal tumors. RESULTS: Multiple studies have confirmed that percutaneous biopsy is safe, and the cost is minimal relative to the cost of surgical operation...
November 23, 2016: Urologic Oncology
Ben Yi Tew, Sumanta K Pal, Miaoling He, Tommy Tong, Huiqing Wu, JoAnn Hsu, Xueli Liu, Susan L Neuhausen, Jeremy O Jones
PURPOSE: Increasing evidence has demonstrated that men taking the anticoagulant warfarin have a lower risk of developing prostate cancer. This phenomenon is not observed in other cancers. We sought to determine if the target of warfarin, vitamin K epoxide reductase (VKOR), is expressed in benign and cancerous prostate tissues and if a functional single nucleotide polymorphism (SNP) in the VKOR gene is associated with prostate cancer risk. MATERIALS AND METHODS: The expression of VKOR was quantified by immunohistochemistry in an institutional series of 54 radical prostatectomy samples and metastatic biopsies, as well as in 40 other cancers and matched benign tissues on a tissue microarray...
November 23, 2016: Urologic Oncology
Diane D Lu, Stephen A Boorjian, Jay D Raman
: To determine the use of prophylactic intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) and barriers to utilization in a survey study of urologic oncologists. METHODS: A survey instrument was constructed, which queried respondents on professional experience, practice environment, pIVC use, and reasons for not recommending pIVC when applicable. The survey was electronically distributed to members of the Society of Urologic Oncology over an 8-week period...
November 21, 2016: Urologic Oncology
Xiang Zhang, Yanlin Wang, Yuan Ning
OBJECTIVE: Protein kinase, DNA-activated, catalytic polypeptide (PRKDC) is a critical component of DNA repair machinery and its dysregulated expression has been observed in various cancer types or premalignant cells. However, its role in prostate cancer (PCa) development and its prognostic significance in PCa is unknown. METHODS: The mRNA and protein levels of PRKDC were analyzed in 15 pairs of PCa and benign prostatic hyperplasia tissues as well as PCa cell lines by quantitative real-time polymerase chain reaction and Western blot, respectively...
November 14, 2016: Urologic Oncology
Jesús Benítez Granados, Juan Pablo Méndez, Guillermo Feria-Bernal, Eduardo García-García, María Elena Tejeda, David Rojano-Mejía, André Tapia, Patricia Canto
BACKGROUND: Mitochondrial dysfunction has been associated with the development of cancer and obesity, being prostate cancer more aggressive in obese men. It has been suggested that the mitochondrial transcription factor A (TFAM) plays a central role in these events. OBJECTIVE: The aim of this study was to analyze the possible association of 3 TFAM polymorphisms, as well as their haplotypes, with the development of aggressive prostate cancer in overweight or obese Mexican Mestizo men...
November 11, 2016: Urologic Oncology
Simon P Kim, Cary P Gross, Neal Meropol, Alexander Kutikov, Marc C Smaldone, Nilay D Shah, James B Yu, Sarah Psutka, Jonathon Kiechle, Robert Abouassaly
OBJECTIVE: To assess the national trends in treatment of localized renal tumors among older patients with limited life expectancy. MATERIALS AND METHODS: Using the National Cancer Database, we identified older patients (≥70y) diagnosed with T1 renal cell carcinoma from 2002 to 2011. Primary outcome was the initial treatment-partial nephrectomy (PN), radical nephrectomy, EM, and ablation. Multivariable logistic regression analysis stratified by tumor size (<2, 2-3...
November 10, 2016: Urologic Oncology
Line Victoria Moen, Håkon Ramberg, Sen Zhao, Helene Hartvedt Grytli, Anita Sveen, Viktor Berge, Rolf I Skotheim, Kristin Austlid Taskén, Bjørn Steen Skålhegg
BACKGROUND: Today overtreatment of indolent prostate cancers and undertreatment of aggressive prostate cancer are a major concern for patients, their families, and the health care system. New biomarkers distinguishing indolent and aggressive prostate cancer are needed to improve precision medicine. In prostate cancer, protein kinase A (PKA) is known to activate the androgen receptor and published data indicate that PKA subunits can act as predictive markers for response to radiation and chemotherapy...
November 9, 2016: Urologic Oncology
Stephen J Hankinson, Mina Fam, Nitin N Patel
OBJECTIVES: Metformin has numerous antineoplastic effects including an AMP-activated protein kinase-dependent mechanism, AMP-activated protein kinase-independent mechanisms, alteration of insulin and insulin-like growth factor signaling pathways, and suppression of androgen signaling pathways that trigger prostate cancer growth and proliferation. In contrast to other malignancies that are associated with increased incidence among patients with obesity and type II diabetes mellitus (T2DM), epidemiological studies suggest that obesity and T2DM may impart a protective effect on prostate cancer incidence by creating a set of metabolic conditions that lower androgen levels...
November 8, 2016: Urologic Oncology
Leticia Serrano-Oviedo, José M Giménez-Bachs, Syongh Y Nam-Cha, Francisco J Cimas, Jesús García-Cano, Ricardo Sánchez-Prieto, Antonio S Salinas-Sánchez
OBJECTIVES: To determine the expression status of several proteins related to VHL gene function and its relationship with common clinicopathological parameters. MATERIAL AND METHODS: Observational, analytical, cross-sectional study with 50 patients diagnosed with clear cell renal cell carcinoma. The study analyzed VHL mutations and hypermethylation as well as protein expression of VHL, CA-IX, HIF-1alpha, VEGF, ERK1/2, and ERK5, relating them to clinical variables...
November 8, 2016: Urologic Oncology
Annie L Darves-Bornoz, Matthew J Resnick
The U.S. health care system continues to evolve toward value-based payment, rewarding providers based upon outcomes per dollar spent. To date, payment innovation has largely targeted primary care, with little consideration for the role of surgical specialists. As such, there remains appropriate uncertainty surrounding the optimal role of the urologic oncologist in alternative payment models. This commentary summarizes the context of U.S. health care reform and offers insights into supply-side innovations including accountable care organizations and bundled payments...
November 7, 2016: Urologic Oncology
Nobuyuki Tanaka, Ryuichi Mizuno, Yota Yasumizu, Keiichi Ito, Suguru Shirotake, Ayako Masunaga, Yujiro Ito, Yasumasa Miyazaki, Masayuki Hagiwara, Kent Kanao, Shuji Mikami, Ken Nakagawa, Tetsuo Momma, Takeshi Masuda, Tomohiko Asano, Masafumi Oyama, Mototsugu Oya
PURPOSE: The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model has been designed for prognostification in patients with metastatic renal cell carcinoma (mRCC) treated with targeted therapy. One factor is neutrophil count; however, increasing evidence has suggested the superiority of neutrophil-to-lymphocyte ratio (NLR) for predicting outcome. In this study, we evaluate the prognostic effect of NLR levels on patients with mRCC treated with targeted therapy, and then we compare the predictive accuracy of the IMDC risk model and its modified one by using NLR, instead of neutrophil count...
November 4, 2016: Urologic Oncology
Vignesh T Packiam, Vijay A Agrawal, Andrew J Cohen, Joseph J Pariser, Scott C Johnson, Gregory T Bales, Norm D Smith, Gary D Steinberg
OBJECTIVES: Ureteroenteric anastomotic strictures are common after cystectomy with urinary diversion. Endoscopic treatments have poor long-term success, although ureteral reimplantation is associated with morbidity. Predictors of successful open repair are poorly defined. Our objective was to characterize outcomes of ureteral reimplantation after cystectomy and identify risk factors for stricture recurrence. PATIENTS AND METHODS: We performed a retrospective review of 124 consecutive patients with a total of 151 open ureteral reimplantations for postcystectomy ureteroenteric strictures between January 2006 and December 2015...
November 4, 2016: Urologic Oncology
Tian C Zhou, Alexander I Sankin, Steven A Porcelli, David S Perlin, Mark P Schoenberg, Xingxing Zang
PURPOSE: Recent observations have focused attention on the means that human tumors employ to evade host defense systems critical to immune surveillance. The concepts of immunotherapy are familiar to urologists because of the use of bacillus Calmette-Guérin in bladder cancer. Research demonstrating the importance of checkpoint inhibitors in suppressing immune responses against tumors has heightened interest in immunotherapy at a time when there is a need for alternatives to bacillus Calmette-Guérin...
November 2, 2016: Urologic Oncology
Evanguelos Xylinas, Luis Kluth, Malte Rieken, Morgan Rouprêt, Bashir Al Hussein Al Awamlh, Thomas Clozel, Maxine Sun, Pierre I Karakiewicz, Mithat Gonen, Shahrokh F Shariat
OBJECTIVES: To externally validate our previously developed pathological nodal staging model (pNSS) that allows quantification of the likelihood that a patient with pathologic node-negative status has, indeed, no lymph node metastasis (LNM). PATIENTS AND METHODS: We analyzed data from 2,768 patients treated with radical nephroureterectomy (RNU) and lymph node dissection (LND) using the Surveillance, Epidemiology, and End Results database from 1988 to 2010. We estimated the sensitivity of pathologic nodal staging using a beta-binomial model and developed a new pNSS...
November 2, 2016: Urologic Oncology
Johannes Huber, Philipp Maatz, Tanja Muck, Bastian Keck, Hans-Christoph Friederich, Wolfgang Herzog, Andreas Ihrig
OBJECTIVE: To analyze the effect of an online support group (OSG) on the final treatment decision for localized prostate cancer. METHODS: We performed a cross-sectional descriptive study of the largest German prostate cancer OSG between July and October 2013. The online survey comprised 127 questions covering sociodemographic and disease-related information, decision-making habits, health-related quality of life, distress, depression, and anxiety. The primary outcome was to measure the effect of an OSG on the final treatment decision...
October 31, 2016: Urologic Oncology
Meera R Chappidi, Heather J Chalfin, Daniel J Johnson, Max Kates, Nikolai A Sopko, Michael H Johnson, Jen-Jane Liu, Steven M Frank, Trinity J Bivalacqua
BACKGROUND: Patients with bladder cancer undergoing radical cystectomy (RC) experience high rates of perioperative blood transfusions (PBTs) and morbidity. The aim of this study was to evaluate the effect of blood storage duration on the risk of adverse perioperative outcomes in this high-risk patient population. MATERIALS AND METHODS: In a retrospective review of RC patients from 2010 to 2014 who received PBTs, the average storage duration for all units transfused was used to classify patients as receiving older blood using 3 different definitions (≥21 days,≥28 days, and≥35 days)...
October 19, 2016: Urologic Oncology
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