26
|
Mulligan A, Burrage M, Savage M, Black P, Scalia G. Prevalence of Disproportionate RV Filling Pressures to LV Filling Pressures. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Afferi L, Lonati C, Montorsi F, Briganti A, Mari A, Schulz G, Black P, Di Trapani E, Karnes R, Mir M, Rink M, Zamboni S, Antonelli A, Tafuri A, Krajewski W, Xylinas E, Soria F, Teoh JC, Mattei A, Albisinni S, Roghmann F, Alvarez-Maestro M, Shariat S, Moschini M. Selecting the best candidates for cisplatin-based adjuvant chemotherapy after radical cystectomy in patients with pN+ bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
28
|
Wang G, Yuan R, Zhou C, Guo C, Villamil C, Hayes M, Eigl BJ, Black P. Urinary Large Cell Neuroendocrine Carcinoma: A Clinicopathologic Analysis of 22 Cases. Am J Surg Pathol 2021; 45:1399-1408. [PMID: 34074810 PMCID: PMC8428850 DOI: 10.1097/pas.0000000000001740] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the urinary tract is a rare disease. We present a relatively large retrospective cohort of urinary LCNEC, 20 from the urinary bladder, and 2 from the ureter, from a single institution. The patients included 16 men and 6 women with a median age of 74.5 years. Most LCNEC presented at an advanced stage with tumors invading the muscularis propria and beyond (21/22). Eight cases were pure LCNEC, while 14 cases were mixed with other histologic types, including conventional urothelial carcinoma (n=9), carcinoma in situ (n=7), small cell carcinoma (n=6), and urothelial carcinoma with glandular (n=3) features. Most LCNEC expressed neuroendocrine markers synaptophysin (22/22), chromogranin (13/16), CD56 (7/7), TTF1 (8/8), and INSM1 (2/3). They were negative for common urothelial markers including HMWCK (0/3), p40/p63 (0/6), CK20 (0/10), and had variable GATA3 staining (4/8). Ki-67 stained 25% to nearly 100% tumor cell nuclei. Patient survival was associated with cancer stage, and pure LCNEC showed worse survival than mixed LCNEC. Compared with small cell carcinoma at similar stages from a prior study, LCNEC had a worse prognosis only when patients developed metastatic disease. For organ-confined LCNEC, neoadjuvant chemotherapy followed by radical resection is the treatment option to achieve long-term survival.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Carcinoma, Large Cell/chemistry
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/therapy
- Carcinoma, Neuroendocrine/chemistry
- Carcinoma, Neuroendocrine/mortality
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Chemotherapy, Adjuvant
- Cystectomy
- Databases, Factual
- Female
- Humans
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Staging
- Retrospective Studies
- Treatment Outcome
- Ureteral Neoplasms/chemistry
- Ureteral Neoplasms/mortality
- Ureteral Neoplasms/pathology
- Ureteral Neoplasms/therapy
- Urinary Bladder Neoplasms/chemistry
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/therapy
Collapse
|
29
|
Rosiello G, Palumbo C, Deuker M, Stolzenbach LF, Martin T, Tian Z, Gallina A, Montorsi F, Black P, Kassouf W, Shariat SF, Saad F, Briganti A, Karakiewicz PI. Sex- and age-related differences in the distribution of bladder cancer metastases. Jpn J Clin Oncol 2021; 51:976-983. [PMID: 33558890 DOI: 10.1093/jjco/hyaa273] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Our objective was to investigate age- and sex-related differences in the distribution of metastases in patients with metastatic bladder cancer. METHODS Within the National Inpatient Sample database (2008-2015), we identified 7040 patients with metastatic bladder cancer. Trend test and Chi-square test analyses were used to evaluate the relationship between age and site of metastases, according to sex. RESULTS Of 7040 patients with metastatic bladder cancer, 5226 (74.2%) were men and 1814 (25.8%) were women. Thoracic, abdominal, bone and brain metastases were present in 19.5 vs. 23.0%, 43.6 vs. 46.9%, 23.9 vs. 18.7% and 2.4 vs. 2.9% of men vs. women, respectively. Bone was the most common metastatic site in men (23.9%) vs. lung in women (22.4%). Increasing age was associated with decreasing rates of abdominal (from 44.9 to 40.2%) and brain (from 3.2 to 1.4%) metastases in men vs. decreasing rates of bone (from 21.0 to 13.3%) and brain (from 5.1 to 2.0%) metastases in women (all P < 0.05). Finally, rates of metastases in multiple organs also decreased with age, in both men and women. CONCLUSIONS The distribution of metastases in bladder cancer varies according to sex. Moreover, differences exist according to patient age and these differences are also sex-specific. In consequence, patient age and sex should be considered in the interpretation of imaging, especially when findings are indeterminate.
Collapse
|
30
|
Afferi L, Lonati C, Montorsi F, Briganti A, Mari A, Krajewski W, Simone G, Schulz G, Black P, Mir M, Roumiguié M, Teoh J, Soria F, Roupret M, Ribal M, Xylinas E, Zamboni S, Antonelli A, Tafuri A, Albisinni S, Mattei A, Alvarez-Maestro M, Shariat S, Moschini M. Ureteral stenting does not increase the risk of metachronous upper tract urothelial carcinoma in patients with bladder cancer presenting with hydronephrosis in comparison with percutaneous nephrostomy: A multicenter analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
31
|
Minvielle-Moncla T, Emmanuel P, Pericart S, Babjuk M, Black P, Brisuda A, Burger M, Colombel M, Dominguez Escrig J, Eenikev D, Ilaria L, Jensen J, Liatsikos E, Lusuardi L, Mostafid H, Mottet N, Rassler J, Ouzaid I, Teoh J, Ukimura U, Xylinas E, Roumiguie M, Malavaud B. Youtube clips to select low-grade low-stage recurrent Non-Muscle-Invasive Bladder Cancers (NMIBC) for office fulguration, a multinational multi institutional study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
32
|
Matsumoto T, Chen Y, Contreras-Sanz A, Ikeda K, Sano T, Roberts M, Moskalev I, Black P. FBXW7 loss identifies a subgroup of bladder cancer patients with poor prognosis who benefit from neoadjuvant chemotherapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
33
|
Tortora D, Morgan R, Kumar G, Ritch E, McConeghy B, Sinha S, Johnson A, Wong J, Thaper D, Truong S, Nelepcu I, Black P, Daugaard M. Regulation of PPARγ expression in luminal muscle invasive bladder cancer. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Black P. Commentary on MJM Focus (Vol. 1, No. 2): Surgery for Temporal Lobe Epilepsy. Mcgill J Med 2020. [DOI: 10.26443/mjm.v1i2.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
35
|
Oh J, Eigl B, Black P, Sunderland K, Tyldesley S. PO-1205: Small cell carcinoma of the bladder: Retrospective long-term outcomes of chemoradiation. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
Debski M, Howard L, Black P, Goode A, Cassidy C, Seed A. Real world experience with heart failure risk status generated by cardiac resynchronisation therapy defibrillators: high heart failure risk status incidence, causes and timing of remote transmissions. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Proactive patient monitoring is of paramount importance in effective management of heart failure (HF) patients. Cardiac implantable electronic devices (CIEDs) used in HF patients are able to derive long-term trends in physiologic parameters and provide timely warning to clinicians. Little is known, however, on the real-world experience with device-generated HF risk-stratifying algorithms.
Purpose
Heart Failure Risk Score (HFRS) takes into account nine parameters and is calculated automatically based on long-term clinical trends. Remote transmissions provide information on the risk of HF event in next 30 days categorized as low, medium or high based on a maximum daily risk status in prior 30 days. We aimed to evaluate the ability of HFRS to alert HF specialists on the actual HF risk status.
Methods
The prospective registry included all patients with CIEDs featuring integrated Heart Failure Risk Score (HFRS) followed via Medtronic CareLink remote monitoring system and enabled for Co-management (CM) from May 2015 to August 2019 in a tertiary centre. High HFRS does not trigger automatic alert transmission. Study follow-up spanned between start of CM and last transmission in 2019. Inclusion criteria were CRT-D in situ, active Home Monitor, switched on OptiVol 2.0 remote alert and transmission data available on CareLink following study period completion. Transmissions were scheduled 3-monthly.
Results
Out of 229 consecutive patients, 132 met study criteria. Mean age was 74±10 years, 18% were female. Median follow-up duration was 2.7 years (IQR 1.3). Total number of transmissions was 2652, median per patient was 18 (IQR 13); scheduled, unscheduled and care alerts constituted 42%, 44% and 14%, respectively. One third of transmissions were automatically sent for CM review. There were 398 high HFRS episodes. OptiVol fluid index was below the threshold throughout 128 (32%) episodes. Missed episodes (not transmitted within 30 days from the final day of high HFRS) amounted to 130 (33%) and the reasons behind this included OptiVol alerting before the first day of high HFRS or persistently elevated when HFRS changed from low/medium to high (52%), low OptiVol index during the episode (38%) or other (10%). Median duration of high HFRS was 7 days (IQR 12, range, 1–187). Among timely picked-up high HFRS episodes, 38% were transmitted during the relevant episode and 62% afterwards with median delay of 10 days (IQR 15) from the last day of high HFRS; 21% of transmissions showing high HFRS were not highlighted for CM review which correlated with low OptiVol index, P<0.001. The factors contributing to high HFRS included: raised OptiVol (60%), patient activity (83%), AT/AF (46%), ventricular rate (VR) during AF (6%), % of VP (40%), shocks (2%), treated VT/VF (2%), night VR (72%) and HR variability (34%).
Conclusions
In a real-world clinical setting high HFRS was frequently under-reported. The investigation into clinical implications is warranted.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Our department has benefited from unrestricted grants from Boston Scientific and Medtronic Inc during the last 5 years.
Collapse
|
37
|
Rosiello G, Palumbo C, Deuker M, Stolzenbach LF, Martin T, Tian Z, Gallina A, Montorsi F, Black P, Kassouf W, Shariat SF, Saad F, Briganti A, Karakiewicz PI. Racial differences in the distribution of bladder cancer metastases: a population-based analysis. Cent European J Urol 2020; 73:407-415. [PMID: 33552564 PMCID: PMC7848828 DOI: 10.5173/ceju.2020.0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Bladder cancer is the second most common genitourinary malignancy in the United States. The incidence of bladder cancer rises with age, and it is two times more common in Caucasians than in African-Americans (23.1 vs. 12.6 cases/100,000 persons). We aimed to investigate the racial and age-related differences in the distribution of metastasis in a large, contemporary cohort of metastatic bladder cancer patients. MATERIAL AND METHODS Within the National Inpatient Sample database (2008-2015) we identified 5,767 patients with metastatic bladder cancer. Trend test, Chi-square test and multivariable logistic regression models were used to evaluate the relationship between ethnicity, age, and site of metastasis. RESULTS Of 5,767 patients with metastatic bladder cancer, 598 (10.4%) were African-American. Lung was the most common metastatic site in African-Americans (28.6%) vs. bone in Caucasians (21.7%). Overall, African-Americans showed higher rates of lung (+10.2%), liver (+7.5%) and bone (+5.2%) metastases, compared to Caucasians (all p <0.01). Brain metastases were rare in both ethnicities (3.3 vs. 2.4%; p = 0.2). Rates of exclusive bone, lung or liver metastases increased with age, but were higher in African-Americans, regardless of age strata. In the multivariable logistic regression models, African-American ethnicity independently predicted higher risk of lung (Odds ratio: 1.69), liver (odds ratio: 1.50) and bone (odds ratio: 1.27) metastases, relative to Caucasians. Moreover, a dose-response effect was found after combining the three main risk factors for developing bone metastases, namely African-American ethnicity, younger age and male gender. CONCLUSIONS Racial differences exist in the distribution of metastatic bladder cancer metastasis. Moreover, based on higher risk of bone metastases in African-American patients, bone imaging may be warranted in this patient population, especially in the presence of other risk factors for bone metastases, namely male gender or younger age.
Collapse
|
38
|
Soria F, Giordano A, Black P, Fairey A, Cookson M, Yu E, Kassouf W, Dall’Era M, Sridhar S, McGrath J, Wright J, Thorpe A, Morgan T, Daneshmand S, Holzbeierlein J, Bivalacqua T, North S, Barocas D, Lotan Y, Grivas P, Stephenson A, Shah J, van Rhijn B, Spiess P, Shariat S, Gontero P. Neoadjuvant chemotherapy plus radical cystectomy versus radical cystectomy alone in clinical T2 bladder cancer patients without hydronephrosis: results from a large multicenter cohort study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
39
|
Marandino L, de Jong J, Raggi D, Gallina A, Bandini M, Giannatempo P, Colecchia M, Briganti A, Montorsi F, Davicioni E, Seiler R, Black P, Gibb E, Necchi A. Molecular profiling of post-pembrolizumab muscle-invasive bladder cancer reveals unique features that may inspire new sequential therapies in nonresponders. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31120-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Necchi A, de Jong J, Raggi D, Gallina A, Bandini M, Giannatempo P, Marandino L, Colecchia M, Briganti A, Montorsi F, Davicioni E, Seiler R, Black P, Gibb E. 762P Molecular profiling of post-pembrolizumab muscle-invasive bladder cancer (MIBC) reveals unique features that may inspire new sequential therapies in pathologically-nonresponders. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
41
|
Necchi A, Raggi D, Briganti A, Farè E, Giannatempo P, Marandino L, Gallina A, Colecchia M, Lucianò R, Bianchi M, Colombo R, Salonia A, Gandaglia G, Fossati N, Capitanio U, Montorsi F, Boormans J, Liu Y, De Jong J, Dittamore R, Davicioni E, Black P, Gibb E. Impact of molecular subtyping and immune infiltration on response and outcome following neoadjuvant pembrolizumab (pembro), versus neoadjuvant chemotherapy (NAC), in muscle-invasive bladder cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
42
|
Marchioni M, Mir M, Zargar H, Grivas P, Dall’era M, Spiess P, Van Rhijn B, Lotan Y, Bivalacqua T, Holzbeierlein J, Thorpe A, Yu E, Shariat S, Kassouf W, Barocas D, Daneshmand S, Dinney C, Mcgrath J, Sridhar S, Wright J, North S, Stephenson A, Xylinas E, Black P. Nomogram predicting bladder cancer specific mortality after neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: Results of an international consortium. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33692-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
43
|
Williams S, Cumberbatch M, Kamat A, Kerr P, Mcgrath J, Djaladat H, Collins J, Jubber I, Packiam V, Steinberg G, Lee E, Kassouf W, Black P, Cerantola Y, Catto J, Daneshmand S. Reporting radical cystectomy outcomes following implementation of Enhanced Recovery after Surgery (ERAS) protocols: A systematic review and individual patient data meta-analysis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
44
|
Kalia M, Mathur P, Tsang K, Black P, Navab N, Salcudean S. Evaluation of a marker-less, intra-operative, augmented reality guidance system for robot-assisted laparoscopic radical prostatectomy. Int J Comput Assist Radiol Surg 2020; 15:1225-1233. [PMID: 32500450 DOI: 10.1007/s11548-020-02181-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/22/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical robot is a common treatment for organ-confined prostate cancer. Augmented reality (AR) can help during RALRP by showing the surgeon the location of anatomical structures and tumors from preoperative imaging. Previously, we proposed hand-eye and camera intrinsic matrix estimation procedures that can be carried out with conventional instruments within the patient during surgery, take < 3 min to perform, and fit seamlessly in the existing surgical workflow. In this paper, we describe and evaluate a complete AR guidance system for RALRP and quantify its accuracy. METHODS Our AR system requires three transformations: the transrectal ultrasound (TRUS) to da Vinci transformation, the camera intrinsic matrix, and the hand-eye transformation. For evaluation, a 3D-printed cross-wire was visualized in TRUS and stereo endoscope in a water bath. Manually triangulated cross-wire points from stereo images were used as ground truth to evaluate overall TRE between these points and points transformed from TRUS to camera. RESULTS After transforming the ground-truth points from the TRUS to the camera coordinate frame, the mean target registration error (TRE) (SD) was [Formula: see text] mm. The mean TREs (SD) in the x-, y-, and z-directions are [Formula: see text] mm, [Formula: see text] mm, and [Formula: see text] mm, respectively. CONCLUSIONS We describe and evaluate a complete AR guidance system for RALRP which can augment preoperative data to endoscope camera image, after a deformable magnetic resonance image to TRUS registration step. The streamlined procedures with current surgical workflow and low TRE demonstrate the compatibility and readiness of the system for clinical translation. A detailed sensitivity study remains part of future work.
Collapse
|
45
|
Javadi G, Samadi S, Bayat S, Pesteie M, Jafari MH, Sojoudi S, Kesch C, Hurtado A, Chang S, Mousavi P, Black P, Abolmaesumi P. Multiple instance learning combined with label invariant synthetic data for guiding systematic prostate biopsy: a feasibility study. Int J Comput Assist Radiol Surg 2020; 15:1023-1031. [PMID: 32356095 DOI: 10.1007/s11548-020-02168-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Ultrasound imaging is routinely used in prostate biopsy, which involves obtaining prostate tissue samples using a systematic, yet, non-targeted approach. This approach is blinded to individual patient intraprostatic pathology, and unfortunately, has a high rate of false negatives. METHODS In this paper, we propose a deep network for improved detection of prostate cancer in systematic biopsy. We address several challenges associated with training such network: (1) Statistical labels: Since biopsy core's pathology report only represents a statistical distribution of cancer within the core, we use multiple instance learning (MIL) networks to enable learning from ultrasound image regions associated with those data; (2) Limited labels: The number of biopsy cores are limited to at most 12 per patient. As a result, the number of samples available for training a deep network is limited. We alleviate this issue by effectively combining Independent Conditional Variational Auto Encoders (ICVAE) with MIL. We train ICVAE to learn label-invariant features of RF data, which is subsequently used to generate synthetic data for improved training of the MIL network. RESULTS Our in vivo study includes data from 339 prostate biopsy cores of 70 patients. We achieve an area under the curve, sensitivity, specificity, and balanced accuracy of 0.68, 0.77, 0.55 and 0.66, respectively. CONCLUSION The proposed approach is generic and can be applied to several other scenarios where unlabeled data and noisy labels in training samples are present.
Collapse
|
46
|
Mostafid H, Babjuk M, Bochner B, Lerner SP, Witjes F, Palou J, Roupret M, Shariat S, Gontero P, van Rhijn B, Zigeuner R, Sylvester R, Comperat E, Burger M, Malavaud B, Soloway M, Williams S, Black P, Daneshmand S, Steinberg G, Brausi M, Catto J, Kamat AM. Transurethral Resection of Bladder Tumour: The Neglected Procedure in the Technology Race in Bladder Cancer. Eur Urol 2020; 77:669-670. [PMID: 32192815 DOI: 10.1016/j.eururo.2020.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
Transurethral resection of bladder tumour is the initial, most critical step in the management of bladder cancer; as such, this is a call to arms for the urological community to it the due diligence it deserves regarding technology and training.
Collapse
|
47
|
Au S, Keyes M, Black P, Villamil CF, Tavassoli P. Clinical and pathological characteristics of bladder cancer in post brachytherapy patients. Pathol Res Pract 2020; 216:152822. [PMID: 31982182 DOI: 10.1016/j.prp.2020.152822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/16/2019] [Accepted: 01/09/2020] [Indexed: 11/25/2022]
Abstract
The long-term risk of secondary malignancy is a potential late effect of brachytherapy. However, the time interval, anatomic site and histopathology are not well studied. We sought to characterize the bladder cancers that developed following treatment of prostate cancer with brachytherapy. Between 1998 and 2014, 4570 patients were treated with brachytherapy at the BC Cancer Agency. Out of those, 69 patients subsequently developed bladder cancer, some of which could have been radiation induced. Histology slides were reviewed for all cases, and site and pathologic features were recorded. Cases were classified as luminal and basal subtypes based on GATA3 and CK5/6 immunohistochemistry. Bladder neck and trigone were among the common sites of involvement. Pathologic review of cases showed that 68 % were high-grade, 25 % were muscle-invasive, and 20 % showed variant histology, including small cell carcinoma, sarcomatoid carcinoma, squamous cell carcinoma, and adenocarcinoma. A subgroup of cases more likely to be radiation-induced, based on site and time interval, was associated with increased pathologic stage (pT1 or higher) compared to the other cases (70 % vs 34 %, p = 0.01). In conclusion, the majority of bladder cancers following brachytherapy in this cohort were of high grade and low stage at diagnosis, most of them demonstrating luminal immunophenotype. A significant number of variant histologies are seen, each demonstrating a specific immunophenotype.
Collapse
|
48
|
Black P, Savage M, Pincus M, Murdoch D, Raffel C. 816 Diagnostic Accuracy of Myocardial Perfusion Scintigraphy at Predicting Significant Coronary Artery Disease on Invasive Angiography: The Impact of Gender and Body Mass Index. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
49
|
Hasanzadeh A, Black P, Pourmand MR, Pourmand G. Clinical and Bacterial Risk Factors for Development of Post-Prostate Biopsy Infections. UROLOGY JOURNAL 2019; 16:603-608. [PMID: 30882177 DOI: 10.22037/uj.v0i0.4603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To research on clinical and bacterial risk factors and their relationship with post-prostate biopsy infection (PBI). MATERIALS AND METHODS In this prospective cohort study, rectal swabs were collected from 158 men prior to prostate biopsy and cultured selectively for identify ciprofloxacin-resistant (FQ-R) gram-negative bacteria. The patient characteristics, phylogenetic background, sequence typing and pulsed field gel electrophoresis (PFGE) pattern were compared in two groups of FQ-R E. coli rectal and clinical isolates. RESULTS In total, PBI was observed in 20 (12.5%) cases; the most of these subjects were FQ-R-colonized. (17/73 [24%] vs 3/85 [3.5%]; P < 0.001). FQ-R colonization, diabetes, hospitalization and UTI were independent risk factors (95% CI: 1.1-20.1, OR = 4.73; 95% CI: 1.7-25.3, OR = 6.57; 95% CI: 1.9-27.5, OR = 7.22; and 95% CI: 1.2-14.3, OR = 4.05; respectively), that increased the rate of PBI (All P < 0.05). Despite the increase in infections among patients colonized with strains of E. coli ST131, its prevalence was near significance between colonized and infected groups (P = 0.07). The PFGE patterns and antimicrobial susceptibility profiles of rectal and clinical isolates in 13 patients were similar which is remarkably important and informative. CONCLUSIONS The most PBIs originate from FQ-R E. coli rectal colonization. Rectal culture screening and assessment of clinical risk factors can predict the incidence of PBI in patients.
Collapse
|
50
|
Rouprêt M, Malmstrom PU, Black P. Recurrent Ta Low-grade Non-muscle-invasive Bladder Cancer: What Are the Options? Eur Urol Oncol 2019; 2:723-729. [DOI: 10.1016/j.euo.2019.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
|