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Fossati N, Karnes J, Boorjian S, Motterle G, Bossi A, Kumar T, Di Muzio N, Cozzarini C, Noris Chiorda B, Mazzone E, Robesti D, Gandaglia G, Bartkowiak D, Shariat S, Goldner G, Joniau S, Van Poppel H, Berghen C, De Meerleer G, Montorsi F, Wiegel T, Briganti A. The key role of PSA doubling time in patients treated with salvage radiation therapy after radical prostatectomy: Implications for the extent of radiation and the concomitant use of hormonal therapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01554-2] [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]
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmüller B, Shariat S, Nini A, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Identifying the optimal candidates for radiation therapy after salvage lymph node dissection for node-only recurrent prostate cancer after radical prostatectomy: Results from a multi-institutional collaboration. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01563-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Jueneman KP, Grubmuller B, Shariat S, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Definition and impact on oncologic outcomes of persistently elevated PSA after salvage lymph node dissection for node-only recurrent prostate cancer after radical prostatectomy: Clinical Implications for multi-modal therapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schmidinger M, Shariat SF, Fajkovic H. Dual immune checkpoint inhibition in metastatic renal cell carcinoma: Editorial re.: Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced RCC: extended 4-year follow-up of the phase III CheckMate 214 trial. ESMO Open 2021; 6:100035. [PMID: 33421736 PMCID: PMC7808104 DOI: 10.1016/j.esmoop.2020.100035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
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Roumiguie M, Brisuda A, Burger M, Escrig J, Hammerer P, Mccracken S, Mostafid H, Muto G, Redorta J, de Reijke T, Shariat S, Ströck V, Malavaud B. Un patient sur quatre ressent un inconfort significatif lors des cystoscopies de surveillance (TVNIM) dans une étude observationnelle européenne. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.228] [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]
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Mazouin C, Khene Z, Peyronnet B, Gasmi A, Dosin G, Brassier M, Thi Dang V, Ouzaid I, Larcher A, Roumiguié M, Verhoest G, Pradère B, Shariat S, Mathieu R, Bigot P, Doumerc N, Bensalah K. Prédire la morbidité de la néphrectomie partielle : retour à la simplicité. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.096] [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]
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Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy. Urol Oncol 2020; 39:296.e11-296.e19. [PMID: 33046366 DOI: 10.1016/j.urolonc.2020.09.005] [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: 07/22/2020] [Revised: 09/06/2020] [Accepted: 09/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The rapidly changing treatment landscape in metastatic castration-resistant prostate cancer (mCRPC) calls for biomarkers to guide treatment decisions. We recently identified MMP-7 as a potential serum marker for the prediction of response and survival in mCRPC patients who received docetaxel (DOC) chemotherapy. Here, we aimed to test this finding in an independent patient cohort and in addition to explore the prognostic potential of serum MMP-7 in abiraterone (ABI) or enzalutamide (ENZA) treated patients. METHODS AND MATERIALS MMP-7 levels were measured in 836 serum samples from 320 mCRPC patients collected before and during DOC (n = 95), ABI (n = 140), or ENZA (n = 85) treatment by using the ELISA method. Results were correlated with clinical and follow-up data. RESULTS MMP-7 baseline levels were similar between the 3 treatment groups. In the ABI and ENZA cohorts, baseline MMP-7 levels were lower in patients with prior radical prostatectomy (P = 0.058 and P = 0.041, respectively). Baseline MMP-7 levels above the median were associated with shorter overall survival for the DOC (P = 0.001) and ENZA (P = 0.006) cohorts. Multivariable analyses in the DOC and ENZA cohorts revealed that high pretreatment MMP-7 level is an independent risk factor for patients' survival. In addition, in DOC-treated patients with high baseline MMP-7 level, marker decrease at the third DOC cycle was associated with improved survival. Patients with high baseline MMP-7 levels had better survival when treated with ABI compared to DOC or ENZA. CONCLUSIONS We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients.
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Fossati N, Karnes R, Boorjian S, Motterle G, Bossi A, Mazzone E, Cucchiara V, Scuderi S, Zito E, Gandaglia G, Kumar T, Di Muzio N, Cozzarini C, Chiorda B, Bartkowiak D, Shariat S, Goldner G, Devos G, Joniau S, Berghen C, De Meerleer G, Van Poppel H, Montorsi F, Wiegel T, Briganti A. Association between the extent of lymph node dissection and severe toxicity in men with prostate cancer treated with post-prostatectomy radiation therapy: results from a large multi-institutional series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35565-8] [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] Open
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Fossati N, Karnes R, Boorjan S, Motterle G, Bossi A, Kumar T, Di Muzio N, Cozzarini C, Chiorda B, Mazzone E, Bravi C, Stabile A, Gandaglia G, Cucchiara V, Bartkowiak D, Shariat S, Goldner G, Devos G, Joniau S, Berghen C, De Meerleer G, Van Poppel H, Montorsi F, Wiegel T, Briganti A. Cure without toxicity: development of a novel model predicting trifecta outcomes after salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35560-9] [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
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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
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Claps F, Pavan N, Maresma MM, Mazzon G, Rizzo M, Ramirez-Backhaus M, Boltri M, Soria F, Massanova M, D’Andrea D, Traunero F, Marra G, Liguori G, Gontero P, Shariat S, Rubio-Briones J, Celia A, Trombetta C. Impact of preoperative Controlling nutritional status (CONUT) score on perioperative morbidity and survival outcomes in patients with bladder cancer treated with radical cystectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35599-3] [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
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Martini A, Gill I, Mottrie A, Montorsi F, Briganti A. Persistently elevated prostate-specific antigen after salvage lymph node dissection and its impact on long-term oncological outcomes. the importance of an extensive, multi-modal approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35585-3] [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] Open
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Cannoletta D, Gandaglia G, Pfister D, Shariat S, Grubmuller B, Fossati N, Stabile A, Scuderi S, Pellegrino F, Sorce G, Fallara G, Martini A, Cucchiara V, Robesti D, Rizzo A, Scalvi F, Gallina A, Mazzone E, Karakiewicz P, Karnes R, Montorsi F, Briganti A, Heidenreich A. The impact of persistently elevated PSA levels on progression and survival of patients undergoing cytoreductive radical prostatectomy for oligometastatic prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Martini A, Fossati N, Gandaglia G, Bravi C, Motterle G, Karnes R, Schmautz M, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Patterns of clinical recurrences after salvage lymph node dissection for lymph-node recurrent prostate cancer and their impact on oncological outcomes. the importance of patient stratification for tailored post-operative treatments. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35582-8] [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] Open
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Mir MC, Marchioni M, Zargar H, Zargar-Shoshtari K, Fairey AS, Mertens LS, Dinney CP, Krabbe LM, Cookson MS, Jacobsen NE, Griffin J, Montgomery JS, Vasdev N, Yu EY, Xylinas E, McGrath JS, Kassouf W, Dall'Era MA, Sridhar SS, Aning J, Shariat SF, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Grivas P, Stephenson AJ, Shah JB, van Rhijn BW, Spiess PE, Daneshmand D, Black PC. Nomogram Predicting Bladder Cancer-specific Mortality After Neoadjuvant Chemotherapy and Radical Cystectomy for Muscle-invasive Bladder Cancer: Results of an International Consortium. Eur Urol Focus 2020; 7:1347-1354. [PMID: 32771446 DOI: 10.1016/j.euf.2020.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) is associated with improved overall and cancer-specific survival. The post-NAC pathological stage has previously been reported to be a major determinant of outcome. OBJECTIVE To develop a postoperative nomogram for survival based on pathological and clinical parameters from an international consortium. DESIGN, SETTING, AND PARTICIPANTS Between 2000 and 2015, 1866 patients with MIBC were treated at 19 institutions in the USA, Canada, and Europe. Analysis was limited to 640 patients with adequate follow-up who had received three or more cycles of NAC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A nomogram for bladder cancer-specific mortality (BCSM) was developed by multivariable Cox regression analysis. Decision curve analysis was used to assess the model's clinical utility. RESULTS AND LIMITATIONS A total of 640 patients were identified. Downstaging to non-MIBC (ypT1, ypTa, and ypTis) occurred in 271 patients (42 %), and 113 (17 %) achieved a complete response (ypT0N0). The 5-yr BCSM was 47.2 % (95 % confidence interval [CI]: 41.2-52.6 %). On multivariable analysis, covariates with a statistically significant association with BCSM were lymph node metastasis (hazard ratio [HR] 1.90 [95% CI: 1.4-2.6]; p < 0.001), positive surgical margins (HR 2.01 [95 % CI: 1.3-2.9]; p < 0.001), and pathological stage (with ypT0/Tis/Ta/T1 as reference: ypT2 [HR 2.77 {95 % CI: 1.7-4.6}; p < 0.001] and ypT3-4 [HR 5.9 {95 % CI: 3.8-9.3}; p < 0.001]). The area under the curve of the model predicting 5-yr BCSM after cross validation with 300 bootstraps was 75.4 % (95 % CI: 68.1-82.6 %). Decision curve analyses showed a modest net benefit for the use of the BCSM nomogram in the current cohort compared with the use of American Joint Committee on Cancer staging alone. Limitations include the retrospective study design and the lack of central pathology. CONCLUSIONS We have developed and internally validated a nomogram predicting BCSM after NAC and radical cystectomy for MIBC. The nomogram will be useful for patient counseling and in the identification of patients at high risk for BCSM suitable for enrollment in clinical trials of adjuvant therapy. PATIENT SUMMARY In this report, we looked at the outcomes of patients with muscle-invasive bladder cancer in a large multi-institutional population. We found that we can accurately predict death after radical surgical treatment in patients treated with chemotherapy before surgery. We conclude that the pathological report provides key factors for determining survival probability.
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Bravi C, Fossati N, Motterle G, Karnes R, Schmautz M, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Patterns of clinical recurrences after salvage lymph node dissection for lymph-node recurrent prostate cancer and their impact on oncological outcomes. The importance of patient stratification for tailored post-operative treatments. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33534-5] [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
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Bravi C, Fossati N, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Persistently elevated prostate-specific antigen after salvage lymph node dissection and its impact on long-term oncological outcomes. The importance of an extensive, multi-modal approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33533-3] [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
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Bravi C, Fossati N, Karnes R, Motterle G, Schmautz M, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann KP, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. What is the optimal surgical template for salvage pelvic lymph node dissection in patients with pelvic lymph-node recurrent prostate cancer? Results from a large, multi-institutional series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33396-6] [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
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Fossati N, Karnes R, Boorjian S, Motterle G, Bossi A, Kumar T, Di Muzio N, Cozzarini C, Noris Chiorda B, Mazzone E, Gandaglia G, Barletta F, Rizzo A, Cannoletta D, Bartkowiak D, Shariat S, Goldner G, Devos G, Joniau S, Berghen C, De Meerleer G, Van Poppel H, Montorsi F, Wiegel T, Briganti A. Assessing the optimal timing of salvage radiation therapy administration after radical prostatectomy: A stage-specific analysis from a large multi-institutional series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33291-2] [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
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Heidenreich A, Shariat S, Fahad Q, Karnes J, Pfister D. Radical Salvage Prostatectomy (RSP) for Radiorecurrent Prostate Cancer (rPCA): Onological and functional outcome of a large contemporary series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33525-4] [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] Open
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Bruchbacher A, Ilijazi D, Hassler M, Müllauer L, Haitel A, Baltzer P, Ertl I, Gust K, Lemberger U, Shariat S. DNA damage repair gene alteration status as a predictive marker for response to neoadjuvant chemotherapy in muscle invasive bladder cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33142-6] [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] Open
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Polanec SH, Bickel H, Wengert GJ, Arnoldner M, Clauser P, Susani M, Shariat SF, Pinker K, Helbich TH, Baltzer PAT. Can the addition of clinical information improve the accuracy of PI-RADS version 2 for the diagnosis of clinically significant prostate cancer in positive MRI? Clin Radiol 2019; 75:157.e1-157.e7. [PMID: 31690449 DOI: 10.1016/j.crad.2019.09.139] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/27/2019] [Indexed: 02/04/2023]
Abstract
AIM To report prostate cancer (PCa) prevalence in Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) categories and investigate the potential to avoid unnecessary, magnetic resonance imaging (MRI)-guided in-bore biopsies by adding clinical and biochemical patient characteristics. MATERIALS AND METHODS The present institutional review board-approved, prospective study on 137 consecutive men with 178 suspicious lesions on 3 T MRI was performed. Routine data collected for each patient included patient characteristics (age, prostate volume), clinical background information (prostate-specific antigen [PSA] levels, PSA density), and PI-RADS v2 scores assigned in a double-reading approach. RESULTS Histopathological evaluation revealed a total of 93/178 PCa (52.2%). The mean age was 66.3 years and PSA density was 0.24 ng/ml2 (range, 0.04-0.89 ng/ml). Clinically significant PCa (csPCa, Gleason score >6) was confirmed in 50/93 (53.8%) lesions and was significantly associated with higher PI-RADS v2 scores (p=0.0044). On logistic regression analyses, age, PSA density, and PI-RADS v2 scores contributed independently to the diagnosis of csPCa (p=7.9×10-7, p=0.097, and p=0.024, respectively). The resulting area under the receiver operating characteristic curve (AUC) to predict csPCa was 0.76 for PI-RADS v2, 0.59 for age, and 0.67 for PSA density. The combined regression model yielded an AUC of 0.84 for the diagnosis of csPCa and was significantly superior to each single parameter (p≤0.0009, respectively). Unnecessary biopsies could have been avoided in 50% (64/128) while only 4% (2/50) of csPCa lesions would have been missed. CONCLUSIONS Adding age and PSA density to PI-RADS v2 scores improves the diagnostic accuracy for csPCa. A combination of these variables with PI-RADS v2 can help to avoid unnecessary in-bore biopsies while still detecting the majority of csPCa.
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Horwich A, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Van Der Kwast T, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, DeBlok W, De Visschere PJL, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Carmen Mir M, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, Oyen WJG, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Vahr Lauridsen S, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Vives Rivera FA, Wiegel T, Wiklund P, Williams A, Zigeuner R, Witjes JA. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees†. Ann Oncol 2019; 30:1697-1727. [PMID: 31740927 PMCID: PMC7360152 DOI: 10.1093/annonc/mdz296] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING Online Delphi survey and consensus conference. PARTICIPANTS The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.
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Ferro M, Di Lorenzo G, Vartolomei MD, Bruzzese D, Cantiello F, Lucarelli G, Musi G, Di Stasi S, Hurle R, Guazzoni G, Busetto GM, Gabriele A, Del Giudice F, Damiano R, Perri F, Perdona S, Verze P, Borghesi M, Schiavina R, Almeida GL, Bove P, Lima E, Autorino R, Crisan N, Farhan ARA, Battaglia M, Russo GI, Ieluzzi V, Morgia G, De Placido P, Terracciano D, Cimmino A, Scafuri L, Mirone V, De Cobelli O, Shariat S, Sonpavde G, Buonerba C. Absolute basophil count is associated with time to recurrence in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral resection of the bladder tumor. World J Urol 2019; 38:143-150. [PMID: 30993426 DOI: 10.1007/s00345-019-02754-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/01/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Basophils, eosinophils and monocytes may be involved in BCG-induced immune responses and be associated with outcomes of bladder cancer patients receiving intravesical BCG. Our objective was to explore the association of baseline counts of basophils, eosinophils and monocytes with outcomes of patients with high-grade T1 bladder cancer receiving a standard course of intravesical BCG. METHODS We retrospectively reviewed medical records of patients with primary T1 HG/G3 bladder cancer. After re-TURBT, patients were treated with a 6-week course of intravesical BCG induction followed by intravesical BCG every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months from initiation of therapy The analysis of potential risk factors for recurrence, muscle invasion and cancer-specific and overall survival was performed using univariable Cox regression models. Those factors that presented, at univariate analysis, an association with the event at a liberal p < 0.1, have been selected for the development of a multivariable model. RESULTS A total of 1045 patients with primary T1 HG/G3 were included. A total of 678 (64.9%) recurrences, 303 (29.0%) progressions and 150 (14.3%) deaths were observed during follow-up. Multivariate analysis showed that logarithmic transformation of basophils count was associated with a 30% increment in the hazard of recurrence per unit increase of logarithmic basophils count (HR 1.30; 95% confidence interval 1.09-1.54; p = 0.0026). Basophil count modeled by quartiles was also significantly associated with time to recurrence [second vs. lower quartile HR 1.42 (1.12-1.79); p = 0.003, third vs. lower quartile HR 1.26 (1.01-1.57); p = 0.041; upper vs. lower quartile HR 1.36 (1.1-1.68); p = 0.005]. The limitations of a retrospective study are applicable. CONCLUSION Baseline basophil count may predict recurrence in BCG-treated HG/G3 T1 bladder cancer patients. External validation is warranted.
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Necchi A, Raggi D, Gust K, D’Andrea D, Briganti A, Capitanio U, Colecchia M, Chung J, Ali S, Ross J, Montorsi F, Shariat S. PURE-02: An open label, multicenter, single-arm, phase 2 study of neoadjuvant pembrolizumab (Pembro), preceding radical nephroureterectomy (RNU), for patients with localized high-risk urothelial carcinoma of the upper urinary tract (UTUC). ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)31329-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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76
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Anract J, Ouzaid I, Gontero P, Wetterlein M, Necchi A, Seiler R, Roghmann F, Gontero P, Cumberbatch M, Dobruch J, Mertens L, Seisen T, Pycha A, Poyet C, Noon A, Van Rhijn B, Roupret M, Shariat S, Rink M, Xylinas E. L’impact de l’intoxication tabagique sur la réponse à la chimiothérapie néoadjuvante à base de sels de platine chez les patients traités pour carcinome urothélial de vessie – étude prospective multicentrique. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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77
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Soria F, Pisano F, Gontero P, Palou J, Joniau S, Serretta V, Larré S, Di Stasi S, van Rhijn B, Witjes JA, Grotenhuis A, Colombo R, Briganti A, Babjuk M, Soukup V, Malmstrom PU, Irani J, Malats N, Baniel J, Mano R, Cai T, Cha E, Ardelt P, Varkarakis J, Bartoletti R, Dalbagni G, Shariat SF, Xylinas E, Karnes RJ, Sylvester R. Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy. World J Urol 2018; 36:1775-1781. [PMID: 30171454 DOI: 10.1007/s00345-018-2450-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p < 0.001), as did patients with CIS at cystectomy (HR = 2.39, p < 0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) CONCLUSIONS: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery.
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Leisser A, Nejabat M, Hartenbach M, Duan H, Shariat SF, Kramer G, Krainer M, Hacker M, Haug AR. Hematopoiesis is prognostic for toxicity and survival of 223Radium treatment in patients with metastatic castration-resistant prostate cancer. HELLENIC JOURNAL OF NUCLEAR MEDICINE 2017; 20 Suppl:157. [PMID: 29324927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE We evaluated the impact of pre-therapeutic hematopoiesis on survival, hematotoxicity (HT) and number of 223Radium (223Ra) treatments in patients with metastatic castration-resistant prostate cancer. SUBJECTS AND METHOD Hemoglobin-levels (Hb), the number of platelets (Plts), leukocytes (Leuk), and survival data were collected in 56 patients treated with 223Ra. Pre-therapeutic hematopoiesis as well as adverse events during and after therapy were scored (grade 0-4) according to the CTCAE recommendations. The association of pre-therapeutic hematopoiesis, survival, HT and numbers of 223Ra cycles was analyzed. RESULTS Median survival in all patients was 69.9 weeks; 77% of patients had pre-existing impaired Hb (1.7% grade 3, 12.5% grade 2, 62.5% grade 1). 8/56 (14.3%) had impaired Plt (grade 1) Maximum toxicity (Tox) grades of patients during treatment were grade 4 (Hb 1.7%; Plt 1.7%), grade 3 (Hb 14.3%; Plt 7.1%; Leu 7.1%), grade 2 (Hb 33.9%; Plt 7.1%; Leu 23.2%), grade 1 (Hb 46.4%; Plt 17.9%; Leu 23.2%) and grade 0 (Hb 5.4%; Plt 66.1%; Leu 44.6%). Interestingly, patients with thrombocytopenia had a significantly shorter survival compared to those with normal Plt levels (21 weeks vs not reached; P<0.003). As expected patients with pre-therapeutic low Hb-level (<10g/dL) had a significantly shorter survival compared to those with Hb-level >10g/dL (28 weeks vs not reached, P<0.004), whereas survival of patients with mildly impaired Hb (>10 but <13.5g/dL) did not differ from patients with normal levels of Hb (X vs. Y, P=...). Also patients with impaired Hb also developed significantly more grade 3 and 4 HT (Hb <10g/dL: 42.9 vs 14.3%, P<0.001; Plt <150G/mL: 25.0% vs 6.3%; P=0.002) and received significantly fewer treatment cycles (Hb<10g/dL: 5.1 vs 5.8, P<0.04; Plt <150G/mL: 3.4 vs 5.6; P<0.001). Neither extent of bone metastases nor previous chemotherapy were associated with survival, number of 223Ra cycles and HT. CONCLUSION Patients with metastatic castration-resistant prostate cancer and impaired hematopoiesis, in particular thrombocytopenia and anemia, before 223Ra therapy suffer from significantly more high-grade HT, shorter survival and receive significantly fewer 223Ra treatments. Therefore, Hb-levels and platelet counts are essential parameters for adequate patient selection for 223Ra therapy.
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Mathieu R, Moschini M, Beyer B, Gust KM, Seisen T, Briganti A, Karakiewicz P, Seitz C, Salomon L, de la Taille A, Rouprêt M, Graefen M, Shariat SF. Prognostic value of the new Grade Groups in Prostate Cancer: a multi-institutional European validation study. Prostate Cancer Prostatic Dis 2017; 20:197-202. [DOI: 10.1038/pcan.2016.66] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/29/2016] [Accepted: 10/24/2016] [Indexed: 11/09/2022]
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80
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Anract J, Barry Delongchamps N, Gontero P, Dobruch J, Necchi A, Seisen T, Rouprêt M, Shariat S, Aziz A, Rink M, Xylinas E. L’impact de l’intoxication tabagique sur l’agressivité tumorale au moment de la cystectomie totale. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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81
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Aziz A, Bes P, Masson-lecomte A, Barry-delongchamps N, Rouprêt M, Shariat S, Qvick B, Xylinas E. Discordance entre les recommandations et la pratique quotidienne dans la prise en charge des tumeurs de vessie n’infiltrant pas le muscle. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.076] [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]
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82
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Wirth GJ, Haitel A, Moschini M, Soria F, Klatte T, Hassler MR, Bensalah K, Briganti A, Karam JA, Lotan Y, Margulis V, Raman JD, Remzi M, Rioux-Leclercq N, Robinson BD, Rouprêt M, Wood CG, Shariat SF. Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract. World J Urol 2016; 35:943-949. [PMID: 27730305 DOI: 10.1007/s00345-016-1946-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/27/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC). METHODS AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). RESULTS Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS. CONCLUSIONS In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.
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Pouessel D, Neuzillet Y, Mertens LS, van der Heijden MS, de Jong J, Sanders J, Peters D, Leroy K, Manceau A, Maille P, Soyeux P, Moktefi A, Semprez F, Vordos D, de la Taille A, Hurst CD, Tomlinson DC, Harnden P, Bostrom PJ, Mirtti T, Horenblas S, Loriot Y, Houédé N, Chevreau C, Beuzeboc P, Shariat SF, Sagalowsky AI, Ashfaq R, Burger M, Jewett MAS, Zlotta AR, Broeks A, Bapat B, Knowles MA, Lotan Y, van der Kwast TH, Culine S, Allory Y, van Rhijn BWG. Tumor heterogeneity of fibroblast growth factor receptor 3 (FGFR3) mutations in invasive bladder cancer: implications for perioperative anti-FGFR3 treatment. Ann Oncol 2016; 27:1311-6. [PMID: 27091807 DOI: 10.1093/annonc/mdw170] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/06/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Fibroblast growth factor receptor 3 (FGFR3) is an actionable target in bladder cancer. Preclinical studies show that anti-FGFR3 treatment slows down tumor growth, suggesting that this tyrosine kinase receptor is a candidate for personalized bladder cancer treatment, particularly in patients with mutated FGFR3. We addressed tumor heterogeneity in a large multicenter, multi-laboratory study, as this may have significant impact on therapeutic response. PATIENTS AND METHODS We evaluated possible FGFR3 heterogeneity by the PCR-SNaPshot method in the superficial and deep compartments of tumors obtained by transurethral resection (TUR, n = 61) and in radical cystectomy (RC, n = 614) specimens and corresponding cancer-positive lymph nodes (LN+, n = 201). RESULTS We found FGFR3 mutations in 13/34 (38%) T1 and 8/27 (30%) ≥T2-TUR samples, with 100% concordance between superficial and deeper parts in T1-TUR samples. Of eight FGFR3 mutant ≥T2-TUR samples, only 4 (50%) displayed the mutation in the deeper part. We found 67/614 (11%) FGFR3 mutations in RC specimens. FGFR3 mutation was associated with pN0 (P < 0.001) at RC. In 10/201 (5%) LN+, an FGFR3 mutation was found, all concordant with the corresponding RC specimen. In the remaining 191 cases, RC and LN+ were both wild type. CONCLUSIONS FGFR3 mutation status seems promising to guide decision-making on adjuvant anti-FGFR3 therapy as it appeared homogeneous in RC and LN+. Based on the results of TUR, the deep part of the tumor needs to be assessed if neoadjuvant anti-FGFR3 treatment is considered. We conclude that studies on the heterogeneity of actionable molecular targets should precede clinical trials with these drugs in the perioperative setting.
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Fossati N, Karnes J, Morlacco A, Moschini M, Boorjian S, Seisen T, Bossi A, Cozzarini C, Fiorino C, Noris Chiorda B, Gandaglia G, Tosco L, De Ridder D, Joniau S, Goldner G, Shariat S, Hinkelbein W, Haustermans K, Tombal B, Montorsi F, Van Poppel H, Wiegel T, Briganti A. 544 Long-term impact of adjuvant versus early salvage radiation therapy on clinical recurrence in pT3N0 prostate cancer patients treated with radical prostatectomy: Results of a multi-institutional analysis. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60546-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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85
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Gandaglia G, Lista G, Fossati N, Suardi N, Gallina A, Moschini M, Bianchi L, Rossi MS, Schiavina R, Shariat SF, Salonia A, Montorsi F, Briganti A. Non-surgically related causes of erectile dysfunction after bilateral nerve-sparing radical prostatectomy. Prostate Cancer Prostatic Dis 2016; 19:185-90. [DOI: 10.1038/pcan.2016.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 11/11/2015] [Accepted: 12/08/2015] [Indexed: 11/09/2022]
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Sevcenco S, Mathieu R, Baltzer P, Klatte T, Fajkovic H, Seitz C, Karakiewicz PI, Rouprêt M, Rink M, Kluth L, Trinh QD, Loidl W, Briganti A, Scherr DS, Shariat SF. The prognostic role of preoperative serum C-reactive protein in predicting the biochemical recurrence in patients treated with radical prostatectomy. Prostate Cancer Prostatic Dis 2016; 19:163-7. [PMID: 26810014 DOI: 10.1038/pcan.2015.60] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/11/2015] [Accepted: 10/07/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND To assess the prognostic value of preoperative C-reactive protein (CRP) serum levels for prognostication of biochemical recurrence (BCR) after radical prostatectomy (RP) in a large multi-institutional cohort. METHODS Data from 7205 patients treated with RP at five institutions for clinically localized prostate cancer (PCa) were retrospectively analyzed. Preoperative serum levels of CRP within 24 h before surgery were evaluated. A CRP level ⩾0.5 mg dl(-1) was considered elevated. Associations of elevated CRP with BCR were evaluated using univariable and multivariable Cox proportional hazards regression models. Harrel's C-index was used to assess prognostic accuracy (PA). RESULTS Patients with higher Gleason score on biopsy and RP, extracapsular extension, seminal vesicle invasion, lymph node metastasis, and positive surgical margins status had a significantly elevated preoperative CRP compared to those without these features. Patients with elevated CRP had a lower 5-year BCR survival proportion as compared to those with normal CRP (55% vs 76%, respectively, P<0.0001). In pre- and postoperative multivariable models that adjusted for standard clinical and pathologic features, elevated CRP was independently associated with BCR (P<0.001). However, the addition of preoperative CRP did not improve the accuracy of the standard pre- and postoperative models for prediction of BCR (70.9% vs 71% and 78.9% vs 78.7%, respectively). CONCLUSIONS Preoperative CRP is elevated in patients with pathological features of aggressive PCa and BCR after RP. While CRP has independent prognostic value, it does not add prognostically or clinically significant information to standard predictors of outcomes.
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Moschini M, Fossati N, Abdollah F, Gandaglia G, Cucchiara V, Dell'Oglio P, Luzzago S, Shariat SF, Dehò F, Salonia A, Montorsi F, Briganti A. Determinants of long-term survival of patients with locally advanced prostate cancer: the role of extensive pelvic lymph node dissection. Prostate Cancer Prostatic Dis 2015; 19:63-7. [DOI: 10.1038/pcan.2015.51] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/29/2015] [Accepted: 09/18/2015] [Indexed: 11/09/2022]
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88
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Mathieu R, Mbeutcha A, Lucca I, Briganti A, Karakiewicz P, Rouprêt M, Seitz C, Klatte T, Shariat S. [Not Available]. Prog Urol 2015; 25:740. [PMID: 26544245 DOI: 10.1016/j.purol.2015.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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89
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Mathieu R, Lucca I, Mbeutcha A, Seitz C, Karakiewicz P, Sun M, Montorsi F, Briganti A, Rouprêt M, Robinson B, Xylinas E, Shariat S. [Not Available]. Prog Urol 2015; 25:741-2. [PMID: 26544248 DOI: 10.1016/j.purol.2015.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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90
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Fiorino C, Broggi S, Fossati N, Cozzarini C, Goldner G, Wiegel T, Hinkelbein W, Karnes J, Haustermans K, Joniau S, Shariat S, Montorsi F, Van Poppel H, Di Muzio N, Calandrino R, Briganti A. Predicting Clinical Outcome Following Post Prostatectomy Radiation Therapy: A Poisson-Based Tumor Control Probability (TCP) Model Based on a Large Multi-institutional Series. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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91
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Seisen T, Granger B, Colin P, Léon P, Utard G, Renard Penna R, Compérat E, Mozer P, Cussenot O, Shariat S, Rouprêt M. Revue systématique de la littérature et méta-analyse des facteurs de risque de récidive vésicale après néphro-uréterectomie totale pour le traitement d’une tumeur de la voie excrétrice urinaire supérieure. Prog Urol 2015; 25:805. [DOI: 10.1016/j.purol.2015.08.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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92
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Nison L, Colin P, Remzi M, Shariat S, Klatte T, Yakoubi R, Bozzini G, Capitanio U, Babjuk M, Merseburger A, Cha E, Fritsche H, Novara G, Montorsi F, Hora M, Roupret M. Résultats oncologiques du traitement des TVES≤pT2 de l’uretère pelvien par néphro-urétérectomie, résection segmentaire et chirurgie endoscopique : résultats d’une étude multicentrique européenne. Prog Urol 2015; 25:807. [DOI: 10.1016/j.purol.2015.08.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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93
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Mbeutcha A, Lucca I, De martino M, Mathieu R, Rieken M, Xylinas E, Kluth L, Crivelli J, Lotan Y, Shariat S, Klatte T, Karakiewicz P. Le rapport neutrophiles/lymphocytes est un facteur prédictif indépendant de récidive et de progression dans les tumeurs de vessie non infiltrantes. Prog Urol 2015; 25:759-60. [DOI: 10.1016/j.purol.2015.08.090] [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]
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Neuzillet Y, Mertens L, Shariat S, Bostrom P, Mirtti T, Sagalowsky A, Ashfaq R, Broeks A, Van der Heijden M, Peters D, Curial C, De Jong J, Horenblas S, Hurst C, Tomlinson D, Knowles M, Bapat B, Jewett M, Zlotta A, Sanders J, Lotan Y, Van der Kwast T, Van Rhijn B. [Not Available]. Prog Urol 2015; 24:806-7. [PMID: 26461579 DOI: 10.1016/j.purol.2014.08.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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95
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Soave A, Engel O, Von Amsberg G, Becker A, Dahlem R, Shariat SF, Fisch M, Rink M. Management of advanced bladder cancer in the era of targeted therapies. MINERVA UROL NEFROL 2015; 67:103-115. [PMID: 25604695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Systemic chemotherapy is the standard treatment of advanced and metastatic urothelial carcinoma of the bladder (UCB). Unfortunately, systemic chemotherapy is ineffective in a significant number of patients, while side effects occur frequently. Detailed molecular-genetic investigations revealed a broad heterogeneity of underlying genomic mutations in UCB and led to the detection of cancer-specific therapeutic targets. These findings may allow a more tailored and individualized patient-based therapy, focusing on specific genomic variations, which may cause chemo-resistance in patients progressing or relapsing after standard chemotherapy. Targeted therapies hold the potential to be more effective in inhibiting cancer cell growth and progression, as well as to cause fewer side effects. While targeted therapies have been successfully established in the treatment of various malignancies including renal cell carcinoma, the clinical impact of these modern treatment strategies still remains unsettled for UCB. In this review, we comprehensively summarize the most current and relevant findings on targeted therapy in advanced and metastatic UCB, elucidating chances and limitations and discussing future perspectives.
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Pisano F, Witjes J, Dalbagni G, Shariat S, Joniau S, Serretta V, Palou J, Di Stasi S, Larré S, Colombo R, Babjuk M, Malmstrom P, Irani J, Malats N, Baniel J, Cai T, Cha E, Ardelt P, Varkarakis J, Bartoletti R, Spahn M, Pisano F, Gontero P, Sylvester R. 948 The impact of different BCG strains on outcome in a large cohort of T1G3 patients treated with BCG. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60936-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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97
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Seisen T, Colin P, Hupertan V, Léon P, Bozzini G, Nison L, Phé V, Rozet F, Shariat S, Cussenot O, Rouprêt M. Validation externe du nomogramme prédictif de la récidive vésicale après néphro-urétérectomie totale pour le traitement des tumeurs de la voie excrétrice urinaire supérieure. Prog Urol 2014; 24:845-6. [DOI: 10.1016/j.purol.2014.08.139] [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]
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98
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Xylinas E, Rieken M, Shariat S. Comparaison des tables de l’EORTC et de la nouvelle classification simplifiée EAU pour la prédiction de la récidive tumorale et de la progression des TVNIM. Prog Urol 2014; 24:846-7. [DOI: 10.1016/j.purol.2014.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Xylinas E, Rink M, Rouprêt M, Shariat S. Impact de la consommation tabagique sur la récidive vésicale après néphro-urétérectomie totale pour tumeur de la voie excrétrice supérieure. Prog Urol 2014; 24:845. [DOI: 10.1016/j.purol.2014.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schiffmann J, Gandaglia G, Larcher A, Sun M, Tian Z, Shariat SF, McCormack M, Valiquette L, Montorsi F, Graefen M, Saad F, Karakiewicz PI. Contemporary 90-day mortality rates after radical cystectomy in the elderly. Eur J Surg Oncol 2014; 40:1738-45. [PMID: 25454826 DOI: 10.1016/j.ejso.2014.10.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 09/28/2014] [Accepted: 10/06/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Existing radical cystectomy (RC) perioperative mortality estimates may underestimate the contemporary rates due to more advanced age, more baseline comorbidities and potentially broader inclusion criteria for RC, relative to past criteria. METHODS Within the most recent Surveillance, Epidemiology, and End Results (SEER)-Medicare database we identified clinically non-metastatic, muscle-invasive (T2-T4a) urothelial carcinoma of the urinary bladder (UCUB) patients, who underwent RC between 1991 and 2009. Mortality at 30- and 90-day after RC was quantified. Multivariable logistic regression analyses tested predictors of 90-day mortality. RESULTS Within 5207 assessable RC patients 30- and 90-day mortality rates were 5.2 and 10.6%, respectively. According to age 65-69, 70-79 and ≥ 80 years, 90-day mortality rates were 6.4, 10.1 and 14.8% (p < 0.001). Additionally, 90-day mortality rates increased with increasing Charlson Comorbidity Index (CCI, 0, 1, 2 and ≥ 3): 6.3, 10.3, 12.6 and 15.9% (p < 0.001). 90-day mortality rate in unmarried patients was 13.0 vs. 9.3% in married individuals (p < 0.001). In multivariable logistic regression analyses, advanced age, higher CCI, low socioeconomic status, unmarried status and non organ-confined stage were independent predictors of 90-day mortality (all p < 0.05). CONCLUSIONS The contemporary SEER-Medicare derived 90-day mortality rates are substantially higher than previously reported estimates from centers of excellence, and even exceed previous SEER reports. More advanced age, higher CCI score, and other patient characteristics that distinguish the current population from others account for these differences.
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