401
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Kutikov A, Long CJ, Egleston BL, Uzzo RG. PERCUTANEOUS VERSUS SURGICAL CRYOABLATION OF THE SMALL RENAL MASS (SRM): IS EFFICACY COMPROMISED? J Urol 2009. [DOI: 10.1016/s0022-5347(09)60784-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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402
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Mayer WA, Resnick MJ, Canter D, Ramchandani P, Kutikov A, Harryhill JF, Carpiniello VL, Guzzo TJ. Synchronous metastatic renal cell carcinoma to the genitourinary tract: two rare case reports and a review of the literature. Can J Urol 2009; 16:4611-4614. [PMID: 19364439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Synchronous metastasis of renal cell carcinoma (RCC) to the ureter or the bladder represents an extremely rare event. We report one case of synchronous metastasis of RCC to the ipsilateral ureter and one case of solitary synchronous metastasis of RCC to the urinary bladder. We review the literature and discuss possible mechanisms of dissemination. We discuss the surgical management of metastases from RCC as well as the surgical options in the treatment of these rare occurrences.
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Affiliation(s)
- W A Mayer
- Division of Urology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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403
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Kutikov A, Caputo PA, Uzzo RG. THE FOX CHASE R.E.N.A.L. NEPHROMETRY SCORE (R.E.N.A.L.-NS): A COMPREHESIVE STANDARDIZED SCORING SYSTEM FOR ASSESSING RENAL TUMOR SIZE, LOCATION, AND DEPTH. J Urol 2009. [DOI: 10.1016/s0022-5347(09)61005-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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404
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Kutikov A, Egleston BL, Morrison T, Henske EP, Huang M, Al-Saleem T, Uzzo RG. MTOR PATHWAY ACTIVATION IN PRIMARY RENAL CELL CARCINOMA (RCC) AND MATCHED METASTASES. J Urol 2009. [DOI: 10.1016/s0022-5347(09)61413-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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405
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Kutikov A, Stitzenberg KB, Uzzo RG. PATIENTS WITH MEDICARE AS THE PRIMARY PAYER ARE LESS LIKELY TO UNDERGO NEPHRON SPARING SURGERY (NSS) FOR RENAL CELL CARCINOMA (RCC) THAN THEIR PRIVATELY INSURED COUNTERPARTS. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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406
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Kutikov A, Casale P, White MA, Meyer WA, Chang A, Gosalbez R, Canning DA. Testicular Compartment Syndrome: A New Approach to Conceptualizing and Managing Testicular Torsion. Urology 2008; 72:786-9. [DOI: 10.1016/j.urology.2008.03.031] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2007] [Revised: 03/14/2008] [Accepted: 03/21/2008] [Indexed: 11/29/2022]
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407
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Kutikov A, VanArsdalen KN, Gershman B, Fossett LK, Guzzo TJ, Wein AJ, Malkowicz SB. Enucleation of renal cell carcinoma with ablation of the tumour base. BJU Int 2008; 102:688-91. [DOI: 10.1111/j.1464-410x.2008.07661.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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408
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Guzzo TJ, Kutikov A, Canter DJ, Tomaszewski JE, Magerfleish L, VanArsdalen K, Wein AJ, Malkowicz SB. The clinical and pathological history of prostate cancer progression in men with a prior history of high grade prostatic intraepithelial neoplasia. Can J Urol 2008; 15:4174-4179. [PMID: 18706146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES The natural history of high grade prostatic intraepithelial neoplasia (HGPIN) is incompletely understood limiting evidence based recommendations regarding screening and repeat biopsy intervals. Our objective was to evaluate the natural history of HGPIN to better assess the time frame to disease progression and the pathological findings at the time of progression to cancer. METHODS AND MATERIALS We retrospectively reviewed 74 consecutive patients with an initial diagnosis of HGPIN. The number and timing of all biopsies leading to the diagnosis of cancer were assessed. Clinical and pathological features of those patients with eventual disease progression were evaluated. RESULTS The mean number of biopsies performed before subsequent cancer diagnosis was 5 (range: 3-13). The mean time to the diagnosis of cancer was 29 months (range: 7-83). Men with a history of HGPIN had lower percent positive biopsies at the time of cancer diagnosis (p < 0.001) and smaller volume tumors on final pathology (p = 0.041) compared to men without a history of HGPIN. CONCLUSIONS Patients with an initial diagnosis of HGPIN on transrectal ultrasound (TRUS) guided biopsy progressed to cancer at a mean of 29 months. The vast majority of patients that progressed to prostate cancer had low volume disease at the time of diagnosis and definitive treatment. Our data indicate the importance of re-evaluation in HGPIN patients and suggest a trend toward low volume disease in carefully followed patients. Prospective data is warranted to adequately define an evidence based biopsy regimen in men with HGPIN.
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Affiliation(s)
- Thomas J Guzzo
- The James Buchanan Brady Urologic Institute, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
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409
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Mucksavage P, Mitchell CR, Kutikov A, Wein AJ, Torigian DA, Malkowicz SB. ANTHROPOMORPHIC DIFFERENCES IN OBESE MEN WITH BIOCHEMICAL FAILURE AFTER RADICAL RETROPUBIC PROSTATECTOMY. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60197-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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410
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Kutikov A, Van Arsdalen KN, Levin BM, Ferlise VJ, Howard PC, Carpenter JP, Ramchandani P. Communication between the ureter and an aortic aneurysm sac after an abdominal aortic aneurysm repair. Urology 2008; 71:351.e7-8. [PMID: 18308122 DOI: 10.1016/j.urology.2007.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Revised: 09/03/2007] [Accepted: 10/19/2007] [Indexed: 10/22/2022]
Abstract
Fistulae between the vasculature and the ureter are rare. We describe a communication between the ureter and the sac of an aortic aneurysm following abdominal aortic aneurysm repair.
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Affiliation(s)
- Alexander Kutikov
- Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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411
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Kutikov A, Nguyen M, Guzzo T, Canter D, Casale P. Laparoscopic and robotic complex upper-tract reconstruction in children with a duplex collecting system. J Endourol 2007; 21:621-4. [PMID: 17638558 DOI: 10.1089/end.2006.0227] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE We suggest that when surgical correction is considered to treat a duplicated collecting system with well-functioning moieties, a laparoscopic approach at the renal level is feasible even in cases requiring complex reconstruction. PATIENTS AND METHODS Six children between the ages of 4 months and 10 years (mean age 5.2 years) presented with urinary-tract infection, incontinence, or pain and underwent transperitoneal laparoscopic reconstruction for duplex collecting system pathology in renal moieties with preserved function. Five patients underwent laparoscopic upper pole-to-lower pole ureteroureterostomies, whereas one patient underwent a complex reconstruction of a long narrowing defect utilizing a Scardino-Prince vertical flap. Four patients underwent conventional laparoscopy, while the da Vinci Surgical System was used during the surgical procedures of the other two patients. RESULTS The mean operative time was 3.1 hours (range 2.6-4.9 hours) for the entire procedure, including cystoscopic evaluation. Stents were removed 6 weeks postoperatively. The patients were evaluated with retroperitoneal ultrasonography and either intravenous urography or diuretic radionuclide imaging to assess the anatomic integrity of the reconstruction. The presenting symptomatology resolved in all patients. CONCLUSIONS We believe that complex laparoscopic upper-tract reconstruction in children who benefit from a parenchyma-preserving approach is possible and should be evaluated against open techniques.
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Affiliation(s)
- Alexander Kutikov
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania 19107, USA
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412
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Kutikov A, Canning DA. Should renal and bladder function be our compass for management of vesicoureteral reflux? Nat Clin Pract Urol 2007; 4:356-7. [PMID: 17457316 DOI: 10.1038/ncpuro0804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 03/20/2007] [Indexed: 05/15/2023]
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413
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Kutikov A, Fossett LK, Ramchandani P, Tomaszewski JE, Siegelman ES, Banner MP, Van Arsdalen KN, Wein AJ, Malkowicz SB. Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology 2006; 68:737-40. [PMID: 17070344 DOI: 10.1016/j.urology.2006.04.011] [Citation(s) in RCA: 214] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2005] [Revised: 03/09/2006] [Accepted: 04/07/2006] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine the incidence of benign pathologic findings at partial nephrectomy for a solitary renal lesion when preoperative imaging is reviewed by an experienced team of academic genitourinary radiologists. METHODS From 1996 to 2004, 143 patients underwent resection of a solitary renal lesion for presumed renal cell carcinoma amenable to partial nephrectomy. Our experienced team of genitourinary radiologists interpreted all preoperative imaging scans. Of the 143 patients, 44 underwent partial nephrectomy for a solitary lesion less than 2 cm, 85 for a lesion 2 to 4 cm, and 14 for a lesion greater than 4 cm. RESULTS Of the 143 solitary masses resected, 23 revealed benign pathologic findings (16.1%). Ten lesions (43.5%) were angiomyolipomas (AMLs), eight (34.8%) were oncocytomas, three (13.0%) were benign Bosniak-type cysts, and one each was a low-grade spindle cell lesion most consistent with mesoblastic nephroma, and a metanephric adenoma. CONCLUSIONS A significant fraction of small solitary renal masses presumed to be renal cell carcinoma had benign pathologic findings on resection, despite thorough expert radiologic review. Management should favor parenchyma-sparing approaches, because resection serves not only a therapeutic but also a diagnostic function. Patients should be counseled accordingly when faced with the diagnosis of renal mass.
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Affiliation(s)
- Alexander Kutikov
- Department of Surgery, Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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414
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Abstract
PURPOSE Robot assisted pyeloplasty is emerging as an effective tool for treatment of ureteropelvic junction obstruction in the pediatric population. However, access needed for the procedure is difficult in the small abdominal cavity of an infant. We present our experience with infant robot assisted pyeloplasty, along with some lessons learned that render this procedure possible in these small patients. MATERIALS AND METHODS Nine children 3 to 8 months old (mean 5.6) underwent transperitoneal robot assisted pyeloplasty for ureteropelvic junction obstruction using the da Vinci Surgical System. All patients underwent Anderson-Hynes dismembered pyeloplasty without renal pelvis tapering. Outcome measures included operative time, length of hospital stay, and resolution of obstruction by ultrasonography and/or diuretic radionuclide imaging. RESULTS All infants successfully underwent robot assisted laparoscopic pyeloplasty without conversion to pure laparoscopy or open procedure. Mean operative time was 122.8 minutes, with a mean console time of 72.1 minutes. Mean hospital stay was 1.4 days. Of the 9 patients 7 (78%) had resolution of or improvement in hydronephrosis, while 2 had no evidence of obstruction based on followup diuretic renography. CONCLUSIONS Robot assisted pyeloplasty is a safe and effective option in the surgical treatment of infant ureteropelvic junction obstruction. Further long-term studies are needed to confirm the usefulness of robotics in minimally invasive pediatric surgery.
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Affiliation(s)
- Alexander Kutikov
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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415
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Kutikov A, Guzzo TJ, Canter DJ, Casale P. Initial Experience With Laparoscopic Transvesical Ureteral Reimplantation at the Children’s Hospital of Philadelphia. J Urol 2006; 176:2222-5; discussion 2225-6. [PMID: 17070297 DOI: 10.1016/j.juro.2006.07.082] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Indexed: 11/18/2022]
Abstract
PURPOSE Laparoscopic transvesical ureteral reimplantation with or without robotic assisted surgical devices is being developed as an alternative to open surgery. We review our experience with laparoscopic transvesical ureteral reimplantation. MATERIALS AND METHODS A total of 32 patients underwent laparoscopic transvesical reimplantation by the same surgeon. Of the patients 5 had primary obstructing megaureters and 27 had vesicoureteral reflux. Transvesical laparoscopic cross-trigonal ureteral reimplantation was performed in patients with reflux, and a Glenn-Anderson reimplantation was used in patients with a primary obstructing megaureter. A pure laparoscopic approach using two 3 mm working ports and a 5 mm camera port was used. RESULTS The operative success rates were 92.6% and 80% for vesicoureteral reflux and primary obstructing megaureter cases, respectively. Complications included a postoperative urinary leak in 4 patients (12.5%) and ureteral stricture at the neoureterovesical anastomosis in 2 (6.3%). All but 1 complication occurred in patients 2 years or younger with bladder capacity less than 130 cc. CONCLUSIONS Laparoscopic intravesical reimplantation is in its infancy and appears to have higher complication rates in young patients with small bladder capacity.
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Affiliation(s)
- Alexander Kutikov
- Department of Surgery, Division of Urology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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416
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Abstract
Prostatic disease continues to present clinicians with challenges. Although giant strides have been made in the medical and surgical management of benign prostatic hyperplasia, many fundamental questions about its pathogenesis, progression, and treatment efficacy remain unanswered. Prostate cancer also continues to be an area in which progress is needed despite major recent advancements. Numerous debates that include the value of prostate-specific antigen screening and appropriate roles for each of the numerous therapeutic modalities await resolution. For millions of patients who suffer from prostatitis, a major breakthrough is yet to come. Current treatment regimens for prostatitis remain ineffective at best. Contemporary approaches to the pathogenesis, diagnosis, and treatment of benign prostatic hyperplasia, prostate cancer, and prostatitis are discussed in this review.
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Affiliation(s)
- Alexander Kutikov
- Division of Urology, Department of Surgery, University of Pennsylvania Medical Center, 9 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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417
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Kutikov A, Fossett LK, Guzzo TJ, Wein AJ, Vanarsdalen KN, Malkowicz SB. 45: Enucleation of Renal Cell Carcinoma with Ablation of Tumor Base: Is Cancer Control Comparable to Partial Nephrectomy? J Urol 2006. [DOI: 10.1016/s0022-5347(18)32312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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418
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Kutikov A, Resnick M, Casale P. Laparoscopic Pyeloplasty in the Infant Younger Than 6 Months—Is it Technically Possible? J Urol 2006; 175:1477-9; discussion 1479. [PMID: 16516026 DOI: 10.1016/s0022-5347(05)00673-7] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Indexed: 11/22/2022]
Abstract
PURPOSE Laparoscopic dismembered pyeloplasty is an acceptable option for UPJ obstruction in the pediatric population. We report our initial experience with this approach in infants. MATERIALS AND METHODS Eight infants 3 to 5 months old (mean 4.5) underwent transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction. All patients underwent dismembered pyeloplasty with renal pelvis tapering. Two patients underwent concomitant pyelolithotomy and 1 underwent contralateral nephrectomy. Outcome measures included operative time, length of hospital stay, and resolution of obstruction by ultrasonography and DRI. RESULTS Mean operative time was 1.8 hours for the pyeloplasty portion. Mean hospital stay was 1.2 days. The stent was removed 6 weeks postoperatively in all patients except 1. This patient, 1 of the 2 patients who underwent concomitant pyelolithotomy, had development of a new stone while the stent was still indwelling. Laparoscopic pyeloplasty resulted in 100% resolution of UPJ obstruction in this series. CONCLUSIONS We believe that laparoscopic dismembered pyeloplasty is technically possible in infants younger than 6 months.
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Affiliation(s)
- Alexander Kutikov
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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419
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Barnes KR, Kutikov A, Lippard SJ. Synthesis, Characterization, and Cytotoxicity of a Series of Estrogen-Tethered Platinum(IV) Complexes. ACTA ACUST UNITED AC 2004; 11:557-64. [PMID: 15123250 DOI: 10.1016/j.chembiol.2004.03.024] [Citation(s) in RCA: 198] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Revised: 01/25/2004] [Accepted: 01/30/2004] [Indexed: 10/26/2022]
Abstract
Several estrogen-tethered platinum(IV) complexes were prepared and characterized by ESI-MS and (1)H NMR spectroscopy. Their design was inspired by the observation that estrogen receptor-positive cells exposed to the hormone are sensitized to cisplatin. Intracellular reduction of bis-estrogen-cis-diamminedichloroplatinum(IV), BEP(n) (where n = 1-5 methylene groups between Pt and estrogen), occurs to afford cisplatin and two equivalents of the linker-modified estrogen. The ability of BEP(n) to induce overexpression of HMGB1 was established by immunofluorescence microscopy. The cytotoxicity of the compounds was evaluated in ER(+) MCF-7 and ER(-) HCC-1937 human breast cancer cell lines. BEP3 selectively induces overexpression of HMGB1 in MCF-7 cells, compared to HCC-1937 cells, and enhances their sensitivity (IC(50) = 2.1 +/- 0.4 microM versus 3.7 +/- 0.9 microM, respectively) to the compound. The difference in compound activities and the potential of compounds of this class for treating breast and ovarian cancer are discussed.
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Affiliation(s)
- Katie R Barnes
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139 USA
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420
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Moore SJ, Kutikov A, Lachicotte RJ, Marzilli LG. Methyl B12 Models Containing Unsubstituted Imidazole As an Axial Ligand Investigated by Structural and NMR Spectroscopic Methods. Evidence that μ-Imidazolato-Bridged Dimers Are Formed by Base Addition to Some Analogues with Macrocyclic Equatorial Ligands Incorporating BF2. Inorg Chem 1999. [DOI: 10.1021/ic980944d] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Scott J. Moore
- Department of Chemistry, Emory University, Atlanta, Georgia 30322 and Department of Chemistry, University of Rochester, Rochester, New York 14627
| | - Alexander Kutikov
- Department of Chemistry, Emory University, Atlanta, Georgia 30322 and Department of Chemistry, University of Rochester, Rochester, New York 14627
| | - Rene J. Lachicotte
- Department of Chemistry, Emory University, Atlanta, Georgia 30322 and Department of Chemistry, University of Rochester, Rochester, New York 14627
| | - Luigi G. Marzilli
- Department of Chemistry, Emory University, Atlanta, Georgia 30322 and Department of Chemistry, University of Rochester, Rochester, New York 14627
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