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Martini DJ, Case KB, Gratz D, Pellegrini K, Beagle E, Schneider T, Dababneh M, Nazha B, Brown JT, Joshi SS, Narayan VM, Ogan K, Master VA, Carthon BC, Kucuk O, Harik LR, Bilen MA. PD-L1 and nectin-4 expression and genomic characterization of bladder cancer with divergent differentiation. Cancer 2024; 130:3658-3670. [PMID: 38959291 PMCID: PMC11464191 DOI: 10.1002/cncr.35465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Bladder cancer with divergent differentiation (BCDD) comprises a heterogenous group of tumors with a poor prognosis, and differential expression of nectin-4 and programmed death ligand-1 (PD-L1) has been reported in BCDD. Importantly, nectin-4 expression in bladder cancer is associated with response to enfortumab vedotin, and PD-L1 expression is associated with responses to immune checkpoint inhibitors (ICIs). METHODS The authors conducted a retrospective review identifying 117 patients with advanced or metastatic BCDD who were treated at Winship Cancer Institute from 2011 to 2021. They performed immunohistochemistry staining for nectin-4 and PD-L1 expression by histologic subtype as well as genomic analysis of these patients, including RNA sequencing, whole-exome sequencing, and fusion detection analysis as well as a subgroup genomic analysis of patients with BCDD who received ICIs. RESULTS The results indicated that nectin-4 expression was highest in the groups who had the squamous and plasmacytoid subtypes, whereas the group that had the sarcomatoid subtype (70.8%) had the highest proportion of PD-L1-positive patients. Genomic analysis yielded several key findings, including a 50% RB1 mutation rate in patients who had small cell BCDD, targetable PIK3CA mutations across multiple subtypes of BCDD, and significantly higher expression of TEC in responders to ICIs. CONCLUSIONS In this study, the authors identified clinically relevant data on nectin-4 and PD-L1 expression in patients with rare bladder tumors. They also identified several novel findings in the genomic analysis that highlight the role of precision medicine in this population of patients. Larger, prospective studies are needed to validate these hypothesis-generating data.
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Affiliation(s)
- Dylan J. Martini
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Derrik Gratz
- Department of Bioinformatics, Emory University, Atlanta, GA
| | | | | | - Thomas Schneider
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Melad Dababneh
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Bassel Nazha
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Jacqueline T. Brown
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Shreyas S. Joshi
- Winship Cancer Institute of Emory University, Atlanta, GA
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Vikram M. Narayan
- Winship Cancer Institute of Emory University, Atlanta, GA
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Kenneth Ogan
- Winship Cancer Institute of Emory University, Atlanta, GA
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Viraj A. Master
- Winship Cancer Institute of Emory University, Atlanta, GA
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Bradley C. Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Lara R Harik
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
- Winship Cancer Institute of Emory University, Atlanta, GA
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Zhai H, Wang T, Wang Y, Xing J, Zhu X, Wang F, Hao G. Prognostic impact of tumor size in ureteral cancer following segmental ureterectomy. Urol Oncol 2024; 42:372.e11-372.e19. [PMID: 38852018 DOI: 10.1016/j.urolonc.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To evaluate the classification and prognostic effects of a 2 cm tumor size in patients with ureteral cancer (UC) undergoing segmental ureterectomy (SU). PATIENTS AND METHODS A total of 75 patients with UC who underwent SU in our hospital between April 2013 and April 2023 were included in this study. The study population was grouped based on tumor size, which was defined as the maximum diameter of the pathological specimens, resulting in 30 patients (40.0%) with tumor size <2 cm and 45 patients (60.0%) with tumor size ≥2 cm. The clinicopathological variables, perioperative parameters, and oncological outcomes were compared between the 2 groups. The endpoints were recurrence-free survival (RFS), and cancer-specific survival (CSS). RESULTS A tumor ≥2 cm was related to a higher positive rate of urine exfoliative cytology (P = 0.049) and fewer preoperative ureteroscopies (P = 0.033) than tumors <2 cm. After a follow-up of 6.3 to 128.7 months (median 40.2 months), 23 cases (30.7%) experienced recurrence and 11 patients (14.7%) succumbed to UC in the end. Compared to those with tumor size <2 cm, patients with tumor size ≥2 cm experienced more urothelial recurrence (P = 0.032). Kaplan-Meier analysis demonstrated that patients with tumor size ≥2 cm displayed inferior urothelial RFS than those with tumor size <2 cm (P = 0.026). Multivariate Cox analysis identified tumor size ≥2 cm, and pathological stage ≥T2 were significant prognostic factors of poor urothelial RFS (all P < 0.05). CONCLUSION Tumor size ≥2 cm was associated with a high rate of urothelial recurrence and served as an independent prognostic factor of adverse urothelial RFS in SU-treated patients with UC. Patients are advised to select surgical treatments for UC following the EAU guidelines.
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Affiliation(s)
- Hongyun Zhai
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Tao Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanghai Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiyu Xing
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xi Zhu
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fengxian Wang
- Department of Medical Engineering, The Seventh Medical Center of PLA General Hospital, Beijing, China.
| | - Gangyue Hao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Wang X, Xu C, Ma J, Wang X, Chen X. Identification of key genes participating in copper-diethyldithiocarbamate-related cell death process and predicting the development of prostate cancer. Discov Oncol 2024; 15:519. [PMID: 39361158 PMCID: PMC11450124 DOI: 10.1007/s12672-024-01390-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 09/24/2024] [Indexed: 10/06/2024] Open
Abstract
Copper (Cu) is used as a cofactor in all organisms, and yet it can be toxic at high intracellular concentrations, causing cell death. Diethyldithiocarbamate (DDC) is a Cu ionophore that can transport Cu effectively into the cell. Copper-diethyldithiocarbamate (Cu-DDC) can treat prostate cancer (PCa) and may correlate with the cell death process. However, the specific Cu-DDC-related cell death genes in PCa are still unknown. Information about the Cu-DDC-related cell death genes was obtained from a previous study. Concurrently, the RNA expression profiles and clinical data were downloaded from public databases such as GEO, TCGA, and CPGEA. Using data from TCGA database, the logistic and lasso regression models were generated using R software. The influence of these genes in affecting PCa progression and prognosis was analyzed. Finally, the expression of these genes was verified in clinical samples. We found five Cu-DDC-related cell death genes associated with the occurrence of PCa from GSE35988, a gene dataset, namely, CDKN2A, PRC1, CDK1, SOX2, and ZNF365. CDKN2A, PRC1, and CDK1 are known to influence PCa patients' disease-free survival (DFS) status and were overexpressed, whereas SOX2 and ZNF365 were under-expressed in PCa in the different databases. Some of these genes can affect PCa progression. Consistent with the database results, the mRNA and protein expression of CDKN2A, PRC1, and CDK1 was also higher in clinical samples. In conclusion, we identified five hub genes which are important for Cu-DDC-related cell death process that can predict the development of PCa.
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Affiliation(s)
- Xin'an Wang
- Department of Urology, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Chengdang Xu
- Department of Urology, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Junjie Ma
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, 1518 North Huancheng Road, Jiaxing, 314000, Zhejiang, China
| | - Xiao Wang
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, 1518 North Huancheng Road, Jiaxing, 314000, Zhejiang, China.
| | - Xi Chen
- Department of Urology, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
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Liu F, Wang L, Meagher MF, Afari J, Saitta C, Dhanji S, Ghassemzadeh S, Shah A, Puri D, Nguyen MV, Hakimi K, Schmeusser B, Greenwald R, Medline A, Kamal F, Ali A, Fukuda S, Kobayashi M, Chen W, Fan B, Aida Y, Maezawa Y, Asai S, Tanaka H, Patil D, Fujii Y, Master V, Derweesh IH. Predictive factors for recurrence and outcomes in T1a renal cell carcinoma: Analysis of the INMARC (International Marker Consortium for Renal Cancer) database. Urol Oncol 2024; 42:333.e21-333.e31. [PMID: 38926077 DOI: 10.1016/j.urolonc.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 01/29/2024] [Accepted: 04/01/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Stage migration in renal cell carcinoma (RCC) has led to an increasing proportion of diagnosed small renal masses. Emerging knowledge regarding heterogeneity of RCC histologies and consequent impact on prognosis led us to further explore outcomes and predictive factors in surgically-treated T1a RCC. METHODS The INMARC database was queried for T1aN0M0 RCC. Patients were stratified into groups based on recurrence. Primary outcome was overall survival (OS). Multivariable analyses (MVA) were performed for factors associated with recurrence, cancer-specific (CSM), and all-cause mortality (ACM). Kaplan-Meier analyses (KMA) assessed survival by histology and grade. Subset analysis for time to recurrence was conducted for grade and histologic groups and compared with recent AUA follow-up guidelines [low-risk (AUA-LR), intermediate-risk (AUA-IR), high-risk (AUA-HR), and very-high risk (AUA-VHR) groups]. RESULTS We analyzed 1,878 patients (median follow-up 35.2 months); 101 (5.4%) developed recurrence. MVA for recurrence demonstrated increasing age (P = 0.026), male sex (P = 0.043), diabetes (P = 0.007), high/unclassified grade (P < 0.001-0.007), and variant histology (P = 0.017) as independent risk factors for increased risk, while papillary (P = 0.016) and chromophobe (P = 0.049) were associated with decreased risk. MVA identified high/unclassified grade (P = 0.003-0.004) and pT3a upstaging (P = 0.043) as predictive factors for worsened risk of CSM while papillary (P = 0.034) was associated with improved risk. MVA for ACM demonstrated increasing age (P < 0.001), non-white (P < 0.001), high-grade (P = 0.022), variant histology (P = 0.049), recurrence (P = 0.004), and eGFR<45 at last follow-up (P < 0.001) to be independent risk factors. KMA comparing clear cell, chromophobe, papillary, and variant RCC revealed significant differences for 5-year CSS (P = 0.018) and RFS (P < 0.001), but not OS (P = 0.34). Median time to recurrence was 23.8 months for low-grade (AUA-LR), 17.3 months for high-grade (AUA-IR), 18 months for pT3a upstaging (AUA-HR), and 12 months for variant histology (AUA-VHR; P < 0.001). CONCLUSION We noted differential outcomes in T1a RCC based on histology and grade for recurrence and CSM, while renal functional decline in addition to pathological factors and recurrence were predictive for ACM. Our findings support recently promulgated AUA follow-up guidelines for low-grade and variant histology pT1a RCC, but call for consolidation of follow-up protocols for high-grade pT1a and pT3a upstaged patients, with intensification of frequency of imaging follow-up in pT1a high-grade RCC.
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Affiliation(s)
- Franklin Liu
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Luke Wang
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Margaret F Meagher
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Jonathan Afari
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Cesare Saitta
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Sohail Dhanji
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Saeed Ghassemzadeh
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Aastha Shah
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Dhruv Puri
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Mimi V Nguyen
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Kevin Hakimi
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037
| | - Benjamin Schmeusser
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Rachel Greenwald
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Alexandra Medline
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Fatima Kamal
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Adil Ali
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wei Chen
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Bo Fan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Aida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuya Maezawa
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shintaro Asai
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Viraj Master
- Department of Urology, Emory University School of Medicine, Building B Suite 1403 1365-B Clifton Road NE, Atlanta, GA 30322
| | - Ithaar H Derweesh
- Department of Urology, UC San Diego School of Medicine, 9400 Campus Point Drive, La Jolla, CA 92037.
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Chen H, Wu M, Chen M. Prognostic Significance of Albumin-Globulin Ratio in Urachal Carcinoma. Urol Int 2024:1-10. [PMID: 39342932 DOI: 10.1159/000540665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/30/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION Although albumin-globulin ratio (AGR) has been used in the prognostic assessment of multiple solid malignancies, so far no research has confirmed the prognostic significance of AGR as a biomarker for urachal carcinoma. We analyzed the relationship between AGR and prognosis in urachal carcinoma, aiming to identify a promising prognostic biomarker for urachal carcinoma. METHODS We reviewed the clinical data of 25 patients diagnosed with urachal carcinoma in the Xiangya Hospital, Central South University, from January 2008 to October 2021. The best cut-off value of preoperative AGR was determined according to the receiver operator characteristic curve. The Kaplan-Meier curve was used to analyze the effect of preoperative AGR on the overall survival (OS) and relapse-free survival (RFS) of patients. Cox proportional hazards model was used to analyze prognostic factors including preoperative AGR. RESULTS The best cut-off value of preoperative AGR in urachal carcinoma patients is 1.45. Low preoperative AGR is significantly associated with worse OS and RFS. Univariate analysis and multivariate analysis indicated that low preoperative AGR is an independent and reliable factor to predict poor prognosis, OS, and RFS in urachal carcinoma patients. CONCLUSION Urachal carcinoma patients with low preoperative AGR have worse prognosis, and preoperative AGR is a valuable prognostic indicator for urachal carcinoma research.
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Affiliation(s)
- Hengxin Chen
- Department of Urology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China,
| | - Menghai Wu
- Department of Urology, Xiangya Hospital Central South University, Changsha, China
| | - Minfeng Chen
- Department of Urology, Xiangya Hospital Central South University, Changsha, China
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Chen R, Su Q, Li Y, Shen P, Zhang J, Tan Y. Multi-sequence MRI-based radiomics model to preoperatively predict the WHO/ISUP grade of clear Cell Renal Cell Carcinoma: a two-center study. BMC Cancer 2024; 24:1176. [PMID: 39333970 PMCID: PMC11438199 DOI: 10.1186/s12885-024-12930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
OBJECTIVES To develop radiomics models based on multi-sequence MRI from two centers for the preoperative prediction of the WHO/ISUP grade of Clear Cell Renal Cell Carcinoma (ccRCC). METHODS This retrospective study included 334 ccRCC patients from two centers. Significant clinical factors were identified through univariate and multivariate analyses. MRI sequences included Dynamic contrast-enhanced MRI, axial fat-suppressed T2-weighted imaging, diffusion-weighted imaging, and in-phase/out-of-phase images. Feature selection methods and logistic regression (LR) were used to construct clinical and radiomics models, and a combined model was developed using the Rad-score and significant clinical factors. Additionally, seven classifiers were used to construct the combined model and different folds LR was used to construct the combined model to evaluate its performance. Models were evaluated using receiver operating characteristic (ROC) curves, area under the curve (AUC), and decision curve analysis (DCA). The Delong test compared ROC performance, with p < 0.050 considered significant. RESULTS Multivariate analysis identified intra-tumoral vessels as an independent predictor of high-grade ccRCC. In the external validation set, the radiomics model (AUC = 0.834) outperformed the clinical model (AUC = 0.762), with the combined model achieving the highest AUC (0.855) and significantly outperforming the clinical model (p = 0.003). DCA showed that the combined model had a higher net benefit within the 0.04-0.54 risk threshold range than clinical model. Additionally, the combined model constructed using logistic regression has a higher priority compared to other classifiers. Additionally, 10-fold cross-validation with LR for the combined model showed consistent AUC values (0.849-0.856) across different folds. CONCLUSION The radiomics models based on multi-sequence MRI might be a noninvasive and effective tool, demonstrating good efficacy in preoperatively predicting the WHO/ISUP grade of ccRCC.
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Affiliation(s)
- Ruihong Chen
- Department of Radiology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, Shanxi Province, 030001, P.R. China
- Department of College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, 030001, P.R. China
| | - Qiaona Su
- Department of Radiology, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/ Cancer Hospital Affiliated to Shanxi Medical University, No. 3 Workers' New Street, Taiyuan, Shanxi Province, 030013, P.R. China
- Department of College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, 030001, P.R. China
| | - Yangyang Li
- Department of Radiology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, Shanxi Province, 030001, P.R. China
- Department of College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, 030001, P.R. China
| | - Pengxin Shen
- Department of Radiology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, Shanxi Province, 030001, P.R. China
- Department of College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, 030001, P.R. China
| | - Jianxin Zhang
- Department of Radiology, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/ Cancer Hospital Affiliated to Shanxi Medical University, No. 3 Workers' New Street, Taiyuan, Shanxi Province, 030013, P.R. China.
| | - Yan Tan
- Department of Radiology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, Shanxi Province, 030001, P.R. China.
- Department of Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, 030001, P.R. China.
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Lee J, Moon S, Kwon HJ, Lee S, Choe G, Lee KS. Evaluation of PD-L1 expression in PBRM1-altered clear cell renal cell carcinoma. Urol Oncol 2024:S1078-1439(24)00658-6. [PMID: 39341712 DOI: 10.1016/j.urolonc.2024.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 08/05/2024] [Accepted: 09/15/2024] [Indexed: 10/01/2024]
Abstract
PURPOSE Clear cell renal cell carcinoma (ccRCC) often harbors Polybromo 1 (PBRM1) alterations. These alterations are associated with immune checkpoint blockade response in ccRCC, particularly antiprogrammed cell death 1 (PD1)/programmed cell death ligand 1 (PD-L1)-targeted therapy. However, the association between PBRM1 alterations and PD-L1 expression in ccRCC remains unclear. MATERIALS AND METHODS We analyzed alterations in PBRM1 and PD-L1 expression using immunohistochemistry (IHC) targeting PBRM1 and PD-L1 (22C3) in tissues collected from patients with localized ccRCC (Cohort 1) and advanced ccRCC (Cohort 2). Additionally, next-generation sequencing (NGS) was conducted on Cohort 2 patients to analyze PBRM1 alterations. RESULTS Cohort 1 comprised 526 patients, of whom 139 (26.4%) exhibited PD-L1 positivity and 205 (38.9%) exhibited loss of PBRM1 expression in IHC. PD-L1 expression was positively associated with the loss of PBRM1 expression (P < 0.001) in localized ccRCC. Kaplan-Meier analysis indicated that PBRM1 expression loss and PD-L1 expression positively correlated with tumor recurrence (P < 0.001 and P = 0.003, respectively). Cohort 2 comprised 59 patients with advanced ccRCC, of whom 33 (56.9%) exhibited PBRM1 genetic alterations. PBRM1 IHC exhibited a sensitivity of 84.48% and specificity of 87.5% compared to NGS results. We did not find a significant association between PBRM1 mutation and PD-L1 expression, in contrast to the findings in Cohort 1. However, we frequently observed that PBRM1 mutation and PD-L1 expression occur concurrently, with 60% of PBRM1-altered ccRCC cases being PD-L1 positive. CONCLUSION Although our study did not establish a correlation between PBRM1 mutations and PD-L1 expression, it demonstrated that the occurrence of PBRM1-altered ccRCC with PD-L1 expression is not uncommon. Therefore, the presence of PBRM1 alterations may challenge the use of PD-L1 IHC as a predictive marker for PD-L1 blockade in ccRCC.
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Affiliation(s)
- Jieun Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seyoung Moon
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hyun Jung Kwon
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Pathology, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Sejoon Lee
- Precision Medicine Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Gheeyoung Choe
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Pathology, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Pathology, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea.
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Zhou J, Wang C, Lv T, Fan Z. Association between tumor size and prognosis in patients with small bowel adenocarcinoma-a SEER-based study. Heliyon 2024; 10:e36881. [PMID: 39281496 PMCID: PMC11402183 DOI: 10.1016/j.heliyon.2024.e36881] [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: 07/02/2024] [Revised: 08/09/2024] [Accepted: 08/23/2024] [Indexed: 09/18/2024] Open
Abstract
Background The association between small-bowel adenocarcinoma (SBA) tumor size and prognosis is unclear, and we used the Surveillance, Epidemiology, and End Results (SEER) database to assess the prognostic value of SBA tumor size. Methods Patients with postoperative SBA were selected from the SEER database, and overall survival (OS) and cancer-specific survival (CSS) were used as outcome variables. Tumor size was used as a categorical and continuous variable, respectively, to adjust for confounders and analyze the association between SBA tumor size and prognosis using Cox proportional hazard regression, and the results were visualized using restricted cubic splines (RCS). Spearman correlation coefficient was used to evaluate the statistical correlation between tumor size and tumor invasion depth (T-stage). Kaplan-Meier survival curves were used to estimate OS at different T stages. Results When the tumor size was analyzed as a quantitative variable, the adjusted covariate model showed that the HR was 1.008 (P = 0.04) for OS and 1.021 (P = 0.03) for CSS. And regardless of OS or CSS, when the tumor size < 3-4 cm, there was a close linear relationship between tumor size and HR. What's more, in the SEER database, the 5-year survival rates of T1, T2, T3 and T4 patients were 81.8 %, 81.1 %, 66.0 % and 50.9 % (P < 0.001) according to AJCC T-stage. However, in the modified T-stage (mT), these rates were 82.8 %, 70.6 %, 60.7 % and 39.8 % (P < 0.001). When patients within each of the AJCC T stages were stratified by mT stages, significant survival heterogeneity was observed within each of the AJCC T1 to T4 stages(P < 0.001). Conclusion When tumor size is used in a quantitative way, tumor size is an independent predictor of poor outcome in patients with SBA. Furthermore, we established a modified T-stage based on tumor size and depth of invasion.
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Affiliation(s)
- Jialin Zhou
- Department of General Surgery, The Third People's Hospital of Dalian, Dalian Medical University, Dalian, China
- Department of General Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Cong Wang
- Department of General Surgery, The Third People's Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Tingcong Lv
- Department of General Surgery, The Third People's Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Zhe Fan
- Department of General Surgery, The Third People's Hospital of Dalian, Dalian Medical University, Dalian, China
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9
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Bertolo R, Veccia A, Montanaro F, Artoni F, Baielli A, Boldini M, Ditonno F, Costantino S, De Marco V, Migliorini F, Porcaro AB, Rizzetto R, Cerruto MA, Antonelli A. Partial nephrectomy after a period of active surveillance: Are perioperative and pathology outcomes worsened compared to immediate surgery? EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108464. [PMID: 38865931 DOI: 10.1016/j.ejso.2024.108464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/06/2024] [Accepted: 06/01/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Active surveillance (AS) is a viable strategy for managing small renal masses (SRMs) in lieu of immediate surgery, but concerns persist regarding its impact on delayed partial nephrectomy (PN) outcomes. We aimed to compare perioperative and pathological outcomes of patients initially on AS for SRMs, later undergoing PN, against those undergoing immediate PN. MATERIALS AND METHODS Data were extracted from a prospective institutional database (January 2018-September 2023) for patients with cT1a renal masses. Only malignancies confirmed at final pathology were included. Baseline patient and tumor characteristics and the time from AS enrollment to PN were recorded. Surgical, renal functional, and final pathology outcomes were analyzed, including histology, tumor size, pT stage, upstaging rate, and positive surgical margins. Predictors of upstaging were identified using logistic regression models. RESULTS Analysis included 356 patients: 307 immediate PN and 49 deferred PN after a median of 18 months in AS. Groups had comparable baseline characteristics; no significant differences emerged in surgical and postoperative outcomes. Final pathology revealed no significant disparities in tumor size, histology, positive margins, or upstaging, though pT stage distribution differed (2.4 % versus 4.3 % for pT3a, immediate versus deferred, p = 0.04). Univariable analysis identified RENAL Score (OR 1.29, 95 % C.I. 1.09-1.53, p = 0.003) and clinical tumor size (OR 1.16, 95 % C.I. 1.10-1.22, p < 0.01) as upstaging predictors, confirmed by multivariable analysis (p < 0.01). CONCLUSION Our comparative analysis found no worsened perioperative or adverse pathological outcomes in patients with deferred PN, supporting the safety of this approach in managing SRMs, at least as an initial option.
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Affiliation(s)
- Riccardo Bertolo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy.
| | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Francesca Montanaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Francesco Artoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Alberto Baielli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Michele Boldini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Francesco Ditonno
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Sonia Costantino
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Vincenzo De Marco
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Piazzale Aristide Stefani 1, 37126, Verona, Italy
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10
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Zhang Z, Xue B, Chen Y, Shao Y, Wang D. A systematic review and meta-analysis combined with bioinformatic analysis on the predictive value of E-cadherin in patients with renal cell carcinoma. Expert Rev Mol Diagn 2024; 24:859-871. [PMID: 39187988 DOI: 10.1080/14737159.2024.2392641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 03/08/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES Renal cell carcinoma (RCC) is the most common cancer of the kidney. This study aims to evaluate the potential predictive value of E-cadherin, a marker of the epithelial mesenchymal transit (EMT) process that has been associated with tumor metastasis. METHODS We searched PubMed, Embase, and Cochrane Library to identify prospective studies. Hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were summarized to validate the relationship between E-cadherin and survival and clinical characteristics. The quality of the included studies was assessed using the NOS table. Then, we analyzed genetic data and clinical characteristics from The Cancer Genome Atlas Program (TCGA) database using R language with the dplyr package for validation. RESULTS Including 21 articles. The analysis revealed a strong link between high E-cadherin expression and favorable prognosis (for OS, HR = 0.35, 95% CI: 0.19-0.62; for PFS, HR = 0.19, 95% CI: 0.03-0.53; for DSS, HR = 0.25, 95% CI: 0.08-0.76; for RFS, HR = 0.71, 95% CI: 0.44-1.16; for DFS, HR = 0.28, 95% CI: 0.13-0.61; for T stage, OR = 0.21, 95% CI: 0.11-0.41; for N stage, OR = 0.07, 95%CI: 0.02-0.25; for M stage, OR = 0.12, 95% CI: 0.02-0.60; for clinical stage, OR = 0.29, 95% CI: 0.18-0.47; for nuclear grade, OR = 0.23, 95% CI: 0.13-0.41; for tumor size, OR = 0.49, 95% CI: 0.26-0.92). The findings were supported by bioinformatic analysis which used TCGA RCC patient's cohort (P < 0.01). CONCLUSION Based on the current data, E-cadherin may predict a better prognosis in RCC patients.
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Affiliation(s)
- Zikuan Zhang
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Bo Xue
- Shanxi Medical University, Taiyuan, Shanxi, China
| | | | - Yuan Shao
- Tianjin Medical University, Tianjin, China
| | - Dongwen Wang
- Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
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11
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Tao J, Bian X, Zhou J, Zhang M. From microscopes to molecules: The evolution of prostate cancer diagnostics. Cytojournal 2024; 21:29. [PMID: 39391208 PMCID: PMC11464998 DOI: 10.25259/cytojournal_36_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/27/2024] [Indexed: 10/12/2024] Open
Abstract
In the ever-evolving landscape of oncology, the battle against prostate cancer (PCa) stands at a transformative juncture, propelled by the integration of molecular diagnostics into traditional cytopathological frameworks. This synthesis not only heralds a new epoch of precision medicine but also significantly enhances our understanding of the disease's genetic intricacies. Our comprehensive review navigates through the latest advancements in molecular biomarkers and their detection technologies, illuminating the potential these innovations hold for the clinical realm. With PCa persisting as one of the most common malignancies among men globally, the quest for early and precise diagnostic methods has never been more critical. The spotlight in this endeavor shines on the molecular diagnostics that reveal the genetic underpinnings of PCa, offering insights into its onset, progression, and resistance to conventional therapies. Among the genetic aberrations, the TMPRSS2-ERG fusion and mutations in genes such as phosphatase and tensin homolog (PTEN) and myelocytomatosis viral oncogene homolog (MYC) are identified as significant players in the disease's pathology, providing not only diagnostic markers but also potential therapeutic targets. This review underscores a multimodal diagnostic approach, merging molecular diagnostics with cytopathology, as a cornerstone in managing PCa effectively. This strategy promises a future where treatment is not only tailored to the individual's genetic makeup but also anticipates the disease's trajectory, offering hope for improved prognosis and quality of life for patients.
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Affiliation(s)
- Junyue Tao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiaokang Bian
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jun Zhou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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12
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Oshina T, Yamada Y, Fujimura T, Taguchi S, Akiyama Y, Kamei J, Kaneko T, Kawai T, Obinata D, Yamada D, Fukuhara H, Nakagawa T, Takahashi S, Kume H. Oncologic and Functional Outcomes of Salvage Robot-Assisted Radical Prostatectomy: Report of the First 10 Cases. Curr Oncol 2024; 31:4762-4768. [PMID: 39195339 DOI: 10.3390/curroncol31080356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/17/2024] [Accepted: 08/19/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP. METHODS Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy. Initial definitive treatment included volumetric modulated arc therapy, intensity-modulated radio therapy, stereotactic body radiotherapy, heavy-ion radiotherapy, low-dose-rate brachytherapy, and high-intensity focused ultrasound. We retrospectively investigated 10 cases on oncologic and functional outcomes of sRARP. RESULTS The median PSA level at sRARP, amount of blood loss, and console time were 2.17 ng/mL, 100 mL, and 136 min, respectively. Positive surgical margins were found in half of the cases. Median follow-up was 1.1 years. There were no 30-day major complications. No patients had erections after sRARP. Urinary continence and biochemical recurrence (BCR) rate were 40% and 30% at 1 year after sRARP, respectively. CONCLUSIONS Salvage RARP may be a feasible option after PSA failure in patients who underwent radiotherapy or focal therapy as initial treatment, showing acceptable BCR rate.
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Affiliation(s)
- Takahiro Oshina
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tetsuya Fujimura
- Department of Urology, Jichi Medical University, Tochigi 329-0498, Japan
| | - Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Shinshu University School of Medicine, Nagano 390-8621, Japan
| | - Jun Kamei
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoyuki Kaneko
- Department of Urology, Teikyo University School of Medicine, Tokyo 173-8606, Japan
| | - Taketo Kawai
- Department of Urology, International University of Health and Welfare Ichikawa Hospital, Chiba 272-8501, Japan
| | - Daisuke Obinata
- Department of Urology, Nihon University Itabashi Hospital, Tokyo 173-8610, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Tokyo 181-0004, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Tokyo 173-8606, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University Itabashi Hospital, Tokyo 173-8610, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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13
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Deivasigamani S, Adams ES, Stock S, Kotamarti S, Séguier D, Taha T, Howard LE, Aminsharifi A, Jibara G, Amling CL, Aronson WJ, Cooperberg MR, Kane CJ, Terris MK, Klaassen Z, Guerrios-Rivera L, Freedland SJ, Polascik TJ. Select black men are potential candidates for prostate hemi-ablation based on radical prostatectomy histopathology for intermediate-risk prostate cancer-a multicenter SEARCH cohort study. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00880-6. [PMID: 39134653 DOI: 10.1038/s41391-024-00880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/27/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024]
Abstract
IMPORTANCE AND OBJECTIVE Partial gland ablation (PGA) is increasingly popular as a treatment for men with intermediate-risk prostate cancer (IR-PCa) to preserve functional outcomes while controlling their cancer. We aimed to determine the impact of race and clinical characteristics on the risk of upstaging (≥pT2c) and having adverse pathological outcomes including seminal vesicle invasion (SVI), extra prostatic extension (EPE) and lymph node invasion (LNI) at radical prostatectomy (RP) among men with IR disease eligible for PGA with hemi-ablation (HA). DESIGN Retrospective analysis. SETTING Multicenter. PARTICIPANTS AND MEASURES We studied patients diagnosed with unilateral IR-PCa treated with RP between 1988 and 2020 at 9 different Veterans Affairs hospitals within the SEARCH cohort. We analyzed differences in clinicopathological characteristics and outcome variables (odds of ≥pT2c and SVI, EPE and LNI) by race using multivariable logistic regression after adjusting for covariates. RESULTS Among 3127 patients, 33% were African American (AA) men with unilateral IR-PCa undergoing RP. Compared to non-AA men, AA individuals were younger (61 vs. 65 years, p < 0.001), presented with a higher prostate specific antigen (PSA) category (≥10 ng/ml; 34 vs. 26%, p < 0.001), and had a lower clinical stage (p < 0.001). Among the 2,798 (89.5%) with ≥pT2c stage, AA men exhibited higher ≥ pT2c rates (93 vs. 89%, p < 0.001), primarily due to increased pT2c staging (64 vs. 57%), where upstaging beyond pT2 was lower than non-AA men (29 vs. 32%). On multivariable analysis, AA men were found to have higher odds of ≥pT2c (odds ratio [OR]: 1.39 CI, 1.02-1.88, p = 0.04), lower odds of EPE (OR: 0.73 CI, 0.58-0.91, p < 0.01) and no statistically significant associations with LNI (OR: 0.79 CI, 0.42-1.46, p = 0.45) and SVI (OR: 1 CI, 0.74-1.35, p = 0.99) compared to non-AA men. On multivariable analysis, clinical features associated with higher odds of ≥pT2c were pre-operative PSA ≥ 15 (OR = 2.07, P = 0.01) and higher number of positive cores (HPC) on biopsy (OR = 1.36, P < 0.001). Similarly, PSA ≥ 15, Gleason grade ≥3 and HPC on biopsy were associated with higher odds of SVI, EPE and LNI, respectively. CONCLUSIONS In men with IR-PCa undergoing RP, AA men demonstrated an overall higher likelihood of ≥pT2c with lower upstaging beyond pT2, lower likelihood of EPE and no significant difference in likelihood of SVI and LNI compared to non-AA men. These findings support select AA men to be potential candidates for PGA, such as HA. Clinical factors are predictive of higher pathological stage and adverse pathological outcomes at RP and could be considered when selecting candidates for PGA.
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Affiliation(s)
| | - Eric S Adams
- Department of Urology, Duke University Medical Center, Durham, NC, USA
| | - Shannon Stock
- Department of Mathematics and Computer Science, College of the Holy Cross, Worcester, MA, USA
| | - Srinath Kotamarti
- Department of Urology, Duke University Medical Center, Durham, NC, USA
| | - Denis Séguier
- Department of Urology, Duke University Medical Center, Durham, NC, USA
- Department of Urology, Lille University Hospital, Lille, France
| | | | - Lauren E Howard
- Division of Urology, Durham VA Medical Center, Durham, NC, USA
| | - Alireza Aminsharifi
- Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Ghalib Jibara
- Department of Urology, Duke University Medical Center, Durham, NC, USA
| | | | | | | | | | - Martha K Terris
- Department of Surgery, Section of Urology, Augusta University- Medical College of Georgia, Augusta, GA, USA
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Augusta University- Medical College of Georgia, Augusta, GA, USA
| | - Lourdes Guerrios-Rivera
- Department of Urology, UC San Diego Health System, San Diego, CA, USA
- Department of Surgery, University of Puerto Rico, San Juan, PR, USA
| | - Stephen J Freedland
- Division of Urology, Durham VA Medical Center, Durham, NC, USA
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Thomas J Polascik
- Department of Urology, Duke University Medical Center, Durham, NC, USA
- Division of Urology, Durham VA Medical Center, Durham, NC, USA
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14
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Lai Y, Lin Y. Biological functions and therapeutic potential of CKS2 in human cancer. Front Oncol 2024; 14:1424569. [PMID: 39188686 PMCID: PMC11345170 DOI: 10.3389/fonc.2024.1424569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/23/2024] [Indexed: 08/28/2024] Open
Abstract
The incidence of cancer is increasing worldwide and is the most common cause of death. Identification of novel cancer diagnostic and prognostic biomarkers is important for developing cancer treatment strategies and reducing mortality. Cyclin-dependent kinase subunit 2 (CKS2) is involved in cell cycle and proliferation processes, and based on these processes, CKS2 was identified as a cancer gene. CKS2 is expressed in a variety of tissues in the human body, but its abnormal expression is associated with cancer in a variety of systems. CKS2 is generally elevated in cancer, plays a role in almost all aspects of cancer biology (such as cell proliferation, invasion, metastasis, and drug resistance) through multiple mechanisms regulating certain important genes, and is associated with clinicopathological features of patients. In addition, CKS2 expression patterns are closely related to cancer type, stage and other clinical variables. Therefore, CKS2 is considered as a tool for cancer diagnosis and prognosis and may be a promising tumor biomarker and therapeutic target. This article reviews the biological function, mechanism of action and potential clinical significance of CKS2 in cancer, in order to provide a new theoretical basis for clinical molecular diagnosis, molecular targeted therapy and scientific research of cancer.
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Affiliation(s)
- Yueliang Lai
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
- The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Ye Lin
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
- The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
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15
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Cooper S, Yankelevich GR, Clarke HSC, Lin A. Novel Utilization of Protrieve™ to Decrease Embolization Risk During Radical Nephrectomy With Inferior Vena Cava (IVC) Thrombectomy: A Case Report. Cureus 2024; 16:e68185. [PMID: 39347317 PMCID: PMC11439480 DOI: 10.7759/cureus.68185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/29/2024] [Indexed: 10/01/2024] Open
Abstract
Intraoperative efforts have been made to reduce the risk of tumor thrombus in renal cell carcinoma during nephrectomy and inferior vena cava (IVC) thrombectomy to decrease mortality. We present a patient diagnosed with renal malignancy and IVC thrombus. The patient underwent a nephrectomy combined with IVC thrombectomy, utilizing a novel approach with the Inari Protrieve™ (Inari Medical, Inc., Irvine, CA) to prevent embolization of tumor thrombus. With the integration of Protrieve™, we propose an approach to facilitate future surgical techniques for nephrectomy with IVC extension.
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Affiliation(s)
- Samantha Cooper
- Department of Urology, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | | | | | - Angelo Lin
- Department of Transplant Surgery, Medical College of Georgia, Augusta University, Augusta, USA
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16
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Zemp LW, Rudzinski JK, Pettaway CA, Nicholson S, Spiess PE. Management of Bulky Inguinal and Pelvic Lymph Nodes. Urol Clin North Am 2024; 51:335-345. [PMID: 38925736 DOI: 10.1016/j.ucl.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Penile cancer with bulky inguinal metastasis has a high probability of harboring pathologically involved lymph nodes best managed in a multidisciplinary care setting. Appropriate staging with cross-sectional imaging and fine-needle aspirate cytology of suspicious nodes guide decision-making for the use of platinum-based neoadjuvant chemotherapy followed by inguinal lymph node dissection. Surgical resection plays an important diagnostic, therapeutic, and guiding role in disease management. Patients with adverse pathologic features, especially those with extranodal disease extension, may derive additional benefit from adjuvant radiotherapy.
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Affiliation(s)
- Logan W Zemp
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
| | - Jan K Rudzinski
- Catherine and Joseph Aresty Department of Urology, Institute of Urology, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA
| | - Curtis A Pettaway
- Division of Surgery, Department of Urology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA
| | - Steve Nicholson
- Division of Medical Oncology, Mid- & South Essex NHS Foundation Trust, Court Road, Broomfield, Chelmsford CM1 7ET, UK
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive Office 12538, Tampa, FL 33612, USA
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17
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Miyake M, Anai S, Iemura Y, Ichikawa K, Miyamoto T, Tomioka A, Kuwada M, Itami Y, Hosokawa Y, Matsumura Y, Okajima E, Torimoto K, Nishimura N, Tomizawa M, Shimizu T, Hori S, Morizawa Y, Gotoh D, Nakai Y, Fujimoto K. A Multicenter, Single-Arm, Prospective Trial to Evaluate Efficacy and Safety of Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Carboplatin (DD-MVACarbo) Chemotherapy for Cisplatin-Ineligible Patients with Advanced Urothelial Cancer: Study Protocol of the CARBUNCLE Trial. Methods Protoc 2024; 7:58. [PMID: 39195436 DOI: 10.3390/mps7040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/21/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024] Open
Abstract
Unresectable, metastatic, advanced urothelial carcinoma (aUC) is an aggressive disease and is treated with platinum-containing first-line chemotherapy, followed by immune checkpoint inhibitors and antibody-drug conjugates. Response to first-line chemotherapy is a vital priority in sequential treatment strategies because a better response to first-line chemotherapy is associated with a better response to subsequent therapies. Gemcitabine plus carboplatin chemotherapy is conventionally recommended for cisplatin-ineligible patients. This multicenter, single-arm prospective trial will investigate whether dose-dense methotrexate, vinblastine, doxorubicin, and carboplatin (DD-MVACarbo) chemotherapy is superior to gemcitabine plus carboplatin chemotherapy in terms of efficacy in platinum-naïve, cisplatin-ineligible patients with aUC. After screening and registration, a total of 46 patients will be treated with this novel chemotherapy regimen. The primary endpoint is the objective response rate. The secondary endpoints include disease control rate, patient-reported outcomes, and adverse events. No evidence of this novel intervention is available as of July 2024. The results are expected to change the standard of care and improve the management of patients with aUC.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Satoshi Anai
- Department of Urology, Nara Prefectural Seiwa Medical Center, Ikoma 636-0802, Nara, Japan
| | - Yusuke Iemura
- Department of Urology, Yamatotakada Municipal Hospital, Yamatotakada 635-8501, Nara, Japan
| | - Kazuki Ichikawa
- Department of Urology, Yamatotakada Municipal Hospital, Yamatotakada 635-8501, Nara, Japan
| | - Tatsuki Miyamoto
- Department of Urology, Takai Hospital, Tenri 632-0006, Nara, Japan
| | - Atsushi Tomioka
- Department of Urology, Saiseikai Chuwa Hospital, Sakurai 633-0054, Nara, Japan
| | - Masaomi Kuwada
- Department of Urology, Matsusaka Chuo General Hospital, Matsusaka 515-0818, Mie, Japan
| | - Yoshitaka Itami
- Department of Urology, Tane General Hospital, Osaka 550-0025, Osaka, Japan
| | - Yukinari Hosokawa
- Department of Urology, Tane General Hospital, Osaka 550-0025, Osaka, Japan
| | | | - Eijiro Okajima
- Department of Urology, Nara City Hospital, Nara 630-8305, Nara, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Prefecture General Medical Center, Nara 630-8054, Nara, Japan
| | - Nobutaka Nishimura
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Mitsuru Tomizawa
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara 634-8522, Nara, Japan
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Nakane K, Taniguchi K, Nezasa M, Enomoto T, Yamada T, Tomioka-Inagawa R, Niwa K, Tomioka M, Ishida T, Nagai S, Yokoi S, Taniguchi T, Kawase M, Kawase K, Iinuma K, Tobisawa Y, Koie T. Oncologic Outcomes of Patients with Immune Checkpoint Inhibitor Resistant Urothelial Carcinoma Treated with Enfortumab Vedotin and the Impact of Neutrophil-to-Lymphocyte Ratio and Dysgeusia on Overall Survival: A Retrospective Multicenter Cohort Study in Japan. Cancers (Basel) 2024; 16:2648. [PMID: 39123376 PMCID: PMC11312170 DOI: 10.3390/cancers16152648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Randomized phase III trial results have demonstrated enfortumab vedotin (EV), an antibody-drug conjugate (ADC) consisting of an anti-Nectin-4 human IgG1 monoclonal antibody and monomethyl auristatin E, is a useful treatment for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) that progressed after immune checkpoint inhibitor (ICI) therapies. This multicenter retrospective cohort study aimed to identify predictive factors for the efficacy of EV therapy and prolonged overall survival (OS) of patients in clinical practice. This study included patients with la/mUC who received ICI treatment. Patients who subsequently received EV treatment, those who received non-EV chemotherapy, and those who received no treatment were defined as EV, non-EV, and best supportive care (BSC) groups, respectively. The median OS was 20, 15, and 7 months in the EV, non-EV, and BSC groups, respectively (p < 0.001). Patients with la/mUC who had a complete or partial response after EV treatment had a significantly prolonged OS compared with those with stable or progressive disease. Univariate analysis showed age, neutrophil-to-lymphocyte ratio (NLR), dysgeusia, and rash as independent predictors of OS improvement. NLR and dysgeusia were independent predictors of OS after EV in multivariate analysis. Patients without these factors had a significantly prolonged OS compared to those with both factors. In real-world practice, EV therapy is an effective treatment for patients with la/mUC after ICI treatment.
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Affiliation(s)
- Keita Nakane
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Kazuki Taniguchi
- Department of Urology, Gifu Prefectural General Medical Center, Gifu 5008717, Japan;
| | - Minori Nezasa
- Department of Urology, Matsunami General Hospital, Gifu 5016062, Japan;
| | - Torai Enomoto
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
- Department of Urology, Matsunami General Hospital, Gifu 5016062, Japan;
| | - Toyohiro Yamada
- Department of Urology, Ogaki Municipal Hospital, Ogaki 5038502, Japan;
| | - Risa Tomioka-Inagawa
- Department of Urology, Japanese Red Cross Takayama Hospital, Takayama 5068550, Japan;
| | - Kojiro Niwa
- Department of Urology, Daiyukai Daiichi Hospital, Ichinomiya 4918551, Japan;
| | - Masayuki Tomioka
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
- Department of Urology, Chuno Kosei Hospital, Seki 5013802, Japan
| | - Takashi Ishida
- Department of Urology, Gifu Municipal Hospital, Gifu 5008513, Japan;
| | - Shingo Nagai
- Department of Urology, Toyota Memorial Hospital, Toyota 4718513, Japan;
| | - Shigeaki Yokoi
- Department of Urology, Central Japan International Medical Center, Minokamo 5058510, Japan;
| | - Tomoki Taniguchi
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Makoto Kawase
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Kota Kawase
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Koji Iinuma
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Yuki Tobisawa
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
| | - Takuya Koie
- Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan; (K.N.); (T.E.); (M.T.); (T.T.); (M.K.); (K.K.); (K.I.); (Y.T.)
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Muneer A, Bandini M, Compérat E, De Meerleer G, Fizazi K, Gietema J, Gillessen S, Kirkham A, Sangar V, Alifrangis C, Powles T. Penile cancer: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2024; 9:103481. [PMID: 39089768 PMCID: PMC11360427 DOI: 10.1016/j.esmoop.2024.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 08/04/2024] Open
Abstract
•This ESMO CPG provides recommendations for diagnosis, staging, pathology, treatment and follow-up of penile cancer. •Algorithms for the management of primary penile tumours and inguinal lymph nodes are provided. •The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe. •Recommendations are based on available scientific data and the authors’ collective expert opinion. •In clinical practice, all recommendations provided need to be discussed with patients in a shared decision-making approach.
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Affiliation(s)
- A Muneer
- Department of Urology and NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London; Division of Surgery and Interventional Science, University College London, UK
| | - M Bandini
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - E Compérat
- Department of Pathology, Medical University Vienna, Austria
| | - G De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - J Gietema
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - S Gillessen
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona; Universita della Svizzera Italiana, Lugano, Switzerland
| | - A Kirkham
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London
| | - V Sangar
- Department of Urology, The Christie NHS Foundation Trust, Manchester
| | - C Alifrangis
- Department of Oncology and NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
| | - T Powles
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, London, UK
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Qin C, Tian Q, Zhou H, Qin Y, Zhou S, Wu Y, Tianjiao E, Duan S, Li Y, Wang X, Chen Z, Zheng G, Feng F. Detecting Muscle Invasion of Bladder Cancer: An Application of Diffusion Kurtosis Imaging Ratio and Vesical Imaging-Reporting and Data System. J Magn Reson Imaging 2024; 60:54-64. [PMID: 37916908 DOI: 10.1002/jmri.29053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Independent factors are needed to supplement vesical imaging-reporting and data system (VI-RADS) to improve its ability to identify muscle invasive bladder cancer (MIBC). PURPOSE To assess the correlation between MIBC and diffusion kurtosis imaging (DKI) ratio, VI-RADS, and other factors (such as tumor location). STUDY TYPE Retrospective. POPULATION Sixty-eight patients (50 males and 18 females; age: 70.1 ± 9.5 years) with bladder urothelial carcinoma. FIELD STRENGTH/SEQUENCE 1.5 T, conventional diffusion-weighted imaging (DWI), and DKI (single shot echo-planar sequence). ASSESSMENT Three radiologists independently measured the diffusion parameters of each bladder cancer (BCa) and obturator internus, including the mean apparent diffusion coefficient (ADCmean), mean kurtosis (MK), and mean diffusion (MD). And the ratio of diffusion parameters between BCa and obturator internus was calculated (diffusion parameter ratio = bladder cancer:obturator internus). Based on the VI-RADS, the target lesions were independently scored. Furthermore, the actual tumor-wall contact length (ACTCL) and absolute tumor-wall contact length (ABTCL) were measured. STATISTICAL TESTS Multicollinearity among independent variables was evaluated using the variance inflation factor (VIF). Multivariable logistic regression analysis was used to determine the independent risk factors of MIBC. The receiver operating characteristic curve was used to evaluate the efficacy of each variable in detecting MIBC. The DeLong test was used to compare the area under the curve (AUC). A P < 0.05 was considered statistically significant. RESULTS MKratio (median: 0.62) and VI-RADS were independent risk factors for MIBC. AUCs for MKratio, VI-RADS, and MKratio combined with VI-RADS in assessing MIBC were 0.895, 0.871, and 0.973, respectively. MKratio combined with VI-RADS was more effective in diagnosing MIBC than VI-RADS alone. DATA CONCLUSIONS MKratio has potential to assist the assessment of MIBC. MKratio can be used as a supplement to VI-RADS for detecting MIBC. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Cai Qin
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Qi Tian
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Hui Zhou
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yihan Qin
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Siyu Zhou
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yutao Wu
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Tianjiao E
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Shufeng Duan
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yueyue Li
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Xiaolin Wang
- Department of Urology Surgery, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Zhigang Chen
- Department of Urology Surgery, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Guihua Zheng
- Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Feng Feng
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
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21
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Kundlia A, Dharwadkar A, Gore C, Viswanathan V, Ingale Y. Exploring the Histopathological Landscape of Urinary Bladder Diseases: A Tertiary Care Center Study. Cureus 2024; 16:e64557. [PMID: 39144899 PMCID: PMC11323198 DOI: 10.7759/cureus.64557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Urinary bladder lesions encompass a wide spectrum, from benign inflammatory conditions to malignant neoplasms, presenting diagnostic and therapeutic challenges. Urothelial carcinoma predominates among bladder malignancies, exhibiting diverse clinical presentations and prognoses. Objective This study aimed to delineate the histopathological spectrum of urinary bladder lesions and correlate demographic profiles, clinical features, and cystoscopic findings with various bladder lesions. Methods This prospective descriptive observational study spanned 24 months at a tertiary care center, involving 65 cases of urinary bladder biopsies, including transurethral resection of bladder tumors, cystoscopic biopsies, and cystectomy specimens. The histopathological examination followed the WHO 2022 classification of urinary bladder tumors and the American Joint Committee on Cancer eighth edition staging. Clinical data, including age, gender, cystoscopic findings, and presenting symptoms, were correlated with histopathological diagnoses to explore the spectrum of bladder lesions. Results Neoplastic lesions predominated, constituting 92.3% of cases, with urothelial carcinoma comprising 83.33% of these cases. Among neoplastic lesions, invasive high-grade urothelial carcinoma (36.7%) and non-invasive low-grade papillary urothelial neoplasm (20.0%) were the most frequently observed subtypes. Non-neoplastic lesions accounted for 7.7%, including various forms of cystitis. Hematuria was the predominant presenting symptom (81.5%), while cystoscopic examinations revealed that most lesions were situated in the lateral bladder wall. High-grade urothelial carcinomas were mostly associated with muscularis propria invasion. Conclusion This study underscores the critical role of histopathological examination in diagnosing and managing urinary bladder diseases and distinguishing between non-neoplastic and neoplastic lesions. Urothelial carcinoma, prevalent among older age groups, often demonstrated muscle invasion indicative of high-grade tumors. Including the muscle layer in cystoscopic biopsies is crucial for an accurate diagnosis. Conversely, though less common, non-neoplastic conditions encompass various forms of cystitis. These findings highlight the importance of precise diagnostic tools such as cystoscopy and histopathological examination for the early detection and management of bladder neoplasms. Histopathological assessment offers essential prognostic guidance, aids in precise staging and grading, and directs tailored treatment strategies.
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Affiliation(s)
- Aakriti Kundlia
- Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Pune, IND
| | - Arpana Dharwadkar
- Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Pune, IND
| | - Charusheela Gore
- Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Pune, IND
| | - Vidya Viswanathan
- Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Pune, IND
| | - Yaminy Ingale
- Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Pune, IND
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22
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Yang FK, Tian C, Zhou LX, Guan TY, Chen GL, Zheng YY, Cao ZG. The value of urinary exosomal microRNA-21 in the early diagnosis and prognosis of bladder cancer. Kaohsiung J Med Sci 2024; 40:660-670. [PMID: 38801488 DOI: 10.1002/kjm2.12845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/29/2024] Open
Abstract
Bladder cancer (BC) poses high morbidity and mortality, with urinary exosomal microRNA (miR)-21 showing potential value in its diagnosis and prognosis, and we probed its specific role. We prospectively selected 116 BC patients and 116 healthy volunteers as the BC and control groups, respectively. BC urinary exosomal miR-146a-5p, miR-93-5p, miR-663b, miR-21, and miR-4454 relative expression levels were assessed. The correlations between clinical indexes and urinary exosomal miR-21, prognostic value of miR-21, and diagnostic value of the five candidate miRNAs, urine cytology, and miRNA joint diagnostic panel for BC and urinary exosomal miR-21, miR-4454, and urine cytology for Ta-T1 and T2-T4 stage BC were analyzed. Urinary exosomal miR-146a-5p, miR-93-5p, miR-663b, miR-21, and miR-4454 were highly expressed in BC patients. miR-146a-5p, miR-93-5p, miR-663b, miR-21, miR-4454, miRNA combined diagnostic panel, and urine cytology had certain diagnostic value for BC, with miR-21, miR-4454, and miRNA co-diagnostic panel showing the highest diagnostic value. Collectively, urinary exosomal miR-21 was closely related to Tumor-Node-Metastasis staging and grading in BC patients. Urinary exosomal miR-21 had high diagnostic value for BC and Ta-T1 and T2-T4 stage BC, and had high predictive value for BC poor prognosis, providing an effective indicator for the occurrence, development, and prognostic assessment of BC.
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Affiliation(s)
- Fu-Kan Yang
- Department of Urology, Guangdong Medical University, Zhanjiang, China
| | - Chao Tian
- Department of Urology, Yuebei people's hospital, Shaoguan, China
| | - Lin-Xiong Zhou
- Department of Urology, Yuebei people's hospital, Shaoguan, China
| | - Tian-Yu Guan
- Department of Urology, Yuebei people's hospital, Shaoguan, China
| | - Gui-Liu Chen
- Department of Urology, Yuebei people's hospital, Shaoguan, China
| | - Yi-Ying Zheng
- Department of Urology, Yuebei people's hospital, Shaoguan, China
| | - Zheng-Guo Cao
- Department of Urology, Dongguan People's Hospital, Guangdong Medical University, Dongguan, China
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Guan R, Zuo Y, Du Q, Zhang A, Wu Y, Zheng J, Shi T, Wang L, Wang H, Yu N. Development and evaluation of a disulfidoptosis-related lncRNA index for prognostication in clear cell renal cell carcinoma. Heliyon 2024; 10:e32294. [PMID: 38975147 PMCID: PMC11225747 DOI: 10.1016/j.heliyon.2024.e32294] [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: 01/31/2024] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 07/09/2024] Open
Abstract
Background This study introduces a novel prognostic tool, the Disulfidoptosis-Related lncRNA Index (DRLI), integrating the molecular signatures of disulfidoptosis and long non-coding RNAs (lncRNAs) with the cellular heterogeneity of the tumor microenvironment, to predict clinical outcomes in patients with clear cell renal cell carcinoma (ccRCC). Methods We analyzed 530 tumor and 72 normal samples from The Cancer Genome Atlas (TCGA), employing k-means clustering based on disulfidoptosis-associated gene expression to stratify ccRCC samples into prognostic groups. lncRNAs correlated with disulfidoptosis were identified and used to construct the DRLI, which was validated by Kaplan-Meier and receiver operating characteristic curves. We utilized single-cell deconvolution analysis to estimate the proportion of immune cell types within the tumor microenvironment, while the ESTIMATE and TIDE algorithms were employed to assess immune infiltration and potential response to immunotherapy. Results The Disulfidoptosis-Related lncRNA Index (DRLI) effectively stratified ccRCC patients into high and low-risk groups, significantly impacting survival outcomes (P < 0.001). High-risk patients, marked by a unique lncRNA profile associated with disulfidoptosis, faced worse prognoses. Single-cell analysis revealed marked tumor microenvironment heterogeneity, especially in immune cell makeup, correlating with patient risk levels. In prognostic predictions, DRLI outperformed traditional clinical indicators, achieving AUC values of 0.779, 0.757, and 0.779 for 1-year, 3-year, and 5-year survival in the training set, and 0.746, 0.734, and 0.750 in the validation set. Notably, while the constructed nomogram showed exceptional predictive capability for short-term prognosis (AUC = 0.877), the DRLI displayed remarkable long-term predictive accuracy, with its AUC value reaching 0.823 for 10-year survival, closely approaching the nomogram's performance. Conclusions The study introduces the DRLI as a groundbreaking molecular stratification tool for ccRCC, enhancing prognostic precision and potentially guiding personalized treatment strategies. This advancement is particularly significant in the context of long-term survival predictions. Our findings also elucidate the complex interplay between disulfidoptosis, lncRNAs, and the immune microenvironment in ccRCC, offering a comprehensive perspective on its pathogenesis and progression. The DRLI and the nomogram together represent significant strides in ccRCC research, highlighting the importance of molecular-based assessments in predicting patient outcomes.
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Affiliation(s)
- Renhui Guan
- Clinical College, Chengde Medical University, Chengde, Hebei, 067000, China
| | - You Zuo
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Qinglong Du
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Aijing Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Yijian Wu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Jianguo Zheng
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Tongrui Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Lin Wang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Hui Wang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
- Department of Urology, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, 253000, China
| | - Nengwang Yu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
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Király J, Szabó E, Fodor P, Vass A, Choudhury M, Gesztelyi R, Szász C, Flaskó T, Dobos N, Zsebik B, Steli ÁJ, Halmos G, Szabó Z. Expression of hsa-miRNA-15b, -99b, -181a and Their Relationship to Angiogenesis in Renal Cell Carcinoma. Biomedicines 2024; 12:1441. [PMID: 39062015 PMCID: PMC11274182 DOI: 10.3390/biomedicines12071441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) play a regulatory role in various human cancers. The roles of hsa-miR-15a-5p, hsa-miR-99b-5p, and hsa-miR-181a-5p have not been fully explored in the angiogenesis of renal cell carcinoma (RCC). AIMS The present study aimed to evaluate the expression of these miRNAs in tumorous and adjacent healthy tissues of RCC. METHODS Paired tumorous and adjacent normal kidney tissues from 20 patients were studied. The expression levels of hsa-miR-15b-5p, hsa-miR-99b-5p, and hsa-miR-181a-5p were quantified by TaqMan miRNA Assays. Putative targets were analyzed by qRT-PCR. RESULTS Significant downregulation of all three miRNAs investigated was observed in tumorous samples compared to adjacent normal kidney tissues. Spearman analysis showed a negative correlation between the expression levels of miRNAs and the pathological grades of the patients. Increased expression of vascular endothelial growth factor-A (VEGF-A) and hypoxia-inducible factor-1α (HIF-1α), a tissue inhibitor of metalloproteinases-1 (TIMP-1), was observed in tumorous samples compared to adjacent normal tissues. Depletion of tissue inhibitors of metalloproteinase-2 (TIMP-2) and metalloproteinase-2 (MMP-2) was detected compared to normal adjacent tissues. The examined miRNAs might function as contributing factors to renal carcinogenesis. However, more prospective studies are warranted to evaluate the potential role of miRNAs in RCC angiogenesis.
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Affiliation(s)
- József Király
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Erzsébet Szabó
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary;
- HUN-REN-DE Pharmamodul Research Group, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary
| | - Petra Fodor
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Anna Vass
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Mahua Choudhury
- Texas A&M Health Science Center, Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, College Station, TX 77845, USA;
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Csaba Szász
- Department of Pathology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Tibor Flaskó
- Department of Urology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Nikoletta Dobos
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Barbara Zsebik
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Ákos József Steli
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Gábor Halmos
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
| | - Zsuzsanna Szabó
- Department of Biopharmacy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (J.K.); (P.F.); (A.V.); (N.D.); (B.Z.); (Á.J.S.); (G.H.)
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Fan Z, Guo J, Zhang X, Chen Z, Wang B, Jiang Y, Li Y, Wang Y, Yang G, Wang X. Non-Gaussian diffusion metrics with whole-tumor histogram analysis for bladder cancer diagnosis: muscle invasion and histological grade. Insights Imaging 2024; 15:138. [PMID: 38853200 PMCID: PMC11162990 DOI: 10.1186/s13244-024-01701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/13/2024] [Indexed: 06/11/2024] Open
Abstract
PURPOSE To investigate the performance of histogram features of non-Gaussian diffusion metrics for diagnosing muscle invasion and histological grade in bladder cancer (BCa). METHODS Patients were prospectively allocated to MR scanner1 (training cohort) or MR2 (testing cohort) for conventional diffusion-weighted imaging (DWIconv) and multi-b-value DWI. Metrics of continuous time random walk (CTRW), diffusion kurtosis imaging (DKI), fractional-order calculus (FROC), intravoxel incoherent motion (IVIM), and stretched exponential model (SEM) were simultaneously calculated using multi-b-value DWI. Whole-tumor histogram features were extracted from DWIconv and non-Gaussian diffusion metrics for logistic regression analysis to develop diffusion models diagnosing muscle invasion and histological grade. The models' performances were quantified by area under the receiver operating characteristic curve (AUC). RESULTS MR1 included 267 pathologically-confirmed BCa patients (median age, 67 years [IQR, 46-82], 222 men) and MR2 included 83 (median age, 65 years [IQR, 31-82], 73 men). For discriminating muscle invasion, CTRW achieved the highest testing AUC of 0.915, higher than DWIconv's 0.805 (p = 0.014), and similar to the combined diffusion model's AUC of 0.885 (p = 0.076). For differentiating histological grade of non-muscle-invasion bladder cancer, IVIM outperformed a testing AUC of 0.897, higher than DWIconv's 0.694 (p = 0.020), and similar to the combined diffusion model's AUC of 0.917 (p = 0.650). In both tasks, DKI, FROC, and SEM failed to show diagnostic superiority over DWIconv (p > 0.05). CONCLUSION CTRW and IVIM are two potential non-Gaussian diffusion models to improve the MRI application in assessing muscle invasion and histological grade of BCa, respectively. CRITICAL RELEVANCE STATEMENT Our study validates non-Gaussian diffusion imaging as a reliable, non-invasive technique for early assessment of muscle invasion and histological grade in BCa, enhancing accuracy in diagnosis and improving MRI application in BCa diagnostic procedures. KEY POINTS Muscular invasion largely determines bladder salvageability in bladder cancer patients. Evaluated non-Gaussian diffusion metrics surpassed DWIconv in BCa muscle invasion and histological grade diagnosis. Non-Gaussian diffusion imaging improved MRI application in preoperative diagnosis of BCa.
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Affiliation(s)
- Zhichang Fan
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junting Guo
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaoyue Zhang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zeke Chen
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Bin Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yueluan Jiang
- Department of MR Research Collaboration, Siemens Healthineers, Beijing, China
| | - Yan Li
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yongfang Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Guoqiang Yang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaochun Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Zheng J, Chen J, Li H, Li Y, Dong W, Jiang X. Predicting prostate adenocarcinoma patients' survival and immune signature: a novel risk model based on telomere-related genes. Discov Oncol 2024; 15:203. [PMID: 38825615 PMCID: PMC11144689 DOI: 10.1007/s12672-024-00986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
Alterations in telomeres constitute some of the earliest occurrences in the tumourigenesis of prostate adenocarcinoma (PRAD) and persist throughout the progression of the tumour. While the activity of telomerase and the length of telomeres have been demonstrated to correlate with the prognosis of PRAD, the prognostic potential of telomere-related genes (TRGs) in this disease remains unexplored. Utilising mRNA expression data from the Cancer Genome Atlas (TCGA), we devised a risk model and a nomogram to predict the survival outcomes of patients with PRAD. Subsequently, our investigations extended to the relationship between the risk model and immune cell infiltration, sensitivity to chemotherapeutic drugs, and specific signalling pathways. The risk model we developed is predicated on seven key TRGs, and immunohistochemistry results revealed significant differential expression of three TRGs in tumours and paracancerous tissues. Based on the risk scores, PRAD patients were stratified into high-risk and low-risk cohorts. The Receiver operating characteristics (ROC) and Kaplan-Meier survival analyses corroborated the exceptional predictive performance of our novel risk model. Multivariate Cox regression analysis indicated that the risk score was an independent risk factor associated with Overall Survival (OS) and was significantly associated with T and N stages of PRAD patients. Notably, the high-risk group exhibited a greater response to chemotherapy and immunosuppression compared to the low-risk group, offering potential guidance for treatment strategies for high-risk patients. In conclusion, our new risk model, based on TRGs, serves as a reliable prognostic indicator for PRAD. The model holds significant value in guiding the selection of immunotherapy and chemotherapy in the clinical management of PRAD patients.
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Affiliation(s)
- Jiefang Zheng
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiahui Chen
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hongxiao Li
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuanchao Li
- Clinical College of Acupuncture, Moxibustion, and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Weimin Dong
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Xianhan Jiang
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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Cussenot O, Timms KM, Perrot E, Blanchet P, Brureau L, Solimeno C, Fromont G, Comperat E, Cancel-Tassin G. Tumour-based Mutational Profiles Predict Visceral Metastasis Outcome and Early Death in Prostate Cancer Patients. Eur Urol Oncol 2024; 7:597-604. [PMID: 38182487 DOI: 10.1016/j.euo.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Visceral metastases are known to occur in advanced prostate cancer, usually when the tumour is resistant to androgen deprivation and, have worse outcomes regardless of therapies. OBJECTIVE To analyse genomic alterations in tumour samples according to their lymphatic, bone, and visceral metastatic stages and overall survival. DESIGN, SETTING, AND PARTICIPANTS We selected 200 patients with metastatic prostate cancer. Genomic profiling of 111 genes and molecular signatures (homologous recombination deficiency [HRD], microsatellite instability, and tumour burden mutation) was performed with the MyChoice test (Myriad Genetics, Inc, Salt Lake City, UT, USA). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The association between genomic profiles and visceral metastatic evolution was evaluated using logistic regression. Kaplan-Meier and Cox proportional hazard analyses were used for analyses of early death. RESULTS AND LIMITATIONS A total of 173 (87%) genomic profiles were obtained. Eighty-four (49%) patients died during the follow-up period (median duration = 76 mo). TP53 was the most frequently mutated gene, followed by FANC genes, including BRCA2, and those of the Wnt-pathway (APC/CTNNB1). TP53 gene mutations were more frequent in patients of European (42%) than in those of African (16%) ancestry. An HRD score of >25 was predictive of FANC gene mutations. The mutational status of TP53 (p < 0.001) and APC (p = 0.002) genes were significantly associated with the risk of visceral metastases. The mutational status of CTNNB1 (p = 0.001), TP53 (p = 0.015), BRCA2 (p = 0.027), and FANC (p = 0.005) genes were significantly associated with an earlier age at death. The limitations are the retrospective study design based on a selection of genes and the low frequency of certain molecular events. CONCLUSIONS Mutations in the TP53 gene and genes (APC/CTNNB1) related to the Wnt pathway are associated with metastatic visceral dissemination and early death. These genomic alterations could be considered as markers to identify prostate cancer patients at a high risk of life-threatening disease who might benefit from more intensified treatment or new targeted therapies. PATIENT SUMMARY In this report, we evaluated the relationships between genomic profiles (gene mutations and molecular signatures) of tumour samples from patients with metastatic prostate cancer and early death. We found that mutations of specific genes, notably TP53 and APC/CTNNB1 related to the Wnt pathway, are associated with visceral metastatic progression and an earlier age at death.
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Affiliation(s)
- Olivier Cussenot
- CeRePP, Paris, France; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Emmanuel Perrot
- Department of Urology, CHU Pointe-a-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France; Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, Guadeloupe, France
| | - Pascal Blanchet
- Department of Urology, CHU Pointe-a-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France; Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, Guadeloupe, France
| | - Laurent Brureau
- Department of Urology, CHU Pointe-a-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France; Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, Guadeloupe, France
| | | | - Gaelle Fromont
- CeRePP, Paris, France; Faculté de Médecine, Inserm UMR1069 "Nutrition, Croissance et Cancer" Université François Rabelais, Tours, France; Departments of Pathology and Urology, CHRU Bretonneau, Tours, France
| | - Eva Comperat
- CeRePP, Paris, France; Department of Pathology, Medical University of Vienna, Vienna, Austria
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Chen Y, Meng T, Cao W, Zhang W, Ling J, Wen Z, Qian L, Guo Y, Lin J, Wang H. Histogram analysis of MR quantitative parameters: are they correlated with prognostic factors in prostate cancer? Abdom Radiol (NY) 2024; 49:1534-1544. [PMID: 38546826 DOI: 10.1007/s00261-024-04227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE To investigate the correlation between quantitative MR parameters and prognostic factors in prostate cancer (PCa). METHOD A total of 186 patients with pathologically confirmed PCa who underwent preoperative multiparametric MRI (mpMRI), including synthetic MRI (SyMRI), were enrolled from two medical centers. The histogram metrics of SyMRI [T1, T2, proton density (PD)] and apparent diffusion coefficient (ADC) values were extracted. The Mann‒Whitney U test or Student's t test was employed to determine the association between these histogram features and the prognostically relevant factors. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the differentiation performance. Spearman's rank correlation coefficients were calculated to determine the correlations between histogram parameters and the International Society of Urological Pathology (ISUP) grade group as well as pathological T stage. RESULTS Significant correlations were found between the histogram parameters and the ISUP grade as well as pathological T stage of PCa. Among these histogram parameters, ADC_minimum had the strongest correlation with the ISUP grade (r = - 0.481, p < 0.001), and ADC_Median showed the strongest association with pathological T stage (r = - 0.285, p = 0.008). The ADC_10th percentile exhibited the highest performance in identifying clinically significant prostate cancer (csPCa) (AUC 0.833; 95% CI 0.771-0.883). When discriminating between the status of different prognostically relevant factors, a significant difference was observed between extraprostatic extension-positive and -negative cancers with regard to histogram parameters of the ADC map (10th percentile, 90th percentile, mean, median, minimum) and T1 map (minimum) (p = 0.002-0.032). Moreover, histogram parameters of the ADC map (90th percentile, maximum, mean, median), T2 map (10th percentile, median), and PD map (10th percentile, median) were significantly lower in PCa with perineural invasion (p = 0.009-0.049). The T2 values were significantly lower in patients with seminal vesicle invasion (minimum, p = 0.036) and positive surgical margin (10th percentile, 90th percentile, mean, median, and minimum, p = 0.015-0.025). CONCLUSION Quantitative histogram parameters derived from synthetic MRI and ADC maps may have great potential for predicting the prognostic features of PCa.
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Affiliation(s)
- Yanling Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Tiebao Meng
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, Guangdong, People's Republic of China
| | - Wenxin Cao
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Weijing Zhang
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, Guangdong, People's Republic of China
| | - Jian Ling
- Department of Radiology, The Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, No.183 Huangpu Eastern Road, Guangzhou, Guangdong, People's Republic of China
| | - Zhihua Wen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, People's Republic of China
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
| | - Jinhua Lin
- Division of Interventional Ultrasound, Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, Guangdong, People's Republic of China.
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
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Yan CY, Gu YM, Shi GD, Shang QX, Zhang HL, Yang YS, Wang WP, Yuan Y, Chen LQ. Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer. J Surg Oncol 2024; 129:1056-1062. [PMID: 38314575 DOI: 10.1002/jso.27593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/24/2023] [Accepted: 01/15/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes. METHODS We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model. RESULTS A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46-6.35; p < 0.001) was correlated with lymph node metastases using logistic regression. T substage (hazard ratio [HR]: 1.37, 95% CI: 1.05-1.79; p < 0.001) and N status (HR: 1.51, 95% CI: 1.05-2.17; p < 0.001) were independent risk factors in multivariate Cox regression analysis. The deep muscle invasion was associated with worse overall survival (HR: 1.52, 95% CI: 1.19-1.94; p = 0.001) than superficial, specifically in T2N0 patients (HR: 1.38, 95% CI: 1.08-1.94; p = 0.035). CONCLUSIONS We found that deep muscle invasion was associated with significantly worse outcomes and recommended the substaging of pT2 esophageal squamous cell carcinoma in routine pathological examination.
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Affiliation(s)
- Cheng-Yi Yan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Cardiothoracic Surgery, Changsha Central Hospital, University of South China, Changsha, Hunan, China
| | - Yi-Min Gu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gui-Dong Shi
- Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qi-Xin Shang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Han-Lu Zhang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu-Shang Yang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen-Ping Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yong Yuan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Long-Qi Chen
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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de Deus A, Gonçalves G, da Silva J, de Jesus LC, Azevedo-Santos APS, Dall Agnol H, Pereira SR. Microbiome reveals inflammatory-related bacteria and putative functional pathways involved in human papillomavirus-associated penile squamous cell carcinoma. Andrology 2024; 12:809-820. [PMID: 37840240 DOI: 10.1111/andr.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/07/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Penile squamous cell carcinoma (PSCC) is a rare disease that is more prevalent in developing countries, such as Brazil, and is linked to poor genital hygiene, which promotes the proliferation of microorganisms. Dysbiosis has an effect on the local immune response, increases the risk of viral infection, and can generate inflammatory processes. Current knowledge of the microbiota found in penile tissues is limited, and the bacterial diversity of the PSCC remains unknown. In this investigation, the microbiota associated with penile cancer and its potential role in tumor development and progression were identified. METHODS The 16S rRNA gene was analyzed by next-generation sequencing in 19 tumors and their respective non-tumor adjacent tissues to perform taxonomic classification, analysis of core microbiome, abundance, and diversity of amplicon sequence variants (ASVs) (QIIME2 v.2020.2), and in silico functional prediction (PICRUST2, p < 0.05). RESULTS In both tissues, the phyla Proteobacteria and Firmicutes, and genera Alcaligenes and Fusobaterium, were the most prevalent. Tumors presented a greater relative abundance of Fusobacteriota, Campilobacteria, and Fusobacterium (p = 0.04, p = 0.04, and p = 0.039, respectively). In addition, the beta diversity analysis revealed a tendency for the formation of two distinct groups when only advanced tumors (pT2 and pT3) were considered. Further, the functional analysis identified the top 35 pathways, and 79.5% of PSCC samples contained pro-inflammatory microorganisms. CONCLUSION We describe the first microbiome of penile carcinoma, which revealed an abundant and diverse microbiota as well as inflammatory-related taxa (the phyla Proteobacteria and Firmicutes, the genera Fusobacterium and Prevotella, and the species Finegoldia magma and Pseudomonas geniculata) and molecular pathways (chitin derivates degradation, the protocatechuic acid pathway, inositol metabolism, and the sucrose pathway), which have also been linked to inflammation and carcinogenesis. Moreover, we found specific and abundant ASVs in both tumor and non-tumor tissues. Our data encourage further study to better understand the role of these microorganisms in penile carcinogenesis, offering an opportunity for advances in diagnosis, prognosis, and early therapy.
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Affiliation(s)
- Amanda de Deus
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Brazil
| | - Gabriele Gonçalves
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Brazil
| | - Jenilson da Silva
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Brazil
| | - Luís Cláudio de Jesus
- Department of Genetics, Ecology, and Evolution, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Hivana Dall Agnol
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Brazil
- Department of Pathology, Federal University of Maranhão, São Luís, Brazil
| | - Silma Regina Pereira
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Brazil
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Wu X, Zhou M, Lyu J, Chen L. Competing risk nomogram predicting cause-specific mortality in older patients with testicular germ cell tumors. Front Med (Lausanne) 2024; 11:1327485. [PMID: 38695022 PMCID: PMC11061386 DOI: 10.3389/fmed.2024.1327485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/20/2024] [Indexed: 05/04/2024] Open
Abstract
Background Testicular germ cell tumor (TGCT) is the most common type of malignancy in young men, but rarely in older adults. We aimed to construct a competing risk model to predict the prognosis for older patients with TGCT. Methods We collected TGCT patients aged 50 years or older diagnosed between 2004 and 2015 from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. We estimated the cumulative incidences of cause-specific death (CSD) and other causes of death and established a nomogram predicting cause-specific mortality in older patients with TGCT by Fine-Gray competing risk regression. The concordance index (C-index), calibration curves, area under the receiver operating characteristic curve (AUC), and decision analysis curves (DCA) were used to evaluate the differentiation, accuracy, and clinical significance of the nomogram. Results A total of 2,751 older TGCT patients were included in the study. The 3-, 5-, and 10-year cumulative incidences were 4.4, 5.0 and 6.1%, respectively, for cause-specific death, and 3.8, 6.2, 13.1%, respectively, for other causes of death. Predictors of cause-specific mortality in older TGCT included age, marital status, annual household income, histology, tumor size, stage and surgery. In the training and validation sets, the C-indexes were greater than 0.8, indicating that the nomogram had good discrimination. The AUC revealed the same result. The calibration curves showed good agreement between the predicted and observed results of the nomogram. DCA curves indicated that the nomogram had more clinical significance than the conventional American Joint Committee on Cancer (AJCC) staging. Based on the total nomogram score of each case, all patients were categorized into low-risk and high-risk groups, and risk categorization allowed the identification of cases with a high risk of death. Conclusion We established a competing risk nomogram with good performance that may help clinicians accurately predict the prognosis of older TGCT patients.
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Affiliation(s)
- Xiaoying Wu
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Mingfei Zhou
- Drug Clinical Trial Institution, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lin Chen
- Drug Clinical Trial Institution, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Wang B, Zhou B, Chen J, Sun X, Yang W, Yang T, Yu H, Chen P, Chen K, Huang X, Fan X, He W, Huang J, Lin T. Type III interferon inhibits bladder cancer progression by reprogramming macrophage-mediated phagocytosis and orchestrating effective immune responses. J Immunother Cancer 2024; 12:e007808. [PMID: 38589249 PMCID: PMC11015199 DOI: 10.1136/jitc-2023-007808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Interferons (IFNs) are essential for activating an effective immune response and play a central role in immunotherapy-mediated immune cell reactivation for tumor regression. Type III IFN (λ), related to type I IFN (α), plays a crucial role in infections, autoimmunity, and cancer. However, the direct effects of IFN-λ on the tumor immune microenvironment have not been thoroughly investigated. METHODS We used mouse MB49 bladder tumor models, constructed a retroviral vector expressing mouse IFN-λ3, and transduced tumor cells to evaluate the antitumor action of IFN-λ3 in immune-proficient tumors and T cell-deficient tumors. Furthermore, human bladder cancer samples (cohort 1, n=15) were used for immunohistochemistry and multiplex immunoflurescence analysis to assess the expression pattern of IFN-λ3 in human bladder cancer and correlate it with immune cells' infiltration. Immunohistochemistry analysis was performed in neoadjuvant immunotherapy cohort (cohort 2, n=20) to assess the correlation between IFN-λ3 expression and the pathological complete response rate. RESULTS In immune-proficient tumors, ectopic Ifnl3 expression in tumor cells significantly increased the infiltration of cytotoxic CD8+ T cells, Th1 cells, natural killer cells, proinflammatory macrophages, and dendritic cells, but reduced neutrophil infiltration. Transcriptomic analyses revealed significant upregulation of many genes associated with effective immune response, including lymphocyte recruitment, activation, and phagocytosis, consistent with increased antitumor immune infiltrates and tumor inhibition. Furthermore, IFN-λ3 activity sensitized immune-proficient tumors to anti-PD-1/PD-L1 blockade. In T cell-deficient tumors, increased Ly6G-Ly6C+I-A/I-E+ macrophages still enhanced tumor cell phagocytosis in Ifnl3 overexpressing tumors. IFN-λ3 is expressed by tumor and stromal cells in human bladder cancer, and high IFN-λ3 expression was positively associated with effector immune infiltrates and the efficacy of immune checkpoint blockade therapy. CONCLUSIONS Our study indicated that IFN-λ3 enables macrophage-mediated phagocytosis and antitumor immune responses and suggests a rationale for using Type III IFN as a predictive biomarker and potential immunotherapeutic candidate for bladder cancer.
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Affiliation(s)
- Bo Wang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Bingkun Zhou
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Junyu Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Xi Sun
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Wenjuan Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Department of Hematology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Tenghao Yang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Hao Yu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Peng Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Ke Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Xiaodong Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Xinxiang Fan
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Wang He
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-sen (Zhongshan) University, Guangzhou, China
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Porcaro AB, Panunzio A, Orlando R, Tafuri A, Gallina S, Bianchi A, Serafin E, Mazzucato G, Montanaro F, Baielli A, Artoni F, Ditonno F, Roggero L, Franceschini A, Boldini M, Treccani LP, Veccia A, Rizzetto R, Brunelli M, De Marco V, Siracusano S, Cerruto MA, Bertolo R, Antonelli A. The 2012 Briganti nomogram predicts disease progression after surgery in high-risk prostate cancer patients. Arab J Urol 2024; 22:227-234. [PMID: 39355796 PMCID: PMC11441050 DOI: 10.1080/20905998.2024.2339062] [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: 01/24/2024] [Accepted: 03/30/2024] [Indexed: 10/03/2024] Open
Abstract
Objectives We tested whether the 2012 Briganti nomogram for the risk of pelvic lymph node invasion (PLNI) may represent a predictor of disease progression after surgical management in high-risk (HR) prostate cancer (PCa) patients according to the European Association of Urology. Methods Between January 2013 and December 2021, HR PCa patients treated with robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND) were identified. The 2012 Briganti nomogram was evaluated as a continuous and categorical variable, which was dichotomized using the median. The risk of disease progression, defined as the event of biochemical recurrence and/or local recurrence/distant metastases was assessed by Cox regression models. Results Overall, 204 patients were identified. The median 2012 Briganti nomogram score resulted 12.0% (IQR: 6.0-22.0%). PLNI was detected in 57 (27.9%) cases. Compared to patients who had preoperatively a 2012 Briganti nomogram score ≤12%, those with a score >12% were more likely to present with higher percentage of biopsy positive cores, palpable tumors at digital rectal examination, high-grade cancers at prostate biopsies, and unfavorable pathology in the surgical specimen. At multivariable Cox regression analyses, disease progression, which occurred in 85 (41.7%) patients, was predicted by the 2012 Briganti nomogram score (HR: 1.02; 95%CI: 1.00-1.03; p = 0.012), independently by tumors presenting as palpable (HR: 1.78; 95%CI: 1.10.2.88; p = 0.020) or the presence of PLNI in the surgical specimen (HR: 3.73; 95%CI: 2.10-5.13; p = 0.012). Conclusions The 2012 Briganti nomogram represented an independent predictor of adverse prognosis in HR PCa patients treated with RARP and ePLND. As the score increased, so patients were more likely to experience disease progression, independently by the occurrence of PLNI. The association between the nomogram, unfavorable pathology and tumor behavior might turn out to be useful for selecting a subset of patients needing different treatment paradigms in HR disease.
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Affiliation(s)
- Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Rossella Orlando
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Sebastian Gallina
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alberto Bianchi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Emanuele Serafin
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giovanni Mazzucato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Francesca Montanaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alberto Baielli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Francesco Artoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Francesco Ditonno
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Luca Roggero
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Andrea Franceschini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michele Boldini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Vincenzo De Marco
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Salvatore Siracusano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Riccardo Bertolo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Yajima S, Nakanishi Y, Ogasawara RA, Imasato N, Hirose K, Katsumura S, Kataoka M, Masuda H. Comparing Preoperative Screening Tools for Elective Urologic Cancer Surgery: Insights from a Cluster Analysis. Gerontology 2024; 70:741-754. [PMID: 38583416 DOI: 10.1159/000538733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/31/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the features and benefits of different geriatric screening tools for enhancing the perioperative care of patients who undergo elective cancer surgery using cluster analysis. METHODS This study was a retrospective, observational analysis of 1,019 consecutive patients who had elective major cancer surgery in the urology department of our hospital from October 2019 to January 2023. Before the surgery, a trained nurse screened the patients using six tools: Eastern Clinical Oncology Group performance status (ECOG-PS), flemish version of the triage risk screening tool (fTRST), geriatric-8 (G8), instrumental activities of daily living, patient health questionnaire-2 (PHQ-2), and simple questionnaire to rapidly diagnose sarcopenia (SARC-F). The study grouped the patients into four clusters based on their scores on these tools and compared their outcomes after the surgery. The outcomes included overall survival, ambulation failure, delirium, and severe complications. The study also examined how each screening tool was associated with the outcomes. RESULTS Based on their clinical data and screening results, we classified the patients into four groups: Healthy (73%), Depressive (11%), Intermediate (11%), and Unhealthy (5%). The Unhealthy group had the worst outcomes in overall survival (OS), ambulation failure, and delirium, followed by the Intermediate group. In addition, fTRST and SARC-F emerged as significant predictors of OS; ECOG-PS, fTRST, G8, and SARC-F of ambulation failure; ECOG-PS, fTRST, and G8 of delirium; and G8 of severe complications. CONCLUSION Various geriatric screening tools were found to have the potential to forecast diverse postoperative outcomes.
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Affiliation(s)
- Shugo Yajima
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yasukazu Nakanishi
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ryo Andy Ogasawara
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Naoki Imasato
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kohei Hirose
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Sao Katsumura
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Madoka Kataoka
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hitoshi Masuda
- Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan
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Cai T, Feng T, Li G, Wang J, Jin S, Ye D, Zhu Y. Deciphering the prognostic features of bladder cancer through gemcitabine resistance and immune-related gene analysis and identifying potential small molecular drug PIK-75. Cancer Cell Int 2024; 24:125. [PMID: 38570787 PMCID: PMC10993528 DOI: 10.1186/s12935-024-03258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/02/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Bladder cancer (BCa) stands out as a prevalent and highly lethal malignancy worldwide. Chemoresistance significantly contributes to cancer recurrence and progression. Traditional Tumor Node Metastasis (TNM) stage and molecular subtypes often fail to promptly identify treatment preferences based on sensitivity. METHODS In this study, we developed a prognostic signature for BCa with uni-Cox + LASSO + multi-Cox survival analysis in multiple independent cohorts. Six machine learning algorithms were adopted to screen out the hub gene, RAC3. IHC staining was used to validate the expression of RAC3 in BCa tumor tissue. RT-qPCR and Western blot were performed to detect and quantify the mRNA and protein levels of RAC3. CCK8, colony formation, wound healing, and flow cytometry analysis of apoptosis were employed to determine cell proliferation, migration, and apoptosis. Molecular docking was used to find small target drugs, PIK-75. 3D cell viability assay was applied to evaluate the ATP viability of bladder cancer organoids before and after PIK-75 treated. RESULTS The established clinical prognostic model, GIRS, comprises 13 genes associated with gemcitabine resistance and immunology. This model has demonstrated robust predictive capabilities for survival outcomes across various independent public cohorts. Additionally, the GIRS signature shows significant correlations with responses to both immunotherapy and chemotherapy. Leveraging machine learning algorithms, the hub gene, RAC3, was identified, and potential upstream transcription factors were screened through database analysis. IHC results showed that RAC3 was higher expressed in GEM-resistant BCa patients. Employing molecular docking, the small molecule drug PIK-75, as binding to RAC3, was identified. Experiments on cell lines, organoids and animals validated the biological effects of PIK-75 in bladder cancer. CONCLUSIONS The GIRS signature offers a valuable complement to the conventional anatomic TNM staging system and molecular subtype stratification in bladder cancer. The hub gene, RAC3, plays a crucial role in BCa and is significantly associated with resistance to gemcitabine. The small molecular drug, PIK-75 having the potential as a therapeutic agent in the context of gemcitabine-resistant and immune-related pathways.
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Affiliation(s)
- Tingting Cai
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tao Feng
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guangren Li
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jin Wang
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Shandong, China
- Shandong Provincial Qianfoshan Hospital, Shandong, China
| | - Shengming Jin
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Yiping Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Li Z, Li S, Li G, Yu T, Zhang Z. Clear-cell renal cell carcinoma(ccRCC) with hemangioblastoma(HB)-like features: A rare case report and literature review. Asian J Surg 2024; 47:1859-1860. [PMID: 38182515 DOI: 10.1016/j.asjsur.2023.12.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/25/2023] [Indexed: 01/07/2024] Open
Affiliation(s)
- Zhen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Shike Li
- Graduate School of Dalian Medical University, Lvshun South Road, Dalian, 116044, Liaoning Province, China.
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Tingting Yu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Zhuo Zhang
- Department of Radiation Oncology, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
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Lesko P, Obertova J, Kajo K, Rejlekova K, Orszaghova Z, Lehotska V, Ondrusova M, Chovanec M, Ondrus D, Mego M. Testicular Seminoma in Prostate: Case Report and Review of Literature. Clin Genitourin Cancer 2024; 22:210-216. [PMID: 38040557 DOI: 10.1016/j.clgc.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Peter Lesko
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Jana Obertova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Karol Kajo
- Department of Pathology, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Katarina Rejlekova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Zuzana Orszaghova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Viera Lehotska
- 2nd Department of Radiology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Martina Ondrusova
- Department of Preventive and Clinical Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Michal Chovanec
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1st Department of Oncology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Michal Mego
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic.
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Bologna E, Licari LC, Franco A, Ditonno F, Manfredi C, De Nunzio C, Antonelli A, De Sio M, Leonardo C, Simone G, Cherullo EE, Autorino R. Incidental Prostate Cancer in Patients Treated for Benign Prostatic Hyperplasia: Analysis from a Contemporary National Dataset. Diagnostics (Basel) 2024; 14:677. [PMID: 38611590 PMCID: PMC11011333 DOI: 10.3390/diagnostics14070677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Prostate Cancer (PCa) may be incidentally diagnosed during the microscopic evaluation of resected tissue from BPH surgeries, characterizing the clinical condition known as incidental PCa (iPCa). This study aims to assess the prevalence of iPCa following BPH surgery to evaluate the associated surgical procedures and to scrutinize preoperative and postoperative management. (2) Methods: A retrospective analysis was conducted using the PearlDiver™ Mariner database, containing patient records compiled between 2011 and 2021. International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were employed to identify the population and outcomes. Our primary objective was to assess the prevalence of iPCa, categorized by the type of procedures, and to evaluate the subsequent treatment strategies. The secondary aim was to assess the impact of prostate biopsy (PB) and prostate MRI on iPCa detection. (3) Results: The overall cohort, accounting for 231,626 patients who underwent BPH surgery, exhibited a 2.2% prevalence rate of iPCa. The highest rate was observed for TURP (2.32%), while the lowest was recorded for RASP (1.18%). Preoperative MRI and PB demonstrated opposing trends over the years. Of the 5090 patients identified with iPCa, nearly 68% did not receive active treatment. The most common treatments were RT and ADT; 34.6% underwent RT, 31.75% received ADT, and 21.75% were treated with RT+ADT. RP was administered to approximately 9% of patients undergoing endoscopic procedures. Multivariate logistic regression analysis revealed age and openSP as additional risk factors for iPCa. Conversely, PB and MRI before surgery were linked to a decreased risk. (4) Conclusions: The contemporary prevalence of iPCa after BPH surgery is <3%. The increase in the use of prostate MRI mirrors a decline in the PB biopsy prior to BPH surgery but without resulting in an increased detection rate of iPCa. In contemporary routine clinical practice, iPCa is mostly managed in a different way when compared to biopsy-detected PCa.
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Affiliation(s)
- Eugenio Bologna
- Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (E.B.); (L.C.L.)
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
| | - Leslie Claire Licari
- Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (E.B.); (L.C.L.)
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
| | - Antonio Franco
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
- Department of Urology, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy;
| | - Francesco Ditonno
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
- Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, 37129 Verona, Italy;
| | - Celeste Manfredi
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Cosimo De Nunzio
- Department of Urology, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy;
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, 37129 Verona, Italy;
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Costantino Leonardo
- Department of Urology, “Regina Elena” National Cancer Institute, 00144 Rome, Italy; (C.L.); (G.S.)
| | - Giuseppe Simone
- Department of Urology, “Regina Elena” National Cancer Institute, 00144 Rome, Italy; (C.L.); (G.S.)
| | - Edward E. Cherullo
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
| | - Riccardo Autorino
- Department of Urology, Rush University, Chicago, IL 60612, USA; (A.F.); (F.D.); (C.M.); (E.E.C.)
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Li S, Wang J, Zhang Z, Wu Y, Liu Z, Yin Z, Liu J, He D. Establishment and validation of nomograms to predict the overall survival and cancer-specific survival for non-metastatic bladder cancer patients: A large population-based cohort study and external validation. Medicine (Baltimore) 2024; 103:e37492. [PMID: 38489693 PMCID: PMC10939645 DOI: 10.1097/md.0000000000037492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/08/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
This study aimed to develop nomograms to accurately predict the overall survival (OS) and cancer-specific survival (CSS) of non-metastatic bladder cancer (BC) patients. Clinicopathological information of 260,412 non-metastatic BC patients was downloaded from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2020. LASSO method and Cox proportional hazard regression analysis were utilized to discover the independent risk factors, which were used to develop nomograms. The accuracy and discrimination of models were tested by the consistency index (C-index), the area under the subject operating characteristic curve (AUC) and the calibration curve. Decision curve analysis (DCA) was used to test the clinical value of nomograms compared with the TNM staging system. Nomograms predicting OS and CSS were constructed after identifying independent prognostic factors. The C-index of the training, internal validation and external validation cohort for OS was 0.722 (95%CI: 0.720-0.724), 0.723 (95%CI: 0.721-0.725) and 0.744 (95%CI: 0.677-0.811). The C-index of the training, internal validation and external validation cohort for CSS was 0.794 (95%CI: 0.792-0.796), 0.793 (95%CI: 0.789-0.797) and 0.879 (95%CI: 0.814-0.944). The AUC and the calibration curves showed good accuracy and discriminability. The DCA showed favorable clinical potential value of nomograms. Kaplan-Meier curve and log-rank test uncovered statistically significance survival difference between high- and low-risk groups. We developed nomograms to predict OS and CSS for non-metastatic BC patients. The models have been internally and externally validated with accuracy and discrimination and can assist clinicians to make better clinical decisions.
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Affiliation(s)
- Shan Li
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Jinkui Wang
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhaoxia Zhang
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yuzhou Wu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenyu Liu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhikang Yin
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junhong Liu
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Dawei He
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
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Bagheri H, Mahdavi SR, Geramifar P, Neshasteh-Riz A, Sajadi Rad M, Dadgar H, Arabi H, Zaidi H. An Update on the Role of mpMRI and 68Ga-PSMA PET Imaging in Primary and Recurrent Prostate Cancer. Clin Genitourin Cancer 2024; 22:102076. [PMID: 38593599 DOI: 10.1016/j.clgc.2024.102076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 04/11/2024]
Abstract
The objective of this work was to review comparisons of the efficacy of 68Ga-PSMA-11 (prostate-specific membrane antigen) PET/CT and multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer among patients undergoing initial staging prior to radical prostatectomy or experiencing recurrent prostate cancer, based on histopathological data. A comprehensive search was conducted in PubMed and Web of Science, and relevant articles were analyzed with various parameters, including year of publication, study design, patient count, age, PSA (prostate-specific antigen) value, Gleason score, standardized uptake value (SUVmax), detection rate, treatment history, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and PI-RADS (prostate imaging reporting and data system) scores. Only studies directly comparing PSMA-PET and mpMRI were considered, while those examining combined accuracy or focusing on either modality alone were excluded. In total, 24 studies comprising 1717 patients were analyzed, with the most common indication for screening being staging, followed by relapse. The findings indicated that 68Ga-PSMA-PET/CT effectively diagnosed prostate cancer in patients with suspected or confirmed disease, and both methods exhibited comparable efficacy in identifying lesion-specific information. However, notable heterogeneity was observed, highlighting the necessity for standardization of imaging and histopathology systems to mitigate inter-study variability. Future research should prioritize evaluating the combined diagnostic performance of both modalities to enhance sensitivity and reduce unnecessary biopsies. Overall, the utilization of PSMA-PET and mpMRI in combination holds substantial potential for significantly advancing the diagnosis and management of prostate cancer.
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Affiliation(s)
- Hamed Bagheri
- Radiation Biology Research Center, Iran University of Medical Science (IUMS), Tehran, Iran
| | - Seyed Rabi Mahdavi
- Radiation Biology Research Center and Department of Medical Physics, Iran University of Medical Sciences, Tehran, Iran.
| | - Parham Geramifar
- Department Nuclear Medicine, School of Medicine Shariati Hospital, Tehran, Iran
| | - Ali Neshasteh-Riz
- Radiation Biology Research Center, Iran University of Medical Science (IUMS), Tehran, Iran
| | - Masoumeh Sajadi Rad
- Radiation Biology Research Center, Iran University of Medical Science (IUMS), Tehran, Iran
| | - Habibollah Dadgar
- Imam Reza research Center, Nuclear Medicine and Molecular imaging department, RAZAVI Hospital, Mashhad, Iran
| | - Hossein Arabi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University 6Medical Center Groningen, Groningen, Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark; University Research and Innovation Center, Óbuda University, Budapest, Hungary.
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Zhai H, Wang Y, Chen Z, Wang Z, Xing J, Zhu X, Hao G. Clinicopathological characteristics, surgical treatments, and oncological outcomes of localized primary unifocal urothelial carcinoma involving the ureterovesical junction. Int Urol Nephrol 2024; 56:941-955. [PMID: 37847324 DOI: 10.1007/s11255-023-03838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To investigate clinicopathological characteristics, surgical treatments, and oncological outcomes of patients with localized primary unifocal urothelial carcinoma involving the ureterovesical junction (UC-UVJ). PATIENTS AND METHODS Localized primary unifocal UC-UVJ cases in patients admitted to our hospital from March 2013 to August 2021 were reviewed. Clinicopathological parameters, perioperative data, and oncological outcomes were compared between patients grouped by tumor location and surgical treatment. RESULTS A total of 130 patients with localized primary unifocal UC-UVJ were enrolled in this study. These included 72 cases of bladder cancer (BC) involving the ureteral orifice, and 58 cases of upper urinary tract urothelial carcinoma (UTUC) involving the intramural ureter. The proportion of male patients, hydronephrosis, flank pain/abdominal pain, and tumor size differed significantly between the BC and UTUC groups (all P < 0.05). During the median follow-up period of 32.9 months, 49 cases (37.7%) recurred and 29 (22.3%) died from urothelial carcinoma (UC), though no statistical difference in recurrence (P = 0.436) or cancer-specific mortality (P = 0.653) was observed between the BC and UTUC groups. Cox proportional hazards regression analysis identified age, tumor grade, and lymphovascular invasion (LVI) as independent predictors of cancer-specific survival (CSS), and sex, T stage, tumor grade, and LVI as independent predictors of recurrence-free survival (RFS). CONCLUSION Owing to positional properties, patients with localized primary unifocal UC-UVJ exhibited significant heterogeneity, leading to varied treatment strategies. No statistically significant differences in CSS or RFS were observed between the BC and UTUC groups. Furthermore, age, sex, T stage, tumor grade, and LVI should be carefully considered in clinical practice because of their associations with CSS and RFS.
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Affiliation(s)
- Hongyun Zhai
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Yanghai Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zhenghao Chen
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zhiwen Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jiyu Xing
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Xi Zhu
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Gangyue Hao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Yao L, Du Y, Dong W, Gao X, Guo J, Qiu J, Wei Q, Wu S, Ye D, Yu W, Zeng H, Zhang Q, Zhang Y, Zhang Z, Zhou F, Yang W, Wang H, Zhang X, He Z. Chinese quality control indices for standardized diagnosis and treatment of renal cancer (2022 edition). JOURNAL OF THE NATIONAL CANCER CENTER 2024; 4:6-13. [PMID: 39036384 PMCID: PMC11256713 DOI: 10.1016/j.jncc.2023.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 07/23/2024] Open
Abstract
Renal cancer is one of the most common malignancies of the urinary system, and the number of deaths continues to increase. The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions. The Renal Cancer Expert Committee of the National Cancer Quality Control Center (NCQCC) identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer. The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization, uniformity, and normalization of renal cancer diagnosis and treatment, which ultimately improved the survival rate and quality of life of renal cancer patients. A panel of experts with renal cancer surgery, renal cancer medicine, medical imaging, pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer. The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer, such as standard diagnosis, surgery treatment, systemic treatment, and prognostic evaluation.
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Affiliation(s)
- Lin Yao
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Yicong Du
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Wen Dong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xianshu Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - Jun Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jianxing Qiu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Shikai Wu
- Department of Oncology, Peking University First Hospital, Beijing, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Yong Zhang
- Department of Urology Surgery, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiling Zhang
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Fangjian Zhou
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Wenjing Yang
- Office for Cancer Diagnosis and Treatment Quality Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Wang
- Office for Cancer Diagnosis and Treatment Quality Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Zhang
- Department of Urology, The Third Medical Center, Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Zhisong He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
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Yajima S, Nakanishi Y, Ogasawara RA, Imasato N, Hirose K, Katsumura S, Kataoka M, Masuda H. Housework participation and mortality in Japanese male patients undergoing cancer surgery: A propensity score-matched study. Prev Med 2024; 180:107896. [PMID: 38360151 DOI: 10.1016/j.ypmed.2024.107896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Participation in housework and meal preparation are instrumental activity of daily living (IADL) evaluation items that is known to predict prognosis and complications in cancer care. However, these items are often assessed only for females, not for males, in IADL. METHODS We examined the impact of habit of housework and meal preparation on overall survival (OS) in 1025 Japanese male patients who underwent elective urologic cancer surgery at our institution. The study also used a cohort that was matched by propensity score. RESULTS We found that patients who did not prepare meals or do housework had significantly shorter OS (hazard ratio [HR] = 3.34, P = 0.005; HR = 5.01, P < 0.001, respectively). Even in the cohort of 448 patients matched by propensity score and adjusted for age, body mass index, comorbidities, performance status, living status, cancer type, stage groups of cancer, and surgical approach, lack of participation in housework was associated with shorter OS (HR = 2.92, P = 0.04) and was an independent predictor of worse OS in multivariable analysis (HR = 5.13, P = 0.008). CONCLUSIONS Males who did not regularly do household chores before elective cancer surgery had worse life outcomes. Doing more daily physical activities, such as household chores like making the bed and cleaning the room, might have a positive impact on survival when fighting cancer.
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Affiliation(s)
- Shugo Yajima
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan.
| | - Yasukazu Nakanishi
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Ryo Andy Ogasawara
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Naoki Imasato
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Kohei Hirose
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Sao Katsumura
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Madoka Kataoka
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
| | - Hitoshi Masuda
- National Cancer Center Hospital East, Department of Urology, 6-5-1 Kashiwa no ha, Kashiwa City, Chiba 277-8577, Japan
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McHugh DJ, Gleeson JP, Feldman DR. Testicular cancer in 2023: Current status and recent progress. CA Cancer J Clin 2024; 74:167-186. [PMID: 37947355 DOI: 10.3322/caac.21819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 11/12/2023] Open
Abstract
Testicular germ cell tumor (GCT) is the most common solid tumor in adolescent and young adult men. Progress in the management of GCT has been made in the last 50 years, with a substantial improvement in cure rates for advanced disease, from 25% in the 1970s to nearly 80%. However, relapsed or platinum-refractory disease occurs in a proportion, 20% of whom will die from disease progression. This article reviews the current evidence-based treatments for extracranial GCT, the acute and chronic toxic effects that may result, and highlights contemporary advances and progress in the field.
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Affiliation(s)
- Deaglan J McHugh
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medicine, New York, New York, USA
| | - Jack P Gleeson
- Cancer Research, College of Medicine and Health, University College Cork, Cork, Ireland
- Medical Oncology Department, Cork University Hospital, Cork, Ireland
| | - Darren R Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medicine, New York, New York, USA
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Li F, Wang P, Ye J, Xie G, Yang J, Liu W. Serum EZH2 is a novel biomarker for bladder cancer diagnosis and prognosis. Front Oncol 2024; 14:1303918. [PMID: 38476362 PMCID: PMC10927824 DOI: 10.3389/fonc.2024.1303918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024] Open
Abstract
Objective The primary objective of this study was to examine the levels of serum EZH2 in patients diagnosed with bladder cancer, and subsequently evaluate its potential as a biomarker for both the diagnosis and prognosis of bladder cancer. Methods Blood samples were obtained from 115 bladder cancer patients and 115 healthy persons. We measured the EZH2 concentrations in the serum of these subjects via enzyme-linked immunosorbent assay (ELISA). To assess the diagnostic performance of serum EZH2 in detecting bladder cancer, we plotted receiver operating characteristic (ROC) curves and calculated their corresponding area under the curve (AUC). We also used the Cox regression model and log-rank test to investigate the correlation between EZH2 levels and clinicopathological characteristics, and survival rates of bladder cancer patients. Results Serum EZH2 levels were significantly higher in bladder cancer patients when compared to those in healthy persons. Serum EZH2 levels exhibited a significant correlation with TNM stage, lymph node metastasis, muscle invasion, and tumor size. At a cutoff value of 8.23 ng/mL, EZH2 was able to differentiate bladder cancer patients from healthy persons, with an AUC of 0.87, a sensitivity of 81.31%, and a specificity of 78.42%. High EZH2 levels correlated with poor overall survival rates and progression-free survival rates of bladder cancer patients. Conclusions Serum EZH2 levels were elevated in bladder cancer patients, and patients with higher serum EZH2 levels exhibited a poorer prognosis. This indicates that serum EZH2 could be a novel biomarker for bladder cancer diagnosis and prognosis. Such findings could improve the prognosis of bladder cancer patients by facilitating early detection and continuous monitoring.
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Affiliation(s)
- Feng Li
- Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Pengqiao Wang
- Department of Medical Administration, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jun Ye
- Department of Clinical Laboratory, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Guoping Xie
- Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jinfeng Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Wei Liu
- Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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Yu SH, Kim SS, Kim S, Lee H, Kang TW. FGFR3 Mutations in Urothelial Carcinoma: A Single-Center Study Using Next-Generation Sequencing. J Clin Med 2024; 13:1305. [PMID: 38592174 PMCID: PMC10931944 DOI: 10.3390/jcm13051305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Mutations of fibroblast growth factor receptor 3 (FGFR3) are associated with urothelial carcinoma (UC) oncogenesis and are considered an important therapeutic target. Therefore, we evaluated the FGFR3 mutation rate and its clinical significance in urothelial carcinoma (UC) using next-generation sequencing. Methods: A total of 123 patients with UC who were treated at Chonnam National University Hospital (Gwang-ju, Korea) from January 2018 to December 2020 were enrolled. We performed NGS using the Oncomine panel with tumor specimens and blood samples corresponding to each specimen. We analyzed the FGFR3 mutation results according to the type of UC and the effects on early recurrence and progression. Results: The mean age of the patients was 71.39 ± 9.33 years, and 103 patients (83.7%) were male. Overall, the FGFR3 mutation rate was 30.1% (37 patients). The FGFR3 mutation rate was the highest in the non-muscle-invasive bladder cancer (NMIBC) group (45.1%), followed by the muscle-invasive bladder cancer (22.7%) and upper tract UC (UTUC) (14.3%) groups. Patients with FGFR3 mutations had a significantly lower disease stage (p = 0.019) but a high-risk of NMIBC (p < 0.001). Conclusions: Our results revealed that FGFR3 mutations were more prevalent in patients with NMIBC and lower stage UC and associated with a high-risk of NMIBC. Large multicenter studies are needed to clarify the clinical significance of FGFR3 mutations in UC.
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Affiliation(s)
- Seong Hyeon Yu
- Department of Urology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Republic of Korea;
| | - Sung sun Kim
- Department of Pathology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Republic of Korea;
| | - Shinseung Kim
- MediCloud Corporation, Hwasun 58128, Republic of Korea; (S.K.); (H.L.)
| | - Hyungki Lee
- MediCloud Corporation, Hwasun 58128, Republic of Korea; (S.K.); (H.L.)
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Republic of Korea;
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Ateş SG, Demirel BB, Başar H, Uçmak G. The Added-value of Staging 18F-FDG PET/CT in the Prediction of Overall Survival in the Patients with Bladder Cancer. Mol Imaging Radionucl Ther 2024; 33:11-18. [PMID: 38390706 PMCID: PMC10899737 DOI: 10.4274/mirt.galenos.2023.65002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/05/2023] [Indexed: 02/24/2024] Open
Abstract
Objectives This retrospective study aimed to evaluate the prognostic importance of 18F-fluorodeoxyglucose (18F-FDG)-positive pelvic lymph nodes (LNs) and extra-pelvic disease on staging 18F-FDG positron emission tomography/computed tomography (PET/CT) in patients with bladder cancer. Methods Bladder cancer patients who underwent staging 18F-FDG PET/CT were included in the study. Histopathologic features of tumors, therapy histories, presence of distinguishable tumors on CT and PET images, sizes and maximum standardized uptake value (SUVmax) of primary tumors, total numbers, sizes, and SUVmax of 18F-FDG-positive pelvic and extra-pelvic LNs, and total numbers and SUVmax of distant metastases (M1a/1b) were recorded. Patients were followed up until death or the last medical visit. Factors predicting overall survival were determined using Cox regression analysis. Results Fifty-five patients [median age: 70 (53-84), 48 (87.3%) male, 7 (12.7%) female] with bladder cancer were included in this study. Twenty-nine (52.7%) patients had 18F-FDG positive pelvic LNs, while 24 (43.7%) patients had 18F-FDG positive extra-pelvic disease. Patients with 18F-FDGpositive pelvic LNs had a higher rate of extra-pelvic disease (p=0.003). The median follow-up duration was 13.5 months. The median overall survival was 16.3 months [95% confidence interval (CI) 8.9-23.7]. The primary tumor distinguishability on PET (p=0.011) and CT (p=0.009) images, the presence of 18F-FDG-positive pelvic LNs (p<0.001) and 18F-FDG-positive extra-pelvic disease/distant metastases (M1a/M1b) (p<0.001), and the number of distant metastases (p=0.034) were associated with mortality. The 18F-FDG-positive extra-pelvic disease/distant metastases [p=0.029, odds ratio: 4.15 (95% CI 1.16-14.86)] was found to be an independent predictor of mortality in patients with bladder cancer. Conclusion The presence of 18F-FDG-positive extra-pelvic disease in pretreatment 18F-FDG PET/CT is an important prognostic factor in bladder cancer patients.
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Affiliation(s)
- Seda Gülbahar Ateş
- Hitit University Çorum Erol Olçok Training and Research Hospital, Department of Nuclear Medicine, Çorum, Türkiye
| | - Bedriye Büşra Demirel
- University of Health Sciences Türkiye, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Türkiye
| | - Halil Başar
- University of Health Sciences Türkiye, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Urology, Ankara, Türkiye
| | - Gülin Uçmak
- University of Health Sciences Türkiye, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Türkiye
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Jiang L, Tong Y, Wang J, Jiang J, Gong Y, Zhu D, Zheng L, Zhao D. A dynamic visualization clinical tool constructed and validated based on the SEER database for screening the optimal surgical candidates for bone metastasis in primary kidney cancer. Sci Rep 2024; 14:3561. [PMID: 38347099 PMCID: PMC10861469 DOI: 10.1038/s41598-024-54085-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
The implementation of primary tumor resection (PTR) in the treatment of kidney cancer patients (KC) with bone metastases (BM) has been controversial. This study aims to construct the first tool that can accurately predict the likelihood of PTR benefit in KC patients with BM (KCBM) and select the optimal surgical candidates. This study acquired data on all patients diagnosed with KCBM during 2010-2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was utilized to achieve balanced matching of PTR and non-PTR groups to eliminate selection bias and confounding factors. The median overall survival (OS) of the non-PTR group was used as the threshold to categorize the PTR group into PTR-beneficial and PTR-Nonbeneficial subgroups. Kaplan-Meier (K-M) survival analysis was used for comparison of survival differences and median OS between groups. Risk factors associated with PTR-beneficial were identified using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC), area under the curve (AUC), calibration curves, and decision curve analysis (DCA) were used to validate the predictive performance and clinical utility of the nomogram. Ultimately, 1963 KCBM patients meeting screening criteria were recruited. Of these, 962 patients received PTR and the remaining 1061 patients did not receive PTR. After 1:1 PSM, there were 308 patients in both PTR and non-PTR groups. The K-M survival analysis results showed noteworthy survival disparities between PTR and non-PTR groups, both before and after PSM (p < 0.001). In the logistic regression results of the PTR group, histological type, T/N stage and lung metastasis were shown to be independent risk factors associated with PTR-beneficial. The web-based nomogram allows clinicians to enter risk variables directly and quickly obtain PTR beneficial probabilities. The validation results showed the excellent predictive performance and clinical utility of the nomograms for accurate screening of optimal surgical candidates for KCBM. This study constructed an easy-to-use nomogram based on conventional clinicopathologic variables to accurately select the optimal surgical candidates for KCBM patients.
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Affiliation(s)
- Liming Jiang
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Yuexin Tong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Jun Wang
- Department of Orthopedics, Rizhao People's Hospital, Rizhao, 276800, Shandong, People's Republic of China
| | - Jiajia Jiang
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Yan Gong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Dejin Zhu
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Linyang Zheng
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China
| | - Dongxu Zhao
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, Jilin, People's Republic of China.
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Yajima S, Nakanishi Y, Ogasawara RA, Imasato N, Hirose K, Katsumura S, Kataoka M, Masuda H. Value of Cystatin C-Based Sarcopenia Index in Patients Undergoing Surgery for Renal Tumors. Clin Genitourin Cancer 2024:102051. [PMID: 38423930 DOI: 10.1016/j.clgc.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Sarcopenia is a condition of low muscle strength and quantity, severe if low physical performances. The sarcopenia index (SI), calculated by blood levels of creatinine and cystatin C, had been reported to be correlated with skeletal muscle mass and is a potential simple screening tool for sarcopenia. We hypothesized that patients with a low SI, meaning low muscle mass, would have an inflated estimated glomerular filtration rate (eGFR) value based on serum creatinine levels. We also tested the prognostic value of the SI in a cohort of patients who had surgery for renal malignancies. PATIENTS AND METHODS We conducted a retrospective, observational study of 322 patients that had surgery for renal tumors in National Cancer Center Hospital East (Kashiwa, Chiba) between April 2017 and June 2023. We assessed sarcopenia measuring psoas muscle index (PMI), psoas muscle density (PMD), and skeletal muscle area (SMA) by computed tomography. We assessed the association between SI and eGFR before and after surgery. We also assessed the association between SI and postoperative outcome, including overall survival. RESULTS Of the 322 patients, 211 (66%) were males, with a median age of 69 years. SI had a weak correlation with both PMI and PMD in males (PMI: ρ = 0.25; PMD: ρ = 0.21). In females, SI and PMD exhibited a low correlation (ρ = 0.26), while SI and PMI displayed an insignificant correlation (ρ = 0.19). The correlation between SMA and SI was moderate for both males and females (males: ρ = 0.51; females: ρ = 0.46). After radical nephrectomy, eGFR decreased in 98% of patients with high SI, compared to 69% of patients with low SI. We also demonstrated that low SI predicted poor prognosis. CONCLUSIONS Clinicians can recognize the possibility of overestimated eGFR in the low SI group by measuring SI around the surgery. Low SI may also help predict poor prognosis.
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Affiliation(s)
- Shugo Yajima
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan.
| | - Yasukazu Nakanishi
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Ryo Andy Ogasawara
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Naoki Imasato
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Kohei Hirose
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Sao Katsumura
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Madoka Kataoka
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Hitoshi Masuda
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
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Noronha V, Kapu V, Joshi A, Menon N, Singh A, Prakash G, Menon S, Sable N, Murthy V, Pal M, Arora A, Kumar S, Banavali S, Prabhash K. Clinical Profile and Outcomes of Carcinoma Penis Patients Receiving Systemic Therapy at an Indian tertiary care Center: A Retrospective Observational Study. Clin Genitourin Cancer 2024; 22:102053. [PMID: 38442451 DOI: 10.1016/j.clgc.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/03/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Penile cancer is a rare malignancy with scant data on the impact of systemic therapy on outcomes. METHODS Retrospective observational study of patients with a histological diagnosis of carcinoma penis treated with systemic therapy at the Tata Memorial Centre (Mumbai, India) between August 2010 and February 2018. Primary objective was overall survival (OS); secondary objectives included assessment of clinical characteristics, treatment approaches, and toxicity profiles. RESULTS We included 91 patients with penile carcinoma who received systemic therapy at our center. Intent of therapy was curative in 71 patients (78%), and palliative in 20 (22%). Median age was 57 years (interquartile range [IQR], 50-65.5) for curatively treated patients and 58.5 years (IQR, 44-65.2) for those with advanced disease. Common presenting symptoms were lumps (70%), and pain (57%). Neoadjuvant chemotherapy (NACT) with paclitaxel + platinum was administered to 19 patients (20.9%), of which 7 (37%) attained complete or partial response. Six patients (31.5%) underwent R0 surgery post-NACT. All 71 patients underwent primary surgery; 47 (66.2%) undergoing partial penectomy. Of the 20 patients treated with palliative first-line chemotherapy, 4(20%) attained a partial response. Median OS of patients treated in curative and palliative settings was 33.8 months (95% CI, 17.2-not recorded) and 11.4 months (95% CI, 9.53-23.3), respectively. CONCLUSIONS Patients with penile cancer treated with systemic therapy have poor outcomes. Little over a third of the patients respond to neoadjuvant chemotherapy and those with advanced disease have poor survival despite systemic therapy, emphasizing the need for early detection and optimum management of primary and nodal disease.
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Affiliation(s)
- Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Venkatesh Kapu
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Ajaykumar Singh
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Nilesh Sable
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Amandeep Arora
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Sravan Kumar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Shripad Banavali
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India.
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