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Gallagher BDT, Chiam K, Bang A, Patel MI, Kench JG, Edwards S, Nair-Shalliker V, Smith DP. Descriptive analysis of prostate cancer pathology data from diagnosis and surgery in men from the 45 and Up Study. Pathology 2024; 56:39-46. [PMID: 38104002 DOI: 10.1016/j.pathol.2023.09.011] [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: 03/19/2023] [Revised: 08/12/2023] [Accepted: 09/19/2023] [Indexed: 12/19/2023]
Abstract
Information available from the New South Wales Cancer Registry (NSWCR) about the aggressiveness of prostate cancer is limited to the summary stage variable 'degree of spread', which contains a high proportion of cases defined as 'unknown'. In this study we demonstrate the feasibility of obtaining and analysing prostate cancer pathology data from stored pathology records. Pathology data were extracted from stored pathology records of incident prostate cancer cases in men participating in the 45 and Up Study, a large Australian prospective cohort study, who were diagnosed between January 2006 and December 2013. Baseline questionnaires from the 45 and Up Study were linked to the NSWCR. Demographic and pathology items were tabulated and associations described. We evaluated the completeness of pathological characteristics by degree of spread of cancer at diagnosis. Among the 123,921 men enrolled in the 45 and Up Study, 5,091 had incident prostate cancer and 5,085 were linked to a pathology record. The most complete variables included grade group of diagnostic (85.8%) and surgical (99.8%) specimens, margin status (98.1%), extraprostatic extension (95.1%) and seminal vesicle invasion (96.8%). Most diagnostic specimens were grade group 1 (26.6%) or 2 (23.5%). Of the 5,085 cases, 30.8% were classified by the NSWCR with unknown degree of spread; a pathology record could be extracted for 99.4% of these. The unknown degree of spread cases had similar levels of completeness and distribution of diagnostic and surgical pathology features to those with a localised degree of spread. This study demonstrated the feasibility of obtaining and analysing data derived from pathology reports from centralised state-based cancer registry notifications. Supplementing degree of spread information with pathology data from diagnosis and surgery will improve both the quality of research and policy aimed at improving the lives of men with prostate cancer.
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Affiliation(s)
- Benjamin D T Gallagher
- Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, NSW, Australia; The Daffodil Centre, University of Sydney, Sydney, NSW, Australia.
| | - Karen Chiam
- Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, NSW, Australia; The Daffodil Centre, University of Sydney, Sydney, NSW, Australia
| | - Albert Bang
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia
| | - Manish I Patel
- Department of Urology, Westmead Hospital, Specialty of Surgery, University of Sydney, Sydney, NSW, Australia
| | - James G Kench
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Sue Edwards
- Cancer Services and Information, Cancer Institute NSW, Sydney, NSW, Australia
| | - Visalini Nair-Shalliker
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health Science, Macquarie University, Sydney, NSW, Australia
| | - David P Smith
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia; Menzies Health Institute Queensland, Griffith University, Southport, Qld, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic, Australia
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Lin Y, Johnson LA, Fennessy FM, Turkbey B. Prostate Cancer Local Staging with Magnetic Resonance Imaging. Radiol Clin North Am 2024; 62:93-108. [PMID: 37973247 PMCID: PMC10656475 DOI: 10.1016/j.rcl.2023.06.010] [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] [Indexed: 11/19/2023]
Abstract
Accurate determination of the local stage of prostate cancer is crucial for treatment planning and prognosis. The primary objective of local staging is to distinguish between organ-confined and locally advanced disease, with the latter carrying a worse clinical prognosis. The presence of locally advanced disease features of prostate cancer, such as extra-prostatic extension, seminal vesicle invasion, and positive surgical margin, can impact the choice of treatment. Over the past decade, multiparametric MRI (mpMRI) has become the preferred imaging modality for the local staging of prostate cancer and has been shown to provide accurate information on the location and extent of disease. It has demonstrated superior performance compared to staging based on traditional clinical nomograms. Despite being a relatively new technique, mpMRI has garnered considerable attention and ongoing investigations. Therefore, in this review, we will discuss the current use of mpMRI on prostate cancer local staging.
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Affiliation(s)
- Yue Lin
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA
| | - Latrice A Johnson
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA
| | - Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA.
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Acklin-Wehnert S, Carpenter D, Natesan D, Floyd RW, Waters L, Song H, Lee WR, Salama J, Boyer M. Toxicity and Outcomes of Moderately Hypofractionated Radiation for Prostate Cancer With Seminal Vesicle Involvement. Adv Radiat Oncol 2023; 8:101252. [PMID: 37408675 PMCID: PMC10318209 DOI: 10.1016/j.adro.2023.101252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/11/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose The aim of this study was to assess the toxicity and outcomes following treatment of prostate cancer with seminal vesicle involvement (SVI) evident on magnetic resonance imaging or clinical examination with moderately hypofractionated radiation therapy (MHRT). Methods and Materials Forty-one patients treated with MHRT to the prostate and 1 or both seminal vesicles from 2013 to 2021 at a single institution were identified and propensity score matched to 82 patients treated during the same period with prescription dose given to the prostate alone. Dosimetry of the planning target volume, bladder, and rectum were compared. Urinary and bowel toxicity were scored by National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. Clinical outcomes including freedom from biochemical recurrence, prostate cancer-specific survival, and overall survival were assessed. Results Of the 41 patients identified with SVI, 26.8% had SVI by clinical examination and 95.1% had high-risk prostate cancer. Compared with the cohort without SVI, treatment plans to include SVI had a larger planning target volume (152.2 vs 109.9 cc; P < .001), maximum point dose (107.9% vs 105.8%; P < .001), and volume receiving 100% of the prescription dose (143.1 vs 95.9 cc; P < .001). No difference in bladder dosimetric variables between cohorts was observed, but there was an increase in the rectal maximum point dose (103.9% vs 102.8%; P = .030) and rectal volume receiving 100% of the prescription dose (1.8 vs 1.2 cc; P = .016). Despite these differences, there was no difference in the cumulative incidence of grade 2+ urinary (hazard ratio [HR], 0.73; 95% CI, 0.39-1.35; P = .31) or bowel (HR, 0.35; 95% CI, 0.04-3.03; P = .34) toxicity. Freedom from biochemical recurrence (HR, 0.47; 95% CI, 0.16-1.38; P = .17), prostate cancer-specific survival (HR, 0.31; 95% CI, 0.04-2.49; P = .31), and overall survival (HR, 0.35; 95% CI, 0.10-1.16; P = .09) also did not differ with or without SVI, respectively. Conclusions Treatment of SVI to prescription dose with MHRT for localized prostate cancer does not increase bowel or urinary toxicity. Similar clinical outcomes were also observed with or without SVI.
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Affiliation(s)
- Scarlett Acklin-Wehnert
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - David Carpenter
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Divya Natesan
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - R. Warren Floyd
- Department of Internal Medicine, Wellstar Kennestone Hospital, Marietta, Georgia
| | - Laura Waters
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
| | - Haijun Song
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - W. Robert Lee
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Joseph Salama
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Matthew Boyer
- Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
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Kawase M, Ebara S, Tatenuma T, Sasaki T, Ikehata Y, Nakayama A, Toide M, Yoneda T, Sakaguchi K, Teishima J, Makiyama K, Inoue T, Kitamura H, Saito K, Koga F, Urakami S, Koie T. Clinical factors associated with biochemical recurrence of prostate cancer with seminal vesicle invasion followed by robot-assisted radical prostatectomy: a retrospective multicenter cohort study in Japan (the MSUG94 group). J Robot Surg 2023; 17:1609-1617. [PMID: 36928750 DOI: 10.1007/s11701-023-01567-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
Locally advanced prostate cancer (PCa) with pathological seminal vesicle invasion (pT3b) is a very-high-risk disease associated with biochemical recurrence (BCR), local recurrence, distant metastases, or mortality following definitive therapies. This study aimed to evaluate the risk factors associated with BCR following robot-assisted radical prostatectomy (RARP) in PCa patients with pT3b. A retrospective multicenter cohort study was conducted on 3,195 patients with PCa who underwent RARP at nine domestic centers between September 2011 and August 2021. Biochemical recurrence-free survival (BRFS) after RARP in PCa patients with pT3b was the primary end-point of the study. The secondary end-point was to determine the association between BCR and covariates. We enrolled 188 PCa patients with pT3b. The median follow-up period was 32.8 months. At the end of the follow-up period, 76 patients (40.4%) developed BCR, of whom 15 (8.0%) were BCR at the date of surgery. The 1-, 2-, and 3-year BRFS rates were 76.4, 65.9, and 50.8%, respectively. Multivariate analysis identified initial prostate-specific antigen level and positive surgical margins (PSM) as significant predictors of BCR in PCa patients with pT3b undergoing RARP. In this study, we investigated the BRFS in PCa patients with pT3b. As PSM was an independent predictor of BCR in PCa patients with pT3b, these patients may require a combination of therapies to improve the BCR.
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Affiliation(s)
- Makoto Kawase
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagito, Gifu, 501-1194, Japan
| | - Shin Ebara
- Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | | | - Takeshi Sasaki
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu, Japan
| | | | - Akinori Nakayama
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Masahiro Toide
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tatsuaki Yoneda
- Department of Urology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | | | - Jun Teishima
- Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital, Kobe, Japan
| | | | - Takahiro Inoue
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu, Japan
| | | | - Kazutaka Saito
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Fumitaka Koga
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Takuya Koie
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagito, Gifu, 501-1194, Japan.
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Fujimoto A, Sakamoto S, Horikoshi T, Zhao X, Yamada Y, Rii J, Takeuchi N, Imamura Y, Sazuka T, Matsusaka K, Ikeda JI, Ichikawa T. Tumor localization by Prostate Imaging and Reporting and Data System (PI-RADS) version 2.1 predicts prognosis of prostate cancer after radical prostatectomy. Sci Rep 2023; 13:10079. [PMID: 37344491 DOI: 10.1038/s41598-023-36685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
An improved reading agreement rate has been reported in version 2.1 (v2.1) of the Prostate Imaging and Reporting and Data System (PI-RADS) compared with earlier versions. To determine the predictive efficacy of bi-parametric MRI (bp-MRI) for biochemical recurrence (BCR), our study assessed PI-RADS v2.1 score and tumor location in Japanese prostate cancer patients who underwent radical prostatectomy. Retrospective analysis was performed on the clinical data of 299 patients who underwent radical prostatectomy at Chiba University Hospital between 2006 and 2018. The median prostate-specific antigen (PSA) level before surgery was 7.6 ng/mL. Preoperative PI-RADS v2.1 categories were 1-2, 3, 4, and 5 in 35, 56, 138, and 70 patients, respectively. Tumor location on preoperative MRI was 107 in the transition zone (TZ) and 192 in the peripheral zone (PZ). BCR-free survival was significantly shorter in the PZ group (p = 0.001). In the total prostatectomy specimens, preoperative PI-RADS category 5, radiological tumor location, pathological seminal vesicle invasion, and Grade Group ≥ 3 were independent prognostic factors of BCR. These four risk factors have significant potential to stratify patients and predict prognosis. Radiological tumor location and PI-RADS v2.1 category using bp-MRI may enable prediction of BCR following radical prostatectomy.
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Affiliation(s)
- Ayumi Fujimoto
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
| | - Takuro Horikoshi
- Department of Radiology, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Xue Zhao
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Junryo Rii
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Nobuyoshi Takeuchi
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Keisuke Matsusaka
- Department of Pathology, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Jun-Ichiro Ikeda
- Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
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68Ga-PSMA-11 PET/CT Initial Staging in Black and White South African Males with ISUP Grade Group 1 and 2 Prostate Adenocarcinoma. Biomedicines 2022; 10:biomedicines10040882. [PMID: 35453632 PMCID: PMC9028798 DOI: 10.3390/biomedicines10040882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Prostate adenocarcinoma (PCa) is a leading cause of mortality. Black males with high-risk PCa have a poorer prognosis compared to white males. Patients with International Society of Urological Pathology (ISUP) Grade Group (GG) 1 and 2 PCa have little potential for metastases post radical prostatectomy. 68Gallium prostate specific membrane antigen (68Ga-PSMA) PET/CT imaging for metastatic PCa is superior to conventional imaging in staging high-risk PCa. No strong evidence is available to support imaging low-risk patients. We aimed to evaluate the value of 68Ga-PSMA PET/CT in black and white South African (BSA and WSA) males with GG1 and 2 PCa at initial staging. We evaluated 25 WSA and 123 BSA males. The image findings were correlated with prostate specific antigen (PSA). PSA levels significantly correlated with both primary tumor and whole-body PSMA-tumor volume (PSMA-TV) and were higher in BSA males. No differences were noted in the occurrence of metastases; however, PSA, seminal vesicle invasion and black race predicted metastases. Our findings suggest higher PSMA expression and tumor burden in BSA with histologically low-risk PCa, and future research with immunohistochemistry evaluation will be essential to confirm these findings.
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Bratt O. Integrating magnetic resonance imaging and prostate-specific membrane antigen positron emission tomography/computed tomography results into prostate cancer treatment decision making. BJU Int 2021; 129:3-4. [PMID: 34967997 DOI: 10.1111/bju.15560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Ola Bratt
- Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Gok B, Hajiyev E, Hamidi N, Koc E, Asil E, Canda AE, Ardicoglu A, Atmaca AF, Keseroglu BB. Which is the best radiological imaging method for predicting actual prostate weight? Andrologia 2020; 52:e13770. [PMID: 32721048 DOI: 10.1111/and.13770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 11/26/2022] Open
Abstract
In this study, we compared the weight of the prostate specimen removed after robotic radical prostatectomy with the prostate weight measured pre-operatively by four different imaging modalities. Pre-operative prostate weight before robotic radical prostatectomy was measured by Transabdominal Ultrasonography (TAUS), Transrectal Ultrasonography (TRUS), Abdominal Tomography (CT) and MultiparametricProstate Magnetic Resonance imaging (mpMRI). Of the 170 patients enrolled in the study, the mean age was 65.2 ± 7.08 (46-84) years and mean prostate-specific antigen (PSA) 9.6 ± 7.7 (1.8-50). The mean post-operative actual prostate weight was 63.1 ± 30 gr. The mean pre-operative prostate volumes measured by TAUS, TRUS, CT and MPMRI were 64.5 ± 28.5, 49.1 ± 30.6, 54.5 ± 30.5 and 68.7 ± 31.7 ml, respectively (p < .001). Post-operative actual prostate weight correlated with prostate weight measured by TAUS, TRUS, CT and mpMRI (r coefficient 0.776, 0.802, 0.768 and 0.825 respectively). The best of these was mpMRI. Although prostate weight measured by different imaging methods has a high correlation to predict actual prostate weight, actual prostate weight is best predicted by measurements with mpMRI. However, errors and deviations that may occur with these imaging methods should be taken into consideration.
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Affiliation(s)
- Bahri Gok
- Department of Urology, School of Medicine affiliated with Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Elchin Hajiyev
- Department of Urology, School of Medicine affiliated with Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Nurullah Hamidi
- Department of Urology, Ankara Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey
| | - Erdem Koc
- Department of Urology, School of Medicine affiliated with Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Erem Asil
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | | | - Arslan Ardicoglu
- Department of Urology, School of Medicine affiliated with Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ali Fuat Atmaca
- Deparment of Urology, Ankara Memorial Private Hospital, Ankara, Turkey
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