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Małkiewicz B, Jędrzejuk D, Gurwin A, Wilk K, Knecht-Gurwin K, Kiełb P, Krajewski W, Bolanowski M, Hałoń A, Szydełko T. Diagnostic Value of the Sentinel Lymph Node Technique in Patients with Muscle-Invasive Bladder Cancer. J Clin Med 2023; 12:jcm12093092. [PMID: 37176533 PMCID: PMC10179622 DOI: 10.3390/jcm12093092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/17/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The optimal limits of the bilateral pelvic lymph node dissection (PLND) template in bladder cancer treatment remain controversial. This study aimed to investigate whether radio-guided sentinel node (SLN) detection is a reliable technique for the perioperative localisation of potential lymphatic metastasis during cystectomy for muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS We studied 54 patients with pT2-pT4 MIBC who underwent cystectomy with extended PLND (ePLND) augmented by the SLN technique. The identification of SLN was performed by preoperative SPECT/CT hybrid lymphoscintigraphy using peritumoral injection of nanocolloid-Tc-99m, followed by intraoperative navigation with a handheld γ-probe. All nodal specimens were collected separately and then fixed in formalin, stained with haematoxylin and eosin, and examined by an experienced uropathologist. RESULTS A total of 1414 LNs were resected and examined for the presence of metastases. The mean number of harvested LNs was 26 (range: 11-50) per patient. In 51 of 54 patients, 192 SLNs were resected. In addition, 20/192 (10.4%) SLNs were located outside of the ePLND area. Overall, 72 metastatic LNs (LN+) were found in 22 of 54 patients (40.7%) and in 24/192 SLNs (12.5%). The SLN technique detected LN+ in 14 of 22 (64%) patients. The SLNs were the only sites of metastasis (SLN+ = LN+) in 6 of 22 (27.3%) LN+ patients, including two cases with foci located in the pararectal region. The diagnostic values for the sensitivity, specificity, positive predictive value, and false-negative rate for the SLN technique were 66.66%, 4.16%, 28.57%, and 33.33%, respectively. Extended lymphadenectomy and its combination with the SLN technique enabled the correct assessment in 96.3 and 100% of patients, respectively. CONCLUSIONS The combination of ePLND and SLN provides a better pN assessment compared to ePLND alone. Although the SLN technique has restrictions that limit its diagnostic value, its use as an addition to lymphadenectomy allows for the visualisation of nonstandard lymph drainage pathways that may be potential metastatic routes.
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Affiliation(s)
- Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | - Diana Jędrzejuk
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Adam Gurwin
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | - Karol Wilk
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | - Klaudia Knecht-Gurwin
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Paweł Kiełb
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | - Marek Bolanowski
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Agnieszka Hałoń
- Department of Clinical and Experimental Pathology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Tomasz Szydełko
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wrocław, Poland
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Szlasa W, Wilk K, Knecht-Gurwin K, Gurwin A, Froń A, Sauer N, Krajewski W, Saczko J, Szydełko T, Kulbacka J, Małkiewicz B. Prognostic and Therapeutic Role of CD15 and CD15s in Cancer. Cancers (Basel) 2022; 14:cancers14092203. [PMID: 35565333 PMCID: PMC9101515 DOI: 10.3390/cancers14092203] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary CD15 (Lewis X) is a typical myeloid antigen presented in myeloid and monocytic lineages of cells. This molecule interacts with E-, L- and P-selectins, which allows for adhesion with endothelial cells. CD15 is found on various cancer cells, including renal cancer, prostate and bladder cancers, acute leukaemias, hepatocellular carcinoma, breast cancer and melanoma cells. Its high expression can serve as a prognostic marker for patients and is a potentially valuable target for immunotherapy against cancer. Blockage of the antigen’s function results in reduced metastatic potential and it may be an immunotherapeutic target. CD15s is a sialyl derivative of CD15; however, unlike the high expression of CD15, which is a prognostic factor in Hodgkin lymphoma, CD15s relates to poor prognosis for patients. CD15 is considered a marker of cancer stem cells. This review presents a comprehensive description of the prognostic role of CD15 and CD15s and their use in anticancer therapy. Abstract CD15 (Lewis X/Lex) is a fucosyl (3-fucosly-N-acetyl-lactosamine) moiety found on membrane proteins of various cancer cells. These cancers include renal cancer, prostate and bladder cancers, acute leukaemias, hepatocellular carcinoma, breast cancer and melanoma. The biological role of CD15 is interaction with E-, L- and P-selectins (adhesion molecules), allowing for adhesion with endothelial cells. In this way, cancer cells start to interact with the endothelia of blood vessels and consequently move out from the blood flow to the surrounding tissues. Blockage of the antigen’s function results in reduced metastatic potential. Moreover, the molecule may be a therapeutic target against cancer in monoclonal antibody-based therapies. CD15 may serve as a prognostic marker for patients and there are high hopes for its use in the immunotherapeutic treatment of tumours. CD15s is a sialyl derivative of CD15 that possesses its own unique characteristics. Its soluble form may act as a competitive inhibitor of the interaction of cancer cells with epithelial cells and thus disallow migration through the vessels. However, the prognostic relevance of CD15 and CD15s expression is very complex. This review presents a comprehensive description of the role of CD15 and CD15s in cancer development and metastasis and overviews its significance for clinical applications.
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Affiliation(s)
- Wojciech Szlasa
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
- Correspondence: (W.S.); (B.M.)
| | - Karol Wilk
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
| | - Klaudia Knecht-Gurwin
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Adam Gurwin
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
| | - Anita Froń
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
| | - Natalia Sauer
- Department of Drugs Form Technology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
| | - Jolanta Saczko
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.S.); (J.K.)
| | - Tomasz Szydełko
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.S.); (J.K.)
| | - Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.W.); (A.G.); (A.F.); (W.K.); (T.S.)
- Correspondence: (W.S.); (B.M.)
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Araiza-Garaygordobil D, Montalto C, Martinez-Amezcua P, Cabello-Lopez A, Gopar-Nieto R, Alabrese R, Almaghraby A, Catoya-Villa S, Chacon-Diaz M, Kaufmann CC, Corbi-Pascual M, Deharo P, El-Tahlawi M, Elgohari-Abdelwahab A, Guerra F, Jarakovic M, Martinez-Gomez E, Moderato L, Montero S, Morejon-Barragan P, Omar AM, Jorge-Pérez P, Przybyło P, Selim E, Sinan UY, Stratinaki M, Tica O, Trêpa M, Uribarri A, Uzokov J, Wilk K, Czerwińska-Jelonkiewicz K, Sionis A, Gierlotka M, Leonardi S, Krychtiuk KA, Tavazzi G. Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study. QJM 2021; 114:642-647. [PMID: 33486512 PMCID: PMC7928691 DOI: 10.1093/qjmed/hcab013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). AIM To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. DESIGN Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. RESULTS A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. CONCLUSIONS Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.
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Affiliation(s)
- D Araiza-Garaygordobil
- From the Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, México
| | - C Montalto
- Department of Cardiology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, USA
| | - A Cabello-Lopez
- Occupational Health Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México
| | - R Gopar-Nieto
- From the Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, México
| | - R Alabrese
- Department of Cardiology, Parma University Hospital, Italy
| | - A Almaghraby
- Department of Cardiology and Angiology, University of Alexandria, Egypt
| | - S Catoya-Villa
- Department of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M Chacon-Diaz
- Cardiology Clinic and Intensive Cardiac Care, Instituto Nacional Cardiovascular INCOR-Essalud, Lima, Perú
| | - C C Kaufmann
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - M Corbi-Pascual
- Coronary Care Unit, Cardiology Service, Albacete General Hospital, Albacete
| | - P Deharo
- Aix Marseille University, Inserm, Inra, C2VN, Marseille, France
| | - M El-Tahlawi
- Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt
| | | | - F Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Ospedali Riuniti “Umberto I—Lancisi—Salesi”, Ancona, Italy
| | - M Jarakovic
- Cardiology Intensive Care Unit, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - E Martinez-Gomez
- Acute Cardiovascular Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - L Moderato
- Cardiology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - S Montero
- Acute Cardiovascular Care Unit, Cardiology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - P Morejon-Barragan
- Coronary Care Unit, Cardiology Service, UAI University Hospital, Buenos Aires, Argentina
| | - A M Omar
- Tripoli University Hospital, Tripoli, Libya
| | - P Jorge-Pérez
- Acute Cardiovascular Care Unit, Cardiology Department, Canary Islands University Hospital, Tenerife, Spain
| | - P Przybyło
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - E Selim
- Coronary Care Unit, Emergency Department and Cardiology Clinic, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - U Y Sinan
- Department of Cardiology, PH and ACHD, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - M Stratinaki
- Cardiology Department, General Hospital Venizeleio, Heraklion, Crete, Greece
| | - O Tica
- Faculty of Medicine and Pharmacy, University of Oradea; Emergency County Clinical Hospital of Oradea, Romania
| | - M Trêpa
- Cardiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Uribarri
- Cardiovascular Care Unit, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - J Uzokov
- Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | - K Wilk
- Department of Cardiology, Medical University of Białystok, Bialystok, Poland
| | - K Czerwińska-Jelonkiewicz
- Intensive Therapy Unit, Harefield Hospital, Royal Brompton & Harefield NHS Fundation Trust, London, UK
| | - A Sionis
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - S Leonardi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology-Fondazione IRCCS Policlinico San Matteo, and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - K A Krychtiuk
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria
| | - G Tavazzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy
- Address correspondence to Dr Guido Tavazzi, MD, PhD, University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences; Anaesthesia, Intensive Care and Pain Therapy, Fondazione IRCCS Policlinico San Matteo, Anestesia e Rianimazione I, DEA Piano-1, Viale Golgi 19, 27100 Pavia, Italy.
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As-Sanie S, Giudice L, Abrao M, Wilk K, Mehedintu C, Becker C, Arjona Ferreira J, Wagman R, Wang F, Warsi Q, Johnson N. Sustained Efficacy and Safety of Relugolix Combination Therapy in Women with Endometriosis-Associated Pain: Spirit 52-Week Data. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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As-Sanie S, Giudice L, Abrao MS, Wilk K, Mehedintu C, Becker C, Arjona Ferreira JC, Wagman RB, Wang F, Warsi QA, Neil J. O-132 Sustained efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT 52-week data. Hum Reprod 2021. [DOI: 10.1093/humrep/deab126.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
To assess the long-term (52-week) efficacy and safety of relugolix combination therapy (Relugolix-CT) in the treatment of endometriosis-associated pain.
Summary answer
Relugolix-CT demonstrated a sustained improvement of endometriosis-associated pain and maintenance of bone mineral density (BMD) over the extension treatment period. It was well tolerated.
What is known already
Endometriosis is a chronic condition characterized by symptoms of menstrual and non-menstrual pain, and dyspareunia, which have a substantial impact on women’s lives. SPIRIT 1 and 2 were Phase 3, randomized, double-blind, placebo-controlled studies of once-daily Relugolix-CT (relugolix 40 mg, estradiol 1 mg, norethindrone acetate 0.5 mg) in premenopausal women (age 18–50 years) with surgically diagnosed endometriosis and moderate-to-severe dysmenorrhea and non-menstrual pelvic pain (NMPP) at baseline. These trials demonstrated a significant improvement of dysmenorrhea, NMPP and dyspareunia in women treated with Relugolix-CT, with a minimal decline in BMD vs placebo over 24 weeks.
Study design, size, duration
Women who completed the 24-week pivotal studies (SPIRIT 1 and 2 trials) were eligible to enroll in an open-label, single-arm, long-term safety and efficacy extension study for an additional 80 weeks. All women received once-daily oral Relugolix-CT. Analyses were done based on original randomization in pivotal studies: Relugolix-CT, delayed Relugolix-CT (relugolix 40 mg alone for 12 weeks, then Relugolix-CT for 12 weeks), or placebo. Here, 52-week efficacy and safety outcomes are presented.
Participants/materials, setting, methods
The primary endpoints were the proportion of dysmenorrhea and NMPP responders at Week 52, based on daily Numerical Rating Scale (NRS) scores (0=no pain, 10=worst pain imaginable). A responder was a woman who achieved a predefined, clinically meaningful reduction from baseline in NRS score with no increase in analgesic use. Secondary efficacy endpoints included change in Endometriosis Health Profile-30 (EHP-30) pain domain scores, and analgesic/opioid use. Safety endpoints included adverse events (AEs) and BMD evaluation.
Main results and the role of chance
Of 1261 randomized patients, 1044 completed the primary studies; 802 enrolled in the long-term extension and 681 completed 52 weeks of treatment. Baseline demographics and clinical characteristics of the extension population were consistent with those of the original randomized population.
Sustained improvement of endometriosis-associated pain was demonstrated with Relugolix-CT through 52 weeks, the proportion of responders for dysmenorrhea was 84.8% and 73.3% for NMPP.
NRS least squares (LS) mean scores for dysmenorrhea and NMPP decreased from 7.4 (severe) and 6.0 (moderate) at SPIRIT study baseline to 1.3 (mild) and 2.2 (mild) at Week 52, equating to 82.8% and 62.9% reduction in dysmenorrhea and NMPP, respectively. Mean NRS for dyspareunia decreased from 5.9 (moderate) to 2.4 (mild), demonstrating 60.1% reduction with Relugolix-CT.
Daily functioning measured by the EHP-30 pain domain score was improved (–38.1 point) and the majority of women (85.6%) were opioid-free at Week 52. There was no disproportionate increase in the incidence of AEs in the Relugolix-CT group with no new safety signals identified through the 52 weeks. BMD was preserved over the extension period with overall LS mean change from baseline to Week 52 of –0.83% (95% CI: –1.34, –0.32) for lumbar spine in the Relugolix-CT group.
Limitations, reasons for caution
The study was conducted as an open-label study without a control group over the 28 weeks of the extension period.
Wider implications of the findings
Relugolix-CT demonstrated a sustained improvement of dysmenorrhea, NMPP, and dyspareunia, and reduced pain-related functional limitations and the need for opioids over 52 weeks in women with moderate-to-severe endometriosis-associated pain. Relugolix-CT was generally well tolerated and associated with minimal BMD loss after treatment initiation followed by BMD maintenance over 52 weeks.
Trial registration number
NCT03654274
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Affiliation(s)
- S As-Sanie
- University of Michigan, Obstetrics and Gynecology, Ann Arbor- Michigan, U.S.A
| | - L Giudice
- University of California San Francisco, School of Medicine, San Francisco, U.S.A
| | - M S Abrao
- Sao Paulo University, Obstetrics and Gynaecology, Sao Paulo, Brazil
| | - K Wilk
- Boni Fratres Hospital, Obstetrics and Gynecology Department, Katowice, Poland
| | - C Mehedintu
- Carol Davila University of Medicine and Pharmacy, Obstetrics and Gynaecology, Bucharest, Romania
| | - C Becker
- John Radcliffe Hospital, Nuffield Department of Women’s and Reproductive Health, Headington Oxford, United Kingdom
| | | | - R B Wagman
- Myovant Sciences- Inc., Clinical Development, Brisbane- California, U.S.A
| | - F Wang
- Myovant Sciences- Inc., Clinical Development, Brisbane- California, U.S.A
| | - Q A Warsi
- Myovant Sciences- Inc., Clinical Development, Brisbane- California, U.S.A
| | - J Neil
- Robinson Research Institute- Auckland Gynaecology Group and Repromed Auckland, Gynaecology, Auckland, New Zealand
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Małkiewicz B, Ptaszkowski K, Knecht K, Gurwin A, Wilk K, Kiełb P, Dudek K, Zdrojowy R. External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer-Setting a New Threshold Value. Life (Basel) 2021; 11:life11060479. [PMID: 34070313 PMCID: PMC8227656 DOI: 10.3390/life11060479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Introduction: The study aimed to test and validate the performance of the 2012 Briganti nomogram as a predictor for pelvic lymph node invasion (LNI) in men who underwent radical prostatectomy (RP) with extended pelvic lymph node dissection (PLND) to examine their performance and to analyse the therapeutic impact of using a different nomogram cut-off. (2) Material and Methods: The study group consisted of 222 men with clinically localized prostate cancer (PCa) who underwent RP with ePLND between 01/2012 and 10/2018. Measurements included: preoperative PSA, clinical stage (CS), primary and secondary biopsy Gleason pattern, and the percentage of positive cores. The area under the curve (AUC) of the receiver operator characteristic analysis was appointed to quantify the accuracy of the primary nomogram model to predict LNI. The extent of estimation associated with the use of this model was graphically depicted using calibration plots. (3) Results: The median number of removed lymph nodes was 16 (IQR 12–21). A total of 53 of 222 patients (23.9%) had LNI. Preoperative clinical and biopsy characteristics differed significantly (all p < 0.005) between men with and without LNI. A nomogram-derived cut-off of 7% could lead to a reduction of 43% (95/222) of lymph node dissection while omitting 19% (10/53) of patients with LNI. The sensitivity, specificity, and negative predictive value associated with the 7% cut-off were 81.1%, 50.3%, and 96.3%, respectively. (4) Conclusions: The analysed nomogram demonstrated high accuracy for LNI prediction. A nomogram-derived cut-off of 7% confirmed good performance characteristics within the first external validation cohort from Poland.
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Affiliation(s)
- Bartosz Małkiewicz
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
- Correspondence: ; Tel.: +48-506-158-136
| | - Kuba Ptaszkowski
- Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka 2, 50-355 Wroclaw, Poland;
| | - Klaudia Knecht
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
| | - Adam Gurwin
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
| | - Karol Wilk
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
| | - Paweł Kiełb
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
| | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland;
| | - Romuald Zdrojowy
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (A.G.); (K.W.); (P.K.); (R.Z.)
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Małkiewicz B, Kiełb P, Gurwin A, Knecht K, Wilk K, Dobruch J, Zdrojowy R. The Usefulness of Lymphadenectomy in Bladder Cancer-Current Status. ACTA ACUST UNITED AC 2021; 57:medicina57050415. [PMID: 33922894 PMCID: PMC8145304 DOI: 10.3390/medicina57050415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 12/13/2022]
Abstract
The purpose of this review is to present the current status of lymph node dissection (LND) during radical cystectomy in patients with bladder cancer (BCa). Despite the growing body of evidence of LND utility at the time of radical cystectomy (RC) in high-risk nonmuscle-invasive and muscle-invasive BCa (MIBC), therapeutic and prognostic value and optimal extent of LND remain unsolved issues. Recently published results of the first prospective, a randomized trial assessing the therapeutic benefit of extended versus limited LND during RC, failed to demonstrate survival improvement with the extended template. Although LND is the most accurate staging procedure, the direct therapeutic effect is still not evident from the current literature, limiting the possibility of establishing clear recommendations. This indicates the need for robust and adequately powered clinical trials.
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Affiliation(s)
- Bartosz Małkiewicz
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
- Correspondence: ; Tel.: +48-506-158-136
| | - Paweł Kiełb
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
| | - Adam Gurwin
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
| | - Klaudia Knecht
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
| | - Karol Wilk
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
| | - Jakub Dobruch
- First Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Romuald Zdrojowy
- Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (P.K.); (A.G.); (K.K.); (K.W.); (R.Z.)
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O'Loughlin M, Wilk K, Priest C, Ralston J, Popescu MN. Capillary rise dynamics of aqueous glycerol solutions in glass capillaries: a critical examination of the Washburn equation. J Colloid Interface Sci 2013; 411:257-64. [PMID: 24041546 DOI: 10.1016/j.jcis.2013.05.077] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/12/2013] [Accepted: 05/31/2013] [Indexed: 11/25/2022]
Abstract
The classic description of capillary rise given by the Washburn equation was recently questioned in the light of experimental evidence for a velocity dependent dynamic contact angle at a moving contact line. We present a systematic investigation of the capillary rise dynamics of glycerol and aqueous glycerol solutions in vertical glass capillaries of various radii. For pure glycerol, the results of our experiments are in almost perfect agreement with the predictions of the Washburn equation using independently measured values for the liquid and capillary parameters. For aqueous glycerol solutions we observe discrepancies between the theoretical expectations and the experimental results, which are increasing with the water content of the solution. A thorough analysis, combined with scaling arguments, allows us to conclude that dynamic contact angle effects alone cannot provide a consistent explanation for these discrepancies. Rather, they can be perfectly accounted for if the mixture flowing in the capillary would have an effective, increased viscosity (in respect to the nominal value). We suggest and briefly discuss various mechanisms that could contribute to this observed behavior.
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Affiliation(s)
- M O'Loughlin
- Ian Wark Research Institute, University of South Australia, Adelaide, SA 5095, Australia
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Zalewska M, Wilk K, Milnerowicz H. Capillary electrophoresis application in the analysis of the anti-cancer drugs impurities. Acta Pol Pharm 2013; 70:171-180. [PMID: 23614272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Due to the low therapeutic index of anti-cancer drugs, they should be closely monitored for evidence of potential contamination that may be of high toxicity and not to have the desired therapeutic effect. Therefore, analytical methods to detect drugs related substances at low concentrations are necessary. Capillary electrophoresis allows for fast and clear separation of drug derivatives. A multitude of submethods make selection of suitable environment for various types of chemicals possible. Publications concerning separation of drugs such as cisplatin, carboplatin, lobaplatin, methotrexate, tamoxifen, paclitaxel from their derivatives, which are their potential contaminations, show that capillary electrophoresis provides the appropriate tools to analyze the impurities of these anti-cancer drugs and is able to partially displace such technique as thin layer chromatography and high performance liquid chromatography, which still play a major role in this field.
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Affiliation(s)
- Marta Zalewska
- Department of Biomedical and Environmental Analysis, Faculty of Pharmacy, Wroclaw Medical University, Grunwaldzka 2, 50-355 Wrocław, Poland.
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Wilk K, Trenner M, Nägler K, Schönknecht P, Hegerl U. EEG-based assessment of vigilance regulation in patients with depression, and healthy controls. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Trenner M, Olbrich O, Sander C, Wilk K, Schönknecht P, Hegerl U. EEG-based assessment of wakefulness regulation in patients with mental disorders. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Drosdzol A, Skrzypulec V, Wilk K, Nowosielski K. The influence of bronchial asthma on sexual maturation of girls. J Physiol Pharmacol 2007; 58 Suppl 5:155-163. [PMID: 18204126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The aim of this study was to evaluate the effect of bronchial asthma on sexual maturation of girls. The study encompassed 111 girls aged 8-17 years (58 girls treated for bronchial asthma and 53 healthy girls). The assessment of girls' sexual maturation has been performed using the Tanner-Marshall scale, determining stages of the development of secondary gender characters - mammary gland (Thelarche: Th1 - Th5), public hair (Pubarche: P1-P5), axillary hair (Adrenarche: A1-A4) and menarche age. The first symptoms of puberty among asthmatic girls started at 11.83+/-2.37 (Th2) and 12.85+/-1.87 (P2) years; they achieved the last stadium, on average, at 15 (Th5) and 17 (P5) years. The ages of Th2 and P2 were comparable, but the ages of Th4 and P5 were statistically younger in healthy girls. Asthmatic girls started to menstruate earlier (10.84+/-1.93 years) than controls (12.24+/-1.16 years). We conclude that bronchial asthma does not affect the beginning of sexual maturation, but it delays the final stage of secondary sexual characters' development. The age at menarche is accelerated in bronchial asthma and it depends on asthma severity and its clinical control.
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Affiliation(s)
- A Drosdzol
- Women's Health Chair, Department of Obstetrics and Gynecology, Medical University of Silesia, Katowice, Poland.
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Drosdzol A, Skrzypulec V, Wilk K, Rachel M. The influence of bronchial asthma on menstrual cycle. J Physiol Pharmacol 2007; 58 Suppl 5:165-173. [PMID: 18204127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The aim of this study was to evaluate the effect of bronchial asthma on menstrual cycle. The study population consisted of 111 girls aged 8-17 years (58 girls with bronchial asthma and 53 healthy girls) of the mean age of 13.17+/-2.74 years. The age at menarche and menstrual cycle parameters were analyzed. Asthmatic girls started to menstruate earlier than healthy girls (P=0.0004). The severity of bronchial asthma (P=0.0096) correlated with the age at menarche. Irregular menstrual cycles were found in 50.0% of asthmatic girls and 27.8% of control group (P=0.03). Algomenorrhea was observed in 68.0% of girls with asthma and in 80.6% of healthy ones (P=0.013). We conclude that bronchial asthma increases the risk of irregular menstrual cycles prevalence but decreases the frequency of algomenorrhea among girls. The age at menarche is accelerated in bronchial asthma.
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Affiliation(s)
- A Drosdzol
- Women's Health Chair, Department of Obstetrics and Gynecology, Medical University of Silesia, Katowice, Poland.
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Schönenberg M, Wilk K, Jacob H, Reichwald U, Domes G, Hautzinger M. Effects of the NMDA receptor antagonist ketamine on stress hormone system regulation, cognitive functioning and posttraumatic stress symptomatology in accident victims. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
A long-term follow-up was performed on 22 patients treated for a posterior glenoid osteophyte and symptomatic posterior shoulder pain during either the late cocking, acceleration, or follow-through phases of throwing. Arthroscopic evaluation of these patients revealed undersurface tearing of the rotator cuff in all but one. Fifteen patients also had tearing of the posterior labrum. Anterior labral fraying was noted in four patients. Treatment consisted of debridement of the rotator cuff and labral tears. The posterior glenoid osteophyte was removed arthroscopically in 11 patients. Eighteen of 22 throwers treated were available for long-term follow-up at a mean of 6.3 years (range, 1 to 12). Only 10 of 18 (55%) throwers evaluated had returned to their premorbid level of throwing. All 10 were asymptomatic and had maintained a high level of performance for a mean of 3.6 years (range, 1 to 8). At the time of latest follow-up, five players were still participating at the major league level and five had retired. One patient had recurrence of the exostosis 8 years after surgery. Among our patients a trend existed toward a poorer result and failure of return to activity with a posterior osteophyte greater than 100 mm2. A posterior glenoid exostosis, when identified in the symptomatic shoulder of the throwing athlete, can be considered a definite marker of internal impingement.
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Affiliation(s)
- K Meister
- University of Florida Department of Orthopaedics, Gainesville, USA
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Stempień J, Wilk K. [An artificial kidney center at a regional hospital]. Pol Tyg Lek 1979; 34:597-9. [PMID: 377263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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