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Dariane C, Chierigo F, Ouellet V, Delvoye N, Jammal MP, Bégin LR, Paradis JB, Mes-Masson AM, Karakiewicz PI, Saad F. Analysis of active surveillance uptake for localized prostate cancer in Quebec in 2016: A Canadian bicentric study and comparison with 2010 data. Fr J Urol 2024; 34:102544. [PMID: 37858379 DOI: 10.1016/j.purol.2023.09.031] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Active surveillance (AS) has emerged as a primary management strategy for low-risk prostate cancer (PC) patients. We aimed to assess AS uptake over a 1-year snapshot throughout Quebec and to compare it to 2010 multicentric Canadian data. METHODS A retrospective chart review and data collection was performed in 1 academic and 2 non-academic community centres from Quebec, among men identified in 2016 with localized T1c-T2c PC on biopsy, fulfilling NCCN criteria of low-risk (LR)-PC, including very-low-risk (VLR) and non-VLR-PC, and favourable-intermediate risk (FIR)-PC. AS adherence was defined when chosen as initial strategy, without any radical treatment within 6 months. RESULTS Overall, 259 patients fulfilled the inclusion criteria with 50.2% of VLR-PC patients. At 6 months, 81% patients in the LR group and 65% in the FIR group were considered as adherent to AS, in both centres, but with an increased use of AS in the community centres compared to 2010 data. The rates of AS maintenance decreased at 12 months to respectively 69% and 58%. Among the VLR group, the rate of initiation was 98% and decreased to 85% at 12 months. CONCLUSION Our data suggest that the majority of low-risk PC patients indeed initiated an AS in 2016, with even a greater proportion of VLR-PC patients compared to 2010. This ideal strategy should be encouraged and improved at 12 months, and assessed with recent data and longer follow-up. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- C Dariane
- Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada; Department of Urology, hôpital européen Georges-Pompidou, Paris University, 20, rue Leblanc, 75015 Paris, France.
| | - F Chierigo
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada
| | - V Ouellet
- Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada
| | - N Delvoye
- Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada
| | - M-P Jammal
- Centre de santé et des services sociaux de Laval, Laval, QC, Canada
| | - L R Bégin
- Centre intégré de santé et des services sociaux des Laurentides, St-Eustache, QC, Canada
| | - J-B Paradis
- Centre de santé et des services sociaux de Chicoutimi, Chicoutimi, QC, Canada
| | - A-M Mes-Masson
- Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada
| | - F Saad
- Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada; Department of Surgery, Division of Urology, centre hospitalier de l'université de Montréal (CHUM), Montréal, Canada
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Piccinelli M, Panunzio A, Tappero S, Barletta F, Incesu RB, Luzzago S, Mistretta F, Nardini S, Tozzi M, Cozzi G, Bottero D, Ferro M, Tian Z, Saad F, Shariat S, Graefen M, Briganti A, Chun F, Terrone C, Antonelli A, De Cobelli O, Musi G, Karakiewicz P. Cancer-specific mortality free survival rates in non-metastatic non-clear cell renal carcinoma patients at intermediate/high risk of recurrence. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Law K, Piccinelli M, Tappero S, Panunzio A, Cano Garcia C, Barletta F, Incesu RB, Vaccaro C, Nardini S, Guzzo S, Lievore E, Tian Z, Karakiewicz P. Demographics and clinical characteristics of solitary fibrous tumours: A contemporary population-based analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Flammia RS, Lavigne D, Tian Z, Saad F, Anceschi U, Gallucci M, Leonardo C, Preisser F, Mandel P, Chun FKH, Karakiewicz PI, Delouya G, Taussky D, Hoeh B. Trial Participation is Not Associated with Better Biochemical Recurrence-free Survival in a Large Cohort of External Beam Radiotherapy-Treated Intermediate- and High-Risk Prostate Cancer Patients. Clin Oncol (R Coll Radiol) 2023; 35:e77-e84. [PMID: 36115747 DOI: 10.1016/j.clon.2022.08.031] [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: 03/26/2022] [Revised: 08/04/2022] [Accepted: 08/22/2022] [Indexed: 01/06/2023]
Abstract
AIMS There is a widespread belief that outcomes of cancer patients treated within clinical trials might not be representative of the outcomes obtained within standard clinical settings. We sought to investigate the effect of trial participation on biochemical recurrence (BCR) in localised, D'Amico intermediate- and high-risk prostate cancer patients treated with external beam radiotherapy (EBRT). MATERIALS AND METHODS We relied on a study population treated with EBRT between January 2001 and January 2021 at a single tertiary care centre, stratified according to trial enrolment. Separate Kaplan-Meier and multivariable Cox regression models tested BCR-free survival at 60 months within intermediate- and high-risk EBRT patients, after adjustment for covariables. Additionally, the analyses were refitted after inverse probability treatment weighting was performed separately for both risk subgroups. RESULTS Of 932 eligible patients, 635 (68%) and 297 (32%) had intermediate- and high-risk prostate cancer, respectively. Overall, 53% of patients were trial participants. BCR rates were 11 versus 5% (P = 0.27) and 12 versus 14% (P = 0.08) in trial participants versus non-participants for intermediate- and high-risk subgroups, respectively. Differences in patient and clinical characteristics were recorded. Trial participation status failed to reach predictor status in multivariable Cox regression models for BCR in both intermediate-risk (hazard ratio 1.34; 95% confidence interval 0.71-2.49; P = 0.4) and high-risk patients (hazard ratio 1.03; 95% confidence interval 0.45-2.34; P = 0.9). Virtually the same results were recorded in inverse probability treatment weighting cohorts. CONCLUSIONS Relying on a large cohort of EBRT-treated intermediate- and high-risk patients, no BCR differences were recorded between trial participants and non-participants after accounting for confounders.
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Affiliation(s)
- R S Flammia
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy; Cancer Prognostics and Health Outcomes Unit, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - D Lavigne
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
| | - Z Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - F Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada; Department of Surgery, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - U Anceschi
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy; Department of Uro-oncology, National Cancer Institute, IRCCS "IFO-Reginal Elena", Rome, Italy
| | - M Gallucci
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - C Leonardo
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - F Preisser
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - P Mandel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - F K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - G Delouya
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - D Taussky
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - B Hoeh
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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von Deimling M, Rajwa P, Tilki D, Heidenreich A, Pallauf M, Bianchi A, Yanagisawa T, Kawada T, Karakiewicz PI, Gontero P, Pradere B, Ploussard G, Rink M, Shariat SF. The current role of precision surgery in oligometastatic prostate cancer. ESMO Open 2022; 7:100597. [PMID: 36208497 PMCID: PMC9551071 DOI: 10.1016/j.esmoop.2022.100597] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022] Open
Abstract
Oligometastatic prostate cancer (omPCa) is a novel intermediate disease state characterized by a limited volume of metastatic cells and specific locations. Accurate staging is paramount to unmask oligometastatic disease, as provided by prostate-specific membrane antigen-positron emission tomography. Driven by the results of prospective trials employing conventional and/or modern staging modalities, the treatment landscape of omPCa has rapidly evolved over the last years. Several treatment-related questions comprising the concept of precision strikes are under development. For example, beyond systemic therapy, cohort studies have found that cytoreductive radical prostatectomy (CRP) can confer a survival benefit in select patients with omPCa. More importantly, CRP has been consistently shown to improve long-term local symptoms when the tumor progresses across disease states due to resistance to systemic therapies. Metastasis-directed treatments have also emerged as a promising treatment option due to the visibility of oligometastatic disease and new technologies as well as treatment strategies to target the novel PCa colonies. Whether metastases are present at primary cancer diagnosis or detected upon biochemical recurrence after treatment with curative intent, targeted yet decisive elimination of disseminated tumor cell hotspots is thought to improve survival outcomes. One such strategy is salvage lymph node dissection in oligorecurrent PCa which can alter the natural history of progressive PCa. In this review, we will highlight how refinements in modern staging modalities change the classification and treatment of (oligo-)metastatic PCa. Further, we will also discuss the current role and future directions of precision surgery in omPCa.
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Affiliation(s)
- M von Deimling
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - D Tilki
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - A Heidenreich
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Hospital Cologne, Cologne, Germany
| | - M Pallauf
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - A Bianchi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - T Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - T Kawada
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - P Gontero
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - B Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, La Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - G Ploussard
- Department of Urology, La Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, USA; Department of Urology, University of Texas Southwestern, Dallas, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
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Pecoraro A, Knipper S, Palumbo C, Giuseppe R, Luzzago S, Deuker M, Tian Z, Shariat S, Saad F, Briganti A, Kapoor A, De Cillis S, Piana A, Piramide F, Volpi G, Amparore D, Checcucci E, Manfredi M, Fiori C, Porpiglia F, Karakiewicz P. The effect of age on cancer-specific mortality in T1a stage renal cell carcinoma patients: a population-based study across all treatment’s modalities. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Scilipoti P, Fossati N, Mazzone E, Karnes J, Boorjian S, Motterle G, Bossi A, Kumar T, Di Muzio N, Cozzarini C, Chiorda BN, Robesti D, Cirulli G, Gandaglia G, Suardi N, Bartkowiak D, Shariat S, Goldner G, Berghen C, Joniau S, Stabile A, Cucchiara V, van Poppel H, De Meerleer G, Karakiewicz P, Wiegel T, Montorsi F, Briganti A. Development and validation of a novel nomogram predicting long-term progression in patients treated with early salvage radiation therapy after radical prostatectomy: the key role of PSA kinetics. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Musso G, Rosiello G, Fallara G, Cignoli D, Basile G, Colandrea G, Cei F, Baiamonte G, Belladelli F, Giancristofaro C, Canibus D, Rowe I, Karakiewicz P, Briganti A, Bertini R, Montorsi F, Salonia A, Larcher A, Capitanio U. Frailty status predicts worse postoperative and long-term oncologic outcomes in patients treated with partial nephrectomy for small renal masses. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Larcher A, Cignoli D, Fallara G, Rosiello G, Basile G, Colandrea G, Baiamonte G, Cei F, Musso G, Canibus D, Bertini R, Karakiewicz P, Mottrie A, Dehó F, Gallina A, Montorsi F, Salonia A, Capitanio U. Risks and benefits of partial nephrectomy with limited or without ischemia time. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00429-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sari Motlagh R, Schuettfort V, Mori K, Katayama S, Rajwa P, Aydh A, Grossmann N, Laukhtina E, Pradere B, Mostafai H, Quhal F, Abufaraj M, Lee R, Karakiewicz P, Lotan Y, Comprate E, Moschini M, Gontero P, Shariat S. Prognostic impact of perioperative circulating levels of Insulin-like growth factor-I (IGF-I) and its binding proteins, IGFBP-2 and IGFBP-3, on disease outcomes after radical cystectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gandaglia G, Rosiello G, Pellegrino F, Pellegrino A, Bandini M, Salonia A, Tutolo M, De Angelis M, Sorce G, Stabile A, Mazzone E, Cucchiara V, Zaffuto E, Mirone V, Karakiewicz P, Shariat S, Montorsi F, Briganti A. A more extended pelvic lymph node dissection decreases recurrence rates in selected prostate cancer patients undergoing radical prostatectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00752-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sari Motlagh R, Yanagisawa T, Kawada T, Laukhtina E, Rajwa P, Aydh A, König F, Pallauf M, Huebner N, Baltzer P, Karakiewicz P, Heidenreich A, Shariat S. Accuracy of SelectMDx compared to mpMRI in the diagnosis of prostate cancer: A diagnostic meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nocera L, Basile G, Larcher A, Colandrea G, Scuderi S, Barletta F, Crescenti A, Mattioli C, Karakiewicz P, Mottrie A, Moschini M, Stabile A, Gandaglia G, Capitanio U, Salonia A, Briganti A, Montorsi F. The use of abdominal drain after robot-assisted surgery in urology: Impact on postoperative pain. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fossati N, Mazzone E, Karnes R, Boorjian S, Motterle G, Bossi A, Kumar T, Di Muzio N, Cozzarini C, Noris Chiorda B, Robesti D, Stabile A, Gandaglia G, Suardi N, Bartkowiak D, Shariat S, Goldner G, Joniau S, Van Poppel H, Berghen C, De Meerleer G, Karakiewicz P, Montorsi F, Wiegel T, Briganti A. Development and validation of a novel nomogram predicting long-term progression in patients treated with early salvage radiation therapy after radical prostatectomy: The key role of PSA kinetics. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00272-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rosiello G, Fallara G, Basile G, Martini A, Cignoli D, Nocera L, Belladelli F, Colandrea G, Canibus D, Re C, Musso G, Cei F, Giancristofaro C, Briganti A, Bertini R, Necchi A, Raggi D, Karakiewicz P, Montorsi F, Salonia A, Larcher A, Capitanio U. The detrimental effect of frailty status on renal function recovery after partial nephrectomy – long-term results from a prospective surgical cohort. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hoeh B, Wenzel M, Humke C, Wittler C, Hohenhorst J, Volckmann-Wilde M, Köllermann J, Steuber T, Graefen M, Derya T, Karakiewicz P, Becker A, Kluth L, Chun F, Mandel P. Correlation of urine loss after catheter removal and early continence in men undergoing radical prostatectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01215-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dariane C, Taussky D, Delouya G, Wenzel M, Karakiewicz P, Timsit M, Méjean A, Saad F, Wurnschimmel C. Validation du nouveau système de stadification pronostique Star-Cap chez des patients avec cancer de la prostate traités par radiothérapie ou curiethérapie. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.228] [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: 10/19/2022]
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Dariane C, Wenzel M, Saad F, Karakiewicz P, Mandel P, Graefen M, Delouya G, Taussky D, Wurnschimmel C. Impact du délai jusqu’à obtention du Nadir de PSA sur la récidive biochimique et la mortalité, après irradiation pour cancer localisé de la prostate. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.227] [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: 10/19/2022]
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Rosiello G, Fallara G, Martini A, Cignoli D, Basile G, Colandrea G, Baiamonte G, Canibus D, Trevisani F, Bettiga A, Tian Z, Kapoor A, Shariat S, Giancristofaro C, Romani M, Briganti A, Montorsi F, Salonia A, Karakiewicz P, Larcher A, Capitanio U. Partial nephrectomy in frail patients: effect of surgical approach on complications and health-careexpenditures. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00758-8] [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] Open
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Rosiello G, Fallara G, Martini A, Cignoli D, Basile G, Colandrea G, Baiamonte G, Canibus D, Trevisani F, Bettiga A, Tian Z, Kapoor A, Shariat S, Giancristofaro C, Romani M, Briganti A, Montorsi F, Salonia A, Karakiewicz P, Larcher A, Capitanio U. Partial nephrectomy in frail patients: Effect of surgical approach on complications and health-care expenditures. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00960-x] [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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Würnschimmel C, Wenzel M, Wang N, Tian Z, Karakiewicz P, Graefen M, Huland H, Tilki D. Long-term overall survival of radical prostatectomy patients is often superior to the general population: A comparison using life-table data. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Afferi L, Moschini M, Mattei A, Mordasini L, Abufaraj M, Soria F, D’Andrea D, Xylinas E, Seisen T, Colin P, Bensalah K, Pradere B, Mari A, Krajewski W, Alvarez-Maestro M, Kikuchi E, Chlosta P, Montorsi F, Briganti A, Simone G, Ornaghi P, Cerruto M, Antonelli A, Matsumoto K, Karakiewicz P, Shariat S. A comparison of perioperative outcomes of laparoscopic versus open nephroureterectomy for upper tract urothelial carcinoma: a propensity score matching analysis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35625-1] [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: 10/23/2022] Open
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Leyh-Bannurah SR, Kachanov M, Beyersdorff D, Karakiewicz P, Oh-Hohenhorst S, Pompe R, Fisch M, Sauter G, Maurer T, Graefen M, Budäus L. Predicting proportion of Gleason 4 pattern in radical prostatectomy specimen by multiparametric MRI/ultrasound fusion targeted biopsy: Implications for active surveillance candidate selection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zakaria A, Couture F, Nguyen D, Shahine H, Côme T, Cristina N, Law K, Karakiewicz P, El-Hakim A, Zorn K. Impact of surgical wait times during summer months on the oncological outcomes following robotic-assisted radical prostatectomy: 10 years’ experience from a large Canadian Academic Center. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32962-1] [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: 10/23/2022] Open
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Nini A, Larcher A, Muttin F, Rosiello G, Baiamonte G, Re C, Trevisani F, Karakiewicz P, Mottrie A, Montorsi F, Briganti A, Salonia A, Bertini R, Capitanio U. Concordance of pathologic outcomes in patients with synchronous bilateral renal masses elected for surgical treatment: Implications for preoperative renal biopsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33073-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pompe R, Krüger A, Karakiewicz P, Preisser F, Graefen M, Huland H, Tilki D. The impact of anxiety and depression on surgical and functional outcomes in patients who underwent radical prostatectomy. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)31511-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mathieu R, Moschini M, Beyer B, Gust KM, Seisen T, Briganti A, Karakiewicz P, Seitz C, Salomon L, de la Taille A, Rouprêt M, Graefen M, Shariat SF. Prognostic value of the new Grade Groups in Prostate Cancer: a multi-institutional European validation study. Prostate Cancer Prostatic Dis 2017; 20:197-202. [DOI: 10.1038/pcan.2016.66] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/29/2016] [Accepted: 10/24/2016] [Indexed: 11/09/2022]
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Sevcenco S, Mathieu R, Baltzer P, Klatte T, Fajkovic H, Seitz C, Karakiewicz PI, Rouprêt M, Rink M, Kluth L, Trinh QD, Loidl W, Briganti A, Scherr DS, Shariat SF. The prognostic role of preoperative serum C-reactive protein in predicting the biochemical recurrence in patients treated with radical prostatectomy. Prostate Cancer Prostatic Dis 2016; 19:163-7. [PMID: 26810014 DOI: 10.1038/pcan.2015.60] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/11/2015] [Accepted: 10/07/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND To assess the prognostic value of preoperative C-reactive protein (CRP) serum levels for prognostication of biochemical recurrence (BCR) after radical prostatectomy (RP) in a large multi-institutional cohort. METHODS Data from 7205 patients treated with RP at five institutions for clinically localized prostate cancer (PCa) were retrospectively analyzed. Preoperative serum levels of CRP within 24 h before surgery were evaluated. A CRP level ⩾0.5 mg dl(-1) was considered elevated. Associations of elevated CRP with BCR were evaluated using univariable and multivariable Cox proportional hazards regression models. Harrel's C-index was used to assess prognostic accuracy (PA). RESULTS Patients with higher Gleason score on biopsy and RP, extracapsular extension, seminal vesicle invasion, lymph node metastasis, and positive surgical margins status had a significantly elevated preoperative CRP compared to those without these features. Patients with elevated CRP had a lower 5-year BCR survival proportion as compared to those with normal CRP (55% vs 76%, respectively, P<0.0001). In pre- and postoperative multivariable models that adjusted for standard clinical and pathologic features, elevated CRP was independently associated with BCR (P<0.001). However, the addition of preoperative CRP did not improve the accuracy of the standard pre- and postoperative models for prediction of BCR (70.9% vs 71% and 78.9% vs 78.7%, respectively). CONCLUSIONS Preoperative CRP is elevated in patients with pathological features of aggressive PCa and BCR after RP. While CRP has independent prognostic value, it does not add prognostically or clinically significant information to standard predictors of outcomes.
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Affiliation(s)
- S Sevcenco
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria
| | - R Mathieu
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria.,Department of Urology, Rennes University Hospital, Rennes, France
| | - P Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - T Klatte
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria
| | - H Fajkovic
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria
| | - C Seitz
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - M Rouprêt
- Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Kluth
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Q-D Trinh
- School of Medicine, Sacramento, CA, USA.,Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - W Loidl
- Department of Urology, Krankenhaus der Barmherzigen Schwestern, Linz, Austria
| | - A Briganti
- Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy
| | - D S Scherr
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | - S F Shariat
- Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
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Mathieu R, Mbeutcha A, Lucca I, Briganti A, Karakiewicz P, Rouprêt M, Seitz C, Klatte T, Shariat S. [Not Available]. Prog Urol 2015; 25:740. [PMID: 26544245 DOI: 10.1016/j.purol.2015.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - A Mbeutcha
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - I Lucca
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - A Briganti
- Department of urology, urological research institute, San Raffaele scientific institute, Milan, Italie
| | - P Karakiewicz
- Cancer prognostics and health outcomes unit, university of Montreal health centre, Montréal, Canada
| | - M Rouprêt
- Department of urology, Pitié-Salpétrière hospital, Paris, France
| | - C Seitz
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - T Klatte
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - S Shariat
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
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Mathieu R, Lucca I, Mbeutcha A, Seitz C, Karakiewicz P, Sun M, Montorsi F, Briganti A, Rouprêt M, Robinson B, Xylinas E, Shariat S. [Not Available]. Prog Urol 2015; 25:741-2. [PMID: 26544248 DOI: 10.1016/j.purol.2015.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - I Lucca
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - A Mbeutcha
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - C Seitz
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
| | - P Karakiewicz
- Cancer prognostics and health outcomes unit, university of Montreal health centre, Montreal, Canada
| | - M Sun
- Cancer prognostics and health outcomes unit, university of Montreal health centre, Montreal, Canada
| | - F Montorsi
- Department of urology, vita-salute San Raffaele university, Milan, Italie
| | - A Briganti
- Department of urology, vita-salute San Raffaele university, Milan, Italie
| | - M Rouprêt
- Academic department of urology, la Pitié-Salpetrière hospital, assistance publique-hôpitaux de Paris, faculté de médecine Pierre-et-Marie-Curie, university Paris 6, Paris, France
| | - B Robinson
- Department of pathology, Weill Cornell medical college, New York, NY, États-Unis
| | - E Xylinas
- Cochin hospital, assistance publique-hôpitaux de Paris, Paris-Descartes university, Paris, France
| | - S Shariat
- Department of urology, medical university Vienna, general hospital, Vienna, Autriche
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Mbeutcha A, Lucca I, De martino M, Mathieu R, Rieken M, Xylinas E, Kluth L, Crivelli J, Lotan Y, Shariat S, Klatte T, Karakiewicz P. Le rapport neutrophiles/lymphocytes est un facteur prédictif indépendant de récidive et de progression dans les tumeurs de vessie non infiltrantes. Prog Urol 2015; 25:759-60. [DOI: 10.1016/j.purol.2015.08.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schiffmann J, Haese A, Leyh-Bannurah SR, Salomon G, Steuber T, Schlomm T, Boehm K, Beyer B, Larcher A, Michl U, Heinzer H, Huland H, Graefen M, Karakiewicz PI. Adherence of the indication to European Association of Urology guideline recommended pelvic lymph node dissection at a high-volume center: Differences between open and robot-assisted radical prostatectomy. Eur J Surg Oncol 2015; 41:1547-53. [PMID: 26117216 DOI: 10.1016/j.ejso.2015.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 12/07/2014] [Revised: 04/01/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Contemporary adherence of the indication to European Association of Urology (EAU) guideline recommendation for pelvic lymph node dissection (PLND) at either open (ORP) or robot-assisted radical prostatectomy (RARP) at a high-volume center is unknown. To assess guideline recommended and observed PLND rates in a high-volume center cohort. METHODS We relied on the Martini-Clinic database and focused on patients treated with either ORP or RARP, between 2010 and 2013. Actual performed PLND was compared to European Association of Urology (EAU) guideline recommendation defined by nomogram predicted risk of lymph node invasion >5%. Categorical and multivariable logistic regression analyses targeted two endpoints: 1) probability of guideline recommended PLND and 2) probability of no PLND, when not recommended by EAU guideline. RESULTS Within 7868 PCa patients, adherence to EAU PLND guideline recommendation was 97.1% at ORP and 96.8% at RARP (p = 0.7). When PLND was not recommended, it was more frequently performed at RARP (71.6%) than at ORP (66.2%) (p = 0.002). Gleason score, PSA and number of positive biopsy cores were independent predictors for both either PLND when recommended, or no PLND when not recommended (all p < 0.05). Clinical tumor stage, age and surgical approach were also independent predictors for no PLND when not recommended (all p < 0.05). CONCLUSIONS Adherence of the indication to EAU guideline recommended PLND is high at this high-volume center. Neither ORP nor RARP represent a barrier for PLND, when recommended. However, a high number of patients underwent PLND despite absence of guideline recommendation. Possible staging advantages and PLND related complications needs to be individually considered, especially, when LNI risk is low.
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Affiliation(s)
- J Schiffmann
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
| | - A Haese
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - G Salomon
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Steuber
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Schlomm
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Boehm
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada
| | - B Beyer
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Larcher
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - U Michl
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Heinzer
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Huland
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Graefen
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada
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Schiffmann J, Gandaglia G, Larcher A, Sun M, Tian Z, Shariat SF, McCormack M, Valiquette L, Montorsi F, Graefen M, Saad F, Karakiewicz PI. Contemporary 90-day mortality rates after radical cystectomy in the elderly. Eur J Surg Oncol 2014; 40:1738-45. [PMID: 25454826 DOI: 10.1016/j.ejso.2014.10.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 09/28/2014] [Accepted: 10/06/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Existing radical cystectomy (RC) perioperative mortality estimates may underestimate the contemporary rates due to more advanced age, more baseline comorbidities and potentially broader inclusion criteria for RC, relative to past criteria. METHODS Within the most recent Surveillance, Epidemiology, and End Results (SEER)-Medicare database we identified clinically non-metastatic, muscle-invasive (T2-T4a) urothelial carcinoma of the urinary bladder (UCUB) patients, who underwent RC between 1991 and 2009. Mortality at 30- and 90-day after RC was quantified. Multivariable logistic regression analyses tested predictors of 90-day mortality. RESULTS Within 5207 assessable RC patients 30- and 90-day mortality rates were 5.2 and 10.6%, respectively. According to age 65-69, 70-79 and ≥ 80 years, 90-day mortality rates were 6.4, 10.1 and 14.8% (p < 0.001). Additionally, 90-day mortality rates increased with increasing Charlson Comorbidity Index (CCI, 0, 1, 2 and ≥ 3): 6.3, 10.3, 12.6 and 15.9% (p < 0.001). 90-day mortality rate in unmarried patients was 13.0 vs. 9.3% in married individuals (p < 0.001). In multivariable logistic regression analyses, advanced age, higher CCI, low socioeconomic status, unmarried status and non organ-confined stage were independent predictors of 90-day mortality (all p < 0.05). CONCLUSIONS The contemporary SEER-Medicare derived 90-day mortality rates are substantially higher than previously reported estimates from centers of excellence, and even exceed previous SEER reports. More advanced age, higher CCI score, and other patient characteristics that distinguish the current population from others account for these differences.
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Affiliation(s)
- J Schiffmann
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - G Gandaglia
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - A Larcher
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - M Sun
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada
| | - Z Tian
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada
| | - S F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - M McCormack
- Department of Urology, University of Montreal Health Center, Montreal, Canada
| | - L Valiquette
- Department of Urology, University of Montreal Health Center, Montreal, Canada
| | - F Montorsi
- Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - M Graefen
- Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Saad
- Department of Urology, University of Montreal Health Center, Montreal, Canada
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada
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Gandaglia G, Karakiewicz PI, Briganti A, Menon M, Sun M, Abdollah F. In reply to the letter to the editor 'in Reply to Gandaglia et al.' by De Bari et al. Ann Oncol 2014; 25:1862-1863. [PMID: 24914042 DOI: 10.1093/annonc/mdu215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Gandaglia
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada
| | - A Briganti
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - M Menon
- Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation, Detroit, USA
| | - M Sun
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada
| | - F Abdollah
- Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation, Detroit, USA.
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Gandaglia G, Karakiewicz PI, Abdollah F, Becker A, Roghmann F, Sammon JD, Kim SP, Perrotte P, Briganti A, Montorsi F, Trinh QD, Sun M. The effect of age at diagnosis on prostate cancer mortality: a grade-for-grade and stage-for-stage analysis. Eur J Surg Oncol 2014; 40:1706-15. [PMID: 24915856 DOI: 10.1016/j.ejso.2014.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 03/10/2014] [Revised: 04/28/2014] [Accepted: 05/04/2014] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the effect of advancing age on cancer-specific mortality (CSM) after radical prostatectomy (RP). MATERIALS AND METHODS Overall, 205,551 patients with PCa diagnosed between 1988 and 2009 within the Surveillance Epidemiology and End Results (SEER) database were included in the study. Patients were stratified according to age at diagnosis: ≤ 50, 51-60, 61-70, and ≥ 71 years. The 15-year cumulative incidence CSM rates were computed. Competing-risks regression models were performed to test the effect of age on CSM in the entire cohort, and for each grade (Gleason score 2-4, 5-7, and 8-10) and stage (pT2, pT3a, and pT3b) sub-cohorts. RESULTS Advancing age was associated with higher 15-year CSM rates (2.3 vs. 3.4 vs. 4.6 vs. 6.3% for patients aged ≤ 50 vs. 51-60 vs. 61-70 vs. ≥ 71 years, respectively; P < 0.001). In multivariable analyses, age at diagnosis was a significant predictor of CSM. This relationship was also observed in sub-analyses focusing on patients with Gleason score 5-7, and/or pT2 disease (all P ≤ 0.05). Conversely, age failed to reach the independent predictor status in men with Gleason score 2-4, 8-10, pT3a, and/or pT3b disease. CONCLUSIONS Advancing age increases the risk of CSM. However, when considering patients affected by more aggressive disease, age was not significantly associated with higher risk of dying from PCa. In high-risk patients, tumor characteristics rather than age should be considered when making treatment decisions.
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Affiliation(s)
- G Gandaglia
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - F Abdollah
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - A Becker
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Martiniclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Roghmann
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, Ruhr-University Bochum, Germany
| | - J D Sammon
- Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - S P Kim
- Department of Urology, Mayo Clinic, Rochester, NY, USA
| | - P Perrotte
- Department of Urology, University of Montreal Health Centre, Montreal, Canada
| | - A Briganti
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - F Montorsi
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Q-D Trinh
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - M Sun
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
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Rouprêt M, Colin P, Shariat S, Karakiewicz P, Xylinas E. Survie et récidive carcinologique chez les patients diagnostiqués pT0 après néphro-urétérectomie pour une tumeur de la voie excrétrice supérieure. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Seisen T, Hupertan V, Colin P, Xylinas E, Yates D, Bensalah K, Kassouf W, Ouzzane A, Rozet F, Cussenot O, Lotan Y, Wood C, Karakiewicz P, Montorsi F, Margulis V, Shariat S, Rouprêt M. Tumeurs de la voie excrétrice supérieure : développement d’un modèle international postopératoire de prédiction de la survie après néphro-urétérectomie à l’aide de l’analyse des courbes de décision. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.251] [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: 12/01/2022]
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Rieken M, Xylinas E, Kluth L, Trinh QD, Lee RK, Fajkovic H, Novara G, Margulis V, Lotan Y, Martinez-Salamanca JI, Matsumoto K, Seitz C, Remzi M, Karakiewicz PI, Scherr DS, Briganti A, Kautzky-Willer A, Bachmann A, Shariat SF. Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. Eur J Surg Oncol 2013; 40:113-20. [PMID: 24113620 DOI: 10.1016/j.ejso.2013.09.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 07/03/2013] [Revised: 09/04/2013] [Accepted: 09/10/2013] [Indexed: 12/16/2022] Open
Abstract
AIMS Evidence suggests a detrimental effect of diabetes mellitus (DM) on cancer incidence and outcomes. To date, the effect of DM and its treatment on prognosis in upper tract urothelial carcinoma (UTUC) remains uninvestigated. We tested the hypothesis that DM and metformin use impact oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for UTUC. METHODS Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU without neoadjuvant therapy. Cox regression models addressed the association of DM and metformin use with disease recurrence, cancer-specific mortality and any-cause mortality. RESULTS A total of 365 (14.3%) patients had DM and 194 (7.8%) patients used metformin. Within a median follow-up of 36 months, 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Diabetic patients who did not use metformin were at significantly higher risk of disease recurrence and cancer-specific death compared to non-diabetic patients and diabetic patients who used metformin. In multivariable Cox regression analyses, DM treated without metformin was associated with worse recurrence-free survival (HR: 1.44, 95% CI 1.10-1.90, p = 0.009) and cancer-specific mortality (HR: 1.49, 95% CI 1.11-2.00, p = 0.008). CONCLUSIONS Diabetic UTUC patients without metformin use have significantly worse oncologic outcomes than diabetics who used metformin and non-diabetics. The possible mechanism behind the impact of DM on UTUC biology and the potentially protective effect of metformin need further elucidation.
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Affiliation(s)
- M Rieken
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, University Hospital Basel, Basel, Switzerland
| | - E Xylinas
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France
| | - L Kluth
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Q-D Trinh
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - R K Lee
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - H Fajkovic
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - G Novara
- Department of Surgical, Oncological and Gastroenterologic Sciences, Urology Clinic, University of Padua, Italy
| | - V Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Y Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J I Martinez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - K Matsumoto
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - C Seitz
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - M Remzi
- Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria
| | - P I Karakiewicz
- Department of Urology, University of Montreal, Montreal, QC, Canada
| | - D S Scherr
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - A Briganti
- Department of Urology, Vita-Salute University, Milan, Italy
| | - A Kautzky-Willer
- Unit of Gender Medicine, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - A Bachmann
- Department of Urology, University Hospital Basel, Basel, Switzerland
| | - S F Shariat
- Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna, Austria.
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Xylinas E, Kent M, Kluth L, Pycha A, Comploj E, Svatek RS, Lotan Y, Trinh QD, Karakiewicz PI, Holmang S, Scherr DS, Zerbib M, Vickers AJ, Shariat SF. Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder. Br J Cancer 2013; 109:1460-6. [PMID: 23982601 PMCID: PMC3776972 DOI: 10.1038/bjc.2013.372] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/13/2013] [Accepted: 06/22/2013] [Indexed: 11/24/2022] Open
Abstract
Background: The European Organization for Research and Treatment of Cancer (EORTC) risk tables and the Spanish Urological Club for Oncological Treatment (CUETO) scoring model are the two best-established predictive tools to help decision making for patients with non-muscle-invasive bladder cancer (NMIBC). The aim of the current study was to assess the performance of these predictive tools in a large multicentre cohort of NMIBC patients. Methods: We performed a retrospective analysis of 4689 patients with NMIBC. To evaluate the discrimination of the models, we created Cox proportional hazard regression models for time to disease recurrence and progression. We incorporated the patients calculated risk score as a predictor into both of these models and then calculated their discrimination (concordance indexes). We compared the concordance index of our models with the concordance index reported for the models. Results: With a median follow-up of 57 months, 2110 patients experienced disease recurrence and 591 patients experienced disease progression. Both tools exhibited a poor discrimination for disease recurrence and progression (0.597 and 0.662, and 0.523 and 0.616, respectively, for the EORTC and CUETO models). The EORTC tables overestimated the risk of disease recurrence and progression in high-risk patients. The discrimination of the EORTC tables was even lower in the subgroup of patients treated with BCG (0.554 and 0.576 for disease recurrence and progression, respectively). Conversely, the discrimination of the CUETO model increased in BCG-treated patients (0.597 and 0.645 for disease recurrence and progression, respectively). However, both models overestimated the risk of disease progression in high-risk patients. Conclusion: The EORTC risk tables and the CUETO scoring system exhibit a poor discrimination for both disease recurrence and progression in NMIBC patients. These models overestimated the risk of disease recurrence and progression in high-risk patients. These overestimations remained in BCG-treated patients, especially for the EORTC tables. These results underline the need for improving our current predictive tools. However, our study is limited by its retrospective and multi-institutional design.
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Affiliation(s)
- E Xylinas
- 1] Department of Urology, Weill Cornell Medical College, New York, NY, USA [2] Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France
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40
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Xylinas E, Cha EK, Sun M, Rink M, Trinh QD, Novara G, Green DA, Pycha A, Fradet Y, Daneshmand S, Svatek RS, Fritsche HM, Kassouf W, Scherr DS, Faison T, Crivelli JJ, Tagawa ST, Zerbib M, Karakiewicz PI, Shariat SF. Risk stratification of pT1-3N0 patients after radical cystectomy for adjuvant chemotherapy counselling. Br J Cancer 2013; 107:1826-32. [PMID: 23169335 PMCID: PMC3504939 DOI: 10.1038/bjc.2012.464] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In pT1-T3N0 urothelial carcinoma of the bladder (UCB) patients, multi-modal therapy is inconsistently recommended. The aim of the study was to develop a prognostic tool to help decision-making regarding adjuvant therapy. METHODS We included 2145 patients with pT1-3N0 UCB after radical cystectomy (RC), naive of neoadjuvant or adjuvant therapy. The cohort was randomly split into development cohort based on the US patients (n=1067) and validation cohort based on the Europe patients (n=1078). Predictive accuracy was quantified using the concordance index. RESULTS With a median follow-up of 45 months, 5-year recurrence-free and cancer-specific survival estimates were 68% and 73%, respectively. pT-stage, ge, lymphovascular invasion, and positive margin were significantly associated with both disease recurrence and cancer-specific mortality (P-values ≤ 0.005). The accuracies of the multivariable models at 2, 5, and 7 years for predicting disease recurrence were 67.4%, 65%, and 64.4%, respectively. Accuracies at 2, 5, and 7 years for predicting cancer-specific mortality were 69.3%, 66.4%, and 65.5%, respectively. We developed competing-risk, conditional probability nomograms. External validation revealed minor overestimation. CONCLUSION Despite RC, a significant number of patients with pT1-3N0 UCB experience disease recurrence and ultimately die of UCB. We developed and externally validated competing-risk, conditional probability post-RC nomograms for prediction of disease recurrence and cancer-specific mortality.
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Affiliation(s)
- E Xylinas
- Department of Urology, Weill Cornell Medical College, Starr 900, 525 East 68th Street, Box 94, New York, NY 10065, USA
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41
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Rink M, Chun FKH, Robinson B, Sun M, Karakiewicz PI, Bensalah K, Fisch M, Scherr DS, Lee RK, Margulis V, Shariat SF. Tissue-based molecular markers for renal cell carcinoma. MINERVA UROL NEFROL 2011; 63:293-308. [PMID: 21996985] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Since the introduction of targeted therapies in renal cell carcinoma (RCC), more individualized treatment options have become available. Molecular markers might support treatment planning due to more accurate individual risk stratification. Current molecular markers in RCC were reviewed to elucidate clinical impact and future perspectives. An English-language literature review of the Medline database (1990 to September 2010) of published data on tissue-based molecular markers and RCC was undertaken. Histological types, clinical and oncological behaviour are variable in renal masses. Molecular markers offer potential for additional information in tumour detection and diagnosis, prognostic and predictive values, as well as determination of therapeutic targets. Investigations on molecular biomarkers in RCC include hypoxia inducible factor (HIF-α), vascular endothelial growth factor (VEGF), carbonic anhydrase IX (CAIX), mammalian target of rapamycin (mTOR), survivin, B7-H1, p53, matrix metalloproteinases (MMP), Insulin-like growth factor II mRNA-binding protein 3 (IMP3), Ki-67, C-reactive protein (CRP), Vimentin, Fascin, platelet count, hemoglobin level and combinations of these factors. Although some markers offer promising results, utilization in daily practice is compromised due to limited specificity, predictive accuracy and tumour histology variablity. There is an imminent need for novel molecular markers that allow accurate histologic and biologic classification of RCC to improve upon current outcomes. It is very likely that a panel of molecular markers will be used to achieve a sufficient degree of certainty in order to guide clinical decisions. A large concerted effort is required to advance the field of RCC molecular marker through systematic discovery, verification, and validation.
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Affiliation(s)
- M Rink
- Department of Urology, University of Hamburg, Hamburg, Germany
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Bianchi M, Sun M, Jeldres C, Shariat SF, Trinh QD, Briganti A, Tian Z, Schmitges J, Graefen M, Perrotte P, Menon M, Montorsi F, Karakiewicz PI. Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol 2011; 23:973-80. [PMID: 21890909 DOI: 10.1093/annonc/mdr362] [Citation(s) in RCA: 429] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We assessed the distribution of site-specific metastases in patients with renal cell carcinoma (RCC) according to age. Moreover, we evaluated recommendations proposed by guidelines and focused specifically on bone and brain metastases. PATIENTS AND METHODS Patients with metastatic RCC (mRCC) were abstracted from the Nationwide Inpatient Sample (1998-2007). Age was stratified into four groups: <55, 55-64, 65-74 and ≥ 75 years. Cochran-Armitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of multiple metastatic sites. Finally, we examined the rates of brain or bone metastases according to the presence of other metastatic sites. RESULTS In 11,157 mRCC patients, the rate of multiple metastatic sites decreased with increasing age (P < 0.001). This phenomenon was confirmed in patients with lung, bone, liver and brain metastases (all P ≤ 0.01). The rate of bone metastases was 10% in patients with exclusive abdominal metastases and 49% in patients with abdominal, thoracic and brain metastases. The rate of brain metastases was 2% in patients with exclusive abdominal metastases and 16% in patients with thoracic and bone metastases. CONCLUSIONS The proportion of patients with multiple metastatic sites is higher in young patients. The rates of bone (10%-49%) and brain (2%-16%) metastases are nonnegligible in mRCC patients.
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Affiliation(s)
- M Bianchi
- Department of Urology, Vita-Salute University, Urological Research Institute, Milan, Italy.
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Shariat S, Chromecki T, Cha E, Chun F, Chiu Y, Lotan Y, Novara G, Svatek R, Karakiewicz P, Scherr D. POD-05.05 Risk Stratification of Patients Who Are pT0N0 after Radical Cystectomy. Urology 2011. [DOI: 10.1016/j.urology.2011.07.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Budäus L, Morgan M, Abdollah F, Zorn KC, Sun M, Johal R, Thuret R, Abdo A, Schmitges J, Isbarn H, Jeldres C, Perrotte P, Graefen M, Karakiewicz PI. Impact of annual surgical volume on length of stay in patients undergoing minimally invasive prostatectomy: a population-based study. Eur J Surg Oncol 2011; 37:429-34. [PMID: 21492776 DOI: 10.1016/j.ejso.2011.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 01/29/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND On average, patients remain hospitalized no more than 2 days after MIRP. The aim of our study was to examine the temporal trends in length of stay ≥ 3 days and to test the relationship between annual surgical volume (ASV) and annual hospital volume (AHV) and length of stay ≥ 3 days in patients undergoing MIRP. MATERIAL AND METHODS Within the Florida Hospital Inpatient Datafile, 2439 men who were treated with MIRP for prostate cancer between 2005 and 2008 were identified. Temporal trends were assessed and uni and multi-variable logistic regression models tested the relationship between ASV, AHV and length of stay ≥ 3 days. RESULTS The average length of stay decreased from 2.4 in 2005 to 1.7 days in 2008. Length of stay ≥ 3 days was recorded in 13.6% of patients and the proportion of patients staying more than ≥ 3 days decreased over time (25.5-12.2%; Chi Square trend p < 0.001). After stratification into low (<1-15 MIRPs) vs. intermediate (16-63 MIRPs) vs. high ASV tertiles (≥ 64 MIRPs) the proportion of patients with length of stay ≥ 3 days were 29.1; 13.2 and 11.1%. In multivariable logistic regression models predicting length of stay ≥ 3 days, ASV, year of surgery and comorbidities achieved independent predictor status and MIRP patients operated by highest ASV tertile surgeons were 71% (p < 0.001) less likely to be hospitalized for more than 3 days. CONCLUSION The length of stay after MIRP decreased between 2005 and 2008. Surgical expertise represented one of the main determinants of shorter length of stay.
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Affiliation(s)
- L Budäus
- Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Abdollah F, Sun M, Shariat SF, Schmitges J, Djahangirian O, Tian Z, Jeldres C, Perrotte P, Montorsi F, Karakiewicz PI. The importance of pelvic lymph node dissection in the elderly population: implications for interpreting the 2010 national comprehensive cancer network practice guidelines for bladder cancer treatment. Int Braz J Urol 2011. [DOI: 10.1590/s1677-55382011000300029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- F Abdollah
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - M Sun
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - SF Shariat
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - J Schmitges
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - O Djahangirian
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - Z Tian
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - C Jeldres
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - P Perrotte
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
| | - F Montorsi
- Cancer Prognostics and Health Outcomes Unit, Canada; Vita Salute San Raffaele University, Italy
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Barbieri CE, Lotan Y, Lee RK, Sonpavde G, Karakiewicz PI, Robinson B, Scherr DS, Shariat SF. Tissue-based molecular markers for bladder cancer. MINERVA UROL NEFROL 2010; 62:241-258. [PMID: 20940694] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Bladder cancer is the second most common genitourinary malignancy in the United States, and is a major cause of morbidity and mortality. Despite aggressive treatment, survival for patients with muscle-invasive urothelial carcinoma of the bladder remains poor. Cancer stage, grade, and other clinical and pathological characteristics provide only limited prognostic information, and there is significant heterogeneity in patient outcomes using current risk stratification. Recent research into the profiling of bladder cancer at the molecular level has begun to shed light on important mechanisms of pathogenesis, as well as providing a number of potential tissue markers. These may provide useful prognostic information and guide patient selection for therapeutic strategies. This review explores recent advances in tissue-based molecular markers in bladder cancer and their potential utility. We also discuss design and statistical consideration for development and validation of molecular markers. A combination of complementary and yet independent molecular markers will likely better capture the biologic potential of each individual bladder tumor resulting in improved clinical decision-making.
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Affiliation(s)
- C E Barbieri
- Department of Urology, Weill Cornell Medical Center, New York, NY, USA.
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Karakiewicz P, Sun M, Sneller V, Escudier B. Use of a nomogram to quantify overall survival (OS) benefit in patients with metastatic renal cell carcinoma (mRCC) receiving bevacizumab (BEV) with interferon (IFN) versus IFN alone. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sagalowsky A, Shariat S, Karakiewicz P, Fradet Y, Ashfaq R, Stein J, Bastian P, Nielsen M, Suardi N, Montorsi F, Groshen S, Mueller S, Rigaud J, Heukamp L, Netto G, Lerner S, Cote R, Lotan Y. POD-7.09: Combination of Cell Cycle Regulating Bio-markers Improves Prognosis in Patients with Organ Confined Urothelial Cancer at Radical Cystectomy. Urology 2008. [DOI: 10.1016/j.urology.2008.08.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jeldres C, Gallina A, Walz J, Fred S, Perrotte P, Valiquette L, McCormack M, Huland H, Montorsi F, Karakiewicz P. The effect of surgical volume on the rate of secondary therapy after radical prostatectomy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15620 Introduction and Objective: Some argue that prostate cancer (PCa) detection and treatment at a younger age may translate into higher rate of clinically insignificant PCa. We assessed the effect of patients age at diagnosis on the pathological stage at radical prostatectomy (RP). Methods: Clinical and pathological data were available for 11975 patients from 3 European and 3 North American tertiary care centers. All RPs were performed between 1987 and 2006. Univariable and multivariable logistic regression analyses addressed the effect of age at RP on the rate of extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node invasion (LNI), after controlling for PSA, clinical stage, biopsy Gleason sum and year of surgery. Age at RP was coded as cubic spline to allow non-linear effects. Results: Mean age was 61.6 years (range 32–85) and mean PSA was 8.7 ng/mL (range 0.1–50.0). Biopsy Gleason sum was 2–6, 7 or 8–10 in 7510 (62.7%), 3656 (30.5%) and 809 (6.8%) patients, respectively. At RP, ECE, SVI and LNI were identified in 3383 (28.3%), 1309 (10.9%) and 469 (3.9%), respectively. In multivariable analyses, age was only an independent predictor of SVI (p<0.001). Older men had a higher rate of SVI. Conclusions: Pathological age only affects the rate of SVI. However, only one in ten men harbored SVI and this percentage may decrease even further with ongoing stage migration. Nonetheless, these data suggest that the removal of seminal vesicles should not be omitted in older men. No significant financial relationships to disclose.
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Affiliation(s)
- C. Jeldres
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - A. Gallina
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - J. Walz
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - S. Fred
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - P. Perrotte
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - L. Valiquette
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - M. McCormack
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - H. Huland
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - F. Montorsi
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
| | - P. Karakiewicz
- University of Montreal, Montreal, PQ, Canada; University of Hamburg, Hamburg, Germany; University Vita Salute, Milan, Italy
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Porter C, Walz J, Gallina A, Jeldres C, Kodama K, Gibbons R, Correa R, Perrotte P, Benard F, Saad F, Karakiewicz P. 634 NATURAL HISTORY OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY FOR PROSTATE CANCER. EUR UROL SUPPL 2007. [DOI: 10.1016/s1569-9056(07)60632-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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