1
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Erdem S, Capitanio U, Campi R, Amparore D, Carme Mir M, Roussel E, Pavan N, Kara O, Klatte T, Degirmenci E, Aydin R, Minervini A, Serni S, Berni A, Giacomo R, Ozcan F. How important are morphologic subtypes on the prognosis of surgically treated non-metastatic papillary renal cell carcinoma? An analysis from a contemporary multi-institutional database. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00154-3] [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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2
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Campi R, Pecoraro A, Mir M, Amparore D, Bertolo R, Erdem S, Kara O, Ingels A, Kriegmair M, Ouzaid I, Pavan N, Pecoraro A, Russel E, Minervini A, Serni S, Klatte T, Capitanio U. Decision-making and management strategies for patients with bilateral synchronous non-metastatic renal masses: Insights from a multi-centre European dataset. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00309-8] [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: 11/28/2022]
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3
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Serra De Oliveira Marconi L, Dabestani S, Ljungberg B, Volpe A, Fernandez-Pello S, Capitanio U, Lam T, D Stewart G, Beisland C, Klatte T, Kuusk T, Bex A. Local treatment of metastasis in metastatic RCC may have a significant survival effect across all risk of recurrence groups. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00461-4] [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: 11/04/2022]
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4
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Lonati C, Baumeister P, Afferi L, Mari A, Minervini A, Krajewski W, Hendricksen K, Montorsi F, Briganti A, Colombo R, Antonelli A, Rouprêt M, Masson-Lecomte A, Shariat S, D’Andrea D, Soria F, Hurle R, Mir M, Zamboni S, Simeone C, Klatte T, Teoh J, Schulz G, Mattei A, Moschini M. Survival outcomes after radical cystectomy versus conservative management for T1 high grade non-muscle invasive micropapillary bladder cancer: a multicentre collaboration by the European Association of Urology – young academic urologists (EAU-YAU): urothelial carcinoma working group. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00702-3] [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: 11/29/2022] Open
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5
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Fallara G, Larcher A, Dabestani S, Fossati N, Järvinen P, Nisen H, Gudmundsson E, Lam T, Marconi L, Fernandéz-Pello S, Meijer R, Volpe A, Beisland C, Klatte T, Stewart G, Ljungberg B, Montorsi F, Bex A, Capitanio U. Impact of surgical approach (open vs. minimally invasive) on oncological outcomes after nephrectomy for localised renal cell carcinoma: a recur database project. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00995-2] [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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Satish P, Kuusk T, Campain N, Abu-Ghanem Y, Neves J, Barod R, El-Sheikh S, Mumtaz F, Patki P, Tran M, Tran-Dang M, Grant L, Klatte T, Bex A. European Association of Urology COVID intermediate prioritisation group is poorly predictive of pathological high-risk among patients with renal tumours. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00996-9] [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: 11/25/2022]
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7
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Fallara G, Larcher A, Dabestani S, Fossati N, Järvinen P, Nisen H, Gudmundsson E, Lam T, Marconi L, Fernandéz-Pello S, Meijer R, Volpe A, Beisland C, Klatte T, Stewart G, Ljungberg B, Montorsi F, Bex A, Capitanio U. Impact of surgical approach (open vs. minimally invasive) on oncological outcomes after nephrectomy for localized renal cell carcinoma: A RECUR database project. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00947-7] [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: 11/28/2022]
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8
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Erdem S, Capitanio U, Campi R, Mir M, Eduard R, Pavan N, Kara O, Klatte T, Kriegmair M, Degirmenci E, Aydin R, Minervini A, Serni S, Rebez G, Ozcan F. External validation of the VENUSS prognostic model to predict disease recurrence after surgery for non-metastatic papillary renal cell carcinoma: An analysis of a multi-institutional European cohort. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00997-0] [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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9
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Lonati C, Afferi L, Baumeister P, Minervini A, Mari A, Krajewski W, Borghesi M, Rink M, Montorsi F, Briganti A, Hurle R, Contieri R, Umari P, Klatte T, Teoh JC, Soria F, Simeone C, Zamboni S, Roumiguié M, Rouprêt M, Masson-Lecomte A, Einerhand S, Mattei A, Moschini M. Survival outcomes of urothelial carcinoma with squamous differentiation versus pure squamous cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01111-8] [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: 11/25/2022]
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Lonati C, Baumeister P, Afferi L, Mari A, Minervini A, Krajewski W, Einerhand S, Montorsi F, Briganti A, Antonelli A, Rouprêt M, Masson-Lecomte A, Shariat S, D’Andrea D, Soria F, Hurle R, Mir M, Zamboni S, Simeone C, Klatte T, Teoh J, Schulz G, Mattei A, Moschini M. Survival outcomes after radical cystectomy versus conservative management for clinical T1 high grade non-muscle invasive micropapillary bladder cancer: A multicenter collaboration by the European Association of Urology–Young Academic Urologists. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01126-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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Di Maida F, Campi R, Tellini R, Lane B, De Cobelli O, Sanguedolce F, Hatzichristodoulou G, Antonelli A, Mari A, Brookman-May S, Klatte T, Roscigno M, Akdogan B, Karakoyunlu N, Langenhuijsen H, Keeley F, Marszalek M, Capitanio U, Carini M, Kutikov A, Minervini A. Predictors of trifecta after open and robot partial nephrectomy for highly complex localized renal tumor: results from a large multicenter international prospective observational project (the surface-intermediate-base margin score consortium). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35482-3] [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: 11/25/2022] Open
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Marchioni M, Campi R, Minervini A, Klatte T, Kriegmair M, Erdem S, Capitanio U, Roussel E, Albertsen M, Heck M, Porpiglia F, Van Bruwaene S, Linares E, Hevia V, Musquera M, Darweesh I, Autorino R, Pavan N, Antonelli A, Rubio-Briones J, Veccia A, Checcucci E, Claps F, Mir C. The impact of sarcomatoid features on survival outcomes in metastatic renal cell carcinoma patients receiving upfront cytoreductive nephrectomy: a retrospective analysis of a contemporary series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35499-9] [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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Marchioni M, Campi R, Minervini A, Klatte T, Kriegmair M, Erdem S, Capitanio U, Roussel E, Albertsen M, Heck M, Porpiglia F, Van Bruwaene S, Linares E, Hevia V, Musquera M, Derweesh I, Autorino R, Pavan N, Antonelli A, Rubio-Briones J, Vecchia A, Checcucci E, Claps F, Mir M. The impact of sarcomatoid features on survival outcomes in metastatic renal cell carcinoma patients receiving upfront cytoreductive nephrectomy: A retrospective analysis of a contemporary series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33439-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: 11/29/2022] Open
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Capitanio U, Selcuk E, Rowe I, Onder K, Roussel E, Campi R, Villari D, Klatte T, Kriegmair M, Bertolo R, Ouzaid I, Mir M, Larcher A, Salonia A. Clinical, surgical, pathological and follow-up features of kidney cancer in patients with Von Hippel-Lindau syndrome: Novel insights from a large European consortium. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33904-5] [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: 10/23/2022] Open
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15
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Campi R, Marchioni M, Roussel E, Capitanio U, Klatte T, Kriegmair M, Erdem S, Rubio-Briones J, Minervini A, Heck M, Porpiglia F, Van Bruwaene S, Linares E, Hevia V, Musquera M, Derweesh I, Autorino R, Pavan N, Antonelli A, Palumbo C, Guruli G, Ghali F, Amiel T, Mir M. Minimally invasive versus open cytoreductive nephrectomy for primary metastatic renal cancer: A multi-institutional experience from the REMARCC registry. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33438-8] [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: 11/15/2022] Open
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16
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Capitanio U, Stewart G, Larcher A, Ouzaid I, Akdogan B, Roscigno M, Marszalek M, Dell'Oglio P, Salagierski M, Volpe A, Mir M, Kriegmair M, Terrone C, Brookman-May S, Montorsi F, Klatte T. European temporal trends in the use of lymph node dissection in patients with renal cancer. Eur J Surg Oncol 2017; 43:2184-2192. [DOI: 10.1016/j.ejso.2017.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/02/2017] [Accepted: 07/18/2017] [Indexed: 11/15/2022] Open
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17
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Wirth GJ, Haitel A, Moschini M, Soria F, Klatte T, Hassler MR, Bensalah K, Briganti A, Karam JA, Lotan Y, Margulis V, Raman JD, Remzi M, Rioux-Leclercq N, Robinson BD, Rouprêt M, Wood CG, Shariat SF. Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract. World J Urol 2016; 35:943-949. [PMID: 27730305 DOI: 10.1007/s00345-016-1946-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/27/2016] [Accepted: 09/27/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC). METHODS AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). RESULTS Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS. CONCLUSIONS In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.
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Affiliation(s)
- G J Wirth
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Division of Urology, Department of Surgery, Geneva University Hospital, Geneva, Switzerland
| | - A Haitel
- Department of Clinical Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Moschini
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - F Soria
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy
| | - T Klatte
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Karl-Landsteiner Institute for Urology and Andrology, Vienna, Austria
| | - M R Hassler
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - K Bensalah
- Department of Urology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - A Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - J A Karam
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Y Lotan
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - V Margulis
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J D Raman
- Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - M Remzi
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - N Rioux-Leclercq
- Department of Pathology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - B D Robinson
- Department of Pathology, Weill Cornell Medical College, New York, NY, USA
| | - 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
| | - C G Wood
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Department of Urology, Weill Cornell Medical College, New York, NY, USA.
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18
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Capitanio U, Stewart G, Klatte T, Volpe A, Akdogan B, Roscigno M, Langenhuijsen H, Marszalek M, Rodriguez Faba O, Salagierski M, Minervini A, Brookman-May S. 522 Temporal trends in the rate of lymph node dissection for renal cell carcinoma. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60524-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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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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20
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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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Nison L, Colin P, Remzi M, Shariat S, Klatte T, Yakoubi R, Bozzini G, Capitanio U, Babjuk M, Merseburger A, Cha E, Fritsche H, Novara G, Montorsi F, Hora M, Roupret M. Résultats oncologiques du traitement des TVES≤pT2 de l’uretère pelvien par néphro-urétérectomie, résection segmentaire et chirurgie endoscopique : résultats d’une étude multicentrique européenne. Prog Urol 2015; 25:807. [DOI: 10.1016/j.purol.2015.08.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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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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23
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Bures C, Bobak-Wieser R, Koppitsch C, Klatte T, Zielinski V, Freissmuth M, Friedrich G, Repasi R, Hermann M. Late-onset palsy of the recurrent laryngeal nerve after thyroid surgery. Br J Surg 2014; 101:1556-9. [DOI: 10.1002/bjs.9648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/03/2014] [Accepted: 08/12/2014] [Indexed: 12/25/2022]
Abstract
Abstract
Background
A small subset of patients may develop late-onset palsy of the recurrent laryngeal nerve (RLN) after thyroid surgery. However, no conclusive data have been published regarding the incidence of, and possible risk factors for, this complication.
Methods
Preoperative, intraoperative and postoperative data from consecutive patients who underwent thyroid surgery at a single centre between 1999 and 2012 were analysed. Late-onset palsy of the RLN was defined as deterioration of RLN function after normal vocal cord function as investigated by routine preoperative and postoperative laryngoscopy.
Results
The cohort included 16 692 patients with 28 757 nerves at risk. Early postoperative palsy of the RLN was diagnosed in 1183 nerves at risk (4·1 per cent), whereas late-onset RLN palsy was found in 41 (0·1 per cent). Late-onset palsy of the RLN was diagnosed after a median interval of 2·5 (range 0·5–12) weeks and nerve function recovered completely in 28 patients after a median interval of 3 months. This recovery rate was significantly lower than that for early-onset RLN palsy: 1068 (90·3 per cent) of 1183 nerves (P < 0·001). No particular risk factor for late-onset RLN palsy was identified.
Conclusion
Late-onset palsy of the RLN was diagnosed in a small subset of patients after thyroid surgery, and recovery of nerve function occurred less frequently than in patients with early-onset RLN palsy.
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Affiliation(s)
- C Bures
- Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria
- Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria
| | - R Bobak-Wieser
- Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria
- Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria
| | - C Koppitsch
- Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria
- Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria
| | - T Klatte
- Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - V Zielinski
- Department of Otorhinolaryngology, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - M Freissmuth
- Institute of Pharmacology, Medical University of Vienna, Vienna, Austria
| | - G Friedrich
- Ear, Nose and Throat, University Hospital Graz, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - R Repasi
- Department of Otorhinolaryngology, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - M Hermann
- Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria
- Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria
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Lusch A, Okhunov Z, Osann K, Derweesh I, Liss M, Kavoussi L, Wyler S, Badani K, Laguna M, De La Rosette J, Barwari K, Tsivian M, Polascik T, Klatte T, Klingler H, Pattaras J, Landman J. 97 Intermediate term oncologic outcomes of renal cryoablation: An international multi-institution analysis. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)60098-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Aumayr K, Susani M, Horvat R, Wrba F, Mazal P, Klatte T, Koller A, Neudert B, Haitel A. P16INK4A immunohistochemistry for detection of human papilloma virus-associated penile squamous cell carcinoma is superior to in-situ hybridization. Int J Immunopathol Pharmacol 2014; 26:611-20. [PMID: 24067458 DOI: 10.1177/039463201302600305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We evaluated p16INK4A as a reliable option to detect human papilloma virus (HPV) DNA in penile tumor specimens. Formalin-fixed paraffin embedded samples of 26 patients with penile cancer and another 18 cases with non-tumorigenic lesions were stained by three different widely used commercially available chromogenic in-situ hybridization assays high-risk HPV CISH Y1443 (Genpoint, DAKO), pan HPV CISH Y1404 (Genpoint, DAKO), INFORM HPV III (Ventana, Tucson, Arizona) and p16INK4A immunohistochemistry, then compared to the known gold standard polymerase chain reaction detecting HPV 16, 18, 31, and 33. Immunoreactivity for p16INK4A was evaluated by using a 4-tiered (0, 1, 2, and 3) pattern based system. 19 cases were positive for p16INK4A, 13 of which showed a continuous transepithelial staining (pattern 3). Pan HPV ISH showed positivity in 9 cases, high-risk HPV ISH in 7 cases and INFORM HPVIII ISH in 7 cases. p16INK4A IHC pattern 3 versus pattern 0, 1 and 2 exhibited a specificity and positive predictive value of 100 percent, with a sensitivity and negative predictive value of 72 and 62 percent, respectively, which was much better than all HPV in-situ hybridization methods referred to polymerase chain reaction. p16INK4A seems to be a superior marker for the detection of HPV-associated penile squamous cell carcinoma compared to CISH tests, but is not recommend for the detection of non-tumorigenic lesions, where PCR should be used for the initial assessment.
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Affiliation(s)
- K Aumayr
- Department of Pathology, Medical University of Vienna, Vienna, Austria
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Bures C, Klatte T, Friedrich G, Kober F, Hermann M. Guidelines for complications after thyroid surgery: pitfalls in diagnosis and advices for continuous quality improvement. Eur Surg 2014. [DOI: 10.1007/s10353-013-0247-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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27
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Tonninger-Bahadori K, Bures C, Zipko HT, Klatte T, Hermann M. Intraoperative pharmacologic increase of systemic blood pressure to detect the source of hemorrhage in thyroid surgery and reoperation: a case report. Eur Surg 2013. [DOI: 10.1007/s10353-013-0235-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Klatte T, Zigeuner R, Rouprêt M, Babjuk M, Capitanio U, Cha E, Colin P, Comploj E, Dalpiaz O, Fritsche HM, Herrmann T, Hora M, Hübner W, Merseburger A, Montorsi F, Nison L, Novara G, Roscigno M, Shariat S, Remzi M. 575 Segmental ureterectomy versus radical nephroureterectomy for urothelial cancer of the ureter: A matched-pair analysis. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/s1569-9056(13)61058-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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de Martino M, Hoetzenecker K, Ankersmit HJ, Roth GA, Haitel A, Waldert M, Klatte T. Serum 20S proteasome is elevated in patients with renal cell carcinoma and associated with poor prognosis. Br J Cancer 2012; 106:904-8. [PMID: 22294183 PMCID: PMC3305962 DOI: 10.1038/bjc.2012.20] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [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] [Indexed: 12/13/2022] Open
Abstract
Background: To date, no reliable serum marker for clear cell renal cell carcinoma (CCRCC) is available. The aim of this study was to evaluate the putative significance of circulating 20S proteasome levels. Methods: Preoperative 20S proteasome serum levels were determined in 113 CCRCC patients and 15 healthy controls by a sandwich enzyme-linked immunosorbent assay. Associations with CCRCC, pathological variables, disease-specific survival (DSS), and response to sunitinib were evaluated. Results: Median 20S proteasome levels were higher in CCRCC patients than in healthy controls (4.66 vs 1.52 μg ml−1, P<0.0001). The area under the receiver operating characteristics curve curve was 87.1%. The 20S proteasome levels were associated with symptoms (P=0.0008), distant metastases (P=0.0011), grade (P=0.0247), and necrosis (P=0.0462). The 20S proteasome levels were identified as a prognostic factor for DSS in both univariable (hazards ratio 1.21, P<0.001) and multivariable (hazards ratio 1.17, P=0.0015) survival analysis. In patients responding to sunitinib, 20S proteasome levels were lower than in patients with stable disease and progressive disease. Conclusion: This study demonstrates for the first time that increased 20S proteasome levels are associated with CCRCC, advanced disease, and poor prognosis. Routine use of this marker may allow better diagnosis, risk stratification, risk-adjusted follow-up, and identification of patients with a greater likelihood of response to targeted therapy.
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Affiliation(s)
- M de Martino
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria
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de Martino M, Böhm M, Klatte T. [Malignant solitary fibrous tumour of the kidney: report of a case and cumulative analysis of the literature]. Aktuelle Urol 2012; 43:59-62. [PMID: 22271338 DOI: 10.1055/s-0030-1283853] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We report the case of a primary metastatic renal solitary fibrous tumour (SFT) and present a cumulative analysis of the literature. A 68-year-old woman presenting with a history of flank pain was diagnosed with a 7 cm renal mass. Further staging showed liver, lung and bone metastases. The patient underwent radical nephrectomy. Microscopically, the tumour consisted of pleomorphic, high-grade spindle cells with high mitotic activity, tumour necrosis and dense collagenous bands. Immunohistochemistry showed the strong expression of CD34 and vimentin, a weak expression of bcl-2 and CD99, and no expression of smooth muscle actin, desmin, S-100, pan-cytokeratin, and epithelial membrane antigen. These findings are consistent with an SFT. For the cumulative analysis, a total of 46 renal SFTs from 35 reports were analysed. Median age at the time of surgery was 52 years and 63% of the patients were female. Sixty-two percent of the tumours were symptomatic, most commonly with flank / back pain (24%). Median tumor size was 6.4 cm. Histologically, 91% of the SFTs were benign and 9% were malignant. One patient died of the disease, while 90% are alive without evidence of disease.
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Affiliation(s)
- M. de Martino
- Universitätsklinik für Urologie, Medizinische Universität Wien, Wien, Österreich
| | - M. Böhm
- Urologische Abteilung, Klinikverbund Lahn-Dill-Kliniken, Dillenburg, Deutschland
- Universitätsklinik für Urologie, Otto-von-Guericke Universität Magdeburg, Magdeburg, Deutschland
| | - T. Klatte
- Universitätsklinik für Urologie, Medizinische Universität Wien, Wien, Österreich
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Kroeger N, Klatte T, Birkhaeuser FD, Rampersaud EN, Seligson DB, Zomorodian N, Kabbinavar FF, Belldegrun AS, Pantuck AJ. The effect of tobacco exposure in renal cell carcinoma (RCC) overall and cancer-specific survival. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4578] [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: 11/20/2022] Open
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Hutterer GC, Chromecki TF, Zigeuner R, Klatte T, Kampel-Kettner K, Pummer K, Remzi M, Mannweiler S. Evaluation of tumor-associated macrophages as a prognostic indicator in patients with papillary renal cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.372] [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
372 Background: Prognostic indicators in papillary renal cell carcinoma (PRCC) are not well defined. We evaluated the prognostic relevance of tumor-associated macrophages (TAM) in patients with PRCC. Methods: PRCC specimens were re-evaluated by one blinded pathologist (SM), with respect to pT-classification (TNM 2002), nodal status, Fuhrman grade (I-IV), tumor size, subtype (type 1 or 2), tumor necrosis, and presence of TAM. Presence of TAM was associated with pathological parameters (chi-square and fisher's exact tests). Impact of TAM on cancer-specific survival (CSS) was assessed (Kaplan-Meier method and log-rank test). A multivariate regression analysis including pT-stage, grade, vascular invasion, necrosis, tumor size, papillary subtype and TAM was performed with respect to CSS. Results: 177 patients operated for PRCC from 1984 to 2006, were evaluated. Presence of TAM was noted in 112/177 (63%) tumors and was significantly associated with favorable pathological parameters: low pT-classification (pT1a/b: 71/90, 79%; pT2: 14/31, 45%; pT3a/b: 27/56, 48%; p<0.001), node negative tumors (Nx/pN0: 111/170, 65% vs. pN1/2: 1/7, 14%; p=0.01), low grade (G1: 35/45, 78%; G2: 67/110, 61%; G3: 10/22, 45%; p=0.025), absence of vascular invasion (V0: 106/153, 69% vs. V1/2: 6/24, 25%; p<0.001), and papillary subtype (type 1: 64/87, 74% vs. 48/89, 54%; p=0.007), respectively. Median follow-up was 68.3 months. Five-year CSS probabilities for patients with TAM-positive tumors were 93.5%, compared with 72.5% in patients with TAM-negative tumors (p<0.001). Median survival was not reached in both groups. Multivariate analysis revealed node positive tumors (HR=2.4, 95%CI=1.1-5.0; p=0.025), distant metastases (HR=8.7, 95%CI=2.6-29.3; p<0.001), and tumor size (HR=1.2, 95%CI=1.0-1.3; p=0.03) as independent predictors of death from PRCC, whereas presence of TAM was independently associated with favorable outcome (HR=0.3, 95%CI=0.1-0.9, p=0.026). Conclusions: Presence of TAM was independently associated with a favorable outcome in patients with PRCC and was shown to reduce the risk of death from cancer by 66%. Presence of TAM should therefore be part of routine pathology reporting in PRCC. No significant financial relationships to disclose.
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Affiliation(s)
- G. C. Hutterer
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - T. F. Chromecki
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - R. Zigeuner
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - T. Klatte
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - K. Kampel-Kettner
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - K. Pummer
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - M. Remzi
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
| | - S. Mannweiler
- Department of Urology, Medical University Graz, Graz, Austria; Weill Cornell Medical College, New York, NY; Department of Urology, Medical University Vienna, Vienna, Austria; Institute of Pathology, Medical University Graz, Graz, Austria
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Pouliot F, Anterasian C, Klatte T, Finley D, Shuch B, Kabbinavar FF, Zomorodian N, Belldegrun AS, Pantuck AJ. Use of the UCLA-integrated staging system (UISS) to predict survival after sunitinib treatment for patients with metastatic renal cell carcinoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Weibl P, Klatte T, Kollarik B, Geryk B, Schüller G, Marberger M, Remzi M. 298 COMPLEX RENAL CYSTIC MASSES: INTERPERSONAL VARIABILITY OF BOSNIAK CLASSIFICATION IS SIGNIFICANT – FACT OR FICTION. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60297-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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de Martino M, Klatte T, Seligson DB, LaRochelle J, Shuch B, Caliliw RR, Li Z, Kabbinavar FF, Pantuck AJ, Belldegrun AS. Use of CA9 gene single nucleotide polymorphisms to predict prognosis and treatment response of metastatic renal cell carcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5003] [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
5003 Background: Carbonic anhydrase 9 gene (CA9) is located in a prognostically relevant chromosomal area on chromosome 9p and is encoding for one of the most significant protein markers in metastatic renal cell carcinoma (MRCC), CAIX. In contrast to CAIX protein, however, no efforts have been made to date to study CA9 gene in metastatic RCC. Here, we test the hypotheses that single nucleotide polymorphisms (SNPs) and mutations of the CA9 gene are associated with CAIX expression, response to immunotherapy and survival. Methods: Genomic DNA was extracted from frozen tumor samples of 54 patients with clear cell MRCC. All exons of the CA9 gene were PCR-amplified and sequenced. The antibody M75 was used to evaluate CAIX protein expression immunohistochemically. Statistical associations of CA9 gene status and CAIX protein expression with response to IL-2 based immunotherapy and overall survival were assessed with chi-square tests, t-tests, Kaplan-Meier survival estimates and Cox proportional hazards regression models. Results: CA9 reference SNP (rs) 2071676 was found in 59%, rs12553173 in 15%, rs3829078 in 11% and rs1048638 in 33% of the patients. The deletion c.376del393 was observed in two patients. CAIX expression was high (>85%) in 65% of the patients. None of the SNPs was significantly associated with CAIX expression. Patients with the C allele variant of rs12553173 had improved median survival (27.3 vs. 13.6 months, p = 0.0431) and a greater likelihood of response to IL-2 (57% vs. 22%, p = 0.081) Likewise, high CAIX expression was associated with longer median survival (25.5 vs. 8.5 months, p < 0.0001) and a greater IL-2 response rate (37% vs. 8%, p = 0.070). In a multivariate Cox model, both C allele variant of CA9 SNP rs12553173 and CAIX expression were retained as independent prognostic factors. Conclusions: CA9 SNPs are frequently found in patients with MRCC. The C allele variant of rs12553173 is associated with improved overall survival and a greater likelihood of response to IL-2. CA9 rs12553173 and CAIX are both independent prognostic factors of overall survival and complementary in predicting prognosis of MRCC. No significant financial relationships to disclose.
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LaRochelle JC, Dastane A, Rao N, Klatte T, Shuch B, Kabbinavar F, Said J, Belldegrun A, Pantuck A. Use of chromosome 9p status to identify a subset of high-risk localized renal cell carcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5090] [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
5090 Background: We investigated whether deletion of chromosome 9p in clear cell renal cell carcinoma (ccRCC) predicts worse disease-specific (DSS) and recurrence-free survival (RFS), and if it is associated with worse prognosis in tumors < 4 cm. Methods: 316 patients undergoing nephrectomy prior to 2001 were included on a tissue microarray in whom FISH analysis using the LSI p16/CEP 9 Dual Color Probe was performed to assess chromosome 9p deletion status. An additional 389 patients undergoing nephrectomy after 2001 had 9p status determined by standard cytogenetics. Tumor grade, stage, size, 9p status, nodal involvement, and the presence of metastasis were recorded. Disease-specific and recurrence-free survival were determined, and independence was assessed using Cox proportional hazards models. Results: 9p deletions were detected in 14% of tumors. 54% of 9p-deleted tumors were high grade (G3–4) vs. 38% without 9p deletions, and 60% of 9p-deleted tumors were T3–4 vs 38% without 9p deletions (p < 0.01). 55% of those with 9p deletions had positive nodes or metastases vs. 34% of those without 9p deletions (p < 0.01). Median DSS for those with and without 9p deletions was 80 months and 37 months, respectively (p < 0.01). In localized disease, median RFS for those with 9p deletions was 53 months and was not reached in those without 9p deletions (p<0.01). In 188 patients presenting with localized RCC < 4 cm, loss of 9p occurred in 3/7 (42.9%) of patients with post-nephrectomy recurrence vs. 13/168 (7.2%) of patients without disease recurrence (p = 0.001). DSS for patients with 9p deletion in tumors < 4 cm was significantly worse than DSS in those without 9p deletions (HR 6.18; p = 0.02), and an independent effect on RFS was seen for 9p deletions in localized RCC (HR 2.3, p < 0.01). 9p status was not a significant predictor in metastatic RCC. Conclusions: Deletion of chromosome 9p in ccRCC occurs in 14% of patients and is associated with higher grade and T stage, presence of nodal and distant disease, worse prognosis, and in patients with small NOMO tumors, 9p deletions but not tumor size was independently associated with RFS. Identifying high risk patients with 9p deletions will allow better risk stratification for surveillance protocols and for adjuvant trials. No significant financial relationships to disclose.
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Affiliation(s)
- J. C. LaRochelle
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - A. Dastane
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - N. Rao
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - T. Klatte
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - B. Shuch
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - F. Kabbinavar
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - J. Said
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - A. Belldegrun
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
| | - A. Pantuck
- University of California, Los Angeles, Santa Monica, CA; University of California, Los Angeles, Los Angeles, CA
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Klatte T, Remzi M, Said JW, Haitel A, Kabbinavar FF, Waldert M, de Martino M, Marberger M, Belldegrun AS, Pantuck AJ. A nomogram predicting disease-specific survival after nephrectomy for papillary renal cell carcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5091] [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
5091 Background: Whereas multiple nomograms have been developed to assess outcomes of patients with clear cell renal cell carcinoma, a model to assess prognosis of papillary renal cell carcinoma (PRCC) has not yet been developed. After data collection and slide review of a large cohort of patients, the aim of this study was to develop and to internally validate a nomogram for prediction of disease-specific survival for PRCC. Methods: Out of 2,687 patients who underwent surgery for a renal tumor between 1989 and 2008 at two institutions, 258 (10%) were found to have PRCC. H&E slides were reviewed by one uro-pathologist at each institution for papillary sub-type, tumor grade, microvascular invasion, sarcomatoid features, collecting system invasion and presence and extent of tumor necrosis. A nomogram was constructed as a graphical representation of significant variables of disease-specific survival in multivariate Cox proportional hazards regression analysis. The discrimination and calibration of the nomogram were assessed, both utilizing bootstrapping to obtain relatively unbiased estimates. Results: After a median follow-up of 35 months, 49 PRCC-related deaths (19%) had occurred. In univariate analysis, incidental detection, T, N, M stage, grade, microvascular invasion, collecting system invasion, papillary sub-type, sarcomatoid features, and necrosis were all associated with prognosis. Multivariate Cox proportional hazards analysis, however, identified incidental detection, T stage, M stage, microvascular invasion, and necrosis, but not papillary sub-type as independent prognostic factors of disease-specific survival. These variables formed the basis of the nomogram that predicted 5-year disease-specific survival probability. The nomogram predicted well, with a bootstrapped corrected concordance index of 0.93, and showed good calibration. Conclusions: A highly accurate tool utilizing basic clinical and pathological information for predicting disease-specific survival was developed specifically for PRCC. This tool should be helpful for identification of the subset of PRCC patients with aggressive clinical behavior, and may contribute to the ability to individualize postoperative surveillance and therapy. No significant financial relationships to disclose.
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Affiliation(s)
- T. Klatte
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | - M. Remzi
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | - J. W. Said
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | - A. Haitel
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | | | - M. Waldert
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | - M. de Martino
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | - M. Marberger
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
| | | | - A. J. Pantuck
- University of Vienna, Vienna, Austria; UCLA, Los Angeles, CA
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Shuch B, La Rochelle JC, Klatte T, Riggs SB, Kabbinavar FF, Pantuck AJ, Belldegrun AS. Brain metastasis from renal cell carcinoma: Presentation, recurrence, survival and implications for systemic therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5097] [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: 11/20/2022] Open
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Rettig MB, Heber D, An J, Klatte T, Seeram N, Liu H, Rao JY, Henning S, Belldegrun AS, Pantuck AJ. Impact of pomegranate extract on NF-κΒ activation and emerge of androgen-independent prostate cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16099] [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: 11/20/2022] Open
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Pantuck AJ, Klatte T, Patard J, Cindolo L, De La Taille A, Tostain J, Ferriere J, Pfister C, Kabbinavar FF, Belldegrun AS, George DJ. The impact of gender and age in renal cell carcinoma: age is an independent prognostic factor in women but not men. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Jaeger E, Waldman F, Roydasgupta R, Klatte T, McDermott DF, Signoretti S, Atkins MB, LaRochelle J, Belldegrun AS, Pantuck AJ. Array-based comparative genomic hybridization (CGH) identifies chromosomal imbalances between Interleukin-2 complete and non-responders. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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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Patard J, Bensalah K, Pantuck A, Klatte T, Crepel M, Verhoest G, Guille F, Manunta A, Vincendeau S, Avakian R, Bellec L, Soulie M, Rischmann P, Albouy B, Pfister C, Bernhard J, Ferriere J, Lacroix B, Tostain J, De La Taille A, Abbou C, Salomon L, Colombel M, Ficarra V, Cindolo L, Bertini R, Karakiewicz P, Montorsi F, Belldegrun A. RADICAL NEPHRECTOMY IS NOT SUPERIOR TO NEPHRON SPARING SURGERY IN PT1B-PT2N0M0 RENAL TUMOURS: A MATCHED COMPARISON ANALYSIS IN 546 CASES. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60490-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Klatte T, Said J, Seligson D, De Martino M, Larochelle J, Shuch B, Kabbinavar F, Belldegrun A, Pantuck A. PAPILLARY RENAL CELL CARCINOMA WITH CLEAR CELLS – PATHOLOGICAL, IMMUNOHISTOCHEMICAL AND CYTOGENETIC CHARACTERISTICS OF A NOVEL ENTITY. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60835-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Riggs SB, Klatte T, Seligson DB, Pantuck AJ, Leppert JT, Lam JS, Zomorodian N, Kabbinavar FF, Belldegrun AS. Prognostic and biologic impact of molecular markers in papillary renal cell carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15525] [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
15525 Background: Papillary renal cell carcinoma (PRCC) is the second most common histological subtype among patients undergoing surgery for kidney cancer, but the molecular profile of this entity is not well characterized. The goals of this study were (1) to evaluate differences in expression between type 1 and 2 PRCC, and (2) to analyze the prognostic impact of molecular markers. Methods: We examined clinicopathological and molecular parameters of 42 patients treated with nephrectomy with the final pathology being PRCC. A tissue microarray consisting of the tumor specimens was constructed. Immunohistochemical staining was performed with antibodies directed against CAIX, CAXII, CXCR3, Gelsolin, HIF-1a, Ki-67, Vimentin, EpCAM, p21, p27, p53, pS6, pAkt, PTEN, VEGF-A, VEGF-C, VEGF-D, VEGF-R1, VEGF-R2, and VEGF-R3. Staining was analyzed by one anatomical pathologist (DS) who was blinded to outcome. Mann- Whitney’s U-test was used to compare marker expressions between type 1 and 2. Endpoint was disease-specific survival (DSS). Expression cut-offs were detected by using recursive partitioning. The Kaplan-Meier curves were compared using the log-rank test. Results: At last follow-up, 21 patients (50%) had died including 12 (29%) of RCC. The median follow-up for the patients alive was 8 years. Type 1 PRCC had significantly higher expression of nuclear p27, nuclear pAkt, and p53 compared with type 2. Since none of these 3 markers provided prognostic information, survival analyses were performed together for both types. Using the cut-offs identified with recursive partitioning, higher expression of Ki-67 (p=0.02), lower gelsolin (p<0.001), lower p21 (p=0.01), higher cytoplasmic p27 (p=0.01), higher endothelial VEGF-A (p=0.01), lower epithelial VEGF-D (p=0.04), and lower endothelial VEGFR-3 (p=0.01) were adverse prognostic factors. Conclusions: Out of 19 molecular markers, a specific molecular profile for PRCC was identified. pAkt, p27, and p53 can assist in subdividing type 1 and type 2 PRCC. Ki-67, gelsolin, p21, p27 and proteins of the VEGF family were found to be important prognostic factors among these patients. Although prognostic relevant, the VEGF proteins cannot be used to differentiate type 1 and 2 PRCC. No significant financial relationships to disclose.
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Affiliation(s)
| | - T. Klatte
- UCLA School of Medicine, Los Angeles, CA
| | | | | | | | - J. S. Lam
- UCLA School of Medicine, Los Angeles, CA
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Klatte T, Zomorodian N, Kabbinavar FF, Belldegrun AS, Pantuck AJ. Prospective evaluation of carbonic anhydrase IX (CAIX) as a molecular marker in metastatic renal cell carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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
5112 Background: CAIX is an important molecular marker of survival and response to immunotherapy in patients with metastatic renal cell carcinoma (RCC). The purpose of this study was to prospectively evaluate the performance of CAIX in patients with metastatic RCC. Methods: This study accrued 32 consecutive patients who were treated for metastatic clear cell RCC between January 2004 and May 2006. Immunohistochemical staining of the primary tumor was performed using the mouse monoclonal antibody MN-75. Patients were stratified into two groups: high CAIX expression (>85%) and low CAIX expression (=85%) according to the percentage of cells staining positive for CAIX. Study endpoints included disease-specific survival time (DSS) and response to treatment according to RECIST criteria. Results: Four (12.5%), 21 (65.6%), and 7 patients (21.9%) were classified into low risk, intermediate risk, and high risk groups according to the University of California Integrated Staging System (UISS). Twenty (62.5%) of the 32 patients had high CAIX expression. The median follow-up was 11.4 months. Patients with low CAIX expression had significantly worse prognosis than patients with high CAIX expression (median survival: 15.2 months vs. not reached, p=0.01, 1-year DSS rate: 63% vs. 83%) and a 3.9 fold increased risk of death from RCC (95% CI, 1.2–12.7). All 4 patients in the low risk UISS group had high CAIX expression, and all were alive at 1 year. Nine patients received high dose IL-2 based immunotherapy, including 8 who had high CAIX expression, and a 1-year DSS rate of 87.5%. Of the patients expressing high CAIX, 3 (37.5%) were responders to IL-2 including 1 partial and 2 complete responses, 3 (37.5%) exhibited stable disease and 2 (25.0%) progressed during treatment. Conclusions: The results of this first prospective study of CAIX in metastatic RCC confirm that high CAIX expression is associated with better survival and enhanced response to IL-2 based immunotherapy. Patients with high CAIX expression, specifically those with low risk RCC, should be considered candidates to receive immunotherapy, whereas patients with low CAIX expression or in higher risk groups may be better candidates for targeted or other experimental therapy. No significant financial relationships to disclose.
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Affiliation(s)
- T. Klatte
- University of California, Los Angeles, Los Angeles, CA
| | - N. Zomorodian
- University of California, Los Angeles, Los Angeles, CA
| | | | | | - A. J. Pantuck
- University of California, Los Angeles, Los Angeles, CA
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Nelius T, Klatte T, de Riese W, Filleur S. Clinical outcome of patients (pts) with taxane-resistant (TR) hormone-refractory prostate cancer (HRPC) treated with second-line cyclophosphamide (CP) -based metronomic chemotherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
15647 Background: For pts with TR HRPC no standard chemotherapeutic treatment exist. In this study we evaluate the efficacy of CP-based metronomic chemotherapy in this pt population. Methods: Pts with metastatic HRPC with disease progression under docetaxel-based chemotherapy were eligible. The primary endpoint was PSA response. Secondary endpoints were time to progression (TTP), survival and toxicity. Low dose CP (50 mg/d) and dexamethasone (1 mg/d) were administered orally in a metronomic manner. Treatment was continued until disease progression. Results: Between February 2005 and May 2006 17 pts were enrolled in this study. The median follow-up was 12 weeks (range: 4–60). Median Age was 68 years (range: 42–85). Median PSA at study entry was 134 ng/ml (range: 46.0–6554). 9 pts had a PSA response (medium 44.4%), 4 pts = 50% and 5 pts < 50%. 8 pts had a PSA progression. The medium time to maximal response was 12 weeks (range: 4–36). TTP/survival for pts with PSA response and PSA progression was 24/60 weeks and 4/4 weeks, respectively. 3 pts of the progression group showed a decrease in PSA doubling time. 5 pts reported a decrease in bone pain after 4 weeks treatment. No grade 3 and 4 toxicities were noted. Conclusions: In this study, low-dose metronomic administered CP demonstrated efficacy as second line treatment in pts with TR HRPC. The treatment was well tolerated and almost without toxicity. The mechanism of action of low dose CP involves inhibition of tumor angiogenesis secondary to inhibition of dividing endothelial cells in tumor associated blood vessels. Dexamethasone may also have antiangiogenic properties by inhibiting the production of vascular endothelial growth factor. Further investigation regarding an antiangiogenic treatment strategy for HRPC are therefore of great interest. No significant financial relationships to disclose.
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Affiliation(s)
- T. Nelius
- Texas Tech University, Lubbock, TX; Otto-von-Guericke University, Magdeburg, Germany
| | - T. Klatte
- Texas Tech University, Lubbock, TX; Otto-von-Guericke University, Magdeburg, Germany
| | - W. de Riese
- Texas Tech University, Lubbock, TX; Otto-von-Guericke University, Magdeburg, Germany
| | - S. Filleur
- Texas Tech University, Lubbock, TX; Otto-von-Guericke University, Magdeburg, Germany
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Belldegrun AS, Riggs S, Zomorodian N, Pantuck AJ, Klatte T, Kabbinavar FF. Personalized surveillance and prognostication of patients undergoing kidney cancer surgery: The 15-year UCLA experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5045] [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
5045 Background: Renal cell carcinoma (RCC) is a heterogeneous disease with varying biology, clinical manifestations, and outcome. An evolving understanding of prognostic factors for patients is leading toward individualized surveillance as well as treatment. We reviewed our large single center experience trying to maximize prognostication and surveillance for each patient. Methods: The charts of 1,825 patients with renal masses from 1989–2006 were reviewed and 263 variables/patient were recorded. 1,492 underwent partial or radical nephrectomy with the final histology being RCC. Statistical analysis was performed via Cox regression and concordance models. This enabled us to investigate the Surveillance & Prognosis University of California Integrated Staging System (S&P-UISS), a 3-tiered group system for based on low (LR), intermediate (IR) and high risk (HR) categorization separately for both non-metastatic (NM) and metastatic (M) patients, and to compare its prognostic accuracy with the current TNM classification. Results: Of all patients analyzed 66% were male. A Fuhrman grade of 1, 2, 3 and 4 was assigned to 179 (12.3%), 675 (46.5%), 485 (33.4%), and 114 patients (7.8%), respectively. ECOG performance status was 0, 1, 2 and 3 in 768 (52.1%), 652 (44.3%), 51 (3.5%), and 2 (0.1%), respectively. The disease-specific survival (%) for NM LR (n=326, 22%), IR (n=464, 32%), and HR (n=121, 8%) patients was, respectively, 97, 81, 62 at 5 years; 92, 46, 41 at 10 years; 92, 45, 20 at 15 years. For M LR (n=78, 5%), IR (n=406, 28%) and HR (n=58, 4%) survival was 41, 18, 8 at 5 years; 31, 7, 0 at 10 years; and 31, 0, 0 at 15 years, respectively. Based on concordance statistics, S&P-UISS predicted disease-specific survival better than the 2002 TNM system. Conclusions: The S&P-UISS system is a highly reliable and reproducible predictor of mortality following surgical therapy for localized and metastatic RCC. Surveillance and personal treatments should be individualized for a particular patient based on risk group categorization following surgery for their primary tumor. Accurate prognostication allows personal tailoring for treatments as well as allocation into clinical trials. No significant financial relationships to disclose.
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Affiliation(s)
| | - S. Riggs
- UCLA School of Medicine, Los Angeles, CA
| | | | | | - T. Klatte
- UCLA School of Medicine, Los Angeles, CA
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Sawhney R, Kabbinavar F, Pantuck A, Klatte T, Zomorodian N, Belldegrun A. Symptom profile and clinical characteristics of metastases in metastatic renal cell carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19638] [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
19638 Background: In the US, 39,000 new cases of renal cell carcinoma (RCC) will be diagnosed and 13,000 people will die of RCC, in 2006(1). While incidence has increased 126% since 1950 (2,3), little information is available regarding prevalence of symptoms & signs or metastases in patients presenting with metastatic RCC. Significance of such information is high as patients will be living longer, in this emerging era of targeted therapies for RCC. Method: Data were taken from prospective database of 1818 patients evaluated at UCLA with histologically confirmed RCC. From this 631 patients were identified with metastatic disease & surveyed at diagnosis. Data was obtained on matching variables, that included age, gender, ethnicity, smoking status, comorbidities, performance status, symptoms, site of metastasis & therapy. Results: 449 (71%) men, 182 (29%) women, were evaluated. Weight loss, hematuria, fatigue, flank pain, cough and musculoskeletal pains were the five most prevalent symptoms and signs. Of these patients, 557 (88%) were symptomatic with atleast one or more symptom on presentation and their presence lead to a diagnosis in 565 (90%) patients. In only 55 (8%) patients was metastatic RCC diagnosed incidentally. Most common metastatic site were the lungs 461 (73%), bones 200 (32%), followed by adrenals, non regional lymph nodes and soft tissue.Conclusion: In a large survey of metastatic RCC patients, weight loss, hematuria, fatigue, flank pain, cough and musculoskeletal pains were the five most prevalent symptoms and signs. Presence of atleast one or more of the above mentioned signs and symptoms led to a diagnosis in 90% of patients. Involvement of lungs and bones was most common at presentation. We believe that a better understanding of symptom and signs in patients with metastatic RCC, will lead to the development of better symptom assessment strategies, as well as early and thus cost-effective interventions. Especially in an era of increased disease control with targeted therapies. No significant financial relationships to disclose. [Table: see text]
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Affiliation(s)
| | | | | | - T. Klatte
- UCLA Medical Center, Los Angeles, CA
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Abstract
We report a 19-year-old female with a grade 2 transitional cell carcinoma of the bladder invading the lamina propria. In addition, lymphangiosis carcinomatosa and a carcinoma in situ were found. The presenting symptom was painless gross hematuria. The patient was treated with transurethral resection. No tumor recurrence occurred during the 21-year follow-up. The literature on bladder tumors in the first two decades of life is reviewed in this article.
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Affiliation(s)
- T Klatte
- Urologische Gemeinschaftspraxis, 39104, Erzbergerstrasse 13, Magdeburg, Deutschland.
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Klatte T, Ittenson A, Röhl FW, Ecke M, Allhoff EP, Böhm M. Perioperative immunomodulation with interleukin-2 in patients with renal cell carcinoma: results of a controlled phase II trial. Br J Cancer 2006; 95:1167-73. [PMID: 17031403 PMCID: PMC2360567 DOI: 10.1038/sj.bjc.6603391] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We conducted a non-randomised controlled phase II trial to investigate the role of preoperative administration of interleukin-2 (IL-2) in patients with renal cell carcinoma undergoing tumour nephrectomy. A total of 120 consecutive patients were allocated alternately to the two study groups: perioperative immunomodulation with IL-2 (IL-2 group; n=60) and perioperative immunomonitoring without immunomodulation (control group; n=60). Patients from the IL-2 group received four doses of 10 × 106 IU m−2 twice daily subcutaneously a week before operation followed by a daily maintenance dose of 3 × 106 IU m−2 subcutaneously until a day before the operation. Parameters of cellular and humoral immunity (leucocytes, T-cell markers CD3, CD4, and CD8, B-cell marker CD19, monocyte marker CD14, natural killer (NK) cell markers CD16, CD56, and CD57, activation markers CD6, CD25, CD28, and CD69, progenitor cell marker CD34, as well as IL-2, IL-6, IL-10, soluble IL-2 receptor, IL-1 receptor antagonist, transforming growth factor-β1, and vascular endothelial growth factor) were measured in peripheral venous blood at various intervals. Interleukin-2-related toxicity was WHO grade 1 (24%), 2 (67%), and 3 (9%). In the postoperative period, T-cell markers, activation markers, and NK cell markers decreased, and IL-6 and IL-10 increased. However, all these alterations were significantly less accentuated in patients who had been pretreated with IL-2. Median follow-up was 40 months. Tumour-specific survival in the IL-2 group and the control group was 98 vs 81% after 1 year and 86 vs 73% after 5 years (P=0.04). A similar effect was found for progression-free survival. We conclude that IL-2 can be safely administered in the perioperative period and modulates immunological parameters. However, to validate the survival data, a larger randomised phase III trial is needed.
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Affiliation(s)
- T Klatte
- Department of Urology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - A Ittenson
- Institute of Immunology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - F-W Röhl
- Institute of Biometrics and Medical Informatics, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - M Ecke
- Department of Urology, Städtisches Klinikum, Birkenallee 34, 39130 Magdeburg, Germany
| | - E P Allhoff
- Department of Urology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - M Böhm
- Department of Urology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
- E-mail:
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