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Ecke T, Meisl C, Hofbauer S, Labonté F, Schlomm T, Friedersdorff F, Gössl A, Barski D, Otto T, Grunewald C, Niegisch G, Hennig M, Kramer M, Koch S, Hallmann S. BTA stat®, Alere NMP22® BladderChek®, UBC® rapid test, and uromonitor® in comparison to cytology as tumor marker for urinary bladder cancer: New results of a german multicentre-study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00164-6] [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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2
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Guldvik I, Sivanesan S, Ramberg H, Tennstedt P, Nunes-Xavier C, Katz B, Svindland A, Lopez J, Rustøen Braadland P, Dunne C, Schlomm T, Berge V, Eri L, Lilleby W, Mills I, Austlid Taskén K. Pre-surgery blood levels of leucine-rich alpha-2-glycoprotein 1 identify patients with a high risk of progressing to castration-resistant prostate cancer. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01012-0] [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: 11/04/2022]
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3
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Schlomm T, Rödiger T, Graalmann J. [Precision oncology : How can high-quality healthcare remain affordable for all in the face of diagnostic and therapeutic costs?]. Urologe A 2020; 60:3-7. [PMID: 33315135 DOI: 10.1007/s00120-020-01416-1] [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] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
Medicine is becoming increasingly precise. This is particularly evident in the field of pharmaceuticals and especially in oncology. Driven by the steadily growing understanding of biomedical interrelationships and the resulting increase in precision, we are currently experiencing a paradigm shift from a one-drug-fits-all model towards an individualized biomarker-driven approach. This essentially enables the transition from efficacy to effectiveness. In order to ensure that the promise of high-quality, affordable precision medicine for all remains valid in the future, the step from efficacy in clinical studies to effectiveness in the practice of care is crucial in the next decade. This will be achieved with end-to-end precision from diagnostics to real-world evidence.
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Affiliation(s)
- T Schlomm
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Charité Platz 1, 10117, Berlin, Deutschland.
| | - T Rödiger
- Die Brückenköpfe GmbH, Mohrenstraße 34, 10117, Berlin, Deutschland
| | - J Graalmann
- Die Brückenköpfe GmbH, Mohrenstraße 34, 10117, Berlin, Deutschland
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4
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Schönthaler M, Schlomm T. [Network medicine and health services research in urology]. Urologe A 2020; 60:39-44. [PMID: 33315136 DOI: 10.1007/s00120-020-01406-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
It is the aim of the Medical Informatics Funding Scheme and other national and local projects for digital networking in healthcare to facilitate the exchange and use of patient data between institutions in compliance with data protection regulations. This requires the integration of data from various sources-such as digital workplace systems, laboratory systems, picture archiving and communication (PAC) systems or tumor boards-into a data warehouse or research databases. Digital networking of service providers and research institutions will open access to high-performance and precision medicine (e.g., virtual molecular tumor boards) for even more patients, thereby providing data for basic and care research. Network medicine will establish the translational link between basic research (e.g., genome research) and patient care. Digitally integrated "real world" patient data will also facilitate a detailed analysis of health care and the quality of treatments.
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Affiliation(s)
- M Schönthaler
- Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland.
| | - T Schlomm
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Köcher S, Beyer B, Lange T, Nordquist L, Burdak-Rothkamm S, Schlomm T, Petersen C, Rothkamm K, Mansour W. OC-0635 Targeting TEMPRSS2:ERG fusion to achieve a tumor-specific radiosensitization in prostate cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31055-2] [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: 11/17/2022]
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Friedersdorff F, Putz J, Dreikorn K, Giessing M, Fornara P, Stöckle M, Schlomm T. [The 2018 annual report on the 26th annual meeting of the working group for kidney transplantation of the German Society of Urology in Berlin]. Urologe A 2019; 58:324-328. [PMID: 30762078 DOI: 10.1007/s00120-019-0873-x] [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: 10/27/2022]
Affiliation(s)
- F Friedersdorff
- Klinik für Urologie, Charité-Universitätsmedizin Berlin, Berlin, Deutschland. .,Klinik für Urologie - Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - J Putz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - K Dreikorn
- AK Nierentransplantation, Urologicum Ärztezentrum Horn, Bremen, Deutschland
| | - M Giessing
- Klinik für Urologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - P Fornara
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - M Stöckle
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - T Schlomm
- Klinik für Urologie, Charité-Universitätsmedizin Berlin, Berlin, Deutschland
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Neymeyer J, Weinberger S, Moldovan DE, Kornienko K, Salem F, Schlomm T. Modernes Komplikationsmanagement der kompletten Ureterdurchtrennung mittels minimalinvasiver, überbrückender, kontinuitätswiederherstellender, ummantelter Ureterschienung – Ureteric bridging with a fully coated stent. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671396] [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: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - K Kornienko
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - F Salem
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weinberger S, Moldovan DE, Schlomm T. Vaginale anatomisch gerechte hohe mediale Rekonstruktion mit Lateraldefektbehebung der deszensusbedingten Blasenentleerungsstörung mittels Antegradem Nahtinstrument (ARSD-Ney). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671395] [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: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weichert A, Weinberger S, Schlomm T. The „Pumping Probe Technique“ and complete sealing stent – a new simple method for the detection and treatment of ureteric fistulae. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671398] [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: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Weichert
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weintraub AY, Weinberger S, Moldovan DE, Kornienko K, Schlomm T. The elevation angle of the vagina (EAV) following different pelvic reconstructive procedures. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671397] [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: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - AY Weintraub
- Soroka University Medical Center, Department of Obstetrics and Gynecology, Beer Sheva, Israel
| | - S Weinberger
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - K Kornienko
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
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11
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Köcher S, Volquardsen J, Nordquist L, Lange T, Schlomm T, Beyer B, Petersen C, Rothkamm K, Mansour W. EP-2301: ERG overexpression in PCa drives a switch to the alt-EJ which render cells radiosensitive to PARPi. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32610-0] [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: 10/14/2022]
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12
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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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13
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Boehm K, Beyer B, Tennstedt P, Schiffmann J, Budaeus L, Haese A, Graefen M, Schlomm T, Heinzer H, Salomon G. No impact of blood transfusion on oncological outcome after radical prostatectomy in patients with prostate cancer. World J Urol 2014; 33:801-6. [DOI: 10.1007/s00345-014-1351-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 06/19/2014] [Indexed: 10/25/2022] Open
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14
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Hartmann A, Schlomm T, Bertz S, Heinzelmann J, Hölters S, Simon R, Stoehr R, Junker K. [Prognostic and predictive molecular markers for urologic cancers]. Urologe A 2014; 53:491-500. [PMID: 24700189 DOI: 10.1007/s00120-014-3442-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Molecular prognostic factors and genetic alterations as predictive markers for cancer-specific targeted therapies are used today in the clinic for many malignancies. In recent years, many molecular markers for urogenital cancers have also been identified. However, these markers are not clinically used yet. In prostate cancer, novel next-generation sequencing methods revealed a detailed picture of the molecular changes. There is growing evidence that a combination of classical histopathological and validated molecular markers could lead to a more precise estimation of prognosis, thus, resulting in an increasing number of patients with active surveillance as a possible treatment option. In patients with urothelial carcinoma, histopathological factors but also the proliferation of the tumor, mutations in oncogenes leading to an increasing proliferation rate and changes in genes responsible for invasion and metastasis are important. In addition, gene expression profiles which could distinguish aggressive tumors with high risk of metastasis from nonmetastasizing tumors have been recently identified. In the future, this could potentially allow better selection of patients needing systemic perioperative treatment. In renal cell carcinoma, many molecular markers that are associated with metastasis and survival have been identified. Some of these markers were also validated as independent prognostic markers. Selection of patients with primarily organ-confined tumors and increased risk of metastasis for adjuvant systemic therapy could be clinically relevant in the future.
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Affiliation(s)
- A Hartmann
- Institut für Pathologie, Universität Erlangen, Erlangen, Deutschland
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15
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Roiss M, Schiffmann J, Tennstedt P, Kessler T, Blanc I, Goetz A, Schlomm T, Graefen M, Reuter DA. Oncological long-term outcome of 4772 patients with prostate cancer undergoing radical prostatectomy: does the anaesthetic technique matter? Eur J Surg Oncol 2014; 40:1686-92. [PMID: 24613743 DOI: 10.1016/j.ejso.2014.02.223] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 11/20/2013] [Revised: 01/31/2014] [Accepted: 02/07/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Recent data suggest that using additional neuroaxial anaesthesia during oncological surgery is associated with favourable recurrence-free survival, when compared with general anaesthesia alone. We assessed the impact of adjunctive perioperative spinal anaesthesia and dose of opioids on the oncological long-term outcome of patients following radical prostatectomy. METHODS We selected patients from our institutional review board-approved database who consecutively underwent radical prostatectomy between 2002 and 2007. Patients were stratified by type of anaesthesia, administered as general anaesthesia alone, or spinal anaesthesia in addition to general anaesthesia. Biochemical recurrence-free survival, metastasis-free survival and overall survival were analysed by a multivariate Cox regression model and by Kaplan-Meier analysis in propensity-score based matched cohorts, adjusted for standard clinico-pathological variables and year of surgery. RESULTS Overall, 4772 patients were analysed. Regarding the type of anaesthesia no significant difference for biochemical recurrence-free survival, metastasis-free survival and overall survival was analysed by a multivariate Cox regression model (p = 0.5, 0.8 and 0.7). The Kaplan-Meier analyses after propensity-score matched based comparisons revealed no significant difference depending on type of anaesthesia for biochemical recurrence-free survival, metastasis-free survival and overall survival (p = 0.6, 0.1 and 0.4). The same accounted for a propensity-score matched model adjusted for the year of surgery on biochemical recurrence-free survival (p = 0.7). CONCLUSIONS The oncological outcome after radical prostatectomy was not affected by the adjunctive use of spinal anaesthesia.
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Affiliation(s)
- M Roiss
- Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - J Schiffmann
- Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Germany
| | - P Tennstedt
- Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Germany
| | - T Kessler
- Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - I Blanc
- Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - A Goetz
- Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - T Schlomm
- Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Germany; Department of Urology, Section for Translational Prostate Cancer Research, University Medical Center Hamburg-Eppendorf, Germany
| | - M Graefen
- Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Germany
| | - D A Reuter
- Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany.
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Schmitges J, Trinh QD, Jonas L, Budäus L, Larbig R, Schlomm T, Karakiewicz P, Heinzer H, Huland H, Graefen M, Steuber T. Influence of low-molecular-weight heparin dosage on red blood cell transfusion, lymphocele rate and drainage duration after open radical prostatectomy. Eur J Surg Oncol 2012; 38:1082-8. [DOI: 10.1016/j.ejso.2012.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 07/08/2012] [Accepted: 08/02/2012] [Indexed: 11/28/2022] Open
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17
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Fleischmann A, Huland H, Mirlacher M, Wilczak W, Simon R, Erbersdobler A, Sauter G, Schlomm T. Prognostic relevance of Bcl-2 overexpression in surgically treated prostate cancer is not caused by increased copy number or translocation of the gene. Prostate 2012; 72:991-7. [PMID: 22024950 DOI: 10.1002/pros.21504] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 09/29/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Overexpression of anti-apoptotic Bcl-2 plays a role in prostate cancer progression, particularly in transformation to androgen-independent disease. Androgen-independent prostate cancers have been shown to harbor Bcl-2 gene copy number gains frequently suggesting that this genetic alteration might play a role in Bcl-2 overexpression. The relation of Bcl-2 overexpression and copy number gains or translocation of the BCL-2 gene in prostate cancer under hormone-naïve conditions is unknown. METHODS Prostate cancers of 3,261 hormone-naïve patients undergoing radical prostatectomy were arrayed in a TMA with one tissue core (diameter 0.6 mm) per tumor. Bcl-2 immunohistochemistry, analyzed for Bcl-2 expression level (negative, low, and high), was correlated with clinical, histopathological and molecular (Ki67, p53) tumor features, and biochemical failure. Cancers with high-level Bcl-2 expression were evaluated for genetic aberrations by fluorescence in situ hybridization (FISH). RESULTS Bcl-2 expression was significantly up-regulated in tumors with aggressive phenotype as indicated by high Gleason score (P < 0.0001), advanced stage (P < 0.0001), and high proliferation index (P = 0.0114). The different Bcl-2 expression levels translated into significantly different survival curves showing better outcome for patients with lower Bcl-2 levels. The prognostic information obtained from the anti-apoptotic Bcl-2 was independent from the proliferation index (Ki67) of the cancer. FISH analysis detected no copy number gains or translocation of the Bcl-2 gene. CONCLUSION Bcl-2 overexpression in prostate cancers under hormone-naïve conditions is not associated with increased copy numbers of the gene. This suggests that these frequently detected genetic alterations in androgen-independent tumors occur late in prostate cancer progression.
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Affiliation(s)
- A Fleischmann
- Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Trepel M, Flammiger A, Weisbach L, Schlomm T, Huland H, Minner S, Tennstaedt P, Bokemeyer C, Sauter G. Relationship of T lymphocytes, T regulatory cells, and B lymphocytes to clinical outcome in prostate cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4632] [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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19
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Gannon PO, Lessard L, Forest V, Begin LR, Schlomm T, Minner S, Graefen M, Mes-Masson A, Saad F. Validation of NF-kappaB p65 as a prostate cancer prognostic marker on a large European cohort. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4537] [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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20
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Minner S, Krohn A, Burkhardt L, Tennstedt P, Simon R, Sirma H, Huland H, Sauter G, Schlomm T. Chromosomal deletions, tumor phenotype, and prognosis in prostate cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.37] [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
37 Background: Chromosomal deletions are frequent in prostate cancer (PCa) but target genes and potential clinical significance are often unknown. This project aimed at the identification of frequent and new deletions in PCa and to study their association with tumor phenotype and PSA recurrence. Methods: Array CGH was performed on 77 advanced PCa. Deletions of interest were subsequently analyzed on a tissue microarray containing more than 2000 PCa with clinical follow-up data using fluorescence in situ hybridization (FISH). The FISH probes used included a break-apart probe for TMPRSS2-ERG and dual-labeling probes for centromere 10/PTEN and centromere 3/3p14. Results: The most frequent circumscribed deletions found by array CGH were 3p14 (including FOXP1) in 18%, 5q31 in 16%, 5q21 in 14%, 6q13 in 21%, 6q21 in 19%, 6q26 in 14%, 8p11 in 17%, 10q23 (including PTEN) in 18%, 12p13 in 14%, 13q14 in 14%, 16q24 in 22% and 21q (representing TMPRSS2-ERG fusion) in 18%. TMPRSS2-ERG fusions, PTEN and FOXP1 deletions were selected for FISH analysis. A TMPRSS2-ERG fusion was observed in 394 of 947 interpretable cases (41.6%). TMPRSS2-ERG fusion was unrelated to tumor stage, Gleason grade, and PSA recurrence. PTEN deletions were observed in 8.9% of 1844 interpretable cases and were associated with advanced tumor stage (p<0.0001), high Gleason grade (p<0.0001), and early biochemical recurrence (p<0.0001). FOXP1 deletions were seen in 5.0% of 619 cases. FOXP1 deletions were not significantly linked to tumor phenotype and outcome. Both PTEN and FOXP1 deletions were strongly linked to TMPRSS2-ERG fusions. TMPRSS2-ERG fusion positive tumors had PTEN deletions in 15.4% and FOXP1 deletions in 10.7%, while TMPRSS2-ERG fusion negative cancers had PTEN deletions in only 5.8% and FOXP1 deletions in only 2.0% of cases (p<0.0001 each). Conclusions: The TMPRSS2-ERG fusion determines a genetically distinct subgroup of prostate cancers. Our data provide no evidence for a particular clinical behaviour of TMPRSS2-ERG fusion positive cancers in radically operated patients. PTEN and FOXP1 alterations are preferentially found in TMPRSS2-ERG fusion positive cancers. Both genes may potentially be involved in pathway dysregulation in these cancers. No significant financial relationships to disclose.
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Affiliation(s)
- S. Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A. Krohn
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L. Burkhardt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P. Tennstedt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R. Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H. Sirma
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H. Huland
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G. Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T. Schlomm
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hellwinkel OJC, Asong LE, Rogmann JP, Sültmann H, Wagner C, Schlomm T, Eichelberg C. Transcription alterations of members of the ubiquitin-proteasome network in prostate carcinoma. Prostate Cancer Prostatic Dis 2010; 14:38-45. [PMID: 21102547 DOI: 10.1038/pcan.2010.48] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this work was to investigate the role of the ubiquitin-proteasome network (UPN) in prostate cancer (PCA) and to elicit potential markers for this disease. The UPN represents a key factor in the maintenance of cellular homoeostasis as a result of its fundamental function in the regulation of intracellular protein degradation. Members of this network have a role in the biology of haematological and solid tumours. Tumour cells and normal epithelial cells from 22 prostatectomy specimens were isolated by laser microdissection. Prostate biopsy samples from healthy individuals served for technical calibration and as controls. Transcript levels of eight selected genes with E3 ubiquitin ligase activity (labelling target proteins for proteasome degradation) and two genes belonging to the proteasome-multienzyme complex itself were analysed by quantitative real-time RT-PCR. The proteasome genes PSMC4 and PSMB5 and the E3 ubiquitin ligase NEDD4L were significantly and coherently upregulated in PCA cells compared with the corresponding adjacent normal prostate tissue. Transcription of the E3 ubiquitin ligase SMURF2 was significantly higher in organ-confined tumours (pT2) compared with non-organ-confined cancers (pT3). The results indicate a role for PSMC4 and PSMB5 and the E3 ubiquitin ligase NEDD4L in prostate tumourigenesis, whereas SMURF2 downregulation could be associated with clinical progression. NEDD4L and SMURF2 both target transforming growth factor (TGF)-β for degradation. This reflects the pleiotropic role of the TGF-β signalling pathway acting as a tumour suppressor in normal and pre-cancerous cells, but having oncogenic properties in progressing cancer. Further studies have to elucidate whether these alterations could represent clinically relevant PCA-diagnostic and progression markers.
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Affiliation(s)
- O J C Hellwinkel
- Department of Legal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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22
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Köllermann J, Albrecht H, Schlomm T, Huland H, Graefen M, Bokemeyer C, Simon R, Sauter G, Wilczak W. Activating BRAF gene mutations are uncommon in hormone refractory prostate cancer in Caucasian patients. Oncol Lett 2010; 1:729-732. [PMID: 22966370 DOI: 10.3892/ol_00000127] [Citation(s) in RCA: 13] [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] [Received: 12/07/2009] [Accepted: 04/23/2010] [Indexed: 01/02/2023] Open
Abstract
Activating mutations in the cytosolic serine/threonine kinase, BRAF, have been reported in a variety of neoplasms. BRAF activation may contribute to tumor growth via activation of the MAP/ERK kinase pathway, and BRAF represents a possible therapeutic target. Activating BRAF mutations were recently reported in approximately 10% of prostate cancer cases in Asian patients. In the present study, 43 hormone refractory prostate cancers were analyzed for BRAF mutations in order to determine whether anti-BRAF therapy is a suitable approach for advanced prostate cancer patients. In all of the studied tumors, BRAF exons 11 and 15 were PCR-amplified and sequenced, including the backward and forward sequences. BRAF mutations were noted only in the positive control tissues, but were not found in any of the 43 analyzed prostate cancers. We conclude that BRAF mutations occur only rarely in prostate cancers in Caucasian patients and are not associated with tumor progression. The application of anti-BRAF therapies may therefore not be beneficial for prostate cancer.
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Affiliation(s)
- J Köllermann
- Department of Pathology, Hospital Eltville, Eltville/Rhein
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23
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Steuber T, Schlomm T, Heinzer H, Zacharias M, Ahyai S, Chun K, Haese A, Klutmann S, Köllermann J, Sauter G, Mester J, Mikecz P, Fisch M, Huland H, Graefen M, Salomon G. [F18]-fluoroethylcholine combined in-line PET-CT scan for detection of lymph-node metastasis in high risk prostate cancer patients prior to radical prostatectomy: Preliminary results from a prospective histology-based study. Eur J Cancer 2010; 46:449-55. [DOI: 10.1016/j.ejca.2009.11.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 09/21/2009] [Accepted: 11/12/2009] [Indexed: 10/20/2022]
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Schlomm T, Sültmann H, Köllermann J. [Identification and validation of clinically relevant molecular alterations in prostate cancer]. Pathologe 2009; 30:111-6. [PMID: 19139898 DOI: 10.1007/s00292-008-1113-0] [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] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Significant cellular alterations required for the development and progression of cancers are detectable at the molecular level and represent potential targets for gene-specific therapies. Modern chip techniques allow the parallel analysis of virtually all known human genes and proteins in a single experiment. Using modern high-throughput techniques, numerous potential new biomarkers for the diagnosis and prediction of prostate cancer have been identified. However, so far none of these markers has improved clinical practice. One of the most important challenges in the coming years is the extensive clinical validation of molecular data using clinically relevant end points. For this venture the pivotal prerequisite is the availability of large, comprehensively annotated and standardized high-quality bioresources.
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Affiliation(s)
- T Schlomm
- Martini-Klinik, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
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25
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Lessard L, Bégin LR, Schlomm T, Köllermann J, Graefen M, Karakiewicz PI, Mes-Masson A, Saad F. Validation of NF-kappaB p65 as a prostate cancer prognostic marker on a large cohort of European patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11055] [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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27
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Affiliation(s)
- T Schlomm
- Martini-Klinik am UKE, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Gebäude O46, 20246 Hamburg.
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Sültmann H, Schlomm T, Hellwinkel O, Buness A, Ruschhaupt M, Erbersdobler A, Lübke A, Luu V, Huland H, Poustka A. 4007 POSTER Molecular and functional profiling for an improved clinical management of prostate cancer. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71075-3] [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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29
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Graefen M, Salomon G, Currlin E, Eichelberg C, Schlomm T, Huland H. [Selection criteria for the expected management of localised prostate cancer]. Urologe A 2006; 44:1277-8, 1280-6. [PMID: 16205879 DOI: 10.1007/s00120-005-0924-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Prostate cancer harbours the possibility of overtreatment more than any other malignant disease. Due to its slow growth, expected management is an established therapeutic option in newly diagnosed carcinomas. Improved diagnostic methods and the widespread use of PSA lead to earlier diagnosis of cancers that would not adversely affect the life expectancy of the patient, even when they were left untreated. Several statistical models have been published to identify such insignificant cancers; however, all such nomograms suffer from limited sensitivity and specificity. For the indication of expected management, comorbidity and life expectancy must be considered using risk scores and life tables. In general, expected management is a suitable option for elderly patients with low grade cancers. Young patients and those with intermediate or high-grade cancers are most likely to benefit from active local treatment.
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Affiliation(s)
- M Graefen
- Martini-Klinik, Prostatazentrum an der Universitätsklinik Hamburg-Eppendorf.
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30
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Luebke AM, Schlomm T, Gunawan B, Bonkhoff H, Füzesi L, Erbersdobler A. Simultaneous tumour-like, atypical basal cell hyperplasia and acinar adenocarcinoma of the prostate: a comparative morphological and genetic approach. Virchows Arch 2005; 446:338-41. [PMID: 15726402 DOI: 10.1007/s00428-004-1199-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Accepted: 12/06/2004] [Indexed: 11/25/2022]
Abstract
Basal cell tumours of the prostatic gland are rare, and the classification is difficult. In the present case report, a large, tumour-like proliferation of atypical basaloid cells was found incidentally in a prostatectomy specimen that otherwise contained a conventional acinar adenocarcinoma. The basaloid cells displayed a solid or adenoid-cystic growth pattern and strongly expressed high-molecular-weight cytokeratins and bcl-2. A high Ki-67 index was recorded within the atypical basaloid cells, by far exceeding the one counted in the conventional adenocarcinoma. However, there were no definite criteria for a malignant behaviour of the basal cell tumour. Comparative genomic hybridisation from microdissected tumour cells yielded losses at the short arms of chromosomes 8 and 12 in the conventional adenocarcinoma and a normal karyotype in the basal cell tumour. The pathological findings favoured the diagnosis of an atypical basal cell hyperplasia.
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Affiliation(s)
- A M Luebke
- Department of Urology, University of Hamburg, Martinistrasse 52, 22081 Hamburg, Germany
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