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Wang S, Jiang B, Xie D, Li X, Wu G. Regulatory roles of ferroptosis-related non-coding RNAs and their research progress in urological malignancies. Front Genet 2023; 14:1133020. [PMID: 36936418 PMCID: PMC10017998 DOI: 10.3389/fgene.2023.1133020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Ferroptosis is a new type of cell death characterized by damage to the intracellular microenvironment, which causes the accumulation of lipid hydroperoxide and reactive oxygen species to cause cytotoxicity and regulated cell death. Non-coding RNAs (ncRNAs) play an important role in gene expression at the epigenetic, transcriptional, and post-transcriptional levels through interactions with different DNAs, RNAs, or proteins. Increasing evidence has shown that ferroptosis-related ncRNAs are closely related to the occurrence and progression of several diseases, including urological malignancies. Recently, the role of ferroptosis-associated ncRNAs (long non-coding RNAs, micro RNAs, and circular RNAs) in the occurrence, drug resistance, and prognosis of urological malignancies has attracted widespread attention. However, this has not yet been addressed systematically. In this review, we discuss this issue as much as possible to expand the knowledge and understanding of urological malignancies to provide new ideas for exploring the diagnosis and treatment of urological malignancies in the future. Furthermore, we propose some challenges in the clinical application of ferroptosis-associated ncRNAs.
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Affiliation(s)
| | | | | | - Xiunan Li
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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2
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Zhu XH, Wu CL, Zu XB, Lu J. Editorial: The application of artificial intelligence in diagnosis, treatment and prognosis in urologic oncology. Front Oncol 2022; 12:1118442. [PMID: 36620559 PMCID: PMC9812432 DOI: 10.3389/fonc.2022.1118442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Xue-hua Zhu
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Chin-Lee Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiong-bing Zu
- Department of Urology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Lu
- Department of Urology, Peking University Third Hospital, Beijing, China,*Correspondence: Jian Lu,
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Laughlin BS, Narang GL, Cheney SM, Humphreys MR, Vargas CE, Keole SR, Rwigema JM, Schild SE, Wong WW. Toxicity and outcomes after external beam irradiation for prostate cancer in patients with prior holmium laser enucleation of the prostate: Early experience. Cancer Rep (Hoboken) 2022; 6:e1672. [PMID: 35790091 PMCID: PMC9875616 DOI: 10.1002/cnr2.1672] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/11/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE/OBJECTIVES Holmium laser enucleation of the prostate (HoLEP) is commonly performed in patients with significant bladder outlet obstruction. However, there are few reports on the toxicity of external beam irradiation (RT) for prostate cancer in patients after prior HoLEP. In this study, we evaluate the side effects and treatment outcomes of RT after HoLEP. MATERIALS/METHODS Eighteen patients who had HoLEP and subsequently received RT for prostate cancer were included. Data collected included patient and disease characteristics, urinary function, and radiation dose. Acute and late urinary (GU) and gastrointestinal (GI) side effects were evaluated. Disease control and survival rates were calculated using Kaplan-Meier method. RESULTS Median follow-up was 18 months (range: 4-46 months). Median prostate volume was 107 ml before HoLEP and 24 ml after HoLEP. Median International Prostate Symptom Score (IPSS) was 17 (range: 5-32) before HoLEP. Median decline in IPSS score after HoLEP was 7 (range: -2-21). On uroflow study, peak flow rate, and post-void residual were significantly improved after HoLEP. After radiation, peak flow rate and average flow rate showed a decline but remained significantly improved compared to pre-HoLEP measurements. Maximum acute Common Terminology Criteria for Adverse Events (CTCAE) adverse events were 12 grade 1 and 3 grade 2 for GU, and 3 grade 1 for GI, respectively. Maximum late adverse events were 13 grade 1 and 2 grade 2 for GU, and all grade 0 for GI, respectively. At last follow-up, there were 8 grade 1 and 1 grade 2 late GU, and 3 grade 1 late GI adverse events, respectively. There was no significant increase in urinary incontinence after RT compared to before RT. The 18-month biochemical control, local control, distant control rates were 78%, 94%, and 80%, respectively. CONCLUSIONS Patients who received RT as definitive treatment for prostate cancer after prior HoLEP had low risk of serious acute and late side effects. HoLEP can be safely performed and should be considered in patients with significant bladder outlet obstruction and large prostate volume before RT.
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Affiliation(s)
| | | | | | | | | | | | | | | | - William W. Wong
- Department of Radiation Oncology, Mayo ClinicPhoenixArizonaUSA
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4
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Stroup SP, Robertson AH, Onofaro KC, Santomauro M, Rocco NR, Kuo H, Chaurasia A, Streicher S, Nousome D, Brand T, Musser JE, Porter CR, Rosner I, Chesnut GT, D'Amico A, Lu‐Yao G, Cullen J. Race-specific prostate cancer outcomes in a cohort of low and favorable-intermediate risk patients who underwent external beam radiation therapy from 1990 to 2017. Cancer Med 2022; 11:4756-4766. [PMID: 35616266 PMCID: PMC9761079 DOI: 10.1002/cam4.4802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Previous research exploring the role of race on prostate cancer (PCa) outcomes has demonstrated greater rates of disease progression and poorer overall survival for African American (AA) compared to Caucasian American (CA) men. The current study examines self-reported race as a predictor of long-term PCa outcomes in patients with low and favorable-intermediate risk disease treated with external beam radiation therapy (EBRT). METHODS This retrospective cohort study examined patients who were consented to enrollment in the Center for Prostate Disease Research Multicenter National Database between January 01, 1990 and December 31, 2017. Men self-reporting as AA or CA who underwent EBRT for newly diagnosed National Comprehensive Cancer Network-defined low or favorable-intermediate risk PCa were included. Dependent study outcomes included: biochemical recurrence-free survival, (ii) distant metastasis-free survival, and (iii) overall survival. Each outcome was modeled as a time-to-event endpoint using race-stratified Kaplan-Meier estimation curves and multivariable Cox proportional hazards analysis. RESULTS Of 840 men included in this study, 268 (32%) were AA and 572 (68%) were CA. The frequency of biochemical recurrence, distant metastasis, and deaths from any cause was 151 (18.7%), 29 (3.5%), and 333 (39.6%), respectively. AA men had a significantly younger median age at time of EBRT and slightly higher biopsy Gleason scores. Multivariable Cox proportional hazards analyses demonstrated no racial differences in any of the study endpoints. CONCLUSIONS These findings reveal no racial disparity in PCa outcomes for AA compared to CA men, in a long-standing, longitudinal cohort of patients with comparable access to cancer care.
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Affiliation(s)
- Sean P. Stroup
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of UrologyNaval Medical Center San DiegoSan DiegoCaliforniaUSA
| | - Audry H. Robertson
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of UrologyNaval Medical Center San DiegoSan DiegoCaliforniaUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA
| | - Kayla C. Onofaro
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of UrologyNaval Medical Center San DiegoSan DiegoCaliforniaUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA
| | - Michael G. Santomauro
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of UrologyNaval Medical Center San DiegoSan DiegoCaliforniaUSA
| | - Nicholas R. Rocco
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of UrologyNaval Medical Center San DiegoSan DiegoCaliforniaUSA
| | - Huai‐ching Kuo
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA,Infectious Disease Clinical Research ProgramUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Avinash R. Chaurasia
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Department of Radiation OncologyWalter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Samantha Streicher
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA
| | - Darryl Nousome
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA,Frederick National Laboratory for Cancer ResearchNational Cancer InstituteFrederickMarylandUSA
| | - Timothy C. Brand
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Madigan Army Medical CenterTacomaWashingtonUSA
| | - John E. Musser
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Tripler Army Medical CenterHonoluluHawaiiUSA
| | - Christopher R. Porter
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Virginia Mason Medical CenterSeattleWashingtonUSA
| | - Inger L. Rosner
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Urology Service, Department of SurgeryWalter Reed National Military Medical CenterBethesdaMarylandUSA,INOVAFalls ChurchVirginiaUSA
| | - Gregory T. Chesnut
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,Urology Service, Department of SurgeryWalter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Anthony D'Amico
- Department of Radiation OncologyBrigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical SchoolBostonMassachusettsUSA
| | - Grace Lu‐Yao
- Department of Medical OncologySidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical CollegePhiladelphiaPennsylvaniaUSA,Sidney Kimmel Cancer Center at JeffersonPhiladelphiaPennsylvaniaUSA,PhiladelphiaJefferson College of Population HealthPennsylvaniaUSA
| | - Jennifer Cullen
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of SurgeryUniformed Services University of the Health SciencesBethesdaMarylandUSA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA,Department of Population and Quantitative Health SciencesCase Western Reserve UniversityClevelandOhioUSA,Case Comprehensive Cancer CenterClevelandOhioUSA
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Allach Y, Banda A, van Gemert W, de Groot M, Derks Y, Schilham M, Hoepping A, Perk L, Gotthardt M, Janssen M, Nagarajah J, Privé BM. An Explorative Study of the Incidental High Renal Excretion of [ 18F]PSMA-1007 for Prostate Cancer PET/CT Imaging. Cancers (Basel) 2022; 14:cancers14092076. [PMID: 35565204 PMCID: PMC9100267 DOI: 10.3390/cancers14092076] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023] Open
Abstract
Positron emission tomography (PET) of prostate-specific membrane antigen (PSMA) allows for accurate diagnosis and staging of prostate cancer (PCa). Compared to other PSMA PET tracers available, [18F]PSMA-1007 is predominantly excreted via the hepatobiliary tract resulting in low renal excretion which improves evaluation of the pelvic area. However, some patients do show high urinary uptake of [18F]PSMA-1007. The present study aimed to investigate this sudden high urinary uptake of [18F]PSMA-1007 by evaluating [18F]PSMA-1007 PET scans from PCa patients. In this single-center retrospective study, patients that underwent [18F]PSMA-1007 PET imaging between July 2018 and January 2021 were included. Data regarding the individual patient characteristics, scan acquisition and batch production were analyzed. To determine the urinary excretion of [18F]PSMA-1007, a region of interest was drawn in the bladder, and standardized uptake values (SUVs) were calculated and compared to SUVs in the prostate. An SUVmax of >10 was considered high urinary excretion, an SUVmax 7.5−10 intermediate and an SUVmax < 7.5 low urinary excretion. A total of 344 patients underwent [18F]PSMA-1007 PET/CT imaging, with 37 patients receiving three or more [18F]PSMA-1007 PET/CT scans. The mean SUVmean and SUVmax of the bladder were 3.9 (SD 2.9) and 5.9 (SD 4.2), respectively. Fourteen percent of patients showed high urinary uptake of [18F]PSMA-1007. Twelve of the thirty-seven patients (32.4%) that had multiple scans showed a varying urinary uptake of [18F]PSMA-1007 per PSMA PET/CT scan. In terms of patient characteristics, risk factors, medication and blood laboratory results, no significant influencing variables were found. Nor was there a difference observed in the batch size and the mean radiochemical purity of PSMA-1007 for high- and low-excreting patients. However, the bladder volume affected the mean SUVmax in the bladder significantly, with higher SUVs in lower bladder volumes. In this study, we observed that a higher SUV in the urinary tract seemed to occur in patients with low bladder volume. A prospective study is needed to corroborate this hypothesis.
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Affiliation(s)
- Youssra Allach
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
- Department of Cardiology, Erasmus MC, 3015 CE Rotterdam, The Netherlands
| | - Amina Banda
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Willemijn van Gemert
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Michel de Groot
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Yvonne Derks
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Melline Schilham
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Alexander Hoepping
- Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds GmbH, 1454 Radeberg, Germany;
| | - Lars Perk
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Marcel Janssen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - James Nagarajah
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
| | - Bastiaan M. Privé
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (Y.A.); (A.B.); (W.v.G.); (M.d.G.); (Y.D.); (M.S.); (L.P.); (M.G.); (M.J.); (J.N.)
- Correspondence: ; Tel.: +31-24-3690031
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Köther AK, Büdenbender B, Grüne B, Holbach S, Huber J, von Landenberg N, Lenk J, Martini T, Michel MS, Kriegmair MC, Alpers GW. Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making. Cancer Med 2022; 11:2999-3008. [PMID: 35322925 PMCID: PMC9359866 DOI: 10.1002/cam4.4667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Patient-centered care and shared decision making (SDM) are generally recognized as the gold standard for medical consultations, especially for preference-sensitive decisions. However, little is known about psychological patient characteristics that influence patient-reported preferences. We set out to explore the role of personality and anxiety for a preference-sensitive decision in bladder cancer patients (choice of urinary diversion, UD) and to determine if anxiety predicts patients' participation preferences. METHODS We recruited a sample of bladder cancer patients (N = 180, primarily male, retired) who awaited a medical consultation on radical cystectomy and their choice of UD. We asked patients to fill in a set of self-report questionnaires before this consultation, including measures of treatment preference, personality (BFI-10), anxiety (STAI), and participation preference (API and API-Uro), as well as sociodemographic characteristics. RESULTS Most patients (79%) indicated a clear preference for one of the treatment options (44% continent UD, 34% incontinent UD). Patients who reported more conscientiousness were more likely to prefer more complex methods (continent UD). The majority (62%) preferred to delegate decision making to healthcare professionals. A substantial number of patients reported elevated anxiety (32%), and more anxiety was predictive of higher participation preference, specifically for uro-oncological decisions (β = 0.207, p < 0.01). CONCLUSIONS Our findings provide insight into the role of psychological patient characteristics for SDM. Aspects of personality such as conscientiousness influence treatment preferences. Anxiety contributes to patients' motivation to be involved in pertinent decisions. Thus, personality and negative affect should be considered to improve SDM.
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Affiliation(s)
- Anja K Köther
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Björn Büdenbender
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Britta Grüne
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sonja Holbach
- Department of Urology, Caritas St Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University Marburg, Marburg, Germany.,Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Julia Lenk
- Urological Hospital Munich-Planegg, Planegg, Germany
| | - Thomas Martini
- Department of Urology, University Hospital Ulm, Ulm, Germany
| | - Maurice S Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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7
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Buskbjerg CR, Amidi A, Agerbaek M, Gravholt CH, Hosseini SMH, Zachariae R. Cognitive changes and brain connectomes, endocrine status, and risk genotypes in testicular cancer patients-A prospective controlled study. Cancer Med 2021; 10:6249-6260. [PMID: 34390226 PMCID: PMC8446403 DOI: 10.1002/cam4.4165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Previous research has indicated cognitive decline (CD) among testicular cancer patients (TCPs), even in the absence of chemotherapy, but little is known about the underlying pathophysiology. The present study assessed changes in cognitive functions and structural brain connectomes in TCPs and explored the associations between cognitive changes and endocrine status and hypothesized risk genotypes. METHODS Thirty-eight newly orchiectomized TCPs and 21 healthy controls (HCs) comparable to TCPs in terms of age and years of education underwent neuropsychological testing, structural MRI, and a biological assessment at baseline and 6 months later. Cognitive change was assessed with a neuropsychological test battery and determined using a standardized regression-based approach, with substantial change defined as z-scores ≤-1.64 or ≥1.64. MRI scans and graph theory were used to evaluate changes in structural brain connectomes. The associations of cognitive changes with testosterone levels, androgen receptor gene (AR) CAG repeat length, and genotypes (APOE, COMT, and BDNF) were explored. RESULTS Compared with HCs, TCPs showed higher rates of substantial decline on processing speed and visuospatial ability and higher rates of substantial improvement on verbal recall and visuospatial learning (p < 0.05; OR = 8.15-15.84). Brain network analysis indicated bilateral thalamic changes in node degree in HCs, but not in TCPs (p < 0.01). In TCPs, higher baseline testosterone levels predicted decline in verbal memory (p < 0.05). No effects were found for AR CAG repeat length, APOE, COMT, or BDNF. CONCLUSIONS The present study confirms previous findings of domain-specific CD in TCPs following orchiectomy, but also points to domain-specific improvements. The results do not indicate changes in brain connectomes or endocrine status to be the main drivers of CD. Further studies evaluating the mechanisms underlying CD in TCPs, including the possible role of the dynamics of the hypothalamic-pituitary-gonadal axis, are warranted.
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Affiliation(s)
- Cecilie R. Buskbjerg
- Unit for Psychooncology and Health PsychologyDepartment of Psychology and Behavioral SciencesAarhus UniversityAarhusDenmark
| | - Ali Amidi
- Unit for Psychooncology and Health PsychologyDepartment of Psychology and Behavioral SciencesAarhus UniversityAarhusDenmark
| | - Mads Agerbaek
- Department of OncologyAarhus University HospitalAarhusDenmark
| | - Claus H. Gravholt
- Department of EndocrinologyAarhus University HospitalAarhusDenmark
- Department of Molecular MedicineAarhus University HospitalAarhusDenmark
| | - SM Hadi Hosseini
- Department of Psychiatry and Behavioral SciencesSchool of MedicineStanford UniversityStanfordCaliforniaUSA
| | - Robert Zachariae
- Unit for Psychooncology and Health PsychologyDepartment of Psychology and Behavioral SciencesAarhus UniversityAarhusDenmark
- Department of OncologyAarhus University HospitalAarhusDenmark
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8
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Pobel C, Auclin E, Teyssonneau D, Laguerre B, Cancel M, Boughalem E, Noel J, Brachet PE, Maillet D, Barthelemy P, Helissey C, Thibault C, Oudard S. Cabazitaxel multiple rechallenges in metastatic castration-resistant prostate cancer. Cancer Med 2021; 10:6304-6309. [PMID: 34382352 PMCID: PMC8446560 DOI: 10.1002/cam4.4172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction Cabazitaxel multiple rechallenges may be a treatment option in heavily pretreated patients with metastatic castration‐resistant prostate cancer (mCRPC) who had a good initial response to cabazitaxel and who are still fit to receive it. Our objective was to assess the efficacy and toxicity of multiple rechallenges. Patients and methods We retrospectively identified 22 mCRPC patients previously treated with docetaxel and/or androgen receptor‐targeted agents who received multiple cabazitaxel rechallenges in 9 French centers. Cabazitaxel was initiated at a dose of 25 mg/m2 q3week. A reduced dose (20 mg/m2 q3w) or an alternative schedule (mainly 16 mg/m2 q2w) was increasingly used for subsequent rechallenges. Progression‐free survival, prostate‐specific antigen (PSA) response, best clinical response, and grade ≥3 toxicities were collected. Overall survival was calculated from various time points. Results Twenty‐two patients with an initial response to cabazitaxel were rechallenged at least twice. The median number of cabazitaxel cycles was 7 at first cabazitaxel treatment, 6 at first rechallenge, and 5 at subsequent rechallenges. Median progression‐free survival at first rechallenge was 9.6 months and 5.6 months at second rechallenge. Median overall survival was 50.9 months from the first cabazitaxel dose, 114.9 months from first life‐extending therapy initiation in mCRPC, and 105 months from mCRPC diagnosis. There was no cumulative grade ≥3 neuropathy or nail disorder and one case of febrile neutropenia. Conclusion Cabazitaxel multiple rechallenges may be a treatment option without cumulative toxicity in heavily pretreated patients having a good response to first cabazitaxel use and still fit to receive it. Novelty & Impact Statements Patients with metastatic castration‐resistant prostate cancer can be treated with Cabazitaxel after docetaxel and androgen receptor‐targeted agent. This chemotherapy can be used multiple times with efficacy and manageable toxicity.
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Affiliation(s)
- Cedric Pobel
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | - Edouard Auclin
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | | | | | | | - Elouen Boughalem
- Oncology Department, Institut de Cancérologie de l'Ouest, Angers, France
| | - Johanna Noel
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | | | - Denis Maillet
- Oncology Department, University hospital of Lyon, France
| | - Philippe Barthelemy
- Medical Oncology, University Hospital Strasbourg / Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Carole Helissey
- Clinical Research Unit, Military Hospital Begin, Saint Mandé, France
| | - Constance Thibault
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | - Stéphane Oudard
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
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9
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Heijnsdijk EAM, Supit SJ, Looijenga LHJ, de Koning HJ. Screening for cancers with a good prognosis: The case of testicular germ cell cancer. Cancer Med 2021; 10:2897-2903. [PMID: 33710779 PMCID: PMC8026933 DOI: 10.1002/cam4.3837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/18/2022] Open
Abstract
Background To determine, using testicular germ cell cancer screening as an example, whether screening can also be effective for cancers with a good prognosis. Methods Based on the Dutch incidence, stage distribution, and survival and mortality data of testicular germ cell cancer, we developed a microsimulation model. This model simulates screening scenarios varying in screening age, interval, self‐examination or screening by the general practitioner (GP), and screening of a defined high‐risk group (cryptorchidism). For each scenario, the number of clinically and screen‐detected cancers by stage, referrals, testicular germ cell cancer deaths, and life‐years gained were projected. Results Annual self‐examination from age 20 to 30 years resulted in 767 cancers detected per 100,000 men followed over life‐time, of which 123 (16%) by screening. In this scenario, 19.2 men died from the disease, 4.7 (20%) less than without screening, and 230 life‐years were gained. Around 14,000 visits to the GP and 2080 visits to an urologist were required. This scenario resulted in the most favorable ratio between extra visits to the GP or urologist and deaths prevented (1418 and 116 respectively). Monthly screening, or screening until age 40 resulted in less favorable ratios. Self‐examination by only the high‐risk population prevented 1.0 death per 100,00 men in the general population. In all scenarios, 46–50 life‐years were gained for each testicular germ cell cancer death prevented. Conclusion Despite the good prognosis, self‐examination at young ages for testicular germ cell cancer could be considered.
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Affiliation(s)
- Eveline A M Heijnsdijk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Steven J Supit
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Harry J de Koning
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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10
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Lange SM, Ambrose JP, Flynn MC, Lowrance WT, Hanson HA, O'Neil BB. Prostate-specific antigen testing among young men: an opportunity to improve value. Cancer Med 2021; 10:2075-2079. [PMID: 33626214 PMCID: PMC7957163 DOI: 10.1002/cam4.3800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Prostate cancer screening using prostate‐specific antigen (PSA) testing remains widespread. The prevalence of PSA testing in young men is unknown and may be an appropriate target for improving health care by decreasing low‐value testing in this age group. The purpose of this study was to determine PSA testing rates in men younger than current guidelines support. Materials and Methods Health Informational National Trends Surveys (HINTS) from 2011 to 2014 and 2017 were analyzed to establish the prevalence of PSA testing in young men and to evaluate the differences in testing rates based on race. Results The combined survey data included 5178 men, with 2393 reporting previous PSA screening. Of men ages 18–39, 7% recalled receipt of PSA testing. Twenty‐two percent of men between the ages of 40 and 44 had been tested. Among men under age 40, PSA testing was more common among black men (14%) compared to white men (7%), Hispanics (6%), and men of Asian descent (8%). Logistic regression modeling demonstrates that black men under the age of 40 were more likely to undergo PSA testing than other racial or ethnic groups (odds ratio 2.14; 95% CI 1.17, 3.93). Conclusions Current guidelines do not recommend routine PSA testing in average‐risk men under the age of 40. This study found that a significant number of young men are exposed to testing, with the greatest risk among black men. This suggests that there is an opportunity to improve the value of PSA testing by decreasing testing in young men.
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Affiliation(s)
- Suzanne M Lange
- Division of Urology, University of Utah, Salt Lake City, UT, USA
| | - Jacob P Ambrose
- Departments of Surgery and Population Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael C Flynn
- Department of Internal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - William T Lowrance
- Division of Urology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Heidi A Hanson
- Departments of Surgery and Population Sciences, University of Utah, Salt Lake City, UT, USA
| | - Brock B O'Neil
- Division of Urology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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11
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Song G, Xiong GY, Fan Y, Huang C, Kang YM, Ji GJ, Chen JC, Xin ZC, Zhou LQ. The role of tumor size, ultrasonographic findings, and serum tumor markers in predicting the likelihood of malignant testicular histology. Asian J Androl 2020; 21:196-200. [PMID: 30648671 PMCID: PMC6413548 DOI: 10.4103/aja.aja_119_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The clinical predictive factors for malignant testicular histology remain unclear because of the low prevalence. Therefore, the aim of this study was to investigate predictors of malignant histology for testicular masses and decide more testis-sparing surgeries before surgery. This retrospective study enrolled 325 consecutive testicular mass patients who underwent radical orchiectomy (310/325) or testicular preserving surgery (15/325) from January 2001 to June 2016. The clinicopathological factors, including tumor diameter, cryptorchidism history, ultrasound findings, serum alpha-fetoprotein, and human chorionic gonadotropin (HCG) levels, were collected retrospectively for statistical analysis. A predictive nomogram was also generated to evaluate the quantitative probability. Among all patients, 247 (76.0%) were diagnosed with a malignant testicular tumor and 78 (24.0%) with benign histology. Larger tumor diameter (per cm increased, hazard ratio [HR] = 1.284, P = 0.036), lower ultrasound echo (HR = 3.191, P = 0.001), higher ultrasound blood flow (HR = 3.320, P < 0.001), and abnormal blood HCG (HR = 10.550, P < 0.001) were significant predictive factors for malignant disease in all testicular mass patients. The nomogram generated was well calibrated for all predictions of malignant probability, and the accuracy of the model nomogram measured by Harrell's C statistic (C-index) was 0.92. According to our data, the proportion of patients who underwent radical orchiectomy for benign tumors (24.0%) was much larger than generally believed (10.0%). Our results indicated that the diameter, ultrasonic echo, ultrasonic blood flow, and serum HCG levels could predict the malignancy in testicular mass patients.
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Affiliation(s)
- Gang Song
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Geng-Yan Xiong
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Yu Fan
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Cong Huang
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Yong-Ming Kang
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China.,Department of Urology, Suining Central Hospital, Suining 629000, China
| | - Guang-Jie Ji
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Jin-Chao Chen
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
| | - Zhong-Cheng Xin
- Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China.,Department of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Li-Qun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
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12
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Shabto JM, Martini DJ, Liu Y, Ravindranathan D, Brown J, Hitron EE, Russler GA, Caulfield S, Kissick H, Alemozaffar M, Ogan K, Harris WB, Master VA, Kucuk O, Carthon BC, Bilen MA. Novel risk group stratification for metastatic urothelial cancer patients treated with immune checkpoint inhibitors. Cancer Med 2020; 9:2752-2760. [PMID: 32100417 PMCID: PMC7163104 DOI: 10.1002/cam4.2932] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/01/2020] [Accepted: 02/03/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND We developed a novel risk scoring system for urothelial cancer (UC) patients receiving immune checkpoint inhibitors (ICI). METHODS We conducted a retrospective review of 67 UC patients treated with ICI at Winship Cancer Institute of Emory University from 2015 to 2018. Using stepwise variable selection in Cox proportional hazard model and Sullivan's weighting schema, baseline platelet-to-lymphocyte ratio (PLR), presence of liver metastasis, baseline albumin, and baseline Eastern Cooperative Oncology Group performance status (ECOG PS) were used for risk scoring. Patients were categorized into good risk (risk score 0-1), intermediate risk (risk score 2-3), and poor risk (risk score 4-6). Univariable (UVA) and multivariable analysis (MVA) and Kaplan-Meier method were used to assess overall survival (OS) and progression free survival (PFS). RESULTS The Emory Risk Scoring System had C-statistics of 0.74 (Standard Error = 0.047) in predicting OS and 0.70 (Standard Error = 0.043) in predicting PFS. Compared to good risk patients, poor risk patients had significantly shorter OS and PFS in both UVA and MVA (all P < .001), and intermediate risk patients had significantly shorter OS and PFS in both UVA and MVA (all P < .03). CONCLUSIONS Risk scoring using baseline PLR, presence of liver metastasis, baseline albumin, and baseline ECOG PS may effectively predict OS and PFS in UC patients receiving ICI.
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Affiliation(s)
- Julie M Shabto
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Dylan J Martini
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Yuan Liu
- Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Deepak Ravindranathan
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Department of Medicine, Emory University, Atlanta, GA, USA
| | - Jacqueline Brown
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Emilie E Hitron
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Greta A Russler
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Sarah Caulfield
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Pharmaceutical Services, Emory University School of Medicine, Atlanta, GA, USA
| | - Haydn Kissick
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Mehrdad Alemozaffar
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Kenneth Ogan
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Wayne B Harris
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Viraj A Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Bradley C Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Mehmet A Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
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13
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Zhu Z, Wang X, Wang J, Wang S, Fan Y, Fu T, Cao S, Zhang X. Preoperative predictors of early death risk in bladder cancer patients treated with robot-assisted radical cystectomy. Cancer Med 2019; 8:3447-3452. [PMID: 31091022 PMCID: PMC6601570 DOI: 10.1002/cam4.2237] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/07/2019] [Accepted: 04/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background Early identification of early death for bladder cancer patients undergoing radical cystectomy based on the laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for bladder cancer patients. Methods A total of 186 bladder cancer patients who underwent robot‐assisted radical cystectomy (RARC) were identified between October 2014 and May 2017. The probability of dying within 1 year after RARC was defined as the end point “early death.” Predictive factors including clinical features and laboratory findings at diagnosis were retrospectively collected. Results Median follow‐up time after RARC was 20.6 months (1.2‐43.7 months). Fifty‐one patients (27.4%) died during follow‐up and 31 within 1 year from surgery (1‐year mortality rate: 16.7%). All potentially prognostic factors were assessed on univariate analyses, which revealed the following factors as being associated with higher risk of early death within 1 year after RARC: older age (P = 0.004), advanced clinical stage (P = 0.005), presence of hydronephrosis (P = 0.021), higher fibrinogen (P = 0.007), higher PLR (P = 0.031), and lower PNI (P = 0.016). In a multivariate Cox proportional hazard regression model analysis, age >60 years (HR = 7.303, 95% CI 1.734‐30.764; P = 0.007) and fibrinogen ≥3.295 g/L (HR = 2.396, 95% CI 1.138‐5.045; P = 0.007) at diagnosis were independent prognostic factors of early death after RARC. Conclusion Age and preoperative elevated plasma fibrinogen level were independent predictors for 1‐year mortality after RARC. We believe that plasma fibrinogen levels may become a useful biomarker, which may help guide the treatment decision‐making process for patients with bladder cancer.
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Affiliation(s)
- Zhaowei Zhu
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Xiaojing Wang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiange Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Shengzheng Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Yafeng Fan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Tianlong Fu
- Department of Urology, Zhengzhou Central Hospital, Zhengzhou, PR China
| | - Songqiang Cao
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng, PR China
| | - Xuepei Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
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14
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Abstract
Precision medicine (PM) is a medical model that proposes the customization of healthcare—with medical decisions, practices, and/or products being tailored to the individual patient. In this model, diagnostic testing is often employed for selecting appropriate and optimal therapies based on the context of a patient’s genetic content or other molecular or cellular analysis. Tools employed in PM can include molecular diagnostics, imaging, and analytics/software. Oncology is the clear choice of PM. Cancers are common diseases, although cancers are largely a consequence of accumulating genomic damage during life, inherited genetic variations contribute to cancer risk, sometimes profoundly. This new understanding of oncogenic mechanisms has begun to influence risk assessment, diagnostic categories, and therapeutic strategies, with increasing use of drugs and antibodies designed to counter the influence of specific molecular drivers. In the field of urology oncology, some new progresses are making contribution to the PM, we summaries some of them from this year’s ASCO and EAU conference. Also, in our institution, some our research work are also push forward the PM in urology. PM of urological oncology is actually coming.
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15
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Porta C, Levy A, Hawkins R, Castellano D, Bellmunt J, Nathan P, McDermott R, Wagstaff J, Donnellan P, McCaffrey J, Vekeman F, Neary MP, Diaz J, Mehmud F, Duh MS. Impact of adverse events, treatment modifications, and dose intensity on survival among patients with advanced renal cell carcinoma treated with first-line sunitinib: a medical chart review across ten centers in five European countries. Cancer Med 2014; 3:1517-26. [PMID: 25045157 PMCID: PMC4298378 DOI: 10.1002/cam4.302] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/17/2014] [Accepted: 06/24/2014] [Indexed: 11/05/2022] Open
Abstract
Angiogenesis inhibitors have become standard of care for advanced and/or metastatic renal cell carcinoma (RCC), but data on the impact of adverse events (AEs) and treatment modifications associated with these agents are limited. Medical records were abstracted at 10 tertiary oncology centers in Europe for 291 patients ≥18 years old treated with sunitinib as first-line treatment for advanced RCC (no prior systemic treatment for advanced disease). Logistic regression models were estimated to compare dose intensity among patients who did and did not experience AEs during the landmark periods (18, 24, and 30 weeks). Cox proportional hazard models were used to explore the possible relationship of low-dose intensity (defined using thresholds of 0.7, 0.8, and 0.9) and treatment modifications during the landmark periods to survival. 64.4% to 67.9% of patients treated with sunitinib reported at least one AE of any grade, and approximately 10% of patients experienced at least one severe (grade 3 or 4) AE. Patients reporting severe AEs were statistically significantly more likely to have dose intensities below either 0.8 or 0.9. Dose intensity below 0.7 and dose discontinuation during all landmark periods were statistically significantly associated with shorter survival time. This study of advanced RCC patients treated with sunitinib in Europe found a significant relationship between AEs and dose intensity. It also found correlations between dose intensity and shorter survival, and between dose discontinuation and shorter survival. These results confirm the importance of tolerable treatment and maintaining dose intensity.
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Affiliation(s)
- Camillo Porta
- IRCCS San Matteo University Hospital Foundation, Pavia, Italy
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16
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Dubrowinskaja N, Gebauer K, Peters I, Hennenlotter J, Abbas M, Scherer R, Tezval H, Merseburger AS, Stenzl A, Grünwald V, Kuczyk MA, Serth J. Neurofilament Heavy polypeptide CpG island methylation associates with prognosis of renal cell carcinoma and prediction of antivascular endothelial growth factor therapy response. Cancer Med 2014; 3:300-9. [PMID: 24464810 PMCID: PMC3987080 DOI: 10.1002/cam4.181] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/29/2013] [Accepted: 11/19/2013] [Indexed: 12/26/2022] Open
Abstract
Neurofilament Heavy polypeptid (NEFH) belongs to the group of type IV intermediate filament proteins. DNA methylation of the NEFH promoter and loss of expression have previously been shown to activate the AKT/β-catenin pathway in tumor cells. When identifying hypermethylation of the NEFH CpG island (CGI) in renal cell cancer (RCC) we asked whether methylation could provide clinical or prognostic information for RCC and/or predict therapy response in patients with metastatic RCC (mRCC) undergoing antiangiogenic therapy. Relative methylation of the NEFH CGI was analyzed in 132 RCC samples and 83 paired normal tissues using quantitative methylation-specific PCR. Results were statistically compared with tumor histology, clinicopathological parameters, progression-free survival (PFS) as well as with overall survival (OS) in a subset of 18 mRCC patients following antiangiogenic therapy regimens. The NEFH CGI methylation demonstrated a tumor-specific increase (P < 0.001), association with advanced disease (P < 0.001), and distant metastasis (P = 0.005). Higher relative methylation was also significantly associated with a poor PFS (HR = 8.6, P < 0.001) independent from the covariates age, gender, diameter of tumors, state of advanced disease, and local and distant metastasis. Median OS following targeted therapy was 29.8 months for patients with low methylation versus 9.8 months for the group with high methylation (P = 0.028). We identified NEFH methylation as a candidate epigenetic marker for prognosis of RCC patients as well as prediction of anti-vascular endothelial growth factor-based therapy response.
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Adamowicz J, Pokrywczyńska M, Tworkiewicz J, Wolski Z, Drewa T. The relationship of cancer stem cells in urological cancers. Cent European J Urol 2013; 66:273-80. [PMID: 24707363 PMCID: PMC3974476 DOI: 10.5173/ceju.2013.03.art7] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/12/2013] [Accepted: 08/20/2013] [Indexed: 01/13/2023] Open
Abstract
Numerous studies are ongoing to identify and isolate cancer stem cells from cancers of genito-urinary tracts. Better understanding of their role in prostate, urothelial and kidney cancer origin, growth and progression opens new pathways in development of more effective treatment methods. However there are still many issues before advances in this field can be introduced for clinical application. This review addresses current achievements in cancer stem cells research in uro-oncology.
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Affiliation(s)
- Jan Adamowicz
- Nicolaus Copernicus University, Faculty of Medicine, Department of Tissue Engineering, Bydgoszcz, Poland ; Department of General, Oncologic and Pediatric Urology, University Hospital, Bydgoszcz, University of Nicolaus Copernicus, Poland
| | - Marta Pokrywczyńska
- Nicolaus Copernicus University, Faculty of Medicine, Department of Tissue Engineering, Bydgoszcz, Poland
| | - Jakub Tworkiewicz
- Nicolaus Copernicus University, Faculty of Medicine, Department of Tissue Engineering, Bydgoszcz, Poland ; Nicolaus Copernicus City Hospital, Department of General and Oncologic Urology, Toruń, Poland
| | - Zbigniew Wolski
- Department of General, Oncologic and Pediatric Urology, University Hospital, Bydgoszcz, University of Nicolaus Copernicus, Poland
| | - Tomasz Drewa
- Nicolaus Copernicus University, Faculty of Medicine, Department of Tissue Engineering, Bydgoszcz, Poland ; Nicolaus Copernicus City Hospital, Department of General and Oncologic Urology, Toruń, Poland
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