1
|
Paproski R, Pink D, Pham D, Vasquez C, Fairey A, Hyndman M, Aprikian A, Kinnaird A, Beatty P, Pavlovich C, Lewis J. Clinical validation of optimized neural network risk models to predict grade group 2 and above prostate cancer and avoid unneeded biopsies. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
2
|
Tourigny R, Moussa H, Robitaille K, Bussières V, Saad F, Carmel M, Aprikian A, Fradet Y, Network BIOCGR, Fradet V. 271 - Analyse de la qualité de vie des hommes à risque de cancer de la prostate. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
3
|
Marcq G, Souhami L, Cury F, Salimi A, Aprikian A, Tanguay S, Vanhuyse M, Rajan R, Brimo F, Mansure J, Kassouf W. Étude de phase I évaluant l’administration concomitante de l’atezolizumab à la thérapie trimodale pour patients atteints d’un cancer de vessie localisé infiltrant le muscle. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
4
|
Le Page AY, de Polo A, Guérard KP, Lazaris A, Petrillo S, Ebrahimizadeh W, Tabariès S, Shinde-Jadhav S, Feldiorean A, Boufaeid N, Kassouf W, Piccirillo C, Siegel P, Aprikian A, Gregorieff A, Lapointe J, Metrakos P, Labbé D. Abstract A26: Immune profiling and organoids generation of a rare case of prostate cancer liver metastasis. Cancer Immunol Res 2020. [DOI: 10.1158/2326-6074.tumimm18-a26] [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: 11/16/2022]
Abstract
Abstract
Introduction: Prostate cancer (PCa) is the second most frequent cancer in men and a leading cause of cancer-related mortality. Despite major advances in immunotherapy, PCa remains a poor responder. Metastatic PCa is responsible for the majority of PCa-associated mortality. Most PCa metastases are multifocal and display a strong bones tropism (91.1% of cases), but PCa metastases can also spread to the lymph nodes (8.7%), lungs (5.7%), liver (4.5%) and brain (1.8%). Liver metastases are associated with worse prognosis but due to their multifocal nature and frequent spreading to other sites, PCa metastases are rarely resected. Therefore, immunologic characterization of these lesions concomitant with generation of research tools derived from these lesions are urgently needed to understand how to intercept disease progression.
Methods: A 62-year-old male who previously underwent radical prostatectomy in 2016 was diagnosed in July 2018 with a single liver metastasis (5.3 cm) by MRI. The tumor was surgically resected and tumor tissue along with peripheral blood was collected and processed for in-depth immunologic/molecular characterization and generation of tumor models. The study was done in accordance with the guidelines approved by MUHC IRB. Prior written informed consent was obtained from the subject to participate in the study (protocol: SDR-11-066).
Results: The prostatic origin of the tumor mass was confirmed by positivity for PSMA and NKX3.1 expression. Patient-derived xenografts, 2D cell and organoid cultures were generated and immunophenotyping of the innate and adaptive peripheral and tumor-infiltrating immune cells subsets was performed. Genomic alterations are currently being characterized by multiplex ligation-dependent probe amplification (MLPA). Additionally, chromatin accessibility-based characterization of the gene regulatory network of tumor luminal cells (CD49-CD26+) using the assay for transposase-accessible chromatin using sequencing (ATAC-seq) together with RNA-seq is presently under way.
Conclusions: Our collaborative effort will provide the much-needed research tools required to model and understand the processes leading to the rare, but lethal, progression from a localized PCa lesion to liver metastases. Combined with other ongoing research efforts, we believe this case will help us understand the molecular basis to the liver tropism of a subset of PCa metastases and ultimately provide biomarkers for early identification of patients with increased metastatic potential as well as a basis to determine the appropriate immunotherapy modality for metastatic patients.
Citation Format: Aurélie Y. Le Page, Anna de Polo, K-P Guérard, A. Lazaris, S.K. Petrillo, W. Ebrahimizadeh, S. Tabariès, S. Shinde-Jadhav, A. Feldiorean, N. Boufaeid, W. Kassouf, C. Piccirillo, P.M. Siegel, A. Aprikian, A. Gregorieff, J. Lapointe, P. Metrakos, D.P. Labbé. Immune profiling and organoids generation of a rare case of prostate cancer liver metastasis [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2018 Nov 27-30; Miami Beach, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(4 Suppl):Abstract nr A26.
Collapse
Affiliation(s)
- Aurélie Y. Le Page
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - Anna de Polo
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - K-P Guérard
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - A. Lazaris
- 2Research Institute of the McGill University Health Centre, Department of Surgery, McGill University, Montreal, QC, Canada,
| | - S.K. Petrillo
- 2Research Institute of the McGill University Health Centre, Department of Surgery, McGill University, Montreal, QC, Canada,
| | - W. Ebrahimizadeh
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - S. Tabariès
- 3Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada,
| | - S. Shinde-Jadhav
- 4Research Institute of the McGill University Health Centre, Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada,
| | - A. Feldiorean
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - N. Boufaeid
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - W. Kassouf
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - C. Piccirillo
- 5Research Institute of the McGill University Health Centre, The Centre of Excellence in Translational Immunology, McGill University, Department of Microbiology and Immunology, Montreal, QC, Canada,
| | - P.M. Siegel
- 3Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada,
| | - A. Aprikian
- 1Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - A. Gregorieff
- 6Research Institute of the McGill University Health Centre, Department of Pathology, McGill University, Montreal, QC, Canada,
| | - J. Lapointe
- 7Division of Urology, Department of Surgery, Division of Experimental Medicine, Department of Medicine, Montreal, QC, Canada,
| | - P. Metrakos
- 6Research Institute of the McGill University Health Centre, Department of Pathology, McGill University, Montreal, QC, Canada,
| | - D.P. Labbé
- 8Division of Urology, Department of Surgery, McGill University, Research Institute of the McGill University Health Centre, Division of Experimental Medicine, Department of Medicine; McGill University, Goodman Cancer Research Centre; McGill University, The Centre of Excellence in Translational Immunology, Montreal, QC, Canada
| |
Collapse
|
5
|
Marcq G, Kool R, El-Achkar A, Brimo F, Vanhuyse M, Aprikian A, Tanguauy S, Cury F, Souhami L, Kassouf W. Résultats oncologiques de la thérapie trimodale pour cancer de vessie infiltrant le muscle. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
6
|
Alrashidi S, Souhami L, Cury F, Vanhuyse M, Aprikian A, Duclos M, Rajan R, Tanguay S, Faria S, Kassouf W. Bladder-Sparing Hypofractionated Intensity Modulated Radiation Therapy plus Weekly Gemcitabine in Patients with Invasive Bladder Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
7
|
Santos F, Dragomir A, Kassouf W, Franco E, Aprikian A. Urologist referral delay and its impact on survival after radical cystectomy for bladder cancer. ACTA ACUST UNITED AC 2015; 22:e20-6. [PMID: 25684993 DOI: 10.3747/co.22.2052] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Evidence shows that wait times before bladder cancer surgery have been increasing, and wait time can negatively affect survival. We aimed to determine if a long delay caused by an indirect referral before a first urologist visit affects the survival of patients undergoing radical cystectomy for bladder cancer. METHODS We analyzed data from 1271 patients who underwent surgery for bladder cancer during the decade 2000-2009. The cohort was obtained by linking two administrative databases in the province of Quebec. Patients were considered to have been directly referred to a urologist if they had 5 or fewer visits with a general practitioner before their first urologist visit; otherwise, they were considered to have been indirectly referred. The effect on survival after surgery of a longer delay before a first urologist visit was assessed using Cox regression models. RESULTS Median referral delay for the study population was 30 days (56 days for women, 23 days for men; p < 0.0001). Indirect referral was observed for 49% of women and 33% of men. Compared with patients who were directly referred, those who were indirectly referred after first symptoms of bladder cancer experienced poorer survival (hazard ratio: 1.29; 95% confidence interval: 1.10 to 1.52). Women who were indirectly referred had a significant 47% greater risk of death after radical cystectomy. Men who were indirectly referred also experienced decreased survival (adjusted hazard ratio: 1.25; 95% confidence interval: 1.03 to 1.51). CONCLUSIONS Patients indirectly referred to a urologist had an increased risk of mortality after surgery. Compared with men, women had longer wait times and poorer survival.
Collapse
Affiliation(s)
- F Santos
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC
| | - A Dragomir
- Division of Urology, Department of Urology, McGill University Health Centre, Montreal, QC
| | - W Kassouf
- Division of Urology, Department of Urology, McGill University Health Centre, Montreal, QC
| | - E Franco
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC
| | - A Aprikian
- Division of Urology, Department of Urology, McGill University Health Centre, Montreal, QC
| |
Collapse
|
8
|
Klotz L, Drachenberg D, Singal R, Aprikian A, Fradet Y, Kebabdjian M, Zarenda M, Chin J. An open-label, phase 2 trial of bicalutamide dose escalation from 50 mg to 150 mg in men with CAB and castration resistance. A Canadian Urology Research Consortium Study. Prostate Cancer Prostatic Dis 2014; 17:320-4. [DOI: 10.1038/pcan.2014.24] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/01/2014] [Accepted: 05/04/2014] [Indexed: 11/09/2022]
|
9
|
Aprikian A, Atef A, Duguid W, Bazinet M, Laplante M, Reid E, Macisaac S, Ackman D, Elhilali M. Survival after pelvic lymphadenectomy and radical cystectomy in patients with lymph-node metastatic transitional-cell carcinoma of the bladder. Oncol Rep 2013; 2:633-5. [PMID: 21597790 DOI: 10.3892/or.2.4.633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of this study was to determine the clinical outcome of patients with invasive transitional cell carcinoma of the bladder and pelvic lymph node metastases treated by radical cystectomy and bilateral pelvic lymphadenectomy in a single institution. From January 1980 to December 1993, 116 patients with transitional cell carcinoma of the bladder underwent bilateral pelvic lymphadenectomy and radical cystectomy at the Montreal General Hospital. Of these patients, 25 (21.6%) were found to have nodal metastases and form the basis of this retrospective analysis. Extent of nodal disease was as follows: 7 (28%) with N1, 17 (68%) with N2, and 1 (4%) patient with N3 disease. Of the 25 patients, 9 (36%) were alive with no evidence of disease and 1 (4%) died at 42 months from cardiovascular disease without clinical evidence of cancer recurrence. The median follow-up interval for these 10 patients was 26.5 months (mean, 31.4 months; range, 7-104 months). Fourteen (56%) patients died of recurrent bladder cancer and one patient was alive with systemic disease at 14 months. The median survival was estimated at 27 months, with 73% alive at 1 year, 51% alive at 2 years, and 33% alive at 3 years. Our data suggests that long-term survival free of disease can be achieved by radical surgery in some patients with node-positive bladder cancer.
Collapse
Affiliation(s)
- A Aprikian
- MCGILL UNIV,MONTREAL GEN HOSP,DEPT PATHOL,MONTREAL,PQ H3G 1A4,CANADA
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Al-Abdin OZ, Rabah DM, Badr G, Kotb A, Aprikian A. Differences in prostate cancer detection between Canadian and Saudi populations. Braz J Med Biol Res 2013; 46:539-45. [PMID: 23802226 PMCID: PMC3854441 DOI: 10.1590/1414-431x20132757] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 03/20/2013] [Indexed: 11/22/2022] Open
Abstract
Few studies have addressed racial differences in prostate cancer (PCa) detection
between Western and Arabian countries, although PCa has a significantly lower
prevalence in Arabic populations compared to Western populations. Therefore, an
explanation of this difference is lacking. Serum prostate-specific antigen (PSA)
is a valuable marker used to select patients who should undergo prostate
biopsies, although the manner in which it is used may require adjustments based
on the ethnic population in question. We investigated racial differences in the
PCa detection rate between Canadian and Saudi populations. A retrospective
analysis was performed of data collected prospectively over 5 consecutive years
in urology clinics at the McGill University Health Center (MUHC) and King Saud
University Hospital (KSUH). Men who had high (>4'ng/mL) or rising PSA levels
and a negative digital rectal examination were eligible. A total of 1403
Canadian and 414 Saudi patients were evaluated for the study; 717 and 158 men,
median age 64 and 68 years, were included in the MUHC and KSUH cohorts,
respectively, P<0.0001). Median serum PSA, prostate volume, and PSA density
values were 6.1'ng/mL, 47.3 g, and 0.12'ng·mL−1·g−1,
respectively, for MUHC patients and 5.2'ng/mL, 64.5'g, and
0.08'ng·mL−1·g−1, respectively, for KSUH patients
(P<0.0001, t-test followed by one-way ANOVA). In addition, the KSUH group had
a significantly lower PCa detection rate among patients younger than 60 years of
age and with PSA values <10'ng/mL.
Collapse
Affiliation(s)
- O Z Al-Abdin
- King Saud University, Princess Al-Johara Al-Ibrahim Center for Cancer Research, Prostate Cancer Research Chair, College of Medicine, Prostate Cancer Research Chair, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
11
|
Patel N, Cury F, Souhami L, Aprikian A, Faria S, David M, Duclos M. Correlation Between PSA Bounce, Time to Nadir, and Biochemical Failure in Patients With Prostate Cancer Treated With a Combination of HDR-Brachytherapy and Hypofractionated External Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1068] [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: 10/27/2022]
|
12
|
Bazinet M, Hamdy S, Begin L, Aprikian A, Fair W, Wright G. Monoclonal-antibody pd-41 recognizes a prostate-cancer associated antigen whose expression increases in metastases and following hormonal-therapy. Int J Oncol 2012; 7:1421-5. [PMID: 21552982 DOI: 10.3892/ijo.7.6.1421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Tissues of prostatic origin representing variable phenotypes were tested for reactivity to the prostate cancer specific mouse monoclonal antibody PD-41. Avidin biotin immunoperoxidase was applied on formalin-fixed, paraffin-embedded tissue sections of 15 benign prostatic hyperplasia (BPH), 23 prostatic intraepithelial neoplasia (PIN), 14 untreated primary adenocarcinoma, 35 diethylstilbestrol (DES) treated tumors, 50 lymph node and 11 bone metastases. Specimens were stratified according to the percentage of tumor cells expressing PD-41 antigen and degree of staining intensity, and correlated with PIN grade, Gleason score, flow cytometry (FCM) measured DNA ploidy, and reactivity to other antibodies. In PIN, 4 specimens (17.4%) showed reactivity in a significant number of cells while a few cells were reactive in most cases. PD-41 was significantly reactive (>5% of tumor cells) in 88% of nodal metastases and in 73% of bone metastases in contrast to 49% reactivity in primary tumors (p=0.0003). There was a tendency of increased antigen expression in hormonally treated primary tumors. In addition, involutional and metaplastic changes in hormonally treated cases were reactive in many instances. Semi-quantitative evaluation of PD-41 reactivity showed a statistically significant correlation with Gleason score in primary tumors (p=0.007) and in lymph node metastases (p=0.009). Moreover, the PD-41 antibody reacted in metastatic lesions that failed to express both prostatic acid phosphatase and prostate specific antigen. These data suggest that monoclonal antibody PD-41 merits further investigation to evaluate its potential diagnostic, prognostic and therapeutic role in prostate cancer.
Collapse
Affiliation(s)
- M Bazinet
- MCGILL UNIV,DEPT UROL & PATHOL,MONTREAL,PQ,CANADA. MEM SLOAN KETTERING CANC CTR,DEPT UROL SURG,NEW YORK,NY 10021. EASTERN VIRGINIA MED SCH,DEPT MICROBIOL & IMMUNOL,NORFOLK,VA 23501
| | | | | | | | | | | |
Collapse
|
13
|
Abstract
Several lines of evidence implicate the ras oncogene in tumorigenesis. However, changes in ras oncogene is uncommon in prostate cancer. We evaluated tumors from 55 patients with metastatic prostate cancer (50 lymph nodes, 5 bone metastases), 10 patients with localized cancers and 35 diethylstilbestrol treated primary tumors. Also, 15 patients with benign prostatic hyperplasia and 23 with prostatic intraepithelial neoplasia (PIN) were investigated for ras p21 expression. Avidin biotin immunoperoxidase was used on formalin-fixed, paraffin-embedded tissues with the Pan-ras (Ab-1) monoclonal antibody. Antibody titration demonstrated expression of ras p21 in none of the benign, PIN or DES-treated primary tumor specimens. However, 30% of untreated primary tumors and 94.5% of metastatic tumors (94% of lymph node metastases, 100% of bone metastases) showed expression (p=0.00002). Semi-quantitative evaluation of ras protein expression revealed a significant correlation with Gleason score in lymph node metastases (p=0.001). This study suggests a possible role of ras oncogene in prostate cancer progression, metastasis and androgen independency.
Collapse
Affiliation(s)
- S Hamdy
- MCGILL UNIV,MONTREAL GEN HOSP,DEPT UROL,1650 CEDAR,MONTREAL H3G 1A4,QUEBEC,CANADA. MCGILL UNIV,MONTREAL GEN HOSP,DEPT PATHOL,MONTREAL H3G 1A4,QUEBEC,CANADA. MEM SLOAN KETTERING CANC CTR,UROL SERV,NEW YORK,NY 10021
| | | | | | | | | |
Collapse
|
14
|
Luz M, Dal Pra A, Chevalier S, Aprikian A, Scarlata E, Hamel L, Cury F. Prostate Volume Assessment Prior Brachytherapy Implant - How Accurate is Trans-rectal Ultrasound? Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
15
|
Moussa S, Yafi F, El-Hakim A, Fahmy N, Aprikian A, Tanguay S, Anidjar M, Kassouf W. Outcome of Surgical Treatment of Patients with Upper versus Lower Urinary Tract Urothelial Carcinoma: Stage-by-Stage Comparison. Urol Int 2010; 84:50-5. [DOI: 10.1159/000273466] [Citation(s) in RCA: 22] [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: 03/09/2009] [Accepted: 05/12/2009] [Indexed: 11/19/2022]
|
16
|
Chalasani V, Martinez C, Izawa J, Aprikian A, Fradet Y, Estey E, Fairey A, Rendon R, Cagiannos I, Lacombe L, Lattouf J, Bell D, Drachenberg D, Kassouf W, Chin J. POD-07.09: Incidental Adenocarcinoma of the Prostate Discovered at the Time of Radical Cystectomy: Analysis of the Canadian Bladder Cancer Network Database. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Yafi F, Aprikian A, Chin J, Fradet Y, Izawa J, Estey E, Fairey A, Rendon R, Cagiannos I, Lacombe L, Lattouf J, Bell D, Drachenberg D, Kassouf W. POD-07.10: Outcome Analysis of Bladder Cancer Patients Treated with Radical Cystectomy in a Universal Health Care System: A Multicenter Canadian Series of 2,287 Patients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
18
|
Drachenberg D, Aprikian A, Chin J, Fradet Y, Izawa J, Estey E, Fairey A, Rendon R, Cagiannos I, Lacombe L, Lattouf J, Bell D, Kassouf W. MP-13.10: Achieving Pt0n0 at Radical Cystectomy: Outcomes of 135 Pt0n0 Bladder Cancer Patients Treated with Radical Cystectomy: The Canadian Bladder Cancer Network Experience. Urology 2009. [DOI: 10.1016/j.urology.2009.07.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
19
|
Klotz L, Aprikian A, Fleshner N, Chin J, Gleave M, Zarenda M. POD-3.07: An Open-Label, Phase II Trial of 250mg Gefitinib (Iressa) in Prostate Cancer Patients with Early Biochemical Failure Post-prostatectomy. Urology 2008. [DOI: 10.1016/j.urology.2008.08.138] [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: 10/21/2022]
|
20
|
Feifer A, Al-Otaibi M, Sircar K, Begin L, Kassouf W, Aprikian A, Tanguay S. POD-5.12: Pathological Disease Progression on Repeat Transrectal Biopsy in a Contemporary Active Surveillance Cohort of Prostate Cancer Patients: Looking at Disease Progression with a 5-year Follow-Up. Urology 2008. [DOI: 10.1016/j.urology.2008.08.113] [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: 10/21/2022]
|
21
|
Trachtenberg J, Bogaards A, Weersink RA, Haider MA, Evans A, McCluskey SA, Scherz A, Gertner MR, Yue C, Appu S, Aprikian A, Savard J, Wilson BC, Elhilali M. Vascular targeted photodynamic therapy with palladium-bacteriopheophorbide photosensitizer for recurrent prostate cancer following definitive radiation therapy: assessment of safety and treatment response. J Urol 2007; 178:1974-9; discussion 1979. [PMID: 17869307 DOI: 10.1016/j.juro.2007.07.036] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Indexed: 11/30/2022]
Abstract
PURPOSE Tookad is a novel intravascular photosensitizer. When activated by 763 nm light, it destroys tumors by damaging their blood supply. It then clears rapidly from the circulatory system. To our knowledge we report the first application of Tookad vascular targeted photodynamic therapy in humans. We assessed the safety, pharmacokinetics and preliminary treatment response as a salvage procedure after external beam radiation therapy. MATERIALS AND METHODS Patients received escalating drug doses of 0.1 to 2 mg/kg at a fixed light dose of 100 J/cm or escalated light doses of 230 and 360 J/cm at the 2 mg/kg dose. Four optical fibers were placed transperineally in the prostate, including 2 for light delivery and 2 for light dosimetry. Treatment response was assessed primarily by hypovascular lesion formation on contrast enhanced magnetic resonance imaging and transrectal ultrasound guided biopsies targeting areas of lesion formation and secondarily by serum prostate specific antigen changes. RESULTS Tookad vascular targeted photodynamic therapy was technically feasible. The plasma drug concentration was negligible by 2 hours after infusion. In the drug escalation arm 3 of 6 patients responded, as seen on magnetic resonance imaging, including 1 at 1 mg/kg and 2 at 2 mg/kg. The light dose escalation demonstrated an increasing volume of effect with 2 of 3 patients in the first light escalation cohort responding and all 6 responding at the highest light dose with lesions encompassing up to 70% of the peripheral zone. There were no serious adverse events, and continence and potency were maintained. CONCLUSIONS Tookad vascular targeted photodynamic therapy salvage therapy is safe and well tolerated. Lesion formation is strongly drug and light dose dependent. Early histological and magnetic resonance imaging responses highlight the clinical potential of Tookad vascular targeted photodynamic therapy to manage post-external beam radiation therapy recurrence.
Collapse
Affiliation(s)
- J Trachtenberg
- Department of Surgical Oncology, Ontario Cancer Institute/Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Al Otaibi M, Fahmy N, Ross P, Kassouf W, Jeyaganth S, Steinberg J, Begin L, Sircar K, Aprikian A, Tanguay S. POD-01.03: The impact of first repeated biopsy in predicting progression in a cohort of prostate cancer patients managed with active surveillance. Urology 2007. [DOI: 10.1016/j.urology.2007.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Sircar K, Gottlieb B, Alvarado C, Aprikian A, Beitel LK, Alam-Fahmy M, Begin L, Trifiro M. Androgen receptor CAG repeat length contraction in diseased and non-diseased prostatic tissues. Prostate Cancer Prostatic Dis 2007; 10:360-8. [PMID: 17440439 DOI: 10.1038/sj.pcan.4500967] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/09/2022]
Abstract
To investigate contraction of CAG repeats within the androgen receptor gene (AR) as shorter CAG repeats have been implicated as a possible risk factor in prostate cancer (PCa). AR CAG repeat lengths were analyzed in DNA from microdissected diseased prostates, leukocytes from matched peripheral blood, and control non-diseased prostates. Consistently, all prostatic tissues, whether from benign or cancerous areas of diseased prostates, or from control prostates, showed multiple AR CAG repeat contractions. Germline DNA from blood leukocytes had single CAG repeat lengths in the normal range. AR CAG repeat length contraction may be involved in prostate carcinogenesis and may precede the pathological process.
Collapse
Affiliation(s)
- K Sircar
- Department of Pathology, McGill University Health Center, Montreal, Quebec, Canada
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Fahmy N, Jeyaganth S, Mahmud S, Tanguay S, Aprikian A. MP-13.09. Urology 2006. [DOI: 10.1016/j.urology.2006.08.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
25
|
Fahmy N, Jeyaganth S, Mahmud S, Tanguay S, Aprikian A. PD-11.06. Urology 2006. [DOI: 10.1016/j.urology.2006.08.125] [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: 10/24/2022]
|
26
|
Cury F, Duclos M, Aprikian A, Mansour M, Souhami L. 151 Volumetric changes post single fraction high-dose rate brachytherapy (HDRB) as a boost to external beam radiation therapy (EBRT) in prostate cancer (PCa) - should it be considered an important factor for margin definition? Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Abstract
Animal and laboratory studies suggest that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce prostate cancer risk. To assess this association, we conducted a systematic review and meta-analysis of observational studies published before January 2003. We derived summary odds ratios (ORs) using both fixed and random effects models and performed subgroup analyses to explore the possible sources of heterogeneity between combined studies. We identified 12 reports (five retrospective and seven prospective studies). Most studies of aspirin use reported inverse associations, but only two were statistically significant. The summary OR for the association between aspirin use and prostate cancer was 0.9 (95% confidence interval: 0.82-0.99; test of homogeneity P=0.32), and varied from 1.0 for retrospective studies to 0.85 for prospective studies. Studies that measured exposure to a mixture of NSAIDs were less consistent. These results indicate an inverse association between aspirin use and prostate cancer risk. The current epidemiological evidence and, in particular, the strong and consistent laboratory evidence underline the need for additional epidemiological studies to confirm the direction and magnitude of the association.
Collapse
Affiliation(s)
- S Mahmud
- Department of Oncology, McGill University, Gerald Bronfman Centre, 546 Pine Avenue West, Montreal, Quebec, Canada.
| | | | | |
Collapse
|
28
|
Allard P, Beaulieu P, Aprikian A, Chevalier S. Bombesin modulates the association of Src with a nuclear 110-kd protein expressed in dividing prostate cells. J Androl 2000; 21:367-75. [PMID: 10819444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Polyclonal antibodies produced against a peptide derived from the Fer tyrosine kinase sequence also specifically recognized a 110-kd protein (p110) up-regulated in dividing versus resting dog prostate epithelial cells in vitro. In vivo in the dog prostate, p110 expression was detected when basal cell metaplasia was induced by estrogens after castration but not when renewing the differentiated epithelium with androgens. It was also detected in extracts from the human prostatic carcinoma cell lines LNCaP, DU145, and PC-3, and from 6 out of 11 human prostate cancer tissues analyzed, but not from normal or hyperplastic glands. The tyrosine kinase Src was shown by coimmunoprecipitation to associate with p110, and this interaction was positively modulated by bombesin stimulation of PC-3 cells. However, p110 was not tyrosine phosphorylated. Moreover, it was mainly distributed in the nuclear fraction. This nuclear p110 protein, expressed in dividing prostate epithelial cells and in human prostate cancer cells and tissues, could thus be a downstream mediator of bombesin-signaling pathways, acting via its association with Src.
Collapse
Affiliation(s)
- P Allard
- Department of Biochemistry, University of Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
29
|
Allard P, Zoubeidi A, Nguyen LT, Tessier S, Tanguay S, Chevrette M, Aprikian A, Chevalier S. Links between Fer tyrosine kinase expression levels and prostate cell proliferation. Mol Cell Endocrinol 2000; 159:63-77. [PMID: 10687853 DOI: 10.1016/s0303-7207(99)00205-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [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] [Indexed: 01/03/2023]
Abstract
In our cloning strategy to identify tyrosine kinases implicated in the regulation of prostate growth, the dog fer cDNA was obtained and shown to be highly homologous to known fer cDNAs. Using a polyclonal Fer antibody directed against a C-terminal peptide, we studied its associations with cortactin, beta-catenin and p120Cas in human prostate carcinoma PC-3 cells. In contrast to previous reports, no interactions were observed. To assess its functional role, fer cDNA constructs were transfected in PC-3 cells. Antisense clones exhibiting a marked diminution of Fer expression had a reduced growth rate (doubling time of 29 vs. 42 h) and were unable to form colonies in soft agar. In agreement with these results, Fer protein expression was linked to human prostatic proliferative diseases, with enhanced levels in extracts from cancer tissues as compared to those from normal and hyperplastic ones, and was also expressed in the human prostate carcinoma cell lines DU145 and LNCaP. In the dog model, Fer expression was up-regulated in dividing versus resting prostate epithelial cells in vitro, and also in vivo when basal cell hyperplasia and metaplasia was induced by estrogen after castration. Minimal effects were observed when renewing the luminal epithelium with androgens. Taken together, these results show that Fer expression is associated with prostate cell proliferation and enhanced in prostate cancer.
Collapse
Affiliation(s)
- P Allard
- Department of Biochemistry, University of Montreal, Quebec, Canada
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Eeles RA, Durocher F, Edwards S, Teare D, Badzioch M, Hamoudi R, Gill S, Biggs P, Dearnaley D, Ardern-Jones A, Dowe A, Shearer R, McLellan DL, McLennan DL, Norman RL, Ghadirian P, Aprikian A, Ford D, Amos C, King TM, Labrie F, Simard J, Narod SA, Easton D, Foulkes WD. Linkage analysis of chromosome 1q markers in 136 prostate cancer families. The Cancer Research Campaign/British Prostate Group U.K. Familial Prostate Cancer Study Collaborators. Am J Hum Genet 1998; 62:653-8. [PMID: 9497242 PMCID: PMC1376940 DOI: 10.1086/301745] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Prostate cancer shows evidence of familial aggregation, particularly at young ages at diagnosis, but the inherited basis of familial prostate cancer is poorly understood. Smith et al. recently found evidence of linkage to markers on 1q, at a locus designated "HPC1," in 91 families with multiple cases of early-onset prostate cancer. Using both parametric and nonparametric methods, we attempted to confirm this finding, in 60 affected related pairs and in 76 families with three or more cases of prostate cancer, but we found no significant evidence of linkage. The estimated proportion of linked families, under a standard autosomal dominant model, was 4%, with an upper 95% confidence limit of 31%. We conclude that the HPC1 locus is responsible for only a minority of familial prostate cancer cases and that it is likely to be most important in families with at least four cases of the disease.
Collapse
Affiliation(s)
- R A Eeles
- Cancer Genetics Team, ICR and Royal Marsden NHS Trust, Sutton, Surrey SM2 5PT, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Brenner PC, Herr HW, Morse MJ, Sheinfeld J, Aprikian A, Bosl GJ, Motzer RJ, Bajorin DF, Schantz S, Fair WR, Burt M. Simultaneous retroperitoneal, thoracic, and cervical resection of postchemotherapy residual masses in patients with metastatic nonseminomatous germ cell tumors of the testis. J Clin Oncol 1996; 14:1765-9. [PMID: 8656244 DOI: 10.1200/jco.1996.14.6.1765] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE We report our experience with simultaneous resection of residual masses above and below the diaphragm in patients with metastatic nomseminomatous germ cell tumor (NSGCT) of the testis. MATERIALS AND METHODS Twenty-four patients underwent simultaneous resection of residual postchemotherapy masses in the retroperitoneum and chest, including three who also had radical neck dissection. All had been heavily pretreated with chemotherapy and five had undergone previous retroperitoneal lymph node dissections (RPLNDs). RESULTS The combined procedure was performed with no mortality and low morbidity. The median length of the procedure was 5 hours 45 minutes, median blood loss 500 mL, and median length of hospital stay 9 days. Complications included one patient with chylous ascites and one with a prolonged air leak, both of which resolved with conservative management. Eighteen patients had similar pathologic findings in all sites: 13 with necrosis only and five with teratoma only. Six patients had discordant pathology in the abdomen and chest, including one with viable tumor in the chest only and two with viable tumor in the abdomen only. The overall actuarial 5-year survival rate for all patients was 79%. CONCLUSION Simultaneous resection of neck, chest, and abdominal residual masses after chemotherapy for germ cell tumors is both a feasible and safe alternative to staged excision in selected patients who require surgical intervention at multiple sites and fulfills the objective of rendering patients disease-free in a single operative procedure.
Collapse
Affiliation(s)
- P C Brenner
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
|
33
|
Ritchie KA, Aprikian A, Gollahon KA, Hickstein DD. The human leukocyte integrin CD11a promoter directs expression in leukocytes of transgenic mice. Blood 1995; 86:147-55. [PMID: 7795220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The human CD11a molecule is expressed specifically on lymphocytes, monocyte/macrophages, and neutrophils, in which it mediates important adhesion-related functions. We used 1.7 kb of regulatory sequences upstream from the human CD11a gene transcription start site to drive expression of a modified human CD4 reporter gene in transgenic mice. The transgene was expressed in a tissue-specific fashion on all leukocytes and paralleled endogenous mouse CD11a expression. All five founder mice expressed the transgene, providing evidence for integration site-independent expression. However, expression was not proportional to transgene copy number. These studies indicate that (1) the mutated human CD4 serves as an excellent reporter for analysis of leukocyte-specific promoters; (2) the CD11a regulatory unit used here represents a novel reagent for targeting gene expression to leukocytes; and (3) additional regulatory regions will be required for copy-number-dependent activity of CD11a regulatory sequences.
Collapse
Affiliation(s)
- K A Ritchie
- Medical Research Service, Seattle Veterans Affairs Medical Center, WA 98108, USA
| | | | | | | |
Collapse
|
34
|
Brenner PC, Rettig WJ, Sanz-Moncasi MP, Reuter V, Aprikian A, Old LJ, Fair WR, Garin-Chesa P. TAG-72 expression in primary, metastatic and hormonally treated prostate cancer as defined by monoclonal antibody CC49. J Urol 1995; 153:1575-9. [PMID: 7536270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Monoclonal antibodies CC49 and B72.3, which recognize a tumor associated glycoprotein (TAG-72) related to sialyted Tn antigen, have been used in clinical trials for radionuclide imaging, and treatment of colon, breast and ovarian carcinoma. In addition, studies with CC49 in patients with metastatic hormone refractory prostate cancer have been initiated based on the observed expression of TAG-72 in primary prostate cancer. We examined whether TAG-72 expression is a common feature of primary, metastatic and hormonally treated prostatic carcinoma. Immunohistochemical analysis of 25 primary prostatic carcinomas confirmed previous data that 21 of 25 specimens (80%) were immunoreactive with CC49. CC49 staining was noted in all 6 well (Gleason score 2 to 4), 8 of 10 moderately (Gleason score 5 to 6) and 7 of 9 poorly (Gleason score 7 to 9) differentiated tumors. CC49 immunoreactivity was noted in 10 of 20 hormonally treated prostate cancers and in 21 of 25 tumors without hormonal therapy. Intense CC49 staining of prostatic intraepithelial neoplasia was present in all 5 specimens examined. In contrast to the primary lesion, many metastatic prostate cancers lacked detectable CC49 immunoreactivity. Of 24 pelvic lymph node metastases from different patients only 4 (17%) had significant CC49 staining and 5 others had rare CC49 positive cells. However, 6 of 12 bone metastases showed CC49 immune staining. One specimen from an anaplastic locally recurrent tumor showed no reactivity. To our knowledge we present the first analysis of TAG-72 expression in a large series of patients with hormonally treated and metastatic prostate cancer, the most likely candidates for CC49 immunotherapy. Our findings that lymph node and bone metastases from prostate cancer are less likely to express significant amounts of TAG-72 than primary prostate cancer suggest that pretreatment biopsy typing for TAG-72 may be necessary to optimize the results of ongoing CC49 imaging and therapy studies.
Collapse
Affiliation(s)
- P C Brenner
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Zhang ZF, Sarkis AS, Cordon-Cardo C, Dalbagni G, Melamed J, Aprikian A, Pollack D, Sheinfeld J, Herr HW, Fair WR. Tobacco smoking, occupation, and p53 nuclear overexpression in early stage bladder cancer. Cancer Epidemiol Biomarkers Prev 1994; 3:19-24. [PMID: 8118380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Epidemiological studies show an increased risk of bladder cancer associated with tobacco smoking and occupational exposures. Certain carcinogens in tobacco and occupational exposures cause DNA damage and may produce specific mutations. TP53 is considered a common target for carcinogenic agents, and mutations of this gene are reported to be the most frequent nuclear abnormalities in human cancer. In order to investigate the relationship between tobacco smoking, occupations, and altered patterns of p53 expression, we have analyzed a group of 109 incident patients with superficial transitional cell carcinoma of the bladder. We assessed p53 nuclear overexpression by the use of anti-p53 antibody PAb1801 and immunohistochemistry, and identified 45 of 109 patients (41%) displaying p53-positive phenotype. We observed a significant association between the number of cigarettes smoked per day and p53 nuclear overexpression (p = 0.02). The odds ratios were 2.3 for those smoking 1-2 packs per day and 8.4 for smoking more than 2 packs per day. Similar estimates were obtained after controlling for age, sex, and race. Elevated odds ratios were also observed for dye-/ink-related (odds ratio = 2.0; 95% CI, 0.4-9.4) and cooking-related occupations (1.8, 0.6-5.0), although those were not statistically significant. These data support the hypothesis that certain carcinogens derived from cigarette smoking and occupations may induce TP53 mutations, which in turn are involved in early steps of bladder carcinogenesis.
Collapse
Affiliation(s)
- Z F Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Abstract
BACKGROUND Although hormonal manipulation is standard therapy for patients with metastatic prostatic cancer, its use in localized disease in combination with surgical extirpation of the gland has not been investigated thoroughly and systematically. METHODS The authors report their initial pilot studies using preoperative neoadjuvant endocrine therapy. RESULTS Although marked reduction in serum prostate-specific antigen (PSA) levels occurred in all patients, the PSA level after endocrine manipulation did not predict the pathologic stage. In addition, immunohistochemical staining of the radical prostatectomy specimen for PSA, in several patients with a zero serum PSA level, after endocrine therapy revealed intense PSA staining in the cancer cells but not in benign epithelium. The effects on tumor downstaging were inconclusive. Overall, only 33% of patients had organ-confined disease, but in some patients, complete tumor regression (PO) occurred. CONCLUSIONS Neoadjuvant hormonal therapy in prostatic cancer, although definitely not standard therapy, bears investigation. In addition to the effect on the "index" cancer, it also provides an opportunity to evaluate the effect of hormonal agents on microfocal ("early") cancer and known precursors of malignant change. Therefore, it may provide a means of assessing agents of potential use in the development of chemopreventive strategies.
Collapse
Affiliation(s)
- W R Fair
- Memorial Sloan Kettering Cancer Center, New York, NY 10021
| | | | | | | | | |
Collapse
|
37
|
Aprikian A, Berardinucci G, Pike J, Kiruluta G. Experience with the AS-800 artificial urinary sphincter in myelodysplastic children. Can J Surg 1992; 35:396-400. [PMID: 1498739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The authors describe their experience with an artificial urinary sphincter (model AS-800; American Medical Systems, Minnetonka, Minn.) in treating urinary incontinence in children. Twenty-eight sphincters were implanted in 27 boys between May 1986 and June 1989. All the boys had neurogenic bladders secondary to myelomeningocele or sacral agenesis. The mean age at the time of initial implantation was 14 years (range from 9 to 19 years), and the median follow-up was 12 months (range from 6 to 31 months). The sphincters were implanted initially around the bladder neck in 25 cases. Three required reimplantation around the bulbous urethra. The complication rate was 39% (11 of 28 cases). There were two cases of erosion, two cases of infection without erosion and seven cases of device-related problems. The artificial sphincter had to be removed in four cases. There were no deaths. The revision rate was 25% (7 of 28 cases). Continence was evaluated in 22 (88%) of 25 boys who had functional sphincters in place. Five boys required oxybutinin chloride to maintain continence. Ten boys required augmentation cystoplasty before (3), after (6) and combined with (1) sphincter implantation. Eight of these 10 children were able to void spontaneously and were continent. One required intermittent catheterization twice a day and another six times a day. The authors conclude from their experience that the artificial urinary sphincter (model AS-800) can establish continence in boys with neurogenic bladders. Proper selection of the ideal patient for the artificial sphincter is essential to avoid complications.
Collapse
Affiliation(s)
- A Aprikian
- Department of Surgery, Montreal Children's Hospital, McGill University, Que
| | | | | | | |
Collapse
|
38
|
Abstract
Androgen ablation using hormonal manipulation is used extensively in metastatic prostate cancer; however, its use in localized disease combined with surgical extirpation of the gland has not been thoroughly and systematically investigated. The rationale for neoadjuvant therapy stems from the demonstrated effectiveness of androgen ablative therapy in metastatic disease and the high rate of "positive" surgical margins, especially in patients with Stage B2 disease. In addition, the essentially anecdotal clinical report of Scott and Boyd [1], using endocrine therapy plus radical prostatectomy in patients with Stage C disease, gives 15 year survival results comparable to those obtained by Jewett [2] in Stage 1 patients treated by radical prostatectomy. Finally, experimental observations in the androgen-sensitive mammary tumor (Shionogi) lend support to the concept of neoadjuvant hormonal manipulation. A pilot study of neoadjuvant endocrine therapy in 55 patients treated at Memorial Sloan-Kettering Cancer Center with 3 months of diethylstilbestrol (DES) (3 mg/day) prior to radical prostatectomy indicates marked reductions in prostate-specific antigen (PSA), although persistent evidence of adverse local tumor features was common. Some patients, however, exhibited evidence of significant downstaging. Whether or not any alteration in disease progression will accrue from demonstrated local downstaging is, of course, uncertain. However, clinical and laboratory effects of such treatment may provide a means for correlation with subsequent tumor behavior, and may prove useful in treatment decisions. Additionally, a decrease in the number of foci of grade 3 prostatic intraepithelial neoplasia (PIN-3) was noted in a small number of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- W R Fair
- Memorial Sloan-Kettering Cancer Center, New York, NY 10021
| | | | | |
Collapse
|