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Droller MJ. Introduction to the 25th anniversary issue. Urol Oncol 2021; 39:504-505. [PMID: 33775529 DOI: 10.1016/j.urolonc.2020.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Michael J Droller
- Department of Urology, The Mount Sinai Medical Center, New York, NY 10029
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Droller MJ. Urologic Oncology: Seminars and Original Investigations. A Twenty-Fifth Anniversary History. Urol Oncol 2021; 39:506-513. [PMID: 33612355 DOI: 10.1016/j.urolonc.2021.01.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/11/2021] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
This narrative reviews the history of Urologic Oncology: Seminars and Original Investigations from its inception and founding through its development to reach its current status. It describes the difficulties it experienced during its initial years when it almost folded, its resuscitation when it was designated as the "official journal" of the Society of Urologic Oncology, its merger with Seminars in Urologic Oncology to strengthen the content of both journals in a new format, its acceptance for indexation by the National Library of Medicine, its progress to monthly publication in addressing the needs of both authors and readership, and its current status as a leading multidisciplinary journal in urologic oncology. As a founding editor and managing editor for the first 5 years and then as editor-in-chief for the next 20 years, the author has been integrally involved in each step of the Journal's development and maturation. The Journal has been referred to as "the journal that almost never was" as it now has reached its 25th year of publication. This article commemorates the Journal's 25th Anniversary and gratefully acknowledges all of those investigators, authors, reviewers, editors, publishers and the readership who have contributed to the Journal's ongoing success.
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Affiliation(s)
- Michael J Droller
- Department of Urology, The Mount Sinai Medical Center, New York, NY.
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Droller MJ. Urologic Oncology: A Personal History and Lessons Learned. Urol Oncol 2021. [DOI: 10.1016/j.urolonc.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Droller MJ. Letter from the Editor, “Thank you”, Michael J. Droller, M.D. Urol Oncol 2020; 38:313. [PMID: 32408990 PMCID: PMC7213955 DOI: 10.1016/j.urolonc.2020.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Soria F, Droller MJ, Lotan Y, Gontero P, D'Andrea D, Gust KM, Rouprêt M, Babjuk M, Palou J, Shariat SF. An up-to-date catalog of available urinary biomarkers for the surveillance of non-muscle invasive bladder cancer. World J Urol 2018; 36:1981-1995. [PMID: 29931526 PMCID: PMC6280823 DOI: 10.1007/s00345-018-2380-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/15/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES With the advent of novel genomic and transcriptomic technologies, new urinary biomarkers have been identified and tested for bladder cancer (BCa) surveillance. To summarize the current status of urinary biomarkers for the detection of recurrence and/or progression in the follow-up of non-muscle invasive BCa patients, and to assess the value of urinary biomarkers in predicting response to intravesical Bacillus Calmette-Guerin (BCG) therapy. METHODS AND MATERIALS A medline/pubmed© literature search was performed. The performance of commercially available and investigational biomarkers has been reviewed. End points were cancer detection (recurrence), cancer progression, and response to BCG therapy. RESULTS The performance requirements for biomarkers are variable according to the clinical scenario. The clinical role of urinary biomarkers in the follow-up of non-muscle invasive BCa patients remains undefined. The FDA-approved tests provide unsatisfactory sensitivity and specificity levels and their use is limited. Fluorescence in situ hybridization (FISH) has been shown to be useful in specific scenarios, mostly as a reflex test and in the setting of equivocal urinary cytology. FISH and immunocytology could conceivably be used to assess BCG response. Recently developed biomarkers have shown promising results; upcoming large trials will test their utility in specific clinical scenarios in a manner similar to a phased drug development strategy. CONCLUSIONS Current commercially available urinary biomarker-based tests are not sufficiently validated to be widely used in clinical practice. Several novel biomarkers are currently under investigation. Prospective multicenter analyses will be needed to establish their clinical relevance and value.
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Affiliation(s)
- Francesco Soria
- Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - Michael J Droller
- Department of Urology, The Mount Sinai Medical Center, New York, USA
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - David D'Andrea
- Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Kilian M Gust
- Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Morgan Rouprêt
- Department of Urology, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
| | - Marek Babjuk
- Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Shahrokh F Shariat
- Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA.
- Department of Urology, Weill Cornell Medical College, New York, USA.
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
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Affiliation(s)
- Michael J Droller
- Department of Urology, Mount Sinai School of Medicine, New York, New York
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Droller MJ. Legends in Urology. Can J Urol 2016; 23:8430-8434. [PMID: 27705726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Michael J Droller
- Katherine and Clifford Goldsmith Professor of Urology, Professor of Oncology, Mount Sinai Medical Center, New York, NY USA
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Zietman A, Smith J, Klein E, Droller MJ, Dasgupta P, Catto J. New Gleason grading system: Statement from the Editors of six journals. Urol Oncol 2016; 34:253. [DOI: 10.1016/j.urolonc.2016.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sun Y, Chung LW, Droller MJ. WITHDRAWN: Introducing the Asian Journal of Urology. Asian J Urol 2014. [DOI: 10.1016/j.ajur.2014.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Willis DL, Flaig TW, Hansel DE, Milowsky MI, Grubb RL, Al-Ahmadie HA, Plimack ER, Koppie TM, McConkey DJ, Dinney CP, Hoffman VA, Droller MJ, Messing E, Kamat AM. Micropapillary bladder cancer: current treatment patterns and review of the literature. Urol Oncol 2014; 32:826-32. [PMID: 24931270 DOI: 10.1016/j.urolonc.2014.01.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 12/30/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES No guidelines exist for the management of micropapillary bladder cancer (MPBC) and most reports of this variant of urothelial carcinoma are case series comprising small numbers of patients. We sought to determine current practice patterns for MPBC using a survey sent to the Society of Urologic Oncology (SUO) and to present those results in the setting of a comprehensive review of the existing literature. MATERIALS AND METHODS A survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network-sponsored Think Tank meeting was distributed to members of the SUO. The results from 118 respondents were analyzed and presented with a literature review. RESULTS Most survey respondents were urologists, with 80% considering bladder cancer their primary area of interest. Although 78% of the respondents reported a dedicated genitourinary pathologist at their institution, there were discrepant opinions on how a pathologic diagnosis of MPBC is determined as well as variability on the proportion of MPBC that is clinically significant. Among them, 78% treat MPBC differently than conventional urothelial carcinoma, with 81% reporting that they would treat cT1 MPBC with upfront radical cystectomy. However, the respondents had split opinions regarding the sensitivity of MPBC to cisplatin-based chemotherapy, which affected utilization of neoadjuvant chemotherapy in muscle-invasive disease. CONCLUSIONS The management of MPBC is diverse among members of the SUO. Although most favors early cystectomy for cT1 MPBC, there is no consensus on the use of neoadjuvant chemotherapy for muscle-invasive MPBC.
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Affiliation(s)
- Daniel L Willis
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas W Flaig
- Division of Medical Oncology, University of Colorado Denver, School of Medicine, Denver, CO
| | - Donna E Hansel
- Department of Pathology, UC San Diego, School of Medicine, San Diego, CA
| | - Matthew I Milowsky
- Division of Hematology/Oncology, University of North Carolina, School of Medicine, Chapel Hill, NC
| | - Robert L Grubb
- Division of Urologic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York City, NY
| | | | - Theresa M Koppie
- Department of Urology, Oregon Health and Science University, Portland, OR
| | - David J McConkey
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Colin P Dinney
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Edward Messing
- Department of Urology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY
| | - Ashish M Kamat
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Droller MJ. George Russell Prout Jr., M.D., 1924–2013, Founding Editor, Urologic Oncology. Urol Oncol 2014; 32:217-8. [DOI: 10.1016/j.urolonc.2013.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lavery HJ, Stensland KD, Niegisch G, Albers P, Droller MJ. Pathological T0 Following Radical Cystectomy with or without Neoadjuvant Chemotherapy: A Useful Surrogate. J Urol 2014; 191:898-906. [DOI: 10.1016/j.juro.2013.10.142] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2013] [Indexed: 02/03/2023]
Affiliation(s)
- Hugh J. Lavery
- Departments of Urology, Mount Sinai Medical Center, New York, New York, and Dusseldorf University Hospital (GN, PA), Dusseldorf, Germany
| | - Kristian D. Stensland
- Departments of Urology, Mount Sinai Medical Center, New York, New York, and Dusseldorf University Hospital (GN, PA), Dusseldorf, Germany
| | - Guenter Niegisch
- Departments of Urology, Mount Sinai Medical Center, New York, New York, and Dusseldorf University Hospital (GN, PA), Dusseldorf, Germany
| | - Peter Albers
- Departments of Urology, Mount Sinai Medical Center, New York, New York, and Dusseldorf University Hospital (GN, PA), Dusseldorf, Germany
| | - Michael J. Droller
- Departments of Urology, Mount Sinai Medical Center, New York, New York, and Dusseldorf University Hospital (GN, PA), Dusseldorf, Germany
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Droller MJ. New steps forward for Urologic Oncology. Urol Oncol 2013; 31:135-6. [DOI: 10.1016/j.urolonc.2013.01.002] [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]
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Abstract
PURPOSE The Gleason scoring system has been the traditional basis for studies on the assessment and treatment of prostate cancer. Recent reports of long-term prostate cancer outcomes stratified by Gleason score based on the 2005 ISUP (International Society of Urological Pathology) update suggest that important aspects of the biology of prostate cancer correlate with commonly available histopathological information. In this review we present a conceptual framework for the possible existence of distinct but interrelated developmental pathways in the context of the Gleason score in considering various biological and clinical aspects of prostate cancer. This may be useful in characterizing prostate cancer as an indolent condition in some and an aggressive disease in others, in decision making for treatment, and in the interpretation of the biological course and treatment outcomes. MATERIALS AND METHODS A comprehensive review of clinical, pathological and investigational biological literature on this topic was conducted. In addition, the biological behavior of prostate cancer as interpreted from this survey was compared to that of other solid neoplasms in developing a schema for characterizing the pathogenesis of various forms of the disease. RESULTS The Gleason scoring system has been found to have fundamental value in predicting the behavior of prostate cancer and assessing outcomes of its treatment. Increasingly, the proportion of Gleason pattern 4 in a prostatectomy specimen is being recognized as a critical factor in predicting the rates of biochemical recurrence and prostate cancer specific mortality. Under the current Gleason classification, a Gleason 3 + 3 = 6 cancer carries a minimal long-term risk of progression or mortality. Risk of biochemical recurrence and prostate cancer specific mortality increases with increasing proportions of the Gleason 4 component in the prostatectomy specimen, from 3 + 3 = 6 with tertiary 4 (ie less than 5% of a 4 component) to 3 + 4 = 7, 4 + 3 = 7 and 4 + 4 = 8. Assuming that the Gleason 4 component increases in volume more rapidly with time than well differentiated components, it can be inferred that a smaller proportion of Gleason 4 could mean that the cancer has been identified at an earlier phase in the natural history of the disease. This could explain the improved prognosis on the basis of length and lead time biases, and conceivably on the basis of a decreased likelihood of cancer cells having metastasized. Correspondingly, increasing amounts of Gleason 4 cancer in a prostate specimen might be explained in 2 ways, as the preferential growth of a single clone of Gleason 4 cells, possibly with intraprostatic spread, or the evolution of Gleason 3 cancer cells to become Gleason 4. These hypotheses have been examined by genetic analysis of metastatic deposits and by comparisons of multiple foci of cancer within individual prostates. The clinical significance of these concepts in regard to disease status at diagnosis, treatment selection, outcomes of treatment, and implications for future research on the basis of clinical and molecular observations are the basis of the developmental schemata we propose. CONCLUSIONS Given the relatively benign nature of homogeneous, low volume Gleason 3 tumors, and the progressive risk of biochemical recurrence and prostate cancer specific mortality with increasing quantities of Gleason 4 components, we propose that Gleason 4 (and 5) cancers constitute cancer diatheses distinct from that of Gleason 3 cancer. This distinction may contribute to the understanding of the prognosis intrinsic to these biological behavioral patterns, and help guide the translation of findings at molecular and histological levels to a more precise selection of treatments.
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Affiliation(s)
- Hugh J Lavery
- Department of Urology, Mount Sinai Medical Center, New York, New York 10022, USA.
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Droller MJ, Bahnson RR, Lerner SP, Schoenberg M, Thalmann GA. Plagiarism. Urol Oncol 2012; 30:547-8. [DOI: 10.1016/j.urolonc.2012.06.004] [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]
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Abstract
PURPOSE Bladder cancer presents as a spectrum of different diatheses. Accurate assessment for individualized treatment depends on initial diagnostic accuracy. Detection relies on white light cystoscopy accuracy and comprehensiveness. Aside from invasiveness and potential risks, white light cystoscopy shortcomings include difficult flat lesion detection, precise tumor delineation to enable complete resection, inflammation and malignancy differentiation, and grade and stage determination. Each shortcoming depends on surgeon ability and experience with the technology available for visualization and resection. Fluorescence cystoscopy/photodynamic diagnosis, narrow band imaging, confocal laser endomicroscopy and optical coherence tomography address the limitations and have in vivo feasibility. They detect suspicious lesions (photodynamic diagnosis and narrow band imaging) and further characterize lesions (optical coherence tomography and confocal laser endomicroscopy). We analyzed the added value of each technology beyond white light cystoscopy and evaluated their maturity to alter the cancer course. MATERIALS AND METHODS Detailed PubMed® searches were done using the terms "fluorescence cystoscopy," "photodynamic diagnosis," "narrow band imaging," "optical coherence tomography" and "confocal laser endomicroscopy" with "optical imaging," "bladder cancer" and "urothelial carcinoma." Diagnostic accuracy reports and all prospective studies were selected for analysis. We explored technological principles, preclinical and clinical evidence supporting nonmuscle invasive bladder cancer detection and characterization, and whether improved sensitivity vs specificity translates into improved correlation of diagnostic accuracy with recurrence and progression. Emerging preclinical technologies with potential application were reviewed. RESULTS Photodynamic diagnosis and narrow band imaging improve nonmuscle invasive bladder cancer detection, including carcinoma in situ. Photodynamic diagnosis identifies more papillary lesions than white light cystoscopy, enabling more complete resection and fewer residual tumors. Despite improved treatment current data on photodynamic diagnosis do not support improved high risk diathetic detection and characterization or correlation with disease progression. Prospective recurrence data are lacking on narrow band imaging. Confocal laser endomicroscopy and optical coherence tomography potentially grade and stage lesions but data are lacking on diagnostic accuracy. Several emerging preclinical technologies may enhance the diagnostic capability of endoscopic imaging. CONCLUSIONS New optical imaging technologies may improve bladder cancer detection and characterization, and transurethral resection quality. While data on photodynamic diagnosis are strongest, the clinical effectiveness of these technologies is not proven. Prospective studies are needed, particularly of narrow band imaging, confocal laser endomicroscopy and optical coherence tomography. As each technology matures and new ones emerge, cost-effectiveness analysis must be addressed in the context of the various bladder cancer types.
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Affiliation(s)
- Jen-Jane Liu
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
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Droller MJ. Preface urologic issues for the internist. Med Clin North Am 2011; 95:xv-xvi. [PMID: 21095406 DOI: 10.1016/j.mcna.2010.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael J Droller
- Department of Urology, The Mount Sinai Medical Center, Box 1272, One Gustave L. Levy Place, New York, NY 10029, USA.
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Grossman HB, Stenzl A, Moyad MA, Droller MJ. Bladder Cancer: Chemoprevention, complementary approaches and budgetary considerations. ACTA ACUST UNITED AC 2010:213-33. [DOI: 10.1080/03008880802284258] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Arnulf Stenzl
- Eberhard-Karls-University Tuebingen, Tuebingen, Germany
| | - Mark A. Moyad
- University of Michigan Medical Center, Ann Arbor, Michigan, USA
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Droller MJ. Vigilance, Vigilance, Vigilance. J Urol 2010; 183:9-10. [DOI: 10.1016/j.juro.2009.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Shariat SF, Sfakianos JP, Droller MJ, Karakiewicz PI, Meryn S, Bochner BH. The effect of age and gender on bladder cancer: a critical review of the literature. BJU Int 2009; 105:300-8. [PMID: 19912200 DOI: 10.1111/j.1464-410x.2009.09076.x] [Citation(s) in RCA: 228] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
While patient age and gender are important factors in the clinical decision-making for treating urothelial carcinoma of the bladder (UCB), there are no evidence-based recommendations to guide healthcare professionals. We review previous reports on the influence of age and gender on the incidence, biology, mortality and treatment of UCB. Using MEDLINE, we searched for previous reports published between January 1966 and July 2009. While men are three to four times more likely to develop UCB than women, women present with more advanced disease and have worse survival rates. The disparity among genders is proposed to be the result of a differential exposure to carcinogens (i.e. tobacco and chemicals) as well as reflecting genetic, anatomical, hormonal, societal and environmental factors. Inpatient length of stay, referral patterns for haematuria and surgical outcomes suggest that inferior quality of care for women might be an additional cause of gender inequalities. Age is the greatest single risk factor for developing UCB and dying from it once diagnosed. Elderly patients face both clinical and institutional barriers to appropriate treatment; they receive less aggressive treatment and sub-therapeutic dosing. Much evidence suggests that chronological age alone is an inadequate indicator in determining the clinical and behavioural response of older patients to UCB and its treatment. Epidemiological and mechanistic molecular studies should be encouraged to design, analyse and report gender- and age-specific associations. Improved bladder cancer awareness in the lay and medical communities, careful patient selection, treatment tailored to the needs and the physiological and physical reserve of the individual patient, and proactive postoperative care are particularly important. We must strive to develop transdisciplinary collaborative efforts to provide tailored gender- and age-specific care for patients with UCB.
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Affiliation(s)
- Shahrokh F Shariat
- Division of Urology/Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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Abstract
INTRODUCTION Age is now widely accepted as the greatest single risk factor for developing bladder cancer, and bladder cancer is considered as primarily a disease of the elderly. Because of the close link between age and incidence of bladder cancer, it can be expected that this disease will become an enormous challenge with the growth of an aging population in the years ahead. METHODS Using MEDLINE, a search of the literature between January 1966 and July 2007 was performed to describe normative physiologic changes associated with aging, elucidate genetic and epigenetic alterations that associate aging with bladder cancer and its phenotypes; and to characterize how aging influences efficacies, risks, side effects, and potential complications of the treatments needed for the various stages of bladder cancer. RESULTS We discuss influence of aging on host physiology, genetic and epigenetic changes, environmental influences, and host factors in the development and treatment of bladder cancer. Treatments with intravesical bacille Calmette Guerin, radical cystectomy, and perioperative chemotherapy are less well tolerated and have poorer response in elderly patients compared with their younger counterparts. Elderly patients face both clinical and broader institutional barriers to appropriate treatment and may receive less aggressive treatment and sub-therapeutic dosing. However, when appropriately selected, elderly patients tolerate and respond well to cancer treatments. CONCLUSIONS The decision to undergo treatment for cancer is a tradeoff between loss of function and/or independence and extension of life, which is complicated by a host of concomitant issues such as comorbid medical conditions, functional declines and "frailty", family dynamics, and social and psychologic issues. Chronological age should not preclude definitive surgical therapy. It is imperative that healthcare practitioners and researchers from disparate disciplines collectively focus efforts towards gaining a better understanding of what the consequences of bladder cancer and its treatments are for older adults and how to appropriately meet the multifaceted medical and psychosocial needs of this growing population.
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Affiliation(s)
- Shahrokh F. Shariat
- Division of Urology, Sidney Kimmel Center for Prostate and Urologic Cancer, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Matthew Milowsky
- Genitourinary Oncology Service, Sidney Kimmel Center for Prostate and Urologic Cancer, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Michael J. Droller
- Department of Urology, The Mount Sinai Medical Center, New York, NY, USA
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Affiliation(s)
- Michael J Droller
- Department of Urology, The Mount Sinai Medical Center, New York, NY, USA
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Droller MJ. A Guideline for Discussion and Some Thoughts. J Urol 2009; 181:1530-1. [DOI: 10.1016/j.juro.2009.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- Lennart Andersson
- WHO Collaborating Center for Urologic Tumors, Karolinska University Hospital, Stockholm, Sweden
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Kakizoe T, Mucci LA, Albertsen PC, Droller MJ. Screening for bladder cancer: theoretical and practical issues in considering the treated and untreated natural history of the various forms of the disease. ACTA ACUST UNITED AC 2009:191-212. [PMID: 18815934 DOI: 10.1080/03008880802284936] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Screening is used to detect disease earlier in its course, allow earlier treatment, and presumably decrease morbidities and potential mortality associated with the later expression of more advanced disease and presumably more complex treatments consequently required. Judicious screening in bladder cancer depends on an understanding of how the different forms of bladder cancer express their biological potential, whether the tools available for screening have sufficient sensitivity and specificity to have accurate predictive value in accurately diagnosing and assessing each cancer diathesis earlier in its course, and how this may influence the morbidities and mortality associated with each. The principles of screening, potential biases that can affect their accuracy and the interpretation of outcomes, tools currently available for screening, their efficacies and pitfalls, and lessons learned from studies of the role of screening in prostate cancer will be reviewed to offer an understanding of the potential role that screening may play in the different forms of bladder cancer in the context of their preclinical and treated natural history.
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Affiliation(s)
- Tadao Kakizoe
- National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
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Droller MJ. Peer Review of Guidelines, Best Practice Statements and New Documents: What This Means for How We Use Them. J Urol 2008; 180:2297-8. [DOI: 10.1016/j.juro.2008.09.066] [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]
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Andersson L, Droller MJ, Adolfsson J, Månsson W, Kirkali Z, Boffetta P, Montironi R, Malmstrom PU, Tribukait B, Grossman HB. Chairmen's summary. Scand J Urol Nephrol Suppl 2008; 42:7-11. [PMID: 18815912 DOI: 10.1080/03008880802399684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Lennart Andersson
- WHO Collaborating Center for Urological Tumors, Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
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Abstract
Patient advocacy organizations play a critical role in increasing public awareness of a specific cancer and in demanding improvement in approaches to treatment. These organizations also can increase participation in clinical trials and help raise funds for research. But not all cancer patients are represented by advocacy organizations. Until the founding of the Bladder Cancer Advocacy Network in 2005, there was no patient advocacy group for bladder cancer despite the prevalence of the disease. Working with health care professionals, this new advocacy organization can facilitate further advances in research and treatment, leading possibly to a cure for bladder cancer.
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Droller MJ. Urologic cancer--when is less more? J Urol 2007; 178:1837-9. [PMID: 17869308 DOI: 10.1016/j.juro.2007.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fradet Y, Grossman HB, Gomella L, Lerner S, Cookson M, Albala D, Droller MJ. A Comparison of Hexaminolevulinate Fluorescence Cystoscopy and White Light Cystoscopy for the Detection of Carcinoma In Situ in Patients With Bladder Cancer: A Phase III, Multicenter Study. J Urol 2007; 178:68-73; discussion 73. [PMID: 17499291 DOI: 10.1016/j.juro.2007.03.028] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE We compared hexaminolevulinate (Hexvix) fluorescence cystoscopy with white light cystoscopy for detecting carcinoma in situ. MATERIALS AND METHODS In this multicenter study 298 patients with known or suspected bladder cancer underwent bladder instillation with 50 ml 8 mM hexaminolevulinate for 1 hour. Cystoscopy was then performed, first using standard white light and then hexaminolevulinate fluorescence cystoscopy. Lesions or suspicious areas identified under the 2 illumination conditions were mapped and biopsied for histological examination. In addition, 1 directed biopsy was obtained from an area appearing to be normal. RESULTS Of 196 evaluable patients 29.6% (58 of 196) had carcinoma in situ, including 18 with carcinoma in situ alone, and 35 with carcinoma in situ and concomitant papillary disease, which was only detected on random biopsy in 5. Of the 18 patients with no concomitant papillary disease carcinoma in situ was detected only by hexaminolevulinate fluorescence in 4 and only by white light in 4. In the group with concomitant papillary disease carcinoma in situ was found only by hexaminolevulinate fluorescence in 5 patients and only by white light in 3. The proportion of patients in whom 1 or more carcinoma in situ lesions were found only by hexaminolevulinate cystoscopy was greater than the hypothesized 5% (p=0.0022). Overall more carcinoma in situ lesions were found by hexaminolevulinate than by white light cystoscopy in 22 of 58 patients (41.5%), while the converse occurred in 8 of 58 (15.1%). Biopsy results confirmed cystoscopy findings. Of a total of 113 carcinoma in situ lesions in 58 patients 104 (92%) were detected by hexaminolevulinate cystoscopy and 77 (68%) were detected by white light cystoscopy, while 5 were detected only on directed visually normal mucosal biopsy. Hexaminolevulinate instillation was well tolerated with no local or systemic side effects. CONCLUSIONS In patients with bladder cancer hexaminolevulinate fluorescence cystoscopy with blue light can diagnose carcinoma in situ that may be missed with white light cystoscopy. Hexaminolevulinate fluorescence cystoscopy can be used in conjunction with white light cystoscopy to aid in the diagnosis of this form of bladder cancer.
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Affiliation(s)
- Yves Fradet
- L'Hotel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Québec, Province de Québec, Canada
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Grossman HB, Gomella L, Fradet Y, Morales A, Presti J, Ritenour C, Nseyo U, Droller MJ. A phase III, multicenter comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of superficial papillary lesions in patients with bladder cancer. J Urol 2007; 178:62-7. [PMID: 17499283 DOI: 10.1016/j.juro.2007.03.034] [Citation(s) in RCA: 219] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Indexed: 11/17/2022]
Abstract
PURPOSE We compared hexaminolevulinate fluorescence cystoscopy with white light cystoscopy for detecting Ta and T1 papillary lesions in patients with bladder cancer. MATERIALS AND METHODS A total of 311 patients with known or suspected bladder cancer underwent bladder instillation with 50 ml 8 mM HAL for 1 hour. The bladder was inspected using white light cystoscopy, followed by blue light (fluorescence) cystoscopy. Papillary lesions were mapped and resected for histological examination. RESULTS Noninvasive pTa tumors were found in 108 of 196 evaluable patients (55.1%). In 31 patients (29%) at least 1 more tumor was detected by HAL than by white light cystoscopy (p<0.05). Six of these patients had no lesions detected by white light, 12 had 1 lesion detected by white light and more than 1 by HAL, and 13 had multiple Ta lesions detected by the 2 methods. Conversely at least 1 more tumor was detected by white light cystoscopy than by HAL cystoscopy in 10 patients (9%, 95% CI 5-16). Tumors invading the lamina propria (T1) were found in 20 patients (10.2%). At least 1 additional T1 tumor was detected by HAL but not by white light cystoscopy in 3 of these patients (15%), while at least 1 more T1 tumor was detected by white light cystoscopy than by HAL cystoscopy in 1 patient (5%, 95% CI 0-25). Detection rates for Ta tumors were 95% for HAL cystoscopy and 83% for white light cystoscopy (p=0.0001). Detection rates were 95% and 86%, respectively, for T1 tumors (p=0.3). HAL instillation was well tolerated with few local or systemic side effects. CONCLUSIONS HAL fluorescence cystoscopy detected at least 1 more Ta and T1 papillary tumor than white light cystoscopy in approximately a third of the patients with such tumors. Whether this would translate to improved patient outcomes has yet to be determined.
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Affiliation(s)
- H Barton Grossman
- University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA, and L'Hotel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Canada
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Droller MJ. Re: Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay. Eur Urol 2006; 50:1119-20. [DOI: 10.1016/j.eururo.2006.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Michael J. Droller
- Department of Urology, Mount Sinai School of Medicine, New York, New York
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Droller MJ. We Need to Lead and Not Be Led. J Urol 2006; 176:861-2. [PMID: 16890638 DOI: 10.1016/j.juro.2006.06.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lokeshwar VB, Habuchi T, Grossman HB, Murphy WM, Hautmann SH, Hemstreet GP, Bono AV, Getzenberg RH, Goebell P, Schmitz-Dräger BJ, Schalken JA, Fradet Y, Marberger M, Messing E, Droller MJ. Bladder tumor markers beyond cytology: International Consensus Panel on bladder tumor markers. Urology 2006; 66:35-63. [PMID: 16399415 DOI: 10.1016/j.urology.2005.08.064] [Citation(s) in RCA: 295] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2005] [Accepted: 08/08/2005] [Indexed: 12/27/2022]
Abstract
This is the first of 2 articles that summarize the findings of the International Consensus Panel on cytology and bladder tumor markers. The objectives of our panel were to reach a consensus on the areas where markers are needed, to define the attributes of an ideal tumor marker, and to identify which marker(s) would be suitable for diagnosis and/or surveillance of bladder cancer. Our panel consisted of urologists and researchers from Europe, Asia, and the United States who reviewed original articles, reviews, and book chapters on individual bladder tumor markers published in the English language mainly using the PubMed search engine. Panel members also met during 3 international meetings to write recommendations regarding bladder tumor markers. The panel found that the most practical use of noninvasive tests is to monitor bladder cancer recurrence, thereby reducing the number of surveillance cystoscopies performed each year. Markers also may be useful in the screening of high-risk individuals for early detection of bladder cancer. However, more prospective studies are needed to strengthen this argument. Case-control and cohort studies show that several markers have a higher sensitivity to detect bladder cancer. However, cytology is the superior marker in terms of specificity, although some markers in limited numbers of studies have shown specificity equivalent to that of cytology. Our panel believes that several bladder tumor markers are more accurate in detecting bladder cancer than prostate-specific antigen (PSA) is in detecting prostate cancer. However, bladder tumor markers are held to a higher standard than PSA. Therefore, use of bladder tumor markers in the management of patients with bladder cancer will require the willingness of both urologists and clinicians to accept them.
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Habuchi T, Marberger M, Droller MJ, Hemstreet GP, Grossman HB, Schalken JA, Schmitz-Dräger BJ, Murphy WM, Bono AV, Goebell P, Getzenberg RH, Hautmann SH, Messing E, Fradet Y, Lokeshwar VB. Prognostic markers for bladder cancer: International Consensus Panel on bladder tumor markers. Urology 2005; 66:64-74. [PMID: 16399416 DOI: 10.1016/j.urology.2005.08.065] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [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] [Received: 05/16/2005] [Accepted: 08/08/2005] [Indexed: 10/25/2022]
Abstract
The International Consensus Panel on cytology and bladder tumor markers evaluated markers that have the ability to predict tumor recurrence, progression, development of metastases, or response to therapy or patient survival. This article summarizes those findings. The panel mainly reviewed articles listed in PubMed on various prognostic indicators for bladder cancer. Based on these studies, most of which were case-control retrospective studies, various prognostic indicators were classified into 6 groups: (1) microsatellite-associated markers, (2) proto-oncogenes/oncogenes, (3) tumor suppressor genes, (4) cell cycle regulators, (5) angiogenesis-related factors, and (6) extracellular matrix adhesion molecules. The panel concluded that although certain markers, such as Ki-67 and p53, appear to be promising in predicting recurrence and progression of bladder cancer, the data are still heterogeneous. The panel recommends that identifying definitive criteria for test positivity, a clearly defined patient population, standardization of techniques used to evaluate markers, and clearly specified endpoints and statistical methods will help to bring accurate independent prognostic indicators into the clinical management of patients with bladder cancer.
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Abstract
In bladder cancer, variations in clinical course and treatment outcomes support the concept that the condition may comprise a compendium of different types of tumor diathesis with unique, albeit interrelated, pathways of development. This concept and the schema of developmental pathways of bladder cancer derived from it are intended to complement the traditional classification used to stage bladder cancer, providing a perspective on the potential evolution of a particular malignancy over time. The schema represents the intrinsic biologic potential of various types of bladder cancer. It also indicates a given tumor's likely behavior as can be predicted by its histopathologic appearance at a given point in time, what may be expected through specific interventions, how approaches to treatment may need to be adjusted in considering the pathway a specific tumor may follow, as well as how the disease course may reflect genetic changes associated with the generation of a specific malignant diathesis. These considerations and the concept of specific but interrelated pathways of development in bladder cancer are presented in their historical context and current clinical use.
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Affiliation(s)
- Michael J Droller
- Department of Urology, Mount Sinai Medical Center, New York, New York 10029-6574, USA.
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Lehrer S, Diamond EJ, Mamkine B, Droller MJ, Stone NN, Stock RG. C-reactive protein is significantly associated with prostate-specific antigen and metastatic disease in prostate cancer. BJU Int 2005; 95:961-2. [PMID: 15839913 DOI: 10.1111/j.1464-410x.2005.05447.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [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: 11/29/2022]
Abstract
OBJECTIVE To further analyse the relationship of c-reactive protein (CRP) levels to prostate cancer, by measuring CRP in men with prostate cancer and benign prostatic hypertrophy (BPH), as chronic inflammation has long been linked to cancers with an infectious cause and CRP is a nonspecific marker for inflammation, associated with prostate cancer incidence and progression. PATIENTS AND METHODS Data from 114 men, most of whom had had radioactive seeds implanted, were evaluated from November 1990 to April 2002. In addition, 27 men were included who had biopsy-confirmed BPH. CRP was assessed with an automated chemiluminometric high-sensitivity assay kit. RESULTS There was no significant difference in CRP levels in men with localized prostate cancer or BPH but levels were significantly higher in men with bone metastases. There was also a significant correlation of CRP level with prostate-specific antigen (PSA) in those with cancer. Because PSA is correlated with disease stage, multiple linear regression was used with CRP as the dependent variable, and PSA and disease stage as independent variables. The regression was significant overall (P < 0.001) and the effect of disease stage on CRP (P < 0.001) was independent of the effect of PSA level (P = 0.001). CONCLUSION The strong association of CRP with PSA, independent of tumour stage, suggests that inflammation might be fundamental in prostate cancer, and that chronic inflammation may be a legitimate target for prostate cancer chemoprevention and treatment.
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Affiliation(s)
- Steven Lehrer
- Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY 10029, USA.
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Droller MJ. A Model for 3-Dimensional Growth of Bladder Cancers to Investigate Cell-Matrix Interactions. J Urol 2004. [DOI: 10.1016/s0022-5347(05)60946-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Droller MJ. DD23 Biomarker. A Prospective Clinical Assessment in Routine Urinary Cytology Specimens From Patients Being Monitored for TCC. J Urol 2004. [DOI: 10.1016/s0022-5347(05)60947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Droller MJ. Comparison of Telomerase Activity and Matrix Metalloproteinase-9 in Voided Urine and Bladder Wash Samples as a Useful Diagnostic Tool for Bladder Cancer. J Urol 2004. [DOI: 10.1016/s0022-5347(05)60942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Droller MJ. FGFR3 and P53 Characterize Alternative Genetic Pathways in the Pathogenesis of Urothelial Cell Carcinoma. J Urol 2004. [DOI: 10.1016/s0022-5347(05)60945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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