33 results on '"Fajkovic, Harun"'
Search Results
2. Direct Patlak Reconstruction of [68Ga]Ga-PSMA PET for the Evaluation of Primary Prostate Cancer Prior Total Prostatectomy: Results of a Pilot Study
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Rasul, Sazan, primary, Geist, Barbara Katharina, additional, Einspieler, Holger, additional, Fajkovic, Harun, additional, Shariat, Shahrokh F., additional, Schmitl, Stefan, additional, Mitterhauser, Markus, additional, Bartosch, Rainer, additional, Langsteger, Werner, additional, Baltzer, Pascal Andreas Thomas, additional, Beyer, Thomas, additional, Ferrara, Daria, additional, Haug, Alexander R., additional, Hacker, Marcus, additional, and Rausch, Ivo, additional
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- 2023
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3. Oncological and safety profiles in patients undergoing simultaneous <scp>transurethral resection (TUR) of bladder tumour</scp> and <scp>TUR of the prostate</scp>
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Laukhtina, Ekaterina, Moschini, Marco, Krajewski, Wojciech, Teoh, Jeremy Yuen-Chun, Ploussard, Guillaume, Soria, Francesco, Roghmann, Florian, Muenker, Mara Anna, Roumiguie, Mathieu, Alvarez-Maestro, Mario, Misrai, Vincent, Antonelli, Alessandro, Tafuri, Alessandro, Simone, Giuseppe, Mastroianni, Riccardo, Zhao, Hongda, Rahota, Razvan-George, D'Andrea, David, Mori, Keiichiro, Albisinni, Simone, Karakiewicz, Pierre I, Fajkovic, Harun, Enikeev, Dmitry, Montorsi, Francesco, Shariat, Shahrokh F, and Pradere, Benjamin
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#UroBPH ,#blcsm ,#uroonc ,TURP ,Settore MED/24 ,TURB ,BPH ,Urology ,#BladderCancer ,bladder cancer ,simultaneous - Abstract
To determine the oncological impact and adverse events of performing simultaneous transurethral resection of bladder tumour (TURB) and transurethral resection of the prostate (TURP), as evidence on the outcomes of simultaneous TURB for bladder cancer and TURP for obstructive benign prostatic hyperplasia is limited and contradictory.Patients from 12 European hospitals treated with either TURB alone or simultaneous TURB and TURP (TURB+TURP) were retrospectively analysed. A propensity score matching (PSM) 1:1 was performed with patients from the TURB+TURP group matched to TURB-alone patients. Associations between surgery approach with recurrence-free (RFS) and progression-free (PFS) survivals were assessed in Cox regression models before and after PSM. We performed a subgroup analysis in patients with risk factors for recurrence (multifocality and/or tumour size3 cm).A total of 762 men were included, among whom, 76% (581) underwent a TURB alone and 24% (181) a TURB+TURP. There was no difference in terms of tumour characteristics between the groups. We observed comparable length of stay as well as complication rates including major complications (Clavien-Dindo Grade ≥III) for the TURB-alone vs TURB+TURP groups, while the latest led to longer operative time (P 0.001). During a median follow-up of 44 months, there were more recurrences in the TURB-alone (47%) compared to the TURB+TURP group (28%; P 0.001). Interestingly, there were more recurrences at the bladder neck/prostatic fossa in the TURB-alone group (55% vs 3%, P 0.001). TURB+TURP procedures were associated with improved RFS (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.29-0.53; P 0.001), but not PFS (HR 1.63, 95% CI 0.90-2.98; P = 0.11). Within the PSM cohort of 254 patients, the simultaneous TURB+TURP was still associated with improved RFS (HR 0.33, 95% CI 0.22-0.49; P 0.001). This was also true in the subgroup of 380 patients with recurrence risk factors (HR 0.41, 95% CI 0.28-0.62; P 0.001).In our contemporary cohort, simultaneous TURB and TURP seems to be an oncologically safe option that may, even, improve RFS by potentially preventing disease recurrence at the bladder neck and in the prostatic fossa.
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- 2022
4. Critical Role of Neprilysin in Kidney Angiotensin Metabolism
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Kaltenecker, Christopher C., Domenig, Oliver, Kopecky, Chantal, Antlanger, Marlies, Poglitsch, Marko, Berlakovich, Gabriela, Kain, Renate, Stegbauer, Johannes, Rahman, Masudur, Hellinger, Roland, Gruber, Christian, Grobe, Nadja, Fajkovic, Harun, Eskandary, Farsad, Böhmig, Georg A., Säemann, Marcus D., and Kovarik, Johannes J.
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- 2020
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5. Elevated preoperative neutrophil–lymphocyte ratio predicts upgrading at radical prostatectomy
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Özsoy, Mehmet, Moschini, Marco, Fajkovic, Harun, Soria, Francesco, Seitz, Christian, Klatte, Tobias, Gust, Kilian, Briganti, Alberto, Karakiewicz, Pierre I., Roupret, Morgan, Kramer, Gero, and Shariat, Shahrokh F.
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- 2018
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6. A Review of How Lasers Are Used in UTUC Surgery: Can the Choice of Laser Affect Outcomes?
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Taratkin, Mark, primary, Singla, Nirmish, additional, Babaevskaya, Diana, additional, Androsov, Alexander, additional, Shariat, Shahrokh F., additional, Fajkovic, Harun, additional, Baniel, Jack, additional, and Enikeev, Dmitry, additional
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- 2023
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7. Direct Patlak Reconstruction of [ 68 Ga]Ga-PSMA PET for the Evaluation of Primary Prostate Cancer Prior Total Prostatectomy: Results of a Pilot Study.
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Rasul, Sazan, Geist, Barbara Katharina, Einspieler, Holger, Fajkovic, Harun, Shariat, Shahrokh F., Schmitl, Stefan, Mitterhauser, Markus, Bartosch, Rainer, Langsteger, Werner, Baltzer, Pascal Andreas Thomas, Beyer, Thomas, Ferrara, Daria, Haug, Alexander R., Hacker, Marcus, and Rausch, Ivo
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ENDORECTAL ultrasonography ,POSITRON emission tomography ,PROSTATE ,PROSTATE cancer ,PROSTATECTOMY ,PROSTATE cancer patients ,RADICAL prostatectomy - Abstract
To investigate the use of kinetic parameters derived from direct Patlak reconstructions of [
68 Ga]Ga-PSMA-11 positron emission tomography/computed tomography (PET/CT) to predict the histological grade of malignancy of the primary tumor of patients with prostate cancer (PCa). Thirteen patients (mean age 66 ± 10 years) with a primary, therapy-naïve PCa (median PSA 9.3 [range: 6.3–130 µg/L]) prior radical prostatectomy, were recruited in this exploratory prospective study. A dynamic whole-body [68 Ga]Ga-PSMA-11 PET/CT scan was performed for all patients. Measured quantification parameters included Patlak slope (Ki: absolute rate of tracer consumption) and Patlak intercept (Vb: degree of tracer perfusion in the tumor). Additionally, the mean and maximum standardized uptake values (SUVmean and SUVmax) of the tumor were determined from a static PET 60 min post tracer injection. In every patient, initial PSA (iPSA) values that were also the PSA level at the time of the examination and final histology results with Gleason score (GS) grading were correlated with the quantitative readouts. Collectively, 20 individual malignant prostate lesions were ascertained and histologically graded for GS with ISUP classification. Six lesions were classified as ISUP 5, two as ISUP 4, eight as ISUP 3, and four as ISUP 2. In both static and dynamic PET/CT imaging, the prostate lesions could be visually distinguished from the background. The average values of the SUVmean, slope, and intercept of the background were 2.4 (±0.4), 0.015 1/min (±0.006), and 52% (±12), respectively. These were significantly lower than the corresponding parameters extracted from the prostate lesions (all p < 0.01). No significant differences were found between these values and the various GS and ISUP (all p > 0.05). Spearman correlation coefficient analysis demonstrated a strong correlation between static and dynamic PET/CT parameters (all r ≥ 0.70, p < 0.01). Both GS and ISUP grading revealed only weak correlations with the mean and maximum SUV and tumor-to-background ratio derived from static images and dynamic Patlak slope. The iPSA demonstrated no significant correlation with GS and ISUP grading or with dynamic and static PET parameter values. In this cohort of mainly high-risk PCa, no significant correlation between [68 Ga]Ga-PSMA-11 perfusion and consumption and the aggressiveness of the primary tumor was observed. This suggests that the association between SUV values and GS may be more distinctive when distinguishing clinically relevant from clinically non-relevant PCa. [ABSTRACT FROM AUTHOR]- Published
- 2023
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8. Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review
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Vartolomei, Mihai Dorin, primary, Remzi, Mesut, additional, Fajkovic, Harun, additional, and Shariat, Shahrokh F., additional
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- 2022
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9. Training in ureteroscopy for urolithiasis
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Seitz, Christian and Fajkovic, Harun
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- 2014
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10. The significance of De Ritis ratio in patients with radiation-recurrent prostate cancer undergoing salvage radical prostatectomy
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Quhal, Fahad, primary, Abufaraj, Mohammad, additional, Janisch, Florian, additional, Mori, Keiichiro, additional, Lysenko, Ivan, additional, Mostafaei, Hadi, additional, D’Andrea, David, additional, Mathieu, Romain, additional, Enikeev, Dmitry V., additional, Fajkovic, Harun, additional, Heidenreich, Axel, additional, and Shariat, Shahrokh F., additional
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- 2020
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11. Der Einfluss von Früh- und Spätrezidiv auf das Überleben von Patienten mit Nierenzellkarzinom nach Nephrektomie
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Omid, Sara, D'Andrea, David, Garstka, Nathalie, Fajkovic, Harun, Abufaraj, Mohammad, Shariat, Shahrohk F., and Remzi, Mesut
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Ziel dieser Studie war es, das Gesamtüberleben von Patienten mit Nierenzellkarzinom, die nach partieller/radikaler Nephrektomie in kurativer Absicht ein Früh- (≤5 Jahren) oder Spätrezidiv (>5 Jahren) erlitten hatten, zu evaluieren. Wir nahmen an, dass eine[zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung
- Published
- 2019
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12. Sunitinib Dose Escalation in Metastatic Renal Cell Carcinoma
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Bruchbacher, Andreas, primary, Nachbargauer, Sebastian, additional, Fajkovic, Harun, additional, and Schmidinger, Manuela, additional
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- 2019
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13. Adjuvant cisplatin-based combined chemotherapy for lymph node (LN)-positive urothelial carcinoma of the bladder (UCB) after radical cystectomy (RC): a retrospective international study of > 1500 patients
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Lucca Ilaria, Roupret Morgan, Kluth Luis, Rink Michael, Tilki Derya, Fajkovic Harun, Kassouf Wassim, Hofbauer Sebastian L., de Martino Michela, Karakiewicz Pierre I., BRIGANTI , ALBERTO, Quoc dien Trinh, Seitz Christian, Fritsche Hans Martin, Burger Maximilian, Lotan Yair, Kramer Gero, Shariat Shahrokh F., Klatte Tobias, Lucca, Ilaria, Roupret, Morgan, Kluth, Lui, Rink, Michael, Tilki, Derya, Fajkovic, Harun, Kassouf, Wassim, Hofbauer Sebastian, L., de Martino, Michela, Karakiewicz Pierre, I., Briganti, Alberto, Quoc dien, Trinh, Seitz, Christian, Fritsche Hans, Martin, Burger, Maximilian, Lotan, Yair, Kramer, Gero, Shariat Shahrokh, F., and Klatte, Tobias
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Male ,Carcinoma, Transitional Cell ,Urology ,Lymphatic Metastasi ,Middle Aged ,Cystectomy ,survival ,urothelial carcinoma of bladder ,adjuvant chemotherapy ,Antineoplastic Agent ,Survival Rate ,Chemotherapy, Adjuvant ,Retrospective Studie ,Urinary Bladder Neoplasm ,Drug Therapy, Combination ,Female ,Cisplatin ,radical cystectomy ,lymph node positive ,Aged ,Human - Abstract
Objective To compare outcomes of patients with lymph node (LN)-positive urothelial carcinoma of the bladder (UCB) treated with or without cisplatin-based combined adjuvant chemotherapy (AC) after radical cystectomy (RC). Patients and Methods We retrospectively analysed 1523 patients with LN-positive UCB, who underwent RC with bilateral pelvic LN dissection. All patients had no evidence of disease after RC. AC was administered within 3 months. Competing-risks models were applied to compare UCB-related mortality. Results Of the 1523 patients, 874 (57.4%) received AC. The cumulative 1-, 2- and 5-year UCB-related mortality rates for all patients were 16%, 36% and 56%, respectively. Administration of AC was associated with an 18% relative reduction in the risk of UCB-related death (subhazard ratio 0.82, P = 0.005). The absolute reduction in mortality was 3.5% at 5 years. The positive effect of AC was detectable in patients aged â¤70 years, in women, in pT3-4 disease, and in those with a higher LN density and lymphovascular invasion. This study is limited by its retrospective and non-randomised design, selection bias, the absence of central pathological review and lack in standardisation of LN dissection and cisplatin-based protocols. Conclusion AC seems to reduce UCB-related mortality in patients with LN-positive UCB after RC. Younger patients, women and those with high-risk features such as pT3-4 disease, a higher LN density and lymphovascular invasion appear to benefit most. Appropriately powered prospective randomised trials are necessary to confirm these findings.
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- 2015
14. Elevated preoperative neutrophil–lymphocyte ratio predicts upgrading at radical prostatectomy
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Özsoy, Mehmet, primary, Moschini, Marco, additional, Fajkovic, Harun, additional, Soria, Francesco, additional, Seitz, Christian, additional, Klatte, Tobias, additional, Gust, Kilian, additional, Briganti, Alberto, additional, Karakiewicz, Pierre I., additional, Roupret, Morgan, additional, Kramer, Gero, additional, and Shariat, Shahrokh F., additional
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- 2017
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15. Female with bladder cancer: what and why is there a difference?
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Marks, Phillip, primary, Soave, Armin, additional, Shariat, Shahrokh F., additional, Fajkovic, Harun, additional, Fisch, Margit, additional, and Rink, Michael, additional
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- 2016
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16. DOES INCREASING THE NODAL YIELD IMPROVE OUTCOMES IN PATIENTS WITHOUT NODAL METASTASIS AT RADICAL PROSTATECTOMY?
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Kluth Luis A., Xylinas Evanguelos, Chun Felix K. H., Fajkovic Harun, Karakiewicz Pierre I., Passoni Niccolo, Schmid Marianne, Herman Mike, Lotan Yair, Seitz Christian, Schramek Paul, Remzi Mesut, Loidl Wolfgang, Guillonneau Bertrand, Scherr Douglas S., Graefen Markus, Tewari Ashutosh, Shariat Shahrokh F., BRIGANTI , ALBERTO, Kluth Luis, A., Xylinas, Evanguelo, Chun Felix, K. H., Fajkovic, Harun, Karakiewicz Pierre, I., Passoni, Niccolo, Schmid, Marianne, Herman, Mike, Lotan, Yair, Seitz, Christian, Schramek, Paul, Remzi, Mesut, Loidl, Wolfgang, Guillonneau, Bertrand, Briganti, Alberto, Scherr Douglas, S., Graefen, Marku, Tewari, Ashutosh, and Shariat Shahrokh, F.
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- 2013
17. Quantitative Apparent Diffusion Coefficient Measurements Obtained by 3-Tesla MRI Are Correlated with Biomarkers of Bladder Cancer Proliferative Activity
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Sevcenco, Sabina, primary, Haitel, Andrea, additional, Ponhold, Lothar, additional, Susani, Martin, additional, Fajkovic, Harun, additional, Shariat, Shahrokh F., additional, Hiess, Manuela, additional, Spick, Claudio, additional, Szarvas, Tibor, additional, and Baltzer, Pascal A. T., additional
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- 2014
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18. Upper urinary tract urothelial carcinoma: what have we learned in the last 4 years?
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Remzi, Mesut, primary, Shariat, Shahrokh, additional, Huebner, Wilhelm, additional, Fajkovic, Harun, additional, and Seitz, Christian, additional
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- 2011
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19. Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma
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Romain Mathieu, Vitaly Margulis, Michael Rink, Alberto Briganti, Christian Seitz, Aurélie Mbeutcha, Harun Fajkovic, Pierre I. Karakiewicz, Morgan Rouprêt, Tobias Klatte, Mesut Remzi, Ilaria Lucca, Shahrokh F. Shariat, Mihai Dorin Vartolomei, Karim Bensalah, Medizinische Universität Wien = Medical University of Vienna, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Urology, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Weill Medical College of Cornell University [New York], Department of Experimental Pharmacology and Toxicology, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE)-Cardiovascular Research Center, Hospital Weinviertel-Korneuburg-Landesklinikum Korneuburg, Hospital Barmherzige Brüder, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Fajkovic, Harun, Shariat, Shahrokh F., Klatte, Tobia, Vartolomei, Mihai Dorin, Lucca, Ilaria, Mbeutcha, Aurélie, Rouprêt, Morgan, Briganti, Alberto, Karakiewicz, Pierre I., Margulis, Vitaly, Rink, Michael, Remzi, Mesut, Seitz, Christian, Bensalah, Karim, Mathieu, Romain, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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Male ,Oncology ,Time Factors ,Survival ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Nephrectomy ,0302 clinical medicine ,Risk Factors ,Retrospective Studie ,Cytoreductive nephrectomy ,Renal cell carcinoma ,Renal carcinoma ,Smoking status ,Smoking ,Kidney Neoplasm ,Cytoreduction Surgical Procedures ,Kidney Neoplasms ,3. Good health ,Europe ,Survival Rate ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cohort ,Female ,Human ,United State ,medicine.medical_specialty ,Time Factor ,Urology ,survival ,Follow-Up Studie ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Carcinoma, Renal Cell ,Retrospective Studies ,Cytoreduction Surgical Procedure ,business.industry ,Proportional hazards model ,Risk Factor ,Retrospective cohort study ,medicine.disease ,Former Smoker ,United States ,Log-rank test ,Smoking statu ,Smoking cessation ,Neoplasm Recurrence, Local ,business ,Kidney cancer ,Follow-Up Studies - Abstract
International audience; OBJECTIVE: To assess the association of smoking status with standard clinicopathological features and overall survival (OS) in a large multi-institutional cohort of patients with metastatic renal cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CNT). METHODS: A total of 613 patients with mRCC treated with CNT in US and Europe institutions between 1990 and 2013 were included. Smoking history comprised smoking status, smoking duration in years, number of cigarettes per day and years since smoking cessation. Cumulative smoking exposure was categorized as light short term, heavy long term and moderate. Association between smoking history and OS was assessed by Cox regression logistic analysis. RESULTS: One hundred and seventy-one patients (27.9 %) never smoked, 193 (31.5 %) were former smokers and 249 (40.6 %) were current smokers. Smoking status was associated with a higher number of metastases (p \textless 0.001) and an abnormal preoperative corrected calcium level (p = 0.01). Median follow-up was 16 (IQR 7-24) months. Current smokers had a shorter OS than never and former smokers (log rank, p = 0.004). Smoking status was significantly associated with OS in univariable analysis (HR 1.45; 95 % CI 1.16-1.82; p \textless 0.001), and in multivariable analysis that adjusted for established prognostic factors (HR 1.46; 95 % CI 1.16-1.84; p = 0.002). Daily consumption of more than 20 cigarettes, more than 20 years of smoking exposure and heavy long exposure were all independent prognosticators of worse OS. CONCLUSIONS: Current smoking and a higher cumulative smoking exposure are associated with a higher risk of death in patients with mRCC treated with CNT. Even at this stage, smoking negatively affects kidney cancer outcomes
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- 2016
20. Predictors of Cancer-specific Survival After Disease Recurrence in Patients With Renal Cell Carcinoma: The Effect of Time to Recurrence
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Mikhail Regelman, Andrea Mari, Alberto Briganti, Vitaly Margulis, Shahrokh F. Shariat, Laura Maria Krabbe, Malte Rieken, Mohammad Abufaraj, Pierre I. Karakiewicz, Daniel Sjöberg, Harun Fajkovic, Umberto Capitanio, Sabine Brookman-May, Luis A. Kluth, Jay D. Raman, Beat Foerster, Rieken, Malte, Kluth, Luis A, Fajkovic, Harun, Capitanio, Umberto, Briganti, Alberto, Krabbe, Laura-Maria, Margulis, Vitaly, Abufaraj, Mohammad, Mari, Andrea, Foerster, Beat, Raman, Jay D, Regelman, Mikhail, Brookman-May, Sabine, Sjoberg, Daniel D, Karakiewicz, Pierre I, and Shariat, Shahrokh F
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Oncology ,Male ,medicine.medical_specialty ,Time Factors ,Prognosi ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Disease ,Nephrectomy ,Cancer specific survival ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Renal cell carcinoma ,Internal medicine ,medicine ,Humans ,In patient ,Carcinoma, Renal Cell ,Risk stratification ,Outcome ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Middle Aged ,medicine.disease ,Survival Analysis ,Kidney Neoplasms ,Regimen ,Time to recurrence ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,business ,Prediction - Abstract
A few studies addressed predictive factors of cancer-specific mortality (CSM) in patients with recurrent renal cell carcinoma (RCC) following surgery. Time to recurrence (TTR) is an important predictor of CSM in various types of cancers. The aim of our study was to describe the course of RCC following disease recurrence and to identify prognostic factors that influence CSM with a special focus on TTR.Retrospective analysis of 331 patients who experienced disease recurrence after radical nephrectomy (n = 307) or partial nephrectomy (n = 24) with curative intent. A Cox proportional hazards regression model addressed the association between various clinicopathologic features and CSM after disease recurrence. TTR was defined as time from surgery to occurrence of disease recurrence.Of the 331 patients, 232 (70%) were male, and 99 (30%) were female. The median age at surgery was 62 years (interquartile range, 53-69 years). Median time from nephrectomy to disease recurrence was 1.2 years (interquartile range, 0.5-3.3 years). Of the recurrences, 63 (19%) were local, and 268 (81%) were distant. Shorter time to recurrence (P = .0008), female gender (P = .035), and distant versus local recurrence location (P .0001) were found to be independently associated with CSM following disease recurrence.In patients experiencing disease recurrence after nephrectomy for presumably localized RCC, shorter TTR, female gender, and distant recurrence were found to be associated with worse CSM. The inclusion of these factors into risk-stratification tools may help patient counseling and decision-making regarding type and regimen of salvage treatment.
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- 2018
21. Prognostic value of Caveolin-1 in patients treated with radical prostatectomy: a multicentric validation study
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Shahrokh F. Shariat, Brian D. Robinson, Wolgang Loidl, Evanguelos Xylinas, Martin Susani, Morgan Rouprêt, Lukas Kenner, Michael Rink, Francesco Montorsi, Alberto Briganti, Christian Seitz, Yair Lotan, Maxine Sun, Luis A. Kluth, Aurélie Mbeutcha, Malte Rieken, Vitaly Margulis, Harun Fajkovic, Tobias Klatte, Ilaria Lucca, Pierre I. Karakiewicz, Douglas S. Scherr, Romain Mathieu, Mathieu, Romain, Klatte, Tobia, Lucca, Ilaria, Mbeutcha, Aurelie, Seitz, Christian, Karakiewicz Pierre, I., Fajkovic, Harun, Sun, Maxine, Lotan, Yair, Scherr Douglas, S., Montorsi, Francesco, Briganti, Alberto, Roupret, Morgan, Margulis, Vitaly, Rink, Michael, Kluth Luis, A., Rieken, Malte, Kenner, Luka, Susani, Martin, Robinson Brian, D., Xylinas, Evanguelo, Loidl, Wolgang, and Shariat Shahrokh, F.
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Male ,Biochemical recurrence ,Oncology ,Pathology ,medicine.medical_specialty ,Caveolin ,Prognosi ,Urology ,medicine.medical_treatment ,Caveolin 1 ,030232 urology & nephrology ,disease recurrence ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Retrospective Studie ,Interquartile range ,Internal medicine ,medicine ,Humans ,Lymph node ,Retrospective Studies ,Aged ,Prostatectomy ,Tissue microarray ,business.industry ,Hazard ratio ,breakpoint cluster region ,Prostatic Neoplasms ,Middle Aged ,Prognosis ,prostate cancer ,medicine.disease ,radical prostatectomy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Prostatic Neoplasm ,business ,Human - Abstract
Objective To validate Caveolin-1 as an independent prognostic marker of biochemical recurrence (BCR) in a large multi-institutional cohort of patients with prostate cancer treated with radical prostatectomy (RP). Patients and Methods Caveolin-1 expression was evaluated by immunochemistry on a tissue microarray in 3 117 patients treated with RP for prostate cancer at five institutions. Univariable and multivariable Cox proportional hazards regression models assessed the association of Caveolin-1 status with BCR. Harrell's c-index quantified prognostic accuracy. Results Caveolin-1 was overexpressed in 644 (20.6%) patients and was associated with higher pathological Gleason sum (P = 0.002) and lymph node metastases (P = 0.05). Within a median (interquartile range) follow-up of 38 (21–66) months, 617 (19.8%) patients experienced BCR. Patients with overexpression of Caveolin-1 had worse BCR-free survival than those with normal expression (log-rank test, P = 0.004). Caveolin-1 was an independent predictor of BCR in multivariable analyses that adjusted for the effects of standard clinicopathological features (hazard ratio 1.21, P = 0.037). Addition of Caveolin-1 in a model for prediction of BCR based on these standard prognosticators did not significantly improve the predictive accuracy of the model. In subgroup analyses, Caveolin-1 was associated with BCR in patients with favourable pathological features (pT2pN0 and Gleason score = 6; P = 0.021). Conclusions We confirmed that overexpression of Caveolin-1 is associated with adverse pathological features in prostate cancer and independently predicts BCR after RP, especially in patients with favourable pathological features. However, it did not add prognostically relevant information to established predictors of BCR, limiting its use in clinical practice.
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- 2015
22. Elevated preoperative neutrophil-lymphocyte ratio predicts upgrading at radical prostatectomy
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Alberto Briganti, Shahrokh F. Shariat, Pierre I. Karakiewicz, Harun Fajkovic, Tobias Klatte, Morgan Rouprêt, Kilian M. Gust, Mehmet Özsoy, Francesco Soria, Christian Seitz, Marco Moschini, Gero Kramer, Özsoy, Mehmet, Moschini, Marco, Fajkovic, Harun, Soria, Francesco, Seitz, Christian, Klatte, Tobia, Gust, Kilian, Briganti, Alberto, Karakiewicz, Pierre I., Roupret, Morgan, Kramer, Gero, and Shariat, Shahrokh F.
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Male ,Cancer Research ,medicine.medical_specialty ,Neutrophils ,Urology ,Lymphocyte ,medicine.medical_treatment ,Biopsy ,030232 urology & nephrology ,Gastroenterology ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Median follow-up ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,Lymphocytes ,Pathological ,Aged ,Prostatectomy ,Tumor ,medicine.diagnostic_test ,Proportional hazards model ,business.industry ,fungi ,Confounding ,Prostate ,Prostatic Neoplasms ,Middle Aged ,Neoplasm Grading ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Prostate surgery ,business ,Biomarkers - Abstract
Background: Neutrophilâlymphocyte ratio (NLR) is a widely used, representative marker of systemic inflammatory response within the body. NLR can be calculated from simple, inexpensive peripheral blood samples. High NLR is a negative prognostic factor in a variety of malignancies including urological tumors. In this study, we aim to assess the prognostic value of preoperative neutrophil- lymphocyte ratio (NLR) in patients treated with radical prostatectomy (RP) for localized prostate cancer (PCa). Materials and methods: Records of 7426 patients were retrospectively analyzed from prospectively collected datasets. A cut-off point of 3 was taken for NLR based on ROC analyses and previous literature. Results: 23% (n = 1707) of patients had an NLR of â¥3. Patients with NLR â¥3 were more likely to harbor unfavorable pathological features such as higher biopsy Gleason score (GS), higher RP GS, higher rates of extra capsular extension, nodal involvement (all p < 0.001) and positive surgical margins (p = 0.002). On multivariable analyses, NLR ⥠3 was associated with higher RP GS (OR 2.32; p < 0.001), seminal vesicle invasion (OR 1.60; p < 0.001) and nodal involvement (OR 1.43; p < 0.001). On multivariable analyses, NLR ⥠3 was significantly associated with GS upgrading at RP (OR 1.39 p < 0.001). During a median follow up of 45 months, NLR ⥠3 was associated with higher risk of BCR (p = 0.001). However, on multivariable Cox regression analysis such association was not shown (HR 0.86; p = 0.4). Conclusion: Preoperative NLR ⥠3 was associated with aggressive PCa, such as upgrading at RP. Even though its effect on clinical-decision making seems to be limited when all clinical and pathological confounders are taken into account, preoperative NLR may still be useful in selected patients to identify aggressive PCa helping patient selection for active surveillance protocols. Conversely, it does not predict BCR when adjusted for the effect of pathological features.
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- 2017
23. Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy
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Karim Bensalah, Nathalie Rioux-Leclercq, Evanguelos Xylinas, Shahrokh F. Shariat, Michael Rink, Christopher G. Wood, Aurélie Mbeutcha, Romain Mathieu, Ilaria Lucca, Vitaly Margulis, Christian Seitz, Alberto Briganti, Harun Fajkovic, Mihai Dorin Vartolomei, Morgan Rouprêt, Jay D. Raman, Andrea Haitel, Pierre I. Karakiewicz, Jose A. Karam, Alon Z. Weizer, Dept of Urology [Vienne], Medizinische Universität Wien = Medical University of Vienna, Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Dpt of Urology [Dallas], University of Texas Southwestern Medical Center [Dallas], Dpt of Urology [Houston], The University of Texas M.D. Anderson Cancer Center [Houston], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Dept of Urology [Lausanne ], Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Dpt of Urology [Michigan], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, Division of Urology - Penn State Milton S., S. Hershey Medical Center, Service de Pathologie [Rennes] = Pathology [Rennes], CHU Pontchaillou [Rennes], Dpt of Pathology [Vienna], Medical University of Vienna, Department of Pathology, Dpt of Urology [Hamburg], Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Dpt of Urology [Milan], Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics, Service d'urologie, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Dpt of Urology [New York], Weill Medical College of Cornell University [New York], Department of Urology, Comprehensive Cancer Center, General Hospital of Vienna, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Vartolomei, Mihai Dorin, Mathieu, Romain, Margulis, Vitaly, Karam, Jose A., Rouprêt, Morgan, Lucca, Ilaria, Mbeutcha, Aurélie, Seitz, Christian, Karakiewicz, Pierre I., Fajkovic, Harun, Wood, Christopher G., Weizer, Alon Z., Raman, Jay D., Rioux-Leclercq, Nathalie, Haitel, Andrea, Bensalah, Karim, Rink, Michael, Briganti, Alberto, Xylinas, Evanguelo, Shariat, Shahrokh F., Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Service de Pathologie [CHU Rennes]
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Male ,Recurrence Death ,Neutrophils ,Lymphovascular invasion ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Nephrectomy ,Gastroenterology ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Leukocyte Count ,0302 clinical medicine ,Retrospective Studie ,Recurrence ,Medicine ,Lymphocytes ,Multivariate Analysi ,Neutrophil-to-lymphocyte ratio ,Prognostic factor ,Neutrophil ,Kidney Neoplasm ,Ureteral Neoplasm ,Middle Aged ,Prognosis ,Kidney Neoplasms ,Tumor Burden ,3. Good health ,Death ,030220 oncology & carcinogenesis ,Lymphocyte ,Female ,Original Article ,Human ,medicine.medical_specialty ,Prognosi ,Urology ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Disease-Free Survival ,03 medical and health sciences ,Internal medicine ,Carcinoma ,Humans ,Lymphocyte Count ,Neutrophil to lymphocyte ratio ,Ureteral neoplasm ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Carcinoma, Transitional Cell ,Ureteral Neoplasms ,business.industry ,Proportional hazards model ,fungi ,Cancer ,Retrospective cohort study ,medicine.disease ,Surgery ,Multivariate Analysis ,Proportional Hazards Model ,Lymphadenectomy ,Ureter ,Urothelium ,business - Abstract
International audience; Objective: Several retrospective studies with small cohorts reported neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). We aimed at validating the predictive and prognostic role of NLR in a large multi-institutional cohort.Methods : Preoperative NLR was assessed in a multi-institutional cohort of 2477 patients with UTUC treated with RNU. Altered NLR was defined by a ratio >2.7. Logistic regression analyses were performed to assess the association between NLR and lymph node metastasis, muscle-invasive and non-organ-confined disease. The association of altered NLR with recurrence-free survival (RFS) and cancer-specific survival (CSS) was evaluated using Cox proportional hazards regression models.Results: Altered NLR was observed in 1428 (62.8 %) patients and associated with more advanced pathological tumor stage, lymph node metastasis, lymphovascular invasion, tumor necrosis and sessile tumor architecture. In a preoperative model that included age, gender, tumor location and architecture, NLR was an independent predictive factor for the presence of lymph node metastasis, muscle-invasive and non-organ-confined disease (p < 0.001). Within a median follow-up of 40 months (IQR 20–76 months), 548 (24.1 %) patients experienced disease recurrence and 453 patients (19.9 %) died from their cancer. Compared to patients with normal NLR, those with altered NLR had worse RFS (0.003) and CSS (p = 0.002). In multivariable analyses that adjusted for the effects of standard clinicopathologic features, altered NLR did not retain an independent value. In the subgroup of patients treated with lymphadenectomy in addition to RNU, NLR was independently associated with CSS (p = 0.03).Conclusion:In UTUC, preoperative NLR is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC such as lymph node metastasis, muscle-invasive or non-organ-confined status. NLR may help better risk stratify patients with regard to lymphadenectomy and conservative therapy.
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- 2017
24. Pathologic Nodal Staging Scores in Patients Treated with Radical Prostatectomy: A Postoperative Decision Tool
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Yair Lotan, Harun Fajkovic, Andreas Becker, Maxine Sun, Evanguelos Xylinas, Shahrokh F. Shariat, Mithat Gönen, Pierre I. Karakiewicz, Douglas S. Scherr, Alberto Briganti, Malte Rieken, Alessandro Nonis, Michael Herman, Karl Pummer, Francesco Montorsi, Felix K.-H. Chun, Markus Graefen, Luis A. Kluth, Paul Schramek, Firas Abdollah, Ashutosh K. Tewari, Wolfgang Loidl, Daniel Seiler, Christian Seitz, Richard K. Lee, Kluth, Luis A., Abdollah, Fira, Xylinas, Evanguelo, Rieken, Malte, Fajkovic, Harun, Sun, Maxine, Karakiewicz, Pierre I., Seitz, Christian, Schramek, Paul, Herman, Michael P., Becker, Andrea, Loidl, Wolfgang, Pummer, Karl, Nonis, Alessandro, Lee, Richard K., Lotan, Yair, Scherr, Douglas S., Seiler, Daniel, Chun, Felix K. -H., Graefen, Marku, Tewari, Ashutosh, Gönen, Mithat, Montorsi, Francesco, Shariat, Shahrokh F., and Briganti, Alberto
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Extended lymph node dissection ,Male ,medicine.medical_specialty ,Decision tool ,Pelvi ,Urology ,medicine.medical_treatment ,Nodal staging ,Decision Support Techniques ,Pelvis ,Lymph node metastasi ,Decision Support Technique ,Prostate cancer ,Retrospective Studie ,medicine ,Humans ,In patient ,Postoperative Period ,Risk factor ,False Negative Reactions ,Lymph node ,Aged ,Neoplasm Staging ,Probability ,Retrospective Studies ,Aged, 80 and over ,Prostatectomy ,business.industry ,Lymph Node ,Prostatic Neoplasms ,Lymphatic Metastasi ,Middle Aged ,False Negative Reaction ,medicine.disease ,Pelvic lymph node dissection ,Surgery ,Dissection ,Nodal yield ,medicine.anatomical_structure ,Lymphatic Metastasis ,Prostatic Neoplasm ,Lymph Node Excision ,Lymph Nodes ,Radiology ,business ,Human - Abstract
Background Nodal metastasis is the strongest risk factor of disease recurrence in patients with localized prostate cancer (PCa) treated with radical prostatectomy (RP). Objective To develop a model that allows quantification of the likelihood that a pathologically node-negative patient is indeed free of nodal metastasis. Design, setting, and participants Data from patients treated with RP and pelvic lymph node dissection (PLND; n = 7135) for PCa between 2000 and 2011 were analyzed. For external validation, we used data from patients (n = 4209) who underwent an anatomically defined extended PLND. Intervention RP and PLND. Outcome measurements and statistical analysis We developed a novel pathologic (postoperative) nodal staging score (pNSS) that represents the probability that a patient is correctly staged as node negative based on the number of examined nodes and the patient's characteristics. Results and limitations In the development and validation cohorts, the probability of missing a positive node decreases with an increasing number of nodes examined. Whereas in pT2 patients, a 90% pNSS was achieved with one single examined node in both the development and validation cohort, a similar level of nodal staging accuracy was achieved in pT3a patients by examining five and nine nodes, respectively. The pT3b/T4 patients achieved a pNSS of 80% and 70% when 17 and 20 nodes in the development and validation cohort were examined, respectively. This study is limited by its retrospective design and multicenter nature. The number of nodes removed was not directly correlated with the extent/template of PLND. Conclusions Every patient needs PLND for accurate nodal staging. However, a one-size-fits-all approach is too inaccurate. We developed a tool that indicates a node-negative patient is indeed free of lymph node metastasis by evaluating the number of examined nodes, pT stage, RP Gleason score, surgical margins, and prostate-specific antigen. This tool may help in postoperative decision making. © 2013 European Association of Urology.
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- 2014
25. Validation of lymphovascular invasion is an independent prognostic factor for biochemical recurrence after radical prostatectomy
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Alberto Briganti, Shahrokh F. Shariat, Nicolai Hübner, Yair Lotan, Martin Susani, Christian Seitz, Pierre I. Karakiewicz, Romain Mathieu, Luis A. Kluth, Morgan Rouprêt, Ilaria Lucca, Michael Rink, Wolfgang Loidl, Harun Fajkovic, Tobias Klatte, Gero Kramer, Richard K. Lee, Manuela Hiess, Fajkovic, Harun, Mathieu, Romain, Lucca, Ilaria, Hiess, Manuela, Hübner, Nicolai, Al Awamlh, Bashir Al Hussein, Lee, Richard, Briganti, Alberto, Karakiewicz, Pierre, Lotan, Yair, Roupret, Morgan, Rink, Michael, Kluth, Lui, Loidl, Wolfgang, Seitz, Christian, Klatte, Tobia, Kramer, Gero, Susani, Martin, and Shariat, Shahrokh F.
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Oncology ,Male ,Lymphovascular invasion ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Prostate cancer ,0302 clinical medicine ,Interquartile range ,Retrospective Studie ,Outcome Assessment, Health Care ,Medicine ,Multivariate Analysi ,Prostatectomy ,Prostate ,Lymph Node ,Middle Aged ,Prognosis ,Radical prostatectomy ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Human ,Biochemical recurrence ,medicine.medical_specialty ,Blood Vessel ,Prognosi ,Urology ,Follow-Up Studie ,03 medical and health sciences ,Outcome Assessment (Health Care) ,Internal medicine ,Humans ,Neoplasm Invasiveness ,Proportional Hazards Models ,Retrospective Studies ,Aged ,Localized prostate cancer ,Neoplasm Invasivene ,business.industry ,Proportional hazards model ,Prostatic Neoplasms ,Retrospective cohort study ,Lymphatic Metastasi ,medicine.disease ,Multivariate Analysis ,Prostatic Neoplasm ,Proportional Hazards Model ,Blood Vessels ,Lymph Node Excision ,Lymphadenectomy ,Lymph Nodes ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Objective: To validate the impact of lymphovascular invasion (LVI) on biochemical recurrence (BCR) in patients treated with radical prostatectomy (RP) in a large multiinstitutional cohort. Material and methods: Retrospective data from 6,678 patients treated with a RP and bilateral lymphadenectomy for prostate cancer (PC) from 8 centers were collected. The primary endpoint was BCR. Results: Overall, 767 patients (11.5%) had LVI. Patients with LVI had significantly higher Gleason scores (P = 0.01). After a median follow-up of 28 months (interquartile range: 21-44), patients with LVI had a 1.66 fold increased risk of BCR (P
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- 2016
26. Prognostic Value of Extranodal Extension and Other Lymph Node Parameters in Patients With Upper Tract Urothelial Carcinoma
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Jay D. Raman, Thomas F. Chromecki, Eugene K. Cha, Christian Seitz, Gerhard Donner, Harun Fajkovic, Claudio Jeldres, Karim Bensalah, Vitaly Margulis, Armin Pycha, Mesut Remzi, Giacomo Novara, Alon Z. Weizer, Yair Lotan, Wassim Kassouf, Vincenzo Ficarra, Kazumasa Matsumoto, Eiji Kikuchi, Francesco Montorsi, Marco Roscigno, Pierre I. Karakiewicz, Douglas S. Scherr, Eckart Breinl, Shahrokh F. Shariat, Weill Medical College of Cornell University [New York], Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Department of Urology, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Departement of Oncological and Surgical Sciences, Universita degli Studi di Padova, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], University of Michigan [Ann Arbor], University of Michigan System, Keio University School of Medicine [Tokyo, Japan], Hospital Weinviertel-Korneuburg-Landesklinikum Korneuburg, General Hospital of Bolzano, Health Robotics S.r.l., Department of urology, Università Vita-Salute San Raffaele, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Fajkovic, Harun, Cha Eugene, K., Jeldres, Claudio, Donner, Gerhard, Chromecki Thomas, F., Margulis, Vitaly, Novara, Giacomo, Lotan, Yair, Raman Jay, D., Kassouf, Wassim, Seitz, Christian, Bensalah, Karim, Weizer, Alon, Kikuchi, Eiji, Roscigno, Marco, Remzi, Mesut, Matsumoto, Kazumasa, Breinl, Eckart, Pycha, Armin, Ficarra, Vincenzo, Montorsi, Francesco, Karakiewicz Pierre, I., Scherr Douglas, S., and Shariat Shahrokh, F.
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Male ,Oncology ,MESH: Chi-Square Distribution ,urothelial carcinoma carcinoma ,MESH: Lymphatic Metastasis ,medicine.medical_treatment ,030232 urology & nephrology ,carcinoma ,Nephrectomy ,lymph node excision ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,MESH: Proportional Hazards Models ,neoplasm metastasis ,0302 clinical medicine ,Risk Factors ,MESH: Risk Factors ,MESH: Ureteral Neoplasms ,Stage (cooking) ,Lymph node ,Neoadjuvant therapy ,MESH: Treatment Outcome ,MESH: Statistics, Nonparametric ,MESH: Follow-Up Studies ,MESH: Neoplasm Staging ,Prognosis ,MESH: Urinary Bladder Neoplasms ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Chemotherapy, Adjuvant ,MESH: Chemotherapy, Adjuvant ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Female ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Lymph ,Radiology ,MESH: Neoplasm Recurrence, Local ,medicine.medical_specialty ,Urology ,urinary tract ,urothelium ,Statistics, Nonparametric ,MESH: Prognosis ,03 medical and health sciences ,Internal medicine ,medicine ,Carcinoma ,Humans ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Chi-Square Distribution ,MESH: Humans ,Ureteral Neoplasms ,MESH: Lymph Node Excision ,business.industry ,Carcinoma in situ ,MESH: Retrospective Studies ,Retrospective cohort study ,medicine.disease ,MESH: Male ,MESH: Nephrectomy ,Urinary Bladder Neoplasms ,Neoplasm Recurrence, Local ,business ,MESH: Female ,Follow-Up Studies - Abstract
International audience; PURPOSE: We assessed the prognostic value of extranodal extension and other lymph node parameters in a large multicenter cohort of patients with lymph node metastasis after radical nephroureterectomy. MATERIALS AND METHODS: We retrospectively analyzed the records of 222 patients with lymph node metastasis treated with radical nephroureterectomy for upper tract urothelial carcinoma without neoadjuvant therapy. Each lymph node metastasis was microscopically evaluated for extranodal extension. RESULTS: A median of 4 lymph nodes (IQR 8) was removed. Two lymph nodes (IQR 2) were positive. Lymph node density was 51.3% (IQR 71.7%). Overall 110 patients (49.5%) had extranodal extension, which was associated with more advanced pT stage (p = 0.026). On multivariable analysis extranodal extension was associated with disease recurrence (p = 0.01) and cancer specific mortality (p = 0.013). When stratified by a 30% cutoff, lymph node density was associated with disease recurrence and cancer specific mortality on univariable but not multivariable analysis (p = 0.048 and 0.049, respectively). Adding extranodal extension to a multivariable model including pT stage and tumor architecture improved predictive accuracy for disease recurrence from 70.3% to 74.5% (p
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- 2012
27. Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy
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Alberto Briganti, Karim Bensalah, Pierre I. Karakiewicz, Douglas S. Scherr, Morgan Rouprêt, Vitaly Margulis, Malte Rieken, Evanguelos Xylinas, Yair Lotan, Francesco Montorsi, Romain Mathieu, Christian Seitz, Maxine Sun, Luis A. Kluth, Markus Margreiter, Ilaria Lucca, Shahrokh F. Shariat, Harun Fajkovic, Alexander Bachman, Michael Rink, Brian D. Robinson, Ashutosh K. Tewari, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Medizinische Universität Wien = Medical University of Vienna, Weill Medical College of Cornell University [New York], Department of Urology, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Department of urology, Università Vita-Salute San Raffaele, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Department of Experimental Pharmacology and Toxicology, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE)-Cardiovascular Research Center, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mathieu, Romain, Shariat Shahrokh, F., Seitz, Christian, Karakiewicz Pierre, I., Fajkovic, Harun, Sun, Maxine, Lotan, Yair, Scherr Douglas, S., Tewari, Ashutosh, Montorsi, Francesco, Briganti, Alberto, Roupret, Morgan, Lucca, Ilaria, Margulis, Vitaly, Rink, Michael, Kluth Luis, A., Rieken, Malte, Bachman, Alexander, Xylinas, Evanguelo, Robinson Brian, D., Bensalah, Karim, and Margreiter, Markus
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Oncology ,Male ,Neoplasm, Residual ,Lymphovascular invasion ,medicine.medical_treatment ,030232 urology & nephrology ,Prostate cancer ,0302 clinical medicine ,Retrospective Studie ,biology ,Prostatectomy ,Kallikrein ,Middle Aged ,Prognosis ,Radical prostatectomy ,Immunohistochemistry ,3. Good health ,Prostate-specific antigen ,Local ,030220 oncology & carcinogenesis ,Ki-67 ,Residual ,Kallikreins ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Human ,Biochemical recurrence ,Adult ,medicine.medical_specialty ,Prognosi ,Urology ,03 medical and health sciences ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,prostate-specific antigen ,Neoplasm Invasiveness ,Aged ,Neoplasm Staging ,Retrospective Studies ,Neoplasm Invasivene ,prostatectomy ,business.industry ,Proportional hazards model ,Prostatic Neoplasms ,Prostate-Specific Antigen ,medicine.disease ,Disease recurrence ,Ki-67 Antigen ,Neoplasm Recurrence ,Prostatic Neoplasm ,biology.protein ,Neoplasm ,Neoplasm Recurrence, Local ,business - Abstract
Objective: Several smaller single-center studies have reported a prognostic role for Ki-67 labeling index in prostate cancer. Our aim was to test whether Ki-67 is an independent prognostic marker of biochemical recurrence (BCR) in a large international cohort of patients treated with radical prostatectomy (RP). Methods: Ki-67 immunohistochemical staining on prostatectomy specimens from 3,123 patients who underwent RP for prostate cancer was retrospectively performed. Univariable and multivariable Cox regression models were used to assess the association of Ki-67 status with BCR. Results: Ki-67Âpositive status was observed in 762 (24.4Â%) patients and was associated with lymph node involvement (LNI) (pÂ=Â0.039). Six hundred and twenty-one (19.9Â%) patients experienced BCR. The estimated 3-year biochemical-free survivals were 85Â% for patients with negative Ki-67 status and 82.1Â% for patients with positive Ki-67 status (log-rank test, pÂ=Â0.014). In multivariable analysis that adjusted for the effects of age, preoperative PSA, RP Gleason sum, seminal vesicle invasion, extracapsular extension, positive surgical margins, lymphovascular invasion, and LNI, Ki-67 was significantly associated with BCR (HRÂ=Â1.19; pÂ=Â0.019). Subgroup analysis revealed that Ki-67 is associated with BCR in patients without LNI (pÂ=Â0.004), those with RP Gleason sum 7 (pÂ=Â0.015), and those with negative surgical margins (pÂ=Â0.047). Conclusion: We confirmed Ki-67 as an independent predictor of BCR after RP. Ki-67 could be particularly informative in patients with favorable pathologic characteristics to help in the clinical decision-making regarding adjuvant therapy and optimized follow-up scheduling.
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- 2015
28. Association of Cigarette Smoking and Smoking Cessation with Biochemical Recurrence of Prostate Cancer in Patients Treated with Radical Prostatectomy
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Shahrokh F. Shariat, Morgan Rouprêt, Alberto Briganti, Michael Rink, Malte Rieken, Harun Fajkovic, Luis A. Kluth, Pierre I. Karakiewicz, Christian Seitz, Gholamreza Pourmand, Alexander Bachmann, Quoc-Dien Trinh, Wolfgang Loidl, Rieken, Malte, Shariat Shahrokh, F., Kluth Luis, A., Fajkovic, Harun, Rink, Michael, Karakiewicz Pierre, I., Seitz, Christian, Briganti, Alberto, Roupret, Morgan, Loidl, Wolfgang, Trinh Quoc, Dien, Bachmann, Alexander, and Pourmand, Gholamreza
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Biochemical recurrence ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Retrospective Studie ,Interquartile range ,Risk Factors ,Internal medicine ,medicine ,Humans ,Neoadjuvant therapy ,Retrospective Studies ,Gynecology ,Prostatectomy ,Prostate cancer ,Proportional hazards model ,business.industry ,Risk Factor ,Hazard ratio ,Smoking ,Prostatic Neoplasms ,Middle Aged ,Radical prostatectomy ,Confidence interval ,Prostatic Neoplasm ,Smoking cessation ,Smoking Cessation ,Neoplasm Recurrence, Local ,business ,Human - Abstract
Background Cigarette smoking seems to be associated with prostate cancer (PCA) incidence and mortality. Objective To elucidate the association between pretreatment smoking status, cumulative smoking exposure, and time since smoking cessation and the risk of biochemical recurrence (BCR) of PCA in patients treated with radical prostatectomy (RP). Design, setting, and participants Retrospective analysis of 6538 patients with pathologically node-negative PCA treated with RP between 2000 and 2011. Clinicopathologic and smoking variables, including smoking status, number of cigarettes per day (CPD), duration in years, and time since smoking cessation were collected. Intervention RP without neoadjuvant therapy. Outcome measurements and statistical analysis Univariable and multivariable Cox regression analyses assessed the association between smoking and risk of PCA BCR. Results and limitations Of 6538 patients, 2238 (34%), 2086 (32%), and 2214 (34%) were never, former, and current smokers, respectively. Median follow-up for patients not experiencing BCR was 28 mo (interquartile range 14-42). RP Gleason score (p = 0.3), extracapsular extension (p = 0.2), seminal vesicle invasion (p = 0.8), and positive surgical margins (p = 0.9) were comparable among the three groups. In multivariable Cox regression analysis, former smokers (hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.30-2.04; p < 0.001) and current smokers (HR 1.80, 95% CI 1.45-2.24; p < 0.001) had a higher risk of PCA BCR compared with non-smokers. Smoking cessation for â¤10 yr mitigated the risk of BCR in multivariable analyses (HR 0.96, 95% CI 0.68-1.37; p = 0.84). In multivariable analysis, no significant association between cumulative smoking exposure and risk of BCR could be detected. Limitations of the study include the retrospective design and potential recall bias regarding smoking history. Conclusion Smoking seems to be associated with a higher risk of PCA BCR after RP. The effects of smoking appear to be mitigated by â¤10 yr of cessation. Smokers should be counseled regarding the detrimental effects of smoking on PCA prognosis. Patient summary We investigated the effect of smoking on the risk of prostate cancer recurrence in patients with treated with surgery. We found that former smokers and current smokers were at higher risk of cancer recurrence compared to patients who never smoked; the detrimental effect of smoking was mitigated after 10 yr or more of smoking cessation. We conclude that smokers should be counseled regarding the detrimental effects on prostate cancer outcomes.
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- 2015
29. The role of adjuvant chemotherapy for lymph node-positive upper tract urothelial carcinoma following radical nephroureterectomy: A retrospective study
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Ricardo A. Rendon, Péter Nyirády, Shahrokh F. Shariat, Yair Lotan, Giacomo Novara, Sebastian L. Hofbauer, Pierre I. Karakiewicz, Harun Fajkovic, Mesut Remzi, Alberto Briganti, Tobias Klatte, Morgan Rouprêt, Jonathan I. Izawa, Anil Kapoor, Christian Seitz, Ilaria Lucca, Vitaly Margulis, Adrian Fairey, Wassim Kassouf, Peter C. Black, Michela de Martino, Lucca, Ilaria, Kassouf, Wassim, Kapoor, Anil, Fairey, Adrian, Rendon Ricardo, A., Izawa Jonathan, I., Black Peter, C., Fajkovic, Harun, Seitz, Christian, Remzi, Mesut, Nyirady, Peter, Roupret, Morgan, Margulis, Vitaly, Lotan, Yair, de Martino, Michela, Hofbauer Sebastian, L., Karakiewicz Pierre, I., Briganti, Alberto, Novara, Giacomo, Shariat Shahrokh, F., and Klatte, Tobias
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Male ,medicine.medical_specialty ,Urologic Neoplasms ,Adjuvant chemotherapy ,Urology ,Antineoplastic Agents ,survival ,Antineoplastic Agent ,radical nephroureterectomy ,adjuvant chemotherapy ,lymph node positive ,upper tract urothelial carcinoma ,Aged ,Chemotherapy, Adjuvant ,Drug Therapy, Combination ,Female ,Humans ,Lymph Nodes ,Middle Aged ,Retrospective Studies ,Survival Rate ,Treatment Outcome ,Urothelium ,Medicine (all) ,Drug Therapy ,Retrospective Studie ,Medicine ,Chemotherapy ,Pathological ,Survival rate ,Adjuvant ,Urothelial carcinoma ,business.industry ,Lymph Node ,Retrospective cohort study ,Urologic Neoplasm ,Upper tract ,Combination ,Lymph ,business ,Human - Abstract
Objective To evaluate the effect of adjuvant chemotherapy (AC) on mortality after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) with positive lymph nodes (LNs) and to identify patient subgroups that are most likely to benefit from AC. Patients and methods We retrospectively analysed data of 263 patients with LN-positive UTUC, who underwent full surgical resection. In all, 107 patients (41%) received three to six cycles of AC, while 156 (59.3%) were treated with RNU alone. UTUC-related mortality was evaluated using competing-risks regression models. Results In all patients (Tall N+), administration of AC had no significant impact on UTUC-related mortality on univariable (P = 0.49) and multivariable (P = 0.11) analysis. Further stratified analyses showed that only N+ patients with pT3–4 disease benefited from AC. In this subgroup, AC reduced UTUC-related mortality by 34% (P = 0.019). The absolute difference in mortality was 10% after the first year and increased to 23% after 5 years. On multivariable analysis, administration of AC was associated with significantly reduced UTUC-related mortality (subhazard ratio 0.67, P = 0.022). Limitations of this study are the retrospective non-randomised design, selection bias, absence of a central pathological review and different AC protocols. Conclusions AC seems to reduce mortality in patients with pT3–4 LN-positive UTUC after RNU. This subgroup of LN-positive patients could serve as target population for an AC prospective randomised trial.
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- 2015
30. Validation of tertiary Gleason pattern 5 in Gleason score 7 prostate cancer as an independent predictor of biochemical recurrence and development of a prognostic model
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Christoph Klingler, Harun Fajkovic, Tobias Klatte, Mesut Remzi, Wolfgang Loidl, Yair Lotan, Christian Seitz, Pierre I. Karakiewicz, Alberto Briganti, Morgan Rouprêt, Claus G. Roehrborn, Maxine Sun, Karl Pummer, Shahrokh F. Shariat, Ilaria Lucca, Francesco Montorsi, Lucca, Ilaria, Shariat, Shahrokh, Briganti, Alberto, Lotan, Yair, Roherborn, Clau, Montorsi, Francesco, Remzi, Mesut, Seitz, Christian, Fajkovic, Harun, Klingler, Christoph, Karakiewicz, Pierre, Sun, M, Roupret, Morgan, Loidl, Wolfgang, Pummer, Karl, and Klatte, Tobias
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Biochemical recurrence ,Oncology ,Male ,medicine.medical_specialty ,Prognosi ,medicine.medical_treatment ,Urology ,Reproducibility of Result ,Prostate cancer ,Retrospective Studie ,Internal medicine ,medicine ,Clinical endpoint ,Adjuvant therapy ,Risk-stratification model ,Humans ,Pathological ,Retrospective Studies ,Aged ,Prostatectomy ,Tertiary Gleason pattern 5 ,business.industry ,Proportional hazards model ,Prostatic Neoplasms ,Reproducibility of Results ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Prognosis ,Gleason 7 ,Surgery ,Prostatic Neoplasm ,Neoplasm Grading ,business ,Human - Abstract
OBJECTIVE: To validate the biological and prognostic value of tertiary Gleason pattern 5 (TGP5) in patients with Gleason score 7 (GS 7) prostate cancer (PCa) and to develop a prognostic model to identify the high-risk group of patients with TGP5.MATERIAL AND METHODS: We retrospectively reviewed the data from 4,146 patients with localized (pT2-3 N0 M0) GS 7 PCa treated by radical prostatectomy (RP) without adjuvant therapy. The primary end point was biochemical recurrence (BCR), and the secondary one was to build a bootstrap-corrected multivariable Cox model.RESULTS: Of the 4,146 patients, 416 (10%) had a TPG5 in the RP specimen. TGP5 was associated with BCR in both univariable and multivariable analyses that adjusted for the effects of standard pathological features (P
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- 2015
31. The Neutrophil-to-lymphocyte Ratio as a Prognostic Factor for Patients with Urothelial Carcinoma of the Bladder Following Radical Cystectomy: Validation and Meta-analysis
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Aurélie Mbeutcha, Agnes Maj-Hes, Shahrokh F. Shariat, Patrice Jichlinski, Malte Rieken, Michela de Martino, Christian Seitz, Marko Babjuk, Morgan Rouprêt, Harun Fajkovic, Tobias Klatte, Yair Lotan, Pierre I. Karakiewicz, Luis A. Kluth, Michael Rink, Romain Mathieu, Alberto Briganti, Ilaria Lucca, Lucca, Ilaria, Jichlinski, Patrice, Shariat, Shahrokh F., Rouprêt, Morgan, Rieken, Malte, Kluth, Luis A., Rink, Michael, Mathieu, Romain, Mbeutcha, Aurelie, Maj-Hes, Agne, Fajkovic, Harun, Briganti, Alberto, Seitz, Christian, Karakiewicz, Pierre I., de Martino, Michela, Lotan, Yair, Babjuk, Marko, and Klatte, Tobias
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Oncology ,medicine.medical_specialty ,Survival ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Cystectomy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Meta-analysi ,Neutrophil to lymphocyte ratio ,Neutrophil-to-lymphocyte ratio ,Gynecology ,Bladder cancer ,Urothelial carcinoma of the bladder ,business.industry ,Proportional hazards model ,fungi ,Hazard ratio ,Retrospective cohort study ,medicine.disease ,Confidence interval ,Radical cystectomy ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,business - Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic inflammatory response has been proposed as a prognostic factor for patients with urothelial carcinoma of the bladder (UCB) following radical cystectomy (RC). Objective To validate NLR as a prognostic biomarker and to perform a pooled meta-analysis. Design, setting, and participants The NLR was assessed in 4061 patients within 30 days before RC. A systematic review of the literature was undertaken using electronic databases. Outcome measurements and statistical analysis Associations with overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox models. Hazard ratios (HRs) were pooled in a meta-analysis using random-effects modeling. Results and limitations A high NLR (â¥2.7) was associated with advanced pathological tumor stages (pÂ
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- 2014
32. Does increasing the nodal yield improve outcomes in contemporary patients without nodal metastasis undergoing radical prostatectomy?
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Yair Lotan, Ashutosh Tewari, Morgan Rouprêt, Alberto Briganti, Felix K.-H. Chun, Mesut Remzi, Bertrand Guillonneau, Niccolo Passoni, Luis A. Kluth, Andreas Becker, Markus Graefen, Evanguelos Xylinas, Shahrokh F. Shariat, Christian Seitz, Paul Schramek, Wolfgang Loidl, Pierre I. Karakiewicz, Douglas S. Scherr, Malte Rieken, Michael Herman, Harun Fajkovic, Kluth, Luis A., Xylinas, Evanguelo, Rieken, Malte, Chun, Felix K. -H., Fajkovic, Harun, Becker, Andrea, Karakiewicz, Pierre I., Passoni, Niccolo, Herman, Michael, Lotan, Yair, Seitz, Christian, Schramek, Paul, Remzi, Mesut, Loidl, Wolfgang, Guillonneau, Bertrand, Rouprêt, Morgan, Briganti, Alberto, Scherr, Douglas S., Graefen, Marku, Tewari, Ashutosh K., and Shariat, Shahrokh F.
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Oncology ,Male ,medicine.medical_treatment ,Prostate cancer ,Interquartile range ,Retrospective Studie ,medicine.diagnostic_test ,Prostatectomy ,Micrometastasis ,Lymph Node ,Middle Aged ,Prognosis ,Pelvic lymph node dissection ,Prostate-specific antigen ,Treatment Outcome ,Lymphatic Metastasis ,Human ,Biochemical recurrence ,medicine.medical_specialty ,Prognosi ,Urology ,Disease-Free Survival ,Follow-Up Studie ,Lymph node metastasi ,Internal medicine ,Biopsy ,medicine ,Humans ,Retrospective Studies ,Aged ,Neoplasm Staging ,business.industry ,Prostatic Neoplasms ,Lymphatic Metastasi ,Prostate-Specific Antigen ,medicine.disease ,Nodal yield ,Prostatic Neoplasm ,T-stage ,Lymph Node Excision ,Lymph Nodes ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Objectives: To determine if the number of lymph nodes (LNs) removed is an independent predictor of biochemical recurrence (BCR) in patients without LN metastases undergoing radical prostatectomy (RP). Material and methods: Retrospective analysis of 7,310 patients treated at 7 centers with RP and pelvic LN dissection for clinically localized prostate cancer between 2000 and 2011. Patients with LN metastases (n = 398) and other reasons (stated later in the article) (n = 372) were excluded, which left 6,540 patients for the final analyses. Results: Overall, median biopsy and RP Gleason score were both 7; median prostate specific antigen level was 6. ng/ml (interquartile range [IQR]: 5); and median number of LNs removed was 6 (IQR: 8). A total of 3,698 (57%), 2,064 (32%), and 508 (8%) patients had â¥6, â¥10, and â¥20 LNs removed, respectively. Patients with more LNs removed were older, had a higher prostate specific antigen level, had higher clinical and pathologic T stage, and had higher RP Gleason score (all P
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- 2014
33. Predicting clinical outcomes after radical nephroureterectomy for upper tract urothelial carcinoma
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Wassim Kassouf, Yair Lotan, Christian Bolenz, Giacomo Novara, Theresa M. Koppie, Juan Ignacio Martínez-Salamanca, Kazumasa Matsumoto, Jean Jacques Patard, Armin Pycha, Cord Langner, Jay D. Raman, Vincenzo Ficarra, Harun Fajkovic, Mesut Remzi, Marco Roscigno, Pierre I. Karakiewicz, Douglas S. Scherr, Francesco Montorsi, Eiji Kikuchi, Stefan Tritschler, Vitaly Margulis, Casey K. Ng, Eugene K. Cha, Shahrokh F. Shariat, Behfar Ehdaie, Thomas J. Walton, Alon Z. Weizer, Richard Zigeuner, Karim Bensalah, Thomas F. Chromecki, Hans-Martin Fritsche, Matthias Kormaksson, Christopher G. Wood, Weill Medical College of Cornell University [New York], Departement of Oncological and Surgical Sciences, Universita degli Studi di Padova, Department of Urology, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Medical University Graz, Hospital Weinviertel-Korneuburg-Landesklinikum Korneuburg, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], University of Michigan [Ann Arbor], University of Michigan System, Mannheim Medical Center, Universität Heidelberg [Heidelberg], General Hospital of Bolzano, Health Robotics S.r.l., Service d'urologie, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Department of urology, Università Vita-Salute San Raffaele, Cancer Prognostics and Health Outcome Unit, Université de Montréal (UdeM), Service d'urologie [Rennes], CHU Pontchaillou [Rennes]-Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Cha Eugene, K., Shariat Shahrokh, F., Kormaksson, Matthia, Novara, Giacomo, Chromecki Thomas, F., Scherr Douglas, S., Lotan, Yair, Raman Jay, D., Kassouf, Wassim, Zigeuner, Richard, Remzi, Mesut, Bensalah, Karim, Weizer, Alon, Kikuchi, Eiji, Bolenz, Christian, Roscigno, Marco, Koppie Theresa, M., Ng Casey, K., Fritsche Hans, Martin, Matsumoto, Kazumasa, Walton Thomas, J., Ehdaie, Behfar, Tritschler, Stefan, Fajkovic, Harun, Martinez Salamanca Juan, I., Pycha, Armin, Langner, Cord, Ficarra, Vincenzo, Patard Jean, Jacque, Montorsi, Francesco, Wood Christopher, G., Karakiewicz Pierre, I., and Margulis, Vitaly
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Oncology ,Male ,MESH: Carcinoma ,Time Factors ,Lymphovascular invasion ,medicine.medical_treatment ,MESH: Lymphatic Metastasis ,030232 urology & nephrology ,Kaplan-Meier Estimate ,MESH: Risk Assessment ,Nephrectomy ,Nephroureterectomy ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Nomogram ,MESH: Proportional Hazards Models ,0302 clinical medicine ,Risk Factors ,MESH: Risk Factors ,Medicine ,MESH: Ureteral Neoplasms ,Stage (cooking) ,urothelial carcinoma ,Survival prediction ,Upper urinary tract ,MESH: Treatment Outcome ,MESH: Urologic Surgical Procedures ,MESH: Aged ,MESH: Middle Aged ,MESH: Urologic Neoplasms ,Middle Aged ,3. Good health ,Europe ,Treatment Outcome ,MESH: Ureter ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Urologic Surgical Procedures ,Female ,Urothelial carcinoma ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,MESH: Neoplasm Recurrence, Local ,medicine.medical_specialty ,Urologic Neoplasms ,Urology ,Risk Assessment ,Disease-Free Survival ,MESH: Multivariate Analysis ,03 medical and health sciences ,Internal medicine ,Adjuvant therapy ,Humans ,MESH: Kaplan-Meier Estimate ,Aged ,Proportional Hazards Models ,Retrospective Studies ,MESH: Humans ,business.industry ,Proportional hazards model ,Ureteral Neoplasms ,Carcinoma in situ ,Carcinoma ,MESH: Time Factors ,Retrospective cohort study ,MESH: Retrospective Studies ,medicine.disease ,MESH: Urothelium ,MESH: Male ,MESH: North America ,MESH: Nephrectomy ,Multivariate Analysis ,North America ,MESH: Disease-Free Survival ,MESH: Europe ,Neoplasm Recurrence, Local ,Ureter ,Urothelium ,business ,MESH: Female - Abstract
Background: Novel prognostic factors for patients after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) have recently been described. Objective: We tested the prognostic value of pathologic characteristics and developed models to predict the individual probabilities of recurrence-free survival (RFS) and cancer-specific survival (CSS) after RNU. Design, setting, and participants: Our study included 2244 patients treated with RNU without neoadjuvant or adjuvant therapy at 23 international institutions. Tumor characteristics included T classification, grade, lymph node status, lymphovascular invasion, tumor architecture, location, and concomitant carcinoma in situ (CIS). The cohort was randomly split for development (12 centers, n = 1273) and external validation (11 centers, n = 971). Interventions: All patients underwent RNU. Measurements: Univariable and multivariable models addressed RFS, CSS, and comparison of discrimination and calibration with American Joint Committee on Cancer (AJCC) stage grouping. Results and limitations: At a median follow-up of 45 mo, 501 patients (22.3%) experienced disease recurrence and 418 patients (18.6%) died of UTUC. On multivariable analysis, T classification (p for trend
- Published
- 2012
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