Systemic therapy in bladder preservation.
Abstract Bladder cancer is an aggressive and lethal disease. Even when presenting as localized muscle-invasive disease, the 5-year survival rate is about 70%, and the recurrence rate after radical cystectomy is approximately 50%. Neoadjuvant chemotherapy (NAC) has the potential to downstage the primary tumor and treat micrometastases, leading to a decrease in recurrence rates and an increase in cure rates. There is level 1 evidence in favor of neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy. However, data from clinical trials evaluating NAC for patients undergoing bladder-sparing treatments ar...
Source: Urologic Oncology - November 19, 2020 Category: Urology & Nephrology Authors: Girardi DM, Ghatalia P, Singh P, Iyer G, Sridhar SS, Apolo AB Tags: Urol Oncol Source Type: research

Predicting morbidity and mortality after radical cystectomy using risk calculators: A comprehensive review of the literature.
CONCLUSION: There exists a strong need to develop a comprehensive and accurate preoperative risk calculator that predicts morbidity and mortality after RC. PMID: 33223369 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 19, 2020 Category: Urology & Nephrology Authors: Razdan S, Sljivich M, Pfail J, Wiklund PK, Sfakianos JP, Waingankar N Tags: Urol Oncol Source Type: research

Impact of treatment modality on overall survival in localized ductal prostate adenocarcinoma: A national cancer database analysis.
Abstract PURPOSE: Ductal adenocarcinoma is considered a rare histological variant of prostate adenocarcinoma (PCa). Given the rarity of this subtype, optimal treatment strategies for men with nonmetastatic ductal PCa is largely unknown. We aimed to describe the impact of surgery, radiotherapy, systemic therapy, and observation on overall survival (OS) in men with nonmetastatic ductal PCa. MATERIALS AND METHODS: We selected 1,656 cases of nonmetastatic ductal PCa, diagnosed between 2004 and 2015, within the National Cancer Database. Covariates included age, race, Charlson comorbidity score, clinical T stage, c...
Source: Urologic Oncology - November 19, 2020 Category: Urology & Nephrology Authors: Bronkema C, Arora S, Keeley J, Rakic N, Sood A, Dalela D, Jamil M, Peabody JO, Rogers CG, Menon M, Abdollah F Tags: Urol Oncol Source Type: research

Primary lymph-node staging with 68Ga-PSMA PET in high-risk prostate cancer: pathologic correlation with extended pelvic lymphadenectomy specimens.
CONCLUSIONS: 68Ga PSMA PET-CT appears to have a high negative predictive value for local lymph node metastases in high-risk primary PCa when compared to pathologic findings of eLND. Its role in the primary nodal staging of high-risk PCa patients worths further evaluation. PMID: 33223371 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 19, 2020 Category: Urology & Nephrology Authors: Corona-Montes VE, González-Cuenca E, Fernández-Noyola G, Olarte-Casas MA, Bobadilla-Salazar D, Medrano-Urtecho HM, Asimakopoulos AD Tags: Urol Oncol Source Type: research

Management of prostate cancer after holmium laser enucleation of the prostate.
CONCLUSION: Screening for CaP in HoLEP candidates with PSA and MRI is recommended given that>10% will have incidental CaP. After HoLEP for BPH/LUTS, patients with CaP can be surveilled with PSA and/or MRI. Further investigation is warranted to determine the durability of success of these approaches. PMID: 33221258 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 19, 2020 Category: Urology & Nephrology Authors: Hutchison D, Peabody H, Kuperus JM, Humphrey JE, Ryan M, Moriarity A, Brede CM, Lane BR Tags: Urol Oncol Source Type: research

PI-RADS 3 lesions: Does the association of the lesion volume with the prostate-specific antigen density matter in the diagnosis of clinically significant prostate cancer?
CONCLUSIONS: In this series, the association of the volume of PIRADS 3 lesion and the PSAd improves specificity and PPV contributing to improve the management of csCaP. PMID: 33221259 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 18, 2020 Category: Urology & Nephrology Authors: Luis R, Leandro B, Gonzalo V, Pablo C, Hernando RP, Carlos A Tags: Urol Oncol Source Type: research

Minimally invasive evaluation of the clinically negative inguinal node in penile cancer: Dynamic sentinel node biopsy.
Abstract The presence of lymph node metastasis is the most important prognostic factor in penile cancer (PeCa). Due to limited sensitivity of currently available imaging modalities, invasive staging approaches remain indispensable for adequate nodal staging. As an alternative to radical inguinal lymphadenectomy and with the aim to reduce morbidity, staging strategies such as modified lymphadenectomy and dynamic sentinel node biopsy (DSNB) have been introduced. Over the years, DSNB evolved into a safe and reliable staging technique when performed in high volume centers. Recent enhancements of the procedure such as ...
Source: Urologic Oncology - November 17, 2020 Category: Urology & Nephrology Authors: Wever L, de Vries HM, van der Poel H, van Leeuwen F, Horenblas S, Brouwer O Tags: Urol Oncol Source Type: research

At a time of global BCG shortage, attempts at optimizing BCG dose and schedule is no longer the answer.
PMID: 33218921 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 17, 2020 Category: Urology & Nephrology Authors: Morales A, Siemens DR, Koti M Tags: Urol Oncol Source Type: research

Risk of renal cancer in patients with inflammatory bowel disease: A pooled analysis of population-based studies.
CONCLUSIONS: Our findings indicate that IBD patients with special reference to CD patients have a significantly higher risk of RCa. Further studies are warranted to enable definite conclusions to be drawn. PMID: 33214029 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 16, 2020 Category: Urology & Nephrology Authors: Feng D, Bai Y, Liu S, Yang Y, Han P, Wei W Tags: Urol Oncol Source Type: research

Comparison of the prognosis of primary vs. progressive muscle invasive bladder cancer after radical cystectomy: Results from a large multicenter study.
CONCLUSIONS: Our results suggest that patient having a progressive BC have a worse prognosis in terms of OS, PFS, and CSS than patient with primary disease. These 2 groups may require different management and patients with high risk NMIBC should be assessed properly to avoid progression and be offered early cystectomy. PMID: 33214030 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 16, 2020 Category: Urology & Nephrology Authors: Nouhaud FX, Chakroun M, Lenormand C, Ouzaid I, Peyronnet B, Gryn A, Prudhomme T, Grafeille V, Soulié M, Roumiguié M, Verhoest G, Xylinas E, Bouzouita A, Chebil M, Pfister C Tags: Urol Oncol Source Type: research

The role of multiparametric MRI in active surveillance for low-risk prostate cancer: The ROMAS randomized controlled trial.
Abstract BACKGROUND: We aim to evaluate the impact of multiparametric magnetic resonance imaging and fusion-target biopsy for early reclassification of patients with low-risk Prostate Cancer in a randomized trial. MATERIALS AND METHODS: Between 2015 and 2018, patients diagnosed with Prostate Cancer after random biopsy fulfilling PRIAS criteria were enrolled and centrally randomized (1:1 ratio) to study group or control group. Patients randomized to study group underwent multiparametric magnetic resonance imaging at 3 months from enrollment: patients with positive findings (PIRADS-v2>2) underwent fusion-tar...
Source: Urologic Oncology - November 12, 2020 Category: Urology & Nephrology Authors: Schiavina R, Droghetti M, Novara G, Bianchi L, Gaudiano C, Panebianco V, Borghesi M, Piazza P, Mineo Bianchi F, Guerra M, Corcioni B, Fiorentino M, Giunchi F, Verze P, Pultrone C, Golfieri R, Porreca A, Mirone V, Brunocilla E Tags: Urol Oncol Source Type: research

Prognostic classifier for predicting biochemical recurrence in localized prostate cancer patients after radical prostatectomy.
Abstract OBJECTIVE: The purpose of the study was to develop an improved classifier for predicting biochemical recurrence (BCR) in clinically localized PCa patients after radical prostatectomy. METHODS AND MATERIALS: Retrospective study including 122 PCa patients who attended our department between 2000 and 2007. Gene expression patterns were analyzed in 21 samples from 7 localized, 6 locally advanced, and 8 metastatic PCa patients using Illumina microarrays. Expression levels of 41 genes were validated by quantitative PCR in 101 independent PCa patients who underwent radical prostatectomy. Logistic regression...
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Carrion A, Ingelmo-Torres M, Lozano JJ, Montalbo R, D'Anna M, Mercader C, Velez E, Ribal MJ, Alcaraz A, Mengual L Tags: Urol Oncol Source Type: research

Gemcitabine based trimodality treatment in patients with muscle invasive bladder cancer: May neutrophil lymphocyte and platelet lymphocyte ratios predict outcomes?
CONCLUSION: Gemcitabine based trimodality treatment is well-tolerated with similar oncologic outcomes reported in the literature. Older age, presence of CIS and high NLR and PLR values seem to deteriorate DSS. PMID: 33189528 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Hurmuz P, Ozyigit G, Kilickap S, Esen CSB, Akdogan B, Ozen H, Akyol F Tags: Urol Oncol Source Type: research

Incidence and Clinical Pattern of Contralateral Synchronous and Metachronous Germ Cell Testicular Cancer.
CONCLUSIONS: Incidence of second testicular neoplasm in this cohort of 3,834 patients was similar to that which has been reported in other countries. Metachronous tumors and seminomas are more common. Follow-up of the contralateral testis is mandatory, as well as adequate information for patients to prevent a second neoplasm if feasible, and to detect and treat it as soon as possible. PMID: 33189529 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Maroto P, García Del Muro X, Valverde C, Pinto A, Sanchez A, Guma J, Alonso T, Martínez Del Prado P, Vazquez S, Mellado B, Aparicio J, Fernandez-Aramburo A, Girones R, Terrasa J, Spanish Germ Cell Cancer Group Tags: Urol Oncol Source Type: research

Impact of Preoperative Serum Albumin-Globulin Ratio on Disease Outcome After Radical Cystectomy for Urothelial Carcinoma of the Bladder.
In this study, we assessed the association of preoperative AGR (pAGR) with survival in patients who underwent radical cystectomy (RC) for UCB. MATERIAL AND METHODS: We conducted a retrospective analysis of an established multicenter database of 4.335 patients who were treated with RC for UCB. The cohort was divided into 2 groups according to the pAGR status. Binominal logistic regression as well as uni- and multivariable Cox regression analyses were used. The predictive value of the models was assessed by calculating receiver operating characteristics curves and concordance-indices (C-Index). The additional clinical v...
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Schuettfort VM, D Andrea D, Quhal F, Mostafaei H, Laukhtina E, Mori K, Sari Motlagh R, Rink M, Abufaraj M, Karakiewicz PI, Luzzago S, Rouprêt M, Chlosta P, Babjuk M, Deuker M, Moschini M, Shariat SF, Pradere B Tags: Urol Oncol Source Type: research

Impact of neuraxial analgesia on outcomes following radical cystectomy: A systematic review.
Abstract Radical cystectomy (RC) is associated with significant morbidity. Neuraxial analgesia is recommended by enhanced recovery after surgery guidelines, but largely supported by evidence extrapolated from colorectal surgery outcomes. We synthesized current evidence regarding short- and long-term outcomes associated with neuraxial analgesia versus patient controlled non-neuraxial analgesia following RC. PubMed, Embase, and Cochrane databases were searched for relevant studies published up to May 2020. Studies reporting complications, length of stay (LOS), pain score, opioid usage within 72 hours, overall surviv...
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Rahman SN, Cao DJ, Flores VX, Monaghan TF, Weiss JP, McNeil BK, Lazar JM, Dimaculangan D, Winer AG Tags: Urol Oncol Source Type: research

External beam radiation therapy improves survival in elderly metastatic prostate cancer patients with low PSA.
Abstract BACKGROUND: It is unknown, whether metastatic prostate cancer (CaP) patients with intermediate life expectancy (5-10 years) should be considered for external beam radiation therapy (EBRT) to the prostate. We addressed this void. METHODS: Within the Surveillance, Epidemiology, and End Results database (2004-2016), we identified 835 M1a or M1b CaP substaged patients with prostate-specific antigen (PSA)
Source: Urologic Oncology - November 11, 2020 Category: Urology & Nephrology Authors: Stolzenbach LF, Rosiello G, Deuker M, Martin T, Knipper S, Tian Z, Briganti A, Zorn KC, Saad F, Chun FKH, Graefen M, Karakiewicz PI Tags: Urol Oncol Source Type: research

Radical cystectomy for locally advanced urothelial carcinoma of the urinary bladder: Health-related quality of life, oncological outcomes and predictors for survival.
Abstract PURPOSE: While survival outcomes of locally advanced bladder cancer patients undergoing radical cystectomy are known to be poor, less is known regarding patient-reported outcomes and predictive features for survival in this patient subgroup. METHODS: One hundred and eighteen consecutive patients with pT4a cM0 urothelial carcinoma of the bladder were included. Based on pathological review, patients were stratified into 3 subgroups based on existence of additional lesions and invasion depth of the respective lesions. Cancer-specific survival and overall survival (OS) was determined using Kaplan-Meier-a...
Source: Urologic Oncology - November 10, 2020 Category: Urology & Nephrology Authors: Volz Y, Grimm T, Ormanns S, Eismann L, Pfitzinger PL, Jokisch JF, Schulz G, Casuscelli J, Schlenker B, Karl A, Stief CG, Kretschmer A Tags: Urol Oncol Source Type: research

Outcomes of patients with metastatic renal cell carcinoma with sarcomatoid dedifferentiation to immune checkpoint inhibitors.
CONCLUSION: ICIs appear to be effective in sccRCC while the treatment of snccRCC remains challenging. PMID: 33187886 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 10, 2020 Category: Urology & Nephrology Authors: Chahoud J, Msaouel P, Ross JA, McCormick BZ, Bathala TK, Gao J, Horn R, Xiao L, Sircar K, Campbell MT, Shah AY, Goswami S, Zurita AJ, Jonasch E, Matin SF, Wood CG, Karam JA, Sharma P, Tannir NM Tags: Urol Oncol Source Type: research

"Robotic fatigue?" - The impact of case order on positive surgical margins in robotic-assisted laparoscopic prostatectomy.
CONCLUSION: Case sequence was not associated with PSM, lymph node yield, or operative time for RALP. Disease specific factors and institutional experience are associated with increased risk for positive surgical margin which can aid providers in scheduling of patients. PMID: 33160844 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 4, 2020 Category: Urology & Nephrology Authors: Bukavina L, Mishra K, Mahran A, Fernstrum A, Ray A, Markt S, Schumacher F, Conroy B, Abouassaly R, MacLennan G, Smith G, Ferry E, Wong D, Lotan Y, Chaparala H, Sharp D, Alazem K, Moinzadeh A, Adamic B, Zagaja G, Kang P, Lawry H, Lee B, Calaway A, Ponsky L Tags: Urol Oncol Source Type: research

High HNRNPA3 expression is associated with lymph node metastasis and poor prognosis in patients treated with radical cystectomy.
Abstract OBJECTIVE: We sought to identify heterogeneous nuclear ribonucleoprotein A3 (HNRNPA3) expression in bladder cancer and its relationship to clinicopathological findings and prognosis. METHODS: Immunohistochemical staining for HNRNPA3 was performed on 122 archived radical cystectomy specimens, with immunoreactivity being stratified on a 0 to 3 scale. The percentage of HNRNPA3 expressing tumor cells was calculated and multiplied by the staining score over an average of 5 areas to obtain a semiquantitative H-score (maximum value: 300). HNRNPA3 expression was categorized as high (≥80) or low (
Source: Urologic Oncology - November 4, 2020 Category: Urology & Nephrology Authors: Amano N, Matsumoto K, Shimizu Y, Nakamura M, Tsumura H, Ishii D, Sato Y, Iwamura M Tags: Urol Oncol Source Type: research

Prediction of clinically significant prostate cancer after negative prostate biopsy: The current value of microscopic findings.
CONCLUSION: Currently, mHGPIN in negative prostate biopsy seems not able to predict the risk of future csPCa. The low incidence of ASAP and PINATYP, in our series, did not allow us to draw conclusions. PIA finding associated with a reduced risk of csPCa, and it could be integrated in a useful based-mpMRI predictive nomogram. PMID: 33160846 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 4, 2020 Category: Urology & Nephrology Authors: Morote J, Schwartzman I, Borque A, Esteban LM, Celma A, Roche S, de Torres IM, Mast R, Semidey ME, Regis L, Santamaría A, Planas J, Trilla E Tags: Urol Oncol Source Type: research

Utilization of renal mass biopsy in patients with localized renal cell carcinoma: A population-based study utilizing the National Cancer Database.
Abstract OBJECTIVE: To evaluate trends and factors predicting use of renal mass biopsy (RMB) for localized Renal Cell Carcinoma in the United States (US) in the context of current guidelines recommendations. METHODS: We queried the National Cancer Database for cT1-cT3N0M0 Renal Cell Carcinoma diagnosed between 2004 and 2015. Temporal trends of RMB were characterized based on tumor size, treatment (partial nephrectomy [PN], radical nephrectomy [RN], ablation, and no treatment), age and Charlson Comorbidity Index with slopes compared using analysis of variance. Multivariable analysis was used to determine facto...
Source: Urologic Oncology - November 4, 2020 Category: Urology & Nephrology Authors: Patel DN, Ghali F, Meagher MF, Javier-Desloges J, Patel SH, Soliman S, Hakimi K, Yuan J, Murphy J, Derweesh IH Tags: Urol Oncol Source Type: research

Prostate cancer recurrence in patients with negative or equivocal conventional imaging: A role for 18F-fluciclovine-PET/CT in delineating sites of recurrence and identifying patients with oligometastatic disease.
CONCLUSION: Even at low PSA levels, 18F-fluciclovine-PET/CT identified a diverse pattern of recurrence missed with conventional imaging. One-quarter of men had oligometastatic disease, raising the potential for 18F-fluciclovine-PET/CT to guide targeted treatment of oligometastases. PMID: 33160848 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 4, 2020 Category: Urology & Nephrology Authors: Kim EH, Siegel BA, Teoh EJ, Andriole GL, LOCATE Study Group Tags: Urol Oncol Source Type: research

Disparities in precision medicine-Examining germline genetic counseling and testing patterns among men with prostate cancer.
CONCLUSIONS: The results of the current study highlight that the role of social factors in contributing to disparities in genetic counseling and testing among men with prostate cancer. These results underscore the importance of developing novel strategies to tackle contributors of observed disparities including language, age, and insurance status. PMID: 33158741 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 3, 2020 Category: Urology & Nephrology Authors: Borno HT, Odisho AY, Gunn CM, Pankowska M, Rider JR Tags: Urol Oncol Source Type: research

Targeting barriers to wider use of trimodality therapy in localized muscle invasive bladder cancer.
Abstract Radical cystectomy with bilateral pelvic lymphadenectomy and trimodality bladder-sparing therapy or TMT, are both curative options for patients with nonmetastatic muscle invasive bladder cancer. Patients should be afforded the opportunity for a multidisciplinary evaluation with equipoise in discussing these options for eligible patients. We discuss the barriers to broader acceptance and utilization of TMT and encourage support of clinical trials of TMT. PMID: 33153882 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - November 2, 2020 Category: Urology & Nephrology Authors: Ballas L, Singh P, Lerner SP Tags: Urol Oncol Source Type: research

Statin use and risk of prostate cancer biochemical recurrence after radical prostatectomy.
Abstract BACKGROUND: Multiple studies have investigated the role of statins in prostate cancer (CaP), the leading cause of cancer related death in men. Retrospective cohort studies investigating the correlation between statin use and biochemical recurrence free (BCRF) survival in men with CaP have been inconclusive. OBJECTIVES: In the largest reported surgical cohort to date, we investigated the effect of statin therapy on BCRF and overall survival in patients with CaP who have undergone radical prostatectomy (RP). PATIENTS AND METHODS: We performed a retrospective analysis of men (n = 3,088) partici...
Source: Urologic Oncology - October 29, 2020 Category: Urology & Nephrology Authors: Prabhu N, Kapur N, Catalona W, Leikin R, Helenowski I, Jovanovich B, Gurley M, Okwuosa TM, Kuzel TM Tags: Urol Oncol Source Type: research

Optimizing MRI-targeted prostate biopsy: the diagnostic benefit of additional targeted biopsy cores.
CONCLUSION: Clinically significant prostate cancer detection is improved with increased number of MRI-targeted biopsy cores, particularly for urologists early in their learning curve. PMID: 33127298 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 27, 2020 Category: Urology & Nephrology Authors: Tracy CR, Flynn KJ, Sjoberg DD, Gellhaus PT, Metz CM, Ehdaie B Tags: Urol Oncol Source Type: research

The role of surgical experience in patient selection, surgical quality, and outcomes in robot-assisted radical cystectomy.
Abstract BACKGROUND: Robot-assisted radical cystectomy (RARC) remains one of the most complex urological procedures. Due to regionalization of bladder cancer care, there is likely an imbalance in experience among urologists performing RARC. We sought to describe changes in patient selection, surgical quality surrogates and rates of complications in relation to surgical experience. METHODS: We retrospectively reviewed 409 consecutive patients with bladder cancer who underwent RARC between 2006 and 2017 by a single surgeon. The cohort was divided into 4 quartiles (Q1-Q4) according to surgical experience, based ...
Source: Urologic Oncology - October 27, 2020 Category: Urology & Nephrology Authors: Posada Calderon L, Al Hussein Al Awamlh B, Shoag J, Patel N, Nicolas JD, Scherr DS Tags: Urol Oncol Source Type: research

Is partial nephrectomy safe and effective in the setting of frail comorbid patients affected by renal cell carcinoma? Insights from the RECORD 2 multicentre prospective study.
Minervini A Abstract BACKGROUND: To investigate the perioperative and morbidity outcomes after partial nephrectomy (PN) in patients with short life expectancy (SLE) (≥95% 10-year expected mortality (10y-EM)), to assess the main predictors of outcomes in this population and to compare these results with those of a group at the opposite upper range with long LE (LLE, ≤5% 10y-EM) relying on a multicenter Italian prospective registry of kidney surgery (the RECORD 2 project). METHODS: Clinical data of 4,325 patients undergone kidney surgery were collected at 26 urological Italian Centers from 2013 to 2016. S...
Source: Urologic Oncology - October 27, 2020 Category: Urology & Nephrology Authors: Gontero P, Mari A, Marra G, Nazzani S, Allasia M, Antonelli A, Barale M, Brunocilla E, Capitanio U, Di Maida F, Gallioli A, Longo N, Montorsi F, Porpiglia F, Porreca A, Rocco B, Simeone C, Schiavina R, Tellini R, Terrone C, Villari D, Ficarra V, Carini M, Tags: Urol Oncol Source Type: research

Increased risk of disease progression in younger men: Analysis of factors predicting biochemical failure and castration-resistant prostate cancer after high-dose intensity-modulated radiation therapy for nonmetastatic prostate cancer.
CONCLUSIONS: Younger men with NMPCa had increased risks of BF and CRPC after high-dose IMRT, and may benefit from more intensive treatments. Our findings should be further tested in prospective studies. PMID: 33127301 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 27, 2020 Category: Urology & Nephrology Authors: Aizawa R, Takayama K, Nakamura K, Inoue T, Yamasaki T, Kobayashi T, Akamatsu S, Ogawa O, Mizowaki T Tags: Urol Oncol Source Type: research

Optimizing the risk threshold of lymph node involvement for performing extended pelvic lymph node dissection in prostate cancer patients: a cost-effectiveness analysis.
CONCLUSION: Applying a WTP threshold of €20.000, completely omitting ePLND in CaP patients is cost-effective compared to other risk-based strategies. However, applying a 20% threshold for probable LNI to the Briganti 2012 nomogram or the Memorial Sloan Kettering Cancer Center web-calculator, may be a feasible alternative, in particular when higher WTP values are considered. PMID: 33121913 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 26, 2020 Category: Urology & Nephrology Authors: Hueting TTA, Cornel EEB, Korthorst RRA, Pleijhuis RRG, Somford DDM, van Basten JJPA, van der Palen JJAM, Koffijberg HH Tags: Urol Oncol Source Type: research

Pathologic nodal downstaging in men with clinically involved lymph nodes undergoing radical prostatectomy: Implications for definitive locoregional therapy.
Abstract A prostate cancer (CaP) patient with nonmetastatic but clinical positive lymph nodes (cN+) represents a difficult clinical scenario. We compare overall survival (OS) between cN+ men that underwent radical prostatectomy (RP) and were found to have negative node status (pN) with those found to have positive nodal status (pN+), and assess predictors of discordant nodal status. We queried the National Cancer Data Base between 2004 and 2015 for patients that were cT1-3 cN+ cM0 CaP treated with RP. Patients with 0 nodes, cT4, or cM1 disease were excluded. We compared groups based on pathologic nodal status: Dis...
Source: Urologic Oncology - October 26, 2020 Category: Urology & Nephrology Authors: Ghali F, Daly WC, Hansen M, Hayn M, Sammon J, Beaule LT, Sarkar R, Murphy J, Kader AK, Derweesh I, Rose B, Ryan ST Tags: Urol Oncol Source Type: research

Oncological outcomes of pathologically organ-confined, lymph node-positive prostate cancer after radical prostatectomy.
Abstract BACKGROUND: The aim of this study was to investigate the impact of lymph-node involvement on oncological outcomes in patients with pathologically organ-confined prostate cancer (pT2 CaP) after radical prostatectomy (RP). METHODS: We retrospectively analyzed 9,631 pT2 CaP patients who underwent RP at a single institution between 1998 and 2018. Kaplan-Meier plots and Cox regression models (CRMs) assessed biochemical recurrence (BCR)-free survival and metastasis-free survival (MFS) according to N-stage. In subgroup analyses of N1 patients, Kaplan-Meier plots and CRMs were stratified according to adjuvan...
Source: Urologic Oncology - October 20, 2020 Category: Urology & Nephrology Authors: Stolzenbach LF, Knipper S, Mandel P, Ascalone L, Deuker M, Tian Z, Heinzer H, Tilki D, Maurer T, Graefen M, Karakiewicz PI, Steuber T Tags: Urol Oncol Source Type: research

Prognostic significance of complete blood count parameters in castration-resistant prostate cancer patients treated with androgen receptor pathway inhibitors.
This study investigated the prognostic significance of complete blood count data in castration-resistant prostate cancer patients treated using androgen receptor pathway inhibitors (ARPIs). PATIENTS AND METHODS: Patients treated with an ARPI, abiraterone or enzalutamide, as first-line therapy for castration-resistant prostate cancer from 2014 to 2018 were included. The association between complete blood count data and prognoses including progression-free survival and overall survival (OS) was investigated. RESULTS: High white blood cell counts (
Source: Urologic Oncology - October 16, 2020 Category: Urology & Nephrology Authors: Machidori A, Shiota M, Kobayashi S, Matsumoto T, Monji K, Kashiwagi E, Takeuchi A, Takahashi R, Inokuchi J, Eto M Tags: Urol Oncol Source Type: research

[18F]Fluoro-Deoxy-Glucose positron emission tomography to evaluate lymph node involvement in patients with muscle-invasive bladder cancer receiving neoadjuvant pembrolizumab.
chi A Abstract BACKGROUND: Data regarding the role of positron emission tomography/computed tomography (PET/CT) to stage lymph nodes in patients receiving neoadjuvant immunotherapy before radical cystectomy are lacking. The aim of this study is to evaluate the role of PET/CT to predict the pathologic lymph node involvement (LNI) in patients with MIBC receiving neoadjuvant pembrolizumab within the PURE-01 trial (NCT02736266). MATERIAL AND METHODS: Three courses of pembrolizumab were administered before radical cystectomy and extended pelvic lymph node dissection in clinical T2-4aN0M0 MIBC based on contrast-enh...
Source: Urologic Oncology - October 15, 2020 Category: Urology & Nephrology Authors: Marandino L, Capozza A, Bandini M, Raggi D, Farè E, Pederzoli F, Gallina A, Capitanio U, Bianchi M, Gandaglia G, Fossati N, Colecchia M, Giannatempo P, Serafini G, Padovano B, Salonia A, Briganti A, Montorsi F, Alessi A, Necchi A Tags: Urol Oncol Source Type: research

Site of metastatic recurrence impacts prognosis in patients with high-grade upper tract urothelial carcinoma.
CONCLUSIONS: A significant proportion of high-grade upper tract urothelial carcinoma patients recur systemically after radical nephroureterectomy. Lymphovascular invasion is a predictor of metastatic recurrence and may inform decisions regarding perioperative chemotherapy. Hepatic and osseous recurrences have relatively quicker onset and less favorable prognosis compared to other sites. These findings may benefit future efforts to develop recurrence site-specific treatment plans and highlight the necessity of subsequent endeavors to explore the genetic associations of recurrence in upper tract urothelial carcinoma. PM...
Source: Urologic Oncology - October 15, 2020 Category: Urology & Nephrology Authors: Cheaib JG, Claus LE, Patel HD, Kates MR, Matoso A, Hahn NM, Bivalacqua TJ, Hoffman-Censits JH, Pierorazio PM Tags: Urol Oncol Source Type: research

PD-L1 expression in tumor-infiltrating lymphocytes (TILs) as an independent predictor of prognosis in patients with pN0 bladder cancer undergoing radical cystectomy.
CONCLUSION: Positive PD-L1 expression is associated with high-grade tumors. PD-L1-positive TILs are independent predictors of favorable survival outcomes in surgically resected UCB patients at stage pN0. PMID: 33071109 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 15, 2020 Category: Urology & Nephrology Authors: Murakami Y, Matsumoto K, Shimizu Y, Ikeda M, Amano N, Shimura S, Ishii D, Sato Y, Iwamura M Tags: Urol Oncol Source Type: research

Outcome prediction following radical nephroureterectomy for upper tract urothelial carcinoma.
CONCLUSION: We designed a predictive model for survival outcomes following RNU in UTUC. This model uses simple, readily available data for patients without the need for expensive or additional testing. PMID: 33069555 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 14, 2020 Category: Urology & Nephrology Authors: Abdul-Muhsin H, De Lucia N, Singh V, Faraj K, Rose K, Cha S, Zhang N, Judge N, Navaratnam A, Tyson M, Ho T, Jacobsohn K, Castle E Tags: Urol Oncol Source Type: research

The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy.
CONCLUSIONS: We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients. PMID: 33046366 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 9, 2020 Category: Urology & Nephrology Authors: Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G Tags: Urol Oncol Source Type: research

Stratifying patients with intermediate-risk prostate cancer: Validation of a new model based on MRI parameters and targeted biopsy and comparison with NCCN and AUA subclassifications.
Albisinni S Abstract OBJECTIVE: Intermediate-risk prostate cancer regroups heterogeneous patients with different oncologic outcomes. Aim of the study is to validate a novel intermediate-risk subclassification ("magnetic resonance imaging [MRI] subclassification") that defines favorable and unfavorable diseases based on multiparametric MRI parameters and compare it to NCCN and AUA intermediate-risk subclassifications. METHODS: A total of 429 patients treated with radical prostatectomy for NCCN intermediate-risk prostate cancer were identified. Using MRI subclassification, a favorable disease was defi...
Source: Urologic Oncology - October 8, 2020 Category: Urology & Nephrology Authors: Diamand R, Ploussard G, Roumiguié M, Malavaud B, Oderda M, Gontero P, Fourcade A, Fournier G, Benamran D, Iselin C, Fiard G, Descotes JL, Peltier A, Simone G, Roche JB, Roumeguère T, Albisinni S Tags: Urol Oncol Source Type: research

Functional and oncological outcome of percutaneous cryoablation versus laparoscopic partial nephrectomy for clinical T1 renal tumors: A propensity score-matched analysis.
Abstract PURPOSE: To evaluate the clinical trifecta of percutaneous cryoablation (PCA) vs. laparoscopic partial nephrectomy (LPN) for cT1 renal tumors. PATIENTS AND METHODS: We retrospectively analyzed the records of patients who had undergone 2 types of nephron sparing surgeries (NSS) PCA or LPN for cT1 renal tumors between November 2011 and December 2019. The cohorts were matched by one-to-one propensity scores based on patient demographics, renal function, and tumor complexity. Perioperative and oncological outcomes and preservation of renal function following surgery were compared. RESULTS: After mat...
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Yanagisawa T, Miki J, Shimizu K, Fukuokaya W, Urabe F, Mori K, Sasaki H, Kimura T, Miki K, Egawa S Tags: Urol Oncol Source Type: research

The effect of sex on disease stage and survival after radical cystectomy: a population-based analysis.
Abstract BACKGROUND: The increased awareness regarding the sex gap in bladder cancer (BCa) care over the last decade may have resulted in more timely-wise referral patterns and treatment of female patients with BCa. Thus, we tested the association of sex with disease stage at presentation, as well as with cancer-specific mortality (CSM) after radical cystectomy (RC) in a contemporary cohort of patients with nonmetastatic urothelial bladder cancer (UCUB). METHODS: Within the Surveillance, Epidemiology, and End Results database (2004-2016), we identified 14,086 patients (10,879 men and 3,207 women) treated with...
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Rosiello G, Palumbo C, Pecoraro A, Luzzago S, Deuker M, Stolzenbach LF, Tian Z, Gallina A, Gandaglia G, Montorsi F, Shariat SF, Saad F, Briganti A, Karakiewicz PI Tags: Urol Oncol Source Type: research

A new index (A/G) associated with early complications of radical cystectomy and intestinal urinary diversion.
CONCLUSIONS: We put forward a new index named A/G associated with complications after radical cystectomy, not singular considering albumin or blood glucose any more. This novel related index may provide an early alert for RC-IUD patients thus aiding in directing individual rehabilitation and improving postoperative outcomes after RC-IUD. PMID: 33036901 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Cheng Q, Gu L, Zhao X, Chen W, Chang X, Ai Q, Zhang X, Li H Tags: Urol Oncol Source Type: research

Topical chemotherapy for penile carcinoma in situ: Contemporary outcomes and reported toxicity.
CONCLUSIONS: Topical chemotherapy is a reasonable first-line therapy for penile CIS. A substantial proportion of patients experience acute toxicity and are unable to complete the full course of therapy. We recommend that patients with penile CIS be monitored regularly in order to promptly address issues with adherence and toxicity associated with topical treatment. PMID: 33036902 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Hajiran A, Zemp L, Aydin AM, Cheryian SK, Pow-Sang JM, Chahoud J, Spiess PE Tags: Urol Oncol Source Type: research

Trends in urologic oncology clinical practice and medical education under COVID-19 pandemic: An international survey of senior clinical and academic urologists.
Abstract OBJECTIVE: Ad-hoc guidelines for managing the COVID-19 pandemic are published worldwide. We investigated international applications of such policies in the urologic-oncology community. METHODS: A 20-item survey was e-mailed via SurveyMonkey to 100 international senior urologic-oncology surgeons. Leaders' policies regarding clinical/surgical management and medical education were surveyed probing demographics, affiliations, urologic-oncologic areas of interest, and current transportation restrictions. Data on COVID-19 burden were retrieved from the ECDC. Statistical analyses employed non-parametric tes...
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Rosenzweig B, Bex A, Dotan ZA, Frydenberg M, Klotz L, Lotan Y, Schulman CC, Tsaur I, Ramon J Tags: Urol Oncol Source Type: research

Comparison of renal function after open radical cystectomy, extracorporeal robot assisted radical cystectomy, and intracorporeal robot assisted radical cystectomy.
Abstract PURPOSE: Renal function outcomes following robot-assisted radical cystectomy (RARC) have not been well established. We sought to compare long-term renal function outcomes between open radical cystectomy, RARC with extracorporeal urinary diversion and intracorporeal urinary diversion at a high volume institution. MATERIALS AND METHODS: We retrospectively reviewed our institutional bladder cancer database for patients who underwent RC from 2010 to 2019 with pre-operative estimated glomerular filtration rate (eGFR)> 45 ml/min/1.73m2. Changes in renal function were assessed through locally weighted sc...
Source: Urologic Oncology - October 6, 2020 Category: Urology & Nephrology Authors: Lone Z, Murthy PB, Zhang JH, Ericson KJ, Thomas L, Khanna A, Haber GP, Lee BH Tags: Urol Oncol Source Type: research

Cystectomy outcomes in patients who have failed Radiofrequency-induced Thermo-chemotherapeutic Effect Mitomycin-C (RITE-MMC) treatment for high-risk non-muscle invasive bladder cancer (HRNMIBC)-Does it complicate surgery and adversely impact oncological outcome?
CONCLUSION: We have found that RITE-MMC treatment does not result in a technically more challenging cystectomy and does not compromise oncological outcome compared to those patients undergoing cystectomy immediately post-BCG failure. We feel RITE-MMC remains a useful tool in a carefully selected group of patients who may not be willing to accept the morbidity of a cystectomy at the time, without significantly compromising their long-term outcome. PMID: 33032922 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - October 5, 2020 Category: Urology & Nephrology Authors: Sri D, Lee HJ, El-Gemmal S, Backhouse C, Tay A, John B, Perry MJ, Ayres BE, Issa R Tags: Urol Oncol Source Type: research

Trends in management of ureteral urothelial carcinoma and effects on survival: a hospital-based registry study.
CONCLUSION: Our study suggests that SU may be an appropriate alternative to NU for the management of high-risk ureteral tumors. Further, lymphadenectomy may play an important role at the time of NU, and adjuvant chemotherapy is infrequently utilized in patients with advanced pathology. PMID: 33012575 [PubMed - as supplied by publisher] (Source: Urologic Oncology)
Source: Urologic Oncology - September 30, 2020 Category: Urology & Nephrology Authors: Lec PM, Venkataramana A, Lenis AT, Fero KE, Sharma V, Golla V, Gollapudi K, Blumberg J, Chamie K Tags: Urol Oncol Source Type: research

Evolving insights into penile cancer pathology and the eighth edition of the AJCC TNM staging system.
la AL Abstract The majority of penile malignant tumors are squamous cell carcinomas. They are pathologically defined as epithelial neoplasms originating in the squamous cells of the inner mucosal lining of the glans, coronal sulcus or foreskin. Tumor location and site of origin is preferentially in glans (70%) followed by foreskin (25%) and coronal sulcus (5%). Despite the variable geographic distribution, pathological features of penile carcinomas in areas of high- and low-risk are similar. Penile tumors are morphologically heterogeneous. A major advance, based on biological, etiological and prognostic factors, i...
Source: Urologic Oncology - September 28, 2020 Category: Urology & Nephrology Authors: Sanchez DF, Fernandez-Nestosa MJ, Cañete-Portillo S, Cubilla AL Tags: Urol Oncol Source Type: research