11 results on '"Yossepowitch, Ofer"'
Search Results
2. The oncologic role of local treatment in primary metastatic prostate cancer
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Ghadjar, Pirus, Briganti, Alberto, De Visschere, Peter J. L., Fütterer, Jurgen J., Giannarini, Gianluca, Isbarn, Hendrik, Ost, Piet, Sooriakumaran, Prasanna, Surcel, Christian I., van den Bergh, Roderick C. N., van Oort, Inge M., Yossepowitch, Ofer, and Ploussard, Guillaume
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- 2015
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3. Preferences in management of high-risk prostate cancer among urologists in Europe: results of a web-based survey
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Surcel, Cristian I, Sooriakumaran, Prasanna, Briganti, Alberto, De Visschere, Pieter, Fütterer, Jurgen J, Ghadjar, Pirus, Isbarn, Hendrik, Ost, Piet, Ploussard, Guillaume, van den Bergh, Roderick CN, van Oort, Inge M, Yossepowitch, Ofer, Sedelaar, JP Michiel, and Giannarini, Gianluca
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prostatectomy ,MORTALITY ,RADICAL PROSTATECTOMY ,UNITED-STATES ,MEN ,androgen deprivation therapy ,TRENDS ,radiation therapy ,prostatic neoplasms ,LYMPH-NODE DISSECTION ,RADIATION-THERAPY ,Medicine and Health Sciences ,survey ,high-risk prostate cancer ,RATES - Abstract
Objective : To explore preferences in the management of patients with newly diagnosed high-risk prostate cancer (PCa) among urologists in Europe through a web-based survey. Materials and Methods : A web-based survey was conducted between 15 August and 15 September 2013 by members of the Prostate Cancer Working Group of the Young Academic Urologists Working Party of the European Association of Urology (EAU). A specific, 29-item multiple-choice questionnaire covering the whole spectrum of diagnosis, staging and treatment of high-risk PCa was e-mailed to all urologists included in the mailing list of EAU members. Europe was divided into four geographical regions: Central-Eastern Europe (CEE), Northern Europe (NE), Southern Europe (SE) and Western Europe (WE). Descriptive statistics were used. Differences among sample segments were obtained from a z-test compared with the total sample. Results : Of the 12 850 invited EAU members, 585 urologists practising in Europe completed the survey. High-risk PCa was defined as serum PSA >= 20 ng/mL or clinical stage >= T3 or biopsy Gleason score >= 8 by 67% of responders, without significant geographical variations. The preferred single-imaging examinations for staging were bone scan (74%, 81% in WE and 70% in SE; P = 0.02 for both), magnetic resonance imaging (53%, 72% in WE and 40% in SE; P = 0.02 and P = 0.01, respectively) and computed tomography (45%, 60% in SE and 23% in WE; P = 0.01 for both). Pre-treatment predictive tools were routinely used by 62% of the urologists, without significant geographical variations. The preferred treatment was radical prostatectomy as the initial step of a multipletreatment approach (60%, 40% in NE and 70% in CEE; P = 0.02 and P < 0.01, respectively), followed by external beam radiation therapy with androgen deprivation therapy (29%, 45% in NE and 20% in CEE; P = 0.01 and P = 0.02, respectively), and radical prostatectomy as monotherapy (4%, 7% in WE; P = 0.04). When surgery was performed, the open retropubic approach was the most popular (58%, 74% in CEE, 37% in NE; P < 0.01 for both). Pelvic lymph node dissection was performed by 96% of urologists, equally split between a standard and extended template. There was no consensus on the definition of disease recurrence after primary treatment, and much heterogeneity in the administration of adjuvant and salvage treatments. Conclusion : With the limitation of a low response rate, the present study is the first survey evaluating preferences in the management of high-risk PCa among urologists in Europe. [...]
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- 2015
4. Nitric oxide charged catheters as a potential strategy for prevention of hospital acquired infections.
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Margel, David, Mizrahi, Mark, Regev-Shoshani, Gili, KO, Mary, Moshe, Maya, Ozalvo, Rachel, Shavit-Grievink, Liat, Baniel, Jack, Kedar, Daniel, Yossepowitch, Ofer, Lifshitz, David, Nadu, Andrei, Greenberg, David, and Av-Gay, Yossef
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NOSOCOMIAL infection prevention ,CATHETER-related infections ,NITRIC oxide ,BIOFILMS ,MICROBIAL cells - Abstract
Background: Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces. Aims and methods: The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 10
3 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed. Results: NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24–48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's). Conclusion: These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's. [ABSTRACT FROM AUTHOR]- Published
- 2017
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5. Pathological results and rates of treatment failure in high-risk prostate cancer patients after radical prostatectomy.
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Walz, Jochen, Joniau, Steven, Chun, Felix K., Isbarn, Hendrik, Jeldres, Claudio, Yossepowitch, Ofer, Chao-Yu, Hsu, Klein, Eric A., Scardino, Peter T., Reuther, Alwyn, Poppel, Hein Van, Graefen, Markus, Huland, Hartwig, and Karakiewicz, Pierre I.
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PROSTATE cancer patients ,BIOPSY ,PATHOLOGY ,SURGICAL site ,PROGNOSIS ,MODALITY (Theory of knowledge) - Abstract
OBJECTIVE • To investigate the pathological characteristics and the rates of biochemical recurrence (BCR) -free survival after radical prostatectomy (RP) in men with high-risk prostate cancer. METHODS • Of 4760 patients treated with RP for prostate cancer at three institutions, 293 patients (6.2%) had clinical stage T3, 269 (5.7%) had a biopsy Gleason sum ⩾ 8, 370 (7.8%) had preoperative PSA ⩾ 20 ng/mL and 887 (18.6%) were considered high-risk according to the D'Amico classification (clinical stage ⩾ T2c or prostate-specific antigen (PSA) ⩾ 20 ng/mL or biopsy Gleason sum ⩾ 8). • Actuarial BCR-free survival probabilities after RP and the rate of favourable pathology (organ-confined cancer, negative surgical margin and Gleason ? 7) were assessed. RESULTS • Median follow up was 2.4 years and 1179 (24.8%) patients had follow up beyond 5 years. • The rate of favourable pathology increased in the following order: clinical stage T3 (13.7%), biopsy Gleason ⩾ 8 (16.4%), the D'Amico high-risk group (21.4%) and PSA ⩾ 20 ng/mL (21.6%). • The 5-year BCR-free survival probabilities were 35.4% for Gleason ⩾ 8, 39.8% for PSA ⩾ 20 ng/mL, 47.4% for D'Amico high-risk group and 51.6% for clinical stage T3. • Patients with only one risk factor had the most favourable 5-year BCR-free survival (50.3%), relative to patients with two or more risk factors (27.5%) CONCLUSIONS • Men with clinically localized high-risk prostate cancer do not have a uniformly poor prognosis after RP. • The rate of favourable pathology and of BCR-free survival may vary substantially, depending on the definition used. • RP should be considered a valid treatment modality for high-risk prostate cancer patients, as many can be surgically downstaged. [ABSTRACT FROM AUTHOR]
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- 2011
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6. Positive Surgical Margins in Radical Prostatectomy: Outlining the Problem and Its Long-Term Consequences
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Yossepowitch, Ofer, Bjartell, Anders, Eastham, James A., Graefen, Markus, Guillonneau, Bertrand D., Karakiewicz, Pierre I., Montironi, Rodolfo, and Montorsi, Franceso
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PROSTATE cancer treatment , *CANCER radiotherapy , *FROZEN tissue sections , *ETIOLOGY of diseases , *MAGNETIC resonance imaging , *LAPAROSCOPY ,PROSTATECTOMY complications - Abstract
Abstract: Context: This review focuses on positive surgical margins (PSM) in radical prostatectomy (RP). Objective: To address the etiology, incidence, and oncologic impact of PSM and discuss technical points to help surgeons minimize their positive margin rate. An evidence-based approach to assist clinicians in counseling patients with a PSM is provided. Evidence acquisition: A literature search in English was performed using the National Library of Medicine database and the following key words: prostate cancer, surgical margins, and radical prostatectomy. Seven hundred sixty-eight references were scrutinized, and 73 were selected for rigorous review based on their pertinence, study size, and overall contribution to the field. Evidence synthesis: In contemporary series, PSM are reported in 11–38% of patients undergoing RP. Although variability exists in the pathologic interpretation of surgical margins, PSM are associated with an increased hazard of biochemical recurrence (BCR) and local disease recurrence as well as the need for secondary cancer treatment. A posterolateral PSM appears to confer the greatest risk of recurrence, whereas the prognostic significance of positive apical margins remains controversial. The role of preoperative imaging and intraoperative frozen section analysis are being investigated to reduce margin positivity rates. Level-1 evidence indicates that adjuvant radiotherapy (RT) in men with PSM reduces BCR rates and clinical progression and possibly improves overall survival (OS). Conclusions: PSM in RP specimens are uniformly considered an adverse outcome. Regardless of approach (open or laparoscopic), attention to surgical detail is essential to minimize rates. For patients with a PSM destined to experience a cancer recurrence, RT is the only established treatment with curative potential. A randomized trial in patients with PSM comparing immediate postoperative RT to salvage RT is critically needed before definitive recommendations can be made. [Copyright &y& Elsevier]
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- 2009
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7. Secondary Therapy, Metastatic Progression, and Cancer-Specific Mortality in Men with Clinically High-Risk Prostate Cancer Treated with Radical Prostatectomy
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Yossepowitch, Ofer, Eggener, Scott E., Serio, Angel M., Carver, Brett S., Bianco, Fernando J., Scardino, Peter T., and Eastham, James A.
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PROSTATE cancer , *CANCER patients , *CANCER treatment , *PROSTATE-specific antigen , *THERAPEUTICS , *DISEASE relapse - Abstract
Abstract: Objectives: Commonly used definitions for high-risk prostate cancer identify men at increased risk of PSA relapse after radical prostatectomy (RP). We assessed how accurately these definitions identify patients likely to receive secondary cancer therapy, experience metastatic progression, or die of prostate cancer. Materials and methods: Among 5960 men with clinically localized or locally advanced prostate cancer who underwent RP, we identified eight different high-risk subsets, each comprising 4–40% of the study population. Estimates of freedom from radiation therapy, hormonal therapy, and metastatic progression after surgery were generated for each high-risk cohort with the Kaplan-Meier method, and hazard ratios (HR) were calculated with a Cox proportional hazards regression. The cumulative incidence and HR for prostate cancer–specific mortality (PCSM) were estimated with competing risk analysis. Results: Each of the studied high-risk criteria was associated with increased hazard of secondary cancer therapy (HR=1.3–5.2, p <0.05) and metastatic progression (HR=2.1–6.9, p <0.05). However, depending on the definition, the probability of freedom from additional therapy 10 yr after surgery ranged from 35% to 76%. The 10-yr cumulative incidence of PCSM in high-risk patients ranged from 3% to 11% (HR=3.2–10.4, p <0.0005). Conclusions: Commonly used definitions for high-risk prostate cancer identify men at increased risk of secondary cancer therapy, metastatic progression, and PCSM following RP. However, a substantial proportion of high-risk patients remain free from additional therapy or metastatic disease many years after surgery. The risk of PCSM within 10 yr of treatment is remarkably low, even for patients at the highest risk of recurrent disease. [Copyright &y& Elsevier]
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- 2008
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8. Assessing the value of a pelvic drain for urinary leak after robotic radical prostatectomy.
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Bologna, Eugenio, Perlman, Hilly, Zeeman, Idan, Bashi, Tomer, Lifshitz, Karin, Beri, Avi, Mano, Roy, Yossepowitch, Ofer, Dekalo, Snir, Bar‐Yosef, Yuval, and Savin, Ziv
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Aim Methods Results Conclusions The value of post‐operative pelvic drain placement after robot‐assisted radical prostatectomy (RARP) for the purpose of diagnosing post‐operative complications is undetermined. The aim of this study was to assess the yield of pelvic drain outputs in predicting post‐operative early‐onset urinary leaks from a vesicourethral anastomosis.We conducted a retrospective analysis of 204 consecutive patients who underwent RARP in our institution between 2018 and 2022. The daily outputs of the drain and the urinary catheter were measured, and patients with early‐onset anastomotic urinary leak were compared with those who were free of any leak. The association between post‐operative drain output and the presence of urinary leak was investigated by regression analyses.Post‐operative early‐onset leak was present in six patients (3.4%) whose baseline characteristics were not different from those of patients with no leak. The median pelvic drain output on post‐operative day 1 (D‐POD1) was 80 mL (interquartile range [IQR] 51–150 mL) and 122 mL (IQR 62–200 mL) on D‐POD2. The median D‐POD1 of patients with a leak was significantly higher than those without one (250 mL vs 80 mL, respectively; P < .001). The threshold to predict an anastomotic urinary leak was 227 mL on D‐POD1 (area under the curve 0.88; P < .001), and an association between D‐POD1 >227 mL and the presence of urinary leak (odds ratio 35; P < .001) was found.Pelvic drain output on POD1 can predict early‐onset urinary leak. Given the relatively low rate of this complication via a robotic approach, however, we consider that, unless otherwise indicated, the routine placement of a pelvic drain may be safely avoided. [ABSTRACT FROM AUTHOR]
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- 2024
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9. 68Ga-PSMA PET/CT: Does it predict adverse pathology findings at radical prostatectomy?
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Dekalo, Snir, Kuten, Jonathan, Mabjeesh, Nicola J, Beri, Avi, Even-Sapir, Einat, and Yossepowitch, Ofer
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PROSTATE cancer , *RECEIVER operating characteristic curves , *POSITRON emission tomography computed tomography , *NUCLEAR medicine , *PROSTATECTOMY - Abstract
Introduction: Data on the accuracy of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with intermediate/high-risk prostate cancer are being accumulated. Its role in assessing the extent of local disease has not been fully elaborated.Aim: To determine the performance characteristics of 68Ga-PSMA PET/CT in identifying local disease extension in patients with intermediate/high risk prostate cancer.Methods: 68Ga-PSMA PET/CT studies of 61 consecutive patients with intermediate/high-risk prostate cancer who underwent radical prostatectomy were reviewed by nuclear medicine specialists. Tumor location, extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph nodes involvement (LNI) were compared to pathological findings. The incremental value of 68Ga-PSMA PET/CT to established nomograms was determined.Results: Two patients without pathologic uptake of 68Ga-PSMA were excluded. Seventeen patients were diagnosed with EPE (29%), 12(20%) had SVI and 3(5%) LNI. The concordance between tumor location and 68Ga-PSMA PET/CT findings was 48%, and EPE was not indicated by PET in any of the patients. The sensitivity, specificity, positive, and negative predictive value for SVI were 58%, 96%, 78%, 90%, respectively (area under the receiver operating characteristic curve = 0.77) and for LNI 67%, 98%, 67%, 98%, respectively (area under the receiver operating characteristic curve = 0.82). Incorporating imaging findings into the MSKCC-SVI nomogram enhanced the diagnostic accuracy from 0.84 to 0.95 (Integrated Discrimination Increment 0.24, P = 0.004).Conclusion: In patients with intermediate/high-risk prostate cancer, 68Ga-PSMA PET/CT provides information regarding intraprostatic tumor location, SVI and LNI but has no role in assessment for EPE. This information might be useful for pretreatment counseling, decision-making and possibly preoperative planning. [ABSTRACT FROM AUTHOR]- Published
- 2019
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10. The oncologic role of local treatment in primary metastatic prostate cancer
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Gianluca Giannarini, Inge M. van Oort, Guillaume Ploussard, Alberto Briganti, Christian I. Surcel, Hendrik Isbarn, Piet Ost, Roderick C.N. van den Bergh, Jurgen J. Fütterer, Ofer Yossepowitch, Pirus Ghadjar, Prasanna Sooriakumaran, Peter J.L. De Visschere, Ghadjar, Piru, Briganti, Alberto, De Visschere Peter, J. L., Futterer Jurgen, J., Giannarini, Gianluca, Isbarn, Hendrik, Ost, Piet, Sooriakumaran, Prasanna, Surcel Christian, I., van den Bergh Roderick, C. N., van Oort Inge, M., Yossepowitch, Ofer, and Ploussard, Guillaume
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Oncology ,Male ,medicine.medical_treatment ,Metastasi ,law.invention ,Metastasis ,Androgen deprivation therapy ,Prostate cancer ,Randomized controlled trial ,law ,Prostate ,Androgen Antagonist ,Neoplasm Metastasis ,Outcome ,education.field_of_study ,Prostatectomy ,High risk ,Local treatment ,Lymph Node ,Radical prostatectomy ,Radiation therapy ,Neoplasm Metastasi ,medicine.anatomical_structure ,Treatment Outcome ,Chemotherapy, Adjuvant ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Metastatic ,Human ,medicine.medical_specialty ,Pelvi ,Urology ,Population ,Bone Neoplasms ,Bone Neoplasm ,Pelvis ,Internal medicine ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,medicine ,Humans ,education ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Androgen Antagonists ,medicine.disease ,Prostatic Neoplasm ,Lymph Node Excision ,Radiotherapy, Adjuvant ,Lymph Nodes ,business - Abstract
Item does not contain fulltext PURPOSE: To determine the oncologic benefit or otherwise of local treatment of the prostate in patients with primary metastatic prostate cancer. METHODS: A review of the literature was performed in April 2014 using the Medline/PubMed database. Studies were identified using the search terms "prostate cancer," "metastatic," "metastasis," "high risk," "radiation therapy," "radiotherapy" and "prostatectomy" from 1990 until April, 2014. Articles were also identified through searches of references of these articles. RESULTS: Retrospective series and population-based data suggest that the use of local treatment of the prostate in patients with primary metastatic prostate cancer may improve cancer-specific survival and overall survival compared with treating these patients with androgen deprivation therapy alone. The clinical outcome in metastatic prostate cancer is largely determined by the extent of lymph node involvement and overall metastatic burden. Contemporary data are lacking to recommend one alternative of local therapy (radiotherapy or radical prostatectomy) over the other. The primary limitation of this literature review is the lack of published randomized trial assessing the role of local treatment in addition to systemic therapy. CONCLUSIONS: Local treatment appears to improve oncologic outcomes in metastatic prostate cancer patients. Nevertheless, due to the lack of high-quality evidence, its role needs to be confirmed in future prospective trials. The selection of ideal candidates and optimal treatment alternative (radiotherapy, radical prostatectomy or other) warrants further investigation.
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- 2014
11. Can we expand active surveillance criteria to include biopsy Gleason 3+4 prostate cancer? A multi-institutional study of 2,323 patients.
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Ploussard, Guillaume, Isbarn, Hendrik, Briganti, Alberto, Sooriakumaran, Prasanna, Surcel, Christian I., Salomon, Laurent, Freschi, Massimo, Mirvald, Cristian, van der Poel, Henk G., Jenkins, Anna, Ost, Piet, van Oort, Inge M., Yossepowitch, Ofer, Giannarini, Gianluca, and van den Bergh, Roderick C.N.
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PROSTATE cancer patients , *BIOPSY , *PROSTATE cancer risk factors , *PROSTATECTOMY , *PROSTATE-specific antigen , *BIOSURVEILLANCE - Abstract
Objective To test the expandability of active surveillance (AS) to Gleason score 3+4 cancers by assessing the unfavorable disease risk in a large multi-institutional cohort. Materials and methods We performed a retrospective analysis including 2,323 patients with localized Gleason score 3+4 prostate cancer who underwent a radical prostatectomy between 2005 and 2013 from 6 academic centers. We analyzed the rates of biopsy downgrading/upgrading and advanced stage in the overall cohort by employing standardized AS criteria (using biopsy Gleason score 3+4). Results The final pathologic Gleason score was 3+3 = 6 in 8%, 3+4 = 7 in 67%, 4+3 = 7 in 20%, and 8 to 10 in 5% cases. The overall rate of unfavorable disease (upgrading or advanced stage or both) was 46%. In multivariable analysis, prostate-specific antigen (PSA) level>10 ng/ml, PSA density (PSAD) >0.15 ng/ml/g, clinical stage >T1, and>2 positive cores were predictors of unfavorable disease. According to the AS criteria used, the risk of unfavorable disease ranged from 30% to 42%. In patients without any risk factor (PSA level≤10 ng/ml, PSAD ≤0.15 ng/ml/g, T1c, and≤2 positive cores), the unfavorable disease rate was 19%. The main limitations of this study are the retrospective design and nonstandardization of pathologic assessment between centers. Conclusions Approximately half of patients with biopsy Gleason score 3+4 cancer have unfavorable disease at final pathology. Nevertheless, expanding AS eligibility to these patients may be acceptable provided adherence to strict selection criteria leading to a<20% risk of unfavorable disease. Future tools for selection such as magnetic resonance imaging, early rebiopsy, and serum markers may be especially beneficial in this group of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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