532 results on '"Edward M. Messing"'
Search Results
102. Molecular Landscape of Non-Muscle Invasive Bladder Cancer
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Edward M. Messing
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0301 basic medicine ,Bladder cancer ,business.industry ,Urology ,medicine.disease ,Paper Alert ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Text mining ,Oncology ,030220 oncology & carcinogenesis ,medicine ,Cancer research ,Non muscle invasive ,business - Published
- 2018
103. Bladder Cancer Extracellular Vesicles Drive Tumorigenesis by Inducing Endoplasmic Reticulum Stress
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Chia-Hao Wu, Edward M. Messing, Yi-Fen Lee, and Christopher Silvers
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Chemistry ,medicine.medical_treatment ,Endoplasmic reticulum ,Contact inhibition ,Inflammation ,medicine.disease_cause ,Malignant transformation ,Cytokine ,Cancer research ,medicine ,Unfolded protein response ,Neoplastic transformation ,medicine.symptom ,Carcinogenesis - Abstract
The field cancerization effect has been proposed to explain bladder cancer's multifocal and recurrent nature, yet its mechanisms remain unknown. In this work we show that chronic exposure to tumor-derived extracellular vesicles (TEVs) resulted in the neoplastic transformation of non-malignant human SV-HUC urothelial cells. Inhibition of EV uptake prevented transformation. Transformed cells not only possessed several oncogenic properties, such as genome instability, loss of cell-cell contact inhibition, and invasiveness, but also displayed altered morphology where cells show enlarged cytoplasm with disrupted ER alignment and the accumulation of smaller mitochondria. Treatment of SV-HUC cells with TEVs provoked the unfolded protein response of endoplasmic reticulum (UPRER). Prolonged induction of UPRER signaling led to the activation of the survival branch of the UPRER pathway, where cells had elevated expression of the IRE1, NFi«B and the inflammatory cytokine leptin, and loss of CHOP, a pro-apoptotic protein. More importantly, inhibition of ER stress by docosahexaenoic acid prevented TEV-induced transformation. We propose that TEVs promote malignant transformation of predisposed cells by inhibiting pro-apoptotic signals and activating tumor-promoting ER stress-induced unfolded protein response and inflammation. This study provides insight into the mechanisms of the bladder cancer field effect and tumor recurrence. Funding Statement: This work is supported by NCI R01 CA173986 (YF Lee, PI). Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: The study was approved by the University of Rochester Committee on Animal Resources, and the mice were kept in a specific pathogen-free environment.
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- 2018
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104. The conundrum of recurrent low-grade tumours: to treat or to observe?
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Edward M. Messing, Iris Brummelhuis, and J. Alfred Witjes
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Ablation Techniques ,medicine.medical_specialty ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,Risk Factors ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,In patient ,Watchful Waiting ,Carcinoma, Transitional Cell ,Heterogeneous group ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Fulguration ,Cystoscopy ,medicine.disease ,Prognosis ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Risk stratification ,Radiology ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Intermediate risk - Abstract
Item does not contain fulltext PURPOSE OF REVIEW: To describe the importance of risk stratification and the role of more conservative management like office fulguration, office laser ablation and active surveillance in recurrent low-grade Ta tumours. RECENT FINDINGS: Updated models have been designed for risk stratification of intermediate-risk tumours. Conservative forms of management like office fulguration or laser ablation and even active surveillance seem well tolerated; however, randomized, controlled trials are lacking. In patients who have been tumour free for 5 years, late recurrences have been described. SUMMARY: Recurrent low-grade Ta tumours are classified in the intermediate risk group, which is a heterogeneous group. Therefore, risk stratification should be done by updated models or patients should be stratified in a risk group sub-classification. Recurrent low-grade Ta patients have a favourable prognosis and consequently are prone to overtreatment. Office fulguration or laser ablation or even active surveillance could be implemented in strictly selected patients. For active surveillance, Miyake et al. proposed a helpful flowchart with criteria for patient selection and for intervention. Follow up using cystoscopy and cytology is essential, but an optimal scheme has not been identified. As late recurrences are not infrequent and recurrent low-grade Ta patients can even die from bladder cancer, long term follow-up should be performed yearly, by cystoscopy and cytology.
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- 2018
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105. Automated Urinalysis Machines: Potential Impact on the Diagnosis of Bladder Cancer
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Edward M. Messing
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medicine.medical_specialty ,Potential impact ,Bladder cancer ,Oncology ,Urinalysis ,medicine.diagnostic_test ,business.industry ,Urology ,medicine ,business ,medicine.disease - Published
- 2019
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106. Characterization of the Host Immuno-Inflammatory State in Response to Radiation Therapy and Correlation with Patient Reported Toxicities In Prostate Adenocarcinoma, A Prospective Observational Trial
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Hengshan Zhang, Carmen Bergom, A. Baran, Sarah L. Kerns, Edward M. Messing, Derick R. Peterson, Gary R. Morrow, William A. Hall, Kevin Bylund, Yuhchyau Chen, and Colleen A. Lawton
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Prostate adenocarcinoma ,Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,Observational Trial ,business.industry ,medicine.medical_treatment ,Radiation therapy ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2019
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107. Antiandrogen Therapy with Hydroxyflutamide or Androgen Receptor Degradation Enhancer ASC-J9 Enhances BCG Efficacy to Better Suppress Bladder Cancer Progression
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Yuanjie Niu, Minghao Zhang, Edward M. Messing, Chawnshang Chang, Jing Tian, Yanjun Li, Zhiqun Shang, Chih-Rong Shyr, Ruifa Han, and Shuyuan Yeh
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Cancer Research ,Curcumin ,Cell Survival ,Gene Expression ,Biology ,urologic and male genital diseases ,Article ,Flutamide ,Mice ,chemistry.chemical_compound ,Cell Movement ,Cell Line, Tumor ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Animals ,Humans ,Cytotoxic T cell ,Antiandrogen Therapy ,skin and connective tissue diseases ,Interleukin 6 ,Bladder cancer ,Interleukin-6 ,Reverse Transcriptase Polymerase Chain Reaction ,Macrophages ,Androgen Antagonists ,Drug Synergism ,medicine.disease ,Androgen receptor ,Treatment Outcome ,Urinary Bladder Neoplasms ,Oncology ,chemistry ,Receptors, Androgen ,Immunology ,BCG Vaccine ,Disease Progression ,Cancer research ,biology.protein ,Female ,Hydroxyflutamide ,BCG vaccine ,Integrin alpha5beta1 - Abstract
Recent studies suggest that the androgen receptor (AR) might play important roles in influencing bladder cancer progression, yet its clinical application remains unclear. Here, we developed a new combined therapy with Bacillus Calmette–Guérin (BCG) and the AR degradation enhancer ASC-J9 or antiandrogen hydroxyflutamide (HF) to better suppress bladder cancer progression. Mechanism dissection revealed that ASC-J9 treatment enhanced BCG efficacy to suppress bladder cancer cell proliferation via increasing the recruitment of monocytes/macrophages that involved the promotion of BCG attachment/internalization to the bladder cancer cells through increased integrin-α5β1 expression and IL6 release. Such consequences might then enhance BCG-induced bladder cancer cell death via increased TNFα release. Interestingly, we also found that ASC-J9 treatment could directly promote BCG-induced HMGB1 release to enhance the BCG cytotoxic effects for suppression of bladder cancer cell growth. In vivo approaches also concluded that ASC-J9 could enhance the efficacy of BCG to better suppress bladder cancer progression in BBN-induced bladder cancer mouse models. Together, these results suggest that the newly developed therapy combining BCG plus ASC-J9 may become a novel therapy to better suppress bladder cancer progress. Mol Cancer Ther; 14(11); 2586–94. ©2015 AACR.
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- 2015
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108. Beyond Cisplatin – I
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Edward M. Messing
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Oncology ,medicine.medical_specialty ,Chemotherapy ,Bevacizumab ,business.industry ,Urology ,medicine.medical_treatment ,Afatinib ,Phases of clinical research ,Combination chemotherapy ,Paper Alert ,Ramucirumab ,Surgery ,Clinical trial ,Docetaxel ,Internal medicine ,medicine ,business ,medicine.drug - Abstract
Roughly 25% of patients at diagnosis of urothelial cancer (UC) have at least muscle invasive disease [1] and about half of these have extravesical extension or more advanced disease at that time. Additionally 10–15% of patients who initially have non-muscle invasive UC will subsequently develop muscle invasive or more advanced cancer. The outlook for patients with advanced or metastatic UC, particularly those who do not respond to Cisplatin-based combination chemotherapy regimens is very poor. Moreover, except in adjuvant and neoadjuvant settings, despite objective response rates to Cisplatin based combination therapies of about 50% [2] median survival is only about 15 months and time to progression far briefer, with 5 year survival only being about 15% [3]. Additionally, because of comorbidities and frailty, many patients with advanced UC cannot receive these Cisplatin containing regimens. Relapsing patients respond poorly to additional treatments with median survival of usually 10 months in patients heavily pretreated with cisplatin chemotherapy [11]. Moreover, neither of these studies used biomarkers to select participants; since if they had, a higher proportion of responses may have been seen. Interestingly, in other studies, inhibitors of VEGF-R1 and VEGF-R3 were not effective [7]. In a separate report [12], Afatinib, an oral irreversible inhibitor of the ErbB receptor family was used as a single agent in 23 patients with metastatic UC, and while only 22% (N = 5) of patients had responses, 5 of the 6 patients with HER2 or ErbB3 alterations accounted for all of these, while none of the 15 without either of these alterations responded. Moreover the one patient with both HER2 amplification and ErbB3 mutations achieved the longest response (10.3 months), actually never progressing while on therapy (stopped because of reduced cardiac ejection fraction which may or may not have been related to the drug). While ErbB3 does not have intrinsic receptor tyrosine kinase activity, it is thought to dimerize with HER2, increasing activity of HER2 akin to amplification of HER2. These alterations in HER2 and ErbB3 were determined by genetic analyses, which did not correlate with immunhistochemical (IHC) expression of the proteins – and, as opposed to the genetic analyses, IHC did not correlated with clinical response. Diarrhea, fatigue and rash were major side effects but only 2 patients experienced grade 3 toxicity. The papers reviewed here illustrate both the promise and complexities of studying targeted agents in advanced UC. While there’s much work still to do, we now have begun to have means to help patients who are refractory to, or unsuitable for cisplatin therapy.
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- 2016
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109. Bladder Sparing Therapy for BCG Failures - I - Intravesical Immunotherapy
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Edward M. Messing
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medicine.medical_specialty ,Oncology ,business.industry ,Urology ,Medicine ,business ,Intravesical chemotherapy ,Bladder sparing ,Paper Alert - Published
- 2017
110. Recruited T cells promote the bladder cancer metastasis via up-regulation of the estrogen receptor β/IL-1/c-MET signals
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Chawnshang Chang, Jianxin Qiu, Shuyuan Yeh, Li Zuo, Zhihong Liu, Elizabeth A. Guancial, Spencer Slavin, Zhenyu Ou, Jifu Ge, Edward M. Messing, and Le Tao
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0301 basic medicine ,CD4-Positive T-Lymphocytes ,Male ,Cancer Research ,Indoles ,Estrogen receptor ,Proto-Oncogene Mas ,Receptor tyrosine kinase ,Piperazines ,Metastasis ,chemistry.chemical_compound ,Mice ,0302 clinical medicine ,Cell Movement ,skin and connective tissue diseases ,Promoter Regions, Genetic ,Sulfonamides ,biology ,Chemistry ,Proto-Oncogene Proteins c-met ,Up-Regulation ,Gene Expression Regulation, Neoplastic ,Oncology ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,Signal transduction ,Signal Transduction ,C-Met ,Urinary Bladder ,Mice, Nude ,Cystectomy ,03 medical and health sciences ,Downregulation and upregulation ,Cell Line, Tumor ,medicine ,Animals ,Estrogen Receptor beta ,Humans ,Neoplasm Invasiveness ,Estrogen receptor beta ,Cell Proliferation ,Bladder cancer ,medicine.disease ,Xenograft Model Antitumor Assays ,030104 developmental biology ,Pyrimidines ,Urinary Bladder Neoplasms ,biology.protein ,Cancer research ,Pyrazoles ,Interleukin-1 - Abstract
Clinical data indicates that T cells can be recruited to bladder cancer (BCa), yet the impact of T cells on BCa progression remains unclear. In the present study, we found that T cells were recruited more to BCa tissues than to the surrounding normal bladder tissues. Results from an in vitro co-culture system also found that BCa recruited more CD4+ T cells than did normal bladder cells. The recruiting of T cells to BCa tissues may increase the proliferation and invasion of BCa cells. Mechanistic studies revealed that infiltrating T cells stimulate BCa estrogen receptor beta (ERβ) signaling and consequently increase the expression of MET proto-oncogene, receptor tyrosine kinase (c-MET), through either direct binding to its promoter or via modulation of IL-1 expression. Interruption of ERβ/c-MET or ERβ/IL-1/c-MET signaling via ERβ-shRNA, IL-1 antagonist, or the c-MET inhibitor, SU11274, could partially reverse the T cell-enhanced BCa cell invasion and proliferation. Finally, the mouse BCa model with xenografted BCa 5637 cells with T (HH) cells confirmed the results of in vitro co-culture studies showing that infiltrating T cells could promote BCa metastasis via modulation of the ERβ/c-MET or ERβ/IL-1/c-MET signaling pathways. These findings may provide a new therapeutic approach to better combat BCa progression via targeting these newly identified signaling pathways.
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- 2017
111. Rate of Symptomatic Lymphocele Formation After Extraperitoneal vs Transperitoneal Robot-Assisted Radical Prostatectomy and Bilateral Pelvic Lymphadenectomy
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Changyong Feng, David Horovitz, Jean V. Joseph, Edward M. Messing, and Xiang Lu
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Lymphocele ,Operative Time ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Prostate ,medicine ,Humans ,Propensity Score ,Lymph node ,Aged ,Retrospective Studies ,Prostatectomy ,business.industry ,Incidence ,Prostatic Neoplasms ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Inguinal hernia ,Dissection ,medicine.anatomical_structure ,Logistic Models ,030220 oncology & carcinogenesis ,Concomitant ,Lymph Node Excision ,Lymph Nodes ,Neoplasm Grading ,Peritoneum ,business ,Body mass index - Abstract
With the peritoneum acting as a natural surface for lymphatic reabsorption, transperitoneal robot-assisted radical prostatectomy (tRARP) is thought to be associated with a lower incidence of symptomatic lymphoceles (SLs) compared with its extraperitoneal counterpart (eRARP) when bilateral pelvic lymph node dissection (BPLND) is performed. In this study, we aim to determine if there is a difference in SL formation and characteristics between the two approaches.We retrospectively reviewed the records of patients who underwent eRARP or tRARP and BPLND by a single surgeon at a tertiary care academic center from July 1, 2003, to May 31, 2016. Patients with a history of prior pelvic radiotherapy, concomitant inguinal hernia repair, RARP without BPLND, or nonadenocarcinoma of the prostate were excluded. The resulting eRARP and tRARP groups were propensity matched for age, body mass index (BMI), American Association of Anesthesiologists (ASA) score, D'Amico risk classification, and pathological lymph node (LN) count.A total of 3183 RARPs were performed during this time period. After applying exclusion criteria and propensity score matching, 671 patients remained in each group. No statistically significant differences were noted between the groups with regard to age, BMI, ASA, pre-RARP prostate-specific antigen, D'Amico risk classification, biopsy and pathological Gleason sum score, pathological T stage, or margin status. The tRARP group had a higher clinical T stage (p = 0.0015), length of stay (LOS; p = 0.005), pathological N stage (4.92% vs 1.36%, p = 0.0002), and high total LN count (7.22 ± 5.54 vs 5.78 ± 4.18 LNs, p 0.0001). The eRARP group had higher operating room times (197.4 ± 48.96 minutes vs 192.2 ± 44.12 minutes, p = 0.04) and estimated blood loss (218.4 ± 152.0 mL vs 179.9 ± 119.4 mL, p 0.0001). No differences were noted in the frequency of SL formation [eRARP: 19/671 (2.83%) vs tRARP: 10/671 (1.49%), p = 0.09] or any clinical characteristics of the SL. Logistic regression analysis showed no effect of LN count (p = 0.071), pathological N stage (p = 0.111), or both combined (p = 0.085) on SL formation.In this cohort, the rate and clinical characteristics of SL were similar among patients treated with eRARP or tRARP and BPLND. The low event rate of SL in each group and trends favoring higher SL with LN yield and pN1 disease in the tRAPR group may deem the study underpowered to make definitive conclusions.
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- 2017
112. Retroperitoneal Lymphadenectomy for High Risk, Nonmetastatic Renal Cell Carcinoma: An Analysis of the ASSURE (ECOG-ACRIN 2805) Adjuvant Trial
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Daniel Y.C. Heng, Judi Manola, Naomi B. Haas, Robert G. Uzzo, Christopher G. Wood, Edward M. Messing, Christopher J. Kane, Benjamin T. Ristau, and Robert S. DiPaola
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Oncology ,Male ,Kidney Disease ,medicine.medical_treatment ,030232 urology & nephrology ,carcinoma ,urologic and male genital diseases ,chemotherapy ,lymph node excision ,Nephrectomy ,0302 clinical medicine ,Renal cell carcinoma ,80 and over ,Sunitinib ,Medicine ,Cancer ,Aged, 80 and over ,Kidney ,Urology & Nephrology ,Middle Aged ,Sorafenib ,Kidney Neoplasms ,Survival Rate ,medicine.anatomical_structure ,Treatment Outcome ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,6.1 Pharmaceuticals ,Female ,Patient Safety ,6.4 Surgery ,medicine.drug ,Adult ,Risk ,medicine.medical_specialty ,kidney ,Urology ,Clinical Trials and Supportive Activities ,Clinical Sciences ,Antineoplastic Agents ,Disease-Free Survival ,03 medical and health sciences ,adjuvant ,Clinical Research ,Internal medicine ,Carcinoma ,Adjuvant therapy ,Humans ,Carcinoma, Renal Cell ,Aged ,Neoplasm Staging ,business.industry ,Renal Cell ,Evaluation of treatments and therapeutic interventions ,medicine.disease ,mortality ,Clinical trial ,Lymph Node Excision ,Lymphadenectomy ,business - Abstract
PurposeLymphadenectomy is a well established practice for many urological malignancies but its role in renal cell carcinoma is less clear. Our primary objective was to determine whether lymphadenectomy impacted survival in patients with fully resected, high risk renal cell carcinoma.Materials and methodsPatients with fully resected, high risk, nonmetastatic renal cell carcinoma were randomized to adjuvant sorafenib, sunitinib or placebo in the ASSURE (Adjuvant Sorafenib and Sunitinib for Unfavorable Renal Carcinoma) trial. Lymphadenectomy was performed for cN+ disease or at surgeon discretion. Patients treated with lymphadenectomy were compared to patients in the trial who did not undergo lymphadenectomy. The primary outcome was overall survival associated with lymphadenectomy. Secondary outcomes were disease free survival, factors associated with performing lymphadenectomy and surgical complications.ResultsOf the 1,943 patients in ASSURE 701 (36.1%) underwent lymphadenectomy, including all resectable patients with cN+ and 30.1% of those with cN0 disease. A median of 3 lymph nodes (IQR 1-8) were removed and the rate of pN+ disease in the lymphadenectomy group was 23.4%. There was no overall survival benefit for lymphadenectomy relative to no lymphadenectomy (HR 1.14, 95% CI 0.93-1.39, p = 0.20). In patients with pN+ disease who underwent lymphadenectomy no improvement in overall or disease-free survival was observed for adjuvant therapy relative to placebo. Lymphadenectomy did not confer an increased risk of surgical complications (14.2% vs 13.4%, p = 0.63).ConclusionsThe benefit of lymphadenectomy in patients undergoing surgery for high risk renal cell carcinoma remains uncertain. Future strategies to answer this question should include a prospective trial in which patients with high risk renal cell carcinoma are randomized to specific lymphadenectomy templates.
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- 2017
113. A Comprehensive Analysis of Cribriform Morphology on Magnetic Resonance Imaging/Ultrasound Fusion Biopsy Correlated with Radical Prostatectomy Specimens
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Edward M. Messing, Eric Weinberg, Thomas Frye, Gary Hollenberg, Matthew Truong, Changyong Feng, and Hiroshi Miyamoto
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Image-Guided Biopsy ,Male ,Pathology ,medicine.medical_specialty ,Prostate biopsy ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Multimodal Imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Biopsy ,Medicine ,Humans ,Multiparametric Magnetic Resonance Imaging ,Aged ,Retrospective Studies ,Ultrasonography ,Prostatectomy ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,PI-RADS ,Prostate-specific antigen ,030220 oncology & carcinogenesis ,Cribriform ,Radiology ,business - Abstract
Recently a large body of evidence has emerged indicating that cribriform morphology is an aggressive prostate cancer morphological pattern associated with higher cancer specific mortality. In a comprehensive analysis we compared traditional and contemporary prostate biopsy techniques to detect prostate cancer with cribriform morphology with radical prostatectomy serving as the reference standard.We queried a retrospectively maintained, single institution, multiparametric magnetic resonance imaging database of 1,001 patients to identify 240 who underwent magnetic resonance imaging-ultrasound fusion targeted biopsy and concurrent systematic biopsy from December 2014 to December 2016. Of the 3,978 biopsy cores obtained 694 positive cores were rereviewed by a genitourinary pathologist for pattern 4 subtype (cribriform, fused and poorly formed glands). Using paired analysis pathological results among 3 biopsy methods (systematic biopsy, targeted biopsy and systematic plus targeted biopsy) were compared. Prostatectomy specimens were also pathologically reviewed.Systematic plus targeted biopsy was superior to systematic biopsy alone or targeted biopsy alone to detect cribriform morphology (all p0.0001). On final histopathology cribriform tumor foci were associated with an increased percent of pattern 4 involvement and extraprostatic extension (p0.0001 and 0.003, respectively). Only 17.4% of cribriform tumors in pure form were visible on multiparametric magnetic resonance imaging. Based on final histopathology the sensitivity of systematic biopsy, targeted biopsy and systematic plus targeted biopsy for cribriform morphology was 20.7%, 28.6% and 37.1%, respectively.Although systematic plus targeted biopsy was the most accurate biopsy method to detect cribriform morphology, biopsy sensitivity and specificity remained poor.
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- 2017
114. The role of urinary cytology when diagnostic workup is suspicious for upper tract urothelial carcinoma but tumour biopsy is nonconfirmatory
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David Horovitz, Changyong Feng, Yifan Meng, Jean V. Joseph, Hani Rashid, Guan Wu, and Edward M. Messing
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medicine.medical_specialty ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Urology ,Urinary system ,medicine.medical_treatment ,030232 urology & nephrology ,medicine.disease ,Malignancy ,Group B ,Surgery ,Cystectomy ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Upper tract ,030220 oncology & carcinogenesis ,Cytology ,Biopsy ,medicine ,Radiology ,business ,Original Research - Abstract
Introduction: We sought to determine the value of obtaining preoperative urinary cytology when diagnostic workup of an upper tract mass is suspicious for upper tract urothelial carcinoma (UTUC), but biopsy fails to confirm the diagnosis.Methods: Using billing code data, 239 patients were identified as having undergone radical nephroureterectomy (RNU) by 16 urologists from September 29, 1998 to July 31, 2015. Of this group, 19 adult patients had a presumed preoperative diagnosis of UTUC in a native kidney, at least three months of followup, no history of concurrent radical cystectomy with RNU, and negative/non-diagnostic tissue biopsy. These patients were divided into three groups: Group A had no urinary cytology taken (n=6); Group B had upper and/or lower tract cytology performed with neither positive nor atypical (n=7); Group C had upper and/or lower tract cytology performed with at least one positive or atypical (n=6).Results: Demographic information and diagnostic workup was similar between the groups, although Group A had more patients with a history of prior radical cystectomy for bladder cancer (p=0.02). One patient in Group B had benign tissue on final pathology. All patients in Groups A and C had malignancy on final pathology and overall, the three groups had similar rates of malignancy.Conclusions: When a composite of clinical findings suggest UTUC, performing urinary cytology may not be necessary. A negative result in this setting should not be used to rule out UTUC, as this is often discordant with final pathology. A positive cytology result may help solidify the diagnosis when other findings are less clear.
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- 2017
115. Reduced estimated glomerular filtration rate (eGFR60 mL/min/1.73 m
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Michael L, Blute, Victor, Kucherov, Timothy J, Rushmer, Shivashankar, Damodaran, Fangfang, Shi, E Jason, Abel, David F, Jarrard, Kyle A, Richards, Edward M, Messing, and Tracy M, Downs
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Male ,Analysis of Variance ,Urinary Bladder Neoplasms ,Disease Progression ,Humans ,Female ,Middle Aged ,Neoplasm Recurrence, Local ,Renal Insufficiency, Chronic ,Aged ,Glomerular Filtration Rate ,Retrospective Studies - Abstract
To evaluate if moderate chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR)60 mL/min/1.73 mA multi-institutional database identified patients with serum creatinine values prior to first transurethral resection of bladder tumour (TURBT). The CKD-epidemiology collaboration formula calculated patient eGFR. Cox proportional hazards models evaluated associations with recurrence-free (RFS) and progression-free survival (PFS).In all, 727 patients were identified with a median (interquartile range [IQR]) patient age of 69.8 (60.1-77.6) years. Data for eGFR were available for 632 patients. During a median (IQR) follow-up of 3.7 (1.5-6.5) years, 400 (55%) patients had recurrence and 145 (19.9%) patients had progression of tumour stage or grade. Moderate or severe CKD was identified in 183 patients according to eGFR. Multivariable analysis identified an eGFR of60 mL/min/1.73 mModerate CKD at first TURBT is associated with reduced RFS and PFS. Patients with reduced renal function should be considered for increased surveillance.
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- 2017
116. Multi-institutional nomogram predicting benign prostate pathology on magnetic resonance/ultrasound fusion biopsy in men with a prior negative 12-core systematic biopsy
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Matthew, Truong, Bokai, Wang, Jennifer B, Gordetsky, Jeffrey W, Nix, Thomas P, Frye, Edward M, Messing, John V, Thomas, Changyong, Feng, and Soroush, Rais-Bahrami
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Image-Guided Biopsy ,Male ,Nomograms ,Prostate ,Humans ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,Magnetic Resonance Imaging ,Aged ,Retrospective Studies ,Ultrasonography - Abstract
Prostate multiparametric magnetic resonance imaging (mpMRI) may be recommended for patients with a prior negative systematic biopsy (SB). However, a proportion of these patients will continue to have no prostate cancer (PCa) identified on magnetic resonance/ultrasound fusion biopsy (FB) despite abnormal mpMRI findings.In this multi-institutional, retrospective study, clinical and mpMRI parameters were assessed for 285 consecutive patients with at least 1 prior negative biopsy who underwent FB for a Prostate Imaging Reporting and Data System (PI-RADS) score of 3 to 5 at the University of Rochester Medical Center from December 2014 to December 2016, or at the University of Alabama at Birmingham from February 2014 to February 2017. Nomograms were generated for predicting benign prostate pathology on both the targeted biopsy and the concurrent SB.Benign pathology was found in 132 of 285 patients (46.3%). In a multivariate analysis, the predictors of benign prostate pathology on FB were age, prostate-specific antigen, prostate volume, and PI-RADS score. The predicted probabilities were plotted on a receiver operating characteristic curve, and the area under the curve was 0.825. The nomogram demonstrated excellent calibration and a high net benefit in a decision curve analysis. With a theoretical cutoff probability of ≥0.7 used to recommend deferment of FB, 61 of 285 patients (21.4%) would have avoided an unnecessary biopsy, and only 4 of 285 patients (1.4%) with PCa with a Gleason score ≥ 3 + 4 would have been missed.False-positive mpMRI examinations may occur in up to 46.3% of patients with a prior negative biopsy. Thus, a multi-institutional nomogram has been developed and validated for predicting benign pathology after FB in patients with a prior negative biopsy, and this may help to reduce the number of unnecessary biopsies in the setting of abnormal mpMRI findings. Cancer 2018;124:278-85. © 2017 American Cancer Society.
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- 2017
117. PNFLBA-10 A PHASE III BLINDED STUDY OF IMMEDIATE POST-TURBT INSTILLATION OF GEMCITABINE VERSUS SALINE IN PATIENTS WITH NEWLY DIAGNOSED OR OCCASIONALLY RECURRING GRADE I/II NON-MUSCLE INVASIVE BLADDER CANCER: SWOG S0337
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Khalid Hafez, Ian M. Thompson, Guan Wu, Jeffrey M. Holzbeierlein, Edward M. Messing, Nicholas J. Vogelzang, Deepak M. Sahasrabudhe, Christopher H. Evans, Darien Wood, Timothy C. Brand, Shandra Wilson, Robert S. Svatek, Philip C. Mack, Lawrence Karsh, Catherine M. Tangen, Seth P. Lerner, Daniel J. Culkin, Theresa M. Koppie, and Melissa Plets
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medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Newly diagnosed ,medicine.disease ,Gemcitabine ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,In patient ,Non muscle invasive ,business ,Saline ,Blinded study ,medicine.drug - Published
- 2017
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118. MP65-02 CANCER EXTRACELLULAR VESICLES PROMOTE BLADDER TUMORIGENESIS BY INDUCING CHRONIC ENDOPLASMIC RETICULUM STRESS AND INFLAMMATION: A NOVEL MECHANISM FOR FIELD CANCERIZATION
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Chia-Hao Wu, Christopher Silvers, Yi-Fen Lee, and Edward M. Messing
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Mechanism (biology) ,business.industry ,Urology ,Endoplasmic reticulum ,Cancer ,Inflammation ,medicine.disease ,medicine.disease_cause ,Extracellular vesicles ,Cell biology ,medicine ,Field cancerization ,medicine.symptom ,Carcinogenesis ,business - Published
- 2017
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119. MP08-14 DEVELOPMENT AND VALIDATION OF A NOMOGRAM FOR PREDICTING PIRADS 4-5 LESIONS ON MULTIPARAMETRIC PROSTATE MRI
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Eric Weinberg, Dang Lam, Ji Hae Park, Changyong Feng, Thomas Frye, Gary Hollenberg, Bokai Wang, Matthew Truong, and Edward M. Messing
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,medicine.anatomical_structure ,business.industry ,Prostate ,030220 oncology & carcinogenesis ,Urology ,Medicine ,030211 gastroenterology & hepatology ,Radiology ,Nomogram ,business - Published
- 2017
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120. MP64-08 SYMPTOMATIC LYMPHOCELE FORMATION AFTER EXTRAPERITONEAL VS. TRANSPERITONEAL ROBOT ASSISTED RADICAL PROSTATECTOMY AND BILATERAL PELVIC LYMPHADENECTOMY
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Changyong Feng, Xiang Lu, Jean V. Joseph, Edward M. Messing, and David Horovitz
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medicine.medical_specialty ,Lymphocele ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,business ,Pelvic lymphadenectomy ,medicine.disease - Published
- 2017
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121. PD71-05 VALIDATION OF GEMCAP AS A DNA BASED BIOMARKER TO PREDICT PROSTATE CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY
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Cristina Magi-Galluzzi, Karla Lindquist, Matthew R. Cooperberg, Edward M. Messing, Eric A. Klein, Hao G. Nguyen, Vy Ngo, Jorge L. Yao, Henrik Bengtsson, Peter R. Carroll, Elizabeth Gilbert, Pamela L. Paris, Jerome Jean Gilles, and Christopher J. Welty
- Subjects
Oncology ,medicine.medical_specialty ,Prostate cancer ,Prostatectomy ,business.industry ,Urology ,Internal medicine ,medicine.medical_treatment ,medicine ,Biomarker (medicine) ,medicine.disease ,business - Published
- 2017
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122. MP87-13 ESTROGEN RECEPTOR α IN CANCER ASSOCIATED FIBROBLASTS SUPPRESSES PROSTATE CANCER INVASION VIA REDUCING CCL5, IL6 AND MACROPHAGE INFILTRATION IN THE TUMOR MICROENVIRONMENT
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Chiuan-Ren Yeh, Fu-Ju Chou, Yang Yang, Edward M. Messing, Spencer Slavin, Jie Luo, Keliang Wang, Chawnshang Chang, Shuyuan Yeh, and Matthew Truong
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Oncology ,Tumor microenvironment ,medicine.medical_specialty ,business.industry ,Urology ,Macrophage infiltration ,Estrogen receptor ,medicine.disease ,CCL5 ,Prostate cancer ,Internal medicine ,medicine ,Cancer research ,Cancer-Associated Fibroblasts ,business - Published
- 2017
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123. PD11-10 IMPACT OF GLEASON PATTERN 4 CRIBRIFORM ARCHITECTURE ON PROSTATE CANCER DETECTION USING MULTIPARAMETRIC MRI
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Eric Weinberg, Thomas Frye, Matthew Truong, Edward M. Messing, Gary Hollenberg, and Hiroshi Miyamoto
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Pathology ,medicine.medical_specialty ,business.industry ,Urology ,030232 urology & nephrology ,Multiparametric MRI ,medicine.disease ,Gleason pattern ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Cribriform ,Medicine ,business - Published
- 2017
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124. MP65-01 EXTRACELLULAR VESICLES AS A POSSIBLE MECHANISM FOR BACILLUS CALMETTE-GUÉRIN IMMUNOTHERAPY
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Carlos Ortiz-Bonilla, Christopher Silvers, Peng-Nien Yin, Edward M. Messing, and Yi-Fen Lee
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Bacillus (shape) ,biology ,business.industry ,Mechanism (biology) ,Urology ,medicine.medical_treatment ,medicine ,Immunotherapy ,business ,biology.organism_classification ,Extracellular vesicles ,Microbiology - Published
- 2017
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125. PD05-10 ANTIBIOTIC PROPHYLAXIS PRIOR TO URINARY CATHETER REMOVAL AFTER RADICAL PROSTATECTOMY DOES NOT PREVENT URINARY TRACT INFECTIONS: A RANDOMIZED CONTROLLED CLINICAL TRIAL
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Janet Baack Kukreja, Claudia Berrondo, Edward M. Messing, Jean V. Joseph, and Changyong Feng
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Clinical trial ,medicine.medical_specialty ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,Urinary system ,medicine ,Antibiotic prophylaxis ,business ,Urinary catheter ,Surgery - Published
- 2017
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126. MP65-12 TARGETING ESTROGEN/ESTROGEN RECEPTOR SIGNAL PATHWAYS TO ENHANCE THE EFFICACY OF BACILLUS CALMETTE-GUÉRIN TREATMENT IN BLADDER CANCER
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Yanjun Li, Chawnshang Chang, Jing Tian, Edward M. Messing, Yuanjie Niu, Zhiqun Shang, Matthew Truong, Ruifa Han, Simeng Wen, Shuyuan Yeh, Iawen Hsu, and Yang Yang
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Bacillus (shape) ,Bladder cancer ,biology ,Signal Pathways ,business.industry ,medicine.drug_class ,Urology ,Estrogen receptor ,biology.organism_classification ,medicine.disease ,Estrogen ,Cancer research ,Medicine ,business ,Estrogen receptor beta - Published
- 2017
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127. MP03-11 INSTITUTIONAL LEARNING CURVE ASSOCIATED WITH IMPLEMENTATION OF A MR/US FUSION BIOPSY PROGRAM USING PIRADS VERSION 2: FACTORS THAT INFLUENCE SUCCESS
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Eric Weinberg, Thomas Frye, Marianne Borch, Gary Hollenberg, Hani Rashid, Edward M. Messing, Jean V. Joseph, Changyong Feng, Guan Wu, Ji Hae Park, Jacob Gantz, Matthew Truong, and Ahmed Ghazi
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medicine.medical_specialty ,Pathology ,medicine.diagnostic_test ,Index Lesion ,business.industry ,Urology ,030232 urology & nephrology ,Cancer ,Magnetic resonance imaging ,medicine.disease ,Logistic regression ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine.anatomical_structure ,Prostate ,030220 oncology & carcinogenesis ,Biopsy ,Institutional learning ,medicine ,Radiology ,business - Abstract
Background The purpose of this study is to assess the institutional learning curve associated with adopting FB using PI-RADS Version 2 (v2) for detecting clinically significant prostate cancer (csPCa), defined as Gleason ≥ 7 in men with prior negative biopsies and to identify patient and technical factors that predict success at detecting csPCa. Methods A total of 113 consecutive patients with at least one prior negative biopsy and a multiparametric MRI (mpMRI) exam of the prostate with a PIRADS 3 or greater index lesion underwent FB at a single academic center previously naive to FB technology. Outcomes are detection rates for Gleason 6 cancer, csPCa, and any cancer. Multiple logistic regression with model selection was used to select covariates having significant effects on the outcome. Results Prostate cancers were identified in 52% of cases in patients with prior negative prostate biopsies. Among patients diagnosed with prostate cancer, 80% were clinically significant. The detection rates of csPCa using FB when a PIRADS 3, 4, or 5 index lesion was present on mpMRI were 6%, 46%, and 66%, respectively. PI-RADS v2 score had a predictive accuracy (AUC) of 0.79 for csPCa detection. Institutional experience over time, MRI-estimated prostate volume, and PI-RADS v2 score were independent predictors of csPCa using FB. Conclusions Since FB is a highly technique-driven process, development of internal quality measures to assess the institutional learning curve and the quality of PI-RADS v2 scoring is critical with adoption of this technology.
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- 2017
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128. Editorial Comment
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Edward M. Messing
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5-alpha Reductase Inhibitors ,Urinary Bladder Neoplasms ,Urology ,Chronic Disease ,Humans ,Neoplasm Recurrence, Local ,Oxidoreductases - Published
- 2017
129. A More Thorough Transurethral Resection
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Edward M. Messing
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medicine.medical_specialty ,Text mining ,Oncology ,business.industry ,Urology ,General surgery ,Medicine ,business ,Paper Alert ,Resection - Published
- 2017
130. Extraperitoneal vs Transperitoneal Robot-Assisted Radical Prostatectomy in the Setting of Prior Abdominal or Pelvic Surgery
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Edward M. Messing, Jean V. Joseph, Changyong Feng, and David Horovitz
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Prostate adenocarcinoma ,Male ,medicine.medical_specialty ,Gastrointestinal Diseases ,Urology ,medicine.medical_treatment ,Operative Time ,030232 urology & nephrology ,Abdominal cavity ,Adenocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,Prostate ,medicine ,Humans ,In patient ,Postoperative Period ,Pelvic surgery ,Aged ,Neoplasm Staging ,Retrospective Studies ,Prostatectomy ,business.industry ,Prostatic Neoplasms ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Inguinal hernia ,medicine.anatomical_structure ,Logistic Models ,030220 oncology & carcinogenesis ,Concomitant ,Linear Models ,Neoplasm Grading ,business - Abstract
During robot-assisted radical prostatectomy (RARP), the prostate may be approached extraperiteoneally (extraperitoneal robot-assisted radical prostatectomy [eRARP]) or transperitoneally (transperitoneal robot-assisted radical prostatectomy [tRARP]). The former avoids the abdominal cavity, which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique.A retrospective review of patients treated with RARP from July 1, 2003 to December 31, 2014 with a minimum follow-up of 3 months was undertaken. Of 2927 patients, 620 were identified as having undergone RARP (without concomitant unrelated procedures) and PAPS (excluding patients with prior inguinal hernia repair with mesh or unclear surgical histories) for prostate adenocarcinoma without prior pelvic radiotherapy. Of these, 340 patients underwent eRARP and 280 patients underwent tRARP.Patients in the eRARP group were younger (61.04 years vs 62.32, p = 0.02), had a higher body mass index (29.65 vs 28.98, p = 0.09), lower American Society of Anesthesiologists scores (p = 0.03), and lower D'Amico risk classification disease (p 0.0001). The two groups had similar rates of 1, 2, and2 PAPS. On univariate analysis, the eRARP group had lower operative time (188.96 minutes vs 197.92 minutes, p = 0.003), extensive lysis of adhesions (0.9% vs 14.3%, p 0.0001), length of hospital stay (LOS) (1.13 days ±0.45 vs 1.33 day ±1.08, p = 0.003), and higher estimated blood loss (210.74 mL vs 190.79 mL, p = 0.06). The eRARP group had a lower rate of gastrointestinal complications (0% vs 3.21%, p = 0.0007), a trend toward lower early post-operative complications (8.53% vs 12.86%, p = 0.08), and lower overall complications (9.41% vs 15%, p = 0.03). In regression analysis with model selection, only LOS was lower in the eRARP group (p = 0.02).Both methods are safe in patients with prior abdominal surgeries. A lower incidence of gastrointestinal complications and a shorter length of stay were noted in the extraperitoneal cohort.
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- 2017
131. Bladder Cancer Exosomes Contain EDIL-3/Del1 and Facilitate Cancer Progression
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Chia-Hao Wu, Carla Beckham, Peng-Nien Yin, Jayme Olsen, Huei-Ju Ting, Fred K. Hagen, Yi-Fen Lee, Emelian Scosyrev, and Edward M. Messing
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Pathology ,medicine.medical_specialty ,Urothelial Cell ,Angiogenesis ,Urology ,Exosomes ,urologic and male genital diseases ,Malignancy ,Epidermal growth factor ,Tumor Cells, Cultured ,medicine ,Humans ,Aged ,Aged, 80 and over ,Urinary bladder ,Bladder cancer ,business.industry ,Calcium-Binding Proteins ,Cancer ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Microvesicles ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,Disease Progression ,Cancer research ,Carrier Proteins ,business ,Cell Adhesion Molecules - Abstract
High grade bladder cancer is an extremely aggressive malignancy associated with high rates of morbidity and mortality. Understanding how exosomes may affect bladder cancer progression could reveal novel therapeutic targets.Exosomes derived from human bladder cancer cell lines and the urine of patients with high grade bladder cancer were assessed for the ability to promote cancer progression in standard assays. Exosomes purified from the high grade bladder cancer cell line TCC-SUP and the nonmalignant urothelial cell line SV-HUC were submitted for mass spectrometry analysis. EDIL-3 was identified and selected for further analysis. Western blot was done to determine EDIL-3 levels in urinary exosomes from patients with high grade bladder cancer. shRNA gene knockdown and recombinant EDIL-3 were applied to study EDIL-3 function.Exosomes isolated from high grade bladder cancer cells and the urine of patients with high grade bladder cancer promoted angiogenesis and migration of bladder cancer cells and endothelial cells. We silenced EDIL-3 expression and found that shEDIL-3 exosomes did not facilitate angiogenesis, and urothelial and endothelial cell migration. Moreover, exosomes purified from the urine of patients with high grade bladder cancer contained significantly higher EDIL-3 levels than exosomes from the urine of healthy controls. EDIL-3 activated epidermal growth factor receptor signaling while blockade of epidermal growth factor receptor signaling abrogated this EDIL-3 induced bladder cell migration.Exosomes derived from the urine of patients with bladder cancer contains bioactive molecules such as EDIL-3. Identifying these components and their associated oncogenic pathways could lead to novel therapeutic targets and treatment strategies.
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- 2014
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132. Bladder cancer incidence and mortality in patients treated with radiation for uterine cancer
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Emil Scosyrev, Guan Wu, Janet Baack Kukreja, Edward M. Messing, R.A. Brasacchio, and Eugene Toy
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Gynecology ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,Incidence (epidemiology) ,Age adjustment ,Retrospective cohort study ,medicine.disease ,Rate ratio ,Confidence interval ,Uterine cancer ,Internal medicine ,Epidemiology ,Medicine ,business - Abstract
Objective To estimate the effect of radiation therapy (RT) administered for uterine cancer (UtC) on bladder cancer (BC) incidence, tumour characteristics at presentation, and mortality. Patients and Methods In this retrospective cohort study, records of 56 681 patients diagnosed with UtC as their first primary malignancy during 1980–2005 were obtained from the Surveillance, Epidemiology and End-Results (SEER) database. Follow-up for incident BC ended on 31 December 2008. Occurrences of BC diagnoses and BC deaths in patients with UtC managed with or without RT were summarised with counts and person-time incidence rates (counts divided by person-years of observation). Age adjustment of rates was performed by direct standardisation. Incident BC cases were described in terms of histological types, grades and stages. Results With a mean follow-up of 15 years, BC was diagnosed in 146 (0.93%) of 15 726 patients with UtC managed with RT, and in 197 (0.48%) of 40 955 patients with UtC managed without RT, with an age-adjusted rate ratio of 2.0 (95% confidence interval [CI] 1.6–2.5). Fatal BC occurred in 39 (0.25%) and 36 (0.09%) of patients with UtC managed with vs without RT, respectively, with an age-adjusted rate ratio of 2.9 (95% CI 1.8–4.6). Incident BC cases diagnosed in patients with UtC managed with vs without RT had similar distributions of histological types, grades, and stages. Conclusions Use of RT for UtC is associated with increased BC incidence and mortality later in life. Heightened awareness should help identify women with new voiding symptoms or haematuria, all of which should be fully evaluated.
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- 2014
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133. Overall Survival after Partial Versus Radical Nephrectomy for a Small Renal Mass: Systematic Review of Observational Studies
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Guan Wu, Emil Scosyrev, Kevin Wu, Vineet Agrawal, Helen R. Levey, Carla Beckham, and Edward M. Messing
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medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Confounding ,Hazard ratio ,medicine.disease ,Nephrectomy ,Surgery ,law.invention ,Randomized controlled trial ,Interquartile range ,law ,Renal cell carcinoma ,medicine ,Observational study ,business ,Survival analysis - Abstract
Introduction In EORTC trial 30904 of partial versus radical nephrectomy overall survival was significantly better in the radical nephrectomy arm. However, many observational studies reported better survival after partial than radical nephrectomy. We present an updated systematic review of observational studies of overall survival after partial versus radical nephrectomy with assessment of quality of evidence. Methods The literature search was performed until December 31, 2013, and all studies reporting overall survival after partial vs radical nephrectomy were included in the initial review. Further inclusion criteria for complete review were malignant tumors 7 cm or smaller, or benign tumors of any size, and survival analysis performed with adjustment for confounding variables. Studies not meeting these criteria were excluded from full review because of selection bias in favor of patients treated with partial nephrectomy who were younger and with less advanced tumors. Results A total of 34 studies were included in the initial review and 13 were included in the full review. The 13 studies were based on the SEER database (6) or on institutional cohorts (7). In 8 of the 13 studies the estimated hazard ratios were significantly below 1, indicating better overall survival after partial nephrectomy, while in the remaining 5 studies estimated HR was not significantly different from 1. Median HR was 0.80 (interquartile range 0.57 to 0.96, absolute range 0.40 to 1.10). Conclusions In most observational studies overall survival was better after partial than after radical nephrectomy. However, because residual confounding could be present despite adjustment for measured covariates, another randomized trial of partial vs radical nephrectomy may be needed to confirm or refute the findings of EORTC 30904.
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- 2014
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134. Perioperative Blood Transfusions and Bladder Cancer Outcomes
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Edward M. Messing
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medicine.medical_specialty ,Bladder cancer ,Text mining ,Oncology ,business.industry ,Urology ,General surgery ,MEDLINE ,medicine ,Perioperative ,medicine.disease ,business ,Paper Alert - Published
- 2018
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135. Psychological Stress and Suicide in Bladder Cancer Patients
- Author
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Edward M. Messing
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Oncology ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,MEDLINE ,medicine.disease_cause ,medicine.disease ,Paper Alert ,Text mining ,Internal medicine ,medicine ,Psychological stress ,business - Published
- 2018
136. A phase II study of enzalutamide (Enz) with dutasteride (Dut) or finasteride (Fin) in men ≥ 65 years with hormone-naive systemic prostate cancer (HNSPCa): Tolerability and geriatric asssessment (GA) results
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Dilip Sankar Babu, John D. Burfeind, Chunkit Fung, Bokai Wang, Jason Zittel, Amita Patil, Edward M. Messing, Kaylinn Musto, Kathryn A. Bylow, Deepak M. Sahasrabudhe, Supriya G. Mohile, Elizabeth A. Guancial, and Deepak Kilari
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Phases of clinical research ,medicine.disease ,Dutasteride ,Androgen deprivation therapy ,chemistry.chemical_compound ,Prostate cancer ,chemistry ,Tolerability ,Internal medicine ,Finasteride ,medicine ,Enzalutamide ,Adverse effect ,business - Abstract
e16518 Background: Older men are at a high risk for adverse events (AEs) from androgen deprivation therapy (ADT). In this phase II study, we evaluated Enz and Dut/Fin in lieu of ADT for at-risk older patients with HNSPCa. Methods: Eligible patients were ≥65 years (y); at high risk of AEs from ADT by GA or treating physicians; metastatic (M1) or non-metastatic (M0) HNSPCa with a PSA doubling time ≤ 9 months and testosterone > 50ng/dl. They received Enz 160 mg/day and Dut 0.5 mg/day or Fin 5 mg/day until disease progression. GA was performed at baseline and week (wk) 61 and/or at the time of progression. GA included validated tests: Instrumental Activities of Daily Living (IADL), fall history, Short Physical Performance Battery (SPPB), Geriatric Depression Scale (GDS), and Montreal Cognitive Assessment (MOCA). The prevalence of impairment for each assessment was calculated; change in prevalence from baseline to wk 61 was analyzed using paired sample t-test. Results: 43 patients were enrolled in the study. Median age at enrollment was 78 y (range 66-94) and 93% were ECOG 0-1; 37% (n = 16) had M0 and 63% (n = 27) had M1 HNSPCa, with the majority (67%) having Gleason 6 or 7 disease. At baseline, 18.6% met the cutoff for impairment for IADLs, 53.7% for SPPB, 7.9% for GDS and 64.3% for MOCA; 9.8% had a recent fall. Median baseline PSA was 11.38 ng/ml (range: 2-145). At the time of analysis, 29 men (67.4%) remain on study treatment. 95.3%, 74.4% and 46.5% of patients reported at least one Grade 1, 2 or 3 AE respectively. No patient had a Grade 4 AE and one Grade 5 AE was reported but was an unrelated event. The most common Grade 3 AEs were hypertension (27.8%), GI (19.4%), and cardiac (8.3%); all Grade 3 GI AEs reported were deemed unrelated to the study drugs. Only impairment in ≥ 1 IADL showed a statistically significant increase in prevalence at wk 61 of treatment (40.6%) compared to baseline (18.6%, p = 0.036). Conclusions: For older men with HNSPCa, Enz with Dut/Fin demonstrated efficacy with reasonable toxicity profile, and no significant impact on the majority of GA domains. Clinical trial information: NCT02213107.
- Published
- 2019
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137. Antibiotic prophylaxis at the time of catheter removal after radical prostatectomy: A prospective randomized clinical trial
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Edward M. Messing, Janet Baack Kukreja, Changyong Feng, Jean V. Joseph, and Claudia Berrondo
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Male ,medicine.medical_specialty ,Randomization ,medicine.drug_class ,Urology ,medicine.medical_treatment ,Antibiotics ,030232 urology & nephrology ,Administration, Oral ,Urinary Catheters ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Ciprofloxacin ,law ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Antibiotic prophylaxis ,Enterocolitis, Pseudomembranous ,Aged ,Prostatectomy ,Clostridioides difficile ,business.industry ,Incidence ,Prostate ,Prostatic Neoplasms ,Perioperative ,Antibiotic Prophylaxis ,Middle Aged ,Clostridium difficile ,Anti-Bacterial Agents ,Treatment Outcome ,Oncology ,Catheter-Related Infections ,030220 oncology & carcinogenesis ,Urinary Tract Infections ,business ,medicine.drug - Abstract
Objective To evaluate the role of antibiotic prophylaxis with oral ciprofloxacin prior to urinary catheter removal after radical prostatectomy in preventing urinary tract infection (UTI). Materials and methods Patients undergoing radical prostatectomy were prospectively enrolled and randomized to either the antibiotic prophylaxis group (2 doses of oral ciprofloxacin prior to urinary catheter removal) or the control group (no antibiotics given prior to urinary catheter removal). Neither patients nor study providers were blinded to the group. The primary objective was to assess for development of UTI. The secondary objective was to assess for development of Clostridium difficile (C diff) enterocolitis. Continuous variables were compared using a 2-sample t test. Categorical variables were compared using Pearson's chi-squared test or Fisher's exact test. Results One hundred seventy-five patients were enrolled and randomized (90 control and 85 antibiotic prophylaxis). After randomization, 4 patients were excluded and 4 patients withdrew voluntarily. One hundred sixty-seven patients (84 control and 83 antibiotic prophylaxis) completed the study and were available for analysis. There were no significant differences in baseline characteristics, perioperative data, or complications. There was no significant difference in the rate of UTI between the control group and antibiotic prophylaxis group (5.95% vs. 6.02%, P = 1). There was also no significant difference in the rates of C diff infection between the control and the antibiotic prophylaxis groups (3.57% vs. 0%, P = 0.21). Conclusions In this prospective, randomized, controlled trial, the use of antibiotic prophylaxis with oral ciprofloxacin prior to urinary catheter removal after radical prostatectomy did not decrease the rate of UTI, and was not associated with an increased incidence of C diff enterocolitis.
- Published
- 2019
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138. Paper Alert
- Author
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Edward M. Messing
- Subjects
0301 basic medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Urology ,Other ,Research Article - Published
- 2015
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139. Non-bladder cancer mortality in patients with urothelial cancer of the bladder
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Emil Scosyrev, Guan Wu, Dragan Golijanin, and Edward M. Messing
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Urology ,Comorbidity ,Disease ,Cause of Death ,Neoplasms ,Internal medicine ,medicine ,Surveillance, Epidemiology, and End Results ,Humans ,Stage (cooking) ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Cause of death ,Aged, 80 and over ,Bladder cancer ,Proportional hazards model ,business.industry ,Incidence ,Hazard ratio ,Cancer ,medicine.disease ,Survival Analysis ,United States ,Survival Rate ,Urinary Bladder Neoplasms ,Multivariate Analysis ,Female ,Neoplasm Grading ,Urothelium ,business ,Follow-Up Studies ,SEER Program - Abstract
Objectives Because bladder cancer (BC) patients often have comorbidities that adversely affect their health, we wanted to determine whether grade and stage of BC at diagnosis are associated with the hazard of death from causes other than BC. Materials and methods Cancer records for 93,033 patients diagnosed with urothelial BC during 1988–2002 were obtained from the Surveillance Epidemiology and End Results (SEER) database. The grade-stage categories were defined as follows: (1) low grade, stage 0/I (Ta/T1, N0/Nx), (2) high grade, stage 0/I (Ta/Tis/T1, N0/Nx), (3) any grade, stage II (T2, N0/Nx), (4) any grade, stage III (T3-T4a, N0/Nx), (5) any grade, stage IV (T4b and/or N+). Patients with known distant metastases at presentation were excluded. Other covariates were age, gender, and race. The outcome measures were defined as the hazard of death from all causes, from BC, and from non-BC causes. Cox regression model was used to estimate the effect of grade-stage categories on over-all and cause-specific hazards with adjustment for covariates. Results The 5-year mortality proportions by grade-stage category were as follows: low grade, stage 0/I: all-causes 25%, BC 3%, non-BC 22%; high grade stage 0/I: all-causes 38%, BC 13%, non-BC 25%; stage II: all-causes 63%, BC 36%, non-BC 27%; stage III: all-causes 69%, BC 45%, non-BC 24%; stage IV: all-causes 83%, BC 68%, non-BC 15%. Using low grade, stage 0/I as a reference category, the hazard ratios for increasing grade-stage categories (high grade 0/I, II, III, IV) were as follows: all-cause mortality 1.30, 2.37, 3.07, 6.14; BC-related hazard 3.31, 10.02, 14.65, 32.04; non-BC-related hazard: 1.05, 1.37, 1.49, 1.65 (all P Conclusion Grade-stage categories were associated with the hazard of death from non-BC causes. However, their influence on BC-related hazard was much greater in magnitude. Because BC (rather than co-morbidities) is the main cause of death in patients with muscle-invasive disease, aggressive BC-directed therapies in these patients, when feasible, are justified.
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- 2013
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140. Complications Associated With Extraperitoneal Robot-assisted Radical Prostatectomy Using the Standardized Martin Classification
- Author
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Emelian Scosyrev, Jean V. Joseph, Ahmed Ghazi, Edward M. Messing, and Hitendra R.H. Patel
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Male ,medicine.medical_specialty ,Multivariate analysis ,Lymphocele ,Urology ,medicine.medical_treatment ,Operative Time ,Anastomotic Leak ,Anastomosis ,Logistic regression ,Prostate cancer ,Postoperative Complications ,Humans ,Medicine ,Intraoperative Complications ,Aged ,Prostatectomy ,business.industry ,Incidence (epidemiology) ,Urinary Bladder Diseases ,Robotics ,Middle Aged ,medicine.disease ,Surgery ,Exact test ,Logistic Models ,Multivariate Analysis ,Lymph Node Excision ,Clinical Competence ,business - Abstract
Objective To report and identify the predictors of early and long-term complications in a large series of extraperitoneal robot-assisted radical prostatectomy using the standardized Martin criteria. MaterialS and Methods A total of 1503 patients underwent extraperitoneal robot-assisted radical prostatectomy for the treatment of clinically localized prostate cancer from July 2003 to August 2010 at a tertiary referral center. The median follow-up was 28.9 months. Fisher’s exact test was used to examine the association of multiple variables in a bivariate analysis with the incidence and types of complications. Independent predictors were also examined in a multivariate analysis using logistic regression models. Results A total of 151 complications were recorded in 127 of 1503 patients (8.45%). Approximately one third (30.5%) were classified as major complications requiring intervention (Clavien grade III and IV). The most commonly encountered complications were lymphocele (1.46%), bladder neck contracture (1.33%), and anastomotic leak (1.20%). The operative time was a significant predictor of all complications and of major complications on multivariate analysis. Surgeon experience was also predictive of complications on multivariate analysis. Conclusion Extraperitoneal robot-assisted radical prostatectomy remains an underused alternative approach for the treatment of localized prostate cancer. Its safety profile is equivalent to that of other approaches in experienced hands.
- Published
- 2013
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141. Checkpoint Inhibitors for Advanced Bladder Cancer
- Author
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Edward M. Messing
- Subjects
business.industry ,Urology ,Immune checkpoint inhibitors ,Paper Alert ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Oncology ,030220 oncology & carcinogenesis ,Advanced bladder cancer ,Cancer research ,Medicine ,030212 general & internal medicine ,business - Published
- 2016
142. Complete Remission of Locally Advanced Penile Squamous Cell Carcinoma after Multimodality Treatment
- Author
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Edward M. Messing, Yifan Meng, Dean-An Ling, Elizabeth Guancial, Tzu-Hua Weng, and Helen Levey Bernie
- Subjects
Oncology ,medicine.medical_specialty ,Histology ,Penile squamous cell carcinoma ,medicine.medical_treatment ,030232 urology & nephrology ,Locally advanced ,Case Report ,Disease ,Neoadjuvant chemotherapy ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Cisplatin ,Chemotherapy ,business.industry ,Multimodality Treatment ,Multimodal therapy ,Chemoradiation ,030220 oncology & carcinogenesis ,Surgery ,business ,medicine.drug - Abstract
Treatment of locally advanced penile squamous cell carcinoma (pSCC) remains highly controversial secondary to disease rarity and lack of prospective randomized controlled trials. The current mainstays of care are multi-modality treatment with neoadjuvant chemotherapy and surgery. However, clinicians often have difficulty making recommendations for patients unable to tolerate chemotherapy or surgery due to scarcity of data to guide clinical decision-making. We report two cases of locally advanced pSCC that achieved complete remission after treatment with cisplatin-based neoadjuvant chemotherapy and surgery in one case, and concurrent cisplatin chemoradiation in a second, supporting the use of chemotherapy as part of first-line multimodal therapy. We also discuss additional treatment options for patients unable to tolerate traditional chemotherapy regimens.
- Published
- 2016
143. Quality Improvement in Cystectomy Care with Enhanced Recovery (QUICCER) study
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Janet Baack Kukreja, Guan Wu, Katia Noyes, Ahmed Ghazi, James G. Dolan, Adriana Hontar, Ann Dozier, Hani Rashid, Benjamin Nelson, Bethany A Schempp, Edward M. Messing, Aisha Siebert, and Maureen Kiernan
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Male ,medicine.medical_specialty ,Quality management ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Aftercare ,Cystectomy ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Enhanced recovery ,Randomized controlled trial ,law ,Clinical endpoint ,Medicine ,Humans ,Aged ,business.industry ,Recovery of Function ,Middle Aged ,Quality Improvement ,Surgery ,030220 oncology & carcinogenesis ,Emergency medicine ,Propensity score matching ,Critical Pathways ,Female ,Fast track ,business ,Complication - Abstract
Objectives To determine if patients managed with a cystectomy enhanced recovery pathway (CERP) have improved quality of care after radical cystectomy (RC), as defined by a decrease in length of hospital stay (LOS) without an increase in complications or readmissions compared with those not managed with CERP. Subjects and Methods The Quality Improvement in Cystectomy Care with Enhanced Recovery (QUICCER) study was a non-randomized quasi-experimental study. Data were collected between June 2011 and April 2015. The CERP was implemented in July 2013. The primary endpoint was LOS. Secondary endpoints were quality scores, complications and readmissions. Multivariable regression was performed. Propensity score matching was carried out to further simulate randomized clinical trial conditions. A CERP quality composite score was created and evaluated with regard to adherence to CERP elements. Results The study included 79 patients managed with CERP and 121 who were not managed with CERP. After matching, there were 75 patients in the non-CERP group. The LOS was significantly different between the groups: the median LOS was 5 and 8 days for the CERP and non-CERP group, respectively (P < 0.001). Multivariable linear regression showed that any complication was the most significant predictor of total LOS at 90 days after RC. The higher the quality composite score the shorter the LOS (P < 0.001). There was no association between CERP and a greater number of complications or readmissions. Conclusions Audited quality measures in the CERP are associated with a reduction in LOS with no increase in readmissions or complications. The CERP is important for the future improvement of peri-operative care for RC and provides an opportunity to improve the quality of care provided.
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- 2016
144. MP80-09 IS EXTRAPERITONEAL ROBOT-ASSISTED RADICAL PROSTATECTOMY CONTRAINDICATED IN THE SETTING OF PRIOR INGUINAL HERNIA REPAIR WITH MESH?
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Changyong Feng, David Horovitz, Edward M. Messing, and Jean V. Joseph
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medicine.medical_specialty ,Randomization ,Urinary continence ,business.industry ,Prostatectomy ,Urology ,General surgery ,medicine.medical_treatment ,Urinary incontinence ,Anastomosis ,medicine.disease ,Interim analysis ,law.invention ,Inguinal hernia ,Randomized controlled trial ,law ,Medicine ,medicine.symptom ,business - Abstract
INTRODUCTION AND OBJECTIVES: Urinary incontinence post radical prostatectomy is a common complication regardless of approach, with significant negative impact on health-related quality of life. Although 12-month continence rates range from 85-95% in established studies, few patients are continent in the early postoperative period. The posterior reconstruction of Denonvilliers’ musculofascial plate (PRDMP) may improve the early return to urinary continence, though reports in the literature have been mixed, warranting further study. Weaknesses in previous studies of PRDMP included varied definitions of continence, differing surgeon experience, lack of randomization, and insufficient statistical power. We compared the PRDMP versus standard urethrovesical anastomosis during robotassisted radical prostatectomy (RARP) in a randomized controlled trial (RCT). METHODS: Patients with clinically localized prostate cancer scheduled for RARP were prospectively recruited in clinic and randomly allocated to PRDMP or conventional anastomosis. Patients were blinded to allocation status and the surgeon was informed immediately before the case to minimize bias. All cases were performed by a highvolume surgeon at a tertiary healthcare center. Our primary outcome was assessed by using the Expanded Prostate Cancer Index Composite Short Form (EPIC-26) survey at baseline and 2, 3, 4, 6, 8, and 12-months postoperatively. Continence was defined as an answer of 0-1 safety pad per day. The trial is powered to detect a significant improvement in continence of 40-75% at 3 months with an a level of 0.05 at 80%, requiring 65 patients per group for power. We have oversampled to account for attrition. Follow-up interviews were done via telephone. RESULTS: Recruitment occurred from April 2014 to July 2015, with a total N1⁄4164. We currently have 6-month follow-up data available on 55 patients in the PRDMP group and 42 in the control group. At months 2, 3, 4, and 6, use of pads for the intervention group and the control group at 0-1 per day (measured continence) was 36.5% and 37.5%, 60.7% and 60.5%, 72.6% and 65.7%, and 83% and 76.5%, respectively CONCLUSIONS: Interim analysis of this RCT suggests a trend toward the PRPMD being more effective than conventional anastomosis in terms of early return to continence following RARP, but more so as the data reached the fourth month. The two groups were also not equal in size. Final analysis at the completion of this RCT is required to establish statistical significance of these findings.
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- 2016
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145. MP69-13 EXTRAPERITONEAL VS. TRANSPERITONEAL ROBOT-ASSISTED RADICAL PROSTATECTOMY IN THE SETTING OF PRIOR ABDOMINAL OR PELVIC SURGERY
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Changyong Feng, David Horovitz, Jean V. Joseph, and Edward M. Messing
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medicine.medical_specialty ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,General surgery ,medicine ,business ,Pelvic surgery - Published
- 2016
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146. V8-01 FULL PROCEDURAL SIMULATION FOR TRANSURETHRAL RESECTION OF BLADDER TUMORS (TURBT) USING 3-D PRINTING TECHNOLOGY
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Ahmed Ghazi, Janet E. Baack Kukreja, Jonathan J. Stone, Braden Candela, Edward M. Messing, Jennifer Park, and Hani Rashid
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medicine.medical_specialty ,business.industry ,Urology ,media_common.quotation_subject ,030232 urology & nephrology ,Fidelity ,Construct validity ,3 d printing ,Resection ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,High fidelity ,Content validity ,Medicine ,Vascular tumor ,Medical physics ,business ,030217 neurology & neurosurgery ,media_common ,Face validity - Abstract
INTRODUCTION AND OBJECTIVES: Our understanding of simulation-based training is evolving from simply practicing basic and partial tasks to learning full procedures through an accurate re-creation in the operating room. However, for full procedural simulation to be effective it requires an artificially created learning situation, that allows for the rehearsal of all salient aspects of a procedure in the same order utilizing the same devices with the opportunity to enact both appropriate and inappropriate learner actions (i.e., errors). In this video we demonstrate a high fidelity, inexpensive, simulated inanimate model for physical learning experience in TURBT (S.I.M.P.L.E.TURBT) that encompasses all fundamental aspects for an effective full procedural simulation, including procedure-based assessment metrics. METHODS: Using a proprietary method, anatomically correct models of the human bladder and relevant structures were created with poly-vinyl alcohol (PVA) hydrogels using 3-D printed molds. Individual bladder layers including mucosal, muscular, serosal and perivesival fat were created containing 3 tumors of varying size, location and depth of invasion. All steps of TURBT were simulated by 6 volunteer urologists. Expert designation was based on caseload (> 100 TURBT cases). Face validity was calculated by ratings of realism. Content validity was calculated by rating the usefulness of the model as a training tool. Construct validity was calculated by comparison of procedural metrics (Operative time, tumor margins, missed tumors, muscle layer sampling and complications) between the groups. RESULTS: The model was determined to have good face and content validity with an average score of 4.3/5 and 4.1/5, respectively. A significant difference between expert and novice urologists was demonstrated in both total procedure time and time to resect the large vascular tumor. No difference in resection time was appreciated in the 2cm papillary non-vascular tumor. 66 % of the novice performance exhibited bladder perforations and a missed anterior wall tumor (Table 1). CONCLUSIONS: Validation of our portable, inexpensive, high fidelity model offers a full procedural, TURBT simulation with the potential for training and maintenance of advanced procedural skills together with acquisition of procedure wisdom.
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- 2016
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147. MP13-12 MODERATE CHRONIC KIDNEY DISEASE (EGFR <60 ML/MIN) PREDICTS RECURRENCE AND PROGRESSION IN BLADDER CANCER PATIENTS TREATED WITH TRANSURETHRAL RESECTION
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Tracy M. Downs, Timothy J. Rushmer, Benjamin Fuller, Edward M. Messing, Kyle A. Richards, David F. Jarrard, Victor Kucherov, Fangfang Shi, Michael L. Blute, E. Jason Abel, and Daniel D. Shapiro
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medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,medicine ,medicine.disease ,business ,Surgery ,Kidney disease ,Resection - Published
- 2016
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148. MP83-05 GLYCOLYTIC AND INFLAMMATORY PATHWAY GENES ARE OVEREXPRESSED IN BLADDER CANCER TUMORS
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David Gentile, Thomas Osinski, Edward M. Messing, Carla Beckham, and Benjamin Nelson
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Bladder cancer ,business.industry ,Urology ,Cancer research ,Medicine ,Glycolysis ,business ,medicine.disease ,Gene - Published
- 2016
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149. Copper Transporter-CTR1 Expression and Pathological Outcomes in Platinum-treated Muscle-invasive Bladder Cancer Patients
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Deepak, Kilari, Kenneth A, Iczkowski, Chintan, Pandya, Adam J, Robin, Edward M, Messing, Elizabeth, Guancial, and Eric S, Kim
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Adult ,Aged, 80 and over ,Male ,Muscle Neoplasms ,Middle Aged ,Prognosis ,Neoadjuvant Therapy ,Immunoenzyme Techniques ,Urinary Bladder Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,Carcinoma, Squamous Cell ,Humans ,Female ,Neoplasm Invasiveness ,Cation Transport Proteins ,Aged ,Copper Transporter 1 ,Follow-Up Studies ,Neoplasm Staging ,Platinum - Abstract
Platinum (Pt)-based neoadjuvant chemotherapy (NAC) is the standard-of-care for muscle-invasive bladder cancer (MIBC). However, the survival benefit with NAC is driven by patients with pathological response at cystectomy. Non-responders are subject to adverse effects of Pt, with delay in definitive treatment. Copper transporter receptor 1 (CTR1) plays an important role in Pt uptake and the level of expression may influence Pt sensitivity. We hypothesized that tumor CTR1 expression correlated with pathological outcome.We identified matched paraffin-embedded tissues from pre-NAC transurethral bladder tumor resection (TURBT) and post-NAC radical cystectomy (RC) specimens in 47 patients with MIBC who received Pt-based NAC. Tumor and adjacent normal tissues were stained with CTR1 antibody. CTR1 expression was determined through immunohistochemistry by two pathologists blinded to the outcome (0=undetectable; 1+=barely detectable; 2+=moderate; and 3+=intense staining). Pathological response was defined as either down-staging to non-MIBC (≤pT1N0M0) or complete pathological response (pT0). Pathological outcome was compared between the CTR1 expression groups.Forty-three percent of TURBT and 41% of RC specimens expressed a CTR1 score of 3+. Forty-four percent of patients had a pathological response to NAC, and 17% had pT0 disease at cystectomy. In both pre-NAC TURBT and post-NAC RC specimens, a CTR1 expression score of 3+ correlated with pathological response (p=0.0076 and p=0.023, respectively).This is the first study to demonstrate a correlation between CTR1 tumor expression and pathological outcome in Pt-treated MIBC. These findings suggest that CTR1 expression may be a biomarker for Pt sensitivity.
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- 2016
150. Prostate Cancer in the Elderly
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Janet E. Baack Kukreja and Edward M. Messing
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- 2016
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