Publications by authors named "Ragheed Saoud"

7 Publications

  • Page 1 of 1

Rapidly Progressing Urothelial Carcinoma Due to a Rare TP53 (p.Arg110Pro) Mutation: A Case Report and Review of the Literature.

Res Rep Urol 2021 20;13:181-184. Epub 2021 Apr 20.

Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA.

We present a case of a 69-year-old male patient diagnosed with high grade (T HG) urothelial carcinoma of the bladder who progressed rapidly towards muscle invasive disease and eventually death despite neoadjuvant chemotherapy and radical cystectomy. We postulate that this may be due to a deleterious underlying somatic gene mutation. Molecular pathologic data obtained on the initial, non-muscle invasive tumor and the final cystectomy specimen, revealed the same TP53 mutation (p.Arg110Pro) in both specimens with a variant allele frequency of 44%. The tumor was tested for 50 common gene mutations in urothelial carcinoma and no other identifiable DNA repair mutations were found, suggesting that this specific TP53 aberration, one that has never been reported in the bladder cancer literature, could be particularly deleterious. Knowing that bladder cancer cell lines that lack TP53 are more resistant to cisplatin and because the tumor lacked any other DNA mutation, this patient may have been a candidate for upfront surgery without neoadjuvant chemotherapy. In addition to histological analysis of the tumor, early molecular and cytogenetic characterization of resected tissue is essential in predicting progression and eventual prognosis of the disease based on identifiable gene mutations. Further comparative prospective studies are required to clarify the importance of molecular heterogeneity and subtyping in bladder cancer.
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http://dx.doi.org/10.2147/RRU.S288948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068478PMC
April 2021

Long term renal function following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy: A matched case-control study.

Investig Clin Urol 2021 May 25;62(3):267-273. Epub 2021 Mar 25.

Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA.

Purpose: Partial nephrectomy is associated with a 1%-2% risk of renal iatrogenic vascular lesion (IVL) that are commonly treated with selective angioembolization (SAE). The theoretical advantage of SAE is preservation of renal parenchyma by targeting only the bleeding portion of the kidney. Our study aims to assess the long-term effect of SAE on renal function, especially that this intervention requires potentially nephrotoxic contrast load injection.

Materials And Methods: A retrospective review of patients undergoing partial nephrectomy between 2002 and 2018 was performed, and patients who developed IVL were identified. A 1:4 matched case-control analysis was performed. Paired t-test and χ² test were used for continuous and categorical variables, respectively. Multivariable logistic and Cox proportional hazards regression analyses were used to identify risk factors and confounders for SAE and postoperative renal function.

Results: Eighteen patients found to have an IVL after partial nephrectomy were matched with 72 control patients. IVL's were more common in patients after minimally invasive partial nephrectomy (89% vs. 70%, p=0.008) and in those with higher RENAL nephrometry scores (8.8±2.0 vs. 6.5±1.8, p<0.001). On multivariable analysis, lower RENAL scores proved to decrease the odds of requiring postoperative SAE. No significant difference in renal function outcomes was seen at 24 months of follow-up after surgery.

Conclusions: SAE for the management of IVL following partial nephrectomy is a safe and efficient procedure with no significant impact on short or long-term renal function. Less complex renal tumors with lower RENAL scores are less likely to require postoperative SAE.
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http://dx.doi.org/10.4111/icu.20200510DOI Listing
May 2021

Defining best practices for tissue procurement in immuno-oncology clinical trials: consensus statement from the Society for Immunotherapy of Cancer Surgery Committee.

J Immunother Cancer 2020 11;8(2)

Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA.

Immunotherapy is now a cornerstone for cancer treatment, and much attention has been placed on the identification of prognostic and predictive biomarkers. The success of biomarker development is dependent on accurate and timely collection of biospecimens and high-quality processing, storage and shipping. Tumors are also increasingly used as source material for the generation of therapeutic T cells. There have been few guidelines or consensus statements on how to optimally collect and manage biospecimens and source material being used for immunotherapy and related research. The Society for Immunotherapy of Cancer Surgery Committee has brought together surgical experts from multiple subspecialty disciplines to identify best practices and to provide consensus on how best to access and manage specific tissues for immuno-oncology treatments and clinical investigation. In addition, the committee recommends early integration of surgeons and other interventional physicians with expertise in biospecimen collection, especially in clinical trials, to optimize the quality of tissue and the validity of correlative clinical studies in cancer immunotherapy.
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http://dx.doi.org/10.1136/jitc-2020-001583DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670953PMC
November 2020

Impact of Non-guideline-directed Care on Quality of Life in Testicular Cancer Survivors.

Eur Urol Focus 2020 Oct 26. Epub 2020 Oct 26.

Section of Urology, University of Chicago Medicine, Chicago, IL, USA. Electronic address:

Background: Non-guideline-directed care (NGDC) is seen in ∼30% of testicular cancer patients and has been identified as a significant predictor of relapse. However, the potential impact of mismanagement on patient quality of life (QoL) is yet to be established.

Objective: To explore the impact of NGDC on long-term QoL in testicular cancer survivors (TCSs).

Design, Setting, And Participants: A retrospective review of TCSs, who completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in person or via mail ≥6 mo after completion of treatment, was conducted.

Outcome Measurements And Statistical Analysis: The validated questionnaire evaluates global health status (GHS); cognitive, social, physical, emotional, and role functioning; financial burden; and treatment-specific side effects.

Results And Limitations: A total of 120 men with a median age of 31.5 (interquartile range: 24-42) yr completed the questionnaire. Thirty-four (28%) men received NGDC: overtreatment (44%), improper imaging (32%), and undertreatment (29%). Men with NGDC presented with a more advanced clinical stage (≥IIA: 64% vs 32%, p = 0.007) and were less likely to undergo surveillance (19% vs 37%, p = 0.016). Patients receiving guideline-directed care reported higher GHS (84.1 vs 77.5, p = 0.015), higher physical function scores (98.5 vs 91.2, p = 0.013), and fewer financial difficulties (5.8 vs 18.6, p = 0.006) than those receiving NGDC. Multivariable linear regression showed a significant association between NGDC and poorer GHS (p = 0.002). Limitations of the study include its retrospective nature, modest sample size due to a 21% response rate, and quality-of-life assessment at a single time point rather than serially over time.

Conclusions: In addition to treatment delay, avoidable morbidity, and higher rates of relapse, NGDC leads to inferior global QoL, worse physical functioning, and more financial stress.

Patient Summary: We have previously shown how mismanagement of testicular cancer results in a higher rate of disease relapse. In this study, we emphasize how the lack of adherence to standard treatment guidelines can lead to worse quality of life outcomes and financial stress in testicular cancer survivors.
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http://dx.doi.org/10.1016/j.euf.2020.10.005DOI Listing
October 2020

Incorporating Prognostic Biomarkers into Risk Assessment Models and TNM Staging for Prostate Cancer.

Cells 2020 09 17;9(9). Epub 2020 Sep 17.

Department of Surgery (Section of Urology), University of Chicago, Chicago, IL 60637, USA.

In current practice, prostate cancer staging alone is not sufficient to adequately assess the patient's prognosis and plan the management strategies. Multiple clinicopathological parameters and risk tools for prostate cancer have been developed over the past decades to better characterize the disease and provide an enhanced assessment of prognosis. Herein, we review novel prognostic biomarkers and their integration into risk assessment models for prostate cancer focusing on their capability to help avoid unnecessary imaging studies, biopsies and diagnosis of low risk prostate cancers, to help in the decision-making process between active surveillance and treatment intervention, and to predict recurrence after radical prostatectomy. There is an imperative need of reliable biomarkers to stratify prostate cancer patients that may benefit from different management approaches. The integration of biomarkers panel with risk assessment models appears to improve prostate cancer diagnosis and management. However, integration of novel genomic biomarkers in future prognostic models requires further validation in their clinical efficacy, standardization, and cost-effectiveness in routine application.
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http://dx.doi.org/10.3390/cells9092116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564222PMC
September 2020

Laparoscopic treatment of giant renal cystic echinococcosis.

Int J Infect Dis 2016 Jan 28;42:58-60. Epub 2015 Nov 28.

Division of Urology, Department of Surgery, American University of Beirut, Faculty of Medicine, PO Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon. Electronic address:

Hydatid disease is a parasitic infestation caused by the larval form of the cestode Echinococcus granulosus. Isolated renal involvement is quite rare. Surgery is the mainstay of treatment and is classically performed through an open approach with kidney-sparing when feasible. The case of a 33-year-old male patient who underwent laparoscopic unroofing of a giant renal hydatid cyst is described herein.
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http://dx.doi.org/10.1016/j.ijid.2015.11.016DOI Listing
January 2016

Primary osteosarcoma in a bladder diverticulum.

Can J Urol 2014 Aug;21(4):7393-5

American University of Beirut-Medical Center, Beirut, Lebanon.

Osteosarcoma is a highly malignant soft tissue tumor. Bladder extra-skeletal osteosarcomas are very rare, and only few cases are reported in the English medical literature. This case is the third one of its kind to be reported consisting of a bladder diverticulum osteosarcoma. Compared to urothelial bladder carcinoma, urinary bladder osteosarcomas have a poorer prognosis. Biopsy and immunochemical staining are critical for the diagnosis. Treatment regimens vary based on the stage of the disease. However, choosing the best option for treatment is still unclear, due to the scarcity of cases available.
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August 2014