Search Our Scientific Publications & Authors

Radiology 2019 Mar 22;290(3):709-719. Epub 2019 Jan 22.

From the Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany (S.M.); Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (S.M., J.B., S.G., G.H., K.R., P.A.P.); Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892-1088 (S.M., C.S., M.C., P.L.C., B.T.); Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, National Institutes of Health, Rockville, Md (J.H.S.); Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, NCI Campus at Frederick, Frederick, Md (S.H.); Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Md (M.J.M.); and Center for Interventional Oncology, National Cancer Institute and Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Md (B.J.W.).

Purpose To evaluate MRI features associated with pathologically defined extraprostatic extension (EPE) of prostate cancer and to propose an MRI grading system for pathologic EPE. Materials and Methods In this prospective study, consecutive male study participants underwent preoperative 3.0-T MRI from June 2007 to March 2017 followed by robotic-assisted laparoscopic radical prostatectomy. Read More

Minerva Urol Nefrol 2019 Jan 17. Epub 2019 Jan 17.

Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.

Background: The knowledge of tumour location and extension can allow a modulated radical prostatectomy in order to minimize positive surgical margins and reduce functional morbidity after surgery in patients with prostate cancer (PCa). Multiparametric (mp) magnetic resonance imaging (MRI) could allow the assessment of tumour extension and of its relationship with external structures. Aim of this study is to propose a new radiological Wheeler (rW) staging system applied to mp-MRI, based on the pathologic staging system (pW) for the local assessment of PCa. Read More

Turk J Urol 2018 Aug 17. Epub 2018 Aug 17.

Department of Urology, İstanbul Medeniyet University, İstanbul, Turkey.

Objective: To investigate the factors to predict Gleason score upgrading (GSU) of patients with prostate cancer who were evaluated by using the International Society for Urological Pathology (ISUP) 2014 Gleason grading system.

Material And Methods: Between January 2008 and December 2015, we retrospectively investigated patients who had undergone radical prostatectomy and followed up in the uro-oncology outpatient clinic. The pathologic specimens of the patients were evaluated based on the ISUP 2014 classification system. Read More

Urol Oncol 2018 12 13;36(12):528.e7-528.e13. Epub 2018 Nov 13.

Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, Weill Cornell Medical College, New York, NY. Electronic address:

Purpose: To evaluate the predictive and prognostic role as well as the clinical impact on decision-making of serum cholinesterase (ChoE) levels in patients treated with radical prostatectomy for clinically nonmetastatic prostate cancer.

Materials And Methods: We conducted a retrospective analysis of our multi institutional database. Preoperative ChoE was evaluated as continuous and dichotomized variable using a visual assessment of the functional form of the association of ChoE with biochemical recurrence (BCR)-free survival. Read More

Actas Urol Esp 2019 Mar 22;43(2):84-90. Epub 2018 Oct 22.

Servicio de Cirugía General y Digestiva, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.

Introduction: Given the high prevalence of erectile dysfunction in male population between 40-70 years old and the effect of radical prostatectomy on this domain, it is important to perform a baseline study.

Material And Methods: Prior radical prostatectomy, erectile function has been assessed prospectively in 112 prostate cancer patients using the erectile function (EF) domain of the International Index of Erectile Function (EF-IIEF), Erectile Hardness Score (EHS) and a penile doppler ultrasound (PDUS). Comorbidities and Charlson index were collected. Read More

World J Urol 2018 Oct 22. Epub 2018 Oct 22.

Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea.

Purpose: Prostate-specific antigen nadir and time to prostate-specific antigen nadir are predictors of disease progression in patients who undergo radical prostatectomy. However, a mutually conflicting relationship exists between them. Thus, we compared postoperative prostate-specific antigen levels at the first follow-up with the expected levels while considering the half-life of prostate-specific antigen to improve the prediction of biochemical failure after radical prostatectomy in patients with adverse pathologic features. Read More

BMC Urol 2018 Sep 10;18(1):78. Epub 2018 Sep 10.

Institut du cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St-Denis St, room R10-464, Montréal, Québec, H2X 0A9, Canada.

Background: Refinement of parameters defining prostate cancer (PC) prognosis are urgently needed to identify patients with indolent versus aggressive disease. The Canadian Prostate Cancer Biomaker Network (CPCBN) consists of researchers from four Canadian provinces to create a validation cohort to address issues dealing with PC diagnosis and management.

Methods: A total of 1512 radical prostatectomy (RP) specimens from five different biorepositories affiliated with teaching hospitals were selected to constitute the cohort. Read More

Eur Urol 2018 11 1;74(5):668-675. Epub 2018 Sep 1.

Department of Urology, University of California San Francisco, San Francisco, CA, USA.

Background: Despite the availability of numerous genomic predictors of prostate cancer (PCa) outcome, few comparative studies have been performed.

Objective: To compare the prognostic utility of previously validated immunohistochemical (IHC) markers with an expression-based cell-cycle progression (CCP) score.

Design, Setting, And Participants: We identified 424 men with localized PCa treated with radical prostatectomy (RP). Read More

Prostate Cancer Prostatic Dis 2018 11 7;21(4):594-603. Epub 2018 Aug 7.

Department of Pathology, Icahn School of Medicine at Mt. Sinai, 1468 Madison Avenue, New York City, NY, 10029, USA.

Background: Postoperative risk assessment remains an important variable in the effective treatment of prostate cancer. There is an unmet clinical need for a test with the potential to enhance the Gleason grading system with novel features that more accurately reflect a personalized prediction of clinical failure.

Methods: A prospectively designed retrospective study utilizing 892 patients, post radical prostatectomy, followed for a median of 8 years. Read More

J Vasc Interv Radiol 2018 05 23;29(5):589-597. Epub 2018 Mar 23.

Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Purpose: To provide initial data on tumoricidal efficacy of embolization on prostate cancer via histopathologic examination of prostatectomy specimens after embolization.

Materials And Methods: In this bicentric prospective trial, 12 men with localized prostate cancer underwent radical prostatectomy 6 weeks after prostatic artery embolization (PAE) from October 2016 to May 2017. PAE was performed with the use of 100-μm Embozene microspheres (Boston Scientific, Natick, Massachusetts). Read More

Virchows Arch 2018 Mar 16;472(3):451-460. Epub 2018 Feb 16.

Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain.

Positive surgical margin (PSM) extension reported as focal or non-focal/extensive is an important pathologic prognostic parameter after radical prostatectomy. Likewise, there is limited or no agreement on how to measure and what the best cut-off points to be used in practice are. We hypothesized that digital microscopy (DM) would potentially provide a more objective way to measure PSM and better define its clinical significance. Read More

World J Urol 2018 May 24;36(5):713-718. Epub 2018 Jan 24.

Texas Health Presbyterian Dallas, 8230 Walnut Hill Lane, Suite 700, Dallas, TX, 75231, USA.

Purpose: The purpose this study is to evaluate the efficacy of multiparametric ultrasound-targeted biopsies in patients undergoing initial biopsy of the prostate for the suspicion of prostate cancer.

Materials And Methods: A total of 167 patients who are biopsy naïve underwent multiparametric ultrasound-targeted biopsy of the prostate. All patients had a transrectal ultrasound which included gray-scale evaluation and color Doppler evaluation. Read More

J Korean Med Sci 2018 Jan 29;33(5):e36. Epub 2018 Jan 29.

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Significant clinical heterogeneity within contemporary risk group is well known, particularly for those with intermediate-risk prostate cancer (IRPCa). Our study aimed to analyze the ability of the Cancer of the Prostate Risk Assessment (CAPRA) score to discern between favorable and non-favorable risk in patients with IRPCa.

Methods: We retrospectively reviewed the data of 203 IRPCa patients who underwent extraperitoneal robot-assisted radical prostatectomy (RARP) performed by a single surgeon. Read More

Asian J Urol 2017 Jan 19;4(1):31-36. Epub 2016 Nov 19.

The Smith Institute for Urology, Hofstra Northwell School of Medicine, New Hyde Park, NY, USA.

Objective: Extracapsular extension (ECE) of prostate cancer is a poor prognostic factor associated with progression, recurrence after treatment, and increased prostate cancer-related mortality. Accurate staging prior to radical prostatectomy is crucial in avoidance of positive margins and when planning nerve-sparing procedures. Multi-parametric magnetic resonance imaging (mpMRI) of the prostate has shown promise in this regard, but is hampered by poor sensitivity. Read More

Eur Urol 2018 07 10;74(1):107-114. Epub 2017 Dec 10.

Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Prostate cancer patients who have a detectable prostate-specific antigen (PSA) postprostatectomy may harbor pre-existing metastatic disease. To our knowledge, none of the commercially available genomic biomarkers have been investigated in such men.

Objective: To evaluate if a 22-gene genomic classifier can independently predict development of metastasis in men with PSA persistence postoperatively. Read More

Int Urol Nephrol 2017 Dec 13;49(12):2119-2125. Epub 2017 Sep 13.

Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea.

Purpose: Reports on the impact of a family history of prostate cancer among Asians are scarce. We evaluated whether a positive prostate cancer family history is associated with the prognosis and features of the disease.

Methods: From January 2006 to December 2015, patients who received treatment for pathologically diagnosed prostate cancer were enrolled. Read More

Oncol Res Treat 2017 10;40(9):508-514. Epub 2017 Aug 10.

Aim: The aim of this study was to clarify and examine the outcomes of prostate cancer patients classified as intermediate risk (IR) using the D'Amico risk classification system, specifically focusing on the influence of primary and secondary biopsy Gleason score (BGS).

Patients And Methods: An institutional review board-approved database of robotic-assisted radical prostatectomies performed after 2006 was stratified by standard D'Amico criteria. IR patients were then sub-stratified by BGS. Read More

Eur Urol Focus 2018 01 23;4(1):80-86. Epub 2016 Nov 23.

Division of Urology, San Luigi Gonzaga Hospital-Orbassano, University of Turin, Turin, Italy.

Background: The literature is lacking randomised controlled trials comparing robot-assisted (RARP) and laparoscopic (LRP) radical prostatectomy, especially for follow-up >1 yr.

Objective: To report 5-yr outcomes for our previously published prospective randomised study comparing RARP and LRP.

Design, Setting, And Participants: From January 2010 to January 2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP. Read More

Eur J Nucl Med Mol Imaging 2017 Sep 23;44(10):1622-1635. Epub 2017 May 23.

Nuclear Medicine, Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy.

Methods: After primary treatment, biochemical relapse (BCR) occurs in a substantial number of patients with prostate cancer (PCa). PET/CT imaging with prostate-specific membrane antigen based tracers (68Ga-PSMA) has shown promising results for BCR patients. However, a standardized image interpretation methodology has yet to be properly agreed. Read More

J Cancer Res Clin Oncol 2017 Sep 18;143(9):1871-1878. Epub 2017 May 18.

Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Purpose: To evaluate the better risk stratification based on surgical pathology, and to predict oncologic outcomes after radical prostatectomy (RP) with a better scoring system in high-risk prostate cancer (PCa) patients.

Methods: We evaluated high-risk PCa patients (PSA >20 ng/ml, ≥cT3a, or Gleason score 8-10) who underwent RP between 2007 and 2013 at our institute. We classified patients into three groups according to their pathologic outcomes: favorable (pT2, Gleason score ≤7, and node negative), intermediate (specimen-confined disease (pT2-3a, node negative PCa with negative surgical margins) but not in the favorable group), and unfavorable (the remaining patients). Read More

World J Urol 2017 Oct 10;35(10):1517-1524. Epub 2017 May 10.

Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Purpose: Gleason score upgrading should be considered when indicating surgery in prostate cancer (PCa) patients. In elderly patients, definitive treatment of low-risk PCa must be weighed with the risks of overtreatment. Our aim was to evaluate rates of Gleason score upgrading in patients ≥75 years undergoing radical prostatectomy (RP) for localized PCa and to identify predictors associated with upgrading. Read More

Urologia 2017 Apr 22;84(2):93-97. Epub 2017 Apr 22.

Department of Urology, ASST Rohdense, G. Salvini Hospital, Garbagnate Milanese, Milan - Italy.

Introduction: Three-dimensional (3D) laparoscopy with a flexible camera was developed to overcome the main limitation of traditional laparoscopic surgery, which is two-dimensional (2D) vision.The aim of our article is to present the largest casistic of 3D laparoscopic radical prostatectomy (LRP) available in literature and evaluate our results in terms of pentafecta and compare it with the literature.

Methods: We retrospectively evaluated consecutive patients who underwent LRP with 3D technology between March 2014 and December 2015. Read More

Eur Urol 2018 02 8;73(2):168-175. Epub 2017 Apr 8.

James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address:

Background: Risk of prostate cancer-specific mortality (PCSM) is highly variable for men with adverse pathologic features at radical prostatectomy (RP); a majority will die of other causes. Accurately stratifying PCSM risk can improve therapy decisions.

Objective: Validate the 22 gene Decipher genomic classifier (GC) to predict PCSM in men with adverse pathologic features after RP. Read More

J Clin Oncol 2017 Jun 28;35(18):1982-1990. Epub 2017 Mar 28.

Deepansh Dalela, Mani Menon, and Firas Abdollah, Henry Ford Health System, Detroit, MI; María Santiago-Jiménez, Kasra Yousefi, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; R. Jeffrey Karnes, Mayo Clinic, Rochester, MN; Ashley E. Ross, Johns Hopkins Hospital, Baltimore, MD; Adam P. Dicker and Robert B. Den, Thomas Jefferson University, Philadelphia, PA; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles, CA; Edward M. Schaeffer, Northwestern University Feinberg School of Medicine, Chicago, IL; and Alberto Briganti, Vita Salute San Raffaele Hospital, Milan, Italy.

Purpose Despite documented oncologic benefit, use of postoperative adjuvant radiotherapy (aRT) in patients with prostate cancer is still limited in the United States. We aimed to develop and internally validate a risk-stratification tool incorporating the Decipher score, along with routinely available clinicopathologic features, to identify patients who would benefit the most from aRT. Patient and Methods Our cohort included 512 patients with prostate cancer treated with radical prostatectomy at one of four US academic centers between 1990 and 2010. Read More

Eur Urol 2017 08 18;72(2):238-249. Epub 2017 Mar 18.

Academic Urology Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK.

Context: The incidence of low-risk prostate cancer (PCa) has increased as a consequence of prostate-specific antigen testing.

Objective: In this collaborative review article, we examine recent literature regarding low-risk PCa and the available prognostic and therapeutic options.

Evidence Acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. Read More

Anticancer Res 2017 03;37(3):1237-1242

Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA, U.S.A.

Background/aim: We evaluated whether sub-stratifying intermediate-risk (IR) prostate cancer using the Memorial Sloan Kettering Cancer (MSKCC) or Prostate Cancer Risk Stratification (ProCaRS) model predicts for adverse imaging or pathologic features.

Patients And Methods: 56 consecutive IR patients who underwent multi-parametric MRI (mpMRI) and radical prostatectomy (RP) were studied. The different groups were tested for correlation with adverse findings. Read More

AJR Am J Roentgenol 2017 May 7;208(5):1037-1044. Epub 2017 Mar 7.

1 Department of Medical Imaging, The Ottawa Hospital, The University of Ottawa, 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada.

Objective: The purpose of this study is to assess associations between Prostate Imaging Reporting and Data System, version 2 (PI-RADSv2), categories and the presence of a tumor with a Gleason score (GS) of 4 + 3 = 7 or greater or the presence of extraprostatic extension (EPE) at radical prostatectomy (RP) in patients with a GS 3 + 4 = 7 tumor at biopsy.

Materials And Methods: A total of 81 men with GS 3 + 4 = 7 prostate cancer diagnosed by transrectal ultrasound-guided biopsy underwent multiparametric MRI and RP between 2012 and 2015. Two blinded radiologists assessed multiparametric MR images and assigned PI-RADSv2 assessment categories (categories 1-5) with the use of sector maps, which were compared with regard to the location of the tumor, the GS, and the presence of EPE at RP. Read More

Asian J Androl 2017 Nov-Dec;19(6):700-706

Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Division of Urology, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08903, USA.

The aim of this study is to identify optimal patients for adjuvant radiation therapy (ART) in pT3 prostate cancer. The role of ART for patients with adverse pathologic features after radical prostatectomy (RP) has been demonstrated, but over- or under-treatment remains a significant concern. Two-hundred and five patients with pT3N0M0 who underwent robot-assisted RP without ART were analyzed. Read More

Prostate Cancer Prostatic Dis 2017 06 31;20(2):241-248. Epub 2017 Jan 31.

Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA.

Background: In focused radiotherapy for prostate cancer (PC), a full dose of radiation is delivered to the index lesion while reduced dose is delivered to the remaining prostate to reduce morbidity. As PC is commonly multifocal, we investigated whether baseline clinical characteristics or multiparametric magnetic resonance imaging (mpMRI) may be useful to predict the actual pathologic distribution of PC in men with intermediate- or high-risk PC, which may better inform how to deliver focused radiotherapy.

Methods: A retrospective single-institutional study was performed on 71 consecutive men with clinically localized, intermediate- or high-risk PC who underwent mpMRI followed by radical prostatectomy (RP) from January 2012 to December 2012. Read More

BJU Int 2017 08 8;120(2):219-225. Epub 2017 Feb 8.

London School of Hygiene and Tropical Medicine, London, UK.

Objectives: To develop and validate a surgical performance indicator based on severe urinary complications that require an intervention within 2 years of radical prostatectomy (RP), identified in hospital administrative data.

Patients And Methods: Men who underwent RP between 2008 and 2012 in England were identified using hospital administrative data. A transparent coding framework based on procedure codes was developed to identify severe urinary complications which were grouped into 'stricture', 'incontinence' and 'other'. Read More

Minerva Urol Nefrol 2017 02 10;69(1):101-107. Epub 2016 Nov 10.

Department of Urology, Institut Jules Bordet, Bruxelles, Belgium.

Background: In intermediate and high-risk prostate cancer patients, a robotic-assisted approach is increasingly being used for prostatectomy and extended pelvic lymph node dissection (ePLND). This is reducing the number of conventional laparoscopic radical prostatectomies (LR P) and laparoscopic ePLNDs for prostate cancer in Europe. Aim of this study is to compare laparoscopic ePLND to robotic-assisted ePLND in a cohort of patients with intermediate and high risk prostate cancer. Read More

World J Urol 2017 Aug 16;35(8):1191-1197. Epub 2016 Dec 16.

Department of Urology, Institut Mutualiste Monsouris, Paris-Descartes University, Paris, France.

Background: Prognoses for intermediate-risk prostate cancer (PCa) remain heterogeneous. Improved substratification could optimize treatment and monitoring strategies. The objective was to validate this subclassification in a radical prostatectomy (RP) series. Read More

Urology 2017 Apr 25;102:73-78. Epub 2016 Nov 25.

Department of Surgical Sciences, Urology, University of Turin, Turin, Italy. Electronic address:

Objective: To assess whether cell-cycle progression (CCP)-score (Prolaris) can improve the current risk assessment in newly diagnosed prostate cancer (PCa) patients. CCP-score is a well-validated prognostic assay predictive of PCa death, biochemical recurrence, and progression.

Methods: We evaluated CCP-score at biopsy in 52 patients newly diagnosed with PCa who underwent radical prostatectomy. Read More

Eur Urol 2017 06 19;71(6):907-912. Epub 2016 Nov 19.

Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address:

Background: The newly proposed five-tiered prostate cancer grading system (PCGS) divides Gleason score (GS) 8-10 disease into GS 8 and GS 9-10 on the basis of biochemical recurrence (BCR) following radical prostatectomy (RP) as an outcome. However, BCR does not necessarily portend worse survival outcomes.

Objective: To assess the significance of distinguishing GS 8 versus 9-10 disease in terms of long-term survival outcomes for both the preoperative setting using biopsy (Bx) GS and the postoperative setting with RP GS. Read More

Oncotarget 2017 May;8(19):32237-32257

Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Context: The safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. Recently, a number of large-scale and high-quality studies have been conducted.

Objective: To obtain a more valid assessment, we update the meta-analysis of RARP compared with RRP to assessed its safety and feasibility in treatment of prostate cancer. Read More

PLoS One 2016 7;11(10):e0164497. Epub 2016 Oct 7.

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Current National Comprehensive Cancer Network guidelines recommend postoperative radiation therapy based only on adverse pathologic findings (APFs), irrespective of preoperative risk group. We assessed whether a model incorporating both the preoperative risk group and APFs could predict long-term oncologic outcomes better than a model based on APFs alone.

Methods: We retrospectively reviewed 4,404 men who underwent radical prostatectomy (RP) at our institution between 1992 and 2014. Read More

Prostate Cancer Prostatic Dis 2016 12 4;19(4):423-428. Epub 2016 Oct 4.

Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.

Background: Approximately 29-38% of all positive surgical margins (PSMs) at radical prostatectomy (RP) involve the apex. The prognostic significance of apical PSM remains unclear. We therefore compared the long-term oncologic outcomes of men with apical PSMs to those with negative PSMs, apical and other PSMs, and other PSMs at RP. Read More

J Cancer Res Clin Oncol 2017 Jan 20;143(1):123-129. Epub 2016 Sep 20.

Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dong Fang Road, Shanghai, 200127, China.

Purpose: To evaluate the ability of the new Gleason grade groups (GGGs) to stratify risk in prostate cancer patients with locally adverse pathologic features after radical prostatectomy (RP) thereby allowing more accurate assessment for planning eventual adjuvant therapy.

Patients And Methods: Data on 172 patients with locally adverse pathologic features (including seminal vesicle invasion, extracapsular extension, or positive surgical margins) who had been treated with wait and see policy after RP were retrospectively analyzed for biochemical recurrence (BCR)-free survival. Kaplan-Meier survival analysis and Cox proportional hazard regression models were used to test the association between the GGGs and BCR. Read More

World J Urol 2017 May 15;35(5):729-735. Epub 2016 Sep 15.

Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, Madison, WI, 53705, USA.

Introduction: A significant proportion of patients that fail active surveillance (AS) for prostate cancer management do so because of cancer upgrading. A previously validated upgrading nomogram generates a score that predicts risk of biopsy Gleason 6 upgrading following radical prostatectomy in lower-risk populations that are candidates for Active Surveillance (Cancer, 2013).

Objectives: We hypothesize that the upgrading risk (UR) score generated by this nomogram at diagnosis improves the ability to predict patients that will subsequently fail AS. Read More

Prostate Cancer Prostatic Dis 2016 12 30;19(4):374-379. Epub 2016 Aug 30.

GenomeDx Biosciences Inc., Vancouver, BC, Canada.

Background: Currently, there are multiple commercially available RNA-based biomarkers that are Medicare approved and suggested for use by the National Comprehensive Cancer Network guidelines. There is uncertainty as to which patients benefit from genomic testing and for whom these tests should be ordered. Here, we examined the correlation patterns of Decipher assay to understand the relationship between the Decipher and patient tumor characteristics. Read More

Eur Urol 2017 07 11;72(1):135-141. Epub 2016 Aug 11.

The Johns Hopkins University School of Medicine, The James Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address:

Background: Active surveillance (AS) is an alternative to curative intervention, but overtreatment persists. Imperfect alignment of prostate biopsy and Gleason score after radical prostatectomy (RP) may be a contributing factor.

Objective: To develop a statistical model that predicts the post-RP Gleason score (pathologic Gleason score [PGS]) using clinical observations made in the course of AS. Read More

Urology 2016 11 8;97:153-159. Epub 2016 Aug 8.

Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA.

Objective: To determine the association of statin use with oncological outcomes and risk of pathologic upgrading following radical prostatectomy.

Materials And Methods: Using a prospectively populated database of 3042 men who underwent open radical prostatectomy, patients were grouped according to reported statin use at the time of surgery. The primary outcome was time to biochemical recurrence. Read More

Radiology 2017 Feb 11;282(2):429-436. Epub 2016 Aug 11.

From the Departments of Radiology and Biomedical Imaging (J.Y.C., J.Y., S.M.N., S.B., J.K., Y.S.), Radiation Oncology (A.J.C., Y.S.), Anatomic Pathology (J.P.S.), and Urology (H.G.N., P.R.C.), University of California, San Francisco, San Francisco, Calif and Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea (J.Y.C. ).

Purpose To investigate the initial clinical value of fluorine 18 (F) fluorocholine (FCH) dynamic positron emission tomography (PET)/magnetic resonance (MR) imaging by comparing its parameters with clinical-pathologic findings in patients with newly diagnosed intermediate- to high-risk prostate cancer (PCa) who plan to undergo radical prostatectomy. Materials and Methods The institutional review board approved the study protocol, and informed written consent was obtained from all subjects for this HIPAA-compliant study. Twelve men (mean age ± standard deviation, 61. Read More

BMC Cancer 2016 07 29;16:557. Epub 2016 Jul 29.

Dana Farber Cancer Institute and Harvard TH Chan School of Public Health, Boston, MA, USA.

Background: Little is known about the relationship between preoperative body mass index and need for adjuvant radiation therapy (RT) following radical prostatectomy. The goal of this study was to evaluate the utility of body mass index in predicting adverse clinical outcomes which require adjuvant RT among men with organ-confined prostate cancer (PCa).

Methods: We used a prospective cohort of 1,170 low-intermediate PCa risk men who underwent radical prostatectomy and evaluated the effect of body mass index on adverse pathologic features and freedom from biochemical failure (FFbF). Read More

BMC Urol 2016 Jun 8;16(1):26. Epub 2016 Jun 8.

Department of Urology, Clinique St Jean du Languedoc, Toulouse, France.

Background: We propose to improve the prognostic assessment after radical prostatectomy (RP) by dividing high-risk prostate cancer (hrPCa) (according to the d'Amico classification) into subgroups combining 1, 2 or 3 criteria of aggressiveness (cT2c-T3a, PSA >20 ng/ml, Gleason score (GS) > 7).

Methods: Data from 4795 hrPCa patients who underwent RP in two French university hospitals from 1991 to 2013 were analyzed. Subgroups were formed to determine whether an increasing number (1, 2 or 3) of criteria of tumor aggressiveness was associated with poorer oncological results and early biochemical recurrence (BCR) (PSA > 0. Read More

Eur Urol 2017 09 4;72(3):329-332. Epub 2016 May 4.

Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.

For men with low-stage prostate cancer (PCa) managed with active surveillance (AS), clinical thresholds for intervention have not been definitively established. We aimed to evaluate whether the magnitude of quantitative risk change may serve as a refined end point. We identified 735 men managed with AS at our institution who received a minimum of two biopsies and who were followed for a median of 52 mo. Read More

Urology 2016 08 3;94:173-9. Epub 2016 May 3.

Department of Urology, Henri Mondor Hospital, Assistance-Publique Hopitaux de Paris, Creteil, France.

Objective: To assess changes in conditional disease-free survival (DFS) rates after radical prostatectomy (RP) and how the impact of well-known prognostic factors evolves over time.

Materials And Methods: There were 2813 patients treated with RP and postoperatively followed with clinical and prostate-specific antigen assessments. Estimation of conditional survival (CS) probabilities used the Kaplan-Meier method. Read More

Urology 2016 Aug 28;94:259-64. Epub 2016 Apr 28.

Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH.

Objective: To describe our technique and outcomes of robotic-assisted nerve-sparing cystoprostatectomy with prostatic apex preservation and orthotopic ileal conduit urinary diversion in young men undergoing robotic-assisted radical cystectomy (RARC) for the management of urothelial carcinoma.

Materials And Methods: Young men (<40 years old) with the diagnosis of urothelial carcinoma undergoing RARC with orthotopic neobaldder formation were eligible for our technique of nerve-sparing cystoprostatectomy with prostatic apex preservation at the time of orthotopic ileal conduit urinary diversion. During the apical prostatic dissection step of the RARC, the plane of dissection is directed under the dorsal vein complex and through anterior prostatic fibromuscular stroma. Read More

J Robot Surg 2016 Jun 15;10(2):151-6. Epub 2016 Apr 15.

Division of Urology, Washington University School of Medicine, Campus Box 8242, 660 S Euclid Ave, St. Louis, MO, 63110, USA.

We sought to examine the impact of baseline patient characteristics and perioperative outcomes on postoperative hospital length of stay (LOS), following the robot-assisted radical prostatectomy (RARP). We retrospectively reviewed consecutive patients receiving RARP at our institution by two surgeons between January 2012 and March 2014 (n = 274). Baseline patient characteristics were collected, including Charlson comorbidity index (CCI). Read More

World J Urol 2016 Nov 13;34(11):1541-1546. Epub 2016 Apr 13.

Department of Urology, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.

Purpose: To examine the clinicopathological features and identify the predictors of pathological upgrading in low-risk prostate cancer (PCa) patients without hypointense lesions on the apparent diffusion coefficient (ADC) map calculated from multiparametric magnetic resonance imaging.

Methods: We reviewed the medical records of 1905 PCa patients who underwent radical prostatectomy between 2007 and 2015. All ADC images were graded using the five-grade Likert scale; the positive hypointense lesions were graded 4-5. Read More