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Inman, Brant Allen

Overview:

Clinical research interests:
Clinical trials of novel diagnostic tests and therapies for genitourinary malignancies, with a strong focus on bladder cancer.

Basic science research interests:
Immune therapies for cancer, hyperthermia and heat-based treatment of cancer, molecular biology of genitourinary cancers, novel diagnostics and therapies for genitourinary cancers

Positions:

Cary N. Robertson, MD, Associate Professor

Surgery, Urology
School of Medicine

Associate Professor of Surgery

Surgery, Urology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1999

B.S. — University of Alberta (Canada)

M.D. 2000

M.D. — University of Alberta (Canada)

M.S. 2011

M.S. — Mayo Medical School

Residency, Urology

Universite Laval (Canada)

Fellowship, Urologic Oncology

Mayo Clinic

News:

Grants:

PHASE III, OPEN-LABEL, MULTICENTER, RANDOMIZED STUDY BLADDER CANCER

Administered By
Surgery, Urology
AwardedBy
Genentech, Inc.
Role
Principal Investigator
Start Date
July 01, 2015
End Date
September 30, 2024

Bladder Tumor TURBT Study

Administered By
Surgery, Urology
AwardedBy
GenomeDx Biosciences, Inc.
Role
Principal Investigator
Start Date
November 07, 2017
End Date
November 06, 2022

MitoGel

Administered By
Surgery, Urology
AwardedBy
UroGen Pharma Ltd
Role
Principal Investigator
Start Date
March 13, 2017
End Date
February 28, 2022

Phase II open label study of Atezolizumab administered with/without BCG

Administered By
Surgery, Urology
AwardedBy
Genentech, Inc.
Role
Principal Investigator
Start Date
November 01, 2016
End Date
October 31, 2021

Translational Research in Surgical Oncology

Administered By
Surgery, Surgical Sciences
AwardedBy
National Institutes of Health
Role
Co-Mentor
Start Date
January 01, 2002
End Date
August 31, 2021

EpiCheck Study

Administered By
Surgery, Urology
AwardedBy
Nucleix Ltd.
Role
Principal Investigator
Start Date
April 09, 2017
End Date
February 29, 2020

A Phase III, Open Label Study to Evaluate the Safety and Efficacy of INSTILADRIN® (rAd-IFN/Syn3) Administered Intravesically to Patients with High Grade, BCG Unresponsive Non-Muscle Invasive Bladder C

Administered By
Surgery, Urology
AwardedBy
FKD Therapies Oy
Role
Principal Investigator
Start Date
January 30, 2017
End Date
October 31, 2019

Synergistic Immuno-Photo-Nanotherapy for Bladder Cancer

Administered By
Surgery, Urology
AwardedBy
Department of Defense
Role
Principal Investigator
Start Date
September 30, 2017
End Date
September 29, 2019

Therapeutic targeting of B7-H3 to reverse prostate cancer treatment resistance.

Administered By
Surgery, Urology
AwardedBy
Department of Defense
Role
Principal Investigator
Start Date
September 15, 2016
End Date
September 14, 2019

Pig Bladder Hyperthermia Testing Device

Administered By
Surgery, Urology
AwardedBy
Combat Medical
Role
Principal Investigator
Start Date
July 18, 2017
End Date
July 17, 2018

Evaluation of Urovysion in Patients Receiving BCG

Administered By
Surgery, Urology
AwardedBy
Abbott Molecular Diagnostics
Role
Principal Investigator
Start Date
December 01, 2013
End Date
May 31, 2018

Phase II Trial of Aerobic Training in Metastatic Breast Cancer

Administered By
Radiation Oncology
AwardedBy
National Institutes of Health
Role
Investigator
Start Date
September 17, 2010
End Date
February 14, 2014

Randomized Trial of Optimal Type of Aerobic Training in Breast Cancer

Administered By
Radiation Oncology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
April 01, 2010
End Date
February 14, 2014
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Awards:

Reviewer of the month. European Urology.

Type
International
Awarded By
European Urology
Date
February 01, 2016

Leadership program. American Urological Association.

Type
National
Awarded By
American Urological Association
Date
January 01, 2016

Platinum Scalpel Award for Excellence in Teaching. Division of Urology, Duke University.

Type
Department
Awarded By
Division of Urology, Duke University
Date
June 01, 2015

International exchange scholar. European Association of Urology and American Urological Association.

Type
International
Awarded By
European Association of Urology and American Urological Association
Date
March 01, 2014

Best Clinical Paper of 2014. International Journal of Hyperthermia.

Type
International
Awarded By
International Journal of Hyperthermia
Date
January 01, 2014

Honorary Judge, Ferdinand C. Valentine Contest . New York Academy of Medicine.

Type
National
Awarded By
New York Academy of Medicine
Date
January 01, 2013

Best reviewer, prostate cancer. Journal of Urology.

Type
National
Awarded By
Journal of Urology
Date
January 01, 2008

Best of posters, bladder cancer, basic science. American Urological Association.

Type
National
Awarded By
American Urological Association
Date
January 01, 2007

Merit award. ASCO Foundation.

Type
National
Awarded By
ASCO Foundation
Date
January 01, 2007

Merit award. ASCO Prostate Cancer Symposium .

Type
National
Awarded By
ASCO Prostate Cancer Symposium
Date
January 01, 2007

Merit award. ASCO Prostate Cancer Symposium .

Type
National
Awarded By
ASCO Prostate Cancer Symposium
Date
January 01, 2006

Clinical prize essay. Canadian Urologic Association .

Type
International
Awarded By
Canadian Urologic Association
Date
January 01, 2005

Gerald P. Murphy Scholar . American Urological Association.

Type
International
Awarded By
American Urological Association
Date
January 01, 2004

Clinical prize essay. Quebec Urologic Association .

Type
International
Awarded By
Quebec Urologic Association
Date
January 01, 2003

Basic science prize essay. Quebec Urologic Association .

Type
International
Awarded By
Quebec Urologic Association
Date
January 01, 2002

Clinical prize essay. Quebec Urologic Association .

Type
International
Awarded By
Quebec Urologic Association
Date
January 01, 2001

Letter of exceptional proficiency, general surgery. University of Calgary.

Type
University
Awarded By
University of Calgary
Date
January 01, 2001

Letter of exceptional proficiency, internal medicine. University of Calgary.

Type
University
Awarded By
University of Calgary
Date
January 01, 2001

Dr. Morris Weinlos Prize in Pathology & Surgery . University of Alberta.

Type
International
Awarded By
University of Alberta
Date
January 01, 2000

MRC Burroughs Wellcome Research Studentship . University of Alberta.

Type
International
Awarded By
University of Alberta
Date
January 01, 1996

Student Bursary. College of Physicians and Surgeons of Alberta .

Type
International
Awarded By
College of Physicians and Surgeons of Alberta
Date
January 01, 1996

Research Studentship. Alberta Heritage Foundation for Medical Research .

Type
International
Awarded By
Alberta Heritage Foundation for Medical Research
Date
January 01, 1995

Louise McKinney Post-Secondary Scholarship . Government of Alberta (Canada).

Type
International
Awarded By
Government of Alberta (Canada)
Date
January 01, 1994

Alexander Rutherford Post-Secondary Scholarship . Government of Alberta (Canada).

Type
International
Awarded By
Government of Alberta (Canada)
Date
January 01, 1993

Bronze medal for academic achievement. Governor General of Canada.

Type
International
Awarded By
Governor General of Canada
Date
January 01, 1993

Publications:

Intravesical rAd-IFNα/Syn3 for Patients With High-Grade, Bacillus Calmette-Guerin-Refractory or Relapsed Non-Muscle-Invasive Bladder Cancer: A Phase II Randomized Study.

Purpose Many patients with high-risk non-muscle-invasive bladder cancer (NMIBC) are either refractory to bacillus Calmette-Guerin (BCG) treatment or may experience disease relapse. We assessed the efficacy and safety of recombinant adenovirus interferon alfa with Syn3 (rAd-IFNα/Syn3), a replication-deficient recombinant adenovirus gene transfer vector, for patients with high-grade (HG) BCG-refractory or relapsed NMIBC. Methods In this open-label, multicenter (n = 13), parallel-arm, phase II study ( ClinicalTrials.gov identifier: NCT01687244), 43 patients with HG BCG-refractory or relapsed NMIBC received intravesical rAd-IFNα/Syn3 (randomly assigned 1:1 to 1 × 1011 viral particles (vp)/mL or 3 × 1011 vp/mL). Patients who responded at months 3, 6, and 9 were retreated at months 4, 7, and 10. The primary end point was 12-month HG recurrence-free survival (RFS). All patients who received at least one dose were included in efficacy and safety analyses. Results Forty patients received rAd-IFNα/Syn3 (1 × 1011 vp/mL, n = 21; 3 × 1011 vp/mL, n = 19) between November 5, 2012, and April 8, 2015. Fourteen patients (35.0%; 90% CI, 22.6% to 49.2%) remained free of HG recurrence 12 months after initial treatment. Comparable 12-month HG RFS was noted for both doses. Of these 14 patients, two experienced recurrence at 21 and 28 months, respectively, after treatment initiation, and one died as a result of an upper tract tumor at 17 months without a recurrence. rAd-IFNα/Syn3 was well tolerated; no grade four or five adverse events (AEs) occurred, and no patient discontinued treatment because of an adverse event. The most frequently reported drug-related AEs were micturition urgency (n = 16; 40%), dysuria (n = 16; 40%), fatigue (n = 13; 32.5%), pollakiuria (n = 11; 28%), and hematuria and nocturia (n = 10 each; 25%). Conclusion rAd-IFNα/Syn3 was well tolerated. It demonstrated promising efficacy for patients with HG NMIBC after BCG therapy who were unable or unwilling to undergo radical cystectomy.

Authors
Shore, ND; Boorjian, SA; Canter, DJ; Ogan, K; Karsh, LI; Downs, TM; Gomella, LG; Kamat, AM; Lotan, Y; Svatek, RS; Bivalacqua, TJ; Grubb, RL; Krupski, TL; Lerner, SP; Woods, ME; Inman, BA; Milowsky, MI; Boyd, A; Treasure, FP; Gregory, G; Sawutz, DG; Yla-Herttuala, S; Parker, NR; Dinney, CPN
MLA Citation
Shore, ND, Boorjian, SA, Canter, DJ, Ogan, K, Karsh, LI, Downs, TM, Gomella, LG, Kamat, AM, Lotan, Y, Svatek, RS, Bivalacqua, TJ, Grubb, RL, Krupski, TL, Lerner, SP, Woods, ME, Inman, BA, Milowsky, MI, Boyd, A, Treasure, FP, Gregory, G, Sawutz, DG, Yla-Herttuala, S, Parker, NR, and Dinney, CPN. "Intravesical rAd-IFNα/Syn3 for Patients With High-Grade, Bacillus Calmette-Guerin-Refractory or Relapsed Non-Muscle-Invasive Bladder Cancer: A Phase II Randomized Study." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 35.30 (October 2017): 3410-3416.
PMID
28834453
Source
epmc
Published In
Journal of Clinical Oncology
Volume
35
Issue
30
Publish Date
2017
Start Page
3410
End Page
3416
DOI
10.1200/jco.2017.72.3064

Bladder Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology

Authors
Spiess, PE; Agarwal, N; Bangs, R; Boorjian, SA; Buyyounouski, MK; Clark, PE; Downs, TM; Efstathiou, JA; Flaig, TW; Friedlander, T; Greenberg, RE; Guru, KA; Hahn, N; Herr, HW; Hoimes, C; Inman, BA; Jimbo, M; Kader, AK; Lele, SM; Meeks, JJ; Michalski, J; Montgomery, JS; Pagliaro, LC; Pal, SK; Patterson, A; Plimack, ER; Pohar, KS; Porter, MP; Preston, MA; Sexton, WJ; Siefker-Radtke, AO; Sonpavde, G; Tward, J; Wile, G; Dwyer, MA; Gurski, LA
MLA Citation
Spiess, PE, Agarwal, N, Bangs, R, Boorjian, SA, Buyyounouski, MK, Clark, PE, Downs, TM, Efstathiou, JA, Flaig, TW, Friedlander, T, Greenberg, RE, Guru, KA, Hahn, N, Herr, HW, Hoimes, C, Inman, BA, Jimbo, M, Kader, AK, Lele, SM, Meeks, JJ, Michalski, J, Montgomery, JS, Pagliaro, LC, Pal, SK, Patterson, A, Plimack, ER, Pohar, KS, Porter, MP, Preston, MA, Sexton, WJ, Siefker-Radtke, AO, Sonpavde, G, Tward, J, Wile, G, Dwyer, MA, and Gurski, LA. "Bladder Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology." Journal of the National Comprehensive Cancer Network 15.10 (October 2017): 1240-1267.
Source
crossref
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
15
Issue
10
Publish Date
2017
Start Page
1240
End Page
1267
DOI
10.6004/jnccn.2017.0156

Physical activity patterns and associations with health-related quality of life in bladder cancer survivors.

Physical activity has been shown to significantly improve health-related quality of life (HRQOL) and survivorship in a variety of patients with cancer . However, little is known about the physical activity patterns of bladder cancer survivors and how these are related to HRQOL in the United States. Our objective was to describe self-reported physical activity patterns and HRQOL and examine the association between these measures in a large cohort of bladder cancer survivors.In this cross-sectional study, long-term bladder cancer survivors identified through an institutional database were mailed a survey that included the Functional Assessment of Cancer Therapy Bladder Cancer (FACT-BL) and the International Physical Activity Questionnaire (IPAQ). Associations between HRQOL, as assessed by the FACT-BL, and physical activity, as assessed by the IPAQ, were examined by stratified analyses of HRQOL by different levels of physical activity, proportional odds ordinal logistic regression models, and local polynomial regression models.A total of 472 subjects (49% response rate) completed the survey. The mean age was 74 years; 81% were male and 87% were white. The median total weekly physical activity was 2,794 MET-min. Subjects reporting "high" physical activity had a median FACT-BL score of 129 compared with 119 among those reporting "low" physical activity, a statistically and clinically significant difference. Similarly, subjects reporting "high" physical activity had a 2.2-fold increased odds of reporting higher global HRQOL compared with subjects reporting "low" physical activity.This large cohort of bladder cancer survivors reported high levels of physical activity. Physical activity was positively associated with HRQOL. Further studies investigating the causal relationship between physical activity and HRQOL in the posttreatment setting in bladder cancer survivors are warranted.

Authors
Gopalakrishna, A; Longo, TA; Fantony, JJ; Harrison, MR; Inman, BA
MLA Citation
Gopalakrishna, A, Longo, TA, Fantony, JJ, Harrison, MR, and Inman, BA. "Physical activity patterns and associations with health-related quality of life in bladder cancer survivors." Urologic oncology 35.9 (September 2017): 540.e1-540.e6.
PMID
28527621
Source
epmc
Published In
Urologic Oncology: Seminars and Original Investigations
Volume
35
Issue
9
Publish Date
2017
Start Page
540.e1
End Page
540.e6
DOI
10.1016/j.urolonc.2017.04.016

Physical activity patterns and associations with health-related quality of life in bladder cancer survivors

Authors
Gopalakrishna, A; Longo, TA; Fantony, JJ; Harrison, MR; Inman, BA
MLA Citation
Gopalakrishna, A, Longo, TA, Fantony, JJ, Harrison, MR, and Inman, BA. "Physical activity patterns and associations with health-related quality of life in bladder cancer survivors." UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS 35.9 (September 2017).
Source
wos-lite
Published In
Urologic Oncology: Seminars and Original Investigations
Volume
35
Issue
9
Publish Date
2017
DOI
10.1016/j.nrolonc.2017.04.016

Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) for the Treatment of Unresectable and Metastatic Cancers.

Metastatic spread is the mechanism in more than 90 percent of cancer deaths and current therapeutic options, such as systemic chemotherapy, are often ineffective. Here we provide a proof of principle for a novel two-pronged modality referred to as Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) having the potential to safely eradicate both primary tumors and distant metastatic foci. Using a combination of immune-checkpoint inhibition and plasmonic gold nanostar (GNS)-mediated photothermal therapy, we were able to achieve complete eradication of primary treated tumors and distant untreated tumors in some mice implanted with the MB49 bladder cancer cells. Delayed rechallenge with MB49 cancer cells injection in mice that appeared cured by SYMPHONY did not lead to new tumor formation after 60 days observation, indicating that SYMPHONY treatment induced effective long-lasting immunity against MB49 cancer cells.

Authors
Liu, Y; Maccarini, P; Palmer, GM; Etienne, W; Zhao, Y; Lee, C-T; Ma, X; Inman, BA; Vo-Dinh, T
MLA Citation
Liu, Y, Maccarini, P, Palmer, GM, Etienne, W, Zhao, Y, Lee, C-T, Ma, X, Inman, BA, and Vo-Dinh, T. "Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) for the Treatment of Unresectable and Metastatic Cancers." Scientific reports 7.1 (August 17, 2017): 8606-.
PMID
28819209
Source
epmc
Published In
Scientific Reports
Volume
7
Issue
1
Publish Date
2017
Start Page
8606
DOI
10.1038/s41598-017-09116-1

Need for Evidence and Consensus on Laser Treatment for Management of Select Primary Penile Tumors.

Laser ablation for low-risk primary penile tumors (Ta, Tis, and T1, preferably of low grade) offers satisfactory oncologic outcomes and excellent functional outcomes. Patients require long-term close surveillance given the substantial likelihood of local recurrence, and must adhere to strict follow-up protocols.

Authors
Leone, A; Inman, B; Spiess, PE
MLA Citation
Leone, A, Inman, B, and Spiess, PE. "Need for Evidence and Consensus on Laser Treatment for Management of Select Primary Penile Tumors." European urology 72.1 (July 2017): 4-6.
PMID
28131464
Source
epmc
Published In
European Urology
Volume
72
Issue
1
Publish Date
2017
Start Page
4
End Page
6
DOI
10.1016/j.eururo.2017.01.024

Anticipatory Positive Urine Tests for Bladder Cancer.

The aim of this study was to establish the criteria defining an anticipatory positive test for bladder cancer.We reviewed all patients at our institution who underwent urine cytology or UroVysion fluorescence in situ hybridization (FISH) and cystoscopy from 2003 to 2012. Test performance and cancer anticipation was assessed using generalized linear mixed models, mixed-effects proportional hazards models, and cumulative incidence curves using tests performed within 30 days of each other as well as within a lag time of 1 year.Overall, 6729 urine tests (4729 cytology and 2040 UroVysion FISH) were paired with gold-standard cystoscopies. Sensitivity and specificity were 63 and 41% for cytology, and 37 and 84% for UroVysion FISH, respectively. A 1-year lag time allowed for cancer anticipation and neither test improved. Among patients with positive cytology and initially negative cystoscopy, the hazard ratio of developing a bladder tumor at 1 year was 1.83; 76% of these patients developed a tumor within 1 year. Similarly, among patients with a positive FISH and initially negative cystoscopy, the hazard ratio of developing a bladder tumor at 1 year was 1.56; 40% of these patients developed a tumor within 1 year.Urine-based tests for bladder cancer are frequently falsely positive. With further follow-up time, some of these false positive tests are vindicated as true (anticipatory) positive tests, although many will remain false positives. We developed statistical criteria to determine if a test anticipates future cancers or not.

Authors
Gopalakrishna, A; Fantony, JJ; Longo, TA; Owusu, R; Foo, W-C; Dash, R; Denton, BT; Inman, BA
MLA Citation
Gopalakrishna, A, Fantony, JJ, Longo, TA, Owusu, R, Foo, W-C, Dash, R, Denton, BT, and Inman, BA. "Anticipatory Positive Urine Tests for Bladder Cancer." Annals of surgical oncology 24.6 (June 2017): 1747-1753.
PMID
28074325
Source
epmc
Published In
Annals of Surgical Oncology
Volume
24
Issue
6
Publish Date
2017
Start Page
1747
End Page
1753
DOI
10.1245/s10434-016-5763-5

Curative Treatment for Muscle Invasive Bladder Cancer in Elderly Patients: A Systematic Review.

The incidence of muscle invasive bladder cancer (MIBC) increases with age. With increased life expectancy the number of elderly MIBC patients is expected to increase. Existing guidelines on management of MIBC do not preclude curative treatments for elderly patients. However, it is necessary to assess the risks and benefits of a treatment to avoid overtreatment that results in decreased health-related quality of life without prolonging survival.To report on overall survival (OS), cancer specific survival (CSS), and morbidity after curative treatment in elderly patients, defined as age >70 yr, with nonmetastatic MIBC and to compare this with the outcome of younger MIBC patients.A systematic review was performed using Medline, PubMed, and Embase databases. Articles were included if they addressed one of the three research questions: Only articles including >100 patients and with a clear age-stratification were included.Forty-two articles were retrieved for review. No article directly addressed the use of geriatric assessment. OS and CSS worsen significantly with age both after radical cystectomy and radiotherapy regimens. While POM significantly increases with age, morbidity seems comparable between younger and older patients.Although a proportion of elderly patients with MIBC will benefit from curative treatment, we observed worse OS, CSS, and POM with age. The impact of age on late morbidity is less clear. Prospective studies evaluating geriatric assessments are critically needed to optimize MIBC management in the elderly.We performed a systematic review to evaluate the outcome and complication rate in elderly patients with muscle invasive bladder cancer. We observed that overall survival and cancer specific survival significantly decrease and perioperative mortality significantly increases with age. The impact of age on late morbidity is less clear. There is a need for geriatric assessments to select those patients that will benefit from curative treatment.

Authors
Fonteyne, V; Ost, P; Bellmunt, J; Droz, JP; Mongiat-Artus, P; Inman, B; Paillaud, E; Saad, F; Ploussard, G
MLA Citation
Fonteyne, V, Ost, P, Bellmunt, J, Droz, JP, Mongiat-Artus, P, Inman, B, Paillaud, E, Saad, F, and Ploussard, G. "Curative Treatment for Muscle Invasive Bladder Cancer in Elderly Patients: A Systematic Review." European urology (May 3, 2017). (Review)
PMID
28478043
Source
epmc
Published In
European Urology
Publish Date
2017
DOI
10.1016/j.eururo.2017.03.019

Authors' reply to letter to editor: "reply to 'it may be time to abandon urine tests for bladder cancer'"

Authors
Inman, BA; Fantony, JJ
MLA Citation
Inman, BA, and Fantony, JJ. "Authors' reply to letter to editor: "reply to 'it may be time to abandon urine tests for bladder cancer'"." JNCCN Journal of the National Comprehensive Cancer Network 15.5 (May 1, 2017): lxxi-lxxii. (Letter)
Source
scopus
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
15
Issue
5
Publish Date
2017
Start Page
lxxi
End Page
lxxii

Reply to 'It May be Time to Abandon Urine Tests for Bladder Cancer'.

Authors
Furuya, H; Rosser, CJ; Inman, BA; Fantony, JJ
MLA Citation
Furuya, H, Rosser, CJ, Inman, BA, and Fantony, JJ. "Reply to 'It May be Time to Abandon Urine Tests for Bladder Cancer'." Journal of the National Comprehensive Cancer Network : JNCCN 15.5 (May 2017): lxx-lxxii. (Letter)
PMID
28476745
Source
epmc
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
15
Issue
5
Publish Date
2017
Start Page
lxx
End Page
lxxii
DOI
10.6004/jnccn.2017.0054

Atezolizumab: A PD-L1-Blocking Antibody for Bladder Cancer.

Atezolizumab (Tecentriq, MPDL3280A; Genentech/Roche) is an FcγR binding-deficient, fully humanized IgG1 mAb designed to interfere with the binding of PD-L1 ligand to its two receptors, PD-1 and B7.1. By blocking the PD-L1/PD-1 immune checkpoint, atezolizumab reduces immunosuppressive signals found within the tumor microenvironment and, consequently, increases T-cell-mediated immunity against the tumor. Atezolizumab has been FDA approved as second-line therapy for advanced bladder cancer. This accelerated approval was based on phase II trial data in patients with metastatic bladder cancer that showed unexpected and durable tumor responses. In subjects whose tumors progressed on first-line platinum-based chemotherapy, the objective response rate was 15%, the complete response rate was 5%, and 1-year overall survival was 36%. In subjects that were chemotherapy naïve and cisplatin ineligible, the objective response rate was 24%, the complete response rate was 7%, and 1-year overall survival was 57%. Better responses were associated with higher PD-L1 expression on the tumor-infiltrating leukocytes. These data suggest that patients with advanced bladder cancer treated with atezolizumab have significantly better response rates and survival than historical controls treated with other second-line regimens. The toxicity profile of atezolizumab is also favorable. Trials are currently assessing whether atezolizumab is effective in earlier bladder cancer stages and in the first-line metastatic setting. Clin Cancer Res; 23(8); 1886-90. ©2016 AACR.

Authors
Inman, BA; Longo, TA; Ramalingam, S; Harrison, MR
MLA Citation
Inman, BA, Longo, TA, Ramalingam, S, and Harrison, MR. "Atezolizumab: A PD-L1-Blocking Antibody for Bladder Cancer." Clinical cancer research : an official journal of the American Association for Cancer Research 23.8 (April 2017): 1886-1890. (Review)
PMID
27903674
Source
epmc
Published In
Clinical cancer research : an official journal of the American Association for Cancer Research
Volume
23
Issue
8
Publish Date
2017
Start Page
1886
End Page
1890
DOI
10.1158/1078-0432.ccr-16-1417

HEAT-TARGETED DRUG DELIVERY USING THE COMBAT BRS DEVICE FOR TREATING BLADDER CANCER

Authors
Brousell, SC; Longo, TA; Fantony, JJ; Etienne, W; Needham, D; Dewhirst, MW; Maccarini, PF; Spasojevic, I; Inman, BA
MLA Citation
Brousell, SC, Longo, TA, Fantony, JJ, Etienne, W, Needham, D, Dewhirst, MW, Maccarini, PF, Spasojevic, I, and Inman, BA. "HEAT-TARGETED DRUG DELIVERY USING THE COMBAT BRS DEVICE FOR TREATING BLADDER CANCER." April 2017.
Source
wos-lite
Published In
The Journal of Urology
Volume
197
Issue
4
Publish Date
2017
Start Page
E855
End Page
E855

Urinary NID2 and TWIST1 methylation to augment conventional urine cytology for the detection of bladder cancer.

Abnormal methylation of urinary TWIST1 and NID2 conferred high sensitivity and specificity for the detection of urothelial carcinoma.We examine the performance of the urine-based TWIST1/NID2 methylation assay with the addition of urine cytology for the detection of urothelial carcinoma.A prospective multi-institutional study was conducted to assess the performance of a methylation assay for patients with hematuria or under surveillance for non-muscle invasive bladder cancer (NMIBC). All patients underwent cystoscopy, a methylation assay, and cytology. Receiver operator characteristic (ROC) curves were constructed for cytology alone, the methylation assay alone, and a combined model. Areas under the curve (AUC) were compared using likelihood ratio tests.A total of 172 patients were enrolled (37% for hematuria and 63% NMIBC). The AUC for cytology alone with equivocal cytologies positive was 0.704, and improved to 0.773 with the addition of the DNA methylation assay (p < 0.001). When the equivocal cytologies were considered negative, the AUC improved from 0.558 to 0.697 with the addition of the DNA methylation assay (p = 0.003).Addition of a TWIST1/NID2-based DNA methylation assay adds diagnostic value to urine cytology and the model is sensitive to the classification of equivocal cytology.

Authors
Fantony, JJ; Longo, TA; Gopalakrishna, A; Owusu, R; Lance, RS; Foo, W-C; Inman, BA; Abern, MR
MLA Citation
Fantony, JJ, Longo, TA, Gopalakrishna, A, Owusu, R, Lance, RS, Foo, W-C, Inman, BA, and Abern, MR. "Urinary NID2 and TWIST1 methylation to augment conventional urine cytology for the detection of bladder cancer." Cancer biomarkers : section A of Disease markers 18.4 (January 13, 2017): 381-387.
PMID
28106542
Source
epmc
Published In
Cancer biomarkers : section A of Disease markers
Volume
18
Issue
4
Publish Date
2017
Start Page
381
End Page
387
DOI
10.3233/cbm-160261

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8-12 Hz) electroencephalogram (EEG) power to decrease occipitally and increase frontally (known as "anteriorization"), and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction), and might be a useful measure of neurocognitive function in older adults.

Authors
Giattino, CM; Gardner, JE; Sbahi, FM; Roberts, KC; Cooter, M; Moretti, E; Browndyke, JN; Mathew, JP; Woldorff, MG; Berger, M; MADCO-PC Investigators,
MLA Citation
Giattino, CM, Gardner, JE, Sbahi, FM, Roberts, KC, Cooter, M, Moretti, E, Browndyke, JN, Mathew, JP, Woldorff, MG, Berger, M, and MADCO-PC Investigators, . "Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults." Frontiers in systems neuroscience 11 (January 2017): 24-.
Website
http://hdl.handle.net/10161/14971
PMID
28533746
Source
epmc
Published In
Frontiers in Systems Neuroscience
Volume
11
Publish Date
2017
Start Page
24
DOI
10.3389/fnsys.2017.00024

Targeted Exome Sequencing of the Cancer Genome in Patients with Very High-risk Bladder Cancer.

We completed targeted exome sequencing of the tumors of 50 patients with pTis-pT4b bladder cancer. Mutations were categorized by type, stratified against previously identified cancer loci in the Catalogue of Somatic Mutations in Cancer and The Cancer Genome Atlas databases, and evaluated in pathway analysis and comutation plots. We analyzed mutation associations with receipt of neoadjuvant chemotherapy, nodal involvement, metastatic disease development, and survival. Compared with The Cancer Genome Atlas, we found higher mutation rates in genes encoding products involved in epigenetic regulation and cell cycle regulation. Of the pathways examined, PI3K/mTOR and Cell Cycle/DNA Repair exhibited the greatest frequencies of mutation. RB1 and TP53, as well as NF1 and PIK3CA were frequently comutated. We identified no association between mutations in specific genes and key clinical outcomes of interest when corrected for multiple testing. Discovery phase analysis of the somatic mutations in 50 high-risk bladder cancer patients revealed novel mutations and mutational patterns, which may be useful for developing targeted therapy regimens or new biomarkers for patients at very high risk of disease metastasis and death.In this report we found known, as well as previously unreported, genetic mutations in the tumors of patients with high-risk bladder cancer. These mutations, if validated, may serve as actionable targets for new trials.

Authors
Longo, T; McGinley, KF; Freedman, JA; Etienne, W; Wu, Y; Sibley, A; Owzar, K; Gresham, J; Moy, C; Szabo, S; Greshock, J; Zhou, H; Bai, Y; Inman, BA
MLA Citation
Longo, T, McGinley, KF, Freedman, JA, Etienne, W, Wu, Y, Sibley, A, Owzar, K, Gresham, J, Moy, C, Szabo, S, Greshock, J, Zhou, H, Bai, Y, and Inman, BA. "Targeted Exome Sequencing of the Cancer Genome in Patients with Very High-risk Bladder Cancer." European urology 70.5 (November 2016): 714-717.
PMID
27520487
Source
epmc
Published In
European Urology
Volume
70
Issue
5
Publish Date
2016
Start Page
714
End Page
717
DOI
10.1016/j.eururo.2016.07.049

Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines

© National Comprehensive Cancer Network, Inc. 2016, All rights reserved. These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice.

Authors
Clark, PE; Spiess, PE; Agarwal, N; Bangs, R; Boorjian, SA; Buyyounouski, MK; Efstathiou, JA; Flaig, TW; Friedlander, T; Greenberg, RE; Guru, KA; Hahn, N; Herr, HW; Hoimes, C; Inman, BA; Kader, AK; Kibel, AS; Kuzel, TM; Lele, SM; Meeks, JJ; Michalski, J; Montgomery, JS; Pagliaro, LC; Pal, SK; Patterson, A; Petrylak, D; Plimack, ER; Pohar, KS; Porter, MP; Sexton, WJ; Siefker-Radtke, AO; Sonpavde, G; Tward, J; Wile, G; Dwyer, MA; Smith, C
MLA Citation
Clark, PE, Spiess, PE, Agarwal, N, Bangs, R, Boorjian, SA, Buyyounouski, MK, Efstathiou, JA, Flaig, TW, Friedlander, T, Greenberg, RE, Guru, KA, Hahn, N, Herr, HW, Hoimes, C, Inman, BA, Kader, AK, Kibel, AS, Kuzel, TM, Lele, SM, Meeks, JJ, Michalski, J, Montgomery, JS, Pagliaro, LC, Pal, SK, Patterson, A, Petrylak, D, Plimack, ER, Pohar, KS, Porter, MP, Sexton, WJ, Siefker-Radtke, AO, Sonpavde, G, Tward, J, Wile, G, Dwyer, MA, and Smith, C. "Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines." JNCCN Journal of the National Comprehensive Cancer Network 14.10 (October 1, 2016): 1213-1224.
Source
scopus
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
14
Issue
10
Publish Date
2016
Start Page
1213
End Page
1224

Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review.

Diet, physical activity, and smoking cessation are modifiable lifestyle factors that have been shown to improve health-related quality of life (HRQOL) in many cancer survivors. Our objective was to systematically review the literature on the associations between lifestyle factors, namely diet, physical activity, smoking status, and HRQOL in bladder cancer survivors.We queried PubMed, EMBASE, and Cochrane libraries. Two reviewers reviewed abstracts independently, and a third reviewer arbitrated disagreements. A descriptive analysis was performed. Quality assessment was conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for clinical trials.We identified 1167 publications in the initial search, of which 9 met inclusion criteria for full-text review. We were able to obtain data on the outcomes of interest for 5 publications. A total of 1288 patients who underwent treatment for bladder cancer were included. Three studies were observational by design and two were randomized controlled trials. Physical activity was addressed by 4 studies, smoking status by 2 studies, and diet by 1 study.The review highlights the limited evidence around lifestyle factors and quality of life in bladder cancer survivors. There is some evidence for a positive association between HRQOL and physical activity, but insufficient evidence upon which to draw conclusions about the effects of consuming fruits and vegetables or non-smoking.There is limited evidence to support a positive association between health-related quality of life and physical activity, but insufficient evidence upon which to base any conclusions about consumption of fruits and vegetables or smoking cessation in bladder cancer survivors.

Authors
Gopalakrishna, A; Longo, TA; Fantony, JJ; Van Noord, M; Inman, BA
MLA Citation
Gopalakrishna, A, Longo, TA, Fantony, JJ, Van Noord, M, and Inman, BA. "Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review." Journal of cancer survivorship : research and practice 10.5 (October 2016): 874-882. (Review)
PMID
27002077
Source
epmc
Published In
Journal of Cancer Survivorship
Volume
10
Issue
5
Publish Date
2016
Start Page
874
End Page
882
DOI
10.1007/s11764-016-0533-8

NCCN Guidelines Insights: Bladder Cancer, Version 2.2016.

These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice.

Authors
Clark, PE; Spiess, PE; Agarwal, N; Bangs, R; Boorjian, SA; Buyyounouski, MK; Efstathiou, JA; Flaig, TW; Friedlander, T; Greenberg, RE; Guru, KA; Hahn, N; Herr, HW; Hoimes, C; Inman, BA; Kader, AK; Kibel, AS; Kuzel, TM; Lele, SM; Meeks, JJ; Michalski, J; Montgomery, JS; Pagliaro, LC; Pal, SK; Patterson, A; Petrylak, D; Plimack, ER; Pohar, KS; Porter, MP; Sexton, WJ; Siefker-Radtke, AO; Sonpavde, G; Tward, J; Wile, G; Dwyer, MA; Smith, C
MLA Citation
Clark, PE, Spiess, PE, Agarwal, N, Bangs, R, Boorjian, SA, Buyyounouski, MK, Efstathiou, JA, Flaig, TW, Friedlander, T, Greenberg, RE, Guru, KA, Hahn, N, Herr, HW, Hoimes, C, Inman, BA, Kader, AK, Kibel, AS, Kuzel, TM, Lele, SM, Meeks, JJ, Michalski, J, Montgomery, JS, Pagliaro, LC, Pal, SK, Patterson, A, Petrylak, D, Plimack, ER, Pohar, KS, Porter, MP, Sexton, WJ, Siefker-Radtke, AO, Sonpavde, G, Tward, J, Wile, G, Dwyer, MA, and Smith, C. "NCCN Guidelines Insights: Bladder Cancer, Version 2.2016." Journal of the National Comprehensive Cancer Network : JNCCN 14.10 (October 2016): 1213-1224.
PMID
27697976
Source
epmc
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
14
Issue
10
Publish Date
2016
Start Page
1213
End Page
1224
DOI
10.6004/jnccn.2016.0131

NCCN Guidelines (R) Insights Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines

Authors
Clark, PE; Spiess, PE; Agarwal, N; Bangs, R; Boorjian, SA; Buyyounouski, MK; Efstathiou, JA; Flaig, TW; Friedlander, T; Greenberg, RE; Guru, KA; Hahn, N; Herr, HW; Holmes, C; Inman, BA; Kader, AK; Kibel, AS; Kuzel, TM; Lele, SM; Meeks, JJ; Michalski, J; Montgomery, JS; Pagliaro, LC; Pal, SK; Patterson, A; Petrylak, D; Plimack, ER; Pohar, KS; Porter, MP; Sexton, WJ; Siefker-Radtke, AO; Sonpavde, G; Tward, J; Wile, G; Dwyer, MA; Smith, C
MLA Citation
Clark, PE, Spiess, PE, Agarwal, N, Bangs, R, Boorjian, SA, Buyyounouski, MK, Efstathiou, JA, Flaig, TW, Friedlander, T, Greenberg, RE, Guru, KA, Hahn, N, Herr, HW, Holmes, C, Inman, BA, Kader, AK, Kibel, AS, Kuzel, TM, Lele, SM, Meeks, JJ, Michalski, J, Montgomery, JS, Pagliaro, LC, Pal, SK, Patterson, A, Petrylak, D, Plimack, ER, Pohar, KS, Porter, MP, Sexton, WJ, Siefker-Radtke, AO, Sonpavde, G, Tward, J, Wile, G, Dwyer, MA, and Smith, C. "NCCN Guidelines (R) Insights Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines." JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK 14.10 (October 2016): 1213-1224.
Source
wos-lite
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
14
Issue
10
Publish Date
2016
Start Page
1213
End Page
1224

High rates of venous thromboembolic events in patients undergoing systemic therapy for urothelial carcinoma: A systematic review and meta-analysis.

Patients undergoing systemic therapy for urothelial carcinoma (UC) are at increased risk for venous thromboembolic (VTE) events. The objective of the current study was to determine the rate of VTE events in patients undergoing systemic therapy for UC and assess factors affecting this rate.This study was registered with the PROSPERO database (CRD42015025774). We searched Pubmed, MEDLINE, EMBASE, The Cochrane Library, CINAHL, and Web of Science libraries through August 2014. As per PRISMA guidelines, 2 reviewers independently reviewed titles and abstracts. Disagreements were arbitrated by a third reviewer. After full text review, data were abstracted and pooled using a random effects model. Authors were contacted for clarification of data. To determine VTE risk factors, subgroup analyses and meta-regression were conducted.We identified 3,635 publications in the initial search, of which 410 met inclusion criteria for full text review. Of these, we were able to obtain data on the outcome of interest for 62 publications. A total of 5,082 patients, of which 77% were male, underwent systemic therapy for UC, with 373 VTE events. The proportion of patients who had had prior surgery, chemotherapy, or radiation was 55%, 25%, and 9%, respectively. Fixed effects and random effects models were used to estimate the VTE rate, yielding event rates of 6.7% and 5.4%, respectively.VTE occurs frequently in patients undergoing systemic therapy for UC. The VTE rate was affected by the country of origin, history of radiation, as well as by the systemic treatment class. The study was limited by the incomplete reporting of all variables of interest.

Authors
Gopalakrishna, A; Longo, TA; Fantony, JJ; Doshi, U; Harrison, MR; Van Noord, M; Inman, BA
MLA Citation
Gopalakrishna, A, Longo, TA, Fantony, JJ, Doshi, U, Harrison, MR, Van Noord, M, and Inman, BA. "High rates of venous thromboembolic events in patients undergoing systemic therapy for urothelial carcinoma: A systematic review and meta-analysis." Urologic oncology 34.9 (September 2016): 407-414. (Review)
PMID
27267581
Source
epmc
Published In
Urologic Oncology: Seminars and Original Investigations
Volume
34
Issue
9
Publish Date
2016
Start Page
407
End Page
414
DOI
10.1016/j.urolonc.2016.05.009

The diagnostic accuracy of urine-based tests for bladder cancer varies greatly by patient.

Spectrum effects refer to the phenomenon that test performance varies across subgroups of a population. When spectrum effects occur during diagnostic testing for cancer, difficult patient misdiagnoses can occur. Our objective was to evaluate the effect of test indication, age, gender, race, and smoking status on the performance characteristics of two commonly used diagnostic tests for bladder cancer, urine cytology and fluorescence in situ hybridization (FISH).We assessed all subjects who underwent cystoscopy, cytology, and FISH at our institution from 2003 to 2012. The standard diagnostic test performance metrics were calculated using marginal models to account for clustered/repeated measures within subjects. We calculated test performance for the overall cohort by test indication as well as by key patient variables: age, gender, race, and smoking status.A total of 4023 cystoscopy-cytology pairs and 1696 FISH-cystoscopy pairs were included in the analysis. In both FISH and cytology, increasing age, male gender, and history of smoking were associated with increased sensitivity and decreased specificity. FISH performance was most impacted by age, with an increase in sensitivity from 17 % at age 40 to 49 % at age 80. The same was true of cytology, with an increase in sensitivity from 50 % at age 40 to 67 % at age 80. Sensitivity of FISH was higher for a previous diagnosis of bladder cancer (46 %) than for hematuria (26 %). Test indication had no impact on the performance of cytology and race had no significant impact on the performance of either test.The diagnostic performance of urine cytology and FISH vary significantly according to the patient demographic in which they were tested. Hence, the reporting of spectrum effects in diagnostic tests should become part of standard practice. Patient-related factors must contextualize the clinicians' interpretation of test results and their decision-making.

Authors
Gopalakrishna, A; Longo, TA; Fantony, JJ; Owusu, R; Foo, W-C; Dash, R; Inman, BA
MLA Citation
Gopalakrishna, A, Longo, TA, Fantony, JJ, Owusu, R, Foo, W-C, Dash, R, and Inman, BA. "The diagnostic accuracy of urine-based tests for bladder cancer varies greatly by patient." BMC urology 16.1 (June 13, 2016): 30-.
PMID
27296150
Source
epmc
Published In
BMC Urology
Volume
16
Issue
1
Publish Date
2016
Start Page
30
DOI
10.1186/s12894-016-0147-5

Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis.

Postcystectomy bladder cancer (BCa) patients are at high risk for developing venous thromboembolism (VTE). The literature varies widely in the reporting of VTE in this population.To determine the VTE rate in subjects undergoing radical cystectomy (RC) and highlight specific factors affecting this rate.This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42015016776. We queried MEDLINE, the Cochrane Library, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Search terms captured BCa, RC, and VTE. Per the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, abstracts were reviewed for inclusion/exclusion criteria by two reviewers, and disagreements were resolved by a third reviewer. A search of the gray literature and references of pertinent articles was also performed. The date of our last search was December 15, 2014. For unreported data, authors were contacted. Data were abstracted in duplicate and pooled using a random effects (RE) model. Subgroup analyses and meta-regression were performed to determine risk factors for VTE.We identified 2927 publications, of which 223 met inclusion criteria for this review. A total of 1 115 634 surgeries were performed on patient population (80% men) with a total of 51 908 VTEs. The VTE rate estimated by the RE model was 3.7%. Due to significant heterogeneity, subgroup and meta-regression analyses were undertaken. These revealed a higher rate of VTE in US studies at 4.49% compared with "westernized" non-US studies at 3.43% and "nonwesternized" non-US based studies at 2.50%. Other important modifiers included minimally invasive surgery at 5.54% versus open surgery at 3.55%, and age. The case-fatality rate of pulmonary emboli was 44%.VTE is common in patients undergoing RC. Reporting of VTE is heterogeneous and the rate varies according to study-level factors, including surgery type and country of origin. Limitations of this study include the preponderance of observational studies in the final analysis and lack of complete reporting of all variables of interest within each study.In this review, we determined the venous thromboembolism (VTE) rate in postsurgical bladder cancer patients. VTE events did vary significantly among certain subgroups.

Authors
Fantony, JJ; Gopalakrishna, A; Van Noord, M; Inman, BA
MLA Citation
Fantony, JJ, Gopalakrishna, A, Van Noord, M, and Inman, BA. "Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis." European urology focus 2.2 (June 2016): 189-196.
PMID
27430026
Source
epmc
Published In
European urology focus
Volume
2
Issue
2
Publish Date
2016
Start Page
189
End Page
196

A systematic review of regional hyperthermia therapy in bladder cancer.

Bladder cancer therapy remains suboptimal as morbidity and mortality remain high amongst those with non-muscle-invasive and muscle-invasive disease. Regional hyperthermia therapy (RHT) is a promising adjunctive therapy being tested in multiple clinical contexts.The aim of this study was to systematically review the literature on the efficacy and toxicity of RHT.This systematic review was registered with the PROSPERO database (Registration number: CRD42015025780) and was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We queried PubMed, EMBASE, and Cochrane libraries. Two reviewers reviewed abstracts independently and a third reviewer arbitrated disagreements. The last search was performed on 28 August 2015. A descriptive analysis was performed and quality assessment was conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies, and the Cochrane Risk of Bias Assessment Tool for trials.We identified 859 publications in the initial search, of which 24 met inclusion criteria for full-text review. Of these, we were able to obtain data on the outcomes of interest for 15 publications.The review underscores the limited nature of the evidence; definitive conclusions are elusive. However, the promising results of RHT in the setting of intravesical chemotherapy, chemotherapy and radiotherapy show a trend towards legitimate efficacy.

Authors
Longo, TA; Gopalakrishna, A; Tsivian, M; Van Noord, M; Rasch, CR; Inman, BA; Geijsen, ED
MLA Citation
Longo, TA, Gopalakrishna, A, Tsivian, M, Van Noord, M, Rasch, CR, Inman, BA, and Geijsen, ED. "A systematic review of regional hyperthermia therapy in bladder cancer." International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 32.4 (June 2016): 381-389.
PMID
27134130
Source
epmc
Published In
International Journal of Hyperthermia (Informa)
Volume
32
Issue
4
Publish Date
2016
Start Page
381
End Page
389
DOI
10.3109/02656736.2016.1157903

The use of hyperthermia in the treatment of bladder cancer.

Authors
Crezee, H; Inman, BA
MLA Citation
Crezee, H, and Inman, BA. "The use of hyperthermia in the treatment of bladder cancer." International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 32.4 (June 2016): 349-350.
PMID
27353655
Source
epmc
Published In
International Journal of Hyperthermia (Informa)
Volume
32
Issue
4
Publish Date
2016
Start Page
349
End Page
350
DOI
10.3109/02656736.2016.1163739

Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis.

Postcystectomy bladder cancer (BCa) patients are at high risk for developing venous thromboembolism (VTE). The literature varies widely in the reporting of VTE in this population.To determine the VTE rate in subjects undergoing radical cystectomy (RC) and highlight specific factors affecting this rate.This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42015016776. We queried MEDLINE, the Cochrane Library, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Search terms captured BCa, RC, and VTE. Per the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, abstracts were reviewed for inclusion/exclusion criteria by two reviewers, and disagreements were resolved by a third reviewer. A search of the gray literature and references of pertinent articles was also performed. The date of our last search was December 15, 2014. For unreported data, authors were contacted. Data were abstracted in duplicate and pooled using a random effects (RE) model. Subgroup analyses and meta-regression were performed to determine risk factors for VTE.We identified 2927 publications, of which 223 met inclusion criteria for this review. A total of 1 115 634 surgeries were performed on patient population (80% men) with a total of 51 908 VTEs. The VTE rate estimated by the RE model was 3.7%. Due to significant heterogeneity, subgroup and meta-regression analyses were undertaken. These revealed a higher rate of VTE in US studies at 4.49% compared with "westernized" non-US studies at 3.43% and "nonwesternized" non-US based studies at 2.50%. Other important modifiers included minimally invasive surgery at 5.54% versus open surgery at 3.55%, and age. The case-fatality rate of pulmonary emboli was 44%.VTE is common in patients undergoing RC. Reporting of VTE is heterogeneous and the rate varies according to study-level factors, including surgery type and country of origin. Limitations of this study include the preponderance of observational studies in the final analysis and lack of complete reporting of all variables of interest within each study.In this review, we determined the venous thromboembolism (VTE) rate in postsurgical bladder cancer patients. VTE events did vary significantly among certain subgroups.

Authors
Fantony, JJ; Gopalakrishna, A; Noord, MV; Inman, BA
MLA Citation
Fantony, JJ, Gopalakrishna, A, Noord, MV, and Inman, BA. "Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis." European urology focus 2.2 (June 2016): 189-196. (Review)
PMID
28723534
Source
epmc
Published In
European urology focus
Volume
2
Issue
2
Publish Date
2016
Start Page
189
End Page
196
DOI
10.1016/j.euf.2015.09.003

CAN A GENE METHYLATION ASSAY IMPROVE THE PERFORMANCE OF CYTOLOGY?

Authors
Longo, T; Gopalakrishna, A; Fantony, J; Owusu, R; Lance, R; Foo, W-C; Inman, B; Abern, M
MLA Citation
Longo, T, Gopalakrishna, A, Fantony, J, Owusu, R, Lance, R, Foo, W-C, Inman, B, and Abern, M. "CAN A GENE METHYLATION ASSAY IMPROVE THE PERFORMANCE OF CYTOLOGY?." April 2016.
Source
wos-lite
Published In
The Journal of Urology
Volume
195
Issue
4
Publish Date
2016
Start Page
E4
End Page
E4

Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa-pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation?

The European Association of Urology non-muscle-invasive bladder cancer (NMIBC) guidelines recommend that all low- and intermediate-risk patients receive a single immediate instillation of chemotherapy after transurethral resection of the bladder (TURB), but its use remains controversial.To identify which NMIBC patients benefit from a single immediate instillation.A systematic review and individual patient data (IPD) meta-analysis of randomized trials comparing the efficacy of a single instillation after TURB with TURB alone in NMIBC patients was carried out.A total of 13 eligible studies were identified. IPD were obtained for 11 studies randomizing 2278 eligible patients, 1161 to TURB and 1117 to a single instillation of epirubicin, mitomycin C, pirarubicin, or thiotepa. A total of 1128 recurrences, 108 progressions, and 460 deaths (59 due to bladder cancer [BCa]) occurred. A single instillation reduced the risk of recurrence by 35% (hazard ratio [HR]: 0.65; 95% confidence interval [CI], 0.58-0.74; p<0.001) and the 5-yr recurrence rate from 58.8% to 44.8%. The instillation did not reduce recurrences in patients with a prior recurrence rate of more than one recurrence per year or in patients with an European Organization for Research and Treatment of Cancer (EORTC) recurrence score ≥5. The instillation did not prolong either the time to progression or death from BCa, but it resulted in an increase in the overall risk of death (HR: 1.26; 95% CI, 1.05-1.51; p=0.015; 5-yr death rates 12.0% vs 11.2%), with the difference appearing in patients with an EORTC recurrence score ≥5.A single immediate instillation reduced the risk of recurrence, except in patients with a prior recurrence rate of more than one recurrence per year or an EORTC recurrence score ≥5. It does not prolong either time to progression or death from BCa. The instillation may be associated with an increase in the risk of death in patients at high risk of recurrence in whom the instillation is not effective or recommended.A single instillation of chemotherapy immediately after resection reduces the risk of recurrence in non-muscle-invasive bladder cancer; however, it should not be given to patients at high risk of recurrence due to its lack of efficacy in this subgroup.

Authors
Sylvester, RJ; Oosterlinck, W; Holmang, S; Sydes, MR; Birtle, A; Gudjonsson, S; De Nunzio, C; Okamura, K; Kaasinen, E; Solsona, E; Ali-El-Dein, B; Tatar, CA; Inman, BA; N'Dow, J; Oddens, JR; Babjuk, M
MLA Citation
Sylvester, RJ, Oosterlinck, W, Holmang, S, Sydes, MR, Birtle, A, Gudjonsson, S, De Nunzio, C, Okamura, K, Kaasinen, E, Solsona, E, Ali-El-Dein, B, Tatar, CA, Inman, BA, N'Dow, J, Oddens, JR, and Babjuk, M. "Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa-pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation?." European urology 69.2 (February 2016): 231-244. (Review)
PMID
26091833
Source
epmc
Published In
European Urology
Volume
69
Issue
2
Publish Date
2016
Start Page
231
End Page
244
DOI
10.1016/j.eururo.2015.05.050

Effect of diet on bladder cancer survivors

Authors
Longo, TA; Gopalakrishna, A; Fantony, JJ; Inman, BA
MLA Citation
Longo, TA, Gopalakrishna, A, Fantony, JJ, and Inman, BA. "Effect of diet on bladder cancer survivors." January 10, 2016.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
34
Issue
2
Publish Date
2016

Associations between health-related quality of life and physical activity in bladder cancer survivors: A cross-sectional study

Authors
Gopalakrishna, A; Fantony, JJ; Longo, TA; Inman, BA
MLA Citation
Gopalakrishna, A, Fantony, JJ, Longo, TA, and Inman, BA. "Associations between health-related quality of life and physical activity in bladder cancer survivors: A cross-sectional study." January 10, 2016.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
34
Issue
2
Publish Date
2016

Your opinion counts: How do you treat atypical/suspicious cytology?

Authors
Longo, TA; Gopalakrishna, A; Fantony, JJ; Inman, BA
MLA Citation
Longo, TA, Gopalakrishna, A, Fantony, JJ, and Inman, BA. "Your opinion counts: How do you treat atypical/suspicious cytology?." January 10, 2016.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
34
Issue
2
Publish Date
2016

Multi-institutional external validation of urinary TWIST1 and NID2 methylation as a diagnostic test for bladder cancer.

We previously reported a clinical trial in which we were unable to replicate the excellent diagnostic metrics produced in the developmental study of the TWIST1 and NID2 gene methylation assay. In this expanded trial with subjects enrolled from another institution, we reexamine the diagnostic capabilities of the test to externally validate our previous study.TWIST1 and NID2 gene methylation was assessed in DNA isolated from the urine of subjects at risk of bladder cancer undergoing cystoscopy for hematuria or bladder cancer surveillance. The diagnostic gold standard was cystoscopy. Two thresholds of TWIST1 and NID2 gene methylation were used for determining test result positivity, those published by Renard et al. and Abern et al. The sensitivity, specificity, positive and negative predictive values, diagnostic likelihood ratios, and receiver operating characteristic curves were calculated for each gene, as well as their combination. In all, 3 methods were used to combine TWIST1 and NID2 into a single composite test: (1) believe-the-positive decision rule-if either gene is methylated the test result is positive, which maximizes test sensitivity; (2) believe-the-negative decision rule-if either gene is not methylated the test result is negative, which maximizes test specificity; and (3) a likelihood-based logistic regression model approach that balances sensitivity and specificity. Clinical utility was determined using a decision curve analysis.A total of 209 subjects were evaluated: 40% for hematuria and 60% for bladder cancer surveillance. Approximately 75% were male, most of the prior cancers being low-grade Ta. Using cystoscopy as the gold standard, areas under the curve were 0.67 for TWIST1, 0.64 for NID2, and 0.66 for combined TWIST1 and NID2. Decision rule results revealed optimization of sensitivity at 67% using Renard thresholds and specificity using the Abern thresholds at 69%. We found improved sensitivity (78%) in current smokers. Decision curve analyses revealed that the methylation assay provided only a modest benefit even at high probabilities of missed cancer.A urine DNA test measuring TWIST1 and NID2 methylation was externally examined with a larger cohort and its results continue to be poor. These 2 biomarkers are unlikely to replace cystoscopy, but they may be worthy of study in active smokers.

Authors
Fantony, JJ; Abern, MR; Gopalakrishna, A; Owusu, R; Jack Tay, K; Lance, RS; Inman, BA
MLA Citation
Fantony, JJ, Abern, MR, Gopalakrishna, A, Owusu, R, Jack Tay, K, Lance, RS, and Inman, BA. "Multi-institutional external validation of urinary TWIST1 and NID2 methylation as a diagnostic test for bladder cancer." Urologic oncology 33.9 (September 2015): 387.e1-387.e6.
PMID
26027762
Source
epmc
Published In
Urologic Oncology: Seminars and Original Investigations
Volume
33
Issue
9
Publish Date
2015
Start Page
387.e1
End Page
387.e6
DOI
10.1016/j.urolonc.2015.04.014

Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?

The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology.A multi-institutional, retrospective study of patients with a history of urothelial carcinoma of the bladder identified 664 patients with a FISH assay after excluding those with cystoscopic evidence of a tumor and/or positive cytology. Our primary end point was cancer recurrence, defined by biopsy. Progression was defined as recurrence with a tumor stage ≥T2. Statistical analyses were performed using Fisher's exact test as a one-tailed test and Chi-square test with significance at 0.05, using SPSS(®) version 19.0 (SPSS Inc., Chicago, IL, USA).Of the 664 patients in this study, tumor stage was Ta (363, 55 %), T1 (183, 28 %), and CIS (109, 16 %) and most were high grade (440 pts, 66 %). The median follow-up was 26 months (3-104 months), and 277 (41.7 %) patients were recurred. In patients who were FISH positive, mean time to recurrence was 12.6 months, compared to 17.9 months if FISH negative (p = 0.03). In univariate analysis, atypical cytology, positive FISH, cystoscopic findings (atypical vs. normal), and previous intravesical therapy were associated with recurrence (p < 0.05). On multivariate analysis, pathologic stage, cystoscopic findings, and cytology were independently associated with recurrence (p < 0.05). Progression to ≥T2 disease occurred in 34 (5.1 %) patients in this cohort. On multivariate analysis, only initial T stage and FISH result were found to be independent predictors of progression (p < 0.05).Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.

Authors
Seideman, C; Canter, D; Kim, P; Cordon, B; Weizer, A; Oliva, I; Rao, J; Inman, BA; Posch, M; Herr, H; Lotan, Y
MLA Citation
Seideman, C, Canter, D, Kim, P, Cordon, B, Weizer, A, Oliva, I, Rao, J, Inman, BA, Posch, M, Herr, H, and Lotan, Y. "Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?." World journal of urology 33.9 (September 2015): 1309-1313.
PMID
25420920
Source
epmc
Published In
World Journal of Urology
Volume
33
Issue
9
Publish Date
2015
Start Page
1309
End Page
1313
DOI
10.1007/s00345-014-1452-9

It May Be Time to Abandon Urine Tests for Bladder Cancer.

Authors
Fantony, JJ; Inman, BA
MLA Citation
Fantony, JJ, and Inman, BA. "It May Be Time to Abandon Urine Tests for Bladder Cancer." Journal of the National Comprehensive Cancer Network : JNCCN 13.9 (September 2015): 1163-1166.
PMID
26358800
Source
epmc
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
13
Issue
9
Publish Date
2015
Start Page
1163
End Page
1166
DOI
10.6004/jnccn.2015.0141

Inflammation: A Significant Contributor to Upper-tract Urothelial Carcinoma Prognosis?

Authors
Inman, B; Tay, KJ
MLA Citation
Inman, B, and Tay, KJ. "Inflammation: A Significant Contributor to Upper-tract Urothelial Carcinoma Prognosis?." European urology focus 1.1 (August 2015): 64-65.
PMID
28723358
Source
epmc
Published In
European urology focus
Volume
1
Issue
1
Publish Date
2015
Start Page
64
End Page
65
DOI
10.1016/j.euf.2015.02.004

Effect of aerobic training on the host systemic milieu in patients with solid tumours: an exploratory correlative study.

Few studies have investigated the effects of exercise on modulation of host factors in cancer patients. We investigated the efficacy of chronic aerobic training on multiple host-related effector pathways in patients with solid tumours.Paired peripheral blood samples were obtained from 44 patients with solid tumours receiving cytotoxic therapy and synthetic erythropoietin (usual care; n=21) or usual care plus supervised aerobic training (n=23) for 12 weeks. Samples were characterised for changes in immune, cytokine and angiogenic factors, and metabolic intermediates. Aerobic training consisted of three supervised cycle ergometry sessions per week at 60% to 100% of peak oxygen consumption (VO2peak), 30-45 min per session, for 12 weeks following a nonlinear prescription.The between-group delta change in cardiopulmonary function was +4.1 ml kg (-1) min(-1), favouring aerobic training (P<0.05). Significant pre-post between-group differences for five cytokine and angiogenic factors (HGF, IL-4, macrophage inflammatory protein-1β (MIP-1β), vascular endothelial growth factor (VEGF), and TNF-α) also favour the aerobic training group (P's<0.05). These reductions occurred in conjunction with nonsignificant group differences for T lymphocytes CD4(+), CD8(+), and CD8(+)/CD45RA (P<0.10). For these factors, circulating concentrations generally increased from baseline to week 12 in the aerobic training group compared with decreases or no change in the usual care group. No significant changes in any metabolic intermediates were observed.Aerobic training alters host availability of select immune-inflammatory effectors in patients with solid tumours; larger confirmatory studies in more homogenous samples are warranted.

Authors
Glass, OK; Inman, BA; Broadwater, G; Courneya, KS; Mackey, JR; Goruk, S; Nelson, ER; Jasper, J; Field, CJ; Bain, JR; Muehlbauer, M; Stevens, RD; Hirschey, MD; Jones, LW
MLA Citation
Glass, OK, Inman, BA, Broadwater, G, Courneya, KS, Mackey, JR, Goruk, S, Nelson, ER, Jasper, J, Field, CJ, Bain, JR, Muehlbauer, M, Stevens, RD, Hirschey, MD, and Jones, LW. "Effect of aerobic training on the host systemic milieu in patients with solid tumours: an exploratory correlative study." British journal of cancer 112.5 (March 2015): 825-831.
PMID
25584487
Source
epmc
Published In
British Journal of Cancer
Volume
112
Issue
5
Publish Date
2015
Start Page
825
End Page
831
DOI
10.1038/bjc.2014.662

Thromboembolism and bleeding in bladder cancer.

Bladder cancer is a unique disease process in that clinically significant hemorrhage can occur simultaneously with equally significant aberrant clotting. With hematuria the key presenting symptom of bladder cancer, hemorrhage is generally thought to be a component of the natural history of the disease, and to commonly occur during its treatment. However, as those who regularly treat bladder cancer know, the need to address a predisposition to clotting is also very much part of the treatment paradigm. Physicians must be cognizant of the biochemical changes that confer a propensity for both significant bleeding and clotting occurring simultaneously in their patients. Both of these entities remain important issues, and further study is needed to find ways to mitigate and balance the associated risks. Here, we performed a review of the literature, focusing on the concomitant issues of bleeding and venous thromboembolism in both the pre- and post-operative periods in patients with bladder cancer. We formulated a general management approach with respect to these two processes, and we provide direction for further investigation.

Authors
Fantony, JJ; Inman, BA
MLA Citation
Fantony, JJ, and Inman, BA. "Thromboembolism and bleeding in bladder cancer." Oncology (Williston Park, N.Y.) 28.10 (October 2014): 847-854. (Review)
Website
http://hdl.handle.net/10161/9377
PMID
25323610
Source
epmc
Published In
Oncology
Volume
28
Issue
10
Publish Date
2014
Start Page
847
End Page
854

A pilot clinical trial of intravesical mitomycin-C and external deep pelvic hyperthermia for non-muscle-invasive bladder cancer.

This paper aims to evaluate the safety and heating efficiency of external deep pelvic hyperthermia combined with intravesical mitomycin C (MMC) as a novel therapy for non-muscle-invasive bladder cancer (NMIBC).We enrolled subjects with bacillus Calmette-Guérin (BCG) refractory NMIBC to an early phase clinical trial of external deep pelvic hyperthermia (using a BSD-2000 device) combined with MMC. Bladders were heated to 42 °C for 1 h during intravesical MMC treatment. Treatments were given weekly for 6 weeks, then monthly for 4 months. Heating parameters, treatment toxicity, and clinical outcomes were systematically measured.Fifteen patients were enrolled on the clinical trial. Median age was 66 years and 87% were male. Median European Organisation for Research and Treatment of Cancer (EORTC) recurrence and progression scores were 6 and 8, respectively. The full treatment course was attained in 73% of subjects. Effective bladder heating was possible in all but one patient who could not tolerate the supine position due to lung disease. Adverse events were all minor (grade 2 or less) and no systemic toxicity was observed. The most common adverse effects were Foley catheter pain (40%), abdominal discomfort (33%), chemical cystitis symptoms (27%), and abdominal skin swelling (27%). With a median follow-up of 3.18 years, 67% experienced another bladder cancer recurrence (none were muscle invasive) and 13% experienced an upper tract recurrence.External deep pelvic hyperthermia using the BSD-2000 device is a safe and reproducible method of heating the bladder in patients undergoing intravesical MMC. The efficacy of this treatment modality should be explored further in clinical trials.

Authors
Inman, BA; Stauffer, PR; Craciunescu, OA; Maccarini, PF; Dewhirst, MW; Vujaskovic, Z
MLA Citation
Inman, BA, Stauffer, PR, Craciunescu, OA, Maccarini, PF, Dewhirst, MW, and Vujaskovic, Z. "A pilot clinical trial of intravesical mitomycin-C and external deep pelvic hyperthermia for non-muscle-invasive bladder cancer." International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 30.3 (May 2014): 171-175.
PMID
24490762
Source
epmc
Published In
International Journal of Hyperthermia (Informa)
Volume
30
Issue
3
Publish Date
2014
Start Page
171
End Page
175
DOI
10.3109/02656736.2014.882021

Thermal dosimetry characteristics of deep regional heating of non-muscle invasive bladder cancer.

The aim of this paper is to report thermal dosimetry characteristics of external deep regional pelvic hyperthermia combined with intravesical mitomycin C (MMC) for treating bladder cancer following transurethral resection of bladder tumour, and to use thermal data to evaluate reliability of delivering the prescribed hyperthermia dose to bladder tissue.A total of 14 patients were treated with MMC and deep regional hyperthermia (BSD-2000, Sigma Ellipse or Sigma 60). The hyperthermia objective was 42° ± 2 °C to bladder tissue for ≥40 min per treatment. Temperatures were monitored with thermistor probes and recorded values were used to calculate thermal dose and evaluate treatment. Anatomical characteristics were examined for possible correlations with heating.Combined with BSD-2000 standard treatment planning and patient feedback, real-time temperature monitoring allowed thermal steering of heat sufficient to attain the prescribed thermal dose to bladder tissue within patient tolerance in 91.6% of treatments. Mean treatment time for bladder tissue >40 °C was 61.9 ± 11.4 min and mean thermal dose was 21.3 ± 16.5 CEM43. Average thermal doses obtained in normal tissues were 1.6 ± 1.2 CEM43 for the rectum and 0.8 ± 1.3 CEM43 in superficial normal tissues. No significant correlation was seen between patient anatomical characteristics and thermal dose achieved in bladder tissue.This study demonstrates that a hyperthermia prescription of 42° ± 2 °C for 40-60 min can be delivered safely to bladder tissue with external radiofrequency phased array applicators for a typical range of patient sizes. Using the available thermometry and treatment planning, the BSD-2000 hyperthermia system was shown to be an effective method of focusing heat regionally around the bladder with good patient tolerance.

Authors
Juang, T; Stauffer, PR; Craciunescu, OA; Maccarini, PF; Yuan, Y; Das, SK; Dewhirst, MW; Inman, BA; Vujaskovic, Z
MLA Citation
Juang, T, Stauffer, PR, Craciunescu, OA, Maccarini, PF, Yuan, Y, Das, SK, Dewhirst, MW, Inman, BA, and Vujaskovic, Z. "Thermal dosimetry characteristics of deep regional heating of non-muscle invasive bladder cancer." International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 30.3 (May 2014): 176-183.
PMID
24669804
Source
epmc
Published In
International Journal of Hyperthermia (Informa)
Volume
30
Issue
3
Publish Date
2014
Start Page
176
End Page
183
DOI
10.3109/02656736.2014.898338

A clinical trial of neoadjuvant hyperthermic intravesical chemotherapy (HIVEC) for treating intermediate and high-risk non-muscle invasive bladder cancer.

PURPOSE: Ths paper reports a pilot/feasibility trial of neoadjuvant hyperthermic intravesical chemotherapy (HIVEC) prior to transurethral resection of bladder tumour (TURBT) for non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS: A pilot/feasibility clinical trial was performed and 15 patients with intermediate to high-risk NMIBC received HIVEC prior to TURBT. HIVEC consisting of eight weekly instillations of intravesical MMC (80 mg in 50 mL) delivered with the novel Combat BRS® system at a temperature of 43 °C for 60 min. Treatment-related adverse effects were measured and patients were followed for 2 years for disease recurrence. RESULTS: A total of 119 HIVEC treatments occurred. Grade 1 adverse events consisted of irritative bladder symptoms (33%), bladder spasms (27%), pain (27%), haematuria (20%) and urinary tract infection (UTI; 14%). Grade 2 adverse events were bladder calcification (7%) and reduced bladder capacity (7%). No grade 3 or higher toxicity was observed. At TURBT, eight patients (53%) were complete responders (pT0) while seven (47%) were partial responders. With a median follow-up of 29 months, the 3-year cumulative incidence of recurrence was 15%. CONCLUSIONS: The Combat BRS® system achieved target bladder temperatures and delivered HIVEC with a favourable side-effect profile. Our pilot trial also provides preliminary evidence of treatment efficacy.

Authors
Sousa, A; Inman, BA; Piñeiro, I; Monserrat, V; Pérez, A; Aparici, V; Gómez, I; Neira, P; Uribarri, C
MLA Citation
Sousa, A, Inman, BA, Piñeiro, I, Monserrat, V, Pérez, A, Aparici, V, Gómez, I, Neira, P, and Uribarri, C. "A clinical trial of neoadjuvant hyperthermic intravesical chemotherapy (HIVEC) for treating intermediate and high-risk non-muscle invasive bladder cancer." International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 30.3 (May 2014): 166-170.
PMID
24697672
Source
epmc
Published In
International Journal of Hyperthermia (Informa)
Volume
30
Issue
3
Publish Date
2014
Start Page
166
End Page
170
DOI
10.3109/02656736.2014.900194

Thromboprophylaxis with fondaparinux in high-risk postoperative patients with renal insufficiency.

Fondaparinux is an antithrombin-dependent factor Xa inhibitor that is used for thromboprophylaxis of patients undergoing hip fracture surgery, hip or knee replacement, or abdominal surgery. It is cleared by the kidney and should be used with caution in patients with renal impairment and avoided in patients with severe renal insufficiency. Recently, several studies have demonstrated that a lower dose of fondaparinux in patients with moderate renal impairment appears to be safe and effective. The purpose of this study was to obtain pharmacokinetic and clinical data on the use of prophylactic fondaparinux in patients with renal insufficiency undergoing major abdominal surgery for cancer (n=8) or orthopedic surgery (n=1). Anti-factor Xa levels were obtained, and a published population pharmacokinetic model for fondaparinux was fit to the data. The data were analyzed using NONMEM software. Fondaparinux did not appear to accumulate in these patients, even when the drug was administered for up to twelve days. Pharmacokinetic analysis revealed that the apparent clearance in this population, who were primarily undergoing cancer surgery, was similar to prior studies in orthopedic surgery patients. In contrast, lower estimates were obtained for volume of distribution and absorption rate constant parameters. None of the patients sustained a hemorrhagic complication attributable to fondaparinux. One patient developed hypoxia in the setting of transient atrial fibrillation and clinical suspicion for pulmonary embolism, but this was not confirmed radiographically. These results support the use of 1.5mg of fondaparinux every 24hours for thromboprophylaxis in patients with renal insufficiency undergoing high-risk surgical procedures.

Authors
Hester, W; Fry, C; Gonzalez, D; Cohen-Wolkowiez, M; Inman, BA; Ortel, TL
MLA Citation
Hester, W, Fry, C, Gonzalez, D, Cohen-Wolkowiez, M, Inman, BA, and Ortel, TL. "Thromboprophylaxis with fondaparinux in high-risk postoperative patients with renal insufficiency." Thrombosis research 133.4 (April 2014): 629-633.
PMID
24508189
Source
epmc
Published In
Thrombosis Research
Volume
133
Issue
4
Publish Date
2014
Start Page
629
End Page
633
DOI
10.1016/j.thromres.2013.11.019

Penile cancer

© Springer-Verlag Berlin Heidelberg 2014. All rights reseved Penile cancer is a rare tumor entity in Europe and North America, e.g., the estimated incidence in Germany is 1.4 cases per 100,000 men [ 1, 2 ]. Due to poor economic and hygienic conditions, the incidence in countries of South America and Southeast Asia is tenfold higher [ 1 ] . Penile cancer is most frequently found in men between 60 and 80 years. Younger patients often suffer from more aggressive subtypes. This fact has to be taken into consideration for treatment.

Authors
Protzel, C; Hakenberg, OW; Inman, BA
MLA Citation
Protzel, C, Hakenberg, OW, and Inman, BA. "Penile cancer." Urology at a Glance. January 1, 2014. 305-310.
Source
scopus
Publish Date
2014
Start Page
305
End Page
310
DOI
10.1007/978-3-642-54859-8_58

Bladder cancer

© Springer-Verlag Berlin Heidelberg 2014. All rights reseved Worldwide, approximately 330,000 new cases of bladder cancer (BC) are diagnosed each year and 130,000 people die annually of this disease. Median age at diagnosis is 70 years and men are at 3.8 times higher risk than women. In western countries, the lifetime risk of developing BC is 2.4 % and it is the fourth most common solid tumor in men. Exposures known to increase the risk of BC include tobacco smoke, occupational carcinogens, and schistosomiasis. Dietary factors that decrease BC risk include high water intake and cruciferous legume consumption.

Authors
Kramer, MW; Cash, H; Inman, BA
MLA Citation
Kramer, MW, Cash, H, and Inman, BA. "Bladder cancer." Urology at a Glance. January 1, 2014. 151-155.
Source
scopus
Publish Date
2014
Start Page
151
End Page
155
DOI
10.1007/978-3-642-54859-8_31

Clinical performance and utility of a DNA methylation urine test for bladder cancer.

INTRODUCTION: Abnormal gene methylation has been observed in several cancers. A prior study reported methylation of TWIST1 and NID2 as a quantitative biomarker for urothelial carcinoma, but external validation has yet to be performed. We sought to externally validate a urine-based methylation assay combining TWIST1 and NID2 and assess its clinical utility. METHODS: A prospective trial was conducted comparing the methylation assay to cystoscopy and biopsy in patients with hematuria or prior non-muscle invasive bladder cancer. Sensitivity, specificity, negative and positive predictive values, and likelihood ratios of the methylation assay were calculated. Area under the receiver operating characteristic curves for each gene and the combined assay were computed. Bayesian analyses were performed to assess utility of the assay for a variety of clinical scenarios. RESULTS: Complete data were available for 111 patients. In validating the prior assay definition in the current cohort, sensitivity and specificity were 79% and 63%, respectively, and when optimized for the current cohort were 75% and 71%, respectively. The area under the curve for the assay was 0.73 compared with biopsy and 0.71 compared with cystoscopy. CONCLUSIONS: We failed to replicate the excellent performance of the methylation assay in this external validation; however, this assay may have utility for screening or surveillance for non-muscle invasive bladder cancer.

Authors
Abern, MR; Owusu, R; Inman, BA
MLA Citation
Abern, MR, Owusu, R, and Inman, BA. "Clinical performance and utility of a DNA methylation urine test for bladder cancer." Urol Oncol 32.1 (January 2014): 51.e21-51.e26.
PMID
24360662
Source
pubmed
Published In
Urologic Oncology: seminars and original investigations
Volume
32
Issue
1
Publish Date
2014
Start Page
51.e21
End Page
51.e26
DOI
10.1016/j.urolonc.2013.08.003

Note on "Simulation optimization of PSA-threshold based prostate cancer screening policies"

Authors
Underwood, DJ; Zhang, J; Denton, BT; Shah, ND; Inman, BA
MLA Citation
Underwood, DJ, Zhang, J, Denton, BT, Shah, ND, and Inman, BA. "Note on "Simulation optimization of PSA-threshold based prostate cancer screening policies"." Health Care Management Science 16.4 (December 1, 2013): 377-378.
Source
scopus
Published In
Health Care Management Science
Volume
16
Issue
4
Publish Date
2013
Start Page
377
End Page
378
DOI
10.1007/s10729-013-9238-y

Magnetic fluid hyperthermia for bladder cancer: a preclinical dosimetry study.

PURPOSE: This paper describes a preclinical investigation of the feasibility of thermotherapy treatment of bladder cancer with magnetic fluid hyperthermia (MFH), performed by analysing the thermal dosimetry of nanoparticle heating in a rat bladder model. MATERIALS AND METHODS: The bladders of 25 female rats were instilled with magnetite-based nanoparticles, and hyperthermia was induced using a novel small animal magnetic field applicator (Actium Biosystems, Boulder, CO). We aimed to increase the bladder lumen temperature to 42 °C in <10 min and maintain that temperature for 60 min. Temperatures were measured within the bladder lumen and throughout the rat with seven fibre-optic probes (OpSens Technologies, Quebec, Canada). An MRI analysis was used to confirm the effectiveness of the catheterisation method to deliver and maintain various nanoparticle volumes within the bladder. Thermal dosimetry measurements recorded the temperature rise of rat tissues for a variety of nanoparticle exposure conditions. RESULTS: Thermal dosimetry data demonstrated our ability to raise and control the temperature of rat bladder lumen ≥1 °C/min to a steady state of 42 °C with minimal heating of surrounding normal tissues. MRI scans confirmed the homogenous nanoparticle distribution throughout the bladder. CONCLUSION: These data demonstrate that our MFH system with magnetite-based nanoparticles provides well-localised heating of rat bladder lumen with effective control of temperature in the bladder and minimal heating of surrounding tissues.

Authors
Oliveira, TR; Stauffer, PR; Lee, C-T; Landon, CD; Etienne, W; Ashcraft, KA; McNerny, KL; Mashal, A; Nouls, J; Maccarini, PF; Beyer, WF; Inman, B; Dewhirst, MW
MLA Citation
Oliveira, TR, Stauffer, PR, Lee, C-T, Landon, CD, Etienne, W, Ashcraft, KA, McNerny, KL, Mashal, A, Nouls, J, Maccarini, PF, Beyer, WF, Inman, B, and Dewhirst, MW. "Magnetic fluid hyperthermia for bladder cancer: a preclinical dosimetry study." Int J Hyperthermia 29.8 (December 2013): 835-844.
PMID
24050253
Source
pubmed
Published In
International Journal of Hyperthermia (Informa)
Volume
29
Issue
8
Publish Date
2013
Start Page
835
End Page
844
DOI
10.3109/02656736.2013.834384

Contemporary epidemiological trends in complex congenital genitourinary anomalies.

PURPOSE: Anecdotal evidence suggests that complex congenital genitourinary anomalies are occurring less frequently. However, few epidemiological studies are available to confirm or refute this suggestion. MATERIALS AND METHODS: The Kids' Inpatient Database (KID) is a national, all payer database of several million inpatient pediatric hospitalizations per year, including complicated and uncomplicated in-hospital births. We reviewed the 1997 to 2009 KID to determine the birth prevalence of spina bifida, posterior urethral valves, bladder exstrophy, epispadias, prune belly syndrome, ambiguous genitalia and imperforate anus. For posterior urethral valves and prune belly syndrome we limited our search to newborn males only. RESULTS: During the study period, there was a diagnosis of spina bifida in 3,413 neonates, bladder exstrophy in 214, epispadias in 1,127, ambiguous genitalia in 726, prune belly syndrome in 180, posterior urethral valves in 578 and imperforate anus in 4,040. We identified no significant change in the birth prevalence of spina bifida (from 33.9 new spina bifida births of 100,000 uncomplicated births to 29.0/100,000, p = 0.08), posterior urethral valves (from 10.4/100,000 to 11.0/100,000, p = 0.51), prune belly syndrome (from 4.8/100,000 to 3.3/100,000, p = 0.44) or ambiguous genitalia (from 5.82/100,000 to 5.87/100,000, p = 0.38). There was a significant decrease in the birth prevalence of bladder exstrophy (from 2.4/100,000 to 1.6/100,000 uncomplicated births, p = 0.01) and a significant increase in epispadias (from 8.0/100,000 to 11.6/100,000) and imperforate anus (from 33.6/100,000 to 35.0/100,000, each p = 0.04) during the study period. CONCLUSIONS: The birth prevalence of spina bifida, posterior urethral valves and prune belly syndrome appears to have been stable in the last 12 years. Epispadias, ambiguous genitalia and imperforate anus diagnoses in newborns became more common in the same period, while bladder exstrophy diagnoses became less common.

Authors
Lloyd, JC; Wiener, JS; Gargollo, PC; Inman, BA; Ross, SS; Routh, JC
MLA Citation
Lloyd, JC, Wiener, JS, Gargollo, PC, Inman, BA, Ross, SS, and Routh, JC. "Contemporary epidemiological trends in complex congenital genitourinary anomalies." J Urol 190.4 Suppl (October 2013): 1590-1595.
PMID
23791903
Source
pubmed
Published In
The Journal of Urology
Volume
190
Issue
4 Suppl
Publish Date
2013
Start Page
1590
End Page
1595
DOI
10.1016/j.juro.2013.04.034

Maintenance bacillus Calmette-Guérin: why is there continued debate?

Authors
Inman, BA; Abern, MR
MLA Citation
Inman, BA, and Abern, MR. "Maintenance bacillus Calmette-Guérin: why is there continued debate?." Eur Urol 64.4 (October 2013): 586-587.
PMID
23773556
Source
pubmed
Published In
European Urology
Volume
64
Issue
4
Publish Date
2013
Start Page
586
End Page
587
DOI
10.1016/j.eururo.2013.05.055

Report of a rare fistula between a Studer neobladder and external iliac artery.

A neobladder-arterial fistula is a very rare complication following cystectomy, with only 1 previously reported case. Delay in diagnosis can be rapidly fatal and requires prompt intervention. We report the case of a 63-year-old male who developed massive hematuria, and was found to have a fistula between the right external iliac artery and Studer neobladder during emergent exploratory laparotomy. Treatment success relies on a high index of suspicion and may include open operative intervention.

Authors
Kuntz, NJ; Inman, BA
MLA Citation
Kuntz, NJ, and Inman, BA. "Report of a rare fistula between a Studer neobladder and external iliac artery." Can Urol Assoc J 7.9-10 (September 2013): E645-E647.
PMID
24409215
Source
pubmed
Published In
Canadian Urological Association journal = Journal de l'Association des urologues du Canada
Volume
7
Issue
9-10
Publish Date
2013
Start Page
E645
End Page
E647
DOI
10.5489/cuaj.402

Interpreting a study on bladder cancer screening.

Authors
Inman, BA; Abern, MR
MLA Citation
Inman, BA, and Abern, MR. "Interpreting a study on bladder cancer screening." Eur Urol 64.1 (July 2013): 48-50.
PMID
23582948
Source
pubmed
Published In
European Urology
Volume
64
Issue
1
Publish Date
2013
Start Page
48
End Page
50
DOI
10.1016/j.eururo.2013.03.047

Phase I clinical trial of external hyperthermia and intravesical mitomycin C to treat BCG-refractory bladder cancer.

Authors
Abern, M; Vujaskovic, Z; Dewhirst, MW; Lan, L; Craciunescu, OI; Stauffer, P; Inman, BA
MLA Citation
Abern, M, Vujaskovic, Z, Dewhirst, MW, Lan, L, Craciunescu, OI, Stauffer, P, and Inman, BA. "Phase I clinical trial of external hyperthermia and intravesical mitomycin C to treat BCG-refractory bladder cancer." May 20, 2013.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
31
Issue
15
Publish Date
2013

Novel immunotherapeutic strategies in development for renal cell carcinoma.

CONTEXT: The purpose of this report is to review immunotherapies under investigation for patients with renal cell carcinoma (RCC), the most common form of kidney cancer, for which the incidence and mortality rate continue to increase. OBJECTIVE: To summarize and evaluate current data on immunotherapies for RCC and discuss issues to be resolved before integration into the RCC treatment paradigm. EVIDENCE ACQUISITION: A search of Medline, clinicaltrials.gov, and congress abstracts/treatment guidelines was performed in May 2012 using the following terms (and variations): metastatic renal cell carcinoma, practice guidelines, response/resistance to current treatments, immunotherapy, novel immunotherapeutic strategies, T-cell modulation, immune priming, innate immunity, and combination therapy. EVIDENCE SYNTHESIS: Prior to the advent of novel agents targeting the vascular endothelial growth factor and mechanistic target of rapamycin pathways, interleukin-2 (IL-2) and interferon-α were the mainstays of RCC treatment. IL-2 remains one of the only treatments capable of curing advanced RCC, albeit in few patients. Despite recent advances, unmet need still exists for patients in the adjuvant setting, those with poor prognostic factors, and those who have progressed on prior targeted therapies. Improved understanding of host-tumor immune interactions has led to development of novel immunotherapeutic agents, including antibodies against immune checkpoint proteins (eg, programmed death-1 and cytotoxic T-lymphocyte antigen-4), and various vaccines. Because many of these compounds are in development, clinical experience with them is limited, although some have demonstrated activity in preliminary studies. CONCLUSIONS: It is not yet clear where these new immunotherapies will fit into RCC treatment paradigms, but they may provide new options for patients whose current choices are limited. Furthermore, predictive biomarkers are needed to identify patients who will derive the greatest benefit from immunotherapy.

Authors
Inman, BA; Harrison, MR; George, DJ
MLA Citation
Inman, BA, Harrison, MR, and George, DJ. "Novel immunotherapeutic strategies in development for renal cell carcinoma." Eur Urol 63.5 (May 2013): 881-889. (Review)
PMID
23084331
Source
pubmed
Published In
European Urology
Volume
63
Issue
5
Publish Date
2013
Start Page
881
End Page
889
DOI
10.1016/j.eururo.2012.10.006

The impact of temperature and urinary constituents on urine viscosity and its relevance to bladder hyperthermia treatment.

PURPOSE: The aim of this study was to determine the kinematic viscosity of human urine and factors associated with its variability. This value is necessary for accurate modelling of fluid mechanics and heat transfer during hyperthermia treatments of bladder cancer. MATERIALS AND METHODS: Urine samples from 64 patients undergoing routine clinical testing were subject to dipstick urinalysis and measurement of viscosity with a Cannon-Fenske viscometer. Viscosity measurements were taken at relevant temperatures for hyperthermia studies: 20 °C (room temperature), 37 °C (body temperature), and 42 °C (clinical hyperthermia temperature). Factors that might affect viscosity were assessed, including glucosuria, haematuria, urinary tract infection status, ketonuria and proteinuria status. The correlation of urine specific gravity and viscosity was measured with Spearman's rho. RESULTS: Urine kinematic viscosity at 20 °C was 1.0700 cSt (standard deviation (SD) = 0.1076), at 37 °C 0.8293 cSt (SD = 0.0851), and at 42 °C 0.6928 cSt (SD = 0.0247). Proteinuria appeared to increase urine viscosity, whereas age, gender, urinary tract infection, glucosuria, ketonuria, and haematuria did not affect it. Urine specific gravity was only modestly correlated with urine viscosity at 20 °C (rho = 0.259), 37 °C (rho = 0.266), and 42 °C (rho = 0.255). CONCLUSIONS: The kinematic viscosity of human urine is temperature dependent and higher than water. Urine specific gravity was not a good predictor of viscosity. Of factors that might affect urine viscosity, only proteinuria appeared to be clinically relevant. Estimates of urine viscosity provided in this manuscript may be useful for temperature modelling of bladder hyperthermia treatments with regard to correct prediction of the thermal conduction effects.

Authors
Inman, BA; Etienne, W; Rubin, R; Owusu, RA; Oliveira, TR; Rodriques, DB; Maccarini, PF; Stauffer, PR; Mashal, A; Dewhirst, MW
MLA Citation
Inman, BA, Etienne, W, Rubin, R, Owusu, RA, Oliveira, TR, Rodriques, DB, Maccarini, PF, Stauffer, PR, Mashal, A, and Dewhirst, MW. "The impact of temperature and urinary constituents on urine viscosity and its relevance to bladder hyperthermia treatment." Int J Hyperthermia 29.3 (May 2013): 206-210.
PMID
23489163
Source
pubmed
Published In
International Journal of Hyperthermia (Informa)
Volume
29
Issue
3
Publish Date
2013
Start Page
206
End Page
210
DOI
10.3109/02656736.2013.775355

Staging and risk stratification in penile cancer

This book highlights many of the significant advances made in this field, which include a discussion of penile-sparing surgical and radiotherapeutic approaches to select primary penile tumors typically of lower stage and grade as well as ...

Authors
Inman, BA; Stewart, SB; Kattan, MW
MLA Citation
Inman, BA, Stewart, SB, and Kattan, MW. "Staging and risk stratification in penile cancer." Penile Cancer. Ed. PE Spiess. Humana PressInc, April 30, 2013. 11-42.
Source
manual
Publish Date
2013
Start Page
11
End Page
42

Abstract 1376: Exercise alters breast cancer phenotype through distinct reductions in host-derived proinflammatory growth factor ligands.

Authors
Glass, O; Inman, BA; Courneya, KS; Mackey, JR; Nelson, E; Hartman, Z; Jones, LW
MLA Citation
Glass, O, Inman, BA, Courneya, KS, Mackey, JR, Nelson, E, Hartman, Z, and Jones, LW. "Abstract 1376: Exercise alters breast cancer phenotype through distinct reductions in host-derived proinflammatory growth factor ligands." April 15, 2013.
Source
crossref
Published In
Cancer Research
Volume
73
Issue
8 Supplement
Publish Date
2013
Start Page
1376
End Page
1376
DOI
10.1158/1538-7445.AM2013-1376

Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.

The role for a single dose of intravesical chemotherapy (IVC) after transurethral resection (TUR) remains unclear in patients with non-muscle-invasive bladder cancer (NMIBC). Several recent randomized clinical trials (RCTs) have evaluated its effect on recurrence, prompting this systematic review of RCTs comparing a single immediate postoperative dose of IVC versus placebo within 24 hours of TUR of NMIBC, and this meta-analysis using a random-effects model to predict the pooled relative risk (RR) of tumor recurrence. Subanalyses pooled studies by drug type and a meta-regression was performed to determine the effect of underlying patient risk factors on the efficacy of a single dose of IVC. A total of 3103 patients were randomized in the 18 RCTs that met inclusion criteria. The recurrence rate in patients receiving perioperative IVC and TUR was 37% versus 50% in the TUR-alone group. The pooled RR of recurrence for IVC and TUR was 0.67 (95% CI, 0.56-0.79), corresponding to a 13% absolute reduction and a number needed to treat of 7.2 patients to avoid 1 recurrence. The proportions of patients with tumor risk factors (T1, high-grade, multifocal, or recurrent) were not associated with IVC efficacy. A single dose of IVC administered within 24 hours of TUR of NMIBC was found to result in a reduction in tumor recurrence (RR, 0.67; 95% CI, 0.56-0.79). Patients with higher-risk tumor features seem to benefit at a similar rate.

Authors
Abern, MR; Owusu, RA; Anderson, MR; Rampersaud, EN; Inman, BA
MLA Citation
Abern, MR, Owusu, RA, Anderson, MR, Rampersaud, EN, and Inman, BA. "Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis." J Natl Compr Canc Netw 11.4 (April 1, 2013): 477-484. (Review)
PMID
23584348
Source
pubmed
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
11
Issue
4
Publish Date
2013
Start Page
477
End Page
484

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

UNLABELLED: Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. MATERIALS AND METHODS: Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. RESULTS: In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. CONCLUSIONS: A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

Authors
Wang, AJ; Goldsmith, ZG; Neisius, A; Astroza, GM; Oredein-McCoy, O; Iqbal, MW; Simmons, WN; Madden, JF; Preminger, GM; Inman, BA; Lipkin, ME; Ferrandino, MN
MLA Citation
Wang, AJ, Goldsmith, ZG, Neisius, A, Astroza, GM, Oredein-McCoy, O, Iqbal, MW, Simmons, WN, Madden, JF, Preminger, GM, Inman, BA, Lipkin, ME, and Ferrandino, MN. "Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer." J Endourol 27.3 (March 2013): 288-293.
PMID
22998421
Source
pubmed
Published In
Journal of Endourology
Volume
27
Issue
3
Publish Date
2013
Start Page
288
End Page
293
DOI
10.1089/end.2012.0211

Preclinical Dosimetry of Magnetic Fluid Hyperthermia for Bladder Cancer.

BACKGROUND: Despite positive efficacy, thermotherapy is not widely used in clinical oncology. Difficulties associated with field penetration and controlling power deposition patterns in heterogeneous tissue have limited its use for heating deep in the body. Heat generation using iron-oxide super-paramagnetic nanoparticles excited with magnetic fields has been demonstrated to overcome some of these limitations. The objective of this preclinical study is to investigate the feasibility of treating bladder cancer with magnetic fluid hyperthermia (MFH) by analyzing the thermal dosimetry of nanoparticle heating in a rat bladder model. METHODS: The bladders of 25 female rats were injected with 0.4 ml of Actium Biosystems magnetite-based nanoparticles (Actium Biosystems, Boulder CO) via catheters inserted in the urethra. To assess the distribution of nanoparticles in the rat after injection we used the 7 T small animal MRI system (Bruker ClinScan, Bruker BioSpin MRI GmbH, Ettlingen, Germany). Heat treatments were performed with a small animal magnetic field applicator (Actium Biosystems, Boulder CO) with a goal of raising bladder temperature to 42°C in <10min and maintaining for 60min. Temperatures were measured throughout the rat with seven fiberoptic temperature probes (OpSens Technologies, Quebec Canada) to characterize our ability to localize heat within the bladder target. RESULTS: The MRI study confirms the effectiveness of the catheterization procedure to homogenously distribute nanoparticles throughout the bladder. Thermal dosimetry data demonstrate our ability to controllably raise temperature of rat bladder ≥1°C/min to a steady-state of 42°C. CONCLUSION: Our data demonstrate that a MFH system provides well-localized heating of rat bladder with effective control of temperature in the bladder and minimal heating of surrounding tissues.

Authors
Oliveira, TR; Stauffer, PR; Lee, C-T; Landon, C; Etienne, W; Maccarini, PF; Inman, B; Dewhirst, MW
MLA Citation
Oliveira, TR, Stauffer, PR, Lee, C-T, Landon, C, Etienne, W, Maccarini, PF, Inman, B, and Dewhirst, MW. "Preclinical Dosimetry of Magnetic Fluid Hyperthermia for Bladder Cancer." Proc SPIE Int Soc Opt Eng 8584 (February 26, 2013): 1656985-.
PMID
23837123
Source
pubmed
Published In
Proceedings of SPIE - The International Society for Optical Engineering
Volume
8584
Publish Date
2013
Start Page
1656985
DOI
10.1117/12.2005623

Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy.

Authors
Abern, MR; Freedland, SJ; Inman, BA
MLA Citation
Abern, MR, Freedland, SJ, and Inman, BA. "Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy." BJU Int 111.2 (February 2013): 187-188.
PMID
22727145
Source
pubmed
Published In
Bju International
Volume
111
Issue
2
Publish Date
2013
Start Page
187
End Page
188
DOI
10.1111/j.1464-410X.2012.11331.x

Re: Final results of an EORTC-GU cancers group randomized study of maintenance bacillus calmette-guérin in intermediate- and high-risk ta, T1 papillary carcinoma of the urinary bladder: One-third dose versus full dose and 1 year versus 3 years of maintenance

Authors
Inman, BA
MLA Citation
Inman, BA. "Re: Final results of an EORTC-GU cancers group randomized study of maintenance bacillus calmette-guérin in intermediate- and high-risk ta, T1 papillary carcinoma of the urinary bladder: One-third dose versus full dose and 1 year versus 3 years of maintenance." European Urology 64.1 (2013): 171-172.
PMID
23746323
Source
scival
Published In
European Urology
Volume
64
Issue
1
Publish Date
2013
Start Page
171
End Page
172
DOI
10.1016/j.eururo.2013.04.027

Utility of preoperative echocardiograms in patients receiving treatment for bladder cancer. a retrospective study

Background: Preoperative risk assessment is part of routine clinical management that evaluates a patient's physical status and therefore surgical eligibility. These evaluations include age, comorbidities, physical status, and cardiac function, including resting LVEF. Patients with bladder cancer are especially high-risk due to older age and higher frequency of coexisting disease. This study aims to investigate the relationship between cardiac function reflected by resting LVEF and postoperative LOS in patients undergoing cystectomy or cystourethroscopy for treatment of bladder cancer. Methods: Data were compiled from a database of patients undergoing treatment for bladder cancer at DUH from July 2000-August 2012. Decision to order a preoperative echocardiogram was based on clinical judgment. Echo reports were retrieved from the medical records and LVEF was recorded. Patients were stratified based on the values of LVEF. Echocardiogram with LVEF >50% were recorded as normal, and LVEF<50% were considered abnormal. Results: Eighty-one patients were identified with an echocardiogram within 30 days prior to cystectomy or cystourethroscopy. Thirty-four cystectomy patients and 47 cystourethroscopy patients were identified. The chances of an abnormal finding from preoperative resting echocardiograms based on clinical judgment range between 10%- 22%. Thirty-one cystectomy patients with normal echocardiogram had a mean LOS of 14.3 days. Three cystectomy patients with abnormal echocardiogram had a mean LOS of 22.6 days. In the cystourethroscopy cohort, 37 patients had normal echocardiogram and averaged 2.5 LOS, while ten patients with abnormal echocardiogram averaged 2.6 LOS. Conclusion: The findings from preoperative echocardiogram is not a predictor in the LOS following cystourethroscopy although there was a trend towards longer LOS in patients undergoing cystectomy (p=0.09). Exploring other options such as exercise or stress echocardiogram as well as fitness assessments such as cardiopulmonary exercise testing may provide more powerful surgical risk stratification and prognostic information to urologists managing patients with bladder cancer. © 2013 Crowgey TR, et al.

Authors
Crowgey, TR; Inman, B; Gan, TJ
MLA Citation
Crowgey, TR, Inman, B, and Gan, TJ. "Utility of preoperative echocardiograms in patients receiving treatment for bladder cancer. a retrospective study." Journal of Anesthesia and Clinical Research 4.6 (2013).
Source
scival
Published In
Journal of Anesthesia and Clinical Research
Volume
4
Issue
6
Publish Date
2013
DOI
10.4172/2155-6148.1000330

Comprehensive handbook for developing a bladder cancer cystectomy database

Objective: In an effort to standardize data collection for research regarding bladder cancer, the Bladder Cancer Working Group sought to provide a handbook that can be used as a guide for prospective or retrospective data collection. Methods: Expert opinions for various data groups were compiled through a team of researchers at the BCAN. Peer review of each data group was performed from within the group. Results: Essential and comprehensive data elements are provided for 9 groups of data elements, including demographics, comorbidities, staging, laboratory data, operative details, pathology, complications, outcomes, and quality of life measurements. Conclusions: Establishment of a comprehensive bladder cancer database is important in initiating multicenter collaborations. While not every data point is critical, this review may be useful in serving as a reference in initiating projects and providing a framework for collaborations. © 2013 Elsevier Inc.

Authors
Lotan, Y; Amiel, G; Boorjian, SA; Clark, PE; Droller, M; Gingrich, JR; Guzzo, TJ; Inman, BA; Kamat, AM; Karsh, L; Nielsen, ME; Smith, ND; Shariat, SF; Svatek, RS; Taylor, JM
MLA Citation
Lotan, Y, Amiel, G, Boorjian, SA, Clark, PE, Droller, M, Gingrich, JR, Guzzo, TJ, Inman, BA, Kamat, AM, Karsh, L, Nielsen, ME, Smith, ND, Shariat, SF, Svatek, RS, and Taylor, JM. "Comprehensive handbook for developing a bladder cancer cystectomy database." Urologic Oncology: Seminars and Original Investigations 31.6 (2013): 812-826.
Source
scival
Published In
Urologic Oncology: Seminars and Original Investigations
Volume
31
Issue
6
Publish Date
2013
Start Page
812
End Page
826
DOI
10.1016/j.urolonc.2011.09.004

Penile cancer

Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations on the diagnosis and management of this devastating disease based on evidence and expert consensus. Copyright © 2013 by the National Comprehensive Cancer Network. All rights reserved.

Authors
Clark, PE; Spiess, PE; Agarwal, N; Biagioli, MC; Eisenberger, MA; Greenberg, RE; Herr, HW; Inman, BA; Kuban, DA; Kuzel, TM; Lele, SM; Michalski, J; Pagliaro, L; Pal, SK; Patterson, A; Plimack, ER; Pohar, KS; Porter, MP; Richie, JP; Sexton, WJ; Shipley, WU; Small, EJ; Trump, DL; Wile, G; Wilson, TG; Dwyer, M; Ho, M
MLA Citation
Clark, PE, Spiess, PE, Agarwal, N, Biagioli, MC, Eisenberger, MA, Greenberg, RE, Herr, HW, Inman, BA, Kuban, DA, Kuzel, TM, Lele, SM, Michalski, J, Pagliaro, L, Pal, SK, Patterson, A, Plimack, ER, Pohar, KS, Porter, MP, Richie, JP, Sexton, WJ, Shipley, WU, Small, EJ, Trump, DL, Wile, G, Wilson, TG, Dwyer, M, and Ho, M. "Penile cancer." JNCCN Journal of the National Comprehensive Cancer Network 11.5 (2013): 594-615.
Source
scival
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
11
Issue
5
Publish Date
2013
Start Page
594
End Page
615

Bladder cancer: Clinical practice guidelines in oncology

Bladder cancer is the fourth most common cancer in the United States. Urothelial carcinoma that originates from the urinary bladder is the most common subtype. These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) provide recommendations on the diagnosis and management of non-muscle-invasive and muscle-invasive urothelial carcinoma of the bladder. This version of the guidelines provides extensive reorganization and updates on the principles of chemotherapy management. Copyright © 2013 by the National Comprehensive Cancer Network. All rights reserved.

Authors
Clark, PE; Agarwal, N; Biagioli, MC; Eisenberger, MA; Greenberg, RE; Herr, HW; Inman, BA; Kuban, DA; Kuzel, TM; Lele, SM; Michalski, J; Pagliaro, LC; Pal, SK; Patterson, A; Plimack, ER; Pohar, KS; Porter, MP; Richie, JP; Sexton, WJ; Shipley, WU; Small, EJ; Spiess, PE; Trump, DL; Wile, G; Wilson, TG; Dwyer, M; Ho, M
MLA Citation
Clark, PE, Agarwal, N, Biagioli, MC, Eisenberger, MA, Greenberg, RE, Herr, HW, Inman, BA, Kuban, DA, Kuzel, TM, Lele, SM, Michalski, J, Pagliaro, LC, Pal, SK, Patterson, A, Plimack, ER, Pohar, KS, Porter, MP, Richie, JP, Sexton, WJ, Shipley, WU, Small, EJ, Spiess, PE, Trump, DL, Wile, G, Wilson, TG, Dwyer, M, and Ho, M. "Bladder cancer: Clinical practice guidelines in oncology." JNCCN Journal of the National Comprehensive Cancer Network 11.4 (2013): 446-475.
Source
scival
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
11
Issue
4
Publish Date
2013
Start Page
446
End Page
475

Hyperthermia as adjunct to intravesical chemotherapy for bladder cancer.

Nonmuscle invasive bladder cancer remains a very costly cancer to manage because of high recurrence rates requiring long-term surveillance and treatment. Emerging evidence suggests that adjunct and concurrent use of hyperthermia with intravesical chemotherapy after transurethral resection of bladder tumor further reduces recurrence risk and progression to advanced disease. Hyperthermia has both direct and immune-mediated cytotoxic effect on tumor cells including tumor growth arrest and activation of antitumor immune system cells and pathways. Concurrent heat application also acts as a sensitizer to intravesical chemotherapy agents. As such the ability to deliver hyperthermia to the focus of tumor while minimizing damage to surrounding benign tissue is of utmost importance to optimize the benefit of hyperthermia treatment. Existing chemohyperthermia devices that allow for more localized heat delivery continue to pave the way in this effort. Current investigational methods involving heat-activated drug delivery selectively to tumor cells using temperature-sensitive liposomes also offer promising ways to improve chemohyperthermia efficacy in bladder cancer while minimizing toxicity to benign tissue. This will hopefully allow more widespread use of chemohyperthermia to all bladder cancer patients, including metastatic bladder cancer.

Authors
Owusu, RA; Abern, MR; Inman, BA
MLA Citation
Owusu, RA, Abern, MR, and Inman, BA. "Hyperthermia as adjunct to intravesical chemotherapy for bladder cancer." Biomed Res Int 2013 (2013): 262313-. (Review)
PMID
24073396
Source
pubmed
Published In
BioMed Research International
Volume
2013
Publish Date
2013
Start Page
262313
DOI
10.1155/2013/262313

Outcomes of metallic stents for malignant ureteral obstruction.

PURPOSE: Malignant ureteral obstruction often necessitates chronic urinary diversion and is associated with high rates of failure with traditional ureteral stents. We evaluated the outcomes of a metallic stent placed for malignant ureteral obstruction and determined the impact of risk factors previously associated with increased failure rates of traditional stents. MATERIALS AND METHODS: Patients undergoing placement of the metallic Resonance® stent for malignant ureteral obstruction at an academic referral center were identified retrospectively. Stent failure was defined as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). Predictors of time to stent failure were assessed using Cox regression. RESULTS: A total of 37 stents were placed in 25 patients with malignant ureteral obstruction. Of these stents 12 (35%) were identified to fail. Progressive hydroureteronephrosis and increasing creatinine were the most common signs of stent failure. Three failed stents had migrated distally and no stents required removal for recurrent infection. Patients with evidence of prostate cancer invading the bladder at stent placement were found to have a significantly increased risk of failure (HR 6.50, 95% CI 1.45-29.20, p = 0.015). Notably symptomatic subcapsular hematomas were identified in 3 patients after metallic stent placement. CONCLUSIONS: Failure rates with a metallic stent are similar to those historically observed with traditional polyurethane based stents in malignant ureteral obstruction. The invasion of prostate cancer in the bladder significantly increases the risk of failure. Patients should be counseled and observed for subcapsular hematoma formation with this device.

Authors
Goldsmith, ZG; Wang, AJ; Bañez, LL; Lipkin, ME; Ferrandino, MN; Preminger, GM; Inman, BA
MLA Citation
Goldsmith, ZG, Wang, AJ, Bañez, LL, Lipkin, ME, Ferrandino, MN, Preminger, GM, and Inman, BA. "Outcomes of metallic stents for malignant ureteral obstruction." J Urol 188.3 (September 2012): 851-855.
Website
http://hdl.handle.net/10161/7365
PMID
22819410
Source
pubmed
Published In
The Journal of Urology
Volume
188
Issue
3
Publish Date
2012
Start Page
851
End Page
855
DOI
10.1016/j.juro.2012.04.113

An examination of the dynamic changes in prostate-specific antigen occurring in a population-based cohort of men over time.

OBJECTIVE: • To determine whether prostate-specific antigen velocity (PSA-V), PSA doubling time (PSA-DT), or PSA percentage change (PSA-PC) add incremental information to PSA alone for community-based men undergoing prostate cancer (PCa) screening. PARTICIPANTS AND METHODS: • A population-based cohort of 11 872 men from Olmsted County, MN undergoing PSA screening for PCa from 1993 to 2005 was analysed for PSA, PSA-DT, PSA-PC and PSA-V and subsequent PCa. • Receiver-operating characteristics curves and logistic regression were used to calculate the area under the curve (AUC) and Aikaike's information criterion. • Reclassification analysis was performed and the net reclassification improvement and integrated discrimination improvement were measured. • The method of Begg and Greenes was used to adjust for verification bias. RESULTS: • The single best predictor of future PCa was PSA (AUC = 0.773) with PSA-V (AUC = 0.729) and PSA-DT/PSA-PC (AUC = 0.689) performing worse. • After age adjustment, combining PSA with PSA-V (AUC = 0.773) or PSA-DT/PSA-PC (AUC = 0.773) resulted in no better predictions than PSA alone. • Reclassification analysis showed that adding PSA-V or PSA-DT/PSA-PC to PSA did not result in a meaningful amount of reclassification. CONCLUSIONS: • PSA is a better predictor of future PCa than PSA-V, PSA-DT, or PSA-PC. • Adding PSA-V, PSA-DT, or PSA-PC to PSA does not result in clinically relevant improvements in the ability to predict future PCa.

Authors
Inman, BA; Zhang, J; Shah, ND; Denton, BT
MLA Citation
Inman, BA, Zhang, J, Shah, ND, and Denton, BT. "An examination of the dynamic changes in prostate-specific antigen occurring in a population-based cohort of men over time." BJU Int 110.3 (August 2012): 375-381.
PMID
22313933
Source
pubmed
Published In
Bju International
Volume
110
Issue
3
Publish Date
2012
Start Page
375
End Page
381
DOI
10.1111/j.1464-410X.2011.10925.x

Anatomy and principles of renal surgery

Take it with you anywhere! Access the full text, downloadable image library, video clips, and more at www.expertconsult.com.

Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Anatomy and principles of renal surgery." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 967-974.
Source
manual
Publish Date
2012
Start Page
967
End Page
974

Simple nephrectomy

Take it with you anywhere! Access the full text, downloadable image library, video clips, and more at www.expertconsult.com.

Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Simple nephrectomy." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 975-988.
Source
manual
Publish Date
2012
Start Page
975
End Page
988

Radical nephrectomy

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Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Radical nephrectomy." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 989-1000.
Source
manual
Publish Date
2012
Start Page
989
End Page
1000

Partial nephrectomy

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Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Partial nephrectomy." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 1001-1008.
Source
manual
Publish Date
2012
Start Page
1001
End Page
1008

Nephroureterectomy

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Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Nephroureterectomy." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 1009-1021.
Source
manual
Publish Date
2012
Start Page
1009
End Page
1021

Extracorporeal renal surgery

Take it with you anywhere! Access the full text, downloadable image library, video clips, and more at www.expertconsult.com.

Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Extracorporeal renal surgery." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 1021-1024.
Source
manual
Publish Date
2012
Start Page
1021
End Page
1024

Vena caval thrombectomy

Take it with you anywhere! Access the full text, downloadable image library, video clips, and more at www.expertconsult.com.

Authors
Blute, ML; Inman, BA
MLA Citation
Blute, ML, and Inman, BA. "Vena caval thrombectomy." Hinman's Atlas of Urologic Surgery. Ed. JAS Jr, SS Howards, and GM Preminger. Elsevier Health Sciences, June 21, 2012. 1025-1042.
Source
manual
Publish Date
2012
Start Page
1025
End Page
1042

African American race to predict for earlier failure of active surveillance: Results from the Duke Prostate Center

Authors
Bassett, M; Abern, M; Banez, LL; Ferrandino, M; Robertson, CN; Inman, BA; Polascik, T; Freedland, SJ; Walther, PJ; Moul, JW
MLA Citation
Bassett, M, Abern, M, Banez, LL, Ferrandino, M, Robertson, CN, Inman, BA, Polascik, T, Freedland, SJ, Walther, PJ, and Moul, JW. "African American race to predict for earlier failure of active surveillance: Results from the Duke Prostate Center." May 20, 2012.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
30
Issue
15
Publish Date
2012

The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men.

Authors
Banez, LL; Davidson, AK; Etienne, W; Allott, EH; Calloway, EE; Inman, BA
MLA Citation
Banez, LL, Davidson, AK, Etienne, W, Allott, EH, Calloway, EE, and Inman, BA. "The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men." February 10, 2012.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
30
Issue
5
Publish Date
2012

The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men.

143 Background: We recently reported that the ADH1B*3 allele, which is specific to African Americans (AA), when combined with ethanol intake may constitute a gene-environment interaction leading to elevated prostate cancer (CaP) and potentially aggressive CaP risk among AA men possibly through intra-prostatic acetaldehyde accumulation. Indeed, studies have shown microsomes from rat ventral prostates biotransform ethanol to acetaldehyde that further metabolizes into oxidative stress-inducing acetyl radicals. In addition, acetaldehyde has been previously shown to enhance proliferation of colon cancer cells. Whether acetaldehyde has the same effect on CaP is unknown.We subjected DU-145 CaP cells to varying concentrations of acetaldehyde using acute and chronic models of exposure and measured tumor proliferation using MTS assay. Proliferation was measured over 4 days of acetaldehyde treatment in acute and after 2 weeks of treatment in chronic exposure experiments. All experiments were conducted in triplicate. Results were expressed as mean values for each treatment referenced to untreated cells. Doubling times were calculated using least squares fitting exponential regression.In the acute exposure model, proliferation of DU-145 cells was inhibited by 150 uM acetaldehyde by 28% while 1,500uM and higher concentrations resulted in complete inhibition of proliferation. After chronic exposure to acetaldehyde, proliferation of DU-145 cells was inhibited by 500 uM acetaldehyde by 19%. In contrast, chronic exposure with 1,000 uM acetaldehyde resulted in increased proliferation by 9% and shortened tumor doubling time.Acute exposure to acetaldehyde resulted in inhibition of CaP cellular proliferation. Chronic exposure to high acetaldehyde concentrations promoted tumor proliferation likely through selection for more robust CaP cells that survive the repeated chemical insult. Our results suggest that chronic acetaldehyde exposure of existent CaP may potentially promote disease aggressiveness. Uncovering mechanisms for enhanced CaP cell proliferation by acetaldehyde are warranted.

Authors
Banez, LL; Davidson, AK; Etienne, W; Allott, EH; Calloway, EE; Inman, BA
MLA Citation
Banez, LL, Davidson, AK, Etienne, W, Allott, EH, Calloway, EE, and Inman, BA. "The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30.5_suppl (February 2012): 143-.
PMID
27968253
Source
epmc
Published In
Journal of Clinical Oncology
Volume
30
Issue
5_suppl
Publish Date
2012
Start Page
143

The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men.

143 Background: We recently reported that the ADH1B*3 allele, which is specific to African Americans (AA), when combined with ethanol intake may constitute a gene-environment interaction leading to elevated prostate cancer (CaP) and potentially aggressive CaP risk among AA men possibly through intra-prostatic acetaldehyde accumulation. Indeed, studies have shown microsomes from rat ventral prostates biotransform ethanol to acetaldehyde that further metabolizes into oxidative stress-inducing acetyl radicals. In addition, acetaldehyde has been previously shown to enhance proliferation of colon cancer cells. Whether acetaldehyde has the same effect on CaP is unknown.We subjected DU-145 CaP cells to varying concentrations of acetaldehyde using acute and chronic models of exposure and measured tumor proliferation using MTS assay. Proliferation was measured over 4 days of acetaldehyde treatment in acute and after 2 weeks of treatment in chronic exposure experiments. All experiments were conducted in triplicate. Results were expressed as mean values for each treatment referenced to untreated cells. Doubling times were calculated using least squares fitting exponential regression.In the acute exposure model, proliferation of DU-145 cells was inhibited by 150 uM acetaldehyde by 28% while 1,500uM and higher concentrations resulted in complete inhibition of proliferation. After chronic exposure to acetaldehyde, proliferation of DU-145 cells was inhibited by 500 uM acetaldehyde by 19%. In contrast, chronic exposure with 1,000 uM acetaldehyde resulted in increased proliferation by 9% and shortened tumor doubling time.Acute exposure to acetaldehyde resulted in inhibition of CaP cellular proliferation. Chronic exposure to high acetaldehyde concentrations promoted tumor proliferation likely through selection for more robust CaP cells that survive the repeated chemical insult. Our results suggest that chronic acetaldehyde exposure of existent CaP may potentially promote disease aggressiveness. Uncovering mechanisms for enhanced CaP cell proliferation by acetaldehyde are warranted.

Authors
Banez, LL; Davidson, AK; Etienne, W; Allott, EH; Calloway, EE; Inman, BA
MLA Citation
Banez, LL, Davidson, AK, Etienne, W, Allott, EH, Calloway, EE, and Inman, BA. "The effect of acute and chronic exposure to acetaldehyde-a mutagenic metabolite of dietary ethanol-on prostate cancer cells: A potential source of race disparity disfavoring black men." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30.5_suppl (February 2012): 143-.
PMID
28143312
Source
epmc
Published In
Journal of Clinical Oncology
Volume
30
Issue
5_suppl
Publish Date
2012
Start Page
143

Miniature microwave applicator for murine bladder hyperthermia studies.

PURPOSE: Novel combinations of heat with chemotherapeutic agents are often studied in murine tumour models. Currently, no device exists to selectively heat small tumours at depth in mice. In this project we modelled, built and tested a miniature microwave heat applicator, the physical dimensions of which can be scaled to adjust the volume and depth of heating to focus on the tumour volume. Of particular interest is a device that can selectively heat murine bladder. MATERIALS AND METHODS: Using Avizo(®) segmentation software, we created a numerical mouse model based on micro-MRI scan data. The model was imported into HFSS™ (Ansys) simulation software and parametric studies were performed to optimise the dimensions of a water-loaded circular waveguide for selective power deposition inside a 0.15 mL bladder. A working prototype was constructed operating at 2.45 GHz. Heating performance was characterised by mapping fibre-optic temperature sensors along catheters inserted at depths of 0-1 mm (subcutaneous), 2-3 mm (vaginal), and 4-5 mm (rectal) below the abdominal wall, with the mid depth catheter adjacent to the bladder. Core temperature was monitored orally. RESULTS: Thermal measurements confirm the simulations which demonstrate that this applicator can provide local heating at depth in small animals. Measured temperatures in murine pelvis show well-localised bladder heating to 42-43°C while maintaining normothermic skin and core temperatures. CONCLUSIONS: Simulation techniques facilitate the design optimisation of microwave antennas for use in pre-clinical applications such as localised tumour heating in small animals. Laboratory measurements demonstrate the effectiveness of a new miniature water-coupled microwave applicator for localised heating of murine bladder.

Authors
Salahi, S; Maccarini, PF; Rodrigues, DB; Etienne, W; Landon, CD; Inman, BA; Dewhirst, MW; Stauffer, PR
MLA Citation
Salahi, S, Maccarini, PF, Rodrigues, DB, Etienne, W, Landon, CD, Inman, BA, Dewhirst, MW, and Stauffer, PR. "Miniature microwave applicator for murine bladder hyperthermia studies." Int J Hyperthermia 28.5 (2012): 456-465.
PMID
22690856
Source
pubmed
Published In
International Journal of Hyperthermia (Informa)
Volume
28
Issue
5
Publish Date
2012
Start Page
456
End Page
465
DOI
10.3109/02656736.2012.677931

Optimization of prostate biopsy referral decisions

Prostate cancer is the most common solid tumor in American men and is screened for using prostate-specific antigen (PSA) tests. We report on a nonstationary partially observable Markov decision process (POMDP) for prostate biopsy referral decisions. The core states are the patients' prostate cancer related health states, and PSA test results are the observations. Transition probabilities and rewards are inferred from the Mayo Clinic Radical Prostatectomy Registry and the medical literature. The objective of our model is to maximize expected qualityadjusted life years. We solve the POMDP model to obtain an age and belief (probability of having prostate cancer) dependent optimal biopsy referral policy. We also prove a number of structural properties including the existence of a control-limit type policy for the biopsy referral decision. Our empirical results demonstrate a nondecreasing belief threshold in age, and we provide sufficient conditions under which PSA screening should be discontinued for older patients. Finally, the benefits of screening under the optimal biopsy referral policy are estimated, and sensitivity analysis is used to prioritize the model parameters that would benefit from additional data collection. © 2012 INFORMS.

Authors
Zhang, J; Denton, BT; Balasubramanian, H; Shah, ND; Inman, BA
MLA Citation
Zhang, J, Denton, BT, Balasubramanian, H, Shah, ND, and Inman, BA. "Optimization of prostate biopsy referral decisions." Manufacturing and Service Operations Management 14.4 (2012): 529-547.
Source
scival
Published In
Manufacturing & Service Operations Management
Volume
14
Issue
4
Publish Date
2012
Start Page
529
End Page
547
DOI
10.1287/msom.1120.0388

Bilateral renal cell carcinoma in a child

Renal cell carcinoma is a rare renal tumor in the pediatric population with an incidence of 0.1-0.3%. We report on the first case of bilateral renal clear cell carcinoma that was treated by partial nephrectomies. We performed a complete genetic evaluation to exclude a family inheritance and we looked at the deletions associated with the possible histologic subtypes of renal cell carcinoma. The patient had no evidence of recurrence after 80-month follow-up and her renal function remained normal. © 2012 Elsevier Inc.

Authors
Cloutier, J; Aziz, A; Inman, B; Bolduc, S
MLA Citation
Cloutier, J, Aziz, A, Inman, B, and Bolduc, S. "Bilateral renal cell carcinoma in a child." Urology 80.2 (2012): 430-433.
PMID
22386253
Source
scival
Published In
Urology
Volume
80
Issue
2
Publish Date
2012
Start Page
430
End Page
433
DOI
10.1016/j.urology.2012.01.015

Open versus laparoscopic nephroureterectomy: Is there really a debate?

Authors
Inman, BA
MLA Citation
Inman, BA. "Open versus laparoscopic nephroureterectomy: Is there really a debate?." European Urology 61.4 (2012): 722-723.
PMID
22226580
Source
scival
Published In
European Urology
Volume
61
Issue
4
Publish Date
2012
Start Page
722
End Page
723
DOI
10.1016/j.eururo.2011.12.051

Optimization of PSA screening policies: A comparison of the patient and societal perspectives

Objective. To estimate the benefit of PSA-based screening for prostate cancer from the patient and societal perspectives. Method. A partially observable Markov decision process model was used to optimize PSA screening decisions. Age-specific prostate cancer incidence rates and the mortality rates from prostate cancer and competing causes were considered. The model trades off the potential benefit of early detection with the cost of screening and loss of patient quality of life due to screening and treatment. PSA testing and biopsy decisions are made based on the patient's probability of having prostate cancer. Probabilities are inferred based on the patient's complete PSA history using Bayesian updating. Data Sources. The results of all PSA tests and biopsies done in Olmsted County, Minnesota, from 1993 to 2005 (11,872 men and 50,589 PSA test results). Outcome Measures. Patients' perspective: to maximize expected quality-adjusted life years (QALYs); societal perspective: to maximize the expected monetary value based on societal willingness to pay for QALYs and the cost of PSA testing, prostate biopsies, and treatment. Results. From the patient perspective, the optimal policy recommends stopping PSA testing and biopsy at age 76. From the societal perspective, the stopping age is 71. The expected incremental benefit of optimal screening over the traditional guideline of annual PSA screening with threshold 4.0 ng/mL for biopsy is estimated to be 0.165 QALYs per person from the patient perspective and 0.161 QALYs per person from the societal perspective. PSA screening based on traditional guidelines is found to be worse than no screening at all. Conclusions. PSA testing done with traditional guidelines underperforms and therefore underestimates the potential benefit of screening. Optimal screening guidelines differ significantly depending on the perspective of the decision maker.

Authors
Zhang, J; Denton, BT; Balasubramanian, H; Shah, ND; Inman, BA
MLA Citation
Zhang, J, Denton, BT, Balasubramanian, H, Shah, ND, and Inman, BA. "Optimization of PSA screening policies: A comparison of the patient and societal perspectives." Medical Decision Making 32.2 (2012): 337-349.
PMID
21933990
Source
scival
Published In
Medical Decision Making
Volume
32
Issue
2
Publish Date
2012
Start Page
337
End Page
349
DOI
10.1177/0272989X11416513

Soluble B7-H1: Differences in production between dendritic cells and T cells

Tumor cells aberrantly express several T cell inhibitory molecules including members of the B7-H co-regulatory family. Presumably tumor-expressed B7-H1 and B7-H3 confer resistance to elimination by the immune system. In addition, elevated levels of soluble B7-H1 (sB7-H1) has been identified in the sera of cancer patients, including renal carcinoma patients and is associated with increased cancer related death. Here we report that sB7-H1 is produced and released by activated mature dendritic cells (mDC). Immature DC, macrophages, monocytes, or T cells are refractory to releasing sB7-H1. Exposure of CD4+ and CD8+ T cells to mDC-derived sB7-H1 molecules induced apoptosis. These data suggest that the immunobiology of B7-H1 is perhaps more complex than previously thought. sB7-H1 molecules may represent an unanticipated contributing factor to immune homeostasis. That both immune and tumor cells can be sources of sB7-H1 suggests that optimization of co-regulatory blockade immunotherapy for solid malignancies of necessity will require impact of targeting tumor and immune-derived B7-H1 molecules. © 2011 Elsevier B.V.

Authors
Frigola, X; Inman, BA; Krco, CJ; Liu, X; Harrington, SM; Bulur, PA; Dietz, AB; Dong, H; Kwon, ED
MLA Citation
Frigola, X, Inman, BA, Krco, CJ, Liu, X, Harrington, SM, Bulur, PA, Dietz, AB, Dong, H, and Kwon, ED. "Soluble B7-H1: Differences in production between dendritic cells and T cells." Immunology Letters 142.1-2 (2012): 78-82.
PMID
22138406
Source
scival
Published In
Immunology Letters
Volume
142
Issue
1-2
Publish Date
2012
Start Page
78
End Page
82
DOI
10.1016/j.imlet.2011.11.001

Simulation optimization of PSA-threshold based prostate cancer screening policies

We describe a simulation optimization method to design PSA screening policies based on expected quality adjusted life years (QALYs). Our method integrates a simulation model in a genetic algorithm which uses a probabilistic method for selection of the best policy. We present computational results about the efficiency of our algorithm. The best policy generated by our algorithm is compared to previously recommended screening policies. Using the policies determined by our model, we present evidence that patients should be screened more aggressively but for a shorter length of time than previously published guidelines recommend. © 2012 Springer Science+Business Media, LLC.

Authors
Underwood, DJ; Zhang, J; Denton, BT; Shah, ND; Inman, BA
MLA Citation
Underwood, DJ, Zhang, J, Denton, BT, Shah, ND, and Inman, BA. "Simulation optimization of PSA-threshold based prostate cancer screening policies." Health Care Management Science 15.4 (2012): 293-309.
PMID
22302420
Source
scival
Published In
Health Care Management Science
Volume
15
Issue
4
Publish Date
2012
Start Page
293
End Page
309
DOI
10.1007/s10729-012-9195-x

Dynamic prediction of metastases after radical prostatectomy for prostate cancer.

UNLABELLED: What's known on the subject? and What does the study add? One of two problems plagues virtually are existing post-prostatectomy prediction tools: either (1) they predict PSA recurrences (which are of unclear importance) or (2) the predictions they make are anchored at the date of surgery and are not updated based on how patients evolve over the postoperative years. Our prediction tool is a significant improvement over existing prediction tools in that it predicts the development of metastases which is a very important clinical endpoint that indicates incurable prostate cancer. Additionally, our tool allows for updated predictions at any point following radical prostatectomy by considering commonly available postoperative information (postoperative serum PSA and use of adjuvant therapies) to modify its risk predictions. The net result is a dynamic tool that renders clinically relevant predictions that change as the patient's clinical status changes throughout the postoperative course. OBJECTIVE: • To develop a dynamic algorithm that predicts the risk of metastases from any time point after radical prostatectomy (RP). PATIENTS AND METHODS: • The study cohort consisted of 5741 RP patients who were treated from 1990-99. • Patients were grouped into one of four clinical states at follow-up: State(1) , prostate-specific antigen (PSA) undetectable; State(2), PSA 0.15-0.39 ng/mL; State(3), PSA ≥0.4 ng/mL; and State(4), previous androgen deprivation or radiation therapy. • Follow-up epochs (alive and at risk of systemic progression) at 0, 2, 4 and 6 years post-RP, cumulative incidence curves and multistate Cox models were used to assess the risk of metastases over the ensuing 5-year interval. • Gleason score, seminal vesicle and surgical margin involvement, and PSA variables were evaluated as predictors. RESULTS: • Median follow-up was 11.7 years, with 4411, 4256 and 3983 patients followed with PSA at 2, 4 and 6 years, respectively. • In total, 287 metastatic events occurred and the 5-year risk of metastasis was 0.4%, 2.1%, 8.7% and 12.6% for men in States 1, 2, 3 and 4, respectively. • Independent predictors of metastasis by group included seminal vesicle involvement (all groups), Gleason score (groups 1, 3 and 4), current PSA (groups 3 and 4) and maximum past PSA (group 4). CONCLUSIONS: • We present a web-based prognostic tool for patients undergoing RP that is valid at many time points after surgery. • Our tool predicts the development of metastases.

Authors
Inman, BA; Frank, I; Boorjian, SA; Akornor, JW; Karnes, RJ; Leibovich, BC; Blute, ML; Bergstralh, EJ
MLA Citation
Inman, BA, Frank, I, Boorjian, SA, Akornor, JW, Karnes, RJ, Leibovich, BC, Blute, ML, and Bergstralh, EJ. "Dynamic prediction of metastases after radical prostatectomy for prostate cancer." BJU Int 108.11 (December 2011): 1762-1768.
PMID
21615849
Source
pubmed
Published In
Bju International
Volume
108
Issue
11
Publish Date
2011
Start Page
1762
End Page
1768
DOI
10.1111/j.1464-410X.2011.10208.x

CDX-1307: a novel vaccine under study as treatment for muscle-invasive bladder cancer.

Cancer vaccines have demonstrated clinical benefit, however greater efficacy could be achieved by enhancing their immunogenicity. Owing to cancer vaccines depending on uptake and cross-presentation of tumor antigens by antigen-presenting cells (APCs), we hypothesized that greater immunogenicity would accompany strategies that direct antigen to APC-expressed mannose receptors, initiating a pathway increasing class I and II presentation to T cells. CDX-1307 consists of a human monoclonal antibody targeting the mannose receptor, fused to the human chorionic gonadotropin-β chain (hCG-β), a tumor antigen frequently expressed by epithelial cancers including bladder cancer. In Phase I studies of cancer patients, CDX-1307 was well tolerated and induced significant hCG-β-specific cellular and humoral immune responses when co-administered with GM-CSF and the Toll-like receptor agonists resiquimod and poly-ICLC. An ongoing Phase II trial evaluates CDX-1307 in patients with newly diagnosed, resectable, hCG-β-expressing bladder cancer, where low tumor burden and early intervention may provide greater potential for benefit.

Authors
Morse, MA; Bradley, DA; Keler, T; Laliberte, RJ; Green, JA; Davis, TA; Inman, BA
MLA Citation
Morse, MA, Bradley, DA, Keler, T, Laliberte, RJ, Green, JA, Davis, TA, and Inman, BA. "CDX-1307: a novel vaccine under study as treatment for muscle-invasive bladder cancer." Expert Rev Vaccines 10.6 (June 2011): 733-742. (Review)
PMID
21692696
Source
pubmed
Published In
Expert Review of Vaccines
Volume
10
Issue
6
Publish Date
2011
Start Page
733
End Page
742
DOI
10.1586/erv.11.20

Third prize: the role of endoscopic nephron-sparing surgery in the management of upper tract urothelial carcinoma.

INTRODUCTION: Upper tract urothelial carcinoma (UT-UC) is an uncommon disease with pronounced difference in 5-year survival for noninvasive (96%) versus invasive (17%) disease. High survival rate of early disease questioned the accepted norm of using radical nephroureterectomy (RNU) for all stages. This review assesses effectiveness of endoscopic management for UT-UC. METHODS: A review of 131 UT-UC patients seen between January 1999 and October 2009 was performed. Demographic, clinicopathologic, and outcomes data were collected and compared between patients initially managed with RNU versus those initially managed with nephron-sparing surgery (NSS). The chi-square or Fisher's exact tests for categorical variables and the Wilcoxon-Mann-Whitney test for continuous variables were used. Clinical and pathologic stages of RNU patients were evaluated with chi-square testing, whereas difference in length of stay was detected using linear regression. Recurrence rates were compared using multivariate Cox regression. RESULTS: The two arms had similar distributions of age, sex, frequency of medical comorbidities, American Society of Anesthesiologists (ASA), and Charlson scores. Mean-adjusted length of stay was 2.1 (95% confidence interval [1.6, 2.5]) and 5.5 days (95% confidence interval [5.3, 6.4]) for the NSS and RNU groups, respectively (p < 0.001). Comparison of clinical and pathologic stages of RNU patients showed a difference (p < 0.001), with under-staging noted in 32%. Men (Hazards Ratio = 2.9 [1.5-5.5], p = 0.001) and NSS patients (hazards ratio [HR] = 3.5 [1.7-7.3], p < 0.001) had threefold increased recurrence risk. CONCLUSION: NSS offered shorter hospital stay but had increased risk of recurrence. Therefore, extreme care should be made to rule out occult invasive tumors preoperatively. Patients being managed endoscopically must be informed of the necessity for close follow-up.

Authors
Raymundo, EM; Lipkin, ME; Bañez, LB; Mancini, JG; Zilberman, DE; Preminger, GM; Inman, BA
MLA Citation
Raymundo, EM, Lipkin, ME, Bañez, LB, Mancini, JG, Zilberman, DE, Preminger, GM, and Inman, BA. "Third prize: the role of endoscopic nephron-sparing surgery in the management of upper tract urothelial carcinoma." J Endourol 25.3 (March 2011): 377-384.
PMID
21401392
Source
pubmed
Published In
Journal of Endourology
Volume
25
Issue
3
Publish Date
2011
Start Page
377
End Page
384
DOI
10.1089/end.2010.0276

Is tumor response important for renal carcinoma?

Authors
Inman, BA; George, DJ
MLA Citation
Inman, BA, and George, DJ. "Is tumor response important for renal carcinoma?." European Urology 59.1 (2011): 16-17.
PMID
20970245
Source
scival
Published In
European Urology
Volume
59
Issue
1
Publish Date
2011
Start Page
16
End Page
17
DOI
10.1016/j.eururo.2010.10.010

The role of a combined regimen with intravesical chemotherapy and hyperthermia in the management of non-muscle-invasive bladder cancer: A systematic review

Context: Due to the suboptimal clinical outcomes of current therapies for non-muscle-invasive bladder cancer (NMIBC), the search for better therapeutic options continues. One option is chemohyperthermia (C-HT): microwave-induced hyperthermia (HT) with intravesical chemotherapy, typically mitomycin C (MMC). During the last 15 yr, the combined regimen has been tested in different clinical settings. Objective: To perform a systematic review to evaluate the efficacy of C-HT as a treatment for NMIBC. Evidence acquisition: The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. An electronic search of the Medline, Embase, Cochrane Library, CancerLit, and ClinicalTrials.gov databases was undertaken. Relevant conference abstracts and urology journals were also searched manually. Two reviewers independently reviewed candidate studies for eligibility and abstracted data from studies that met inclusion criteria. The primary end point was time to recurrence. Secondary end points included time to progression, bladder preservation rate, and adverse event (AE) rate. Evidence synthesis: A total of 22 studies met inclusion criteria and underwent data extraction. When possible, data were combined using random effects meta-analytic techniques. Recurrence was seen 59% less after C-HT than after MMC alone. Due to short follow-up, no conclusions can be drawn about time to recurrence and progression. The overall bladder preservation rate after C-HT was 87.6%. This rate appeared higher than after MMC alone, but valid comparison studies were lacking. AEs were higher with C-HT than with MMC alone, but this difference was not statistically significant. Conclusions: Published data suggest a 59% relative reduction in NMIBC recurrence when C-HT is compared with MMC alone. C-HT also appears to improve bladder preservation rate. However, due to a limited number of randomized trials and to heterogeneity in study design, definitive conclusions cannot be drawn. In the future, C-HT may become standard therapy for high-risk patients with recurrent tumors, for patients who are unsuitable for radical cystectomy, and in cases for which bacillus Calmette-Guérin treatment is contraindicated. © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Authors
Lammers, RJM; Witjes, JA; Inman, BA; Leibovitch, I; Laufer, M; Nativ, O; Colombo, R
MLA Citation
Lammers, RJM, Witjes, JA, Inman, BA, Leibovitch, I, Laufer, M, Nativ, O, and Colombo, R. "The role of a combined regimen with intravesical chemotherapy and hyperthermia in the management of non-muscle-invasive bladder cancer: A systematic review." European Urology 60.1 (2011): 81-93.
PMID
21531502
Source
scival
Published In
European Urology
Volume
60
Issue
1
Publish Date
2011
Start Page
81
End Page
93
DOI
10.1016/j.eururo.2011.04.023

Identification of a soluble form of B7-H1 that retains immunosuppressive activity and is associated with aggressive renal cell carcinoma

Purpose: Release of inhibitory coregulatory proteins into the circulation may represent one mechanism by which tumors thwart immune responses. Our objective was to determine whether soluble B7-H1 (sB7-H1) levels in patients with clear cell renal cell carcinoma (ccRCC) are associated with pathologic features and patient outcome. Experimental Design: We developed an ELISA for quantification of sB7-H1 in biological fluids. Biochemical confirmation of the measured analyte as sB7-H1 was done by protein microsequencing using supernates from tumor cell lines. Biological activity of sB7-H1 was assessed in vitro utilizing T-cell apoptosis assays. We tested sB7-H1 levels in the sera from 172 ccRCC patients and correlated sB7-H1 levels with pathologic features and patient outcome. Results: sB7-H1 was detected in the cell supernatants of some B7-H1-positive tumor cell lines. Protein sequencing established that the measured sB7-H1 retained its receptor-binding domain and could deliver proapoptotic signals to T cells. Higher preoperative sB7-H1 levels were associated with larger tumors (P < 0.001), tumors of advanced stage (P=0.017) and grade (P=0.044), and tumors with necrosis (P=0.003). A doubling of sB7-H1 levels was associated with a 41% increased risk of death (P = 0.010). Conclusion: Our observations suggest that sB7-H1 may be detected in the sera of ccRCC patients and that sB7-H1 may systemically impair host immunity, thereby fostering cancer progression and subsequent poor clinical outcome. ©2011 AACR.

Authors
Frigola, X; Inman, BA; Lohse, CM; Krco, CJ; Cheville, JC; Thompson, RH; Leibovich, B; Blute, ML; Dong, H; Kwon, ED
MLA Citation
Frigola, X, Inman, BA, Lohse, CM, Krco, CJ, Cheville, JC, Thompson, RH, Leibovich, B, Blute, ML, Dong, H, and Kwon, ED. "Identification of a soluble form of B7-H1 that retains immunosuppressive activity and is associated with aggressive renal cell carcinoma." Clinical Cancer Research 17.7 (2011): 1915-1923.
PMID
21355078
Source
scival
Published In
Clinical cancer research : an official journal of the American Association for Cancer Research
Volume
17
Issue
7
Publish Date
2011
Start Page
1915
End Page
1923
DOI
10.1158/1078-0432.CCR-10-0250

Hyperthermia as a treatment for bladder cancer.

Modern cancer care is characterized by a focus on organ-sparing multi-modal treatments. In the case of non-muscle-invasive bladder cancer this is particularly true; treatment is focused on reducing the frequency of low-risk recurrences and preventing high-risk progression. Deep regional hyperthermia is an oncologic therapeutic modality that can help achieve these two goals. The combination of hyperthermia with chemotherapy and radiotherapy has improved patient outcomes in several tumor types. In this review, we highlight the biology of therapeutic fever-range hyperthermia, discuss how hyperthermia is administered and dosed, demonstrate how heat can be added to other treatment regimens, and summarize the data supporting the role of hyperthermia in the management of bladder cancer.

Authors
Rampersaud, EN; Vujaskovic, Z; Inman, BA
MLA Citation
Rampersaud, EN, Vujaskovic, Z, and Inman, BA. "Hyperthermia as a treatment for bladder cancer." Oncology (Williston Park) 24.12 (November 15, 2010): 1149-1155. (Review)
PMID
21141697
Source
pubmed
Published In
Oncology
Volume
24
Issue
12
Publish Date
2010
Start Page
1149
End Page
1155

Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer.

BACKGROUND: The Exercise Intensity Trial (EXcITe) is a randomized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training, relative to attention control, on aerobic capacity, physiologic mechanisms, patient-reported outcomes, and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy. METHODS/DESIGN: Using a single-center, randomized design, 174 postmenopausal women (58 patients/study arm) with histologically confirmed, operable breast cancer presenting to Duke University Medical Center (DUMC) will be enrolled in this trial following completion of primary therapy (including surgery, radiation therapy, and chemotherapy). After baseline assessments, eligible participants will be randomized to one of two supervised aerobic training interventions (moderate-intensity or moderate/high-intensity aerobic training) or an attention-control group (progressive stretching). The aerobic training interventions will include 150 mins.wk⁻¹ of supervised treadmill walking per week at an intensity of 60%-70% (moderate-intensity) or 60% to 100% (moderate to high-intensity) of the individually determined peak oxygen consumption (VO₂peak) between 20-45 minutes/session for 16 weeks. The progressive stretching program will be consistent with the exercise interventions in terms of program length (16 weeks), social interaction (participants will receive one-on-one instruction), and duration (20-45 mins/session). The primary study endpoint is VO₂peak, as measured by an incremental cardiopulmonary exercise test. Secondary endpoints include physiologic determinants that govern VO₂peak, patient-reported outcomes, and biomarkers associated with breast cancer recurrence/mortality. All endpoints will be assessed at baseline and after the intervention (16 weeks). DISCUSSION: EXCITE is designed to investigate the intensity of aerobic training required to induce optimal improvements in VO₂peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer. Overall, this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy. TRIAL REGISTRATION: NCT01186367.

Authors
Jones, LW; Douglas, PS; Eves, ND; Marcom, PK; Kraus, WE; Herndon, JE; Inman, BA; Allen, JD; Peppercorn, J
MLA Citation
Jones, LW, Douglas, PS, Eves, ND, Marcom, PK, Kraus, WE, Herndon, JE, Inman, BA, Allen, JD, and Peppercorn, J. "Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer. (Published online)" BMC Cancer 10 (October 6, 2010): 531-.
Website
http://hdl.handle.net/10161/4358
PMID
20925920
Source
pubmed
Published In
BMC Cancer
Volume
10
Publish Date
2010
Start Page
531
DOI
10.1186/1471-2407-10-531

THE ROLE OF ENDOSCOPIC NEPHRON-SPARING SUREGY IN THE MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA

Authors
Raymundo, MEM; Lipkin, ME; Banez, LL; Mancini, JG; Yong, DZ; Zilberman, DE; Preminger, GM; Inman, BA
MLA Citation
Raymundo, MEM, Lipkin, ME, Banez, LL, Mancini, JG, Yong, DZ, Zilberman, DE, Preminger, GM, and Inman, BA. "THE ROLE OF ENDOSCOPIC NEPHRON-SPARING SUREGY IN THE MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA." September 2010.
Source
wos-lite
Published In
Journal of Endourology
Volume
24
Publish Date
2010
Start Page
A264
End Page
A265

Imaging tumors of the penis and urethra.

In penile and urethral cancers, imaging has come to play a crucial role in enhancing the precision of clinical staging and facilitating optimal surgical planning. Over the years, great improvements have occurred in imaging. High-resolution magnetic resonance imaging (MRI) now represents the gold standard for evaluating the primary tumor and its local extension. Lymphotropic nanoparticle-enhanced MRI, dynamic sentinel lymph node biopsy, and ultrasonography with fine-needle aspiration seem to be the superior modalities for detecting malignant regional lymph nodes. Positron emission tomography combined with computed tomography has shown great promise as a whole body screen for the detection of distant metastases. Ultimately, the ability of imaging to augment clinical evaluation and enhance the accuracy of staging penile and urethral cancers will translate into improved surgical decision making and overall superior patient outcomes.

Authors
Stewart, SB; Leder, RA; Inman, BA
MLA Citation
Stewart, SB, Leder, RA, and Inman, BA. "Imaging tumors of the penis and urethra." Urol Clin North Am 37.3 (August 2010): 353-367.
PMID
20674692
Source
pubmed
Published In
Urologic Clinics of North America
Volume
37
Issue
3
Publish Date
2010
Start Page
353
End Page
367
DOI
10.1016/j.ucl.2010.04.014

A randomized phase II study of a novel antigen-presenting cell-targeted hCG-beta vaccine (the CDX-1307 regimen) in muscle-invasive bladder cancer

Authors
Bradley, DA; Morse, M; Keler, T; Green, JA; Davis, TA; Inman, BA
MLA Citation
Bradley, DA, Morse, M, Keler, T, Green, JA, Davis, TA, and Inman, BA. "A randomized phase II study of a novel antigen-presenting cell-targeted hCG-beta vaccine (the CDX-1307 regimen) in muscle-invasive bladder cancer." May 20, 2010.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
28
Issue
15
Publish Date
2010

Pilot study of external hyperthermia and intravesical mitomycin-C to treat recurrent biadder cancer after failed standard therapy

Authors
Vujaskovic, Z; Craciunescu, OI; Stauffer, P; Carroll, M; Lan, L; Dewhirst, M; Inman, BA
MLA Citation
Vujaskovic, Z, Craciunescu, OI, Stauffer, P, Carroll, M, Lan, L, Dewhirst, M, and Inman, BA. "Pilot study of external hyperthermia and intravesical mitomycin-C to treat recurrent biadder cancer after failed standard therapy." May 20, 2010.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
28
Issue
15
Publish Date
2010

Dextranomer/hyaluronic acid for pediatric vesicoureteral reflux: systematic review.

OBJECTIVE: Published success rates of dextranomer/hyaluronic acid (Dx/HA) injection for pediatric vesicoureteral reflux (VUR) vary widely. Our objective of this study was to assess whether underlying patient or study factors could explain the heterogeneity in reported Dx/HA success rates. METHODS: We searched the Cochrane Controlled Trials Register and Medline, Embase, and Scopus databases from 1990 to 2008 for reports in any language, along with a hand search of included study bibliographies. Articles were assessed and data abstracted in duplicate, and differences were resolved by consensus. Conflict of interest (COI) was determined by published disclosure. Meta-regression was performed to adjust for patient as well as study-level factors. RESULTS: We identified 1157 reports, 89 of which were reviewed in full with 47 included in the pooled analysis. Of 7303 ureters that were injected with Dx/HA, 5633 (77%) were successfully treated according to the authors' definition. Injection success seemed to vary primarily on the basis of the preoperative reflux grade. After adjustment for VUR grade, other factors, such as the presence or absence of COI disclosure, were not significant. Studies were markedly heterogeneous overall. CONCLUSIONS: The overall per-ureter Dx/HA success rate was 77% after 3 months, although success rates varied widely among studies. Increased VUR grade negatively affected success rates, whereas COI, patient age, and injected Dx/HA volume were not significantly associated with treatment outcome after adjustment for VUR grade. There is a significant need for improved reporting of VUR treatments, including comparative studies of Dx/HA and other VUR treatments.

Authors
Routh, JC; Inman, BA; Reinberg, Y
MLA Citation
Routh, JC, Inman, BA, and Reinberg, Y. "Dextranomer/hyaluronic acid for pediatric vesicoureteral reflux: systematic review." Pediatrics 125.5 (May 2010): 1010-1019. (Review)
PMID
20368325
Source
pubmed
Published In
Pediatrics
Volume
125
Issue
5
Publish Date
2010
Start Page
1010
End Page
1019
DOI
10.1542/peds.2009-2225

Carcinoma of the upper urinary tract: predictors of survival and competing causes of mortality.

BACKGROUND: Carcinomas of the upper urinary tract are uncommon tumors that usually occurred in elderly patients. Competing causes of mortality should be considered when treating these patients. METHODS: All patients with upper urinary tract tumors who were treated surgically at Centre Hospitalier Universitaire de Québec and affiliated hospitals from 1978 to 2001 were retrospectively reviewed. Clinical and pathologic variables were assessed from both the preoperative and postoperative periods of management, and clinical outcomes were tracked. Competing risks regression, Cox proportional hazards modeling, and multiple imputation were used to assess predictors of cancer-related and competing risks-related mortality in both preoperative and postoperative settings. RESULTS: Competing risks were responsible for 46% of deaths in this cohort of 168 patients. Preoperatively, the most important predictor of cancer-related mortality was a clinically invasive tumor (hazards ratio [HR], 3.97; P < .001), whereas increasing age (HR, 1.07; P < .001) was found to be the most important predictor of competing mortality. Postoperatively, tumor grade was the most important predictor of cancer-related mortality (HR, 3.92; P < .001) whereas constitutional symptoms (HR, 1.91; P = .015) and increasing age (HR, 1.06; P < .001) were found to be predictive of competing mortality. CONCLUSIONS: In the current study, stage and grade were found to be the 2 most important independent predictors of survival in patients with tumors of the upper urinary tract and were highly correlated. Pain or weight loss was found to be a novel predictor of survival in this cancer. Although a survival disadvantage was not noted for women, nephron-sparing surgery, ureteral tumors, or older patients with respect to cancer, competing causes of mortality were found to be responsible for greater than one-third of observed deaths and age was the best predictor of this occurrence.

Authors
Inman, BA; Tran, V-T; Fradet, Y; Lacombe, L
MLA Citation
Inman, BA, Tran, V-T, Fradet, Y, and Lacombe, L. "Carcinoma of the upper urinary tract: predictors of survival and competing causes of mortality." Cancer 115.13 (July 1, 2009): 2853-2862.
PMID
19434668
Source
pubmed
Published In
Cancer
Volume
115
Issue
13
Publish Date
2009
Start Page
2853
End Page
2862
DOI
10.1002/cncr.24339

The Impact of Obesity on Overall and Cancer Specific Survival in Men With Prostate Cancer EDITORIAL COMMENT

Authors
Inman, BA
MLA Citation
Inman, BA. "The Impact of Obesity on Overall and Cancer Specific Survival in Men With Prostate Cancer EDITORIAL COMMENT." JOURNAL OF UROLOGY 182.1 (July 2009): 117-117.
Source
wos-lite
Published In
The Journal of Urology
Volume
182
Issue
1
Publish Date
2009
Start Page
117
End Page
117

Restoring host antitumoral immunity: how coregulatory molecules are changing the approach to the management of renal cell carcinoma

In the second edition of their critically acclaimed book, Ronald Bukowski, Robert Motzer, and Robert Figlin have thoroughly updated and expanded their survey of clinical, biological and pathological management of localized and advanced ...

Authors
Inman, BA; Frigola, X; Dong, H; Yang, JC; Kwon, ED
MLA Citation
Inman, BA, Frigola, X, Dong, H, Yang, JC, and Kwon, ED. "Restoring host antitumoral immunity: how coregulatory molecules are changing the approach to the management of renal cell carcinoma." Renal Cell Carcinoma. Ed. RM Bukowski, RA Figlin, and R Motzer. Humana Press, March 3, 2009. 367-434.
Source
manual
Publish Date
2009
Start Page
367
End Page
434

A population-based, longitudinal study of erectile dysfunction and future coronary artery disease.

OBJECTIVE: To assess the association between erectile dysfunction (ED) and the long-term risk of coronary artery disease (CAD) and the role of age as a modifier of this association. PARTICIPANTS AND METHODS: From January 1, 1996, to December 31, 2005, we biennially screened a random sample of 1402 community-dwelling men with regular sexual partners and without known CAD for the presence of ED. Incidence densities of CAD were calculated after age stratification and adjusted for potential confounders by time-dependent Cox proportional hazards models. RESULTS: The prevalence of ED was 2% for men aged 40 to 49 years, 6% for men aged 50 to 59 years, 17% for men aged 60 to 69 years, and 39% for men aged 70 years or older. The CAD incidence densities per 1000 person-years for men without ED in each age group were 0.94 (40-49 years), 5.09 (50-59 years), 10.72 (60-69 years), and 23.30 (> or =70 years). For men with ED, the incidence densities of CAD for each age group were 48.52 (40-49 years), 27.15 (50-59 years), 23.97 (60-69 years), and 29.63 (> or =70 years). CONCLUSION: ED and CAD may be differing manifestations of a common underlying vascular pathology. When ED occurs in a younger man, it is associated with a marked increase in the risk of future cardiac events, whereas in older men, ED appears to be of little prognostic importance. Young men with ED may be ideal candidates for cardiovascular risk factor screening and medical intervention.

Authors
Inman, BA; Sauver, JLS; Jacobson, DJ; McGree, ME; Nehra, A; Lieber, MM; Roger, VL; Jacobsen, SJ
MLA Citation
Inman, BA, Sauver, JLS, Jacobson, DJ, McGree, ME, Nehra, A, Lieber, MM, Roger, VL, and Jacobsen, SJ. "A population-based, longitudinal study of erectile dysfunction and future coronary artery disease." Mayo Clin Proc 84.2 (February 2009): 108-113.
PMID
19181643
Source
pubmed
Published In
Mayo Clinic Proceedings
Volume
84
Issue
2
Publish Date
2009
Start Page
108
End Page
113
DOI
10.4065/84.2.108

A population-based, longitudinal study of erectile dysfunction and future coronary artery disease

Authors
Inman, BA; Sauver, JLS; Jacobson, DJ; McGree, ME; Nehra, A; Lieber, MM; Roger, VL; Jacobsen, SJ
MLA Citation
Inman, BA, Sauver, JLS, Jacobson, DJ, McGree, ME, Nehra, A, Lieber, MM, Roger, VL, and Jacobsen, SJ. "A population-based, longitudinal study of erectile dysfunction and future coronary artery disease." Obstetrical and Gynecological Survey 64.7 (2009): 459-460.
Source
scival
Published In
Obstetrical and Gynecological Survey
Volume
64
Issue
7
Publish Date
2009
Start Page
459
End Page
460
DOI
10.1097/01.ogx.0000351674.39682.89

Obstructive sleep apnea associated with erectile dysfunction and cardiovascular disease: Reply

Authors
Sauver, JLS; Jacobson, DJ; Nehra, A; Inman, BA; Jacobsen, SJ
MLA Citation
Sauver, JLS, Jacobson, DJ, Nehra, A, Inman, BA, and Jacobsen, SJ. "Obstructive sleep apnea associated with erectile dysfunction and cardiovascular disease: Reply." Mayo Clinic Proceedings 84.6 (2009): 562--.
Source
scival
Published In
Mayo Clinic Proceedings
Volume
84
Issue
6
Publish Date
2009
Start Page
562-
DOI
10.4065/84.6.562-a

Outcome Analysis of Urethral Wall Stent Insertion With Artificial Urinary Sphincter Placement for Severe Recurrent Bladder Neck Contracture Following Radical Prostatectomy

Purpose: We present outcome and quality of life analyses for the treatment of post-radical prostatectomy bladder neck contracture with urethral wall stent insertion and subsequent artificial urinary sphincter placement. Materials and Methods: A retrospective analysis from June 2001 to September 2007 identified 25 consecutive men who underwent urethral wall stent placement for severe, recurrent bladder neck contracture despite aggressive transurethral resection after radical prostatectomy. Assessment of symptoms and quality of life impact from urinary incontinence was conducted with a self-administered, standardized questionnaire. Nonparametric testing was used for comparing covariates among groups. Univariate Cox proportional hazards modeling was used to assess predictors of treatment failure. P values are double-sided and are considered statistically significant if ≤0.05. Results: Etiology of recurrent bladder neck contracture was radical prostatectomy in all patients. Concurrent severe stress incontinence before treatment of bladder neck contracture was noted in 23 of 25 patients (92%). Before urethral wall stent insertion a median of 3 (IQR 2 to 5) failed endoscopic treatments were performed. Bladder neck contracture stabilization with insertion of 1 urethral wall stent was noted in 13 of 25 (52%) patients with a median followup of 2.9 years from last urethral wall stent insertion. Multiple urethral wall stent insertions (range 2 to 4) salvaged an additional 6 of 25 (24%) patients and failure to obtain patency was observed in 6 of 25 (24%). All patients responded to the questionnaire and quality of life improvement was noted in 23 of 25 patients (92%). Conclusions: Urethral wall stent and delayed artificial urinary sphincter placement for treatment of severe, recurrent bladder neck contracture and incontinence after radical prostatectomy is associated with improvement in quality of life. Long-term followup is required to further delineate the efficacy of this treatment approach. © 2009 American Urological Association.

Authors
Jr, JSM; Inman, BA; Elliott, DS
MLA Citation
Jr, JSM, Inman, BA, and Elliott, DS. "Outcome Analysis of Urethral Wall Stent Insertion With Artificial Urinary Sphincter Placement for Severe Recurrent Bladder Neck Contracture Following Radical Prostatectomy." Journal of Urology 181.3 (2009): 1236-1241.
PMID
19152938
Source
scival
Published In
The Journal of Urology
Volume
181
Issue
3
Publish Date
2009
Start Page
1236
End Page
1241
DOI
10.1016/j.juro.2008.11.011

Editorial Comment

Authors
Inman, BA
MLA Citation
Inman, BA. "Editorial Comment." Journal of Urology 181.2 (2009): 591--.
Source
scival
Published In
The Journal of Urology
Volume
181
Issue
2
Publish Date
2009
Start Page
591-
DOI
10.1016/j.juro.2008.10.175

Early detection of prostate cancer local recurrence by urinary prostate-specific antigen

Purpose: We assessed the role of urinary prostate-specific antigen (uPSA) in the follow-up of prostate cancer after retropubic radical prostatectomy (RRP) for the early detection of local recurrences. Methods: We recruited 50 patients previously treated for prostate cancer with RRP and who had not experienced a prostatespecific antigen (PSA) recurrence within their first postoperative year into a cross-sectional laboratory assessment and prospective 6-year longitudinal follow-up study. We defined biochemical failure as a serum PSA (sPSA) of 0.3 μg/L or greater. Patients provided blood samples and a 50-mL sample of first-voided urine. We performed Wilcoxon rank-sum and Fisher exact tests for statistical analysis. Results: The median sPSA was 0.13 μg/L. The median uPSA was 0.8 μg/L, and was not significantly different when comparing Gleason scores or pathological stages. Of the 50 patients, 27 initially had a nondetectable sPSA but a detectable uPSA, and 11 patients experienced sPSA failure after 6 years. Six patients had detectable sPSA and uPSA initially. Fifteen patients were negative for both sPSA and uPSA, and 13 remained sPSA-free after 6 years. The odds ratio (OR) of having sPSA failure given a positive uPSA test was 4.5 if sPSA was undetectable, but was reduced to 2.6 if sPSA was detectable. The pooled Mantel-Haenszel OR of 4.2 suggested that a detectable uPSA quadrupled the risk of recurrence, independent of whether sPSA was elevated or not. The sensitivity of uPSA for detecting future sPSA recurrences was 81% and specificity was 45%. Conclusion: Urinary PSA could contribute to an early detection of local recurrences of prostate cancer after a radical prostatectomy. © 2009 Canadian Urological Association.

Authors
Bolduc, S; Inman, BA; Lacombe, L; Fradet, Y; Tremblay, RR
MLA Citation
Bolduc, S, Inman, BA, Lacombe, L, Fradet, Y, and Tremblay, RR. "Early detection of prostate cancer local recurrence by urinary prostate-specific antigen." Journal of the Canadian Urological Association 3.3 (2009): 213-217.
PMID
19543465
Source
scival
Published In
Canadian Urological Association journal = Journal de l'Association des urologues du Canada
Volume
3
Issue
3
Publish Date
2009
Start Page
213
End Page
217

Effects of Curcumin in an Orthotopic Murine Bladder Tumor Model EDITORIAL COMMENT

Authors
Inman, BA
MLA Citation
Inman, BA. "Effects of Curcumin in an Orthotopic Murine Bladder Tumor Model EDITORIAL COMMENT." INTERNATIONAL BRAZ J UROL 35.5 (2009): 607-607.
Source
wos-lite
Published In
International braz j urol : official journal of the Brazilian Society of Urology
Volume
35
Issue
5
Publish Date
2009
Start Page
607
End Page
607

Urothelial Cell Carcinoma of the Upper Urinary Tract: Introduction

A hugely important book that details significant changes in imaging in oncological conditions related to the bladder, prostate and kidneys. The sole focus is on oncology in urology, mainly Ultrasound and MRI, with organ-oriented topics.

Authors
Inman, BA; Blute, ML; Hartman, RP
MLA Citation
Inman, BA, Blute, ML, and Hartman, RP. "Urothelial Cell Carcinoma of the Upper Urinary Tract: Introduction." Imaging in Oncological Urology. Ed. JJMCH Rosette, MJ Manyak, MG Harisinghani, and H Wijkstra. Springer, December 22, 2008. 115-120.
Source
manual
Publish Date
2008
Start Page
115
End Page
120

Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level > or =50 ng/mL.

BACKGROUND: The authors evaluated the long-term outcomes of men with prostate cancer and very high (> or =50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy. METHODS: This study included 236 men with preoperative serum PSA values > or =50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels > or =100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality. RESULTS: Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and > or =100 ng/mL were 43% and 36% at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA > or =100 ng/mL groups were 83% and 74% at 10 years, respectively. Estimated overall cancer-specific survival was 87% at 10 years. CONCLUSIONS: Patients with prostate cancer and a serum PSA level > or =50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.

Authors
Inman, BA; Davies, JD; Rangel, LJ; Bergstralh, EJ; Kwon, ED; Blute, ML; Karnes, RJ; Leibovich, BC
MLA Citation
Inman, BA, Davies, JD, Rangel, LJ, Bergstralh, EJ, Kwon, ED, Blute, ML, Karnes, RJ, and Leibovich, BC. "Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level > or =50 ng/mL." Cancer 113.7 (October 1, 2008): 1544-1551.
PMID
18680171
Source
pubmed
Published In
Cancer
Volume
113
Issue
7
Publish Date
2008
Start Page
1544
End Page
1551
DOI
10.1002/cncr.23767

Is the location of a positive surgical margin after radical prostatectomy important for prognosis?

This Practice Point commentary discusses the findings and limitations of the study by Eastham and co-workers, which concludes that the location of a positive surgical margin after radical prostatectomy is important for prognosis. The study found that posterolateral margins markedly increased the risk of biochemical failure while apical margins did not. Posterolateral margin status was found to be even more important for predicting biochemical failure than was lymph node positivity or seminal vesicle invasion. For several reasons, however, these results might not be generalizable to other groups of patients or to clinically relevant end points, such as cancer-specific survival. Consequently, these data should be regarded as preliminary and should not inform therapeutic decisions. Instead, knowledge of the most-common sites of margin positivity might direct surgeons to examine any shortcomings in their surgical technique. We contend that positive margins can be prevented at even the most difficult-to-access locations if appropriate steps are taken.

Authors
Inman, BA; Myers, RP
MLA Citation
Inman, BA, and Myers, RP. "Is the location of a positive surgical margin after radical prostatectomy important for prognosis?." Nat Clin Pract Urol 5.9 (September 2008): 476-477.
PMID
18648332
Source
pubmed
Published In
Nature Clinical Practice Urology
Volume
5
Issue
9
Publish Date
2008
Start Page
476
End Page
477
DOI
10.1038/ncpuro1151

Unilateral vesicoureteral reflux: does endoscopic injection based on the cystoscopic appearance of the ureteral orifice decrease the incidence of de-novo contralateral reflux?

OBJECTIVE: In patients with unilateral vesicoureteral reflux (VUR), it has been suggested that injection of a non-refluxing but cystoscopically abnormal contralateral ureteral orifice (UO) with dextranomer/hyaluronic acid (Dx/HA) should be performed to prevent the development of de-novo contralateral VUR. We evaluate the effectiveness of this practice. PATIENTS AND METHODS: Patients with primary unilateral VUR undergoing injection of Dx/HA from 2002 to 2005 at two institutions were eligible. Patients with unilateral VUR with cystoscopically abnormal contralateral UOs were injected with Dx/HA, while patients with normal appearing UOs received no treatment. Multivariate logistic regression models were used to estimate the impact of prophylactic injection on the development of de-novo contralateral VUR. RESULTS: In total, 101 patients with unilateral VUR and an abnormal appearing contralateral UO underwent prophylactic injection of Dx/HA while 45 patients with a normal appearing contralateral UO were untreated. In patients receiving prophylactic Dx/HA, 9% (9/101) of the previously non-refluxing ureters developed de-novo VUR. Similarly, 13% (6/45) of patients with a normal appearing UO treated by observation alone developed de-novo VUR (P=0.55). The overall incidence of 10% (15/146) de-novo contralateral VUR matches published results where this protocol was not followed. CONCLUSIONS: Our findings suggest that cystoscopic assessment and prophylactic treatment of an abnormal appearing, non-refluxing contralateral UO with Dx/HA is of little clinical benefit and should be abandoned.

Authors
Routh, JC; Inman, BA; Ashley, RA; Vandersteen, DR; Reinberg, Y; Wolpert, JJ; Kramer, SA; Husmann, DA
MLA Citation
Routh, JC, Inman, BA, Ashley, RA, Vandersteen, DR, Reinberg, Y, Wolpert, JJ, Kramer, SA, and Husmann, DA. "Unilateral vesicoureteral reflux: does endoscopic injection based on the cystoscopic appearance of the ureteral orifice decrease the incidence of de-novo contralateral reflux?." J Pediatr Urol 4.4 (August 2008): 260-264.
PMID
18644526
Source
pubmed
Published In
Journal of Pediatric Urology
Volume
4
Issue
4
Publish Date
2008
Start Page
260
End Page
264
DOI
10.1016/j.jpurol.2007.12.008

Therapeutic counseling for the medical management of renal cell carcinoma

This book is a state-of-the-art reference work covering every aspect of the field of renal cell cancer, from diagnostics to clinical management.

Authors
Inman, BA; Leibovich, BC
MLA Citation
Inman, BA, and Leibovich, BC. "Therapeutic counseling for the medical management of renal cell carcinoma." Renal Cell Cancer: Diagnosis and Therapy. Ed. JJMCH Rosette, CN Sternberg, and HPV Poppel. Springer, July 11, 2008. 515-534.
Source
manual
Publish Date
2008
Start Page
515
End Page
534

Sacral neuromodulation for the dysfunctional elimination syndrome: a single center experience with 20 children.

PURPOSE: Recent advances in neuromodulation have demonstrated promise in treating children with the dysfunctional elimination syndrome refractory to medical management. Sacral nerve stimulation with the InterStim implantable device has been used in adults for management of chronic urinary complaints. However, there are few data regarding the usefulness of sacral nerve stimulation in children. We report our experience with sacral nerve stimulation for severe dysfunctional elimination syndrome. MATERIALS AND METHODS: A total of 20 patients 8 to 17 years old with the dysfunctional elimination syndrome refractory to maximum medical treatment underwent sacral nerve stimulation at our institution. Patients were followed prospectively for a median of 27 months after the procedure. RESULTS: Urinary incontinence, urgency and frequency, nocturnal enuresis and constipation were improved or resolved in 88% (14 of 16), 69% (9 of 13), 89% (8 of 9), 69% (11 of 16) and 71% (12 of 17) of the patients, respectively. Urinary retention requiring intermittent catheterization persisted in 75% of the patients (3 of 4) despite sacral nerve stimulation. Complications requiring operative treatment occurred in 20% of the patients (4 of 20). Following marked symptomatic improvement 2 devices were explanted at 20 and 19 months following placement, and both patients have remained symptom-free. CONCLUSIONS: Sacral nerve stimulation is effective in the majority of our patients, and should be considered in children with severe dysfunctional elimination syndrome refractory to maximum medical treatment.

Authors
Roth, TJ; Vandersteen, DR; Hollatz, P; Inman, BA; Reinberg, YE
MLA Citation
Roth, TJ, Vandersteen, DR, Hollatz, P, Inman, BA, and Reinberg, YE. "Sacral neuromodulation for the dysfunctional elimination syndrome: a single center experience with 20 children." J Urol 180.1 (July 2008): 306-311.
PMID
18499169
Source
pubmed
Published In
The Journal of Urology
Volume
180
Issue
1
Publish Date
2008
Start Page
306
End Page
311
DOI
10.1016/j.juro.2008.03.033

Reassessing the diagnostic yield of saturation biopsy of the prostate.

OBJECTIVE: Prostate biopsy remains the gold standard for detection of prostate cancer (PCa). This study was performed to determine whether saturation biopsy (>or= 24 cores) detects more prostate cancer than a standard 12-18 core office biopsy technique. METHODS: We conducted a nonrandomized cohort study of a consecutive series of prostate biopsies. The primary outcome assessed by both univariate and multivariate analysis was the detection of PCa, whereas the secondary outcomes of HGPIN (high-grade prostatic intraepithelial neoplasia) and ASAP (atypical small acinar proliferation) were also analyzed. RESULTS: From September 2005 to June 2006, a total of 469 patients undergoing prostate biopsy were included in this study. A standard office prostate biopsy was performed in 301 men, whereas 168 underwent a saturation biopsy. Age, body mass index (BMI), prostate volume, and family history of PCa were similar. However, patients in the saturation biopsy cohort were more likely to have had prior biopsies, higher prebiopsy PSA, longer PSA doubling times, and to carry more frequent diagnoses of HGPIN or ASAP (all p<0.05). After adjusting for covariates, saturation biopsy did not detect more abnormal pathology than standard office prostate biopsy, including PCa (OR, 1.2; p=0.339), HGPIN (OR, 1.4; p=0.368), or ASAP (OR, 2.2; p=0.201). CONCLUSIONS: Saturation biopsy does not appear to detect more abnormal prostate pathology than standard office biopsy of the prostate. This procedure may be associated with increased cost and patient morbidity.

Authors
Ashley, RA; Inman, BA; Routh, JC; Mynderse, LA; Gettman, MT; Blute, ML
MLA Citation
Ashley, RA, Inman, BA, Routh, JC, Mynderse, LA, Gettman, MT, and Blute, ML. "Reassessing the diagnostic yield of saturation biopsy of the prostate." Eur Urol 53.5 (May 2008): 976-981.
PMID
17997028
Source
pubmed
Published In
European Urology
Volume
53
Issue
5
Publish Date
2008
Start Page
976
End Page
981
DOI
10.1016/j.eururo.2007.10.049

Timing of androgen deprivation therapy and its impact on survival after radical prostatectomy: a matched cohort study.

PURPOSE: We assessed the impact of the timing of androgen deprivation on disease progression after radical prostatectomy for patients with localized prostate cancer. MATERIALS AND METHODS: We evaluated all patients who underwent radical prostatectomy between 1990 and 1999. Patients with pathological lymph node negative disease who received androgen deprivation therapy were then separated into 5 groups for analysis based on the time of hormone therapy initiation: 1--adjuvant androgen deprivation, 2--androgen deprivation therapy started at a postoperative prostate specific antigen of 0.4 ng/ml or greater, 3--at prostate specific antigen 1.0 or greater, 4--at prostate specific antigen 2.0 or greater and 5--at systemic progression. The first 4 groups were matched by clinical and pathological features to control groups who did not receive androgen deprivation after surgery using a nested, matched cohort design. Median followup for the entire cohort was 10 years. Clinical end points included systemic progression-free survival and cancer specific survival. RESULTS: After matching clinicopathological variables adjuvant androgen deprivation therapy was associated with improved 10-year systemic progression-free survival (95% vs 90%, p <0.001) and 10-year cancer specific survival (98% vs 95%, p = 0.009), although overall survival for these patients remained unchanged (84% vs 83%, p = 0.427). In contrast, we found that men who started hormonal therapy at a postoperative prostate specific antigen of 0.4 or greater, 1.0 or 2.0 did not have improved systemic progression-free or cancer specific survival. CONCLUSIONS: Adjuvant hormonal therapy modestly improves cancer specific survival and systemic progression-free survival after prostatectomy. The benefit of hormone therapy is lost when androgen deprivation is delivered at the time of prostate specific antigen recurrence or systemic progression.

Authors
Siddiqui, SA; Boorjian, SA; Inman, B; Bagniewski, S; Bergstralh, EJ; Blute, ML
MLA Citation
Siddiqui, SA, Boorjian, SA, Inman, B, Bagniewski, S, Bergstralh, EJ, and Blute, ML. "Timing of androgen deprivation therapy and its impact on survival after radical prostatectomy: a matched cohort study." J Urol 179.5 (May 2008): 1830-1837.
PMID
18353378
Source
pubmed
Published In
The Journal of Urology
Volume
179
Issue
5
Publish Date
2008
Start Page
1830
End Page
1837
DOI
10.1016/j.juro.2008.01.022

Questionable relevance of gamma delta T lymphocytes in renal cell carcinoma.

Adoptive gammadelta T cell immunotherapy has moved briskly into clinical trials prompted by several small studies suggesting abundant accumulation of gammadelta T cells within renal cell carcinoma (RCC). In this study, we re-examined levels of gammadelta T cells within RCC tumors and correlated levels of these cells with pathologic features and outcome associated with this form of cancer. Tissues from 248 consecutive clear cell RCC tumors obtained from 2000 to 2003 were stained and quantified for total CD3+ and gammadelta T cells per mm2. Wilcoxon rank sum and Kruskal-Wallis tests were used to evaluate associations between T cell amounts and prognostic factors (age, gender, tumor size, stage, grade, tumor necrosis). Cox models were used to assess associations with RCC-specific death. Median numbers of total CD3+ and gammadelta T cells were 281/mm2 (interquartile range (IQR): 149-536) and 2.6/mm2 (IQR: 1.3-4.6), respectively. The median percentage of CD3+ T cells that were gammadelta T cells was 1.0% (IQR: 0.4-1.9). This low percentage of intratumoral gammadelta T cells was diluted even further with rising CD3+ T cell infiltration. Percentages of gammadelta T cells were not associated with even one single clinicopathologic feature examined. Median follow-up for this study was 3.1 years (48 patients died of RCC) and Cox analysis failed to demonstrate that gammadelta T cells (hazard ratio=1.02, p=0.25) were predictive of RCC-specific death. gammadelta T cells are rare and not recruited nor expanded within RCC tumors. Percentages of gammadelta T cells fail to correlate with any prognostic features of RCC nor specific death. As such, the role of gammadelta T cells in RCC immunobiology remains questionable.

Authors
Inman, BA; Frigola, X; Harris, KJ; Kuntz, SM; Lohse, CM; Leibovich, BC; Kwon, ED
MLA Citation
Inman, BA, Frigola, X, Harris, KJ, Kuntz, SM, Lohse, CM, Leibovich, BC, and Kwon, ED. "Questionable relevance of gamma delta T lymphocytes in renal cell carcinoma." J Immunol 180.5 (March 1, 2008): 3578-3584.
PMID
18292585
Source
pubmed
Published In
Journal of immunology (Baltimore, Md. : 1950)
Volume
180
Issue
5
Publish Date
2008
Start Page
3578
End Page
3584

Utility of dextranomer/hyaluronic acid injection in setting of bladder and ureteral anomalies.

OBJECTIVES: Previous studies have shown that the cure rates after dextranomer/hyaluronic acid (Dx/HA) injection can be decreased in patients with neurogenic bladder, previous ureteroneocystostomy, duplicated ureters, or periureteral diverticula. We attempted to determine whether these factors reduce the efficacy of Dx/HA injection compared with that in otherwise normal patients. METHODS: All children with vesicoureteral reflux (VUR) undergoing Dx/HA injection from April 2002 to March 2006 at two institutions were eligible for this study. Multivariate logistic regression models were built to assess the effect of bladder/ureteral anomalies on the success of Dx/HA injection. We adjusted for previously described predictors of injection success, including VUR grade, sex, age, surgeon experience, and injection technique. RESULTS: A total of 543 refluxing ureters (373 patients) were included, of which 145 (27%) had persistent VUR on postoperative voiding cystourethrography; 86 ureters (16%) had anatomic anomalies. On univariate analysis, the most important predictors of injection failure were increasing VUR grade, male sex, younger age, subureteral injection, ureteral duplication anomaly, increasing Dx/HA volume, and surgeon experience. On multivariate analysis, however, the only significant predictors of injection failure were increasing VUR grade, subureteral injection technique, and surgeon experience. No anatomic or functional abnormalities, considered individually or grouped, significantly affected the probability of injection failure. CONCLUSIONS: In our experience, children with functional and anatomic bladder/ureteral anomalies were no more likely to have Dx/HA injection fail than were children with uncomplicated VUR. The most important predictors of Dx/HA success remained VUR grade, injection technique, and surgeon experience. Dx/HA injection in patients with complex bladders could be a reasonable therapeutic option.

Authors
Routh, JC; Kramer, SA; Inman, BA; Ashley, RA; Wolpert, JJ; Vandersteen, DR; Husmann, DA; Reinberg, Y
MLA Citation
Routh, JC, Kramer, SA, Inman, BA, Ashley, RA, Wolpert, JJ, Vandersteen, DR, Husmann, DA, and Reinberg, Y. "Utility of dextranomer/hyaluronic acid injection in setting of bladder and ureteral anomalies." Urology 71.3 (March 2008): 435-438.
PMID
18342182
Source
pubmed
Published In
Urology
Volume
71
Issue
3
Publish Date
2008
Start Page
435
End Page
438
DOI
10.1016/j.urology.2007.10.043

Re: Endoscopic treatment of vesicoureteral reflux associated with paraureteral diverticula in children. W. H. Cerwinka, H. C. Scherz and A. J. Kirsch. J Urol 2007; 178: 1469-1473.

Authors
Routh, JC; Inman, BA; Reinberg, Y
MLA Citation
Routh, JC, Inman, BA, and Reinberg, Y. "Re: Endoscopic treatment of vesicoureteral reflux associated with paraureteral diverticula in children. W. H. Cerwinka, H. C. Scherz and A. J. Kirsch. J Urol 2007; 178: 1469-1473." J Urol 179.3 (March 2008): 1205-. (Letter)
PMID
18206165
Source
pubmed
Published In
The Journal of Urology
Volume
179
Issue
3
Publish Date
2008
Start Page
1205
DOI
10.1016/j.juro.2007.10.098

Increased optical magnification from 2.5x to 4.3x with technical modification lowers the positive margin rate in open radical retropubic prostatectomy.

PURPOSE: We compared the positive surgical margin rate of 2.5x and 4.3x optical loupe magnification with associated technical improvement during open radical retropubic prostatectomy. MATERIALS AND METHODS: From January 2, 2004 to September 16, 2005, 511 consecutive patients underwent open radical retropubic prostatectomy, as performed by 1 surgeon. Because 10 patients refused authorization for a retrospective chart review, 501 were evaluable. For the first 265 patients 2.5x power loupes were used and for the subsequent 236 we used 4.3x power loupes. We used the chi-square test for univariate analysis, followed by multivariate logistic regression analysis adjusted for commonly recognized predictors of positive surgical margins in the 2 successive cohorts. Focusing on the apex, which was the most commonly reported site of positive surgical margins, we include operative video segments mimicking 4.3x magnification to demonstrate the surgical precision possible at 4.3x for managing the periurethral fascial bands of Walsh and urethral transection at the prostato-urethral junction. RESULTS: Positive surgical margins were identified in 39 of 265 patients (14.7%) at 2.5x and in 12 of 236 (5.1%) at 4.3x. Apical positive surgical margins were identified in 25 of 265 patients (9.4%) at 2.5x and in 5 of 236 (2.1%) at 4.3x. On multivariate analysis 4.3x magnification was independently associated with a 75% decrease in the odds of a positive surgical margin overall and in the apex alone (p <0.001 and 0.003, respectively). CONCLUSIONS: This exploratory retrospective study suggests that, compared with 2.5x magnification, the use of 4.3x magnification with technical refinements that are not possible or deemed safe at 2.5x resulted in a substantial decrease in the positive surgical margin rate.

Authors
Magera, JS; Inman, BA; Slezak, JM; Bagniewski, SM; Sebo, TJ; Myers, RP
MLA Citation
Magera, JS, Inman, BA, Slezak, JM, Bagniewski, SM, Sebo, TJ, and Myers, RP. "Increased optical magnification from 2.5x to 4.3x with technical modification lowers the positive margin rate in open radical retropubic prostatectomy." J Urol 179.1 (January 2008): 130-135.
PMID
17997426
Source
pubmed
Published In
The Journal of Urology
Volume
179
Issue
1
Publish Date
2008
Start Page
130
End Page
135
DOI
10.1016/j.juro.2007.08.128

After radical retropubic prostatectomy 'insignificant' prostate cancer has a risk of progression similar to low-risk 'significant' cancer.

OBJECTIVE: To assess progression and survival among patients with small-volume, well-differentiated, organ-confined prostate cancer found at radical retropubic prostatectomy (RRP), often defined as being 'insignificant', thus testing whether they are indeed 'insignificant'. PATIENTS AND METHODS: We identified 6496 men treated for prostate cancer by RRP between 1990 and 1999, and defined 'insignificant' tumours as those in men having a prostate-specific antigen (PSA) level of < 10 ng/mL before RRP, a cancer volume of < or = 0.5 mL, a specimen Gleason of score < or = 6 and stage < or = pT2. Survival was assessed using the Kaplan-Meier method and compared using the two-sided log-rank test. RESULTS: 'Insignificant' tumours were found in 354 (5.5%) men, of whom only one had metastatic progression and none died from prostate cancer, with a median (range) follow-up of 9.2 (0.8-15.6) years. Biochemical progression-free survival (87% vs 85%, respectively, at 10 years, P = 0.5), systemic progression-free survival (100% vs 99%, P = 0.3), overall survival (91% vs 88%, P = 0.16) and cancer-specific survival (100% in each group, P = 0.32) were each similar among men with 'insignificant' prostate cancer and men with low-risk (defined by Gleason score, preoperative PSA level, seminal vesicle and surgical margin status) 'significant' cancer. Clinical stage, biopsy Gleason score and preoperative PSA doubling time were multivariably predictive of 'insignificant' tumours at RRP. CONCLUSIONS: 'Insignificant' prostate cancer at RRP is associated with a comparable risk of biochemical progression as low-risk 'significant' cancer. Although clinical predictors for 'insignificant' pathology can be identified, it remains to be established whether such patients can be safely managed conservatively.

Authors
Sengupta, S; Blute, ML; Bagniewski, SM; Inman, B; Leibovich, BC; Slezak, JM; Myers, RP; Zincke, H
MLA Citation
Sengupta, S, Blute, ML, Bagniewski, SM, Inman, B, Leibovich, BC, Slezak, JM, Myers, RP, and Zincke, H. "After radical retropubic prostatectomy 'insignificant' prostate cancer has a risk of progression similar to low-risk 'significant' cancer." BJU Int 101.2 (January 2008): 170-174.
PMID
18173824
Source
pubmed
Published In
Bju International
Volume
101
Issue
2
Publish Date
2008
Start Page
170
End Page
174
DOI
10.1111/j.1464-410X.2007.07270.x

Editorial Comment

Authors
Inman, BA; Reinberg, Y
MLA Citation
Inman, BA, and Reinberg, Y. "Editorial Comment." Urology 72.3 (2008): 538--.
Source
scival
Published In
Urology
Volume
72
Issue
3
Publish Date
2008
Start Page
538-
DOI
10.1016/j.urology.2008.04.043

Editorial Comment

Authors
Inman, BA
MLA Citation
Inman, BA. "Editorial Comment." Journal of Urology 180.3 (2008): 902-903.
Source
scival
Published In
The Journal of Urology
Volume
180
Issue
3
Publish Date
2008
Start Page
902
End Page
903
DOI
10.1016/j.juro.2008.05.160

Editorial Comment

Authors
Inman, BA; Blute, ML
MLA Citation
Inman, BA, and Blute, ML. "Editorial Comment." Journal of Urology 179.1 (2008): 161-162.
Source
scival
Published In
The Journal of Urology
Volume
179
Issue
1
Publish Date
2008
Start Page
161
End Page
162
DOI
10.1016/j.juro.2007.08.225

The role of partial nephrectomy for the management of sporadic renal angiomyolipoma.

OBJECTIVES: Angiomyolipoma is a benign renal tumor that has a propensity to grow over time and may cause local complications. Given the benign nature of these lesions, renal-preserving treatments are favored. We evaluated our experience with nephron-sparing surgery for renal angiomyolipoma. METHODS: We reviewed our institutional nephrectomy registry to identify patients treated with nephron-sparing surgery for renal angiomyolipoma between 1970 and 2004. Patients with a diagnosis of tuberous sclerosis were excluded. Patient demographics, perioperative complications, and postoperative outcomes were recorded. RESULTS: We identified 58 patients treated with nephron-sparing surgery for sporadic renal angiomyolipoma, including 44 women and 14 men. The median tumor size was 3.9 cm (range, 0.8-12.5 cm). In 7 patients (12%), several ipsilateral angiomyolipomas were resected, whereas 2 patients were treated with nephron-sparing surgery for bilateral angiomyolipomas. The overall early complication rate was 12%, including a urine leak in 3 (5%) patients. At a median postoperative follow-up of 8 years (range, 1-31 years), 2 (3.4%) patients had radiographic evidence of local recurrence, although no patient experienced symptom recurrence. The median preoperative serum creatinine level was 1.0 mg/dL (range, 0.5-3.9 mg/dL), and the median creatinine level at last follow-up was 1.1 mg/dL (range, 0.6-3.6 mg/dL). No patient developed de novo chronic renal insufficiency after nephron-sparing surgery, including 4 patients treated for angiomyolipomas in a solitary kidney. CONCLUSIONS: Nephron-sparing surgery for sporadic renal angiomyolipomas offers preservation of renal function and is associated with acceptable complication and low local recurrence rates. The results of this study support nephron-sparing surgery for these lesions.

Authors
Boorjian, SA; Frank, I; Inman, B; Lohse, CM; Cheville, JC; Leibovich, BC; Blute, ML
MLA Citation
Boorjian, SA, Frank, I, Inman, B, Lohse, CM, Cheville, JC, Leibovich, BC, and Blute, ML. "The role of partial nephrectomy for the management of sporadic renal angiomyolipoma." Urology 70.6 (December 2007): 1064-1068.
PMID
18158015
Source
pubmed
Published In
Urology
Volume
70
Issue
6
Publish Date
2007
Start Page
1064
End Page
1068
DOI
10.1016/j.urology.2007.07.045

Preventing pain during office biopsy of the prostate: a single center, prospective, double-blind, 3-arm, parallel group, randomized clinical trial.

BACKGROUND: A prospective, double-blind, 3-arm, parallel group, randomized clinical trial was performed to compare 3 anesthetic techniques for preventing pain during prostate biopsy. METHODS: A total of 243 men undergoing a 12-core prostate biopsy were randomized to 1 of 3 anesthetic methods: 1) seminal vesical-prostatic base blockade, 2) intraprostatic blockade, and 3) apical-rectal blockade. Pain was estimated with the 10-point visual analog scale. Multivariate logistic regression evaluated factors predictive of pain. The Kruskal-Wallis test analyzed overall group comparisons and the Steel-Dwass test assessed between-group comparisons in pain scores. Proportional odds ordinal logistic regression quantified the ability of covariates and treatment arms to predict biopsy pain. These values are presented as odds ratios with confidence intervals (OR, 95% CI). RESULTS: From November 2005 to June 2006, 81 men were randomized to 3 study arms. Lidocaine administration was the most painful element of the procedure, while probe insertion was the least. Apical biopsies were routinely more painful than mid-gland biopsies, which were more painful than base biopsies. The apical-rectal blockade was the most painful to administer, but has lasting effects and led to better pain control than the prostatic base-seminal vesicle blockade. Similarly, the intraprostatic blockade was more effective than the prostatic base-seminal vesicle blockade. Besides pain reported at the time of anesthetic injection, no difference was identified between the intraprostatic and apical-rectal blockades. CONCLUSIONS: Mid and apical biopsies of the prostate are more painful than base biopsies. The seminal vesicle-prostatic base blockade is less effective than intraprostatic and apical-rectal blockade at controlling pain.

Authors
Ashley, RA; Inman, BA; Routh, JC; Krambeck, AE; Siddiqui, SA; Mynderse, LA; Gettman, MT; Blute, ML
MLA Citation
Ashley, RA, Inman, BA, Routh, JC, Krambeck, AE, Siddiqui, SA, Mynderse, LA, Gettman, MT, and Blute, ML. "Preventing pain during office biopsy of the prostate: a single center, prospective, double-blind, 3-arm, parallel group, randomized clinical trial." Cancer 110.8 (October 15, 2007): 1708-1714.
PMID
17724727
Source
pubmed
Published In
Cancer
Volume
110
Issue
8
Publish Date
2007
Start Page
1708
End Page
1714
DOI
10.1002/cncr.22973

Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement?

PURPOSE: We determined if the incidence of a perioperative surgical site-positive culture was reduced by a 5-day topical antimicrobial scrub before implantation of an artificial urinary sphincter. MATERIALS AND METHODS: A single surgeon prospective cohort study was conducted of 100 consecutive artificial urinary sphincter implants placed between May 2003 and November 2005. We compared 50 men who performed preoperative topical antimicrobial scrub with 4% chlorhexidine to the abdominal site and perineal site with 50 men who used their normal hygiene (soap and water). All received povidone-iodine skin disinfection before incision, and bacterial cultures of the abdominal and perineal sites were collected immediately after skin disinfection and after artificial urinary sphincter implantation. Baseline comparisons between groups were done with the Wilcoxon rank sum and Fisher exact tests. Predictors of positive culture were identified using multivariate logistic regression analysis. RESULTS: The causes of incontinence were radical prostatectomy (90), radiation therapy (8) and transurethral resection of the prostate (2). There were no baseline differences between the groups including age, diabetes or previous urethral surgery. Overall 140 of the 400 cultures were positive with only 37% of the positive cultures (52 of 140) observed with topical antimicrobial scrub. For the perineal site the only factor affecting preoperative culture status was topical antimicrobial scrub (OR 0.23, p = 0.003). A positive postoperative culture was predicted by a positive preoperative perineal (OR 4.61, p = 0.003) and abdominal culture (OR 3.80, p = 0.013). CONCLUSIONS: Preoperative topical antimicrobial scrub resulted in a 4-fold reduction in preoperative perineal colonization rate and overall reduction in positive surgical site cultures. Given the low cost, safety and efficacy, topical antimicrobial scrub should be considered before artificial urinary sphincter placement.

Authors
Magera, JS; Inman, BA; Elliott, DS
MLA Citation
Magera, JS, Inman, BA, and Elliott, DS. "Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement?." J Urol 178.4 Pt 1 (October 2007): 1328-1332.
PMID
17698144
Source
pubmed
Published In
The Journal of Urology
Volume
178
Issue
4 Pt 1
Publish Date
2007
Start Page
1328
End Page
1332
DOI
10.1016/j.juro.2007.05.146

Multivariate comparison of the efficacy of intraureteral versus subtrigonal techniques of dextranomer/hyaluronic acid injection.

PURPOSE: Numerous factors have been postulated to increase success rates for dextranomer/hyaluronic acid injection for vesicoureteral reflux. Ureteral hydrodistention combined with intraureteral injection reportedly improves injection success rates. We combined the results of 5 pediatric urologists to evaluate the efficacy of this technique compared to that of subtrigonal-only injection in relation to other factors. MATERIALS AND METHODS: Patients with primary vesicoureteral reflux undergoing dextranomer/hyaluronic acid injection from April 2002 to December 2005 at 2 institutions were eligible. Only patients with primary vesicoureteral reflux were included in the study. Injection success was defined as the complete absence of reflux on followup voiding cystourethrogram or radionuclide cystogram. Predictors of a successful outcome were analyzed statistically with logistic regression. Factors included in our analysis were gender, age, vesicoureteral reflux grade, dysfunctional voiding, amount of injected dextranomer/hyaluronic acid, injection technique (intraureteral vs subureteral) and surgeon. RESULTS: A total of 301 patients (453 ureters) with a median age of 5.5 years met inclusion criteria, of whom 199 (66%) were cured at 3 months of followup. Of the patients 145 (48%) underwent subureteral injection and 156 (52%) underwent ureteral hydrodistention combined with intraureteral injection. On multivariate analysis only vesicoureteral reflux grade (p <0.001) and surgeon (p = 0.01) were significantly predictive of injection success. There was a trend toward significance with ureteral hydrodistention combined with intraureteral injection (p = 0.056). CONCLUSIONS: In our multivariate model only vesicoureteral reflux grade and surgeon were independently predictive of injection success in patients with primary, uncomplicated vesicoureteral reflux. There was a trend toward improved results with ureteral hydrodistention combined with intraureteral injection, although this did not achieve statistical significance.

Authors
Routh, JC; Reinberg, Y; Ashley, RA; Inman, BA; Wolpert, JJ; Vandersteen, DR; Husmann, DA; Kramer, SA
MLA Citation
Routh, JC, Reinberg, Y, Ashley, RA, Inman, BA, Wolpert, JJ, Vandersteen, DR, Husmann, DA, and Kramer, SA. "Multivariate comparison of the efficacy of intraureteral versus subtrigonal techniques of dextranomer/hyaluronic acid injection." J Urol 178.4 Pt 2 (October 2007): 1702-1705.
PMID
17707019
Source
pubmed
Published In
The Journal of Urology
Volume
178
Issue
4 Pt 2
Publish Date
2007
Start Page
1702
End Page
1705
DOI
10.1016/j.juro.2007.03.174

Urachal anomalies: a longitudinal study of urachal remnants in children and adults.

PURPOSE: Urachal anomalies are often recognized in children but they may persist into adulthood and cause considerable morbidity. We reviewed the clinical findings associated with these embryological structures and evaluated risk factors for cancer to define the optimal timing for intervention. MATERIALS AND METHODS: We examined the medical records of 176 patients diagnosed with a urachal anomaly between 1951 and 2005. Association of clinicopathological features with malignancy for adults was evaluated using univariate and multivariate logistic regression studies. RESULTS: Urachal remnants were identified in 46 children and 130 adults. Of the 46 children 20 (43%) presented with umbilical drainage and 23 (50%) could be diagnosed by physical examination. A total of 34 children (74%) underwent simple excision. In contrast, 65 of the 130 adults (50%) presented with hematuria, 78 (60%) required cystoscopy and 53 (41%) required computerized tomography. A total of 66 adults (51%) required more extensive surgical intervention with partial or radical cystectomy. Of adult urachal anomalies 66 (51%) were malignant. Patient age 55 years or older and hematuria were the strongest predictors of urachal malignancy (each p <0.001). Cancer risk increased with advancing adult age. CONCLUSIONS: Urachal anomalies present and progress differently in pediatric and adult populations. Adults are at high risk for urachal cancer but children usually incur lower morbidity. Urachal lesions noted early in childhood should be excised to prevent problems in adulthood.

Authors
Ashley, RA; Inman, BA; Routh, JC; Rohlinger, AL; Husmann, DA; Kramer, SA
MLA Citation
Ashley, RA, Inman, BA, Routh, JC, Rohlinger, AL, Husmann, DA, and Kramer, SA. "Urachal anomalies: a longitudinal study of urachal remnants in children and adults." J Urol 178.4 Pt 2 (October 2007): 1615-1618.
PMID
17707039
Source
pubmed
Published In
The Journal of Urology
Volume
178
Issue
4 Pt 2
Publish Date
2007
Start Page
1615
End Page
1618
DOI
10.1016/j.juro.2007.03.194

Targeting molecular and cellular inhibitory mechanisms for improvement of antitumor memory responses reactivated by tumor cell vaccine.

Development of effective vaccination approaches to treat established tumors represents a focus of intensive research because such approaches offer the promise of enhancing immune system priming against tumor Ags via restimulation of pre-existing (memory) antitumoral helper and effector immune cells. However, inhibitory mechanisms, which function to limit the recall responses of tumor-specific immunity, remain poorly understood and interfere with therapies anticipated to induce protective immunity. The mouse renal cell carcinoma (RENCA) tumor model was used to investigate variables affecting vaccination outcomes. We demonstrate that although a whole cell irradiated tumor cell vaccine can trigger a functional antitumor memory response in the bone marrows of mice with established tumors, these responses do not culminate in the regression of established tumors. In addition, a CD103+ regulatory T (Treg) cell subset accumulates within the draining lymph nodes of tumor-bearing mice. We also show that B7-H1 (CD274, PD-L1), a negative costimulatory ligand, and CD4+ Treg cells collaborate to impair the recall responses of tumor-specific memory T cells. Specifically, mice bearing large established RENCA tumors were treated with tumor cell vaccination in combination with B7-H1 blockade and CD4+ T cell depletion (triple therapy treatment) and monitored for tumor growth and survival. Triple treatment therapy induced complete regression of large established RENCA tumors and raised long-lasting protective immunity. These results have implications for developing clinical antitumoral vaccination regimens in the setting in which tumors express elevated levels of B7-H1 in the presence of abundant Treg cells.

Authors
Webster, WS; Thompson, RH; Harris, KJ; Frigola, X; Kuntz, S; Inman, BA; Dong, H
MLA Citation
Webster, WS, Thompson, RH, Harris, KJ, Frigola, X, Kuntz, S, Inman, BA, and Dong, H. "Targeting molecular and cellular inhibitory mechanisms for improvement of antitumor memory responses reactivated by tumor cell vaccine." J Immunol 179.5 (September 1, 2007): 2860-2869.
PMID
17709500
Source
pubmed
Published In
Journal of immunology (Baltimore, Md. : 1950)
Volume
179
Issue
5
Publish Date
2007
Start Page
2860
End Page
2869

B7-H3 ligand expression by prostate cancer: a novel marker of prognosis and potential target for therapy.

B7 coregulatory ligands can be aberrantly expressed in human disease. In the context of cancer, these ligands may act as antigen-specific inhibitors of T-cell-mediated antitumoral immunity. We recently reported that B7-H1 expression by carcinomas of the kidney and bladder portends aggressive disease and diminished survival. The expression of these proteins in prostate cancer, however, has not been investigated. We evaluated B7-H3 and B7-H1 protein expression in the pathologic specimens of 338 men treated for clinically localized prostate cancer between 1995 and 1998 with radical retropubic prostatectomy. Expression levels of B7-H3 in prostate cancer were correlated with pathologic indicators of aggressive cancer as well as clinical outcome. We report that B7-H3 is uniformly and aberrantly expressed by adenocarcinomas of the prostate, high-grade prostatic intraepithelial neoplasia, and four prostate cancer cell lines, whereas B7-H1 is rarely expressed. B7-H3 is expressed by benign prostatic epithelia, although at a more reduced level relative to neoplastic tissue. Increasing levels of B7-H3 intensity correlate with worsening clinicopathologic features of prostate cancer. Marked B7-H3 intensity, present in 67 (19.8%) specimens, confers a >4-fold increased risk of cancer progression after surgery (risk ratio, 4.42; P < 0.001). A survey of normal tissues revealed that B7-H3 is expressed within the liver, urothelium, and fetal kidney. In summary, B7-H3 is aberrantly expressed in all prostate cancers and represents an independent predictor of cancer progression following surgery. Moreover, B7-H3 encompasses a novel diagnostic and potential therapeutic target for the clinical management of prostate cancer and, perhaps, other malignancies as well.

Authors
Roth, TJ; Sheinin, Y; Lohse, CM; Kuntz, SM; Frigola, X; Inman, BA; Krambeck, AE; McKenney, ME; Karnes, RJ; Blute, ML; Cheville, JC; Sebo, TJ; Kwon, ED
MLA Citation
Roth, TJ, Sheinin, Y, Lohse, CM, Kuntz, SM, Frigola, X, Inman, BA, Krambeck, AE, McKenney, ME, Karnes, RJ, Blute, ML, Cheville, JC, Sebo, TJ, and Kwon, ED. "B7-H3 ligand expression by prostate cancer: a novel marker of prognosis and potential target for therapy." Cancer Res 67.16 (August 15, 2007): 7893-7900.
PMID
17686830
Source
pubmed
Published In
Cancer Research
Volume
67
Issue
16
Publish Date
2007
Start Page
7893
End Page
7900
DOI
10.1158/0008-5472.CAN-07-1068

PD-L1 (B7-H1) expression by urothelial carcinoma of the bladder and BCG-induced granulomata: associations with localized stage progression.

BACKGROUND: PD-L1 (programmed death ligand 1, B7-H1) is a cell surface glycoprotein that can impair T-cell function. PD-L1 is aberrantly expressed by multiple human malignancies and has been shown to carry a highly unfavorable prognosis in patients with kidney cancer. The role of PD-L1 was evaluated as a mechanism for local stage progression in urothelial carcinoma (UC) of the bladder. METHODS: Using immunohistochemistry, PD-L1 expression was evaluated in a cohort of 280 high-risk UCs of the bladder. PD-L1 was modeled as a predictor of bladder cancer stage using ordinal logistic regression. Other covariates evaluated as potential confounders included age, gender, tumor grade, and lymphocytic infiltration. Further, PD-L1 was evaluated as a potential mechanism of bacillus Calmette-Guerin (BCG) failure in the subset of high-risk nonmuscle-invasive tumors that received this treatment. RESULTS: PD-L1 expression was observed in 7% of pTa, 16% of pT1, 23% of pT2, 30% of pT3/4, and 45% of carcinoma in situ (CIS) tumors. PD-L1 expression was associated with high-grade tumors (odds ratio [OR] = 2.4, P = .009) and tumor infiltration by mononuclear cells (OR = 5.5, P = .004). We observed that the key determinants of stage progression in this cohort were World Health Organization/International Society of Urologic Pathology (WHO/ISUP) high-grade tumor pathology (OR = 4.77, 95% confidence interval [CI]: 2.73-8.34; P < .001) and PD-L1 expression (OR = 2.20, P = .012). PD-L1 expression was found to be extremely abundant in the BCG-induced bladder granulomata in 11 of 12 patients failing BCG treatment. CONCLUSIONS: Collectively, these data indicate that tumor PD-L1 may facilitate localized stage-advancement of UC and attenuate responses to BCG immunotherapy by neutralizing T cells that normally guard against cancer invasion from the epithelium into the bladder musculature.

Authors
Inman, BA; Sebo, TJ; Frigola, X; Dong, H; Bergstralh, EJ; Frank, I; Fradet, Y; Lacombe, L; Kwon, ED
MLA Citation
Inman, BA, Sebo, TJ, Frigola, X, Dong, H, Bergstralh, EJ, Frank, I, Fradet, Y, Lacombe, L, and Kwon, ED. "PD-L1 (B7-H1) expression by urothelial carcinoma of the bladder and BCG-induced granulomata: associations with localized stage progression." Cancer 109.8 (April 15, 2007): 1499-1505.
PMID
17340590
Source
pubmed
Published In
Cancer
Volume
109
Issue
8
Publish Date
2007
Start Page
1499
End Page
1505
DOI
10.1002/cncr.22588

Costimulation, coinhibition and cancer.

The immune system is an important defense mechanism against cancer and is often dysfunctional in patients with malignancies. The central regulator of the anti-cancer adaptive immune response is the T lymphocyte. T lymphocyte activation requires the completion of a carefully orchestrated series of specific steps that can be preempted or disrupted by any number of critical events. Particularly important is the provision of a costimulatory signal, the binding of accessory molecules on the antigen presenting cell to receptors on the T lymphocyte. Though costimulatory signals were traditionally envisioned as T lymphocyte-activating events, recent discoveries have highlighted their duality: they can be either stimulatory (costimulation) or inhibitory (coinhibition). In this article we review costimulation and coinhibition as potential targets for cancer therapy. We begin by presenting a general framework for thinking about the immune system in the context of cancer. Our discussion then bridges the various aspects of immune dysfunction seen in cancer with the presence of coinhibitory (ex: PD-1, PD-L1, CTLA-4, BTLA) and costimulatory (ex: CD28, ICOS, 4-1BB, CD40, OX40, CD27) signaling. Lastly, we develop a model of cancer-related immune dysfunction that parallels the concept of immunoediting. Throughout the article we emphasize clinically relevant research often applicable-but not limited-to the example of renal cell carcinoma.

Authors
Inman, BA; Frigola, X; Dong, H; Kwon, ED
MLA Citation
Inman, BA, Frigola, X, Dong, H, and Kwon, ED. "Costimulation, coinhibition and cancer." Curr Cancer Drug Targets 7.1 (February 2007): 15-30. (Review)
PMID
17305475
Source
pubmed
Published In
Current cancer drug targets
Volume
7
Issue
1
Publish Date
2007
Start Page
15
End Page
30

Re: Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J. S. Jones, A. Patel, L. Schoenfield, J. C. Rabets, C. D. Zippe and C. Magi-Galluzzi. J Urol, 175: 485-488, 2006.

Authors
Inman, BA; Myers, RP
MLA Citation
Inman, BA, and Myers, RP. "Re: Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J. S. Jones, A. Patel, L. Schoenfield, J. C. Rabets, C. D. Zippe and C. Magi-Galluzzi. J Urol, 175: 485-488, 2006." J Urol 176.3 (September 2006): 1252-1253. (Letter)
PMID
16890738
Source
pubmed
Published In
The Journal of Urology
Volume
176
Issue
3
Publish Date
2006
Start Page
1252
End Page
1253
DOI
10.1016/j.juro.2006.04.056

Outcomes of Gleason score 10 prostate carcinoma treated by radical prostatectomy.

OBJECTIVES: To evaluate the outcome of radical prostatectomy for the rarest and most poorly differentiated prostate tumors of all: those with Gleason score 10. Controversy exists as to which form of therapy is most effective for high-grade prostate cancer (PCa). METHODS: We retrospectively reviewed the charts of all patients with pathologic Gleason score 10 PCa treated at our institution with radical prostatectomy from 1977 to 1999. All pathology specimens were reviewed by a urologic pathologist, and 13 cases with true Gleason score 10 PCa were identified. The preoperative covariables (prostate-specific antigen level, biopsy Gleason score, and clinical stage), perioperative covariables (pathologic stage, margin status, and tumor ploidy), and postoperative covariables (prostate-specific antigen level and adjuvant and salvage treatments) were assessed with respect to the oncologic outcomes. RESULTS: The median follow-up was 4.2 years. Preoperatively, only 4 of the 13 cases were correctly identified at biopsy, and the median preoperative prostate-specific antigen level was 4.5 ng/mL (interquartile range 0.3 to 12.5). Pathologic examination showed a small cell component in 7 cases, seminal vesicle invasion in 11, and positive lymph nodes in 3. Six patients developed recurrent PCa: three local, two systemic, and one biochemical recurrence. The biochemical recurrence-free and cancer-specific survival rate at 5 years was 53.8% and 76.9%, respectively. CONCLUSIONS: Gleason score 10 PCa is a highly aggressive disease that is usually lethal if managed conservatively. The results of the present study have provided some evidence that radical prostatectomy may be of benefit to patients with Gleason score 10 PCa.

Authors
Inman, BA; DiMarco, DS; Slezak, JM; Sebo, TJ; Kwon, ED; Leibovich, BC; Blute, ML; Zincke, H
MLA Citation
Inman, BA, DiMarco, DS, Slezak, JM, Sebo, TJ, Kwon, ED, Leibovich, BC, Blute, ML, and Zincke, H. "Outcomes of Gleason score 10 prostate carcinoma treated by radical prostatectomy." Urology 68.3 (September 2006): 604-608.
PMID
16979719
Source
pubmed
Published In
Urology
Volume
68
Issue
3
Publish Date
2006
Start Page
604
End Page
608
DOI
10.1016/j.urology.2006.03.041

Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy.

BACKGROUND: Urachal carcinoma (UrC) is a rare malignancy, and patients with this disease have a poor prognosis. In this article, the authors report 50 years of experience with this tumor at the Mayo Clinic. METHODS: A urachal mass was described in 130 patients, and 66 of those masses were malignant. The authors identified multivariate predictors of malignancy in clinically diagnosed urachal masses and predictors of UrC-specific survival. This report presents a novel 4-category staging system for UrC along with the treatment history of this tumor and the results of salvage therapy. RESULTS: Twenty women and 46 men were identified with UrC. The strongest predictors of malignancy in a urachal mass were hematuria and age older than 55 years. The 5-year cancer-specific survival rate was 49%. The new Mayo staging system was less complicated than the Sheldon system, although both systems predicted cancer-specific mortality equally well. Positive surgical margins (hazard ratio [HR], 4.7), high tumor grade (HR, 3.6), positive local lymph nodes (HR, 5.1), metastases at diagnosis (HR, 3.3), advanced tumor stage (HR, 4.8), failure to perform umbilectomy (HR, 3.0), and primary radiation therapy (HR, 2.9) were all univariately associated with death (P <.05). Only grade and margins were significant in the multivariate analysis. No survival benefit was noted for lymphadenectomy or adjuvant therapy. Salvage surgery resulted in a long-term cure for 50% of patients who had local recurrences. No effective treatment was identified for patients with metastatic UrC. CONCLUSIONS: Early and complete extended partial cystectomy, including umbilectomy, is critical to the survival of patients with UrC. The authors recommend using the Mayo staging system in future studies because of its simplicity. The current results indicated that the most important predictors of prognosis were tumor grade and surgical margin status.

Authors
Ashley, RA; Inman, BA; Sebo, TJ; Leibovich, BC; Blute, ML; Kwon, ED; Zincke, H
MLA Citation
Ashley, RA, Inman, BA, Sebo, TJ, Leibovich, BC, Blute, ML, Kwon, ED, and Zincke, H. "Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy." Cancer 107.4 (August 15, 2006): 712-720.
PMID
16826585
Source
pubmed
Published In
Cancer
Volume
107
Issue
4
Publish Date
2006
Start Page
712
End Page
720
DOI
10.1002/cncr.22060

Obesity and survival after radical prostatectomy: A 10-year prospective cohort study.

BACKGROUND: Obesity and prostate cancer are among the most common health problems affecting American men today. The authors' goal was to assess the impact of obesity on clinical and pathologic features of prostate cancer and long-term outcomes. METHODS: The authors performed a prospective cohort study on 5313 men who underwent radical prostatectomy between 1990 and 1999. Patient height and weight were measured at the time of surgery to calculate the body mass index (BMI). The patients were separated into 3 BMI groups: BMI <25, 25-29.9, and > or =30 kg/m2. The associations between BMI and age, prostate-specific antigen (PSA) level, and Gleason score were assessed with the Spearman rank correlation test. The associations between BMI and pathologic features were assessed with the Mantel-Haenszel chi 2 test. Fifteen-year biochemical progression-free survival, systemic progression-free survival, cancer-specific survival, and overall survival were estimated using the Kaplan-Meier method and evaluated using Cox models. RESULTS.: The median length of follow-up for the entire cohort was 10.1 years. Clinical and pathologic features appear worse in patients with a higher BMI. On univariate and multivariate analyses, it was found that BMI had no impact on biochemical progression, systemic progression, prostate cancer survival, or overall survival. CONCLUSIONS: Obese patients appear to have worse pathologic features at the time of prostatectomy. Despite these features, long-term oncologic outcomes, including cancer-specific survival, remain the same regardless of BMI. BMI appears to influence prostate cancer outcomes at the time of prostatectomy, as evidenced by more aggressive pathologic features. However, after prostatectomy, BMI does not appear to be an independent predictor of recurrence or survival.

Authors
Siddiqui, SA; Inman, BA; Sengupta, S; Slezak, JM; Bergstralh, EJ; Leibovich, BC; Zincke, H; Blute, ML
MLA Citation
Siddiqui, SA, Inman, BA, Sengupta, S, Slezak, JM, Bergstralh, EJ, Leibovich, BC, Zincke, H, and Blute, ML. "Obesity and survival after radical prostatectomy: A 10-year prospective cohort study." Cancer 107.3 (August 1, 2006): 521-529.
PMID
16773619
Source
pubmed
Published In
Cancer
Volume
107
Issue
3
Publish Date
2006
Start Page
521
End Page
529
DOI
10.1002/cncr.22030

Re: Has a 3-fold decreased dose of bacillus Calmette-Guerin the same efficacy against recurrences and progression of T1G3 and Tis bladder tumors than the standard dose? Results of a prospective randomized trial.

Authors
Inman, BA
MLA Citation
Inman, BA. "Re: Has a 3-fold decreased dose of bacillus Calmette-Guerin the same efficacy against recurrences and progression of T1G3 and Tis bladder tumors than the standard dose? Results of a prospective randomized trial." J Urol 175.5 (May 2006): 1960-. (Letter)
PMID
16600806
Source
pubmed
Published In
The Journal of Urology
Volume
175
Issue
5
Publish Date
2006
Start Page
1960
DOI
10.1016/S0022-5347(05)00970-5

Editorial Comment

Authors
Inman, BA; Leibovich, BC
MLA Citation
Inman, BA, and Leibovich, BC. "Editorial Comment." Journal of Urology 176.4 (2006): 1337-1338.
Source
scival
Published In
The Journal of Urology
Volume
176
Issue
4
Publish Date
2006
Start Page
1337
End Page
1338
DOI
10.1016/j.juro.2006.06.130

Insulin-like growth factor binding protein 2: an androgen-dependent predictor of prostate cancer survival.

BACKGROUND: Evidence suggests that the insulin-like growth factor (IGF) family is important in prostate cancer. We evaluate the ability of IGF markers to predict biochemical recurrence-free survival (bRFS) following radical prostatectomy (RRP). METHODS: Preoperative sera from 141 patients undergoing RRP were analyzed for IGF-I, IGFBP-1, IGFBP-2 and IGFBP-3. A multivariate Cox model was created to assess the ability of these markers to predict bRFS. Preoperative covariables included: biopsy Gleason score, clinical TNM stage, serum PSA and neoadjuvant hormonotherapy. Kaplan-Meier curves were stratifying by IGF cutpoints (determined by ROC analysis) and hormonotherapy status. RESULTS: Average follow-up was 6.92 years, median PSA was 6.9 ng/ml and 85.1% of patients had cT2NxM0 disease. 49 patients experienced a PSA failure. Average levels of IGF-I, IGFBP-1, IGFBP-2 and IGFBP-3 were 156.5 ng/ml, 48.1 ng/ml, 396.8 ng/ml and 3303.7 ng/ml, respectively. IGFBP-2 was an independent predictor of PSA failure. Patients treated with neoadjuvant ADT (n=71) and whom had high IGFBP-2 levels experienced a 5-year bRFS that was better than those with low IGFBP-2 levels (77.7% vs. 53.3%). Patients without neoadjuvant ADT whom had high IGFBP-2 levels had a 5-year bRFS that was worse than those with low IGFBP-2 levels (64.5% vs. 82.7%). CONCLUSIONS: Preoperative IGFBP-2 predicts post-radical prostatectomy bRFS and is independent of stage, Gleason score and PSA. Increased IGFBP-2 is associated with better survival in patients with neoadjuvant hormonotherapy but worse survival in those without, suggesting a dramatic switch in function of this protein dependent on the presence or absence of androgens.

Authors
Inman, BA; Harel, F; Audet, J-F; Meyer, F; Douville, P; Fradet, Y; Lacombe, L
MLA Citation
Inman, BA, Harel, F, Audet, J-F, Meyer, F, Douville, P, Fradet, Y, and Lacombe, L. "Insulin-like growth factor binding protein 2: an androgen-dependent predictor of prostate cancer survival." Eur Urol 47.5 (May 2005): 695-702.
PMID
15826765
Source
pubmed
Published In
European Urology
Volume
47
Issue
5
Publish Date
2005
Start Page
695
End Page
702
DOI
10.1016/j.eururo.2004.12.015

Routine nasogastric tubes are not required following cystectomy with urinary diversion: a comparative analysis of 430 patients.

PURPOSE: Postoperative nasogastric tube (NGT) use has been shown to increase postoperative morbidity in patients undergoing nonurological abdominal surgery. We examine the omission of NGTs as a method of decreasing postoperative gastrointestinal complications and hospital stay in patients undergoing cystectomy with urinary diversion. MATERIALS AND METHODS: Between January 1983 and December 2001, 430 patients underwent cystectomy with urinary diversion at our institution. We retrospectively compared patients who received postoperative NGTs with those who did not with regard to gastrointestinal recovery time, gastrointestinal complications and hospital stay. RESULTS: After correcting for confounding factors using ANCOVA the time to first bowel sounds, time to first flatus and the duration of hospitalization were shorter in patients not receiving NGTs (p = 0.006, 0.001 and 0.032, respectively). Omitting NGTs did not increase the risk of ileus, bowel obstruction, wound dehiscence, anastomotic leakage or aspiration pneumonia and it did not result in more frequent postoperative NGT placement. CONCLUSIONS: The results of the current study suggest that gastric decompression with NGTs following cystectomy with urinary diversion may prolong gastrointestinal recovery, which may be a factor leading to increased duration of hospitalization. We propose that postoperative NGTs should not be used routinely in the management of cystectomy cases.

Authors
Inman, BA; Harel, F; Tiguert, R; Lacombe, L; Fradet, Y
MLA Citation
Inman, BA, Harel, F, Tiguert, R, Lacombe, L, and Fradet, Y. "Routine nasogastric tubes are not required following cystectomy with urinary diversion: a comparative analysis of 430 patients." J Urol 170.5 (November 2003): 1888-1891.
PMID
14532800
Source
pubmed
Published In
The Journal of Urology
Volume
170
Issue
5
Publish Date
2003
Start Page
1888
End Page
1891
DOI
10.1097/01.ju.0000092500.68655.48

Re: Pretreatment total testosterone level predicts pathological stage in patients with localized prostate cancer treated with radical prostatectomy [5] (multiple letters)

Authors
Tiguert, R; Inman, BA
MLA Citation
Tiguert, R, and Inman, BA. "Re: Pretreatment total testosterone level predicts pathological stage in patients with localized prostate cancer treated with radical prostatectomy [5] (multiple letters)." Journal of Urology 170.6 I (2003): 2392--.
PMID
14634433
Source
scival
Published In
Journal of Urology
Volume
170
Issue
6 I
Publish Date
2003
Start Page
2392-

Microchimerism in sensitized renal patients.

BACKGROUND: Patients exposed to allogeneic human tissue sometimes produce anti-HLA antibody for many years in the absence of further obvious antigen exposure. To investigate the mechanism of sustained sensitization, we identified females awaiting renal transplantation with high panel-reactive antibody but no exposure to allogeneic tissue for at least 1 month. METHODS: We analyzed peripheral blood microchimerism using nested polymerase chain reaction amplification specific for the SRY region of the Y chromosome. RESULTS: Microchimerism was detected in 3 of 10 patients but in none of 8 normal female subjects. In two cases, the amplified DNA polymerase chain reaction product was sequenced and was confirmed to be identical to the SRY gene. The estimated level of chimerism as compared with serial dilutions of DNA from male peripheral blood leukocytes was about 1/50000. CONCLUSION: These results do not establish causality but support the possibility that antigens from microchimeric donor cells may sustain the HLA antibody response in certain patients.

Authors
Inman, B; Halloran, B; Melk, A; Ramassar, V; Halloran, PF
MLA Citation
Inman, B, Halloran, B, Melk, A, Ramassar, V, and Halloran, PF. "Microchimerism in sensitized renal patients." Transplantation 67.10 (May 27, 1999): 1381-1383.
PMID
10360597
Source
pubmed
Published In
Transplantation
Volume
67
Issue
10
Publish Date
1999
Start Page
1381
End Page
1383
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Research Areas:

  • BCG Vaccine
  • Cancer Vaccines
  • Carcinoma, Renal Cell
  • Clinical Trial
  • Cystectomy
  • Immunotherapy
  • Immunotherapy, Adoptive
  • Kidney Neoplasms
  • Magnetic nanoparticle hyperthermia
  • Metastasectomy
  • Nephrectomy
  • Penile Neoplasms
  • Prostate
  • Prostatic Neoplasms
  • Thermotherapy
  • Urethral Neoplasms
  • Urinary Bladder Neoplasms
  • Urinary Diversion
  • Urologic Neoplasms
  • Urology