Medicine and Health Sciences Commons^™

Comparison Of Mri- And Trus-Informed Prostate Biopsy For Prostate Cancer Diagnosis In Biopsy-Naive Men: A Systematic Review And Meta-Analysis., Hanan Goldberg, Ardalan E. Ahmad, Thenappan Chandrasekar, Laurence Klotz, Mark Emberton, Masoom A. Haider, Samir S. Taneja, Karan Arora, Neil Fleshner, Antonio Finelli, Nathan Perlis, Mark D. Tyson, Zachary Klaassen, Christopher J.D. Wallis

Department of Urology Faculty Papers

PURPOSE: Multiparametric magnetic resonance imaging (mpMRI) with informed targeted biopsies (TGBX) has changed the paradigm of prostate cancer (PCa) diagnosis. Randomized studies have demonstrated a diagnostic benefit of Clinically significant (CS) for TGBX compared to standard systematic biopsies (SBX). We aimed to evaluate whether mpMRI-informed TGBX has superior diagnosis rates of any-, CS-, high-grade (HG)-, and clinically insignificant (CI)-PCa compared to SBX in biopsy-naive men.

METHODS: Data was searched in Medline, Embase, Web of Science, and Evidence-based medicine reviews-Cochrane Database of systematic reviews from database inception until 2019. Studies were selected by two authors independently, with disagreements resolved by consensus …

Incorporating Mpmri Biopsy Data Into Established Pre-Rp Nomograms: Potential Impact Of An Increasingly Common Clinical Scenario, Joon Yau Leong, Jaime O. Herrera-Caceres, Hanan Goldberg, Elwin Tham, Seth Teplitsky, Leonard G. Gomella, Neil E. Fleshner, Costas D. Lallas, Edouard J. Trabulsi, Thenappan Chandrasekar

Department of Urology Faculty Papers

Background: We examine the practical application of multiparametric MRI (mpMRI) prostate biopsy data using established pre-RP nomograms and its potential implications on RP intraoperative decision-making. We hypothesize that current nomograms are suboptimal in predicting outcomes with mpMRI targeted biopsy (TBx) data.

Materials and methods: Patients who underwent mpMRI-based TBx prior to RP were assessed using the MSKCC and Briganti nomograms with the following iterations: (1) Targeted (T) (targeted only), (2) Targeted and Systematic (TS) and (3) Targeted Augmented (TA) (targeted core data; assumed negative systematic cores for 12 total cores). Nomogram outcomes, lymph node involvement (LNI), extracapsular extension (ECE), organ-confined …

Twitter And Academic Urology In The United States And Canada: A Comprehensive Assessment Of The Twitter-Verse In 2019., Thenappan Chandrasekar, Hanan Goldberg, Zachary Klaassen, Christopher J. Wallis, Joon Yau Leong, Spencer Liem, Seth Teplitsky, Rodrigo Noorani, Stacy Loeb

Department of Urology Faculty Papers

OBJECTIVE: To provide the first comprehensive analysis of the Twitter-verse amongst academic urologists and programs in North America.

METHODS: Using national accreditation and individual program websites, all active urology residency programs (USA & Canada) and academic Urology faculty at these programs were identified. Demographic data for each program (AUA section, resident class size) and physician (title, fellowship training, Scopus H-index and citations) were documented. Twitter metrics (Twitter handle, date joined, # tweets, # followers, # following, likes) for programs and physicians were catalogued (data capture: March-April 2019). Descriptive analyses and temporal trends in Twitter utilization amongst programs and physician were …

Medical Evaluation And Management Of Male And Female Voiding Dysfunction: A Review., Alana Murphy, Seth Teplitsky, Akhil K. Das, Joon Yau Leong, Andrew Margules, Costas D. Lallas

Department of Urology Faculty Papers

A significant workforce shortage of urologists available to serve the US population has been projected to occur over the next decade. Accordingly, much of the management of urologic patients will need to be assumed by other specialties and practitioners. Since primary care physicians are often first evaluate common urologic complaints, it makes sense that these physicians are in an excellent position to intervene in the management of these patients when appropriate. One of the most common complaints in urology is voiding dysfunction. The incidence of voiding dysfunction increases with age, with conservative estimates showing that over 50% of elderly patients …

Prevalence Of Suspected Hereditary Cancer Syndromes And Germline Mutations Among A Diverse Cohort Of Probands Reporting A Family History Of Prostate Cancer: Toward Informing Cascade Testing For Men., Thenappan Chandrasekar, Laura Gross, Leonard G. Gomella, Sarah E. Hegarty, Joon Yau Leong, Veda N. Giri

Department of Urology Faculty Papers

BACKGROUND: Prostate cancer (PCa) is increasingly recognized as part of hereditary cancer syndromes (HCSs). HCS prevalence among diverse probands seeking genetic evaluation with PCa family history (FHx) has not been reported and has implications for cascade genetic testing.

OBJECTIVE: To evaluate the rates of HCSs among probands reporting PCa FHx and germline mutations among probands.

DESIGN, SETTING, AND PARTICIPANTS: A prospective genetic testing database queried for individuals with PCa FHx. Pedigrees analyzed for three HCSs: hereditary breast and ovarian cancer (HBOC), hereditary PCa, and Lynch syndrome.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Associations between HCS overall, and with plausible link to …

Impact Of Tumor Regional Involvement On Active Surveillance Outcomes: Validation Of The Cumulative Cancer Location Metric In A Us Population., Joon Yau Leong, Courtney Capella, Seth Teplitsky, Leonard G. Gomella, Edouard J. Trabulsi, Costas D. Lallas, Thenappan Chandrasekar

Department of Urology Faculty Papers

BACKGROUND: Treatment progression for men on active surveillance (AS) for prostate cancer (PCa) is driven primarily by grade and volume progression on isolated prostate biopsies (PBx). As PCa is a multifocal disease, regional disease progression over time should be accounted for.

OBJECTIVE: To validate the utility of the cumulative cancer location (CCLO) metric, which assesses regional core involvement, as described by Erickson et al (Cumulative cancer locations is a novel metric for predicting active surveillance outcomes: a multicenter study. Eur Urol Oncol 2018;1:268-75), in predicting AS outcomes in a North American cohort.

DESIGN, SETTING, AND PARTICIPANTS: A single-institutional retrospective chart …

A Clinician's Guide To Next Generation Imaging In Patients With Advanced Prostate Cancer (Radar Iii)., E. David Crawford, Phillip J. Koo, Neal Shore, Susan F. Slovin, Raoul S. Concepcion, Stephen J. Freedland, Leonard G. Gomella, Lawrence Karsh, Thomas E. Keane, Paul Maroni, David Penson, Daniel P. Petrylak, Ashley Ross, Vlad Mouraviev, Robert E. Reiter, Chaitanya Divgi, Evan Y. Yu

Department of Urology Faculty Papers

PURPOSE: The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration naïve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.

MATERIALS AND METHODS: The RADAR (Radiographic Assessments for Detection of Advanced …

Endoscopic Laser-Ablation For The Treatment Of Orthotopic And Ectopic Ureteroceles In Dogs: 13 Cases (2008-2017)., Cleo P. Rogatko, Allyson C. Berent, Larry G. Adams, Chick W. Weisse, Demetrius H. Bagley

Department of Urology Faculty Papers

BACKGROUND: Ureteroceles are a rare condition in dogs in which conventional treatments can result in substantial morbidity. Cystoscopic and fluoroscopic-guided laser ablation (CLA) of ureteroceles can successfully relieve obstruction.

OBJECTIVES: To describe the technique and outcomes of attempting CLA for treatment of ureteroceles in dogs.

ANIMALS: Thirteen client-owned dogs that underwent CLA for treatment of ureteroceles.

METHODS: Retrospective multicentered study. Medical records were reviewed in all dogs that underwent CLA for ureterocele(s). A laser was used to extend the opening of the ureteral orifice (UO) unless surgical conversion was necessary. Data collected included signalment, clinicopathologic data, imaging, procedural findings, complications, …