Urology Commons^™

Steap1-4 (Six-Transmembrane Epithelial Antigen Of The Prostate 1-4) And Their Clinical Implications For Prostate Cancer, Michael Xu, Latese Evans, Candice L Bizzaro, Fabio Quaglia, Cecilia E Verrillo, Li Li, Julia Stieglmaier, M J Schiewer, Lucia R Languino, William Kevin Kelly

Department of Urology Faculty Papers

Six-Transmembrane Epithelial Antigen of the Prostate 1-4 (STEAP1-4) compose a family of metalloproteinases involved in iron and copper homeostasis and other cellular processes. Thus far, five homologs are known: STEAP1, STEAP1B, STEAP2, STEAP3, and STEAP4. In prostate cancer, STEAP1, STEAP2, and STEAP4 are overexpressed, while STEAP3 expression is downregulated. Although the metalloreductase activities of STEAP1-4 are well documented, their other biological functions are not. Furthermore, the properties and expression levels of STEAP heterotrimers, homotrimers, heterodimers, and homodimers are not well understood. Nevertheless, studies over the last few decades have provided sufficient impetus to investigate STEAP1-4 as potential biomarkers and therapeutic …

A Scoping Review Of Penile Implant Biofilms-What Do We Know And What Remains Unknown?, Joon Yau Leong, Courtney E Capella, Maria J D'Amico, Selin Isguven, Caroline Purtill, Priscilla Machado, Lauren J Delaney, Gerard D Henry, Noreen J Hickok, Flemming Forsberg, Paul H Chung

Department of Urology Faculty Papers

Background: Penile prosthesis (PP) is a gold standard for treatment of erectile dysfunction given its reliability and efficacy. Infection remains the most feared complication of prosthetic surgery, which usually results in device removal, and places a significant economic burden on the healthcare system. While biofilms have shown to support the persistence of microorganisms, the degree by which this matrix is truly pathogenic remains unknown given its high prevalence even in asymptomatic patients. We aim to review and summarize the current literature pertaining to biofilm formation in the setting of PP surgeries in clinically infected and non-infected cases.

Methods: Searches were …

Microorganism Profiles Of Penile Prosthesis Removed For Infection, Erosion, And Mechanical Malfunction Based On Next-Generation Sequencing., Paul H Chung, Joon Yau Leong, Caleb D Phillips, Gerard D Henry

Department of Urology Faculty Papers

BACKGROUND: Next-generation sequencing (NGS) is an emerging technology that may allow for more sensitive and sophisticated microbial testing of the microbiota of penile prostheses (PP).

AIM: To describe the microorganism profiles of PP explanted for infection, erosion, and mechanical malfunction using NGS.

METHODS: All patients who underwent PP removal by two physicians at two institutions were identified. Differences in alpha diversity (ie, number of species detected, species diversity across samples) and microbiome compositional profiles (Bray-Curtis community dissimilarities) across samples were assessed using ANOVA and PERMANOVA, respectively.

OUTCOMES: Number of species detected, species diversity across samples, and microbiome compositional profiles.

RESULTS: …

Case Report: Bilateral Emphysematous Pyelonephritis With Pneumatosis Intestinalis, Maria D'Amico, Joseph Izes, Akhil Das

Department of Urology Faculty Papers

Emphysematous pyelonephritis is a severe and rare gas producing infection in the renal parenchyma or collecting system. Diabetes mellitus is an established risk factor. Treatment options include antibiotics, minimally invasive management such as percutaneous drainage, or nephrectomy. This case report describes a 40-year-old female with newly diagnosed diabetes and cirrhosis who presented with left sided emphysematous pyelonephritis. After initial management with intravenous antibiotics and drainage of the collecting system, this patient's clinical condition worsened, and subsequent repeat imaging revealed bilateral emphysematous pyelonephritis as well as pneumatosis intestinalis.

Gross Hematuria: An Unusual Presenting Symptom Of Systemic Wild-Type Transthyretinamyloidosis., Sage A. Vincent, Daniel Christensen, Perry R. Weiner

Department of Urology Faculty Papers

Amyloidosis of the urinary bladder is a rare cause of gross hematuria. In patients with systemic amyloidosis, identification is nearly always related to cardiac complaints; urologic presenting symptoms are extremely uncommon. We present a 77-year-old male patient with painless gross hematuria ultimately found to be secondary to systemic wild-type transthyretin amyloidosis. He underwent transurethral resection of the bladder lesion and was initiated on transthyretin stabilizing medication. In the 6 months since starting treatment, the patient has had no further episodes of gross hematuria, but will require cystoscopic surveillance for evidence of recurrence or concomittment urothelial carcinoma.

Collaborative Review: Factors Influencing Treatment Decisions For Patients With A Localized Solid Renal Mass., Thenappan Chandrasekar, Stephen A. Boorjian, Umberto Capitanio, Boris Gershman, Maria Carmen Mir, Alexander Kutikov

Department of Urology Faculty Papers

CONTEXT: With the addition of active surveillance and thermal ablation (TA) to the urologist's established repertoire of partial (PN) and radical nephrectomy (RN) as first-line management options for localized renal cell carcinoma (RCC), appropriate treatment decision-making has become increasingly nuanced.

OBJECTIVE: To critically review the treatment options for localized, nonrecurrent RCC; to highlight the patient, renal function, tumor, and provider factors that influence treatment decisions; and to provide a framework to conceptualize that decision-making process.

EVIDENCE ACQUISITION: A collaborative critical review of the medical literature was conducted.

EVIDENCE SYNTHESIS: We identify three key decision points when managing localized RCC: (1) …

Perspectives And Experiences Of Transgender And Non-Binary Individuals On Seeking Urological Care., Paul H Chung, Sabina Spigner, Vishal Swaminathan, Seth Teplitsky, Rosemary Frasso

Department of Urology Faculty Papers

OBJECTIVE: To describe perspectives and experiences related to urology care-seeking of transgender and non-binary (TGNB) individuals assigned male at birth.

MATERIALS AND METHODS: This HIPAA-compliant study was IRB approved and followed Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines. Through semistructured interviews, perspectives, and experiences of individuals related to urology care-seeking were explored. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Codes pertaining to patient experiences were assessed and described.

RESULTS: Twenty-five TGNB individuals assigned male at birth were interviewed. Participants reported an array of factors that …

Ureteroscopic Biopsy Of Upper Tract Urothelial Carcinoma And Role Of Urinary Biomarkers, Katherine E Smentkowski, Demetrius H. Bagley, Scott G. Hubosky

Department of Urology Faculty Papers

Ureteroscopic biopsy is an integral part of diagnosis of urothelial carcinoma of the upper urinary tract. It can be a technical challenge, but diagnostic rates have improved remarkably with refinements in surgical technique and specimen processing. Cytology aids with diagnosis and other urinary biomarkers continue to evolve, which may help further stratify patients for treatment. The current literature on the ureteroscopic biopsy and role of urinary biomarkers is reviewed and summarized below.

Stress Urinary Incontinence Post-Holmium Laser Enucleation Of The Prostate: A Single-Surgeon Experience., Akhil K Das, Seth Teplitsky, Tomy Perez, Jenny Guo, Joon Yau Leong, Patrick J Shenot

Department of Urology Faculty Papers

PURPOSE: To identify incidence and predictors of stress urinary incontinence (SUI) following Holmium laser enucleation of the prostate (HoLEP).

MATERIALS AND METHODS: We performed a retrospective review of 589 HoLEP patients from 2012-2018. Patients were assessed at pre-operative and post-operative visits. Univariate and multivariate regression analyses were performed to identify predictors of SUI.

RESULTS: 52/589 patients (8.8%) developed transient SUI, while 9/589 (1.5%) developed long-term SUI. tSUI resolved for 46 patients (88.5%) within the first six weeks and in 6 patients (11.5%) between 6 weeks to 3 months. Long-term SUI patients required intervention, achieving continence at 16.4 months on average, …

Simple Frameshifts In Minimally Invasive Surgery Postoperative Pain Management Significantly Reduce Opiate Prescriptions., Thenappan Chandrasekar, Lydia Glick, Daniella Wong, Timothy M. Han, Joon Yau Leong, Misung Yi, James R. Mark, Mark J. Mann, Edouard J. Trabulsi, Costas D. Lallas

Department of Urology Faculty Papers

INTRODUCTION: To evaluate the impact of an 'opt-in' non-narcotic postoperative pain regimen on narcotic utilization and patient-reported pain scores.

MATERIALS AND METHODS: A prospective, non-blinded pre- and post-interventional trial was conducted, including a lead-in period for baseline evaluation. The intervention group received a new pain protocol prioritizing non-narcotic medications, an 'opt-in' requirement for opiates, and standardized patient education. Study outcomes included opiate prescription and utilization (measured in Morphine Equivalent Doses) and reported pain scores on postoperative day (POD) 1, discharge and follow up.

RESULTS: At discharge, 70% fewer patients were prescribed any opioids (ARR: -0.7; p < 0.001); the amount prescribed was reduced by 95% (pre-intervention 69.3 mg versus post-intervention 3.5 mg, p < 0.001). Mean opioids used following discharge decreased by 76% (14.7 mg versus 3.5 mg, p = 0.011). In a subgroup analysis of robotic prostatectomies, there was a 95% reduction in mean opioids prescribed at discharge (64.6 mg versus 3.2 mg, p < 0.001) and 82% reduction in utilization over entire postoperative course (87.6 mg versus 15.7 mg, p = 0.001). There was no significant difference in pain scores between intervention groups at POD 1, discharge and follow up for patients (entire cohort and post-prostatectomy).

CONCLUSION: A standardized pain …

Non-Obstetrical Robotic-Assisted Laparoscopic Surgery In Pregnancy: A Systematic Literature Review., Courtney Capella, Joseph Godovchik, Thenappan Chandrasekar, Huda B. Al-Kouatly

Department of Urology Faculty Papers

Urologic and gynecologic surgeons are the top utilizers of robotic surgery; however, non-obstetrical robotic-assisted laparoscopic surgery (RALS) in pregnant patients is infrequent. A systematic literature review was performed to ascertain the frequency, indication and complications of RALS in pregnancy. Results showed thirty-eight pregnancies from eleven publications between 2008-2020. Five cases were for urologic indication and thirty-three for gynecologic indication. Minimal surgical alterations were required. Although no adverse maternal-fetal outcomes were reported, there are not enough cases published to determine safety. This review demonstrates the feasibility of RALS for the pregnant population in the hands of competent robotic surgeons.

Robotic Adrenalectomy For Functional Adenoma In Second Trimester Treats Worsening Hypertension., Courtney E. Capella, Thenappan Chandrasekar, May Jean Counsilman, Christopher Sebastiano, Costas D. Lallas, Huda B. Al-Kouatly

Department of Urology Faculty Papers

A 33-year-old G6P3023 was found to have a 4.2 cm right adrenal incidentaloma during an admission for right pyelonephritis. Computed tomography (CT) was performed to rule out perinephric abscess in the setting of worsening leukocytosis while on antibiotics ( Fig. 1). Initial differential diagnosis from endocrinology included pheochromocytoma and primary aldosteronism. Due to the lack of typical physical exam stigmata, Cushing syndrome was initially of low concern. Of note, her past medical history included hypertension treated with amlodipine 10 mg and hydrochlorothiazide 12.5 mg. During admission, extensive endocrine laboratory workup demonstrated an elevated aldosterone:plasma renin activity, suppressed dehydroepiandrosterone (DHEA), normal …

Setting The Standards: Examining Research Productivity Among Academic Urologists In The Usa And Canada In 2019., Thenappan Chandrasekar, Timothy M. Han, Lydia Glick, Joon Yau Leong, Seth Teplitsky, Rodrigo Noorani, Hanan Goldberg, Zachary Klaassen, Christopher J.D. Wallis, James R. Mark, Edouard J. Trabulsi, Costas D. Lallas, Leonard G. Gomella

Department of Urology Faculty Papers

BACKGROUND: Research productivity among academic urologists is strongly encouraged, but little data are available on productivity metrics within the field.

OBJECTIVE: To provide the first comprehensive survey of research productivity among academic urologists in the USA and Canada.

DESIGN, SETTING, AND PARTICIPANTS: Using the Accreditation Council for Graduate Medical Education, the Canadian Resident Matching Service, and individual program websites, all active accredited urology faculties were identified. For each individual, we collected data on American Urological Association section, title, gender, fellowship training, Scopus H-index, and citations. Comprehensive searches were completed during March-May 2019.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Descriptive statistics for …

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 …

Multi-Institution Analysis Of Racial Disparity Among African- American Men Eligible For Prostate Cancer Active Surveillance, Michael Dinizo, Weichung Shih, Young Suk Kwon, Daniel Eun, Adam Reese, Laura Giusto, Edouard J. Trabulsi, Bertram Yuh, Nora Ruel, Daniel Marchalik, Jonathan Hwang, Shilajit D. Kundu, Scott Eggener, Isaac Yi Kim

Department of Urology Faculty Papers

There is a significant controversy on whether race should be a factor in considering active surveillance for low-risk prostate cancer. To address this question, we analyzed a multi-institution database to assess racial disparity between African-American and White-American men with low risk prostate cancer who were eligible for active surveillance but underwent radical prostatectomy. A retrospective analysis of prospectively collected clinical, pathologic and oncologic outcomes of men with low-risk prostate cancer from seven tertiary care institutions that underwent radical prostatectomy from 2003–2014 were used to assess potential racial disparity. Of the 333 (14.8%) African-American and 1923 (85.2%) White-American men meeting active …

First Report Of Nrg Oncology/Radiation Therapy Oncology Group 0622: A Phase 2 Trial Of Samarium-153 Followed By Salvage Prostatic Fossa Irradiation In High-Risk Clinically Nonmetastatic Prostate Cancer After Radical Prostatectomy., Richard K. Valicenti, Stephanie L. Pugh, Edouard J. Trabulsi, Oliver Sartor, Eric C. Ko, Michael R. Girvigian, Seth A. Rosenthal, Mark E. Shaves, Jean Hoffman-Censits, John Schallenkamp, Howard M. Sandler

Department of Urology Faculty Papers

PURPOSE: To investigate the utility of ¹⁵³Sm lexidronam (Quadramet) in the setting of men with prostate cancer status post radical prostatectomy who develop biochemical failure with no clinical evidence of osseous metastases.

PATIENTS AND METHODS: Trial NRG Oncology RTOG 0622 is a single-arm phase 2 trial that enrolled men with pT2-T4, N0-1, M0 prostate cancer status post radical prostatectomy, who meet at least 1 of these biochemical failure criteria: (1) prostate-specific antigen (PSA) > 1.0 ng/mL; (2) PSA > 0.2 ng/mL if Gleason score 9 to 10; or (3) PSA > 0.2 ng/mL if N1. Patients received ¹⁵³Sm (2.0 mCi/kg intravenously …

Interdisciplinary Learning Project, Demetrius H. Bagley, Md, Maryann Sonzogni, Rn, Bsn, Bridget Weissinger, Cst, Kelly A. Healy, Md

Department of Urology Faculty Papers

Description

With a 20 year history, we have implemented a multifaceted IPE program for members of the urology team. These include urologists, both faculty and community, residents, medical students, nurses, nurse practitioners, physician assistants, medical technicians/assistants and administrative/ clerical personnel with patient contact. The program was designed with three components: a yearly symposium for all, and journal club(JC) and lectures for non-physicians. Participation is on a voluntary, noncompensatory basis. Outcome measures include routine anonymous participant feedback via questionnaire.

Results

The programs were very positively received. Limiting obstacles were also observed. Initially too many papers were assigned in the Journal club. …

Clinical Influences In The Multidisciplinary Management Of Small Renal Masses At A Tertiary Referral Center, Costas D. Lallas, Kymora Scotland, Michael Zhang, Daisey Schaeffer, Anne Calvaresi, Leonard G. Gomella, Daniel Brown, Colette Shaw, Edouard J. Trabulsi

Department of Urology Faculty Papers

Introduction We designed a multidisciplinary Small Renal Mass Center to help patients decide among treatment options and individualize therapy for small renal masses. In this model physicians and support staff from multiple specialties work as a team to evaluate and devise a treatment plan for patients at the same organized visit. Methods We retrospectively reviewed the records of 263 patients seen from 2009 to 2014. Monitored patient characteristics included age, Charlson comorbidity index, body mass index, nephrometry score, tumor size and estimated glomerular filtration rate. Univariate and multivariate analyses were performed to identify patient characteristics associated with each treatment choice. …

An Approach Using Psa Levels Of 1.5 Ng/Ml As The Cutoff For Prostate Cancer Screening In Primary Care., E. David Crawford, Matt T. Rosenberg, Alan W. Partin, Matthew R. Cooperberg, Michael Maccini, Stacy Loeb, Curtis A. Pettaway, Neal D. Shore, Paul Arangua, John Hoenemeyer, Mike Leveridge, Michael Leapman, Peter Pinto, Ian M. Thompson, Peter Carroll, James Eastham, Leonard G. Gomella, Eric A. Klein

Department of Urology Faculty Papers

No abstract provided.

Mechanisms Of Progranulin Action And Regulation In Genitourinary Cancers., Ryuta Tanimoto, Kuojung G Lu, Shi-Qiong Xu, Simone Buraschi, Antonino Belfiore, Renato V. Iozzo, Andrea Morrione

Department of Urology Faculty Papers

The growth factor progranulin has emerged in recent years as a critical regulator of transformation in several cancer models, including breast cancer, glioblastomas, leukemias, and hepatocellular carcinomas. Several laboratories, including ours, have also demonstrated an important role of progranulin in several genitourinary cancers, including ovarian, endometrial, cervical, prostate, and bladder tumors, where progranulin acts as an autocrine growth factor thereby modulating motility and invasion of transformed cells. In this review, we will focus on the mechanisms of action and regulation of progranulin signaling in genitourinary cancers with a special emphasis on prostate and bladder tumors.

Long-Term Oncological Outcomes Of A Phase Ii Trial Of Neoadjuvant Chemohormonal Therapy Followed By Radical Prostatectomy For Patients With Clinically Localised, High-Risk Prostate Cancer., Jonathan L. Silberstein, Stephen A. Poon, Daniel D. Sjoberg, Alexandra C. Maschino, Andrew J. Vickers, Aaron Bernie, Badrinath R. Konety, William Kevin Kelly, James A. Eastham

Department of Urology Faculty Papers

OBJECTIVE: To determine long-term oncological outcomes of radical prostatectomy (RP) after neoadjuvant chemohormonal therapy (CHT) for clinically localised, high-risk prostate cancer.

PATIENTS AND METHODS: In this phase II multicentre trial of patients with high-risk prostate cancer (PSA level >20 ng/mL, Gleason ≥8, or clinical stage ≥T3), androgen-deprivation therapy (goserelin acetate depot) and paclitaxel, carboplatin and estramustine were administered before RP. We report the long-term oncological outcomes of these patients and compared them to a contemporary cohort who met oncological inclusion criteria but received RP only.

RESULTS: In all, 34 patients were enrolled and followed for a median of 13.1 years. …

Trop-2 Is Up-Regulated In Invasive Prostate Cancer And Displaces Fak From Focal Contacts., Marco Trerotola, Kirat K Ganguly, Ladan Fazli, Carmine Fedele, Huimin Lu, Anindita Dutta, Qin Liu, Tiziana De Angelis, Luke W Riddell, Natalia A Riobo, Martin E Gleave, Amina Zoubeidi, Richard Pestell, Dario C Altieri, Lucia R Languino

Department of Urology Faculty Papers

In this study, we show that the transmembrane glycoprotein Trop-2 is up-regulated in human prostate cancer (PCa) with extracapsular extension (stages pT3/pT4) as compared to organ-confined (stage pT2) PCa. Consistent with this evidence, Trop-2 expression is found to be increased in metastatic prostate tumors of Transgenic Adenocarcinoma of Mouse Prostate mice and to strongly correlate with α5β1 integrin levels. Using PCa cells, we show that Trop-2 specifically associates with the α5 integrin subunit, as binding to α3 is not observed, and that Trop-2 displaces focal adhesion kinase from focal contacts. In support of the role of Trop-2 as a promoter …

A Novel Role For Drebrin In Regulating Progranulin Bioactivity In Bladder Cancer., Shi-Qiong Xu, Simone Buraschi, Alaide Morcavallo, Marco Genua, Tomoaki Shirao, Stephen C Peiper, Leonard G Gomella, Ruth Birbe, Antonino Belfiore, Renato V Iozzo, Andrea Morrione

Department of Urology Faculty Papers

We recently established a critical role for the growth factor progranulin in bladder cancer insofar as progranulin promotes urothelial cancer cell motility and contributes, as an autocrine growth factor, to the transformed phenotype by modulating invasion and anchorage-independent growth. In addition, progranulin expression is upregulated in invasive bladder cancer tissues compared to normal controls. However, the molecular mechanisms of progranulin action in bladder cancer have not been fully elucidated. In this study, we searched for novel progranulin-interacting proteins using pull-down assays with recombinant progranulin and proteomics. We discovered that drebrin, an F-actin binding protein, bound progranulin in urothelial cancer cells. …

Treatment Of Exophytic Renal Cancer Smaller Than 3 Cm: Surgery Versus Active Surveillance., Costas D. Lallas, Edouard J. Trabulsi, Samuel D. Kaffenberger, Karim A Touijer

Department of Urology Faculty Papers

No abstract provided.