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  • 1
    Language: English
    In: Central European journal of urology, 2015, Vol.68(3), pp.277
    Description: Radical cystectomy represents nowadays the gold standard in the treatment of localized muscle-invasive bladder cancer and high risk non-muscle-invasive bladder cancer. On the other hand, the rate of morbidity and mortality remains significant despite the advances in perioperative management and postoperative care in recent years [1]. This is even more expressed with the fact that firstly, we talk about a disease affecting eldery people and secondly, the population is aging. Comorbities, and thus the risk of a complication or death, come with age that implies consideration of bladder sparing treatment like radiochemotherapy or partial cystectomy in these patients [2]. EAU guidelines recommend using the Charleson Comorbidity Index as an independent prognostic factor for perioperative mortality [2]. POSSUM and P-POSSUM provide tools for risk adjustment to predict morbidity and mortality which were developed and validated within the general surgical population. A retrospective multicenter study from Japan [3] validated both predictors on 280 patients operated on within a period of 9 years. The authors came to somewhat non-convincing results. POSSUM significantly underestimated morbidity and overestimated mortality. Only P-POSSUM correctly predicted mortality, though the AUC was not that impressive (0.518). Nontheless, the authors concluded that POSSUM underestimated mortality in low-risk patients. This was explained, besides other things, by the fact that most of the low-risk patiens had diversion different to ureterocutaneostomy, which led to longer operative times and consequently to more complications and deaths. The main limitations of the study are the retrospective data collection, short follow-up of 30 days, and obvious selection bias (a strikingly high number of ureterocutaneostomies implicating a co-morbid population with signifiant risk of morbidity and mortality). However, in order to choose the right treatment for an individual patient with advanced bladder cancer, validation of existing predictors or the investigation of new tools becomes more and more important. To get a global view on the matter, not only refferal centers with multiple operations done within a year must take part. The most important factors are a prospective standardized approach to data collection, developing appropriate patient databases and registers and adequate follow-up [4].
    Keywords: Medicine;
    ISSN: 2080-4806
    E-ISSN: 20804873
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  • 2
    Language: English
    In: European Urology Supplements, October 2015, Vol.14(6), pp.e1181-e1181
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S1569-9056(15)30217-7 Byline: K. Duskova, A . VeselA1/2, A. Brisuda, L. Jaroli, Z. Heger, M. Schmidt, M. Babjuk
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
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  • 3
    Language: English
    In: Cytopathology : official journal of the British Society for Clinical Cytology, December 2018, Vol.29(6), pp.537-544
    Description: The methodology of cell blocks (CBs) has long been an integrated part of cytology. However, there are very few data on CBs derived from urine. Their main disadvantage is a lack of cellularity, which limits their broader clinical applicability. Factors affecting cellular adequacy in urine remain unclear. We assessed the impact of basic clinical and cytopathological factors on the adequacy of cellularity in urinary CBs. Freshly voided urine was collected from 401 consecutive individuals. Of these, 167 patients were diagnosed with urothelial carcinoma. The remaining 234 patients had various benign urological conditions. Papanicolaou classes were determined and CBs produced. Cellular adequacy was assigned to each CB (acellular, hypocellular, moderate cellularity, high cellularity), and moderately and highly cellular CBs were considered as adequate. Several factors were analysed to find any correlation with the adequacy of the cellularity. In univariate analysis, seven factors significantly correlated with the adequacy of the CBs. In the multivariate model, positive sediment (OR = 3.7), female sex (OR = 2.7), positive urinary cytology (OR = 2.6) and positive leucocyturia (OR = 2.1) were independent predictors of adequate cellularity. Positive predictive value and negative predictive value of the model were 65.0% and 77.7%, respectively. We determined four clinical and cytopathological factors which independently predict adequate cellularity in urinary CBs. Based on these results, several clinical situations have been proposed, in which the highest probability of adequate cellularity in urinary CBs can be achieved.
    Keywords: Adequate Cellularity ; Immunocytochemistry ; Urinary Bladder ; Urinary Cell Block ; Urinary Cytology ; Urothelial Carcinoma
    ISSN: 09565507
    E-ISSN: 1365-2303
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  • 4
    Language: English
    In: PLoS ONE, 01 January 2013, Vol.8(3), p.e57886
    Description: Gene expression microarray and next generation sequencing efforts on conventional, clear cell renal cell carcinoma (ccRCC) have been mostly performed in North American and Western European populations, while the highest incidence rates are found in Central/Eastern Europe. We conducted whole-genome expression profiling on 101 pairs of ccRCC tumours and adjacent non-tumour renal tissue from Czech patients recruited within the "K2 Study", using the Illumina HumanHT-12 v4 Expression BeadChips to explore the molecular variations underlying the biological and clinical heterogeneity of this cancer. Differential expression analysis identified 1650 significant probes (fold change ≥2 and false discovery rate 〈0.05) mapping to 630 up- and 720 down-regulated unique genes. We performed similar statistical analysis on the RNA sequencing data of 65 ccRCC cases from the Cancer Genome Atlas (TCGA) project and identified 60% (402) of the downregulated and 74% (469) of the upregulated genes found in the K2 series. The biological characterization of the significantly deregulated genes demonstrated involvement of downregulated genes in metabolic and catabolic processes, excretion, oxidation reduction, ion transport and response to chemical stimulus, while simultaneously upregulated genes were associated with immune and inflammatory responses, response to hypoxia, stress, wounding, vasculature development and cell activation. Furthermore, genome-wide DNA methylation analysis of 317 TCGA ccRCC/adjacent non-tumour renal tissue pairs indicated that deregulation of approximately 7% of genes could be explained by epigenetic changes. Finally, survival analysis conducted on 89 K2 and 464 TCGA cases identified 8 genes associated with differential prognostic outcomes. In conclusion, a large proportion of ccRCC molecular characteristics were common to the two populations and several may have clinical implications when validated further through large clinical cohorts.
    Keywords: Sciences (General)
    E-ISSN: 1932-6203
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  • 5
    Language: English
    In: European Urology Supplements, October 2012, Vol.11(4), pp.103-103
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
    Source: ScienceDirect Journals (Elsevier)
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  • 6
    Language: English
    In: European Urology Supplements, November 2017, Vol.16(11), pp.e2941-e2941
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
    Source: ScienceDirect Journals (Elsevier)
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  • 7
    Language: English
    In: European Urology Supplements, November 2017, Vol.16(11), pp.e2942-e2942
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
    Source: ScienceDirect Journals (Elsevier)
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  • 8
    Language: English
    In: European Urology Supplements, November 2014, Vol.13(6), pp.e1313-e1313
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S1569-9056(14)61514-1 Byline: J. Hrbacek, A. Brisuda, M. Koldova, J. Hacek, M. Babjuk
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
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  • 9
    Language: English
    In: European Urology Supplements, November 2014, Vol.13(6), pp.e1386-e1386
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S1569-9056(14)61587-6 Byline: A. Brisuda, E. Pazourkova, V. Soukup, J. Hrbacek, O. Aapoun, J. Mares, M. Korabecna, A. HoAinek, T. Hanus, M. Babjuk
    Keywords: Medicine
    ISSN: 1569-9056
    E-ISSN: 1878-1500
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  • 10
    In: BJU International, March 2013, Vol.111(3b), pp.E30-E36
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2012.11433.x/abstract Byline: Michael Rink(1)(4), Daniel J. Lee(1), Matthew Kent(2), Evanguelos Xylinas(1)(7), Hans-Martin Fritsche(5), Marko Babjuk(8), Antonin Brisuda(8), Jens Hansen(4)(9), David A. Green(1), Atiqullah Aziz(5), Eugene K. Cha(1), Giacomo Novara(10), Felix K. Chun(4), Yair Lotan(3), Patrick J. Bastian(6), Derya Tilki(6), Paolo Gontero(11), Armin Pycha(12), Jack Baniel(13), Roy Mano(13), Vincenzo Ficarra(10), Quoc-Dien Trinh(9), Scott T. Tagawa(1), Pierre I. Karakiewicz(9), Douglas S. Scherr(1), Daniel D. Sjoberg(2), Shahrokh F. Shariat(1), Keywords: urothelial carcinoma; bladder cancer; recurrence; survival; prognosis Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Outcomes after disease recurrence in patients with urothelial carcinoma of the bladder treated with radical cystectomy are variable, but the majority of patients die from the disease within 2 years after disease recurrence. Knowledge about prognostic factors that may influence survival after disease recurrence is limited. We found that outcomes after disease recurrence in patients with urothelial carcinoma of the bladder are significantly affected by common clinicopathological factors. In addition, a shorter time from surgery to disease recurrence is significantly associated with poor outcomes. These factors should be considered when scheduling salvage chemotherapy protocols/clinical trials. OBJECTIVE To describe the natural history following disease recurrence after radical cystectomy (RC) and to identify prognostic factors that influence cancer-specific survival with special focus on time from RC to disease recurrence. METHODS We identified 1545 patients from 16 international institutions who experienced disease recurrence after RC and bilateral lymphadenectomy. None of the patients received preoperative chemotherapy; 549 patients received adjuvant chemotherapy. A multivariable Cox regression model addressed time to cancer-specific mortality after disease recurrence. RESULTS The median cancer-specific survival time after disease recurrence was 6.9 months (95% CI 6.3-7.4). Overall, 1254 of 1545 patients died from urothelial carcinoma of the bladder and 47 patients died from other causes. The actuarial cancer-specific survival estimate at 12 months after disease recurrence was 32%. On multivariable analysis, non-organ-confined tumour stages (hazard ratio [HR] 1.38, P= 0.002), lymph node metastasis (HR 1.25, P 0.001), positive soft tissue surgical margin (HR 1.32, P= 0.002), female gender (HR 1.21, P= 0.003), advanced age (HR 1.16, P 0.001) and a shorter interval from surgery to disease recurrence (P 0.001) were significantly associated with cancer-specific mortality. The adjusted risk of death from cancer within 1 year after disease recurrence for patients who recurred 6, 12 and 24 months after surgery was 70%, 64% and 60%, respectively. CONCLUSIONS Over two-thirds of patients who experience disease recurrence of urothelial carcinoma of the bladder after RC die within 12 months. Common clinicopathological factors are strongly associated with cancer-specific mortality. A shorter time from surgery to disease recurrence is significantly associated with poor outcomes. Accurate risk stratification could help in patient counselling and decision-making regarding salvage treatment. Author Affiliation: (1)Weill Cornell Medical College, New York Presbyterian Hospital (2)Memorial Sloan Kettering Cancer Center, New York, NY (3)University of Texas Southwestern Medical Center, Dallas, TX, USA (4)University Medical Center Hamburg-Eppendorf, Hamburg (5)Caritas St Josef Medical Centre, University of Regensburg, Regensburg (6)Ludwig-Maximilians-Universitat Munchen, Klinikum Grosshadern, Munich, Germany (7)Cochin Hospital, APHP, Paris Descartes University, Paris, France (8)Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (9)University of Montreal, Montreal, QC, Canada (10)University of Padua, Padua (11)University of Turin, Urologia 1 Molinette Hospital, Torino (12)General Hospital of Bolzano, Italy (13)Rabin Medical Center, Petah-Tikva, Israel Correspondence: (*) Shahrokh F. Shariat, Department of Urology and Division of Medical Oncology, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 East 68th Street, Box 94, Starr 900, New York, NY 10065, USA. e-mail: sfshariat@gmail.com Article Note: (*) MR and DJL contributed equally to this paper. Accepted for publication 20 June 2012
    Keywords: Urothelial Carcinoma ; Bladder Cancer ; Recurrence ; Survival ; Prognosis
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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