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Reis H, Al-Ahmadie H, Szarvas T, Grünwald V, Köllermann J, Koll F, Hadaschik B, Chun F, Wild PJ, Paner GP. [Rare tumors and tumor types of the urinary system in the 5th edition of the WHO classification 2022]. Pathologie (Heidelb) 2024:10.1007/s00292-024-01329-2. [PMID: 38639771 DOI: 10.1007/s00292-024-01329-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
The 5th edition of the World Health Organization (WHO) classification of tumors of the urinary tract and male genital organs introduced both general and specific changes in structure, classification, and nomenclature. This also applies to rarer tumors and tumor subtypes of the urinary system. Knowledge of these changes is relevant for routine histopathological work. This article provides an overview of the main new features of the rarer tumors and tumor subtypes of the urinary system in the new edition of the WHO classification.
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Affiliation(s)
- Henning Reis
- Dr. Senckenbergisches Institut für Pathologie (SIP), Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Deutschland.
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, USA
| | - Tibor Szarvas
- Klinik für Urologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Urologie, Semmelweis Universität, Budapest, Ungarn
| | - Viktor Grünwald
- Klinik für Urologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - Jens Köllermann
- Dr. Senckenbergisches Institut für Pathologie (SIP), Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Deutschland
| | - Florestan Koll
- Klinik für Urologie, Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
| | - Boris Hadaschik
- Klinik für Urologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - Felix Chun
- Klinik für Urologie, Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
| | - Peter J Wild
- Dr. Senckenbergisches Institut für Pathologie (SIP), Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Deutschland
| | - Gladell P Paner
- Department of Pathology, University of Chicago, Chicago, USA
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Püllen L, Costa PF, Darr C, Hess J, Kesch C, Rehme C, Wahl M, Yirga L, Reis H, Szarvas T, van Leeuwen FWB, Herrmann K, Hadaschik BA, Tschirdewahn S, Krafft U. Near-infrared fluorescence lymph node template region dissection plus backup lymphadenectomy in open radical cystectomy for bladder cancer using an innovative handheld device: A single center experience. J Surg Oncol 2024. [PMID: 38583145 DOI: 10.1002/jso.27618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/10/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND The extent of pelvic lymphadenectomy (PLND) as part of radical cystectomy (RC) for bladder cancer (BC) remains unclear. Sentinel-based and lymphangiographic approaches could lead to reduced morbidity without sacrificing oncologic safety. OBJECTIVE To evaluate the feasibility and diagnostic value of fluorescence-guided template sentinel region dissection (FTD) using a handheld near-infrared fluorescence (NIRF) camera in open radical cystectomy. DESIGN, SETTING, AND PARTICIPANTS After peritumoral cystoscopic injection of indocyanine green (ICG) 21 patients underwent open RC with FTD due to BC between June 2019 and June 2021. Intraoperatively, the FIS-00 Hamamatsu Photonics® NIRF camera was used to identify and resect fluorescent template sentinel regions (FTRs) followed by extended pelvic lymphadenectomy (ePLND) as oncological back-up. OUTCOME MEASUREMENT AND STATISTICAL ANALYSIS Descriptive analysis of positive and negative results per template region. RESULTS AND LIMITATIONS FTRs were identified in all 21 cases. Median time (range) from ICG injection to fluorescence detection was 75 (55-125) minutes. On average (SD), 33.4 (9.6) lymph nodes were dissected per patient. Considering template regions as the basis of analysis, 67 (38.3%) of 175 resected regions were NIRF-positive, with 13 (7.4%) regions harboring lymph node metastases. We found no metastatic lymph nodes in NIRF-negative template regions. Outside the standard template, two NIRF-positive benign nodes were identified. CONCLUSION The concept of NIRF-guided FTD proved for this group all lymph node metastases to be found in NIRF-positive template regions. Pending validation in a larger collective, resection of approximately 40% of standard regions may be sufficient and may result in less morbidity.
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Affiliation(s)
- Lukas Püllen
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Pedro F Costa
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Nuclear Medicine, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
| | - Christopher Darr
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Jochen Hess
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Claudia Kesch
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christian Rehme
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Milan Wahl
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Leubet Yirga
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tibor Szarvas
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Fijs W B van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Ken Herrmann
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Nuclear Medicine, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
| | - Boris A Hadaschik
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Stephan Tschirdewahn
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Ulrich Krafft
- Department of Urology, West German Cancer Center, University Duisburg Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
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Fazekas T, Shim SR, Basile G, Baboudjian M, Kói T, Przydacz M, Abufaraj M, Ploussard G, Kasivisvanathan V, Rivas JG, Gandaglia G, Szarvas T, Schoots IG, van den Bergh RCN, Leapman MS, Nyirády P, Shariat SF, Rajwa P. Magnetic Resonance Imaging in Prostate Cancer Screening: A Systematic Review and Meta-Analysis. JAMA Oncol 2024:2817308. [PMID: 38576242 PMCID: PMC10998247 DOI: 10.1001/jamaoncol.2024.0734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/22/2024] [Indexed: 04/06/2024]
Abstract
Importance Prostate magnetic resonance imaging (MRI) is increasingly integrated within the prostate cancer (PCa) early detection pathway. Objective To systematically evaluate the existing evidence regarding screening pathways incorporating MRI with targeted biopsy and assess their diagnostic value compared with prostate-specific antigen (PSA)-based screening with systematic biopsy strategies. Data Sources PubMed/MEDLINE, Embase, Cochrane/Central, Scopus, and Web of Science (through May 2023). Study Selection Randomized clinical trials and prospective cohort studies were eligible if they reported data on the diagnostic utility of prostate MRI in the setting of PCa screening. Data Extraction Number of screened individuals, biopsy indications, biopsies performed, clinically significant PCa (csPCa) defined as International Society of Urological Pathology (ISUP) grade 2 or higher, and insignificant (ISUP1) PCas detected were extracted. Main Outcomes and Measures The primary outcome was csPCa detection rate. Secondary outcomes included clinical insignificant PCa detection rate, biopsy indication rates, and the positive predictive value for the detection of csPCa. Data Synthesis The generalized mixed-effect approach with pooled odds ratios (ORs) and random-effect models was used to compare the MRI-based and PSA-only screening strategies. Separate analyses were performed based on the timing of MRI (primary/sequential after a PSA test) and cutoff (Prostate Imaging Reporting and Data System [PI-RADS] score ≥3 or ≥4) for biopsy indication. Results Data were synthesized from 80 114 men from 12 studies. Compared with standard PSA-based screening, the MRI pathway (sequential screening, PI-RADS score ≥3 cutoff for biopsy) was associated with higher odds of csPCa when tests results were positive (OR, 4.15; 95% CI, 2.93-5.88; P ≤ .001), decreased odds of biopsies (OR, 0.28; 95% CI, 0.22-0.36; P ≤ .001), and insignificant cancers detected (OR, 0.34; 95% CI, 0.23-0.49; P = .002) without significant differences in the detection of csPCa (OR, 1.02; 95% CI, 0.75-1.37; P = .86). Implementing a PI-RADS score of 4 or greater threshold for biopsy selection was associated with a further reduction in the odds of detecting insignificant PCa (OR, 0.23; 95% CI, 0.05-0.97; P = .048) and biopsies performed (OR, 0.19; 95% CI, 0.09-0.38; P = .01) without differences in csPCa detection (OR, 0.85; 95% CI, 0.49-1.45; P = .22). Conclusion and relevance The results of this systematic review and meta-analysis suggest that integrating MRI in PCa screening pathways is associated with a reduced number of unnecessary biopsies and overdiagnosis of insignificant PCa while maintaining csPCa detection as compared with PSA-only screening.
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Affiliation(s)
- Tamás Fazekas
- Comprehensive Cancer Center, Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Sung Ryul Shim
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Giuseppe Basile
- Unit of Urology, Urological Research Institute, Division of Oncology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Michael Baboudjian
- Department of Urology, Assistance Publique des Hôpitaux de Marseille, North Academic Hospital, Marseille, France
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Mathematics, Department of Stochastics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | | | - Veeru Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London, England
| | - Juan Gómez Rivas
- Department of Urology, Hospital Universitario La Paz, Madrid, Spain
| | - Giorgio Gandaglia
- Unit of Urology, Urological Research Institute, Division of Oncology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium–University Hospital Essen, Essen, Germany
| | - Ivo G. Schoots
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Roderick C. N. van den Bergh
- Department of Urology, St Antonius Hospital, Utrecht, the Netherlands
- Department of Urology, Erasmus MC, Rotterdam, the Netherlands
| | | | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Shahrokh F. Shariat
- Comprehensive Cancer Center, Department of Urology, Medical University of Vienna, Vienna, Austria
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Urology, Weill Cornell Medical College, New York, New York
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Pawel Rajwa
- Comprehensive Cancer Center, Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Urology, Medical University of Silesia, Zabrze, Poland
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Filipov T, Teutsch B, Szabó A, Forintos A, Ács J, Váradi A, Hegyi P, Szarvas T, Ács N, Nyirády P, Deák PÁ. Investigating the role of ultrasound-based shear wave elastography in kidney transplanted patients: correlation between non-invasive fibrosis detection, kidney dysfunction and biopsy results-a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-023-01856-w. [PMID: 38427308 DOI: 10.1007/s40620-023-01856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Interstitial fibrosis and tubular atrophy are leading causes of renal allograft failure. Shear wave elastography could be a promising noninvasive method for providing information on the state of the kidney, with specific regard to fibrosis but currently available data in the literature are controversial. Our study aimed to analyze the correlation between shear wave elastography and various kidney dysfunction measures. METHODS This review was registered on PROSPERO (CRD42021283152). We systematically searched three major databases (MEDLINE, Embase, and CENTRAL) for articles concerning renal transplant recipients, shear wave elastography, fibrosis, and kidney dysfunction. Meta-analytical calculations for pooled Pearson and Spearman correlation coefficients (r) were interpreted with 95% confidence intervals (CIs). Heterogeneity was tested with Cochran's Q test. I2 statistic and 95% CI were reported as a measurement of between-study heterogeneity. Study quality was assessed with the QUADAS2 tool. RESULTS In total, 16 studies were included in our meta-analysis. Results showed a moderate correlation between kidney stiffness and interstitial fibrosis and tubular atrophy, graded according to BANFF classification, on biopsy findings for pooled Pearson (r = 0.48; CI: 0.20, 0.69; I2 = 84%) and Spearman correlations (r = 0.57; CI: 0.35, 0.72; I2 = 74%). When compared to kidney dysfunction parameters, we found a moderate correlation between shear wave elastography and resistive index (r = 0.34 CI: 0.13, 0.51; I2 = 67%) and between shear wave elastography and estimated Glomerular Filtration Rate (eGFR) (r = -0.65; CI: - 0.81, - 0.40; I2 = 73%). All our outcomes had marked heterogeneity. CONCLUSION Our results showed a moderate correlation between kidney stiffness measured by shear wave elastography and biopsy results. While noninvasive assessment of kidney fibrosis after transplantation is an important clinical goal, there is insufficient evidence to support the use of elastography over the performance of a kidney biopsy.
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Affiliation(s)
- Teodóra Filipov
- Department of Interventional Radiology, Heart and Vascular Center, Faculty of Medicine, Semmelweis University, Határőr ut 18, 1122, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Forintos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Júlia Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Metagenomics, University of Debrecen, Debrecen, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Pál Ákos Deák
- Department of Interventional Radiology, Heart and Vascular Center, Faculty of Medicine, Semmelweis University, Határőr ut 18, 1122, Budapest, Hungary.
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Szarvas T. Editorial Comment to Identification of tumor immunophenotypes associated with immunotherapy response in bladder cancer. Int J Urol 2023; 30:1132-1133. [PMID: 37667422 DOI: 10.1111/iju.15296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Affiliation(s)
- Tibor Szarvas
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
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Fazekas T, Széles ÁD, Teutsch B, Csizmarik A, Vékony B, Váradi A, Kói T, Lang Z, Ács N, Kopa Z, Hegyi P, Hadaschik B, Grünwald V, Nyirády P, Szarvas T. Therapeutic sensitivity to standard treatments in BRCA positive metastatic castration-resistant prostate cancer patients-a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2023; 26:665-672. [PMID: 36509931 PMCID: PMC10638083 DOI: 10.1038/s41391-022-00626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent oncology guidelines recommend BRCA1/2 testing for a wide range of prostate cancer (PCa) patients. In addition, PARP inhibitors are available for mutation-positive metastatic castration-resistant PCa (mCRPC) patients following prior treatment with abiraterone, enzalutamide or docetaxel. However, the question of which of these standard treatments is the most effective for BRCA1/2 positive mCRPC patients remains to be answered. The aim of this meta-analysis was to assess the efficacy of abiraterone, enzalutamide and docetaxel in BRCA1/2 mutation-positive mCRPC patients in terms of PSA-response (PSA50), progression-free survival (PFS) and overall survival (OS). METHODS As no interventional trials are available on this topic, we performed the data synthesis of BRCA1/2 positive mCRPC patients by using both proportional and individual patient data. For PSA50 evaluation, we pooled event rates with 95% confidence intervals (CI), while for time-to-event (PFS, OS) analyses we used individual patient data with random effect Cox regression calculations. RESULTS Our meta-analysis included 16 eligible studies with 348 BRCA1/2 positive mCRPC patients. In the first treatment line, response rates for abiraterone, enzalutamide and docetaxel were 52% (CI: 25-79%), 64% (CI: 43-80%) and 55% (CI: 36-73%), respectively. Analyses of individual patient data revealed a PFS (HR: 0.47, CI: 0.26-0.83, p = 0.010) but no OS (HR: 1.41, CI: 0.82-2.42, p = 0.210) benefit for enzalutamide compared to abiraterone-treated patients. CONCLUSIONS Our PSA50 analyses revealed that all the three first-line treatments have therapeutic effect in BRCA1/2 positive mCRPC; although, based on the results of PSA50 and PFS analyses, BRCA positive mCRPC patients might better respond to enzalutamide treatment. However, molecular marker-driven interventional studies directly comparing these agents are crucial for providing higher-level evidence.
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Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám D Széles
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Bálint Vékony
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zsolt Lang
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zsolt Kopa
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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7
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Ács J, Szabó A, Fehérvári P, Harnos A, Skribek B, Tenke M, Szarvas T, Nyirády P, Ács N, Hegyi P, Majoros A. Safety and Efficacy of Vaginal Implants in Pelvic Organ Prolapse Surgery: A Meta-analysis of 161 536 Patients. Eur Urol Focus 2023:S2405-4569(23)00243-2. [PMID: 37968187 DOI: 10.1016/j.euf.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
CONTEXT Among the many surgical treatments for pelvic organ prolapse (POP), better results can be achieved with the use of vaginal implants. However, owing to perceived complications, vaginal implant surgeries have been restricted or banned in many countries. OBJECTIVE To assess the real value of vaginal implants in POP surgery and compare the safety and efficacy of operations with and without implants. EVIDENCE ACQUISITION A systematic search was performed in three medical databases. Randomised controlled trials and observational studies comparing the safety and efficacy of vaginal POP surgery with implants versus native tissue were included. Safety outcomes were defined as different types of complications (functional and non-functional) and reoperations for complications. Efficacy outcomes were parameters of anatomical success and the rate of reoperations due to recurrence. A multivariate meta-analysis framework was used to estimate pooled odds ratios (ORs) with confidence intervals (CIs) with simultaneous control for study correlations and estimation of multiple correlated outcomes. EVIDENCE SYNTHESIS We included 50 comparative studies in the analysis. Rates of reoperation for complications (OR 2.15, 95% CI 1.20-3.87), vaginal erosion (OR 14.05, 95% CI 9.07-21.77), vaginal bleeding (OR 1.67, 95% CI 1.25-2.23), and de novo stress urinary incontinence (OR 1.44, 95% CI 1.18-1.75) were significantly higher in the implant group. Rates of anatomical success (OR 3.22, 95% CI 2.06-5.0) and reoperation for recurrence (OR 0.55, 95% CI 0.36-0.85) were superior in the implant group. CONCLUSIONS POP surgeries with vaginal implants are more effective than surgeries without implants, with acceptable complication rates. Therefore, the complete prohibition of implants for POP surgeries should be reconsidered. PATIENT SUMMARY We compared vaginal surgery with and without implants for repair of pelvic organ prolapse. Despite higher complication rates, vaginal implants provide better long-term results overall than surgery without implants.
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Affiliation(s)
- Júlia Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Andrea Harnos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Benjamin Skribek
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Martin Tenke
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, University of Duisburg-Essen and German Cancer Consortium, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, University of Pécs Medical School, Pécs, Hungary
| | - Attila Majoros
- Department of Urology, Semmelweis University, Budapest, Hungary.
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8
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Váradi M, Horváth O, Módos O, Fazekas T, Grunewald CM, Niegisch G, Krafft U, Grünwald V, Hadaschik B, Olah C, Maráz A, Furka A, Szűcs M, Nyirády P, Szarvas T. Efficacy of immune checkpoint inhibitor therapy for advanced urothelial carcinoma in real-life clinical practice: results of a multicentric, retrospective study. Sci Rep 2023; 13:17378. [PMID: 37833455 PMCID: PMC10575904 DOI: 10.1038/s41598-023-44103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Clinical trials revealed significant antitumor activity for immune checkpoint inhibitors (ICI) in metastatic urothelial carcinoma (mUC). Due to their strict eligibility criteria, clinical trials include selected patient cohorts, and thus do not necessarily represent real-world population outcomes. In this multicentric, retrospective study, we investigated real-world data to assess the effectiveness of pembrolizumab and atezolizumab and to evaluate the prognostic value of routinely available clinicopathological and laboratory parameters. Clinical and follow-up data from mUC patients who received ICIs (01/2017-12/2021) were evaluated. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and duration of response (DOR) were used as endpoints. Patients' (n = 210, n = 76 atezolizumab and 134 pembrolizumab) median OS and PFS were 13.6 and 5.9 months, respectively. Impaired ECOG-PS, the presence of visceral, liver or bone metastases, and hemoglobin levels were independently associated with poor OS and DCR. Furthermore, Bellmunt risk factors and the enhanced Bellmunt-CRP score were shown to be prognostic for OS, PFS and DCR. In conclusion, ICIs are effective treatments for a broad range of mUC patients. Our results confirmed the prognostic value of numerous risk factors and showed that Bellmunt risk scores can further be improved when adding CRP to the model.
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Affiliation(s)
- Melinda Váradi
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Orsolya Horváth
- Department of Genitourinary Medical Oncology and Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Camilla M Grunewald
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Anikó Maráz
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - Andrea Furka
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Clinical Radiology, Institute of Practical Methodology and Diagnostics, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary.
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany.
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9
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Fazekas T, Széles ÁD, Teutsch B, Csizmarik A, Vékony B, Kói T, Ács N, Hegyi P, Hadaschik B, Nyirády P, Szarvas T. Poly (ADP-ribose) Polymerase Inhibitors Have Comparable Efficacy with Platinum Chemotherapy in Patients with BRCA-positive Metastatic Castration-resistant Prostate Cancer. A Systematic Review and Meta-analysis. Eur Urol Oncol 2023:S2588-9311(23)00174-8. [PMID: 37722977 DOI: 10.1016/j.euo.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
CONTEXT Testing for mutations in Breast Cancer Gene 1/2 (BRCA) has emerged as a novel decision-making tool for clinicians. Patients with metastatic castration-resistant prostate cancer (mCRPC) harboring pathogenic BRCA mutations can benefit from poly (ADP-ribose) polymerase inhibitor (PARPi) and platinum treatments, whereas the impact of the mutation on sensitivity to cabazitaxel and prostate-specific membrane antigen (PSMA)-ligand therapy is currently unknown. OBJECTIVE To assess the efficacy of PARPi, platinum, cabazitaxel, and PSMA-ligand therapies in BRCA-positive mCRPC. EVIDENCE ACQUISITION Databases were queried in February 2022. We performed data synthesis by using both proportional and individual patient data. For prostate-specific antigen (PSA) response rate (≥50% decrease from baseline [PSA50]) evaluation, we pooled event rates with 95% confidence intervals (CIs). Progression-free (PFS) and overall (OS) survival analyses with individual patient data were performed with the mixed-effect Cox proportional hazard model and single-arm random-effect analysis, providing pooled medians. EVIDENCE SYNTHESIS We included 23 eligible studies with 901 BRCA-positive mCRPC patients. PSA50 response rates for PARPi and platinum were 69% (CI: 53-82%), and 74% (CI: 49-90%), respectively. Analyses of OS data showed no difference between PARPi and platinum treatments (hazard ratio: 0.86; CI: 0.49-1.52; p = 0.6). The single-arm OS and PFS analyses revealed similarities among different PARPis; pooled PFS and OS medians were 9.7 mo (CI: 8.1-12.5) and 17.4 mo (CI: 12.7-20.1), respectively. CONCLUSIONS Our data revealed that different PARPis were similarly effective in terms of PFS and OS. Moreover, we found that PARPi and platinum therapy were comparable in terms of PSA50 response rate and OS, highlighting that platinum is a valid treatment option for BRCA-positive mCRPC patients. However, prospective interventional studies comparing these agents are essential to provide a higher level of evidence. PATIENT SUMMARY In this report, we found that different poly (ADP-ribose) polymerase inhibitors had similar efficacy, and platinum was a valid treatment option in BRCA-positive metastatic castration-resistant prostate cancer patients.
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Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám D Széles
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Bálint Vékony
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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10
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Csizmarik A, Nagy N, Keresztes D, Váradi M, Bracht T, Sitek B, Witzke K, Puhr M, Tornyi I, Lázár J, Takács L, Kramer G, Sevcenco S, Maj-Hes A, Hadaschik B, Nyirády P, Szarvas T. Comparative proteome and serum analysis identified FSCN1 as a marker of abiraterone resistance in castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00713-y. [PMID: 37634036 DOI: 10.1038/s41391-023-00713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Abiraterone (Abi) is an androgen receptor signaling inhibitor that significantly improves patients' life expectancy in metastatic prostate cancer (PCa). Despite its beneficial effects, many patients have baseline or acquired resistance against Abi. The aim of this study was to identify predictive serum biomarkers for Abi treatment. METHODS We performed a comparative proteome analysis on three Abi sensitive (LNCaPabl, LAPC4, DuCaP) and resistant (LNCaPabl-Abi, LAPC4-Abi, DuCaP-Abi) PCa cell lines using liquid chromatography tandem mass spectrometry (LC-MS/MS) technique. Two bioinformatic selection workflows were applied to select the most promising candidate serum markers. Serum levels of selected proteins were assessed in samples of 100 Abi-treated patients with metastatic castration-resistant disease (mCRPC) using ELISA. Moreover, FSCN1 serum concentrations were measured in samples of 69 Docetaxel (Doc) treated mCRPC patients. RESULTS Our proteome analysis identified 68 significantly, at least two-fold upregulated proteins in Abi resistant cells. Using two filtering workflows four proteins (AMACR, KLK2, FSCN1 and CTAG1A) were selected for ELISA analyses. We found high baseline FSCN1 serum levels to be significantly associated with poor survival in Abi-treated mCRPC patients. Moreover, the multivariable analysis revealed that higher ECOG status (>1) and high baseline FSCN1 serum levels (>10.22 ng/ml by ROC cut-off) were independently associated with worse survival in Abi-treated patients (p < 0.001 and p = 0.021, respectively). In contrast, no association was found between serum FSCN1 concentrations and overall survival in Doc-treated patients. CONCLUSIONS Our analysis identified baseline FSCN1 serum levels to be independently associated with poor survival of Abi-treated, but not Doc-treated mCRPC patients, suggesting a therapy specific prognostic value for FSCN1.
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Affiliation(s)
- Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
- Department of Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Melinda Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ilona Tornyi
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | - József Lázár
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | - László Takács
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
- Biosystems International Kft, Debrecen, Hungary
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Sabina Sevcenco
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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11
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Dér B, Fazekas T, Csizmarik A, Soós Á, Fekete B, Nyirády P, Szarvas T. [Current therapeutic and familial implications of the genetic background of prostate cancer]. Magy Onkol 2023; 67:154-160. [PMID: 37314077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 06/15/2023]
Abstract
Genetic testing for prostate cancer (PC) is becoming more widely used in the clinical routine, primarily due to the introduction of PARP inhibitors targeting genetically affected patients in their BRCA1/2 and other homologous recombination repair (HRR) genes. Simultaneously, the number of available therapies that are specifically targeting genetically defined PC subgroups is steadily increasing. As a result, the selection of treatment for PC patients is likely to require testing of multiple genes to enable more specific treatment sequences that consider the genetic characteristics of the tumor. Some of the mutations discovered by genetic testing may be hereditary, necessitating the use of germline testing from normal tissue, which is only permitted within the framework of clinical counseling. This change in PC care requires the collaboration by multiple specialists, including experts in molecular pathology, bioinformatics, biology, and genetic counseling. In this review, we aim to provide an overview on the currently relevant genetic alterations in PC for therapeutic purposes and their implications for familial testing.
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Affiliation(s)
- Bálint Dér
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Tamás Fazekas
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Anita Csizmarik
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Áron Soós
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Bálint Fekete
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Péter Nyirády
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Tibor Szarvas
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
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12
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Koll FJ, Döring C, Olah C, Szarvas T, Köllermann J, Hoeh B, Chun FKH, Reis H, Wild PJ. Optimizing identification of consensus molecular subtypes in muscle-invasive bladder cancer: a comparison of two sequencing methods and gene sets using FFPE specimens. BMC Cancer 2023; 23:504. [PMID: 37270477 DOI: 10.1186/s12885-023-11016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Molecular subtypes predict prognosis in muscle-invasive bladder cancer (MIBC) and are explored as predictive markers. To provide a common base for molecular subtyping and facilitate clinical applications, a consensus classification has been developed. However, methods to determine consensus molecular subtypes require validation, particularly when FFPE specimens are used. Here, we aimed to evaluate two gene expression analysis methods on FFPE samples and to compare reduced gene sets to classify tumors into molecular subtypes. METHODS RNA was isolated from FFPE blocks of 15 MIBC patients. Massive analysis of 3' cDNA ends (MACE) and the HTG transcriptome panel (HTP) were used to retrieve gene expression. We used normalized, log2-transformed data to call consensus and TCGA subtypes with the consensusMIBC package for R using all available genes, a 68-gene panel (ESSEN1), and a 48-gene panel (ESSEN2). RESULTS Fifteen MACE-samples and 14 HTP-samples were available for molecular subtyping. The 14 samples were classified as Ba/Sq in 7 (50%), LumP in 2 (14.3%), LumU in 1 (7.1%), LumNS in 1 (7.1%), stroma-rich in 2 (14.3%) and NE-like in 1 (7.1%) case based on MACE- or HTP-derived transcriptome data. Consensus subtypes were concordant in 71% (10/14) of cases when comparing MACE with HTP data. Four cases with aberrant subtypes had a stroma-rich molecular subtype with either method. The overlap of the molecular consensus subtypes with the reduced ESSEN1 and ESSEN2 panels were 86% and 100%, respectively, with HTP data and 86% with MACE data. CONCLUSION Determination of consensus molecular subtypes of MIBC from FFPE samples is feasible using various RNA sequencing methods. Inconsistent classification mainly involves the stroma-rich molecular subtype, which may be the consequence of sample heterogeneity with (stroma)-cell sampling bias and highlights the limitations of bulk RNA-based subclassification. Classification is still reliable when analysis is reduced to selected genes.
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Affiliation(s)
- Florestan J Koll
- Department of Urology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
- Frankfurt Cancer Institute (FCI), University Hospital, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
- University Cancer Center (UCT) Frankfurt, University Hospital, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
| | - Claudia Döring
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590, Frankfurt Am Main, Germany
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Jens Köllermann
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590, Frankfurt Am Main, Germany
| | - Benedikt Hoeh
- Department of Urology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Felix K-H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590, Frankfurt Am Main, Germany
| | - Peter J Wild
- Frankfurt Cancer Institute (FCI), University Hospital, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590, Frankfurt Am Main, Germany
- Frankfurt Institute for Advanced Studies (FIAS), 60438, Frankfurt Am Main, Germany
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13
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Kubik A, das Virgens IPA, Szabó A, Váradi M, Csizmarik A, Keszthelyi A, Majoros A, Fehérvári P, Hegyi P, Ács N, Nyirády P, Szarvas T. Comprehensive Analysis of the Prognostic Value of Circulating MMP-7 Levels in Urothelial Carcinoma: A Combined Cohort Analysis, Systematic Review, and Meta-Analysis. Int J Mol Sci 2023; 24:ijms24097859. [PMID: 37175566 PMCID: PMC10178327 DOI: 10.3390/ijms24097859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 04/08/2023] [Indexed: 05/15/2023] Open
Abstract
Lymph node (LN) status is the most significant prognostic factor for invasive urothelial bladder cancer (UBC); however, the optimal extent of LN dissection (LND) is debated. We assessed circulating matrix metalloproteinase-7 (MMP-7) as a prognostic factor and decision-making marker for the extent of LND. Preoperative serum MMP-7 levels were determined in two independent UBC cohorts (n = 188; n = 68) and in one control cohort (n = 97) by using the ELISA method. A systematic review and meta-analysis on the prognostic role of circulating pretreatment MMP-7 levels were performed. Serum MMP-7 levels were higher in patients compared to controls (p < 0.001) with the highest levels in LN-positive cases. Half of LN-positive UBC patients had low MMP-7 levels, whereas the survival of LN-negative patients with high serum MMP-7 findings was poor. MMP-7 levels were independently associated with poor survival in both cohorts (p = 0.006, p < 0.001). Accordingly, our systematic review of six eligible publications revealed a 2.5-fold higher mortality risk in patients with high MMP-7 levels. In conclusion, preoperative MMP-7 level is a validated and independent prognostic factor in urothelial cancer. It cannot be used to decide between regional or extended LND but may be useful in identifying LN-negative high-risk patients with potentially undetected metastases.
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Affiliation(s)
- András Kubik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | | | - Anett Szabó
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | - Melinda Váradi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Keszthelyi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Majoros
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1083 Budapest, Hungary
| | - Nándor Ács
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK), 45147 Essen, Germany
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14
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Módos O, Váradi M, Dér B, Keszthelyi A, Szűcs M, Reis H, Nyirády P, Szarvas T. [Current diagnostic and treatment strategies for urachal cancer]. Orv Hetil 2023; 164:602-609. [PMID: 37087728 DOI: 10.1556/650.2023.32754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 04/24/2023]
Abstract
Urachal carcinoma is a rare malignancy that is uniquely associated with the field of urology. Urachal carcinoma is mostly diagnosed in urological care centers due to its most frequently presenting symptom that is hematuria. Currently available diagnostic and therapeutic knowledge is solely based on case reports and single center series, while no prospective clinical studies are carried out due to the modest number of patients. These circumstances have made creating professional guidelines challenging, hence the treatment of urachal carcinoma is commonly based on individual clinical decisions. In this review, we summarize the epidemiology, diagnostic modalities, prognosis as well as local and systemic therapeutic approaches of urachal carcinoma. Furthermore, we aim to draw conclusions from this knowledge base that may guide clinical decision-making. Finally, we highlight some of the novel therapeutic strategies that hold the potential to improve urachal carcinoma patients' prognosis and quality of life. Orv Hetil. 2023; 164(16): 602-609.
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Affiliation(s)
- Orsolya Módos
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Melinda Váradi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Bálint Dér
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Attila Keszthelyi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Henning Reis
- 2 Dr. Senckenberg Patológiai Intézet, Frankfurti Egyetemi Kórház Frankfurt, Németország Magyarország
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
- 3 Essen-Duisburgi Egyetem, Urológiai Klinika Essen, Németország Magyarország
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15
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Njouendou AJ, Szarvas T, Tiofack AAZ, Kenfack RN, Tonouo PD, Ananga SN, Bell EHMD, Simo G, Hoheisel JD, Siveke JT, Lueong SS. SOX2 dosage sustains tumor-promoting inflammation to drive disease aggressiveness by modulating the FOSL2/IL6 axis. Mol Cancer 2023; 22:52. [PMID: 36932385 PMCID: PMC10022277 DOI: 10.1186/s12943-023-01734-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/26/2022] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Inflammation is undoubtedly a hallmark of cancer development. Its maintenance within tumors and the consequences on disease aggressiveness are insufficiently understood. METHODS Data of 27 tumor entities (about 5000 samples) were downloaded from the TCGA and GEO databases. Multi-omic analyses were performed on these and in-house data to investigate molecular determinants of tumor aggressiveness. Using molecular loss-of-function data, the mechanistic underpinnings of inflammation-induced tumor aggressiveness were addressed. Patient specimens and in vivo disease models were subsequently used to validate findings. RESULTS There was significant association between somatic copy number alterations (sCNAs) and tumor aggressiveness. SOX2 amplification was the most important feature among novel and known aggressiveness-associated alterations. Mechanistically, SOX2 regulates a group of genes, in particular the AP1 transcription factor FOSL2, to sustain pro-inflammatory signaling pathways, such as IL6-JAK-STAT3, TNFA and IL17. FOSL2 was found overexpressed in tumor sections of specifically aggressive cancers. In consequence, prolonged inflammation induces immunosuppression and activates cytidine deamination and thus DNA damage as evidenced by related mutational signatures in aggressive tumors. The DNA damage affects tumor suppressor genes such as TP53, which is the most mutated gene in aggressive tumors compared to less aggressive ones (38% vs 14%), thereby releasing cell cycle control. These results were confirmed by analyzing tissues from various tumor types and in vivo studies. CONCLUSION Our data demonstrate the implication of SOX2 in promoting DNA damage and genome instability by sustaining inflammation via FOSL2/IL6, resulting in tumor aggressiveness.
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Affiliation(s)
- Abdel Jelil Njouendou
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, South West Region, Cameroon
- Phytopharmacy and Drug Discovery Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
| | - Tibor Szarvas
- Department of Urology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122, Essen, Germany
- Department of Urology, Semmelweis University, 1082, Budapest, Hungary
| | - Arnol Auvaker Zebaze Tiofack
- Molecular Parasitology and Entomology Unit (MPEU), Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon
- Early Detection and Biomarker Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
| | - Rovaldo Nguims Kenfack
- Early Detection and Biomarker Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
- Research Unit of Microbiology and Antimicrobial Substances (RUMAS), Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon
| | - Pamela Derliche Tonouo
- Early Detection and Biomarker Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Littoral Region, Cameroon
- Department of Medical Oncology, Douala General Hospital, Douala, Littoral Region, Cameroon
| | - Sidonie Noa Ananga
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Littoral Region, Cameroon
- Department of Medical Oncology, Douala General Hospital, Douala, Littoral Region, Cameroon
- Epidemiology and Clinical Trial Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
| | - Esther H M Dina Bell
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Littoral Region, Cameroon
- Department of Medical Oncology, Douala General Hospital, Douala, Littoral Region, Cameroon
- Epidemiology and Clinical Trial Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
| | - Gustave Simo
- Molecular Parasitology and Entomology Unit (MPEU), Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon
- Directorate of Scientific Affairs, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon
| | - Jörg D Hoheisel
- Division of Functional Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Jens T Siveke
- Bridge Institute for Experimental Cancer Therapy, West German Cancer Center, University Hospital Essen, Hufeland Str. 55, 45147, Essen, Germany
- Division for Solid Tumor Translational Oncology German Cancer Research Center (DKFZ)West German Cancer Center, The German Consortium for Translational Cancer Research (DKTK), Essen/Düsseldorf Partner, Site University Hospital Essen, Essen, Germany
| | - Smiths S Lueong
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, South West Region, Cameroon.
- Molecular Parasitology and Entomology Unit (MPEU), Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon.
- Early Detection and Biomarker Section, The Cameroon Consortium for Translational Cancer Research (CCOTCARE), Douala, Cameroon.
- Bridge Institute for Experimental Cancer Therapy, West German Cancer Center, University Hospital Essen, Hufeland Str. 55, 45147, Essen, Germany.
- Division for Solid Tumor Translational Oncology German Cancer Research Center (DKFZ)West German Cancer Center, The German Consortium for Translational Cancer Research (DKTK), Essen/Düsseldorf Partner, Site University Hospital Essen, Essen, Germany.
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16
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Olah C, Reis H, Hoffmann MJ, Mairinger F, Ting S, Hadaschik B, Krafft U, Grünwald V, Nyirady P, Varadi M, Győrffy B, Kiss A, Szekely E, Sjödahl G, Szarvas T. Predictive value of molecular subtypes and APOBEC3G for adjuvant chemotherapy in urothelial bladder cancer. Cancer Med 2023; 12:5222-5232. [PMID: 36204983 PMCID: PMC10028049 DOI: 10.1002/cam4.5324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Although targeted approaches have become available in second- and third-line settings, platinum-based chemotherapy remains the standard first-line treatment for advanced muscle-invasive bladder cancer (MIBC). Therefore, the prediction of platinum resistance is of utmost clinical importance. METHODS In this study, we established a routine compatible method for the molecular classification of MIBC samples according to various classification systems and applied this method to evaluate the impact of subtypes on survival after adjuvant chemotherapy. This retrospective study included 191 patients with advanced MIBC (pT≥3 or pN+) who underwent radical cystectomy, with or without adjuvant chemotherapy. A 48-gene panel and classifier rule set were established to determine molecular subtypes according to TCGA, MDA, LundTax, and Consensus classifications. Additionally, 12 single platinum-predictive candidate genes were assessed. The results were correlated with patients' clinicopathological and follow-up data and were validated using independent data sets. RESULTS Our final evaluation of 159 patients demonstrated better survival in the luminal groups for those who received chemotherapy compared with those who did not. In contrast, no such differences were observed in basal subtypes. The use of chemotherapy was associated with better survival in patients with high APOBEC3G expression (p < 0.002). This association was confirmed using an independent data set of patients who received neoadjuvant platinum therapy. CONCLUSIONS The proposed method robustly replicates the most commonly used transcriptome-based subtype classifications from paraffin-embedded tissue samples. The luminal, but not basal, molecular subtypes had the greatest benefit from adjuvant platinum therapy. We identified and validated APOBEC3G as a novel predictive marker for platinum-treated patients.
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Affiliation(s)
- Csilla Olah
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michèle J Hoffmann
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Fabian Mairinger
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Saskia Ting
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Viktor Grünwald
- Department of Medical Oncology, University of Duisburg-Essen, Essen, Germany
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Melinda Varadi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Balázs Győrffy
- Research Centre for Natural Sciences, Cancer Biomarker Research Group, Institute of Enzymology, Budapest, Hungary
- 2nd Department of Pediatrics and Department of Bioinformatics, Semmelweis University, Budapest, Hungary
| | - Andras Kiss
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Eszter Szekely
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Gottfrid Sjödahl
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
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Darr C, Möller L, Schürger N, Szarvas T, Reis H, Stang A, Hadaschik BA, Kajüter H, Grünwald V. Incidence and survival in patients with urachal carcinoma: Cancer registry analysis between 2008 and 2019. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
480 Background: Urachal carcinoma (UrC) is a rare and poorly studied cancer without evidence-based treatment strategies. Due to the low prevalence of this cancer, only sparse data on its incidence and survival are available. Therefore, we analyzed the incidence and survival rates of patients with UrC in North Rhine-Westphalia (NRW), a state of the Federal Republic of Germany. Methods: UrC (ICD-O-3: C67.7) diagnosed between 2008 and 2019 were identified via the NRW Cancer Registry (population 18 million) and classified according to Mayo-staging and T-category. Mayo stage was based on the TNM classification. We calculated age-standardized incidence rates using the European standard and Kaplan-Meier overall survival (OS). Age was stated as mean and standard deviation (SD). Results: A total of 121 UrC patients were described, of which men were more frequently affected at 57%. The distribution for women was 43%. The mean age was 61.1 (SD: 15.5) years for men and 58.8 (SD: 15.3) years for women. The overall age-standardized incidence rate was 0.43 per 1.000.000 person-years, which was 0.5 for men and 0.37 for women. 85.1% had adenocarcinomas, 6.6% urothelial carcinoma, 4.1% unspecified cancer, 2.5% epithelial carcinomas, 0.8% squamous cell carcinomas or others, respectively. The 5-year OS rate were 60.4% (CI-95%: 48.9%; 74.7%) for men and 41.7% (CI-95%: 28.8%; 60.2%) for women. According to TNM classification, 33% of the patients presented with T1-2, 29.8% with T3-4, while for the Mayo staging a distribution of 17.4% for stage I-II and 13.2% for stage III-IV was shown. Data regarding T-category and Mayo-satging were available in 63.6% (44 patients) and 30.6% (84 patients), respectively. The 5-year OS was 73.3% (CI-95%: 59.3%; 90.6%) in T1-2, 37.2% (CI-95%: 23.6%; 58.6%) in T3-4. and 69.3% (CI-95%: 47.6%; 100%) and 25.6% (CI-95%: 9.89%; 66.49%) in Mayo stage I-II and III-IV, respectively. Conclusions: UrC is a rare cancer and OS rate in NRW were comparable to historical data. The prognosis was stage-dependent and identified poor outcome in patients with advanced disease. Our data underscored the role of proper staging and diagnosis for future clinical studies that investigate optimal treatment strategies.
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Affiliation(s)
- Christopher Darr
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lennart Möller
- Cancer Registry of North Rhine-Westphalia, Bochum, Germany, Bochum, Germany
| | - Niklas Schürger
- Department of Urology, University Hospital Essen, Essen, Germany, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary, Budapest, Hungary
| | - Henning Reis
- Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany, Frankfurt, Germany
| | - Andreas Stang
- Cancer Registry of North Rhine-Westphalia, Bochum, Germany, Bochum, Germany
| | - Boris A. Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany, Essen, Germany
| | - Hiltraud Kajüter
- Cancer Registry North Rhine-Westphalia, Germany, Bochum, Germany
| | - Viktor Grünwald
- Interdisciplinary Genitourinary Oncology at the West-German Cancer Center, Clinic for Medical Oncology, Clinic for Urology, Essen University Hospital, Essen, Germany
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18
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Váradi M, Horváth O, Fazekas T, Csizmarik A, Módos O, Széles Á, Kenessey I, Reis H, Oláh C, Hadaschik B, Krafft U, Ting S, Furka A, Nyirády P, Szarvas T. Molecular analysis of urothelial carcinoma to predict the efficacy of immune checkpoint inhibitor therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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19
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Varadi M, Nagy N, Reis H, Hadaschik B, Niedworok C, Modos O, Szendroi A, Ablat J, Black PC, Keresztes D, Csizmarik A, Olah C, Gaisa NT, Kiss A, Timar J, Toth E, Csernak E, Gerstner A, Mittal V, Karkampouna S, Kruithof de Julio M, Gyorffy B, Bedics G, Rink M, Fisch M, Nyirady P, Szarvas T. Clinical sequencing identifies potential actionable alterations in a high rate of urachal and primary bladder adenocarcinomas. Cancer Med 2023; 12:9041-9054. [PMID: 36670542 PMCID: PMC10134276 DOI: 10.1002/cam4.5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Administration of targeted therapies provides a promising treatment strategy for urachal adenocarcinoma (UrC) or primary bladder adenocarcinoma (PBAC); however, the selection of appropriate drugs remains difficult. Here, we aimed to establish a routine compatible methodological pipeline for the identification of the most important therapeutic targets and potentially effective drugs for UrC and PBAC. METHODS Next-generation sequencing, using a 161 cancer driver gene panel, was performed on 41 UrC and 13 PBAC samples. Clinically relevant alterations were filtered, and therapeutic interpretation was performed by in silico evaluation of drug-gene interactions. RESULTS After data processing, 45/54 samples passed the quality control. Sequencing analysis revealed 191 pathogenic mutations in 68 genes. The most frequent gain-of-function mutations in UrC were found in KRAS (33%), and MYC (15%), while in PBAC KRAS (25%), MYC (25%), FLT3 (17%) and TERT (17%) were recurrently affected. The most frequently affected pathways were the cell cycle regulation, and the DNA damage control pathway. Actionable mutations with at least one available approved drug were identified in 31/33 (94%) UrC and 8/12 (67%) PBAC patients. CONCLUSIONS In this study, we developed a data-processing pipeline for the detection and therapeutic interpretation of genetic alterations in two rare cancers. Our analyses revealed actionable mutations in a high rate of cases, suggesting that this approach is a potentially feasible strategy for both UrC and PBAC treatments.
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Affiliation(s)
- Melinda Varadi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany.,Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Christian Niedworok
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Orsolya Modos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Attila Szendroi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Jason Ablat
- Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Peter C Black
- Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - David Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Csilla Olah
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Andras Kiss
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Jozsef Timar
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Erika Toth
- National Institute of Oncology, Budapest, Hungary
| | | | | | - Vinay Mittal
- Thermo Fisher Scientific, Ann Arbor, Michigan, USA
| | - Sofia Karkampouna
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, Bern, Switzerland
| | - Marianna Kruithof de Julio
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, Bern, Switzerland.,Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Balazs Gyorffy
- Research Centre for Natural Sciences, Cancer Biomarker Research Group, Institute of Enzymology, Budapest, Hungary.,2nd Department of Pediatrics and Department of Bioinformatics, Semmelweis University, Budapest, Hungary
| | - Gabor Bedics
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
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20
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Szabó A, Váncsa S, Hegyi P, Váradi A, Forintos A, Filipov T, Ács J, Ács N, Szarvas T, Nyirády P, Kopa Z. Lifestyle-, environmental-, and additional health factors associated with an increased sperm DNA fragmentation: a systematic review and meta-analysis. Reprod Biol Endocrinol 2023; 21:5. [PMID: 36653793 PMCID: PMC9847125 DOI: 10.1186/s12958-023-01054-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Infertility affects one in every six couples in developed countries, and approximately 50% is of male origin. In 2021, sperm DNA fragmentation (SDF) testing became an evidence-based test for fertility evaluations depicting fertility more clearly than standard semen parameters. Therefore, we aimed to summarize the potential prognostic factors of a higher SDF. METHODS We conducted a systematic search in three medical databases and included studies investigating any risk factors for SDF values. We calculated mean differences (MD) in SDF with 95% confidence interval (CI) for exposed and non-exposed individuals. RESULTS We included 190 studies in our analysis. In the group of associated health conditions, varicocele (MD = 13.62%, CI: 9.39-17.84) and impaired glucose tolerance (MD = 13.75%, CI: 6.99-20.51) had the most significant increase in SDF. Among malignancies, testicular tumors had the highest impact, with a maximum of MD = 11.3% (CI: 7.84-14.76). Among infections, the overall effects of both Chlamydia and HPV were negligible. Of lifestyle factors, smoking had the most disruptive effect on SDF - an increase of 9.19% (CI: 4.33-14.06). Different periods of sexual abstinence did not show significant variations in SDF values. Age seemed to have a more drastic effect on SDF from age 50 onwards, with a mean difference of 12.58% (CI: 7.31-17.86). Pollution also had a detrimental effect - 9.68% (CI: 6.85-12.52). CONCLUSION Of the above risk factors, varicocele, impaired glucose tolerance, testicular tumors, smoking, pollution, and paternal age of over 50 were associated with the highest SDF. TRIAL REGISTRATION CRD42021282533.
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Affiliation(s)
- Anett Szabó
- Department of Urology, Semmelweis University, Üllői Ut 78/B, Budapest, H-1082, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Forintos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Teodóra Filipov
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Interventional Radiology, Semmelweis University, Budapest, Hungary
| | - Júlia Ács
- Department of Urology, Semmelweis University, Üllői Ut 78/B, Budapest, H-1082, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Üllői Ut 78/B, Budapest, H-1082, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Üllői Ut 78/B, Budapest, H-1082, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Zsolt Kopa
- Department of Urology, Semmelweis University, Üllői Ut 78/B, Budapest, H-1082, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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21
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Olah C, Szarvas T. A Panel-Based Method for the Reproduction of Distinct Molecular Subtype Classifications of Muscle-Invasive Urothelial Bladder Cancer. Methods Mol Biol 2023; 2684:27-43. [PMID: 37410226 DOI: 10.1007/978-1-0716-3291-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Transcriptome-based molecular subtype classification of muscle-invasive urothelial bladder cancer was shown to have prognostic and therapy-predictive relevance and thus may help to inform therapeutic decision-making. However, current classification systems rely on whole transcriptome analysis, which is expensive, requires higher amounts of tissue samples, and therefore is not compatible with the daily clinical routine. Therefore, we developed a simple and robust gene panel-based classifier method to reproduce various relevant molecular classification systems (TCGA, MDA, GSC, LundTax, and Consensus). This approach was then tested on institutional cohorts of frozen and formalin-fixed and paraffin-embedded tissue samples using reverse transcription quantitative PCR and NanoString analyses. Here, we provide a step-by-step description of our panel-based subtype classifier method.
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Affiliation(s)
- Csilla Olah
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, Essen, Germany.
- Department of Urology, Semmelweis University, Budapest, Hungary.
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22
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Csizmarik A, Keresztes D, Nagy N, Bracht T, Sitek B, Witzke K, Puhr M, Tornyi I, Lázár J, Takács L, Kramer G, Sevcenco S, Maj-Hes A, Jurányi Z, Hadaschik B, Nyirády P, Szarvas T. Proteome profiling of enzalutamide-resistant cell lines and serum analysis identified ALCAM as marker of resistance in castration-resistant prostate cancer. Int J Cancer 2022; 151:1405-1419. [PMID: 35689436 PMCID: PMC9539937 DOI: 10.1002/ijc.34159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/05/2022]
Abstract
Enzalutamide (ENZA) is a frequently used therapy in metastatic castration‐resistant prostate cancer (mCRPC). Baseline or acquired resistance to ENZA have been observed, but the molecular mechanisms of resistance are poorly understood. We aimed to identify proteins involved in ENZA resistance and to find therapy‐predictive serum markers. We performed comparative proteome analyses on ENZA‐sensitive parental (LAPC4, DuCaP) and ‐resistant prostate cancer cell lines (LAPC4‐ENZA, DuCaP‐ENZA) using liquid chromatography tandem mass spectrometry (LC‐MS/MS). The top four most promising candidate markers were selected using bioinformatic approaches. Serum concentrations of selected markers (ALCAM, AGR2, NDRG1, IDH1) were measured in pretreatment samples of 72 ENZA‐treated mCRPC patients using ELISA. In addition, ALCAM serum levels were measured in 101 Abiraterone (ABI) and 100 Docetaxel (DOC)‐treated mCRPC patients' baseline samples. Results were correlated with clinical and follow‐up data. The functional role of ALCAM in ENZA resistance was assessed in vitro using siRNA. Our proteome analyses revealed 731 significantly differentially abundant proteins between ENZA‐sensitive and ‐resistant cells and our filtering methods identified four biomarker candidates. Serum analyses of these proteins revealed only ALCAM to be associated with poor patient survival. Furthermore, higher baseline ALCAM levels were associated with poor survival in ABI‐ but not in DOC‐treated patients. In LAPC4‐ENZA resistant cells, ALCAM silencing by siRNA knockdown resulted in significantly enhanced ENZA sensitivity. Our analyses revealed that ALCAM serum levels may help to identify ENZA‐ and ABI‐resistant patients and may thereby help to optimize future clinical decision‐making. Our functional analyses suggest the possible involvement of ALCAM in ENZA resistance.
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Affiliation(s)
- Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ilona Tornyi
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | | | - László Takács
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary.,Biosystems International Kft, Debrecen, Hungary
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Sabina Sevcenco
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Zsolt Jurányi
- Department of Radiobiology and Diagnostic Onco-Cytogenetics, Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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23
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Szarvas T, Reis H. Commentary: Treatment Outcome of Different Chemotherapy in Patients With Relapsed or Metastatic Malignant Urachal Tumor. Front Oncol 2022; 12:864708. [PMID: 35707349 PMCID: PMC9189274 DOI: 10.3389/fonc.2022.864708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tibor Szarvas
- Department of Urology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- *Correspondence: Henning Reis,
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24
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Kovács PT, Mayer T, Csizmarik A, Váradi M, Oláh C, Széles Á, Tschirdewahn S, Krafft U, Hadaschik B, Nyirády P, Riesz P, Szarvas T. Elevated Pre-Treatment Serum MMP-7 Levels Are Associated with the Presence of Metastasis and Poor Survival in Upper Tract Urothelial Carcinoma. Biomedicines 2022; 10:biomedicines10030698. [PMID: 35327500 PMCID: PMC8945654 DOI: 10.3390/biomedicines10030698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Upper tract urothelial carcinoma (UTUC) is a rare cancer with a barely predictable clinical behaviour. Serum MMP-7 is a validated prognostic marker in urothelial bladder cancer, a tumour entity with large clinical, histological, and molecular similarity to UTUC. The serum MMP-7 levels have not yet been investigated in UTUC. In the present study, we determined MMP-7 concentrations in an overall number of 103 serum samples from 57 UTUC patients who underwent surgical or systemic (platinum or immune checkpoint inhibitor) therapy by using the ELISA method. In addition to pre-treatment samples, the serum samples collected at predefined time points after or during therapy were also investigated. Serum MMP-7 concentrations were correlated with clinicopathological and follow-up data. Our results revealed significantly, two-fold elevated pre-treatment serum MMP-7 levels in metastatic cases of UTUC in both the radical surgery- and the chemotherapy-treated cohorts (p = 0.045 and p = 0.040, respectively). In addition, high serum MMP-7 levels significantly decreased after radical surgery, and high pre-treatment MMP-7 concentrations were associated with shorter survival both in the surgery- and chemotherapy-treated cohorts (p = 0.029 and p = 0.001, respectively). Our results revealed pre-treatment serum MMP-7 as a prognostic marker for UTUC, which may help to improve preoperative risk-stratification and thereby improve therapeutic decision-making.
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Affiliation(s)
- Petra Terézia Kovács
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Tamás Mayer
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Melinda Váradi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Csilla Oláh
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Ádám Széles
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Stephan Tschirdewahn
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Péter Riesz
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
- Correspondence:
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25
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Wessolly M, Mairinger FD, Herold T, Hadaschik B, Szarvas T, Reis H. Proteasomal Processing Immune Escape Mechanisms in Platinum-Treated Advanced Bladder Cancer. Genes (Basel) 2022; 13:genes13030422. [PMID: 35327977 PMCID: PMC8948673 DOI: 10.3390/genes13030422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
In recent years, the number and type of treatment options in advanced bladder cancer (BC) have been rapidly evolving. To select an effective therapy and spare unnecessary side effects, predictive biomarkers are urgently needed. As the host’s anti-cancer immune response is by far the most effective system to impede malignant tumor growth, immune system-based biomarkers are promising. We have recently described altered proteasomal epitope processing as an effective immune escape mechanism to impair cytotoxic T-cell activity. By altering the neoantigens’ characteristics through different proteasomal peptide cleavage induced by non-synonymous somatic mutations, the ability for T-cell activation was decreased (“processing escapes”). In the present study, we analyzed primary chemo-naïve tissue samples of 26 adjuvant platinum-treated urothelial BC patients using a targeted next-generation sequencing panel followed by the epitope determination of affected genes, a machine-learning based prediction of epitope processing and proteasomal cleavage and of HLA-affinity as well as immune activation. Immune infiltration (immunohistochemistries for CD8, granzyme B, CD45/LCA) was digitally quantified by a pathologist and clinico-pathological and survival data were collected. We detected 145 epitopes with characteristics of a processing escape associated with a higher number of CD8-positive but lower number of granzyme B-positive cells and no association with PD-L1-expression. In addition, a high prevalence of processing escapes was associated with unfavorable overall survival. Our data indicate the presence of processing escapes in advanced BC, potentially creating a tumor-promoting pro-inflammatory environment with lowered anti-cancerous activity and independence from PD-L1-expression. The data also need to be prospectively validated in BC treated with immune therapy.
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Affiliation(s)
- Michael Wessolly
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.W.); (F.D.M.); (T.H.)
| | - Fabian D. Mairinger
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.W.); (F.D.M.); (T.H.)
| | - Thomas Herold
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.W.); (F.D.M.); (T.H.)
| | - Boris Hadaschik
- Department of Urology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.H.); (T.S.)
| | - Tibor Szarvas
- Department of Urology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.H.); (T.S.)
- Department of Urology, Semmelweis University Budapest, 1085 Budapest, Hungary
| | - Henning Reis
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.W.); (F.D.M.); (T.H.)
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany
- Correspondence: ; Tel.: +49-69-6301-4514
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26
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Keresztes D, Csizmarik A, Nagy N, Módos O, Fazekas T, Bracht T, Sitek B, Witzke K, Puhr M, Sevcenco S, Kramer G, Shariat S, Küronya Z, Takács L, Tornyi I, Lázár J, Hadaschik B, Lászik A, Szűcs M, Nyirády P, Szarvas T. Comparative proteome analysis identified CD44 as a possible serum marker for docetaxel resistance in castration-resistant prostate cancer. J Cell Mol Med 2021; 26:1332-1337. [PMID: 34970839 PMCID: PMC8831956 DOI: 10.1111/jcmm.17141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
Baseline or acquired resistance to docetaxel (DOC) represents a significant risk for patients with metastatic prostate cancer (PC). In the last years, novel therapy regimens have been approved providing reasonable alternatives for DOC‐resistant patients making prediction of DOC resistance of great clinical importance. We aimed to identify serum biomarkers, which are able to select patients who will not benefit from DOC treatment. DOC‐resistant PC3‐DR and DU145‐DR sublines and their sensitive parental cell lines (DU145, PC3) were comparatively analyzed using liquid chromatography‐coupled tandem mass spectrometry (LC‐MS/MS). Results were filtered using bioinformatics approaches to identify promising serum biomarkers. Serum levels of five proteins were determined in serum samples of 66 DOC‐treated metastatic castration‐resistant PC patients (mCRPC) using ELISA. Results were correlated with clinicopathological and survival data. CD44 was subjected to further functional cell culture analyses. We found at least 177 two‐fold significantly overexpressed proteins in DOC‐resistant cell lines. Our bioinformatics method suggested 11/177 proteins to be secreted into the serum. We determined serum levels of five (CD44, MET, GSN, IL13RA2 and LNPEP) proteins in serum samples of DOC‐treated patients and found high CD44 serum levels to be independently associated with poor overall survival (p = 0.001). In accordance, silencing of CD44 in DU145‐DR cells resulted in re‐sensitization to DOC. In conclusion, high serum CD44 levels may help identify DOC‐resistant patients and may thereby help optimize clinical decision‐making regarding type and timing of therapy for mCRPC patients. In addition, our in vitro results imply the possible functional involvement of CD44 in DOC resistance.
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Affiliation(s)
- Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shahrokh Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Zsófia Küronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - László Takács
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Biosystems International Kft., Debrecen, Hungary
| | - Ilona Tornyi
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - József Lázár
- Biosystems International Kft., Debrecen, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - András Lászik
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, University of Duisburg-Essen, Essen, Germany
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27
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Riesz P, Juhász D, Kovács TP, Vargha J, Szarvas T. [Local care and systemic drug treatment of non-muscle invasive bladder tumors]. Magy Onkol 2021; 65:313-317. [PMID: 34874362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Bladder cancer is the most common malignancy of the urinary tract. It can be divided into non-muscle invasive and muscle-invasive groups according to depth of tumor invasion. Based on the significant differences regarding their biological behavior, propensity to progress, and therapy responsiveness these two groups are discussed seperately. Treatment of non-muscle invasive bladder cancers has traditionally been performed by urologists, but recent advances in the field predict that clinical oncologists may have a more intense role in high-risk non-muscle invasive cases. In the present study, we summarize the current surgical and pharmacological treatment options for non-muscle invasive bladder cancer.
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Affiliation(s)
- Péter Riesz
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - Dániel Juhász
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - Terézia Petra Kovács
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - Judit Vargha
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - Tibor Szarvas
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
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28
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Rehme C, Fritsch B, Thomas L, Istin S, Burchert C, Hummel B, Baleanu-Curaj B, Reis H, Szarvas T, Ruebben H, Hadaschik B, Niedworok C. Clinical outcome and quality of life in octogenarian patients with muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy or transurethral resection of the bladder tumor: a retrospective analysis of 143 patients. Int Urol Nephrol 2021; 54:71-79. [PMID: 34817753 PMCID: PMC8732805 DOI: 10.1007/s11255-021-03073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare clinical outcome and quality of life (QoL) in octogenarian patients with muscle-invasive urothelial carcinoma (MIBC) either treated by radical cystectomy (RC) or transurethral resection of the tumor (TURBT). METHODS We identified octogenarian patients with MIBC in our institutions since 2005. Clinical treatment outcomes and QoL were analyzed. Uni- and multivariable Cox regression analyses, two-tailed Wilcoxon test, Mann-Whitney test and Fisher's exact test were assessed as appropriate. QoL was evaluated using FACT-G (Functional Assessment of Cancer Therapy-General) questionnaire. RESULTS 143 patients were identified (RC: 51 cases, TURBT: 92 cases). Mean follow-up was 14 months (0-100 months). Median overall survival (OS) was 12 months in the RC group and 7 months in the TURBT group. TURBT and low preoperative hemoglobin were independent risk factors for reduced cancer-specific survival (CSS) (TURBT: p = 0.019, Hb: p = 0.008) and OS (TURBT: p = 0.026, Hb: p = 0.013) in multivariable analyses. Baseline QoL was low throughout the whole cohort. There was no difference in baseline FACT-G scoring comparing RC and TURBT (FACT-G total score (median): RC 43.7/108 vs. TURBT 44.0/108, p = 0.7144). Increased FACT-G questionnaire scoring was assessed for RC patients (median percentage score change RC 22.9%, TURBT 2.3%, p < 0.0001). CONCLUSION RC and TURBT are feasible treatment options for MIBC in octogenarian patients. In our cohort, RC was associated with increased CSS, OS and QoL. QoL in general was low throughout the whole cohort. Interdisciplinary decision-making has to be improved for these critically ill patients.
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Affiliation(s)
- Christian Rehme
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany
| | - Beatrix Fritsch
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany
| | - Luca Thomas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany
| | - Stefan Istin
- Department of Urology, Hermann-Josef-Hospital, Erkelenz, Germany
| | - Carolin Burchert
- Department of Urology, Hermann-Josef-Hospital, Erkelenz, Germany
| | - Bastian Hummel
- Department of Urology, Hermann-Josef-Hospital, Erkelenz, Germany
| | | | - Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
| | - Herbert Ruebben
- Department of Urology, Helios Hospital Duisburg, Duisburg, Germany
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany
| | - Christian Niedworok
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 52, 45147, Essen, Germany. .,Department of Urology, Hermann-Josef-Hospital, Erkelenz, Germany.
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29
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Darr C, Fragoso Costa P, Kesch C, Krafft U, Püllen L, Harke NN, Hess J, Szarvas T, Haubold J, Reis H, Fendler WP, Herrmann K, Radtke JP, Hadaschik BA, Tschirdewahn S. Prostate specific membrane antigen-radio guided surgery using Cerenkov luminescence imaging-utilization of a short-pass filter to reduce technical pitfalls. Transl Androl Urol 2021; 10:3972-3985. [PMID: 34804840 PMCID: PMC8575587 DOI: 10.21037/tau-20-1141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/07/2020] [Indexed: 12/27/2022] Open
Abstract
Background Intraoperative Cerenkov luminescence imaging (CLI) is a novel technique to assess surgical margins in patients undergoing nerve sparing radical prostatectomy (RP). Here, we analyze the efficacy of a 550-nm optical short-pass filter (OF) to improve its performance. Methods In this prospective single-center feasibility study ten patients with prostate cancer (PC) were included between December 2019 and April 2020, including three patients without tracer injection as a control group. After preoperative injection of 68-Ga-prostate-specific membrane antigen (PSMA)-11 followed by RP, CLI of the excised prostate and the incised index lesion was performed to visualize the primary tumor lesion. We compared the findings on intraoperative CLI to postoperative histopathology. Furthermore, CLI-intensities determined as tumor to background ratio (TBR) and contrast to noise ratio (CNR) were measured. Results Histopathology proved positive surgical margins (PSM) in 3 patients with corresponding findings in CLI. After magnetic resonance imaging (MRI)-informed incision above the index lesion 2 out of 3 prostates demonstrated elevated CLI signals with histopathological confirmation of PC cells. The use of the OF enabled a significant reduction of the area of the regions of interest from a median of 1.80 to 0.15 cm2 (reduction by 85%, P=0.005) leading to increased specificity. Signals due to PSMs were not suppressed by the 550-nm OF. The median TBR was reduced from 3.33 to 2.10. In all three patients of the control group elevated CLI intensities were detected at locations with diathermal energy deposition during surgery. After application of the 550-nm OF these were almost totally suppressed with a TBR of 1.10. Measurements of Cerenkov luminescence intensity with the 550-nm OF showed a significant Pearson's correlation of 0.82 between PSM and the elevated TBR (P=0.003) and a significant Pearson's correlation of 0.66 between PSM and elevated CNR (P=0.04). Measurements without the OF did not correlate significantly. Conclusions Intraoperative 68-Ga-PSMA CLI in PC is a tool that warrants further investigation to visualize PSM especially in intermediate and high-risk PC. Intraoperative CLI benefits from usage of a 550-nm OF to reduce false-positive signals.
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Affiliation(s)
- Christopher Darr
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Pedro Fragoso Costa
- German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.,Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Claudia Kesch
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Lukas Püllen
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Nina Natascha Harke
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Jochen Hess
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Johannes Haubold
- German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.,Institute of Diagnostics and Radiology, University Hospital Essen, Essen, Germany
| | - Henning Reis
- German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.,Institute of Pathology, University of Duisburg-Essen, Essen, Germany
| | - Wolfgang Peter Fendler
- German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.,Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.,Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Jan Philipp Radtke
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Boris Alexander Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Stephan Tschirdewahn
- Department of Urology, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
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30
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Püllen L, Kaspar C, Panic A, Hess J, Reis H, Szarvas T, Radtke JP, Krafft U, Darr C, Hadaschik B, Tschirdewahn S. Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort. Urol Int 2021; 106:638-643. [PMID: 34758471 DOI: 10.1159/000519898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/26/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Patients with bladder cancer (BC) are at risk of developing upper tract urothelial carcinoma (UTUC). Therefore, CT urography is recommended for follow-up. To avoid intravenous contrast agents, retrograde pyelography (RPG) is an alternative. However, it is still unclear whether RPG increases the incidence of UTUC. The aim of this study was to investigate the impact of RPG in the presence of BC on the risk of developing UTUC. PATIENTS AND METHODS Retrospectively analysing a total of 3,680 RPGs between 2009 and 2016, all patients with simultaneous BC (group 1) and those without synchronous BC (group 2) during RPG were compared. All patients were risk stratified according to the EORTC bladder calculator. In patients without BC during RPG, risk stratification was based on the worst prior tumour characteristics. RESULTS A total of 145 patients with a history of BC were analysed. Of these, 112 patients underwent RPG with simultaneous BC. UTUC developed in 6 of 112 patients (5.4%) and 58.9% (66/112) had high-risk BC according to the EORTC bladder calculator. In the control group, one out of 33 (3%) patients with metachronous high-risk BC developed UTUC. CONCLUSIONS Using RPG in the presence of BC did not increase the risk of UTUC. Due to the predominant number of high-risk/high-grade tumours, individual tumour biology appears to be the primary driver for the development of UTUC.
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Affiliation(s)
- Lukas Püllen
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany,
| | - Cordelia Kaspar
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andrej Panic
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jochen Hess
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
| | - Jan Philipp Radtke
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christopher Darr
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stephan Tschirdewahn
- Department of Urology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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31
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Reider B, Gacsi E, Jankovics H, Vonderviszt F, Szarvas T, Guttman A, Jarvas G. Integrated workflow for urinary prostate specific antigen N-glycosylation analysis using sdAb partitioning and downstream capillary electrophoresis separation. Anal Chim Acta 2021; 1184:338892. [PMID: 34625256 DOI: 10.1016/j.aca.2021.338892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/09/2021] [Accepted: 07/25/2021] [Indexed: 11/27/2022]
Abstract
Prostate cancer represents the second highest malignancy rate in men in all cancer diagnoses worldwide. The development and progression of prostate cancer is not completely understood yet at molecular level, but it has been reported that changes in the N-glycosylation of prostate-specific antigen (PSA) occur during tumor genesis. In this paper we report on the development and implementation of a high-throughput capillary electrophoresis based glycan analysis workflow for urinary PSA analysis. The technology utilizes selective, high yield single domain antibody based PSA capture, followed by preconcentration and capillary electrophoresis coupled with laser-induced fluorescence detection, resulting in high resolution N-glycan profiles. Urinary PSA glycan profiles were compared to a commercially available PSA standard revealing differences in their α2,3- and α2,6-sialylated isomers, proving the excellent selectivity of the suggested workflow. This is important as sialylation classification plays an important role in the differentiation between indolent, significant and aggressive forms of prostate cancer.
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Affiliation(s)
- Balazs Reider
- Translational Glycomics Research Group, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Eszter Gacsi
- Bio-Nanosystems Laboratory, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Hajnalka Jankovics
- Bio-Nanosystems Laboratory, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Ferenc Vonderviszt
- Bio-Nanosystems Laboratory, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Andras Guttman
- Translational Glycomics Research Group, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary; Horváth Csaba Memorial Laboratory of Bioseparation Sciences, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabor Jarvas
- Translational Glycomics Research Group, Research Institute of Biomolecular and Chemical Engineering, Faculty of Engineering, University of Pannonia, Veszprem, Hungary; Horváth Csaba Memorial Laboratory of Bioseparation Sciences, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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32
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Küronya Z, Fröhlich G, Ladányi A, Martin T, Géczi L, Gyergyai F, Horváth O, Kiszner G, Kovács Á, Dienes T, Lénárt E, Nagyiványi K, Szarvas T, Szőnyi M, Tóth A, Biró K. Low socioeconomic position is a risk factor for delay to treatment and mortality of testicular cancer patients in Hungary, a prospective study. BMC Public Health 2021; 21:1707. [PMID: 34538241 PMCID: PMC8451119 DOI: 10.1186/s12889-021-11720-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023] Open
Abstract
Background In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the EU average. We prospectively evaluated the effect of socioeconomic position on patient delay and therapy outcomes. Methods Questionnaires on subjective social status (MacArthur Subjective Status Scale), objective socioeconomic position (wealth, education, and housing data), and on patient’s delay were completed by newly diagnosed TGCC patients. Results Patients belonged to a relatively high socioeconomic class, a university degree was double the Hungarian average, Cancer-specific mortality in the highest social quartile was 1.56% while in the lowest social quartile 13.09% (p = 0.02). In terms of patient delay, 57.2% of deceased patients waited more than a year before seeking help, while this number for the surviving patients was 8.0% (p = 0.0000). Longer patient delay was associated with a more advanced stage in non-seminoma but not in seminoma, the correlation coefficient for non-seminoma was 0.321 (p < 0.001). For patient delay, the most important variables were the mother’s and patient’s education levels (r = − 0.21, p = 0.0003, and r = − 0.20, p = 0.0005), respectively. Since the patient delay was correlated with the social quartile and resulted in a more advanced stage in non-seminoma, the lower social quartile resulted in higher mortality in non-seminoma patients (p = 0.005) but not in seminoma patients (p = 0.36) where the patient delay was not associated with a more advanced stage. Conclusions Based on our result, we conclude that to improve survival, we should promote testicular cancer awareness, especially among the most deprived populations, and their health care providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11720-w.
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Affiliation(s)
- Zsófia Küronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary.
| | - Georgina Fröhlich
- Faculty of Science, Eötvös Loránd University, Budapest, Hungary.,Centre of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Andrea Ladányi
- Department of Surgical and Molecular Pathology, National Institute of Oncology, Budapest, Hungary
| | - Tamás Martin
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Lajos Géczi
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Fruzsina Gyergyai
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Orsolya Horváth
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Gergő Kiszner
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Ágnes Kovács
- Boehringer Ingelheim RCV GmbH & Co. KG Branch Office Budapest, Budapest, Hungary
| | - Tamás Dienes
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Enikő Lénárt
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Krisztián Nagyiványi
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Mihály Szőnyi
- Semmelweis University Faculty of Medicine, Budapest, Hungary
| | | | - Krisztina Biró
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
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33
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Olah C, Hahnen C, Nagy N, Musial J, Varadi M, Nyiro G, Gyorffy B, Hadaschik B, Rawitzer J, Ting S, Sjödahl G, Hoffmann MJ, Reis H, Szarvas T. A quantitative polymerase chain reaction based method for molecular subtype classification of urinary bladder cancer-Stromal gene expressions show higher prognostic values than intrinsic tumor genes. Int J Cancer 2021; 150:856-867. [PMID: 34536301 DOI: 10.1002/ijc.33809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/10/2021] [Accepted: 08/31/2021] [Indexed: 12/17/2022]
Abstract
Transcriptome-based molecular subtypes of muscle-invasive bladder cancer (MIBC) have been shown to be both prognostic and predictive, but are not used in routine clinical practice. We aimed to develop a feasible, reverse transcription quantitative polymerase chain reaction (RT-qPCR)-based method for molecular subtyping. First, we defined a 68-gene set covering tumor intrinsic (luminal, basal, squamous, neuronal, epithelial-to-mesenchymal, in situ carcinoma) and stromal (immune, extracellular matrix, p53-like) signatures. Then, classifier methods with this 68-gene panel were developed in silico and validated on public data sets with available subtype class information (MD Anderson [MDA], The Cancer Genome Atlas [TCGA], Lund, Consensus). Finally, expression of the selected 68 genes was determined in 104 frozen tissue samples of our MIBC cohort by RT-qPCR using the TaqMan Array Card platform and samples were classified by our newly developed classifiers. The prognostic value of each subtype classification system and molecular signature scores were assessed. We found that the reduced marker set combined with the developed classifiers were able to reproduce the TCGA II, MDA, Lund and Consensus subtype classification systems with an overlap of 79%, 76%, 69% and 64%, respectively. Importantly, we could successfully classify 96% (100/104) of our MIBC samples by using RT-qPCR. Neuronal and luminal subtypes and low stromal gene expressions were associated with poor survival. In conclusion, we developed a robust and feasible method for the molecular subtyping according to the TCGA II, MDA, Lund and Consensus classifications. Our results suggest that stromal signatures have a superior prognostic value compared to tumor intrinsic signatures and therefore underline the importance of tumor-stroma interaction during the progression of MIBC.
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Affiliation(s)
- Csilla Olah
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Christina Hahnen
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Joanna Musial
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Melinda Varadi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Gabor Nyiro
- MTA-SE Molecular Medicine Research Group, Semmelweis University, Budapest, Hungary
| | - Balazs Gyorffy
- 2nd Department of Pediatrics and Department of Bioinformatics, Semmelweis University, Budapest, Hungary.,Research Centre for Natural Sciences, Cancer Biomarker Research Group, Institute of Enzymology, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - Josefine Rawitzer
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Saskia Ting
- Institute of Pathology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Gottfrid Sjödahl
- Department of Oncology, Clinical Sciences, Lund University Hospital, Lund University, Lund, Sweden
| | - Michéle J Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Henning Reis
- Department of Oncology, Clinical Sciences, Lund University Hospital, Lund University, Lund, Sweden
| | - Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
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34
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Neumann JM, Niehaus K, Neumann N, Knobloch HC, Bremmer F, Krafft U, Kellner U, Nyirády P, Szarvas T, Bednarz H, Reis H. A new technological approach in diagnostic pathology: mass spectrometry imaging-based metabolomics for biomarker detection in urachal cancer. J Transl Med 2021; 101:1281-1288. [PMID: 34021261 PMCID: PMC8367814 DOI: 10.1038/s41374-021-00612-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Urachal adenocarcinomas (UrC) are rare but aggressive. Despite being of profound therapeutic relevance, UrC cannot be differentiated by histomorphology alone from other adenocarcinomas of differential diagnostic importance. As no reliable tissue-based diagnostic biomarkers are available, we aimed to detect such by integrating mass-spectrometry imaging-based metabolomics and digital pathology, thus allowing for a multimodal approach on the basis of spatial information. To achieve this, a cohort of UrC (n = 19) and colorectal adenocarcinomas (CRC, n = 27) as the differential diagnosis of highest therapeutic relevance was created, tissue micro-arrays (TMAs) were constructed, and pathological data was recorded. Hematoxylin and eosin (H&E) stained tissue sections were scanned and annotated, enabling an automized discrimination of tumor and non-tumor areas after training of an adequate algorithm. Spectral information within tumor regions, obtained via matrix-assisted laser desorption/ionization (MALDI)-Orbitrap-mass spectrometry imaging (MSI), were subsequently extracted in an automated workflow. On this basis, metabolic differences between UrC and CRC were revealed using machine learning algorithms. As a result, the study demonstrated the feasibility of MALDI-MSI for the evaluation of FFPE tissue in UrC and CRC with the potential to combine spatial metabolomics data with annotated histopathological data from digitalized H&E slides. The detected Area under the curve (AUC) of 0.94 in general and 0.77 for the analyte taurine alone (diagnostic accuracy for taurine: 74%) makes the technology a promising tool in this differential diagnostic dilemma situation. Although the data has to be considered as a proof-of-concept study, it presents a new adoption of this technology that has not been used in this scenario in which reliable diagnostic biomarkers (such as immunohistochemical markers) are currently not available.
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Affiliation(s)
- Judith Martha Neumann
- Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - Karsten Niehaus
- Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - Nils Neumann
- Research Institute for Cognition and Robotics (CoR-Lab), Bielefeld University, Bielefeld, Germany
| | - Hans Christoph Knobloch
- Department of Urology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Felix Bremmer
- Institute of Pathology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Ulrich Krafft
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Udo Kellner
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - Peter Nyirády
- Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Hanna Bednarz
- Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany.
- Medical School OWL, Bielefeld University, Bielefeld, Germany.
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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35
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Kesch C, Yirga L, Dendl K, Handke A, Darr C, Krafft U, Radtke JP, Tschirdewahn S, Szarvas T, Fazli L, Gleave M, Giesel FL, Haberkorn U, Hadaschik B. High fibroblast-activation-protein expression in castration-resistant prostate cancer supports the use of FAPI-molecular theranostics. Eur J Nucl Med Mol Imaging 2021; 49:385-389. [PMID: 34226953 PMCID: PMC8712308 DOI: 10.1007/s00259-021-05423-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/19/2021] [Indexed: 01/26/2023]
Abstract
Purpose To evaluate fibroblast-activation-protein (FAP) expression in different clinical stages of prostate cancer (PC) with regards to utility of [68 Ga]Ga-FAPI-04 PET/CT imaging in patients with castration-resistant PC (CRPC). Methods Tissue microarrays (TMAs) were constructed from prostatic tissue from 94 patients at different stages of PC (primary PC, patients undergoing neoadjuvant androgen deprivation therapy, CRPC, and neuroendocrine PC (NEPC)) and were stained with anti-FAP monoclonal antibody. A positive pixel count algorithm (H-Index) was used to compare FAP expression between the groups. Additionally, three men with advanced CRPC or NEPC underwent [68 Ga]Ga-FAPI-04 PET/CT, and PET positivity was analyzed. Results The mean H-index for benign tissue, primary PC, neoadjuvant androgen deprivation therapy before radical prostatectomy, CRPC, and NEPC was 0.018, 0.031, 0.042, 0.076, and 0.051, respectively, indicating a significant rise in FAP expression with advancement of disease. Corroborating these findings [68 Ga]Ga-FAPI-04 PET/CT was highly positive in men with advanced CRPC. Conclusion Increased FAP tissue expression supports the use of FAP inhibitor (FAPI)-molecular theranostics in CRPC. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05423-y.
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Affiliation(s)
- Claudia Kesch
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Leubet Yirga
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Katharina Dendl
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Analena Handke
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Christopher Darr
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Jan Philipp Radtke
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Stephan Tschirdewahn
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
| | - Ladan Fazli
- Vancouver Prostate Center, Vancouver General Hospital and Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | - Martin Gleave
- Vancouver Prostate Center, Vancouver General Hospital and Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | - Frederik L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Nuclear Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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36
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Maj-Hes A, Szarvas T, Sevcenco S, Kramer G. Multiple Docetaxel Retreatments Without Prednisone for Metastatic Castration-Resistant Prostate Cancer in the Docetaxel-Only Era: Effects on PSA Kinetics and Survival. Adv Ther 2021; 38:3831-3841. [PMID: 34043207 PMCID: PMC8280015 DOI: 10.1007/s12325-021-01778-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/06/2021] [Indexed: 01/10/2023]
Abstract
Introduction This study aimed to assess the effects of multiple docetaxel (DOC) treatments on prostate-specific antigen (PSA) kinetics and survival among patients with metastatic castration-resistant prostate cancer (mCRPC) who were sensitive to first-line DOC and received no other life-prolonging agents. To eliminate the effect of cortisone on serum PSA, only patients who were treated without prednisone were included. Methods This IRB-approved retrospective study evaluated 52 patients with mCRPC who were retreated using DOC after first-line DOC (without prednisone in both cases), based on a PSA response of > 50% and no radiographic progression. Twenty-three PSA-based factors, including static and kinetic PSA measures, were evaluate for their ability to predict overall survival (OS) Results The patients received 688 cycles of DOC in 143 series, including 91 courses of retreatments (1 cycle: 28 patients, 2 cycles: 14 patients, 3 cycles: 8 patients, 4 cycles: 1 patient, and 7 cycles: 1 patient). The median overall number of cycles per patient was 12 (range: 7–31). The median durations of the first, second, and third holidays were 18 weeks (6–60 weeks), 16 weeks (3–44 weeks), and 17 weeks (8–51 weeks), respectively. The median OSs were 22 months (10.5–70 months) after the first DOC treatment and 14 months (3–65 months) after the second DOC treatment. The > 50% PSA decline rate was 48% after retreatment. Short treatment holidays (< 3 months) were associated with shortened OS (p = 0.01). In the multivariate analysis, a 25% PSA increase over the nadir was the strongest predictor of survival (HR: 3.20, 95% CI: 1.47–6.99, p = 0.003). Conclusions DOC retreatment without prednisone had anti-tumor activity in a considerable proportion of mCRPC cases that were initially sensitive to first-line DOC. A 25% PSA increase over the nadir might predict acquired DOC resistance.
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Nagy ND, Fazekas T, Baghy K, Papp G, Csizmarik A, Szűcs M, Nyirády P, Szarvas T. Efficacy of carboplatin chemotherapy in a metastatic, castration-resistant BRCA2 mutation positive prostate cancer patient. Orv Hetil 2021; 162:1004-1008. [PMID: 34148027 DOI: 10.1556/650.2021.32112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. A sérült BRCA1/2 gént hordozó prosztatadaganatok klinikai szempontból elkülönülő, agresszív altípust képviselnek. Ugyanakkor a BRCA1/2 gén sérülése a DNS-támadáspontú kemoterápiákkal szemben érzékennyé teszi a daganatot, ami terápiás szempontból kihasználható. A platinaalapú kemoterápia hatékonysága prosztatarákban klinikai vizsgálatokkal nincs alátámasztva, ezért annak alkalmazására igen ritkán kerül sor. Közleményünkben egy előrehaladott stádiumú, agresszív prosztata adenocarcinomával diagnosztizált beteg esetét mutatjuk be, akinél a BRCA2-gén patogén mutációját találtuk, és akinél az előzőleg alkalmazott androgénmegvonásos, valamint docetaxelkezelések sikertelensége miatt karboplatinkezelést alkalmaztunk - ez a beteg állapotának, valamint radiológiai és biokémiai paramétereinek látványos javulásához vezetett. Ez az eset rámutat a DNS-hiba-javító mechanizmusban szerepet játszó gének terápiás szempontból történő felhasználásának potenciális előnyeire prosztatarákban. Orv Hetil. 2021; 162(25): 1004-1008. Summary. BRCA1/2 deficient prostate cancers represent a clinically distinct aggressive subtype. However, the presence of BRCA1/2 alterations enhance the sensitivity to platinum-based chemotherapies. The efficacy of platinum-based chemotherapies in prostate cancer has not been proven in prospective clinical studies and therefore these treatments are rarely used in prostate adenocarcinomas. Here we present a case of BRCA2 mutant prostate cancer, which was diagnosed at a metastatic stage and showed no or only little response to androgen deprivation and docetaxel therapies. Therefore, we started carboplatin chemotherapy which resulted in an exceptional response regarding biochemical, radiographic parameters accompanied by significant improvement of patients' physical condition. This case underlines the potential therapeutic benefits of testing for genes involved in the DNA repair mechanism. Orv Hetil. 2021; 162(25): 1004-1008.
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Affiliation(s)
- Noémi Dalma Nagy
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tamás Fazekas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Kornélia Baghy
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Gergő Papp
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Anita Csizmarik
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082.,3 Essen-Duisburgi Egyetem, Urológiai Klinika, Essen, Németország
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Ortiz-Brüchle N, Wucherpfennig S, Rose M, Garczyk S, Bertz S, Hartmann A, Reis H, Szarvas T, Kiss A, Bremmer F, Golz R, Knüchel R, Gaisa NT. Molecular Characterization of Muellerian Tumors of the Urinary Tract. Genes (Basel) 2021; 12:genes12060880. [PMID: 34200508 PMCID: PMC8228991 DOI: 10.3390/genes12060880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022] Open
Abstract
In the 2016 WHO classification of genitourinary tumors Muellerian tumors of the urinary tract (MTUT) comprise clear cell adenocarcinomas and endometrioid carcinomas. Since these rare tumors remained understudied, we aimed to characterize their molecular background by performing DNA- and RNA-based targeted panel sequencing. All tumors (n = 11) presented single nucleotide alterations (SNVs), with ARID1A mutations being the most prevalent (5/11, 45%). Besides frequent ARID1A mutations, loss of ARID1A protein is not a suitable marker since protein expression is (partly) preserved also in mutated cases. Copy number alterations (CNVs) were found in 64% of cases (7/11), exclusively gene amplifications. Interestingly, a functionally relevant RSPO2 gene fusion/microdeletion was discovered in the endometrioid adenocarcinoma case. Comparing our findings with mutational profiles of other tumor entities, absence of TERT promoter mutations argues for a non-urothelial origin. No similarities were also found between MTUT and kidney cancers while parallels were observed for specific SNVs with endometrial carcinomas. In conclusion, immunohistochemical PAX8-positivity and lack of TERT promoter mutations could serve as key diagnostic features in difficult cases. Thus, understanding the molecular background of these tumors helps to refine treatment options and offers the possibility of targeted therapies in cases where needed.
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Affiliation(s)
- Nadina Ortiz-Brüchle
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
| | - Sophie Wucherpfennig
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
| | - Michael Rose
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
| | - Stefan Garczyk
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
| | - Simone Bertz
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.B.); (A.H.)
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.B.); (A.H.)
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147 Essen, Germany;
| | - Tibor Szarvas
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, University Hospital Essen, 45147 Essen, Germany;
- Department of Urology, Semmelweis University, 1085 Budapest, Hungary
| | - András Kiss
- 2nd Department of Pathology, Semmelweis University, 1085 Budapest, Hungary;
| | - Felix Bremmer
- Institute of Pathology, University Medical Center, University of Göttingen, 37075 Göttingen, Germany;
| | - Reinhard Golz
- Institute of Pathology, HELIOS Clinic Wuppertal, 37075 Wuppertal, Germany;
| | - Ruth Knüchel
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
| | - Nadine T. Gaisa
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (N.O.-B.); (S.W.); (M.R.); (S.G.); (R.K.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
- Correspondence: ; Tel.: +49-241-8089288; Fax: +49-241-8082439
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Krafft U, Olah C, Reis H, Kesch C, Darr C, Grünwald V, Tschirdewahn S, Hadaschik B, Horvath O, Kenessey I, Nyirady P, Varadi M, Modos O, Csizmarik A, Szarvas T. High Serum PD-L1 Levels Are Associated with Poor Survival in Urothelial Cancer Patients Treated with Chemotherapy and Immune Checkpoint Inhibitor Therapy. Cancers (Basel) 2021; 13:cancers13112548. [PMID: 34067347 PMCID: PMC8196869 DOI: 10.3390/cancers13112548] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 01/08/2023] Open
Abstract
Serum PD-L1 (sPD-L1) levels are associated with prognosis in various tumors but has not yet been investigated in advanced bladder cancer. We assessed pretreatment serum samples from 83 BC patients who received platinum chemotherapy and from 12 patients who underwent immune checkpoint inhibitor (ICI) therapy. In addition, on-treatment samples from further therapy cycles were collected during chemotherapy (n = 58) and ICI therapy (n = 11). Serum PD-L1 levels were determined using ELISA. High baseline sPD-L1 levels were associated with worse ECOG status (p = 0.007) and shorter overall survival for both chemotherapy- and ICI-treated patients (p = 0.002 and p = 0.040, respectively). Multivariate analysis revealed high baseline sPD-L1 level as an independent predictor of poor survival for platinum-treated patients (p = 0.002). A correlation analysis between serum concentrations of PD-L1 and matrix metalloprotease-7 (MMP-7)-a protease which was recently found to cleave PD-L1-revealed a positive correlation (p = 0.001). No significant sPD-L1 changes were detected during chemotherapy, while in contrast we found a strong, 25-fold increase in sPD-L1 levels during atezolizumab treatment. In conclusion, our work demonstrates that pretreatment sPD-L1 levels are associated with a poor prognosis of BC patients undergoing platinum and ICI therapy. Future research should prospectively address the value of sPD-L1 in predicting treatment response.
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Affiliation(s)
- Ulrich Krafft
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Csilla Olah
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Henning Reis
- Institute of Pathology, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Claudia Kesch
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Christopher Darr
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Viktor Grünwald
- Clinic for Urology and Clinic for Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| | - Stephan Tschirdewahn
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Boris Hadaschik
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Orsolya Horvath
- Department of Genitourinary Medical Oncology and Pharmacology, National Institute of Oncology, 1122 Budapest, Hungary;
| | - Istvan Kenessey
- 2nd Department of Pathology, Semmelweis University, 1122 Budapest, Hungary;
- National Cancer Registry and Centre for Biostatistics, National Institute of Oncology, 1122 Budapest, Hungary
| | - Peter Nyirady
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Melinda Varadi
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Orsolya Modos
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Tibor Szarvas
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
- Correspondence: ; Tel.: +49-201-723-4547
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Szarvas T, Pothorszky S, Erdei D, Molnár G, Nádudvari G, Almásy O, Spindler S, Kretschmer R, Bauer S. Application of light scattering tomography for Si(111) samples. Rev Sci Instrum 2021; 92:053701. [PMID: 34243353 DOI: 10.1063/5.0036868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
The detection of bulk micro-defects in Czochralski-grown silicon (Si) 〈100〉 wafers has significant importance in wafer quality control. Light Scattering Tomography (LST) is an industry standard technique for this purpose. This optical non-contact metrology requires destructive sample preparation: Samples have to be cleaved into half. One particular feature of the method is a dark field detection arrangement, which is achieved by separating the light detection part (microscope unit) from the illumination. Illumination is applied to the front surface of the sample, and the light scattered off of the defects is collected via the cleaved surface. The technique requires the perpendicularity of the cleaved surface to the front surface, which is fulfilled for Si(100) wafers. However, the nominally cleaved surface for Si(111) wafers is not perpendicular to the front surface but has an angle of 70.5°. This significant difference in cleavage results in the fact that Si(111) wafers cannot be measured by standard LST systems. Fortunately, the standard LST system can be modified by tilting the detection part under a proper angle allowing the measurements of Si(111) samples. In this article, we present this new technique in detail, showing the design and measurement capability of the new system. The measurement results are validated by a direct comparison to standard LST measurements on the same samples after proper sample preparation.
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Affiliation(s)
- T Szarvas
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Sz Pothorszky
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - D Erdei
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - G Molnár
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Gy Nádudvari
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - O Almásy
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Sz Spindler
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - R Kretschmer
- Siltronic AG, Einsteinstraße 172, 81677 Munich, Germany
| | - S Bauer
- Siltronic AG, Einsteinstraße 172, 81677 Munich, Germany
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Oláh C, Váradi M, Horváth O, Nyirády P, Szarvas T. Oncological relevance of gut and urine microbiomes. Orv Hetil 2021; 162:579-586. [PMID: 33798103 DOI: 10.1556/650.2021.32052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Az immunrendszer nem megfelelő működése meghatározó szerepet játszik a daganatok kialakulásában, progressziójában és az egyes terápiák hatékonyságában is. A bélrendszer baktériumai a szervezet immunitásán keresztül képesek befolyásolni a szervezet gyógyszeres terápiákra adott válaszreakcióját, kiváltképpen az immunellenőrzőpont-gátló kezelések hatását. Az újgenerációs nukleinsav-szekvenálási technológiák felhasználásával részletes képet kaphatunk a szervezetben jelen lévő baktériumok minőségi és mennyiségi viszonyairól. A közelmúltban összefüggést igazoltak a vastagbéldaganat, a melanoma, a vesesejtes carcinoma és a nem kissejtes tüdőrák esetén alkalmazott immunellenőrzőpont-gátló terápiák hatékonysága és a bél mikrobiom-összetétele között. Számos olyan baktériumot azonosítottak, melynek jelenlétéből, illetve mennyiségéből következtethetünk az egyes kezelésekkel szembeni egyéni érzékenységre. Ezzel összhangban, az antibiotikumkezelés által okozott dysbiosis növelte az immunellenőrzőpont-gátló terápia sikertelenségének kockázatát. Ezen eredmények tükrében a jövőben a mikrobiom-összetétel meghatározása is fontos tényező lehet az immunterápiák hatékonyságának előrejelzésében, illetve egyre inkább bizonyított, hogy a széles spektrumú antibiotikumkezelés a legtöbbször csökkenti a daganatellenes immunterápiák hatékonyságát. Jelenleg folyó klinikai vizsgálatok pedig a mikrobiom-összetétel mesterséges úton történő megváltoztatásának terápiás lehetőségeit tanulmányozzák. Bebizonyosodott, hogy a korábbi állásponttal szemben a vizelet nem steril. DNS-szekvenálás alkalmazásával számos olyan, a vizeletben előforduló baktériumot sikerült azonosítani, melynek jelenléte hozzájárulhat a húgyhólyagrák kialakulásához és progressziójához, illetve a húgyhólyagban lokálisan alkalmazott BCG-terápia hatékonyságához. Jelen munkában a közelmúlt publikációit feldolgozva összefoglaljuk, mely baktériumok jelenléte hozható összefüggésbe a különböző daganatok kialakulásával, progressziójával és terápiarezisztenciájával. Orv Hetil. 2020; 162(15): 579-586. Summary. Dysfunction of the immune system plays a crucial role in the development and progression of cancer as well as the effectiveness of antitumor therapies. Gut microbiota, due to their impact on the immune system, are able to influence response to anticancer drug therapies. Next-generation DNA-sequencing technologies enabled a comprehensive quantitative and qualitative exploration of the gut microbiome. An increasing body of evidence indicates the association between the efficacy of immune checkpoint inhibitor therapies and gut microbiome composition in colorectal cancer, malignant melanoma, renal cell carcinoma, and non-small cell lung cancer. Recently, several bacterial strains and species were shown to be associated with treatment efficacies. In accordance, dysbiosis caused by antibiotic treatment was found to increase the risk of failure to immune checkpoint inhibitor therapies. In the light of these results, examination of microbiome composition may become an important factor for the prediction of immunotherapies. Currently ongoing clinical trials are investigating the potential of therapeutic alteration of microbiome composition. Contrary to the previous view, urine has been shown not to be sterile. By using sensitive DNA-sequencing technologies, several urinary bacteria could be identified which may contribute to the development and progression of bladder cancer and may influence the efficacy of intravesical BCG therapy. In the present work, we summarize recent studies that identified the presence of certain bacteria associated with the development, progression, and therapy resistance of various cancers. Orv Hetil. 2020; 162(15): 579-586.
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Affiliation(s)
- Csilla Oláh
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Melinda Váradi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Orsolya Horváth
- 2 Országos Onkológiai Intézet, Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Budapest
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082.,3 Duisburg-Essen Egyetem, Urológiai Klinika, Essen
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Szarvas T, Molnár G, Nádudvari G, Tóth S, Almásy O, Spindler S, Erdei D, Pothorszky S, Kretschmer R, Bauer S. Bulk micro-defect detection with low-angle illumination. Rev Sci Instrum 2021; 92:043701. [PMID: 34243430 DOI: 10.1063/5.0027147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/14/2021] [Indexed: 06/13/2023]
Abstract
The detection of oxygen precipitates, voids, and other defects is critical for semiconductor wafer makers. One of the industry standard techniques for detecting these Bulk Micro-Defects (BMDs) is Semilab's Light Scattering Tomograph (LST) system. In this measurement, unpatterned wafers are nominally cleaved in half. Illumination is applied to the front surface of the sample, and the light scattered off of the defects is collected via the cleaved surface. This technique had been limited to the measurement of unpatterned wafers, but device makers show significant interest in measuring BMD distributions on patterned wafers using scattering-based techniques. A pattern on the surface of the wafer can cause significant scattering, making the standard LST technique unsuitable for this task. We present a solution for patterned wafer BMD measurements by an addition of a low-angle illumination unit to the standard LST system. This new illumination unit focuses the light into the bulk of the wafer via the cleaved surface, which enables measurement on patterned samples. The new system is called "light scattering tomograph enhanced by low-angle illumination." Excellent correlation was found between the detected defect densities obtained by the low-angle and the standard LST illumination mode.
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Affiliation(s)
- T Szarvas
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - G Molnár
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Gy Nádudvari
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Sz Tóth
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - O Almásy
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Sz Spindler
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - D Erdei
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - Sz Pothorszky
- Semilab Co. Ltd., Prielle Kornélia u. 4/A, 1117 Budapest, Hungary
| | - R Kretschmer
- Siltronic AG, Einsteinstraße 172, 81677 Munich, Germany
| | - S Bauer
- Siltronic AG, Einsteinstraße 172, 81677 Munich, Germany
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Ingenwerth M, Nyirády P, Hadaschik B, Szarvas T, Reis H. The prognostic value of cytokeratin and extracellular collagen expression in urinary bladder cancer. Curr Mol Med 2021; 22:941-949. [PMID: 33632097 DOI: 10.2174/1566524021666210225100041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Expression levels of collagens have been implicated in the progression of various cancers and interact with cytokeratins, but are not well studied in bladder cancer (BC). Therefore, we analyzed the gene and protein expression levels of collagen 1A1 (Col1a1/COL1A1), collagen 3A1 (col3a1/COL3A1), collagen 5A2 (col5a2/COL5A2), cytokeratin 14 (krt14/CK14), and cytokeratin 17 (krt17/CK17) in urothelial BC samples of different stages. METHODS In total, 102 fresh frozen and 190 formalin fixed and paraffin embedded (FFPE) samples were tested using immunohistochemistry and RT-qPCR. Expression levels were correlated to clinicopathological and follow-up data. RESULTS Col1a1, col3a1, col5a2 and krt14 mRNA levels were significantly overexpressed in high-grade and muscle-invasive BC (MIBC) compared to low-grade and non-muscle invasive BC (NMIBC) cases. Disease-specific survival (DSS) was shorter in patients with high expression levels of col1a1 (p = 0.004), col3a1 (p = 0.004), and col5a2 (p = 0.028). CK14 (p = 0.020), COL3A1 (p = 0.006) and Col5A2 (p = 0.006) protein expression levels were significantly higher and protein expression levels of CK17 (p = 0.05) significantly lower in MIBC compared to NMIBC. Furthermore, CK14 (p = 0.002) and COL5A2 (p = 0.006) protein expressions were significantly higher in high-grade compared to low-grade BC. DSS was shorter in patients with high expression levels of COL5A2 (p = 0.033) and CK14 (p = 0.042). CONCLUSION Expression changes of collagens and cytokeratins are univariable prognostic markers in BC.
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Affiliation(s)
- Marc Ingenwerth
- Institute of Pathology, Faculty of Medicine, University of Duisburg-Essen, 45147 Essen. Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest. Hungary
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, 45147 Essen. Germany
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest. Hungary
| | - Henning Reis
- Institute of Pathology, Faculty of Medicine, University of Duisburg-Essen, 45147 Essen. Germany
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Rehme C, Burchert C, Tosun M, Szarvas T, Nagy N, Ruebben H, Hadaschik B, Niedworok C. Stone extraction with loop ureteral catheter versus ureteroscopy in small distal ureteral stones-retrospective comparison of 547 consecutive patients. Transl Androl Urol 2021; 10:87-95. [PMID: 33532299 PMCID: PMC7844532 DOI: 10.21037/tau-20-909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To evaluate whether stone extraction with a loop ureteral catheter (LUC) in distal ureteral stones is associated with a higher frequency of ureteral strictures compared to treatment with primary ureteroscopic stone removal (p-URS) or ureteroscopic laser lithotripsy (l-URS). Methods Five hundred and forty-seven consecutive patients were primarily endourologically treated for distal ureteral stones in our department between 2005 and 2019 and included in the study protocol. Data was retrospectively obtained from the patients’ charts and medical reports as well as from office-based urologists. Data analysis was performed using Fisher’s exact test, Mann-Whitney test or Student’s t-test as appropriate. A level of P<0.05 was assigned statistical significance. Results Four hundred and twelve patients were treated by URS (p-URS n=304, l-URS n=108) and another 135 by LUC stone extraction. Median follow-up was 41 [2–159] months. There was no difference between the groups concerning age, gender, proportion of patients with ureteral stenting, operating time, hospitalization or readmission rates. The number of ureteric strictures was small in all procedures [n=3 (1.0%) in p-URS, n=2 (1.9%) in l-URS and n=2 (1.5%) in LUC] and there was no difference between the groups concerning this serious complication (p-URS vs. LUC: P=0.6465; l-URS vs. LUC: P=0.9999). Conclusions In small distal stones, LUC stone extraction still is an alternative to URS procedures in stone management with comparable results concerning postinterventional ureteral strictures. In experienced hands, it still has its value in accurately selected patients.
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Affiliation(s)
- Christian Rehme
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carolin Burchert
- Department of Urology, Hermann-Josef Hospital Erkelenz, University of Duisburg-Essen, Essen, Germany
| | - Mustafa Tosun
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nadine Nagy
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Herbert Ruebben
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Urology, Helios Hospital Duisburg, Duisburg, Germany
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christian Niedworok
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Urology, Hermann-Josef Hospital Erkelenz, University of Duisburg-Essen, Essen, Germany
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Neumann JM, Niehaus K, Neumann N, Knobloch HC, Bremmer F, Krafft U, Kellner U, Nyirády P, Szarvas T, Bednarz H, Reis H. Correction to: A new technological approach in diagnostic pathology: mass spectrometry imaging-based metabolomics for biomarker detection in urachal cancer. J Transl Med 2021; 101:1414. [PMID: 36775441 PMCID: PMC8440205 DOI: 10.1038/s41374-021-00625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Judith Martha Neumann
- grid.7491.b0000 0001 0944 9128Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - Karsten Niehaus
- grid.7491.b0000 0001 0944 9128Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - Nils Neumann
- grid.7491.b0000 0001 0944 9128Research Institute for Cognition and Robotics (CoR-Lab), Bielefeld University, Bielefeld, Germany
| | - Hans Christoph Knobloch
- grid.411984.10000 0001 0482 5331Department of Urology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Felix Bremmer
- grid.411984.10000 0001 0482 5331Institute of Pathology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Ulrich Krafft
- grid.410718.b0000 0001 0262 7331Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Udo Kellner
- grid.477456.3Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - Peter Nyirády
- grid.11804.3c0000 0001 0942 9821Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Tibor Szarvas
- grid.410718.b0000 0001 0262 7331Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany ,grid.11804.3c0000 0001 0942 9821Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Hanna Bednarz
- Proteome and Metabolome Research, Center for Biotechnology (CeBiTec), Faculty of Biology, Bielefeld University, Bielefeld, Germany. .,Medical School OWL, Bielefeld University, Bielefeld, Germany.
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Szarvas T, Hoffmann MJ, Olah C, Szekely E, Kiss A, Hess J, Tschirdewahn S, Hadaschik B, Grotheer V, Nyirady P, Csizmarik A, Varadi M, Reis H. MMP-7 Serum and Tissue Levels Are Associated with Poor Survival in Platinum-Treated Bladder Cancer Patients. Diagnostics (Basel) 2020; 11:diagnostics11010048. [PMID: 33396213 PMCID: PMC7824149 DOI: 10.3390/diagnostics11010048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/19/2020] [Accepted: 12/26/2020] [Indexed: 01/09/2023] Open
Abstract
Chemotherapy resistance is a main cause of therapeutic failure and death in bladder cancer. With the approval of immune checkpoint inhibitors, prediction of platinum treatment became of great clinical importance. Matrix metalloproteinase-7 (MMP-7) was shown to be involved in cisplatin resistance. Therefore, tissue and circulating MMP-7 levels were evaluated in 124 bladder cancer patients who received postoperative platinum-based chemotherapy. Tissue MMP-7 levels were analyzed by immunohistochemistry in 72 formalin-fixed, paraffin-embedded chemo-naïve tumor samples, while MMP-7 serum concentrations were determined in 132 serum samples of an independent cohort of 52 patients. MMP-7 tissue and serum levels were correlated with clinicopathological and follow-up data. MMP-7 gene expression was determined by RT-qPCR in 20 urothelial cancer cell lines and two non-malignant urothelial cell lines. MMP-7 was overexpressed in RT-112 and T-24 cells by stable transfection, to assess its functional involvement in platinum sensitivity. High MMP-7 tissue expression and pretreatment serum concentrations were independently associated with poor overall survival (tissue HR = 2.296, 95%CI = 1.235–4.268 and p = 0.009; serum HR = 2.743, 95%CI = 1.258–5.984 and p = 0.011). Therefore, MMP-7 tissue and serum analysis may help to optimize therapeutic decisions. Stable overexpression in RT-112 and T-24 cells did not affect platinum sensitivity.
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Affiliation(s)
- Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
- Correspondence: ; Tel.: +49-201-7238-4967
| | - Michèle J. Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Eszter Szekely
- 2nd Department of Pathology, Semmelweis University, 1091 Budapest, Hungary; (E.S.); (A.K.)
| | - Andras Kiss
- 2nd Department of Pathology, Semmelweis University, 1091 Budapest, Hungary; (E.S.); (A.K.)
| | - Jochen Hess
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Stephan Tschirdewahn
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Vera Grotheer
- Department of Orthopedics and Trauma Surgery, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Peter Nyirady
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Melinda Varadi
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
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Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy. Urol Oncol 2020; 39:296.e11-296.e19. [PMID: 33046366 DOI: 10.1016/j.urolonc.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/06/2020] [Accepted: 09/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The rapidly changing treatment landscape in metastatic castration-resistant prostate cancer (mCRPC) calls for biomarkers to guide treatment decisions. We recently identified MMP-7 as a potential serum marker for the prediction of response and survival in mCRPC patients who received docetaxel (DOC) chemotherapy. Here, we aimed to test this finding in an independent patient cohort and in addition to explore the prognostic potential of serum MMP-7 in abiraterone (ABI) or enzalutamide (ENZA) treated patients. METHODS AND MATERIALS MMP-7 levels were measured in 836 serum samples from 320 mCRPC patients collected before and during DOC (n = 95), ABI (n = 140), or ENZA (n = 85) treatment by using the ELISA method. Results were correlated with clinical and follow-up data. RESULTS MMP-7 baseline levels were similar between the 3 treatment groups. In the ABI and ENZA cohorts, baseline MMP-7 levels were lower in patients with prior radical prostatectomy (P = 0.058 and P = 0.041, respectively). Baseline MMP-7 levels above the median were associated with shorter overall survival for the DOC (P = 0.001) and ENZA (P = 0.006) cohorts. Multivariable analyses in the DOC and ENZA cohorts revealed that high pretreatment MMP-7 level is an independent risk factor for patients' survival. In addition, in DOC-treated patients with high baseline MMP-7 level, marker decrease at the third DOC cycle was associated with improved survival. Patients with high baseline MMP-7 levels had better survival when treated with ABI compared to DOC or ENZA. CONCLUSIONS We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients.
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Affiliation(s)
- T Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Hüttl
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - V Grünwald
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - S Sevcenco
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - A Maj-Hes
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - G Kramer
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
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48
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Nagy N, Reis H, Hadaschik B, Niedworok C, Módos O, Szendrői A, Bíró K, Hager T, Herold T, Ablat J, Black PC, Okon K, Tolkach Y, Csizmarik A, Oláh C, Keresztes D, Bremmer F, Gaisa NT, Kriegsmann J, Kovalszky I, Kiss A, Tímár J, Szász MA, Rink M, Fisch M, Nyirády P, Szarvas T. Prevalence of APC and PTEN Alterations in Urachal Cancer. Pathol Oncol Res 2020; 26:2773-2781. [PMID: 32754865 PMCID: PMC7471184 DOI: 10.1007/s12253-020-00872-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
Urachal carcinoma (UrC) is a rare tumor with remarkable histological and molecular similarities to colorectal cancer (CRC). Adenomatous polyposis coli (APC) is the most frequently affected gene in CRC, but the prevalence and significance of its alterations in UrC is poorly understood. In addition, loss of phosphatase and tensin homologue (PTEN) was shown to be associated with therapy resistance in CRC. Our primary aim was to assess specific genetic alterations including APC and PTEN in a large series of UrC samples in order to identify clinically significant genomic alterations. We analyzed a total of 40 UrC cases. Targeted 5-gene (APC, PTEN, DICER1, PRKAR1A, TSHR, WRN) panel sequencing was performed on the Illumina MiSeq platform (n = 34). In addition, ß-catenin (n = 38) and PTEN (n = 30) expressions were assessed by immunohistochemistry. APC and PTEN genes were affected in 15% (5/34) and 6% (2/34) of cases. Two of five APC alterations (p.Y1075*, p.K1199*) were truncating pathogenic mutations. One of the two PTEN variants was a pathogenic frameshift insertion (p.C211fs). In 29% (11/38) of samples, at least some weak nuclear ß-catenin immunostaining was detected and PTEN loss was observed in 20% (6/30) of samples. The low prevalence of APC mutations in UrC represents a characteristic difference to CRC. Based on APC and ß-catenin results, the Wnt pathway seems to be rarely affected in UrC. Considering the formerly described involvement of PTEN protein loss in anti-EGFR therapy-resistance its immunohistochemical testing may have therapeutic relevance.
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Affiliation(s)
- Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Christian Niedworok
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Attila Szendrői
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | | | - Thomas Hager
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Thomas Herold
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Jason Ablat
- Vancouver Prostate Centre, University of British Columbia, Vancouver, V6H 3Z6, Canada
| | - Peter C Black
- Vancouver Prostate Centre, University of British Columbia, Vancouver, V6H 3Z6, Canada
| | - Krzysztof Okon
- Department of Pathomorphology, Jagiellonian University, 30252, Cracow, Poland
| | - Yuri Tolkach
- Institute of Pathology, University of Bonn, 53113, Bonn, Germany
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Csilla Oláh
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - David Keresztes
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Felix Bremmer
- Institute of Pathology, University of Göttingen, 37073, Göttingen, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, 52074, Aachen, Germany
| | - Joerg Kriegsmann
- Cytology and Molecular Diagnostics Trier, Center for Histology, 54296, Trier, Germany
| | - Ilona Kovalszky
- 1st Institute of Pathology and Expreimental Cancer Research, Semmelweis University, Budapest, 1085, Hungary
| | - András Kiss
- 2nd Department of Pathology, Semmelweis University, Budapest, 1091, Hungary
| | - József Tímár
- 2nd Department of Pathology, Semmelweis University, Budapest, 1091, Hungary
| | - Marcell A Szász
- Cancer Center, Semmelweis University, Budapest, 1083, Hungary
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary.
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany.
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Harke NN, Darr C, Radtke JP, von Ostau N, Schiefelbein F, Eraky A, Hamann C, Szarvas T, Hadaschik BA, Tropmann-Frick M, Juenemann KP, Schoen G, Osmonov D. Retroperitoneal Versus Transperitoneal Robotic Partial Nephrectomy: A Multicenter Matched-pair Analysis. Eur Urol Focus 2020; 7:1363-1370. [PMID: 32912841 DOI: 10.1016/j.euf.2020.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/27/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND With increasing acceptance of robotic partial nephrectomy over the last decade, there is an ongoing discussion about the transperitoneal versus retroperitoneal access. OBJECTIVE To report outcomes after transperitoneal (TRPN) versus retroperitoneal (RRPN) robotic partial nephrectomy. DESIGN, SETTING, AND PARTICIPANTS A total of 754 patients were identified from the databases of three high-volume centers who underwent either TRPN (n = 551) or RRPN (n = 203). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Perioperative data were evaluated retrospectively. A propensity score matched-pair analysis was performed with the following variables: grade of renal insufficiency, age, body mass index, tumor diameter, and preoperative aspects and dimensions used for an anatomical (PADUA) score with a subsequent subgroup analysis for tumor location. For quality outcomes, the margin, ischemia, and complications (MIC) criteria were used (negative margins, ischemia time <20 min, and no major complications). Statistical analyses included chi-square and Mann-Whitney U tests. RESULTS AND LIMITATIONS In all, 176 patients could be matched in each group. The median tumor diameter was 28 mm with a PADUA score of 9. In 11% of RRPN versus 44% of TRPN cases, an anterior tumor location was found, and in 55% versus 30%, a posterior lesion was found (p < 0.001). Operative time (119 vs 139 min, p < 0.001) and warm ischemia time (9 vs 10 min, p = 0.003) were significantly shorter for RRPN. No significant differences were observed between intra- and postoperative complication rates, with 8% major complications in TRPN versus 3% in RRPN (p = 0.06). The MIC criteria were achieved in 90% in the RRPN versus 88% in the TRPN group, without differences for tumor location. CONCLUSIONS Significant differences between TRPN and RRPN could be found for intraoperative time, while complication rates and quality outcomes were comparable. RRPN can also be a considerable alternative for anterior tumors. PATIENT SUMMARY In this study, we demonstrate that robotic partial nephrectomy is feasible with either a transperitoneal or a retroperitoneal surgical access. The posterior approach can also be used for anterior renal tumors and may result in shorter operative time.
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Affiliation(s)
- Nina N Harke
- Department of Urology, University Hospital Essen, Essen, Germany.
| | - Christopher Darr
- Department of Urology, University Hospital Essen, Essen, Germany
| | | | - Nicola von Ostau
- Department of Urology, University Hospital Essen, Essen, Germany
| | | | - Ahmed Eraky
- Department of Urology, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Claudius Hamann
- Department of Urology, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, Essen, Germany; Department of Urology, Semmelweis University, Budapest, Hungary
| | | | | | | | - Georg Schoen
- Department of Urology, Missioklinik, Wuerzburg, Germany; Department of Urology, Urologische Klinik Muenchen-Planegg, Planegg, Germany
| | - Daniar Osmonov
- Department of Urology, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
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Fazekas T, Szarvas T, Csizmarik A, Hadaschik B, Nyirády P. Correction to: COVID-19 research: promising tracks leading to uro-oncology. Int Urol Nephrol 2020; 53:95. [PMID: 32816158 PMCID: PMC7439631 DOI: 10.1007/s11255-020-02613-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary.
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