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Prasad SM. Primary Chemoablation for Intermediate-Risk Low-Grade Bladder Cancer: New Paradigm or Added Uncertainty? Letter. J Urol 2023; 210:840. [PMID: 37769639 DOI: 10.1097/ju.0000000000003729] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
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Fernandez G, Prasad SM. Editorial Comment. Urol Pract 2023; 10:585-586. [PMID: 37856724 DOI: 10.1097/upj.0000000000000448.01] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 10/21/2023]
Affiliation(s)
| | - Sandip M Prasad
- Editorial Committee, Urology Practice®
- Garden State Urology, Atlantic Health System, Morristown, New Jersey
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Prasad SM, Huang WC, Shore ND, Hu B, Bjurlin M, Brown G, Genov P, Shishkov D, Khuskivadze A, Ganev T, Marchev D, Orlov I, Kopyltsov E, Zubarev V, Nosov A, Komlev D, Burger B, Raju S, Meads A, Schoenberg M. Treatment of Low-grade Intermediate-risk Nonmuscle-invasive Bladder Cancer With UGN-102 ± Transurethral Resection of Bladder Tumor Compared to Transurethral Resection of Bladder Tumor Monotherapy: A Randomized, Controlled, Phase 3 Trial (ATLAS). J Urol 2023; 210:619-629. [PMID: 37548555 DOI: 10.1097/ju.0000000000003645] [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] [Received: 07/05/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE Low-grade intermediate-risk nonmuscle-invasive bladder cancer is a chronic illness commonly treated by repetitive transurethral resection of bladder tumor. We compared the efficacy and safety of intravesical chemoablation with UGN-102 (a reverse thermal gel containing mitomycin), with or without subsequent transurethral resection of bladder tumor, to transurethral resection of bladder tumor alone in patients with low-grade intermediate-risk nonmuscle-invasive bladder cancer. MATERIALS AND METHODS This prospective, randomized, phase 3 trial recruited patients with new or recurrent low-grade intermediate-risk nonmuscle-invasive bladder cancer to receive initial treatment with either UGN-102 once weekly for 6 weeks or transurethral resection of bladder tumor. Patients were followed quarterly by endoscopy, cytology, and for-cause biopsy. The primary end point was disease-free survival. All patients were followed for adverse events. RESULTS Trial enrollment was halted by the sponsor to pursue an alternative development strategy after 282 of a planned 632 patients were randomized to UGN-102 ± subsequent transurethral resection of bladder tumor (n=142) or transurethral resection of bladder tumor monotherapy (n=140), rendering the trial underpowered to perform hypothesis testing. Patients were predominantly male and ≥65 years of age. Tumor-free complete response 3 months after initial treatment was achieved by 92 patients (65%) who received UGN-102 and 89 patients (64%) treated by transurethral resection of bladder tumor. The estimated probability of disease-free survival 15 months after randomization was 72% for UGN-102 ± transurethral resection of bladder tumor and 50% for transurethral resection of bladder tumor (hazard ratio 0.45). The most common adverse events (incidence ≥10%) in the UGN-102 group were dysuria, micturition urgency, nocturia, and pollakiuria. CONCLUSIONS Primary, nonsurgical chemoablation with UGN-102 for the management of low-grade intermediate-risk nonmuscle-invasive bladder cancer offers a potential therapeutic alternative to immediate transurethral resection of bladder tumor monotherapy and warrants further investigation.
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Affiliation(s)
- Sandip M Prasad
- Morristown Medical Center/Atlantic Health System and Garden State Urology, Morristown, New Jersey
| | | | - Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, South Carolina
| | - Brian Hu
- The Department of Urology, Loma Linda University, Loma Linda, California
| | - Marc Bjurlin
- The Department of Urology, University of North Carolina, Chapel Hill, North Carolina
| | | | - Pencho Genov
- Department of Urology, University Multiprofile Hospital for Active Treatment "Kanev," Ruse, Bulgaria
| | - Dimitar Shishkov
- Department of Urology, University Multiprofile Hospital for Active Treatment, Plovdiv, Bulgaria
| | | | - Tosho Ganev
- Urology Clinic, Multiprofile Hospital for Active Treatment "Sveta Anna," Varna, Bulgaria
| | - Dobri Marchev
- Department of Urology Multiprofile Hospital for Active Treatment-Shumen, Shumen, Bulgaria
| | - Igor Orlov
- Department of Urology, St Luka Clinical Hospital, Saint Petersburg, Russia
| | - Evgeny Kopyltsov
- Department of Urology and Oncology, Clinical Oncology Center, Omsk, Russia
| | - Vadim Zubarev
- Department of Urology, Medical and Sanitary Unit 70 of Passazhiravtotrans, Saint Petersburg, Russia
| | - Alexander Nosov
- Oncourology Department, NN Petrov National Medical Research Center of Oncology, Leningrad, Russia
| | - Dmitrii Komlev
- Medical Center for Diagnostics and Prevention Plus, Yaroslavl, Russia
| | | | | | | | - Mark Schoenberg
- UroGen Pharma, Princeton, New Jersey
- The Department of Urology, The Albert Einstein College of Medicine & The Montefiore Medical Center, Bronx, New York
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Prasad SM, Kovac E. Editorial Comment. J Urol 2023:101097JU000000000000346101. [PMID: 37102721 DOI: 10.1097/ju.0000000000003461.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Sandip M Prasad
- Garden State Urology, Morristown Medical Center/Atlantic Health System, Morristown, New Jersey
| | - Evan Kovac
- Rutgers New Jersey Medical School, Cancer Institute of New Jersey, Newark, New Jersey
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Somanath PR, Chernoff J, Cummings BS, Prasad SM, Homan HD. Targeting P21-Activated Kinase-1 for Metastatic Prostate Cancer. Cancers (Basel) 2023; 15:cancers15082236. [PMID: 37190165 DOI: 10.3390/cancers15082236] [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: 03/22/2023] [Revised: 04/06/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023] Open
Abstract
Metastatic prostate cancer (mPCa) has limited therapeutic options and a high mortality rate. The p21-activated kinase (PAK) family of proteins is important in cell survival, proliferation, and motility in physiology, and pathologies such as infectious, inflammatory, vascular, and neurological diseases as well as cancers. Group-I PAKs (PAK1, PAK2, and PAK3) are involved in the regulation of actin dynamics and thus are integral for cell morphology, adhesion to the extracellular matrix, and cell motility. They also play prominent roles in cell survival and proliferation. These properties make group-I PAKs a potentially important target for cancer therapy. In contrast to normal prostate and prostatic epithelial cells, group-I PAKs are highly expressed in mPCA and PCa tissue. Importantly, the expression of group-I PAKs is proportional to the Gleason score of the patients. While several compounds have been identified that target group-I PAKs and these are active in cells and mice, and while some inhibitors have entered human trials, as of yet, none have been FDA-approved. Probable reasons for this lack of translation include issues related to selectivity, specificity, stability, and efficacy resulting in side effects and/or lack of efficacy. In the current review, we describe the pathophysiology and current treatment guidelines of PCa, present group-I PAKs as a potential druggable target to treat mPCa patients, and discuss the various ATP-competitive and allosteric inhibitors of PAKs. We also discuss the development and testing of a nanotechnology-based therapeutic formulation of group-I PAK inhibitors and its significant potential advantages as a novel, selective, stable, and efficacious mPCa therapeutic over other PCa therapeutics in the pipeline.
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Affiliation(s)
- Payaningal R Somanath
- Department of Clinical & Administrative Pharmacy, College of Pharmacy, University of Georgia, Augusta, GA 30912, USA
- MetasTx LLC, Basking Ridge, NJ 07920, USA
| | - Jonathan Chernoff
- MetasTx LLC, Basking Ridge, NJ 07920, USA
- Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Brian S Cummings
- MetasTx LLC, Basking Ridge, NJ 07920, USA
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Sandip M Prasad
- Morristown Medical Center, Atlantic Health System, Morristown, NJ 07960, USA
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Autio KA, Higano CS, Nordquist L, Appleman LJ, Zhang T, Zhu XH, Babiker H, Vogelzang NJ, Prasad SM, Schweizer MT, Madan RA, Billotte S, Cavazos N, Bogg O, Li R, Chan K, Cho H, Kaneda M, Wang IM, Zheng J, Tang SY, Hollingsworth R, Kern KA, Petrylak DP. First-in-human, phase 1 study of PF-06753512, a vaccine-based immunotherapy regimen (VBIR), in non-metastatic hormone-sensitive biochemical recurrence and metastatic castration-resistant prostate cancer (mCRPC). J Immunother Cancer 2023; 11:jitc-2022-005702. [PMID: 36948505 PMCID: PMC10040068 DOI: 10.1136/jitc-2022-005702] [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] [Accepted: 12/07/2022] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND This phase 1 study evaluated PF-06753512, a vaccine-based immunotherapy regimen (PrCa VBIR), in two clinical states of prostate cancer (PC), metastatic castration-resistant PC (mCRPC) and biochemical recurrence (BCR). METHODS For dose escalation, patients with mCRPC received intramuscular PrCa VBIR (adenovirus vector and plasmid DNA expressing prostate-specific membrane antigen (PSMA), prostate-specific antigen (PSA), and prostate stem cell antigen (PSCA)) with or without immune checkpoint inhibitors (ICIs, tremelimumab 40 or 80 mg with or without sasanlimab 130 or 300 mg, both subcutaneous). For dose expansion, patients with mCRPC received recommended phase 2 dose (RP2D) of PrCa VBIR plus tremelimumab 80 mg and sasanlimab 300 mg; patients with BCR received PrCa VBIR plus tremelimumab 80 mg (Cohort 1B-BCR) or tremelimumab 80 mg plus sasanlimab 130 mg (Cohort 5B-BCR) without androgen deprivation therapy (ADT). The primary endpoint was safety. RESULTS Ninety-one patients were treated in dose escalation (mCRPC=38) and expansion (BCR=35, mCRPC=18). Overall, treatment-related and immune-related adverse events occurred in 64 (70.3%) and 39 (42.9%) patients, with fatigue (40.7%), influenza-like illness (30.8%), diarrhea (23.1%), and immune-related thyroid dysfunction (19.8%) and rash (15.4%), as the most common. In patients with mCRPC, the objective response rate (ORR, 95% CI) was 5.6% (1.2% to 15.4%) and the median radiographic progression-free survival (rPFS) was 5.6 (3.5 to not estimable) months for all; the ORR was 16.7% (3.6% to 41.4%) and 6-month rPFS rate was 45.5% (24.9% to 64.1%) for those who received RP2D with measurable disease (n=18). 7.4% of patients with mCRPC achieved a ≥50% decline in baseline PSA (PSA-50), with a median duration of 4.6 (1.2-45.2) months. In patients with BCR, 9 (25.7%) achieved PSA-50; the median duration of PSA response was 3.9 (1.9-4.2) and 10.1 (6.9-28.8) months for Cohorts 5B-BCR and 1B-BCR. Overall, antigen specific T-cell response was 88.0% to PSMA, 84.0% to PSA, and 80.0% to PSCA. CONCLUSIONS PrCa VBIR overall demonstrated safety signals similar to other ICI combination trials; significant side effects were seen in some patients with BCR. It stimulated antigen-specific immunity across all cohorts and resulted in modest antitumor activity in patients with BCR without using ADT. TRIAL REGISTRATION NUMBER NCT02616185.
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Affiliation(s)
- Karen A Autio
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Celestia S Higano
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | | | - Tian Zhang
- Duke Cancer Institute, Durham, North Carolina, USA
- UT Southwestern Medical Center, Dallas, Texas, USA
| | - Xin-Hua Zhu
- Northwell Health Cancer Institute, New Hyde Park, New York, USA
| | - Hani Babiker
- University of Arizona Cancer Center, Tucson, Arizona, USA
| | | | - Sandip M Prasad
- Morristown Medical Center/Atlantic Health System, Morristown, New Jersey, USA
| | - Michael T Schweizer
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Ravi A Madan
- National Cancer Institute, Bethesda, Maryland, USA
| | | | | | | | - Ray Li
- Pfizer Inc, New York, New York, USA
| | - Kam Chan
- Pfizer Inc, New York, New York, USA
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Prasad SM. Editorial Commentary. Urol Pract 2023; 10:87-88. [PMID: 37103451 DOI: 10.1097/upj.0000000000000360.01] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/05/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Sandip M Prasad
- Garden State Urology and Morristown Medical Center/Atlantic Health System, Morristown, New Jersey
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Prasad SM. Editorial Commentary. Urol Pract 2022; 9:303. [PMID: 37145784 DOI: 10.1097/upj.0000000000000305.01] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Sandip M Prasad
- Garden State Urology/Atlantic Health System, Morristown, New Jersey
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Singh SK, Husain T, Suhel M, Prasad SM, Singh VP. Hydrogen sulphide ameliorates hexavalent chromium toxicity in two cereal crops: Role of antioxidant enzymes and proline metabolism. Plant Biol (Stuttg) 2022; 24:636-641. [PMID: 35384231 DOI: 10.1111/plb.13413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/07/2022] [Indexed: 05/21/2023]
Abstract
Chromium pollution in soils is a major threat as it reduces crop yields. Hence, researchers seek methods/strategies which could curtail such losses. We report the role of H2 S in alleviating hexavalent chromium [Cr(VI)] stress in two cereals crops, i.e. wheat and rice seedlings, by estimating various physiological attributes. Cr(VI) reduced shoot and root length in both cereals through increased accumulation of Cr(VI) in root tips and increased in oxidative stress markers, i.e. superoxide radicals (SOR), H2 O2 and lipid peroxidation (as MDA equivalent). Supplementation with H2 S alleviated Cr(VI) toxicity in both cereal crops. Application of H2 S increased tolerance to Cr(VI) stress by protecting photosynthesis and enhancing activity of antioxidant enzymes, particularly glutathione-S-transferase and content of proline. Rice was more resistant to Cr(VI) than wheat seedlings.
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Affiliation(s)
- S K Singh
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Prayagraj, India
| | - T Husain
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Prayagraj, India
| | - M Suhel
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Prayagraj, India
| | - S M Prasad
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Prayagraj, India
| | - V P Singh
- Plant Physiology Laboratory, Department of Botany, C.M.P. Degree College, University of Allahabad, Prayagraj, India
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Husain T, Suhel M, Prasad SM, Singh VP. Ethylene and hydrogen sulphide are essential for mitigating hexavalent chromium stress in two pulse crops. Plant Biol (Stuttg) 2022; 24:652-659. [PMID: 34490701 DOI: 10.1111/plb.13324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/21/2021] [Indexed: 05/21/2023]
Abstract
Chromium toxicity to crops is a major scientific problem of the present time. Thus, scientific attempts have been made for reducing chromium toxicity to crop plants. In this study, we examined the potential of ethylene (ET, 25 µM) and hydrogen sulphide (H2 S, 10 µM) to alleviate hexavalent chromium [Cr(VI), 50 µM] stress in two pulse crops, black bean and mung bean, by assessing physiological and biochemical attributes. Cr(VI) reduced shoot and root length in black bean and mung bean in comparison to the control. Plants had increased accumulation of oxidative stress markers, i.e. superoxide radicals (SOR), hydrogen peroxide (H2 O2 ) and lipid peroxidation (as malondialdehyde, MDA). The addition of AVG (an inhibitor of ET biosynthesis) and PAG (an inhibitor of H2 S biosynthesis) to Cr(VI)-treated plants further increased Cr(VI) toxicity, suggesting their endogenous levels are important for tolerating Cr(VI) toxicity. However, supplementation with either ET or H2 S alleviated Cr(VI) toxicity. Interestingly, ET did not rescue negative effects of PAG under Cr(VI) stress but NaHS rescued negative effect of AVG. Overall, results indicate that, although both ET and H2 S alleviate Cr(VI) stress, endogenous H2 S is better. Furthermore, H2 S appears to be a downstream signal for ET in alleviating Cr(VI) stress in these two pulse crops.
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Affiliation(s)
- T Husain
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Allahabad, India
| | - M Suhel
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Allahabad, India
| | - S M Prasad
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Allahabad, India
| | - V P Singh
- Plant Physiology Laboratory, Department of Botany, C.M.P. Degree College, A Constituent Post Graduate College of University of Allahabad, Allahabad, India
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Sherer BA, Chow AK, Newsome MJ, Coogan CL, Prasad SM, Latchamsetty KC. Author Reply. Urology 2017; 105:74-75. [DOI: 10.1016/j.urology.2017.01.053] [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: 10/19/2022]
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Greiman AK, Rosoff JS, Prasad SM. Association of Human Development Index with global bladder, kidney, prostate and testis cancer incidence and mortality. BJU Int 2017; 120:799-807. [PMID: 28480994 DOI: 10.1111/bju.13875] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To describe contemporary worldwide age-standardized incidence and mortality rates for bladder, kidney, prostate and testis cancer and their association with development. MATERIALS AND METHODS We obtained gender-specific, age-standardized incidence and mortality rates for 184 countries and 16 major world regions from the GLOBOCAN 2012 database. We compared the mortality-to-incidence ratios (MIRs) at national and regional levels in males and females, and assessed the association with socio-economic development using the 2014 United Nations Human Development Index (HDI). RESULTS Age-standardized incidence rates were 2.9 (bladder) to 7.4 (testis) times higher for genitourinary malignancies in more developed countries compared with less developed countries. Age-standardized mortality rates were 1.5-2.2 times higher in more vs less developed countries for prostate, bladder and kidney cancer, with no variation in mortality rates observed in testis cancer. There was a strong inverse relationship between HDI and MIR in testis (regression coefficient 1.65, R2 = 0.78), prostate (regression coefficient -1.56, R2 = 0.85), kidney (regression coefficient -1.34, R2 = 0.74), and bladder cancer (regression coefficient -1.01, R2 = 0.80). CONCLUSION While incidence and mortality rates for genitourinary cancers vary widely throughout the world, the MIR is highest in less developed countries for all four major genitourinary malignancies. Further research is needed to understand whether differences in comorbidities, exposures, time to diagnosis, access to healthcare, diagnostic techniques or treatment options explain the observed inequalities in genitourinary cancer outcomes.
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Affiliation(s)
- Alyssa K Greiman
- Department of Urology, Medical University of South Carolina, Charleston, SC, USA
| | - James S Rosoff
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC, USA.,Department of Surgery, Ralph M. Johnson VA Medical Center, Charleston, SC, USA
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Rice LJ, Jefferson M, Briggs V, Delmoor E, Johnson JC, Gattoni-Celli S, Savage SJ, Lilly M, Prasad SM, Kittles R, Halbert CH. Discordance in perceived risk and epidemiological outcomes of prostate cancer among African American men. Prev Med Rep 2017; 7:1-6. [PMID: 28507891 PMCID: PMC5423348 DOI: 10.1016/j.pmedr.2017.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/16/2022] Open
Abstract
As guidelines for prostate cancer screening have changed from an annual screening recommendation starting at age 50 to discussing the benefits and harms of screening with health care providers, it is necessary to examine other types of factors that are important to prostate cancer screening decisions among African American men. Perceived risk of developing cancer has been shown to predict cancer control behaviors and is lower among African Americans. We characterized perceived risk of developing prostate cancer among African American men from November 2009 to 2011 and evaluated the relationship between prostate cancer risk perceptions and sociodemographic characteristics, health care experiences, and knowledge and exposure to health information about cancer. Chi square tests and logistic regression were employed to determine independent associations. Overall, men did not believe they were at increased risk of developing prostate cancer; they believed their risk was equivalent to or lower than men the same age. Perceived risk of prostate cancer was associated with income (OR = 0.59, 95% CI = 0.26, 1.34, p = 0.03), hypertension (OR = 2.68, 95% CI = 1.17, 6.16, p = 0.02), and beliefs about the association between race and cancer risk (OR = 2.54, 95% CI = 1.24, 5.20, p = 0.01). Clinic and community-based approaches to improve prostate cancer risk comprehension among African American men are needed to reduce the discordance between perceived risk and epidemiological data on prostate cancer risk factors. Risk education interventions that are developed for African American men may need to integrate information about susceptibility for multiple diseases as well as address strategies for risk reduction and prevention, and chronic disease management. Perceived risk was associated with income, hypertension and race and cancer risk. There is discordance in perceived risk for prostate cancer and risk outcomes data. Clinic and community-based approaches are needed to improve risk comprehension.
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Affiliation(s)
- LaShanta J Rice
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Melanie Jefferson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States
| | - Vanessa Briggs
- Health Promotion Services, Public Health Management Corporation, Pennsylvania, 260 South Broad Street, Philadelphia, PA 19102, United States
| | - Ernestine Delmoor
- Philadelphia Chapter, National Black Leadership Initiative on Cancer, 1415 N. Broad Street, Suite 221B, Philadelphia, PA 19122, United States
| | - Jerry C Johnson
- Department of Medicine, Division of Geriatrics, University of Pennsylvania, 3615 Chestnut St, Philadelphia, PA 19104-2676, United States
| | - Sebastiano Gattoni-Celli
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Stephen J Savage
- Department of Urology, Medical University of South Carolina, Charleston, SC, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Michael Lilly
- Department of Medicine, Division of Hematology/Oncology, Medical University of South Carolina, Charleston, SC, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Rick Kittles
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
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14
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Sherer BA, Chow AK, Newsome MJ, Coogan CL, Prasad SM, Latchamsetty KC. En Bloc Stapling of the Renal Hilum During Laparoscopic Nephrectomy: A Double-institutional Analysis of Safety and Efficacy. Urology 2017; 105:69-75. [PMID: 28366703 DOI: 10.1016/j.urology.2017.01.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/23/2017] [Accepted: 01/27/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the safety and efficacy of en bloc stapling of the renal hilum (EBSH) during laparoscopic nephrectomy (LNx) in a large double-institution cohort with an extended follow-up period. METHODS We performed a retrospective review of patients undergoing LNx with EBSH between 2008 and 2014 at 2 academic medical centers. Data analyzed included tumor size, tumor pathology, operative time, estimated blood loss, and perioperative or postoperative complications. Evaluation of arteriovenous fistula (AVF) formation was assessed by postoperative imaging studies, physical examination, or new-onset diastolic hypertension. RESULTS A total of 428 patients (mean age: 63 years) underwent LNx, of which there were a total of 433 renal units with EBSH (226 left renal units, 207 right renal units). Mean operative time was 169 minutes (range: 51-489 minutes). Mean estimated blood loss was 155 mL (range: 5 mL-2000 mL). Mean tumor size was 5.6 cm (range: 0.9-14.5 cm). EBSH was performed on 69 patients with chronic infectious and inflammatory benign conditions. Three hundred (70%) patients received post-procedural imaging. No patients developed clinical or radiographic evidence of AVF at a mean follow-up of 51 months. CONCLUSION EBSH during LNx is efficient, effective, and safe. This large series lends further support that EBSH during LNx may not be associated with any significant risk of AVF formation at extended follow-up. We advocate that this technique is a safe alternative to ligating the renal artery and vein during LNx.
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Halbert CH, Gattoni-Celli S, Savage S, Prasad SM, Kittles R, Briggs V, Delmoor E, Rice LJ, Jefferson M, Johnson JC. Ever and Annual Use of Prostate Cancer Screening in African American Men. Am J Mens Health 2016; 11:99-107. [PMID: 26240090 DOI: 10.1177/1557988315596225] [Citation(s) in RCA: 16] [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] [Indexed: 11/17/2022] Open
Abstract
Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 ( n = 132). Overall, 64% of men ( n = 85) reported that they had ever had a PSA test; the mean ( SD) age for first use of PSA testing was 47.7 ( SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annual household income that was greater than $20,000 (OR = 9.80; 95% CI = 3.15, 30.51; p = .0001). The odds of ever having a PSA test were also decreased with each unit increase in future temporal orientation (OR = 0.66; 95% CI = 0.47, 0.93; p = .02). Of the men who had ever had PSA testing, 57% were screened during the past year. Only health insurance status had a significant independent association with having annual PSA testing (OR = 5.10; 95% CI = 1.67, 15.60; p = .004). Different factors were associated significantly with ever having PSA testing and annual testing among African American men. African American men may not be making an informed decision about prostate cancer screening.
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Affiliation(s)
- Chanita Hughes Halbert
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Sebastiano Gattoni-Celli
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Stephen Savage
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Sandip M Prasad
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | | | - Vanessa Briggs
- 4 Health Promotion Council of Southeastern Pennsylvania, Philadelphia, PA, USA
| | - Ernestine Delmoor
- 5 Philadelphia Chapter, National Black Leadership Initiative on Cancer, Philadelphia, PA, USA
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Bennett CL, Prasad SM, Kennedy WA. Editorial Comment. Urology 2016; 94:15-6. [PMID: 27207146 DOI: 10.1016/j.urology.2016.02.062] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Charles L Bennett
- College of Pharmacy, University of South Carolina, Hollins National Cancer Institute Designated Cancer Center, Charleston, SC
| | - Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC; Section of Urology, Department of Surgery, Ralph H. Johnson VAMC, Charleston, SC
| | - William A Kennedy
- Department of Urology, Stanford University Medical Center, Palo Alto, CA
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17
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Prasad SM, Sartor AO, Bennett CL. Population-Based Assessment of Determining Treatments for Prostate Cancer. JAMA Oncol 2015; 1:67-8. [PMID: 26182306 DOI: 10.1001/jamaoncol.2014.183] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston
| | - A Oliver Sartor
- Departments of Urology and Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Charles L Bennett
- The Hollings National Cancer Institute Designated Cancer Center, Medical University of South Carolina, Charleston
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18
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Prasad SM, Hu JC. Reply to P. Stattin. J Clin Oncol 2015; 33:1087. [PMID: 25646193 DOI: 10.1200/jco.2014.59.3269] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Jim C Hu
- University of California Los Angeles, Los Angeles, CA
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19
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Prasad SM, Eyre S, Loughlin KR. Salvage combination intravesical immunotherapy with Bacillus Calmette-Guérin and interferon-α2B: impact on recurrence, progression, and survival. Hosp Pract (1995) 2014; 41:31-9. [PMID: 24145587 DOI: 10.3810/hp.2013.10.1078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The population of patients with bladder cancer who have recurrence following an initial instillation of Bacillus Calmette-Guérin (BCG) is critical to study, as treatment delay with repeated courses of intravesical therapy may yield poor prognosis in patients with disease progression. OBJECTIVE To evaluate our institution's experience with use of BCG alone and in combination with interferon (INF)-α2B in regard to the rates of bladder cancer recurrence, disease progression, need for eventual cystectomy, and survival in patients with initial BCG failure. STUDY DESIGN We identified a combined series of 139 patients who had undergone intravesical instillations of BCG alone (n = 114) or in combination with INF-α2B (n = 25) performed at Brigham and Women's Hospital, Boston, between 2002 and 2007. All patients previously received an initial 6-week course of BCG therapy and subsequently had BCG failure on follow-up cystoscopy. Study outcome measures included: time to cancer recurrence in patients, progression of disease, eventual cystectomy, and patient mortality. RESULTS At a median follow-up of 64.7 months from initial BCG administration, 84% of patients treated with BCG + INF-α2B had disease recurrence. The average time to recurrence was < 1 year, and 63% of patients had recurrence on the first post-treatment biopsy. Among patients with a positive first biopsy, 52% had disease progression on initial surveillance. Overall, disease progression was seen in 48% of patients receiving BCG + INF-α2B therapy, and 28% of all patients eventually underwent radical cystectomy. All outcomes occurred more frequently in patients undergoing combination intravesical therapy compared with patients given BCG monotherapy. CONCLUSIONS Patients with bladder cancer undergoing salvage intravesical BCG + INF-α2B at our institution had a > 50% chance of disease recurrence and progression, and > 25% of patients eventually proceeded to radical cystectomy. Randomized trials are needed to clarify the issues present in our findings and to determine the appropriate role for concomitant INF therapy in patients when BCG monotherapy has failed.
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Affiliation(s)
- Sandip M Prasad
- Division of Urologic Surgery, Medical University of South Carolina, Charleston, SC
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20
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Prasad SM, Eggener SE, Lipsitz SR, Irwin MR, Ganz PA, Hu JC. Effect of depression on diagnosis, treatment, and mortality of men with clinically localized prostate cancer. J Clin Oncol 2014; 32:2471-8. [PMID: 25002728 DOI: 10.1200/jco.2013.51.1048] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Although demographic, clinicopathologic, and socioeconomic differences may affect treatment and outcomes of prostate cancer, the effect of mental health disorders remains unclear. We assessed the effect of previously diagnosed depression on outcomes of men with newly diagnosed prostate cancer. PATIENTS AND METHODS We performed a population-based observational cohort study using Surveillance, Epidemiology, and End Results-Medicare linked data of 41,275 men diagnosed with clinically localized prostate cancer from 2004 to 2007. We identified 1,894 men with a depressive disorder in the 2 years before the prostate cancer diagnosis and determined its effect on treatment and survival. RESULTS Men with depressive disorder were older, white or Hispanic, unmarried, resided in nonmetropolitan areas and areas of lower median income, and had more comorbidities (P < .05 for all), but there was no variation in clinicopathologic characteristics. In adjusted analyses, men with depressive disorder were more likely to undergo expectant management for low-, intermediate-, and high-risk disease (P ≤ .05, respectively). Conversely, depressed men were less likely to undergo definitive therapy (surgery or radiation) across all risk strata (P < .01, respectively). Depressed men experienced worse overall mortality across risk strata (low: relative risk [RR], 1.86; 95% CI, 1.48 to 2.33; P < .001; intermediate: RR, 1.25; 95% CI, 1.06 to 1.49; P = .01; high: RR, 1.16; 95% CI, 1.03 to 1.32; P = .02). CONCLUSION Men with intermediate- or high-risk prostate cancer and a recent diagnosis of depression are less likely to undergo definitive treatment and experience worse overall survival. The effect of depression disorders on prostate cancer treatment and survivorship warrants further study, because both conditions are relatively common in men in the United States.
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Affiliation(s)
- Sandip M Prasad
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Scott E Eggener
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Stuart R Lipsitz
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Michael R Irwin
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Patricia A Ganz
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Jim C Hu
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA.
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21
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Friedlander DF, Gu X, Prasad SM, Lipsitz SR, Nguyen PL, Trinh QD, Sun M, Hu JC. Population-based comparative effectiveness of salvage radical prostatectomy vs cryotherapy. Urology 2014; 83:653-7. [PMID: 24581527 DOI: 10.1016/j.urology.2013.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/04/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To characterize population-based practice patterns, disease-specific and overall mortality, and cost associated with salvage cryotherapy (SCT) vs salvage radical prostatectomy (SRP). METHODS We retrospectively identified 440 men who failed primary radiation therapy and subsequently underwent SCT (n = 341, 77.5%) or SRP (n = 99, 22.5%) between 1992 and 2009 from Surveillance, Epidemiology, and End Results-Medicare linked data. Propensity score analyses were used to compare overall and prostate cancer-specific mortality and associated Medicare expenditures for SRP vs SCT. RESULTS Men undergoing SCT were more likely to be white (P <.001), less likely to be high school graduates (P = .008), and experienced shorter median time from diagnosis to salvage therapy (44.1 vs 60.1, P <.001) and from primary radiotherapy to salvage therapy (38.7 vs 55.8 months, P <.001). In adjusted analyses, overall mortality was higher (21.6 vs 6.1 deaths/100 person years, P <.001) for SRP vs SCT. There was a trend for higher prostate cancer-specific death rates with SRP vs SCT (6.5 vs 1.4 deaths/100 person years, P = .061). Medicare expenditures for SRP vs SCT were more than 2-fold higher ($19,543 vs $8,088, P <.001). CONCLUSION SRP vs SCT is associated with higher overall mortality and greater health care expenditures. However, longer follow-up is needed to assess long-term functional outcomes and cancer control.
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Affiliation(s)
| | - Xiangmei Gu
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
| | - Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC; Section of Urology, Ralph A. Johnson VA Medical Center, Charleston, SC
| | - Stuart R Lipsitz
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
| | - Paul L Nguyen
- Department of Radiation Oncology, Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, MA
| | - Quoc-Dien Trinh
- Division of Urologic Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
| | - Maxine Sun
- Department of Public Health, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Jim C Hu
- Department of Urology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
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22
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Li G, Ci W, Karmakar S, Chen K, Dhar R, Fan Z, Guo Z, Zhang J, Ke Y, Wang L, Zhuang M, Hu S, Li X, Zhou L, Li X, Calabrese MF, Watson ER, Prasad SM, Rinker-Schaeffer C, Eggener SE, Stricker T, Tian Y, Schulman BA, Liu J, White KP. SPOP promotes tumorigenesis by acting as a key regulatory hub in kidney cancer. Cancer Cell 2014; 25:455-68. [PMID: 24656772 PMCID: PMC4443692 DOI: 10.1016/j.ccr.2014.02.007] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 10/26/2013] [Accepted: 02/14/2014] [Indexed: 01/29/2023]
Abstract
Hypoxic stress and hypoxia-inducible factors (HIFs) play important roles in a wide range of tumors. We demonstrate that SPOP, which encodes an E3 ubiquitin ligase component, is a direct transcriptional target of HIFs in clear cell renal cell carcinoma (ccRCC). Furthermore, hypoxia results in cytoplasmic accumulation of SPOP, which is sufficient to induce tumorigenesis. This tumorigenic activity occurs through the ubiquitination and degradation of multiple regulators of cellular proliferation and apoptosis, including the tumor suppressor PTEN, ERK phosphatases, the proapoptotic molecule Daxx, and the Hedgehog pathway transcription factor Gli2. Knockdown of SPOP specifically kills ccRCC cells, indicating that it may be a promising therapeutic target. Collectively, our results indicate that SPOP serves as a regulatory hub to promote ccRCC tumorigenesis.
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Affiliation(s)
- Guoqiang Li
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weimin Ci
- Laboratory of Disease Genomics and Individualized Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Subhradip Karmakar
- Institute for Genomics and Systems Biology, University of Chicago and Argonne National Laboratory, Chicago, IL 60637, USA; Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA
| | - Ke Chen
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Ruby Dhar
- Institute for Genomics and Systems Biology, University of Chicago and Argonne National Laboratory, Chicago, IL 60637, USA; Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA
| | - Zhixiang Fan
- Kunming Medical University, Kunming, Yunnan 650500, China
| | - Zhongqiang Guo
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Department of Urology, First Hospital of Peking University, Beijing 100034, China
| | - Jing Zhang
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Yuwen Ke
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Lu Wang
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Min Zhuang
- Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Shengdi Hu
- Laboratory of Animal Research Center, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Xuesong Li
- Department of Urology, First Hospital of Peking University, Beijing 100034, China
| | - Liqun Zhou
- Department of Urology, First Hospital of Peking University, Beijing 100034, China
| | - Xianghong Li
- Department of Pathology, Peking University Cancer Hospital, Beijing 100142, China
| | - Matthew F Calabrese
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Edmond R Watson
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Sandip M Prasad
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, USA
| | | | - Scott E Eggener
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, USA
| | - Thomas Stricker
- Institute for Genomics and Systems Biology, University of Chicago and Argonne National Laboratory, Chicago, IL 60637, USA; Department of Pathology, University of Chicago, Chicago, IL 60637, USA
| | - Yong Tian
- Laboratory of Animal Research Center, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Brenda A Schulman
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; Howard Hughes Medical Institute, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Jiang Liu
- Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China.
| | - Kevin P White
- Institute for Genomics and Systems Biology, University of Chicago and Argonne National Laboratory, Chicago, IL 60637, USA; Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA; Section on Genetic Medicine, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
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Prasad SM, Sartor O, Bennett CL. Editorial comment. Urology 2014; 83:786-7. [PMID: 24680449 DOI: 10.1016/j.urology.2013.11.041] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC
| | | | - Charles L Bennett
- Hollings National Cancer Institute Comprehensive Cancer Center, Charleston, SC; Center for Medication Safety and Efficacy, the Medical University of South Carolina, Charleston, SC; University of South Carolina, Columbia, SC
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Prasad SM, Sartor O, Bennett CL. Reply to W. Read. J Clin Oncol 2014; 32:604-5. [DOI: 10.1200/jco.2013.53.7225] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Oliver Sartor
- Tulane University School of Medicine, New Orleans, LA
| | - Charles L. Bennett
- South Carolina College of Pharmacy, Medical University of South Carolina and the University of South Carolina, Columbia, SC
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Drazer MW, Prasad SM, Huo D, Schonberg MA, Dale W, Szmulewitz RZ, Eggener SE. National trends in prostate cancer screening among older American men with limited 9-year life expectancies: Evidence of an increased need for shared decision making. Cancer 2014; 120:1491-8. [DOI: 10.1002/cncr.28600] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/23/2013] [Accepted: 12/25/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Michael W. Drazer
- Department of Medicine; University of Chicago Medical Center; Chicago Illinois
| | - Sandip M. Prasad
- Department of Urology; Medical University of South Carolina; Charleston South Carolina
| | - Dezheng Huo
- Department of Health Studies; University of Chicago Medical Center; Chicago Illinois
| | - Mara A. Schonberg
- Department of Medicine; Harvard Medical School; Boston Massachusetts
| | - William Dale
- Department of Medicine; University of Chicago Medical Center; Chicago Illinois
| | | | - Scott E. Eggener
- Section of Urology; University of Chicago Medical Center; Chicago Illinois
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Prasad SM, Large MC, Patel AR, Famakinwa O, Galocy RM, Karrison T, Shalhav AL, Zagaja GP. Early removal of urethral catheter with suprapubic tube drainage versus urethral catheter drainage alone after robot-assisted laparoscopic radical prostatectomy. J Urol 2014; 192:89-95. [PMID: 24440236 DOI: 10.1016/j.juro.2014.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Retrospective single institution data suggest that postoperative pain after robot-assisted laparoscopic radical prostatectomy is decreased by early removal of the urethral catheter with suprapubic tube drainage. In a randomized patient population we determined whether suprapubic tube drainage with early urethral catheter removal would improve postoperative pain compared with urethral catheter drainage alone. MATERIALS AND METHODS Men with a body mass index of less than 40 kg/m(2) who had newly diagnosed prostate cancer and elected robot-assisted laparoscopic radical prostatectomy were included in analysis. Block randomization by surgeon was used and randomization assignment was done after completing the urethrovesical anastomosis. In patients assigned to suprapubic tube drainage the urethral catheter was removed on postoperative day 1 and all catheters were removed on postoperative day 7. Visual analog pain scale and satisfaction questionnaires were administered on postoperative days 0, 1 and 7. RESULTS A total of 29 patients were randomized to the urethral catheter vs 29 to the suprapubic tube plus early urethral catheter removal at the time of interim futility analysis. Mean visual analog pain scale scores did not differ between the groups at any time point and a similar percent of patients cited the catheter as the greatest bother with nonsignificant differences in treatment related satisfaction. Complications during postoperative week 1 did not vary between the groups. Based on interim results the trial was terminated due to lack of effect. CONCLUSIONS Patients randomized to suprapubic tube vs urethral catheter drainage for the week after prostatectomy had similar pain, catheter related bother and treatment related satisfaction in the perioperative period. We no longer routinely offer suprapubic tube drainage with early urethral catheter removal at our institution.
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Affiliation(s)
- Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, South Carolina.
| | - Michael C Large
- Section of Urology, University of Chicago Hospitals, Chicago, Illinois
| | - Amit R Patel
- Department of Urology, DuPage Medical Group, Downers Grove, Illinois
| | | | - R Matthew Galocy
- Section of Urology, University of Chicago Hospitals, Chicago, Illinois
| | - Theodore Karrison
- Department of Health Studies, University of Chicago Hospitals, Chicago, Illinois
| | - Arieh L Shalhav
- Section of Urology, University of Chicago Hospitals, Chicago, Illinois
| | - Gregory P Zagaja
- Section of Urology, University of Chicago Hospitals, Chicago, Illinois
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Prasad SM, Sartor AO, Bennett CL. Editorial Comment. Urology 2014; 83:152-3; discussion 153. [DOI: 10.1016/j.urology.2013.08.085] [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: 10/26/2022]
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Razmaria AA, Marchetti PE, Prasad SM, Shalhav AL, Gundeti MS. Does robot-assisted laparoscopic ileocystoplasty (RALI) reduce peritoneal adhesions compared with open surgery? BJU Int 2013; 113:468-75. [DOI: 10.1111/bju.12284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aria A. Razmaria
- Pediatric Urology; Section of Urology; Department of Surgery; The University of Chicago Medicine and Biological Sciences Division; Comer Children's Hospital; Chicago IL USA
| | - Pablo E. Marchetti
- Pediatric Urology; Section of Urology; Department of Surgery; The University of Chicago Medicine and Biological Sciences Division; Comer Children's Hospital; Chicago IL USA
| | - Sandip M. Prasad
- Pediatric Urology; Section of Urology; Department of Surgery; The University of Chicago Medicine and Biological Sciences Division; Comer Children's Hospital; Chicago IL USA
| | - Arieh L. Shalhav
- Pediatric Urology; Section of Urology; Department of Surgery; The University of Chicago Medicine and Biological Sciences Division; Comer Children's Hospital; Chicago IL USA
| | - Mohan S. Gundeti
- Pediatric Urology; Section of Urology; Department of Surgery; The University of Chicago Medicine and Biological Sciences Division; Comer Children's Hospital; Chicago IL USA
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30
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Prasad SM, Bennett CL. Editorial Comment. Urology 2013; 82:66. [DOI: 10.1016/j.urology.2013.01.073] [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: 10/26/2022]
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31
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Drazer M, Prasad SM, Huo D, Schonberg MA, Szmulewitz RZ, Dale W, Eggener SE. PSA screening rates in older men in the United States based on nine-year estimated remaining life expectancy. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e16006] [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: 11/20/2022] Open
Abstract
e16006 Background: PSA screening for prostate cancer (PCa) is controversial, but informed decision making is recommended for men with an estimated 10 years of remaining life expectancy (RLE). The association between screening of men 65+ and estimated 9-year life expectancy is unknown. Our purpose was to determine the association between predicted 9-year life expectancy and PCa screening in 2005 and 2010. Methods: Data were extracted from the 2005 and 2010 National Health Interview Survey. Men 65+ without prostate known PCa were divided into quartiles with a validated index estimating 9-year RLE (<27%, 27-52%, 53-75%, and >75%). The proportions of men screened in 2005 and 2010 were determined. Logistic regression was used to compare screening in 2005 and 2010. Results: Screening rates for men 65+ were 48.3% (95% CI, 45.6-50.9%) in 2005 and 48.5% (95% CI, 45.5-51.6%) in 2010 (p = 0.9). There were no differences in screening between cohorts by age and predicted mortality for 65-74 (all p > 0.05 for <27%, 27-52%, 53-75%, and >76% predicted mortality) and 75+ year olds (all p> 0.05). The most screened group were 65-74 year olds with a <27% chance of 9-year mortality, with 58.3% (95% CI, 53.6–63.1) and 56.1% (95% CI, 50.6-61.5) screened in 2005 and 2010. Conclusions: PSA-based PCa screening did not differ between 2005 and 2010 for men 65+. Over 35% and 33% of older men with limited estimated 9-year RLE were screened in 2005 and 2010 despite minimal clinical benefit. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - William Dale
- The University of Chicago Medical Center, Chicago, IL
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Sutton SS, Rao GA, Norris LB, Hardin J, Prasad SM, Bennett CL. Overall survival in hormone-resistant prostate cancer patients with different transition of care within the Veterans Affairs (VA) system. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.5091] [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: 11/20/2022] Open
Abstract
5091 Background: Prostate cancer patients with locally advanced /metastatic disease have a poor prognosis and although hormonal therapy can induce long-term remission, development of hormone-resistant prostate cancer (HRPC) is inevitable. The goal of this study is to evaluate overall survival in HRPC patients with different transition of care in the Veterans Affairs (VA) system. We hypothesized that prostate cancer patients with late referral to medical oncologists were more likely to have decreased overall survival. Methods: This is a retrospective, observational analysis of patients enrolled in the Veterans Health Administration system from October 2003 to March 2011. Patients were followed from initial evaluation and treatment by urology until an endpoint of death or the end of the study period. VA patients with a diagnosis of HRPC were identified; prostate specific antigen (PSA), medical and pharmacy records were collected. HRPC was defined as PSA doubling after treatment with hormonal therapy. Transition of care was defined as two encounters with the medical oncology service and at least one encounter was a medical oncologist. Three cohorts were created: patients transitioned to oncology before HRPC, those transitioned to oncology after HRPC, and patients who were never transitioned to oncology. Primary outcome was overall survival (OS). The Charlson score was utilized for comorbidity assessment. Statistical analysis was conducted using chi square test for categorical variables. Results: Total number of patients evaluated was 8,281; 2,168 in transition before HRPC (tbHRPC) cohort, 2,052 in transition after HRPC (taHRPC), and 4,061 patients that never transitioned (tnHPRC). The mean ages for the respective cohorts were: 69.35, 69.69, and 71.64. The Charlson comorbidity scores were 3.79 (tbHRPC), 3.06 (taHRPC), and 3.14 (tnHRPC); p-values < 0.05. Mortality rates among the cohorts were 57% tbHRPC, 69% taHRPC, and 62% tnHRPC; p-values <0.001. PSA doubling within 10 months were: 57% tbHRPC, 60% taHRPC, and 54% tnHRPC; p-values < 0.05. Conclusions: Overall survival was improved among prostate cancer patients that transitioned to oncology before becoming HRPC.
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Affiliation(s)
| | | | - LeAnn B. Norris
- University of South Carolina College of Pharmacy, Columbia, SC
| | | | | | - Charles L. Bennett
- University of South Carolina College of Pharmacy and Medical University of South Carolina, Columbia, SC
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Ellett JD, Rosoff JS, Prasad SM. Long-term differences in urinary, bowel and sexual function among men treated with surgery versus radiation for prostate cancer. Asian J Androl 2013; 15:443-4. [PMID: 23665759 DOI: 10.1038/aja.2013.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Justin D Ellett
- Department of Urology, Medical University of South Carolina, Charleston, SC 29425, USA
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Affiliation(s)
- Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA
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Prasad SM, Bennett CL. Editorial Comment. Urology 2013; 81:154; author reply 154. [DOI: 10.1016/j.urology.2012.08.086] [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: 10/27/2022]
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Singh VP, Srivastava PK, Prasad SM. UV-B induced differential effect on growth and nitrogen metabolism in two cyanobacteria under copper toxicity. Cell Mol Biol (Noisy-le-grand) 2012; 58:85-95. [PMID: 23273196] [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: 05/05/2012] [Accepted: 06/13/2012] [Indexed: 06/01/2023]
Abstract
In the present study, impact of low (UV-B(L): 0.1 μmol m(-2) s(-1)) and high (UV-BH: 1.0 μmol m(-2) s(-1)) fluence rates of ultraviolet-B on growth and nitrogen metabolism in two cyanobacteria: Phormidium foveolarum and Nostoc muscorum under copper toxicity (2 and 5 μM) was investigated after 24 and 72 h of experiments. Copper and UV-BH treatment suppressed growth but more in N. muscorum which was accompanied by significant accumulation of Cu. Nitrate and nitrite uptake rates and activities of nitrogen assimilating enzymes i.e. nitrate reductase (NR), nitrite reductase (NiR), glutamine synthetase (GS) and glutamate synthase (GOGAT) except glutamate dehydrogenase activity (GDH; aminating) were decreased following treatments of Cu and UV-BH, and under combined treatments the effect was greater. On contrary, UV-BL declined Cu toxicity significantly. The study concludes that Cu and UV-BH suppressed the activity of NR, NiR, GS and GOGAT (except GDH) hence decreased growth. However, UV-BL showed cross tolerance in test organisms against Cu toxicity up to certain extent. Phormidium foveolarum is comparatively less sensitive against UV-BH and excess Cu, a situation likely exists in nature, hence it may be used as a biofertilizer for sustainable agriculture.
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Affiliation(s)
- V P Singh
- Ranjan Plant Physiology and Biochemistry Laboratory, Department of Botany, University of Allahabad, Allahabad-211002, India
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Prasad SM, Keane T, Bennett CL. Editorial Comment. Urology 2012; 80:563. [DOI: 10.1016/j.urology.2012.02.086] [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: 11/25/2022]
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Prasad SM, Keane TE, Bennett CL. Editorial comment. Urology 2012; 80:168. [PMID: 22608794 DOI: 10.1016/j.urology.2012.01.069] [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] [Received: 07/18/2011] [Accepted: 01/13/2012] [Indexed: 11/24/2022]
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Affiliation(s)
- Sandip M Prasad
- Section of Urology, University of Chicago Medical Center, Chicago, Illinois, USA
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Kiriluk KJ, Prasad SM, Patel AR, Steinberg GD, Smith ND. Bladder cancer risk from occupational and environmental exposures. Urol Oncol 2012; 30:199-211. [DOI: 10.1016/j.urolonc.2011.10.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 10/21/2011] [Accepted: 10/23/2011] [Indexed: 12/20/2022]
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Prasad SM, Alexander GC, Eggener SE. Prostate-specific antigen testing among primary care physicians and urologists: Patterns of care and impact of professional society guidelines. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.5_suppl.40] [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: 11/20/2022] Open
Abstract
40 Background: During the past decade, the incidence of prostate cancer in the United States has declined. We hypothesized this was related to lower rates of prostate-specific antigen (PSA) testing and sought to evaluate PSA testing rates nationally. Methods: Using the National Ambulatory Medical Care Survey, a nationally representative sample of outpatient visits in the United States, we analyzed rates of PSA testing in men age 40 years or older who visited PCPs or urologists from 1997 to 2008. Results: An estimated 26.6 million (95% CI: 24.8-28.4 million) PSA tests were ordered during 94.5 million (95% CI: 90.9-98.1 million) office visits to urologists and 95 million (95% CI: 87.5-102.8 million) tests were ordered during 1.17 billion (95% CI: 1.15-1.18 billion) visits to PCPs, with an annual increase of 3.4% and 6.0%, respectively (P=0.055 and P<0.001 for trend). After adjusting for year, race, ethnicity, region, insurance and provider type, testing by PCPs was more likely among older men and highest among men aged 60 to 69 years (reference: 40-49 years; OR 2.32, 95% CI: 1.88-2.85). Compared to men without a chronic medical condition, those with one chronic condition had greater odds of receiving a PSA test (OR 1.28, 95% CI: 1.08-1.52). Conclusions: Prostate cancer incidence has declined over the past decade despite increasing rates of office-based PSA testing by PCPs and urologists during the period. Increasing rates of PSA testing merit scrutiny, especially in men with limited life expectancies who are unlikely to benefit from screening.
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Drazer MW, Prasad SM, Huo D, Schonberg MA, Eggener SE. Impact of U.S. Preventive Services Task Force recommendation on screening for prostate cancer in men age 75 or older. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.5_suppl.216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
216 Background: In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended against screening for prostate cancer in men age 75 years or older. We sought to determine the impact of this statement on utilization of prostate-specific antigen (PSA) testing in this patient group. Methods: Using the 2005 and 2010 National Health Interview Survey, a cross-sectional household interview survey providing a representative sample of the U.S. population, we analyzed the use of PSA testing in men age 40 years or older prior to and following the release of the USPSTF statement on prostate cancer screening. Results: In 2010, there were an estimated 2.0 million PSA tests ordered in men 75 years of age and older. In this group, PSA testing rates did not decline between 2005 and 2010 (40.4% vs. 40.6%). In 2010, PSA testing was more common in men aged 75 years and older than in men aged 40 to 49 (9.2%) and 50 to 59 (26.2%) (p < 0.01 between groups). In both 2005 and 2010, PSA testing rates were lowest in men aged 40-49 and highest in men aged 60-74. Conclusions: Despite the USPSTF recommendation against prostate cancer screening in men age 75 or older, there was no decrease in PSA testing rates in these men. A significant proportion of elderly men continue to receive PSA screening despite a very low likelihood of benefit. [Table: see text]
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Affiliation(s)
- Michael W. Drazer
- University of Chicago, Chicago, IL; The University of Chicago Medical Center, Chicago, IL; The University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - Sandip M. Prasad
- University of Chicago, Chicago, IL; The University of Chicago Medical Center, Chicago, IL; The University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - Dezheng Huo
- University of Chicago, Chicago, IL; The University of Chicago Medical Center, Chicago, IL; The University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - Mara A Schonberg
- University of Chicago, Chicago, IL; The University of Chicago Medical Center, Chicago, IL; The University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - Scott E. Eggener
- University of Chicago, Chicago, IL; The University of Chicago Medical Center, Chicago, IL; The University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
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Abstract
The identification of patients with high-risk bladder cancer is important for the timely and appropriate treatment of this lethal disease. The understanding of the natural history of bladder cancer has improved; however, the criteria used to define high-risk disease and the relevant treatment strategies have remained the same for the past several decades, despite multiple large, randomized, prospective clinical trials that have evaluated the use of intravesical, surgical and systemic therapies. The genetic signature of high-risk bladder cancer has been a focus of investigation and has led to the discovery of potential molecular targets for disease identification, risk stratification and therapy. These advances, combined with a comprehensive risk assessment profile that incorporates available pathological and clinical characteristics, might improve the diagnosis and treatment of patients with bladder cancer.
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Affiliation(s)
- Sandip M Prasad
- Section of Urology, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 6038, Chicago, IL 60637, USA
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Prasad SM, Gu X, Lipsitz SR, Nguyen PL, Hu JC. Inappropriate utilization of radiographic imaging in men with newly diagnosed prostate cancer in the United States. Cancer 2011; 118:1260-7. [DOI: 10.1002/cncr.26416] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/03/2011] [Accepted: 06/13/2011] [Indexed: 11/08/2022]
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Prasad SM, Gu X, Lavelle R, Lipsitz SR, Hu JC. Comparative Effectiveness of Perineal Versus Retropubic and Minimally Invasive Radical Prostatectomy. J Urol 2011; 185:111-5. [DOI: 10.1016/j.juro.2010.08.090] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Indexed: 11/28/2022]
Affiliation(s)
| | - Xiangmei Gu
- Center for Surgery and Public Health, Boston, Massachusetts
| | | | | | - Jim C. Hu
- Brigham and Women's Hospital, Boston, Massachusetts
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Williams SB, Prasad SM, Weinberg AC, Shelton JB, Hevelone ND, Lipsitz SR, Hu JC. Trends in the care of radical prostatectomy in the United States from 2003 to 2006. BJU Int 2010; 108:49-55. [PMID: 21087390 DOI: 10.1111/j.1464-410x.2010.09822.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE • o determine differences in surgical outcomes by surgical approach during a period of rapid adoption of minimally invasive surgical approaches in radical prostatectomy. PATIENTS AND METHODS • We identified 19 542 men undergoing minimally invasive (MIRP), perineal (PRP), and retropubic (RRP) radical prostatectomy from 2003 to 2006 from the MarketScan® Medstat database, a national employer-based administrative database. • We assessed for temporal trends in perioperative complications, use of postoperative cystography and anastomotic strictures by surgical approach. RESULTS • Between 2003 and 2006, MIRP use increased 33.6% vs 31.8% and 1.7% decreases in RRP and PRP, respectively. During the 4-year study, median length of stay for MIRP decreased from 2.0 to 1.0 day (P = 0.004) and overall perioperative complications decreased from 13.8 to 10.7%, (P = 0.023). • These findings were driven by reductions in genitourinary complications (3.3 to 2.5%, P = 0.049), miscellaneous surgical complications (3.6 to 2.3%, P = 0.006) and intestinal injury (1.5 to 0.1%, P= 0.009). • Median length of stay for RRP decreased from 3.2 to 2.9 days, (P < 0.001), overall perioperative complications decreased from 18.1 to 14.6%, (P = 0.007), because of reductions in both wound/bleeding complications (2.0 to 1.1%, P = 0.002) and heterologous blood transfusions. • Men undergoing MIRP vs RRP were less likely to have perioperative complications (12.5 vs 17.1%, P < 0.001), blood transfusions (1.5 vs 8.9%, P < 0.001) and anastomotic strictures (6.3 vs 12.8%, P < 0.001), and they had shorter mean lengths of stay (1.8 vs 3.1 days, P < 0.001) during the study period. CONCLUSION • The increased use of MIRP corresponds with a decreasing trend for complications, blood transfusions, lengths of stay and need for reoperation. Additionally, MIRP was found to have fewer associated complications compared with men undergoing open procedures. Further study is needed to assess the impact of tumour characteristics and surgeon volume on these perioperative outcomes as well as effects on long-term cancer control.
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Affiliation(s)
- Stephen B Williams
- Division of Urologic Surgery Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
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Hu JC, Prasad SM, Gu X, Williams SB, Lipsitz SR, Nguyen PL, Choueiri TK, Choi WW, D'Amico AV. Determinants of performing radical prostatectomy pelvic lymph node dissection and the number of lymph nodes removed in elderly men. Urology 2010; 77:402-6. [PMID: 20719365 DOI: 10.1016/j.urology.2010.05.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 04/27/2010] [Accepted: 05/12/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Controversy persists regarding the adequacy of pelvic lymph node dissection (PLND) and cancer control when comparing minimally invasive radical prostatectomy (MIRP) and open radical prostatectomy (RRP). We characterized determinants of performance and extent of PLND during radical prostatectomy in elderly men. METHODS A population-based study was conducted comprised of 5448 men ≥65 years undergoing RRP and MIRP during 2004 to 2006 from Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data. Multivariable logistic regression was used to assess the effect of demographic and tumor characteristics, surgical approach, and surgeon volume on the likelihood of performing PLND. RESULTS PLND was performed for 87.6% vs. 38.3% of men undergoing RRP vs. MIRP (P <.001). Among RRP, 82.6% vs. 4.6% underwent extended vs. limited PLND, with a median yield of 4 vs. 3 lymph nodes (P <.001). Median MIRP PLND yield was 3 lymph nodes. In adjusted analyses, men undergoing RRP vs. MIRP (odds ratio [OR] 16.7; 95% confidence interval [CI], 11.1-25.0), those with few vs. multiple comorbidities (OR 1.4, 95% CI 1.02-1.91), intermediate (OR 1.87; 95% CI 1.48-2.37), and high (OR 2.77; 95% CI 2.02-3.78) vs. low-risk features, and men treated by high-volume surgeons (OR 1.008; 95% CI 1.004-1.011) were more likely to undergo PLND. Conversely, Hispanic (OR 0.68, 95% CI 0.49-0.96) vs. white men were less likely to undergo PLND. CONCLUSIONS Independent of tumor characteristics, men undergoing RRP vs. MIRP were more likely to undergo PLND with greater lymph node yield and racial variation observed. Further studies are needed to determine the appropriate use of PLND.
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Affiliation(s)
- Jim C Hu
- Division of Urologic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Prasad MM, Prasad SM, Hevelone ND, Gu X, Weinberg AC, Lipsitz SR, Palapattu GS, Hu JC. REVIEW: Utilization of Pharmacotherapy for Erectile Dysfunction Following Treatment for Prostate Cancer. J Sex Med 2010; 7:1062-73. [DOI: 10.1111/j.1743-6109.2009.01644.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Prasad SM, Czepiel M, Cetinkaya C, Smigielska K, Weli SC, Lysdahl H, Gabrielsen A, Petersen K, Ehlers N, Fink T, Minger SL, Zachar V. Continuous hypoxic culturing maintains activation of Notch and allows long-term propagation of human embryonic stem cells without spontaneous differentiation. Cell Prolif 2009; 42:63-74. [PMID: 19143764 DOI: 10.1111/j.1365-2184.2008.00571.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The maintenance of pluripotency of human embryonic stem cells (hESCs) requires a high efficiency of self-renewal. During in vitro propagation, however, hESCs have a propensity to differentiate spontaneously. In this study, we assessed the nature of hESC responses to hypoxic conditions. MATERIALS AND METHODS Human embryonic stem cells were grown in normoxic and hypoxic conditions, and the cells expressing Oct4 and stage-specific embryonic antigen-1 were identified by indirect immunofluorescence. The transcriptional expression of Nanog, Notch1, and Oct4 was determined by a real-time reverse transcription-polymerase chain reaction, and the inhibition of Notch-mediated signalling was achieved with a gamma-secretase inhibitor. RESULTS In contrast to culture at 21% oxygen, where the colonies displayed a marked degree of differentiation, we found that during exposure to 5% oxygen, the hESC colonies displayed a homogenous and flat morphology that was consistent with the presence of Oct4-positive phenotype, indicating no spontaneous differentiation. When cultured at 5% oxygen for either 4 weeks or up to 18 months, high levels of Nanog and Notch1 transcriptional expression were detected, albeit the expression was significantly lower during longer exposure. The suppression of differentiation was rapidly reversed on transfer of the hypoxic cultures to normoxic conditions. Looking into the molecular mechanisms of the maintenance of self-renewal at low oxygen tensions, we found that inhibition of Notch signalling fully abrogated the hypoxic induction of undifferentiated phenotype. CONCLUSION Our data, thus, indicate that hypoxic exposure has the capacity to sustain long-term self-renewal of hESCs and that this effect is mediated through activation of Notch.
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Affiliation(s)
- S M Prasad
- Laboratory for Stem Cell Research, Aalborg University, Aalborg, Denmark
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