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  1. Article ; Online: Lymph node dissection in bladder cancer: Where do we stand?

    Hugen, Cory M / Daneshmand, Siamak

    World journal of urology

    2017  Volume 35, Issue 4, Page(s) 527–533

    Abstract: Radical cystectomy with lymphadenectomy remains the standard-of-care treatment for muscle-invasive bladder cancer. Lymphadenectomy is a central component of the operation because it continues to play both diagnostic and therapeutic roles. Routinely ... ...

    Abstract Radical cystectomy with lymphadenectomy remains the standard-of-care treatment for muscle-invasive bladder cancer. Lymphadenectomy is a central component of the operation because it continues to play both diagnostic and therapeutic roles. Routinely available preoperative imaging has limited diagnostic accuracy as it relies mostly on size to identify nodal metastasis increasing the value of lymphadenectomy. While the merits of lymphadenectomy are not in question, the extent of lymphadenectomy required to provide maximum benefit while limiting morbidity remains controversial. Furthermore, although robotic-assisted surgery has gained popularity in many centers, concern remains regarding the learning curve required and skill needed to replicate the quality of an open lymphadenectomy. Research efforts have been focused on these unresolved issues, and several trials are currently ongoing to help address these knowledge deficit areas. In this update, we will focus on the current state of lymphadenectomy for bladder cancer and highlight recent advances.
    MeSH term(s) Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery ; Cystectomy/methods ; Humans ; Lymph Node Excision/methods ; Lymph Nodes/pathology ; Robotic Surgical Procedures ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery
    Language English
    Publishing date 2017-04
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-015-1751-9
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    Zs.A 1832: Show issues Location:
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  2. Article ; Online: Orthotopic urinary diversion in the elderly.

    Hugen, Cory M / Daneshmand, Siamak

    World journal of urology

    2016  Volume 34, Issue 1, Page(s) 13–18

    Abstract: Introduction: Age is an established risk factor for developing bladder cancer and is associated with increased stage and worse treatment outcomes. Furthermore, elderly patients who require radical cystectomy are more likely to undergo an incontinent ... ...

    Abstract Introduction: Age is an established risk factor for developing bladder cancer and is associated with increased stage and worse treatment outcomes. Furthermore, elderly patients who require radical cystectomy are more likely to undergo an incontinent urinary diversion compared with younger patients.
    Methods: To evaluate whether evidence exists to support performing an orthotopic neobladder in the elderly, we reviewed the literature to identify studies reporting outcomes, complications, patient-selection criteria, and quality-of-life data on elderly patients who underwent orthotopic neobladder following radical cystectomy.
    Results: While age was shown to be a risk factor for complications following orthotopic neobladder, similar complication rates were reported between those who received either an orthotopic neobladder or ileal conduit when compared within age groups. Additionally, in properly selected elderly patients, similar outcomes and quality of life can be expected when compared with younger patients.
    Conclusions: It is appropriate to offer an orthotopic neobladder to well-selected elderly patients following radical cystectomy.
    MeSH term(s) Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/surgery ; Cystectomy/methods ; Humans ; Patient Selection ; Quality of Life ; Treatment Outcome ; Urinary Bladder Neoplasms/surgery ; Urinary Diversion/methods ; Urinary Reservoirs, Continent
    Language English
    Publishing date 2016-01
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-015-1696-z
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    Zs.A 1832: Show issues Location:
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  3. Article: Circulating Tumor Cells in Genitourinary Malignancies: An Evolving Path to Precision Medicine.

    Hugen, Cory M / Zainfeld, Daniel E / Goldkorn, Amir

    Frontiers in oncology

    2017  Volume 7, Page(s) 6

    Abstract: Precision medicine with molecularly directed therapeutics is rapidly expanding in all subspecialties of oncology. Molecular analysis and treatment monitoring require tumor tissue, but resections or biopsies are not always feasible due to tumor location, ... ...

    Abstract Precision medicine with molecularly directed therapeutics is rapidly expanding in all subspecialties of oncology. Molecular analysis and treatment monitoring require tumor tissue, but resections or biopsies are not always feasible due to tumor location, patient safety, and cost. Circulating tumor cells (CTCs) offer a safe, low-cost, and repeatable tissue source as an alternative to invasive biopsies. "Liquid biopsies" can be collected from a peripheral blood draw and analyzed to isolate, enumerate, and molecularly characterize CTCs. While there is deserved excitement surrounding new CTC technologies, studies are ongoing to determine whether these cells can provide reliable and accurate information about molecular drivers of cancer progression and inform treatment decisions. This review focuses on the current status of CTCs in genitourinary (GU) cancer. We will review currently used methodologies to isolate and detect CTCs, their use as predictive biomarkers, and highlight emerging research and applications of CTC analysis in GU malignancies.
    Language English
    Publishing date 2017-01-27
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2017.00006
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  4. Article: A Randomized Feasibility Trial Comparing Surveillance Regimens for Patients with Low and Low-Intermediate Risk Non-Muscle Invasive Bladder Cancer.

    Reyes, Ryan M / Rios, Emily / Barney, Shane / Hugen, Cory M / Michalek, Joel E / Lotan, Yair / Messing, Edward M / Svatek, Robert S

    Bladder cancer (Amsterdam, Netherlands)

    2021  Volume 7, Issue 3, Page(s) 285–295

    Abstract: Background: Surveillance regimens for non-muscle invasive bladder cancer (NMIBC) are disparate and controlled trials could inform guidelines. The feasibility of randomizing patients to variable frequency surveillance is unknown.: Objectives: To ... ...

    Abstract Background: Surveillance regimens for non-muscle invasive bladder cancer (NMIBC) are disparate and controlled trials could inform guidelines. The feasibility of randomizing patients to variable frequency surveillance is unknown.
    Objectives: To determine patient willingness to randomization to high frequency (HF) versus low frequency (LF) surveillance regimen for NMIBC and compare patient comfort and healthcare costs across regimens.
    Methods: A non-blinded, two-arm, randomized-controlled study of patients with low or low-intermediate risk NMIBC was conducted at two institutions where patients were offered randomization to HF vs. LF surveillance following initial tumor resection. The HF group underwent cystoscopy every three months for 2 years, then every 6 months for 2 years, then annually. The LF group underwent cystoscopy at 9 months following the 3-month cystoscopy, then annually. Assuming 75% of patients approached would agree to enrollment, a sample size of
    Results: Of 70 patients approached, 45 (64.3%) agreed to participate and 25 (35.7%) declined enrollment due to preference for HF. Twelve biopsies were performed, including 4 (19%) of 21 patients in the HF group and 8 (33.3%) of 24 patients in the LF group. Disease recurrence (low grade Ta) was observed in 3 (14.3%) and 5 (20.8%) patients in the HF and LF groups, respectively. No patients experienced high grade recurrence or progression. Both groups had similar patient-reported procedure-related discomfort and quality of life measures over time. Patient out-of-pocket cost and healthcare systems costs were $383.80 more per patient annually in the HF group.
    Conclusions: Randomization to variable frequency surveillance is challenging as over a third of patients declined participation. However, these data provide important preliminary insights into the potential effects of surveillance frequency on oncologic and economic outcomes in patients with low and low-intermediate risk bladder cancer.
    Language English
    Publishing date 2021-09-21
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2352-3727
    ISSN 2352-3727
    DOI 10.3233/blc-201535
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  5. Article ; Online: Preoperative Imaging for Clinical Staging Prior to Radical Cystectomy.

    Hugen, Cory M / Duddalwar, Vinay / Daneshmand, Siamak

    Current urology reports

    2016  Volume 17, Issue 9, Page(s) 62

    Abstract: The importance of patient selection for quality outcomes following radical cystectomy is critical. Clinical staging is one of the key elements necessary for patient selection, and staging relies on accurate preoperative imaging. Many imaging modalities ... ...

    Abstract The importance of patient selection for quality outcomes following radical cystectomy is critical. Clinical staging is one of the key elements necessary for patient selection, and staging relies on accurate preoperative imaging. Many imaging modalities are available and have been utilized for preoperative staging with published operating characteristics. In this update, we review recently published literature for advances in preoperative imaging prior to radical cystectomy.
    MeSH term(s) Cystectomy ; Humans ; Neoplasm Staging ; Preoperative Care ; Urinary Bladder/diagnostic imaging ; Urinary Bladder Neoplasms/diagnostic imaging ; Urinary Bladder Neoplasms/pathology
    Language English
    Publishing date 2016-10-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057354-6
    ISSN 1534-6285 ; 1527-2737
    ISSN (online) 1534-6285
    ISSN 1527-2737
    DOI 10.1007/s11934-016-0618-y
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5528: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  6. Article ; Online: Optimizing Diagnosis of Urothelial Bladder Cancer with Blue Light Cystoscopy via Recognition of False-Positive Lesions.

    Bazargani, Soroush T / Djaladat, Hooman / Schuckman, Anne K / Hugen, Cory M / Daneshmand, Siamak

    Videourology (New Rochelle, N.Y.)

    2018  Volume 32, Issue 2

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2018-04-06
    Publishing country United States
    Document type Journal Article
    ISSN 2151-1136
    ISSN (online) 2151-1136
    DOI 10.1089/vid.2017.0073
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  7. Article ; Online: Prognostic variables and nomograms for renal cell carcinoma.

    Flanigan, Robert C / Polcari, Anthony J / Hugen, Cory M

    International journal of urology : official journal of the Japanese Urological Association

    2011  Volume 18, Issue 1, Page(s) 20–31

    Abstract: The term renal cell carcinoma (RCC) is used to describe a heterogeneous group of tumors that vary histologically, genetically and molecularly. Extensive research has been conducted to identify characteristics that predict outcomes among patients with RCC. ...

    Abstract The term renal cell carcinoma (RCC) is used to describe a heterogeneous group of tumors that vary histologically, genetically and molecularly. Extensive research has been conducted to identify characteristics that predict outcomes among patients with RCC. In addition to histological subtype these include tumor size, patient age, mode of presentation and various hematological indices, among others. Several groups have incorporated these clinical and pathological features into nomograms which help the clinician better define individual patient prognosis and direct the optimum therapeutic approach. In the present article we review these prognostic variables and nomograms for RCC.
    MeSH term(s) Age Factors ; Carcinoma, Renal Cell/blood ; Carcinoma, Renal Cell/pathology ; Humans ; Kidney/pathology ; Kidney Neoplasms/blood ; Kidney Neoplasms/pathology ; Nomograms
    Language English
    Publishing date 2011-01
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 1328401-0
    ISSN 1442-2042 ; 0919-8172
    ISSN (online) 1442-2042
    ISSN 0919-8172
    DOI 10.1111/j.1442-2042.2010.02642.x
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    Zs.A 4460: Show issues Location:
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    Zs.MO 278: Show issues

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  8. Article: Endoscopic management of upper tract urothelial carcinoma.

    Polcari, Anthony J / Hugen, Cory M / Turk, Thomas M

    The Canadian journal of urology

    2009  Volume 16, Issue 6, Page(s) 4887–4894

    Abstract: While radical nephroureterectomy remains the gold standard of treatment for patients with upper tract urothelial tumors, technological advances have made endoscopic management possible. The careful selection of patients for such an approach is dependent ... ...

    Abstract While radical nephroureterectomy remains the gold standard of treatment for patients with upper tract urothelial tumors, technological advances have made endoscopic management possible. The careful selection of patients for such an approach is dependent upon an accurate diagnosis and an understanding of the natural history of the disease. High grade tumors behave aggressively and warrant radical extirpation unless an absolute contraindication exists. Motivated patients with low grade tumors and relative contraindications to nephroureterectomy can be managed with percutaneous or retrograde ureteroscopic techniques. High recurrence rates in the ipsilateral upper tract and bladder mandate close surveillance of patients treated conservatively. We review the important diagnostic, staging, technical, and surveillance issues in the endoscopic treatment of upper tract urothelial carcinoma.
    MeSH term(s) Carcinoma, Transitional Cell/surgery ; Humans ; Treatment Outcome ; Ureteral Neoplasms/surgery ; Ureteroscopy/methods
    Language English
    Publishing date 2009-12
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2064475-9
    ISSN 1195-9479
    ISSN 1195-9479
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    Zs.A 5607: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  9. Article ; Online: Long term oncologic outcome in patients with bladder cancer after radical cystectomy: Impact of carcinoma in situ in the era of neoadjuvant chemotherapy.

    Amini, Erfan / Ahmadi, Nariman / Clifford, Thomas G / Hugen, Cory M / Bazargani, Soroush T / Cai, Jie / Miranda, Gus / Sherrod, Andy E / Daneshmand, Siamak / Djaladat, Hooman

    International urology and nephrology

    2019  Volume 51, Issue 3, Page(s) 435–441

    Abstract: Purpose: To assess the impact of carcinoma in situ (CIS) on oncologic outcomes in patients who underwent radical cystectomy, with a focus on those who received neoadjuvant chemotherapy (NAC) including patients with down-staging to ≤ pT1cancer after ... ...

    Abstract Purpose: To assess the impact of carcinoma in situ (CIS) on oncologic outcomes in patients who underwent radical cystectomy, with a focus on those who received neoadjuvant chemotherapy (NAC) including patients with down-staging to ≤ pT1cancer after chemotherapy.
    Materials and methods: All patients who underwent radical cystectomy for urothelial cancer with curative intent from 1985 to 2011 were included. The impact of CIS on recurrence free and overall survival (OS) was assessed in the whole cohort and a subgroup who received NAC as well as those with response to chemotherapy and down-staging to ≤ pT1.
    Results: A total of 2518 patients with a median follow-up period of 9 years were included. Among all, 1397 (55.5%) had concomitant CIS on final pathology. CIS was associated with high risk pathologic features including high-grade disease, multifocality, and nodal involvement as well as worse recurrence free survival (RFS) with no impact on OS. We did not find a significant association between CIS and oncologic outcomes in a subset of patients who received NAC including those with down-staging to ≤ pT1 disease. In multivariate analysis, CIS had no association with either recurrence free or OS.
    Conclusions: Concomitant CIS in radical cystectomy specimens is associated with decreased RFS; however, in multivariate analysis, it was not an independent predicting factor of oncologic outcomes. Moreover, the impact of CIS on oncologic outcomes in a subset of patients who received NAC was insignificant.
    MeSH term(s) Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma in Situ/pathology ; Carcinoma in Situ/therapy ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/therapy ; Chemotherapy, Adjuvant ; Cisplatin/therapeutic use ; Cystectomy ; Deoxycytidine/administration & dosage ; Deoxycytidine/analogs & derivatives ; Disease-Free Survival ; Doxorubicin/therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Methotrexate/therapeutic use ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Staging ; Neoplasms, Multiple Primary/pathology ; Neoplasms, Multiple Primary/therapy ; Survival Rate ; Time Factors ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/therapy ; Vinblastine/therapeutic use
    Chemical Substances Deoxycytidine (0W860991D6) ; Vinblastine (5V9KLZ54CY) ; Doxorubicin (80168379AG) ; gemcitabine (B76N6SBZ8R) ; Cisplatin (Q20Q21Q62J) ; Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2019-01-31
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 204048-7
    ISSN 1573-2584 ; 0301-1623 ; 0042-1162
    ISSN (online) 1573-2584
    ISSN 0301-1623 ; 0042-1162
    DOI 10.1007/s11255-019-02087-4
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    Zs.A 733: Show issues Location:
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  10. Article ; Online: Utilization of retroperitoneal lymph node dissection for testicular cancer in the United States: Results from the National Cancer Database (1998-2011).

    Hugen, Cory M / Hu, Brian / Jeldres, Claudio / Burton, Claire / Nichols, Craig R / Porter, Christopher R / Daneshmand, Siamak

    Urologic oncology

    2016  Volume 34, Issue 11, Page(s) 487.e7–487.e11

    Abstract: Introduction: Retroperitoneal lymph node dissection (RPLND) for the treatment of testicular cancer is a relatively rare and complex operation that may contribute to differences in utilization. We sought to characterize the use of RPLND between different ...

    Abstract Introduction: Retroperitoneal lymph node dissection (RPLND) for the treatment of testicular cancer is a relatively rare and complex operation that may contribute to differences in utilization. We sought to characterize the use of RPLND between different categories of cancer center facilities in the United States.
    Materials and methods: The National Cancer Database was queried for patients with germ cell tumors treated at different types of cancer centers between 1998 and 2011. The proportion of patients who underwent RPLND was stratified by stage and histology and then compared between treatment facilities. RPLND utilization was then compared between facility types as a function of time.
    Results: A total of 59,652 patients met inclusion criteria and 5,475 (9.2%) underwent RPLND. The proportion of patients treated with RPLND for non-seminomatous germ cell tumor (NSGCT) was significantly different between cancer center types for all stages (P<0.001) and used most often in academic comprehensive cancer centers. There was no difference in the proportion of RPLND utilization for stage II and III seminoma stratified by treatment facility. There was a significantly decreased trend in the utilization of RPLND for stage I (P = 0.032) NSGCT whereas utilization was increased for stage III NSGCT (P≤0.001) over the study period.
    Conclusions: The proportion of patients undergoing RPLND for NSGCT varies significantly by the type of cancer center and is used most often in academic cancer centers. Utilization of RPLND decreased for stage I NSGCT and increased for stage III NSGCTs during the study period.
    Language English
    Publishing date 2016-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1336505-8
    ISSN 1873-2496 ; 1078-1439
    ISSN (online) 1873-2496
    ISSN 1078-1439
    DOI 10.1016/j.urolonc.2016.05.036
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