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Article: [PARADIGM SHIFTS IN DIAGNOSIS AND MANAGEMENT OF LOCALIZED PROSTATE CANCER IN 2022].

Laufer, Menachem

2023 Volume 162, Issue 3, Page(s) 157–159

Abstract: Introduction: In recent years, we witnessed significant changes in the way we diagnose prostate cancer and the options for management of low risk localized prostate cancer. This review discusses today's approach to men with elevated PSA. The use of ... ...

Abstract	Introduction: In recent years, we witnessed significant changes in the way we diagnose prostate cancer and the options for management of low risk localized prostate cancer. This review discusses today's approach to men with elevated PSA. The use of biomarkers and or prostate MRI is strongly recommended prior to the decision on a biopsy. Following a suspicious finding in MRI the best approach is MRI-guided biopsy. Traditionally, biopsies are performed transrectally but the emerging transperineal biopsy has considerable advantage. With a new diagnosis of low risk prostate cancer, each man should have a lengthy discussion with his urologist and in many cases the preferred way is to proceed with active surveillance and avoid radical treatment.
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/therapy ; Prostate/pathology ; Image-Guided Biopsy ; Magnetic Resonance Imaging
Language	Hebrew
Publishing date	2023-03-26
Publishing country	Israel
Document type	Review ; English Abstract ; Journal Article
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article: [PHYTOTHERAPY AND NATURAL AGENTS IN SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH)].

Laufer, Menachem / Shoenfeld, Shir

Harefuah

2024 Volume 163, Issue 1, Page(s) 50–53

Abstract: Introduction: Benign prostatic hyperplasia (BPH) is a very common condition among men over 50 years of age. Some patients require immediate surgical intervention for urinary retention. However, most men have a variety of symptoms that may require ... ...

Abstract	Introduction: Benign prostatic hyperplasia (BPH) is a very common condition among men over 50 years of age. Some patients require immediate surgical intervention for urinary retention. However, most men have a variety of symptoms that may require treatment. Medical therapy for BPH has been well known for many years including alpha-adrenergic receptor blockers and 5-alpha reductase inhibitors. In recent years, men also receive anti-cholinergic agents, PDE5 inhibitors and other medical interventions. However, many men pursue alternative treatments and herbal medicines for BPH. We review herbs and herbal medicines that are used worldwide for symptomatic BPH. Many of them are supported by laboratory and clinical data. Mostly, mechanism of action are not fully understood but clinical benefit does support their use. Serenoa repens in hexanic extract (Permixon) is the only medicine that is backed with clinical data in high-quality clinical trials.
MeSH term(s)	Male ; Humans ; Middle Aged ; Prostatic Hyperplasia/drug therapy ; Phytotherapy ; Plant Extracts/pharmacology ; Plant Extracts/therapeutic use ; Adrenergic alpha-Antagonists/therapeutic use ; Cholinergic Antagonists
Chemical Substances	Plant Extracts ; Adrenergic alpha-Antagonists ; Cholinergic Antagonists
Language	Hebrew
Publishing date	2024-01-31
Publishing country	Israel
Document type	Review ; English Abstract ; Journal Article
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article: Low Alanine Aminotransferase as a Marker for Sarcopenia and Frailty, Is Associated with Decreased Survival of Bladder Cancer Patients and Survivors-A Retrospective Data Analysis of 3075 Patients.

Laufer, Menachem / Perelman, Maxim / Segal, Gad / Sarfaty, Michal / Itelman, Edward

Cancers

2023 Volume 16, Issue 1

Abstract: Background: Sarcopenia is characterized by the loss of muscle mass and function and is associated with frailty, a syndrome linked to an increased likelihood of falls, fractures, and physical disability. Both frailty and sarcopenia are recognized as ... ...

Abstract	Background: Sarcopenia is characterized by the loss of muscle mass and function and is associated with frailty, a syndrome linked to an increased likelihood of falls, fractures, and physical disability. Both frailty and sarcopenia are recognized as markers for shortened survival in a number of medical conditions and in cancer patient populations. Low alanine aminotransferase (ALT) values, representing low muscle mass (sarcopenia), may be associated with increased frailty and subsequently shortened survival in cancer patients. In the current study, we aimed to assess the potential relationship between low ALT and shorter survival in bladder cancer patients and survivors. Patients and methods: This was a retrospective analysis of bladder cancer patients and survivors, both in and outpatients. We defined patients with sarcopenia as those presenting with ALT < 17 IU/L. Results: A total of 5769 bladder cancer patients' records were identified. After the exclusion of patients with no available ALT values or ALT levels above the upper normal limit, the final study cohort included 3075 patients (mean age 73.2 ± 12 years), of whom 80% were men and 1362 (53% had ALT ≤ 17 IU/L. The mean ALT value of patients within the low ALT group was 11.44 IU/L, while the mean value in the higher ALT level group was 24.32 IU/L ( Conclusions: Low ALT values, indicative of sarcopenia and frailty, are associated with decreased survival of bladder cancer patients and survivors and could potentially be applied for optimizing individual treatment decisions.
Language	English
Publishing date	2023-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16010174
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Article ; Online: Low Alanine Aminotransferase, as a Marker of Sarcopenia and Frailty, Is Associated with Shorter Survival Among Prostate Cancer Patients and Survivors. A Retrospective Cohort Analysis of 4064 Patients.

Laufer, Menachem / Perelman, Maxim / Sarfaty, Michal / Itelman, Edward / Segal, Gad

European urology open science

2023 Volume 55, Page(s) 38–44

Abstract: Background: Sarcopenia is characterized by loss of muscle mass and function and is associated with frailty, a syndrome with higher likelihood of falls, fractures, physical disability, and mortality. Both frailty and sarcopenia are known markers of ... ...

Abstract	Background: Sarcopenia is characterized by loss of muscle mass and function and is associated with frailty, a syndrome with higher likelihood of falls, fractures, physical disability, and mortality. Both frailty and sarcopenia are known markers of shorter survival in various cancer patient populations. Low alanine aminotransferase (ALT), reflecting loss of muscle mass (sarcopenia), may be associated with greater frailty and shorter survival in multiple cancers. Objective: To assess the potential association between low ALT and shorter survival among prostate cancer (PCa) patients and survivors. Design setting and participants: This was a retrospective analysis of a historical cohort of PCa patients and survivors. Patients were defined as those still actively receiving PCa treatment, while those no longer receiving such treatment were classified as PCa survivors. Outcome measurements and statistical analysis: ALT data were obtained from results for basic biochemical blood testing carried out for patients on their first hospital admission. Patients were divided into two groups: those with ALT ≥17 IU/l and those with ALT <17 IU/l. Univariate and multivariable analyses were conducted for between-group survival comparisons. Results and limitations: We identified 9489 PCa records. The final study cohort with ALT data available included 4064 patients with ALT <40 IU/l. Of this cohort, 536 patients were actively receiving medical anticancer therapy for PCa. The mean age for the entire cohort was 74.6 yr (standard deviation 9.6) and the median ALT level was 19.28 IU/l; 1676 patients (41%) had low ALT (<17 IU/l). On univariate analysis, low ALT was associated with a 78% increase in mortality risk (95% confidence interval [CI] 1.62-1.97; Conclusions: Low ALT, which is indicative of sarcopenia and frailty, is associated with shorter survival among PCa patients and survivors and could potentially be used for treatment personalization. Patient summary: We compared survival for prostate cancer patients and survivors according to their blood level of the protein alanine aminotransferase (ALT). Low ALT levels in the general population are associated with loss of muscle mass. We found that in our group of prostate cancer patients and survivors, the risk of death from any cause was higher for those with low ALT levels.
Language	English
Publishing date	2023-08-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2023.07.007
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Article ; Online: Autoimmune disorders caused by intravesical bacillus Calmette-Guerine treatment: A systematic review.

Anis, Omer / Yogev, David / Dotan, Arad / Tsur, Avishai M / David, Paula / Vishnevskia Dai, Vicktoria / Laufer, Menachem / Dotan, Zohar / Shoenfeld, Yehuda

Autoimmunity reviews

2023 Volume 22, Issue 6, Page(s) 103329

Abstract: Intravesical bacillus Calmette-Guérin (BCG) is a common and highly effective treatment for non-muscle invasive urothelial carcinoma of the urinary bladder. BCG may cause an autoimmune reaction in some patients. One hundred and fifty-eight papers were ... ...

Abstract	Intravesical bacillus Calmette-Guérin (BCG) is a common and highly effective treatment for non-muscle invasive urothelial carcinoma of the urinary bladder. BCG may cause an autoimmune reaction in some patients. One hundred and fifty-eight papers were analyzed, for a total of hundred and thirty patients with reactive arthritis, sixty patients with ocular manifestations and eighteen patients with other rheumatologic diseases. Among 130 subjects with reactive arthritis, an autoimmune symptom occurred after 5 instillations of intravesical BCG (IQR 4-6), which represents 5 weeks in most cases. Fifty-one patients had concurrent ocular involvement. The resolution of symptoms was achieved in a median of 32.5 days (IQR 14-90). Forty-two men and twenty women had ocular manifestations, most commonly conjunctivitis. Patients with HLA-B27 typing had earlier presentation of ocular symptoms related to the number of instillations (4.5 vs 6 [p < 0.05]. Resolution of symptoms was achieved at a median of 128 days (IQR 21-150). Among patients treated with NSAIDs (either with or without steroids), the duration of the disease was significantly shorter in both the articular and the ocular groups (28 vs. 120 [p < 0.05] and 30 vs.105 [p < 0.05], respectively). Other autoimmune manifestations included general autoimmune diseases, such as vasculitis, psoriasis and myasthenia gravis.
MeSH term(s)	Female ; Humans ; Male ; Adjuvants, Immunologic/adverse effects ; Administration, Intravesical ; Arthritis, Reactive/chemically induced ; Autoimmune Diseases/etiology ; Autoimmune Diseases/chemically induced ; BCG Vaccine/adverse effects ; Carcinoma, Transitional Cell/chemically induced ; Carcinoma, Transitional Cell/drug therapy ; Carcinoma, Transitional Cell/pathology ; Neoplasm Recurrence, Local/chemically induced ; Neoplasm Recurrence, Local/pathology ; Urinary Bladder Neoplasms/drug therapy ; Urinary Bladder Neoplasms/chemically induced ; Urinary Bladder Neoplasms/pathology
Chemical Substances	Adjuvants, Immunologic ; BCG Vaccine
Language	English
Publishing date	2023-04-13
Publishing country	Netherlands
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2023.103329
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Article: [UPPER TRACT UROTHELIAL CARCINOMA].

Shvero, Asaf / Laufer, Menachem / Zilberman, Dorit E / Winkler, Harry / Dotan, Zohar A / Kleinmann, Nir

Harefuah

2020 Volume 160, Issue 9, Page(s) 619–624

Abstract: Introduction: Upper tract urothelial carcinoma is a relatively rare malignancy, but with an increasing prevalence. The main risk factor for the disease is smoking. The most common presentation is hematuria or flank pain. Workup is made by imaging of the ...

Abstract	Introduction: Upper tract urothelial carcinoma is a relatively rare malignancy, but with an increasing prevalence. The main risk factor for the disease is smoking. The most common presentation is hematuria or flank pain. Workup is made by imaging of the upper tract - CTU/MRU (Computed Tomography-Urography/Magnetic resonance (MR) urography) and diagnostic uretero-nephroscopy with biopsy. In the past several years there is major advancement in our understanding of the disease and how to treat it, mainly in nephron-sparing treatments. A risk-stratification is usually conducted according to parameters such as tumor size, distribution, and pathologic diagnosis. The low-risk group is usually offered nephron-sparing treatments such as segmental ureterectomy, endoscopic treatments, and lately - local chemotherapy. The high-risk group is usually offered radical resection of the kidney and ureter, with the possible addition of new-adjuvant and adjuvant treatments. In this article we will review the epidemiology, risk factors, diagnosis, and treatment of this malignancy, with a distinction between the risk groups.
MeSH term(s)	Carcinoma, Transitional Cell/diagnosis ; Carcinoma, Transitional Cell/epidemiology ; Carcinoma, Transitional Cell/therapy ; Hematuria ; Humans ; Magnetic Resonance Imaging ; Urinary Bladder Neoplasms ; Urography
Language	Hebrew
Publishing date	2020-12-03
Publishing country	Israel
Document type	Journal Article
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article ; Online: Risk of prostate cancer in patients with schizophrenia.

Raviv, Gil / Laufer, Menachem / Baruch, Yehuda / Barak, Yoram

Comprehensive psychiatry

2014 Volume 55, Issue 7, Page(s) 1639–1642

Abstract: Objectives: To examine the rate of prostate cancer in a cohort of schizophrenia in-patients in the PSA-era as compared to expected rates. There is conflicting evidence on the relative risk of prostate cancer in men with schizophrenia.: Methods: the ... ...

Abstract	Objectives: To examine the rate of prostate cancer in a cohort of schizophrenia in-patients in the PSA-era as compared to expected rates. There is conflicting evidence on the relative risk of prostate cancer in men with schizophrenia. Methods: the study sample was comprised of schizophrenia patients who had been admitted to a tertiary care mental health center between 1990 and 2011. The data for the sample was cross-referenced with the National Cancer Registry. Analyses of Standardized Incidence Rates (SIR) for prostate cancer and for lung cancer (representing an organ system not sensitive to sex hormones) were performed. Results: Of 4,326 schizophrenia patients included in the present study, 181 (4.2%) were diagnosed with cancer at any site. Only 10 of these patients were diagnosed with prostate cancer. This reflects a reduced risk; SIR of 0.56 (95% CI 0.27-1.03). In the same cohort, 33 schizophrenia patients were diagnosed with lung cancer presenting a SIR of 1.43 (95% CI 0.98-2.01) in this sample. Conclusions: The present study suggests a reduced rate of prostate cancer in patients admitted for schizophrenia. There are several possible explanations for this finding including chronic state of hyperprolactinemia induced by antipsychotic drugs.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Humans ; Inpatients/statistics & numerical data ; Israel ; Lung Neoplasms/complications ; Male ; Middle Aged ; Prostatic Neoplasms/complications ; Registries ; Risk ; Schizophrenia/complications ; Young Adult
Language	English
Publishing date	2014-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	127556-2
ISSN	1532-8384 ; 0010-440X
ISSN (online)	1532-8384
ISSN	0010-440X
DOI	10.1016/j.comppsych.2014.05.007
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Article ; Online: Hematospermia--the added value of transrectal ultrasound to clinical evaluation: is transrectal ultrasound necessary for evaluation of hematospermia?

Raviv, Gil / Laufer, Menachem / Miki, Haifler

Clinical imaging

2013 Volume 37, Issue 5, Page(s) 913–916

Abstract: Hematospermia is usually caused by nonspecific inflammation of the prostate and seminal vesicles. Transrectal ultrasound (TRUS) is a safe and inexpensive modality for evaluating patients with hematospermia. The aim of this study is to describe the ... ...

Abstract	Hematospermia is usually caused by nonspecific inflammation of the prostate and seminal vesicles. Transrectal ultrasound (TRUS) is a safe and inexpensive modality for evaluating patients with hematospermia. The aim of this study is to describe the findings of TRUS and its contribution to patients' management. A total of 115 consecutive patients presented with hematospermia and evaluated with TRUS between 2006 and 2012. All patients exhibited an abnormality in the TRUS examination. A 12-core TRUS-guided biopsy of the prostate was taken from 10 patients, but none of these samples were positive for tumor. In the vast majority of cases, a benign cause can be identified using TRUS. These causes usually do not require treatment.
MeSH term(s)	Adult ; Aged ; Hemospermia/diagnostic imaging ; Hemospermia/epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostatic Hyperplasia/diagnostic imaging ; Prostatic Hyperplasia/enzymology ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/epidemiology ; Seminal Vesicles/diagnostic imaging ; Seminal Vesicles/pathology ; Ultrasonography/methods
Language	English
Publishing date	2013-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2013.05.007
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Article ; Online: Is Ultra Hypofractionated Radiation Therapy a Safe and Effective Treatment for Invasive Bladder Cancer in the Elderly?: A Retrospective Single Institution Review.

Symon, Noam / Mattout, Jacoubo / Lewin, Ron / Hammer, Liat / Laufer, Menachem / Berger, Raanan / Leibowitz, Raya / Dotan, Zohar / Ben-Ayun, Maoz / Tsvang, Lev / Weiss, Ilana / Symon, Zvi

American journal of clinical oncology

2021 Volume 44, Issue 7, Page(s) 369–373

Abstract: Purpose: The aim was to determine the efficacy, safety, and tolerability of weekly ultra hypofractionated radiation therapy for older unfit patients with invasive bladder cancer.: Methods: We retrospectively analyzed a cohort of patients with muscle ... ...

Abstract	Purpose: The aim was to determine the efficacy, safety, and tolerability of weekly ultra hypofractionated radiation therapy for older unfit patients with invasive bladder cancer. Methods: We retrospectively analyzed a cohort of patients with muscle invasive bladder cancer deemed unfit for chemoradiation therapy and thus treated with 6 weekly doses of 6 Gy using intensity modulated radiotherapy. Charlson comorbidity was calculated retrospectively. Cystoscopy and computed tomography were used to evaluate local control and toxicity using the common terminology criteria. Survival outcomes were estimated using the Kaplan-Meier method. Results: Twenty-two patients with a median age of 84 (range: 70 to 96) years were included. The median comorbidity index was 6±1.5 SD. Nineteen (90%) patients received the full 36 Gy dose. Median follow-up was 10±7 months (range: 6 to 27 mo). Local control in the bladder was achieved in 16 of 19 evaluable patients (84%). One-year overall survival was 62.5%, 1 patient had a retroperitoneal nodal recurrence and 3 patients developed distant metastasis. Grade 3 genitourinary and gastrointestinal toxicity was observed in 4 (18%) and 1 (4.5%) patients, respectively. Conclusion: Weekly ultra hypofractionated intensity modulated radiotherapy with image guidance and bladder training is an effective, safe, and well-tolerated regimen for older patients with invasive bladder cancer unfit for radical treatment.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Frail Elderly ; Humans ; Male ; Neoplasm Recurrence, Local ; Positron Emission Tomography Computed Tomography ; Radiation Dose Hypofractionation ; Radiotherapy, Intensity-Modulated/adverse effects ; Radiotherapy, Intensity-Modulated/methods ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder Neoplasms/diagnostic imaging ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/radiotherapy
Language	English
Publishing date	2021-05-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	604536-4
ISSN	1537-453X ; 0277-3732
ISSN (online)	1537-453X
ISSN	0277-3732
DOI	10.1097/COC.0000000000000824
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Article ; Online: Salvage re-irradiation using stereotactic body radiation therapy for locally recurrent prostate cancer: the impact of castration sensitivity on treatment outcomes.

Lewin, Ron / Amit, Uri / Laufer, Menachem / Berger, Raanan / Dotan, Zohar / Domachevsky, Liran / Davidson, Tima / Portnoy, Orith / Tsvang, Lev / Ben-Ayun, Maoz / Weiss, Ilana / Symon, Zvi

Radiation oncology (London, England)

2021 Volume 16, Issue 1, Page(s) 114

Abstract: Background: Advances in imaging, biomaterials and precision radiotherapy provide new opportunities to salvage locally recurrent prostate cancer (PC). This study evaluates the efficacy and safety of re-irradiation using stereotactic body radiation ... ...

Abstract	Background: Advances in imaging, biomaterials and precision radiotherapy provide new opportunities to salvage locally recurrent prostate cancer (PC). This study evaluates the efficacy and safety of re-irradiation using stereotactic body radiation therapy (SBRT). We hypothesized that patients with castrate-resistant PC (CRPC) would benefit less from local salvage. Methods: A prospective clinical database was reviewed to extract 30 consecutive patients treated with prostate re-irradiation. Gallium prostate specific membrane antigen (PSMA) ligand positron emission tomography was performed following prostate-specific antigen failure in all patients and biopsy was obtained in 18 patients (60%). Re-irradiation was either focal (n = 13) or whole-gland (n = 17). Endo-rectal balloons were used in twenty-two patients and hydrogel spacers in eight patients. The median prescription dose was 5 fractions of 6.5 (range: 6-8) Gray (Gy). Results: Median follow-up was 28 months. Failure occurred in 10 (out of 11) CRPC patients versus 6 (out of 19) castrate-sensitive patients (91% vs. 32%, p = 0.008) after a median of 13 and 23 months, respectively. Metastases occurred in 64% (n = 7) of CRPC patients versus 16% (n = 3) of castrate-sensitive patients (p = 0.007). Two patients experienced local in-field recurrence, thus local control was 93%. The 2 and 3-year recurrence-free survival were 84% and 79% for castrate-sensitive patients versus 18% and 9% for CRPC patients (p < 0.001), and 3-year metastasis-free survival was 90% versus 27% (p < 0.01) for castrate-sensitive and CRPC patients, respectively. Acute grade II and III genitourinary (GU) toxicity occurred in 27% and 3%, and late GU toxicity in 30% and 3%, respectively. No ≥ grade II acute gastrointestinal (GI) toxicity occurred, and only one patient (3%) developed late grade II toxicity. Conclusions: Early delivery of salvage SBRT for local recurrence is associated with excellent 3-year disease control and acceptable toxicity in the castrate-sensitive phenotype. PSMA imaging for detection of local recurrence and the use of precision radiotherapy with rectal protective devices should be further investigated as a novel salvage strategy for radio-recurrent PC.
MeSH term(s)	Aged ; Antigens, Surface/metabolism ; Castration/statistics & numerical data ; Glutamate Carboxypeptidase II/metabolism ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Recurrence, Local/surgery ; Organs at Risk/radiation effects ; Prognosis ; Prospective Studies ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/surgery ; Radiosurgery/methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Re-Irradiation/methods ; Salvage Therapy ; Survival Rate
Chemical Substances	Antigens, Surface ; FOLH1 protein, human (EC 3.4.17.21) ; Glutamate Carboxypeptidase II (EC 3.4.17.21)
Language	English
Publishing date	2021-06-23
Publishing country	England
Document type	Journal Article
ISSN	1748-717X
ISSN (online)	1748-717X
DOI	10.1186/s13014-021-01839-w
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