bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological features and their impacts on the prognoses of patients with nonurothelial carcinoma: A hospital-based cancer registry in Japan.
Authors: Nagumo Yoshiyuki , Kojima Takahiro , Kojo Kosuke , Kimura Tomokazu , Kandori Shuya , Kawai Koji , Okuyama Ayako , Higashi Takahiro , Nishiyama Hiroyuki 
Published: February 2020

555 Background: Urothelial carcinoma (UC) is the most common histology of genitourinary (GU) tract cancer. Non-UC tumors in the GU tract appear to be more aggressive than UC at that location, but the clinicopathological features and their impacts on the prognoses of the non-UC patients are not known due to the low numbers of these patients. Methods: We used Hospital-Based Cancer Registry (HBCR) data in Japan to extract non-UC cases, i.e., patients with adenocarcinoma (AC), squamous cell carcinoma (SCC), or small cell carcinoma (SmCC) of the GU tract who were diagnosed in 2008–2009 with histological confirmation and had received first course of treatment. We retrospectively analyzed the clinicopathological features of these patients, stratified by the bladder and the upper urinary tract (UUT) as tumor locations. We used a Cox proportional hazards regression to identify prognostic factors associated with the overall survival (OS). Results: Of the 8,095 cases at the bladder and 2,580 cases at the UUT, 384 (4.7%) and 131 (5.1%) non-UC cases were identified, respectively. The proportions of histologic subtypes in the bladder were 1.7% AC, 2.4% SCC, and 0.7% SmCC. In the UUT group, these proportions were 1.3%, 3.4%, and 0.4%, respectively. At both tumor locations, the distribution of ages was similar across all subtypes, with the age peak in the 70s. More patients with non-UC were diagnosed at an advanced clinical stage compared to the patients with UC at either location. The 5-yr OS rates of the non-UC patients with a tumor in the bladder and at the UUT were 40% and 26%, whereas the corresponding 5-yr OS rates among the UC patients were 61% and 52%, respectively. A multivariate analysis revealed that the presence of non-UC was significantly associated with increased mortality (hazard ratio 1.66, 95% confidence interval 1.48–1.87) regardless of the tumor location. Conclusions: The clinicopathological features of the non-UC patients were similar between both tumor locations. The presence of non-UC was associated with poor prognosis regardless of the tumor location. A standard of care must be established for non-UC patients, since the prognoses of these patients are not satisfactory.
Variance in symptom assessment between patient and caregiver: A prospective study of patients staged as metastatic prostate cancer—An interim analysis.
Authors: Swift Sadie , Vitin Jane , Prime Hillary , Topp Robert , Dato Paul , Cohen Edward , Gaylis Franklin 
Published: February 2020

56 Background: Closely monitored and managed patient reported outcomes (PROs) can impact survival of cancer patients. However, the reliability and validity of patients’ self-reported symptoms are somewhat open to question, as past studies have shown that patients may underreport health information to their physicians. Identifying where the discrepancy between PROs and actual symptomology lies may be important in improving providers’ grasp of a patients’ disease state. The purpose of this study is to compare prostate cancer patients’ reports of their symptoms and functioning with the patients’ caregivers’ perception of the same factors. Methods: 50 patients with metastatic prostate cancer on Androgen Deprivation Therapy (ADT) and their caregivers were asked to independently complete the Functional Assessment of Cancer Therapy- Prostate (FACT-P), Brief Pain Inventory- Short Form (BPI-SF), and EQ-5D-3L questionnaires in relation to the patient’s condition. Patient and caregiver dyad responses to these instruments were then compared by t-tests for continuous measures and Chi-Square for discrete measures. Results: Not all patient and caregiver dyads completed all of the data collection instruments. Patients are more likely than caregivers to rate themselves as having fewer limitations on mobility (n=47, p≤0.001), less pain and/or discomfort (n=46, p≤0.001), and less limitations with self-care (n=46, p≤0.001). Furthermore, caregivers were more likely to rate patients as having more anxiety (n=47, p≤0.001), more severe pain (n=20, p<0.05), and lower overall physical wellbeing scores (n=40, p<0.005). Ratings for emotional and social functioning were not significantly different between the patient and their caregiver. Conclusions: Overall a high degree of agreement was reported between patient and caregiver ratings of the patient’s symptoms and functioning; however, when differences were present the caregivers consistently rated the patients’ conditions as more severe, particularly in relation to physical symptoms. This may indicate that patients are minimizing their symptoms when reporting to their physicians.
Association of baseline modified Glasgow Prognostic Score (mGPS) with survival outcomes in patients with metastatic urothelial cell carcinoma (mUCC) treated with immune checkpoint inhibitors (CPI).
Authors: Brown Jacqueline T , Liu Yuan , Shabto Julie M. , Martini Dylan J. , Ravindranathan Deepak , Hitron Elise , Russler Greta , Caulfield Sarah , Yantorni Lauren Beth , Joshi Shreyas S. , Kissick Haydn , Ogan Kenneth , Harris Wayne , Carthon Bradley Curtis , Kucuk Omer , Master Viraj A. , Bilen Mehmet Asim 
Published: February 2020

563 Background: The mGPS, a clinical tool that incorporates albumin and C-reactive protein, has proven useful in the prognostication of multiple cancers. Several CPI agents have been approved for the treatment of mUCC but a prognostic biomarker is needed. We investigated the impact of mGPS on survival outcomes in mUCC patients receiving CPI. Methods: We retrospectively reviewed mUCC patients treated with CPI (PD-1 or PD-L1 inhibitors) at Winship Cancer Institute from 2015 to 2018. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of CPI until death or clinical/radiographic progression, respectively. mGPS was defined as a summary score with one point given for CRP > 10 mg/L and/or albumin < 3.5 g/dL. Univariate (UVA) and multivariate (MVA) analyses were carried out using Cox proportional hazard model for OS and PFS. Results: A total of 53 patients were included with a median follow up 27.1 months. The median age was 70 years with 84.9% male and 20.8% black. Baseline mGPS was 0 in 43.4%, 1 in 28.3% and 2 in 28.3%. The correlation between mGPS and other inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), was high with Pearson correlation coefficients ≥ 0.48 (p ≤ 0.0003). Increased mGPS at the time of CPI initiation was associated with poorer OS and PFS (Table). Conclusions: The mGPS may be a useful prognostic tool in mUCC patients when treatment with CPI is under consideration. These results warrant a larger study for validation.[Table: see text]
Molecular characterization of advanced muscle invasive bladder cancer (MIBC): Comparison of low-input targeted RNA sequencing (RNAseq) strategies.
Authors: Shibata Yoichiro , Uronis Joshua M. , Conroy Jeffrey M. , Glenn Sean , Guo John , Mayhew Gregory , Eisner Joel Robert , Milburn Michael Vance 
Published: February 2020

564 Background: 5-year survival for advanced MIBC is poor (~5%), but newer targeted agents (e.g., PD-1/PD-L1 or FGFR) have improved survival over traditional chemotherapy. To better select patients suited for targeted therapies, molecular characterization is more important than ever. The following study compares RNAseq using two low-RNA-input methods (SureSelect hybridization-capture and AmpliSeq PCR amplification, using 200 ng and 10 ng extracted RNA, respectively), as part of a retrospective study of advanced MIBC patients treated with anti-PD-1/PD-L1 therapy (Mayhew et al, 2019 ASCO). RNAseq results, including correlation between methods and molecular subtype agreement are presented herein. Methods: RNA extracts from 24 representative FFPE MIBC tumor samples were analyzed using SureSelect XT RNA (Agilent) and AmpliSeq transcriptome (Illumina) by NovaSeq6000 paired end sequencing. Samples were split between 4 molecular subtypes using the GeneCentric 60-gene MIBC nearest centroid subtyper (n = 6/subtype; luminal, luminal infiltrated, basal, basal infiltrated) (Mayhew et al, 2019 ASCO). Pearson correlation analysis was performed for all genes, as well as the 60 suptyper genes. Expression subtype calls were compared using RNAseq data obtained from both sequencing methods. Results: Of 58,000 genes queried (GrCH38.v22), 27,671 (55%) were found using both methods and 13,992 (28%) were not found using either method. 15,575 unique genes were found using SureSelect and 1,149 unique genes were found using AmpliSeq. The two methods were well correlated: median of 0.87 (0.73-0.89) overall and 0.80 (0.54-0.86) for the 60 subtyper genes. 22 of the 24 samples (92%) had congruent subtype calls using the 60-gene MIBC subtyper; one luminal-infiltrated called basal and one basal called basal-infiltrated. Conclusions: This study demonstrated comparable RNAseq analysis using two low-input FFPE-compatible methods. Using AmpliSeq, MIBC tumors were able to be molecularly characterized, including subtype analysis, with only 1/20th of the extracted RNA needed for SureSelect. Further validation of AmpliSeq methodology in MIBC and other tumor types is warranted.
Racial disparities in the outcomes of transitional cell carcinoma of the bladder: A population-based analysis.
Authors: Baidoun Firas , Ruhban Inas A. , Saad Anas M. , Gad Mohamed M. , Jazieh Khalid , Al-Husseini Muneer J. , Ornstein Moshe Chaim , Rini Brian I. , Gupta Shilpa 
Published: February 2020

577 Background: Bladder cancer is the most common type of genitourinary malignancy and is the fourth most common cancer in men in the US. Transitional cell carcinoma (TCC) of the bladder accounts for most bladder cancer cases. Previous studies have observed racial disparities in the prognosis between white and black populations with very little mentioned about other ethnicities and race groups that are part of the United States population. We hereby, present a detailed and comprehensive analysis of racial disparities in TCC survival in the US. Methods: Using the data from surveillance Epidemiology and End results (SEER) database, we identified patients with TCC between 1992 and 2015. We used multivariable covariate-adjusted Cox models to analyze the overall and TCC-specific survival of patients according to their race. Results: We evaluated 176,388 patients with TCC and after we adjusted for age, sex, race, stage, grade, and undergoing cancer-targeted surgery, we found that Asians/Pacific Islanders and Hispanics had a better overall survival when compared to whites (HR= 0.792, 95% CI [0.761-0.824], P<.001 and HR = 0.941, 95% CI [0.909-0.974], P = .001, respectively). Asians/Pacific Islanders also showed better TCC specific survival (HR = 0.843, 95% CI [0.759-0.894], P<.001). Blacks had worse overall survival and TCC-specific survival (HR =1.221, 95% CI [1.181-1.262], P <.001 and HR =1.325, 95% CI [1.268- 1.384], P <.001, respectively). When stage IV TCC was analyzed separately, only Hispanics showed better overall and TCC specific survival when compared to whites (HR = 0.896, 95% CI [0.806-0.997], P = 0.044 and HR = 0.891, 95% CI [0.797-0.996], P = 0.42). Conclusions: Asians/Pacific Islanders have better overall and TCC-specific outcome while blacks have the worst outcome compared to whites. Hispanics have better overall and cancer specific survival in stage IV TCC. These disparities likely related to different and complex factors from lifestyle and chemical exposure to genetic factors. Further studies can help us more in understanding and approaching this malignancy in different race groups.
Characteristics of radiation-associated bladder cancer compared to primary bladder cancer
Authors: Sha Sybil , Dee Edward Christopher , Mahal Brandon Arvin Virgil , Mouw Kent William , Nguyen Paul L. , Muralidhar Vinayak 
Published: February 2020

582 Background: Radiation-associated muscle-invasive bladder cancer (RA-MIBC) has been suggested to represent a more aggressive disease variant compared to primary (non-radiation associated) MIBC. We sought to characterize the presentation, patterns of care, and outcomes of RA-MIBC compared to primary MIBC. Methods: We identified 60,117 patients diagnosed with non-metastatic or metastatic MIBC between 1988 and 2015 using the Surveillance, Epidemiology, and End Results (SEER) database and stratified patients based on whether radiation had been administered to a pelvic primary prior to the development of bladder cancer. We used logistic regression to compare rates of chemotherapy, surgery, or radiation for patients with RA-MIBC compared to primary MIBC. We used Fine-Gray competing risks regression to compare adjusted bladder cancer-specific mortality (BCSM) for RA-MIBC and primary MIBC. Results: There were 1,093 patients with RA-MIBC and 59,024 patients with primary MIBC. Patients with RA-MIBC were older compared to patients with primary MIBC (mean age 77.4 years vs 72.4 years, p < 0.001) and more likely to be male (86.8% vs 73.3%, p<0.001). RA-MIBCs were more likely to be high-grade (57.5% vs 47.6%, p<0.001), more likely to have T4 disease at diagnosis (21.0% vs 17.3%, p<0.001), and less likely to be node-positive (4.2% vs 8.1%, p < 0.001). In terms of treatment, non-metastatic primary MIBC patients were more likely to undergo radiation (14.0% vs 3.1%, p<0.001) as well as radiation with cystectomy (1.9% vs 0.8%, p<0.001) compared to those with RA-MIBC. Median survival was significantly shorter for patients with RA-MIBC (13 mo. vs 19 mo.; p<0.001). Conclusions: RA-MIBCs tend to present with higher grade and higher stage disease and are less likely to receive curative treatment. Even when adjusting for stage, grade, and receipt of treatment, patients with RA-MIBC have worse survival compared to those with primary MIBC. These findings raise the possibility that RA-MIBC represents a biologically more aggressive disease compared to primary MIBC. Future research is needed to better understand biological differences between RA-MIBC and primary MIBC and develop improved therapeutics for radiation-associated cancers.
Oncological outcomes following radical cystectomy for urothelial carcinoma of the bladder with positive lymph nodes.
Authors: Ladi Seyedian Seyedeh Sanam , Bateni Zhoobin , Pearce Shane , Ghodoussipour Saum , Nazami Azadeh , Cai Jie , Miranda Gus , Bhanvadia Sumeet , Djaladat Hooman , Schuckman Anne K. , Daneshmand Siamak 
Published: February 2020

584 Background: To determine oncological outcomes among patients who underwent radical cystectomy (RC) for urothelial carcinoma (UC) of the bladder with positive lymph nodes (LN). Methods: On a retrospective review of 4093 patients from our institutional IRB approved cystectomy database from Jan 1971 to Dec 2017, we identified 3284 patients who underwent RC for UC of the bladder. We included patients with positive LNs at the final pathology. The data was stratified into three groups based on number of positive LNs: 1, 2-9, and more than 10 positive LNs. Multivariable analysis was performed to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS). A subgroup analysis was performed to assess the oncological outcomes in cases that did not receive any chemotherapy (adjuvant or neoadjuvant). Results: 712 patients (22%) had positive LN after RC. Median age was 68 years and 76% of patients were male. 105 (15%) patients had clinical evidence of LN involvement on pre-operative imaging. Patient characteristics are provided in Table. Five-year (5-y) RFS for 1, 2-9 and 10+ positive LNs was 39%, 36% and 16%, respectively (p<0.001). 5-y OS were 45%, 33% and 14%, respectively (p<0.001). On multivariable analysis, more than 10 positive LNs pathologic tumor stage >pT2, and neoadjuvant chemotherapy were associated with increased risk of recurrence and worse overall survival after radical cystectomy. Adjuvant chemotherapy was associated with decreased risk of recurrence and better overall survival after radical cystectomy. On subgroup analysis of patients with positive LNs without peri-operative chemotherapy, 5-y RFS for 1, 2-9 and 10+ positive LNs was 25%, 32% and 5%, respectively (p<0.001). 5-y OS was 31%, 20% and 4%, respectively (p<0.001). Conclusions: Only 15% of patients with positive LNs have clinical evidence of LN involvement prior to cystectomy. Oncological outcomes after radical cystectomy are associated with the number of involved LNs. Surgery alone can be curative in 20-30% of patients with less than 10+ LN.
Comparison between oncological outcomes of primary versus salvage radical cystectomy for urothelial carcinoma of the bladder.
Authors: Ladi Seyedian Seyedeh Sanam , Bateni Zhoobin , Bazargani Soroush T. , Zainfeld Daniel , Cai Jie , Miranda Gus , Ballas Leslie , Bhanvadia Sumeet , Schuckman Anne K. , Djaladat Hooman , Daneshmand Siamak 
Published: February 2020

585 Background: This study aims to compare oncologic outcomes among patients who underwent salvage radical cystectomy (sRC) for recurrent urothelial carcinoma (UC) of the bladder following radiotherapy (RT) with primary radical cystectomy (pRC). Methods: We retrospectively reviewed the data of 3705 primary consented cystectomy patients of our IRB-approved bladder cancer database from Jan 1971 to June 2017 who underwent radical cystectomy for urothelial carcinoma of the bladder. Clinical and pathological data at the time of both RT and RC was collected. Patients with non-UCs and those receiving radiation for non-UCs were excluded. Multivariate analyses was performed to identify prognostic factors after RC for overall survival and recurrence-free survival. Results: 3050 patients were identified who underwent radical cystectomy for UC of the bladder. Of these, 128 patients (4.2%) underwent sRC following radiotherapy (RT). Patient characteristics including age, BMI, gender, and comorbidities were similar between the groups. Complications rates between the groups were similar at 30 days (43% sRC vs 39% pRC patients, p=0.41) and 90 days (52% sRC vs 48% pRC, p=0.42). Patients receiving sRC were less likely to receive a continent diversion (p<0.001). Five-year overall survival following sRC was 47% in comparison to 63% for those undergoing pRC (p<0.001) (Fig 1). However, no significant difference in five-year recurrence free survival was found (61% sRC vs 68% pRC; p=0.15). On multivariate analysis, sRC (HR 1.37, p=0.048), pathologic tumor stage ≥pT3a (HR 2.6, P < 0.001) and lymph node metastases (HR 2.5, P < 0.001) were associated with increased risk of local recurrence after radical cystectomy. Conclusions: Patients undergoing sRC are less likely to receive a continent urinary diversion and are at increased risk of local recurrence following cystectomy in comparison to patients receiving primary cystectomy.
Salivary proteomic profile of patients with renal cell carcinoma.
Authors: Balasubramanian Adithya , Zhou Weidong , Petricoin Emanuel , Streckfus Charles F. , Klein John R , Qiao Wei , Wood Christopher G. , Karam Jose A. , Lozano Marisa , Matin Surena F. 
Published: February 2020

622 Background: We aimed to explore the salivary proteomic profile (SPP) of patients undergoing surgery for suspected renal cell carcinoma (RCC), then evaluate any significant findings in a validation cohort. Methods: Prospective IRB approved trial of consecutive patients with suspected RCC undergoing curative surgery. Saliva was collected pre- and postoperatively, and from healthy volunteers. Saliva was mixed with sodium orthovanadate and protease inhibitor, aliquoted, and frozen at -80oC. SPP performed using biomarker concentrated saliva via core-shell hydrogel nanoparticles functionalized with molecular baits coupled to high resolution MS/MS electrospray mass spectrometry analysis; output represented as spectral counts. Wilcoxon Rank Sum test was used for comparisons; p-values were adjusted using false discovery rate (FDR) for multiple testing. Results: Exploratory phase: saliva was collected from 27 volunteers and 34 RCC patients (24 clear cell (cc)RCC, 6 chromophobe (ch)RCC, 4 other). Evaluation of cc vs chRCC revealed differential counts for 56 proteins; none were significant after adjustment by FDR. Comparison of matched pre/post-operative SPP in 14 ccRCC patients identified differential counts of 3 proteins: basic salivary proline-rich protein 3 precursor; prolactin-inducible protein precursor; and submaxillary gland androgen-regulated protein 3B precursor. These were not affected by patient age, partial/radical nephrectomy, or tumor size/stage/grade. Validation phase: power analyses indicated a sample size of 38/53 patients = 90% power = effect size of 0.6/0.5, respectively, 2-sided Type 1 error of 0.025. 49 ccRCC patients were enrolled with pre/postop saliva. 611 proteins were identified; none had differential counts after FDR. Conclusions: Using a unique biomarker technology coupled to high resolution MS, interesting SPP’s were seen between RCC subtypes and before/after ccRCC curative resection. We were unable to show significant differences in pre/post-op levels. More research is needed to further study the SPP in RCC patients and the factors impacting their differential expression. In order to aid such efforts, the raw data will be made available for future researchers.
Renal tumor biopsy to reduce overtreatment of renal oncocytomas.
Authors: Neves Joana B. , Withington John , Varley Rebecca , Agnesi Stefano , Capitanio Umberto , Grant Lee , Tran-Dang My-Anh , El-Sheikh Soha , Walkden Miles , Yuminaga Yuigi , Patki Prasad , Barod Ravi , Mumtaz Faiz , Bex Axel , Tran Maxine Gia Binh 
Published: February 2020

623 Background: Up to 30% of renal masses are benign tumours, the most common of which is renal oncocytomas (RO). Our practice is to offer renal tumour biopsy (RTB) for small renal masses (SRM; ≤4cm) as part of a multi-disciplinary pathway. Our objective was to determine whether RTB influenced the management of RO. Methods: Retrospective descriptive analysis of the management of all sporadic cases with a histological diagnosis of RO (biopsy or surgical) at a high-volume tertiary centre from January/2012 to June/2019. Results: 170 patients (66% male; median age 67 years; median age-related Charlson comorbidity index 3) were diagnosed with 177 RO (median size 36mm). 70% (124) of RO were diagnosed using tumour biopsy (median size 33mm), of which 116 (93.4%) embarked on active surveillance (AS; 101) or watchful waiting (15). 53 (30%) RO were diagnosed after surgical excision (median size 50mm; 15 partial and 38 radical nephrectomies), of which 4 lesions were initially managed with AS. Median follow-up on AS was 20 months (2 to 84 months), with a median decrease in estimated glomerular filtration rate of 3 ml/min/1.73m2 over this period. 79% of RO on AS were SRMs. Median overall lesion size change was 1.1mm/year during follow up. Overall 62.6% of lesions grew, a quarter of which at a rate >5mm/year. Nine cases of RO on AS changed to intervention due to lesion growth or patient choice. No metastases were reported in the whole cohort. Three patients on AS died (stroke, respiratory arrest secondary to food inhalation, and unknown cause). One patient who had had surgical excision of RO died of unknown cause. Conclusions: Surgical risks for benign renal lesions are not different to those taken for renal cell carcinoma. RTB reduces the use of unnecessary surgery and its incumbent morbidity for benign renal lesions, such as RO. AS is a safe management option for patients with RO and can be used to reduce overtreatment-associated harm.