Authors - Reviews in Urology

Directory of Authors from the Journal and their last article.

Proton Beam Therapy for Localized Prostate Cancer 101: Basics, Controversies, and Facts

Treatment Update

Eric S Wisenbaugh Paul E Andrews Robert G Ferrigni Steven E Schild Sameer R Keole William W Wong Sujay A Vora

Proton beam therapy for prostate cancer has become a source of controversy in the urologic community, and the rapid dissemination and marketing of this technology has led to many patients inquiring about this therapy. Yet the complexity of the technology, the cost, and the conflicting messages in the literature have left many urologists ill equipped to counsel their patients regarding this option. This article reviews the basic science of the proton beam, examines the reasons for both the hype and the controversy surrounding this therapy, and, most importantly, examines the literature so that every urologist is able to comfortably discuss this option with inquiring patients. [Rev Urol. 2014;16(2):67-75 doi: 10.3909/riu0601] © 2014 MedReviews®, LLC

Prostate cancer Proton beam therapy External beam radiation therapy Intensity

Samih HayekView Articles

Volume 16, Number 1 Review Articles

Calyceal Diverticula: A Comprehensive Review

Disease State Review

Zeph Okeke Nikhil Waingankar Samih Hayek Arthur D Smith

Calyceal diverticula are rare outpouchings of the upper collecting system that likely have a congenital origin. Stones can be found in up to 50% of calyceal diverticula, although, over the combined reported series, 96% of patients presented with stones. Diagnosis is best made by intravenous urography or computed tomography urogram. Shock wave lithotripsy (SWL) is an option for first-line therapy in patients with stone-bearing diverticula that have radiologically patent necks in mid- to upper-pole diverticula and small stone burdens. Stone-free rates are the lowest with SWL, although patients report being asymptomatic following therapy in up to 75% of cases with extended follow-up. Ureteroscopy (URS) is best suited for management of anteriorly located mid- to upper-pole diverticular stones. Drawbacks to URS include difficulty in identifying the ostium and low rate of obliteration. Percutaneous management is best used in posteriorly located mid- to lower-pole stones, and offers the ability to directly ablate the diverticulum. Percutaneous nephrolithotomy remains effective in the management of upper-pole diverticula, but carries the risk of pulmonary complications unless subcostal access strategies such as triangulation or renal displacement are used. Laparoscopic surgery provides definitive management, but should be reserved for cases with large stones in anteriorly located diverticula with thin overlying parenchyma, and cases that are refractory to other treatment. This article reviews the current theories on the pathogenesis of calyceal diverticula. The current classification is examined in addition to the current diagnostic methods. Here we summarize an extensive review of the literature on the outcomes of the different treatment approaches. [ Rev Urol. 2014;16(1):29-43 doi: 10.3909/riu0581] © 2014 MedReviews®, LLC

Ureterorenoscopy Calyceal diverticula Percutaneous nephrostolithotomy Laparoscopic surgery Shock wave lithotripsy

Samir S TanejaView Articles

Volume 5, Supplement 2 Supplement

A Multidisciplinary Approach to the Management of Hormone-Refractory Prostate Cancer

Samir S Taneja

Prostate cancer Androgen-insensitive Hormone-refractory Multidisciplinary

Samira SyedView Articles

Volume 5, Supplement 3 Supplement

Innovative Therapies for Prostate Cancer Treatment

Anthony Tolcher Samira Syed

Docetaxel Hormone-refractory prostate cancer Antisense oligonucleotides

Samuel GoldView Articles

Volume 20, Number 4 Review Articles

Focal Ablation of Prostate Cancer

Treatment Update

Herbert Lepor James Wysock Samuel Gold

The challenge to the urology community is to reduce the risks of screening and treatment by reducing the number of men undergoing unnecessary biopsy and whole-gland curative treatment of low-risk disease. There is compelling evidence that focal ablation of prostate cancer is truly minimally invasive and offers major functional advantages over whole-gland treatment. [Rev Urol. 2018;20(3):145–157 doi: 10.3909/riu0809] © 2019 MedReviews®, LLC

Prostate cancer screening High-intensity focused ultrasound Irreversible electroporation Focal ablation Prostate cancer treatment Vascular targeted photodynamic therapy

Sanae BennisView Articles

Volume 9, Number 1 Reviews in Urology

Solitary Fibrous Tumor of the Kidney: A Case Report and Review of the Literature

Case Review

Imane Kamaoui Afaf Amarti Sanae Bennis Laila Chbani Hinde El Fatemi Taoufik Harmouch Fadl Tazi Kaoutar Znati

A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually occurs in the pleura but has recently been described in diverse extrapleural sites. Urogenital localization is rare, and only 19 cases of SFT of the kidney have been described. We report a case of a large SFT clinically thought to be renal cell carcinoma arising in the kidney of a 70-year-old man. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands, with areas of necrosis or cystic changes noted macroscopically and microscopically. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin, S-100 protein, or muscle markers, confirming the diagnosis of SFT. This tumor is benign in up to 90% of cases. The immunohistochemical study is the key to diagnosis. [Rev Urol. 2007;9(1):36-40]

Kidney Immunohistochemical study Renal neoplasm Spindle cells

Sandip M. PrasadView Articles

Volume 23, Number 2 Bladder Cancer

Integrating JELMYTO (Mitomycin) for Pyelocalyceal Solution Into Community Practice: Practical Tips for the Urologist

Michael J. Shannon Sandip M. Prasad

Treatment options for upper-tract urothelial carcinoma are based on whether the patient has high-risk or low-risk disease. Low-grade tumors can be managed with nephron-sparing approaches, including ureteroscopic resection and ablation, although most patients undergoing endoscopic treatment of upper-tract urothelial cancers face a risk of recurrence. Mitomycin gel for pyelocalyceal solution provides an effective alternative therapy. In OLYMPUS, a phase 3, single-arm, open-label study, 58% of patients with low-grade disease experienced a complete response to induction therapy at 3 months. Kaplan-Meier analysis revealed an estimated 12-month durable response rate of 82%. The most common treatment-emergent adverse events were ureteric stenosis, urinary tract infection, hematuria, and flank pain (grade <3). Mitomycin gel offers a novel, kidney-sparing, nonoperative approach to managing low-grade upper-tract urothelial carcinoma.

Mitomycin Urology Drug therapy Urinary tract Carcinoma Urologic neoplasms urinary bladder neoplasms

Sanford J SiegelView Articles

Volume 16, Supplement 1 Review Articles

Options for the Medical Treatment of Peyronie’s Disease

KOL Interview

Laurence A Levine Sanford J Siegel

Sanoj PunnenView Articles

Volume 17, Number 1 Review Articles

Finding the Wolf in Sheep’s Clothing: The 4Kscore Is a Novel Blood Test That Can Accurately Identify the Risk of Aggressive Prostate Cancer

Diagnosis and Screening Update

Dipen J Parekh Sanoj Punnen MAS Nicola Pavan

Better biomarkers that can discriminate between aggressive and indolent phenotypes of prostate cancer are urgently needed. In the first 20 years of the prostate-specific antigen (PSA) era, screening for prostate cancer has successfully reduced prostate cancer mortality, but has led to significant problems with overdiagnosis and overtreatment. As a result, many men are subjected to unnecessary prostate biopsies and overtreatment of indolent cancer in order to save one man from dying of prostate cancer. A novel blood test known as the 4Kscore® Test (OPKO Lab, Nashville, TN) incorporates a panel of four kallikrein protein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-related peptidase 2) and other clinical information in an algorithm that provides a percent risk for a high-grade (Gleason score ≥ 7) cancer on biopsy. In 10 peer-reviewed publications, the four kallikrein biomarkers and algorithm of the 4Kscore Test have been shown to improve the prediction not only of biopsy histopathology, but also surgical pathology and occurrence of aggressive, metastatic disease. Recently, a blinded prospective trial of the 4Kscore Test was conducted across the United States among 1012 men. The 4Kscore Test replicated previous European results showing accuracy in predicting biopsy outcome of Gleason score ≥ 7. In a recent case-control study nested within a population-based cohort from Västerbotten, Sweden, the four kallikrein biomarkers of the 4Kscore Test also predicted the risk for aggressive prostate cancer that metastasized within 20 years after the test was administered. These results indicate that men with an abnormal PSA or digital rectal examination result, and for whom an initial or repeat prostate biopsy is being considered, would benefit from a reflex 4Kscore Test to add important information to the clinical decision-making process. A high-risk 4Kscore Test result may be used to select men with a high probability of aggressive prostate cancer who would benefit from a biopsy of the prostate to prevent an adverse and potentially lethal outcome from prostate cancer. Men with a low 4Kscore Test result may safely defer biopsy. [Rev Urol. 2015;17(1):3-13 doi: 10.3909/riu0668] © 2015 MedReviews®, LLC

Prostate cancer Biomarker Screening High-grade prostate cancer

Sara Babcock GilbertView Articles

Volume 17, Number 4 Review Articles

Fertility Preservation Options for Men and Women With Cancer

Savvas E MendrinosView Articles

Volume 15, Number 4 Original Research

Utilization Trends and Positive Biopsy Rates for Prostate Biopsies in the United States: 2005 to 2011

Deepak A Kapoor Ann E Anderson Carl A Olsson Savvas E Mendrinos David G Bostwick

This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in . 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%—this was identical at both the NRL and UPL (P 5 .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P 5 .03). For the most recent 3-year period (2009-2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P 5 0.08). Positive biopsy rate correlated strongly (P , .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009 to 2011 there was no significant difference in specimen vials per biopsy across sites of service. Increased cancer detection rate correlated significantly with increased number of specimens examined. Segregation of prostate biopsy cores into 10 to 12 unique specimen vials has been widely adopted by urologists across sites of service. [Rev Urol. 2013;15(4):137-144 doi: 10.3909/riu0600] © 2014 MedReviews®, LLC

Prostate cancer Prostate biopsy Utilization trends National reference laboratory

Scott B SellingerView Articles

Volume 20, Number 2 LUGPA News

Member Census Shows LUGPA Practices Exhibit High Level of Innovation, Sophistication, and Growth

Neal D Shore Scott B Sellinger

Scott B ShappellView Articles

Volume 10, Number 1 Review Articles

Clinical Utility of Prostate Carcinoma Molecular Diagnostic Tests

Diagnostic Update

Scott B Shappell

Instead of relying on serum prostate-specific antigen (PSA) to identify patients for prostate biopsy, new laboratory tests are needed that have improved specificity for prostate carcinoma (CaP), allow accurate classification of clinically insignificant CaPs, allow for detection of clinically significant CaP in patients without elevated serum PSA, and allow for identification of aggressive forms of CaP, which may warrant adjunctive or even molecularly targeted therapy in the future. Over the last several years, highthroughput gene expression profiling and proteinomics have led to the identification of genes and proteins that are specifically overexpressed in CaP. Molecular diagnostic techniques readily translated to the clinical laboratory have been incorporated into the development of new tests based on these novel molecular alterations in CaP. Some of these tests already have well-documented clinical utility, such as in facilitating prostate biopsy decisions, and are routinely available. The current review focuses on the biological, clinical, and laboratory aspects of the most promising of these current and nearfuture molecular CaP tests. [Rev Urol. 2008;10(1):44-69]

Molecular diagnostics Prostate carcinoma Prostate cancer antigen 3 Alpha-methylacyl-CoA racemase Early prostate cancer antigen Transmembrane protease,serine 2 ERG DNA RNA

Scott E EggenerView Articles

Volume 4, Number 4 Reviews in Urology

Juxtaglomerular Apparatus Tumor: A Rare, Surgically Correctable Cause of Hypertension

Jonathan Rubenstein Steven C Campbell Sumant Chugh Scott E Eggener Michael R Pins Karol Rosner

Accelerated hypertension Juxtaglomerular apparatus tumor Hyperreninism

Scott EggenerView Articles

Volume 20, Number 2 Original Research

Effectiveness of Subcutaneously Administered Leuprolide Acetate to Achieve Low Nadir Testosterone in Prostate Cancer Patients

Scott Eggener Christopher M Pieczonka Jason Hafron Joseph Renzulli II Przemyslaw Twardowskim Deborah M Boldt-Houle Stuart Atkinson

Evidence suggests lower nadir testosterone levels during the first year of androgen deprivation therapy improve advanced prostate cancer clinical outcomes. We evaluated pivotal trials for subcutaneously administered leuprolide acetate (1-, 3-, 4-, and 6-month doses) to determine nadir testosterone levels. Pooled analysis showed 99%, 97%, and 91% of patients reached nadir testosterone ≤20, ≤10, and ≤5 ng/dL respectively (median ≤3 ng/dL). Across all available categories, ≥88% of patients reached nadir testosterone ≤5 ng/dL, and <3% experienced a microsurge. Achievement and maintenance of low nadir testosterone levels may improve progression-free survival and time to onset of castrate-resistant prostate cancer. [Rev Urol. 2018;20(2):63–68 doi: 10.3909/riu0798] © 2018 MedReviews®, LLC

Prostate cancer Androgen deprivation therapy LHRH agonists Leuprolide acetate Nadir testosterone

Scott HalperinView Articles

Volume 20, Number 2 Case Review

Clinical Relevance of Petit’s Triangle: A Forgotten Landmark

Scott Halperin Julian Spector David Penn Barry Zisholtz

This rare case details a right-sided hydronephrotic kidney herniated through Petit’s triangle. Petit’s triangle is an anatomical landmark that is usually not clinically significant and only alluded to during multiple-choice examinations. This case describes the clinical ramification of this area of weakness and allows us to revisit and relearn the anatomy, and its relevance in clinical practice. [Rev Urol. 2018;20(2):112–114 doi: 10.3909/riu0796] © 2018 MedReviews®, LLC

Hernia Petit’s triangle Hydronephrotic kidney

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