Publications by authors named "Jared M Whitson"
Introduction: Multiple exfoliative urinary markers are available and commonly used in various clinical settings. However despite an abundance of primary data and reviews an evidence-based application in the detection and monitoring of bladder cancer is lacking. We provide a framework in which the clinician caring for patients at risk for and diagnosed with bladder cancer can easily understand and incorporate these tools into routine practice.
View Article and Find Full Text PDFObjective: To investigate variation in the International Prostate Symptom Score (IPSS) in men following prostate brachytherapy.
Methods: From January 2004 to November 2009, 524 consecutive patients underwent prostate brachytherapy either alone or in combination with external beam radiation therapy for T1c-T3b prostate cancer. The IPSS was assessed preimplant and at 1, 6, 12, 24, 36, and 48 months after treatment.
Purpose: NCCN Guidelines® recommend annual prostate biopsies for men with low risk prostate cancer on active surveillance. We determined whether erectile function decreases with the number of biopsies experienced.
Materials And Methods: During a median 3.
Objective: To determine, in a population-based cohort, if disease-specific survival (DSS) was equivalent in patients undergoing ablation vs nephron-sparing surgery (NSS) for clinical stage T1a renal cell carcinoma (RCC).
Patients And Methods: A retrospective cohort study was performed using patients from the Surveillance, Epidemiology and End Results cancer registry with RCC < 4 cm and no evidence of distant metastases, who underwent ablation or NSS. Kaplan-Meier and Cox regression analyses were performed to determine if treatment type was independently associated with DSS.
Unlabelled: What's known on the subject? and What does the study add? It is well documented that biopsy of small renal masses is inaccurate and tends to under-estimate tumour grade compared with surgical specimens. To our knowledge there has not been a study showing grading discrepancy between biopsy and surgical excision in a large population-based cohort.
Objective: To determine whether differences exist in tumour grade between patients who undergo partial nephrectomy (PN) and those who undergo ablation for renal tumours.
Unlabelled: What's known on the subject? and What does the study add? Treatment options for small renal masses include radical nephrectomy (RN), partial nephrectomy (PN), ablation, and surveillance. PN provides equivalent oncological as RN for small tumours, but long-term outcomes for ablation and surveillance are poorly defined. Due to changing techniques and technology, treatment patterns for small renal masses are rapidly developing.
View Article and Find Full Text PDFObjectives: The natural history of untreated renal cell carcinoma (RCC) with venous tumor thrombus (VTT) is poorly characterized. We aimed to describe the natural history of this disease, and to identify prognostic factors associated with disease-specific survival.
Materials And Methods: We identified patients in the Surveillance, Epidemiology, and End Results (SEER) database with untreated renal cell carcinoma and venous tumor thrombi.
Unlabelled: Study Type - Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The widespread use of serum PSA testing followed by TRUS-guided biopsy have resulted in profound prostate cancer stage migration with many patients presenting with focal rather than multifocal disease. There is increasing interest in the use of focal rather than whole-gland treatment. However, current biopsy schemes may still miss cancer or, even when cancer is identified, its extent or grade might not be accurately characterized.
View Article and Find Full Text PDFPurpose: In men with biochemical recurrence after radical prostatectomy, a rapid prostate specific antigen doubling time is associated with adverse outcomes, and is often used to guide the type and timing of salvage therapy. It is unknown whether prostate specific antigen doubling time calculated in the ultrasensitive range (prostate specific antigen less than 0.2 ng/ml) accurately reflects measures performed in the traditional range (prostate specific antigen greater than 0.
View Article and Find Full Text PDFPurpose: We described changes in tumor volume on serial biopsies during an extended period in men on active surveillance.
Materials And Methods: The study cohort included men diagnosed with prostate cancer between 1998 and 2010 enrolled in active surveillance with 6 or more months of followup. Change in volume over time was assessed as change in percent cores positive, percent cancer in 1 biopsy core and the doubling of total cancer volume (mm).
Objectives: To identify prognostic factors for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and determine the significance of thrombus level on survival.
Materials And Methods: Patients within the Surveillance, Epidemiology, and End Results (SEER) database with RCC and VTT were identified and included if managed surgically. The Kaplan-Meier method and Cox regression analyses were performed to identify factors associated with disease-specific survival.
Purpose: Active surveillance is now considered a viable treatment option for men with low-risk prostate cancer. However, little is known regarding changes in Gleason grade on serial biopsies over an extended period of time.
Patients And Methods: Men diagnosed with prostate cancer between 1998 and 2009 who elected active surveillance as initial treatment, with 6 or more months of follow-up and a minimum of six cores at biopsy, were included in analysis.
Objective: To determine the factors associated with downgrading between biopsy and prostatectomy in the contemporary era using extended-template biopsy techniques.
Materials And Methods: The UCSF Urologic Oncology Database was used to identify subjects diagnosed with high grade prostate cancer (primary pattern 4 or 5) in at least one core on extended-pattern biopsy. Multivariable logistic regression analysis was performed to identify independent factors associated with downgrading at radical prostatectomy, defined as a change from primary pattern 4 or 5 to primary pattern 3.
Purpose: In a population based cohort we determined whether an increase in the number of lymph nodes removed is associated with improved disease specific survival of patients with renal cell carcinoma treated with nephrectomy.
Materials And Methods: Patients in the Surveillance, Epidemiology and End Results database with renal cell carcinoma and no evidence of distant metastases were identified. Those patients included in the study underwent radical or partial nephrectomy with lymphadenectomy.
Purpose: We assessed whether an association exists between a change in prostate specific antigen and biopsy progression in men on active surveillance.
Materials And Methods: A cohort of patients undergoing active surveillance for prostate cancer was identified from the urological oncology database at our institution. Multivariate logistic regression was performed to determine whether prostate specific antigen velocity, defined as the change in ln(prostate specific antigen) per year, is associated with biopsy progression, defined as a Gleason upgrade or volume progression on repeat biopsy within 24 months of diagnosis.
Objective: To report oncological and functional results in women undergoing radical cystectomy and orthotopic bladder replacement.
Materials And Methods: The charts of all women undergoing bladder replacement after radical cystectomy at UCSF through April 2008 were reviewed. Pathologic characteristics, survival (overall and disease-specific), and urinary functional outcomes are reported.