Distance to Treatment With Radical Cystectomy in a Rural State: Long Car Rides, Equivalent Outcomes.

Introduction: Radical cystectomy is a complex surgery with better outcomes reported when performed at high-volume centers. This may lead to patients traveling farther for care. We examined the impact of travel distance on clinical outcomes.

Testicular Radiomics To Predict Pathology At Time of Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Tumor.

Introduction: Testicular germ cell tumors are the most common malignancy in young adult males. Patients with metastatic disease receive standard of care chemotherapy followed by retroperitoneal lymph node dissection for residual masses >1cm. However, there is a need for better preoperative tools to discern which patients will have persistent disease after chemotherapy given low rates of metastatic germ cell tumor after chemotherapy.

Refining the serum miR-371a-3p test for viable germ cell tumor detection.

Circulating miR-371a-3p has excellent performance in the detection of viable (non-teratoma) germ cell tumor (GCT) pre-orchiectomy; however, its ability to detect occult disease is understudied. To refine the serum miR-371a-3p assay in the minimal residual disease setting we compared performance of raw (Cq) and normalized (∆Cq, RQ) values from prior assays, and validated interlaboratory concordance by aliquot swapping. Revised assay performance was determined in a cohort of 32 patients suspected of occult retroperitoneal disease.

Impact of testicular cancer stage on semen parameters in patients before orchiectomy.

Objective: To study the impact of testicular cancer composite stage and histology with semen parameters in preorchiectomy cryopreservation samples.

Methods: We retrospectively collected semen parameter data, composite stage, and tumor histology for patients who cryopreserved sperm prior to orchiectomy for testicular cancer between 2006 and 2018. Stage I was considered localized disease, and Stages II and III were considered metastatic disease.

Outcomes of Patients with Bacillus Calmette-Guérin (BCG)-Unresponsive Non-Muscle Invasive Bladder Cancer as Defined by the U.S. Food and Drug Administration.

Background: Limited data are available on the outcomes of patients with non-muscle invasive bladder cancer (NMIBC) unresponsive to intravesical bacillus Calmette-Guérin (BCG), as defined by the United States Food and Drug Administration.

Objective: To define the outcomes of patients with BCG-unresponsive NMIBC.

Methods: This was a retrospective, single-institution observational cohort study.

Decreased Muscle Mass Prior to and Following Chemotherapy Predicts Morbidity in Testicular Cancer Patients Undergoing Post-Chemotherapy Retroperitoneal Lymph Node Dissection.

Introduction/background: The importance of nutritional status before oncologic surgery has been demonstrated in several solid malignancies. Testicular cancer primarily effects young men, and therefore clinicians may not consider sarcopenia as a factor in this population. We therefore sought to determine the impact of decreased muscle mass, measured by psoas muscle diameter, on outcomes in patients undergoing post-chemotherapy retroperitoneal lymphadenectomy (PC-RPLND) for metastatic germ cell tumors (mGCTs).

Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series.

Introduction: Radical cystectomy (RC) and radical nephroureterectomy (RNU) are commonly performed in urological oncology. Concurrent disease in the upper tract and bladder is rare, so performing both procedures in the same setting is uncommon. Here, we report the perioperative and oncological outcomes of a single-institution series of concurrent RC+RNU.

Routine Overnight Vital Signs Are Rarely Associated with Major Clinical Events in Patients Undergoing Radical Cystectomy: A Retrospective Cohort Study.

Introduction: Evidence has associated patient sleep disruption with adverse clinical outcomes. Overnight vital sign checks are a frequent source of patient sleep disruption. We sought to determine the utility of routine overnight vital sign checks in stable postoperative patients following radical cystectomy for bladder cancer.

The early impact of medicaid expansion on urologic malignancies in the United States.

Purpose: To assess the effects of variable adoption of Medicaid Expansion (ME) of the Affordable Care Act among different states on urologic malignancies using a new variable that defines ME status of patient's residence in a nationwide cancer registry.

Basic Procedures: The National Cancer Database was queried for urologic malignancies (bladder, prostate, kidney and testis) from 2011 to 2016, spanning the period surrounding the primary ME which took place in 2014. Trends in insurance status at time of diagnosis and effects on stage at presentation and survival after ME were evaluated using a difference-in-differences estimator and stratified Cox proportional hazards regression model.

Disparities in Pre-Orchiectomy Sperm Cryopreservation Among Testicular Cancer Patients at a Public Safety Net Hospital and a Private Tertiary Care Center.

Objective: To compare pre-orchiectomy sperm cryopreservation use in testicular cancer patients at a private tertiary care academic center and an affiliated public safety-net hospital.

Methods: This was a retrospective cohort study of patients who underwent radical orchiectomy for testicular cancer at a private tertiary-care hospital, which cared primarily for patients with private health insurance, and at a public "safety-net" facility, which cared for patients regardless of insurance status. Clinical and demographic predictors of cryopreservation use prior to orchiectomy were determined by chart review.

Metastasis-directed radiation therapy after radical cystectomy for bladder cancer.

Purpose: Metastasis-directed radiation therapy (MDRT) may improve oncologic and quality of life outcomes in patients with metastatic cancer, but data on its use in metastatic bladder cancer is severely limited. We sought to review our institutional experience with MDRT in patients with metastatic bladder cancer following radical cystectomy.

Materials And Methods: We reviewed records of patients who underwent radical cystectomy and subsequent MDRT at our institution between 2009 and 2020.

Demographic Factors Associated With Non-Guideline-Based Treatment of Kidney Cancer in the United States.

Importance: Significant demographic disparities have been found to exist in the delivery of health care. Demographic factors associated with clinical decision-making in kidney cancer have not been thoroughly studied.

Objective: To determine whether demographic factors, including sex and race/ethnicity, are associated with receipt of non-guideline-based treatment for kidney cancer.

Enhanced Endoscopy with IMAGE1 S CHROMA Improves Detection of Nonmuscle Invasive Bladder Cancer During Transurethral Resection.

We assessed the ability of enhanced cystoscopy with CHROMA image enhancement (Karl Storz SE & Co. KG, Tuttlingen, Germany) to improve cancer detection during transurethral resection of bladder tumors (TURBT) in patients with known or suspected nonmuscle invasive bladder cancer (NMIBC). A total of 49 patients (82% men) with a median age of 71 years underwent TURBT for known or suspected NMIBC.

TCF7L1 promotes skin tumorigenesis independently of β-catenin through induction of LCN2.

The transcription factor is an embryonic stem cell signature gene that is upregulated in multiple aggressive cancer types, but its role in skin tumorigenesis has not yet been defined. Here we document TCF7L1 upregulation in skin squamous cell carcinoma (SCC) and demonstrate that TCF7L1 overexpression increases tumor incidence, tumor multiplicity, and malignant progression in the chemically induced mouse model of skin SCC. Additionally, we show that downregulation of TCF7L1 and its paralogue TCF7L2 reduces tumor growth in a xenograft model of human skin SCC.

Tcf3 expression marks both stem and progenitor cells in multiple epithelia.

The Lef/Tcf-family transcription factor Tcf3 has important roles in development, stem cell function and malignancy. Previous gain- and loss-of-function studies have suggested that Tcf3 is a mediator of self-renewal and an undifferentiated state in stem and progenitor cells in skin, but little is known of its role in other postnatal tissues. Here, we explore the distribution and behavior of Tcf3-expressing cells in several adult tissues using a novel Tcf3-CreER knock-in mouse model.

Tcf3 promotes cell migration and wound repair through regulation of lipocalin 2.

Cell migration is an integral part of re-epithelialization during skin wound healing, a complex process involving molecular controls that are still largely unknown. Here we identify a novel role for Tcf3, an essential transcription factor regulating embryonic and adult skin stem cell functions, as a key effector of epidermal wound repair. We show that Tcf3 is upregulated in skin wounds and that Tcf3 overexpression accelerates keratinocyte migration and skin wound healing.

Foxp1 maintains hair follicle stem cell quiescence through regulation of Fgf18.

Hair follicles cyclically degenerate and regenerate throughout adult life and require regular stem cell activation to drive the cycle. In the resting phase of the hair cycle, hair follicle stem cells are maintained in a quiescent state until they receive signals to proliferate. We found that the forkhead transcription factor Foxp1 is crucial for maintaining the quiescence of hair follicle stem cells.

Ex vivo gene transfer for improved adoptive immunotherapy of cancer.

Adoptive immunotherapy is an appealing approach to cancer treatment, with the potential for more precise targeting and reduced toxicity. While early clinical trial data using adoptive T cells against post-transplant virus-associated hematologic malignancies, lymphoma and melanoma have been promising, treating other solid tumors has proven to be more challenging. Adoptive lymphocytes have been genetically modified in many ways to improve activity and circumvent tumor evasion, including transfer of transgenic T-cell receptors and chimeric antigen receptors to redirect T cell and natural killer cell antigen specificity.