Publications by authors named "Shahrokh F Shariat"
Objectives: To examine critical care therapy rates after cytoreductive nephrectomy in metastatic kidney cancer patients.
Design, Setting, And Patients: Relying on the National Inpatient Sample (2000-2019), we addressed critical care therapy use (total parenteral nutrition, invasive mechanical ventilation, renal replacement therapy, percutaneous endoscopic gastrostomy tube insertion, and tracheostomy) and in-hospital mortality in surgically treated metastatic kidney cancer patients. Estimated annual percentage changes and multivariable logistic regression models were fitted.
Urachal cancer (UrC) is a rare disease which is mostly diagnosed late due to symptoms caused by its local invasion to the urinary bladder. Given the lack of clinical trials and guideline recommendations for systemic treatment, a molecularly informed precision oncology approach is a viable option for UrC already in the early lines of systemic treatment. While single case experiences may provide valuable reference for later decision-making, well-documented clinical experience with off-label targeted treatments is limited to a few patients.
View Article and Find Full Text PDFTo test for rates of inpatient palliative care (IPC) in metastatic testicular cancer patients receiving critical care therapy (CCT). Within the Nationwide Inpatient Sample (NIS) database (2008-2019), we tabulated IPC rates in metastatic testicular cancer patients receiving CCT, namely invasive mechanical ventilation (IMV), percutaneous endoscopic gastrostomy tube (PEG), dialysis for acute kidney failure (AKF), total parenteral nutrition (TPN) or tracheostomy. Univariable and multivariable logistic regression models addressing IPC were fitted.
View Article and Find Full Text PDFPurpose Of Review: Men face distinctive health-related challenges as a result of biological, behavioral, and sociocultural factors. In addition, the modern healthcare system does not offer men equal opportunities and options to ensure sex-specific access and delivery to health services. Men's health concerns are, indeed, often not addressed or even forgotten.
View Article and Find Full Text PDFSurvival differences in rare histological prostate cancer (PCa) subtypes relative to age-matched population-based controls are unknown. Within Surveillance, Epidemiology, and End Results database (2004-2020), newly diagnosed (2004-2015) PCa patients were identified. Relying on the Social Security Administration Life Tables (2004-2020) with 5 years of follow-up, age-matched population-based controls (Monte Carlo simulation) were simulated for each patient.
View Article and Find Full Text PDFArticle Synopsis
- Bladder cancer (BCa) presents a significant financial challenge for both healthcare systems and patients, necessitating an understanding of its economic impacts for better resource management and treatment effectiveness.
- A systematic review was performed following PRISMA guidelines to assess the financial implications of BCa, including various costs, cost effectiveness, and the phenomenon of financial toxicity (FT) across multiple studies.
- High-risk non-muscle-invasive BCa can lead to expenses over $200,000 within five years, while metastatic BCa presents the most financial strain, with treatment costs ranging wildly and disproportionately affecting younger, less-educated, and minority groups.
Current epidemiological indicators reflect the prevalence of prostate-specific antigen (PSA) testing rather than the actual incidence of clinically significant prostate cancer. These indicators are also biased because of the variability of the PSA test. We therefore need to adopt new reliable criteria in causal epidemiological studies and screening programs.
View Article and Find Full Text PDFBackground And Objective: The role of genetic variants in response to systemic therapy in muscle-invasive bladder cancer (MIBC) is still elusive. We assessed variations in genes involved in DNA damage repair (DDR) before and after cisplatin-based neoadjuvant chemotherapy (NAC) and correlation of alteration patterns with DNA damage and response to therapy.
Methods: Matched tissue from 46 patients with MIBC was investigated via Ion Torrent-based next-generation sequencing using a self-designed panel of 30 DDR genes.
Background: Immune checkpoint inhibitors (ICIs) are an important therapeutic pillar in metastatic urothelial carcinoma (mUC). The occurrence of immune-related adverse events (irAEs) appears to be associated with improved outcomes in observational studies. However, these associations are likely affected by immortal time bias and do not represent causal effects.
View Article and Find Full Text PDFBackground: Electronic patient-reported outcomes (ePROs) have been shown to enhance healthcare quality by improving patient symptom management or quality of life (QoL). However, ePROs data for urothelial cancer (UC) patients receiving systemic therapies are scarce, and the application of ePROs in this patient cohort may need specific setups. This study tested the feasibility of ePROs for UC patients receiving systemic therapies in the outpatient clinic of a tertiary care center.
View Article and Find Full Text PDFArticle Synopsis
- Enfortumab vedotin (EV) is a new treatment option for patients with advanced urothelial carcinoma who haven't responded to other therapies.
- A study involving 128 patients in Austria showed an objective response rate of 31%, with median progression-free survival of 4.8 months and overall survival of 10.75 months.
- The treatment was found to be feasible and effective, with an acceptable safety profile, although lower efficacy was noted compared to earlier trials, likely due to the patient population being in later therapy lines.
Objectives: It is not known whether cancer-specific mortality (CSM) differences distinguish radical cystectomy (RC) from trimodal therapy (TMT) in octogenarians harbouring organ-confined (T2N0M0) urothelial cancer of the urinary bladder (UCUB).
Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2021), CSM and other-cause mortality (OCM) rates were computed in octogenarian patients with organ-confined UCUB undergoing either TMT or RC. Smoothed cumulative incidence plots depicted 5-year CSM and OCM rates according to RC vs TMT.
Article Synopsis
- Radical prostatectomy (RP) is a standard treatment for localized prostate cancer, but accurately detecting extraprostatic extension (EPE) before surgery is difficult, which can lead to suboptimal treatments.
- This study explores using explainable machine learning to improve EPE detection by analyzing data from newly diagnosed prostate cancer patients who underwent PET/MRI imaging and subsequent surgery.
- The results showed machine learning models outperformed traditional imaging methods in predicting EPE, which could lead to better clinical decision-making and improved patient outcomes.
Purpose: Temporal trends in and predictors of inpatient palliative care use in patients with metastatic renal cell carcinoma (mRCC) undergoing critical care therapy are unknown.
Methods: Relying on the National Inpatient Sample (2008-2019), we identified mRCC patients undergoing critical care therapy, namely invasive mechanical ventilation, percutaneous endoscopic gastrostomy tube insertion, dialysis for acute kidney failure, total parenteral nutrition, or tracheostomy. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models addressed inpatient palliative care use.
Objective: This study aimed to compare adverse in-hospital outcomes in ileal conduit versus neobladder urinary diversion type after radical cystectomy (RC) in contemporary versus historical patients.
Methods: Patients were identified within the National Inpatient Sample (NIS 2000-2019). Propensity score matching (PSM; 1:2 ratio) and multivariable logistic regression models (LRMs) were used.
Background: Perioperative complication rates and in-hospital mortality after radical nephroureterectomy (RNU) in patients with a history of heart valve replacement are unknown.
Methods: Within the National Inpatient Sample (2000-2019), we identified non-metastatic upper urinary tract carcinoma patients treated with RNU according to the presence or absence of a history of heart valve replacement. Propensity score matching (1:10 ratio) and multivariable logistic regression as well as Poisson regression models were used.
Background And Objective: Radical cystectomy (RC) is the standard treatment for muscle-invasive bladder cancer (MIBC). It is highly invasive and associated with perioperative risks, while bladder-preserving trimodality therapy (TMT) offers a less invasive alternative with preferable quality of life for selected patients. We aimed to compare oncological outcomes of TMT and RC in MIBC patients, and evaluate TMT-specific outcomes.
View Article and Find Full Text PDFBackground: Androgen-receptor signaling inhibitors (ARSIs) significantly improve survival in systemic therapy for advanced/metastatic prostate cancer (PCa) patients; however possible central nervous system (CNS) toxicity is an unaddressed concern. We aimed to assess and compare the incidence of CNS-related adverse events (AEs) secondary to the treatment of PCa patients with different ARSIs.
Materials: In August 2023, a comprehensive seach was conducted in three databases for randomized controlled trials (RCTs) of PCa patients receiving ARSIs plus ADT.
The Impact of Concomitant Medications on the Overall Survival of Patients Treated with Systemic Therapy for Advanced or Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-analysis.
Clin Genitourin Cancer
December 2024
Article Synopsis
- Immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) are standard treatments for advanced renal cell carcinoma, but the impact of other medications taken alongside these treatments is uncertain.
- A review of 22 studies involving over 16,000 patients found that certain concomitant medications like proton pump inhibitors and antibiotics negatively affect overall survival when taken with ICIs, while statins, renin-angiotensin system inhibitors, and beta-blockers improve survival when combined with TKIs.
- Clinicians should evaluate patients' baseline medications before starting systemic therapy for metastatic RCC, as some drugs can either reduce or enhance the effectiveness of cancer treatments.
Background: The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN).
Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2004-2020), we identified mRCC patients who underwent either pTA, NLT or CN.