Publications by authors named "Tarek Ajami"
Purpose: In patients with prostate cancer (PCa), focal therapy with High-Intensity Focused Ultrasound (HIFU) combined with benign prostatic hyperplasia (BPH) surgery has been used to improve immediate post-operative voiding symptoms. Our study aimed to evaluate the functional outcomes of patients undergoing simultaneous holmium laser enucleation of the prostate (HoLEP) + HIFU and compare them to those who underwent HoLEP for bladder outlet obstruction secondary to BPH.
Methods: We performed retrospective review of patients who underwent HoLEP + HIFU or HoLEP between June 2017 and May 2024.
Objective: To assess the association of being overweight or obese with Nonmuscle invasive bladder cancer (NMIBC) recurrence, stage progression, and grade progression.
Methods: Patients with NMIBC were included and categorized into 3 groups based on their body mass index (BMI): normal weight, overweight, and obese. Recurrence was defined as any histologically proven bladder cancer on subsequent transurethral resection of bladder tumor (TURBT).
Background And Objective: Prostate cancer (PC) heterogeneity can result in sampling discrepancies during biopsy, leading to inaccurate molecular classifications that affect treatment decisions. We evaluated transcriptomic profile variability between multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy (TBx) and systematic biopsy (SBx) methods using the Decipher GRID platform.
Methods: The study included 205 men from the MAST trial.
Purpose: To examine prostate cancer (PCa) screening disparities among ethnic groups in the U.S. using the All of Us database.
View Article and Find Full Text PDFBackground And Objective: Focal therapy is increasingly being used as a treatment for localized prostate cancer (PC). Our aim was to evaluate oncological outcomes, recurrence patterns, and survival after high-intensity focused ultrasound (HIFU), to discuss the lessons learned from our experience, and to propose strategies to enhance patient selection for HIFU treatment.
Methods: Between 2016 and 2023, 113 patients underwent focal HIFU treatment for PC.
Article Synopsis
- In a study of 4011 patients who had unilateral cT1a-b renal mass treated with partial nephrectomy, researchers aimed to explore how a surgeon's experience affects surgical outcomes, specifically acute kidney injury (AKI) and kidney function a year post-surgery.
- Previously, it was known that complications and ischemia times improved with surgeon experience, but there was limited data on long-term kidney function.
- The findings revealed no significant association between surgical experience and AKI or recovery of kidney function in either laparoscopic or robot-assisted techniques, suggesting other factors may play a more crucial role in these outcomes.
Background: The need for increased clinical efficacy and efficiency has been the main force in developing artificial intelligence (AI) tools in medical imaging. The INCISIVE project is a European Union-funded initiative aiming to revolutionize cancer imaging methods using AI technology. It seeks to address limitations in imaging techniques by developing an AI-based toolbox that improves accuracy, specificity, sensitivity, interpretability, and cost-effectiveness.
View Article and Find Full Text PDFPurpose: The aim of the present study is to assess the role of indocyanine green (ICG) to evaluate distal ureteral vascularity during robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion and its impact on the incidence of benign ureteroenteric strictures (UES).
Methods: The study included patients who underwent RARC for bladder cancer between 2018 and 2023. All patients included underwent intracorporeal urinary diversion with ileal conduit or neobladder.
Objective: This study aims to investigate the impact of risk group classification, restaging transurethral resection (re-TURBT), and adjuvant treatment intensity on recurrence and progression risks in high-grade Ta tumours in patients with non-muscle invasive bladder cancer (NMIBC).
Materials And Methods: Data from a comprehensive bladder cancer database were utilized for this study. Patients with primary high-grade Ta tumours were included.
Article Synopsis
- - Penile squamous cell carcinoma (PSCC) is divided into two main types: HPV-associated and HPV-independent, with the prognosis being influenced by the status of the p53 protein, which is somewhat debated.
- - A study involving 122 PSCC patients explored the correlation between HPV and p53 status, categorizing tumors into three subtypes based on immunohistochemistry and HPV tests.
- - Results showed that patients with HPV-independent tumors and abnormal p53 patterns had significantly worse outcomes, with a higher rate of disease-related deaths compared to those with HPV-associated or HPV-independent/p53-normal tumors.
Article Synopsis
- The study investigates the clinical and radiologic characteristics that can predict clinically significant prostate cancer (csPCa) in men with PI-RADS 3 lesions identified via multiparametric MRI, addressing an unmet need for risk-adapted approaches in clinical practice.
- Data from 230 patients revealed that factors like PSA density (PSAd) and 4Kscore were significant predictors of csPCa, with PSAd showing the best performance in terms of prediction capability.
- The findings suggest that combining PSAd with clinical factors is more effective for risk stratification of csPCa in patients with PI-RADS 3 lesions, particularly highlighting the predictive strength of 4Kscore in those with low PSAd.
Article Synopsis
- Deterioration of kidney function can lead to higher mortality rates, and it's unclear how different surgical options (partial nephrectomy [PN] vs. radical nephrectomy [RN]) for large renal masses impact long-term kidney health.
- A study analyzing data from 23 institutions showed that patients undergoing PN experienced significantly lower rates of acute kidney injury (AKI) and better recovery of kidney function at one year compared to those undergoing RN.
- The findings suggest that avoiding RN, when possible, is beneficial for preserving kidney function and reducing the risk of serious complications related to kidney health after surgery.
Article Synopsis
- The study evaluates the combined effectiveness and safety of High-Intensity Focused Ultrasound (HIFU) and Holmium Laser Enucleation of the Prostate (HoLEP) for patients with localized prostate cancer (PCa) and large prostate sizes (> 60 g).
- It reviewed data from 100 patients treated between 2016 and 2023, comparing outcomes between those who underwent only HIFU and those who had the combined approach.
- Results showed that while the combined treatment led to better PSA results initially, both treatment groups had similar cancer recurrence rates, and although the combined treatment resulted in more initial urinary issues, long-term functionality appeared comparable between both treatments.
Objectives: The objectives of this study are to evaluate the impact of incidental prostate cancer (iPCa) and its different grade group (GG) on the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and, furthermore, to assess the independent risk factors associated with the detection of iPCa.
Patients Or Materials And Methods: A retrospective chart review was conducted at a single institution for HoLEP cases that were performed between 2017 and 2022. Patients with a preoperative diagnosis of prostate cancer and those without baseline prostate-specific antigen (PSA) levels within 1 year were excluded.
The transplant community is focused on prolonging the preservation time of kidney grafts to allow for long-distance kidney graft transportation, assess the viability of marginal grafts, and optimize a platform for the translation of innovative therapeutics to clinical practice, especially those focused on cell and vector delivery to organ conditioning and reprogramming. We describe the first case of feasible preservation of a kidney from a donor after uncontrolled circulatory death over a 73-h period using normothermic perfusion and analyze hemodynamic, biochemical, histological, and transcriptomic parameters for inflammation and kidney injury. The mean pressure and flow values were 71.
View Article and Find Full Text PDFBackground: Cancer poses significant challenges for healthcare professionals across the disease pathway including cancer imaging. This study constitutes part of the user requirement definition of INCISIVE EU project. The project has been designed to explore the full potential of artificial intelligence (AI)-based technologies in cancer imaging to streamline diagnosis and management.
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- AI technology is increasingly recognized for its potential to improve cancer care, leading to a study focused on healthcare professionals' (HCPs) views on AI's role in cancer treatment as part of the INCISIVE EU project.
- The study used mixed methods, including anonymous online surveys filling out responses from 95 HCPs and in-depth interviews with 27 HCPs from various European countries to gather insights on current practices and needs.
- While many HCPs reported issues like diagnostic delays and false positives in existing imaging methods, they generally agreed that implementing AI technology could enhance patient care but also highlighted a lack of familiarity with such tools, indicating a need for further training and education.
Article Synopsis
- The study aimed to evaluate the effectiveness of holmium laser enucleation of the prostate (HoLEP) across different prostate sizes, classified into three groups: small (≤40 g), medium (41-200 g), and large (>200 g).
- Results showed that HoLEP provides similar voiding outcomes for all size groups, but small prostates had worse symptom scores post-surgery, while very large prostates had higher blood transfusion rates.
- Overall, the findings indicate that HoLEP is a safe and effective treatment for various prostate sizes, although certain risks, like blood transfusions and acute urinary retention, vary by size.
p53 immunohistochemistry (IHC) has been proposed as a surrogate for mutations in penile squamous cell carcinomas (PSCC). We aimed to evaluate the performance of a pattern-based evaluation of p53 IHC in PSCC. Human papilloma virus (HPV) DNA testing, p16 and p53 IHC, and whole exome sequencing were performed in a series of 40 PSCC.
View Article and Find Full Text PDFCell-free DNA (cfDNA) has recently emerged as a real-time biomarker for diagnosis, monitoring and prediction of therapy response in tumoral disease. Here, we evaluated cfDNA as a prognostic biomarker for monitoring muscle-invasive bladder cancer (MIBC) patients at different follow-up time points. Blood samples from 37 MIBC patients who underwent radical cystectomy (RC) were collected at cystectomy and 1, 4, 12 and 24 months later.
View Article and Find Full Text PDFBackground: The view of prostate cancer (PCa) progression as a result of the interaction of epithelial cancer cells with the host's immune system is supported by the presence of tumor infiltrating lymphocytes (TILs). TILs fate and interaction with the tumor microenvironment is mediated by accessory molecules such as CD5 and CD6, two signal-transducing coreceptors involved in fine-tuning of T cell responses. While the nature of the CD5 ligand is still controversial, CD6 binds CD166/ALCAM, a cell adhesion molecule involved in progression and dissemination of epithelial cancers, including PCa.
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- The study focuses on HPV-independent penile squamous cell carcinomas (PSCCs) and their possible origins from an intraepithelial precursor known as differentiated penile intraepithelial neoplasia.
- Out of 55 surgical PSCC specimens from 2000 to 2021, 36 (65%) were found to be HPV-independent, with 26 of those containing a precursor lesion and 5 of them showing features similar to high-grade squamous intraepithelial lesions (HSIL) typically associated with HPV.
- The research highlights the importance of using p16 immunohistochemical staining to identify these unique lesions in PSCC, which are morphologically similar to HPV-associated HSIL, an aspect not previously detailed
Introduction: The transperitoneal laparoscopic approach is considered the gold standard technique for living kidney donation. Other accepted laparoscopic techniques include the retroperitoneal approach, natural orifice transluminal endoscopic surgery (NOTES)-assisted, laparo-endoscopic single-site surgery (LESS), with excellent results in the donor and graft. Many studies have compared these techniques with open ones.
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