Samir Taneja, M.D.

Focal therapy for prostate cancer - where are we in 2011?
Borofsky, Michael S; Ito, Timothy; Rosenkrantz, Andrew B; Taneja, Samir S
2011 Aug;3(4):183-192, Therapeutic advances in urology
Prostate cancer treatment is a controversial topic amongst physicians and patients alike. Radical therapies such as prostatectomy and whole gland radiation offer the best outcomes in terms of oncologic efficacy, but the decision to undergo treatment must be weighed against its potential morbidity. Over the past decade, the concept of focal therapy for prostate cancer has been introduced as a potential method of achieving oncologic control with a lesser degree of morbidity. Focal therapy refers to isolated ablation of a tumor focus with sparing of uninvolved, surrounding tissue. While it remains in the early stages of development, considerable research is underway that will help determine the optimal method of achieving this goal. Current areas of investigation include appropriate candidate selection, lesion identification, modality of treatment, and follow-up strategies
— id: 138116, year: 2011, vol: 3, page: 183, stat: Journal Article,

MRI appearance of massive renal replacement lipomatosis in the absence of renal calculus disease
Fitzgerald, E; Melamed, J; Taneja, S S; Rosenkrantz, A B
2011 Feb;84(998):e41-e44, British journal of radiology
Renal replacement lipomatosis is a rare benign entity in which extensive fibrofatty proliferation of the renal sinus is associated with marked renal atrophy. In this report, we present a case of massive renal replacement lipomatosis demonstrated on MRI. The presentation was atypical given an absence of associated renal calculus disease, and an initial CT scan was interpreted as suspicious for a liposarcoma. The differential diagnosis and key MRI findings that served to establish this specific diagnosis are reviewed. Histopathological correlation is also presented, as the patient underwent nephroureterectomy
— id: 121307, year: 2011, vol: 84, page: e41, stat: Journal Article,

Long-term follow-up of men with isolated high-grade prostatic intra-epithelial neoplasia followed by serial delayed interval biopsy
Godoy, Guilherme; Huang, George J; Patel, Trushar; Taneja, Samir S
2011 Mar;77(3):669-674, Urology
OBJECTIVES: To analyze the outcomes of serial delayed interval biopsy (DIBx) in men with isolated high-grade prostatic intraepithelial neoplasia (HGPIN). The natural history of isolated HGPIN is poorly defined. Since January 2000, we have monitored men with isolated HGPIN using DIBx every 3 years, regardless of the change in prostate-specific antigen (PSA) level. METHODS: The institutional biopsy records from 1996 onward were reviewed to identify the men with isolated HGPIN found on 12-core needle biopsy specimens who had undergone a minimum of 1 DIBx in our follow-up strategy. Patient age, biopsy and prostatectomy pathologic outcomes, and longitudinal PSA measurements were recorded. RESULTS: A total of 112 men had undergone a first DIBx and 47 had undergone a second DIBx at the last follow-up examination at a mean of 34.4 and 66.2 months after the HGPIN diagnosis, respectively. Prostate cancer was found in 25 (22.3%) of 112 men and 11 (23.4%) of 47 men at DIBx-1 and DIBx-2, respectively. The PSA velocity was not predictive of cancer during short-term follow-up. Of the men diagnosed with cancer, 63.6% had a Gleason score of >/=7, and 9 (81.8%) of 11 men had clinically significant disease (Gleason score of >/=7 and/or >5% cancer volume) at surgery. All cancers were organ confined at and surgery. CONCLUSIONS: Men with isolated HGPIN have a continued risk of developing prostate cancer during long-term follow-up, regardless of the changes in the serum PSA level. Collectively, the relatively high likelihood of organ confinement and clinically significant cancer suggest empiric DIBx every 2-3 years could be a valuable tool in the follow-up of men with isolated HGPIN found by extended core biopsy
— id: 130900, year: 2011, vol: 77, page: 669, stat: Journal Article,

Impact of race on survival in patients with clinically nonmetastatic prostate cancer who deferred primary treatment
Koscuiszka M; Hatcher D; Christos PJ; Rose AE; Greenwald HS; Chiu YL; Taneja SS; Mazumdar M; Lee P; Osman I
2011 Oct 21;:?-?, Cancer
BACKGROUND: Prostate cancer (PCa) racial disparity studies typically focus on survival differences after curative treatment. The authors of this report hypothesized that comparing mortality rates between African American (AA) and Caucasian American (CA) patients who deferred primary treatment for clinically nonmetastatic PCa may provide a better assessment of the impact of race on the natural course of PCa. METHODS: The pathology database of the New York Veterans Administration Medical Center (VAMC), an equal access-of-care facility, was searched for patients with biopsy-proven PCa. Inclusion criteria included 1) no evidence of metastatic disease or death within 3 years after diagnosis, 2) no primary treatment, and 3) a minimum of 5 years of follow-up for survivors. RESULTS: In total, 518 patients met inclusion criteria between 1990 and 2005. AA patients were younger (P = .02) and had higher median prostate-specific antigen (PSA) levels (P = .001) at the time of diagnosis compared with CA patients. In a multivariate model, higher Gleason score and PSA level were associated with increased mortality (P = .001 and P = .03, respectively), but race was not a predictor of death from PCa. CONCLUSIONS: The current data suggested that race did not have a major impact on survival in patients with PCa who deferred primary treatment for clinically nonmetastatic disease. Cancer 2011. (c) 2011 American Cancer Society
— id: 139502, year: 2011, vol: , page: ?, stat: Journal Article,

Clinical evaluation of a novel method for the measurement of prostate-specific antigen, AccuPSA(TM) , as a predictor of 5-year biochemical recurrence-free survival after radical prostatectomy: results of a pilot study
Lepor H; Cheli CD; Thiel RP; Taneja SS; Laze J; Chan DW; Sokoll LJ; Mangold L; Partin AW
2011 Oct 12;:?-?, BJU international
Study Type - Diagnostic (validating cohort) Level of Evidence 1b What's known on the subject? and What does the study add? Nadir Ultrasensitive PSA levels has some value for predicting BCR following RD. AccuPSA assays lower limit of PSA quantification of <0.01 pg/ml greatly enhances sensitivity and specificity of nadir PSA to predict BCR following RP. Our pilot study shows an AccuPSA of 3 pg/ml has a sensitory and specificity of 100% and 75% respectively for predicting 5 year BCR following RP. OBJECTIVES * To conduct a proof of concept study to evaluate a novel digital single molecule immunoassay (AccuPSA(TM) ) that detects prostate-specific antigen (PSA) a thousandfold more sensitively than current PSA detection methods. * To determine the ability of the AccuPSA(TM) assay to predict 5-year biochemical recurrence (BCR)-free survival after radical prostatectomy (RP). PATIENTS AND METHODS * A total of 31 frozen serum specimens were obtained from specimen logs maintained at New York University Langone Medical Center and the Johns Hopkins University School of Medicine on men who had undergone RP. Those men without evidence of BCR had a minimum of 5 years' PSA follow-up. * In all cases, preoperative and pathological information were available, as was a serum specimen 3-6 months after RP, with a PSA level of <0.1 ng/mL measured by conventional PSA methods at the time of serum collection. * Specimens were tested using the AccuPSA(TM) method. * A Cox proportional hazard model and Kaplan-Meier analysis were used to determine whether AccuPSA(TM) predicted the risk of BCR. RESULTS * Overall, 11/31 (35.5%) men developed BCR. * Mean AccuPSA(TM) nadir levels were significantly different (P < 0.001) between the non-BCR group (2.27 pg/mL) and the BCR group (46.99 pg/mL). * Using a multivariate Cox proportional hazard model, AccuPSA(TM) nadir level was a significant predictor of BCR-free survival (P < 0.01). * Kaplan-Meier analysis of up to 5 years follow-up showed that 100% of men with AccuPSA(TM) nadir values <3 pg/mL did not develop BCR, whereas 62.5% of men with values >3 pg/mL developed BCR (P= 0.00024). * The sensitivity, specificity, positive predictive value and negative predictive value of the AccuPSA(TM) method was 100%, 75%, 69% and 100%, respectively. CONCLUSIONS * AccuPSA(TM) assay predicts 5-year BCR- free survival after RP. * Identifying a reliable predictor of BCR soon after RP has important implications for frequency of PSA testing, selection of candidates for adjuvant therapy, and reassuring a large subset of men that they are not at risk of recurrence. * Larger studies are needed to validate these findings
— id: 139935, year: 2011, vol: , page: ?, stat: Journal Article,

Squamous cell carcinoma of the prostate
Malik, Rena D; Dakwar, George; Hardee, Matthew E; Sanfilippo, Nicholas J; Rosenkrantz, Andrew B; Taneja, Samir S
2011 ;13(1):56-60, Reviews in urology
Squamous cell carcinoma of the prostate is a rare tumor, making up 0.5% to 1% of all prostate carcinomas. It is typically described as an aggressive cancer, with a median postdiagnosis survival of 14 months. Presented here is a case of primary squamous cell carcinoma of the prostate, with a complicated presentation of metastatic disease. Due to the extent of the patient's disease, he was treated with palliative radiation therapy using a four-field technique (AP/PA and left and right lateral fields) with 18 mV photons prescribed to the 100% isodose line. The prescription dose was 4000 cGy in 16 fractions of 250 cGy per fraction. No definitive treatment of squamous cell carcinoma of the prostate exists but varying approaches including surgical intervention, chemotherapy, and radiation therapy have been implemented without durable response. However, multimodal treatments appear to be the most promising with longer durations of survival
— id: 139936, year: 2011, vol: 13, page: 56, stat: Journal Article,

Prostate cancer: comparison of tumor visibility on trace diffusion-weighted images and the apparent diffusion coefficient map
Rosenkrantz, Andrew B; Kong, Xiangtian; Niver, Benjamin E; Berkman, Douglas S; Melamed, Jonathan; Babb, James S; Taneja, Samir S
2011 Jan;196(1):123-129, American journal of roentgenology
OBJECTIVE: The purpose of our study was to compare the visibility of prostate cancer on trace diffusion-weighted (DW) images and the apparent diffusion coefficient (ADC) map. MATERIALS AND METHODS: In this retrospective study, 45 patients with prostate cancer underwent preoperative MRI, including DW imaging (DWI) (b values 0, 500, and 1,000 s/mm(2)). A single observer reviewed the images in conjunction with tumor maps constructed from prostatectomy. For 132 peripheral zone (PZ) tumor foci, the visibility and contrast relative to benign PZ were recorded for T2-weighted imaging, trace DWI b500 images, trace DWI b1,000 images, and ADC maps. Trace DWI b1,000 images and ADC maps were compared in terms of Gleason score, size, normalized T2 signal intensity, ADC, and normalized ADC of visible tumors. RESULTS: For each image set, the percentage of visible tumor foci and contrast relative to benign PZ were as follows: T2-weighted imaging, 80.3% and 0.411; trace DWI b500, 26.5% and 0.131; trace DWI b1,000, 46.2% and 0.119; and ADC maps, 62.1% and 0.309. Forty-seven tumor foci were visible on both trace DWI b1,000 images and ADC maps, 14 only on trace DWI b1,000 images, 35 only on ADC maps, and 36 on neither image set. There was no significant difference in Gleason score, size, normalized T2 signal intensity, ADC, or normalized ADC between tumors visible only on trace DWI b1,000 images and those visible only on ADC maps. CONCLUSION: Given a greater proportion of tumors visible on the ADC map than trace DWI and greater contrast relative to benign PZ on the ADC map, we suggest that, when performing DWI of the prostate, careful attention be given to the ADC map for tumor identification
— id: 116225, year: 2011, vol: 196, page: 123, stat: Journal Article,

Prostate cancer: Utility of fusion of T2-weighted and high b-value diffusion-weighted images for peripheral zone tumor detection and localization
Rosenkrantz, Andrew B; Mannelli, Lorenzo; Kong, Xiangtian; Niver, Ben E; Berkman, Douglas S; Babb, James S; Melamed, Jonathan; Taneja, Samir S
2011 Jul;34(1):95-100, Journal of magnetic resonance imaging
PURPOSE: To retrospectively assess the utility of fusion of T2-weighted images (T2WI) and high b-value diffusion-weighted images (DWI) for prostate cancer detection and localization. MATERIALS AND METHODS: In this IRB-approved HIPAA-compliant study, 42 patients with prostate cancer underwent MRI including multiplanar T2WI and axial DWI before prostatectomy. Two independent radiologists first assessed multiplanar T2WI and axial DWI(b-1000) images and recorded whether tumor was present in each sextant. Axial T2WI was then fused with axial DWI(b-1000) images, and the radiologists re-evaluated each sextant for tumor. Accuracy was compared using generalized estimating equations based on a binary logistic regression model. RESULTS: The accuracy, sensitivity, specificity, PPV, and NPV for tumor detection on a sextant-basis using separate and fused image sets was 65.1%, 50.8%, 78.0%, 67.8%, and 63.6% and 71.0%, 60.8%, 80.3%, 73.7%, and 69.3%, respectively, for reader 1, and 54.0%, 42.5%, 64.4%, 52.0%, and 55.2%, and 61.1%, 56.7%, 65.2%, 59.6%, and 62.3%, respectively, for reader 2. The improvements in accuracy, sensitivity, and NPV using fused images were statistically significant for both readers, as was the improvement in PPV for reader 2 (P ranging from <0.0001 to 0.041). With either separate or fused images, there was greater sensitivity for tumors of higher grade or larger size (P ranging from <0.001 to 0.099). CONCLUSION: Fusion of T2WI and high b-value DWI resulted in significant improvements in sensitivity and accuracy for tumor detection on a sextant-basis, with similar specificity. J. Magn. Reson. Imaging 2011;. (c) 2011 Wiley-Liss, Inc
— id: 134472, year: 2011, vol: 34, page: 95, stat: Journal Article,

Role of MRI in minimally invasive focal ablative therapy for prostate cancer
Rosenkrantz, Andrew B; Scionti, Stephen M; Mendrinos, Savvas; Taneja, Samir S
2011 Jul;197(1):W90-W96, American journal of roentgenology
OBJECTIVE: The purpose of this article is to review the roles that MRI is expected to play in emerging minimally invasive focal ablative therapies for prostate cancer. CONCLUSION: MRI, in combination with biopsy, will impact patient selection for focal ablation by helping to localize clinically significant tumor foci. Also, some ablation procedures may be performed using real-time MRI guidance. In addition, MRI may be used for assessment of extent of necrosis shortly after therapy and for long-term surveillance for recurrent tumor
— id: 134729, year: 2011, vol: 197, page: W90, stat: Journal Article,

Re: "zero ischemia" partial nephrectomy: novel laparoscopic and robotic technique
Taneja, Samir S
2011 Nov;186(5):1803-1804, Journal of urology
— id: 139934, year: 2011, vol: 186, page: 1803, stat: Journal Article,

Re: delayed haemorrhage after laparoscopic partial nephrectomy: frequency and angiographic findings
Taneja, Samir S
2011 Nov;186(5):1804-1805, Journal of urology
— id: 139933, year: 2011, vol: 186, page: 1804, stat: Journal Article,

Re: How Often are Patients With Diabetes or Hypertension Being Treated With Partial Nephrectomy for Renal Cell Carcinoma? A Population-Based Analysis
Taneja, Samir S
2011 Nov;186(5):1805-1805, Journal of urology
— id: 139931, year: 2011, vol: 186, page: 1805, stat: Journal Article,

Re: objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy
Taneja, Samir S
2011 Nov;186(5):1805-1806, Journal of urology
— id: 139932, year: 2011, vol: 186, page: 1805, stat: Journal Article,

Laparoscopic partial nephrectomy: technique and outcomes
Berkman, Douglas S; Taneja, Samir S
2010 Feb;11(1):1-7, Current urology reports
Laparoscopic partial nephrectomy (LPN) was first described in 1992. Its increased use in recent years is a product of overall trends in surgery to minimize operative morbidity, as well as the downward stage migration of renal tumors detected incidentally through widespread medical imaging. Today the indications for LPN have expanded to include larger and higher stage tumors. This review focuses on techniques that will be helpful to the practicing urologist and examines the most up-to-date reports regarding the oncologic and functional outcomes in LPN. Alternative approaches and emerging techniques are also discussed
— id: 109530, year: 2010, vol: 11, page: 1, stat: Journal Article,

Focal therapy in urologic oncology: maximizing organ function and oncologic disease control
Cadeddu, Jeffrey A; Taneja, Samir S
2010 Oct;28(5):549-550, World of urology
— id: 139937, year: 2010, vol: 28, page: 549, stat: Journal Article,

Focal therapy in prostate cancer-report from a consensus panel
de la Rosette, J; Ahmed, H; Barentsz, J; Johansen, T Bjerklund; Brausi, M; Emberton, M; Frauscher, F; Greene, D; Harisinghani, M; Haustermans, K; Heidenreich, A; Kovacs, G; Mason, M; Montironi, R; Mouraviev, V; de Reijke, T; Taneja, S; Thuroff, S; Tombal, B; Trachtenberg, J; Wijkstra, H; Polascik, T
2010 May;24(5):775-780, Journal of endourology
PURPOSE: To establish a consensus in relation to case selection, conduct of therapy, and outcomes that are associated with focal therapy for men with localized prostate cancer. MATERIAL AND METHODS: Urologic surgeons, radiation oncologists, radiologists, and histopathologists from North America and Europe participated in a consensus workshop on focal therapy for prostate cancer. The consensus process was face to face within a structured meeting, in which pertinent clinical issues were raised, discussed, and agreement sought. Where no agreement was possible, this was acknowledged, and the nature of the disagreement noted. RESULTS: Candidates for focal treatment should have unilateral low- to intermediate-risk disease with clinical stage <or=cT(2a). Prostate size and both tumor volume and tumor topography are important case selection criteria that depend on the ablative technology used. Currently, the best method to ascertain the key characteristics for men who are considering focal therapy is exposure to transperineal template mapping biopsies. MRI of the prostate using novel techniques such as dynamic contrast enhancement and diffusion weighed imaging are increasingly being used to diagnose and stage primary prostate cancer with excellent results. For general use, however, these new techniques require validation in prospective clinical trials. Until such are performed, MRI will, in most centers, continue to be an investigative tool in assessing eligibility of patients for focal therapy. CONCLUSIONS: Consensus was derived for most of the key aspects of case selection, conduct of treatment, and outcome measures for men who are undergoing focal therapy for localized prostate cancer. The level of agreement achieved will pave the way for future collaborative trials
— id: 134349, year: 2010, vol: 24, page: 775, stat: Journal Article,

Prostate-specific antigen testing and prostate cancer screening
Djavan, Bob; Eckersberger, Elisabeth; Finkelstein, Julia; Sadri, Helen; Taneja, Samir S; Lepor, Herbert
2010 Sep;37(3):441-59, vii, Primary care
Prostate specific antigen (PSA) screening is an integral part of current screening for prostate cancer. Together with digital rectal examinations, it is recommended annually by the American Cancer Society. PSA screening has resulted in a significant stage migration in the past decades. Different forms of PSA, including free PSA, volume adjusted, complexed, intact, or pro-PSA, are being used in the screening process. Other aspects of the screening process include age at diagnosis, survival, overdiagnosis, and overtreatment. Recent studies have cast doubt on whether PSA screening positively affects mortality and how the quality of life of patients may be affected by screening. Future considerations include the need for more longitudinal studies as well as further study of the PSA components that may become more relevant in the future
— id: 111969, year: 2010, vol: 37, page: 441, stat: Journal Article,

Open Versus Laparoscopic Versus Robot-Assisted Laparoscopic Prostatectomy: The European and US Experience
Finkelstein, Julia; Eckersberger, Elisabeth; Sadri, Helen; Taneja, Samir S; Lepor, Herbert; Djavan, Bob
2010 Winter;12(1):35-43, Reviews in urology
Open radical prostatectomy (ORP) is the reference standard for the surgical management of localized prostate cancer. With wider availability of minimally invasive radical prostatectomy techniques, there is a debate regarding the standard treatment of the management of localized prostate cancer. Therefore, we reviewed the current status of laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALRP) as compared with ORP. Because no prospective, randomized trials comparing the different techniques have been performed, outcomes must be assessed from published series by centers that focus on ORP, LRP, and RALRP. Aside from reducing the amount of blood loss, current data suggest that the most significant outcomes (cure, continence, and potency) are no better with LRP or RALRP than with conventional ORP. Therefore, in experienced hands, ORP remains the gold standard procedure. However, there is a trend toward consistently better outcomes following RALRP in comparison with LRP. In the end, individual patient outcomes can be maximized by choosing the best modality based on the patient's comorbid medical conditions, cancer characteristics, and surgeon experience. Future studies are needed to further investigate long-term cancer control as well as functional outcomes for RALRP series
— id: 109532, year: 2010, vol: 12, page: 35, stat: Journal Article,

Laparoscopic and open partial nephrectomy: frequency and long-term follow-up of postoperative collections
Hecht, Elizabeth M; Bennett, Genevieve L; Brown, Kevin W; Robbins, David; Hyams, Elias S; Taneja, Samir S; Stifelman, Michael A
2010 May;255(2):476-484, Radiology
PURPOSE: To compare imaging findings between laproscopic and open partial nephrectomy at 6 months after surgery and to follow the evolution of the findings over time. MATERIALS AND METHODS: This HIPAA-compliant retrospective study had institutional review board approval and consent was waived. A surgical database was cross-referenced with an imaging database to identify patients who underwent partial nephrectomy and computed tomographic and/or magnetic resonance imaging within 6 months of surgery. Fifty-eight patients (mean age, 61 years; range, 34-78 years; 21 women, 37 men) underwent 62 partial nephrectomies (laparoscopic, 31; open, 31) to remove 68 masses. Two radiologists in consensus reviewed images obtained between 10 days and 72 months (mean, 28 months) after surgery. Preoperative mass size and location and postoperative kidney orientation, fat stranding, parenchymal defect, collection (including size, location, and appearance), and other complications were recorded. Relative incidence of postoperative imaging findings, demographics, and initial imaging findings of both groups were statistically assessed by using Student t and chi(2) tests corrected for multiple comparisons. RESULTS: Common imaging findings following surgery included kidney displacement (48% [30 of 62]), perinephric fat stranding (93% [63 of 68]), parenchymal defect (74% [50 of 68]), and a non-fat-containing postoperative collection 75%, with significantly more posterior renal displacement (P < .01) and a trend toward more persistent fat stranding in the open surgery group. Fifty-one collections were identified in 74% (43 of 58) of patients, with significantly more collections in the laparoscopic (90% [27 of 30] vs 55% [16 of 29]; P < .05). The proportion of resolved collections increased over time, with significantly more resolving in the open group within 24 months of surgery (P < .05). Development or resolution of a collection was not dependent on age, sex, preoperative lesion size, or location (P > .05). CONCLUSION: Prevalence of findings 2-3 years after partial nephrectomy depends on the surgical approach. After laparoscopic partial nephrectomy, collections are more frequently detected on images and may take longer to resolve than following an open approach
— id: 109518, year: 2010, vol: 255, page: 476, stat: Journal Article,

The effect of changes in Medicare reimbursement on the practice of office and hospital-based endoscopic surgery for bladder cancer
Hemani, Micah L; Makarov, Danil V; Huang, William C; Taneja, Samir S
2010 Mar 1;116(5):1264-1271, Cancer
BACKGROUND:: Procedures performed in the office offer potential cost savings. Recent analyses suggest, however, that a fee-for-service system may incentivize subscale operations and, thus, contribute to excessive spending. The authors of this report sought to characterize changes in the practice of office-based and hospital-based endoscopic bladder surgery after 2005 increases in Medicare reimbursement. METHODS:: All office and hospital-based endoscopic surgeries that were performed in a faculty practice from 2002 through 2007 were identified using billing codes for procedures, diagnoses, and procedure locations and then analyzed using the chi-square test and logistic regression. Costs were estimated based on published Medicare reimbursements for office and hospital-based surgeries. RESULTS:: In total, 1341 endoscopic bladder surgeries were performed, including 764 in the office and 577 in the hospital. After 2005, the odds ratio (OR) for office surgery occurring among all cystoscopies and for surgery occurring in the office versus the hospital was 2.01 (95% confidence interval [CI], 1.71-2.37) and 2.29 (95% CI, 1.83-2.87), respectively. Among all treated lesions that were associated with a diagnosis of bladder cancer and nonbladder cancer, the OR for a procedure occurring in the office versus the hospital was 1.36 (95% CI, 1.07-1.73) and 1.99 (95% CI, 1.52-2.60), respectively. The likelihood of repeat surgery on the same lesion increased after 2005 (OR, 2.86; 95% CI, 1.46-5.62), and the likelihood of an office surgery leading to a bladder cancer diagnosis at the next visit declined (OR, 0.29; 95% CI, 0.16-0.51). The overall estimated expenditure increased by 50%. CONCLUSIONS:: After 2005, more bladder lesions were identified and treated in the office. In a single group practice, office treatment of bladder cancer did not fully explain this new practice pattern, suggesting a lowered threshold for office intervention. Cancer 2010. (c) 2010 American Cancer Society
— id: 107773, year: 2010, vol: 116, page: 1264, stat: Journal Article,

COMPARISON OF POSITIVE SURGICAL MARGINS IN PATIENTS WITH PATHOLOGIC T3 DISEASE UNDERGOING ROBOTIC ASSISTED LAPAROSCOPIC PROSTATECTOMY OR OPEN RADICAL RETROPUBIC PROSTATECTOMY
Jain, R.; Berkman, D. S.; Taneja, S. S.; Huang, W. C.; Lepor, H.; Stifelman, M.
2010 SEP ;24(1):A45-A46, Journal of endourology
— id: 124116, year: 2010, vol: 24, page: A45, stat: Journal Article,

Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy
Kaag, Matthew G; O'Malley, Rebecca L; O'Malley, Padraic; Godoy, Guilherme; Chen, Mang; Smaldone, Marc C; Hrebinko, Ronald L; Raman, Jay D; Bochner, Bernard; Dalbagni, Guido; Stifelman, Michael D; Taneja, Samir S; Huang, William C
2010 Oct;58(4):581-587, European urology
BACKGROUND: Nephroureterectomy alone fails to adequately treat many patients with advanced upper tract urothelial carcinoma (UTUC). Perioperative platinum-based chemotherapy has been proposed but requires adequate renal function. OBJECTIVE: Our aim was to determine whether the ability to deliver platinum-based chemotherapy following nephroureterectomy is affected by postoperative changes in renal function. DESIGN, SETTINGS, AND PARTICIPANTS: We retrospectively reviewed data on 388 patients undergoing nephroureterectomy for UTUC between 1991 and 2009. Four institutions were included. INTERVENTION: All patients underwent nephroureterectomy. MEASUREMENTS: All patients had serum creatinine measured before and after surgery. The value closest to 3 mo after surgery was taken as the postoperative value (range: 2-52 wk). Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation. eGFR values before and after surgery were compared using the paired t test. We chose an eGFR of 45 and 60 ml/min per 1.73 m(2) as possible cut-offs for chemotherapy eligibility and compared eligibility before and after surgery using the chi-square test. RESULTS AND LIMITATIONS: Our cohort of 388 patients included 233 men (60%) with a median age of 70 yr. Mean eGFR decreased by 24% after surgery. Using a cut-off of 60 ml/min per 1.73 m(2), 49% of patients were eligible for chemotherapy before surgery, but only 19% of patients remained eligible postoperatively. Using a cut-off of 45 ml/min per 1.73 m(2), 80% of patients were eligible preoperatively, but only 55% remained eligible after surgery. This distribution persisted when we limited the analysis to patients with advanced pathologic stage (T3 or higher). Patients older than the median age of 70 yr were more likely to be ineligible for chemotherapy both pre- and postoperatively by either definition, and they were significantly more likely to have an eGFR <45 ml/min per 1.73 m(2) postoperatively, regardless of their starting eGFR. This study is limited by its retrospective nature, and there was some variability in the timing of postoperative serum creatinine measurements. CONCLUSIONS: eGFR is significantly diminished after nephroureterectomy, particularly in elderly patients. These changes in renal function likely affect eligibility for adjuvant cisplatin-based therapy. Accordingly, we suggest strong consideration of neoadjuvant regimens
— id: 134397, year: 2010, vol: 58, page: 581, stat: Journal Article,

Angiomyolipoma with epithelial cysts: mimic of renal cell carcinoma
Rosenkrantz, Andrew B; Hecht, Elizabeth M; Taneja, Samir S; Melamed, Jonathan
2010 Jan-Feb;34(1):65-68, Clinical imaging
Angiomyolipoma with epithelial cysts (AMLEC) is a rare variant of angiomyolipoma with minimal fat that contains epithelial-lined cysts and may mimic a cystic renal cell carcinoma. While 17 cases have been described in the pathology literature since this entity was first described in 2006, the radiologic appearance was not demonstrated in any of these cases. We report the CT and MRI appearance of AMLEC found incidentally in a patient with lupus nephritis
— id: 107271, year: 2010, vol: 34, page: 65, stat: Journal Article,

Prostate cancer: Comparison of 3D T2-weighted with conventional 2D T2-weighted imaging for image quality and tumor detection
Rosenkrantz, Andrew B; Neil, Jeffry; Kong, Xiangtian; Melamed, Jonathan; Babb, James S; Taneja, Samir S; Taouli, Bachir
2010 Feb;194(2):446-452, American journal of roentgenology
OBJECTIVE: The purpose of this study was to compare a 3D T2-weighted imaging sequence with a conventional multiplanar 2D turbo spin-echo T2-weighted sequence in terms of tumor detection and staging of prostate cancer, as well as image quality. MATERIALS AND METHODS: Before prostatectomy, 38 men (mean age, 60 years) with prostate cancer underwent MRI of the prostate with multiplanar 2D turbo spin-echo T2-weighted sequences (total acquisition time, approximately 11 minutes 4 seconds) and a 3D T2-weighted sampling perfection with application optimized contrasts sequence with different flip angle evolutions (SPACE) (acquisition time, approximately 3 minutes 52 seconds). Two blinded observers in consensus reviewed 2D turbo spin-echo T2-weighted images and SPACE images for detection of peripheral zone cancer, extracapsular extension, and seminal vesicle invasion. The observers also assessed subjective image quality and measured the signal-to-noise ratio (SNR) of normal peripheral zone and tumor-to-peripheral zone contrast. Prostatectomy was used as the reference standard. The diagnostic accuracy of the two sequences was assessed with generalized estimating equations and McNemar tests. The agreement between sequences was assessed with kappa coefficients. A paired Wilcoxon signed rank test was used to compare the subjective image quality, SNR, and tumor-to-peripheral zone contrast of the two sequences. RESULTS: For tumor detection and diagnosis of extracapsular extension, there was substantial agreement between the two sequences (kappa = 0.79, kappa = 0.76) with no difference in sensitivity, specificity, positive predictive value, negative predictive value, accuracy (p = 0.25-1), or image quality (p = 0.937). Images obtained with the 2D turbo spin-echo sequence had a significantly higher SNR ratio for normal peripheral zone (p = 0.0010), but SPACE images had significantly greater tumor-to-peripheral zone contrast (p < 0.0001). CONCLUSION: In comparison with conventional multiplanar 2D turbo spin-echo MRI of the prostate, 3D T2-weighted SPACE MRI was associated with substantial time saving (nearly 8 minutes), had similar image quality and accuracy in the diagnosis of tumor and extracapsular extension, and had better tumor conspicuity
— id: 106383, year: 2010, vol: 194, page: 446, stat: Journal Article,

Positive surgical margins at radical prostatectomy: Do they really matter?
Taneja, Samir S
2010 Mar-Apr;28(2):195-196, Urologic oncology
— id: 107933, year: 2010, vol: 28, page: 195, stat: Journal Article,

Proceeding of the 2009 society of urologic oncology spring meeting
Taneja, Samir S
2010 Sep-Oct;28(5):541-541, Urologic oncology
— id: 112201, year: 2010, vol: 28, page: 541, stat: Journal Article,

Candidate selection for prostate cancer focal therapy
Taneja, Samir S; Mason, Malcolm
2010 May;24(5):835-841, Journal of endourology
Focal therapy has emerged as a potential treatment paradigm for men with localized prostate cancer, because it serves as a medium between the ambiguity of surveillance and the potential reduction of quality of life observed with radical treatment. Candidate selection remains the major challenge of implementing focal therapy in clinical practice. While focal therapy is potentially widely applicable, there is general consensus that initial efforts to initiate focal therapy protocols in practice should be limited to men with disease features that are low to low-intermediate risk, thereby limiting the likelihood of early systemic failure. Selection of candidates is first dependent on the intent of focal therapy. Curative intent focal therapy is limited to a small number of men with isolated, low-risk, unifocal, or unilateral disease. In men for whom local control-and potential prolongation of the natural history of disease-is desired, mapping strategies would focus on identification of the dominant site of disease and ruling out high-risk features. Tools such as conventional transrectal biopsy, transperineal saturation biopsy, and prostate MRI all have relative merits and shortcomings. While ultimately limitation of biopsy is desirable through combinations of transrectal biopsy and imaging, for now, limitations of conventional imaging modalities make it likely that most men will need transperineal saturation biopsy before inclusion in focal therapy protocols
— id: 111625, year: 2010, vol: 24, page: 835, stat: Journal Article,

Screening for Prostate Cancer: A Review of the ERSPC and PLCO Trials
Eckersberger, Elisabeth; Finkelstein, Julia; Sadri, Helen; Margreiter, Markus; Taneja, Samir S; Lepor, Herbert; Djavan, Bob
2009 Summer;11(3):127-133, Reviews in urology
The advent of prostate-specific antigen (PSA) testing in the early 1980s revolutionized the diagnosis of prostate cancer. As a result of PSA testing, there has been a surge in the number of prostate cancer diagnoses. This review examines the results of 2 recent landmark trials that studied the effect of screening on prostate cancer mortality: the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the US-based Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial
— id: 108182, year: 2009, vol: 11, page: 127, stat: Journal Article,

The continued debate: intermittent vs. continuous hormonal ablation for metastatic prostate cancer
Gleave, Martin; Klotz, Laurence; Taneja, Samir S
2009 Jan-Feb;27(1):81-86, Urologic oncology
OBJECTIVES: To summarize the debate regarding use of intermittent androgen suppression therapy in the treatment of prostate cancer originally presented at the 2007 Spring Meeting of the Society of Urologic Oncology. METHODS: The debate was framed within the context of known toxicities of therapy and impact on quality of life. Arguments for and against IAS were summarized. RESULTS: IAS appears to be a reasonable treatment approach for men with advanced prostate cancer except those with high risk features including PSA > 20, or bone metastatic disease. Men with TxN1-3M0 who are sexually active, compliant to close follow-up, or who do not tolerate the side effects of androgen ablation can be considered for IAS as long as they realize it is investigational. There is not a clear consensus upon duration of treatment, interval between treatment cycles, or appropriate PSA nadir, but it does appear that PSA nadir > 4 ng/ml may predict a poor outcome. Based on time to PSA nadir and changes in expression of proliferation markers staining, treatment duration of 6 to 9 months is recommended prior to stopping therapy. Trigger points for restarting therapy are individualized, and factors that are considered include pretreatment PSA levels, stage, PSA velocity, presence of symptoms, and tolerance of androgen ablation therapy. CONCLUSIONS: IAS should be considered in the management of men with advanced prostate cancer and no evidence of bone metastases. While intermittent therapy is feasible and offers potential improvement in quality of life, it is not yet shown that it reverses the long-term side effects of androgen suppression
— id: 94944, year: 2009, vol: 27, page: 81, stat: Journal Article,

Sequential and intermittent docetaxel (D) and imatinib (Im) in hormone-refractory prostate cancer patients (NYU 04-47)
Gmez-Pinillos A.; Ballard H.; Shelton G.; Reilly M.M.; Chachoua A.; Taneja S.; Ferrari A.C.
2009 ;27(15 Suppl 1):?-? #e16108, Journal of clinical oncology
Background: Platelet-derived growth factor is frequently expressed in advanced prostate cancer (PC) lesions where it supports PC cell growth and neo-angiogenesis. Im. is a PDGF inhibitor that blocks cell cycle in G1-S due to MEK/erk inhibition. D blocks cell cycle progression in G2-M. Sequential block of the cell cycle progression in G2-M followed by G1-S may increase anti-tumor responses. The phase II study dose of sequential D on day 1 and Im started 24-36h later given daily for 14 d was established in a previous phase I. Methods: Eligibility: at least 2 prior hormone manipulations and up to one prior chemotherapy, PSA>5ng/ml, ECOG PS 0-2. Treatment schedule: D 70mg/m2 day 1 followed 24-36 hours later by Im 600mg PO daily x 14 days. Cycles were repeated every 21d until toxicity or progression. Pegfilgrastim was given each cycle for neutropenia prevention. A two steps design was planned to assess activity (PSA decline >50% and/or measurable or symptomatic response) and tolerance including interim analysis to determine if 37 patients (pts) should be enrolled. Results: Of 15 pts enrolled, 13 had metastasis and 5(33%) received prior chemotherapy. There were 98 cycles of trial therapy administered and 9 events (PSA or bone progression) registered at the time of analysis. Median baseline PSA 73,5ng/ml (2.1-1954.3). Median follow-up estimated by inverse Kaplan Meier: 308 days (CI95%, 133-482). Median of cycles administrated 6 (1-12). PSA decline >50% observed in 7/15pts (46.67%) of which 3 was >80% (20%). PSA decline <50%, observed in 6/15(40%). 2/15(15.3%) were non-responders. Pain scores improved in all symptomatic pts. Median duration of response was 162 days (42- 281). Estimated median progression free survival by Kaplan-Meier was 155 days (CI95%, 80-339). Toxicity: there was G1-2 fatigue, anorexia, weight change in 66% pts; nausea, vomiting, taste changes in 66% pts, anemia in 46% and neuropathy in 46% pts. G3 fatigue in 2 pts, neuropathy and CHF in 1 pt. No G4 toxicities were observed. Conclusions: Sequential and intermittent D every 21 days and Im for 14 days is tolerable and active by PSA decline and symptomatic improvement. Compared to previous report with weekly D and continuous Im, this alternative schedule appears to have similar activity with better tolerance
— id: 111804, year: 2009, vol: 27, page: ?, stat: Journal Article,

Effect of warm ischemia time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate
Godoy, Guilherme; Ramanathan, Vigneshwaran; Kanofsky, Jamie A; O'Malley, Rebecca L; Tareen, Basir U; Taneja, Samir S; Stifelman, Michael D
2009 Jun;181(6):2438-2443, Journal of urology
PURPOSE: We evaluated the effect of warm ischemia time on early postoperative renal function following laparoscopic partial nephrectomy. MATERIALS AND METHODS: Of 453 patients who were surgically treated for renal tumors between May 2001 and September 2007, and who were identified in our database 128 underwent laparoscopic partial nephrectomy. Of these 128 patients 101 who were evaluable had complete demographic, operative, preoperative and early postoperative data available. Renal function was estimated using the glomerular filtration rate. Warm ischemia time was stratified into 4 interval groups and also analyzed based on different time cutoffs. Ultimately we also tested the relationship between postoperative renal failure, and preoperative factors and warm ischemia time. RESULTS: Warm ischemia time interval analysis was not significant. However, when analyzing the effect of warm ischemia time cutoffs, patients with warm ischemia time greater than 40 minutes had a significantly greater decrease in the glomerular filtration rate (p = 0.03) and a lower glomerular filtration rate postoperatively. The incidence of renal function impairment was more than 2-fold higher in those with a warm ischemia time of greater than 40 minutes than in the other groups (p = 0.077). Warm ischemia time was significant on univariate analysis when only patients with a preoperative glomerular filtration rate of 60 ml per minute per 1.73 m(2) or greater were analyzed. However, this did not hold as an independent predictor of postoperative renal function impairment on multivariate analysis. The preoperative glomerular filtration rate was the only independent predictor of postoperative renal function impairment. CONCLUSIONS: A warm ischemia time of 40 minutes appears to be an appropriate cutoff, after which a significantly greater decrease in renal function occurs after laparoscopic partial nephrectomy. The preoperative glomerular filtration rate was the only independent predictor of an increased risk of renal insufficiency following laparoscopic partial nephrectomy
— id: 98898, year: 2009, vol: 181, page: 2438, stat: Journal Article,

Predicting the outcome of prostate biopsy: comparison of a novel logistic regression-based model, the prostate cancer risk calculator, and prostate-specific antigen level alone
Hernandez, David J; Han, Misop; Humphreys, Elizabeth B; Mangold, Leslie A; Taneja, Samir S; Childs, Stacy J; Bartsch, Georg; Partin, Alan W
2009 Mar;103(5):609-614, BJU international
OBJECTIVES: To develop a logistic regression-based model to predict prostate cancer biopsy at, and compare its performance to the risk calculator developed by the Prostate Cancer Prevention Trial (PCPT), which was based on age, race, prostate-specific antigen (PSA) level, a digital rectal examination (DRE), family history, and history of a previous negative biopsy, and to PSA level alone. PATIENTS AND METHODS: We retrospectively analysed the data of 1280 men who had a biopsy while enrolled in a prospective, multicentre clinical trial. Of these, 1108 had all relevant clinical and pathological data available, and no previous diagnosis of prostate cancer. Using the PCPT risk calculator, we calculated the risks of prostate cancer and of high-grade disease (Gleason score > or =7) for each man. Receiver operating characteristic (ROC) curves for the risk calculator, PSA level and the novel regression-based model were compared. RESULTS: Prostate cancer was detected in 394 (35.6%) men, and 155 (14.0%) had Gleason > or =7 disease. For cancer prediction, the area under the ROC curve (AUC) for the risk calculator was 66.7%, statistically greater than the AUC for PSA level of 61.9% (P < 0.001). For predicting high-grade disease, the AUCs were 74.1% and 70.7% for the risk calculator and PSA level, respectively (P = 0.024). The AUCs increased to 71.2% (P < 0.001) and 78.7% (P = 0.001) for detection and high-grade disease, respectively, with our novel regression-based models. CONCLUSIONS: ROC analyses show that the PCPT risk calculator modestly improves the performance of PSA level alone in predicting an individual's risk of prostate cancer or high-grade disease on biopsy. This predictive tool might be enhanced by including percentage free PSA and the number of biopsy cores
— id: 94945, year: 2009, vol: 103, page: 609, stat: Journal Article,

Renal involvement by chronic myelomonocytic leukemia requiring nephroureterectomy
Hyams, Elias S; Gupta, Raavi; Melamed, Jonathan; Taneja, Samir S; Shah, Ojas
2009 Winter;11(1):33-37, Reviews in urology
Chronic monomyelocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Renal impairment from CMML is infrequent and can result from both direct (ie, infiltrative) and indirect (eg, vasculitis, infarction) mechanisms. This case report describes a patient with refractory gross hematuria requiring nephroureterectomy with diffuse involvement of the upper tract by CMML and accompanying extramedullary hematopoiesis. Underscored are the need to maintain a broad differential diagnosis for upper tract lesions in the setting of gross hematuria, and the potential need for drastic measures to control upper tract bleeding if conservative measures fail
— id: 108184, year: 2009, vol: 11, page: 33, stat: Journal Article,

Correction of prostate-specific antigen velocity for variation may improve prediction of cancer following prostate repeat biopsy
Kumar, Angelish; Godoy, Guilherme; Taneja, Samir S
2009 Jun;16(3):4655-4659, Canadian journal of urology
OBJECTIVE: To determine if adjustment of prostate-specific antigen velocity (PSAV) for variation improves prediction of cancer in men with previous negative prostate biopsy. PATIENTS AND METHODS: Records of men undergoing prostate biopsy between 1999 and 2004 by a single urologist were reviewed to identify men with at least three follow up PSA measurements. Patients with atypia, high grade prostatic intraepithelial neoplasia or cancer on baseline biopsy were excluded. Men were rebiopsied if perceived to have rising PSA. Men with cancer, no cancer, or no repeat biopsy were compared for PSAV and a new parameter, PSAV%/Variation. PSAV was calculated by linear regression, and adjusted to percent change (PSAV%). Diagnostic accuracy was assessed by receiver operating characteristic curve. RESULTS: Of 118 men who met inclusion criteria, 32 had repeat biopsies. Nine biopsies were positive (group 1) and 22 were negative (group 2). The PSAV%, PSAV, and PSAV%/Variation for groups 1 versus 2 was 22.9% and 1.7% (p = 0.004), 1.12 versus 0.4 ng/ml/year (p = 0.007), and 1.07 verus 0.03 (p < 0.001), respectively. PSAV%/Variation had the largest area under the curve (0.881), compared with PSAV (0.744) and PSAV% (0.784). At cut off of 0.77, specificity was 86.4% and sensitivity was 87.5% for PSAV%/Variation. At the same sensitivity level, the specificities of PSAV% and PSAV were 77.3% and 63.6%, respectively. CONCLUSION: Correction for variation could potentially make PSAV a more reliable parameter in patients with prior negative biopsy. The results of our preliminary study warrant further analysis in a larger prospective cohort
— id: 99326, year: 2009, vol: 16, page: 4655, stat: Journal Article,

Genome-wide impact of androgen receptor trapped clone-27 loss on androgen-regulated transcription in prostate cancer cells
Nwachukwu, Jerome C; Mita, Paolo; Ruoff, Rachel; Ha, Susan; Wang, Qianben; Huang, S Joseph; Taneja, Samir S; Brown, Myles; Gerald, William L; Garabedian, Michael J; Logan, Susan K
2009 Apr 1;69(7):3140-3147, Cancer research
The androgen receptor (AR) directs diverse biological processes through interaction with coregulators such as AR trapped clone-27 (ART-27). Our results show that ART-27 is recruited to AR-binding sites by chromatin immunoprecipitation analysis. In addition, the effect of ART-27 on genome-wide transcription was examined. The studies indicate that loss of ART-27 enhances expression of many androgen-regulated genes, suggesting that ART-27 inhibits gene expression. Surprisingly, classes of genes that are up-regulated upon ART-27 depletion include regulators of DNA damage checkpoint and cell cycle progression, suggesting that ART-27 functions to keep expression levels of these genes low. Consistent with this idea, stable reduction of ART-27 by short-hairpin RNA enhances LNCaP cell proliferation compared with control cells. The effect of ART-27 loss was also examined in response to the antiandrogen bicalutamide. Unexpectedly, cells treated with ART-27 siRNA no longer exhibited gene repression in response to bicalutamide. To examine ART-27 loss in prostate cancer progression, immunohistochemistry was conducted on a tissue array containing samples from primary tumors of individuals who were clinically followed and later shown to have either recurrent or nonrecurrent disease. Comparison of ART-27 and AR staining indicated that nuclear ART-27 expression was lost in the majority of AR-positive recurrent prostate cancers. Our studies show that reduction of ART-27 protein levels in prostate cancer may facilitate antiandrogen-resistant disease
— id: 99292, year: 2009, vol: 69, page: 3140, stat: Journal Article,

Is surveillance of small renal masses safe in the elderly?
O'Malley RL; Godoy G; Phillips CK; Taneja SS
2009 Apr;105(8):1098-101 L, BJU international
OBJECTIVE To determine if preoperative variables, including gender, age and tumour size, influence the decision for active surveillance of renal masses, as due to the increasing detection of incidental renal masses within the ageing population there is a need to identify reliable means of selecting patients who require therapy. PATIENTS AND METHODS We retrospectively identified all renal masses resected at our institution between 1 December 1999, and 1 October 2005. The size of tumour, patient age and gender were compared between those with and without malignancy on final pathology. The influence of these variables in predicting malignancy, high grade, and high stage were assessed by univariate and multivariate analysis using logistic regression models, with a significance level of P < 0.05. Subsets were analysed for the groups of patients with tumours of </=3 or >3 cm and those aged </=75 or >75 years. RESULTS Among 466 of 501 patients with evaluable data, univariate analysis showed that both male gender and increasing size positively predicted malignancy (odds ratio 1.13 and 1.40, respectively), but age, treated as a continuous variable, did not. On multivariate analysis both remained independent predictors of malignancy (odds ratio 1.13 and 1.40, respectively). Size was the only independent predictor of high-stage and high-grade disease on both univariate and multivariate analysis. Among 156 patients with tumours of </=3 cm, on multivariate analysis, male gender was only weakly associated with the risk of malignancy, whereas size remained strongly predictive (odds ratio 1.98, P = 0.076; and 2.16, P = 0.015, respectively). Neither male gender, size nor age increased the risk of high-stage or high-grade disease in this cohort. Patients who were aged >75 years had a greater risk of high-stage disease than those aged <75 years (odds ratio 2.64, P = 0.008). On multivariate analysis, age >75 years remained an independent predictor of malignancy and high-stage, along with size (odds ratio 2.75, P = 0.014; and 1.35, P < 0.001). CONCLUSIONS Increased size of tumour increases the risk of malignancy and the likelihood of high-stage and high-grade disease. Among patients aged >75 years there was a higher risk of malignancy and high-stage disease than in those aged </=75 years. As such, the decision for observation should not be based upon age alone, and should be approached with caution in patients aged >75 years, particularly for larger lesions
— id: 138386, year: 2009, vol: 105, page: 1098, stat: Journal Article,

Bosniak category IIF designation and surgery for complex renal cysts
O'Malley, Rebecca L; Godoy, Guilherme; Hecht, Elizabeth M; Stifelman, Michael D; Taneja, Samir S
2009 Sep;182(3):1091-1095, Journal of urology
PURPOSE: We investigated whether adding the IIF categorization improved the accuracy of Bosniak renal cyst classification, as evidenced by a low rate of progression in IIF lesions and a high rate of malignancy in category III lesions. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with complex renal cysts categorized as a Bosniak IIF or III. Surveillance imaging and pathological outcomes of category IIF cysts were recorded to determine radiological predictors of progression. Pathological outcomes of category III cysts were recorded to determine the malignancy rate. RESULTS: A total of 112 patients met study inclusion criteria, of whom 81 were initially diagnosed with a category IIF cyst and 31 had a Bosniak category III cyst. At a median followup of 15 months 14.8% of Bosniak IIF lesions progressed in complexity with a median time to progression of 11 months (maximum greater than 4 years). There were no differences in tumor or patient characteristics between cysts that progressed and those that remained stable. In the 33 patients with Bosniak III lesions who underwent surgical extirpation the malignancy rate was 81.8%. Most patients had low stage, low grade disease and remained recurrence-free at a median followup of 6 months. CONCLUSIONS: Adding the IIF category has increased the accuracy and clinical impact of the Bosniak categorization system, as evidenced by a low rate of progression in category IIF cysts and an increased rate of malignancy in surgically treated category III lesions compared to those in historical controls
— id: 101448, year: 2009, vol: 182, page: 1091, stat: Journal Article,

The necessity of adrenalectomy at the time of radical nephrectomy: a systematic review
O'Malley, Rebecca L; Godoy, Guilherme; Kanofsky, Jamie A; Taneja, Samir S
2009 May;181(5):2009-2017, Journal of urology
PURPOSE: We describe the literature base pertaining to adrenalectomy at radical nephrectomy and present a pragmatic approach based on primary tumor and disease characteristics. MATERIALS AND METHODS: Literature searches were performed via the National Center for Biotechnology Information databases using various keywords. Articles that pertained to the concomitant use of adrenalectomy with radical nephrectomy were surveyed. RESULTS: The incidence of solitary, synchronous, ipsilateral adrenal involvement, ie that which is potentially curable with ipsilateral adrenalectomy along with nephrectomy, is much lower than previously thought at 1% to 5%. Evidence to date supports increased size and T stage, multifocality, upper pole location and venous thrombosis as risk factors for adrenal involvement. Cross-sectional imaging is now accurate at demonstrating the absence of adrenal involvement but still carries a significant risk of false-positives. The morbidity of adrenalectomy is minimal except in those patients with metachronous contralateral adrenal metastasis in whom the impact of adrenal insufficiency can be devastating. Disease specific and overall survival of those undergoing radical nephrectomy, with or without adrenalectomy, are similar. The survival of patients with widespread metastatic disease is historically poor regardless of whether adrenalectomy is performed. There is evidence for a survival advantage in patients with isolated adrenal metastasis, although this group comprises no more than 2% of those undergoing surgery for renal tumors. CONCLUSIONS: The apparent benefit of ipsilateral adrenalectomy does not support it as a standard practice in all patients with normal imaging. However, it should be considered in select cases in which there are risk factors for adrenal involvement
— id: 98779, year: 2009, vol: 181, page: 2009, stat: Journal Article,

Circulating tumor cells as a potential efficacy end point in clinical trials of hormone-resistant prostate cancer
Taneja, Samir S
2009 Jan;10(1):4-5, Current urology reports
— id: 94943, year: 2009, vol: 10, page: 4, stat: Journal Article,

Editorial comment. Nerve quantification and computerized planimetry to evaluate periprostatic nerve distribution--does size matter?
Taneja, Samir S
2009 Aug;74(2):405-405, Urology
— id: 108183, year: 2009, vol: 74, page: 405, stat: Journal Article,

Simplified reconstruction after laparoscopic partial nephrectomy using a single-pass suturing technique
Taneja, Samir S; Dakwar, George; Godoy, Guilherme
2009 Apr;23(4):589-591, Journal of endourology
Laparoscopic partial nephrectomy (LPN) has been underused because of its technical complexity and difficulty. We present a knotless and bolsterless technique that allows simultaneous repair of the pelvicaliceal system and compression of the parenchyma defect using a series of single-pass running sutures. We believe that this technique will simplify reconstruction and aid in popularization of LPN
— id: 100420, year: 2009, vol: 23, page: 589, stat: Journal Article,

Creation of Urinary Stoma Before Abdominal Wall Transposition of Ileal Conduit Improves Stomal Protrusion, Eversion, and Symmetry
Taneja, Samir S; Godoy, Guilherme
2009 Apr;73(4):893-895, Urology
OBJECTIVES: To report a technique of stomal creation before abdominal wall transposition of the conduit that reduces asymmetry, retraction, and stenosis of the stoma. The ileal conduit remains the most common form of urinary diversion. Despite extensive experience with the procedure, a significant rate of stomal complications is still observed. METHODS: Unlike the traditional approach, after the segment of the distal ileum is selected and excluded from the bowel continuity, the stoma is prepared intracorporeally. The critical elements of this technique include defatting of the distal mesentery, placement of everting sutures immediately adjacent to the bowel mesentery in a diamond configuration, full-thickness locking sutures to fix the eversion, and fascial fixation sutures on abdominal wall transposition. RESULTS: The technique of early stomal maturation has been performed in 45 consecutive ileal conduit procedures. To date, early stomal retraction with poor appliance fit has been observed in 1 patient who underwent simultaneous abdominal wall reconstruction, requiring early revision of the stoma. The remaining stomas have demonstrated excellent protrusion with no requirement for revision owing to stenosis or retraction. CONCLUSIONS: To date, we have experienced excellent outcomes with the technique, independent of body habitus or mesenteric thickness. The usual tendency of the stoma to be flush at the position of the mesentery is avoided, and symmetric protrusion of the stoma appears to allow a better stomal appliance fit. The effect on long-term complication rates remains to be defined
— id: 94940, year: 2009, vol: 73, page: 893, stat: Journal Article,

Reply
Tareen B.; Taneja S.S.
2009 ;73(2):355-, Urology
— id: 92854, year: 2009, vol: 73, page: 355, stat: Journal Article,

Can contemporary transrectal prostate biopsy accurately select candidates for hemi-ablative focal therapy of prostate cancer?
Tareen, Basir; Godoy, Guilherme; Sankin, Alex; Temkin, Steve; Lepor, Herbert; Taneja, Samir S
2009 Jul;104(2):195-199, BJU international
OBJECTIVE To determine if biopsy characteristics can be used to identify men with unilateral prostate cancer on radical prostatectomy (RP) pathological specimens, thereby selecting candidates for hemi-ablative focal therapy. PATIENTS AND METHODS Of 1458 men who had RP from January 2000 to June 2007, we identified 590 of 880 evaluable patients with unilateral disease on their preoperative biopsy. Charts were reviewed to record preoperative prostate-specific antigen (PSA) level, high-grade prostatic intraepithelial neoplasia (HGPIN), clinical stage, Gleason score, perineural invasion (PNI), prostate volume, number of positive cores, and percentage of positive cores. Final surgical pathology was evaluated for unilateral cancer. Univariate analysis was used (logistic regression method) to identify independent predictors of unilateral disease on the RP specimen. A subset analysis was done in men with low-risk disease, defined as clinical stage T1C, Gleason score <7 and a PSA level of <10 ng/mL. RESULTS Of 590 men with unilateral disease on biopsy, 163 (27.3%) had unilateral disease on the RP specimen. Pathological features, including HGPIN (P = 0.714), Gleason score (P > 0.608), PNI (P = 0.714), number of positive cores (P = 0.076), percentage of cores positive (P = 0.056), prostate volume (P = 0.285), and PSA level (P = 0.062) did not improve the prediction of unilateral disease. When men with unilateral cancer were further stratified to include only those with low-risk disease, 28.4% had unilateral disease on the RP specimen. None of the biopsy or clinical features evaluated were predictors of unilateral disease on the RP specimen. CONCLUSION Unilateral prostate cancer on biopsy predicts unilateral disease on RP pathology in only 27.6% of cases. The predictive ability is not improved by adding biopsy and clinical characteristics. Additional methods are needed to accurately identify men appropriate for focal therapy
— id: 94941, year: 2009, vol: 104, page: 195, stat: Journal Article,

Laterality alone should not drive selection of candidates for hemi-ablative focal therapy
Tareen, Basir; Godoy, Guilherme; Sankin, Alex; Temkin, Steve; Lepor, Herbert; Taneja, Samir S
2009 Mar;181(3):1082-1089, Journal of urology
PURPOSE: Because many investigators have suggested that ideal candidates for focal therapy are those with unilateral prostate cancer, we evaluated whether these men are at decreased risk for adverse pathological and oncological outcomes. MATERIALS AND METHODS: We reviewed the charts of 1,458 consecutive patients who underwent open radical prostatectomy, as performed by a single surgeon. Patients were divided into 311 with unilateral (group 1) and 1,147 with bilateral (group 2) disease on final surgical pathology. They were also substratified by clinical risk into low risk (prostate specific antigen less than 10 ng/ml, clinical stage less than T2b or Gleason score less than 7) and high risk groups. The groups were compared with respect to extracapsular extension, seminal vesical invasion, percent of tumor involvement, pathological Gleason score and biochemical recurrence. RESULTS: Compared to patients with bilateral disease those with unilateral disease had a lower rate of extracapsular extension (p = 0.004), seminal vesical invasion (p = 0.003), greater than 10% tumor involvement (p <0.001) and Gleason score 7 or greater (p <0.001). At a median followup of 36 months 8.3% and 16.7% of the men in groups 1 and 2, respectively, experienced biochemical recurrence (p = 0.001). Low risk disease was more prevalent in those with unilateral disease than in those with bilateral disease. Of men with low risk disease the risk of adverse pathological features/biochemical recurrence did not differ between groups 1 and 2. CONCLUSIONS: Although men with unilateral prostate cancer have more favorable oncological outcomes than those with bilateral prostate cancer, this appears to be due to the higher prevalence of low risk disease. While focality/laterality may direct the method of subtotal gland treatment, clinical risk features may be adequate to select candidates for focal therapy
— id: 94942, year: 2009, vol: 181, page: 1082, stat: Journal Article,

Focal therapy: a new paradigm for the treatment of prostate cancer
Tareen, Basir; Godoy, Guilherme; Taneja, Samir S
2009 Fall;11(4):203-212, Reviews in urology
Focal therapy has been proposed in recent years as a means of bridging the gap between radical prostatectomy and active surveillance for treatment of prostate cancer. The rationale for focal therapy comes from its success in treating other malignancies. One of the challenges in applying such an approach to the treatment of prostate cancer has been the multifocal nature of the disease. This review addresses the selection of potentially ideal candidates for focal therapy and discusses which modalities are currently being used and proposed for focal therapy. Setting and meeting guidelines for oncologic efficacy is a challenge we must embrace to safely deliver this potentially revolutionary approach to treating men with prostate cancer
— id: 108181, year: 2009, vol: 11, page: 203, stat: Journal Article,

Appropriate candidates for hemiablative focal therapy are infrequently encountered among men selected for radical prostatectomy in contemporary cohort
Tareen, Basir; Sankin, Alex; Godoy, Guilherme; Temkin, Steve; Lepor, Herbert; Taneja, Samir S
2009 Feb;73(2):351-354, Urology
OBJECTIVES: To assess the prevalence and pathologic features of men with unilateral prostate cancer at radical prostatectomy (RP), because it has recently been proposed that men with small-volume, well-differentiated, unilateral prostate cancer can be treated with focal therapy. METHODS: The records of 1467 consecutive men who underwent open RP by a single surgeon from January 2000 to June 2007 were reviewed after institutional review board approval. The RP pathologic reports were analyzed to determine the frequency of unilateral or bilateral disease, surgical margin status, presence of extracapsular extension, seminal vesicle invasion, Gleason score, percentage of tumor involvement (PTI), prostate-specific antigen (PSA) level, and prostate volume. Logistic regression analysis was performed to analyze the relationship between these factors and the detection of unilateral disease. RESULTS: Unilateral cancer was identified in 313 of 1467 patients (21.3%). Of these patients, 206 had a PTI of < or = 5%, 40 had a PTI of 5%-10%, 8 had a PTI of 10%-15%, and 40 had a PTI > 15%. The factors significantly associated with unilateral disease on univariate analysis were PTI, PSA level, pathologic Gleason score, seminal vesicle invasion, and extracapsular extension. The PSA level and seminal vesicle invasion remained significant predictors on multivariate analysis. Overall, 163 men (11.1%) had unilateral, low-risk disease (defined as a PSA level < 10 ng/mL, Gleason score < 7, and PTI < 10%). CONCLUSIONS: Although candidates for focal therapy exist among men undergoing RP within a contemporary cohort, they represent a small minority. Before proceeding with focal therapy, the urology community must identify accurate methods of candidate selection
— id: 93566, year: 2009, vol: 73, page: 351, stat: Journal Article,

Transperitoneal laparoscopic radical nephrectomy for large (more than 7 cm) renal masses
Berger, Aaron D; Kanofsky, Jamie A; O'Malley, Rebecca L; Hyams, Elias S; Chang, Carolyn; Taneja, Samir S; Stifelman, Michael D
2008 Mar;71(3):421-424, Urology
OBJECTIVES: To evaluate our laparoscopic radical nephrectomy (LRN) series to determine whether any significant increases have occurred in operative morbidity when resecting large (7 cm or greater) renal masses. LRN is becoming the reference standard for treating suspicious renal masses not amenable to nephron-sparing surgery. METHODS: We retrospectively reviewed the charts of 164 consecutive patients who had undergone laparoscopic radical nephrectomy performed for suspicious renal masses by two surgeons from February 2000 and December 2006. After institutional review board approval, we reviewed the patient charts to determine whether patients with 7-cm or larger lesions had significant differences in age, body mass index, American Society of Anesthesiologists class, operative time, estimated blood loss, conversion rate, positive margin rate, postoperative creatinine, and hematocrit compared with patients with lesions smaller than 7 cm. RESULTS: The data from 164 patients were reviewed. Of these 164 patients, 124 had less than 7-cm masses and 40 had lesions 7 cm or larger. The mean tumor size in the less than 7-cm group was 4.2 cm (range 1.8 to 6.9) and was 9.2 cm (range 7 to 14) in the 7-cm or larger group. The patients with large tumors had a significantly longer operative time, greater estimated blood loss, and increase in postoperative serum creatinine than those with smaller tumors but all other perioperative variables were similar. Two conversions to open radical nephrectomy occurred in both groups. CONCLUSIONS: Our data have clearly shown that larger tumors can safely be resected with transperitoneal laparoscopic nephrectomy. Open nephrectomy for large tumors can be associated with increased morbidity and the use of LRN could minimize this increased risk. Urologists with laparoscopic experience should consider expanding their indication for LRN
— id: 79155, year: 2008, vol: 71, page: 421, stat: Journal Article,

Pathologic characteristics of cancer diagnosed during the follow-up of patients with isolated HGPIN on previous biopsy
Coney, G; Marien, T; Kumar, A; Huang, G; Tareen, B; Taneja, SS
2008 MAR ;7(3):225-225, European Urology Supplements
— id: 76437, year: 2008, vol: 7, page: 225, stat: Journal Article,

Impact of Socioeconomic Factors on Prostate Cancer Outcomes in Black Patients Treated with Surgery
Dash, Atreya; Lee, Peng; Zhou, Qin; Jean-Gilles, Jerome; Taneja, Samir; Satagopan, Jaya; Reuter, Victor; Gerald, William; Eastham, James; Osman, Iman
2008 Sep;72(3):641-646, Urology
OBJECTIVES: The role of socioeconomic factors in the worse outcome of black men with prostate cancer remains unclear. To determine whether socioeconomic factors affect prostate cancer outcomes, we studied a cohort of only black patients to minimize known confounding factors. METHODS: We studied black men treated with radical prostatectomy at New York Veterans Administration Medical Center and Memorial Sloan-Kettering Cancer Center between 1990 and 2005. A centralized pathology review process determined the Gleason score of all cases. Prostate-specific antigen (PSA) recurrence at both sites was defined as PSA of 0.2 or greater with a confirmatory rise. By matching patients' home zip codes to the U.S. Census Bureau database, we obtained corresponding socioeconomic data regarding median household income (income) and percentage of population with a high school (degree). We analyzed income, education, and clinical and pathological parameters for the whole cohort. RESULTS: We studied 430 black patients. They resided in neighborhoods where median household income was $41,498.10 and mean percentage of high school graduates was 73.4%. A total of 88 patients (20.9%) had PSA recurrence. Median follow-up for survivors was 37 months. Neither income nor education evaluated as continuous or categorical variables were predictors of PSA recurrence. When evaluated as composite categorical variable, the combination of greater income and education did not predict disease-free survival. CONCLUSIONS: Data suggest that socioeconomic factors have limited impact on PSA recurrence in black men treated with radical prostatectomy. Thus, biologic factors might have a role in the poor outcomes in this population
— id: 76449, year: 2008, vol: 72, page: 641, stat: Journal Article,

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer
Fleshner, N; Keane, T E; Lawton, C A; Mulders, P F; Payne, H; Taneja, S S; Morris, T
2008 ;11(1):46-52, Prostate cancer & prostatic diseases
Historically, adjuvant androgen deprivation therapy has been viewed as a palliative treatment option for patients with poor-prognosis non-metastatic prostate cancer. In addition, guidelines from bodies such as the European Association of Urology and American Society for Clinical Oncology do not specifically categorize adjuvant hormonal therapy as being curative in intent. We propose that adjuvant androgen deprivation therapy should now be classified as a treatment of curative intent in patients with poor-prognosis, non-metastatic prostate cancer. By applying a carefully considered definition of cure (based on long-term (10- to 15-year) disease-free survival curves) to the findings from randomized controlled clinical trials that have studied adjuvant hormonal treatments in non-metastatic prostate cancer, we challenged whether this viewpoint should now be considered redundant. According to our review of relevant studies and our definition of cure, goserelin appears to augment cure in a sizeable proportion of men with poor-prognosis non-metastatic prostate cancer when given adjuvant to radical prostatectomy or radiotherapy. Across several trials, the relevant survival curves for the goserelin-treated population became indefinitely flat after long-term follow-up. This indicates that these patients have a mortality risk comparable to the general population without prostate cancer. On the basis of the evidence presented within this review, we believe that, given it can control disease for a long period of time, adjuvant goserelin should be reclassified as a treatment of curative intent for patients with poor-prognosis non-metastatic prostate cancer
— id: 108185, year: 2008, vol: 11, page: 46, stat: Journal Article,

Contemporary clinical management of isolated high-grade prostatic intraepithelial neoplasia
Godoy, G; Taneja, S S
2008 ;11(1):20-31, Prostate cancer & prostatic diseases
High-grade prostatic intraepithelial neoplasia (HGPIN) is a premalignant lesion associated with increased risk of coexistent cancer or delayed progression to carcinoma. Extended biopsy schemes have improved the ability to rule out concurrent cancers, increased the detection of isolated HGPIN and removed the routine necessity for immediate repeat biopsy. As the natural history of HGPIN is poorly defined, and no non-invasive marker allows monitoring of progression to cancer, routine delayed interval biopsy should be considered in all patients. In this article, we present an overview of the existing literature on HGPIN and a proposed strategy for clinical management
— id: 78632, year: 2008, vol: 11, page: 20, stat: Journal Article,

Granular cell tumor of scrotum: a rare tumor of the male external genitalia
Godoy, Guilherme; Mufarrij, Patrick W; Tsou, Hui C; Torre, Pablo; Taneja, Samir S
2008 Sep;72(3):716.e7-716.e9, Urology
We report a rare case of granular cell tumor in the scrotum. Granular cell tumors are soft-tissue neoplasms originating from Schwann cells that rarely affect male external genitalia. They are essentially benign; therefore, the treatment is complete excision of the lesion. Although never previously reported in the male external genitalia, malignant variants exist in 2% of cases. Because the clinical presentation is not specific, the diagnosis of malignant granular cell tumors can be made only by the pathologist. To our knowledge, only 5 other cases in the scrotum and 19 cases described in the penis have been reported
— id: 86542, year: 2008, vol: 72, page: 716.e7, stat: Journal Article,

Lymph node dissection during the surgical treatment of renal cancer in the modern era
Godoy, Guilherme; O'Malley, Rebecca L; Taneja, Samir S
2008 Mar-Apr;34(2):132-142, International Brazillian journal of urology
The increasing use of routine CT scan, along with advances in imaging technology, have facilitated the early diagnosis of incidental renal masses. This has resulted in the reduction in the rate of metastatic disease diagnosis. Although surgery remains the mainstay in the treatment of renal tumors, the decreasing incidence of lymph node involvement has created controversy regarding the importance and the ideal extent of lymph node dissection, formerly considered mandatory at the time of radical nephrectomy. In this review, we critically assessed the role of lymph node dissection at the time of radical nephrectomy. To date, randomized trials have failed to show a benefit of lymph node dissection when broadly employed. This is likely due to the low prevalence of lymph node metastasis at the time of presentation, the unpredictable pattern of lymph node metastasis from renal tumors, and the continued downward stage migration of the disease. As a result, lymph node dissection for renal cancer is currently not recommended in the absence of gross lymphadenopathy. In high risk patients, lymph node dissection may be considered, but it remains controversial and more clinical evidence is warranted. Extended lymph node dissection is still recommended in individuals with isolated gross nodal disease or those with lymphadenopathy at the time of cytoreductive surgery prior to systemic therapy. A practical approach is summarized in an algorithm form
— id: 94947, year: 2008, vol: 34, page: 132, stat: Journal Article,

Regulation of prostate cell growth through androgen receptor cofactors
Logan, SK; Nwachukwu, JC; Mita, P; Taneja, SS; Garabedian, MJ
2008 ;179(4):190-190, Journal of urology
— id: 104579, year: 2008, vol: 179, page: 190, stat: Journal Article,

Evaluation of a novel precision template-guided biopsy system for detecting prostate cancer
Megwalu, Ifeanyichukwu I; Ferguson, Genoa G; Wei, John T; Mouraviev, Vladimir; Polascik, Thomas J; Taneja, Samir; Black, Linda; Andriole, Gerald L; Kibel, Adam S
2008 Aug 5;102(5):546-550, BJU international
OBJECTIVE: To explore the ability of a novel transrectal ultrasonography (TRUS) device (TargetScan, Envisioneering Medical Technologies, St. Louis MO) that creates a three-dimensional map of the prostate and calculates an optimal biopsy scheme, to accurately sample the prostate and define the true extent of disease, as standard TRUS-guided prostate biopsy relies on the operator to distribute the biopsy sites, often resulting in under- and oversampling regions of the gland. PATIENTS AND METHODS: In a multicentre retrospective chart review evaluating patients who had a TargetScan prostate biopsy between January 2006 and June 2007, we determined the overall cancer detection rate in all patients and in subgroups based on prostate specific antigen level, digital rectal examination, and indication for biopsy. We assessed the pathological significance of cancer detected, defined as a Gleason score of > or = 7, positive margins, extracapsular disease or > 20% tumour volume in the prostatectomy specimen. We also evaluated the concordance in Gleason score between the biopsy and prostatectomy specimen. RESULTS: Cancer was detected in 50 (35.7%) of the 140 patients biopsied, including 39 (47.6%) with no previous biopsies. Of 23 prostatectomy specimens, 20 (87%) had pathologically significant disease. The biopsy predicted the prostatectomy Gleason score in 12 patients (52%), overestimated in two (9%), underestimated in eight (35%), and biopsy Gleason score could not be assigned in one (4%). CONCLUSIONS: Template-guided biopsy potentially produces a higher cancer detection rate and more accurate assessment of grade. Prostatectomy specimens did not have a high rate of pathologically insignificant disease
— id: 139938, year: 2008, vol: 102, page: 546, stat: Journal Article,

Endoscopic manipulation of upper tract urothelial carcinoma results in a higher risk of subsequent bladder recurrence
Perlmutter, M; Shah, O; Godoy, G; Stifelman, M; Taneja, S
2008 MAR ;7(3):77-77, European Urology Supplements
— id: 76434, year: 2008, vol: 7, page: 77, stat: Journal Article,

Phase I/II study of biweekly paclitaxel and radiation in androgen-ablated locally advanced prostate cancer
Sanfilippo, Nicholas J; Taneja, Samir S; Chachoua, Abraham; Lepor, Herbert; Formenti, Silvia C
2008 Jun 20;26(18):2973-2978, Journal of clinical oncology
PURPOSE: To determine the maximum-tolerated dose (MTD) of concurrent paclitaxel and radiation therapy (RT) in patients with locally advanced prostate cancer. MATERIALS AND METHODS: Eligible patients had T2-4 tumors with Gleason scores greater than 7 and/or PSA levels greater than 10 ng/mL and/or had tumors with pathologic stage TxN1. Hormonal ablation was initiated 3 months before RT and was given for 9 months. RT was delivered daily (1.8 Gy) with concurrent twice-weekly paclitaxel (30 mg/m(2)). The whole pelvis was irradiated to 39.6 Gy. The radiation dose was escalated as follows: 63 Gy, 66.6 Gy, 70.2 Gy, and 73.8 Gy. The last RT dose level was fixed at 73.8 Gy. RESULTs: Between January 2000 and October 2006, 22 patients were enrolled. The median age was 59 years (range, 48 to 72 years); the median PSA level was 22.4 ng/mL (range, 2.8 to 113 ng/mL). The number of patients per stage was as follows: three with T1, eight with T2, 11 with T3, and five with pN1 = 5. No grade 3 toxicities occurred at 63 Gy. Grade 3 diarrhea occurred in three patients at 66.6 Gy. The protocol then was amended to treat the prostate volume first followed by the whole pelvis. No grade 3 toxicities were observed at 70.2 Gy. One patient experienced grade 3 diarrhea at 73.8 Gy. Five additional patients were treated to 73.8 Gy without grade 3 toxicity, which established the MTD for combined paclitaxel and RT at 73.8 Gy. At 38 months median follow-up (range, 9 to 87 months), 21 (95%) of 22 patients are alive. Six (27%) of 22 experienced recurrence. CONCLUSION: Concurrent biweekly paclitaxel with RT is feasible, with an MTD of 73.8 Gy. Recovery of gonadal function occurs in the majority of patients. These results encourage testing in a phase III setting
— id: 79569, year: 2008, vol: 26, page: 2973, stat: Journal Article,

Targeting prostate cancer for focal destruction: can we find it?
Taneja, Samir S; Tareen, Basir
2008 Oct 1;113(7):1500-1501, Cancer
— id: 94946, year: 2008, vol: 113, page: 1500, stat: Journal Article,

Baseline characteristics validate the inclusion criteria of a phase III comparison of toremifene and placebo for the prevention of prostate cancer in men with isolated high grade prostatic intraepithelial neoplasia (HGPIN)
Taneja, SS
2008 MAR ;7(3):224-224, European Urology Supplements
— id: 76436, year: 2008, vol: 7, page: 224, stat: Journal Article,

Prediction of Extraprostatic Extension in Men With Biopsy Gleason Score of 8 or Greater COMMENTS
Taneja, SS; Neissa, JM; Neissa, JR
2008 DEC ;180(6):2445-2446, Journal of urology
— id: 90948, year: 2008, vol: 180, page: 2445, stat: Journal Article,

Comparison of pathologic and oncologic outcomes of radical retro pubic prostatectomy among men with unilateral vs. bilateral prostate cancer: Implications for focal therapy
Tareen, B; Sankin, A; Godoy, G; Temkin, S; Lepor, H; Taneja, SS
2008 MAR ;7(3):169-169, European Urology Supplements
— id: 76435, year: 2008, vol: 7, page: 169, stat: Journal Article,

Do biopsy characteristics predict unilateral prostate cancer on radical prostatectomy?
Tareen, U; Sankin, A; Temkin, S; Godoy, G; Lepor, H; Taneja, S
2008 MAR ;7(3):252-252, European Urology Supplements
— id: 76440, year: 2008, vol: 7, page: 252, stat: Journal Article,

Delay in the progression of low-risk prostate cancer: rationale and design of the Reduction by Dutasteride of Clinical Progression Events in Expectant Management (REDEEM) trial
Fleshner, Neil; Gomella, Leonard G; Cookson, Michael S; Finelli, Antonio; Evans, Andrew; Taneja, Samir S; Lucia, M Scott; Wolford, Eric; Somerville, Matthew C; Rittmaster, Roger
2007 Nov;28(6):763-769, Contemporary clinical trials
PURPOSE: Men with prostate cancer may live as long as men their age without prostate cancer. Those with low-risk disease may benefit from expectant management, which actively monitors disease progression. Dutasteride, a dual 5alpha-reductase inhibitor (5ARI), may delay prostate cancer progression or extend the time to initiation of more aggressive therapy. MATERIALS AND METHODS: The Reduction by Dutasteride of Clinical Progression Events in Expectant Management (REDEEM) trial will evaluate whether dutasteride decreases time to prostate cancer progression. Three hundred candidates for expectant management with biopsy-proven, low-risk, localized prostate cancer will receive dutasteride 0.5 mg/day or placebo for 3 years. Eligible men are between 50 and 80 years of age, have clinical stage T1c-T2a prostate cancer, a Gleason score of less than or equal to 6, and serum prostate-specific antigen (PSA) less than or equal to 10 ng/mL. Entry biopsy of at least 10 cores had to be performed within 6 months of screening and will be repeated at 1.5 and 3 years. Men will complete questionnaires to measure symptoms, quality of life (QOL), and anxiety. Because PSA is an important monitoring tool in expectant management that may impact patients' comfort levels, actual PSA values will be provided to physicians and subjects. Time-to-disease progression (primary therapy for prostate cancer or pathologic progression), positive cores, change in Gleason score, and QOL assessments will be compared between groups. RESULTS: The trial completed recruitment of 302 subjects in March 2007. The study will be completed in 2010. CONCLUSIONS: The REDEEM study will evaluate the potential for dutasteride to delay disease progression in men with low-risk, localized prostate cancer. This study will better define which patients with prostate cancer can be managed with less invasive and potentially less debilitating therapy
— id: 94950, year: 2007, vol: 28, page: 763, stat: Journal Article,

Transcriptional regulation of the androgen receptor cofactor androgen receptor trapped clone-27
Nwachukwu, Jerome C; Li, Wenhui; Pineda-Torra, Ines; Huang, Hong Ying; Ruoff, Rachel; Shapiro, Ellen; Taneja, Samir S; Logan, Susan K; Garabedian, Michael J
2007 Dec;21(12):2864-2876, Molecular endocrinology
Cofactors modulate nuclear receptor activity and impact human health and disease, yet surprisingly little is known about their transcriptional regulation. Androgen receptor trapped clone-27 (ART-27) is a cofactor that binds to androgen receptor (AR) amino terminus and modulates AR-dependent transcription. Interestingly, ART-27 displays both a cell type- and developmental stage-specific expression pattern. However, the cis-acting elements and trans-acting factors affecting ART-27 gene expression have not been elucidated. We found that ART-27 gene expression is repressed and its promoter is histone H3-K27 tri-methylated in human embryonic kidney cells, but not prostate cells, and the histone deacetylase inhibitor, trichostatin A, relieves this inhibition. The DNA response elements that control the induction of ART-27 gene expression were also characterized. The major cis-acting element corresponds to a consensus cAMP-responsive element (CRE) and binds the CRE-binding protein (CREB) as shown by EMSA and chromatin immunoprecipitation assays. Furthermore, ART-27 promoter activity is induced upon CREB overexpression. Epidermal growth factor, which activates CREB via phosphorylation, also induces ART-27 expression, whereas a reduction in CREB phosphorylation or expression blocks this induction in prostate cells. In human prostate development, both epithelial and stromal cells express CREB; however, active phosphorylated CREB is restricted to epithelial cells where ART-27 is expressed. Based on these findings, we propose a transcriptional regulatory circuit for the developmental expression of ART-27 that includes repression by chromatin modification through a trichostatin A-sensitive factor and activation upon growth factor stimulation via CREB
— id: 94948, year: 2007, vol: 21, page: 2864, stat: Journal Article,

A matched-cohort comparison of laparoscopic cryoablation and laparoscopic partial nephrectomy for treating renal masses
O'Malley, Rebecca L; Berger, Aaron D; Kanofsky, Jamie A; Phillips, Courtney K; Stifelman, Michael; Taneja, Samir S
2007 Feb;99(2):395-398, BJU international
OBJECTIVE: To compare the surgical outcomes of elderly patients with renal masses treated with laparoscopic partial nephrectomy (LPN) or laparoscopic cryoablation (LCA). PATIENTS AND METHODS: All 15 patients who had LCA at the authors' institution between May 2003 and July 2005 were included, and compared with a matched cohort of 15 patients selected by patient age and tumour size, from a pre-existing database of 104 patients who had LPN from July 2002 to July 2005. The two groups were compared for gender, number of comorbidities, American Society of Anesthesiologists status (ASA), body mass index (BMI), baseline renal function and haematocrit, location and size of lesion, length of stay, operative time, estimated blood loss (EBL), transfusion rate, number and type of complications, conversion rate, and postoperative renal function and haematocrit. RESULTS: The two groups were similar in age, sex, BMI, ASA, baseline renal function, haematocrit, size and side of tumour, the percentage of exophytic tumours, and the likelihood of more than one comorbidity. Surgical outcomes between the groups were also relatively similar. The length of stay, creatinine and haematocrit levels after surgery did not differ between the groups. The LPN group had a significantly longer operation (248 vs 152 min, P < 0.001) and higher EBL (222 vs 59 mL, P = 0.007) than the LCA group, but only one patient required a transfusion and there was no discernible difference in discharge haematocrit values. No recurrences were detected in either group, with a similar mean follow-up of 9.8 and 11.9 months, respectively. CONCLUSION: Although this matched-cohort comparison showed that LPN had a higher mean EBL, a longer operation and higher relative risk of open conversion, the overall clinical outcome was similar in terms of complication rates, length of stay and changes in creatinine and haematocrit after surgery. In this small retrospective evaluation, there was similar morbidity, treatment outcome and short-term efficacy with LCA and LPN. At present, although still experimental, LCA is a good choice for elderly patients with comorbidities precluding blood loss or renal ischaemia. However, in experienced hands, LPN is a preferred option for most elderly patients and should be considered when contemplating definitive treatment of renal masses
— id: 71143, year: 2007, vol: 99, page: 395, stat: Journal Article,

Does endoscopic manipulation of upper tract Urothelial Carcinoma result in higher risk of subsequent bladder recurrence?
Perlmutter, M; Taneja, S; Godoy, G; Stifelman, M; Shah, O
2007 OCT ;21(1):A80-A80, Journal of endourology
— id: 75787, year: 2007, vol: 21, page: A80, stat: Journal Article,

Phase I study of bi-weekly paclitasel and definitive radiation in androgen ablated locally advanced prostate cancer
Sanfilippo, NJ; Taneja, SS; Chachoua, A; Lepor, H; Formenti, SC
2007 JAN ;69(3):S112-S113, International journal of radiation oncology biology physics
— id: 87193, year: 2007, vol: 69, page: S112, stat: Journal Article,

CT and MR imaging findings following laparoscopic and open nephron sparing surgery
Stifelman, M; Brown, K; Hyams, E; Lipkin, M; Hecht, E; Taneja, S
2007 OCT ;21(1-2):A274-A274, Journal of endourology
— id: 98150, year: 2007, vol: 21, page: A274, stat: Journal Article,

Words of wisdom. Re: Age adjusted prostate specific antigen and prostate specific antigen velocity cut points in prostate cancer screening
Taneja, Samir S
2007 Aug;52(2):607-607, European urology
— id: 94949, year: 2007, vol: 52, page: 607, stat: Journal Article,

A new staging system for locally advanced (pT3-4) renal cell carcinoma: A multicenter European study including 2,000 patients - Editorial comments
Taneja, SS
2007 AUG ;178(2):423-424, Journal of urology
— id: 73816, year: 2007, vol: 178, page: 423, stat: Journal Article,

Differences in clinicopathologic features of prostate cancer between black and white patients treated in the 1990s and 2000s
Berger, Aaron D; Satagopan, Jaya; Lee, Peng; Taneja, Samir S; Osman, Iman
2006 Jan;67(1):120-124, Urology
OBJECTIVES: We have previously reported on the disparity in the clinicopathologic features of prostate cancer between black and white patients at our equal-access institution during the 1990s. The goal of this study was to determine whether the worse clinicopathologic features of prostate cancer in black patients have persisted in the 2000s. METHODS: We examined 362 men (224 black and 138 white) treated with radical prostatectomy at the Veterans Affairs Medical Center in New York. We compared the clinicopathologic variables between 227 patients treated during the 1990s (group 1) and 135 treated in the 2000s (group 2). RESULTS: In group 1, black patients were significantly younger (P < 0.001) and had a greater prostate-specific antigen (PSA) level (P = 0.001), Gleason score (P = 0.005), and stage (P = 0.03) than white patients. In group 2, black patients continued to have significantly greater PSA levels (P = 0.04) and Gleason scores (P = 0.005) than white patients. Comparing only the black patients, those in group 2 had significantly lower PSA levels (P < 0.001) and stage (P = 0.03), but had worse Gleason scores (P = 0.03) than those in group 1. On multivariate analysis, black patients were significantly more likely to have a worse Gleason score (P = 0.005) than white patients. CONCLUSIONS: Our data have demonstrated a narrowing of the differences in pathologic stage between black and white patients in the 2000s. However, black men have continued to have worse Gleason scores and greater PSA levels than white patients. These findings suggest that there may be different patterns of molecular alterations in black men that may contribute to the poor tumor differentiation. Additional research is underway to better characterize these underlying molecular mechanisms
— id: 68181, year: 2006, vol: 67, page: 120, stat: Journal Article,

Robot assisted laparoscopic partial nephrectomy: initial experience
Caruso, Robert P; Phillips, Courtney K; Kau, Eric; Taneja, Samir S; Stifelman, Michael D
2006 Jul;176(1):36-39, Journal of urology
PURPOSE: Advances in laparoscopy have made laparoscopic partial nephrectomy a technically feasible procedure but it remains challenging to even experienced laparoscopists. We hypothesized that robotic assisted laparoscopic partial nephrectomy may make this procedure more efficacious than the standard laparoscopic approach. MATERIALS AND METHODS: Ten patients with a mean age of 58 years and mean tumor size of 2.0 cm underwent robotic assisted laparoscopic partial nephrectomy and another 10 with a mean age of 61 years and mean tumor size of 2.18 cm underwent laparoscopic partial nephrectomy, as performed by a team of 2 surgeons (MS and ST) between May 2002 and January 2004. Demographic data, intraoperative parameters and postoperative data were compared between the 2 groups. RESULTS: There were no significant differences in patient demographics between the 2 groups. Intraoperative data and postoperative outcomes were statistically similar. In the 10 patients who underwent robotic assisted laparoscopic partial nephrectomy there were 2 intraoperative complications. There was 1 conversion in the laparoscopic partial nephrectomy group. CONCLUSIONS: Robotic assisted laparoscopic partial nephrectomy is a safe and feasible procedure in patients with small exophytic masses. The robotic approach to laparoscopic partial nephrectomy does not offer any clinical advantage over conventional laparoscopic nephrectomy
— id: 66462, year: 2006, vol: 176, page: 36, stat: Journal Article,

Impact of discordant radiologic and pathologic tumor size on renal cancer staging
Kanofsky, Jamie A; Phillips, Courtney K; Stifelman, Michael D; Taneja, Samir S
2006 Oct;68(4):728-731, Urology
OBJECTIVES: To determine whether the discrepancy in the radiologic and pathologic size of renal cell carcinoma influences the final cancer stage. METHODS: Renal masses resected from December 1999 to September 2004 were identified using a pathologic database and compared by surgical accession number to an existing clinical renal tumor database to identify those T1 and T2 tumors for which radiologic and pathologic data were available. The tumor histologic features, maximal pathologic diameter, and maximal radiologic diameter were recorded. The percentage of tumor size reduction was then calculated using these data. RESULTS: Of the 236 renal cancers evaluated, 52% had regressed in size when comparing the pathologic and radiologic sizes. When stratified by histologic subtype, clear cell tumors regressed more often and to a greater degree than those that were chromophobe or papillary. Also, 15 organ-confined tumors were downstaged when comparing the maximal radiologic diameter and the maximal pathologic diameter, and 13 of these were clear cell tumors. CONCLUSIONS: A reduction in kidney tumor size is commonly observed at surgical resection because of a loss of blood flow to the tumor. This tumor size reduction has an impact on the final pathologic stage in organ-confined tumors for which size is the only criterion. The greatest tumor size reduction, and most frequent downstaging, was observed for conventional (clear cell) tumors. We believe this may explain, in part, the worse stage-stratified outcomes for clear cell tumors compared with other tumor types. We propose that renal cancer staging should be determined from accurate measurement of the radiologic size, rather than the pathologic size
— id: 69087, year: 2006, vol: 68, page: 728, stat: Journal Article,

Obesity and prostate cancer
O'Malley, Rebecca L; Taneja, Samir S
2006 Apr;13 Suppl 2:11-17, Canadian journal of urology
The relationship between obesity and prostate cancer is currently a hotly debated topic, but despite the number of publications devoted to the topic, the actual nature of the relationship remains uncertain. Obesity has been shown to have a direct relationship with the incidence of prostate cancer in a number of studies but an equal number of studies have shown no association. The relationship is further obscured with recent findings that obesity in younger obese men may actually be protective against prostate cancer. Confounding factors include the lack of correlation of body mass index (BMI) as a measure of central obesity and the lack of consistency in timing of BMI measurements, i.e. before or after diagnosis and in young or advanced adulthood. Evidence for increased BMI as a risk factor for prostate cancer is unclear, but less ambiguous is the mounting substantiation that obesity is associated with prognostically worse disease, poorer post-surgical outcomes and increased prostate cancer mortality, irregardless of margin status. From a biologic perspective, one can put forth a number of potential mechanisms by which obesity might promote prostate cancer and/or prostate cancer progression including; low levels of testosterone, increased levels of estrogen, co-existing diabetes or metabolic syndrome, increased circulating insulin-growth factor-one (IGF-1), increased levels of leptin, decreased levels of adiponectin and increased dietary saturated fats. Evidence for the association of these factors with prostate cancer are examined herein. The timing of serum measurements is crucial in elucidating whether these factors have causative influence on prostate cancer or rather are produced by the prostate cancer cells and are better understood as markers of disease. The interaction between obesity and prostate cancer is important to clarify because it will have impact on the prevention, prognostication and treatment of prostate cancer. Future study with careful attention to avoid the methodological pitfalls of the past need be accomplished to bear out the nature of the interaction of obesity and prostate cancer
— id: 67386, year: 2006, vol: 13 Suppl 2, page: 11, stat: Journal Article,

Loss of neutral endopeptidase and activation of protein kinase B (Akt) is associated with prostate cancer progression
Osman, Iman; Dai, Jie; Mikhail, Maryann; Navarro, Daniel; Taneja, Samir S; Lee, Peng; Christos, Paul; Shen, Ruoqian; Nanus, David M
2006 Dec 1;107(11):2628-2636, Cancer
BACKGROUND: Neutral endopeptidase (NEP) is a cell-surface peptidase that can regulate the activation of Akt kinase through catalytic-dependent and independent mechanisms. NEP expression is absent in approximately 50% of prostate cancers. The authors investigated whether NEP loss in vivo would result in Akt phosphorylation and potentially contribute to prostate cancer progression by examining the interaction of NEP, Akt, and phosphatase and tensin homolog (PTEN) in a prostate xenograft model and in clinical specimens from patients with prostate cancer. METHODS: Using a tetracycline-repressible expression system to express NEP in a tumor animal xenograft model, the effects of NEP were tested on tumor growth, Akt phosphorylation, and PTEN expression. The clinical relevance of NEP, phosphorylated Akt, and PTEN protein expression also was investigated in 204 patients who had undergone radical prostatectomy. RESULTS: The results indicated that the induction of NEP expression inhibited established xenograft tumor growth, diminished Akt phosphorylation, and increased PTEN protein levels. In humans, prostate cancers with complete loss of NEP expression were significantly more likely to express phosphorylated Akt (P = .02). Moreover, patients who had prostate cancers with concomitant loss of NEP and expression of phosphorylated Akt had an increased, independent risk of prostate-specific antigen (PSA) recurrence (P = .03). In the study cohort, loss of PTEN protein expression did not correlated significantly with phosphorylated Akt or with patients' clinical outcome. CONCLUSIONS: The findings from this investigation demonstrated that NEP loss leads to Akt activation and contributes to the clinical progression of prostate cancer
— id: 94952, year: 2006, vol: 107, page: 2628, stat: Journal Article,

The Mitsuyama/Wallner/Merrick article reviewed
Taneja SS; Neissa JM; Neissa JR
2006 ;20(10):1198+1206-, Oncology
— id: 73052, year: 2006, vol: 20, page: 1198+1206, stat: Journal Article,

Prostate biopsy: targeting cancer for detection and therapy
Taneja, Samir S
2006 Fall;8(4):173-182, Reviews in urology
Despite improvements in cancer detection, prostate biopsy still lacks the ability to accurately map locations of cancer within the prostate. Improvements in prostate imaging may allow more accurate mapping of overall disease volume. Magnetic resonance (MR) spectroscopy allows improved specificity in detecting even small foci of disease within the peripheral zone. Improvements in MR-guided biopsy techniques may allow this technology to be adapted to therapeutics as well. Computer modeling of individual prostates serves as a means of designing optimized plans for prostate biopsy. The use of novel targeted biopsy schemes may allow an integration of available technologies in detection and localization of prostate cancer. Computer-directed needle biopsies based on anatomic landmarks within the prostate and computerized three-dimensional reconstruction of the gland may allow a highly reproducible means of identifying small foci of cancer, targeting them for therapy, and monitoring for recurrence. The TargetScan(R) system (Envisioneering Medical Technologies, St. Louis, MO) is the first technology to integrate available targeting methodologies in a systematic fashion
— id: 94951, year: 2006, vol: 8, page: 173, stat: Journal Article,

Toremifene--a promising therapy for the prevention of prostate cancer and complications of androgen deprivation therapy
Taneja, Samir S; Smith, Matthew R; Dalton, James T; Raghow, Sharan; Barnette, Gary; Steiner, Mitchell; Veverka, Karen A
2006 Mar;15(3):293-305, Expert opinion on investigational drugs
Deregulation of the estrogen axis in humans prompts a series of tissue-specific events. In the breast and prostate, alterations in estrogen signalling lead to genotypic and phenotypic molecular alterations that result in dysplastic cellular appearance, deregulated cell growth and carcinoma. In bone, decreased estrogen leads to increased osteoclastogenesis and bone resorption, decreased bone mineral density and a significant fracture risk. Toremifene is a selective estrogen receptor modulator that exerts pharmacological activity in the breast, bone and prostate. An intense interest in developing this agent for prostate cancer chemoprevention is based on the reduction of premalignant and malignant prostate lesions in a transgenic model of prostate cancer. Biological and clinical activity was demonstrated in Phase II trials by the prevention of progression to prostate cancer in men with high-grade prostate intraepithelial neoplasia and through suppression of bone turnover biomarkers and increased bone mineral density in men on androgen deprivation therapy for prostate cancer
— id: 63837, year: 2006, vol: 15, page: 293, stat: Journal Article,

Extranodal extension in regional lymph nodes is associated with outcome in patients with renal cell carcinoma - Comment
Taneja, SS
2006 NOV ;176(5):1982-1983, Journal of urology
— id: 69001, year: 2006, vol: 176, page: 1982, stat: Journal Article,

Multifocal renal oncocytoma in a patient with Von Hippel-Lindau mutation
Fiske, Joshua; Patel, Rupa; Kau, Eric; Pappas, John G; Garcia, Roberto A; Taneja, Samir S
2005 Dec;66(6):1320-1320, Urology
Von Hippel-Lindau disease (VHL) is a rare genetic disease with a lifetime risk of clear cell renal cell carcinoma in approximately 70% of cases. We present a case of a 63-year-old man with bilateral, multifocal renal masses. Genetic testing results were consistent with a VHL deletion. The patient had no other disease manifestations consistent with VHL. The patient underwent staged bilateral nephron-sparing procedures. Pathology of all renal masses revealed oncocytoma. To our knowledge, we describe the first reported case of multiple renal oncocytomas in a male patient with a germline VHL mutation
— id: 61863, year: 2005, vol: 66, page: 1320, stat: Journal Article,

Adjuvant androgen deprivation therapy offers a "CURE" in patients with poor prognosis non-metastatic prostate cancer
Fleshner, N; Keane, TE; Lawton, CA; Payne, H; Mulders, PF; Taneja, S
2005 NOV 16 ;63(2):S288-S288, International journal of radiation oncology biology physics
— id: 58993, year: 2005, vol: 63, page: S288, stat: Journal Article,

Androgen receptor mutations identified in prostate cancer and androgen insensitivity syndrome display aberrant ART-27 coactivator function
Li, Wenhui; Cavasotto, Claudio N; Cardozo, Timothy; Ha, Susan; Dang, Thoa; Taneja, Samir S; Logan, Susan K; Garabedian, Michael J
2005 May 26;19(9):2273-2282, Molecular endocrinology
The transcriptional activity of the androgen receptor (AR) is modulated by interactions with coregulatory molecules. It has been proposed that aberrant interactions between AR and its coregulators may contribute to diseases related to AR activity, such as prostate cancer and androgen insensitivity syndrome (AIS); however, evidence linking abnormal receptor:cofactor interactions to disease is scant. The Androgen Receptor Trapped clone-27 (ART-27) is a recently identified AR N-terminal coactivator that is associated with AR-mediated growth inhibition. Here we analyze a number of naturally occurring AR mutations identified in prostate cancer and AIS for their ability to affect AR response to ART-27. Although the vast majority of AR mutations appeared capable of increased activation in response to ART-27, an AR mutation identified in prostate cancer (AR P340L) and AIS (AR E2K) show reduced transcriptional responses to ART-27, whereas their response to the p160 class of coactivators was not diminished. Relative to the wild-type receptor, less ART-27 protein associated with the AR E2K substitution, consistent with reduced transcriptional response. Surprisingly, more ART-27 associated with AR P340L, despite the fact that the mutation decreased transcriptional activation in response to ART-27. Our findings suggest that aberrant AR-coactivator association interferes with normal ART-27 coactivator function resulting in suppression of AR activity and may contribute to the pathogenesis of diseases related to alterations in AR activity, such as prostate cancer and AIS
— id: 56038, year: 2005, vol: 19, page: 2273, stat: Journal Article,

Overactive bladder: achieving a differential diagnosis from other lower urinary tract conditions
Nitti, V; Taneja, S
2005 Jul;59(7):825-830, International journal of clinical practice
Overactive bladder (OAB) is a debilitating condition characterised by an urgent need to urinate (urgency), often with urinary frequency and, in some cases, urgency incontinence and nocturnal frequency. Patients often adopt complex adaptive behaviours to cope with their symptoms as OAB can compromise all dimensions of a patient's quality of life. Most OAB patients present initially to their primary care physician. Diagnosis is based on presenting symptomatology and does not require any invasive tests. Direct questioning about symptoms is important in achieving a differential diagnosis. The most common condition to be considered when working towards a differential diagnosis is a urinary tract infection (UTI). However, some physicians have expressed concerns about identifying the small number of cases where bladder cancer is a potential underlying aetiology for the symptoms of OAB. In this review, we examine the prevalence and patient profiles for these bladder conditions and their presenting symptomatology. We also review tests that may be recommended to exclude a diagnosis of UTI or bladder cancer and present a diagnostic algorithm suitable for office-based primary care practice.
— id: 58184, year: 2005, vol: 59, page: 825, stat: Journal Article,

Serum levels of shed Her2/neu protein in men with prostate cancer correlate with disease progression
Osman, Iman; Mikhail, Maryann; Shuch, Brian; Clute, Megan; Cheli, Carol D; Ghani, Farooq; Thiel, Robert P; Taneja, Samir S
2005 Dec;174(6):2174-2177, Journal of urology
PURPOSE: We determined the association between serum levels of shed Her-2/neu protein and disease progression in men with prostate cancer. MATERIALS AND METHODS: Serum from 279 patients enrolled in a prospective serum bank and database at New York University Medical Center was analyzed using the Food and Drug Administration approved Immuno-1 Her-2/neu assay. Patients were classified by the Prostate-Specific Antigen Working Group model into 5 groups, namely group 1-no evidence of cancer in 60, group 2-clinically localized disease in 67, group 3-prostate specific antigen increasing after therapy and no clinical metastases in 77, group 4-clinical metastases and castration sensitivity in 42, and group 5-clinical metastases and castration resistance in 33. A cutoff of 14 ng/ml for normal serum Her-2/neu was established based on the 95th order statistic in group 1. RESULTS: Of 279 patients 37 (13.3%) had increased serum Her-2/neu, that is 5%, 11.9%, 10.4%, 16.7% and 33.3% in groups 1 to 5, respectively. There was a significant difference between patients with (groups 4 and 5) and without (groups 2 and 3) clinical metastases (p = 0.006). In group 5 patients serum Her-2/neu was significantly higher than in group 2 patients (p <0.02). The risk of cause specific death increased significantly with each unit increase in serum Her-2/neu (p <0.001). CONCLUSIONS: Increased serum Her-2/neu correlates with the presence of metastatic disease and it may indicate an increased risk of death in patients with castrate, metastatic prostate cancer. The detection of serum Her-2/neu is a minimally invasive alternative to tumor sampling for identifying potential candidates for anti-Her-2/neu treatment strategies. Further studies are needed to optimize this assay for application in the clinical setting
— id: 68182, year: 2005, vol: 174, page: 2174, stat: Journal Article,

Prostate-specific antigen velocity accurately predicts response to salvage radiotherapy in men with biochemical relapse after radical prostatectomy
Patel, Rupa; Lepor, Herbert; Thiel, Robert P; Taneja, Samir S
2005 May;65(5):942-946, Urology
OBJECTIVES: To determine whether prostate-specific antigen (PSA) velocity (PSAV), used as a selection criterion for salvage radiotherapy (RT) after radical prostatectomy (RP), predicts the likelihood of response to RT in men with biochemical relapse. METHODS: We retrospectively reviewed the records of 48 patients who had undergone salvage RT for biochemical relapse after RP. All men were followed up with serial PSA measurements for a minimum of 6 months from their initial PSA recurrence, and RT was only offered to those patients with a serum PSA level remaining at less than 1.0 ng/mL. The response to RT was defined as maintenance of a PSA level of less than 0.1 ng/mL. The pathologic and clinical parameters, including PSAV, were examined to determine their individual ability to predict the response to RT. RESULTS: Of the 48 patients, 30 had maintained a PSA level of less than 0.1 ng/mL at a median follow-up of 16 months. The PSAV was strongly predictive of the likelihood of a response to salvage RT. The median relapse-free survival time for patients with a PSAV of less than 0.035 ng/mL/mo was 28 months compared with 16 months for patients with a PSAV greater than 0.035 ng/mL/mo. All other parameters tested, including Gleason score, seminal vesicle invasion, extracapsular extension, and margin status, were not predictive of the likelihood of a response to RT. CONCLUSIONS: In the present study, PSAV accurately predicted the likelihood of response to salvage RT in men with biochemical relapse after RP. No other pathologic parameters predicted the likelihood of response to RT. Using PSAV as a sole selection criterion for salvage RT after RP may allow improvement in the historically low rates of durable response
— id: 56091, year: 2005, vol: 65, page: 942, stat: Journal Article,

Renal tumor with associated venous tumor thrombus prolapsing through tricuspid valve during diastole
Patel, Rupa; Schwartzbard, Arthur; Bosco, Joseph; Torre, Pablo; Taneja, Samir S
2005 Jul;66(1):195-195, Urology
We describe the case of a 76-year-old man with a renal cell carcinoma thrombus extending into the right atrium, prolapsing across the tricuspid valve into the right ventricle during diastole, and producing sufficient portal venous pressure to result in intestinal venous thrombosis and necrosis of the upper gastrointestinal mucosa. The related published studies are reviewed and discussed
— id: 58656, year: 2005, vol: 66, page: 195, stat: Journal Article,

Robot-assisted laparoscopic partial nephrectomy: the NYU technique
Phillips, Courtney K; Taneja, Samir S; Stifelman, Michael D
2005 May;19(4):441-445, Journal of endourology
The introduction of the daVinci surgical system has changed the way both surgeon and patient view radical prostatectomy. We hypothesized that the same theoretical and tangible benefits may be realized when employing the system for partial nephrectomy. This paper reviews our technique of robot-assisted laparoscopic partial nephrectomy (RALPN) utilizing the daVinci surgical system. Intraoperative hilar clamping is utilized in all cases. With the daVinci system, the tumor is excised with cold scissors, biopsies are taken from the base for frozen-section study, sutures are placed at the base, Gelfoam/fibrin glue is activated in the defect, a Surgicel bolster is laid in the defect, and mattress sutures are placed prior to releasing the clamp. After performing 12 RALPNs, it appears this technique is safe, feasible, and reproducible both for small exophytic masses and for deeper lesions involving the collecting system. A RALPN requires two surgeons, both well versed in laparoscopic and robotic techniques
— id: 56167, year: 2005, vol: 19, page: 441, stat: Journal Article,

Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy
Shen, Samson; Lepor, Herbert; Yaffee, Robert; Taneja, Samir S
2005 Mar;173(3):777-780, Journal of urology
PURPOSE: Ultrasensitive prostate specific antigen (PSA) assays allow a lower limit of detection (less than 0.01 ng/ml) than standard PSA assays. In this study we examined the ability of ultrasensitive PSA nadir to predict relapse after radical prostatectomy (RP). MATERIALS AND METHODS: A total of 906 men treated with RP were followed with PSA measurements at 3, 6 and 12 months, and yearly thereafter. Of the 906 men 545 (60%) with a PSA nadir of less than 0.01 ng/ml or at least 3 followup ultrasensitive PSA measurements underwent analysis and stratification by PSA nadir. Biochemical relapse was defined as 2 consecutive increasing post-nadir PSA measurements of 0.1 ng/ml or greater. The ability of ultrasensitive PSA nadir to predict relapse was assessed by univariate and multivariate analysis. RESULTS: At a mean followup of 3.1 years 54 of 545 men (9.9%) experienced biochemical relapse with a mean time to relapse of 25.2 months. Relapse rates in men with a PSA nadir of less than 0.01 (423), 0.01 (75), 0.02 (19) and 0.04 or greater ng/ml (28) were 4%, 12%, 16% and 89%, respectively. Men with a nadir of less than 0.01 ng/ml had a significantly lower relapse rate than men with a nadir of 0.01 (p <0.01), 0.02 (p <0.025) or 0.04 or greater ng/ml (p <0.01). Multivariate logistic regression analysis showed that a nadir of 0.01 (p <0.05), 0.02 (p <0.05) and 0.04 or greater ng/ml (p <0.01) independently predicted an increased risk of biochemical relapse compared to a nadir of less than 0.01 ng/ml. CONCLUSIONS: Ultrasensitive PSA nadir accurately predicts the risk of early biochemical relapse following RP. Men who achieve a nadir of less than 0.01 ng/ml have a low likelihood of early relapse. Higher nadir points may identify candidates for early adjuvant or salvage therapies
— id: 56092, year: 2005, vol: 173, page: 777, stat: Journal Article,

Robot-assisted laparoscopic partial nephrectomy
Stifelman, Michael D; Caruso, Robert P; Nieder, Alan M; Taneja, Samir S
2005 Jan-Mar;9(1):83-86, Journal of the Society of Laparoendoscopic Surgeons
The indications for nephron-sparing surgery and for minimally invasive surgery are continually expanding. Nephron-sparing surgery, also known as partial nephrectomy, presents a challenge to the minimally invasive surgeon. Herein, we describe our technique of robot-assisted laparoscopic partial nephrectomy. This approach may have potential advantages of including easier excision and suturing. Moderate training is required
— id: 56168, year: 2005, vol: 9, page: 83, stat: Journal Article,

Drug therapies for eradicating high-grade prostatic intraepithelial neoplasia in the prevention of prostate cancer
Taneja, Samir S
2005 ;7 Suppl 3:S19-S29, Reviews in urology
High-grade prostatic intraepithelial neoplasia (HGPIN) is a precursor to invasive prostate cancer observed as an isolated entity in a growing subset of men undergoing prostate biopsy. The presence of HGPIN predicts an increased risk of 1) coexisting occult prostate cancer at baseline and 2) delayed progression to prostate cancer. As such, men with HGPIN represent a population at high risk for the development of prostate cancer. Because the current recommended therapy is observation and delayed-interval biopsies until cancer develops, a well-tolerated therapeutic agent capable of interrupting the progression of HGPIN to cancer is highly desirable. Given the known cancer-stimulatory effects of estrogens in the prostate, the use of selective estrogen receptor modulators (SERMs) to provide an antiestrogen effect represents a novel strategy for prostate cancer prevention. Recent phase II data from trials using toremifene in the treatment of men with HGPIN validate the use of SERMs as a rational and provocative strategy for the prevention of prostate cancer
— id: 108188, year: 2005, vol: 7 Suppl 3, page: S19, stat: Journal Article,

Cell-specific regulation of androgen receptor phosphorylation in vivo
Taneja, Samir S; Ha, Susan; Swenson, Nicole K; Huang, Hong Ying; Lee, Peng; Melamed, Jonathan; Shapiro, Ellen; Garabedian, Michael J; Logan, Susan K
2005 Dec 9;280(49):40916-40924, Journal of biological chemistry
The biological ramifications of phosphorylation of the androgen receptor (AR) are largely unknown. To examine the phosphorylation of AR at serine 213, a putative substrate for Akt, a phosphorylation site-specific antibody was generated. The use of this antibody indicated that AR Ser-213 is phosphorylated in vivo and that phosphorylation is tightly regulated in a cell type-specific manner. Furthermore, Ser-213 phosphorylation took place with rapid kinetics and was inhibited by the phosphatidylinositol 3-kinase inhibitor LY294002. Phosphorylation occurred in response to R1881 and dihydrotestosterone but weakly if at all in response to testosterone. It did not occur in response to AR antagonists or growth factor stimulation in the absence of an AR agonist. Transcription assays using an AR-responsive reporter gene construct showed that activated phosphatidylinositol 3-kinase inhibited transcription mediated by wild type AR but not that of a mutant AR variant (S213A), which could not be phosphorylated at Ser-213. By immunohistochemistry, the AR Ser(P)-213 antigen was detected in prostate epithelial but not stromal cells despite the fact that an antibody recognizing both phosphorylated and non-phosphorylated forms of AR demonstrates that AR is present in both cell types as expected. In fetal tissue the AR-Ser(P)-213 antigen was present in epithelial cells of the urogenital sinus when endogenous androgen levels were high and activated Akt was prevalent, but absent at a later stage of development when endogenous androgen levels were low and Akt activation was minimal. Immunoreactivity was evident in differentiated cells lining the lumen of the urogenital sinus but not in rapidly dividing, Ki67 positive cells within the developing prostate or stromal tissue, suggesting that site-specific phosphorylation of AR Ser-213 by cellular kinases occurs in a non-proliferating cellular milieu
— id: 61359, year: 2005, vol: 280, page: 40916, stat: Journal Article,

"A randomized, controlled 6-Mo intervention with soy protein isolate in men with biochemical recurrence after radical prostatectomy"
Bosland, MC; Zeleniuch-Jacquotte, A; Melamed, J; Lepor, H; Taneja, SS; Schmoll, J; Watanabe, H; Levinson, B; Randolph, C; Walden, PD
2004 MAY ;134(5):1259S-1259S, Journal of nutrition
— id: 46488, year: 2004, vol: 134, page: 1259S, stat: Journal Article,

Altered N-myc downstream-regulated gene 1 protein expression in African-American compared with caucasian prostate cancer patients
Caruso, Robert P; Levinson, Benjamin; Melamed, Jonathan; Wieczorek, Rosemary; Taneja, Samir; Polsky, David; Chang, Caroline; Zeleniuch-Jacquotte, Anne; Salnikow, Konstantin; Yee, Herman; Costa, Max; Osman, Iman
2004 Jan 1;10(1 Pt 1):222-227, Clinical cancer research
PURPOSE: The protein encoded by N-myc downstream-regulated gene 1 (NDRG1) is a recently discovered protein whose transcription is induced by androgens and hypoxia. We hypothesized that NDRG1 expression patterns might reveal a biological basis for the disparity of clinical outcome of prostate cancer patients with different ethnic backgrounds. EXPERIMENTAL DESIGN: Patients who underwent radical prostatectomy between 1990 and 2000 at Veterans Administration Medical Center of New York were examined. We studied 223 cases, including 157 African Americans and 66 Caucasians (T2, n = 144; >/=T3, n = 79; Gleason <7, n = 122; >/=7, n = 101). Three patterns of NDRG1 expression were identified in prostate cancer: (a) intense, predominately membranous staining similar to benign prostatic epithelium; (b) intense, nucleocytoplasmic localization; and (c) low or undetectable expression. We then examined the correlations between patients' clinicopathological parameters and different NDRG1 expression patterns. RESULTS: In this study of patients with equal access to care, African-American ethnic origin was an independent predictor of prostate-specific antigen recurrence (P < 0.05). We also observed a significant correlation between different patterns of NDRG1 expression and ethnic origin. Pattern 2 was less frequent in African Americans (21% versus 38%), whereas the reverse was observed for pattern 3 (60% in African Americans versus 44% in Caucasians; P = 0.03). This association remained significant after controlling for both grade and stage simultaneously (P = 0.02). CONCLUSIONS: Our data suggest that different NDRG1 expression patterns reflect differences in the response of prostatic epithelium to hypoxia and androgens in African-American compared with Caucasian patients. Further studies are needed to determine the contribution of NDRG1 to the disparity in clinical outcome observed between the two groups
— id: 44771, year: 2004, vol: 10, page: 222, stat: Journal Article,

Malignant epithelioid angiosarcoma of the external iliac vein presenting as venous thrombosis
Greenwald, Uri; Newman, Elliot; Taneja, Samir; Rockman, Caron
2004 Jul;18(4):493-496, Annals of vascular surgery
A case is reported of a 28-year-old female who initially presented with a right iliac deep venous thrombosis of unclear etiology. A stenosis in the iliac vein was seen, but no intrinsic or extrinsic mass was noted on multiple imaging studies. The patient presented 2 years later with right hydronephrosis, and at that time a right pelvic mass was discovered. Resection was performed with concomitant reconstruction of the right iliac arterial system, and pathology revealed a malignant epithelioid angiosarcoma
— id: 46864, year: 2004, vol: 18, page: 493, stat: Journal Article,

Preoperative renal tumor evaluation by three-dimensional magnetic resonance imaging: Staging and detection of multifocality
Huang, George J; Israel, Gary; Berman, Adam; Taneja, Samir S
2004 Sep;64(3):453-457, Urology
OBJECTIVES: To evaluate, retrospectively, the staging accuracy of three-dimensional magnetic resonance imaging (3D-MRI) in our institution as a prelude to a prospective comparison of 3D-MRI and 3D computed tomography (CT) for preoperative planning of partial nephrectomy. In recent years, the use of 3D-CT for preoperative evaluation and surgical planning in patients undergoing nephron-sparing surgery has gained considerable popularity. METHODS: The images of 26 consecutive patients evaluated by 3D-MRI as part of the preoperative imaging studies for renal tumor were evaluated retrospectively and compared with the surgical pathologic findings to evaluate the ability of 3D-MRI to predict tumor multifocality, tumor stage, collecting system invasion, and venous invasion. RESULTS: 3D-MRI accurately predicted tumor multifocality in 1 of 2 cases. Imaging identified five of seven multifocal lesions. Two subcentimeter lesions were missed. Preoperative staging was correct in 29 of 30 lesions (97% accuracy). One T3b tumor was incorrectly staged as T2. Venous invasion was identified in 2 of 3 cases (67% sensitivity), but no false-positive results were seen. 3D-MRI had 100% sensitivity and 88% specificity in the prediction of collecting system invasion. CONCLUSIONS: The staging accuracy of 3D-MRI appears to be quite good. Given the accuracy of this technique, along with the popularity of 3D imaging before renal surgery, these results provide the impetus for a future study directly comparing 3D-CT with 3D-MRI in the capacity of surgical preoperative planning
— id: 44980, year: 2004, vol: 64, page: 453, stat: Journal Article,

Racial disparity of epidermal growth factor receptor (EGFR) expression in prostate cancer (PC)
Osman, I; Shuch, B; Yee, H; Lee, P; Cordon-Crado, C; Taneja, S; Chang, C; Satagopan, J
2004 JUL 15 ;22(14):395S-395S, Journal of clinical oncology
— id: 48683, year: 2004, vol: 22, page: 395S, stat: Journal Article,

Neutral endopeptidase protein expression and prognosis in localized prostate cancer
Osman, Iman; Yee, Herman; Taneja, Samir S; Levinson, Benjamin; Zeleniuch-Jacquotte, Anne; Chang, Caroline; Nobert, Craig; Nanus, David M
2004 Jun 15;10(12 Pt 1):4096-4100, Clinical cancer research
PURPOSE: Neutral endopeptidase (NEP) is a cell-surface peptidase that inactivates neuropeptide growth factors implicated in prostate cancer progression. The clinical significance of decreased NEP expression observed in prostate cancer is unclear. We investigated whether decreased NEP expression in localized prostate cancers is associated with prostate-specific antigen (PSA) relapse after radical prostatectomy. EXPERIMENTAL DESIGN: NEP expression patterns were examined by immunohistochemistry in 223 men, who underwent radical prostatectomy between 1990 and 2000 at the Veterans Administration Medical Center (New York, NY) with available representative tissues and adequate follow up. We also examined whether hypermethylation of the NEP promoter contributes to down-regulation of NEP protein expression in a subset of patients that showed decreased NEP expression (n = 22). RESULTS: Three patterns of NEP expression were observed: (a) membranous expression similar to benign prostate epithelium (n = 82; 37%); (b) complete loss of NEP expression in prostate cancer compared with adjacent benign prostate glands (n = 105; 47%); and (c) heterogeneous NEP expression (n = 36; 16%). In a multivariate analysis, complete loss of NEP expression was associated with PSA relapse after controlling for grade, stage, pretreatment PSA, and race simultaneously (hazard ratio, 1.99; 95% confidence interval, 1.13-3.52; two-sided chi(2) P = 0.017). In addition, DNA hypermethylation of the NEP promoter was frequently (73%) identified in a subset of 22 of cases that showed decreased NEP expression. CONCLUSION: Our data suggest that decreased NEP expression might contribute to progression of localized prostate cancer after surgery. Data also suggest that methylation is an important mechanism of NEP protein silencing. Larger prospective studies are required for confirmation
— id: 44832, year: 2004, vol: 10, page: 4096, stat: Journal Article,

The role of lymphadenectomy in the surgical management of renal cell carcinoma
Phillips, Courtney K; Taneja, Samir S
2004 May-Jun;22(3):214-223, Urologic oncology
After decades of evaluation, the role of lymphadenectomy in the management of renal cell carcinoma remains a controversy. Contemporary series suggest that the true incidence of isolated lymph node metastases in clinically localized disease is small, and the location of such metastases is unpredictable. While several institutional series have suggested a therapeutic benefit for extended lymphadenectomy, there remains a lack of randomized data to support its routine use. Despite this, there remains a role for lymphadenectomy in individuals with high risk of lymph node metastasis or known lymphadenopathy in whom few other options exist for aggressive, potentially curative therapy
— id: 44982, year: 2004, vol: 22, page: 214, stat: Journal Article,

Impact of fusion of indium-111 capromab pendetide volume data sets with those from MRI or CT in patients with recurrent prostate cancer
Schettino, Chris J; Kramer, Elissa L; Noz, Marilyn E; Taneja, Samir; Padmanabhan, Priya; Lepor, Herbert
2004 Aug;183(2):519-524, American journal of roentgenology
OBJECTIVE: Our goal was to evaluate the impact of image fusion on the interpretation of indium-111 Prosta-Scint SPECT scans. MATERIALS AND METHODS: Sixty-seven consecutive patients referred for rising prostate-specific antigen (PSA) levels after initial therapy for primary prostate cancer underwent SPECT 96 hr after infusion of (111)In Prosta-Scint, with simultaneous technetium-99m blood pool imaging. Volume data sets from the SPECT scans were then fused with those from CT and MR images of the pelvis using a 3D landmark-based warping program. The SPECT scans were initially interpreted without benefit of MRI or CT fusion. The fused Prosta-Scint MRI-CT volumes were reevaluated by a nuclear radiologist and an MRI radiologist. Independent reviews before and after fusion were available in these patients. Validation of results after fusion was performed through correlation with PSA changes after radiation therapy. RESULTS: Six patients with sites that could not be evaluated and three without their original Prosta-Scint scanning reports were excluded; thus, 58 patients were studied clinically. Seventy-four of 161 prefusion-positive sites were found to be negative after fusion. These 74 sites subsequently were identified primarily as showing bowel, vessel, or marrow uptake after fusion. In two patients, nodal disease was identified although the review before perfusion indicated none. Twenty-five patients previously thought to have nodal disease appeared to have only local disease after fusion. After local radiation therapy, PSA levels decreased in 12 of 25 patients, increased in five, and were unavailable in eight. CONCLUSION: Although Prosta-Scint SPECT alone can help in the proper management of recurrent prostate cancer, fusion with MRI-CT of the pelvis can improve the specificity of the examination
— id: 43816, year: 2004, vol: 183, page: 519, stat: Journal Article,

Renal imaging: what the urologist wants to know
Shah, Ojas; Taneja, Samir S
2004 Aug;12(3):387-402, v, Magnetic resonance imaging clinics of North America
Preoperative imaging in renal surgery is of utmost importance in contemporary surgical practice. From a diagnostic standpoint, imaging discovers many renal tumors incidentally before they become symptomatic. These tumors often are amenable to partial renal resection or minimally invasive surgical approaches. In general, surgical interventions for renal abnormalities have evolved to a less invasive endourologic or laparoscopic approach.Selection of the appropriate surgical intervention for renal tumors, collecting system tumors, and hydronephrosis depends heavily on the anatomy of the renal pathology. Thus, renal imaging is crucial in clinical decision-making. This article reviews the contribution of imaging to the surgical management of renal tumors, upper tract urothelial tumors, and ureteropelvic junction obstruction
— id: 44981, year: 2004, vol: 12, page: 387, stat: Journal Article,

Racial disparity of epidermal growth factor receptor expression in prostate cancer
Shuch, Brian; Mikhail, Maryann; Satagopan, Jaya; Lee, Peng; Yee, Herman; Chang, Caroline; Cordon-Cardo, Carlos; Taneja, Samir S; Osman, Iman
2004 Dec 1;22(23):4673-4677, Journal of clinical oncology
PURPOSE: The epidermal growth factor receptor (EGFR) plays a critical role in prostate cancer (PC) signal transduction and is the target of a novel class of anticancer agents. Despite recent reports of interethnic variation in response to EGFR inhibitors, limited information exists regarding differences in expression of EGFR in PC patients. This has therapeutic relevance because a better understanding of the molecular basis underlying the ethnic variability will help in the design of individualized treatment regimens using EGFR inhibitors. PATIENTS AND METHODS: We investigated EGFR expression in a well-characterized cohort of PC patients to determine the association between EGFR expression and race. Tumor tissues from 202 radical prostatectomies performed between 1990 and 2000 at the Veterans Administration Medical Center (New York, NY) were studied (142 African Americans, 60 whites; median age, 67 years; stage T2, n = 130; stage > or = T3, n = 72; Gleason score < 7, n = 110; Gleason score > or = 7, n = 92). Membrane-specific EGFR expression was evaluated immunohistochemically. RESULTS: EGFR overexpression, defined as complete membrane staining in more than 10% of tumor cells, was observed in 75 of 202 patients (37%). There was a significant association between EGFR overexpression and African American race (P = .0006), higher pretreatment prostate-specific antigen (PSA; P = .02), and stage (P = .02), but not Gleason score (P = .33). The association between African American race and EGFR overexpression remained significant in a multivariate model after controlling for grade, stage, and pretreatment PSA simultaneously (P = .003). CONCLUSION: Our data demonstrate that race contributes significantly to variability of EGFR expression in prostate cancer. Racial background may have an impact on the design of clinical trials to test the efficacy of anti-EGFR agents
— id: 46900, year: 2004, vol: 22, page: 4673, stat: Journal Article,

Imaging in the diagnosis and management of prostate cancer
Taneja, Samir S
2004 Summer;6(3):101-113, Reviews in urology
The current diagnosis and management of prostate cancer is largely based on the use of serum prostate-specific antigen (PSA) and pathologic risk factors such as Gleason score and clinical stage. The use of serum PSA in clinical practice has resulted in significant stage migration and, as such, imaging modalities historically utilized to stage prostate cancer are no longer able to reliably identify the small amounts of prostate cancer most often found at presentation. Molecular imaging techniques have focused on improving sensitivity and specificity for cancer detection through knowledge of specific attributes of disease biology. The evolution of imaging techniques has created a new role for imaging in the management of prostate cancer
— id: 108190, year: 2004, vol: 6, page: 101, stat: Journal Article,

ProstaScint(R) Scan: Contemporary Use in Clinical Practice
Taneja, Samir S
2004 ;6 Suppl 10:S19-S28, Reviews in urology
Indium In 111 capromab pendetide (ProstaScint(R); Cytogen Corporation, Princeton, NJ), a radiolabeled monoclonal antibody to prostate-specific membrane antigen, offers a potential means of localizing sites of soft tissue metastasis in prostate cancer patients. Although the test was previously limited by poor positive predictive value and specificity owing to the inherent limitations of single photon emission computed tomography, improvements in techniques of anatomic localization, along with increased reader experience, have significantly improved its accuracy. In addition to the conventional roles for ProstaScint, such as staging and detection of relapse, a number of new potential applications have emerged
— id: 108187, year: 2004, vol: 6 Suppl 10, page: S19, stat: Journal Article,

ART-27, an androgen receptor coactivator regulated in prostate development and cancer
Taneja, Samir S; Ha, Susan; Swenson, Nicole K; Torra, Ines Pineda; Rome, Serge; Walden, Paul D; Huang, Hong Ying; Shapiro, Ellen; Garabedian, Michael J; Logan, Susan K
2004 Apr 2;279(14):13944-13952, Journal of biological chemistry
Androgen receptor trapped clone-27 (ART-27) is a newly described transcriptional coactivator that binds to the N terminus of the androgen receptor (AR). Given the vital importance of AR signaling in prostate growth and differentiation, we investigated the role of ART-27 in these processes. Immunohistochemical studies indicate that ART-27 protein is expressed in differentiated epithelial cells of adult human prostate and breast tissue. In prostate, ART-27 is abundant in AR-positive prostate luminal epithelial cells, in contrast to the stroma, where cells express AR but not ART-27. The use of a rat model of androgen depletion/reconstitution indicates that ART-27 expression is associated with the elaboration of differentiated prostate epithelial cells. Interestingly, regulated expression of ART-27 in the androgen-sensitive LNCaP prostate cancer cell line inhibits androgen-mediated cellular proliferation and enhances androgen-mediated transcription of the prostate-specific antigen (PSA) gene. Consistent with a growth suppressive function, we show that ART-27 expression levels are negligible in human prostate cancer. Importantly, examination of ART-27 protein expression in early fetal prostate development demonstrates that ART-27 is detected only when the developing prostate gland has proceeded from a solid mass of undifferentiated cells to a stage in which differentiated luminal epithelial cells are evident. Thus, ART-27 is an AR cofactor shown to be subject to both cell type and developmental regulation in humans. Overall, the results suggest that decreased levels of ART-27 protein in prostate cancer tissue may occur as a result of de-differentiation, and indicate that ART-27 is likely to regulate a subset of AR-responsive genes important to prostate growth suppression and differentiation
— id: 44732, year: 2004, vol: 279, page: 13944, stat: Journal Article,

A randomized, controlled six-month intervention study soy protein isolate in men with biochemical recurrence after radical prostatectomy
Bosland, MC; Zeleniuch-Jacquotte, A; Melamed, J; Lepor, H; Taneja, SS; Schmoll, J; Watanabe, H; Levinson, B; Walden, PD
2003 NOV ;12(11):1327S-1328S, Cancer epidemiology biomarkers & prevention
— id: 55376, year: 2003, vol: 12, page: 1327S, stat: Journal Article,

Altered expression of p27 and Skp2 proteins in prostate cancer of African-American patients
Drobnjak, Marija; Melamed, Jonathan; Taneja, Samir; Melzer, Kate; Wieczorek, Rosemary; Levinson, Benjamin; Zeleniuch-Jacquotte, Anne; Polsky, David; Ferrara, Jay; Perez-Soler, Roman; Cordon-Cardo, Carlos; Pagano, Michele; Osman, Iman
2003 Jul;9(7):2613-2619, Clinical cancer research
PURPOSE: The purpose is to investigate the clinical relevance of altered patterns of p27 and Skp2 expression in African-American patients with localized prostate cancer. The abundance of p27, an inhibitor of cell proliferation, is controlled by Skp2-dependent proteolysis. EXPERIMENTAL DESIGN: A well-characterized cohort of 162 African-Americans who underwent radical prostatectomy at the Veterans Affairs Medical Center of New York between 1990 and 2000 was studied. We analyzed p27 and Skp2 expression by immunohistochemistry. Altered expression of p27 (defined as <40% tumor cells expressing the protein) and Skp2 (defined as > or ==' BORDER='0'>20% tumor cells expressing the protein) were correlated with clinicopathological parameters and time to prostate-specific antigen (PSA) recurrence. RESULTS: Altered expression of p27 and Skp2 was observed in 112 of 162 (69.1%) and 93 of 162 (57.4%) cases, respectively. Inverse patterns of Skp2 and p27 protein expression were seen in 87 of 162 (53.7%) cases. A marginally significant association was found between Skp2 overexpression and extracapsular extension (P = 0.065). Moreover, patients with Skp2 overexpression had a 2.77 years decreased median time to PSA recurrence compared with patients with low Skp2 expression; however, the difference was not statistically significant. In multivariate analysis, only tumor grade and stage independently predicted PSA recurrence in this cohort. CONCLUSIONS: Our data suggest a role for Skp2 overexpression in prostate cancer pathogenesis that might not be exclusively related to p27 degradation. More studies are needed to determine the mechanistic role of Skp2 in prostate cancer
— id: 38153, year: 2003, vol: 9, page: 2613, stat: Journal Article,

Volume indexes of total, free, and complexed prostate-specific antigen enhance prediction of extraprostatic disease extension in men with nonpalpable prostate cancer
Naya, Yoshio; Fritsche, Herbert A; Cheli, Carol D; Stamey, Thomas A; Bartsch, Georg; Brawer, Michael K; Childs, Stacy; Taneja, Samir S; Lepor, Herbert; Partin, Alan W; Sokoll, Lori J; Chan, Daniel W; Babaian, Richard J
2003 Dec;62(6):1058-1062, Urology
OBJECTIVES: To analyze the ability of volume-adjusted total, complexed, and free prostate-specific antigen (PSA) to predict organ-confined cancer at radical prostatectomy in patients with nonpalpable disease. METHODS: Collected sera were assayed for total PSA (tPSA), complexed PSA (cPSA), and free PSA (fPSA) in 78 men who underwent radical prostatectomy with nonpalpable prostate cancer. The pathologic results (organ-confined versus extraprostatic extension [EPE]), tPSA, cPSA, fPSA/tPSA ratio, cPSA/tPSA ratio, fPSA/cPSA ratio, tPSA density (tPSAD), cPSA density (cPSAD), and fPSA density (fPSAD) were compared by the Mann-Whitney U test and receiver operating characteristic curves. RESULTS: Fifteen men (19.2%) had pathologic EPE. After stratifying the patients on the basis of the Beckman tPSA, the cPSAD, tPSAD, and fPSAD were significant predictors of EPE when comparing their respective medians in individuals with tPSA greater than 4.0 ng/mL. Statistically significant differences were noted between patients with and without EPE for tPSAD (P = 0.0015), cPSAD (P = 0.0018), and fPSAD (P = 0.0022), but not for the fPSA/tPSA, cPSA/tPSA, and fPSA/cPSA ratios. The area under the receiver operating characteristic curve was similar for tPSA (0.539) and cPSA (0.542), as it was for tPSAD (0.708), cPSAD (0.700), and fPSAD (0.731). The specificity and diagnostic accuracy of tPSAD, cPSAD, and fPSAD were significantly greater than those of tPSA and cPSA (specificity P <0.001; diagnostic accuracy P <0.05). CONCLUSIONS: In men with nonpalpable prostate cancer, the density parameters of tPSA, cPSA, and fPSA performed equivalently and appeared to enhance the predictability of EPE
— id: 44933, year: 2003, vol: 62, page: 1058, stat: Journal Article,

Genetic counseling for prostate cancer risk
Nieder, A M; Taneja, S S; Zeegers, M P A; Ostrer, H
2003 Mar;63(3):169-176, Clinical genetics
Major risk factors for developing prostate cancer, including positive family history and African-American ethnicity, can be quantified for genetic counseling. Factors increasing familial risk for prostate cancer are closer degree of kinship, number of affected relatives, and early age of onset (< 50 years) among the affected relatives. Genetic testing may be useful for modification of risk, but currently should be performed only within the context of a well-designed research study that will determine penetrance and genotype-phenotype correlation of specific mutations. Even in the absence of genetic testing, African-American men and men with a strong family history of prostate cancer may opt to initiate screening by prostate specific antigen (PSA) and digital rectal exam (DRE) screening at age 40
— id: 39247, year: 2003, vol: 63, page: 169, stat: Journal Article,

The role of partial nephrectomy for renal cell carcinoma in contemporary practice
Nieder, Alan M; Taneja, Samir S
2003 Aug;30(3):529-542, Urologic clinics of North America
Partial nephrectomy has proved to be a safe and effective treatment modality, even for patients with normal contralateral kidneys. The indications for elective partial nephrectomy continue to evolve as contemporary series demonstrate low morbidity approaching that of radical nephrectomy. Furthermore, patients who undergo partial nephrectomy have a significantly decreased risk of future renal insufficiency. As such, a rationale exists for expanding indications in an era of excellent technical outcomes and increased patient longevity. Characterization of newer diagnostic (three-dimensional imaging) and treatment (laparoscopic partial nephrectomy, cryosurgery) modalities will allow continued evolution of nephron-sparing techniques
— id: 39094, year: 2003, vol: 30, page: 529, stat: Journal Article,

Complexed prostate specific antigen improves specificity for prostate cancer detection: results of a prospective multicenter clinical trial
Partin, Alan W; Brawer, Michael K; Bartsch, Georg; Horninger, Wolfgang; Taneja, Samir S; Lepor, Herbert; Babaian, Richard; Childs, Stacy J; Stamey, Thomas; Fritsche, Herbert A; Sokoll, Lori; Chan, Daniel W; Thiel, Robert P; Cheli, Carol D
2003 Nov;170(5):1787-1791, Journal of urology
PURPOSE: Complexed (c) prostate specific antigen (PSA) has been shown to enhance specificity for prostate cancer (CaP) detection over total PSA (tPSA), although a large multi-institutional prospective evaluation was required to confirm these findings. We compared the clinical performance of cPSA with tPSA as a first line test for CaP detection and secondarily to determine if PSA ratios, namely percent free PSA (fPSA) and percent cPSA, can provide further enhancement in diagnostic performance over cPSA or tPSA. MATERIALS AND METHODS: Consecutive men scheduled for initial biopsy of the prostate were enrolled prospectively at each of 7 university centers and community based urology practices. Serum was collected and tested with the Immuno 1 (Bayer Diagnostics, Tarrytown, New York), tPSA and cPSA, and Access (Beckman, Inc., San Diego, California) fPSA and tPSA methods. RESULTS: A total of 831 patients were evaluated, of whom 313 (37.5%) were diagnosed with CaP. ROC curve analysis performed from the results of all samples and those within the clinically relevant cPSA ranges of 1.5 to 3.2, 1.5 to 5.1, 1.5 to 8.3 and 3.2 to 8.3 ng/ml (tPSA 2 to 4, 2 to 6, 2 to 10 and 4 to 10 ng/ml, respectively) indicated a significant improvement in the AUC ROC curve for cPSA compared with tPSA (p < or =0.001). Using cutoff points that provide a sensitivity of 80% to 95% for CaP detection within the 1.5 to 8.3 ng/ml cPSA range cPSA provided a statistically significant enhancement in specificity over tPSA of 6.2% to 7.9%. Within the cPSA range of 1.5 to 3.2 ng/ml using a cutoff point of 2.5 ng/ml for tPSA and 2.2 ng/ml for cPSA provided a specificity of 21.2% and 35%, respectively, and 85% sensitivity for CaP detection. PSA ratios provided no further enhancement in specificity over cPSA within these ranges. CONCLUSIONS: The use of cPSA as a single test provided improved specificity over tPSA. Percent fPSA and percent cPSA offered little to no additional benefit in the differentiation of benign and malignant disease at clinically relevant cPSA concentrations
— id: 44934, year: 2003, vol: 170, page: 1787, stat: Journal Article,

Use of fibrin glue and gelfoam to repair collecting system injuries in a porcine model: implications for the technique of laparoscopic partial nephrectomy
Patel, Rupa; Caruso, Robert P; Taneja, Samir; Stifelman, Michael
2003 Dec;17(9):799-804, Journal of endourology
BACKGROUND AND PURPOSE: One of the challenges of laparoscopic partial nephrectomies is the repair of a collecting system injury. We hypothesized that fibrin glue plus Gelfoam could be sufficient to repair such injuries. MATERIALS AND METHODS: Four pigs (eight kidneys) underwent collecting system injuries of various lengths (3, 5, and 10 mm) (N = 8 each) during partial nephrectomy. Gelfoam soaked in the fibrin glue was applied to seal the collecting system and parenchymal defects. After 1 hour of passive filling, the renal pelvis was distended at supraphysiologic pressure to the point of leakage. Each repair site was examined for urinary extravasation during the physiologic and active phases of filling. RESULTS: Hemostasis was achieved, and all collecting system injuries, regardless of size, were free of urinary leakage at physiologic pressures. Moreover, all defects maintained a seal at supraphysiologic pressures of at least 50 cm H(2)O. CONCLUSION: The combined use of fibrin glue and Gelfoam is an effective means to obtain hemostasis and seal collecting system injuries up to 10 mm at physiologic pressures and up to 50 cm H(2)O in the acute setting. Our hope is that this technique can facilitate both laparoscopic and open partial nephrectomies. New technologies will be employed in an attempt to obtain better seating of the sealant plug in the future. Survival studies are in progress
— id: 46184, year: 2003, vol: 17, page: 799, stat: Journal Article,

A phase I study of paclitaxel, estramustine phosphate and vinorelbine (Pacl-E-Vin) in advanced malignancies: triple tubulin targeting
Sewak, Sanjeev; Chachoua, Abraham; Hamilton, Anne; Taneja, Samir; Lee, Janet; Utate, Minerva; Sorich, Joan; Muggia, Franco M
2003 Jan;14(1):67-72, Anti-cancer drugs
Anti-tubulin couplets have activity in hormone-resistant prostate cancer. This study was designed to define the dose-limiting toxicity (DLT) and recommended phase II dose (RPTD) of the unique triplet combination of paclitaxel, estramustine phosphate (EMP) and vinorelbine (Pacl-E-Vin). Patients with advanced malignancies who had failed standard therapy, ECOG performance status (PS 0-2) and adequate organ function were included. Dose of EMP was fixed at 300 mg/m /dose p.o. t.i.d. on days 1-3 and 8-10. Vinorelbine dose was 20 mg/m /day i.v. on days 3 and 10. Paclitaxel was dose escalated from 40 to 50 mg/m /day i.v. on days 3 and 10. Cycles were repeated every 3 weeks. Twelve adults (median age 72) were entered on this study. Primary tumors included prostate ( =7), cervix ( =2), melanoma ( =1), colon (1) and lung with synchronous prostate cancer ( =1). Nine patients had received no prior chemotherapy, one had received a prior regimen and two had received two or more prior regimens. Of four evaluable patients at dose level 1, one patient had grade 3 neutropenia leading to the day 10 dose being withheld. Of five evaluable patients at dose level 2, there was one DLT (febrile neutropenia) and two grade 3 neutropenias leading to the day 10 dose being withheld. One patient had a lower extremity deep vein thrombosis. Other side effects were mild and reversible. Nine patients were evaluable for efficacy: three with prostate cancer had a greater than 50% prostate-specific antigen (PSA) response, and a patient with synchronous prostate and lung cancer had a greater than 50% PSA response. We conclude that the DLT of Pacl-E-Vin is neutropenia. RPTD is vinorelbine 20 mg/m, paclitaxel 40 mg/m, both administered on days 3 and 10, and EMP 900 mg/m /day on days 1-3 and 8-10, q3w. Dose omission at day 10 followed by 20% dose reduction of paclitaxel and vinorelbine is recommended in the event of grade 3 neutropenia. Activity in hormone-refractory prostate cancer is promising and warrants phase II evaluation
— id: 34609, year: 2003, vol: 14, page: 67, stat: Journal Article,

Evaluation of the renal mass and renal biopsy
Shah O; Taneja SS
Renal and adrenal tumors: biology and management New York : Oxford UP, 2003,
— id: 3153, year: 2003, vol: , page: 197, stat: Chapter,

Hand-assisted laparoscopy for large renal specimens: a multi-institutional study
Stifelman, Michael D; Handler, Toby; Nieder, Alan M; Del Pizzo, Joseph; Taneja, Samir; Sosa, R Ernest; Shichman, Steven J
2003 Jan;61(1):78-82, Urology
OBJECTIVES: To present our experience with hand-assisted laparoscopy (HAL) for larger renal specimens. One of the theoretical benefits of HAL is the ability to manage large renal specimens, which we defined as tumors greater than 7 cm, and tumors in obese patients. METHODS: Between March 1998 and October 2000, 106 HAL radical nephrectomies were performed for enhancing renal masses, for which 95 patients had complete preoperative, intraoperative, and postoperative data. Of the 95 patients, 32 underwent HAL for large tumors (7 cm or greater) and 41 had a body mass index of 31 or greater. The demographic and outcome data of these two groups were compared with 63 patients who underwent HAL for tumors less than 7 cm and 54 patients with a body mass index of less than 31. RESULTS: When comparing cohorts by tumor size, the only statistically significant differences were in convalescence and specimen weight. Patients with lesions 7 cm or greater required 21 days to recover compared with 18 days for patients with lesions less than 7 cm. Obese patients had statistically significantly higher American Society of Anesthesiologists classifications, longer operative times (214 versus 176 minutes), and longer convalescences (21 versus 17.5 days) compared with nonobese patients. The estimated blood loss and conversion rate was not different between the groups. Furthermore, no difference was noted between the groups in the incidence of positive margins, local recurrence, or metastatic recurrence at a mean follow-up of 12.2 months. CONCLUSIONS: HAL provides a safe, reproducible, and minimally invasive technique to remove large renal tumors and renal tumors in the obese
— id: 68183, year: 2003, vol: 61, page: 78, stat: Journal Article,

A multidisciplinary approach to the management of hormone-refractory prostate cancer
Taneja, Samir S
2003 ;5 Suppl 2:S53-S59, Reviews in urology
The patient with hormone-refractory prostate cancer (HRPC) presents unique management challenges for both the urologist and the medical oncologist. Because of a lack of effective treatment options, the management of patients with HRPC has historically been palliative. Over the past 10 years, the advent of relatively efficacious chemotherapeutic regimens, particularly taxane-based chemotherapy, has resulted in a desire to treat patients with HRPC more aggressively. The complex needs of these patients have made a multidisciplinary approach, inclusive of specialists with expertise in disease processes directly affecting the patient, the optimal means of treating HRPC. An understanding of the natural history and complications of HRPC, combined with a systemic evaluative process, can allow the multidisciplinary team to comprehensively address the needs of the individual patient with HRPC
— id: 94953, year: 2003, vol: 5 Suppl 2, page: S53, stat: Journal Article,

A multidisciplinary approach to the management of hormone-refractory prostate cancer
Taneja, Samir S
2003 ;5 Suppl 3:S85-S91, Reviews in urology
The patient with hormone-refractory prostate cancer (HRPC) presents unique management challenges for both the urologist and the medical oncologist. Because of a lack of effective treatment options, the management of patients with HRPC has historically been palliative. Over the past 10 years, the advent of relatively efficacious chemotherapeutic regimens, particularly taxane-based chemotherapy, has resulted in a desire to treat patients with HRPC more aggressively. The complex needs of these patients have made a multidisciplinary approach, inclusive of specialists with expertise in disease processes directly affecting the patient, the optimal means of treating HRPC. An understanding of the natural history and complications of HRPC, combined with a systemic evaluative process, can allow the multidisciplinary team to comprehensively address the needs of the individual patient with HRPC
— id: 108186, year: 2003, vol: 5 Suppl 3, page: S85, stat: Journal Article,

Optimizing prostate biopsy strategies for the diagnosis of prostate cancer
Taneja, Samir S
2003 Summer;5(3):149-155, Reviews in urology
The importance of prostate biopsy in urologic practice has been magnified by the routine use of serum prostate-specific antigen in prostate cancer screening. Given the potential impact of the procedure on both patient care and health care costs, an optimal strategy for accurate and judicious detection of early prostate cancer is imperative. Maintaining maximal sensitivity and negative predictive value are equally important to the patient. In this article, we review recent modifications in prostate biopsy indications and techniques that may allow for a systematic biopsy approach to the patient in whom prostate cancer is suspected
— id: 108189, year: 2003, vol: 5, page: 149, stat: Journal Article,

Contemporary management of renal cell carcinoma - Preface
Taneja, SS
2003 AUG ;30(3):XV-XVI, Urologic clinics of North America
— id: 38488, year: 2003, vol: 30, page: XV, stat: Journal Article,

Predicting cancer on repeat biopsy: Results of a multicenter prospective evaluation of complexed PSA
Cheli, CD; Bartsch, G; Babaian, R; Fritsche, H; Sokoll, L; Chan, D; Partin, A; Taneja, S; Brawer, M
2002 Jun;48(6):A43-, Clinical chemistry
— id: 30704, year: 2002, vol: 48, page: A43, stat: Journal Article,

Complexed PSA for early detection of prostate cancer in men with serum PSA values of 2-4 ng/mL
Cheli, CD; Horninger, W; Babaian, R; Fritsche, H; Taneja, S; Lepor, H; Sokoll, L; Chan, D; Childs, S
2002 Jun;48(6):A41-, Clinical chemistry
— id: 30703, year: 2002, vol: 48, page: A41, stat: Journal Article,

Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter
Horninger, Wolfgang; Cheli, Carol D; Babaian, Richard J; Fritsche, Herbert A; Lepor, Herbert; Taneja, Samir S; Childs, Stacy; Stamey, Thomas A; Sokoll, Lori J; Chan, Daniel W; Brawer, Michael K; Partin, Alan W; Bartsch, Georg
2002 Oct;60(4 Suppl 1):31-35, Urology
Complexed PSA (cPSA) has been shown to improve specificity in the detection of prostate cancer over that of total PSA (tPSA) testing in men with tPSA values greater than the cutoff value of 4.0 ng/mL. However, recent studies have reported a 25% incidence of prostate cancer in men with tPSA values in the 2.5- to 4.0-ng/mL range. We performed a multicenter study of cPSA in a population of men who underwent prostate biopsies because of elevated PSA levels or abnormal digital rectal examination (DRE). As part of this study, we sought to assess the clinical value of cPSA in comparison to tPSA, the free/tPSA ratio (f/tPSA) and the complexed/tPSA ratio (c/tPSA) in early detection of prostate cancer in men with tPSA values in the range of 2 to 4 ng/mL. The study was performed at 7 centers. Sera were drawn from men who underwent biopsy procedures consisting of >10 prostate tissue cores. Receiver operating characteristic (ROC) analysis was performed from the results of patients with tPSA values in the range of 2 to 4 ng/mL, including men with suspicious as well as unremarkable findings on DRE. Sera were collected and tested with the Bayer tPSA and cPSA assay and the Beckman free PSA and tPSA assays. ROC analysis was performed for all samples in the 2- to 4-ng/mL PSA range. At biopsy, 158 men had no evidence of malignancy and 57 (26.5%) were diagnosed with prostate cancer. ROC analysis indicated that the area under the curve (AUC) for cPSA was 0.64, which was statistically significantly greater than that achieved for tPSA (AUC, 0.57; P <0.0001). The AUC for f/tPSA and c/tPSA were 0.60 and 0.63, respectively, which was not statistically significantly different from that of tPSA or cPSA (P >or=0.252). A cutpoint of 2.5 ng/mL for tPSA and 2.1 ng/mL for cPSA provided a specificity of 20.3% and 34.2%, respectively, and sensitivity levels of 86%. Using cutpoints of 25% for f/tPSA and 74% for c/tPSA provided a specificity of 11.0% and 21.5%, respectively, and sensitivity levels of 97%. In all, >92% of the cancers treated with radical prostatectomy were organ confined, and the histologic grading of the tumors ranged from moderately to poorly differentiated with Gleason scores from 5 to 9. These data confirm that there is a high incidence of clinically significant prostate cancer in men with tPSA levels <4.0 ng/mL. Measurement of cPSA proved useful in stratifying men with tPSA values in the 2- to 4-ng/mL range into high- and low-risk groups for prostate cancer. The use of cPSA as a single test was found to enhance detection of prostate cancer over that of testing with tPSA and PSA ratios in men with tPSA values in the range of 2 to 4 ng/mL
— id: 68185, year: 2002, vol: 60, page: 31, stat: Journal Article,

Followup interval prostate biopsy 3 years after diagnosis of high grade prostatic intraepithelial neoplasia is associated with high likelihood of prostate cancer, independent of change in prostate specific antigen levels
Lefkowitz, Gary K; Taneja, Samir S; Brown, Jordan; Melamed, Jonathan; Lepor, Herbert
2002 Oct;168(4 Pt 1):1415-1418, Journal of urology
PURPOSE: Repeat biopsy has been advocated following the diagnosis of high grade prostatic intraepithelial neoplasia to exclude coexisting prostate cancer. We further define the natural history of high grade prostatic intraepithelial neoplasia by determining the incidence of prostate cancer 3 years following diagnosis. MATERIALS AND METHODS: A total of 31 men underwent followup interval biopsy 3 years after high grade prostatic intraepithelial neoplasia diagnosis in 1996 to 1997, regardless of change in serum prostate specific antigen (PSA) or digital rectal examination findings. A single pathologist reviewed all biopsy specimens. All men had a minimum of 12 biopsy cores taken at the time of diagnosis. RESULTS: A 3-year followup interval biopsy eight (25.8%) men had prostate cancer, 11 (35.5%) had high grade prostatic intraepithelial neoplasia only and 12 (38.7%) had no disease. Mean serum PSA at diagnosis and before the followup biopsy was 6.88 and 9.69 ng./dl., respectively (p = 0.008). Of the men 48% had less than a 1.0 unit increase in serum PSA. Upon univariate regression analysis change in serum PSA was not associated with the detection of prostate cancer (p >0.10). All 4 patients who subsequently underwent radical prostatectomy had organ confined disease. CONCLUSIONS: In a high proportion of men with high grade prostatic intraepithelial neoplasia prostate cancer will develop in a 3-year interval. Our findings support the concept that high grade prostatic intraepithelial neoplasia is a precursor to prostate cancer and that repeat biopsy at a delayed interval is recommended regardless of changes in PSA
— id: 68187, year: 2002, vol: 168, page: 1415, stat: Journal Article,

ART-27, a novel androgen receptor (AR) interacting protein, is a potential. mediator of prostate eptihelial differentiation
Logan, S; Ha, S; Rome, S; Garabedian, MJ; Taneja, SS
2002 ;167(4):56-56, Journal of urology
— id: 104583, year: 2002, vol: 167, page: 56, stat: Journal Article,

Identification and characterization of ART-27, a novel coactivator for the androgen receptor N terminus
Markus, Steven M; Taneja, Samir S; Logan, Susan K; Li, Wenhui; Ha, Susan; Hittelman, Adam B; Rogatsky, Inez; Garabedian, Michael J
2002 Feb;13(2):670-682, Molecular biology of the cell
The androgen receptor (AR) is a ligand-regulated transcription factor that stimulates cell growth and differentiation in androgen-responsive tissues. The AR N terminus contains two activation functions (AF-1a and AF-1b) that are necessary for maximal transcriptional enhancement by the receptor; however, the mechanisms and components regulating AR transcriptional activation are not fully understood. We sought to identify novel factors that interact with the AR N terminus from an androgen-stimulated human prostate cancer cell library using a yeast two-hybrid approach designed to identify proteins that interact with transcriptional activation domains. A 157-amino acid protein termed ART-27 was cloned and shown to interact predominantly with the AR(153-336), containing AF-1a and a part of AF-1b, localize to the nucleus and increase the transcriptional activity of AR when overexpressed in cultured mammalian cells. ART-27 also enhanced the transcriptional activation by AR(153-336) fused to the LexA DNA-binding domain but not other AR N-terminal subdomains, suggesting that ART-27 exerts its effect via an interaction with a defined region of the AR N terminus. ART-27 interacts with AR in nuclear extracts from LNCaP cells in a ligand-independent manner. Interestingly, velocity gradient sedimentation of HeLa nuclear extracts suggests that native ART-27 is part of a multiprotein complex. ART-27 is expressed in a variety of human tissues, including sites of androgen action such as prostate and skeletal muscle, and is conserved throughout evolution. Thus, ART-27 is a novel cofactor that interacts with the AR N terminus and plays a role in facilitating receptor-induced transcriptional activation
— id: 39704, year: 2002, vol: 13, page: 670, stat: Journal Article,

Can volume measurement of the prostate enhance the performance of complexed prostate-specific antigen?
Naya, Yoshio; Stamey, Thomas A; Cheli, Carol D; Partin, Alan W; Sokoll, Lori J; Chan, Daniel W; Brawer, Michael K; Taneja, Samir S; Lepor, Herbert; Bartsch, Georg; Childs, Stacy; Fritsche, Herbert A; Babaian, Richard J
2002 Oct;60(4 Suppl 1):36-41, Urology
We assessed whether volume-based complexed prostate-specific antigen (cPSA) indices could enhance prostate cancer detection in men with serum total PSA (tPSA) between 2.5 and 10.0 ng/mL. Between December 1998 and April 2000, cPSA assay was measured in 480 men who underwent transrectal ultrasound-guided prostate biopsies at 7 institutions. We compared the usefulness of cPSA and its indices with the ratio of free PSA (fPSA) to tPSA (percent fPSA) for early detection of prostate cancer. Overall, 168 men (35%) had cancer. In the 341 men with tPSA between 4.01 and 10.0 ng/mL at approximately 90% sensitivity and areas under the receiver operating characteristics curve, the performances of volume-based parameters were significantly better (P <0.05) than those of tPSA and cPSA. In the 139 men with tPSA between 2.5 and 4.0 ng/mL, at 90% sensitivity, the specificity of the ratio of cPSA to tPSA (percent cPSA) was best, followed by cPSA density (cPSAD). In the 101 men with the history of a previous prostate biopsy, at approximately 90% sensitivity, the specificity of cPSAD was significantly better than those of tPSA and percent fPSA (P <0.05). In the 371 men with a total prostate volume of >or=30 cm(3) at approximately 90% sensitivity, the specificity of the cPSAD was significantly better than that of tPSA, percent fPSA, and cPSA (P <0.05). In the 109 men with a total prostate volume of <30 cm(3), at 90% sensitivity the specificity of cPSA and cPSAD was better than that of percent fPSA. In conclusion, volume-based cPSA can modestly enhance the performance of cPSA
— id: 68184, year: 2002, vol: 60, page: 36, stat: Journal Article,

Complexed prostate-specific antigen as a staging tool: results based on a multicenter prospective evaluation of complexed prostate-specific antigen in cancer diagnosis
Taneja, Samir S; Hsu, Elias I; Cheli, Carol D; Walden, Paul; Bartsch, Georg; Horninger, Wolfgang; Babaian, Richard J; Fritsche, Herbert A; Childs, Stacy; Stamey, Thomas A; Sokoll, Lori J; Chan, Daniel W; Brawer, Michael K; Partin, Alan W; Lepor, Herbert
2002 Oct;60(4 Suppl 1):10-17, Urology
Within a 7-site prospective evaluation of the Bayer complexed prostate-specific antigen PSA (cPSA) assay, we analyzed the ability of cPSA to predict extracapsular extension (ECE) before radical prostatectomy. Included in this analysis were 152 men diagnosed with cancer, who subsequently underwent radical prostatectomy. Sera were tested with the Bayer total PSA (tPSA) and cPSA assays, and the Beckman free PSA (fPSA) and tPSA assays. Treating surgical pathology result as a binary variable (organ confined vs ECE), mean tPSA, cPSA, fPSA/tPSA (f/tPSA) ratios, tPSA density (tPSAD), and cPSA density (cPSAD) were compared by receiver operating characteristic (ROC) curves and univariate analysis. In all, 28 men (18.4%) had pathologically identified ECE. Between those with and without ECE, significant differences were observed for tPSA (P = 0.0127), cPSA (P = 0.0120), tPSAD (P = 0.0001), and cPSAD (P = 0.0002), but not f/tPSA (P = 0.3774) or c/tPSA (P = 0.2882). All tested parameters except f/tPSA (P = 0.376) and c/tPSA (P = 0.288) predicted ECE (P <0.05) by logistic regression. The ROC area under the curve (AUC) was identical for tPSA and cPSA (0.621) and for tPSAD (0.692) and cPSAD (0.691). Kendall-tau correlation coefficients also demonstrated the strongest correlation with ECE for cPSAD and tPSAD. Either alone or as a tPSAD calculation, cPSA carries equivalent staging ability to tPSA. The use of f/tPSA appears to be less effective in staging than either cPSA or tPSA, whereas the use of either cPSAD or tPSAD provides maximal staging accuracy. Therefore, cPSA could be applied as an accurate predictor of ECE independently or in a nomogram along with other predictive variables
— id: 68186, year: 2002, vol: 60, page: 10, stat: Journal Article,

Chemoprevention trials in men with prostate-specific antigen failure or at high risk for recurrence after radical prostatectomy: Application to efficacy assessment of soy protein
Bosland MC; Kato I; Melamed J; Taneja S; Lepor H; Torre P; Walden P; Zeleniuch-Jacquotte A; Lumey LH
2001 Apr;57(4 Suppl 1):202-204, Urology
This article discusses the basic elements of chemoprevention trial designs using cohorts of men following radical prostatectomy who either have prostate-specific antigen (PSA) failure indicative of recurrence or are at high risk for recurrence (positive surgical margins, extracapsular extension, seminal vesicle invasion, positive lymph nodes, Gleason score of greater than or equal to 8, preoperative serum PSA less than 20 ng/mL). Two ongoing randomized, double-blind, placebo-controlled clinical trials with soy protein as intervention in these 2 populations are described. In the trial with men at high risk for recurrence, participants started intervention within 4 months after surgery and were followed for up to 2 years; primary endpoints were PSA failure rate and time-to-PSA failure. In the trial with men with PSA failure (PSA 0.1 to 2.0 ng/mL), participants received treatment for 8 months and the primary endpoint is rise in PSA over time. The strengths and limitations of these designs are discussed and interim experience using studies with soy protein as the intervention agent are summarized
— id: 18555, year: 2001, vol: 57, page: 202, stat: Journal Article,

Complications of urologic surgery : prevention and management
Ehrlich, Richard M. (Richard Michael); Smith, Robert B.; Taneja, Samir S
Philadelphia : Saunders, c2001,
— id: 715, year: 2001, vol: , page: , stat: ,

A Phase I/II study of weekly paclitaxel and 3 days of high dose oral estramustine in patients with hormone-refractory prostate carcinoma
Ferrari AC; Chachoua A; Singh H; Rosenthal M; Taneja S; Bednar M; Mandeli J; Muggia F
2001 Jun 1;91(11):2039-2045, Cancer
BACKGROUND: The maximum tolerated dose (MTD) and efficacy of weekly 1-hour paclitaxel with 3 days of high dose oral estramustine were evaluated in patients with hormone-refractory prostate carcinoma. METHODS: Patients enrolled in cohorts of three received two cycles of six weekly treatments with 1 week of rest: Cohort I received paclitaxel 40 mg/m2 and estramustine 600 mg/m2, and Cohorts II-IV received paclitaxel 60 mg/m2, 75 mg/m2, or 90 mg/m2, respectively, and estramustine 900 mg/m2. Toxicity was assessed weekly, and response was measured by serum prostate specific antigen (PSA), abdominal computed tomography scans, and bone scans at Week 13. RESULTS: Eighteen patients were enrolled, with 12 in Cohorts III and IV. Four patients did not complete treatment. Grade 3 toxicity included one patient with nausea and diarrhea in Cohort III and one patient each with neutropenia and edema followed by Grade 4 thromboembolism in Cohort IV. Grade 1-2 anemia or myelotoxicity were not observed; 3 patients had neuropathy, 5 patients had hair loss, and 8 patients had gastrointestinal symptoms. A decline in the serum PSA level > or = 50% occurred in none of three patients, one of three patients, four of six patients, and four of six patients in Cohorts I-IV, respectively. An intent-to-treat analysis showed responses in 9 of 18 patients (50%) in Cohorts I-IV, with 9 of 15 responders (60%) in Cohorts II-IV. Seven patients achieved declines in serum PSA levels > 75%. The median duration of PSA response was 16.7 weeks. Response was observed in one of three patients with measurable disease. CONCLUSIONS: The MTD for 1-hour weekly paclitaxel was 90 mg/m2 with 3 days of 900 mg/m2 estramustine. Hematologic and neurotoxicity were reduced markedly, and gastrointestinal symptoms were ameliorated, but thromboembolic events were unaffected. PSA response rates were within the expected 60% range for these agents
— id: 34610, year: 2001, vol: 91, page: 2039, stat: Journal Article,

A multi-institutional phase ii study of SU101, a platelet-derived growth factor receptor inhibitor, for patients with hormone-refractory prostate cancer
Ko YJ; Small EJ; Kabbinavar F; Chachoua A; Taneja S; Reese D; DePaoli A; Hannah A; Balk SP; Bubley GJ
2001 Apr;7(4):800-805, Clinical cancer research
In a multi-institutional Phase II trial, we evaluated the efficacy of a platelet-derived growth factor receptor (PDGF-r) inhibitor, SU101, in patients with hormonerefractory prostate cancer. The patients received a 4-day i.v. loading dose of SU101 at 400 mg/m(2) for 4 consecutive days, followed by 10 weekly infusions at 400 mg/m(2). The primary study end points were a decline in prostate-specific antigen (PSA) and a decrease in measurable tumor. Secondary end points were time to progression and an effect on pain as measured by the Brief Pain Survey. Expression of PDGF-r was examined in both metastatic and archival primary prostate tumor samples. Forty-four patients were enrolled at four centers. The median age was 72 years, the median PSA was 223 ng/ml, and 21 patients had at least one prior chemotherapy. Thirty-nine patients are evaluable for PSA, and three patients demonstrated a PSA decline >50% from baseline (55-99.9% decrease). The median time to progression was 90 days. Of 19 patients evaluable for measurable disease, 1 patient had a partial response. Nine of 35 evaluable patients had significant improvement in pain. The most frequent adverse events were asthenia (75%), nausea (55%), anorexia (50%), and anemia (41%). PDGF-r expression was detected in 80% of the metastases and 88% of primary prostate cancers. The results of this trial may warrant further clinical studies with other PDGF-r inhibitors
— id: 34611, year: 2001, vol: 7, page: 800, stat: Journal Article,

Is repeat prostate biopsy for high-grade prostatic intraepithelial neoplasia necessary after routine 12-core sampling?
Lefkowitz GK; Sidhu GS; Torre P; Lepor H; Taneja SS
2001 Dec;58(6):999-1003, Urology
OBJECTIVES: To determine whether repeat biopsy is necessary when the diagnosis of high-grade prostatic intraepithelial neoplasia (HGPIN) is made with a 12-core biopsy. Repeated biopsy has been recommended for individuals with HGPIN noted on sextant prostate biopsy because of the high likelihood of cancer detection. Recently, we have recommended the routine use of 12 cores, rather than 6, to improve cancer detection. METHODS: The charts of all patients undergoing prostate biopsy during a 2-year period at the Manhattan Veterans Administration Medical Center were reviewed. Patients diagnosed with HGPIN on a 12-core biopsy were identified, and those undergoing a repeat 12-core biopsy within 1 year of the initial biopsy were evaluated to determine the rate of cancer detection. RESULTS: A total of 619 men underwent biopsy during the study period. Of 103 men diagnosed with HGPIN, 43 underwent a repeat biopsy within 1 year at the discretion of the managing urologist. The mean age and median prostate-specific antigen level of those undergoing a repeat biopsy was 65.5 years and 5.37 ng/mL, respectively. At the time of the repeat biopsy, 1 patient was found to have cancer (2.3%), 20 had HGPIN (46.5%), 20 had benign pathologic findings (46.5%), and 1 patient (2.3%) had atypical small acinar proliferation. CONCLUSIONS: A repeat biopsy after the diagnosis of HGPIN on 12-core prostate biopsy rarely results in cancer detection. In the absence of other factors increasing the suspicion of cancer, immediate repeat biopsy for HGPIN diagnosed on a 12-core biopsy is unnecessary
— id: 26550, year: 2001, vol: 58, page: 999, stat: Journal Article,

Impact of image fusion of In-111 Capromab Pendetide with MR or CT in patients with recurrent prostate CA
Schettino, CJ; Noz, ME; Kramer, E; Taneja, S; Lepor, H
2001 MAY abstract #1224;42(5):294-294, Journal of nuclear medicine
— id: 33363, year: 2001, vol: 42, page: 294, stat: Journal Article,

Hematologic complications
Shah O; Park RS; Taneja SS
Complications of urologic surgery Philadelphia : Saunders, 2001,
— id: 3152, year: 2001, vol: , page: 32, stat: Chapter,

Enhanced antitumor efficacy of a herpes simplex virus mutant isolated by genetic selection in cancer cells
Taneja S; MacGregor J; Markus S; Ha S; Mohr I
2001 Jul 17;98(15):8804-8808, Proceedings of the National Academy of Sciences of the United States of America
Replication-competent, attenuated herpes simplex virus-1 (HSV-1) derivatives that contain engineered mutations into the viral gamma34.5 virulence gene have been used as oncolytic agents. However, as attenuated mutants often grow poorly, they may not completely destroy some tumors and surviving cancer cells simply regrow. Thus, although HSV-1 gamma34.5 mutants can reduce the growth of human tumor xenografts in mice and have passed phase I safety studies, their efficacy is limited because they replicate poorly in many human tumor cells. Previously, we selected for a gamma34.5 deletion mutant variant that regained the ability to replicate efficiently in tumor cells. Although this virus contains an extragenic suppressor mutation that confers enhanced growth in tumor cells, it remains attenuated. Here, we demonstrate that the suppressor virus replicates to greater levels in prostate carcinoma cells and, importantly, is a more potent inhibitor of tumor growth in an animal model of human prostate cancer than the gamma34.5 parent virus. Thus, genetic selection in cancer cells can be used as a tool to enhance the antitumor activity of a replication-competent virus. The increased therapeutic potency of this oncolytic virus may be useful in the treatment of a wide variety of cancers
— id: 21150, year: 2001, vol: 98, page: 8804, stat: Journal Article,

Androgen stimulated cellular proliferation in the human prostate cancer cell line LNCaP is associated with reduced retinoblastoma protein expression
Taneja SS; Ha S; Garabedian MJ
2001 ;84(1):188-199, Journal of cellular biochemistry
To elucidate the mechanism of androgen-dependent cellular proliferation in prostate cancer, androgen-dependent alterations of individual cell cycle regulatory proteins in the androgen-sensitive prostate cancer cell line LNCaP were evaluated. LNCaP cells were deprived of androgens by culture in steroid-depleted media for 5 days, which resulted in the maximal accumulation of cells in G(0)/G(1) phase of the cell cycle. The mitogenic concentration of the synthetic androgen R1881 was established as 0.1 nM using cell proliferation assay. Protein and mRNA levels of particular cyclins, cyclin-dependent kinases (Cdks), cyclin-dependent kinase inhibitors (Ckis), and the retinoblastoma proteins (Rb) were assessed. Androgen stimulation resulted in a post-transcriptional reduction in Rb protein levels, an increase in Rb phosphorylation at serine 780 and an accumulation of high molecular weight Rb protein species. Androgen stimulation also induced the expression of the Cdk2 and Cdk1 as well as their regulatory partners, cyclin A and cyclin B, resulting in a corresponding increase in cyclin A/Cdk2 activity in vitro. Pulse-chase showed decreased Rb protein stability in androgen-treated LNCaP cells. Collectively, our findings suggest a novel mechanism of androgen-dependent prostate cancer growth in which androgen stimulation results in decreased Rb protein expression in LNCaP cells. The observation of decreased Rb protein stability in the setting of increased phosphorylation supports the concept of phosphorylation mediated protein degradation. We propose that the observed reduction in Rb protein level occurs through Rb degradation via the ubiquitin/proteasome pathway, and is preceded by selective Rb phosphorylation by cyclin A/Cdk2 and cyclin B/Cdk1
— id: 39463, year: 2001, vol: 84, page: 188, stat: Journal Article,

Volume-specific cutoffs are necessary for reproducible application of prostate-specific antigen density of the transition zone in prostate cancer detection
Taneja SS; Tran K; Lepor H
2001 Aug;58(2):222-227, Urology
OBJECTIVES: To determine the effect of prostate volume on the specificity of prostate-specific antigen density (PSAD) and PSAD of the transition zone (PSA-TZ) in the detection of prostate cancer. METHODS: Between February 1994 and April 1998, transrectal ultrasound-guided prostate needle biopsies were performed in 235 men with serum prostate-specific antigen (PSA) levels between 4.0 and 10.0 ng/mL. The PSAD and PSA-TZ specificities were calculated at 95% sensitivity cutoff levels generated from the whole group, as well as from cohorts stratified by transition zone index or prostate volume. RESULTS: Statistical significance was noted between the benign (n = 176) and prostate cancer (n = 59) groups for all tested PSA parameters. At 95% sensitivity, PSA-TZ carried a specificity of 37.5% compared with 29.6% for PSAD. When applying a single 95% sensitivity cutoff derived from the entire group to individual volume-stratified cohorts, the specificity decreased to 0% in glands less than 30 g in size. A 95% sensitivity PSA-TZ cutoff generated individually for volume-stratified cohorts of glands less than 30, 30 to 40, and 40 to 60 g resulted in more consistent specificity of 28.2%, 35.2%, and 45.7% for each cohort, respectively. CONCLUSIONS: Unlike whole group-derived cutoffs, the use of volume-specific PSA-TZ cutoffs allows consistently high specificity in all volume-stratified cohorts. The discrepancies in the PSA-TZ and PSAD specificities in published reports are likely due to the application of published cutoffs to populations of differing prostate volumes. The use of volume-specific cutoffs results in reproducible specificity in populations with differing prostate volume distribution, and thereby definitively resolves the differences in PSA-TZ specificity reported in published reports
— id: 26709, year: 2001, vol: 58, page: 222, stat: Journal Article,

The role of androgen receptor coactivators in prostate cancer growth
Taneja SS
2000 Dec;3(S1):S38-S38, Prostate cancer & prostatic diseases
— id: 44983, year: 2000, vol: 3, page: S38, stat: Journal Article,

Molecular markers of cancer progression. Ready or not, here they come
Taneja, S S
2000 Dec;164(6):1996-1997, Journal of urology
— id: 108191, year: 2000, vol: 164, page: 1996, stat: Journal Article,

Radical prostatectomy: The value of preoperative, individually labeled apical biopsies - Comment
Taneja, SS
2000 SEP ;164(3):757-758, Journal of urology
— id: 54547, year: 2000, vol: 164, page: 757, stat: Journal Article,

Detection of circulating uroplakin-positive cells in patients with transitional cell carcinoma of the bladder
Li SM; Zhang ZT; Chan S; McLenan O; Dixon C; Taneja S; Lepor H; Sun TT; Wu XR
1999 Sep;162(3 Pt 1):931-935, Journal of urology
PURPOSE: Although transitional cell carcinoma of the bladder (TCC) metastasizes frequently with devastating consequences, no marker has been available to monitor this process. Uroplakins are a group of specific markers for normal urothelium and are continuously expressed by the majority of TCCs. Detection of uroplakin-positive cells in the circulation would be a strong indication of hematogenous dissemination of tumor cells in patients with TCC. MATERIALS AND METHODS: Total RNAs were extracted from peripheral blood of 60 patients with TCC (50 non-metastatic and 10 metastatic) and 10 healthy controls, reverse-transcribed and subjected to polymerase chain reaction amplification (RT-PCR) using oligonucleotide primers of human uroplakin II gene. A uroplakin-expressing human bladder cancer cell line (RT4) was used as a positive control to establish the sensitivity of the RT-PCR assay. RESULTS: We showed that the PCR-amplification of the mRNA encoding uroplakin II (UPII), a 15-kDa urothelium-specific marker, constitutes a highly sensitive and specific assay for detecting 100% of transitional cell carcinoma tissue, and that this assay can detect a single bladder cancer cell in a 5-ml. blood sample. UPII mRNA was detected in the blood samples of 2 patients with metastatic bladder cancer without chemotherapy and 1 out of 8 such patients with chemotherapy, but not in those of 50 non-metastatic patients or normal controls. CONCLUSIONS: Uroplakin II is a highly specific marker for human TCC and the detection of uroplakin II in the peripheral blood is associated with metastatic spread of bladder cancer cells. The specific and sensitive detection of uroplakin II provides a useful adjunct for detecting bladder cancer metastasis, staging, and monitoring chemotherapeutic response
— id: 6182, year: 1999, vol: 162, page: 931, stat: Journal Article,

Does site specific labeling of sextant biopsy cores predict the site of extracapsular extension in radical prostatectomy surgical specimen
Taneja SS; Penson DF; Epelbaum A; Handler T; Lepor H
1999 Oct;162(4):1352-1357, Journal of urology
PURPOSE: We determine whether site specific labeling of sextant prostate biopsy cores predicts the site of extracapsular extension in a radical prostatectomy specimen, thereby justifying increased cost of pathological evaluation. MATERIALS AND METHODS: Between January 1994 and December 1997, 407 radical prostatectomies were performed at our institution by a single surgeon (H. L.). Surgical specimens showing extracapsular extension were examined by a single pathologist (J. M.) to identify the site of extension. Several different methods of submitting transrectal ultrasound guided biopsy cores were used since the majority of cases did not undergo biopsy at our institution. In 243 cases sextant biopsies were labeled right versus left. Of these cases 103 specimen cores were individually labeled. The ability of the positive biopsy core location to predict the location of extracapsular extension in the surgical specimen was determined. Univariate and multivariate logistic regression analyses were performed to assess the ability of biopsy core characteristics, including Gleason score, percentage of cancer in the core, core location and number of positive cores in the specimen, to predict the site of extracapsular extension. A similar analysis was performed for the 243 cases with right versus left core labeling. RESULTS: The positive predictive value was 8.9+/-2.2% for a single positive core to identify the location of extracapsular extension correctly in the individually labeled core cases. The absence of cancer in a sextant biopsy had a negative predictive value of 96.9+/-1.4%. The overall sensitivity was 59.4+/-3.8% for a positive biopsy core. In the right versus left core cases the positive predictive value was 12.9+/-3.0% with a sensitivity of 85.1+/-3.2%. In an individual core Gleason score 8 or greater and/or cancer in more than 50% of tissue enhanced the positive predictive value but not to a clinically useful level. Multivariate logistic regression identified Gleason score, number of positive ipsilateral cores and base position of the positive biopsy as the most predictive variables for the site of extracapsular extension. CONCLUSIONS: When submitting biopsy specimens by individually labeled core or right versus left core, the positive predictive value of an individual positive core for the location of extracapsular extension is not sufficient to guide the surgical decision to spare or excise a neurovascular bundle. Therefore, the clinical information provided by individually labeled or right versus left core labeling does not justify the increased associated costs
— id: 6203, year: 1999, vol: 162, page: 1352, stat: Journal Article,

Prospects for gene therapy in human prostate cancer
Ficazzola MA; Taneja SS
1998 Nov;4(11):494-504, Molecular medicine today
Prostate cancer is the most common neoplasm in men and a significant cause of mortality in affected patients. Despite significant advances, current methods of treatment are effective only in the absence of metastatic disease. Gene therapy offers a renewed hope of using the differential characteristics of normal and malignant tissue in constructing treatment strategies. Several clinical trials in prostate cancer gene therapy are currently under way, using immunomodulatory genes, anti-oncogenes, tumor suppressor genes and suicide genes. A continued understanding of the etiological mechanisms involved in the establishment and progression of prostate cancer, along with advances in gene therapy technology, should make gene therapy for prostate cancer therapeutically valuable in the future
— id: 57147, year: 1998, vol: 4, page: 494, stat: Journal Article,

Phytoestrogens and prostate cancer: possible preventive role
Rosenthal MA; Taneja S; Bosland MC
1998 May 4;168(9):467-467, Medical journal of Australia
— id: 7770, year: 1998, vol: 168, page: 467, stat: Journal Article,

Superactivation of expanded CAG repeat mutant androgen receptor by overexpression of TAF130
Taneja, SS; Kern, A; Tanese, N; Garabedian, MJ
1998 ;159(5):35-35, Journal of urology
— id: 104584, year: 1998, vol: 159, page: 35, stat: Journal Article,

Prostate specific antigen density of the transition zone for early detection of prostate cancer - Comment
Taneja, SS; Lepor, H
1998 AUG ;160(2):418-419, Journal of urology
— id: 53406, year: 1998, vol: 160, page: 418, stat: Journal Article,

Refining the gold standard--can we do better with serum prostate specific antigen in the detection of prostate cancer?
Taneja, S S
1997 May;157(5):1752-1753, Journal of urology
— id: 108192, year: 1997, vol: 157, page: 1752, stat: Journal Article,

Gene therapy: principles and potential
Taneja, S S; Pang, S; Cohan, P; Belldegrun, A
1995 ;23:247-266, Cancer surveys
Gene therapy is a new and provocative means of treating human malignancy. Insight into the mechanisms of growth and growth regulation within cancer cells has offered multiple potential methods for genetic intervention. The application of gene therapy to prostate cancer is in its infancy. The development of both adenoviral and retroviral replication deficient vectors has provided the ability consistently to transfer genes into cancer cells. Although the ideal gene for transfer has not yet been clearly identified, many genes capable of altering the biological behaviour of prostate cancer exist. Selection of the appropriate gene is highly dependent on the desired therapeutic outcome. A gene therapy strategy, whether dependent on ex vivo or in vivo transfection, must ultimately be tailored to meet the specific needs of the disease to be treated. The potential to treat locally confined disease, preventing subsequent metastasis, or widespread metastatic disease exists. The ultimate success of a prostate cancer gene therapy strategy will rely on comprehensive investigation of the biology of the tumour and careful planning of an effective intervention
— id: 108194, year: 1995, vol: 23, page: 247, stat: Journal Article,

Immunotherapy for renal cell carcinoma: the era of interleukin-2-based treatment
Taneja, S S; Pierce, W; Figlin, R; Belldegrun, A
1995 Jun;45(6):911-924, Urology
— id: 108193, year: 1995, vol: 45, page: 911, stat: Journal Article,

Management of disseminated kidney cancer
Taneja, S S; Pierce, W; Figlin, R; Belldegrun, A
1994 Nov;21(4):625-637, Urologic clinics of North America
The approach to disseminate renal cell carcinoma (RCC) has evolved significantly in recent years, largely owing to the progress of biologic therapy development. With increasing knowledge of biologic therapy come several dilemmas, including the choice of cytokine therapy, the appropriate mode of delivery, the selection of candidates for given therapeutic options, and the role of cytoreductive nephrectomy in immunotherapy protocols. This article reviews the historical development of immunotherapy and the lessons learned from previous experience and offers a logical approach to the patient with disseminated RCC
— id: 108195, year: 1994, vol: 21, page: 625, stat: Journal Article,