Michael L. Blute

Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials.

The objective of the current study was to develop an algorithm to predict progression to metastases after radical nephrectomy for patients with clinically localized renal cell carcinoma (RCC) to allow stratification of patients for potential adjuvant therapy trials.

Risk of prostate carcinoma death in patients with lymph node metastasis

The presence of lymph node metastasis is a poor prognostic sign for patients with prostate carcinoma. Results of published reports on survival among patients with lymph node metastasis are difficult to assess because of treatment selections. The extent to which lymph node status will have an impact on a patients survival is uncertain.

Costimulatory molecule B7‐H1 in primary and metastatic clear cell renal cell carcinoma

Cancer cell expression of costimulatory molecule B7‐H1 has been implicated as a potent inhibitor of T‐cell–mediated antitumoral immunity. The authors recently reported that B7‐H1 is aberrantly expressed in primary renal cell carcinoma (RCC). Blockade of B7‐H1, as demonstrated in several murine cancer models, now represents a promising therapeutic target in RCC. However, the potential expression of B7‐H1 in metastatic RCC has not been investigated. In the current study, the authors updated their primary RCC results with additional follow‐up and investigated the potential role of B7‐H1 in metastatic RCC.

Outcomes for men with clinically nonmetastatic prostate carcinoma managed with radical prostactectomy, external beam radiotherapy, or expectant management

With a lack of data from randomized trials, the optimal management of men with nonmetastatic prostate carcinoma is controversial. The authors sought to define the outcomes of three common strategies for managing patients with nonmetastatic prostate carcinoma: expectant management, radiotherapy, and radical prostatectomy.

Prognostic significance of positive surgical margins in patients with extraprostatic carcinoma after radical prostatectomy

A significant number of prostate adenocarcinoma patients undergoing radical prostatectomy are found to have microscopic extraprostatic disease extension. A majority of these patients have focal extraprostatic extension limited to one or both sides of the prostate. In addition, positive surgical margins are a common pathologic finding in this patient subgroup. In the current study, the authors evaluated the impact of positive surgical margins as an independent predictive factor for prostate specific antigen (PSA) progression in patients with pT3a/b N0M0 carcinoma.

Reclassification of patients with pT3 and pT4 renal cell carcinoma improves prognostic accuracy

The significance of adrenal invasion and tumor thrombus in renal cell carcinoma (RCC) has been debated recently. The authors evaluated the associations of direct adrenal invasion, perinephric fat invasion, and tumor thrombus level with outcome to determine whether reclassification would improve the prognostic accuracy of the current primary tumor classification.

Pathologic staging of renal cell carcinoma

The TNM staging system for renal cell carcinoma was revised by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (UICC) in 1997. The 1997 TNM staging system for renal cell carcinoma reclassifies tumors using criteria for size and for extent of renal vein/vena cava involvement that are different from the criteria used in the 1987 staging system. The current study investigated the prognostic significance of tumor classification and other factors using the new staging system.

Pathologic classification of prostate carcinoma

A proposed pathologic (pTNM) classification system for prostate carcinoma was analyzed for its impact on survival outcome in the prostate specific antigen (PSA) era. The impact of margin status on the survival outcome of patients with otherwise organ‐confined disease (i.e., without extraprostatic extension or seminal vesicle involvement) was assessed.

pT1 clear cell renal cell carcinoma: A study of the association between MIB-1 proliferative activity and pathologic features and cancer specific survival

The majority of patients with pT1 clear cell renal cell carcinoma (RCC) are cured with nephrectomy. However, a few patients will die of RCC. In several studies, MIB‐1 proliferative activity was identified as an independent predictor of survival in patients with RCC. The objective of the current study was to examine MIB‐1 proliferative activity in a large series of patients with pT1 clear cell RCC who were treated uniformly with radical nephrectomy, and to examine the association between proliferative activity and cancer specific survival in a multivariate model incorporating tumor size, nuclear grade, and tumor necrosis.

Prognostic Value of p53 and MIB-1 in Transitional Cell Carcinoma of the Urinary Bladder with Regional Lymph Node Involvement

The effect of p53 protein expression and MIB‐1 proliferative activity on survival and chemotherapeutic response in patients with lymph node (LN)‐positive transitional cell carcinoma (TCC) of the urinary bladder remains unclear. The objective of this study was to assess the ability of these markers to predict disease‐associated outcomes and response to chemotherapy in a cohort of patients with LN‐positive TCC.