Stephan Buse

Positive surgical margins after radical prostatectomy: do they have an impact on biochemical or clinical progression?

To prospectively examine the effects of the margin status after radical prostatectomy (RP), the location, and the number of positive surgical margins (PSMs) on biochemical and clinical outcome, as even if there seems to be little debate that there is a higher risk of both local and distant recurrence of prostate cancer in the face of a PSM the significance of a PSM after RP is only followed for biochemical progression in most studies.

Vaporization of prostates of ≥80 mL using a potassium-titanyl-phosphate laser: midterm-results and comparison with prostates of <80 mL

To compare the safety and outcome of potassium‐titanyl‐phosphate (KTP) GreenlightTM (Laserscope, AMS, Minnetonka, MN, USA) vaporization for treating benign prostatic hyperplasia (BPH) in prostates of ≥80 vs <80 mL.

The enhancer of zeste homolog 2 gene contributes to cell proliferation and apoptosis resistance in renal cell carcinoma cells.

The enhancer of zeste homolog 2 (EZH2) gene has been recently linked to human malignancies where it may serve as a new target for cancer therapy. Here, we analyzed EZH2 expression in primary renal cell carcinoma (RCC) specimens and in nontumorous tissue samples from adult kidney. EZH2 transcripts were detectable in all RCC specimens examined. Expression levels were significantly higher in tumor tissue (p ≤ 0.0001) than in samples from normal adult kidney. Moreover, inhibition of endogenous EZH2 expression in RCC cell lines by RNA interference (RNAi) led to reduced proliferation and increased apoptosis in RCC cells. These data show that EZH2 is overexpressed in RCC. Furthermore, they indicate that the EZH2 gene plays a role for both the proliferation and the apoptosis resistance of RCC cells. Targeted inhibition of EZH2 could therefore represent a novel strategy to improve the therapeutic response of RCC.

Perinephric and renal sinus fat infiltration in pT3a renal cell carcinoma: possible prognostic differences

To evaluate the influence of perinephric (PN) and renal sinus (RS) fat infiltration on cancer‐specific survival beyond other prognostic factors, as the Tumour‐Node‐Metastasis (TNM) classification system defines stage T3a renal cell carcinoma (RCC) as infiltration of perirenal fat and/or direct infiltration of the adrenal gland. Perirenal fat invasion is differentiated into RS and PN fat infiltration, but not further classified for the prognosis.

The influence of body mass index on the long‐term survival of patients with renal cell carcinoma after tumour nephrectomy

To assess whether under‐ or overweight at the time of surgery has any effect on the survival of the patients with renal cell carcinoma (RCC), as obesity increases the risk of developing RCC.

Prognostic Stratification of Localized Renal Cell Carcinoma by Tumor Size

PURPOSE Recent retrospective studies have challenged the current TNM classification of 7.0 cm to distinguish between T1 and T2 tumors. We reevaluated the optimal tumor size cutoff point that independently differentiates patient prognosis beyond the other accepted prognostic features. MATERIALS AND METHODS From 1990 to October 2006, 398 patients who underwent radical nephrectomy for localized renal cell carcinoma (T1-T2, N0, M0) were followed prospectively. Median followup was 5.3 years and 37 patients died of tumor related causes. The optimal tumor cutoff point was calculated and multivariate Cox proportional hazards models were used to adjust for the effects of Fuhrman grade, tumor type, sex, age and Karnofsky performance status on cancer specific survival. Sensitivity analysis included all 66 patients with elective nephron sparing surgery. RESULTS Univariate analysis supported 7 cm as the optimal cutoff point for prognostic stratification (p = 0.002). The 4 cm cutoff point that is used to distinguish between stage T1a and T1b could not be confirmed with analogous statistical significance (p = 0.20). On multivariate analysis tumor size dichotomized at 7 cm was an independent prognostic factor (HR 2.89, 95% CI 1.46-5.73, p = 0.002), as was Fuhrman grade 3 (HR 3.68, 95% CI 1.37-9.83, p = 0.010) and age older than 60 years (HR 3.64, 95% CI 1.63-8.14, p = 0.002). The inclusion of patients with elective nephron sparing surgery confirmed these results. CONCLUSIONS Univariate and multivariate analyses of our patient cohort undergoing radical nephrectomy for localized renal cell carcinoma showed no cutoff point other than 7 cm to be more suitable for distinguishing between T1 and T2 tumors, supporting the current TNM classification. In T1 tumors the analysis did not allow a clear dichotomization of tumor size in this group.

High nuclear Livin expression is a favourable prognostic indicator in renal cell carcinoma

To assess the protein expression of Livin, an apoptosis inhibitor, in renal cell carcinoma (RCC) and to determine its prognostic relevance.

En bloc stapler ligation of the renal vascular pedicle during laparoscopic nephrectomy

To evaluate, in a prospective series of laparoscopic nephrectomies (LNs), the safety and feasibility of en bloc stapling for resection and occlusion of the vascular renal pedicle.

Characterization and risk stratification of prostate cancer in patients undergoing radical cystoprostatectomy

To describe the prevalence of incidental prostate cancer in patients undergoing radical cystoprostatectomy for bladder malignancy; to quantify the association between incidental prostate cancer and mortality in these patients; and to quantify the association between incidental prostate cancer and age in radical cystoprostatectomy specimens.

Is the body mass index a predictor of adverse outcome in prostate cancer after radical prostatectomy in a mid-European study population?

To evaluate the effect of body mass index (BMI) on the histopathological and clinical outcome in prostate cancer.