Urology News Feeds
E-cigarettes and Urologic Health: A Collaborative Review of Toxicology, Epidemiology, and Potential Risks
Use of electronic cigarettes (ECs) is on the rise in most high-income countries. Smoking conventional cigarettes is a known risk factor for urologic malignancy incidence, progression, and mortality, as well as for other urologic health indicators. The potential impact of EC use on urologic health is therefore of clinical interest to the urology community.Objective
To review the available data on current EC use, including potential benefits in urologic patients, potential issues linked to toxicology of EC constituents, and how this might translate into urologic health risks.Evidence acquisition
A Medline search was carried out in August 2016 for studies reporting urologic health outcomes and EC use. Snowballing techniques were also used to identify relevant studies from recent systematic reviews. A narrative synthesis of data around EC health outcomes, toxicology, and potential use in smoking cessation and health policy was carried out.Evidence synthesis
We found no studies to date that have been specifically designed to prospectively assess urologic health risks, even in an observational setting. Generating such data would be an important contribution to the debate on the role of ECs in public health and clinical practice. There is evidence from a recent Cochrane review of RCTs that ECs can support smoking cessation. There are emerging data indicating that potentially harmful components of ECs such as tobacco-specific nitrosamines, polyaromatic hydrocarbons, and heavy metals could be linked to possible urologic health risks.Conclusions
ECs might be a useful tool to encourage cessation of conventional cigarette smoking. However, data collection around the specific impact of ECs on urologic health is needed to clarify the possible patient benefits, outcomes, and adverse events.Patient summary
While electronic cigarettes might help some people to stop smoking, their overall impact on urologic health is not clear.Take Home Message
While electronic cigarettes might help some people to stop smoking, it is not clear if they may be bad for urologic health.
Keywords: Electronic cigarettes, Smoking cessation, Toxicology, Urologic health.Footnotes
a Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
b Institute for Social Marketing and UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
c National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
d Academic Urology Unit, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
e Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
f Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
g Wolfson Institute of Preventative Medicine and UK Centre for Tobacco and Alcohol Studies, Queen Mary University of London, London, UK
h Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
Corresponding author. Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent, Sheffield S10 2BP, UK. Tel. +44 114 2255396.
© 2017 Published by Elsevier B.V.
Liquid Biopsy Analysis of FGFR3 and PIK3CA Hotspot Mutations for Disease Surveillance in Bladder Cancer
Disease surveillance in patients with bladder cancer is important for early diagnosis of progression and metastasis and for optimised treatment.Objective
To develop urine and plasma assays for disease surveillance for patients with FGFR3 and PIK3CA tumour mutations.Design, setting, and participants
Droplet digital polymerase chain reaction (ddPCR) assays were developed and tumour DNA from two patient cohorts was screened for FGFR3 and PIK3CA hotspot mutations. One cohort included 363 patients with non–muscle-invasive bladder cancer (NMIBC). The other cohort included 468 patients with bladder cancer undergoing radical cystectomy (Cx). Urine supernatants (NMIBC n = 216, Cx n = 27) and plasma samples (NMIBC n = 39, Cx n = 27) from patients harbouring mutations were subsequently screened using ddPCR assays.Outcome measurements and statistical analysis
Progression-free survival, recurrence-free survival, and overall survival were measured. Fisher's exact test, the Wilcoxon rank-sum test and Cox regression analysis were applied.Results and limitations
In total, 36% of the NMIBC patients (129/363) and 11% of the Cx patients (44/403) harboured at least one FGFR3 or PIK3CA mutation. Screening of DNA from serial urine supernatants from the NMIBC cohort revealed that high levels of tumour DNA (tDNA) were associated with later disease progression in NMIBC (p = 0.003). Furthermore, high levels of tDNA in plasma samples were associated with recurrence in the Cx cohort (p = 0.016). A positive correlation between tDNA levels in urine and plasma was observed (correlation coefficient 0.6). The retrospective study design and low volumes of plasma available for analysis were limitations of the study.Conclusions
Increased levels of FGFR3 and PIK3CA mutated DNA in urine and plasma are indicative of later progression and metastasis in bladder cancer.Patient summary
Urine and plasma from patients with bladder cancer may be monitored for diagnosis of progression and metastasis using mutation assays.Take Home Message
Detection of hotspot mutations in FGFR3 and PIK3CA in liquid biopsies may allow efficient prediction of aggressiveness and surveillance of relapse in patients with bladder cancer.
Keywords: Biomarker, Cell-free DNA, Liquid biopsy, Personalised analysis, FGFR3, PIK3CA, Droplet digital polymerase chain reaction.Footnotes
a Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
b Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
c Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
d Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
e Department of Urology, Aarhus University Hospital, Aarhus, Denmark
Corresponding author. Department of Molecular Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard, DK-8200 Aarhus N, Denmark. Tel. +45 78455320.
© 2016 European Association of Urology, Published by Elsevier B.V.
Our Metabolic Findings in First Time Pediatric Stone Formers Questions the Need for a Full Metabolic Evaluation in Every Child
Re: mTORC1-Mediated Inhibition of Polycystin-1 Expression Drives Renal Cyst Formation in Tuberous Sclerosis Complex
Re: Daniel E. Spratt, Herbert A. Vargas, Zachary S. Zumsteg, et al. Patterns of Lymph Node Failure after Dose-escalated Radiotherapy: Implications for Extended Pelvic Lymph Node Coverage. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2016.07...
Refers to article:Patterns of Lymph Node Failure after Dose-escalated Radiotherapy: Implications for Extended Pelvic Lymph Node Coverage
Accepted 22 July 2016
January 2017 (Vol. 71, Issue 1, pages 37 - 43)Footnotes
a Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
b Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
c Department of Nuclear Medicine, San Raffaele Scientific Institute, Milan, Italy
Corresponding author. Department of Radiation Oncology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. Tel. +39 022 6437634; Fax: +39 022 6433855.
© 2016 European Association of Urology, Published by Elsevier B.V.
Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Corresponding author. Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
© 2016 Published by Elsevier B.V.