Shaheen Alanee

Memorial Sloan-Kettering Cancer Center, New York City, New York, United States

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Publications (23)102.09 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The natural history of prostate-specific antigen (PSA)-defined biochemical recurrence (BCR) of prostate cancer (PCa) after definitive local therapy is highly variable. Validated prediction models for PCa-specific mortality (PCSM) in this population are needed for treatment decision-making and clinical trial design.
    European urology. 10/2014;
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    ABSTRACT: It is thought that over forty percent of an individual's risk of developing prostate cancer (PCa) is related to familial and genetic factors. Although multiple genes have been implicated in the development of PCa, few confer as high a risk as mutations in the genes associated with early-onset breast cancer (BRCA1 and BRCA2). Not only do mutations in BRCA genes increase the risk of PCa, but they have also been related to adverse disease characteristics and outcomes. Therefore, a better understanding of the association between BRCA gene mutations and PCa may provide the backdrop for individualized management of patients with PCa who are carriers of a gene mutation. Such management may include an individualized approach to screening and treatment including chemotherapeutic regimens targeted to the underlying genetic mechanism of disease. In this paper, we review the evidence relating BRCA gene mutations to the risk of PCa, as well as outcomes and response to therapy, and suggest an approach to the management of such patients.
    Frontiers in bioscience (Elite edition) 01/2014; 6:15-30.
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    ABSTRACT: Variations in urothelial carcinoma (UC) response to platinum chemotherapy are common and frequently attributed to genetic and epigenetic variations of somatic DNA. We hypothesized that variations in germline DNA may contribute to UC chemosensitivity. DNA from 210 UC patients treated with platinum-based chemotherapy was genotyped for 80 single nucleotide polymorphisms (SNPs). Logistic regression was used to examine the association between SNPs and response, and a multivariable predictive model was created. Significant SNPs were combined to form a SNP score predicting response. Eleven UC cell lines were genotyped as validation. Six SNPs were significantly associated with 101 complete or partial responses (48%). Four SNPs retained independence association and were incorporated into a response prediction model. Each additional risk allele was associated with a nearly 50% decrease in odds of response [odds ratio (OR) = 0.51, 95% confidence interval 0.39-0.65, P = 1.05 × 10(-7)). The bootstrap-adjusted area under the curves of this model was greater than clinical prognostic factors alone (0.78 versus 0.64). The SNP score showed a positive trend with chemosensitivity in cell lines (P = 0.115). Genetic variants associated with response of UC to platinum-based therapy were identified in germline DNA. A model using these genetic variants may predict response to chemotherapy better than clinical factors alone.
    Annals of Oncology 07/2013; · 7.38 Impact Factor
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    ABSTRACT: We performed a retrospective analysis of germline DNA samples from Ashkenazi Jewish men and a comparison group of non-Ashkenazi men treated for prostate cancer at our institution to determine the prevalence of HOXB13 G84E mutation in prostate cancer patients of Ashkenazi Jewish heritage, an ethnic group common to the New York City area. Patients were genotyped for G84E using a TaqMan assay (Applied Biosystems). Positive cases were confirmed using Sanger sequencing. Median age at prostate cancer diagnosis was 68 years for 889 Ashkenazi Jewish patients, 64 years for 920 non-Ashkenazi Jewish patients. The median follow up was 9 years for Ashkenazi Jewish patients and 8.8 years for non-Ashkenazi Jewish patients. Only 4 patients were found to be heterozygous carriers of G84E. They were all of non-Ashkenazi Jewish ancestry and were diagnosed at 70, 66, 78, and 49 years of age. Two of them presented with high-risk prostate cancer. The prevalence of G84E in the non-Ashkenazi sample was 0.4 %. HOXB13 G84E mutation was not observed in prostate cancer patients of Ashkenazi Jewish ancestry treated at our institution. Screening for G84E, therefore, may be unnecessary in Ashkenazi Jewish men if these results are validated by other studies.
    Familial Cancer 03/2013; · 1.94 Impact Factor
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    ABSTRACT: Technological advances have dramatically changed medical education, particularly in the era of work-hour restrictions, which increasingly highlights a need for novel methods to teach surgical skills. The purpose of this study was to evaluate the validity of a novel, computer-based, interactive, cognitive simulator for training surgeons to perform pelvic lymph node dissection (PLND). Eight prostate cancer experts evaluated the content of the simulator. Contextual aspects of the simulator were rated on a five-point Likert scale. The experts and nine first-year residents completed a simulated PLND. Time and deviations were logged, and the results were compared between experts and novices using the Mann-Whitney test. Before training, 88% of the experts felt that a validated simulator would be useful for PLND training. After testing, 100% of the experts felt that it would be more useful than standard video training. Eighty-eight percent stated that they would like to see the simulator in the curriculum of residency programs and 56% thought it would be useful for accreditation purposes. The experts felt that the simulator aided in overall understanding, training indications, concepts and steps of the procedure, training how to use an assistant, and enhanced the knowledge of anatomy. Median performance times taken by experts and interns to complete a PLND procedure on the simulator were 12.62 and 23.97 minutes, respectively. Median deviation from the incorporated procedure pathway for experts was 24.5 and was 89 for novices. We describe an interactive, computer-based simulator designed to assist in mastery of the cognitive steps of an open surgical procedure. This platform is intuitive and flexible, and could be applied to any stepwise medical procedure. Overall, experts outperformed novices in their performance on the trainer. Experts agreed that the content was acceptable, accurate, and representative.
    Advances in medical education and practice. 01/2013; 4:23-30.
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    ABSTRACT: BRCA1 functions as a tumor suppressor gene and germline and somatic mutations in this gene have been shown to be associated with many types of cancer. We report the first tumor study of renal cell carcinoma in a carrier of the deleterious BRCA1 mutation-c.68_69delAG.
    Familial Cancer 10/2012; · 1.94 Impact Factor
  • Shaheen Alanee, Fergus Couch, Kenneth Offit
    New England Journal of Medicine 08/2012; 367(5):480-1. · 54.42 Impact Factor
  • Shaheen Alanee, Adam Nicholson, Joel Slaton
    Urologic Oncology 01/2012; 30(6):749-51. · 3.65 Impact Factor
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    ABSTRACT: Prevalence of kidney stone disease is increasing worldwide, and several factors may be involved. We aimed to establish a correlation between stress and kidney stones. We prospectively evaluated 200 patients with a diagnosis of kidney stone disease having them self-respond to a validated questionnaire to measure stress (Perceived Stress Scale-10 [PSS-10]). Stone-related characteristics and potential stressing factors were assessed. Variables that were significant on the univariate analysis were used to construct a model that was able to explain the variability in PSS-10 score in our patients. Mean PSS-10 score was 15.3 ± 1.1. Female sex (P=0.014), occurrence of death or serious illness of a family member or close friend within the last 6 months of the interview (P=0.044), occurrence of other psychological trauma (P<0.0001) all proved to be significant factors. Stone-related aspects associated with stress were presence of symptoms at the time of the interview (P=0.012) and passage of two or more stones per year (P=0.022). We were able to construct a model that explains 34% of the variability of the PSS-10 between subjects. Employment status was the only significant variable, but sex, age, and presence of symptoms at the time of questionnaire administration had to be kept in to achieve a model that explains the largest variability. Passage of two or more stones per year and presence of symptoms proved to be factors related to elevated stress in patients with a diagnosis of kidney stone disease. Female sex, age, and unemployment may also contribute to a stressed state in this population.
    Journal of endourology / Endourological Society 09/2011; 26(5):551-5. · 1.75 Impact Factor
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    ABSTRACT: To present two cases of type IIA urethral duplication and propose a reproducible surgical approach. Two cases are presented in this report. The first was a male child with a type IIA1 urethral duplication with two urethral channels arising from the bladder through separate bladder necks coursing to the glans penis. The second infant had a type IIA2 urethral duplication with a single bladder neck. Both children were repaired using a surgical approach that joined both urethral openings into a single orthopic meatus. This was accomplished by incising the common septum and utilizing techniques similar to that of a distal epispadias repair. At six months of follow-up both infants are voiding from a single stream without complication. Long-term outcomes remain to be determined. The technique presented in this report both functionally and cosmetically unites the two urethral meatuses while eliminating the risk of damage to the sphincter.
    Journal of pediatric urology 08/2011; 8(4):343-7. · 1.38 Impact Factor
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    ABSTRACT: OBJECTIVE: We evaluated patients with history of previous malignancy to determine risk of an ensuing bladder cancer. MATERIALS AND METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results 9 registry database from 1973 to 1999 (SEER) was reviewed for patients with initial primary cancers in oral cavity and pharynx, colon and rectum, respiratory system, breast, prostate, testis, or penis. This group of patients was then examined to identify subsequent separate primary malignancies in the bladder. Comparison was made to the incidence of bladder cancer in the general population to determine a standardized incidence ratio (SIR). Additional analysis was performed based on age at diagnosis, stage, gender, race, and use of external beam radiation for treatment of initial cancer. RESULTS: A total of 7,289 (0.5%) of patients had a bladder cancer following their initial malignancy. Patients with prostate cancer had the largest increase in risk of bladder cancer with a SIR of 8.24, and all initial cancer groups had an elevated risk of bladder cancer relative to the general population. External beam radiation and non-White gender were associated with an increased risk of bladder cancer. Older age at diagnosis of the initial cancer correlated with a lower risk of subsequent bladder cancer. CONCLUSIONS: This study suggests an increased risk of bladder cancer following a separate initial cancer. Lower threshold for working up those patients for bladder cancer may be warranted.
    Urologic Oncology 07/2011; · 3.65 Impact Factor
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    ABSTRACT: To evaluate the use of tandem double J stents in recalcitrant ureteral stenosis after kidney transplant. We reviewed patients who underwent tandem double J stent placement after kidney transplant, assessing demographics (gender, age, cause of renal failure, recipient implantation site, blood pressure, donor status), renal function, biopsy results, site of stenosis, dilations, time with tandem stents, and outcome. Success was defined as ureteral patency without reconstructive surgery. Student t test was used for creatinine levels. Multivariate survival analysis identified risk factors for failure. A total of 19 patients (mean age 36.6 years) were included. The most common site of ureteral stenosis was distal (79%). Average number of biopsies before tandem stents was 1.8 (0-5) and, pathology results showed acute rejection in 16%. Percutaneous nephrostomy was performed after 66.8 ± 140.8 weeks from transplantation date. Dilations averaged 2 ± 1.1 (0-4) before tandem placement. Renal function improved after tandem stents (P < .01) and remained stable throughout follow-up (P = .147). The patency success rate was 58% with a mean of 48.7 ± 48 weeks with tandem in place. The failure rate was 26%, with a mean of 16 ± 7 weeks for tandem time. No perioperative complications were identified. Number of dilations before tandem was the only factor associated with failure (hazard ratio = 2.61; confidence interval = 1.150-5.908, P < .03). Proximal strictures (P = .072) and renal function (P = .067) were associated with a trend for tandem stent failure. Tandem stents can treat recurrent and recalcitrant ureteral stenosis after kidney transplantation that failed previous balloon dilation or ureteral reconstruction.
    Urology 12/2010; 77(6):1299-303. · 2.42 Impact Factor
  • Shaheen Alanee, Roland Ugarte, Manoj Monga
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    ABSTRACT: We compared the results of shock wave lithotripsy with a newer electromagnetic lithotripter to those of an electrohydraulic lithotripter using identical treatment and followup criteria. We performed a case matched comparison of 8,565 patients treated from 2003 to 2007 using the Medstone STS™ and the Modulith® SLX machines, matching for stone size, location and patient body mass index. The outcome of interest was treatment success in producing stone-free status. We report treatment characteristics, such as stone site and size, gating and final stone-free rate. Significance was considered at p<0.05. Overall Modulith SLX and Medstone STS stone-free rates were equivalent (61.1% and 64.5%, respectively, p=0.0664). Matching and logistic regression results showed that differences in the stone-free rate were insignificant for all stones (p>0.7592), lower pole kidney stones (p=0.9659) and ureteral stones (p=0.6409). Medstone STS performed better than Modulith SLX only for distal ureteral stones (83.63% vs 66.67%, p=0.0154). The rate of post-lithotripsy secondary procedures was equivalent (p=0.2079). The difference was insignificant for harder stones (p=0.2988). Shock wave lithotripsy is equally effective using Medstone STS and Modulith SLX for different stone sizes and most stone sites. Shock wave lithotripsy is more successful for lower ureteral stones using the Medstone STS. To our knowledge this is the first study comparing these 2 commonly used lithotripters.
    The Journal of urology 10/2010; 184(6):2364-7. · 3.75 Impact Factor
  • Shaheen Alanee, Aseem R. Shukla
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    ABSTRACT: Study Type – Prognosis (inception cohort) Level of Evidence 1bOBJECTIVE To present descriptive statistics for bladder tumours in children, calculated from the Surveillance, Epidemiology and End Results (SEER) database, as bladder malignancies are relatively uncommon in children, causing difficulty in understanding their incidence and survival.PATIENTS AND METHODS The SEER database was interrogated to report the incidence of bladder malignancies in children from birth to 18 years old. Race and sex differences were assessed. The 5-year survival by disease stage at diagnosis and 5-year conditional survival after surviving for 1–3 years is reported for 1973–2003. The incidence and survival rates for bladder embryonal rhabdomyosarcoma were further characterized.RESULTSWe identified 140 cases of bladder cancers in the selected cohort. Papillary urothelial neoplasm of low malignant potential (PUNLMP) and rhabdomyosarcoma comprised 50.7% and 36.4% of the tumours, respectively. The incidence of bladder malignancies significantly increased between 1973 and 2003. Conditional survival calculated for 1 and 2 years after disease diagnosis was 93.6% and 97.5%. Fifty-one cases of embryonal rhabdomyosarcoma were identified. The male to female incidence ratio was ≈2:1 for these tumours. The 5-year survival rates were 50–80% over the past three decades.CONCLUSIONS We present the most contemporary survey of the SEER database for the incidence and survival for bladder tumours in children. Depending on the patient’s age, PUNLMP and rhabdomyosarcoma predominated in different proportions. The 2–3-year conditional survival and overall survival were excellent. We also identified improving survival for embryonal bladder rhabdomyosarcoma with time.
    BJU International 08/2010; 106(4). · 3.05 Impact Factor
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    ABSTRACT: Recent studies suggest that patients undergoing Roux-en-Y gastric bypass (RYGB) for morbid obesity are at risk for hyperoxaluria, nephrolithiasis, and oxalate nephropathy. Our objective was to conduct a long-term prospective longitudinal study to establish the incidence, clinical progression, and severity of hyperoxaluria after RYGB. Patients undergoing RYGB between December 2005 and April 2007 provided 24-hour urine collections for comprehensive stone risk analysis 1 week before and 3 months and 1 and 2 years after surgery. Primary outcomes were changes in 24-hour urinary oxalate excretion and relative supersaturation of calcium oxalate from baseline to 2 years post-RYGB. The cohort consisted of 21 patients, including 5 (24%) men and 16 (76%) women. Mean preoperative age and body mass index (calculated as kg/m(2)) were 48.2 +/- 10.5 years (range 25 to 64 years) and 50.5 +/- 9.1 (range 39.7 to 66.6), respectively. Urinary oxalate excretion increased significantly after RYGB (33 +/- 9 mg/day versus 63 +/- 29 mg/day; p <or= 0.001). De novo hyperoxaluria developed in 11 (52%) patients. Increasing age at the time of surgery was predictive of de novo hyperoxaluria developing (odds ratio = 1.162; 95% CI, 1.002-1.347; p = 0.046). The percentage of patients with hypocitraturia increased from 10% at baseline to 48% at 2 years. The relative supersaturation of calcium oxalate was unchanged (1.73 +/- 0.67 versus 2.20 +/- 2.07; p = 0.27). RYGB is associated with a long-term increase in urinary oxalate excretion and decrease in urinary citrate excretion. Although calcium oxalate relative supersaturation increases early in the postoperative period, this returns to baseline with long-term follow-up. These data suggest that patients who have undergone RYGB are at risk for oxalate nephropathy developing.
    Journal of the American College of Surgeons 07/2010; 211(1):8-15. · 4.50 Impact Factor
  • Shaheen Alanee, Joel Slaton
    Journal of Urology - J UROL. 01/2010; 183(4).
  • Shaheen Alanee, Joel Slaton
    Journal of Urology - J UROL. 01/2010; 183(4).
  • Journal of Urology - J UROL. 01/2010; 183(4).
  • Shaheen Alanee, Aseem R Shukla
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    ABSTRACT: To present descriptive statistics for bladder tumours in children, calculated from the Surveillance, Epidemiology and End Results (SEER) database, as bladder malignancies are relatively uncommon in children, causing difficulty in understanding their incidence and survival. The SEER database was interrogated to report the incidence of bladder malignancies in children from birth to 18 years old. Race and sex differences were assessed. The 5-year survival by disease stage at diagnosis and 5-year conditional survival after surviving for 1-3 years is reported for 1973-2003. The incidence and survival rates for bladder embryonal rhabdomyosarcoma were further characterized. We identified 140 cases of bladder cancers in the selected cohort. Papillary urothelial neoplasm of low malignant potential (PUNLMP) and rhabdomyosarcoma comprised 50.7% and 36.4% of the tumours, respectively. The incidence of bladder malignancies significantly increased between 1973 and 2003. Conditional survival calculated for 1 and 2 years after disease diagnosis was 93.6% and 97.5%. Fifty-one cases of embryonal rhabdomyosarcoma were identified. The male to female incidence ratio was approximately 2:1 for these tumours. The 5-year survival rates were 50-80% over the past three decades. We present the most contemporary survey of the SEER database for the incidence and survival for bladder tumours in children. Depending on the patient's age, PUNLMP and rhabdomyosarcoma predominated in different proportions. The 2-3-year conditional survival and overall survival were excellent. We also identified improving survival for embryonal bladder rhabdomyosarcoma with time.
    BJU International 12/2009; 106(4):557-60. · 3.05 Impact Factor
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    ABSTRACT: Risk factors and treatment efficacy for ureteral obstruction following pediatric renal transplantation are poorly understood. We describe a single center experience with pediatric transplant recipients in an effort to discern risk factors and treatment efficacy. We retrospectively reviewed the pediatric renal transplant database at our institution from January 1984 to March 2008. Donor and recipient demographics, treatment indications, graft characteristics, surgical techniques, treatment course, complications and graft outcomes were abstracted from clinical records. A total of 449 children (mean age 8.6 years) who underwent 526 renal transplants were included in the study. Ureteral obstruction requiring intervention developed in 42 cases (8%). Recipient age and gender, recipient and donor race, donor harvest technique, ureterovesical anastomosis with or without stenting, number of donor arteries, number of human leukocyte antigen mismatches, prior renal transplant and ischemia time were not significantly associated with increased incidence of ureteral obstruction. Renal failure secondary to posterior urethral valves was the only parameter significantly associated with increased incidence of ureteral obstruction (univariate OR 4.93, p = <0.0001; multivariate point estimate 7.59, p <0.0001). Of patients with ureteral obstruction 48% presented within 100 days after transplant. Kaplan-Meier analysis showed significantly decreased ureteral obstruction-free survival in patients with vs without posterior urethral valves (log rank test, p <0.0001). Ureteral obstruction, stenting and dilation were not significantly associated with increased graft loss or patient death. Ureteral obstruction after renal transplantation in children is a challenging complication that demands clinical vigilance. Posterior urethral valves appear to be a significant risk factor for post-transplant ureteral obstruction likely due to local factors such as ischemia, thick bladder wall and collagen remodeling.
    The Journal of urology 11/2009; 183(1):317-22. · 3.75 Impact Factor

Publication Stats

73 Citations
102.09 Total Impact Points

Institutions

  • 2012–2014
    • Memorial Sloan-Kettering Cancer Center
      • • Department of Surgery
      • • Clinical Genetics Service
      New York City, New York, United States
  • 2008–2012
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 2011
    • Children's Hospitals and Clinics of Minnesota
      Minneapolis, Minnesota, United States
  • 2009–2011
    • University of Minnesota Twin Cities
      • • Department of Urology
      • • Department of Pediatrics
      Minneapolis, MN, United States