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Publications (5)5.89 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Prostate cancer is the second most common cause of cancer death in American men. For patients with adverse pathologic features, postoperative radiotherapy to prostate bed after radical prostatectomy has been shown in randomized studies to improve many important clinical endpoints including overall survival. In this review article, we distinguish adjuvant radiation treatment (ART) from salvage radiation treatment (SRT), discuss the evidences for ART and its potential side effects focusing on the debate concerning the optimal timing of post prostatectomy radiation treatment (RT). A comprehensive literature search was conducted in MEDLINE including pre-MEDLINE. for patients with adverse pathologic factors, adjuvant radiation treatment after prostatectomy reduces the rate of PSA failure with the potential for significantly improving metastases-free and overall survival. Whether an equivalent survival benefit can be attained with early salvage radiation treatment after biochemical recurrence, is still an area of debate.
    The Canadian Journal of Urology 04/2011; 18(2):5592-600. · 0.74 Impact Factor
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    ABSTRACT: Although less common than endometrioid carcinoma, uterine serous carcinoma (USC) accounts for a disproportionate number of endometrial cancer-related deaths. It is relatively more common in black compared to white women. The aim of our study is to analyze the impact of race on survival in USC. We conducted a retrospective review in women with USC managed at two large urban medical centers. Clinical and histopathologic parameters were retrieved. Recurrence and survival data were obtained from medical records and the Surveillance, Epidemiology, and End Results (SEER) registry. Differences in overall survival between African American and Caucasian women were compared using Kaplan-Meier curves and log rank test for univariate analysis. Cox regression models for multivariate analyses were built to evaluate the relative impact of the various prognostic factors. One hundred seventy-two women with USC were included in this study, including 65 Caucasian women and 107 African American women. Both groups were similar with respect to age, stage at diagnosis, angiolymphatic invasion (p=0.79), and the depth of myometrial invasion (p=0.36). There was no statistical difference in overall survival between African American and Caucasian patients in univariate analysis (p=0.14). In multivariate analysis, stage at diagnosis, angiolymphatic invasion, and depth of myometrial invasion, but not race, were significantly associated with overall survival. In this study, African American women with USC had a similar survival to Caucasian women. This suggests that the racial differences seen in USC at a larger population level may be diminished in hospital-based studies, where women are managed in a uniform way.
    Gynecologic Oncology 03/2011; 121(3):577-80. · 3.93 Impact Factor
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    ABSTRACT: We studied the impact of different prognostic factors on the clinical outcome for the patients with pathologic Stage IIA endometrial adenocarcinoma who had surgical staging (SS) and received adjuvant high-dose-rate intravaginal brachytherapy (IVB) alone. Sixty-one patients with Stage IIA endometrial adenocarcinoma were retrospectively studied. Cox proportional hazards regression was used to study prognostic factors. All the patients underwent SS between July 1994 and December 2005. The median age was 64 years (range, 46-71 years). The median number of lymph nodes sampled was 8 (range, 7-12). All the patients received adjuvant IVB to doses of 35-36Gy in four to five fractions prescribed to the surface. The myometrial invasion was <50% in 33 patients and > or =50% for 28 patients. The lymphovascular invasion (LVI) and the lower uterine segment involvement were identified in 18% and 61%, respectively. At a median followup of 64 months (range, 8-153 months), there were 7 patients who developed recurrences. On univariate analysis, the only factor significantly predictive for locoregional recurrence was LVI (p=0.01). In regard to overall survival (OS), factors that were significantly predictive on univariate analysis were LVI (p=0.03), tumor grade (p=0.04), and depth of myometrial invasion (p=0.04). The 5-year rates of vaginal and pelvic recurrences were 1.7% and 8.2%, respectively. The 5-year local control and OS rates were both 87%. Our results suggest excellent local control with adjuvant IVB alone for selected patients with Stage IIA endometrial adenocarcinoma. The patients with positive LVI and deep myometrial invasion have a worse locoregional control and OS despite SS and adjuvant IVB.
    Brachytherapy 10/2009; 8(4):396-400. · 1.22 Impact Factor
  • International Journal of Radiation Oncology Biology Physics - INT J RADIAT ONCOL BIOL PHYS. 01/2008; 72(1).
  • International Journal of Radiation Oncology Biology Physics - INT J RADIAT ONCOL BIOL PHYS. 01/2008; 72(1).