Bonnie Choy

University of Rochester, Rochester, New York, United States

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Publications (7)41.07 Total impact

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    ABSTRACT: It remains unanswered whether and how intraoperative frozen section analysis contributes to the surgical margin status on radical prostatectomy specimens. We aimed to determine whether frozen section analysis during radical prostatectomy reduces the incidence of positive surgical margins. We retrospectively analyzed a consecutive series of patients undergoing robot-assisted laparoscopic radical prostatectomy performed at our institution between 2004 and 2011. We identified 2608 cases, including 1128 (43.3%) where intraoperative frozen section analysis was performed to assess surgical margins. Of the cases with positive (n = 60; 5.3%)/negative (n = 1029; 91.2%)/atypical or indeterminate (n = 39; 3.5%) frozen section analyses, 22 (36.7%)/83 (8.1%)/4 (10.3%) were found to have positive surgical margins on radical prostatectomy specimens, respectively. Thus, 109 (9.7%) of 1128 cases with frozen section analysis had positive surgical margins, compared with 163 (11.0%) of 1480 cases with no frozen section analysis (P = .264). When the patients were subgrouped by histopathologic characteristics, frozen section analysis led to a considerable reduction in the rate of positive surgical margins in cases with biopsy Gleason score 7 (12.4% → 8.7%; P = .087)/8 (28.6% → 16.3%; P = .048)/≥7 (15.3% → 10.1%; P = .012) tumor or pT3b (36.6% → 23.2%; P = .075)/≥pT3b (38.1% → 25.4%; P = .091) disease. Multivariate analysis further revealed that performing frozen section analysis in biopsy Gleason score 7 or higher tumors was an independent predictor of negative surgical margins (odds ratio, 0.61; P = .018). In addition, frozen section analysis of the distal urethra or apex of the prostate (7.5%, P = .035) as well as multiple negative frozen section analyses (≥2: 6.2%, P = .001; ≥4: 2.2%, P = .007) correlated with significantly lower rates of positive surgical margin, compared with no frozen section analysis. Overall, intraoperative frozen section analysis did not dramatically change surgical margin status of radical prostatectomy. Nonetheless, it could be useful in preventing incomplete tumor resection, especially in men with high-grade (Gleason score ≥7) tumor at the apex.
    Human pathology 04/2013; 44(8). DOI:10.1016/j.humpath.2012.12.011 · 2.81 Impact Factor
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    ABSTRACT: Background High expression of Bmi-1, a key regulatory component of the polycomb repressive complex-1, has been associated with many solid and hematologic malignancies including esophageal squamous cell carcinoma. However, little is known about the role of Bmi-1 in esophageal adenocarcinoma. The aim of this study is to investigate the amplification and high expression of Bmi-1 and the associated clinicopathologic characteristics in esophageal adenocarcinoma and squamous cell carcinoma. Methods The protein expression level of Bmi-1 was detected by immunohistochemistry (IHC) from tissue microarrays (TMA) constructed at the University of Rochester from using tissues accrued between 1997 and 2005. Types of tissues included adenocarcinoma, squamous cell carcinoma and precancerous lesions. Patients’ survival data, demographics, histologic diagnoses and tumor staging data were collected. The intensity (0–3) and percentage of Bmi-1 expression on TMA slides were scored by two pathologists. Genomic DNA from 116 esophageal adenocarcinoma was analyzed for copy number aberrations using Affymetrix SNP 6.0 arrays. Fisher exact tests and Kaplan-Meier methods were used to analyze data. Results By IHC, Bmi-1 was focally expressed in the basal layers of almost all esophageal squamous mucosa, which was similar to previous reports in other organs related to stem cells. High Bmi-1 expression significantly increased from squamous epithelium (7%), columnar cell metaplasia (22%), Barrett’s esophagus (22%), to low- (45%) and high-grade dysplasia (43%) and adenocarcinoma (37%). The expression level of Bmi-1 was significantly associated with esophageal adenocarcinoma differentiation. In esophageal adenocarcinoma, Bmi-1 amplification was detected by DNA microarray in a low percentage (3%). However, high Bmi-1 expression did not show an association with overall survival in both esophageal adenocarcinoma and squamous cell carcinoma. Conclusions This study demonstrates that high expression Bmi-1 is associated with esophageal adenocarcinoma and precancerous lesions, which implies that Bmi-1 plays an important role in early carcinogenesis in esophageal adenocarcinoma.
    BMC Gastroenterology 10/2012; 12(1):146. DOI:10.1186/1471-230X-12-146 · 2.11 Impact Factor
  • European Urology 05/2012; 62(2):354-5. DOI:10.1016/j.eururo.2012.05.035 · 12.48 Impact Factor
  • The Journal of Urology 04/2012; 187(4):e281-e282. DOI:10.1016/j.juro.2012.02.773 · 3.75 Impact Factor
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    ABSTRACT: No abstract available.
    Urologia Internationalis 01/2012; 88(2):247-8. DOI:10.1159/000334335 · 1.15 Impact Factor
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    Journal of the American College of Cardiology 03/2010; 55(10). DOI:10.1016/S0735-1097(10)60138-6 · 15.34 Impact Factor
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    ABSTRACT: Obesity has been identified as a risk factor for cardiovascular disease and heart failure. However, data regarding the relation of body mass index (BMI) to outcome in patients with established heart failure are conflicting. We examined the risk of all-cause mortality and sudden cardiac death (SCD) in 1,231 patients after myocardial infarction with left ventricular dysfunction enrolled the Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-II). Interaction-term analysis was used to assess the benefit of the implantable cardioverter-defibrillator (ICD) in upper (obese > or =30 kg/m(2), n = 361) and lower (nonobese <30 kg/m(2), n = 870) BMI categories. Mean BMI in the study population was 27.9 +/- 5.1 kg/m(2). In multivariate analysis, decreased BMI was shown to be independently associated with an increase in the risk of all-cause mortality (23% risk increase per 5-U BMI decreased, p = 0.009) and SCD (41% risk increase per 5-U BMI decrease, p = 0.01). Consistently, patients with BMI <30 kg/m(2) exhibited 46% (p = 0.03) and 76% (p = 0.04) increases in risk of all-cause mortality and SCD, respectively, compared to patients who had higher BMI values. The benefit of the ICD was pronounced in higher-risk patients with BMI <30 kg/m(2) (hazard ratio 0.68, p = 0.017) and maintained in the lower-risk subgroup of patients with BMI > or =30 kg/m(2) (hazard ratio 0.73, p = 0.32; p = 0.86 for ICD-by-BMI interaction). In conclusion, our findings suggest an independent inverse association between BMI values and risk of all-cause mortality and SCD in patients after myocardial infarction with left ventricular dysfunction enrolled in the MADIT-II trial.
    The American journal of cardiology 03/2010; 105(5):581-6. DOI:10.1016/j.amjcard.2009.10.041 · 3.43 Impact Factor