Kamran Zargar-Shoshtari

University of Auckland · Auckland Urology Research

Objectives To assess the impact of differences in Prostate-Specific Antigen (PSA) testing rates on prostate cancer (PCa) diagnosis and PCa-specific mortality among Māori men in a New Zealand (NZ) population. Patients and Methods Māori men aged 40 years or older, without a history of PCa, with a PSA test between 2006 and 2018 were included. The coh...

Objectives: Perioperative blood transfusion (PBT) has been associated with worse survival after radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC). Here, we evaluated the association between PBT and survival after RC that was preceded by neoadjuvant chemotherapy (NAC). Methods: A retrospective analysis was performed on 9...

Prostate cancer is a significant healthcare problem worldwide. Current diagnosis and treatment methods are limited by a lack of precise in vivo tissue analysis methods. Real‐time cancer identification and grading could dramatically improve current protocols. Here, we report the testing of a thin optical probe using Raman spectroscopy and classifica...

Purpose Cisplatin-based chemotherapy followed by radical cystectomy (RC) is recommended in patients with muscle-invasive bladder cancer (MIBC). However, up to 50% of patients are cisplatin ineligible. The aim of this study was to compare clinical outcomes after ≥ 3 cycles of preoperative gemcitabine–carboplatin (gem–carbo) versus gemcitabine–cispla...

Machine learning has shown great potential for classifying diverse samples in biomedical applications based on their Raman spectra. However, the acquired spectra typically require several preprocessing steps before standard machine learning algorithms can accurately and reliably classify them. To simplify this workflow and enable future growth of t...

Purpose To assess the association of patient age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer (MIBC). Materials and methods We analyzed data from 1105 patients with MIBC. Patients age was evaluated as continuous variable and stratified in quartiles. Pathologic objective response (pOR; ypT0-Ta-Tis-T1N0)...

Objectives To systematically evaluates the evidence on ethnic differences in age-adjusted reference values of PSA. Materials and Methods In concordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement, a review of English articles using Medline, Embase and Cochrane databases, from inception to December...

Bacterial extracellular vesicles (EVs) are nanoscale lipid-enclosed packages that are released by bacteria cells and shuttle various biomolecules between bacteria or host cells. They are implicated in playing several important roles, from infectious disease progression to maintaining proper gut health, however the tools available to characterise an...

Background: Prostate cancer (Pca) is the most frequently diagnosed cancer in New Zealand (NZ) men and the third leading cause of cancer deaths. Temporal changes in Pca incidence and mortality have not been reported despite changes in the Pca landscape. This study aims to analyse the temporal trends in Pca with focus on ethnic and regional variatio...

Background Positive surgical margins (PSM) after radical prostatectomy (RP) have been associated with increased risk of biochemical recurrence (BCR). This is heavily influenced by other clinicopathological factors. This study aims to assess the impact of the extent and location of PSM on BCR following RP for Gleason 7 carcinoma of the prostate (CaP...

Objectives: The objectives of this study are to determine the predictors of success following extracorporeal shock-wave lithotripsy (ESWL) in a contemporary cohort at a high-volume stone center. Methods: We conducted a retrospective review all patients who underwent an elective ESWL within our institution over a 24-month period (January 2014 to Dec...

Background Prostate cancer represents a significant health burden on New Zealand men. There are increasing concerns regarding inequities in prostate cancer morbidity and mortality among the different ethnic groups in New Zealand. This study aims to assess ethnic differences in survival outcomes among men newly diagnosed with prostate cancer. Mater...

Objective: To establish age-adjusted reference values for prostate-specific antigen in an ethnically diverse population. Methods: Between 2009 and 2017, data were collected from all men aged 40-79 years, who had a prostate-specific antigen test in the northern region of New Zealand, where the prostate-specific antigen testing service is provided...

Prostate cancer represents a significant health burden worldwide. The cancer incidence had substantially increased since the introduction of prostate specific antigen (PSA) in cancer screening. This had led to considerable debates among health professionals and epidemiologists, since PSA as a screening tool seemed to be far from perfect. In New Zea...

Background : Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) is associated with improved overall and cancer-specific survival. The post-NAC pathological stage has previously been reported to be a major determinant of outcome. Objective : To develop a postoperative nomogram for survival based on pathological...

Objectives: To investigate the presence of ethnic and socioeconomic disparities in Prostate cancer screening and identify its impact on cancer outcomes. Materials and methods: From January 2008 to December 2017, all men in the Northern region of New Zealand, who had a Prostate Specific Antigen (PSA) test performed in the community, were identifi...

Objective: To assess the effect of patient's sex on response to neoadjuvant chemotherapy (NAC) in patients with clinically nonmetastatic muscle-invasive bladder cancer (MIBC). Methods: Complete pathologic response, defined as ypT0N0 at radical cystectomy, and downstaging were evaluated using sex-adjusted univariable and multivariable logistic re...

Background: Prostate specific antigen (PSA) utilization in population-based prostate cancer (CaP) screening, has been a controversial area for decades. Current recommendation in our region is for an opportunistic approach to screening, with estimated low prevalence of such practice in the community. However, our clinical observations suggested tha...

Introduction: The neutrophil-to-lymphocyte ratio (NLR) is an attractive marker because it is derived from routine bloodwork. NLR has shown promise as a prognostic factor in muscle invasive bladder cancer (MIBC) but its value in patients receiving neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is not yet established. Since NLR is rel...

INTRODUCTION. Neutrophil-to-lymphocyte ratio (NLR) is an attractive biomarker because it is derived from routine bloodwork. NLR has shown promise as a prognostic factor in muscle invasive bladder cancer (MIBC) but its value in patients receiving neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is not yet established. Since NLR has been...

Purpose: To identify clinical and stone-related factors predicting the need for surgical intervention in patients who were clinically considered appropriate for non-surgical intervention. Patients and methods: We conducted a retrospective review of a contemporary cohort of patients who were selected for surveillance following presentation with a...

Introduction: Prostate-specific membrane antigen (PSMA) is a receptor highly expressed on the membranes of prostate cancer (PCa) cells and provides a new opportunity for imaging and targeted therapy in metastatic prostate cancer. The use of radio-labelled peptides with high affinity for PSMA-receptor allows for localization of oligo-metastasis to...

Abstract PURPOSE: Level I evidence supports the usefulness of neoadjuvant cisplatin based chemotherapy for muscle invasive bladder cancer. Since dose dense MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) has mostly replaced traditional MVAC, we compared pathological response and survival rates in patients with locally advanced bladder c...

Background: Treatment of locoregionally advanced penile squamous cell carcinoma (LAPSCC) is challenging. The exact role (in terms of oncological benefit) of extensive surgery is not well established. Moreover, surgery invariably leads to large defects requiring reconstructive surgery. Rectus abdominis myocutaneous (RAM) and abdominal advancement f...

Purpose: Our primary endpoint was to assess pathological response rate (pT0N0 and ≤pT1N0) for patients with BCa treated with the accelerated or dose dense MVAC (ddMVAC) chemotherapy followed by radical cystectomy (RC) in this real-word multi-institutional cohort. Materials and methods: We retrospectively reviewed records of patients with urothel...

Introduction: Biomarkers are increasingly used in the diagnosis and management of various malignancies. Selected biomarkers may also play a role in management of certain cases of penile carcinoma. In this article, we provide an overview of the clinical role of such markers in the management of penile cancer. Method: This is a nonsystematic revie...

Purpose: To determine the therapeutic value of lymph node dissection (LND) during cytoreductive nephrectomy (CN) and assess predictors of cancer-specific survival (CSS) in metastatic renal-cell carcinoma. Patients and methods: We identified 293 consecutive patients treated with CN at 4 academic institutions from March 2000 to May 2015. LND was p...

Accumulating evidence suggests that peritoneal cytokine concentrations may predict anastomotic leak after colorectal surgery, but previous studies have been under-powered. We aimed to test this hypothesis using a larger prospectively collected data set.

PurposeThe benefits of robotic-assisted radical cystectomy (RARC) are unclear, especially in patients with high-risk disease (pT3/T4). We evaluated pathological and postoperative outcomes of RARC versus open radical cystectomy (ORC) in these patients. Methods We identified bladder cancer patients treated with RARC or ORC from January 2010–August 20...

Session title: BLEXIT - best oncological outcomes from cystectomy Session type: Poster Session 68 Presentation type: Standard presentation Date: Monday, 27 March 2017 from 12:15 to 13:45 Room: Room Munich (Boulevard, level 1)

Purpose: Careful selection is critical to identify metastatic renal cell carcinoma (mRCC) patients who are most likely to benefit from cytoreductive nephrectomy (CN). Surgery for mRCC patients with tumor thrombus is complex and may not benefit some patients with very poor overall survival (OS). The objective of this study was to evaluate whether p...

Introduction: We conducted this study to determine if, in appropriately selected elderly patients receiving neoadjuvant chemotherapy (NAC), clinical outcomes including pathologic complete response/downstaging and overall survival were similar to a younger cohort. Methods: Chart review was performed on patients receiving NAC for urothelial carcin...

Background The goal was to assess the natural history and management of patients with pathologically proven bilateral (synchronous) RO after undergoing initial partial nephrectomy (PN). Methods All patients underwent either robotic/laparoscopic or open PN by two experienced genitourinary oncologists from 2005–2013. Final pathology was determined b...

This article discusses the diagnostic and therapeutic options in the management of urethral cancer recurrence in patients treated with urethral sparing cystectomy as well as those who had urethral preservation following primary urethral carcinoma.

Purpose Neoadjuvant chemotherapy (NAC) can downstage invasive bladder cancers prior to radical cystectomy (RC) and improve overall survival. However, the optimal management in patients with persistent non-organ confined disease (pT3–T4 and/or pN+) following RC has not been completely defined. The aim of this study was to describe outcomes associate...

Background: Although penile cancer is a rare malignancy in developed nations, racial and socioeconomic differences exist in the incidence of the disease and its associated survival-related outcomes. Methods: A search of the literature was performed for research published between the years 1990 and 2015. Case reports and non-English-language arti...

Primary urethral carcinomas (PUCs) account for <1 % of all genitourinary malignancies. According to the Surveillance, Epidemiology, and End Results (SEER) database, over the past three decades, the annual incidence has ranged from 1.5 per million in women and a nearly threefold larger incidence in men (4.3 per million). The prevalence of all histol...

Background: Accumulating evidence suggests that peritoneal cytokine concentrations may predict anastomotic leak after colorectal surgery, but previous studies have been underpowered. Objective: We aimed to test this hypothesis by using a larger prospectively collected data set. Design: This study is an analysis of prospectively collected data....

Review of current literature regarding bilateral renal oncocytoma, including a cohort of patients at Moffitt Cancer Center

Introduction: The choice of approach for partial nephrectomy often depends on surgical complexity. We aimed to determine if surgeon intuition was equivalent to markers of operative complexity, such as RENAL nephrometry and Mayo adhesive probability (MAP) score, in determining the surgical approach for partial nephrectomy (PN). Materials and metho...

Purpose: Neoadjuvant chemotherapy (NAC) can downstage invasive bladder cancers prior to radical cystectomy (RC) and improve overall survival. However, the optimal management in patients with persistent non-organ confined disease (pT3-T4 and/or pN+) following RC has not been completely defined. The aim of this study was to describe outcomes associa...

Review of current literature regarding bilateral renal oncocytoma, including a cohort of patients at Moffitt Cancer Center

Background: To perform a systematic examination of the available evidence identifying factors that predict the detection of occult nodal metastatic disease at the time of radical cystectomy in patients with urothelial cancer of the bladder (BCa). Methods: A systematic literature search of the Pubmed database was performed in August 2015 using me...

496 Background: RCC with tumor thrombus may require complex surgery to remove the primary tumor. Some patients with tumor venous thrombus and metastatic RCC are unlikely to benefit from cytoreductive nephrectomy. The purpose of this study was to identify risk factors for poor overall survival in metastatic RCC patients with tumor thrombus. Methods:...

Prostate cancer (PCa) has variable biological potential with multiple treatment options. A more personalized approach, therefore, is needed to better define men at higher risk of developing PCa, discriminate indolent from aggressive disease and improve risk stratification after treatment by predicting the likelihood of progression. This may improve...

Background: Because of the low incidence of penile carcinoma (PC), the value of p16(ink4a), p53, and human papilloma virus (HPV) infection status in clinical practice remains unclear. Herein, we report our experience with potential clinical utility of these markers in men with PC treated at our institution. Patients and methods: Tissue microarra...

The most effective intravesical regimen for the treatment of non-muscle invasive bladder cancer (NMIBC) refractory to Bacillus Calmette-Guérin (BCG) has still not been identified or optimized to minimize recurrence-free survival and prevent progression reliably and consistently. Valrubicin, however, is a cytotoxic chemotherapeutic agent that is use...

Purpose: We evaluated sociodemographic and economic differences in overall survival (OS) of patients with penile SCC using the National Cancer Data Base (NCDB). Methods: We identified 5,412 patients with a diagnosis of penile squamous cell carcinoma from 1998 to 2011 with clinically nonmetastatic disease and available pathologic tumor and nodal...

Purpose: Our aim was to assess survival dependent on pathologic response after neoadjuvant chemotherapy (NAC) in a large multicenter patient cohort, with particular focus on the difference between absence of residual cancer (pT0) and the presence of only non-muscle invasive residual cancer (pTa, pTis, pT1). Materials and methods: We retrospectiv...

Abstract PURPOSE: We assessed survival dependent on pathological response after neoadjuvant chemotherapy in a large multicenter patient cohort, with a particular focus on the difference between the absence of residual cancer (pT0) and the presence of only nonmuscle invasive residual cancer (pTa, pTis, pT1). MATERIALS AND METHODS: We retrospectively...

Lymphadenectomy (LND) is part of the surgical management of penile cancer but causes significant perioperative morbidity. We determined whether sarcopenia, a novel marker of nutritional status, is a predictor of postoperative complications after LND. Seventy-nine patients underwent LND for penile cancer from 1999 to 2014, and 43 had available preop...

Background Management of renal cell carcinoma (RCC) with inferior vena cava thrombus (IVCT) is associated with high morbidity. Chronic kidney disease (CKD) is a known risk factor for perioperative complications in many surgical procedures. The objective of this study was to review the association between preoperative CKD (eGFR < 60 mL/min) and post...

Several disease characteristics have been identified as potential predictors for pathological node involvement (pN+) following radical cystectomy (RC). However, these have not been assessed in patients treated with neoadjuvant chemotherapy (NAC). We endeavored to assess factors predicting adverse pathology in clinically node-negative patients treat...

We present our experience with minimally-invasive retroperitoneal lymph node dissection (MI-RPLND) in the post-chemotherapy (PC) setting for residual masses in patients with nonseminoma. Nineteen men who underwent PC MI-RPLND (14 - laparoscopic, 5 - robotic) for low-volume residual disease (no more than 5 clinically enlarged retroperitoneal masses,...

Background: To assess the pathological response rates and survival outcomes in patients with squamous or glandular histological variation (HV) treated with neoadjuvant chemotherapy (nCT) and radical cystectomy (RC), and compare these with patients with pure urothelial carcinoma of the bladder (PUCB). Patients and methods: We performed a retrospe...

Psychological distress has been associated with impaired immune response and poor wound healing. We hypothesized that preoperative patient-reported mental health would be associated with high-grade 30-day complications after radical cystectomy (RC). We retrospectively identified patients who underwent RC for bladder cancer (BC) who completed Short...

Selected bladder cancer patients with pelvic lymphadenopathy (cN1-3) are treated with induction chemotherapy followed by radical cystectomy (RC). However, the data on clinical outcomes in these patients are limited. The aim of this project is to assess pathological and survival outcomes in cN1-3 patients treated with induction chemotherapy and RC....

To assess the pattern of renal cell carcinoma (RCC) recurrences in nephron-sparing surgery (NSS) patients, and to determine whether current guidelines for surveillance could be modified based on such patterns. Retrospective review of a single-institution NSS database. Pattern of RCC recurrences and factors associated with recurrence were analyzed u...

The aim of the study is to assess the contemporary patterns of utilization of various therapeutic options for the management of nephrolithiasis in our tertiary referral institution in Auckland, New Zealand. A retrospective audit was conducted for all urinary stone procedures between January 2007 and December 2013. Procedure-related information was...

We determined whether adjuvant chemotherapy (AC) would be associated with improved survival after lymph node dissection (LND) for patients with penile cancer (PeCa) who have positive pelvic lymph nodes (PPLNs). We retrospectively identified patients across 4 centers with penile squamous cell carcinoma who underwent LND from 1978 to 2013 and were fo...

Current guidelines on management of penile carcinoma (PC) recommend ipsilateral pelvic lymph node dissection (PLND) in patients with inguinal lymph node metastasis (LNM) who meet specific criteria. The aim of this article was to assess outcomes in patients treated with bilateral PLND in the presence of unilateral metastatic pelvic nodes. After IRB...