Biomedical subjects

Shahrokh Shariat

Publications and source records attributed to Shahrokh Shariat.

3 recordsLinked to original sources

PubMed2005

Exploration of health-related quality of life areas that may distinguish between continent diversion and ileal conduit patients.

OBJECTIVES: We explored the specific impact of urinary diversion type on HRQOL in men after cystectomy for bladder cancer. Our intent was to provide a basis for the development of a diversion-specific instrument. METHODS: We invited 13 ileal conduit and 12 orthotopic urinary diversion (neo-bladder) male patients to several open-ended interviews. We explored HRQOL domains that may have been affected by cystectomy and urinary diversion, and that could then be used to form a basis for a diversion-specific HRQOL measure. RESULTS: The average age of neo-bladder patients was 59 versus 65 years for ileal conduit patients. We identified 10 HRQOL domains, ranging from involuntary urine leakage to dietary modifications, which were recognized as important by ileal conduit and neobladder patients. Within each domain, a sufficient amount of overlap existed to allow developing a measure that might be applied to both groups of patients. CONCLUSIONS: Ten HRQOL domains were identified as important by ileal conduit and neobladder patients. These demonstrated a significant amount of overlap between conduit and neobladder patients. Potentially, these domains could be used to develop scales for distinguishing between conduit and neobladder-specific HRQOL detriments.

Aged↗

PubMed2005

BPSA: A Novel Serum Marker for Benign Prostatic Hyperplasia.

Free prostate-specific antigen (fPSA) testing was developed and approved for widespread use despite the lack of knowledge regarding the underlying biologic basis for its ability to discriminate between benign prostatic hyperplasia (BPH) and prostate cancer. We hypothesized that the relationship of total PSA to prostate volume was due primarily to the fPSA component of serum PSA, and we studied the molecular forms of PSA found in prostate tissue. Later, more sophisticated studies resulted in the discovery of BPSA (benign PSA), a novel form of fPSA associated with nodular hyperplasia of the transition zone (TZ). We found that the serum BPSA level is highly correlated with TZ and total prostate volume. In our most recent studies, we found that BPSA correlates better with TZ volume than does PSA and can predict clinically significant prostate enlargement better than PSA or fPSA. Furthermore, the relation of BPSA and fPSA to total prostate and TZ volumes is independent of age.

Journal Article↗

PubMed2004

Predicting the presence and side of extracapsular extension: a nomogram for staging prostate cancer.

PURPOSE: We developed a model to predict the side specific probability of extracapsular extension (ECE) in radical prostatectomy (RP) specimens based on the clinical features of the cancer. MATERIALS AND METHODS: We studied 763 patients with clinical stage T1c-T3 prostate cancer who were diagnosed by systematic needle biopsy and subsequently treated with RP. Candidate predictor variables associated with ECE were clinical T stage, the highest Gleason sum in any core, percent positive cores, percent cancer in the cores from each side and serum prostate specific antigen (PSA). Receiver operating characteristic (ROC) analyses were performed to assess the predictive value of each variable alone and in combination. We constructed and internally validated nomograms to predict the side specific probability of ECE based on logistic regression analysis. RESULTS: Overall 30% of the patients and 17% of 1,526 prostate lobes (left or right) had ECE. The areas under the ROC curves (AUC) of the standard features in predicting side specific probability of ECE were 0.627 for PSA, 0.695 for clinical T stage on each side and 0.727 for Gleason sum on each side. When these features were combined predictive accuracy increased to 0.788. The highest value (0.806) was achieved by adding the percent positive cores and the percent cancer in the biopsy specimen to the standard features. The resulting nomograms were internally validated and had excellent calibration and discrimination accuracy. CONCLUSIONS: Standard clinical features of prostate cancer in each lobe-PSA, palpable induration and biopsy Gleason sum-can be used to predict the side specific probability of ECE in RP specimens. The predictive accuracy is increased by adding information from systematic biopsy results. The predictive nomograms are sufficiently accurate for use in clinical practice in decisions such as wide versus close dissection of the cavernous nerves from the prostate.

Adult↗