Bibliographic record
Abstract
Background: Urologic malignancies are common after heart transplantation, with prostate cancer (CaP) being the most common solid tumor.To date, there are no studies comparing the aggressiveness of urologic malignancies in heart transplant recipients (HTR).Methods: We retrospectively reviewed our institution's transplant database to identify patients diagnosed with urologic malignancies following heart transplantation between January 1980 and January 2010.Prostate cancer was detected after routine screening with both digital rectal exam (DRE) and prostate-specific antigen (PSA), whereas renal cell carcinoma (RCC) and bladder cancer (CaB) were diagnosed either incidentally on imaging or upon evaluation for hematuria.Data was analyzed using descriptive statistics.Results: Among 1250 HTR, 12 patients were found and treated based on elevated PSA levels.One additional CaP case was incidentally discovered on transurethral prostate resection and not treated.Of the 12 CaP patients that were treated, 5 underwent prostatectomy, 6 had radiation, and 1 received both radiation and hormone ablation therapy.The mean time between transplantation and CaP diagnosis was 65 ± 33 months.Nine patients (75%) were biochemically free of recurrence at a mean of 49 months.Three (25%) are alive with disease.No patients died from CaP at a mean follow up of 45 ± 30 months.Four patients were diagnosed with CaB.Three (75%) are dead with disease: 2 after cystectomy were aborted due to metastatic disease and 1 after chemotherapy and radiation.Mean interval between transplantation and CaB diagnosis was 54 ± 33 months.At a mean follow up of 42 ± 46 months, 3 mortalities were attributed to CaB.Two patients were diagnosed with RCC and surgically treated.The mean interval between transplantation and RCC diagnosis was 66 ± 29 months.At a mean follow up of 54 ± 15 months, there was 1 mortality (Table 1).Conclusion: As in the generalized population, routine PSA testing and DRE appear to be beneficial as screening for CaP in HTR.In our experience, both CaB and RCC appear to be uncommon, but aggressive in HTR.Given the limited number of patients in this cohort, no definitive conclusions can be made.However, patients with signs or symptoms of CaB or RCC should be evaluated in a timely fashion.P50
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.499 | 0.225 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".