Concomitant Carcinoma in situ in Cystectomy Specimens Is Not Associated with Clinical Outcomes after Surgery

Objective: The aim of this study was to externally validate the prognostic value of concomitant urothelial carcinoma in situ (CIS) in radical cystectomy (RC) specimens using a large international cohort of bladder cancer patients. Methods: The records of 3,973 patients treated with RC and bilateral lymphadenectomy for urothelial carcinoma of the bladder (UCB) at nine centers worldwide were reviewed. Surgical specimens were evaluated by a genitourinary pathologist at each center. Uni- and multivariable Cox regression models addressed time to recurrence and cancer-specific mortality after RC. Results: 1,741 (43.8%) patients had concomitant CIS in their RC specimens. Concomitant CIS was more common in organ-confined UCB and was associated with lymphovascular invasion (p < 0.001). Concomitant CIS was not associated with either disease recurrence or cancer-specific death regardless of pathologic stage. The presence of concomitant CIS did not improve the predictive accuracy of standard predictors for either disease recurrence or cancer-specific death in any of the subgroups. Conclusions: We could not confirm the prognostic value of concomitant CIS in RC specimens. This, together with the discrepancy between pathologists in determining the presence of concomitant CIS at the morphologic level, limits the clinical utility of concomitant CIS in RC specimens for clinical decision-making

Concomitant Carcinoma in situ in Cystectomy Specimens Is Not Associated with Clinical Outcomes after Surgery

Objective: The aim of this study was to externally validate the prognostic value of concomitant urothelial carcinoma in situ (CIS) in radical cystectomy (RC) specimens using a large international cohort of bladder cancer patients. Methods: The records of 3,973 patients treated with RC and bilateral lymphadenectomy for urothelial carcinoma of the bladder (UCB) at nine centers worldwide were reviewed. Surgical specimens were evaluated by a genitourinary pathologist at each center. Uni- and multivariable Cox regression models addressed time to recurrence and cancer-specific mortality after RC. Results: 1,741 (43.8%) patients had concomitant CIS in their RC specimens. Concomitant CIS was more common in organ-confined UCB and was associated with lymphovascular invasion (p < 0.001). Concomitant CIS was not associated with either disease recurrence or cancer-specific death regardless of pathologic stage. The presence of concomitant CIS did not improve the predictive accuracy of standard predictors for either disease recurrence or cancer-specific death in any of the subgroups. Conclusions: We could not confirm the prognostic value of concomitant CIS in RC specimens. This, together with the discrepancy between pathologists in determining the presence of concomitant CIS at the morphologic level, limits the clinical utility of concomitant CIS in RC specimens for clinical decision-making. Copyright (C) 2011 S. Karger AG, Base

Impact of electron beam quality on nonlinear harmonic generation in high-gain free-electron lasers

Nonlinear harmonic generation can be a very useful and important phenomenon for single-pass free-electron lasers (FELs) operating in the high-gain regime. Strong bunching at the fundamental wavelength and its associated higher harmonic content allow significant radiation at shorter wavelengths to be emitted without serious effects upon the output power at the fundamental. Here, we analyze the relative sensitivities to beam quality variations of the output fundamental and harmonic powers for a visible-wavelength FEL operating in the high-gain regime

A plan for the development of superconducting Undulator prototypes for LCLS-II and future FELs

Undulators serve as the primary source of radiation for modern storage rings, and more recently for the advent of Free-Electron Lasers (FELs). The performance of future FELs can be greatly enhanced using the much higher magnetic fields of superconducting undulators (SCU) [1]. For example, the LCLS-II hard x-ray undulator can be shortened by up to 70 m using an SCU in place of a PMU (permanent magnet undulator), or its spectral performance can be critically improved when using a similar length. In addition, SCUs are expected to be orders of magnitude less sensitive to radiation dose; a major issue at LCLS-II with its 1-MHz electron bunch rate. We present a funded R&amp;D collaboration between SLAC, ANL, and LBNL, which aims to demonstrate the viability of superconducting undulators for FELs by building, testing, measuring, and tuning two 1.5-m long planar SCU prototypes using two different technologies: NbTi at ANL and Nb Sn at LBNL. Our goal is to review and reassess the LCLS-II HXR baseline plans (PMU) in July of 2015, after the development and evaluation of both prototypes, possibly in favor of an SCU for LCLS-II.

Electron Beam Alignment Strategy in the LCLS Undulators

The x-ray FEL process puts very tight tolerances on the straightness of the electron beam trajectory (2 {micro}m rms) through the LCLS undulator system. Tight but less stringent tolerances of 80 {micro}m rms vertical and 140 {micro}m rms horizontally are to be met for the placement of the individual undulator segments with respect to the beam axis. The tolerances for electron beam straightness can only be met through beam-based alignment (BBA) based on electron energy variations. Conventional alignment will set the start conditions for BBA. Precision-fiducialization of components mounted on remotely adjustable girders and the use of beam-finder wires (BFW) will satisfy placement tolerances. Girder movement due to ground motion and temperature changes will be monitored continuously by an alignment monitoring system (ADS) and remotely corrected. This stabilization of components as well as the monitoring and correction of the electron beam trajectory based on BPMs and correctors will increase the time between BBA applications. Undulator segments will be periodically removed from the undulator Hall and measured to monitor radiation damage and other effects that might degrade undulator tuning