About

Gregory Zagaja, MD, is a Professor of Surgery at UChicago Medicine and the Director of the Prostate Cancer Program. He specializes in urologic oncology, with particular expertise in the management of prostate and bladder cancers. Dr. Zagaja performs minimally invasive surgical techniques designed to preserve urinary control and sexual function for prostate cancer patients. He is a national leader in the development of robotic-assisted laparoscopic prostate cancer surgery and has been instrumental in establishing the University of Chicago Robotic Surgery Program. His work includes analyzing outcomes data to optimize surgical techniques, maximizing quality of life while ensuring effective cancer control. Dr. Zagaja and his colleagues host an annual robotics training course to assist other urologists in performing robotic prostatectomies and are actively involved in clinical research assessing surgical outcomes. He is also a reviewer for multiple urological journals and serves as an advisor to the University of Chicago Clinical Trials Review Committee.

Research topics

• Internal medicine
• Medicine
• Urology
• Surgery
• Classics
• Art

Selected publications

• PIVOTAL STUDY OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) OF LOCALIZED PROSTATE CANCER: 5-YEAR FOLLOW UP

  Urologic Oncology Seminars and Original Investigations · 2024-03-01 · 3 citations

  article
  PublisherDOI

• A Contemporary Report of Low-Dose-Rate Brachytherapy for Prostate Cancer Using MRI for Risk Stratification: Disease Outcomes and Patient-Reported Quality of Life

  Cancers · 2023 · 5 citations

  • Medicine
  • Urology
  • Internal medicine

  PURPOSE: We examined a prospective consecutive cohort of low dose rate (LDR) brachytherapy for prostate cancer to evaluate the efficacy of monotherapy for unfavorable-intermediate risk (UIR) disease, and explore factors associated with toxicity and quality of life (QOL). METHODS: 149 men with prostate cancer, including 114 staged with MRI, received Iodine-125 brachytherapy alone (144-145 Gy) or following external beam radiation therapy (110 Gy; EBRT). Patient-reported QOL was assessed by the Expanded Prostate Index Composite (EPIC) survey, and genitourinary (GU) and gastrointestinal (GI) toxicity were prospectively recorded (CTC v4.0). Global QOL scores were assessed for decline greater than the minimum clinically important difference (MCID). Univariate analysis (UVA) was performed, with 30-day post-implant dosimetry covariates stratified into quartiles. Median follow-up was 63 mo. RESULTS: < 0.05) in UC at 2 mo, UIO at 2 and 6 mo, and SF at 2-24 mo, and >5 yr. Analysis did not reveal any significant associations with any examined rectal or urethral dosimetry for late toxicity or QOL. CONCLUSION: Disease outcomes and patient-reported QOL support LDR brachytherapy, including monotherapy for UIR disease.

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• Seminal vesicle cystadenoma with dysplasia: missing link to adenocarcinoma?

  Histopathology · 2021-03-30 · 5 citations

  letter
  PublisherDOI

• PD17-02 PIVOTAL TRIAL OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION IN MEN WITH LOCALIZED PROSTATE CANCER: TWO-YEAR FOLLOW-UP

  The Journal of Urology · 2020 · 2 citations

  • Medicine
  • Classics
  • Art

  You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (PD17)1 Apr 2020PD17-02 PIVOTAL TRIAL OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION IN MEN WITH LOCALIZED PROSTATE CANCER: TWO-YEAR FOLLOW-UP Scott Eggener*, Michael Koch, David Penson, Christian Pavlovich, Joseph Chin, Yair Lotan, Steven Raman, Gencay Hatiboglu, Aytekin Oto, James Relle, Jurgen Fütterer, Marc Serrallach, Axel Heidenreich, Masoom Haider, David Bonekamp, Temel Tirkes, Sandeep Arora, Allan Pantuck, Gregory Zagaja, Michiel Sedelaar, Katarzyna Macura, Daniel Costa, Thorsten Persigehl, Andrei Purysko, and Laurence Klotz Scott Eggener*Scott Eggener* More articles by this author , Michael KochMichael Koch More articles by this author , David PensonDavid Penson More articles by this author , Christian PavlovichChristian Pavlovich More articles by this author , Joseph ChinJoseph Chin More articles by this author , Yair LotanYair Lotan More articles by this author , Steven RamanSteven Raman More articles by this author , Gencay HatibogluGencay Hatiboglu More articles by this author , Aytekin OtoAytekin Oto More articles by this author , James RelleJames Relle More articles by this author , Jurgen FüttererJurgen Fütterer More articles by this author , Marc SerrallachMarc Serrallach More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , Masoom HaiderMasoom Haider More articles by this author , David BonekampDavid Bonekamp More articles by this author , Temel TirkesTemel Tirkes More articles by this author , Sandeep AroraSandeep Arora More articles by this author , Allan PantuckAllan Pantuck More articles by this author , Gregory ZagajaGregory Zagaja More articles by this author , Michiel SedelaarMichiel Sedelaar More articles by this author , Katarzyna MacuraKatarzyna Macura More articles by this author , Daniel CostaDaniel Costa More articles by this author , Thorsten PersigehlThorsten Persigehl More articles by this author , Andrei PuryskoAndrei Purysko More articles by this author , and Laurence KlotzLaurence Klotz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000860.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MRI-guided transurethral ultrasound ablation (TULSA) is a novel minimally-invasive procedure for prostate ablation. We report two-year outcomes from the pivotal TULSA-PRO Ablation Clinical Trial (TACT). METHODS: The study enrolled 115 men with organ-confined prostate cancer (≤T2b, PSA ≤15 ng/ml, Gleason Grade Group 1-2) across 13 centers in USA, Europe, and Canada. Treatment was whole-gland ablation with sparing of the urethra and urinary sphincter. Primary endpoints were safety and PSA reduction at one year. Secondary endpoints included one-year prostate volume reduction, mpMRI, and 10-core biopsy. Two-year outcomes include adverse events, quality of life (IPSS, IIEF, EPIC), and PSA stability. RESULTS: Median (IQR) baseline age was 65 (59-69) years, PSA 6.3 (4.6-7.9) ng/ml, with Grade Group ≥2 (GG2+) disease in 72/115 men (63%). Targeted prostate volumes of 40 (32-50) cc were ablated in 51 (39-66) min, with 98% thermal coverage and ±1.4 mm spatial precision on MRI thermometry. Grade 3 adverse events occurred in 9 (8%) men (all resolved before one year), with no rectal injuries or Grade ≥ 4 events. At one year MRI and biopsy, median prostate volume decreased from 37 to 3 cc, GG2 disease was eliminated in 54/68 (79%) men, and 72/111 (65%) had no evidence of any cancer. Two-year PSA and QoL are currently available for 48/115 patients. Median PSA decreased 95% to a nadir of 0.30 ng/ml, stable from 0.53 ng/ml at one year to 0.68 ng/ml (n=48) at 2 years. Median IPSS was unchanged from 7 to 6 at one year and 5 (n=47) at two years. Moderate urinary incontinence (Grade 2, pads) was reported by 3 patients (2.6%) at one year, with no new incontinence at two years. The rate of moderate erectile dysfunction (Grade 2, responding to PDE5) was 23% at one year, with one new onset at two years. Median change in IIEF-5 recovered from -3 at one year to -1 (n=46) at two years. Erections sufficient for penetration (IIEF Q2 ≥ 2) were maintained by 69/92 (75%) at one year, and for the patient subset with two-year follow-up, by 25/37 (68%) and 23/37 (62%) at one and two years, respectively. Three men whose one-year biopsy indicated incomplete ablation underwent uncomplicated salvage radical prostatectomy. CONCLUSIONS: With two-year follow-up, the TACT pivotal study of MRI-guided transurethral ultrasound ablation (TULSA) in men with localized prostate cancer showed effective disease control in most patients with low toxicity and stable quality of life. Source of Funding: Profound Medical © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e369-e369 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Eggener* More articles by this author Michael Koch More articles by this author David Penson More articles by this author Christian Pavlovich More articles by this author Joseph Chin More articles by this author Yair Lotan More articles by this author Steven Raman More articles by this author Gencay Hatiboglu More articles by this author Aytekin Oto More articles by this author James Relle More articles by this author Jurgen Fütterer More articles by this author Marc Serrallach More articles by this author Axel Heidenreich More articles by this author Masoom Haider More articles by this author David Bonekamp More articles by this author Temel Tirkes More articles by this author Sandeep Arora More articles by this author Allan Pantuck More articles by this author Gregory Zagaja More articles by this author Michiel Sedelaar More articles by this author Katarzyna Macura More articles by this author Daniel Costa More articles by this author Thorsten Persigehl More articles by this author Andrei Purysko More articles by this author Laurence Klotz More articles by this author Expand All Advertisement PDF downloadLoading ...

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• “Robotic fatigue?” – The impact of case order on positive surgical margins in robotic-assisted laparoscopic prostatectomy

  Urologic Oncology Seminars and Original Investigations · 2020 · 4 citations

  • Medicine
  • Urology
  • Surgery
  PublisherDOI

• Pivotal trial of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer: Two-year follow-up

  European Urology Open Science · 2020-07-01

  articleOpen access
  PublisherDOI

• LBA-26 PIVOTAL TRIAL OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION IN MEN WITH LOCALIZED PROSTATE CANCER

  The Journal of Urology · 2019-04-01 · 3 citations

  articleOpen access

  You have accessJournal of UrologySunday Next Frontier (LBA)1 Apr 2019LBA-26 PIVOTAL TRIAL OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION IN MEN WITH LOCALIZED PROSTATE CANCER Scott Eggener*, David Penson, Christian Pavlovich, Joseph Chin, Steven S. Raman, Michael Koch, Jurgen Futterer, James Relle, Gencay Hatiboglu, Aytekin Oto, Yair Lotan, Axel Heidenreich, Marc Serrallach, Allan Pantuck, Sandeep S. Arora, Katarzyna Macura, Temel Tirkes, Daniel Costa, Gregory Zagaja, Thorsten Persigehl, J. P. Michiel Sedelaar, William Li, Robert Staruch, Mathieu Burtnyk, David Bonekamp, Masoom Haider, and Laurence Klotz Scott Eggener*Scott Eggener* More articles by this author , David PensonDavid Penson More articles by this author , Christian PavlovichChristian Pavlovich More articles by this author , Joseph ChinJoseph Chin More articles by this author , Steven S. RamanSteven S. Raman More articles by this author , Michael KochMichael Koch More articles by this author , Jurgen FuttererJurgen Futterer More articles by this author , James RelleJames Relle More articles by this author , Gencay HatibogluGencay Hatiboglu More articles by this author , Aytekin OtoAytekin Oto More articles by this author , Yair LotanYair Lotan More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , Marc SerrallachMarc Serrallach More articles by this author , Allan PantuckAllan Pantuck More articles by this author , Sandeep S. AroraSandeep S. Arora More articles by this author , Katarzyna MacuraKatarzyna Macura More articles by this author , Temel TirkesTemel Tirkes More articles by this author , Daniel CostaDaniel Costa More articles by this author , Gregory ZagajaGregory Zagaja More articles by this author , Thorsten PersigehlThorsten Persigehl More articles by this author , J. P. Michiel SedelaarJ. P. Michiel Sedelaar More articles by this author , William LiWilliam Li More articles by this author , Robert StaruchRobert Staruch More articles by this author , Mathieu BurtnykMathieu Burtnyk More articles by this author , David BonekampDavid Bonekamp More articles by this author , Masoom HaiderMasoom Haider More articles by this author , and Laurence KlotzLaurence Klotz More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557518.07195.d7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: MRI-guided transurethral ultrasound ablation (TULSA) is a novel minimally-invasive procedure for customized prostate ablation. We report one-year outcomes from the TULSA-PRO Ablation Clinical Trial (TACT). METHODS: The study enrolled 115 men with organ-confined prostate cancer (≤T2b, PSA ≤15 ng/ml, Gleason Grade Group 1-2) across 13 centers in USA, Europe, and Canada. Treatment intent was whole-gland ablation with sparing of the urethra and urinary sphincter. The primary safety endpoint was frequency and severity of adverse events (CTCAE). The primary efficacy endpoint was proportion of men achieving a PSA reduction ≥ 75%. Secondary endpoints included one-year 10-core biopsy, prostate volume reduction, and quality of life (IPSS, IIEF-15, EPIC). RESULTS: Median (IQR) age was 65 (59-69) years and PSA 6.3 (4.6-7.9) ng/ml. Pre-treatment, 72 of 115 (63%) men had Grade Group 2 (GG2) and 77 (67%) had NCCN intermediate-risk disease. Median (IQR) treatment delivery time was 51 (39-66) min for targeted prostate volumes of 40 (32-50) cc with 98% (95-99%) thermal coverage of target volume and spatial ablation precision of ±1.4 mm on MRI thermometry. Grade 3 adverse events occurred in 9 (8%) men, including infections (4%), urethral stricture (2%), urinary retention (2%), urethral calculus and pain (1%), and urinoma (1%), all resolved. There were no rectal injuries or Grade ≥ 4 events. The primary endpoint of PSA reduction ≥75% was achieved in 110 of 115 (96%), with median (IQR) PSA reduction of 95% (91-98%) and nadir of 0.34 (0.12-0.56) ng/ml. Median perfused prostate volume decreased from 41 to 4 cc. Among 68 men with pre-treatment intermediate-risk GG2, 52 (79%) were free of GG2 disease on one-year biopsy. Of 111 men with one-year biopsy data, 72 (65%) had no evidence of any cancer. Of 112 men with one-year continence data, 1% were incontinent (>1 pad/day), daily leakage increased 4%, and 8% wore a pad. Median IPSS was unchanged at one year, from 6 to 6 (n=105). At one year, 20% of patients had Grade 2 erectile dysfunction, median (IQR) change in IIEF-5 was -3 (-13 to 0, n=105), and 69 of 92 (75%) maintained erections sufficient for penetration (IIEF Q2 ≥ 2). Multivariate predictors of GG2 at one year included presence of intraprostatic calcifications at screening, MRI thermal coverage of target volume, and PIRADS ≥ 3 lesion at one-year post-treatment MRI (p < 0.05). CONCLUSIONS: The TACT pivotal study of MRI-guided transurethral ultrasound whole-gland ablation (TULSA) in men with localized prostate cancer met its primary endpoint of ≥75% PSA reduction in 96% of patients with low rates of severe toxicity and residual GG2 disease. Source of Funding: Profound Medical Chicago, IL; Nashville, TN; Baltimore, MD; London, Canada; Santa Monica, CA; Indianapolis, IN; Nijmegen, Netherlands; Royal Oak, MI; Heidelberg, Germany; Chicago, IL; Dallas, TX; Cologne, Germany; Barcelona, Spain; Santa Monica, CA; Nashville, TN; Baltimore, MD; Indianapolis, IN; Dallas, TX; Chicago, IL; Cologne, Germany; Nijmegen, Netherlands; Mississauga, Canada; Heidelberg, Germany; Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1004-e1004 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Eggener* More articles by this author David Penson More articles by this author Christian Pavlovich More articles by this author Joseph Chin More articles by this author Steven S. Raman More articles by this author Michael Koch More articles by this author Jurgen Futterer More articles by this author James Relle More articles by this author Gencay Hatiboglu More articles by this author Aytekin Oto More articles by this author Yair Lotan More articles by this author Axel Heidenreich More articles by this author Marc Serrallach More articles by this author Allan Pantuck More articles by this author Sandeep S. Arora More articles by this author Katarzyna Macura More articles by this author Temel Tirkes More articles by this author Daniel Costa More articles by this author Gregory Zagaja More articles by this author Thorsten Persigehl More articles by this author J. P. Michiel Sedelaar More articles by this author William Li More articles by this author Robert Staruch More articles by this author Mathieu Burtnyk More articles by this author David Bonekamp More articles by this author Masoom Haider More articles by this author Laurence Klotz More articles by this author Expand All Advertisement PDF downloadLoading ...

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• Pivotal study of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer: Preliminary results

  European Urology Supplements · 2019-03-01 · 1 citations

  article
  PublisherDOI

• Heart Transplantation in Patients with Active Prostate Cancer; Are We Denying a Life Saving Therapy Due to an Indolent Tumor?

  The Journal of Heart and Lung Transplantation · 2018-03-30

  article
  PublisherDOI

• LBA20 MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) IN PATIENTS WITH LOCALIZED PROSTATE CANCER: PRELIMINARY RESULTS OF TACT PIVOTAL STUDY

  The Journal of Urology · 2018-04-01 · 4 citations

  articleOpen access

  INTRODUCTION AND OBJECTIVES: Indolent forms of PC or low-risk prostate cancer (LRPC) represent 50% of newly diagnosed PC. Definition of LRPC and AS candidates remains problematic due to the lack of relevant markers of PC aggressiveness and difficulties in assessing disease progression under AS. Current knowledge suggests that PC aggressiveness could be assessed by response to early ADT. Long-term administration of a 5-alpha-reductase inhibitor may prevent the development of PC and reverse LRPC. Preliminary results of a pilot series at 2 French urology centers in LRPC pts receiving 2 drugs (analogs and 5-alpha-reductase inhibitor) for 3 months (mo), show tumor regression in about 60% of cases and suggest that LRPC can be reversed by ADT. Our study aims at confirming these results on a larger scale.

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Frequent coauthors

• Arieh L. Shalhav

  128 shared

• Kevin C. Zorn

  76 shared

• Sergey Shikanov

  54 shared

• Marcelo A. Orvieto

  47 shared

• Ofer N. Gofrit

  Hadassah Medical Center

  39 shared

• Gary D. Steinberg

  NYU Langone Health

  31 shared

• Charles B. Brendler

  25 shared

• Mark H. Katz

  Boston Medical Center

  23 shared

Education

• M.D.

  University of Chicago