Quantifying treatment burden: the patient burden score a study of 758 patients across three clinical urologic scenarios.

IF 2.8 2区医学 Q2 UROLOGY & NEPHROLOGY World Journal of Urology Pub Date : 2024-11-27 DOI:10.1007/s00345-024-05378-3

Ofer N Gofrit, S Nahum Goldberg, Amitay Lorber, Mordechai Duvdevani, Marc Wygoda, Guy Hidas, Vladimir Yutkin, Liat Appelbaum Pikarsky

{"title":"Quantifying treatment burden: the patient burden score a study of 758 patients across three clinical urologic scenarios.","authors":"Ofer N Gofrit, S Nahum Goldberg, Amitay Lorber, Mordechai Duvdevani, Marc Wygoda, Guy Hidas, Vladimir Yutkin, Liat Appelbaum Pikarsky","doi":"10.1007/s00345-024-05378-3","DOIUrl":null,"url":null,"abstract":"Objectives: To develop a comprehensive scale that measures the three burden types of any treatment, including expected, unexpected (complications), and need for ancillary procedures.Methods: A panel of experts created a scale that assessed the burden of all aspects of treatment, including hospitalization, anesthesia, surgery, and follow-up. The total score is defined as the burden score (BS). BS was calculated retrospectively for patients in three clinical scenarios in urology, each with two acceptable treatment options: patients with a small renal mass (T1a) treated with either partial nephrectomy (PN, 139 patients) or percutaneous ablation (PA, 83 patients), patients with bladder cancer (stages T2-4a, N0, M0) treated with radical cystectomy (RC, 162 patients) or trimodal therapy (TMT, 88 patients), and patients with upper ureteral stones ≤ 10 mm treated with either ureteroscopy (137 patients) or extracorporeal shock-wave lithotripsy (SWL, 150 patients).Results: Both PN and PA provided excellent oncological results (5-year recurrence-free survival ≥ 97%) and low complication rates. However, the BS of PN was more than twice that of PA (27.3 ± 7.7 vs. 12.5 ± 6.4, p < 0.01). RC and TMT showed identical 3-year disease-specific survival rates (73%), but the BS of TMT was significantly lower (53.8 ± 11.1 vs. 42.0 ± 11.6, p < 0.01). Both ureteroscopy and SWL have achieved high stone-free rates (≥ 97%) and low complication rates. However, the BS of ureteroscopy was significantly lower (7.8 ± 3 vs. 9.0 ± 3.5, p < 0.01).Conclusion: PA treatment for small renal masses, TMT for muscle-invasive bladder cancer, and ureteroscopy for upper ureteral stones provided similar success rates to those of PN, RC, and SWL, but with significantly lower BS. This tool can assist in patient consultation when multiple treatment options are available. The concept of BS can be extended to other fields of medicine.","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"650"},"PeriodicalIF":2.8000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00345-024-05378-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: To develop a comprehensive scale that measures the three burden types of any treatment, including expected, unexpected (complications), and need for ancillary procedures.

Methods: A panel of experts created a scale that assessed the burden of all aspects of treatment, including hospitalization, anesthesia, surgery, and follow-up. The total score is defined as the burden score (BS). BS was calculated retrospectively for patients in three clinical scenarios in urology, each with two acceptable treatment options: patients with a small renal mass (T1a) treated with either partial nephrectomy (PN, 139 patients) or percutaneous ablation (PA, 83 patients), patients with bladder cancer (stages T2-4a, N0, M0) treated with radical cystectomy (RC, 162 patients) or trimodal therapy (TMT, 88 patients), and patients with upper ureteral stones ≤ 10 mm treated with either ureteroscopy (137 patients) or extracorporeal shock-wave lithotripsy (SWL, 150 patients).

Results: Both PN and PA provided excellent oncological results (5-year recurrence-free survival ≥ 97%) and low complication rates. However, the BS of PN was more than twice that of PA (27.3 ± 7.7 vs. 12.5 ± 6.4, p < 0.01). RC and TMT showed identical 3-year disease-specific survival rates (73%), but the BS of TMT was significantly lower (53.8 ± 11.1 vs. 42.0 ± 11.6, p < 0.01). Both ureteroscopy and SWL have achieved high stone-free rates (≥ 97%) and low complication rates. However, the BS of ureteroscopy was significantly lower (7.8 ± 3 vs. 9.0 ± 3.5, p < 0.01).

Conclusion: PA treatment for small renal masses, TMT for muscle-invasive bladder cancer, and ureteroscopy for upper ureteral stones provided similar success rates to those of PN, RC, and SWL, but with significantly lower BS. This tool can assist in patient consultation when multiple treatment options are available. The concept of BS can be extended to other fields of medicine.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

量化治疗负担：对三种临床泌尿外科情况下 758 名患者进行的患者负担评分研究。

目的制定一个综合量表，衡量任何治疗的三种负担类型，包括预期负担、意外负担（并发症）和对辅助程序的需求：方法：一个专家小组制定了一个量表，用于评估住院、麻醉、手术和随访等所有治疗环节的负担。总分被定义为负担评分（BS）。BS 是对泌尿外科三种临床情况下的患者进行回顾性计算得出的，每种情况下有两种可接受的治疗方案：肾小肿块（T1a）患者，采用肾部分切除术（PN，139 例）或经皮消融术（PA，83 例）；膀胱癌患者（T2-4a 期，N0，M0），采用根治性膀胱切除术（RC，162 例）或三联疗法、162例）或三联疗法（TMT，88例）治疗的膀胱癌（T2-4a期，N0，M0）患者，以及输尿管镜检查（137例）或体外冲击波碎石（SWL，150例）治疗的输尿管上段结石≤10毫米的患者。结果：PN和PA都能提供极佳的肿瘤治疗效果（5年无复发生存率≥97%）和较低的并发症发生率。然而，PN 的 BS 是 PA 的两倍多（27.3 ± 7.7 vs. 12.5 ± 6.4，P 结论：PN 和 PA 治疗小肾脏肿块的疗效都很好：PA治疗肾脏小肿块、TMT治疗肌层浸润性膀胱癌、输尿管镜检查输尿管上段结石的成功率与PN、RC和SWL相似，但BS明显较低。当有多种治疗方案可供选择时，该工具可帮助患者进行咨询。BS的概念可扩展到其他医学领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

World Journal of Urology 医学-泌尿学与肾脏学

CiteScore

6.80

自引率

8.80%

发文量

317

审稿时长

4-8 weeks

期刊介绍： The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.