International Journal of Urology最新文献

英文中文

Can the Briganti 2019 nomogram be modified to predict lymph node metastasis risk in patients with prostate cancer detected with in-bore biopsy? 能否修改布里甘蒂 2019 提名图，以预测通过腔内活检发现的前列腺癌患者的淋巴结转移风险？

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-14 DOI: 10.1111/iju.15553

Serdar Madendere, Mert Kılıç, Bengi Gürses, Metin Vural, Ayşe Armutlu, İbrahim Kulaç, Kayhan Tarım, Barış Esen, İbrahim Can Aykanat, Mert Veznikli, Abdullah Erdem Canda, Derya Balbay, Dilek Ertoy Baydar, Yakup Kordan, Tarık Esen

Objectives

We aimed to modify the Briganti 2019 nomogram and to test whether it is valid for patients who were diagnosed with prostate cancer through in-bore prostate biopsies.

Methods

Data for 204 patients with positive multiparametric prostate MRI and prostate cancer identified either by mpMRI-cognitive/software fusion or in-bore biopsy and who underwent robot-assisted radical prostatectomy and extended pelvic lymph node dissection between 2012 and 2023 were retrospectively analyzed. The Briganti 2019 nomogram was applied to the mpMRI-cognitive/software fusion biopsy group (142 patients) in the original form, and then, two modifications were tested for the targeted component. Original and modified scores were compared. These modifications were adapted for the in-bore biopsy group (62 patients). The final histopathologic stage was regarded as the gold standard.

Results

Nodal metastases were identified in 18/142 (12.6%) of mpMRI-cognitive/software fusion biopsy patients and 8/62 (12.9%) of the in-bore biopsy patients. In the mpMRI-cognitive/software fusion biopsy group, tumor size/core size (%) of targeted biopsy cores and positive core percentage on systematic biopsy were significant parameters for lymph node metastasis based on univariate logistic regression analyses (p < 0.05). With the modifications of these parameters for the in-bore biopsy group, V1 modification of the Briganti 2019 nomogram provided 100% sensitivity and 31.5% specificity (AUC:0.627), while V2 modification provided 75% sensitivity and 46.3% specificity (AUC:0.645).

Conclusions

Briganti 2019 nomogram may be modified by utilizing tumor size/core size (%) for targeted biopsy cores instead of positive core percentage on systematic biopsy or by not taking both parameters into consideration to detect node metastasis risk of patients diagnosed with in-bore biopsies.

目的我们旨在修改 Briganti 2019 提名图，并检验该提名图是否适用于通过前列腺腔内活检确诊为前列腺癌的患者：回顾性分析了204名多参数前列腺MRI阳性患者的数据，这些患者通过mpMRI-认知/软件融合或腔内活检确定了前列腺癌，并在2012年至2023年期间接受了机器人辅助根治性前列腺切除术和盆腔淋巴结扩大清扫术。对 mpMRI-认知/软件融合活检组（142 名患者）应用了原始形式的 Briganti 2019 提名图，然后对目标部分进行了两次修改测试。对原始得分和修改后得分进行了比较。孔内活检组（62 名患者）也采用了这些修改。最终的组织病理学分期被视为金标准：结果：在mpMRI-认知/软件融合活检患者中，有18/142（12.6%）人发现了结节转移；在钻孔活检患者中，有8/62（12.9%）人发现了结节转移。在 mpMRI-认知/软件融合活检组中，根据单变量逻辑回归分析，肿瘤大小/靶向活检核大小（%）和系统活检的阳性核百分比是淋巴结转移的重要参数（p 结论：在 mpMRI-认知/软件融合活检组中，肿瘤大小/靶向活检核大小（%）和系统活检的阳性核百分比是淋巴结转移的重要参数：Briganti 2019提名图可以通过利用靶向活检核心的肿瘤大小/核心大小（%）而非系统活检的阳性核心百分比，或者不考虑这两个参数来检测孔内活检患者的淋巴结转移风险。

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引用次数: 0

Preoperative risk stratification models after radical cystectomy for bladder cancer: A multi-center study 膀胱癌根治性切除术后术前风险分层模型：一项多中心研究。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-14 DOI: 10.1111/iju.15560

Hiroshi Yamane, Shuichi Morizane, Masashi Honda, Kuniyasu Muraoka, Hirofumi Oono, Tadahiro Isoyama, Koji Ono, Takehiro Sejima, Hiroyuki Kadowaki, Atsushi Takenaka

Objective

We investigated preoperative patient factors associated with prognosis in 263 bladder cancer (BC) patients undergoing radical cystectomy (RC). We also developed new risk stratification models for prognosis.

Methods

This retrospective study included patients treated at Tottori University Hospital and affiliated hospitals between January 2010 and December 2019. The relationship between preoperative patient factors and overall recurrence-free and cancer-specific survival (CSS) was analyzed. The modified Glasgow prognosis score (mGPS) was calculated using serum albumin and C-reactive protein (CRP) levels. Statistical analyses included the log-rank test and Cox proportional hazards regression.

Results

Eastern Cooperative Oncology Group performance status (ECOG-PS), mGPS, and clinical tumor stage independently predicted CSS in multivariate analysis. A new risk stratification model included ECOG-PS ≥2, clinical tumor stage ≥3, serum albumin <3.5 g/dL, and serum CRP >0.5 mg/dL. Risk groups were defined as 0 factors (low risk), 1–2 factors (intermediate risk), and 3–4 factors (high risk). High-risk patients showed significantly poorer 3-year cancer-free survival: 86.9% (low risk), 76.7% (intermediate risk), and 50.0% (high risk).

Conclusions

ECOG-PS, clinical tumor stage, and mGPS are predictive of poor cancer-free survival post-RC for BC. Our model offers the potential for prognostic prediction in these patients.

目的我们调查了263名接受根治性膀胱切除术（RC）的膀胱癌（BC）患者术前与预后相关的患者因素。我们还建立了新的预后风险分层模型：这项回顾性研究纳入了 2010 年 1 月至 2019 年 12 月期间在鸟取大学医院及其附属医院接受治疗的患者。分析了患者术前因素与无复发总生存期和癌症特异性生存期（CSS）之间的关系。使用血清白蛋白和C反应蛋白（CRP）水平计算改良格拉斯哥预后评分（mGPS）。统计分析包括对数秩检验和考克斯比例危险度回归：结果：在多变量分析中，东部合作肿瘤学组表现状态（ECOG-PS）、mGPS和临床肿瘤分期可独立预测CSS。新的风险分层模型包括 ECOG-PS ≥2、临床肿瘤分期≥3、血清白蛋白 0.5 mg/dL。风险组定义为 0 个因子（低风险）、1-2 个因子（中度风险）和 3-4 个因子（高度风险）。高危患者的 3 年无癌生存率明显较低：86.9%（低危）、76.7%（中危）和 50.0%（高危）：结论：ECOG-PS、临床肿瘤分期和 mGPS 可预测 BCRC 后较差的无癌生存率。我们的模型为这些患者的预后预测提供了可能。

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引用次数: 0

Considerations on perioperative hemodynamic instability in pheochromocytoma 嗜铬细胞瘤围术期血流动力学不稳定的考虑因素。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-12 DOI: 10.1111/iju.15559

Fumihiko Urabe MD, PhD, Shoji Kimura MD, PhD, Takahiro Kimura MD, PhD

引用次数: 0

Novel clipping procedure for preventing post-operative inguinal hernia in robot-assisted radical prostatectomy 预防机器人辅助前列腺癌根治术术后腹股沟疝的新型剪切术。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-09 DOI: 10.1111/iju.15544

Yuji Hakozaki, Yuta Yamada, Tetsuya Fujimura, Naoki Kimura, Kenichi Sasaki, Kazuki Maki, Kazuma Sugimoto, Taro Izumi, Jun Kaneko, Fumihiko Urabe, Mayuko Tokunaga, Yoichi Fujii, Jun Kamei, Taketo Kawai, Satoru Taguchi, Yoshiyuki Akiyama, Daisuke Yamada, Haruki Kume

Objectives

Inguinal hernia (IH) is a common postoperative complication after robot-assisted radical prostatectomy (RARP). We developed a novel clipping technique for the prevention of IH developing after RARP.

Methods

This cohort included 759 consecutive patients who underwent RARP for prostate cancer at the University of Tokyo Hospital between January 2011 and December 2018. We reviewed clinical parameters and identified the risk factors of postoperative IH. The prophylactic preventive procedure of IH development was performed by clipping the peritoneum and underlying tissue around the internal inguinal ring using Hem-o-Lok clip to prevent the prolapse of the intestine through the internal inguinal ring.

Results

In total, 236 patients received the clipping procedure. The median follow-up time was 50 months. The incidence rate of IH was 10.8% (78/720). The median time to the diagnosis of IH was 10 months. Univariate analysis revealed that patients with higher age (age ≥ 63), low BMI (BMI < 25 kg/m²), and lower number of surgical experiences (Surgical experience < 40) showed a significantly higher odds ratio of developing IH. Multivariate analysis showed that “BMI < 25 kg/m²” and “Surgical experience < 40” were independent predictive factors of IH. Among the patients with a high risk of IH due to receiving surgery from inexperienced surgeons, there was a statistically significant preventive effect for the patients with “BMI ≥ 25 kg/m²” by the novel clipping procedure.

Conclusions

The novel clipping procedure reduced the risk of post-operative IH in obese patients when the RARP was performed by inexperienced surgeons.

目的：腹股沟疝（IH）是机器人辅助前列腺癌根治术（RARP）术后常见的并发症。我们开发了一种新型剪切技术，用于预防 RARP 术后出现 IH：该队列包括 2011 年 1 月至 2018 年 12 月期间在东京大学医院接受前列腺癌根治术的 759 名连续患者。我们回顾了临床参数，并确定了术后 IH 的风险因素。通过使用Hem-o-Lok夹对腹股沟内环周围的腹膜和下层组织进行剪切，以防止肠道通过腹股沟内环脱垂，从而对IH的发生进行预防性治疗：共有236名患者接受了剪切手术。中位随访时间为 50 个月。IH发生率为10.8%（78/720）。确诊IH的中位时间为10个月。单变量分析显示，年龄较大（年龄≥63岁）、体重指数较低（体重指数2）和手术经验较少（手术经验2 "和 "手术经验2"）的患者采用新型剪切术：结论：当由经验不足的外科医生实施 RARP 时，新型剪切术可降低肥胖患者术后 IH 的风险。

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引用次数: 0

Editorial Comment to: “Survival of stage III non-seminoma testis cancer patients versus simulated controls, according to race/ethnicity” 编辑评论："根据种族/人种，III期非精索瘤睾丸癌患者与模拟对照组的生存率"。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-06 DOI: 10.1111/iju.15557

Christoph Würnschimmel MD, Luca Afferi MD, Mike Wenzel MD, BSc

引用次数: 0

Annual record on the number of general urological surgeries registered in the National Clinical Database system between April 2018 and December 2021 in Japan 2018 年 4 月至 2021 年 12 月期间，日本在国家临床数据库系统中登记的普通泌尿外科手术数量的年度记录。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-06 DOI: 10.1111/iju.15551

Takahiro Yasui, Eiji Kikuchi, Hiroyuki Yamamoto, Daisuke Ishii, Ryuichi Mizuno, Shingo Hatakeyama, Takashi Kobayashi, Junji Uchida, Masayuki Takahashi, Shinichi Sakamoto, Shuichi Morizane, Toshiyuki Kamoto, Masatoshi Eto

Background

The Japanese National Clinical Database (NCD) is a large-scale, nationwide, web-based data entry system that covers the majority of surgical cases performed in Japan. An NCD specializing in urological surgery was launched based on the NCD system in 2018.

Methods

All urological surgeries performed at more than 1000 institutions were registered from 2018. We herein report the number of surgeries conducted as stipulated in the “Certified Urology Surgeon Training Curriculum” between April 2018 and December 2021.

Results

A total of 1 377 677 cases were registered from 1185 facilities nationwide under the initiative of the Japanese Urological Association. We examined the number of procedures performed every year for each of the 10 categories.

Conclusions

The NCD system sustainably provides important information relating to the preoperative status, operational outcome, and best practice for urological surgery in Japan.

背景：日本国家临床数据库（NCD）是一个大规模、全国性、基于网络的数据录入系统，涵盖了日本大部分外科手术病例。2018 年，在 NCD 系统的基础上推出了泌尿外科专业 NCD：从 2018 年起，对 1000 多家机构实施的所有泌尿外科手术进行了登记。我们在此报告 2018 年 4 月至 2021 年 12 月期间按照 "认证泌尿外科医师培训课程 "规定实施的手术数量：在日本泌尿外科协会的倡议下，全国 1185 家机构共登记了 1 377 677 例手术。我们对 10 个类别中每个类别每年实施的手术数量进行了研究：NCD系统为日本泌尿外科手术的术前状态、手术结果和最佳实践提供了重要信息。

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引用次数: 0

Location-specific diagnostic efficiency of photodynamic diagnosis-guided biopsy in bladder mapping biopsies 光动力诊断引导下膀胱图谱活检的特定位置诊断效率。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-02 DOI: 10.1111/iju.15552

Yuki Nakamura, Yudai Ishikawa, Masaki Kobayashi, Motohiro Fujiwara, Bo Fan, Shohei Fukuda, Yuma Waseda, Hajime Tanaka, Soichiro Yoshida, Yasuhisa Fujii

Background

Photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumors (TURBT) has emerged as a promising complementary tool to white light (WL) cystoscopy, potentially improving cancer detection and replacing conventional mapping biopsies. This study aimed to investigate the diagnostic accuracy of PDD by anatomical locations in mapping biopsies through lesion-based analysis.

Methods

PDD and WL findings were prospectively recorded in 102 patients undergoing mapping biopsies and PDD-assisted TURBT using oral 5-aminolevulinic acid. We evaluated 673 specimens collected from flat tumor or normal-looking lesions on WL cystoscopy, after excluding 98 specimens collected from papillary or nodular tumors.

Results

Among the 673 lesions, cancer was detected in 110 (16%) by lesion-based analysis. PDD demonstrated significantly higher sensitivity (65.5% vs. 46.4%, p < 0.001) and negative predictive value (92.5% vs. 89.5%, p < 0.001) compared to WL. The sensitivity of PDD findings varied by location: posterior (100%), right (78.6%), dome (73.3%), left (70.6%), trigone (58.8%), bladder neck (41.7%), anterior (40.0%), and prostatic urethra (25.0%). Incorporating targeted biopsies of specific locations (bladder neck, anterior, and prostatic urethra) into the PDD-guided biopsies, regardless of PDD findings, significantly increased the overall sensitivity from 65.5% to 82.7% (p = 0.001).

Conclusions

This study first demonstrated the detection rate of location-specific mapping biopsies using PDD, revealing difficulties in accuracy assessment in areas susceptible to tangential fluorescence. While PDD-guided biopsy improves cancer detection compared to WL cystoscopy even for flat tumors or normal-looking lesions, more careful decisions, including mapping biopsies, may be beneficial for an assessment in these tangential areas.

背景：光动力诊断（PDD）辅助经尿道膀胱肿瘤切除术（TURBT）已成为白光（WL）膀胱镜检查的一种有前途的补充工具，有可能改善癌症检测并取代传统的绘图活检。本研究旨在通过基于病变的分析，研究PDD在映射活检中解剖位置的诊断准确性：方法：前瞻性地记录了102名患者的PDD和WL结果，这些患者接受了图谱活检，并在PDD辅助下使用口服5-氨基乙酰乙酸进行了TURBT。我们评估了 673 份在 WL 膀胱镜下从扁平肿瘤或正常病灶采集的标本，排除了 98 份从乳头状或结节状肿瘤采集的标本：在 673 个病灶中，通过病灶分析检测出 110 个（16%）癌细胞。PDD 的灵敏度明显更高（65.5% 对 46.4%，P 结论：该研究首次证明了使用 PDD 进行特定位置绘图活检的检出率，揭示了在易受切向荧光影响的区域进行准确性评估的困难。与 WL 膀胱镜检查相比，PDD 引导下的活检可提高癌症检出率，即使是扁平肿瘤或外观正常的病变，但更谨慎的决定（包括绘图活检）可能有利于对这些切向区域进行评估。

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引用次数: 0

Is meta-analysis effective in evaluating local treatment benefits for oligometastatic prostate cancer? 荟萃分析是否能有效评估少转移性前列腺癌的局部治疗效果？

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-01 DOI: 10.1111/iju.15555

Fumihiko Urabe MD, PhD, Shoji Kimura MD, PhD, Kojiro Tashiro MD, PhD

引用次数: 0

This issue 31-8 本期 31-8。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-08-01 DOI: 10.1111/iju.15523

Takahiko Mitsui MD, PhD

引用次数: 0

Japanese clinical practice guidelines for prostate cancer 2023 日本 2023 年前列腺癌临床实践指南。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-30 DOI: 10.1111/iju.15545

Yasuo Kohjimoto, Hiroji Uemura, Masahiro Yoshida, Shiro Hinotsu, Satoru Takahashi, Tsutomu Takeuchi, Kazuhiro Suzuki, Hiroshi Shinmoto, Tsutomu Tamada, Takahiro Inoue, Mikio Sugimoto, Atsushi Takenaka, Tomonori Habuchi, Hitoshi Ishikawa, Takashi Mizowaki, Shiro Saito, Hideaki Miyake, Nobuaki Matsubara, Norio Nonomura, Hideki Sakai, Akihiro Ito, Osamu Ukimura, Hideyasu Matsuyama, Isao Hara

This fourth edition of the Japanese Clinical Practice Guidelines for Prostate Cancer 2023 is compiled. It was revised under the leadership of the Japanese Urological Association, with members selected from multiple academic societies and related organizations (Japan Radiological Society, Japanese Society for Radiation Oncology, the Department of EBM and guidelines, Japan Council for Quality Health Care (Minds), Japanese Society of Pathology, and the patient group (NPO Prostate Cancer Patients Association)), in accordance with the Minds Manual for Guideline Development (2020 ver. 3.0). The most important feature of this revision is the adoption of systematic reviews (SRs) in determining recommendations for 14 clinical questions (CQs). Qualitative SRs for these questions were conducted, and the final recommendations were made based on the results through the votes of 24 members of the guideline development group. Five algorithms based on these results were also created. Contents not covered by the SRs, which are considered textbook material, have been described in the general statement. In the general statement, a literature search for 14 areas was conducted; then, based on the general statement and CQs of the Japanese Clinical Practice Guidelines for Prostate Cancer 2016, the findings revealed after the 2016 guidelines were mainly described. This article provides an overview of these guidelines.

日本 2023 年前列腺癌临床实践指南》（Japanese Clinical Practice Guidelines for Prostate Cancer 2023）已编纂完成第四版。该指南是在日本泌尿外科协会的领导下，由多个学术团体和相关组织（日本放射学会、日本放射肿瘤学会、EBM和指南部、日本医疗质量委员会（Minds）、日本病理学会和患者团体（NPO前列腺癌患者协会））根据《指南制定Minds手册》（2020年3.0版）选出的成员共同修订的。本次修订的最大特点是采用系统回顾（SR）来确定 14 个临床问题（CQ）的建议。对这些问题进行了定性 SR，并根据结果通过指南制定小组 24 名成员的投票提出了最终建议。此外，还根据这些结果创建了五种算法。一般性声明中描述了性报告未涵盖的内容，这些内容被视为教科书材料。在一般性声明中，对 14 个领域进行了文献检索；然后，根据一般性声明和《2016 年日本前列腺癌临床实践指南》的 CQ，主要介绍了 2016 年指南之后的研究结果。本文对这些指南进行了概述。

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