To identify risk factors for the long-term persistent genitourinary toxicity (GUT) after stereotactic body radiation therapy (SBRT) for localized prostate cancer (PCa).
Methods
A total of 306 patients who underwent SBRT at our institution between March 2017 and April 2022 were retrospectively evaluated. SBRT was performed at 35 Gy in five fractions over 5 or 10 days. Factors related to the long-term persistence of acute GUT after SBRT were analyzed.
Results
During the median follow-up period of 39.1 months, 203 (66%) patients experienced any grade of acute GUT, which remained in 78 (26%) patients 6 months after SBRT. Multivariate analysis revealed that age ≥75 years was consistently a significant independent risk factor for any grade of acute GUT 6, 12, and 24 months after SBRT (hazard ratio [HR] 2.31, p = 0.010; HR 2.84, p = 0001; and HR 3.05, p = 0.009, respectively). Older age was not a significant risk factor for the development of grade ≥2 acute GUT. The duration of acute GUT was significantly longer in the older group than in the nonolder group (median duration = 234 vs. 61 days, p < 0.001), and the incidence of persistent GUT was significantly more frequent in the older group beyond 6 months after SBRT.
Conclusions
Older age is a significant independent risk factor for the long-term persistent GUT after SBRT for localized PCa.
{"title":"Risk factors for the long-term persistent genitourinary toxicity after stereotactic body radiation therapy for localized prostate cancer: A single-center, retrospective study of 306 patients","authors":"Kenji Tanabe, Shuichiro Kobayashi, Takashi Tamiya, Tsuzumi Konishi, Ryoichi Hinoto, Nobuhiro Tsukamoto, Shiho Kashiyama, Takahisa Eriguchi, Akira Noro","doi":"10.1111/iju.15507","DOIUrl":"10.1111/iju.15507","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify risk factors for the long-term persistent genitourinary toxicity (GUT) after stereotactic body radiation therapy (SBRT) for localized prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 306 patients who underwent SBRT at our institution between March 2017 and April 2022 were retrospectively evaluated. SBRT was performed at 35 Gy in five fractions over 5 or 10 days. Factors related to the long-term persistence of acute GUT after SBRT were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the median follow-up period of 39.1 months, 203 (66%) patients experienced any grade of acute GUT, which remained in 78 (26%) patients 6 months after SBRT. Multivariate analysis revealed that age ≥75 years was consistently a significant independent risk factor for any grade of acute GUT 6, 12, and 24 months after SBRT (hazard ratio [HR] 2.31, <i>p</i> = 0.010; HR 2.84, <i>p</i> = 0001; and HR 3.05, <i>p</i> = 0.009, respectively). Older age was not a significant risk factor for the development of grade ≥2 acute GUT. The duration of acute GUT was significantly longer in the older group than in the nonolder group (median duration = 234 vs. 61 days, <i>p</i> < 0.001), and the incidence of persistent GUT was significantly more frequent in the older group beyond 6 months after SBRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older age is a significant independent risk factor for the long-term persistent GUT after SBRT for localized PCa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate and compare the voting results of Japanese urologists with the global panel at the Advanced Prostate Cancer Consensus Conference (APCCC) 2022.
Methods
Among the 198 questions discussed at the APCCC 2022, the APCCC-JAPAN 2023 focused on 14 key questions related to the management of advanced prostate cancer with insufficient high-level evidence based on their relevance to the Japanese cohort. A panel of six prostate cancer experts addressed these 14 questions and presented the latest evidence to Japanese urologists who voted on-site using a web-based system. The results were compared with those of APCCC 2022.
Results
This study found significant differences in the voting results between Japanese urologists and the global panel regarding several crucial issues related to advanced prostate cancer management. These differences were those observed in treatment preferences, monitoring strategies, and treatment choices in specific clinical scenarios. These findings highlight the need for a nuanced approach tailored to the unique challenges with considerations of the Japanese healthcare environment.
Conclusions
APCCC-JAPAN 2023 provides valuable insights into the current clinical issues surrounding the management of advanced prostate cancer in Japan. The partial divergence in the consensus between Japanese urologists and the global panel underscores the importance of a context-specific approach. The results of this study provide practical guidance for physicians facing complex challenges and should be used to inform decision-making in the management of advanced prostate cancer.
{"title":"Current issues and management consensus of advanced prostate cancer: Report of the Advanced Prostate Cancer Consensus Conference—JAPAN 2023","authors":"Kohei Hashimoto, Takeo Kosaka, Naoki Terada, Takahiro Kimura, Norio Nonomura, Hiroyoshi Suzuki, Hiroji Uemura","doi":"10.1111/iju.15499","DOIUrl":"10.1111/iju.15499","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate and compare the voting results of Japanese urologists with the global panel at the Advanced Prostate Cancer Consensus Conference (APCCC) 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among the 198 questions discussed at the APCCC 2022, the APCCC-JAPAN 2023 focused on 14 key questions related to the management of advanced prostate cancer with insufficient high-level evidence based on their relevance to the Japanese cohort. A panel of six prostate cancer experts addressed these 14 questions and presented the latest evidence to Japanese urologists who voted on-site using a web-based system. The results were compared with those of APCCC 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study found significant differences in the voting results between Japanese urologists and the global panel regarding several crucial issues related to advanced prostate cancer management. These differences were those observed in treatment preferences, monitoring strategies, and treatment choices in specific clinical scenarios. These findings highlight the need for a nuanced approach tailored to the unique challenges with considerations of the Japanese healthcare environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>APCCC-JAPAN 2023 provides valuable insights into the current clinical issues surrounding the management of advanced prostate cancer in Japan. The partial divergence in the consensus between Japanese urologists and the global panel underscores the importance of a context-specific approach. The results of this study provide practical guidance for physicians facing complex challenges and should be used to inform decision-making in the management of advanced prostate cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine the effects of prophylactic urethrectomy (PU) on oncological and perioperative outcomes in patients with bladder cancer (BC) undergoing radical cystectomy (RC).
Methods
This retrospective study analyzed data on 1976 evaluable patients with BC who underwent RC. Patients were drawn from 36 institutions within the Japanese Urological Oncology Group. Oncological outcomes were compared using restricted mean survival times (RMSTs) based on inverse probability of treatment weighting (IPTW)-adjusted Kaplan–Meier curves for non-urinary tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Interaction terms within IPTW-adjusted Cox regression models were examined to assess the heterogeneity of treatment effect based on the risk of urethral recurrence (UR). The association between PU, estimated blood loss (EBL), and the incidence of severe postoperative surgical complications (SPSCs) (Clavien-Dindo grade 3 or higher) was analyzed.
Results
Of 1976 patients, 1448 (73.3%) received PU. IPTW adjustment was used to balance baseline characteristics between the treatment groups. Within the 107-month window of patient monitoring, PU showed no survival benefits (NUTRFS difference: 0.2 months [95% confidence interval: −6.8 to 7.3]; CSS, 1.2 [−4.9 to 7.3]; OS, 0 [−6.5 to 6.5]). No significant interactions were observed with factors associated with UR, and PU was associated with unfavorable perioperative outcomes (EBL, 1179 mL vs. 983 mL; SPSC, 14.6% vs. 7.0%).
Conclusions
This study showed that (1) PU was not associated with survival in patients with BC undergoing RC, regardless of UR-associated factors, and (2) PU was associated with unfavorable perioperative outcomes.
目的确定预防性尿道切除术（PU）对接受根治性膀胱切除术（RC）的膀胱癌（BC）患者的肿瘤学和围手术期结果的影响：这项回顾性研究分析了 1976 名接受根治性膀胱切除术的可评估 BC 患者的数据。患者来自日本泌尿肿瘤学组的 36 家机构。根据反治疗概率加权（IPTW）调整后的卡普兰-梅耶曲线，采用限制性平均生存时间（RMST）比较了非泌尿道无复发生存期（NUTRFS）、癌症特异性生存期（CSS）和总生存期（OS）的肿瘤学结果。对IPTW调整后的Cox回归模型中的交互项进行了检验，以评估基于尿道复发（UR）风险的治疗效果的异质性。分析了PU、估计失血量（EBL）和术后严重手术并发症（SPSC）（Clavien-Dindo 3级或以上）发生率之间的关联：在1976例患者中，1448例（73.3%）接受了PU治疗。IPTW调整用于平衡治疗组之间的基线特征。在对患者进行为期 107 个月的监测期间，PU 未显示出任何生存益处（NUTRFS 差异为 0.2 个月 [95% 置信度]）：0.2个月[95%置信区间：-6.8至7.3]；CSS，1.2[-4.9至7.3]；OS，0[-6.5至6.5]）。未观察到与 UR 相关的因素之间存在明显的相互作用，PU 与不利的围手术期结果相关（EBL，1179 mL vs. 983 mL；SPSC，14.6% vs. 7.0%）：本研究表明：(1) 无论UR相关因素如何，PU与接受RC手术的BC患者的生存率无关；(2) PU与不利的围手术期结果有关。
{"title":"Oncological outcomes of prophylactic urethrectomy at the time of radical cystectomy for bladder cancer: A nationwide multi-institutional study","authors":"Jun Miki MD, PhD, Wataru Fukuokaya MD, Rikiya Taoka MD, PhD, Ryoichi Saito MD, PhD, Yoshiyuki Matsui MD, PhD, Shingo Hatakeyama MD, PhD, Takashi Kawahara MD, PhD, Ayumu Matsuda MD, Taketo Kawai MD, PhD, Minoru Kato MD, PhD, Tomokazu Sazuka MD, PhD, Takeshi Sano MD, PhD, Fumihiko Urabe MD, PhD, Soki Kashima MD, PhD, Hirohito Naito MD, Yoji Murakami MD, PhD, Naotaka Nishiyama MD, PhD, Hiroyuki Nishiyama MD, PhD, Hiroshi Kitamura MD, PhD, Takahiro Kimura MD, PhD, the Japan Urological Oncology Group","doi":"10.1111/iju.15505","DOIUrl":"10.1111/iju.15505","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the effects of prophylactic urethrectomy (PU) on oncological and perioperative outcomes in patients with bladder cancer (BC) undergoing radical cystectomy (RC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed data on 1976 evaluable patients with BC who underwent RC. Patients were drawn from 36 institutions within the Japanese Urological Oncology Group. Oncological outcomes were compared using restricted mean survival times (RMSTs) based on inverse probability of treatment weighting (IPTW)-adjusted Kaplan–Meier curves for non-urinary tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Interaction terms within IPTW-adjusted Cox regression models were examined to assess the heterogeneity of treatment effect based on the risk of urethral recurrence (UR). The association between PU, estimated blood loss (EBL), and the incidence of severe postoperative surgical complications (SPSCs) (Clavien-Dindo grade 3 or higher) was analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1976 patients, 1448 (73.3%) received PU. IPTW adjustment was used to balance baseline characteristics between the treatment groups. Within the 107-month window of patient monitoring, PU showed no survival benefits (NUTRFS difference: 0.2 months [95% confidence interval: −6.8 to 7.3]; CSS, 1.2 [−4.9 to 7.3]; OS, 0 [−6.5 to 6.5]). No significant interactions were observed with factors associated with UR, and PU was associated with unfavorable perioperative outcomes (EBL, 1179 mL vs. 983 mL; SPSC, 14.6% vs. 7.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study showed that (1) PU was not associated with survival in patients with BC undergoing RC, regardless of UR-associated factors, and (2) PU was associated with unfavorable perioperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the efficacy and safety of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) with gemcitabine-based regimens for neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) patients treated in Japan.
Methods
Data for MIBC patients who received NAC-dd-MVAC followed by a radical cystectomy from June 2019 to May 2023 performed at our hospital were analyzed. For comparisons, data for MIBC patients who received NAC gemcitabine and cisplatin (GC) or gemcitabine and carboplatin (GCarbo) therapy between January 2010 and March 2019 were also obtained. Rates of ypT1N0 or less, progression-free survival (PFS), overall survival (OS), and NAC adverse effects were compared between the GC/GCarbo and dd-MVAC regimens.
Results
Results for 32 patients who received dd-MVAC and 30 who received GC/GCarbo NAC therapy were analyzed. ypT1N0 or less was noted in 40.7% of the dd-MVAC and 40.0% of the GC/GCarbo groups, while ypT0N0 rates were 25% and 10%, respectively, with no statistical differences noted. However, Kaplan–Meier analysis of the total cohort demonstrated that dd-MVAC was associated with significantly better PFS and OS rates than GG/GCarbo (hazard ratios: 0.33, p = 0.0237, and 0.23, p = 0.0127, respectively). Propensity-matched models also showed similar results for both PFS and OS. Adverse effects of dd-MVAC were acceptable and the incidence of hematologic toxicity was lower as compared with GC/GCarbo therapy.
Conclusion
The present study is the first to show that dd-MVAC as NAC can provide better survival as compared with a gemcitabine-based regimen for patients with MIBC treated in Japan.
{"title":"Effectiveness of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin as compared to gemcitabine-based regimens as neoadjuvant chemotherapy for oncologic outcomes in muscle-invasive bladder cancer cases—Single-center study in Japan","authors":"Yozo Mitsui, Mizuho Okawa, Shunsuke Hori, Masato Uetani, Mizuki Kasahara, Fumito Yamabe, Hideyuki Kobayashi, Koichi Nagao, Koichi Nakajima","doi":"10.1111/iju.15509","DOIUrl":"10.1111/iju.15509","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the efficacy and safety of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) with gemcitabine-based regimens for neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) patients treated in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data for MIBC patients who received NAC-dd-MVAC followed by a radical cystectomy from June 2019 to May 2023 performed at our hospital were analyzed. For comparisons, data for MIBC patients who received NAC gemcitabine and cisplatin (GC) or gemcitabine and carboplatin (GCarbo) therapy between January 2010 and March 2019 were also obtained. Rates of ypT1N0 or less, progression-free survival (PFS), overall survival (OS), and NAC adverse effects were compared between the GC/GCarbo and dd-MVAC regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results for 32 patients who received dd-MVAC and 30 who received GC/GCarbo NAC therapy were analyzed. ypT1N0 or less was noted in 40.7% of the dd-MVAC and 40.0% of the GC/GCarbo groups, while ypT0N0 rates were 25% and 10%, respectively, with no statistical differences noted. However, Kaplan–Meier analysis of the total cohort demonstrated that dd-MVAC was associated with significantly better PFS and OS rates than GG/GCarbo (hazard ratios: 0.33, <i>p</i> = 0.0237, and 0.23, <i>p</i> = 0.0127, respectively). Propensity-matched models also showed similar results for both PFS and OS. Adverse effects of dd-MVAC were acceptable and the incidence of hematologic toxicity was lower as compared with GC/GCarbo therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study is the first to show that dd-MVAC as NAC can provide better survival as compared with a gemcitabine-based regimen for patients with MIBC treated in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Kay MD, Tracy L. Rose MD, Matthew I. Milowsky MD, Angela B. Smith MD, Marc A. Bjurlin DO, MSc
{"title":"Can genitourinary cancer survivors understand quality of life (QoL) questionnaires? Assessing the readability of commonly used urologic oncology QoL instruments","authors":"Hannah Kay MD, Tracy L. Rose MD, Matthew I. Milowsky MD, Angela B. Smith MD, Marc A. Bjurlin DO, MSc","doi":"10.1111/iju.15501","DOIUrl":"10.1111/iju.15501","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yunus Çolakoğlu, Mithat Ekşi, Deniz Noyan Özlü, Abdülmüttalip Şimşek, Volkan Tuğcu, Ali İhsan Taşçı
Objective
We aimed to compare the functional and oncological outcomes of patients who underwent open perineal radical prostatectomy (OPP) and robotic perineal radical prostatectomy (RPP) for prostate cancer (PCa).
Methods
The data of patients who underwent OPP and RPP from June 2016 to February 2019 due to localized PCa were analyzed. Demographic characteristics, perioperative data and oncological results of the patients were recorded. In addition, the incontinence status of the patients immediately after catheter removal and at the 3rd, 6th, and 12th months were compared. Potency status was evaluated among the patients with preoperative potency, and 12th month potency status was compared.
Results
A total of 135 patients were included, of whom 58 (43%) were in the OPP group and 77 (57%) were in the RPP group. The operation time was statistically significantly shorter in the OPP group (83.90 ± 15.48 vs. 110.88 ± 28.10 min, p = 0.001). The amount of bleeding was significantly lower in the RPP group (59.51 ± 22.04 vs. 74.06 ± 17.66, p = 0.002). The continence rates evaluated at the early period, 3rd, 6th, and 12th months were 40.3%, 80.5%, 87.0%, and 90.9%, respectively, for the RPP group and 36.2%, 70.7%, 86.2%, and 89.7%, for the OPP group, indicating no statistically significant difference (p > 0.05). There was no statistically significant difference in the 12th month rates of postoperative potency according to the surgical technique (p > 0.05).
Conclusion
Although differences were observed between the OPP and RPP techniques in terms of perioperative parameters, oncological and functional results were similar.
{"title":"Comparison of oncological and functional results of robotic and open perineal radical prostatectomy","authors":"Yunus Çolakoğlu, Mithat Ekşi, Deniz Noyan Özlü, Abdülmüttalip Şimşek, Volkan Tuğcu, Ali İhsan Taşçı","doi":"10.1111/iju.15500","DOIUrl":"10.1111/iju.15500","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to compare the functional and oncological outcomes of patients who underwent open perineal radical prostatectomy (OPP) and robotic perineal radical prostatectomy (RPP) for prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients who underwent OPP and RPP from June 2016 to February 2019 due to localized PCa were analyzed. Demographic characteristics, perioperative data and oncological results of the patients were recorded. In addition, the incontinence status of the patients immediately after catheter removal and at the 3rd, 6th, and 12th months were compared. Potency status was evaluated among the patients with preoperative potency, and 12th month potency status was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 135 patients were included, of whom 58 (43%) were in the OPP group and 77 (57%) were in the RPP group. The operation time was statistically significantly shorter in the OPP group (83.90 ± 15.48 vs. 110.88 ± 28.10 min, <i>p</i> = 0.001). The amount of bleeding was significantly lower in the RPP group (59.51 ± 22.04 vs. 74.06 ± 17.66, <i>p</i> = 0.002). The continence rates evaluated at the early period, 3rd, 6th, and 12th months were 40.3%, 80.5%, 87.0%, and 90.9%, respectively, for the RPP group and 36.2%, 70.7%, 86.2%, and 89.7%, for the OPP group, indicating no statistically significant difference (<i>p</i> > 0.05). There was no statistically significant difference in the 12th month rates of postoperative potency according to the surgical technique (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although differences were observed between the OPP and RPP techniques in terms of perioperative parameters, oncological and functional results were similar.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madhu S. Agrawal MS (Surgery), MCh (Urology), FAMS (Urology), FRCS (Glasgow)
{"title":"Editorial Comments on Perioperative complications and postoperative ureteral stricture after ureteroscopy with laser lithotripsy for upper urinary tract stones in Japan","authors":"Madhu S. Agrawal MS (Surgery), MCh (Urology), FAMS (Urology), FRCS (Glasgow)","doi":"10.1111/iju.15503","DOIUrl":"10.1111/iju.15503","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li-Jen Cheng, Janet Kim, Apurba Mukherjee, Neil Milloy, Mia Unsworth, Daniel Ng
Objectives
To evaluate demographic and clinical characteristics, treatment patterns, and quality of life in patients with locally advanced or metastatic urothelial carcinoma in Asia.
Methods
Data were drawn from the Adelphi Real World Metastatic Urothelial Carcinoma Disease Specific Programme™, a cross-sectional survey of medical oncologists/urologists and their adult patients in Saudi Arabia, South Korea, Taiwan, and Turkey. Exploratory patient-reported outcomes included the EQ-5D visual analog scale, European Organisation for Research and Treatment of Cancer Quality of Life of Patient Questionnaire global health, and Brief Pain Inventory. Analyses were descriptive.
Results
Overall, 175 physicians reported data for 988 patients. Mean (standard deviation) patient age was 66.3 (10.8) years, 77% were men, and 82% had bladder tumors at diagnosis. Of patients receiving first- (n = 988), second- (n = 290), and third-line (n = 87) treatments, 81%, 35%, and 59% received chemotherapy, respectively, and 17%, 63%, and 34% received programmed cell death protein 1/ligand 1 inhibitors, respectively. Patient-reported (n = 319) mean (standard deviation) EQ-5D visual analog scale score was 51.8 (15.6), European Organisation for Research and Treatment of Cancer Quality of Life of Patient Questionnaire global health status score was 44.6 (19.9), and Brief Pain Inventory score was 6.5 (1.9; n = 315).
Conclusion
The most common first- and second-line treatments for locally advanced or metastatic urothelial carcinoma were chemotherapy and programmed cell death protein 1/ligand inhibitors, respectively. At third line, 10% of patients received best supportive care alone, underscoring an unmet need for effective third-line treatment options. Patients in all regions reported quality-of-life impairment.
{"title":"Real-world treatment patterns and quality of life among patients with locally advanced or metastatic urothelial carcinoma living in Saudi Arabia, South Korea, Taiwan, and Turkey","authors":"Li-Jen Cheng, Janet Kim, Apurba Mukherjee, Neil Milloy, Mia Unsworth, Daniel Ng","doi":"10.1111/iju.15497","DOIUrl":"10.1111/iju.15497","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate demographic and clinical characteristics, treatment patterns, and quality of life in patients with locally advanced or metastatic urothelial carcinoma in Asia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were drawn from the Adelphi Real World Metastatic Urothelial Carcinoma Disease Specific Programme™, a cross-sectional survey of medical oncologists/urologists and their adult patients in Saudi Arabia, South Korea, Taiwan, and Turkey. Exploratory patient-reported outcomes included the EQ-5D visual analog scale, European Organisation for Research and Treatment of Cancer Quality of Life of Patient Questionnaire global health, and Brief Pain Inventory. Analyses were descriptive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 175 physicians reported data for 988 patients. Mean (standard deviation) patient age was 66.3 (10.8) years, 77% were men, and 82% had bladder tumors at diagnosis. Of patients receiving first- (<i>n</i> = 988), second- (<i>n</i> = 290), and third-line (<i>n</i> = 87) treatments, 81%, 35%, and 59% received chemotherapy, respectively, and 17%, 63%, and 34% received programmed cell death protein 1/ligand 1 inhibitors, respectively. Patient-reported (<i>n</i> = 319) mean (standard deviation) EQ-5D visual analog scale score was 51.8 (15.6), European Organisation for Research and Treatment of Cancer Quality of Life of Patient Questionnaire global health status score was 44.6 (19.9), and Brief Pain Inventory score was 6.5 (1.9; <i>n</i> = 315).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The most common first- and second-line treatments for locally advanced or metastatic urothelial carcinoma were chemotherapy and programmed cell death protein 1/ligand inhibitors, respectively. At third line, 10% of patients received best supportive care alone, underscoring an unmet need for effective third-line treatment options. Patients in all regions reported quality-of-life impairment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.15497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to compare the prognostic outcomes between metastatic castration-sensitive prostate cancer (mCSPC) patients receiving conventional androgen deprivation therapy (ADT) and those receiving ADT plus a novel androgen-receptor signaling inhibitor (ARSI) in routine clinical practice in Japan.
Methods
This was conducted as a retrospective multicenter study including 581 mCSPC patients, consisting of 305 receiving ADT alone or in combination with bicalutamide (group 1) and 276 receiving ADT plus one of the following ARSIs: abiraterone acetate, apalutamide, or enzalutamide (group 2). Prognostic outcomes between these 2 groups were comprehensively compared.
Results
In the entire cohort, prostate-specific antigen—progression-free survival (PSA-PFS) in group 2 was significantly longer than that in group 1, while no significant difference was noted in overall survival (OS) between the two groups. In patients corresponding to the LATITUDE high-risk group, however, both PSA-PFS and OS in group 2 were significantly longer than those in group 1. Of several factors examined, the following were identified as independent predictors of poor PSA-PFS in the entire cohort as well as the LATITUDE high-risk group: high C-reactive protein, high lactate dehydrogenase, high alkaline phosphatase, high Gleason score, and group 1. Furthermore, it was possible to precisely classify both the entire cohort and LATITUDE high-risk group into 3 risk groups regarding PSA-PFS according to the positive numbers of independent factors: positive for ≤1 factor, favorable; 2 factors, intermediate; and ≥3 factors, poor.
Conclusion
Combined use of ARSIs with ADT could improve the prognostic outcomes of mCSPC patients, particularly those in the LATITUDE high-risk group, in real-world clinical practice in Japan.
研究目的本研究旨在比较日本常规临床实践中接受传统雄激素剥夺疗法（ADT）和接受ADT加新型雄激素受体信号转导抑制剂（ARSI）的转移性阉割敏感性前列腺癌（mCSPC）患者的预后结果：该研究是一项回顾性多中心研究，包括581名mCSPC患者，其中305人接受ADT单独治疗或与比卡鲁胺联合治疗（第1组），276人接受ADT联合以下一种ARSI：醋酸阿比特龙、阿帕鲁胺或恩扎鲁胺（第2组）。对这两组的预后结果进行了综合比较：在整个队列中，第2组的前列腺特异性抗原-无进展生存期（PSA-PFS）明显长于第1组，而两组的总生存期（OS）无明显差异。但在 LATITUDE 高危组中，第 2 组的 PSA-PFS 和 OS 均明显长于第 1 组。 在所研究的几个因素中，以下因素被认为是整个队列和 LATITUDE 高危组中 PSA-PFS 较差的独立预测因素：高 C 反应蛋白、高乳酸脱氢酶、高碱性磷酸酶、高 Gleason 评分和第 1 组。此外，根据独立因素的阳性数量，可以将整个队列和LATITUDE高风险组精确划分为3个PSA-PFS风险组：≤1个因素阳性，为良好组；2个因素阳性，为中等组；≥3个因素阳性，为不良组：结论：在日本的实际临床实践中，ARSIs与ADT联合使用可改善mCSPC患者的预后，尤其是LATITUDE高危组中的患者。
{"title":"Prognostic outcomes in Japanese patients with metastatic castration-sensitive prostate cancer: Comparative assessments between conventional androgen deprivation therapy (ADT) and ADT with novel androgen receptor signal inhibitor","authors":"Hiromitsu Watanabe, Keita Nakane, Kiyoshi Takahara, Taku Naiki, Takahiro Yasui, Ryoichi Shiroki, Takuya Koie, Hideaki Miyake","doi":"10.1111/iju.15498","DOIUrl":"10.1111/iju.15498","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to compare the prognostic outcomes between metastatic castration-sensitive prostate cancer (mCSPC) patients receiving conventional androgen deprivation therapy (ADT) and those receiving ADT plus a novel androgen-receptor signaling inhibitor (ARSI) in routine clinical practice in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was conducted as a retrospective multicenter study including 581 mCSPC patients, consisting of 305 receiving ADT alone or in combination with bicalutamide (group 1) and 276 receiving ADT plus one of the following ARSIs: abiraterone acetate, apalutamide, or enzalutamide (group 2). Prognostic outcomes between these 2 groups were comprehensively compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the entire cohort, prostate-specific antigen—progression-free survival (PSA-PFS) in group 2 was significantly longer than that in group 1, while no significant difference was noted in overall survival (OS) between the two groups. In patients corresponding to the LATITUDE high-risk group, however, both PSA-PFS and OS in group 2 were significantly longer than those in group 1. Of several factors examined, the following were identified as independent predictors of poor PSA-PFS in the entire cohort as well as the LATITUDE high-risk group: high C-reactive protein, high lactate dehydrogenase, high alkaline phosphatase, high Gleason score, and group 1. Furthermore, it was possible to precisely classify both the entire cohort and LATITUDE high-risk group into 3 risk groups regarding PSA-PFS according to the positive numbers of independent factors: positive for ≤1 factor, favorable; 2 factors, intermediate; and ≥3 factors, poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined use of ARSIs with ADT could improve the prognostic outcomes of mCSPC patients, particularly those in the LATITUDE high-risk group, in real-world clinical practice in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paola Calleja Hermosa, Clara Sánchez Guerrero, Vanessa Viegas, Miguel Rebassa LLul, Miguel Jiménez Cidre, Eduardo Morán Pascual, Carlos Errando Smet, Salvador Arlandis Guzmán, Esther Martínez Cuenca, José Miguel Gómez de Vicente, Mercedes Ruiz Hernández, Javier Casado Varela, Jorge Mora Gurrea, María Pérez Polo, Luis López-Fando Lavalle
Objective
The study evaluated the anatomical and functional outcomes, as well as the safety data of laparoscopic sacrocolpopexy (LSC) for pelvic organ prolapse (POP) using a lightweight macroporous mesh.
Methods
A multicentric observational study was developed including five expert centers between March 2011 and December 2019. Inclusion criteria were female patients with symptomatic ≥stage II POP (POP-Q classification), who underwent a LSC. A lightweight and macroporous mesh device (Surelift Uplift) was used. Baseline anatomical positions were evaluated using POP-Q stage. The anatomical outcomes and procedural complications were assessed during the postoperative period. Primary outcomes were anatomical success, defined as POP-Q stage ≤I, and subjective success, defined as no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse.
Results
A total of 325 LSCs were analyzed with a median patient age of 66 (interquartile range [IQR] 61–73). After a median follow-up of 68 months (IQR 46.5–89), anatomical success was found in 88.9%, whereas subjective success was seen in 98.5% of the patients. Recurrent prolapse presented as cystocele (1.5%). Reported complications were bladder (4.6%) or rectum lesions (0.6%), de novo urinary incontinence (12.9%), and mesh extrusion (1.2%).
Conclusions
LSC provides significant clinical improvement and excellent anatomical results, with a low risk of serious complications for women with ≥2 grade POP in a real clinical practice setting.
{"title":"Anatomical outcomes and complications of sacrocolpopexy using Surelift Uplift mesh: A multicentric observational study","authors":"Paola Calleja Hermosa, Clara Sánchez Guerrero, Vanessa Viegas, Miguel Rebassa LLul, Miguel Jiménez Cidre, Eduardo Morán Pascual, Carlos Errando Smet, Salvador Arlandis Guzmán, Esther Martínez Cuenca, José Miguel Gómez de Vicente, Mercedes Ruiz Hernández, Javier Casado Varela, Jorge Mora Gurrea, María Pérez Polo, Luis López-Fando Lavalle","doi":"10.1111/iju.15486","DOIUrl":"10.1111/iju.15486","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study evaluated the anatomical and functional outcomes, as well as the safety data of laparoscopic sacrocolpopexy (LSC) for pelvic organ prolapse (POP) using a lightweight macroporous mesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentric observational study was developed including five expert centers between March 2011 and December 2019. Inclusion criteria were female patients with symptomatic ≥stage II POP (POP-Q classification), who underwent a LSC. A lightweight and macroporous mesh device (Surelift Uplift) was used. Baseline anatomical positions were evaluated using POP-Q stage. The anatomical outcomes and procedural complications were assessed during the postoperative period. Primary outcomes were anatomical success, defined as POP-Q stage ≤I, and subjective success, defined as no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 325 LSCs were analyzed with a median patient age of 66 (interquartile range [IQR] 61–73). After a median follow-up of 68 months (IQR 46.5–89), anatomical success was found in 88.9%, whereas subjective success was seen in 98.5% of the patients. Recurrent prolapse presented as cystocele (1.5%). Reported complications were bladder (4.6%) or rectum lesions (0.6%), de novo urinary incontinence (12.9%), and mesh extrusion (1.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LSC provides significant clinical improvement and excellent anatomical results, with a low risk of serious complications for women with ≥2 grade POP in a real clinical practice setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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