R. Axell, H. Yasmin*, K. Aleksejeva, E. Solomon, B. Toia, M. Thommyppillai, M. Pakzad, R. Hamid, J. Ockrim, T. Greenwell
ObjectivesTo determine the diagnostic value of overnight ambulatory urodynamics (aUDS) and to assess if a urodynamic diagnosis of detrusor overactivity (DO) or nocturnal enuresis resulted in a change in patient management and an improvement in their urinary symptoms.MethodsA retrospective review of 25 consecutive patients (28% male) with a median age of 38 years (range 18 to 86) having overnight aUDS for bothersome urinary symptoms of primarily nocturia and/or nocturnal enuresis following non-diagnostic conventional urodynamics between November 1998 and August 2018. Urinary symptoms were assessed before overnight aUDS and again after urological treatment following any changes in urodynamics diagnosis and treatment. Six patients were excluded as follow-up data were not available.ResultsTwenty-four patients (96%) presented with nocturia and 20 (80%) presented with nocturnal enuresis. DO was demonstrated in 19 (76%) patients (mean pressure 69.1±53.3 cmH2O). UUI was demonstrated in 16 (80%) out of the 20 patients who complained of nocturnal enuresis. Of the 19 patients with follow-up data, following overnight aUDS a change in urodynamic diagnosis was made in 15 patients (79%); 16 patients (84%) also had their clinical diagnosis and subsequent management changed; and 15 patients (79%) reported an improvement in their urinary symptoms following these changes in diagnosis and treatment. There was a significant improvement in ICIQ-OAB (120±44 versus 32±53, P < 0.0001) scores following the changes to clinical management post-overnight aUDS.ConclusionIn our study cohort, change in primary diagnosis following overnight aUDS led to a significant change in treatment care pathway and resulted in significant improvement in urinary symptoms at follow-up.
{"title":"Overnight Ambulatory Urodynamics Change Patient Management Strategies and Improve Symptomatic Outcomes","authors":"R. Axell, H. Yasmin*, K. Aleksejeva, E. Solomon, B. Toia, M. Thommyppillai, M. Pakzad, R. Hamid, J. Ockrim, T. Greenwell","doi":"10.48083/rdtd8562","DOIUrl":"https://doi.org/10.48083/rdtd8562","url":null,"abstract":"ObjectivesTo determine the diagnostic value of overnight ambulatory urodynamics (aUDS) and to assess if a urodynamic diagnosis of detrusor overactivity (DO) or nocturnal enuresis resulted in a change in patient management and an improvement in their urinary symptoms.MethodsA retrospective review of 25 consecutive patients (28% male) with a median age of 38 years (range 18 to 86) having overnight aUDS for bothersome urinary symptoms of primarily nocturia and/or nocturnal enuresis following non-diagnostic conventional urodynamics between November 1998 and August 2018. Urinary symptoms were assessed before overnight aUDS and again after urological treatment following any changes in urodynamics diagnosis and treatment. Six patients were excluded as follow-up data were not available.ResultsTwenty-four patients (96%) presented with nocturia and 20 (80%) presented with nocturnal enuresis. DO was demonstrated in 19 (76%) patients (mean pressure 69.1±53.3 cmH2O). UUI was demonstrated in 16 (80%) out of the 20 patients who complained of nocturnal enuresis. Of the 19 patients with follow-up data, following overnight aUDS a change in urodynamic diagnosis was made in 15 patients (79%); 16 patients (84%) also had their clinical diagnosis and subsequent management changed; and 15 patients (79%) reported an improvement in their urinary symptoms following these changes in diagnosis and treatment. There was a significant improvement in ICIQ-OAB (120±44 versus 32±53, P < 0.0001) scores following the changes to clinical management post-overnight aUDS.ConclusionIn our study cohort, change in primary diagnosis following overnight aUDS led to a significant change in treatment care pathway and resulted in significant improvement in urinary symptoms at follow-up.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75206872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Sandbergen, M. I. Omar, L. Othman, F. V. van Etten-Jamaludin, M. Soytaş, J. J. de la Rosette, M. P. Laguna
Objective: To perform a systematic review assessing the impact of the different management options on health-related quality of life (HRQoL) of patients with localized renal masses or renal cell carcinomas (LRM/LRCC). Materials and Methods: Searches covering PubMed, Embase (Ovid), CENTRAL, PsycINFO (Ovid), CINAHL (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted for papers published up to 25 April 2021. Methods as per Cochrane Handbook were followed. “Modality” of treatment included radical nephrectomy (RN), nephron-sparing surgery (NSS), thermal ablation (TA), and active surveillance (AS). “Approach” was categorized as open incision and minimally invasive surgery (MIS). Risk of bias was assessed by ROBINS-I and Cochrane RoB 2 for observational studies and randomized controlled trials, respectively and certainty of the evidence by GRADE. Results: Sixteen observational studies and 1 randomized controlled trial (2.370 patients) met inclusion criteria. Fifteen different patient reported outcome measures (PROMs) were identified. Heterogeneity prevented quantitative analysis. Generic HRQoL decreases after RN and NSS, recovers within 6 to 12 months, and mostly overlaps with baseline values, irrespective of modality. Cancer-specific HRQoL improve faster after open-NSS than open-RN. The detrimental effect of RN may persist long-term in cross-evaluations. QoL scales significantly decrease after open surgery and MIS during the first weeks but improve faster after MIS. They are similar for both approaches at 1-year. Long-term cancer-specific QoL is similar for MIS and open procedures. Fear of recurrence is lower in older patients and affected by neither modality nor approach. Conclusions: Low quality evidence supports the use of MIS over the open approach when HRQoL is considered in the management of LRMs/LRCCs; data regarding the effect of the treatment modality of the LRM/LRCC show contradictory outcomes.
目的:对不同治疗方案对局限性肾肿块或肾细胞癌(LRM/LRCC)患者健康相关生活质量(HRQoL)的影响进行系统评价。材料和方法:检索PubMed、Embase (Ovid)、CENTRAL、PsycINFO (Ovid)、CINAHL (EBSCO)和Cochrane CENTRAL Register of Controlled Trials (CENTRAL)数据库，检索截止到2021年4月25日发表的论文。方法参照Cochrane手册。治疗的“方式”包括根治性肾切除术(RN)、保留肾元手术(NSS)、热消融(TA)和主动监测(AS)。“入路”分为切开微创手术(MIS)。观察性研究和随机对照试验的偏倚风险分别采用ROBINS-I和Cochrane RoB 2进行评估，证据的确定性采用GRADE进行评估。结果:16项观察性研究和1项随机对照试验(2,370例患者)符合纳入标准。确定了15种不同的患者报告的结果测量(PROMs)。异质性阻碍了定量分析。一般HRQoL在RN和NSS后下降，在6至12个月内恢复，并且大多数与基线值重叠，无论何种方式。开放性nss术后癌症特异性HRQoL的改善比开放性rn更快。交叉评价中，RN的有害影响可能长期存在。生活质量量表在开放手术和MIS后的第一周内显著下降，但MIS后改善更快。两种方法在1年时的结果是相似的。MIS和开放式手术的长期癌症特异性生活质量相似。老年患者对复发的恐惧较低，且不受手术方式和入路的影响。结论:低质量证据支持在lrm / lrcc管理中考虑HRQoL时使用MIS而不是开放方法;关于LRM/LRCC治疗方式效果的数据显示出相互矛盾的结果。
{"title":"Systematic Review of Comparative Patient Reported Outcomes and Health-Related Quality of Life After Management of Localized Renal Masses or Renal Cell Carcinomas","authors":"L. Sandbergen, M. I. Omar, L. Othman, F. V. van Etten-Jamaludin, M. Soytaş, J. J. de la Rosette, M. P. Laguna","doi":"10.48083/qode9040","DOIUrl":"https://doi.org/10.48083/qode9040","url":null,"abstract":"Objective: To perform a systematic review assessing the impact of the different management options on health-related quality of life (HRQoL) of patients with localized renal masses or renal cell carcinomas (LRM/LRCC).\u0000\u0000Materials and Methods: Searches covering PubMed, Embase (Ovid), CENTRAL, PsycINFO (Ovid), CINAHL (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted for papers published up to 25 April 2021. Methods as per Cochrane Handbook were followed. “Modality” of treatment included radical nephrectomy (RN), nephron-sparing surgery (NSS), thermal ablation (TA), and active surveillance (AS). “Approach” was categorized as open incision and minimally invasive surgery (MIS). Risk of bias was assessed by ROBINS-I and Cochrane RoB 2 for observational studies and randomized controlled trials, respectively and certainty of the evidence by GRADE.\u0000\u0000Results: Sixteen observational studies and 1 randomized controlled trial (2.370 patients) met inclusion criteria. Fifteen different patient reported outcome measures (PROMs) were identified. Heterogeneity prevented quantitative analysis.\u0000\u0000Generic HRQoL decreases after RN and NSS, recovers within 6 to 12 months, and mostly overlaps with baseline values, irrespective of modality. Cancer-specific HRQoL improve faster after open-NSS than open-RN. The detrimental effect of RN may persist long-term in cross-evaluations. QoL scales significantly decrease after open surgery and MIS during the first weeks but improve faster after MIS. They are similar for both approaches at 1-year. Long-term cancer-specific QoL is similar for MIS and open procedures. Fear of recurrence is lower in older patients and affected by neither modality nor approach.\u0000\u0000Conclusions: Low quality evidence supports the use of MIS over the open approach when HRQoL is considered in the management of LRMs/LRCCs; data regarding the effect of the treatment modality of the LRM/LRCC show contradictory outcomes.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83043783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gender Disparity on Editorial Boards","authors":"Peter C. Black","doi":"10.48083/tkcx3667","DOIUrl":"https://doi.org/10.48083/tkcx3667","url":null,"abstract":"","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74653819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.48083/10.48083/tiwq1657
C. Pham, Manish I. Patel, S. Mungovan
Objectives: To evaluate the correlation between 3- and 6-week postoperative 24-hour pad weight, daily pad number, and the International Consultation on Incontinence Questionnaires for Male Lower Urinary Tract (ICIQ-MLUTS), ICIQ-Short Form (ICIQ-SF) and UCLA Prostate Cancer Index (UCLA-PCI) in patients undergoing robotic-assisted radical prostatectomy (RARP). Methods: This prospective study included patients undergoing RARP between February and November 2019. Patients completed a 24-hour pad test, assessing pad weight and number, and 3 validated patient-reported outcome measures (PROMs); the ICIQ-MLUTS, ICIQ-SF and UCLA-PCI, preoperatively and at 3 and 6 weeks postoperatively. Results: A total of 47 patients were included in the study. There was a strong correlation between 24-hour pad weight and the ICIQ-SF at 3 weeks (r = 0.71, P < 0.001) and 6 weeks (r = 0.68, P < 0.001). There was a strong correlation between 24-hour pad weight and ICIQ-MLUTS incontinence (r = 0.80, P < 0.01) and incontinence QoL burden (r = 0.79, P < 0.01) at 6 weeks. There was a moderate correlation between the 24-hour pad weight and UCLA-PCI urinary function (r = 0.58, P < 0.001) and urinary QoL burden (r = 0.66, P < 0.001) at 6 weeks. The correlation between pad number and 24-hour pad weight was weak at 6 weeks (r = 0.34, P < 0.001). Conclusion: PROMs may be used as a substitute for the 24-hour pad weight test for post-prostatectomy incontinence (PPI) assessments in the early post-RARP period. The ICIQ-SF and UCLA-PCI urinary function and QoL scores correlate with 24-hour pad weight. However, the ICIQ-MLUTS incontinence and QoL scores provide the strongest correlation with PPI.
目的:评估机器人辅助根治性前列腺切除术(RARP)患者术后3周和6周24小时尿垫重量、每日尿垫数与男性下尿路失禁国际咨询问卷(ICIQ-MLUTS)、ICIQ-SF和UCLA前列腺癌指数(UCLA- pci)的相关性。方法:这项前瞻性研究纳入了2019年2月至11月期间接受RARP治疗的患者。患者完成了24小时尿垫试验，评估尿垫的重量和数量，以及3个经过验证的患者报告的结果测量(PROMs);ICIQ-MLUTS, ICIQ-SF和UCLA-PCI，术前、术后3周和6周。结果:共纳入47例患者。24小时尿垫重量与3周(r = 0.71, P < 0.001)和6周(r = 0.68, P < 0.001) ICIQ-SF有很强的相关性。24小时尿垫重量与6周时ICIQ-MLUTS尿失禁(r = 0.80, P < 0.01)和尿失禁生活质量负担(r = 0.79, P < 0.01)有很强的相关性。6周时24小时尿垫重量与UCLA-PCI尿功能(r = 0.58, P < 0.001)和尿生活质量负担(r = 0.66, P < 0.001)有中度相关性。6周时尿垫数与24小时尿垫重量相关性较弱(r = 0.34, P < 0.001)。结论:PROMs可替代24小时尿垫重量试验用于前列腺切除术后尿失禁(PPI)的早期评估。ICIQ-SF和UCLA-PCI尿功能和生活质量评分与24小时尿垫重量相关。然而，ICIQ-MLUTS尿失禁和生活质量评分与PPI的相关性最强。
{"title":"Pad Weight, Pad Number and Incontinence-Related Patient-Reported Outcome Measures After Radical Prostatectomy","authors":"C. Pham, Manish I. Patel, S. Mungovan","doi":"10.48083/10.48083/tiwq1657","DOIUrl":"https://doi.org/10.48083/10.48083/tiwq1657","url":null,"abstract":"Objectives: To evaluate the correlation between 3- and 6-week postoperative 24-hour pad weight, daily pad number, and the International Consultation on Incontinence Questionnaires for Male Lower Urinary Tract (ICIQ-MLUTS), ICIQ-Short Form (ICIQ-SF) and UCLA Prostate Cancer Index (UCLA-PCI) in patients undergoing robotic-assisted radical prostatectomy (RARP). Methods: This prospective study included patients undergoing RARP between February and November 2019. Patients completed a 24-hour pad test, assessing pad weight and number, and 3 validated patient-reported outcome measures (PROMs); the ICIQ-MLUTS, ICIQ-SF and UCLA-PCI, preoperatively and at 3 and 6 weeks postoperatively. Results: A total of 47 patients were included in the study. There was a strong correlation between 24-hour pad weight and the ICIQ-SF at 3 weeks (r = 0.71, P < 0.001) and 6 weeks (r = 0.68, P < 0.001). There was a strong correlation between 24-hour pad weight and ICIQ-MLUTS incontinence (r = 0.80, P < 0.01) and incontinence QoL burden (r = 0.79, P < 0.01) at 6 weeks. There was a moderate correlation between the 24-hour pad weight and UCLA-PCI urinary function (r = 0.58, P < 0.001) and urinary QoL burden (r = 0.66, P < 0.001) at 6 weeks. The correlation between pad number and 24-hour pad weight was weak at 6 weeks (r = 0.34, P < 0.001). Conclusion: PROMs may be used as a substitute for the 24-hour pad weight test for post-prostatectomy incontinence (PPI) assessments in the early post-RARP period. The ICIQ-SF and UCLA-PCI urinary function and QoL scores correlate with 24-hour pad weight. However, the ICIQ-MLUTS incontinence and QoL scores provide the strongest correlation with PPI.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81107135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bilateral Spermatic Vein Thrombosis Following COVID-19 Infection","authors":"Alfin Okullo, P. Crispin, D. Gilbourd","doi":"10.48083/lmlq3196","DOIUrl":"https://doi.org/10.48083/lmlq3196","url":null,"abstract":"<jats:p>None.</jats:p>","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83875785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.48083/10.48083/hndx7233
Peter C. Black
None.
一个也没有。
{"title":"International Conflict in Urology","authors":"Peter C. Black","doi":"10.48083/10.48083/hndx7233","DOIUrl":"https://doi.org/10.48083/10.48083/hndx7233","url":null,"abstract":"<jats:p>None.</jats:p>","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90902283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ala'a Farkouh, Nassib F. Abou Heidar, R. Dobbs, I. Abu-Gheida, M. Bulbul, M. Shahait
Locally advanced prostate cancer poses a clinical challenge for physicians. Despite the established role of radiotherapy and androgen-deprivation therapy in these cases, some patients with locally advanced disease experience recurrent disease or persistent disease with debilitating local symptoms, such as intractable pain and urinary symptoms. In this narrative review, we sought to evaluate the role of exenterative surgery in the management of locally advanced prostate cancer. From our search, we found that total pelvic exenteration or cystoprostatectomy represents a viable therapeutic modality to manage prostate cancer directly invading the bladder, lower urinary tract symptoms, debilitating pain caused by locally advanced disease, and as salvage treatment after failure of primary treatment among other applications. Reports on minimally invasive pelvic exenteration for prostate cancer were also retrieved, as this represents a feasible and effective treatment option for experienced clinicians. Pelvic exenteration may be an effective tool for the treatment of locally advanced prostate cancer in the surgeon’s armamentarium; however, further studies are needed to establish its role in improving survival and overall patient outcomes
{"title":"The Role of Pelvic Exenteration in the Management of Locally Advanced Prostate Cancer","authors":"Ala'a Farkouh, Nassib F. Abou Heidar, R. Dobbs, I. Abu-Gheida, M. Bulbul, M. Shahait","doi":"10.48083/kgmi7850","DOIUrl":"https://doi.org/10.48083/kgmi7850","url":null,"abstract":"Locally advanced prostate cancer poses a clinical challenge for physicians. Despite the established role of radiotherapy and androgen-deprivation therapy in these cases, some patients with locally advanced disease experience recurrent disease or persistent disease with debilitating local symptoms, such as intractable pain and urinary symptoms. In this narrative review, we sought to evaluate the role of exenterative surgery in the management of locally advanced prostate cancer. From our search, we found that total pelvic exenteration or cystoprostatectomy represents a viable therapeutic modality to manage prostate cancer directly invading the bladder, lower urinary tract symptoms, debilitating pain caused by locally advanced disease, and as salvage treatment after failure of primary treatment among other applications. Reports on minimally invasive pelvic exenteration for prostate cancer were also retrieved, as this represents a feasible and effective treatment option for experienced clinicians. Pelvic exenteration may be an effective tool for the treatment of locally advanced prostate cancer in the surgeon’s armamentarium; however, further studies are needed to establish its role in improving survival and overall patient outcomes","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78765036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.48083/10.48083/rqbn1626
G. Marra, D. Meseure, M. Lefevre, A. Nicolas, Laëtitia Lesage, N. Ghinea, M. Moschini, C. Pasquali, P. Macek, C. Filippini, P. Gontero, R. Sanchez-Salas, X. Cathelineau
BackgroundCurrently, no markers accurately differentiate benign from malignant renal masses. CD34 and FSHR are transmembrane proteins involved in neo-angiogenetic pathways and are differently expressed in several normal and cancerous tissues. However, little evidence exists on their distribution in different renal tumors. We aimed to evaluate their expressions in various renal tumors and adjacent normal tissue.MethodsWe retrieved 810 histological samples from 26 patients who underwent surgery for suspected RCa. In each case a core of 10 × 1 mm was selected perpendicular to the tumor capsule between normal kidney and tumor. Within this core 30 regions of interest (ROI), each measuring 669 μm × 500 μm, were acquired at 20× magnification (n = 2 adjacent normal tissue; n = 2 tumor capsule; n = 26 tumor). The surface area of FSHR and CD34 immunostaining was quantified in each ROI using number of stained pixels. The results were compared between RCa and normal kidney.ResultsImmunostaining was significantly different in normal, tumor capsular, and tumor tissues (both CD34 and FSHR P < 0.0001), with overall highest expression in normal and lowest in tumor tissues, where CD34 and FSHR were differently expressed amongst different tumor subtypes (both P < 0.0001). CD34 and FSHR were more expressed in benign versus malignant (both P < 0.0001) and in chromophobe carcinoma versus oncocytoma tumor tissues (CD34 P = 0.0003; FSHR P < 0.0001). The discriminating ability of FSHR alone for benign versus malignant (AUC 0.805; 95% CI 0.771 to 0.837) and chromophobe carcinoma versus oncocytoma (AUC 0.973; 95% CI 0.939 to 0.991) was high. In both cases FSHR AUC was significantly higher than CD34 (both P < 0.0001) and equivalent to the combination of CD34 and FSHR (both P > 0.9). The correlation amongst levels of staining in tumor tissues and distance from the capsule were overall weak (Spearman coefficient CD34 to 0.0644; FSHR-0.16322).ConclusionCD34 and FSHR are differentially expressed across renal tumor subtypes and between tumor and surrounding tissues. FSHR expression alone may be a useful tool to differentiate benign from malignant tumors and chromophobe carcinoma from oncocytoma.
{"title":"CD34 and FSHR Expression to Differentiate Multiple Subtypes of Benign and Malignant Renal Neoplasms","authors":"G. Marra, D. Meseure, M. Lefevre, A. Nicolas, Laëtitia Lesage, N. Ghinea, M. Moschini, C. Pasquali, P. Macek, C. Filippini, P. Gontero, R. Sanchez-Salas, X. Cathelineau","doi":"10.48083/10.48083/rqbn1626","DOIUrl":"https://doi.org/10.48083/10.48083/rqbn1626","url":null,"abstract":"BackgroundCurrently, no markers accurately differentiate benign from malignant renal masses. CD34 and FSHR are transmembrane proteins involved in neo-angiogenetic pathways and are differently expressed in several normal and cancerous tissues. However, little evidence exists on their distribution in different renal tumors. We aimed to evaluate their expressions in various renal tumors and adjacent normal tissue.MethodsWe retrieved 810 histological samples from 26 patients who underwent surgery for suspected RCa. In each case a core of 10 × 1 mm was selected perpendicular to the tumor capsule between normal kidney and tumor. Within this core 30 regions of interest (ROI), each measuring 669 μm × 500 μm, were acquired at 20× magnification (n = 2 adjacent normal tissue; n = 2 tumor capsule; n = 26 tumor). The surface area of FSHR and CD34 immunostaining was quantified in each ROI using number of stained pixels. The results were compared between RCa and normal kidney.ResultsImmunostaining was significantly different in normal, tumor capsular, and tumor tissues (both CD34 and FSHR P < 0.0001), with overall highest expression in normal and lowest in tumor tissues, where CD34 and FSHR were differently expressed amongst different tumor subtypes (both P < 0.0001). CD34 and FSHR were more expressed in benign versus malignant (both P < 0.0001) and in chromophobe carcinoma versus oncocytoma tumor tissues (CD34 P = 0.0003; FSHR P < 0.0001). The discriminating ability of FSHR alone for benign versus malignant (AUC 0.805; 95% CI 0.771 to 0.837) and chromophobe carcinoma versus oncocytoma (AUC 0.973; 95% CI 0.939 to 0.991) was high. In both cases FSHR AUC was significantly higher than CD34 (both P < 0.0001) and equivalent to the combination of CD34 and FSHR (both P > 0.9). The correlation amongst levels of staining in tumor tissues and distance from the capsule were overall weak (Spearman coefficient CD34 to 0.0644; FSHR-0.16322).ConclusionCD34 and FSHR are differentially expressed across renal tumor subtypes and between tumor and surrounding tissues. FSHR expression alone may be a useful tool to differentiate benign from malignant tumors and chromophobe carcinoma from oncocytoma.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84161243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hadia Khanani, G. McClintock, H. Fernando, G. Heller, R. Asher, Cindy Garcia, David P. Smith, I. Getley, N. Ahmadi, Norbert Doeuk, S. Leslie, Niruban Thanigasalam, H. Woo
Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of and mortality from PCa in CCC based on studies published to date. PubMed, Medline, EMBASE and SCOPUS were searched from 1946 to April 2021. Cohort studies reporting standardized incidence ratios (SIR) and/or standardized mortality ratios (SMR) of PCa in CCC were included. Military, cabin crew and service personnel data were excluded. Independent data extraction was conducted, and study quality assessed. Standardized ratios were pooled using a fixed effects model and expressed with 95% confidence intervals. 75 studies were assessed for eligibility from which 6 involving 129 374 licensed CCC were included in the final analysis: Two reported incidence only, 1 incidence and mortality and 3 reported mortalities only. The pooled SIR for PCa in CCC was 1.41 (95% CI 1.17 to 1.71) with moderate heterogeneity (I2 = 53%) however, the pooled SMR was not statistically significant (1.08; 95% CI 0.94 to 1.24) also with moderate heterogeneity (I2 = 70%). The available evidence shows that CCC are at a higher risk of developing PCa but there is no evidence to suggest a similarly higher risk of death from the disease. The effect of early detection through PSA testing in this cohort is unclear. Occupational exposure to radiation and sleep disturbance may play a role, but clear evidence of additional risk is lacking. Our review indicates that most evidence is dated and to confidently assess contemporary health outcomes of CCC, further research is required.
商业航空公司驾驶舱机组人员可能面临可能对健康产生有害影响的职业风险因素。然而，关于前列腺癌(PCa)作为一种健康结果的现有文献是矛盾的。因此，这篇队列研究综述的目的是基于迄今发表的研究，评估前列腺癌在CCC中的发病率和死亡率。检索自1946年至2021年4月的PubMed、Medline、EMBASE和SCOPUS。纳入了报告CCC中PCa标准化发病率(SIR)和/或标准化死亡率(SMR)的队列研究。军人、机组人员和服务人员的数据不包括在内。进行独立数据提取，并评估研究质量。标准化比率采用固定效应模型合并，并以95%置信区间表示。我们对75项研究的合格性进行了评估，其中6项涉及1229374例获得许可的CCC纳入最终分析:2项仅报告发病率，1项报告发病率和死亡率，3项仅报告死亡率。CCC中PCa的合并SIR为1.41 (95% CI 1.17 ~ 1.71)，具有中等异质性(I2 = 53%)，但合并SMR无统计学意义(1.08;95% CI 0.94 ~ 1.24)也具有中等异质性(I2 = 70%)。现有证据表明，CCC患者发生前列腺癌的风险较高，但没有证据表明该疾病导致死亡的风险也较高。在这个队列中，通过PSA检测早期检测的效果尚不清楚。职业暴露于辐射和睡眠障碍可能起作用，但缺乏额外风险的明确证据。我们的回顾表明，大多数证据都是过时的，为了自信地评估CCC的当代健康结果，需要进一步的研究。
{"title":"Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis","authors":"Hadia Khanani, G. McClintock, H. Fernando, G. Heller, R. Asher, Cindy Garcia, David P. Smith, I. Getley, N. Ahmadi, Norbert Doeuk, S. Leslie, Niruban Thanigasalam, H. Woo","doi":"10.48083/pdkf1241","DOIUrl":"https://doi.org/10.48083/pdkf1241","url":null,"abstract":"Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of and mortality from PCa in CCC based on studies published to date. PubMed, Medline, EMBASE and SCOPUS were searched from 1946 to April 2021. Cohort studies reporting standardized incidence ratios (SIR) and/or standardized mortality ratios (SMR) of PCa in CCC were included. Military, cabin crew and service personnel data were excluded. Independent data extraction was conducted, and study quality assessed. Standardized ratios were pooled using a fixed effects model and expressed with 95% confidence intervals. 75 studies were assessed for eligibility from which 6 involving 129 374 licensed CCC were included in the final analysis: Two reported incidence only, 1 incidence and mortality and 3 reported mortalities only. The pooled SIR for PCa in CCC was 1.41 (95% CI 1.17 to 1.71) with moderate heterogeneity (I2 = 53%) however, the pooled SMR was not statistically significant (1.08; 95% CI 0.94 to 1.24) also with moderate heterogeneity (I2 = 70%). The available evidence shows that CCC are at a higher risk of developing PCa but there is no evidence to suggest a similarly higher risk of death from the disease. The effect of early detection through PSA testing in this cohort is unclear. Occupational exposure to radiation and sleep disturbance may play a role, but clear evidence of additional risk is lacking. Our review indicates that most evidence is dated and to confidently assess contemporary health outcomes of CCC, further research is required.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89391216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Cash, S. Hofbauer, N. Shore, C. Pavlovich, Stephan Bulang, M. Schostak, E. Planken, J. J. Jaspars, F. Luger, L. Klotz, G. Salomon
Objective Micro-ultrasound is an imaging modality used to visualize and target prostate cancer during transrectal or transperineal biopsy. We evaluated the effectiveness of a micro-ultrasound training program and estimated the learning curve for prostate biopsy. Methods A training program registry was assessed for the rate of clinically significant prostate cancer (csPCa, grade group ≥ 2), negative predictive value, and specificity at each stage of the program. Nine metrics of biopsy quality were evaluated in 4 stages for each practitioner. Non-linear fitting and logistic regression models were used to evaluate the time-course of these metrics over training. Results Thirteen practitioners from 8 institutions completed stages 1 to 3 of the program, and 9 completed all 4 stages. Over 1190 micro-ultrasound biopsy procedures were performed. Detection of csPCa increased from 40% to 57% from stage 1 to stage 4 (P < 0.01). Stage 4 “expert” level was independently associated with higher detection of csPCa when correcting for overall risk factors (OR 1.95; P = 0.03). Limitations include the retrospective analysis and variation in biopsy protocols. Conclusion The micro-ultrasound training program was effective in improving biopsy quality and rate of csPCa detection. The presented learning curve provides an initial guide for acquiring expertise with real-time micro ultrasound image-guided biopsy.
{"title":"Prostate Cancer Detection by Novice Micro-Ultrasound Users Enrolled in a Training Program","authors":"H. Cash, S. Hofbauer, N. Shore, C. Pavlovich, Stephan Bulang, M. Schostak, E. Planken, J. J. Jaspars, F. Luger, L. Klotz, G. Salomon","doi":"10.48083/kkvj7280","DOIUrl":"https://doi.org/10.48083/kkvj7280","url":null,"abstract":"Objective Micro-ultrasound is an imaging modality used to visualize and target prostate cancer during transrectal or transperineal biopsy. We evaluated the effectiveness of a micro-ultrasound training program and estimated the learning curve for prostate biopsy. Methods A training program registry was assessed for the rate of clinically significant prostate cancer (csPCa, grade group ≥ 2), negative predictive value, and specificity at each stage of the program. Nine metrics of biopsy quality were evaluated in 4 stages for each practitioner. Non-linear fitting and logistic regression models were used to evaluate the time-course of these metrics over training. Results Thirteen practitioners from 8 institutions completed stages 1 to 3 of the program, and 9 completed all 4 stages. Over 1190 micro-ultrasound biopsy procedures were performed. Detection of csPCa increased from 40% to 57% from stage 1 to stage 4 (P < 0.01). Stage 4 “expert” level was independently associated with higher detection of csPCa when correcting for overall risk factors (OR 1.95; P = 0.03). Limitations include the retrospective analysis and variation in biopsy protocols. Conclusion The micro-ultrasound training program was effective in improving biopsy quality and rate of csPCa detection. The presented learning curve provides an initial guide for acquiring expertise with real-time micro ultrasound image-guided biopsy.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"62 17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82089096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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