BJUI compass最新文献

{"title":"Day-case artificial urinary sphincter for post-prostatectomy incontinence: A comparative pilot study","authors":"Konstantinos Kapriniotis,&nbsp;Ioannis Loufopoulos,&nbsp;Richard Nobrega,&nbsp;Anthony Noah,&nbsp;Helena Gresty,&nbsp;Tamsin Greenwell,&nbsp;Jeremy Ockrim","doi":"10.1002/bco2.412","DOIUrl":"10.1002/bco2.412","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Implantation of an artificial urinary sphincter (AUS) to treat post-prostatectomy incontinence (PPI) has been traditionally offered with an overnight hospital stay. The aim of this prospective, comparative pilot study was to assess the feasibility and outcomes of the AUS procedure in a day-case setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We included consecutive patients having primary or redo AUS surgery over an 18-month period. We excluded patients with previous urethral erosion of AUS, urethroplasty or high anaesthetic risk. All patients were offered day-case surgery. Patients who declined or could not have day-case surgery for logistical reasons had standard care with overnight stay and formed the control group for the study. Primary outcome was the proportion of successful same day-discharges in the day-case group. We also compared baseline characteristics, complications and continence at 1 year post surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve patients consented for day-case procedure, and 13 patients had standard overnight care. Mean age was 69.5 years (range 58–79). Twenty-one patients (84%) had primary AUS, whereas 4 (16%) had a redo procedure. There were no significant differences between the groups in baseline demographics. Median number of pads/24 h was 5 in the day-case group and 4 in the overnight group. Eight of 12 patients (66.7%) in the day-case group were successfully discharged on the same day. Failed discharges were due to anaesthetic recovery (<i>n</i> = 2), high post-void residuals that resolved spontaneously (<i>n</i> = 1) and intraoperative superficial urethral injury (<i>n</i> = 1). All patients in the day-case group and all but one in the standard of care group were socially continent (0–1 pads) at 1 year post procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Day-case catheter-free discharge of AUS patients is feasible and safe in selected patients with comparable continence outcomes and complication rates to those with standard overnight stays.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"845-850"},"PeriodicalIF":1.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shedding light on night-time erections: Determining the feasibility of nocturnal erection detection with penile transdermal light reflection of haemoglobin","authors":"Evelien J. Trip,&nbsp;Hille J. Torenvlied,&nbsp;Henk W. Elzevier,&nbsp;Rob C. M. Pelger,&nbsp;Jack J. H. Beck","doi":"10.1002/bco2.410","DOIUrl":"10.1002/bco2.410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Utilizing penile saturation and temperature measurements presents a promising avenue for the development of an innovative sensor system aimed at nocturnal erection detection. This study aims to determine the feasibility of erection detection with light reflection of haemoglobin (LRH), as a precursor for penile saturation measurements, as well as penile temperature by comparison with simultaneous overnight RigiScan measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This is a proof-of-concept observational study on 10 healthy volunteers with a cross sectional design. A penile transdermal haemoglobin and temperature sensor was developed to measure penile LRH through real-time monitoring with receiving photodiodes and emitting light-emitting diode (LED). Besides statistical analysis on LRH, temperature and RigiScan data, a visual assessment was done to determine detectability of changes in the LRH and temperature course during the RigiScan-annotated erections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 40 nocturnal erections from 10 healthy volunteers were annotated with the RigiScan. The LRH values significantly increase during a nocturnal erection (<i>p</i> &lt; 0.01) and penile temperature (<i>p</i> &lt; 0.01). The largest elevation of temperature was seen in the last erection, with an increase of 0.94°C. The corrected temperature shows an increase of 1.29°C in the last erection. Furthermore, visual detectability was feasible for 80% of the erections with LRH values and 90% with the temperature output.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Penile LRH and temperature have the potential to serve as an alternative methodology for nocturnal erection detection compared with the currently applied circumference and rigidity measurements. This is an important step in the development of a patient-friendly and modernized tool for erectile dysfunction diagnostics. An improved sensor should be developed to allow for calculation of saturation percentage from LRH values. In combination with penile temperature measurements, this allows for conduction of further validity studies to work towards translation into clinical practice for non-invasive ED diagnostics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"837-844"},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141832616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences on androgen deprivation therapy prescribing before surgery in high-risk prostate cancer","authors":"Jennifer Dunsmore,&nbsp;Eilidh Duncan,&nbsp;Sara J. MacLennan,&nbsp;James N'Dow,&nbsp;Philip Cornford,&nbsp;Francesco Esperto,&nbsp;Nicola Pavan,&nbsp;María J. Ribal,&nbsp;Monique J. Roobol,&nbsp;Ted A. Skolarus,&nbsp;Steven MacLennan","doi":"10.1002/bco2.411","DOIUrl":"10.1002/bco2.411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand how best to further reduce the inappropriate use of pre-surgical androgen deprivation therapy (ADT), we investigated the determinants (influences) of ADT prescribing in urologists in two European countries using an established behavioural science approach. Additionally, we sought to understand how resource limitations caused by COVID-19 influenced this practice. Identification of key determinants, of undistributed and disrupted practice, will aid development of future strategies to reduce inappropriate ADT prescribing in current and future resource-limited settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants and Methods</h3>\u0000 \u0000 <p>We conducted semi-structured qualitative interviews with urologists practicing in Italy and the UK from February to July 2022. Interviews focussed on undisrupted (usual) practice and disrupted practice (changes made during COVID-19 restrictions). Codes were generated inductively and were mapped to the 14 domains of the Theoretical Domains Framework. Relevant domains of influence were identified, and the similarities and differences between the UK and Italy were distinguished.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 10 domains that were influential to ADT prescribing in the UK and eight in Italy. The role of guidance and evidence, the cancer care setting, the patients and the urologist's beliefs and experiences were identified as areas that were influential to ADT prescribing before surgery. Twenty-one similarities and 22 differences between the UK and Italy, for usual and COVID-19 practice, were identified across these 10 domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Similarities and differences influencing ADT prescribing prior to surgery should be considered in behavioural strategy development and tailoring to reduce inappropriate ADT use. We gained an understanding of usual, undistributed care and resource-limited or disrupted care due to COVID-19 in two European countries. This gives an indication of how influences on ADT prescribing may change in future resource-limited circumstances and where efforts can be focused now and in future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"874-884"},"PeriodicalIF":1.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141650415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer detection after atypical small acinar proliferation (ASAP): A 10-year single-centre cohort","authors":"Thineskrishna Anbarasan,&nbsp;Mutie Raslan,&nbsp;Kanchan Ghosh,&nbsp;Philip Macklin,&nbsp;Claudia Mercader,&nbsp;Tom Leslie,&nbsp;Freddie C. Hamdy,&nbsp;Richard Colling,&nbsp;Lisa Browning,&nbsp;Ian Roberts,&nbsp;Clare Verrill,&nbsp;Richard J. Bryant,&nbsp;Francisco Lopez,&nbsp;Alastair D. Lamb","doi":"10.1002/bco2.407","DOIUrl":"10.1002/bco2.407","url":null,"abstract":"&lt;p&gt;Atypical small acinar proliferation (ASAP), found in 5% of prostate biopsies, represents a focus of atypical cells that fall short of a cancer diagnosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; ASAP may be associated with a diagnosis of prostate cancer (PCa) upon repeat biopsy in 25%–50% of patients within 5 years.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The proportion of these cases that may be classified as being intermediate- or high-grade PCa varies in the literature, ranging from 6.0% to 22.5%.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Until recently, diagnosis of ASAP was an indication for early repeat biopsy in international guidelines. However, recent studies referenced by the European Association of Urology (EAU) guidelines suggest low rates of subsequent Gleason grade group (GG) ≥ 2 PCa, similar to following a previous negative biopsy, leading to a softening of the recommendation for ASAP as an indication for performing early repeat biopsy.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; We therefore aimed to test the hypothesis that prostate cancer diagnosed on early re-biopsy after detection ASAP is always low grade by interrogating a large prospective pathology database. We also aimed to determine the time interval between detection of ASAP and diagnosis of csPCa, if present.&lt;/p&gt;&lt;p&gt;We scrutinised pathology records according to a prospectively derived protocol (ID: CU96T) for all consecutive patients with ASAP on needle biopsy, transurethral resection of the prostate (TURP) chippings, or holmium laser enucleation of the prostate (HoLEP) specimens between January 2010 and November 2021 at a single tertiary institution. We classified pathological upgrading to csPCa as any Gleason pattern 4 disease identified within 2 years of the initial biopsy/TURP/HoLEP specimen detecting ASAP. Where available, we reviewed pre-biopsy multiparametric MRI (mpMRI) reports for PI-RADS scores at the time of ASAP diagnosis and obtained the prostate volume in order to derive the PSA density (PSAD). A multi-variable logistic regression model (including age, PSAD and PI-RADS) was constructed to determine factors associated with the development of csPCa.&lt;/p&gt;&lt;p&gt;Approximately 13 240 prostate samplings were performed (11 240 needle biopsy and 2000 HoLEP/TURP specimens) over the 10-year period. ASAP was identified in 617 (4.7%) biopsy samplings, involving 523 patients. Of these, 51 (9.7%) patients had a pre-existing history of PCa and were excluded from further analysis, leaving a sample size of 472 individuals with de novo ASAP (Table 1). The baseline characteristics of the cohort are summarised in Table 1. Two hundred and thirty-seven (50.2%) patients had a repeat biopsy (Table S1) within a median of 92 days (IQR: 56–283). The median PSA within 3–6 months of ASAP detection was higher amongst patients who underwent repeat biopsy (6.7 vs. 5.08 ng/ml, &lt;i&gt;p&lt;/i&gt; = 0.001) consistent with clinical judgement advocating repeat biopsy. In the 248 of 472 (52.5%) patients with pre-biopsy MRI, logistic regression revealed age &lt;65 years","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"834-836"},"PeriodicalIF":1.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early economic evaluation of magnetic resonance imaging for prostate cancer detection in primary care","authors":"Samuel William David Merriel,&nbsp;Peter Buttle,&nbsp;Sarah J. Price,&nbsp;Nick Burns-Cox,&nbsp;Fiona M. Walter,&nbsp;William Hamilton,&nbsp;Anne E. Spencer","doi":"10.1002/bco2.409","DOIUrl":"10.1002/bco2.409","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore the potential impacts of incorporating prebiopsy magnetic resonance imaging into primary care as a triage test within the prostate cancer diagnostic pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and methods</h3>\u0000 \u0000 <p>Decision analytic modelling with decision trees was utilised for this early economic evaluation. A conceptual model was developed reflecting the common primary care routes to diagnosis for prostate cancer: opportunistic, asymptomatic prostate-specific antigen (PSA) screening or symptomatic presentation. The use of multiparametric MRI (mpMRI) or biparametric MRI (bpMRI) as a primary care triage test following an elevated PSA result was evaluated. A health system perspective was adopted with a time horizon of 12 months. Health effects were expressed in terms of utilities drawn from the literature. The primary outcome was prostate cancer diagnosis. Evidence used to inform the model was drawn from published primary studies, systematic reviews, and secondary analyses of primary and secondary care datasets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Base case analysis showed that the PSA pathway was dominated by both mpMRI- and bpMRI-based pathways for patients undergoing opportunistic screening and symptomatic assessment. bpMRI pathways had greater improvement in cost and utility than mpMRI pathways in both clinical scenarios. Significantly more MRI scans would be performed using the modelled approach (66 626 scans vs. 37 456 scans per 100 000 patients per annum), with fewer subsequent urgent suspected cancer referrals for both mpMRI (38% reduction for screening and symptomatic patients) and bpMRI (72% reduction for screening; 71% for symptomatic) pathways, and a small increase in number of missed cancer diagnoses. Deterministic sensitivity analyses, varying each parameter to its upper and lower 95% confidence intervals, showed no significant change in the dominance of the MRI-based prostate cancer diagnostic pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using prostate MRI as a second-level triage test for suspected prostate cancer in primary care could reduce health service costs without a detrimental effect on patient utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"855-864"},"PeriodicalIF":1.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications and added value of videourodynamics in men with spinal cord injury","authors":"Marc Françot,&nbsp;Chloé Lefevre,&nbsp;Bénédicte Reiss,&nbsp;Marc Lefort,&nbsp;Georges Karam,&nbsp;Jerome Rigaud,&nbsp;Loic Le Normand,&nbsp;Alain Ruffion,&nbsp;Brigitte Perrouin-Verbe,&nbsp;Marie-Aimee Perrouin-Verbe","doi":"10.1002/bco2.370","DOIUrl":"10.1002/bco2.370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aim of this study was to evaluate the indications and additional information provided by videourodynamic study (VUDS) over urodynamic studies (UDS) in men with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD). The secondary aim was to determine the added value of VUDS and its impact on bladder management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Single-centre retrospective study of all men with SCI who underwent VUDS between 2011 and 2021. Participant characteristics, clinical data and indications for UDS and VUDS as well as bladder management were recorded. The added value of VUDS was defined as additional information not provided by standard UDS that impacted on bladder management (choice of voiding mode, surgical indication or type of surgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-eight men with a median age of 52 years were included. In 20 men who were unable to perform self-catheterisation, the VUDS clarified the nature and extent of the obstruction and enabled targeted surgery to achieve reflex bladder emptying in all of them. VUDS also clarified the type and level of obstruction in 28 patients, enabling targeted surgery in 24. In 11 men, VUDS was performed as part of the preoperative assessment for a Brindley procedure or after this operation if a complication occurred during follow-up to confirm the need for further surgery or to target surgical revision. Overall, VUDS had added value in 59 patients (67%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VUDS had added value over UDS in specific situations; the additional information provided impacted on bladder management in men with SCI and NLUTD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"761-769"},"PeriodicalIF":1.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141669443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suction use in ureterorenoscopy: A systematic review and meta-analysis of comparative studies","authors":"Lazaros Tzelves,&nbsp;Robert Geraghty,&nbsp;Patrick Juliebø-Jones,&nbsp;Yuhong Yuan,&nbsp;Konstantinos Kapriniotis,&nbsp;Daniele Castellani,&nbsp;Vineet Gauhar,&nbsp;Andreas Skolarikos,&nbsp;Bhaskar Somani","doi":"10.1002/bco2.408","DOIUrl":"10.1002/bco2.408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Ureterorenoscopy is seeing a bloom of technological advances, one of which is incorporating suction. The objective of this study is to systematically review existing literature regarding suction use in rigid and flexible ureterorenoscopy and perform meta-analysis of studies comparing suction versus no suction ureteroscopy or mini percutaneous nephrolithotomy (PCNL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was performed (November 2023) in MEDLINE, Embase and Cochrane CENTRAL. Study protocol was registered at PROSPERO (CRD42023482360). Comparative studies (observational and randomized) were eligible for inclusion if they compared suction versus no suction group and reported at least one primary outcome of interest (stone-free or complication rate).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies (5 randomized and 11 observational), analysing 1086 and 1109 patients in standard and suction groups, respectively, were included. Final stone-free rates (SFRs), overall and infectious complications and length of hospital stay exhibited significant improvement when suction was used. When mini-PCNL was compared with flexible ureterorenoscopy with suction, no differences were found in terms of stone-free and infectious complications rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ureterorenoscopy is a commonly performed endoscopic procedure for urolithiasis treatment, the success of which is defined by SFRs and complication rates. Application of suction via ureteral access sheaths, ureteral catheters or scopes may provide improved SFRs, reduced overall and infectious complication rates, along with a reduction in length of hospital stay. Further randomized studies are needed to validate these findings and standardize indications and protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 10","pages":"895-912"},"PeriodicalIF":1.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging modalities for characterising T1 renal tumours: A systematic review and meta-analysis of diagnostic accuracy","authors":"Hannah Warren,&nbsp;Jack B. Fanshawe,&nbsp;Valerie Mok,&nbsp;Priyanka Iyer,&nbsp;Vinson Wai-Shun Chan,&nbsp;Richard Hesketh,&nbsp;Eleanor Zimmermann,&nbsp;Veeru Kasivisvanathan,&nbsp;Mark Emberton,&nbsp;Maxine G. B. Tran,&nbsp;Kurinchi Gurusamy","doi":"10.1002/bco2.355","DOIUrl":"https://doi.org/10.1002/bco2.355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>International guidelines recommend resection of suspected localised renal cell carcinoma (RCC), with surgical series showing benign pathology in 30%. Non-invasive diagnostic tests to differentiate benign from malignant tumours are an unmet need. Our objective was to determine diagnostic accuracy of imaging modalities for detecting cancer in T1 renal tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed for reports of diagnostic accuracy of any imaging test compared to a reference standard of histopathology for T1 renal masses, from inception until January 2023. Twenty-seven publications (including 2277 tumours in 2044 participants) were included in the systematic review, and nine in the meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forest plots of sensitivity and specificity were produced for CT (seven records, 1118 participants), contrast-enhanced ultrasound (seven records, 197 participants), [^99mTc]Tc-sestamibi SPECT/CT (five records, 263 participants), MRI (three records, 220 participants), [¹⁸F]FDG PET (four records, 43 participants), [⁶⁸Ga]Ga-PSMA-11 PET (one record, 27 participants) and [¹¹¹In]In-girentuximab SPECT/CT (one record, eight participants). Meta-analysis returned summary estimates of sensitivity and specificity for [^99mTc]Tc-sestamibi SPECT/CT of 88.6% (95% CI 82.7%–92.6%) and 77.0% (95% CI 63.0%–86.9%) and for [¹⁸F]FDG PET 53.5% (95% CI 1.6%–98.8%) and 62.5% (95% CI 14.0%–94.5%), respectively. A comparison hierarchical summary receiver operating characteristic (HSROC) model did not converge. Meta-analysis was not performed for other imaging due to different thresholds for test positivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The optimal imaging strategy for T1 renal masses is not clear. [^99mTc]Tc-sestamibi SPECT/CT is an emerging tool, but further studies are required to inform its role in clinical practice. The field would benefit from standardisation of diagnostic thresholds for CT, MRI and contrast-enhanced ultrasound to facilitate future meta-analyses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 7","pages":"636-650"},"PeriodicalIF":1.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141631240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle matters: Skeletal muscle index and body mass index impact on complications and survival in renal cancer","authors":"Alexander Hintze Hillers,&nbsp;Signe Wang Bach,&nbsp;Atena Saito,&nbsp;Nessn Azawi","doi":"10.1002/bco2.405","DOIUrl":"10.1002/bco2.405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to independently assess skeletal muscle index (SMI) and body mass index (BMI) as prognostic determinants for renal cell carcinoma (RCC) and investigate their correlation with surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>A retrospective cohort study of 524 RCC patients diagnosed between August 2010 and July 2018 was conducted using data from the Zealand University Hospital Renal Cancer Database in Denmark. Patient information was extracted from electronic patient records and the National Cancer Registry and encompassed demographics, clinical factors, tumour characteristics and surgical details. SMI was calculated from a single third lumbar vertebra (L3) axial computed tomography (CT) image via CoreSlicer software and classified into high using gender-specific thresholds. Primary outcomes focused on complications within 90 days as well as survival outcomes, and their relation with both SMI and BMI. Multivariable analysis assessed SMI's independent prognostic significance in RCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 524 patients, 18.5% experienced complications, with high SMI correlating significantly (<i>p</i> = 0.018) with a 72% higher complication risk. High SMI patients had a 22.7% complication rate compared to 14.5% in the low SMI group. High SMI was also linked to prolonged survival (110.95 vs. 94.87 months; <i>p</i> = 0.001), whereas BMI showed no significant survival differences (<i>p</i> = 0.326). Multivariable analysis (<i>n</i> = 522) revealed high SMI associated with improved survival (hazard ratio [HR] = 0.738; 95% CI, 0.548–0.994; <i>p</i> = 0.046). Advanced T-stage significantly impacted mortality (T2: HR = 2.057; T3: HR = 4.361; <i>p</i> &lt; 0.001), and each additional year of age raised mortality risk by 4.3% (HR = 1.043; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher SMI increases the risk of postoperative complications, yet it significantly improves overall survival rates. Different BMI categories lack RCC prognostic significance. The increasing incidence in RCC calls for the use of CT scan to assess SMI and aid treatment planning in patients who might benefit from preoperative interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"783-790"},"PeriodicalIF":1.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence patterns following nephrectomy for renal cell carcinoma in a Danish nationwide cohort","authors":"Goran Bencina,&nbsp;Rolf Billeskov,&nbsp;Rasmine Bak,&nbsp;Ahmed Al-Sabbagh,&nbsp;Julie Højgaard Pedersen,&nbsp;Marina Lunetcas,&nbsp;Emma Heeno,&nbsp;Sara Tolouee,&nbsp;Tuba Ashraf,&nbsp;Niels Fristrup,&nbsp;Nessn Azawi","doi":"10.1002/bco2.375","DOIUrl":"https://doi.org/10.1002/bco2.375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to characterize the demographic and clinical features of patients with renal cell carcinoma (RCC) post-surgery for localized or locally advanced disease in a national Danish cohort, with a specific focus on describing recurrence patterns in a subgroup aligned with the adjuvant KEYNOTE-564 trial classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of the Danish Renal Cancer (DaRenCa) database. Eligible subjects were individuals with an RCC diagnosis between January 2014 and December 2017 who subsequently underwent radical or partial nephrectomy. Variables of interest were demographic and clinical characteristics, rates and sites of recurrence. Recurrence rates were also assessed in a subpopulation stratified using the risk classifications of the KEYNOTE-564 trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2164 RCC patients were identified. Most patients (84.8%) had non-metastatic RCC (stage M0). A recurrence was observed in 250 of the M0 patients (13.6%). Patients with a recurrence were older, male, had a higher tumour stage, had undergone radical nephrectomy and had a higher Leibovich score. The majority (74.8%) of M0 patients had recurrence at distant metastatic sites. A total of 392 patients were stratified by the KEYNOTE-564 risk classification: 335 intermediate-high risk, 17 high risk and 40 M1 NED (metastatic with no evidence of disease). Recurrence was observed in 37.0%, 88.2% and 27.5% of these risk groups, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study elucidates the rates and determinants of post-surgical RCC recurrence in Denmark, underscoring the potential of adjuvant immunotherapy in refining therapeutic strategies, identifying suitable beneficiaries and minimizing overtreatment risks in RCC care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"791-798"},"PeriodicalIF":1.6,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}