Naeem Bhojani, Ben H. Chew, Samir Bhattacharyya, Amy E. Krambeck, Khurshid R. Ghani, Larry E. Miller
Objectives
This work aims to determine the efficacy and safety of preoperative alpha-blocker therapy on ureteroscopy (URS) outcomes.
Methods
In this systematic review and meta-analysis of randomised trials of URS with or without preoperative alpha-blocker therapy, outcomes included the need for ureteral dilatation, stone access failure, procedure time, residual stone rate, hospital stay, and complications. Residual stone rates were reported with and without adjustments for spontaneous stone passage, medication noncompliance, or adverse events leading to patient withdrawal. Data were analysed using random-effects meta-analysis and meta-regression. Certainty of evidence was assessed using the GRADE criteria.
Results
Among 15 randomised trials with 1653 patients, URS was effective and safe with a stone-free rate of 81.2% and rare (2.3%) serious complications. The addition of preoperative alpha-blockers reduced the need for ureteral dilatation (risk ratio [RR] = 0.48; 95% CI = 0.30 to 0.75; p = 0.002), access failure rate (RR = 0.36; 95% CI = 0.23 to 0.57; p < 0.001), procedure time (mean difference [MD] = −6 min; 95% CI = −8 to −3; p < 0.001), risk of residual stone in the primary (RR = 0.44; 95% CI = 0.33 to 0.66; p < 0.001) and adjusted (RR = 0.52; 95% CI = 0.40 to 0.68; p < 0.001) analyses, hospital stay (MD = −0.3 days; 95% CI = −0.4 to −0.1; p < 0.001), and complication rate (RR = 0.46; 95% CI = 0.35 to 0.59; p < 0.001). Alpha-blockers increased ejaculatory dysfunction risk and were less effective for renal/proximal ureter stones. The certainty of evidence was high or moderate for all outcomes. The main limitation of the review was inconsistency in residual stone assessment methods.
Conclusion
While URS is an effective and safe treatment for stone disease, preoperative alpha-blocker therapy is well tolerated and can further improve patient outcomes.
这项工作旨在确定术前α-受体阻滞剂治疗对输尿管镜检查（URS）结果的有效性和安全性。在这项系统性回顾和荟萃分析中，对有无术前α-受体阻滞剂治疗的URS随机试验进行了分析，结果包括输尿管扩张需求、取石失败、手术时间、残余结石率、住院时间和并发症。报告的残石率包括自发排石、不遵医嘱用药或导致患者退出手术的不良事件的调整值和未调整值。数据采用随机效应荟萃分析和荟萃回归进行分析。在15项随机试验的1653名患者中，URS有效且安全，无结石率为81.2%，严重并发症罕见（2.3%）。术前添加α-受体阻滞剂可减少输尿管扩张的需要（风险比 [RR] = 0.48；95% CI = 0.30 至 0.75；P = 0.002）、通路失败率（RR = 0.36；95% CI = 0.23 至 0.57；P < 0.001）、手术时间（平均差 [MD] = -6 分钟；95% CI = -8 至 -3；P < 0.001）、主要分析（RR = 0.44；95% CI = 0.33 至 0.66；P < 0.001）和调整分析（RR = 0.52；95% CI = 0.40 至 0.68；P < 0.001）中残留结石的风险、住院时间（MD = -0.3 天；95% CI = -0.4 至 -0.1；P < 0.001）和并发症发生率（RR = 0.46；95% CI = 0.35 至 0.59；P < 0.001）。α-受体阻滞剂会增加射精功能障碍的风险，对肾/近端输尿管结石的疗效较差。所有结果的证据确定性均为高或中等。虽然尿路结石治疗是一种有效而安全的结石病治疗方法，但术前α-受体阻滞剂治疗的耐受性良好，可进一步改善患者的预后。
{"title":"Effect of preoperative alpha-blockers on ureteroscopy outcomes: A meta-analysis of randomised trials","authors":"Naeem Bhojani, Ben H. Chew, Samir Bhattacharyya, Amy E. Krambeck, Khurshid R. Ghani, Larry E. Miller","doi":"10.1002/bco2.358","DOIUrl":"10.1002/bco2.358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aims to determine the efficacy and safety of preoperative alpha-blocker therapy on ureteroscopy (URS) outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this systematic review and meta-analysis of randomised trials of URS with or without preoperative alpha-blocker therapy, outcomes included the need for ureteral dilatation, stone access failure, procedure time, residual stone rate, hospital stay, and complications. Residual stone rates were reported with and without adjustments for spontaneous stone passage, medication noncompliance, or adverse events leading to patient withdrawal. Data were analysed using random-effects meta-analysis and meta-regression. Certainty of evidence was assessed using the GRADE criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 15 randomised trials with 1653 patients, URS was effective and safe with a stone-free rate of 81.2% and rare (2.3%) serious complications. The addition of preoperative alpha-blockers reduced the need for ureteral dilatation (risk ratio [RR] = 0.48; 95% CI = 0.30 to 0.75; <i>p</i> = 0.002), access failure rate (RR = 0.36; 95% CI = 0.23 to 0.57; <i>p</i> < 0.001), procedure time (mean difference [MD] = −6 min; 95% CI = −8 to −3; <i>p</i> < 0.001), risk of residual stone in the primary (RR = 0.44; 95% CI = 0.33 to 0.66; <i>p</i> < 0.001) and adjusted (RR = 0.52; 95% CI = 0.40 to 0.68; <i>p</i> < 0.001) analyses, hospital stay (MD = −0.3 days; 95% CI = −0.4 to −0.1; <i>p</i> < 0.001), and complication rate (RR = 0.46; 95% CI = 0.35 to 0.59; <i>p</i> < 0.001). Alpha-blockers increased ejaculatory dysfunction risk and were less effective for renal/proximal ureter stones. The certainty of evidence was high or moderate for all outcomes. The main limitation of the review was inconsistency in residual stone assessment methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While URS is an effective and safe treatment for stone disease, preoperative alpha-blocker therapy is well tolerated and can further improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 7","pages":"613-620"},"PeriodicalIF":1.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140748659","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}
Ryan Sutherland, Cary P. Gross, Xiaomei Ma, Farah Jeong, Tyler M. Seibert, Matthew R. Cooperberg, William J. Catalona, Shellie D. Ellis, Stacy Loeb, Dena Schulman-Green, Michael S. Leapman
Introduction
Although prostate magnetic resonance imaging (MRI) is commonly used in the diagnosis, staging and active surveillance of prostate cancer, little is known about patient perspectives on MRI.
Methods
We performed a qualitative study consisting of in-depth, semi-structured interviews of patients with low- and intermediate-risk prostate cancer managed with active surveillance. Interviews focused on experiences with and knowledge of prostate MRI and MRI-ultrasound fusion biopsy during active surveillance. We purposively sampled patients who received prostate MRI as part of their clinical care, conducted interviews until reaching thematic saturation and performed conventional content analysis to analyse data.
Results
Twenty patients aged 51–79 years (mean = 68 years) participated in the study. At diagnosis, 17 (85%) had a Gleason grade group 1, and three (15%) had a grade group 2 tumour. Overall, participants viewed prostate MRI as a valuable tool that accurately localizes and monitors prostate cancer over time, and they considered prostate MRI central to active surveillance monitoring. We identified five thematic categories related to MRI use: (1) the experiential aspects of undergoing an MRI scan; (2) the experience of visualizing one's own prostate and prostate cancer; (3) adequacy of provider explanations of MRI results; (4) confidence in prostate MRI in decision-making; and (5) the role of prostate MRI in longitudinal follow-up, including an interest in using MRI to modify the timing of, or replace, prostate biopsy.
Conclusion
Patients value prostate MRI as a tool that enhances their confidence in the initial diagnosis and monitoring of prostate cancer. This work can inform future studies to optimize patient experience, education and counselling during active surveillance for prostate cancer.
{"title":"‘It Just Makes Sense to Me’: A qualitative study exploring patient decision-making and experiences with prostate MRI during active surveillance for prostate cancer","authors":"Ryan Sutherland, Cary P. Gross, Xiaomei Ma, Farah Jeong, Tyler M. Seibert, Matthew R. Cooperberg, William J. Catalona, Shellie D. Ellis, Stacy Loeb, Dena Schulman-Green, Michael S. Leapman","doi":"10.1002/bco2.351","DOIUrl":"10.1002/bco2.351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although prostate magnetic resonance imaging (MRI) is commonly used in the diagnosis, staging and active surveillance of prostate cancer, little is known about patient perspectives on MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a qualitative study consisting of in-depth, semi-structured interviews of patients with low- and intermediate-risk prostate cancer managed with active surveillance. Interviews focused on experiences with and knowledge of prostate MRI and MRI-ultrasound fusion biopsy during active surveillance. We purposively sampled patients who received prostate MRI as part of their clinical care, conducted interviews until reaching thematic saturation and performed conventional content analysis to analyse data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty patients aged 51–79 years (mean = 68 years) participated in the study. At diagnosis, 17 (85%) had a Gleason grade group 1, and three (15%) had a grade group 2 tumour. Overall, participants viewed prostate MRI as a valuable tool that accurately localizes and monitors prostate cancer over time, and they considered prostate MRI central to active surveillance monitoring. We identified five thematic categories related to MRI use: (1) the experiential aspects of undergoing an MRI scan; (2) the experience of visualizing one's own prostate and prostate cancer; (3) adequacy of provider explanations of MRI results; (4) confidence in prostate MRI in decision-making; and (5) the role of prostate MRI in longitudinal follow-up, including an interest in using MRI to modify the timing of, or replace, prostate biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients value prostate MRI as a tool that enhances their confidence in the initial diagnosis and monitoring of prostate cancer. This work can inform future studies to optimize patient experience, education and counselling during active surveillance for prostate cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"593-601"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751513","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}
Henning Plage, Kira Furlano, Jörg Neymeyer, Sarah Weinberger, Benedikt Gerdes, Mandy Hubatsch, Bernhard Ralla, Antonia Franz, Annika Fendler, Michela de Martino, Florian Roßner, Simon Schallenberg, Sefer Elezkurtaj, Martina Kluth, Maximilian Lennartz, Niclas C. Blessin, Andreas H. Marx, Henrik Samtleben, Margit Fisch, Michael Rink, Krystian Kaczmarek, Thorsten Ecke, Steffen Hallmann, Stefan Koch, Nico Adamini, Sarah Minner, Ronald Simon, Guido Sauter, Joachim Weischenfeldt, Tobias Klatte, Thorsten Schlomm, David Horst, Henrik Zecha, Marcin Slojewski
Objectives
Carcinoembryonic antigen (CEA) is a cell surface glycoprotein that represents a promising therapeutic target. Serum measurement of shedded CEA can be utilized for monitoring of cancer patients.
Material and Methods
To evaluate the potential clinical significance of CEA expression in urothelial bladder neoplasms, CEA was analysed by immunohistochemistry in more than 2500 urothelial bladder carcinomas in a tissue microarray format.
Results
CEA staining was largely absent in normal urothelial cells but was observed in 30.4% of urothelial bladder carcinomas including 406 (16.7%) with weak, 140 (5.8%) with moderate, and 192 (7.9%) with strong staining. CEA positivity occurred in 10.9% of 411 pTaG2 low-grade, 32.0% of 178 pTaG2 high-grade, and 43.0% of 93 pTaG3 tumours (p < 0.0001). In 1335 pT2–4 carcinomas, CEA positivity (34.1%) was lower than in pTaG3 tumours. Within pT2–4 carcinomas, CEA staining was unrelated to pT, pN, grade, L-status, V-status, overall survival, recurrence free survival, and cancer specific survival (p > 0.25).
Conclusion
CEA increases markedly with grade progression in pTa tumours, and expression occurs in a significant fraction of pT2–4 urothelial bladder carcinomas. The high rate of CEA positivity in pT2–4 carcinomas offers the opportunity of using CEA serum measurement for monitoring the clinical course of these cancers. Moreover, CEA positive urothelial carcinomas are candidates for a treatment by targeted anti-CEA drugs.
癌胚抗原（CEA）是一种细胞表面糖蛋白，是一种很有前景的治疗靶标。为了评估 CEA 在尿路膀胱肿瘤中表达的潜在临床意义，我们采用组织芯片格式对 2500 多例尿路膀胱癌中的 CEA 进行了免疫组化分析。正常尿路细胞中基本没有 CEA 染色，但在 30.4% 的尿路膀胱癌中观察到了 CEA 染色，其中 406 例（16.7%）为弱染色，140 例（5.8%）为中度染色，192 例（7.9%）为强染色。在 411 例 pTaG2 低级别肿瘤中，CEA 阳性占 10.9%；在 178 例 pTaG2 高级别肿瘤中，CEA 阳性占 32.0%；在 93 例 pTaG3 肿瘤中，CEA 阳性占 43.0%（p 0.25）。pT2-4 癌症的 CEA 阳性率很高，这为使用 CEA 血清测量来监测这些癌症的临床病程提供了机会。此外，CEA 阳性的尿路上皮癌也是抗 CEA 靶向药物治疗的候选对象。
{"title":"CEA (CEACAM5) expression is common in muscle-invasive urothelial carcinoma of the bladder but unrelated to the disease course","authors":"Henning Plage, Kira Furlano, Jörg Neymeyer, Sarah Weinberger, Benedikt Gerdes, Mandy Hubatsch, Bernhard Ralla, Antonia Franz, Annika Fendler, Michela de Martino, Florian Roßner, Simon Schallenberg, Sefer Elezkurtaj, Martina Kluth, Maximilian Lennartz, Niclas C. Blessin, Andreas H. Marx, Henrik Samtleben, Margit Fisch, Michael Rink, Krystian Kaczmarek, Thorsten Ecke, Steffen Hallmann, Stefan Koch, Nico Adamini, Sarah Minner, Ronald Simon, Guido Sauter, Joachim Weischenfeldt, Tobias Klatte, Thorsten Schlomm, David Horst, Henrik Zecha, Marcin Slojewski","doi":"10.1002/bco2.354","DOIUrl":"10.1002/bco2.354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Carcinoembryonic antigen (CEA) is a cell surface glycoprotein that represents a promising therapeutic target. Serum measurement of shedded CEA can be utilized for monitoring of cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>To evaluate the potential clinical significance of CEA expression in urothelial bladder neoplasms, CEA was analysed by immunohistochemistry in more than 2500 urothelial bladder carcinomas in a tissue microarray format.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CEA staining was largely absent in normal urothelial cells but was observed in 30.4% of urothelial bladder carcinomas including 406 (16.7%) with weak, 140 (5.8%) with moderate, and 192 (7.9%) with strong staining. CEA positivity occurred in 10.9% of 411 pTaG2 low-grade, 32.0% of 178 pTaG2 high-grade, and 43.0% of 93 pTaG3 tumours (<i>p</i> < 0.0001). In 1335 pT2–4 carcinomas, CEA positivity (34.1%) was lower than in pTaG3 tumours. Within pT2–4 carcinomas, CEA staining was unrelated to pT, pN, grade, L-status, V-status, overall survival, recurrence free survival, and cancer specific survival (<i>p</i> > 0.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CEA increases markedly with grade progression in pTa tumours, and expression occurs in a significant fraction of pT2–4 urothelial bladder carcinomas. The high rate of CEA positivity in pT2–4 carcinomas offers the opportunity of using CEA serum measurement for monitoring the clinical course of these cancers. Moreover, CEA positive urothelial carcinomas are candidates for a treatment by targeted anti-CEA drugs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"585-592"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752840","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}
Patrick Juliebø-Jones, Vineet Gauhar, Ee Jean Lim, Olivier Traxer, Yesica Quiroz Madarriaga, Daniele Castellani, Khi Yung Fong, Anna Bujons, Deepak Ragoori, Anil Shrestha, Chandra Mohan Vaddi, Tanuj Paul Bhatia, Cagri Akin Sekerci, Yiloren Tanidir, Jeremy Yuen-Chun Teoh, Bhaskar Kumar Somani
Purpose
The aim of this study is to evaluate the outcomes of retrograde intra renal surgery (RIRS) in the setting of large or multiple stones in children (<18 years).
Materials and Methods
Retrospective analysis was performed of paediatric RIRS cases at nine centres worldwide over a 6-year period. Patients were divided into two groups: Group 1 had a single stone <15 mm. Group 2 had either multiple stones, maximum stone diameter of >15 mm, or both. Outcomes included stone free rate (SFR) and complications within 30 days.
Results
In total, 344 patients were included with 197 and 147 in Groups 1 and 2, respectively. Ureteric access sheaths were more frequently used in Group 2 (39.5% vs. 56.8%, p = 0.021). The operation time was significantly longer in Group 2 (p < 0.001). SFR after a single procedure was 84.7% in Group 1 and 63.7% in Group 2. Overall complication rates in Groups 1 and 2 were 7.6% and 33.3%, respectively. The most frequently reported complication in both groups was post-operative fever (4.4% vs. 14%, p = 0.004). The rate of Clavien I/II complications in groups 1 and 2 was 6% and 25.1%, respectively (p < 0.05). The rate of Clavien ≥ III complications in groups 1 and 2 was 1.6% and 8.1%, respectively (p < 0.05). On multivariate analysis, total operation time, stone size and multiplicity were significant predictors of residual fragments.
Conclusions
RIRS can be performed in paediatric cases with large and multiple stone burdens, but the complication rate is significantly higher when compared to smaller stones.
{"title":"Outcomes and considerations for retrograde intrarenal surgery (RIRS) in the setting of multiple and large renal stones (>15 mm) in children: Findings from multicentre and real-world setting","authors":"Patrick Juliebø-Jones, Vineet Gauhar, Ee Jean Lim, Olivier Traxer, Yesica Quiroz Madarriaga, Daniele Castellani, Khi Yung Fong, Anna Bujons, Deepak Ragoori, Anil Shrestha, Chandra Mohan Vaddi, Tanuj Paul Bhatia, Cagri Akin Sekerci, Yiloren Tanidir, Jeremy Yuen-Chun Teoh, Bhaskar Kumar Somani","doi":"10.1002/bco2.357","DOIUrl":"https://doi.org/10.1002/bco2.357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study is to evaluate the outcomes of retrograde intra renal surgery (RIRS) in the setting of large or multiple stones in children (<18 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Retrospective analysis was performed of paediatric RIRS cases at nine centres worldwide over a 6-year period. Patients were divided into two groups: Group 1 had a single stone <15 mm. Group 2 had either multiple stones, maximum stone diameter of >15 mm, or both. Outcomes included stone free rate (SFR) and complications within 30 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 344 patients were included with 197 and 147 in Groups 1 and 2, respectively. Ureteric access sheaths were more frequently used in Group 2 (39.5% vs. 56.8%, <i>p</i> = 0.021). The operation time was significantly longer in Group 2 (<i>p</i> < 0.001). SFR after a single procedure was 84.7% in Group 1 and 63.7% in Group 2. Overall complication rates in Groups 1 and 2 were 7.6% and 33.3%, respectively. The most frequently reported complication in both groups was post-operative fever (4.4% vs. 14%, <i>p</i> = 0.004). The rate of Clavien I/II complications in groups 1 and 2 was 6% and 25.1%, respectively (<i>p</i> < 0.05). The rate of Clavien ≥ III complications in groups 1 and 2 was 1.6% and 8.1%, respectively (<i>p</i> < 0.05). On multivariate analysis, total operation time, stone size and multiplicity were significant predictors of residual fragments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RIRS can be performed in paediatric cases with large and multiple stone burdens, but the complication rate is significantly higher when compared to smaller stones.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"558-563"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141315514","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}
Bülent Çetinel, Göktuğ Kalender, Elif Altınay Kırlı, Aydın Yenilmez, Ömer Gülpınar, Adnan Şimşir, Gökhan Temeltaş, Alkan Çubuk, Günay Can
Objective
To compare the functional (obstruction relieving) outcomes and complications of unilateral J-cut division, partial and subtotal vaginal removal techniques were performed for mesh-related urethral obstruction (MRUO) in females.
Methods
Patient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow-up data. Variables were compared between the three groups.
Results
Out of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow-up of 48 (17–96) months. Unilateral J-cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25–34), 40 (35–56) and 60 (60–70) minutes, respectively (p = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post-void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J-cut division, partial and subtotal removal groups, respectively (p = 0.007).
Conclusions
The unilateral J-cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (p = 0.001) and lower risk of de novo SUI (p = 0.007). Comparative studies with a larger number of patients are needed.
{"title":"Unilateral J-cut division versus partial and subtotal removal techniques in female patients with mesh-related urethral obstruction: Multicentric comparative study","authors":"Bülent Çetinel, Göktuğ Kalender, Elif Altınay Kırlı, Aydın Yenilmez, Ömer Gülpınar, Adnan Şimşir, Gökhan Temeltaş, Alkan Çubuk, Günay Can","doi":"10.1002/bco2.350","DOIUrl":"https://doi.org/10.1002/bco2.350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the functional (obstruction relieving) outcomes and complications of unilateral J-cut division, partial and subtotal vaginal removal techniques were performed for mesh-related urethral obstruction (MRUO) in females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow-up data. Variables were compared between the three groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow-up of 48 (17–96) months. Unilateral J-cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25–34), 40 (35–56) and 60 (60–70) minutes, respectively (<i>p</i> = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post-void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J-cut division, partial and subtotal removal groups, respectively (<i>p</i> = 0.007).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The unilateral J-cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (<i>p</i> = 0.001) and lower risk of de novo SUI (<i>p</i> = 0.007). Comparative studies with a larger number of patients are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"551-557"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141315443","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}
Malignant ureteral obstruction (MUO) is a frequent challenge for urologists. Patients have poor prognoses, treatment aims to improve quality-of-life while optimising renal function. Standard practice in the United Kingdom is to use polyurethane stents, which require frequent surgical replacements for blockages and encrustation. More durable metallic stents are available, although these incur an increased initial purchase price.
Aims
We aim to assess whether the use of polyurethane double-J (JJ) or metallic stent, Resonance® is more cost-effective for managing MUO in the UK healthcare setting.
Methods
A Markov model was parameterised to 5 years with costs and health-related quality-of-life consequences for treating MUO with Resonance metallic stent (Cook Medical), versus standard JJ stents, from the UK care system perspective, with 3.5% discounting. Deterministic and probabilistic sensitivity analyses were undertaken to assess the effect of uncertainty.
Results
Over 5 years, approximately four fewer repeat surgical interventions were estimated in the metallic stent arm compared with the JJ stent, driving a 23.4% reduction in costs. The mean estimates of costs and benefits indicate that treatment of MUO with Resonance for 5 years is dominant over JJ stents. Over 5 years a cost-saving of £2164.74 and a health gain of +0.046 quality-adjusted life years (QALYs) per patient is estimated. With a maximum willingness to pay of £20 k per QALY, a net monetary benefit (NMB) of £3077.83 is estimated. Probabilistic sensitivity analysis at a willingness to pay threshold of £20 000 indicates an 89.3% probability of Resonance being cost-effective over JJ stents. Within 1-year savings of £726.53 are estimated driven by a reduction of two fewer repeat surgical interventions when using the metallic stent.
Conclusions
Resonance metallic stents for the treatment of MUO reduce the number of repeat procedures and could be a cost-effective option for the treatment, potentially offering efficiencies to the healthcare system.
{"title":"Cost-effectiveness of Resonance® metallic ureteral stent compared with standard polyurethane ureteral stents in malignant ureteric obstruction: A cost-utility analysis","authors":"Dawn M. Cooper, Rachel Lines, Iqbal Shergill","doi":"10.1002/bco2.332","DOIUrl":"10.1002/bco2.332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malignant ureteral obstruction (MUO) is a frequent challenge for urologists. Patients have poor prognoses, treatment aims to improve quality-of-life while optimising renal function. Standard practice in the United Kingdom is to use polyurethane stents, which require frequent surgical replacements for blockages and encrustation. More durable metallic stents are available, although these incur an increased initial purchase price.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aim to assess whether the use of polyurethane double-J (JJ) or metallic stent, Resonance® is more cost-effective for managing MUO in the UK healthcare setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Markov model was parameterised to 5 years with costs and health-related quality-of-life consequences for treating MUO with Resonance metallic stent (Cook Medical), versus standard JJ stents, from the UK care system perspective, with 3.5% discounting. Deterministic and probabilistic sensitivity analyses were undertaken to assess the effect of uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 5 years, approximately four fewer repeat surgical interventions were estimated in the metallic stent arm compared with the JJ stent, driving a 23.4% reduction in costs. The mean estimates of costs and benefits indicate that treatment of MUO with Resonance for 5 years is dominant over JJ stents. Over 5 years a cost-saving of £2164.74 and a health gain of +0.046 quality-adjusted life years (QALYs) per patient is estimated. With a maximum willingness to pay of £20 k per QALY, a net monetary benefit (NMB) of £3077.83 is estimated. Probabilistic sensitivity analysis at a willingness to pay threshold of £20 000 indicates an 89.3% probability of Resonance being cost-effective over JJ stents. Within 1-year savings of £726.53 are estimated driven by a reduction of two fewer repeat surgical interventions when using the metallic stent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Resonance metallic stents for the treatment of MUO reduce the number of repeat procedures and could be a cost-effective option for the treatment, potentially offering efficiencies to the healthcare system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 5","pages":"465-475"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226297","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}
The objective of this study is to describe a standardised technique of full TOT removal with groin dissection and to report clinical improvement, satisfaction, safety and long-term functional, quality of life (QoL) and sexual QoL outcomes.
Materials and methods
A retrospective review enrolling all women who had full TOT removal, in a tertiary referral centre from May 2017 to November 2020. Functional outcomes, satisfaction and QoL were assessed using a bespoke composite questionnaire (UDI-6, EQ-5D-5L and ICIQ-S) with additional questions on sexual QoL. Secondary outcomes were post-operative recurrent stress urinary incontinence (SUI) and complication rate according to the Clavien-Dindo classification.
Results
Full TOT removal using a vaginal approach and bilateral groin/para-labial incisions was performed in 67 patients. Chronic pelvic pain was the main indication for mesh removal (51% of cases, n = 34). QoL questionnaires were answered by 43 patients. The satisfaction rate was high 86% (n = 37), and 81% (n = 35) of the patients considered the surgery successful. Seventy per cent (n = 30) of patients returned to having a sexual life after surgery. Recurrent SUI was reported in 32% (n = 14) of cases. The complication rate was 10% (7/67), all of them Clavien–Dindo ≤2.
Conclusion
Despite a high rate of postoperative bothersome SUI, full TOT removal with bilateral groin dissection improves pain and QoL. It is associated with a high overall satisfaction rate and an acceptable rate of complications.
本研究旨在描述一种腹股沟剥离全TOT切除术的标准化技术，并报告临床改善、满意度、安全性以及长期功能、生活质量（QoL）和性生活质量（QoL）结果。采用定制的综合问卷（UDI-6、EQ-5D-5L 和 ICIQ-S）对功能结果、满意度和 QoL 进行评估，并增加了有关性 QoL 的问题。根据克拉维恩-丁多（Clavien-Dindo）分类法，次要结果为术后复发性压力性尿失禁（SUI）和并发症发生率。慢性盆腔疼痛是切除网片的主要指征（51%的病例，n = 34）。43 名患者回答了 QoL 问卷。满意度高达 86%（37 人），81%（35 人）的患者认为手术成功。70%（30 人）的患者在术后恢复了性生活。据报告，32%的病例（14 例）出现了 SUI 复发。并发症发生率为10%（7/67），所有并发症的Clavien-Dindo指数均≤2。尽管术后尿频尿急的发生率很高，但通过双侧腹股沟切除术进行TOT全切可以改善疼痛和生活质量。其总体满意度高，并发症发生率可接受。
{"title":"Quality of life outcomes after transobturator tape full removal surgeries: A monocentric experience","authors":"Marie-Aimee Perrouin-Verbe, D-Carolina Ochoa, Rachel Skews, Mez Acharya, Antonin Prouza, Hashim Hashim","doi":"10.1002/bco2.317","DOIUrl":"10.1002/bco2.317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to describe a standardised technique of full TOT removal with groin dissection and to report clinical improvement, satisfaction, safety and long-term functional, quality of life (QoL) and sexual QoL outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>A retrospective review enrolling all women who had full TOT removal, in a tertiary referral centre from May 2017 to November 2020. Functional outcomes, satisfaction and QoL were assessed using a bespoke composite questionnaire (UDI-6, EQ-5D-5L and ICIQ-S) with additional questions on sexual QoL. Secondary outcomes were post-operative recurrent stress urinary incontinence (SUI) and complication rate according to the Clavien-Dindo classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Full TOT removal using a vaginal approach and bilateral groin/para-labial incisions was performed in 67 patients. Chronic pelvic pain was the main indication for mesh removal (51% of cases, <i>n</i> = 34). QoL questionnaires were answered by 43 patients. The satisfaction rate was high 86% (<i>n</i> = 37), and 81% (<i>n</i> = 35) of the patients considered the surgery successful. Seventy per cent (<i>n</i> = 30) of patients returned to having a sexual life after surgery. Recurrent SUI was reported in 32% (<i>n</i> = 14) of cases. The complication rate was 10% (7/67), all of them Clavien–Dindo ≤2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite a high rate of postoperative bothersome SUI, full TOT removal with bilateral groin dissection improves pain and QoL. It is associated with a high overall satisfaction rate and an acceptable rate of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 5","pages":"454-464"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225880","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}
Samuel Sii, Jeremy Bolton, Jake Tempo, Damien Bolton
Objective
To evaluate via a review of published literature, the efficacy of endoluminal ultrasound (ELUS) and optical coherence tomography (OCT) in the following ureteric diseases: urolithiasis, upper tract urothelial carcinoma, stricture disease and pelvic-ureteric junction obstruction (PUJO).
Patients and methods
Ureteric high-frequency ELUS provides 360° imaging, to a depth of 20 mm, and has been demonstrated to assess ureteric stricture length, degree of fibrosis and aetiology. OCT produces high-quality images with a penetration depth of 2 mm. ELUS has proven to be useful at the time of endopyelotomy for PUJO as it can identify crossing vessels, some not detectable on CT angiography, allowing the urologist to avoid these when making their incision. Ureteric ELUS may be utilised for submucosal ureteric stones as they are highly visible. Endoluminal ultrasound may be deployed in the case of known sub-mucosal urolithiasis when the ureter appears stone-free. It may help identify sub-mucosal stones or stones within diverticulum.
Results
Endoluminal ultrasound has been analysed for its use in determining muscle-invasive urothelial carcinoma of the ureter. The PPV for ≥pT2 was only 16.7% in one study of six patients with MIBC and 76.2% in 21 patients with <pT2 disease. Analysis of OCT for staging UTUC during ureteroscopy and biopsy demonstrated sensitivity for tumour invasion of 100% and specificity of 92%, 83% of lesion staging matched with histological analysis. Imaging analysis did not match histology in three patients with large exophytic tumours that exceeded the OCT depth penetration. Due to its superficial penetration, OCT cannot reliably stage large tumours.
Conclusions
Ureteric ELUS has been reported to be a useful tool in endopyelotomy, urolithiasis and stricture disease. The staging of ureteric urothelial carcinoma remains unsatisfactory with current imaging techniques and biopsy methods, and, based on the current literature, ELUS does not appear to have a strong enough PPV to determine muscle invasion. Ureteric OCT may be a useful tool in the future staging of upper tract urothelial carcinoma, particularly in differentiating the stage of small tumours. Further studies are needed in this area.
通过回顾已发表的文献，评估腔内超声（ELUS）和光学相干断层扫描（OCT）在以下输尿管疾病中的疗效：尿路结石、上尿路上皮癌、狭窄疾病和肾盂输尿管交界处梗阻（PUJO）。输尿管高频 ELUS 可提供深度达 20 毫米的 360° 成像，已被证实可评估输尿管狭窄长度、纤维化程度和病因。OCT 可生成穿透深度为 2 毫米的高质量图像。事实证明，ELUS 在对 PUJO 进行输尿管内切开术时非常有用，因为它可以识别交叉血管，有些交叉血管在 CT 血管造影中无法检测到，这样泌尿科医生在进行切开术时就可以避开这些血管。输尿管 ELUS 可用于粘膜下输尿管结石，因为这些结石非常明显。如果已知是粘膜下输尿管结石，但输尿管看起来没有结石，则可以使用腔内超声检查。对腔内超声在确定输尿管肌层浸润性尿路上皮癌方面的应用进行了分析。在一项对 6 名肌浸润性尿路上皮癌患者进行的研究中，≥pT2 的 PPV 仅为 16.7%，而在 21 名＜pT2 患者中，≥pT2 的 PPV 为 76.2%。在输尿管镜检查和活组织检查过程中对 OCT 进行UTUC 分期的分析表明，肿瘤侵犯的敏感性为 100%，特异性为 92%，83% 的病变分期与组织学分析相匹配。有三名患者的巨大外生肿瘤超过了 OCT 的穿透深度，成像分析与组织学分析不匹配。据报道，输尿管ELUS是输尿管内切开术、尿路结石和狭窄疾病的有用工具。目前的成像技术和活检方法对输尿管尿路上皮癌的分期仍不能令人满意，而且根据目前的文献，ELUS似乎没有足够强的PPV来确定肌肉侵犯。输尿管 OCT 可能是未来对上尿路尿路上皮癌进行分期的有用工具，尤其是在区分小肿瘤的分期方面。这方面还需要进一步研究。
{"title":"Contemporary status of diagnostic endoluminal ultrasound and optical coherence tomography in the ureter","authors":"Samuel Sii, Jeremy Bolton, Jake Tempo, Damien Bolton","doi":"10.1002/bco2.352","DOIUrl":"10.1002/bco2.352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate via a review of published literature, the efficacy of endoluminal ultrasound (ELUS) and optical coherence tomography (OCT) in the following ureteric diseases: urolithiasis, upper tract urothelial carcinoma, stricture disease and pelvic-ureteric junction obstruction (PUJO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Ureteric high-frequency ELUS provides 360° imaging, to a depth of 20 mm, and has been demonstrated to assess ureteric stricture length, degree of fibrosis and aetiology. OCT produces high-quality images with a penetration depth of 2 mm. ELUS has proven to be useful at the time of endopyelotomy for PUJO as it can identify crossing vessels, some not detectable on CT angiography, allowing the urologist to avoid these when making their incision. Ureteric ELUS may be utilised for submucosal ureteric stones as they are highly visible. Endoluminal ultrasound may be deployed in the case of known sub-mucosal urolithiasis when the ureter appears stone-free. It may help identify sub-mucosal stones or stones within diverticulum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Endoluminal ultrasound has been analysed for its use in determining muscle-invasive urothelial carcinoma of the ureter. The PPV for ≥pT2 was only 16.7% in one study of six patients with MIBC and 76.2% in 21 patients with <pT2 disease. Analysis of OCT for staging UTUC during ureteroscopy and biopsy demonstrated sensitivity for tumour invasion of 100% and specificity of 92%, 83% of lesion staging matched with histological analysis. Imaging analysis did not match histology in three patients with large exophytic tumours that exceeded the OCT depth penetration. Due to its superficial penetration, OCT cannot reliably stage large tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ureteric ELUS has been reported to be a useful tool in endopyelotomy, urolithiasis and stricture disease. The staging of ureteric urothelial carcinoma remains unsatisfactory with current imaging techniques and biopsy methods, and, based on the current literature, ELUS does not appear to have a strong enough PPV to determine muscle invasion. Ureteric OCT may be a useful tool in the future staging of upper tract urothelial carcinoma, particularly in differentiating the stage of small tumours. Further studies are needed in this area.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"514-523"},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230434","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}
Mohammed Shahait, Sarah Ibrahim, Laith Baqain, Zahi Abdul-Sater
Introduction
The use of focal therapies for prostate cancer (PCa) has soared, as it controls disease and is associated with minimal side effects. Bibliometric analysis examines the global research landscape on any topic to identify gaps in the research and areas for improvement and prioritize future research efforts. This study aims to examine the research outputs and trends and collaboration landscape in the field of focal therapy for PCa on a global scale.
Methods
We searched Medline, PubMed and Scopus for peer-reviewed publications on our research topic using controlled keywords. Search results were limited to the period between 1980 and 2022, screened for duplicates and then included in our study based on prespecified eligibility criteria. The Bibliometrix Package was used for comprehensive science mapping analysis of co-authorship, co-citation and co-occurrence analysis of countries, institutions, authors, references and keywords in this field.
Results
This analysis included 2578 research articles. The annual scientific production increased from one article in 1982 to 143 in 2022 (13.21%). The average citation per year was incrementally increasing, and these documents were cited around 32.52 times. The documents included in this analysis were published in 633 sources. The international collaboration index was 22.7. In total, 6280 author keywords were identified. The most used keywords were ‘prostate cancer’, ‘focal therapy’, ‘prostate’ and ‘photodynamic therapy’.
Conclusion
This bibliometric analysis has provided a comprehensive review of focal therapy in PCa research, highlighting both the significant growth in the field and the existing gaps that require further exploration. The study points to the need for more diverse international collaboration and exploration of various treatment modalities within the context of focal therapy.
{"title":"Bibliometric analysis of focal therapy in prostate cancer research","authors":"Mohammed Shahait, Sarah Ibrahim, Laith Baqain, Zahi Abdul-Sater","doi":"10.1002/bco2.353","DOIUrl":"10.1002/bco2.353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The use of focal therapies for prostate cancer (PCa) has soared, as it controls disease and is associated with minimal side effects. Bibliometric analysis examines the global research landscape on any topic to identify gaps in the research and areas for improvement and prioritize future research efforts. This study aims to examine the research outputs and trends and collaboration landscape in the field of focal therapy for PCa on a global scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched Medline, PubMed and Scopus for peer-reviewed publications on our research topic using controlled keywords. Search results were limited to the period between 1980 and 2022, screened for duplicates and then included in our study based on prespecified eligibility criteria. The Bibliometrix Package was used for comprehensive science mapping analysis of co-authorship, co-citation and co-occurrence analysis of countries, institutions, authors, references and keywords in this field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This analysis included 2578 research articles. The annual scientific production increased from one article in 1982 to 143 in 2022 (13.21%). The average citation per year was incrementally increasing, and these documents were cited around 32.52 times. The documents included in this analysis were published in 633 sources. The international collaboration index was 22.7. In total, 6280 author keywords were identified. The most used keywords were ‘prostate cancer’, ‘focal therapy’, ‘prostate’ and ‘photodynamic therapy’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This bibliometric analysis has provided a comprehensive review of focal therapy in PCa research, highlighting both the significant growth in the field and the existing gaps that require further exploration. The study points to the need for more diverse international collaboration and exploration of various treatment modalities within the context of focal therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"602-609"},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235496","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}
Olamide O. Omidele, Christopher Connors, Nikhil Wainganker, Ketan Badani, John Sfakianos, Reza Mehrazin, Isuru Jayaratna
Background
Renal neuroendocrine neoplasms (R-NEN) are exceptionally rare tumours characterized by high mortality rates.
Objective
The objective of this study is to analyse prognostic factors and treatment impact on overall survival in patients with R-NEN.
Design, setting and participants
We identified all patients with R-NEN in the National Cancer Database (NCDB) from 2004 to 2019 and identified prognostic factors for improved survival.
Results and limitations
Of 542 R-NEN cases, 166 (31%) were neuroendocrine tumour grade 1 (NET-G1), 14 (3%) were neuroendocrine tumour grade 2 (NET-G2), 169 (31%) were neuroendocrine carcinoma (NEC-NOS), 18 (3%) were large cell neuroendocrine carcinoma (LC-NEC) and 175 (32%) were small cell neuroendocrine carcinoma (SC-NEC). Median overall survival for all patients in the study was 44.88 months (SE, 4.265; 95% CI, 27.57–62.19). Median overall survival was 7.89 months (SE 0.67; 95% CI, 6.58–9.20) for patients without surgical intervention and 136.61 months (SE 16.44; 95% CI, 104.38–168.84, p < 0.001) for patients who underwent surgery. Increased age (HR, 1.05; 95% CI, 1.03–1.06; p < 0.001), T4 stage disease (HR, 3.17; 95% CI, 1.96–5.1; p < 0.001), NEC-NOS histology (HR, 2.82; 95% CI, 1.64–4.86; p < 0.001), LC-NEC histology (HR, 2.73; 95% CI, 1.04–7.17; p = 0.041) and SC-NEC histology (HR, 5.17; 95% CI, 2.95–9.05; p < 0.001) were all positive predictors of worsening overall survival. The main limitation of the study is its retrospective design.
Conclusion
R-NEN is an aggressive tumour characterized by high mortality rates. Surgery continues to be the mainstay of treatment and has shown to provide a survival benefit for most patients.
Patient Summary
R-NEN is composed of several tumour histologies that differ based on their aggressiveness with NEC-NOS and SC-NEC being the most lethal. Surgery, predominantly through minimally invasive approaches, is the mainstay of treatment and has a clear survival benefit.
{"title":"Prognostic factors and treatment impact on overall survival in patients with renal neuroendocrine tumour","authors":"Olamide O. Omidele, Christopher Connors, Nikhil Wainganker, Ketan Badani, John Sfakianos, Reza Mehrazin, Isuru Jayaratna","doi":"10.1002/bco2.341","DOIUrl":"10.1002/bco2.341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Renal neuroendocrine neoplasms (R-NEN) are exceptionally rare tumours characterized by high mortality rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to analyse prognostic factors and treatment impact on overall survival in patients with R-NEN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, setting and participants</h3>\u0000 \u0000 <p>We identified all patients with R-NEN in the National Cancer Database (NCDB) from 2004 to 2019 and identified prognostic factors for improved survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and limitations</h3>\u0000 \u0000 <p>Of 542 R-NEN cases, 166 (31%) were neuroendocrine tumour grade 1 (NET-G1), 14 (3%) were neuroendocrine tumour grade 2 (NET-G2), 169 (31%) were neuroendocrine carcinoma (NEC-NOS), 18 (3%) were large cell neuroendocrine carcinoma (LC-NEC) and 175 (32%) were small cell neuroendocrine carcinoma (SC-NEC). Median overall survival for all patients in the study was 44.88 months (SE, 4.265; 95% CI, 27.57–62.19). Median overall survival was 7.89 months (SE 0.67; 95% CI, 6.58–9.20) for patients without surgical intervention and 136.61 months (SE 16.44; 95% CI, 104.38–168.84, <i>p</i> < 0.001) for patients who underwent surgery. Increased age (HR, 1.05; 95% CI, 1.03–1.06; <i>p</i> < 0.001), T4 stage disease (HR, 3.17; 95% CI, 1.96–5.1; <i>p</i> < 0.001), NEC-NOS histology (HR, 2.82; 95% CI, 1.64–4.86; <i>p</i> < 0.001), LC-NEC histology (HR, 2.73; 95% CI, 1.04–7.17; <i>p</i> = 0.041) and SC-NEC histology (HR, 5.17; 95% CI, 2.95–9.05; <i>p</i> < 0.001) were all positive predictors of worsening overall survival. The main limitation of the study is its retrospective design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>R-NEN is an aggressive tumour characterized by high mortality rates. Surgery continues to be the mainstay of treatment and has shown to provide a survival benefit for most patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient Summary</h3>\u0000 \u0000 <p>R-NEN is composed of several tumour histologies that differ based on their aggressiveness with NEC-NOS and SC-NEC being the most lethal. Surgery, predominantly through minimally invasive approaches, is the mainstay of treatment and has a clear survival benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 6","pages":"576-584"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140253735","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}
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