Joep J de Jong, James A Proudfoot, Siamak Daneshmand, Robert S Svatek, Vikram Naryan, Ewan A Gibb, Elai Davicioni, Shreyas Joshi, Aaron Dahmen, Roger Li, Brant A Inman, Paras Shah, Iftach Chaplin, Jonathan Wright, Yair Lotan
Objective: To further evaluate a genomic classifier (GC) in a cohort of patients undergoing radical cystectomy (RC), as long non-coding RNA (lncRNA)-based genomic profiling has suggested utility in identifying a distinct tumour subgroup corresponding to a favourable prognosis in patients with bladder cancer.
Patients and methods: Transcriptome-wide expression profiling using Decipher Bladder was performed on transurethral resection of bladder tumour samples from a cohort of patients with high-grade, clinically organ-confined (cTa-T2N0M0) urothelial carcinoma (UC) who subsequently underwent RC without any neoadjuvant therapy (n = 226). The lncRNA-based luminal favourable status was determined using a previously developed GC. The primary endpoint was overall survival (OS) after RC. Secondary endpoints included cancer-specific mortality and upstaging at RC.
Results: In the study, 134 patients were clinical non-muscle-invasive bladder cancer (cTa/Tis/T1) and 92 patients were cT2. We identified 60 patients with luminal favourable subtype, all of which showed robust gene expression patterns associated with less aggressive bladder cancer biology. On multivariate analysis, patients with the luminal favourable subtype (vs without) were significantly associated with lower odds of upstaging to pathological (p)T3+ disease (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.12-0.82; P = 0.02), any upstaging (OR 0.41, 95% CI 0.20-0.83; P = 0.01), and any upstaging and/or pN+ (OR 0.50, 95% CI 0.25-1.00; P = 0.05). Luminal favourable bladder cancer was significantly associated with better OS (hazard ratio 0.33, 95% CI 0.15-0.74; P = 0.007).
Conclusions: This study validates the performance of the GC for identifying UCs with a luminal favourable subtype, harbouring less aggressive tumour biology.
{"title":"A luminal non-coding RNA-based genomic classifier confirms favourable outcomes in patients with clinically organ-confined bladder cancer treated with radical cystectomy.","authors":"Joep J de Jong, James A Proudfoot, Siamak Daneshmand, Robert S Svatek, Vikram Naryan, Ewan A Gibb, Elai Davicioni, Shreyas Joshi, Aaron Dahmen, Roger Li, Brant A Inman, Paras Shah, Iftach Chaplin, Jonathan Wright, Yair Lotan","doi":"10.1111/bju.16572","DOIUrl":"https://doi.org/10.1111/bju.16572","url":null,"abstract":"<p><strong>Objective: </strong>To further evaluate a genomic classifier (GC) in a cohort of patients undergoing radical cystectomy (RC), as long non-coding RNA (lncRNA)-based genomic profiling has suggested utility in identifying a distinct tumour subgroup corresponding to a favourable prognosis in patients with bladder cancer.</p><p><strong>Patients and methods: </strong>Transcriptome-wide expression profiling using Decipher Bladder was performed on transurethral resection of bladder tumour samples from a cohort of patients with high-grade, clinically organ-confined (cTa-T2N0M0) urothelial carcinoma (UC) who subsequently underwent RC without any neoadjuvant therapy (n = 226). The lncRNA-based luminal favourable status was determined using a previously developed GC. The primary endpoint was overall survival (OS) after RC. Secondary endpoints included cancer-specific mortality and upstaging at RC.</p><p><strong>Results: </strong>In the study, 134 patients were clinical non-muscle-invasive bladder cancer (cTa/Tis/T1) and 92 patients were cT2. We identified 60 patients with luminal favourable subtype, all of which showed robust gene expression patterns associated with less aggressive bladder cancer biology. On multivariate analysis, patients with the luminal favourable subtype (vs without) were significantly associated with lower odds of upstaging to pathological (p)T3+ disease (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.12-0.82; P = 0.02), any upstaging (OR 0.41, 95% CI 0.20-0.83; P = 0.01), and any upstaging and/or pN+ (OR 0.50, 95% CI 0.25-1.00; P = 0.05). Luminal favourable bladder cancer was significantly associated with better OS (hazard ratio 0.33, 95% CI 0.15-0.74; P = 0.007).</p><p><strong>Conclusions: </strong>This study validates the performance of the GC for identifying UCs with a luminal favourable subtype, harbouring less aggressive tumour biology.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Riccardo Bertolo, Riccardo Campi, Nicholas G Zaorsky, Alessandro Antonelli, Sergio Serni, Alessandro Crestani, Gianluca Giannarini
{"title":"Unravelling the evolution of medical scientific publishing to hold the promise of science for better patient care.","authors":"Riccardo Bertolo, Riccardo Campi, Nicholas G Zaorsky, Alessandro Antonelli, Sergio Serni, Alessandro Crestani, Gianluca Giannarini","doi":"10.1111/bju.16573","DOIUrl":"https://doi.org/10.1111/bju.16573","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mario de Angelis, Carolin Siech, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Nicola Longo, Felix K H Chun, Stefano Puliatti, Fred Saad, Shahrokh F Shariat, Giorgio Gandaglia, Marco Moschini, Mattia Longoni, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz
Objective: To conduct a population-based study examining cancer-specific mortality (CSM) and other-cause mortality (OCM) differences in patients with radiation-induced secondary bladder cancer (RT-BCa) vs those with primary bladder cancer (pBCa) undergoing radical cystectomy (RC).
Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients with T2-4N0-3M0 bladder cancer treated with RC, who had previously been treated with external beam radiation therapy (EBRT) or brachytherapy for prostate cancer, as well as patients with T2-4N0-3M0 pBCa treated with RC. Cumulative incidence plots and multivariable competing risks regression (CRR) models were used to assess CSM after additional adjustment for OCM. The same methodology was then repeated based on organ-confined (OC: T2N0M0) and non-organ-confined (NOC: T3-4 and/or N1-3) disease.
Results: Of 9957 RC patients, RT-BCa was identified in 347 (3%) compared with 9610 (97%) who had pBCa. In multivariable CRR models, no CSM differences were recorded in the overall comparison (P = 0.8), nor in sub-groups based on OC and NOC disease (P = 0.8 and 0.7, respectively). Conversely, multivariable CRR models identified RT-BCa as an independent predictor of 1.3-fold higher OCM in the overall cohort and of 1.5-fold higher OCM in those with NOC disease. In a sensitivity analysis of patients with NOC disease, EBRT was associated with higher OCM rates (hazard ratio 1.5). By contrast, OCM rates were not different in those with OC disease (P = 0.8).
Conclusion: Our study showed that RC for RT-BCa was associated with similar CSM rates as RC for pBCa, regardless of disease stage. However, patients who had undergone EBRT exhibited significantly higher OCM in the NOC sub-group.
{"title":"Mortality rates in radical cystectomy patients with bladder cancer after radiation therapy for prostate cancer.","authors":"Mario de Angelis, Carolin Siech, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Nicola Longo, Felix K H Chun, Stefano Puliatti, Fred Saad, Shahrokh F Shariat, Giorgio Gandaglia, Marco Moschini, Mattia Longoni, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz","doi":"10.1111/bju.16571","DOIUrl":"https://doi.org/10.1111/bju.16571","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a population-based study examining cancer-specific mortality (CSM) and other-cause mortality (OCM) differences in patients with radiation-induced secondary bladder cancer (RT-BCa) vs those with primary bladder cancer (pBCa) undergoing radical cystectomy (RC).</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients with T<sub>2-4</sub>N<sub>0-3</sub>M<sub>0</sub> bladder cancer treated with RC, who had previously been treated with external beam radiation therapy (EBRT) or brachytherapy for prostate cancer, as well as patients with T<sub>2-4</sub>N<sub>0-3</sub>M<sub>0</sub> pBCa treated with RC. Cumulative incidence plots and multivariable competing risks regression (CRR) models were used to assess CSM after additional adjustment for OCM. The same methodology was then repeated based on organ-confined (OC: T<sub>2</sub>N<sub>0</sub>M<sub>0</sub>) and non-organ-confined (NOC: T<sub>3-4</sub> and/or N<sub>1-3</sub>) disease.</p><p><strong>Results: </strong>Of 9957 RC patients, RT-BCa was identified in 347 (3%) compared with 9610 (97%) who had pBCa. In multivariable CRR models, no CSM differences were recorded in the overall comparison (P = 0.8), nor in sub-groups based on OC and NOC disease (P = 0.8 and 0.7, respectively). Conversely, multivariable CRR models identified RT-BCa as an independent predictor of 1.3-fold higher OCM in the overall cohort and of 1.5-fold higher OCM in those with NOC disease. In a sensitivity analysis of patients with NOC disease, EBRT was associated with higher OCM rates (hazard ratio 1.5). By contrast, OCM rates were not different in those with OC disease (P = 0.8).</p><p><strong>Conclusion: </strong>Our study showed that RC for RT-BCa was associated with similar CSM rates as RC for pBCa, regardless of disease stage. However, patients who had undergone EBRT exhibited significantly higher OCM in the NOC sub-group.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julian Peter Struck, Nadim Moharam, Armin Leitenberger, Jörg Weber, Lukas Lusuardi, David Oswald, Jens J. Rassweiler, Marcel Fiedler, Jakub Horňák, Marek Babjuk, Salvatore Micali, Carlo Zaraca, Thomas Spreu, Frank Friedersdorff, Hendrik Borgmann, Axel S. Merseburger, Mario W. Kramer
ObjectivesTo determine the safety and oncological advantages of en bloc resection of bladder tumour (ERBT) vs conventional transurethral resection of bladder tumour (cTURBT) in terms of resection quality, staging quality, and safety.Patients and MethodsWe conducted a single‐blinded randomised controlled trial at seven European hospitals with the following inclusion criteria: first diagnosis of non‐muscle‐invasive bladder cancer, no singular carcinoma in situ, and tumour size >4.3 mm. Patients were randomised intraoperatively in a 1:1 ratio to either the ERBT or cTURBT group. Outcome analysis was performed using the chi‐square test, t‐test, and multivariate regression analysis.ResultsA total of 97 patients were randomised into the study (cTURBT = 40, ERBT = 57). A switch to cTURBT was necessary in two patients (3.5%) and 11.5% of the screened patients were preoperatively excluded for ERBT. There was no difference in the specimen presence of detrusor muscle with 73.7% in cTURBT and 67.3% in ERBT specimens (P = 0.69). There were no significant differences in mean operative time (ERBT 27.6 vs cTURBT 25.4 min, P = 0.450) or mean resection time (ERBT 16.3 vs cTURBT 15.5 min, P = 0.732). Overall the complication rate did not differ significantly (ERBT 18.2% vs cTURBT 7.5%, P = 0.142). Bladder perforations occurred significantly more often in the ERBT group (ERBT seven vs cTURBT none, P = 0.020). R0 status was reported more often after ERBT, whilst a second resection was significantly less frequent after ERBT (P = 0.018). Recurrence rates were comparable for both techniques after 6 months of follow‐up.ConclusionThe feasibility of ERBT is higher than previously reported. Whereas other perioperative and safety parameters are comparable to cTURBT, bladder perforations occurred significantly more often in the ERBT group and raised safety concerns. This is why this trial was terminated.
{"title":"An international multicentre randomised controlled trial of en bloc resection of bladder tumour vs conventional transurethral resection of bladder tumour: first results of the en bloc resection of urothelium carcinoma of the bladder (EBRUC) II trial","authors":"Julian Peter Struck, Nadim Moharam, Armin Leitenberger, Jörg Weber, Lukas Lusuardi, David Oswald, Jens J. Rassweiler, Marcel Fiedler, Jakub Horňák, Marek Babjuk, Salvatore Micali, Carlo Zaraca, Thomas Spreu, Frank Friedersdorff, Hendrik Borgmann, Axel S. Merseburger, Mario W. Kramer","doi":"10.1111/bju.16543","DOIUrl":"https://doi.org/10.1111/bju.16543","url":null,"abstract":"ObjectivesTo determine the safety and oncological advantages of <jats:italic>en bloc</jats:italic> resection of bladder tumour (ERBT) vs conventional transurethral resection of bladder tumour (cTURBT) in terms of resection quality, staging quality, and safety.Patients and MethodsWe conducted a single‐blinded randomised controlled trial at seven European hospitals with the following inclusion criteria: first diagnosis of non‐muscle‐invasive bladder cancer, no singular carcinoma <jats:italic>in situ</jats:italic>, and tumour size >4.3 mm. Patients were randomised intraoperatively in a 1:1 ratio to either the ERBT or cTURBT group. Outcome analysis was performed using the chi‐square test, <jats:italic>t</jats:italic>‐test, and multivariate regression analysis.ResultsA total of 97 patients were randomised into the study (cTURBT = 40, ERBT = 57). A switch to cTURBT was necessary in two patients (3.5%) and 11.5% of the screened patients were preoperatively excluded for ERBT. There was no difference in the specimen presence of detrusor muscle with 73.7% in cTURBT and 67.3% in ERBT specimens (<jats:italic>P</jats:italic> = 0.69). There were no significant differences in mean operative time (ERBT 27.6 vs cTURBT 25.4 min, <jats:italic>P</jats:italic> = 0.450) or mean resection time (ERBT 16.3 vs cTURBT 15.5 min, <jats:italic>P</jats:italic> = 0.732). Overall the complication rate did not differ significantly (ERBT 18.2% vs cTURBT 7.5%, <jats:italic>P</jats:italic> = 0.142). Bladder perforations occurred significantly more often in the ERBT group (ERBT seven vs cTURBT none, <jats:italic>P</jats:italic> = 0.020). R0 status was reported more often after ERBT, whilst a second resection was significantly less frequent after ERBT (<jats:italic>P</jats:italic> = 0.018). Recurrence rates were comparable for both techniques after 6 months of follow‐up.ConclusionThe feasibility of ERBT is higher than previously reported. Whereas other perioperative and safety parameters are comparable to cTURBT, bladder perforations occurred significantly more often in the ERBT group and raised safety concerns. This is why this trial was terminated.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sohrab N. Ali, Amanda McCormac, Andrei D. Cumpanas, Jaime Altamirano-Villarroel, Paul Piedras, Minh-Chau Vu, Andrew S. Afyouni, Zachary E. Tano, Kathryn Osann, Michael Klopfer, Pengbo Jiang, Roshan M. Patel, Jaime Landman, Ralph V. Clayman
To define the natural distensibility of the human ureter and evaluate the impact of other possibly favourable factors on ureteric distensibility.
确定人体输尿管的自然伸缩性，并评估其他可能的有利因素对输尿管伸缩性的影响。
{"title":"Clinical determination of the natural distensibility of the human ureter: initial study","authors":"Sohrab N. Ali, Amanda McCormac, Andrei D. Cumpanas, Jaime Altamirano-Villarroel, Paul Piedras, Minh-Chau Vu, Andrew S. Afyouni, Zachary E. Tano, Kathryn Osann, Michael Klopfer, Pengbo Jiang, Roshan M. Patel, Jaime Landman, Ralph V. Clayman","doi":"10.1111/bju.16564","DOIUrl":"https://doi.org/10.1111/bju.16564","url":null,"abstract":"To define the natural distensibility of the human ureter and evaluate the impact of other possibly favourable factors on ureteric distensibility.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niklas Pakkasjärvi, Annaleena Anttila, Seppo Taskinen
{"title":"Reply to the letter by Atan, Sonmez, Karabulut and Turkyilmaz","authors":"Niklas Pakkasjärvi, Annaleena Anttila, Seppo Taskinen","doi":"10.1111/bju.16563","DOIUrl":"https://doi.org/10.1111/bju.16563","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jianliang Liu, Mrunal Hiwase, Dixon T.S. Woon, Benjamin Thomas, Ben Tran, Nathan Lawrentschuk
ObjectiveTo conduct a systematic review of the current literature to determine the current role of primary retroperitoneal lymph node dissection (RPLND) in stage II testicular seminoma and its associated oncological, functional and peri‐operative outcomes.Materials and MethodsA comprehensive literature search was conducted in Medline, Embase, and Scopus for publications from inception until November 2023. The systematic review was registered on PROSPERO (ID CRD42023449781), was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and utilised the Methodological Index for Non‐Randomised Studies (MINORS) tool.ResultsSix studies involving 385 patients were analysed, with 48.5% clinical stage IIA and 51.5% stage IIB seminomas. The patients’ mean (range) age was 37 (20–64) years. The median operation time was 187 min, median estimated blood loss was 150 mL and median length of hospital stay was 4 days. In all, 6.1% of patients developed complications that were greater or equal to Clavien–Dindo grade 3. Only four studies reported on anejaculation rate (median: 4.9%). Only one study had long‐term data, demonstrating a 92% 5‐year overall survival for stage IIA/B disease treated with RPLND. The remaining five studies had a median follow‐up of between 18.5 and 37 months and reported a mean recurrence rate of 15.6%. Most recurrences (78%) were not within the field of RPLND. Recurrence was associated with higher clinical and pathological lymph node stage, and metachronous or delayed development of retroperitoneal lymphadenopathy (initially stage I disease, as opposed to de novo stage IIA/B disease).DiscussionPrimary RPLND, performed by experienced surgeons, has good peri‐operative outcomes. Recurrence is more common than with standard treatment, but long‐term survival and functional data are limited, although promising.
{"title":"Primary retroperitoneal lymph node dissection in stage II testicular seminoma: a systematic review","authors":"Jianliang Liu, Mrunal Hiwase, Dixon T.S. Woon, Benjamin Thomas, Ben Tran, Nathan Lawrentschuk","doi":"10.1111/bju.16536","DOIUrl":"https://doi.org/10.1111/bju.16536","url":null,"abstract":"ObjectiveTo conduct a systematic review of the current literature to determine the current role of primary retroperitoneal lymph node dissection (RPLND) in stage II testicular seminoma and its associated oncological, functional and peri‐operative outcomes.Materials and MethodsA comprehensive literature search was conducted in Medline, Embase, and Scopus for publications from inception until November 2023. The systematic review was registered on PROSPERO (ID CRD42023449781), was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and utilised the Methodological Index for Non‐Randomised Studies (MINORS) tool.ResultsSix studies involving 385 patients were analysed, with 48.5% clinical stage IIA and 51.5% stage IIB seminomas. The patients’ mean (range) age was 37 (20–64) years. The median operation time was 187 min, median estimated blood loss was 150 mL and median length of hospital stay was 4 days. In all, 6.1% of patients developed complications that were greater or equal to Clavien–Dindo grade 3. Only four studies reported on anejaculation rate (median: 4.9%). Only one study had long‐term data, demonstrating a 92% 5‐year overall survival for stage IIA/B disease treated with RPLND. The remaining five studies had a median follow‐up of between 18.5 and 37 months and reported a mean recurrence rate of 15.6%. Most recurrences (78%) were not within the field of RPLND. Recurrence was associated with higher clinical and pathological lymph node stage, and metachronous or delayed development of retroperitoneal lymphadenopathy (initially stage I disease, as opposed to <jats:italic>de novo</jats:italic> stage IIA/B disease).DiscussionPrimary RPLND, performed by experienced surgeons, has good peri‐operative outcomes. Recurrence is more common than with standard treatment, but long‐term survival and functional data are limited, although promising.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Hinojosa‐Gonzalez, Christina Kottooran, Jennifer Saunders, Erin L. Chaussee, Jay Budrewicz, Brian H. Eisner
ObjectiveTo evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.Materials and MethodsIn anaesthetised pigs, a 1‐h ureteroscopy was performed using a pressure‐sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 107 colony‐forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.ResultsIn 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.ConclusionIn this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.
{"title":"Relationship between renal pelvis pressure and post‐ureteroscopy infection in a live swine model","authors":"David Hinojosa‐Gonzalez, Christina Kottooran, Jennifer Saunders, Erin L. Chaussee, Jay Budrewicz, Brian H. Eisner","doi":"10.1111/bju.16539","DOIUrl":"https://doi.org/10.1111/bju.16539","url":null,"abstract":"ObjectiveTo evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.Materials and MethodsIn anaesthetised pigs, a 1‐h ureteroscopy was performed using a pressure‐sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic <jats:italic>Escherichia coli</jats:italic> strain CFT073 (1.5 × 10<jats:sup>7</jats:sup> colony‐forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.ResultsIn 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (<jats:italic>n</jats:italic> = 3); 75 mmHg with saline irrigation (<jats:italic>n</jats:italic> = 4); 37 mmHg with saline irrigation with 1.5 × 10<jats:sup>7</jats:sup> CFU/mL <jats:italic>E. coli</jats:italic> (<jats:italic>n</jats:italic> = 7); and 75 mmHg with saline irrigation with 1.5 × 10<jats:sup>7</jats:sup> CFU/mL <jats:italic>E. coli</jats:italic> (<jats:italic>n</jats:italic> = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + <jats:italic>E. coli</jats:italic> and were significantly elevated compared with the control group and the group receiving <jats:italic>E. coli</jats:italic> irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with <jats:italic>E. coli</jats:italic> at 75 mmHg; no others developed bacteraemia.ConclusionIn this swine model of ureteroscopy, irrigation with saline + <jats:italic>E. coli</jats:italic> at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both <jats:italic>E. coli</jats:italic> irrigation with renal pelvis pressure maintained at 37 mmHg and the control.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savannah Starr, Jj Zhang, Lin Lin, Jolie Shen, Giovanni Gamalong, Mark S. Litwin, Alexandra Drakaki, Karim Chamie
To evaluate the effects of socioeconomic factors, including insurance status, on treatment and survival for patients with testicular cancer.
评估社会经济因素（包括保险状况）对睾丸癌患者的治疗和生存期的影响。
{"title":"Insurance remains a major source of disparity for patients with testicular cancer: call for advocacy","authors":"Savannah Starr, Jj Zhang, Lin Lin, Jolie Shen, Giovanni Gamalong, Mark S. Litwin, Alexandra Drakaki, Karim Chamie","doi":"10.1111/bju.16568","DOIUrl":"https://doi.org/10.1111/bju.16568","url":null,"abstract":"To evaluate the effects of socioeconomic factors, including insurance status, on treatment and survival for patients with testicular cancer.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号