Andrew M. Fang, Justin R. Gregg, Curtis Pettaway, Jingfei Ma, Janio Szklaruk, Tharakeswara K. Bathala, Devaki Shilpa S. Surasi, Brian F. Chapin
ObjectiveTo present a narrative review regarding the diagnostic accuracy of whole‐body magnetic resonance imaging (WBMRI) in staging patients with high‐risk prostate cancer (HRPCa) and compare it to established imaging modalities.MethodsA narrative review was carried out using PubMed using the following keywords: ‘whole body’, ‘magnetic resonance imaging’, ‘MRI’, ‘prostate cancer’, ‘risk stratification’, and ‘staging’. Articles that evaluated WBMRI as the imaging modality to stage patients with HRPCa were included, while studies that solely assessed for biochemical recurrence or metastatic disease progression were excluded.ResultsIn the evaluation of lymphatic metastases, WBMRI has demonstrated a comparable, if not improved, sensitivity and specificity compared to conventional imaging of computed tomography (CT). Furthermore, WBMRI demonstrates improved sensitivity and specificity in detecting bone metastases compared to bone scintigraphy (BS). However, with advent of prostate‐specific membrane antigen (PSMA) radioligands for positron emission tomography (PET), the diagnostic performance of WBMRI to detect metastatic disease appears inferior.ConclusionsThe diagnostic capabilities of WBMRI exceed that of conventional imaging of CT and BS in detecting metastatic disease in patients with HRPCa. However, WBMRI does not perform as well as PSMA PET/CT. Further study on cost comparisons between WBMRI and PSMA PET/CT are needed, as well as evaluations of combined PSMA PET/MRI are needed.
{"title":"Whole‐body MRI for staging prostate cancer: a narrative review","authors":"Andrew M. Fang, Justin R. Gregg, Curtis Pettaway, Jingfei Ma, Janio Szklaruk, Tharakeswara K. Bathala, Devaki Shilpa S. Surasi, Brian F. Chapin","doi":"10.1111/bju.16514","DOIUrl":"https://doi.org/10.1111/bju.16514","url":null,"abstract":"ObjectiveTo present a narrative review regarding the diagnostic accuracy of whole‐body magnetic resonance imaging (WBMRI) in staging patients with high‐risk prostate cancer (HRPCa) and compare it to established imaging modalities.MethodsA narrative review was carried out using PubMed using the following keywords: ‘whole body’, ‘magnetic resonance imaging’, ‘MRI’, ‘prostate cancer’, ‘risk stratification’, and ‘staging’. Articles that evaluated WBMRI as the imaging modality to stage patients with HRPCa were included, while studies that solely assessed for biochemical recurrence or metastatic disease progression were excluded.ResultsIn the evaluation of lymphatic metastases, WBMRI has demonstrated a comparable, if not improved, sensitivity and specificity compared to conventional imaging of computed tomography (CT). Furthermore, WBMRI demonstrates improved sensitivity and specificity in detecting bone metastases compared to bone scintigraphy (BS). However, with advent of prostate‐specific membrane antigen (PSMA) radioligands for positron emission tomography (PET), the diagnostic performance of WBMRI to detect metastatic disease appears inferior.ConclusionsThe diagnostic capabilities of WBMRI exceed that of conventional imaging of CT and BS in detecting metastatic disease in patients with HRPCa. However, WBMRI does not perform as well as PSMA PET/CT. Further study on cost comparisons between WBMRI and PSMA PET/CT are needed, as well as evaluations of combined PSMA PET/MRI are needed.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276941","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}
Letizia Maria Ippolita Jannello, Franco Orsi, Stefano Luzzago, Giovanni Mauri, Francesco A. Mistretta, Mattia Luca Piccinelli, Chiara Vaccaro, Marco Tozzi, Daniele Maiettini, Gianluca Varano, Stefano Caramella, Paolo Della Vigna, Matteo Ferro, Guido Bonomo, Zhe Tian, Pierre I. Karakiewicz, Ottavio De Cobelli, Gennaro Musi
ObjectiveTo conduct a comprehensive comparison of microwave ablation (MWA) vs radiofrequency ablation (RFA) outcomes in the treatment of small renal masses (SRMs), specifically: TRIFECTA ([i] complete ablation, [ii] absence of Clavien–Dindo Grade ≥III complications, and [iii] absence of ≥30% decrease in estimated glomerular filtration rate) achievement, operative time (OT), and local recurrence rate (LRR).Patients and MethodsWe retrospectively analysed 531 patients with SRMs (clinical T1a–b) treated with MWA or RFA at a single centre (2008–2022). First, multivariable logistic regression models were used for testing TRIFECTA achievement. Second, multivariable Poisson regression models were used to evaluate variables associated with longer OT. Finally, Kaplan–Meier plots depicted LRR over time. All analyses were repeated after 1:1 propensity score matching (PSM).ResultsOf 531 patients with SRMs, 373/531 (70.2%) underwent MWA and 158/531 (29.8%) RFA. MWA demonstrated superior TRIFECTA achievement (314/373 [84.2%]) compared to RFA (114/158 [72.2%], P = 0.001). These differences were driven by higher rates of complete ablation in MWA‐ vs RFA‐treated patients (348/373 [93.3%] vs 137/158 [86.7%], P < 0.001). In multivariable logistic regression models, MWA was associated with higher TRIFECTA achievement, compared to RFA, before (odds ratio [OR] 1.92, P = 0.008) and after PSM (OR 1.99, P = 0.023). Finally, the median OT was shorter for MWA vs RFA (105 vs 115 min; P = 0.002). At Poisson regression analyses, MWA predicted shorter OT before (incidence rate ratio [IRR] 0.86, P < 0.001) and after PSM (IRR 0.85, P < 0.001). Local recurrence occurred in 17/373 (4.6%) MWA‐treated patients and 21/158 (13.3%) RFA‐treated patients (P = 0.29) after a median (interquartile range) follow‐up of 24 (8–46) months. There were no differences in the LRR in Kaplan–Meier plots before (P = 0.29) and after PSM (P = 0.42).ConclusionMicrowave ablation provides higher TRIFECTA achievement, and shorter OT than RFA. No significant differences were found regarding the LRR.
{"title":"Microwave vs radiofrequency ablation for small renal masses: perioperative and oncological outcomes","authors":"Letizia Maria Ippolita Jannello, Franco Orsi, Stefano Luzzago, Giovanni Mauri, Francesco A. Mistretta, Mattia Luca Piccinelli, Chiara Vaccaro, Marco Tozzi, Daniele Maiettini, Gianluca Varano, Stefano Caramella, Paolo Della Vigna, Matteo Ferro, Guido Bonomo, Zhe Tian, Pierre I. Karakiewicz, Ottavio De Cobelli, Gennaro Musi","doi":"10.1111/bju.16528","DOIUrl":"https://doi.org/10.1111/bju.16528","url":null,"abstract":"ObjectiveTo conduct a comprehensive comparison of microwave ablation (MWA) vs radiofrequency ablation (RFA) outcomes in the treatment of small renal masses (SRMs), specifically: TRIFECTA ([i] complete ablation, [ii] absence of Clavien–Dindo Grade ≥III complications, and [iii] absence of ≥30% decrease in estimated glomerular filtration rate) achievement, operative time (OT), and local recurrence rate (LRR).Patients and MethodsWe retrospectively analysed 531 patients with SRMs (clinical T1a–b) treated with MWA or RFA at a single centre (2008–2022). First, multivariable logistic regression models were used for testing TRIFECTA achievement. Second, multivariable Poisson regression models were used to evaluate variables associated with longer OT. Finally, Kaplan–Meier plots depicted LRR over time. All analyses were repeated after 1:1 propensity score matching (PSM).ResultsOf 531 patients with SRMs, 373/531 (70.2%) underwent MWA and 158/531 (29.8%) RFA. MWA demonstrated superior TRIFECTA achievement (314/373 [84.2%]) compared to RFA (114/158 [72.2%], <jats:italic>P</jats:italic> = 0.001). These differences were driven by higher rates of complete ablation in MWA‐ vs RFA‐treated patients (348/373 [93.3%] vs 137/158 [86.7%], <jats:italic>P</jats:italic> < 0.001). In multivariable logistic regression models, MWA was associated with higher TRIFECTA achievement, compared to RFA, before (odds ratio [OR] 1.92, <jats:italic>P</jats:italic> = 0.008) and after PSM (OR 1.99, <jats:italic>P</jats:italic> = 0.023). Finally, the median OT was shorter for MWA vs RFA (105 vs 115 min; <jats:italic>P</jats:italic> = 0.002). At Poisson regression analyses, MWA predicted shorter OT before (incidence rate ratio [IRR] 0.86, <jats:italic>P</jats:italic> < 0.001) and after PSM (IRR 0.85, <jats:italic>P</jats:italic> < 0.001). Local recurrence occurred in 17/373 (4.6%) MWA‐treated patients and 21/158 (13.3%) RFA‐treated patients (<jats:italic>P</jats:italic> = 0.29) after a median (interquartile range) follow‐up of 24 (8–46) months. There were no differences in the LRR in Kaplan–Meier plots before (<jats:italic>P</jats:italic> = 0.29) and after PSM (<jats:italic>P</jats:italic> = 0.42).ConclusionMicrowave ablation provides higher TRIFECTA achievement, and shorter OT than RFA. No significant differences were found regarding the LRR.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236360","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}
Steven M. Monda, Benjamin W. Carney, Allison M. May, Shuchi Gulati, Simpa S. Salami, Thenappan Chandrasekar, Evan T. Keller, Nicolai A. Huebner, Ganesh S. Palapattu, Marc A. Dall'Era
ObjectiveTo assess the distribution of key mutations across tumour sizes in clear‐cell renal cell carcinoma (ccRCC), and secondarily to examine the prognostic impact of aggressive mutations in smaller ccRCCs.Patient and MethodsThe distribution of mutations (VHL, PBRM1, SETD2, BAP1 and CDKN2A loss) across tumour sizes was assessed in 1039 ccRCCs treated with nephrectomy in cohorts obtained from the Tracking Cancer Evolution (TRACERx), The Cancer Genome Atlas (TCGA) and the Cancer Genomics of the Kidney (CAGEKID) projects. Logistic regression was used to model the presence of each mutation against size. In our secondary analysis, we assessed a subset of ccRCCs ≤7 cm for associations of key aggressive mutations (SETD2, BAP1, and CDKN2A loss) with metastasis, invasive disease and overall survival, while controlling for size. A subset of localised tumours ≤7 cm was also used to assess associations with recurrence after nephrectomy.ResultsOn logistic regression, each 1‐cm increase in tumour size was associated with aggressive mutations, SETD2, BAP1, and CDKN2A loss, at odds ratios (ORs) of 1.09, 1.10 and 1.19 (P < 0.001), whereas no significant association was observed between tumour size and PBRM1 (OR 1.02; P = 0.23). VHL was mildly negatively associated with a 1‐cm increase in size (OR 0.95; P = 0.01). Among tumours ≤7 cm, SETD2 and CDKN2A loss were associated with metastatic disease at ORs of 3.86 and 3.84 (P < 0.05) while controlling for tumour size. CDKN2A loss was associated with worse overall survival, with a hazard ratio (HR) of 2.19 (P = 0.03). Among localised tumours ≤7 cm, SETD2 was associated with worse recurrence‐free survival (HR 2.00; P = 0.03).ConclusionLarge and small ccRCCs are genomically different. Aggressive mutations, namely, SETD2, BAP1, and CDKN2A loss, are rarely observed in small ccRCCs and are observed more frequently in larger tumours. However, when present in tumours ≤7 cm, SETD2 mutations and CDKN2A loss were still independently associated with invasive disease, metastasis, worse survival, and recurrence after resection, after controlling for size.
{"title":"Differences in mutations across tumour sizes in clear‐cell renal cell carcinoma","authors":"Steven M. Monda, Benjamin W. Carney, Allison M. May, Shuchi Gulati, Simpa S. Salami, Thenappan Chandrasekar, Evan T. Keller, Nicolai A. Huebner, Ganesh S. Palapattu, Marc A. Dall'Era","doi":"10.1111/bju.16527","DOIUrl":"https://doi.org/10.1111/bju.16527","url":null,"abstract":"ObjectiveTo assess the distribution of key mutations across tumour sizes in clear‐cell renal cell carcinoma (ccRCC), and secondarily to examine the prognostic impact of aggressive mutations in smaller ccRCCs.Patient and MethodsThe distribution of mutations (<jats:italic>VHL</jats:italic>, <jats:italic>PBRM1</jats:italic>, <jats:italic>SETD2</jats:italic>, <jats:italic>BAP1</jats:italic> and <jats:italic>CDKN2A</jats:italic> loss) across tumour sizes was assessed in 1039 ccRCCs treated with nephrectomy in cohorts obtained from the Tracking Cancer Evolution (TRACERx), The Cancer Genome Atlas (TCGA) and the Cancer Genomics of the Kidney (CAGEKID) projects. Logistic regression was used to model the presence of each mutation against size. In our secondary analysis, we assessed a subset of ccRCCs ≤7 cm for associations of key aggressive mutations (<jats:italic>SETD2</jats:italic>, <jats:italic>BAP1</jats:italic>, and <jats:italic>CDKN2A</jats:italic> loss) with metastasis, invasive disease and overall survival, while controlling for size. A subset of localised tumours ≤7 cm was also used to assess associations with recurrence after nephrectomy.ResultsOn logistic regression, each 1‐cm increase in tumour size was associated with aggressive mutations, <jats:italic>SETD2</jats:italic>, <jats:italic>BAP1</jats:italic>, and <jats:italic>CDKN2A</jats:italic> loss, at odds ratios (ORs) of 1.09, 1.10 and 1.19 (<jats:italic>P</jats:italic> < 0.001), whereas no significant association was observed between tumour size and <jats:italic>PBRM1</jats:italic> (OR 1.02; <jats:italic>P</jats:italic> = 0.23). <jats:italic>VHL</jats:italic> was mildly negatively associated with a 1‐cm increase in size (OR 0.95; <jats:italic>P</jats:italic> = 0.01). Among tumours ≤7 cm, <jats:italic>SETD2</jats:italic> and <jats:italic>CDKN2A</jats:italic> loss were associated with metastatic disease at ORs of 3.86 and 3.84 (<jats:italic>P</jats:italic> < 0.05) while controlling for tumour size. <jats:italic>CDKN2A</jats:italic> loss was associated with worse overall survival, with a hazard ratio (HR) of 2.19 (<jats:italic>P</jats:italic> = 0.03). Among localised tumours ≤7 cm, <jats:italic>SETD2</jats:italic> was associated with worse recurrence‐free survival (HR 2.00; <jats:italic>P</jats:italic> = 0.03).ConclusionLarge and small ccRCCs are genomically different. Aggressive mutations, namely, <jats:italic>SETD2</jats:italic>, <jats:italic>BAP1</jats:italic>, and <jats:italic>CDKN2A</jats:italic> loss, are rarely observed in small ccRCCs and are observed more frequently in larger tumours. However, when present in tumours ≤7 cm, <jats:italic>SETD2</jats:italic> mutations and <jats:italic>CDKN2A</jats:italic> loss were still independently associated with invasive disease, metastasis, worse survival, and recurrence after resection, after controlling for size.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174731","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}
Francesco Ditonno, Antonio Franco, Zhenjie Wu, Linhui Wang, Firas Abdollah, Giuseppe Simone, Andres F. Correa, Matteo Ferro, Sisto Perdonà, Daniele Amparore, Raj Bhanvadia, Stephan Brönimann, Dhruv Puri, Dinno F. Mendiola, Reuben Ben-David, Sol C. Moon, Courtney Yong, Farshad S. Moghaddam, Alireza Ghoreifi, Eugenio Bologna, Leslie Claire Licari, Marco Finati, Gabriele Tuderti, Emma Helstrom, Marco Tozzi, Antonio Tufano, Soroush Rais-Bahrami, Chandru P. Sundaram, Reza Mehrazin, Mark L. Gonzalgo, Ithaar H. Derweesh, Francesco Porpiglia, Nirmish Singla, Vitaly Margulis, Alessandro Antonelli, Hooman Djaladat, Riccardo Autorino
To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.
在当代大型多机构环境中分析机器人辅助肾切除术（RANU）的手术、功能和中期肿瘤治疗效果。
{"title":"Robot-assisted nephroureterectomy: surgical and mid-term oncological outcomes in over 1100 patients (ROBUUST 2.0 collaborative group)","authors":"Francesco Ditonno, Antonio Franco, Zhenjie Wu, Linhui Wang, Firas Abdollah, Giuseppe Simone, Andres F. Correa, Matteo Ferro, Sisto Perdonà, Daniele Amparore, Raj Bhanvadia, Stephan Brönimann, Dhruv Puri, Dinno F. Mendiola, Reuben Ben-David, Sol C. Moon, Courtney Yong, Farshad S. Moghaddam, Alireza Ghoreifi, Eugenio Bologna, Leslie Claire Licari, Marco Finati, Gabriele Tuderti, Emma Helstrom, Marco Tozzi, Antonio Tufano, Soroush Rais-Bahrami, Chandru P. Sundaram, Reza Mehrazin, Mark L. Gonzalgo, Ithaar H. Derweesh, Francesco Porpiglia, Nirmish Singla, Vitaly Margulis, Alessandro Antonelli, Hooman Djaladat, Riccardo Autorino","doi":"10.1111/bju.16526","DOIUrl":"https://doi.org/10.1111/bju.16526","url":null,"abstract":"To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171326","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}
Sabrina H. Rossi, Geraldine Fox, Malcolm Packer, Andrew Greaves, Maxine Tran, Natalie Charnley, Grenville Oades, Ekaterini Boleti, Grant D. Stewart
<p>Patient and public involvement and engagement (PPIE) is crucial to ensure that patient care and research is relevant to patient needs and is more likely to have a positive impact. Indeed, previous research priority setting initiatives in kidney cancer, which have led to tangible research programmes, have actively involved patients and their carers [<span>1</span>]. A continued focus on the patients and the public perspective of kidney cancer diagnosis and treatment is imperative. Kidney Cancer UK, a UK kidney cancer charity, carried out a survey of patients with kidney cancer annually over the last decade. Here, we report longitudinal survey results and reflect on the future direction of kidney cancer care and how they link to research priorities in the UK.</p> <p>Kidney Cancer UK delivered an annual patient survey, distributed on-line via the QuestionPro platform and via post, between 2014 and 2023. This was publicised via social media platforms (including the charity's website, Facebook, Instagram and X). Additionally, the survey was sent to clinicians and cancer nurse specialists for distribution to patients. The questionnaire focused on the patients’ experience on diagnosis, treatment and information/support received. Survey participation increased over time, with 68 completed in 2013, >300 participants from 2019 onwards and >500 participants in 2022 and 2023.</p> <p>A consistent survey finding was that patients feel the pathway to diagnosis for kidney cancer could be improved. Interestingly, the proportion of respondents waiting >3 months for a specialist kidney cancer diagnosis underwent a sharp rise in 2020, increasing from around 11–18% in the preceding years to 33%, with levels remaining stable since then (Fig. 1). This may be partly related to delays in diagnosis following the coronavirus pandemic, however, there was no improvement in subsequent years, perhaps reflecting growing NHS pressures. NHS data suggest an increased backlog with growing waiting times to see a specialist in secondary care and increased waiting lists for treatment [<span>2</span>]. Timely diagnosis remains a key area for improvement and is a target for NHS England. One in four patients reported that their GP initially misdiagnosed their symptoms as an alternative condition, and they felt that this delayed their diagnosis. This proportion has remained static over the last 4 years (Fig. 1). Indeed, kidney cancer is often asymptomatic or results in non-specific symptoms. Only 19% of survey participants reported haematuria. This is in keeping with UK data demonstrating that only 23% of patients diagnosed with renal cancer report visible haematuria, and this is more commonly associated with advanced tumour stage (49% having Stage III–IV disease) [<span>3</span>]. Although increased public awareness of kidney cancer symptoms has been successfully achieved through public health ‘Blood in the Pee’ Campaigns in England, this was associated with increased early-s
{"title":"A decade long insight into patient views on kidney cancer care delivery","authors":"Sabrina H. Rossi, Geraldine Fox, Malcolm Packer, Andrew Greaves, Maxine Tran, Natalie Charnley, Grenville Oades, Ekaterini Boleti, Grant D. Stewart","doi":"10.1111/bju.16530","DOIUrl":"https://doi.org/10.1111/bju.16530","url":null,"abstract":"<p>Patient and public involvement and engagement (PPIE) is crucial to ensure that patient care and research is relevant to patient needs and is more likely to have a positive impact. Indeed, previous research priority setting initiatives in kidney cancer, which have led to tangible research programmes, have actively involved patients and their carers [<span>1</span>]. A continued focus on the patients and the public perspective of kidney cancer diagnosis and treatment is imperative. Kidney Cancer UK, a UK kidney cancer charity, carried out a survey of patients with kidney cancer annually over the last decade. Here, we report longitudinal survey results and reflect on the future direction of kidney cancer care and how they link to research priorities in the UK.</p>\u0000<p>Kidney Cancer UK delivered an annual patient survey, distributed on-line via the QuestionPro platform and via post, between 2014 and 2023. This was publicised via social media platforms (including the charity's website, Facebook, Instagram and X). Additionally, the survey was sent to clinicians and cancer nurse specialists for distribution to patients. The questionnaire focused on the patients’ experience on diagnosis, treatment and information/support received. Survey participation increased over time, with 68 completed in 2013, >300 participants from 2019 onwards and >500 participants in 2022 and 2023.</p>\u0000<p>A consistent survey finding was that patients feel the pathway to diagnosis for kidney cancer could be improved. Interestingly, the proportion of respondents waiting >3 months for a specialist kidney cancer diagnosis underwent a sharp rise in 2020, increasing from around 11–18% in the preceding years to 33%, with levels remaining stable since then (Fig. 1). This may be partly related to delays in diagnosis following the coronavirus pandemic, however, there was no improvement in subsequent years, perhaps reflecting growing NHS pressures. NHS data suggest an increased backlog with growing waiting times to see a specialist in secondary care and increased waiting lists for treatment [<span>2</span>]. Timely diagnosis remains a key area for improvement and is a target for NHS England. One in four patients reported that their GP initially misdiagnosed their symptoms as an alternative condition, and they felt that this delayed their diagnosis. This proportion has remained static over the last 4 years (Fig. 1). Indeed, kidney cancer is often asymptomatic or results in non-specific symptoms. Only 19% of survey participants reported haematuria. This is in keeping with UK data demonstrating that only 23% of patients diagnosed with renal cancer report visible haematuria, and this is more commonly associated with advanced tumour stage (49% having Stage III–IV disease) [<span>3</span>]. Although increased public awareness of kidney cancer symptoms has been successfully achieved through public health ‘Blood in the Pee’ Campaigns in England, this was associated with increased early-s","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171327","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}
Allen Ao Guo, Kieran Zeng, Ymer Bushati, Paul Kim, Wenjie Zhong, Venu Chalasani, Matthew Winter
To identify the association between cardiopulmonary exercise testing (CPET) and outcomes of radical cystectomy (RC), as RC is historically associated with high rates of short- and long-term morbidity and mortality.
{"title":"Cardiopulmonary exercise testing prior to radical cystectomy: a systematic review and meta-analysis","authors":"Allen Ao Guo, Kieran Zeng, Ymer Bushati, Paul Kim, Wenjie Zhong, Venu Chalasani, Matthew Winter","doi":"10.1111/bju.16476","DOIUrl":"https://doi.org/10.1111/bju.16476","url":null,"abstract":"To identify the association between cardiopulmonary exercise testing (CPET) and outcomes of radical cystectomy (RC), as RC is historically associated with high rates of short- and long-term morbidity and mortality.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166242","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}
Matthew J. Roberts, Nathan Papa, Hans Veerman, Katelijne de Bie, Andrew Morton, Anthony Franklin, Sheliyan Raveenthiran, William J. Yaxley, Maarten L. Donswijk, Henk G. van der Poel, Hemamali Samaratunga, David Wong, Nicholas Brown, Robert Parkinson, Troy Gianduzzo, Boon Kua, Geoffrey D. Coughlin, Daniela E. Oprea-Lager, Louise Emmett, Pim J. van Leeuwen, John W. Yaxley, André N. Vis
To construct and externally calibrate a predictive model for early biochemical recurrence (BCR) after radical prostatectomy (RP) incorporating clinical and modern imaging characteristics of the primary tumour.
{"title":"Prediction of biochemical recurrence after radical prostatectomy from primary tumour characteristics","authors":"Matthew J. Roberts, Nathan Papa, Hans Veerman, Katelijne de Bie, Andrew Morton, Anthony Franklin, Sheliyan Raveenthiran, William J. Yaxley, Maarten L. Donswijk, Henk G. van der Poel, Hemamali Samaratunga, David Wong, Nicholas Brown, Robert Parkinson, Troy Gianduzzo, Boon Kua, Geoffrey D. Coughlin, Daniela E. Oprea-Lager, Louise Emmett, Pim J. van Leeuwen, John W. Yaxley, André N. Vis","doi":"10.1111/bju.16482","DOIUrl":"https://doi.org/10.1111/bju.16482","url":null,"abstract":"To construct and externally calibrate a predictive model for early biochemical recurrence (BCR) after radical prostatectomy (RP) incorporating clinical and modern imaging characteristics of the primary tumour.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171401","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}
Kang Liu, Rossella Nicoletti, Hongda Zhao, Xuan Chen, Peter Ka-Fung Chiu, Chi-Fai Ng, Renate Pichler, Laura S. Mertens, Takafumi Yanagisawa, Luca Afferi, Andrea Mari, Satoshi Katayama, Juan Gomez Rivas, Riccardo Campi, Maria Carmen Mir, Michael Rink, Yair Lotan, Morgan Rouprêt, Shahrokh F. Shariat, Jeremy Yuen-Chun Teoh
To investigate the influence of statins on the survival outcomes of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette-Guérin (BCG) immunotherapy.
{"title":"The potential benefits of concomitant statins treatment in patients with non-muscle-invasive bladder cancer","authors":"Kang Liu, Rossella Nicoletti, Hongda Zhao, Xuan Chen, Peter Ka-Fung Chiu, Chi-Fai Ng, Renate Pichler, Laura S. Mertens, Takafumi Yanagisawa, Luca Afferi, Andrea Mari, Satoshi Katayama, Juan Gomez Rivas, Riccardo Campi, Maria Carmen Mir, Michael Rink, Yair Lotan, Morgan Rouprêt, Shahrokh F. Shariat, Jeremy Yuen-Chun Teoh","doi":"10.1111/bju.16493","DOIUrl":"https://doi.org/10.1111/bju.16493","url":null,"abstract":"To investigate the influence of statins on the survival outcomes of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette-Guérin (BCG) immunotherapy.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166243","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}
Jasper Cornette, Dirk Lange, Ben H Chew, Thomas Tailly
Objective: To evaluate the available literature on ureteric stent-related infections, the use of antibiotics and bacterial colonisation to identify the current incidence of stent-related infections, unveil knowledge gaps and generate potential hypotheses for future research.
Methods: A literature review was conducted using PubMed, Cochrane and urological association websites identifying relevant English literature published between 1983 and January 2024.
Results: There is a worldwide lack of guidelines for antibiotic prophylaxis for stent placement, exchange or extraction. In patients with a negative preoperative urine culture undergoing ureteroscopy and stent placement, it may be considered to only provide prophylaxis in presence of risk factors. However, in pre-stented patients a preoperative urine culture is important to guide prophylaxis during endourological surgery. During stent indwell time, antibiotic prophylaxis does not show any advantage in preventing urinary tract infections (UTIs). There is no strong evidence to support the use of antibiotics at time of stent removal. In the absence of any clear evidence, management strategies for treating UTIs in patients with ureteric stents vary widely. Stent exchange could be considered to remove the biofilm as a potential source of bacteria. Stent culture can help to guide treatment during infection as urine culture and stent culture can differ.
Conclusion: In terms of good antibiotic stewardship, urologists should be aware that unnecessary use of antibiotics provokes bacterial resistance. There is a great need for further research in the field of antibiotic prophylaxis and stent-related infections to develop evidence that can help shape clear guidelines for this very common urological practice.
{"title":"Bridging the knowledge gap: past, present and future of antibiotic use for ureteral stents.","authors":"Jasper Cornette, Dirk Lange, Ben H Chew, Thomas Tailly","doi":"10.1111/bju.16515","DOIUrl":"https://doi.org/10.1111/bju.16515","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the available literature on ureteric stent-related infections, the use of antibiotics and bacterial colonisation to identify the current incidence of stent-related infections, unveil knowledge gaps and generate potential hypotheses for future research.</p><p><strong>Methods: </strong>A literature review was conducted using PubMed, Cochrane and urological association websites identifying relevant English literature published between 1983 and January 2024.</p><p><strong>Results: </strong>There is a worldwide lack of guidelines for antibiotic prophylaxis for stent placement, exchange or extraction. In patients with a negative preoperative urine culture undergoing ureteroscopy and stent placement, it may be considered to only provide prophylaxis in presence of risk factors. However, in pre-stented patients a preoperative urine culture is important to guide prophylaxis during endourological surgery. During stent indwell time, antibiotic prophylaxis does not show any advantage in preventing urinary tract infections (UTIs). There is no strong evidence to support the use of antibiotics at time of stent removal. In the absence of any clear evidence, management strategies for treating UTIs in patients with ureteric stents vary widely. Stent exchange could be considered to remove the biofilm as a potential source of bacteria. Stent culture can help to guide treatment during infection as urine culture and stent culture can differ.</p><p><strong>Conclusion: </strong>In terms of good antibiotic stewardship, urologists should be aware that unnecessary use of antibiotics provokes bacterial resistance. There is a great need for further research in the field of antibiotic prophylaxis and stent-related infections to develop evidence that can help shape clear guidelines for this very common urological practice.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131767","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}
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