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https://www.readbyqxmd.com/read/28319171/a-reported-20-gene-expression-signature-to-predict-lymph-node-positive-disease-at-radical-cystectomy-for-muscle-invasive-bladder-cancer-is-clinically-not-applicable
#1
Kim E M van Kessel, Harmen J G van de Werken, Irene Lurkin, Angelique C J Ziel-van der Made, Ellen C Zwarthoff, Joost L Boormans
BACKGROUND: Neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) provides a small but significant survival benefit. Nevertheless, controversies on applying NAC remain because the limited benefit must be weight against chemotherapy-related toxicity and the delay of definitive local treatment. Therefore, there is a clear clinical need for tools to guide treatment decisions on NAC in MIBC. Here, we aimed to validate a previously reported 20-gene expression signature that predicted lymph node-positive disease at radical cystectomy in clinically node-negative MIBC patients, which would be a justification for upfront chemotherapy...
2017: PloS One
https://www.readbyqxmd.com/read/28316934/neobladder-obstruction-a-non-ischemic-cause-for-hepatic-portal-venous-gas-case-report
#2
Haider K Bangash, Steve P McCombie, Omar K Bangash, Dickon Hayne
Hepatic portal venous gas (HPVG) is a rare ominous radiological sign usually indicative of mesenteric ischemia. Increased detection of HPVG has been associated with a growing number of non-ischemic causes. A 64-year-old gentleman following radical cystectomy and neobladder formation developed clinical signs suggestive of bowel obstruction. HPVG was demonstrated on abdominal imaging. Urgent laparotomy revealed no evidence of ischemia. We hypothesize an obstructed neobladder permitted gas to enter the mesenteric circulation...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28314967/-when-is-surgical-resection-of-the-primary-tumor-indicated-in-metastatic-urothelial-carcinoma-of-the-bladder-and-what-is-the-scientific-rationale
#3
J Ellinger, S Hauser, H Kübler, S C Müller
Cisplatin-based polychemotherapy is still the standard therapy for metastatic urothelial carcinoma, although disease progression is often noted at an early time point even in patients with response. In recent years, cytoreductive surgery has been gaining increasing interest in many tumor entities in the setting of metastatic disease to improve patients outcome, but urothelial carcinoma is not regarded as a candidate for such a multimodal therapy approach. However, several retrospective studies suggest a survival benefit of radical cystectomy and/or metastasectomy for well-selected patients with metastatic urothelial carcinoma...
March 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28290459/contemporary-update-on-neoadjuvant-therapy-for-bladder-cancer
#4
REVIEW
Daniel P Nguyen, George N Thalmann
Administration of neoadjuvant chemotherapy preceding radical cystectomy in patients with bladder cancer remains a matter of debate. Results of prospective, randomized studies have demonstrated an overall absolute survival benefit of 5% at 5 years, provided cisplatin-based combination regimens are used. Owing to the perception of a modest survival benefit, the medical community has been slow to adopt the use of neoadjuvant chemotherapy. Other reasons for the underuse of neoadjuvant chemotherapy range from patient ineligibility to fear of delaying potentially curative surgery in nonresponders...
March 14, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28281310/effectiveness-of-platinum-based-adjuvant-chemotherapy-for-muscle-invasive-bladder-cancer-a-weighted-propensity-score-analysis
#5
Fumitaka Shimizu, Satoru Muto, Masataka Taguri, Takeshi Ieda, Akira Tsujimura, Yoshiro Sakamoto, Kazuhiko Fujita, Takatsugu Okegawa, Raizo Yamaguchi, Shigeo Horie
OBJECTIVES: To evaluate the clinical benefit of adjuvant platinum-based chemotherapy after radical cystectomy for muscle-invasive bladder cancer in routine clinical practice. METHODS: The present observational study was carried out to compare the effectiveness of adjuvant chemotherapy versus observation post-radical cystectomy in patients with clinically muscle-invasive bladder cancer. Cancer-specific survival and overall survival between the adjuvant chemotherapy group and radical cystectomy alone group were compared using Kaplan-Meier method and log-rank test...
March 9, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28275033/short-form-charlson-comorbidity-index-for-assessment-of-perioperative-mortality-after-radical-cystectomy
#6
Paolo Dell'Oglio, Zhe Tian, Sami-Ramzi Leyh-Bannurah, Vincent Trudeau, Alessandro Larcher, Marco Moschini, Ettore Di Trapani, Umberto Capitanio, Alberto Briganti, Francesco Montorsi, Fred Saad, Pierre I Karakiewicz
Background: The Deyo adaptation of the Charlson comorbidity index (DaCCI), which relies on 17 comorbid condition groupings, represents one of the most frequently used baseline comorbidity assessment tools in retrospective database studies. However, this index is not specific for patients with bladder cancer (BCa) treated with radical cystectomy (RC). The goal of this study was to develop a short-form of the original DaCCI (DaCCI-SF) that may specifically predict 90-day mortality after RC, with equal or better accuracy...
March 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28274590/role-of-inflammation-in-the-perioperative-management-of-urothelial-bladder-cancer-with-squamous-cell-features-impact-of-neutrophil-to-lymphocyte-ratio-on-outcomes-and-response-to-neoadjuvant-chemotherapy
#7
Oscar Buisan, Anna Orsola, Mario Oliveira, Roberto Martinez, Olatz Etxaniz, Joan Areal, Luis Ibarz
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) might reflect an increased neutrophilic inflammatory response, and urothelial tumors with squamous-cell features (SqD) have been linked to inflammation. We hypothesized that NLR could be prognostic in these patients. PATIENTS AND METHODS: In patients with SqD muscle-invasive bladder cancer treated with curative intent, NLR and relationships with outcomes were analyzed by Cox regression, log-rank, and Kaplan-Meier analysis...
February 6, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28267606/no-differences-in-population-based-readmissions-after-open-and-robotic-assisted-cystectomy-implications-for-post-discharge-care
#8
Tudor Borza, Bruce L Jacobs, Jeffrey S Montgomery, Alon Z Weizer, Todd M Morgan, Khaled S Hafez, Cheryl T Lee, Benjamin Y, Hye Sung Min, Chang He, Scott M Gilbert, Jonathan E Helm, Mariel S Lavieri, Brent K Hollenbeck, Ted A Skolarus
OBJECTIVE: To inform whether readmission reduction strategies should consider surgical approach, we examined readmission differences between open and robotic-assisted radical cystectomy (RARC) using population-based data. METHODS: We identified patients who underwent cystectomy between January 2010 and September 2013 based on ICD-9 codes and administrative claims from a large, national US health insurer (Clinformatics(TM) Data Mart Database, OptumInsight, Eden Prairie, MN)...
March 3, 2017: Urology
https://www.readbyqxmd.com/read/28267603/prophylactic-antibiotics-and-postoperative-complications-for-radical-cystectomy-a-population-based-analysis-in-the-united-states
#9
Ross E Krasnow, Matthew Mossanen, Sophia Koo, David W Kubiak, Mark A Preston, Benjamin I Chung, Adam S Kibel, Steven L Chang
PURPOSE: Infectious, wound and soft tissue events contribute to the morbidity of radical cystectomy, but the association between these events and antibiotic prophylaxis is not clear. We sought to describe the contemporary use of antibiotic prophylaxis in radical cystectomy, adherence to published guidelines, and identify regimens with the lowest rates of infectious events. MATERIALS AND METHODS: Using a population-based, retrospective cohort study of patients who underwent radical cystectomy across the United States between 2003 and 2013, we identified the intraoperative antibiotic prophylaxis regimen...
March 3, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28259358/prognostic-significance-of-lymphatic-vascular-and-perineural-invasion-for-bladder-cancer-patients-treated-by-radical-cystectomy
#10
Prasuna Muppa, Sounak Gupta, Igor Frank, Stephen A Boorjian, R Jeffrey Karnes, R Houston Thompson, Prabin Thapa, Robert F Tarrell, Loren P Herrera Hernandez, Rafael E Jimenez, John C Cheville
In radical cystectomy specimens with bladder cancer, lymphatic and vascular invasion are often reported as 'angiolymphatic' or 'lymphovascular' invasion, terms that combine the findings of tumour within simple endothelial-lined lymphatic spaces and tumour within muscle-lined blood vessels. It is unclear if these patterns of invasion have different prognostic significance. In addition, there are conflicting data regarding the significance of lymphatic, vascular and perineural invasion in patients with bladder cancer...
March 1, 2017: Pathology
https://www.readbyqxmd.com/read/28257782/natural-history-predictors-and-management-of-uretero-enteric-strictures-after-robot-assisted-radical-cystectomy
#11
Youssef E Ahmed, Ahmed A Hussein, Paul R May, Basim Ahmad, Taimoor Ali, Prasanna Kumar, Khurshid A Guru
PURPOSE: Uretero-enteric strictures (UES) represent the most common complication requiring reoperation after radical cystectomy. Our objective was to investigate the prevalence, outcomes, predictors and management of UES. METHODS: Retrospective review of our quality assurance RARC database and identified patients who developed UES. Data was reviewed for demographics, perioperative outcomes and UES characteristics. Kaplan Meier method was used to compute time to UES and multivariable stepwise regression to evaluate predictors of UES...
February 28, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28256704/a-comprehensive-guide-to-perioperative-management-and-operative-technique-for-robotic-cystectomy-with-intracorporeal-urinary-diversion
#12
Wei Shen Tan, Benjamin W Lamb, Ashwin Sridhar, Timothy P Briggs, John D Kelly
Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion...
February 27, 2017: Urologia
https://www.readbyqxmd.com/read/28256145/combined-endoscopic-resolution-of-iatrogenic-stricture-in-an-ureterosigmoidostomy
#13
Alberto Mir Subías, Monica Navarro Dourdil, Mara Charro Calvillo, Juan José Sebastián Domingo
Ureteroenterostomy allows the replacement of the bladder role after radical cystectomy. Anastomotic stricture is a relatively common complication that may require surgical repair. We report a case of iatrogenic stricture in a Mainz-II ureterosigmoidostomy that was satisfactorily resolved using a combined endoscopic-urological approach.
March 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28247629/-percutaneous-nephrolithotripsy-in-patients-after-different-methods-of-urinary-diversion
#14
B G Guliev, E O Stetsik
The study presents the results of percutaneous nephrolithotripsy (PNL) in patients who underwent different methods of urinary diversion. MATERIALS AND METHODS: The study included the results of PNL in 16 patients (study group) with kidney stones who were subjected to different methods of urinary diversion. Earlier, 2 (12.5%) patients underwent bilateral ureterosigmoidostomy for bladder exstrophy, 12 (75%) experienced radical cystectomy with orthotopic ileocystoplasty and 2 (12.5%) - heterotopic cystoplasty...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28244409/external-validation-and-optimization-of-international-consensus-clinical-target-volumes-for-adjuvant-radiation-therapy-in-bladder-cancer
#15
Abhinav V Reddy, John P Christodouleas, Tianming Wu, Norman D Smith, Gary D Steinberg, Stanley L Liauw
PURPOSE: International consensus (IC) clinical target volumes (CTVs) have been proposed to standardize radiation field design in the treatment of patients at high risk of locoregional failure (LRF) after radical cystectomy. The purpose of this study was to externally validate the IC CTVs in a cohort of postsurgical patients followed up for LRF and identify revisions that might improve the IC CTVs' performance. METHODS AND MATERIALS: Among 334 patients with pT3 to pT4 bladder cancer treated with radical cystectomy, LRF developed in 58 (17%), of whom 52 had computed tomography scans available for review...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28242163/adjuvant-radiotherapy-use-by-us-radiation-oncologists-after-radical-cystectomy-for-muscle-invasive-bladder-cancer
#16
A A Solanki, B Martin, M Korpics, C Small, M M Harkenrider, T Mitin
AIMS: Historic trials suggested significant toxicity with adjuvant radiotherapy (ART) after radical cystectomy for muscle-invasive bladder cancer (MIBC). However, recent trials have found improved locoregional control and the 2016 National Comprehensive Cancer Network (NCCN) guidelines recommend ART consideration for select patients at high risk of local recurrence. ART practice patterns among US radiation oncologists are unknown and we carried out a survey to explore current trends. MATERIALS AND METHODS: We conducted a survey of US radiation oncologists regarding the management of patients with cT2-3N0M0 transitional cell MIBC...
February 24, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28238757/variations-in-preoperative-use-of-bone-scan-among-medicare-beneficiaries-undergoing-radical-cystectomy
#17
Robert M Turner, Jonathan G Yabes, Benjamin J Davies, Dwight E Heron, Bruce L Jacobs
OBJECTIVES: To examine factors associated with the bone scan use in patients undergoing radical cystectomy and to assess trends in use over time. METHODS: Using Surveillance, Epidemiology, and End Results-Medicare data, we identified 5,573 patients who underwent radical cystectomy from 2004-2011. The primary outcome was completion of a bone scan within 6 months prior to surgery. Demographic, regional, and clinicopathologic predictors of bone scan use were examined using a mixed logit model with health service area as a random effect...
February 23, 2017: Urology
https://www.readbyqxmd.com/read/28238343/indication-for-early-cystectomy-in-nonmuscle-invasive-bladder-cancer-literature-review
#18
L Cogorno Wasylkowski, E Ríos-González, E Linares Espinós, A Leibar Tamayo, L Martínez-Piñeiro Lorenzo
CONTEXT: High-risk nonmuscle-invasive bladder cancer is a disease that includes a heterogeneous group of patients, for whom close follow-up is recommended due to the risk of progression to a muscle-invasive tumour. The treatment of choice for these tumours is transurethral resection of the bladder tumour followed by a programme of bacillus Calmette-Guerin instillations. There is a subgroup of patients who have a greater risk of progression and who benefit from early radical treatment...
February 18, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28220653/systematic-review-of-the-oncological-and-functional-outcomes-of-pelvic-organ-preserving-cystectomy-compared-with-standard-radical-cystectomy-in-women-who-undergo-curative-surgery-and-orthotopic-neobladder-substitution-for-bladder-cancer
#19
REVIEW
Erik Veskimäe, Yann Neuzillet, Mathieu Rouanne, Steven MacLennan, Thomas B L Lam, Yuhong Yuan, Eva Compérat, Nigel C Cowan, Georgios Gakis, Antoine G van der Heijden, Maria J Ribal, J Alfred Witjes, Thierry Lebrét
CONTEXT: Pelvic-organ preserving radical cystectomy (POPRC) for female patients may improve postoperative sexual and urinary functions without compromising the oncological outcome compared with standard radical cystectomy (RC). OBJECTIVE: To determine the effect of POPRC on sexual, oncological and urinary outcomes compared with RC in women who undergo standard curative surgery and orthotopic neobladder substitution for bladder cancer (BCa). EVIDENCE ACQUISITION: Medline, Embase, Cochrane controlled trials databases and clinicaltrial...
February 20, 2017: BJU International
https://www.readbyqxmd.com/read/28220605/outcome-predictors-of-radical-cystectomy-in-patients-with-ct4-prostate-cancer-a-multi-institutional-study-of-62-patients
#20
Martin Spahn, Alessandro Morlacco, Silvan Boxler, Steven Joniau, Alberto Briganti, Francesco Montorsi, Paolo Gontero, Pia Bader, Detlef Frohneberg, Hein van Poppel, R Jeffrey Karnes
OBJECTIVES: To identify which patients with macroscopic bladder infiltrating T4 prostate cancer (PCa) might have favorable outcomes when treated with radical cystectomy (RC) MATERIALS AND METHODS: We evaluated 62 patients with cT4cN0-1cM0 PCa treated with RC and pelvic lymph node dissection between 1972-2011. In addition to descriptive statistics, the Kaplan-Meier method and log-rank tests were used to depict survival rates. Uni- and multivariate Cox regression analysis tested the association between predictors and progression-free, PCa-specific-, and overall survival...
February 20, 2017: BJU International
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