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Urologic oncology

Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Bente T Jensen, Susanne V Lauridsen, Jørgen B Jensen
PURPOSE OF REVIEW: Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS: Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy...
March 13, 2018: Current Opinion in Urology
Bernadette Brown, Jane Young, David P Smith, Andrew B Kneebone, Andrew J Brooks, Sam Egger, Miranda Xhilaga, Amanda Dominello, Dianne L O'Connell, Mary Haines
BACKGROUND: This study assessed whether a theoretically conceptualised tailored intervention centred on multidisciplinary teams (MDTs) increased clinician referral behaviours in line with clinical practice guideline recommendations. METHODS: Nine hospital Sites in New South Wales (NSW), Australia with a urological MDT and involvement in a state-wide urological clinical network participated in this pragmatic stepped wedge, cluster randomised implementation trial...
March 12, 2018: Implementation Science: IS
Mahir Maruf, Piyush K Agarwal, Abhinav Sidana
INTRODUCTION: The Physician Payment Sunshine Act was enacted to increase the transparency of financial relationships between physicians and the pharmaceutical industry. These financial relationships are prevalent in the field of oncology, as they are in other fields of medicine. We explored the relationship between industry and urologists for compensations associated with the treatment of urologic malignancies. METHODS: The publicly available Open Payments database was obtained from the Centers for Medicare & Medicaid Services...
August 2017: Seminars in Oncology
Nina Moroz, Robert Sitarz, Andrzej Mruk, Robert Bakalarz, Ewa Maciąg, Jakub Litwiński, Ryszard Wierzbicki
ntroduction: One of the most important goals of preparing a patient for elective gastrointestinal cancer surgery is prevention of postoperative complications. The literature gives many ways to prepare for surgery, but only a few suggests that pre-operative use of rifaximin provides benefits in the form of fewer perioperative complications and reduces the severity of pain during this period. O bjective: The presented project is a retrospective analysis of the effectiveness of rifaximin in the prevention of perioperative complications in patients treated in the Unit of General Surgery with the Orthopedic and Urology in the Hospital of the Ministry of the Interior and Administration in Lublin, and a review of international literature in this subject...
February 28, 2018: Polski Przeglad Chirurgiczny
Benoit Peyronnet, Lauranne Tondut, Jean-Christophe Bernhard, Christophe Vaessen, Nicolas Doumerc, Philippe Sebe, Benjamin Pradere, Bertrand Guillonneau, Zine-Eddine Khene, Francois-Xavier Nouhaud, Nicolas Brichart, Thomas Seisen, Quentin Alimi, Jean-Baptiste Beauval, Romain Mathieu, Adham Rammal, Alexandre De La Taille, Herve Baumert, Stéphane Droupy, Franck Bruyere, Morgan Roupret, Arnaud Mejean, Karim Bensalah
OBJECTIVE: To assess the impact of hospital volume (HV) and surgeon volume (SV) on perioperative outcomes of robot assisted partial nephrectomy (RAPN). PATIENTS AND METHODS: All consecutive patients who underwent a RAPN from 2009 to 2015 at eleven institutions were included in a retrospective study. To evaluate the impact of hospital volume we divided RAPN into four quartiles according to the caseload per year: low HV (<20/year); moderate HV (20-44/year); High HV (45-70/year); very high HV (>70/year)...
March 5, 2018: BJU International
Briony K Varda, Patricia Cho, Andrew A Wagner, Richard S Lee
BACKGROUND: In adult urologic oncology the use of robotics has become commonplace; in pediatric urology it is rare. Herein, we describe a collaboration between an adult and a pediatric urologist performing robotic surgery for children and young adults with suspicious or cancerous genitourinary (GU) lesions. OBJECTIVES: To evaluate clinical and oncologic outcomes in children and young adults undergoing robotic surgery for suspicious or cancerous lesions of the GU tract; to describe our collaborative model between an adult and pediatric surgeon at a free-standing children's hospital...
March 2, 2018: Journal of Pediatric Urology
Ye Wang, Matthew Mossanen, Steven L Chang
OBJECTIVE: Urologic cancers are not only among the most common types of cancers, but also among the most expensive cancers to treat in the United States. This study aimed to review the use of CEAs and other cost analyses in urologic oncology using large databases to better understand the value of management strategies of these cancers. METHODS: A literature review on CEAs and other cost analyses in urologic oncology using large databases. RESULTS: The options for and costs of diagnosing, treating, and following patients with urologic cancers can be expected to rise in the coming years...
February 27, 2018: Urologic Oncology
A Jaulim, A Srinivasan, S Hori, N Kumar, A Y Warren, N C Shah, V J Gnanapragasam
Introduction The aim of this study was to explore the impact of increasing proportions of high risk referrals on surgical margin outcomes of a surgeon's learning curve in robotic prostatectomy. Methods All patients in this study underwent robot assisted radical prostatectomy (RARP) performed by three different consultant urological surgeons. Data collected included preoperative clinical stage, Gleason score and prostate specific antigen levels, which were used to risk stratify patients according to National Institute for Health and Care Excellence criteria...
March 2018: Annals of the Royal College of Surgeons of England
Daniel Pelletier, Michael O'Donnell, Mary Seabury Stone, Vincent Liu
Patients treated with intravesical bacillus Calmette-Guerin therapy for urothelial carcinoma often become refractory and experience recurrent disease, thus necessitating alternative intravesical treatment modalities if the patient is to be spared the morbidities associated with radical cystectomy. Intravesical treatment with taxane-based chemotherapy, such as docetaxel, has gained traction in urologic oncology, proving to be an effective salvage therapy in such patients. Systemic taxane-based chemotherapeutic regimens have long been used in several advanced malignancies, and their systemic side effects and associated histologic correlates have been extensively documented...
February 27, 2018: Journal of Cutaneous Pathology
Angela MacCarthy, Shona Kirtley, Jennifer A de Beyer, Douglas G Altman, Iveta Simera
Many reports of health research omit important information needed to assess their methodological robustness and clinical relevance. Without clear and complete reporting, it is not possible to identify flaws or biases, reproduce successful interventions, or use the findings in systematic reviews or meta-analyses. The EQUATOR Network ( promotes responsible reporting and the use of reporting guidelines to improve the accuracy, completeness, and transparency of health research. EQUATOR supports researchers by providing online resources and training...
February 22, 2018: British Journal of Cancer
Janet E Baack Kukreja
PURPOSE OF REVIEW: Venous thromboembolism (VTE) is a common complication during the perioperative period for major urologic oncology operations. The present review focuses on the risk factors, the mechanisms of hypercoagulability in this patient population, and the timing and prevention of VTE. RECENT FINDINGS: Although the vast majority of patients undergoing major urologic oncology operations do not develop VTEs, when they do develop they can be fatal. The risk factors for VTEs are important to identify in this patient population...
February 19, 2018: Current Opinion in Urology
Zefu Liu, Yunlin Ye, Xiangdong Li, Shengjie Guo, Lijuan Jiang, Pei Dong, Yonghong Li, Yanxia Shi, Weijun Fan, Yun Cao, Kai Yao, Zike Qin, Hui Han, Fangjian Zhou, Zhuowei Liu
PURPOSE: To investigate the effects of intra-arterial chemotherapy on T1 stage bladder cancer (Bca) and evaluate patient outcome with bladder-preserving treatment approaches. MATERIALS AND METHODS: A total of 238 patients with T1 stage Bca were retrospectively analyzed. Among them, 35 patients were categorized into the subgroup of highest-risk T1 stage according to the European Association of Urology guidelines and received immediate radical cystectomy (RC group), whereas 62 were classified as being highest-risk T1 patients but were unwilling to undergo RC and were treated with gemcitabine plus cisplatin intra-arterial chemotherapy (GC group)...
February 19, 2018: World Journal of Urology
Julie R Brahmer, Christina Lacchetti, Bryan J Schneider, Michael B Atkins, Kelly J Brassil, Jeffrey M Caterino, Ian Chau, Marc S Ernstoff, Jennifer M Gardner, Pamela Ginex, Sigrun Hallmeyer, Jennifer Holter Chakrabarty, Natasha B Leighl, Jennifer S Mammen, David F McDermott, Aung Naing, Loretta J Nastoupil, Tanyanika Phillips, Laura D Porter, Igor Puzanov, Cristina A Reichner, Bianca D Santomasso, Carole Seigel, Alexander Spira, Maria E Suarez-Almazor, Yinghong Wang, Jeffrey S Weber, Jedd D Wolchok, John A Thompson
Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process...
February 14, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jean-Baptiste Beauval, Benoit Peyronnet, Thibaut Benoit, Bastien Cabarrou, Thomas Seisen, Mathieu Roumiguié, Benjamin Pradere, Zine-Eddine Khene, Quentin Manach, Gregory Verhoest, Mathieu Thoulouzan, Jerome Parra, Nicolas Doumerc, Romain Mathieu, Christophe Vaessen, Michel Soulié, Morgan Roupret, Karim Bensalah
PURPOSE: This study aimed at reporting the long-term oncological outcomes of robotic partial nephrectomy (RPN) for renal cell carcinoma (RCC). METHODS: Data from all consecutive patients who underwent RAPN for RCC from July 2009 to January 2012 in three departments of urology were prospectively collected. Overall survival (OS), cancer-specific survival (CSS) and disease free-survival (DFS) were estimated using the Kaplan-Meier method. Prognostic factors associated with CSS were sought in univariate analysis...
February 9, 2018: World Journal of Urology
Tim Nestler, Johannes Huber, Adrienne M Laury, Hendrik Isbarn, Axel Heidenreich, Hans U Schmelz, Christian G Ruf
PURPOSE: Due to the excellent cure rates for testicular cancer (TC), focus has shifted towards decreasing therapy-related morbidities. Thrombosis is a frequent complication of cisplatin chemotherapy. Furthermore, the optimal route of administration for chemotherapy is still under debate. The purpose of this study was to assess the patterns of care concerning dosing and duration of thromboprophylaxis currently utilized in TC patients in German-speaking countries as well as the route of chemotherapy administration...
February 7, 2018: World Journal of Urology
Amir H Lebastchi, Roger K Khouri, Ian D McLaren, Gary J Faerber, Kate H Kraft, Khaled S Hafez, Casey A Dauw, Vincent G Bird, Thomas F Stringer, Ajay K Singla, Mathew D Sorensen, Hunter Wessells, Sapan N Ambani
OBJECTIVE: To better understand today's urology applicant. MATERIAL AND METHODS: All 2016 Urology Residency Match applicants to the study-participating institutions were provided a survey via email inquiring about their paths to urology, their career aspirations, how they evaluate a training program, and how they perceive residency programs evaluate them. RESULTS: Out of a possible 468 applicants registered for the match, 346 applicants completed the survey...
February 1, 2018: Urology
Rashid K Sayyid, Abdallah K Sayyid, Zachary Klaassen, Karen Hersey, Hanan Goldberg, Nathan Perlis, Ardalanejaz Ahmad, Ricardo Leao, Thenappan Chandrasekar, Kamel Fadaak, Rabii Madi, Martha K Terris, Antonio Finelli, Robert J Hamilton, Girish S Kulkarni, Alexandre R Zlotta, Neil E Fleshner
INTRODUCTION: Urinary biomarkers are being developed to detect bladder cancer recurrence/progression in patients with non-muscle invasive bladder cancer (NMIBC). We conducted a questionnaire-based study to determine what diagnostic accuracy and cost would such test(s) need for both patients and urologic oncologists to comfortably forgo surveillance cystoscopy in favor of these tests. METHODS: Surveys were administered to NMIBC patients at followup cystoscopy visit and to physician members of the Society of Urologic Oncology...
February 6, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Javier González, Jeffrey J Gaynor, Mahmoud Alameddine, Gaetano Ciancio
PURPOSE OF REVIEW: The techniques derived from abdominal transplant surgery have become a major actor in recent surgical evolution by providing a more optimal solution for urologic malignancies hosted in the upper abdomen. To describe in detail the objectives, rationale, relevant milestones, and surgical maneuvers of the so-called transplant techniques as applied to complex urologic oncology cases. RECENT FINDINGS: The transplant-based surgical approach aims to decrease perioperative complications by improving tumor accessibility and field visibility through an enhanced exposure (via the use of a transverse incision, a specific retractor, and specific surgical maneuvers)...
February 5, 2018: Current Urology Reports
(no author information available yet)
Recently, prostate cancer has become the most common male urological cancer worldwide. However, it was difficult for the currently widely available imaging modalities to precisely diagnose this disease. With the development of nuclear medical technology, molecular imaging targeting prostate specific membrane antigen has been introduced into China. To promote the standardization of this imaging modality, the experts consensus was published by Chinese Anticancer Association Genitourinary Oncology Committee and recommendations for its application in the diagnosis and treatment of prostate cancer were attached, which would be helpful for doctors who are conducting or preparing for this examination...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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