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https://www.readbyqxmd.com/read/28087131/incidence-and-effect-of-variant-histology-on-oncological-outcomes-in-patients-with-bladder-cancer-treated-with-radical-cystectomy
#1
Marco Moschini, Paolo Dell'Oglio, Roberta Luciano', Giorgio Gandaglia, Francesco Soria, Agostino Mattei, Tobias Klatte, Rocco Damiano, Shahrokh F Shariat, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Renzo Colombo, Andrea Gallina
INTRODUCTION: We sought to describe incidence of histological variants after radical cystectomy (RC) due to bladder cancer (BCa). Moreover, we investigated survival outcomes accounting for this parameter. METHODS: We retrospectively evaluated data from 1,067 patients with BCa treated with RC between 1990 and 2013 at a single tertiary care referral center. All specimen were evaluated by dedicated uropathologists. Univariable and multivariable Cox regression analyses tested the effect of different histopathological variant on recurrence, cancer-specific mortality (CSM), and overall mortality (OM) after accounting for all available confounders...
January 10, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28078533/risk-factors-for-intravesical-recurrence-after-nephroureterectomy-in-patients-with-upper-urinary-tract-urothelial-carcinoma
#2
Ryo Yamashita, Reiko Watanabe, Ichiro Ito, Hideo Shinsaka, Masafumi Nakamura, Masato Matsuzaki, Masashi Niwakawa
PURPOSE: To determine major risk factors for bladder cancer (BC) recurrence after nephroureterectomy (Nux) by focusing on the pathologic appearances of tumors in upper urinary tract urothelial carcinomas (UUTUCs). METHODS: We performed 147 Nux procedures between November 2002 and September 2015. Forty-eight patients were excluded because of a history of BC (28 patients), previous or concurrent radical cystectomy (9 patients), neoadjuvant chemotherapy (5 patients), and other reasons (6 patients)...
January 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28070738/robotic-assisted-laparoscopic-radical-cystectomy-with-stentless-intracorporeal-modified-ves-pa-neobladder-early-experience
#3
Patrick Whelan, Wei Phin Tan, Dimitri Papagiannopoulos, Philip Omotosho, Leslie Deane
This study aimed at demonstrating the feasibility of robotic assisted laparoscopic radical cystectomy with pure intracorporeal modified Ves.Pa neobladder with stentless ureteroileal anastomosis. Pure intracorporeal robotic assisted laparoscopic technique has been recently developed with a select number of high-volume centers utilizing various operative and neobladder techniques. We reviewed the patient characteristics, operative details and perioperative courses in the two patients who have undergone robotic assisted laparoscopic radical cystectomy with pure intracorporeal modified Ves...
January 9, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28069289/liquid-biopsy-analysis-of-fgfr3-and-pik3ca-hotspot-mutations-for-disease-surveillance-in-bladder-cancer
#4
Emil Christensen, Karin Birkenkamp-Demtröder, Iver Nordentoft, Søren Høyer, Kirstin van der Keur, Kim van Kessel, Ellen Zwarthoff, Mads Agerbæk, Torben Falck Ørntoft, Jørgen Bjerggaard Jensen, Lars Dyrskjøt
BACKGROUND: Disease surveillance in patients with bladder cancer is important for early diagnosis of progression and metastasis and for optimised treatment. OBJECTIVE: To develop urine and plasma assays for disease surveillance for patients with FGFR3 and PIK3CA tumour mutations. DESIGN, SETTING, AND PARTICIPANTS: Droplet digital polymerase chain reaction (ddPCR) assays were developed and tumour DNA from two patient cohorts was screened for FGFR3 and PIK3CA hotspot mutations...
January 6, 2017: European Urology
https://www.readbyqxmd.com/read/28057402/consultation-with-a-specialized-pain-clinic-reduces-pain-after-oral-and-maxillofacial-surgery
#5
Eva-Maria Dietrich, Norbert Griessinger, Friedrich Wilhelm Neukam, Tilo Schlittenbauer
PURPOSE: Postoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment. MATERIALS AND METHODS: A total of 128 patients treated at our clinic in the period 2012-2015 who required analgesic treatment adaptation by our pain clinic were included...
December 14, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28052947/primitive-neuroectodermal-tumour-of-the-cervix-a-rare-diagnosis
#6
Irfan Ahmad, Kundan Singh Chufal, Amit Bhargava, Irfan Bashir
A 48-year-old woman presented with symptoms of lower abdominal pain and vaginal discharge for 6 months. Clinical examination and pelvic ultrasound scan suggested a diagnosis of infected Gartner's cyst, for which she underwent vaginal cystectomy. However, histopathology and immunohistochemistry revealed a diagnosis of primitive neuroectodermal tumour of the cervix. Further investigations revealed the stage to be FIGO IIIB, which was inoperable. She received neoadjuvant chemotherapy (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, cisplatin and etoposide, every 21 days), but the tumour did not respond to treatment and she was started on radiotherapy with definitive intent (55...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28049550/gec-estro-acrop-recommendations-for-performing-bladder-sparing-treatment-with-brachytherapy-for-muscle-invasive-bladder-carcinoma
#7
Bradley R Pieters, Elzbieta van der Steen-Banasik, Geert A Smits, Marisol De Brabandere, Alberto Bossi, Erik Van Limbergen
The standard treatment for muscle-invasive bladder cancer (MIBC) is a radical cystectomy with pelvic lymph node dissection with or without neoadjuvant chemotherapy. In selected cases a bladder sparing approach is possible, for example a limited surgical excision combined with external beam radiotherapy and brachytherapy. To perform brachytherapy flexible catheters have to be implanted in the bladder wall. The implantation is done either by the open retropubic approach or the endoscopic surgical approach. The largest experience for brachytherapy is with low-dose rate and pulsed-dose rate, although some short-term experience with high-dose rate is also reported...
December 31, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28049215/surgical-management-of-endometriosis-in-patients-with-chronic-pelvic-pain
#8
Rebecca Flyckt, Suejin Kim, Tommaso Falcone
Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis...
January 3, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28040424/prognostic-effect-of-carcinoma-in-situ-in-muscle-invasive-urothelial-carcinoma-patients-receiving-neoadjuvant-chemotherapy
#9
Derek E Thomas, Hristos Z Kaimakliotis, Kevin R Rice, Jose A Pereira, Paul Johnston, Marietta L Moore, Angela Reed, Dylan M Cregar, Cindy Franklin, Rhoda L Loman, Michael O Koch, Richard Bihrle, Richard S Foster, Timothy A Masterson, Thomas A Gardner, Chandru P Sundaram, Charles R Powell, Stephen D W Beck, David J Grignon, Liang Cheng, Costantine Albany, Noah M Hahn
BACKGROUND: Carcinoma in situ (CIS) is a poor prognostic finding in urothelial carcinoma. However, its significance in muscle-invasive urothelial carcinoma (MIUC) treated with neoadjuvant chemotherapy (NAC) is uncertain. We assessed the effect of CIS found in pretreatment transurethral resection of bladder tumor (TURBT) biopsies on the pathologic and clinical outcomes. MATERIALS AND METHODS: Subjects with MIUC treated with NAC before cystectomy were identified. The pathologic complete response (pCR) rates stratified by TURBT CIS status were compared...
November 30, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28040422/pure-but-not-mixed-histologic-variants-are-associated-with-poor-survival-at-radical-cystectomy-in-bladder-cancer-patients
#10
Marco Moschini, Shahrokh F Shariat, Roberta Lucianò, David D'Andrea, Beat Foerster, Mohammad Abufaraj, Marco Bandini, Paolo Dell'Oglio, Rocco Damiano, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Renzo Colombo, Andrea Gallina
PURPOSE: To evaluate the impact of pure and mixed histologic variant versus pure urothelial carcinoma in nonmetastatic bladder cancer (BCa) patients treated with radical cystectomy (RC). PATIENTS AND METHODS: We evaluated data from 1067 patients treated with RC and pelvic lymph node dissection between 1990 and 2013 at a single institution tertiary-care referral center. All specimens were evaluated by dedicated uropathologists. Univariable and multivariable Cox regression analyses tested the impact of the presence of pure and mixed histologic variants versus pure urothelial on recurrence, cancer-specific mortality, and overall mortality after accounting for all available confounders...
December 14, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28040419/a-novel-treatment-strategy-for-newly-diagnosed-high-grade-t1-bladder-cancer-gemcitabine-and-cisplatin-adjuvant-chemotherapy-a-single-institution-experience
#11
Guo-Liang Yang, Lian-Hua Zhang, Qiang Liu, Zhao-Liang Wang, Xue-Hui Duan, Yi-Ran Huang, Juan-Jie Bo
BACKGROUND: Management of high-grade T1 (formerly T1G3) bladder cancer continues to be controversial. Should patients with T1G3 bladder cancer have an immediate radical cystectomy or should they receive intravesical bacillus Calmette-Guérin-preserving bladder? Gemcitabine and cisplatin (GC) adjuvant chemotherapy may help to strike a balance between intravesical and early cystectomy. For purposes of this study, we continue to refer high-grade T1 lesion as "T1G3." OBJECTIVE: To evaluate the characteristics and the long-term outcome of GC adjuvant chemotherapy in T1G3 bladder cancer after transurethral resection of bladder tumor (TURBT)...
December 28, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/28040351/clinical-outcomes-of-patients-with-histologic-variants-of-urothelial-cancer-treated-with-trimodality-bladder-sparing-therapy
#12
Ross E Krasnow, Michael Drumm, Hannah J Roberts, Andrzej Niemierko, Chin-Lee Wu, Shulin Wu, Jing Zhang, Niall M Heney, Matthew F Wszolek, Michael L Blute, Adam S Feldman, Richard J Lee, Anthony L Zietman, William U Shipley, Jason A Efstathiou
BACKGROUND: Trimodality bladder-sparing therapy (TMT) is an acceptable treatment for selected patients with muscle-invasive urothelial cancer. Outcomes of TMT in histologic variants remains largely unknown. OBJECTIVE: To compare outcomes of pure urothelial carcinoma (PUC) to variant urothelial carcinoma (VUC) after TMT. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of patients treated with TMT at a single cancer center from 1993 until 2013...
December 28, 2016: European Urology
https://www.readbyqxmd.com/read/28035325/effect-of-neoadjuvant-chemotherapy-on-renal-function-following-radical-cystectomy-is-there-a%C3%A2-meaningful-impact
#13
Thenappan Chandrasekar, Neil Pugashetti, Blythe Durbin-Johnson, Marc A Dall'Era, Christopher P Evans, Ralph W deVere White, Stanley A Yap
Objective: To evaluate the patterns of impact of neoadjuvant chemotherapy (NAC) on renal function across the initial year following treatment for muscle-invasive bladder cancer (MIBC) with radical cystectomy (RC). Methods: We reviewed the charts of 241 patients who underwent RC for urothelial carcinoma of the bladder between 2003-14 at our institution. Renal function was evaluated at multiple time points (pre-chemotherapy, pre-operatively, post-operatively, 6-12 months follow-up), and then classified by CKD staging...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28035324/the-july-effect-in-radical-cystectomy-mortality-morbidity-and-efficiency
#14
Keegan Zuk, Derek Jensen, Jessie Gills, Hadley Wyre, Jeffrey M Holzbeierlein, Ernesto Lopez-Corona, Eugene K Lee
Background: The "July effect" is the potential effect that new and recently promoted residents have on patient care during the first months of the academic year. Literature suggests that the July effect may worsen patient outcomes and lead to systemic inefficiencies. Objective: We evaluate the July effect on mortality, morbidity, and efficiency outcomes in patients undergoing radical cystectomy. Methods: A chart review was performed in patients who underwent radical cystectomy between January 2008 and April 2012...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28035322/micropapillary-bladder-cancer-insights-from-the-national-cancer-database
#15
Wilson Sui, Justin T Matulay, Maxwell B James, Ifeanyi C Onyeji, Marissa C Theofanides, Arindam RoyChoudhury, G Joel DeCastro, Sven Wenske
Introduction: Micropapillary bladder cancer (MPBC) is a variant histology of urothelial carcinoma (UC) that is associated with poor outcomes however given its rarity, little is known outside of institutional reports. We sought to use a population-level cancer database to assess survival outcomes in patients treated with surgery, radiation therapy and/or chemotherapy. Materials and Methods: The National Cancer Database (NCDB) was queried for all cases of MPBC and UC using International Classification of Disease-O-3 morphologic codes between 2004-2014...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28035321/patterns-of-bladder-preservation-therapy%C3%A2-utilization-for-muscle-invasive-bladder-cancer
#16
Tracy L Rose, Allison M Deal, Sylvain Ladoire, Gilles Créhange, Matthew D Galsky, Jonathan E Rosenberg, Joaquim Bellmunt, Akhila Wimalasingham, Yu-Ning Wong, Lauren C Harshman, Simon Chowdhury, Guenter Niegisch, Michalis Liontos, Evan Y Yu, Sumanta K Pal, Ronald C Chen, Andrew Z Wang, Matthew E Nielsen, Angela B Smith, Matthew I Milowsky
Background: Trimodality bladder preservation therapy (BPT) in muscle invasive bladder cancer (MIBC) includes a maximal transurethral resection followed by concurrent chemoradiotherapy as an alternative to radical cystectomy (RC) in appropriately selected patients, or as a treatment option in non-cystectomy candidates. Several chemotherapy regimens can be used in BPT, but little is known about current practice patterns. Objective: To describe utilization patterns of BPT and associated survival outcomes in MIBC...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28035319/the-role-of-transurethral-resection-in%C3%A2-trimodal-therapy-for-muscle-invasive-bladder-cancer
#17
REVIEW
Christopher M Russell, Amir H Lebastchi, Tudor Borza, Daniel E Spratt, Todd M Morgan
While radical cystectomy (RC) with pelvic lymph node dissection (PLND) represents the accepted gold standard for the treatment of muscle-invasive bladder cancer, this treatment approach is associated with significant morbidity. As such, bladder preservation strategies are often utilized in patients who are either deemed medically unfit due to significant comorbidities or whom decline management with RC and PLND secondary to its associated morbidity. In a select group of patients, meeting strict criteria, bladder preservation approaches may be employed with curative intent...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28034491/a-role-of-multimodality-bladder-preserving-therapy-in-patients-with-muscle-invasive-bladder-cancer-plus-hydronephrosis-with-or-without-pelvic-nodal-involvement
#18
Yun Chiang, Jason Chia-Hsien Cheng, Chao-Yuan Huang, Yu-Chieh Tsai, Chia-Chi Lin, Chih-Hung Hsu, Ann-Lii Cheng, Yeong-Shiau Pu
BACKGROUND/PURPOSE: To retrospectively evaluate the failure patterns of multimodality bladder-preserving therapy in patients with muscle-invasive bladder cancer. METHODS: Patients with muscle-invasive bladder cancer underwent maximal transurethral resection of bladder tumor and induction chemotherapy, followed by concurrent chemoradiotherapy (CCRT). Radiotherapy was given with 45 Gy to the pelvis, 50.4 Gy to the bladder, and 64.8 Gy to the tumor bed. Three protocols of trimodality treatment were used: Protocol A, three cycles of cisplatin and fluorouracil (CF), followed by CCRT with 6 weekly cisplatin; Protocol B, three cycles of weekly paclitaxel plus CF, followed by CCRT with 6 weekly paclitaxel and cisplatin; Protocol C, three cycles of gemcitabine and cisplatin, followed by CCRT with 6 weekly cisplatin...
December 26, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28032711/treatment-for-periprosthetic-cyst-after-total-hip-arthroplasty-analysis-of-six-cases
#19
Wei-Ding Cui, Wei-Min Fan, Zhe-Feng Chen, Feng Liu
The present study investigates the pathogenesis of periprosthetic cysts after total hip replacement, and explores appropriate treatment appoaches. Six patients with periprosthetic cysts after total hip arthroplasty were treated at the First Affiliated Hospital of Nanjing Medical University between 2009 and 2014. During surgery, it was found that all cysts communicated with the hip and the hip prosthesis could be seen after cyst excision. Four patients simply underwent cyst excision, and light red liquid was found in the cyst...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28025739/parastomal-hernia-following-cystectomy-and-ileal-conduit-urinary-diversion-a-systematic-review
#20
REVIEW
Sunil K Narang, Nasra N Alam, Nick J Campain, Samir Pathak, John S McGrath, Ian R Daniels, Neil J Smart
PURPOSE: The natural history of development of Parastomal hernia (PH) following cystectomy and ileal conduit diversion is poorly understood. The aim of this study was to systematically review the frequency and risk factors of PH following ileal conduit diversion. METHODS: A systematic review of literature was performed and the Cochrane, EMBASE and PubMed databases were searched from 1(st) January 1985 to 30th April 2016. All articles reporting occurrence of PH following cystectomy and ileal conduit diversion were analysed...
December 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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