European Urology Open Science最新文献

{"title":"Assessing the Cause of Death for Men with Prostate Cancer Using Official Mortality Statistics or a Dedicated Cause of Death Committee: Results from 30-year ERSPC Rotterdam Data","authors":"Sebastiaan Remmers ,&nbsp;Ivo I. de Vos ,&nbsp;Frederique B. Denijs ,&nbsp;Renée C.A. Leenen ,&nbsp;Tycho M.T.W. Lock ,&nbsp;Arjen Noordzij ,&nbsp;Wim J. Kirkels ,&nbsp;Chris H. Bangma ,&nbsp;Monique J. Roobol ,&nbsp;ERSPC Rotterdam Study Group","doi":"10.1016/j.euros.2024.10.021","DOIUrl":"10.1016/j.euros.2024.10.021","url":null,"abstract":"<div><div>For men with prostate cancer (PCa) within the European Randomized Study of Screening for Prostate Cancer (ERSPC), the cause of death is determined by a Cause of Death Committee (CODC) that evaluates all medical records using a fixed algorithm. The aim of this study was to compare the classification of PCa-specific mortality (PCSM) between the CODC and Statistics Netherlands. We calculated the sensitivity (PCSM agreement divided by total PCSM deaths according to the CODC) and specificity (agreement for other-cause mortality [OCM] divided by total OCM deaths according to the CODC) using the last 21-yr follow-up data from ERSPC Rotterdam. For the core age group (age 55–69 yr at randomization; <em>n</em> = 1732), the sensitivity was 86% (95% CI 83-89) and specificity was 93% (95% CI 91-94), with no statistical difference between the youngest ages and the oldest ages. Extrapolation of our findings to 30 yr of follow-up would result in an expected risk reduction of PCSM of 30% using data from the CODC and 33% using official statistics in favor of screening. In conclusion, our results support the use of official statistics in determining the cause of death, without compromising the main outcome of ERSPC Rotterdam.</div></div><div><h3>Patient summary</h3><div>We compared the classification of prostate cancer death between a dedicated trial committee and official statistics in the Netherlands. We found that official statistics are an accurate representation in determining the cause of death.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"71 ","pages":"Pages 11-14"},"PeriodicalIF":3.2,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Patient and Clinician Perspectives on Clinically Meaningful Extension of Progression-free Survival in Prostate Cancer","authors":"Ek Leone Oh ,&nbsp;Wade Huish ,&nbsp;Sara El-Gamil ,&nbsp;Tim Benson ,&nbsp;Thomas Ferguson","doi":"10.1016/j.euros.2024.10.018","DOIUrl":"10.1016/j.euros.2024.10.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt;It is widely accepted that the value of treatments for incurable metastatic cancer depends on their ability to improve overall survival (OS), quality of life (QoL), or both. Progression-free survival (PFS) is frequently used as a primary endpoint because of challenges in accurately assessing OS and QoL. The perceived value of extending PFS when there is uncertainty regarding the benefit to OS/QoL may vary between clinicians and patients. The aim of our study was to measure patient and clinician perspectives on what defines a clinically meaningful PFS benefit.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted an observational study using a self-administered questionnaire. Participants included patients with advanced prostate cancer (PC) and medical oncology clinicians treating patients with PC. The questionnaire presented a hypothetical scenario of metastatic castrate-resistant PC (mCRPC). Participants were asked about their willingness to undergo or prescribe treatment offering PFS benefits despite uncertain OS outcomes. Participants specified the minimum extension of PFS (ePFS&lt;sub&gt;min&lt;/sub&gt;) beyond the estimated 18-mo duration outlined in the scenario while considering varying toxicity levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Key findings and limitations&lt;/h3&gt;&lt;div&gt;Between April and May 2024, 54 patient responses and 27 clinician responses were received. Some 50/54 patient participants (92.6%) and 22/27 clinician participants (81.5%) expressed willingness to accept a prospective treatment associated with longer PFS but uncertain OS benefit. For treatment with no or mild toxicity, the median ePFS&lt;sub&gt;min&lt;/sub&gt; for treatment acceptance was &gt;12 mo for patient participants and 3–6 mo for clinician participants. For treatment with severe toxicity, 40.7% of patients and 51.9% of clinicians would not accept treatment; the ePFS&lt;sub&gt;min&lt;/sub&gt; for treatment acceptance was 3–6 mo for patient participants and &gt;12 mo for clinician participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;&lt;div&gt;Most patients and clinicians are open to mCRPC treatment with evidence of PFS benefits despite OS uncertainty. Patients needed longer PFS extension to justify treatment but were more accepting of side effects and placed greater importance on a prostate-specific antigen or radiological response than clinicians. The relationship between ePFS&lt;sub&gt;min&lt;/sub&gt; and treatment acceptance according to toxicity levels for patients was unclear, limited by the nature of the self-administered questionnaires.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient summary&lt;/h3&gt;&lt;div&gt;We surveyed patients and doctors about their views on an imaginary treatment for advanced prostate cancer that could delay disease progression but with no certainty about whether it would extend life expectancy. Both patients and doctors were open to this treatment, but patients expected a longer delay in disease progression than doctors before being willing to accept this imaginary tr","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"70 ","pages":"Pages 175-182"},"PeriodicalIF":3.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AGREE II Quality Assessment of National and International Clinical Practice Guidelines on Prostate Cancer Management by the OPTIMA Consortium","authors":"Vasileios Sakalis ,&nbsp;Yagnaseni Bhattacharya ,&nbsp;Katharina Beyer ,&nbsp;Charlotte Murray ,&nbsp;Emma Jane Smith ,&nbsp;Peter-Paul M. Willemse ,&nbsp;Giorgio Gandaglia ,&nbsp;Romain Boissier ,&nbsp;Angelika Borkowetz ,&nbsp;Saeed Dabestani ,&nbsp;Renee C.A. Leenen ,&nbsp;Antoni Vilaseca ,&nbsp;Gianluca Maresca ,&nbsp;Jeremy Teoh ,&nbsp;Juan Gómez Rivas ,&nbsp;Pawel Rajwa ,&nbsp;Michael Lardas ,&nbsp;Nikolas Grivas ,&nbsp;Thomas Van den Broeck ,&nbsp;Benjamin Pradere ,&nbsp;Muhammad Imran Omar","doi":"10.1016/j.euros.2024.10.020","DOIUrl":"10.1016/j.euros.2024.10.020","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt; &lt;!--&gt;Clinical practice guidelines for prostate cancer (PCa) are a valuable resource for everyday clinical practice. The clinical practice guidelines and recommendations produced by various societies should demonstrate a considerable level of consistency in terms of quality, regardless of the society that developed these given the common evidence base. However, to date, no study has assessed the quality of PCa clinical practice guidelines. As part of the Optimal Treatment for Patients with Solid Tumours in Europe Through Artificial intelligence (OPTIMA) project, we evaluated the quality of the most frequently used national and international clinical practice guidelines for PCa using the Appraisal of Guidelines for Research &amp; Evaluation II (AGREE II) tool.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The quality of the identified clinical practice guidelines was assessed independently by two assessors using the AGREE II tool. The AGREE II tool comprises 23 different items organised into six domains, rated on a 7-point scale (1: strongly disagree to 7: strongly agree). The total score of the appraisal was the mean value of the two assessments. The agreement between assessors’ scores was calculated using the interclass correlation coefficient (ICC). Four key recommendations were compared among the included clinical practice guidelines to assess consistency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Key findings and limitations&lt;/h3&gt;&lt;div&gt;Sixteen clinical practice guidelines were assessed using their latest available version (cut-off April 2024). The European Association of Urology, S3LL PCa, Belgian Health Care Knowledge Centre, National Comprehensive Cancer Network, and Prostatacancer—Nationellt vårdprogram guidelines received the highest overall scores with a mean domain score of 82.4% (range: 75.5–88.3%). The de&lt;!--&gt; &lt;!--&gt;l’Association Française d’Urologie (AFU), American Urological Association, and National Institute for Health and Care Excellence received a mean domain score of 77.6% (range: 73.7–84.0%). Below average were the European Society for Medical Oncology, localised (L) and systemic (S) CPPC American Society of Clinical Oncology, and Nederlandse Vereniging voor Urologie (NVU) with a mean domain score of 58.4% (range: 43.5–76.3%). The reasons for scoring below average included the following: inadequate information about the methodology applied, limited scope of the guideline, and limited patient engagement. The highest inter-rater variability was observed in NVU (ICC: 0.58) and the lowest in AFU-L (ICC: 0.84). When examining the scores of each domain, “clarity of presentation” (domain 4) achieved the highest score with a mean of 86.9% ± 12.6%. The domain with the lowest score was applicability (domain 5), with a mean of 48.3% ± 24.8%. The ICC was calculated to be 0.72 (±0.08).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;&lt;div&gt;This is the first study in which a comprehensive quality assessment of the major","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"70 ","pages":"Pages 183-193"},"PeriodicalIF":3.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Emilio Arbelaez, Iris Zünti, Sarah Tschudin-Sutter, et al. Catheter-associated Urinary Tract Infections—Online Questionnaire: Status Quo in Central European Urological Management of Catheter-associated Urinary Tract Infection. Eur Urol Open Sci 2024;69:63–70","authors":"Amnuay Kleebayoon ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.euros.2024.10.017","DOIUrl":"10.1016/j.euros.2024.10.017","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"70 ","pages":"Page 174"},"PeriodicalIF":3.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible Ureteroscopy with a Tip-bendable Suction Ureteral Access Sheath Versus Mini-Percutaneous Nephrolithotomy for Treatment of 2–3-cm Renal Stones: Study Protocol for an International, Multicenter, Randomized, Parallel-group, Noninferiority Trial","authors":"Wei Zhu ,&nbsp;Chu Ann Chai ,&nbsp;Jinxiang Ma ,&nbsp;Mehmet İlker Gökce ,&nbsp;Nariman Gadzhiev ,&nbsp;Jaisukh Kalathia ,&nbsp;Kehua Jiang ,&nbsp;Xianzhong Duan ,&nbsp;Jianwei Cao ,&nbsp;Rongpei Wu ,&nbsp;Rijin Song ,&nbsp;Song Bai ,&nbsp;Xuedong Li ,&nbsp;Shusheng Liu ,&nbsp;Guohua Zeng","doi":"10.1016/j.euros.2024.10.014","DOIUrl":"10.1016/j.euros.2024.10.014","url":null,"abstract":"<div><div>Guidelines recommend percutaneous nephrolithotomy (PCNL) for larger renal stones, but advances in flexible ureteroscopy (f-URS) with a tip-bendable suction ureteral access sheath (S-UAS) have prompted further investigation. Our multicenter, international, randomized controlled trial is investigating whether f-URS with S-UAS is noninferior to mini-PCNL (mPCNL) for renal stones of 2–3 cm. The primary objective is the immediate stone-free rate (SFR). Secondary outcomes include the 3-mo SFR, complication rates, surgical time, hospital stay, auxiliary procedures, and improvements in quality of life. A total of 720 patients from 12 urological centers will be randomized to either f-URS with S-UAS or PCNL. Statistical analyses will include intention-to-treat and per-protocol approaches, with specific methods for normally and non-normally distributed data. Subgroup analyses will focus on stone location and lithotripter types. The significance threshold will be set at <em>p</em> &lt; 0.05. The aim of this trial is to generate high-level evidence regarding the noninferiority of f-URS with S-UAS compared to mPCNL for medium-sized renal stones.</div><div>The trial is registered on ClinicalTrials.gov as NCT06526390.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"70 ","pages":"Pages 167-173"},"PeriodicalIF":3.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of GeneXpert BC as a Triage Test for Patients Presenting with Macroscopic Hematuria Suspicious for Urinary Bladder Cancer: A Multicenter Prospective Case-Control Study","authors":"Suleiman Abuhasanein ,&nbsp;Jonatan Radmann ,&nbsp;Staffan Jahnson ,&nbsp;Henrik Kjölhede","doi":"10.1016/j.euros.2024.10.016","DOIUrl":"10.1016/j.euros.2024.10.016","url":null,"abstract":"<div><h3>Background and objective</h3><div>Our objective was to assess whether GeneXpert BC can be used as a triage test to exclude urinary bladder cancer (UBC) for patients with macroscopic hematuria.</div></div><div><h3>Methods</h3><div>We conducted a prospective study that include consecutive patients being evaluated for macroscopic hematuria between September 2020 and December 2022. Before cystoscopy, study participants provided a voided urine sample for GeneXpert BC analysis according to a case-control design with an emphasis on UBC detection. Descriptive statistics are reported for patient and tumor characteristics. To assess the diagnostic accuracy of the GeneXpert BC test, the sensitivity, specificity, and negative predictive value (NPV) were calculated, using the histopathologically proven UBC as the ground truth.</div></div><div><h3>Key findings and limitations</h3><div>In total, 1505 subjects presenting with macroscopic hematuria were enrolled in the study. After randomization and exclusions, GeneXpert BC testing was carried out for 312 participants. Of these, 151 patients from the case arm had UBC, 122 patients from the control arm (random 10%) were negative for UBC, and 39 patients from the case arm did not have malignancy. Using a predefined linear discriminant analysis (LDA) threshold of ≥0.22, the test had sensitivity of 0.94 (95% confidence interval [CI] 0.90–0.97), specificity of 0.52 (95% CI 0.42–0.59), and NPV of 0.99 (95% CI 0.98–0.99). All false-negative tumors were of low grade (Ta grade 1–2). Cystoscopy and computed tomography urography could have been omitted in 44% of the patients with macroscopic hematuria. At a secondary LDA threshold of ≥0.45, the test had sensitivity of 0.79 (95% CI 0.73–0.86), specificity of 0.83 (95% CI 0.76–0.89), and NPV of 0.97 (95% CI 0.96–0.98).</div></div><div><h3>Conclusions and clinical implications</h3><div>GeneXpert BC is a reliable triage test for deciding on whether further investigations are necessary in patients with macroscopic hematuria.</div></div><div><h3>Patient summary</h3><div>We assessed a test called GeneXpert BC for the detection of bladder cancer in patients with blood in their urine. GeneXpert BC performed well in ruling out bladder cancer for patients who did not have cancer according to further tests. Use of GeneXpert BC could help in avoiding scans and invasive tests for patients with a negative result.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"70 ","pages":"Pages 158-166"},"PeriodicalIF":3.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P005 Ultrasound (US) with Fine Needle Aspiration Cytology (FNAC) as an adjunct in staging cN0 penile cancer patients: Outcomes of a regional centre in the UK","authors":"Fernandes R.,&nbsp;Mubarak M.,&nbsp;Mcguinness L.","doi":"10.1016/S2666-1683(24)01136-4","DOIUrl":"10.1016/S2666-1683(24)01136-4","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"69 ","pages":"Page 6"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P044 A prospective randomized multicenter study on the impact of [18f]choline PET/CT versus conventional imaging for staging intermediate- to high-risk prostate cancer","authors":"Zattoni F.,&nbsp;Novara G.,&nbsp;Burei M.,&nbsp;Bertin D.,&nbsp;Borsatti E.,&nbsp;Baresic T.,&nbsp;Farsad M.,&nbsp;Trenti E.,&nbsp;Bartolomei M.,&nbsp;Panareo S.,&nbsp;Urse L.,&nbsp;Del Bianco P.,&nbsp;Magni G.,&nbsp;De Salvo G.L.,&nbsp;Dal Moro F.,&nbsp;Evangelista L.","doi":"10.1016/S2666-1683(24)01172-8","DOIUrl":"10.1016/S2666-1683(24)01172-8","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"69 ","pages":"Pages 54-55"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P041 MRI-fusion targeted single versus 3 cores index lesions’ biopsy in prostate cancer diagnostic – a bi-center, prospective clinical comparison “through the looking glass” of mismatch-related diagnostic accuracy and peri-procedural complications’ rate","authors":"Geavlete B.,&nbsp;Predoiu G.,&nbsp;Petca R-C.,&nbsp;Geavlete P.,&nbsp;Multescu R.,&nbsp;Mares C.,&nbsp;Georgescu D.,&nbsp;Popescu R-I.","doi":"10.1016/S2666-1683(24)01169-8","DOIUrl":"10.1016/S2666-1683(24)01169-8","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"69 ","pages":"Page 50"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P055 Dosimetric benefits of CT-based online adaptive radiotherapy in stereotactic body radiation therapy for prostate cancer","authors":"Park Y.,&nbsp;Kang B-H.,&nbsp;Lee E.,&nbsp;Park H.J.","doi":"10.1016/S2666-1683(24)01183-2","DOIUrl":"10.1016/S2666-1683(24)01183-2","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"69 ","pages":"Page 68"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}