Reviews in urology最新文献_第9页

Focal Ablation of Prostate Cancer. 癌症前列腺局部消融。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0812

Herbert Lepor

{"title":"Focal Ablation of Prostate Cancer.","authors":"Herbert Lepor","doi":"10.3909/riu0812","DOIUrl":"10.3909/riu0812","url":null,"abstract":"Prior to the era of prostate-specific antigen (PSA) screening, at the time of diagnosis most prostate cancers were locally advanced or metastatic. The most common treatment for prostate cancer was androgen deprivation achieved via medical or surgical castration. The rare man diagnosed with a prostate nodule confined to the gland underwent radical prostatectomy (RP) or radiation therapy (RT) with the intent of curing the disease. In fact, between 1951 and 1963, Hugh Jewitt, MD, the preeminent prostate cancer surgeon at the Johns Hopkins Hospital, performed only 53 RPs.1 Prostatectomy provided durable cancer control for most men with these “early” prostate cancers.2 The clinical challenge was to develop a screening strategy that could identify a greater proportion of men with localized prostate cancer amenable to cure. The only cases managed by active surveillance (AS) in the pre–PSA screening era were men with stage A1 prostate cancer (low-grade and low-volume disease) diagnosed at the time of transurethral resection of the prostate.3 In the 1980s, there were several advances that contributed to the widespread acceptance of PSA screening. A major disincentive for detecting early disease was the significant morbidity associated with both RP and RT. The description of the anatomic nerve-sparing radical prostatectomy4 and more precise delivery of radiation therapy5 greatly reduced the morbidity of whole-gland curative interventions. Around this time, both transrectal ultrasonography (TRUS)6 and serum PSA7,8 were being independently explored as tools for early detection of prostate cancer. Ultimately, PSA testing became the primary screening tool for identifying men at risk for harboring prostate cancer. Diagnostic confirmation ultimately relied upon TRUS-guided biopsy (SB). Due to the limitations of TRUS, biopsy approaches evolved into systematic, random sampling.9","PeriodicalId":21185,"journal":{"name":"Reviews in urology","volume":"20 2","pages":"107-111"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168321/pdf/RIU020002_107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36559272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Balancing Confounding and Generalizability Using Observational, Real-world Data: 17-gene Genomic Prostate Score Assay Effect on Active Surveillance. 使用观察、真实世界数据平衡混淆和泛化：17基因基因组前列腺评分测定对主动监测的影响。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0799

Steven Canfield, Michael J Kemeter, Phillip G Febbo, John Hornberger

{"title":"Balancing Confounding and Generalizability Using Observational, Real-world Data: 17-gene Genomic Prostate Score Assay Effect on Active Surveillance.","authors":"Steven Canfield, Michael J Kemeter, Phillip G Febbo, John Hornberger","doi":"10.3909/riu0799","DOIUrl":"10.3909/riu0799","url":null,"abstract":"Randomized, controlled trials can provide high-quality, unbiased evidence for therapeutic interventions but are not always a practical or viable study design for certain healthcare decisions, such as those involving prognostic or predictive testing. Studies using large, real-world databases may be more appropriate and more generalizable to the intended target population of physicians and patients to answer these questions but carry potential for hidden bias. We illustrate several emerging methods of analyzing observational studies using propensity score matching (PSM) and coarsened exact matching (CEM). These advanced statistical methods are intended to reveal a \"hidden experiment\" within an observational database, and so refute or confirm a potential causal effect of assignment to an intervention and study outcome. We applied these methods to the Optum™ Research Database (ORD; Eden Prairie, MN) of electronic health records and administrative claims data to assess the effect of the 17-gene Genomic Prostate Score® (GPS™; Genomic Health, Redwood City, CA) assay on use of active surveillance (AS). In a traditional multivariable logistic regression, the GPS assay increased the use of AS by 29% (95% CI, 24%-33%). Upon applying the matching methods, the effect of the GPS assay on AS use varied between 27% and 80% and the matched data were significant among all algorithms. All matching algorithms performed well in identifying matched data that improved the imbalance in baseline covariates. By using different matching methods to assess causal inference in an observational database, we provide further confidence that the effect of the GPS assay on AS use is statistically significant and unlikely to be a result of confounding due to differences in baseline characteristics of the patients or the settings in which they were seen.","PeriodicalId":21185,"journal":{"name":"Reviews in urology","volume":"20 2","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168323/pdf/RIU020002_069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36599626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

LUGPA Onsite and LUGPA Virtual Crossfire Programs Offer Novel Alternatives to Attending an Out-oftown LUGPA Meeting. LUGPA现场和LUGPA虚拟交叉火力项目为参加城外的LUGPA会议提供了新颖的选择。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0791

Neal D Shore

引用次数: 1

Best of the 2018 AUA Annual Meeting. 2018 AUA年会最佳成绩。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0806

Zeyad R Schwen, Alan W Partin

引用次数: 1

Endoscopic Management of Ureteral Stricture: NYU Case of the Month, August 2018. 输尿管狭窄的内镜治疗:纽约大学本月病例，2018年8月。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0819

Philip Zhao

引用次数: 1

Accuracy in 24-hour Urine Collection at a Tertiary Center. 三级中心24小时尿液采集的准确性。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0807

Carter Boyd, Kyle Wood, Dustin Whitaker, Omotola Ashorobi, Lisa Harvey, Robert Oster, Ross P Holmes, Dean G Assimos

{"title":"Accuracy in 24-hour Urine Collection at a Tertiary Center.","authors":"Carter Boyd, Kyle Wood, Dustin Whitaker, Omotola Ashorobi, Lisa Harvey, Robert Oster, Ross P Holmes, Dean G Assimos","doi":"10.3909/riu0807","DOIUrl":"10.3909/riu0807","url":null,"abstract":"There is a paucity of studies addressing the accuracy of 24-hour urine collection for assessing stone risk parameters. Collection accuracy is thought to be essential for assigning optimal therapy for stone prevention. The objective of this study was to determine factors associated with accurate and inaccurate collections. During a 2-year period (2015-2016), 241 stone formers completed 24-hour urine collections. They were divided into accurate collectors (AC), defined as at least one accurate urine collection, and inaccurate collectors (IC). Accuracy was assessed by 24-hour urine creatinine (Cr) excretion indexed to body weight (normal: males, 20-25 mg Cr/kg; females, 15-20 mg Cr/kg). Demographic data analyzed included age, gender, race, insurance status, partner status, income, and education. Statistical analysis methods included the chi-square test, Fisher's exact test, and the two-group t-test. Average age was 50.7 years at the time of collection; 50.2% were men, 86% were white, and 14% were black. Overall, 51.0% of collections were inaccurate. There was no statistical significance between AC and IC for gender (P = 0.85), race (P = 0.90), insurance status (P = 0.85), recurrence (P = 0.87), stone type (P = 0.57), education (P = 0.35), income (P 5 0.42), or poverty (P = 0.35). Older age (P = 0.017) and having a partner (P = 0.022) were significantly associated with AC. The high rate of inaccurate 24-hour urine collections is a concern. The only factors we identified as influencing collection accuracy were age and partner status. These results underscore the importance of developing methods to improve the accuracy of collecting 24-hour urine samples.","PeriodicalId":21185,"journal":{"name":"Reviews in urology","volume":"20 3","pages":"119-124"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241899/pdf/RiU020003_119.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36763013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Management of Recurrent Non-Muscle Invasive Bladder Cancer. 复发性非肌肉浸润性膀胱癌的治疗。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0789

Marc A Bjurlin

引用次数: 0

Female Urethral Stricture: NYU Case of the Month, September 2018. 女性尿道狭窄:纽约大学本月病例，2018年9月。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0824A

Benjamin M Brucker

引用次数: 0

Focal Ablation of Prostate Cancer. 癌症前列腺局部消融。

Reviews in urology Pub Date : 2018-01-01 DOI: 10.3909/riu0809

Herbert Lepor, Samuel Gold, James Wysock