Cancer Urology最新文献

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Results of surgical treatment of malignant kidney tumors based on the materials of urology departments of the Siberian State Medical University clinics 基于西伯利亚国立医科大学泌尿外科门诊资料的恶性肾肿瘤手术治疗结果分析
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-25-32
V. R. Latypov, V. Popov, V. N. Latypova, S. I. Novikov, D. B. Akhmedov, O. S. Zebzeeva
{"title":"Results of surgical treatment of malignant kidney tumors based on the materials of urology departments of the Siberian State Medical University clinics","authors":"V. R. Latypov, V. Popov, V. N. Latypova, S. I. Novikov, D. B. Akhmedov, O. S. Zebzeeva","doi":"10.17650/1726-9776-2022-18-4-25-32","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-25-32","url":null,"abstract":"Aim. To analyze the results of treatment of patients with kidney tumors in urology departments of the Siberian State Medical University clinics.Materials and methods. The number of patients with kidney tumors hospitalized in the urology department of the general surgery clinic was 7–10 % of the total annual number of surgical interventions in the urology department. We analyzed 132 cases of malignant kidney tumors. All patients went through imaging and laboratory studies.Results. Treatment results are known in 125 (94.0 %) patients. Mean age of patients was 57.9 years (27 to 86), there were 77 men and 55 women (1.4:1 ratio). Mean tumor size was 6.5 ± 3.6 cm, no significant differences were observed between men and women. Radical nephrectomy was performed in 75 (56.8 %) patients, kidney resection in 57 (43.2 %) patients. Tumor size in nephrectomy cases was 8.2 ± 3.7 cm and 4.3 ± 2.1 cm in kidney resection (p <0.05). In patients with larger tumors five-year survival was lower: tumor size £4 cm was associated with five-year survival of 79.6 %, while tumor size >7 cm with only 36.9 % (p = 0.001).In our study, 23 (17.4 %) patients with inferior vena cava thrombosis were operated on: 11 (8.3 %) men, 12 (9.1 %) women. Mean age of patients with inferior vena cava thrombosis was 57.2 years (between 35 and 74 years). In this group of patients, mean tumor size was 10.8 ± 4.1 cm (between 4.2 and 19). Based on TNM classification, tumors were classified as follows: T3b stage – 17 (12.9 %), T4 stage – 6 (4.5 %), N0 – 15 (11.4 %), N+ – 8 (6.1 %). Left kidney was affected in 6 (4.5 %) cases, right kidney was affected in 17 (12.9 %) cases. Type of surgery performed in this group of patients was classified as: radical nephrectomy with thrombectomy and lymphadenectomy, one case included resection of the inferior vena cava with a section reconstructed using a xenopericardial transplant. Mean surgery duration was 212.4 ± 52.3 (130–320) minutes. Mean blood loss volume was 1177.0 ± 933.4 (100–4600) ml. Postoperative complications were observed in 35 (21.2 %) patients. Overall five-year survival for patients with malignant kidney tumors was 61.8 %, for patients with tumor thrombosis it was 31.3 %.Conclusion. Surgical treatment of patients with malignant kidney tumors allows to significantly improve patients’ survival preserving quality of life.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126995482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of radical prostatectomy in treatment of locally advanced prostate cancer: clinical observations 根治性前列腺切除术治疗局部晚期前列腺癌的临床观察
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-42-55
S. Popov, R. Guseynov, I. Orlov, K. V. Sivak, O. Skryabin, V. V. Perepelitsa, A. Katunin, S. Yasheva, A. S. Zaytsev
{"title":"Outcomes of radical prostatectomy in treatment of locally advanced prostate cancer: clinical observations","authors":"S. Popov, R. Guseynov, I. Orlov, K. V. Sivak, O. Skryabin, V. V. Perepelitsa, A. Katunin, S. Yasheva, A. S. Zaytsev","doi":"10.17650/1726-9776-2022-18-4-42-55","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-42-55","url":null,"abstract":"Background. Radical prostatectomy in treatment of locally advanced prostate cancer is currently recommended as one of the stages of multimodal therapy. Despite this, the expediency of surgical intervention remains a subject of discussion: based on the results of their own research, supporters of surgical tactics for treatment of locally advanced prostate cancer point to the effectiveness and relative safety of radical prostatectomy, opponents point to the high probability of a positive surgical edge associated with the operation, local tumor recurrence, lymphogenic metastasis, and formation of distant metastases.Aim. To evaluate the outcomes of laparoscopic radical prostatectomy performed in combination with expanded pelvic lymphadenectomy in treatment of prostate adenocarcinoma T3a–3bN0M0.Materials and methods. The perioperative, functional, and oncological results of surgical treatment of patients with locally advanced prostate cancer (n = 32) aged between 46 years to 71 years were analyzed. The follow-up period averaged 9–36 months (median 13 months).Results. Mean total duration of surgical intervention and mean volume of intraoperative blood loss were 182.69 ± 3.99 minutes and 253.06 ± 9.80 ml, respectively. Overestimation of the clinical stage of the disease, according to histological examination of the surgical material, was observed in 6.3 % of patients. After the intervention, the function of urinary retention was preserved and did not require correction in 65.6 % of men. In all patients 6 months after the operation, the urinary volume, maximum and mean urine flow rates were normalized, and there was a trend toward a decrease in the post-void residual volume. During the entire follow-up period, there were no signs of biochemical relapse in 78.1 % of patients. None of the participants dropped out of the study due to death.Conclusion. Over the last 20 years in specialized medical periodicals, author teams from various countries have shown the immediate and remote (follow-up period from 3 to 20 years) outcomes of radical surgical treatment of locally advanced prostate cancer in at least 80,000 patients in total, while the criterion for exclusion from research was adjuvant therapy. The authors’ conclusions indicate the effectiveness and relative safety of surgical treatment of locally advanced prostate cancer, as well as the importance of extended pelvic lymphadenectomy, which allows to optimize the tactics of adjuvant therapy if necessary. The results of our own observations are completely comparable with the literature data. Currently, scientific research is continuing with the aim of improving the outcomes of surgical treatment of locally advanced prostate cancer, in particular clarifying the role of individual prognostic factors, improving prediction techniques and choosing a rational scheme of treatment measures.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127722152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Review of the article “Solitary renal cancer metastasis to the thoracic spine: case report” “孤立性肾癌转移至胸椎1例”一文综述
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-134-135
V. Shirokorad
{"title":"Review of the article “Solitary renal cancer metastasis to the thoracic spine: case report”","authors":"V. Shirokorad","doi":"10.17650/1726-9776-2022-18-4-134-135","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-134-135","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131850995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic and epigenetic characteristics of non-muscle invasive and muscle invasive bladder cancer in patients infected by human papillomavirus: literature review 人乳头瘤病毒感染患者非肌肉浸润性和肌肉浸润性膀胱癌的遗传和表观遗传学特征:文献综述
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-108-119
A. A. Pulatova, S. Dimitriadi, D. Kutilin, T. Zykova, A. N. Shevchenko, S. I. Goncharov, V. Khvan
{"title":"Genetic and epigenetic characteristics of non-muscle invasive and muscle invasive bladder cancer in patients infected by human papillomavirus: literature review","authors":"A. A. Pulatova, S. Dimitriadi, D. Kutilin, T. Zykova, A. N. Shevchenko, S. I. Goncharov, V. Khvan","doi":"10.17650/1726-9776-2022-18-4-108-119","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-108-119","url":null,"abstract":"Infectious diseases and chronic inflammation are important risk factors for the development of malignant tumors in humans. One of the key infectious agents involved in human oncogenesis is the human papillomavirus (HPV). Non-muscle invasive bladder cancer is defined as a superficial neoplasia limited to the mucosa, aggravated by recurrence in 80 % of cases and progression in 30 % of cases. The development of this disease is associated with the influence of various carcinogenic agents, including HPV. Currently, a direct relationship has been revealed between the presence of viral DNA in the tumor tissue of the bladder and markers of proliferative activity, angiogenesis, and apoptosis factors. More and more researchers believe in the involvement of the virus in the development of recurrent forms of bladder cancer and the emergence of its invasive/poorly differentiated forms. Improving the diagnosis and postoperative monitoring of non-muscle invasive and muscle invasive bladder cancer is not possible without the improvement of minimally invasive molecular methods, which requires an understanding of the molecular mechanisms of HPV-associated carcinogenesis.Therefore, this review focuses on the analysis of the molecular mechanisms of HPV effect on progression of non-muscle invasive and muscle invasive bladder cancer. The features of miRNA expression in patients with papillomavirus infection of high oncogenic risk types and non-muscle invasive or muscle invasive bladder cancer are considered in detail. In particular, the role of miR-34а, -218, -20a, -424, -200a, -205-5p, -944, -100, -99a, -202, -30a, -145-5p, -195 and -199a-5 is described in the development and progression of bladder cancer. The mechanisms of disruption in the functioning of key cell signaling pathways during HPV integration in patients with bladder cancer, including changes in gene copy number and methylation level, are also considered.However, the number of HPV-positive tumor specimens that have been comprehensively analyzed using genome-wide studies in the literature remains small. Larger patient cohorts would be useful to further refine HPV-associated integration events and genomic changes, as well as to study clinical manifestations of the consequences of these alterations. Further research on the clinical implications of the observed genomic changes is needed to accurately stratify patients for targeted therapy, radiation and chemotherapy.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116008967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progressive prostate cancer with metastasis in the urethra: clinical case 进展性前列腺癌伴尿道转移1例
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-136-140
A. A. Kеln, D. G. Alifov, A. V. Ratobolskikh, M. A. Zasorina, L. V. Volynkina, A. Kupchin, V. Novoselov, A. V. Vayradyan, M. S. Shvedskiy
{"title":"Progressive prostate cancer with metastasis in the urethra: clinical case","authors":"A. A. Kеln, D. G. Alifov, A. V. Ratobolskikh, M. A. Zasorina, L. V. Volynkina, A. Kupchin, V. Novoselov, A. V. Vayradyan, M. S. Shvedskiy","doi":"10.17650/1726-9776-2022-18-4-136-140","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-136-140","url":null,"abstract":"Prostate cancer metastases are a major cause of death among men. Almost all men who died from prostate cancer previously had metastases to the bones or other sites, including the lymph nodes, lung, and liver. Urethral metastases are one of the rarest locations of prostate cancer metastases. In this clinical case, we present a case of a man who had a recurrence of prostatic adenocarcinoma 36 months after radical prostatectomy; diagnosis and treatment of the patient are described.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132133690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prospective study of prostate cancer detection using multiparametric magnetic resonance imaging ultrasound-guided fusion, standard, and saturation biopsy 超声引导下多参数磁共振成像融合、标准和饱和活检检测前列腺癌的前瞻性研究
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-33-41
V. Petov, E. Y. Timofeeva, A. Bazarkin, A. Morozov, M. Taratkin, T. Ganzha, S. Danilov, Y. Chernov, A. Abdusalamov, A. Amosov, D. V. Enikeev, G. Krupinov
{"title":"Prospective study of prostate cancer detection using multiparametric magnetic resonance imaging ultrasound-guided fusion, standard, and saturation biopsy","authors":"V. Petov, E. Y. Timofeeva, A. Bazarkin, A. Morozov, M. Taratkin, T. Ganzha, S. Danilov, Y. Chernov, A. Abdusalamov, A. Amosov, D. V. Enikeev, G. Krupinov","doi":"10.17650/1726-9776-2022-18-4-33-41","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-33-41","url":null,"abstract":"Background. Currently, about 80 % of men with low-grade prostate cancer (per ISUP 1 (International Society of Urological Pathology)) have indications for radical treatment. Overdiagnosis of low-grade cancer is associated with the use of systematic biopsy methods (standard transrectal, saturation) under ultrasound control for diagnosis verification. To improve prostate cancer diagnosis, the European Association of Urology (2019) recommended multiparametric magnetic resonance imaging before biopsy, and in case of detection of a suspicious lesion magnetic resonance imaging (MRI)-targeted biopsy. In clinical practice, the most common method of MRI-targeted biopsy is multiparametric MRI ultrasound-guided (mpMRI/US) fusion biopsy. However, some studies show contradictory results in detection of prostate cancer using systematic and MRI-targeted biopsy techniques.Aim. To compare detection of clinically significant prostate cancer (ISUP ≥2) using mpMRI/US fusion, standard, and saturation biopsy.Materials and methods. The study included 96 patients. The following inclusion criteria were applied: prostate-specific antigen >2 ng/mL and/or detection of a suspicious lesion during digital rectal and/or transrectal ultrasound examination, and PI-RADS (Prostate Imaging Reporting and Data System) v.2.1 score ≥3. At the first stage, “unblinded” urologist performed a transperineal mpMRI/US fusion and saturation biopsies. At the second stage, “blinded” urologist performed standard transrectal biopsy. Clinically significant cancer was defined as ISUP ≥2.Results. Median age was 63 years, prostate volume – 47 cm3, prostate-specific antigen – 6.82 ng/mL. MpMRI/US fusion, standard, and saturation biopsies were comparable in regard to the rate of detection of clinically significant (29, 24, 28 %; p = 0.81) and clinically insignificant (25, 26, 35 %; p = 0.43) cancer. Overall prostate cancer detection rates were also similar: 54, 50, 63 %, respectively (p = 0.59). The percentages of positive cores in mpMRI/US fusion, standard, and saturation biopsies were 33, 10 and 13 %, respectively (p <0.01). The maximal core length in mpMRI/US was 6.4 mm, in standard biopsy – 6.35 mm, in saturation biopsy – 5.1 mm (p = 0.7).Conclusion. Detection rates of clinically significant, clinically insignificant prostate cancer and overall detection rate are comparable between systematic biopsy techniques and mpMRI/US fusion biopsy.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115609151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Solitary kidney cancer metastasis in the thoracic spine: case report 胸椎单发肾癌转移1例
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-129-133
S. A. Zamyatnin, I. S. Gonchar
{"title":"Solitary kidney cancer metastasis in the thoracic spine: case report","authors":"S. A. Zamyatnin, I. S. Gonchar","doi":"10.17650/1726-9776-2022-18-4-129-133","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-129-133","url":null,"abstract":"Metastasis of kidney cancer to the bone tissue can be manifested through development of pathological fractures and spinal cord lesions. The clinical case of clear cell renal cell carcinoma with solitary metastasis in the thoracic spine presented in this article demonstrates the possibility of clinical manifestation of the disease through neurological symptoms and the importance of timely comprehensive diagnosis and adherence to treatment deadlines.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"311 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132703355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Video endoscopic inguinofemoral lymphadenectomy in penile cancer 视频内镜下腹股沟淋巴结切除术在阴茎癌中的应用
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/726-9776-2022-18-4-72-80
E. Metelkova, P. Nesterov, E. V. Gurin, A. V. Ukharskiy
{"title":"Video endoscopic inguinofemoral lymphadenectomy in penile cancer","authors":"E. Metelkova, P. Nesterov, E. V. Gurin, A. V. Ukharskiy","doi":"10.17650/726-9776-2022-18-4-72-80","DOIUrl":"https://doi.org/10.17650/726-9776-2022-18-4-72-80","url":null,"abstract":"Background. Dissection of inguinal lymph nodes is an important method of treatment of invasive and locally advanced penile cancer. Unfortunately, the procedure is associated with very high complication rate exceeding 50 %.Aim. To perform retrospective comparative analysis of oncological outcomes, intraoperative and early postoperative complications of open and endoscopic inguinofemoral lymphadenectomy in treatment of patients with penile cancer.Materials and methods. Treatment outcomes of 64 patients with penile cancer who underwent open or video endoscopic lymphadenectomy were analyzed. Primary and secondary surgical treatment outcomes were evaluated.Results. Open inguinofemoral lymphadenectomy was performed in 54 patients, video endoscopic in 10. Analysis of primary surgical results showed a significant (3-fold) reduction of the duration of lymphorrhea and the duration of hospitalization (2-fold) in patients of the video endoscopic lymphadenectomy group. There was no difference in the number of removed lymph nodes in the two types of surgeries. Average operative time for video endoscopic lymphadenectomy was 15–20 % longer than operative time of open intervention. Analysis of safety indicators showed that during open surgery, the frequency of wound infection was 24 %, skin flap necrosis – 55.5 %, wound dehiscence – 52 %, lymphedema – 15 %. No such complications were observed in lateral video endoscopic inguinofemoral lymphadenectomy.Conclusion. Video endoscopic inguinofemoral lymphadenectomy has significant advantages compared to open method in terms of reduction of the rate of surgical complications and duration of hospitalization.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121083755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhanced recovery program in surgical treatment of patients with germ cell tumors of the testicle: experience of a specialized hospital 专科医院睾丸生殖细胞肿瘤手术治疗的强化康复方案
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-81-92
E. V. Mamizhev, M. Berkut, D. Rumyantseva, N. A. Shchekuteev, N. Krotov, A. M. Sigaev, N. I. Podvigina, D. V. Nekrasov, A. Nosov
{"title":"Enhanced recovery program in surgical treatment of patients with germ cell tumors of the testicle: experience of a specialized hospital","authors":"E. V. Mamizhev, M. Berkut, D. Rumyantseva, N. A. Shchekuteev, N. Krotov, A. M. Sigaev, N. I. Podvigina, D. V. Nekrasov, A. Nosov","doi":"10.17650/1726-9776-2022-18-4-81-92","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-81-92","url":null,"abstract":"Background. Surgical treatment after chemotherapy is extremely difficult technically and should only be performed in a specialized medical center. The postoperative period after these surgical interventions is aimed not only at minimizing complications, but also at early mobilization and rehabilitation of patients. The principles of fast-track surgery, or ERAS (Enhanсed Recovery After Surgery) significantly reduce the incidence and degree of complications after various surgical interventions. However, the results of studies on the use of fast track in retroperitoneal lymphadenectomies have not yet been presented.Aim. To determine the effect of enhanced recovery program on treatment outcomes in patients with germ cell tumors of the testicle after retroperitoneal lymphadenectomy.Materials and methods. Retrospective analysis of 2 groups of patients (n = 93) treated at the N.N. Petrov National Medical Research Center of Oncology (Saint Petersburg) was performed. In the 1st group of patients, standard postoperative care after retroperitoneal lymphadenectomy was performed; in the 2nd group, fast track elements were used. Since the introduction of the ERAS protocol into clinical practice (September 2017), all patients have been included in the 2nd group.Results. The presence or absence of preoperative preparation did not affect the incidence of intraoperative complications (p = 0.031). There were significant differences in the duration of hospitalization between the 1st and 2nd groups –15.3 and 11.9 days (p = 0.03), respectively. Assessment of the pain syndrome using the Numeric Rating Scale for Pain (NRS) showed that median pain level in the 1st group was significantly higher than in the 2nd group: 5 ± 1.5 and 3 ± 1.7, respectively (p = 0.04), which indicates a more severe and less controlled pain syndrome in the 1st group of patients. The rate of infectious complications in the postoperative wound in the 2nd group was 3 cases versus 13 in the 1st group (p = 0.009). The rate of lymphorrhea in 2nd group was significantly lower (p = 0.003), median drainage duration was higher in 1st group (p <0.05). In the 2nd group, 70.6 % of patients did not require drainage, which was an important factor in rapid rehabilitation.Conclusion. The use of fast-track principles in patients after retroperitoneal lymphadenectomy significantly reduces the incidence of postoperative complications and rehabilitation time.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126530955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using Delphi method in the development of a modern prostate cancer care quality indicators 运用德尔菲法制定了一套现代前列腺癌护理质量指标
Cancer Urology Pub Date : 2023-02-28 DOI: 10.17650/1726-9776-2022-18-4-56-62
D. Andreev, A. Zavyalov
{"title":"Using Delphi method in the development of a modern prostate cancer care quality indicators","authors":"D. Andreev, A. Zavyalov","doi":"10.17650/1726-9776-2022-18-4-56-62","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-4-56-62","url":null,"abstract":"Background. Further improvement of the internal quality assurance of clinical practice is critical to achieve the goals and objectives of the Federal project entitled “Battle with cancer”, which aimed at reduction in cancer mortality by 2024 to 185 cases per 100,000 population. Prostate cancer (PCa) is the third leading cause of cancer mortality among men in Russia. For the selection of quality indicators (QIs) for the assessment of oncological care, including the treatment of PCa, the modified Delphi method is widely used.Aim. Identification of examples of actively used modifications of the Delphi technique and the most relevant QIs designed to control the quality of active surveillance of patients with low-risk PCa and the quality of cancer care for patients with metastatic PCa.Materials and methods. The literature search was performed using the following thematic queries in PubMed: “Delphi method/technique”, “quality indicators”, “cancer care”, “prostate cancer”, “tumors”, etc. The search time horizon extended to 2021–2022. The most modern publications devoted to applications of the Delphi methodology in the selection of QIs for treatment of men with PCa were identified.Results. The scientific literature describes in detail how to adapt the Delphi technique to choose the QIs for PCa. 20 QIs for active surveillance of patients with low-risk PCa (the draft version) and 23 QIs for treatment of patients with metastatic PCa were identified. The use of the modified Delphi technique resulted to certain consensus among experts leading to better understanding of QIs for PCa care.Conclusion. The Delphi method is a valid tool for analyzing the points of view of specialists and reaching a consensus on the considered options for solving complex problems. With the consistent improvement of oncourological practice, updating of clinical guidelines for PCa, it is feasible to revise and improve the list of the key QIs for PCa care.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129603649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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