Canadian Journal of Urology最新文献_第2页

Factors associated with surgical refusal and non-surgical candidacy in stage 1 kidney cancer: a National Cancer Database (NCDB) analysis. 与 1 期肾癌患者拒绝手术和非手术候选相关的因素：国家癌症数据库 (NCDB) 分析。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Kennedy E Okhawere, Ralph Grauer, Indu Saini, Iretiayo T Joel, Alp Tuna Beksac, Oluwatoyin Ayo-Farai, Rutul Patel, Talia G Korn, Kirolos N Meilika, Najimdin Pedro, Ketan K Badani

{"title":"Factors associated with surgical refusal and non-surgical candidacy in stage 1 kidney cancer: a National Cancer Database (NCDB) analysis.","authors":"Kennedy E Okhawere, Ralph Grauer, Indu Saini, Iretiayo T Joel, Alp Tuna Beksac, Oluwatoyin Ayo-Farai, Rutul Patel, Talia G Korn, Kirolos N Meilika, Najimdin Pedro, Ketan K Badani","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: We aim to identify factors associated with surgical refusal and non-surgical candidacy in clinical stage I kidney masses and to evaluate their impact on overall survival (OS).Materials and methods: We conducted a retrospective cohort study using the National Cancer Database of patients with clinical stage I kidney cancer between 2004 and 2017. Logistic regression was used to determine baseline sociodemographic-, clinical-, and treatment facility-related factors associated with surgical refusal and non-surgical candidacy. Patients were 1.1 propensity score-matched and Cox regression analysis evaluated the impact of surgical refusal and non-surgical candidacy on OS.Results: Compared to those who underwent surgery, those who refused surgery and those who were non-surgical candidates were more likely to be older, female, non-Hispanic (NH) Black, uninsured, have multiple comorbidities, and traveled a shorter distance to care. Similarly, compared to non-surgical candidates, those who refused surgery were more likely to be younger and have a tumor size ≥ 4.0 cm. Those who refused surgery had significantly lower median survival time and worse OS than those who underwent surgery (HR: 3.18, 95% CI: 2.85, 3.54). Non-surgical candidates had significantly lower median survival time and lower OS than those who had surgery (HR: 4.16, 95% CI: 3.84, 4.51).Conclusion: Various socioeconomic, demographic, and clinical factors are associated with patients refusing to undergo surgery, which in turn leads to lower overall survival rates in stage I kidney cancer patients. Recognizing these factors will enable healthcare professionals to address and potentially alleviate these issues, ultimately ensuring that patients receive the most appropriate care.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"11992-12003"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How I Do It: EnPlace sacrospinous ligament fixation. 我的做法：EnPlace 骶棘韧带固定术。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Bilal Chughtai, Alia Codelia-Anjum, Dean S Elterman, Nirmala Pillalamarri, Vincent Lucente

引用次数: 0

A Chief Wellness Officer, Every Hospital Should Have One; Marlon Brando Was Right. 首席健康官，每家医院都应该有；马龙-白兰度是对的。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Kevin R Loughlin

引用次数: 0

Artificial intelligence improves urologic oncology patient education and counseling. 人工智能改善了泌尿科肿瘤患者的教育和咨询。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Yash B Shah, Anushka Ghosh, Aaron Hochberg, James R Mark, Costas D Lallas, Mihir S Shah

{"title":"Artificial intelligence improves urologic oncology patient education and counseling.","authors":"Yash B Shah, Anushka Ghosh, Aaron Hochberg, James R Mark, Costas D Lallas, Mihir S Shah","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Patients seek support from online resources when facing a troubling urologic cancer diagnosis. Physician-written resources exceed the recommended 6-8th grade reading level, creating confusion and driving patients towards unregulated online materials like AI chatbots. We aim to compare the readability and quality of patient education on ChatGPT against Epic and Urology Care Foundation (UCF).Materials and methods: We analyzed prostate, bladder, and kidney cancer content from ChatGPT, Epic, and UCF. We further studied readability-adjusted responses using specific AI prompting (ChatGPT-a) and Epic material designated as Easy to Read. Blinded reviewers completed descriptive textual analysis, readability analysis via six validated formulas, and quality analysis via DISCERN, PEMAT, and Likert tools.Results: Epic met the recommended grade level, while UCF and ChatGPT exceeded it (5.81 vs. 8.44 vs. 12.16, p < 0.001). ChatGPT text was longer with more complex wording (p < 0.001). Quality was fair for Epic, good for UCF, and excellent for ChatGPT (49.5 vs. 61.67 vs. 64.33). Actionability was overall poor but particularly lowest (37%) for Epic. On qualitative analysis, Epic lagged on all quality measures. When adjusted for user education level (ChatGPT-a and Epic Easy to Read), readability improved (7.50 and 3.53), but only ChatGPT-a retained high quality.Conclusions: Online urologic oncology patient materials largely exceed the average American's literacy level and often lack real-world utility for patients. Our ChatGPT-a model indicates that AI technology can improve accessibility and usefulness. With development, a healthcare-specific AI program may help providers create content that is accessible and personalized to improve shared decision-making for urology patients.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"12013-12018"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of MRI contrast enhancement following focal prostate cancer cryoablation. 局灶性前列腺癌冷冻消融术后磁共振成像对比度增强的意义。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

James Wysock, Jesse Persily, Angela Tong, Eli Rapoport, Ben Zaslavsky, Majlinda Tafa, Herbert Lepor

{"title":"Implications of MRI contrast enhancement following focal prostate cancer cryoablation.","authors":"James Wysock, Jesse Persily, Angela Tong, Eli Rapoport, Ben Zaslavsky, Majlinda Tafa, Herbert Lepor","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Local disease recurrence following focal therapy (FT) for prostate cancer may be due to failure to eradicate focal disease or development of disease in the untreated prostate (in- and out-of-field recurrences). Several studies suggest in-field contrast enhancement (CE) on post-treatment multi-parametric (mp) MRI between 6-12 months following FT indicates residual disease. The present study assesses the incidence and oncologic implications of early CE observed following primary partial gland cryoablation (PPGCA).Material and methods: The surveillance protocol for men enrolled in our prospective outcomes study following PPGCA included mpMRI at 6-12 months, 2 years, 3.5 years, and 5 years. All cases of in-field early CE were re-reviewed retrospectively and graded using the previously described Prostate Imaging after Focal Ablation scoring system. All patients exhibiting early CE were re-evaluated by a single radiologist at 2-year mpMRI Results: A total of 320 men enrolled in our PPGCA outcomes study had at least 6 months of follow up. Three hundred fifteen (98%) of these men had undergone post-PPGCA mpMRI at 6-12 months. Of these men, 9 were found to have early in-field CE and 8 underwent repeat MRI at 2 years. In all 8 cases, the CE resolved on the 2-year mpMRI. Of these 8 patients, seven underwent repeat protocol biopsy at 2 years and in-field significant disease was detected in only 1 case.Conclusions: The most compelling evidence that early CE is not indicative of prostate cancer recurrence is that all lesions resolved within 24 months. While incidence of early CE is low, its consistent resolution calls into question the clinical significance of this finding after PPGCA.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"11986-11991"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Side effect management algorithms for niraparib/abiraterone acetate in prostate cancer. 尼拉帕利/醋酸阿比特龙治疗前列腺癌的副作用管理算法。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Jean-Baptiste Lattouf, Jenny J Ko, Margot K Davis, Christian Constance, Geoffrey T Gotto

{"title":"Side effect management algorithms for niraparib/abiraterone acetate in prostate cancer.","authors":"Jean-Baptiste Lattouf, Jenny J Ko, Margot K Davis, Christian Constance, Geoffrey T Gotto","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Niraparib, a PARP1/2 inhibitor, is newly approved in combination with abiraterone acetate (AA) plus prednisone or prednisolone (niraparib/AA+P) for the treatment of adult patients with BRCA-mutated, treatment-naïve metastatic castration resistant prostate cancer (mCRPC). Detailed guidance beyond the prescribing information may be helpful in managing the side effect profile and dosing practicalities of this combination therapy.Materials and methods: A panel of specialists convened to design management algorithms for four common niraparib/AA+P treatment-related adverse events (AEs) in mCRPC; anemia, thrombocytopenia, hypertension, and nausea. The algorithms build on Health Canada-approved prescribing information to highlight practical considerations related to monitoring, treatment adjustment, and specialist referral to support clinical practice.Results: The panel's recommendations were largely aligned with the niraparib/AA+P product monograph. Single agent AA+P followed by reintroduction niraparib/AA+P using the low dose formulation of niraparib/AA were common strategies for managing higher grade AE's. Recommendations for hypertension management were expanded to include a sequence of anti-hypertensive medication trials prior to a change in anti-cancer therapy, where feasible.Conclusion: These algorithms are intended to provide practical assistance to Canadian clinicians managing the most common AEs encountered with the novel combination, niraparib/AA+P, for mCRPC.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"11977-11985"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prehabilitation in patients undergoing bladder cancer surgery - A systematic review and meta-analysis. 膀胱癌手术患者的术前康复--系统回顾与荟萃分析。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Daniel Steffens, Cherry Koh, Nicholas Hirst, Ruby Cole, Michael J Solomon, Lisa Nguyen-Lal, Ruban Thanigasalam, Scott Leslie, Nariman Ahmadi

{"title":"Prehabilitation in patients undergoing bladder cancer surgery - A systematic review and meta-analysis.","authors":"Daniel Steffens, Cherry Koh, Nicholas Hirst, Ruby Cole, Michael J Solomon, Lisa Nguyen-Lal, Ruban Thanigasalam, Scott Leslie, Nariman Ahmadi","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The evidence on the effectiveness of prehabilitation in patients undergoing bladder cancer surgery remains lacking. Thus, the aim of this study is to determine the effectiveness of prehabilitation on reducing postoperative morbidity and length of hospital stay in patients undergoing bladder cancer surgery.Materials and methods: This systematic review included randomized controlled trials investigating the effect of prehabilitation on postoperative outcomes in patients undergoing bladder cancer surgery. A comprehensive search was conducted, with two reviewers independently screening articles and extracting data. The Cochrane Collaboration's tool was used to assess risk of bias, and GRADE to rate the quality of evidence. When possible, a random effects meta-analysis was conducted. Estimates were presented as risk ratios or mean differences with their 95% confidence intervals.Results: Of the 2764 articles identified, five trials comprising 282 patients met the eligibility criteria. Prehabilitation modalities included preoperative exercise (3), preoperative nutrition (1), and multimodal (1). The mean age of patients ranged from 66.0 to 72.1 years. All included trials presented some or high risk of bias. Pooled analyses according to the different prehabilitation modalities demonstrated low to very low quality of evidence of no effect on postoperative complications and length of hospital stay.Conclusion: This study revealed a small number of trials investigating the effectiveness of prehabilitation on patients undergoing bladder cancer surgery. Whether prehabilitation, including preoperative exercise, nutrition and multimodal interventions reduce postoperative morbidity and length of hospital stay following bladder cancer surgery is uncertain, as the quality of evidence is very low.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"12004-12012"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Legends in Urology v31I05. 泌尿外科传奇》第 31I05 期。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Peter R Carroll

引用次数: 0

The Centennial Celebration of the CJU Legends in Urology. 庆祝 CJU 泌尿外科传奇人物百年诞辰。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-08-01

Leonard G Gomella

引用次数: 0

Abstracts from the Mid-Atlantic Section of the AUA 2024. 2024 年美国宇航学会大西洋中部分会会议摘要。