BJUI compass最新文献

{"title":"VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study","authors":"Nishant Setya,&nbsp;Shridhar C. Ghagane,&nbsp;Rajendra B. Nerli,&nbsp;Ashwin Bokare,&nbsp;Madhukar L. Thakur,&nbsp;Leonard Gomella","doi":"10.1002/bco2.70006","DOIUrl":"https://doi.org/10.1002/bco2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of &gt;4 but &lt;15 ng/ml.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of &gt;4 but &lt;15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 61 patients with a median age of 65.33 ± 8.11 years and with a median serum PSA of 9.56 ± 2.78 ng/ml were further evaluated with both urinary biomarker assessment and mp-MRI. Histopathological (HPR) confirmation of PCa was noted in 25 (40.98%) patients and benign prostatic hyperplasia in the remaining 36 (59.01%) patients. Of the 25 patients with histologically proven PCa, the urinary biomarker (VPAC positivity) was positive for malignancy in 24 (96%), one case showed false negative results (4%) and there were no false positive cases (0%). HPR confirming PCa was seen in 3/16 patients with a PIRADS 2 score, 7/21 patients with a PIRADS 3 score, 7/14 patients with a PIRADS 4 score and 8/8 patients with a PIRADS score of 5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VPAC receptor positivity of prostate cancer cells is an easy test to perform using a voided urine sample. VPAC receptor positivity can be used as an indication for prostate biopsy in patients having a negative previous biopsy but highly suspicious of cancer, in patients with an elevated serum PSA but with a normal digital rectal examination and in patients with benign features and borderline elevation of serum PSA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857163","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}

{"title":"A modified Delphi consensus statement on the role of biopsy in small renal masses","authors":"Darryl E. Bernstein,&nbsp;Hannah Warren,&nbsp;Joseph Santiapillai,&nbsp;Geraldine Fox,&nbsp;William H. Wildgoose,&nbsp;Grant D. Stewart,&nbsp;Jim Armitage,&nbsp;Pieter Le Roux,&nbsp;Frank X. Keeley Jr,&nbsp;Nicholas Campain,&nbsp;Ben Challacombe,&nbsp;Hazel Warburton,&nbsp;Carlotta Palumbo,&nbsp;Riccardo Campi,&nbsp;Stjin H. J. Muselaers,&nbsp;Miles Walkden,&nbsp;Steve Bandula,&nbsp;Dominic Yu,&nbsp;Michael Gonsalves,&nbsp;My-Anh Tran-Dang,&nbsp;Nazanin Etessami,&nbsp;Pedro Oliveira,&nbsp;Anna Calio,&nbsp;Soha El-Sheikh,&nbsp;Tze Wah,&nbsp;Axel Bex,&nbsp;Ravi Barod,&nbsp;Kurinchi Gurusamy,&nbsp;Maxine G. B. Tran","doi":"10.1002/bco2.70018","DOIUrl":"https://doi.org/10.1002/bco2.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand the variable utilisation of diagnostic biopsy for small renal masses (SRM) across the urology community, we worked with expert clinicians and patients to produce a consensus statement on the role of biopsy and to identify research gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In phase I, qualitative interviews were performed to identify potential statements on the role of biopsy and research gaps. In phase II, an expert panel including patients scored statements on a 9-point scale through a modified Delphi process involving three rounds of web-based surveys. Consensus was considered to have been reached when 70% of participants scored a statement greater than or equal to seven. Panel members could propose additional statements for consideration after the first round. Following the second round, a moderation meeting was held to discuss statements where threshold of agreement was not met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 35 participants were involved in this project and consisted of 23 clinicians and 12 patients, with 29 participants completing all three rounds. Overall, 18 statements reached consensus, 11 of which pertained to when and how a biopsy should be used in SRM management and 7 research recommendations to improve the evidence base for biopsy use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Implications</h3>\u0000 \u0000 <p>This Delphi consensus statement, co-produced by patients and clinicians, provides best-practice guidance on the current role of renal tumour biopsy, including offering biopsy prior to active treatment if the outcome would affect management and offering a second attempt should the first biopsy be non-diagnostic. Priority areas for future research included studies to evaluate how a biopsy affects choice of treatment and patient anxiety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857162","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}

{"title":"Does total lesion prostate-specific membrane antigen (PSMA) activity on 68Ga-PSMA PET/CT correlate with PSA and prostatectomy histopathological/clinical outcomes in patients with localised primary prostate cancer?","authors":"Jeremy Cheng,&nbsp;Mohammadmehdi Adhami,&nbsp;Tho Pham,&nbsp;David P. Nadebaum,&nbsp;Ashley Baring,&nbsp;Eldho Paul,&nbsp;Martin Cherk,&nbsp;Jeremy Grummet","doi":"10.1002/bco2.70015","DOIUrl":"https://doi.org/10.1002/bco2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the relationship between total lesion PSMA (PSMA_TL), serum PSA, histopathological findings and biochemical recurrence (BCR) in patients with localised prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective study assessed men undergoing ⁶⁸Ga-PSMA-11 PET/CT for newly diagnosed or treatment-naïve PCa localised to the prostate gland. Volumes of interest were manually mapped to derive SUV_max, SUV_mean, PSMA-avid tumour volume and PSMA_TL. PSMA_TL was defined as the product of PSMA-avid primary tumour volume and SUV_mean. Spearman correlation tests evaluated associations between PET parameters and PSA, ISUP GG and radical prostatectomy (RP) histopathological outcomes. Associations between PET parameters and clinical outcomes were determined using Cox proportional hazards regression with results presented as HR and 95% CI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 patients were included, with a median age of 68 (IQR 62–73) years, PSA of 9.5 (6.6–13.0) ng/ml and follow-up of 41 (25–60) months. Median PSMA_TL was 29.6 (14.8–54.8) and SUV_max 11.0 (6.8–17.9). PSMA_TL and SUV_max demonstrated a weak correlation with baseline PSA (ρ = 0.334, p &lt; 0.001 and ρ = 0.343, p &lt; 0.001), and PSMA_TL showed a weak correlation with PSA density in the RP subgroup (ρ = 0.242, p = 0.021). Among 109 (54.5%) patients undergoing RP, PSMA_TL and SUV_max showed a weak correlation with ISUP GG (ρ = 0.233, p = 0.015 and ρ = 0.340, p &lt; 0.001). There was a weak correlation between PSMA_TL and primary tumour stage (ρ = 0.244, p = 0.010) and lymph node stage (ρ = 0.259, p = 0.007). PSMA_TL was significantly higher in those with seminal vesicle involvement (p = 0.011), perineural invasion (p = 0.025) and lymphovascular invasion (p = 0.002). BCR occurred in 46 patients (42%), with a 1% increased risk of BCR per unit increase in PSMA_TL (HR 1.01, 95% CI 1.00–1.02, p = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSMA_TL correlates with PSA, PSA density, ISUP GG, RP histopathological findings and BCR. As an adjunct to SUV_max, PSMA_TL has the potential to be a useful prognostic tool. Further research is needed to assess its clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836433","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}

{"title":"Multicentre assessment of transperineal targeted prostate biopsy performed as part of a targeted and systematic biopsy diagnostic strategy in men without previous prostate biopsies","authors":"Mohammed Sheweita,&nbsp;Liam Blaney,&nbsp;Jon Oxley,&nbsp;Douglas Kopcke,&nbsp;Stefanos Bolomytis,&nbsp;Paul Burn,&nbsp;Adrian Andreou,&nbsp;Jon Heron,&nbsp;Raj Persad,&nbsp;Nick Burns-Cox,&nbsp;Jonathan Aning,&nbsp;the South West Prostate Dashboard collaborative","doi":"10.1002/bco2.70020","DOIUrl":"https://doi.org/10.1002/bco2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the added value of systematic biopsies in men referred with suspected PCa undergoing visual registration targeted local anaesthetic transperineal prostate biopsies (LATPB) as their first biopsy for MRI-P visible lesions (MRI Score≥3) in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>The outcomes of 2611 biopsy naïve men with MRI Score≥3 who underwent visual registration combined targeted and systematic LATPB at 5 hospitals between 2021 and 2024 were studied. The primary outcome was the clinically significant PCa (csPCa [Gleason≥ 3 + 4 = 7])) cancer detection rate at targeted prostate biopsy without upgrading contributed by the systematic component of the biopsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, PCa was diagnosed in 2079/2611 (80%) patients. The targeted biopsy csPCa detection rate in MRI Score 3,4 and 5 lesions was 108/534 (20%), 461/940 (49%) and 865/1137 (76%), respectively. The csPCa detection rate for combined biopsies in MRI Score 3, 4 and 5 lesions was 150/534 (28%), 579/940 (62%) and 959/1137 (84%). The NPV for targeted biopsies for MRI scores 3,4 and 5 lesions were 81.7%, 95% CI = (78.0%, 84.9%), 68.4%, 95% CI = (63.5%, 73.0%) and 55.7%, 95% CI = (48.0%, 63.1%), respectively. Increasing PSA-D was strongly associated with increased detection of csPCa at targeted prostate biopsy irrespective of MRI score (chi-square test p &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An MRI-P and targeted prostate biopsy-only approach should be considered in all biopsy naïve men with MRI score 5 lesions and MRI score 4 lesions with a PSA Density greater than 0.15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient summary</h3>\u0000 \u0000 <p>We looked at the difference between sampling a specific area of interest identified by prostate MRI compared to sampling the area of interest and additionally the prostate zones. In our study, we concluded that sampling the area of interest guided by the MRI scan alone can be more beneficial with less risk of missing out on clinically important prostate cancer in real-life practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836432","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}

{"title":"Peak early-phase enhancement ratio on contrast-enhanced MRI to differentiate chromophobe renal cell carcinoma from oncocytoma","authors":"Deanna Thorson,&nbsp;Davide Bova,&nbsp;Maria M. Picken,&nbsp;Marcus L. Quek,&nbsp;Gopal N. Gupta,&nbsp;Hiten D. Patel","doi":"10.1002/bco2.70017","DOIUrl":"https://doi.org/10.1002/bco2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility of using the peak early-phase enhancement ratio (PEER) of tumour to renal cortex measured on contrast-enhanced magnetic resonance imaging (MRI) to distinguish between chromophobe renal cell carcinoma (chRCC) and oncocytoma, which are difficult to differentiate on renal mass biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A consecutive case–control study was conducted of patients with chRCC or oncocytoma based on surgical pathology (2006–2020). Two radiologists blinded to pathology results independently measured PEER values on MRI for each tumour. PEER values were compared with surgical pathology results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the 18 renal tumours evaluated, PEER values were higher for the 7 oncocytomas than for the 11 chRCCs (median 1.33 versus 0.55, p &lt; 0.001). Agreement between the image interpreters was high (Pearson's: 0.90). PEER cutoff values ranging from 0.98 to 1.05 provided high performance in identifying chRCC. A PEER cutoff value of ≤1.05 had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100% for the averaged PEER measurements between the two radiologists. High accuracy in identifying chRCC was also achieved for each individual image interpreter using the cutoff value of ≤1.05, with sensitivity of 100%, specificity of 85.7%, PPV of 91.7% and NPV of 100% for radiologist #1 and sensitivity of 90.9%, specificity of 85.7%, PPV of 90.9% and NPV of 85.7% for radiologist #2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Differentiating chRCCs from oncocytomas using PEER measurements obtained from contrast-enhanced MRI is feasible and reproducible between radiologists. We identified an accurate range for PEER cutoff values (0.98 to 1.05) requiring validation and adjustment in additional cohorts to maintain high sensitivity for detecting chRCC and negative predictive value. Using MRI PEER to evaluate oncocytic tumours with a differential diagnosis of chRCC versus oncocytoma based on biopsy pathology may help avoid unnecessary intervention for oncocytomas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822006","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}

{"title":"Impact of recreational football in men with prostate cancer undergoing androgen deprivation therapy","authors":"Sofia Mesquita,&nbsp;Susana Póvoas,&nbsp;Diogo Nunes-Carneiro,&nbsp;David Sá-Couto,&nbsp;Mário Santos,&nbsp;Avelino Fraga,&nbsp;Miguel Silva-Ramos","doi":"10.1002/bco2.70008","DOIUrl":"https://doi.org/10.1002/bco2.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effects of supervised recreational football-based exercise intervention on physical functioning, cardiovascular and metabolic health, bone strength and quality of life in men with PCa receiving ADT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Men with locally advanced or metastatic PCa undergoing ADT were allocated to a supervised recreational football-based exercise programme. Patients were invited to participate in 2–3 one-hour weekly sessions for 8 months and encouraged to participate in at least 2 session/week. Outcomes were physical functioning (postural balance, agility, muscle strength and aerobic capacity), blood pressure, lipid profile (LDL-cholesterol, HDL-cholesterol, total-cholesterol and triglycerides), glucose, glycated haemoglobin (HbA1C) and high sensitivity C-reactive protein (CRP), proximal femoral and lumbar spine (L2-L4) bone mineral density (BMD) and quality of life (EORTC QLQ-C30 and QLQ-PR25). Descriptive and inferential statistical analysis was performed using the IBM® SPSS® Statistics version 29 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From September to October 2022, 23 interested patients were screened and 12 were included and completed the supervised recreational football-based exercise programme. A significant improvement in aerobic capacity was recorded, with the patients improving the distances walked over 6 minutes (580.0 vs. 537.5, <i>p</i> = 0.005). There was a significant reduction in systolic blood pressure from a median of 134 to 123 and a non-statistically significant decrease in diastolic blood pressure from a mean of 80 to 73 mmHg. There were no significant differences for lumbar and femoral BMD. A tendency for higher general health status post-intervention (80.6 vs. 70.8, p = 0.094) and a significant difference in the cognitive domain (83.0 vs. 100.0, p = 0.020) were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Men with PCa undergoing ADT experience side effects that, when combined with the physical inactivity and poor fitness often seen in these patients, may heighten their risk of cardiovascular and metabolic complications. A recreational football-based exercise programme can be implemented to improve physical fitness, aerobic capacity, systolic blood pressure and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809844","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}

{"title":"Transperineal prostate biopsy with freehand technique under local anaesthetic: A systematic review and meta-analysis","authors":"Benjamin M. Mac Curtain,&nbsp;Gavin Calpin,&nbsp;Josh Bruinsma,&nbsp;Wanyang Qian,&nbsp;Avinash Deshwal,&nbsp;Eoin Collins,&nbsp;Hugo C. Temperley,&nbsp;Reuben D. Mac Curtain,&nbsp;William P. Shields,&nbsp;Lee Chien Yap,&nbsp;Claudiu Cozman,&nbsp;John Keane,&nbsp;Padraig Daly","doi":"10.1002/bco2.70016","DOIUrl":"https://doi.org/10.1002/bco2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transperineal prostate biopsy (TPPB) under local anaesthesia is a widely employed biopsy method, and is currently endorsed by the European Association of Urology (EAU). This review aimed to assess the pooled detection rates of clinically significant prostate cancer using TPPB under local anaesthetic. Additionally, pain scores and complications were also reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our search was conducted in line with the most recent Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations up to August 2024. The study was registered on PROSPERO under the ID: CRD42024588824. An electronic search was conducted of the PubMed, Embase and Cochrane Central Register of Controlled Trials databases along with grey literature using the Google search engine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, there were 2881 patients included in this review. Biopsy histology results were reported in 11 studies comprising 2781 cases. We observed a clinically significant prostate cancer rate of 52% (95% CI 44%–60%) for studies that employed both a mix of systematic and targeted biopsies and 26% (95% CI 23%–30%) when systematic biopsies alone were taken. The pooled rate was 48% (95% CI 37%–59%), overall. Complications after prostate biopsies were reported by 9 studies with a combined 2688 patients. There were 61 patients (2.3%) who had Clavien–Dindo (CD) 1–2 complications and three patients (0.1%) who had CD 3–5 complications. The pooled rate of CD 1 and 2 complications was 2% (95% CI 1%–4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TPPB under local anaesthetic is a safe, efficacious and well-tolerated method of prostate biopsy when compared with other methods. Undertaking the procedure under local anaesthesia does not seem to lower cancer detection rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793320","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}

{"title":"Intravesical gemcitabine and docetaxel vs. re-induction Bacillus Calmette Guerin as first-line salvage therapy for non-muscle invasive bladder cancer","authors":"Kylie Yen-Yi Lim,&nbsp;Tran Ngoc An Huynh,&nbsp;Gavin Wei,&nbsp;Jincy Kuriakose,&nbsp;Obaidullah Fazli,&nbsp;David Pook,&nbsp;Sarah Ransley,&nbsp;Janice Downie,&nbsp;Scott Donnellan,&nbsp;Weranja Ranasinghe","doi":"10.1002/bco2.70012","DOIUrl":"https://doi.org/10.1002/bco2.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the outcomes between re-induction Bacillus Calmette-Guérin (BCG) and sequential intravesical gemcitabine-docetaxel (Gem/Doce) therapy in patients with high-grade (HG) non-muscle invasive bladder cancer (NMIBC) following failure of initial induction BCG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We retrospectively identified patients who received induction BCG therapy between 2017 and 2023. Inclusion criteria were high-grade NMIBC recurrence post-BCG induction, with subsequent treatment by either re-induction BCG or Gem/Doce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2017 to 2023, 140 patients received induction BCG, with 30 (21.4%) showing persistent HG NMIBC. Of these, five (16.7%) were treated with re-induction BCG and 11 (36.7%) with Gem/Doce. In the re-induction BCG group, four patients (80%) had HGTa and one (20%) had HGT1. In the Gem/Doce group, eight patients (73%) had HGTa, two (18%) had HGT1 and one (9%) had carcinoma in situ (CIS). Initial post-treatment cystoscopy showed recurrence in one re-induction BCG patient (20%) with HGT1 and CIS and in two Gem/Doce patients (18%) with HGTa. No adverse events were reported with Gem/Doce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our initial experience with intravesical Gem/Doce suggests that it is better tolerated, with fewer adverse events and comparable recurrence rates at three months, compared to re-induction BCG in patients with BCG-failure NMIBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762214","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}

{"title":"The significant costs of prostate cancer management—An analysis from a Caribbean hospital","authors":"Geneva Pantoja,&nbsp;Amanda Wibben,&nbsp;Visham Bhagaloo,&nbsp;Sara Seetaram,&nbsp;Satyendra Persaud","doi":"10.1002/bco2.70003","DOIUrl":"https://doi.org/10.1002/bco2.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this paper is to analyse the annual costs associated with the diagnosis and treatment of prostate cancer at San Fernando General Hospital, a large, public hospital in Trinidad.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A prospective cost-of-illness study analysed 1 month of all prostate cancer-related events at San Fernando General Hospital. These included inpatient admissions, outpatient visits and surgical procedures. All resources utilized during these visits were logged, itemized and assigned a cost via the Costing Unit of San Fernando General Hospital (SFGH). The annual cost was extrapolated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred eight outpatient visits and eight acute presentations were recorded for the month in addition to scheduled surgical presentations. An estimated 2496 outpatient visits and 96 acute admissions occurred annually. The mean age of presenting patients was 69 years old, with the majority (61%) of patients of African ethnicity. The overall estimated cost to the Regional Health Authority was TTD $14052157.66 (USD $2066493). Outpatient visits related to screening, diagnosis or management of prostate cancer, including prostate biopsies, comprised the majority of the costs (57%), while nephrostomies related to upper urinary tract obstruction from prostate cancer contributed least (0.7%). The total cost of metastatic disease was disproportionate to its presentation, with 17% of cases being metastatic but contributing 32% toward overall cost. Of cases with a documented chief complaint, visits related to cancer diagnostics, presentations with symptoms of prostate cancer and biopsies contributed to two thirds of the total cost, while follow-up visits for previously diagnosed prostate cancer contributed to one third.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This analysis shows that prostate cancer has a significant financial burden on the Trinidadian economy. Efforts must be dedicated to early screening and prevention, and policymakers should be aware of the economic impact of the disease when making budgetary allocations. Although diagnostics can be costly, it likely minimizes larger costs associated with extensive treatment and acute hospitalizations related to metastatic disease, as seen in this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762113","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}

{"title":"Feasibility study of using the PREDICT kidney tool for patients with localised renal cell carcinoma","authors":"Panayiotis Laouris,&nbsp;Chiara Re,&nbsp;Georgia Stimpson,&nbsp;Axel Bex,&nbsp;James Blackmur,&nbsp;Alexander Laird,&nbsp;Carley Batley,&nbsp;Grant D. Stewart,&nbsp;Hannah Harrison,&nbsp;Juliet A. Usher-Smith","doi":"10.1002/bco2.70014","DOIUrl":"https://doi.org/10.1002/bco2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Localised renal cell carcinoma (RCC) is usually treated surgically, with post-operative imaging-based surveillance to monitor for recurrence. However, surveillance practices vary widely, and patients often lack a clear understanding of their risk of recurrence and follow-up care. The PREDICT Kidney tool has been developed to enhance risk communication by providing individualised recurrence and mortality risk estimates. The tool uses the Leibovich score augmented with English national data to provide a personalised risk assessment of cancer recurrence and death from other causes, presented in both numerical and visual formats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A multicentre, prospective feasibility study of incorporating the PREDICT Kidney risk communication tool into the first follow-up consultation for localised RCC patients post-surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Endpoints</h3>\u0000 \u0000 <p>Patient uptake into the study, completeness of data collection, consultation duration, the acceptability of the tool to both patients and clinicians, clinician adherence to the study “best-practice” guide, variability in tool usage across clinicians and sites and patient-level clinical outcomes including subjective and objective comprehension of risk of recurrence and follow-up, perceived risk of cancer recurrence, risk conviction, satisfaction with the information provided on risk of recurrence and follow-up, and fear of cancer recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We aim to recruit 60 patients from three hospitals in England and Scotland. Patients treated with surgery for primary localised clear-cell RCC awaiting their first follow-up appointment will be invited to take part. Participants will be allocated into two groups: standard care and standard care supplemented with the use of the PREDICT Kidney tool. Data will be collected through questionnaires, audio/video recordings of consultations and interviews with a subset of patients and clinicians. The study period is planned from September 2024 to July 2025. The findings will guide the design of a future randomised controlled trial to evaluate the tool's efficacy in clinical settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741344","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}