BJUI compass最新文献

{"title":"A novel bladder cancer surveillance schedule using bladder Cx for patients on annual surveillance","authors":"Arjun Guduguntla,&nbsp;Thomas Whish-Wilson,&nbsp;Lauren Chandler,&nbsp;Dennis Gyomber","doi":"10.1002/bco2.468","DOIUrl":"10.1002/bco2.468","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cx bladder monitor (CxM) is a urine test with a proven high sensitivity and negative predictive value in bladder cancer surveillance. The aim of this retrospective study was to report on the outcomes of our newly implemented bladder cancer surveillance program for patients eligible for yearly cystoscopy, as per the European Association of Urology (EAU) guidelines. In this program, eligible patients alternate between yearly surveillance cystoscopy and CxM, instead of the standard yearly surveillance cystoscopy. Outcomes measures were overall results of CxM and subsequent treatment patterns of patients, impact on waiting lists, cost comparison and patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In 2022, 109 eligible and consenting patients were identified, with 98 commencing on the new surveillance program, starting with CxM instead of cystoscopy. A negative CxM, would result in a planned flexible cystoscopy in 12 months. If a patient had a positive CxM, they proceeded to undergo a cystoscopy, and if required, imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 98 that underwent testing, 90 had a negative CxM test and 8 patients had a positive CxM test. Three of these eight were true positive (PPV 0.375). Seventy negative CxM patients had no recurrence at the time of the next cystoscopy/imaging. Of the remaining 20 negative CxM patients, 11 were found to have a recurrence at subsequent cystoscopy/imaging and 9 did not proceed with further surveillance for various reasons. All of the tumour recurrences diagnosed after a negative CxM were non-invasive, thus there was no progression to muscle-invasive disease. All suitable patients consented to continuing with the CxM protocol. The hospital surveillance cystoscopy waitlist was reduced by approximately 59% and CxM was approximately $850 AUD cheaper than a cystoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CxM can be safely used in an alternating schedule with Flexible Cystoscopy for patients on annual bladder cancer surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061608","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":"PARP inhibitor-based treatment in metastatic, castration-resistant prostate cancer (mCRPC): A systematic review and meta-analysis","authors":"Michela Roberto,&nbsp;Mattia Alberto Di Civita,&nbsp;Daniele Marinelli,&nbsp;Andrea Torchia,&nbsp;Nertila Cara,&nbsp;Giulia Maltese,&nbsp;Iolanda Speranza,&nbsp;Daniele Santini","doi":"10.1002/bco2.455","DOIUrl":"10.1002/bco2.455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We present a systematic review and meta-analysis of randomized clinical trials (RCTs) with PARPi either as monotherapy or in combination with an androgen receptor-targeted agent (ARTA) in first- and second-line settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Primary endpoints are radiographic progression free survival (rPFS) and overall survival (OS) in patients with mCRPC and either unselected, homologous recombination repair wild-type (HRR−), homologous recombination repair mutated (HRR+) or with BRCA1, BRCA2, or ATM mutation. The effect of PARPi + ARTA in the second-line setting is also explored. Safety is a secondary end-point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of five phase III (first line: MAGNITUDE, PROpel, TALAPRO-2; second line: PROfound, TRITON3) and two phase II RCTs (second line: NCT01972217, NCT01576172) were selected. In the first-line setting, rPFS was significantly improved in PARPi + ARTA arm in all comers (HR 0.70, <i>p</i> &lt; 0.00001), HRR− (HR 0.76, <i>p</i> = 0.005), HRR+ (HR 0.57, <i>p</i> = 0.0003), and BRCA1/2-mutated patients (HR: 0.33, <i>p</i> &lt; 0.00001). OS was improved in the population with HRR+ status (HR 0.76, <i>p</i> = 0.02) but not statistically significant in BRCA1/2-mutated patients (HR 0.57, 95% CI 0.30–1.08, <i>p</i> = 0.08). In the second line, PARPi improves rPFS (HR for BRCA2 0.31, <i>p</i> = 0.002) and OS (HR for BRCA1/2 0.71, <i>p</i> = 0.01) only in such patients. In this setting, no advantage was reported by adding a PARPi to an ARTA. The arm with PARPi either as monotherapy or in combination with ARTA showed a significantly higher toxicity profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PARPi-based therapy represents a compelling treatment option for HRR+ mCRPC, mainly BRCA1/2-mutated patients. However, further biomarker analysis are needed in order to identify other responsive patients across the different disease settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061087","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":"Concordance with final pathology when transitioning from standard transrectal to cognitive targeted transperineal prostate biopsy","authors":"Alfred Honoré,&nbsp;Karsten Gravdal,&nbsp;Patrick Juliebø-Jones,&nbsp;Lars Anders Rokne Reisæter,&nbsp;Christian Beisland,&nbsp;Christian Arvei Moen","doi":"10.1002/bco2.486","DOIUrl":"10.1002/bco2.486","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Transrectal (TR) prostate biopsy is being increasingly abandoned in favour of a transperineal (TP) approach as well as a targeted biopsy only of the index lesion(s). It remains underreported how these changes could impact concordance at final pathology. We aimed to evaluate the impact of transitioning from standard transrectal (sTR) to cognitive targeted transperineal (cog-tTP) biopsy on final pathology including concordance and upgrading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>Analysis of consecutive patients undergoing prostate biopsy and prostatectomy (RP) between January 2018 and May 2022 at a tertiary centre in Western Norway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 210 and 239 patients in the sTR and cog-tTP groups, respectively. The mean [IQR] number of biopsies decreased from 12 [4–12] to 3 [3–4] (<i>p</i> &lt; 0.001). The overall rate of concordance between biopsy and final pathology was 64% in both groups (Table 3, Figure 1). 24% Twenty-four per cent (cog-tTP) versus 19% (sTR) had grade group (GG) upgrading, while 12% versus 17% were downgraded (<i>p</i> = 0.2). Regarding positive surgical margins (PSMs) that were &gt;3 mm in extension, there were only 3.3% and 2.1% in the sTR and cog-tTP groups, respectively (<i>p</i> = 0.4). For surgical outcomes associated with RP, no differences in terms of postoperative complications between the groups were found (cog-tTP:10% vs. sTR:6%, <i>p</i> = 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transitioning from sTR biopsy to targeted cog-tTP biopsy does not compromise concordance at final pathology nor does it increase the risk of tumour upgrading.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061612","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 impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data","authors":"Anas S. Tresh,&nbsp;Francesco Del Giudice,&nbsp;Shufeng Li,&nbsp;Satvir Basran,&nbsp;Ettore De Berardinis,&nbsp;Dalila Carino,&nbsp;Valerio Santarelli,&nbsp;Bernardo Rocco,&nbsp;Maria Chiara Shighinolfi,&nbsp;Roman Mayr,&nbsp;Matteo Ferro,&nbsp;Riccardo Autorino,&nbsp;Gabriele Bignante,&nbsp;Felice Crocetto,&nbsp;Biagio Barone,&nbsp;Renate Pichler,&nbsp;José Daniel Subiela,&nbsp;Jorge Caño Velasco,&nbsp;Marco Moschini,&nbsp;Andrea Mari,&nbsp;Andrea Gallioli,&nbsp;Francesco Soria,&nbsp;Simone Albisinni,&nbsp;Wojciech Krajewski,&nbsp;Jan Łaszkiewicz,&nbsp;Łukasz Nowak,&nbsp;Tomasz Szydełko,&nbsp;Benjamin Challacombe,&nbsp;Rajesh Nair,&nbsp;Benjamin I. Chung","doi":"10.1002/bco2.481","DOIUrl":"10.1002/bco2.481","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars). Sensitivity analyses on VTE severity (pulmonary embolism [PE], deep venous thrombosis [DVT] or superficial thrombophlebitis/phlebitis [SVT]), as well as TURBT extent (minor vs. major) were additionally examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 139 800 patients were identified, with 5.3% having preoperative VTE, including DVT (<i>n</i> = 3112, 42.20%), PE (<i>n</i> = 2046, 27.74%) and SVT (<i>n</i> = 2217, 30.06%). A history of preoperative VTE predicted higher rates of any complication (adjusted odds ratio [aOR] 1.28, 95% CI 1.14–1.43) and also higher rates of infectious and haemorrhagic complications. Additionally, preoperative VTE increased the risk of novel VTE events following TURBT (aOR 17.30, 95% CI 16.05–18.65), hospital length of stay (aOR 2.23, 95% CI 1.90–2.62), readmissions (aOR 1.47, 95% CI 1.39–1.56), and hospital associated costs (aOR 1.17, 95% CI 1.12–1.23). DVT and non-minor TURBT procedures did not increase the risk of any, infectious, or haemorrhagic complications, but other associations were maintained regardless of the severity of VTE (PE, DVT, SVT) or TURBT extent (minor/major).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A history of VTE before undergoing transurethral procedures for BCa is associated with significantly worse perioperative outcomes and higher healthcare costs. These findings may help us to counsel on the risks of the intervention and hopefully improve our ability to mitigate such risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061011","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":"Evaluating the utility of the HAS-BLED bleeding-estimator tool for transurethral resection of prostate","authors":"Lu Yu Kuo,&nbsp;Zhong Li Titus Lim,&nbsp;Caitlin Letch,&nbsp;Joshua Silverman,&nbsp;Jason Jae Yeun Kim,&nbsp;Scott McClintock","doi":"10.1002/bco2.480","DOIUrl":"10.1002/bco2.480","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the utility of the HAS-BLED bleeding risk-estimation tool to predict for clinically significant postoperative haematuria in patients receiving transurethral resection of prostate (TURP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A single-centre, retrospective cohort analysis of patients underwent TURP from April 2019 to December 2023 for treatment of symptomatic benign prostate hyperplasia. The primary objective was to evaluate reliability of HAS-BLED score in predicting postoperative bleeding event. A focus sub-analysis was performed on anticoagulated patient cohort. Each patient was categorised in to HASBLED low-, moderate- and high-risk group according to the preestablished estimator tool. Patients' demographics, clinical, pathological and operative details were collected. Events of clinically significant haematuria within 3 months postoperatively were captured. Cohort characteristics and outcome were analysed with two-sided <i>t</i> test and ANOVA test. Further weight-adjusted multivariable analysis and ROC curve was performed to evaluate the predictive value of HAS-BLED score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis showed that patients assigned as high-risk by HAS-BLED were at 2.17-times higher chance of developing clinically significant haematuria compared to the low-risk patients. The risk for high-risk patient was 18.5% (95%CI 11.7–25.3%) and 8.5% (95%CI 4.6–12.4%) for low-risk patients. Moderate-risk did not demonstrate any significant difference relative to the low-risk group. Sub-analysis of 113 patients receiving long-term anticoagulation accentuates the utility of the tool. The risk of haematuria for high-risk patient was 32.7% (95%CI 20.7–44.7%), moderate-risk patient was 28.7% (95%CI 17.0–40.3%), and low-risk patient was 9.7% (95%CI 4.2–15.2%). In this cohort, the risk of haematuria was 3.37 and 2.96 times higher in the high and moderate-risk compared to the low-risk group, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to validate a bleeding estimator tool for TURP patients. High HAS-BLED score positively predicts clinically significant post-TURP haematuria, particularly for patients receiving anticoagulation therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061618","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":"Predictive role of ABC transporters in the efficacy of enfortumab vedotin for urothelial carcinoma","authors":"Toshiki Kijima,&nbsp;Atsuko Takada-Owada,&nbsp;Hiroki Shimoda,&nbsp;Hidetoshi Kokubun,&nbsp;Toshitaka Uematsu,&nbsp;Kohei Takei,&nbsp;Hironori Betsunoh,&nbsp;Masahiro Yashi,&nbsp;Kazuyuki Ishida,&nbsp;Takao Kamai","doi":"10.1002/bco2.488","DOIUrl":"10.1002/bco2.488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the correlation between ATP-binding cassette (ABC) transporter expression and therapeutic efficacy of enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, in urothelial cancer, as only a few studies have been conducted on this topic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective study included 20 patients with metastatic urothelial carcinoma (mUC), including bladder and upper urinary tract cancers, who were treated with EV at Dokkyo Medical University Hospital between 2022 and 2024. Immunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue samples. Progression-free survival (PFS) was estimated using the Kaplan–Meier method, and differences between subgroups (e.g., Nectin-4 and ABC transporter expression) were compared using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Immunohistochemical analysis indicated that tumours with high ABC transporter expression exhibited shorter PFS time and poorer response to EV. Furthermore, a decrease in Nectin-4 expression and an increase in ABC transporter expression were observed as the disease progressed from non-muscle-invasive to muscle-invasive and metastatic. Patients with Nectin-4-positive and ABC transporter-negative tumours had the longest PFS, underscoring the prognostic significance of these biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To our knowledge, this study is the first to show a correlation between ABC transporter expression and EV efficacy in urothelial carcinoma. Future research should focus on optimizing treatment strategies based on Nectin-4 and ABC transporter expression to improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061090","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 Global RAdical Cystectomy Evaluation and Management (GRACEM) pathway: single-centre prospective observational cohort study protocol","authors":"Bruno Bernardini,&nbsp;Federico Piccioni,&nbsp;Manuele Pastore,&nbsp;Paolo Casale,&nbsp;NicolòMaria Buffi,&nbsp;Giovanni Lughezzani,&nbsp;Massimo Lazzeri,&nbsp;Alberto Saita,&nbsp;Maria Vittoria Fantacci,&nbsp;Stefano Mancon,&nbsp;Filipo Dagnino,&nbsp;Roberto Contieri,&nbsp;Pietro Brin,&nbsp;Stefano Mancin,&nbsp;Andrea Gobbo,&nbsp;Maria Rosaria Martucci,&nbsp;Giovanna Cerina,&nbsp;Sara Ghirmai,&nbsp;Ezio Lanza,&nbsp;Giulia Goretti,&nbsp;Giorgio Ferruccio Guazzoni,&nbsp;Rodolfoi Hurle","doi":"10.1002/bco2.376","DOIUrl":"10.1002/bco2.376","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite guideline recommendations, few institutions have implemented clinical pathways that incorporate frailty into routine decision-making for patients undergoing radical cystectomy (RC). This paper presents an integrated clinical pathway designed to address the needs of frail patients undergoing RC. The purpose of the study is to determine whether a multifaceted prevention programme that tailors interventions to the syndromic components of frailty can improve postoperative morbidity and recovery time for patients. New insights will be gained into how to optimize the physical and mental status and quality of life of patients before and after surgery, up to 1 year later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study design</h3>\u0000 \u0000 <p>The Global RAdical Cystectomy Evaluation and Management (GRACEM) study is a prospective, observational, single-centre, 2-year cohort study. Patient enrolment began on 27 April 2023, and results are pending.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Endpoints</h3>\u0000 \u0000 <p>The primary endpoints are postoperative morbidity and the in-hospital postoperative care burden. Postoperative morbidity is measured by the number of early (up to 1 month) and late (over 1 month and up to 12 months) complications, graded by severity according to the Clavien–Dindo classification. In-hospital postoperative care burden is measured by the number and duration of key care processes as recorded by the Care Process Monitoring Chart, a tool developed for this study. Secondary endpoints are changes in frailty and health-related quality of life (HRQoL) from pre-intervention to planned follow-up up to 1 year. Frailty is assessed with the Functional Limitations and Geriatric Syndromes Frailty Questionnaire (FLIGS-FQ), another ad hoc tool. HRQoL is assessed using the EQ-5D-5L questionnaire combined with the cystectomy-specific FACT-Bl-cys index from the first month of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>The GRACEM study includes patients with non-metastatic, histologically confirmed, muscle-infiltrating bladder cancer who underwent RC surgery with curative intent. This study is unique in that the GRACEM Core Team shares decision-making throughout the pathway, from before the intervention to the end of the patient's follow-up. The pathway involves the patient, family members and community services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061009","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 significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study","authors":"Sinan Khadhouri,&nbsp;Kevin Gallagher,&nbsp;Kenneth R. MacKenzie,&nbsp;Taimur T. Shah,&nbsp;Chuanyu Gao,&nbsp;Eleanor Zimmermann,&nbsp;Miles Mannas,&nbsp;Taeweon Lee,&nbsp;Giancarlo Marra,&nbsp;Juan Gomez Rivas,&nbsp;Gautier Marcq,&nbsp;Mark A. Assmus,&nbsp;Taha Ucar,&nbsp;Francesco Claps,&nbsp;Matteo Boltri,&nbsp;Giuseppe Pizzuto,&nbsp;Tara Burnhope,&nbsp;Nkwam Nkwam,&nbsp;George Tanasescu,&nbsp;Nicholas E. Boxall,&nbsp;Alison P. Downey,&nbsp;Troy A. Sukhu,&nbsp;Marta Antón-Juanilla,&nbsp;Sonpreet Rai,&nbsp;Madeline Moore,&nbsp;Kathryn Bandeira de Mello,&nbsp;Sian Parsons,&nbsp;John S. McGrath,&nbsp;Veeru Kasivisvanathan,&nbsp;IDENTIFY Study Group: Pubmed indexed collaborator authors","doi":"10.1002/bco2.475","DOIUrl":"10.1002/bco2.475","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist). Sub-analysis of these by clinical role and experience was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1110 patients with isolated de novo red patches were included. 41.5% (n = 461) were biopsied, with a malignancy rate of 12.8% (59/461), which was significantly higher in suspicious versus non-suspicious red patches (19.1% vs. 2.81%, p &lt; 0.01). There was a significant association between bladder cancer and age (OR 1.04, 95% CI 1.01–1.07, p = 0.01), smoking history (OR 2.62, 95% CI 1.09–6.27, p = 0.03) and suspicious-looking patch (OR 6.50, 95% CI 2.47–17.1, p &lt; 0.01). The majority of malignancies were in over 60-year-olds. Malignancy rates in suspicious versus non-suspicious red patches did not differ significantly between clinical roles or experiences.</p>\u0000 \u0000 <p>Limitations included subjectivity in classifying a suspicious patch and selection bias as not all patches were biopsied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many patients still undergo unnecessary biopsies under general anaesthetic for isolated de novo red patches. Clinicians should consider the patient's age, smoking status and how suspicious-looking the patch is, before deciding on surveillance versus biopsy to improve cancer diagnostic yield.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061015","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":"Concealed penis: A review of multilevel classification and surgical reconstruction techniques","authors":"Bo-yu Xiang,&nbsp;Jing-xuan Peng,&nbsp;Xue-jun Shang,&nbsp;Xiong-bing Zu,&nbsp;Dong-jie Li","doi":"10.1002/bco2.470","DOIUrl":"10.1002/bco2.470","url":null,"abstract":"<p>Concealed penis (CP), also known as hidden or buried penis, is an external genital deformity in which a normal-sized penis is covered by skin, subcutaneous tissue or fat tissue in the prepubic area, leading to abnormal exposure. This condition has significant morbidity and a negative effect on certain aspects of the patient's quality of life, including but not limited to hygiene, micturition, self-image and sexual function. Current classification systems for CP are heterogeneous, but most of these further classify CP based on their division into congenital concealed penis (CCP) and adult-acquired buried penis (AABP). The aetiology and pathogenesis of this disease are understood to some extent, but the specific underlying mechanisms need further research. Although conservative treatment may be effective for some children with CCP, surgical intervention is still the main treatment for other children with CCP and AABP. There is no ‘gold standard’ surgical treatment for CP, but there are various surgical methods available; therefore, individualized surgical plans should be created after a comprehensive evaluation based on the classification and aetiology of CP patients.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061610","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 feasibility and safety of robotic-assisted salvage radical cystectomy","authors":"Gal Rinott Mizrahi,&nbsp;Nathan Lawrentschuk,&nbsp;Benjamin Thomas,&nbsp;Philip Dundee","doi":"10.1002/bco2.459","DOIUrl":"10.1002/bco2.459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility and safety of robotic-assisted salvage radical cystectomy (RA-SRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively searched the prospectively collected surgical database of two highly experienced robotic urological surgeons for cases of RA-SRC, defined as RARC performed post-previous pelvic RT for palliative or oncologic treatment purposes. Collected data included demographic and clinical information and outcome measures including operative course, hospital stay and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen patients were included in the current analysis. All patients had previous RT to the pelvis with 12 patients also having prior radical pelvic surgery. Indications for salvage cystectomy were either palliation (<i>n</i> = 12) or oncological (MIBC or high risk NMIBC, <i>n</i> = 6). There were no intraoperative complications and no conversions to open surgery. Ninety day postoperative complications were recorded in 11 patients (61.1%), with major complications (Clavien–Dindo grades 3 and 4) in three patients (16.6%). After a median follow-up of 43.5 months, one late postoperative complication was observed requiring surgical intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our data, together with the limited published data from other cohorts of RA-SRC, suggest that in experienced hands, RA-SRC is feasible, with intraoperative and perioperative complication rates that are lower than the published data for open SRC and are equivalent to open primary RC. These data will contribute to treatment decision making both in patients with post-pelvic radiation symptoms requiring palliation and patients with MIBC considering or treated with trimodal treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061007","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}