BJU International最新文献

{"title":"A novel approach to integrated prostate cancer diagnostics: insights from MRI, prostate biopsy, and pathology reports in a pilot study","authors":"Erik Thimansson, Elin Axén, Fredrik Jäderling, Johan Styrke, Maria Nyberg, Nina Hageman, Johan Ivarsson, Gert Malmberg, Viktoria Gaspar, Magnus Törnblom","doi":"10.1111/bju.16582","DOIUrl":"https://doi.org/10.1111/bju.16582","url":null,"abstract":"<p>In the diagnostic pathway for early detection of prostate cancer, MRI, biopsies, and pathology are included. The shift towards ‘MRI first’ avoids unnecessary biopsies and reduces overdiagnosis [<span>1</span>] but demands high standards for Prostate Imaging-Reporting and Data System (PI-RADS) [<span>2</span>] grading and accuracy in targeted biopsies. Formulating a comprehensive assessment for optimal patient management is challenging for today's urologists as the volume and complexity of data grow. Quality registers are crucial for evaluating, comparing, and improving patient care. The Swedish National Prostate Cancer Register (NPCR) encompasses over 240 000 patients and is routinely used to monitor and evaluate care quality, aiming to optimise patient outcomes through transparent comparisons [<span>3</span>].</p>\u0000<p>Traditionally, reporting to quality registries relies on manual post-registration, which has disadvantages including time consumption, registration errors, and incomplete data. A multi-professional group within the Swedish NPCR developed a nationally endorsed novel model for integrated prostate cancer diagnostics, tested in routine care in autumn 2023. The model (Figs 1, S1 and S2) is based on ‘single entry’ per specialist and comprises six key components: complete data registration, real-time data registration, structured MRI and pathology review and reporting, structured biopsy sampling and referral, individualised automated feedback from biopsy to radiologist, and summarised outcomes from MRI, biopsy, and pathology in an interactive format.</p>\u0000<figure><picture>\u0000<source media=\"(min-width: 1650px)\" srcset=\"/cms/asset/1f94090a-0f84-4957-ab19-cc62cd2b3587/bju16582-fig-0001-m.jpg\"/><img alt=\"Details are in the caption following the image\" data-lg-src=\"/cms/asset/1f94090a-0f84-4957-ab19-cc62cd2b3587/bju16582-fig-0001-m.jpg\" loading=\"lazy\" src=\"/cms/asset/22efa2b7-ee21-4345-b792-beb0f388a95c/bju16582-fig-0001-m.png\" title=\"Details are in the caption following the image\"/></picture><figcaption>\u0000<div><strong>Fig. 1<span style=\"font-weight:normal\"></span></strong><div>Open in figure viewer<i aria-hidden=\"true\"></i><span>PowerPoint</span></div>\u0000</div>\u0000<div>An overview of the model with the workflow from MRI to pathology, feedback loop (top) and registry data (bottom). MDT, multidisciplinary team meeting.</div>\u0000</figcaption>\u0000</figure>\u0000<p>The workgroup included urologists, radiologists, pathologist, urology nurse, patient representative, product owner from the Swedish Information Network for Cancer (INCA), and a project manager. The model was evaluated by a national reference group that included key opinion leaders holding leadership positions for the National Clinical Care guidelines for prostate cancer and the organised prostate cancer testing from urology, pathology, and radiology. Data management occurs within the Swedish INCA, with designated personnel ensuring adaptation to a national model with modular data collection for quality r","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"109 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of contralateral biopsies in men with unilateral MRI foci undergoing targeted biopsy","authors":"Lars Boesen, Nis Nørgaard, Rasmus Bisbjerg, Vibeke Løgager","doi":"10.1111/bju.16579","DOIUrl":"https://doi.org/10.1111/bju.16579","url":null,"abstract":"ObjectivesTo evaluate the additional prostate cancer detection yield and clinical implications of performing contralateral systematic biopsies in men with unilateral suspicious magnetic resonance imaging (MRI) findings undergoing MRI‐guided transperineal (TP) biopsies in an outpatient clinic.Patients and MethodsA prospective study of 655 consecutive men with unilateral MRI suspicious findings undergoing office‐based MRI‐guided TP biopsies between May 2022 and December 2023. All men had pre‐biopsy MRI followed by MRI‐guided TP fusion biopsies with at least four targeted cores per lesion plus five contralateral systematic biopsies. The primary objective was the clinically significant prostate cancer (csPCa) detection rate of contralateral systematic biopsies in men with no or insignificant PCa on targeted biopsies. Secondary objectives included the impact of contralateral biopsies on PCa grade upgrading, additional insignificant PCa diagnoses, and the clinical implications of multifocal csPCa detected on both targeted and contralateral cores.ResultsAny and csPCa (Gleason Grade Group [GG] ≥2) was detected in 564/655 (85%) and 471/655 (71%) men with a median age of 66 years and PSA level of 7.6 ng/mL. Overall, seven of 655 (1%) men had csPCa detected by contralateral systematic biopsies missed on MRI‐targeted biopsy, all of whom had low‐volume Gleason GG 2 PCa eligible for active surveillance. Furthermore, 70/464 (15%) men with csPCa on MRI‐targeted biopsy had matching Gleason GG 2–5 PCa on contralateral biopsy, and another seven had higher Gleason GG. However, the additional information from contralateral biopsies did not seem to influence whole‐gland treatment allocation and nerve‐sparing during surgery.ConclusionContralateral systematic biopsies in men with unilateral MRI findings undergoing MRI‐guided TP targeted biopsies have limited value for csPCa detection and risk assessment for whole‐gland treatment but may be important for determining PCa multifocality considering focal therapy eligibility.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"39 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world use of androgen-deprivation therapy intensification for metastatic hormone-sensitive prostate cancer: a systematic review","authors":"Amit D. Raval, Stephanie Chen, Natasha Littleton, Niculae Constantinovici, Peter J. Goebell","doi":"10.1111/bju.16577","DOIUrl":"https://doi.org/10.1111/bju.16577","url":null,"abstract":"To conduct a systematic literature review of real-world data (RWD) studies to summarise treatment patterns among men with metastatic hormone-sensitive prostate cancer (mHSPC). While androgen-deprivation therapy (ADT) is a primary treatment strategy for mHSPC, ADT intensification with androgen receptor pathway inhibitors (ARPIs) and/or chemotherapy is recommended by current guidelines and has improved clinical outcomes in the last decade.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"196 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of physiotherapy in post-prostatectomy continence and pelvic muscle function","authors":"Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu","doi":"10.1111/bju.16591","DOIUrl":"https://doi.org/10.1111/bju.16591","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"158 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urogeriatrics: a critical perspective for future urologists","authors":"William C. Gibcus, Anne Hong, David C. Chen, Henry C.X. Yao, Anthony Ta, Marlon Perera, Joseph J. Ischia, Damien M. Bolton","doi":"10.1111/bju.16587","DOIUrl":"https://doi.org/10.1111/bju.16587","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"31 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower pole stones 1–2 cm: navigating treatment choices","authors":"Carlotta Nedbal, Bhaskar K. Somani","doi":"10.1111/bju.16589","DOIUrl":"https://doi.org/10.1111/bju.16589","url":null,"abstract":"<p>Lower-pole renal stones might represent a challenge in endoscopic treatment, especially for intermediate sizes (1–2 cm), that come with no strong indication or contraindication for one technique over the other [<span>1</span>]. The sharp infundibulopelvic angle, together with the infudibulopelvic width and length, often determine treatment choices, along with the available expertise, cost and patient choice. On the other hand, some might argue that it would be excessive to perform a percutaneous nephrolithotomy (PCNL) for intermediate stone sizes, when other technologies such as flexible ureteroscopy (f-URS) allow for a lesser invasive approach. One of the most frequently applied strategies to treat intermediate-size lower-pole stones is to relocate them in the upper pole or in the renal pelvis. Despite it being a feasible and efficient technique, stone relocation might sometimes be uneasy due to the stone size or the infundibulopelvic angle, prolonging the operative times.</p>\u0000<p>In a recent prospective randomised trial, Elmansy et al. [<span>1</span>] compared the outcomes between f-URS and laser lithotripsy (f-URSL) and miniaturised PCNL (mini-PCNL) for these intermediate lower-pole stones without relocation. The most interesting finding of the study is indeed on the important difference in reported stone-free rates (SFRs). They found a 1-day SFR of 50% in the mini-PCNL group vs only 11.1% in the f-URSL group, increasing to 72.2% in the mini-PCNL and to 37.1% in the f-URSL group at 90-days follow-up. When including fragments up to 2 mm, the 3-month SFR rose in fact to 86.1% and 71.4% for mini-PCNL and f-URSL, respectively. Recent data from Brian et al. [<span>2</span>] show that over 50 months, residual fragments >4 mm have a disease progression rate of up to 88% and intervention rate of up to 47%.</p>\u0000<p>Indeed, the difference between mini-PCNL and f-URSL reported by Elmansy et al. [<span>1</span>] is significant, favouring the percutaneous treatment [<span>1</span>]. These findings are in line with the literature, reporting higher SFR for PCNL compared to classic f-URSL [<span>3</span>]. In a recent review on 1–2 cm lower-pole stones, mini-PCNL showed in fact higher efficacy in complete stone clearance, while demonstrating comparable complications rates and operative times. The difficult position and manoeuvrability of the retrograde access could be addressed as the main limitation for treating this kind of calculi, reaching lower SFRs than the ones usually reported for stones located in medium/upper renal calyces. At the same time, mini-PCNL has shown good safety profiles, at least partially overcoming the classic limitations of the percutaneous access, namely the high bleeding risk and the need for a postoperative nephrostomy. In their study, Elmansy et al. [<span>1</span>] reported a low bleeding risk during the puncture (7.4%), and good triangulation outcomes avoiding the need for multiple punctures. They also aimed for totally tub","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"10 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MUC Abstracts","authors":"","doi":"10.1111/bju.16560","DOIUrl":"10.1111/bju.16560","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 S1","pages":"4-41"},"PeriodicalIF":3.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The European Association of Urology talent incubator: bridging competencies for holistic urological care","authors":"Fabian P. Stangl, Juan Luis Vásquez","doi":"10.1111/bju.16586","DOIUrl":"https://doi.org/10.1111/bju.16586","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"151 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant immunotherapy for high‐risk renal cell carcinoma—now or never?","authors":"Tivya Kulasegaran, Niara Oliveira, Craig Gedye, Shomik Sengupta","doi":"10.1111/bju.16584","DOIUrl":"https://doi.org/10.1111/bju.16584","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"196 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first step in shared decision-making for prostate cancer screening.","authors":"Takeshi Takahashi","doi":"10.1111/bju.16580","DOIUrl":"https://doi.org/10.1111/bju.16580","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}