BJU International最新文献

{"title":"Telehealth vs face‐to‐face consultations in a urological oncology clinic: a randomised controlled trial","authors":"David Armany, Athos Katelaris, Ankur Dhar, Omar Alghazo, Dale Wood, Lawrence H. Kim, Manish I. Patel","doi":"10.1111/bju.16615","DOIUrl":"https://doi.org/10.1111/bju.16615","url":null,"abstract":"ObjectivesTo determine the effectiveness of telehealth, among patients reviewed for urological oncological diseases, compared with standard face‐to‐face (F2F) consultations with regard to patient‐reported satisfaction through use of a validated questionnaire.Materials and MethodsWe conducted a single‐centre randomised controlled trial in 126 patients recruited from the Crown Princess Mary Cancer Centres urological oncology clinics. Patients were randomised to either a telehealth audio‐only (telephone) consultation group or a standard F2F consultation group for their next routine appointment. Validated questionnaires, using a 4‐point Likert index scale, were completed at the end of the appointments. Questionnaire scores were analysed using the Mann–Whitney <jats:italic>U</jats:italic>‐test. The primary outcome measured was patients' preference for type of consultation on subsequent follow‐up. Secondary outcomes involved evaluation of efficiency, quality of care, ease of understanding, overall satisfaction, professionalism, limitations, and convenience.ResultsA total of 63 patients in the F2F group and 53 patients in the telephone group completed and returned the validated questionnaires. Patients' preference for next follow‐up was statistically significant, favouring the telephone group (<jats:italic>P</jats:italic> = 0.012). For the secondary outcomes, patients in the telephone group also reported greater satisfaction with regard to the efficiency and timing of the consultation (<jats:italic>P</jats:italic> = 0.005). Conversely, patients in the F2F group reported higher rates of satisfaction with regard to ‘tests and follow‐up’ and the clinician's ability to deal with their issues, as compared to the telephone group (<jats:italic>P</jats:italic> = 0.002). Also, patients in the F2F group reported higher rates of perceived quality of consultation (<jats:italic>P</jats:italic> = 0.027).ConclusionOur study demonstrates that patients with urological oncological diseases attending routine follow‐up generally prefer telehealth over F2F appointments. However, patients in the F2F group perceived that there was a higher quality of care in their consultation, and that the services provided were superior, in comparison to patients in the telehealth group. These are barriers to the widespread adoption of telehealth in urological oncology follow‐up care and are rarely reported in the current literature.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"46 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776399","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 impact of positive surgical margins after cystectomy on oncological outcomes: a nationwide study","authors":"Jikke Bosveld, Tri Q. Nguyen, Joost L. Boormans, J. Alfred Witjes, Antoine G. van der Heijden, Niven Mehra, Lambertus A. Kiemeney, Katja K.H. Aben, , Richard P. Meijer, Anke Richters","doi":"10.1111/bju.16611","DOIUrl":"https://doi.org/10.1111/bju.16611","url":null,"abstract":"To evaluate whether surgical margin status, alongside existing postoperative risk indicators, improves the identification of bladder cancer patients who may benefit from adjuvant therapy following radical cystectomy (RC).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"47 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142777399","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":"Is there a minimum percentage of sarcomatoid component required to affect outcomes of localised renal cell carcinoma?","authors":"Mustafa Soytas, Alice Dragomir, Ghady Bou‐Nehme Sawaya, Charles Hesswani, Maude Tanguay, Antonio Finelli, Lori Wood, Ricardo Rendon, Rahul Bansal, Aly‐Khan Lalani, Daniel Y. C. Heng, Bimal Bhindi, Naveen S. Basappa, Lucas Dean, Alan So, Jasmir G. Nayak, Georg Bjarnason, Rodney Breau, Luke Lavallee, Jean‐Baptiste Lattouf, Frederic Pouliot, Michael Bonert, Simon Tanguay","doi":"10.1111/bju.16609","DOIUrl":"https://doi.org/10.1111/bju.16609","url":null,"abstract":"ObjectiveTo evaluate and compare the outcomes of patients with localised renal cell carcinoma (RCC) with and without sarcomatoid features and the impact of this on cancer recurrence and survival.Material and MethodsThe Canadian Kidney Cancer information system database was used to identify patients diagnosed with localised RCC between January 2011 and December 2022. Patients with pT1‐T3, n Nx‐N0N1, M0 stage and documented sarcomatoid status were included. Patients with sarcomatoid RCC were categorised according to the sarcomatoid component percentage (%Sarc). Inverse probability of treatment weighting scores were used to balance the groups. Cox proportional hazards models were used to assess the impact of sarcomatoid status and %Sarc on recurrence‐free and overall survival.ResultsA total of 6660 patients (201 with and 6459 without sarcomatoid features) with non‐metastatic RCC were included. %Sarc data were available in 155 patients, and the median value was 10%. The weighted analysis revealed that the presence of sarcomatoid features was associated with an increased risk of developing metastasis and increased risk of mortality compared to absence of sarcomatoid features. A %Sarc value &gt;10 was associated with an increased risk of developing metastasis and of mortality compared to a %Sarc value ≤10.ConclusionsPatients with a %Sarc &gt;10 have an increased risk of recurrence and mortality. These patients may benefit from a more stringent follow‐up and %Sarc could represent an important criterion in the risk assessment for adjuvant therapy.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"1 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776502","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":"Long‐term quality of life in patients with bladder cancer following radical cystectomy","authors":"Emine Akdemir, Martijn M. Stuiver, Maaike W. van de Kamp, Jolanda Bloos ‐ van der Hulst, Laura S. Mertens, Kees Hendricksen, Wim H. van Harten, Anne M. May, Maike G. Sweegers","doi":"10.1111/bju.16610","DOIUrl":"https://doi.org/10.1111/bju.16610","url":null,"abstract":"ObjectivesTo investigate changes in quality of life (QoL) up to 8 years after radical cystectomy (RC) and compare QoL after RC with a gender‐ and age‐matched Dutch normative population. Furthermore, we aimed to identify patient characteristics associated with QoL and QoL trajectories after RC.Patients and MethodsPatients with bladder cancer were invited to complete QoL questionnaires at 3‐month intervals in the first year and yearly thereafter. Follow‐up data were available for a maximum of 8 years. We used linear mixed‐effect models to investigate changes in QoL subscales (physical functioning [PF], emotional functioning [EF], and QoL summary score [QoL‐sum]) over time, and to identify potential demographic and clinical correlates of QoL and QoL trajectories (i.e., interaction with time).ResultsData from 278 patients was included. Post‐RC EF scores increased from 83.7 (95% confidence interval [CI] 81.7–85.6) to levels comparable to the normative population (90.1) 8 years after RC. PF (post‐RC: 82.4, 95% CI 78.5–86.3) and QoL‐sum (post‐RC: 88.2, 95% CI 85.2–91.2) remained lower compared to the normative population (88.9 and 91.4, respectively) 8 years after RC. Compared to patients with an American Society of Anesthesiologists (ASA) score of 1 at diagnosis, those with ASA score 2 or ASA score 3 had significant lower post‐RC PF (mean difference (MD) = −8 and −22, respectively; <jats:italic>P</jats:italic> &lt; 0.001), EF (MD = −1 and −11; <jats:italic>P</jats:italic> = 0.5 and <jats:italic>P</jats:italic> &lt; 0.01) and QoL‐sum (MD = −2 and −9; <jats:italic>P</jats:italic> = 0.2 and <jats:italic>P</jats:italic> &lt; 0.01). In addition, patients with a higher ASA score had a worse QoL‐sum trajectory (<jats:italic>P</jats:italic><jats:sub>interaction</jats:sub> = 0.01). Older patients had a worse PF trajectory (<jats:italic>P</jats:italic><jats:sub>interaction</jats:sub> &lt; 0.01) but higher post‐RC EF (<jats:italic>P</jats:italic> &lt; 0.01).ConclusionsDirectly after RC, patients have lower PF, EF and QoL‐sum, compared to a normative population. Notably, EF recovers to normative levels over a period of 8 years after RC. Clinicians are encouraged to administer supportive care interventions to enhance the QoL for patients undergoing RC, especially targeting older patients and those with higher ASA scores.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"79 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758489","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":"In-field prostate cancer recurrence following radical prostatectomy and salvage radiation","authors":"Austin Martin, Ahmed M. Mahmoud, Cameron J. Britton, Anthony Fadel, Mohamed E. Ahmed, Vidit Sharma, Daniel S. Childs, Geoffrey B. Johnson, Brian J. Davis, Lance Mynderse, Derek Lomas, David Woodrum, Daniel Frendl, Jeffrey R. Karnes, Matthew K. Tollefson, Eugene D. Kwon, Jack R. Andrews","doi":"10.1111/bju.16598","DOIUrl":"https://doi.org/10.1111/bju.16598","url":null,"abstract":"To define the natural history, patterns of recurrence and treatment modalities for local prostate cancer (PCa) recurrence following radical prostatectomy (RP) and radiation therapy (RT), and to investigate factors that could predict metastasis-free survival (MFS) in this unique patient population.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"23 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142753063","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":"Association of bi-parametric MRI measures with continence after robot-assisted radical prostatectomy","authors":"Alexander B. Nolsøe, Vibeke Løgager, Lars Boesen, Peter Busch Østergren, Henrik Jakobsen, Christian Fuglesang S. Jensen, Niels Henrik Bruun, Jens Sønksen, Mikkel Fode","doi":"10.1111/bju.16594","DOIUrl":"https://doi.org/10.1111/bju.16594","url":null,"abstract":"To investigate the association between pre- and postoperative magnetic resonance imaging (MRI) measurements of the membranous urethra and the prostate volume and continence following robot-assisted radical prostatectomy (RARP).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"259 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742794","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":"Prolonged ischaemia during partial nephrectomy: impact of warm vs cold.","authors":"Akira Kazama, Carlos Munoz-Lopez, Kieran Lewis, Worapat Attawettayanon, Nityam Rathi, Eran Maina, Rebecca A Campbell, Andrew Wood, Zaeem Lone, Angelica Bartholomew, Jihad Kaouk, Georges-Pascal Haber, Samuel Haywood, Nima Almassi, Christopher Weight, Jianbo Li, Steven C Campbell","doi":"10.1111/bju.16605","DOIUrl":"https://doi.org/10.1111/bju.16605","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of prolonged ischaemia during partial nephrectomy (PN), which remains understudied despite its potential clinical relevance.</p><p><strong>Patients and methods: </strong>Of 1371 patients managed with on-clamp PN (2011-2014), 759 (55%) had imaging and assessment of serum creatinine levels before and after PN within the appropriate timeframes necessary for inclusion. This timeframe was chosen to allow for a robust analysis of both warm and cold ischaemia. Recovery from ischaemia (Rec_ischaemia) was defined as ipsilateral glomerular filtration rate (GFR) preserved, normalized by percentage of parenchymal volume preserved (PPVP), and would be 100% if all nephrons recovered completely from ischaemia. Pearson correlation and multivariable linear regression models were used to assess associations between Rec_ischaemia and ischaemia type and duration.</p><p><strong>Results: </strong>Of 759 patients, 525 (69%) were managed with warm ischaemia. The median warm/cold ischaemia times were 22 and 30 min, respectively. Overall, the median percent ipsilateral GFR preserved, PPVP and Rec_ischaemia were 79%, 83% and 96%, respectively. Segmented regression analysis demonstrated substantially greater decline in Rec_ischaemia, beginning at approximately 30 min for warm ischaemia, which was not observed for hypothermia. Prolonged ischaemia (defined as >30 min) occurred in 197 patients (26%; 88 warm/109 cold). For limited ischaemia (≤30 min), hypothermia was often used for tumours with increased tumour size and complexity (P < 0.01), while for prolonged ischaemia, the warm/cold subgroups had similar patient and tumour characteristics. For limited ischaemia and prolonged hypothermia, median Rec_ischaemia remained >95%, independent of ischaemia time. Differences in Rec_ischaemia between the warm and cold cohorts became significant only after 30 min (P < 0.05). On multivariable analysis, prolonged warm ischaemia was associated with reduced Rec_ischaemia (P = 0.02), which fell 3.9% for every additional 10 min beyond 30 min.</p><p><strong>Conclusions: </strong>Our data suggest that Rec_ischaemia begins to decline significantly after 30 min during PN, although hypothermia was protective. Avoidance of prolonged warm ischaemia should be prioritized in patients with solitary kidneys and/or significant pre-existing chronic kidney disease.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749925","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":"Utility of PSA free-to-total ratio for clinically significant prostate cancer in men with a PSA level of <4 ng/mL.","authors":"Samuel Sii, Nathan Papa, Ting Wai Yiu, Jake Tempo, Liang Qu, Marlon Perera, Ian Thompson, Joseph Ischia, Neil Fleshner, Elliot Smith, Weranja Ranasinghe, Damien Bolton, Dixon T S Woon","doi":"10.1111/bju.16597","DOIUrl":"https://doi.org/10.1111/bju.16597","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the prostate-specific antigen (PSA) free-to-total ratio (FTR) and International Society of Urological Pathology Grade Group ≥2, clinically significant prostate cancer (csPCa) in men with a low PSA level (≤4 ng/mL). Patients and Methods Data were obtained from the Prostate Cancer Prevention Trial. Patients with a PSA level of ≤4 ng/mL and who received a biopsy within a year of this PSA measurement were included. Associations between FTR and csPCa were investigated with logistic regression, adjusting for age and PSA, a re-scaled Brier score (index of predictive accuracy), and decision curve analysis.</p><p><strong>Results: </strong>A total of 406 patients were analysed with 139 (34%) having csPCa and 204 (50%) having any grade PCa. For those with an FTR ≤0.15, 46% had csPCa, vs 22% for those with a ratio ≥0.20. In a regression model, the predicted probability of csPCa for a 60-year-old with a PSA of 3 ng/mL was 61% if the FTR was 0.05, falling to 18% if the FTR was 0.30. A clear negative relationship between increasing FTR and probability of csPCa was observed. A model containing FTR additional to PSA and age provides greater net benefit as per decision curve analysis and likely superior discrimination and calibration measured by a higher index of predictive accuracy.</p><p><strong>Conclusions: </strong>In middle-aged men with a PSA level between 1.5 and 4 ng/mL but otherwise indicated for biopsy, a low FTR is associated with higher rates of csPCa. It should be utilised as an additional, readily available and inexpensive test to improve prediction of csPCa and aid in patient counselling.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738169","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":"Urologist underutilisation of androgen receptor pathway inhibitors for metastatic hormone-sensitive prostate cancer","authors":"Daniel Crisafi,&nbsp;Benjamin Ngie Xiong Wong,&nbsp;Damien Bolton,&nbsp;Joseph Ischia,&nbsp;Dixon Woon","doi":"10.1111/bju.16570","DOIUrl":"10.1111/bju.16570","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 S2","pages":"12-13"},"PeriodicalIF":3.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738172","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":"3D-printed model for resection of positive surgical margins in robot-assisted prostatectomy.","authors":"Christian Engesser, Brantner Philipp, Brigitta Gahl, Walter Matthias, Gehweiler Julian, Helge Seifert, Svetozar Subotic, Cyrill Rentsch, Christian Wetterauer, Lukas Bubendorf, Tatjana Vlajnic, Albolfazl Hosseini, Jan Ebbing","doi":"10.1111/bju.16595","DOIUrl":"10.1111/bju.16595","url":null,"abstract":"<p><strong>Objectives: </strong>To improve precision of secondary resection (SR) after positive surgical margin (PSM) detection by frozen section (FS) during nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) by employing a personalised three-dimensional (3D)-printed prostate model derived from pelvic magnetic resonance imaging (MRI). This model was used to mark positive surgical margins (PSM) and guide intraoperative SR during NS-RARP.</p><p><strong>Patients and methods: </strong>Prospective multicentre cohort study with 100 patients undergoing NS-RARP between September 2018 and August 2021. Primary and secondary endpoints were the conversion rate of FS-identified PSM to a tumour-free margin and functional/oncological parameters within a 12-month follow-up, respectively.</p><p><strong>Results: </strong>A PSM was identified in 23% of cases during FS, with a conversion to negative surgical margins (NSM) in 83% (19/23 cases) by model-guided SR. The tumour detection rate in SR specimens was 39% (nine of 23 cases). Among the 19 patients with converted margins, 18 (95%) achieved undetectable prostate-specific antigen levels 2 months postoperatively, with six (32%) having subsequent biochemical recurrence within 12 months. prostate-specific-membrane-antigen positron emission tomography computed tomography found one local recurrence, and five cases of metastatic disease. In converted patients, the baseline median five-item version of the International Index of Erectile Function score decreased by 16% after 1 year, with no significant difference compared to patients with primarily NSM. Limitations include the absence of a control group, the potential for false-negative FS results and limited accuracy of MRI.</p><p><strong>Conclusion: </strong>The integration of 3D-printed prostate models into NS-RARP has the potential to positively impact surgical outcomes by improving the precision of SR and optimising pathosurgical communication.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725772","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}