Abstract:
OBJECTIVE:To describe the characteristics of patients with and without positive surgical margins (PSMs) and to analyse the impact of PSMs on secondary cancer treatment after radical prostatectomy (RP), with short-term follow-up. PATIENTS AND METHODS:We analysed data from 2385 consecutive patients treated using RP, who were notified to the Prostate Cancer Registry by 37 hospitals in Victoria, Australia between August 2008 and February 2012. Independent and multivariate models were constructed to predict the likelihood of PSMs. Independent and multivariate predictors of secondary treatment after RP in the initial 12 months after diagnosis were also assessed. RESULTS:Data on PSM status were collected for 2219/2385 (93%) patients. In total 592/2175 (27.2%) RPs resulted in PSMs; 102/534 (19.1%) in the low-risk group, 317/1218 (26.0%) in the intermediate-risk group, 153/387 (39.5%) in the high-risk group, and 9/11 (81.8%) in the very-high-risk disease group of patients. Patients having surgery in a hospital where <10 RPs occur each year were significantly more likely to have a PSM (incidence rate ratio [IRR] 1.44, 95% confidence interval [CI] 1.07-1.93) and those in the intermediate-, high- or very-high-risk groups (IRR 1.34, 95% CI 1.09-1.65, P = 0.007, IRR 1.96, 95% CI 1.57-2.45, P < 0.001 and IRR 3.81, 95% CI 2.60-5.60, P < 0.001, respectively) were significantly more likely to have a PSM than those in the low-risk group (IRR 2.50, 95% CI 1.23-5.11, P = 0.012). Patients with PSMs were significantly less likely to have been treated at a private hospital than a public hospital (IRR 0.76, 95% CI 0.63-0.93, P = 0.006) or to have undergone robot-assisted RP (IRR 0.69, 95% CI 0.55-0.87; P = 0.002) than open RP. Of the 2182 patients who underwent RP in the initial 12 months after diagnosis, 1987 (91.1%) received no subsequent treatment, 123 (5.6%) received radiotherapy, 47 (2.1%) received androgen deprivation therapy (ADT) and 23 (1.1%) received a combination of radiotherapy and ADT. Two patients (0.1%) received chemotherapy combined with another treatment. At a multivariate level, predictors of additional treatment after RP in the initial 12 months included having a PSM compared with a negative surgical margin (odds ratio [OR] 5.61, 95% CI 3.82-8.22, P < 0.001); pT3 compared with pT2 disease (OR 4.72, 95% CI 2.69-8.23, P < 0.001); and having high- or very-high-risk disease compared with low-risk disease (OR 4.36, 95% CI 2.24-8.50, P < 0.001 and OR 4.50, 95% CI 1.34-15.17, P = 0.015, respectively). Patient age, hospital location and hospital type were not associated with secondary treatment. Patients undergoing robot-assisted RP were significantly less likely to receive additional treatment than those receiving open RP (OR 0.59, 95% CI 0.39-0.88, P = 0.010). CONCLUSIONS:These data indicate an important association between hospital status and PSMs, with patients who underwent RP in private hospitals less likely than those in public hospitals to have a PSM. Patients treated in lower-volume hospitals were more likely to have a PSM and less likely to receive additional treatment after surgery in the initial 12 months, and robot-assisted RP was associated with fewer PSMs than was open RP in this non-randomized observational study. PSM status and pathological T3 disease are both important and independent predictors of secondary cancer treatment for patients undergoing RP. A robot-assisted RP approach appears to decrease the likelihood of subsequent treatment, when compared with the open approach.
journal_name
BJU Intjournal_title
BJU internationalauthors
Evans SM,Millar JL,Frydenberg M,Murphy DG,Davis ID,Spelman T,Bolton DM,Giles GG,Dean J,Costello AJ,Frauman AG,Kearns PA,Day L,Daniels C,McNeill JJdoi
10.1111/bju.12509subject
Has Abstractpub_date
2014-11-01 00:00:00pages
680-90issue
5eissn
1464-4096issn
1464-410Xjournal_volume
114pub_type
杂志文章abstract:OBJECTIVE:To compare the outcome of a modified one-layer and two-layer vasovasotomy (VV) in two groups of similar men undergoing vasectomy reversal. PATIENTS AND METHODS:The charts and surgical records of all surgical procedures performed on men undergoing a modified one- or two-layer VV between June 1992 and July 199...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00668.x
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To propose a standardisable composite method for reporting outcomes of radical cystectomy (RC) that incorporates both perioperative morbidity and oncological adequacy. PATIENTS AND METHODS:From July 2010 to December 2017, 277 consecutive patients who underwent robot-assisted RC with intracorporeal urinary di...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.14861
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:• To investigate the influence of baseline variables on the 4-year incidence of acute urinary retention (AUR), benign prostatic hyperplasia (BPH)-related surgery and overall clinical progression in men treated with tamsulosin, dutasteride, or a combination of both. PATIENTS AND METHODS:• The 4-year Combinati...
journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1464-410X.2011.10124.x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To identify significant prognostic indicators of upper urinary tract (UUT) urothelial carcinoma (UC) and to assess a risk stratification of patients. PATIENTS AND METHODS:We retrospectively analysed data from 162 patients with non-metastatic UC primarily occurring in UUT treated with open nephroureterectomy....
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08134.x
更新日期:2009-04-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? Upper Urinary Tract (UUT) Transitional Cell Carcinoma (TCC) is an uncommon disease and represents approximately 5% of all urothelial carcinomas. We report our series on 73 patients treated with Kidney Sparing Surgery for UUT TCC. Good results have bee...
journal_title:BJU international
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1464-410X.2012.11554.x
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To analyse the mid-term safety and efficacy of the ALTIS® single-incision sling (Coloplast Corp., Minneapolis, MN, USA) for female stress urinary incontinence (SUI). PATIENTS AND METHODS:We conducted a prospective, single-arm, unsponsored, observational single-centre trial in a cohort of patients undergoing ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.14569
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:To determine the risk of COVID-19 transmission during minimally invasive surgical (MIS) procedures METHODS: Surgical society statements regarding the risk of COVID transmission during MIS procedures were reviewed. In addition, the available literature on COVID-19 and other viral transmission in CO2 pneumoper...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/bju.15105
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To confirm abnormal glycosylation of Tamm-Horsfall protein (THP) in patients with interstitial cystitis (IC). PATIENTS, SUBJECTS AND METHODS:The sialic acid content of THP, a critical component of its biological activity, is reduced in patients with IC. N-glycan shows reduced levels of high molecular weight ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08163.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To report on the failure of thalidomide to inhibit tumour growth in an animal model of human renal cell carcinoma (RCC). MATERIALS AND METHODS:An orthotopic xenograft model of human RCC was used in which tumour cells were implanted in the left kidney of male 'severe combined immunodeficient' mice. Thalidomid...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2002.02666.x
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To summarize the urological procedures recorded in Hospital Episodes Statistics (HES, 1998-99) and to examine the accuracy of coding and HES. MATERIALS AND METHODS:Data on the 10 commonest urological procedures from the Department of Health website (www.doh.gov.uk/hes) were extracted, summarized and presente...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2002.02833.x
更新日期:2002-07-01 00:00:00
abstract::Men receiving androgen-deprivation therapy will in time develop metastatic castrate-resistant prostate cancer (mCRPC). Whilst effective treatment options for mCRPC have traditionally been limited, new agents are becoming available. Since 2010, the number and class of agents available to treat mCRPC has increased drama...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/bju.12736
更新日期:2015-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06541.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To determine if FK506-binding proteins (FKBPs) are localized to the autonomic nerve supply of the human penis because FK506 (an immunosuppressant drug) has been linked to enhanced nerve regeneration after nerve injury and neurodegenerative diseases by binding to FKBPs, a select group of immunophilins. MATERI...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2007.07290.x
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:To externally validate the currently available nomograms for predicting lymph node invasion (LNI) in patients with prostate cancer (PCa) and to assess the potential risk of complications of extended pelvic lymph node dissection (ePLND) when using the recommended threshold. METHODS:A total of 14 921 patients...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15220
更新日期:2020-09-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05779.x
更新日期:2005-11-01 00:00:00
abstract::• Renal angiomyolipomas (AMLs) are usually easy to diagnose with imaging alone. They have unique characteristics on ultrasonography, computerised tomography and magnetic resonance imaging that usually allow AMLs to be differentiated from other renal masses. • If this is not possible on imaging criteria then biopsy can...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2012.11618.x
更新日期:2012-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2012.11100.x
更新日期:2012-11-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05993.x
更新日期:2006-03-01 00:00:00
abstract:UNLABELLED:Authors from Iowa City report on the incidence of RCC; they compared the rate of these tumours at autopsy and felt that the decrease found was a result of better antemortem detection, and an increase with time in the frequency of clinically detected renal cancer. A study from New York attempted to determine ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05244.x
更新日期:2005-01-01 00:00:00
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doi:10.1111/j.1464-410X.2006.06606.x
更新日期:2007-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.09046.x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. PATIENTS AND METHODS:Patients managed with AS or RP who completed val...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12209
更新日期:2013-07-01 00:00:00
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journal_title:BJU international
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1046/j.1464-410x.2001.00084.x
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To optimise the diagnostic and phototherapeutic efficacy of hypericin in superficial bladder cancer, by developing a bladder instillation fluid that does not depend on the presence of plasma proteins for an appropriate and reliable urothelial uptake of hypericin. MATERIALS AND METHODS:Sodium hypericinate (in...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05316.x
更新日期:2005-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.08732.x
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of the tension-free vaginal tape procedure in the treatment of primary genuine stress incontinence. PATIENTS AND METHODS:A two-centre follow-up study was conducted on 40 women with urodynamically confirmed primary genuine stress incontinence who had a tension-free vaginal ta...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1464-410x.2000.00731.x
更新日期:2000-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10848.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To review our experience of using the tubularized incised plate (TIP) urethroplasty (useful in the treatment of distal hypospadias) to treat proximal hypospadias. MATERIALS AND METHODS:From March 1997 to March 2000 primary repairs were carried out on 40 boys (mean age 4.5 years) with proximal hypospadias. Af...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00966.x
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To establish a consensus on the utility of multiparametric magnetic resonance imaging (mpMRI) to identify patients for focal therapy. METHODS:Urological surgeons, radiologists, and basic researchers, from Europe and North America participated in a consensus meeting about the use of mpMRI in focal therapy of ...
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pub_type: 共识发展会议,杂志文章
doi:10.1111/bju.12243
更新日期:2014-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00516.x
更新日期:2000-04-01 00:00:00