Abstract:
PURPOSE:Metastatic renal cell carcinoma (mRCC) represents a significant and rising burden of disease, with rapidly evolving treatment modalities. The role of cytoreductive nephrectomy (CN) is controversial in this setting. As such, London Cancer has pursued a multidisciplinary team (MDT) approach when assessing suitability for surgery. METHODS:A retrospective analysis of treatment-naive synchronous mRCC patients, managed via a renal-specialist MDT, was conducted between January 2015 and December 2018. An MDT selection algorithm for CN-using the International Metastatic Renal Cell Carcinoma Database Consortium score (IMDC), performance status and metastatic disease burden-was developed. RESULTS:87 treatment-naive synchronous mRCC patients received either CN (n = 18), Systemic therapy (ST) alone (n = 43) or Best supportive care (BSC) (n = 26). Progression free survival (PFS) and overall survival (OS) were assessed. 51% and 39% were IMDC intermediate and poor risk. Median PFS was 28.6 months and 4.5 months in the CN group and ST alone group, respectively, Hazard Ratio for death was 3.63 [(95% CI 1.68-7.83) p < 0.05]. OS remains immature for the CN group, but a median OS of 12.8 months was observed in the ST group and 5.0 months for BSC. 1-year OS rate for CN, ST and BSC groups was 77.8%, 55.8% and 23.10%, respectively. CONCLUSION:These findings describe outcomes of an unselected series of patients treated via an MDT-driven, protocolised treatment pathway. MDT pathway-based decision making may improve patient selection for CN. Further research is needed to evaluate the role of CN amongst a growing landscape of treatment strategies, including immune checkpoint inhibitors and combination therapies. Multi-disciplinary team, pathway-based treatment strategy may improve patient selection for cytoreductive nephrectomy in patients with metastatic renal cell carcinoma.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Liu WK,Lam JM,Butters T,Grant M,Jackson-Spence F,Bex A,Powles T,Szabados Bdoi
10.1007/s00345-020-03107-0subject
Has Abstractpub_date
2020-12-01 00:00:00pages
3199-3205issue
12eissn
0724-4983issn
1433-8726pii
10.1007/s00345-020-03107-0journal_volume
38pub_type
杂志文章abstract:PURPOSE:Chronic inflammation has been considered a potential risk factor for prostate cancer. Toll-like receptors (TLRs) are important in the innate immune response to pathogens and in cross talk between innate immunity and adaptive immunity. In this study, sequence variants in the TLR4 gene were investigated to determ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0690-3
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVES:To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS:Male patients with urethral stricture disease participated in a choice-base...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-017-2066-9
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Previous study compared limited number of parameters post the treatment of cold knife and laser urethrotomy for urethral stricture and controversy about the superiority of those two techniques still remains. This study aims to update the evidence and provide better clinical guidance. METHOD:We systematicall...
journal_title:World journal of urology
pub_type: 杂志文章,meta分析
doi:10.1007/s00345-019-02729-3
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. METHODS:A retrospective multinational multicenter study of patients who underwent min...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-016-1791-9
更新日期:2016-10-01 00:00:00
abstract::The aim of this project was to evaluate the ice-water test as a predictor of the response to intradetrusor botulinum toxin injection in patients with neurogenic detrusor overactivity. We retrospectively evaluated the urodynamic parameters in 22 patients with neurogenic bladder dysfunction and positive ice-water test. ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-007-0208-1
更新日期:2007-12-01 00:00:00
abstract::We evaluated the quality of micturition in patients with orthotopic neobladder replacement. In the present study, 58 patients who had undergone orthotopic neobladder replacement following cystectomy were enrolled. The quality of micturition was evaluated by means of uroflowmetry, a self-administered questionnaire and ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s003450000156
更新日期:2000-12-01 00:00:00
abstract::This review paper highlights the important health issue of orchialgia and the chronic pelvic pain syndrome. There are a number of specific and non-specific etiologies and different treatment options based on the sub-categorization of orchialgia. The focus of this article is on the specific etiologies of chronic orchia...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-013-1092-5
更新日期:2013-08-01 00:00:00
abstract::Animal models are at the centre of laboratory bladder cancer (BC) research and at the same time, the bridge to the clinic. A new and very promising therapeutical approach is to silence abnormally up-regulated genes in cancer, through small interfering RNA (siRNA) molecules. Therapeutic use and success of siRNAs will l...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-009-0374-4
更新日期:2009-06-01 00:00:00
abstract:PURPOSE:The efficacy and safety of a novel remotely programmed BetterStim sacral neuromodulation (SNM) system was evaluated in patients with refractory overactive bladder (OAB) in a prospective, controlled, multicenter trial. METHODS:A total of 84 patients referred for SNM therapy from October 2015 to January 2018 wer...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00345-019-02698-7
更新日期:2019-11-01 00:00:00
abstract:PURPOSE:To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. PATIENTS AND METHODS:A main stone >10 mm or stones g...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1653-x
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:It was our aim in this study to develop a technique that is rather simple, overcomes the problems of Devine and Horton glanuloplasty in patients with small glans, and is flexible to be tailored to any hypospadias surgery. METHODS:A total of 11 patients were included in this preliminary report. A triangular ski...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-009-0386-0
更新日期:2009-10-01 00:00:00
abstract::The orthotopic neobladder has become the preferred method of handling the urinary tract after removal of the bladder in men and women. However, an improved quality of life compared to urinary diversion fails to be realized when voiding dysfunction arises. These difficulties with urination range from retention to incon...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s003450000146
更新日期:2000-10-01 00:00:00
abstract:INTRODUCTION:Erectile dysfunction (ED) and cardiovascular disease (CVD) share a great number of common risk factors. There is growing evidence that aldosterone, an independent CVD risk factor, is associated with ED. AIMS:The purpose of this study was to determine the relationship between plasma aldosterone and erectil...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1723-0
更新日期:2016-07-01 00:00:00
abstract:PURPOSE:To identify factors predicting the risk of inguinal metastasis in squamous cell carcinoma of the penis. The therapeutic advantages of early lymphadenectomy in squamous cell carcinoma of the penis must be counterbalanced against its post-operative morbidity. Loss to follow up is a major problem in developing cou...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-009-0421-1
更新日期:2010-02-01 00:00:00
abstract:INTRODUCTION:The current pool of organs available for transplantation does not cover requirements, for this reason non-standard risk donors need to be incorporated into the pool. In this way, donors with small renal tumour are considered for transplantation after bench tumour excision. The aim of our study was to analy...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03463-x
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:In this study, we investigated the influence of hematuria on the performance of the bladder tumor antigen (BTA) tests in a clinical cohort and in an experimental model. MATERIALS AND METHODS:Urine samples from a cohort of 126 subjects (64 with BCa and 62 controls) were analyzed by ELISA for hemoglobin and B...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-012-0935-9
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:To assess the association between obstructive sleep apnea (OSA) and Fuhrman grade in patients with clear cell renal cell carcinoma (ccRCC). As secondary endpoints, we studied its association with tumor size, metastasis-free survival (MFS) and cancer-specific survival (CSS). METHODS:We reviewed the databases of...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-016-1830-6
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Numerous recent studies have shown that concomitant carcinoma in situ (CIS) can be closely associated with the prognosis of patients with bladder cancer (BCa). However, the prognostic value of CIS in BCa is still not conclusive. Hence, we performed a systematic review and meta-analysis to explore the associa...
journal_title:World journal of urology
pub_type: 杂志文章,meta分析
doi:10.1007/s00345-019-02738-2
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:Although randomized controlled trials (RCTs) remain the gold standard for determining evidence-based clinical practices, large disease registries that enroll large numbers of patients have become paramount as a relatively cost-effective additional tool. METHODS:We highlight the advantages of disease regis...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0658-3
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:To investigate the association between overactive bladder (OAB) and coronary artery disease (CAD) as demonstrated on coronary angiography in patients > 65 years. METHODS:The patients who were > 65 years completed an OAB-V8 form before undergoing coronary angiography at a tertiary care hospital. The presence of...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-017-2098-1
更新日期:2018-01-01 00:00:00
abstract::Renal cystic disease, ranging from simple cysts to autosomal dominant polycystic kidney disease (ADPKD), can lead to significant complications such as pain, hypertension, infection, upper urinary tract obstruction, and even renal failure. For patients with preserved renal function, laparoscopic ablation of renal cysts...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/pl00007076
更新日期:2000-09-01 00:00:00
abstract:INTRODUCTION:Concomitant anti-incontinence surgery at the time of prolapse repair has been a long-debated topic. Still today, there remains no clear answer to this question, although in recent years the literature has become more robust with the addition of more randomized controlled trials. The lifetime risk for women...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-015-1591-7
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:XPA-210 is a proliferation marker derived from Thymidine kinase-1. It is of clinical significance in kidney, breast, and bladder cancer. There are no data available for XPA-210 in prostate cancer (PC). Herein, we aim to determine the clinical usefulness of XPA-210 in PC. MATERIALS AND METHODS:In a retrospectiv...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0768-y
更新日期:2012-08-01 00:00:00
abstract::The diagnosis of prostate cancer is based on histology. Prostate biopsies are obtained based on the triad of prostate specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasound. Because prostate biopsies still have a large percentage of negative outcomes, patient selection and biopsy direction...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-007-0189-0
更新日期:2007-08-01 00:00:00
abstract::We investigated a possible relationship between brefeldin A (BFA), an antibiotic, and cathepsin D (Cat.D), a lysosomal protease, in prostate cancer proliferation. Effects of BFA (30 ng/ml) were examined on the growth of three human prostatic cancer cell lines, PC-3, DU-145, and LNCaP cells. Its effect on Cat.D in thes...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/pl00007099
更新日期:2001-08-01 00:00:00
abstract:PURPOSE:Urinary tract infection (UTI) is the most common bacterial infection among infectious complications in kidney transplant recipients (KTR). After transplantation, infections can result from surgical complications, donor-derived infections, pre-existing recipient infections, and nosocomial infections. Post-transp...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03173-4
更新日期:2020-11-01 00:00:00
abstract:PURPOSE:We compared perioperative and long-term renal functional outcomes of robot-assisted partial nephrectomy (RAPN) with laparoscopic partial nephrectomy (LPN) for small renal masses. MATERIALS AND METHODS:A total of 1,032 patients were included for evaluation; propensity score matching was performed to adjust for ...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-015-1488-5
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of stone components in postoperative fever following RIRS, and to investigate the role of quick stone component analysis during RIRS procedure. PATIENTS AND METHODS:1493 patients with RIRS were retrospectively reviewed. Propensity score matching (PSM) analysis was performed as infection ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03268-y
更新日期:2020-05-24 00:00:00
abstract:PURPOSE:The lack of precedent in transitioning from pediatric to adult care poses a challenge to providers for patients with spina bifida (SB). The purpose of this study was to summarize perceptions about best practices for the care of adult spina bifida patients. MATERIALS AND METHODS:A national survey was electronic...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02635-8
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To evaluate the clinical significance of invasive urothelial carcinoma that is ambiguous for muscularis propria invasion on initial transurethral resection of bladder tumor (TURBT). METHODS:All consecutive in-house TURBTs with invasive urothelial carcinoma from 1999 to 2017 that underwent radical cystectomy (R...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02782-y
更新日期:2020-02-01 00:00:00