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[PMID]:28453639
[Au] Autor:Abe T; Takada N; Kikuchi H; Matsumoto R; Osawa T; Murai S; Miyajima N; Maruyama S; Shinohara N
[Ad] Endereço:For reprints and all correspondence: Takashige Abe, Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo 060-8638, Japan. E-mail: takataka@rf6.so-net.ne.jp
[Ti] Título:Perioperative morbidity and mortality of octogenarians treated by radical cystectomy-a multi-institutional retrospective study in Japan.
[So] Source:Jpn J Clin Oncol;47(8):755-761, 2017 08 01.
[Is] ISSN:1465-3621
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To determine the characteristics of 90-day morbidity and mortality after radical cystectomy in Japanese octogenarians. Methods: A retrospective multi-institutional study. We reviewed the records of 834 patients treated by open radical cystectomy between 1997 and 2010. All complications within 90 days after surgery were sorted into the 11 categories proposed by the Memorial Sloan-Kettering Cancer Center and graded according to the modified Clavien-Dindo system. We compared the characteristics of complications between ≥80-year (n = 86) and <80-year (n = 748) groups. Multivariate regression models were used to determine the predictors of complications. Results: American Society of Anesthesiologists score III-IV was more frequent (14% vs. 6%, respectively, P < 0.0001), and ureterocutaneostomy was more frequently performed (30% vs. 21%, respectively, P = 0.0148) in the ≥80-year group compared with <80-year group. There were no significant differences in the rates of any complication, major (Grade 3-5) complication, or 90-day mortality between the two groups (≥80-year group: 70%, 21%, 3.5%, respectively, <80-year group: 68%, 22%, 2%, respectively). The ≥80-year group had fewer genitourinary complications (7% vs. 16%, respectively, P = 0.0131). Multivariate regression analyses revealed that bowel-using urinary diversion (P = 0.0031) and the operative time (P = 0.0269) were significant predictors of any grade of complications, and a male sex (P = 0.0167), annual cystectomy volume (P = 0.0284) and prior cardiovascular comorbidity (P = 0.0034) were significant predictors of major complications. Conclusions: In our experience, radical cystectomy in Japanese octogenarians caused similar perioperative comorbidities. Old age as a single criterion should not be used to abandon radical cystectomy; careful preoperative assessment is mandatory.
[Mh] Termos MeSH primário: Cistectomia/efeitos adversos
Período Perioperatório/mortalidade
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Comorbidade
Cistectomia/métodos
Feminino
Seres Humanos
Japão
Masculino
Meia-Idade
Morbidade
Estudos Retrospectivos
Resultado do Tratamento
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/patologia
Derivação Urinária/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/jjco/hyx062


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[PMID]:28464906
[Au] Autor:Fonteyne V; Dirix P; Junius S; Rammant E; Ost P; De Meerleer G; Swimberghe M; Decaestecker K
[Ad] Endereço:Department of Radiation-Oncology, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium. valerie.fonteyne@uzgent.be.
[Ti] Título:Adjuvant radiotherapy after radical cystectomy for patients with muscle invasive bladder cancer: a phase II trial.
[So] Source:BMC Cancer;17(1):308, 2017 May 02.
[Is] ISSN:1471-2407
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Neo-adjuvant chemotherapy followed by radical cystectomy with extended pelvic lymph node dissection is considered to be the treatment of choice for patients with muscle invasive bladder cancer (MIBC). Despite this aggressive treatment the outcome is poor and ultimately, 30% of the patients with ≥pT3 tumors develop a pelvic recurrence. We hypothesize that postoperative adjuvant external beam radiotherapy (EBRT) might prevent local and lymph node recurrence and improve disease free- and overall survival as loco-regional recurrence is linked to the development of distant metastasis. METHODS: We plan to perform a multicentric prospective phase two study including 76 patients. Eligible patients are patients with MIBC, treated with radical cystectomy and presenting with ≥1 of the following characteristics: Pathological (p)T3 stage + presence of lymphovascular invasion on pathological examination pT4 stage <10 lymph nodes removed positive lymph nodes positive surgical margins Patients will have a F-FDG PET-CT to rule out the presence of distant metastasis prior to EBRT. A median dose of 50 Gy in 25 fractions is prescribed to the pelvic lymph node regions with inclusion of the operative bladder bed in case of a positive surgical margin. Patients with suspected lymph nodes on PET- CT can still be included in the trial, but a simultaneous integrated boost to 74Gy to the positive lymph nodes will be delivered. Blood and urine samples will be collected on day-1 and last day of EBRT for evaluation of biomarkers. The primary endpoint is evaluation of acute ≥Grade 3 intestinal or grade 4 urinary toxicity, in case of a neo-bladder reconstruction, within 12 weeks after EBRT. Secondary endpoints are: assessment of QOL, late RTOG toxicity, local control, disease free survival and overall survival. Biomarkers in urine and blood will be correlated with secondary survival endpoints. DISCUSSION: This is a prospective phase 2 trial re-assessing the feasibility of adjuvant radiotherapy in high-risk MIBC. TRIAL REGISTRATION: The Ethics committee of the Ghent University Hospital (EC2014/0630) approved this study on 31/07/2014. Trial registration on Clinicaltrials.gov ( NCT02397434 ) on November 19, 2014.
[Mh] Termos MeSH primário: Neoplasias da Bexiga Urinária/radioterapia
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cistectomia
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Radioterapia Adjuvante
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12885-017-3302-9


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[PMID]:28460449
[Au] Autor:Yong C; Daihui C; Bo Z
[Ad] Endereço:Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
[Ti] Título:Laparoscopic versus open radical cystectomy for patients with bladder cancer over 75-year-old: a prospective randomized controlled trial.
[So] Source:Oncotarget;8(16):26565-26572, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to compare the morbidity, mortality, oncological results and quality of life between laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC) in the elderly patients over 75 years old. Between January 2012 and January 2015, 60 patients were recruited into this study, who were randomly assigned in a 1:1 ratio to either LRC or ORC group. Baseline patient characteristics, pathological factors, operative and postoperative characteristics, postoperative complications and survival data were retrospectively collected, analyzed and compared between the two groups. Patients in LRC group and ORC group had comparable baseline characteristics and pathological factors (all P > 0.05). LRC group required longer operative time (408.2 ± 76.9 vs. 311.7 ± 65.3 min, P = 0.000) and had less EBL (621.6 ± 100.7 vs. 1088.5 ± 109.4 ml, P = 0.000) compared with ORC group. The incidence of infection and ileus within 90 days after surgery in ORC group was significantly higher than LRC group(6.9% vs. 28.6%, P = 0.041; 3.4% vs. 25%, P = 0.025). At a median follow-up of 28 months (range 12-48 months), the survival analysis showed that there were no significant differences between the LRC and ORC groups in overall survival (log-rank χ2 = 0.122; P = 0.726), or progress-free survival (log-rank χ2 = 0.153; P = 0.696). In conclusion, this study confirmed that LRC could achieve similar tumor treatment efficacy compared to ORC, with fewer perioperative complications and less blood loss. We suggest that LRC should be considered as the primary intervention for patients aged over 75 years old with muscle invasive bladder cancer or non-muscle invasive bladder cancer with high risk factors.
[Mh] Termos MeSH primário: Cistectomia
Laparoscopia
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Biomarcadores
Comorbidade
Cistectomia/efeitos adversos
Cistectomia/métodos
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Laparoscopia/efeitos adversos
Laparoscopia/métodos
Masculino
Gradação de Tumores
Estadiamento de Neoplasias
Complicações Pós-Operatórias
Resultado do Tratamento
Neoplasias da Bexiga Urinária/diagnóstico
Neoplasias da Bexiga Urinária/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15717


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[PMID]:28453896
[Au] Autor:Huddart RA; Birtle A; Maynard L; Beresford M; Blazeby J; Donovan J; Kelly JD; Kirkbank T; McLaren DB; Mead G; Moynihan C; Persad R; Scrase C; Lewis R; Hall E
[Ad] Endereço:The Institute of Cancer Research, London, UK.
[Ti] Título:Clinical and patient-reported outcomes of SPARE - a randomised feasibility study of selective bladder preservation versus radical cystectomy.
[So] Source:BJU Int;120(5):639-650, 2017 11.
[Is] ISSN:1464-410X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To test the feasibility of a randomised trial in muscle-invasive bladder cancer (MIBC) and compare outcomes in patients who receive neoadjuvant chemotherapy followed by radical cystectomy (RC) or selective bladder preservation (SBP), where definitive treatment [RC or radiotherapy (RT)] is determined by response to chemotherapy. PATIENTS AND METHODS: SPARE is a multicentre randomised controlled trial comparing RC and SBP in patients with MIBC staged T2-3 N0 M0, fit for both treatment strategies and receiving three cycles of neoadjuvant chemotherapy. Patients were randomised between RC and SBP before a cystoscopy after cycle three of neoadjuvant chemotherapy. Patients with ≤T1 residual tumour received a fourth cycle of neoadjuvant chemotherapy in both groups, followed by radical RT in the SBP group and RC in in the RC group; non-responders in both groups proceeded immediately to RC following cycle three. Feasibility study primary endpoints were accrual rate and compliance with assigned treatment strategy. The phase III trial was designed to demonstrate non-inferiority of SBP in terms of overall survival (OS) in patients whose tumours responded to neoadjuvant chemotherapy. Secondary endpoints included patient-reported quality of life, clinician assessed toxicity, loco-regional recurrence-free survival, and rate of salvage RC after SBP. RESULTS: Trial recruitment was challenging and below the predefined target with 45 patients recruited in 30 months (25 RC; 20 SBP). Non-compliance with assigned treatment strategy was frequent, six of the 25 patients (24%) randomised to RC received RT. Long-term bladder preservation rate was 11/15 (73%) in those who received RT per protocol. OS survival was not significantly different between groups. CONCLUSIONS: Randomising patients with MIBC between RC and SBP based on response to neoadjuvant chemotherapy was not feasible in the UK health system. Strong clinician and patient preferences for treatments impacted willingness to undergo randomisation and acceptance of treatment allocation. Due to the few participants, firm conclusions about disease and toxicity outcomes cannot be drawn.
[Mh] Termos MeSH primário: Cistectomia/estatística & dados numéricos
Tratamentos com Preservação do Órgão/estatística & dados numéricos
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/cirurgia
Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cistectomia/métodos
Estudos de Viabilidade
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Tratamentos com Preservação do Órgão/métodos
Resultado do Tratamento
Neoplasias da Bexiga Urinária/epidemiologia
Neoplasias da Bexiga Urinária/patologia
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/bju.13900


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[PMID]:27771127
[Au] Autor:Liedberg F; Jancke G; Sörenby A; Kannisto P
[Ad] Endereço:Department of Urology, Skåne University Hospital, Lund, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden. Electronic address: fredrik.liedberg@med.lu.se.
[Ti] Título:Should we Refrain from Performing Oophorectomy in Conjunction with Radical Cystectomy for Bladder Cancer?
[So] Source:Eur Urol;71(6):851-853, 2017 Jun.
[Is] ISSN:1873-7560
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Radical cystectomy with neoadjuvant chemotherapy is the gold standard for treating muscle-invasive bladder cancer. Women subjected to radical cystectomy are frequently postmenopausal, and the median age for bladder cancer diagnosis in women in Sweden is currently 73 yr (Swedish National Bladder Cancer Register). Traditionally, most women treated with radical cystectomy have undergone simultaneous bilateral oophorectomy and hysterosalpingectomy to diminish the risk of later ovarian disease and ovarian bladder cancer recurrence, but also the belief that there is no impact on health or health-related quality of life associated with oophorectomy and the fact that it might be easier surgery to take the ovarian pedicles, rather than sparing the ovaries. However, pelvic organ preservation is considered in some younger women to diminish postoperative functional impairment. Based on recent literature in several areas related to oophorectomy, we question the rationale and arguments for performing oophorectomy in women in conjunction with radical cystectomy for bladder cancer.
[Mh] Termos MeSH primário: Cistectomia
Neoplasias Ovarianas/cirurgia
Ovariectomia
Procedimentos Desnecessários
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Tomada de Decisão Clínica
Cistectomia/efeitos adversos
Feminino
Seres Humanos
Meia-Idade
Neoplasias Ovarianas/secundário
Ovariectomia/efeitos adversos
Seleção de Pacientes
Medição de Risco
Fatores de Risco
Fatores Sexuais
Resultado do Tratamento
Neoplasias da Bexiga Urinária/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28463154
[Au] Autor:Chargari C; Haie-Meder C; Guérin F; Minard-Colin V; de Lambert G; Mazeron R; Escande A; Marsolat F; Dumas I; Deutsch E; Valteau-Couanet D; Audry G; Oberlin O; Martelli H
[Ad] Endereço:Brachytherapy Unit, Department of Radiotherapy, Gustave Roussy, Villejuif, France; Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France; French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France. Electronic address: cyrus.chargari@gustaveroussy.fr.
[Ti] Título:Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):352-359, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report the results of a conservative strategy based on partial surgery combined with brachytherapy in a prospective cohort of children with bladder-prostate rhabdomyosarcoma (BP RMS). METHODS AND MATERIALS: We prospectively documented the outcome of children treated in our department between 1991 and 2015 for BP RMS and undergoing a multimodal approach combining conservative surgery (partial cystectomy and/or partial prostatectomy) and perioperative interstitial low-dose-rate or pulse-dose-rate brachytherapy. Before brachytherapy, children had received chemotherapy with modalities depending on their risk group of treatment. RESULTS: A total of 100 patients were identified, with a median age of 28 months (range, 5.6 months-14 years). According to the Intergroup Rhabdomyosarcoma Study (IRS) group, 84 were IRS-III, and 12 were IRS-IV tumors. Four patients were treated at relapse. The median number of chemotherapy cycles before local therapy was 6 (range, 4-13). After surgery, 63 patients had a macroscopic tumor residuum. Five patients underwent a brachytherapy boost before pelvic external beam radiation therapy because of nodal involvement, and 95 had exclusive brachytherapy. Median follow-up was 64 months (range, 6 months-24.5 years). Five-year disease-free and overall survival rates were 84% (95% confidence interval 80%-88%) and 91% (95% confidence interval 87%-95%), respectively. At last follow-up most survivors presented with only mild to moderate genitourinary sequelae and a normal diurnal urinary continence. Five patients required a secondary total cystectomy: 3 for a nonfunctional bladder and 2 for relapse. CONCLUSION: Brachytherapy is effective as part of a conservative strategy for BP RMS, with a relatively low delayed toxicity as compared with previously published studies using external beam radiation therapy. Longer follow-up is required to ensure that the functional results are maintained over time.
[Mh] Termos MeSH primário: Braquiterapia/métodos
Tratamento Conservador/métodos
Neoplasias da Próstata/radioterapia
Neoplasias da Próstata/cirurgia
Rabdomiossarcoma/radioterapia
Rabdomiossarcoma/cirurgia
Neoplasias da Bexiga Urinária/radioterapia
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Antineoplásicos/uso terapêutico
Braquiterapia/efeitos adversos
Criança
Pré-Escolar
Terapia Combinada/métodos
Intervalos de Confiança
Tratamento Conservador/efeitos adversos
Cistectomia/efeitos adversos
Cistectomia/métodos
Cistectomia/estatística & dados numéricos
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Lactente
Masculino
Neoplasia Residual
Estudos Prospectivos
Prostatectomia/efeitos adversos
Prostatectomia/métodos
Prostatectomia/estatística & dados numéricos
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/mortalidade
Rabdomiossarcoma/tratamento farmacológico
Rabdomiossarcoma/mortalidade
Fatores de Tempo
Resultado do Tratamento
Neoplasias da Bexiga Urinária/tratamento farmacológico
Neoplasias da Bexiga Urinária/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:27776977
[Au] Autor:Singh P; Black P
[Ad] Endereço:Division of Hematology and Oncology , Mayo clinic, Phoenix, AZ. Electronic address: drparminder.singh@me.com.
[Ti] Título:Emerging role of checkpoint inhibition in localized bladder cancer.
[So] Source:Urol Oncol;34(12):548-555, 2016 12.
[Is] ISSN:1873-2496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Checkpoint inhibitors have rapidly become a standard treatment option for metastatic urothelial carcinoma. A wave of enthusiasm for these drugs has pushed them also into the setting of localized bladder cancer, including both non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease bladder cancer (MIBC). Here, we aimed to review the emerging role of checkpoint inhibition in localized bladder cancer. METHODS: We reviewed the current treatment landscape for both NMIBC and MIBC and established a significant unmet clinical need for novel therapies. We have compiled the evidence that supports the investigation of checkpoint blockade in localized bladder cancer and have reviewed the corresponding clinical trial׳s landscape. RESULTS: The success of checkpoint inhibitors in metastatic bladder cancer offers the most compelling rationale for testing checkpoint blockade in localized disease. The established benefit of intravesical Bacillus Calmette-Guérin provides precedent for immune therapy in bladder cancer. Immune dysfunction has been described in bladder cancer, and we know that checkpoint molecules are expressed in these tumors. Furthermore, the high neoantigen burden of bladder cancer and results from preclinical studies suggest that checkpoint blockade deserves testing in earlier stage disease. Multiple trials are either planned or underway in almost all bladder cancer disease states. CONCLUSION: Ongoing trials would determine in the next several years whether checkpoint inhibitors can have a similar effect in localized disease as they have had in metastatic bladder cancer. They would also determine if patients with earlier disease would tolerate the toxicity of systemic therapy. The future holds promise for predictive biomarkers to guide individualized use of these agents and for effective combination therapies to overcome resistances.
[Mh] Termos MeSH primário: Antineoplásicos Imunológicos/uso terapêutico
Carcinoma de Células de Transição/terapia
Imunoterapia
Terapia de Alvo Molecular
Neoplasias da Bexiga Urinária/terapia
[Mh] Termos MeSH secundário: Animais
Anticorpos Monoclonais/uso terapêutico
Antineoplásicos Imunológicos/efeitos adversos
Antígeno B7-H1/antagonistas & inibidores
Antígeno B7-H1/imunologia
Antígeno CTLA-4/antagonistas & inibidores
Antígeno CTLA-4/imunologia
Carcinoma de Células de Transição/tratamento farmacológico
Carcinoma de Células de Transição/imunologia
Carcinoma de Células de Transição/cirurgia
Ensaios Clínicos como Assunto
Terapia Combinada
Cistectomia
Seres Humanos
Ipilimumab/uso terapêutico
Receptor de Morte Celular Programada 1/antagonistas & inibidores
Receptor de Morte Celular Programada 1/imunologia
Radioterapia Adjuvante
Subpopulações de Linfócitos T/efeitos dos fármacos
Subpopulações de Linfócitos T/imunologia
Evasão Tumoral
Neoplasias da Bexiga Urinária/tratamento farmacológico
Neoplasias da Bexiga Urinária/imunologia
Neoplasias da Bexiga Urinária/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents, Immunological); 0 (B7-H1 Antigen); 0 (CD274 protein, human); 0 (CTLA-4 Antigen); 0 (Ipilimumab); 0 (PDCD1 protein, human); 0 (Programmed Cell Death 1 Receptor); 52CMI0WC3Y (atezolizumab)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:27771280
[Au] Autor:Chappidi MR; Chalfin HJ; Johnson DJ; Kates M; Sopko NA; Johnson MH; Liu JJ; Frank SM; Bivalacqua TJ
[Ad] Endereço:The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: mchappi1@jhmi.edu.
[Ti] Título:Longer average blood storage duration is associated with increased risk of infection and overall morbidity following radical cystectomy.
[So] Source:Urol Oncol;35(2):38.e17-38.e24, 2017 02.
[Is] ISSN:1873-2496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with bladder cancer undergoing radical cystectomy (RC) experience high rates of perioperative blood transfusions (PBTs) and morbidity. The aim of this study was to evaluate the effect of blood storage duration on the risk of adverse perioperative outcomes in this high-risk patient population. MATERIALS AND METHODS: In a retrospective review of RC patients from 2010 to 2014 who received PBTs, the average storage duration for all units transfused was used to classify patients as receiving older blood using 3 different definitions (≥21 days,≥28 days, and≥35 days). Multivariable Poisson regression models were used to determine the adjusted relative risk of perioperative infections and overall morbidity in those given older blood compared to fresher blood. RESULTS: Of the 451 patients undergoing RC, 205 (45%) received nonirradiated PBTs. In multivariable modeling, increasing average blood storage duration, as a continuous variable, was associated with an increased risk of infections (risk ratio [RR] = 1.08 per day, 95% CI: 1.01-1.17) and overall morbidity (RR = 1.08 per day, 95% CI: 1.01-1.15). Furthermore, ≥28-day blood storage (vs.<28) was associated with increased infections (RR = 2.69, 95% CI: 1.18-6.14) and morbidity (RR = 2.54, 95% CI: 1.31-4.95), and ≥35-day blood storage (vs.<35) was also associated with increased infections (RR = 2.83, 95% CI: 1.42-5.66) and morbidity (RR = 3.35, 95% CI: 1.95-5.77). CONCLUSIONS: Although blood is stored up to 42 days, storage≥28 days may expose RC patients to increased perioperative infections and overall morbidity compared with storage<28 days. Prospective cohort studies are warranted in cystectomy and other high-risk surgical oncology patients to better determine the effect of blood storage duration.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Cistectomia/métodos
Infecção/diagnóstico
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Idoso
Preservação de Sangue/efeitos adversos
Transfusão de Sangue/métodos
Comorbidade
Feminino
Seres Humanos
Infecção/epidemiologia
Infecção/etiologia
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Neoplasias da Bexiga Urinária/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  9 / 6935 MEDLINE  
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[PMID]:29381965
[Au] Autor:Wu J; Liu A; Chen A; Zhang P
[Ad] Endereço:Department of Radiology.
[Ti] Título:Urachal borderline mucinous cystadenoma: A rare case report and literature review.
[So] Source:Medicine (Baltimore);96(47):e8740, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Urachal borderline mucinous cystadenoma is very rare and has only 9 cases in the current literature with the biological behavior between adenoma and adenocarcinoma. PATIENT CONCERNS: We reported a 41-year-old man with moderate lower abdominal pain, and the imaging examination found an irregular cystic lesion extending from umbilicus to the dome of urinary bladder with significant separations and calcifications. DIAGNOSES: The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as mucinous cystadenoma with low malignant potential. INTERVENTIONS: The patient undertook radical excision and partial cystectomy. OUTCOMES: His postoperative condition was good. LESSONS: Urachal borderline mucinous cystadenoma can be located by image examination, which may also offer several diagnostic tips according to separation, calcification, and enhancement in computed tomography scan. When combined with pathological findings, qualitative diagnosis can be determined. Surgical resection should be chosen as an optimal treatment. Our present study reviewed the clinical and biological information of all previous cases which were diagnosed as urachal borderline mucinous cystadenoma and we supplemented more data for further study.
[Mh] Termos MeSH primário: Cistadenoma Mucinoso/diagnóstico
Neoplasias dos Genitais Masculinos/diagnóstico
Úraco/patologia
[Mh] Termos MeSH secundário: Adulto
Cistadenoma Mucinoso/patologia
Cistadenoma Mucinoso/cirurgia
Cistectomia
Neoplasias dos Genitais Masculinos/patologia
Neoplasias dos Genitais Masculinos/cirurgia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008740


  10 / 6935 MEDLINE  
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[PMID]:29304051
[Au] Autor:Kim M; Oh SJ; Kwak C; Kim HH; Ku JH
[Ad] Endereço:Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
[Ti] Título:Psychometric validation study of the Korean version of the Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index.
[So] Source:PLoS One;13(1):e0190570, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSES: To evaluate the reliability and validity of a Korean version of the Functional Assessment of Cancer Therapy (FACT)-Vanderbilt Cystectomy Index (VCI) in Korean patients who underwent radical cystectomy (RC) and urinary diversion (UD). MATERIALS AND METHODS: We prospectively recruited 108 RC and UD patients who did not have evidence of recurrence from 1994 December to 2015 March. All participants were instructed to complete the Korean FACT-VCI and Short-Form 36-Item Health Survey (SF-36; 1st measurement) and to repeat the Korean FACT-VCI survey one month later (2nd measurement). Statistical analysis included intraclass correlation, Cronbach's α, time and UD type fixed mixed linear model, principal components analysis, and criterion-related validity with SF-36. RESULTS: Korean FACT-VCI was internally consistent (α = 0.802) and had adequate test-retest reliability (interclass correlation = 0.803 and 0.822). The three components model of principal component analysis (cumulative explanatory power, 49.2%) confirmed the internal structural validity of the additional concerns (AC) component of the Korean FACT-VCI, and each component represented the "voiding problem", "bowel problem", and "social/functional problem with equivalent explanatory power (19.5%, 15.4%, and 14.4%). Korean FACT-VCI domain scores were generally well correlated with SF-36 domain scores (Pearson correlation coefficients range: 0.286-0.688; all p <0.01). Mixed linear models revealed that the major effect of measurement times was not significant on FACT-VCI (p = 0.589). CONCLUSIONS: This prospective study confirms the reliability and validation of the Korean FACT-VCI. We expect that this validated tool can be widely utilized in the health-related quality of life studies of Korean patients.
[Mh] Termos MeSH primário: Cistectomia
Psicometria
Neoplasias da Bexiga Urinária/terapia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise de Componente Principal
Estudos Prospectivos
República da Coreia
Neoplasias da Bexiga Urinária/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190570



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