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337 results on '"Costello, A"'

1. The Melbourne Consensus Statement on the early detection of prostate cancer.

Author

Murphy, Declan G, Ahlering, Thomas, Catalona, William J, Crowe, Helen, Crowe, Jane, Clarke, Noel, Cooperberg, Matthew, Gillatt, David, Gleave, Martin, Loeb, Stacy, Roobol, Monique, Sartor, Oliver, Pickles, Tom, Wootten, Addie, Walsh, Patrick C, and Costello, Anthony J

Subjects
Humans, Prostatic Neoplasms, Prostate-Specific Antigen, Tumor Markers, Biological, Mass Screening, Risk Factors, Consensus, Decision Making, Aged, Middle Aged, Australia, Male, Digital Rectal Examination, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Early Detection of Cancer, PSA testing, guideline, prostate cancer, risk stratification, screening, Biomarkers, Tumor, Tumor Markers, Biological, Biomarkers, Tumor, Urology & Nephrology, Clinical Sciences
Abstract

Various conflicting guidelines and recommendations about prostate cancer screening and early detection have left both clinicians and their patients quite confused. At the Prostate Cancer World Congress held in Melbourne in August 2013, a multidisciplinary group of the world's leading experts in this area gathered together and generated this set of consensus statements to bring some clarity to this confusion. The five consensus statements provide clear guidance for clinicians counselling their patients about the early detection of prostate cancer.

Published
2014

2. The modified International Society of Urological Pathology system improves concordance between biopsy and prostatectomy tumour grade

Author

Niall M. Corcoran, Anthony J. Costello, Andrew Ryan, David M.Z.B. Hennes, James Sewell, Justin S. Peters, M Kerger, and Christopher M. Hovens

Subjects
Male, medicine.medical_specialty, Pathology, Biopsy, Urology, Concordance, medicine.medical_treatment, Adenocarcinoma, Prostate cancer, Prostate, medicine, Humans, Sampling (medicine), Multiparametric Magnetic Resonance Imaging, Retrospective Studies, Prostatectomy, medicine.diagnostic_test, business.industry, Transperineal biopsy, Prostatic Neoplasms, Prostate-Specific Antigen, medicine.disease, medicine.anatomical_structure, Histopathology, Neoplasm Grading, business
Abstract

OBJECTIVES: To assess the concordance between biopsy and radical prostatectomy (RP) specimens using the 2005 Gleason score (GS) and the International Society of Urological Pathology (ISUP) 2014/World Health Organization 2016 modified system, accounting for the introduction of transperineal biopsy and pre-biopsy multiparametric magnetic resonance imaging (mpMRI). PATIENTS AND METHODS: Between 2002 and 2019, we identified 2431 patients with paired biopsy and RP histopathology from a prospectively recorded and maintained prostate cancer database. Biopsy specimens were graded according to the 2005 GS or ISUP 2014 modified system, according to the year of diagnosis. Multivariable logistic regression analysis was conducted to retrospectively assess the impact of prostate-specific antigen (PSA), PSA density, age, pre-biopsy mpMRI, and biopsy method, on the rate of upgraded disease. The kappa coefficient was used to establish the degree of change in concordance between groups. RESULTS: Overall, 24% of patients had upgraded disease and 8% of patients had downgraded disease when using the modified ISUP 2014 criteria. Agreement in the updated ISUP 2014 cohort was 68%, compared with 55% in the 2005 GS group, which was validated by a kappa coefficient that was good (k = 0.5 ± 0.4) and poor (k = 0.3 ± 0.1), respectively. In multivariable models, a change in grading system independently improved overall disease concordance (P = 0.02), and there were no other co-segregated patient or pathological factors such as PSA, total number of cores, maximum cancer length, biopsy route or the use of mpMRI that impacted this finding. CONCLUSION: The 2014 ISUP modifed system improves overall concordance between biopsy and surgical specimens, and thus allows more accurate prognostication and management in high-grade disease, independent of more extensive prostate sampling and the use of mpMRI.

Published
2021
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5. Funding of prostate magnetic resonance imaging leads to fewer biopsies and potential savings to health systems in the management of prostate cancer

Author

Lih-Ming Wong, Sue Finch, Daniel Costello, Tom Sutherland, and Thomas Whish-Wilson

Subjects
Male, Financing, Government, medicine.medical_specialty, Prostate biopsy, Databases, Factual, Biopsy, Urology, 030232 urology & nephrology, Management of prostate cancer, 03 medical and health sciences, Prostate cancer, Postoperative Complications, 0302 clinical medicine, Cost Savings, Prostate, medicine, Humans, Multiparametric Magnetic Resonance Imaging, Health policy, medicine.diagnostic_test, business.industry, Australia, Prostatic Neoplasms, Magnetic resonance imaging, Health Care Costs, Prostate-Specific Antigen, medicine.disease, Health equity, Clinical research, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Emergency medicine, business
Abstract

OBJECTIVES: To assess the impact of the introduction of multiparametric magnetic resonance imaging of the prostate (mpMRIp) on the number of prostate biopsies performed in Australia. METHODS: Australian Medicare published statistics from 1 July 2007 to 30 June 2019 were obtained from publically available databases for prostate-specific antigen (PSA) testing, prostate biopsy, and mpMRIp. Analysis was divided into three time periods broadly based on availability of mpMRI to the Australian public: 2007-2012 (no mpMRIp), 2012-2018 (mpMRIp available, privately funded), and 2018-2019 (mpMRIp available with Medicare funding). Introduction of mpMRIp was hypothesised to reduce the number of prostate biopsies performed. PSA testing numbers were used as a control. The economics model, proposed by the Medical Services Advisory Committee (MSAC), was analysed for cost savings. RESULTS: Accounting for variations in PSA testing, the introduction of mpMRIp from 2012 coincided with a reduction in the number of prostate biopsies by an average of 354.7/month (95% CI 175, 534.4; P

Published
2020
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32. Late biochemical recurrence after radical prostatectomy is associated with a slower rate of progression

Author

Pia Herrera, Christopher M. Hovens, Justin S. Peters, Ryan Stuchbery, Niall M. Corcoran, Anthony J. Costello, and Ken Chow

Subjects
Male, Biochemical recurrence, Oncology, medicine.medical_specialty, Time Factors, Urology, medicine.medical_treatment, 030232 urology & nephrology, Cohort Studies, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Internal medicine, medicine, Humans, Aged, Neoplasm Staging, Prostatectomy, business.industry, Incidence, breakpoint cluster region, Prostatic Neoplasms, Odds ratio, Middle Aged, Prostate-Specific Antigen, medicine.disease, Prostate-specific antigen, Logistic Models, 030220 oncology & carcinogenesis, Cohort, Neoplasm Recurrence, Local, business, Cohort study
Abstract

To characterise the pattern of late biochemical recurrence (BCR) in the largest contemporary cohort of patients with localised prostate cancer treated with radical prostatectomy (RP) in the active surveillance era.Consecutive patients who underwent RP for localised prostate cancer between 2003 and 2017 were identified from a prospectively recorded, dedicated prostate cancer database. Patients who received neoadjuvant androgen-deprivation therapy were excluded. These patients were categorised into the following groups: no BCR, BCR at12 months (early), BCR at 12-60 months (intermediate), and BCR at60 months (late), after RP. Clinicopathological characteristics were analysed using the Student's t-test, Mann-Whitney U-test, or chi-squared test where appropriate. Multivariable binomial logistic regression models were used to assess predictors of BCR at various time-points.In all, 2312 patients were included in the final analysis with up to 12 years of follow-up data. The average patient had clinically localised prostate cancer, an elevated PSA level, and International Society of Urological Pathology (ISUP) Grade Group 2 on biopsy. In all, 88.7% of patients had ISUP Grade Group ≥2 at RP. A subgroup of 446 patients had undetectable PSA levels at 5 years after RP; 11.7% of them progressed to experience BCR. In this subgroup, late recurrers had significantly higher-grade tumours on ISUP and Gleason sum (P0.001 and P = 0.001, respectively), higher rates of extraprostatic extension (P = 0.022), and larger tumour volumes (P = 0.032). Logistic regression showed that RP ISUP Grade Group was a significant predictor of BCR (odds ratio 2.14, 95% confidence interval 1.43-3.20; P0.001).This study characterises the pattern of late BCR in the largest contemporary active surveillance era cohort. We have identified that RP ISUP Grade Group is a strong predictive indicator for late BCR. We also propose that timing of BCR resides on a continuum of risk and that the potential concept of dormant micrometastatic involvement requires further research and evaluation.

Published
2018
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33. Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence

Author

Mitchell G. Goldenberg, Teodor P. Grantcharov, Jason Y. Lee, Jethro C.C. Kwong, and Anthony J. Costello

Subjects
Psychometrics, Urology, education, 030232 urology & nephrology, MEDLINE, PsycINFO, Crowdsourcing, law.invention, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Randomized controlled trial, law, Humans, Medicine, Robotic surgery, Simulation Training, Medical education, business.industry, Internship and Residency, Reproducibility of Results, Surgery simulator, Robotics, Global Rating, 030220 oncology & carcinogenesis, Clinical Competence, business
Abstract

Objectives To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological training. Materials and methods A literature search of the Medline, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. Results Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. Conclusion There have been rapid expansions in approaches to RAS technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS, such as crowdsourcing and psychometrics, remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present.

Published
2018
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40. The ability of prostate-specific antigen (PSA) density to predict an upgrade in Gleason score between initial prostate biopsy and prostatectomy diminishes with increasing tumour grade due to reduced PSA secretion per unit tumour volume

Author

Corcoran, Niall M., Casey, Rowan G., Hong, Matthew K.H., Pedersen, John, Connolly, Stephen, Peters, Justin, Harewood, Laurence, Gleave, Martin E., Costello, Anthony J., Hovens, Chris M., and Goldenberg, Larry S.

Published
2012
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