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2. Systematic Review of Comorbidity and Competing-risks Assessments for Bladder Cancer Patients

Author

Williams, Stephen B, Kamat, Ashish M, Chamie, Karim, Froehner, Michael, Wirth, Manfred P, Wiklund, Peter N, Black, Peter C, Steinberg, Gary D, Boorjian, Stephen A, Daneshmand, Sia, Goebell, Peter J, Pohar, Kamal S, Shariat, Shahrokh F, and Thalmann, George N

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Cancer, Clinical Research, Patient Safety, 7.3 Management and decision making, Management of diseases and conditions, 7.1 Individual care needs, Good Health and Well Being, Comorbidity, Competing risks, Bladder cancer, Models, Indices, Survival, Mortality, Review, Clinical sciences, Oncology and carcinogenesis
Abstract

ContextRadical cystectomy continues to be associated with a significant risk of morbidity and all-cause mortality (ACM). Practice pattern data demonstrating underuse of surgery for patients with muscle-invasive and high-risk non-muscle invasive bladder cancer (BC) have been linked to the advanced age and higher comorbidity status of such patients, which suggests that rates of ACM as well as cancer-specific mortality should be incorporated into patient counseling and guideline recommendations.ObjectiveTo review the literature on risk assessment tools for preoperative comorbidity in BC that may aid in treatment decision-making.Evidence acquisitionA systematic search was conducted using Ovid and Medline according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2017 reporting on comorbidity risk assessment (CRA) tools for BC. Prospective and retrospective studies were included.Evidence synthesisThere are no published randomized control trials comparing CRA tools for BC. Patients undergoing radical cystectomy with combined high-risk comorbidity and performance scores may face up to a sevenfold greater risk of other-cause mortality compared to those with low scores. The Charlson Comorbidity Index is one of the most widely studied indices for 90-d perioperative mortality and overall and cancer-specific survival, with an area under the receiver operating characteristic curve of up to 0.810. Prospective studies of CRA tools for BC have consistently shown that patients with higher comorbidity have worse outcomes. While not specific for BC, comorbidity indices provide useful assessment of competing risks. Competing-risks assessment tools are lacking, with limited studies assessing the impact of these tools on treatment decision-making by patients and providers. We provide the impetus for incorporation of comorbidity risks into practice guidelines when discussing treatment options with patients.ConclusionsCRA tools should be incorporated into preoperative treatment counseling and the assessment of postoperative outcomes. While retrospective evidence supports the use of CRA tools for BC, further comparative studies evaluating the effectiveness of these tools and identifying the patients most likely to benefit from a treatment according to competing-risks assessment are needed.Patient summaryIn this review we explored the clinical evidence for comorbidity risk assessment tools in bladder cancer. We found evidence to support incorporation of comorbidity risks into practice guidelines when discussing treatment options with patients.

Published
2018

4. Treatment of the Primary Tumor in Metastatic Prostate Cancer: Current Concepts and Future Perspectives

Author

Bayne, Christopher E, Williams, Stephen B, Cooperberg, Matthew R, Gleave, Martin E, Graefen, Markus, Montorsi, Francesco, Novara, Giacomo, Smaldone, Marc C, Sooriakumaran, Prasanna, Wiklund, Peter N, and Chapin, Brian F

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prostate Cancer, Clinical Trials and Supportive Activities, Urologic Diseases, Clinical Research, Cancer, Aging, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Antineoplastic Agents, Combined Modality Therapy, Cytoreduction Surgical Procedures, Humans, Lymph Node Excision, Lymphatic Metastasis, Male, Prostatectomy, Prostatic Neoplasms, Radiotherapy, Risk Assessment, Prostatic neoplasms, Neoplasm metastasis, Chemotherapy, Survival, Urology & Nephrology, Clinical sciences
Abstract

ContextMultimodal treatment for men with locally advanced prostate cancer (PCa) using neoadjuvant/adjuvant systemic therapy, surgery, and radiation therapy is being increasingly explored. There is also interest in the oncologic benefit of treating the primary tumor in the setting of metastatic PCa (mPCa).ObjectiveTo perform a review of the literature regarding the treatment of the primary tumor in the setting of mPCa.Evidence acquisitionMedline, PubMed, and Scopus electronic databases were queried for English language articles from January 1990 to September 2014. Prospective and retrospective studies were included.Evidence synthesisThere is no published randomized controlled trial (RCT) comparing local therapy and systemic therapy to systemic therapy alone in the treatment of mPCa. Prospective studies of men with locally advanced PCa and retrospective studies of occult node-positive PCa have consistently shown the addition of local therapy to a multimodal treatment regimen improves outcomes. Molecular and genomic evidence further suggests the primary tumor may have an active role in mPCa.ConclusionsTreatment of the primary tumor in mPCa is being increasingly explored. While preclinical, translational, and retrospective evidence supports local therapy in advanced disease, further prospective studies are under way to evaluate this multimodal approach and identify the patients most likely to benefit from the inclusion of local therapy in the setting of metastatic disease.Patient summaryIn this review we explored preclinical and clinical evidence for treatment of the primary tumor in metastatic prostate cancer (mPCa). We found evidence to support clinical trials investigating mPCa therapy that includes local treatment of the primary tumor. Currently, treating the primary tumor in mPCa is controversial and lacks high-level evidence sufficient for routine recommendation.

Published
2016

6. A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients

Author

Sooriakumaran, Prasanna, Srivastava, Abhishek, Shariat, Shahrokh F., Stricker, Phillip D., Ahlering, Thomas, Eden, Christopher G., Wiklund, Peter N., Sanchez-Salas, Rafael, Mottrie, Alexandre, Lee, David, Neal, David E., Ghavamian, Reza, Nyirady, Peter, Nilsson, Andreas, Carlsson, Stefan, Xylinas, Evanguelos, Loidl, Wolfgang, Seitz, Christian, Schramek, Paul, Roehrborn, Claus, Cathelineau, Xavier, Skarecky, Douglas, Shaw, Greg, Warren, Anne, Delprado, Warick J., Haynes, Anne-Marie, Steyerberg, Ewout, Roobol, Monique J., and Tewari, Ashutosh K.

Published
2014
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7. Higher preoperative eGFR is a predictor of worse renal function decline after robotic assisted radical cystectomy: Implications for postoperative management

Author

Razdan, Shirin, primary, Eilender, Benjamin, additional, Pfail, John P., additional, Garcia, Mariely, additional, Ranti, Daniel, additional, Rosenzweig, Shoshana, additional, Djordjevic, Sofija, additional, Hosseini, Abolfazl, additional, Radros, Jari, additional, Mehrazin, Reza, additional, Wiklund, Peter N., additional, and Sfakianos, John P., additional

Published
2022
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8. Neobladder creation in patients with chronic kidney disease: A viable diversion strategy

Author

Ranti, Daniel, primary, Pfail, John, additional, Garcia, Mariely, additional, Razdan, Shirin, additional, Bieber, Christine, additional, Rosenzweig, Shoshana, additional, Waingankar, Nikhil, additional, Hosseini, Abolfazl, additional, Radros, Jari, additional, Mehrazin, Reza, additional, Lavallée, Etienne, additional, Wiklund, Peter N., additional, and Sfakianos, John P., additional

Published
2022
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13. Implementation of a nonopioid protocol following robot-assisted radical cystectomy with intracorporeal urinary diversion

Author

Pfail, John L., primary, Garden, Evan B., additional, Gul, Zeynep, additional, Katims, Andrew B., additional, Rosenzweig, Shoshana J., additional, Razdan, Shirin, additional, Omidele, Olamide, additional, Nathaniel, Sarah, additional, Loftus, Katherine, additional, Sim, Alan, additional, Mehrazin, Reza, additional, Wiklund, Peter N., additional, and Sfakianos, John P., additional

Published
2021
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16. Can anesthetics affect bladder cancer recurrence? Total intravenous versus volatile anesthesia in patients undergoing robot-assisted radical cystectomy: A single institution retrospective analysis

Author

Pfail, John L., primary, Katims, Andrew B., additional, Gul, Zeynep, additional, Rosenzweig, Shoshana J., additional, Razdan, Shirin, additional, Nathaniel, Sarah, additional, Martini, Alberto, additional, Mehrazin, Reza, additional, Wiklund, Peter N., additional, Loftus, Katherine, additional, Sim, Alan, additional, DeMaria, Samuel, additional, and Sfakianos, John P., additional

Published
2021
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42. Erectile Function and Oncologic Outcomes Following Open Retropubic and Robot-assisted Radical Prostatectomy: Results from the LAParoscopic Prostatectomy Robot Open Trial

Author

Sooriakumaran, Prasanna, primary, Pini, Giovannalberto, additional, Nyberg, Tommy, additional, Derogar, Maryam, additional, Carlsson, Stefan, additional, Stranne, Johan, additional, Bjartell, Anders, additional, Hugosson, Jonas, additional, Steineck, Gunnar, additional, and Wiklund, Peter N., additional

Published
2018
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43. Corrigendum re: “Early Recurrence Patterns Following Totally Intracorporeal Robot-assisted Radical Cystectomy: Results from the EAU Robotic Urology Section (ERUS) Scientific Working Group” [Eur Urol 2017;71:723–6]

Author

Collins, Justin W., primary, Hosseini, Abolfazl, additional, Adding, Christofer, additional, Nyberg, Tommy, additional, Koupparis, Anthony, additional, Rowe, Edward, additional, Perry, Matthew, additional, Issa, Rami, additional, Schumacher, Martin C., additional, Wijburg, Carl, additional, Canda, Abdullah E., additional, Balbay, Mevlana, additional, Decaestecker, Karel, additional, Schwentner, Christian, additional, Stenzl, Arnulf, additional, Edeling, Sebastian, additional, Pokupić, Saša, additional, D’Hondt, Fredrik, additional, Mottrie, Alexander, additional, and Wiklund, Peter N., additional

Published
2017
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44. Early Recurrence Patterns Following Totally Intracorporeal Robot-assisted Radical Cystectomy: Results from the EAU Robotic Urology Section (ERUS) Scientific Working Group

Author

Collins, Justin W., primary, Hosseini, Abolfazl, additional, Adding, Christofer, additional, Nyberg, Tommy, additional, Koupparis, Anthony, additional, Rowe, Edward, additional, Perry, Matthew, additional, Issa, Rami, additional, Schumacher, Martin C., additional, Wijburg, Carl, additional, Canda, Abdullah E., additional, Balbay, Melvin D., additional, Decaestecker, Karel, additional, Schwentner, Christian, additional, Stenzl, Arnulf, additional, Edeling, Sebastian, additional, Pokupić, Saša, additional, D’Hondt, Fredrik, additional, Mottrie, Alexander, additional, and Wiklund, Peter N., additional

Published
2017
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45. Enhanced Recovery After Robot-assisted Radical Cystectomy: EAU Robotic Urology Section Scientific Working Group Consensus View

Author

Collins, Justin W., primary, Patel, Hiten, additional, Adding, Christofer, additional, Annerstedt, Magnus, additional, Dasgupta, Prokar, additional, Khan, Shamim M., additional, Artibani, Walter, additional, Gaston, Richard, additional, Piechaud, Thierry, additional, Catto, James W., additional, Koupparis, Anthony, additional, Rowe, Edward, additional, Perry, Matthew, additional, Issa, Rami, additional, McGrath, John, additional, Kelly, John, additional, Schumacher, Martin, additional, Wijburg, Carl, additional, Canda, Abdullah E., additional, Balbay, Meviana D., additional, Decaestecker, Karel, additional, Schwentner, Christian, additional, Stenzl, Arnulf, additional, Edeling, Sebastian, additional, Pokupić, Sasa, additional, Stockle, Michael, additional, Siemer, Stefan, additional, Sanchez-Salas, Rafael, additional, Cathelineau, Xavier, additional, Weston, Robin, additional, Johnson, Mark, additional, D’Hondt, Fredrik, additional, Mottrie, Alexander, additional, Hosseini, Abolfazl, additional, and Wiklund, Peter N., additional

Published
2016
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46. Application and Integration of Live Streaming from Leading Robotic Centres Can Enhance Surgical Education

Author

Collins, Justin W., Verhagen, Harko, Mottrie, Alexander, Wiklund, Peter N., Collins, Justin W., Verhagen, Harko, Mottrie, Alexander, and Wiklund, Peter N.

Abstract

Internet-based video-streaming enables us to share surgical knowledge and to study leading surgeons while they operate in their home institutions, and is widely accessible to trainees. Planned developments include enriched learning experiences with improved user friendliness, interactivity, and real-time feedback.

Published
2015
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47. Surgery-related Complications of Robot-assisted Radical Cystectomy With Intracorporeal Urinary Diversion

Author

Schumacher, Martin C. Jonsson, Martin N. Hosseini, Abolfazl and Nyberg, Tommy Poulakis, Vassilis Pardalidis, Nikolaos P. and John, Hubert Wiklund, Peter N.

Abstract

OBJECTIVES To assess the surgery-related complications at robot-assisted radical cystectomy with total intracorporeal urinary diversion during our learning curve in treating 45 patients with bladder cancer. METHODS A total of 45 patients were pooled in 3 consecutive groups of 15 cases each to evaluate the complications according to the Clavien classification. As a surrogate for our learning curve, the following parameters were assessed: operative time, blood loss, urinary diversion type, lymph node yield, surgical margin status, and length of hospital stay. RESULTS Early surgery-related complications were noted in 40% of the patients and late complications in 30%. The early Clavien grade III complications remained significant (27%) and did not decline with time. Overall, fewer complications were observed between the groups over time, with a significant decrease in late versus early complications (P = .005 and P = .058). The mean operative times declined from the first group to the second and third groups (P = .005) and the hospital stays shortened (P = .006). No significant difference was observed between groups regarding the lymph node yield at cystectomy (P = .108), with a mean of 22.5 nodes (range 10-52) removed. More patients received an orthotopic bladder substitute (Studer) in each of the latter 2 groups than in the first. CONCLUSIONS Although robot-assisted radical cystectomy with total intracorporeal urinary diversion is a complex procedure, we observed decreased surgery-related complications and improved outcomes over time in the present series. Our results need to be confirmed by others before robot-assisted radical cystectomy with totally intracorporeal urinary diversion can be accepted as a treatment option for patients with bladder cancer. UROLOGY 77: 871-877, 2011. (c) 2011 Elsevier Inc.

Published
2011

50. Systematic Review and Cumulative Analysis of Perioperative Outcomes and Complications After Robot-assisted Radical Cystectomy

Author

Novara, Giacomo, primary, Catto, James W.F., additional, Wilson, Timothy, additional, Annerstedt, Magnus, additional, Chan, Kevin, additional, Murphy, Declan G., additional, Motttrie, Alexander, additional, Peabody, James O., additional, Skinner, Eila C., additional, Wiklund, Peter N., additional, Guru, Khurshid A., additional, and Yuh, Bertram, additional

Published
2015
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