12 results on '"Lacombe L"'
Search Results
2. Analysis of sex-based differences to Bacillus Calmette-Guérin for non-muscle invasive bladder cancer.
- Author
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Fadel J, Simonyan D, Fradet V, Lodde M, Lacombe L, Fradet Y, and Toren P
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- Female, Humans, Male, Adjuvants, Immunologic therapeutic use, Administration, Intravesical, BCG Vaccine therapeutic use, Neoplasm Invasiveness, Neoplasm Recurrence, Local drug therapy, Retrospective Studies, Carcinoma, Transitional Cell drug therapy, Urinary Bladder Neoplasms pathology
- Abstract
Objective: To evaluate whether differences exist between men and women in response to intravesical BCG treatments. The incidence of urothelial carcinoma of the bladder is lower in women but they tend to present with more aggressive and advanced disease. Some prior studies also suggest there are sex-based differences in response to treatment for non-muscle invasive bladder tumors., Methods: In this retrospective study, we reviewed all consecutive patients who received BCG at the CHU de Québec - Laval University from 2009-2019. Men and women were treated with intravesical BCG therapy following pathologic confirmation of urothelial carcinoma. Outcomes evaluated include recurrence, progression, and treatment tolerability. Recurrence was defined as a pathology confirmed cancer whereas progression was the new development of high-grade (recurrence) pathology or an increase of stage. Tolerability was defined according to the proportion of prescribed BCG received. All clinical details were obtained through review of the medical records, collaborated by pharmacy records for BCG administration. Competing-risk analysis was used to compare outcomes., Results: Among 613 patients who received BCG at our institution between 2009-2019, 472 (77.0%) were men and 141 (23.0%) were women. The recurrence rate was not different between sexes, with a 5-year recurrence risk of 52% (95% CI: 36.93-65.4) among women compared to 57.5% (CI 95%: 51.9-62.6) among men. The overall non-progression rate at 1,3 and 5 years was 97.3% (95% CI: 95.6%-98.3%), 93.6% (95% CI: 91.2%-95.4%), and 91.7% (95% CI: 88.4%-94.1%), respectively. The completion of ≥5 induction BCG instillations and maintenance BCG use was similar in both genders., Conclusions: We report a contemporary NMIBC cohort treated with BCG and find no clear evidence for sex-based differences in response to BCG treatment in regard of progression, recurrence, and tolerability., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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3. Use and duration of antibiotic prophylaxis and the rate of urinary tract infection after radical cystectomy for bladder cancer: Results of a multicentric series.
- Author
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Haider M, Ladurner C, Mayr R, Tandogdu Z, Fritsche HM, Fradet V, Comploj E, Pycha A, Lemire F, Lacombe L, Fradet Y, Toren P, and Lodde M
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- Aged, Bacterial Infections prevention & control, Drug Utilization statistics & numerical data, Female, Humans, Male, Middle Aged, Postoperative Complications microbiology, Postoperative Complications prevention & control, Retrospective Studies, Risk Factors, Time Factors, Urinary Tract Infections microbiology, Urinary Tract Infections prevention & control, Antibiotic Prophylaxis methods, Antibiotic Prophylaxis statistics & numerical data, Bacterial Infections epidemiology, Cystectomy methods, Postoperative Complications epidemiology, Urinary Bladder Neoplasms surgery, Urinary Tract Infections epidemiology
- Abstract
Objectives: To assess the rate of urinary tract infection (UTI), the characteristics of the bacterial aetiological agents involved, the type and duration of antibiotics used, and the clinical risk factors of UTI in a multi-institutional cohort of patients who had undergone radical cystectomy (RC)., Patients and Methods: The pre- and postoperative characteristics of patients who had undergone open RC at 1 of 3 institutions between 2009 and 2015 were analyzed by means of the patient charts. Patients were classified according to the presence or absence of UTI. Analysis of the severity of UTI was based on the EAU/EAU Section of Infections in Urology (ESIU) classification system. The bacterial aetiological agents and their antibiotic susceptibility were also assessed. Factors predicting postoperative UTI were identified using univariable and multivariable logistic regression analysis., Results: Of 217 patients, 42 (19.4%) had developed postoperative UTI, of whom 50% had urosepsis or uroseptic shock. Multivariable analysis showed continent urinary derivation as the only significant predictor of UTI with an odds ratio of 5.03 (95% confidence interval 2.12-11.9, P < 0.001). The duration of perioperative antibiotic prophylaxis was not associated with an increased risk of UTI. Enterococcus was the most commonly isolated bacteria (25.7%), but this species is not covered by the recommended antibiotic prophylaxis., Conclusion: Patients with continent urinary diversion after RC have a significantly higher risk of developing UTI. Prolonged perioperative administration of antibiotics does not seem to reduce the risk of UTI. Enterococcus as the most commonly isolated bacteria is not covered by most recommended antibiotic prophylaxis regimens. Therefore different antibiotic regimens should be considered for high-risk patients., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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4. Contemporary outcomes of palliative transurethral resection of the prostate in patients with locally advanced prostate cancer.
- Author
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Pelletier J, Cyr SJ, Julien AS, Fradet Y, Lacombe L, and Toren P
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- Aged, Aged, 80 and over, Humans, Male, Middle Aged, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Transurethral Resection of Prostate adverse effects, Transurethral Resection of Prostate methods, Urologic Surgical Procedures adverse effects, Urologic Surgical Procedures methods
- Abstract
Background: Advanced prostate cancer may cause significant local complications which affect quality of life, including bladder outlet obstruction and hematuria. We performed a detailed review of our outcomes of palliative transurethral resection of the prostate (pTURP) in the era of taxane chemotherapy and potent androgen receptor antagonists at our tertiary-care institution., Methods: Using hospital coding data, we identified patients with a diagnosis of prostate cancer who underwent a TURP at Hotel-Dieu Hospital in Quebec City between 2006 and 2016 for detailed chart review. Co-morbidities were classified using the Charlson comorbidity index (CCI). Cox regression analyses assessed predictors of perioperative mortality and morbidity., Results: Of 137 patients identified, 58 were included in our study. Median age was 68 years; 27 (47%) men had castration-resistant prostate cancer and 28 (48%) were metastatic at time of pTURP. Mean follow-up from the first pTURP was 2.2 years, with an estimated 5-year overall survival of 16.3% (95% CI: 6.5%-29.8%). Castration-resistant prostate cancer, CCI ≥5, and age predicted poorer survival. Primary indication for pTURP was bladder outlet obstruction (69%) or hematuria (22%). Postoperative Clavien 0, 1, 2, 3, 4, 5 complications occurred in 20 (34%), 16 (28%), 18 (31%), 3 (5%), 0, and 1 (2%) patients, respectively. Overall, 17 (27%) men underwent ≥1 redo pTURPs and 16 (28%) eventually had an indwelling catheter. Nephrostomy tubes or ureteral stents in place before pTURP remained indefinitely in all cases., Conclusions: We conclude palliative TURP remains an important surgical option to relieve bladder outlet obstruction in patients with locally advanced prostate cancer, but is ineffective to relieve ureteral obstruction., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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5. Quality indicators in the management of bladder cancer: A modified Delphi study.
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Khare SR, Aprikian A, Black P, Blais N, Booth C, Brimo F, Chin J, Chung P, Drachenberg D, Eapen L, Fairey A, Fleshner N, Fradet Y, Gotto G, Izawa J, Jewett M, Kulkarni G, Lacombe L, Moore R, Morash C, North S, Rendon R, Saad F, Shayegan B, Siemens R, So A, Sridhar SS, Traboulsi SL, and Kassouf W
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- Female, Humans, Male, Survival Analysis, Urinary Bladder Neoplasms mortality, Urinary Bladder Neoplasms pathology, Delphi Technique, Urinary Bladder Neoplasms therapy
- Abstract
Background: Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherence to best practice and provide data for benchmarking and quality improvement., Objective: To produce an evidence- and consensus-based list of QIs for the management of bladder cancer., Methods: A modified Delphi method was used to develop the indicator list. Candidate indicators were extracted from the literature and rated by a 27-member Canadian expert panel in several rounds until consensus was reached on the final list of indicators. In rounds with numeric ratings, a frequency analysis was performed., Results: A total of 86 indicators were rated, 52 extracted from the literature and 34 suggested by the panel. After iterative rounds of ratings and discussion, a final list of 60 QIs spanning several disciplines and phases of the cancer care continuum was developed., Conclusions: This is the first study to comprehensively produce common QIs representing structure, process, and outcome measures in bladder cancer management. Though developed in Canada, these indicators can be used in other countries with slight modifications to track performance and improve care., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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6. Erratum to "The natural history of renal function after surgical management of renal cell carcinoma: Results from the Canadian Kidney Cancer Information System" [Urol Oncol 34(11) (2016) 486.e1-486.e7].
- Author
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Mason R, Kapoor A, Liu Z, Saarela O, Tanguay S, Jewett M, Finelli A, Lacombe L, Kawakami J, Moore R, Morash C, Black P, and Rendon RA
- Published
- 2017
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7. The natural history of renal function after surgical management of renal cell carcinoma: Results from the Canadian Kidney Cancer Information System.
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Mason R, Kapoor A, Liu Z, Saarela O, Tanguay S, Jewett M, Finelli A, Lacombe L, Kawakami J, Moore R, Morash C, Black P, and Rendon RA
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- Academic Medical Centers, Acute Kidney Injury etiology, Acute Kidney Injury physiopathology, Adult, Aged, Aged, 80 and over, Canada, Carcinoma, Renal Cell physiopathology, Cold Ischemia, Disease Progression, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Kidney blood supply, Kidney Neoplasms physiopathology, Male, Middle Aged, Nephrectomy methods, Renal Insufficiency, Chronic physiopathology, Warm Ischemia, Young Adult, Carcinoma, Renal Cell surgery, Kidney physiopathology, Kidney Neoplasms surgery, Nephrectomy adverse effects, Renal Insufficiency, Chronic etiology
- Abstract
Introduction and Objective: Patients who undergo surgical management of renal cell carcinoma (RCC) are at risk for chronic kidney disease and its sequelae. This study describes the natural history of renal function after radical and partial nephrectomy and explores factors associated with postoperative decline in renal function., Methods: This is a multi-institutional cohort study of patients in the Canadian Kidney Cancer Information System who underwent partial or radical nephrectomy for RCC. Estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease were determined preoperatively and at 3, 12, and 24 months postoperatively. Linear regression was used to determine the association between postoperative eGFR and type of surgery (radical vs. partial), duration of ischemia, ischemia type (warm vs. cold), and tumor size., Results and Limitations: With a median follow-up of 26 months, 1,379 patients were identified from the Canadian Kidney Cancer Information System database including 665 and 714 who underwent partial and radical nephrectomy, respectively. Patients undergoing radical nephrectomy had a lower eGFR (mean = 19ml/min/1.73m
2 lower) at 3, 12, and 24 months postoperatively (P<0.001). Decline in renal function occurred early and remained stable throughout follow-up. A lower preoperative eGFR and increasing age were also associated with a lower postoperative eGFR (P<0.01). Ischemia type and duration were not predictive of postoperative decline in eGFR (P>0.05). Severe renal failure (eGFR<30ml/min/1.73m2 ) developed postoperatively in 12.5% and 4.1% of radical and partial nephrectomy patients, respectively (P<0.001)., Conclusions: After the initial postoperative decline, renal function remains stable in patients undergoing surgery for RCC. Patients undergoing radical nephrectomy have a greater long-term reduction in renal function compared with those undergoing partial nephrectomy. Ischemia duration and type are not predictive of postoperative renal function when adhering to generally short ischemia durations., (Copyright © 2016 Elsevier Inc. All rights reserved.)- Published
- 2016
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8. Disease progression and kidney function after partial vs. radical nephrectomy for T1 renal cancer.
- Author
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Forbes CM, Rendon RA, Finelli A, Kapoor A, Moore RB, Breau RH, Lacombe L, Kawakami J, Drachenberg DE, Pautler SE, Jewett MMA, Saarela O, Liu Z, Tanguay S, and Black PC
- Subjects
- Adult, Aged, Aged, 80 and over, Canada, Confounding Factors, Epidemiologic, Disease Progression, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Kaplan-Meier Estimate, Kidney Neoplasms physiopathology, Linear Models, Male, Middle Aged, Models, Biological, Neoplasm Grading, Neoplasm Staging, Proportional Hazards Models, Young Adult, Kidney physiopathology, Kidney Neoplasms surgery, Nephrectomy methods
- Abstract
Purpose: Partial nephrectomy (PN) for early stage renal cancer preserves renal function better than radical nephrectomy (RN) and is generally considered oncologically similar. The Intergroup European Organisation for Research and Treatment of Cancer trial comparing outcomes after PN vs. RN, however, showed reduced overall survival in the PN group. Our aim was to evaluate recurrence, death, and renal function after PN vs. RN for T1 tumors in a Canadian population., Materials and Methods: From 2000 to 2015, 2,358 patients with a first occurrence of a clinical T1 renal cancer who underwent PN or RN were identified from the Canadian Kidney Cancer Information System. Clinical, surgical, and pathologic parameters were analyzed. Time to progression was compared after PN vs. RN using a Cox proportional hazards model, adjusted for pertinent variables., Results: Inclusion criteria were met in 1,615 PN and 743 RN. Preoperative characteristics appeared similar in both groups. Time to progression was not different after PN vs. RN, adjusted for potential confounders (hazard ratio = 1.17 [95% CI: 0.8-1.72, P = 0.42]). Postoperative estimated glomerular filtration rate at 1 and 3 years was significantly greater for PN vs. RN in a linear regression model, accounting for preoperative estimated glomerular filtration rate., Conclusions: These results suggest that progression-free survival after PN and RN in patients with T1 renal cancer was similar, but that there was better preservation of renal function after PN. This suggests that both PN and RN have similar oncological efficiency, and that selection of surgical approach should be based on other factors such as technical feasibility, potential complications, and preservation of renal function., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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9. Risk factors for bladder cancer recurrence after nephroureterectomy for upper tract urothelial tumors: results from the Canadian Upper Tract Collaboration.
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Fradet V, Mauermann J, Kassouf W, Rendon R, Jacobsen N, Fairey A, Izawa J, Kapoor A, Black P, Tanguay S, Chin J, So A, Lattouf JB, Bell D, Saad F, Sheyegan B, Drachenberg D, Cagiannos I, and Lacombe L
- Subjects
- Aged, Aged, 80 and over, Chemotherapy, Adjuvant, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Proportional Hazards Models, Retrospective Studies, Risk Assessment methods, Risk Assessment statistics & numerical data, Risk Factors, Urologic Neoplasms drug therapy, Urothelium drug effects, Urothelium pathology, Nephrectomy methods, Ureter surgery, Urinary Bladder Neoplasms pathology, Urologic Neoplasms surgery, Urothelium surgery
- Abstract
Objective: To evaluate risk factors for bladder cancer recurrence in a cohort of patients treated with radical nephroureterectomy (RNU)., Patients and Methods: At 10 Canadian University Centers, we retrospectively evaluated data, between 1990 and 2010, from 743 patients who were free from bladder cancer and were previously treated with RNU for upper tract urothelial cancer., Results: Of 743 patients, 167 (22.5%) developed bladder tumors after a median time of 17.2 months after RNU. Multivariable analysis detected age (hazard ratio [HR] = 1.028; 95% CI: 1.010-1.046; P = 0.0018), tumor location in both the renal pelvis and the ureter (HR = 2.205; 95% CI: 1.355-3.589; P = 0.0015), the use of adjuvant systemic chemotherapy (HR = 2.309; 95% CI: 1.439-3.705; P = 0.0005), and laparoscopic surgery (HR = 1.876; 95% CI: 1.226-2.87; P = 0.0037) as risk factors for bladder cancer recurrence. Open excision of a bladder cuff (HR = 0.661; 95% CI: 0.453-0.965; P = 0.0319) and transurethral resection of the intramural ureter (HR = 0.548; 95% CI: 0.306-0.981; P = 0.0429) on comparison with extravesical resection decreased the risk of bladder cancer recurrence significantly. Major limitations were the retrospective design and partially missing data, although the significance of variables did not change in the imputation analysis., Conclusion: Older patients, those with tumor location in both the renal pelvis and the ureter, and those treated with adjuvant systemic chemotherapy were found at higher risk for intravesical recurrence, as were those having undergone extravesical ureterectomy or laparoscopic RNU., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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10. Effect of body mass index on the outcomes of patients with upper and lower urinary tract cancers treated by radical surgery: results from a Canadian multicenter collaboration.
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Bachir BG, Aprikian AG, Izawa JI, Chin JL, Fradet Y, Fairey A, Estey E, Jacobsen N, Rendon R, Cagiannos I, Lacombe L, Lattouf JB, Kapoor A, Matsumoto E, Saad F, Bell D, Black PC, So AI, Drachenberg D, and Kassouf W
- Subjects
- Aged, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Urologic Neoplasms pathology, Urologic Neoplasms surgery, Body Mass Index, Cystectomy mortality, Neoplasm Recurrence, Local mortality, Nephrectomy mortality, Urologic Neoplasms mortality
- Abstract
Objective: To evaluate the effect of body mass index (BMI) on the outcomes of patients with urinary tract carcinoma treated with radical surgery., Materials and Methods: Data were collected from 10 Canadian centers on patients who underwent radical cystectomy (RC) (1998-2008) or radical nephroureterectomy (RNU) (1990-2010). Various parameters among subsets of patients (BMI < 25, 25 ≤ BMI < 30, and BMI ≥ 30 kg/m(2)) were analyzed. Kaplan-Meier and multivariate analyses were performed to assess the effect of BMI on overall survival, disease-specific survival, and recurrence-free survival (RFS)., Results: Among the 847 RC and 664 RNU patients, there was no difference in histology, stage, grade, and margin status among the 3 patient subsets undergoing either surgery. However, RC patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.004), had more nodal metastasis (P = 0.03), and trended toward higher stage (P = 0.052). RNU patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.0004) and fewer received adjuvant chemotherapy (P = 0.04) compared with those with BMI ≥ 30 kg/m(2); however, there was no difference in tumor location (P = 0.20), stage (P = 0.48), and management of distal ureter among the groups (P = 0.30). On multivariate analysis, BMI was not prognostic for overall survival, disease-specific survival, and RFS in the RC group. However, BMI ≥ 30 kg/m(2) was associated with more bladder cancer recurrences and worse RFS in the RNU group (HR = 1.588; 95% CI: 1.148-2.196; P = 0.0052)., Conclusions: Increased BMI did not influence survival among RC patients. BMI ≥ 30 kg/m(2) is associated with worse bladder cancer recurrences among RNU patients; whether this is related to difficulty in obtaining adequate bladder cuff in patients with obesity requires further evaluation., (© 2013 Published by Elsevier Inc.)
- Published
- 2014
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11. Adjuvant chemotherapy for upper-tract urothelial carcinoma treated with nephroureterectomy: assessment of adequate renal function and influence on outcome.
- Author
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Yafi FA, Tanguay S, Rendon R, Jacobsen N, Fairey A, Izawa J, Kapoor A, Black P, Lacombe L, Chin J, So A, Lattouf JB, Bell D, Fradet Y, Saad F, Matsumoto E, Drachenberg D, Cagiannos I, and Kassouf W
- Subjects
- Aged, Antineoplastic Agents therapeutic use, Cisplatin therapeutic use, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Kaplan-Meier Estimate, Kidney surgery, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Retrospective Studies, Treatment Outcome, Chemotherapy, Adjuvant methods, Nephrectomy methods, Urologic Neoplasms drug therapy, Urologic Neoplasms surgery, Urothelium pathology, Urothelium surgery
- Abstract
Objectives: Upper-tract urothelial carcinoma (UTUC) is associated with poor outcomes. Our aim was to assess adequacy of renal function and evaluate the role of adjuvant chemotherapy (AC) in patients with UTUC treated by radical nephroureterectomy (RNU) in a universal health care system., Materials and Methods: Retrospective data from 1,029 patients treated with RNU across 10 Canadian academic centers were collected. Tested variables included various clinico-pathological parameters, the use of perioperative chemotherapy, preoperative and postoperative creatinine values, and estimated glomerular filtration rates (eGFR). Univariable and multivariable Cox regression models addressed overall survival and disease-specific survival after surgery. Kaplan-Meier survival curves were used to compare outcomes in patients who received or did not receive AC., Results: Median age of patients was 70 years with a median follow-up of patients who were alive of 26 months. The median preoperative and postoperative eGFR rates were 59 mL/min/1.73 m(2) and 47 mL/min/1.73 m(2), respectively. Using a cutoff eGFR of 60, 49% of all the patients and 48% of the patients with ≥ pT3 or pTxN+ or both diseases would have been eligible for cisplatin-based chemotherapy preoperatively and only 18% and 21% of the patients, respectively remained eligible postoperatively. Of the patients who received AC, 75% had an eGFR<60. On multivariate analysis, AC was not prognostic for improved overall survival or disease-specific survival., Conclusions: Chronic kidney disease is common in patients with UTUC. Following RNU, 57% of the high-risk patients with good preoperative renal function became ineligible for cisplatin-based chemotherapy. Use of AC did not translate into improved survival. Whether this is due to inherent biases of retrospective analysis, limited efficacy of AC in patients with UTUC, or use of suboptimal regimen or dose because of poor postoperative renal function requires further evaluation., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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12. Multifocality rather than tumor location is a prognostic factor in upper tract urothelial carcinoma.
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Williams AK, Kassouf W, Chin J, Rendon R, Jacobsen N, Fairey A, Kapoor A, Black P, Lacombe L, Tanguay S, So A, Lattouf JB, Bell D, Fradet Y, Saad F, Matsumoto E, Drachenberg D, Cagiannos I, and Izawa JI
- Subjects
- Aged, Canada, Carcinoma, Transitional Cell surgery, Databases, Factual, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Kidney Neoplasms surgery, Kidney Pelvis pathology, Kidney Pelvis surgery, Male, Multivariate Analysis, Nephrectomy, Prognosis, Retrospective Studies, Treatment Outcome, Ureter pathology, Ureter surgery, Ureteral Neoplasms surgery, Urologic Neoplasms surgery, Carcinoma, Transitional Cell pathology, Kidney Neoplasms pathology, Ureteral Neoplasms pathology, Urologic Neoplasms pathology
- Abstract
Objectives: Whether a patient has urothelial carcinoma located within the renal pelvis or ureter remains a controversial prognostic indicator in clinical urology. We wished to evaluate whether tumor location is associated with recurrence in patients undergoing nephroureterectomy for upper tract urothelial cancer in a large volume patient cohort., Subjects and Methods: We created a retrospective database of patients from 7 academic centers throughout Canada who underwent nephroureterectomy for upper tract urothelial carcinoma. Patient demographics as well as pathologic and surgical factors were analyzed to evaluate any statistical association between tumor location and overall survival, disease-free survival, and disease-specific survival., Results: A total of 1,029 patients had data available for analysis with a mean follow up of 3.2 years. Kaplan Meier 5-year disease-free survivals (DFS) were 46%, 37%, and 19% for renal pelvis tumors, ureteric tumors, and multifocal tumors respectively. There was no association between the location of the tumor and the DFS, however, disease involving both the ureter and renal pelvis was associated with lower DFS and overall survival (OS) (P < 0.001)., Conclusions: Tumor location does not appear to have any influence on the risk of recurrence of disease following nephroureterectomy in this large patient cohort. However, multifocal tumors involving both the ureter and renal pelvis had a significantly worse prognosis and should be considered for more aggressive management., (Copyright © 2013. Published by Elsevier Inc.)
- Published
- 2013
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