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5. Selective Use of Neoadjuvant Targeted Therapy Is Associated with Greater Achievement of Partial Nephrectomy for High-complexity Renal Masses in a Solitary Kidney

Author

Attawettayanon, Worapat, Yasuda, Yosuke, Zhang, JJ H., Kazama, Akira, Rathi, Nityam, Munoz-Lopez, Carlos, Lewis, Kieran, Shah, Snehi, Li, Jianbo, Emrich Accioly, João Pedro, Campbell, Rebecca A., Shah, Shetal, Wood, Andrew, Kaouk, Jihad, Haber, Georges-Pascal, Eltemamy, Mohamad, Krishnamurthi, Venkatesh, Abouassaly, Robert, Weight, Christopher, Derweesh, Ithaar, and Campbell, Steven C.

Published
2023
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6. Using IsoPSA With Prostate Imaging Reporting and Data System Score May Help Refine Biopsy Decision Making in Patients With Elevated PSA

Author

Benidir, Tarik, Lone, Zaeem, Wood, Andrew, Abdallah, Nour, Campbell, Rebecca, Bajic, Petar, Purysko, Andrei, Nguyen, Jane K., Kaouk, Jihad, Haber, Georges-Pascal, Eltemamy, Mohamed, Stein, Robert, Haywood, Samuel, Klein, Eric A, Almassi, Nima, Campbell, Steven C., Abouassaly, Robert, and Weight, Christopher J.

Published
2023
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7. Comprehensive Management of Renal Masses in Solitary Kidneys

Author

Yasuda, Yosuke, Zhang, JJ.H., Attawettayanon, Worapat, Rathi, Nityam, Wilkins, Lamont, Roversi, Gustavo, Zhang, Ao, Accioly, Joao Pedro Emrich, Shah, Snehi, Munoz-Lopez, Carlos, Palacios, Diego Aguilar, Hofmann, Martin, Campbell, Rebecca A., Kaouk, Jihad, Haber, Georges-Pascal, Eltemamy, Mohamad, Krishnamurthi, Venkatesh, Abouassaly, Robert, Martin, Charles, III, Li, Jianbo, Weight, Christopher, and Campbell, Steven C.

Published
2023
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14. Pure open versus robotic radical cystectomy with intracorporeal urinary diversion: a propensity matched analysis.

Author

Gabriel, Pierre-Etienne, Ganesan, Vishnuvardhan, Krishnan, Jayram, Autorino, Riccardo, Stephenson, Andrew J., Stein, Robert J., Fergany, Amr, Campbell, Steven C., Kaouk, Jihad, Haber, Georges-Pascal, and Ouzaid, Idir

Abstract

Objective: To compare surgical parameters and short-term outcomes between open radical cystectomy (ORC) and robotic radical cystectomy with total intracorporeal urinary diversion (icRARC). Methods: Among the study period, 133 patients who underwent ORC and pelvic node dissection for bladder cancer (group 1) were matched and compared to 61 patients who underwent icRARC during the same period (group 2). The groups were matched 1:1 according to their propensity scores adjusted on their baseline demographics and disease characteristics. The main surgical parameters compared were: operative time, estimated blood loss (EBL), and postoperative outcomes including time to oral intake, ninety-day complications, readmission rate, and secondary procedures. Results: Overall, 122 patients (61 in each group) were matched and finally analyzed. Although operative times (307 ± 97 min vs. 444 ± 113 min; p < 0.001) were longer, EBL (948 ± 657 ml vs. 357 ± 219 ml; p < 0.001) and transfusion rates were lower in the icRARC group. Overall complications were comparable but late complications tended to be lower in the icRARC group (p = 0.06). Readmission rate (54.8% vs. 26.8%, p = 0.01) was higher in the ORC group while secondary procedures (28.6% vs. 12.5%, p = 0.07) also tended to be lower in the robotic approach. Finally, in multivariable logistic regression the icRARC group was not associated with any complications of any grade including grade 3 or higher compared to the open approach. Conclusion: This study comparing open radical cystectomy to robotic radical cystectomy with total intracorporeal urinary diversion demonstrated encouraging outcomes for the minimally invasive management of urothelial carcinoma. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Parenchymal obliteration by renal masses: Functional and oncologic implications

Author

Kazama, Akira, Munoz-Lopez, Carlos, Attawettayanon, Worapat, Boumitri, Melissa, Maina, Eran, Lone, Zaeem, Rathi, Nityam, Lewis, Kieran, Campbell, Rebecca A., Palacios, Diego Aguilar, Kaouk, Jihad, Haber, Georges-Pascal, Haywood, Samuel, Almassi, Nima, Weight, Christopher J., Remer, Erick M., Ward, Ryan, Nowacki, Amy S., and Campbell, Steven C.

Published
2024
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19. Functional recovery after partial nephrectomy in a solitary kidney

Author

Attawettayanon, Worapat, Yasuda, Yosuke, Zhang, JJ H., Rathi, Nityam, Munoz-Lopez, Carlos, Kazama, Akira, Lewis, Kieran, Ponvilawan, Ben, Shah, Snehi, Wood, Andrew, Li, Jianbo, Accioly, João Pedro Emrich, Campbell, Rebecca A., Zabell, Joseph, Kaouk, Jihad, Haber, Georges-Pascal, Eltemamy, Mohamad, Krishnamurthi, Venkatesh, Abouassaly, Robert, Weight, Christopher, and Campbell, Steven C.

Published
2024
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22. Body morphometry may predict parastomal hernia following radical cystectomy with ileal conduit.

Author

Lone, Zaeem, Shin, David, Nowacki, Amy, Campbell, Rebecca A., Haile, Eiftu, Wood, Andrew, Harris, Kyle, Ellis, Ryan, Eltemamy, Mohammed, Haywood, Samuel C., Kaouk, Jihad, Campbell, Steven C., Weight, Christopher J., Haber, Georges‐Pascal, Miller, Benjamin, Petro, Clayton, Beffa, Lucas, Prabhu, Ajita, Rosen, Michael, and Remer, Erick M.

Subjects
PROPORTIONAL hazards models, RECURSIVE partitioning, ADIPOSE tissues, COMPUTED tomography, MUSCLE mass, ILEAL conduit surgery
Abstract

Objective: To investigate whether preoperative body morphometry analysis can identify patients at risk of parastomal hernia (PH), which is a common complication after radical cystectomy (RC). Patients and Methods: All patients who underwent RC between 2010 and 2020 with available cross‐sectional imaging preoperatively and at 1 and 2 years postoperatively were included. Skeletal muscle mass and total fat mass (FM) were determined from preoperative axial computed tomography images obtained at the level of the L3 vertebral body using Aquarius Intuition software. Sarcopenia and obesity were assigned based on consensus definitions of skeletal muscle index (SMI) and FM index (FMI). PH were graded using both the Moreno‐Matias and European Hernia Society criteria. Binary logistic regression and recursive partitioning were used to identify patients at risk of PH. The Kaplan–Meier method with log‐rank and Cox proportional hazards models included clinical and image‐based parameters to identify predictors of PH‐free survival. Results: A total of 367 patients were included in the final analysis, with 159 (43%) developing a PH. When utilising binary logistic regression, high FMI (odds ratio [OR] 1.63, P < 0.001) and low SMI (OR 0.96, P = 0.039) were primary drivers of risk of PH. A simplified model that only relied upon FMI, SMI, and preoperative albumin improved the classification of patients at risk of PH. On Kaplan–Meier analysis, patients who were obese or obese and sarcopenic had significantly worse PH‐free survival (P < 0.001). Conclusion: Body morphometry analysis identified FMI and SMI to be the most consistent predictors of PH after RC. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Parenchymal volume preservation during partial nephrectomy: improved methodology to assess impact and predictive factors.

Author

Kazama, Akira, Attawettayanon, Worapat, Munoz‐Lopez, Carlos, Rathi, Nityam, Lewis, Kieran, Maina, Eran, Campbell, Rebecca A., Lone, Zaeem, Boumitri, Melissa, Kaouk, Jihad, Haber, Georges‐Pascal, Haywood, Samuel, Almassi, Nima, Weight, Christopher, Li, Jianbo, and Campbell, Steven C.

Subjects
NEPHRECTOMY, PEARSON correlation (Statistics), GLOMERULAR filtration rate, CROSS-sectional imaging, KIDNEY physiology
Abstract

Objective: To rigorously evaluate the impact of the percentage of parenchymal volume preserved (PPVP) and how well the preserved parenchyma recovers from ischaemia (Recischaemia) on functional outcomes after partial nephrectomy (PN) using an accurate and objective software‐based methodology for estimating parenchymal volumes and split renal function (SRF). A secondary objective was to assess potential predictors of the PPVP. Patients and Methods: A total of 894 PN patients with available studies (2011–2014) were evaluated. The PPVP was measured from cross‐sectional imaging at ≤3 months before and 3–12 months after PN using semi‐automated software. Pearson correlation evaluated relationships between continuous variables. Multivariable linear regression evaluated predictors of ipsilateral glomerular filtration rate (GFR) preserved and the PPVP. Relative‐importance analysis was used to evaluate the impact of the PPVP on ipsilateral GFR preserved. Recischaemia was defined as the percentage of ipsilateral GFR preserved normalised by the PPVP. Results: The median tumour size and R.E.N.A.L. nephrometry score were 3.4 cm and 7, respectively. In all, 49 patients (5.5%) had a solitary kidney. In all, 538 (60%)/251 (28%)/104 (12%) patients were managed with warm/cold/zero ischaemia, respectively. The median pre/post ipsilateral GFRs were 40/31 mL/min/1.73 m2, and the median (interquartile range [IQR]) percentage of ipsilateral GFR preserved was 80% (71–88%). The median pre/post ipsilateral parenchymal volumes were 181/149 mL, and the median (IQR) PPVP was 84% (76–92%). In all, 330 patients (37%) had a PPVP of <80%, while only 34 (4%) had a Recischaemia of <80%. The percentage of ipsilateral GFR preserved correlated strongly with the PPVP (r = 0.83, P < 0.01) and loss of parenchymal volume accounted for 80% of the loss of ipsilateral GFR. Multivariable analysis confirmed that the PPVP was the strongest predictor of ipsilateral GFR preserved. Greater tumour size and endophytic and nearness properties of the R.E.N.A.L. nephrometry score were associated with a reduced PPVP (all P ≤ 0.01). Solitary kidney and cold ischaemia were associated with an increased PPVP (all P < 0.05). Conclusions: A reduced PPVP predominates regarding functional decline after PN, although a low Recischaemia can also contribute. Tumour‐related factors strongly influence the PPVP, while surgical efforts can improve the PPVP as observed for patients with solitary kidneys. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Limitations of Parenchymal Volume Analysis for Estimating Split Renal Function and New Baseline Glomerular Filtration Rate After Radical Nephrectomy.

Author

Lewis, Kieran, Maina, Eran N., Lopez, Carlos Munoz, Rathi, Nityam, Attawettayanon, Worapat, Kazama, Akira, Kaouk, Jihad, Haber, Georges-Pascal, Eltemamy, Mohamad, Krishnamurthi, Venkatesh, Abouassaly, Robert, Weight, Christopher J., and Campbell, Steven C.

Subjects
GLOMERULAR filtration rate, KIDNEY physiology, NEPHRECTOMY, RENAL veins, LOGISTIC regression analysis, HYDRONEPHROSIS
Abstract

Purpose: Accurately predicting new baseline glomerular filtration rate (NBGFR) after radical nephrectomy (RN) can improve counseling about RN vs partial nephrectomy. Split renal function (SRF)--based models are optimal, and differential parenchymal volume analysis (PVA) is more accurate than nuclear renal scans (NRS) for this purpose. However, there are minimal data regarding the limitations of PVA. Our objective was to identify patient-/tumor-related factors associated with PVA inaccuracy. Materials and Methods: Five hundred and ninety-eight RN patients (2006-2021) with preoperative CT/MRI were retrospectively analyzed, with 235 also having NRS. Our SRF-based model to predict NBGFR was: 1.25 x (GlobalGFRPre-RN x SRFContralateral), where GFR indicates glomerular filtration rate, with SRF determined by PVA or NRS, and with 1.25 representing the median renal functional compensation in adults. Accuracy of predicted NBGFR within 15% of observed was evaluated in various patient/tumor cohorts using multivariable logistic regression analysis. Results: PVA and NRS accuracy were 73%/52% overall, and 71%/52% in patients with both studies (n [ 235, P < .001), respectively. PVA inaccuracy independently associated with pyelonephritis, hydronephrosis, renal vein thrombosis, and infiltrative features (all P < .03). Ipsilateral hydronephrosis and renal vein thrombosis associated with PVA underprediction, while contralateral hydronephrosis and increased age associated with PVA overprediction (all P < .01). NRS inaccuracy was more common and did not associate with any of these conditions. Even among cohorts where PVA inaccuracy was observed (22% of our patients), there was no significant difference in the accuracies of NRS- and PVAbased predictions. Conclusions: PVA was more accurate for predicting NBGFR after RN than NRS. Inaccuracy of PVA correlated with factors that distort the parenchymal volume/function relationship or alter renal functional compensation. NRS inaccuracy was more common and unpredictable, likely reflecting the inherent inaccuracy of NRS. Awareness of cohorts where PVA is less accurate can help guide clinical decision-making. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Prognostic Factors and Risk Stratification in Invasive Upper Tract Urothelial Carcinoma

Author

Emamekhoo, Hamid, Dhillon, Puneet, Gopalakrishnan, Dharmesh, Elson, Paul, Stephenson, Andrew, Magi-Galluzzi, Cristina, McKenney, Jesse, Harper, Holly, Haber, Georges-Pascal, Kaouk, Jihad, Lee, Byron, Fergany, Amr, Berglund, Ryan, Gong, Michael, Stein, Robert, Krishnamurthi, Venkatesh, Gilligan, Timothy, Ornstein, Moshe, Rini, Brian, Garcia, Jorge, and Grivas, Petros

Published
2018
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30. Outcomes of Robot-assisted Partial Nephrectomy for Clinical T2 Renal Tumors: A Multicenter Analysis (ROSULA Collaborative Group)

Author

Bertolo, Riccardo, Autorino, Riccardo, Simone, Giuseppe, Derweesh, Ithaar, Garisto, Juan D., Minervini, Andrea, Eun, Daniel, Perdona, Sisto, Porter, James, Rha, Koon Ho, Mottrie, Alexander, White, Wesley M., Schips, Luigi, Yang, Bo, Jacobsohn, Kenneth, Uzzo, Robert G., Challacombe, Ben, Ferro, Matteo, Sulek, Jay, Capitanio, Umberto, Anele, Uzoma A., Tuderti, Gabriele, Costantini, Manuela, Ryan, Stephen, Bindayi, Ahmet, Mari, Andrea, Carini, Marco, Keehn, Aryeh, Quarto, Giuseppe, Liao, Michael, Chang, Kidon, Larcher, Alessandro, De Naeyer, Geert, De Cobelli, Ottavio, Berardinelli, Francesco, Zhang, Chao, Langenstroer, Peter, Kutikov, Alexander, Chen, David, De Luyk, Nicolo, Sundaram, Chandru P., Montorsi, Francesco, Stein, Robert J., Haber, Georges Pascal, Hampton, Lance J., Dasgupta, Prokar, Gallucci, Michele, Kaouk, Jihad, and Porpiglia, Francesco

Published
2018
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48. Parenchymal volume analysis to assess longitudinal functional decline following partial nephrectomy.

Author

Munoz‐Lopez, Carlos, Lewis, Kieran, Attawettayanon, Worapat, Yasuda, Yosuke, Accioly, João Pedro Emrich, Rathi, Nityam, Lone, Zaeem, Boumitri, Melissa, Campbell, Rebecca A., Wood, Andrew, Kaouk, Jihad, Haber, Georges‐Pascal, Eltemamy, Mohamad, Krishnamurthi, Venkatesh, Abouassaly, Robert, Haywood, Samuel, Weight, Christopher, and Campbell, Steven C.

Subjects
NEPHRECTOMY, GLOMERULAR filtration rate, CHRONIC kidney failure, KIDNEY physiology, ATROPHY
Abstract

Objective: To identify factors associated with longitudinal ipsilateral functional decline after partial nephrectomy (PN). Patients and Methods: Of 1140 patients managed with PN (2012–2014), 349 (31%) had imaging/serum creatinine levels pre‐PN, 1–12 months post‐PN (new baseline), and >3 years later necessary for inclusion. Parenchymal‐volume analysis was used to determine split renal function. Patients were grouped as having significant renal comorbidity (CohortSRC: diabetes mellitus with insulin‐dependence or end‐organ damage, refractory hypertension, or severe pre‐existing chronic kidney disease) vs not having significant renal comorbidity (CohortNoSRC) preoperatively. Multivariable regression was used to identify predictors of annual ipsilateral parenchymal atrophy and functional decline relative to new baseline values post‐PN, after the kidney had healed. Results: The median follow‐up was 6.3 years with 87/226/36 patients having cold/warm/zero ischaemia. The median cold/warm ischaemia times were 32/22 min. Overall, the median tumour size was 3.0 cm. The preoperative glomerular filtration rate (GFR) and new baseline GFR (NBGFR) were 81 and 71 mL/min/1.73 m2, respectively. After establishment of the NBGFR, the median loss of global and ipsilateral function was 0.7 and 0.4 mL/min/1.73 m2/year, respectively, consistent with the natural ageing process. Overall, the median ipsilateral parenchymal atrophy was 1.2 cm3/year and accounted for a median of 53% of the annual functional decline. Significant renal comorbidity, age, and warm ischaemia were independently associated with ipsilateral parenchymal atrophy (all P < 0.01). Significant renal comorbidity and ipsilateral parenchymal atrophy were independently associated with annual ipsilateral functional decline (both P < 0.01). Annual median ipsilateral parenchymal atrophy and functional decline were both significantly increased for CohortSRC compared to CohortNoSRC (2.8 vs 0.9 cm3, P < 0.01 and 0.90 vs 0.30 mL/min/1.73 m2/year, P < 0.01, respectively). Conclusions: Longitudinal renal function following PN generally follows the normal ageing process. Significant renal comorbidities, age, warm ischaemia, and ipsilateral parenchymal atrophy were the most important predictors of ipsilateral functional decline following establishment of NBGFR. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology

Author

Pavan, Nicola, Autorino, Riccardo, Lee, Hak, Porpiglia, Francesco, Sun, Yinghao, Greco, Francesco, Jeff Chueh, S., Han, Deok Hyun, Cindolo, Luca, Ferro, Matteo, Chen, Xiang, Branco, Anibal, Fornara, Paolo, Liao, Chun-Hou, Miyajima, Akira, Kyriazis, Iason, Puglisi, Marco, Fiori, Cristian, Yang, Bo, Fei, Guo, Altieri, Vincenzo, Jeong, Byong Chang, Berardinelli, Francesco, Schips, Luigi, De Cobelli, Ottavio, Chen, Zhi, Haber, Georges-Pascal, He, Yao, Oya, Mototsugu, Liatsikos, Evangelos, Brandao, Luis, Challacombe, Benjamin, Kaouk, Jihad, and Darweesh, Ithaar

Published
2016
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