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3 results on '"Jeff Webster"'

1. Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer

Author

Michelle Wilson, Naveen S Vasudev, Grant D Stewart, Adebanji Adeyoju, Jon Cartledge, Michael Kimuli, Shibendra Datta, Damian Hanbury, David Hrouda, Grenville Oades, Poulam Patel, Naeem Soomro, Mark Sullivan, Jeff Webster, Peter J Selby, and Rosamonde E Banks

Subjects
Medicine
Abstract

Objectives To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis.Design Multicentre prospective observational cohort study.Setting and participants Eleven UK centres recruiting patients presenting with suspected newly diagnosed RCC. Symptoms reported by patients were recorded and reviewed. Comprehensive clinico-pathological and outcome data were also collected.Outcomes Type and frequency of reported symptoms, incidental diagnosis rate, metastasis-free survival and cancer-specific survival.Results Of 706 patients recruited between 2011 and 2014, 608 patients with a confirmed RCC formed the primary study population. The majority (60%) of patients were diagnosed incidentally. 87% of patients with stage Ia and 36% with stage III or IV disease presented incidentally. Visible haematuria was reported in 23% of patients and was commonly associated with advanced disease (49% had stage III or IV disease). Symptomatic presentation was associated with poorer outcomes, likely reflecting the presence of higher stage disease. Symptom patterns among the 54 patients subsequently found to have a benign renal mass were similar to those with a confirmed RCC.Conclusions Raising public awareness of RCC-related symptoms as a strategy to improve early detection rates is limited by the fact that related symptoms are relatively uncommon and often associated with advanced disease. Greater attention must be paid to the feasibility of screening strategies and the identification of circulating diagnostic biomarkers.

Published
2020
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2. UK Multicenter Prospective Evaluation of the Leibovich Score in Localized Renal Cell Carcinoma: Performance has Altered Over Time

Author

Michelle Hutchinson, Michael P. Messenger, Jon Cartledge, S.N. Datta, Adebanji Adeyoju, Poulam M. Patel, D.C. Hanbury, David Hrouda, Michael Kimuli, Peter Selby, Grant D. Stewart, Jeff Webster, Grenville Oades, Selina Bhattarai, Rosamonde E. Banks, Roisean E. Ferguson, Naeem Soomro, Mark Sullivan, Naveen S. Vasudev, Sebastian Trainor, Stewart, Grant [0000-0003-3188-9140], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Urology, 030232 urology & nephrology, Nephrectomy, Article, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Renal cell carcinoma, Internal medicine, Outcome Assessment, Health Care, medicine, Carcinoma, Humans, Prospective Studies, Prospective cohort study, Carcinoma, Renal Cell, Aged, Aged, 80 and over, business.industry, Middle Aged, Explained variation, medicine.disease, Prognosis, Kidney Neoplasms, United Kingdom, Clinical trial, 030220 oncology & carcinogenesis, Cohort, Female, business, Historical Cohort, Cohort study
Abstract

Objective To examine changes in outcome by the Leibovich score using contemporary and historic cohorts of patients presenting with renal cell carcinoma (RCC) Patients and Methods Prospective observational multicenter cohort study, recruiting patients with suspected newly diagnosed RCC. A historical cohort of patients was examined for comparison. Metastasis-free survival (MFS) formed the primary outcome measure. Model discrimination and calibration were evaluated using Cox proportional hazard regression and the Kaplan-Meier method. Overall performance of the Leibovich model was assessed by estimating explained variation. Results Seven hundred and six patients were recruited between 2011 and 2014 and RCC confirmed in 608 (86%) patients. Application of the Leibovich score to patients with localized clear cell RCC in this contemporary cohort demonstrated good model discrimination (c-index = 0.77) but suboptimal calibration, with improved MFS for intermediate- and high-risk patients (5-year MFS 85% and 50%, respectively) compared to the original Leibovich cohort (74% and 31%) and a historic (1998-2006) UK cohort (76% and 37%). The proportion of variation in outcome explained by the model is low and has declined over time (28% historic vs 22% contemporary UK cohort). Conclusion Prognostic models are widely employed in patients with localized RCC to guide surveillance intensity and clinical trial selection. However, the majority of the variation in outcome remains unexplained by the Leibovich model and, over time, MFS rates among intermediate- and high-risk classified patients have altered. These findings are likely to have implications for all such models used in this setting.

Published
2019

3. Lead Optimization toward Proof-of-Concept Tools for Huntington’s Disease within a 4-(1H-Pyrazol-4-yl)pyrimidine Class of Pan-JNK Inhibitors.

Author

John Wityak, Kevin F. McGee, MichaelP. Conlon, Ren Hua Song, Bryan C. Duffy, Brent Clayton, Michael Lynch, Gwen Wang, Emily Freeman, James Haber, Douglas B. Kitchen, David D. Manning, Jiffry Ismail, Yuri Khmelnitsky, Peter Michels, Jeff Webster, Macarena Irigoyen, Michele Luche, Monica Hultman, and Mei Bai

Published
2015
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