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Risk of Postoperative Up Staging or Upgrading among Men with Low Risk Familial Prostate Cancer.

低风险家族性前列腺癌男性术后分期或升级的风险。

  • 影响因子:1.46
  • DOI:10.1097/JU.0000000000000793
  • 作者列表:"Jansson F","Folkvaljon F","Stattin P","Bratt O","Akre O
  • 发表时间:2020-07-01
Abstract

PURPOSE:We investigated whether men with biopsy verified, low grade cancer and a family history of lethal or advanced prostate cancer are at particularly high risk for harboring undetected high grade disease. MATERIALS AND METHODS:Upgrading and up staging of prostate cancer are common after prostatectomy. In a nationwide population based cohort we identified 6,854 men with low risk prostate cancer who underwent radical prostatectomy. Among these men 1,739 (25%) had a history of prostate cancer in a first-degree relative and 289 (4%) had a first-degree relative with lethal or advanced prostate cancer. RESULTS:Compared to men with no familial occurrence of prostate cancer, the odds ratio for the risk of up staging among men with a familial occurrence of high risk or lethal prostate cancer was 1.06 (95% CI 0.76-1.47). The corresponding odds ratio for upgrading was 1.17 (0.91-1.50). CONCLUSIONS:We found no association between family history of prostate cancer and up staging or upgrading after radical prostatectomy.

摘要

目的: 我们调查了有活检证实、低级别癌症和家族致死性或晚期前列腺癌病史的男性是否具有特别高的患未被发现的高级别疾病的风险。 材料和方法: 前列腺癌的升级和分期是前列腺切除术后常见的。在一个基于全国人群的队列中,我们确定了6,854名接受根治性前列腺切除术的低风险前列腺癌男性。在这些男性中,1,739名 (25%) 有一级亲属的前列腺癌病史,289名 (4%) 有一级亲属患有致命或晚期前列腺癌。 结果: 与无家族性前列腺癌发生的男性相比,家族性高危或致死性前列腺癌发生的男性中分期风险的比值比为1.06 (95% CI 0.76-1.47)。升级的相应比值比为1.17 (0.91-1.50)。 结论: 我们发现前列腺癌家族史与根治性前列腺切除术后分期或升级之间没有关联。

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影响因子:0.73
发表时间:2020-02-01
DOI:10.3138/jvme.1117-158r1
作者列表:["Hunt JA","Heydenburg M","Kelly CK","Anderson SL","Dascanio JJ"]

METHODS::Veterinary educators use models to allow repetitive practice of surgical skills leading to clinical competence. Canine castration is a commonly performed procedure that is considered a Day One competency for a veterinarian. In this study, we sought to create and evaluate a canine pre-scrotal closed castration model and grading rubric using a validation framework of content evidence, internal structure evidence, and relationship with other variables. Veterinarians (n = 8) and students (n = 32) were recorded while they performed a castration on the model and provided survey feedback. A subset of the students (n = 7) then performed a live canine castration, and their scores were compared with their model scores. One hundred percent of the veterinarians and 91% of the students reported that the model was helpful in training for canine castration. They highlighted several areas for continued improvement. Veterinarians' model performance scores were significantly higher than students', indicating that the model had adequate features to differentiate expert from novice performance. Students' performance on the model strongly correlated with their performance of live castration (r = .82). Surgical time was also strongly correlated (r = .70). The internal consistency of model and live rubric scores were good at .85 and .94, respectively. The framework supported validation of the model and rubric. The canine castration model facilitated cost-efficient practice in a safe environment in which students received instructor feedback and learned through experience without the risk of negatively affecting a patient's well-being. The strong correlation between model and live animal performance scores suggests that the model could be useful for mastery learning.

影响因子:2.56
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DOI:10.1007/s00345-019-02780-0
作者列表:["Renninger M","Fahmy O","Schubert T","Schmid MA","Hassan F","Stenzl A","Gakis G"]

METHODS:PURPOSE:To investigate whether hexaminolevulinate-based (HAL) bladder tumor resection (TURBT) impacts on outcomes of patients with primary non-muscle-invasive bladder cancer (NMIBC) who were eventually treated with radical cystectomy (RC). METHODS:A total of 131 consecutive patients exhibiting NMIBC at primary diagnosis were retrospectively investigated whether they had undergone any HAL-guided TURBT prior to RC. Uni- and multivariable analyses were used to evaluate the impact of HAL-TURBT on cancer-specific (CSS) and overall survival (OS). The median follow-up was 38 months (IQR 13-56). RESULTS:Of the 131 patients, 69 (52.7%) were managed with HAL- and 62 (47.3%) with white light (WL)-TURBT only prior to RC. HAL-TURBT was associated with a higher number of TURBTs prior to RC (p = 0.002) and administration of intravesical chemotherapy (p = 0.043). A trend towards a higher rate of tumor-associated immune cell infiltrates in RC specimens (p = 0.07) and a lower utilization rate of post-operative systemic chemotherapy (p = 0.10) was noted for patients who were treated with HAL-TURBT. The 5-year CSS/OS was 90.9%/74.5% for the HAL-group and 73.8%/55.8% for the WL-group (p = 0.042/0.038). In multivariable analysis, lymph node tumor involvement (p = 0.007), positive surgical margins (p = 0.001) and performance of WL-TURBT only (p = 0.040) were independent predictors for cancer-specific death. CONCLUSIONS:The present data suggest that the resection of NMIBC under HAL exerts a beneficial impact on outcomes of patients who will need to undergo RC during their course of disease. This finding may be due to improved risk stratification as the resection under HAL may allow more patients to be treated timely and adequately.

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影响因子:1.46
发表时间:2020-02-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000313
作者列表:["Alder R","Zetner D","Rosenberg J"]

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