Urology News

Exceptional Response on Addition of Everolimus to Taxane in Urothelial Carcinoma Bearing an NF2 Mutation


a Foundation Medicine, Cambridge, MA, USA

b Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA

Corresponding author. Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA. Tel. +1 626 2564673; Fax: +1 626 3018233.

Article information

PII: S0302-2838(15)00038-X
DOI: 10.1016/j.eururo.2015.01.015
© 2015 Published by Elsevier B.V.

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Active Surveillance for Prostate Cancer: Debate over the Application, Not the Concept

Refers to article:

Systematic Review and Meta-analysis of Factors Determining Change to Radical Treatment in Active Surveillance for Localized Prostate Cancer

Andrew J. Simpkin, Kate Tilling, Richard M. Martin, J. Athene Lane, Freddie C. Hamdy, Lars Holmberg, David E. Neal, Chris Metcalfe and Jenny L. Donovan

Accepted 2 January 2015


Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #MG 408, Toronto, Ontario M4N 3M5, Canada. Tel. +1 416 4804673; Fax: +1 416 4806121.

Article information

PII: S0302-2838(15)00021-4
DOI: 10.1016/j.eururo.2015.01.007
© 2015 Published by Elsevier B.V.

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Comparison of Perioperative Outcomes Between Robotic and Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-analysis

Abstract Context

Robotic partial nephrectomy (RPN) is rapidly increasing; however, the benefit of RPN over laparoscopic partial nephrectomy (LPN) is controversial.


To compare perioperative outcomes of RPN and LPN.

Evidence acquisition

We searched Ovid-Medline, Ovid-Embase, the Cochrane Library, KoreaMed, KMbase, KISS, RISS, and KisTi from their inception through August 2013. Two independent reviewers extracted data using a standardized form. Quality of the selected studies was assessed using the methodological index for nonrandomized studies.

Evidence synthesis

A total of 23 studies and 2240 patients were included. All studies were cohort studies with no randomization, and the methodological quality varied. There was no significant difference between the two groups regarding complications of Clavien-Dindo classification grades 1–2 (p = 0.62), Clavien-Dindo classification grades 3–5 (p = 0.78), change of serum creatinine (p = 0.65), operative time (p = 0.35), estimated blood loss (p = 0.76), and positive margins (p = 0.75). The RPN group had a significantly lower rate of conversion to open surgery (p = 0.02) and conversion to radical surgery (p = 0.0006), shorter warm ischemia time (WIT;p = 0.005), smaller change of estimated glomerular filtration rate (eGFR;p = 0.03), and shorter length of stay (LOS;p = 0.004).


This meta-analysis shows that RPN is associated with more favorable results than LPN in conversion rate to open or radical surgery, WIT, change of eGFR, and shorter LOS. To establish the safety and effectiveness outcomes of robotic surgery, well-designed randomized clinical studies with long-term follow-up are needed.

Patient summary

Robotic partial nephrectomy (PN) is more favorable than laparoscopic PN in terms of lower conversion rate to radical nephrectomy, a favorable renal function indexed estimated glomerular filtration rate, shorter length of hospital stay, and shorter warm ischemia time.

Take Home Message

This study is the first systematic review and meta-analysis using updated recent data to report the statistically significant superiority of robot-assisted partial nephrectomy (PN) versus laparoscopic PN in terms of estimated glomerular filtration rate and warm ischemic time.

Keywords: Kidney neoplasms, Robotics, Laparoscopy, Nephrectomy.


a Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea

b Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

c Department of Nursing Science, College of Nursing, Gachon University, Incheon, Korea

Corresponding authors. S.H. Lee, Department of Nursing Science, College of Nursing, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon 406-799, Korea. Tel. +82 32 820 4235; Fax: +82 32 820 4201. K.H. Rha, Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel. +82 2 2228 2310; Fax: +82 2 312 2538.

Article information

PII: S0302-2838(14)01294-9
DOI: 10.1016/j.eururo.2014.12.028
© 2014 European Association of Urology, Published by Elsevier B.V.

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Mortality Following Radical Cystectomy: A Good Start, but How Low Can We Go?

Refers to article:

Trends in Operative Caseload and Mortality Rates after Radical Cystectomy for Bladder Cancer in England for 1998–2010

Luke S. Hounsome, Julia Verne, John S. McGrath and David A. Gillatt

Accepted 1 December 2014


Department of Oncology, Faculty of Medicine and Dentistry, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK

Department of Oncology, Faculty of Medicine and Dentistry, Royal Hallamshire Hospital, University of Sheffield, Sheffield S10 2JF, UK. Tel. +44 114 2261229; Fax: +44 114 2712289.

Article information

PII: S0302-2838(15)00025-1
DOI: 10.1016/j.eururo.2015.01.010
© 2015 European Association of Urology, Published by Elsevier B.V.

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Avoiding or delaying surgery through close monitoring of renal tumors

MedicalNewsToday - Fri, 2015-01-23 03:00
In patients with small renal tumors confined to the kidneys, close, active monitoring, as opposed to immediate surgery, is associated with low rates of tumor growth or death, according to a study by...
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Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment

The purpose of this guideline amendment, herein referred to as the amendment, is to incorporate relevant newly published literature to better provide a clinical framework for the diagnosis and treatment of patients with non-neurogenic overactive bladder.
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Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome: AUA Guideline Amendment

The purpose of this amendment is to provide an updated clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome based upon data received since the publication of original guideline in 2011.
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Abdominal Mesh Sacrocolpopexy Without Promontory Fixation- the Peritoneocolpopexy Technique: Initial Results

To present our experience and early outcomes utilizing a new technique for mesh anchorage during open sacrocolpopexy, termed peritoneocolpopexy (PCP).
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Inhibition of human bladder cancer growth by a suicide gene delivered by JC polyomavirus virus-like particles in a mouse model

Bladder cancer is one of the most common cancers of the urinary tract. The poor 5-year survival rate of invasive bladder cancer presents a challenge for bladder cancer treatment. Previous studies have demonstrated that human urothelial carcinomas are susceptible to infection by the JC polyomavirus (JCPy). In this study, JCPy virus-like particles (VLPs) were employed to deliver genes into human urothelial carcinoma cells for possible therapeutic investigation.
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The pre-operative AST/ALT (De-Ritis) ratio represents a poor prognostic factor in a cohort of non-metastatic renal cell carcinoma patients

Aminotransaminases are strongly involved in cellular metabolism, as well as the turnover of cancer cells and represent easily measureable potential blood-based biomarkers. The objective of the current study was to evaluate the prognostic value of pre-operatively assessed Aspartate Aminotransaminase/Alanine Aminotransaminase (AST/ALT or De-Ritis) ratio on clinically meaningful endpoints in a large European cohort of non-metastatic renal cell carcinoma (RCC) patients.
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Q-island flap urethroplasty, a one stage procedure for reconstruction of Y-type urethral duplications: Experience with 6 cases

To review our experience with Q-flap urethroplasty in children with Y-type duplication.
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An Age-Adjusted Comorbidity Index for Prediction of Long-Term, Other-Cause Mortality in Men with Prostate Cancer

Accurate estimation of life expectancy is critical for men considering aggressive vs. non-aggressive treatment of early-stage prostate cancer. We sought to create an age-adjusted comorbidity index that predicts other-cause mortality in men with prostate cancer.
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Chronic Kidney Disease Stage Progression in Patients Undergoing Repair of Persistent Cloaca

Children born with a persistent cloaca undergo complex pelvic reconstruction early in their life. Long-term risks of bladder dysfunction and chronic kidney disease (CKD) are well described. In this study, we report upper urinary tract outcomes and the risk of CKD stage progression.
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Bone metastasis in renal cell carcinoma is preprogrammed in the primary tumor and caused by AKT and integrin alpha5 signaling

30 % of all renal cell carcinoma (RCC) patients develop bone metastases. The aim of this study was to elucidate the mechanisms that lead to and predict bone metastasis of RCC.
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Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared with Gleason 8 Disease

To examine the differences in outcome in patients with biopsy Gleason score 8 versus 9-10 who received definitive local therapy.
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Untreated Gleason Grade Progression on Serial Biopsies during Prostate Cancer Active Surveillance: Clinical Course and Pathological Outcomes

To describe the outcomes of patients with low-risk localized prostate cancer who upgraded on a surveillance biopsy while on AS, and to evaluate whether delayed treatment was associated with adverse outcome.
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The impact of regionalization of cystectomies on racial disparities in bladder cancer care

Regionalization of surgical care has improved the quality of care for bladder cancer patients. This paper explores if regionalization has benefited whites and blacks equally.
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Percutaneous Endopyelotomy Over High-Pressure Balloon for Secondary Ureteropelvic Junction Obstruction in Children

To analyze the results of secondary percutaneous endopyelotomy (PE) in children with failed primary pyeloplasty for the treatment of secondary ureteropelvic junction obstruction (UPJO).
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Fibroblast growth factor 7 overexpression is an independent prognosticator for patients with urothelial carcinoma of the upper urinary tract and urinary bladder

Urothelial carcinoma (UC) of urinary bladder (UBUC) and upper tract (UTUC) is the most common type of tumor occurring in the urinary tract, while its molecular pathogenesis and survival determinants remain obscure. By data-mining a published transcriptomic database of UBUCs (GSE31684), we identified fibroblast growth factor 7 (FGF7) as the most significant gene upregulated during UC progression. We therefore used our well-characterized cohort of UC to analyze FGF7 transcript and protein expression and its clinicopathological significance.
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The Role of Magnetic Resonance Image-Guided Prostate Biopsy in Stratifying Men for Risk of Extracapsular Extension at Radical Prostatectomy

Magnetic resonance imaging (MRI) detects extracapsular extension (ECE) by prostate cancer (PCa) with excellent specificity, but low sensitivity. This limits surgical planning, which could be modified to account for focal ECE with image-directed guidance for wider excision. The objective of this study is to evaluate the performance of multiparametric MRI (MP-MRI) for ECE detection and to determine which pre-operative variables predict ECE on final pathology when MP-MRI predicts organ-confined disease.
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