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A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease

Asian Journal of Urology 2024年第2期11卷 208-220页

作者： Andrey Morozov Leonid Chuvalov mark taratkin Mikhail Enikeev Leonid Rapoport Nirmish Singla Eric Barret Elena Poddubskaya Maria Borodina Georg Salomon Juan Gomez Rivas Dmitry Enikeev Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Young Academic Urologists EAUthe Netherlands Department of Urology James Buchanan Brady Urological InstituteThe Johns Hopkins University School of MedicineBaltimoreUSA Department of Urology Institut Mutualiste MontsourisParisFrance Sechenov University MoscowRussia Hertsen Moscow Oncology Research InstituteMoscowRussia Hertsen Moscow Oncology Research Institute MoscowRussia Martini Clinic University Medical Center Hamburg-EppendorfHamburgGermany Department of Urology Clinico San Carlos University HospitalMadridSpain Department of Urology Medical University of ViennaViennaAustria

Objective: To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this space.Methods: We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional results.Results: In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p<0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%.Conclusion: CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.

关键词： Systematicreview Prostatecancer Oligometastatic Bone metastases Cytoreductive prostatectomy

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Incidence of urinary incontinence followingendoscopic laser enucleation of the prostate byen-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong Mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan mark taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann Urology Unit IRCCS INRCAAncona 60127Italy Urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy Departmentof Urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel Department of Urology and Robotic Surgery ICUA-Clínica CEMTROMadrid 28701Spain Urology Division AkfaMedline HospitalTashkent 100211Uzbekistan Advanced Urology Gleneagles HospitalSingapore 258499Singapore Department of Urology National University HospitalSingapore 119228Singapore Divisionof Urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada Department of Urology Mahatma Gandhi Mission’s Medical College andHospitalAurangabad 431003India Institute for Urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation Department of Urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation Department of Urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India Department of Urology Medical University of ViennaVienna 1090Austria Department of Urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation Department of Urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho UrologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China Department of Urology University HospitalsSouthampton NHS TrustSouthampton SO166YDUnited Kingdom Department of Urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland.

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

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Artificial intelligence for renal cancer:From imaging to histology and beyond

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Asian Journal of Urology 2022年第3期9卷 243-252页

作者： Karl-Friedrich Kowalewski Luisa Egen Chanel E.Fischetti Stefano Puliatti Gomez Rivas Juan mark taratkin Rivero Belenchon Ines Marie Angela Sidoti Abate Julia Muhlbauer Frederik Wessels Enrico Checcucci Giovanni Cacciamani Department of Urology and Urological Surgery University Medical Centre MannheimMannheimGermany Department of Emergency Medicine Brigham and Women’s HospitalHarvard Medical SchoolBostonMAUSA Urology Department University of Modena&Reggio EmiliaModenaItaly ORSI Academy MelleBelgium Department of Urology Hospital Clinico San CarlosMadridSpain Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Urology and Nephrology Department Virgen del Rocı´o University HospitalManuel Siurot s/nSevilleSpain Department of Surgery Candiolo Cancer InstituteFPO-IRCCSCandioloTurinItaly USC Institute of Urology University of Southern CaliforniaLos AngelesCAUSA

Artificial intelligence(AI)has made considerable progress within the last decade and is the subject of contemporary literature.This trend is driven by improved computational abilities and increasing amounts of complex data that allow for new approaches in analysis and interpretation.Renal cell carcinoma(RCC)has a rising incidence since most tumors are now detected at an earlier stage due to improved imaging.This creates considerable challenges as approximately 10%e17%of kidney tumors are designated as benign in histopathological evaluation;however,certain co-morbid populations(the obese and elderly)have an increased peri-interventional risk.AI offers an alternative solution by helping to optimize precision and guidance for diagnostic and therapeutic decisions.The narrative review introduced basic principles and provide a comprehensive overview of current AI techniques for RCC.Currently,AI applications can be found in any aspect of RCC management including diagnostics,perioperative care,pathology,and follow-up.Most commonly applied models include neural networks,random forest,support vector machines,and regression.However,for implementation in daily practice,health care providers need to develop a basic understanding and establish interdisciplinary collaborations in order to standardize datasets,define meaningful endpoints,and unify interpretation.

关键词： Kidney cancer Imaging Technology Artificial intelligence Machine learning

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New imaging technologies for robotic kidney cancer surgery

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Asian Journal of Urology 2022年第3期9卷 253-262页

作者： Stefano Puliatti Ahmed Eissa Enrico Checcucci Pietro Piazza Marco Amato Stefania Ferretti Simone Scarcella Juan Gomez Rivas mark taratkin Jose Marenco Ines Belenchon Rivero Karl-Friedrich Kowalewski Giovanni Cacciamani Ahmed El-Sherbiny Ahmed Zoeir Abdelhamid MEl-Bahnasy Ruben De Groote Alexandre Mottrie Salvatore Micali Urology Department University of Modena&Reggio EmiliaModenaItaly ORSI Academy MelleBelgium Urology Department Faculty of MedicineTanta UniversityTantaEgypt Department of Surgery Candiolo Cancer InstituteFPO-IRCCSCandioloTurinItaly Division of Urology IRCCS Azienda Ospedaliero-Universitaria di BolognaBolognaItaly Department of Urology Polytechnic University of Marche RegionUmberto I Hospital“Ospedali Riuniti”AnconaItaly Uro-technology and SoMe Working Group of the Young Academic Urologists Working Party European Association of UrologyArnhemthe Netherlands Department of Urology Hospital Clinico San CarlosMadridSpain Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Department of Urology Fundacio´n Instituto Valenciano de Oncologı´aValenciaSpain Urology and Nephrology Department Virgen del Rocı´o University HospitalManuel Siurot Sin NumeroSevilleSpain Department of Urology and Urological Surgery University Medical Centre MannheimMannheimGermany USC Institute of Urology University of Southern CaliforniaLos AngelesCAUSA Department of Urology Onze-Lieve-VrouwziekenhuisAalstBelgium

Objective:Kidney cancers account for approximately 2%of all newly diagnosed cancer in 2020.Among the primary treatment options for kidney cancer,urologist may choose between radical or partial nephrectomy,or ablative therapies.Nowadays,robotic-assisted partial nephrectomy(RAPN)for the management of renal cancers has gained popularity,up to being considered the gold standard.However,RAPN is a challenging procedure with a steep learning curve.Methods:In this narrative review,different imaging technologies used to guide and aid RAPN are discussed.Results:Three-dimensional visualization technology has been extensively discussed in RAPN,showing its value in enhancing robotic-surgery training,patient counseling,surgical planning,and intraoperative guidance.Intraoperative imaging technologies such as intracorporeal ultrasound,near-infrared fluorescent imaging,and intraoperative pathological examination can also be used to improve the outcomes following RAPN.Finally,artificial intelligence may play a role in the field of RAPN soon.Conclusion:RAPN is a complex surgery;however,many imaging technologies may play an important role in facilitating it.

关键词： Kidney cancer Imaging Technology Robotic

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