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Robotic-assisted retroperitoneal lymph node dissection for stage II testicular cancer

Asian Journal of Urology 2024年第1期11卷 121-127页

作者： George McClintock Ahmed S.Goolam Don Perera Ryan Downey Scott Leslie Peter Grimison Henry Woo Peter Ferguson Nariman Ahmadi Department of Urology Chris O'Brien LifehouseSydneyNSWAustralia Department of Anaesthesia Chris O'Brien LifehouseSydneyNSWAustralia The University of Sydney SydneyNSW2006Australia Department of Medical oncology Chris O'Brien LifehouseSydneyNSWAustralia

objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular ***:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our *** were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological *** statistics are ***:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior *** median operative time was 300(interquartile range[IQR]240-315)*** blood loss was 100(IQR 50-175)*** length of stay was 2(range 1-11)*** robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day *** median lymph node yield was 40.5(IQR 38-51)*** patients undergoing nerve-sparing procedures recovered antegrade ejaculatory *** patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had ***:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low *** oncological outcomes are *** cohorts and longer follow-ups are required to validate our institution's findings.

关键词： Retroperitoneal lymph node dissection Robotic surgery Testicular cancer Retroperitoneal node dissection

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Multicenter experience with photoselective vaporization of the prostate on men taking novel oral anticoagulants

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Asian Journal of Urology 2020年第4期7卷 340-344页

作者： Brooke Sachs Vincent Misrai Shahin Tabatabaei Henry H.Woo Bankstown-Lidcombe hospital SydneyAustralia Clinique Pasteur ToulouseFrance Massacheussets General hospital BostonUSA the chris o’brien lifehouse hospital SydneyAustralia

objective:Photoselective vaporization of the prostate(PVP)is a widely performed surgical procedure for benign prostatic *** approach has become particular favoured for men on anti-platelet and anticoagulation agents such as clopidogrel and warfarin but there is minimal published experience in the setting of novel oral anticoagulants(NoACs).This study was to examine the perioperative outcomes in men on NoACs undergoing PVP,with particular reference to perioperative ***:A retrospective analysis of PVP datasets was undertaken from three centres in Sydney(Australia),Toulouse(France)and Boston(USA).Subjects who had been treated whilst on NoACs without discontinuation or bridging were *** outcomes and treatment parameters were examined and morbidity recorded according to Clavien-Dindo(CD)***:There were a total of 20 subjects who had undergone PVP whilst NoACs had been continued during the perioperative *** mean age was 776.5 *** mean prostate volume,energy utilization and vaporisation time was 9456 mL,301211 kJ,and 3521 min *** mean postoperative duration of catheterization and duration of hospitalization was 2.22.4 days and 2.42.4 days *** was a single episode of urinary tract infection and four subjects required re-catheterisation for non-hematuric ***:This study supports the safety of men on NoACs undergoing *** this study represents the largest experience of PVP in these men,larger studies are necessary to confirm the safety of PVP in this group of men undergoing BPH-related surgery.

关键词： Benign prostatic hyperplasia Benign prostatic obstruction Photoselective vaporisation of the prostate Non-vitamin K oral anticoagulants Novel oral anticoagulants

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Commentary on impact of pulmonary function on robotic pulmonary resection

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Laparoscopic, Endoscopic and Robotic Surgery 2021年第3期4卷 93-94页

作者： Anthony Le Matheus Carelli Allen Guo christopher Cao Department of Cardiothoracic Surgery Royal Prince Alfred HospitalSydney UniversitySydneyAustralia The Baird Institute for Applied Heart and Lung Surgical Research SydneyAustralia chris o'brien lifehouse SydneyAustralia

Buitrago and colleagues should be commended on an excellent case report on the effective use of the robotic platform for a successful minimally invasive left lower lobectomy for a patient with biopsy proven squamous cell carcinoma.1 Despite a predicted postoperative forced expiratory volume in one second(ppoFEV1)of 23%and a preoperative diffusing capacity for carbon monoxide(DLCo)of 21%,the patient underwent a lobectomy without any intraoperative complications or evidence of disease at 15 months *** node sampling was performed from 5 *** postoperative length of staywas not clearly *** authors made several interesting points about the impact of pulmonary function on postoperative outcomes,the oncological efficacy of lobectomy versus sublobar resections,and merits of roboticassisted thoracoscopic surgery(RATS)versus thoracotomy and conventional video-assisted thoracoscopic surgery(VATS).We would like to discuss these points in further detail based on the available evidence in the current literature.

关键词： Pulmonary function Lung cancer Robot-assisted thoracoscopic surgery Lobectomy

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The Importance of Nutrition during Treatment for oesophageal Cancer—The Patient’s Perspective

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Food and Nutrition Sciences 2019年第11期10卷 1263-1276页

作者： Georgia Hardy Merran Findlay Sharon Carey University of Sydney Sydney Australia Royal Prince Alfred hospital Sydney Australia chris o’brien lifehouse Sydney Australia

Background and objectives: Nutritional issues are prevalent in patients with oesophageal cancer (oC) across all aspects of treatment, including chemoradiotherapy (CRT) and surgery. There are limited studies investigating nutritional issues faced by people undergoing neoadjuvant or definitive CRT from the patient’s perspective. This study aimed to explore the importance that people with oC place upon nutrition during their treatment which included neoadjuvant or definitive CRT, explore the nutritional issues faced in this patient group and identify areas for improvement of dietetic services. Methods and Study Design: Nine people who had undergone curative treatment for oC in the previous 2 - 25 months participated in semi-structured phone interviews. Interviews were tape-recorded and transcribed verbatim and analysed using an inductive thematic analysis approach. Results: Interviews revealed severe difficulties in food consumption during and following CRT and a period of struggling to adjust eating habits post oesophagectomy. There was significant difficulty in following nutrition advice and, despite participants expressing the importance of nutrition;this was not reflected in attitudes towards weight loss. The medical team significantly influenced the perceptions of some participants in regards to their weight loss. Conclusions: Implications for clinical practice include the need for dietetic services before, during and after treatment for oC, irrespective of treatment type. Patient education regarding detrimental effects of rapid weight loss and effects on body composition is crucial, and this should be consistent from all members of the healthcare team.

关键词： oesophageal Neoplasm Qualitative Research Nutritional Management oesophagectomy Chemoradiotherapy

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Immune checkpoint inhibitor-related hepatotoxicity:A review

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World Journal of Gastroenterology 2021年第32期27卷 5376-5391页

作者： Devika Remash David S Prince Catriona McKenzie Simone I Strasser Steven Kao Ken Liu AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred HospitalSydney 2050NSWAustralia Sydney Medical School University of SydneySydney 2006NSWAustralia Tissue Pathology and Diagnostic oncology Royal Prince Alfred HospitalSydney 2050NSWAustralia New South Wales Health Pathology New South Wales HealthSydney 2050NSWAustralia Medical oncology Chris O’Brien LifehouseSydney 2050NSWAustralia

The application of immune checkpoint inhibitors(ICI)in advanced cancer has been a major development in the last *** indications for ICIs are constantly expanding into new territory across different cancers,disease stages and lines of *** this increased use,adverse events including immune checkpoint inhibitor-related hepatotoxicity(ICH)have emerged as an important clinical *** along with the introduction of ICI as first-and second-line treatments for advanced hepatocellular carcinoma makes ICH very relevant to gastroenterologists and *** incidence of ICH varies between 1%-20%depending on the number,type and dose of ICI *** and management generally involve excluding differential diagnoses and following a stepwise escalation of withholding or ceasing ICI,corticosteroid treatment and adding other immunosuppressive agents depending on the severity of *** majority of patients with ICH recover and some may even safely recommence ICI *** recommendations are largely based on evidence derived from retrospective case series which highlights a priority for future research.

关键词： Immunotherapy Immune checkpoint inhibitors Hepatitis Adverse drug event Drug-induced liver injury Immunosuppression

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Anal cancer screening in women with a history of human papillomavirusrelated lower genital tract cancers:a pilot study

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Gynecology and obstetrics Clinical Medicine 2024年第2期4卷 88-93页

作者： Isobel Mary Poynten Fengyi Jin Rhonda Farrell Trevor Tejada-Berges Carmella Law Richard Hillman Jennifer Roberts Andrew Grulich The Kirby Institute University of New South WalesSydneyNew South WalesAustralia chris o'brien lifehouse SydneyNew South WalesAustralia Prince of Wales Private hospital RandwickNew South WalesAustralia Dysplasia and Anal Cancer Services St Vincent's Hospital SydneyDarlinghurstNewSouthWalesAustralia Douglass Hanly Moir Pathology SydneyNew South WalesAustralia

objectives Women diagnosed with a history of lower genital tract cancer(LGTC)and precancer are at increased risk of anal *** for anal cancer in a manner analogous to cervical cancer may detect precursor anal high-grade squamous intraepithelial lesions(HSILs)and prevent progression to *** In a pilot study of anal cancer screening,women with previous LGTC and aged≥18 years in Sydney,Australia underwent a digital anorectal examination,anal swab for human papillomavirus(HPV)and p16/Ki67 testing and completeda *** with positive HPV and/or p16/Ki67 results were referred for a high-resolution anoscopy(HRA)and evaluation of their *** of 52 participants,46 agreed to screening and 6 provided demographic information *** age was 46.5 years(IQR:36.059.0).Anal high-risk HPV(HRHPV)was detected in only seven(15.2%)participants(three HPV16).Eight(17.4%)had positive p16/Ki67 dual staining,with invalid results for 25(54.4%).0f 10 women referred for HRA,9 attended and 3 had HSILs,representing 6.5%of the screened *** were completed by 41 participants(89.1%).The majority reported that being screenedwas reassuring(97.5%)and was positive for their health(95.1%).Conclusion This pilot study demonstrated a lower-than-expected prevalence of anal *** with HRHPV and p16/Ki67 staining identified anal HSILs in 6.5%of ***,screeningwas viewed as beneficial by almost all *** utility of p16/Ki67dual staining was low,suggesting it may not be a suitable anal cancer screening methodology.

关键词： pilot Sydney screening

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培美曲塞加铂类联合或不联合帕博利珠单抗对初治转移性非鳞状NSCLC患者的疗效与安全性分析：KEYNoTE-189研究方案指定的最终分析

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中国肺癌杂志 2022年第6期25卷 443-456页

作者：周彩存 Delvys RoDRíGUEZ-ABREU S.F.PoWELL M.J.HoCHMAIR S.GAD GEEL E.ESTEBAN E.FELIP G.SPERANZA F.De ANGELIS M.DóMINE S.Y.CHENG H.G.BISCHoFF N.PELED M.RECK R.HUI E.B.GARoN M.BoYER T.KURATA J.YANG M.C.PIETANZA F.SoUZA M.C.GARASSINo 同济大学附属上海市肺科医院肿瘤科 Medical oncology Complejo Hospitalario Universitario Insular Materno-Infantil de Gran CanariaUniversidad de Las Palmas de Gran Canaria oncology Sanford Health 4. Department of Respiratory and Critical Care MedicineKarl Landsteiner Institute of Lung Research and Pulmonary Oncology Thoracic oncology Karmanos Cancer InstituteWayne State University Department of Medical oncology Hospital Universitario Central de Asturias Medical oncology Department Vall d'Hebron UniversityVall d'Hebron Institute of Oncology (VHIO) 8. Centre Integre de Cancerologie de la MontérégieH?pital Charles-Le Moyne 9. Medical Oncology DepartmentHospital Universitario Fundacidn Jiménez DiazIIS-FJD Sunnybrook Health Sciences Centre Thoraxklinik Heidelberg Department of oncology Shaare Zedek Medical Center LungenClinic Airway Research Center NorthGerman Center for Lung Research Department of Medical oncology Westmead Hospital and University of Sydney Department of Medicine David Geffen School of Medicine at UCLA Department of Medical oncology Chris O'Brien Lifehouse Department of Thoracic oncology Kansai Medical University Hospital Merck & Co. Inc. Fondazione IRCCS Istituto Nazionale dei Tumori University of Chicago Medicine & Biological Sciences Knapp Center for Biomedical Discovery

背景在KEYNoTE-189此项Ⅲ期研究(NCT02578680)中,与安慰剂联合培美曲塞加铂类相比,帕博利珠单抗联合培美曲塞加铂类化疗(培美曲塞-铂类)显著改善了初治转移性非鳞状非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的总生存期(over... 详细信息

背景在KEYNoTE-189此项Ⅲ期研究(NCT02578680)中,与安慰剂联合培美曲塞加铂类相比,帕博利珠单抗联合培美曲塞加铂类化疗(培美曲塞-铂类)显著改善了初治转移性非鳞状非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的总生存期(overall survival,oS)和无进展生存期(progression-free survival,PFS)。本研究报告了研究方案指定的最终分析的疗效结局,包括从培美曲塞-铂类交叉至帕博利珠单抗治疗的患者,以及完成35个周期(约2年)帕博利珠单抗治疗组的疗效。方法符合条件的患者以2:1随机分配至帕博利珠单抗,每3周一次,200 mg (n=410)或安慰剂(n=206)(共35周期,约2年),加上4个周期的培美曲塞(500 mg/m~2)和由研究者选择的每3周顺铂(75 mg/m~2)或卡铂(曲线下面积5 mg/min/mL)治疗,随后使用培美曲塞直至疾病进展。若符合纳入标准,分配至安慰剂联合培美曲塞加铂类治疗的患者可在疾病进展时转向帕博利珠单抗治疗。主要研究终点为oS和PFS。结果中位随访31.0个月,无论PD-L1的表达水平如何,与安慰剂联合培美曲塞-铂类治疗相比,帕博利珠单抗联合培美曲塞-铂类治疗可使患者的oS[风险比(hazard ratio,HR)为0.56;95%可信区间(confidence interval,CI) 0.46-0.69]和PFS (HR=0.49;95%CI:0.41-0.59)显著获益。接受帕博利珠单抗联合培美曲塞-铂类治疗的患者客观缓解率(objective response rate,oRR)(48.3%vs 19.9%)和第二次/后续无进展生存期(PFS2;HR=0.50;95%CI:0.41-0.61)均得到改善。安慰剂联合培美曲塞-铂类组的84例患者(40.8%)交叉至帕博利珠单抗治疗组。72.1%的接受帕博利珠单抗联合培美曲塞-铂类的患者和66.8%的接受安慰剂联合培美曲塞-铂类的患者发生了3级-5级不良事件。56例患者完成了35个周期(约2年)的帕博利珠单抗治疗;oRR为85.7%,53例(94.6%)患者存活至数据截止时间。结论与安慰剂联合培美曲塞-铂类治疗相比,帕博利珠单抗联合培美曲塞-铂类可持续提高疗效,且安全性可控。该研究结果支持将帕博利珠单抗联合培美曲塞-铂类作为初治转移性非鳞状NSCLC患者的一线治疗方案。

关键词：帕博利珠单抗化疗非鳞状非小细胞肺癌

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Identification of new genetic risk factors for prostate cancer

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Asian Journal of Andrology 2009年第1期11卷 49-55页

作者： Michelle Guy Zsofia Kote-Jarai Graham G. Giles Ali Amin Al olama Sarah K. Jugurnauth Shani Mulholland Daniel A. Leongamomlert Stephen M. Edwards Jonathan Morrison Helen I. Field Melissa C. Southey Gianluca Severi Jenny L. Donovan Freddie C. Hamdy David R Dearnaley Kenneth R. Muir Charmaine Smith Melisa Bagnato Audrey T. Ardern-Jones Amanda L. Hall Lynne T. o＇brien Beatrice N. Gehr-Swain Rosemary A. Wilkinson Angela Cox Sarah Lewis Paul M. Brown Sameer G. Jhavar Malgorzata Tymrakiewicz Artitaya Lophatananon Sarah L. Bryant The UK Genetic Prostate Cancer Study Collaborators British Association of Urological Surgeons＇ Section of oncology and The UK ProtecT Study Collaborators Alan Horwich Robert A. Huddart Vincent S. Khoo christopher C. Parker christopher J. Woodhouse Alan Thompson Tim christmas chris ogden Cyril Fisher Charles Jameson Colin S. Cooper Dallas R. English John L. Hopper David E. Neal Douglas E Easton Rosalind A. Eeles Section of Cancer Genetics The Institute of Cancer Research Sutton Surrey SM2 5NG UK Cancer Epidemiology Centre The Cancer Council Victoria Carlton VIC 3053 Australia Centre for Molecular Environmental Genetic and Analytic Epidemiology The University of Melbourne Carlton VIC 3053 Australia Cancer Research UK Genetic Epidemiology Unit University of Cambridge Strangeways Laboratory Worts Causeway Cambridge CB1 8RN UK Department of oncology University of Cambridge Strangeways Laboratory Worts Causeway Cambridge CB1 8RN UK Genetic Epidemiology Laboratory Department of Pathology The University of Melbourne Parkville VIC 3052 Australia Department of Social Medicine University of Bristol Bristol BS8 2PR UK Academic Urology Unit University of Sheffield Sheffield SIO 2JF UK The Royal Marsden NHS Foundation Trust Sutton Surrey SM2 5PT and London SW3 6JJ UK University of Nottingham Medical School Queens Medical Centre Nottingham NG7 2UH UK Institute for Cancer Studies University of Sheffield Sheffield SIO 2RX UK Surgical oncology （Uro-oncology S4） Departments of Oncology and Surgery University of Cambridge Addenbrooke＇s Hospital Cambridge CB2 2QQ UK A full list of authors is provided in the Supplementary Note online Ka Shing Centre Cambridge CB2 ORE UK Cancer Research UK Cambridge Research Institute Li Ka Shing Centre Cambridge CB2 ORE UK.

There is evidence that a substantial part of genetic predisposition to prostate cancer （PCa） may be due to lower penetrance genes which are found by genome-wide association studies. We have recently conducted such a study and seven new regions of the genome linked to PCa risk have been identified. Three of these loci contain candidate susceptibility genes： MSMB, LMTK2 and KLK2/3. The MSMB and KLK2/3 genes may be useful for PCa screening, and the LMTK2 gene might provide a potential therapeutic target. Together with results from other groups, there are now 23 germline genetic variants which have been reported. These results have the potential to be developed into a genetic test. However, we consider that marketing of tests to the public is premature, as PCa risk can not be evaluated fully at this stage and the appropriate screening protocols need to be developed. Follow-up validation studies, as well as studies to explore the psychological implications of genetic profile testing, will be vital prior to roll out into healthcare.

关键词： prostate cancer genetics susceptibility loci SNPs relative risks

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