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Chen S, Song W, Zhang R, Jin Y, Lu Y, Lin L, Ye L, Li T, Wei Y. Analysis of survival and prognostic factors of clear cell adenocarcinoma of the prostate: a case-control study for a rare cancer entity. Sci Rep 2023; 13:10317. [PMID: 37365217 DOI: 10.1038/s41598-023-37092-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023] Open
Abstract
Clear cell adenocarcinoma of the prostate (CCPC) is a rare entity compared to acinar carcinoma of the prostate (APC). The survival rate and prognostic factors of CCPC are still unclear and deserve further study. We downloaded data on prostate cancer from the Surveillance, Epidemiology, and End Results database for 1975-2019. After inclusion and exclusion criteria, we compared APC and analyzed cancer-specific mortality (CSM) and overall mortality (OM) in CCPC patients and prognostic risk factors using a propensity score matching (PSM) study and multivariate Cox regression. We included 408,004 cases of APC as a control group and 130 cases of CCPC as a case group. Compared with APC patients, the incidence of CCPC was extremely low, and the median age of diagnosis was older (72.00 years vs. 69.00 years, p < 0.01). In addition, more rates were diagnosed at an earlier stage (1975-1998, 93.1% vs. 50.2%, p < 0.001), more unstaged or unknown stage ratios (87.7% vs. 42.7%, p < 0.001), and more surgical treatments (66.2% vs. 47.6%, p < 0.001), but the prognosis of CCPC patients was worse. After PSM, the median survival time of CCPC patients was shorter (57.50 month vs. 88.00 month, p < 0.01), the rate of CSM was higher (41.5% vs. 27.7%, p < 0.05), and the rate of OM was higher (99.2% vs. 90.8%, p < 0.01). In the adjusted model 2 after PSM, the CSM risk of CCPC patients reached HR 1.76 (95%CI 1.13-2.72), which was 76% higher than that of APC patients (p < 0.05). It was further found that surgical treatment might benefit CSM in CCPC patients (HR 0.39, 95%CI 0.18-0.82, p < 0.05) in Univariate analysis, but it was insignificant in further multivariate analysis. This is the first large-scale case-control report on the survival risk and prognostic factors of CCPC patients. We found that the prognosis of CCPC patients was significantly worse than that of APC. Surgery might be an effective treatment that may improve its prognosis. Clear cell adenocarcinoma, prostate, acinar carcinoma, survival rate, rare cancer, propensity score matching, case-control study.
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Affiliation(s)
- Sijin Chen
- Department of Urology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410005, Hunan Province, China
| | - Wei Song
- Department of Urology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410005, Hunan Province, China
| | - Ruochen Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Yiming Jin
- Department of Urology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yan Lu
- Department of Urology, Juntendo University School of Medicine, Tokyo, Japan
| | - Le Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Liefu Ye
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Tao Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China.
| | - Yongbao Wei
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China.
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Van den Broeck T, Oprea-Lager D, Moris L, Kailavasan M, Briers E, Cornford P, De Santis M, Gandaglia G, Gillessen Sommer S, Grummet JP, Grivas N, Lam TBL, Lardas M, Liew M, Mason M, O'Hanlon S, Pecanka J, Ploussard G, Rouviere O, Schoots IG, Tilki D, van den Bergh RCN, van der Poel H, Wiegel T, Willemse PP, Yuan CY, Mottet N. A Systematic Review of the Impact of Surgeon and Hospital Caseload Volume on Oncological and Nononcological Outcomes After Radical Prostatectomy for Nonmetastatic Prostate Cancer. Eur Urol 2021; 80:531-545. [PMID: 33962808 DOI: 10.1016/j.eururo.2021.04.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/19/2021] [Indexed: 12/13/2022]
Abstract
CONTEXT The impact of surgeon and hospital volume on outcomes after radical prostatectomy (RP) for localised prostate cancer (PCa) remains unknown. OBJECTIVE To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. EVIDENCE ACQUISITION Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. All comparative studies for nonmetastatic PCa patients treated with RP published between January 1990 and May 2020 were included. For inclusion, studies had to compare hospital or surgeon volume, defined as caseload per unit time. Main outcomes included oncological (including prostate-specific antigen persistence, positive surgical margin [PSM], biochemical recurrence, local and distant recurrence, and cancer-specific and overall survival) and nononcological (perioperative complications including need for blood transfusion, conversion to open procedure and within 90-d death, and continence and erectile function) outcomes. Risk of bias (RoB) and confounding assessments were undertaken. Both a narrative and a quantitative synthesis were planned if the data allowed. EVIDENCE SYNTHESIS Sixty retrospective comparative studies were included. Generally, increasing surgeon and hospital volumes were associated with lower rates of mortality, PSM, adjuvant or salvage therapies, and perioperative complications. Combining group size cut-offs as used in the included studies, the median threshold for hospital volume at which outcomes start to diverge is 86 (interquartile range [IQR] 35-100) cases per year. In addition, above this threshold, the higher the caseload, the better the outcomes, especially for PSM. RoB and confounding were high for most domains. CONCLUSIONS Higher surgeon and hospital volumes for RP are associated with lower rates of PSMs, adjuvant or salvage therapies, and perioperative complications. This association becomes apparent from a caseload of >86 (IQR 35-100) per year and may further improve hereafter. Both high- and low-volume centres should measure their outcomes, make them publicly available, and improve their quality of care if needed. PATIENT SUMMARY We reviewed the literature to determine whether the number of prostate cancer operations (radical prostatectomy) performed in a hospital affects the outcomes of surgery. We found that, overall, hospitals with a higher number of operations per year have better outcomes in terms of cancer recurrence and complications during or after hospitalisation. However, it must be noted that surgeons working in hospitals with lower annual operations can still achieve similar or even better outcomes. Therefore, making hospital's outcome data publicly available should be promoted internationally, so that patients can make an informed decision where they want to be treated.
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Affiliation(s)
| | - Daniela Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres, VU University, Amsterdam, The Netherlands
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Philip Cornford
- Department of Urology, Liverpool University Hospitals, Liverpool, UK
| | - Maria De Santis
- Department of Urology, Charité University Hospital, Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Giorgio Gandaglia
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Silke Gillessen Sommer
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland
| | - Jeremy P Grummet
- Department of Surgery, Central Clinical School, Monash University, Australia
| | - Nikos Grivas
- Department of Urology, Hatzikosta General Hospital, Ioannina, Greece
| | - Thomas B L Lam
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Michael Lardas
- Department of Urology, Metropolitan General Hospital, Athens, Greece
| | - Matthew Liew
- Department of Urology, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - Malcolm Mason
- Division of Cancer & Genetics, School of Medicine Cardiff University, Velindre Cancer Centre, Cardiff, UK
| | - Shane O'Hanlon
- Medicine for Older People, Saint Vincent's University Hospital, Dublin, Ireland
| | | | | | - Olivier Rouviere
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôspital Edouard Herriot, Lyon, France
| | - Ivo G Schoots
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Centre, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Henk van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Thomas Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - Peter-Paul Willemse
- Department of Oncological Urology, University Medical Centre, Utrecht Cancer Centre, Utrecht, The Netherlands
| | - Cathy Y Yuan
- Department of Medicine, Health Science Centre, McMaster University, Hamilton, Ontario, Canada
| | - Nicolas Mottet
- Department of Urology, University Hospital, St. Etienne, France
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Compérat E, Renard-Penna R, Ondet V, Cancel-Tassin G, Cussenot O. Diagnosis of prostate cancer in one day: The benefits of cytology in tumour detection. Cytopathology 2020; 32:211-216. [PMID: 33107101 DOI: 10.1111/cyt.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/25/2020] [Accepted: 10/16/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Prostate cancer (PCa) is a frequent and mortal disease. The aim of this study was to introduce a "diagnosis and handling of PCa in one day" concept, accelerating the handling of PCa patients by giving diagnostic results within 3 hours with the help of prostate cytology. Standard histology served as the control. MATERIAL AND METHODS After multiparametric MRI, prostate biopsies were taken and one was used for imprint cytology on superfrost slides. The cytology samples were stained by p63/p504s double staining, a standard stain in PCa histology, followed by on-site interpretation. RESULTS Among 129 patients, 39.5% had a prior history of PCa and were either under active surveillance or had been treated by focal therapy. The others came with suspicion of PCa. In 80.8% of the cases, the cytology and histology results agreed. In low-grade PCa the detection with cytology was more difficult with 72.4% agreement, whereas for intermediate and high-grade PCa the concordance with histology was 81.8 and 90%, respectively. False positive cases were less than 4.0%. CONCLUSION Cytology of the prostate is unusual, but our study is the first to show it is feasible and gives immediate results that are satisfactory, especially in more aggressive cases. Immunocytology can be easily integrated into the laboratory. Our technique allows quicker handling of PCa, which can soften the psychological impact on men waiting for the diagnosis of PCa.
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Affiliation(s)
- Eva Compérat
- GRC5 predictive onco-urology, Sorbonne University, Paris, France.,Department of Pathology, Hopital Tenon, Sorbonne University, Paris, France
| | - Raphaele Renard-Penna
- GRC5 predictive onco-urology, Sorbonne University, Paris, France.,Department of Radiology, Hopital La Pitié Salpêtrière, Sorbonne University, Paris, France
| | - Valérie Ondet
- GRC5 predictive onco-urology, Sorbonne University, Paris, France
| | | | - Olivier Cussenot
- GRC5 predictive onco-urology, Sorbonne University, Paris, France.,Department of Urology, Hopital Tenon, Sorbonne University, Paris, France
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4
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Haider MA, Burks FN, Cassell A, Jalloh M. The Role of Organizations like IVUmed in Developing Centers of Excellence. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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5
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PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review. AJR Am J Roentgenol 2020; 216:3-19. [PMID: 32812795 DOI: 10.2214/ajr.20.24268] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The steadily increasing demand for diagnostic prostate MRI has led to concerns regarding the lack of access to and the availability of qualified MRI scanners and sufficiently experienced radiologists, radiographers, and technologists to meet the demand. Solutions must enhance operational benefits without compromising diagnostic performance, quality, and delivery of service. Solutions should also mitigate risks such as decreased reader confidence and referrer engagement. One approach may be the implementation of MRI without the use gadolinium-based contrast medium (bipara-metric MRI), but only if certain prerequisites such as high-quality imaging, expert interpretation quality, and availability of patient recall or on-table monitoring are mandated. Alternatively, or in combination, a clinical risk-based approach could be used for protocol selection, specifically, which biopsy-naive men need MRI with contrast medium (multiparametric MRI). There is a need for prospective studies in which biopsy decisions are made according to MRI without contrast enhancement. Such studies must define clinical and operational benefits and identify which patient groups can be scanned successfully without contrast enhancement. These higher-quality data are needed before the Prostate Imaging Reporting and Data System (PI-RADS) Committee can make evidence-based recommendations about MRI without contrast enhancement as an initial diagnostic approach for prostate cancer workup.
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6
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Butea-Bocu MC, Müller G, Pucheril D, Kröger E, Otto U. Is there a clinical benefit from prostate cancer center certification? An evaluation of functional and oncologic outcomes from 22,649 radical prostatectomy patients. World J Urol 2020; 39:5-10. [PMID: 32851440 DOI: 10.1007/s00345-020-03411-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/11/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To explore whether patients undergoing radical prostatectomy at a German Cancer Society (DKG: Deutsche Krebsgesellschaft) certified center (CC) have superior functional and surgical outcomes compared to patients undergoing radical prostatectomy at a non-certified hospital (nCC). METHODS A retrospective cohort of 22,649 patients treated between 2008 and 2017 and subsequently recovered at two rehabilitation clinics within 35 days of surgery were analyzed. Urine loss (24 h-pad-test), margin status, and nerve-sparing status at rehab admission were compared between CC and nCC patients, adjusting for age, histopathology (pT, pN, Gleason score), metastases (cM), Karnofsky performance status, time from surgery to rehabilitation, and insurance provider (statutory vs. private). RESULTS Thirty-four percent of patients underwent surgery at a CC. Complete continence is more pronounced in patients treated in CC (16.6% vs. 24.4%, p < 0.001). In the adjusted models, incontinent patients from CC had less urine loss compared to patients from nCC (- 27.41% difference; 95% CI - 31.71% to - 22.84%, p < 0.001). CC patients were less likely to have positive resection margins (adjusted OR 0.71; 95% CI 0.66 to 0.76, p < 0.001) and more likely to have had a nerve-sparing procedure (adjusted OR 1.29; 95% CI 1.21 to 1.38, p < 0.001). CONCLUSION Patients treated at certified centers presented to rehab with better urinary continence, higher nerve-sparing rates, and lower positive-margin rates. These results imply superior care at DKG certified centers.
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Affiliation(s)
| | - Guido Müller
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
| | - Daniel Pucheril
- Department of Urology, Kettering Medical Center, Kettering, OH, USA
| | - Eckhard Kröger
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
| | - Ullrich Otto
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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7
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Montorsi F, Gandaglia G. Key Prerequisites for the Correct Management of Intermediate-risk Prostate Cancer. Eur Urol Oncol 2020; 3:281-282. [DOI: 10.1016/j.euo.2020.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/20/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
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8
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Brausi M, Hoskin P, Andritsch E, Banks I, Beishon M, Boyle H, Colecchia M, Delgado-Bolton R, Höckel M, Leonard K, Lövey J, Maroto P, Mastris K, Medeiros R, Naredi P, Oyen R, de Reijke T, Selby P, Saarto T, Valdagni R, Costa A, Poortmans P. ECCO Essential Requirements for Quality Cancer Care: Prostate cancer. Crit Rev Oncol Hematol 2020; 148:102861. [PMID: 32151466 DOI: 10.1016/j.critrevonc.2019.102861] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 12/23/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND ECCO Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give oncology teams, patients, policymakers and managers an overview of essential care throughout the patient journey. PROSTATE CANCER Prostate cancer is the second most common male cancer and has a wide variation in outcomes in Europe. It has complex diagnosis and treatment challenges, and is a major healthcare burden. Care must only be a carried out in prostate/urology cancer units or centres that have a core multidisciplinary team (MDT) and an extended team of health professionals. Such units are far from universal in European countries. To meet European aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Affiliation(s)
- Maurizio Brausi
- European Association of Urology; Department of Urology, B. Ramazzini Hospital, Carpi-Modena, Italy
| | - Peter Hoskin
- European Society for Radiotherapy and Oncology (ESTRO); Mount Vernon Cancer Centre; University of Manchester, Manchester, United Kingdom
| | - Elisabeth Andritsch
- International Psycho-Oncology Society (IPOS); Clinical Department of Oncology, University Medical Centre of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Ian Banks
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); European Men's Health Forum, Belgium
| | - Marc Beishon
- Cancer World, European School of Oncology (ESO), Milan, Italy.
| | - Helen Boyle
- International Society of Geriatric Oncology (SIOG); Department of Medical Oncology, Centre Léon-Bérard, Lyon, France
| | - Maurizio Colecchia
- European Society of Pathology (ESP); Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Delgado-Bolton
- European Association for Nuclear Medicine (EANM); Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Logroño, La Rioja, Spain
| | - Michael Höckel
- European Society of Oncology Pharmacy (ESOP); Kliniken Kassel, Gesundheit Nordhessen Holding, Kassel, Germany
| | - Kay Leonard
- European Oncology Nursing Society (EONS); Saint Luke's Radiation Oncology Centre, St James's Hospital, Dublin, Ireland
| | - József Lövey
- Organisation of European Cancer Institutes (OECI); National Institute of Oncology, Budapest, Hungary
| | - Pablo Maroto
- European Organisation for Research and Treatment of Cancer (EORTC); Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ken Mastris
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); Europa Uomo
| | - Rui Medeiros
- Association of European Cancer Leagues (ECL); Portuguese Cancer League, Instituto Portugues de Oncologia, Porto, Portugal
| | - Peter Naredi
- European Cancer Organisation (ECCO); Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Raymond Oyen
- European Society of Radiology (ESR); Department of Radiology, KU Leuven, Leuven, Belgium
| | - Theo de Reijke
- European Society of Surgical Oncology (ESSO); Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Selby
- European Cancer Concord (ECC); Leeds Institute of Cancer and Pathology, University of Leeds; St James' University Hospital, Leeds, United Kingdom
| | - Tiina Saarto
- European Association for Palliative Care (EAPC); Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Riccardo Valdagni
- European School of Oncology (ESO); Prostate Cancer Programme and Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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9
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Noris Chiorda B, Zollo F, Magnani T, Badenchini F, Gatto L, Claps M, Macchi A, Andreoli L, Nicolai N, Villa S, Valdagni R. How to implement the requirements of a quality assurance system for prostate cancer. World J Urol 2019; 39:41-47. [PMID: 31776738 DOI: 10.1007/s00345-019-03024-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/15/2019] [Indexed: 12/26/2022] Open
Abstract
PURPOSE In 2003, the German Cancer Society (Deutsche Krebsgesellschaft, DKG) launched a certification program aimed at improving the quality of cancer care. The purpose of this article is to describe the experience of the Prostate Cancer Unit (PCU) at Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, in the process towards DKG certification. METHODS In 2018, PCU decided to apply for certification by adopting DKG catalogue of requirements (CoR) and quality indicators. A multiprofessional working group was established with the aim of acting the necessary steps to meet DKG standards. RESULTS Our organizational setting (procedures, personnel) and activities were accurately analyzed, thus outlining strengths and weaknesses, and modified to comply with DKG CoR and indicators. As examples, (1) a quality management plan was developed; (2) measures were taken to strengthen the surgical expertise; (3) cases evaluated in weekly tumor boards were expanded to include surgical cases with pathological risk factors, metastatic, relapsed and castration-resistant patients; (4) a survey was added to the patient-dedicated initiatives already scheduled; (5) the TuDoc software became the tool to register all new cases of prostate cancer patients referred to PCU. CONCLUSIONS The process of certification requires many efforts but represents a unique opportunity of improving quality of care of prostate cancer patients, making it comparable on an international scale.
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Affiliation(s)
- Barbara Noris Chiorda
- Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Fabiana Zollo
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Tiziana Magnani
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
| | - Fabio Badenchini
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Lucia Gatto
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Melanie Claps
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Division of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Alberto Macchi
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Division of Oncologic Urologic Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Laure Andreoli
- Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Nicola Nicolai
- Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Division of Oncologic Urologic Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Sergio Villa
- Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Riccardo Valdagni
- Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Prostate Cancer Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy
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10
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Wei Y, Zhang R, Ye L. Re: Manfred Wirth, Nicola Fossati, Peter Albers, et al. The European Prostate Cancer Centres of Excellence: A Novel Proposal from the European Association of Urology Prostate Cancer Centre Consensus Meeting. Eur Urol 2019;76:179-86. Eur Urol 2019; 77:e75. [PMID: 31594706 DOI: 10.1016/j.eururo.2019.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Yongbao Wei
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Ruochen Zhang
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Liefu Ye
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Urology, Fujian Provincial Hospital, Fuzhou, China.
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11
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Heidenreich A, Salem J, Paffenholz P, Pfister D. [Interdisciplinary education in urology: innovations for better training]. Urologe A 2019; 58:870-876. [PMID: 31168674 DOI: 10.1007/s00120-019-0958-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The current version of the urology training program will concentrate on the mediation of competences and skills in various fields of action for outpatient urology instead of persisting on the minimum and reference numbers of surgical and diagnostic procedures. However, the following fields of action must be fulfilled: microbiology, andrology and systemic cancer therapy. There is justifiable concern that various institutions will lose their permission for a complete 5‑year residency program based on the above-mentioned demands since not all institutions have all subspecialties in urology. Those institutions need to define new ways of residency training such as interdisciplinary programs within their own institution between disciplines like pediatric surgery, gynecology and medical oncology. Other options are combined training programs between regional urology departments with different main focuses or training programs between institutions and urologists in private practice. There is an unmet need to improve residency training as well as board examinations by new structures and a reliable curriculum. Based on the changed main focuses of the new version of urology training, we need to discuss the future of residency programs. It might be helpful to discuss two different types of urology training with a common trunk for the first three years followed by a more outpatient-based residency training for the general urologist and a more specialized training for the inpatient urologist to be educated in complex treatment modalities. An open mind to broadening our own horizon, respectful discussion with other departments and the development of common, reliable and interdisciplinary contents represent indispensable prerequisites to realize such an innovative future training program.
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Affiliation(s)
- A Heidenreich
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - J Salem
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - P Paffenholz
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - D Pfister
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Centers of Excellence: What are Realistic Goals? Eur Urol 2019; 76:187-188. [DOI: 10.1016/j.eururo.2019.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
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van Luijtelaar A, Bomers J, Fütterer J. A comparison of magnetic resonance imaging techniques used to secure biopsies in prostate cancer patients. Expert Rev Anticancer Ther 2019; 19:705-716. [PMID: 31277551 DOI: 10.1080/14737140.2019.1641086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Prostate cancer (PCa) is the most common diagnosed malignancy among the male population in the United States. The incidence is increasing with an estimated amount of 175.000 cases in 2019. Areas covered: Primarily, PCa is generally detected by an elevated or rising serum prostate-specific antigen (PSA) and digital rectal examination (DRE) followed by pathological examination. Histopathology ultimately confirms the presence of PCa and determines a Gleason score. However, PSA and DRE have low specificity and sensitivity, respectively. Subsequently, accurate assessment of the aggressiveness of PCa is essential to prevent overdiagnosis and thus overtreatment of low-risk or indolent cancers. By visualizing PCa suspicious lesions and sampling them during the targeted biopsy, it is likely that the diagnostic accuracy of significant PCa improves. This article reviews the current imaging techniques used to secure biopsies in patients with a suspicion of PCa. The advantages and limitations of each technique are described. Expert opinion: Multiparametric magnetic resonance imaging (mpMRI) and subsequent-targeted biopsy have improved the diagnostic accuracy of PCa detection in men with an elevated or rising serum PSA. Prostate lesions visible on mpMRI are easily targeted during either in-bore MRI-guided biopsy, cognitive fusion biopsy or MRI-TRUS fusion biopsy.
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Affiliation(s)
- Annemarijke van Luijtelaar
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Joyce Bomers
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Jurgen Fütterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center , Nijmegen , The Netherlands
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Albers P. Volume Matters: Can We Rely on the Evidence? Eur Urol Oncol 2019; 2:274-275. [PMID: 31200841 DOI: 10.1016/j.euo.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Peter Albers
- Department of Urology, Düsseldorf University, Düsseldorf, Germany.
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