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Haaksman M, Ham L, Brom L, Baars A, van Basten JP, van den Borne BEEM, Hendriks MP, de Jong WK, van Laarhoven HWM, van Lindert ASR, Mandigers CMPW, van der Padt-Pruijsten A, Smilde TJ, van Zuylen LC, van Vliet LM, Raijmakers NJH. Open communication between patients and relatives about illness & death in advanced cancer-results of the eQuiPe Study. Support Care Cancer 2024; 32:214. [PMID: 38446248 PMCID: PMC10917842 DOI: 10.1007/s00520-024-08379-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/12/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To assess the degree of openness of communication about illness and death between patients with advanced cancer and their relatives during the last three months of the patient's life, and its association with relatives' characteristics and bereavement distress. METHODS We used data from bereaved relatives of patients with advanced cancer from the prospective, longitudinal, multicenter, observational eQuipe study. Univariate and multivariable linear regression analyses were used to assess the association between the degree of openness of communication (measured using the validated Caregivers' Communication with patients about Illness and Death scale), the a priori defined characteristics of the relatives, and the degree of bereavement distress (measured using the Impact of Event Scale). RESULTS A total of 160 bereaved relatives were included in the analysis. The average degree of open communication about illness and death between patients with advanced cancer and their relatives was 3.86 on a scale of 1 to 5 (SE=0.08). A higher degree of open communication was associated with a lower degree of bereavement distress (p=0.003). No associations were found between the degree of open communication and the relatives' age (p=0.745), gender (p=0.196), level of education (p>0.773), (religious) worldview (p=0.435), type of relationship with the patient (p>0.548), or level of emotional functioning before the patient's death (p=0.075). CONCLUSIONS Open communication about illness and death between patients and relatives seems to be important, as it is associated with a lower degree of bereavement distress. Healthcare professionals can play an important role in encouraging the dialogue. However, it is important to keep in mind that some people not feel comfortable talking about illness and death.
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Affiliation(s)
- Michelle Haaksman
- Department of Health, Medical and Neuropsychology, University of Leiden, Leiden, the Netherlands.
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands.
| | - Laurien Ham
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Linda Brom
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
| | - Arnold Baars
- Department of Internal Medicine, Hospital Gelderse Vallei, Ede, the Netherlands
| | | | | | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, The Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam University Medical Center, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Anne S R van Lindert
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Tineke J Smilde
- Department of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Lia C van Zuylen
- Department of Medical Oncology, Amsterdam University Medical Center, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Liesbeth M van Vliet
- Department of Health, Medical and Neuropsychology, University of Leiden, Leiden, the Netherlands
| | - Natasja J H Raijmakers
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
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van Elst T, van Basten JP, van den Berg P, van den Bergh R, Bloem S, van Dodewaard-de Jong J, Hendriks M, Klaver S, Lalmahomed Z, Luijendijk D, van de Luijtgaarden A, Roelofs L, Vis AN, Vreugdenhil G, Vrijhof E, Wijsman B, Bloemendal H, Mulders P, Mehra N. TripleAiM1: a nationwide registry of de novo metastatic hormone-sensitive prostate cancer with prospective quality-of-life assessment. BMJ Open 2023; 13:e072572. [PMID: 37643855 PMCID: PMC10465920 DOI: 10.1136/bmjopen-2023-072572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION The treatment landscape for de novo metastatic hormone sensitive prostate cancer (mHSPC) is rapidly evolving. With an abundance of available treatment strategies, selecting the optimal strategy for an individual patient is becoming increasingly challenging. TripleAiM1 aims to evaluate the impact of mHSPC treatments on health-related quality of life (HRQoL) and to provide real-world data insights on diagnostics, treatment strategies, patient subgroups and related healthcare expenditure for mHSPC. The aspirational target of TripleAiM1 is that in the near future, a more tailored therapy can be offered based on the individual patient's wishes and needs in accordance with the overarching principle of value-based healthcare. METHODS AND ANALYSIS We describe the TripleAiM1 study design; a nationwide registry comprising a retrospective and prospective cohort of patients with de novo mHSPC. Starting in May 2020, eligible patients are identified, selected and recruited in 14 participating hospitals in the Netherlands. Our hypothesis is that, in a real-world setting, differences in clinically meaningful HRQoL deterioration will be observed for treatment strategies over time. HRQoL data, assessed with patient-reported outcome measures, costs and clinical data will be collected for 24 months.For the retrospective cohort, all patients diagnosed with de novo mHSPC from January 2017 onwards are eligible for inclusion. Patient and tumour characteristics, imaging modalities and treatment patterns will be analysed descriptively to provide a real-world overview.Time-to-event endpoints will be assessed using the Kaplan-Meier method and regression models will be employed to analyse baseline characteristics associated with an increased likelihood of death, progression and HRQoL deterioration. Longitudinal mixed-effects models will be employed to assess change of patient-reported outcome scores from baseline until the end of follow-up. ETHICS AND DISSEMINATION Ethical approval was obtained from the Medical Research Ethics Committee, Twente. Study results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NL9719.
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Affiliation(s)
- Tessa van Elst
- Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Medical Oncology, Radboudumc, Nijmegen, The Netherlands
| | | | | | | | - Sjaak Bloem
- Nyenrode Business Universiteit Expertise Center Marketing and Supply Chain Management, Breukelen, The Netherlands
| | | | - Mathijs Hendriks
- Medical Oncology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Sjoerd Klaver
- Urology, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | | | | | | | - Luc Roelofs
- Urology, Treant Care Group Hospital, Emmen, The Netherlands
| | - André N Vis
- Urology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Gerard Vreugdenhil
- Medical Oncology, Maxima Medical Centre, Veldhoven, The Netherlands
- Medical Oncology, Maastricht University Hospital, Maastricht, The Netherlands
| | - Eric Vrijhof
- Urology, Catharina Hospital, Eindhoven, The Netherlands
| | - Bart Wijsman
- Urology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands
| | | | | | - Niven Mehra
- Medical Oncology, Radboudumc, Nijmegen, The Netherlands
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3
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van der Doelen MJ, Oving IM, Wyndaele DNJ, van Basten JP, Terheggen F, van de Luijtgaarden ACM, Oyen WJG, van Schelven WD, van den Berkmortel F, Mehra N, Janssen MJR, Prins JB, Gerritsen WR, Custers JAE, van Oort IM. Health-related quality of life, psychological distress, and fatigue in metastatic castration-resistant prostate cancer patients treated with radium-223 therapy. Prostate Cancer Prostatic Dis 2023; 26:142-150. [PMID: 35804188 PMCID: PMC10023564 DOI: 10.1038/s41391-022-00569-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Radium-223 is a registered treatment option for symptomatic bone metastatic castration-resistant prostate cancer (mCRPC). Aim of this multicenter, prospective observational cohort study was to evaluate health-related quality of life (HR-QoL), psychological distress and fatigue in mCRPC patients treated with radium-223. METHODS Primary endpoint was cancer-specific and bone metastases-related HR-QoL, as measured by the EORTC QLQ-C30 and BM-22 questionnaires. Secondary endpoints were psychological distress and fatigue, evaluated by the HADS and CIS-Fatigue questionnaires. Outcomes were analyzed for the total cohort and between subgroups (1-3 versus 4-5 versus 6 radium-223 injections). A trajectory analysis was performed to explore HR-QoL patterns over time. RESULTS In total, 122 patients were included for analysis. Baseline HR-QoL, pain intensity, psychological distress and fatigue were worse in patients who did not complete radium-223 therapy. In patients who completed therapy, stabilization of HR-QoL was perceived and psychological distress and fatigue remained stable, whereas clinically meaningful and statistically significant deterioration of HR-QoL, psychological distress and fatigue over time was observed in patients who discontinued radium-223 therapy. Trajectory analysis revealed that HR-QoL deterioration over time was more likely in patients with baseline opioid use, low hemoglobin and high alkaline phosphatase levels. CONCLUSIONS Patients who discontinued radium-223 therapy showed worse HR-QoL, psychological distress and fatigue at baseline and more frequent deterioration of HR-QoL, psychological distress and fatigue over time when compared to patients who completed therapy. Specific attention with regard to HR-QoL during follow-up is indicated in patients with opioid use, low hemoglobin and high alkaline phosphatase levels before radium-223 therapy initiation. CLINICAL TRIAL REGISTRATION NUMBER NCT04995614.
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Affiliation(s)
- Maarten J van der Doelen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Irma M Oving
- Department of Medical Oncology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Dirk N J Wyndaele
- Department of Nuclear Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, The Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Reinier de Graaf Gasthuis and Reinier Haga Prostate Cancer Center, Delft, The Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Nuclear Medicine, Humanitas Clinical and Research Center, Milan, Italy
| | - W Dick van Schelven
- Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel J R Janssen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
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Immerzeel J, Israël B, Bomers J, Schoots IG, van Basten JP, Kurth KH, de Reijke T, Sedelaar M, Debruyne F, Barentsz J. Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 4: Transperineal Magnetic Resonance-Ultrasound Fusion Guided Biopsy Using Local Anesthesia. Eur Urol 2021; 81:110-117. [PMID: 34799197 DOI: 10.1016/j.eururo.2021.10.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/19/2021] [Accepted: 10/22/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Transperineal magnetic resonance imaging-transrectal ultrasound fusion guided biopsy (MFGB) is an increasingly popular technique due to increasing rates of biopsy-related infections. However, its widespread implementation has been hampered by the supposed necessity of epidural or general anesthesia. OBJECTIVE To demonstrate the technique, feasibility, and results of transperineal MFGB under local anesthesia, in an ambulatory setting without the administration of prophylactic antibiotics. DESIGN, SETTING, AND PARTICIPANTS This single-center study enrolled consecutive biopsy-naïve men with a clinical suspicion of prostate cancer into a prospective database between November 2015 and November 2020. Men with Prostate Imaging Reporting and Data System (PI-RADS) version 2 scores 3-5 underwent transperineal MFGB. SURGICAL PROCEDURE Transperineal MFGB was performed in an ambulatory setting under local anesthesia by a single operator. MEASUREMENTS Procedure-associated adverse events were recorded. Patient discomfort during both the local anesthesia and the biopsy procedure was determined using a visual analogic scale (0-10). Detection rates of grade group (GG) ≥2 prostate cancer and the proportion of men with GG 1 cancer were assessed. RESULTS AND LIMITATIONS A total of 1097 eligible men underwent transperineal MFGB. The complication rate was 0.73% (8/1097); complications comprised five (0.46%) urinary tract infections including one hospitalization and three (0.27%) urinary retentions. In 735 men, the median pain scores were 2 (interquartile range [IQR] 2-3) for the local anesthesia procedure and 1 (IQR 0-2) for the biopsy. Prostate cancer was detected in 84% (926/1097) of men; 66% (723/1097) had GG ≥2 and 19% (203/1097) GG 1. CONCLUSIONS Transperineal MFGB can safely be performed as an outpatient procedure under local anesthesia in an ambulatory setting. The detection rate of clinically significant prostate cancer is high, and biopsy is well tolerated. Although no antibiotic prophylaxis was used, the rate of infectious complications is practicably negligible. PATIENT SUMMARY This article shows how tissue samples (biopsies) can accurately be obtained from suspicious regions seen on prostate magnetic resonance imaging via needles inserted in the perineum (skin between the scrotum and the anus) in men with suspected prostate cancer. This technique appears to be very well tolerated under local anesthesia and has a lower risk of infection without antibiotic prophylaxis than the more common biopsy route through the rectum, with antibiotics.
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Affiliation(s)
- Jos Immerzeel
- Department of Urology, Andros Clinics, Arnhem, The Netherlands
| | - Bas Israël
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Urology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Joyce Bomers
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Ivo G Schoots
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jean-Paul van Basten
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; Prosper Collaborative Prostate Cancer Clinics, Nijmegen-Eindhoven, The Netherlands
| | | | - Theo de Reijke
- Department of Urology, Andros Clinics, Arnhem, The Netherlands; Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Sedelaar
- Department of Urology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Prosper Collaborative Prostate Cancer Clinics, Nijmegen-Eindhoven, The Netherlands
| | - Frans Debruyne
- Department of Urology, Andros Clinics, Arnhem, The Netherlands
| | - Jelle Barentsz
- Department of Urology, Andros Clinics, Arnhem, The Netherlands; Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
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5
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Israël B, Immerzeel J, van der Leest M, Hannink G, Zámecnik P, Bomers J, Schoots IG, van Basten JP, Debruyne F, van Oort I, Sedelaar M, Barentsz J. Clinical implementation of pre-biopsy magnetic resonance imaging pathways for the diagnosis of prostate cancer. BJU Int 2021; 129:480-490. [PMID: 34358388 PMCID: PMC9291303 DOI: 10.1111/bju.15562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective To assess the outcomes of pre‐biopsy magnetic resonance imaging (MRI) pathways, as a tool in biopsy‐naïve men with suspicion of prostate cancer, in routine clinical practice. Secondary outcomes included a comparison of transrectal MRI‐directed biopsy (TR‐MRDB) and transperineal (TP)‐MRDB in men with suspicious MRI. Patients and Methods We retrospectively assessed a two‐centre cohort of consecutive biopsy‐naïve men with suspicion of prostate cancer who underwent a Prostate Imaging‐Reporting and Data System version 2 (PI‐RADS v2) compliant pre‐biopsy MRI in a single, high‐volume centre between 2015 and 2019 (Centre 1). Men with suspicious MRI scans underwent TR‐MRDB in Centre 1 and TP‐MRDB with additional random biopsies (RB) in Centre 2. The MRI and histopathology were assessed in the same institution (Centre 1). Outcomes included: (i) overall detection rates of Grade Group (GG) 1, GG ≥2, and GG ≥3 cancer in men with suspicious MRI; (ii) Biopsy‐avoidance due to non‐suspicious MRI; and (iii) Cancer detection rates and biopsy‐related complications between TR‐ and TP‐MRDB. To reduce confounding bias for MRDB comparisons, inverse probability weighting (IPW) was performed for age, digital rectal examination, prostate‐specific antigen (PSA), prostate volume, PSA density, and PI‐RADS category. Results Of the 2597 men included, the overall GG 1, GG ≥2, and GG ≥3 prevalence was 8% (210/2597), 27% (697/2597), and 15% (396/2597), respectively. Biopsy was avoided in 57% (1488/2597) of men. After IPW, the GG 1, GG ≥2 and GG ≥3 detection rates after TR‐ and TP‐MRDB were comparable at 24%, 57%, and 32%; and 18%, 64%, and 38%, respectively; with mean differences of −5.7% (95% confidence interval [CI] −13% to 1.4%), 6.1% (95% CI −2.1% to 14%), and 5.7% (95% CI −1.7% to 13%). Complications were similar in TR‐MRDB (0.50%) and TP‐MRDB with RB (0.62%; mean difference 0.11%, 95% CI −0.87% to 1.1%). Conclusion This high‐volume, two‐centre study shows pre‐biopsy MRI as a decision tool is implementable in daily clinical practice. Compared to recent trials, a substantially higher biopsy avoidance rate was achieved without compromising GG ≥2/GG ≥3 detection and coinciding with lower over detection rates of GG 1 cancer. Prostate cancer detection and complication rates were comparable for TR‐ and TP‐MRDB.
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Affiliation(s)
- Bas Israël
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Urology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Jos Immerzeel
- Department of Urology, Andros Clinics, Arnhem, the Netherlands
| | - Marloes van der Leest
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Gerjon Hannink
- Department of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Patrik Zámecnik
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Joyce Bomers
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Ivo G Schoots
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Frans Debruyne
- Department of Urology, Andros Clinics, Arnhem, the Netherlands
| | - Inge van Oort
- Department of Urology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Michiel Sedelaar
- Department of Urology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Jelle Barentsz
- Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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6
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Beulens AJW, Namba HF, Brinkman WM, Meijer RP, Koldewijn EL, Hendrikx AJM, van Basten JP, van Merriënboer JJG, Van der Poel HG, Bangma C, Wagner C. Analysis of the video motion tracking system "Kinovea" to assess surgical movements during robot-assisted radical prostatectomy. Int J Med Robot 2020; 16:e2090. [PMID: 32034977 DOI: 10.1002/rcs.2090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUNDS Robot-assisted surgery facilitated the possibility to evaluate the surgeon's skills by recording and evaluating the robot surgical images. The aim of this study was to investigate the possibility of using a computer programme (Kinovea) for objective assessment of surgical movements in previously recorded in existing robot-assisted radical prostatectomy (RARP) videos. METHODS Twelve entire RARP procedures were analysed by a trained researcher using the computer programme "Kinovea" to perform semi-automated assessment of surgical movements. RESULTS Data analysis showed Kinovea was on average able to automatically assess only 22% of the total surgical duration per video of the robot-assisted surgery. On average, it lasted 4 hours of continued monitoring by the researcher to assess one RARP using Kinovea. CONCLUSION Although we proved it is technically possible to use the Kinovea system in retrospective analysis of surgical movement in robot-assisted surgery, the acquired data do not give a comprehensive enough analysis of the video to be used in skills assessment.
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Affiliation(s)
- Alexander J W Beulens
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | - Hanae F Namba
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands.,Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Willem M Brinkman
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Richard P Meijer
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Evert L Koldewijn
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | | | | | | | - Henk G Van der Poel
- Department of Urology, Dutch Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Chris Bangma
- Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Cordula Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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Privé B, Kortleve M, van Basten JP. Evaluating the impact of resident involvement during the laparoscopic nephrectomy. Cent European J Urol 2019; 72:369-373. [PMID: 32015905 PMCID: PMC6979558 DOI: 10.5173/ceju.2019.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/17/2019] [Accepted: 10/16/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction Laparoscopic nephrectomy (LN) is the most performed laparoscopic procedure by urologic residents (Res). A large amount of data exists on laparoscopic nephrectomies in terms of safety and surgical outcomes, but only a little is known about the influence of residents. The purpose of this study was to evaluate this influence on the clinical outcome of a laparoscopic nephrectomy. Material and methods Retrospectively, patients who had undergone a LN between 2010 and 2018 were assessed. Data included patient demographics, date of surgery, pre- and postoperative results and complications. The patients who had undergone a LN were divided into two groups: one where residents were involved and another group where only a staff surgeon (Sur) performed the operation. All training residents had a questionnaire sent to them to evaluate their role during the LN. Results A total of 229 patients met the study criteria, of which 78 patients were operated together with a resident and 151 by a staff surgeon alone. Both groups were homogeneous in terms of age, comorbidities, left/right sided LN and tumor-stage. Between these two groups, no significant differences were observed in median estimated blood loss (Res 87 ml vs. Sur 100 ml), intraoperative adverse events (Res 10.3% vs. Sur 6% p = 0.24), conversion to open surgery (Res 6.4% vs. Sur 6%) and high-grade postoperative complications (Res 3.9% vs. Sur 4.6%). However, when a resident participated, the LN lasted on average 20 minutes longer (Res mean 130 min vs. Sur 110 min p ≤0.001). Conclusions Our data shows that involvement of a resident in laparoscopic nephrectomy has no effect on the clinical outcome. Therefore, it is safe to perform a laparoscopic nephrectomy together with a resident, but it is important to take the additional surgical time into account.
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Affiliation(s)
- Bastiaan Privé
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Michael Kortleve
- Department of Urology, Hospital Gelderse Vallei, Ede, The Netherlands
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8
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Morgans AK, van Bommel ACM, Stowell C, Abrahm JL, Basch E, Bekelman JE, Berry DL, Bossi A, Davis ID, de Reijke TM, Denis LJ, Evans SM, Fleshner NE, George DJ, Kiefert J, Lin DW, Matthew AG, McDermott R, Payne H, Roos IAG, Schrag D, Steuber T, Tombal B, van Basten JP, van der Hoeven JJM, Penson DF. Development of a Standardized Set of Patient-centered Outcomes for Advanced Prostate Cancer: An International Effort for a Unified Approach. Eur Urol 2015; 68:891-8. [PMID: 26129856 DOI: 10.1016/j.eururo.2015.06.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/09/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are no universally monitored outcomes relevant to men with advanced prostate cancer, making it challenging to compare health outcomes between populations. OBJECTIVE We sought to develop a standard set of outcomes relevant to men with advanced prostate cancer to follow during routine clinical care. DESIGN, SETTING, AND PARTICIPANTS The International Consortium for Health Outcomes Measurement assembled a multidisciplinary working group to develop the set. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We used a modified Delphi method to achieve consensus regarding the outcomes, measures, and case mix factors included. RESULTS AND LIMITATIONS The 25 members of the multidisciplinary international working group represented academic and nonacademic centers, registries, and patients. Recognizing the heterogeneity of men with advanced prostate cancer, the group defined the scope as men with all stages of incurable prostate cancer (metastatic and biochemical recurrence ineligible for further curative therapy). We defined outcomes important to all men, such as overall survival, and measures specific to subgroups, such as time to metastasis. Measures gathered from clinical data include measures of disease control. We also identified patient-reported outcome measures (PROMs), such as degree of urinary, bowel, and erectile dysfunction, mood symptoms, and pain control. CONCLUSIONS The international multidisciplinary group identified clinical data and PROMs that serve as a basis for international health outcome comparisons and quality-of-care assessments. The set will be revised annually. PATIENT SUMMARY Our international group has recommended a standardized set of patient-centered outcomes to be followed during routine care for all men with advanced prostate cancer.
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Affiliation(s)
| | - Annelotte C M van Bommel
- International Consortium for Health Outcomes Measurement, Cambridge, MA, USA; Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Caleb Stowell
- International Consortium for Health Outcomes Measurement, Cambridge, MA, USA
| | | | - Ethan Basch
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Ian D Davis
- Monash University Eastern Health Clinical School, Melbourne, Australia
| | | | - Louis J Denis
- Oncology Centre Antwerp, Antwerp, Belgium; US TOO Belgium, Antwerp, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | - Bertrand Tombal
- Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | | | - David F Penson
- Vanderbilt University Medical Center, Nashville, TN, USA; VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USA
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