6
|
Catto JWF, Khetrapal P, Ambler G, Sarpong R, Potyka I, Khan MS, Tan M, Feber A, Bourke L, Noon AP, Dixon S, Goodwin L, Williams NR, Rowe E, Kouparis A, McGrath J, Brew-Graves C, Kelly JD. Multidomain Quantitative Recovery Following Radical Cystectomy for Patients Within the Robot-assisted Radical Cystectomy with Intracorporeal Urinary Diversion Versus Open Radical Cystectomy Randomised Controlled Trial: The First 30 Patients. Eur Urol 2018; 74:531-534. [PMID: 29793815 DOI: 10.1016/j.eururo.2018.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/04/2018] [Indexed: 12/24/2022]
Affiliation(s)
- James W F Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK; Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK.
| | - Pramit Khetrapal
- Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Rachael Sarpong
- Surgical & Interventional Trials Unit (SITU), Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Ingrid Potyka
- Surgical & Interventional Trials Unit (SITU), Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Muhammad Shamim Khan
- Department of Urology, Guys and St Thomas' NHS Foundation Trust, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Melanie Tan
- Surgical & Interventional Trials Unit (SITU), Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Andrew Feber
- Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Liam Bourke
- Sheffield Hallam University, Sheffield, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Aidan P Noon
- Academic Urology Unit, University of Sheffield, Sheffield, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Simon Dixon
- Sheffield Hallam University, Sheffield, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Louise Goodwin
- Academic Urology Unit, University of Sheffield, Sheffield, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Norman R Williams
- Surgical & Interventional Trials Unit (SITU), Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Edward Rowe
- Department of Urology, North Bristol NHS Trust, Bristol, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Anthony Kouparis
- Department of Urology, North Bristol NHS Trust, Bristol, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - John McGrath
- Department of Urology, Royal Devon and Exeter NHS Trust, Devon, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - Chris Brew-Graves
- Surgical & Interventional Trials Unit (SITU), Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| | - John D Kelly
- Division of Surgery & Interventional Science, University College London, London, UK; Health Economics and Decision Science, NIHR Research Design Service Yorkshire and the Humber, University of Sheffield, Sheffield, UK
| |
Collapse
|
7
|
Tan WS, Sarpong R, Khetrapal P, Rodney S, Mostafid H, Cresswell J, Hicks J, Rane A, Henderson A, Watson D, Cherian J, Williams N, Brew-Graves C, Feber A, Kelly JD. Can Renal and Bladder Ultrasound Replace Computerized Tomography Urogram in Patients Investigated for Microscopic Hematuria? J Urol 2018; 200:973-980. [PMID: 29702097 PMCID: PMC6179963 DOI: 10.1016/j.juro.2018.04.065] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/24/2022]
Abstract
Purpose Computerized tomography urogram is recommended when investigating patients with hematuria. We determined the incidence of urinary tract cancer and compared the diagnostic accuracy of computerized tomography urogram to that of renal and bladder ultrasound for identifying urinary tract cancer. Materials and Methods The DETECT (Detecting Bladder Cancer Using the UroMark Test) I study is a prospective observational study recruiting patients 18 years old or older following presentation with macroscopic or microscopic hematuria at a total of 40 hospitals. All patients underwent cystoscopy and upper tract imaging comprising computerized tomography urogram and/or renal and bladder ultrasound. Results A total of 3,556 patients with a median age of 68 years were recruited in this study, of whom 2,166 underwent renal and bladder ultrasound, and 1,692 underwent computerized tomography urogram in addition to cystoscopy. The incidence of bladder, renal and upper tract urothelial cancer was 11.0%, 1.4% and 0.8%, respectively, in macroscopic hematuria cases. Patients with microscopic hematuria had a 2.7%, 0.4% and 0% incidence of bladder, renal and upper tract urothelial cancer, respectively. The sensitivity and negative predictive value of renal and bladder ultrasound to detect renal cancer were 85.7% and 99.9% but they were 14.3% and 99.7%, respectively, to detect upper tract urothelial cancer. Renal and bladder ultrasound was poor at identifying renal calculi. Renal and bladder ultrasound sensitivity was lower than that of computerized tomography urogram to detect bladder cancer (each less than 85%). Cystoscopy had 98.3% specificity and 83.9% positive predictive value. Conclusions Computerized tomography urogram can be safely replaced by renal and bladder ultrasound in patients who have microscopic hematuria. The incidence of upper tract urothelial cancer is 0.8% in patients with macroscopic hematuria and computerized tomography urogram is recommended. Patients with suspected renal calculi require noncontrast renal tract computerized tomography. Imaging cannot replace cystoscopy to diagnose bladder cancer.
Collapse
Affiliation(s)
- Wei Shen Tan
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom.
| | - Rachael Sarpong
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Pramit Khetrapal
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Simon Rodney
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Hugh Mostafid
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Joanne Cresswell
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - James Hicks
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Abhay Rane
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Alastair Henderson
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Dawn Watson
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Jacob Cherian
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Norman Williams
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Chris Brew-Graves
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - Andrew Feber
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | - John D Kelly
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| | -
- Division of Surgery and Interventional Science (SR), University College London, London, United Kingdom; Surgical and Interventional Trials Unit (RS, NW, CB-G), University College London, London, United Kingdom; Department of Urology, University College London Hospital (WST, PK, JDK), London, United Kingdom; University College London Cancer Institute (SR, AF), London, United Kingdom; Department of Urology, Royal Surrey County Hospital (HM), Guildford, United Kingdom; Department of Urology, James Cook University Hospital (JC), Middlesbrough, United Kingdom; Department of Urology, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital (JH), Worthing, United Kingdom; Department of Urology, East Surrey Hospital (AR), Redhill, United Kingdom; Department of Urology, Maidstone Hospital (AH), Maidstone, United Kingdom; Department of Urology, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital (JC), Crumpsall, United Kingdom
| |
Collapse
|