Review
Oncology
Omar Fahmy, Maxim Kochergin, Anastasios D. Asimakopoulos, Georgios Gakis
Summary: Extended pelvic lymph node dissection has been a standard practice during radical cystectomy for patients with muscle invasive bladder cancer. However, based on recent studies, standard pelvic lymph node dissection up to the level of iliac bifurcation is sufficient and there is no additional oncologic benefit from extending the dissection above this level.
SEMINARS IN ONCOLOGY
(2023)
Article
Oncology
Shaoxu Wu, Guibin Hong, Abai Xu, Hong Zeng, Xulin Chen, Yun Wang, Yun Luo, Peng Wu, Cundong Liu, Ning Jiang, Qiang Dang, Cheng Yang, Bohao Liu, Runnan Shen, Zeshi Chen, Chengxiao Liao, Zhen Lin, Jin Wang, Tianxin Lin
Summary: This study aimed to develop a lymph node metastases diagnostic model (LNMDM) based on whole slide images and assess the clinical effect of an artificial intelligence-assisted (AI) workflow. The LNMDM showed good performance in detecting lymph node metastases, particularly micrometastases. It has significant clinical potential in improving the accuracy and efficiency of pathologists' work.
Article
Medicine, General & Internal
Artur Leminski, Krystian Kaczmarek, Wojciech Michalski, Bartosz Malkiewicz, Katarzyna Kotfis, Marcin Slojewski
Summary: Radical cystectomy with pelvic lymph node dissection is the main treatment for muscle-invasive bladder cancer, with the number of removed lymph nodes significantly influencing survival outcomes. The benefits of adequate lymph node removal were reduced in patients who received neoadjuvant chemotherapy, suggesting the need for further research to validate these findings.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Surgery
Rahul Jena, Nikita Shrivastava, Aditya Prakash Sharma, Gautam Ram Choudhary, Aneesh Srivastava
Summary: Pelvic lymph node dissection is essential for radical cystectomy in muscle invasive bladder cancer, but there is controversy surrounding what constitutes an adequate dissection. Different anatomical templates and surrogate markers have been proposed, with conflicting evidence on their efficacy. Standardized nomenclature and further research are needed to determine the optimal approach.
FRONTIERS IN SURGERY
(2021)
Article
Oncology
Sara Monteiro-Reis, Joao P. S. Ferreira, Ricardo A. Pires, Joao Lobo, Joao A. Carvalho, Rui L. Reis, Renato Natal Jorge, Carmen Jeronimo
Summary: This study found that the presence of a tumor can alter the stiffness of the bladder wall, which may affect the progression of bladder cancer. Using atomic force microscopy, the researchers measured the micromechanical properties of the bladder wall layers and observed that tumors promote the development of muscle-like structures in the mucosa.
Article
Medicine, General & Internal
Simon Dixon, Harry Hill, Laura Flight, Pramit Khetrapal, Gareth Ambler, Norman R. Williams, Chris Brew-Graves, John D. Kelly, James W. F. Catto
Summary: The cost-effectiveness of robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) was assessed compared to open radical cystectomy (ORC) for bladder cancer patients. While iRARC reduced short-term morbidity and associated costs, the cost-effectiveness ratio exceeded thresholds used by many publicly funded health systems, although the procedure had a high probability of being cost-effective for certain patient subgroups.
Article
Oncology
Stefano Tappero, Andrea Panunzio, Lukas Hohenhorst, Cristina Cano Garcia, Francesco Barletta, Mattia Piccinelli, Zhe Tian, Stefano Parodi, Alessandro Antonelli, Markus Graefen, Felix K. H. Chun, Alberto Briganti, Ottavio De Cobelli, Fred Saad, Shahrokh F. Shariat, Nazareno Suardi, Marco Borghesi, Carlo Terrone, Pierre I. Karakiewicz
Summary: The effect of radical cystectomy (RC) on cancer-specific mortality (CSM) is uncertain in non-metastatic sarcomatoid bladder cancer (SBC) patients. This study aimed to evaluate the benefit of RC in SBC patients and compare it with urothelial bladder cancer (UCB).
Article
Obstetrics & Gynecology
Tanja Ignatov, Johannes Gassner, Mihaela Bozukova, Stylianos Ivros, Jozsef Meszaros, Olaf Ortmann, Holm Eggemann, Atanas Ignatov
Summary: The risk of contralateral non-SLN metastases in patients with unilateral SLN metastases in vulvar cancer is low, suggesting a need for further investigation into the impact of contralateral lymphadenectomy on patient survival.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2021)
Article
Surgery
Mohamed K. Kamel, Sebron Harrison, Benjamin Lee, Jeffrey L. Port, Brendon M. Stiles, Nasser K. Altorki
Summary: This study explored the potential value of extended nodal dissection after neoadjuvant chemoradiation, using data from the National Cancer Database. The results showed that the number of dissected lymph nodes was associated with improved survival, suggesting the importance of extended nodal dissection for patients undergoing neoadjuvant treatment.
Article
Urology & Nephrology
Alberto Martini, Luca Afferi, Stefania Zamboni, Julianne G. Schultz, Chiara Lonati, Agostino Mattei, R. Jeffrey Karnes, Matteo Soligo, Armando Stabile, Ettore Di Trapani, Ottavio De Cobelli, Giuseppe Simone, Claudio Simeone, Mario Alvarez-Maestro, Giorgio Gandaglia, Andrea Gallina, Renzo Colombo, Alberto Briganti, Francesco Montorsi, Evanguelos Xylinas, Shahrokh F. Shariat, Marco Moschini
Summary: The study found that patients with variant histology bladder cancer have a higher risk of recurrence, requiring extended surveillance time, and different histological types have different risks of recurrence and metastasis.
JOURNAL OF UROLOGY
(2021)
Article
Urology & Nephrology
Marco Moschini, Luca Afferi, Giorgio Gandaglia, David D'Andrea, Stefania Zamboni, Carlo Di Bona, Livio Mordasini, Agostino Mattei, Philipp Baumeister, Alberto Martini, Giusy Burgio, Shahrokh F. Shariat, Rafael Sanchez-Salas, Xavier Cathelineau, Armando Stabile, Emanuele Zaffuto, Andrea Salonia, Renzo Colombo, Andrea Necchi, Francesco Montorsi, Alberto Briganti, Andrea Gallina
Summary: A randomized trial found no survival benefit in bladder cancer patients treated with extended pelvic lymph node dissection templates. By analyzing clinical and pathological parameters, the risk of LNI can be predicted and a treatment model can be developed accordingly.
EUROPEAN UROLOGY FOCUS
(2021)
Article
Urology & Nephrology
Carl J. Wijburg, Charlotte T. J. Michels, Gerjon Hannink, Janneke P. C. Grutters, Maroeska M. Rovers, J. Alfred Witjes
Summary: This study did not find significant differences in complications and health-related quality of life between robot-assisted radical cystectomy and open radical cystectomy. However, there were some differences in secondary outcomes, with the main limitation being residual confounding.
Article
Urology & Nephrology
Francesco Soria, Peter C. Black, Adrian S. Fairey, Michael S. Cookson, Evan Y. Yu, Wassim Kassouf, Marc A. Dall'Era, Srikala S. Sridhar, John S. McGrath, Jonathan L. Wright, Andrew C. Thorpe, Todd M. Morgan, Siamak Daneshmand, Jeff M. Holzbeierlein, Trinity J. Bivalacqua, Scott North, Daniel A. Barocas, Yair Lotan, Petros Grivas, Andrew J. Stephenson, Jay B. Shah, Bas W. van Rhijn, Philippe E. Spiess, Shahrokh F. Shariat, Paolo Gontero
Summary: In patients with cT2N0 bladder cancer and no preoperative hydronephrosis, neoadjuvant chemotherapy (NAC) increased the rate of pathological complete response and downstaging, showing a positive impact on overall survival.
Article
Oncology
Andrew T. Lenis, Katherine E. Fero, Leslie Ojeaburu, Patrick M. Lec, Vishnukamal Golla, Wayne Brisbane, Michael S. Leapman, Karim Chamie
Summary: The study found that partial cystectomy is less common among patients with muscle-invasive bladder cancer and is associated with lower utilization of neoadjuvant chemotherapy and lymph node dissection but fewer treatment delays. The adequacy of lymph node dissection is associated with improved overall survival.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2021)
Article
Urology & Nephrology
Jay G. Fuletra, Andrew Watts, Matthew G. Kaag, Erik Lehman, Jay D. Raman, Suzanne B. Merrill
Summary: This study showed that perivesical stranding (PS) was not a reliable predictor of >= pT3 stage in bladder cancer patients who did not receive neoadjuvant chemotherapy, while hydronephrosis was positively associated with higher stage disease. Therefore, caution should be exercised when using PS on imaging for decision-making.
WORLD JOURNAL OF UROLOGY
(2021)
Review
Oncology
Leslie Ballas, Oren Wei, Siamak Daneshmand, Anne Schuckman, Hooman Djaladat, Monish Aron, Anishka D'Souza, David Quinn, Tanya B. Dorff
CLINICAL GENITOURINARY CANCER
(2020)
Article
Urology & Nephrology
Yair Lotan, Iftach Chaplin, Hamed Ahmadi, Xiaosong Meng, Sidney Roberts, Sanam Ladi-Seyedian, Aditya Bagrodia, Vitaly Margulis, Solomon Woldu, Siamak Daneshmand
Summary: The study evaluated the utility of blue-light flexible cystoscopy (BLFC) for surveillance of non-muscle-invasive bladder cancer (NMIBC). Results showed that incorporating BLFC in clinical practice has the potential advantages of detecting cancer in cases with normal WLC and detecting additional cancers in patients with positive WLC and BLFC, which can improve surveillance and performance of office-based biopsy. Further research is needed to determine cost-effectiveness and impact on recurrence rates.
Editorial Material
Oncology
Siamak Daneshmand
Article
Urology & Nephrology
Ryan S. Lee, Runzhuo Ma, Stephanie Pham, Jacqueline Maya-Silva, Jessica H. Nguyen, Manju Aron, Steven Cen, Siamak Daneshmand, Andrew J. Hung
Summary: This study utilized machine learning to investigate the predictive ability of surgeon performance and clinical factors on positive surgical margins (PSMs) after robot-assisted radical prostatectomy (RARP). The strongest predictors of PSMs were found to be nonmodifiable, disease-driven factors (ECE and pT), with automated performance metrics (APMs) also capable of independently predicting PSMs.
JOURNAL OF ENDOUROLOGY
(2022)
Article
Oncology
Charles Nguyen, Saum Ghodoussipour, Matthew Winter, Giovanni Cacciamani, Hamed Ahmadi, Hooman Djaladat, Anne K. Schuckman, Siamak Daneshmand, Monish Aron, Inderbir Gill, Mihir Desai
Summary: This study aimed to assess the impact of chronic kidney disease (CKD) on outcomes in bladder cancer patients undergoing radical cystectomy. The results showed that CKD was independently associated with adverse pathology, 90-day readmissions, and transfusion.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2022)
Article
Oncology
Siamak Daneshmand, Iris S. G. Brummelhuis, Kamal S. Pohar, Gary D. Steinberg, Manju Aron, Christopher J. Cutie, Kirk A. Keegan, John C. Maffeo, Donald L. Reynolds, Bradley Raybold, Albert Chau, J. Alfred Witjes
Summary: TAR-200 is a safe and well-tolerated treatment for MIBC patients undergoing radical cystectomy.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2022)
Article
Oncology
Frederik Konig, Nico C. Grossmann, Francesco Soria, David D'Andrea, Tristan Juvet, Aaron Potretzke, Hooman Djaladat, Alireza Ghoreifi, Eiji Kikuchi, Nozomi Hayakawa, Andrea Mari, Zine-Eddine Khene, Kazutoshi Fujita, Jay D. Raman, Alberto Breda, Matteo Fontana, John P. Sfakianos, John L. Pfail, Ekaterina Laukhtina, Pawel Rajwa, Maximilian Pallauf, Giovanni E. Cacciamani, Thomas van Doeveren, Joost L. Boormans, Alessandro Antonelli, Marcus Jamil, Firas Abdollah, Jeffrey Budzyn, Guillaume Ploussard, Axel Heidenreich, Siamak Daneshmand, Stephen A. Boorjian, Morgan Roupret, Michael Rink, Shahrokh F. Shariat, Benjamin Pradere
Summary: Measuring the quality of care is important in improving patient outcomes. In this study, five indicators were identified to assess the quality of care for patients with upper urinary tract cancer who undergo surgical removal of the affected kidney and ureter. Patients who achieved all five indicators had higher chances of survival and lower rates of recurrence. There were no patient-related factors that predicted a failure to achieve these indicators.
Article
Oncology
Giovanni E. Cacciamani, Ryan S. Lee, Daniel Sanford, Wesley Yip, Jie Cai, Gus Miranda, Siamak Daneshmand, Monish Aron, Hooman Djaladat, Inderbir S. Gill, Mihir Desai
Summary: This study evaluated the impact of patient and surgical factors on discharge disposition after radical cystectomy for bladder cancer. It found that older age, living alone prior to surgery, and/or major post-operative complications were significant predictors of discharge to rehabilitation facilities.
Editorial Material
Oncology
Muhannad Alsyouf, Lucia Nappi, Craig Nichols, Siamak Daneshmand
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Oncology
Siamak Daneshmand, Clint Cary, Timothy Masterson, Lawrence Einhorn, Nabil Adra, Stephen A. Boorjian, Christian Kollmannsberger, Anne Schuckman, Alan So, Peter Black, Aditya Bagrodia, Eila Skinner, Mehrdad Alemozaffar, Timothy Brand, Scott Eggener, Phillip Pierorazio, Kelly Stratton, Lucia Nappi, Craig Nichols, Chunqiao Luo, Ming Li, Brian Hu
Summary: This study aimed to investigate the efficacy of RPLND as a first-line treatment for testicular seminoma with clinically low-volume retroperitoneal lymphadenopathy. The results showed that the 2-year recurrence-free survival rate was 81%, the recurrence rate was 22%, and the 2-year overall survival rate was 100%. The study concluded that RPLND is a viable treatment option with low long-term morbidity.
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Oncology
Daniel D. Joyce, Vidit Sharma, Kevin M. Wymer, James P. Moriarty, Bijan J. Borah, Arman Walia, Brian A. Costello, Lance C. Pagliaro, Siamak Daneshmand, Bradley C. Leibovich, Stephen A. Boorjian
Summary: This study evaluated the cost-effectiveness of three treatment strategies for stage IIA seminoma and found that retroperitoneal lymph node dissection was the most cost-effective approach, followed by radiotherapy, and chemotherapy had the lowest cost-effectiveness. These findings support considering retroperitoneal lymph node dissection as a treatment option for well-selected patients with stage IIA seminoma in clinical guidelines.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2023)
Review
Oncology
Wadi Azuri, Jorge Horacio Jaunarena, Juan Jorge Camean, Joaquin Chemi, Alberto Villaronga, Siamak Daneshmand, Gustavo Martin Villoldo
Summary: This study evaluated the impact of BCG dose reduction on oncological outcomes and toxicity in patients with nonmuscle invasive bladder cancer. The results showed that dose reduction did not affect oncological outcomes, but significantly reduced systemic and local toxicity.
Letter
Urology & Nephrology
Muhannad Alsyouf, Siamak Daneshmand
Review
Urology & Nephrology
Siamak Daneshmand, Azadeh Nazemi
EUROPEAN UROLOGY FOCUS
(2020)
Review
Oncology
Hugh Mostafid, Ashish M. Kamat, Siamak Daneshmand, Joan Palou, John A. Taylor, James McKiernan, James Catto, Marko Babjuk, Mark Soloway
Summary: TURBT is a common but challenging urological procedure with variable outcomes. The review identified optimal best practices for TURBT, including preparation, procedural steps, surgical techniques, and postoperative management. Development of new instruments and techniques, as well as prospective audit of TURBT outcomes, are important future goals.
EUROPEAN UROLOGY ONCOLOGY
(2021)