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Zargar H, Zargar-Shoshtari K, Lotan Y, Shah JB, van Rhijn BW, Daneshmand S, Spiess PE, Black P. Final Pathological Stage after Neoadjuvant Chemotherapy and Radical Cystectomy for Bladder Cancer-Does pT0 Predict Better Survival than pTa/Tis/T1? J Urol 2015; 195:886-93. [PMID: 26521718 DOI: 10.1016/j.juro.2015.10.133] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE We assessed survival dependent on pathological response after neoadjuvant chemotherapy in a large multicenter patient cohort, with a particular focus on the difference between the absence of residual cancer (pT0) and the presence of only nonmuscle invasive residual cancer (pTa, pTis, pT1). MATERIALS AND METHODS We retrospectively reviewed records of patients with urothelial cancer who received neoadjuvant chemotherapy and underwent radical cystectomy at 19 contributing institutions from 2000 to 2013. Patients with cT2-4aN0M0 and eventual pN0 disease were selected for this analysis. Estimated overall survival was compared between patients with pT0 and pTa/Tis/T1 disease. A multivariable Cox proportional hazards regression model for overall survival was generated to evaluate hazard ratios for variables of interest. RESULTS Of 1,543 patients treated with neoadjuvant chemotherapy and radical cystectomy during the study period 257 had pT0N0 and 207 had pTa/Tis/T1N0 disease. The Kaplan-Meier mean estimates of overall survival for pT0 and pTa/Tis/T1 cases were 186.7 months (95% CI 145.9-227.6, median 241.1) and 138 months (95% CI 118.2-157.8, median 187.4), respectively (p=0.58). In the Cox proportional hazards regression model for overall survival pTa/Tis/T1N0 status (HR 0.36, 95% CI 0.23-0.67) and pT0N0 status (HR 0.28, 95% CI 0.17-0.47) compared to pT2N0 pathology, positive surgical margin (HR 1.75, 95% CI 1.07-2.86), and receiving a methotrexate, vinblastine, doxorubicin and cisplatin regimen compared to an "other" regimen (HR 0.45, 95% CI 0.27-0.76) were predictors of overall survival. CONCLUSIONS pTa/Tis/T1N0 and pT0N0 stage on the final cystectomy specimen are strong predictors of survival in patients treated with neoadjuvant chemotherapy and radical cystectomy. We did not discern a statistically significant difference in overall survival when comparing these 2 end points.
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Kassouf W, Traboulsi SL, Kulkarni GS, Breau RH, Zlotta A, Fairey A, So A, Lacombe L, Rendon R, Aprikian AG, Siemens DR, Izawa JI, Black P. CUA guidelines on the management of non-muscle invasive bladder cancer. Can Urol Assoc J 2015; 9:E690-704. [PMID: 26664503 DOI: 10.5489/cuaj.3320] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Reaney M, Eek D, Ascoytia C, Scrabis L, Halling K, Black P, Martin M. 1700 ORAL Similarities and differences between symptoms and impacts of ovarian cancer as reported by the patients and their caregivers. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30024-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Black P, Douglas I, Field H. This could be the start of something big-20 years since the identification of bats as the natural host of Hendra virus. One Health 2015; 1:14-16. [PMID: 28616459 PMCID: PMC5441360 DOI: 10.1016/j.onehlt.2015.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 11/27/2022] Open
Abstract
Hendra virus was first described in 1994 in Australia, causally associated with a cluster of fatal equine and human cases at a thoroughbred racing stable in the Brisbane suburb of Hendra. This year marks the twentieth anniversary of the identification of pteropid bats (flying-foxes) as the natural host of the virus, and it is timely to reflect on a pivotal meeting of an eclectic group of scientists in that process. They included animal and public health experts, environmental scientists, veterinary and horse industry representatives, and wildlife experts. The task was to review and prioritise wildlife surveillance seeking the origin of the previously unknown virus. The group determined that the likely reservoir must occur in disparate locations, and be capable of moving between locations, or exist in continuous, overlapping populations spanning multiple locations. Flying-foxes were considered to be a more probable source of the novel virus than birds. Within weeks, antibodies were detected in several species of flying-fox, and the virus was subsequently isolated. While the identification of the natural host of Hendra virus within 18 months of its description was remarkable in itself, a broader legacy followed. In the subsequent years, a suite of zoonotic viruses including Australian bat lyssavirus, Nipah virus, SARS coronavirus, and Ebola and Marburg viruses have been detected in bats. Bats are now the “go to” taxa for novel viruses. History has repeatedly demonstrated that knowledge begets knowledge. This simple notion of bringing a diverse group of people together in an environment of mutual respect reinforced this principle and proves that the sum is often so much more powerful than the parts.
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Eek D, Reaney M, Ascoytia C, Scrabis L, Halling K, Black P, Martin ML. Patient perceptions of ovarian cancer, its treatment, and its impact: A qualitative interview study in three European countries. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Black P. Canadian guidelines for SRMs: How Canadian are they? Can Urol Assoc J 2015; 9:163-213. [PMID: 26225163 PMCID: PMC4479635 DOI: 10.5489/cuaj.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
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Hayashi T, Gust K, Jäger W, Awrey S, Li N, Altamirano-Dimas M, Buttyan R, Fazli L, Matsubara A, Black P. MP36-17 CANONICAL NOTCH2 SIGNALING PROMOTES TUMOR GROWTH AND METASTASIS IN BLADDER CANCER THROUGH CELL CYCLE PROGRESSION, DEDIFFERENTIATION AND EMT. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dean L, Fairey A, Jacobsen N, Tanguay S, Rendon R, Bell D, Izawa J, Chin J, Kapoor A, Shayegan B, Matsumoto E, Black P, So A, Lattouf JB, Saad F, Drachenberg D, Cagiannos I, Lacombe L, Fradet Y, Kassouf W. MP57-20 VARIANT HISTOLOGY DOES NOT PREDICT SURVIVAL OUTCOMES AFTER RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA: RESULTS FROM THE CANADIAN UPPER TRACT COLLABORATION. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2008] [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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Zargar-Shoshtari K, Zargar H, Fairey AS, Mertens LS, Dinney CP, Mir MC, Krabbe LM, Cookson MS, Jacobsen NE, Gandhi N, Griffin J, Montgomery JS, Vasdev N, Yu EY, Xylinas E, Campain NJ, Kassouf W, Dall'Era MA, Seah JA, Sharma P, Ercole CE, Horenblas S, Sridhar SS, McGrath JS, Aning J, Shariat SF, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Garcia JA, Stephenson AJ, Shah JB, van Rhijn BW, Daneshmand S, Spiess PE, Black P. MP65-06 A MULTI-INSTITUTIONAL ANALYSIS OF OUTCOMES IN PATIENTS WITH CLINICALLY NODE POSITIVE UROTHELIAL BLADDER CANCER TREATED WITH INDUCTION CHEMOTHERAPY AND RADICAL CYSTECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dejima T, Takeuchi A, Hayashi T, Leong J, Tombe T, Tam K, Oo H, Black P, Naito S, Gleave M, Ong C. MP49-13 LIM-SH3 DOMAIN PROTEIN 1 KNOCKDOWN INHIBITS CELL GROWTH AND ENHANCES ACTIVITY OF CISPLATIN IN BLADDER CANCER. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Xylinas E, Zargar-Shoshtari K, Shah J, Zargar H, Fairey A, Mertens L, Mir M, Garcia J, Stephenson A, Krabbe LM, Cookson M, Lotan Y, Jacobsen NE, Gandhi N, Griffin J, Montgomery J, Vasdev N, Yu E, Campain N, Kassouf W, Dall'Era M, Seah JA, Ercole C, Horenblas S, Sridhar S, McGrath J, Aning J, Wright J, Thorpe A, Morgan T, Holzbeierlein J, Bivalacqua T, North S, Barocas D, Daneshmand S, Van Rhijn B, Spiess P, Dinney C, Black P, Shariat S. MP72-15 THE INTERVAL BETWEEN DIAGNOSIS AND RADICAL CYSTECTOMY DOES NOT IMPACT THE OUTCOMES OF PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nayak J, Patel P, Bjazevic J, Saarela O, Liu Z, Kapoor A, Tanguay S, Finelli A, Rendon R, Moore R, Breau R, Kawakami J, Black P, Drachenberg D. MP84-08 PATHOLOGICAL UPSTAGING OF CLINICAL T1 RENAL CELL CARCINOMA: A MULTI-INSTITUTIONAL ANALYSIS OF OUTCOMES. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zargar-Shoshtari K, Zargar H, Dinney CP, Ercole CE, Abdi H, Kovac E, Garcia JA, Stephenson AJ, Shah JB, Black P, Spiess PE. PD31-09 CLINICAL FACTORS PREDICTING PATHOLOGICAL POSITIVE LYMPH NODES IN CLINICALLY NODE NEGATIVE PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY AND RADICAL CYSTECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hayashi T, Seiler R, Bell RH, Ettinger S, Wang K, Awrey S, Gust K, Jäger W, Todenhoefer T, Altamirano-Dimas M, Matsubara A, Collins C, Black P. MP49-09 ACTIVATION OF IFN/STAT1 SIGNALING IN CISPLATIN/GEMCITABINE RESISTANT BLADDER CANCER. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Akamatsu S, Lynch K, Black P, Gleave M, Goldenberg L, Chi KN, So A. The impact of time to metastasis on survival in treatment-naïve prostate cancer patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.7_suppl.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
212 Background: With the emergence of novel therapies, the treatment of advanced prostate cancer has evolved. However, patients eventually succumb to their metastatic disease. Nonetheless, little is known about the impact of time to metastasis on survival. To further expand on this, we separated metastatic prostate cancer patients into three groups according to the timing of metastasis and analyzed their survival. Methods: From 2008 to 2013, 157 CRPC patients were identified in our database. Of those, 92 with metastasis and sufficient data were analysed. The patients were classified into three groups according to the timing of metastasis. There were 35 de novo –M (metastasis within three months of initial diagnosis), 26 CSPC-M (initially metastasis free, metastasis found more than 6 months prior to CRPC), and 31 CRPC-M (metastasis found within 6 months of becoming CRPC, or after becoming CRPC). Patient characteristics were analyzed, and survival was calculated. Results: Median follow up were 2.2, 9.6, and 11.8 years for de novo-M, CSPC-M, and CRPC-M. 85 and 84 % in the CSPC-M and CRPC-M respectively had local therapies by surgery and/or radiation. The types of local therapies were similar between the groups. Mean time to PSA recurrence after intial therapy were 3.5 and 2.2 years for CSPC-M and CRPC-M, and median time to metastasis were 4.4 and 11.4 years respectively. Treatments after CRPC included Abiraterone, Enzalutamide, and Docetaxel, and the use of these agents were similar between the groups. Median time to CRPC were 1.4, 6.2, and 8.6 years, and median overall survival after diagnosis were 3.7, 12.3, and 15.8 years for de novo-M, CSPC-M, and CRPC-M. Conclusions: The overall survival and time to CRPC were significantly shorter in de novo-M. Although there was a marked difference in time to metastasis between CSPC-M and CRPC-M, there was no statistically significant difference in overall survival. Either treated with hormone therapy before or after emergence of metastasis, survival of more than 10 years after initial diagnosis is possible.
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Baxter E, Dennis K, Kollmannsberger C, Black P, Attwell A, Morris WJ, Tyldesley S. Radical trimodality therapy for patients with locally advanced bladder cancer: The British Columbia Cancer Agency experience. Urol Oncol 2015; 33:66.e13-9. [DOI: 10.1016/j.urolonc.2014.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/18/2014] [Accepted: 07/19/2014] [Indexed: 11/17/2022]
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Black P. Reply: To PMID 25623709. Urology 2015; 85:429. [PMID: 25623710 DOI: 10.1016/j.urology.2014.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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118
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Patel M, Pilcher J, Hancox RJ, Sheahan D, Pritchard A, Braithwaite I, Shaw D, Black P, Weatherall M, Beasley R. The use of β2-agonist therapy before hospital attendance for severe asthma exacerbations: a post-hoc analysis. NPJ Prim Care Respir Med 2015; 25:14099. [PMID: 25569185 PMCID: PMC4532151 DOI: 10.1038/npjpcrm.2014.99] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/04/2014] [Accepted: 08/30/2014] [Indexed: 12/03/2022] Open
Abstract
Background: Patterns of inhaled β2-agonist therapy use during severe asthma exacerbations before hospital attendance are poorly understood. Aims: To assess β2-agonist use prior to hospital attendance. Methods: We undertook an exploratory post hoc analysis of data from a 6-month clinical trial of 303 patients randomised to combination budesonide/formoterol inhaler according to a Single combination inhaler as Maintenance And Reliever Therapy regimen (‘SMART’) or fixed-dose budesonide/formoterol with salbutamol as reliever (‘Standard’). Patterns of β2-agonist use for 14 days before hospital attendance with a severe asthma exacerbation were determined by electronic monitoring of inhaler use. Results: There were 22 hospital attendances in 16 patients during the study. Seven and nine hospital attendances were eligible for analysis in the SMART and Standard groups, respectively. In both regimens, β2-agonist use increased before hospital attendance, with a median (range) maximum daily number of actuations of 14 (9 to 63) budesonide/formoterol in SMART and 46 (6 to 95) salbutamol in Standard with 4 (0 to 10) budesonide/formoterol actuations on the day of maximal salbutamol use. There was delay in obtaining medical review despite high β2-agonist use, in 9/16 patients. Different patterns of use were observed, including repeated days of no inhaled corticosteroid despite marked salbutamol use, which occurred in 3/9 patients in the Standard group. Conclusions: Delay in obtaining medical review in association with high β2-agonist use is common in patients before hospital presentation with severe exacerbations of asthma. The SMART regimen reduced nonadherence with inhaled corticosteroid therapy during severe exacerbations.
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Thiara GS, Black P. Comparing extended and standard lymphadenectomy surgeries for bladder cancer (complications, final outcomes and effects of neoadjuvant chemotherapy). BMC Proc 2015. [PMCID: PMC4306043 DOI: 10.1186/1753-6561-9-s1-a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kapoor A, Dason S, Allard CB, Shayegan B, Lacombe L, Rendon R, Jacobsen NE, Fairey A, Izawa J, Black P, Tanguay S, Chin J, So A, Lattouf JB, Bell D, Saad F, Drachenberg D, Cagiannos I, Fradet Y, Alamri A, Kassouf W. The impact of method of distal ureter management during radical nephroureterectomy on tumour recurrence. Can Urol Assoc J 2014; 8:E845-52. [PMID: 25485014 DOI: 10.5489/cuaj.1985] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTON Radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) must include some form of distal ureter management to avoid high rates of tumour recurrence. It is uncertain which distal ureter management technique has the best oncologic outcomes. To determine which distal ureter management technique resulted in the lowest tumour recurrence rate, we analyzed a multi-institutional Canadian radical nephroureterectomy database. METHODS We retrospectively analyzed patients who underwent radical nephroureterectomy with distal ureter management for UTUC between January 1990 and June 2010 at 10 Canadian tertiary hospitals. Distal ureter management approaches were divided into 3 categories: (1) extravesical tenting for ureteric excision without cystotomy (EXTRAVESICAL); (2) open cystotomy with intravesical bladder cuff excision (INTRAVESICAL); and (3) extravesical excision with endoscopic management of ureteric orifice (ENDOSCOPIC). Data available for each patient included demographic details, distal ureter management approach, pathology and operative details, as well as the presence and location of local or distant recurrence. Clinical outcomes included overall recurrence-free survival and intravesical recurrence-free survival. Survival analysis was performed with the Kaplan-Meier method. Multivariable Cox regression analysis was also performed. RESULTS A total of 820 patients underwent radical nephroureterectomy with a specified distal ureter management approach at 10 Canadian academic institutions. The mean patient age was 69.6 years and the median follow-up was 24.6 months. Of the 820 patients, 406 (49.5%) underwent INTRAVESICAL, 316 (38.5%) underwent EXTRAVESICAL, and 98 (11.9%) underwent ENDOSOPIC distal ureter management. Groups differed significantly in their proportion of females, proportion of laparoscopic cases, presence of carcinoma in situ and pathological tumour stage (p < 0.05). Recurrence-free survival at 5 years was 46.3%, 35.6%, and 30.1% for INTRAVESICAL, EXTRAVESICAL and ENDOSCOPIC, respectively (p < 0.05). Multivariable Cox regression analysis confirmed that INTRAVESICAL resulted in a lower hazard of recurrence compared to EXTRAVESICAL and ENDOSCOPIC. When looking only at intravesical recurrence-free survival (iRFS), a similar trend held up with INTRAVESICAL having the highest iRFS, followed by ENDOSCOPIC and then EXTRAVESICAL management (p < 0.05). At last follow-up, 406 (49.5%) patients were alive and free of disease. CONCLUSION Open intravesical excision of the distal ureter (INTRAVESICAL) during radical nephroureterectomy was associated with improved overall and intravesical recurrence-free survival compared with extravesical and endoscopic approaches. These findings suggest that INTRAVESICAL should be considered the gold standard oncologic approach to distal ureter management during radical nephroureterectomy. Limitations of this study include its retrospective design, heterogeneous cohort, and limited follow-up.
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Reaney M, Black P, Gwaltney C. A systematic method for selecting patient-reported outcome measures in diabetes research. Diabetes Spectr 2014; 27:229-32. [PMID: 25647044 PMCID: PMC4231933 DOI: 10.2337/diaspect.27.4.229] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Black P. A new way of thinking about bladder cancer. Urology 2014; 84:1265-6. [PMID: 25312552 DOI: 10.1016/j.urology.2014.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 08/19/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
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Goebell PJ, Kamat AM, Sylvester RJ, Black P, Droller M, Godoy G, Hudson MA, Junker K, Kassouf W, Knowles MA, Schulz WA, Seiler R, Schmitz-Dräger BJ. Assessing the quality of studies on the diagnostic accuracy of tumor markers. Urol Oncol 2014; 32:1051-60. [PMID: 25159014 DOI: 10.1016/j.urolonc.2013.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVES With rapidly increasing numbers of publications, assessments of study quality, reporting quality, and classification of studies according to their level of evidence or developmental stage have become key issues in weighing the relevance of new information reported. Diagnostic marker studies are often criticized for yielding highly discrepant and even controversial results. Much of this discrepancy has been attributed to differences in study quality. So far, numerous tools for measuring study quality have been developed, but few of them have been used for systematic reviews and meta-analysis. This is owing to the fact that most tools are complicated and time consuming, suffer from poor reproducibility, and do not permit quantitative scoring. METHODS The International Bladder Cancer Network (IBCN) has adopted this problem and has systematically identified the more commonly used tools developed since 2000. RESULTS In this review, those tools addressing study quality (Quality Assessment of Studies of Diagnostic Accuracy and Newcastle-Ottawa Scale), reporting quality (Standards for Reporting of Diagnostic Accuracy), and developmental stage (IBCN phases) of studies on diagnostic markers in bladder cancer are introduced and critically analyzed. Based upon this, the IBCN has launched an initiative to assess and validate existing tools with emphasis on diagnostic bladder cancer studies. CONCLUSIONS The development of simple and reproducible tools for quality assessment of diagnostic marker studies permitting quantitative scoring is suggested.
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Fradet V, Mauermann J, Kassouf W, Rendon R, Jacobsen N, Fairey A, Izawa J, Kapoor A, Black P, Tanguay S, Chin J, So A, Lattouf JB, Bell D, Saad F, Sheyegan B, Drachenberg D, Cagiannos I, Lacombe L. Risk factors for bladder cancer recurrence after nephroureterectomy for upper tract urothelial tumors: Results from the Canadian Upper Tract Collaboration1Co-first authors. Urol Oncol 2014; 32:839-45. [DOI: 10.1016/j.urolonc.2014.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/07/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
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Patel M, Pilcher J, Reddel HK, Qi V, Mackey B, Tranquilino T, Shaw D, Black P, Weatherall M, Beasley R. Predictors of severe exacerbations, poor asthma control, and β-agonist overuse for patients with asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:751-8. [PMID: 25439367 DOI: 10.1016/j.jaip.2014.06.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 05/18/2014] [Accepted: 06/09/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Predictors of asthma exacerbations, poor asthma control, or extreme β-agonist overuse may be of clinical utility in the management of asthma. OBJECTIVE To investigate characteristics that predict subsequent adverse outcomes in asthma. METHODS An independent 24-week, randomized controlled trial of 303 adult patients with asthma who are at risk, which compared the efficacy of SMART (single budesonide-formoterol inhaler as maintenance and reliever therapy) with a fixed-dose regimen with salbutamol as reliever ("Standard"). Inhaled medication use was measured by electronic monitoring. Baseline characteristics that were predictors of subsequent severe asthma exacerbations, poor asthma control (Asthma Control Questionnaire -5 score ≥1.5), and "extreme" β-agonist overuse (>16 budesonide-formoterol actuations/d in SMART and >32 salbutamol actuations/d in Standard) were assessed by multivariate analyses. RESULTS FEV₁ % predicted (rate ratio [RR] 1.14 [95% CI, 1.03-1.27] per 10% lower), more previous exacerbations (RR 1.15 [95% CI, 1.01-1.31]), Standard therapy (RR 1.62 [95% CI, 1.07-2.47]), and female sex (RR 2.18 [95% CI, 1.29-3.67]) were associated with future severe exacerbations. Asthma Control Questionnaire--5 (regression coefficient 0.20 [95% CI, 0.13-0.27] per 0.5 points higher) and age (regression coefficient 0.09 [95% CI, 0.01-0.17] per decade older) were associated with future poorly controlled asthma. Higher reliever use (RR 1.63 [95% CI, 1.36-1.95] per categorical score in Asthma Control Questionnaire question no. 6), Māori ethnicity (RR 2.20 [95% CI, 1.43-3.38]) and FEV₁ % predicted (RR 1.16 [95% CI, 1.03-1.31] per 10% lower) were associated with future extreme β-agonist overuse. CONCLUSION Future severe asthma exacerbations, poor asthma control, and extreme β-agonist overuse are predicted by different baseline clinical and demographic characteristics and management approaches in at-risk asthma.
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