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Yajima S, Masuda H. The significance of G8 and other geriatric assessments in urologic cancer management: A comprehensive review. Int J Urol 2024; 31:607-615. [PMID: 38402450 DOI: 10.1111/iju.15432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
In urologic oncology, which often involves older patients, it is important to consider how to manage their care appropriately. Geriatric assessment (GA) is a method that can address the specific needs of older cancer patients. The GA encompasses various assessment domains, but these domains exhibit variations across the literature. Some of the common items include functional ability, nutrition, comorbidities, cognitive ability, psychosocial disorders, polypharmacy, social and financial support, falls/imbalance, and vision/hearing. Despite the diversity of domains, there is limited consensus on reliable measurement methods. This review discusses the role of GA in managing urologic cancer in unique scenarios, such as those necessitating temporary or permanent urinary catheters or stomas due to urinary diversion. A comprehensive GA is time and human-resource-intensive in real-world clinical practice. Hence, simpler tools such as the Geriatric-8 (G8), capable of identifying high-risk patients requiring a detailed GA, are also under investigation in various contexts. Therefore, we conducted a systematic literature review on the G8. Our findings indicate that patients with low G8 scores encounter difficulties with stoma self-care after urinary diversion and have higher risks of urinary tract infections and ileus after radical cystectomy. The utilization of G8 as a screening tool for urologic cancer patients may facilitate the delivery of appropriate and personalized treatment and care.
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Affiliation(s)
- Shugo Yajima
- Department of Urology, National Cancer Center Hospital East, Chiba, Japan
| | - Hitoshi Masuda
- Department of Urology, National Cancer Center Hospital East, Chiba, Japan
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Jochems KFT, Menges D, Sanchez D, de Glas NA, Wildiers H, Eberli D, Puhan MA, Bastiaannet E. Outcomes in studies regarding older patients with prostate cancer: A systematic review. J Geriatr Oncol 2024; 15:101763. [PMID: 38575500 DOI: 10.1016/j.jgo.2024.101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Older patients are often deemed ineligible for clinical research, and many frequently-used endpoints and outcome measures are not as relevant for older patients for younger ones. This systematic review aimed to present an overview of outcomes used in clinical research regarding patients over the age of 65 years with prostate cancer. MATERIALS AND METHODS PubMed and Embase were systematically searched to identify studies on prostate cancer (treatment) in patients aged ≥65 between 2016 and 2023. Data on title, study design, number of participants and age, stage of disease, treatment, and investigated outcomes were synthesized and descriptively analyzed. RESULTS Sixty-eight studies were included. Of these most included patients over 65 years, while others used a higher age. Overall, 39 articles (57.3%) reported on survival-related outcomes, 22 (32.4%) reported on progression of disease and 38 (55.9%) used toxicity or adverse events as an outcome measure. Health-related quality of life and functional outcomes were investigated in 29.4%, and cognition in two studies. The most frequently investigated survival-related outcomes were overall and cancer-specific survival (51.3%); however, 38.5% only studied overall survival. DISCUSSION The main focus of studies included in this review remains survival and disease progression. There is limited attention for health-related quality of life and functional status, although older patients often prioritize the latter. Future research should incorporate outcome measures tailored to the aged population to improve care for older patients with prostate cancer.
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Affiliation(s)
- Kim F T Jochems
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dafne Sanchez
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Nienke A de Glas
- Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans Wildiers
- Oncology, University Hospital Leuven, Leuven, Belgium
| | - Daniel Eberli
- Urology, University Hospital Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Esther Bastiaannet
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Ren X, Wang J, Wang Z, Yin Y, Li X, Tian Y, Guo Z, Zeng X. Frailty as a risk marker of adverse lower urinary symptom outcomes in patients with benign prostatic hyperplasia undergoing transurethral resection of prostate. Front Med (Lausanne) 2023; 10:1185539. [PMID: 37275385 PMCID: PMC10235461 DOI: 10.3389/fmed.2023.1185539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose Lower urinary symptoms (LUTS) may persist in a proportion of patients with benign prostatic hyperplasia (BPH) following transurethral resection of prostate (TURP), which is a major cause of reduced quality-of-life. We aimed to investigate the effect of frailty on LUTS in patients with BPH treated with TURP. Methods We longitudinally evaluated LUTS and health-related quality-of-life (HRQOL) in patients with BPH treated with TURP from February 2019 and January 2022 using International Prostate Symptom Score (IPSS) and Short Form-8 (SF-8), respectively. Patients were divided into frail and non-frail groups according to the Fried phenotype (FP). The primary purpose was comparing the outcomes of LUTS and HRQOL between two groups. Secondary purposes were investigating the frailty as a preoperative predictor of postoperative adverse LUTS outcomes following TURP using logistic regression analysis. A 1:2 propensity score matching (PSM) was performed to reduce the effects of selection bias and potential confounders. Results Of the 567 patients enrolled, 495 (87.3%) patients were non-frail (FP = 0-2), and the remaining 72 (12.7%) patients were classified into the frail group. There were no significant differences in body mass index (BMI), urine white blood cell (UWBC), creatinine, prostate-specific antigen (PSA) and prostate volume in both groups at baseline (all p > 0.05). However, patients with frailty were older, higher comorbidity rates, lower peak flow rates and lower HRQOL. In the frail group, although LUTS and HRQOL at 6 months following TURP improved significantly compared to those at baseline, it did not show a significant improvement compared with the non-frail group (both p < 0.001). Moreover, multivariable logistic regression analysis demonstrated that preoperative frailty was significantly associated with poor LUTS improvement in both the entire cohort and PSM subset (both p < 0.05), whereas age and comorbidities were not after PSM analysis. Conclusion In patients with frail or non-frail, TURP for BPH provides overall good results. However, frail individuals are at higher risk of postoperative adverse LUTS outcomes. Frailty has the potential to be a strong objective tool for risk stratification and should be considered during the perioperative evaluation.
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Affiliation(s)
- Xiang Ren
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhixian Wang
- Department of Urology, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Urology, Wuhan No. 1 Hospital, Wuhan, China
| | - Yisheng Yin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiqun Tian
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zihao Guo
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyong Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kang YJ, Lee MT, Kim MS, You SH, Lee JE, Eom JH, Jung SY. Risk of Fractures in Older Adults with Chronic Non-cancer Pain Receiving Concurrent Benzodiazepines and Opioids: A Nested Case-Control Study. Drugs Aging 2021; 38:687-695. [PMID: 34159565 DOI: 10.1007/s40266-021-00872-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between the concurrent use of benzodiazepines and opioids and the risk of fractures in older patients with chronic non-cancer pain. METHODS Patients with osteoarthritis or low back pain (≥ 65 years of age) included in the Korean National Health Insurance Service-National Sample Cohort database of Korea and with an incident diagnosis of hip, humeral, or forearm fracture between 2011 and 2015 were identified as cases. For each case, four controls were matched for age (within 5 years), sex, and year of cohort entry. We estimated the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for fractures associated with concurrent use of benzodiazepines and opioids using a conditional logistic regression analysis, adjusting for comorbidities and comedications. RESULTS The aOR (95% CI) for the concurrent use of benzodiazepines and opioids was 1.45 (1.22-1.71), compared with those of non-use within 30 days before the index date. The aOR was 1.65 (1.22-2.23) in patients who were continuously receiving benzodiazepines and were newly initiated with concurrent opioids. The aORs for concurrent use were 1.95 (1.39-2.74) and 1.27 (1.03-1.56) in the case of hip fracture and forearm fracture, respectively. CONCLUSION The concurrent use of benzodiazepines and opioids was associated with an increased risk of fractures in older patients with chronic non-cancer pain. Therefore, patients continuously receiving benzodiazepines in whom opioids are newly initiated need careful monitoring, and such combined therapy should be limited to the shortest duration possible.
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Affiliation(s)
- Ye-Jin Kang
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Min-Taek Lee
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Myo-Song Kim
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Seung-Hun You
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Jae-Eun Lee
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Joo-Hyeon Eom
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Sun-Young Jung
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea.
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Selvi I, Arik AI, Baydilli N, Basay MS, Basar H. Evaluation of comorbidity indices in determining the most suitable candidates for uro-oncological surgeries in elderly men. Cent European J Urol 2021; 74:24-38. [PMID: 33976912 PMCID: PMC8097655 DOI: 10.5173/ceju.2021.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/01/2020] [Accepted: 02/10/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction We aimed to evaluate the superiority of different comorbidity indices in determining the most suitable elderly male candidates for uro-oncological operations. While making this assessment, we also aimed to determine the risk factors that may affect surgery-related major complications and overall survival. Material and methods Data of 543 male patients, 60 years or older, who underwent uro-oncological surgery (radical cystectomy, radical prostatectomy, radical or partial nephrectomy, transurethral resection of bladder tumor) between September 2009 and January 2019 were retrospectively evaluated. Demographic, clinical and pathological characteristics of the patients, preoperative comorbidity indices, postoperative complications, length of hospitalization, re-admission rates within 90 days and postoperative follow-up outcomes were recorded. Patients in similar tumor stages were divided into different subgroups. All subgroups were divided into two main categories: middle age (60-69 years-old) and elderly age (≥70-years-old). Results No significant difference was found for all types of surgery in terms of postoperative outcomes in both age groups (p >0.05). Age-adjusted Charlson Comorbidity Index (ACCI), Preoperative Score to Predict Postoperative Mortality (POSPOM), Rockwood Frailty Index (RFI) and tumor characteristics were found to be more significant predictors for postoperative major complications and overall mortality than Eastern Cooperative Oncology Group (ECOG), American Society of Anesthesiologists (ASA) and New York Heart Association (NYHA) functional classification. Conclusions Our findings show that patient age alone is not a risk factor for increased postoperative complications and overall mortality. Although many different comorbidity indices have been used in urological practice, ACCI, POSPOM and RFI are more valuable predictors. Uro-oncological surgeries may be performed safely in elderly males after a good clinical decision based on these indices.
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Affiliation(s)
- Ismail Selvi
- Başakşehir Çam ve Sakura City Hospital, Department of Urology, Istanbul, Turkey
| | - Ali Ihsan Arik
- Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - Numan Baydilli
- Erciyes University Medical School, Department of Urology, Kayseri, Turkey
| | - Mehmet Sinan Basay
- Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - Halil Basar
- Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Urology, Ankara, Turkey
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Zhang X, Li X, Yu Q, Ma J, Zeng X, Xue L. Morbidity and All-Cause Mortality Following Radical Prostatectomy Compared with Observation for Localized Prostate Cancer in Chinese Men: A Non-Randomized Retrospective Study. Med Sci Monit 2021; 27:e928596. [PMID: 33612711 PMCID: PMC7908412 DOI: 10.12659/msm.928596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The Chinese 2018 guidelines and the current 2014 Chinese Urological Association guidelines for prostate cancer recommend radical prostatectomy for Chinese men with localized prostate cancer as the first choice, but it has treatment-related adverse effects. This study aimed to study morbidity and all-cause mortality following radical prostatectomy compared with observation for localized prostate cancer in Chinese men from a single center. MATERIAL AND METHODS Men diagnosed (histologically) as stage T1-T2N×M0 prostate cancer of any grade with 1-year history were included in the analysis. A total of 201 men underwent radical prostatectomy (RP cohort) and 209 men did not undergo radical prostatectomy (OS cohort). RESULTS During follow-up (17-24 years), 135 (67%) men died in the RP cohort and 156 (75%) men died in the OS cohort (P=0.103). All-cause mortality was lower for men with prostate-specific antigen level >10 ng/mL (P<0.0001), Gleason score ≥7 (P=0.004), and high D'Amico tumor risk scores (P=0.007) if they underwent radical prostatectomy. Age ≥65 years (P=0.041), Gleason score ≥7 (P=0.049), and tumor stage ≥2c (P=0.045) were associated with all-cause mortality. CONCLUSIONS The findings from this study showed that radical prostatectomy has no significant beneficial effects when compared with observation for Chinese men with localized prostate cancer, unless they had a prostate-specific antigen level >10 ng/mL, Gleason score ≥7, and high D'Amico tumor risk scores.
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Affiliation(s)
- Xi Zhang
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Xiang Li
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Qiwei Yu
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Jun Ma
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Xuemin Zeng
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Li Xue
- Department of Urology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
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Goto S, Arimoto J, Higurashi T, Takahashi K, Ohkubo N, Kawamura N, Tamura T, Tomonari H, Iwasaki A, Taniguchi L, Chiba H, Atsukawa K, Saigusa Y, Nakajima A. Efficacy and safety of colorectal endoscopic submucosal dissection in patients with sarcopenia. Surg Endosc 2020; 35:5489-5496. [PMID: 32989535 DOI: 10.1007/s00464-020-08041-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) for early-stage colorectal cancer (CRC) has become a common and useful treatment. Although sarcopenia has been identified as an independent risk factor for complications after surgery for CRC, whether sarcopenia is also an independent risk factor for complications after colorectal ESD remains to be clarified. The aim of this study was to compare the outcomes of colorectal ESD in patients with and those without sarcopenia. METHODS This is a retrospective cohort study. A total of 334 patients underwent colorectal ESD for 361 neoplasms at Hiratsuka City Hospital from March 2012 to October 2018. The neoplasms were divided into two groups depending on the presence or absence of sarcopenia in the patients. RESULTS Overall, 334 patients underwent colorectal ESD for 361 neoplasms during the study period. We excluded 90 patients (90 neoplasms), and 244 patients (277 neoplasms) were included in the final analysis (134 from the sarcopenia group, 137 from the non-sarcopenia group). The en-bloc resection rate was high and was not significantly different between the sarcopenia group [126/134 (94.1%)] and the non-sarcopenia group [133/137 (97.1%)], P = 0.1778). The rate of perforation and the rate of delayed bleeding were not significantly different between the sarcopenia group and the non-sarcopenia group [6/134 (4.5%) vs. 9/137 (6.6%), P = 0.314, 4/134 (3%) vs. 6/137 (4.4%), P = 0.3885, respectively]. CONCLUSIONS The presence of sarcopenia did not influence the rate of complications after ESD. Colorectal ESD is safe and effective even in patients with sarcopenia. Prospective multicenter studies are necessary to confirm our results.
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Affiliation(s)
- Shungo Goto
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Jun Arimoto
- Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kota Takahashi
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Naoki Ohkubo
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Nobuyoshi Kawamura
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Tetsuya Tamura
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Hisakuni Tomonari
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Akito Iwasaki
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Leo Taniguchi
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Hideyuki Chiba
- Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
| | - Kazuhiro Atsukawa
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
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Predictive Value of the Age-Adjusted Charlson Comorbidity Index for Outcomes After Hepatic Resection of Hepatocellular Carcinoma. World J Surg 2020; 44:3901-3914. [PMID: 32651603 DOI: 10.1007/s00268-020-05686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to evaluate the impact of the age-adjusted Charlson comorbidity index (ACCI) on outcomes after hepatic resection for hepatocellular carcinoma (HCC). METHODS We assessed 763 patients who underwent hepatic resection for HCC. The ACCI scores were categorized as follows: ACCI ≤ 5, ACCI = 6, and ACCI ≥ 7. RESULTS A multivariate analysis showed that the odds ratios for postoperative complications in ACCI = 6 and ACCI ≥ 7 groups, with reference to ACCI ≤ 5 group, were 0.71 (p = 0.41) and 4.15 (p < 0.001), respectively. The hazard ratios for overall survival of ACCI = 6 and ACCI ≥ 7 groups, with reference to ACCI ≤ 5 group, were 1.52 (p = 0.023) and 2.45 (p < 0.001), respectively. The distribution of deaths due to HCC-related, liver-related, and other causes was 68.2%, 11.8%, and 20% in ACCI ≤ 5 group, 47.2%, 13.9%, and 38.9% in ACCI = 6 group, and 27.3%, 9.1%, and 63.6% in ACCI ≥ 7 group (p = 0.053; ACCI ≤ 5 vs. = 6, p = 0.19; ACCI = 6 vs. ≥ 7, p < 0.001; ACCI ≤ 5 vs. ≥ 7). In terms of the treatment for HCC recurrence in ACCI ≤ 5, ACCI = 6, and ACCI ≥ 7 groups, adaptation rate of surgical resection was 20.1%, 7.3%, and 11.1% and the rate of palliative therapy was 4.3%, 12.2%, and 22.2%, respectively. CONCLUSIONS The ACCI predicted the short-term and long-term outcomes after hepatic resection of HCC. These findings will help physicians establish a treatment strategy for HCC patients with comorbidities.
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Rosiello G, Palumbo C, Knipper S, Deuker M, Stolzenbach LF, Tian Z, Gandaglia G, Fossati N, Montorsi F, Shariat SF, Saad F, Briganti A, Karakiewicz PI. Preoperative frailty predicts adverse short-term postoperative outcomes in patients treated with radical prostatectomy. Prostate Cancer Prostatic Dis 2020; 23:573-580. [DOI: 10.1038/s41391-020-0225-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/30/2022]
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10
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Rosiello G, Palumbo C, Deuker M, Stolzenbach LF, Tian Z, Larcher A, Capitanio U, Montorsi F, Shariat SF, Kapoor A, Saad F, Briganti A, Karakiewicz PI. Preoperative frailty predicts adverse short‐term postoperative outcomes in patients treated with radical nephroureterectomy. J Surg Oncol 2020; 121:688-696. [DOI: 10.1002/jso.25840] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/03/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Giuseppe Rosiello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
- Department of Urology and Division of Experimental OncologyURI, Urological Research Institute, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Carlotta Palumbo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
- Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical SpecialtiesRadiological Science and Public Health, University of Brescia Brescia Italy
| | - Marina Deuker
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
- Department of UrologyUniversity Hospital Frankfurt Frankfurt am Main Germany
| | - Lara Franziska Stolzenbach
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
- Martini‐Klinik Prostate Cancer Center, University Hospital Hamburg‐Eppendorf Hamburg Germany
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
| | - Alessandro Larcher
- Department of Urology and Division of Experimental OncologyURI, Urological Research Institute, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Umberto Capitanio
- Department of Urology and Division of Experimental OncologyURI, Urological Research Institute, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Francesco Montorsi
- Department of Urology and Division of Experimental OncologyURI, Urological Research Institute, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Shahrokh F. Shariat
- Department of UrologyComprehensive Cancer Center, Medical University of Vienna Vienna Austria
- Institute of Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University Moscow Russia
| | - Anil Kapoor
- Division of Urology, Department of SurgeryJuravinski Cancer Centre, McMaster University Hamilton Ontario Canada
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
| | - Alberto Briganti
- Department of Urology and Division of Experimental OncologyURI, Urological Research Institute, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal Quebec Canada
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Calleris G, Marra G, Dalmasso E, Falcone M, Karnes RJ, Morlacco A, Oderda M, Sanchez-Salas R, Soria F, Gontero P. Is it worth to perform salvage radical prostatectomy for radio-recurrent prostate cancer? A literature review. World J Urol 2019; 37:1469-1483. [DOI: 10.1007/s00345-019-02749-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/28/2019] [Indexed: 12/01/2022] Open
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12
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Hah YS, Lee KS, Choi IY, Lee JY, Hong JH, Kim CS, Lee HM, Hong SK, Byun SS, Lee SH, Rha KH, Chung BH, Koo KC. Effects of age and comorbidity on survival vary according to risk grouping among patients with prostate cancer treated using radical prostatectomy: A retrospective competing-risk analysis from the K-CaP registry. Medicine (Baltimore) 2018; 97:e12766. [PMID: 30334964 PMCID: PMC6211932 DOI: 10.1097/md.0000000000012766] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A multicenter Korean Prostate Cancer Database (K-CaP) has been established to provide information regarding Korean patients with prostate cancer (PCa). We used the K-CaP registry to investigate the value of age and comorbidity for predicting cancer-specific mortality (CSM) and other-cause mortality (OCM) according to risk grouping.The K-CaP registry includes 2253 patients who underwent radical prostatectomy (RP) between May 2001 and April 2013 at 5 institutions. Preoperative clinicopathologic data were collected and stratified according to the National Comprehensive Cancer Network risk criteria. Survival was evaluated using Gray's modified log-rank test according to risk category, age (<70 years vs ≥70 years), and Charlson comorbidity index (CCI) (0 vs ≥1).The median follow-up was 55.0 months (interquartile range: 42.0-70.0 months). Competing-risk regression analysis revealed that, independent of CCI, ≥70-year-old high-risk patients had significantly greater CSM than <70-year-old high-risk patients (P = .019). However, <70-year-old high-risk patients with a CCI of ≥1 had similar CSM relative to ≥70-year-old patients. Survival was not affected by age or CCI among low-risk or intermediate-risk patients. Multivariate analysis revealed that a CCI of ≥1 was independently associated with a higher risk of CSM (P = .003), while an age of ≥70 years was independently associated with a higher risk of OCM (P = .005).Age and comorbidity were associated with survival after RP among patients with high-risk PCa, although these associations were not observed among low-risk or intermediate-risk patients. Therefore, older patients with high-risk diseases and greater comorbidity may require alternative multidisciplinary treatment.
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Affiliation(s)
- Yoon Soo Hah
- Department of Urology, Yonsei University College of Medicine
| | - Kwang Suk Lee
- Department of Urology, Yonsei University College of Medicine
| | | | - Ji Youl Lee
- Department of Urology, The Catholic University of Korea College of Medicine
| | - Jun Hyuk Hong
- Department of Urology, University of Ulsan College of Medicine
| | - Choung-Soo Kim
- Department of Urology, University of Ulsan College of Medicine
| | - Hyun Moo Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Hwan Lee
- Department of Urology, Yonsei University College of Medicine
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine
| | - Byung Ha Chung
- Department of Urology, Yonsei University College of Medicine
| | - Kyo Chul Koo
- Department of Urology, Yonsei University College of Medicine
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Ryu JH, Kim SJ, Kim YB, Jung TY, Ko WJ, Kim SI, Kim DY, Oh TH, Moon KT, Cho HJ, Cho JM, Yoo TK. Radical prostatectomy for clinically localized prostate cancer in patients aged 75 years or older: comparison with primary androgen deprivation therapy. Aging Male 2018; 21:17-23. [PMID: 28828908 DOI: 10.1080/13685538.2017.1365122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To determine whether radical prostatetomy (RP) is suitable for prostate cancer patients with age ≥75 years in comparison to primary androgen deprivation therapy (PADT). PATIENTS AND METHODS A cohort study was conducted in clinically localized prostate cancer patients with ≥75 years of age who underwent RP or PADT at six institutions from 2005 to 2013. Patients who had less than 12 months of follow-up, or received neoadjuvant or adjuvant therapy were excluded. We compared clinical characteristics, cancer-specific and overall survivals, and post-treatment complication rates between two groups. RESULTS We included 92 and 99 patients in the RP and PADT groups, respectively. In survival analyses, there were no significant differences in cancer-specific and overall survivals (p = .302 and .995, respectively). The incidence of serious adverse events (cardio- or cerebrovascular event, or bone fracture) was higher in the PADT group (p = .001). Multivariable analysis showed that PADT had a worse effect on the serious adverse events (OR 10.12, p = .038). CONCLUSIONS In selected elderly patients, RP was safe and effective for treatment of localized prostate cancer, as compared to PADT. Surgical treatment options should be considered in elderly patients with respect to life expectancy, rather than chronological age.
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Affiliation(s)
- Jae Hyun Ryu
- a Department of Urology , Veterans Health Service Medical Center , Seoul , Republic of Korea
| | - Sang Jin Kim
- a Department of Urology , Veterans Health Service Medical Center , Seoul , Republic of Korea
| | - Yun Beom Kim
- a Department of Urology , Veterans Health Service Medical Center , Seoul , Republic of Korea
| | - Tae Young Jung
- a Department of Urology , Veterans Health Service Medical Center , Seoul , Republic of Korea
| | - Woo Jin Ko
- b Department of Urology, National Health Insurance Corporation Ilsan Hospital , Goyang , Republic of Korea
| | - Sun Il Kim
- c Department of Urology, Ajou University School of Medicine , Suwon , Republic of Korea
| | - Duk Yoon Kim
- d Department of Urology, Catholic University of Daegu School of Medicine , Daegu , Republic of Korea
| | - Tae Hee Oh
- e Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine , Changwon , Republic of Korea
| | - Kyong Tae Moon
- f Department of Urology, Eulji General Hospital, Eulji University School of Medicine , Seoul , Republic of Korea
| | - Hee Ju Cho
- f Department of Urology, Eulji General Hospital, Eulji University School of Medicine , Seoul , Republic of Korea
| | - Jeong Man Cho
- f Department of Urology, Eulji General Hospital, Eulji University School of Medicine , Seoul , Republic of Korea
| | - Tag Keun Yoo
- f Department of Urology, Eulji General Hospital, Eulji University School of Medicine , Seoul , Republic of Korea
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