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McVey A, Chen D, Snow H, Chan P, Kashyap R, Kelly B. 'Case of the Month' from Peter MacCallum Cancer Centre, Melbourne, Australia: insidious presentation of iatrogenic renal pelvis injury following ureteric cannulation with 5-F catheter diagnosed on unconventional mercaptoacetyltriglycine and single-photon emission computed tomography imaging. BJU Int 2024; 133:532-535. [PMID: 38148570 DOI: 10.1111/bju.16256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Affiliation(s)
- Aoife McVey
- Department of Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Nuclear Medicine, Cancer Imaging Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David Chen
- Department of Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Nuclear Medicine, Cancer Imaging Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Hayden Snow
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Philip Chan
- Department of Radiology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Raghava Kashyap
- Department of Nuclear Medicine, Cancer Imaging Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Radiology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Brian Kelly
- Department of Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Eapen RS, Buteau JP, Jackson P, Mitchell C, Oon SF, Alghazo O, McIntosh L, Dhiantravan N, Scalzo MJ, O'Brien J, Sandhu S, Azad AA, Williams SG, Sharma G, Haskali MB, Bressel M, Chen K, Jenjitranant P, McVey A, Moon D, Lawrentschuk N, Neeson PJ, Murphy DG, Hofman MS. Administering [ 177Lu]Lu-PSMA-617 Prior to Radical Prostatectomy in Men with High-risk Localised Prostate Cancer (LuTectomy): A Single-centre, Single-arm, Phase 1/2 Study. Eur Urol 2024; 85:217-226. [PMID: 37891072 DOI: 10.1016/j.eururo.2023.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND High-risk localised prostate cancer (HRCaP) has high rates of biochemical recurrence; [177Lu]Lu-PSMA-617 is effective in men with advanced prostate cancer. OBJECTIVE To investigate the dosimetry, safety, and efficacy of upfront [177Lu]Lu-PSMA-617 in men with HRCaP prior to robotic radical prostatectomy (RP). DESIGN, SETTING, AND PARTICIPANTS In this single-arm, phase I/II trial, we recruited men with HRCaP (any of prostate-specific antigen [PSA] >20 ng/ml, International Society of Urological Pathology (ISUP) grade group [GG] 3-5, and ≥cT2c), with high tumour uptake on [68Ga]Ga-PSMA-11 positron emission tomography/computed tomography (PSMA PET/CT), and scheduled for RP. INTERVENTION Cohort A (n = 10) received one cycle and cohort B (n = 10) received two cycles of [177Lu]Lu-PSMA-617 (5 GBq) followed by surgery 6 weeks later. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was tumour radiation absorbed dose. Adverse events (AEs; Common Terminology Criteria for Adverse Events (CTCAE) version 5.0), surgical safety (Clavien-Dindo), imaging, and biochemical responses were evaluated (ClinicalTrials.gov: NCT04430192). RESULTS AND LIMITATIONS Between May 29, 2020 and April 28, 2022, 20 patients were enrolled. The median PSA was 18 ng/ml (interquartile range [IQR] 11-35), Eighteen (90%) had GG ≥3, and six (30%) had N1 disease. The median (IQR) highest tumour radiation absorbed dose after cycle 1 for all lesions was 35.5 Gy (19.5-50.1), with 19.6 Gy (11.3-48.4) delivered to the prostate. Five patients received radiation to lymph nodes. Nine (45%) patients achieved >50% PSA decline. The most common AEs related to [177Lu]Lu-PSMA-617 were grade 1 fatigue in eight (40%), nausea in seven (35%), dry mouth in six (30%), and thrombocytopenia in four (20%) patients. No grade 3/4 toxicities or Clavien 3-5 complications occurred. Limitations include small a sample size. CONCLUSIONS In men with HRCaP and high prostate-specific membrane antigen (PSMA) expression, [177Lu]Lu-PSMA-617 delivered high levels of targeted radiation doses with few toxicities and without compromising surgical safety. Further studies of [177Lu]Lu-PSMA-617 in this population are worthwhile to determine whether meaningful long-term oncological benefits can be demonstrated. PATIENT SUMMARY In this study, we demonstrate that up to two cycles of [177Lu]Lu-PSMA-617 given prior to radical prostatectomy in patients with high-risk localised prostate cancer are safe and deliver targeted doses of radiation to tumour-affected tissues. It is tolerated well with minimal treatment-related adverse events, and surgery is safe with a low rate of complications. Activity measured through PSA reduction, repeat PSMA PET/CT, and histological response is promising.
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Affiliation(s)
- Renu S Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | - James P Buteau
- Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Price Jackson
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Catherine Mitchell
- Department of Anatomical Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sheng F Oon
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Omar Alghazo
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lachlan McIntosh
- Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nattakorn Dhiantravan
- Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Mark J Scalzo
- Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jonathan O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Shahneen Sandhu
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Arun A Azad
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Scott G Williams
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Gaurav Sharma
- Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Mohammad B Haskali
- Radiopharmaceutical Research Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Mathias Bressel
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Kenneth Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Daniel Moon
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Paul J Neeson
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Michael S Hofman
- Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
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Chen DC, McVey A, Murphy DG, Eapen R, Lawrentschuk N. Re: Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence (NOSTONE). Eur Urol 2023; 84:353-354. [PMID: 37236856 DOI: 10.1016/j.eururo.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Affiliation(s)
- David C Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Young Urological Researchers Organisation, Heidelberg, Australia
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Renu Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, Australia.
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Chen K, O'Brien J, McVey A, Jenjitranant P, Kelly BD, Kasivisvanathan V, Lawrentschuk N, Murphy DG, Azad AA. Combination treatment in metastatic prostate cancer: is the bar too high or have we fallen short? Nat Rev Urol 2023; 20:116-123. [PMID: 36509970 DOI: 10.1038/s41585-022-00669-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 12/14/2022]
Abstract
Androgen deprivation therapy (ADT) alone has been the cornerstone of treatment for patients with newly diagnosed metastatic prostate cancer for the past century. Based on results from landmark trials in the past decade, combination approaches of ADT with chemotherapy or novel hormonal agents have established a new standard of care for these patients. This paradigm shift in treatment has been reflected in the updates to guideline recommendations of major professional associations. However, real-world data from around the world have highlighted the dismal adoption of combination therapy, despite evidence-based recommendations. The disparity between evidence and practice is concerning, especially with emerging evidence of survival benefit with further treatment intensification using triplet combinations (ADT, docetaxel and novel hormonal agents). Thus, a pressing need to raise awareness and call the uro-oncology community to action exists to deliver evidence-based care for these patients.
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Affiliation(s)
- Kenneth Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Urology, Singapore General Hospital, Singapore, Singapore
| | - Jonathan O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Brian D Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Nathan Lawrentschuk
- Department of Urology, Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- EJ Whitten Prostate Cancer Research Centre at Epworth, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
| | - Arun A Azad
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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O'Brien JS, McVey A, Kelly BD, Chee J, Lawrentschuk N. Recent developments in the diagnosis and management of N1 penile cancer. Curr Opin Urol 2023; 33:64-69. [PMID: 36444651 DOI: 10.1097/mou.0000000000001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW This article presents a critical review of the current literature to provide a brief update on the contemporary advances in diagnosing and managing N1 penile cancer. RECENT FINDINGS Penile squamous cell carcinoma (pSCC) has evolved from being an orphan field for cancer innovation. Advances in the understanding tumour biology have enabled sophisticated diagnostics and predictive modelling to better characterize inguinal disease. Minimally invasive inguinal lymph node dissection is emerging as a technique that reduces morbidity while maintaining oncological safety. Furthermore, robust clinical trials are underway ,which will provide level one evidence to guide treatment decisions. Exciting advances in the field of immune-oncology offer promise as adjuvant therapies. International collaboration and centralisation of care will be essential to driving translational research and equitable evidence-based care. SUMMARY Improving outcomes for men with pSCC remains a global challenge. Radical inguinal lymph node dissection remains the gold standard for diagnosing and curing N1 disease. Although many promising developments are on the horizon, high-level evidence is required to guide therapy.
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Affiliation(s)
- Jonathan S O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Peter MacCallum Cancer Centre
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
| | - Brian D Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, Eastern Health
| | - Justin Chee
- MURAC Health, East Melbourne
- Department of Urology, Alfred Health
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Victoria, Australia
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Williams ISC, McVey A, Perera S, O’Brien JS, Kostos L, Chen K, Siva S, Azad AA, Murphy DG, Kasivisvanathan V, Lawrentschuk N, Frydenberg M. Modern paradigms for prostate cancer detection and management. Med J Aust 2022; 217:424-433. [PMID: 36183329 PMCID: PMC9828197 DOI: 10.5694/mja2.51722] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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] [Received: 05/19/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 01/11/2023]
Abstract
Early detection and management of prostate cancer has evolved over the past decade, with a focus now on harm minimisation and reducing overdiagnosis and overtreatment, given the proven improvements in survival from randomised controlled trials. Multiparametric magnetic resonance imaging (mpMRI) is now an important aspect of the diagnostic pathway in prostate cancer, improving the detection of clinically significant prostate cancer, enabling accurate localisation of appropriate sites to biopsy, and reducing unnecessary biopsies in most patients with normal magnetic resonance imaging scans. Biopsies are now performed transperineally, substantially reducing the risk of post-procedure sepsis. Australian-led research has shown that prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has superior accuracy in the staging of prostate cancer than conventional imaging (CT and whole-body bone scan). Localised prostate cancer that is low risk (International Society for Urological Pathology [ISUP] grade 1, Gleason score 3 + 3 = 6; and ISUP grade group 2, Gleason score 3 + 4 = 7 with less than 10% pattern 4) can be offered active surveillance, reducing harms from overtreatment. Prostatectomy and definitive radiation remain the gold standard for localised intermediate and high risk disease. However, focal therapy is an emerging experimental treatment modality in Australia in carefully selected patients. The management of advanced prostate cancer treatment has evolved to now include several novel agents both in the metastatic hormone-sensitive and castration-resistant disease settings. Multimodal therapy with androgen deprivation therapy, additional systemic therapy and radiotherapy are often recommended. PSMA-based radioligand therapy has emerged as a treatment option for metastatic castration-resistant prostate cancer and is currently being evaluated in earlier disease states.
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Affiliation(s)
| | | | | | - Jonathan S O’Brien
- Peter MacCallum Cancer CentreMelbourneVIC,University of MelbourneMelbourneVIC
| | | | - Kenneth Chen
- Peter MacCallum Cancer CentreMelbourneVIC,Singapore General HospitalSingaporeSingapore
| | - Shankar Siva
- Peter MacCallum Cancer CentreMelbourneVIC,University of MelbourneMelbourneVIC
| | - Arun A Azad
- Peter MacCallum Cancer CentreMelbourneVIC,University of MelbourneMelbourneVIC
| | - Declan G Murphy
- Peter MacCallum Cancer CentreMelbourneVIC,University College LondonLondonUnited Kingdom
| | - Veeru Kasivisvanathan
- Peter MacCallum Cancer CentreMelbourneVIC,University College LondonLondonUnited Kingdom
| | | | - Mark Frydenberg
- Monash UniversityMelbourneVIC,Cabrini Institute, Cabrini HealthMelbourneVIC
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O'Brien JS, McVey A, Kelly BD, Jenjitranant P, Buteau J, Hoffman M, Kasivisvanithan V, Eapen R, Moon D, Murphy DG, Lawrentschuk N. PSMA PET-CT Funding Grants Free Access to Superior Staging for Australian Men with Prostate Cancer. BJU Int 2022; 130 Suppl 3:8-10. [PMID: 35574991 DOI: 10.1111/bju.15773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan S O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.,Department of Urology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Brian D Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | | | - James Buteau
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michael Hoffman
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Veeru Kasivisvanithan
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC) and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Vic, 3000, Australia
| | - Renu Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Daniel Moon
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Urology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Australia
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Chen K, O'Brien J, McVey A, Kasivisvanathan V, Murphy DG. Re: Armando Stabile, Antony Pellegrino, Elio Mazzone, et al. Can Negative Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Avoid the Need for Pelvic Lymph Node Dissection in Newly Diagnosed Prostate Cancer Patients? A Systematic Review and Meta-analysis with Backup Histology as Reference Standard. Eur Urol Oncol 2022;5:1-17. Eur Urol Oncol 2022; 5:375-376. [PMID: 35331682 DOI: 10.1016/j.euo.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Kenneth Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Urology, Singapore General Hospital, Singapore
| | - Jonathan O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
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Chen K, McVey A, Kasivisvanathan V, Jenjitranant P, Azad A, Murphy DG. Re: Darolutamide and Survival in Metastatic, Hormone-sensitive Prostate Cancer. Eur Urol 2022; 82:146-147. [DOI: 10.1016/j.eururo.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
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O'Connor E, McVey A, Demkiw S, Lawrentschuk N, Murphy DG. Assessment and management of haematuria in the general practice setting. Aust J Gen Pract 2021; 50:467-471. [PMID: 34189542 DOI: 10.31128/ajgp-03-21-5892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The presence of haematuria may be a singular symptom signalling underlying urological pathology, either benign or malignant. However, a large proportion of patients with haematuria will have no identifiable cause found. Appropriate early investigation and management of haematuria in the primary care setting is important for timely referral of patients suspected of having serious underlying pathology while avoiding over-investigation in those patients prone to transient and benign causes. OBJECTIVE The aim of this article is to provide a summary of the aetiology, investigation and management of haematuria in the primary care setting, with a focus on urological assessment and outcomes. DISCUSSION The approach to the diagnosis and investigation of haematuria differs depending on whether the haematuria is macro- or microscopic. In both cases, clinicians should begin by obtaining a careful patient history to include specific risk factors for urological malignancy, as often the decision for further work-up requires a risk-stratified approach.
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Affiliation(s)
- Ellen O'Connor
- MBBS, Urology Registrar, Western Health, Vic; Urology Research Fellow, Peter MacCallum Cancer Centre, Vic; Urology Research Fellow, Austin Health, Vic
| | - Aoife McVey
- MBBS, Urology Research Fellow, Austin Health, Vic
| | - Stephanie Demkiw
- MBBS, BBiomedSc, General Practitioner, Access Health and Community, Hawthorn, Vic; Co-Founder, Bladder Cancer Awareness Australia; Board member, World Bladder Cancer Patient Coalition, Brussels, BE
| | - Nathan Lawrentschuk
- MBBS, PhD, FRACS Urol, Director, Royal Melbourne Hospital, Department of Urology, Vic; Director, EJ Whitten Prostate Cancer Research Centre at Epworth, Vic; Urologic Oncologist, Peter MacCallum Cancer Centre, Vic
| | - Declan G Murphy
- MBBCh, BaO, FRACS, FRCS Urol, Director of Genitourinary Oncology, Peter MacCallum Cancer Centre, Vic
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McVey A, Ong S. Working in the Time of a Pandemic - an Australian experience from Junior Doctors and YURO. BJU Int 2021; 127:742. [PMID: 34096165 PMCID: PMC8206913 DOI: 10.1111/bju.15437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aoife McVey
- Austin Health & North Eastern Urology, Young Urology Researchers Organisation (YURO), Melbourne, Vic., Australia
| | - Sean Ong
- EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, and President, Young Urology Researchers Organisation (YURO), Melbourne, Vic., Australia
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McVey A, Qu LG, Chan G, Perera M, Brennan J, Chung E, Gani J. What a mesh! An Australian experience using national female continence surgery trends over 20 years. World J Urol 2021; 39:3931-3938. [PMID: 33837448 DOI: 10.1007/s00345-021-03691-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/30/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To review the evolution of female continence surgical practice in Australia over the last 20 years and observe whether vaginal mesh controversies impacted these trends. MATERIALS AND METHODS From January 2000 to December 2019, medicare benefit schedule codes for female continence procedures were identified and extracted for: mesh sling, fascial sling, bulking agent, female urethral prosthesis, colposuspension, and removal of sling. Population-adjusted incidences per 100,000 persons were calculated using publicly available demographic data. Three discrete phases were defined over the study time frame for analysis: 2000-2006; 2006-2017, and 2017-2019. Interrupted time-series analyses were conducted to assess for impact on incidence at 2006 and 2017. RESULTS There were 119,832 continence procedures performed in Australia from 2000 to 2019, with the mid-urethral sling (MUS) the most common (72%). The majority of mesh (n = 63,668, 73%) and fascial sling (n = 1864, 70%) procedures were in women aged < 65 years. Rates of mesh-related procedures steeply declined after 2017 (initial change: -21 cases per 100,000; subsequent rate change: -12 per 100,000, p < 0.001). Non-mesh related/bulking agents increased from + 0.34 during 2006-2017 to + 2.1 per 100,000 after 2017 (p < 0.001). No significant change in mesh extraction was observed over 2006-2017 (+ 0.06 per 100,000, p = 0.192). There was a significant increase in mesh extraction procedures after 2017 (0.83 per 100,000, p < 0.001). CONCLUSION Worldwide, controversy surrounding vaginal mesh had a significant impact on Australian continence surgery trends. The most standout trends were observed after the 2017 Australian class-action lawsuit and Senate Inquiry.
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Affiliation(s)
- Aoife McVey
- Department of Urology, Austin Health, Melbourne, VIC, Australia
| | - Liang G Qu
- Department of Urology, Austin Health, Melbourne, VIC, Australia
| | - Garson Chan
- Department of Urology, Austin Health, Melbourne, VIC, Australia
- Division of Urology, Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - Marlon Perera
- Department of Urology, Austin Health, Melbourne, VIC, Australia.
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
| | - Janelle Brennan
- Department of Urology, Bendigo Health, Bendigo, VIC, Australia
| | - Eric Chung
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Johan Gani
- Department of Urology, Austin Health, Melbourne, VIC, Australia
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McVey A, Rahiman IF, Chiu Y. 15. Is Certolizumab a better option in treatment of psoriatic patients with active joint and skin involvement? Rheumatol Adv Pract 2017. [PMCID: PMC6652631 DOI: 10.1093/rap/rkx006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | - Yeeho Chiu
- Wirral University Teaching Hospital NHS Trust, Wirral
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McVey A, Crain J. Nonlinear optical methods for cellular imaging and localization. Methods 2014; 68:371-7. [PMID: 24704357 DOI: 10.1016/j.ymeth.2014.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 10/25/2022] Open
Abstract
Of all the ways in which complex materials (including many biological systems) can be explored, imaging is perhaps the most powerful because delivering high information content directly. This is particular relevant in aspects of cellular localization where the physical proximity of molecules is crucial in biochemical processes. A great deal of effort in imaging has been spent on enabling chemically selective imaging so that only specific features are revealed. This is almost always achieved by adding fluorescent chemical labels to specific molecules. Under appropriate illumination conditions only the molecules (via their labels) will be visible. The technique is simple and elegant but does suffer from fundamental limitations: (1) the fluorescent labels may fade when illuminated (a phenomenon called photobleaching) thereby constantly decreasing signal contrast over the course of image acquisition. To combat photobleaching one must reduce observation times or apply unfavourably low excitation levels all of which reduce the information content of images; (2) the fluorescent species may be deactivated by various environmental factors (the general term is fluorescence quenching); (3) the presence of fluorescent labels may introduce unexpected complications or may interfere with processes of interest (4) Some molecules of interest cannot be labelled. In these circumstances we require a fundamentally different strategy. One of the most promising alternative is based on a technique called Coherent Anti-Stokes Raman scattering (CARS). CARS is a fundamentally more complex process than is fluorescence and the experimental procedures and optical systems required to deliver high quality CARS images are intricate. However, the rewards are correspondingly very high: CARS probes the chemically distinct vibrations of the constituent molecules in a complex system and is therefore also chemically selective as are fluorescence-based methods. Moreover,the potentially severe problems of fluorescence bleaching and quenching are circumvented and high-resolution three dimensional images can be obtained on completely unlabelled specimens. We review here aspects of CARS and Multiphoton fluorescence techniques to cellular localization and measurement.
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Affiliation(s)
- A McVey
- School of Physics, The University of Edinburgh, EH9 3JZ Scotland, United Kingdom
| | - J Crain
- School of Physics, The University of Edinburgh, EH9 3JZ Scotland, United Kingdom; National Physical Laboratory Teddington, TW11 0LW, United Kingdom.
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15
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Dimachkie M, Estephan Dajdaj B, Barohn R, Herbelin L, Pasnoor M, McVey A. 49. Sporadic inclusion body myositis: A case cohort. Clin Neurophysiol 2012. [DOI: 10.1016/j.clinph.2011.11.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Wang Y, He J, McVey A, Pasnoor M, Gallagher P, Herbelin L, Statland J, Miller A, Greensmith L, Machado P, Hanna M, Barohn R, Dimachkie M. Twelve-Month Change of IBMFRS in the Arimocolomol Inclusion Body Myositis Pilot Study (P07.225). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Amato AA, McVey A, Cha C, Matthews EC, Jackson CE, Kleingunther R, Worley L, Cornman E, Kagan-Hallet K. Evaluation of neuromuscular symptoms in veterans of the Persian Gulf War. Neurology 1997; 48:4-12. [PMID: 9008485 DOI: 10.1212/wnl.48.1.4] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To comprehensively evaluate complaints of muscle fatigue, weakness, and myalgias in Persian Gulf veterans (PGV). BACKGROUND Approximately 700,000 American troops were deployed to the Persian Gulf during Desert Shield and Desert Storm. Upon return from the Gulf, some PGV developed unexplained illnesses, and special referral centers were established for the evaluation of these patients. Among the most common symptoms of these PGV are fatigue, weakness, and myalgias. An Institute of Medicine committee recommended further exploration into the possible etiologies of these complaints. METHODS Twenty PGV with severe muscle fatigue, weakness, or myalgias that interfered with their daily activities were referred for an extensive prospective neuromuscular evaluation. Routine laboratory studies included serum creatine kinase (CK), erythrocyte sedimentation rate, thyroid function tests, and exercise forearm tests. All patients received nerve conduction studies (NCS), repetitive nerve stimulation, quantitative and single-fiber electromyography (EMG), and muscle biopsies. RESULTS Manual muscle strength examinations were normal in all patients. Six patients had mildly elevated CKs (range 223 to 768 IU/l); otherwise, laboratory tests were unremarkable. NCS were normal except in 2 patients with carpal tunnel syndrome. Quantitative EMGs were normal. One patient had mildly increased jitter on single-fiber EMG. Muscle biopsies demonstrated minor nonspecific abnormalities in 5 patients (i.e., increased central nuclei, rare necrotic fibers, tubular aggregates). CONCLUSIONS Despite severe subjective symptoms, most of our patients had no objective evidence of neuromuscular disease. Mildly increased CKs or nonspecific histologic abnormalities on muscle biopsy were evident in 8 patients but were not believed to be clinically significant in most. We found no evidence of a specific neuromuscular disorder in any patient. Exposures to toxins during the Persian Gulf War were not likely responsible for our patients' symptoms.
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Affiliation(s)
- A A Amato
- Department of Neurology, Wilford Hall Medical Center, San Antonio, TX, USA
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Haycock CE, McVey A. The problems of patient acceptance of the "PAP" smear. Woman Physician 1971; 26:239-43. [PMID: 5580251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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