641 MANAGEMENT OF THE INTRAVESICAL URETER AND BLADDER CUFF DURING RADICAL NEPHROURETERECTOMY: OUTCOMES FROM THE CANADIAN UPPER TRACT COLLABORATION
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Résumé
You have accessJournal of UrologyUrothelial Cancer: Upper Tract Tumors1 Apr 2012641 MANAGEMENT OF THE INTRAVESICAL URETER AND BLADDER CUFF DURING RADICAL NEPHROURETERECTOMY: OUTCOMES FROM THE CANADIAN UPPER TRACT COLLABORATION Anil Kapoor, Shawn Dason, Christopher Allard, Edward Matsumoto, Ricardo Rendon, David Bell, Jonathan Izawa, Joseph Chin, Alan So, Peter Black, Jean-Baptiste Lattouf, Fred Saad, Niels Jacobsen, Adrian Fairey, Darrel Drachenberg, Ilias Cagiannos, Yves Fradet, Louis Lacombe, Simon Tanguay, and Wassim Kassouf Anil KapoorAnil Kapoor Hamilton, Canada More articles by this author , Shawn DasonShawn Dason Hamilton, Canada More articles by this author , Christopher AllardChristopher Allard Hamilton, Canada More articles by this author , Edward MatsumotoEdward Matsumoto Hamilton, Canada More articles by this author , Ricardo RendonRicardo Rendon Halifax, Canada More articles by this author , David BellDavid Bell Halifax, Canada More articles by this author , Jonathan IzawaJonathan Izawa London, Canada More articles by this author , Joseph ChinJoseph Chin London, Canada More articles by this author , Alan SoAlan So Vancouver, Canada More articles by this author , Peter BlackPeter Black Vancouver, Canada More articles by this author , Jean-Baptiste LattoufJean-Baptiste Lattouf Montreal, Canada More articles by this author , Fred SaadFred Saad Montreal, Canada More articles by this author , Niels JacobsenNiels Jacobsen Edmonton, Canada More articles by this author , Adrian FaireyAdrian Fairey Edmonton, Canada More articles by this author , Darrel DrachenbergDarrel Drachenberg Winnipeg, Canada More articles by this author , Ilias CagiannosIlias Cagiannos Ottawa, Canada More articles by this author , Yves FradetYves Fradet Quebec City, Canada More articles by this author , Louis LacombeLouis Lacombe Quebec City, Canada More articles by this author , Simon TanguaySimon Tanguay Montreal, Canada More articles by this author , and Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.720AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A number of surgical approaches exist for management of the intravesical ureter and bladder cuff during radical nephrouretectomy (RNU) for upper tract urothelial carcinoma (UTUC). This study examines how surgical approach during RNU impacts clinical outcomes based on an analysis of a multicenter Canadian UTUC database. METHODS Detailed information on 1029 UTUC patients treated with RNU between 1994 and 2009 was obtained from 10 Canadian academic centers. Available data included bladder cuff management as well as recurrence and survival status. Surgical approach was divided into extravesical management (TENT) (bladder never opened, ureter taken as distal as possible with tenting of the bladder), open bladder cuff excision (OPEN) (bladder opened for complete removal of intramural ureter), and endoscopic management (ENDO) (ureter taken as distal as possible during RNU with endoscopic management concomitantly or staged). The clinical outcomes were overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). Survival analysis was performed with the Kaplan-Meier method and the log-rank test. Cox proportional regression analysis was used for multivariate analysis. RESULTS 820 of 1029 (79.7%) patients had sufficient data for inclusion. 316 (38.5%) patients underwent TENT, 406 (49.5%) underwent OPEN, and 97 (11.8%) underwent ENDO. Median follow-up was 24.6 months (Q1=8.2 months, Q3=56.9 months). Groups differed significantly in the proportion of females, previous UTUC, laparoscopic cases, presence of carcinoma in situ and pathological tumor stage (p<0.05). In univariate and multivariate analyses, no significant differences were found in OS or DSS based on surgical approach. In multivariate analysis, OPEN was found to reduce tumor recurrence compared to TENT (hazard ratio 0.628, 95% CI 0.491-0.801, p=0.0002). ENDO did not improve RFS relative to TENT (p=0.644). CONCLUSIONS In a multicenter Canadian series of 820 patients undergoing radical nephroureterectomy for UTUC with a median follow-up of over 2 years, management of the bladder cuff did not affect overall or disease-specific survival. An open intravesical bladder cuff excision was associated with improved recurrence-free survival. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187 Issue 4S April 2012 Page: e261 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Metrics Author Information Anil Kapoor Hamilton, Canada More articles by this author Shawn Dason Hamilton, Canada More articles by this author Christopher Allard Hamilton, Canada More articles by this author Edward Matsumoto Hamilton, Canada More articles by this author Ricardo Rendon Halifax, Canada More articles by this author David Bell Halifax, Canada More articles by this author Jonathan Izawa London, Canada More articles by this author Joseph Chin London, Canada More articles by this author Alan So Vancouver, Canada More articles by this author Peter Black Vancouver, Canada More articles by this author Jean-Baptiste Lattouf Montreal, Canada More articles by this author Fred Saad Montreal, Canada More articles by this author Niels Jacobsen Edmonton, Canada More articles by this author Adrian Fairey Edmonton, Canada More articles by this author Darrel Drachenberg Winnipeg, Canada More articles by this author Ilias Cagiannos Ottawa, Canada More articles by this author Yves Fradet Quebec City, Canada More articles by this author Louis Lacombe Quebec City, Canada More articles by this author Simon Tanguay Montreal, Canada More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,013 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,005 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».