Use of immunocytology to predict bladder cancer presence in patients with asymptomatic hematuria.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 242-242
Author(s):  
E. K. Cha ◽  
L. Tirsar ◽  
S. F. Shariat ◽  
P. J. Christos ◽  
M. Mazumdar ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Accuracy ◽  
Smoking Status ◽  
Multivariable Analysis ◽  
Urothelial Cells ◽  
Patient Counseling ◽  
History Of ◽  
Sensitivity Specificity ◽  
Strong Independent Predictor

242 Background: The uCyt immunocytology assay detects cellular biomarkers for bladder cancer (BCa) in exfoliated urothelial cells. We assessed the performance of uCy for detecting BCa in patients undergoing initial evaluation for asymptomatic hematuria. Methods: Data from 1,182 subjects without a history of BCa undergoing evaluation for hematuria were collected at three centers: EuromedClinic/Urologie24, University of Tübingen, and Central Hospital of Bolzano. All subjects underwent standard workup (i.e., voided cytology, upper tract imaging, and cystoscopy) and immunocytology. Results: Overall, 245 subjects had BCa (20.7%). The sensitivity/specificity/negative predictive value for uCyt and cytology were 82.4%/86.6%/95.0% and 46.5%/94.9%/87.2%, respectively. uCyt (OR 18.3, p<0.001) and cytology (OR 2.9, p<0.001) were associated with BCa in a multivariable analysis. The base model (age, gender, smoking status, type of hematuria) predicted BCa with an accuracy of 74.1%. Addition of cytology to the base model improved predictive accuracy (PA) to 83.5% (p<0.001), while addition of uCyt to the base model improved PA to 90.1% (p<0.001). Addition of uCyt to Model 1 significantly improved PA (+7.6%, p<0.001), but addition of cytology to Model 2 did not (+1.0%, p=0.057). uCyt performed equally well in patients with microscopic and gross hematuria (OR 30 vs. 27), while cytology did not (OR 18 vs. 12). Conclusions: uCyt is a strong, independent predictor of BCa in patients with hematuria; it outperforms cytology. uCyt may help with patient counseling, quality of care optimization (referral prioritization), and possibly sparing unnecessary hematuria workup in patients at extremely low risk of BCa. [Table: see text] No significant financial relationships to disclose.

The impact of age on general and bladder cancer-specific quality of life among bladder cancer survivors.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 463-463
Author(s):  
Pauline Filippou ◽  
Sean McCabe ◽  
Hannah McCloskey ◽  
Kathryn Gessner ◽  
Judy Hamad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Multiple Linear Regression Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

463 Background: Quality of life among cancer survivors has been shown to vary by age. Our objective was to evaluate differences in general and bladder cancer-specific quality of life based on age among a large cross-sectional bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine general and bladder cancer-specific quality of life (QOL) using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer, of whom 41% were female and 97 % were white. The mean age was 67.6 years (range 29 to 93 years). Respondents were highly educated (67% completed college). 63% of patients identified as having non-invasive (NMIBC) cancer (n=578), 30% had MIBC (n=270), and 7% had metastatic bladder cancer (n=63). On multivariable analysis, older age was significantly associated with better generic QOL and urinary function ( Table), but not sexual function (p=0.19) or bowel function (p=0.73), controlling for sex, race, stage, comorbidity and years since diagnosis. Conclusions: Higher general and domain-specific QOL scores are more common among older bladder cancer patients. Differential impact by age may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Nomogram predicting treatment-related sexual dysfunction for men with localized prostate cancer treated by radical prostatectomy (RP), external-beam radiotherapy (EBRT), and brachytherapy (PI).

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 51-51
Author(s):  
Joseph C. Klink ◽  
Martin G. Sanda ◽  
Mark S. Litwin ◽  
Montserrat Ferrer ◽  
Meredith M. Regan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Multivariable Analysis ◽  
Sexual Problems ◽  
Localized Prostate Cancer ◽  
Patient Counseling ◽  
Patient Reported ◽  
Prospective Longitudinal

51 Background: RP, EBRT, and PI for the treatment of clinically localized prostate cancer may negatively impact sexual function. Predictions of treatment-related sexual problems from patient-reported, prospective data may be useful in decision-making. Methods: Patient-reported data on treatment-related sexual problems was obtained from 4 prospective, longitudinal, health-related quality-of-life (HRQOL) protocols comprising 2,668 patients treated between 1999 and 2011 by RP (n = 1,294), EBRT (n = 630), and PI (n = 744). A single HRQOL instrument was not uniformly used for each study, although questions pertaining to the quality and frequency of erections were identical among the studies. Only those patients with quality of erections sufficient for intercourse were included in the model. The endpoint of the model was erections suitable for intercourse on at least half of attempts at 2 years after treatment, with or without the use of oral medications. Cox proportional hazards regression analysis was used to model the clinical information and follow-up data. Internal validation was performed using bootstrapping. Results: Overall, 931 (74%), 249 (42%), and 323 (45%) patients treated by RP, EBRT, and PI were considered to be potent at baseline. Significant differences in baseline characteristics such as patient age, ethnicity, and disease severity existed between the treatment groups. The potency rate at 2 years for 1,215 patients who were potent at baseline and had complete follow-up data was 38%, 51%, and 61% for patients treated by RP, EBRT, and PI, respectively (p < 0.001). In multivariable analysis, age (p < 0.001), baseline frequency of erections (p < 0.001), EBRT (p < 0.001), PI (p < 0.001), PSA (p = 0.001), and institution (p = 0.006), were associated with potency. A nomogram based on the predictive parameters had a concordance index of 0.72 and predictions were well-calibrated with observed outcome. Conclusions: An externally-validated nomogram that predicts 2-year potency after treatment for localized prostate cancer has been developed and may be useful for patient counseling regarding treatment options.

Cancer stage and quality of life in bladder cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 466-466
Author(s):  
Hannah McCloskey ◽  
Sean McCabe ◽  
Kathryn Gessner ◽  
Pauline Filippou ◽  
Judy Hamad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Multiple Linear Regression Model ◽  
Disease Stage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lower Stage

466 Background: Bladder cancer requires treatment and surveillance which varies in intensity by disease stage. Our objective was to evaluate stage-specific differences in generic and bladder cancer-specific quality of life (QOL) among a large bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine generic and bladder cancer-specific QOL using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer. Among respondents, 41% were female and 97% were white. The mean age was 67.6 years (range 29 to 93 years). Patients identified as having non-muscle-invasive bladder cancer (NMIBC, n=578 [63%]), MIBC (n=270, 30%), and metastatic bladder cancer (n=63, 7%). On bivariable analysis ( Table), lower stage was significantly associated with better generic (p<0.01) and bladder-cancer specific QOL (p<0.01). This associated persisted on multivariable analysis adjusted for age, sex, race, years since diagnosis, and comorbidity (p<0.01 for generic, urinary, sexual, and bowel QOL). Conclusions: Disease stage significantly impacts generic and bladder cancer-specific QOL among bladder cancer survivors. Differential impact by stage may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Impact of a Bladder Cancer Diagnosis on Smoking Behavior

2012 ◽  
Vol 30 (15) ◽  
pp. 1871-1878 ◽  
Author(s):  
Jeffrey C. Bassett ◽  
John L. Gore ◽  
Amanda C. Chi ◽  
Lorna Kwan ◽  
William McCarthy ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Smoking Cessation ◽  
General Population ◽  
Tobacco Use ◽  
Cancer Diagnosis ◽  
Smoking Status ◽  
Simple Random Sample ◽  
Cancer Risk Factors ◽  
History Of ◽  
The Impact

Purpose Bladder cancer is the second most common tobacco-related malignancy. A new bladder cancer diagnosis may be an opportunity to imprint smoking cessation. Little is known about the impact of a diagnosis of bladder cancer on patterns of tobacco use and smoking cessation among patients with incident bladder cancer. Patients and Methods A simple random sample of noninvasive bladder cancer survivors diagnosed in 2006 was obtained from the California Cancer Registry. Respondents completed a survey on history of tobacco use, beliefs regarding bladder cancer risk factors, and physician influence on tobacco cessation. Respondents were compared by smoking status. Those respondents smoking at diagnosis were compared with general population controls obtained from the California Tobacco Survey to determine the impact of a diagnosis of bladder cancer on patterns of tobacco use. Results The response rate was 70% (344 of 492 eligible participants). Most respondents (74%) had a history of cigarette use. Seventeen percent of all respondents were smoking at diagnosis. Smokers with a new diagnosis of bladder cancer were almost five times as likely to quit smoking as smokers in the general population (48% v 10%, respectively; P < .001). The bladder cancer diagnosis and the advice of the urologist were the reasons cited most often for cessation. Respondents were more likely to endorse smoking as a risk factor for bladder cancer when the urologist was the source of their understanding. Conclusion The diagnosis of bladder cancer is an opportunity for smoking cessation. Urologists can play an integral role in affecting the patterns of tobacco use of those newly diagnosed.

scholarly journals Case Report: Risperidone Induced Peripheral Edema

2021 ◽  
pp. 25-28
Author(s):  
Farzana Faruki ◽  
Uma Datta Gupta ◽  
Adeel Anwar ◽  
Saral Desai
Keyword(s):  
Case Reports ◽  
Leg Pain ◽  
Type I ◽  
Patient Counseling ◽  
Atypical Depression ◽  
Medication Discontinuation ◽  
History Of ◽  
Bipolar Type ◽  
Leg Edema

Risperidone is the first line of treatment for bipolar disorder, atypical depression, and Schizophrenia. We present a 55-year-old male with a history of schizoaffective disorder with bipolar type I presented with aggressive behavior and suicidal ideation. Our patient was treated with low-dose Risperidone; after that, he gradually developed leg pain and edema. His leg pain hampers his ambulation, which is clinically improved after a week of medication discontinuation; however, his leg edema did not resolve completely. In addition, we evaluated our patient's compliance with an empathic verbal interview that shows edema and leg pain hampers his quality of life. We have found that not informing edema as one of the possible side effects increases medication non-compliance in our case. There are several case reports about the side effect of Risperidone (such as leg edema) in combination with other medications, but there is no recommendation about patient counseling of forthcoming leg edema and mobility issues.

Gender and quality of life in bladder cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 464-464
Author(s):  
Kathryn Gessner ◽  
Sean McCabe ◽  
Pauline Filippou ◽  
Hannah McCloskey ◽  
Judy Hamad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Multiple Linear Regression Model ◽  
Female Gender ◽  
Bowel Function ◽  
Cross Sectional Survey ◽  
Cross Sectional

464 Background: Quality of life among cancer survivors has been shown to vary by gender. Our objective was to evaluate differences in generic and bladder cancer-specific quality of life (QOL) based on gender among a large bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine generic and bladder cancer-specific QOL using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. The survey was advertised. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer. Among respondents, 41% were female and 97% were white. The mean age was 67.6 years (range 29 to 93 years). Respondents were highly educated (67% completed college). 63% of patients identified as having non-invasive (NMIBC) cancer (n=578), 30% had MIBC (n=270), and 7% had metastatic bladder cancer (n=63). On multivariable analysis ( Table), female gender was significantly associated with worse generic QOL (p<0.001), bowel function (p=0.001), and sexual function (p=0.02), and women trended toward worse urinary function (p=0.06), controlling for age, race, stage, comorbidity and years since diagnosis. Conclusions: Lower generic and domain-specific QOL scores are more common among female bladder cancer patients. Differential impact by gender may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Predictors of Poor Quality of Life 1 Year After Subarachnoid Hemorrhage

Neurosurgery ◽  
2015 ◽  
Vol 78 (2) ◽  
pp. 256-264 ◽  
Author(s):  
Zahrah Taufique ◽  
Teresa May ◽  
Emma Meyers ◽  
Cristina Falo ◽  
Stephan A. Mayer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Rehabilitation ◽  
Sickness Impact Profile ◽  
Multivariable Analysis ◽  
Population Based ◽  
Poor Quality ◽  
History Of ◽  
Grade 3

ABSTRACT BACKGROUND: Risk factors for poor quality of life (QOL) after subarachnoid hemorrhage (SAH) remain poorly described. OBJECTIVE: To identify the frequency and predictors of poor QOL 1 year after SAH. METHODS: We studied 1-year QOL in a prospectively collected cohort of 1181 consecutively admitted SAH survivors between July 1996 and May 2013. Patient clinical, radiographic, surgical, and acute clinical course information was recorded. Reduced QOL (overall, physical, and psychosocial) at 1 year was assessed with the Sickness Impact Profile and defined as 2 SD below population-based normative Sickness Impact Profile values. Logistic regression leveraging multiple imputation to handle missing data was used to evaluate reduced QOL. RESULTS: Poor overall QOL was observed in 35% of patients. Multivariable analysis revealed that nonwhite ethnicity, high school education or less, history of depression, poor clinical grade (Hunt-Hess Grade ≥3), and delayed infarction were predictors of poor overall and psychosocial QOL. Poor physical QOL was additionally associated with older age, hydrocephalus, pneumonia, and sepsis. At 1 year, patients with poor QOL had increased difficulty concentrating, cognitive dysfunction, depression, and reduced activities of daily living. More than 91% of patients with poor QOL failed to fully return to work. These patients frequently received physical rehabilitation, but few received cognitive rehabilitation or emotional-behavioral support. CONCLUSION: Reduced QOL affects as many as one-third of SAH survivors 1 year after SAH. Delayed infarction is the most important in-hospital modifiable factor that affects QOL. Increased attention to cognitive and emotional difficulties after hospital discharge may help patients achieve greater QOL.

Patient-Reported Outcomes After Choice for Contralateral Prophylactic Mastectomy

2016 ◽  
Vol 34 (13) ◽  
pp. 1518-1527 ◽  
Author(s):  
E. Shelley Hwang ◽  
Tracie D. Locklear ◽  
Christel N. Rushing ◽  
Greg Samsa ◽  
Amy P. Abernethy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Prophylactic Mastectomy ◽  
Multivariable Analysis ◽  
Contralateral Prophylactic Mastectomy ◽  
Well Being ◽  
Breast Cancer Surgery ◽  
Patient Reported ◽  
History Of

Purpose The rate of contralateral prophylactic mastectomies (CPMs) continues to rise, although there is little evidence to support improvement in quality of life (QOL) with CPM. We sought to ascertain whether patient-reported outcomes and, more specifically, QOL differed according to receipt of CPM. Methods Volunteers recruited from the Army of Women with a history of breast cancer surgery took an electronically administered survey, which included the BREAST-Q, a well-validated breast surgery outcomes patient-reporting tool, and demographic and treatment-related questions. Descriptive statistics, hypothesis testing, and regression analysis were used to evaluate the association of CPM with four BREAST-Q QOL domains. Results A total of 7,619 women completed questionnaires; of those eligible, 3,977 had a mastectomy and 1,598 reported receipt of CPM. Women undergoing CPM were younger than those who did not choose CPM. On unadjusted analysis, mean breast satisfaction was higher in the CPM group (60.4 v 57.9, P < .001) and mean physical well-being was lower in the CPM group (74.6 v 76.6, P < .001). On multivariable analysis, the CPM group continued to report higher breast satisfaction (P = .046) and psychosocial well-being (P = .017), but no difference was reported in the no-CPM group in the other QOL domains. Conclusion Choice for CPM was associated with an improvement in breast satisfaction and psychosocial well-being. However, the magnitude of the effect may be too small to be clinically meaningful. Such patient-reported outcomes data are important to consider when counseling women contemplating CPM as part of their breast cancer treatment.

scholarly journals Conditional Intravesical Recurrence-free Survival Rate after Radical Nephroureterectomy with Bladder Cuff Excision for Upper Urothelial Carcinoma

2020 ◽  
Author(s):  
Jae Hoon Chung ◽  
Wan Song ◽  
Minyong Kang ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Survival Rate ◽  
Urothelial Carcinoma ◽  
Multivariable Analysis ◽  
Survival Period ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Factors Affecting ◽  
Number Of Patients ◽  
History Of

Abstract To evaluate the incidence and risk factors of (intravesical recurrence) IVR by analyzing a relatively large number of patients who underwent radical nephroureterectomy with bladder cuff excision (RNUx) for upper urothelial carcinoma (UTUC). Additionally, conditional IVR-free survival in patients with UTUC who had no history of bladder cancer and no concomitant bladder cancer was evaluated. We retrospectively analyzed the data of 1,095 patients with UTUC who underwent RNUx. The baseline characteristics, bladder tumor history, and UTUC characteristics were analyzed to evaluate oncological outcomes. To determine the factors affecting IVR, surgical modality, use of preoperative ureteroscopic examination (URS), TNM stage, and pathological outcomes were evaluated. Multivariable Cox regression analyses were performed to evaluate factors affecting IVR, and conditional IVR-free survival rate was analyzed using Kaplan–Meier curves. Among the 1,095 patients, 462 patients developed IVR and mean time of IVR was 13.08 ± 0.84 months after RNUx. A total of 30.74% of the IVR group and 15.32% of the without IVR group had a past history of bladder cancer (p < 0.001). In the multivariable analysis, a previous history of bladder cancer, multifocal tumors, the use of preoperative URS, the extravesical bladder cuffing method, lymph node involvement, positive surgical margins, and the use of adjuvant chemotherapy were determined to affect the IVR. The conditional IVRF rate at 12 months after RNUx was 74.0%, for those who IVRF for 12 months, the IVRF rate was 87.1% for the next 12 months (24 months after RNUx), and for the patients who IVRF for 24 months, the IVRF rate was 93.6% for the next 12 months (36 months after RNUx) and the IVRF rate was 97.3% for the next 12 months in IVRF of 60 months patients. The mean IVRF survival period of all patients was 136.84 months, 156.24 months in the patients with 6 months IVRF, 175.38 months for the patients with 12 months IVRF, 189.14 months for the patients with 36 months IVRF, and mean IVRF survival period was 178.21 months in 60 months IVRF patients. In 24 months IVRF patients after RNUx, only URS was evaluated to independently affect IVR (HR 1.945, p = 0.040). In patients with 36 months or more IVRF, there was no significant factor affecting IVR. Active IVR assessment is required until 36 months after RNUx. In addition, patient education and regular screening test such as urine analysis and cytology are required for patients who had IVRF for 36 months or longer.

scholarly journals Clinical Validation of a Urine Test (Uromonitor-V2®) for the Surveillance of Non-Muscle-Invasive Bladder Cancer Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 745
Author(s):  
Caroline A. Sieverink ◽  
Rui P. M. Batista ◽  
Hugo J. M. Prazeres ◽  
João Vinagre ◽  
Cristina Sampaio ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Value ◽  
Disease Recurrence ◽  
Urine Cytology ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
History Of ◽  
Muscle Invasive ◽  
Sensitivity Specificity

The costly and burdensome nature of the current follow-up methods in non-muscle-invasive bladder cancer (NMIBC) drives the development of new methods that may alternate with regular cystoscopy and urine cytology. The Uromonitor-V2® is a new urine-based assay in the detection of hotspot mutations in three genes (TERT, FGFR3, and KRAS) for evaluation of disease recurrence. The aim of this study was to investigate the Uromonitor-V2®’s performance in detecting NMIBC recurrence and compare it with urine cytology. From February 2018 to September 2019 patients were enrolled. All subjects underwent a standard-of-care (SOC) cystoscopy, either as part of their follow-up for NMIBC or for a nonmalignant urological pathology. Urine cytology was performed in NMIBC patients. Out of the 105 patients enrolled, 97 were eligible for the study. Twenty patients presented nonmalignant lesions, 29 had a history of NMIBC with disease recurrence, and 49 had a history of NMIBC without recurrence. In NMIBC, the Uromonitor-V2® displayed a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 93.1%, 85.4%, 79.4%, and 95.3%, respectively. Urine cytology was available for 52 patients, and the sensitivity, specificity, PPV, and NPV were 26.3%, 90.9%, 62.5%, and 68.2%, respectively. With its high NPV of 95.3%, the Uromonitor-V2® revealed promising properties for the follow-up of patients with NMIBC.

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