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  • 1
    Language: English
    In: Clinical Genitourinary Cancer, April 2016, Vol.14(2), pp.e237-e239
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.clgc.2015.12.022 Byline: Desiree L. Draeger, Chris Protzel, Oliver W. Hakenberg Author Affiliation: Department of Urology, University of Rostock, Rostock, Germany Article History: Received 6 December 2015; Accepted 19 December 2015
    Keywords: Mesenchymal Tumor ; Rarity in Male Patients ; Resection of Scrotal Skin With Plastic Reconstruction ; Scrotal Swelling ; Semimalignant Neoplasm ; Medicine
    ISSN: 1558-7673
    E-ISSN: 1938-0682
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  • 2
    Language: English
    In: Clinical Genitourinary Cancer, October 2017, Vol.15(5), pp.605-609
    Description: The psychological stress of patients with penile cancer arises from the cancer diagnosis per se and the corresponding consequences of treatment (loss of body integrity and sexual function). In addition, cancer-specific distress ensues (eg, fear of metastasis, progression, relapse, death). The present study examined the effects of curative and palliative treatment on the psychological well-being of patients with localized or advanced penile cancer using screening questionnaires to determine the consecutive need for psychosocial care. We undertook a prospective analysis of patients with penile cancer undergoing surgery or chemotherapy. The present study showed that patients with penile cancer have increased psychological stress and, consequently, an increased need for psychosocial care owing to the potentially mutilating surgery. We examined the effects of treatment on the psychological well-being of patients with localized or advanced penile cancer using screening questionnaires to determine the consecutive need for psychosocial care. Penile cancer is a rare, but highly aggressive, malignancy. The psychological stress of patients with penile cancer arises from the cancer diagnosis per se and the corresponding consequences of treatment. In addition, cancer-specific distress results (eg, fear of metastasis, progression, relapse, death). Studies of the psychosocial stress of penile cancer patients are rare. We undertook a prospective analysis of the data from patients with penile cancer who had undergone surgery or chemotherapy from August 2014 to October 2016 at our department. Patients were evaluated using standardized questionnaires for stress screening and the identification for the need for psychosocial care (National Comprehensive Cancer Network Distress Thermometer and Hornheider screening instrument) and by assessing the actual use of psychosocial support. The average stress level was 4.5. Of all the patients, 42.5% showed increased care needs at the time of the survey. Younger patients, patients undergoing chemotherapy, and patients with recurrence were significantly more integrated with the psychosocial care systems. Finally, 67% of all patients received inpatient psychosocial care. Owing to the potentially mutilating surgery, patients with penile cancer experience increased psychological stress and, consequently, have an increased need for psychosocial care. Therefore, the emotional stress of these patients should be recognized and support based on interdisciplinary collaboration offered.
    Keywords: Distress Screening Instruments ; Penile Cancer ; Psychooncology ; Psychological Stress ; Psychosocial Need for Care ; Medicine
    ISSN: 1558-7673
    E-ISSN: 1938-0682
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  • 3
    Language: English
    In: Clinical Genitourinary Cancer, October 2017, Vol.15(5), pp.548-555.e3
    Description: Patients with locally advanced penile squamous-cell carcinoma have a poor prognosis. No difference in survival was noted when using chemotherapy before or after surgery. Uncertainties persist regarding the optimal management of these patients, and new treatments are urgently required, particularly for patients at highest risk, with bilateral and/or pelvic lymph node involvement. The prognosis of patients with locally advanced penile squamous-cell carcinoma is primarily related to the extent of lymph node metastases. Surgery alone yields suboptimal results, and there is a paucity of data on these patients' outcomes. This retrospective study evaluated patients who received neoadjuvant or adjuvant chemotherapy from 1990 onward at 12 centers. Cox models were used to investigate prognostic factors for relapse-free survival and overall survival (OS). Among the 201 included patients, 39 (19.4%) had disease of T3-4 and N0 clinical stage; the remaining patients had clinical lymph node involvement (cN+). Ninety-four patients received neoadjuvant chemotherapy (group 1), 78 received adjuvant chemotherapy (group 2), and 21 received both (group 3). Eight patients for whom the timing of perioperative chemotherapy administration was unavailable were included in the Cox analyses. Forty-three patients (21.4%) received chemoradiation. Multivariate analysis for OS (n = 172) revealed bilateral disease (  = .035) as a negative prognostic factor, while pelvic cN+ tended to be nonsignificantly associated with decreased OS (  = .076). One-year relapse-free survival was 35.6%, 60.6%, and 45.1% in the 3 groups, respectively. One-year OS was 61.3%, 82.2%, and 75%, respectively. No significant differences were seen on univariable analyses for OS between the groups (  = .45). Platinum type of chemotherapy and chemoradiation were not significantly associated with any outcome analyzed. Benchmark survival estimates for patients receiving perioperative chemotherapy for locally advanced penile squamous-cell carcinoma have been provided, with no substantial differences observed between neoadjuvant and adjuvant administration. This analysis may result in improved patient information, although prospective studies are warranted.
    Keywords: Penile Cancer ; Preoperative Chemotherapy ; Regional Lymph Nodes ; Squamous Cell Carcinoma ; Survival ; Medicine
    ISSN: 1558-7673
    E-ISSN: 1938-0682
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  • 4
    Language: English
    In: Clinical Genitourinary Cancer, October 2017, Vol.15(5), pp.e809-e817
    Description: This prospective multicenter study analyzed the effect of hospital and surgeon case volume on perioperative quality of care and short-term complications and mortality in 479 patients undergoing radical cystectomy for bladder cancer. We found that hospital volume might represent an at least equally important factor regarding postoperative complications as the surgeon case volume itself at European tertiary care centers. Case volume has been suggested to affect surgical outcomes in different arrays of procedures. We aimed to delineate the relationship between case volume and surgical outcomes and quality of care criteria of radical cystectomy (RC) in a prospectively collected multicenter cohort. This was a retrospective analysis of a prospectively collected European cohort of patients with bladder cancer treated with RC in 2011. We relied on 479 and 459 eligible patients with available information on hospital case volume and surgeon case volume, respectively. Hospital case volume was divided into tertiles, and surgeon volume was dichotomized according to the median annual number of surgeries performed. Binomial generalized estimating equations controlling for potential known confounders and inter-hospital clustering assessed the independent association of case volume with short-term complications and mortality, as well as the fulfillment of quality of care criteria. The high-volume threshold for hospitals was 45 RCs and, for high-volume surgeons, was 〉 15 cases annually. In adjusted analyses, high hospital volume remained an independent predictor of fewer 30-day (odds ratio, 0.34;  = .002) and 60- to 90-day (odds ratio, 0.41;  = .03) major complications but not of fulfilling quality of care criteria or mortality. No difference between surgeon volume groups was noted for complications, quality of care criteria, or mortality after adjustments. The coordination of care at high-volume hospitals might confer a similar important factor in postoperative outcomes as surgeon case volume in RC. This points to organizational elements in high-volume hospitals that enable them to react more appropriately to adverse events after surgery.
    Keywords: High Volume ; Postoperative Complications ; Quality of Health Care ; Urinary Bladder Neoplasms ; Volume-Outcome Relationship ; Medicine
    ISSN: 1558-7673
    E-ISSN: 1938-0682
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