OC TOBER 2015
■
■
■
V O L U M E 14, I S S U E N U M B E R 8
■
■
■
www.renalandurologynews.com
Adjuvant Chemo Ups Post-RC Survival
© PHANIE / ALAMY STOCK PHOTO
In a study, high-risk bladder cancer patients experienced a 29% decreased risk of death from the malignancy
ADJUVANT CHEMOTHERAPY after radical cystectomy improves outcomes, study finds.
Obesity Not a TOT Failure Risk BY NATASHA PERSAUD OBESITY AND SEVERE obesity do not appear to increase the risk of surgical failure of the transobturator tape (TOT) procedure over 3 years, a new study finds. Tarik Yonguc, MD, and colleagues of Izmir Bozyaka Training and Research Hospital in Izmir, Turkey, reviewed
outcomes for 470 women (average age 53) with stress or mixed urinary incontinence who underwent a TOT procedure. Women with urge-predominant mixed incontinence were excluded. The investigators divided patients into 3 groups by body mass index (BMI) for analysis: the normal-weight group (BMI continued on page 7
EXPERT Q & A
David F. Penson, MD, offers his perspective on major advances in prostate cancer. PAGE 11
ADJUVANT chemotherapy after radical cystectomy (RC) for high-risk bladder cancer may decrease overall and cancer-specific mortality, according to investigators. Michael Fröhner, MD, of Technischen Universität Dresden, and colleagues studied 798 patients who underwent RC for high-risk superficial or muscleinvasive urothelial or undifferentiated bladder cancer from 1993 to 2011. Of these, 23% received adjuvant cisplatinbased chemotherapy and 5% received neoadjuvant chemotherapy. Of the patients who received adjuvant chemotherapy, 75% received cisplatin plus gemcitabine, 22% received cisplatin plus methotrexate with or without epirubicine and vinblastine, and 3%
Bladder Cancer Mortality Tied to Blood Type A BY JODY A. CHARNOW PATIENTS WHO undergo radical cystectomy (RC) for bladder cancer are at increased risk of dying from the malignancy if they have blood type A rather than O, a study found. In a retrospective study of 2,086 patients with urothelial carcinoma (UC) of the bladder treated with RC, a team at Mayo Clinic in Rochester, Minn., led by Boris Gershman, MD, found that non-O blood type was associated with significantly worse 5-year recurrencefree survival and cancer-specific survival compared with O blood type (65% vs. 69% and 64% vs. 70%, respectively). On multivariate analysis, blood type A was independently associated with a significant 22% increased risk of death from bladder cancer compared with blood type O, the researchers reported online ahead of print in Urologic Oncology. Blood types B and AB were not associated with bladder cancer-specific mortality compared with blood type O. The continued on page 7
received other combinations with cisplatin. Patients had a median age of 69 years; the median follow-up for censored patients was 7.1 years. The use of adjuvant chemotherapy was associated with a significant 50% decreased risk of overall mortality and 29% decreased risk of bladdercancer specific mortality. Patients who received adjuvant chemotherapy were significantly younger than those who did not (66 vs. 68 years). They also were healthier, with 31% of recipients having a Charlson score of 2 or higher compared with 40% of patients who did not receive adjuvant chemotherapy. “Although patients who received adjuvant chemotherapy were somewhat continued on page 7
IN THIS ISSUE 5
Finasteride may lower bladder cancer risk in men
6
Erectile dysfunction not less likely in NSAID users
8
Smoking not a risk factor for all RCC subtypes
15
Propofol safer than midazolam for ICU patient sedation
15
Perineural invasion predicts PCa bone metastasis
21
Improved survival after radical cystectomy documented
21
High uric acid at hospital admission raises AKI risk Critically ill patients with high phosphorus levels are at increased risk of death. PAGE 15