Publications
168 results found
Roshan A, Shah B, Anderson KD, et al., 2024, Robot-Assisted Pelvic Dissection for Enlarged Lymph Nodes in Melanoma Improves Recovery with Equivalent Oncological Outcomes to Open Pelvic Dissection., Ann Surg Oncol, Vol: 31, Pages: 2727-2736
BACKGROUND: Robot-assisted pelvic lymph node dissection (rPLND) has been reported in heterogenous groups of patients with melanoma, including macroscopic or at-high-risk-for microscopic metastasis. With changing indications for surgery in melanoma, and availability of effective systemic therapies, pelvic dissection is now performed for clinically detected bulky lymph node metastasis followed by adjuvant drug therapy. rPLND has not been compared with open pelvic lymph node dissection (oPLND) for modern practice. METHODS: All patients undergoing pelvic node dissection for macroscopic melanoma at a single institution were reviewed as a cohort, observational study. RESULTS: Twenty-two pelvic lymph node dissections were identified (8 oPLND; 14 rPLND). The number of pelvic lymph nodes removed was similar (median oPLND 6.5 (interquartile range [IQR] 6.0-12.5] versus rPLND 6.0 [3.75-9.0]), with frequent matted nodes (11/22, 50.0%). Operative time (median oPLND 130 min [IQR 95.5-182] versus rPLND 126 min [IQR 97.8-160]) and complications (Clavien-Dindo scale) were similar. Length of hospital stay (median 5.34 days (IQR 3.77-6.94) versus 1.98 days (IQR 1.39-3.50) and time to postoperative adjuvant therapy (median 11.6 weeks [IQR 10.6-18.5] versus 7.71 weeks [IQR 6.29-10.4]) were shorter in the rPLND group. No differences in pelvic lymph node recurrence (p = 0.984), distant metastatic recurrence (p = 0.678), or melanoma-specific survival (p = 0.655) were seen (median follow-up 21.1 months [rPLND] and 25.7 months [oPLND]). CONCLUSIONS: rPLND is an effective way to remove bulky pelvic lymph nodes in melanoma, with a shorter recovery and reduced interval to initiating adjuvant therapy compared with oPLND. This group of patients may especially benefit from neoadjuvant systemic approaches to management.
Roshan A, Shah B, Anderson KD, et al., 2024, ASO Visual Abstract: Robot-Assisted Pelvic Dissection for Enlarged Lymph Nodes in Melanoma Improves Recovery with Equivalent Oncological Outcomes to Open Pelvic Dissection., Ann Surg Oncol, Vol: 31, Pages: 2747-2748
Pandiaraja M, Pryle I, West L, et al., 2023, Utilisation and impact of predict prostate on decision‐making among clinicians and patients in a specialist tertiary referral centre: A retrospective cohort study, BJUI Compass, ISSN: 2688-4526
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Patients with intermediate‐risk prostate cancer are faced with the decision of whether to undergo radical treatment. Decision‐making aids, such as Predict Prostate, can empower both clinicians and patients to make treatment decisions with personalised information, but their impact on multi‐disciplinary team (MDT) decision‐making and uptake of radical treatment remains unknown.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>The objective of this study is to assess the utilisation and utility of Predict Prostate in informing treatment decisions for patients with intermediate‐risk prostate cancer.</jats:p></jats:sec><jats:sec><jats:title>Patients and Methods</jats:title><jats:p>A retrospective cohort study was conducted in Cambridge University Hospitals (CUH) of patients referred to the prostate cancer specialist multi‐disciplinary team (pcSMDT) and robotic prostatectomy clinic (ROPD) between September 2019 and August 2021 for consideration of radical prostatectomy (RARP). Data on patient characteristics, use of PredictProstate and management decisions were collected from the Epic electronic medical record (EMR) of 839 patients, of whom 386 had intermediate‐risk prostate cancer.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The use of Predict Prostate at the pcSMDT increased in the second half of the study period (34.5% vs. 23.8%, <jats:italic>p</jats:italic> < 0.001). The use of Predict Prostate was associated with an increased likelihood of attending ROPD for men with CPG2 prostate cancer (OR = 2.155, 95% CI = 1.158–4.013, <jats:italic>p</jats:italic> = 0.015) but a reduced likelihood of proceeding with RARP for
Hussein H, Maitra N, Tay LJ, et al., 2023, Analysis of the learning curve for Retzius-sparing robot-assisted radical prostatectomy for a single surgeon, Journal of Clinical Urology, ISSN: 2051-4158
<jats:sec><jats:title>Background:</jats:title><jats:p> The learning curve for Retzius-sparing robotic radical prostatectomy is not fully understood. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> This study attempts to identify the learning curve across the first 130 cases of a single surgeon. </jats:p></jats:sec><jats:sec><jats:title>Design, Setting and Participants:</jats:title><jats:p> All Retzius-sparing robotic radical prostatectomy cases performed by a single surgeon at a high-volume tertiary hospital between April 2019 and July 2022 were included. </jats:p></jats:sec><jats:sec><jats:title>Outcome Measurements and Statistical Analysis:</jats:title><jats:p> Outcome measures included positive surgical margin rate, complication rates and unplanned readmission to hospital, postoperative urinary continence, erectile function and prostate-specific antigen (PSA) measurement. Cases were divided chronologically into three groups and differences between groups assessed. </jats:p></jats:sec><jats:sec><jats:title>Results and Limitation:</jats:title><jats:p> A total of 130 Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) cases were identified. Differences were found between groups in several areas. Positive surgical margin rate fell between Group 1 (30.2%) and Group 3 (9.1%). Safety, postoperative continence, erectile function and PSA remained stable. Median patient age increased between Group 1 (59 years) and Group 3 (66.5 years) ( p = 0.04). Proportion of patients with stage >T2 increased between Group 1 (27.9%) and Group 2 (41.9%) ( p = 0.036). Median console time increased between Group 1 (120 minutes) and Group 2 (150 minutes) ( p = 0.01). Median gland weight increased between Group 1 (2
Tay LJ, Gillangullari K, Maitra N, et al., 2023, Short (23-hour)-stay robotic-assisted radical prostatectomy in a state-funded national health service - Is it safe and feasible?, JOURNAL OF CLINICAL UROLOGY, ISSN: 2051-4158
Soukup T, Lamb BW, Green JSA, et al., 2023, Analysis of communication styles underpinning clinical decision-making in cancer multidisciplinary team meetings, Frontiers in Psychology, Vol: 14, Pages: 1-13, ISSN: 1664-1078
INTRODUCTION: In cancer care, multidisciplinary team (MDT) meetings are the gold standard. While they are trying to maximize productivity on the back of the steadily increasing workload, growing cancer incidence, financial constraints, and staff shortages, concerns have been raised with regards to the quality of team output, as reported by Cancer Research UK in 2017: "Sometimes we discuss up to 70 patients. This is after a whole day of clinics, and we do not finish until after 19.00. Would you want to be number 70?". This study aimed to explore systematically some of the dynamics of group interaction and teamwork in MDT meetings. MATERIALS AND METHODS: This was a prospective observational study conducted across three MDTs/university hospitals in the United Kingdom. We video-recorded 30 weekly meetings where 822 patient cases were reviewed. A cross-section of the recordings was transcribed using the Jefferson notation system and analyzed using frequency counts (quantitative) and some principles of conversation analysis (qualitative). RESULTS: We found that, across teams, surgeons were the most frequent initiators and responders of interactional sequences, speaking on average 47% of the time during case discussions. Cancer nurse specialists and coordinators were the least frequent initiators, with the former speaking 4% of the time and the latter speaking 1% of the time. We also found that the meetings had high levels of interactivity, with an initiator-responder ratio of 1:1.63, meaning that for every sequence of interactions initiated, the initiator received more than a single response. Lastly, we found that verbal dysfluencies (laughter, interruptions, and incomplete sentences) were more common in the second half of meetings, where a 45% increase in their frequency was observed. DISCUSSION: Our findings highlight the importance of teamwork in planning MDT meetings, particularly with regard to Cancer Research UK in 2017 cognitive load/fatigue and decision-
Lamb BW, Linton KD, Narahari K, 2023, BAUS oncology guidance for implementing streamlining in cancer MDT meetings: Selecting standards of care and operational considerations, JOURNAL OF CLINICAL UROLOGY, ISSN: 2051-4158
Soukup T, Winters D, Chua K-C, et al., 2023, Evaluation of changes to work patterns in multidisciplinary cancer team meetings due to the COVID-19 pandemic: A national mixed-method survey study, Cancer Medicine, Vol: 12, Pages: 8729-8741, ISSN: 2045-7634
BackgroundIt is not well understood the overall changes that multidisciplinary teams (MDTs) have had to make in response to the COVID-19 pandemic, nor the impact that such changes, in addition to the other challenges faced by MDTs, have had on decision-making, communication, or participation in the context of MDT meetings specifically.MethodsThis was a mixed method, prospective cross-sectional survey study taking place in the United Kingdom between September 2020 and August 2021.ResultsThe participants were 423 MDT members. Qualitative findings revealed hybrid working and possibility of virtual attendance as the change introduced because of COVID-19 that MDTs would like to maintain. However, IT-related issues, slower meetings, longer lists and delays were identified as common with improving of the IT infrastructure necessary going forward. In contrast, virtual meetings and increased attendance/availability of clinicians were highlighted as the positive outcomes resulting from the change. Quantitative findings showed significant improvement from before COVID-19 for MDT meeting organisation and logistics (M = 45, SD = 20) compared to the access (M = 50, SD = 12, t(390) = 5.028, p = 0.001), case discussions (M = 50, SD = 14, t(373) = −5.104, p = 0.001), and patient representation (M = 50, SD = 12, t(382) = −4.537, p = 0.001) at MDT meetings.DiscussionOur study explored the perception of change since COVID-19 among cancer MDTs using mixed methods. While hybrid working was preferred, challenges exist. Significant improvements in the meeting organisation and logistics were reported. Although we found no significant perceived worsening across the four domains investigated, there was an indication in this direction for the case discussions warranting further ‘live’ assessments of MDT meetings.
Gao C, Peters M, Kurver P, et al., 2022, Nomogram predicting the probability of spontaneous stone passage in patients presenting with acute ureteric colic, BJU INTERNATIONAL, Vol: 130, Pages: 823-831, ISSN: 1464-4096
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Hilbert R, Bibby L, Boxall N, et al., 2022, Anticoagulant but not antiplatelet use is associated with haematuria complications after bladder outflow surgery, JOURNAL OF CLINICAL UROLOGY, ISSN: 2051-4158
Fricker M, Nathan A, Georgi M, et al., 2022, 158 Virtual Interactive Surgical Skills Classroom: A Parallel-Designed, Non-Inferiority, Adjudicator-Blinded, Randomised Controlled Trial (VIRTUAL), Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Pandiaraja M, Pryle I, West L, et al., 2022, 181 Service Evaluation of the Utilisation and Impact of PredictProstate on Clinical Decision-Making in a Prostate Cancer Specialist Multidisciplinary Service, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Stewart GD, Klatte T, Cosmai L, et al., 2022, The multispeciality approach to the management of localised kidney cancer, LANCET, Vol: 400, Pages: 523-534, ISSN: 0140-6736
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- Citations: 7
Caglic I, Sushentsev N, Shah N, et al., 2022, Integration of Prostate Biopsy Results with Pre-Biopsy Multiparametric Magnetic Resonance Imaging Findings Improves Local Staging of Prostate Cancer, CANADIAN ASSOCIATION OF RADIOLOGISTS JOURNAL-JOURNAL DE L ASSOCIATION CANADIENNE DES RADIOLOGISTES, Vol: 73, Pages: 515-523, ISSN: 0846-5371
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- Citations: 5
Hitz F, Ribi K, Grote G, et al., 2022, Team functioning across different tumour types: Insights from a Swiss cancer center using qualitative and quantitative methods, CANCER REPORTS, Vol: 5
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- Citations: 1
Soukup T, Lamb BW, Morbi A, et al., 2022, Cancer multidisciplinary team meetings: impact of logistical challenges on communication and decision-making, BJS OPEN, Vol: 6, ISSN: 2474-9842
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- Citations: 3
Sivathasan S, Patel KM, Smart S, et al., 2022, Incremental modification of robotic prostatectomy technique can lead to aggregated marginal gains to significantly improve functional outcomes without compromising oncological control, JOURNAL OF ROBOTIC SURGERY, Vol: 16, Pages: 665-675, ISSN: 1863-2483
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- Citations: 1
Caglic I, Sushentsev N, Colarieti A, et al., 2022, Value of the capsular enhancement sign on dynamic contrast-enhanced prostate multiparametric MRI for the detection of extracapsular extension, EUROPEAN JOURNAL OF RADIOLOGY, Vol: 150, ISSN: 0720-048X
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- Citations: 2
Harris J, Beck S, Ayers N, et al., 2022, Improving teamwork in maternity services: A rapid review of interventions, MIDWIFERY, Vol: 108, ISSN: 0266-6138
Sajjad W, Thankappannair V, Shah S, et al., 2022, Diagnostic value of the abnormal digital rectal examination in the modern MRI-based prostate cancer diagnostic pathway, JOURNAL OF CLINICAL UROLOGY, ISSN: 2051-4158
Adamina M, Ademuyiwa A, Adisa A, et al., 2022, The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study, Colorectal Disease, Vol: 24, Pages: 708-726, ISSN: 1462-8910
AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January–April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90–1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69–1.27, P = 0.672). Longer delays were not associated with poorer outcomes.ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease.
Sushentsev N, McLean MA, Warren AY, et al., 2022, Hyperpolarised <SUP>13</SUP>C-MRI identifies the emergence of a glycolytic cell population within intermediate-risk human prostate cancer (vol 13, 466, 2022), NATURE COMMUNICATIONS, Vol: 13
Miah S, Maw J, Pang K, et al., 2022, The provision of prostate cancer patient information leaflets on an electronic tablet: A further step to paperless health-care provision, UROLOGY ANNALS, Vol: 14, Pages: 156-161, ISSN: 0974-7796
Pryle I, Pandiaraja M, West L, et al., 2022, Service evaluation of the utilisation and impact of PredictProstate on clinical decision-making in a prostate cancer specialist multidisciplinary service, Publisher: ELSEVIER, Pages: S1660-S1662, ISSN: 0302-2838
Sushentsev N, McLean MA, Warren AY, et al., 2022, Hyperpolarised <SUP>13</SUP>C-MRI identifies the emergence of a glycolytic cell population within intermediate-risk human prostate cancer, NATURE COMMUNICATIONS, Vol: 13
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- Citations: 18
Robertson-Waters E, Donaldson C, Light A, et al., 2022, Guidance for diagnosis and management of bladder injuries - is practice up to date? Comment, BJU INTERNATIONAL, Vol: 129, Pages: 25-27, ISSN: 1464-4096
Nathan A, Hanna N, Rashid A, et al., 2021, New recommendations to reduce unnecessary blood tests after robot-assisted radical prostatectomy, BJU INTERNATIONAL, Vol: 128, Pages: 681-684, ISSN: 1464-4096
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- Citations: 1
Nathan A, Fricker M, Georgi M, et al., 2021, Virtual Interactive Surgical Skills Classroom: A Parallel-group, Non-inferiority, Adjudicator-blinded, Randomised Controlled Trial (VIRTUAL), JOURNAL OF SURGICAL EDUCATION, Vol: 79, Pages: 791-801, ISSN: 1931-7204
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- Citations: 3
Lamb BW, Miah S, Skolarus TA, et al., 2021, Development and Validation of a Short Version of the Metric for the Observation of Decision-Making in Multidisciplinary Tumor Boards: MODe-Lite, ANNALS OF SURGICAL ONCOLOGY, Vol: 28, Pages: 7577-7588, ISSN: 1068-9265
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Lamb BW, Miah S, Soukup T, 2021, ASO Author Reflections: The Pursuit of Digitalised Quality Improvement Assessment Tools for Cancer Multidisciplinary Teams, ANNALS OF SURGICAL ONCOLOGY, Vol: 28, Pages: 7589-7590, ISSN: 1068-9265
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