Publications
168 results found
Khetrapal P, Feber A, Kelly J, et al., 2016, Blood-based liquid biopsy: A comparison between plasma detection of cell-free DNA and circulating tumour cell detection in the detection of bladder cancer, Publisher: WILEY-BLACKWELL, Pages: 125-125, ISSN: 0919-8172
Khetrapal P, Kelly J, Briggs TP, et al., 2016, Robotic assisted radical cystectomy (RARC) with intracorporeal urinary diversion: A single-centre experience reporting 90 day complications, Publisher: WILEY-BLACKWELL, Pages: 40-40, ISSN: 0919-8172
Soukup Ascencao T, Petrides VK, Lamb BW, et al., 2016, The anatomy of clinical decision-making in multidisciplinary cancer meetings: a cross-sectional observational study of teams in a natural context, Medicine, Vol: 95, ISSN: 0025-7974
Abstract: In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable.The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision.This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons.We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis.The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = -0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001).Hawthorne effect is the main limitation of the study.The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient prof
Tan WS, Sridhar A, Ellis G, et al., 2016, Analysis of open and intracorporeal robotic assisted radical cystectomy shows no significant difference in recurrence patterns and oncological outcomes, UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, Vol: 34, ISSN: 1078-1439
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- Citations: 18
Tan WS, Rodney S, Lamb B, et al., 2016, Management of non-muscle invasive bladder cancer: A comprehensive analysis of guidelines from the United States, Europe and Asia, CANCER TREATMENT REVIEWS, Vol: 47, Pages: 22-31, ISSN: 0305-7372
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- Citations: 62
Lamb BW, Rajan P, 2016, Clinical Research Toolkit for Urologists, JOURNAL OF CLINICAL UROLOGY, Vol: 9, Pages: 141-141, ISSN: 2051-4158
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- Citations: 1
Tan WS, Lamb BW, Kelly JD, 2016, Evolution of the neobladder: A critical review of open and intracorporeal neobladder reconstruction techniques, SCANDINAVIAN JOURNAL OF UROLOGY, Vol: 50, Pages: 95-103, ISSN: 2168-1805
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- Citations: 22
Lamb BW, Tan WS, Rehman A, et al., 2015, Is Prebiopsy MRI Good Enough to Avoid Prostate Biopsy? A Cohort Study Over a 1-Year Period, Clinical Genitourinary Cancer, Vol: 13, Pages: 512-517, ISSN: 1938-0682
ntroductionPrebiopsy multiparametric magnetic resonance imaging (MRI) is increasingly used in clinical practice to detect clinically significant prostate cancer, although its role is controversial. We audited the accuracy of prebiopsy MRI for men clinically suspected to have prostate cancer who underwent initial transrectal ultrasound (TRUS) biopsy at our institution.Patients and MethodsAll patients who had a prebiopsy prostate MRI and initial TRUS prostate biopsy from January 1, 2013 to December 31, 2013 were included in the study. Prostate MRI was performed using a 1.5-T machine with T2 and diffusion weighted imaging axial phase. TRUS prostate biopsy was performed using a monoplane ultrasound machine. Systematic 12-core prostate biopsies were taken with a Tru-Cut biopsy needle from the apex, middle, and base of the left and right lobe.ResultsOne hundred seventy-three patients met the inclusion criteria; 128 (74.4%) patients had a lesion detected on MRI and 114 (66.3%) patients had a positive biopsy. The sensitivity of MRI for significant prostate cancer on TRUS biopsy of the prostate was 83.5%, specificity was 35.2%, positive predictive value was 55%, and negative predictive value was 68.9%. A positive MRI scan was significantly associated with significant prostate cancer diagnosis, and higher National Comprehensive Cancer Network (NCCN) risk classification (P ≤ .001). MRI detected 62 of 63 NCCN high-risk and 18 of 18 Gleason score 8 to 10 cases.ConclusionThe sensitivity and specificity of MRI appears insufficient to avoid TRUS biopsy in all men clinically suspected to have prostate cancer. Standardized MRI reporting and robust prospective studies are needed to define the role of prebiopsy MRI in this setting. For patients at risk of complications from biopsy, a negative MRI scan might be used to exclude high-risk disease.
Tan WS, Lamb BW, Payne H, et al., 2015, Management of Node-Positive Bladder Cancer After Neoadjuvant Chemotherapy and Radical Cystectomy: A Survey of Current UK Practice, CLINICAL GENITOURINARY CANCER, Vol: 13, Pages: E153-E158, ISSN: 1558-7673
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- Citations: 10
Murali SS, Kockelbergh R, Lamb B, et al., 2015, Measurement of bladder cancer recurrence on a national scale: A pilot study, Publisher: WILEY-BLACKWELL, Pages: 7-7, ISSN: 0961-5423
Ellis G, Pridgeon S, Lamb BW, et al., 2015, Psychological distress in out-patients undergoing flexible cystoscopy for the investigation of bladder cancer, JOURNAL OF CLINICAL UROLOGY, Vol: 8, Pages: 196-201, ISSN: 2051-4158
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- Citations: 6
Lamb BW, Vasdev N, Mourtzilas E, et al., 2015, Robotic pyeloplasty: Initial experience of a single UK centre, JOURNAL OF CLINICAL UROLOGY, Vol: 8, Pages: 127-131, ISSN: 2051-4158
Patel K, Lamb BW, Hawkesford K, et al., 2015, Acute scrotal pain and priapism: an early sign of progression in metastatic renal cell carcinoma?, BMJ Case Rep, Vol: 2015
A 43 -year-old man was treated with pazopanib for metastatic renal cell carcinoma (RCC) with imaging studies suggesting a partial response to treatment. However, the patient presented numerous times with severe testicular pain and gradually increasing priapism. He underwent an inguinal orchidectomy for symptom control. Histopathology confirmed invasion of the cord and tunica vaginalis with metastatic RCC. Further CT of the abdomen and pelvis suggested non-progression of the disease. The patient continued to develop priapism for several weeks before imaging studies confirmed disease progression; a month later the patient died. Genital involvement in metastatic RCC is unusual but should alert clinicians to the possibility of disease progression.
Tan WS, Lamb BW, Kelly JD, 2015, Complications of Radical Cystectomy and Orthotopic Reconstruction, ADVANCES IN UROLOGY, Vol: 2015, ISSN: 1687-6369
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- Citations: 33
Davari M, Lamb BW, Chowdhury S, et al., 2015, Aggressive Angiomyxoma of the Bladder Neck Requiring Local Excision and Mitrofanoff Formation., Case Rep Urol, Vol: 2015, ISSN: 2090-696X
Aggressive angiomyxoma is a rare mesenchymal tumour predominantly affecting the female pelvis and perineum but has also been described in males. This tumour can often present a diagnostic challenge and has a propensity for local recurrence after surgical excision. We present an unusual case of aggressive angiomyxoma arising from the bladder of a female patient which required local excision and Mitrofanoff formation.
Sarkar S, Arora S, Lamb BW, et al., 2014, Case review in urology multidisciplinary team meetings: What members think of its functioning, Journal of Clinical Urology, Vol: 7, Pages: 394-402, ISSN: 2051-4158
© British Association of Urological Surgeons 2014. Objective: To improve communication and decision making between specialists, multidisciplinary teams (MDTs) were introduced with the premise they would improve cancer care for patients. Minimal evidence exists on MDT functionality. We investigated MDT members’ views on barriers to optimal functioning and explored their suggestions for improvements.Materials and methods: Twenty urology MDT members from seven hospitals including surgeons, oncologists, pathologists, radiologists and clinical nurse specialists took part in a semi-structured interview study. Interviews focused on information presentation, case discussion, factors affecting the multidisciplinary team meeting (MDM) and potential improvements. Interviews were transcribed and analysed through emergent theme analysis.Results: Factors negatively influencing the MDMs included insufficient time to prepare cases so that enough information is available to make appropriate decisions; absence of the clinician in charge or not knowing the patient; and lack of a systematic approach to case discussion. Recommendations included protected time for case preparation, focusing on performance and comorbidities of the patient, standardising the MDT meeting and improving case selection.Conclusions: MDTs in urology have contributed to advances in cancer care but there is significant scope for further improvement. Implementing recommendations from team members on the front line may help drive quality in this sensitive domain.
Patel K, Lamb B, Pathak S, et al., 2014, Vasitis: the need for imaging and clinical acumen., BMJ Case Rep, Vol: 2014
A 55-year-old man presented with an acute, painful groin mass with signs of sepsis. On examination, it was difficult to tell whether this was a strangulated hernia or a testicular torsion. Biochemical investigations revealed raised inflammatory markers and radiological investigations showed a rare inflammatory condition, vasitis, which could be mistaken for various other 'surgical' groin masses. This case report summarises the importance of realising the vast differential diagnoses that come with acute groin masses and how imaging can prevent unnecessary surgery.
Lamb BW, Jalil RT, Sevdalis N, et al., 2014, Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study, BMC HEALTH SERVICES RESEARCH, Vol: 14, ISSN: 1472-6963
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- Citations: 47
Jalil R, Akhter W, Lamb BW, et al., 2014, Validation of Team Performance Assessment of Multidisciplinary Tumor Boards, JOURNAL OF UROLOGY, Vol: 192, Pages: 891-898, ISSN: 0022-5347
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- Citations: 35
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Annual Scientific Meeting of the British-Association-of-Urological-Surgeons (BAUS), Publisher: WILEY-BLACKWELL, Pages: 31-32, ISSN: 1464-4096
Sarkar S, Arora S, Lamb BW, et al., 2014, Urology MDTs : multi-disciplinary or multi-dysfunctional?, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 65-66, ISSN: 0007-1323
Marzouk S, Lamb BW, Harris A, et al., 2014, A retrospective cohort study of patients diagnosed with bladder cancer referred with visible haematuria: the impact of source of referral on prognostic indicators, Journal of Clinical Urology, Vol: 7, Pages: 384-388, ISSN: 2051-4158
© British Association of Urological Surgeons 2014. Objective: Our aim was to establish whether there is a difference in prognostic indicators for bladder urothelial carcinoma (UC) between the patients referred via the 2-week wait (2WW) and those presenting to the emergency department (ED).Patients and methods: We performed a retrospective cohort study of all patients referred with visible haematuria, comparing tumour stage and grade between patients diagnosed with bladder UC via the ED and 2WW at two London hospitals.Results: From 09/2009-09/2011, 51 patients referred from the ED, and 146 from the 2WW clinic were diagnosed with bladder UC. Regarding tumour stage: 57% of the ED group had muscle-invasive UC compared with 23% from 2WW (p=0.001). Regarding tumour grade: 82% of the ED group had G3 tumours, versus 54% from 2WW (p<0.001). ED referrals were significantly older than those from the 2WW (p<0.001).Conclusions: Patients with UC who present as emergencies had worse prognostic indicators and were older than those referred from the 2WW pathway. This supports the need for the inclusion of haematuria in the out-of-hours urology guidelines within the Acute Oncology Service.
Lamb B, Lettin J, Malik S, et al., 2014, INCIDENCE OF RAISED SERUM CREATININE IN PATIENTS ADMITTED WITH UNILATERAL ACUTE URETERIC COLIC, Annual Meeting of the American-Urological-Association (AUA), Publisher: ELSEVIER SCIENCE INC, Pages: E871-E872, ISSN: 0022-5347
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Conference on Changing Paradigms in Urology (UROFAIR), Publisher: WILEY-BLACKWELL, Pages: 27-28, ISSN: 1464-4096
Sarkar S, Arora S, Lamb BW, et al., 2014, Urology MDTs: multi-disciplinary or multi-dysfunctional?, Conference on Changing Paradigms in Urology (UROFAIR), Publisher: WILEY-BLACKWELL, Pages: 28-28, ISSN: 1464-4096
Green JSA, Lamb BW, Allchorne P, 2014, Barriers to the early diagnosis of hematuria in primary care, Hematuria: Etiology, Management and Long-Term Prognosis, Pages: 129-135, ISBN: 9781634630733
Lamb BW, Li CY, Tan WS, et al., 2014, Management of haematuria in patients with prostate cancer, Hematuria: Etiology, Management and Long-Term Prognosis, Pages: 145-158, ISBN: 9781634630733
Green JSA, Allchorne P, Lamb BW, 2014, Barriers to the early diagnosis and treatment of haematuria in secondary care, Hematuria: Etiology, Management and Long-Term Prognosis, Pages: 181-188, ISBN: 9781634630733
Lamb BW, Vasdev N, Jalil RT, et al., 2014, Second-line chemotherapy for advanced bladder cancer: A survey of current UK practice, UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, Vol: 32, ISSN: 1078-1439
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