Publications by authors named "Chandru Sundaram"
Background: The impact of cumulative smoking exposure (CSE) on oncologic outcomes for upper tract urothelial carcinoma (UTUC) remains understudied. We examined the effect of this factor on oncologic outcomes in UTUC patients undergoing radical nephroureterectomy utilizing a large contemporary multicenter, multinational cohort.
Methods: Multicenter review of 1,730 patients across 17 institutions.
Article Synopsis
- This study aimed to analyze how common surgically induced chronic kidney disease (CKD-S) is in patients with upper tract urothelial carcinoma (UTUC) after they undergo radical nephroureterectomy (RNU), focusing on survival outcomes.* -
- Researchers looked at data from 1,862 patients and found that 34.7% developed CKD-S3a and 39.6% developed CKD-S3b after surgery, with older age, lower preoperative kidney function, and certain chemotherapy treatments linked to higher risks of developing CKD-S3b.* -
- The study revealed that while CKD-S3b patients had worse overall survival rates (59% over 5 years), CK
Introduction: Our goal was to compare outcomes of adrenalectomy performed by low-volume and high-volume academic urologists with extensive experience in renal surgery.
Methods: A single-center retrospective review identified patients undergoing adrenalectomy by urologists from 2009 to 2023. Data were gathered on demographics, tumor characteristics, surgeon volume, surgical outcomes including length of procedure, estimated blood loss, length of stay, and complications identified by the Clavien-Dindo complication classification system.
Article Synopsis
- * The survey had a 28.6% completion rate with 201 responses, revealing that while about half of the institutions using SP platforms have done so for over 2 years, structured training is limited, leading to concerns about hands-on experience and the learning curve associated with SP procedures.
- * Despite recognizing the clinical benefits of SP surgery, many trainees do not view proficiency in it as essential for career advancement; however, predictors of future SP implementation include academic aspirations and the availability of SP platforms
Article Synopsis
- The study investigates the effects of neoadjuvant and adjuvant chemotherapy on survival rates in patients with Upper tract urothelial carcinoma undergoing Nephroureterectomy, using data from a multicenter registry.
- A total of 1,994 patients were analyzed, revealing that neoadjuvant chemotherapy notably improved cancer-specific and overall survival, especially in patients with advanced tumors or positive nodes.
- The results suggest a significant survival benefit from neoadjuvant chemotherapy, indicating a need for further research to explore its impact in this patient population.
Survival Outcomes by Race Following Surgical Treatment for Upper Tract Urothelial Carcinoma.
Clin Genitourin Cancer
December 2024
Objective: Discrepancies in survival outcomes of various genitourinary tract malignancies have been documented across different racial and ethnic groups. Here we sought to examine long-term survival outcomes of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU) when stratified by race.
Methods: A multicenter retrospective analysis using the ROBUUST (ROBotic surgery for Upper tract Urothelial cancer Study) registry identified patients undergoing RNU for UTUC between 2015 and 2022 at 12 centers across the United States, Europe, and Asia.
Objective: To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.
Patients And Methods: Data were retrieved from the ROBotic surgery for Upper tract Urothelial cancer STtudy (ROBUUST) 2.0 database, an international, multicentre registry encompassing data of patients with upper urinary tract urothelial carcinoma undergoing curative surgery between 2015 and 2022.
Robotic assisted partial nephrectomy (RPN) has emerged in urologic practice for the management of appropriately sized renal masses. We provide a 20-year comparison of the outcomes of open partial nephrectomy (OPN) versus RPN for renal cell carcinoma (RCC) at our institution. An IRB-approved retrospective review was conducted of RCC patients at a single institution from 2000 to 2022 who underwent RPN or OPN.
View Article and Find Full Text PDFObjectives: We sought to determine whether bladder cuff excision and its technique influence outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).
Methods And Materials: A multicenter, international, retrospective analysis using the ROBotic surgery for Upper tract Urothelial cancer Study (ROBUUST) 2.0 registry identified 1,718 patients undergoing RNU for UTUC between 2015 and 2023 at 17 centers across the United States, Europe, and Asia.
Introduction: We aimed to determine whether sestamibi scan changes management of renal masses.
Methods: All patients undergoing sestamibi scan for renal masses between 2008 and 2022 at a single center were retrospectively reviewed. Data were gathered on patient demographics, pre- and postoperative creatinine, sestamibi scan parameters, and cross-sectional imaging characteristics.
Background: The role of kidney-sparing surgery in patients with high-risk upper urinary tract urothelial carcinoma is controversial. The present study aimed to assess oncological and functional outcomes of robot-assisted distal ureterectomy in patients with high-risk distal ureteral tumors.
Methods: The ROBUUST 2.
Background: Diagnostic ureteroscopy (URS) with or without biopsy remains a subject of contention in the management of upper tract urothelial carcinoma (UTUC), with varying recommendations across different guidelines. The study aims to analyse the decision-making and prognostic role of diagnostic ureteroscopy (URS) in high-risk UTUC patients undergoing curative surgery.
Materials And Methods: In this retrospective multi-institutional analysis of high-risk UTUC patients from the ROBUUST dataset, a comparison between patients who received or not preoperative URS and biopsy before curative surgery was carried out.
Introduction: Studies have reached mixed conclusions on the role of antiplatelet and anticoagulant agents on postoperative complications of partial nephrectomies. This study examines whether preoperative anticoagulation use affected the risk of hemorrhagic complications after partial nephrectomy.
Materials And Methods: This is a retrospective chart review of all partial nephrectomies performed between 2017 and 2022 at a single institution.
Background: Utility of partial nephrectomy (PN) for complex renal mass (CRM) is controversial. We determined the impact of surgical modality on postoperative renal functional outcomes for CRM.
Methods: We retrospectively analyzed a multicenter registry (ROSULA).
Introduction: Oncologic implications of variant histology (VH) have been extensively studied in bladder cancer; however, further investigation is needed in upper tract urothelial carcinoma (UTUC). Our study aims to evaluate the impact of VH on oncological outcomes in UTUC patients treated with radical nephroureterectomy (RNU).
Methods: A retrospective analysis was performed on patients who underwent a robotic or laparoscopic RNU for UTUC using the ROBUUST database, a multi-institutional collaborative including 17 centers worldwide.
Previous studies in robotic-assisted surgery (RAS) have studied cognitive workload by modulating surgical task difficulty, and many of these studies have relied on self-reported workload measurements. However, contributors to and their effects on cognitive workload are complex and may not be sufficiently summarized by changes in task difficulty alone. This study aims to understand how multi-task requirement contributes to the prediction of cognitive load in RAS under different task difficulties.
View Article and Find Full Text PDFPurpose: To compare outcomes of robotic-assisted partial nephrectomy (RAPN) and minimally invasive radical nephrectomy (MIS-RN) for complex renal masses (CRM).
Methods: We conducted a retrospective multicenter analysis of CRM patients who underwent MIS-RN and RAPN. CRM was defined as RENAL score 10-12.
Purpose: To create a suturing skills assessment tool that comprehensively defines criteria around relevant sub-skills of suturing and to confirm its validity.
Materials And Methods: 5 expert surgeons and an educational psychologist participated in a cognitive task analysis (CTA) to deconstruct robotic suturing into an exhaustive list of technical skill domains and sub-skill descriptions. Using the Delphi methodology, each CTA element was systematically reviewed by a multi-institutional panel of 16 surgical educators and implemented in the final product when content validity index (CVI) reached ≥0.