The Role of Sentinel Lymph Node Biopsy in the Management of Merkel Cell Carcinoma: A Systematic Review and Meta-analysis.

Background: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy with high metastatic potential. Sentinel lymph node biopsy (SLNB) is used to assess locoregional spread, facilitate staging, and inform prognosis. Positive nodal status is associated with higher recurrence rates and reduced overall survival.

Developing a patient-driven chronic obstructive pulmonary disease (COPD) research agenda in the U.S.

Background: To document a generalizable process for developing a patient-prioritized chronic obstructive pulmonary disease (COPD) research agenda and to provide an overview of domains that were developed in response to people living with COPD and caregivers' suggestions for research.

Methods: Adults with COPD and caregivers who are members of the COPD Patient-Powered Research Network (PPRN) provided suggestions for COPD-related research through a self-administered, online survey. These responses were analyzed with a content analysis approach: domains for categorizing all survey responses were created, then all responses were categorized independently by a group of researchers, then these categorizations were adjudicated, and finally a density map was created that represented the number of responses in each of the domains.

Self-reported COPD Medication Use and Adherence in the COPD Foundation Patient- Powered Registry Network.

Purpose: Pharmacotherapy is one cornerstone of Chronic Obstructive Pulmonary Disease (COPD) management. Published U.S.

A review of clinical trials of advance care planning interventions adapted for limited health literacy.

Objectives: Advance care planning is vital for ensuring individuals receive end-of-life care that is consistent with their care preferences and improves patient quality of life and satisfaction with care; however, only 11% of Americans have discussed advance care planning with a healthcare provider. Individuals with limited health literacy are even less likely to participate in advance care planning due to difficulty comprehending complex health information. The purpose of this review was to identify randomized controlled trials designed to address the effects of limited health literacy on advance care planning, evaluate the quality of these studies, and summarize evaluation data to inform future studies.

Incidence of Venous Thromboembolism and Safety of Perioperative Subcutaneous Heparin During Inflatable Penile Prosthesis Surgery.

Objective: To identify the incidence of venous thromboembolism (VTE) risk factors, postoperative VTE, and to assess the morbidity of perioperative pharmacologic VTE prophylaxis in men undergoing inflatable penile prosthesis (IPP) surgery.

Methods: We retrospectively reviewed 215 patients undergoing IPP surgery between July 2017 and June 2019. Univariate and multivariate statistical analyzes were performed to assess pre-operative Caprini risk score and compare post-operative day 0 scrotal drain output, scrotal hematoma formation, and VTE in men who received subcutaneous heparin (SqH) vs those who did not receive SqH.

Sexual function in the penile cancer survivor: a narrative review.

Squamous cell carcinoma of the penis is a rare malignancy among men in North America and Europe with an incidence of <1 per 100,00 men. Of all genitourinary cancers, penile carcinoma has the potential to jeopardize sexual function the most. The treatment modalities of penile carcinoma span the gamut from organ-sparing treatments such as topical therapy, laser therapy, radiotherapy, glansectomy, wide-local excision and partial or total penectomy.

Evaluating the Impact of Immediate Lymphatic Reconstruction for the Surgical Prevention of Lymphedema.

Background: Breast cancer-related lymphedema affects one in five patients. Its risk is increased by axillary lymph node dissection and regional lymph node radiotherapy. The purpose of this study was to evaluate the impact of immediate lymphatic reconstruction or the lymphatic microsurgical preventative healing approach on postoperative lymphedema incidence.

The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A Novel Approach to Fixate the Penile Implant Reservoir.

Background: Penile implant reservoir herniation or migration after inflatable penile prosthesis (IPP) placement may occur with standard or submuscular placement. Additionally, fixating the tubing in patients with retained reservoirs may be helpful for future prosthetic surgeons.

Aim: We describe a novel technique to fixate IPP reservoirs in the preferred position.

Predictive Risk Factors for Continued Smoking after the Diagnosis of a Genitourinary Malignancy.

Objective: To determine risk factors for continued smoking following a diagnosis of a genitourinary (GU) malignancy. Smoking is a well established risk factor in the development of cancers involving the GU tract. Unfortunately, a large percentage of patients continue to smoke or relapse after cancer diagnosis; by doing so, there is an increased risk of recurrence, poor survival rates, treatment complications, secondary primary cancers, and other chronic smoking related illnesses.

Low diagnostic sensitivity of cystoscopy and cystography of surgically confirmed vesicoenteric fistulae.

Purpose: The objective of this study was to assess the accuracy of cystoscopy and cystography, as compared to other diagnostic studies, in identifying vesicoenteric fistulae (VEF) in a contemporary series of patients with surgically confirmed VEF.

Methods: With institutional review board approval, we performed a single-center retrospective review of surgically confirmed VEF between 2002 and 2018. Demographic data, comorbidities, symptoms, and diagnostic evaluation were reviewed.

The Influence of Indentation Deformity on Outcomes With Intralesional Collagenase Clostridium Histolyticum Monotherapy for Peyronie's Disease.

Objective: To identify patient-specific factors associated with patient-reported improvements in functional outcomes after intralesional Collagenase Clostridium histolyticum (CCH) for Peyronie's Disease (PD).

Methods: We retrospectively explored our prospectively maintained CCH registry. We sought to identify patient-specific factors that prevented the need for surgical straightening and/or improved ability to engage in penetrative intercourse.

Metastatic Thyroid Cancer Presenting as Renal Cortical Mass.

The authors present a rare case of primary diagnosis of metastatic, differentiated thyroid cancer presenting as a solitary, large renal mass. Renal cortical masses which represent metastatic primary malignancies are often small, multifocal, and in the setting of active malignancy. Surgical excision of this patient's renal mass demonstrated the unexpected diagnosis and subsequent endocrine surgical intervention.

Cutaneous metastasis of bladder urothelial carcinoma.

Cutaneous metastases of genitourinary malignancies are an extremely rare phenomenon. Few cases of skin metastasis from urothelial carcinoma of the bladder have been reported. We report a case of 71-year-old female with primary bladder transitional cell carcinoma who presented with the initial presentation of cutaneous skin lesions that covered the entire lower abdominal wall.

Penoscrotal approach for IPP: still up-to-date after more than 40 years?

Inflatable penile prosthesis is the definitive operative intervention utilized for treatment of erectile dysfunction. There are a handful of surgical approaches to perform this operation in a safe and efficient manner. The aim of this review article is to discuss the surgical approaches described in the literature, and describe the preferred approach of authors.

Collagen organization of renal cell carcinoma differs between low and high grade tumors.

Background: The traditional pathologic grading for human renal cell carcinoma (RCC) has low concordance between biopsy and surgical specimen. There is a need to investigate adjunctive pathology technique that does not rely on the nuclear morphology that defines the traditional grading. Changes in collagen organization in the extracellular matrix have been linked to prognosis or grade in breast, ovarian, and pancreatic cancers, but collagen organization has never been correlated with RCC grade.

Early multicentre experience of pre-pectoral implant based immediate breast reconstruction using Braxon.

Background: The last two decades have seen significant changes in surgical management of breast cancer. The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice. Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options.

Surgical upgrade rate of breast atypia to malignancy: An academic center's experience and validation of a predictive model.

Atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and lobular carcinoma in situ (LCIS) are commonly seen on breast core needle biopsy (CNB). Many institutions recommend excision of these lesions to exclude malignancy. A retrospective chart review was performed on patients who had ADH, ALH, or LCIS on breast CNB from 1/1/08 to 12/31/10 who subsequently had surgical excision of the biopsy site.

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes.

Background And Objectives: Oncoplastic reconstruction allows more patients to become candidates for breast-conserving surgery (BCS). Oncologic resection of a breast lesion is combined with plastic surgical techniques to improve aesthetic results. Choosing the best oncoplastic method is essential to optimize outcomes, improve cosmesis, and minimize postoperative complications.

Comparison of Outcome Measures for Traditional and Online Support Groups for Breast Cancer Patients: An Integrative Literature Review.

Despite widespread use of support groups in the breast cancer patient population, there are heterogeneous outcome measurements and inconsistencies in their perceived benefits. The purpose of this integrative literature review is to compare the efficacies of traditional and online support groups for breast cancer survivors through analysis of outcome measurements and determination of strengths and weaknesses. After examining the literature, it was found that online support groups are ideal for women who require additional support or who are unable to attend a traditional group.

Use and Yield of Baseline Imaging and Laboratory Testing in Stage II Breast Cancer.

Background: Despite guideline recommendations, baseline laboratory testing and advanced imaging are widely ordered in clinical practice to stage asymptomatic patients with clinical stage II breast cancer (BC).

Materials And Methods: A retrospective study at two academic centers in Boston, Massachusetts, between 2006 and 2007 explored the use, results, and implications of laboratory tests, tumor markers, and imaging in patients with clinical stage II BC.

Results: Among 411 patients, 233 (57%) had liver function testing, 134 (33%) had tumor marker tests, and 237 (58%) had computed tomography (CT) as part of their initial diagnostic workup.

Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes.

Background: Nodal staging with sentinel node biopsy (SLNB), post-lumpectomy radiotherapy (RT), and endocrine therapy (ET) for estrogen receptor-positive (ER+) tumors is valuable in the treatment of early-stage (stages 1 or 2) breast cancer but used less often for elderly women.

Methods: This retrospective study investigated women referred for surgical evaluation of biopsy-proven primary early-stage invasive breast cancer from January 2001 to December 2010. Clinicopathologic features, treatment course, and outcomes for women ages 80-89 years and 50-59 years were compared.