Publications by authors named "Jonathan E Kiechle"

Penile and urethral reconstructive surgical procedures are used to treat a variety of urologic diagnoses. Urethral stricture disease can lead to progressive lower urinary tract symptoms and may require multiple surgical procedures to improve patient's symptoms. Male stress urinary incontinence is associated with intrinsic sphincter deficiency oftentimes associated with radical prostatectomy.

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Introduction: Radiation cystitis is associated with a significant burden to patients and the health care system. However, the regional burden of treatment and its associated costs remains poorly described. We assessed the health care costs and need for intervention among patients admitted to the hospital with radiation cystitis.

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Objective: To evaluate racial disparities in the diagnosis and treatment of penile cancer among a contemporary series of men from a large diverse national data base.

Materials And Methods: Using the 1998-2012 National Cancer Data Base, all men with squamous cell carcinoma (SCC) were stratified by race and ethnicity. Demographic and disease characteristics were compared between groups.

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Objective: To assess the national utilization of partial nephrectomy (PN) for T1a renal masses across different racial groups by hospital type. Although clinical guidelines recommend PN for small renal masses (SRMs), racial disparities persist in the use of PN. High-volume and academic hospitals have been associated with greater use of PN for SRMs.

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Purpose: Comorbid medical conditions are highly prevalent among patients with prostate cancer and may be associated with more aggressive disease. We investigated the association between comorbidity burden and higher risk disease among men eligible for active surveillance.

Materials And Methods: Using the National Cancer Data Base we identified 29,447 cases of low risk (Gleason score 6 or less, cT1/T2a, prostate specific antigen less than 10 ng/ml) prostate cancer managed with prostatectomy from 2010 to 2011.

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Objective: To describe recent temporal trends in biopsy use for renal cell carcinoma and to identify factors associated with biopsy.

Materials And Methods: Renal cell carcinoma diagnoses from 2003 to 2011 were identified using the National Cancer Data Base. Cases were classified by traditional (clinical stage T4, N1, or M1, or history of other malignancies) or expanded biopsy indications.

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Objective: To assess national trends in the usage of local ablative therapy for small renal masses (SRMs) in a cohort of young patients. Ablation of SRMs has been shown to offer cancer control with limited follow-up. Although ablation is considered effective for patients with limited life expectancy, its use among younger patients may be considered controversial.

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Objective: To determine the rate of observation utilization over time and to identify factors influencing its use.

Materials And Methods: Using the National Cancer Data Base, we studied observation utilization in patients diagnosed with localized renal cell carcinoma from 2003 to 2010. Relationships between temporal, demographic, provider, and clinical factors and the likelihood of observation were evaluated using multivariate logistic regression.

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Article Synopsis
  • This study evaluated the surgical margin status in patients with clinical T1a renal cell carcinoma who underwent different types of partial nephrectomy (open, laparoscopic, robotic) using data from the National Cancer Database between 2010 and 2011.
  • A total of 11,587 patients were analyzed, revealing that laparoscopic and robotic approaches had significantly higher rates of positive surgical margins (8.1% and 8.7% respectively) compared to open surgery (4.9%).
  • The findings suggest that laparoscopic and robotic surgeries may pose a greater risk for positive surgical margins, prompting further research on how these margins impact long-term cancer outcomes.
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