Publications by authors named "Kamat A"
Background And Objectives: Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item.
Methods: A systematic review was performed to identify the impact of each single ERAS item on RC outcomes.
Article Synopsis
- Bladder cancer (BCa) presents a significant financial challenge for both healthcare systems and patients, necessitating an understanding of its economic impacts for better resource management and treatment effectiveness.
- A systematic review was performed following PRISMA guidelines to assess the financial implications of BCa, including various costs, cost effectiveness, and the phenomenon of financial toxicity (FT) across multiple studies.
- High-risk non-muscle-invasive BCa can lead to expenses over $200,000 within five years, while metastatic BCa presents the most financial strain, with treatment costs ranging wildly and disproportionately affecting younger, less-educated, and minority groups.
Background And Objective: Non-muscle-invasive bladder cancer (NMIBC) patients treated with additional bacillus Calmette-Guérin (BCG) may become unresponsive to BCG. Recently, sequential intravesical gemcitabine and docetaxel (gem/doce) are being used for NMIBC. This study aims to compare oncologic outcomes between sequential intravesical gem/doce versus additional BCG in patients with BCG-unresponsive NMIBC.
View Article and Find Full Text PDFArticle Synopsis
- - The study investigates the expression of nectin-4 (N4) in various genitourinary (GU) cancers, particularly focusing on its relevance as a potential target for antibody-drug conjugates, given its aberrant expression in malignancies like urothelial carcinoma of the bladder (UBC).
- - A systematic review analyzed 25 studies on N4 positivity across different GU tumors, finding that N4 positivity is generally higher in bladder cancers, especially in metastatic and non-muscle-invasive stages, compared to other types like upper tract urothelial carcinoma and non-urothelial cancers.
- - The findings suggest that non-urothelial malignancies have lower rates of N4 positivity compared to bladder cancer,
Article Synopsis
- Intraarticular knee fractures are significant and need proper treatment for better recovery outcomes, with cleavage fractures being a rare type that involves limited areas of the distal femur without additional complications.
- The article presents two case studies: one of a young adult treated successfully without surgery and another adolescent who required minimal-invasive surgical intervention.
- Both patients achieved excellent healing and returned to full function, with follow-up periods of nine and eleven months showing positive results.
Background: Whether extended lymphadenectomy is associated with improved disease-free and overall survival, as compared with standard lymphadenectomy, among patients with localized muscle-invasive bladder cancer undergoing radical cystectomy is unclear.
Methods: We randomly assigned, in a 1:1 ratio, patients with localized muscle-invasive bladder cancer of clinical stage T2 (confined to muscle) to T4a (invading adjacent organs) with two or fewer positive nodes (N0, N1, or N2) to undergo bilateral standard lymphadenectomy (dissection of lymph nodes on both sides of the pelvis) or extended lymphadenectomy involving removal of common iliac, presciatic, and presacral nodes. Randomization was performed during surgery and stratified according to the receipt and type of neoadjuvant chemotherapy, tumor stage (T2 vs.
Background And Objective: Non-muscle-invasive bladder cancer (NMIBC) poses a significant clinical challenge, particularly when failing bacillus Calmette-Guérin (BCG) therapy, necessitating alternative treatments. Despite radical cystectomy being the recommended treatment, many patients are unfit or unwilling to undergo this invasive procedure, highlighting the need for effective bladder-sparing therapies. This review aims to summarize and report the evidence on the efficacy and to estimate the costs of bladder-preserving strategies used in NMIBC recurrence after failure of intravesical BCG therapy.
View Article and Find Full Text PDFObjective: The authors' goal was to perform a retrospective audit of all emergency cranial neurosurgery performed at the Royal Darwin Hospital in the first 5 years of the unit and to compile their data in a similar fashion to an earlier study titled "Emergency Neurosurgery in Darwin: Still the Generalist Surgeons' Responsibility," which was published in 2015.
Methods: All emergency cranial neurosurgery performed by a neurosurgeon between 2017 and 2021 was identified. Data were extracted from the National Critical Care and Trauma Response Centre database.
Implementing Screening for Eating Disorders in Adolescents and Young Adults with a History of Cancer.
J Adolesc Young Adult Oncol
November 2024
Eating disorders are prevalent in the adolescent and young adult (AYA) population, with 2.7% of adolescents effected. AYAs with cancer possess several risk factors for eating disorders that may place them at an even higher risk.
View Article and Find Full Text PDFArticle Synopsis
- The study examined the survival rates and pathologic responses of patients with cT1N0 small-cell neuroendocrine carcinoma (SCNEC) of the bladder who underwent neoadjuvant chemotherapy (neoCTX) from 1996 to 2023.
- Out of 30 patients, 70% received neoCTX, revealing that it significantly reduced the risk of disease progression and recurrence, and led to better disease-free survival (DFS) and overall survival (OS) rates.
- The findings suggest that neoCTX offers meaningful benefits for cT1 bladder SCNEC patients, including lower chances of worsening disease and improved outcomes compared to those with higher stage tumors.
The impact of sex on non-muscle-invasive bladder cancer (NMIBC) remains uncertain and current evidence is conflicting. To address this uncertainty, we conducted an integrative analysis using Surveillance, Epidemiology and End Results (SEER)-Medicare and UROMOL data sets to explore sex disparities in NMIBC oncological outcomes. In the SEER-Medicare cohort, females had lower risks of recurrence and progression in comparison to males, but no significant difference in BC-specific mortality was observed.
View Article and Find Full Text PDFThe evolving role of multidisciplinary teams in optimizing non-muscle invasive bladder cancer care.
Expert Rev Anticancer Ther
October 2024
Introduction: Non-muscle invasive bladder cancer (NMIBC) represents a significant portion of bladder cancer cases and imposes a substantial economic burden, stemming from both direct treatment costs and long-term surveillance. As the treatment landscape evolves with advances in immunotherapy and targeted therapies, a multidisciplinary approach to management is increasingly crucial for optimizing patient outcomes and resource utilization.
Areas Covered: A PubMed search from 2010 to 15 June 2024 was conducted.
Purpose: Trimodality therapy for muscle-invasive bladder cancer (MIBC) yields similar oncologic outcomes compared to radical cystectomy in appropriately selected patients; however, data regarding locally advanced MIBC (LA-MIBC) is limited. We explored our experience with LA-MIBC undergoing radiation therapy (RT).
Methods: We retrospectively identified 30 patients from an institutional prospectively collated database with non-metastatic, LA-MIBC.
Article Synopsis
- Researchers created AI-based histologic assays to predict the likelihood of recurrence and progression in patients with high-risk non-muscle invasive bladder cancer after treatment with intravesical BCG.
- They analyzed whole-slide images from bladder tumor resections and clinical data from multiple centers, successfully categorizing cases into high or low risk for various outcomes.
- The validation cohort showed that high-risk patients had significantly worse survival outcomes, indicating that these AI assays provide crucial predictive information beyond traditional clinical factors.
Background: Tumors harboring two or more PIK3CA short variant (SV) ("multi-hit") mutations have been linked to improved outcomes with anti-PIK3CA-targeted therapies in breast cancer. The landscape and clinical implications of multi-hit PIK3CA alterations in clinically advanced prostate cancer (CAPC) remains elusive.
Objective: To evaluate the genomic landscape of single-hit and multi-hit PIK3CA genomic alterations in CAPC.
Background And Objective: The 2024 US Food and Drug Administration approval of erdafitinib for the treatment of metastatic urothelial carcinoma (mUC) with FGFR3 alterations ushered in the era of targeted therapy for bladder cancer. In this review, we summarize the effects of FGFR pathway alterations in oncogenesis, clinical data supporting FGFR inhibitors in the management of bladder cancer, and the challenges that remain.
Methods: Original articles relevant to FGFR inhibitors in urothelial cancer between 1995 and 2024 were systematically identified in the PubMed and MEDLINE databases using the search terms "FGFR" and "bladder cancer".
Article Synopsis
- The Metal to Insulator Transition (MIT) in vanadium dioxide (VO) is significant for applications like smart windows and sensors, as it changes from an insulating state to a conducting state around 68 °C.
- Researchers are investigating how to adjust this transition temperature in VO thin films by using strain and defect engineering, resulting in a range from 65 °C to 82 °C through controlled growth conditions.
- The study includes various analytical techniques and density functional theory calculations to establish a connection between structural properties, strain, and electrical performance in VO thin films.
Medial epicondyle fractures are uncommon elbow injuries and require careful radiological evaluation for appropriate diagnosis and management. Missed or neglected medial epicondyle fractures, however, are reported as uncommon reports or small series. Incarceration of the medial epicondyle fragment within the elbow joint is often reported and poses therapeutic challenges.
View Article and Find Full Text PDFBackground And Objective: Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches.
View Article and Find Full Text PDFArticle Synopsis
- The pilot study investigated the safety and efficacy of daratumumab, a monoclonal antibody targeting CD38, in patients with muscle-invasive bladder cancer (MIBC) and metastatic renal cell carcinoma (mRCC).
- In the MIBC group, one out of eight patients achieved a pathologic complete response with no toxicity events noted in either cohort, while the mRCC group showed no objective responses and a median progression-free survival of only 1.5 months.
- Overall, the study concluded that while daratumumab was safe for use, its efficacy in these cancers was limited, with indications of targeted effects on CD38-expressing immune cells.
Article Synopsis
- - The study aimed to compare the cancer risks of bladder-sparing therapy (BST) versus radical cystectomy (RC) in patients with BCG-unresponsive non-muscle-invasive bladder cancer (NMIBC).
- - Data from 578 patients showed no significant differences in survival outcomes between the two treatment options, but the BST group had higher rates of high-grade recurrences and progressions to muscle-invasive bladder cancer (MIBC) over time.
- - The findings suggest that while BST and upfront RC provide similar survival rates in the intermediate term, patients receiving BST face increasing recurrence and progression risks, particularly with additional treatment attempts.
Article Synopsis
- There has been an increase in agents for treating bacillus Calmette-Guérin-unresponsive (BCG-U) non-muscle-invasive bladder cancer (NMIBC), and there is a pressing need for patient and therapy selection guidelines due to a lack of randomized trials.
- A global expert committee developed recommendations through literature reviews and a voting process, refining these guidelines during a live meeting in August 2023, achieving over 75% agreement on the final recommendations.
- No single optimal treatment exists for BCG-U patients; personalized treatment based on individual preferences, tumor characteristics, and available agent data is essential, with specific options recommended for carcinoma in situ and papillary-only tumors, and clinical trial participation encouraged.