Publications by authors named "Sarah Psutka"
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: Treatment burden refers to the overall impact of medical treatments on a patient's well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient care.
Methods: We conducted a narrative review of clinical trials focused on GU malignancy (prostate, bladder, and kidney) between January 2000 and June 2024, analyzing related PROs and findings regarding treatment burden.
The study of prehabilitation and rehabilitation ([p]rehabilitation) to alleviate the sequelae of bladder cancer and its treatment has generated numerous opportunities to improve the quality of life of bladder cancer survivors. The authors conducted a scoping review of randomized clinical trials (RCTs) to identify knowledge gaps in and research directions for (p)rehabilitative support for those affected by bladder cancer. The authors systematically searched six databases and synthesized key findings from RCTs conducted from January 1, 2004, through March 15, 2022, that enrolled participants with bladder cancer, survivors, or caregivers in outpatient (p)rehabilitative programs (e.
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- * 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 Society of Women in Urologic Oncology (WUO) started as an informal group at a Urologic Oncology meeting and has now become an official organization recognized by the SUO Board of Directors.
- The main goal of the WUO is to improve the recruitment, retention, and promotion of women in the field of Urologic Oncology.
- The text aims to discuss the history, current status, and future plans of the WUO organization.
Article Synopsis
- The study aimed to use AI algorithms on CT images to measure muscle and fat areas in patients before radical cystectomy (RCx) and link these measurements to complications after surgery.
- It analyzed data from 843 RCx patients between 2009 and 2017 and found that higher levels of certain types of fat were linked to increased complications, while higher skeletal muscle was associated with fewer complications.
- The findings suggest that AI-derived body composition information could help tailor patient care and improve pre-operative counseling by considering both physical metrics and other patient factors.
Purpose: Resilience, the ability to maintain or restore baseline function after a stressor, remains unexplored in patients with bladder cancer. Our objective was to demonstrate the feasibility of prospectively characterizing baseline resilience, related psychological resources, and frailty in patients with bladder cancer and evaluate associations with quality-of-life and mental health outcomes over time.
Materials And Methods: We enrolled patients with bladder cancer (N = 67, September 2020-July 2021) into a prospective, observational, cohort study.
Article Synopsis
- Small cell bladder cancer (SCBC) is a rare and aggressive type of cancer, prompting a study to compare outcomes of two treatment methods: cystectomy with neoadjuvant chemotherapy (NAC) and concurrent chemoradiotherapy (CCRT).
- The study examined data from an institutional database and SEER-Medicare, identifying 53 and 1166 patients, respectively, to evaluate overall survival (OS) and found that NAC followed by cystectomy resulted in a median OS of around 45-46 months compared to lower OS of 23-26 months with CCRT.
- Although NAC + cystectomy correlated with a potential 30% reduction in mortality compared to CCRT, results were not statistically significant, highlighting
Metastatic renal cell carcinoma (RCC) can present with oligometastatic disease and/or develop oligoprogression following systemic therapy. Cytoreductive and focal metastasis-directed therapy options include resection, stereotactic ablative radiation and thermal ablation. Aggressive focal therapy may allow delay in initiation of or modification to systemic therapy and improve clinical outcomes.
View Article and Find Full Text PDFPurpose Of Review: Prehabilitation describes interventions that are undertaken prior to a major surgical or medical intervention with the objective of improving functional capability with the goal of improving candidacy for therapy, bolstering one's ability to withstand treatment-associated toxicity, functional decline, and facilitating accelerated recovery. The objective of this review is to detail the key tenets of prehabilitation, synthesize contemporary advances in prehabilitation science within Urologic Oncology , and discuss key methodologic trial design considerations salient to future prehabilitation investigations.
Recent Findings: Contemporary prehabilitation clinical trials have primarily evaluated unimodal interventions aiming to improve functional capacity across the domains of physical exercise, nutrition, and cognition with heightened interest in evaluating multimodal interventions addressing two or more domains.
Background 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.
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- There is limited data on how often testicular germ cell tumors (TGCT) occur alongside venous tumor thrombus (VTT), and the study aims to provide insights on this rare condition and its management.
- Researchers analyzed records from the IBM Marketscan database, identifying a small prevalence of TGCT with VTT and gathered expert insights from surgeons on the patient management practices at multiple centers.
- Findings showed that approximately 0.3% to 3.1% of TGCT cases involved VTT, with surgical options being the primary treatment, emphasizing the complexity of managing this combination and the need for a multidisciplinary approach.
Article Synopsis
- Recent studies show that stereotactic body radiation therapy (SBRT) can effectively treat renal cell carcinoma (RCC), a type of kidney cancer once thought to be resistant to radiation.
- The article emphasizes the importance of practical guidelines for patient selection and treatment planning, particularly for complex cases like solitary kidneys or large tumors.
- The guide, supported by the Radiosurgery Society, includes case studies and discusses key aspects such as tumor size, radiation dosages, and advanced imaging techniques for assessing treatment response.
Purpose: This study leverages CDC National Health Interview Survey data to examine Financial Distress (FD) among genitourinary (GU) cancer survivors, specifically prostate cancer (PC), kidney cancer (KC), and bladder cancer (BC). It investigates the economic impacts faced by these patients, especially in relation to disparities in insurance coverage and its effects on material, psychological, and behavioral aspects of FD.
Methods: We retrospectively analyzed responses from GU cancer survivors, stratifying by cancer status and age (18-64 years, ≥65 years).
Background: Despite recent drug development for non-muscle invasive bladder cancer (NMIBC), few therapies have been approved by the US Food and Drug Administration (FDA), and there remains an unmet clinical need. Bacillus Calmette-Guerin (BCG) supply issues underscore the importance of developing safe and effective drugs for NMIBC.
Objective: On November 18-19, 2021, the FDA held a public virtual workshop to discuss NMIBC research needs and potential trial designs for future development of effective therapies.
Objective: To characterize changes in body composition following cytotoxic chemotherapy for germ cell carcinoma of the testis (GCT) and quantify associations between body composition metrics and chemotherapy-associated adverse events (AEs) and post-retroperitoneal lymph node dissection (RPLND) complications.
Materials And Methods: This retrospective multi-center study included 216 men with GCT treated with cytotoxic chemotherapy and/or RPLND (2005-2020). We measured body composition including skeletal muscle (SMI), visceral adipose (VAI,), subcutaneous adipose (SAI), and fat mass (FMI) indices on computed tomography.
Case: A 25-year-old man sustained a stable lateral compression Type I (LC I) pelvic ring injury upon missing the landing of a downhill ski jump. He presented with painful voiding from a displaced bony fragment, partially impaling the bladder wall. With operative fixation of the fracture and urologic co-management, the patient had excellent outcomes at 1-year follow-up.
View Article and Find Full Text PDFObjectives: Patients with histologic subtype bladder cancer (HSBC) suffer worse outcomes than those with conventional urothelial carcinoma (UC). We sought to characterize the use of adjuvant chemotherapy (AC) in HSBC after radical cystectomy (RC) using the National Cancer Database (NCDB).
Materials And Methods: We retrospectively queried the NCDB (2006-2019) for patients with non-metastatic bladder cancer (BC) who underwent RC (N = 45,797).
Background: Treatment-related dose-limiting dysuria and irritative bladder symptoms are common in patients receiving intravesical bacillus Calmette-Guérin (BCG) to treat non-muscle-invasive bladder cancer (NMIBC). Acupuncture has been shown to reduce pain and urinary urgency/frequency in other patient populations.
Objective: To evaluate the feasibility, safety, and tolerability of weekly in-clinic preprocedural acupuncture among patients receiving induction BCG.
Introduction: Baseline sarcopenia and postoperative changes in muscle mass are independently associated with overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Here we examine the relationships between preoperative (baseline), postoperative changes in muscle quantity, and survival outcomes following CN as determined by linear segmentation, a clinic-friendly tool that rapidly estimates muscle mass.
Materials And Methods: Our nephrectomy database was reviewed for patients with metastatic disease who underwent CN for RCC.
There are multiple ongoing and planned clinical trials that are evaluating novel therapies to treat patients with BCG-unresponsive high grade nonmuscle invasive bladder cancer (NMIBC). Importantly, there is considerable variation in surveillance strategies between these clinical trials, specifically with regards to the use of advanced imaging, enhanced cystoscopy, and mandatory biopsies, which could impact landmark efficacy assessments of investigational agents. To present guideline recommendations for the standardization of cystoscopic evaluation, surveillance, and efficacy assessments for patients with BCG-unresponsive NMIBC participating in clinical trials.
View Article and Find Full Text PDFImportance: The therapeutic landscape of advanced renal cell carcinoma (RCC) has rapidly evolved in the past 2 decades, with the advent of cytokines therapy followed by targeted therapies and novel immune checkpoint inhibitors (ICI). This article aims to review the current evidence and ongoing trials of neoadjuvant or prenephrectomy ICI therapy in patients with locally advanced and metastatic RCC.
Observations: A literature search was performed using the Cochrane Central Register of Controlled Trials, ClinicalTrials.
Surgically Feasible? Yes. But Is It the Right Option? It Depends.
Int J Radiat Oncol Biol Phys
December 2023