Publications by authors named "Seisen T"
Background And Objective: Given the uncertainty regarding the role of radical nephroureterectomy (RNU) as part of a multimodal treatment strategy for upper tract urothelial carcinoma (UTUC) patients with cN+ disease, we aimed to perform a systematic review and meta-analysis of the corresponding literature.
Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we identified 17 observational comparative and noncomparative studies, published between January 2000 and September 2024, evaluating UTUC patients with cTanyN+M0 disease (P) who received RNU as part of a multimodal treatment strategy (I), as compared with any treatment strategy if applicable (C), to assess oncological or postoperative outcomes (O). Meta-analyses were further performed, as appropriate.
Introduction: The purpose of this study was to propose an update of the French guidelines from the national committee ccAFU on upper tract urothelial carcinomas (UTUC).
Methods: A systematic Medline search for epidemiology, risk factors, diagnosis, prognosis, treatment options and follow-up of UTUC was performed between 2022 and 2024 to evaluate available references and their levels of evidence.
Results: UTUC is a rare malignancy with specific risk factors, including exposure to aristolochic acid and Lynch syndrome.
Objective: To update the CCAFU recommendations for the management of non-muscle invasive bladder cancer (NMIBC).
Methods: A systematic review (Medline) of the literature from 20222024 was performed, taking into account the elements of diagnosis, treatment options and monitoring of NMIBC and evaluating references with their level of evidence.
Results: The diagnosis of NMIBC (Ta, T1, or CIS) is made after complete and deep tumour resection.
Objective: To update the CCAFU recommendations for the management of muscle-invasive bladder cancer (MIBC).
Methods: A systematic review (Medline) of the literature from 2022 to 2024 was carried out, taking into account the elements of the diagnosis, the treatment options and the monitoring of NMIBC and MIBC, evaluating the references with their level of evidence.
Results: MIBC is diagosed after the must complete tumor resection possible .
Purpose: Patients with Ta low-grade (LG) NMIBC rarely develop metastases or die of it. Long-term data are scant and length of follow-up poorly defined.
Materials And Methods: This retrospective study included 521 patients diagnosed with primary TaLG NMIBC (n = 491) or papillary urothelial neoplasm of low malignant potential (n = 30) from 1989 to 2019 at an academic center.
Article Synopsis
- - The study compared the effectiveness of robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC + ICUD) to open radical cystectomy (ORC) for treating bladder cancer, analyzing data from 316 patients between 2014 and 2023.
- - Findings showed that RARC + ICUD led to significantly lower risks of complications, blood loss, and hospital stays, and resulted in higher lymph node counts compared to ORC, implying better immediate surgical outcomes.
- - Despite better perioperative results for RARC + ICUD, the long-term cancer-related outcomes, including survival and recurrence rates, were similar between both surgical approaches.
Article Synopsis
- En bloc resection of bladder tumor (ERBT) is a surgical technique aimed at improving bladder cancer removal compared to conventional transurethral resection (cTURBT), focusing on perioperative and cancer-related outcomes.
- A review of 17 studies found no significant differences in cancer recurrence or progression rates between ERBT and cTURBT, although ERBT was linked to better detection of detrusor muscle (DM) presence, and lower risks of bladder perforation and obturator nerve reflexes.
- ERBT resulted in longer surgery times but shorter catheterization and hospital stays, indicating a safer approach overall, despite the lack of major differences in long-term cancer outcomes.
Purpose: The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR.
View Article and Find Full Text PDFPurpose: Significant concerns remain regarding the long-term outcomes of American Medical Systems 800 artificial urinary sphincter (AUS) implants in men. The objective was to assess the long-term AUS reintervention (replacement or removal) rates after a first-ever AUS implantation.
Materials And Methods: This population-based retrospective cohort study included all men age ≥ 18 years in France who underwent a first-ever AUS implantation (identified using a unique device identifier) for male stress urinary incontinence (SUI) after prostate cancer or benign prostatic hyperplasia (BPH) treatment, between January 1, 2006, and December 31, 2018.
Article Synopsis
- Bladder cancer represents a significant health challenge globally, necessitating tailored treatment approaches for both non muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC).
- Recent advancements in intravesical therapies, like hyperthermic intravesical chemotherapy (HIVEC) and novel drugs, have shown promise in managing NMIBC and MIBC, although their long-term efficacy still needs further research.
- While innovative treatments such as hydrogels and drug-releasing systems (drug-RIS) appear safe and effective, careful patient selection is crucial, as radical cystectomy remains the primary treatment option for bladder cancer.
Background And Objective: This publication represents a summary of the updated 2024 European Association of Urology (EAU) guidelines for non-muscle-invasive bladder cancer (NMIBC), TaT1, and carcinoma in situ. The information presented herein is limited to urothelial carcinoma, unless specified otherwise. The aim is to provide practical recommendations on the clinical management of NMIBC with a focus on clinical presentation.
View Article and Find Full Text PDFBackground And Objective: There is no standardized regimen for follow-up after radical cystectomy (RC) for bladder cancer (BC). To address this gap, we conducted a multicenter study involving urologist members from the European Association of Urology (EAU) bladder cancer guideline panels. Our objective was to identify consistent post-RC follow-up strategies and develop a practice-based framework based on expert opinion.
View Article and Find Full Text PDFObjectives: The objective of our study is to demonstrate the practical application of continent cutaneous urinary diversion (CCUD) in oncological patients, with a focus on various aspects of the procedure: surgical challenges, functional outcomes, and quality of life.
Materials And Methods: We studied the perioperative and follow-up data of patients who underwent cystectomy for cancer associated with CCUD (Mitrofanoff, Monti or Casale). We retrospectively analyzed complications within 30days and beyond 30days post-surgery.
Objective: To perform a collaborative review of the literature exploring the microsatellite instability/deficient mismatch repair (MSI/dMMR) phenotype in patients with upper tract urothelial carcinoma (UTUC).
Method: A collaborative review of the literature available on Medline was conducted by the Cancer Committee of the French Association of Urology to report studies describing the genetic mechanisms, investigation, prevalence and impact of the MSI/dMMR phenotype in UTUC patients.
Results: The predominant genetic mechanism leading to the MSI/dMMR phenotype in UTUC patients is related to the constitutional mutation of one allele of the MMR genes MLH1, MSH2, MSH6 and PMS2 within Lynch syndrome.
Identification of clinically positive pelvic lymph node metastases (cN+) in patients with muscle-invasive bladder cancer is currently challenging, as the diagnostic accuracy of available imaging modalities is limited. Conventional CT is still considered the gold-standard approach to diagnose lymph node metastases in these patients. The development of innovative diagnostic methods including radiomics, artificial intelligence-based models and molecular biomarkers might offer new perspectives for the diagnosis of cN+ disease.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluates the learning curve of multiple operators for MRI-targeted biopsy in adult males suspected of prostate cancer, highlighting the number of cases required to attain proficiency.
- A total of 1,721 patients were part of the study, revealing that operators needed about 40-50 cases to optimize TRUS segmentation and overall biopsy procedure times, while achieving proficiency in detecting clinically significant prostate cancer took 25-45 procedures.
- The findings suggest that completing at least 50 MRI-targeted biopsy cases is essential for achieving consistent clinical and technical proficiency, as well as managing patient pain effectively.
Background: Periprostatic artificial urinary sphincter implantation (pAUSi) is a rare yet relevant indication for male neurogenic stress urinary incontinence (SUI).
Objective: To describe the surgical technique of robot-assisted pAUSi (RApAUSi) and compare the long-term functional results with the open pAUSi (OpAUSi).
Design, Setting, And Participants: Data of 65 consecutive men with neurogenic SUI undergoing pAUSi between 2000 and 2022 in a tertiary centre were collected retrospectively.
Background: Upper urinary tract urothelial carcinoma (UTUC) is often locally advanced at initial diagnosis and is associated with high recurrence and mortality rates after radical nephroureterectomy (RNU). Adjuvant platinum-based chemotherapy has shown a recurrence-free survival benefit in a randomised phase III trial, while neoadjuvant treatment seems promising in retrospective series. On the contrary, little is known about the role of perioperative immunotherapy and its combination with chemotherapy for UTUC patients, although initial positive results have been published for muscle-invasive bladder cancer.
View Article and Find Full Text PDFPurpose: To report perioperative, renal function and oncological outcomes of robot-assisted radical nephroureterectomy (RNU) for patients with upper tract urothelial carcinoma (UTUC).
Methods: This was a retrospective single-arm monocentric study including all consecutive UTUC patients treated with robot-assisted RNU at our institution between 2014 and 2022. Descriptive statistics with median and interquartile range (IQR) for continuous variables and numbers with frequencies for categorical variables were used to report perioperative and renal function outcomes while Kaplan-Meier curves were computed to present extravesical and intravesical recurrence-free survival(RFS) as well as cancer-specific (CSS) and overall survival (OS) with the corresponding 95% confidence intervals(CIs).
Given that most of non-muscle invasive bladder cancer trials available in the literature share the same limitation of an open-label design, they are likely prone to detection bias. Indeed, tumor response is currently assessed by unblinded investigators, mainly via follow-up cystoscopy, which has well-known intraobserver and interobserver variability. Thus, we believe that the use of video-recorded cystoscopy for blinded independent central review of tumor response could help to minimize detection bias in open-label NMIBC trials.
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- * Researchers analyzed data from 1,721 males who underwent fusion MRI-targeted prostate biopsies, calculating the volume differences between TRUS and MRI to determine their relationship with clinically significant prostate cancer detection rates.
- * Findings indicate that a relative volume difference greater than 10% between MRI and TRUS is linked to lower detection rates of clinically significant prostate cancer, highlighting the importance of accurate imaging segmentation in biopsy outcomes.