Surgery (RMH) - Research Publications

Permanent URI for this collection

Search Results

Now showing 1 - 4 of 4
  • Item
    Thumbnail Image
    Survival outcomes in elderly men undergoing radical prostatectomy in Australia
    Ranasinghe, W ; Wang, LL ; Persad, R ; Bolton, D ; Lawrentschuk, N ; Sengupta, S (WILEY, 2018-03-01)
    BACKGROUND: To investigate the outcomes of patients older than 75 years of age in Victoria undergoing radical prostatectomy for prostate cancer. METHODS: Data on all men undergoing radical prostatectomy in Victoria between 1 January 2004 and 31 December 2014 were obtained from the Victorian Cancer Registry. Tumour characteristics including Gleason grade, stage of disease and cause of death were obtained. Statistical analysis was performed using chi-squared test, Cox proportional hazards method and Kaplan-Meier analysis. RESULTS: A total of 14 686 men underwent radical prostatectomy during the defined period, with a median follow-up of 58 months. Of these, 332 were men over the age of 75. All parameters are comparisons between patients >75 years of age and men <75 years of age. Men >75 years had a higher proportion of Gleason grade ≥8 disease (16.6% versus 11.4%, P < 0.001) but had similar stage of disease. Men >75 years had lower rates of 5- and 10-year overall survival (67.3% versus 96.3% and 27.7% versus 89.1%) and lower rates of 5- and 10-year prostate cancer-specific survival (96.2% versus 99.3% and 94.3% versus 97.4%), respectively. Age was an independent risk factor for prostate cancer specific and overall mortality on multivariate analysis (hazard ratio 1.49, 95% confidence interval 1.32-1.68; P < 0.001 and hazard ratio 4.26, 95% confidence interval 2.15-8.42; P < 0.001), when adjusted for stage and grade. CONCLUSION: Older men undergoing radical prostatectomy in Victoria had higher-grade disease but similar stage. Age was an independent risk factor for worse prostate cancer-specific and overall survival.
  • Item
    Thumbnail Image
    National Speakers
    Reynolds, B ; Nzenza, T ; Ngweso, S ; Browne, C ; MacCraith, E ; Manning, T ; Sathianathen, N ; Muilwijk, T ; Pinto, K ; Meraney, A ; Keane, K ; Cecchi, S ; Nolazco, JI ; Kasivisvanathan, V ; Hayne, D ; Bolton, D ; Lawrentschuk, N (WILEY, 2019-07-01)
  • Item
    No Preview Available
    Patient derived organoid model of penile squamous cell carcinoma
    Teh, J ; Guerra, G ; Heriot, A ; Ramsay, R ; Lawrentschuk, N (Elsevier BV, 2020-07)
  • Item
    Thumbnail Image
    Continuous bladder irrigation after transurethral resection of non-muscle invasive bladder cancer for prevention of tumour recurrence: a systematic review
    Li, M ; Toniolo, J ; Nandurkar, R ; Papa, N ; Lawrentschuk, N ; Davis, ID ; Sengupta, S (WILEY, 2021-04-23)
    BACKGROUND: Non-muscle invasive bladder cancer (NMIBC) can recur despite transurethral resection of bladder tumour (TURBT) that clears macroscopic disease, partly from re-implantation of exfoliated cells. Immediate instillation of intravesical chemotherapy (IC) can reduce recurrence, is guideline-recommended but is under-utilized. Continuous bladder irrigation (CBI) immediately post-TURBT is postulated to prevent re-implantation, and may provide a simple, cheap and practical alternative. We undertook a systematic review to assess the effect of CBI on NMIBC recurrence. METHODS: Following PRISMA guidelines, relevant publications were identified by online search of databases, including Ovid Medline and EMBASE (1980-2019). All published prospective randomized controlled trials comparing CBI post-TURBT to a control group were included. The primary end-point was recurrence. RESULTS: Our search yielded 514 studies, of which six met inclusion criteria. Two studies (935 participants), albeit without peer-reviewed publication, comparing CBI to no CBI both showed a reduction in recurrence at 2 years. Four publications from three trials (331 participants) compared CBI to IC, showing similar recurrence rates at 1 year (odds ratio 1.29, 95% confidence interval 0.78-2.13) but a lower risk of adverse events (6-34% versus 27-48%). CONCLUSION: CBI post-TURBT appears to yield 1-year recurrence rates of NMIBC comparable to immediate IC. However, existing studies are small and of heterogenous design, precluding definitive conclusions. Further trials are required to determine if CBI can be implemented routinely to reduce NMIBC recurrence, as well as the optimal irrigant, volume and duration.