Initial results of selective renal parenchymal clamping with an adjustable kidney clamp in nephron-sparing surgery: an easy way to minimise renal ischaemia

published_or_final_versio

Fifteen-year experience in radical nephrectomy with inferior vena cava tumor thrombectomy for patients with locally advanced and metastatic renal cell carcinoma

AbstractObjective: To investigate the clinical out-comes and complications of radicalnephrectomy with inferior vena cava(IVC) tumor thrombectomy for patientswith locally advanced or metastatic renalcell carcinoma (RCC).Patients and Methods: All patientsunderwent radical nephrectomy with IVCtumor thrombectomy from 2001 to 2016were reviewed.Results: 29 patients (male: female: 20:9)with mean age of 66 (48–85) were reviewed.10 patients had metastatic disease (8 withlung metastases and 2 with bone metastases)preoperatively. Level I to IV IVC tumorthrombus were found in 5(17%), 7 (24%), 12(41%) and 5(17%) patients respectively. Themedian follow-up was 61.2 months (1–162).The mean blood loss for level I to IV tumorthrombus was 1,566 mL, 2,040 mL,2,503 mL and 6,340 mL respectively. Threepatients (10.3%) had Clavien-Dindo Grade 3complications. Six patients (60%) with meta-static disease received adjuvant targetedtherapy. There was no 30-day mortality. Thefive-year overall survival rates for localisedand metastatic RCC were 70% and 56%respectively. Five-year recurrence free sur-vival for locally advanced disease was 45%.Conclusion: Radical nephrectomy withIVC tumor thrombectomy provided satis-factory survival outcomes for patients withlocally advanced and metastatic RCC

Evaluate the outcome of developing a clinical pathway on male acute urinary retention in the Accident and Emergency Department (AED) and Urology Centre

Conference Theme: Urological Advancement in AsiaAbstract and Oral Presentatio

Early urological management for patients attended microscopic haematuria clinic

Abstract and Oral PresentationConference Theme: Urological Advancement in Asi

A randomized controlled trial study of the efficacy of intensive pre-operative pelvic floor muscle training (PMT) to decrease post-prostatectomy urinary incontinence among Chinese men

Poster Session 1 - no. P0

Analysis of three pre-operative risk assessment tools for prostate cancer in a local Chinese cohort undergoing radical prostatectomy

Abstract and Poster PresentationConference Theme: Urological Advancement in AsiaThis free journal suppl. entitled: Special Issue: 14th Urological Association of Asia Congress 2016 SingaporeOBJECTIVES: To compare the performance of the CAPRA score, Kattan nomogram and Stephenson nomogram in a local Chinese cohort of patients with prostate cancer undergoing radical prostatectomy. METHODS: This is a review of a prospective cohort of men who underwent radical prostatectomy for prostate cancer. CAPRA score, Kattan score and Stephenson score were calculated by analysis of variables for predicting biochemical recurrence. Biochemical recurrence was defined as PSA more than 0.2 ng/mL or secondary treatment for a rising PSA. Performance of the three risk assessment tools was evaluated using Harrell’s concordance index, plotting calibration curves, and constructing decision analysis curves. RESULTS: Two hundred and eighty-seven men who underwent radical prostatectomy from 1998 to 2012 were recruited. Concordance index for the three assessment tools were high (0.69 for CAPRA score, 0.71 for Kattan score, 0.73 for Stephenson score). The Stephenson score had the best calibration plot in predicting biochemical free recurrence probability. The Stephenson score also had a better performance across various threshold probability in the decision curve analysis. CONCLUSIONS: All three assessment tools were validated in our local Chinese cohort. Stephenson score had the best performance in predicting biochemical free recurrence probability and in the decision curve analysis.link_to_OA_fulltex

Multiparametric magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy with semi-robotic navigation in the Chinese population: initial results

published_or_final_versio

Prospective study on the performance of the prostate-specific antigen isoform P2PSA and its derivative prostate health index in prediction of prostate cancer in local Chinese men with total prostate-specific antigen levels of 4-10 ng/mL

This free journal suppl. entitled: Special Issue: 14th Urological Association of Asia Congress 2016 SingaporeConference Theme: Urological Advancement in AsiaAbstract and Poster PresentationOBJECTIVES To evaluate the accuracy of the prostate-specific antigen isoform P2PSA and its derivatives including Prostate Health Index (PHI) in determining the presence of prostate cancer in prostate biopsies with serum total prostate-specific antigen (tPSA) at 4–10 ng/mL. METHODS This was a prospective cohort study involving two urology centers. Patients with tPSA at 4–10 ng/mL with a negative digital rectal examination who consented to prostate biopsy to detect underlying prostate cancer were recruited from March 2013 to March 2016. Their serum tPSA and P2PSA were checked before the biopsy and evaluated with respect to their prostate biopsy results. RESULTS Two hundred and forty-seven patients were recruited with cancer detected in 43 (17.4%) patients. %P2PSA and PHI were significantly higher in patients with cancer (P < 0.0001) whilst %fPSA and tPSA were similar between the two groups. ROC analysis showed the AUC for tPSA, %fPSA, %PSPSA and PHI to be 0.50, 0.58, 0.77 and 0.76 respectively. %P2PSA and PHI were the best predictor of underlying prostate cancer and were significantly better than tPSA (P < 0.0001 and 0.0005 respectively). At a sensitivity of 90%, PHI has the highest specificity (43.1%) amongst all the markers (tPSA: 7.4%, % fPSA: 27.0%, %P2PSA: 37.7%). When compared with tPSA, the use of the PHI would avoid 73(39%) of patients from unnecessary biopsies. CONCLUSIONS PHI is a superior marker to tPSA in detection of prostate cancer in our cohort of local Chinese men. Its use in addition to tPSA can improve its accuracy and aids in patient counseling regarding whether to proceed with prostate biopsies.link_to_OA_fulltex