0000000000749728

AUTHOR

Robert Jeffrey Karnes

showing 6 related works from this author

The efficacy of BCG TICE and BCG Connaught in a cohort of 2,099 patients with T1G3 non–muscle-invasive bladder cancer

2016

BACKGROUND Potential differences in efficacy of different bacillus Calmette-Guerin (BCG) strains are of importance for daily practice, especially in the era of BCG shortage. OBJECTIVE To retrospectively compare the outcome with BCG Connaught and BCG TICE in a large study cohort of pT1 high-grade non-muscle-invasive bladder cancer patients. DESIGN, SETTING, AND PARTICIPANTS Individual patient data were collected for 2,451 patients with primary T1G3 tumors from 23 centers who were treated with BCG for the first time between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Using Cox multivariable regression and adjusting for the most important prognostic factors in this nonrandomiz…

Malemedicine.medical_treatmentIntravesical drug administration030232 urology & nephrologyKaplan-Meier EstimateBCG ConnaughtSettore MED/24 - Urologia0302 clinical medicineMaintenance therapyMedicine610 Medicine & healthhigh gradeAged 80 and overHazard ratioMiddle AgedAdministration IntravesicalTreatment OutcomeOncology030220 oncology & carcinogenesisCohortbladder cancerFemaleImmunotherapyNon muscle invasivemedicine.medical_specialtyrecurrenceUrologyBCG Connaught; BCG Tice; BCG vaccine; bladder cancer; high grade; Immunotherapy; Intravesical drug administration; progression; recurrence; T1G3; Oncology; UrologyT1G3ArticleMaintenance ChemotherapyBCG Connaught03 medical and health sciencesAdjuvants ImmunologicInternal medicineUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]HumansNeoplasm InvasivenessBCG vaccineAgedNeoplasm StagingProportional Hazards ModelsRetrospective StudiesCarcinoma Transitional CellBladder cancerbusiness.industryImmunotherapy ActiveBCG TiceImmunotherapymedicine.diseaseSurgeryUrinary Bladder NeoplasmsDrug EvaluationprogressionNeoplasm GradingbusinessBCG vaccineFollow-Up StudiesBCG Connaught; BCG Tice; BCG vaccine; Immunotherapy; Intravesical drug administration; T1G3; bladder cancer; high grade; progression; recurrenceUrologic Oncology: Seminars and Original Investigations
researchProduct

Factores de riesgo de enfermedad residual en la re-RTU en una gran cohorte de pacientes con enfermedad T1G3

2021

Resumen Introduccion y objetivos Los objetivos de la reseccion transuretral (RTU) del tumor vesical son la reseccion completa de las lesiones y la realizacion de un diagnostico correcto con el objetivo de estadificar adecuadamente al paciente. Es bien sabido que la presencia de musculo detrusor en el especimen es un requisito previo para minimizar el riesgo de infraestadificacion. La persistencia de enfermedad tras la reseccion de los tumores vesicales no es infrecuente, y es la razon por la que las guias europeas recomiendan una re-reseccion transuretral (re-RTU) para todos los tumores T1. Recientemente se ha publicado que, en los casos con inclusion de musculo en el especimen, la re-RTU n…

Gynecology03 medical and health sciencesmedicine.medical_specialty0302 clinical medicinebusiness.industryUrology030232 urology & nephrologymedicinebusinessActas Urológicas Españolas
researchProduct

Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy

2018

PURPOSE: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1…

NephrologyMalemedicine.medical_treatment030232 urology & nephrologyKaplan-Meier EstimateSettore MED/24 - UrologiaCohort Studies0302 clinical medicineRetrospective StudieMultivariate AnalysiOutcomeeducation.field_of_studyHigh riskBladder cancerMiddle AgedPrognosisEditorialTreatment OutcomeLocal030220 oncology & carcinogenesisBCG VaccineFemaleSurvival AnalysiBladder cancer; Cystectomy; Extravesical disease; High risk; Outcomes; T1G3; UrologyHumanmedicine.medical_specialtyPrognosiUrologyPopulationUrologyOutcomesT1G3CystectomyRisk AssessmentDisease-Free SurvivalCystectomy03 medical and health sciencesAll institutes and research themes of the Radboud University Medical CenterInternal medicineUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]medicineHumansNeoplasm InvasivenesseducationSurvival analysisProportional Hazards ModelsRetrospective StudiesAgedNeoplasm StagingNeoplasm InvasiveneCarcinoma Transitional CellBladder cancerbusiness.industryProportional hazards modelBladder cancer; Cystectomy; Extravesical disease; High risk; Outcomes; T1G3; Aged; BCG Vaccine; Carcinoma Transitional Cell; Cohort Studies; Cystectomy; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Recurrence Local; Neoplasm Staging; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Survival Analysis; Treatment Outcome; Urinary Bladder NeoplasmsCarcinomaRetrospective cohort studymedicine.diseaseSurvival AnalysisNeoplasm RecurrenceUrinary Bladder NeoplasmsConcomitantMultivariate AnalysisProportional Hazards ModelTransitional CellCohort StudieNeoplasm Recurrence LocalbusinessExtravesical disease
researchProduct

Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients

2021

Item does not contain fulltext Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors th…

Detrusor musclemedicine.medical_specialty030232 urology & nephrologyUrologyDiseaseLogistic regression03 medical and health sciencesTumor Status0302 clinical medicineRe-transurethral resection of the bladderRecurrenceRisk FactorsUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]MedicineHumansStage (cooking)Non-muscle invasive bladder cancer; Re-transurethral resection of the bladder; Residual disease; Recurrence; ProgressionNeoplasm StagingRetrospective StudiesUnivariate analysisCarcinoma Transitional CellProgressionbusiness.industryRetrospective cohort studyGeneral MedicineResidual diseaseReconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]Settore MED/24medicine.anatomical_structureUrinary Bladder NeoplasmsConcomitantNon-muscle invasive bladder cancerbusiness
researchProduct

The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer tre…

2015

Objectives To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette–Gu erin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical out…

Malemedicine.medical_treatment030232 urology & nephrologySettore MED/24 - Urologia0302 clinical medicineImmunologicRetrospective Studiehigh gradere-TURHazard ratioMiddle Agedmedicine.anatomical_structureAdministration IntravesicalTreatment Outcome030220 oncology & carcinogenesisUrological cancers Radboud Institute for Health Sciences [Radboudumc 15]CohortUrinary Bladder NeoplasmBCG VaccineUrologic Surgical Proceduresbladder cancerFemaleHumanReoperationmedicine.medical_specialtyrecurrenceUrologyUrologyT1G3CystectomyArticleCystectomy03 medical and health sciencesbladder cancer; high grade; progression; re-TUR; recurrence; T1G3; UrologyAdjuvants ImmunologicUrethramedicineHumansAdjuvantsT1G3; bladder cancer; high grade; progression; re-TUR; recurrenceRetrospective StudiesAgedNeoplasm StagingBladder cancerbusiness.industryCancerRetrospective cohort studymedicine.diseaseSurgerybladder cancer; high grade; progression; re-TUR; recurrence; T1G3; Adjuvants Immunologic; Aged; BCG Vaccine; Cystectomy; Female; Humans; Male; Middle Aged; Neoplasm Grading; Neoplasm Staging; Reoperation; Retrospective Studies; Treatment Outcome; Urethra; Urinary Bladder Neoplasms; UrologyUrethraUrinary Bladder NeoplasmsprogressionNeoplasm GradingbusinessBCG vaccine
researchProduct

Recurrence, progression and cancer-specific mortality according to stage at re-TUR in T1G3 bladder cancer patients treated with BCG: not as bad as pr…

2018

PURPOSE: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis to adequately stage and treat the patient. Persistent disease after TUR is not uncommon and is why re-TUR is recommended in T1G3 patients. When there is T1 tumor in the re-TUR specimen, very high risks of progression (82%) have been reported. We analyze the risks of recurrence, progression to muscle-invasive disease and cancer-specific mortality (CSM) according to tumor stage at re-TUR in T1G3 patients treated with BCG. METHODS: In our retrospective cohort of 2451 T1G3 patients, 934 patients (38.1%) underwent re-TUR. 667 patients had residual disease (7…

NephrologyMalemedicine.medical_treatment030232 urology & nephrologyNon-muscle invasive bladder cancer · Re-transurethral resection of the bladder · Recurrence · ProgressionSettore MED/24 - Urologia0302 clinical medicineRetrospective StudieRe-transurethral resection of the bladderRecurrenceImmunologicCause of DeathCumulative incidenceStage (cooking)Cause of deathProgressionIntravesicalAdministration IntravesicalLocal030220 oncology & carcinogenesisAdministrationBCG VaccineDisease ProgressionFemaleNon-muscle invasive bladder cancerHumanReoperationmedicine.medical_specialtyUrologyUrologyCystectomyArticleFollow-Up StudieCystectomy03 medical and health sciencesAll institutes and research themes of the Radboud University Medical CenterAdjuvants ImmunologicInternal medicineUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]medicineHumansAdjuvantsAgedNeoplasm StagingProportional Hazards ModelsRetrospective StudiesBladder cancerProportional hazards modelbusiness.industryNon-muscle invasive bladder cancer; Progression; Re-transurethral resection of the bladder; Recurrence; Adjuvants Immunologic; Administration Intravesical; Aged; BCG Vaccine; Cause of Death; Cystectomy; Disease Progression; Female; Follow-Up Studies; Humans; Male; Neoplasm Recurrence Local; Neoplasm Staging; Proportional Hazards Models; Reoperation; Retrospective Studies; Urinary Bladder NeoplasmsRetrospective cohort studymedicine.diseaseNeoplasm RecurrenceUrinary Bladder NeoplasmsProportional Hazards ModelNeoplasm Recurrence LocalbusinessFollow-Up Studies
researchProduct