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Article ; Online: Ileal conduit: standard urinary diversion for elderly patients undergoing radical cystectomy.

Siddiqui, Khurram M / Izawa, Jonathan I

2016 Volume 34, Issue 1, Page(s) 19–24

Abstract: Purpose: Ileal conduit (IC) is the most frequent urinary diversion (UD) performed after radical cystectomy (RC). We reviewed the literature to investigate the factors influencing the choice of this diversion and its complications.: Methods: A ... ...

Abstract	Purpose: Ileal conduit (IC) is the most frequent urinary diversion (UD) performed after radical cystectomy (RC). We reviewed the literature to investigate the factors influencing the choice of this diversion and its complications. Methods: A literature search (PubMed) was performed for all English language publications on UDs performed for treatment of bladder cancer from 1950 to 2015. The literature review was focused on studies reporting outcome of IC and its comparison with other types of UDs. Results: IC is the most common UD performed in elderly patients undergoing RC for bladder cancer. Long-term studies looking at the change in renal function after UD report a universal decline in the glomerular filtration rate; however, this decline in renal function is the least for IC. There is a significant morbidity of RC (20-56 %), which can be attributed to patient factors, surgical technique and hospital volume. Modern concepts of bowel preparation, postoperative nutrition, early enteral feeding and involvement of stoma therapists have helped improve the outcomes. The quality of life is preserved, and in many including elderly, it may be improved with IC UD. Conclusions: IC is the most commonly performed UD following radical cystectomy. It is associated with acceptable morbidity and has the lowest reoperation rates as compared to continent diversion. It is also the procedure of choice for most patients' elderly patients as well as patients with limited dexterity, poor motivation, anatomical restrictions and poor renal function. Studies measuring HRQOL report excellent patient acceptability, especially in the elderly population.
MeSH term(s)	Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery ; Cystectomy/methods ; Glomerular Filtration Rate ; Hospitals ; Humans ; Muscle, Smooth/pathology ; Neoplasm Invasiveness ; Postoperative Complications ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery ; Urinary Diversion/methods
Language	English
Publishing date	2016-01
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-015-1706-1
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Article: [No title information]

Curtis Nickel, J / Izawa, Jonathan I / Pace, Kenneth T

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2017 Volume 11, Issue 1-2, Page(s) E60–E61

Title translation	Votre FBAUC : Préserver l’héritage de la recherche canadienne en urologie.
Language	French
Publishing date	2017-02-20
Publishing country	Canada
Document type	News
ZDB-ID	2431403-1
ISSN	1911-6470
ISSN	1911-6470
DOI	10.5489/cuaj.4446
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Article: Your CUASF: Keeping Canada's urological research legacy alive.

Curtis Nickel, J / Izawa, Jonathan I / Pace, Kenneth T

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2017 Volume 11, Issue 1-2, Page(s) 71–72

Language	English
Publishing date	2017-02-20
Publishing country	Canada
Document type	News
ZDB-ID	2431403-1
ISSN	1911-6470
ISSN	1911-6470
DOI	10.5489/cuaj.4423
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Article: [No title information]

Izawa, Jonathan I

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2009 Volume 3, Issue 3, Page(s) 245–250

Title translation	Salvage radiotherapy after radical prostatectomy.
Language	English
Publishing date	2009-05-27
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2431403-1
ISSN	1911-6470
ISSN	1911-6470
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Article: Systematic methods for measuring outcomes: How they may be used to improve outcomes after Radical cystectomy.

Siddiqui, Khurram M / Izawa, Jonathan I

Arab journal of urology

2015 Volume 13, Issue 2, Page(s) 122–127

Abstract: In the era of managed healthcare, the measuring and reporting of surgical outcomes is a universal mandate. The outcomes should be monitored and reported in a timely manner. Methods for measuring surgical outcomes should be continuous, free of bias and ... ...

Abstract	In the era of managed healthcare, the measuring and reporting of surgical outcomes is a universal mandate. The outcomes should be monitored and reported in a timely manner. Methods for measuring surgical outcomes should be continuous, free of bias and accommodate variations in patient factors. The traditional methods of surgical audits are periodic, resource-intensive and have a potential for bias. These audits are typically annual and therefore there is a long time lag before any effective remedial action could be taken. To reduce this delay the manufacturing industry has long used statistical control-chart monitoring systems, as they offer continuous monitoring and are better suited to monitoring outcomes systematically and promptly. The healthcare industry is now embracing such systematic methods. Radical cystectomy (RC) is one of the most complex surgical procedures. Systematic methods for measuring outcomes after RC can identify areas of improvements on an ongoing basis, which can be used to initiate timely corrective measures. We review the available methods to improve the outcomes. Cumulative summation charts have the potential to be a robust method which can prompt early warnings and thus initiate an analysis of root causes. This early-warning system might help to resolve the issue promptly with no need to wait for the report of annual audits. This system can also be helpful for monitoring learning curves for individuals, both in training or when learning a new technology.
Language	English
Publishing date	2015-03-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2631788-6
ISSN	2090-598X
ISSN	2090-598X
DOI	10.1016/j.aju.2015.02.008
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Article ; Online: Estimated glomerular filtration rate from the renal hypothermia trial: clinical implications.

Lemire, Francis / Fergusson, Dean A / Knoll, Greg / Morash, Christopher / Lavallée, Luke T / Mallick, Ranjeeta / Finelli, Antonio / Kapoor, Anil / Pouliot, Frédéric / Izawa, Jonathan / Rendon, Ricardo / Cagiannos, Ilias / Breau, Rodney H

BJU international

2023 Volume 132, Issue 4, Page(s) 452–460

Abstract: Objective: To assess if estimated glomerular filtration rate (eGFR) can replace measured GFR (mGFR) in partial nephrectomy (PN) trials, using data from a randomised clinical trial.: Patients and methods: We conducted a post hoc analysis of the renal ... ...

Abstract	Objective: To assess if estimated glomerular filtration rate (eGFR) can replace measured GFR (mGFR) in partial nephrectomy (PN) trials, using data from a randomised clinical trial. Patients and methods: We conducted a post hoc analysis of the renal hypothermia trial. Patients underwent mGFR with diethylenetriaminepentaacetic acid (DTPA) plasma clearance preoperatively and 1 year after PN. The eGFR was calculated using the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equations incorporating age and sex, with and without race: 2009 eGFRcr(ASR) and 2009 eGFRcr(AS), and the 2021 equation that only incorporates age and sex: 2021 eGFRcr(AS). Performance was evaluated by determining the median bias, precision (interquartile range [IQR] of median bias), and accuracy (percentage of eGFR within 30% of mGFR). Results: Overall, 183 patients were included. Pre- and postoperative median bias and precision were similar between the 2009 eGFRcr(ASR) (-0.2 mL/min/1.73 m Conclusion: The 2009 eGFRcr(AS) can accurately estimate GFR in PN trials and could be used instead of mGFR to reduce cost and patient burden.
MeSH term(s)	Humans ; Glomerular Filtration Rate ; Hypothermia ; Kidney ; Kidney Function Tests ; Renal Insufficiency, Chronic/therapy ; Renal Insufficiency, Chronic/epidemiology ; Creatinine
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2023-07-19
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.16114
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Article ; Online: Benefit of Neoadjuvant Cisplatin-based Chemotherapy for Invasive Bladder Cancer Patients Treated with Radiation-based Therapy in a Real-world Setting: An Inverse Probability Treatment Weighted Analysis.

European urology oncology

2024

Abstract: Background: Neoadjuvant chemotherapy (NAC) improves survival for patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy. Studies on the potential benefit of NAC before radiation-based therapy (RT) are conflicting.: ... ...

Abstract	Background: Neoadjuvant chemotherapy (NAC) improves survival for patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy. Studies on the potential benefit of NAC before radiation-based therapy (RT) are conflicting. Objective: To evaluate the effect of NAC on patients with MIBC treated with curative-intent RT in a real-world setting. Design, setting, and participants: The study cohort consisted of 785 patients with MIBC (cT2-4aN0-2M0) who underwent RT at academic centers across Canada. Patients were classified into two treatment groups based on the administration of NAC before RT (NAC vs no NAC). Outcome measurements and statistical analysis: The inverse probability of treatment weighting (IPTW) with absolute standardized differences (ASDs) was used to balance covariates across treatment groups. The impact of NAC on complete response, overall, and cancer-specific survival (CSS) after RT in the weighted cohort was analyzed. Results and limitations: After applying the exclusion criteria, 586 patients were included; 102 (17%) received NAC before RT. Patients in the NAC subgroup were younger (mean age 65 vs 77 yr; ASD 1.20); more likely to have Eastern Cooperative Oncology Group performance status 0-1 (87% vs 78%; ASD 0.28), lymphovascular invasion (32% vs 20%; ASD 0.27), higher cT stage (cT3-4 in 29% vs 20%; ASD 0.21), and higher cN stage (cN1-2 in 32% vs 4%; ASD 0.81); and more commonly treated with concurrent chemotherapy (79% vs 67%; ASD 0.28). After IPTW, NAC versus no NAC cohorts were well balanced (ASD <0.20) for all included covariates. NAC was significantly associated with improved CSS (hazard ratio [HR] 0.28; 95% confidence interval [CI] 0.14-0.56; p < 0.001) and overall survival (HR 0.56; 95% CI 0.38-0.84; p = 0.005). This study was limited by potential occult imbalances across treatment groups. Conclusions: If tolerated, NAC might be associated with improved survival and should be considered for eligible patients with MIBC planning to undergo bladder preservation with RT. Prospective trials are warranted. Patient summary: In this study, we showed that neoadjuvant chemotherapy might be associated with improved survival in patients with muscle-invasive bladder cancer who elect for curative-intent radiation-based therapy.
Language	English
Publishing date	2024-02-06
Publishing country	Netherlands
Document type	Journal Article
ISSN	2588-9311
ISSN (online)	2588-9311
DOI	10.1016/j.euo.2024.01.014
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Article ; Online: Radiation-based Therapy for Muscle-invasive Bladder Cancer: Contemporary Outcomes Across Tertiary Centers.

Kool, Ronald / Marcq, Gautier / Breau, Rodney H / Black, Peter C / Shayegan, Bobby / Kim, Michael / Busca, Ionut / Abdi, Hamidreza / Dawidek, Mark T / Uy, Michael / Fervaha, Gagan / Cury, Fabio L / Alimohamed, Nimira S / Izawa, Jonathan I / Jeldres, Claudio / Rendon, Ricardo / Siemens, D Robert / Kulkarni, Girish S / Kassouf, Wassim

European urology oncology

2023 Volume 6, Issue 6, Page(s) 597–603

Abstract: Background: Radiation therapy (RT) is an alternative to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC).: Objective: To analyze predictors of complete response (CR) and survival after RT for MIBC.: Design, setting, and ... ...

Abstract	Background: Radiation therapy (RT) is an alternative to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). Objective: To analyze predictors of complete response (CR) and survival after RT for MIBC. Design, setting, and participants: This was a multicenter retrospective study of 864 patients with nonmetastatic MIBC who underwent curative-intent RT from 2002 to 2018. Outcome measurements and statistical analysis: Regression models were used to explore prognostic factors associated with CR, cancer-specific survival (CSS), and overall survival (OS). Results and limitations: The median patient age was 77 yr and median follow-up was 34 mo. Disease stage was cT2 in 675 patients (78%) and cN0 in 766 (89%). Neoadjuvant chemotherapy (NAC) was given to 147 patients (17%) and concurrent chemotherapy to 542 (63%). A CR was experienced by 592 patients (78%). cT3-4 stage (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.29-0.63; p < 0.001) and hydronephrosis (OR 0.50, 95% CI 034-0.74; p = 0.001) were significantly associated with lower CR. The 5-yr survival rates were 63% for CSS and 49% for OS. Higher cT stage (HR 1.93, 95% CI 1.46-2.56; p < 0.001), carcinoma in situ (HR 2.10, 95% CI 1.25-3.53; p = 0.005), hydronephrosis (HR 2.36, 95% CI 1.79-3.10; p < 0.001), NAC use (HR 0.66, 95% CI 0.46-0.95; p = 0.025), and whole-pelvis RT (HR 0.66, 95% CI 0.51-0.86; p = 0.002) were independently associated with CSS; advanced age (HR 1.03, 95% CI 1.01-1.05; p = 0.001), worse performance status (HR 1.73, 95% CI 1.34-2.22; p < 0.001), hydronephrosis (HR 1.50, 95% CI 1.17-1.91; p = 0.001), NAC use (HR 0.69, 95% CI 0.49-0.97; p = 0.033), whole-pelvis RT (HR 0.64, 95% CI 0.51-0.80; p < 0.001), and being surgically unfit (HR 1.42, 95% CI 1.12-1.80; p = 0.004) were associated with OS. The study is limited by the heterogeneity of different treatment protocols. Conclusions: RT for MIBC yields a CR in most patients who elect for curative-intent bladder preservation. The benefit of NAC and whole-pelvis RT require prospective trial validation. Patient summary: We investigated outcomes for patients with muscle-invasive bladder cancer treated with curative-intent radiation therapy as an alternative to surgical removal of the bladder. The benefit of chemotherapy before radiotherapy and whole-pelvis radiation (bladder plus the pelvis lymph nodes) needs further study.
MeSH term(s)	Humans ; Retrospective Studies ; Prospective Studies ; Disease-Free Survival ; Urinary Bladder Neoplasms/radiotherapy ; Urinary Bladder Neoplasms/drug therapy ; Hydronephrosis ; Muscles/pathology
Language	English
Publishing date	2023-03-31
Publishing country	Netherlands
Document type	Multicenter Study ; Journal Article
ISSN	2588-9311
ISSN (online)	2588-9311
DOI	10.1016/j.euo.2023.03.004
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Article: Canadian Urological Association guideline on the management of non-muscle-invasive bladder cancer - Abridged version.

Bhindi, Bimal / Kool, Ronald / Kulkarni, Girish S / Siemens, D Robert / Aprikian, Armen G / Breau, Rodney H / Brimo, Fadi / Fairey, Adrian / French, Christopher / Hanna, Nawar / Izawa, Jonathan I / Lacombe, Louis / McPherson, Victor / Rendon, Ricardo A / Shayegan, Bobby / So, Alan I / Zlotta, Alexandre R / Black, Peter C / Kassouf, Wassim

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2022 Volume 15, Issue 8, Page(s) 230–239

Language	English
Publishing date	2022-01-31
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2431403-1
ISSN	1911-6470
ISSN	1911-6470
DOI	10.5489/cuaj.7487
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Article ; Online: Hypothermia During Partial Nephrectomy for Patients with Renal Tumors: A Randomized Controlled Trial.

Breau, Rodney H / Fergusson, Dean A / Knoll, Greg / McAlpine, Kristen / Morash, Christopher / Cnossen, Sonya / Lavallée, Luke T / Mallick, Ranjeeta / Finelli, Antonio / Jewett, Michael A S / Leibovich, Bradley C / Cook, Jonathan A / Kapoor, Anil / Pouliot, Frederic / Izawa, Jonathan / Rendon, Ricardo / Cagiannos, Ilias

The Journal of urology

2020 Volume 205, Issue 5, Page(s) 1303–1309

Abstract: Purpose: Surgeons induce renal hypothermia during partial nephrectomy to preserve kidney function, without strong evidence of benefit. This trial examined the effectiveness and safety of renal hypothermia during partial nephrectomy.: Materials and ... ...

Abstract	Purpose: Surgeons induce renal hypothermia during partial nephrectomy to preserve kidney function, without strong evidence of benefit. This trial examined the effectiveness and safety of renal hypothermia during partial nephrectomy. Materials and methods: We conducted a parallel randomized controlled trial of hypothermia versus no hypothermia (control group) during partial nephrectomy at 6 academic hospitals. Eligible patients had a planned open partial nephrectomy for the treatment of a renal tumor. During surgery, after clamping the renal hilum, patients were randomized to the intervention or control arm in a 1:1 ratio using permuted blocks of variable lengths (2 and 4), stratified by institution, using a computer-based program. Surgeons and study coordinators were masked to treatment allocation until the renal hilum was clamped. Overall glomerular filtration rates were determined before, and 1-year after, surgery. The primary outcome was measured glomerular filtration rate (mGFR) assessed by the plasma clearance of Results: Of the 184 patients randomized, hypothermia and control patients had similar baseline mean mGFR (87.1 vs 81.0 ml/minute/1.73 m Conclusions: Renal hypothermia during partial nephrectomy does not preserve kidney function in patients with normal or mildly impaired renal function.
MeSH term(s)	Aged ; Female ; Glomerular Filtration Rate ; Humans ; Hypothermia, Induced ; Kidney/physiology ; Kidney Neoplasms/surgery ; Male ; Middle Aged ; Nephrectomy/methods ; Treatment Outcome
Language	English
Publishing date	2020-12-21
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000001517
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Zs.MO 331: Show issues

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