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Article ; Online: Editorial Comment to Benefits of robotic cystectomy compared with open cystectomy in an Enhanced Recovery After Surgery program: A propensity-matched analysis.

Khetrapal, Pramit

International journal of urology : official journal of the Japanese Urological Association

2020 Volume 27, Issue 9, Page(s) 788–789

MeSH term(s)	Cystectomy/adverse effects ; Enhanced Recovery After Surgery ; Humans ; Robotic Surgical Procedures/adverse effects ; Robotics ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2020-08-07
Publishing country	Australia
Document type	Journal Article ; Comment
ZDB-ID	1328401-0
ISSN	1442-2042 ; 0919-8172
ISSN (online)	1442-2042
ISSN	0919-8172
DOI	10.1111/iju.14337
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Zs.A 4460: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 278: Show issues

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Article ; Online: Is It PRIME Time for Biparametric Magnetic Resonance Imaging in Prostate Cancer Diagnosis?

Ng, Alexander / Khetrapal, Pramit / Kasivisvanathan, Veeru

European urology

2022 Volume 82, Issue 1, Page(s) 1–2

Abstract: The PRIME (PRostate Imaging using Mri +/- contrast Enhancement) study is evaluating whether quicker, cheaper, and less invasive biparametric magnetic resonance imaging (bpMRI) is noninferior to multiparametric MRI in diagnosing clinically significant ... ...

Abstract	The PRIME (PRostate Imaging using Mri +/- contrast Enhancement) study is evaluating whether quicker, cheaper, and less invasive biparametric magnetic resonance imaging (bpMRI) is noninferior to multiparametric MRI in diagnosing clinically significant prostate cancer (PCa). If the study results confirm that bpMRI is not inferior, it could become the new standard of care for PCa diagnosis and streamline the diagnosis pathway so that all men who need MRI have access to this diagnostic tool.
MeSH term(s)	Humans ; Magnetic Resonance Imaging/methods ; Male ; Multiparametric Magnetic Resonance Imaging ; Pelvis/pathology ; Prostate/pathology ; Prostatic Neoplasms/pathology
Language	English
Publishing date	2022-03-08
Publishing country	Switzerland
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2022.02.021
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Zs.A 1247: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 294: Show issues

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Article ; Online: Effect of Robot-Assisted Radical Cystectomy vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients With Bladder Cancer-Reply.

Catto, James W F / Khetrapal, Pramit / Ambler, Gareth

JAMA

2022 Volume 328, Issue 12, Page(s) 1258–1259

MeSH term(s)	Cystectomy/adverse effects ; Cystectomy/instrumentation ; Cystectomy/methods ; Cystectomy/mortality ; Humans ; Morbidity ; Postoperative Complications/epidemiology ; Postoperative Complications/mortality ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/instrumentation ; Robotic Surgical Procedures/methods ; Robotic Surgical Procedures/mortality ; Treatment Outcome ; Urinary Bladder/surgery ; Urinary Bladder Neoplasms/complications ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2022-09-20
Publishing country	United States
Document type	Comparative Study ; Letter ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.13600
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Ua VI Zs.88: Show issues

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Article ; Online: Robot-assisted versus open cystectomy in the RAZOR trial.

Khetrapal, Pramit / Catto, James W F / Kelly, John D

Lancet (London, England)

2019 Volume 393, Issue 10172, Page(s) 644–645

MeSH term(s)	Cystectomy ; Humans ; Robotic Surgical Procedures ; Robotics ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2019-02-14
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(18)32998-2
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Ua VI Zs.5: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MG 94: Show issues

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Article ; Online: Comparing open-radical cystectomy and robot-assisted radical cystectomy: current status and analysis of the evidence.

Khetrapal, Pramit / Conroy, Samantha / Kelly, John D / Catto, James W F

Current opinion in urology

2020 Volume 30, Issue 3, Page(s) 400–406

Abstract: Purpose of review: Radical cystectomy is the definitive surgical treatment for aggressive bladder cancer. The robotic platform offers a new approach to radical cystectomy, but the benefits are unclear. This review examines the latest evidence, with a ... ...

Abstract	Purpose of review: Radical cystectomy is the definitive surgical treatment for aggressive bladder cancer. The robotic platform offers a new approach to radical cystectomy, but the benefits are unclear. This review examines the latest evidence, with a particular focus on developments in the last two years. Recent findings: Prospective evaluations of open (ORC) and robot-assisted radical cystectomy (RARC) are emerging. The radical cystectomy in patients with bladder cancer trial reported in 2018 and demonstrated oncological noninferiority for both approaches and marginal shorter length of stays with RARC using an extracorporeal reconstruction. The trial confirmed prospective randomized comparisons are possible, and replicates observations from two earlier, smaller randomised controlled trials with longer follow-up. Although there has been significant traction to the intracorporeal approach to RARC, randomized trial evidence is awaited to show any benefit over ORC. Summary: New evidence alludes to the noninferiority of the robotic platform in radical cystectomy in comparison to open surgery. There is minimal evidence of a clinically meaningful benefit. Until this is addressed, ORC remains the gold standard for the definitive surgical management of bladder cancer.
MeSH term(s)	Cystectomy/instrumentation ; Cystectomy/methods ; Cystectomy/trends ; Humans ; Postoperative Complications ; Robotic Surgical Procedures/instrumentation ; Robotic Surgical Procedures/methods ; Robotics ; Treatment Outcome ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2020-03-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000755
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Zs.A 3345: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Reply to Andreas Skolarikos's Words of Wisdom re: Effect of Robot-assisted Radical Cystectomy with Intracorporeal Urinary Diversion vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients with Bladder Cancer: A Randomized Clinical Trial. Eur Urol. In press.

Catto, James W F / Khetrapal, Pramit / Ambler, Gareth / Williams, Norman R / Brew-Graves, Chris / Kelly, John D

European urology

2022 Volume 82, Issue 5, Page(s) e139–e140

MeSH term(s)	Cystectomy ; Humans ; Morbidity ; Robotics ; Urinary Bladder Neoplasms/surgery ; Urinary Diversion
Language	English
Publishing date	2022-08-06
Publishing country	Switzerland
Document type	Letter ; Randomized Controlled Trial ; Comment
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2022.07.019
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Zs.A 1247: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 294: Show issues

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Article ; Online: Reply to Bernardo Rocco and Maria Chiara Sighinolfi's Letter to the Editor re: James W.F. Catto, Pramit Khetrapal, Federico Ricciardi, et al. Effect of Robot-assisted Radical Cystectomy with Intracorporeal Urinary Diversion vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients with Bladder Cancer: A Randomized Clinical Trial. JAMA 2022;327:2092-103: Lacking the Evidence for Neobladder Use After Radical Cystectomy.

Catto, James W F / Khetrapal, Pramit / Ambler, Gareth / Williams, Norman R / Brew-Graves, Chris / Kelly, John D

European urology

2022 Volume 82, Issue 6, Page(s) e167–e168

MeSH term(s)	Humans ; Cystectomy ; Urinary Bladder Neoplasms/surgery ; Robotics ; Urinary Diversion ; Morbidity
Language	English
Publishing date	2022-09-14
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Letter
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2022.08.035
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Zs.A 1247: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 294: Show issues

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Article ; Online: Choosing appropriate patient-reported outcome measures for prostate disease.

Ng, Alexander / Khetrapal, Pramit / Brew-Graves, Chris / Muirhead, Nicola / Asif, Aqua / Chan, Vinson Wai-Shun / Nathan, Arjun / Kasivisvanathan, Veeru

BJUI compass

2022 Volume 3, Issue 4, Page(s) 263–266

Language	English
Publishing date	2022-01-12
Publishing country	United States
Document type	Journal Article
ISSN	2688-4526
ISSN (online)	2688-4526
DOI	10.1002/bco2.136
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Article ; Online: Cost-Effectiveness of Robot-Assisted Radical Cystectomy vs Open Radical Cystectomy for Patients With Bladder Cancer.

Dixon, Simon / Hill, Harry / Flight, Laura / Khetrapal, Pramit / Ambler, Gareth / Williams, Norman R / Brew-Graves, Chris / Kelly, John D / Catto, James W F

JAMA network open

2023 Volume 6, Issue 6, Page(s) e2317255

Abstract: Importance: The value to payers of robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) when compared with open radical cystectomy (ORC) for patients with bladder cancer is unclear.: Objectives: To compare the cost- ... ...

Abstract	Importance: The value to payers of robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) when compared with open radical cystectomy (ORC) for patients with bladder cancer is unclear. Objectives: To compare the cost-effectiveness of iRARC with that of ORC. Design, setting, and participants: This economic evaluation used individual patient data from a randomized clinical trial at 9 surgical centers in the United Kingdom. Patients with nonmetastatic bladder cancer were recruited from March 20, 2017, to January 29, 2020. The analysis used a health service perspective and a 90-day time horizon, with supplementary analyses exploring patient benefits up to 1 year. Deterministic and probabilistic sensitivity analyses were undertaken. Data were analyzed from January 13, 2022, to March 10, 2023. Interventions: Patients were randomized to receive either iRARC (n = 169) or ORC (n = 169). Main outcomes and measures: Costs of surgery were calculated using surgery timings and equipment costs, with other hospital data based on counts of activity. Quality-adjusted life-years were calculated from European Quality of Life 5-Dimension 5-Level instrument responses. Prespecified subgroup analyses were undertaken based on patient characteristics and type of diversion. Results: A total of 305 patients with available outcome data were included in the analysis, with a mean (SD) age of 68.3 (8.1) years, and of whom 241 (79.0%) were men. Robot-assisted radical cystectomy was associated with statistically significant reductions in admissions to intensive therapy (6.35% [95% CI, 0.42%-12.28%]), and readmissions to hospital (14.56% [95% CI, 5.00%-24.11%]), but increases in theater time (31.35 [95% CI, 13.67-49.02] minutes). The additional cost of iRARC per patient was £1124 (95% CI, -£576 to £2824 [US $1622 (95% CI, -$831 to $4075)]) with an associated gain in quality-adjusted life-years of 0.01124 (95% CI, 0.00391-0.01857). The incremental cost-effectiveness ratio was £100 008 (US $144 312) per quality-adjusted life-year gained. Robot-assisted radical cystectomy had a much higher probability of being cost-effective for subgroups defined by age, tumor stage, and performance status. Conclusions and relevance: In this economic evaluation of surgery for patients with bladder cancer, iRARC reduced short-term morbidity and some associated costs. While the resulting cost-effectiveness ratio was in excess of thresholds used by many publicly funded health systems, patient subgroups were identified for which iRARC had a high probability of being cost-effective. Trial registration: ClinicalTrials.gov Identifier: NCT03049410.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Cystectomy ; Cost-Benefit Analysis ; Quality of Life ; Robotics ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.17255
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Article ; Online: Digital Tracking of Patients Undergoing Radical Cystectomy for Bladder Cancer: Daily Step Counts Before and After Surgery Within the iROC Randomised Controlled Trial.

Khetrapal, Pramit / Bains, Parasdeep S / Jubber, Ibrahim / Ambler, Gareth / Williams, Norman R / Brew-Graves, Chris / Sridhar, Ashwin / Ta, Anthony / Kelly, John D / Catto, James W F

European urology oncology

2023

Abstract: Background: Efforts to improve recovery after radical cystectomy (RC) are needed.: Objective: To investigate wrist-worn wearable activity trackers in RC participants.: Design, setting, and participants: An observational cohort study was conducted ... ...

Abstract	Background: Efforts to improve recovery after radical cystectomy (RC) are needed. Objective: To investigate wrist-worn wearable activity trackers in RC participants. Design, setting, and participants: An observational cohort study was conducted within the iROC randomised trial. Intervention: Patients undergoing RC at nine cancer centres wore wrist-based trackers for 7 days (d) at intervals before and after surgery. Outcome measurements and statistical analysis: Step counts were compared with participant and operative features, and recovery outcomes. Results and limitations: Of 308 participants, 284 (92.2%) returned digital activity data at baseline (median 17 d [interquartile range: 8-32] before RC), and postoperatively (5 [5-6] d) and at weeks 5 (43 [38-43] d), 12 (94 [87-106] d), and 26 (192 [181-205] d) after RC. Compliance was affected by the time from surgery and a coronavirus disease 2019 pandemic lockdown (return rates fell to 0-7%, chi-square p < 0.001). Step counts dropped after surgery (mean of 28% of baseline), before recovering at 5 weeks (wk) (71% of baseline) and 12 wk (95% of baseline; all analysis of variance [ANOVA] p < 0.001). Baseline step counts were not associated with postoperative recovery or death. Patients with extended hospital stays had reduced postoperative step counts, with a difference of 2.2 d (95% confidence interval: 0.856-3.482 d) between the lowest third and highest two-third tertiles (linear regression analysis; p < 0.001). Additionally, they spent less time out of the hospital within 90 d of RC (80.3 vs 74.3 d, p = 0.013). Lower step counts at 5, 12, and 26 wk were seen in those seeking medical help and needing readmission (ANOVA p ≤ 0.002). Conclusions: Baseline step counts were not associated with recovery. Lower postoperative step counts were associated with longer length of stay at the hospital and postdischarge readmissions. Studies are required to determine whether low step counts can identify patients at a risk of developing complications. Patient summary: Postoperative step counts appear to be a promising tool to identify patients in the community needing medical help or readmission. More work is needed to understand which measures are most useful and how best to collect these.
Language	English
Publishing date	2023-10-16
Publishing country	Netherlands
Document type	Journal Article
ISSN	2588-9311
ISSN (online)	2588-9311
DOI	10.1016/j.euo.2023.09.021
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