| 1. |
- Huri, Emre, et al.
(author)
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Evaluation of Residencies in Turkey The First Report of the ESRU Questionnaire in the Europe Home Version
- 2009
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In: UROLOGIA INTERNATIONALIS. - : S. Karger AG. - 0042-1138 .- 1423-0399. ; 83:2, s. 206-210
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Journal article (peer-reviewed)abstract
- Introduction: We aimed to evaluate the general status of last-year residents in Turkey by filling in the questionnaire Evaluation of Residencies in Europe. Subjects and Methods: The questionnaire `Evaluation of Residencies in Europe, designed by the European Society of Residents in Urology (ESRU), was applied to 91 last-year urology residents. It consisted of 7 sections; Introduction, Membership, Residency, Life and Financial Conditions, Future Practice, Training and Research Activities and Contribution to Scientific Literature. The results were determined and reviewed as well. Statistical analysis was performed using ANOVA and the Kruskal-Wallis Test. Results: More than 40 parameters were evaluated. The level of English was average or good for 86%. Half of the residents were aware of ESRU activities, 91% knew national ESRU representatives. Fifty-seven percent of the residents wanted to subspecialize in urology, nephrectomy or andrology, and general urology procedures had a high rate being performed by a first surgeon. Transurethral prostate resection, transurethral resection of bladder and extracorporeal shock wave lithotripsy were well known, with a rate of 76%. Conclusions: Although the Turkish resident number is one of the most excessive in Europe, we have a well-trained homogenous resident group especially in the field of endourology; most of those in the last year of their training period were satisfied with their general condition.
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| 2. |
- Van der Poel, Henk G., et al.
(author)
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Sentinel node biopsy for prostate cancer : Report from a consensus panel meeting
- 2017
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In: BJU International. - : Wiley. - 1464-4096. ; 120:2, s. 204-211
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Journal article (peer-reviewed)abstract
- Objective: To explore the evidence and knowledge gaps in sentinel node biopsy (SNB) in prostate cancer through a consensus panel of experts. Methods: A two-round Delphi survey among experts was followed by a consensus panel meeting of 16 experts in February 2016. Agreement voting was performed using the research and development project/University of California, Los Angeles Appropriateness Methodology on 150 statements in nine domains. The disagreement index based on the interpercentile range, adjusted for symmetry score, was used to assess consensus and non-consensus among panel members. Results: Consensus was obtained on 91 of 150 statements (61%). The main outcomes were: (1) the results from an extended lymph node dissection (eLND) are still considered the 'gold standard', and sentinel node (SN) detection should be combined with eLND, at least in patients with intermediate- and high-risk prostate cancer; (2) the role of SN detection in low-risk prostate cancer is unclear; and (3) future studies should contain oncological endpoints as number of positive nodes outside the eLND template, false-negative and false-positive SN procedures, and recurrence-free survival. A high rate of consensus was obtained regarding outcome measures of future clinical trials on SNB (89%). Consensus on tracer technology was only obtained in 47% of statements, reflecting a need for further research and standardization in this area. The low-level evidence in the available literature and the composition of mainly SNB users in the panel constitute the major limitations of the study. Conclusions: Consensus on a majority of elementary statements on SN detection in prostate cancer was obtained.; therefore, the results from this consensus report will provide a basis for the design of further studies in the field. A group of experts identified evidence and knowledge gaps on SN detection in prostate cancer and its application in daily practice. Information from the consensus statements can be used to direct further studies.
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| 3. |
- Wit, Esther M K, et al.
(author)
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Sentinel Node Procedure in Prostate Cancer : A Systematic Review to Assess Diagnostic Accuracy
- 2017
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In: European Urology. - : Elsevier BV. - 0302-2838. ; 71:4, s. 596-605
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Research review (peer-reviewed)abstract
- Context: Extended pelvic lymph node dissection (ePLND) is the gold standard for detecting lymph node (LN) metastases in prostate cancer (PCa). The benefit of sentinel node biopsy (SNB), which is the first draining LN as assessed by imaging of locally injected tracers, remains controversial. Objective: To assess the diagnostic accuracy of SNB in PCa. Evidence acquisition: A systematic literature search of Medline, Embase, and the Cochrane Library (1999-2016) was undertaken using PRISMA guidelines. All studies of SNB in men with PCa using PLND as reference standard were included. The primary outcomes were the nondiagnostic rate (NDR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false positive (FP) and false negative (FN) rates. Relevant sensitivity analyses based on SN definitions, ePLND as reference standard, and disease risk were undertaken, including a risk of bias (RoB) assessment. Evidence synthesis: Of 373 articles identified, 21 studies recruiting a total of 2509 patients were eligible for inclusion. Median cumulative percentage (interquartile range) results were 4.1% (1.5-10.7%) for NDR, 95.2% (81.8-100%) for sensitivity, 100% (95.0-100%) for specificity, 100% (87.0-100%) for PPV, 98.0% (94.3-100%) for NPV, 0% (0-5.0%) for the FP rate, and 4.8% (0-18.2%) for the FN rate. The findings did not change significantly on sensitivity analyses. Most studies (17/22) had low RoB for index test and reference standard domains. Conclusions: SNB appears to have diagnostic accuracy comparable to ePLND, with high sensitivity, specificity, PPV and NPV, and a low FN rate. With a low FP rate (rate of detecting positive nodes outside the ePLND template), SNB may not have any additional diagnostic value over and above ePLND, although SNB appears to increase nodal yield by increasing the number of affected nodes when combined with ePLND. Thus, in high-risk disease it may be prudent to combine ePLND with SNB. Patient summary: This literature review showed a high diagnostic accuracy for sentinel node biopsy in detecting positive lymph nodes in prostate cancer, but further studies are needed to explore the effect of sentinel node biopsy on complications and oncologic outcome. The accuracy of sentinel node biopsy (SNB) in detecting positive lymph nodes in prostate cancer appears to have diagnostic accuracy comparable to that of extended pelvic lymph node dissection (ePLND). However, SNB may not have any additional diagnostic value over and above ePLND.
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