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  • 1
    Online Resource
    Online Resource
    Inter-observer variability of cribriform architecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome
    Springer Science and Business Media LLC ; 2021
    In:  Virchows Archiv Vol. 478, No. 2 ( 2021-02), p. 249-256
    Details
    In: Virchows Archiv, Springer Science and Business Media LLC, Vol. 478, No. 2 ( 2021-02), p. 249-256
    Abstract: The Grade group is an important parameter for clinical decision-making in prostate cancer. Recently, percent Gleason pattern 4 and presence of invasive cribriform and/or intraductal carcinoma (CR/IDC) have been recognized for their independent predictive value for prostate cancer outcome. There is sparse data on the inter-observer agreement for these pathologic features in practice. Our objectives were to investigate inter-observer variability of percent Gleason pattern and CR/IDC and to relate individual tumour scores to clinical outcome. Our cohort included 80 consecutive radical prostatectomies with a median follow-up 87.1 months (interquartile range 43.3–119.2), of which the slide with largest tumour volume was scored by six pathologists for Grade group (four tiers: 1, 2, 3 and 4/5), percent Gleason pattern 4 (four tiers: 0–25%, 26–50%, 51–75% and 76–100%) and presence of CR/IDC (two tiers: absent, present). The individual assignments were related to post-operative biochemical recurrence (20/80). Inter-observer agreement was substantial (Krippendorff’s α 0.626) for assessment of Grade group and moderate for CR/IDC ( α 0.507) and percent Gleason pattern 4 ( α 0.551). For each individual pathologist, biochemical recurrence rates incremented by Grade group and presence of CR/IDC, although such relation was less clear for percent Gleason pattern 4. In conclusion, inter-observer agreement for CR/IDC and percent Gleason pattern 4 is lower than for Grade groups, indicating awareness of these features needs further improvement. Grade group and CR/IDC, but not percent Gleason pattern 4 was related to biochemical recurrence for each pathologist, indicating overall validity of individual grade assignments despite inter-observer variability.
    Type of Medium: Online Resource
    ISSN: 0945-6317 , 1432-2307
    URL: Article
    DOI: 10.1007/s00428-020-02902-9
    RVK:
    XA 27000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1463276-7
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  • 2
    Online Resource
    Online Resource
    Histoplasma-associated inflammatory pseudotumour of the kidney mimicking renal carcinoma
    Springer Science and Business Media LLC ; 2009
    In:  Virchows Archiv Vol. 454, No. 2 ( 2009-2), p. 229-232
    Details
    In: Virchows Archiv, Springer Science and Business Media LLC, Vol. 454, No. 2 ( 2009-2), p. 229-232
    Type of Medium: Online Resource
    ISSN: 0945-6317 , 1432-2307
    URL: Article
    DOI: 10.1007/s00428-008-0714-6
    RVK:
    XA 27000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2009
    detail.hit.zdb_id: 1463276-7
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  • 3
    Online Resource
    Online Resource
    Intraoperative assessment and reporting of radical prostatectomy specimens to guide nerve‐sparing surgery in prostate cancer patients (NeuroSAFE)
    Wiley ; 2020
    In:  Histopathology Vol. 77, No. 4 ( 2020-10), p. 539-547
    Details
    In: Histopathology, Wiley, Vol. 77, No. 4 ( 2020-10), p. 539-547
    Abstract: Radical prostatectomy for prostate cancer is frequently complicated by urinary incontinence and erectile dysfunction. Nerve‐sparing surgery reduces the risk of postoperative complications and can be optimised by the use of intraoperative frozen sections of the adjacent neurovascular structure (NeuroSAFE). The aims of this study were to evaluate the pathological outcomes of the NeuroSAFE technique and to develop a comprehensive algorithm for intraoperative clinical decision‐making. Methods and results Between September 2018 and May 2019, 491 NeuroSAFE procedures were performed in 258 patients undergoing radical prostatectomy; 74 of 491 (15.1%) NeuroSAFE specimens had positive surgical margins. As compared with the corresponding paraffin sections, NeuroSAFE had a positive predictive value and negative predictive value of 85.1% and 95.4%, respectively. In 72.2% of secondary neurovascular bundle resections prompted by a NeuroSAFE positive surgical margin, no tumour was present. These cases more often had a positive surgical margin of ≤1 mm (48.7% versus 20.0%; P  = 0.001) and only one positive slide (69.2% versus 33.3%; P  = 0.008). None of the nine patients with Gleason pattern 3 at the surgical margin, a positive surgical margin length of ≤1 mm and one positive slide had tumour in the secondary resection. Conclusions This study provides a systematic reporting template for pathological intraoperative NeuroSAFE evaluation, supporting intraoperative clinical decision‐making and comparison between prostate cancer operation centres.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v77.4
    DOI: 10.1111/his.14184
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2006447-0
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  • 4
    Online Resource
    Online Resource
    NeuroSAFE in radical prostatectomy increases the rate of nerve‐sparing surgery without affecting oncological outcome
    Wiley ; 2022
    In:  BJU International Vol. 130, No. 5 ( 2022-11), p. 628-636
    Details
    In: BJU International, Wiley, Vol. 130, No. 5 ( 2022-11), p. 628-636
    Abstract: To investigate the impact of intra‐operative neurovascular structure‐adjacent frozen‐section examination (NeuroSAFE) on the rate of nerve‐sparing surgery (NSS) and oncological outcome in a large radical prostatectomy (RP) cohort. Patients and methods Between January 2016 and December 2020, 1756 prostate cancer patients underwent robot‐assisted RP, of whom 959 (55%) underwent this with NeuroSAFE and 797 (45%) without (control cohort). In cases where NeuroSAFE showed tumour in the margin, a secondary resection was performed. The effect of NeuroSAFE on NSS and positive surgical margin (PSM) status was analysed using logistic regression. Cox regression was used to identify predictors of biochemical recurrence‐free survival (BCRFS). Results and limitations Patients in the NeuroSAFE cohort had a higher tumour grade ( P 〈  0.001) and clinical stage ( P 〈  0.001) than those in the control cohort. NeuroSAFE enabled more frequent NSS for both pT2 (93% vs 76%; P 〈  0.001) and pT3 disease (83% vs 55%; P 〈  0.001). In adjusted analysis, NeuroSAFE resulted in more frequent unilateral (odds ratio [OR] 3.90, 95% confidence interval (CI) 2.90–5.30; P 〈  0.001) and bilateral (OR 5.22, 95% CI 3.90–6.98; P 〈  0.001) NSS. While the PSM rate decreased from 51% to 42% in patients with pT3 stage disease ( P = 0.031), NeuroSAFE was not an independent predictor of PSM status (OR 0.85, 95% CI 0.68–1.06; P = 0.2) in the entire cohort. Patients who underwent NeuroSAFE had better BCRFS compared to the control cohort (hazard ratio 0.62, 95% CI 0.45–0.84; P = 0.002). This study is limited by its comparison with a historical cohort and lack of functional outcomes. Conclusions NeuroSAFE enables more unilateral and bilateral NSS without negatively affecting surgical margin status and biochemical recurrence. This validation study provides a comprehensive overview of the implementation, evaluation and intra‐operative decision making associated with NeuroSAFE in clinical practice.
    Type of Medium: Online Resource
    ISSN: 1464-4096 , 1464-410X
    URL: Issue
    URL: Article
    DOI: 10.1111/bju.v130.5
    DOI: 10.1111/bju.15771
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2019983-1
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  • 5
    Online Resource
    Online Resource
    Nitrofurantoin-induced pulmonary fibrosis: a case report
    Springer Science and Business Media LLC ; 2008
    In:  Journal of Medical Case Reports Vol. 2, No. 1 ( 2008-12)
    Details
    In: Journal of Medical Case Reports, Springer Science and Business Media LLC, Vol. 2, No. 1 ( 2008-12)
    Abstract: Nitrofurantoin is a commonly used drug in the treatment and prevention of urinary tract infections. Many adverse effects of nitrofurantoin have been documented, including aplastic anemia, polyneuritis, and liver and pulmonary toxicity. Case presentation We describe the clinical history and the autopsy findings in a 51-year-old woman with lung fibrosis of unknown etiology. She had a history of recurrent urinary tract infections, treated with nitrofurantoin for many years. She was referred to our hospital for screening for lung transplantation because of severe pulmonary restriction and dyspnea. Unfortunately, she died as a result of progressive respiratory insufficiency. At autopsy bilateral patchy, sharply circumscribed fibrotic areas in the upper and lower lobes of the lungs were seen with honeycombing. Microscopically, end-stage interstitial fibrosis with diffuse alveolar damage was observed. Due to the atypical distribution of the fibrosis involving both the lower and upper lobes of the lung, the microscopic pattern of the fibrosis and the history of long-term nitrofurantoin use, we concluded that this drug induced the lung fibrosis. The recurrent urinary tract infections were probably caused by a diverticulum of the urinary bladder, which was discovered at autopsy. Conclusion This case shows that the use of nitrofurantoin may cause severe pulmonary disease. Patients with long-term use of nitrofurantoin should be monitored regularly for adverse pulmonary effects.
    Type of Medium: Online Resource
    ISSN: 1752-1947
    URL: Article
    DOI: 10.1186/1752-1947-2-169
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2008
    detail.hit.zdb_id: 2269805-X
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