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Item What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021 (vol 82, pg 6, 2022)(ELSEVIER, 2022-01-01) Turco, Fabio; Armstrong, Andrew; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Bossi, Alberto; Briganti, Alberto; Bristow, Rob G.; Bulbul, Muhammad; Caffo, Orazio; Chi, Kim N.; Clarke, Caroline; Clarke, Noel; Davis, Ian D.; de Bono, Johann; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fizazi, Karim; Frydenberg, Mark; George, Dan; Gleave, Martin; Halabi, Susan; Heinrich, Daniel; Higano, Celestia; Hofman, Michael S.; Hussain, Maha; James, Nicholas; Jones, Rob; Kanesvaran, Ravindran; Khauli, Raja B.; Klotz, Laurence; Leibowitz, Raya; Logothetis, Christopher; Maluf, Fernando; Millman, Robin; Morgans, Alicia K.; Morris, Michael J.; Mottet, Nicolas; Mrabti, Hind; Murphy, Declan G.; Murthy, Vedang; Oh, William K.; Ekeke, Onyeanunam Ngozi; Ost, Piet; O'Sullivan, Joe M.; Padhani, Anwar R.; Parker, Christopher; Poon, Darren M. C.; Pritchard, Colin C.; Rabah, Danny M.; Rathkopf, Dana; Reiter, Robert E.; Rubin, Mark; Ryan, Charles J.; Saad, Fred; Sade, Juan Pablo; Sartor, Oliver; Scher, Howard I.; Shore, Neal; Skoneczna, Iwona; Small, Eric; Smith, Matthew; Soule, Howard; Spratt, Daniel; Sternberg, Cora N.; Suzuki, Hiroyoshi; Sweeney, Christopher; Sydes, Matthew; Taplin, Mary-Ellen; Tilki, Derya; Tombal, Bertrand; Turkeri, Levent; Uemura, Hiroji; Uemura, Hirotsugu; van Oort, Inge; Yamoah, Kosj; Ye, Dingwei; Zapatero, Almudena; Gillessen, Silke; Omlin, AureliusItem What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021(ELSEVIER, 2022-01-01) Turco, Fabio; Armstrong, Andrew; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Bossi, Alberto; Briganti, Alberto; Bristow, Rob G.; Bulbul, Muhammad; Caffo, Orazio; Chi, Kim N.; Clarke, Caroline; Clarke, Noel; Davis, Ian D.; de Bono, Johann; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fizazi, Karim; Frydenberg, Mark; George, Dan; Gleave, Martin; Halabi, Susan; Heinrich, Daniel; Higano, Celestia; Hofman, Michael S.; Hussain, Maha; James, Nicholas; Jones, Rob; Kanesvaran, Ravindran; Khauli, Raja B.; Klotz, Laurence; Leibowitz, Raya; Logothetis, Christopher; Maluf, Fernando; Millman, Robin; Morgans, Alicia K.; Morris, Michael J.; Mottet, Nicolas; Mrabti, Hind; Murphy, Declan G.; Murthy, Vedang; Oh, William K.; Onyeanunam, Ngozi Ekeke; Ost, Piet; O'Sullivan, Joe M.; Padhani, Anwar R.; Parker, Christopher; Poon, Darren M. C.; Pritchard, Colin C.; Rabah, Danny M.; Rathkopf, Dana; Reiter, Robert E.; Rubin, Mark; Ryan, Charles J.; Saad, Fred; Pablo Sade, Juan; Sartor, Oliver; Scher I, Howard; Shore, Neal; Skoneczna, Iwona; Small, Eric; Smith, Matthew; Soule, Howard; Spratt, Daniel; Sternberg, Cora N.; Suzuki, Hiroyoshi; Sweeney, Christopher; Sydes, Matthew; Taplin, Mary-Ellen; Tilki, Derya; Tombal, Bertrand; Turkeri, Levent; Uemura, Hiroji; Uemura, Hirotsugu; van Oort, Inge; Yamoah, Kosj; Ye, Dingwei; Zapatero, Almudena; Gillessen, Silke; Omlin, AureliusPatients with advanced prostate cancer (APC) may be at greater risk for severe illness, hospitalisation, or death from coronavirus disease 2019 (COVID-19) due to male gender, older age, potential immunosuppressive treatments, or comorbidities. Thus, the optimal management of APC patients during the COVID-19 pandemic is complex. In October 2021, during the Advanced Prostate Cancer Consensus Conference (APCCC) 2021, the 73 voting members of the panel members discussed and voted on 13 questions on this topic that could help clinicians make treatment choices during the pandemic. There was a consensus for full COVID-19 vaccination and booster injection in APC patients. Furthermore, the voting results indicate that the expert's treatment recommendations are influenced by the vaccination status: the COVID-19 pandemic altered management of APC patients for 70\% of the panellists before the vaccination was available but only for 25\% of panellists for fully vaccinated patients. Most experts (71\%) were less likely to use docetaxel and abiraterone in unvaccinated patients with metastatic hormone-sensitive prostate cancer. For fully vaccinated patients with high-risk localised prostate cancer, there was a consensus (77\%) to follow the usual treatment schedule, whereas in unvaccinated patients, 55\% of the panel members voted for deferring radiation therapy. Finally, there was a strong consensus for the use of telemedicine for monitoring APC patients. Patient summary: In the Advanced Prostate Cancer Consensus Conference 2021, the panellists reached a consensus regarding the recommendation of the COVID-19 vaccine in prostate cancer patients and use of telemedicine for monitoring these patients. (c) 2022 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Item Management of Patients with Advanced Prostate Cancer: Report from the Advanced Prostate Cancer Consensus Conference 2021(ELSEVIER, 2022-01-01) Gillessen, Silke; Armstrong, Andrew; Attard, Gert; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Bossi, Alberto; Briganti, Alberto; Bristow, Robert G.; Bulbul, Muhammad; Caffo, Orazio; Chi, Kim N.; Clarke, Caroline S.; Clarke, Noel; Davis, Ian D.; de Bono, Johann S.; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason; Ekeke, Onyeanunam Ngozi; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fizazi, Karim; Frydenberg, Mark; George, Dan; Gleave, Martin; Halabi, Susan; Heinrich, Daniel; Higano, Celesta; Hofman, Michael S.; Hussain, Maha; James, Nick; Jones, Robert; Kanesvaran, Ravindran; Khauli, Raja B.; Klotz, Laurence; Leibowitz, Raya; Logothetis, Chris; Maluf, Fernando; Millman, Robin; Morgans, Alicia K.; Morris, Michael J.; Mottet, Nicolas; Mrabti, Hind; Murphy, Declan G.; Murthy, Vedang; Oh, William K.; Ost, Piet; O'Sullivan, Joe M.; Padhani, Anwar R.; Parker, Chris; Poon, Darren M. C.; Pritchard, Colin C.; Rabah, Danny M.; Rathkopf, Dana; Reiter, Rob E.; Rubin, Mark; Ryan, Charles J.; Saad, Fred; Sade, Juan P.; Sartor, Oliver; Scher I, Howard; Shore, Neal; Skoneczna, Iwona; Small, Eric; Smith, Matthew; Soule, Howard; Spratt, Daniel E.; Sternberg, Cora N.; Suzuki, Hiroyoshi; Sweeney, Christopher; Sydes, Matthew R.; Taplin, Mary-Ellen; Tilki, Derya; Tombal, Bertrand; Turkeri, Levent; Uemura, Hiroji; Uemura, Hirotsugu; van Oort, Inge; Yamoah, Kosj; Ye, Dingwei; Zapatero, Almudena; Omlin, AureliusBackground: Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but various areas of management still lack high-level evidence to inform clinical practice. The 2021 Advanced Prostate Cancer Consensus Conference (APCCC) addressed some of these questions to supplement guidelines that are based on level 1 evidence. Objective: To present the voting results from APCCC 2021. Design, setting, and participants: The experts identified three major areas of controversy related to management of advanced prostate cancer: newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC), the use of prostate-specific membrane antigen ligands in diagnostics and therapy, and molecular characterisation of tissue and blood. A panel of 86 international prostate cancer experts developed the programme and the consensus questions. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on 107 pre-defined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process. Results and limitations: The voting reflected the opinions of panellists and did not incorporate a standard literature review or formal meta-analysis. The answer options for the consensus questions received varying degrees of support from panellists, as reflected in this article and the detailed voting results reported in the Supplementary material. Conclusions: These voting results from a panel of experts in advanced prostate cancer can help clinicians and patients to navigate controversial areas of management for which high-level evidence is scant. However, diagnostic and treatment decisions should always be individualised according to patient characteristics, such as the extent and location of disease, prior treatment(s), comorbidities, patient preferences, and treatment recommendations, and should also incorporate current and emerging clinical evidence and logistic and economic constraints. Enrolment in clinical trials should be strongly encouraged. Importantly, APCCC 2021 once again identified salient questions that merit evaluation in specifically designed trials. Patient summary: The Advanced Prostate Cancer Consensus Conference is a forum for discussing current diagnosis and treatment options for patients with advanced prostate cancer. An expert panel votes on predefined questions focused on the most clinically relevant areas for treatment of advanced prostate cancer for which there are gaps in knowledge. The voting results provide a practical guide to help clinicians in discussing treatment options with patients as part of shared decision-making. (c) 2022 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Item Management of Patients with Advanced Prostate Cancer: Report of the Advanced Prostate Cancer Consensus Conference 2019(ELSEVIER, 2020-01-01) Gillessena, Silke; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Bossi, Alberto; Briganti, Alberto; Bristow, Rob G.; Chi, Kim N.; Clarke, Noel; Davis, Ian D.; de Bono, Johann; Drake, Charles G.; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fizazi, Karim; Frydenberg, Mark; Gleave, Martin; Halabi, Susan; Heidenreich, Axel; Heinrich, Daniel; Higano, Celestia (Tia) S.; Hofman, Michael S.; Hussain, Maha; James, Nicolas; Kanesvaran, Ravindran; Kantoff, Philip; Khauli, Raja B.; Leibowitz, Raya; Logothetis, Chris; Maluf, Fernando; Millman, Robin; Morgans, Alicia K.; Morris, Michael J.; Mottet, Nicolas; Mrabti, Hind; Murphy, Declan G.; Murthy, Vedang; Oh, William K.; Ost, Piet; OSullivan, Joe M.; Padhani, Anwar R.; Parker, Chris; Poon, Darren M. C.; Pritchard, Colin C.; Reiter, Robert E.; Roach, Mack; Rubin, Mark; Ryan, Charles J.; Saad, Fred; Sade, Juan Pablo; Sartor, Oliver; Scher I, Howard; Shore, Neal; Small, Eric; Smith, Matthew; Soule, Howard; Sternberg, Cora N.; Steuber, Thomas; Suzuki, Hiroyoshi; Sweeneyh, Christopher; Sydes, Matthew R.; Taplinh, Mary-Ellen; Tombal, Bertrand; Turkeri, Levent; van Oort, Inge; Zapatero, Almudena; Omlind, AureliusBackground: Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidelines that are based on level 1 evidence. Objective: To present the results from the APCCC 2019. Design, setting, and participants: Similar to prior conferences, experts identified 10 important areas of controversy regarding the management of advanced prostate cancer: locally advanced disease, biochemical recurrence after local therapy, treating the primary tumour in the metastatic setting, metastatic hormone-sensitive/naive prostate cancer, nonmetastatic castration-resistant prostate cancer, metastatic castration-resistant prostate cancer, bone health and bone metastases, molecular characterisation of tissue and blood, inter- and intrapatient heterogeneity, and adverse effects of hormonal therapy and their management. A panel of 72 international prostate cancer experts developed the programme and the consensus questions. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on 123 predefined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process. Results and limitations: Panellists voted based on their opinions rather than a standard literature review or formal meta-analysis. The answer options for the consensus questions had varying degrees of support by the panel, as reflected in this article and the detailed voting results reported in the Supplementary material. Conclusions: These voting results from a panel of prostate cancer experts can help clinicians and patients navigate controversial areas of advanced prostate management for which high-level evidence is sparse. However, diagnostic and treatment decisions should always be individualised based on patient-specific factors, such as disease extent and location, prior lines of therapy, comorbidities, and treatment preferences, together with current and emerging clinical evidence and logistic and economic constraints. Clinical trial enrolment for men with advanced prostate cancer should be strongly encouraged. Importantly, APCCC 2019 once again identified important questions that merit assessment in specifically designed trials. Patient summary: The Advanced Prostate Cancer Consensus Conference provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference, which has been held three times since 2015, aims to share the knowledge of world experts in prostate cancer management with health care providers worldwide. At the end of the conference, an expert panel discusses and votes on predefined consensus questions that target the most clinically relevant areas of advanced prostate cancer treatment. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients as part of shared and multidisciplinary decision making. (C) 2020 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.Item Report of the Second Asian Prostate Cancer (A-CaP) Study Meeting(ELSEVIER INC, 2017-01-01) Kim, Choung-Soo; Lee, Ji Youl; Chung, Byung Ha; Kim, Wun-Jae; Fai, Ng Chi; Hakim, Lukman; Umbas, Rainy; Ong, Teng Aik; Lim, Jasmine; Letran, Jason L.; Chiong, Edmund; Wu, Tong-lin; Lojanapiwat, Bannakij; Turkeri, Levent; Murphy, Declan G.; Gardiner, Robert A.; Moretti, Kim; Cooperberg, Matthew; Carroll, Peter; Mun, Seong Ki; Hinotsu, Shiro; Hirao, Yoshihiko; Ozono, Seiichiro; Horie, Shigeo; Onozawa, Mizuki; Kitagawa, Yasuhide; Kitamura, Tadaichi; Namiki, Mikio; Akaza, HideyukiThe Asian Prostate Cancer (A-CaP) Study is an Asia-wide initiative that has been developed over the course of 2 years. The study was launched in December 2015 in Tokyo, Japan, and the participating countries and regions engaged in preparations for the study during the course of 2016, including patient registration and creation of databases for the purpose of the study. The Second A-CaP Meeting was held on September 8, 2016 in Seoul, Korea, with the participation of members and collaborators from 12 countries and regions. Under the study, each participating country or region will begin registration of newly diagnosed prostate cancer patients and conduct prognostic investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. At the Second Meeting, participating countries and regions discussed the status of preparations and discussed various issues that are being faced. These issues include technical challenges in creating databases, promoting participation in each country or region, clarifying issues relating to data input, addressing institutional issues such as institutional review board requirements, and the need for dedicated data managers. The meeting was positioned as an opportunity to share information and address outstanding issues prior to the initiation of the study. In addition to A-CaP-specific discussions, a series of special lectures was also delivered as a means of providing international perspectives on the latest developments in prostate cancer and the use of databases and registration studies around the world. (C) 2017 Asian Pacific Prostate Society, Published by Elsevier Korea LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Item Report of the third Asian Prostate Cancer study meeting(ELSEVIER INC, 2019-01-01) Lojanapiwat, Bannakij; Lee, Ji Youl; Gang, Zhu; Kim, Choung-Soo; Fai, Ng Chi; Hakim, Lukman; Umbas, Rainy; Ong, Teng Aik; Lim, Jasmine; Letran, Jason L.; Chiong, Edmund; Lee, Seung Hwan; Turkeri, Levent; Murphy, Declan G.; Moretti, Kim; Cooperberg, Matthew; Carlile, Robert; Hinotsu, Shiro; Hirao, Yoshihiko; Kitamura, Tadaichi; Horie, Shigeo; Onozawa, Mizuki; Kitagawa, Yasuhide; Namiki, Mikio; Fukagai, Takashi; Miyazaki, Jun; Akaza, HideyukiThe Asian Prostate Cancer (A-CaP) study is an Asia-wide initiative that was launched in December 2015 in Tokyo, Japan, with the objective of surveying information about patients who have received a histopathological diagnosis of prostate cancer (PCa) and are undergoing treatment and clarifying distribution of staging, the actual status of treatment choices, and treatment outcomes. The study aims to clarify the clinical situation for PCa in Asia and use the outcomes for the purposes of international comparison. Following the first meeting in Tokyo in December 2015, the second A-CaP meeting was held in Seoul, Korea, in September 2016. This, the third A-CaP meeting, was held on October 14, 2017, in Chiang Mai, Thailand, with the participation of members and collaborators from 12 countries and regions. In the meeting, participating countries and regions presented the current status of data collection, and the A-CaP office presented a preliminary analysis of the registered cases received from each country and region. Participants discussed ongoing challenges relating to data input and collection, institutional, and legislative issues that may present barriers to data sharing, and the outlook for further patient registrations through to the end of the registration period in December 2018. In addition to A-CaP-specific discussions, a series of special lectures were also delivered on the situation for health insurance in the United States, the correlation between insurance coverage and PCa outcomes, and the outlook for robotic surgery in the Asia-Pacific region. Members also confirmed the principles of authorship in collaborative studies, with a view to publishing original articles based on A-CaP data in the future. (C) 2018 Asian Pacific Prostate Society, Published by Elsevier Korea LLC.Item Managing advanced prostate cancer in the Asia Pacific region: ``Real-world'' application of Advanced Prostate Cancer Consensus Conference 2019 statements(WILEY, 2022-01-01) Chiong, Edmund; Murphy, Declan G.; Buchan, Nicholas C.; Chua, Melvin L. K.; Hakim, Lukman; Hamid, Agus Rizal; Hong, Sung K.; Horvath, Lisa G.; Kanesvaran, Ravi; Khochikar, Makarand; Letran, Jason; Lojanapiwat, Bannakij; Malek, Rohan; Ng, Anthony C. F.; Vinh, Nguyen Tuan; Pang, See-Tong; Poon, Darren M. C.; Ong, Teng Aik; Saad, Marniza; Schubach, Kathryn; Shiroki, Ryoichi; Turkeri, Levent; Williams, Scott; Wong, Alvin; Ye, Dingwei; Davis, Ian D.; Grp, A.N.Z.U.P. Canc TrialsAim The second Asia-Pacific Advanced Prostate Cancer Consensus Conference (APAC APCCC 2020) gathered insights into the real-world application in the Asia-Pacific (APAC) region of consensus statements from the 3rd Advanced Prostate Cancer Consensus Conference (APCCC 2019). Methods The 4-h our virtual meeting in October 2020 brought together 26 experts from 14 APAC countries to discuss APCCC 2019 recommendations. Presentations were prerecorded and viewed prior to the meeting. A postmeeting survey gathered views on current practice. Results The meeting and survey highlighted several developments since APAC APCCC 2018. Increased access and use in the region of PSMA PET/CT imaging is providing additional diagnostic and staging information for advanced prostate cancer and influencing local and systemic therapy choices. Awareness of oligometastatic disease, although not clearly defined, is increasing. Novel androgen receptor pathway antagonists are expanding treatment options. Cost and access to contemporary treatments and technologies continue to be a significant factor influencing therapeutic decisions in the region. With treatment options increasing, multidisciplinary treatment planning, shared decision making, and informed choice remain critical. A discussion on the COVID-19 pandemic highlighted challenges for diagnosis, treatment, and clinical trials and new service delivery models that will continue beyond the pandemic. Conclusion APAC-specific prostate cancer research and data are important to ensure that treatment guidelines and recommendations reflect local populations and resources. Facilitated approaches to collaboration across the region such as that achieved through APAC APCCC meetings continue to be a valuable mechanism to ensure the relevance of consensus guidelines within the region.Item Management of patients with advanced prostate cancer in the Asia Pacific region: ``real-world' consideration of results from the Advanced Prostate Cancer Consensus Conference (APCCC) 2017(WILEY, 2019-01-01) Chiong, Edmund; Murphy, Declan G.; Akaza, Hideyuki; Buchan, Nicholas C.; Chung, Byung Ha; Kanesvaran, Ravindran; Khochikar, Makarand; Letran, Jason; Lojanapiwat, Bannakij; Ng, Chi-fai; Ong, Teng; Pu, Yeong-Shiau; Saad, Marniza; Schubach, Kathryn; Turkeri, Levent; Umbas, Rainy; Chuyen, Vu Le; Williams, Scott; Ye, Ding-Wei; Davis, Ian D.; Grp, A.N.Z.U.P. Canc TrialsObjectiveThe Asia Pacific Advanced Prostate Cancer Consensus Conference (APAC APCCC 2018) brought together 20 experts from 15 APAC countries to discuss the real-world application of consensus statements from the second APCCC held in St Gallen in 2017 (APCCC 2017). FindingsDifferences in genetics, environment, lifestyle, diet and culture are all likely to influence the management of advanced prostate cancer in the APAC region when compared with the rest of the world. When considering the strong APCCC 2017 recommendation for the use of upfront docetaxel in metastatic castration-naive prostate cancer, the panel noted possible increased toxicity in Asian men receiving docetaxel, which would affect this recommendation in the APAC region. Although androgen receptor-targeting agents appear to be well tolerated in Asian men with metastatic castration-resistant prostate cancer, access to these drugs is very limited for financial reasons across the region. The meeting highlighted that cost and access to contemporary treatments and technologies are key factors influencing therapeutic decision-making in the APAC region. Whilst lower cost/older treatments and technologies may be an option, issues of culture and patient or physician preference mean, these may not always be acceptable. Although generic products can reduce cost in some countries, costs may still be prohibitive for lower-income patients or communities. The panellists noted the opportunity for a coordinated approach across the APAC region to address issues of access and cost. Developments in technologies and treatments are presenting new opportunities for the diagnosis and treatment of advanced prostate cancer. Differences in genetics and epidemiology affect the side-effect profiles of some drugs and influence prescribing. ConclusionsAs the field continues to evolve, collaboration across the APAC region will be important to facilitate relevant research and collection and appraisal of data relevant to APAC populations. In the meantime, the APAC APCCC 2018 meeting highlighted the critical importance of a multidisciplinary team-based approach to treatment planning and care, delivery of best-practice care by clinicians with appropriate expertise, and the importance of patient information and support for informed patient choice.Item Predicting intra-operative and postoperative consequential events using machine-learning techniques in patients undergoing robot-assisted partial nephrectomy: a Vattikuti Collective Quality Initiative database study(WILEY, 2020-01-01) Bhandari, Mahendra; Nallabasannagari, Anubhav Reddy; Reddiboina, Madhu; Porter, James R.; Jeong, Wooju; Mottrie, Alexandre; Dasgupta, Prokar; Challacombe, Ben; Abaza, Ronney; Rha, Koon Ho; Parekh, Dipen J.; Ahlawat, Rajesh; Capitanio, Umberto; Yuvaraja, Thyavihally B.; Rawal, Sudhir; Moon, Daniel A.; Buffi, Nicolo M.; Sivaraman, Ananthakrishnan; Maes, Kris K.; Porpiglia, Francesco; Gautam, Gagan; Turkeri, Levent; Meyyazhgan, Kohul Raj; Patil, Preethi; Menon, Mani; Rogers, CraigObjective To predict intra-operative (IOEs) and postoperative events (POEs) consequential to the derailment of the ideal clinical course of patient recovery. Materials and Methods The Vattikuti Collective Quality Initiative is a multi-institutional dataset of patients who underwent robot-assisted partial nephectomy for kidney tumours. Machine-learning (ML) models were constructed to predict IOEs and POEs using logistic regression, random forest and neural networks. The models to predict IOEs used patient demographics and preoperative data. In addition to these, intra-operative data were used to predict POEs. Performance on the test dataset was assessed using area under the receiver-operating characteristic curve (AUC-ROC) and area under the precision-recall curve (PR-AUC). Results The rates of IOEs and POEs were 5.62\% and 20.98\%, respectively. Models for predicting IOEs were constructed using data from 1690 patients and 38 variablesItem Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2022-01-01) Sharma, Gopal; Shah, Milap; Ahluwalia, Puneet; Dasgupta, Prokar; Challacombe, Benjamin J.; Bhandari, Mahendra; Ahlawat, Rajesh; Rawal, Sudhir; Buffi, Nicolo M.; Sivaraman, Ananthakrishnan; Porter, James R.; Rogers, Craig; Mottrie, Alexandre; Abaza, Ronney; Rha, Khoon Ho; Moon, Daniel; Thyavihally, Yuvaraja B.; Parekh, Dipen J.; Capitanio, Umberto; Maes, Kris K.; Porpiglia, Francesco; Turkeri, Levent; Gautam, GaganIntroduction: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. We aimed to study the perioperative outcomes of RAPN for patients with complex renal masses using the Vattikuti Collective Quality Initiative (VCQI) database that allowed evaluation of multinational data. Methods: From the VCQI, we extracted data for all the patients who underwent RAPN with preoperative aspects and dimensions used for an anatomical (PADUA) score of >= 10. Multivariate logistic regression was conducted to ascertain predictors of trifecta (absence of complications, negative surgical margins, and warm ischemia times {[}WIT] <25 min or zero ischemia) outcomes. Results: Of 3,801 patients, 514 with PADUA scores >= 10 were included. The median operative time, WIT, and blood loss were 173 (range 45-546) min, 21 (range 0-55) min, and 150 (range 50-3500) ml, respectively. Intraoperative complications and blood transfusions were reported in 2.1\% and 6\%, respectively. In 8.8\% of the patients, postoperative complications were noted, and surgical margins were positive in 10.3\% of the patients. Trifecta could be achieved in 60.7\% of patients. Clinical tumor size, duration of surgery, WIT, and complication rates were significantly higher in the group with a high (12 or 13) PADUA score while the trifecta was significantly lower in this group (48.4\%). On multivariate analysis, surgical approach (retroperitoneal vs. transperitoneal) and high PADUA score (12/13) were identified as predictors of the trifecta outcomes. Conclusion: RAPN may be a reasonable surgical option for patients with complex renal masses with acceptable perioperative outcomes.