External validation of Pentafecta in patients undergoing laparoscopic radical cystectomy: results from a high-volume center

Li, Kai; Yang, Xiao; Zhuang, Juntao; Cai, Lingkai; Han, Jie; Yu, Hao; Zhou, Zijian; Lv, Jianchen; Feng, Dexiang; Yuan, Baorui; Wu, Qikai; Li, Pengchao; Cao, Qiang; Lü, Qiang

doi:10.1186/s12894-022-00987-9

Cited by 3 publications

(9 citation statements)

References 37 publications

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“…Fourth, it is arguable that PC for RC should be assessable peri-operatively. Diversion-related complications have been extensively discussed as a pentafecta metric to reflect long-term functional outcomes [12][13][14][15][16][17][18]. Similarly to recurrence at 12 months, such metrics are unfortunately not suitable for perioperative patient stratification and counselling.…”

Section: Discussionmentioning

confidence: 99%

“…The first endpoint of our study was PC attainment, which was defined as fulfilment of all five PC [8,[12][13][14][15][16][17][18]. The second endpoint was OM, which was defined as time from RC to death from any cause.…”

Section: Study Endpoints and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A few studies have validated PC in patients undergoing robot-assisted, conventional laparoscopic and open RC (ORC) [12][13][14][15][16][17][18]. These studies have in common that oncological follow-up did not exceed 3 years and PC attainment was merely dichotomized into all PC (5/5) attained vs all PC not attained (≤4/5) [12][13][14][15][16][17][18]. Thus, it is still not known whether the number of attained PC has an impact on oncological endpoints, given that previous studies did not investigate the discriminative ability of PC attainment [12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…These studies have in common that oncological follow-up did not exceed 3 years and PC attainment was merely dichotomized into all PC (5/5) attained vs all PC not attained (≤4/5) [12][13][14][15][16][17][18]. Thus, it is still not known whether the number of attained PC has an impact on oncological endpoints, given that previous studies did not investigate the discriminative ability of PC attainment [12][13][14][15][16][17][18]. Against this backdrop, we aimed to validate the predictive ability of PC, as defined by the PROMETRICS group, in patients with BCa undergoing ORC with a long-term oncological follow-up [8].…”

Section: Introductionmentioning

confidence: 99%

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Oncological validation and discriminative ability of pentafecta criteria after open radical cystectomy

et al. 2022

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To validate the pentafecta criteria (PC) proposed by the PROMETRICS group for outcome reporting after radical cystectomy in an open radical cystectomy (ORC) cohort with long-term follow-up and to assess the discriminative ability of PC attainment for oncological endpoints. Patients and MethodsBetween January 2009 and December 2017, 420 patients underwent ORC with pelvic lymph node dissection and urinary diversion for non-metastatic bladder cancer. The PC were defined as reported by the PROMETRICS group. The primary endpoint was PC attainment, and oncological outcomes comprised further endpoints. We used uni-and multivariable logistic regression analysis to assess predictors of PC attainment. The discriminative ability of PC for overall mortality (OM), cancer-specific mortality (CSM) and other-cause mortality (OCM) was compared using Kaplan-Meier curves and cumulative incidence functions. After stratification by the number of PC attained, the association between PC attainment and the survival endpoints was tested on multivariable Cox regression and competing-risks models. ResultsA total of 108 patients (26%) fulfilled all PC, while 195 (46%), 77 (18%), 35 (8.3%) and five (1.2%) attained 4/5, 3/5, 2/5 and ≤1/5 PC, respectively. Increasing age-adjusted Charlson comorbidity index (odds ratio [OR] 0.80, P = 0.015) and incontinent diversion (OR 0.38, P = 0.005) were independent predictors of PC non-attainment. The median follow-up was 73 months. PC attainment (≥4/5 vs 3/5 vs ≤2/5 PC attained) was used to stratify patients into groups at significantly different risk of death (P < 0.001). A decreasing number of PC attained (<4/5) was associated with unfavourable survival estimates for both OM and CSM (all P ≤ 0.005) but not for OCM (all P ≥ 0.2). ConclusionsThe PC proposed by the PROMETRICS group represent accurate quality indicators for oncological outcome reporting after ORC for non-metastatic bladder cancer and have a distinct discriminative ability to predict long-term OM and CSM.

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Section: Discussionmentioning

confidence: 99%

Section: Study Endpoints and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oncological validation and discriminative ability of pentafecta criteria after open radical cystectomy

et al. 2022

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Perioperative outcomes and continence following robotic-assisted radical cystectomy with mainz pouch II urinary diversion in patients with bladder cancer

Jing,

Yang,

Luo

et al. 2024

BMC Cancer

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Purpose To present the widely unknown perioperative outcomes and continence status of bladder cancer patients following robotic-assisted radical cystectomy (RARC) with Mainz pouch II urinary diversion (UD). Materials and methods From November 2020 to December 2023, 37 bladder cancer patients who underwent RARC with Mainz pouch II UD were retrospectively assessed (ChiCTR2300070279). The results, which included patient demographics, perioperative data, continence, and complications (early ≤ 30 days and late ≤ 30 days) were reported using the RC-pentafecta criteria. RC-pentafecta criteria included ≥ 16 lymph nodes removed, negative soft tissue surgical margins, absence of major (Grade III–IV) complication at 90 days, absence of clinical recurrence at ≤ 12 months, and absence of long-term UD-related sequelae. A numeric rating scale assessed patient satisfaction with urinary continence 30 days after surgery. The validated Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire was used to evaluate bowel function. The Kaplan-Meier curve was used to evaluate overall survival (OS). Results Of the 37 patients evaluated over a median (range) follow-up period of 23.0 (12.0-36.5) months. The median (range) age was 65 (40–81) years. The median (range) time to urinary continence after surgery was 2.3 (1.5-6) months. Of the 37 patients, 31 (83.8%) were continent both during the day and at night, 34 (91.9%) were continent during the day, 32 (86.5%) were continent at night, 35 (94.6%) were satisfied with their urinary continence status, and 21 (56.8%) were very satisfied. The mean (range) voiding frequency was 6 (4–10) during the day and 3 (2-5.5) at night. The mean (range) PAC-SYM total score was 9.50 (4.00–15.00). In 12 (32.4%) of the patients, RC-pentafecta was achieved, and achieving RC-pentafecta was linked to better satisfaction scores (7.3 vs. 5.5, p = 0.034). There was no significant difference between RC-pentafecta and No RC-pentafecta groups in terms of OS (25.6 vs. 21.5 months, p = 0.16). 7 (19.4%) patients experienced late complications. Conclusions Mainz pouch II UD following RARC in bladder cancer patients results in a satisfactory continence rate. Achieving RC-pentafecta was correlated with better satisfaction scores. The intracorporeal approach to Mainz pouch II UD is beneficial for female patients due to its reduced invasiveness. Trial registration ChiCTR2300070279; Registration: 07/04/2023, Last updated version: 01/06/2023. Retrospectively registered.

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The current role of pentafecta in the reporting of radical cystectomy outcomes: a scoping review

Mahmoud,

Al-Nader,

Püllen

et al. 2024

Transl Androl Urol

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External validation of Pentafecta in patients undergoing laparoscopic radical cystectomy: results from a high-volume center

Cited by 3 publications

References 37 publications

Oncological validation and discriminative ability of pentafecta criteria after open radical cystectomy

Oncological validation and discriminative ability of pentafecta criteria after open radical cystectomy

Perioperative outcomes and continence following robotic-assisted radical cystectomy with mainz pouch II urinary diversion in patients with bladder cancer

The current role of pentafecta in the reporting of radical cystectomy outcomes: a scoping review

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