PURPOSE: To assess the spectrum of computed tomography (CT) findings in patients with genitourinary cancers visiting the emergency room (ER) and evaluate the relationship between CT findings and overall survival (OS). METHODS: Retrospective analysis of consecutive patients with genitourinary cancers undergoing CT during an ER visit at a tertiary cancer center during a 20-month period. CTs were considered positive if there were findings relevant to the presenting complaint(s). Demographic/clinical variables were recorded. OS was evaluated using Kaplan-Meier curves. Univariate and multivariate Cox proportional hazards regression (HR) was used to evaluate OS predictors. RESULTS: Two hundred twenty-seven patients (243 visits) were included. The most common primary tumors were prostate (121 [49.8%]), bladder/urothelial (78 [32.1%]), and renal (69 [28.4%]). Common presenting complaints were abdominal pain (67 [27.6%]), respiratory symptoms (49 [20.2%]), neurological signs (37 [15.2%]), and fever (34 [14.0%]). CT findings were positive in 172 patients (70.8%) and included new/increased metastases (21.4% [52/243]), fluid collections (7.4% [18/243]), urinary tract infection/inflammation (6.2% [15/243]), enteritis/colitis (5.3% [13/243]), and pneumonia (4.9% [12/243]). A positive ER CT was associated with patient admission (p = 0.01). At multivariate analysis, independently predictive factors of shorter survival were positive ER CT (HR = 2.09 [95% CI 1.16-3.76, p = 0.01), hospital admission (HR = 2.17 [95% CI 1.38-3.41], p < 0.01), and recent systemic treatment (HR = 2.10 [95% CI 1.32-3.35], p < 0.01). CONCLUSION: When CT was performed, it was able to identify a structural cause for the presenting complaint in the majority of patients with genitourinary cancers attending the ER. A positive ER CT was associated with hospital admission and poorer overall survival.
PURPOSE: To assess the spectrum of computed tomography (CT) findings in patients with genitourinary cancers visiting the emergency room (ER) and evaluate the relationship between CT findings and overall survival (OS). METHODS: Retrospective analysis of consecutive patients with genitourinary cancers undergoing CT during an ER visit at a tertiary cancer center during a 20-month period. CTs were considered positive if there were findings relevant to the presenting complaint(s). Demographic/clinical variables were recorded. OS was evaluated using Kaplan-Meier curves. Univariate and multivariate Cox proportional hazards regression (HR) was used to evaluate OS predictors. RESULTS: Two hundred twenty-seven patients (243 visits) were included. The most common primary tumors were prostate (121 [49.8%]), bladder/urothelial (78 [32.1%]), and renal (69 [28.4%]). Common presenting complaints were abdominal pain (67 [27.6%]), respiratory symptoms (49 [20.2%]), neurological signs (37 [15.2%]), and fever (34 [14.0%]). CT findings were positive in 172 patients (70.8%) and included new/increased metastases (21.4% [52/243]), fluid collections (7.4% [18/243]), urinary tract infection/inflammation (6.2% [15/243]), enteritis/colitis (5.3% [13/243]), and pneumonia (4.9% [12/243]). A positive ER CT was associated with patient admission (p = 0.01). At multivariate analysis, independently predictive factors of shorter survival were positive ER CT (HR = 2.09 [95% CI 1.16-3.76, p = 0.01), hospital admission (HR = 2.17 [95% CI 1.38-3.41], p < 0.01), and recent systemic treatment (HR = 2.10 [95% CI 1.32-3.35], p < 0.01). CONCLUSION: When CT was performed, it was able to identify a structural cause for the presenting complaint in the majority of patients with genitourinary cancers attending the ER. A positive ER CT was associated with hospital admission and poorer overall survival.
Authors: Daniar K Osmonov; Amr A Faddan; Alexey V Aksenov; Carsten M Naumann; Leonid M Rapoport; Evgeny A Bezrukov; Dmitry G Tsarichenko; Klaus P Jünemann Journal: Turk J Urol Date: 2018-07
Authors: Lucy Modahl; Subba R Digumarthy; James T Rhea; Alasdair K Conn; Sanjay Saini; Susanna I Lee Journal: J Am Coll Radiol Date: 2006-11 Impact factor: 5.532
Authors: Gwenaelle Gravis; Jean-Marie Boher; Yu-Hui Chen; Glenn Liu; Karim Fizazi; Michael A Carducci; Stephane Oudard; Florence Joly; David M Jarrard; Michel Soulie; Mario J Eisenberger; Muriel Habibian; Robert Dreicer; Jorge A Garcia; Maha H M Hussain; Manish Kohli; Nicholas J Vogelzang; Joel Picus; Robert DiPaola; Christopher Sweeney Journal: Eur Urol Date: 2018-02-21 Impact factor: 20.096
Authors: Elizabeth K Weidman; Andrew J Plodkowski; Darragh F Halpenny; Sara A Hayes; Rocio Perez-Johnston; Junting Zheng; Chaya Moskowitz; Michelle S Ginsberg Journal: Radiology Date: 2018-09-11 Impact factor: 11.105
Authors: Marko Babjuk; Maximilian Burger; Eva M Compérat; Paolo Gontero; A Hugh Mostafid; Joan Palou; Bas W G van Rhijn; Morgan Rouprêt; Shahrokh F Shariat; Richard Sylvester; Richard Zigeuner; Otakar Capoun; Daniel Cohen; José Luis Dominguez Escrig; Virginia Hernández; Benoit Peyronnet; Thomas Seisen; Viktor Soukup Journal: Eur Urol Date: 2019-08-20 Impact factor: 20.096
Authors: Jae Young Joung; Jiwon Lim; Chang-Mo Oh; Kyu-Won Jung; Hyunsoon Cho; Sung Han Kim; Ho Kyung Seo; Weon Seo Park; Jinsoo Chung; Kang Hyun Lee; Young-Joo Won Journal: Cancer Res Treat Date: 2016-09-23 Impact factor: 4.679
Authors: Sungmin Woo; Abdallah Araji; Mohammad Ali El Amine; Natalie Gangai; Elizabeth Acquafredda; Anita P Price; Tanya M Trippett; Hedvig Hricak; Hebert Alberto Vargas; Gerald G Behr Journal: Cancer Imaging Date: 2021-08-28 Impact factor: 3.909