Open Access

EDITORIAL

Neil Fleshner
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 1-2, 2006
Abstract This article has no abstract. More >

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ARTICLE

Neil Fleshner¹, George Dranitsaris², Antonio Finelli¹, John Tsihlias¹, David Bell³, Martin Gleave⁴
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 3-13, 2006
Abstract Background: The wait times for urological cancer surgeries in Canada have increased over the past 2 decades. This is of concern to patients, physicians and other key stakeholders because there is evidence that delaying surgery beyond a recommended threshold could have a negative impact on clinical outcomes. To address these trends, a Canadian surgical wait times (SWAT) initiative has been undertaken to develop a consensus document and make recommendations on appropriate wait times. As a first step, the SWAT steering committee determined that current wait times estimates were required for the four key disease sites: prostate,… More >

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ARTICLE

Alan R. Hudson
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 14-15, 2006
Abstract IIncrease focus has been given to surgical wait times for oncology. The Ontario government has initiated a system to track and measure wait times for cancers including urological tumors. This strategy was initiated 1.5 years ago and has accomplished a great deal in its infancy. Along with an information technology strategy, targeted funding has successfully increased the numbers of cases done in the province. In time, outcome data will be required. Approaches such as these have occurred throughout Canada and are encouraged in order to improve access to the public health care system. More >

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ARTICLE

Fred Saad¹, Antonio Finelli², George Dranitsaris³, Larry Goldenberg⁴, Scott Bagnell⁵, Martin Gleave⁴, Neil Fleshner²
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 16-24, 2006
Abstract Background: The wait times for prostate cancer surgery in Canada have increased over the past 2 decades. Prolonged wait times have a negative impact on patient quality of life but the effect on long-term cancer control is undefined. We conducted a systematic literature review to examine the best available evidence addressing the following key questions:
• What is the reported time interval for prostate cancer patients from the decision to operate until the day of cancer surgery?
• Are there recommendations/guidelines in the urological cancer literature and, if so, how do the Canadian times compare?
• Is… More >

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Robert J. Hamilton, Antonio Finelli
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 25-29, 2006
Abstract Wait times for radical prostatectomy are increasing in Canada. However, the impact of adopting a new surgical technique, such as laparoscopic radical prostatectomy (LRP), is not known. We outline the determinants of surgical wait time, the potential impact of adopting LRP and ways to minimize the impact. Surgical wait time is determined by surgical demand (number of people wanting surgery) relative to supply (number of surgeries a centre is able to offer). The introduction of any new technique will at first prolong operative times, but the degree to which it does is dependent on the… More >

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David Bell¹, Christopher Morash², George Dranitsaris³, Jonathan Izawa⁴, Thomas Short⁵, Laurence H. Klotz⁶, Neil Fleshner⁷
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 30-36, 2006
Abstract Background: The wait times for urological cancer surgeries in Canada are beyond those recommended by the Canadian Association of Surgical Oncology. Prolonged wait times have a negative impact on patient quality of life but the effect on long-term cancer control is controversial. We conducted a systematic review of the testicular cancer literature to examine the best available evidence addressing the following key questions:
• What is the reported time interval for testicular cancer patients from the decision to operate until the day of testicular cancer surgery?
• Are there recommendations/guidelines in the urological cancer literature and, if… More >

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Yves Fradet¹, Armen Aprikian², George Dranitsaris³, Robert Siemens⁴, John Tsihlias⁵, Neil Fleshner⁵
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 37-47, 2006
Abstract Background: Prolonged surgical wait times have significant effects on a patient's psychological well-being and a negative impact on quality of life but the effect on long-term cancer control is controversial. We conducted a systematic review of the bladder cancer literature to examine the best available evidence addressing the following key questions:
• What is the reported time interval for bladder cancer patients from the decision to operate until the day of bladder cancer surgery?
• Are there recommendations/guidelines in the urological cancer literature and, if so, how do the Canadian times compare?
• Is there a known… More >

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Jonathan I. Izawa^1,2,3, Joseph L. Chin^1,2,3, Eric Winquist^2,4
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 48-53, 2006
Abstract Introduction: The ability of cystectomy to cure patients with muscle-invasive transitional cell carcinoma of the bladder (TCC) is diminished by the presence of occult micrometastases. Chemotherapy contributes to cure to the extent that it may eradicate these micrometastases. In the absence of methods to preoperatively stage TCC precisely or assess tumor biology, we review the current literature regarding the timing of cystectomy and use of perioperative chemotherapy. Based on this data, we suggest optimal and feasible strategies for treating TCC in a resource-constrained environment.
Materials and methods: Systematic reviews of TCC were sought using electronic databases to… More >

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Michael Jewett¹, Ricardo Rendon², George Dranitsaris³, Darrel Drachenberg⁴, Simon Tanguay⁵, Bryan Donnelly⁶, Neil Fleshner¹
Canadian Journal of Urology, Vol.13, Suppl.3, pp. 54-61, 2006
Abstract Background: Prolonged surgical wait times have significant effects on a patient's psychological well-being and a negative impact on quality of life but the effect on long-term cancer control is controversial. We conducted a systematic review of the renal cancer literature to examine the best available evidence addressing the following key questions:
• What is the reported time interval for renal cancer patients from the initial surgical consultation until the day of renal cancer surgery?
• Are there recommendations/guidelines in the urological cancer literature and, if so, how do the Canadian times compare?
• Is there a known… More >

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Canadian Journal of Urology, Vol.13, Suppl.3, pp. 62-64, 2006
Abstract Wait times for medical procedures in Canada continue to be a major issue in the delivery of timely health care. Patients scheduled to undergo surgery for urological malignancies, which include prostate, bladder, kidney and testes cancer, are among the many affected populations. To address these important issues, a Surgical Wait Time (SWAT) initiative was undertaken. The SWAT initiative, whose members consist of urological oncologists, surgeons and methodologists was mandated to assess current wait times in Canada, review the relevant literature on the surgical wait times for urological cancers and then develop a consensus document that More >

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