Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications (“Sleep C.A.L.M.”) in the evaluation and management of nocturia: A simple approach to a complex diagnosis

Thomas Monaghan (1) , Jeffrey Weiss (2) , Alan Wein (3) , Syed Rahman (4) , Jason Lazar (5) , Donald Bliwise (6) , Karel Everaert (7) , Gary Lemack (8) , Jean‐nicolas Cornu (9, 10, 11) , Marcus Drake (12) , Christopher Chapple (13) , Hashim Hashim (14) , Jerry Blaivas (15) , Roger Dmochowski (16)

1 Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
2 Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.
3 Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
4 Department of Urology, Yale University School of Medicine, New Haven, Connecticut, USA.
5 Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.
6 Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
7 Department of Human Structure and Repair, Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium.
8 Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
9 ADEN - Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau
10 IRIB - Institute for Research and Innovation in Biomedicine
11 Service d'urologie [Rouen]
12 Imperial College London
13 Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
14 Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
15 MSSM - Icahn School of Medicine at Mount Sinai [New York]
16 Department of Urological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Data on efficacy and safety of sorafenib in a neoadjuvant setting for HCC awaiting liver transplantation (LT) are heterogeneous and scarce. We aimed to investigate the trajectory of patients treated with sorafenib while awaiting LT. All patients listed for HCC and treated with sorafenib were included in a monocentric observational study. A clinical and biological evaluation was performed every month. Radiological tumor response evaluation was realized every 3 months on the waiting list and every 6 months after LT. Among 327 patients listed for HCC, 62 (19%) were treated with Sorafenib. Sorafenib was initiated for HCC progression after loco-regional therapy (LRT) in 50% of cases and for impossibility of LRT in 50% of cases. The mean duration of treatment was 6 months. Thirty six patients (58%) dropped-out for tumor progression and 26 (42%) patients were transplanted. The 5-year overall and recurrent-free survival after LT was 77% and 48% respectively. Patients treated for impossibility of LRT had acceptable 5-year intention-to-treat overall and post-LT survivals. Conversely, patients treated for HCC progression presented high dropout rate and low intention-to-treat survival. Our results suggest that it is very questionable in terms of utility that patients treated for HCC progression should even be kept listed once the tumor progression has been observed.

Domaines: Sciences de l'Homme et Société

Thomas Monaghan, Jeffrey Weiss, Alan Wein, Syed Rahman, Jason Lazar, et al.. Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications (“Sleep C.A.L.M.”) in the evaluation and management of nocturia: A simple approach to a complex diagnosis. Neurourology and Urodynamics, 2022, 35, ⟨10.1002/nau.25128⟩. ⟨hal-03993733⟩