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Laguna MP. Re: Effectiveness of Adjuvant Chemotherapy after Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node Upper Tract Urothelial Carcinoma. J Urol 2017; 198:739-740. [PMID: 28905781 DOI: 10.1016/j.juro.2017.06.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
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Laguna MP. Re: Management of Small Renal Masses: American Society of Clinical Oncology Clinical Practice Guideline. J Urol 2017; 198:480-482. [DOI: 10.1016/j.juro.2017.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/24/2022]
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Laguna MP. Re: Irreversible Electroporation of Small Renal Masses: Suboptimal Oncologic Efficacy in an Early Series. J Urol 2017; 198:481-482. [PMID: 28817909 DOI: 10.1016/j.juro.2017.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Laguna MP. Re: Body Mass Index and Metastatic Renal Cell Carcinoma: Clinical and Biological Correlations. J Urol 2017; 198:36-37. [PMID: 28618706 DOI: 10.1016/j.juro.2017.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 11/29/2022]
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Laguna MP. Re: Robot-Assisted vs Open Adrenalectomy: Evaluation of Cost-Effectiveness and Peri-Operative Outcome. J Urol 2017; 197:1438. [PMID: 28505893 DOI: 10.1016/j.juro.2017.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Laguna MP. Re: Oncologic Outcomes of Kidney-Sparing Surgery versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review by the EAU Non-Muscle Invasive Bladder Cancer Guidelines Panel. J Urol 2017; 197:1437-1438. [PMID: 28505892 DOI: 10.1016/j.juro.2017.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Laguna MP. Re: First-Line Sunitinib versus Pazopanib in Metastatic Renal Cell Carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium. J Urol 2017; 197:603. [DOI: 10.1016/j.juro.2016.12.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Buijs M, van Lienden KP, Wagstaff PG, Scheltema MJ, de Bruin DM, Zondervan PJ, van Delden OM, van Leeuwen TG, de la Rosette JJ, Laguna MP. Irreversible Electroporation for the Ablation of Renal Cell Carcinoma: A Prospective, Human, In Vivo Study Protocol (IDEAL Phase 2b). JMIR Res Protoc 2017; 6:e21. [PMID: 28209559 PMCID: PMC5334515 DOI: 10.2196/resprot.6725] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/27/2016] [Accepted: 01/03/2017] [Indexed: 12/18/2022] Open
Abstract
Background Irreversible electroporation (IRE) is an emerging technique delivering electrical pulses to ablate tissue, with the theoretical advantage to overcome the main shortcomings of conventional thermal ablation. Recent short-term research showed that IRE for the ablation of renal masses is a safe and feasible treatment option. In an ablate and resect design, histopathological analysis 4 weeks after radical nephrectomy demonstrated that IRE-targeted renal tumors were completely covered by ablation zone. In order to develop a validated long-term IRE follow-up study, it is essential to obtain clinical confirmation of the efficacy of this novel technology. Additionally, follow-up after IRE ablation obliges verification of a suitable imaging modality. Objective The objectives of this study are the clinical efficacy and safety of IRE ablation of renal masses and to evaluate the use of cross-sectional imaging modalities in the follow-up after IRE in renal tumors. This study conforms to the recommendations of the IDEAL Collaboration and can be categorized as a phase 2B exploration trial. Methods In this prospective clinical trial, IRE will be performed in 20 patients aged 18 years and older presenting with a solid enhancing small renal mass (SRM) (≤4 cm) who are candidates for ablation. Magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) will be performed at 1 day pre-IRE, and 1 week post-IRE. Computed tomography (CT), CEUS, and MRI will be performed at 3 months, 6 months, and 12 months post-IRE. Results Presently, recruitment of patients has started and the first inclusions are completed. Preliminary results and outcomes are expected in 2018. Conclusions To establish the position of IRE ablation for treating renal tumors, a structured stepwise assessment in clinical practice is required. This study will offer fundamental knowledge on the clinical efficacy of IRE ablation for SRMs, potentially positioning IRE as ablative modality for renal tumors and accrediting future research with long-term follow-up. Trial Registration Clinicaltrials.gov registration number NCT02828709; https://clinicaltrials.gov/ct2/show/NCT02828709 (archived by WebCite at http://www.webcitation.org/6nmWK7Uu9). Dutch Central Committee on Research Involving Human Subjects NL56935.018.16
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Laguna MP. Re: Clinically Localized Type 1 and 2 Papillary Renal Cell Carcinomas Have Similar Survival Outcomes following Surgery. J Urol 2016; 197:50-51. [PMID: 27979566 DOI: 10.1016/j.juro.2016.09.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 11/16/2022]
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Laguna MP. Re: Change in Neutrophil-to-Lymphocyte Ratio in Response to Targeted Therapy for Metastatic Renal Cell Carcinoma as a Prognosticator and Biomarker of Efficacy. J Urol 2016; 196:1634-1635. [DOI: 10.1016/j.juro.2016.09.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 10/21/2022]
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Laguna MP. Re: Nephron-Sparing Surgery across a Nation-Outcomes from the British Association of Urological Surgeons 2012 National Partial Nephrectomy Audit. J Urol 2016; 196:1635. [PMID: 27845100 DOI: 10.1016/j.juro.2016.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Laguna MP. Re: Natural History of Renal Angiomyolipoma (AML): Most Patients with Large AMLs >4cm can be Offered Active Surveillance as an Initial Management Strategy. J Urol 2016; 196:1397-1398. [DOI: 10.1016/j.juro.2016.08.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
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Jaunarena JH, Cristallo C, González MS, Daels FP, De la Rosette J, Laguna MP. [Management of malignant ureteral obstruction.]. ARCH ESP UROL 2016; 69:507-517. [PMID: 27725327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the different therapeutic alternatives in malignant ureteral obstruction (MUO), and to analyze short and long-term results. METHODS We conducted a bibliographic search about MUO in Spanish and English languages in PubMed and Google Scholar. We examined the most relevant reviews, original manuscripts and their respective citations. Last search was on April 2016. RESULTS Polymeric double J stent is the cheapest and most accessible internal urinary diversion, but has also the shortest duration. Early and late failure rates were 0-35% and 14-49% respectively. Mean time to late failure was 3-12 months. Percutaneous nephrostomy is the safest alternative in terms of failure rates, though it has frequent complications such as tube dislodgement, and may have a negative effect on quality of life. The only metallic double J stent with enough bibliographic background is the Resonance® stent. Early failure was 0-15% and late failure 4-41%, with a mean time to late failure of 2.6-13 months. Regarding metallic stents, Memokath 051® has obtained the best results, with 0-5% early failure rates, 19-49% late failures and mean time to late failure of 7-11 months. In patients with polymeric double J stent failure, patients benefited from tandem double J stents, metallic double J catheters or metallic stents, avoiding the need of a percutaneous nephrostomy. The evidence level was low in all cases. CONCLUSIONS Results in MUO are very heterogeneous and have a low evidence level. Factors that influence results include stent characteristics, status and prognosis of the obstructive condition and probably patient and physician's preferences. Polymeric double J stents seem to have higher early and late failure rates than metallic double J catheters and metallic stents. Even though, the difference is not clearly evident. Prospective, multicenter, multidisciplinary trials are necessary to elucidate convenience and adequate selection of each type of stent.
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Scheltema MJ, Tay KJ, Postema AW, de Bruin DM, Feller J, Futterer JJ, George AK, Gupta RT, Kahmann F, Kastner C, Laguna MP, Natarajan S, Rais-Bahrami S, Rastinehad AR, de Reijke TM, Salomon G, Stone N, van Velthoven R, Villani R, Villers A, Walz J, Polascik TJ, de la Rosette JJMCH. Utilization of multiparametric prostate magnetic resonance imaging in clinical practice and focal therapy: report from a Delphi consensus project. World J Urol 2016; 35:695-701. [PMID: 27637908 PMCID: PMC5397427 DOI: 10.1007/s00345-016-1932-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/06/2016] [Indexed: 12/25/2022] Open
Abstract
Purpose To codify the use of multiparametric magnetic resonance imaging (mpMRI) for the interrogation of prostate neoplasia (PCa) in clinical practice and focal therapy (FT). Methods An international collaborative consensus project was undertaken using the Delphi method among experts in the field of PCa. An online questionnaire was presented in three consecutive rounds and modified each round based on the comments provided by the experts. Subsequently, a face-to-face meeting was held to discuss and finalize the consensus results. Results mpMRI should be performed in patients with prior negative biopsies if clinical suspicion remains, but not instead of the PSA test, nor as a stand-alone diagnostic tool or mpMRI-targeted biopsies only. It is not recommended to use a 1.5 Tesla MRI scanner without an endorectal or pelvic phased-array coil. mpMRI should be performed following standard biopsy-based PCa diagnosis in both the planning and follow-up of FT. If a lesion is seen, MRI-TRUS fusion biopsies should be performed for FT planning. Systematic biopsies are still required for FT planning in biopsy-naïve patients and for patients with residual PCa after FT. Standard repeat biopsies should be taken during the follow-up of FT. The final decision to perform FT should be based on histopathology. However, these consensus statements may differ for expert centers versus non-expert centers. Conclusions The mpMRI is an important tool for characterizing and targeting PCa in clinical practice and FT. Standardization of acquisition and reading should be the main priority to guarantee consistent mpMRI quality throughout the urological community. Electronic supplementary material The online version of this article (doi:10.1007/s00345-016-1932-1) contains supplementary material, which is available to authorized users.
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Laguna MP. Re: Cystic Renal Cell Carcinoma Carries an Excellent Prognosis Regardless of Tumor Size. J Urol 2016; 196:1042-3. [PMID: 27628787 DOI: 10.1016/j.juro.2016.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2016] [Indexed: 11/26/2022]
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Laguna MP. Re: Prediction of Complications following Partial Nephrectomy: Implications for Ablative Techniques Candidates. J Urol 2016; 196:685-7. [PMID: 27597058 DOI: 10.1016/j.juro.2016.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/29/2022]
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Laguna MP. Re: The Subclassification of Papillary Renal Cell Carcinoma Does Not Affect Oncological Outcomes after Nephron Sparing Surgery. J Urol 2016; 196:686-7. [PMID: 27597059 DOI: 10.1016/j.juro.2016.06.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zondervan PJ, Buijs M, de la Rosette JJ, van Delden O, van Lienden K, Laguna MP. Cryoablation of small kidney tumors. Int J Surg 2016; 36:533-540. [PMID: 27500963 DOI: 10.1016/j.ijsu.2016.06.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 06/04/2016] [Accepted: 06/19/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Cryoablation (CA) has been broadly used mostly in the treatment of small renal masses (SRMs). The present review aims to define the current role of CA in the treatment of SRMs by assessing clinical indications and outcomes. METHOD A comprehensive review on patient selection, procedural details, perioperative complications, and short/long-term oncological and functional outcomes was conducted. For each section, a take-home message was formulated with level of evidence (LoE) according to Cochrane collaboration. RESULTS Age and comorbidity drive the choice of ablation in SRMs, although hospital setting also influences the decision. Technically in adequate CA or first post-CA control occurs in 3-5% of laparoscopic cryoablation (LCA) or percutaneous cryoablation (PCA) series. Meta-analysis does not evidence differences in the rate of residual tumor per person-year between the approaches (0.033 LCA vs. 0.046 PCA, p = 0.25). Perioperative complications (8-25%) are erratically reported. LCA has significantly lower likelihood of complications than minimally invasive partial nephrectomy (MIPN). Systematic reviews indicate 30-month local tumor progression rate of 8.5% for LCA in renal cell carcinoma but low metastatic progression (1-4.4%). Few LCA long-term follow-up series (mean/media 48-98 months) report recurrence-free survival (RFS) and cancer-specific survival (CSS) ranges of 80-100%. For PCA, Kaplan-Meier local disease-free survival (DFS) of 95.6% at 3-5 years [32] and 5-year overall survival and local RFS of 86.3% were reported. The decrease in renal function after CA is minimal, and the only risk factor associated is the basal estimated glomerular filtration rate (eGFR). CONCLUSION LoE 3a/b confirms lower CA perioperative complication rate and higher local progression rate than those for MIPN. CA preserves postoperative renal functional, without any evidence of differences in mid-/long-term follow-up compared to nephron sparing surgery.
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Laguna MP. Re: Prediction of Pulmonary Metastasis in Renal Cell Carcinoma Patients with Indeterminate Pulmonary Nodules. J Urol 2016; 196:350. [PMID: 27479373 DOI: 10.1016/j.juro.2016.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Laguna MP. Re: Guideline of Guidelines: Follow-up after Nephrectomy for Renal Cell Carcinoma. J Urol 2016; 196:349-50. [PMID: 27479371 DOI: 10.1016/j.juro.2016.05.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
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Laguna MP. Re: Comprehensive Characterization of the Perioperative Morbidity of Cytoreductive Nephrectomy. J Urol 2016; 196:57-9. [PMID: 27321494 DOI: 10.1016/j.juro.2016.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Indexed: 10/21/2022]
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Laguna MP. Re: Genomic Characterization of Upper Tract Urothelial Carcinoma. J Urol 2016; 195:1719. [PMID: 27191062 DOI: 10.1016/j.juro.2016.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Laguna MP. Re: Partial vs Radical Nephrectomy for T1 Renal Tumours: An Analysis from the British Association of Urological Surgeons Nephrectomy Audit. J Urol 2016; 195:1377-1379. [PMID: 27186720 DOI: 10.1016/j.juro.2016.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
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Scheltema MJV, van den Bos W, de Bruin DM, Wijkstra H, Laguna MP, de Reijke TM, de la Rosette JJMCH. Focal vs extended ablation in localized prostate cancer with irreversible electroporation; a multi-center randomized controlled trial. BMC Cancer 2016; 16:299. [PMID: 27150293 PMCID: PMC4858903 DOI: 10.1186/s12885-016-2332-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/01/2016] [Indexed: 12/17/2022] Open
Abstract
Background Current surgical and ablative treatment options for prostate cancer (PCa) may result in a high incidence of (temporary) incontinence, erectile dysfunction and/or bowel damage. These side effects are due to procedure related effects on adjacent structures including blood vessels, bowel, urethra and/or neurovascular bundle. Ablation with irreversible electroporation (IRE) has shown to be effective and safe in destroying PCa cells and also has the potential advantage of sparing surrounding tissue and vital structures, resulting in less impaired functional outcomes and maintaining men’s quality of life. Methods/Design In this randomized controlled trial (RCT) on IRE in localized PCa, 200 patients with organ-confined, unilateral (T1c-T2b) low- to intermediate-risk PCa (Gleason sum score 6 and 7) on transperineal template-mapping biopsies (TTMB) will be included. Patients will be randomized into focal or extended ablation of cancer foci with IRE. Oncological efficacy will be determined by multiparametric Magnetic Resonance Imaging, Contrast-Enhanced Ultrasound imaging if available, TTMP and Prostate Specific Antigen (PSA) follow-up. Patients will be evaluated up to 5 years on functional outcomes and quality of life with the use of standardized questionnaires. Discussion There is critical need of larger, standardized RCTs evaluating long-term oncological and functional outcomes before introducing IRE and other focal therapy modalities as an accepted and safe therapeutic option for PCa. This RCT will provide important short- and long-term data and elucidates the differences between focal or extended ablation of localized, unilateral low- to intermediate-risk PCa with IRE. Trial registration Clinicaltrials.gov database registration number NCT01835977. The Dutch Central Committee on Research Involving Human Subjects registration number NL50791.018.14.
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Laguna MP. Re: Clinical and Radiographic Predictors of the Need for Inferior Vena Cava Resection during Nephrectomy for Patients with Renal Cell Carcinoma and Caval Tumour Thrombus. J Urol 2016; 195:609. [PMID: 26887703 DOI: 10.1016/j.juro.2015.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Laguna MP. Re: Health Economic Changes as a Result of Implementation of Targeted Therapy for Metastatic Renal Cell Carcinoma: National Results from DARENCA Study 2. J Urol 2016; 195:608. [PMID: 26887702 DOI: 10.1016/j.juro.2015.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/27/2022]
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Laguna MP. Re: Trifecta and Optimal Perioperative Outcomes of Robotic and Laparoscopic Partial Nephrectomy in Surgical Treatment of Small Renal Masses: A Multi-Institutional Study. J Urol 2016; 195:298. [PMID: 26852967 DOI: 10.1016/j.juro.2015.10.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Zondervan PJ, van Lienden KP, van Delden OM, de la Rosette JJ, Laguna MP. Preoperative Decision Making for Nephron-Sparing Procedure in the Renal Mass: Time for Using Standard Tools? J Endourol 2016; 30:128-34. [DOI: 10.1089/end.2015.0472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Laguna MP. Re: Interobserver Variability of R.E.N.A.L., PADUA, and Centrality Index Nephrometry Score Systems. J Urol 2015; 195:60-1. [PMID: 26699952 DOI: 10.1016/j.juro.2015.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
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Laguna MP. Re: Novel Kidney Segmentation System to Describe Tumour Location for Nephron-Sparing Surgery. J Urol 2015; 195:61. [PMID: 26699953 DOI: 10.1016/j.juro.2015.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Laguna MP. Re: Risk Stratification for Bladder Recurrence of Upper Urinary Tract Urothelial Carcinoma after Radical Nephroureterectomy. J Urol 2015; 194:1582-3. [PMID: 26582659 DOI: 10.1016/j.juro.2015.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
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Laguna MP. Re: Evaluation of the Prognostic Significance of Perirenal Fat Invasion and Tumor Size in Patients with pT1-pT3a Localized Renal Cell Carcinoma in a Comprehensive Multicenter Study of the CORONA Project. Can we Improve Prognostic Discrimination for Patients with Stage pT3a Tumors? J Urol 2015. [DOI: 10.1016/j.juro.2015.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laguna MP. Re: Partial Nephrectomy for the Treatment of Renal Cell Carcinoma (RCC) and the Risk of End-Stage Renal Disease (ESRD). J Urol 2015. [DOI: 10.1016/j.juro.2015.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Laguna MP. Re: Subcentimeter Pulmonary Nodules Are Not Associated with Disease Progression in Patients with Renal Cell Carcinoma. Eur Urol 2015; 68:908. [PMID: 26460875 DOI: 10.1016/j.eururo.2015.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Laguna MP. Re: International Variations and Trends in Renal Cell Carcinoma Incidence and Mortality. J Urol 2015; 194:950-1. [DOI: 10.1016/j.juro.2015.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Indexed: 02/07/2023]
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Cicione A, Autorino R, Laguna MP, De Sio M, Micali S, Turna B, Sanchez-Salas R, Quattrone C, Dias E, Mota P, Bianchi G, Damiano R, Rassweiler J, Lima E. Three-dimensional Technology Facilitates Surgical Performance of Novice Laparoscopy Surgeons: A Quantitative Assessment on a Porcine Kidney Model. Urology 2015; 85:1252-6. [PMID: 26099869 DOI: 10.1016/j.urology.2015.03.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/03/2015] [Accepted: 03/13/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine whether the use of 3-dimensional (3D) imaging translates into a better surgical performance of naïve urologic laparoscopic surgeons during pyeloplasty (PY) and partial nephrectomy (PN) procedures. MATERIALS AND METHODS Eighteen surgeons without any previous laparoscopic experience were randomly assigned to perform PY and PN in a porcine model using initially 2-dimensional (2D) and 3D laparoscopy. A surgical performance score was rated by an "expert" tutor through a modified 5-item global rating scale contemplating operative field view, bimanual dexterity, efficiency, tissue handling, and autonomy. Overall surgical time, complications, subjective perception of participating surgeons, and inconveniences related to the 3D vision were recorded. RESULTS No difference in terms if operative time was found between 2D or 3D laparoscopy for both the PY (P = .51) and the PN (P = .28) procedures. A better rate in terms of surgical performance score was noted by the tutors when the study participants were using 3D vs 2D, for both PY (3.6 [0.8] vs 3.0 [0.4]; P = .034) and PN (3.6 [0.51] vs 3.15 [0.63]; P = .001). No complications occurred in any of the procedures. Most (77.2%) of the participating naïve laparoscopic surgeons had the perception that 3D laparoscopy was overall easier than 2D. Headache (18.1%), nausea (18.1%), and visual disturbance (18.1%) were the most common issues reported by the surgeons during 3D procedures. CONCLUSION Despite the absence of translation in a shorter operative time, the use of 3D technology seems to facilitate the surgical performance of naïve surgeons during laparoscopic kidney procedures on a porcine model.
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Laguna MP. Re: Benefit in Regionalization of Care for Patients Treated with Nephrectomy: A Nationwide Inpatient Sample. J Urol 2015; 194:664-5. [PMID: 26292853 DOI: 10.1016/j.juro.2015.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Indexed: 11/20/2022]
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Laguna MP. Re: Impact of Warm versus Cold Ischemia on Renal Function following Partial Nephrectomy. J Urol 2015. [PMID: 26195357 DOI: 10.1016/j.juro.2015.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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90
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Laguna MP. Re: Perioperative Outcomes of 6042 Nephrectomies in 2012: Surgeon-Reported Results in the UK from the British Association of Urological Surgeons (BAUS) Nephrectomy Database. J Urol 2015; 194:42-3. [PMID: 26088218 DOI: 10.1016/j.juro.2015.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Indexed: 10/23/2022]
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91
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Laguna MP. Re: Evaluation of the National Comprehensive Cancer Network and American Urological Association Renal Cell Carcinoma Surveillance Guidelines. J Urol 2015; 194:43. [PMID: 26088219 DOI: 10.1016/j.juro.2015.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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92
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Laguna MP. Re: Comparison of Radiation Dose from Conventional and Triple-Bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients with Renal Cortical Neoplasms. J Urol 2015; 193:1929. [DOI: 10.1016/j.juro.2015.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 11/16/2022]
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93
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Laguna MP. Re: Renal tumor contact surface area: a novel parameter for predicting complexity and outcomes of partial nephrectomy. J Urol 2015; 193:1515. [PMID: 25895756 DOI: 10.1016/j.juro.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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94
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Laguna MP. Re: Internal validation of the renal pelvic score: a novel marker of renal pelvic anatomy that predicts urine leak after partial nephrectomy. J Urol 2015; 193:1151-2. [PMID: 25890510 DOI: 10.1016/j.juro.2015.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 11/17/2022]
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95
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Wagstaff P, Ingels A, Zondervan P, de la Rosette JJMCH, Laguna MP. Thermal ablation in renal cell carcinoma management: a comprehensive review. Curr Opin Urol 2015; 24:474-82. [PMID: 25051022 DOI: 10.1097/mou.0000000000000084] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW This article provides an overview of recent developments in the field of thermal ablation for renal cell carcinoma and focuses on current standard techniques, new technologies, imaging for ablation guidance and evaluation, and future perspectives. RECENT FINDINGS Emerging long-term data on cryoablation and radiofrequency ablation (RFA) show marginally lower oncologic outcomes compared to surgical treatment, balanced by better functional and perioperative outcomes. Reports on residual disease vary widely, influenced by different definitions and strategies in determining ablation failure. Stratifying disease-free survival after RFA according to tumor size suggests 3 cm to be a reasonable cut off for RFA tumor selection. Microwave ablation and high-intensity focal ultrasound are modalities with the potential of creating localized high temperatures. However, difficulties in renal implementation are impairing sufficient ablation results. Irreversible electroporation, although not strictly thermal, is a new technology showing promising results in animal and early human research. SUMMARY Although high-level randomized controlled trials comparing thermal ablation techniques are lacking, evidence shows that thermal ablation for small renal masses is a safe procedure for both long-term oncologic and functional outcomes. Thermal ablation continues to be associated with a low risk of residual disease, for which candidates should be properly informed. RFA and cryoablation remain the standard techniques whereas alternative techniques require further studies.
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Westendarp M, Postema A, de la Rosette JJMC, Wijkstra H, Laguna MP. [Advances in ultrasound techniques for the diagnosis and staging of prostate cancer. Elastography, Doppler ultrasound, ultrasound contrast media, ultrasound quantification media and MRI fusion]. ARCH ESP UROL 2015; 68:307-315. [PMID: 25948802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Transrectal ultrasound-guided prostate biopsy remains the gold standard in the diagnosis of prostate cancer. Various Ultrasound modalities have been proposed to increase the cancer detection rate. Our purpose is to evaluate each of these methods , and to present its current literature and clinical utility. METHOD A non structured review of the current literature was conducted over these different various ultrasound modalities used during the transrectal ultrasound-guided prostate biopsied in the diagnosis of prostate cancer. RESULTS The data investigation of the various modalities associated sonographic features exhibits great heterogeneity and highly variable results. Some new techniques sampling present promising results with high sensitivity and specificity, thus increasing the diagnostic yield of transrectal biopsy. It seems that elastography shows encouraging figures, especially given the recent introduction of the "shearvawe" elastography that decreases the user-dependent factor. CONCLUSIONS The ultrasound-guided prostate biopsy has an acceptable sensitivity in the diagnosis of prostate cancer, but its specificity is still low. Various modalities associated with ultrasound are available in clinical practice in order to increase cancer detection rate. Although some promising data have been published for some of the modalities, we believe the combination of these includes validated ultrasound guided biopsy protocols to accurately target and diagnose prostate cancer.
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97
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Pearce S, Steinberg Z, Zigeuner R, Mochtar C, Gueglio G, Shalhav A, Eggener S, Laguna MP. MP84-04 GENDER AND RACIAL DISPARITIES IN UTILIZATION OF PARTIAL NEPHRECTOMY FOR RENAL MASSES. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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98
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Laguna MP. Re: Quality assessment of partial nephrectomy complications reporting using EAU standardised quality criteria. J Urol 2015; 193:783. [PMID: 25765381 DOI: 10.1016/j.juro.2014.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/15/2022]
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99
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Laguna MP. Re: Margins, ischaemia and complications rate after laparoscopic partial nephrectomy: impact of learning curve and tumour anatomical characteristics. J Urol 2015; 192:57-8. [PMID: 25701443 DOI: 10.1016/j.juro.2014.04.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/15/2022]
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100
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Laguna MP. Re: Cytology as an alternative to frozen section at the time of nephron-sparing surgery to evaluate surgical margin status. J Urol 2015; 192:58. [PMID: 25701444 DOI: 10.1016/j.juro.2014.04.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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