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Schmidbauer J, Remzi M, Lindenau G, Susani M, Marberger M. OPTICAL COHERENCE TOMOGRAPHY AND HEXAMINOLEVULINATE FLUORESCENCE CYSTOSCOPY FOR DETECTING UROTHELIAL CARCINOMA OF THE BLADDER. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60955-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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102
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Kramer G, Steiner G, Marberger M. A CD-38-Like Molecule - A Novel Prostatic Antigen and its Differential Expression in Normal Prostatic Epithelium and Prostatic Disease. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1055659] [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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103
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Haese A, Chun F, De La Taille A, Van Poppel H, Marberger M, Mulders P, Abbou C, Stenzl A, Huland H, Tinzl M, Remzi M, Feyerabend S, Van Gils M, Stillebroer A, Schalken J. PCA3 REPRESENTS A CLINICALLY MEANINGFUL PREDICTOR OF PROSTATE CANCER AT REPEAT BIOPSY. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60278-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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104
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Remzi M, Waldert M, Klingler H, Haitel A, Mueller L, Marberger M. OUTCOME AND RE-EVALUATION BY IMMUNO HISTOCHEMICAL STAINING OF RENAL ONCOCYTOMAS AND CHROMOPHOBE RENAL CELL CANCER (RCC). ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60245-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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105
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El-Taieb M, Herwig R, Djavan B, Margreiter M, Greilberger J, Marberger M. CARBONYL PROTEIN ANALYSIS REVEALS EFFECT OF OXIDATIVE STRESS ON SPERM MOTILITY AND MIDPEACE DEFORMITIES. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60087-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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106
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Schmidbauer J, Remzi M, Lindenau G, Susani M, Marberger M. OPTICAL COHERENCE TOMOGRAPHY AND HEXAMINOLEVULINATE FLUORESCENCE CYSTOSCOPY IN DETECTING UROTHELIAL CARCINOMA OF THE BLADDER. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60031-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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107
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Emberton M, Marberger M, de la Rosette J. Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: The Prostate Research on Behaviour and Education (PROBE) Survey. Int J Clin Pract 2008; 62:18-26. [PMID: 18028388 PMCID: PMC2268973 DOI: 10.1111/j.1742-1241.2007.01635.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS Benign prostatic hyperplasia (BPH) is a bothersome disease that can progress if left untreated. However, patient and urologist perspectives on BPH management are not fully understood. The aim of the Prostate Research on Behaviour and Education (PROBE) Survey was to assess healthcare-seeking behaviour and attitudes to BPH treatment in 502 BPH patients, and the beliefs and management practices of 100 urologists, from France, Germany, Italy, Spain and the UK. RESULTS The principal concerns of patients seeking medical advice were fear of cancer, sleep disruption, discomfort or embarrassment. The majority of BPH patients recalled receiving a digital rectal examination (61%), routine prostate-specific antigen (PSA) tests (67%) and prescription medication (72%). Eighty per cent of 5alpha-reductase inhibitor (5ARI) users vs. 68% of alpha-blocker users were satisfied with their treatment. More than half of the patients were concerned about requiring surgery or developing acute urinary retention, and >75% would prefer a drug that provides reduction in the risk of surgery than one that provides rapid symptom relief. Most urologists performed digital rectal examinations (96%) and PSA tests (71%) on >90% of patients presenting with BPH symptoms. Eighty-seven per cent of urologists believe that BPH progresses, and 78% believe that 5ARIs prevent BPH progression. However, most urologists prescribe alpha-blockers while few prescribe 5ARIs. CONCLUSIONS This study highlights discrepancies between views and beliefs of patients and physicians regarding BPH and current practice in Europe.
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Djavan B, Ravery V, Rocco B, Zlotta A, Brausi M, Margreiter M, Hammerer P, Kaisary A, Anagnostou T, Romics I, Dobronski P, De Cobelli O, Marberger M. European Study of Radical Prostatectomy: time trends in Europe, 1993-2005. BJU Int 2007; 100 Suppl 2:22-5. [PMID: 17594353 DOI: 10.1111/j.1464-410x.2007.06948.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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109
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Schmidbauer J, Marberger M. Recent developments in fluorescence cystoscopy: do novel agents bring a benefit? Curr Opin Urol 2007; 17:347-51. [PMID: 17762629 DOI: 10.1097/mou.0b013e3282c8c73f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW In flat bladder cancer and carcinoma in situ, and in multifocal papillary cancer, some smaller lesions may be overlooked at cystoscopy. For 10 years fluorescence cystoscopy has been promoted to solve these problems without wider acceptance. New fluorophobes now promise better clinical applicability. RECENT FINDINGS In prospective multicenter studies fluorescence cystoscopy shows significant improvement in the detection of flat bladder cancer and carcinoma in situ. It also permits more reliable identification of all neoplastic lesions with multifocal tumors, hence more precise removal and as a consequence lower recurrence rates. SUMMARY New agents bring a significant benefit. Hexyl-aminolevulinate offers more rapid urothelial accumulation, better fluorescence contrast and less photobleaching than previously used fluorophobes. It is simple to use in everyday practice and has a favorable toxicity profile.
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Haese A, van Poppel H, Marberger M, Mulders P, Abbou C, Boccon-Gibod L, Stenzl A, Huland H, de la Taille A, Schalken J. POD-08.05: The PCA3 assay is useful in guiding prostate biopsy (PB) decision in men with a prior negative biopsy. Urology 2007. [DOI: 10.1016/j.urology.2007.06.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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111
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van Adelsberg J, Gann P, Ko AT, Damber JE, Logothetis C, Marberger M, Schmitz-Drager BJ, Tubaro A, Harms CJ, Roehrborn C. The VIOXX in Prostate Cancer Prevention study: cardiovascular events observed in the rofecoxib 25 mg and placebo treatment groups. Curr Med Res Opin 2007; 23:2063-70. [PMID: 17651539 DOI: 10.1185/030079907x219526] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND A double-blind, randomized, placebo-controlled study was designed to determine the cumulative incidence of developing prostate cancer over 6 years of treatment with rofecoxib 25 mg/day versus placebo. Before completion, this trial was terminated following the voluntary withdrawal of rofecoxib. (On September 30, 2004, Merck & Co., Inc. announced the voluntary worldwide withdrawal of rofecoxib from the market.) Here we report the cardiovascular (CV) safety data collected from this study. METHODS A total of 4741 men (44-81 years old) exhibiting prostate-specific antigen levels (PSA) between 2.5 and 10 ng/mL were enrolled. Patients were stratified by PSA level and use of low-dose aspirin (LDA), then randomized to rofecoxib 25 mg (n = 2369) or placebo (n = 2372). Safety data were analyzed in all patients receiving > or = 1 dose of study medication. All reported thrombotic CV events occurring on-treatment or within 14 days after study drug discontinuation were adjudicated by an independent panel of clinical experts blinded to treatment assignment. Rates per 100 patient-years and relative risk (RR) of thrombotic CV events, rofecoxib vs. placebo, were determined. RESULTS Approximately 36% of patients had > or = 2 CV risk factors or LDA indicated. Median treatment duration was 4.14 (range: 0.03-15.90) months. Twenty-nine patients (14 rofecoxib, rate 1.27; 15 placebo, rate 1.36) experienced confirmed thrombotic CV events; RR 0.94 (95% CI: 0.45, 1.94) vs. placebo. Four patients (one rofecoxib; three placebo) died due to a confirmed thrombotic event. Significantly (p = 0.002) more patients receiving rofecoxib (n = 20; 0.8%) experienced hypertension-related adverse events versus placebo (n = 2; 0.1%). There were no cases of congestive heart failure. CONCLUSIONS Rofecoxib 25 mg and placebo demonstrated similar risk of thrombotic CV events in this limited dataset.
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Herwig R, Djavan B, Kramer G, El-Taieb MA, Kühhas F, Leers M, Marberger M. Prostatakarzinomscreening durch einen neuen Marker auf der Basis zirkulierender Blutmakrophagen? Urologe A 2007; 46:1066-70. [PMID: 17622505 DOI: 10.1007/s00120-007-1421-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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113
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Djavan B, Rocco B, Stangelberger A, De Cobelli O, Marberger M. Is the era of prostate-specific antigen over? BJU Int 2007; 100 Suppl 2:8-10. [PMID: 17594349 DOI: 10.1111/j.1464-410x.2007.06944.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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115
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Lackner JE, Koller A, Schatzl G, Marberger M, Kratzik C. Does histopathologic tumor type or vascular invasion influence spermatogenesis in testicular cancer? Fertil Steril 2007; 88:1377-81. [PMID: 17544417 DOI: 10.1016/j.fertnstert.2006.12.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 12/26/2006] [Accepted: 12/26/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the quality and activity of spermatogenesis in the contralateral healthy testicle at the time of orchiectomy and to assess whether any tumor-related factor such as tumor type or vascular invasion is a risk factor for impaired spermatogenesis. DESIGN Retrospective cohort study. SETTING University hospital. PATIENT(S) Seventy-six patients undergoing orchiectomy for seminoma or nonseminomatous germ cell tumor (NSGCT). INTERVENTION(S) Open biopsy of contralateral healthy testicle at the time of orchiectomy. MAIN OUTCOME MEASURE(S) Quality of spermatogenesis using median and highest Johnsen score in correlation with histopathologic tumor type, vascular invasion, and serum tumor markers and hormone levels. RESULT(S) Contralateral spermatogenesis is reduced in seminomas and in NSGCTs, with median Johnsen scores of 8.9 and 8.6, respectively. Similar results were seen in tumors with vascular invasion (median Johnsen score 8.8 [range 8.2-9.5]) and without vascular invasion (median Johnsen score 8.8 [range 8.1-9.2]). Areas with good-quality spermatogenesis were found in 88.9% of seminoma and 92.5% of NSGCT biopsies. CONCLUSION(S) Testicular cancer is associated with impaired spermatogenesis, but neither the histopathologic tumor type nor the presence of vascular invasion correlated with significantly reduced spermatogenesis.
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Lackner JE, Märk I, Schatzl G, Marberger M, Kratzik C. Hypogonadism and androgen deficiency symptoms in testicular cancer survivors. Urology 2007; 69:754-8. [PMID: 17445664 DOI: 10.1016/j.urology.2007.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Revised: 10/02/2006] [Accepted: 01/03/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the prevalence of hypogonadism in correlation with androgen deficiency symptoms in testicular cancer survivors. METHODS Luteinizing hormone, follicle-stimulating hormone, serum testosterone, dehydroepiandrosterone, and sex hormone binding globulin levels were determined in patients who had undergone treatment for unilateral testicular cancer. Patients with serum testosterone levels less than 3.0 ng/mL were classified as hypogonadal; all other testosterone levels signified eugonadism. Additionally, all patients completed the Aging Males' Symptoms scale: scores of less than 26 indicated no androgen deficiency symptoms and scores greater than 27 indicated symptoms. RESULTS According to testosterone level, 18 (26.5%) of 68 patients were hypogonadal and 50 (73.5%) were eugonadal (P = 0.456). According to the Aging Males' Symptoms scale, 23 (33.8%) of the 68 patients had androgen deficiency symptoms and 45 (66.2%) had no symptoms (P = 0.267). The median testosterone level was 3.6 ng/mL in all patients with androgen deficiency symptoms, 2.4 ng/mL in patients with androgen deficiency symptoms who were hypogonadal, and 4.7 ng/mL in those with androgen deficiency symptoms who were eugonadal. CONCLUSIONS Testicular cancer survivors are at risk of developing hypogonadism and androgen deficiency symptoms. However, no specific testosterone threshold could be detected at which symptoms start, indicating that each patient has an individual testosterone threshold for androgen deficiency symptoms.
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Klingler HC, Marberger M, Mauermann J, Remzi M, Susani M. ?Skipping? is still a problem with radiofrequency ablation of small renal tumours. BJU Int 2007; 99:998-1001. [PMID: 17437433 DOI: 10.1111/j.1464-410x.2007.06769.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the homogeneity and extent of necrosis obtained with next-generation radiofrequency ablation (RFA) equipment and techniques, as incomplete tumour necrosis, or 'skipping', has been documented after RFA of renal tumours and subsequent partial nephrectomy, but this was assumed to result from insufficient energy deposition with first-generation low-energy generators. PATIENTS AND METHODS In all, 17 patients with solitary renal tumours of <or=4 cm were treated with RFA under laparoscopic control. A state-of-the-art monopolar RFA generator and 15 G multi-tined needle probes were used. The probe tines were deployed to create an ablation zone>0.5-1.0 cm beyond the sonographically controlled tumour borders. Target temperatures of 105 degrees C were applied in three cycles for 10-30 min at up to 150 W. Tumours were then removed by laparoscopic partial nephrectomy and specimens evaluated by detailed histology. RESULTS The mean (range) resected tumour size was 22 (11-40) mm, the mean RFA time was 39 (27-59) min and the mean surgical resection time was 25 (12-45) min. In 13 patients, haemostasis was sufficient to avoid the renal pedicle being clamped. Intraoperative repeated positive margins in one patient required a laparoscopic radical nephrectomy. Thirteen (76%) renal masses showed histologically complete ablation of the entire tumour. Of the four RFA failures, three tumours were >3 cm in diameter, two were highly vascularized and three had a very heterogeneous tissue texture. CONCLUSION Even with state-of-the-art technology, skipping remains a problem with RFA for small renal masses and renders the technique unreliable.
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Remzi M, Katzenbeisser D, Waldert M, Klingler HC, Susani M, Memarsadeghi M, Heinz-Peer G, Haitel A, Herwig R, Marberger M. Renal tumour size measured radiologically before surgery is an unreliable variable for predicting histopathological features: benign tumours are not necessarily small. BJU Int 2007; 99:1002-6. [PMID: 17437434 DOI: 10.1111/j.1464-410x.2007.06758.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To compare histopathological findings as a function of radiological tumour size, as published data suggest that small renal tumours are often benign and large tumours are renal cell cancer (RCC). PATIENTS AND METHODS Data from 543 surgically treated patients with solid renal tumours were analysed retrospectively. Tumour size measured by computed tomography (CT) before surgery was stratified into seven subgroups (cm): 0-2, 2.1-3, 3.1-4, 4.1-5, 5.1-6, 6.1-7 and >7, and correlated with final histology. RESULTS In all, 80 lesions (14.7%) were benign on final histology; tumour size did not correlate with benign histology (P=0.660). Histopathological tumour size was not statistically significant different (P=0.521) from measured tumour size on CT, and there was no statistical significance between CT and histopathological tumour size (P=0.528). Only 13 (17%) of lesions were correctly defined as benign on CT before surgery, whereas 67 (83%) were considered to be suspicious for malignant disease. Only one patient with a tumour correctly defined as benign had a radical nephrectomy; by contrast, 28 of 67 (42%) had a radical nephrectomy for benign lesions not correctly identified as benign on CT before surgery (P<0.001). CONCLUSION Substantially many renal masses are benign, independent of tumour size. Radical nephrectomy could potentially have been avoided in 42% of patients with benign renal tumours. These data provide a good argument for the use of a more refined preoperative diagnostic evaluation, in particular needle biopsy.
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Marberger M. Energy-based ablative therapy of prostate cancer: high-intensity focused ultrasound and cryoablation. Curr Opin Urol 2007; 17:194-9. [PMID: 17414518 DOI: 10.1097/mou.0b013e3280dd8a65] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review is an update on the role of the two minimally invasive techniques in primary therapy of organ-confined prostate cancer: as a salvage option after standard-therapy failure and for focal ablation of index tumors. RECENT FINDINGS Energy-based ablative techniques are of growing interest for today's heterogeneous spectrum of prostate cancer. At present, primary high-intensity focused ultrasound appears to be a valid alternative to active surveillance protocols in low-risk cancers and, in older patients, to standard therapy. Morbidity is low, although postoperative impotence occurs frequently. Cryoablation has higher morbidity, even with third-generation conformal technology. With radiorecurrent cancer the potential radiation damage of the rectal wall renders transrectal high-intensity focused ultrasound more hazardous. Third-generation cryoablation seems to give better cancer control with lower morbidity in this situation. Unfortunately, long-term outcome data from controlled trials are not available. SUMMARY These minimally invasive techniques are not magic bullets, and patients must be informed accordingly. Focal ablation of the prostate segment with the index cancer would minimize morbidity and therefore appears highly appealing. Its success depends on correct localization of the lesion. Until this is achieved with sufficient reliability by appropriate biopsy or imaging techniques it remains strictly experimental.
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Marberger M, Janetschek G. [Renal cell carcinoma--developments in therapy]. Urologe A 2007; 46:475-7. [PMID: 17426953 DOI: 10.1007/s00120-007-1331-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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122
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Remzi M, Schmidbauer J, Memarsadeghi M, Klingler HC, Wiener H, Heinz-Peer G, Susani M, Marberger M. 905: Diagnostic Accuracy of Percutaneous Biopsy of Renal Masses Guided by Computerized Tomography. J Urol 2007. [DOI: 10.1016/s0022-5347(18)31133-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Waldert M, Seitz C, Harik M, Alavi S, Margreiter M, Dobronski P, Ravery V, Nowak M, Kaisary A, Marberger M, Djavan B. 1834: Evaluation of the long term Efficacy, Safety and Retreatment rates of Targeted high Energy Transurethral Microwave Thermotherapy. J Urol 2007. [DOI: 10.1016/s0022-5347(18)32007-x] [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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Djavan B, Rocco B, Brausi M, Zlotta AR, Ravery V, Hammerer P, Anagnostou T, Naegele R, Margreiter M, Harik M, Lepor H, Marberger M. 1947: Predictors of Prostate Cancer in the Transition Zone: Results of a Multicenter Trial. J Urol 2007. [DOI: 10.1016/s0022-5347(18)32107-4] [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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125
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Roehrborn CG, Marberger M, Tubaro A, Siami P, Wilson TH. 1557: Relationship between Screening IPSS and the Placebo Run-In Response in the Pooled Reduce and Combat Population. J Urol 2007. [DOI: 10.1016/s0022-5347(18)31745-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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