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Saoudi González N, Ros J, Baraibar I, Salvà F, Rodríguez-Castells M, Alcaraz A, García A, Tabernero J, Élez E. Cetuximab as a Key Partner in Personalized Targeted Therapy for Metastatic Colorectal Cancer. Cancers (Basel) 2024; 16:412. [PMID: 38254903 PMCID: PMC10814823 DOI: 10.3390/cancers16020412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Cetuximab, a chimeric IgG1 monoclonal antibody targeting the epidermal growth factor receptor (EGFR), has revolutionized personalized treatment of metastatic colorectal cancer (mCRC) patients. This review highlights the mechanism of action, characteristics, and optimal indications for cetuximab in mCRC. Cetuximab has emerged as a pivotal partner for novel therapies in specific molecular subgroups, including BRAF V600E, KRAS G12C, and HER2-altered mCRC. Combining cetuximab with immunotherapy and other targeted agents further expands the therapeutic landscape, offering renewed hope for mCRC patients who face the development of resistance to conventional therapies. Ongoing clinical trials have continued to uncover innovative cetuximab-based treatment strategies, promising a brighter future for mCRC patients. This review provides a comprehensive overview of cetuximab's role and its evolving importance in personalized targeted therapy of mCRC patients, offering valuable insights into the evolving landscape of colorectal cancer treatment.
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Affiliation(s)
- Nadia Saoudi González
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Javier Ros
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Iosune Baraibar
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Francesc Salvà
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Marta Rodríguez-Castells
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Adriana Alcaraz
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Ariadna García
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
| | - Josep Tabernero
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
| | - Elena Élez
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; (N.S.G.); (F.S.)
- Vall d’Hebron Hospital Campus, 08035 Barcelona, Spain
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Rodriguez Castells M, Baraibar I, Ros J, Saoudi N, Salvà F, García A, Alcaraz A, Tabernero J, Élez E. The impact of clinical and translational research on the quality of life during the metastatic colorectal cancer patient journey. Front Oncol 2023; 13:1272561. [PMID: 37909013 PMCID: PMC10614292 DOI: 10.3389/fonc.2023.1272561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
The journey of metastatic colorectal cancer patients is complex and challenging, requiring coordination and collaboration between multiple healthcare providers. Understanding patients' needs, fears, feelings, concerns, and behaviors is essential for providing individualized patient-centered care. In recent years, mCRC patients have experienced improvements in clinical outcomes, from 16 months of overall survival to 32 months, thanks to research. However, there is still room for improvement, and integrating clinical and translational research into routine practice can help patients benefit from treatments and techniques that would not be an option. In the Journey of mCRC patients, living well with cancer and quality of life becomes a priority given the outcomes of the disease. Patient reported outcomes (PRO) and Patient Reported Outcome Measures (PROMs) are becoming therefore new estimands in Oncology. Patient advocates represent important figures in this process by prioritizing issues and research questions; evaluating research designs and the performance of the research; the analysis and interpretation of data; and how results are disseminated. Multidisciplinary Tumor Boards and shared decision-making is essential for designing treatment strategies for individual patients. Quality of Life is often prioritized only when it comes to refractory advanced disease and end-of-life care, but it has to be integrated from the beginning, as the emotional impact of diagnosis leads to a vulnerable situation where patients' needs and preferences can be easily overseen. First-line treatment will be chosen among more treatment options than subsequent lines, with longer progression-free survival and a bigger impact on the outcomes. Practicing patient-centered care and optimizing first-line treatment for colorectal cancer patients requires a comprehensive understanding of patient experience and treatment outcomes, which can guide clinical practice and inform regulatory decisions for the benefit of patients.
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Affiliation(s)
- Marta Rodriguez Castells
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Iosune Baraibar
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Ros
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Francesc Salvà
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Ariadna García
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Adriana Alcaraz
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Elena Élez
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Sureda Riera J, Ajami T, Matheu R, Peradejordi M, Franco De Castro A, Musquera M, Peri L, Alcaraz A. Vesico-urethral anastomosis stenosis after robotic radical prostatectomy: Descriptive analysis and risk factors. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Mengual L, Ingelmo-Torres M, Roldán F, Carrasco R, Ajami T, Padullés B, Sureda J, Matheu R, Mas J, Ribal M, Izquierdo L, Alcaraz A. Bladder EpiCheck methylation test predicts short- and long-term HG events in bladder cancer patients treated with bacillus Calmette-Guérin. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00468-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Carbonell E, Mercader C, Sureda J, Gutiérrez A, Muñoz J, Gallardo E, Feltes N, Vilaseca A, Franco A, Musquera M, Alcaraz A, Ribal M. Nadir prostate-specific antigen after salvage cryotherapy as a potential prognostic factor for oncologic outcomes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01156-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Carbonell E, Izquierdo L, Moreno L, Peradejordi M, Tello A, Sureda J, Matheu R, Muní M, Martínez C, Alfambra H, Ribal M, Alcaraz A. Upper tract urothelial carcinoma in patients with DNA mismatch repair genes mutations. Clinicopathologic characteristics, management, and recurrence patterns. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Mengual L, Frantzi M, Mokou M, Ingelmo-Torres M, Vlaming M, Merseburger A, Roesch M, Culig Z, Alcaraz A, Vlahou A, Mischak H, Van Der Heijden A. Multicentric validation of nomograms based on urine peptide biomarkers for bladder cancer diagnostics and monitoring in two prospective cohorts of patients. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gauhar V, Gadzhiev N, Semenyakin I, Morshnev A, Alcaraz A, Okhunov Z. Can mixed reality technology in laparoscopic partial nephrectomy enhance the surgical experience: Outcomes of a prospective RCT using an indigenously developed software. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00120-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mengual L, Ingelmo-Torres M, Carrasco R, Roldan F, Garcia M, Alcaraz A, Izquierdo L, Ribal M. Utility of bladder EpiCheck methylation test for the surveillance of bladder cancer patients treated with bacillus Calmette-Guérin. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00165-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lombardo R, De Nunzio C, Bellangino M, Rovesti L, Albano A, Chacon R, Lopez J, Luque M, Ribal M, Alcaraz A, Tubaro A. Complications and outcomes of laser ureterolithotripsy for ureteric stones: a multicentre analysis of risk factors. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00901-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Armstrong A, Iguchi T, Azad A, Szmulewitz R, Holzbeierlein J, Villers A, Alcaraz A, Alekseev B, Shore N, Petrylak D, Rosbrook B, Zohren F, Yamada S, Haas G, Stenzl A. LBA25 Final overall survival (OS) analysis from ARCHES: A phase III, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) + androgen deprivation therapy (ADT) in men with metastatic hormone-sensitive prostate cancer (mHSPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Iordan Z, Poinsot P, Iceta S, Morfin D, Berthiller J, Fourneret P, Alcaraz A, Segrestin B, Peretti N. Micronutrient status in children with anorexia nervosa: high frequency of early copper and selenium deficiencies. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lombardo R, De Nunzio C, Bellangino M, Voglino O, Albano A, Chacon R, Sica A, Lopez J, Luque P, Ribal M, Alcaraz A, Tubaro A. Multicentre external validation of the Imamura nomogram for the prediction of success after semi-rigid ureterolithotripsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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De Nunzio C, Lombardo R, Bellangino M, Albano A, Chacon R, Lopez J, Luque P, Ribal M, Alcaraz A, Tubaro A. Complications and outcomes of laser ureterolithotripsy for ureteral stones: a multicentre analysis of risk factors. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Vignolini G, Campi R, Decaestecker K, Greco I, Tuğcu V, Musquera M, Territo A, Gausa L, Randon C, Stöckle M, Zeuschner P, Fornara P, Mohammed N, Doumerc N, Vigues F, Barod R, Banga N, Alcaraz A, Serni S, Breda A. Robotic kidney transplantation using right-versus left-sided grafts from living donors: an european multicentre experience (ERUS-RAKT working group). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Carles J, Alcaraz A, Clarke N, Conde A, Heidenreich A, Juarez A, Maroto Rey J, Puente J, Hernandez-Medrano I, Salcedo I, Haddad I, Munoz del Toro J, Servan A, Pissart G, Casariego J, Fizazi K. 695TiP ORACULUM: A retrospective observational epidemiological study using artificial intelligence and natural language processing in electronic health records to characterize the prostate cancer pathway, management and outcomes in Europe, Middle East and Africa (EMEA region). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gallioli A, Boissier R, Territo A, Campi R, Vignolini G, Musquera M, Alcaraz A, Decaestecker K, Tugcu V, Vanacore D, Serni S, Breda A. Innovations and technical variations in robot-assisted kidney transplantation: Results from the ERUS working group. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34238-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Costa Grau M, Peri L, D’anna M, Franco A, Álvarez-Vijande R, Alcaraz A. Outcomes of Virtue® male sling for postprostatectomy incontinence. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32873-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Campi R, Vignolini G, Decaestecker K, Greco I, Tuğcu V, Musquera M, Territo A, Gausa L, Randon C, Stockle M, Zeuschner P, Fornara P, Mohammed N, Doumerc N, Vigues F, Barod R, Banga N, Alcaraz A, Serni S, Breda A. Robot-assisted kidney transplantation (RAKT) from living donors using right- versus left-sided grafts: Results from the EAU Robotic Urology Section (ERUS)-RAKT working group. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Gallioli A, Territo A, Boissier R, Campi R, Vignolini G, Musquera M, Alcaraz A, Decaestecker K, Tugcu V, Vanacore D, Serni S, Breda A. The European experience in robot-assisted kidney transplantation: Learning curve. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Prudhomme T, Beauval J, Lesourd M, Roumiguié M, Decaestecker K, Vignolini G, Campi R, Serni S, Territo A, Gausa L, Tugcu V, Sahin S, Alcaraz A, Musquera M, Stockle M, Janssen M, Fornara P, Mohammed N, Kamar N, Sallusto F, Breda A, Doumerc N. Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: The European experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33559-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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De Nunzio C, Lombardo R, Russo G, Albano A, Bellangino M, Baldassarri V, Sica A, Lopez J, Luque P, Ribal M, Alcaraz A, Tubaro A. Development of a nomogram predicting the probability of stone free rate in patients with ureteral stones eligible for laser ureterolitothripsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ajami Fardoun T, Martos R, D’Anna M, Mercader C, Sierra A, Alcaraz A. Laparoscopic partial nephrectomy with intra-arterial hypothermic perfusion. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Carrion A, Ribal MJ, Morote J, Huguet J, Raventós C, Lozano F, Costa-Grau M, Alcaraz A. A comparative study of different surgical techniques for the management of distal ureter during laparoscopic radical nephroureterectomy. Actas Urol Esp 2019; 43:543-550. [PMID: 31447089 DOI: 10.1016/j.acuro.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/14/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the oncological outcomes between two open surgical techniques and two endoscopic approaches for the management of the distal ureter during laparoscopic radical nephroureterectomy (LRNU). MATERIAL AND METHODS Retrospective review of 152 patients submitted to LRNU for the management of upper urinary tract tumors between 2007-2014. We analyzed the potential impact of two different open surgical (extravesical vs intravesical) and two endoscopic (resection of ureteral orifice and fragment removal vs endoscopic bladder cuff) techniques on the development of bladder recurrence, distant/local recurrence and cancer-specific survival (CSS). RESULTS A total of 152 patients with a mean age of 69.9 years (±10.1) underwent LRNU. We reported 62 pTa-T1 (41%), 35 pT2 (23%) and 55 pT3-4 (36%). Thirty-two were low grade (21.1%) and 120 high grade (78.9%). An endoscopic approach was performed in 89 cases (58.5%), 32 with resection (36%) and 57 with bladder cuff (64%), and open approach in 63 (41.5%), 42 intravesical (66.7%) and 21 extravesical (33.3%). Within a median follow-up of 32 months (3-120), 38 patients (25%) developed bladder recurrence, 42 distant/local recurrence (27.6%) and 34 died of tumor (22.4%). In the univariate analysis, the type of endoscopic technique was not related to bladder recurrence (P=.961), distant/local recurrence (P=.955) nor CSS (P=.802). The open extravesical approach was not related to bladder recurrence (P=.12) but increased distant/local recurrence (P=.045) and decreased CSS (P=.034) compared to intravesical approach. CONCLUSIONS LRNU outcomes are not dependant on the type of endoscopic approach performed. The open extravesical approach is a more difficult technique and could worsen the oncological outcomes when compared to the intravesical.
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Affiliation(s)
- A Carrion
- Departamento de Urología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
| | - M J Ribal
- Departamento de Urología, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - J Morote
- Departamento de Urología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - J Huguet
- Departamento de Urología, Fundación Puigvert, Universitat Autònoma de Barcelona, Barcelona, España
| | - C Raventós
- Departamento de Urología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - F Lozano
- Departamento de Urología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - M Costa-Grau
- Departamento de Urología, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - A Alcaraz
- Departamento de Urología, Hospital Clínic, Universidad de Barcelona, Barcelona, España
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Prudhomme T, Beauval J, Lesourd M, Roumiguié M, Decaestecker K, Siena G, Serni S, Territo A, Gausa L, Tugcu V, Alcaraz A, Musquera M, Stockle M, Janssen M, Fornara P, Mohammed N, Kamar N, Sallusto F, Breda A, Doumerc N. Comparaison de la transplantation rénale cœlioscopique robot-assistée de donneur vivant entre receveurs obèses et non-obèses : une série internationale de 169 transplantations. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stenzl A, Szmulewitz R, Petrylak D, Holzbeierlein J, Villers A, Azad A, Alcaraz A, Alekseev B, Iguchi T, Shore N, Rosbrook B, Baron B, Kunieda F, Morlock R, Ramaswamy K, Armstrong A. ARCHES–efficacité du traitement par suppression androgénique en association avec l’enzalutamide ou placebo dans le cancer de la prostate hormono-sensible métastatique : résultats de l’antigène spécifique de la prostate (PSA). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Stenzl A, Szmulewitz R, Petrylak D, Holzbeierlein J, Villers A, Azad A, Alcaraz A, Alekseev B, Iguchi T, Shore N, Rosbrook B, Baron B, Haas G, Morlock R, Ramaswamy K, Armstrong A. ARCHES - The role of androgen deprivation therapy (ADT) with enzalutamide (ENZA) or placebo (PBO) in metastatic hormone-sensitive prostate cancer (mHSPC): Post hoc analyses of high and low disease volume and risk groups. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alfie V, Alcaraz A, Garcia Marti S, Gonzalez L, Virgilio S, Pichon-Riviere A, Augustovski F. PNS45 APPLYING A RAPID REVIEW METHODOLOGY TO INFORM THE UPDATE OF ARGENTINA'S HEALTH BENEFIT PACKAGE. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Martínez-López E, Peñalver J, Escriña A, Lara L, Gens MJ, María Dolores E, Alcaraz A, García-Fernández AJ. Trace metals in striped dolphins (Stenella coeruleoalba) stranded along the Murcia coastline, Mediterranean Sea, during the period 2009-2015. Chemosphere 2019; 229:580-588. [PMID: 31100629 DOI: 10.1016/j.chemosphere.2019.04.214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
Mercury (Hg), cadmium (Cd), lead (Pb), selenium (Se) and arsenic (As) concentrations in internal tissues of 72 striped dolphins (Stenella coeruleoalba) from Murcia Region (Mediterranean coastline) have been investigated for the first time. Hg showed the highest concentration, followed by Se, Cd, As and Pb. In general, the levels of metal found in this study were similar to those described in similar studies in the Mediterranean Sea. However, in some adult specimens, Hg liver concentrations were related with toxic effects in cetacean. A significant correlation was observed with age, likewise between Se and Hg and Cd in tissues, which agree with detoxify effect attributed to Se through inert complex formation. Molar ratio Hg:Se in liver was close to 1:1 in some specimens, which would indicate overload of the Hg-Se detoxify function and compromised health. These results could contribute to a better knowledge of the distribution of these persistent pollutants in the Mediterranean Sea.
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Affiliation(s)
- E Martínez-López
- Area of Toxicology, Department of Health Sciences, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain; Laboratory of Toxicology, Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, Spain.
| | - J Peñalver
- Area of Toxicology, Department of Health Sciences, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain; Fisheries and Aquaculture Service (CARM), 30100, Murcia, Spain
| | - A Escriña
- Area of Toxicology, Department of Health Sciences, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - L Lara
- "El Valle" Wildlife Recovery Center (CARM), 30100, Murcia, Spain
| | - M J Gens
- "El Valle" Wildlife Recovery Center (CARM), 30100, Murcia, Spain
| | - E María Dolores
- Fisheries and Aquaculture Service (CARM), 30100, Murcia, Spain
| | - A Alcaraz
- Agrarian and Animal Health Laboratory (CARM), 30100, Murcia, Spain
| | - A J García-Fernández
- Area of Toxicology, Department of Health Sciences, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain; Laboratory of Toxicology, Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, Spain
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Tapia-López E, Bardach A, Ciapponi A, Alcaraz A, García-Perdomo H, Ruvinsky S, Belizán M. Barriers and facilitators for the implementation of interventions to control Aedes aegypti in Latin America and the Caribbean: Qualitative study with in-depth interviews. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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García-Cruz E, Romero-Otero J, Fode M, Alcaraz A. The digital environment in men's sexual disorders: A systematic review. Actas Urol Esp 2018; 42:365-374. [PMID: 29102483 DOI: 10.1016/j.acuro.2017.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 01/23/2023]
Abstract
CONTEXT The revolution of digital technologies constitutes a new setting for the patient-physician relationship and provides patients with a scenario of privacy and universal access to a vast amount of information. However, there is little information on how digital resources are used and what their advantages and disadvantages are. OBJECTIVES To explore the scope of the scientific research on the use of digital technology related to men's sexual disorders and to analyze the primary sources of digital information related to this field. ACQUISITION OF EVIDENCE Systematic searches of the scientific literature, websites (10 first results in each google search) and mobile applications (apps). The searches combined the keywords "web" and "app" with "erectile dysfunction", "premature ejaculation", "Peyronie", "male hypogonadism", and "infertility". Websites and apps were assessed for quality according to predefined indicators. SYNTHESIS OF EVIDENCE The qualitative analysis of the scientific literature included 116 manuscripts; 47% were clinical studies based on online survey, 9% dealt with digital treatments, 11% with quality/safety of digital healthcare environment, 3% with digital activity, 21% with patient empowerment, and 9% with online drug selling. Of 50 websites assessed for quality, 29 (58%) scored 4 or 5 on a 5-point Likert scale. The app search yielded 40 apps; only 3 of them (8%) reported the identity of a health center or healthcare professional involved. CONCLUSIONS Patients and healthcare professionals may benefit from digital resources related to men's sexual disorders; however, a strong commitment by the scientific and healthcare community is essential to increase the quality of these resources.
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Affiliation(s)
- E García-Cruz
- Departmento de Urología, Hospital Plató, Barcelona, España; Departmento de Urología, Hospital Clínic de Barcelona, Barcelona, España; European Association of Urology's Young Academic Urologist's, Men's Health Group member.
| | - J Romero-Otero
- Departmento de Urología, Hospital Universitario 12 de octubre, Madrid, España
| | - M Fode
- Department of Urology, Roskilde Hospital, Roskilde, Dinamarca; Department of Urology, Herlev University Hospital, Herlev, Dinamarca
| | - A Alcaraz
- Departmento de Urología, Hospital Clínic de Barcelona, Barcelona, España
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García-Cruz E, Bretonnet A, Alcaraz A. Testing Smart Glasses in urology: Clinical and surgical potential applications. Actas Urol Esp 2018; 42:207-211. [PMID: 29037757 DOI: 10.1016/j.acuro.2017.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We aimed to explore the potential benefits of using smart glasses - wearable computer optical devices with touch-less command features - in the surgery room and in outpatient care settings in urology. MATERIALS AND METHODS Between April and November 2015, 80 urologists were invited to use Google Glass in their daily surgical and clinical practice, and to share them with other urologists. Participants rated the usefulness of smart glasses on a 10-point scale, and provided insights on their potential benefits in a telephone interview. RESULTS During the testing period, 240 urologists used smart glasses, and the 80 initially invited rated their usefulness. Mean scores for usefulness in the surgery room and in outpatient clinics were 7.4 and 5.4, respectively. The interview revealed that the applications of smart glasses considered most promising in surgery were live video streaming and static image playback, augmented reality, laparoscopic navigation, and digital checklist for safety verification. In outpatient settings, participants considered the glasses useful as a viewing platform for sharing test results, for browsing digital vademecum, and for checking medical records in emergency situations. CONCLUSIONS Urologists engaged in our experience identified various uses of smart glasses with potential benefits for physician's daily practice, particularly in the urological surgery setting. Further quantitative studies are needed to exploit the actual possibilities of smart glasses and address the technical limitations for their safe use in clinical and surgical practice.
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Affiliation(s)
- E García-Cruz
- Departamento de Urología, Hospital Plató, Barcelona, España; Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, España; EAU Young Academic Urologists Men's Health Group, Barcelona, España.
| | - A Bretonnet
- Healthcare Innovation, Soft for You, Barcelona, España
| | - A Alcaraz
- Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, España
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Carrion A, D'Anna M, Costa-Grau M, Luque P, García-Cruz E, Franco A, Alcaraz A. Office stent placement under local anesthesia is a safe and efficient procedure for the management of multiple ureteral disorders. Actas Urol Esp 2018; 42:126-132. [PMID: 29107431 DOI: 10.1016/j.acuro.2017.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/12/2017] [Accepted: 06/13/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the outcomes of ureteral stent placement under local anesthesia for the management of multiple ureteral disorders. METHODS Retrospective study of 45 consecutive ureteral stents placed under local anesthesia from January 2015 to July 2016. Inclusion criteria were hemodynamically stable patients with urinary obstruction, urinary fistula or for prophylactic ureteral localization during surgery. Five minutes before the procedure, 10ml of lidocaine gel and 50ml of lidocaine solution were instilled in the bladder. A 4.8Fr ureteral stent was placed using a 15.5Fr flexible cystoscope under fluoroscopic control. Characteristics of procedures and outcomes were analysed. RESULTS A total of 45 procedures (33 placement, 12 replacements) were attempted in 37 patients, of which 40 (89%) were successful. There were 10 male (27%) and 27 female patients (73%) with a mean age of 58.6 years (±17.5). Main indications for stent placement were stones (37.8%), extrinsic ureteral compression (28.9%) and surgery ureteral localization (22.2%). The reasons for failing to complete a procedure were the inability to pass the guidewire/stent in 4 cases (8.8%) or to identify the ureteral orifice in 1 (2.2%). Postoperative complications occurred in 8 patients (17.8%) (7 Clavien I, 1 Clavien IIIa). No procedure was prematurely terminated due to pain. Statistical analysis did not find significant successful predictors. The outpatient setting provided a fourfold cost decrease. CONCLUSIONS Ureteral stent placement can be safely and effectively performed under local anesthesia in the office cystoscopy room. This procedure could free operating room time, reduce costs and minimize side effects of general anesthesia.
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Affiliation(s)
- A Carrion
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España.
| | - M D'Anna
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - M Costa-Grau
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - P Luque
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - E García-Cruz
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - A Franco
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - A Alcaraz
- Departamento de Urología, Hospital Clinic, Universidad de Barcelona, Barcelona, España
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García-Cruz E, Carrión A, Ajami T, Álvarez M, Correas MÁ, García B, García JV, González C, Portillo JA, Romero-Otero J, Simón C, Torremadé J, Vigués F, Alcaraz A. The Patient's Comorbidity Burden Correlates with the Erectile Dysfunction Severity. Actas Urol Esp 2018. [PMID: 28641871 DOI: 10.1016/j.acuro.2017.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To explore the potential relationship between erectile dysfunction (ED), low testosterone levels, and the Charlson Comorbidity Index (CCI). MATERIAL AND METHODS Cross-sectional study on patients referred to the andrology unit in 7 Spanish centers. The ED was diagnosed and graded using the International Index of Erectile Function (IIEF-5) score. Total testosterone, the prevalence of each comorbidity, and the CCI were compared between patients with different grades of ED. Besides, the correlation between total testosterone and the CCI score, the influence of each comorbidity, and the ED severity on the CCI was assessed in a multiple linear regression. RESULTS The study included 430 men with a mean age of 61 years. The mean CCI was 3.5, and mean total testosterone 15.2 nmol/L; 389 (91%) subjects had some grade of ED: 97 (23%) mild, 149 (35%) mild-to-moderate, 86 (20%) moderate, and 57 (13%) severe. The increase in ED severity was significantly associated with a decrease in total testosterone (P=.002), and an increase in the CCI score (P<.001). Testosterone levels were significantly lower in patients with obesity, diabetes, hypercholesterolemia, and hypertriglyceridemia (P<.05). However, only the prevalence of diabetes and hypertension was significantly associated with the severity of ED. The multivariate analysis including variables related to all assessed comorbidities, total testosterone levels, and the DE severity significantly predicted the CCI score (P<.001, R2=.426). The severity of ED significantly contributed to this model (P=.011), but total testosterone did not (P=.204). CONCLUSIONS The CCI is significantly associated with the ED severity, but it shows a weak correlation with the testosterone levels.
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Affiliation(s)
- E García-Cruz
- Departamento de Urología, Hospital Plató, Barcelona, España; Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España.
| | - A Carrión
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
| | - T Ajami
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
| | - M Álvarez
- Deparatmento de Urología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M Á Correas
- Departamento de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - B García
- Unidad de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - J V García
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - C González
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - J A Portillo
- Departamento de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J Romero-Otero
- Unidad de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - C Simón
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - J Torremadé
- Departamento de Urología, Hospital de Bellvitge, Barcelona, España
| | - F Vigués
- Departamento de Urología, Hospital de Bellvitge, Barcelona, España
| | - A Alcaraz
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
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Gómez-Veiga F, Rodríguez-Antolín A, Miñana B, Hernández C, Suárez J, Fernández-Gómez J, Unda M, Burgos J, Alcaraz A, Rodríguez P, Medina R, Castiñeiras J, Moreno C, Pedrosa E, Cózar J. Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study - GESCAP group. Actas Urol Esp 2017; 41:359-367. [PMID: 28285790 DOI: 10.1016/j.acuro.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the adherence to European Association of Urology (EAU) guidelines in the management of prostate cancer (PCa) in Spain. PATIENTS AND METHODS Epidemiological, population-based, study including a national representative sample of 3,918 incident patients with histopathological confirmation during 2010; 95% of the patient's sample was followed up for at least one year. Diagnosis along with treatment related variables (for localized PCa -low, intermediate, high and locally-advanced by D'Amico risk stratification) was recorded. Differences between groups were tested with Chi-squared and Kruskal-Wallis tests. RESULTS Mean (SD) age of PCa patients was 68.48 (8.18). Regarding diagnostic by biopsy procedures, 64.56% of all patients had 8-12 cores in first biopsy and 46.5% of the patients over 75 years, with PSA<10ng/mL were biopsied. Staging by Computer Tomography (CT) or Bone Scan (BS) was used for determining tumor extension in 60.09% of high-risk cases and was applied differentially depending on patients' age; 3,293 (84.05%) patients received a treatment for localized PCa. Radical prostatectomy was done in 1,277 patients and 206 out of these patients also had a lymphadenectomy, being 4.64% low-risk, 22.81% intermediate-risk and 36.00% high-risk patients; 86.08% of 1,082 patients who had radiotherapy were treated with 3D or IMRT and 35.77% received a dose ≥75Gy; 419 patients were treated with brachytherapy (BT): 54.81% were low-risk patients, 22.84% intermediate-risk and 12.98% high-risk. Hormonotherapy (HT, n=521) was applied as single therapy in 9.46% of low-risk and 17.92% of intermediate-risk patients. Additionally, HT was combined with RT in 14.34% of lower-risk patients and 58.26% of high-risk patients, and 67.19% low-intermediate risk with RT and/or BT received neoadjuvant/concomitant/adjuvant HT. Finally, 83.75% of high-risk patients undergoing RT and/or BT also received HT. CONCLUSIONS Although EAU guidelines for PCa management are easily available in Europe, the adherence to their recommendations is low, finding the highest discrepancies in the need for a prostate biopsy and the diagnostic methods. Improve information and educational programs could allow a higher adherence to the guidelines and reduce the variability in daily practice. (Controlled-trials.com: ISRCTN19893319).
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Miñana B, Rodríguez-Antolín A, Gómez-Veiga F, Hernández C, Suárez JF, Fernández-Gómez JM, Unda M, Burgos J, Alcaraz A, Rodríguez P, Moreno C, Pedrosa E, Cózar JM. Treatment trends for clinically localised prostate cancer. National population analysis: GESCAP group. Actas Urol Esp 2016; 40:209-16. [PMID: 26723895 DOI: 10.1016/j.acuro.2015.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/27/2015] [Accepted: 09/28/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the established therapies for localised prostate cancer (PC) in Spain and to assess compliance with the 2010 UAE guidelines. PATIENTS AND METHODS This was an epidemiological, observational, prospective and multicentre study. Of the 3,918 patients diagnosed with PC during 2010, only those patients with localised PC were included. Follow-up was ultimately conducted for a minimum of one year from the diagnosis for 3,713 patients (94.77%). The treatment groups assessed were as follows: radical prostatectomy, radiation therapy, hormone therapy, brachytherapy, active surveillance or observation and experimental local treatment (cryotherapy or other treatment). Compliance with the recommendations of the EAU guidelines was studied, describing the treatment groups according to D'Amico risk stratification criteria (localised [low, intermediate and high risk] and locally advanced), age, PSA and Gleason score. RESULTS By applying the D'Amico criteria, we included 3,641 (92.93%) patients. Based on the UAE recommendations: 1) 68.87% of the patients at low-intermediate risk aged≤65 years underwent radical prostatectomy; 2) 34.51% of the patients>65 years at high risk with locally advanced disease were administered radiation therapy and hormone therapy; 3) 30.36% of the patients at high risk with locally advanced disease were only treated with hormone therapy; 4) 15.20% of the patients at low risk were only treated with brachytherapy; 5) active surveillance or observation was selected for 2.44% of the patients aged≤65 years and for 10.63% of the patients at low-intermediate risk who were>65 years. Lastly, 86.5% of the patients at low risk underwent a single treatment, and 43.62% of the patients at high risk with locally advanced disease underwent combined treatments. CONCLUSIONS This is the first national European study to evaluate the therapeutic management of localised PC based on the risk group to which the patient belonged. Most young patients (≤65 years) with low-intermediate risk localised PC were treated with surgery, which adheres to the recommendations of the 2010 UAE guidelines. Various therapeutic combinations have been employed for patients with high-risk, locally advanced localised tumours, revealing the need for a multidisciplinary approach (Controlled-trials.com number: ISRCTN19893319).
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Affiliation(s)
- B Miñana
- Departamento de Urología, Hospital Morales Meseguer, Murcia, España; Cátedra de Urología, Universidad Católica San Antonio (UCAM), Murcia, España.
| | | | - F Gómez-Veiga
- Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | | | - J F Suárez
- Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | | | - M Unda
- Hospital de Basurto, Bilbao, Vizcaya, España
| | - J Burgos
- Hospital Ramón y Cajal, Madrid, España
| | - A Alcaraz
- Hospital Clínic i Provincial, Barcelona, España
| | - P Rodríguez
- Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - C Moreno
- Departamento Médico, Astellas Pharma S. A., Madrid, España
| | - E Pedrosa
- Departamento Médico, Astellas Pharma S. A., Madrid, España
| | - J M Cózar
- Hospital Virgen de las Nieves, Granada, España
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Vilaseca A, Musquera M, Nguyen D, Di Paola G, Romeo L, Melnick A, García-Cruz E, Ribal M, Huguet J, Alcaraz A. Changing patterns in the surgical management of renal masses. Actas Urol Esp 2016; 40:148-54. [PMID: 26687094 DOI: 10.1016/j.acuro.2015.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 08/07/2015] [Accepted: 08/08/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To describe the temporal trends in surgical techniques for the management of renal masses at a single Spanish academic institution and identify factors associated with partial nephrectomy (PN) decision. MATERIALS AND METHODS A total of 646 patients were treated by surgery for clinically localised renal masses from January 2004 to December 2012 at a tertiary referral center. Surgical techniques included open radical nephrectomy (RN), open PN, laparoscopic RN, and laparoscopic PN. Descriptive statistics were used to compare baseline characteristics and proportions of patients treated by different surgical techniques. Annual trends in the proportion of procedures performed were determined. Adjusted odds ratios (OR) and 95% confidence intervals were calculated to evaluate clinical variables predictive of PN. RESULTS During the 9-year study period, the proportion of PN relative to RN increased from 21% to 55%. With regard to surgical approach, open procedures for both RN and PN decreased gradually in favor of minimally invasive approaches (83% in 2004 to 4% in 2011-2012). While median tumor size did not significantly change over the study period, laparoscopic PN became the most commonly performed kidney procedure in 2011-2012 (49% of all procedures). Clinical variables independently predictive of partial nephrectomy were ASA score, baseline renal function and tumor size (all P<.05). CONCLUSIONS At our academic institution, temporal trends in the management of renal masses have established PN as the most common surgical option. Although PN was increasingly used over the study period, a parallel increase in minimally invasive approaches for RN and PN was seen.
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Mateu L, García-Cruz E, Asiaín I, Castañeda R, Carrión A, Huguet J, Ribal M, Alcaraz A. A higher Charlson comorbidity index is related to more aggressive characteristics in de novo vesical tumours. Actas Urol Esp 2016; 40:23-8. [PMID: 26231864 DOI: 10.1016/j.acuro.2015.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To analyze the relationship between the age--adjusted Charlson Comorbidity Index (aCCI) and pathological outcomes of transurethral resection of de novo bladder tumours (BT). MATERIAL AND METHODS Data from 208 patients who underwent a transurethral resection (TUR) of a de novo BT between 2007 and 2008 were collected. We recorded the following variables: age, sex, tobacco consumption, comorbidities assessed according to the ICCa (score and mortality rate), disease stage, tumour grade and risk of recurrence and progression. The relationship between the preoperative variables and the final pathological characteristics was analyzed. The multivariate study was conducted with the significant variables (P<.05) from the univariate analysis. RESULTS The mean age of the patients was 69.5 ± 12 years, and 77% were men. The mean ICCa was 6.4 ± 2.5. The final pathology results showed a Tx, T0, Ta, T1 and T ≥ 2 in 5.3, 6.7, 31.7, 26.9, and 28.8% of the cases, respectively. 33.3% of the tumours were low-grade and 66.7% were high-grade. 14.3% of the tumours were associated with carcinoma in situ. Among those non musculo-invasive bladder tumour (non-MIBT), 34.7% had a low risk of recurrence and progression, 18.1% had an intermediate risk and 47.2% had a high risk. The patients with a ICCa ≥ 5 had an increased number of MIBT (RR: 2.29; 1.1-4.8; P=.032), high-grade tumours (RR: 3.1; CI: 1.6-6; P=.001) and tumours with a high risk of recurrence and progression (RR: 2.9; CI: 1.4-5.9; P<.001). CONCLUSION The ICCa is related to the pathological characteristics of de novo BT. Patients with greater comorbidity can present more aggressive tumours. The ICCa could therefore be useful in clinical practice for identifying patients with worse prognosis.
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Mateu L, Huguet J, Carrión A, García-Cruz E, Izquierdo L, Musquera M, Ribal M, Alcaraz A. Predictors, pathological characteristics and outcomes of bladder recurrences following nephroureterectomy. Actas Urol Esp 2015; 39:488-93. [PMID: 25881516 DOI: 10.1016/j.acuro.2015.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To analyze the predictors for bladder recurrence (BR) after nephroureterectomy (NU) for upper urinary tract tumors (UUTT), as well as its pathological characteristics, outcomes and impact on survival. MATERIAL AND METHODS Retrospective study of 117 patients who underwent laparoscopic nephroureterectomy by UUTT between 2007-2012 at our center. The potential predictors for BR were analyzed using Cox regression; Kaplan-Meier curves were employed to study survival. RESULTS The sample was composed of 85 men (73%) and 32 women (27%), with a mean age of 70 years. After a mean follow-up of 26 months, 23 patients presented BR (19.6%). In the multivariate analysis, sex (p=.003; HR [female], 3.8) and the location of the UUTT in the distal ureter (p=.002; HR, 4.8) were independent predictors for BR. The median time to BR was 8 months. Fifteen patients presented a nonmuscle-invasive BR (65.2%), and 8 presented a muscle-invasive BR (34.8%). All BRs, except for 2, appeared during the first 2 years. Five cases with nonmuscle-invasive BR presented a new BR. Six patients with muscle-invasive BR died before it could be determined whether cause of death was the BR or an UUTT relapse. The onset of BR showed no repercussion on the survival of patients with UUTT. CONCLUSIONS Sex (female) and the location of the UUTT (distal ureter) are predictors for BR after NU. Patients with these characteristics might benefit from adjuvant intravesical treatment and closer monitoring. The onset for RV has no impact on the survival of patients with UUTT.
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Vendrell M, Hessheimer AJ, Ruiz A, de Sousa E, Paredes D, Rodríguez C, Saavedra S, Fuster J, Alcaraz A, Oppenheimer F, Taurá P, García-Valdecasas JC, Fondevila C. Coagulation profiles of unexpected DCDD donors do not indicate a role for exogenous fibrinolysis. Am J Transplant 2015; 15:764-71. [PMID: 25655040 DOI: 10.1111/ajt.13058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/08/2014] [Accepted: 10/11/2014] [Indexed: 01/25/2023]
Abstract
It has been suggested that vascular stasis during cardio-circulatory arrest leads to the formation of microvascular thrombi and the viability of organs arising from donation after circulatory determination of death (DCDD) donors may be improved through the application of fibrinolytic therapy. Our aim was to comprehensively study the coagulation profiles of Maastricht category II DCDD donors in order to determine the presence of coagulation abnormalities that could benefit from fibrinolytic therapy. Whole blood from potential DCDD donors suffering out-of-hospital cardiac arrest was sampled after declaration of death in the emergency department, and rotational thromboelastomeric analysis was performed. Between July 2012 and December 2013, samples from 33 potential DCDD donors were analyzed. All patients demonstrated hyperfibrinolysis (HF), as reflected by maximum clot lysis of 98-100% in all cases, indicating that there is no role for additional fibrinolytic therapy in this setting. As well, we observed correlations between thromboelastomeric lysis parameters and maximum hepatic transaminase levels measured in potential donors and renal artery flows measured during ex situ hypothermic oxygenated machine perfusion, indicating that further studies on the utility of thromboelastometry to evaluate organ injury and perhaps even viability in unexpected DCDD may be warranted.
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Affiliation(s)
- M Vendrell
- Anesthesiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
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Miñana B, Cózar JM, Alcaraz A, Morote J, Gómez-Veiga FJ, Solsona E, Rodríguez-Antolín A, Carballido J. Bone health in patients with prostate cancer. Actas Urol Esp 2014; 38:685-93. [PMID: 24934457 DOI: 10.1016/j.acuro.2014.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022]
Abstract
CONTEXT In patients with prostate cancer, bone health is compromised by advanced age at diagnosis, androgen suppression treatments and the developmentofbone metastases. In this paper the medical literature is reviewed in order to update the state of the art on their incidence, prevention and management. EVIDENCE ACQUISITION A literature review about bone involvement in patients with prostate cancer in different clinical settings is performed. SYNTHESIS OF THE EVIDENCE Decreased bone mineral density is higher in patients diagnosed of prostate cancer before starting treatment than in healthy men with the same age. During the first year of treatment, a severe loss bone density is reported due to androgen suppression therapy. From then on, loss bone density seems to slow down, persisting at long-term. It is important to know the starting point and the dynamics of loss bone in order to prevent its progression. The skeletal events have an important impact on quality of life in patients with prostate cancer. Both Denosumab and Zoledronic Acid have proven effective in reducing loss bone. CONCLUSIONS The prevention and management of bone involvement in patients with prostate cancer is critical to quality of life in these patients and requires an individualized approach. Before starting a prolonged androgen deprivation, baseline risk of fracture should be evaluated in order to adopt the proper protective measures. In patients with metastases, early treatments reducing the risk of bone events should be taken into account.
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Affiliation(s)
- B Miñana
- Servicio de Urología, Hospital Morales Meseguer, Universidad Católica San Antonio, UCAM, Murcia, España.
| | - J M Cózar
- Servicio de Urología, Hospital Virgen de las Nieves, Granada, España
| | - A Alcaraz
- Servicio de Urología, Hospital Clínic, Barcelona, España
| | - J Morote
- Servicio de Urología, Hospital Vall de Hebrón, Barcelona, España
| | | | - E Solsona
- Servicio de Urología, IVO, Valencia, España
| | | | - J Carballido
- Servicio de Urología, Hospital Puerta de Hierro, Madrid, España
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de Haro Jorge I, García-Aparicio L, Vila-Santandreu A, Martín Solé O, Musquera M, Peri L, Alvarez-Vijande R, Alcaraz A. [Kidney transplantation in children weighing 11 kg or less]. Cir Pediatr 2014; 27:131-134. [PMID: 25845102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIMS OF THE STUDY To evaluate the outcome of kidney transplantation in children with low weight. METHODS Retrospective review of the medical records of patients weighing 11 kg or less that received kidney transplantation between 2001 and 2013 were retrospectively reviewed. RESULTS Fifty-nine kidney transplantations were performed in pediatric patients in our center, 12 of them were performed in patients weighing 11 kg or less (20%). The mean age of the recipient at the time of transplantation was 2 years (1-3.5); the mean weight was 9.4 ± 1.1 kg (8.3-11). The etiology of kidney failure was malformative in 42% of patients, inherited in 33%, glomerular in 8% and oiler etiologies in 17% of the patients. Two patients did not receive replacement therapy before transplantation (16.7%), nine received peritoneal dialysis (75%) and one of them hemodialysis (8.3%). Eleven of the grafts were from cadaveric donor (91.7%) and one of them from a living donor (8.3%). The mean donor age was 10 years (0.5-29). There was one case of acute graft thrombosis (8.3%) and one case of eventration requiring reoperation; there were no other major complications. Mean follow-up was 59 months (4-130). Overall survival (OS) was 100% at 1 year and 91.7% at 5 years. There was one death in a patient with mitochondrial disease with a functioning graft. Graft survival (GS) was 92% at 1 year and 75% at 5 years. CONCLUSION Kidney transplantation is the treatment of choice for end-stage kidney failure in the young child. It provides good results in terms of patient and graft survival.
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Mengual L, Ars E, Lozano J, Burset M, Izquierdo L, Ingelmo-Torres M, Gaya J, Algaba F, Villavicencio H, Ribal M, Alcaraz A. Gene expression profiles in prostate cancer: identification of candidate non-invasive diagnostic markers. Actas Urol Esp 2014; 38:143-9. [PMID: 24206626 DOI: 10.1016/j.acuro.2013.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyze gene expression profiles of prostate cancer (PCa) with the aim of determining the relevant differentially expressed genes and subsequently ascertain whether this differential expression is maintained in post-prostatic massage (PPM) urine samples. MATERIAL AND METHODS Forty-six tissue specimens (36 from PCa patients and 10 controls) and 158 urine PPM-urines (113 from PCa patients and 45 controls) were collected between December 2003 and May 2007. DNA microarrays were used to identify genes differentially expressed between tumour and control samples. Ten genes were technically validated in the same tissue samples by quantitative RT-PCR (RT-qPCR). Forty two selected differentially expressed genes were validated in an independent set of PPM-urines by qRT-PCR. RESULTS Multidimensional scaling plot according to the expression of all the microarray genes showed a clear distinction between control and tumour samples. A total of 1047 differentially expressed genes (FDR≤.1) were indentified between both groups of samples. We found a high correlation in the comparison of microarray and RT-qPCR gene expression levels (r=.928, P<.001). Thirteen genes maintained the same fold change direction when analyzed in PPM-urine samples and in four of them (HOXC6, PCA3, PDK4 and TMPRSS2-ERG), these differences were statistically significant (P<.05). CONCLUSION The analysis of PCa by DNA microarrays provides new putative mRNA markers for PCa diagnosis that, with caution, can be extrapolated to PPM-urines.
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Vilaseca A, García-Cruz E, Ribal M, Pérez Márquez M, Alcaraz A. Erectile function after cystectomy with neurovascular preservation. Actas Urol Esp 2013; 37:554-9. [PMID: 23790714 DOI: 10.1016/j.acuro.2013.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 02/12/2013] [Accepted: 02/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To study the utility of neurovascular preservation for postoperative erection in radical cystectomy. MATERIALS AND METHODS Retrospective analysis of 44 cystectomies performed at our center between January 2006-December 2009 in men <65 years. In 11 cases a neurovascular preservation was done. We analyzed age, BMI, indication for surgery, urinary diversion, use of i-PDE5 or alprostadil, and daytime and nighttime continence. Erection Hardness Score (EHS) was used to assess erectile function. RESULTS Spontaneous postoperative erectile function in preservation group was 44,4% EHS 4, 33,3% EHS 3 and 22,3% EHS 1 (achieving EHS 3 or 4 with alprostadil). In the non preservation group, 4,5% achieved EHS 4 spontaneously. The other 95,5% had EHS 0 (4,5% achieved EHS 3 with tadalafil 20 mg and 9% with intracavernous injections). Variables age (P=.001) and nerve-sparing surgery (P<.001) were related to postoperative erectile function recovery. In the multivariate analysis, nerve-sparing surgery remained statisticaly significant. CONCLUSIONS The functional results in preserving cystectomy are promising. The preservation should be considered in young patients without erectile dysfunction.
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García-Cruz E, Castañeda-Argáiz R, Carrión A, Alcover J, Sallent A, Leibar-Tamayo A, Romero-Otero J, Alcaraz A. Preoperative hormonal pattern in patients undergoing radical prostatectomy due to prostate cancer. Actas Urol Esp 2013; 37:280-5. [PMID: 23246101 DOI: 10.1016/j.acuro.2012.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/02/2012] [Accepted: 08/07/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There is controversial evidence regarding preoperative testosterone (T) levels related to poor prognosis factors after radical prostatectomy (RP). The aim of this manuscript is to determine the relationship between preoperative T levels and final pathologic report together to biochemical recurrence after RP. MATERIALS AND METHODS We prospectively analysed 143 patients submitted to RP from February 2008 to June 2010 in our centre. Pretreatment T and sex hormone-binding globulin levels were determined as part of our clinical protocol. Free calculated (fT) and bioavailable (bioT) T were calculated using Vermeulen's formula. Low T levels were defined as 346 ng/dL or less. A comparative analysis with variables pTNM, positive margins, tumour burden, Gleason score, multifocality and biochemical recurrence (using both PSA>0.4 ng/dL and PSA>0.2 ng/dL as cut-off values) was performed, according to preoperative levels of T. RESULTS Variables Gleason score, rate and number of positive margins, tumour burden, tumour multifocality, time to biochemical recurrence and pathological stage were not related to preoperative hormonal levels. Preoperative T<346 ng/dL was not found to be related to PSA recurrence (PSA>0,4 ng/dL log-rank, P=.512), although a trend was observed when PSA>0,2 ng/dL (log-rank, P=.097). CONCLUSION Preoperative T levels were not related to final pathological report or to biochemical recurrence.
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Affiliation(s)
- E García-Cruz
- Departamento de Urología, Hospital Clínic, Barcelona, España.
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Ciudin A, Musquera M, Huguet J, Peri L, Alvarez-Vijande J, Ribal M, Alcaraz A. Transposition of Iliac Vessels in Implantation of Right Living Donor Kidneys. Transplant Proc 2012. [DOI: 10.1016/j.transproceed.2012.07.143] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cózar JM, Solsona E, Morote J, Miñana B, Maroto JP, González Del Alba A, Climent MA, Carles J, Alcaraz A, Castellano D. [Recomendations on the management of controversies in advanced castrate-resistant prostate cancer]. Actas Urol Esp 2012; 36:569-77. [PMID: 22999347 DOI: 10.1016/j.acuro.2012.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 06/30/2012] [Indexed: 11/17/2022]
Abstract
CONTEXT Controversies and uncertainties among integral management of advanced castration resistant prostate cancer continue to exist despite the number of evidence based clinical practice guidelines published with high international consensus. OBJECTIVE To develop a document that reviews the management of controversies in advanced castration resistant prostate cancer, with recommendations from the definition, to the management in hormonal maneuvers, first-line treatment and second-line with new treatments as cabazitaxel or abirarerone and the multidisciplinary approach of the pathology with the goal of finding the most efficient, best time to act and safety. EVIDENCE ACQUISITION Two meetings of a multidisciplinary group of experts involved in the management of this disease (Oncologist and Urologist) where pooled analysis of original literature and reached consensus document of recommendations on castration resistant prostate cancer, reviewing and attempting to address the current controversies of the disease. EVIDENCE SYNTHESIS This document is endorsed by the corresponding Scientific Associations and Working Groups involved in the current management of Genitourinary Tumours: the Spanish Association of Urology (AEU) with the Uro-Oncoloy Group (GUO) and the Spanish Oncology of Genitourinary Group (SOGUG). CONCLUSIONS With the adaptation and implementation of this Document of Recommendations for clinical practice are available for the first time, a real road map for quality, efficiency and safety in the management of patients with CRPC.
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Affiliation(s)
- J M Cózar
- Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España.
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Bellmunt J, De Piedra CL, Esteban E, Climent M, González B, Álvarez-Ossorio J, Gonzalez IC, Mellado B, Lara P, Alcaraz A. Bone Turnover Markers and Potential Correlation with Outcomes in Patients with Genitourinary Cancer (Renal and Bladder) and Bone Metastasis (Results of the Tugamo Study). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33373-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Alcaraz A, Medina R, Maroto P, Climent M, Castellano D, Carles J. [Castration-resistant prostate cancer: where are we going?]. Actas Urol Esp 2012; 36:367-74. [PMID: 22188754 DOI: 10.1016/j.acuro.2011.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 10/17/2011] [Accepted: 10/17/2011] [Indexed: 10/28/2022]
Abstract
CONTEXT Hormonal therapy allows effective control of cancer-related symptoms in advanced stages. However, the disease will progress in almost all these metastatic prostate cancer patient until becoming resistant to androgen suppression. The emergence of new drugs will most probably have open up new expectations regarding the treatment of this cancer. OBJECTIVE The aim of the present review has been to provide an overview of the current status of castration-resistant prostate cancer and to share the high expectations created with the new treatments. EVIDENCE ACQUISITION Evidence was obtained from multidisciplinary meetings with the participation of urologists and oncologists, where they pooled the analysis of original articles in the literature and defined the content of the article. EVIDENCE SYNTHESIS Chemotherapy with docetaxel was a turning point in castration-resistant prostate cancer after the failure of hormonal therapy failure. For the first time, it achieved increased survival time in comparison with mitoxantrone and prednisone. Combination therapy with docetaxel and prednisone is the first-line choice treatment. Once the cancer has progressed, there is no clear alternative, although some novel agents have created expectations for the treatment of this type of cancer. CONCLUSIONS The range of therapeutic options for castration-resistant prostate cancer has increased dramatically with the arrival of new drugs. At present, cabazitaxel, and in the near future, abiraterone, have been found to be effective drugs in second-line treatment after progression to docetaxel, increasing survival by 2-4 months and reducing risk of death by 30-35%.
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García-Cruz E, Piqueras M, Gosálbez D, Pérez-Márquez M, Peri L, Izquierdo L, Franco A, Luque P, Corral J, Alvarez-Vijande R, Alcaraz A. [Erectile dysfunction and its severity are related to the number of cardiovascular risk factors]. Actas Urol Esp 2012; 36:291-5. [PMID: 22266257 DOI: 10.1016/j.acuro.2011.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 11/28/2011] [Accepted: 11/29/2011] [Indexed: 10/28/2022]
Abstract
AIM Erectile dysfunction (ED) is a very common condition in the general population. ED is closely related to Hypertension (HT), Diabetes Mellitus (DM), Dyslipidemia (DLP) and Metabolic Syndrome (MS). This study has aimed to clarify whether the presence and severity of ED are related to the presence and number of cardiovascular risk factors (CVRF). MATERIAL AND METHODS We retrospectively analyzed the characteristics of 242 males referred to our center for a prostate biopsy from September 2007 to December 2009. The following variables were collected prospectively: age, height, weight, body mass index (BMI), AHT, DM, DLP and obesity (BMI<30 kg/m(2)). The Erection Hardness Score Questionnaire was used to assess erectile function. We analyzed the relation between the presence and severity of ED and the presence of HT, DM, DLP and obesity. We analyzed the clinical variables based on the presence or absence of ED and in relationship to its severity. RESULTS The presence of ED was related to HT (OR: 1.805 [1.128-2.887]; p=0.013), DM (OR 3.585 [1.613-7.966]; p=0.001) and Dyslipidemia (OR: 1.928 [1.062-3.500]; p=0.029). Erectile function was not related to Obesity (OR: 0.929 [0.522-1.632]; p=0.795). Patients with ED were more likely to have more CVRF (p=0.009) and the severity of ED was related to the presence of HT (p<0.001), DM (p<0.001), DLP (p=0.001) and the number of CVRF (p<0.001). CONCLUSIONS The presence and severity of ED correlate with the presence of HT, DM, Dyslipidemia and the number of DVRF.
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