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Sarcan S, Wolff I, Lusuardi L, Kravchuk A, Wiegland J, Yakac A, Thomas C, Burger M, Gilfrich C, Lebentrau S, Ahyai S, Merseburger A, May M. The landscape of penile cancer research in Germany and Austria: a survey among professors in academic centers holding chair positions and results of a literature search. World J Urol 2024; 42:12. [PMID: 38189947 DOI: 10.1007/s00345-023-04719-y] [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: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Research on penile cancer (PeCa) is predominantly conducted in countries with centralized treatment of PeCa-patients. In Germany and Austria (G + A), no state-regulated centralization is established, and no information is available on how PeCa-research is organized. METHODS Current research competence in PeCa was assessed by a 36-item questionnaire sent to all chairholders of urological academic centers in G + A. Based on PubMed records, all scientific PeCa-articles of 2012-2022 from G + A were identified. Current research trends were assessed by dividing the literature search into two periods (P1: 2012-2017, P2: 2018-2022). A bibliometric analysis was supplemented. RESULTS Response rate of the questionnaire was 75%, a median of 13 (IQR: 9-26) PeCa-patients/center was observed in 2021. Retrospective case series were conducted by 38.9% of participating clinics, while involvement in randomized-controlled trials was stated in 8.3% and in basic/fundamental research in 19.4%. 77.8% declared an interest in future multicenter projects. 205 PeCa-articles were identified [median impact factor: 2.77 (IQR: 0.90-4.37)]. Compared to P1, P2 showed a significant increase in the median annual publication count (29 (IQR: 13-17) vs. 15 (IQR: 19-29), p < 0.001), in multicenter studies (79.1% vs. 63.6%, p = 0.018), and in multinational studies (53% vs. 28.9%, p < 0.001); the proportion of basic/fundamental research articles significantly declined (16.5% vs. 28.9%, p = 0.041). Four of the top-5 institutions publishing PeCa-articles are academic centers. Bibliometric analyses revealed author networks, primary research areas in PeCa, and dominant journals for publications. CONCLUSIONS Given the lack of centralization in G + A, this analysis highlights the need for research coordination within multicenter PeCa-projects. The decline in basic/fundamental research should be effectively addressed by the allocation of funded research projects.
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Affiliation(s)
- Semih Sarcan
- Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Ingmar Wolff
- Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Lukas Lusuardi
- Department of Urology and Andrology, Paracelsus Medical University, Salzburg, Austria
| | - Anton Kravchuk
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Jens Wiegland
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Abdulbaki Yakac
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Maximilian Burger
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany
| | - Christian Gilfrich
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Steffen Lebentrau
- Department of Urology, Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
- Department of Urology, Werner Forssmann Hospital, Eberswalde, Germany
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Matthias May
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany.
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Gomez Rivas J, Nicoletti R, Ibáñez L, Steinbeisser C, de Meulder B, Golozar A, Axelsson SE, Snijder R, Bjartell A, Cornford P, Van Hemelrijck M, Beyer K, Willemse PP, Murtola T, Roobol MJ, Moreno-Sierra J, Campi R, Gacci M, Mottet N, Merseburger A, Ndow J. Research protocol to identify progression and death amongst patients with metastatic hormone-sensitive prostate cancer treated with available treatments: PIONEER IMI's "big data for better outcomes" program. Int J Surg Protoc 2023; 27:122-129. [PMID: 38046899 PMCID: PMC10688536 DOI: 10.1097/sp9.0000000000000009] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/24/2023] [Indexed: 12/05/2023] Open
Abstract
Androgen deprivation therapy-based with or without first-generation anti-androgens, was the standard of care for patients with metastatic hormone-sensitive prostate cancer (mHSPC) for decades. However, the development of docetaxel chemotherapy and new androgen receptor-targeted agents, abiraterone acetate and prednisolone, apalutamide , enzalutamide and darolutamide (in combination with docetaxel chemotherapy) has proven that combination of treatments is more effective. Recently, intensification therapy, so-called "triplets", have emerged in the armamentarium of mHSPC treatment. Metastatic disease is a clinical state that remains poorly understood. The optimal diagnostic and management of patients with mHSPC are changing thanks to the development of new imaging techniques and therapies. The primary objective of this study is to develop and validate a predictive model for the occurrence of symptomatic progression, initiation of new treatments and death amongst patients with mHSPC treated with one of the approved treatment plans, on characteristics present at admission.
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Affiliation(s)
- Juan Gomez Rivas
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain
| | - Rossella Nicoletti
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Laura Ibáñez
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Bertrand de Meulder
- European Institute for Systems Biology and Medicine, CIRI UMR5308, CNRS-ENS-UCBL-INSERM, Lyon
| | - Asieh Golozar
- Regeneron Pharmaceuticals, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | | | | | | | | | - Peter-Paul Willemse
- Department of Urology, Cancer Center University Medical Center Utrecht, Utrecht
| | - Teemu Murtola
- Department of Urology, Tampere University Hospital, Tampere, Finland; Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
| | | | | | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Nicolas Mottet
- Department of Urology, Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | - Axel Merseburger
- University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - James Ndow
- Department of Urology, University of Aberdeen, Aberdeen, Scotland
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3
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Hadaschik B, Merseburger A. [Metastatic castration-resistant prostate cancer: practical guidance for personalized decision-making]. Urologie 2023; 62:1267-1268. [PMID: 38055026 DOI: 10.1007/s00120-023-02224-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Boris Hadaschik
- Klinik für Urologie, Universitätsklinikum Essen (AöR), Hufelandstr. 55, 45147, Essen, Deutschland.
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
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4
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Bamias A, Stenzl A, Brown SL, Albiges L, Babjuk M, Birtle A, Briganti A, Burger M, Choudhury A, Colecchia M, De Santis M, Fanti S, Fonteyne V, Gallucci M, Rivas JG, Huddart R, Junker K, Kroeze S, Loriot Y, Merseburger A, Montironi R, Necchi A, Oing C, Oldenburg J, Ost P, Pinkawa M, Ribal MJ, Rouprêt M, Thoeny H, Zilli T, Hoskin P. Definition and Diagnosis of Oligometastatic Bladder Cancer: A Delphi Consensus Study Endorsed by the European Association of Urology, European Society for Radiotherapy and Oncology, and European Society of Medical Oncology Genitourinary Faculty. Eur Urol 2023; 84:381-389. [PMID: 37217391 DOI: 10.1016/j.eururo.2023.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/01/2023] [Revised: 04/15/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND In contrast to other cancers, the concept of oligometastatic disease (OMD) has not been investigated in bladder cancer (BC). OBJECTIVE To develop an acceptable definition, classification, and staging recommendations for oligometastatic BC (OMBC) spanning the issues of patient selection and the roles of systemic therapy and ablative local therapy. DESIGN, SETTING, AND PARTICIPANTS A European consensus group of 29 experts, led by the European Association of Urology (EAU), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Medical Oncology (ESMO), and including members from all other relevant European societies, was established. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A modified Delphi method was used. A systematic review was used to build consensus questions. Consensus statements were extracted from two consecutive surveys. The statements were formulated during two consensus meetings. Agreement levels were measured to determine if consensus was achieved (≥75% agreement). RESULTS AND LIMITATIONS The first survey included 14 questions and the second survey had 12. Owing to a considerable lack of evidence, which was the major limitation, definition was limited in the context of de novo OMBC, which was further classified as synchronous OMD, oligorecurrence, and oligoprogression. A maximum of three metastatic sites, all resectable or amenable to stereotactic therapy, was proposed as the definition of OMBC. Pelvic lymph nodes represented the only "organ" not included in the definition of OMBC. For staging, no consensus on the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography was reached. A favourable response to systemic treatment was proposed as the criterion for selection of patients for metastasis-directed therapy. CONCLUSIONS A consensus statement on the definition and staging of OMBC has been formulated. This statement will help to standardise inclusion criteria in future trials, potentiate research on aspects of OMBC for which consensus was not achieved, and hopefully will lead to the development of guidelines on optimal management of OMBC. PATIENT SUMMARY As an intermediate state between localised cancer and disease with extensive metastasis, oligometastatic bladder cancer (OMBC) might benefit from a combination of systemic treatment and local therapy. We report the first consensus statements on OMBC drawn up by an international expert group. These statements can provide a basis for standardisation of future research, which will lead to high-quality evidence in the field.
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Affiliation(s)
- Aristotelis Bamias
- National & Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Greece.
| | - Arnulf Stenzl
- University of Tübingen Medical Center, Tübingen, Germany
| | | | | | - Marko Babjuk
- 2nd Faculty of Medicine, Hospital Motol, Charles University, Praha, Czechia
| | - Alison Birtle
- Rosemere Cancer Centre, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Alberto Briganti
- Department of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany
| | - Ananya Choudhury
- Department of Clinical Oncology, The Christie NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Maurizio Colecchia
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Maria De Santis
- Department of Urology, Charité University Hospital, Berlin, Germany
| | - Stefano Fanti
- Division of Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Michele Gallucci
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Juan Gómez Rivas
- Department of Urology. Hospital Clinico San Carlos. Madrid, Spain
| | | | - Kerstin Junker
- Klinik für Urologie und Kinderurologie, Abteilung für Klinisch-Experimentelle Forschung, Homburg, Germany
| | | | | | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | - Rodolfo Montironi
- Molecular Medicine and Cell Therapy Foundation, Polytechnic University of the Marche Region, Ancona, Italy
| | - Andrea Necchi
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Christoph Oing
- Translational and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | | | - Piet Ost
- Department of Radiation Oncology, Iridium Network, Wilrijk, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Michael Pinkawa
- Department of Radiation Oncology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Morgan Rouprêt
- Sorbonne University GRC 5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Paris, France
| | - Harriet Thoeny
- Department of Radiology, HFR Fribourg-Hôpital Cantonal, University of Fribourg, Villars-sur-Glâne, Switzerland
| | - Thomas Zilli
- Clinica di Radio-Oncologia, Istituto Oncologico della Svizzera Italiana, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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5
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Gillessen S, Bossi A, Davis ID, de Bono J, Fizazi K, James ND, Mottet N, Shore N, Small E, Smith M, Sweeney CJ, Tombal B, Antonarakis ES, Aparicio AM, Armstrong AJ, Attard G, Beer TM, Beltran H, Bjartell A, Blanchard P, Briganti A, Bristow RG, Bulbul M, Caffo O, Castellano D, Castro E, Cheng HH, Chi KN, Chowdhury S, Clarke CS, Clarke N, Daugaard G, De Santis M, Duran I, Eeles R, Efstathiou E, Efstathiou J, Ekeke ON, Evans CP, Fanti S, Feng FY, Fonteyne V, Fossati N, Frydenberg M, George D, Gleave M, Gravis G, Halabi S, Heinrich D, Herrmann K, Higano C, Hofman MS, Horvath LG, Hussain M, Jereczek-Fossa BA, Jones R, Kanesvaran R, Kellokumpu-Lehtinen PL, Khauli RB, Klotz L, Kramer G, Leibowitz R, Logothetis C, Mahal B, Maluf F, Mateo J, Matheson D, Mehra N, Merseburger A, Morgans AK, Morris MJ, Mrabti H, Mukherji D, Murphy DG, Murthy V, Nguyen PL, Oh WK, Ost P, O'Sullivan JM, Padhani AR, Pezaro CJ, Poon DMC, Pritchard CC, Rabah DM, Rathkopf D, Reiter RE, Rubin MA, Ryan CJ, Saad F, Sade JP, Sartor O, Scher HI, Sharifi N, Skoneczna I, Soule H, Spratt DE, Srinivas S, Sternberg CN, Steuber T, Suzuki H, Sydes MR, Taplin ME, Tilki D, Türkeri L, Turco F, Uemura H, Uemura H, Ürün Y, Vale CL, van Oort I, Vapiwala N, Walz J, Yamoah K, Ye D, Yu EY, Zapatero A, Zilli T, Omlin A. Management of patients with advanced prostate cancer-metastatic and/or castration-resistant prostate cancer: Report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. Eur J Cancer 2023; 185:178-215. [PMID: 37003085 DOI: 10.1016/j.ejca.2023.02.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Innovations in imaging and molecular characterisation together with novel treatment options have improved outcomes in advanced prostate cancer. However, we still lack high-level evidence in many areas relevant to making management decisions in daily clinical practise. The 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) addressed some questions in these areas to supplement guidelines that mostly are based on level 1 evidence. OBJECTIVE To present the voting results of the APCCC 2022. DESIGN, SETTING, AND PARTICIPANTS The experts voted on controversial questions where high-level evidence is mostly lacking: locally advanced prostate cancer; biochemical recurrence after local treatment; metastatic hormone-sensitive, non-metastatic, and metastatic castration-resistant prostate cancer; oligometastatic prostate cancer; and managing side effects of hormonal therapy. A panel of 105 international prostate cancer experts voted on the consensus questions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The panel voted on 198 pre-defined questions, which were developed by 117 voting and non-voting panel members prior to the conference following a modified Delphi process. A total of 116 questions on metastatic and/or castration-resistant prostate cancer are discussed in this manuscript. In 2022, the voting was done by a web-based survey because of COVID-19 restrictions. RESULTS AND LIMITATIONS The voting reflects the expert opinion of these panellists and did not incorporate a standard literature review or formal meta-analysis. The answer options for the consensus questions received varying degrees of support from panellists, as reflected in this article and the detailed voting results are reported in the supplementary material. We report here on topics in metastatic, hormone-sensitive prostate cancer (mHSPC), non-metastatic, castration-resistant prostate cancer (nmCRPC), metastatic castration-resistant prostate cancer (mCRPC), and oligometastatic and oligoprogressive prostate cancer. CONCLUSIONS These voting results in four specific areas from a panel of experts in advanced prostate cancer can help clinicians and patients navigate controversial areas of management for which high-level evidence is scant or conflicting and can help research funders and policy makers identify information gaps and consider what areas to explore further. However, diagnostic and treatment decisions always have to be individualised based on patient characteristics, including the extent and location of disease, prior treatment(s), co-morbidities, patient preferences, and treatment recommendations and should also incorporate current and emerging clinical evidence and logistic and economic factors. Enrolment in clinical trials is strongly encouraged. Importantly, APCCC 2022 once again identified important gaps where there is non-consensus and that merit evaluation in specifically designed trials. PATIENT SUMMARY The Advanced Prostate Cancer Consensus Conference (APCCC) provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference aims to share the knowledge of international experts in prostate cancer with healthcare providers worldwide. At each APCCC, an expert panel votes on pre-defined questions that target the most clinically relevant areas of advanced prostate cancer treatment for which there are gaps in knowledge. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients and their relatives as part of shared and multidisciplinary decision-making. This report focuses on the advanced setting, covering metastatic hormone-sensitive prostate cancer and both non-metastatic and metastatic castration-resistant prostate cancer. TWITTER SUMMARY Report of the results of APCCC 2022 for the following topics: mHSPC, nmCRPC, mCRPC, and oligometastatic prostate cancer. TAKE-HOME MESSAGE At APCCC 2022, clinically important questions in the management of advanced prostate cancer management were identified and discussed, and experts voted on pre-defined consensus questions. The report of the results for metastatic and/or castration-resistant prostate cancer is summarised here.
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Affiliation(s)
- Silke Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
| | - Alberto Bossi
- Genitourinary Oncology, Prostate Brachytherapy Unit, Gustave Roussy, Paris, France
| | - Ian D Davis
- Monash University and Eastern Health, Victoria, Australia
| | - Johann de Bono
- The Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | | | | | - Neal Shore
- Medical Director, Carolina Urologic Research Center, Myrtle Beach, SC, USA; CMO, Urology/Surgical Oncology, GenesisCare, Myrtle Beach, SC, USA
| | - Eric Small
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Matthew Smith
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Christopher J Sweeney
- South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, SA, Australia
| | | | | | - Ana M Aparicio
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew J Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA
| | | | - Tomasz M Beer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Himisha Beltran
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Pierre Blanchard
- Gustave Roussy, Département de Radiothérapie, Université Paris-Saclay, Oncostat, Inserm U-1018, F-94805, Villejuif, France
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Rob G Bristow
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Christie NHS Trust and CRUK Manchester Institute and Cancer Centre, Manchester, UK
| | - Muhammad Bulbul
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, 38122 Trento, Italy
| | - Daniel Castellano
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Elena Castro
- Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain
| | - Heather H Cheng
- University of Washington, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kim N Chi
- BC Cancer, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon Chowdhury
- Guys and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - Caroline S Clarke
- Research Department of Primary Care & Population Health, Royal Free Campus, University College London, London, UK
| | - Noel Clarke
- The Christie and Salford Royal Hospitals, Manchester, UK
| | - Gedske Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria De Santis
- Department of Urology, Charité Universitätsmedizin, Berlin, Germany; Department of Urology, Medical University of Vienna, Austria
| | - Ignacio Duran
- Department of Medical Oncology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - Ross Eeles
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jason Efstathiou
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Onyeanunam Ngozi Ekeke
- Department of Surgery, University of Port Harcourt Teaching Hospital, Alakahia, Port Harcourt, Nigeria
| | | | - Stefano Fanti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Felix Y Feng
- University of California, San Francisco, San Francisco, CA, USA
| | - Valerie Fonteyne
- Department of Radiation-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Nicola Fossati
- Department of Urology, Ospedale Regionale di Lugano, Civico USI - Università della Svizzera Italiana, Lugano, Switzerland
| | - Mark Frydenberg
- Department of Surgery, Prostate Cancer Research Program, Department of Anatomy & Developmental Biology, Faculty Nursing, Medicine & Health Sciences, Monash University, Melbourne, Australia
| | - Dan George
- Departments of Medicine and Surgery, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Martin Gleave
- Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille Université, Marseille, France
| | - Susan Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Daniel Heinrich
- Department of Oncology and Radiotherapy, Innlandet Hospital Trust, Gjøvik, Norway
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Celestia Higano
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Hofman
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Lisa G Horvath
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Garvan Institute of Medical Research, Darlinghurst, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Maha Hussain
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Barbara A Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Department of Radiotherapy, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Rob Jones
- School of Cancer Sciences, University of Glasgow, United Kingdom
| | | | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and Tampere Cancer Center, Tampere, Finland; Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Raja B Khauli
- Division of Urology and the Naef K. Basile Cancer Institute (NKBCI), American University of Beirut Medical Center, Beirut, Lebanon
| | - Laurence Klotz
- Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Raja Leibowitz
- Oncology Institute, Shamir Medical Center, Be'er Ya'akov, Israel; Faculty of Medicine, Tel-Aviv University, Israel
| | - Christopher Logothetis
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; University of Athens Alexandra Hospital, Athens, Greece
| | - Brandon Mahal
- Department of Radiation Oncology, University of Miami Sylvester Cancer Center, Miami, FL, USA
| | - Fernando Maluf
- Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil; Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Joaquin Mateo
- Department of Medical Oncology and Prostate Cancer Translational Research Group. Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - David Matheson
- Faculty of Education, Health and Wellbeing, Walsall Campus, Walsall, UK
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Alicia K Morgans
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Morris
- Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hind Mrabti
- National Institute of Oncology, Mohamed V University, Rabat, Morocco
| | - Deborah Mukherji
- Clemenceau Medical Center Dubai, United Arab Emirates, Faculty of Medicine, American University of Beirut, Lebanon
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | | | - Paul L Nguyen
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - William K Oh
- Chief, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium, Ghent University, Ghent, Belgium
| | - Joe M O'Sullivan
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland
| | - Anwar R Padhani
- Mount Vernon Cancer Centre and Institute of Cancer Research, London, UK
| | - Carmel J Pezaro
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Darren M C Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong; The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Colin C Pritchard
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, USA
| | - Danny M Rabah
- Cancer Research Chair and Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Urology, KFSHRC Riyadh, Saudi Arabia
| | - Dana Rathkopf
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mark A Rubin
- Bern Center for Precision Medicine and Department for Biomedical Research, Bern, Switzerland
| | - Charles J Ryan
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Fred Saad
- Centre Hospitalier de Université de Montréal, Montreal, Canada
| | | | | | - Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Nima Sharifi
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; Department of Cancer Biology, GU Malignancies Research Center, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Iwona Skoneczna
- Rafal Masztak Grochowski Hospital, Maria Sklodowska Curie National Research Institute of Oncology, Warsaw, Poland
| | - Howard Soule
- Prostate Cancer Foundation, Santa Monica, CA, USA
| | - Daniel E Spratt
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Sandy Srinivas
- Division of Medical Oncology, Stanford University Medical Center, Stanford, CA, USA
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, Division of Hematology and Oncology, Meyer Cancer Center, New York Presbyterian Hospital, New York, NY, USA
| | - Thomas Steuber
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Levent Türkeri
- Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey
| | - Fabio Turco
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yüksel Ürün
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey; Ankara University Cancer Research Institute, Ankara, Turkey
| | - Claire L Vale
- University College London, MRC Clinical Trials Unit at UCL, London, UK
| | - Inge van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Neha Vapiwala
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France
| | - Kosj Yamoah
- Department of Radiation Oncology & Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, FL, USA
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Evan Y Yu
- Department of Medicine, Division of Oncology, University of Washington and Fred Hutchinson Cancer Center, G4-830, Seattle, WA, USA
| | - Almudena Zapatero
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Health Research Institute, Madrid, Spain
| | - Thomas Zilli
- Radiation Oncology, Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Aurelius Omlin
- Onkozentrum Zurich, University of Zurich and Tumorzentrum Hirslanden Zurich, Switzerland
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Gillessen S, Bossi A, Davis ID, de Bono J, Fizazi K, James ND, Mottet N, Shore N, Small E, Smith M, Sweeney C, Tombal B, Antonarakis ES, Aparicio AM, Armstrong AJ, Attard G, Beer TM, Beltran H, Bjartell A, Blanchard P, Briganti A, Bristow RG, Bulbul M, Caffo O, Castellano D, Castro E, Cheng HH, Chi KN, Chowdhury S, Clarke CS, Clarke N, Daugaard G, De Santis M, Duran I, Eeles R, Efstathiou E, Efstathiou J, Ngozi Ekeke O, Evans CP, Fanti S, Feng FY, Fonteyne V, Fossati N, Frydenberg M, George D, Gleave M, Gravis G, Halabi S, Heinrich D, Herrmann K, Higano C, Hofman MS, Horvath LG, Hussain M, Jereczek-Fossa BA, Jones R, Kanesvaran R, Kellokumpu-Lehtinen PL, Khauli RB, Klotz L, Kramer G, Leibowitz R, Logothetis CJ, Mahal BA, Maluf F, Mateo J, Matheson D, Mehra N, Merseburger A, Morgans AK, Morris MJ, Mrabti H, Mukherji D, Murphy DG, Murthy V, Nguyen PL, Oh WK, Ost P, O'Sullivan JM, Padhani AR, Pezaro C, Poon DMC, Pritchard CC, Rabah DM, Rathkopf D, Reiter RE, Rubin MA, Ryan CJ, Saad F, Pablo Sade J, Sartor OA, Scher HI, Sharifi N, Skoneczna I, Soule H, Spratt DE, Srinivas S, Sternberg CN, Steuber T, Suzuki H, Sydes MR, Taplin ME, Tilki D, Türkeri L, Turco F, Uemura H, Uemura H, Ürün Y, Vale CL, van Oort I, Vapiwala N, Walz J, Yamoah K, Ye D, Yu EY, Zapatero A, Zilli T, Omlin A. Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-/High-risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022. Eur Urol 2023; 83:267-293. [PMID: 36494221 PMCID: PMC7614721 DOI: 10.1016/j.eururo.2022.11.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Innovations in imaging and molecular characterisation and the evolution of new therapies have improved outcomes in advanced prostate cancer. Nonetheless, we continue to lack high-level evidence on a variety of clinical topics that greatly impact daily practice. To supplement evidence-based guidelines, the 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) surveyed experts about key dilemmas in clinical management. OBJECTIVE To present consensus voting results for select questions from APCCC 2022. DESIGN, SETTING, AND PARTICIPANTS Before the conference, a panel of 117 international prostate cancer experts used a modified Delphi process to develop 198 multiple-choice consensus questions on (1) intermediate- and high-risk and locally advanced prostate cancer, (2) biochemical recurrence after local treatment, (3) side effects from hormonal therapies, (4) metastatic hormone-sensitive prostate cancer, (5) nonmetastatic castration-resistant prostate cancer, (6) metastatic castration-resistant prostate cancer, and (7) oligometastatic and oligoprogressive prostate cancer. Before the conference, these questions were administered via a web-based survey to the 105 physician panel members ("panellists") who directly engage in prostate cancer treatment decision-making. Herein, we present results for the 82 questions on topics 1-3. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Consensus was defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. RESULTS AND LIMITATIONS The voting results reveal varying degrees of consensus, as is discussed in this article and shown in the detailed results in the Supplementary material. The findings reflect the opinions of an international panel of experts and did not incorporate a formal literature review and meta-analysis. CONCLUSIONS These voting results by a panel of international experts in advanced prostate cancer can help physicians and patients navigate controversial areas of clinical management for which high-level evidence is scant or conflicting. The findings can also help funders and policymakers prioritise areas for future research. Diagnostic and treatment decisions should always be individualised based on patient and cancer characteristics (disease extent and location, treatment history, comorbidities, and patient preferences) and should incorporate current and emerging clinical evidence, therapeutic guidelines, and logistic and economic factors. Enrolment in clinical trials is always strongly encouraged. Importantly, APCCC 2022 once again identified important gaps (areas of nonconsensus) that merit evaluation in specifically designed trials. PATIENT SUMMARY The Advanced Prostate Cancer Consensus Conference (APCCC) provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference aims to share the knowledge of international experts in prostate cancer with health care providers and patients worldwide. At each APCCC, a panel of physician experts vote in response to multiple-choice questions about their clinical opinions and approaches to managing advanced prostate cancer. This report presents voting results for the subset of questions pertaining to intermediate- and high-risk and locally advanced prostate cancer, biochemical relapse after definitive treatment, advanced (next-generation) imaging, and management of side effects caused by hormonal therapies. The results provide a practical guide to help clinicians and patients discuss treatment options as part of shared multidisciplinary decision-making. The findings may be especially useful when there is little or no high-level evidence to guide treatment decisions.
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Affiliation(s)
- Silke Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
| | - Alberto Bossi
- Genitourinary Oncology, Prostate Brachytherapy Unit, Gustave Roussy, Paris, France
| | - Ian D Davis
- Monash University and Eastern Health, Victoria, Australia
| | - Johann de Bono
- The Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | | | | | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA; Urology/Surgical Oncology, GenesisCare, Myrtle Beach, SC, USA
| | - Eric Small
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Mathew Smith
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Christopher Sweeney
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Ana M Aparicio
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew J Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA
| | | | - Tomasz M Beer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Himisha Beltran
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Pierre Blanchard
- Département de Radiothérapie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Rob G Bristow
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Christie NHS Trust and CRUK Manchester Institute and Cancer Centre, Manchester, UK
| | - Muhammad Bulbul
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | - Daniel Castellano
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Elena Castro
- Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain
| | - Heather H Cheng
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - Kim N Chi
- BC Cancer, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Caroline S Clarke
- Research Department of Primary Care & Population Health, Royal Free Campus, University College London, London, UK
| | - Noel Clarke
- The Christie and Salford Royal Hospitals, Manchester, UK
| | - Gedske Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria De Santis
- Department of Urology, Charité Universitätsmedizin, Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Ignacio Duran
- Department of Medical Oncology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - Ros Eeles
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jason Efstathiou
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Onyeanunam Ngozi Ekeke
- Department of Surgery, University of Port Harcourt Teaching Hospital, Alakahia, Port Harcourt, Nigeria
| | | | - Stefano Fanti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Felix Y Feng
- University of California San Francisco, San Francisco, CA, USA
| | - Valerie Fonteyne
- Department of Radiation-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Nicola Fossati
- Department of Urology, Ospedale Regionale di Lugano, Civico USI - Università della Svizzera Italiana, Lugano, Switzerland
| | - Mark Frydenberg
- Department of Surgery, Prostate Cancer Research Program, Monash University, Melbourne, Australia; Department of Anatomy & Developmental Biology, Faculty of Nursing, Medicine & Health Sciences, Monash University, Melbourne, Australia
| | - Daniel George
- Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA; Department of Surgery, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Martin Gleave
- Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille Université, Marseille, France
| | - Susan Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Daniel Heinrich
- Department of Oncology and Radiotherapy, Innlandet Hospital Trust, Gjøvik, Norway
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Celestia Higano
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Hofman
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Lisa G Horvath
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Garvan Institute of Medical Research, Darlinghurst, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Maha Hussain
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Barbara Alicja Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Department of Radiotherapy, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Robert Jones
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and Tampere Cancer Center, Tampere, Finland; Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Raja B Khauli
- Department of Urology and the Naef K. Basile Cancer Institute (NKBCI), American University of Beirut Medical Center, Beirut, Lebanon
| | - Laurence Klotz
- Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Raya Leibowitz
- Oncology Institute, Shamir Medical Center, Be'er Ya'akov, Israel; Faculty of Medicine, Tel-Aviv University, Israel
| | - Christopher J Logothetis
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; University of Athens Alexandra Hospital, Athens, Greece
| | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami Sylvester Cancer Center, Miami, FL, USA
| | - Fernando Maluf
- Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil; Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Joaquin Mateo
- Department of Medical Oncology and Prostate Cancer Translational Research Group, Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - David Matheson
- Faculty of Education, Health and Wellbeing, Walsall Campus, Walsall, UK
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Alicia K Morgans
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Morris
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hind Mrabti
- National Institute of Oncology, Mohamed V University, Rabat, Morocco
| | - Deborah Mukherji
- Clemenceau Medical Center, Dubai, United Arab Emirates; Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | | | - Paul L Nguyen
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - William K Oh
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
| | - Piet Ost
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Joe M O'Sullivan
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland
| | - Anwar R Padhani
- Mount Vernon Cancer Centre and Institute of Cancer Research, London, UK
| | - Carmel Pezaro
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Darren M C Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong; The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Colin C Pritchard
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Danny M Rabah
- Cancer Research Chair and Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Urology, KFSHRC, Riyadh, Saudi Arabia
| | - Dana Rathkopf
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mark A Rubin
- Bern Center for Precision Medicine and Department for Biomedical Research, Bern, Switzerland
| | - Charles J Ryan
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Fred Saad
- Centre Hospitalier de Université de Montréal, Montreal, Quebec, Canada
| | | | | | - Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Nima Sharifi
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; Department of Cancer Biology, GU Malignancies Research Center, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Iwona Skoneczna
- Rafal Masztak Grochowski Hospital, Maria Sklodowska Curie National Research Institute of Oncology, Warsaw, Poland
| | - Howard Soule
- Prostate Cancer Foundation, Santa Monica, CA, USA
| | - Daniel E Spratt
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Sandy Srinivas
- Division of Medical Oncology, Stanford University Medical Center, Stanford, CA, USA
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, Division of Hematology and Oncology, Meyer Cancer Center, New York Presbyterian Hospital, New York, NY, USA
| | - Thomas Steuber
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Levent Türkeri
- Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey
| | - Fabio Turco
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yüksel Ürün
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey; Ankara University Cancer Research Institute, Ankara, Turkey
| | - Claire L Vale
- University College London, MRC Clinical Trials Unit at UCL, London, UK
| | - Inge van Oort
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Neha Vapiwala
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France
| | - Kosj Yamoah
- Department of Radiation Oncology & Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, FL, USA
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Evan Y Yu
- Department of Medicine, Division of Oncology, University of Washington and Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Almudena Zapatero
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Health Research Institute, Madrid, Spain
| | - Thomas Zilli
- Radiation Oncology, Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Aurelius Omlin
- Onkozentrum Zurich, University of Zurich and Tumorzentrum Hirslanden Zurich, Switzerland
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7
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Bamias A, Merseburger A, Loriot Y, James N, Choy E, Castellano D, Lopez-Rios F, Calabrò F, Kramer M, de Velasco G, Zakopoulou R, Tzannis K, Sternberg CN. New prognostic model in patients with advanced urothelial carcinoma treated with second-line immune checkpoint inhibitors. J Immunother Cancer 2023; 11:jitc-2022-005977. [PMID: 36627145 PMCID: PMC9835946 DOI: 10.1136/jitc-2022-005977] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Bellmunt Risk Score, based on Eastern Cooperative Oncology Group (ECOG) performance status (PS), hemoglobin levels and presence of liver metastases, is the most established prognostic algorithm for patients with advanced urothelial cancer (aUC) progressing after platinum-based chemotherapy. Nevertheless, existing algorithms may not be sufficient following the introduction of immunotherapy. Our aim was to develop an improved prognostic model in patients receiving second-line atezolizumab for aUC. METHODS Patients with aUC progressing after cisplatin/carboplatin-based chemotherapy and enrolled in the prospective, single-arm, phase IIIb SAUL study were included in this analysis. Patients were treated with 3-weekly atezolizumab 1200 mg intravenously. The development and internal validation of a prognostic model for overall survival (OS) was performed using Cox regression analyses, bootstrapping methods and calibration. RESULTS In 936 patients, ECOG PS, alkaline phosphatase, hemoglobin, neutrophil-to-lymphocyte ratio, liver metastases, bone metastases and time from last chemotherapy were identified as independent prognostic factors. In a 4-tier model, median OS for patients with 0-1, 2, 3-4 and 5-7 risk factors was 18.6, 10.4, 4.8 and 2.1 months, respectively. Compared with Bellmunt Risk Score, this model provided enhanced prognostic separation, with a c-index of 0.725 vs 0.685 and increment in c-statistic of 0.04 (p<0.001). Inclusion of PD-L1 expression did not improve the model. CONCLUSIONS We developed and internally validated a prognostic model for patients with aUC receiving postplatinum immunotherapy. This model represents an improvement over the Bellmunt algorithm and could aid selection of patients with aUC for second-line immunotherapy. TRIAL REGISTRATION NUMBER NCT02928406.
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Affiliation(s)
- Aristotelis Bamias
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Chaidari, Greece
| | | | | | | | | | | | - F Lopez-Rios
- Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Fabio Calabrò
- GU Oncology Unit, San Camillo Forlanini Hospital, Roma, Italy
| | - Mario Kramer
- University Clinic Schleswig-Holstein-Lubeck, Lübeck, Germany
| | | | | | - Kimon Tzannis
- National and Kapodistrian University of Athens, Athens, Greece
| | - Cora N Sternberg
- Hematology and Oncology Englander Institute for Precision Medicine Weill Cornell Medicine, New York, New York, USA
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Powles T, Tomczak P, Park SH, Venugopal B, Ferguson T, Symeonides SN, Hajek J, Gurney H, Chang YH, Lee JL, Sarwar N, Thiery-Vuillemin A, Gross-Goupil M, Mahave M, Haas NB, Sawrycki P, Burgents JE, Xu L, Imai K, Quinn DI, Choueiri TK, Choueiri T, Park SH, Venugopal B, Ferguson TR, Hajek J, Lin TP, Symeonides SN, Lee JL, Sawrycki P, Haas NB, Gurney HP, Mahave M, Sarwar N, Thiery-Vuillemin A, Gross-Goupil M, Chevreau C, Burke JM, Doshi G, Melichar B, Topart D, Oudard S, Kopyltsov E, Hammers HJ, Quinn DI, Alva A, Menezes JDJ, Silva AGE, Winquist EW, Hamzaj A, Procopio G, Karaszewska B, Nowakowska-Zajdel EM, Alekseev BY, Gafanov RA, Izmailov A, Semenov A, Afanasyev SG, Lipatov ON, Powles TB, Srinivas S, McDermott D, Kochuparambil ST, Davis ID, Peltola K, Sabbatini R, Chung J, Shkolnik MI, Matveev VB, Gajate Borau P, McCune S, Hutson TE, Dri A, Sales SC, Yeung C, Alcala Castro CM, Bostrom P, Laguerre B, Buttigliero C, de Giorgi U, Fomin EA, Zakharia Y, Hwang C, Singer EA, Yorio JT, Waterhouse D, Kowalyszyn RD, Alfie MS, Yanez Ruiz E, Buchler T, Kankaanranta K, Ferretti G, Kimura G, Nishimura K, Masumori N, Tamada S, Kato H, Kitamura H, Danielewicz I, Wojcik-Tomaszewska J, Sala Gonzalez N, Chiu KY, Atkins MB, Heath E, Rojas-Uribe GA, Gonzalez Fernandez ME, Feyerabend S, Pignata S, Numakura K, Cybulska Stopa B, Zukov R, Climent Duran MA, Maroto Rey PJ, Montesa Pino A, Chang CH, Vengalil S, Waddell TS, Cobb PW, Hauke R, Anderson DM, Sarantopoulos J, Gourdin T, Zhang T, Jayram G, Fein LE, Harris C, Beato PMM, Flores F, Estay A, Rubiano JA, Bedke J, Hauser S, Neisius A, Busch J, Anai S, Tsunemori H, Sawka D, Sikora-Kupis B, Arranz JA, Delgado I, Chen CH, Gunderson E, Tykodi S, Koletsky A, Chen K, Agrawal M, Kaen DL, Sade JP, Tatangelo MD, Parnis F, Barbosa FM, Faucher G, Iqbal N, Marceau D, Paradis JB, Hanna N, Acevedo A, Ibanez C, Villanueva L, Galaz PP, Durango IC, Manneh R, Kral Z, Holeckova P, Hakkarainen H, Ronkainen H, Abadie-Lacourtoisie S, Tartas S, Goebell PJ, Grimm MO, Hoefner T, Wirth M, Panic A, Schultze-Seemann W, Yokomizo A, Mizuno R, Uemura H, Eto M, Tsujihata M, Matsukawa Y, Murakami Y, Kim M, Hamberg P, Marczewska-Skrodzka M, Szczylik C, Humphreys AC, Jiang P, Kumar B, Lu G, Desai A, Karam JA, Keogh G, Fleming M, Zarba JJ, Leiva VE, Mendez GA, Harris SJ, Brown SJ, Antonio Junior JN, Costamilan RDC, Rocha RO, Muniz D, Brust L, Lalani AK, Graham J, Levesque M, Orlandi F, Kotasek R, Deville JL, Borchiellini D, Merseburger A, Rink M, Roos F, McDermott R, Oyama M, Yamamoto Y, Tomita Y, Miura Y, Ioritani N, Westgeest H, Kubiatowski T, Bal W, Girones Sarrio R, Rowe J, Prow DM, Senecal F, Hashemi-Sadraei N, Cole SW, Kendall SD, Richards DA, Schnadig ID, Gupta M. Pembrolizumab versus placebo as post-nephrectomy adjuvant therapy for clear cell renal cell carcinoma (KEYNOTE-564): 30-month follow-up analysis of a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2022; 23:1133-1144. [PMID: 36055304 DOI: 10.1016/s1470-2045(22)00487-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The first interim analysis of the KEYNOTE-564 study showed improved disease-free survival with adjuvant pembrolizumab compared with placebo after surgery in patients with clear cell renal cell carcinoma at an increased risk of recurrence. The analysis reported here, with an additional 6 months of follow-up, was designed to assess longer-term efficacy and safety of pembrolizumab versus placebo, as well as additional secondary and exploratory endpoints. METHODS In the multicentre, randomised, double-blind, placebo-controlled, phase 3 KEYNOTE-564 trial, adults aged 18 years or older with clear cell renal cell carcinoma with an increased risk of recurrence were enrolled at 213 hospitals and cancer centres in North America, South America, Europe, Asia, and Australia. Eligible participants had an Eastern Cooperative Oncology Group performance status of 0 or 1, had undergone nephrectomy 12 weeks or less before randomisation, and had not received previous systemic therapy for advanced renal cell carcinoma. Participants were randomly assigned (1:1) via central permuted block randomisation (block size of four) to receive pembrolizumab 200 mg or placebo intravenously every 3 weeks for up to 17 cycles. Randomisation was stratified by metastatic disease status (M0 vs M1), and the M0 group was further stratified by ECOG performance status and geographical region. All participants and investigators involved in study treatment administration were masked to the treatment group assignment. The primary endpoint was disease-free survival by investigator assessment in the intention-to-treat population (all participants randomly assigned to a treatment). Safety was assessed in the safety population, comprising all participants who received at least one dose of pembrolizumab or placebo. As the primary endpoint was met at the first interim analysis, updated data are reported without p values. This study is ongoing, but no longer recruiting, and is registered with ClinicalTrials.gov, NCT03142334. FINDINGS Between June 30, 2017, and Sept 20, 2019, 994 participants were assigned to receive pembrolizumab (n=496) or placebo (n=498). Median follow-up, defined as the time from randomisation to data cutoff (June 14, 2021), was 30·1 months (IQR 25·7-36·7). Disease-free survival was better with pembrolizumab compared with placebo (HR 0·63 [95% CI 0·50-0·80]). Median disease-free survival was not reached in either group. The most common all-cause grade 3-4 adverse events were hypertension (in 14 [3%] of 496 participants) and increased alanine aminotransferase (in 11 [2%]) in the pembrolizumab group, and hypertension (in 13 [3%] of 498 participants) in the placebo group. Serious adverse events attributed to study treatment occurred in 59 (12%) participants in the pembrolizumab group and one (<1%) participant in the placebo group. No deaths were attributed to pembrolizumab. INTERPRETATION Updated results from KEYNOTE-564 support the use of adjuvant pembrolizumab monotherapy as a standard of care for participants with renal cell carcinoma with an increased risk of recurrence after nephrectomy. FUNDING Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, USA.
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Affiliation(s)
- Thomas Powles
- Royal Free Hospital NHS Foundation Trust, University College London, London, UK; Barts Cancer Institute, Experimental Cancer Medicine Centre, Queen Mary University of London, St Bartholomew's Hospital, London, UK.
| | - Piotr Tomczak
- Poznań University of Medical Sciences, Poznań, Poland
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Balaji Venugopal
- Beatson West of Scotland Cancer Centre, Glasgow, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Stefan N Symeonides
- Cancer Research UK Edinburgh Centre, Edinburgh, UK; Edinburgh Cancer Centre, Edinburgh, UK; Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | - Howard Gurney
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | | | - Jae Lyun Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | | | | | | | | | - Piotr Sawrycki
- Wojewódzki Szpital Zespolony im L Rydygiera w Toruniu, Torun, Poland
| | | | - Lei Xu
- Merck & Co, Inc, Rahway, NJ, USA
| | | | - David I Quinn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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Merseburger A. Editorial. Aktuelle Urol 2022; 53:293-294. [DOI: 10.1055/a-1812-6279] [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: 10/16/2022]
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Lange B, Ozimek T, Wießmeyer JR, Kramer M, Merseburger A, Brinkmann R. Theoretical and experimental evaluation of the distance dependence of fiber-based fluorescence and reflection measurements for laser lithotripsy. Biomed Phys Eng Express 2022; 8. [PMID: 35858536 DOI: 10.1088/2057-1976/ac82c7] [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: 02/28/2022] [Accepted: 07/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES In laser lithotripsy, a green aiming beam overlying the infrared (IR) treatment radiation gives rise to reflection and fluorescence signals that can be measured via the treatment fiber. While stone autofluorescence is used for target detection, the condition of the fiber can be assessed based on its Fresnel reflection. For good applicability, fluorescence detection of stones should work even when the stone and fiber are not in direct contact. Fiber breakage detection, on the other hand, can be falsified if surfaces located in front of the fiber reflect light from the aiming laser back into it. For both applications, therefore, a fundamental investigation of the dependence of the signal amplitude on the distance between fiber and surface is important. METHODS Calculations of the signal drop of fluorescence or diffuse and specular reflection with increasing fiber distance were performed using ray tracing based on a simple geometric model for different fiber core diameters. Reflection signals from a mirror, diffuse reflector, human calculi, and porcine renal tissue placed in water were measured at varying distances (0 - 5 mm). For human calculi, fluorescence signals were recorded simultaneously. RESULTS The calculations showed a linear signal decrease down to ~60% of the maximum signal (fiber in contact). The distance z at which the signal drops to for example 50% depends linearly on the diameter of the fiber core. For fibers used in lithotripsy and positioned in water,z50%ranges from 0.55 mm (200 µm core diameter) to 2.73 mm (1 mm core diameter). The calculations were in good agreement with the experimental results. CONCLUSIONS The autofluorescence signals of stones can be measured in non-contact mode. Evaluating the Fresnel signal of the end face of the fiber to detect breakage is possible unless the fiber is situated less than some millimeters to reflecting surfaces.
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Affiliation(s)
- Birgit Lange
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, Lubeck, 23562, GERMANY
| | - Tomasz Ozimek
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23568, GERMANY
| | - Judith Riccarda Wießmeyer
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23568, GERMANY
| | - Mario Kramer
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23568, GERMANY
| | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23568, GERMANY
| | - Ralf Brinkmann
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, Lubeck, 23562, GERMANY
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Merseburger A, Kübler H, Roth S. Editorial. Aktuelle Urol 2022; 53:1. [PMID: 35078250 DOI: 10.1055/a-1658-3703] [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: 10/19/2022]
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12
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von Amsberg G, Thiele H, Merseburger A. [Cardiovascular side effects in patients undergoing androgen deprivation therapy: superiority of gonadotropin-releasing hormone antagonists? An update]. Urologe A 2021; 60:1450-1457. [PMID: 34213627 PMCID: PMC8568757 DOI: 10.1007/s00120-021-01583-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) plays a crucial role in treatment of advanced prostate cancer (PCa). The additional application of new drugs results in prolonged overall survival, both in the hormone sensitive and castration resistant state. Consequently, the long-term use of ADT moves potential side effects into the focus of interest. In this context special consideration must be given to cardiovascular events. OBJECTIVES Review of current evidence on potential differences regarding the cardiovascular risk profile of gonadotropin-releasing hormone (GnRH) agonists compared to GnRH antagonists. METHODS Narrative review based on an expert consensus supported by a literature search in PubMed (MEDLINE) and the abstract databases of ASCO and ESMO was conducted for publications published between January 2015 and January 2021. Significant meta-analyses, randomized controlled trials (RCTs) and real-world data (RWD) revealing relevant results for clinical practice were taken into account. Selection of studies was performed based on the clinical relevance for everyday practice. RESULTS The search yielded three relevant meta-analyses, two prospective RCTs as well as three RWD publications that are of importance for clinical practice. Overall, a decreased incidence of cardiovascular events was reported for GnRH antagonists compared to GnRH agonists. Only one RWD publication described comparable rates of complications for both drug classes. CONCLUSION GnRH antagonists have a lower risk of treatment related cardiovascular events compared to GnRH agonists. Risks should be minimized by taking known cardiovascular risk factors into account before initiating therapy.
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Affiliation(s)
- Gunhild von Amsberg
- II. medizinische Klinik, Onkologisches Zentrum und Martini-Klinik, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Holger Thiele
- Herzzentrum Leipzig, Universitätsklinik für Kardiologie, Leipzig, Deutschland
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
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Elghazaly H, Mottet N, Garcia J, Oudard S, Roach M, Abbou C, Merseburger A, Emara A, Shehata S, Tawfik H, Khorshid O, Selim A, Assem A, Abdelkarim K, Ezz El-Arab L, Bazarbashi S, Omar A, Elwakil H, Elashry M, Abou ElFotouh M, Osman T, Ezz El Din M. Clinical recommendations in the management of advanced prostate cancer: International Gastrointestinal, Liver and Uro-oncology (IGILUC 2019) experts. World J Urol 2021; 39:1421-1429. [PMID: 32643031 DOI: 10.1007/s00345-020-03328-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/30/2019] [Accepted: 06/23/2020] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Advancements in the diagnosis and treatment of prostate cancer (PC) have rapidly progressed through the past years. Various factors should be taken into account while treating individual patients to ensure optimal and careful decision making. The purpose of this consensus review is to summarize the current practice patterns when managing patients with advanced prostate cancer (APC) as there is still a lack of or very limited evidence on its clinical management in some areas. METHODS Pre-defined questions were shared with experts prior to the consensus session that took place in Cairo, Egypt in April 2019 during the 8th International gastrointestinal, liver and uro-oncology conference (IGILUC). Voting was based mainly on the expert opinions of the panel after a thorough discussion and review of available evidence from guidelines or best evidence available concerning the topic at hand. RESULTS A strong consensus or unanimity was reached on 47% of the proposed questions. Notably, the panelists reached consensus on several topics based on high-level expert opinion. These findings contribute in several ways to our understanding of the management of PC and provide a basis for future recommendations. There was also a lack of consensus on other several topics, which suggests the need for further supporting data addressing these knowledge gaps. CONCLUSION This review offers a thorough understanding of APC practice and offers insight on the various opinions shared amongst experts in the field that can serve as guidance regionally and deepens our understanding of disease management globally.
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Affiliation(s)
- Hesham Elghazaly
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Nicolas Mottet
- Department of Urology, University Hospital Nord St. Etienne, St. Etienne, France
| | - Jorge Garcia
- Department of Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Stephane Oudard
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France
| | - Mack Roach
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Claude Abbou
- Department of Urology, Hôpital Henri Mondor, Creteil, France
| | - Axel Merseburger
- Department of Urology and Urologic Oncology, Campus Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Amr Emara
- Department of Urology, Hampshire Hospitals, NHS Foundation Trust, Basingstoke, UK
| | - Samir Shehata
- Clinical Oncology Department, Assiut University Cancer Centre, Assiut, Egypt
| | - Hesham Tawfik
- Clinical Oncology Department, Tanta University, Tanta, Egypt
| | - Ola Khorshid
- Medical Oncology Department National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmed Selim
- Clinical Oncology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Akram Assem
- Urology Department, Alexandria University, Alexandria, Egypt
| | - Khalid Abdelkarim
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Lobna Ezz El-Arab
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Shouki Bazarbashi
- Medical Oncology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abbass Omar
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hesham Elwakil
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Elashry
- Department of Clinical Oncology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Abou ElFotouh
- Department of Clinical Oncology, Faculty of Medicine, Menoufia University, Al Minufya, Egypt
| | - Tarek Osman
- Department of Urology, Ain Shams University, Cairo, Egypt
| | - Mai Ezz El Din
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Merseburger A. Editorial. Aktuelle Urol 2021; 52:97. [PMID: 33822336 DOI: 10.1055/a-1296-2878] [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: 10/21/2022]
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Merseburger A. [Prostate cancer - where is the journey going?]. Aktuelle Urol 2020; 51:545-546. [PMID: 33233001 DOI: 10.1055/a-1220-0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Lübeck
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Rexer H, Bedke J, Merseburger A. Perioperativer Einsatz von Pembrolizumab bei muskelinvasivem Blasenkarzinom. Aktuelle Urol 2020; 51:418-420. [PMID: 32846453 DOI: 10.1055/a-1177-3856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- H. Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252 Schwarz
| | - J. Bedke
- Leiter der klinischen Prüfung, Universitätsklinikum Tübingen, Klinik und Poliklinik für Urologie, Hoppe-Seyler-Str. 3, 72076 Tübingen
| | - A. Merseburger
- Organgruppensprecher der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e. V., Kuno-Fischer-Str. 8, 14057 Berlin
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Bamias A, Merseburger A, Loriot Y, James N, Choy E, Castellano Gauna D, Lopez-Rios F, Calabro F, Kramer M, de Velasco G, Zakopoulou R, Tzannis K, Sternberg C. 748P Prognostic factors related to post-platinum atezolizumab for relapsed metastatic urothelial cancer (mUC) from the SAUL study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.820] [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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Abu-Ghanem Y, Fernández-Pello S, Bex A, Ljungberg B, Albiges L, Dabestani S, Giles R, Hofmann F, Hora M, Kuczyk M, Kuusk T, Marconi L, Merseburger A, Tahbaz R, Staehler M, Volpe A, Powles T, Lam T, Bensalah K. Bias of available data makes it unreliable to compare outcomes of thermo-ablation versus surgery for the treatment of T1 renal tumours: A systematic review from the European Association of Urology Renal Cell Cancer Guideline Panel. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33805-2] [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: 11/15/2022] Open
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Rexer H, Schmid S, Merseburger A. Kombinierte Strahlen-Immuntherapie beim lokal fortgeschrittenen Blasenkarzinom. Aktuelle Urol 2020; 51:101-102. [PMID: 32208509 DOI: 10.1055/a-1017-4964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252 Schwarz
| | - S Schmid
- Leiter der klinischen Prüfung (LKP), TU München, Klinikum r. d. I., Urologische Klinik und Poliklinik, Ismaninger Str. 22, 81675 München
| | - A Merseburger
- Organgruppensprecher der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e. V., Kuno-Fischer-Str. 8, 14057 Berlin
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Weber CL, Schneider M, Merseburger A. Zeitgleiche Entfernung von Blasenkatheter und DJ-Harnleiterschienen nach transvesikaler Prostataadenomenukleation nach Freyer. Aktuelle Urol 2019; 50:585. [PMID: 31770805 DOI: 10.1055/a-0894-9313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Michael Schneider
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Rexer H, Doehn C, Merseburger A. Randomisierte, doppelblinde, placebokontrollierte Phase-III-Studie zu Pembrolizumab (MK-3475) als adjuvante Monotherapie des Nierenzellkarzinoms nach Nephrektomie (Keynote-564) – AUO-Nr. AN 45/17. Aktuelle Urol 2019; 50:578-580. [PMID: 31770803 DOI: 10.1055/a-0963-6306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- H. Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252 Schwarz
| | - C. Doehn
- Organgruppe Nierenzellkarzinom der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft, Kuno-Fischer-Straße 8, 14057 Berlin
| | - A. Merseburger
- Leiter der klinischen Prüfung, Universitätsklinikum Lübeck, Urologie, Ratzeburger Allee 160, 23538 Lübeck
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Jayaram A, Shen D, Wingate A, Wetterskog D, Sternberg C, Jones R, Berruti A, Lefresne F, Lahaye M, Thomas S, Joshi S, Gormley M, Tombal B, Merseburger A, Ricci D, Attard G. Plasma gene conversions after one cycle (C) abiraterone acetate (AA) for metastatic castration-resistant prostate cancer (mCRPC): A biomarker analysis of a multi-centre, international trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.014] [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: 11/12/2022] Open
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23
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Agarwal N, McQuarrie K, Bjartell A, Chowdhury S, Gomes AJPDS, Chung B, Özgüroğlu M, Soto ÁJ, Merseburger A, Uemura H, Ye D, Given R, Miladinovic B, Dearden L, Deprince K, Naini V, Lopez-Gitlitz A, Chi K. Patient-reported outcomes (PROs) from TITAN: A phase III, randomized, double-blind study of apalutamide (APA) versus placebo (PBO) added to androgen deprivation therapy (ADT) in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Rexer H, Graefen M, Merseburger A. Zweitlinientherapie beim metastasierten kastrationsrefraktären Prostatakarzinom (mCRPC). Aktuelle Urol 2019; 50:478-479. [PMID: 31466095 DOI: 10.1055/a-0901-9007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252 Schwarz
| | - M. Graefen
- Organgruppensprecher der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e. V., Kuno-Fischer-Str. 8, 14057 Berlin
| | - A. Merseburger
- LKP der Studie in Deutschland, Universitätsklinikum Lübeck, Klinik für Urologie, Ratzeburger Allee 160, 23538 Lübeck
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Rexer H, Merseburger A, Bögemann M. Kombinationstherapie beim Hochrisiko- nicht-muskelinvasiven Blasenkarzinom (HR-NMIBC). Aktuelle Urol 2019; 50:345-346. [PMID: 31398753 DOI: 10.1055/a-0884-4480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - A Merseburger
- Organgruppensprecher der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e. V., Kuno-Fischer-Str. 8, 14057 Berlin
| | - M Bögemann
- Leiter der klinischen Prüfung, Universitätsklinikum Münster, Klinik für Urologie und Kinderurologie, Albert-Schweitzer-Campus 1, 48149 Münster
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Rexer H, Hammerer P, Merseburger A. Drittlinientherapie beim metastasierten kastrationsrefraktären Prostatakarzinom (mCRPC). Aktuelle Urol 2019; 50:144-145. [PMID: 30897635 DOI: 10.1055/a-0832-4855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252 Schwarz
| | - P Hammerer
- Organgruppensprecher der Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e.V., Kuno-Fischer-Str. 8, 14057 Berlin
| | - A Merseburger
- LKP der Studie in Deutschland, Universitätsklinikum Lübeck, Klinik für Urologie, Ratzeburger Allee 160, 23538 Lübeck
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Abstract
Due to demographic changes and aging in the German population combined with the shortage of doctors, new techniques are needed to ensure urological patient care in the future. Telemedicine offers great potential to facilitate patient monitoring in their familiar surroundings and to ameliorate patient's compliance with the suggested therapy concept. Through optimal and reliable transfer of patient data, telemedicine helps to optimise patient satisfaction with urological therapies, binds them to their doctor and raises diagnostic safety. For a successful use of telemedicine, detailed education of participating patients and urologists as well as detailed fault monitoring are required.
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Affiliation(s)
- Julian Struck
- Universitätsklinikum Schleswig Holstein, Campus Lübeck, Urologie, Lübeck
| | - Mike Wenzel
- Universitätsklinikum Frankfurt, Klinik für Urologie, Frankfurt
| | - Axel Heidenreich
- Universitätsklinikum Köln, Klinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Köln
| | - Axel Merseburger
- Universitätsklinikum Schleswig Holstein, Campus Lübeck, Urologie, Lübeck
| | - Johannes Salem
- Universitätsklinikum Köln, Klinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Köln
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Merseburger A, Bro Falkenberg A, Kornilova OJ. New study suggests patients with advanced prostate cancer on androgen deprivation therapy need more dialogue with health care provider, especially around cardiovascular risk. World J Urol 2018; 37:1085-1093. [PMID: 30244335 DOI: 10.1007/s00345-018-2495-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To study the current level of patients' awareness, and patient-health care provider (HCP) dialogue with respect to treatment-related risks, especially cardiovascular risk (CVR) associated with advanced prostate cancer (PCa) treatment. METHODS This 10-min online survey summarised data by treatment, region, and CVR (high or low). RESULTS Of the 411 patients, 83% were at high CVR while only 8% patients were aware of CVR associated with PCa treatment, majority of which (80%) were informed about this risk by HCPs. No significant difference in treatment approach was reported, regardless of patient's CVR status. Compared to other potential risks, patients were more likely to initiate discussion about heart problems with HCPs (38% patients). When prompted, 26% patients rated heart problems as the most concerning risk factor, and this concern was twice in patients with high CVR (28%) versus low CVR (14%). Lifestyle modifications were made by 64% patients, of which 45% patients reported an improvement in overall well-being. Improved diet was the most adopted lifestyle modification. CONCLUSION There is a need to enhance a constant patient-HCP dialogue, and both groups need to make a conscious effort in that direction. This would help in increasing patients' awareness of risks, having better treatment choice and acceptance, and reducing side-effects.
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Affiliation(s)
- Axel Merseburger
- University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | | | - Olga J Kornilova
- Ferring International Center, Chemin de la Vergognausaz 50, Saint-Prex, Switzerland
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29
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Gilbert N, Merseburger A, Kramer M. [Symptomatic renal tumours in metastatic renal cell carcinoma - surgical options]. Aktuelle Urol 2018; 49:417-421. [PMID: 30184600 DOI: 10.1055/a-0658-0832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Between 15 and 20 % of patients diagnosed with renal cell carcinoma suffer from metastatic disease by the time of diagnosis. In addition to systemic therapy, there are various surgical strategies to treat the primary tumour, e. g. cytoreductive nephrectomy (CN) or palliative nephrectomy (PN). In the immunotherapy era, the standard treatment was to perform CN followed by interferon therapy, based on 2 prospective randomised trials and their combined analysis. Since the introduction of targeted therapy around 2005, data of that quality has been missing and clinicians have had to rely on big retrospective studies, which have confirmed the benefit of CN except for patients with low performance status, cerebral metastases, low life expectancy, and old age. The recently published results of the CARMENA trial, which compared the use of sunitinib versus CN followed by sunitinib in a prospective randomised trial, have now demonstrated non-inferiority of sunitinib alone in patients classified as having intermediate-risk or poor-risk disease. Nevertheless, these results remain debatable given the large number of patients with poor-risk disease and a higher percentage of locally advanced tumours in the nephrectomy-sunitinib group. Indications for palliative nephrectomy are pain, haemorrhage, or severe paraneoplastic syndrome. Since there are excellent supportive and less invasive therapies, e. g. angioembolisation in case of haemorrhage, the decision in favour of surgical intervention should be based on the characteristics of the primary tumour, individual risk factors, and alternative therapies. Technically, palliative nephrectomy can be performed as an open or laparoscopic procedure and even as a partial nephrectomy, if indicated.
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Affiliation(s)
- Nils Gilbert
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | - Mario Kramer
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
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Hupe M, Merseburger A, de Wit M, Rexer H, Gschwend J, Krege S. [Practice Pattern of Systemic Therapy for Urothelial Cancer in Germany - A Survey of the German Cancer Society]. Aktuelle Urol 2018; 49:346-354. [PMID: 30086593 DOI: 10.1055/a-0645-1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND In 2016, the first German guideline for bladder cancer was introduced. This survey evaluates current management of bladder cancer in Germany, focusing on systemic therapies and compares this to the guidelines. MATERIAL AND METHODS More than 4000 urologists and oncologists in Germany received a questionnaire assessing surgical and systemic therapeutic management of bladder cancer. We received 278 evaluable responses. RESULTS This is the largest nationwide survey evaluating current bladder cancer management in Germany. Management can be optimised of non-muscle invasive bladder cancer including intravesical instillation therapies, as well as of muscle invasive bladder cancer including (neo)adjuvant chemotherapies, particularly with respect to the numbers of chemotherapy courses. Management of metastasised bladder cancer is predominantly performed according to the guidelines. CONCLUSIONS Adherence to bladder cancer guidelines in Germany can be optimised and could possibly decrease cancer-specific mortality, supported by the development of novel diagnostic and therapeutic options.
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Affiliation(s)
- Marie Hupe
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | - Maike de Wit
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Vivantes Klinikum Neukölln, Berlin
| | | | - Jürgen Gschwend
- Klinik und Poliklinik für Urologie, Technische Universität München, Universitätsklinikum rechts der Isar, München
| | - Susanne Krege
- Klinik für Urologie, Kinderurologie und Urologische Onkologie, Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
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Rexer H, Graefen M, Merseburger A. [Phase II study of pembrolizumab (MK-3475) in patients with metastatic castration-resistant prostate cancer (KEYNOTE-199)-study AP 93/16 of the AUO]. Urologe A 2018; 56:1471-1472. [PMID: 28980011 DOI: 10.1007/s00120-017-0519-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- H Rexer
- AUO Geschäftsstelle, Seestr. 11, 17252, Schwarz, Deutschland.
| | - M Graefen
- Organgruppe Prostatakarzinom, Arbeitsgemeinschaft Urologische Onkologie in der Deutschen Krebsgesellschaft e. V., Berlin, Deutschland
| | - A Merseburger
- Klinikum für Urologie, Universitätsklinikum Lübeck, 23538, Lübeck, Deutschland
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Abstract
Endosalpingiosis of the urinary bladder is a rare benign condition characterised by the presence of ectopic endosalpingeal tissue in the bladder. If histology shows two or more Müllerian-derived components, this condition is referred to as Müllerianosis.To our knowledge less than 20 cases of Müllerianosis and 5 cases of endosalpingiosis have been documented in the literature.Although the pathogenesis remains unclear, two theories exist. The implantation theory assumes that Müllerian-derived tissue gets implanted in the wall of the urinary bladder during pelvic surgery. The second theory proposes a metaplastic origin of the disease.Patients suffering from endosalpingiosis or Müllerianosis may present with symptoms such as suprapubic pain, frequent urination, dysuria or gross haematuria, possibly with a cyclical appearance.We present the case of a 40-year-old female patient, who primarily presented with painful haematuria and was diagnosed with endosalpingiosis and treated by transurethral resection. Also we review the current literature.
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Affiliation(s)
- N. Gilbert
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - X. Guo
- Klinik für Urologie und Kinderurologie, DIAKO Ev. Diakonie-Krankenhaus gGmbH, Bremen
| | - J. Bauer
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - M. Hennig
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - C. Kümpers
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Merseburger
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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33
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Miller K, Gschwend JE, Merseburger A, Retz M, Stenzl A. [Immunotherapy with checkpoint inhibitors in local advanced and metastatic urothelial carcinoma]. Aktuelle Urol 2018; 49:142-156. [PMID: 29587321 DOI: 10.1055/s-0043-123067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The approval of immune checkpoint inhibitors has started a new era in the treatment of urothelial carcinoma, which, so far, has been a disease with limited treatment options. However, in the current German S3 guideline for bladder cancer the remarkable improvements provided by immune checkpoint inhibitors have not been reflected. As cancer immunotherapy is a novel approach, there are several questions related to the daily clinical routine: What clinical data was used as the basis for the approval of the individual substances? What does this mean for previous treatment algorithms? What issues must be considered in the management of adverse events? What side-effects may occur and how can they be recognised and treated? The present paper provides an overview of the new treatment options regarding their relevance as well as recommendations for their application in clinical practice.
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Affiliation(s)
- Kurt Miller
- Charite Universitätsmedizin Berlin, Klinik für Urologie
| | | | | | - Margitta Retz
- Klinikum rechts der Isar der Technischen Universität München
| | - Arnulf Stenzl
- Universitätsklinik für Urologie, Universitätsklinikum Tübingen
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Zoidakis J, Mokou M, Galaras A, Latosinska A, Lygirou V, Makridakis M, Fragkoulis C, Mullen W, Mischak H, Roubelakis M, Merseburger A, Ntoumas K, Vlahou A. Proteomics phenotyping of bladder cancer. Urol Oncol 2017. [DOI: 10.1016/j.urolonc.2017.06.050] [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]
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Struck J, Kramer M, Merseburger A, Hartmann A, Herrmann T. [En-bloc resection of bladder tumours (ERBT): current and future perspectives]. Aktuelle Urol 2017; 48:306-313. [PMID: 28750447 DOI: 10.1055/s-0043-109819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Limitations inherent in the conventional transurethral resection of bladder tumours, the standard approach for diagnosis and treatment of bladder cancer, are well known: staging errors due to insufficient resection depth as well as intravesical tumour fragmentation, both of which make histopathological evaluation difficult. The purpose of this review is to present recent clinical data on the en-bloc resection of bladder tumours (ERBT), which has been demonstrated to offer a high potential to overcome these limitations. The recent findings show that ERBT provides a good resection quality with varying detection rates for tunica muscularis, which is a surrogate marker for resection quality regarding muscle-invasive tumours. ERBT can be performed using all energy sources. Available data show no relevant difference with regard to perioperative morbidity compared with cTURB. No conclusions can be drawn regarding the impact of ERBT on recurrence as the data are partly controversial. This has to be defined by further studies.
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Affiliation(s)
- J. Struck
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - M. Kramer
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Merseburger
- Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Hartmann
- Klinik für Pathologie, Universitätsklinikum Erlangen
| | - T. Herrmann
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover
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Weinhold I, Keck T, Merseburger A, Rody A, Wollenberg B, Wende D, Häckl D, Elsner C. [Utility Analysis of Oncological Centre Building in the Field of Colorectal Cancer]. Zentralbl Chir 2017; 143:181-192. [PMID: 28472845 DOI: 10.1055/s-0042-122854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In the field of colorectal cancer and other cancer entities, there is an ongoing trend to establish multidisciplinary treatment in specialised cancer centres. Little is known by now about the outcomes of this centralised and quality-driven treatment approach. In light of the increasing cost-benefit discussions, assessments of their impact seem to be necessary. This paper discusses positive effects of cancer centres with a particular focus on the multidisciplinary approach and its potential impact on survival outcomes of colorectal cancer patients. The study applies a Markov approach to assess the epidemiological impact of the cancer centre establishment and associated life years gained, both at a regional level and over time. MATERIALS AND METHODS We conducted a systematic literature review to evaluate effects of multidisciplinary treatment in specialised cancer centres in the field of colorectal cancer. Applying the PRISMA scheme, 602 articles were assessed by title, abstract and full text. Finally, 10 publications met the inclusion criteria and were included in a meta-analysis. Using the example of the "Krebszentrum Nord" at the University Hospital in the federal state of Schleswig-Holstein, we assessed the impact of changes in survival rates at the regional level by simulating expected incidence, mortality and prevalence rates in a Markov model including detailed population data of Schleswig-Holstein. RESULTS The meta-analysis revealed that multidisciplinary treatment in a cancer centre was associated with a 4.5 % reduction of mortality rates in colorectal cancer patients. The greatest benefits were found for patients in advanced disease stages. At the regional level, 106 life years could be gained through the centre for colorectal cancer until 2020, according to the assumptions of the simulation. CONCLUSION The establishment of colorectal cancer centres is associated with positive outcomes for patients. However, the scarce evidence base underpins the need for additional studies to further examine the impact of centre building in colorectal cancer care. Cancer registries are a solid foundation for further research. Future requirements for oncological care can be derived from the predicted epidemiological development.
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Affiliation(s)
- Ines Weinhold
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
| | - Tobias Keck
- Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Axel Merseburger
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Achim Rody
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Barbara Wollenberg
- Klinik für Hals-Nasen und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Danny Wende
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
| | - Dennis Häckl
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
| | - Christian Elsner
- Management, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
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Hupe M, Vahlensieck W, Hennig M, Ozimek T, Struck J, Tezval H, Merseburger A, Kuczyk M, Kramer M. PD57-11 CROSS-SECTIONAL STUDY EVALUATING LONG-TERM BOWEL ISSUES IN BLADDER CANCER PATIENTS: DIARRHEA AS A LIMITING FACTOR OF QUALITY OF LIFE AFTER RADICAL CYSTECTOMY. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hupe M, Lokeshwar S, Hennig M, Schimmelpfennig D, Kramer M, Merseburger A, Soloway M, Lokeshwar V. MP48-01 EXPRESSION AND FUNCTION OF A NOVEL CHONDROITINASE IN BLADDER CANCER. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wimmer K, Rody A, Merseburger A, Guo X, Wünsch L, Birnbaum W, Marshall L, Hiort O. Intraabdominelles Seminom bei einer Patientin mit kompletter Androgenresistenz. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593053] [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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40
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Tolkach Y, Herrmann T, Merseburger A, Burchardt M, Wolters M, Huusmann S, Kramer M, Kuczyk M, Imkamp F. Development of a clinical algorithm for treating urethral strictures based on a large retrospective single-center cohort. F1000Res 2016; 5:2378. [PMID: 28529689 PMCID: PMC5414819 DOI: 10.12688/f1000research.9427.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 11/20/2022] Open
Abstract
Aim: To analyze clinical data from male patients treated with urethrotomy and to develop a clinical decision algorithm. Materials and methods: Two large cohorts of male patients with urethral strictures were included in this retrospective study, historical (1985-1995, n=491) and modern cohorts (1996-2006, n=470). All patients were treated with repeated internal urethrotomies (up to 9 sessions). Clinical outcomes were analyzed and systemized as a clinical decision algorithm. Results: The overall recurrence rates after the first urethrotomy were 32.4% and 23% in the historical and modern cohorts, respectively. In many patients, the second procedure was also effective with the third procedure also feasible in selected patients. The strictures with a length ≤ 2 cm should be treated according to the initial length. In patients with strictures ≤ 1 cm, the second session could be recommended in all patients, but not with penile strictures, strictures related to transurethral operations or for patients who were 31-50 years of age. The third session could be effective in selected cases of idiopathic bulbar strictures. For strictures with a length of 1-2 cm, a second operation is possible for the solitary low-grade bulbar strictures, given that the age is > 50 years and the etiology is not post-transurethral resection of the prostate. For penile strictures that are 1-2 cm, urethrotomy could be attempted in solitary but not in high-grade strictures. Conclusions: We present data on the treatment of urethral strictures with urethrotomy from a single center. Based on the analysis, a clinical decision algorithm was suggested, which could be a reliable basis for everyday clinical practice.
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Affiliation(s)
- Yuri Tolkach
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany.,Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Thomas Herrmann
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Axel Merseburger
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | | | - Mathias Wolters
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Stefan Huusmann
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Mario Kramer
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Markus Kuczyk
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Florian Imkamp
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
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Affiliation(s)
- H Rexer
- AUO, MeckEvidence, Seestr. 11, 17252, Schwarz, Deutschland.
| | - A Merseburger
- AUO, MeckEvidence, Seestr. 11, 17252, Schwarz, Deutschland.,Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig Holstein, Lübeck, Deutschland
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Merseburger A, Sedding D. GnRH-Antagonisten bei PCa-Patienten mit klinisch relevanter kardiovaskulärer Vorerkrankung. Urologe A 2016; 55:1240-1. [DOI: 10.1007/s00120-016-0197-z] [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: 11/27/2022]
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43
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Kovacs G, Mueller K, Melchert C, Guo X, Soror T, Broschk J, Jocham D, Merseburger A. Focal Prostate HDR Dose Escalation Based on Real-Time Biological Planning in the Boost Treatment of Locally Advanced Prostate Cancer: Long Term Results. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.315] [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: 10/21/2022]
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44
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Borgmann H, Woelm JH, Merseburger A, Nestler T, Salem J, Brandt MP, Haferkamp A, Loeb S. Qualitative Twitter analysis of participants, tweet strategies, and tweet content at a major urologic conference. Can Urol Assoc J 2016; 10:39-44. [PMID: 26977205 DOI: 10.5489/cuaj.3322] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The microblogging social media platform Twitter is increasingly being adopted in the urologic field. We aimed to analyze participants, tweet strategies, and tweet content of the Twitter discussion at a urologic conference. METHODS A comprehensive analysis of the Twitter activity at the European Association of Urology Congress 2013 (#eau2013) was performed, including characteristics of user profiles, engagement and popularity measurements, characteristics and timing of tweets, and content analysis. RESULTS Of 218 Twitter contributors, doctors (45%) were the most frequent, ahead of associations (15%), companies (10%), and journals (3%). However, journals had the highest tweet/participant rate (22 tweets/participant), profile activity (median: 1177, total tweets, 1805 followers, 979 following), and profile popularity (follower/following ratio: 2.1; retweet rank percentile: 96%). Links in a profile were associated with higher engagement (p<0.0001) and popularity (p<0.0001). Of 1572 tweets, 57% were original tweets, 71% contained mentions, 20% contained links, and 25% included pictures. The majority of tweets (88%) were during conference hours, with an average of 24.7 tweets/hour and a peak activity of 71 tweets/hour. Overall, 59% of tweets were informative, led by the topics uro-oncology (21%), urologic research (21%), and urotechnology (12%). Limitations include the analysis of a single conference analysis, assessment of global profile and not domain-specific activity, and the rapid evolution in Twitter-using habits. CONCLUSION Results of this single conference qualitative analysis are promising for an enrichment of the scientific discussions at urologic conferences through the use of Twitter.
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Affiliation(s)
| | | | | | - Tim Nestler
- Department of Urology, Armed Forces Hospital Koblenz, Germany
| | - Johannes Salem
- Department of Urology, St Joseph Hospital, Dortmund, Germany
| | | | - Axel Haferkamp
- Department of Urology, University Hospital Frankfurt, Germany
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, NY, U.S.A
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Nison L, Colin P, Remzi M, Shariat S, Klatte T, Yakoubi R, Bozzini G, Capitanio U, Babjuk M, Merseburger A, Cha E, Fritsche H, Novara G, Montorsi F, Hora M, Roupret M. Résultats oncologiques du traitement des TVES≤pT2 de l’uretère pelvien par néphro-urétérectomie, résection segmentaire et chirurgie endoscopique : résultats d’une étude multicentrique européenne. Prog Urol 2015; 25:807. [DOI: 10.1016/j.purol.2015.08.182] [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: 10/22/2022]
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46
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Tolkach Y, Merseburger A, Herrmann T, Kuczyk M, Serth J, Imkamp F. Signatures of Adverse Pathological Features, Androgen Insensitivity and Metastatic Potential in Prostate Cancer. Anticancer Res 2015; 35:5443-5451. [PMID: 26408707] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIM The genetic characterization of prostate tumors is important for personalized therapy. The aim of the present study was to investigate the role of previously described prostate cancer-related genes in the genetic characterization of prostate tumors. MATERIALS AND METHODS Forty-two genes were selected for expression analysis (real time-quantitative polymerase chain reaction). One normal prostatic epithelial cell line and three standardized prostate cancer cell lines were used. Twenty-eight patients treated with radical prostatectomy were included in the study. RESULTS The following genes appeared to be possibly related to the metastatic potential of the tumor: ELOVL fatty acid elongase 7 (ELOVL7), enhancer of zeste 2 polycomb repressive complex 2 subunit (EZH2), gastrulation brain homeobox 2 (GBX2), golgi membrane protein 1 (GOLM1), homeobox C6 (HOXC6), minichromosome maintenance complex component 6 (MCM6), marker of proliferation Ki-67 (MKI67), mucin 1, cell surface associated (MUC1), MYC binding protein 2, E3 ubiquitin protein ligase (MYCBP2), somatostatin receptor 1 (SSTR1), topoisomerase (DNA) II alpha 170 kDa (TOP2A) and exportin 6 (XPO6). Six genes were differentially expressed in patients with localized and locally advanced cancer (GOLM1, GBX2, XPO6, SSTR1, TOP2A and cell division cycle associated 5, CDCA5) and three genes (HOXC6, Cyclin-dependent kinase inhibitor 2A (CDKN2A) and MYC binding protein 2, E3 ubiquitin protein ligase, MYCBP2) in patients with a low vs. high Gleason grade/sum. CONCLUSION Some of the investigated genes show promising prognostic and classification features, which might be useful in a clinical setting, warranting for further validation.
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Affiliation(s)
- Yuri Tolkach
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
| | - Axel Merseburger
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
| | - Thomas Herrmann
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
| | - Markus Kuczyk
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
| | - Jürgen Serth
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
| | - Florian Imkamp
- Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
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Hupe M, Kramer M, Kuczyk M, Merseburger A. [Neoadjuvant or Adjuvant Chemotherapy for Bladder Cancer?]. Aktuelle Urol 2015; 46:242-7. [PMID: 26077309 DOI: 10.1055/s-0035-1549948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Advanced urothelial carcinoma of the bladder is associated with a high metastatic potential. Life expectancy for metastatic patients is poor and rarely exceeds more than one year without further therapy. Neoadjuvant chemotherapy can decrease the tumour burden while reducing the risk of death. Adjuvant chemotherapy has been discussed controversially. Patients with lymph node-positive metastases seem to benefit the most from adjuvant chemotherapy. In selected patients, metastasectomy can prolong survival. In metastastic patients, the combination of gemcitabine and cisplatin has become the new standard regimen due to a lower toxicity in comparison to the combination of methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC). For second-line treatment, vinflunine is the only approved therapeutic agent.
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Affiliation(s)
- M. Hupe
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - M. Kramer
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - M. Kuczyk
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - A. Merseburger
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
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48
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Merseburger A, Böker A, Kuczyk M, von Klot CA. [Castration resistant prostate cancer 2015]. Aktuelle Urol 2015; 46:59-65. [PMID: 25658232 DOI: 10.1055/s-0034-1395655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Prostate cancer is still the most common urological cancer of the elderly man. In some patients, a metastatic prostate cancer arises which may remain a stable disease for years with palliative antiandrogen therapy. On average, after 3-4 years, affected men develop a PSA rise and disease progression with the formation of a so-called castration-resistant disease. 5 years ago cytotoxic chemotherapy with docetaxel was the only life-prolonging treatment option in this situation. In the last 5 years, the results of randomised phase III studies have led to the approval of 5 new agents for the treatment of metastatic castration resistant prostate cancer (mCRPC). The results and approval status of the substances, Abiraterone, Enzalutamide, Cabazitaxel, Sipuleucel-T and radium-223 are described below. In addition, some aspects of sequential therapy and possible future molecular approaches are discussed.
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Affiliation(s)
- A. Merseburger
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - A. Böker
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - M. Kuczyk
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
| | - C.-A. von Klot
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover
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Stoehr C, Erber R, Frohnauer J, Martignoni G, Becker F, Bedke J, Fornara P, Füssel S, Gajda M, Gunawan B, Jung V, Wieland W, Meinhardt M, Merseburger A, Strauss A, Wunderlich H, Meyer B, Hauke S, Junker K, Hartmann A. MP30-05 DETECTION OF TRANSLOCATION TUMOURS ON RENAL CELL CARCINOMA TISSUE MICRO ARRAYS BY FISH. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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50
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Heidenreich A, Pfister D, Merseburger A, Bartsch G. Castration-resistant Prostate Cancer: Where We Stand in 2013 and What Urologists Should Know. Eur Urol 2013; 64:260-5. [DOI: 10.1016/j.eururo.2013.05.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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