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Koerber SA, Kroener RC, Dendl K, Kratochwil C, Fink CA, Ristau J, Winter E, Herfarth K, Hatiboglu G, Hohenfellner M, Haberkorn U, Debus J, Giesel FL. Detecting and Locating the Site of Local Relapse Using 18F-PSMA-1007 Imaging After Primary Treatment of 135 Prostate Cancer Patients-Potential Impact on PSMA-Guided Radiation Therapy. Mol Imaging Biol 2023; 25:375-383. [PMID: 35999425 PMCID: PMC10006015 DOI: 10.1007/s11307-022-01766-6] [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: 05/11/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Due to limited imaging options, the visualization of a local relapse of prostate cancer used to pose a considerable challenge. However, since the integration of 18F-PSMA-1007-PET/CT into the clinic, a relapsed tumor can now easily be detected by hybrid imaging. The present study aimed to evaluate and map the allocate relapse in a large cohort of prostate cancer patients focusing on individual patient management conclusions for radiation therapy. PROCEDURES The current study included 135 men with prostate cancer after primary treatment who underwent 18F-PSMA-1007-PET/CT due to biochemical relapse detecting a local relapse. Imaging data were reassessed and analyzed with regard to relapse locations. For the correlation of tumor foci with clinical data, we used binary logistic regression models as well as the Kruskal-Wallis test and Mann-Whitney test. RESULTS In total, 69.6% of all patients (mean age: 65 years) underwent prostatectomy while 30.4% underwent radiation therapy. PET imaging detected most frequently a unifocal relapse (72.6%). There was a statistically significantly higher rate of ipsilateral cases among the relapsed tumors. Comparing both treatment approaches, tumors relapsed most commonly within the posterior region after surgery and transition/peripheral zone after radiation therapy, respectively. CONCLUSIONS The present study confirms that 18F-PSMA-1007-PET/CT is highly suitable for the localization and allocation of a local relapse in patients with prostate cancer. The data enable further optimizing dose prescriptions and target volume delineations of radiation therapy in the future.
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Affiliation(s)
- S A Koerber
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. .,National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. .,Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. .,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - R C Kroener
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - K Dendl
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - C A Fink
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - J Ristau
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - E Winter
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - K Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 450, 69120, Heidelberg, Germany
| | - G Hatiboglu
- Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - M Hohenfellner
- Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - J Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), partner site Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - F L Giesel
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Moorenstr. 5, Duesseldorf, Germany
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Klotz L, Chin J, Futterer J, Hatiboglu G, Pavlovich C, Koch M, Penson D, Relle J, Raman S, Lotan Y, Serrallach M, Heidenreich A, Oto A, Sedelaar J, Tirkes T, Arora S, Macura K, Costa D, Pantuck A, Bomers J, Bonekamp D, Persigehl T, Clarke G, Eggener S. Four-year follow-up of MRI-guided Transurethral Ultrasound Ablation (TULSA) in men with localized prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01004-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Chin J, Hatiboglu G, Nair S, Relle J, Hafron J, Roethke M, Mueller-Wolf M, Bonekamp D, Kassam Z, Staruch R, Burtnyk M, Schlemmer H, Pahernik S. Five-year outcomes from a prospective phase I study of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33482-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Görtz M, Radtke J, Hatiboglu G, Schütz V, Tosev G, Güttlein M, Leichsenring J, Stenzinger A, Bonekamp D, Schlemmer H, Hohenfellner M, Nyarangi-Dix J. The value of PSA density in PI-RADS 3 lesions on multiparametric MRI - a strategy to avoid unnecessary prostate biopsies. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33752-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Klotz L, Chin J, Hatiboglu G, Koch M, Penson D, Pavlovich C, Raman S, Oto A, Fütterer J, Relle J, Lotan Y, Heidenreich A, Serrallach M, Haider M, Bonekamp D, Tirkes T, Arora S, Pantuck A, Zagaja G, Sedelaar M, Macura K, Costa D, Persigehl T, Eggener S. Pivotal trial of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer: Two-year follow-up. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bonekamp D, Wolf MB, Roethke MC, Pahernik S, Hadaschik BA, Hatiboglu G, Kuru TH, Popeneciu IV, Chin JL, Billia M, Relle J, Hafron J, Nandalur KR, Staruch RM, Burtnyk M, Hohenfellner M, Schlemmer HP. Twelve-month prostate volume reduction after MRI-guided transurethral ultrasound ablation of the prostate. Eur Radiol 2018; 29:299-308. [PMID: 29943185 DOI: 10.1007/s00330-018-5584-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 01/08/2018] [Revised: 05/08/2018] [Accepted: 06/01/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To quantitatively assess 12-month prostate volume (PV) reduction based on T2-weighted MRI and immediate post-treatment contrast-enhanced MRI non-perfused volume (NPV), and to compare measurements with predictions of acute and delayed ablation volumes based on MR-thermometry (MR-t), in a central radiology review of the Phase I clinical trial of MRI-guided transurethral ultrasound ablation (TULSA) in patients with localized prostate cancer. MATERIALS AND METHODS Treatment day MRI and 12-month follow-up MRI and biopsy were available for central radiology review in 29 of 30 patients from the published institutional review board-approved, prospective, multi-centre, single-arm Phase I clinical trial of TULSA. Viable PV at 12 months was measured as the remaining PV on T2-weighted MRI, less 12-month NPV, scaled by the fraction of fibrosis in 12-month biopsy cores. Reduction of viable PV was compared to predictions based on the fraction of the prostate covered by the MR-t derived acute thermal ablation volume (ATAV, 55°C isotherm), delayed thermal ablation volume (DTAV, 240 cumulative equivalent minutes at 43°C thermal dose isocontour) and treatment-day NPV. We also report linear and volumetric comparisons between metrics. RESULTS After TULSA, the median 12-month reduction in viable PV was 88%. DTAV predicted a reduction of 90%. Treatment day NPV predicted only 53% volume reduction, and underestimated ATAV and DTAV by 36% and 51%. CONCLUSION Quantitative volumetry of the TULSA phase I MR and biopsy data identifies DTAV (240 CEM43 thermal dose boundary) as a useful predictor of viable prostate tissue reduction at 12 months. Immediate post-treatment NPV underestimates tissue ablation. KEY POINTS • MRI-guided transurethral ultrasound ablation (TULSA) achieved an 88% reduction of viable prostate tissue volume at 12 months, in excellent agreement with expectation from thermal dose calculations. • Non-perfused volume on immediate post-treatment contrast-enhanced MRI represents only 64% of the acute thermal ablation volume (ATAV), and reports only 60% (53% instead of 88% achieved) of the reduction in viable prostate tissue volume at 12 months. • MR-thermometry-based predictions of 12-month prostate volume reduction based on 240 cumulative equivalent minute thermal dose volume are in excellent agreement with reduction in viable prostate tissue volume measured on pre- and 12-month post-treatment T2w-MRI.
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Affiliation(s)
- David Bonekamp
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - M B Wolf
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - M C Roethke
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Pahernik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - B A Hadaschik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - G Hatiboglu
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - T H Kuru
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - I V Popeneciu
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - J L Chin
- Department of Urology, University of Western Ontario (UWO), London Health Sciences Center, Victoria Hospital, London, ON, Canada
| | - M Billia
- Department of Urology, University of Western Ontario (UWO), London Health Sciences Center, Victoria Hospital, London, ON, Canada
| | - J Relle
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA
| | - J Hafron
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA
| | - K R Nandalur
- Department of Radiology, Beaumont Health System, Royal Oak, MI, USA
| | - R M Staruch
- Clinical Science, Profound Medical Inc., Toronto, ON, Canada
| | - M Burtnyk
- Clinical Science, Profound Medical Inc., Toronto, ON, Canada
| | - M Hohenfellner
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - H-P Schlemmer
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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Hüttenbrink C, Hatiboglu G, Simpfendörfer T, Radtke JP, Becker R, Teber D, Hadaschik B, Pahernik S, Hohenfellner M. Incidental appendectomy during robotic laparoscopic prostatectomy-safe and worth to perform? Langenbecks Arch Surg 2017; 403:265-269. [PMID: 29098385 DOI: 10.1007/s00423-017-1630-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/06/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this study is to investigate the safety and patients' benefit of incidental appendectomy during robot-assisted laparoscopic radical prostatectomy (RALRP). METHODS Fifty-three patients, who had incidental appendectomy during RALRP between January 2012 and March 2014, were enrolled to this study. To evaluate the safety of the procedure, following parameters were evaluated: patient age, duration of surgery, perioperative complications (classified by Clavien-Dindo), time to bowel movement, and length of hospital stay. Furthermore, intraoperative visual appearance, location, and histopathological evaluation of the appendix were evaluated. Data was analyzed by descriptive statistics. RESULTS Mean age of patients was 61 years, the average hospital stay 5 days. No perioperative complications occurred. The appendix was unsuspicious in 39 patients (73.6%); 14 patients (26.4%) had macroscopically signs of inflammation. Of the 53 resected appendixes, the histopathological evaluation showed 33 (62.2%) inconspicuous appendices, 11 (20.8%) post-inflammatory changes, 4 (7.5%) with chronical signs of inflammation and 3 (5.7%) with signs of acute inflammation. In 2 patients (3.8%), low-grade mucinous neoplasms were found in the specimens. CONCLUSIONS Incidental appendectomy during RALRP is a feasible procedure. With regard to inflammation and neoplastic changes, incidental appendectomy can be considered for patients scheduled for robot-assisted prostate surgery.
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Affiliation(s)
- C Hüttenbrink
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| | - G Hatiboglu
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| | - T Simpfendörfer
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - J P Radtke
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - R Becker
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - D Teber
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - B Hadaschik
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - S Pahernik
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - M Hohenfellner
- Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
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8
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Hatiboglu G, Simpfendörfer T, Uhlmann L, Bergero M, Macher-Goeppinger S, Pahernik S, Hadaschik B, Hohenfellner M, Teber D. A prospective randomized controlled trial for assessment of perineal hydrodissection technique for nervesparing robot assisted radical prostatectomy. Int J Med Robot 2017; 13. [DOI: 10.1002/rcs.1835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 03/14/2017] [Accepted: 04/05/2017] [Indexed: 11/12/2022]
Affiliation(s)
- G. Hatiboglu
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
| | - T. Simpfendörfer
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
| | - L. Uhlmann
- Department of Medical Biometry; University of Heidelberg, Im Neuenheimer Feld; Heidelberg Germany
| | - M.A. Bergero
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
- Department of Urology; Italian Hospital of Buenos Aires; Buenos Aires Argentina
| | - S. Macher-Goeppinger
- Institute of Pathology; University of Heidelberg, Im Neuenheimer Feld 220/221; Heidelberg Germany
| | - S. Pahernik
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
| | - B. Hadaschik
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
| | - M. Hohenfellner
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
| | - D. Teber
- Department of Urology; University of Heidelberg, Im Neuenheimer Feld 110; Heidelberg Germany
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Hofer L, Gasch C, Hatiboglu G, Motsch J, Grüllich C, Duensing S, Hohenfellner M. [Level IV inferior vena cava tumor thrombus : A rare diagnosis in patients with renal cell carcinoma]. Urologe A 2017; 56:868-875. [PMID: 28349189 DOI: 10.1007/s00120-017-0369-5] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Renal cell carcinoma in combination with a supradiaphragmatic tumor thrombus is a rare tumor entity. Radical surgery including nephrectomy and thrombectomy is still considered standard treatment. The extent of the tumor thrombus should be preoperatively evaluated by MRI and TEE. An interdisciplinary team is important for surgery planning and realization. Despite the known risks of an operation, a longer overall survival is achieved.
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Affiliation(s)
- L Hofer
- Urologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
| | - C Gasch
- Urologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - G Hatiboglu
- Urologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - J Motsch
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Grüllich
- Klinik für Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - S Duensing
- Urologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - M Hohenfellner
- Urologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
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Hatiboglu G, Popeneciu IV, Deppert M, Nyarangi-Dix J, Hadaschik B, Hohenfellner M, Teber D, Pahernik S. Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer. BMC Urol 2017; 17:5. [PMID: 28077116 PMCID: PMC5225650 DOI: 10.1186/s12894-017-0198-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/05/2017] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate quality of life, functional and oncological outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer. Methods One hundred thirty-one patients, treated with TURP and HIFU in a single institution were followed up for oncological and functional outcome. Oncological outcome was quantified by biochemical recurrence free survival using the Stuttgart and Phoenix criteria. Quality of life was assessed by usage of standardized QLQ-C30 and QLQ-PR25 questionnaires. In addition, functional questionnaires such as IPSS and IIEF-5 were used. Complications were assessed by the Clavien-Dindo classification. Results One hundred thirty-one patients with a mean age of 72.8 years (SD: 6.0) underwent HIFU for prostate cancer (29.0% low risk, 58.8% intermediate risk, 12.2% high risk). PSA nadir was 0.6 ng/ml (SD: 1.2) after a mean of 4.6 months (SD: 5.7). Biochemical recurrence free survival defined by Stuttgart criteria was 73.7%, 84.4% and 62.5% for low-, intermediate- and high-risk patients after 22.2 months. Complications were grouped according to Clavien-Dindo and occurred in 10.7% (grade II) and 11.5% (grade IIIa) of cases. 35.1% of patients needed further treatment for bladder neck stricture. Regarding incontinence, 14.3%, 2.9% and 0% of patients had de novo urinary incontinence grade I°, II° and III° and 3.8% urge incontinence due to HIFU treatment. Patients were asked for the ability to have intercourse: 15.8%, 58.6% and 66.7% of patients after non-, onesided and bothsided nervesparing procedure were able to obtain sufficient erection for intercourse, respectively. Regarding quality of life, mean global health score according to QLQ-C30 was 69.4%. Conclusion HIFU treatment for localized prostate cancer shows acceptable oncological safety. Quality of life after HIFU is better than in the general population and ranges within those of standard treatment options compared to literature. HIFU seems a safe valuable treatment alternative for patients not suitable for standard treatment.
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Affiliation(s)
- G Hatiboglu
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| | - I V Popeneciu
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - M Deppert
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - J Nyarangi-Dix
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - B Hadaschik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - M Hohenfellner
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - D Teber
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - S Pahernik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
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Simpfendörfer T, Hatiboglu G, Hadaschik BA, Wild E, Maier-Hein L, Rassweiler MC, Rassweiler J, Hohenfellner M, Teber D. [Navigation in urological surgery: Possibilities and limits of current techniques]. Urologe A 2016; 54:709-15. [PMID: 25572970 DOI: 10.1007/s00120-014-3709-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Surgical navigation describes the concept of real-time processing and presentation of preoperative and intraoperative data from different sources to intraoperatively provide surgeons with additional cognitive support. Imaging methods such as 3D ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) and data from optical, electromagnetic or mechanical tracking methods are used. The resulting information of the navigation system will be presented by the means of visual methods. Mostly virtual reality or augmented reality visualization is used. There are different guidance systems for various disciplines introduced. Mostly it operates on rigid structures (bone, brain). For soft tissue navigation motion compensation and deformation detection are necessary. Therefore, marker-based tracking methods are used in several urological application examples; however, the systems are often still under development and have not yet arrived in the clinical routine.
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Affiliation(s)
- T Simpfendörfer
- Urologische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland,
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Höfflin R, Roth W, Sültmann H, Grüllich C, Hatiboglu G, Nyarangi-Dix J, Schönberg G, Teber D, Hadaschik B, Pahernik S, Hohenfellner M, Duensing S. [Intratumoral heterogeneity in renal cell carcinoma. Molecular basis and translational implications]. Urologe A 2016; 54:800-3. [PMID: 25758237 DOI: 10.1007/s00120-015-3800-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Advanced clear cell renal cell carcinoma is characterized by extensive intratumoral genomic heterogeneity and branched as well as convergent evolutionary traits with genomically different subclones evolving in parallel in the same tumor. Distinct driver mutations can be found in spatially separated subclones, which may hinder the development of novel targeted therapies. However, truncal mutations of the VHL tumor suppressor gene and chromosome 3p loss were ubiquitously detected and will hence continue to be a focus of future drug development. Nevertheless, genomic instability, enhanced tumor genome plasticity and intratumoral heterogeneity are likely to represent major challenges towards biomarker development and personalized patient care.
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Affiliation(s)
- R Höfflin
- Sektion Molekulare Uroonkologie, Urologische Universitätsklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 517, 69120, Heidelberg, Deutschland
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Hatiboglu G, Huber J, Herpel E, Popeneciu IV, Nyarangi-Dix J, Teber D, Hadaschik BA, Pahernik S, Duensing S, Hohenfellner M. [Structure of biobanks for urological research]. Urologe A 2014; 54:1256-60. [PMID: 25503899 DOI: 10.1007/s00120-014-3722-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Biomedical research plays an important role in the development of novel diagnostic procedures, drugs and treatment strategies with regard to cancerous and chronic inflammatory diseases. Biobanks are essential tools in this process. The complex structures and benefits of biobanks are presented in this article.
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Affiliation(s)
- G Hatiboglu
- Klinik und Poliklinik für Urologie, Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland,
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Wolf MB, Roethke M, Pahernik S, Hadaschik B, Kuru T, Popeneciu IV, Hatiboglu G, Chin J, Billia M, Relle J, Hafron J, Nandalur K, Burtnyk M, Schlemmer HP. Localised prostate cancer treated with MRI-guided transurethral ultrasound ablation: phase I trial results. Cancer Imaging 2014. [PMCID: PMC4242781 DOI: 10.1186/1470-7330-14-s1-s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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15
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Hatiboglu G, Hadaschik B, Teber D, Duensing S, Hohenfellner M, Pahernik S. [Management of prostate cancer in the elderly]. Urologe A 2013; 52:832-7. [PMID: 23695158 DOI: 10.1007/s00120-013-3152-2] [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: 10/26/2022]
Abstract
The management of prostate cancer in elderly patients is a topic of controversial discussion. The current guidelines recommend diagnosis and treatment of prostate cancer only in patients with a life expectancy of more than 10 years. Especially in elderly patients pre-existing comorbidities play a crucial role in life expectancy. In clinical practice mostly patient age alone is considered for the treatment decision; however, a guideline-based therapy of prostate cancer should also be offered to elderly patients. The treatment decision should be based on patient general health status and the oncological risk. The patient individual health status can be determined on the basis of comorbidities present and patient nutritional and performance status. For an optimal therapy regime the oncological risk has to be considered in treatment decisions. The aim of this article is to give an overview of risk stratification and treatment options for localized and metastatic prostate cancer in elderly patients.
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Affiliation(s)
- G Hatiboglu
- Klinik für Urologie und Kinderurologie, Urologische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Deutschland.
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Hatiboglu G, Pfitzenmaier J, Pahernik S, Herfarth K, Hadaschik B, Hohenfellner M. UP-02.205 Hydro-Dissection Technique for Fast and Safe Transperineal Spacer Injection. Urology 2011. [DOI: 10.1016/j.urology.2011.07.1023] [Citation(s) in RCA: 2] [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: 11/26/2022]
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Nyarangi-Dix JN, Schultz-Lampel D, Hohenfellner U, Huber J, Hatiboglu G, Djakovic N, Haferkamp A, Hohenfellner M. [Conservative management of postoperative urinary incontinence in men]. Urologe A 2010; 49:498-503. [PMID: 20376652 DOI: 10.1007/s00120-010-2264-1] [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: 10/19/2022]
Abstract
Urinary incontinence in men most commonly occurs after radical prostatectomy. Of these patients, 3-23% remain incontinent a year after prostatectomy. Data on conservative therapy for postoperative incontinence is contradictory. Nonetheless, conservative treatment strategies must generally be attempted before any operative technique. Early pelvic floor muscle training with or without biofeedback therapy and duloxetine seem to have a positive effect on continence. Further randomised controlled studies are necessary to accurately assess other conservative therapeutic options such as extracorporeal magnetic innervation and electrical stimulation therapy.
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Affiliation(s)
- J N Nyarangi-Dix
- Urologische Universitätsklinik, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
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Huber J, Lagally C, Buse S, Hatiboglu G, Höfner T, Hach C, Hohenfellner M. [Infiltrating perineal and scrotal inflammation: rare cutaneous manifestation of familial Mediterranean fever or acne inversa?]. Urologe A 2008; 47:345-7. [PMID: 18210069 DOI: 10.1007/s00120-007-1617-x] [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: 10/22/2022]
Abstract
Familial Mediterranean fever (FMF) can present cutaneous symptoms. In the reported case, infiltrating perineal and scrotal inflammation were attributed to FMF and treated by systemic medication with colchicine. The poor outcome of this conservative approach and pathognomonic axillary dermatological findings allowed the diagnosis of acne inversa to be made. Knowledge of this clinical picture possibly including genital manifestations is crucial, as early excision of all affected regions is the therapy of choice that enables healing.
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Affiliation(s)
- J Huber
- Urologische Universitätsklinik, Ruprecht-Karls-Universität, Heidelberg, Germany.
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