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Laguna MP. Urological Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2024; 211:496-500. [PMID: 38179932 DOI: 10.1097/ju.0000000000003827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2024; 211:197-199. [PMID: 37850551 DOI: 10.1097/ju.0000000000003753] [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] [Received: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
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Freitas NR, Vieira PM, Tinoco C, Anacleto S, Oliveira JF, Vaz AIF, Laguna MP, Lima E, Lima CS. Multiple mask and boundary scoring R-CNN with cGAN data augmentation for bladder tumor segmentation in WLC videos. Artif Intell Med 2024; 147:102723. [PMID: 38184356 DOI: 10.1016/j.artmed.2023.102723] [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: 02/10/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 01/08/2024]
Abstract
Automatic diagnosis systems capable of handling multiple pathologies are essential in clinical practice. This study focuses on enhancing precise lesion localization, classification and delineation in transurethral resection of bladder tumor (TURBT) to reduce cancer recurrence. Despite deep learning models success, medical applications face challenges like small and limited datasets and poor image characterization, including the absence lack of color/texture modeling. To address these issues, three solutions are proposed: (1) an improved texture-constrained version of the pix2pixHD cGAN for data augmentation, addressing the tradeoff of generating high-quality images with enough stochasticity using the Fréchet Inception Distance (FID) measure. (2) Introducing the Multiple Mask and Boundary Scoring R-CNN (MM&BS R-CNN), a new mask sub-net scheme where multiple masks are generated from the different levels of the mask sub-net pipeline, improving segmentation accuracy by including a new scoring module to refine object boundaries. (3) A novel accelerated training strategy based on the SGD optimizer with the second momentum. Experimental results show significant mAP improvements: the data generation scheme improves by more than 12 %; MM&BS R-CNN proposed architecture is responsible for an improvement of about 1.25 %, and the training algorithm based on the second-order momentum increases mAP by 2-3 %. The simultaneous use of all three proposals improved the state-of-the-art mAP by 17.44 %.
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Affiliation(s)
- Nuno R Freitas
- CMEMS-UMinho, University of Minho, 4800-058 Guimaraes, Portugal; LABBELS - Associate Laboratory, Guimaraes, Portugal.
| | - Pedro M Vieira
- CMEMS-UMinho, University of Minho, 4800-058 Guimaraes, Portugal; LABBELS - Associate Laboratory, Guimaraes, Portugal
| | - Catarina Tinoco
- Department of Urology, Hospital of Braga, 4710-243 Braga, Portugal
| | - Sara Anacleto
- Department of Urology, Hospital of Braga, 4710-243 Braga, Portugal
| | - Jorge F Oliveira
- Instituto de Telecomunicações, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; School of Technology and Management, Polytechnic Institute of Leiria, Morro do Lena, Alto Vieiro, Apartado 4163, 2411-901 Leiria, Portugal.
| | - A Ismael F Vaz
- Algoritmi Center, University of Minho, Guimaraes, Portugal.
| | - M Pilar Laguna
- Department of Urology, Istanbul Medipol University, 34214 Istanbul, Turkey; Department of Biomedical Engineering and Physics, AMC-University of Amsterdam, L0-108, 1105 AZ Amsterdam, the Netherlands.
| | - Estêvão Lima
- Life and Health Sciences Research Institute, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; Department of Urology, CUF Hospitals, 4100-180 Oporto, Portugal.
| | - Carlos S Lima
- CMEMS-UMinho, University of Minho, 4800-058 Guimaraes, Portugal; LABBELS - Associate Laboratory, Guimaraes, Portugal.
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 210:926-928. [PMID: 37774388 DOI: 10.1097/ju.0000000000003668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 10/01/2023]
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Boormans JL, Sylvester R, Anson-Cartwright L, Glicksman RM, Hamilton RJ, Hahn E, Daugaard G, Lauritsen J, Wagner T, Avuzzi B, Nicolai N, Del Muro XG, Aparicio J, Stalder O, Rothermundt C, Fischer S, Laguna MP. Prognostic Factor Risk Groups for Clinical Stage I Seminoma: An Individual Patient Data Analysis by the European Association of Urology Testicular Cancer Guidelines Panel and Guidelines Office. Eur Urol Oncol 2023:S2588-9311(23)00232-8. [PMID: 37951820 DOI: 10.1016/j.euo.2023.10.014] [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: 09/07/2023] [Revised: 09/28/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The relapse rate in patients with clinical stage I (CSI) seminomatous germ cell tumor of the testis (SGCTT) who were undergoing surveillance after radical orchidectomy is 4-30%, depending on tumor size and rete testis invasion (RTI). However, the level of evidence supporting the use of both risk factors in clinical decision-making is low. OBJECTIVE We aimed to identify the most important prognostic factors for relapse in CSI SGCTT patients. DESIGN, SETTING, AND PARTICIPANTS Individual patient data for 1016 CSI SGCTT patients diagnosed between 1994 and 2019 with normal postorchidectomy serum tumor marker levels and undergoing surveillance were collected from nine institutions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariable Cox proportional hazard regression models were fit to identify the most important prognostic factors. The primary endpoint was the time to first relapse by imaging and/or markers. Relapse probabilities were estimated by the Kaplan-Meier method. RESULTS AND LIMITATIONS After a median follow-up of 7.7 yr, 149 (14.7%) patients had relapsed. Categorical tumor size (≤2, >2-5, and >5 cm), presence of RTI, and lymphovascular invasion were used to form three risk groups: low (56.4%), intermediate (41.3%), and high (2.3%) risks with 5-yr cumulative relapse probabilities of 8%, 20%, and 44%, respectively. The model outperformed the currently used model with tumor size ≤4 versus >4 cm and presence of RTI (Harrell's C index 0.65 vs 0.61). The low- and intermediate-risk groups were validated successfully in an independent cohort of 285 patients. CONCLUSIONS The risk of relapse after radical orchidectomy in CSI SGCTT patients under surveillance is low. We propose a new risk stratification model that outperformed the current model and identified a small subgroup with a high risk of relapse. PATIENT SUMMARY The risk of relapse after radical orchidectomy in patients with clinical stage I seminomatous germ cell tumor of the testis is low. We propose a new risk stratification model that outperformed the current model and identified a small subgroup with a high risk of relapse.
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Affiliation(s)
- Joost L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Richard Sylvester
- European Association of Urology Guidelines Office, Brussels, Belgium
| | - Lynn Anson-Cartwright
- Department of Surgery (Urology), Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Robert J Hamilton
- Department of Surgery (Urology), Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ezra Hahn
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Gedske Daugaard
- Department of Oncology 5073, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jakob Lauritsen
- Department of Oncology 5073, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Wagner
- Department of Oncology 5073, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Barbara Avuzzi
- Radiation Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Nicolai
- Urology Unit, Fondazione IRCCS Instituto Nazionale dei Tumori, Milan, Italy
| | - Xavier García Del Muro
- Department of Medical Oncology, Hospital Universitario y Politécnico La Fe, Valencia, Spain(1)
| | - Jorge Aparicio
- Department of Medical Oncology, Hospital Universitario y Politécnico La Fe, Valencia, Spain(1)
| | - Odile Stalder
- Department of Medical Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | | | - Stefanie Fischer
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - M Pilar Laguna
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 210:818-821. [PMID: 37615289 DOI: 10.1097/ju.0000000000003667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 210:714-715. [PMID: 37490595 DOI: 10.1097/ju.0000000000003632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 210:562-564. [PMID: 37334533 DOI: 10.1097/ju.0000000000003586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/20/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 210:215-216. [PMID: 37128715 DOI: 10.1097/ju.0000000000003471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023:101097JU0000000000003539. [PMID: 37199092 DOI: 10.1097/ju.0000000000003539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 209:804-806. [PMID: 36660916 DOI: 10.1097/ju.0000000000003171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Laguna MP. Urologic Oncology: Adrenal, Renal, Ureteral, and Retroperitoneal Tumors. J Urol 2023; 209:1227-1228. [PMID: 36950937 DOI: 10.1097/ju.0000000000003416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
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Heidenreich A, Seelemeyer F, Altay B, Laguna MP. Testis-sparing Surgery in Adult Patients with Germ Cell Tumors: Systematic Search of the Literature and Focused Review. Eur Urol Focus 2022; 9:244-247. [PMID: 36418210 DOI: 10.1016/j.euf.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/22/2022]
Abstract
Testis-sparing surgery (TSS) is a guideline-recommended treatment option for men with synchronous or metachronous bilateral testicular germ-cell tumor (GCT) or GCT in a solitary testicle. The tumor volume should not exceed 50% of the total testicular volume and serum concentrations of both testosterone and luteinizing hormone should be within the normal ranges. After tumor enucleation, patients should undergo adjuvant radiation of the testicle in case of germ cell neoplasia in situ. The local relapse rate is approximately 4% if TSS is performed properly. Physiological serum testosterone concentrations are achieved in more than 85% of patients, and approximately 50% of men with intact spermatogenesis can achieve paternity. The risk of systemic metastases is not increased by TSS. PATIENT SUMMARY: Testis-sparing surgery is the treatment of choice for men with testicular cancer in both testes or in men who have just one testis. In more than 85% of patients this approach results in maintenance of normal testosterone levels.
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Affiliation(s)
- Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Vienna, Austria.
| | - Felix Seelemeyer
- Department of Urology, Medipol Mega, Istanbul Medipol University, Istanbul, Turkey
| | - Bulent Altay
- Department of Urology, Medipol Mega, Istanbul Medipol University, Istanbul, Turkey
| | - M Pilar Laguna
- Department of Urology, Medipol Mega, Istanbul Medipol University, Istanbul, Turkey
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Freitas NR, Vieira PM, Cordeiro A, Tinoco C, Morais N, Torres J, Anacleto S, Laguna MP, Lima E, Lima CS. Detection of bladder cancer with feature fusion, transfer learning and CapsNets. Artif Intell Med 2022; 126:102275. [DOI: 10.1016/j.artmed.2022.102275] [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] [Received: 06/29/2021] [Revised: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 12/24/2022]
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Soria F, Laguna MP, Roupret M, Garcia-Marchinena P, Gonzalez MS, Habuchi T, Erkan E, Ng A, Gontero P, de la Rosette J. Flexible fibre optic vs digital ureteroscopy and enhanced vs unenhanced imaging for diagnosis and treatment of upper tract urothelial carcinoma (UTUC): results from the Clinical Research Office of the Endourology Society (CROES)-UTUC registry. BJU Int 2021; 128:734-743. [PMID: 34028166 PMCID: PMC9292011 DOI: 10.1111/bju.15494] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives To compare the oncological outcomes of patients with upper tract urothelial carcinoma (UTUC) undergoing kidney‐sparing surgery (KSS) with fibre‐optic (FO) vs digital (D) ureteroscopy (URS). To evaluate the oncological impact of image‐enhancement technologies such as narrow‐band imaging (NBI) and Image1‐S in patients with UTUC. Patients and Methods The Clinical Research Office of the Endourology Society (CROES)‐UTUC registry is an international, multicentre, cohort study prospectively collecting data on patients with UTUC. Patients undergoing flexible FO‐ or D‐URS for diagnostic or diagnostic and treatment purposes were included. Differences between groups in terms of overall survival (OS) and disease‐free survival (DFS) were evaluated. Results The CROES registry included 2380 patients from 101 centres and 37 countries, of whom 401 patients underwent URS (FO‐URS 186 and D‐URS 215). FO‐URS were performed more frequently for diagnostic purposes, while D‐URS was peformed when a combined diagnostic and treatment strategy was planned. Intra‐ and postoperative complications did not differ between the groups. The 5‐year OS and DFS rates were 91.5% and 66.4%, respectively. The mean OS was 42 months for patients receiving FO‐URS and 39 months for those undergoing D‐URS (P = 0.9); the mean DFS was 28 months in the FO‐URS group and 21 months in the D‐URS group (P < 0.001). In patients who received URS with treatment purposes, there were no differences in OS (P = 0.9) and DFS (P = 0.7). NBI and Image1‐S technologies did not improve OS or DFS over D‐URS. Conclusions D‐URS did not provide any oncological advantage over FO‐URS. Similarly, no differences in terms of OS and DFS were found when image‐enhancement technologies were compared to D‐URS. These findings underline the importance of surgeon skills and experience, and reinforce the need for the centralisation of UTUC care.
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Affiliation(s)
- Francesco Soria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - M Pilar Laguna
- Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - Morgan Roupret
- GRC 5 Predictive ONCO-URO, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | | | | | | | - Erkan Erkan
- TCSB Istanbul Training Hospital, Istanbul, Turkey
| | - Anthony Ng
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - Jean de la Rosette
- Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey
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Calik G, Laguna MP, Gravas S, Albayrak S, de la Rosette J. Preservation of antegrade ejaculation after surgical relief of benign prostatic obstruction is a valid endpoint. World J Urol 2021; 39:2277-2289. [PMID: 33796882 DOI: 10.1007/s00345-021-03682-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/02/2021] [Accepted: 03/20/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To review the current data on retrograde ejaculation (RE) and ejaculatory dysfunction (EjD) after endoscopic and minimally invasive surgical treatment of benign prostatic obstruction (BPO) and, their perceived impact in the quality of life (QoL) and sexual life of patients and their partners. METHODS Narrative review of systematic reviews (SR) assessing comparative rates of RE, EjD or erectile dysfunction (EF) was carried out. Relevant articles on the prevalence of RE, EjD or EF and on their impact in the QoL or sexual life of patients and partners were manually selected based on relevance. RESULTS Twelve SRs reporting on comparisons of different endoscopic/minimally invasive treatments of BPO were found. Data on outcomes varied widely. Overall, after conventional TURP or laser techniques 42-75% of patients present RE. Prostatic incision and ablative procedures present lowest rates of de novo RE or EjD whereas laser adenomectomy and ejaculation preservation procedures preserve antegrade ejaculation in 46-68% of patients. EjDs is associated to LUTS and present in 10% of sexualy active men before intervention. It modulates the QoL and sexual life of the couple. In spite of the scarce literature assessing patient's and partner's perception of postoperative EjD, it strongly suggests that both parties value the maintenance of the ejaculatory function. CONCLUSION Ejaculation-preserving techniques and minimally invasive techniques successfully prevent BPO treatment-induced RE or EjD in 70-100% of the cases. While this is appealing to patients and spouses, technique selection and treatment durability are issues to be discussed with the couple.
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Affiliation(s)
- Gokhan Calik
- Department of Urology, Faculty of Medicine, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - M Pilar Laguna
- Department of Urology, Faculty of Medicine, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - Stavros Gravas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Selami Albayrak
- Department of Urology, Faculty of Medicine, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - Jean de la Rosette
- Department of Urology, Faculty of Medicine, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey.
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Fankhauser CD, Oldenburg J, Albers P, Algaba F, Bokemeyer C, Boormans JL, Fischer S, Fizazi K, Gremmels H, Mayor de Castro J, Janisch F, Muilwijk T, Leão R, Nicol D, Nicolai N, Tandstad T, Pilar Laguna M. Recommendations to Balance Benefits and Risks Of Thromboprophylaxis and to Avoid Central Venous-access Devices During First-line Chemotherapy in Men with Metastatic Germ Cell Tumors: The European Association Of Urology Testicular Cancer Panel Position in 2021. Eur Urol 2021; 80:4-6. [PMID: 33722419 DOI: 10.1016/j.eururo.2021.02.032] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 11/28/2022]
Abstract
Men with metastatic germ cell tumors undergoing chemotherapy are at high risk of venous thromboembolic events and low risk of bleeding. A central venous-access device should be avoided whenever possible. Thromboprophylaxis may be prescribed after balancing the risks and benefits for each individual patient.
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Affiliation(s)
| | - Jan Oldenburg
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Peter Albers
- Department of Urology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ferran Algaba
- Department of Pathology, Fundacio Puigvert, Barcelona, Spain
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Pneumology Section, Universitätskliniken Eppendorf, Hamburg, Germany
| | - Joost L Boormans
- Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Stefanie Fischer
- Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Hendrik Gremmels
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | | | - Florian Janisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Muilwijk
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Ricardo Leão
- Department of Urology, Faculty of Medicine, University of Coimbra, Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - David Nicol
- Department of Urology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Nicola Nicolai
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Torgrim Tandstad
- Department of Oncology, The Cancer Clinic, St. Olav's University Hospital, Trondheim, Norway
| | - M Pilar Laguna
- Department of Urology Medipol Mega, Istanbul Medipol University, Istanbul, Turkey
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Amaresh M, Hegde P, Chawla A, de la Rosette JJMCH, Laguna MP, Kriplani A. Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study. World J Urol 2020; 39:2155-2161. [PMID: 32865690 PMCID: PMC8216999 DOI: 10.1007/s00345-020-03409-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 05/05/2020] [Accepted: 08/11/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones. Methods Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (p value < 0.05). Results Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (p = 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (p = 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (p = 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (p = 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (p = 0.243).Post operatively blood transfusion was required in two patients in group 2 (p = 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (p = 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (p = 0.046). Conclusions Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications. Study registration Clinical trials registry – INDIA; CTRI/2018/07/014,687.
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Affiliation(s)
- M Amaresh
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
| | - P Hegde
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
| | - A Chawla
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India.
| | | | - M P Laguna
- Department of Urology, Istanbul Medipol University Hospital, Istanbul, Turkey
| | - A Kriplani
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
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Kordan Y, Canda AE, Köseoğlu E, Balbay D, Laguna MP, de la Rosette J. Robotic-Assisted Simple Prostatectomy: A Systematic Review. J Clin Med 2020; 9:E1798. [PMID: 32527020 PMCID: PMC7356910 DOI: 10.3390/jcm9061798] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 05/05/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
Contemporary minimally invasive surgical (MIS) treatment options of patients with male Lower Urinary Tract Symptoms (LUTS) in men with prostate glands >80 mL include Holmium Laser Enucleation Prostate (HoLEP), Thulium laser VapoEnucleation Prostate (ThuVEP), and Laparoscopic (LSP) or Robotic-Assisted Simple Prostatectomy (RASP). Implementing new laser technologies is costly, and the steep learning curve of these laser techniques limit their wide range use. This promoted the use of LSP and RASP in centers with readily established laparoscopy or robotic surgery programs. The aim of this study is to review case and comparative series of RASP. We systematically reviewed published data from 2008 to 2020 on RASP and have identified 26 non-comparative and 9 comparative case series. RASP has longer operation time but less time spent in hospital and less blood loss. The outcomes of improvements in symptom score, post-voiding residual urine (PVR), postoperative PSA decline, complications, and cost are similar when compared to open and laser enucleation techniques. These outcomes position RASP as a viable MIS treatment option for patients with male LUTS needing surgical treatment for enlarged prostates. Nevertheless, prospective, randomized controlled trials (RCTs) with multicenter and large sample size are needed to confirm the findings of this systematic review.
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Affiliation(s)
- Yakup Kordan
- Department of Urology, School of Medicine, Koc University, Zeytinburnu, 34010 Istanbul, Turkey; (A.E.C.); (E.K.); (D.B.)
| | - Abdullah Erdem Canda
- Department of Urology, School of Medicine, Koc University, Zeytinburnu, 34010 Istanbul, Turkey; (A.E.C.); (E.K.); (D.B.)
| | - Ersin Köseoğlu
- Department of Urology, School of Medicine, Koc University, Zeytinburnu, 34010 Istanbul, Turkey; (A.E.C.); (E.K.); (D.B.)
| | - Derya Balbay
- Department of Urology, School of Medicine, Koc University, Zeytinburnu, 34010 Istanbul, Turkey; (A.E.C.); (E.K.); (D.B.)
| | - M. Pilar Laguna
- Department of Urology, School of Medicine, Istanbul Medipol University, 34083 Istanbul, Turkey; (M.P.L.); (J.d.l.R.)
| | - Jean de la Rosette
- Department of Urology, School of Medicine, Istanbul Medipol University, 34083 Istanbul, Turkey; (M.P.L.); (J.d.l.R.)
- Amsterdam University Medical Centers, 1105 Amsterdam, The Netherlands
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Laguna MP. Re: Effect of Renal Mass Biopsy on Subsequent Nephrectomy Outcomes: A Population-Based Assessment. J Urol 2020; 203:1059-1060. [PMID: 32182169 DOI: 10.1097/ju.0000000000000998.01] [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]
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21
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Laguna MP. Re: Evolving Trends for Selected Treatments of T1a Renal Cell Carcinoma. J Urol 2020; 203:877. [PMID: 32073958 DOI: 10.1097/ju.0000000000000777] [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]
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22
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Baard J, Celebi M, de la Rosette J, Alcaraz A, Shariat S, Cormio L, Cavadas V, Laguna MP. Evaluation of Patterns of Presentation, Practice, and Outcomes of Upper Tract Urothelial Cancer: Protocol for an Observational, International, Multicenter, Cohort Study by the Clinical Research Office of the Endourology Society. JMIR Res Protoc 2020; 9:e15363. [PMID: 32012106 PMCID: PMC7007587 DOI: 10.2196/15363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/14/2019] [Accepted: 10/20/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Available guidelines on the management of upper tract urothelial carcinoma (UTUC) are restricted due to the lack of strong evidence-based recommendations. Adequate, well-powered randomized trials are missing due to the rarity of the disease. To overcome this problem, we need alternative study designs to provide generalizable data. OBJECTIVE The primary aim of this registry is to provide a real-world overview on patterns of presentation and management of UTUC. Secondary objectives include comparison of outcomes of different treatments and tumor stages and evaluation of compliance with the current European Association of Urology recommendations for UTUC. METHODS For this observational, international, multicenter, cohort study, clinical data of consecutive patients suspected of having UTUC, irrespective of type of management, will be prospectively collected up to 5 years after inclusion. Data on the patterns of presentation, diagnostics, and treatment as well as short-, mid-, and long-term oncological and functional outcomes will be analyzed. Possible associations between variables, basal characteristics, and outcomes will be tested by multivariable analyses. The methodology will address potential sources of bias and confounders. RESULTS The registry was initiated in November 2014 after obtaining institutional review board approval. Data collection started in December 2014. At the time of submission of this manuscript, 2451 patients from 125 centers from 37 countries were included. Inclusion of patients will be closed 5 years after initiation of the registry. Quality checks will be performed centrally with continuous communication and feedback with the centers to ensure accuracy. The first results are expected in the first trimester of 2020. CONCLUSIONS This large observational prospective cohort will generate landmark "real-world" data and hypotheses for further studies. We expect these data to optimize the management of UTUC, provide insights on harms and benefits of treatment, and serve as quality control. TRIAL REGISTRATION ClinicalTrials.gov NCT02281188; https://clinicaltrials.gov/ct2/show/NCT02281188. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15363.
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Affiliation(s)
- Joyce Baard
- Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | | | | | - Shahrokh Shariat
- Medical University of Vienna, Vienna, Austria
- University of Texas Southwestern, Dallas, TX, United States
- Motol Hospital Charles University, Prague, Czech Republic
- IM Sechenov University, Moscow, Russian Federation
| | | | - Vítor Cavadas
- Centro Hospitalar Universitário do Porto, Porto, Portugal
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Sandbergen L, Spriensma AS, de la Rosette JJ, Laguna MP. Health-related quality of life in localized renal masses: A matter of sparing nephrons or minimizing the incision? Urol Oncol 2019; 38:43.e1-43.e11. [PMID: 31711835 DOI: 10.1016/j.urolonc.2019.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/10/2019] [Accepted: 09/22/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Longitudinal assessment of health-related quality of life (HRQoL) differences in patients with localized renal masses according to treatment strategy. METHODS Consecutive patients ≥ 18 years with localized renal masses treated with different approaches (open [O], laparoscopic [L], and percutaneous [P]) and modalities (radical nephrectomy [RN], nephron sparing surgery [NSS] and cryoablation [CA]). The SF-36, Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 questionnaires and pain visual analog scale were completed pretreatment and at 1, 3, and 12 months posttreatment. Questionnaire results were stratified according to approach and treatment modality using a longitudinal multilevel linear regression model. Clinical patient and tumor characteristics, complications, and histopathology results were tested as confounders. RESULTS Ninety eight patients completed baseline and at least one follow-up questionnaires; 27.5%, 16.3%, 22.5%, 9.2%, 13.3%, and 11.2% patients received LNSS, ONSS, LRN, ORN, LCA, and PCA, respectively. Higher baseline SF-36 (3 domains) and Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 scores were reported in L group compared with the O approach. Overall, HRQoL decreased at 1 month and gradually normalized to baseline level or higher at 1 year. For treatment modality at baseline, higher mean visual analog scale was observed in CA than RN group. A trend to decreased HRQoL was observed at 1 month for RN and NSS; thereafter, scores normalized to baseline levels or higher. Approach or treatment modality HRQoL did not change substantially when corrected for confounders. CONCLUSION At short-term, HRQoL outcome favored minimally invasive treatment of RCC; at mid-term, these advantages were no longer apparent. This suggest that in selecting the best surgical treatment for the patient, oncological outcome should be the primary consideration as both approach and treatment modality result in similar HRQoL outcomes.
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Affiliation(s)
- Laura Sandbergen
- Amsterdam UMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam, the Netherlands
| | - Alette S Spriensma
- Amsterdam UMC, VU University Medical Center, Department of Epidemiology & Biostatistics, Amsterdam, the Netherlands
| | | | - M Pilar Laguna
- Istanbul Medipol University, Department of Urology, Istanbul, Turkey.
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Laguna MP. Re: Below Safety Limits, Every Unit of Glomerular Filtration Rate Counts: Assessing the Relationship between Renal Function and Cancer-Specific Mortality in Renal Cell Carcinoma. J Urol 2019; 201:1049-1050. [PMID: 30865856 DOI: 10.1097/ju.0000000000000225] [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]
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25
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Laguna MP. Re: Multiple Growth Periods Predict Unfavourable Pathology in Patients with Small Renal Masses. J Urol 2018. [DOI: 10.1016/j.juro.2018.09.016] [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: 12/01/2022]
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Deng T, Chen Y, Liu B, Laguna MP, de la Rosette JJMCH, Duan X, Wu W, Zeng G. Systematic review and cumulative analysis of the managements for proximal impacted ureteral stones. World J Urol 2018; 37:1687-1701. [PMID: 30430253 DOI: 10.1007/s00345-018-2561-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/03/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To compare the efficacy and safety of different treatment options for the management of proximal impacted ureteral stones (PIUS). METHODS A systematic literature search using Pubmed, Medline, Embase and Cochrane Library was conducted to obtain studies concerning different managements for PIUS up to Jan 2018. Summary odds ratios (ORs), standard mean differences (SMDs) or weighted mean differences with their 95% confidence intervals (CIs) were calculated to compare the efficacy and safety of all included treatment methods, registered in PROSPERO under number CRD42018092745. RESULTS A total of 15 comparative studies with 1780 patients were included. Meta-analyses of final stone-free rate (SFR) favored percutaneous nephrolithotomy (PCNL) over ureteroscopic lithotripsy (URL) (OR 10.35; 95% CI 5.26-20.35; P < 0.00001), laparoscopic ureterolithotomy over URL (OR 0.11; 95% CI 0.05-0.25; P < 0.00001) and URL over extracorporeal shockwave lithotripsy (OR 0.47; 95% CI 0.28-0.77; P = 0.003). As to complications, PCNL had a significantly higher blood transfusion rate (OR 7.47; 95% CI 1.3-42.85; P = 0.02) and a lower ureteral injury rate (OR 0.15; 95% CI 0.04-0.52; P = 0.003) compared with URL. It also shared a significantly lower stone-retropulsion rate (OR 0.03; 95% CI 0.01-0.15; P < 0.0001) and higher treatment costs (SMD = 2.71; 95% CI 0.71-4.70; P = 0.008) than URL. CONCLUSIONS Our meta-analysis suggested that PCNL might be the best option for PIUS owing to its higher successful rate. Complications such as hemorrhage could be decreased by the application on mini-PCNL.
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Affiliation(s)
- Tuo Deng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1#, Haizhu District, Guangzhou, 510230, China.,Guangzhou Institute of Urology, Guangzhou, China.,Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Yiwen Chen
- Department of Urology, Longgang District Central Hospital, Shenzhen, China
| | - Bing Liu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - M Pilar Laguna
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey.,AMC University Hospital, Amsterdam, The Netherlands
| | - Jean J M C H de la Rosette
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey.,AMC University Hospital, Amsterdam, The Netherlands
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1#, Haizhu District, Guangzhou, 510230, China.,Guangzhou Institute of Urology, Guangzhou, China.,Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1#, Haizhu District, Guangzhou, 510230, China.,Guangzhou Institute of Urology, Guangzhou, China.,Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1#, Haizhu District, Guangzhou, 510230, China. .,Guangzhou Institute of Urology, Guangzhou, China. .,Guangdong Key Laboratory of Urology, Guangzhou, China.
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Laguna MP. Re: Patients' Preferences for Adjuvant Sorafenib after Resection of Renal Cell Carcinoma in the SORCE Trial: What Makes it Worthwhile? J Urol 2018; 200:494-496. [PMID: 30412976 DOI: 10.1016/j.juro.2018.05.103] [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] [Accepted: 05/24/2018] [Indexed: 11/24/2022]
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Laguna MP. Re: Perioperative Morbidity of Lymph Node Dissection for Renal Cell Carcinoma: A Propensity Score-Based Analysis. J Urol 2018; 200:495-496. [PMID: 30412977 DOI: 10.1016/j.juro.2018.05.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Laguna MP. Re: A Multigene Signature Based on Cell Cycle Proliferation Improves Prediction of Mortality within 5 Yr of Radical Nephrectomy for Renal Cell Carcinoma. J Urol 2018; 200:941-942. [PMID: 30360337 DOI: 10.1016/j.juro.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 11/15/2022]
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Laguna MP. Re: Pathological Heterogeneity in Sporadic Synchronous Renal Tumors: Is the Histological Concordance Predictable? J Urol 2018; 200:694-695. [PMID: 30227576 DOI: 10.1016/j.juro.2018.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2018] [Indexed: 11/16/2022]
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Freund JE, Liem EI, Baard J, Kamphuis GM, Laguna MP, de Reijke TM, de la Rosette JJ, de Bruin DM. Confocal Laser Endomicroscopy for the Diagnosis of Urothelial Carcinoma in the Bladder and the Upper Urinary Tract. ACTA ACUST UNITED AC 2018. [DOI: 10.1089/vid.2017.0078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Jan Erik Freund
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
- These authors have contributed equally to this work
| | - Esmee I.M.L. Liem
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
- These authors have contributed equally to this work
| | - Joyce Baard
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | - Guido M. Kamphuis
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Theo M. de Reijke
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Daniel M. de Bruin
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
- Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
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Laguna MP. Re: Trends of Lymphadenectomy in Upper Tract Urothelial Carcinoma (UTUC) Patients Treated with Radical Nephroureterectomy. J Urol 2018. [DOI: 10.1016/j.juro.2018.04.041] [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: 10/17/2022]
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Laguna MP. Re: Randomized Phase III Trial of Adjuvant Pazopanib versus Placebo after Nephrectomy in Patients with Localized or Locally Advanced Renal Cell Carcinoma. J Urol 2018; 199:1393-1394. [PMID: 29783587 DOI: 10.1016/j.juro.2018.03.051] [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: 10/17/2022]
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Laguna MP. Re: Stereotactic Ablative Body Radiotherapy for Inoperable Primary Kidney Cancer: A Prospective Clinical Trial. J Urol 2018; 199:1393-1394. [PMID: 29783588 DOI: 10.1016/j.juro.2018.03.050] [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] [Accepted: 03/12/2018] [Indexed: 10/17/2022]
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Laguna MP. Re: Recommendations for the Management of Rare Kidney Cancers. J Urol 2018; 199:1109. [DOI: 10.1016/j.juro.2018.02.051] [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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Laguna MP. Re: Intravenous Mannitol versus Placebo during Partial Nephrectomy in Patients with Normal Kidney Function: A Double-Blind, Clinically-Integrated, Randomized Trial. J Urol 2018; 199:1108-1109. [PMID: 29677895 DOI: 10.1016/j.juro.2018.02.050] [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] [Accepted: 02/12/2018] [Indexed: 10/18/2022]
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Laguna MP. Re: Defining the Role of Intraoperative Transesophageal Echocardiography during Radical Nephrectomy with Inferior Vena Cava Tumor Thrombectomy for Renal Cell Carcinoma. J Urol 2018; 199:890. [PMID: 29642355 DOI: 10.1016/j.juro.2018.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Laguna MP. Re: Early Tumour Shrinkage: A Tool for the Detection of Early Clinical Activity in Metastatic Renal Cell Carcinoma. J Urol 2018. [PMID: 29539886 DOI: 10.1016/j.juro.2017.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laguna MP. Re: End-Stage Renal Disease after Renal Surgery in Patients with Normal Preoperative Kidney Function: Balancing Surgical Strategy and Individual Disorders at Baseline. J Urol 2018. [PMID: 29539885 DOI: 10.1016/j.juro.2017.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Scheltema MJ, Postema AW, de Bruin DM, Buijs M, Engelbrecht MR, Laguna MP, Wijkstra H, de Reijke TM, de la Rosette JJMCH. Irreversible electroporation for the treatment of localized prostate cancer: a summary of imaging findings and treatment feedback. Diagn Interv Radiol 2018; 23:365-370. [PMID: 28830850 DOI: 10.5152/dir.2017.16608] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Imaging plays a crucial role in ablative therapies for prostate cancer (PCa). Irreversible electroporation (IRE) is a new treatment modality used for focal treatment of PCa. We aimed to demonstrate what imaging modalities can be used by descriptively reporting contrast-enhanced ultrasonography (CEUS), multiparametric magnetic resonance imaging (mpMRI), and grey-scale transrectal ultrasound (TRUS) results. Furthermore, we aimed to correlate quantitatively the ablation zone seen on mpMRI and CEUS with treatment planning to provide therapy feedback. METHODS Imaging data was obtained from two prospective multicenter trials on IRE for localized low- to intermediate-risk PCa. The ablation zone volume (AZV) seen on mpMRI and CEUS was 3D reconstructed to correlate with the planned AZV. RESULTS Descriptive examples are provided using mpMRI, TRUS, and CEUS for treatment planning and follow-up after IRE. The mean AZV on T2-weighted imaging 4 weeks following IRE was 12.9 cm3 (standard deviation [SD]=7.0), 5.3 times larger than the planned AZV. Linear regression showed a positive correlation (r=0.76, P = 0.002). For CEUS the mean AZV was 20.7 cm3 (SD=8.7), 8.5 times larger than the planned AZV with a strong positive correlation (r=0.93, P = 0.001). Prostate volume is reduced over time (mean= -27.5%, SD=11.9%) due to ablation zone fibrosis and deformation, illustrated by 3D reconstruction. CONCLUSION The role of imaging in conjunction with IRE is of crucial importance to guide clinicians throughout the treatment protocol. CEUS and mpMRI may provide essential treatment feedback by visualizing the ablation zone dimensions and volume.
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Laguna MP. Re: Renal Functional Outcomes in Patients Undergoing Percutaneous Cryoablation or Partial Nephrectomy for a Solitary Renal Mass. J Urol 2018. [DOI: 10.1016/j.juro.2017.11.082] [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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Laguna MP. Re: Mortality, Morbidity and Healthcare Expenditures after Local Tumour Ablation or Partial Nephrectomy for T1A Kidney Cancer. J Urol 2018; 198:252-254. [PMID: 29370646 DOI: 10.1016/j.juro.2017.05.015] [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] [Accepted: 05/04/2017] [Indexed: 11/25/2022]
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Laguna MP. Re: Findings and Impact of Early Imaging after Partial Nephrectomy. J Urol 2018; 198:253-254. [PMID: 29370647 DOI: 10.1016/j.juro.2017.05.016] [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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Laguna MP. Re: The Impact of Quality Variations on Patients Undergoing Surgery for Renal Cell Carcinoma: A National Cancer Database Study. J Urol 2018; 199:338-339. [PMID: 29357556 DOI: 10.1016/j.juro.2017.11.049] [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] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
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Basiri A, de la Rosette JJMCH, Tabatabaei S, Woo HH, Laguna MP, Shemshaki H. Comparison of retropubic, laparoscopic and robotic radical prostatectomy: who is the winner? World J Urol 2018; 36:609-621. [DOI: 10.1007/s00345-018-2174-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/03/2018] [Indexed: 12/11/2022] Open
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Laguna MP. Re: Partial Nephrectomy versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-Analysis of Comparative Studies. J Urol 2017; 198:1204-1206. [DOI: 10.1016/j.juro.2017.09.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
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Laguna MP. Re: Efficacy of Systemic Chemotherapy plus Radical Nephroureterectomy for Metastatic Upper Tract Urothelial Carcinoma. J Urol 2017; 198:1205-1206. [PMID: 29144939 DOI: 10.1016/j.juro.2017.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laguna MP. Re: Clear Cell Type A and B Molecular Subtypes in Metastatic Clear Cell Renal Cell Carcinoma: Tumor Heterogeneity and Aggressiveness. J Urol 2017; 198:977-978. [PMID: 29059770 DOI: 10.1016/j.juro.2017.08.026] [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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Laguna MP. Re: A Phase II Study of Intermittent Sunitinib in Previously Untreated Patients with Metastatic Renal Cell Carcinoma. J Urol 2017; 199:23-25. [PMID: 29310178 DOI: 10.1016/j.juro.2017.09.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 01/11/2023]
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Pessoa RR, Autorino R, Laguna MP, Molina WR, Gustafson D, Nogueira L, da Silva RD, Werahera PN, Kim FJ. Laparoscopic Versus Percutaneous Cryoablation of Small Renal Mass: Systematic Review and Cumulative Analysis of Comparative Studies. Clin Genitourin Cancer 2017; 15:513-519.e5. [DOI: 10.1016/j.clgc.2017.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/01/2017] [Accepted: 02/19/2017] [Indexed: 01/24/2023]
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