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Heidenreich A, Pfister D, Walter C, Pearce A, Seelemeyer F, Nichol D. Outcomes of postchemotherapy retroperitoneal lymph node dissection: Comparison of two reference centres to a national data set. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00802-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Giesen A, Van Den Broeck T, Pfister D, Develtere D, Wymer K, Langley S, Hente R, Claessens M, Eden C, Heidenreich A, Karnes R, Raskin Y, Joniau S. Salvage vesiculectomy for local prostate cancer recurrence: PSA response and oncological outcomes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00316-0] [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: 02/12/2023]
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Seelemeyer F, Pfister D, Pappesch R, Merkelbach-Bruse S, Stammel C, Paffenholz P, Heidenreich A. Evaluation of miRNA-371a-3p (miR371a) assay to predict final pathohistology in patients undergoing primary nerve-sparing Retroperitoneal Lymphadenectomy (nsRPLND) for stage IIA/B seminomas and non-seminomas. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00791-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Paffenholz P, Landwehr G, Seidel C, Poch A, Bokemeyer C, Cathomas R, Pongratanakul P, Hiester A, Albers P, Pichler M, Krege S, Syring-Schmandke I, Heinzelbecker J, Nestler T, Pfister D, Heidenreich A. Non-seminomatous testicular germ cell tumours with teratoma-free primaries exhibit a superior early relapse-free survival. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00787-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Nestler T, Paffenholz P, Pfister D, Maatoug Y, Che Y, Hiester A, Albers P, Heidenreich A. Need for organ preservation in Postchemotherapy Retroperitoneal Lymph Node Dissection (PC-RPLND). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00800-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Rajwa P, Pfister D, Rieger C, Heidenreich J, Drzezga A, Persigehl T, Shariat S, Heidenreich A. Importance of magnetic resonance imaging and prostate-specific membrane antigen PET-CT in patients treated with salvage radical prostatectomy for radiorecurrent prostate cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02371-0] [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: 11/11/2022] Open
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Heidenreich A, Paffenholz P, Nestler T, Pfister D. 514P Nerve sparing retroperitoneal lymph node dissection for clinical stage IIA/B seminomas: A clinical phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.642] [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: 11/01/2022] Open
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Oudard S, Beuzeboc P, Voog E, Barthelemy P, Thiery-Vuillemin A, Bennamoun M, Hasbini A, Aldabbagh K, Saldana C, Sevin E, Amela Y, Von Amsberg G, Houede N, Besson D, Feyerabend S, Boegemann M, Pfister D, Schostak M, Huillard O, Helissey C. 1363MO Cabazitaxel every 2 weeks versus every 3 weeks in older patients with metastatic castration-resistant prostate cancer (mCRPC): The CABASTY randomized phase III trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nestler T, Kremer L, Von Brandenstein M, Wittersheim M, Wagener-Ryczek S, Paffenholz P, Mueller S, Quaas A, Hellmich M, Odenthal M, Pfister D, Heidenreich A. Differentially expressed mRNA/proteins can distinguish viable germ cell tumors and teratomas from necrosis in retroperitoneal lymph node resections after chemotherapy (pcRPLND). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00643-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fossati N, Karnes J, Heidenreich A, Kretschmer A, Buchner A, Stief C, Joniau S, Van Poppel H, Osmonov D, Jueneman K, Shariat S, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Pfister D, Mazzone E, Gandaglia G, Stabile A, Gallina A, Mottrie A, Montorsi F, Briganti A. How to optimize patient selection before salvage lymph node dissection for nodal recurrent prostate cancer: A novel risk stratification tool. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00591-7] [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: 11/28/2022]
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Scuderi S, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Jueneman K, Grubmuller B, Shariat S, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Bravi C, Montorsi F, Briganti A. Definition and impact on oncologic outcomes of persistently elevated PSA after salvage lymph node dissection for node-only recurrent prostate cancer after radical prostatectomy: clinical implications for multi-modal therapy. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00895-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Scuderi S, Mazzone E, Heidenreich A, Gandaglia G, Pfister D, Shariat S, Bernhard G, Fossati N, Fallara G, Pellegrino A, Karnes R, Cucchiara V, Bravi C, Scuderi S, Robesti D, Leni R, Cannoletta D, Gallina A, Moschini M, Suardi N, Stabile A, Necchi A, Montorsi F, Briganti A. Which patients with oligometastatic prostate cancer should be considered for cytoreductive radical prostatectomy as part of a multimodal treatment? Results from a large, multi-institutional collaboration. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pfister D, Bündgen M, Schmautz M, Hartmann FH, Heidenreich A. [Influence of the working model on the education of young urologists : Education through the ages]. Urologe A 2021; 60:1432-1439. [PMID: 34170359 DOI: 10.1007/s00120-021-01572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is a trend of increasing discontent of urologic residents with educational programs. One point being mentioned is lack of time during residency for education and self-training. We analyzed the available time for education in our department depending on the used working model through the last 25 years. MATERIALS AND METHODS We calculated the absolute availability of residents during their residency for working models in 1996, 2000, 2007 and 2017. As a basis we used the working model of 1996 as no compensatory time-off for being on call was used. All days on which a delayed start is planned and no schedule in daily routine is possible had been excluded from education time. The numbers implemented in the regulation on further education in the corresponding years had been used to calculate the expenditure of time on the basis of median length of the different intervention. In addition, the patient numbers on the ward and our outpatient clinic had been documented over time. RESULTS With increasing patient numbers in the in- and outpatient clinic there is a continuous decreasing time available for education. The absolute available time in our department is calculated to be 3.1 years compared to 5 years in 1996. With the first day of training a resident has to complete 66.9 min of self-contained diagnostics or interventions per day in addition to clinical routine and administration to meet the requested numbers of the regulation on further education. CONCLUSIONS The limited time being available for the educational program is improved by the current regulation of education. To teach the complex segments of urology there is an urgent need for a well-structured curriculum, which should be used nationwide.
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Affiliation(s)
- D Pfister
- Klinik für Urologie, Uroonkologie, spezielle urologische und roboter-assistierte Chirurgie, Kerpener Str. 62, 50937, Köln, Deutschland.
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Jueneman K, Grubmuller B, Shariat S, Nini A, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Assessing the association between the template of pelvic salvage lymph node dissection for node-only recurrent prostate cancer and oncological outcomes. Results of a multi-institutional series. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Scuderi S, Mazzone E, Heidenreich A, Gandaglia G, Pfister D, Shariat S, Grubmuller B, Fossati N, Fallara G, Pellegrino A, Karnes R, Cucchiara V, Bravi C, Scuderi S, Robesti D, Leni R, Cannoletta D, Gallina A, Moschini M, Suardi N, Stabile A, Necchi A, Montorsi F, Briganti A. Which patients with Oligometastatic Prostate Cancer should be considered for Cytoreductive Radical Prostatectomy as part of a multimodal treatment? Results from a large, multi-institutional collaboration. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01219-7] [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: 10/20/2022]
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmüller B, Shariat S, Nini A, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Identifying the optimal candidates for radiation therapy after salvage lymph node dissection for node-only recurrent prostate cancer after radical prostatectomy: Results from a multi-institutional collaboration. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01563-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Jueneman KP, Grubmuller B, Shariat S, Hiester A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Definition and impact on oncologic outcomes of persistently elevated PSA after salvage lymph node dissection for node-only recurrent prostate cancer after radical prostatectomy: Clinical Implications for multi-modal therapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heidenreich A, Paffenholz P, Nestler T, Tolkach Y, Pfister D. Targeted therapy in patients with chemorefractory, progressing testicular germ cell tumors. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01043-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bravi C, Fossati N, Gandaglia G, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Martini A, Gill I, Mottrie A, Montorsi F, Briganti A. Persistently elevated prostate-specific antigen after salvage lymph node dissection and its impact on long-term oncological outcomes. the importance of an extensive, multi-modal approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Cannoletta D, Gandaglia G, Pfister D, Shariat S, Grubmuller B, Fossati N, Stabile A, Scuderi S, Pellegrino F, Sorce G, Fallara G, Martini A, Cucchiara V, Robesti D, Rizzo A, Scalvi F, Gallina A, Mazzone E, Karakiewicz P, Karnes R, Montorsi F, Briganti A, Heidenreich A. The impact of persistently elevated PSA levels on progression and survival of patients undergoing cytoreductive radical prostatectomy for oligometastatic prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Bravi C, Fossati N, Motterle G, Karnes R, Pfister D, Heidenreich A, Kretschmer A, Buchner A, Stief C, Devos G, Joniau S, Van Poppel H, Osmonov D, Juenemann K, Grubmuller B, Shariat S, Hiester A, Nini A, Albers P, Tilki D, Graefen M, Gill I, Mottrie A, Montorsi F, Briganti A. Persistently elevated prostate-specific antigen after salvage lymph node dissection and its impact on long-term oncological outcomes. The importance of an extensive, multi-modal approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nestler T, Paffenholz P, Pfister D, Hiester A, Nini A, Albers P, Heidenreich A. Adjunctive surgery in postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) - is there always an oncologic benefit? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32835-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Pfister D, Nestler T, Haidl F, Hartmann F, Heidenreich A. Feasibility and oncologic outcome of salvage surgery in isolated seminal vesical remnants after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Paffenholz P, Nestler T, Maatoug Y, Von Brandenstein M, Köditz B, Pfister D, Heidenreich A. Teratomatous elements in orchiectomy specimens are associated with a reduced relapse-free survival in metastasized testicular germ cell tumors. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Nestler T, Paffenholz P, Baeßler B, Hellmich M, Hiester A, Nini A, Pfister D, Albers P, Heidenreich A. Do patients with advanced germ cell tumors still need Postchemotherapy Retroperitoneal Lymph Node Dissection (PC-RPLND) if the two best models predict a “benign” pathohistology? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32833-0] [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: 12/01/2022] Open
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Heidenreich A, Shariat S, Fahad Q, Karnes J, Pfister D. Radical Salvage Prostatectomy (RSP) for Radiorecurrent Prostate Cancer (rPCA): Onological and functional outcome of a large contemporary series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Heidenreich A, Mazzone E, Gandaglia G, Pfister D, Shahrokh S, Grubmueller B, Fossatti N, Karnes J, Montorsi F, Briganti A. Oncological and functional outcomes of cytoreductive radical prostatectomy (cRP) in men with metastatic hormone-naive prostate cancer (mhnPCA). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33708-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ural A, Heidenreich A, Elter T, Michael H, Datta R, Kleinert R, Pfister D. Validation and implementation of a mobile app decision support system for quality assurance of tumor boards. Analyzing the concordance rates for prostate cancer at a multidisciplinary tumor board of a tertiary referral centre. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33394-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ural A, Elter T, Hallek M, Pfister D, Heidenreich A. Validation and implementation of a mobile app decision support system for quality assurance of multidisciplinary tumor boards (MTD) to optimize management of advanced testicular cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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König F, Strauß A, Johannsen M, Mommsen C, Fricke E, Klier J, Mehl S, Pfister D, Sahlmann CO, Werner A, Goebell PJ. [Radium-223 for the treatment of metastatic castration-resistant prostate cancer (mCRPC) : The androgen receptor-independent active agent in the therapeutic sequence]. Urologe A 2019; 59:53-64. [PMID: 31598745 DOI: 10.1007/s00120-019-01052-4] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND Radium-223 improves overall survival and preserves quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC) and symptomatic bone metastases and no known visceral metastases. Radium-223 can be used in combination with a luteinizing hormone releasing hormone (LHRH) analogue and as part of a sequential treatment scheme if disease progresses after at least two prior lines of systemic mCRPC therapies or if no other available systemic treatment is eligible. OBJECTIVES Today physicians are faced with a previously unknown multitude and complexity of options for the treatment of mCRPC. An increasing number of clinical trials contribute to the dynamics of the therapeutic landscape. Radium-223 was approved for mCRPC treatment in 2013. Up to now the recommendations of use have been adjusted several times. Highlighting recent clinical trials and practice, this paper explores the position of radium-223 within the therapeutic sequence and outlines key elements for the interdisciplinary cooperation between uro-oncologists and nuclear medicine specialists. RESULTS The mode of action of radium-223 does not depend on the androgen receptor (AR) pathway. Thus, it is an option in the therapeutic sequence when the efficacy of other agents is reduced by resistance. Furthermore, the efficacy of prior or subsequent medications are neither reduced nor enhanced by radium-223. The opportunity of an AR-independent and survival-prolonging medication should be taken as soon as the indication criteria are met because the incidence of visceral metastases increases during disease progression. According to current mCRPC guidelines, the osteoprotective use of bisphosphonates or denosumab is recommended, before treatment with radium-223 is started or resumed.
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Affiliation(s)
- F König
- ATURO, Fachärzte für Urologie und Andrologie, Berlin, Deutschland
| | - A Strauß
- Klinik für Urologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - M Johannsen
- Urologische Facharztpraxis PD Dr. M. Johannsen & T. Laux, Berlin, Deutschland
| | - C Mommsen
- Praxen für diagnostische und therapeutische Nuklearmedizin, Berlin, Deutschland
| | - E Fricke
- Klinik für Nuklearmedizin, Klinikum Lippe, Lemgo, Deutschland
| | - J Klier
- Urologie Bayenthal, Gemeinschaftspraxis Dr. J. Klier & Dr. T. Strunk, Köln, Deutschland
| | - S Mehl
- Praxen für diagnostische und therapeutische Nuklearmedizin, Berlin, Deutschland
| | - D Pfister
- Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - C-O Sahlmann
- Abteilung Nuklearmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - A Werner
- Radiologie Rhein-Neckar, Schwetzingen und Heidelberg, Deutschland
| | - P J Goebell
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
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Abstract
The current version of the urology training program will concentrate on the mediation of competences and skills in various fields of action for outpatient urology instead of persisting on the minimum and reference numbers of surgical and diagnostic procedures. However, the following fields of action must be fulfilled: microbiology, andrology and systemic cancer therapy. There is justifiable concern that various institutions will lose their permission for a complete 5‑year residency program based on the above-mentioned demands since not all institutions have all subspecialties in urology. Those institutions need to define new ways of residency training such as interdisciplinary programs within their own institution between disciplines like pediatric surgery, gynecology and medical oncology. Other options are combined training programs between regional urology departments with different main focuses or training programs between institutions and urologists in private practice. There is an unmet need to improve residency training as well as board examinations by new structures and a reliable curriculum. Based on the changed main focuses of the new version of urology training, we need to discuss the future of residency programs. It might be helpful to discuss two different types of urology training with a common trunk for the first three years followed by a more outpatient-based residency training for the general urologist and a more specialized training for the inpatient urologist to be educated in complex treatment modalities. An open mind to broadening our own horizon, respectful discussion with other departments and the development of common, reliable and interdisciplinary contents represent indispensable prerequisites to realize such an innovative future training program.
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Affiliation(s)
- A Heidenreich
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - J Salem
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - P Paffenholz
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - D Pfister
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Wülfing C, Bögemann M, Goebell PJ, Hammerer P, Machtens S, Pfister D, Schwentner C, Steuber T, von Amsberg G, Schostak M. [Treatment situation in metastastic Castration Naive Prostate Cancer (mCRPC) and the implications on clinical routine]. Urologe A 2019; 58:1066-1072. [PMID: 31041460 DOI: 10.1007/s00120-019-0925-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is an ongoing change of paradigm in the treatment of metastatic prostate cancer (mPC). Taxan-based chemotherapy demonstrated a prolonged survival of patients in several randomized phase III trials. This is true in the situation of metastatic castration-resistent prostate cancer (mCRPC) as well as in the hormone-naïve stage (metastatic castration-naive PC [mCNPC]). In patients with mCNPC, treatment with docetaxel in combination with androgen deprivation therapy (ADT) prolonged the median total survival time by 15 months in comparison to ADT alone. Comparable results were obtained by the endocrine combination treatment with ADT/abiraterone. With the current data in mind it seems to be useful to discuss the value of early combination therapy with ADT/docetaxel or ADT/abiraterone as well as the impact on further treatment options in the mCRPC setting and to define criteria for treatment decisions in clinical practice.
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Affiliation(s)
- C Wülfing
- Abteilung für Urologie, Asklepios Klinik Altona, Paul-Ehrlich-Straße 1, 22763, Hamburg, Deutschland.
| | - M Bögemann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Münster, Münster, Deutschland
| | - P J Goebell
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - P Hammerer
- Klinik für Urologie und Uro-Onkologie, Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - S Machtens
- Klinik für Urologie und Kinderurologie, GFO Kliniken Rhein Berg, Betriebsstätte, Marien-Krankenhaus Bergisch Gladbach, Bergisch Gladbach, Deutschland
| | - D Pfister
- Klinik für Urologie, Uro-Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - C Schwentner
- Urologische Klinik, Diakonie-Klinikum Stuttgart, Stuttgart, Deutschland
| | - T Steuber
- Martini-Klinik, Prostatakrebszentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - G von Amsberg
- Klinik für Onkologie, Hämatologie und Knochenmarkstransplantation, Onkologisches Zentrum, Universitätsklinikum Hamburg, Hamburg, Deutschland
| | - M Schostak
- Klinik für Urologie und Kinderurologie, Universitätsklinik Magdeburg, Magdeburg, Deutschland
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Nettersheim D, Oing C, Schönberger S, Skowron M, Vermeulen M, Müller M, Watolla M, Bremmer F, Pfister D, Calaminus G, Looijenga L, Lorch A, Albers P. [Current research on pediatric and adult germ cell tumors : A report from the first "Düsseldorfer Testis Cancer Day"]. Urologe A 2019; 58:804-808. [PMID: 31119354 DOI: 10.1007/s00120-019-0954-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D Nettersheim
- Klinik für Urologie, Urologisches Forschungslabor, Translationale Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
| | - C Oing
- Klinik für Onkologie, Hämatologie und Knochenmarkstransplantation mit Abteilung für Pneumologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - S Schönberger
- Zentrum für Kinderheilkunde, Abteilung für Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Skowron
- Klinik für Urologie, Urologisches Forschungslabor, Translationale Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Vermeulen
- Klinik für Urologie, Urologisches Forschungslabor, Translationale Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Müller
- Klinik für Urologie, Urologisches Forschungslabor, Translationale Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Watolla
- Klinik für Urologie, Urologisches Forschungslabor, Translationale Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - F Bremmer
- Institut für Pathologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - D Pfister
- Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - G Calaminus
- Zentrum für Kinderheilkunde, Abteilung für Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - L Looijenga
- Department of Pathology, Laboratory for Experimental Patho-Oncology, Erasmus MC, Cancer Institute, University Medical Center, Rotterdam, Niederlande
- Pediatric Oncology, Princess Maxima Center, Utrecht, Niederlande
| | - A Lorch
- Klinik für Medizinische Onkologie und Hämatologie, Universitätsspital Zürich, Zürich, Schweiz
| | - P Albers
- Klinik für Urologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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Pfister D, Heidenreich A. Management of Residual Tumor in Testicular Cancer. Urol Oncol 2019. [DOI: 10.1007/978-3-319-42603-7_8-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heidenreich A, Paffenholz P, Haidl F, Pfister D. [When is surgical resection of metastases in testicular germ cell tumors indicated and is there a scientific basis?]. Urologe A 2018; 56:627-636. [PMID: 28432399 DOI: 10.1007/s00120-017-0385-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Surgical resection of metastases represents an integral part of curative management in patients with testicular germ cell tumors (GCT). Primary nerve-sparing retroperitoneal lymph node dissection (nsRPLND) for low volume metastases in clinical stages I-IIB has to be differentiated from the more complex and more extensive postchemotherapeutic procedures. In Europe, primary nerve-sparing retroperitoneal lymph node dissection (nsRPLND) for clinical stage I nonseminomatous GCT (NSGCT) plays a subordinate. In clinical stage IIA/B, nsRPLND is indicated for patients with marker-negative metastases in whom cure rates of about 65% can be achieved with surgery alone. For clinical stage IIA/B seminomas, nsRPLND represents an individual, still experimental procedure with high cure rates. Postchemotherapy residual tumor resection (pRTR) for advanced seminomas is only indicated in the context of a FDG-PET/CT-positive residual mass >3 cm in diameter. For NSGCT, pRTR is indicated in patients with residual masses >1 cm and negative or plateauing tumor markers to resect persisting teratoma or vital cancer. Complete resection of all masses including resection of adjacent vascular, visceral or skeletal metastases is mandatory to achieving the highest cure rate possible. Due to the complexity and the lower rate of significant morbidity and mortality, these procedures should be done at tertiary referral centers.
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Affiliation(s)
- A Heidenreich
- Klinik für Urologie, Uro - Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - P Paffenholz
- Klinik für Urologie, Uro - Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - F Haidl
- Klinik für Urologie, Uro - Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - D Pfister
- Klinik für Urologie, Uro - Onkologie, Roboter-assistierte und Spezielle Urologische Chirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Carlson R, Nardi E, Bacigalupo J, Darlow S, McClure J, Pfister D. Resource-stratification of national comprehensive cancer network (NCCN®) head and neck cancers guideline. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.048] [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: 11/14/2022] Open
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Paffenholz P, Pfister D, Heidenreich A. [Postchemotherapy residual tumour resection in complex metastatic sites of advanced testicular germ cell tumours]. Urologe A 2017; 55:632-40. [PMID: 26820659 DOI: 10.1007/s00120-016-0031-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Postchemotherapy residual tumour resection (PC-RTR) is an integral part of the multimodal therapy for advanced testicular germ cell tumours. Depending on the extent and localisation of the residual mass, PC-RTR may necessitate a multidisciplinary procedure (which should be planned preoperatively), to resolve even complex situations in an oncologically sound manner, with lower treatment-related morbidity The aim of article is to report on the interdisciplinary management of complex residual masses. PATIENTS AND METHODS Of a total of 162 patients who underwent PC-RTR, 24 (17.8 %) patients underwent, in addition to a bilateral postchemotherapy retroperitoneal lymphadenectomy (PC-RPLND), complex adjunctive resections including the abdominal aorta, the inferior vena cava, or the thoracic/lumbar spine, and the neighbouring vessels (n = 15). We performed a retrospective analysis of treatment-associated complications according to the Clavien-Dindo classification and of progression-free, cancer-specific and overall survival. RESULTS Median patient age was 24.5 (18-52) years. All patients had an intermediate or poor prognosis according to the International Germ Cell Cancer Collaboration Group (IGCCCG). Median tumour diameter at the time of surgery was 18.6 (9.0-35) cm. In 5 patients 1-2 metastatic lumbar vertebral bodies were completely resected, stabilised and replaced by means of a cage. In 6 patients resection of the abdominal aorta/inferior vena cava with vascular prosthesis replacement was required owing to infiltration. In 2 patients the common iliac artery or vein was resected and replaced. In addition, retrocrural lymph nodes had to be resected in 5 patients and 3 patients required adjunctive nephrectomy. In another 4 patients the Whipple procedure was required owing to infiltration into the pancreas and/or duodenum. The median operating time was 7.8 (6-15) h, the median blood loss was around 1,450 (900-3,400) ml, and 2 Clavien-Dindo grade IVa complications occurred. Pathohistology revealed teratoma/vital cancer in 16/24 patients and scarring/necrosis in 8 patients. After a median follow-up of 2.5 years, 1 patient developed recurrent disease and 1 patient died of the disease. CONCLUSIONS Postchemotherapy, a few patients with advanced nonseminomas (NS) need complex residual tumour resection in an interdisciplinary setting, with a good functional and oncological outcome. Even the involvement of vascular vertebral structures does not constitute a contraindication for complete resection.
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Affiliation(s)
- P Paffenholz
- Klinik für Urologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - D Pfister
- Klinik für Urologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Heidenreich
- Klinik für Urologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Salem J, Paffenholz P, Akbarov I, Grabbert M, Herden J, Kauffmann C, Pfister D, Porres D, Thissen A, Zugor V, Heidenreich A. Ein erfolgreicher Auftakt zum 1. Kölner OP-Workshop der GeSRU. Urologe A 2017. [DOI: 10.1007/s00120-017-0384-6] [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]
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Pfister D, David L, Holzer M, Nicoud RM. Designing affinity chromatographic processes for the capture of antibodies. Part I: A simplified approach. J Chromatogr A 2017; 1494:27-39. [DOI: 10.1016/j.chroma.2017.02.070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
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Suardi N, Briganti A, Fossati N, Dell’Oglio P, Gandaglia G, Colicchia M, Karnes J, Haidl F, Pfister D, Porres D, Heidenreich A, Gratzke C, Herlemann A, Stief C, Battaglia A, Everaerts W, Joniau S, Van Poppel H, Aksenov A, Osmonov D, Jünemann K, Abreu A, Almeida F, Fay C, Gill I, Mottrie A, Montorsi F. Identifying the optimal candidate for salvage lymph node dissection for nodal recurrence of prostate cancer: Results from a large, multi-institutional analysis. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)31004-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Heidenreich A, Haidl F, Paffenholz P, Pape C, Neumann U, Pfister D. Surgical management of complex residual masses following systemic chemotherapy for metastatic testicular germ cell tumours. Ann Oncol 2017; 28:362-367. [DOI: 10.1093/annonc/mdw605] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Porres D, Pfister D, Thissen A, Kuru TH, Zugor V, Buettner R, Knuechel R, Verburg FA, Heidenreich A. The role of salvage extended lymph node dissection in patients with rising PSA and PET/CT scan detected nodal recurrence of prostate cancer. Prostate Cancer Prostatic Dis 2016; 20:85-92. [PMID: 27824042 DOI: 10.1038/pcan.2016.54] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/16/2016] [Accepted: 09/11/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Non-prostatic bed recurrence of prostate cancer (PCa) is usually treated with androgen deprivation therapy (ADT). We analyzed the impact of salvage extended lymph node dissection (sLND) on cancer control in patients with rising PSA and lymph node (LN) metastases. METHODS Between 2009 and 2016 we performed sLND in 87 patients with biochemical recurrence (BCR) and positive LNs on 18FEC and 68Ga-PSMA positron emission tomography/X-ray computer tomography (PET/CT) after primary treatment (PT) of PCa. Intra- and postoperative complications according to Clavien-Dindo were assessed and the rates of biochemical response (BR), BCR-free and clinical recurrence (CR)-free survival, as well as time to initiation of systemic treatment were evaluated. RESULTS Mean age of patients and mean PSA at sLND was 66.7 years (46-80 years) and 2.63 ng ml-1 (1.27-3.75 ng ml-1), respectively. With 87.4% radical prostatectomy (RP) was the most common PT. In all, 57.9% of patients additionally underwent adjuvant/salvage radiation therapy (RT) and 18.4% received ADT before sLND. Complete BR (cBR) was diagnosed in 27.5% of patients and incomplete BR in 40.6%. In total, 62.2% of patients remained without ADT at follow-up. With a median follow-up of 21 months (1-75 months), the cancer-specific mortality rate was 3.7%. The 3-year BCR-free, systemic therapy-free and CR-free survival rates for patients with cBR were 69.3%, 77.0% and 75%, respectively. CONCLUSIONS sLND can be performed without significant complications and achieves an immediate BR, thus allowing a significant postponement of systemic therapy in selected patients with BCR and nodal recurrence of PCa. Therefore, sLND following 68Ga-PSMA PET/CT should be considered as part of a multimodal diagnostic and treatment concept for selective patients.
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Affiliation(s)
- D Porres
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - D Pfister
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - A Thissen
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - T H Kuru
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - V Zugor
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - R Buettner
- Department of Pathology, University Hospital of Cologne, Cologne, Germany
| | - R Knuechel
- Department of Pathology, RWTH University Hospital Aachen, Aachen, Germany
| | - F A Verburg
- Department of Nuclear Medicine, RWTH University Hospital Aachen, Aachen, Germany.,Department of Nuclear Medicine, University Hospital Gießen and Marburg, Marburg, Germany
| | - A Heidenreich
- Department of Urology, University Hospital of Cologne, Cologne, Germany
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Iyengar N, Ghossein R, Kochhar A, Morris L, Zhou X, Morris P, Awad M, Fury M, Pfister D, Patel S, Boyle J, Hudis C, Dannenberg A. 2874 Impact of white adipose tissue inflammation on survival in patients with squamous cell carcinoma of the oral tongue. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31611-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
The therapeutic role of cytoreductive surgery for urogenital malignancies is controversially discussed in the literature. The current article critically reflects the potential impact of cytoreductive surgery in patients with renal cell cancer and prostate cancer with locoregional lymph node or systemic metastases based on a review of the literature and personal experience.Even in the era of molecular targeted therapies in metastatic renal cell cancer, cytoreductive radical nephrectomy seems to exert survival benefit when compared to systemic therapy alone if (1) patients demonstrate a good ECOG performance status, (2) exhibit good or intermediate prognosis according to the Heng criteria, (3) cerebral metastases have been excluded, and (4) >90% of the total cancer volume can be eliminated. Preliminary clinical studies suggest that neoadjuvant systemic treatment might be associated with a significantly reduced 1-year mortality rate.For prostate cancer cytoreductive radical prostatectomy is one of the guideline-recommended treatment options for men with intrapelvic lymph node metastases resulting in survival benefit when compared to androgen deprivation as monotherapy. Cytoreductive radical prostatectomy should be performed (1) in the presence of limited intrapelvic lymph node metastasis without bulky disease, (2) if complete resectability of the primary cancer and its metastasis can be achieved by extended radical prostatectomy and extended pelvic lymphadenectomy, (3) if the patient is included in a multimodality approach, and (4) if the life expectancy is > 10 years.The role of cytoreductive radical prostatectomy in men with osseous metastases remains unclear due to the lack of large clinical trials. Despite the presence of the first promising studies, it is not justified to perform cytoreductive radical prostatectomy outside clinical trials. Preliminary results from small studies indicate that patients with minimal metastatic burden, PSA decrease < 1.0 ng/ml following neoadjuvant ADT for 6 months and complete resectability of the tumor exhibit the best prognosis to benefit from this new surgical approach.
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Affiliation(s)
- A Heidenreich
- Klinik für Urologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland,
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Pfister D, Porres D, Matveev V, Heidenreich A. Reduzierte Morbidität bei der Resektion von Residualtumoren nach Chemotherapie beim Seminom. Urologe A 2015; 54:1402-6. [DOI: 10.1007/s00120-014-3708-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Porres D, Subotic S, Pfister D, Heidenreich A. [Laparoscopic transperitoneal nephrectomy and kidney cyst resection]. Aktuelle Urol 2014; 45:400-9. [PMID: 25230025 DOI: 10.1055/s-0034-1390680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- D. Porres
- Universitätsklinikum der RWTH Aachen
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Pfister D, Wolsky I, Porres D, Thissen A, Heidenreich A. Complications During Cisplatin Based Primary Chemotherapy in Patients with Testicular Cancer: is There a Need for Thromboembolic Prophylaxis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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48
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Steffens S, Schrader A, Lehmann R, Eggers H, Ising S, Pfister D, Riechert-Mühe N, Leitenberger A, Heidenreich A, Thon W, Merseburger A, Kuczyk M. Blickdiagnose bei der transurethralen Resektion von Harnblasentumoren. Urologe A 2014; 53:1639-43. [DOI: 10.1007/s00120-014-3585-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Pfister D. [Puncture biopsy of the prostate]. Aktuelle Urol 2014; 45:320-3. [PMID: 25166612 DOI: 10.1055/s-0034-1365874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Testicular tumors can be divided into germ cell tumors and sex cord stromal tumors. Malignant testicular germ cell tumors (TGCT) represent about 90-95 % of all testicular tumors and are the most common solid neoplasms in young men aged 20-40 years with an increasing incidence in industrialized countries. Treatment of TGCT is performed by an individual and risk-adapted approach taking primary tumor histology, histopathlogical and molecular prognostic risk factors, tumor stage and for metastasized tumors the response to systemic chemotherapy into consideration. Knowledge of the specific histopathology of the primary tumor and the prognostic factors is of utmost importance for the treating urologist and oncologist in order to avoid undertreatment or overtreatment. Established risk factors which have been validated in retrospective and prospective studies for clinical stage I non-seminomatous TGCT are the presence of vascular invasion and the percentage of embryonal carcinoma. In clinical stage I seminomas tumor size (> 4 cm) and presence of rete testis infiltration have been identified as risk factors in retrospective but not in prospective studies. Quantitative histopathology of the primary tumor is also important for the management of small residual masses following chemotherapy: if the masses are ≤ 1 cm, postchemotherapy retroperitoneal lymph node dissection is only indicated if the primary tumor contains ≥ 50 % teratoma. Quantitative pathohistology of the resected residual masses is of importance for the decision-making process of a consolidating chemotherapy which is only of benefit if the amount of vital cancer tissue is > 10 %. Resection of residual hepatic and thoracic masses is indispensable. For gonadal stromal tumors knowledge of atypical nuclear forms, increased rate of mitosis and increased growth fractions are important for therapy planning.
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Affiliation(s)
- A Heidenreich
- Klinik für Urologie, RWTH Uniklinik Aachen, Pauwelsstr. 30, 5074, Aachen, Deutschland,
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