EAU Update Series最新文献_第9页

BCG Immunotherapy for Superficial Bladder Cancer: An Overview of the Past, the Present and the Future 卡介苗免疫治疗浅表性膀胱癌:过去，现在和未来的概述

EAU Update Series Pub Date : 2003-06-01 Epub Date: 2003-05-28 DOI: 10.1016/S1570-9124(03)00016-3

Adrian P van der Meijden , Richard J Sylvester

{"title":"BCG Immunotherapy for Superficial Bladder Cancer: An Overview of the Past, the Present and the Future","authors":"Adrian P van der Meijden , Richard J Sylvester","doi":"10.1016/S1570-9124(03)00016-3","DOIUrl":"10.1016/S1570-9124(03)00016-3","url":null,"abstract":"<div>Objectives: The role of intravesical immunotherapy with bacillus Calmette-Guérin (BCG) for the treatment of superficial bladder cancer is discussed and the achievements of the past 25 years are reviewed.Method: Evidence based results for clinical trials as well as from basic research are used in trying to answer a number of questions relevant for the use of BCG.Results: The exact working mechanism of BCG has not been revealed yet. Clinical and basic research have shown that the best route of BCG administration is the intravesical route. BCG is superior to intravesical chemotherapy for preventing recurrence. Recently it has been shown that BCG is able to prevent or delay invasion to muscle invasive bladder cancer. However to achieve this, maintenance therapy is necessary. Intermediate and high risk tumors can be treated with BCG, but for low risk tumors BCG should be avoided due to its possible side effects. No differences in efficacy have been found between the different strains. The presence or absence of side effects does not appear to be a prognostic factor for BCG efficacy and maintenance therapy is not associated with increased toxicity. In the future, the optimal scheme and dose should be defined and this is probably different for each individual.</div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 80-86"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00016-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77074806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Introduction to Issue of Bladder Cancer 介绍膀胱癌的问题

EAU Update Series Pub Date : 2003-06-01 Epub Date: 2003-05-31 DOI: 10.1016/S1570-9124(03)00024-2

Alexandre R. Zlotta

引用次数: 0

Lymphadenectomy in Bladder Cancer 膀胱癌的淋巴结切除术

EAU Update Series Pub Date : 2003-06-01 Epub Date: 2003-05-29 DOI: 10.1016/S1570-9124(03)00021-7

George N Thalmann , Achim Fleischmann , Robert D Mills , Fiona C Burkhard , Regula Markwalder , Urs E Studer

引用次数: 7

Is There a Need or an Evidence for Rebiopsying Patients after a First TUR 第一次TUR后是否需要或有证据对患者进行再活检

EAU Update Series Pub Date : 2003-06-01 Epub Date: 2003-05-27 DOI: 10.1016/S1570-9124(03)00017-5

T Otto , J Suhr , H Rübben

引用次数: 0

Treatment of Prostate Cancer—The Role of Primary Hormonal Therapy 前列腺癌的治疗:原发性激素治疗的作用

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00007-2

John Anderson

引用次数: 16

The Treatment of Hormone Refractory Prostate Cancer 激素难治性前列腺癌的治疗

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00008-4

Axel Heidenreich, Andres J Schrader

{"title":"The Treatment of Hormone Refractory Prostate Cancer","authors":"Axel Heidenreich, Andres J Schrader","doi":"10.1016/S1570-9124(03)00008-4","DOIUrl":"10.1016/S1570-9124(03)00008-4","url":null,"abstract":"<div>Hormone refractory prostate cancer (HRPCA) is generally defined as: (1) consecutive PSA rise on three serial measures occuring a minimum of 1 week from the reference value, (2) testosterone serum levels equal to castrate levels (<50ng/ml), (3) PSA rise following anti-androgen withdrawal or following the addition of secondary hormonal manipulations. HRPCA includes a heterogeneous group of patients with variable rates of tumour growth and it is evident that survival rates of these different groups will differ significantly and that these parameters have to be accounted for when designing and analyzing future trials in HRPCA.Currently, chemotherapy is not curative. However, with new developments chemotherapy can be effective in prolonging life and in providing definite palliation. For patients with advanced symptomatic HRPCA, mitoxantrone/prednisone, docetaxel or bisphosphonates (BP) result in significant improvements with regard to pain reduction and to the daily use of narcotics. Improvement in quality of life, pain reduction, and improvement in fatigue may be clinically appropriate endpoints for palliative clinical trials.For those patients with HRPCA characterized by rising PSA levels or by measurable asymptomatic disease, prospective randomized clinical phase III studies are needed to define the role of the different effective chemotherapeutic approaches which have been tested in phase II studies. Currently, taxanes as single agents or in combination with estramustine phosphate (EMP) appear to represent the most effective drugs although a prolongation of survival has not been demonstrated for any chemotherapeutic approach. In the future, monoclonal antibodies, signal transduction inhibitors targeting growth factors, neovascularisation and apoptosis will be evaluated in clinical phase II and III trials.</div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 1","pages":"Pages 40-50"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00008-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74143500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Treatment of Prostate Cancer—The Clinical Use of Radical Prostatectomy 前列腺癌的治疗——根治性前列腺切除术的临床应用

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00005-9

Joachim Noldus, Jüri Palisaar, Hartwig Huland

{"title":"Treatment of Prostate Cancer—The Clinical Use of Radical Prostatectomy","authors":"Joachim Noldus, Jüri Palisaar, Hartwig Huland","doi":"10.1016/S1570-9124(03)00005-9","DOIUrl":"10.1016/S1570-9124(03)00005-9","url":null,"abstract":"<div>Objective: To discuss the clinical use of radical prostatectomy in patients with clinically localized prostate cancer regarding outcome, quality of life, and morbidity based on own data and results of the literature.Methods: A review of the currently available literature was performed. Moreover, data of 1755 patients who underwent radical retropubic prostatectomy between 1992 and 2001 at our institution were analyzed in uni- and multivariate analyses and included.Results: Disease-free survival of about 80% over a 5-year period are reported. Pathologic stage and the Gleason score are the most influencing factors on postoperative outcome. Continence rates of about 90% are common; nerve-sparing radical prostatectomy seemed to have a protecting factor on continence. Rates of erection depend on the extent of nerve-sparing and achieve up to 90% after bilateral nerve-sparing. 30-days perioperative morbidity decreased to less than 5% in major series with a mortality rate of nil.Conclusions: Selecting the right patient with clinically localized disease, radical prostatectomy showed excellent data on long-term follow-up. Due to respectful understanding of anatomical structures and improvements in surgical techniques, morbidity of the operation decreased and with the nerve-sparing technique quality of life increased.</div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 1","pages":"Pages 16-22"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00005-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85758017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Treatment of Localized or Locally Advanced Prostate Cancer: The Clinical Use of Radiotherapy 局部或局部晚期前列腺癌放疗的临床应用

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00006-0

Michel Bolla

引用次数: 9

Diagnosis of Prostate Cancer—The Clinical Use of Prostate Specific Antigen 前列腺癌的诊断——前列腺特异性抗原的临床应用

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00003-5

Hans-Peter Schmid , Ladislav Prikler , Catharine M. Sturgeon , Axel Semjonow

{"title":"Diagnosis of Prostate Cancer—The Clinical Use of Prostate Specific Antigen","authors":"Hans-Peter Schmid , Ladislav Prikler , Catharine M. Sturgeon , Axel Semjonow","doi":"10.1016/S1570-9124(03)00003-5","DOIUrl":"10.1016/S1570-9124(03)00003-5","url":null,"abstract":"<div>Objective: To give recommendations for the clinical use of prostate specific antigen (PSA) and its molecular forms for diagnosis of prostate cancer. Analysis is based on a structured review of clinical guidelines which adhere to the principles of evidence-based medicine.Methods: Original publications on concepts for improving the specificity of PSA were identified and analysed with regard to their clinical utility. They include PSA density, PSA density of the transition zone, age specific reference ranges, ratio of free to total PSA, complexed PSA, isoenzymes of free PSA, PSA velocity and PSA doubling time. National and international guidelines were reviewed in order to define a common denominator for PSA use in routine clinic.Results: PSA in conjunction with digital rectal examination is almost uniformly recommended for early diagnosis of prostate cancer, although the value of (population-based) screening with PSA is still controversial. Static concepts play only a minor role, whereas dynamic concepts are currently being evaluated in large prospective trials.Conclusions: PSA is a useful test for early detection of prostatic carcinoma provided that the patient is well informed and has a life expectancy of at least 10 years.</div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 1","pages":"Pages 3-8"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00003-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88498169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Diagnosis of Prostate Cancer: The Clinical Use of Transrectal Ultrasound and Biopsy 前列腺癌的诊断:经直肠超声和活检的临床应用

EAU Update Series Pub Date : 2003-03-01 Epub Date: 2003-04-23 DOI: 10.1016/S1570-9124(03)00004-7

Bob Djavan, Mesut Remzi, Keywan Ghawidel, Michael Marberger

{"title":"Diagnosis of Prostate Cancer: The Clinical Use of Transrectal Ultrasound and Biopsy","authors":"Bob Djavan, Mesut Remzi, Keywan Ghawidel, Michael Marberger","doi":"10.1016/S1570-9124(03)00004-7","DOIUrl":"10.1016/S1570-9124(03)00004-7","url":null,"abstract":"<div>A number of diagnostic dilemmas arise regarding diagnosis of prostate cancer. Undoubtedly transrectal ultrasound (TRUS) guided prostate biopsy has become standard in urology to diagnose prostate cancer. Nevertheless a lot of questions regarding the clinical use of TRUS-biopsy are open. Should we perform lesion-directed or random biopsies? How many biopsy cores should be obtained for optimal diagnostic yield, to reduce the incidence of false-negative biopsies? What areas of the prostate should be biopsied to give the best diagnostic results? If the initial biopsy fails to detect cancer, who should undergo repeat biopsy? And how often should we repeat it? What role do PSA and PSA parameters such as PSAD, PSA-TZ, PSAV, percent-free PSA play in findings upon the outcome of repeat biopsies? What role plays prostate volume or age? Are cancers detected on multiple repeat biopsies clinically “significant” and thus deserve therapy? In this review answers regarding these questions are given using the recent literature and the results of the European Prostate Cancer Detections Study (EPCDS).</div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 1","pages":"Pages 9-15"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00004-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88181430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15