EAU-EBU Update Series最新文献_第2页

Cryoablation of Small Renal Tumors 肾小肿瘤的冷冻消融

EAU-EBU Update Series Pub Date : 2007-10-01 DOI: 10.1016/j.eeus.2007.05.001

Steve Konrad Williams , Jean J.M.C.H. de la Rosette , Jaime Landman , Francis Xavier Keeley Jr.

{"title":"Cryoablation of Small Renal Tumors","authors":"Steve Konrad Williams , Jean J.M.C.H. de la Rosette , Jaime Landman , Francis Xavier Keeley Jr.","doi":"10.1016/j.eeus.2007.05.001","DOIUrl":"10.1016/j.eeus.2007.05.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To review the worldwide experience with cryoablation of small renal tumors.</p></div><div><h3>Methods</h3><p><span>A systematic review<span> was made of all English language publications on cryoablation of renal tumors as well as partial nephrectomy, </span></span>radiofrequency ablation<span> and high intensity focused ultrasound published prior to September 2006. The literature was reviewed and the findings analyzed.</span></p></div><div><h3>Results</h3><p>Data from basic science and clinical trials<span> supports renal<span> cryoablation as a safe and effective method for treatment of small renal tumors. Clinical studies document less peri- and post-operative morbidity than laparoscopic partial nephrectomy. Basic science and clinical studies suggest superior efficacy with cryoablation as compared to radiofrequency ablation. Longer follow-up is needed before its true efficacy can be established.</span></span></p></div><div><h3>Conclusion</h3><p>Laparoscopic renal cryoablation, though evolving, appears to be a reasonable alternative for the treatment of small renal tumors in selected patients. Meticulous long-term clinical and radiologic follow-up will be critical for determining local recurrence and cancer-free survival rates, to establish the ultimate role of renal cryoablation in the management of small renal tumors.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 5","pages":"Pages 206-218"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78267150","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: 7

Answers to the CME Questions Published in EAU-EBU Update Series Volume 5, Issue 4 CME问题解答发表于eu - ebu更新系列第5卷第4期

EAU-EBU Update Series Pub Date : 2007-10-01 DOI: 10.1016/j.eeus.2007.07.001

引用次数: 0

Medical Management of BPH: Role of Plant Extracts BPH的医疗管理:植物提取物的作用

EAU-EBU Update Series Pub Date : 2007-10-01 DOI: 10.1016/j.eeus.2007.04.004

Stephan Madersbacher, Anton Ponholzer, Ingrid Berger, Martin Marszalek

{"title":"Medical Management of BPH: Role of Plant Extracts","authors":"Stephan Madersbacher, Anton Ponholzer, Ingrid Berger, Martin Marszalek","doi":"10.1016/j.eeus.2007.04.004","DOIUrl":"10.1016/j.eeus.2007.04.004","url":null,"abstract":"<div><h3>Objectives</h3><p><span>Since decades plant extracts belong to the most popular drugs for </span>lower urinary tract symptoms<span><span> (LUTS) due to benign prostatic hyperplasia<span> (BPH)/benign prostatic enlargement (BPE). Herein we review biological mechanisms, the placebo effect, results of </span></span>clinical trials, the role of meta-analyses and guideline recommendations.</span></p></div><div><h3>Methods</h3><p>Review of the literature with particular reference to long-term (study period ≥6 months) controlled trials and of BPH-guideline recommendations.</p></div><div><h3>Results</h3><p>Only few of the large number of available studies meet the criteria defined by the WHO-BPH consensus conference. The few, placebo-controlled, long-term (study period ≥6 months) studies suggest a positive effect of some extracts (saw palmetto, ß-sitosterol, urtica, saw palmetto/urtica combination) on LUTS, an effect on uroflow, post-void residual volume, prostate volume and PSA was not consistently demonstrable. Randomised trials against active comparators (α1-blocker, 5α-reductase inhibitors) are difficult to interpret. Due to the lack of prospective studies, several meta-analyses have been published that can not replace prospective studies according to WHO-BPH recommendations. None of the BPH-guidelines currently recommends plant extracts, yet universally conclude that this is an interesting approach.</p></div><div><h3>Conclusions</h3><p>Further prospective studies according to WHO-standards are required to reliably determine the role of plant extracts in contemporary LUTS-management.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 5","pages":"Pages 197-205"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81158972","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: 14

The Role of Surgery in the Management of Recurrent or Persistent Non-seminomatous Germ Cell Tumors 手术在治疗复发性或持续性非半瘤性生殖细胞肿瘤中的作用

EAU-EBU Update Series Pub Date : 2007-08-01 DOI: 10.1016/j.eeus.2007.03.003

Niels-Erik B. Jacobsen, Richard S. Foster

{"title":"The Role of Surgery in the Management of Recurrent or Persistent Non-seminomatous Germ Cell Tumors","authors":"Niels-Erik B. Jacobsen, Richard S. Foster","doi":"10.1016/j.eeus.2007.03.003","DOIUrl":"10.1016/j.eeus.2007.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To review the management of patients with non-seminomatous germ cell tumors (NSGCTs) with persistent or recurrent disease following primary or secondary therapy, with particular attention devoted to the role of surgery.</p></div><div><h3>Methods</h3><p>A non-structured review of the literature until January 2007 was performed using the PubMed database.</p></div><div><h3>Results</h3><p><span>The management of persistent or recurrent disease among patients with NSGCT depends on stage at presentation and relapse, serum tumor marker levels at relapse, prior therapy, and timing of relapse. Clinical stage I patients who relapse following active surveillance are usually treated with induction chemotherapy<span>. Likewise, patients who relapse following primary retroperitoneal lymph node dissection (RPLND) are treated with induction chemotherapy based on the systemic pattern of recurrence. Advanced cases with residual radiographic disease >1</span></span> <span>cm and normal tumor markers following induction chemotherapy are generally recommended for postchemotherapy surgical resection, whereas those with persistently elevated markers undergo salvage chemotherapy. Select patients with resectable disease and elevated serum tumor markers may be appropriate candidates for surgery. Based on intrinsic chemoresistance, the treatment of patients with advanced disease who relapse >2 yr (late relapse) following successful chemotherapy is primarily surgery.</span></p></div><div><h3>Conclusion</h3><p>Patients with NSGCTs with persistent disease or recurrence within 2 yr of initial therapy remain highly curable. The prognosis of patients with late relapse is compromised based on tumor chemoresistance. The role of surgery in the management of recurrent disease is primarily limited to the postchemotherapy setting; however, in the context of late relapse it often represents the primary treatment.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 4","pages":"Pages 163-176"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75335361","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: 1

The Evolution of Staging of Lymph Node Metastases in Clinically Localized Prostate Cancer 临床局限性前列腺癌淋巴结转移分期的演变

EAU-EBU Update Series Pub Date : 2007-08-01 DOI: 10.1016/j.eeus.2007.04.003

Georg C. Hutterer , Alberto Briganti , Felix K.-H. Chun , Andrea Gallina , Patrizio Rigatti , Francesco Montorsi , Pierre I. Karakiewicz

{"title":"The Evolution of Staging of Lymph Node Metastases in Clinically Localized Prostate Cancer","authors":"Georg C. Hutterer , Alberto Briganti , Felix K.-H. Chun , Andrea Gallina , Patrizio Rigatti , Francesco Montorsi , Pierre I. Karakiewicz","doi":"10.1016/j.eeus.2007.04.003","DOIUrl":"10.1016/j.eeus.2007.04.003","url":null,"abstract":"<div><h3>Objectives</h3><p><span>We performed a systematic literature review of the staging of pelvic </span>lymph node metastases<span> in clinically localized prostate cancer.</span></p></div><div><h3>Methods</h3><p>The description of the evolution of the staging paradigms of lymph node invasion (LNI) in localized prostate cancer is based on a systematic review of the English language literature on this topic.</p></div><div><h3>Results</h3><p>A single randomized trial addressing pelvic lymph node dissection (PLND) exists and no Cochrane review covers the topic of lymph node staging in localized prostate cancer. Most publications are based on retrospective analyses, including some large multicenter validation studies. The available reports demonstrate that extended PLND improves staging and that ideally 30 lymph nodes should be removed. This represents a shift away from either no PLND or very limited PLND, in historic series. However, not all men need to be subjected to an extended PLND. At least some patients can be effectively staged with limited PLND.</p></div><div><h3>Conclusions</h3><p>This review illustrates the evolution of lymph node staging in prostate cancer, which changed from no staging through limited staging to extended staging. This review provides evidence-based criteria for identifying patients at risk of LNI, as well as for defining the extent of PLND, when indicated.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 4","pages":"Pages 153-162"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74634301","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: 6

Inguinal Metastasis in Penile Cancer: Diagnosis and Management 阴茎癌腹股沟转移的诊断与治疗

EAU-EBU Update Series Pub Date : 2007-08-01 DOI: 10.1016/j.eeus.2007.04.002

Joost A.P. Leijte , Simon Horenblas

{"title":"Inguinal Metastasis in Penile Cancer: Diagnosis and Management","authors":"Joost A.P. Leijte , Simon Horenblas","doi":"10.1016/j.eeus.2007.04.002","DOIUrl":"10.1016/j.eeus.2007.04.002","url":null,"abstract":"<div><p><span><span><span>We provide an overview of current clinical practice and future developments regarding the diagnosis and management of nodal metastasis </span>in patients with </span>penile carcinoma<span><span>. The dissemination pattern of penile carcinoma is predominantly lymphogenic. The inguinal regions<span> are the first site of metastasis. Patients with proven inguinal metastasis should undergo an inguinal lymph node dissection. However, the management of clinically node negative patients remains subject of debate. Physical examination and present </span></span>imaging techniques are not sensitive enough to detect occult nodal metastasis. The current </span></span>EAU<span> guidelines divide this group of patients into three risk groups (for having nodal metastasis) based on primary tumour characteristics. A wait-and-see policy is advised for patients in the low risk group, while patients in the highest risk group should undergo an elective inguinal lymph node dissection. However, using the guidelines the majority of patients still needlessly undergoes inguinal lymph node dissection, a procedure associated with high morbidity. Dynamic sentinel node<span> biopsy is a minimally-invasive technique to reliably assess the lymph node status of clinically node-negative patients, though its use is currently not widespread. The role of chemo- and radiation therapy is confined to advanced stages of disease. Future developments include the use of new imaging techniques such as nanoparticle enhanced magnetic resonance imaging. Several biomarkers to detect nodal metastasis are under investigation.</span></span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 4","pages":"Pages 145-152"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72925755","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: 6

Technique of TUR of Bladder Tumours: Value of Repeat TUR and Random Biopsies 膀胱肿瘤TUR技术:重复TUR与随机活检的价值

EAU-EBU Update Series Pub Date : 2007-08-01 DOI: 10.1016/j.eeus.2007.04.001

J.P. Michiel Sedelaar, J. Alfred Witjes

引用次数: 9

Answers to the CME Questions Published in EAU-EBU Update Series Volume 5, Issue 3 CME问题解答发表于eu - ebu更新系列第5卷第3期

EAU-EBU Update Series Pub Date : 2007-08-01 DOI: 10.1016/j.eeus.2007.05.003

引用次数: 0

The Role of Urinary Kidney Stone Inhibitors and Promoters in the Pathogenesis of Calcium Containing Renal Stones 尿肾结石抑制剂和促进剂在含钙肾结石发病机制中的作用

EAU-EBU Update Series Pub Date : 2007-06-01 DOI: 10.1016/j.eeus.2007.03.002

Doddametikurke Ramegowda Basavaraj , Chandra Shekhar Biyani , Anthony J. Browning , Jon J. Cartledge

{"title":"The Role of Urinary Kidney Stone Inhibitors and Promoters in the Pathogenesis of Calcium Containing Renal Stones","authors":"Doddametikurke Ramegowda Basavaraj , Chandra Shekhar Biyani , Anthony J. Browning , Jon J. Cartledge","doi":"10.1016/j.eeus.2007.03.002","DOIUrl":"https://doi.org/10.1016/j.eeus.2007.03.002","url":null,"abstract":"<div><p><span><span>Urinary stone disease is an </span>ailment afflicting human kind for many centuries. It can affect up to a quarter the population in certain geographic areas and hence poses a significant </span>health problem<span><span>. Various aetiological factors have been attributed to stone formation – hereditary, dietary, geographical, infective etc. Approximately 85% of the stones in human are calcium stones comprising </span>oxalate and phosphate, either alone or combined. Though supersaturation of stone forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation.</span></p><p>The pathogenesis of calcium oxalate<span><span><span> stone formation is a multi-step process and in essence includes – nucleation, crystal growth, crystal aggregation and crystal retention. Various substances in the body have an effect on one or more of the above stone forming processes, thereby influencing a person's ability to promote or prevent stone formation. Promoters of stone formation facilitate stone formation whilst inhibitors prevent it. Low urine volume, low urine pH, calcium, sodium, oxalate, and urate are known to promote stone formation. Many inorganic (eg. Citrate, magnesium) and organic (eg. Urinary </span>prothrombin fragment 1, </span>glycosaminoglycans, osteopontin) substances are known to inhibit stone formation. Organic inhibitory compounds adsorb to the surface of the crystal, thereby inhibiting crystal growth and nucleation. This review presents a comprehensive account of the basic principles of stone formation and role of urinary inhibitors/promoters in calcium oxalate crystallisation.</span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"5 3","pages":"Pages 126-136"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2007.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91738929","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: 248

Radionuclide Treatment in Metastasized Prostate Cancer 放射性核素治疗转移性前列腺癌

EAU-EBU Update Series Pub Date : 2007-06-01 DOI: 10.1016/J.EEUS.2007.02.002

H. Poel

引用次数: 6