EAU-EBU Update Series最新文献

{"title":"HIFU: Local Treatment of Prostate Cancer","authors":"H. Azzouz,&nbsp;J.J.M.C.H. de la Rosette","doi":"10.1016/j.eeus.2006.01.002","DOIUrl":"10.1016/j.eeus.2006.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>Treatment of carcinoma of the prostate (CaP) begs some complex questions. Different disease stages call for different treatment modalities and no universally ‘gold standard’ treatment has yet been agreed upon. In the present work we will present the results, indications and limitations of HIFU in the treatment of CaP.</p></div><div><h3>Methods</h3><p>Relevant information on HIFU treatment was identified through a literature search of published studies and review articles.</p></div><div><h3>Results</h3><p>HIFU can be considered for patients with (recurrent) localized CaP and a prostate volume of 40<!--> <span><span>cc or failure after radiotherapy. Treatment outcome is evaluated with PSA measurements and </span>prostate biopsies. Mid-term follow up (2–5 years) reveals a PSA of 0.15</span> <!-->ng/ml and in 85% of cases the PSA level remains at the post HIFU nadir. The negative control biopsies are found in 90% of patients. A combination with a TURP reduces the treatment related morbidity.</p></div><div><h3>Conclusions</h3><p>HIFU has proven mid-term high local and biochemical efficacy in patients with local confined prostate cancer<span>. A HIFU also shows promising results in local recurrence of prostate cancer after external beam radiation.</span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 2","pages":"Pages 62-70"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2006.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75949870","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}

{"title":"PSA and the Detection of Prostate Cancer After 2005. Part II: Ways Out of the PSA Dilemma?","authors":"Fritz H. Schröder,&nbsp;Claartje Gosselaar,&nbsp;Stijn Roemeling,&nbsp;Renske Postma,&nbsp;Monique J. Roobol,&nbsp;Chris H. Bangma","doi":"10.1016/j.eeus.2006.01.001","DOIUrl":"10.1016/j.eeus.2006.01.001","url":null,"abstract":"<div><p>This part II of a paper on the “dilemma of PSA” is a continuation of part I which appeared in the first issue of the EAU-EBU update series. The paper deals with the two dilemma's of PSA: (1) the decreased prediction of PSA as a diagnostic tool in pre-screened populations. (2) the fact that even at in very low PSA ranges large proportions of biopsy detectable cancers are present and that Gleason 7 or higher cancers have a low but possibly clinically relevant prevalence in these populations.</p><p>In the first place the issue of test performance of PSA is addressed. It is pointed out that we cannot really calculate test sensitivity and specificity as long as we do not know the prevalence of those cancers we wish to put into the denominator of the equation. Any calculation of sensitivity which uses a “gold standard” leads to erroneous numbers. The discussion of this issue concludes that clinically the most useful denominator in calculating sensitivity would be the rate of aggressive cancers which do not include those indolent cases which are most likely to contribute to overdiagnosis.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 2","pages":"Pages 71-81"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2006.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75281926","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}

{"title":"Non-Oncological and Non-Infectious Diseases of the Penis (Penile Lesions)","authors":"F. van Dijk,&nbsp;H.B. Thio,&nbsp;H.A.M. Neumann","doi":"10.1016/j.eeus.2005.11.004","DOIUrl":"10.1016/j.eeus.2005.11.004","url":null,"abstract":"<div><p><span><span><span><span><span>Skin diseases of the male genitalia can be categorized in three major areas: oncology, infectious and inflammatory diseases. Inflammatory </span>dermatoses<span> are frequently not restricted to the genital skin and often occur on other sites of the body. Herein we will deal the most important non-oncological and non-infectious skin disorders of the penis, such as </span></span>psoriasis, </span>lichen planus, </span>lichen sclerosus<span><span>, eczema, plasma cell </span>balanitis<span>, fixed drug eruption and </span></span></span>vitiligo<span><span>. Early adequate diagnosis is based on the principle of pattern recognition. Histological examination of a biopsy may help the clinician in the diagnostic process. The T cell is believed to play a central role in the pathogenesis of these inflammatory dermatoses, although the exact nature of the triggers involved in the T cell activation is not known. Anti-inflammatory therapy with </span>topical corticosteroids is effective and safe. This is warranted since abnormalities of the penile skin are frequently accompanied by a profound psychological impact.</span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 1","pages":"Pages 13-19"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2005.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85181765","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}

{"title":"Potency after Radical Prostatectomy: From New Techniques to Better Results","authors":"Alberto Briganti,&nbsp;Andrea Salonia,&nbsp;Andrea Gallina,&nbsp;Nazareno Suardi,&nbsp;Federico Deho’,&nbsp;Fabio Fabbri,&nbsp;Giuseppe Zanni,&nbsp;Vincenzo Scattoni,&nbsp;Patrizio Rigatti,&nbsp;Francesco Montorsi","doi":"10.1016/j.eeus.2005.11.005","DOIUrl":"10.1016/j.eeus.2005.11.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p><span>Radical prostatectomy<span> remains a commonly used procedure in the treatment of clinically localized prostate cancer. We critically analyzed current and future evidence-based strategies for preventing and managing postoperative </span></span>erectile dysfunction (ED).</p></div><div><h3>Methods</h3><p>We conducted a systematic literature review using MEDLINE and CancerLit for the period from January 1997 through August 2005. We also assessed abstracts published in <em>European Urology</em>, the <em>Journal of Urology</em>, the <em>International Journal of Impotence Research</em>, and the <em>Journal of Sexual Medicine</em>, as well as official proceedings of internationally recognized scientific societies, during the same period.</p></div><div><h3>Results</h3><p><span>Patient selection and surgical technique are the major determinants of postoperative erectile function. Novel surgical approaches have been associated with increasing success in terms of restoring of erectile and urinary function after surgery. Pathophysiology of ED after radical prostatectomy includes chronic cavernosal </span>hypoxia<span><span> and apoptosis of corporeal </span>smooth muscle cells, which might play a role in the development of cavernous arteriogenic and veno-occlusive dysfunction following radical prostatectomy. Recent evidence suggests that both pharmacological prophylaxis and treatment of postoperative ED are effective and safe.</span></p></div><div><h3>Conclusion</h3><p>In the hands of experienced high-volume surgeons, properly selected patients undergoing nerve-sparing radical prostatectomy should be able to achieve unassisted or medically assisted full erections in the postoperative period.</p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 1","pages":"Pages 33-45"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2005.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78168459","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}

{"title":"EAU–EBU Update Series (EEUS): Structure and Goals","authors":"Fritz H. Schröder","doi":"10.1016/j.eeus.2005.11.002","DOIUrl":"10.1016/j.eeus.2005.11.002","url":null,"abstract":"","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 1","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2005.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79622271","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}

{"title":"Advances in Metabolic Imaging in Patients with Elevated Prostate Specific Antigen (PSA)","authors":"Michael Seitz ,&nbsp;Bernhard Scher ,&nbsp;Anno Graser ,&nbsp;Oliver Reich ,&nbsp;Christian Gratzke ,&nbsp;Michael Scherr ,&nbsp;Christian G. Stief ,&nbsp;Ullrich G. Mueller-Lisse","doi":"10.1016/j.eeus.2005.11.001","DOIUrl":"10.1016/j.eeus.2005.11.001","url":null,"abstract":"<div><p>Prostate cancer<span> is difficult to visualise in its early stages and after definitive therapy (radiation, prostatectomy) and PSA-failure using current imaging technology. The present update aims to clarify the utility of PET (positron emission tomography) and magnetic resonance imaging (MRI) combined with proton MR spectroscopy (MRS). Past and current literature of both metabolic imaging modalities are reviewed. Although still under investigation, PET as well as MRI/MRS already have relative indications in staging and restaging of patients diagnosed with prostate cancer.</span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 1","pages":"Pages 20-32"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2005.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72560289","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}

{"title":"PSA and the Detection of Prostate Cancer After 2005. Part I","authors":"Fritz H. Schröder,&nbsp;Claartje Gosselaar,&nbsp;Stijn Roemeling,&nbsp;Renske Postma,&nbsp;Monique J. Roobol,&nbsp;Chris H. Bangma","doi":"10.1016/j.eeus.2005.11.003","DOIUrl":"10.1016/j.eeus.2005.11.003","url":null,"abstract":"<div><p><span>PSA has been shown to be a powerful tool to detect prostate cancer in men at risk due to their age. Catalona et al. </span><span>[1]</span> used a PSA cut-off value of 4<!--> <span>ng/mL in a group of 1653 men in age groups at risk as a biopsy indication. 37 cancers (2.3%) were detected. 16 of the 37 cancers would have been missed by rectal examination<span> alone. With increasing use of PSA it then emerged that the prostate cancers detected in excess of rectal examination had a more favourable distribution of prognostic factors. This was again shown early on in a prospective setting by Catalona et al. </span></span><span>[2]</span>. Recent developments have cast doubt on the use of the traditional PSA cut-off of 4.0<!--> <span>ng/mL and on the value of PSA levels in general and specifically in heavily pre-screened populations. It seems that recent findings, which will be subject to review in this paper, have made the role of PSA in diagnosing prostate cancer more uncertain than ever before. While lowering PSA cut-off levels leads to a higher detection rate of prostate cancer, it also leads to an increase of the diagnosis of cancers which might otherwise never bother their carrier (overdiagnosis). In addition, potentially aggressive cancers as defined by Gleason scores above 7 cannot be identified by appropriate PSA cut-off levels. Even with PSA values below 3.0</span> <span>ng/mL 10–15% of cancers identified have been shown to have aggressive features. The high rate of overdiagnosis makes strategies desirable, which identify aggressive but still curable cancers with an acceptable accuracy. This unfortunately is still impossible. Potentially valid approaches, which include the use of PSA kinetics over time, are in the process of being evaluated. The best way of making use of PSA in the future for diagnosing prostate cancer and its role in differentiating between aggressive and less aggressive tumours seems uncertain at this time. Further research in this field is urgently needed and directions are outlined. For the time being, arbitrary cut-off levels will remain the best option even in repeat screening.</span></p></div>","PeriodicalId":100386,"journal":{"name":"EAU-EBU Update Series","volume":"4 1","pages":"Pages 2-12"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.eeus.2005.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80982545","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}