Aktuelle Urologie最新文献

{"title":"[Clinical stage IIA/B seminoma - to do or not to do: the role of retroperitoneal lymphadenectomy].","authors":"Axel Heidenreich, Felix Seelemeyer, Ruben Gößmann, Julian Heidenreich, David Pfister","doi":"10.1055/a-2358-8224","DOIUrl":"10.1055/a-2358-8224","url":null,"abstract":"<p><p>About 10% of patients with seminomatous testicuar germ cell tumors are diagnosed with clinical stage II/B. The current guideline recommended treatment options include systemic chemotherapy with 3 cycles PEB or radiation therapy with 30 Gy for CS IIA and 36 Gy for CS IIB. Despite a high cure rate of 90-94% and 82-90% for CS IIA and CS IIB, respectively, both options are associated with a high rate of treatment-associated long-term toxicities. A significantly increased risk for the development of secondary malignancies, cardiovascular and metabolic disease as well as an increased for treatment-associated mortality has been proven in various studies. Primary nerve sparing retroperitoneal lymph node dissection (nsRPLND) has been evaluated in 5 prospective and retrospective clinical studies and it has emerged as a valid treatment alternative. The relapse-rate after a median follow-up of 25-33 months is in the range of 11-30%, so that 70-90% of patients are cured without being subjected to chemotherapy and potential long-term toxicities. All relapsing patients have been cured with secondary salvage chemotherapy. The frequency of significant surgery-associated complications is low with 3-13%. Therapeutic success depends on the surgical experience of the various surgeons and the chosen template, so that this type of surgical interventions should only be performed in centres of excellence with dedicated surgeons. Preoperative evaluation of the new biomarker miR371 has been shown to predict the presence of metastatic disease with an accuracy of around 100% so that this marker might be used in daily routine prior to active treatment in CS IIA/B seminomas.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"537-542"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dank an die Gutachter*innen.","authors":"","doi":"10.1055/a-2432-9655","DOIUrl":"https://doi.org/10.1055/a-2432-9655","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"509"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Studie beim muskelinvasiven Blasenkarzinom (MIBC) mit Indikation zur radikalen Zystektomie.","authors":"","doi":"10.1055/a-2312-8464","DOIUrl":"https://doi.org/10.1055/a-2312-8464","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"505-508"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New tumor markers for testicular cancer - in the here and now and in the future].","authors":"Justine Schoch, Hans Schmelz, Klaus-Peter Dieckmann, Tim Nestler","doi":"10.1055/a-2422-0354","DOIUrl":"10.1055/a-2422-0354","url":null,"abstract":"<p><p>Germ cell tumors of the testis are the most common tumor entities in young men. Since the introduction of platinum-based chemotherapy in the 1970s, most patients can be cured despite the aggressiveness of germ cell tumors. Optimal serum tumor markers are required for diagnostics, therapy monitoring and aftercare, and these are subject to high requirements. The conventional testicular tumor markers human chorionic gonadotropin (hCG), alpha fetoprotein (AFP) and lactate dehydrogenase (LDH) only meet these requirements with insufficient sensitivity (30-70%). The markers investigated in recent decades, such as PLAP, CEA and NSE, have not become established. Currently, miRNA-371 is being researched in particular. Reliable findings are available for initial staging with significantly better specificities of miRNA-371 compared to conventional tumor markers. Further prospective studies are being conducted for other possible clinical applications, such as follow-up care, therapy monitoring or residual tumors, in order to investigate the revolutionary potential of miRNA-371 in these areas as well. Research is also currently being conducted on circulating tumor cells (CTCs) and cell-free DNA (cfNA) in various areas of application. With regard to germ cell tumors of the testis, however, these analyses are still in their infancy, but it is hoped that this will provide a further sufficient opportunity to use serum tumor markers.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"520-527"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Testicular Germ Cell Tumours - features and prospects of the novel tumour marker microRNA-371a-3p (M371 test): a narrative review].","authors":"Klaus-Peter Dieckmann, Gazanfer Belge","doi":"10.1055/a-2358-8355","DOIUrl":"10.1055/a-2358-8355","url":null,"abstract":"<p><p>Testicular germ cell tumours (GCTs) represent a paradigm for the usefulness of serum tumour markers in clinical management of diseases. However, the tumour markers currently in use, beta human chorionic gonadotropin (bHCG), alpha fetoprotein (AFP) and lactate dehydrogenase (LDH) are expressed in less than 50% of GCT cases. In 2011, microRNA-371a-3p (currently named M371) was suggested as a novel marker for the first time. Chemically, microRNAS represent small RNA molecules consisting of 18-24 base pairs. Physiologically, these microRNAs play a prominent role in the epigenetic control of protein biosynthesis. M371 can be measured in serum with PCR-techniques.There is high level evidence for a 90% sensitivity and >90% specificity for GCTs of the marker M371. That high diagnostic accuracy is true for both seminoma and nonseminoma but not for the histologic subgroup of teratoma. Testicular tumours of non-germ cell origin and malignant neoplasms of other organs do not express the marker. M371 involves a very short half-life of <24 hours.The test does likely involve the prospects of providing substantial aid in clinical decision-making with respect to instances where improvement of GCT management is still required. In particular, the following clinical scenarios will probably benefit from the employment of the M371 test: (1) diagnostic work-up of incidentally detected small testicular masses with decision-making in regard to testis sparing surgery or full orchiectomy (2) simplifying the follow-up of GCT patients with sparing of imaging procedures in a number of cases; (3) diagnostic evaluation of retroperitoneal lymphadenopathy upon clinical staging; (4) diagnostic evaluation of false-positive elevations of classical tumour markers (AFP, bHCG); (5) rapid appraisal of therapeutic success or failure by means of the very short half-life of M371; (6) diagnostic evaluation of postchemotherapy residual masses particularly those in seminoma patients.The discovery and development of the novel tumour marker M371 probably represents a milestone progress in the history of the clinical management of testicular GCTs.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"510-519"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoskopische Adrenalektomie – lateraler transperitonealer Zugang.","authors":"Georg Schoen","doi":"10.1055/a-2315-4897","DOIUrl":"https://doi.org/10.1055/a-2315-4897","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"555-563"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hodentumore.","authors":"Mark Schrader","doi":"10.1055/a-2312-8491","DOIUrl":"https://doi.org/10.1055/a-2312-8491","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"481"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aktive Überwachung beim Niedrigrisiko-Prostatakarzinom.","authors":"","doi":"10.1055/a-2321-2153","DOIUrl":"https://doi.org/10.1055/a-2321-2153","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"503-504"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kommentar zu: Radikale Zystektomie: Weniger Hernien durch Netz beim Ileum-Conduit?","authors":"","doi":"10.1055/a-2357-1678","DOIUrl":"https://doi.org/10.1055/a-2357-1678","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"494-496"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Preoperative Renal Tumour Biopsy Impact Trifecta Achievement in Partial Nephrectomy?","authors":"Muhammed Fatih Simsekoglu, Muhammet Demirbilek, Ahmet Vural, Ugur Aferin, Burcin Tunc, Sinharib Citgez, Cetin Demirdag","doi":"10.1055/a-2448-1029","DOIUrl":"https://doi.org/10.1055/a-2448-1029","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the effect of renal tumour biopsy (RTB) on trifecta criteria achievement in patients treated with open partial nephrectomy (OPN).</p><p><strong>Methods: </strong>Patients who were diagnosed with renal cancer and underwent OPN between 2012 and 2023 were retrospectively reviewed. The RTB group consisted of patients who underwent RTB before OPN, while the non-RTB group consisted of those who did not undergo RTB. No matching method was employed since parameters such as tumour size and Padua score were comparable between the two groups. The primary outcome was trifecta achievement, defined as negative surgical margins, warm ischemia time (WIT) <25 minutes, and no complications. Secondary outcomes were the clinicopathologic and survival outcomes of both groups.</p><p><strong>Results: </strong>There were 137 (82.03%) patients in the non-RTB group and 30 (17.96%) patients in the RTB group. The median postoperative follow-up was 45 (24-141) months. The median tumour size was 3.4 (1-7) cm and 3 (1.4-7) cm in the non-RTB group and RTB group, respectively (p=0.282). Seventy-five of the 137 (54.76%) patients in the non-RTB group and 16 of the 30 (53.3%) patients in the RTB group achieved the trifecta criteria (p=0.878). There was no statistically significant difference between the two groups in terms of metastasis-free survival (p=0.332) or overall survival (p=0.359) at 24 months. The rate of intraparenchymal lymphovascular invasion was significantly higher in the RTB group (16.6%) than in the non-RTB group (2.92%) (p=0.013).</p><p><strong>Conclusions: </strong>Our study indicated that trifecta achievement rates were comparable between patients who did and those who did not undergo RTB. Consequently, RTB can be safely performed in renal cancer.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}