Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-09-05DOI: 10.1055/a-2363-4744
Alexander Fichtner, Daniel Nettersheim, Felix Bremmer
{"title":"[Histopathological analysis of germ cell tumours: aspects to consider].","authors":"Alexander Fichtner, Daniel Nettersheim, Felix Bremmer","doi":"10.1055/a-2363-4744","DOIUrl":"10.1055/a-2363-4744","url":null,"abstract":"<p><p>Germ cell tumours (GCT) are the most common testicular tumours and form a heterogenous group of tumours with different biological behaviour. Based on differences regarding patient age at first manifestation, morphological characteristics and molecular changes, they are divided into three different groups of GCTs (type I-III). For treatment and prognosis, an exact histopathological analysis of an orchiectomy resection specimen is very important, including the specification of all different histological subtypes with their proportional distribution. This article describes the approach of the preparation of a resection specimen and the histopathological analysis of a testicular tumour. In addition, it describes cases in which additional tools like immunohistochemical and molecular analyses are necessary. Furthermore, the current WHO classification of testicular GCT is discussed.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"528-536"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138995","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}
Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-12-03DOI: 10.1055/a-2321-2423
{"title":"ProstataCa – Extraprostatische Ausdehnung als Risikofaktor erst ab ISUP Grad 2.","authors":"","doi":"10.1055/a-2321-2423","DOIUrl":"https://doi.org/10.1055/a-2321-2423","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"500"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765416","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}
Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-12-03DOI: 10.1055/a-2288-2572
Andreas Wiedemann, Barbara Bojack, Claudia Drews, Ruth Kirschner-Hermanns, Klaus Becher
{"title":"S2k-Leitlinie „Harninkontinenz bei geriatrischen Patienten“ – Teil 3: Operative Therapie der Harninkontinenz.","authors":"Andreas Wiedemann, Barbara Bojack, Claudia Drews, Ruth Kirschner-Hermanns, Klaus Becher","doi":"10.1055/a-2288-2572","DOIUrl":"10.1055/a-2288-2572","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"55 6","pages":"549-554"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765420","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}
Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-08-06DOI: 10.1055/a-2364-4213
Christoph Oing, Marcus Hentrich
{"title":"[Conventional versus high-dose salvage chemotherapy for relapsed testicular germ cell tumours].","authors":"Christoph Oing, Marcus Hentrich","doi":"10.1055/a-2364-4213","DOIUrl":"10.1055/a-2364-4213","url":null,"abstract":"<p><p>Since the introduction of cisplatin-based combination chemotherapy, patients with metastatic germ cell tumours achieve very high cure rates of >80%. Nevertheless, about 30% of patients relapse despite guideline-endorsed first-line treatment. Of these, again about 50% of patients can still achieve cure with platinum-based salvage chemotherapy and eventually post-chemotherapy residual mass resection.Salvage chemotherapy generally involves platinum-based combination chemotherapy, either as conventional dose cisplatin-based combinations again or as high-dose chemotherapy with subsequent autologous stem cell transplantation.To date, high level evidence from randomised trials supporting the use of salvage high-dose chemotherapy for all patients relapsing after first-line treatment remains lacking, but a large international retrospective registry study had shown a 15% overall survival benefit for patients undergoing salvage high-dose chemotherapy.In this article, we summarise the available literature on the different salvage treatment approaches and discuss these in the light of current treatment guideline recommendations for the management of testicular cancer.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"543-548"},"PeriodicalIF":0.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896482","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}
Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-08-01DOI: 10.1055/a-2358-8224
Axel Heidenreich, Felix Seelemeyer, Ruben Gößmann, Julian Heidenreich, David Pfister
{"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}
Aktuelle UrologiePub Date : 2024-12-01Epub Date: 2024-12-03DOI: 10.1055/a-2432-9655
{"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}