29 results on '"G. Tosev"'
Search Results
2. An online prostate cancer patient decision aid structurally improves patient care: Results from the EvEnt-PCA randomized controlled trial
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J. Huber, P. Karschuck, R. Koch, A. Ihrig, T. Krones, A. Neisius, S. Von Ahn, C. Klopf, S. Weikert, M. Siebels, N. Haseke, C. Weißflog, M. Baunacke, P. Liske, G. Tosev, T. Benusch, M. Schostack, J. Stein, P. Spiegelhalder, C. Thomas, and C. Groeben
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Urology - Published
- 2023
3. PD-L1 as urine biomarker in urological malignancies
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P. Reimold, G. Tosev, A. Kaczorowski, C. Aksoy, V. Schütz, C. Schwab, F. Schneider, S. Zschäbitz, A. Stenzinger, M. Hohenfellner, A. Duensing, and S. Duensing
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Urology - Published
- 2023
4. Peer-to-peer counseling in non-metastatic prostate cancer: Results from a randomized controlled trial
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J. Huber, P. Karschuck, R. Koch, A. Ihrig, T. Krones, A. Neisius, S. Von Ahn, C. Klopf, S. Weikert, M. Siebels, N. Haseke, C. Weißflog, M. Baunacke, P. Liske, G. Tosev, T. Benusch, M. Schostak, J. Stein, P. Spiegelhalder, C. Thomas, and C. Groeben
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Urology - Published
- 2022
5. Retzius-sparing vs. conventional robotic assisted radical prostatectomy in a prospective, randomised trial – early functional outcome and quality of life
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Luisa Hofer, G. Tosev, Markus Hohenfellner, M. Güttlein, D. Würkner, Magdalena Görtz, Viktoria Schütz, K. Kaltenecker, Joanne Nyarangi-Dix, and P. Reimold
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medicine.medical_specialty ,Quality of life ,Robotic assisted ,business.industry ,Prostatectomy ,Urology ,medicine.medical_treatment ,Medicine ,business ,Outcome (game theory) ,Surgery - Published
- 2021
6. Match of Patient Reported Outcome Measures (PROMs) and the urologists’ assessment in non-metastatic prostate cancer: Results from a randomized controlled trial
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C. Groeben, S. Von Ahn, J. U. Stein, T. Benusch, Johannes Huber, Christian Klopf, A. Neisius, G. Tosev, N. Haseke, Martin Baunacke, Philipp Karschuck, M. Siebels, Rainer Koch, P. Liske, C. Weißflog, P. Spiegelhalder, Andreas Ihrig, Tanja Krones, Martin Schostak, Christian Thomas, and Steffen Weikert
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Oncology ,medicine.medical_specialty ,business.industry ,Urology ,medicine.disease ,law.invention ,Prostate cancer ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Non metastatic ,Patient-reported outcome ,business - Published
- 2021
7. Contents Vol. 90, 2013
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Raja B. Khauli, Ken McElreavey, Gonzalo García-Fadrique, Tolga Akman, Yutian Dai, Lei Yin, Gaetano Ciancio, Cevper Ersoz, Bingkun Li, Mesrur Selcuk Silay, Muzaffer Akcay, Jinxian Pu, Shaobo Zheng, Aixia Zhang, M.A. Mirjalili, Dongxu Zhang, Yingbo Dai, Akbar Nouralizadeh, John R. Haaga, Daniel Turudić, Serkan Keskin, Shivam Joshi, Amr Kadah, Manuel Esteban Fuertes, Druck Reinhardt Druck Basel, Wei-Jie Zhu, Ahmet Yaser Muslumanoglu, Dalila Satta, Mohammad Masoud Nikkar, Jianming Guo, Chongrui Jin, Kamran Ahmed, Fenglei Zhang, Berkan Resorlu, Hamane Douadi, Ivan Povo-Martin, Cem Kezer, X. Wang, Jin Tang, Omer Faruk Bozkurt, Akif Erbin, J. Lassmann, A. Miernik, Zhibing Xu, Deirdre Anderson, Manuel Salvador-Marin, Matthew J. Maurice, Nashaat Nabil, Li Lu, Seyed Amir Mohsen Ziaee, Mohammad Hossein Soltani, G. Tosev, Sina Kardas, Noureddine Abadi, M. Kardoust Parizi, J. Liu, Yuemin Xu, Juan Carlos Gallego-Gómez, M. Oezsoy, Ekrem Ozyuvali, Huan Jiang, Danko Batinić, Declan Cahill, Murat Binbay, Hossam Hosny, Michael A. Gorin, Seyed Hossein Hosseini Sharifi, Jonathan Watkiss, Naouel Kherouatou, Nuzhath Khan, Danica Batinić, Jingfei Teng, Yongkang Zhang, M. Schoenthaler, Prokar Dasgupta, Daniel Gallego-Vilar, Zhaowei Zhu, Xu Li, Ali Unsal, Yuanfeng Yang, Sezai Vatansever, P. Weibl, Djalila Chellat, Yong Liu, Guomin Wang, Jose Florensa, Yanjun Zhu, C.L. Zhang, F.E. Kuehhas, Benlatrèche Cherifa, Yinglong Sa, Qilai Long, Tianyuan Xu, N.A. Moosa Nejad, Ljiljana Nizic, Xiang Wang, Yong Lu, Marija Topalović-Grković, Feng Pan, Yuxin Tang, Ali Ahanian, I. Schauer, Rany Shamloul, J.Y. Li, Nazih Khater, Chunxiao Liu, Faruk Tas, Ardalan Ojand, José Escribano, Emilio Rubio, Dean A. Nakamoto, Zhoujun Shen, Hang Wang, Abdullah Armagan, Miguel Vírseda Chamorro, S. Sevcenco, Alireza Lashay, Danfeng Xu, Abdulkadir Tepeler, Xiaohua Zhang, Satz Mengensatzproduktion, Xianzhen Jiang, C.M. Sun, Antonio López García-Moreno, Danko Milosevic, Lee Ponsky, Mohamed Larbi Rezgoune, Sebti Benbouhadja, Lianjun Pan, Jesús Salinas Casado, Emrah Yuruk, Liping Li, Mohammed Shamim Khan, Ben Challacombe, Hulin Li, Kristina Vrljicak, and A. Basiri
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Traditional medicine ,business.industry ,Urology ,Medicine ,business - Published
- 2013
8. PD-L1 as a Urine Biomarker in Renal Cell Carcinoma-A Case Series and Proof-of-Concept Study.
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Reimold P, Tosev G, Kaczorowski A, Friedhoff J, Schwab C, Schütz V, Görtz M, Panzer N, Heller M, Aksoy C, Himmelsbach R, Walle T, Zschäbitz S, Jäger D, Duensing A, Stenzinger A, Hohenfellner M, and Duensing S
- Abstract
Background: Renal cell carcinoma (RCC) is among the most lethal urologic malignancies once metastatic. Current treatment approaches for metastatic RCC (mRCC) involve immune checkpoint inhibitors (ICIs) that target the PD-L1/PD-1 axis. High PD-L1 expression in tumor tissue has been identified as a negative prognostic factor in RCC. However, the role of PD-L1 as a liquid biomarker has not yet been fully explored. Herein, we analyze urine levels of PD-L1 in mRCC patients before and after either ICI therapy or surgical intervention, as well as in a series of patients with treatment-naïve RCC., Patients and Methods: The mid-stream urine of patients with mRCC ( n = 4) or treatment-naïve RCC, i.e., prior to surgery from two centers (cohort I, n = 49: cohort II, n = 29) was analyzed for PD-L1 by ELISA. The results from cohort I were compared to a control group consisting of patients treated for non-malignant urologic diseases ( n = 31). In the mRCC group, urine PD-L1 levels were measured before and after tumor nephrectomy ( n = 1) or before and after ICI therapy ( n = 3). Exosomal PD-L1 in the urine was analyzed in selected patients by immunoblotting., Results: A strong decrease in urine PD-L1 levels was found after tumor nephrectomy or following systemic treatment with ICIs. In patients with treatment-naïve RCC (cohort I), urine PD-L1 levels were significantly elevated in the RCC group in comparison to the control group (median 59 pg/mL vs. 25.7 pg/mL, p = 0.011). PD-L1 urine levels were found to be elevated, in particular, in low-grade RCCs in cohorts I and II. Exosomal PD-L1 was detected in the urine of a subset of patients., Conclusion: In this proof-of-concept study, we show that PD-L1 can be detected in the urine of RCC patients. Urine PD-L1 levels were found to correlate with the treatment response in mRCC patients and were significantly elevated in treatment-naïve RCC patients.
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- 2024
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9. Hydronephrotic pelvic kidney mimicking urinary retention in an 18-year-old male.
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Reimold P, Aksoy C, Tosev G, Hatiboglu G, and Hohenfellner M
- Abstract
We present a case of a hydronephrotic pelvic kidney in an 18-year-old male reporting about inability to void. Ultrasound showed a hypoechogenic mass mimicking a full urinary bladder. Anticipating urinary retention, a foley was inserted but no urin could be aspirated. Imaging showed a hydronephrotic pelvic kidney with no relevant function obstructing the urinary bladder and the contralateral ureter. Nephrectomy was performed and postoperative course was uneventful. A hydronephrotic pelvic kidney is a rare but important differential diagnosis in young men reporting lower abdominal pain and inability to void., Competing Interests: The authors state, that there is no conflict of interest., (© 2022 The Authors.)
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- 2022
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10. Better Knowledge about Testicular Cancer Might Improve the Rate of Testicular (Self-)Examination: A Survey among 1,025 Medical Students in Germany.
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Aksoy C, Ihrig A, Reimold P, Tosev G, Himmelsbach R, Jesser J, Babayigit G, and Huber J
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- Female, Germany, Health Knowledge, Attitudes, Practice, Humans, Male, Neoplasms, Germ Cell and Embryonal, Surveys and Questionnaires, Students, Medical, Testicular Neoplasms diagnosis
- Abstract
Introduction: Testicular cancer (TC) is the most common malignancy among young men. Public awareness of the disease and testicular (self-)examination (TSE) is low. This study aims to evaluate the awareness of German medical students on TC., Methods: A 25-item questionnaire on TC was handed out during a medical student's football tournament in Germany. Data collection was anonymous., Results: Questionnaires were answered by 573 (56%) female and 452 (44%) male medical students. Most students had gaps in their knowledge about TC: 483 (48%) students knew, the most common age at which TC occurs, and 413 (41%) knew its cure rate. Having dealt with TC during their studies was significantly associated with a better knowledge about TC (p = 0.001). These students also had a higher rate of TSE among male students (66% vs. 52%, p = 0.002). This also applies to examining the partner's testicles by female students (25% vs. 13%, p < 0.001)., Conclusion: Even in a positively selected collective like medical students, the knowledge about TC is low. Better knowledge might improve the chance of detecting the disease early. Therefore, our joint project of urologists, patients, and supporters called Prevention and Advocacy of Testicular Education e.V. (PATE) works on rising public TC awareness in Germany., (© 2022 The Author(s). Published by S. Karger AG, Basel.)
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- 2022
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11. Publisher Correction: Detection of PD-L1 in the urine of patients with urothelial carcinoma of the bladder.
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Tosev G, Wahafu W, Reimold P, Damgov I, Schwab C, Aksoy C, Kaczorowski A, Stenzinger A, Nyarangi-Dix J, Hohenfellner M, and Duensing S
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- 2021
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12. Detection of PD-L1 in the urine of patients with urothelial carcinoma of the bladder.
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Tosev G, Wahafu W, Reimold P, Damgov I, Schwab C, Aksoy C, Kaczorowski A, Stenzinger A, Nyarangi-Dix J, Hohenfellner M, and Duensing S
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- Female, Humans, Immunohistochemistry, Male, Carcinoma, Transitional Cell metabolism, Carcinoma, Transitional Cell urine, Programmed Cell Death 1 Receptor metabolism, Urinary Bladder metabolism, Urinary Bladder Neoplasms metabolism, Urinary Bladder Neoplasms urine
- Abstract
There are currently five programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors approved for the treatment of locally advanced or metastatic urothelial carcinoma (UC) of the bladder. For platinum-ineligible patients, testing of tumor specimens for PD-L1 expression is required. However, scoring of PD-L1 immunohistochemistry is complex due to different antibodies used, the requirement to score expression in different cellular compartments and intratumoral heterogeneity. It can also be difficult to obtain and test longitudinal tumor samples, which would be desirable to monitor treatment responses and tumor evolution under treatment-induced selective pressure. In the present proof-of concept study, we provide evidence that PD-L1 can be detected in the urine of patients with non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Urine PD-L1 levels were significantly higher in NMIBC and MIBC patients when compared to patients with various non-malignant urological diseases. Further prospective and independent studies are required to assess the value of PD-L1 in the urine as a novel biomarker with potential for the early detection, prediction and therapeutic monitoring of patients with UC of the bladder., (© 2021. The Author(s).)
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- 2021
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13. Male fertility during and after immune checkpoint inhibitor therapy: A cross-sectional pilot study.
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Salzmann M, Tosev G, Heck M, Schadendorf D, Maatouk I, Enk AH, Hartmann M, and Hassel JC
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- Adult, Azoospermia chemically induced, Azoospermia immunology, Cross-Sectional Studies, Cryopreservation, Fertility immunology, Fertility Preservation, Humans, Male, Melanoma immunology, Middle Aged, Pilot Projects, Referral and Consultation, Semen Analysis, Skin Neoplasms immunology, Spermatogenesis drug effects, Spermatogenesis immunology, Uveal Neoplasms immunology, Azoospermia diagnosis, Fertility drug effects, Immune Checkpoint Inhibitors adverse effects, Melanoma drug therapy, Skin Neoplasms drug therapy, Uveal Neoplasms drug therapy
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Background: Immune checkpoint inhibitors (ICIs) are widely used and may induce long-term survival in various types of cancer. Yet, there is scarce evidence on potential effects on patient fertility and the necessity of cryopreservation before treatment onset. The aim of our study was to assess the prevalence of male infertility after initiation of ICI treatment., Methods: This is a monocenter, cross-sectional pilot study. Fertility was investigated by spermiogram, analysis of sexual hormones and questionnaires on sexual function and sexual activity. Male patients under the age of 60 years previously or currently treated with ICI for cutaneous malignancies or uveal melanoma were included., Results: Twenty-five patients were included, with a median age of 49 years. Eighteen of 22 (82%) available spermiograms showed no pathologies, all patients reported a normal sexual function and sexual activity. Of four patients with pathological spermiogram, three patients were diagnosed with azoospermia and one with oligoasthenoteratozoospermia. Three patients had significant confounding factors (previous inguinal radiotherapy, chemotherapy and chronic alcohol abuse, and bacterial orchitis). One patient with normal spermiogram before ICI treatment presented 1 year after initiation with azoospermia, showing an asymptomatic, inflammatory infiltrate with predominantly neutrophil granulocytes, macrophages and T-lymphocytes in the ejaculate. Infectious causes were ruled out; andrological examination was unremarkable. A second case with reduced sperm counts during treatment may be ICI-induced also., Conclusions: Most patients had no restrictions in fertility, yet an inflammatory loss of spermatogenesis seems possible. Cryopreservation should be discussed with all patients with potential future desire for children before treatment., Competing Interests: Conflict of interest statement M.S.: honoraria and/or travel grants from Abbvie, Bristol-Myers Squibb (BMS), Merck, Merck Sharp & Dohme (MSD), Novartis and Pfizer. G.T.: advisory honoraria from Merck and Boston Scientific. M.He.: No conflict of interest to declare. D.S.: grants, personal fees, non-financial support and/or other from Novartis, BMS, Merck Serono, Amgen, Immunocore, Incyte, 4SC, Pierre Fabre, Sanofi/Regeneron, Array BioPharma, InFlarX, Philogen, Regeneron, Merck/MSD, Sandoz/Hexal, NeraCare, Roche/Genentech; outside the submitted work. I.M.: No conflict of interest to declare. A.H.E.: advisory honoraria from Biotest AG, MSD Oncology, Galderma, Janssen Cilag, AbbVie as well as speaker's honoraria from Roche Pharma. M.Ha.: No conflict of interest to declare. J.C.H.: honoraria for talks from BMS, MSD, Roche, Novartis; advisory board member for MSD, Pierre Fabre; scientific grant support from BMS; travel grants from BMS, Pierre Fabre., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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14. The Value of Prostate-specific Antigen Density for Prostate Imaging-Reporting and Data System 3 Lesions on Multiparametric Magnetic Resonance Imaging: A Strategy to Avoid Unnecessary Prostate Biopsies.
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Görtz M, Radtke JP, Hatiboglu G, Schütz V, Tosev G, Güttlein M, Leichsenring J, Stenzinger A, Bonekamp D, Schlemmer HP, Hohenfellner M, and Nyarangi-Dix JN
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- Biopsy, Humans, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Male, Prostate diagnostic imaging, Prostate-Specific Antigen, Prostatic Neoplasms diagnostic imaging
- Abstract
Background: Multiparametric magnetic resonance imaging (mpMRI) has excellent sensitivity in detecting significant prostate cancer (sPC). Nevertheless, uncertainty exists regarding the management of Prostate Imaging-Reporting and Data System (PI-RADS) 3 lesions., Objective: To investigate whether PI-RADS 3 lesions in combination with clinical parameters, especially prostate-specific antigen density (PSAD), can be used to exclude sPC., Design, Setting, and Participants: A total of 455 consecutive biopsy-naïve men underwent MRI-guided transperineal prostate fusion biopsy at our department between 2017 and 2018. We identified 101 patients who had exclusively one or more PI-RADS 3 lesions on mpMRI. sPC was defined as intermediate- and high-risk PC (according to the D'Amico risk classification)., Outcome Measures and Statistical Analysis: Univariate logistic regression analysis was performed to test different clinical factors as predictors of sPC in men with PI-RADS 3 lesions. The probability of sPC prediction was calculated for different PSAD thresholds., Results and Limitations: Among patients with PI-RADS 3 lesions, PSAD was a significant predictor of sPC (p = 0.005). For a PI-RADS score of 3 the probability of excluding sPC was 85% (86/101), which increased to 98% (42/43) when combined with PSAD <0.1 ng/ml/ml., Conclusions: Inclusion of PSAD < 0.1 ng/ml/ml in the strategy for biopsy-naïve patients with equivocal mpMRI findings would allow a reduction in prostate biopsies in 43% (43/101) of cases at the cost of missing a very small number (2%, 1/43) of intermediate-risk PCs., Patient Summary: At high-volume tertiary care centers with significant experience in prostate multiparametric magnetic resonance imaging, immediate biopsies could be safely omitted for men with lesions with a Prostate Imaging-Reporting and Data System score of 3 and prostate-specific antigen density of PSAD < 0.1 ng/ml/ml. Any decision to omit an immediate biopsy should be associated with close monitoring., (Copyright © 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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15. High prevalence of DNA damage repair gene defects and TP53 alterations in men with treatment-naïve metastatic prostate cancer -Results from a prospective pilot study using a 37 gene panel.
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Nientiedt C, Endris V, Jenzer M, Mansour J, Sedehi NTP, Pecqueux C, Volckmar AL, Leichsenring J, Neumann O, Kirchner M, Hoveida S, Lantwin P, Kaltenecker K, Dieffenbacher S, Gasch C, Hofer L, Franke D, Tosev G, Görtz M, Schütz V, Radtke JP, Nyarangi-Dix J, Hatiboglu G, Simpfendörfer T, Schönberg G, Isaac S, Teber D, Koerber SA, Christofi G, Czink E, Kreuter R, Apostolidis L, Kratochwil C, Giesel F, Haberkorn U, Debus J, Sültmann H, Zschäbitz S, Jäger D, Duensing A, Schirmacher P, Grüllich C, Hohenfellner M, Stenzinger A, and Duensing S
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- Adult, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Pilot Projects, Prevalence, Prospective Studies, Prostatic Neoplasms pathology, Treatment Outcome, DNA Damage genetics, DNA Repair genetics, Neoplasm Metastasis genetics, Prostatic Neoplasms genetics, Tumor Suppressor Protein p53 genetics
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Background: Defects in DNA damage repair genes characterize a subset of men with prostate cancer and provide an attractive opportunity for precision oncology approaches. The prevalence of such perturbations in newly diagnosed, treatment-naïve patients with a high risk for lethal disease outcome, however, has not been sufficiently explored., Patients and Methods: Prostate cancer specimens from 67 men with newly diagnosed early onset, localized high-risk/locally advanced or metastatic prostate cancer were included in this prospective pilot study. Tumor samples, including 30 prostate biopsies, were analyzed by targeted next generation sequencing using a formalin-fixed, paraffin-embedded tissue-optimized 37 DNA damage repair and checkpoint gene panel., Results: The drop-out rate due to an insufficient quantity of DNA was 4.5% (3 of 67 patients). In the remaining 64 patients, the rate of pathogenic DNA damage repair gene mutations was 26.6%. The highest rate of pathogenic DNA damage repair and checkpoint gene mutations was found in men with treatment-naïve metastatic prostate cancer (38.9%). In addition, a high number of likely pathogenic mutations and gene deletions were detected. Altogether, one or more pathogenic mutation, likely pathogenic mutation or gene deletion affected 43 of 64 patients (67.2%) including 29 of 36 patients (80.6%) with treatment-naïve metastatic prostate cancer. Men with metastatic prostate cancer showed a high prevalence of alterations in TP53 (36.1%)., Conclusions: This pilot study demonstrates the feasibility, performance and clinical relevance of somatic targeted next generation sequencing using a unique 37 DNA damage repair and checkpoint gene panel under routine conditions. Our results indicate that this approach can detect actionable DNA repair gene alterations, uncommon mutations as well as mutations associated with therapy resistance in a high number of patients, in particular patients with treatment-naïve metastatic prostate cancer., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2020
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16. Magnetic resonance imaging-guided transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: single-center evaluation of 6-month treatment safety and functional outcomes of intensified treatment parameters.
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Hatiboglu G, Popeneciu V, Bonekamp D, Burtnyk M, Staruch R, Pahernik S, Tosev G, Radtke JP, Motsch J, Schlemmer HP, Hohenfellner M, and Nyarangi-Dix JN
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- Aged, Clinical Trials, Phase I as Topic, Endosonography, Feasibility Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multicenter Studies as Topic, Surgery, Computer-Assisted, Treatment Outcome, Ultrasonography, Interventional, Prostate diagnostic imaging, Prostate surgery, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms surgery, Transurethral Resection of Prostate methods
- Abstract
Objectives: To evaluate the effect of intensified treatment parameters on safety, functional outcomes, and PSA after MR-Guided Transurethral Ultrasound Ablation (TULSA) of prostatic tissue., Patients and Methods: Baseline and 6-month follow-up data were collected for a single-center cohort of the multicenter Phase I (n = 14/30 at 3 sites) and Pivotal (n = 15/115 at 13 sites) trials of TULSA in men with localized prostate cancer. The Pivotal study used intensified treatment parameters (increased temperature and spatial extent of ablation coverage). The reporting site recruited the most patients to both trials, minimizing the influence of physician experience on this comparison of adverse events, urinary symptoms, continence, and erectile function between subgroups of both studies., Results: For Phase I and TACT patients, median age was 71.0 and 67.0 years, prostate volume 41.0 and 44.5 ml, and PSA 6.7 and 6.7 ng/ml, respectively. All 14 Phase I patients had low-risk prostate cancer, whereas 7 of 15 TACT patients had intermediate-risk disease. Baseline IIEF, IPSS, quality of life, and pad use were similar between groups. Pad use at 1 month and quality of life at 3 months favored Phase I patients. At 6 months, there were no significant differences in functional outcomes or adverse events., Conclusion: TULSA demonstrated acceptable clinical safety in Phase I trial. Intensified treatment parameters in the TACT Pivotal trial increased ablation coverage from 90 to 98% of the prostate without affecting 6-month adverse events or functional outcomes. Long-term follow-up and 12-month biopsies are needed to evaluate oncological safety.
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- 2020
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17. Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer.
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Nyarangi-Dix JN, Tosev G, Damgov I, Reimold P, Aksoy C, Hatiboglu G, Teber D, Mansour J, Kuehhas FE, Radtke JP, and Hohenfellner M
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- Aged, Follow-Up Studies, Humans, Male, Middle Aged, Prostatic Neoplasms complications, Retrospective Studies, Treatment Outcome, Urinary Incontinence etiology, Urinary Incontinence surgery, Prostatectomy methods, Prostatic Neoplasms surgery, Recovery of Function, Robotics methods, Urinary Incontinence physiopathology, Urination physiology
- Abstract
Purpose: To analyze urinary continence outcome following robot-assisted radical prostatectomy (RARP) for aggressive prostate cancer in men aged ≥ 70 and < 70 years., Methods: Retrospective analyses of prospectively collected long-term data from a monocentric cohort of 350 men with D'Amico high-risk prostate cancer undergone robot-assisted radical prostatectomy at a single institution between 2005 and 2016. The association between time since operation and zero-pad urinary continence recovery was comparatively analyzed by separate pre-operative and post-operative Cox proportional-hazard regression models., Results: Median age in the age group ≥ 70 years was 73 years compared with 62 years in the < 70 year age group. Distribution of men receiving adjuvant and salvage radiotherapy/hormonal therapy was similar in both age groups. Urinary continence recovery rate at 12, 24, and 36 months after surgery of men aged ≥ 70 years was 66, 79 and 83%, respectively, and statistically similar to that of men < 70 years: 71, 81, and 85% (log-rank test p = 0.24). Multivariable analyses demonstrated no significant difference in return to continence between the two age groups (p = 0.28 and p = 0.17). In addition, clinical stage and type of nerve sparing (unilateral, bilateral or non-nerve sparing) were found to be independently predictive of pad-free continence recovery., Conclusions: Regardless of age, return to continence in men with aggressive prostate cancer undergoing RARP continues to improve way beyond the first 12 months after surgery. Considering the dire effects of post-operative radiotherapy on continence in this aggressive cancer cohort, advanced age alone should not discourage recommending multimodal therapy involving RARP.
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- 2020
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18. Intracardiac Extension of Wilms Tumor: A Case of a 2.5-Year-Old Girl Presenting with Upper Venous Congestion Caused by Tumor Growth into the Right Cardiac Ventricle.
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Imle R, Tosev G, Behnisch W, Schenk JP, Rauch H, Mueller A, Gorenflo M, Loukanov T, Kulozik A, and Nyarangi-Dix J
- Abstract
While Wilms tumors (WT) typically present solely with an abdominally palpable mass, rare cases exhibiting vascular tumor growth can also present with circulatory problems. Here, we report the case of a 2.5-year-old girl presenting with upper venous congestion and arterial hypertension as the primary symptoms of intraventricular tumor growth exhibiting remarkable tubular and perfused morphology. Clinical situation stabilized after initiation of neoadjuvant chemotherapy (NAC) with actinomycin D and vincristine, followed by surgical resection via laparotomy and sternotomy supported by cardiopulmonary bypass and deep hypothermia. Our results highlight the previously reported feasibility of this approach, even in primarily unstable patients.
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- 2019
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19. Prostatic metastasis from intrahepatic cholangiocarcinoma.
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Tosev G, Schuetz V, Nyarangi-Dix J, Stenzinger A, Stoegbauer F, Kulu Y, Radtke JP, Teber D, Hatzinger M, Springfeld C, Koehler BC, and Hohenfellner M
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- 2018
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20. Complete bladder neck preservation promotes long-term post-prostatectomy continence without compromising midterm oncological outcome: analysis of a randomised controlled cohort.
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Nyarangi-Dix JN, Tichy D, Hatiboglu G, Pahernik S, Tosev G, and Hohenfellner M
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- Aged, Cohort Studies, Disease-Free Survival, Humans, Logistic Models, Male, Margins of Excision, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prostatic Neoplasms pathology, Quality of Life, Single-Blind Method, Kallikreins blood, Neoplasm Recurrence, Local blood, Organ Sparing Treatments methods, Postoperative Complications epidemiology, Prostate-Specific Antigen blood, Prostatectomy methods, Prostatic Neoplasms surgery, Urinary Bladder, Urinary Incontinence epidemiology
- Abstract
Purpose: The only RCT available on complete bladder neck preservation (cBNP) during radical prostatectomy reported superior continence and QoL outcomes in the first 12 months after cBNP. We provide the first data on long-term urinary continence, QoL and biochemical recurrence (BCR) after complete bladder neck preservation in a randomised controlled cohort., Methods: After approval by IRB, 199 men recruited for the randomised, controlled single-blind Heidelberger cBNP Study had prostatectomy performed with (cBNP) or without (noBNP) complete bladder neck preservation. Only men with renewed consent for this follow-up were evaluated for continence, QoL outcomes and BCR by ICIQ-SF self-assessment questionnaire, Pad-use/day and PSA levels. Students-t test, Pearson´s Chi-square, Fishers exact test and multiple logistic regression analyses were applied., Results: Mean follow-up was approx. 4 years. There were no significant differences in baseline characteristics between responders/non-responders or between study groups. We noted significantly higher continence rates (p = 0.004), less pad-use (p < 0.001), reduced frequency (p = 0.023) and amount (p = 0.009) of urine loss, and higher QoL outcomes (p = 0.012) after cBNP. A younger age positively influenced continence (OR = 0.91), but the multivariate analysis found cBNP to be the only independent predictor of continence (p = 0.008; OR = 8.1). pT stage was the only predictor for positive surgical margins (PSM; p < 0.001). There was no significant difference in pT stage (p = 0.23) or BCR (p = 0.63) between study groups and also no significant correlation between BCR and presence (p = 0.26) or localisation (p = 0.11) of PSM, nerve sparing (p = 0.70), surgeon (p = 0.41), preoperative PSA (p = 0.53) or pT stage (p = 0.17). No cancer-related death was noted., Conclusions: Results of this first follow-up on a prospective randomised controlled cohort demonstrate that cBNP is associated with significantly higher continence and QoL outcomes without compromising cancer control making cBNP a novel objective during radical prostatectomy.
- Published
- 2018
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21. Paraganglioma of the Seminal Vesicle Case Report and Review of the Literature.
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Tosev G, Mendler M, Bergmann F, Klein T, Pahernik SA, Hadaschik BA, and Hohenfellner M
- Abstract
Background: The present case report describes an extremely rare case of a norepinephrine secreting extraadrenal paraganglioma (PGL) located in the seminal vesicle. Case Presentation: A 36-year-old patient had signs of intermittent hypertensive derailments, bradycardia, increased norepinephrine excretion in 24-hour urine, an increased metanephrine plasma concentration, and a positive clonidine suppression test. A suspicious mass was detected in an (18)F-DOPA-PET/CT-scan in the left seminal vesicle. Following adrenergic blockade, a robotically assisted laparoscopic left vesiculectomy with negative soft tissue surgical margins was performed. The patient sustained a couple of few months of voiding difficulties of the lower urinary tract and obstruction of the left upper urinary tract after the surgery, which resolved spontaneously with home medical treatment. Two years after the initial treatment, the patient relapsed, which was confirmed by endocrinologic follow-up tests with increased urine catecholamine, a positive clonidine suppression test, as well as an elevated blood pressure. Staging with (18)F-DOPA-PET/CT-scan confirmed the diagnosis of a recurrent PGL. This was followed by subsequent open surgical removal of the suspicious lesion in the seminal fossa. The patient is still recurrence free 15 months after the second surgery. Complications after the second surgery included an intermittent paresthesia of the left leg lasting 3 to 4 months. No other urologic symptoms such as voiding or erectile dysfunction occurred. Conclusion: DaVinci-assisted laparoscopic vesiculectomy is a viable procedure to treat such cases providing satisfactory results. Relevant for clinical practice are the regular and lifelong follow-up examinations to detect recurrences., Competing Interests: Statement No competing financial interests exist.
- Published
- 2016
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22. Primary melanoma of the prostate: case report and review of the literature.
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Tosev G, Kuru TH, Huber J, Freier G, Bergmann F, Hassel JC, Pahernik SA, Hohenfellner M, and Hadaschik BA
- Subjects
- Adult, Biopsy, Needle, Chemotherapy, Adjuvant, Combined Modality Therapy, Disease Progression, Fatal Outcome, Humans, Immunohistochemistry, Male, Neoplasm Invasiveness pathology, Neoplasm Staging, Rare Diseases, Melanoma pathology, Melanoma therapy, Prostatectomy methods, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy
- Abstract
Background: Primary melanoma of the prostate has an extremely rare incidence. Only five cases have been reported in the literature and prognosis is poor. The most likely origin of prostatic melanoma is the transitional epithelium of the prostatic urethra. Surgical care for primary melanoma of mucosal sites is less well established than for primary cutaneous melanoma, but excision of the primary is recommended if the patient has no systemic disease., Case Presentation: Here, we describe a case of primary malignant melanoma of the prostate. A 37-year-old male patient with history of both chemo- and radiation therapy for Hodgkin's disease was admitted to the University Hospital Heidelberg on suspicion of pleomorphic sarcoma of the bladder. In-house diagnostic work-up revealed a malignant melanoma of the prostate. We then performed radical prostatectomy with extended lymphadenectomy. Despite presumably curative surgery, the patient suffered from early relapse of disease with pulmonary metastasis. Systemic chemotherapy and subsequent immuno-oncologic treatment was thereafter initiated., Conclusion: Since prostatic melanoma is a rare disease and a melanoma metastasis of unknown primary is the differential diagnosis, a multidisciplinary approach including early imaging to rule out possible metastases and to search for another potentially existing primary is advisable. To prevent complications related to local tumor progression and to receive tissue for mutational analysis, we recommend complete surgical resection to reduce the tumor mass. Novel immune and targeted oncologic therapies can lead to an improved survival in some cases and support of clinical trials is needed.
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- 2015
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23. Efficacy of targeted treatment beyond third-line therapy in metastatic kidney cancer: retrospective analysis from a large-volume cancer center.
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Vallet S, Pahernik S, Höfner T, Tosev G, Hadaschik B, Duensing S, Sedlaczek O, Hohenfellner M, Jäger D, and Grüllich C
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Retrospective Studies, Survival Analysis, Treatment Outcome, Antineoplastic Agents therapeutic use, Kidney Neoplasms drug therapy, Kidney Neoplasms pathology
- Abstract
Introduction/background: Currently, 7 agents are approved for the first- and second-line therapy for metastatic renal cell carcinoma. In contrast, data supporting their use beyond second line are limited. Here we summarize our experience in patients treated with more than 4 lines of therapy., Methods: We retrospectively assessed the outcome of 24 patients treated at our institution with at least 4 lines of therapy. Progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier estimates., Results: Median OS from the initiation of first-line therapy for the whole cohort is 64.7 months. Up to 96% of the patients received a tyrosine kinase inhibitor (TKI) and mammalian target of rapamycin (mTOR) inhibitor (mTOR-I) within the first 3 lines of treatment. In the fourth or following lines, patients were treated with TKI, mTOR-I, bevacizumab/interferon, or experimental drugs. Seven patients continued treatment with a sixth-line agent; one has been treated up to the ninth line. Sixteen percent of the patients receiving fourth-line therapy and 13% receiving fifth-line therapy experienced a partial remission, which was independent from response to previous therapies. Median OS from fourth and fifth line was 30.8 and 26.2 months, respectively. Median PFS for fourth-line therapy was 5.8 months. No significant difference in PFS was observed for patients with disease that responded or did not respond to first-line therapy., Conclusion: Despite the limitations of a retrospective analysis, our study suggests that selected patients benefit from multiple lines of treatment, independent of response to first-line therapy. However, the optimal sequence of treatment with regard to later lines remains to be determined., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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24. International multicentre psychometric evaluation of patient-reported outcome data for the treatment of Peyronie's disease.
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Kueronya V, Miernik A, Stupar S, Kojovic V, Hatzichristodoulou G, Egydio PH, Tosev G, Falcone M, De Luca F, Mulalic D, Djordjevic M, Schoenthaler M, Fahr C, and Kuehhas FE
- Subjects
- Adolescent, Adult, Aged, Humans, Internationality, Male, Middle Aged, Psychometrics, Retrospective Studies, Treatment Outcome, Urologic Surgical Procedures, Male methods, Young Adult, Patient Satisfaction, Penile Implantation, Penile Induration surgery, Self Report
- Abstract
Objective: To compare patient-reported outcomes (PROs) of surgical correction of Peyronie's disease (PD) with the Nesbit procedure, plaque incision and grafting, and the insertion of a malleable penile implant after surgical correction of penile curvature., Patients and Methods: We performed a retrospective review of men who underwent surgical correction of PD between January 2010 and December 2012 at six international centres. Treatment-related PROs and satisfaction were evaluated with a non-validated questionnaire., Results: The response rate to the questionnaire was 70.9%, resulting in a study cohort of 206 patients. The Nesbit procedure, plaque incision with grafting, or implantation of a malleable penile prosthesis was performed in 50, 48, and 108 patients, respectively. Overall, 79.1% reported a subjective loss of penile length due to PD preoperatively (range 2.1-3.2 cm). Those patients treated with a malleable penile implant reported the greatest subjective penile length loss, due to PD. A subjective loss of penile length of >2.5 cm resulted in reduced preoperative sex ability. Postoperatively, 78.0%, 29.2% and 24.1% patients in the Nesbit, grafting, and implant groups reported a postoperative, subjective loss of penile length (range 0.4-1.2 cm), with 86.3%, 78.6%, and 82.1% of the patients in each group, respectively, being bothered by the loss of length., Conclusions: Penile length loss due to PD affects most patients. Further penile length loss due to the surgical correction leads to bother among the affected patients, irrespective of the magnitude of the loss. The Nesbit procedure was associated with the highest losses in penile length. In patients with PD and severe erectile dysfunction, a concomitant lengthening procedure may be offered to patients to help overcome the psychological burden caused by the loss of penile length., (© 2014 The Authors. BJU International © 2014 BJU International.)
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- 2015
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25. Identification of cell-free microRNAs in the urine of patients with prostate cancer.
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Korzeniewski N, Tosev G, Pahernik S, Hadaschik B, Hohenfellner M, and Duensing S
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- Aged, Aged, 80 and over, Cell Line, Tumor, Humans, Male, MicroRNAs genetics, Middle Aged, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology, MicroRNAs urine, Prostatic Neoplasms urine
- Abstract
Objectives: Current methods for the early detection of prostate cancer (PCa), in particular prostate-specific antigen screening, are likely to benefit from complementary molecular analyses to enhance specificity. MicroRNAs (miRNA) are small endogenously expressed noncoding RNAs that negatively regulate the expression of protein-coding genes at the transcriptional or translational level. Accumulating evidence suggests that miRNAs play an important role in tumorigenesis, are differentially expressed in different cancer types, and can be found in all bodily fluids so-far tested, including urine., Methods and Materials: This study was undertaken to determine if miRNA could be isolated from the cell-free fraction of freely voided urine of PCa patients and if a miRNA signature could be found that would identify patients with cancer., Results: In a first set of proof-of-concept experiments, we isolated RNA from the supernatant of cultured PCa cells, as well as cellular RNA, and compared the expression of cell-free miRNAs vs. cellular miRNAs. We identified miRNA-483-5p, miRNA-1275, and miRNA-1290 among the most abundant cell-free miRNAs. We then tested the expression of these miRNAs in patient urine samples. A total of 18 patients without detectable PCa by transperineal template-saturation biopsy and 71 patients with diagnosed biopsy-proven PCa were retrospectively analyzed. We could confirm that cell-free miRNAs found in cultures of PCa cells can in fact be isolated from freely voided patients' urine. Furthermore, we found that patients with PCa express miR-483-5p in the cell-free urine fraction at a higher level than control patients do., Conclusions: The present study is among the first to show that miRNAs can be detected in the cell-free, non-exosome-enriched fraction of urine collected from patients with PCa. As the method used here does not require isolation of exosomes, it could potentially simplify the future use of miRNAs as urine-based biomarkers., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2015
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26. Incidence of balanitis xerotica obliterans in boys younger than 10 years presenting with phimosis.
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Kuehhas FE, Miernik A, Weibl P, Schoenthaler M, Sevcenco S, Schauer I, Tosev G, Oezsoy M, and Lassmann J
- Subjects
- Age Factors, Austria epidemiology, Balanitis Xerotica Obliterans diagnosis, Balanitis Xerotica Obliterans therapy, Child, Child, Preschool, Circumcision, Male, Humans, Incidence, Infant, Male, Phimosis diagnosis, Phimosis therapy, Time Factors, Treatment Outcome, Balanitis Xerotica Obliterans epidemiology, Phimosis epidemiology
- Abstract
Objective: Evaluation of the true incidence of balanitis xerotica obliterans (BXO) among boys younger than 10 years., Methods: In a period of 13 months, 75 boys younger than 10 years were treated for phimosis. Suspicion of BXO was raised in phimosis grade 2 or 3 (classification by Kikiros). Patients were offered primarily either circumcision or conservative therapy and circumcision secondarily (if treatment failed in the conservative group). Each circumcision specimen was examined histopathologically., Results: Circumcision was primarily performed in 29 and secondarily in 17 patients. The mean age was 3.7 years (range 1-10). BXO, chronic inflammation, and normal histological results were found in 8/26/12 (17.4/56.5/26.1%) cases, respectively. The mean follow-up was 8.1 months. No recurrences were reported., Conclusions: The incidence of BXO appears to be higher than previously reported. The clinical appearance in children may be confusing. The preoperative BXO suspicion did not correlate with the final histopathological results., (Copyright © 2012 S. Karger AG, Basel.)
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- 2013
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27. Predictive power of objectivation of phimosis grade on outcomes of topical 0.1% betamethasone treatment of phimosis.
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Kuehhas FE, Miernik A, Sevcenco S, Tosev G, Weibl P, Schoenthaler M, and Lassmann J
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- Administration, Topical, Child, Child, Preschool, Humans, Infant, Male, Phimosis diagnosis, Severity of Illness Index, Treatment Outcome, Betamethasone administration & dosage, Glucocorticoids administration & dosage, Phimosis drug therapy
- Abstract
Objective: To evaluate the predictive power of the objectivation of the phimosis grade according to the classification defined by Kikiros and Woodward, with regard to the expected efficacy of 0.1% betamethasone cream as a treatment option., Methods: From October 2010 to May 2011, a total of 55 boys (aged <10 years) were treated for phimosis at our department. An assessment of the category of phimosis and the retractability of the foreskin, according to the classification of Kikiros and Woodward, was performed. The proposed treatment options included complete circumcision or topical treatment with steroid cream (0.1% betamethasone-17-valerate)., Results: Of the 55 patients, 19 (34.5%) underwent conventional circumcision, and 36 (65.5%) were treated with an 8-week course of topical steroid cream. The mean age was 3.9 years (range 0.6-10). Grade 1, 2, 3, 4, and 5 phimosis was seen in 1 (2.8%), 4 (11.1%), 8 (22.2%), 16 (44.4%), and 7 (19.4%) of the cases in the topical steroid cream group, respectively. The success rate for the topical steroid cream was 69.4% and 63.9% at 3 and 8.3 months, respectively. The objectivation of the phimosis grade did not predict the outcome (P > .05). No side effects were associated with the topical steroid treatment., Conclusion: The pretreatment classification of phimosis did not allow the prediction of success with the topical steroid treatment. We believe that topical steroid therapy with foreskin retraction and daily cleansing is a valid therapy modality that should be offered before any surgical intervention, regardless of the degree of phimosis., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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28. Multidetector computed tomography virtual cystoscopy: an effective diagnostic tool in patients with hematuria.
- Author
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Kuehhas FE, Weibl P, Tosev G, Schatzl G, and Heinz-Peer G
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma in Situ complications, Carcinoma in Situ diagnostic imaging, Carcinoma, Transitional Cell complications, Carcinoma, Transitional Cell diagnostic imaging, Diverticulum complications, Diverticulum diagnostic imaging, Endometriosis complications, Endometriosis diagnostic imaging, Female, Humans, Male, Middle Aged, Neoplasm Metastasis diagnostic imaging, Neoplasms diagnostic imaging, Sensitivity and Specificity, Urinary Bladder Diseases complications, Urinary Bladder Neoplasms complications, Urinary Bladder Neoplasms diagnostic imaging, User-Computer Interface, Cystoscopy, Diagnostic Techniques, Urological, Hematuria etiology, Imaging, Three-Dimensional, Tomography, Spiral Computed methods, Urinary Bladder Diseases diagnostic imaging
- Abstract
Objective: To evaluate the efficacy and the potential use of multidetector computed tomography virtual cystoscopy (MDCT-VC) in patients with gross hematuria., Methods: A total of 32 patients underwent MDCT-VC, cystoscopy, and a cytologic examination. The slice thickness of MDCT was 1 mm. Bladder distension was done with room air. The data were converted into 3-dimensional virtual reconstructive models. The data sets were reviewed independently by 2 experienced radiologists. Tumors confined to the mucosa, infiltrating the muscularis, and transmural tumors were distinguished., Results: VC showed a sensitivity and specificity of 100%. The radiologic accuracy regarding T stage correlated in 87.5%. MDCT-VC identified 21 bladder lesions suspicious for bladder cancer in 18 patients. The histologic results showed 22 patients with bladder lesions, 18 were diagnosed with transitional cell carcinoma of the bladder, 3 had bladder endometriosis, and 1 had an infiltrating colon cancer. Four patients had concomitant carcinoma in situ lesions, which were not seen completely with MDCT-VC. However, cytology was positive in those cases. Ten patients did not have any tumor signs on VC and the subsequent conventional cystoscopy did not bring any change to the initial tumor-free diagnosis of VC., Conclusion: MDCT-VC combined with urine cytology is a good alternative to conventional cystoscopy for patients with painless gross hematuria. It should be used as a decision-making aid to identify patients who will benefit from additional cystoscopic examination. Future developments should focus on the visibility of sessile and carcinoma in situ lesions., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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29. New findings in bladder and prostate cancer: highlights from the 26th annual congress of the European Association of Urology, March 18-22, 2011, Vienna, Austria.
- Author
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Farr A, Herout R, Margreiter M, Tosev G, and Djavan B
- Subjects
- Androstenes, Androstenols therapeutic use, Biomarkers metabolism, Humans, Lymphatic Metastasis, Male, Neoplasm Invasiveness, Neoplasm Metastasis, Pelvis, Prostatic Neoplasms diagnosis, Urinary Bladder Neoplasms diagnosis, Urinary Bladder Neoplasms surgery, Lymph Node Excision, Prostatectomy methods, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Radioimmunotherapy, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms radiotherapy
- Abstract
At the recent annual congress, of the European Association of Urology (EAU), urologists from around the world presented their exciting discoveries related to an array of topics. Besides the huge variety of different sessions and courses, the EAU Section of Uro-Technology (ESUT) transmitted live broadcasts of surgeries from the medical universities of Vienna and Heilbronn, focusing on novel surgical techniques. Unfortunately, this year's congress was clouded by the environmental disaster and nuclear accident in Japan, which prevented a number of Japanese urologists to attend the congress due to obstacles in travelling. In this brief update, we will highlight some of the findings and the clinical significance of a few of this year's important abstracts in bladder and prostate cancer.
- Published
- 2011
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