pubmed: 0302-2838The Optimal Application of Prostate-Specific Antigen (PSA) Velocity to Predict High-Risk Disease. Loeb S, Kettermann A, Ferrucci L, Landis P, Metter EJ, Carter BH
The Optimal Application of Prostate-Specific Antigen (PSA) Velocity to Predict High-Risk Disease.
Eur Urol. 2008 Nov;54(5):978-979
Authors: Loeb S, Kettermann A, Ferrucci L, Landis P, Metter EJ, Carter BH
PMID: 19884959 [PubMed - as supplied by publisher]
A New Multimodality Technique Accurately Maps the Primary Lymphatic Landing Sites of the Bladder. Roth B, Wissmeyer MP, Zehnder P, Birkhäuser FD, Thalmann GN, Krause TM, Studer UE
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A New Multimodality Technique Accurately Maps the Primary Lymphatic Landing Sites of the Bladder.
Eur Urol. 2009 Oct 23;
Authors: Roth B, Wissmeyer MP, Zehnder P, Birkhäuser FD, Thalmann GN, Krause TM, Studer UE
BACKGROUND: Pathoanatomic studies have failed to map accurately the primary lymphatic landing sites of the urinary bladder. OBJECTIVE: To use single-photon emission computed tomography (SPECT) combined with computed tomography (CT) plus intraoperative gamma probe verification to map the primary lymphatic landing sites of the bladder. DESIGN, SETTING, AND PARTICIPANTS: Clinical trial of 60 consecutive cystectomy patients at a single centre. INTERVENTION: Flexible cystoscopy-guided injection of technetium nanocolloid into one of six non-tumour-bearing sites of the bladder for preoperative detection of radioactive lymph nodes (LNs) with SPECT/CT followed by intraoperative verification with a gamma probe. Backup extended pelvic LN dissection (PLND) for ex vivo detection of missed LNs. MEASUREMENTS: Three-dimensional projection of each LN site. RESULTS AND LIMITATIONS: A median of 4 (range: 1-14) radioactive LNs were detected per site and patient. Ninety-two percent of all LNs were found distal and caudal to where the ureter crosses the common iliac arteries. Eight percent were found proximal to the uretero-iliac crossing, none without simultaneous detection of additional radioactive LNs within the endopelvic region. Extended PLND resected 92% of all primary lymphatic landing sites; limited PLND resected only 52%. A few LNs may have been missed despite preoperative SPECT/CT, intraoperative gamma probe verification, and extended backup PLND. CONCLUSIONS: Multimodality SPECT/CT plus intraoperative gamma probe show the template of the bladder's primary lymphatic landing sites to be larger than is often thought. PLND limited to the ventral portion of the external iliac vessels and obturator fossa removes only about 50% of all primary lymphatic landing sites, whereas extended PLND along the major pelvic vessels, including the internal iliac, external iliac, obturator, and common iliac region up to the uretero-iliac crossing, removes about 90%. TRIAL REGISTRATION: ClinicalTrials.gov, ISRCTN39379749.
PMID: 19879039 [PubMed - as supplied by publisher]
Editorial comment on: a review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate. Rassweiler J
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Editorial comment on: a review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate.
Eur Urol. 2009 Jun;55(6):1357
Authors: Rassweiler J
PMID: 19361917 [PubMed - indexed for MEDLINE]
A review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate. Naspro R, Bachmann A, Gilling P, Kuntz R, Madersbacher S, Montorsi F, Reich O, Stief C, Vavassori I
A review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate.
Eur Urol. 2009 Jun;55(6):1345-57
Authors: Naspro R, Bachmann A, Gilling P, Kuntz R, Madersbacher S, Montorsi F, Reich O, Stief C, Vavassori I
CONTEXT: Holmium laser enucleation of the prostate (HoLEP) and 532-nm laser vaporisation of the prostate (with potassium titanyl phosphate [KTP] or lithium borate [LBO]) are promising alternatives to transurethral resection of the prostate (TURP) and open prostatectomy (OP). OBJECTIVE: To assess safety, efficacy, and durability by analysing the most recent evidence of both techniques, aiming to identify advantages, pitfalls, and unresolved issues. EVIDENCE ACQUISITION: A Medline search of recently published data (2006-2008) regarding both techniques over the last 2 yr (January 2006 to September 2008) was performed using evidence obtained from randomised trials (level of evidence: 1b), well-designed controlled studies without randomisation (level of evidence: 2a), individual cohort studies (level of evidence: 2b), individual case control studies (level of evidence: 3), and case series (level of evidence: 4). EVIDENCE SYNTHESIS: In the last 2 yr, several case-control and cohort studies have demonstrated reproducibility, safety, and efficacy of HoLEP and 80-W KTP laser vaporisation. Four randomised controlled trials (RCTs) were available for HoLEP, two compared with TURP and two compared with OP, with follow-up >24 mo. Results confirmed general efficacy and durability of HoLEP, as compared with both standard techniques. Only two RCTs were available comparing KTP laser vaporisation with TURP with short-term follow-up, and only one RCT was available comparing KTP laser vaporisation with OP. The results confirmed the overall low perioperative morbidity of KTP laser vaporisation, although efficacy was comparable to TURP in the short term, despite a higher reoperation rate. CONCLUSIONS: Although they are at different points of maturation, KTP or LBO laser vaporisation and HoLEP are promising alternatives to both TURP and OP. Sufficient data proves HoLEP's durability for most prostate sizes at long-term follow-up; KTP laser vaporisation needs further evaluation to define the reoperation rate. Increasing the number of quality prospective RCTs with adequate follow-up is mandatory to tailor each technique to the right patient.
PMID: 19361906 [PubMed - indexed for MEDLINE]
Will the global economic downturn affect prostate cancer care? Pelvic lymphadenectomy as an example. Moul JW
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Will the global economic downturn affect prostate cancer care? Pelvic lymphadenectomy as an example.
Eur Urol. 2009 Jun;55(6):1266-8
Authors: Moul JW
PMID: 19349110 [PubMed - indexed for MEDLINE]
Nondestructive testing in urologic oncology. Egawa S
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Nondestructive testing in urologic oncology.
Eur Urol. 2009 Jun;55(6):1289-91; discussion 1291-2
Authors: Egawa S
PMID: 19342153 [PubMed - indexed for MEDLINE]
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