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Current Opinion in Urology

Alireza Aminsharifi, Jean de la Rosette, Thomas J Polascik
No abstract text is available yet for this article.
September 18, 2018: Current Opinion in Urology
Alireza Aminsharifi, Rajan T Gupta, Jiaoti Huang, Thomas J Polascik
PURPOSE OF REVIEW: The current trend in image-based identification and characterization of prostate cancer (PCa) utilizing multiparametric MRI (mpMRI) has affected diagnostic and treatment planning in terms of targeted biopsy, risk stratification and prognostic evaluation, clinical management and follow-up. However, the accuracy of MRI to detect clinically significant disease is variable between different institutions. The role of quality control initiatives to increase the concordance between clinical-imaging-histopathological data and to improve accurate targeting of the suspicious lesions cannot be overemphasized...
September 18, 2018: Current Opinion in Urology
Nicolai Hübner, Shahrokh F Shariat, Mesut Remzi
PURPOSE OF REVIEW: The aim of this study was to summarize the latest evidence, as well as the rationale behind using focal therapy for the treatment of prostate cancer. With patients becoming more educated, knowledge of the available evidence is key when discussing treatment. RECENT FINDINGS: In older works, the natural history of prostate cancer has been described as being multifocal, driven by one index lesion. This represents the key argument for most experts, why focal therapy is feasible in prostate cancer...
September 18, 2018: Current Opinion in Urology
Jared S Winoker, Peter A Pinto, Ardeshir R Rastinehad
PURPOSE OF REVIEW: To discuss contemporary data on the value of multiparametric MRI (mpMRI) for guiding the decision to biopsy men at risk for prostate cancer, as well as its utility in active surveillance programs. RECENT FINDINGS: Although a systematic 12-core biopsy is the current standard of care for men with increased suspicion for prostate cancer, MRI with or without targeted biopsy has been shown to reliably improve the detection of clinically significant disease following a prior negative biopsy...
September 18, 2018: Current Opinion in Urology
Iris S G Brummelhuis, J Alfred Witjes, Edward M Messing
PURPOSE OF REVIEW: To describe the importance of risk stratification and the role of more conservative management like office fulguration, office laser ablation and active surveillance in recurrent low-grade Ta tumours. RECENT FINDINGS: Updated models have been designed for risk stratification of intermediate-risk tumours. Conservative forms of management like office fulguration or laser ablation and even active surveillance seem well tolerated; however, randomized, controlled trials are lacking...
September 18, 2018: Current Opinion in Urology
Alexa R Meyer, Gregory A Joice, Mohamad E Allaf, Steven P Rowe, Michael A Gorin
PURPOSE OF REVIEW: To explore the current state of using prostate-specific membrane antigen (PSMA)-targeted PET imaging to aid in the diagnosis of clinically significant prostate cancer. RECENT FINDINGS: Prostate-specific antigen screening remains controversial, as it is associated with the underdetection of clinically significant prostate cancer as well as the overdetection and subsequent overtreatment of clinically insignificant disease. A diagnostic test that can accurately assess the presence of clinically significant prostate cancer and avoid detection of low-risk tumors is needed...
September 3, 2018: Current Opinion in Urology
Andreas Bruchbacher, Francesco Soria, Melanie Hassler, Shahrokh F Shariat, David D'Andrea
PURPOSE OF REVIEW: To summarize recent findings on tissue biomarkers for nonmuscle-invasive bladder cancer (NMIBC) with an emphasis on their prognostic and predictive role. RECENT FINDINGS: Accurate risk stratification is essential and the major driver in patient counseling regarding surveillance and decision making relative to therapeutic strategies. In NMIBC, there is an unmet need for improving the accuracy of current prognostic and predictive models, which rely only on clinicopathologic features and do not reflect the biological heterogeneity of the cancer in each individual...
September 3, 2018: Current Opinion in Urology
Francesco Soria, David D'Andrea, Kamal Pohar, Shahrokh F Shariat, Yair Lotan
PURPOSE OF REVIEW: To summarize the current knowledge about the clinical role of novel urinary markers in bladder cancer (BCa) management, from diagnosis to follow-up, from prognosis of oncological outcomes to response to intravesical therapy. RECENT FINDINGS: Urinary markers have been developed to overcome the limitations of the current available tools for the diagnosis and surveillance of BCa patients. However, to date, because of their limited performances, urinary markers are not generally used in clinical practice...
August 27, 2018: Current Opinion in Urology
Miles P Mannas, Taeweon Lee, Timo K Nykopp, Jose Batista da Costa, Peter C Black
PURPOSE OF REVIEW: A bladder-preserving approach for high-grade nonmuscle invasive bladder cancer that has invaded the lamina propria (T1HG) may result in increased recurrence, progression, and even death from bladder cancer in some patients. Initial radical cystectomy does have increased cancer-specific survival (CSS), but represents significant overtreatment for many patients. An evidence-based, risk-stratified approach is required to select patients for immediate radical cystectomy in order to improve CSS...
August 24, 2018: Current Opinion in Urology
Lars Dyrskjøt, Molly A Ingersoll
PURPOSE OF REVIEW: Despite that nearly 75% of bladder cancer patients are diagnosed with nonmuscle-invasive disease, our understanding of the biological landscape in bladder cancer is primarily within the context of muscle-invasive bladder cancer. More recent studies addressing the genomic changes and immunology of nonmuscle-invasive bladder cancer (NMIBC) have helped to extend our understanding of this prevalent disease. RECENT FINDINGS: Genomic studies reveal that NMIBC possesses complexity that can be defined by specific gene expression signatures and has helped to define subsets within this disease...
August 21, 2018: Current Opinion in Urology
Mohammad Abufaraj, Hugh Mostafid, Shahrokh F Shariat, Marek Babjuk
PURPOSE OF REVIEW: Over the last decade, the world has experienced health-threatening supply shortages of Bacillus Calmette-Guérin (BCG) immunotherapy for nonmuscle-invasive bladder cancer (NMIBC). We summarize the current literature to assist in treatment decisions in light of suboptimal supply. RECENT FINDINGS: Currently available data do not support a superiority of one BCG strain over the other. Intravesical chemotherapy seems to provide similar results in term of disease progression but not recurrence in intermediate-risk patients...
August 21, 2018: Current Opinion in Urology
Rafael R Tourinho-Barbosa, Jean de la Rosette, Rafael Sanchez-Salas
PURPOSE OF REVIEW: Most of focal therapies has addressed index lesion as the targeted tumour focus to treat localized prostate cancer (PCa), a multifocal disease. The interaction between tumour foci and host cells creates a tumour microenvironment (TME) which affects tumour growth, cellular proliferation, and PCa progression. This review aims to better understand the biology of cancer foci and their interaction with the prostatic microenvironment after focal therapy. RECENT FINDINGS: Index lesions are representative of PCa grade in low-risk patients, but the other foci of tumour, the satellite lesions, gain relevance in higher risk patients...
August 21, 2018: Current Opinion in Urology
Kae Jack Tay
PURPOSE OF REVIEW: Prostate focal therapy has the potential to preserve urinary and sexual function while eliminating clinically significant cancer in a subset of men with low-volume, organ-confined prostate cancer. This systematic review aims to examine current evidence to determine the efficacy and safety of focal therapy for standard clinical application. RECENT FINDINGS: Focal therapy reduces the rate of cancer progression and conversion to radical therapy in men on active surveillance for prostate cancer...
August 16, 2018: Current Opinion in Urology
Francesco Soria, Giancarlo Marra, Marco Allasia, Paolo Gontero
PURPOSE OF REVIEW: To summarize the current knowledge about the evaluation of disease persistence and recurrence after focal therapy ablation (FTA) for small renal masses and to assess the outcomes and complications of related treatment options. RECENT FINDINGS: FTA procedures continuously increased over the last 20 years, being now performed in more than one on 10 patients with T1a renal cell carcinoma. Disease recurrence seems to occur more often following radiofrequency ablation (RFA) compared with cryoablation...
August 16, 2018: Current Opinion in Urology
Akbar N Ashrafi, Alessandro Tafuri, Giovanni E Cacciamani, Daniel Park, Andre L de Castro Abreu, Inderbir S Gill
PURPOSE OF REVIEW: To present a perspective on the current status and future directions of focal therapy for prostate cancer (PCa). RECENT FINDINGS: Focal therapy for localized PCa is a rapidly evolving field. Various recent concepts - the index lesion driving prognosis, the enhanced detection of clinically significant PCa using multiparametric MRI and targeted biopsy, improved risk-stratification using novel blood/tissue biomarkers, the recognition that reducing radical treatment-related morbidity (along with reducing pathologic progression) is a clinically meaningful end-point - have all led to a growing interest in focal therapy...
August 10, 2018: Current Opinion in Urology
Takumi Shiraishi, Osamu Ukimura
PURPOSE OF REVIEW: With the increasing incidence of low-to-intermediate risk of prostate cancer (PCa) by the introduction of prostate-specific antigen (PSA) screening, focal therapy has become one of the promising treatment options in the world. In Asia, same movement are occurring using several technologies including cryoablation, high-intensity focused ultrasound, brachytherapy and irreversible electroporation. However, these are still not common strategies to treat organ-confined PCa...
August 10, 2018: Current Opinion in Urology
Jan Schraml, Joana Do Carmo Silva, Marko Babjuk
PURPOSE OF REVIEW: Transurethral resection of bladder cancer (TURB) is the critical step in the management of nonmuscle invasive bladder cancer (NMIBC). This review presents new improvements in the strategy and technique of TURB as well as in technological developments used for tumour visualization and removal. RECENT FINDINGS: The goal of TURB is to perform complete resection of NMIBC. Tumor visualization during procedure can be improved by enhanced optical technologies...
August 9, 2018: Current Opinion in Urology
Marco Bandini, Nicola Fossati, Alberto Briganti
PURPOSE OF REVIEW: To critically review the current literature regarding the recently published nomograms in urologic oncology and to examine the advantages and disadvantages of their application. RECENT FINDINGS: Several nomograms have been developed in the field of urologic oncology over the recent years, to improve clinical decision-making and patients counseling. In the current review, we examined 6 nomograms on prostate cancer, 9 nomograms on kidney cancer and 8 nomograms on bladder cancer that have been recently published...
August 7, 2018: Current Opinion in Urology
Rodrigo Suarez-Ibarrola, Mohammad Abufaraj, Shahrokh F Shariat
PURPOSE OF REVIEW: Although platinum-based chemotherapy (CHT) remains the cornerstone of clinical stage I testicular germ cell tumor (GCT) treatment, its long-term toxicity and complications in cancer survivors are unclear. RECENT FINDINGS: Cardiovascular disease and secondary malignancies represent the most life-threatening long-term complications and typically occur 10 years after treatment. Other potential intermediate deleterious effects include pulmonary toxicity, ototoxicity, neurotoxicity, hypogonadism and infertility...
September 2018: Current Opinion in Urology
Aditya Bagrodia, Peter Albers
No abstract text is available yet for this article.
September 2018: Current Opinion in Urology
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