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Current Opinion in Urology

Dan Wood
PURPOSE OF REVIEW: There is increasing recognition of the need for life-long care in patients who have congenital urological anomalies. This study looks at the factors surrounding transition and suggests those, which may improve the success. RECENT FINDINGS: One of the most challenging phases in this care is adolescence. There are the physical and psychological changes that all adolescents go through. Patients need medical surveillance through this time in order to ensure good care and patient safety...
October 5, 2016: Current Opinion in Urology
Jeroen R Scheepe, Bertil F M Blok, Lisette A 't Hoen
PURPOSE OF REVIEW: The purpose of this article is to provide an overview about the applicability of botulinum toxin type A (BTX-A) in paediatric neurogenic bladder based on the recently published literature combined with hypothetical notes and future perspectives. RECENT FINDINGS: The indications, clinical outcomes, urodynamic outcome parameters and cost-effectiveness are presented from recent publications. Also, alternative routes of application of BTX-A in the bladder are discussed as well as the influence of BTX-A on conservative and invasive treatment...
September 29, 2016: Current Opinion in Urology
Solomon L Woldu, James F Amatruda, Aditya Bagrodia
PURPOSE OF REVIEW: Testicular germ cell tumors (TGCTs) are a model for curable cancer because of exquisite chemosensitivity and incorporation of multimodal therapy. Nevertheless, our ability to predict metastases in early-stage disease and responders to chemotherapy in advanced disease is limited. Treatment options for cisplatin-resistant disease are sparse. A further understanding of TGCT biology may allow for more precise patient counseling and identify novel therapies in patients with cisplatin-resistant disease...
August 31, 2016: Current Opinion in Urology
Solene-Florence Kammerer-Jacquet, Romain Mathieu, Benoit Peyronnet, Nathalie Rioux-Leclercq, Karim Bensalah
PURPOSE OF REVIEW: Upper tract urothelial carcinoma (UTUC) is a relatively rare and poorly investigated disease. The objective of this review was to discuss recent advances in genomics and their implication regarding prognosis and treatment. RECENT FINDINGS: UTUC were compared with urothelial carcinoma of the bladder (UCB) at genomic and transcriptomic levels. Molecular studies focused on identifying new prognostic biomarkers that were often initially described in UCB and extrapolated to UTUC...
August 31, 2016: Current Opinion in Urology
Juanita Crook
PURPOSE OF REVIEW: As penile cancer is an uncommon malignancy in the Western society, randomized trials to address the controversies in management have not previously been undertaken. The incorporation of multidisciplinary approaches in the management of advanced penile carcinoma has largely borrowed evidence from analogous malignancies in the anogenital region. This review is being undertaken in preparation for the international launch of InPACT, the International Penile Advanced Cancer Trial, a collaborative effort from European and North American trialists...
August 31, 2016: Current Opinion in Urology
Amy B Wisniewski
PURPOSE OF REVIEW: Historically, studies of caregivers of children with disorders of sex development (DSD) have been limited. RECENT FINDINGS: Recent data reveal that parents of young children with DSD report increased stress, anxiety, depression, and decreased quality of life in ways that are similar to parents of children with other types of chronic illnesses. Also similar to other chronic illnesses of childhood, parents of children with DSD exhibit overprotective parenting and perceive their child as being vulnerable...
August 31, 2016: Current Opinion in Urology
Benjamin Pradere, Yair Lotan, Morgan Roupret
PURPOSE OF REVIEW: Lynch syndrome is a genetic syndrome that integrates a large spectrum of cancers caused by germline mutations in mismatch repair genes. Its incidence is underestimated due to a lack of systematic screening in the population. Because upper tract urothelial carcinoma is the third-most common cancer associated with the syndrome, urologists should be aware of the diagnostic pathway. RECENT FINDINGS: Lynch syndrome can be positively diagnosed after the three following distinct steps: meeting the clinical criteria, tissue and genetic testing, and familial genetic counseling...
August 16, 2016: Current Opinion in Urology
Marie C Hupe, Florian Imkamp, Axel S Merseburger
PURPOSE OF REVIEW: There are multiple minimal invasive approaches to remove the adrenal gland. The purpose of this review is to summarize the most up-to-date findings about laparoscopic, retroperitoneoscopic, robot-assisted, and single-site adrenalectomy, and to define the most common approaches to the adrenal gland. RECENT FINDINGS: Laparoscopic adrenalectomy is the gold standard to remove adrenal tumors. New approaches are being explored to outperform the advantages of laparoscopic adrenalectomy...
August 16, 2016: Current Opinion in Urology
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No abstract text is available yet for this article.
November 2016: Current Opinion in Urology
Michael E Hurwitz, Joseph Sokhn, Daniel P Petrylak
PURPOSE OF REVIEW: Over the last 10 years, harnessing of the immune system to attack tumors has been one of the major breakthroughs in cancer, primarily through the use of immune checkpoint inhibitors (ICIs). This review will summarize current immune treatments in urologic malignancies and ongoing trials with novel combinations and in different disease settings. RECENT FINDINGS: Patients with urologic malignancies such as kidney and bladder cancer have benefited significantly from these advances with the approval of ICIs in both of these diseases...
November 2016: Current Opinion in Urology
Axel Heidenreich, Judd W Moul, Shahrokh Shariat, R Jeffrey Karnes
PURPOSE OF REVIEW: Oligometastatic prostate cancer (PCA) has increasingly been detected in the era of modern imaging studies such as choline-specific and prostate-specific membrane antigen (PSMA)-positron emission tomography and X-ray computed tomography (PET/CT). Recent evidence suggests that durable control is attainable with local treatment modalities such as salvage metastasectomy or stereotactic radiation therapy targeting oligometastases, either with or without the use of systemic therapy...
November 2016: Current Opinion in Urology
Stephanie A Mullane, Joaquim Bellmunt
PURPOSE OF REVIEW: Immunotherapy in urological cancer has made substantial progress during the last 20 years, but recent advances in immunotherapy have completely transformed the present treatment landscape. In this review, we summarize major clinical achievements of immunotherapy in genitourinary cancers, as well as address potential new directions for these therapies, including new agents, combinations, and biomarkers. RECENT FINDINGS: Recently, nivolumab and atezolizumab have joined sipuleucel-T as Food and Drug Administration-approved therapies in urological malignancies...
November 2016: Current Opinion in Urology
Axel Heidenreich
No abstract text is available yet for this article.
November 2016: Current Opinion in Urology
Shaveta Mehta, Tim Illidge, Ananya Choudhury
PURPOSE OF REVIEW: Radiotherapy has the potential to augment the host's immune response to cancer. Urological malignancies are highly immunogenic and the combination of radiotherapy and immunotherapy shows promise. In this review, we discuss the effects of radiotherapy on the cancer immune system and highlight the rationale for using the combined approach in prostate, urothelial and renal cancers. Current clinical studies are summarized emphasising the synergistic effects of the combination and the possibility of improved clinical outcomes...
November 2016: Current Opinion in Urology
Nicola Nicolai, Mario Catanzaro, Michele Zazzara
PURPOSE OF REVIEW: Prognosis of penile squamous cell cancer (PeSCC) depends on the involvement of the groin(s) as first step. We introduce the current available evidences that should rule the use of surgery in the management of PeSCC. RECENT FINDINGS: Prophylactic inguinal node dissection in patients with no palpable nodes associates with immediate and long-term side-effects in up to 70% of patients. Recent findings support selective intervention based on early identification of dynamic sentinel node biopsy (DSNB) with false negative rate of 4-12%...
November 2016: Current Opinion in Urology
Hans Hammers
PURPOSE OF REVIEW: Kidney cancer, in particular clear cell renal cell carcinoma (ccRCC) has long been considered to be sensitive to immunotherapies. With the recent breakthroughs in immunotherapy for solid tumors and the recent approval of the first immune checkpoint inhibitor for ccRCC, we are reviewing the history of immunotherapy in kidney cancer, describing its current state and look into the future of a rapidly evolving landscape in immunotherapy for kidney cancer. RECENT FINDINGS: Systemic treatment options over the past decade have been dominated by targeted therapies inhibiting the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways...
November 2016: Current Opinion in Urology
Susan F Slovin
PURPOSE OF REVIEW: The purpose of this review is to identify possible reasons why prostate cancer suboptimally responds to immune therapies. RECENT FINDINGS: Interrogation of the intraprostatic milieu suggests that within the normal prostate, foci of tumor can be surrounded by inflammatory cells that may or may not represent foci of immune sensitivity. Whether or not these cells are specific 'immune responders' depends on a multiplicity of factors within the host and intratumoral/stromal milieu...
November 2016: Current Opinion in Urology
Ana Collazo-Lorduy, Matthew D Galsky
PURPOSE OF REVIEW: Immune checkpoint blockade results in durable responses in a subset of patients with advanced urologic tumors. However, the majority of patients do not respond to single agent therapy raising the hypothesis that combination regimens may extend the benefits of immune checkpoint blockade to an even broader patient population. Preclinical data support combining immunotherapy with various classes of anticancer agents including standard cytotoxic chemotherapy. Herein, we provide an overview of the preclinical and clinical efforts to combine chemotherapy with immunotherapeutic approaches focusing on immune checkpoint blockade...
November 2016: Current Opinion in Urology
Abhishek Tripathi, Marina D Kaymakcalan, Nicole R LeBoeuf, Lauren C Harshman
PURPOSE OF REVIEW: Immune checkpoint inhibitors such as those that target the programmed cell death (PD)-1 pathway harness the host immune system to elicit an antitumor response. Their remarkable clinical benefit has led to regulatory approvals in several malignancies including the genitourinary cancers, renal cell carcinoma, and urothelial carcinoma. This review will focus on the management of the toxicities encountered with these agents. RECENT FINDINGS: Although generally well tolerated, a small proportion of patients (10-20%) treated with PD-1 directed agents as monotherapy can develop severe autoimmune manifestations, also known as, immune-related adverse events...
November 2016: Current Opinion in Urology
Jean Hoffman-Censits, Lindsay Wilde
PURPOSE OF REVIEW: Combination immunotherapy has already shown promise in several tumor types, such as melanoma and nonsmall cell lung cancer, and studies are ongoing to evaluate this approach in other malignancies. Trials such as these will only continue to expand as additional immune therapies are shown to have efficacy as single agents in cancer. The purpose of this review is to outline the current landscape of immunotherapy in genitourinary cancer, and to highlight ongoing and pending combination immunotherapy trials in bladder, kidney, and prostate cancers...
November 2016: Current Opinion in Urology
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