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Personalised treatment on horizon for rare genetic disease patients

MedicalNewsToday - 9 hours 13 min ago
UK researchers have identified the most serious genetic mutations responsible for a rare condition that causes blindness, opening the door for personalised treatment and tailored gene therapies.
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Dialysis drives progressive white matter brain injury due to blood pressure instability: cooling of dialysis fluids protects against this damage

MedicalNewsToday - 11 hours 13 min ago
While dialysis can cause blood pressure changes that damage the brain, cooling dialysis fluids can protect against such effects.
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Plant-derived compound 'may effectively treat lupus with fewer side effects'

MedicalNewsToday - 11 hours 13 min ago
Researchers from the University of Houston, TX, say a plant-derived compound called CDDO halted development of lupus nephritis in mice and produced no significant side effects.
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Experimental vaccine for catheter-related urinary tract infections

MedicalNewsToday - Sun, 2014-09-21 02:00
The most common type of hospital-associated infection may be preventable with a vaccine, new research in mice suggests.
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Magnetic Resonance Imaging–Transectal Ultrasound Image-fusion Biopsies Accurately Characterize the Index Tumor: Correlation with Step-sectioned Radical Prostatectomy Specimens in 135 Patients

Abstract Background

Prostate biopsies targeted by elastic fusion of magnetic resonance (MR) and three-dimensional (3D) transrectal ultrasound (TRUS) images may allow accurate identification of the index tumor (IT), defined as the lesion with the highest Gleason score or the largest volume or extraprostatic extension.

Objective

To determine the accuracy of MR-TRUS image-fusion biopsy in characterizing ITs, as confirmed by correlation with step-sectioned radical prostatectomy (RP) specimens.

Design, setting, and participants

Retrospective analysis of 135 consecutive patients who sequentially underwent pre-biopsy MR, MR-TRUS image-fusion biopsy, and robotic RP at two centers between January 2010 and September 2013.

Intervention

Image-guided biopsies of MR-suspected IT lesions were performed with tracking via real-time 3D TRUS. The largest geographically distinct cancer focus (IT lesion) was independently registered on step-sectioned RP specimens.

Outcome measurements and statistical analysis

A validated schema comprising 27 regions of interest was used to identify the IT center location on MR images and in RP specimens, as well as the location of the midpoint of the biopsy trajectory, and variables were correlated.

Results and limitations

The concordance between IT location on biopsy and RP specimens was 95% (128/135). The coefficient for correlation between IT volume on MRI and histology was r = 0.663 (p < 0.001). The maximum cancer core length on biopsy was weakly correlated with RP tumor volume (r = 0.466, p < 0.001). The concordance of primary Gleason pattern between targeted biopsy and RP specimens was 90% (115/128; κ = 0.76). The study limitations include retrospective evaluation of a selected patient population, which limits the generalizability of the results.

Conclusion

Use of MR-TRUS image fusion to guide prostate biopsies reliably identified the location and primary Gleason pattern of the IT lesion in >90% of patients, but showed limited ability to predict cancer volume, as confirmed by step-sectioned RP specimens.

Patient summary

Biopsies targeted using magnetic resonance images combined with real-time three-dimensional transrectal ultrasound allowed us to reliably identify the spatial location of the most important tumor in prostate cancer and characterize its aggressiveness.

Take Home Message

Targeted prostate biopsy, guided by elastic fusion of magnetic resonance and three-dimensional transrectal ultrasound images, can reliably predict the location and primary Gleason grade pattern of index tumors, with statistically significant predictability of tumor volume and overall Gleason score, as confirmed by correlation with radical prostatectomy specimens.

Keywords: Prostate cancer, Magnetic resonance imaging, Ultrasound, Image fusion, Biopsy, Radical prostatectomy, Index tumor, Location, Cancer volume, Gleason score.

Footnotes

a Division for Cancer Medicine, Surgery, and Transplantation, Department of Urology, Oslo University Hospital Aker, Oslo, Norway

b USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

c Department of Radiology, Oslo University Hospital Aker, Oslo, Norway

d Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway

e Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

f Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, USA

g Department of Urology, Centre Hospitalier Universitaire, Lille, France

h Chirurgie Urologique et Transplantation rénale – CHU Bordeaux, INSERM U1029 – Université Bordeaux I, France

i Department of Radiology and Nuclear Medicine, Oslo University Hospital

Corresponding author. Division for Cancer Medicine, Surgery, and Transplantation, Department of Urology, Oslo University Hospital Aker, P.O. Box 4959, Nydalen, 0424 Oslo, Norway. Tel. +47 2 3033188; Fax: +47 2 2894240.

These authors contributed equally.

Article information

PII: S0302-2838(14)00881-1
DOI: 10.1016/j.eururo.2014.08.077
© 2014 European Association of Urology, Published by Elsevier B.V.

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Invasive kidney biopsy for lupus patients may be replaced by math model

MedicalNewsToday - Sat, 2014-09-20 02:00
Mathematics might be able to reduce the need for invasive biopsies in patients suffering kidney damage related to the autoimmune disease lupus.
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Tracking the Origin of Metastatic Prostate Cancer

Abstract

Metastatic prostate cancer is a monoclonal disease. We previously failed to identify a common somatic denominator between primary tumor tissue and two lymph-node metastases by exome sequencing [Lindberg J, et al. Eur Urol 2013;63:702–8]. To track the seeding clone we performed copy-number alteration analysis on 34 morphologically distinct tissue areas in one prostatectomy specimen. Using break-point regions to infer phylogenetic relationships, the clone most closely related to the metastases was found in intraductal carcinoma of the prostate. Although the majority of tumor areas harbored events also found in the metastases, three carried none. This emphasizes the importance of intraprostatic tumor heterogeneity for prediction of prognosis. These findings also support recent evidence that intraductal carcinoma is a marker of aggressive disease.

Patient summary

We identified the area in the prostate that gave rise to metastases by searching for metastatic-specific DNA alterations in multiple regions of the prostate. The metastasizing component grew within prostatic ducts, suggesting that intraductal cancer should be reported when found in needle biopsies. It is also important to be aware of tumor heterogeneity when assessing somatic changes linked to tumor aggressiveness.

Take Home Message

Detailed spatial mapping of somatic events in a primary prostatic carcinoma demonstrated a high level of intraprostatic tumour heterogeneity. The greatest somatic similarity to the metastases was found in intraductal carcinoma, suggesting that this lesion harbors the capacity to metastasize.

Keywords: Prostate cancer, Heterogeneity, Metastasis, Intraductal carcinoma.

Footnotes

a Department of Medical Epidemiology and Biostatistics, Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden

b Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden

c Department of Urology, Division of Surgery, Karolinska Hospital, Stockholm, Sweden

d Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Corresponding author. Department of Pathology, Radiumhemmet P1:02, Karolinska University Hospital, 171 76 Stockholm, Sweden. Tel. +46 707 205979.

These authors contributed equally.

Article information

PII: S0302-2838(14)00892-6
DOI: 10.1016/j.eururo.2014.09.006
© 2014 European Association of Urology, Published by Elsevier B.V.

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For diagnosing kidney stones, CT scans are no more accurate than ultrasound

MedicalNewsToday - Fri, 2014-09-19 03:00
To diagnose painful kidney stones in hospital emergency rooms, CT scans are no better than less-often-used ultrasound exams, according to a clinical study conducted at 15 medical centers and...
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Creating predictive tool that lets prostate cancer patients decide which treatment is right for them

MedicalNewsToday - Fri, 2014-09-19 02:00
Men with prostate cancer may one day be able to predict when and how much various treatments will impact their urinary and sexual functioning, thanks in part to new findings that researchers at Fox...
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Progress in Management of Low-risk Prostate Cancer: How Registries May Change the World

Refers to article:

Contemporary Use of Initial Active Surveillance Among Men in Michigan with Low-risk Prostate Cancer

Paul R. Womble, James E. Montie, Zaojun Ye, Susan M. Linsell, Brian R. Lane and David C. Miller for the Michigan Urological Surgery Improvement Collaborative.

Accepted 11 August 2014

Footnotes

Departments of Urology and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

Departments of Urology and Epidemiology and Biostatistics, University of California, San Francisco, 1600 Divisadero St, Box 1695, San Francisco, CA 94143-1695, USA.

Article information

PII: S0302-2838(14)00894-X
DOI: 10.1016/j.eururo.2014.09.008
© 2014 European Association of Urology, Published by Elsevier B.V.

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Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

Abstract Background

Few studies have reported on late declines and long-term health-related quality of life (HRQOL) after prostate cancer (PCa) treatment.

Objective

We assessed long-term HRQOL following various treatments for localized PCa.

Design, setting, and participants

This cohort study of HRQOL up to 10 yr after treatment used a prospectively accrued, nationwide PCa registry that collects longitudinal patient-reported HRQOL.

Intervention

Various primary treatments for localized PCa.

Outcome measurements and statistical analysis

The Medical Outcomes Studies 36-item Short Form and the University of California, Los Angeles, Prostate Cancer Index characterized physical function, mental health, and sexual, urinary, and bowel function and bother. Repeated measures mixed-model analysis assessed change in HRQOL by treatment over time, and logistic regression was used to measure the likelihood of a clinically significant decline in HRQOL.

Results and limitations

Among 3294 men, 1139 (34%) underwent nerve-sparing radical prostatectomy (NSRP), 860 (26%) underwent non-NSRP, 684 (21%) underwent brachytherapy, 386 (12%) underwent external beam radiotherapy, 161 (5%) underwent primary androgen deprivation therapy, and 64 (2%) pursued watchful waiting/active surveillance. Median follow-up was 74 mo (interquartile range: 50–102). Most treatments resulted in early declines in HRQOL, with some recovery over the next 1–2 yr and a plateau in scores thereafter. Surgery had the largest impact on sexual function and bother and on urinary function, radiation had the strongest effect on bowel function, and androgen deprivation therapy had the strongest effect on physical function. The main limitation was attrition among the cohort.

Conclusions

Although most men experience initial declines in HRQOL in the first 2 yr after treatment, there is little change from 3 to 10 yr and most differences between treatments attenuated over time.

Patient summary

Various treatments for prostate cancer result in a distinct constellation of adverse effects on health-related quality of life, which may have a long-term impact. These findings are helpful regarding shared decision making over choice of primary treatment.

Take Home Message

Most of the detriments to health-related quality of life occur early after treatment, with some recovery and then a plateau. Different treatments have a distinct constellation of adverse effects. These results may help men understand the long-term implications of their treatment decisions.

Keywords: Prostate cancer, Treatment, HRQOL.

Footnotes

a Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA

b University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA

Corresponding author. University of California, San Francisco, Department of Urology, 1600 Divisadero St, Box 1695, San Francisco, CA 94143-1695, USA. Tel. +1 415 885 3660; Fax: +1 415 353 7093.

Article information

PII: S0302-2838(14)00844-6
DOI: 10.1016/j.eururo.2014.08.074
© 2014 Published by Elsevier B.V.

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A Systematic Review and Meta-analysis of Tobacco Use and Prostate Cancer Mortality and Incidence in Prospective Cohort Studies

Abstract Context

An association between tobacco smoking and prostate cancer (PCa) incidence and mortality was suggested in an earlier meta-analysis of 24 prospective studies in which dose–response associations and risks per unit of tobacco use were not examined.

Objective

We investigated the association between several measures of tobacco use and PCa mortality (primary outcome) and incidence (secondary outcome) including dose–response association.

Evidence acquisition

Relevant articles from prospective studies were identified by searching the PubMed and Web of Science databases (through January 21, 2014) and reference lists of relevant articles. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects methods. We also calculated population attributable risk (PAR) for smoking and PCa mortality.

Evidence synthesis

We included 51 articles in this meta-analysis (11 823 PCa deaths, 50 349 incident cases, and 4 082 606 cohort participants). Current cigarette smoking was associated with an increased risk of PCa death (RR: 1.24; 95% CI, 1.18–1.31), with little evidence for heterogeneity and publication bias. The number of cigarettes smoked per day had a dose–response association with PCa mortality (p = 0.02; RR for 20 cigarettes per day: 1.20). The PAR for cigarette smoking and PCa deaths in the United States and Europe were 6.7% and 9.5%, respectively, corresponding to >10 000 deaths/year in these two regions. Current cigarette smoking was inversely associated with incident PCa (RR: 0.90; 95% CI, 0.85–0.96), with high heterogeneity in the results. However, in studies completed in 1995 or earlier (considered as completed before the prostate-specific antigen screening era), ever smoking showed a positive association with incident PCa (RR: 1.06; 95% CI, 1.00–1.12) with little heterogeneity.

Conclusions

Combined evidence from observational studies shows a modest but statistically significant association between cigarette smoking and fatal PCa. Smoking appears to be a modifiable risk factor for PCa death.

Patient summary

Smoking increases the chance of prostate cancer death. Not smoking prevents this harm and many other tobacco-related diseases.

Take Home Message

Smoking is associated with fatal prostate cancer (PCa), and this can have major public health implications. Smoking and PCa are common, and this association provides guidance on how to prevent PCa death, for which there are few established preventive measures.

Keywords: Cigarettes, Meta-analysis, Prostate cancer, Prospective, Smoking.

Footnotes

a The Tisch Cancer Institute and Institute for Transitional Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

b Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA

c Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran

d The Arthur Smith Institute for Urology, North Shore Long Island Jewish Health System, New Hyde Park, NY, USA

e Urology Section, Veterans Affairs Medical Center, Durham, NC, USA

f Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

g Department of Pathology, Duke University School of Medicine, Durham, NC, USA

Corresponding author. Duke University Medical Center, 571 Research Drive, MSRB 475, Box 2626, Durham, NC 27710, USA. Tel. +1 919 668 5946; Fax: +1 919 668 7093.

Article information

PII: S0302-2838(14)00812-4
DOI: 10.1016/j.eururo.2014.08.059
© 2014 European Association of Urology, Published by Elsevier B.V.

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HIVMA/IDSA guidelines: Antiretroviral therapies are beneficial for HIV patients with kidney problems

MedicalNewsToday - Thu, 2014-09-18 04:00
Antiretroviral therapy (ART) is beneficial for the 5 to 10 percent of HIV-infected patients with reduced kidney function, although tenofovir - the most widely prescribed medication - should be...
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Gonadal Maldevelopment as Risk Factor for Germ Cell Cancer: Towards a Clinical Decision Model

Abstract Context

A disturbed process of gonadal formation and maintenance may result in testicular dysgenesis syndrome or disorders of sex development (DSDs), with an increased germ cell cancer (GCC) risk. Early diagnosis and treatment requires the identification of relevant risk factors and initial pathologic stages.

Objective

To evaluate current knowledge and novel insights regarding GCC risk in patients with DSDs, with the aim of providing a model for clinical use.

Evidence acquisition

A Medline search was conducted to identify all original and review articles assessing the aetiology of GCC, GCC risk in DSD patients, new predictive markers related to GCC, and possible clinical scenarios related to GCC and DSDs.

Evidence synthesis

Embryonic development is controlled by orchestrated patterns of gene and subsequent protein expression. Knowledge of these networks is essential to understand the mechanisms of disturbed development including GCC formation. GCCs are subdivided into seminomas and nonseminomas, and they all arise from embryonic germ cells that have failed to mature appropriately. The precursor is known as carcinoma in situ (also referred to as testicular intratubular neoplasia and intratubular germ cell neoplasia unclassified) in a testicular microenvironment and gonadoblastoma in a dysgenetic/ovarian microenvironment. GCCs mimic embryonic development, resulting in the identification of diagnostic markers (eg, OCT3/4, SRY [sex determining region Y]-box 2 [SOX2], and [sex determining region Y]-box 17 [SOX17]). Novel insights indicate a subtle interplay of specific single nucleotide polymorphisms, environmental factors, and epigenetic aberrations in the aetiology of GCCs. A genvironmental model combining these factors is presented, proposed as a guideline for clinical management by an experienced multidisciplinary team. The goal is individualised treatment including preservation of gonadal function (if possible) and prevention of malignant transformation.

Conclusions

A hypothesis is presented in which combined interactions of epigenetic and environmental parameters affect embryonic gonadal development, resulting in delayed/blocked germ cell maturation that determines the risk for GCC formation. Current and future possibilities for early detection of GCCs in risk populations and follow-up in a clinical setting are discussed.

Patient summary

This review analyses current knowledge about the underlying networks that relate to the development of a germ cell cancer in the context of a disorder of sex development. A combined effect of epigenetic and environmental factors is identified in the pathogenesis, and a model is proposed to apply this knowledge to clinical practice.

Take Home Message

We analyse current knowledge about the underlying networks related to the development of a germ cell cancer in the context of disorders of sex development. A combined effect of epigenetic and environmental factors is identified in the pathogenesis, and a model is proposed to apply this information to clinical practice.

Keywords: DSDs, GCC, Epigenetics, Microenvironment, Clinical decision guideline.

Footnotes

a Department of Pathology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands

b Department of Urology, Erasmus MC - Sophia, Rotterdam, The Netherlands

c Department of Paediatrics, Ghent University Hospital, Ghent University, Belgium

Corresponding author. Department of Pathology, Laboratory of Experimental Patho-Oncology, Erasmus MC - University Medical Centre, Building Be, Room 432, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. Tel. +31 10 7044 329; Fax: +31 10 7044 365.

Article information

PII: S0302-2838(14)00651-4
DOI: 10.1016/j.eururo.2014.07.011
© 2014 European Association of Urology, Published by Elsevier B.V.

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Diagnosing the Pathophysiologic Mechanisms of Nocturnal Polyuria

Abstract Background

Diagnosis of nocturnal polyuria (NP) is based on a bladder diary. Addition of a renal function profile (RFP) for analysis of concentrating and solute-conserving capacity allows differentiation of NP pathophysiology and could facilitate individualized treatment.

Objective

To map circadian rhythms of water and solute diuresis by comparing participants with and without NP.

Design, setting, and participants

This prospective observational study was carried out in Ghent University Hospital between 2011 and 2013. Participants with and without NP completed a 72-h bladder dairy. RFP, free water clearance (FWC), and creatinine, solute, sodium, and urea clearance were measured for all participants.

Results

The study participants were divided into those with (n = 77) and those without (n = 35) NP. The mean age was 57 yr (SD 16 yr) and 41% of the participants were female. Compared to participants without NP, the NP group exhibited a higher diuresis rate throughout the night (p = 0.015); higher FWC (p = 0.013) and lower osmolality (p = 0.030) at the start of the night; and persistently higher sodium clearance during the night (p < 0.001). The pathophysiologic mechanism of NP was identified as water diuresis alone in 22%, sodium diuresis alone in 19%, and a combination of water and sodium diuresis in 47% of the NP group.

Conclusion

RFP measurement in first-line NP screening to discriminate between water and solute diuresis as pathophysiologic mechanisms complements the bladder diary and could facilitate optimal individualized treatment of patients with NP.

Patient summary

We evaluated eight urine samples collected over 24 h to detect the underlying problem in NP. We found that NP can be attributed to water or sodium diuresis or a combination of both. This urinalysis can be used to adapt treatment according to the underlying mechanism in patients with bothersome consequences of NP, such as nocturia and urinary incontinence.

Take Home Message

Nocturnal polyuria (NP) is a heterogeneous condition involving water diuresis alone, sodium diuresis alone, or a combination of both. A renal function profile based on analysis of eight urine samples collected over 24 h allows differentiation of the pathophysiologic mechanisms underlying NP and the timing of high free water or sodium clearance during the night. Use of this test to complement the bladder diary in diagnosing NP might facilitate optimal individualized treatment for patients with NP and bothersome symptoms.

Keywords: Nocturnal polyuria, Renal function profile, Circadian rhythms, Water diuresis, Sodium diuresis.

Footnotes

a Urology Department, Ghent University Hospital, Ghent, Belgium

b Faculty of Medicine, Ghent University, Ghent, Belgium

c Pediatric Nephrology Department, Ghent University Hospital, Ghent, Belgium

Corresponding author. Urology Department, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.

Article information

PII: S0302-2838(14)00888-4
DOI: 10.1016/j.eururo.2014.09.003
© 2014 European Association of Urology, Published by Elsevier B.V.

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Metastasis-directed Therapy of Regional and Distant Recurrences After Curative Treatment of Prostate Cancer: A Systematic Review of the Literature

Abstract Context

The introduction of novel imaging modalities has increased the detection of oligometastatic prostate cancer (PCa) recurrence, potentially justifying the use of a metastasis-directed therapy (MDT) with surgery or radiotherapy (RT) rather than a systemic approach.

Objective

To perform a systematic review of MDT for oligometastatic PCa recurrence.

Evidence acquisition

This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. We searched the Medline and Embase databases from 1946 to February 2014 for studies reporting on biochemical or clinical progression and/or toxicity or complications of MDT (RT or surgery). Reports were excluded if these end points could not be ascertained or separately analysed, or if insufficient details were provided. Methodological quality was assessed using an 18-item validated quality appraisal tool for case series.

Evidence synthesis

Fifteen single-arm case series reporting on a total of 450 patients met the inclusion criteria. Seven studies were considered of acceptable quality. Oligometastatic PCa recurrence was diagnosed with positron emission tomography with coregistered computed tomography in most of the patients (98%). Nodal, bone, and visceral metastases were treated in 78%, 21%, and 1%, respectively. Patients were treated with either RT (66%) or lymph node dissection (LND) (34%). Adjuvant androgen deprivation was given in 61% of patients (n = 275). In the case of nodal metastases, prophylactic nodal irradiation was administered in 49% of patients (n = 172). Overall, 51% of patients were progression free 1–3 yr after salvage MDT, with most of them receiving adjuvant treatment. For RT, grade 2 toxicity was observed in 8.5% of patients, with one case of grade 3 toxicity. In the case of LND, 11% and 12% of grade 2 and grade 3 complications, respectively, were reported.

Conclusions

MDT is a promising approach for oligometastatic PCa recurrence, but the low level of evidence generated by small case series does not allow extrapolation to a standard of care.

Patient summary

We performed a systematic review to assess complications and outcomes of treating oligometastatic prostate cancer recurrence with surgery or radiotherapy. We concluded that although this approach is promising, it requires validation in randomised controlled trials.

Take Home Message

In this systematic review, we report the outcomes and complication rates of the treatment of oligometastatic prostate cancer recurrence with surgery or radiotherapy. We conclude that this approach is promising, but larger comparative studies are required to draw strong conclusions.

Keywords: Prostatic neoplasms, Neoplasm metastasis, Neoplasm recurrence, Radiosurgery, Lymph node excision.

Footnotes

a Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium

b Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France

c Department of Urology, Ghent University Hospital, Ghent, Belgium

d Department of Experimental and Clinical Medical Sciences, Urology Unit, University of Udine, Udine, Italy

e Department of Urology, Mayo Clinic, Rochester, MN, USA

f Department of Radiation Oncology, University of California at San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA

g Division of Oncology/Unit of Urology (URI), IRCCS Ospedale San Raffaele, Milan, Italy

Corresponding author. Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. Tel. +32 93322411; Fax: +32 93323040.

Article information

PII: S0302-2838(14)00889-6
DOI: 10.1016/j.eururo.2014.09.004
© 2014 European Association of Urology, Published by Elsevier B.V.

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Healthcare practitioners encouraged to adopt a more collaborative approach to continence care, to benefit patients and society as a whole

MedicalNewsToday - Wed, 2014-09-17 04:00
A major new report, which examines how best to organize community care for people with incontinence, suggests there could be significant benefits for patients and the health and social care system...
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Potential for targeted treatments with new knowledge of genes driving bladder cancer

MedicalNewsToday - Wed, 2014-09-17 03:00
The story of cancer care seems so simple: find the mutated gene that causes cancer and turn it off or fix it. But rarely does a single gene cause cancer.
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New recommendations for treating urinary incontinence in women

MedicalNewsToday - Wed, 2014-09-17 03:00
Kegel exercises to strengthen pelvic floor muscles, bladder training, and weight loss and exercise are effective nonsurgical treatment options for women with urinary incontinence (UI), according to a...
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Accurate test for aggressive prostate cancer steps closer with genetic study

MedicalNewsToday - Tue, 2014-09-16 05:00
New study that shows there is a 9 in 10 chance of prostate cancer returning in patients who carry certain genes opens door to more accurate testing and new treatments.
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