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Rumpff C, Lieb V, Wullich B, Schiffer M, Kunath F, Apel H. Kidney transplantation in prostate cancer patients after local therapy with curative intent: a systematic review. World J Urol 2024; 42:127. [PMID: 38460021 DOI: 10.1007/s00345-024-04817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/16/2024] [Indexed: 03/11/2024] Open
Abstract
PURPOSE It is still unclear whether kidney transplantation can be safely performed in patients with prostate cancer after local therapy with curative intent. METHODS The protocol was registered in PROSPERO. We systematically searched Google, MEDLINE, the Cochrane Library, and the ICTRP for studies, official standards, clinical practice guidelines and organ transplant laws. Two review authors independently examined the full-text reports and identified relevant studies and one review author extracted the data. We assessed the overall certainty of the evidence for each outcome according to the GRADE approach. RESULTS We identified 1346 references through electronic database searching and finally included 6 references for official standards, clinical practice guidelines, and organ transplant laws, and 6 references for retrospective studies with very low certainty of evidence. We identified no prospective or ongoing studies and reported all results narratively. CONCLUSION We recommend that decisions on kidney transplantation in patients with prostate cancer after local therapy with curative intent should be made on a case-by-case basis. It is indispensable to consult with health care professionals or specialists at transplant centers to obtain individualized information regarding the waiting time requirements for renal transplantation in prostate cancer patients after local therapy with curative intent. No recommendation can be made regarding the waiting times after prostate cancer therapy with curative intent.
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Affiliation(s)
- C Rumpff
- Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - V Lieb
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany
- Transplant Centre Erlangen-Nürnberg, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - B Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany
- Transplant Centre Erlangen-Nürnberg, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Schiffer
- Transplant Centre Erlangen-Nürnberg, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - F Kunath
- Klinik für Urologie und Kinderurologie, Klinikum Bayreuth GmbH, Bayreuth, Germany
- Medizinische Fakultät am Medizincampus Oberfranken, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - H Apel
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany.
- Transplant Centre Erlangen-Nürnberg, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
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Bahlinger V, Angeloni M, Cabanas M, Doeveren T, Eckstein M, Ferrazzi F, Geppert C, Heers H, Helleman J, Leenders A, José Lozano M, Matas-Rico E, Stoehr R, Sikic D, Taubert H, Volland P, Wullich B, Wach S, Herrera-Imbroda B, Allory Y, Boormans J, Hartmann A. Protein-based molecular subtypes associate with clinical-pathological characteristics in a multi-institutional cohort of upper tract urothelial carcinomas. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Erlmeier F, Klümper N, Landgraf L, Strissel P, Strick R, Sikic D, Taubert H, Wach S, Geppert C, Bahlinger V, Breyer J, Ritter M, Bolenz C, Roghmann F, Erben P, Schwamborn K, Wirtz R, Horn T, Wullich B, Hölzel M, Hartmann A, Gschwend J, Weichert W, Eckstein M. Spatial immunephenotypes of distant metastases but not matched primary urothelial carcinomas predict response to immune checkpoint inhibition. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Cox A, Klümper N, Stein J, Sikic D, Breyer J, Bolenz C, Roghmann F, Erben P, Wirtz R, Wullich B, Ritter M, Hölzel M, Schwamborn K, Horn T, Gschwend J, Hartmann A, Weichert W, Erlmeier F, Eckstein M. Intrinsic molecular urothelial cancer subtypes remain stable during metastatic evolution. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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5
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Wullich B, Golka K. [Urology and the environment]. Urologie 2022; 61:1177-1178. [PMID: 36331603 DOI: 10.1007/s00120-022-01944-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Affiliation(s)
- B Wullich
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
| | - K Golka
- Leibniz-Institut für Arbeitsforschung an der TU Dortmund (IfADo), Ardeystr. 67, 44139, Dortmund, Deutschland.
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6
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Schüttler C, Jahns R, Prokosch U, Wach S, Wullich B. [Biobanks, translational research and medical informatics]. Urologie 2022; 61:722-727. [PMID: 35925243 DOI: 10.1007/s00120-022-01850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
When we think of medical research, one intuitively associates it with the analysis of study data collected for a specific research question or with the secondary use of patient data from routine care. However, these are not the only sources for answering scientific questions. Especially for translational research, tissue and liquid samples such as blood, DNA or other body fluids provide essential insights into disease pathogenesis, development of new therapies and treatment decisions. Access to these biomedical materials is provided by so-called biobanks. By collecting, characterizing, documenting and, if necessary, processing human biospecimens in accordance with high quality standards, they can support research of the causes of diseases, early diagnosis and the targeted treatment of diseases, or make a significant contribution to the investigation of common diseases.
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Affiliation(s)
- C Schüttler
- Central Biobank Erlangen (CeBE), Universitätsklinikum Erlangen und Medizinische Fakultät, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - R Jahns
- Interdisziplinäre Biomaterial- und Datenbank der Medizinischen Fakultät Würzburg, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - U Prokosch
- Lehrstuhl für Medizinische Informatik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - S Wach
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - B Wullich
- Central Biobank Erlangen (CeBE), Universitätsklinikum Erlangen und Medizinische Fakultät, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland.
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland.
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7
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Wullweber A, Strick R, Lange F, Sikic D, Taubert H, Wach S, Wullich B, Bertz S, Weyerer V, Stöhr R, Breyer J, Burger M, Hartmann A, Strissel P, Eckstein M. Bladder tumor subtype commitment occurs in carcinoma in-situ driven by key signaling pathways including ECM remodeling. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00847-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Weyerer V, Geppert CI, Bertz S, Taubert H, Breyer J, Bolenz C, Erben P, Wach S, Sikic D, Kunath F, Wullich B, Hartmann A, Eckstein M. Divergent immunobiological correlates of FDA-/EMA-approved PD-L1 assays and scoring algorithms in muscle-invasive bladder cancer. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Weyerer V, Lange F, Wullweber A, Stöhr R, Bertz S, Wach S, Taubert H, Wullich B, Sikic D, Strissel P, Strick R, Hartmann A, Eckstein M. Heterogeneity-analysis of molecular subtypes of muscle-invasive bladder cancer and their precursor lesions in multiregion mapped whole-organ bladders. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Mehrabi A, Kulu Y, Sabagh M, Khajeh E, Mohammadi S, Ghamarnejad O, Golriz M, Morath C, Bechstein WO, Berlakovich GA, Demartines N, Duran M, Fischer L, Gürke L, Klempnauer J, Königsrainer A, Lang H, Neumann UP, Pascher A, Paul A, Pisarski P, Pratschke J, Schneeberger S, Settmacher U, Viebahn R, Wirth M, Wullich B, Zeier M, Büchler MW. Consensus on definition and severity grading of lymphatic complications after kidney transplantation. Br J Surg 2020; 107:801-811. [PMID: 32227483 DOI: 10.1002/bjs.11587] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/23/2020] [Accepted: 02/14/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy. METHODS Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres. RESULTS Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention. CONCLUSION A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.
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Affiliation(s)
- A Mehrabi
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - Y Kulu
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - M Sabagh
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - E Khajeh
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - S Mohammadi
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - O Ghamarnejad
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - M Golriz
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - C Morath
- Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany
| | - W O Bechstein
- Department of General and Visceral Surgery, Frankfurt University Hospital, Goethe University, Frankfurt am Main, Germany
| | - G A Berlakovich
- Division of Transplantation, Department of Surgery, Vienna Medical University, Vienna, Austria
| | - N Demartines
- Department of Visceral Surgery, CHUV University Hospital, Lausanne, Switzerland
| | - M Duran
- Department of Vascular and Endovascular Surgery, Düsseldorf University Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | - L Fischer
- Department of Visceral and Transplantation Surgery, Hamburg-Eppendorf University Hospital, Hamburg, Germany
| | - L Gürke
- Department of Vascular and Transplantation Surgery, Basel University Hospital, Basel, Switzerland
| | - J Klempnauer
- Department of General, Visceral, and Transplantation Surgery, Hannover Medical University, Hannover, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplantation Surgery, Eberhard-Karls-University Hospital, Tübingen, Germany
| | - H Lang
- Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg Medical University, Mainz, Germany
| | - U P Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital, Aachen, Germany
| | - A Pascher
- Department of General, Visceral and Transplantation Surgery, Münster University Hospital, Münster, Germany
| | - A Paul
- Department of General, Visceral and Transplantation Surgery, Essen University Hospital, Essen, Germany
| | - P Pisarski
- Department of General, Visceral and Surgery, Freiburg University Hospital, Freiburg, Germany
| | - J Pratschke
- Department of Surgery, Charité University Hospital, Berlin, Germany
| | - S Schneeberger
- Department of Visceral, Transplantation and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - U Settmacher
- Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
| | - R Viebahn
- Department of Surgery, Knappschaftskrankenhaus University Hospital of Bochum, Ruhr University of Bochum, Bochum, Germany
| | - M Wirth
- Department of Urology, Carl Gustav Carus University Hospital, Dresden, Germany
| | - B Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Erlangen, Germany
| | - M Zeier
- Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany
| | - M W Büchler
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
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11
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Roghmann F, Wirtz R, Jarczyk J, Kriegmair M, Worst T, Sikic D, Wach S, Taubert H, Wullich B, Weyerer V, Stoehr R, Zengerling F, Bolenz C, Breyer J, Burger M, Porubsky S, Hartmann A, Erben P, Eckstein M, Juette H. Prognostic role of FGFR Mutations and FGFR mRNA expression in metastatic urothelial cancer treated with anti-PD(L1) inhibitors in first and second-line setting. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Eckstein M, Hartmann A, Strissel P, Strick R, Wach S, Taubert H, Wullich B, Geppert C, Weyerer V, Stoehr R, Rübner M, Fasching P, Rabizadeh S, Benz S, Haller F, Moskalev E, Toegel L. Comparative analysis of tumour mutational burden (TMB) prediction methods and its association with determinants of the tumour immune microenvironment of urothelial bladder cancer (UBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Jarczyk J, Wirtz R, Roghmann F, Juette H, Kriegmair M, Worst T, Sikic D, Wach S, Taubert H, Wullich B, Weyerer V, Stoehr R, Zengerling F, Bolenz C, Breyer J, Burger M, Porubsky S, Hartmann A, Erben P, Eckstein M. Efficacy of anti-PD(L)1 treatment in patients with metastatic urothelial cancer based on mRNA- and protein- based PD-L1 determination: Results from the multicentric, retrospective FOsMIC trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Schoeb DS, Wullich B, Dürschmied D, Heimbach B, Heupel-Reuter M, Gross AJ, Wilhelm K, Gratzke C, Miernik A. [Treatment of benign prostatic hyperplasia in geriatric patients-use and limitations of existing guidelines]. Urologe A 2019; 58:1029-1038. [PMID: 31451881 DOI: 10.1007/s00120-019-0988-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The demographic developments of western society and the resulting increase in the number of very old patients in urology represents a challenge for the design of clinical studies and, consequently, recommendations of guidelines. While in internal medicine there is already a subspecialization with a focus on the treatment of elderly and multimorbid patients, in urology there is hardly any subspecialization into the problems of geriatric patients. Thus, using a case study as an example, the treatment decisions for benign prostatic hyperplasia (BPH) in geriatric patients are discussed. In addition the available evidence from the literature and guidelines are presented in order to assiste in daily management of geriatric patients with lower urinary tract symptoms and to critically discuss potential fields of application and limitations of the existing guidelines. In this context, we also examine the challenges when choosing a drug therapy and in deciding which of the many surgical options should be used.
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Affiliation(s)
- D S Schoeb
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.
| | - B Wullich
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - D Dürschmied
- Medizinische Fakultät, Klinik für Kardiologie und Angiologie, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - B Heimbach
- Medizinische Fakultät, Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland
| | - M Heupel-Reuter
- Medizinische Fakultät, Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland
| | - A J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
| | - K Wilhelm
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - C Gratzke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - A Miernik
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
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Hirsch K, Schwaiger B, Kraske S, Wullich B. Megaprepuce: presentation of a modified surgical technique with excellent cosmetic and functional results. J Pediatr Urol 2019; 15:401.e1-401.e6. [PMID: 31301977 DOI: 10.1016/j.jpurol.2019.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/29/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Congenital megaprepuce is a malformation consisting of a great redundancy of the inner preputial skin over a penis with normal shaft and glans and is combined with a severe phimosis. Patients suffer from difficulties in voiding because the urine is trapped in the large dome-shaped megaprepuce. We describe a modification of the surgical technique of reconstructing a megaprepuce initially presented by Leao et al. PATIENTS AND METHODS We retrospectively reviewed 7 patients aged 6-53 months (mean age 17 months, 6 were younger than 18 months) who underwent congenital megaprepuce repair between 02/2014 and 05/2018 in our institution. All these otherwise healthy children suffering from difficulties in voiding and reporting genital ballooning during micturition and urinary retention were referred to our hospital. In all cases, parents needed to express the trapped urine. Four of these patients additionally showed a glanular hypospadias, another one a distal penile hypospadias. In addition to the repair of the megaprepuce, six patients needed correction of a penile curvature, five of whom needed correction of the chordee and one a corporoplasty (Schröder-Essed). The patient showing the distal penile hypospadias additionally underwent hypospadias repair. During the follow-up, we evaluated the cosmetic result and complications such as secondary concealed penis, difficulties in voiding, urinary retention, and urinary infections. RESULTS Mean follow-up was 18 months. All patients following surgery showed normal voiding without urinary retention or urinary infections and good cosmetic results resembling a circumcised penis in appearance without reconcealment. No intraoperative complications occurred. One patient had a scrotal hematoma postoperatively. Mild transient edema of the penis was seen in all patients, which disappeared spontaneously within one week after surgery. CONCLUSION Our surgical approach is a safe and relatively simple procedure with a low rate of complications, good cosmetic results, and functional outcome. Whether the hypospadias associated with ventral curvature was a coincidence or part of the disease pattern remains unclear but will probably be the object of further investigations.
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Affiliation(s)
- K Hirsch
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany.
| | - B Schwaiger
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - S Kraske
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - B Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
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16
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Taubert H, Becker C, Füssel S, Seitz G, Kristiansen G, Wach S, Wullich B. [The 16th DPKK annual conference "Urology meets Pathology"]. Urologe A 2019; 58:686-689. [PMID: 31069452 DOI: 10.1007/s00120-019-0941-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- H Taubert
- Urologische und Kinderurologische Klinik, Universtitäsklinikum Erlangen, Erlangen, Deutschland
| | - C Becker
- Forschungskoordination, Geschäftsstelle Düsseldorf, Deutsche Gesellschaft für Urologie e. V., Uerdinger Str. 64, 40474, Düsseldorf, Deutschland.
| | - S Füssel
- Klinik und Poliklinik für Urologie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - G Seitz
- Institut für Pathologie, Klinikum Bamberg, Bamberg, Deutschland
| | - G Kristiansen
- Institut für Pathologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - S Wach
- Urologische und Kinderurologische Klinik, Universtitäsklinikum Erlangen, Erlangen, Deutschland
| | - B Wullich
- Urologische und Kinderurologische Klinik, Universtitäsklinikum Erlangen, Erlangen, Deutschland
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17
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Abstract
For the estimation of perioperative risks and mortality in the context of radical urological tumor surgery in elderly patients, the guidelines meanwhile require the use of geriatric assessments. The aim of this work is therefore to explain frequently used geriatric assessments and to give an overview of their predictive significance in radical urological tumor surgery. Comprehensive geriatric assessments provide a good description of the patient's state of health, but are hardly feasible in clinical routine due to their complexity. It is more reasonable to use screening tools with subsequent targeted examination of high-risk patients. Special tools allow the standardized assessment of functional status, mobility, cognition, mood, nutrition, frailty, comorbidities and polypharmacy and have different prognostic significance. Evidence on the predictive value of assessments prior to radical urological tumor surgery is mainly described for the systematic classification of comorbidities. In cystectomy, the Charlson Comorbidity Index (CCI) and the American Society of Anesthesiologists (ASA) score allow an estimation of the risk of complications and mortality. The focus of assessments prior to prostatectomy is to identify patients with sufficient life expectancy to benefit from radical surgery. CCI and ASA scores as well as the Eastern Co-operative Oncology Group (ECOG) score can help to assess the risk of perioperative complications in kidney tumor surgery.
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Affiliation(s)
- A Kahlmeyer
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
| | - P J Goebell
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - B Wullich
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
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Kunath F, Goebell PJ, Wullich B, Sikic D, Kahlmeyer A. Timing of androgen deprivation monotherapy and combined treatments in castration-sensitive and castration-resistant prostate cancer: a narrative review. World J Urol 2019; 38:601-611. [PMID: 30830274 DOI: 10.1007/s00345-019-02704-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/25/2019] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Standard androgen deprivation therapy (ADT) can be initiated early at the time of diagnosis in asymptomatic castration-sensitive advanced prostate cancer. This definition has recently been expanded to also include an early combined treatment with standard ADT and new antihormonal drugs. We aimed to present the best available evidence for the timing of initiation of ADT monotherapy and combined treatments in castration-sensitive/-resistant prostate cancer. METHODS For this narrative review, we searched Cochrane reviews in the Cochrane Library, systematic reviews and randomized controlled trials in MEDLINE, phase III and ongoing trials in ClinicalTrials.gov and screened the reference lists to extract articles of interest. One author screened the references which were finally included after assessing their relevance through discussion with other experts in the field. RESULTS The identified references were grouped by medication (standard ADT, androgen biosynthesis inhibitor, androgen receptor antagonists or combined therapies) and tumor stage (castration sensitive or resistant). The evidence was narratively summarized and discussed in the context of the current therapeutic landscape. CONCLUSIONS Early standard ADT can reduce symptoms of disease progression and may extend progression-free and overall survival. The patient should be well informed about the higher rates of treatment-related side effects. Deferring standard ADT might be indicated only for well-informed or unfit patients. Early standard ADT is increasingly combined with new antihormonal drugs in castration-sensitive metastatic prostate cancer to gain additional survival and quality of life benefits. Combined treatment at the time of development of castration-resistant disease is well established.
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Affiliation(s)
- F Kunath
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany. .,UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
| | - P J Goebell
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany
| | - B Wullich
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany.,UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany
| | - D Sikic
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany
| | - A Kahlmeyer
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany
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Pinart M, Kunath F, Lieb V, Tsaur I, Wullich B, Schmidt S. Prognostic models for predicting overall survival in metastatic castration-resistant prostate cancer: a systematic review. World J Urol 2018; 38:613-635. [PMID: 30554274 DOI: 10.1007/s00345-018-2574-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/20/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Prognostic models are developed to estimate the probability of the occurrence of future outcomes incorporating multiple variables. We aimed to identify and summarize existing multivariable prognostic models developed for predicting overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). METHODS The protocol was prospectively registered (CRD42017064448). We systematically searched Medline and reference lists up to May 2018 and included experimental and observational studies, which developed and/or internally validated prognostic models for mCRPC patients and were further externally validated or updated. The outcome of interest was overall survival. Two authors independently performed literature screening and quality assessment. RESULTS We included 12 studies that developed models including 8750 patients aged 42-95 years. Models included 4-11 predictor variables, mostly hemoglobin, baseline PSA, alkaline phosphatase, performance status, and lactate dehydrogenase. Very few incorporated Gleason score. Two models included predictors related to docetaxel and mitoxantrone treatments. Model performance after internal validation showed similar discrimination power ranging from 0.62 to 0.73. Overall survival models were mainly constructed as nomograms or risk groups/score. Two models obtained an overall judgment of low risk of bias. CONCLUSIONS Most models were not suitable for clinical use due to methodological shortcomings and lack of external validation. Further external validation and/or model updating is required to increase prognostic accuracy and clinical applicability prior to their incorporation in clinical practice as a useful tool in patient management.
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Affiliation(s)
- M Pinart
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Erlangen, Germany
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany
| | - F Kunath
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Erlangen, Germany
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany
| | - V Lieb
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Erlangen, Germany
| | - I Tsaur
- Department of Urology, University Medicine Mainz, Mainz, Germany
| | - B Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Erlangen, Germany
| | - Stefanie Schmidt
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
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Wullich B, Alloussi S. Urologische Herausforderungen durch Flucht und Migration. Urologe A 2018; 57:1183-1184. [DOI: 10.1007/s00120-018-0765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Mammadova D, Hirsch K, Schwaiger B, Wullich B, Rascher W. [Renal transplantation: Opportunities and risks for medical refugees]. Urologe A 2018; 57:1200-1207. [PMID: 30132015 DOI: 10.1007/s00120-018-0759-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Families with children and adolescents with end-stage renal disease came to Germany from the former Eastern Bloc countries before the wave of refugees in 2015, in order to enable their children to survive with adequate kidney replacement therapy and in the best case a kidney transplant. METHODS In a case study, medical records of 4 childen and adolescents were retrospectively analyzed. These patients who fled to Germany for the treatment of terminal renal failure applied for asylum and were successfully transplanted after the usual waiting period. RESULTS Four of the eight children and adolescents who came to Erlangen for treatment of terminal renal failure between 2003 and 2013 received a functioning kidney transplant (deceased donor kidney) after dialysis therapy was difficult due to lack of compliance to drug and dietary recommendations such as fluid restriction. Since children and adolescents are treated with chronic dialysis only with the aim of kidney transplantation, a living donation was discussed but was not possible for medical reasons. 3 recipients are symptom-free with a functional graft. DISCUSSION The case study demonstrates that children and adolescents fleeing to Germany due to their end stage renal disease are better integrated after kidney transplantation, have better chances of obtaining a good education and can be expected to live independently with their own income in the future.
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Affiliation(s)
- D Mammadova
- Kinder- und Jugendklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Deutschland
| | - K Hirsch
- Urologische und Kinderurologische Klinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, 91054, Deutschland
| | - B Schwaiger
- Urologische und Kinderurologische Klinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, 91054, Deutschland
| | - B Wullich
- Urologische und Kinderurologische Klinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, 91054, Deutschland
| | - W Rascher
- Kinder- und Jugendklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Deutschland.
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Apel H, Putz J, Fornara P, Friedersdorff F, Dreikorn K, Stöckle M, Wullich B. [Report of the 24th annual conference of the Working Group Kidney Transplantation of the German Society of Urology in Erlangen]. Urologe A 2017; 56:1182-1184. [PMID: 28681234 DOI: 10.1007/s00120-017-0452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- H Apel
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Deutschland.
| | - J Putz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - P Fornara
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - F Friedersdorff
- Klinik für Urologie - Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - K Dreikorn
- AK Nierentransplantation, Urologicum Ärztezentrum Horn, Bremen, Deutschland
| | - M Stöckle
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - B Wullich
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Deutschland
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May M, Protzel C, Vetterlein MW, Gierth M, Noldus J, Karl A, Grimm T, Wullich B, Grimm MO, Nuhn P, Bastian PJ, Roigas J, Hadaschik B, Gilfrich C, Burger M, Fisch M, Brookman-May S, Aziz A, Hakenberg OW. Is there evidence for a close connection between side of intravesical tumor location and ipsilateral lymphatic spread in lymph node-positive bladder cancer patients at radical cystectomy? Results of the PROMETRICS 2011 database. Int Urol Nephrol 2016; 49:247-254. [DOI: 10.1007/s11255-016-1469-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
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Abstract
The treatment of bone metastases from urological tumors represents a palliative form of therapy, apart from the resection of solitary metastases from renal cell carcinomas. Due to the high incidence of spinal metastases this can result in clinically significant symptoms and possible complications for patients, such as pain, spinal instability and compression of the spinal canal with corresponding neurological deficits. By the use of targeted diagnostics and induction of radiotherapeutic and/or surgical treatment, for the majority of patients an immediate reduction in pain as well as early mobilization and sometimes even regression of existing neurological deficits and therefore an improved quality of life can be achieved.
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Affiliation(s)
- R H Richter
- Orthopädische Universitätsklinik Erlangen, Friedrich-Alexander Universität Erlangen, Rathsberger Straße 57, 91054, Erlangen, Deutschland.
| | - M Hammon
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - M Uder
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J Huber
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland
| | - P J Goebell
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - F Kunath
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - B Wullich
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - B Keck
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
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Keck B, Hammon M, Uder M, Huber J, Goebell PJ, Kunath F, Wullich B, Richter RH. [Vertebral metastases of urogenital carcinomas: Diagnosis and conservative therapy]. Urologe A 2015; 55:226-31. [PMID: 26450096 DOI: 10.1007/s00120-015-3977-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The high incidence of bone metastases of urologic neoplasms and their morbidity, especially of vertebral metastases, requires exact diagnosis and consequent therapy. Conventional radiography plays an important role in the diagnosis of symptomatic bone lesions. Computed tomography can evaluate the stability of metastatic lesions and is indispensable for therapy planning. MRI and PET-CT have the highest diagnostic accuracy for the detection of bone metastases and MRI can evaluate their intra- and extraosseus components. PET-CT, PET-MRI, or SPECT-CT in combination with specific tracers - due to their high specificity and sensitivity - have the potential to replace conventional methods in the future. Conservative treatment basically consists of analgesic therapy, the administration of calcium and vitamin D3 and bisphosphonates or inhibitors of RANKL (denosumab). Moreover radium-223-dichloride can improve overall survival and the time to the first symptomatic skeletal event in castration-resistant prostate cancer patients with bone metastases.
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Affiliation(s)
- B Keck
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
| | - M Hammon
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - M Uder
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J Huber
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland
| | - P J Goebell
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - F Kunath
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - B Wullich
- Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - R H Richter
- Orthopädische Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen, Erlangen, Deutschland
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Schmidt S, Kunath F, Kranz J, Zengerling F, Dräger DL, Kröger N, Krabbe LM, Miernik A, Borgmann H, Spek A, Meerpohl J, Dahm P, Wullich B. [Overcoming the language barrier: UroEvidence translates Cochrane abstracts]. Urologe A 2014; 54:76-7. [PMID: 25519997 DOI: 10.1007/s00120-014-3750-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Schmidt
- UroEvidence, Deutsche Gesellschaft für Urologie e.V., Düsseldorf/Berlin, Deutschland
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Keck B, Wach S, Taubert H, Zeiler S, Ott OJ, Kunath F, Hartmann A, Bertz S, Weiss C, Hönscheid P, Schellenburg S, Rödel C, Baretton GB, Sauer R, Fietkau R, Wullich B, Krause FS, Datta K, Muders MH. Neuropilin-2 and its ligand VEGF-C predict treatment response after transurethral resection and radiochemotherapy in bladder cancer patients. Int J Cancer 2014; 136:443-51. [PMID: 24862180 DOI: 10.1002/ijc.28987] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 03/30/2014] [Accepted: 04/25/2014] [Indexed: 12/11/2022]
Abstract
The standard treatment for invasive bladder cancer is radical cystectomy. In selected patients, bladder-sparing therapy can be performed by transurethral resection (TURBT) and radio-chemotherapy (RCT) or radiotherapy (RT). Our published in vitro data suggest that the Neuropilin-2 (NRP2)/VEGF-C axis plays a role in therapy resistance. Therefore, we studied the prognostic impact of NRP2 and VEGF-C in 247 bladder cancer patients (cN0M0) treated with TURBT and RCT (n = 198) or RT (n = 49) and a follow-up time up to 15 years. A tissue microarray was analyzed by immunohistochemistry. NRP2 expression emerged as a prognostic factor in overall survival (OS; HR: 3.42; 95% CI: 1.48 - 7.86; p = 0.004) and was associated with a 3.85-fold increased risk of an early cancer specific death (95% CI: 0.91 - 16.24; p = 0.066) in multivariate analyses. Cancer specific survival (CSS) dropped from 166 months to 85 months when NRP2 was highly expressed (p = 0.037). Patients with high VEGF-C expression have a 2.29-fold increased risk of shorter CSS (95% CI: 1.03-5.35; p = 0.043) in univariate analysis. CSS dropped from 170 months to 88 months in the case of high VEGF-C expression (p = 0.041). Additionally, NRP2 and VEGF-C coexpression is a prognostic marker for OS in multivariate models (HR: 7.54; 95% CI: 1.57-36.23; p = 0.012). Stratification for muscle invasiveness (T1 vs. T2-T4) confirmed the prognostic role of NRP2 and NRP2/VEGF-C co-expression in patients with T2-T4 but also with high risk T1 disease. In conclusion, immunohistochemistry for NRP2 and VEGF-C has been determined to predict therapy outcome in bladder cancer patients prior to TURBT and RCT.
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Affiliation(s)
- B Keck
- Department of Urology, University Hospital Erlangen, Germany
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Schneidewind L, Borowitz R, Wullich B, Borgmann H. Das GeSRU-Hospitationsprogramm. Urologe A 2014; 53:557-60. [DOI: 10.1007/s00120-014-3446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kranz J, Kunath F, Borgmann H, Dräger DL, Krabbe LM, Kröger N, Otto W, Spek A, Zengerling F, Wullich B, Miernik A. ["UroEvidence" - Centre for knowledge translation of the DGU (German Society of Urology). Summarizing, analysing and making current knowledge available]. Urologe A 2014; 53:83-6. [PMID: 24452404 DOI: 10.1007/s00120-013-3396-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J Kranz
- Klinik für Urologie und Kinderurologie, St.-Antonius Hospital, Dechant-Deckers-Straße 8, 52249, Eschweiler, Deutschland,
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Kunath F, Becker C, Jena S, Meerpohl J, Antes G, Wullich B. Studienregistrierung zur Verbesserung der Transparenz in der klinischen Forschung. Urologe A 2012; 51:1278-81. [DOI: 10.1007/s00120-012-2914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Junker K, Becker C, Wullich B. [Securing the future through research - light on the horizon?]. Urologe A 2011; 50:932-7. [PMID: 21725647 DOI: 10.1007/s00120-011-2544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research is more important than ever for urology as a clinical specialty. The enormous advances being achieved in molecular medicine should not develop outside the realm of urology. In fact, implementing them in urology serves to guarantee the further existence of our specialty with its current clinical scope. If drug therapy for cancer is to remain an enduring part of urology or if kidney transplantation is to continue to be an integral part of urology and not belong to transplant surgery, then the expertise in these clinical entities and understanding of their pathogenetic relationships must be found in urology. As a result, research must be an essential part of our specialty on the one hand and the results of research must be applied to the whole extent of urology on the other hand.
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Affiliation(s)
- K Junker
- Klinik für Urologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität, Lessingstraße 1, 07743 Jena, Deutschland.
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Burger M, Becker C, Wullich B. Arbeitsgruppe urologische Forschung der DGU. Urologe A 2011; 50:481-2. [DOI: 10.1007/s00120-011-2566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Krause F, Ott O, Haeberle L, Wullich B. Validation of a trimodalitiy treatment and selective organ preservation for bladder cancer: Influence of clinical different parameters on the 15-year long-term outcome. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Keck B, Stoehr R, Wach S, Rogler A, Fritsche H, Lehmann J, Wullich B, Hartmann A. 923 PLASMACYTOID UROTHELIAL CARCINOMA: RARE VARIANT OF AGGRESSIVE UROTHELIAL CARCINOMA. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60903-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wernert N, Wullich B, Unteregger G. Deutsches Prostatakarzinom-Konsortium (DPKK) e.V. Urologe A 2010. [DOI: 10.1007/s00120-010-2247-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sievert KD, Unteregger G, Nawroth R, Junker K, Becker C, Wullich B. Ausbildungsinitiative der Deutschen Gesellschaft für Urologie für innovative Forschung. Urologe A 2010; 49:91-4. [DOI: 10.1007/s00120-009-2216-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bastian P, Becker C, Burger M, Brenner W, Wullich B. 1. Symposium „Urologische Forschung der Deutschen Gesellschaft für Urologie“. Urologe A 2010. [DOI: 10.1007/s00120-009-2165-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kroening S, Solomovitch S, Sachs M, Wullich B, Goppelt-Struebe M. Regulation of connective tissue growth factor (CTGF) by hepatocyte growth factor in human tubular epithelial cells. Nephrol Dial Transplant 2008; 24:755-62. [DOI: 10.1093/ndt/gfn530] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Lindenmeir T, Zwergel T, Albers S, Wullich B, Unteregger G. In-vitro-Kultivierung und individuelle Charakterisierung von menschlichen Zellen des Prostatakarzinoms. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1058290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zwergel T, Lindenmeir T, Wullich B, Unteregger G. Molekularpathologie der proliferierenden Prostatazelle. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1058237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
BACKGROUND Wilms' tumor (nephroblastoma) is the most frequent renal tumor in childhood. In contrast nephroblastoma in adults is rare, and the disease used to have a poor prognosis. PATIENTS AND METHODS Of 1,300 registered patients, a total of 41 patients older than 16 years were enrolled in the pediatric nephroblastoma trial from 1994 to 2005. Median age at diagnosis was 25.4 years (range: 16-62 years). Treatment was given according to the pediatric protocol. RESULTS The adults had higher local stages, more frequent metastasis, and developed more toxicity due to therapy. Vincristine caused severe neurotoxicity in many cases. The distribution of histological subtypes was similar to the children's. The outcome is better than previously described with an overall survival of 71%. Patients with local stage I and II have an event-free survival of 84%. This is comparable to children's survival rates. CONCLUSION Adults with nephroblastoma have a very good prognosis if treated according to a pediatric protocol.
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Affiliation(s)
- H Reinhard
- Klinik für Pädiatrische Hämatolgie und Onkologie, Universitätsklinikum, 66421, Homburg/Saar.
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47
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Abstract
As individual risk assessment mainly depends on the correct prediction of the tumor's biological behavior, primary diagnosis plays a key role in the clinical management of prostate cancer patients. Prostate core needle biopsy, as a primary diagnostic tool, should not only confirm clinical suspicion but also supply the urologist with information which is necessary for risk-adapted therapy. The experience and competence of both the urologist and the pathologist are crucial for the quality of prostate core needle biopsy diagnosis. Optimized handling and submission of prostate core needle biopsy specimens by the urologist to the pathologist are of outstanding importance for improving the number of cancer cases detected. Increasing availability of molecular markers leads to the necessity of developing new tissue sampling procedures which allow prostate core needle biopsy specimens to be simultaneously studied histologically and by molecular approaches.
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Affiliation(s)
- B Wullich
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Kirrberger Strasse, Geb. 6, 66421 Homburg/Saar, Germany.
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48
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Jung V, Wullich B, Kamradt J, Stöckle M, Unteregger G. An improved in vitro model to characterize invasive growing cancer cells simultaneously by function and genetic aberrations. Toxicol In Vitro 2006; 21:183-90. [PMID: 17126525 DOI: 10.1016/j.tiv.2006.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 09/12/2006] [Accepted: 09/14/2006] [Indexed: 11/17/2022]
Abstract
Invasion into the surrounding tissue and bone metastasis is a common feature of advanced prostate cancer. Chromosomal and other genetic or epigenetic abnormalities were aligned to this behaviour mostly by using permanent cell lines, paraffin embedded tissue or primary tumour samples. Both attempts fail to reflect either the original situation or functional information in the patient's tissue. Thus, we developed an improved in vitro assay to follow invasion of prostate cancer cells derived from fresh samples of radical prostatectomy specimens. Fresh tumour samples were applied onto Matrigeltrade mark-coated invasion chambers using a cocultivation model. Invasive growing cells were harvested from the bottom of the membrane or from the underlying gel and further characterized using comparative genomic hybridization. Prostate cancer cells have the capability to invasively grow through the barrier of a Matrigeltrade mark and could easily be sampled in a pad of Matrigeltrade mark. Comparative genomic hybridization revealed characteristic chromosomal aberrations of the invasive growing cells. Noteworthy is their ability to spheroid formation, which allows for further cell propagation by standard cell culture methods. Thus, our improved invasion model is a tool for the sampling of invasive growing cancer cells from fresh human tumour material allowing for functional as well as genetic studies.
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Affiliation(s)
- V Jung
- Department of Urology and Pediatric Urology, University Clinic of the Saarland, Homburg/Saar, Germany
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49
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Wullich B, Michel MS. [Further development of urology in the tension field of surgical and molecular medicine]. Urologe A 2006; 45 Suppl 4:20-2. [PMID: 16858607 DOI: 10.1007/s00120-006-1112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Methods based on molecular biology and molecular medicine now have important practical applications in many areas of theoretical and clinical medicine, and it is no longer possible to imagine life without them. This means that in a largely surgical discipline, such as urology, completely new challenges are coming to the fore, which urology, as an academic and clinical discipline, now has to face up to, and to a much greater degree than hitherto. However, there is less and less freedom of action in any university department of urology, as a result not only of intensified legal outline conditions in the healthcare sector and tight public budgets, but also of faculty- and hospital-specific blocks to innovation. There is an urgent need for the creation of appropriate outline conditions and innovative structures that will allow efficient surgical care and also an efficient way of working scientifically.
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Affiliation(s)
- B Wullich
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Kirrbergerstrasse, 66421 Homburg/Saar.
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50
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Zwergel U, Hack M, Schreier U, Schröder T, Wullich B, Lehmann J, Stöckle M. Follow-Up von Patienten mit radikaler Prostatektomie und initialen präoperativen PSA-Werten von über 20 ng/ml. Aktuelle Urol 2006. [DOI: 10.1055/s-2006-947449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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