Aristolochic acid and its effect on different cancers in uro-oncology
Purpose of review
To acquaint urologists with aristolochic acid nephropathy, an iatrogenic disease that poses a distinct threat to global public health. In China alone, 100 million people may currently be at risk. We illustrate the power of molecular epidemiology in establishing the cause of this disease.
Recent findings
Molecular epidemiologic approaches and novel mechanistic information established a causative linkage between exposure to aristolochic acid and urothelial carcinomas of the bladder and upper urinary tract. Noninvasive tests are available that detect urothelial cancers through the genetic analysis of ur...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research
An up-to-date catalogue of urinary markers for the management of prostate cancer
Purpose of review
Prostate cancer (PCa) is the most commonly diagnosed cancer in men. Poor specificity and sensitivity of total PSA often results in over and sometimes underdetection/treatment. Therefore, more specific and sensitive biomarkers for the detection and monitoring especially of clinically significant PCa as well as treatment-specific markers are much sought after. In this field, urine has emerged as a promising noninvasive source of biomarkers.
Recent findings
RNA-based biomarkers are the most extensively studied type of urinary nucleic acids. ERG-Score/MiPS (Mi-Prostate Score) and SelectMDx might be consi...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research
Tubeless percutaneous nephrolithotomy: evaluation of minimal invasive exit strategies after percutaneous stone treatment
Purpose of review
To provide an updated overview of different exit strategies for percutaneous nephrolithotomy (PCNL) in times of miniaturization and minimal invasive surgery.
Recent findings
The majority of the reported studies concluded that a tubeless procedure is associated with less patient discomfort and a shorter hospital stay compared to the standard PCNL. Additionally, no significant difference in the complication rate was observed, including postoperative fever, hematocrit decrease, stone-free rate, and urine extravasation.
Summary
Underlined by recent literature tubeless PCNL is a well tolerated and effe...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research
Where to next prostate-specific membrane antigen PET imaging frontiers?
Purpose of review
Technical improvements in imaging equipment and availability of radiotracers, such as PSMA-ligands have increased the synergy between Urology and Nuclear Medicine. Meanwhile artificial intelligence is introduced in Nuclear Imaging. This review will give an overview of recent technical and clinical developments and an outlook on application of these in the near future.
Recent findings
Digital PET/CT has shown gradual improvement in lesion detection and demarcation over conventional PET/CT, but total-body PET/CT holds promise for a magnitude of improvement in scan duration and quality, quantification, ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
PET imaging in testicular tumours
Purpose of review
Testicular cancer is rare, but its incidence is expected to rise. [18F] fluorodeoxyglucose ([18F]FDG) PET/computed tomography (CT) added role in testicular cancer management has been defined in a set of specific clinical settings. The current review focuses on recent advances in the employment of PET/CT in testicular cancer patients.
Recent findings
[18F]FDG PET/CT is not recommended for initial staging or for suspected testicular tumours. PET/CT role in testicular cancer management is mainly for the assessment of seminoma residual masses after therapy (>3 cm). Although [18F]FDG PET/CT has a very h...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer
Purpose of review
In this narrative review, we assessed the role of 18F-fluoro-2-deoxy-D-glucose-positron emission tomography/CT (FDG-PET/CT) in preoperative staging and response evaluation of neoadjuvant chemotherapy in muscle-invasive bladder carcinoma (MIBC), and to assess its incremental value to contrast-enhanced (CE)CT and MRI in terms of patient management at initial diagnosis and detection of recurrence.
Recent findings
A literature search in PubMed yielded 46 original reports, of which 15 compared FDG-PET/CT with CECT and one with MRI. For primary tumor assessment, FDG-PET/CT proved not accurate enough (13 re...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
Clinical impact of PET imaging in prostate cancer management
Purpose of review
Imaging of prostate cancer has been a rapidly evolving field in recent years with the introduction of multiple new PET tracer agents. Introduction of novel imaging techniques into clinical practice requires careful evaluation, with the ultimate aims of improved patient outcomes, better sequencing of treatments, and cost effectiveness. The increased sensitivity and specificity of these new PET agents present both challenges and opportunities. We know they frequently change management, but are these effective management changes, and is it always in the best interests of the patients?
Recent findings
Th...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
Clinical application of Fluciclovine PET, choline PET and gastrin-releasing polypeptide receptor (bombesin) targeting PET in prostate cancer
Purpose of review
The aim of this review is to explore the clinical application of different PET radiopharmaceuticals in prostate cancer (PCa), beyond inhibitors of the prostate-specific membrane antigen (PSMA).
Recent findings
Choline PET represented in the last decades the standard of reference for PET imaging in PCa and has been recently included in clinical trials evaluating the efficacy of metastasis-directed therapy in oligo-metastatic disease. Fluciclovine, as synthetic amino acid, has been proposed for investigating PCa. The results obtained by the first prospective studies led to FDA approval in 2016 in patie...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
Prostate-specific membrane antigen targeted PET imaging for prostate cancer recurrence
Purpose of review
Prostate-specific membrane antigen targeted PET imaging (PSMA PET) of biochemically recurrent prostate cancer (BCR) is implemented in routine management in many countries and recommended in European Association of Urology (EAU) and American Society of Clinical Oncology (ASCO) guidelines. Purpose of this review is to summarize recently published evidence of accuracy, management impact, and clinical benefit of PSMA PET in this setting and to state our opinion on the role of PSMA PET in future trials and clinical routine to improve patient outcomes.
Recent findings
The past two years saw an increase of ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
Prostate-specific membrane antigen PET/computed tomography for staging prostate cancer
Purpose of review
Molecular imaging with PET/CT targeting the prostate-specific membrane antigen (PSMA) receptor is increasingly utilized in men with prostate cancer (PCa), with clinical indications now expanding beyond biochemical recurrence. PSMA PET/CT often detects sub-centimetre size pathologic nodes and low-volume bone marrow disease that are occult on conventional imaging when the lesion does not cause sclerosis or osteoblastic reaction in surrounding bone. This review focuses on recent evidence for PSMA PET/CT in initial disease staging.
Recent findings
Several recent studies including a large randomized trial...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
PET imaging in urology: a rapidly growing successful collaboration
Purpose of review
To discuss and highlight the recent findings in urological oncology focusing on nuclear medicine advances on imaging and therapy.
Recent findings
Testicular tumors: 18F-FDG as the standard positron emission tomography (PET) tracer with proven good accuracy in detecting metastatic testicular cancer; urothelial cancer: good accuracy of 18F-FDG PET in detecting distant metastases but poor results in detecting local disease; prostate cancer: prostate-specific membrane antigen (PSMA) is a promising target for imaging prostate cancer with unprecedented accuracy in both staging and restaging and prospective...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Chemotherapy, not androgen receptor-targeted therapy should be used upfront for metastatic hormone-sensitive prostate cancer. CON: Novel oral agents provide an attractive alternative to chemotherapy in metastatic hormone-sensitive prostate cancer
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research
Chemotherapy, not androgen receptor-targeted therapy should be used upfront for metastatic hormone-sensitive prostate cancer. PRO: docetaxel chemotherapy should be the default consideration in metastatic hormone-sensitive prostate cancer
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research
Where do urologists stand in the era of novel coronavirus-2019 disease
Purpose of review
The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption.
Recent findings
Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of n...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research
