Abstract:
OBJECTIVE:To assess whether the optimal use of combined treatment with chemotherapy and appropriately timed surgical intervention by a specialized team might improve the outcome for patients with poor- and intermediate-prognosis (International Germ Cell Consensus Classification, IGCCC) nonseminomatous germ cell tumours (NSGCTs). PATIENTS AND METHODS:Between 1984 and 1998, 47 patients with intermediate (16) and poor prognosis (31) NSGCT were treated; 43 had a testicular and four a retroperitoneal primary. RESULTS:Of the 47 patients only seven (15%) had a complete radiological response after primary chemotherapy; 36 (77%) required surgery after chemotherapy (29 para-aortic lymphadenectomy, 13 resection of pulmonary metastases, two each excision of supraclavicular and retrocrural lymph nodes and one resection of brain metastases; 13 required surgery at more than one site). There was no surgical mortality, with postoperative wound pain the commonest morbidity. On pathology, the resected masses were mature teratoma in 13, necrosis in 12 and malignant disease in 11 patients, the resection being complete in 30. There were microscopically positive margins in the other six patients, all but one having viable residual cancer. Of the 47 patients, 18 needed treatment for relapse, with four having surgery for growing mature teratoma, six chemotherapy plus surgery and eight salvage chemotherapy alone. Of 31 patients, 22 (71%) with a poor and 13 of 16 with an intermediate prognosis were alive at a median (range) follow-up of 94 (41-171) months; of all 47, 34 (72%) remain in complete remission. Ten patients died from disease progression. The presence of residual malignant disease at the resection margin was significantly associated with poorer survival (hazard ratio 7.21, P = 0.0016). Prognostic factors, e.g. number of involved sites, IGCCC group and viable tumour in resected masses, were not significant. The 5-year overall and relapse-free survival (95% confidence interval) was 81 (69-93)% and 57 (43-71)%, respectively. CONCLUSION:The optimal delivery and timing of chemotherapy and surgical resection by a specialist team of oncologists, urological and cardiothoracic surgeons is critical in treating poor-risk NSGCT and might be responsible for improving the outcome of these patients. The detection of residual malignant disease after chemotherapy by positron emission tomography should be investigated to identify those who might benefit from further systemic treatment before complete surgical resection.
journal_name
BJU Intjournal_title
BJU internationalauthors
Pentheroudakis G,De Bono JS,Kaye SB,Simpson A,Paul J,Brown I,Pamenter B,Kirk A,Vasey P,Raby N,Kirk Ddoi
10.1046/j.1464-410x.2003.04261.xkeywords:
subject
Has Abstractpub_date
2003-07-01 00:00:00pages
36-42issue
1eissn
1464-4096issn
1464-410Xpii
4261journal_volume
92pub_type
杂志文章abstract:UNLABELLED:WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: For patients who are unfit for extirpative surgery, percutaneous cryoablation (PCA) presents a minimally-invasive alternative for the treatment of renal masses. PCA has been demonstrated to be safe, with complication rates <10% being reported consist...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11432.x
更新日期:2013-05-01 00:00:00
abstract::The first two reviews are from the same unit in Germany and describe the well-known but still much discussed ways of improving the prognosis of patients undergoing cystectomy for bladder cancer. The authors review the roles of lymph node dissection and perioperative chemotherapy, and draw conclusions which will be of ...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2007.07114.x
更新日期:2007-12-01 00:00:00
abstract::To assess the evidence for the concept that the androgen receptor of prostate cancer (PCa) cells becomes saturated when testosterone values exceed castrate levels, so that testosterone administration in hypogonadal men with untreated PCa does not stimulate tumour growth. To propose basic criteria for administration of...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2011.10193.x
更新日期:2011-05-01 00:00:00
abstract::To compare the incidence of infective complications after transrectal ultrasonography (TRUS)-guided biopsy with either empirical fluoroquinolone or culture-based targeted antimicrobial prophylaxis, and the prevalence of fluoroquinolone resistance (FQ-R) in men undergoing prostate biopsy. A systematic review of the lit...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/bju.13402
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To document the clinicopathological features of prostate cancer in a cohort of Jamaican men, and to determine which of these features are of prognostic significance in this population. PATIENTS AND METHODS:The clinical and pathological findings in 99 patients with prostate cancer (diagnosed consecutively aft...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-4096.2001.01871.x
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To assess the totality of prostate cancer eradication in radical prostatectomy (RP) specimens from men with a unilaterally positive prostate biopsy, and who would currently qualify for subtotal prostate ablation with controlled thermal energy such as cryoablation or high-intensity focused ultrasound. MATERIA...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.08359.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To investigate the long-term outcomes of laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS:In all, 1138 patients underwent LRP during a 163-month period from 2000 to 2008, of which 51.5%, 30.3% and 18.2% were categorised into D'Amico risk groups of low-, intermediate- and high-risk, respectivel...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12887
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To investigate the detection rate and extent of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical glands (AG) suspicious for prostate cancer, and the cancer risk in subsequent biopsies, diagnosed by a first 24-core saturation biopsy, as although the optimum extent of biopsy is controversial ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06728.x
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To determine the angiogenic profiles in the bladder of patients with bladder pain syndrome (BPS)/interstitial cystitis (IC), and to evaluate the relationship between these profiles and associated clinical features including pelvic pain and glomerulations. PATIENTS AND METHODS:Angiogenesis and angiogenic comp...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.08467.x
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of race on the effectiveness of hormonal therapy in patients with prostate cancer, by comparing the outcomes of Caucasian men (CM) and Japanese-American men (JAM) treated with hormonal therapy at one institution. PATIENTS AND METHODS:Fifty-nine CM and 105 JAM with prostate cancer we...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06201.x
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of demographic, clinical, treatment and patient-reported parameters on satisfaction with prostate cancer care. Despite the significant worldwide impact of prostate cancer, few data are available specifically addressing satisfaction with treatment-related care. PATIENTS AND METHODS:CaPS...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11423.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To present our initial experience in children undergoing single-port laparoscopic varicocelectomy (SPLV) using a new approach in which the entire procedure is performed through a multichannel single laparoscopic port inserted in the umbilicus rather than the traditional LV performed through three abdominal po...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07584.x
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of degarelix vs luteinizing hormone-releasing hormone analogue (triptorelin) plus short-term antiandrogen treatment for advanced prostate cancer. METHODS:We developed a decision analytic model based on a clinical trial and literature review. The two interventions evaluated ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10434.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To determine whether very small prostate cancers present in patients who also have lymph node (LN) metastases represent a particularly aggressive disease variant compared with larger LN-positive tumours. PATIENTS AND METHODS:We identified 37 501 patients diagnosed with prostate cancer between 1988 and 2001 t...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.13248
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To assess, in a repeat audit of a regional lithotripsy service, whether changes implemented after a regional audit in 1994 (which showed disappointing results from shock wave lithotripsy, attributable to both poor patient selection and an inadequate fixed-site lithotripter) have had any effect. PATIENTS AND ...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1464-410x.2002.02674.x
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of solitary rib lesions on pre-treatment 68 Gallium-labelled prostate-specific membrane antigen (PSMA)/computed tomography (CT) scans in men with prostate cancer that are malignant and examine any predictive factors. PATIENTS AND METHODS:This retrospective single tertiary referra...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15152
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To examine the results of open partial nephrectomy (OPN) over a 15-year period in a large UK teaching hospital and to compare results with other series including minimally invasive techniques, as nephron-sparing techniques are still under-utilized in the surgical treatment of renal carcinoma. A standardized ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07829.x
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To determine whether the predictive value of isolated high-grade prostatic intraepithelial neoplasia (HGPIN) for an unsampled prostate cancer on an extended biopsy is lower due to more thorough prostate sampling, and whether the proportion of cores with HGPIN is associated with prostate cancer, as isolated HG...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06681.x
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:To determine the incidence of severe pain after ureteric stent removal. To evaluate the efficacy of a single dose of a non-steroidal anti-inflammatory drug (NSAID) in preventing this complication. PATIENTS AND METHODS:A prospective, randomised, double-blind, placebo-controlled trial was performed at our ins...
journal_title:BJU international
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2012.11214.x
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To develop and test the safety and feasibility of a novel anti-biofilm mechanism configured for wireless capsule endoscopy (WCE) in a sheep bladder model. MATERIALS AND METHODS:A WCE mechanism, designed for long-term bladder monitoring, was developed and introduced into a sheep bladder for 5 months. The tran...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12040
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:To determine whether modified transperineal template prostate-mapping (TTPM) biopsy protocols, altering the template or the biopsy density, have sensitivity and negative predictive value (NPV) equal to full 5-mm TTPM. PATIENTS AND METHODS:Retrospective analysis of an institutional registry including treatme...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.13306
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of commercially available single-layer small intestinal submucosa (SIS) for urethral replacement, both as an onlay and as a tube, in a rabbit model. MATERIALS AND METHODS:Thirty-six male rabbits were assigned to four experimental groups. Group 1 had the ventral wall of the penile urethra ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2004.05115.x
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To examine the effects of castration and continuous gonadotrophin releasing-hormone (GnRH) agonist and antagonist therapy on the expression of GnRH-receptors type I (GnRH-RI) in rat ventral prostate (VP) and pituitary tissue, and to compare the effects on prostate morphology. MATERIAL AND METHODS:Mature Spra...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.03054.x
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To detect occult regional lymph node metastases in patients with T3pN0M0 prostate cancer not recognized by routine haematoxylin and eosin staining, and to evaluate the clinical relevance of this finding. PATIENTS AND METHODS:Formalin-fixed and paraffin-embedded pelvic lymph nodes (1118) from 92 patients were...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00406.x
更新日期:2000-02-01 00:00:00
abstract:UNLABELLED:Study Type--Therapy (cohort) Level of Evidence 2a. What's known on the subject? and What does the study add? Despite expanding treatment options for castration-resistant prostate cancer (CRPC), therapies with long response duration remain intangible due to prostate cancer cells' natural ability to develop it...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11456.x
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To determine if athermal methods are as effective in preventing blood transfusions as the use of cautery across various prostate volumes following prostate tissue resection for benign prostatic hyperplasia using Aquablation. PATIENTS AND METHODS:The current commercial AQUABEAM robot that performs Aquablation...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/bju.14990
更新日期:2020-04-01 00:00:00
abstract::To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training d...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2012.11270.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that three-dimensional hypofractionated radiotherapy (3D-HFRT) is well tolerated and not worse than 3-D conventional RT (3D-CRT) for oncological outcome. PATIENTS AND METHODS:In all, 162 men with hystologically confirmed prostate adenocarcinoma were included in the analysis. In all, 82...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09418.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To analyse the technical details and the long-term results of laparoscopic ureterolithotomy. PATIENTS AND METHODS:Laparoscopic ureterolithotomy was undertaken in 101 patients between 1991 and 2001; in only one patient with retroperitoneal fibrous adhesions was the procedure transperitoneal, being retroperito...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-4096.2001.01562.x
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To describe the preclinical pharmacology of Ro 115-1240, a peripherally acting selective alpha1A/1L-adrenoceptor (AR) partial agonist, compared with the alpha1A/1L-AR full agonist amidephrine, as AR agonists have some utility in the treatment of stress urinary incontinence (SUI) but are limited by undesirable...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410x.2004.04577.x
更新日期:2004-01-01 00:00:00