Abstract:
:Clinical stage I testicular nonseminomatous germ cell tumours (NSGCT) are highly curable. Following orchidectomy a risk-adapted approach using active surveillance (AS), nerve sparing retroperitoneal lymph node dissection (nsRPLND) and primary chemotherapy is recommended by the current guidelines. CS I is defined negative or declining tumour markers to their half-life following orchidectomy and negative imaging studies of the chest, abdomen and retroperitoneum. Low risk CS I NSGCT are defined by the absence of vascular invasion, low percentage of embryonal carcinoma (ECA) and low proliferating Ki-67 index. High risk CS I NSGCT are defined by the presence of VI, high percentage of ECA and a high Ki-67 index. According to the current guidelines, active surveillance, primary chemotherapy and nerve sparing RPLND represent 3 treatment options with the same high cure rate of about 100% but significantly different long-term complications. As demonstrated, active surveillance can be performed in low risk and in high risk NSGCT with an anticipated relapse rate of about 15% and 50%. The majority of patients will relapse with good and intermediate prognosis tumours which have to be treated with 3 to 4 cycles chemotherapy. About 25% to 30% of these patients will have to undergo postchemotherapy RPLND for residual masses. Primary chemotherapy with 1 -2 cycles PEB is a therapeutic option for high risk clinical stage I NSGCT associated with a recurrence rate of only 2-3% and a minimal acute and long-term toxicity rate. Nerve sparing RPLND, if performed properly, will cure about 85% of all high risk patients with clinical stage I NSGCT without the need for chemotherapy. Although armchair calculations of the odds of cure and toxicity associated with the various treatment options can be performed, recommendations about the most optimal therapy in clinical stage I NSGCT remain controversial. There seems to be a consensus that active surveillance is the treatment strategy of choice for CS I low risk patients. However, there is no clear cut recommendation in high risk patients. Each treatment has its own advantages and disadvantages which have to be discussed thoroughly with the patient. If, however, the positive results of 1 cycle of PEB can be validated, it will become the standard cytotoxic approach for clinical stage I NSGCT.
journal_name
Arch Esp Uroljournal_title
Archivos espanoles de urologiaauthors
Heidenreich A,Pfister Dsubject
Has Abstractpub_date
2012-03-01 00:00:00pages
215-26issue
2eissn
0004-0614issn
1576-8260journal_volume
65pub_type
杂志文章,评审abstract:OBJECTIVE:We report a rare clinical case of scrotum carcinoma and evaluate its treatment and prognosis. METHODS:We describe the case of a 62 year old man who presented an ulcerated-bleeding lesion on the right side of the scrotum. The diagnostic tests found carcinoma of the scrotum. We performed surgical radical treat...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To report a case of granuloma due to a retained surgical sponge that mimicked a pseudotumor in a patient with autosomal dominant polycystic kidney disease. The appearance of retained surgical sponges on diagnostic imaging is reviewed. METHODS:Patient evaluation included renal ultrasound, magnetic resonance i...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:The results of in situ dissolution of a cystine calculus is described. This approach was attempted in a female patient for whom surgery was not considered to be the best therapeutic option. METHODS:An obstructive cystine calculus was treated by in situ litholysis using N-acetylcysteine applied locally via tw...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::The therapeutic indications for renal cysts, a pathology observed in more than 50% of subjects aged over fifty years, are currently limited to their symptomatic forms or those of uncertain diagnosis. The approach has changed from the unroofing procedure to percutaneous sclerotherapy and, thereafter, to percutaneous re...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:Benign tumors account for less than 1% of testicular tumors and the incidence is even lower in children. A rare case of epidermoid cyst of the testis in a child is described. The differential diagnosis and treatment options are discussed. METHODS/RESULTS:A case of unilateral epidermoid cyst of the testis in ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::Herein we describe two additional cases of non-acquired arteriovenous renal fistula, one was congenital or cirsoid and the other was idiopathic or aneurysmal. Patient clinical work up prompted us to suspect this condition which was confirmed by renal arteriography. The usefulness of the diagnostic tests are highlighte...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVES:The growing interest on increasing the number of biopsy samples during ultrasound guided prostatic biopsies moved us to evaluate the tolerability and complications of the extensive biopsy with/without blockage of neurovascular bundles. METHODS:A group of 222 patients underwent prostatic biopsy with the aim ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142005001000003
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:The ovarian metastasis by a gastrointestinal cancer is called Krukenberg tumor. We report a case of metastasis to the testis and epididymis by gastric cancer that can be the analogue in male. METHODS:A patient, submitted to total gastrectomy for a poorly differentiated gastric adenocarcinoma (TNM stage: pT3...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142005000900019
更新日期:2005-11-01 00:00:00
abstract::The psoas bladder hitch is an invaluable surgical procedure in the treatment of lesions of the lower ureteral third and transplantation with short ureters. We briefly review this procedure and describe an illustrative case of ureteroneocystostomy of the right lumbar ureter. ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:Cystic tumors of the adrenal gland are uncommon, but are being increasingly more frequently diagnosed during routine radiological evaluation as "incidentalomas". We discuss the differential diagnosis, therapeutic approach and the existing controversies concerning the management of this tumor type. METHODS:Tw...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:Evaluate the treatment of the meatus urethral lithiasis. METHODS/RESULTS:A case of a 52 year-old male patient is reported with a big stone in the urethral meatus. Male patient that consults for Micturitional Syndrome, disury and difficully when urinating, in whom felt induration of the glans and observed a w...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2005-12-01 00:00:00
abstract::We describe the unusual case of a young male who presented lower urinary tract obstruction secondary to a bladder-prostate embryonal rhabdomyosarcoma. Initially he was treated with multiagent chemotherapy and radiotherapy in an attempt to preserve bladder function, but eventually radical cystoprostatectomy was warrant...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:We report two cases of collecting duct carcinoma that were diagnosed in our hospital in a six-month period. METHODS/RESULTS:The first case was a 75years-old woman showing in CT scan a mass in the left kidney which infiltrated perinephric fat. The second case was a 72-years-old that showed in a CT scan a righ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract::A case of polyorchism is described and the literature reviewed, highlighting the rarity of this pathological condition. To our knowledge, only 70 cases have been reported in the world literature. Similarly, Nocks' embryological development theory is discussed herein. The present case was diagnosed intraoperatively. No...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:We present a case of X-Y translocation with male phenotype (46,XX testicular disorder of sex development) and review the literature. METHODS:Disorders of sex development with mismatch of genetic, gonadal and phenotypic sex are quite rare, and some are due to genetic or chromosomal abnormalities. The karyotyp...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2011-06-01 00:00:00
abstract::We reviewed the records of patients with genitourinary tumors that had been diagnosed and treated at the Section of Pediatric Surgery of Marqués de Valdecilla Hospital from 1974 to 1990. There were 14 such tumors. Of these, 12 (85.7%) were Wilm's tumor. This tumor type is the subject of the present study. Regarding it...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVES:To describe a method to obtain images of open surgery at the lowest possible cost. The images provide useful information for patient records and teaching. METHODS:We have utilized a submersible endoscopic camera with no special features, close up lenses or automatic focussing device and a color printer. RE...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract::A case of recurrent emphysematous cystitis in a 44-year-old male diabetic is described. Treatment of the first episode had been effective and demonstrable radiologically. A recurrent episode of cystitis disclosed a neurogenic bladder, which had not been detected previously. The literature on the pathogenesis of this e...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:To report one case of metastatic prostatic carcinoma with a gaudy presentation as a lump which resulted to be a cutaneous metastasis. METHODS:We describe the debut in a patient, who thanks to the pathologic analysis of a lesion mimicking a lipoma, which was reported as adenocarcinoma, was worked up for prost...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::The experience of two units (Gastroenterology and Urology) of Clínica La Luz, Madrid, in the treatment of gallbladder and renal lithiasis using the Dornier MPL-9000 lithotripter is reported herein. This lithotriptor has been utilized in the treatment of all cases of gallbladder calculi for which it is indicated and re...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:Low grade, low stage superficial bladder tumors have, in general, a good prognosis; however, some of these tumors progress and behave more aggressively, displaying a high incidence of recurrence and rapid transformation into a higher grade of malignancy with deep invasion of the bladder wall. Numerous studies...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of urinary BTA-TRAK as a marker in monitoring superficial transitional cell carcinoma of the bladder and to compare urine cytology with urinary sediment testing. METHODS:700 consecutive determinations using BTA-TRAK to monitor unselected patients that had undergone surgery for trans...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To present a new case of adenomatoid tumor of the epididymis, the first report in our hospital since 1962. METHODS:We report a clinical case with a brief bibliographic review about adenomatoid tumor of the epididymis. The diagnostic and therapeutic implications are discussed focusing on the role of ultrasou...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142009000800009
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To describe a case of renocolic fistula diagnosed by retrograde pyelography. METHODS:A case of renocolic fistula associated with pyonephrosis and left pleural empyema in a 48-year-old female with a history of recurrent pyelonephritis is presented. RESULTS:The ultrasound findings were suggestive of pyonephro...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:To report the principles of penile resculpturing of different deformities caused by M. Peyronie: restoration of penile length, girth and shape with or without penile prosthesis implantation. METHODS:In the period between February 2007 and March 2009, we performed grafting surgery for M. Peyronie in 98 patie...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2010-11-01 00:00:00
abstract::The presence of gas in the bladder wall and/or lumen (emphysematous cystitis) is an uncommon disease entity that may be caused by infectious organisms. Diabetes and chronic urinary infection are predisposing factors. Its clinical features are unspecific and the prognosis depends on the degree of aggressiveness at pres...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVES:Experimental data show the relationship between the area of injured urothelium and recurrence rates in superficial bladder cancer. Tumor cell adherence is increased by the exposure to the extracellular matrix (ECM). Transurethral resection uncovers the ECM and might lead to recurrent tumors. The question if ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:To determine the type and to quantify the DURR phenomena in the male. METHODS:We conducted a clinical and urodynamic study in 31 male patients with functional lower urinary tract symptoms. RESULTS:DURR is produced by two types of mechanisms: urethral rigidity and contraction of the urethral wall. The patie...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To discuss briefly the new therapeutic strategies for poor-prognosis testicular germ cell cancer. METHODS:The use of new drugs in first line chemotherapy, intensive alternating and sequential chemotherapy and high dose chemotherapy with autologous bone marrow or stem cell transplantation are briefly discusse...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:We describe the case of a young male presenting with non-specific abdominal symptoms on follow-up after radical nephrectomy for renal carcinoma leading to the finding of local recurrence and peritoneal metastases. A second exploratory laparotomy was carried out for tumor reduction, but it was followed by fast...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142006000900015
更新日期:2006-11-01 00:00:00