Abstract:
PURPOSE OF REVIEW:To give an overview of current options for conservative treatment of patients failing intravesical bacillus Calmette-Guerin (BCG) and to discuss emerging approaches with potential future clinical applications. RECENT FINDINGS:Radical cystectomy is the standard-of-care for patients failing BCG therapy. In patients unfit or unwilling to undergo surgery, salvage therapy options could be proposed with the aim to offer local cancer control and prevent progression to muscle-invasive disease. Salvage treatments have been conducted using intravesical chemotherapy regimens, chemoradiation or chemohyperthermia. Intravesical agents such as valrubicin, gemcitabine or docetaxel showed response rates varying between 16 and 40%, whereas combination treatments of gemcitabine with docetaxel or mitomycin reported response rates in up to 50% of all patients with durable responses in about one out of three patients. For chemohyperthermia, 2-year recurrence rates between 41 and 56% have been reported. Ongoing clinical trials are evaluating chemoradiation as well as novel approaches such as systemic immunotherapy, viral gene therapy, targeted therapy or vaccination strategies with promising preliminary outcomes. SUMMARY:Salvage therapeutic bladder-sparing strategies for BCG failure such as intravesical chemotherapy or chemoradiation should currently only be considered in patients unfit for or refusing surgery. Innovative concepts such as chemohyperthermia, checkpoint inhibitors, targeted therapy or viral gene therapy could lead to major changes in clinical management of BCG failures in the future.
journal_name
Curr Opin Uroljournal_title
Current opinion in urologyauthors
Hassler MR,Shariat SF,Soria Fdoi
10.1097/MOU.0000000000000593subject
Has Abstractpub_date
2019-05-01 00:00:00pages
239-246issue
3eissn
0963-0643issn
1473-6586journal_volume
29pub_type
杂志文章abstract:PURPOSE OF REVIEW:Immunotherapies for urological malignancies have made tremendous progress by targeting immune checkpoints and have been implemented in clinical practice nowadays. Though siginifcant number of patients does not respond to immunotherapy. Biomarkers could help to predict response to treatment, but are st...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000465
更新日期:2018-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Underactive bladder (UAB) is a clinical symptom complex only recently gaining recognition as a clinical diagnosis. Lack of consensus agreement on a definition of UAB has limited its recognition and diagnosis in clinical practice. The purposes of this review are to: present existing definitions of UAB,...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000280
更新日期:2016-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients who undergo urinary tract diversion are at an increased risk of urolithiasis for various reasons. The purpose of this article is to provide an up-to-date summary of the progress that has been made in the pathogenesis, diagnosis and treatment of stones in patients with urinary diversions. Fina...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200207000-00007
更新日期:2002-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Traditionally, curative therapy for most renal cancers involved open radical nephrectomy. However, as increased radiological monitoring has led to more incidentally discovered small renal masses, the optimal treatment has evolved. Nephron-sparing surgery, initially developed for patients with solitary...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200305000-00004
更新日期:2003-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe mechanisms behind and extent of overdetection in prostate cancer screening as well as possible ways to avoid unnecessary overdiagnosis. RECENT FINDINGS:Overdetection and overtreatment is common in many areas of modern medicine. Current prostate-specific antigen (PSA) testing has resulted ...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000054
更新日期:2014-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Radical cystectomy with pelvic lymph node dissection (PLND) is the preferred treatment for invasive bladder cancer. It not only results in the best disease-free term survival rates, but also provides the most accurate disease staging and most effective local symptom control. Recent investigations have...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32833c9194
更新日期:2010-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Benign prostatic hyperplasia is the most common human neoplasm and it is the most frequent tumour requiring surgical treatment in men. Not surprisingly, interest centres on either understanding of prostatic growth during ageing or on various medical or interventional treatments. RECENT FINDINGS:Recen...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200301000-00003
更新日期:2003-01-01 00:00:00
abstract::Molecularly based novel therapeutic agents are needed to address the problem of locally recurrent, or metastatic, advanced hormone-refractory prostate cancer. Recent basic science advances in mechanisms of gene expression, vector delivery, and targeting have rendered clinically relevant gene therapy to the prostatic f...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200109000-00007
更新日期:2001-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Training in female urology in Europe so far has been a national focus of individual European countries. Because of reasons like differentiation in pathology, activities of other specialisms like gynaecology and reimbursement issues, the way in which extra training in female urology is organized varies...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32832ae1a4
更新日期:2009-07-01 00:00:00
abstract::Recent developments in renal magnetic resonance angiography have led to a significant improvement in the technical success rate and diagnostic accuracy of the methods. Specifically, three-dimensional contrast-enhanced magnetic resonance angiography methods have been shown to provide a more reliable depiction of renal ...
journal_title:Current opinion in urology
pub_type: 杂志文章
doi:10.1097/00042307-199803000-00006
更新日期:1998-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Partial nephrectomy provides equivalent long-term oncologic and superior functional outcomes as radical nephrectomy for T1a renal masses. Herein, we review the various vascular clamping techniques employed during minimally invasive partial nephrectomy, describe the evolution of our partial nephrectomy...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000140
更新日期:2015-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The success in the use of the tension-free midurethral sling procedures (tension-free vaginal tape, suprapubic arch, transobturator tape) has dramatically altered the approach to the surgical management of stress urinary incontinence in women and marked a resurgence in the use of mesh. We will analyze...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000232042.95427.9f
更新日期:2006-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Orthotopic urinary diversion has been performed for more than 30 years. Although it is considered to be the gold standard form of diversion in many centers of expertise, however it is uncommonly performed outside these institutions. The purpose of this article is to review the current indications and ...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000226
更新日期:2015-11-01 00:00:00
abstract:PURPOSE OF REVIEW:To review the developments and current status of robot-assisted radical cystectomy (RARC) with pelvic lymphadenectomy (PLND) and urinary diversion for the treatment of bladder cancer. RECENT FINDINGS:RARC is growing steadily in 2008, and it is superseding pure laparoscopic radical cystectomy (LRC) at...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32831c50b4
更新日期:2009-01-01 00:00:00
abstract::Pharmacotherapy for men experiencing erectile dysfunction has undergone dramatic advances over the past 5 years with the introduction of an effective oral agent. Sildenafil has increased the pool of couples seeking treatment for this important health issue as well as expanding the numbers of physicians treating it. Re...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200111000-00011
更新日期:2001-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this study is to provide an overview of the current status of novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education. RECENT FINDINGS:Kinematics of end-effector trajectories, as well as cognitive state features of su...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000408
更新日期:2017-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Secondary data analysis has become increasingly common in health services research, specifically comparative effectiveness research. While a comprehensive study of the techniques and methods for secondary data analysis is a wide-ranging topic, we sought to perform a descriptive study of some key metho...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000407
更新日期:2017-07-01 00:00:00
abstract::Since Sternberg et al. in 1985 first published preliminary results of polychemotherapy in patients with metastatic bladder cancer, it became apparent that transitional carcinoma of the bladder is highly responsive to chemotherapy. Response rates up to 70% with combination therapy regimens like methotrexate, vinblastin...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-199909000-00009
更新日期:1999-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Overactive bladder affects 10-12% of men, of which 13% are refractory to medical therapy and seek second-line treatment. This places a substantial clinical and economic burden on the National Health Service United Kingdom. RECENT FINDINGS:This review identifies current evidence for the use of onabotu...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.MOU.0000434594.87575.26
更新日期:2013-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Robotic-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) is gaining acceptance as an alternative to open and laparoscopic RPLND for the treatment of testicular cancer. We discuss the current state of R-RPLND and summarize the latest relevant literature regarding the feasibility of...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000582
更新日期:2019-03-01 00:00:00
abstract:PURPOSE OF REVIEW:We review the concepts surrounding prostate cancer prevention strategies with 5-alpha reductase inhibitors (5-ARIs) and the controversies associated with their use. RECENT FINDINGS:Updated data have shown no increased risk of death from the diagnosis of higher risk cancer; however, 5-ARIs remain cont...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000464
更新日期:2018-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to outline the initial development of histotripsy, a noninvasive image-guided focused ultrasound technology that mechanically homogenizes targeted tissues and to describe the results of preclinical translational research directed toward urologic applications. RECENT FINDING...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000001
更新日期:2014-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Supine percutaneous nephrolithotomy (PCNL) has been described in 1988 and several modifications followed since. Despite claimed benefits, supine PCNL is still neglected by the majority of urologists. Lack of experience and the fear of complications are possible explanations for the resistance to supin...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000023
更新日期:2014-03-01 00:00:00
abstract::Advances in the diagnosis of early stage disease, and particularly the introduction of prostate-specific antigen (PSA) testing, have had a dramatic effect on the presentation and clinical management of prostate cancer during the past ten years. As a result, there have been significant epidemiological changes in countr...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200007000-00006
更新日期:2000-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Ureteral stents are a mainstay of today's urological armamentarium. This review critically evaluates the recent literature and provides a concise summary of the use of stents in urology today. While stents are used in many reconstructive urologic procedures, this review focuses on the use of stents in...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200403000-00011
更新日期:2004-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Radical cystectomy and urinary diversion is the accepted standard of care for invasive bladder cancer. Although orthotopic neobladder is the preferred method of urinary diversion in men, less experience is available for women. Recent studies and reports on this subject are summarized and reviewed. RE...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32834b31c4
更新日期:2011-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Increasingly, screening of both deceased and living donor organs has led to the early detection of kidney stones prior to donation. A number of transplant recipients will still present with donor-gifted and de-novo stones. A range of treatment modalities is available in the management of renal transpl...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32835d3097
更新日期:2013-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Partial nephrectomy has become the standard of treatment for renal tumors less than 4 cm in size. Recent reports have even applied this technique for T1b lesions as well. With advancement in minimally invasive techniques, laparoscopic and robotic surgeries are performed with the advantage of decreased...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3283337b76
更新日期:2010-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The diagnosis and treatment of bladder cancer represents a significant financial burden to the population in the United States. Therapeutic advances in bladder cancer care have come at a high cost to payers, providers, and patients. This study describes the principals of cost-effectiveness evaluation ...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32830b8910
更新日期:2008-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Serenoa repens extract is a popular phytotherapeutic agent in men with lower urinary tract symptoms. Although the exact mechanism of action is unknown, the agent is generally well accepted for its easy availability and good tolerability. This paper reviews the evidence of its efficacy in comparison wi...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200501000-00011
更新日期:2005-01-01 00:00:00