Albers P.,Heinrich Heine University Dusseldorf |
Albrecht W.,Rudolfstiftung |
Algaba F.,Fundacio Puigvert |
Bokemeyer C.,Universitatskliniken Eppendorf |
And 4 more authors.
European Urology | Year: 2011
Context: On behalf of the European Association of Urology (EAU), guidelines for the diagnosis, therapy, and follow-up of testicular cancer were established. Objective: This article is a short version of the EAU testicular cancer guidelines and summarises the main conclusions from the guidelines on the management of testicular cancer. Evidence acquisition: Guidelines were compiled by a multidisciplinary guidelines working group. A systematic review was carried out using Medline and Embase, also taking Cochrane evidence and data from the European Germ Cell Cancer Consensus Group into consideration. A panel of experts weighted the references, and a level of evidence and grade of recommendation were assigned. Results: There is a paucity of literature especially regarding longer term follow-up, and results from a number of ongoing trials are awaited. The choice of treatment centre is of the utmost importance, and treatment in reference centres within clinical trials, especially for poor-prognosis nonseminomatous germ cell tumours, provides better outcomes. For patients with clinical stage I seminoma, based on recently published data on long-term toxicity, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment. The TNM classification 2009 is recommended. Conclusions: These guidelines contain information for the standardised management of patients with testicular cancer based on the latest scientific insights. Cure rates are generally excellent, but because testicular cancer mainly affects men in their third or fourth decade of life, treatment effects on fertility require careful counselling of patients, and treatment must be tailored taking individual circumstances and patient preferences into account. © 2011 European Association of Urology. Source
Mazo V.,Hospital Universitari Germans Trias i Pujol |
Sabate S.,Fundacio Puigvert |
Canet J.,Hospital Universitari Germans Trias i Pujol
Minerva Anestesiologica | Year: 2016
Pulmonary complications are a source of greater postoperative morbidity and mortality and longer hospital stays. Although many factors have been implicated as predictors, few models have been developed with the rigorous methodology required for clinically useful tools. In this article we attempt to describe what to look for when developing or assessing a newly proposed predictive tool and to discuss what must be taken into consideration on incorporating a model into clinical practice. Above all, we stress that we still lack evidence for the clinical and cost effectiveness of many measures proposed for reducing risk or for managing complications perioperatively. For a good predictive model to truly prove its utility in clinical decision-making, such evidence is required. © 2016 EDIZIONI MINERVA MEDICA. Source
Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-2.4.1-1;HEALTH-2007-2.4.1-2 | Award Amount: 3.92M | Year: 2008
Bladder cancer is a recurrent and very prevalent cancer and it generates the highest cost per patient in Europe. New genomic methods have allowed identifying new markers with potential clinical application. However, due to the use of single-marker assays and poor study design, none of these markers has made it to the clinic. FGFR3 and PIK3CA mutations, expression profiles, and microsatellite alterations in tumor tissue and urine, as well as polymorphisms in immune response genes, are very promising biomarkers that predict a tumor being present in the bladder and its likelihood of progression to invade the muscle. Here, we propose to combine the best markers of bladder cancer outcome in a prospective multicenter validation study in Spain, the Netherlands, Sweden and Denmark as genetic predictors. Pre-validation of markers has been or will be made utilizing the worlds largest bladder cancer biobank (60,000 samples from 2500 patients). To achieve enough power to rapidly generate conclusive results, 2000 patients will consecutively be enrolled, and subjected to analysis, as well as follow-up for 2-4 years. The approach is a pre-defined, standard operating procedure based, prospective study with fixed end-points and testing relatively few independent variables on tumor tissue, urine and blood. To obtain a seamless introduction into the clinic we will use a mathematical approach in which the best markers are weighted based on disease models and nomogram construction, leading to a risk score applied to each patient at each visit. The team has a very strong track record in bladder cancer research, micro-array application, nomogram construction, and bio-banking. The validated biomarkers will lead to specific recommendations for changes in patient management based on the risk scores. We estimate saving of more than 40 mill Euros annually based on a reduced frequency of cystoscopies, as well as an increased survival and a better quality of life for the patients.
Fundacio Puigvert | Date: 2012-04-23
In vitro method for predicting fecundity of semen. The present invention belongs to the field of reproductive medicine, particularly related to male and female infertility. Thus, the present invention is focused on the evaluation and assessment of the sperm expression gene profile, in order to identify a specific group of genes whose expression profile is correlated with the fecundity ability of spermatozoa. This group of genes could be used as biomarkers for discriminating those samples with the worst ability to fertilize oocyte.
Roupret M.,Pitie Salpetrire Hospital |
Roupret M.,University Pierre and Marie Curie |
Zigeuner R.,Medical University of Graz |
Palou J.,Fundacio Puigvert |
And 6 more authors.
European Urology | Year: 2011
Context: The European Association of Urology (EAU) Guideline Group for urothelial cell carcinoma of the upper urinary tract (UUT-UCC) has prepared new guidelines to aid clinicians in assessing the current evidence-based management of UUT-UCC and to incorporate present recommendations into daily clinical practice. Objective: This paper provides a brief overview of the EAU guidelines on UUT-UCC as an aid to clinicians in their daily practice. Evidence acquisition: The recommendations provided in the current guidelines are based on a thorough review of available UUT-UCC guidelines and papers identified using a systematic search of Medline. Data on urothelial malignancies and UUT-UCCs in the literature were searched using Medline with the following keywords: urinary tract cancer, urothelial carcinomas, upper urinary tract, carcinoma, transitional cell, renal pelvis, ureter, bladder cancer, chemotherapy, nephroureterectomy, adjuvant treatment, neoadjuvant treatment, recurrence, risk factors, and survival. A panel of experts weighted the references. Evidence synthesis: There is a lack of data in the current literature to provide strong recommendations due to the rarity of the disease. A number of recent multicentre studies are now available, whereas earlier publications were based only on limited populations. However, most of these studies have been retrospective analyses. The TNM classification 2009 is recommended. Recommendations are given for diagnosis as well as for radical and conservative treatment; prognostic factors are also discussed. Recommendations are provided for patient follow-up after different therapeutic options. Conclusions: These guidelines contain information for the diagnosis and treatment of individual patients according to a current standardised approach. When determining the optimal treatment regimen, physicians must take into account each individual patient's specific clinical characteristics with regard to renal function including medical comorbidities; tumour location, grade and stage; and molecular marker status. © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved. Source