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Article ; Online: Beyond the knife: strategic patient selection for cytoreductive nephrectomy.

Brönimann, Stephan / Ged, Yasser / Singla, Nirmish

2024 Volume 34, Issue 3, Page(s) 210–216

Abstract: Purpose of review: To evaluate the current role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) within the context of evolving treatment paradigms, focusing on implications for patient selection.: Recent findings: Two ... ...

Abstract	Purpose of review: To evaluate the current role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) within the context of evolving treatment paradigms, focusing on implications for patient selection. Recent findings: Two randomized trials failed to show significant benefits from CN for intermediate and poor-risk patients undergoing targeted therapy. Despite this, subgroup analysis and retrospective data suggest potential benefits for a subset of good and intermediate-risk patients. Although currently used risk stratification tools guide CN eligibility, they have limitations, including, subjectivity, perioperative variability, and missing validation. Deferred CN may benefit patients responding to systemic treatment, whereas other patients may benefit from upfront CN. Emerging data supports the value of CN with immune checkpoint inhibitors (ICI) in selected patients, emphasizing the need for ongoing trials in the ICI era. Summary: The role and timing of CN in mRCC have evolved across therapeutic eras. Although awaiting prospective evidence in the current era of ICI, CN still has a role in the therapeutic approach for a subset of patients. The decision to recommend CN must be personalized and involve multidisciplinary discussions considering both patient- and tumor-related factors.
MeSH term(s)	Humans ; Carcinoma, Renal Cell/surgery ; Carcinoma, Renal Cell/drug therapy ; Kidney Neoplasms/pathology ; Cytoreduction Surgical Procedures ; Retrospective Studies ; Patient Selection ; Prospective Studies ; Nephrectomy
Language	English
Publishing date	2024-01-18
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000001160
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Article ; Online: Treatment of adrenocortical carcinoma: oncological and endocrine outcomes.

Brönimann, Stephan / Garstka, Nathalie / Remzi, Mesut

Current opinion in urology

2022 Volume 33, Issue 1, Page(s) 50–58

Abstract: Purpose of review: Adrenocortical carcinoma (ACC) is a rare, aggressive disease with a paucity of data and great variability between published studies regarding its treatment. This review provides information on current clinical management and ... ...

Abstract	Purpose of review: Adrenocortical carcinoma (ACC) is a rare, aggressive disease with a paucity of data and great variability between published studies regarding its treatment. This review provides information on current clinical management and oncological and endocrine outcomes. Recent findings: Complete surgical resection is the only potentially curative treatment for adrenocortical carcinoma (ACC). Adjuvant mitotane treatment is recommended in patients with favourable/intermediate prognosis. As part of the endocrine follow-up, steroid hormones and thyroid hormones may be decreased or increased and may need to be substituted or suppressed. Recurrences are common. If the disease-free interval is more than 12 months, surgery is a treatment if complete resection is feasible. In advanced/metastatic ACC patients, the prognosis is poor. Mitotane monotherapy is only appropriate for patients with low tumour burden and indolent disease. Patients with unfavourable prognosis should be treated with aggressive cytotoxic therapy. Patients requiring third-line treatment should be considered for clinical trials. Immunotherapy and targeted therapy are currently being investigated, but have so far yielded only unsatisfactory results. Summary: There is scarce evidence for the treatment of ACC, which often complicates clinical decision-making. Patients who progress on EDP-M should be treated in clinical trials.
MeSH term(s)	Humans ; Mitotane ; Adrenocortical Carcinoma/surgery ; Medical Oncology ; Immunotherapy ; Rare Diseases ; Adrenal Cortex Neoplasms/surgery
Chemical Substances	Mitotane (78E4J5IB5J)
Language	English
Publishing date	2022-10-21
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000001045
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Article ; Online: Increase and Plateauing of Testicular Cancer Incidence in Austria-A Time Trend Analysis of the Past Four Decades.

Brönimann, Stephan / Mun, Dong-Ho / Hackl, Monika / Yang, Lin / Shariat, Shahrokh F / Waldhoer, Thomas

European urology open science

2023 Volume 49, Page(s) 104–109

Abstract: Background: Testicular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have ... ...

Abstract	Background: Testicular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have been increasing in many countries since, at least, the mid-20th century. Objective: To investigate the incidence rates of TGCTs in Austria by analyzing data from the Austrian Cancer Registry. Design setting and participants: Available data between 1983 and 2018 were provided by the Austrian National Cancer Registry and analyzed retrospectively. Outcome measurements and statistical analysis: Germ cell tumors derived from germ cell neoplasia in situ were classified into seminomas and nonseminomas. Age-specific incidence rates and age-standardized rates were calculated. Annual percent changes (APCs) and average annual percent changes in incidence rates were determined to describe trends from 1983 to 2018. All statistical analyses were performed using SAS version 9.4 and joinpoint. Results and limitations: The study population consists of 11 705 patients diagnosed with TGCTs. The median age at diagnosis was 37.7 yr. The standardized incidence rate of TGCTs increased significantly ( Conclusions: The incidence rate of TGCTs increased in Austria over the past decades and appears to have reached a plateau at a high level. A time trend analysis by age group for the overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. These data should lead to awareness campaigns and research to further investigate the causes of this development. Patient summary: We reviewed the data between 1983 and 2018 provided by the Austrian National Cancer Registry to analyze the incidence and incidence trend in testicular cancer. Testicular cancer shows an increasing incidence in Austria. The overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. The incidence appears to have reached a plateau at a high level in recent years.
Language	English
Publishing date	2023-02-06
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2023.01.005
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Article ; Online: Ischemic Priapism in a 12 Year Old Patient Associated With Coronavirus Disease 2019 (COVID-19): A Case Report.

Brönimann, Stephan / Thalhammer, Florian / Springer, Alexander / Tonnhofer, Ursula / Shariat, Shahrokh F / D'Andrea, David

Urology

2022 Volume 165, Page(s) 316–318

Abstract: Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been associated with changes in blood coagulation resulting in increased incidence of venous thromboembolic events and coagulopathy. Moreover, single cases of ischemic ... ...

Abstract	Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been associated with changes in blood coagulation resulting in increased incidence of venous thromboembolic events and coagulopathy. Moreover, single cases of ischemic priapism have been reported in adult patients with SARS-CoV-2 infection. In this report, we describe the case of ischemic priapism in a 12-year-old child with recent SARS- CoV-2 infection.
MeSH term(s)	COVID-19/complications ; Child ; Humans ; Male ; Priapism/etiology ; SARS-CoV-2 ; Venous Thromboembolism ; Venous Thrombosis
Language	English
Publishing date	2022-01-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2022.01.022
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Zs.A 1142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Poly(ADP-ribose) polymerase inhibitors in prostate and urothelial cancer.

Brönimann, Stephan / Lemberger, Ursula / Bruchbacher, Andreas / Shariat, Shahrokh F / Hassler, Melanie R

Current opinion in urology

2020 Volume 30, Issue 4, Page(s) 519–526

Abstract: Purpose of review: The aim of this article is to give an overview of poly(ADP-ribose) polymerase inhibitors (PARPis) trials in prostate cancer and to discuss emerging approaches with potential future clinical implementation in both prostate and ... ...

Abstract	Purpose of review: The aim of this article is to give an overview of poly(ADP-ribose) polymerase inhibitors (PARPis) trials in prostate cancer and to discuss emerging approaches with potential future clinical implementation in both prostate and urothelial cancer. Recent findings: PARPis are a class of drugs that can be applied for the treatment of homologous recombination repair (HRR)-deficient tumors. Tumors are potentially sensitive to PARPi harbor mutations in genes relevant for DNA damage repair, such as BRCA1/2 or ATM, which are present to a significant degree in metastatic prostate and urothelial cancer patients. Several PARPis have been successfully tested in clinical trials for HRR-deficient metastatic castration-resistant prostate cancer (mCRPC), and olaparib and rucaparib have recently received breakthrough approval in BRCA1/2 mutated mCRPC. Combination treatment of PARPis with androgen-receptor inhibitors or with checkpoint inhibitors and earlier frontline applications are currently being evaluated, and clinical trials enrolling bladder cancer (BCa) patients with HRR deficiency have recently been initiated. Summary: Approximately 10% of mCRPC patients and 34% of metastatic BCa patients have tumors with HRR deficiency and may benefit from PARPi treatment. Correct identification of these patients as well as determining the most adequate time point for drug administration will be key to successful clinical implementation.
MeSH term(s)	Carcinoma, Transitional Cell ; DNA Damage ; Enzyme Inhibitors/therapeutic use ; Humans ; Male ; Neoplasm Metastasis ; Nucleic Acid Synthesis Inhibitors/therapeutic use ; Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/pathology ; Urinary Bladder Neoplasms/drug therapy ; Urinary Bladder Neoplasms/pathology
Chemical Substances	Enzyme Inhibitors ; Nucleic Acid Synthesis Inhibitors ; Poly(ADP-ribose) Polymerase Inhibitors
Language	English
Publishing date	2020-07-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000776
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Article ; Online: An up-to-date catalogue of urinary markers for the management of prostate cancer.

Brönimann, Stephan / Pradere, Benjamin / Karakiewicz, Pierre / Huebner, Nicolai A / Briganti, Alberto / Shariat, Shahrokh F

Current opinion in urology

2020 Volume 30, Issue 5, Page(s) 684–688

Abstract: 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 ... ...

Abstract	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 considered as additional parameters together with clinical and imaging modalities to decrease unnecessary biopsies. miR Sentinel Tests could make it possible to accurately detect the presence of cancer and to distinguish low-grade from high-grade disease. In men with previous negative biopsies, PCA3 may suggest the need to repeat biopsy. Summary: The definitive role of these markers and their clinical benefit needs future validation.
MeSH term(s)	Antigens, Neoplasm/urine ; Biomarkers, Tumor/urine ; Biopsy ; Humans ; Male ; Prostate/diagnostic imaging ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/urine ; Urinalysis/methods ; Urinalysis/trends
Chemical Substances	Antigens, Neoplasm ; Biomarkers, Tumor ; Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2020-07-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000807
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Article ; Online: An overview of current and emerging diagnostic, staging and prognostic markers for prostate cancer.

Brönimann, Stephan / Pradere, Benjamin / Karakiewicz, Pierre / Abufaraj, Mohammad / Briganti, Alberto / Shariat, Shahrokh F

Expert review of molecular diagnostics

2020 Volume 20, Issue 8, Page(s) 841–850

Abstract: Introduction: This manuscript aims to give an overview of current diagnostic, staging, and prognostic markers for prostate cancer (PCa) and discuss emerging approaches. The widespread use of PSA for early detection led to improved survival but at the ... ...

Abstract	Introduction: This manuscript aims to give an overview of current diagnostic, staging, and prognostic markers for prostate cancer (PCa) and discuss emerging approaches. The widespread use of PSA for early detection led to improved survival but at the cost of over-diagnosis, often associated with over-treatment and its adverse events. There is thus an unmet need for new markers to sustainably improve the diagnosis and risk assessment, thereby providing a more accurate treatment decision for each individual patient. Areas covered: Promising new molecular serum (PSA, PHI, 4Kscore®), urine (Progensa®, SelectMDx®, MiPS) and tissue-based markers (Ki-67, Prolaris®, ConfirmMDx®, Oncotype Dx®, Decipher®, Promark®) will be discussed in this review. Expert opinion: Over-diagnosis and difficulties in prognosticating clinical outcome among patients with similar histological and clinical parameters often lead to over- or under-treatment. New markers will probably be used with clinical and histopathological features as well as imaging diagnostics to capture the comprehensive biology and clinical behavior of PCa. New biomarkers open the avenue to avoid mpMRI with targeted biopsy in the future, thereby sparing risks and pitfalls associated with this approach. Before this utopia becomes reality, the panel of technologically complementary markers need to prove that they are better, cheaper, and faster than current strategies.
MeSH term(s)	Biomarkers, Tumor ; Clinical Decision-Making ; Disease Management ; Disease Susceptibility ; Humans ; Male ; Molecular Diagnostic Techniques/methods ; Neoplasm Staging ; Prognosis ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/etiology
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2020-06-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2112530-2
ISSN	1744-8352 ; 1473-7159
ISSN (online)	1744-8352
ISSN	1473-7159
DOI	10.1080/14737159.2020.1785288
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Article ; Online: Secretion of severe acute respiratory syndrome coronavirus 2 in urine.

Brönimann, Stephan / Rebhan, Katharina / Lemberger, Ursula / Misrai, Vincent / Shariat, Shahrokh F / Pradere, Benjamin

Current opinion in urology

2020 Volume 30, Issue 5, Page(s) 735–739

Abstract: Purpose of review: Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse.: Recent findings: We could identify 34 publications including a total of 2172 ... ...

Abstract	Purpose of review: Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse. Recent findings: We could identify 34 publications including a total of 2172 patients. Among those, 549 patients were tested for SARS-CoV-2 secretion in urine, which was detected in only 38 patients (6.9%). Within the seven studies displaying positive results, the majority of positive patients (86.8%) was from not yet peer-reviewed studies including weak data and heterogeneous techniques for sample testing. Furthermore, none of the studies available in the literature addressed the virulence of detected viral RNA in urine. Summary: Overall, only seven studies were able to detect SARS-CoV-2 secretion in urine, all of them with a considerably low rate of positivity. However, these studies were of rather low quality considering their methodology. Despite this, as SARS-CoV-2 has been detected in urine, it is of importance to discuss safety and urinary hygiene protocols. Until further research provides valid data on viral shedding and virulence in urine, potential risk of transmission through urine cannot be ruled out. Therefore, safety and hygiene measures need to be discussed.
MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/urine ; Humans ; Pandemics ; Pneumonia, Viral/urine ; SARS-CoV-2 ; Virus Shedding
Keywords	covid19
Language	English
Publishing date	2020-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000808
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Article ; Online: Salvage Radical Prostatectomy for Radio-Recurrent Prostate Cancer: An Updated Systematic Review of Oncologic, Histopathologic and Functional Outcomes and Predictors of Good Response.

Grubmüller, Bernhard / Jahrreiss, Victoria / Brönimann, Stephan / Quhal, Fahad / Mori, Keiichiro / Heidenreich, Axel / Briganti, Alberto / Tilki, Derya / Shariat, Shahrokh F

Current oncology (Toronto, Ont.)

2021 Volume 28, Issue 4, Page(s) 2881–2892

Abstract: A valid treatment option for recurrence after definite radiotherapy (RT) for localized prostate cancer (PC) is salvage radical prostatectomy (SRP). However, data on SRP are scarce, possibly resulting in an underutilization. A systematic review was ... ...

Abstract	A valid treatment option for recurrence after definite radiotherapy (RT) for localized prostate cancer (PC) is salvage radical prostatectomy (SRP). However, data on SRP are scarce, possibly resulting in an underutilization. A systematic review was performed using MEDLINE (Pubmed), Embase, and Web of Science databases including studies published between January 1980 and April 2020. Overall, 23 English language articles including a total number of 2323 patients were selected according to PRISMA criteria. The overall median follow-up was 37.5 months (IQR 35.5-52.5). Biochemical-recurrence (BCR)-free probability ranged from 34% to 83% at five years, respectively, and from 31% to 37% at 10 years. Cancer specific survival (CSS) and overall survival (OS) ranged from 88.7% to 98% and 64% to 95% at five years and from 72% to 83% and 65% to 72% at 10 years, respectively. Positive surgical margins ranged from 14% to 45.8% and pathologic organ-confined disease was reported from 20% to 57%. The rate of pathologic > T2-disease ranged from 37% to 80% and pN1 disease differed between 0% to 78.4%. Pre-SRP PSA, pre-SRP Gleason Score (GS), pathologic stage after SRP, and pathologic lymph node involvement seemed to be the strongest prognostic factors for good outcomes. SRP provides accurate histopathological and functional outcomes, as well as durable cancer control. Careful patient counseling in a shared decision-making process is recommended.
MeSH term(s)	Humans ; Male ; Neoplasm Recurrence, Local ; Prostatectomy ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/surgery ; Salvage Therapy ; Treatment Outcome
Language	English
Publishing date	2021-07-29
Publishing country	Switzerland
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol28040252
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Article: Secretion of severe acute respiratory syndrome coronavirus 2 in urine

Brönimann, Stephan / Rebhan, Katharina / Lemberger, Ursula / Misrai, Vincent / Shariat, Shahrokh F / Pradere, Benjamin

Curr Opin Urol

Abstract: PURPOSE OF REVIEW: Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse. RECENT FINDINGS: We could identify 34 publications including a total of 2172 patients. ... ...

Abstract	PURPOSE OF REVIEW: Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse. RECENT FINDINGS: We could identify 34 publications including a total of 2172 patients. Among those, 549 patients were tested for SARS-CoV-2 secretion in urine, which was detected in only 38 patients (6.9%). Within the seven studies displaying positive results, the majority of positive patients (86.8%) was from not yet peer-reviewed studies including weak data and heterogeneous techniques for sample testing. Furthermore, none of the studies available in the literature addressed the virulence of detected viral RNA in urine. SUMMARY: Overall, only seven studies were able to detect SARS-CoV-2 secretion in urine, all of them with a considerably low rate of positivity. However, these studies were of rather low quality considering their methodology. Despite this, as SARS-CoV-2 has been detected in urine, it is of importance to discuss safety and urinary hygiene protocols. Until further research provides valid data on viral shedding and virulence in urine, potential risk of transmission through urine cannot be ruled out. Therefore, safety and hygiene measures need to be discussed.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #669954
Database	COVID19

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