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Article ; Online: Editorial Comment.

Metzner, Thomas J / Leppert, John T

2017 Volume 100, Page(s) 156–157

Language	English
Publishing date	2017-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2016.10.048
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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: The Harms of Overdiagnosis and Overtreatment in Patients with Small Renal Masses: A Mini-review.

Sohlberg, Ericka M / Metzner, Thomas J / Leppert, John T

European urology focus

2019 Volume 5, Issue 6, Page(s) 943–945

Abstract: Overdiagnosis and overtreatment refer to the detection and treatment of conditions that would not ultimately affect an individual's health. With increasing detection of small renal masses there is growing awareness of the overdiagnosis and overtreatment ... ...

Abstract	Overdiagnosis and overtreatment refer to the detection and treatment of conditions that would not ultimately affect an individual's health. With increasing detection of small renal masses there is growing awareness of the overdiagnosis and overtreatment of these tumors, supported by studies showing that 15-30% of nephrectomy specimens are pathologically benign, and that many small renal cell carcinomas are indolent. The harms of overdiagnosis and overtreatment are numerous, including psychosocial stressors and renal morbidity, in addition to unnecessary surgical complications. A greater understanding of the potential harms of overdiagnosis and overtreatment is crucial as clinicians focus on optimizing patient selection for renal mass biopsy, active surveillance protocols, and minimally invasive surgery. PATIENT SUMMARY: In this mini-review we discuss the issues of overdiagnosis and overtreatment in patients with kidney cancer. We enumerate the risks of overdiagnosis and overtreatment, and examine the next steps towards preventing these harms.
MeSH term(s)	Awareness ; Biopsy ; Carcinoma, Renal Cell/epidemiology ; Carcinoma, Renal Cell/mortality ; Carcinoma, Renal Cell/surgery ; Decision Making, Shared ; Humans ; Incidence ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/pathology ; Medical Overuse/statistics & numerical data ; Minimally Invasive Surgical Procedures/methods ; Nephrectomy/methods ; Patient Selection ; Watchful Waiting/methods
Language	English
Publishing date	2019-03-21
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2405-4569
ISSN (online)	2405-4569
DOI	10.1016/j.euf.2019.03.006
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Article: Early Changes in CT Perfusion Parameters: Primary Renal Carcinoma Versus Metastases After Treatment with Targeted Therapy.

Fan, Alice C / Sundaram, Vandana / Kino, Aya / Schmiedeskamp, Heiko / Metzner, Thomas J / Kamaya, Aya

Cancers

2019 Volume 11, Issue 5

Abstract: Computed tomography (CT) perfusion is a novel imaging method to determine tumor perfusion using a low-dose CT technique to measure iodine concentration at multiple time points. We determined if early changes in perfusion differ between primary renal ... ...

Abstract	Computed tomography (CT) perfusion is a novel imaging method to determine tumor perfusion using a low-dose CT technique to measure iodine concentration at multiple time points. We determined if early changes in perfusion differ between primary renal tumors and metastatic tumor sites in patients with renal cell carcinoma (RCC) receiving targeted anti-angiogenic therapy. A total of 10 patients with advanced RCC underwent a CT perfusion scan at treatment baseline and at one week after initiating treatment. Perfusion measurements included blood volume (BV), blood flow (BF), and flow extraction product (FEP) in a total of 13 lesions (six primary RCC tumors, seven RCC metastases). Changes between baseline and week 1 were compared between tumor locations: primary kidney tumors vs metastases. Metastatic lesions had a greater decrease in BF (average BF difference ± standard deviation (SD): -75.0 mL/100 mL/min ± 81) compared to primary kidney masses (-25.5 mL/100 mL/min ± 35). Metastatic tumors had a wider variation of change in BF, BV and FEP measures compared to primary renal tumors. Tumor diameters showed little change after one week, but early perfusion changes are evident, especially in metastatic lesions compared to primary lesions. Future studies are needed to determine if these changes can predict which patients are benefiting from targeted therapy.
Language	English
Publishing date	2019-04-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers11050608
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Article ; Online: Detecting androgen receptor (AR), AR variant 7 (AR-V7), prostate-specific membrane antigen (PSMA), and prostate-specific antigen (PSA) gene expression in CTCs and plasma exosome-derived cfRNA in patients with metastatic castration-resistant prostate cancer (mCRPC) by integrating the VTX-1 CTC isolation system with the QIAGEN AdnaTest.

Liu, Haiyan E / Vuppalapaty, Meghah / Hoerner, Christian R / Bergstrom, Colin P / Chiu, Michael / Lemaire, Clementine / Che, James / Kaur, Amanpreet / Dimmick, Adam / Liu, Sean / Metzner, Thomas J / Araya, Menna / Crouse, Steve / Sprenger-Haussels, Markus / Schlumpberger, Martin / Leppert, John T / Hauch, Siegfried / Sollier, Elodie / Fan, Alice C

BMC cancer

2024 Volume 24, Issue 1, Page(s) 482

Abstract: Background: Therapies for metastatic castration-resistant prostate cancer (mCRPC) include targeting the androgen receptor (AR) with androgen receptor inhibitors (ARIs) and prostate-specific membrane antigen (PSMA). Having the ability to detect AR, AR ... ...

Abstract	Background: Therapies for metastatic castration-resistant prostate cancer (mCRPC) include targeting the androgen receptor (AR) with androgen receptor inhibitors (ARIs) and prostate-specific membrane antigen (PSMA). Having the ability to detect AR, AR splice variant 7 (AR-V7), or PSMA in circulating tumor cells (CTCs) or circulating exosomal cell-free RNA (cfRNA) could be helpful to guide selection of the appropriate therapy for each individual patient. The Vortex Biosciences VTX-1 system is a label-free CTC isolation system that enables the detection of the expression of multiple genes in both CTCs and exosomal cfRNA from the same blood sample in patients with mCRPC. Detection of both AR-V7 and PSMA gene expression in both CTCs and cfRNA simultaneously has not yet been reported. Methods: To characterize the combined VTX-1-AdnaDetect workflow, 22Rv1 cancer cells were spiked into blood from healthy donors and processed with the VTX-1 to mimic patient samples and assess performances (capture efficiency, purity, AR and AR-V7 expression). Then, we collected 19 blood samples from 16 patients with mCRPC and therapeutic resistance to androgen receptor inhibitors (ARIs). Plasma was separated and the plasma-depleted blood was processed further with the VTX-1 to collect CTCs. Both plasma exosomal cfRNA and CTCs were subsequently analyzed for AR, AR-V7, PSMA, and prostate-specific antigen (PSA) mRNA expression using the AdnaTest ProstateCancerPanel AR-V7 assay. Results: AR-V7 expression could be detected in 22Rv1 cells spiked into blood from healthy volunteers as well as in CTCs and plasma-derived exosomal cfRNA from patients with mCRPC by processing blood with the VTX-1 CTC isolation system followed by the AdnaTest ProstateCancerPanel AR-V7 assay. 94.7% of patient blood samples (18/19) had detectable AR expression in either CTCs or exosomal cfRNA (16 in CTCs, 12 in cfRNA). 15.8% of the 19 patient blood samples (3/19) were found to have AR-V7-positive (AR-V7+) CTCs, one of which was also AR-V7+ in the exosomal cfRNA analysis. 42.1% of patient blood samples (8/19) were found to be PSMA positive (PSMA+): 26.3% (5/19) were PSMA+ in the CTC analysis and 31.6% (6/19) were PSMA+ in the exosomal cfRNA analysis. Of those 8 PSMA+ samples, 2 had detectable PSMA only in CTCs, and 3 had detectable PSMA only in exosomal cfRNA. Conclusion: VTX-1 enables isolation of CTCs and plasma exosomes from a single blood draw and can be used for detecting AR-V7 and PSMA mRNA in both CTCs and cfRNA in patients with mCRPC and resistance to ARIs. This technology facilitates combining RNA measurements in CTCs and exosomal cfRNA for future studies to develop potentially clinically relevant cancer biomarker detection in blood.
MeSH term(s)	Humans ; Male ; Androgen Receptor Antagonists/pharmacology ; Androgen Receptor Antagonists/therapeutic use ; Biomarkers, Tumor/genetics ; Cell-Free Nucleic Acids/genetics ; Cell-Free Nucleic Acids/metabolism ; Exosomes/genetics ; Exosomes/metabolism ; Neoplastic Cells, Circulating/pathology ; Prostate/pathology ; Prostate-Specific Antigen ; Prostatic Neoplasms, Castration-Resistant/drug therapy ; Protein Isoforms/genetics ; Receptors, Androgen/genetics ; Receptors, Androgen/metabolism ; RNA, Messenger/genetics
Chemical Substances	Androgen Receptor Antagonists ; Biomarkers, Tumor ; Cell-Free Nucleic Acids ; Prostate-Specific Antigen (EC 3.4.21.77) ; Protein Isoforms ; Receptors, Androgen ; RNA, Messenger
Language	English
Publishing date	2024-04-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2041352-X
ISSN	1471-2407 ; 1471-2407
ISSN (online)	1471-2407
ISSN	1471-2407
DOI	10.1186/s12885-024-12139-3
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Article ; Online: Preclinical Testing of a Combination Stone Basket and Ureteral Balloon to Extract Ureteral Stones.

Massoudi, Rustin / Metzner, Thomas J / Bonneau, Buzz / Ngo, Tin C / Shinghal, Rajesh / Leppert, John T

Journal of endourology

2018 Volume 32, Issue 2, Page(s) 96–99

Abstract: We have developed the Peralta Stone Extraction System to increase the safety of ureteral stone extraction. The device combines a nitinol stone basket and low-pressure balloon into a single device. After visualization, the stone is captured in the tipless ...

Abstract	We have developed the Peralta Stone Extraction System to increase the safety of ureteral stone extraction. The device combines a nitinol stone basket and low-pressure balloon into a single device. After visualization, the stone is captured in the tipless nitinol basket and enveloped by a low-pressure balloon. We tested the performance of device prototypes in a porcine model using stone mimics with diameters ranging from 4.2 to 6.2 mm. Stones extracted with the device required less force when compared with stones in a standard ureteral stone basket. The force reduction was most pronounced for stones greater than 4.2 mm in diameter, and when traversing a ureteral stenosis model. In conclusion, a combination stone basket and balloon device may provide a new and safer way to extract ureteral stones.
MeSH term(s)	Alloys ; Animals ; Dilatation/instrumentation ; Humans ; Hysteroscopes ; Male ; Swine ; Ureteral Calculi/surgery ; Ureteral Obstruction/surgery ; Ureteroscopy/instrumentation
Chemical Substances	Alloys ; nitinol (2EWL73IJ7F)
Language	English
Publishing date	2018-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	356931-7
ISSN	1557-900X ; 0892-7790
ISSN (online)	1557-900X
ISSN	0892-7790
DOI	10.1089/end.2017.0626
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Zs.A 2628: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Clinical laboratory tests associated with survival in patients with metastatic renal cell carcinoma: A Laboratory Wide Association Study (LWAS).

Velaer, Kyla / Thomas, I-Chun / Yang, Jaden / Kapphahn, Kristopher / Metzner, Thomas J / Golla, Abhinav / Hoerner, Christian R / Fan, Alice C / Master, Viraj / Chertow, Glenn M / Brooks, James D / Patel, Chirag J / Desai, Manisha / Leppert, John T

Urologic oncology

2021 Volume 40, Issue 1, Page(s) 12.e23–12.e30

Abstract: Background: Prognostic models for patients with metastatic renal cell carcinoma (mRCC) include select laboratory values. These models have important limitations, including reliance on a limited array of laboratory tests, and use of dichotomous ("high- ... ...

Abstract	Background: Prognostic models for patients with metastatic renal cell carcinoma (mRCC) include select laboratory values. These models have important limitations, including reliance on a limited array of laboratory tests, and use of dichotomous ("high-low") cutoffs. We applied a Laboratory-Wide Association Study (LWAS) framework to systematically evaluate common clinical laboratory results associated with survival for patients diagnosed with mRCC. Methods: We used laboratory data for 3,385 patients diagnosed with mRCC from 2002 to 2017. We developed a LWAS framework, to examine the association with 53 common clinical laboratory tests results (641,712 measurements) and overall survival. We employed false-discovery rate to test the association of multiple laboratory tests with survival, and validated these results using 3 separate cohorts to generate a standardized hazard ratio (sHR), reported for a 1 standard deviation unit change in each laboratory test. Results: The LWAS approach confirmed the association of laboratory values currently used in prognostic models with survival, including calcium (HR 1.35, 95%CI 1.24-1.48), leukocyte count (HR 1.40, 95%CI 1.30-1.51), platelet count (HR 1.36, 95%CI 1.27-1.51), and hemoglobin (HR 0.79, 95%CI 0.72-0.86). Use of these tests as continuous variables improved model performance. LWAS also identified acute phase reactants associated with survival not typically included in prognostic models, including serum albumin (HR 0.66, 95%CI 0.61-0.72), ferritin (HR 1.25, 95%CI 1.08-1.45), alkaline phosphatase (HR 1.31, 95%CI 1.23-1.40), and C-reactive protein (HR 1.70, 95%CI 1.14-2.53). Conclusions: Routinely measured laboratory tests can refine current prognostic models, facilitate comparisons across clinical trial cohorts, and match patients with specific systemic therapies.
MeSH term(s)	Aged ; Carcinoma, Renal Cell/blood ; Carcinoma, Renal Cell/mortality ; Carcinoma, Renal Cell/secondary ; Cohort Studies ; Female ; Hematologic Tests ; Humans ; Kidney Neoplasms/blood ; Kidney Neoplasms/mortality ; Kidney Neoplasms/pathology ; Laboratories, Clinical ; Male ; Middle Aged ; Prognosis ; Survival Rate
Language	English
Publishing date	2021-09-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2021.08.011
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Article ; Online: Surface-Enhanced Raman Scattering Nanoparticles for Multiplexed Imaging of Bladder Cancer Tissue Permeability and Molecular Phenotype.

Davis, Ryan M / Kiss, Bernhard / Trivedi, Dharati R / Metzner, Thomas J / Liao, Joseph C / Gambhir, Sanjiv S

ACS nano

2018 Volume 12, Issue 10, Page(s) 9669–9679

Abstract: Bladder cancer has the highest recurrence rate of all cancers due in part to inadequate transurethral resection. Inadequate resection is caused by the inability of cystoscopes to detect invisible lesions during the resection procedure. To improve ... ...

Abstract	Bladder cancer has the highest recurrence rate of all cancers due in part to inadequate transurethral resection. Inadequate resection is caused by the inability of cystoscopes to detect invisible lesions during the resection procedure. To improve detection and resection of nonmuscle invasive bladder cancer, we quantified the ability of a surface-enhanced Raman nanoparticle and endoscope system to classify bladder tissue as normal or cancerous. Both antibody-based (active) and tissue permeability-based (passive) targeting mechanisms were evaluated by topically applying nanoparticles to ex vivo human bladder tissue samples. Multiplexed molecular imaging of CD47 and Carbonic Anhydrase 9 tumor proteins gave a receiver operating characteristic area under the curve (ROC AUC of 0.93 (0.75, 1.00). Furthermore, passively targeted nanoparticles enabled tissue classification with an ROC AUC of 0.93 (0.73, 1.00). Passively targeted nanoparticles penetrated 5-fold deeper and bound to tumor tissue at 3.3-fold higher concentrations in cancer compared to normal bladder urothelium, suggesting the existence of an enhanced surface permeability and retention effect in human bladder cancer.
MeSH term(s)	Antigens, Neoplasm/analysis ; Antigens, Neoplasm/metabolism ; CD47 Antigen/analysis ; CD47 Antigen/metabolism ; Carbonic Anhydrase IX/analysis ; Carbonic Anhydrase IX/metabolism ; Cell Line, Tumor ; HCT116 Cells ; Humans ; Molecular Imaging ; Nanoparticles/chemistry ; Particle Size ; Permeability ; Phenotype ; Spectrum Analysis, Raman ; Surface Properties ; Urinary Bladder Neoplasms/diagnostic imaging ; Urinary Bladder Neoplasms/metabolism
Chemical Substances	Antigens, Neoplasm ; CD47 Antigen ; CD47 protein, human ; CA9 protein, human (EC 4.2.1.1) ; Carbonic Anhydrase IX (EC 4.2.1.1)
Language	English
Publishing date	2018-09-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	1936-086X
ISSN (online)	1936-086X
DOI	10.1021/acsnano.8b03217
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Article ; Online: Development of a DNA Methylation-Based Diagnostic Signature to Distinguish Benign Oncocytoma From Renal Cell Carcinoma.

Brennan, Kevin / Metzner, Thomas J / Kao, Chia-Sui / Massie, Charlie E / Stewart, Grant D / Haile, Robert W / Brooks, James D / Hitchins, Megan P / Leppert, John T / Gevaert, Olivier

JCO precision oncology

2020 Volume 4

Abstract: Purpose: A challenge in the diagnosis of renal cell carcinoma (RCC) is to distinguish chromophobe RCC (chRCC) from benign renal oncocytoma, because these tumor types are histologically and morphologically similar, yet they require different clinical ... ...

Abstract	Purpose: A challenge in the diagnosis of renal cell carcinoma (RCC) is to distinguish chromophobe RCC (chRCC) from benign renal oncocytoma, because these tumor types are histologically and morphologically similar, yet they require different clinical management. Molecular biomarkers could provide a way of distinguishing oncocytoma from chRCC, which could prevent unnecessary treatment of oncocytoma. Such biomarkers could also be applied to preoperative biopsy specimens such as needle core biopsy specimens, to avoid unnecessary surgery of oncocytoma. Methods: We profiled DNA methylation in fresh-frozen oncocytoma and chRCC tumors and adjacent normal tissue and used machine learning to identify a signature of differentially methylated cytosine-phosphate-guanine sites (CpGs) that robustly distinguish oncocytoma from chRCC. Results: Unsupervised clustering of Stanford and preexisting RCC data from The Cancer Genome Atlas (TCGA) revealed that of all RCC subtypes, oncocytoma is most similar to chRCC. Unexpectedly, however, oncocytoma features more extensive, overall abnormal methylation than does chRCC. We identified 79 CpGs with large methylation differences between oncocytoma and chRCC. A diagnostic model trained on 30 CpGs could distinguish oncocytoma from chRCC in 10-fold cross-validation (area under the receiver operating curve [AUC], 0.96 (95% CI, 0.88 to 1.00)) and could distinguish TCGA chRCCs from an independent set of oncocytomas from a previous study (AUC, 0.87). This signature also separated oncocytoma from other RCC subtypes and normal tissue, revealing it as a standalone diagnostic biomarker for oncocytoma. Conclusion: This CpG signature could be developed as a clinical biomarker to support differential diagnosis of oncocytoma and chRCC in surgical samples. With improved biopsy techniques, this signature could be applied to preoperative biopsy specimens.
Language	English
Publishing date	2020-09-28
Publishing country	United States
Document type	Journal Article
ISSN	2473-4284
ISSN (online)	2473-4284
DOI	10.1200/PO.20.00015
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Article ; Online: Nanoparticle-enabled innate immune stimulation activates endogenous tumor-infiltrating T cells with broad antigen specificities.

Yin, Qian / Yu, Wong / Grzeskowiak, Caitlin L / Li, Jing / Huang, Huang / Guo, Jing / Chen, Liang / Wang, Feng / Zhao, Fan / von Boehmer, Lotta / Metzner, Thomas J / Leppert, John T / Chien, Yueh-Hsiu / Kuo, Calvin J / Davis, Mark M

Proceedings of the National Academy of Sciences of the United States of America

2021 Volume 118, Issue 21

Abstract: Tumors are often infiltrated by T lymphocytes recognizing either self- or mutated antigens but are generally inactive, although they often show signs of prior clonal expansion. Hypothesizing that this may be due to peripheral tolerance, we formulated ... ...

Abstract	Tumors are often infiltrated by T lymphocytes recognizing either self- or mutated antigens but are generally inactive, although they often show signs of prior clonal expansion. Hypothesizing that this may be due to peripheral tolerance, we formulated nanoparticles containing innate immune stimulants that we found were sufficient to activate self-specific CD8
MeSH term(s)	Animals ; Antigens/genetics ; Antigens/immunology ; CD4-Positive T-Lymphocytes/drug effects ; Cell Line, Tumor ; Humans ; Immunity, Innate/drug effects ; Lymphocytes, Tumor-Infiltrating/drug effects ; Melanoma, Experimental/immunology ; Melanoma, Experimental/therapy ; Mice ; Nanoparticles/therapeutic use
Chemical Substances	Antigens
Language	English
Publishing date	2021-05-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2016168118
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Article ; Online: Optical biopsy of penile cancer with in vivo confocal laser endomicroscopy.

Shkolyar, Eugene / Laurie, Mark A / Mach, Kathleen E / Trivedi, Dharati R / Zlatev, Dimitar V / Chang, Timothy C / Metzner, Thomas J / Leppert, John T / Kao, Chia-Sui / Liao, Joseph C

Urologic oncology

2019 Volume 37, Issue 11, Page(s) 809.e1–809.e8

Abstract: Introduction: Surgical management of penile cancer depends on accurate margin assessment and staging. Advanced optical imaging technologies may improve penile biopsy and organ-sparing treatment. We evaluated the feasibility of confocal laser ... ...

Abstract	Introduction: Surgical management of penile cancer depends on accurate margin assessment and staging. Advanced optical imaging technologies may improve penile biopsy and organ-sparing treatment. We evaluated the feasibility of confocal laser endomicroscopy for intraoperative assessment of benign and malignant penile tissue. Patients and methods: With institutional review board approval, 11 patients were recruited, 9 with suspected penile cancer, and 2 healthy controls. Confocal laser endomicroscopy using a 2.6-mm fiber-optic probe was performed at 1 or 2 procedures on all subjects, for 13 imaging procedures. Fluorescein was administered intravenously approximately 3 minutes prior to imaging for contrast. Video sequences from in vivo (n = 12) and ex vivo (n = 6) imaging were obtained of normal glans, suspicious lesions, and surgical margins. Images were processed, annotated, characterized, and correlated with standard hematoxylin and eosin histopathology. Results: No adverse events related to imaging were reported. Distinguishing features of benign and malignant penile tissue could be identified by confocal laser endomicroscopy. Normal skin had cells of uniform size and shape, with distinct cytoplasmic membranes consistent with squamous epithelium. Malignant lesions were characterized by disorganized, crowded cells of various size and shape, lack of distinct cytoplasmic membranes, and hazy, moth-eaten appearance. The transition from normal to abnormal squamous epithelium could be identified. Conclusions: We report the initial feasibility of intraoperative confocal laser endomicroscopy for penile cancer optical biopsy. Pending further evaluation, confocal laser endomicroscopy could serve as an adjunct or replacement to conventional frozen section pathology for management of penile cancer.
MeSH term(s)	Aged ; Aged, 80 and over ; Feasibility Studies ; Humans ; Image-Guided Biopsy ; Intraoperative Period ; Male ; Microscopy, Confocal ; Penile Neoplasms/pathology ; Penile Neoplasms/surgery
Language	English
Publishing date	2019-09-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2019.08.018
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