23 results on '"Horninger, W"'
Search Results
2. The clinical trajectory of patients afflicted by rare histological variants of prostate carcinoma
- Author
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Artamonova, N., primary, Gallee, L., additional, Neuwirt, H., additional, Steiner, E., additional, Bektic, J., additional, Horninger, W., additional, and Heidegger, I., additional
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- 2024
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3. Zurückgewonnene Selbstständigkeit bei hoher und kompletter Querschnittslähmung der Frau
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Gulacsi, A., Kiss, G., Stühmeier, J., Pedrini, M., Horninger, W., and Rehder, P.
- Abstract
Statistisch gesehen sind weltweit mehr als 7 Mio. Menschen von einer Rückenmarkverletzung, darunter 2,7 Mio. von einer manifesten Querschnittslähmung, betroffen. In Österreich sind etwa 50.000 Patienten ausschließlich durch die Hilfe eines Rollstuhls mobil, davon sind etwa 4000 von einer Querschnittslähmung betroffen. Die Betreuung dieser Patienten stellt in der Praxis oft eine besondere Herausforderung dar. Große Bedeutung wird der Nachsorge beigemessen, die aufgrund spezieller Begleitumstände und der Komplikationsgefahren immanent wichtig ist. Aus urologischer Sicht ist eine neurourologische Betreuung unerlässlich. Dabei verändern sich die Therapieoptionen nach dem Maß des Verletzungsniveaus und sind zugleich geschlechterspezifisch. In diesem Artikel wird über die urologischen Aspekte der Versorgung von Frauen diskutiert, die von einer hohen Querschnittslähmung (Tetraplegie) betroffen sind.
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- 2024
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4. The influence of RAS-inhibitors on prostate cancer aggressiveness
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Faiß, L., primary, Klocker, H., additional, Steiner, E., additional, Kafka, M., additional, Ladurner, M., additional, Burtscher, T., additional, Bektic, J., additional, Horninger, W., additional, and Heidegger, I., additional
- Published
- 2022
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5. Biochemisches Rezidiv eines Prostatakarzinoms nach radikaler Prostatektomie: Soll man immer bis PSA 0,2 ng/ml warten?
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Ladurner, M, Moser, A, Heidegger-Pircher, I, Kafka, M, Burtscher, T, Giannini, G, Horninger, W, and Bektic, J
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ddc: 610 ,Medicine and health - Abstract
Einleitung: Die Standardtherapie des biochemischen Rezidivs (BCR) eines Prostatakarzinoms (PCa) nach radikaler Prostatektomie (RP) ohne Metastasennachweis, stellt eine perkutane Salvage Radiotherapie (SRT) des Prostatabetts dar. Es wurde bereits gezeigt, dass auch eine frühere SRT bei PSA Werten [zum vollständigen Text gelangen Sie über die oben angegebene URL]
- Published
- 2022
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6. Geringe diagnostische Wertigkeit der Kontroll-Bildgebung bei asymptomatischen stumpfen traumatischen Nierenrupturen: Erfahrungen eines high-volume Zentrums
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Pichler, R, Lindner, AK, Tulchiner, G, Stäblein, J, Aigner, F, Luger, A, Rehder, P, and Horninger, W
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ddc: 610 ,Medicine and health - Abstract
Einleitung: Obwohl aktuelle Leitlinien eine wiederholte Bildgebung bei hochgradigen stumpfen Nierenverletzungen innerhalb von 48 bis 96 Stunden auch ohne klinische Befunde empfehlen, bleiben die diagnostische Genauigkeit und die klinische Bedeutung der Kontroll-Bildgebung nach wie vor umstritten und [zum vollständigen Text gelangen Sie über die oben angegebene URL]
- Published
- 2022
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7. Der Einfluss von RAS-Inhibitoren auf die Prostatakarzinom-Aggressivität
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Faiß, L, Steiner, E, Kafka, M, Ladurner, M, Burtscher, T, Giannini, G, Bektic, J, Horninger, W, and Heidegger, I
- Subjects
ddc: 610 ,Medicine and health - Abstract
Einleitung: Die Kollagenbiosynthese hat eine wesentliche Bedeutung in der Prostatkarzinomentstehung und Progression. Rezent konnte in mehreren soliden Tumoren gezeigt werden, dass RAS-Inhibitoren (Renin-Angiotensin-System-Inhibitoren) eine wesentliche Rolle in der Kollagensynthese spielen, indem Angiotensin [zum vollständigen Text gelangen Sie über die oben angegebene URL]
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- 2022
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8. Low diagnostic and clinical accuracy of repeated imaging in asymptomatic blunt renal injuries – experiences of a high-volume urological trauma center
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Lindner, A.K., primary, Stäblein, J., additional, Aigner, F., additional, Luger, A., additional, Tulchiner, G., additional, Horninger, W., additional, Rehder, P., additional, and Pichler, R., additional
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- 2022
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9. P30 - The influence of RAS-inhibitors on prostate cancer aggressiveness
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Faiß, L., Klocker, H., Steiner, E., Kafka, M., Ladurner, M., Burtscher, T., Bektic, J., Horninger, W., and Heidegger, I.
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- 2022
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10. A0972 - Low diagnostic and clinical accuracy of repeated imaging in asymptomatic blunt renal injuries – experiences of a high-volume urological trauma center
- Author
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Lindner, A.K., Stäblein, J., Aigner, F., Luger, A., Tulchiner, G., Horninger, W., Rehder, P., and Pichler, R.
- Published
- 2022
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11. A0292 - The clinical trajectory of patients afflicted by rare histological variants of prostate carcinoma.
- Author
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Artamonova, N., Gallee, L., Neuwirt, H., Steiner, E., Bektic, J., Horninger, W., and Heidegger, I.
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PROSTATE , *CARCINOMA , *RETENTION of urine - Published
- 2024
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12. P257 - Impact of RAS inhibitors on prostate cancer aggressiveness – a retrospective multicenter analysis by the Young academic urologists prostate cancer group.
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Artamonova, N., Kafka, M., Faiss, L., Avetisyan, D., Puche Sanz, I., La Bombarda, G., Iacono, G., Zattoni, F., Steiner, E., D'Elia, C., Pycha, A., Gandaglia, G., Horninger, W., and Heidegger, I.
- Subjects
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PROSTATE cancer , *UROLOGISTS , *RETROSPECTIVE studies - Published
- 2024
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13. Real-world Outcomes and Predictive Biomarkers for 177 Lutetium Prostate-specific Membrane Antigen Ligand Treatment in Metastatic Castration-resistant Prostate Cancer: A European Association of Urology Young Academic Urologists Prostate Cancer Working Group Multi-institutional Observational Study.
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Kafka M, Horninger A, di Santo G, Virgolini I, Neuwirt H, Unterrainer LM, Kunte SC, Deiss E, Paffenholz P, Heidenreich A, Rasul S, Einspieler H, Shariat SF, Rajwa P, Dozauer R, Tsaur I, Medlock E, Rölz N, Rausch S, la Fougère C, Trautwein N, Roesch MC, Merseburger AS, Zattoni F, Sepulcri M, Ladurner M, Bektic J, Gandaglia G, Horninger W, and Heidegger I
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- Humans, Male, Retrospective Studies, Aged, Treatment Outcome, Biomarkers, Tumor blood, Middle Aged, Europe, Radioisotopes therapeutic use, Glutamate Carboxypeptidase II metabolism, Antigens, Surface metabolism, Aged, 80 and over, Prostate-Specific Antigen blood, Ligands, Neoplasm Metastasis, Prostatic Neoplasms, Castration-Resistant pathology, Prostatic Neoplasms, Castration-Resistant radiotherapy, Prostatic Neoplasms, Castration-Resistant drug therapy, Lutetium therapeutic use
- Abstract
Background: The European Association of Urology guidelines include the lutetium-177 (
177 Lu) PSMA-617 prostate-specific membrane antigen (PSMA) ligand as a therapy option for metastatic castration-resistant prostate cancer (mCRPC). A major challenge in clinical practice is to pursue a personalized treatment approach based on robust predictive biomarkers., Objective: To assess the performance of177 Lu PSMA in real-world practice and to elaborate clinical biomarkers for evaluating treatment responses., Design, Setting, and Participants: We conducted a retrospective observational study including 233 patients with mCRPC treated with177 Lu PSMA in eight high-volume European centers., Outcome Measurements and Statistical Analysis: Baseline characteristics and clinical parameters during and after177 Lu PSMA treatment were documented. Correlations to treatment response were analyzed using χ2 and log-rank tests, with differences between groups with and without disease progression calculated using a Mann-Whitney U test. Univariate and multivariate-adjusted hazard ratios (HRs) were measured using Cox proportional hazards models., Results and Limitations: A prostate-specific antigen (PSA) decrease of ≥30% was observed in 41.7%, 63.5%, and 77.8% of patients after the first, second, and third treatment cycle, respectively. Restaging performed via PSMA positron emission tomography-computed tomography revealed that 33.7% of patients had an imaging-based response, including two patients with a complete response, while 13.4% had stable disease. The median time to progression was 5 mo and the median time until the start of a consecutive antineoplastic therapy was 8.5 mo. Of importance, a PSA decrease ≥30% after the first two cycles of177 Lu PSMA (1 cycle: p = 0.0003; 2 cycles: p = 0.004), absolute PSA after the first three cycles (1 cycle: p = 0.011; 2 cycles: p = 0.0005; 3 cycles: p = 0.002), and a PSA doubling time >6 mo (p = 0.009) were significantly correlated to treatment response. Furthermore, gamma-glutamyl transferase ≤31 U/L at the start of177 Lu PSMA therapy was correlated with 1.5 times higher risk of progression for patients without but not with visceral metastases (p = 0.046)., Conclusions:177 Lu PSMA is an effective treatment option in mCRPC in the real-world setting. A PSA decrease ≥30% after the first two cycles is an early marker of response that can be easily implemented in clinical practice., Patient Summary:177 Lu PSMA is a radioactive agent approved for treatment of advanced prostate cancer. We reviewed its use outside of clinical trials for patients treated at eight European centers. We found that177 Lu PSMA is an effective treatment option in real-world practice. A PSA (prostate-specific antigen) decrease of ≥30% after the first two therapy cycles is an early indicator of response to treatment and can be used in personalizing treatments for patients., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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14. Real-World Evidence of Triplet Therapy in Metastatic Hormone-Sensitive Prostate Cancer: An Austrian Multicenter Study.
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Kafka M, Giannini G, Artamonova N, Neuwirt H, Ofner H, Kramer G, Bauernhofer T, Luger F, Höfner T, Loidl W, Griessner H, Lusuardi L, Bergmaier A, Berger A, Winder T, Weiss S, Bauinger S, Krause S, Drerup M, Heinrich E, Schneider M, Madersbacher S, Vallet S, Stoiber F, Laimer S, Hruby S, Schachtner G, Nagele U, Lenart S, Ponholzer A, Pfuner J, Wiesinger C, Kamhuber C, Müldür E, Bektic J, Horninger W, and Heidegger I
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- Humans, Male, Androgen Antagonists therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Austria, Docetaxel therapeutic use, Hormones, Positron Emission Tomography Computed Tomography, Randomized Controlled Trials as Topic, Prostatic Neoplasms drug therapy, Prostatic Neoplasms pathology
- Abstract
Introduction: Two randomized trials demonstrated a survival benefit of triplet therapy (androgen deprivation therapy [ADT]) plus androgen receptor pathway inhibitor [ARPI] plus docetaxel) over doublet therapy (ADT plus docetaxel), thus changing treatment strategies in metastatic hormonesensitive prostate cancer (mHSPC)., Patients and Methods: We conducted the first real-world analysis comprising 97 mHSPC patients from 16 Austrian medical centers, among them 79.4% of patients received abiraterone and 17.5% darolutamide treatment. Baseline characteristics and clinical parameters during triplet therapy were documented. Mann-Whitney U test for continuous or X²-test for categorical variables was used. Variables on progression were tested using logistic regression analysis and tabulated as hazard ratios (HR), 95% confidence interval (CI)., Results: Of 83.5% patients with synchronous and 16.5% with metachronous disease were included. 83.5% had high-volume disease diagnosed by conventional imaging (48.9%) or PSMA PET-CT (51.1%). While docetaxel and ARPI were administered consistent with pivotal trials, prednisolone, prophylactic gCSF and osteoprotective agents were not applied guideline conform in 32.5%, 37%, and 24.3% of patients, respectively. Importantly, a nonsimultaneous onset of chemotherapy and ARPI, performed in 44.3% of patients, was associated with significantly worse treatment response (P = .015, HR 0.245). Starting ARPI before chemotherapy was associated with significantly higher probability for progression (P = .023, HR 15.781) than vice versa. Strikingly, 15.6% (abiraterone) and 25.5% (darolutamide) low-volume patients as well as 14.4% (abiraterone) and 17.6% (darolutamide) metachronous patients received triplet therapy. Adverse events (AE) occurred in 61.9% with grade 3 to 5 in 15% of patient without age-related differences. All patients achieved a PSA decline of 99% and imaging response was confirmed in 88% of abiraterone and 75% of darolutamide patients., Conclusions: Triplet therapy arrived in clinical practice primarily for synchronous high-volume mHSPC. Regardless of selected therapy regimen, treatment is highly effective and tolerable. Preferably therapy should be administered simultaneously, however if not possible, chemotherapy should be started first., Competing Interests: Disclosure All authors declare that there are no conflicts of interest. The study was performed in accordance with the local ethical standards., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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15. Glycoprofiling of proteins as prostate cancer biomarkers: A multinational population study.
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Pinkeova A, Tomikova A, Bertokova A, Fabinyova E, Bartova R, Jane E, Hroncekova S, Sievert KD, Sokol R, Jirasko M, Kucera R, Eder IE, Horninger W, Klocker H, Ďubjaková P, Fillo J, Bertok T, and Tkac J
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- Male, Humans, Biomarkers, Tumor, Prostate pathology, ROC Curve, Early Detection of Cancer, Glycoproteins, Polysaccharides, Prostate-Specific Antigen, Prostatic Neoplasms pathology
- Abstract
The glycoprofiling of two proteins, the free form of the prostate-specific antigen (fPSA) and zinc-α-2-glycoprotein (ZA2G), was assessed to determine their suitability as prostate cancer (PCa) biomarkers. The glycoprofiling of proteins was performed by analysing changes in the glycan composition on fPSA and ZA2G using lectins (proteins that recognise glycans, i.e. complex carbohydrates). The specific glycoprofiling of the proteins was performed using magnetic beads (MBs) modified with horseradish peroxidase (HRP) and antibodies that selectively enriched fPSA or ZA2G from human serum samples. Subsequently, the antibody-captured glycoproteins were incubated on lectin-coated ELISA plates. In addition, a novel glycoprotein standard (GPS) was used to normalise the assay. The glycoprofiling of fPSA and ZA2G was performed in human serum samples obtained from men undergoing a prostate biopsy after an elevated serum PSA, and prostate cancer patients with or without prior therapy. The results are presented in the form of an ROC (Receiver Operating Curve). A DCA (Decision Curve Analysis) to evaluate the clinical performance and net benefit of fPSA glycan-based biomarkers was also performed. While the glycoprofiling of ZA2G showed little promise as a potential PCa biomarker, the glycoprofiling of fPSA would appear to have significant clinical potential. Hence, the GIA (Glycobiopsy ImmunoAssay) test integrates the glycoprofiling of fPSA (i.e. two glycan forms of fPSA). The GIA test could be used for early diagnoses of PCa (AUC = 0.83; n = 559 samples) with a potential for use in therapy-monitoring (AUC = 0.90; n = 176 samples). Moreover, the analysis of a subset of serum samples (n = 215) revealed that the GIA test (AUC = 0.81) outperformed the PHI (Prostate Health Index) test (AUC = 0.69) in discriminating between men with prostate cancer and those with benign serum PSA elevation., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Pinkeova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
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16. Subsets of preoperative sex hormones in testicular germ cell cancer: a retrospective multicenter study.
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Törzsök P, Oswald D, Dieckmann KP, Angerer M, Scherer LC, Tymoszuk P, Kunz Y, Pinggera GM, Lusuardi L, Horninger W, and Pichler R
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- Humans, Male, Adult, Neoplasm Recurrence, Local, Gonadal Steroid Hormones, Luteinizing Hormone, Follicle Stimulating Hormone, Human, Testicular Neoplasms, Neoplasms, Germ Cell and Embryonal, Seminoma
- Abstract
Preoperative homeostasis of sex hormones in testicular germ cell tumor (TGCT) patients is scarcely characterized. We aimed to explore regulation of sex hormones and their implications for histopathological parameters and prognosis in TGCT using a data-driven explorative approach. Pre-surgery serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2) and prolactin were measured in a retrospective multicenter TGCT cohort (n = 518). Clusters of patients were defined by latent class analysis. Clinical, pathologic and survival parameters were compared between the clusters by statistical hypothesis testing, Random Forest modeling and Peto-Peto test. Cancer tissue expression of sex hormone-related genes was explored in the publicly available TCGA cohort (n = 149). We included 354 patients with pure seminoma and 164 patients with non-seminomatous germ cell tumors (NSGCT), with a median age of 36 years. Three hormonal clusters were defined: 'neutral' (n = 228) with normal sex hormone homeostasis, 'testicle' (n = 91) with elevated T and E2, low pituitary hormones, and finally 'pituitary' subset (n = 103) with increased FSH and LH paralleled by low-to-normal levels of the gonadal hormones. Relapse-free survival in the hormonal subsets was comparable (p = 0.64). Cancer tissue expression of luteinizing hormone- and follicle-stimulating hormone-coding genes was significantly higher in seminomas, while genes of T and E2 biosynthesis enzymes were strongly upregulated in NSGCT. Substantial percentages of TGCT patients are at increased risk of sex hormone dysfunction at primary diagnosis before orchiectomy. TGCT may directly influence systemic hormonal homeostasis by in-situ synthesis of sex hormones., (© 2023. Springer Nature Limited.)
- Published
- 2023
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17. Real-world comparison of Docetaxel versus new hormonal agents in combination with androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer descrying PSA Nadir ≤ 0.05 ng/ml as marker for treatment response.
- Author
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Kafka M, Burtscher T, Fritz J, Schmitz M, Bektic J, Ladurner M, Horninger W, and Heidegger I
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- Humans, Male, Androgen Antagonists adverse effects, Androgens therapeutic use, Antineoplastic Combined Chemotherapy Protocols, Docetaxel therapeutic use, Prostate-Specific Antigen, Retrospective Studies, Treatment Outcome, Prostatic Neoplasms pathology
- Abstract
Propose: Using Docetaxel chemotherapy or new hormonal agents (NHT) to intensify upfront systemic therapy resulted in improved survival rates compared to androgen deprivation monotherapy (ADT). Hence, combination therapies have become the new standard of care (SOC) in metastatic hormone-sensitive prostate cancer (mHSPC). However, head-to-head trails comparing different therapies as well as treatment-guiding biomarkers are still lacking. Thus, the aim of the present study was to compare clinical outcomes of Docetaxel versus NHT therapy in the real-world setting as well as to elaborate biomarkers predicting clinical outcome., Methods: We retrospectively assessed overall-survival (OS), progression-free survival 1 and 2 (PFS1/2) and time to progression (TTP) in 42 patients treated by either ADT + NHT or ADT + Docetaxel. In addition, we investigated clinical prognostic biomarkers., Results: Our survival analysis revealed 3-year OS of 89.4% in the NHT group compared to 82.4% in the Docetaxel group. 3-year PFS1 was 59.6% in the NHT group compared to 32.2% in the Docetaxel group and the TTP was 53.8% vs 32.2% (pOS = 0.189; pPFS1 = 0.082; pTTP = 0.055). In addition, castration-resistance occurred more often in the Docetaxel group (78.6% vs 25%, p = 0.004). Interestingly, a PSA-Nadir ≤ 0.05 ng/ml during therapy was associated with increased survival rates (p < 0.001) while PSA levels at primary diagnosis had no influence on therapy outcome. Furthermore, a thyroid-stimulating hormone (TSH) increase during therapy was associated with improved clinical outcome (p = 0.06)., Conclusion: We observed a trend towards a higher benefit of NHT as first-line treatment compared to Docetaxel in men with mHSPC. Of note, a PSA-Nadir ≤ 0.05 ng/ml or a TSH-increase during therapy were predictors for therapy response., (© 2022. The Author(s).)
- Published
- 2023
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18. Do we need repeated CT imaging in uncomplicated blunt renal injuries? Experiences of a high-volume urological trauma centre.
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Lindner AK, Luger AK, Fritz J, Stäblein J, Radmayr C, Aigner F, Rehder P, Tulchiner G, Horninger W, and Pichler R
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- Adult, Female, Humans, Kidney injuries, Male, Retrospective Studies, Tomography, X-Ray Computed, Trauma Centers, Wounds, Nonpenetrating surgery
- Abstract
Background: Current guidelines recommend repeat computed tomography (CT) imaging in high-grade blunt renal injury within 48-96 h, yet diagnostic value and clinical significance remain controversial. The aim of this work was to determine the possible gain of CT re-imaging in uncomplicated patients with blunt renal trauma at 48 h after injury, presenting one of the largest case series., Methods: A retrospective database of patients admitted to our centre with isolated blunt renal trauma due to sporting injuries was analysed for a period of 20 years (2000-2020). We included only patients who underwent repeat imaging at 48 h after trauma irrespective of AAST renal injury grading (grade 1-5) and initial management. The primary outcome was intervention rates after CT imaging at 48 h in uncomplicated patients versus CT scan at the time of clinical symptoms., Results: A total of 280 patients (mean age: 37.8 years; 244 (87.1%) male) with repeat CT after 48 h were included. 150 (53.6%) patients were classified as low-grade (grade 1-3) and 130 (46.4%) as high-grade (grade 4-5) trauma. Immediate intervention at trauma was necessary in 59 (21.1%) patients with high-grade injuries: minimally invasive therapy in 48 (81.4%) and open surgery in 11 (18.6%) patients, respectively. In only 16 (5.7%) cases, intervention was performed based on CT re-imaging at 48 h (low-grade vs. high-grade: 3.3% vs. 8.5%; p = 0.075). On the contrary, intervention rate due to clinical symptoms was 12.5% (n = 35). Onset of clinical progress was on average (range) 5.3 (1-17) days post trauma. High-grade trauma (odds ratio [OR]
grade 4 vs. grade 3 , 14.62; p < 0.001; ORgrade 5 vs. grade 3 , 22.88, p = 0.004) and intervention performed at the day of trauma (OR 3.22; p = 0.014) were powerful predictors of occurrence of clinical progress., Conclusion: Our data suggest that routine CT imaging 48 h post trauma can be safely omitted for patients with low- and high-grade blunt renal injury as long as they remain clinically stable. Patients with high-grade renal injury have the highest risk for clinical progress; thus, close surveillance should be considered especially in this group., (© 2022. The Author(s).)- Published
- 2022
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19. Effects of cycling and rowing on serum concentrations of prostate-specific antigen: A randomized study of 101 male subjects.
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Lunacek A, Tischler M, Mrstik C, Hebenstreit D, Oeser R, Bektic J, Klocker H, Horninger W, and Plas E
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- Exercise, Humans, Male, Prostate-Specific Antigen, Prostatic Neoplasms, Water Sports
- Abstract
Objective: To determine the effects if cycling and rowing on serum prostate-specific antigen (PSA) levels., Methods: Male volunteers (n = 101), aged 20-80 (mean, 49.9) years were randomized to exercise at the first or second study visit. They performed 1 h of either cycling or rowing on a stationary machine. To determine exercise-induced effects on the PSA level, serum total PSA (tPSA) and free PSA (fPSA) concentrations were evaluated before and after exercise and another sampling was performed at the second study visit. Pre-exercise and postexercise tPSA and fPSA concentrations were compared using the Wilcoxon matched-pairs test. The results were analyzed using the Mann-Whitney U-test., Results: A significant (p < 0.001) average increase in tPSA after exercise (1.14 ± 1.11 ng/ml to 1.24 ± 1.26 ng/ml [mean, +8.8%]) was observed after both cycling and rowing, without significant differences between the sports (p = 0.54). The exercise-induced increase in PSA concentration affected participants aged ≥50 years (difference, 0.16 ± 0.37; p < 0.001), but not those aged <50 years (difference, 0.01 ± 0.06; p = 0.23). The effect size was clinically irrelevant in all except two outliers, in whom a distinct increase of PSA level by averages of 1.80 ng/ml (+55%) for tPSA and 1.25 ng/ml (+227%) for fPSA following cycling was observed., Conclusion: Rowing and cycling generally do not have a clinically relevant effect on PSA levels. However, outliers exist. Our findings do not support abstaining from exercise during the days approaching PSA sampling., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
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20. Optilume® drug-coated balloon dilation in complex female urethral stricture.
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Stuehmeier J, Jelisejevas LA, Kink P, Gulacsi A, Horninger W, and Rehder P
- Abstract
The treatment of female urethral stricture disease is in flux in terms of developing guidelines for surgical treatment. Urethral strictures in women are rare, but frequently result because of urethral instrumentation or surgery. Stricture sites vary from proximal, intrasphincteric, distal or at the meatus. Stricture formation after previous urethral surgery may pose a special challenge. We describe the first Optilume ® urethral drug-coated balloon dilation for female urethral stricture disease involving the sphincter. After six months follow-up the patient remains stricture free with full continence and complete bladder emptying., Competing Interests: None., (© 2021 The Authors.)
- Published
- 2021
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21. Early Injection of Furosemide Increases Detection Rate of Local Recurrence in Prostate Cancer Patients with Biochemical Recurrence Referred for 68 Ga-PSMA-11 PET/CT.
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Uprimny C, Bayerschmidt S, Kroiss AS, Fritz J, Nilica B, Svirydenka H, Decristoforo C, von Guggenberg E, Horninger W, and Virgolini IJ
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- Humans, Male, Aged, Retrospective Studies, Middle Aged, Aged, 80 and over, Radiopharmaceuticals pharmacokinetics, Tissue Distribution, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms metabolism, Positron Emission Tomography Computed Tomography, Furosemide pharmacokinetics, Furosemide administration & dosage, Gallium Radioisotopes, Gallium Isotopes, Edetic Acid analogs & derivatives, Oligopeptides pharmacokinetics, Neoplasm Recurrence, Local diagnostic imaging
- Abstract
The aim of this study was twofold. First, we aimed to assess the impact of forced diuresis with early furosemide injection on the detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for
68 Ga-labeled Glu-NH-CO-NH-Lys(Ahx)-HBED-CC (68 Ga-PSMA-11) PET/CT. Second, we determined whether intravenous administration of furosemide shortly after tracer injection increases renal washout of68 Ga-PSMA-11 before it binds to the PSMA receptor with possible influence on biodistribution and intensity of tracer uptake in organs with physiologic tracer accumulation. Methods: In a retrospective analysis, 2 different groups with 220 prostate cancer patients each, referred for68 Ga-PSMA-11 PET/CT because of biochemical recurrence after primary therapy, were compared: patients in group 1 (median prostate-specific antigen, 1.30 ng/mL) received no preparation before imaging, whereas patients in group 2 (median prostate-specific antigen, 0.82 ng/mL) were injected with 20 mg of furosemide and 500 mL of sodium chloride (NaCl 0.9%) immediately after tracer injection. The presence of local recurrence was assessed visually. In addition, the intensity of tracer accumulation in organs with physiologic tracer uptake was evaluated. Results: The detection rate of lesions judged positive for local recurrence was significantly higher in patients receiving furosemide than in patients without preparation: 56 cases (25.5%) versus 38 cases (17.3%), respectively ( P = 0.048). Median maximum SUVs (SUVmax ) of organs with physiologic uptake of68 Ga-PSMA-11 in groups 1 and 2 were urinary bladder (63.0 vs. 8.9), kidney (55.6 vs. 54.5), liver (9.9 vs. 9.4), spleen (11.2 vs. 11.9), small bowel (16.2 vs. 17.1), parotid gland (19.2 vs. 19.6), lacrimal gland (8.9 vs. 10.9), blood-pool activity (2.2 vs. 2.3), muscle (1.0 vs. 1.1), and bone (1.6 vs. 1.6). Apart from bladder activity, no significant reduction of tracer accumulation was found in the patient group receiving furosemide. Conclusion: Injection of 20 mg of furosemide at the time point of radiotracer administration significantly increases the detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for68 Ga-PSMA-11 PET/CT. As intensity of68 Ga-PSMA-11 uptake in organs with physiologic uptake is not significantly reduced, a negative impact of early furosemide injection on targeting properties and biodistribution of68 Ga-PSMA-11 seems unlikely., (© 2021 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2021
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22. Seasonal Variations in the Diagnosis of Testicular Germ Cell Tumors: A National Cancer Registry Study in Austria.
- Author
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Tulchiner G, Staudacher N, Fritz J, Hackl M, Pichler M, Seles M, Shariat SF, D'Andrea D, Gust K, Albrecht W, Grubmüller K, Madersbacher S, Graf S, Lusuardi L, Augustin H, Berger A, Loidl W, Horninger W, and Pichler R
- Abstract
We conducted a retrospective National Cancer Registry study in Austria to assess a possible seasonal variation in the clinical diagnosis of testicular germ cell tumors (TGCT). In total, 3615 testicular cancer diagnoses were identified during an 11-year period from 2008 to 2018. Rate ratios for the monthly number of TGCT diagnoses, as well as of seasons and half-years, were assessed using a quasi-Poisson model. We identified, for the first time, a statistically significant seasonal trend ( p < 0.001) in the frequency of monthly newly diagnosed cases of TGCT. In detail, clear seasonal variations with a reduction in the tumor incidence during the summer months (Apr-Sep) and an increase during the winter months (Oct-Mar) were observed ( p < 0.001). Focusing on seasonality, the incidence during the months of Oct-Dec ( p = 0.008) and Jan-Mar ( p < 0.001) was significantly higher compared to the months of Jul-Sep, respectively. Regarding histopathological features, there is a predominating incidence in the winter months compared to summer months, mainly concerning pure seminomas ( p < 0.001), but not the non-seminoma or mixed TGCT groups. In conclusion, the incidence of TGCT diagnoses in Austria has a strong seasonal pattern, with the highest rate during the winter months. These findings may be explained by a delay of self-referral during the summer months. However, the hypothetical influence of vitamin D3 in testicular carcinogenesis underlying seasonal changes in TGCT diagnosis should be the focus of further research.
- Published
- 2021
- Full Text
- View/download PDF
23. Sex-specific hormone changes during immunotherapy and its influence on survival in metastatic renal cell carcinoma.
- Author
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Tulchiner G, Pichler R, Ulmer H, Staudacher N, Lindner AK, Brunner A, Zelger B, Steinkohl F, Aigner F, Horninger W, and Thurnher M
- Subjects
- Aged, Carcinoma, Renal Cell mortality, Child, Female, Humans, Immune Checkpoint Inhibitors pharmacology, Male, Middle Aged, Neoplasm Metastasis, Prospective Studies, Retrospective Studies, Gonadal Steroid Hormones metabolism, Immune Checkpoint Inhibitors therapeutic use, Immunotherapy methods
- Abstract
Renal cell carcinoma (RCC) is a highly vascularized and immunogenic tumor, being an ideal candidate for checkpoint blockade-based immunotherapy. Accordingly, checkpoint inhibitors have demonstrated clinical efficacy in patients with metastatic RCC (mRCC). Sex-specific differences in cancer immunotherapy may be explained by the interaction of sex hormone signaling, genetic and environmental factors, affecting the innate and adaptive immune response in men and women in different ways. The aim of this prospective study was to monitor for the first time changes in sex hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio and 17-ß-estradiol (E2) in 22 mRCC patients (12 male and 10 female) receiving nivolumab therapy. In contrast to female patients, male patients showed a significant increase in E2 (p = 0.006) and LH/FSH ratio (p = 0.013) from the beginning of nivolumab therapy to week 12 of follow-up. Moreover, survival analysis revealed a significant negative association between LH/FSH ratio and progression-free survival (PFS) (p = 0.022) as well as between therapy response (p = 0.009) in males compared to females at interim evaluation (week 6/8). Our findings may therefore be the first reference to sex hormone changes during immunotherapy., (© 2021. The Author(s).)
- Published
- 2021
- Full Text
- View/download PDF
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