Circulating and Disseminated Tumor Cells in the Management of Advanced Prostate Cancer

Management of prostate cancer is recognized as one of the most important medical problems. Latest findings concerning the role of circulating (CTC) and disseminated tumor cells (DTC) have provided new insights into the biology of metastasis with important implications for the clinical management of prostate cancer patients. Most of the established methods of circulating/disseminated tumor cell enrichment use density-gradient centrifugation and immunomagnetic procedures. Reverse transcriptase polymerase chain reaction is another used detection technique. Novel methods, the CTC-chip and the epithelial immunospot assay already showed promising results. For localized and metastatic prostate cancer, significant correlations between spreading tumor cells and well-established indicators of disease activity have been demonstrated. Careful randomized prospective trials will be required to justify the routine use of CTCs/DTCs for therapy decision making

Urinary biomarkers in bladder cancer: A review of the current landscape and future directions

AIM: This narrative review aims to describe established and emerging urinary biomarkers in the diagnosis and surveillance of non-muscle invasive bladder cancer. It provides a comprehensive account of classical, FDA-approved protein biomarkers and discusses their limitations. Further, we discuss the role that epigenetic, genetic, and exosomal markers can play to enhance sensitivity and specificity of the available tests. BACKGROUND: The initial diagnosis and surveillance of bladder cancer involves a combination of cystoscopy, upper urinary tract imaging, and urine cytology. Despite high specificity, cytology is limited by low sensitivity. There are currently 6 urinary assays approved by the FDA to enhance diagnosis and surveillance of bladder cancer. While these have improved diagnosis and surveillance when combined with cytology, these tests are still not sufficiently sensitive and false positives often occur in benign conditions which result in inflammation of the urinary tract. Advancements in laboratory techniques have produced significant advancements in epigenetic and genetic markers, as well as extracellular vesicles, with DNA- and RNA-based markers dominating the research in this area in recent years. METHODS: We identified relevant published data, using the PubMed/ Medline search engines as well as Google Scholar. We performed an online search using the terms "bladder cancer", "non-muscle invasive bladder cancer" in combination with "urine biomarkers" and limited articles in English published up to February 2020. This review consolidated on all available narrative and systematic reviews published in the 5 years in this field, while also reviewing the original data of each clinical trial or observational study which led to the development of the biomarkers. CONCLUSION: The development of laboratory techniques and understanding urine-based biomarkers in BC has fuelled the use of noninvasive liquid-based biomarkers to complement urine cytology. Nonetheless, none are sufficiently effective when used in isolation, and cytology remains the gold standard in many practices. Future efforts will be focused on using these markers in combination as a predictive signature, and moving on to validating them for use in everyday clinical practice

Isolated Late Metastasis of a Renal Cell Cancer Treated by Radical Distal Pancreatectomy

A 53–year-old man underwent right nephrectomy for a locally advanced renal cell carcinoma with concomitant resection of a solitary metastasis in the right lung. Ten years later, he presented with haematochezia caused by a tumour in the tail of pancreas, invading the transverse colon and the greater curvature of the stomach. The tumour was radically resected, and histological examination revealed a solitary metastasis of the previous renal cell carcinoma. This case illustrates a rare indication for pancreatic resection because of pancreatic metastasis

”Peripherie” und ”Zentrum”: Fragen im Hinblick auf die Handschrift SG 383

Dokument enthält auch die nachfolgende Diskussion

Robotic intracorporeal urinary diversion: practical review of current surgical techniques

In this practical review, we discuss current surgical techniques reported in the literature to perform Intracorporeal Urinary Diversion (ICUD) after Robotic Radical Cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with Extracorporeal Urinary Diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analysing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes. Only analysis of long-term follow-up data from large-scale homogeneous series can ascertain whether robotic intracorporeal urinary diversion is superior to other approaches

Datenschutzrechtliche Probleme im Zivilverfahren

Zu Beginn der Arbeit werden die Entwicklung des Datenschutzes sowie die wichtigsten Regelungen des Datenschutzgesetzes, insbesondere die Grundsätze einer zulässigen Datenanwendung, erläutert. Anschließend folgt eine Darstellung des Datenschutzes im Bereich der Gerichtsbarkeit. Die Rechtsprechung muss, um ihre Aufgabe erfüllen zu können, personenbezogene Daten verwenden und greift dadurch in das Grundrecht auf Datenschutz des Betroffenen ein. Die Geltung des Grundrechtes auf Datenschutz steht somit in einem natürlichen Spannungsverhältnis zu den Aufgaben der Gerichte berechtigen Ansprüchen zum Durchbruch zu verhelfen. Im Zuge der Zivilverfahrensnovelle 2004 wurden die §§ 83 ff GOG geschaffen, in denen Rechtsbehelfe zur Durchsetzung der im DSG 2000 normierten Rechte des Betroffenen „in Angelegenheiten der Gerichtsbarkeit“ vorgesehen sind. Diese Regelungen im GOG werden in der Arbeit dargestellt. In der Folge werden zivilverfahrens- und prozessrechtliche Situationen aufgezeigt, in denen auf unterschiedliche Weise personenbezogene Daten übermittelt werden, wodurch im Besonderen eine Gefahr der Verletzung des Grundrechtes auf Datenschutz gegeben ist. Diskutiert wird beispielsweise die Öffentlichkeit des Verfahrens, die Akteneinsicht, die Bestimmung des § 294 a EO, die Aktenbeischaffung, die Strafregisterauskunft und die Problematik des Datenschutzes im Zuge eines Aufkündigungsverfahrens. Als nächster großer Themenkreis wird die Diskussion um Beweisverwertungsverbote im Zivilprozess dargestellt. Zunächst wird die deutsche Lehre und Rechtsprechung erläutert, weil diese die österreichische Diskussion maßgeblich beeinflusst hat. Die Frage der Verwertbarkeit von fehlerhaft erhobenen Beweisen ist in Deutschland bisher nicht restlos geklärt die Verwertung derartiger Daten ist „nicht grundsätzlich unzulässig.“ Der dBVerG hat sich mit einer Grundsatzentscheidung zur Problematik heimlicher Tonbandaufnahmen und deren Verwertung im gerichtlichen Verfahren geäußert. Das Recht eines jeden Menschen auf freie Entfaltung seiner Persönlichkeit schließe auch das Recht am eigenen Wort mit ein. Jeder Mensch habe das Recht selbst zu entscheiden, ob sein Wort auf einen Tonträger aufgenommen und damit möglicherweise einem Dritten zugänglich gemacht werden soll. Auch in der österreichischen Zivilprozessordnung findet sich keine allgemeine Regelung über Beweisverwertungsverbote. Im Zivilrecht hat sich – im Gegensatz zum Verwaltungsrecht – bisher keine einheitliche Meinung zu diesem Thema herausgebildet. In der Lehre wurde dieser Problembereich, im Vergleich zu Deutschland, bisher eher stiefmütterlich behandelt. Die unterschiedlichen Standpunkte der österreichischen Lehre und Rechtsprechung werden in der Arbeit ausführlich dargestellt. Da die österreichische Rechtsprechung, die sich nicht mit der rechtswidrigen Verwertung von Tonbandaufnahmen sondern mit anderen Beweismitteln auseinandersetzt, bisher eher spärlich ist, wird überdies kurz ausgeführt, wie es sich mit der Verwertung anderer rechtswidrig erlangter Beweismittel, wie beispielsweise Photographien, Urkunden, Tagebüchern oder Briefen, verhält. Im abschließenden Kapitel der Arbeit werden sämtliche wesentlichen Entscheidungen des Obersten Gerichtshofes, die bisher zum Thema der Verwertung rechtswidrig erlangter Beweismittel vorliegen, dargestellt

Analysis of 8 X-chromosomal markers in the population of central Croatia

Aim To analyze 8 X-linked short tandem repeat (STR) markers in the population of central Croatia and to evaluate their forensic efficiency. Methods We carried out a statistical analysis of the data from previously performed genetic analyses, collected during routine forensic work by the Forensic Science Centre ‘‘Ivan Vučetić.’’ Mentype® Argus X-8 PCR amplification kit was used for typing the data of 99 unrelated healthy women and 78 men from central Croatia. Haplotype frequencies were calculated only in male samples. Arlequin 3.5 software was used to assess Hardy-Weinberg equilibrium (HWE), linkage disequilibrium (LD), observed and expected heterozygosity. Power of discrimination (PD) for men and women, polymorphism information content (PIC), power of exclusion, and mean exclusion chance for deficiency cases, normal trios, and duos were determined using online database ChrX-STR.org. Results In female samples, deviations from HWE (P = 0.006) for each locus were not found. LD test performed both on female and male samples revealed no significant association between markers (P = 0.002). DXS10135 was the most polymorphic locus (PIC = 0.931). PD varied from 0.692 to 0.935 in male and from 0.845 to 0.992 in female samples. Combined PD reached 99.999999% in men and 99.9999999999% in women. Conclusion Performed analyses revealed that the studied marker set contained polymorphic markers with high power of discrimination. We can conclude that Mentype® Argus X-8 PCR is suitable for application in the population of central Croatia. Results of this study, together with collected allele and haplotype frequencies, are the first step in establishing a national reference X-STR database based on 8 X-STR loci

The current status of checkpoint inhibitors in metastatic bladder cancer

For many decades, no significant improvements could be achieved to prolong the survival in metastatic bladder cancer. Recently, systemic immunotherapy with checkpoint inhibitors (anti-PD-L1/anti-CTLA-4) has been introduced as a novel treatment modality for patients with metastatic bladder cancer. We conducted a systematic review according to the PRISMA statement for data published on the clinical efficacy of checkpoint inhibitors in metastatic bladder cancer. Clinical efficacy of anti PD-L1 therapy was investigated in prospective trials in a total of 155 patients. Patients with positive expression for PD-L1 tended towards better overall response rates (ORR) compared to those with negative expression (34/76 vs 10/73, 45 vs 14 %; p = 0.21). Among patients with PD-L1 positive tumors, those with non-visceral metastases exhibited significantly higher ORR compared to those with visceral metastases (82 vs 28 %; p = 0.001). For anti-CTLA4 therapy, there were no data retrievable on clinical efficacy. Although data on clinical efficacy of checkpoint inhibitors in metastatic bladder cancer are currently limited, the efficacy of these drugs might depend mainly on the metastatic volume and immune system integrity. Patients with PD-L1 positive tumors and non-visceral metastases seem to derive the highest benefit from therapy