Publications by authors named "Paffenholz P"

Introduction: Prostate cancer guidelines recommend molecular analysis of biomaterial following resistance to first-line systemic therapy in order to identify druggable mutations. We report on our results of molecular analysis of tissue specimens via next generation sequencing (NGS) in men with metastatic castration resistant prostate cancer (mCRPC).

Patients And Methods: In all, 311 mCRPC patients underwent NGS analysis from biopsy samples of progressive metastatic lesions or archival radical prostatectomy specimens.

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Objectives: To reassess the role of primary retroperitoneal lymph node dissection (RPLND) in patients with marker-negative non-seminomatous germ cell tumour (NSGCT) clinical stage (CS) 2a, to explore results in patients with CS 2b and to evaluate surgical methods, recurrence, and adjuvant chemotherapy indications.

Materials And Methods: Data from 17 institutions were collected, comprising 305 men who underwent primary RPLND for CS 2 NSGCT. Regression analyses were conducted to predict histology in the RPLND specimen and disease-free survival (DFS).

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Background: Lu PSMA therapy is increasingly used for metastatic castration-resistant prostate cancer (mCRPC) treatment. However, data on its efficacy and safety in patients previously treated with Ra remain limited.

Methods: This retrospective, multicenter study evaluated 233 mCRPC patients treated with Lu PSMA at 5 European centers.

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Article Synopsis
  • Testicular tumors mainly affect younger men, while penile cancer is more frequently seen in older men, and early detection can improve survival chances.
  • Comprehensive literature review finds no general screening programs for these cancers; instead, self-examination for testicular tumors and education on risk factors for penile cancer are highlighted.
  • Raising awareness and educating at-risk individuals is vital, with physicians playing a crucial role in promoting early detection strategies.
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  • The study aimed to identify key factors influencing the choice of surgical treatment for patients with localized Renal-Cell Carcinoma (RCC) using clinical and nephrometry data.
  • It involved a retrospective analysis of patients who underwent surgery for localized RCC between 2010 and 2017 and used multivariate predictive modeling to assess risks associated with surgical options.
  • Results indicated that the risks for partial nephrectomy (PN) were linked to remaining functioning kidney tissue volumes for polar and lateral tumors, while tumor size was the main factor for medial tumors, with the predictive model showing high sensitivity (95.2%) and specificity (95.4%).
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  • Patients with muscle-invasive urothelial carcinoma (pT2-pt4a pN0) should receive neoadjuvant cisplatin-based chemotherapy before undergoing radical cystectomy, improving overall survival rates.
  • If chemotherapy is not given beforehand, it can still be administered in the adjuvant setting for patients with more advanced disease (greater than pT3 or pN+).
  • Many cisplatin-eligible patients either do not receive chemotherapy or are not suitable for it, highlighting the need for new treatment strategies, such as antibody-drug conjugates and combination therapies with checkpoint inhibitors.
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Introduction: Combinations of immune-checkpoint inhibitors (ICIs) are the standard of care (SOC) for treatment-naive metastatic renal cell carcinoma (mRCC) patients. In this multicenter study, we evaluated the RW safety and efficacy of cabozantinib plus nivolumab in mRCC patients.

Methods: Data were retrospectively collected from twelve cancer centers in Germany, Switzerland, and Austria.

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Background: The guideline-recommended treatment of choice for clinical stage IIA/B testicular germ cell tumors is chemotherapy with three cycles of PEB/four cycles of PE or, alternatively, radiation for seminomas. Despite their high curative efficacy, both options are associated with significant long-term toxicities. We evaluated the functional and oncological outcomes of primary retroperitoneal lymph node dissection (RPLND) as a therapeutic alternative.

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Article Synopsis
  • - Testicular germ cell tumors (TGCTs) are rare, making up about 1% of new cancer diagnoses in men, with incidence rates ranging from 7 to 10 per 100,000 in Europe and North America.
  • - About 2-5% of men with TGCT have a risk of germ cell neoplasia in situ (GCNIS) in the other testicle, which can develop into cancer in over 50% of cases.
  • - The review explores whether routine biopsies of the healthy testicle should be done to check for GCNIS, emphasizing the need for treatment only if it improves patient outcomes without significantly affecting testicular function.
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Treatment de-escalation strategies in patients with seminoma with retroperitoneal metastases are being investigated in ongoing clinical trials. Primary retroperitoneal lymph node dissection conducted by expert surgeons may avoid any cytotoxic treatment and related long-term side effects in ≥70% of patients with clinical stage IIA/B seminoma.

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Article Synopsis
  • - Testicular germ cell tumors are uncommon cancers but are the most frequent type found in men aged 15 to 30.
  • - Initial management steps like staging and tumor marker tests can be conducted at various facilities, but surgery and chemotherapy should be done at specialized centers.
  • - Focusing treatment at reference centers improves overall cancer outcomes for patients with testicular cancer.
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Background And Objective: Serum levels of microRNA-371a-3p (M371) represent a novel and sensitive biomarker of germ cell tumours (GCTs). This study analysed the utility of M371 to identify viable cancer (VC) in postchemotherapy (pc) residual masses with the underlying goal of avoiding overtreatment.

Methods: A multicentric, prospective diagnostic study was conducted in 180 GCT patients undergoing pc resection of residual masses.

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Purpose: Urologists' practices reported decreasing medical care provision and increasing stress experience in the first wave of the COVID-19 pandemic. However, long-term effects of the pandemic are unknown.

Methods: Medical record data of n = 127 urologists were used to assess changes in healthcare provision, comparing the pandemic with the pre-pandemic period.

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In germ cell tumors (GCT), a growing teratoma during chemotherapy with decreasing tumor markers was defined as 'growing teratoma syndrome' (GTS) by Logothetis et al. in 1982. So far, its pathogenesis and specific treatment options remain elusive.

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Approximately 30% of seminoma (SEM) patients present with moderately elevated human chorionic gonadotropin (hCG) levels at first diagnosis. In case of high hCG serum levels, the presence of a non-SEM component, i.e.

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Purpose: Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for advanced nonseminomatous germ cell tumors (GCTs) aims to resect all remaining metastatic tissue. Resection of adjacent visceral or vascular organs is commonly performed for complete resection. Resection of organs harboring only necrosis results in relevant overtreatment.

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Article Synopsis
  • * Out of 258 patients monitored over 18 months, the M371 test achieved 100% sensitivity and 96.3% specificity for relapse detection, with some ability to detect relapses earlier.
  • * While the M371 test shows promise for routine use in monitoring relapses, postoperative levels of M371 did not predict future relapses, and the time advantage for earlier detection was not significant.
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Patients with marker-negative clinical stage IIA/B seminoma or nonseminoma represent a therapeutic challenge, as 20-30% might harbor nonmalignant histologies. MicroRNA 371a-3p (miR371) may represent a biomarker with diagnostic and predictive properties in testicular germ cell tumors (TGCTs). We evaluated the predictive accuracy of this biomarker in identifying the presence or absence of lymph node metastases (LNMs) in clinical stage IIA/B TGCT.

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Purpose: No consensus exists on the management of men with nonseminoma and viable nonteratomatous germ cell tumor in the postchemotherapy retroperitoneal lymph node dissection (pcRPLND) specimen after first-line chemotherapy. We analyzed surveillance versus different adjuvant chemotherapy regimens and the influence of time to pcRPLND on oncologic outcomes.

Methods: Data on 117 men treated with cisplatin-based first-line chemotherapy between 1990 and 2018 were collected from 13 institutions.

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At present, androgen deprivation therapy (ADT) as monotherapy for metastatic hormone-sensitive prostate cancer (mHSPC) should be an exception. The new standard of care is a doublet combination consisting of ADT + a new hormonal agent (NHA) or ADT + chemotherapy. Contemporary investigations even recommend a triplet therapy consisting of ADT + NHA + chemotherapy for selected mHSPC patients.

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Background: The European Association of Urology guidelines include the lutetium-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 of Lu PSMA in real-world practice and to elaborate clinical biomarkers for evaluating treatment responses.

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Background: Treatment options for patients with urothelial cancer (UC) refractory to platinum and immunotherapy are limited and survival is short. Enfortumab vedotin (EV) is a monoclonal anti-NECTIN4 antibody conjugated to monomethyl auristatin. It was recently approved because of superior survival in comparison to standard-of-care (SOC) chemotherapy.

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Background: Radiation therapy and systemic chemotherapy are recommended treatment options in marker-negative clinical stage (CS) IIA/B seminoma. Despite high cure rates of 82-94%, both therapeutic options are associated with significant long-term toxicities.

Objective: To evaluate the feasibility, oncological efficacy, and treatment-associated morbidity of primary nerve-sparing retroperitoneal lymph node dissection (nsRPLND) in CS IIA/B seminoma.

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