Author
Marian Jecu
Bio: Marian Jecu is an academic researcher. The author has contributed to research in topics: Cystoscopy & Bladder cancer. The author has an hindex of 10, co-authored 54 publications receiving 512 citations.
Papers
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TL;DR: Study Type – Therapy (individual cohort) – Intervention (group cohort) and study type – therapy ( individual cohort)
Abstract: Study Type – Therapy (individual cohort)
Level of Evidence 2b
What's known on the subject? and What does the study add?
HAL fluorescence cystoscopy is known to improve tumour detection in NMIBC cases and to have a potentially favourable impact concerning the recurrence rates.
The present trial assessed the advantages of HAL cystoscopy with regard to postoperative treatment changes and 2 years' recurrence rates, subjects that are poorly evaluated in the literature.
OBJECTIVES
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To evaluate in a prospective, randomized study the impact of hexaminolevulinate blue-light cystoscopy (HAL-BLC) on the diagnostic accuracy and treatment changes in cases of non-muscle invasive bladder cancer (NMIBC) compared with standard white-light cystoscopy (WLC).
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To compare the long-term recurrence rates in the two study arms.
PATIENTS AND METHODS
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In all, 362 patients suspected of NMIBC were included in the trial based on positive urinary cytology and/or ultrasonographic suspicion of bladder tumours and underwent transurethral resection of bladder tumours.
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A single postoperative mytomicin-C instillation was performed in all cases, intravesical chemotherapy for intermediate-risk patients and BCG instillations for high-risk cases.
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The follow-up protocol consisted of urinary cytology and WLC every 3 months for 2 years.
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Only first-time recurrences after the initial diagnosis were considered.
RESULTS
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In the 142 patients with NMIBC in the HAL-BLC series, tumour detection rates significantly improved for carcinoma in situ, pTa andoverall cases.
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In 35.2% of the cases, additional malignant lesions were found by HAL-BLC and consequently, the recurrence- and progression-risk categories of patients and subsequent treatment improved in 19% of the cases due to fluorescence cystoscopy.
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In all, 125 patients in the HAL-BLC group and 114 of the WLC group completed the follow-up.
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The recurrence rate at 3 months was lower in the HAL-BLC series (7.2% vs 15.8%) due to fewer ‘other site’ recurrences when compared with the WLC series (0.8% vs 6.1%).
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The 1 and 2 years recurrence rates were significantly decreased in the HAL-BLC group compared with the WLC group (21.6% vs 32.5% and 31.2% vs 45.6%, respectively).
CONCLUSIONS
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HAL-BLC was better than WLC for detecting NMIBC cases and improved tumour detection rates.
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HAL-BLC significantly modified the postoperative treatment of cases.
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The 3 months, 1 and 2 years recurrence rates were significantly improved in the HAL-BLC arm.
91 citations
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TL;DR: BPVP represents a valuable endoscopic treatment alternative for BPH patients, with superior efficacy and satisfactory complication rate, and the long-term follow-up emphasized durable improvements of the postoperative parameters for BPVP.
85 citations
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TL;DR: NBI cystoscopy significantly improved the diagnostic accuracy in cases of large NMIBTs, and BPV emphasized superior efficacy and safety compared with TURBT.
76 citations
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TL;DR: Blue-light cystoscopy and resection significantly reduced the short-term recurrence rates determined during the standard Re-TURBT in all categories of high-risk patients compared with the standard cystoscopic procedures.
54 citations
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TL;DR: In this article, the authors evaluated the efficiency, safety and short-term outcome of transurethral resection in saline plasma vaporization of the prostate (TURis-PVP), and to compare it to the standard TUR of TURP.
Abstract: Study Type – Therapy (RCT) Level of Evidence 1b
OBJECTIVE
To evaluate the efficiency, safety and short-term outcome of transurethral resection in saline plasma vaporization of the prostate (TURis-PVP), and to compare it to the standard TUR of the prostate (TURP).
PATIENTS AND METHODS
In all, 155 patients with benign prostatic enlargement (BPE) secondary to benign prostatic hyperplasia (BPH), with a maximum urinary flow rate (Qmax) of 19 and prostate volume of 30–80 mL were enrolled in this prospective, randomized trial. All patients were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, health-related quality of life (HRQL) score, Qmax and postvoid residual urine volume (PVR).
RESULTS
Patients from both series had similar preoperative characteristics. TURis-PVP and TURP were successfully performed in all cases (75 and 80, respectively). The operative duration, catheterization period and hospital stay were significantly shorter for TURis-PVP patients at 35.1 vs 50.4 min, 23.8 vs 71.2 and 47.6 vs 93.1 h, respectively (all P < 0.05). At the 1, 3 and 6 months follow-ups, improvements in the variables measured were better in the TURis-PVP group: the IPSS was 4.4 vs 8.3 and the Qmax was 22.7 vs 20.5 mL/s at 1 month; the IPSS was 4.8 vs 8.6 and the Qmax was 22.3 vs 20.0 mL/s at 3 months; and the IPSS was 5 vs 9.1 and the Qmax was 21.8 vs 19.3 mL/s at 6 months (All P < 0.05).
CONCLUSIONS
TURis-PVP represents a valuable endoscopic treatment alternative for patients with BPE, with superior efficacy, short-term results and complication rates compared with monopolar TURP.
50 citations
Cited by
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TL;DR: The 2013 version of the European Association of Urology guidelines on the treatment and follow-up of male lower urinary tract symptoms (LUTS) provides practical guidance for the management of men experiencing LUTS.
1,060 citations
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Northwestern University1, Seattle Cancer Care Alliance2, Case Western Reserve University3, Washington University in St. Louis4, Ohio State University5, Stanford University6, University of California, San Diego7, Brigham and Women's Hospital8, Memorial Sloan Kettering Cancer Center9, University of Colorado Boulder10, University of Texas MD Anderson Cancer Center11, Mayo Clinic12, Fox Chase Cancer Center13, Harvard University14, Duke University15, University of Pennsylvania16, Vanderbilt University17, Yale University18, City of Hope National Medical Center19, University of Wisconsin-Madison20, University of Michigan21, University of California, San Francisco22, Johns Hopkins University23, University of South Florida24, University of Alabama at Birmingham25, University of Utah26, Roswell Park Cancer Institute27, National Comprehensive Cancer Network28
TL;DR: The NCCN Guidelines specific to the workup and treatment of patients with recurrent/stage IV breast cancer are discussed in this article.
Abstract: This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Bladder Cancer focuses on the clinical presentation and workup of suspected bladder cancer, treatment of non-muscle-invasive urothelial bladder cancer, and treatment of metastatic urothelial bladder cancer because important updates have recently been made to these sections. Some important updates include recommendations for optimal treatment of non-muscle-invasive bladder cancer in the event of a bacillus Calmette-Guerin (BCG) shortage and details about biomarker testing for advanced or metastatic disease. The systemic therapy recommendations for second-line or subsequent therapies have also been revised. Treatment and management of muscle-invasive, nonmetastatic disease is covered in the complete version of the NCCN Guidelines for Bladder Cancer available at NCCN.org. Additional topics covered in the complete version include treatment of nonurothelial histologies and recommendations for nonbladder urinary tract cancers such as upper tract urothelial carcinoma, urothelial carcinoma of the prostate, and primary carcinoma of the urethra.
1,018 citations
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TL;DR: The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics, and a risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk.
936 citations
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TL;DR: A meta-analysis of available randomized controlled trials shows that HoLEP is associated with more favorable outcomes than M-TURP in published RCTs and needs to be refined to propose tailored surgical treatment for benign prostatic obstruction relief.
566 citations
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TL;DR: This meta-analysis confirms that HAL BL cystoscopy significantly improves the detection of bladder tumours leading to a reduction of recurrence at 9-12 mo, and is evident in patients with Ta, T1, CIS, primary, and recurrent cancer.
347 citations