Article

Guidelines for the Management of Non-Muscle Invasive Bladder Cancer (Stages Ta, T1, and TIS): 2007 Update

American Urological Association Education and Research, Inc., USA.
The Journal of urology (Impact Factor: 3.75). 01/2008; 178(6):2314-30. DOI: 10.1016/j.juro.2007.09.003
Source: PubMed
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    • "PDD by transurethral administration of HAL was approved for bladder cancer in Europe in 2005 and the US in 2010, and is now clinically used in many countries. Various recommendations of PDD with transurethral HAL (HAL-PDD) for bladder cancer are described in the guidelines established by the European Association of Urology [11] and American Urological Association [12]. In PDD of bladder cancer, HAL and 5-ALA as photosensitive substances to be transurethrally administered have shown the similar effectiveness with regards to diagnostic accuracy and recurrence prognosis [13]. "
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    ABSTRACT: Photodynamic diagnosis (PDD) of non-muscle-invasive bladder cancer (NMIBC) following transurethral administration of a hexalated form of 5-aminolevulinic acid (5-ALA), 5-ALA hexyl ester, is widely performed in Western countries. In this study, effectiveness and safety of the oral administration of 5-ALA is assessed in a phase II/III study of PDD for NMIBC in comparison to those of conventional white-light endoscopic diagnosis. Patients with NMIBC were allocated to 2 groups that were orally administered 10 and 20mg/kg of 5-ALA under the double-blind condition. Effectiveness was evaluated by setting the primary endpoint to sensitivity. Safety was also analyzed. Moreover, clinically recommended doses of 5-ALA was also investigated as an investigator-initiated multicenter cooperative clinical trial in which 5 medical institutions participated. All 62 enrolled patients completed the clinical trial. The sensitivities of PDD were higher(84.4 and 75.8% in the 10 and 20mg/kg-groups, respectively) than those of conventional endoscopic diagnosis (67.5 and 47.6%, respectively) (p=0.014 and p<0.001, respectively). Five episodes of serious adverse events developed in 4 patients; whereas a causal relationship with the investigational agent was ruled out in all episodes. This investigator-initiated clinical trial confirmed the effectiveness and safety of PDD for NMIBC following oral administration of 5-ALA. Both doses of 5-ALA may be clinically applicable; however, the rate of detecting tumors only by PDD was higher in the 20mg/kg-group suggesting that this dose would be more useful. Copyright © 2015. Published by Elsevier B.V.
    Photodiagnosis and photodynamic therapy 04/2015; 12(2). DOI:10.1016/j.pdpdt.2015.03.008 · 2.52 Impact Factor
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    • "However, results from both the SWOG and EORTC (European Organisation for Research and Treatment of Cancer) trials, point towards a regimen of an induction of 6 weekly instillations and then a maintenance schedule of 3 weekly instillations at 3 and 6 months, then 6 monthly thereafter. This regimen has been recommended by the American Urological Association (AUA) (Hall et al., 2007) and the European Association of Urology (EAU) (Babjuk et al., 2011) as well as local guidelines (National Comprehensive Cancer Network, 2012; Paul et al., 2012). Although the EAU recommends a 3-year maintenance regime it also points out that the optimal maintenance regime is not known and that at least 1 year of maintenance treatment is required to gain superiority over MMC treatment (Babjuk et al., 2011). "
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    ABSTRACT: Since the turn of the 20th century Bacillus Calmette-Guerin (BCG) treatment for non-muscle invasive bladder cancer (NMIBC) has been in and out of favour. However, only a small proportion of patients, as low as 16%, complete what is seen as a gold standard treatment. To understand why it is the gold standard treatment the epidemiology and aetiology of NMIBC is presented. This article discusses how BCG was first discovered in cows to it being used as a treatment for NMIBC. The issues of side effects which can be from mild to severe and local to systemic, will be discussed. The impact of age in the tolerance of this treatment will be also be looked at. In conclusion, with BCG treatment being the preferred option for NMIBC, it also comes with significant side effects. It is these that should be of concern to the health care professional as they can be potentially life threatening.
    International Journal of Urological Nursing 11/2014; DOI:10.1111/ijun.12064 · 0.19 Impact Factor
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    • "The CPM was systematically applied in a series of clinical guidelines developed by the American Urological Association and published between 1987 and 2007 in clinical urological journals. These guidelines cover the management of invasive bladder cancer (Eddy, 1989; Smith et al., 1999; Hall et al., 2007), ureteral calculi (Segura et al., 1997), female stress urinary incontinence (Leach et al., 1997), organic erectile dysfunction (Montague et al., 1996), prostate cancer (Austenfeld et al., 1994), and staghorn calculi (Segura et al., 1994). "
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    ABSTRACT: Researchers may have multiple motivations for combining disparate pieces of evidence in a meta-analysis, such as generalizing experimental results or increasing the power to detect an effect that a single study is not able to detect. However, while in meta-analysis, the main question may be simple, the structure of evidence available to answer it may be complex. As a consequence, combining disparate pieces of evidence becomes a challenge. In this review, we cover statistical methods that have been used for the evidence-synthesis of different study types with the same outcome and similar interventions. For the methodological review, a literature retrieval in the area of generalized evidence-synthesis was performed, and publications were identified, assessed, grouped and classified. Furthermore real applications of these methods in medicine were identified and described. For these approaches, 39 real clinical applications could be identified. A new classification of methods is provided, which takes into account: the inferential approach, the bias modeling, the hierarchical structure, and the use of graphical modeling. We conclude with a discussion of pros and cons of our approach and give some practical advice. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.
    06/2014; 6(1). DOI:10.1002/jrsm.1122
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