Thomas Steuber's research while affiliated with University Medical Center Hamburg - Eppendorf and other places

Publications (418)

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Background In a subset of patients with recurrent oligometastatic prostate cancer (PCa) salvage surgery with prostate-specific membrane antigen (PSMA)-targeted radioguidance (PSMA-RGS) might be of value. Objective To evaluate the oncological outcomes of salvage PSMA-RGS and determine the predictive preoperative factors of improved outcomes. Desig...
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The objective of the study was to test the impact of implementing standard full functional-length urethral sphincter (FFLU) and neurovascular bundle preservation (NVBP) with intraoperative frozen section technique (IFT) on long-term urinary continence in patients undergoing robotic-assisted radical prostatectomy (RARP). We relied on an institutiona...
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Background: We aimed to determine the concordance between the radiologic stage (rT), using multiparametric magnetic resonance imaging (mpMRI), and pathologic stage (pT) in patients with high-risk prostate cancer and its influence on nerve-sparing surgery compared to the use of the intraoperative frozen section technique (IFST). Methods: The conc...
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Background: To test the impact of urethral sphincter length (USL) and anatomic variants of prostatic apex (Lee-type classification) in preoperative multiparametric magnet resonance imaging (mpMRI) on mid-term continence in prostate cancer patients treated with radical prostatectomy (RP). Methods: We relied on an institutional tertiary-care datab...
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142 Background: In ACIS, APA + AAP improved radiographic progression-free survival in mCRPC vs AAP; difference in overall survival (OS) was not statistically significant. We report a prespecified analysis of androgen receptor (AR) or non-AR genomic/transcriptional aberrations, known to be associated with poor prognosis, and their associations with...
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106 Background: Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) allows detection of small and/or atypically localized metastatic prostate cancer (PCa) lesions. In a subset of patients with recurrent oligometastatic PCa salvage surgery with PSMA-targeted radioguidance (PSMA-RGS) may be of value. We aimed to evaluate the...
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Background: To determine the correlation between urine loss in PAD-test after catheter removal, and early urinary continence (UC) in RP treated patients. Methods: Urine loss was measured by using a standardized, validated PAD-test within 24 h after removal of the transurethral catheter, and was grouped as a loss of <1, 1-10, 11-50, and >50 g of...
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The objective was to determine the prognostic utility of a new biomarker combination in prostate cancer (PCa) patients undergoing Radical Prostatectomy (RP). Serum samples and clinical data of 557 men who underwent RP for PCa with pathological stage (pT) <3 at Martini Clinic (Hamburg, Germany) were used for analysis. Clinical Grade Group and clinic...
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Background Prostate cancer metastases may occur at diagnosis (de novo) or metachronous after treatment for localized disease.Objective To describe location, prognosis, and individual treatment concepts for metachronous oligometastatic prostate cancer.Materials and methodsAnalysis of current treatment guidelines and literature for hormone sensitive,...
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Purpose To investigate the concordance of biopsy and pathologic International Society of Urological Pathology (ISUP) grading in salvage radical prostatectomy (SRP) patients for recurrent prostate cancer. Methods Within a high-volume center database, we identified patients who underwent SRP for recurrent prostate cancer (PCa) between 2004 and 2020....
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Objective: To assess whether sampling of the transitional-zone can be spared in patients with exclusively peripheral prostate cancer (PCa)-suspicious mpMRI lesions, who undergo combined mpMRI targeted (TBx) and systematic prostate biopsies (SBx). Materials and methods: Of 1,685 patients, who underwent extended SBx including transitional-zone sam...
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ContextThere is an urgent need to develop novel treatment strategies in patients with unfavorable intermediate- and high-risk localized prostate cancer (PCa) to optimize the outcome of these patients. Androgen receptor signaling inhibitors (ARSI) have demonstrated a survival benefit in metastatic hormonesensitive and castration-resistant PCa. A sim...
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Background The majority of patients with metastatic castration-resistant prostate cancer (mCRPC) will have disease progression of a uniformly fatal disease. mCRPC is driven by both activated androgen receptors and elevated intratumoural androgens; however, the current standard of care is therapy that targets a single androgen signalling mechanism....
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Objective: To determine the feasibility and outcome of radical prostatectomy (RP) following neoadjuvant therapy (NAT) in patients with initial inoperable, rectum-infiltrating cT4 prostate cancer (PCa). Methods: From 01/2018 to 12/2020, 26 patients with clinical (DRE) or radiographical (mpMRI) suspicion of rectum infiltrating PCa at diagnosis and...
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Aim: Few small-scaled studies performed systematic analysis of the benefits of extending prostate specific membrane antigen positron-emission tomography/ computed tomography (68Ga-PSMA I&T PET/CT) to the lower extremities in prostate cancer (PCa) patients. We hypothesized that 68Ga-PSMA I&T PET/CT positive lesions are rare in lower extremities of...
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Background A trend towards inverse stage migration in prostate cancer (PCa) was reported. However, previous analyses did not take into account potential differences in sampling strategies (number of biopsy cores), which might have confounded these reports. Material and Methods Within our single-institutional database we identified PCa patients tre...
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Zusammenfassung Hintergrund Die Osteoprotektion bei Prostatakarzinompatienten spielt nicht nur in der ossär metastasierten kastrationsresistenten (mCRPC) Situation eine Rolle. Auch im ossär metastasiertem hormonsensitiven Stadium (mHSPC) und im Allgemeinen begleitend zur Androgendeprivationstherapie (ADT) wird eine Osteoprotektion empfohlen. Diese...
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Objectives: To reduce the risk of symptomatic lymphocele (SLC), we present a technique using peritoneal fenestration that allows lymphatic fluid to drain into the abdomen. Since SLC formation after open retropubic radical prostatectomy (ORP) with pelvic lymph node dissection (PLND) is a common adverse event. Materials und methods: We identified...
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5037 Background: In the double-blind PBO-controlled ACIS study, investigator-assessed radiographic progression-free survival (rPFS) was significantly improved with APA + AAP vs PBO + AAP in chemo-naive mCRPC, with no significant new safety signals (Rathkopf ASCO GU 2021). Among prespecified subgroups, efficacy and safety were explored in two diffic...
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Objective To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients. Methods Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were abstracted from the Surveillance, E...
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Background: To evaluate the impact of time to castration resistance (TTCR) in metastatic hormone-sensitive prostate cancer (mHSPC) patients on overall survival (OS) in the era of combination therapies for mHSPC. Material and methods: Of 213 mHSPC patients diagnosed between 01/2013-12/2020 who subsequently developed metastatic castration resistan...
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Objective Cytoreductive radical prostatectomy (cRP) has been proposed as local treatment option in metastatic hormone-sensitive prostate cancer (mHSPC) to prevent local complications and potentially improve oncological outcomes. In this study, we examined the feasibility of a multimodal concept with primary chemohormonal therapy followed by cRP and...
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We hypothesized that the survival benefit of external beam radiation therapy (EBRT) recorded in European low-volume metastatic prostate cancer (mPCA) patients, will apply to similar North American patients. Newly diagnosed mPCa patients with M1a/b substages, treated with EBRT or no EBRT were abstracted from the Surveillance, Epidemiology, and End R...
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9 Background: As mCRPC is driven by activated androgen receptors and elevated intratumoral androgens, androgen annihilation may require dual inhibition. APA and AA are approved prostate cancer therapies that have distinct receptor inhibition and ligand suppression actions, respectively. ACIS compared radiographic progression-free survival (rPFS) of...
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Probably, de novo (synchronous) and recurrent (metachronous) oligometastatic hormone sensitive prostate cancer patients have different oncologic outcomes. Thus, we are challenged with different scenarios in clinical practice, where different treatment options may apply. In the last years, several prospective studies have focused on the treatment of...
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Background Prostate-specific antigen (PSA)-based detection of prostate cancer (PCa) often leads to negative biopsy results or detection of clinically insignificant PCa, more frequently in the PSA range of 2–10 ng/ml, in men with increased prostate volume and normal digital rectal examination (DRE). Objective This study evaluated the accuracy of Pr...
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Context Management of newly diagnosed prostate cancer (PCa) is guided in part by accurate clinical staging. The role of imaging, including magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT), in initial staging remains controversial. Objective To systematically review the studies of MRI and/or PET/CT in t...
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Background The aim of this study was to investigate the impact of lymph-node involvement on oncological outcomes in patients with pathologically organ-confined prostate cancer (pT2 CaP) after radical prostatectomy (RP). Methods We retrospectively analyzed 9,631 pT2 CaP patients who underwent RP at a single institution between 1998 and 2018. Kaplan...
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Background: Various life-prolonging therapy options are available for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Objective: The optimal therapy sequence for mCRPC has been discussed for years. With the final results of the CARD study, important prospective data are available to enlighten the discussion about the th...
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Background Claudin-1 is a membrane-tight junction protein and important for the sealing of the paracellular cleft in epithelial and endothelial cells. Differential expression of Claudin-1 is linked to disease outcome in various cancers. Material and methods To evaluate the potential relevance of Claudin-1 expression in prostate cancer, a tissue mi...
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Purpose STAMPEDE arm H demonstrated a survival benefit for newly diagnosed prostate cancer (PCa) patients with low metastatic burden (LMB) who additionally received radiotherapy (RT) to the primary. However, it is unknown if radical prostatectomy (RP) may achieve equivalent results, since existing studies did neither include the same selection crit...
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Purpose One of the advantages of minimally invasive surgery may be reduced postoperative pain and faster recovery. However, reliable comparisons of robot-assisted (RARP) vs. open radical prostatectomy (ORP) addressing perioperative pain regimen are scarce. Methods We identified 420 consecutive treated patients who underwent RARP (n = 254) vs. ORP...
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A pre-specified model based on four kallikrein markers in blood, commercially available as 4Kscore, predicts Gleason Grade (GG) 3 + 4 or higher prostate cancer on biopsy. However, sampling error and variation in pathology reporting may miss aggressive disease. The 4Kscore was measured in cryopreserved blood from 2330 men obtained before prostatecto...
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Objectives: Selecting patients suspected of having prostate cancer (PCa) for a prostate biopsy remains a challenge. Prostate-specific antigen (PSA)-based testing is hampered by its low specificity that often leads to negative biopsy results or detection of clinically insignificant cancers, especially in the 2-10 ng/mL range. The objective was to e...
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Background Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidel...
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Background: Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guid...
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Background: To examine the impact of different pretreatment definitions on biochemical recurrence (BCR)-free survival, metastasis-free survival, and cancer-specific survival after radical prostatectomy. Methods: Overall, 26,364 patients with clinically localized disease who underwent radical prostatectomy at a single institution (1992-2017) were...
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Introduction and objectives In the perioperative setting, temporary interruption of direct oral anticoagulants (DOACs) is recommended. However, the safety of these recommendations is based on non-urological surgical experiences. Our objective was to verify the safety of these recommendations in patients undergoing radical prostatectomy (RP). Mater...
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Die Taxan-basierte Chemotherapie und die gegen den Androgenrezeptor gerichteten Substanzen („androgen receptor-targeted agent“, ARTA) haben die therapeutischen Möglichkeiten beim metastasierten Prostatakarzinom (mPC) deutlich erweitert und bieten den Patienten die Chance, länger zu überleben. Die Therapiesequenz von ARTA und Taxanen kann Einfluss a...
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Introduction The purpose of this study was to investigate adherence to recommended adjuvant radiotherapy (aRT) in radical prostatectomy (RP) patients with adverse pathologic features and to analyse the outcome of patients who followed or denied this recommendation. Patients and Methods We included 1140 consecutive RP patients (2006-2015) with non-...
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Erratum zu: Urologe 2019 10.1007/s00120-019-0925-2 Leider ist im englischen Beitragstitel ein Fehler aufgetreten. Wir bitten den korrekten englischen Titel „Treatment situation in metastatic Castration Naive Prostate Cancer (mCNPC) and the implications on clinical routine“ zu beachten
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Background The prognostic value of circulating tumor cells (CTCs) in patients with hormone-naïve oligometastatic prostate cancer (HNoMPC) undergoing cytoreductive radical prostatectomy (CRP) is unknown. Objective To determine the pre- and postoperative prognostic value of CTC enumeration in patients undergoing CRP. Design, setting, and participan...
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Nach definitiver kurativ intendierter Therapie kommt es bei einem Teil der Patienten mit Prostatakarzinom zu einem biochemischen Rezidiv. In solchen Fällen erfolgt meist anhand klinischer Parameter die Einschätzung, ob es sich um ein lokales oder ein systemisches Rezidiv handelt. Während nach radikaler Prostatektomie die Salvage-Bestrahlung die Sta...
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Die Behandlung des metastasierten Prostatakarzinoms (mPC) erlebt derzeit einen Paradigmenwechsel. Verschiedene randomisierte Phase-III-Studien konnten zeigen, dass die Chemotherapie mit Taxanen das Überleben der Patienten mit mPC signifikant verlängert. Das gilt sowohl für die metastasierte Erkrankung in der Kastrationsresistenz (metastasiertes kas...
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Objectives Cancer survivors are often diagnosed with subsequent prostate cancer. To improve medical care of these patients, we examined the oncological outcomes in men with prostate cancer and a cancer history. Patients and methods We retrospectively analyzed data from 25,422 prostate cancer patients, who underwent a radical prostatectomy between...
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Objective To compare oncological, functional and surgical outcomes of open retropubic radical prostatectomy (ORP) vs. robot‐assisted laparoscopic radical prostatectomy (RARP). Patients and Methods We identified 10,790 consecutive treated patients within our prospective database (2008‐2016) who underwent either ORP (n=7,007) or RARP (n=3,783). All...
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