[Diagnostic markers in urology]. / Diagnostische Marker in der Urologie.

Cancer diagnostics can be supplemented by disease-related biomarkers. In the course of modern patient-tailored cancer treatment, the importance of correct risk stratification, prognosis and monitoring has significantly increased. In recent years, a multitude of biomarkers and related test procedures have emerged to fulfil this purpose. The following review article summarizes the most recent developments with respect to the use of biomarkers in the diagnostics of urological cancers.

Adherence to the EAU Guideline Recommendations for Local Tumor Treatment in Penile Cancer: Results of the European PROspective Penile Cancer Study Group Survey (E-PROPS).

INTRODUCTION: Penile cancer (PeCa) is an orphan disease in European countries. The current guidelines are predominantly based on retrospective studies with a low level of evidence. In our study, we aimed to identify predictors for guideline-conform treatment and hypothesize that reference centers for PeCa and physicians' experience promote guideline compliance and therefore correct local tumor therapy. METHODS: This study is part of the European PROspective Penile Cancer Study (E-PROPS), an international collaboration group evaluating therapeutic management for PeCa in Central Europe. For this module, a 14-item-survey was developed and sent to 681 urologists in 45 European centers. Three questions focused on therapeutic decisions for PeCa in clinical stage Tis, Ta-T1a, and T1b. Four questions addressed potential personal confounders. Survey results were analyzed by bootstrap-adjusted stepwise multivariate linear regression analysis to identify predictors for EAU guideline-conform local treatment of PeCa. RESULTS: For local therapy of cTis 80.4% recommended guideline-conform treatment, for cTa-cT1a 87.3% and for cT1b 59.1%. In total, 42.4% chose a correct approach in all tumor stages. The number of PeCa patients treated at the hospital, a higher level of training of the physicians, resource-based answering and the option of penile-sparing surgery offered at the hospital matched with giving guideline-conform recommendations and thus accurate local tumor treatment. CONCLUSION: Patients with PeCa are best treated by experienced physicians, in centers with a high number of cases, which also offer a wide range of local tumor therapy. This could be offered in reference centers.

Sealing, refurbishment and repair of Class I and Class II defective restorations: a three-year clinical trial.

BACKGROUND: The authors conducted a clinical study to examine the effectiveness of treatments other than replacement for defective Class I and Class II resin-based composite (RBC) and amalgam (AM) restorations. METHODS: The authors recruited 66 patients (age range, 18-80 years) with 271 Classes I and II defective restorations (RBC = 78 and AM = 193). They assigned restorations to one of the following treatment groups on the basis of the type of defect: sealed margins (n = 48), repair (n = 27), refurbishment (n = 73), replacement (n = 42) or untreated (n = 81). They used modified U.S. Public Health Service/Ryge criteria to determine the quality of the restorations. Two examiners assessed the restorations independently at the beginning of the study and three years after treatment (Cohen's kappa = 0.74 at baseline and 0.82 at year 3). They used five parameters in assessing the restorations: marginal adaptation, anatomical form, surface roughness, secondary caries and luster. RESULTS: The authors assessed 237 restorations (RBC = 73, AM = 164) at the three-year recall examination. Restorations that underwent sealing of marginal defects exhibited significant improvements in marginal adaptation (P