Tears have antimicrobial, nourishing, mechanical, and optical properties. They contain components such as growth factors, fibronectin, and vitamins to support proliferation, migration, and differentiation of the corneal and conjunctival epithelium. A lack of these epitheliotrophic factors—for example, in dry eye, can result in severe ocular surface disorders such as persistent epithelial defects. Recently, the use of autologous serum in the form of eye drops has been reported as a new treatment for severe ocular surface disorders. Serum eye drops may be produced as an unpreserved blood preparation. They are by nature non-allergenic and their biomechanical and biochemical properties are similar to normal tears. In vitro cell culture experiments showed that corneal epithelial cell morphology and function are better maintained by serum than by pharmaceutical tear substitutes. Clinical cohort studies have reported its successful use for severe dry eyes and persistent epithelial defects. However, the protocols to prepare and use autologous serum eye drops varied considerably between the studies. As this can result in different biochemical properties protocol variations may also influence the epitheliotrophic effect of the product. Before the definitive role of serum eye drops in the management of severe ocular surface disease can be established in a large randomised controlled trial this has to be evaluated in more detail. In view of legislative restrictions and based upon the literature reviewed here a preliminary standard operating procedure for the manufacture of serum eye drops is proposed.
Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. Design: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. Setting: Online Delphi survey and consensus conference. Participants: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. Outcome measurements and statistical analysis: Statements were ranked by experts according to their level of agreement: 1–3 (disagree), 4–6 (equivocal), 7–9 (agree). A priori (level 1) consensus was defined as 70% agreement and 15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). Results and limitations: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of ...
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus statements provide further guidance on ...
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1–3 (disagree), 4–6 (equivocal), 7–9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus statements provide further guidance on ...
In: Horwich , A , Babjuk , M , Bellmunt , J , Bruins , H M , Reijke , T M D , Santis , M D , Gillessen , S , James , N , Maclennan , S , Palou , J , Powles , T , Ribal , M J , Shariat , S F , Kwast , T V D , Xylinas , E , Agarwal , N , Arends , T , Bamias , A , Birtle , A , Black , P C , Bochner , B H , Bolla , M , Boormans , J L , Bossi , A , Briganti , A , Brummelhuis , I , Burger , M , Castellano , D , Cathomas , R , Chiti , A , Choudhury , A , Compérat , E , Crabb , S , Culine , S , Bari , B D , Blok , W D , De Visschere , P J L , Decaestecker , K , Dimitropoulos , K , Dominguez-Escrig , J L , Fanti , S , Fonteyne , V , Frydenberg , M , Futterer , J J , Gakis , G , Geavlete , B , Gontero , P , Grubmüller , B , Hafeez , S , Hansel , D E , Hartmann , A , Hayne , D , Henry , A M , Hernandez , V , Herr , H , Herrmann , K , Hoskin , P , Huguet , J , Jereczek-Fossa , B A , Jones , R , Kamat , A M , Khoo , V , Kiltie , A E , Krege , S , Ladoire , S , Lara , P C , Leliveld , A , Linares-Espinós , E , Løgager , V , Lorch , A , Loriot , Y , Meijer , R , Mir , M C , Moschini , M , Mostafid , H , Müller , A C , Müller , C R , N'Dow , J , Necchi , A , Neuzillet , Y , Oddens , J R , Oldenburg , J , Osanto , S , Oyen , W J G , Pacheco-Figueiredo , L , Pappot , H , Patel , M I , Pieters , B R , Plass , K , Remzi , M , Retz , M , Richenberg , J , Rink , M , Roghmann , F , Rosenberg , J E , Rouprêt , M , Rouvière , O , Salembier , C , Salminen , A , Sargos , P , Sengupta , S , Sherif , A , Smeenk , R J , Smits , A , Stenzl , A , Thalmann , G N , Tombal , B , Turkbey , B , Lauridsen , S V , Valdagni , R , Van Der Heijden , A G , Van Poppel , H , Vartolomei , M D , Veskimäe , E , Vilaseca , A , Rivera , F A V , Wiegel , T , Wiklund , P , Williams , A , Zigeuner , R & Witjes , J A 2019 , ' EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort : under the auspices of the EAU and ESMO Guidelines Committees† ' , Annals of oncology : official journal of the European Society for Medical Oncology , vol. 30 , no. 11 , pp. 1697-1727 . https://doi.org/10.1093/annonc/mdz296
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus statements provide further guidance on ...
In: Horwich , A , Babjuk , M , Bellmunt , J , Bruins , H M , de Reijke , T M , de Santis , M , Gillessen , S , James , N , Maclennan , S , Palou , J , Powles , T , Ribal , M J , Shariat , S F , van der Kwast , T , Xylinas , E , Agarwal , N , Arends , T , Bamias , A , Birtle , A , Black , P C , Bochner , B H , Bolla , M , Boormans , J L , Bossi , A , Briganti , A , Brummelhuis , I , Burger , M , Castellano , D , Cathomas , R , Chiti , A , Choudhury , A , Compérat , E , Crabb , S , Culine , S , de Bari , B , DeBlok , W , de Visschere , P J L , Decaestecker , K , Dimitropoulos , K , Dominguez-Escrig , J L , Fanti , S , Fonteyne , V , Frydenberg , M , Futterer , J J , Gakis , G , Geavlete , B , Gontero , P , Grubmüller , B , Hafeez , S , Hansel , D E , Hartmann , A , Hayne , D , Henry , A M , Hernandez , V , Herr , H , Herrmann , K , Hoskin , P , Huguet , J , Jereczek-Fossa , B A , Jones , R , Kamat , A M , Khoo , V , Kiltie , A E , Krege , S , Ladoire , S , Lara , P C , Leliveld , A , Linares-Espinós , E , Løgager , V , Lorch , A , Loriot , Y , Meijer , R , Carmen Mir , M , Moschini , M , Mostafid , H , Müller , A C , Müller , C R , N'Dow , J , Necchi , A , Neuzillet , Y , Oddens , J R , Oldenburg , J , Osanto , S , Oyen , W J G , Pacheco-Figueiredo , L , Pappot , H , Patel , M I , Pieters , B R , Plass , K , Remzi , M , Retz , M , Richenberg , J , Rink , M , Roghmann , F , Rosenberg , J E , Rouprêt , M , Rouvière , O , Salembier , C , Salminen , A , Sargos , P , Sengupta , S , Sherif , A , Smeenk , R J , Smits , A , Stenzl , A , Thalmann , G N , Tombal , B , Turkbey , B , Vahr Lauridsen , S , Valdagni , R , van der Heijden , A G , van Poppel , H , Vartolomei , M D , Veskimäe , E , Vilaseca , A , Vives Rivera , F A , Wiegel , T , Wiklund , P , Williams , A , Zigeuner , R & Witjes , J A 2019 , ' EAU–ESMO consensus statements on the management of advanced and variant bladder cancer—an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees ' , Annals of Oncology , vol. 30 , no. 11 , pp. 1697-1727 . https://doi.org/10.1093/annonc/mdz296
Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. Design: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. Setting: Online Delphi survey and consensus conference. Participants: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. Outcome measurements and statistical analysis: Statements were ranked by experts according to their level of agreement: 1–3 (disagree), 4–6 (equivocal), 7–9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). Results and limitations: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. Conclusions: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.