Nuestros investigadores

Francisco Javier Ancizu Marckert

Publicaciones científicas más recientes (desde 2010)

Autores: Robles, JE; et al.
Revista: ACTAS UROLOGICAS ESPAÑOLAS
ISSN 0210-4806  Vol. 43  Nº 43747  2019  págs. 455 - 466
Introduction: With the advanced laparoscopic and robotic surgery, thromboembolic prophylaxis in urologic procedures has traditionally been based on the experience of other surgical specialties. This paper aims to analyze the current recommendations, through a detailed study of the European clinical guidelines and bibliography, applying the recommendations of thromboprophylaxis to the daily urological practice. Objectives: To elaborate general recommendations to surgical patients in Urology, avoiding the risk of perioperative thromboembolic events. Optimize medication in chronic patients and accurately classify who are eligible for bridge therapy. Material and methods: A review of the available literature and the European clinical guidelines was carried out. We analyzed the most recent consensus articles by studying the available bibliography, trials and reviews on which the European guidelines for thromboprophytaxis in urology are based. Results: Thromboembolic prophylaxis should be targeted towards surgeries that require abdominal approaches, prolonged bed rest or oncologicat pathologies. Bridge therapies with low molecular weight heparins should be limited. Patients undergoing treatment for chronic conditions can benefit from bridge therapies in specific cases. Conclusions: According to the current guidelines, there might be an overuse of heparins in the daily clinical practice. The development of -direct oral- anticoagulants have shown to reduce the time to reintroduction of medication for chronic conditions as well as a more effective bleeding management. (C) 2019 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.
Autores: Robles, JE; et al.
Revista: ARCHIVOS ESPAÑOLES DE UROLOGIA
ISSN 0004-0614  Vol. 72  Nº 1  2019  págs. 25 - 35
OBJECTIVES: Studying the psychosocial sphere of patients who undergo any treatment allows to have more information about its repercussion and can help the choice of an appropriate and personalized treatment. Due to the absence of specific instruments at present, the objective is to design and validate a health questionnaire regarding the treatment received with ESWL. METHODS: It was carried out in 6 phases using a sample of 50 patients treated with ESWL in 2015 in our center, whom we interviewed by telephone. In phase 1 the items were proposed based on bibliographic review, in phase 2 those that scored below 7 were eliminated according to the evaluation from 0 to 10 on the items made by specialists. In phase 3, values of 1 to 5 were assigned to each item and those with corrected correlation more than 0.2 and not significant (p>0.05) discriminant power with U-Mann Whitney were eliminated. In phase 4 the reliability of the questionnaire was checked with two indexes (Cronbach's alpha and two Guttman's halves). In phase 5, the factor analysis with Varimax rotation was performed to calculate the construct validity and in stage 6, the scores were analyzed to establish reference values. RESULTS: 50 patients (32 men, 18 women). Median age 59 years (27-79), In phase 1, 35 items were proposed, 9 of which were eliminated in phase 2. The initial questionnaire with 26 items was distributed, with 18 being eliminated in phase 3. The final questionnaire was formed with 8 items. In phase 4 the results of Cronbach's alpha and Guttman's two halves index were 0.44 and 0.323 respectively. In phase 5 after factor analysis, we found 4 factors with 2 items each (background, impact of the acute picture, post-treatment, quality of life) able to explain 71.19% of the variance. The median scores of the scale, extreme values and quartiles studied in phase 6 were respectively: P50: 17 (minimum-maximum 9-25), P25: 14 and P75: 20. CONCLUSIONS: The study carried out has provided a new instrument for assessing satisfaction after treatment with ESWL with adequate reliability and validity values. Future studies will be necessary to contrast its true clinical usefulness.
Autores: Robles, JE; et al.
Revista: ACTAS UROLOGICAS ESPAÑOLAS
ISSN 0210-4806  Vol. 43  Nº 9  2019  págs. 455-466
Autores: Miñana, Bernardino, (Autor de correspondencia); et al.
Revista: ARCHIVOS ESPAÑOLES DE UROLOGIA
ISSN 0004-0614  Vol. 71  Nº 8  2018  págs. 685 - 695
We review the role of immunotherapy in castration resistant prostate cancer. Two immunotherapeutic strategies have been applied, isolated or in combination, either with each other or with other agents with demonstrated efficacy in this scenario that would play a role as immunomodulators: vaccines or monoclonal antibodies aimed to block immune response checkpoint inhibitors. Although CRPC presents, a priori, characteristics suggesting that immunotherapy may play a relevant role as a therapeutic strategy, its clinical application has demonstrated a limited and heterogeneous activity, in terms of proportion of responders and response intensity. Generally, the objective response rate is very low, although, in patients who have response it is possible to detect a clear, long-lasting benefit. Only the autologous vaccine Sipuleucel T has demonstrated an overall survival increase in patients with good prognosis criteria. In these treatments, it is characteristic that no progression free survival increase is visible due to its action mechanism. PSA evolution may not be considered a surrogate variable of radiological response or clinical benefit in this environment either. It is necessary to identify what patient's or tumor's characteristics are able to maximize the response. An important limitation is the absence of response predictive biomarkers that serve for patient preselection. As a general rule, the best responses with isolated immunotherapeutic treatments have been observed in patients with low tumor load, which may suggest that their optimal application could be in earlier phases of the disease (high risk localized, biochemical failure, etc) Combination strategy, without doubt the one with best future, is based on additional treatments increasing cell lysis with the subsequent antigen exposure and/ or producing an immunomodulatory effect that can surmount tumor induced immunologic tolerance. The results obtained suggest that immunotherapy may be more effective in combined therapy with other active therapies (abiraterone, enzalutamide, Radium 223, docetaxel) in a fight to achieve disease chronification.
Autores: Pascual, Juan Ignacio, (Autor de correspondencia); et al.
Revista: ARCHIVOS ESPAÑOLES DE UROLOGIA
ISSN 0004-0614  Vol. 71  Nº 8  2018  págs. 704 - 710
Prostate cancer is a health problem in many Countries worldwide. Understanding the essential function of androgens in the prostate physiology led to the development of hormonal blockade as a therapeutic option in advanced disease, with limited response with time and development of resistance. In this stage, where castration resistant prostate cancer (CRPC) is defined, it is associated with poor prognosis because survival varies between 18 and 24 months. Even with castration levels, tumors are dependent on the functional androgen receptor (AR). In this paper, we analyze pretreatment clinical parameters such as prognostic or progression-predictive biomarkers, castration resistance mechanisms, the development of new technologies for the use of the so called liquid biopsies from biological fluids and the identification of circulating tumor cells as CRPC response and progression biomarkers. Currently ongoing clinical trials are partially oriented to the search of new prognostic and predictive biomarkers, that will enable to open up precision medicine and so to improve oncologicol patient's quality of life with it.
Autores: Pascual, Juan Ignacio; Merino, Imanol; et al.
Revista: ARCHIVOS ESPAÑOLES DE UROLOGIA
ISSN 0004-0614  Vol. 70  Nº 4  2017  págs. 454 - 461
OBJECTIVES: Uretero-pelvic junction (UPJ) obstruction has been classically treated by open dismembered pyeloplasty. Recently, laparoscopic (LP) and robotic pyeloplasty (RP) have become the techniques of choice for the treatment of UPJ stenosis in adult and pediatric population. Our objective in this paper is to review the results of minimally invasive surgery as the treatment of UPJ obstruction, the trend to use these approaches and the current limits of LP and RP. METHODS: A review of most relevant papers and meta-analysis about LP and RP in pediatric and adult population was performed using PubMed. RESULTS: In pediatric population, comparative studies and meta -analysis of relevant series show an overlap of results between LP, RP and open surgery in terms of success rate, rate of complications and hospital stay, being operating time shorter in open pyeloplasty compared to minimally invasive techniques. In infants and pre-school age open surgery remains as technique of choice for pediatric surgeons. In adults, comparative studies and meta -analysis of the most relevant series show also an overlap of results in terms of success rate and complication rate between LP and RP Nonetheless, minimally invasive techniques seem to offer a significant shortening of hospital stay and need for analgesics compared to open surgery, reason why laparoscopic techniques are recommended over open pyeloplasty in adult population. CONCLUSIONS: In view of published literature, minimally invasive surgery has been postulated as the standard treatment in UPJ stenosis, with superimposable results to open surgery. The high cost of robotic approach limits its use in this type of pathology.
Autores:  et al.
Revista: ACTAS UROLOGICAS ESPAÑOLAS
ISSN 0210-4806  Vol. 41  Nº 9  2017  págs. 564-570
Factors in addition to the disease stage pT3-pT4 in patients with localized RCC are important, such as the presence of haematuria and lymphocytic or vascular invasion for DFS. A Furhman grade of 3¿4 and the presence of tumor necrosis are especially relevant for DFS and CSS.
Autores:  et al.
Revista: ACTAS UROLOGICAS ESPAÑOLAS
ISSN 0210-4806  Vol. 41  Nº 7  2017  págs. 451-457
The density, maximum diameter and pyelocaliceal location of the stones are determinant factors in terms of the effectiveness of treatment with ESWL. Using these variables, which can be obtained in advance of deciding on a treatment, the designed risk model provides a precise approach in choosing the most appropriate treatment for each particular case.
Autores: Robles, JE; Merino, Imanol; et al.
Revista: JOURNAL OF SEXUAL MEDICINE
ISSN 1743-6095  Vol. 14  Nº 4, Supl.  2017  págs. e151
Autores: Robles, JE; Merino, Imanol; et al.
Revista: JOURNAL OF SEXUAL MEDICINE
ISSN 1743-6095  Vol. 14  Nº 4, Supl.  2017  págs. e197
Autores: Robles, JE; Merino, Imanol; et al.
Revista: JOURNAL OF SEXUAL MEDICINE
ISSN 1743-6095  Vol. 14  Nº 4, Supl.  2017  págs. E165
Autores: Merino, Imanol; et al.
Revista: EUROPEAN UROLOGY SUPPLEMENTS
ISSN 1569-9056  Vol. 14  Nº 2  2015  págs. e486