Editorial Comment
The authors report 50 intraoperative CRs in this multi-institutional experience with 268 partial nephrectomies for cystic renal masses. In the patients with CR final pathology revealed malignancy in 38 (77.5%) with Fuhrman grade 2 tumors in 69% and grade 3 or greater tumors in 12%. Although it is disconcerting for the surgeon when CR occurs, it is encouraging that there was no local or systemic recurrence at a median followup of 40 months in the CR group while there was a 2.5% local recurrence rate in the nonCR group. (Source: The Journal of Urology)
Source: The Journal of Urology - September 4, 2018 Category: Urology & Nephrology Authors: Arjun Sivaraman, Ramakrishna Venkatesh Tags: Adult Urology Source Type: research
Editorial Comment
In partial nephrectomy for a cystic mass the widely recognized challenge resides in the fact that rupture of the cystic wall might translate into “spillage” of cancerous cells. This is concerning, especially when working in a closed environment (the pneumoperitoneum). The authors performed this intriguing study on those partial nephrectomies in which a cystic renal mass was inadvertently “ruptured.” They reviewed 268 cases done in ope n or robotic fashion at a total of 8 European institutions and recorded an 18% rupture/effraction/spillage rate, which is nonnegligible. (Source: The Journal of Urology)
Source: The Journal of Urology - September 4, 2018 Category: Urology & Nephrology Authors: Riccardo Autorino Tags: Adult Urology Source Type: research
Editorial Comment
Sonpavde et al report the results of a study evaluating the optimal number of cycles of first line, platinum based chemotherapy in patients with advanced urothelial carcinoma. While trials have been done to investigate the most effective platinum based regimen, there is limited guidance regarding the optimal number of cycles of chemotherapy.1 Based on the results of these trials most patients in clinical practice are treated with the goal of completing 6 or more cycles, a number that was arbitrarily chosen in these trials. (Source: The Journal of Urology)
Source: The Journal of Urology - September 3, 2018 Category: Urology & Nephrology Authors: Abhishek Tripathi, Neeraj Agarwal Tags: Adult Urology Source Type: research
Which Patients with Negative Magnetic Resonance Imaging Can Safely Avoid Biopsy for Prostate Cancer?
To determine if there is a sub-set of men who can avoid prostate biopsy (PBx), based on multi-parametric MRI (mpMRI) and clinical characteristics. (Source: The Journal of Urology)
Source: The Journal of Urology - September 3, 2018 Category: Urology & Nephrology Authors: Masakatsu Oishi, Toshitaka Shin, Chisato Ohe, Nima Nassiri, Suzanne L. Palmer, Manju Aron, Akbar N. Ashrafi, Giovanni E. Cacciamani, Frank Chen, Vinay Duddalwar, Mariana C. Stern, Osamu Ukimura, Inderbir S. Gill, Andre Luis de Castro Abreu Source Type: research
Genomic Prostate Score, PI-RADSv2, and Progression in Men with Prostate Cancer on Active Surveillance
OncotypeDx Genomic Prostate Score (GPS) is a 17-gene RNA expression assay intended to help guide treatment decisions for men diagnosed with prostate cancer. The Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) was developed to standardize the risk stratification of lesions identified on multiparametric prostate MRI. We sought to determine whether these tests are associated with increased risk of biopsy upgrade in men on active surveillance (AS). (Source: The Journal of Urology)
Source: The Journal of Urology - September 1, 2018 Category: Urology & Nephrology Authors: Zachary Kornberg, Janet E. Cowan, Antonio C. Westphalen, Matthew R. Cooperberg, June M. Chan, Shoujun Zhao, Katsuto Shinohara, Peter R. Carroll Source Type: research
Coffee, Caffeine Metabolism Genotype, and Disease Progression in Localized Prostate Cancer Patients Managed with Active Surveillance
Active surveillance (AS) is increasingly used as a management strategy for localized prostate cancer. Coffee intake has been associated with lower prostate cancer incidence; and we assessed whether coffee was associated with disease progression in men on AS. (Source: The Journal of Urology)
Source: The Journal of Urology - September 1, 2018 Category: Urology & Nephrology Authors: Justin R. Gregg, David S. Lopez, Chad Reichard, Jiali Zheng, Wenhui Wu, Yuanqing Ye, Brian Chapin, Jeri Kim, Carrie R. Daniel, John Davis Source Type: research
Role of Stereotactic body radiation therapy in the management of oligometastatic renal cell carcinoma
Kidney cancer has been increasing by 1.7% annually. Renal cell carcinoma (RCC) is the most common kidney cancer, and can metastasize. Our aim is to analyze patients treated with Stereotactic Body Radiation Therapy (SBRT) on metastases from RCC. (Source: The Journal of Urology)
Source: The Journal of Urology - September 1, 2018 Category: Urology & Nephrology Authors: Ciro Franzese, Davide Franceschini, Lucia Di Brina, Giuseppe Roberto D ’Agostino, Pierina Navarria, Tiziana Comito, Pietro Mancosu, Stefano Tomatis, Marta Scorsetti Source Type: research
The Impact of Positron Emission Tomography with 18F-Fluciclovine on the Management of Patients with Biochemical Recurrence of Prostate Cancer: Results from the LOCATE Trial
The prospective, multicenter LOCATE trial assessed the impact of positron emission tomography/computed tomography (PET/CT) with 18F-fluciclovine on management plans for patients with biochemical recurrence (BCR) of prostate cancer after curative-intent primary therapy. (Source: The Journal of Urology)
Source: The Journal of Urology - September 1, 2018 Category: Urology & Nephrology Authors: Gerald L. Andriole, Lale Kostakoglu, Albert Chau, Fenghai Duan, Umar Mahmood, David A. Mankoff, David M. Schuster, Barry A. Siegel, LOCATE study group Source Type: research
Re: Comparison of Pathological Stage in Patients Treated with and without Neoadjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma
Liao et al report outcomes of patients with high risk upper tract urothelial carcinoma (UTUC) treated with or without neoadjuvant chemotherapy. The survival rate of patients with high risk UTUC is poor despite the fact that radical nephroureterectomy (RNU) has been the standard treatment for this conditio n. The authors suggest that patients treated with neoadjuvant chemotherapy before RNU had a reduction in pathological tumor stage and a decreased prevalence of pT2 or higher disease. Interestingly we noted that the prevalence of Tis was higher in patients who had undergone neoadjuvant chemotherapy t han those who had no...
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Authors: Wenbin Xue, Lu Yang, Qiang Wei Tags: Letter to the Editor/Errata Source Type: research
Reply by Authors
Patients in the study group had biopsy proved, high grade UTUC as well as a visible lesion on axial imaging and underwent neoadjuvant chemotherapy followed by RNU. By comparison, patients who had biopsy proved, high grade UTUC but no visible lesion on axial imaging underwent RNU alone. Neoadjuvant chemotherapy was not offered to patients with CIS on ureteroscopic biopsy only. Patients in our study group likely had increased rates of CIS on final surgical pathology because CIS is conventionally unresponsive to chemotherapy, and as a result CIS was the only residual disease in patients who responded effectively to neoadjuvan...
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Tags: Letter to the Editor/Errata Source Type: research
Editorial Comment
In this study a cost-effective analysis was done comparing the performance of TRUSB in all men with elevated PSA and the use of various biomarkers or magnetic resonance imaging first and only performing biopsy if the biomarker was positive. The study modeled biopsy outcomes and likely management strategies. All costs, utilities and other inputs that went into the model were ascertained from the literature. (Source: The Journal of Urology)
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Authors: Sanoj Punnen Tags: Adult Urology Source Type: research
Editorial Comment
The PICTURE study (references 13 and 14 in article) and the companion PROMIS study (reference 1 in article), in which men being evaluated for prostate cancer underwent magnetic resonance imaging followed by a comprehensive mapping biopsy, are monumental contributions. The biopsy procedure involved transperineal template sampling of the prostate at 5 mm intervals and often more than 60 cores of tissue were obtained at 1 sitting. The work helped establish the value of MRI in men suspected of having prostate cancer. (Source: The Journal of Urology)
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Authors: Leonard S. Marks Tags: Adult Urology Source Type: research
Editorial Comment
In this series the rate of fistula at the proximal urethral anastomosis (the connection of the native urethra to the urethroplasty portion of the urethra, which is made of tubularized paravaginal flaps) more than doubled from 21% to 48% when simultaneous vaginectomy was not performed. The reasons for this are clear. When the vagina is removed, several more layers can be added to this otherwise delicate urethral suture line. 1) The bulbospongiosus muscle, which in the natal female is splayed out rather than encircling the urethra as in the natal male, can be freed and used to cover the midline urethral suture lines. (Source...
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Authors: Richard A. Santucci Tags: Adult Urology Source Type: research
Reply by Authors
The comment addresses the importance of having patients understand the implications of the choice of whether to leave the vagina intact. In this light we emphasize the value of shared decision making in this field. (Source: The Journal of Urology)
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Tags: Adult Urology Source Type: research
Editorial Comment
This study offers unique observations on the anatomical dimensions of the prostate and the prostatic, periprostatic, pudendal and penile vasculature using MRI before surgical reconstruction in males with bladder exstrophy compared to normal controls. Awareness of the vascular anatomy in this region is intuitively paramount as any damage to these structures during surgery can cause significant morbidity, eg penile loss during radical soft tissue mobilization.1 Unfortunately the authors did not attempt to correlate the findings on preoperative MRI with the intraoperative findings, treatment choices, modifications of the anat...
Source: The Journal of Urology - August 30, 2018 Category: Urology & Nephrology Authors: Marco Castagnetti Tags: Pediatric Urology Source Type: research
