Review Article: Best Evidence Regarding Contemporary Use of Prostate Cancer Biomarkers.

Introduction: Management of prostate cancer was revolutionized by the discovery of prostate specific antigen. While prostate specific antigen is an excellent biomarker for followup after treatment, it has low specificity as a screening test and most biopsies are negative when prompted by elevated prostate specific antigen. Better prognostic biomarkers are needed to improve risk stratification to decide between treatment and observation.

Management of noninvasive bladder cancers.

Purpose Of Review: To summarize clinical management of nonmuscle-invasive bladder cancer (NMIBC) and discuss recent advances in the field.

Recent Findings: NMIBC remains a common and expensive clinical entity. Prevention, early detection, and risk-adapted treatment are the mainstays of clinical management, all of which may improve as a result of recent research.

Real-time, near-infrared fluorescence imaging with an optimized dye/light source/camera combination for surgical guidance of prostate cancer.

Purpose: The prostate-specific membrane antigen (PSMA) is a surface glycoprotein overexpressed on malignant prostate cells, as well as in the neovasculature of many tumors. Recent efforts to target PSMA for imaging prostate cancer rely on suitably functionalized low-molecular-weight agents. YC-27 is a low-molecular-weight, urea-based agent that enables near-infrared (NIR) imaging of PSMA in vivo.

Predictors of outcome in bladder cancer.

Tumor stage and grade have largely been responsible for directing treatment algorithms in bladder cancer. However, the considerable heterogeneity of tumor biology in bladder cancer is incompletely characterized by stage and grade alone, and recent efforts to improve predictive models in bladder cancer may significantly improve accuracy and calibration. This article addresses how current nomograms and risk tables may be best used to individualize bladder cancer management.

Best evidence regarding the superiority or inferiority of robot-assisted radical prostatectomy.

Robotic-assisted laparoscopic radical prostatectomy (RALP) has enjoyed rapid adoption over the past decade without rigorous clinical studies demonstrating superior clinical outcomes over radical retropubic prostatectomy (RRP). This article reviews the literature comparing RALP and RRP with regard to oncologic, perioperative, and functional outcomes, summarizing evidence for and against the superiority of RALP.

Developments and controversies in the management of noninvasive bladder cancer.

Purpose Of Review: To summarize recent developments and controversies in the diagnosis and management of nonmuscle invasive bladder cancer (NMIBC).

Recent Findings: The majority of incident bladder cancer diagnoses are noninvasive. The mainstay of diagnosis remains cystoscopy and transurethral resection, with enhanced optical techniques potentially improving detection of nascent disease.

Contemporaneous comparison of open vs minimally-invasive radical prostatectomy for high-risk prostate cancer.

Objectives: To analyze pathological and short-term oncological outcomes in men undergoing open and minimally-invasive radical prostatectomy (MIRP) for high-risk prostate cancer (HRPC; prostate-specific antigen level [PSA] >20 ng/mL, ≥ cT2c, Gleason score 8-10) in a contemporaneous series.

Patients And Methods: In total, 913 patients with HRPC were identified in the Johns Hopkins Radical Prostatectomy Database subsequent to the inception of MIRP at this institution (2002-2011) Of these, 743 (81.4%) underwent open radical retropubic prostatectomy (ORRP), 105 (11.

An updated prostate cancer staging nomogram (Partin tables) based on cases from 2006 to 2011.

Objective: To update the 2007 Partin tables in a contemporary patient population.

Patients And Methods: The study population consisted of 5,629 consecutive men who underwent RP and staging lymphadenectomy at the Johns Hopkins Hospital between January 1, 2006 and July 30, 2011 and met inclusion criteria. Polychotomous logistic regression analysis was used to predict the probability of each pathologic stage category: organ-confined disease (OC), extraprostatic extension (EPE), seminal vesicle involvement (SV+), or lymph node involvement (LN+) based on preoperative criteria.

Causes of death after radical prostatectomy at a large tertiary center.

Purpose: Most men treated with radical prostatectomy do not die of prostate cancer. We evaluated the cause of death in a large series of patients who underwent radical prostatectomy and compared the rate of death to that of the general American population.

Materials And Methods: The study population consisted of 18,209 men who underwent radical prostatectomy at our institution between 1975 and 2009.

Incidental testicular lesions found during infertility evaluation are usually benign and may be managed conservatively.

Purpose: Hypoechoic lesions on scrotal ultrasonography are often considered germ cell tumors and radical orchiectomy is recommended. We retrospectively reviewed the findings at 1 center in men with ultrasonographically detected testicular lesions found during evaluation of severe male infertility.

Materials And Methods: A total of 145 men with nonobstructive azoospermia at 1 center underwent ultrasonographic analysis before diagnostic or therapeutic testicular biopsy.