Variations in procedure time based on surgery resident postgraduate year level.

Background: With increasing scrutiny being placed on the allocation of health care dollars, data supporting the increased resources used to teach residents in the operating room (OR) are lacking.

Methods: All cases of patients undergoing laparoscopic cholecystectomies (LCs) and pancreaticoduodenectomies (PDs) from July 1, 2006 to July 1, 2011 were analyzed. Procedures were excluded based on the following: more than one resident listed in the operative report, with the exception of interns; LC requiring cholangiogram or conversion to an open procedure; or if a PD required additional procedures.

Results of a surgically derived nomogram to predict Gleason score upgrading applied to a cohort of patients with "favorable-risk" prostate cancer treated with permanent seed brachytherapy.

Objective: To examine a 2-year cohort of patients treated with brachytherapy to determine the likelihood of unfavorable pathologic features using a nomogram recently developed at our center to estimate the likelihood of Gleason score upgrading for patients with favorable prostate cancer undergoing radical prostatectomy. The brachytherapy outcomes for patients with a high likelihood of upgrading were compared with those with a lower likelihood to affirm the effectiveness of brachytherapy in this setting. Information on the likelihood of upgrading could help in the selection between active treatment and surveillance for patients with favorable-risk prostate cancer.

Comparison of health-related quality of life 5 years after SPIRIT: Surgical Prostatectomy Versus Interstitial Radiation Intervention Trial.

Purpose: The American College of Surgeons Oncology Group phase III Surgical Prostatectomy Versus Interstitial Radiation Intervention Trial comparing radical prostatectomy (RP) and brachytherapy (BT) closed after 2 years due to poor accrual. We report health-related quality of life (HRQOL) at a mean of 5.3 years for 168 trial-eligible men who either chose or were randomly assigned to RP or BT following a multidisciplinary educational session.

3D MR-spectroscopic imaging assessment of metabolic activity in the prostate during the PSA "bounce" following 125iodine brachytherapy.

Purpose: A temporary increase in prostate-specific antigen (PSA) values is observed in 30%-40% of men following (125)I brachytherapy (BT) for prostate cancer. We present the results of a study to characterize prostate metabolic activity during the PSA "bounce" and to correlate metabolic changes with PSA levels using three-dimensional magnetic resonance spectroscopic imaging (3D-MRSI).

Methods And Materials: 3D-MRSI was performed in 24 patients during the PSA bounce.

A phase III randomized trial of the timing of meloxicam with iodine-125 prostate brachytherapy.

Purpose: Nonsteroidal anti-inflammatory medication is used to reduce prostate edema and urinary symptoms following prostate brachytherapy. We hypothesized that a cyclooxygenase-2 (COX-2) inhibitor regimen started 1 week prior to seed implant might diminish the inflammatory response, thus reducing edema, retention rates, and symptom severity.

Methods And Materials: From March 2004 to February 2008, 316 men consented to an institutional review board-approved randomized study of a 4-week course of meloxicam, 7.

A phase I trial of pre-operative radiotherapy for prostate cancer: clinical and translational studies.

Background And Purpose: Selected patients undergoing radical prostatectomy for localized prostate cancer can be at high-risk for pT3 disease and require subsequent radiotherapy. In a phase I trial, we investigated the feasibility of pre-operative radiotherapy for this patient subset.

Materials And Methods: Eligibility criteria were: T1/T2N0M0 tumors plus (i) Gleason >or=7, PSA>10 ng/ml and <35 ng/ml, or (ii), PSA >15 ng/ml and less <35 ng/ml (any Gleason).

Impact of a multi-disciplinary patient education session on accrual to a difficult clinical trial: the Toronto experience with the surgical prostatectomy versus interstitial radiation intervention trial.

Purpose: Random assignment to clinical trials involving different treatment modalities can be difficult. We describe our experience with the Surgical Prostatectomy Versus Interstitial Radiation Intervention Trial (SPIRIT; ACOSOG Z0070 NCIC PR10), a randomized trial for early-stage prostate cancer comparing radical prostatectomy (RP), and brachytherapy (BT). A multidisciplinary educational session was developed to improve patient understanding of treatment options and to facilitate accrual.