A Retrospective Observational Analysis of Overall Survival with Sipuleucel-T in Medicare Beneficiaries Treated for Advanced Prostate Cancer.

Introduction: Since sipuleucel-T approval in 2010, the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) now includes the androgen-receptor signaling pathway inhibitors (ASPIs) abiraterone acetate or enzalutamide. In 2013 and 2014, these oral agents were approved for use in men with metastatic prostate cancer who had minimal to no symptoms. We compared overall survival (OS) in men who received their first mCRPC treatment using the Medicare Fee-for-Service 100% administrative claims research dataset with patient-level linkage to the National Death Index.

17-Gene Genomic Prostate Score Test Results in the Canary Prostate Active Surveillance Study (PASS) Cohort.

Purpose: The 17-gene Onco DX Genomic Prostate Score (GPS) test predicts adverse pathology (AP) in patients with low-risk prostate cancer treated with immediate surgery. We evaluated the GPS test as a predictor of outcomes in a multicenter active surveillance cohort.

Materials And Methods: Diagnostic biopsy tissue was obtained from men enrolled at 8 sites in the Canary Prostate Active Surveillance Study.

Performance of PCA3 and TMPRSS2:ERG urinary biomarkers in prediction of biopsy outcome in the Canary Prostate Active Surveillance Study (PASS).

Background: For men on active surveillance for prostate cancer, biomarkers may improve prediction of reclassification to higher grade or volume cancer. This study examined the association of urinary PCA3 and TMPRSS2:ERG (T2:ERG) with biopsy-based reclassification.

Methods: Urine was collected at baseline, 6, 12, and 24 months in the multi-institutional Canary Prostate Active Surveillance Study (PASS), and PCA3 and T2:ERG levels were quantitated.

Continued 5α-Reductase Inhibitor Use after Prostate Cancer Diagnosis and the Risk of Reclassification and Adverse Pathological Outcomes in the PASS.

Purpose: Outcomes in patients who enroll in active surveillance programs for prostate cancer while receiving 5α-reductase inhibitors have not been well defined. We sought to determine the association of 5α-reductase inhibitor use with the risk of reclassification in the PASS (Canary Prostate Active Surveillance Study).

Materials And Methods: Participants in the multicenter PASS were enrolled between 2008 and 2016.

Refined Analysis of Prostate-specific Antigen Kinetics to Predict Prostate Cancer Active Surveillance Outcomes.

Background: For men on active surveillance for prostate cancer, utility of prostate-specific antigen (PSA) kinetics (PSAk) in predicting pathologic reclassification remains controversial.

Objective: To develop prediction methods for utilizing serial PSA and evaluate frequency of collection.

Design, Setting, And Participants: Data were collected from men enrolled in the multicenter Canary Prostate Active Surveillance Study, for whom PSA data were measured and biopsies performed on prespecified schedules.

Role of Surveillance Biopsy with No Cancer as a Prognostic Marker for Reclassification: Results from the Canary Prostate Active Surveillance Study.

Background: Many patients who are on active surveillance (AS) for prostate cancer will have surveillance prostate needle biopsies (PNBs) without any cancer evident.

Objective: To define the association between negative surveillance PNBs and risk of reclassification on AS.

Design, Setting, And Participants: All men were enrolled in the Canary Prostate Active Surveillance Study (PASS) between 2008 and 2016.

Percutaneous transhepatic holmium laser lithotripsy of a large common bile duct stone.

A 58-year-old woman presented with a 4 cm obstructing choledocolith within the proximal common bile duct. She had an extensive operative history resulting in common bile duct to jejunum anastomosis after cholecystectomy. Endoscopic retrograde cholangiopancreatography (ERCP) removal was unsuccessful, and surgical exploration was contraindicated due to multiple comorbidities.

Evaluating the Four Kallikrein Panel of the 4Kscore for Prediction of High-grade Prostate Cancer in Men in the Canary Prostate Active Surveillance Study.

Background: Diagnosis of Gleason 6 prostate cancer can leave uncertainty about the presence of undetected aggressive disease.

Objective: To evaluate the utility of a four kallikrein (4K) panel in predicting the presence of high-grade cancer in men on active surveillance.

Design, Setting, And Participants: Plasma collected before the first and subsequent surveillance biopsies was assessed for 718 men prospectively enrolled in the multi-institutional Canary PASS trial.

Recipient graft failure or death impact on living kidney donor quality of life based on the living organ donor network database.

Background And Purpose: There is a paucity of prospective long-term data on living kidney donor (LKD) quality of life (QoL). The Living Organ Donor Network (LODN) database follows donors longitudinally and cross-references with United Network for Organ Sharing (UNOS) data to assess factors that affect donor QoL.

Patients And Methods: The Short Form (SF)-36 was sent to donors at 6 months and yearly thereafter.

Positive surgical margins after robotic assisted radical prostatectomy: a multi-institutional study.

Purpose: Positive surgical margins are an independent predictive factor for biochemical recurrence after radical prostatectomy. We analyzed the incidence of and associative factors for positive surgical margins in a multi-institutional series of 8,418 robotic assisted radical prostatectomies.

Materials And Methods: We analyzed the records of 8,418 patients who underwent robotic assisted radical prostatectomy at 7 institutions.

Posterior reconstruction before vesicourethral anastomosis in patients undergoing robot-assisted laparoscopic prostatectomy leads to earlier return to baseline continence.

Introduction: Reapproximation of Denonvilliers' fascia adjacent to bladder neck to the rectourethralis, or posterior reconstruction (PR), has been suggested to improve continence in postprostatectomy patients. We examined the impact of the PR on postoperative urinary and other quality-of-life (QoL) outcomes in patients undergoing robot-assisted laparoscopic prostatectomy (RALP).

Methods: We identified 89 patients who underwent RALP for prostate cancer between 2006 and 2009 by a single surgeon (R.

Second prize: Recurrence rates after percutaneous and laparoscopic renal cryoablation of small renal masses: does the approach make a difference?

Background And Purpose: As radiologic detection of small renal masses increases, patients are increasingly offered percutaneous renal cryoablation (PRC) or transperitoneal laparoscopic renal cryoablation (TLRC). This multicenter experience compares these approaches.

Patients And Methods: Between September 1998 and May 2010, review of our PRC and TLRC experience was performed.

Quality of life after open or robotic prostatectomy, cryoablation or brachytherapy for localized prostate cancer.

Purpose: Health related quality of life concerns factor prominently in prostate cancer management. We describe health related quality of life impact and recovery profiles of 4 commonly used operative treatments for localized prostate cancer.

Materials And Methods: Beginning in February 2000 all patients treated with open radical prostatectomy, robot assisted laparoscopic prostatectomy, brachytherapy or cryotherapy were asked to complete the UCLA-PCI questionnaire before treatment, and at 3, 6, 12, 18, 24, 30 and 36 months after treatment.

Renal functional outcomes after cryoablation of small renal masses.

Background And Purpose: Renal function outcomes after renal cryosurgery have not been widely scrutinized. We report 2-year renal function outcomes from a single-center cohort of patients who were treated with cryoablation for small renal masses.

Methods: We performed a retrospective review of our laparoscopic and percutaneous renal cryoablation experience between January 2003 and April 2007.

Single center experience with percutaneous and laparoscopic cryoablation of small renal masses.

Background And Purpose: While partial nephrectomy remains the gold standard for the management of most small renal masses, increasing experience with renal cryoablation has suggested a viable alternative with a favorable morbidity profile and good efficacy. We report intermediate-term oncologic outcomes from a single-center experience with laparoscopic and percutaneous renal cryoablation.

Patients And Methods: We performed a retrospective review of our laparoscopic renal cryoablation (LRC) and percutaneous renal cryoablation (PRC) experience between January 2003 and April 2007.

Is there correlation of nerve-sparing status and return to baseline urinary function after robot-assisted laparoscopic radical prostatectomy?

Background And Purpose: Incontinence is a vital quality-of-life (QoL) concern for men undergoing radical prostatectomy. Using validated QoL instruments, we sought to determine if urinary function was affected by nerve-sparing status at prostatectomy and how this correlated with the three modalities of prostate cancer surgery practiced at our institution: Retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP), or robot-assisted laparoscopic radical prostatectomy (RALRP).

Patients And Methods: Percent of baseline urinary function (PBUF) score was calculated by dividing follow-up urinary function score by baseline urinary function score.

Robot-assisted vaginal construction using ileum in a case of Mayer-Rokitansky-Küster-Hauser syndrome.

Congenital absence of the vagina is a rare condition commonly associated with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, Morris Syndrome, and XY sex reversal. Secondarily this condition may be caused by exenteration of various pelvic tumors. Surgical options for treating this devastating condition include external vaginal dilation, internal dilation using traction devices, and vaginal construction using flaps of skin, bladder, or various bowel segments.

Usefulness of adrenal vein sampling in the evaluation of aldosteronism.

Purpose: To determine the usefulness of adrenal vein sampling (AVS) in patients referred for surgical management of primary aldosteronism (PA).

Patients And Methods: From July 2001 to September 2006, 12 patients with a mean age of 49.3 years (range 31-65 yrs) presented for evaluation.

Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less.

Purpose: The optimal management of lower pole renal calculi is controversial. We compared shock wave lithotripsy (SWL) and ureteroscopy (URS) for the treatment of patients with small lower pole stones in a prospective, randomized, multicenter trial.

Materials And Methods: A total of 78 patients with 1 cm or less isolated lower pole stones were randomized to SWL or URS.

Single center experience with third-generation cryosurgery for management of organ-confined prostate cancer: critical evaluation of short-term outcomes, complications, and patient quality of life.

Background And Purpose: Technical refinements such as improved ultrasonographic localization and the routine use of urethral warmers and small-gauge needle delivery systems have renewed interest in cryosurgical treatment as a minimally invasive option for selected patients with localized prostate cancer. Only three reports of quality of life (QoL) in prostate cryoablation exist, and none report on patients treated with third-generation cryoablative technology. We critically examine our initial series of consecutive patients at a single institution undergoing primary third-generation cryosurgical treatment of localized prostate cancer with respect to treatment outcome, morbidity profile, and QoL parameters.

Postoperative robotic telerounding: a multicenter randomized assessment of patient outcomes and satisfaction.

Hypothesis: Patient safety and satisfaction are adversely affected when robotic videoconferencing (telerounding) is used in the postoperative setting.

Design: Randomized controlled trial.

Setting: Three academic institutions.

Computer modeling technology to assess extracapsular tissue coverage of whole mount sections after retropubic and laparoscopic radical prostatectomy.

Purpose: The introduction of new surgical approaches to radical prostatectomy requires methodologies that permit valid comparison that are more expedient than long-term outcomes of biochemical local and distant failure and survival. We used a computer modeling program to assess the percent of extracapsular tissue coverage of prostate glands removed by the open retropubic and laparoscopic approaches.

Materials And Methods: Specimens were available for 15 and 17 patients who underwent open and laparoscopic radical prostatectomy, respectively.

Robotically assisted radical laparoscopic prostatectomy in a patient with ectopic ureteral insertion into the prostate.

Robotically assisted laparoscopic radical prostatectomy (RaLRP) has become an alternative surgical treatment option for patients with localized prostate cancer. Rare anatomic variations result in modification of established techniques. We describe the first successful completion of RaLRP for localized prostate cancer in a patient with coexisting complete left ureteral duplication and ectopic insertion of the upper pole moiety ureter into the prostatic urethra.

Prospective longitudinal comparative study of early health-related quality-of-life outcomes in patients undergoing surgical treatment for localized prostate cancer: a short-term evaluation of five approaches from a single institution.

Background And Purpose: Quality of life (QoL) issues are a vital concern for the majority of patients seeking therapeutic intervention once they are found to have prostate cancer. A prospective longitudinal comparison using validated QoL instruments is a valuable technique to evaluate outcome differences. We evaluated the short-term QoL changes from baseline of five surgical approaches for localized prostate carcinoma delivered at a single institution.