[What's new in 2009 in prostate cancer: highlights from ASTRO, EAU, ASCO and AUA meetings].

In 2009, prostate cancer was the subject of a large number of communications in international urologic, oncologic and radiation therapy conferences. The most interesting studies that are likely to modify physician's daily practice were selected. This year the results from the European (ERSPC) and the American (PLCO) mass screening studies.

[How radical nephrectomy compares to partial nephrectomy for the treatment of pT1a papillary renal cell carcinomas?].

Purpose: Our objective was to compare oncologic results of nephron sparing surgery (NSS) versus radical nephrectomy (RN) in T1aN0-x M0 papillary renal cell carcinoma (PRCC).

Patients And Methods: We retrospectively reviewed 277 patients treated for a pT1aN0M0 PRCC selected from an academic database from 12 centres. We compared the clinico-pathological features by using Chi-square and Student statistical analyses.

The effect of prostate-specific antigen screening during the last decade: development of clinicopathological variables independently of the biopsy core number.

Objective: To study the development of stage migration in prostate cancer after controlling for the number of biopsy cores.

Patients And Methods: In all, 1826 patients had a first set of 21-core biopsies taken between 2001 and 2008. Among the 801 patients with prostate cancer, 443 had a laparoscopic radical prostatectomy (RP).

The role of tumor-free status in repeat resection before intravesical bacillus Calmette-Guerin for high grade Ta, T1 and CIS bladder cancer.

Purpose: We evaluated the outcome of repeat transurethral bladder tumor resection for high risk nonmuscle invasive bladder cancer before induction and maintenance bacillus Calmette-Guerin.

Materials And Methods: Included in the study were 151 consecutive patients with a mean age of 68.6 years (range 32 to 86) with primary high grade, nonmuscle invasive (Ta, T1 or CIS) bladder cancer.

[Impact of twin gestation on the risk of postpartum stress incontinence].

Objective: To study twin pregnancy and delivery as a risk factor for developing postpartum stress urinary incontinence (SUI).

Patients And Methods: Retrospective single centre study comparing 117 patients who have delivered twins to 117 patients who have given birth to singletons, between January 2003 and December 2005 in a tertiary maternal-foetal medicine unit. The risk factors associated with the onset of postpartum SUI, its severity, and its impact on the quality of life were studied.

A comparison of first trimester measurements for prediction of delivery date.

Objective: We evaluated the biometric values of first trimester measurements for prediction of delivery date by computing new dating formulas and evaluating them within the same settings in a large population.

Methods: We studied unselected pregnancies undergoing first trimester ultrasound examination by a single experimented sonographer. We used 331 pregnancies conceived by assisted reproductive treatment to build a new dating formula and another 3667 normal pregnancies with spontaneous delivery to test the accuracy of these measurements and formulas.

Extended biopsy protocol decreases prostate cancer incidence and risk of aggressive disease on repeated biopsies compared with initial standard procedure.

Objectives: To compare prostate cancer detection rates in repeated biopsy depending on the number of cores at initial biopsy.

Methods: Out of 3,000 consecutive patients, 534 underwent repeat extended biopsies. At first procedure, 345 patients had undergone standard biopsies (10-15 cores; SBx) whereas 189 other patients had already had a 21-core extended protocol (ExtBx).

Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma.

Background: Ipsilateral recurrence after nephron-sparing surgery (NSS) is rare, and little is known about its specific determinants.

Objective: To determine clinical or pathologic features associated with ipsilateral recurrence after NSS performed for renal cell carcinoma (RCC).

Design, Setting, And Participants: We analysed 809 NSS procedures performed at eight academic institutions for sporadic RCCs retrospectively.

Validity of sonographic prediction of fetal weight and weight discordance in twin pregnancies.

Objectives: The aims of this study were (1) to assess the accuracy of estimated fetal weight (EFW) in twins and (2) to assess the accuracy of sonographic examination to predict birth weight discordance (BWD).

Methods: We retrospectively analyzed collected data on twin pregnancies between 2004 and 2007. All twin pregnancies with at least one ultrasound (US) examination within 15 days of delivery were included in this study.

[Laparoscopic radical prostatectomy in the elderly (>75 years old): oncological and functional results].

Objective: Prostate cancer incidence increases with age. Radical prostatectomy (RP) seems to be feasible for elderly well-selected patients. We report our experience with patients older than 75 years old who underwent laparoscopic RP.

[Prenatal management of uncomplicated monochorionic biamniotic pregnancies].

Monochorionic pregnancies accounts for only 20% of twins but are responsible for most of their morbidity and mortality. There is no randomized study evaluating management of monochorionic pregnancies. Based on expert opinion, it is recommended that monochorionic pregnancies should be followed-up by practionners working with specialized centers with expertise in monochorionic pregnancies.

Intrafascial nerve-sparing radical prostatectomy with a laparoscopic robot-assisted extraperitoneal approach: early oncological and functional results.

Objective: We investigated whether an intrafascial approach to prostatectomy would provide significantly improved outcomes compared with retropubic and laparoscopic approaches. We performed 50 radical prostatectomies with an intrafascial, nerve-sparing, laparoscopic, robot-assisted extraperitoneal approach.

Methods: From December 2007 to June 2008, 50 consecutive patients underwent nerve sparing surgery using the intrafascial technique with robotic assistance.

[The screening of prostate cancer in 2009: overview of the oncology committee of the French Urological Association].

Objective: To analyze the impact of screening on prostate cancer (PCa) mortality, and to discuss the main points of controversy regarding this screening.

Methods: A bibliographic analysis was made using Medline services (keywords: prostate cancer, screening). Only the randomized studies regarding the impact of PCa screening on specific mortality were taken into account.

[Does cancer surgery in elderly patients present special issues?].

Surgery is a major arm in cancer management. Elderly patients have more co-morbidities than younger patients. These coexisting conditions can result in contraindicating the necessary act.

[The role and principles of radiotherapy in prostate cancer in the elderly subject].

The aging of the population has resulted in an increase in the number of elderly patients with prostate cancer. Among the curative treatment options in the elderly subject, external radiotherapy is the most frequently chosen option. Combined treatment including radiotherapy and hormone therapy should be preferred to hormonal therapy alone, including in elderly patients, whenever life expectancy surpasses 4-5 years.

[Androgen suppression for the treatment of prostate cancer in the elderly].

Prostate cancer (PaC) is a significant health problem. Elderly have the highest incidence of the disease as age is its strongest risk factor. Despite its complications, the use of androgen suppression in aging patients with prostate cancer has become extremely frequent with probable excess.

[Results of total prostatectomy in the elderly patient].

Only few studies have been published regarding the results of radical Prostatectomy (RP) in elderly patients. The available data suggest that advanced age does not increase the postoperative mortality and morbidity rates, as far as reasonable selection is performed. Similarly, oncological results of RP are similar in patients aged >70 years and in younger patients.

Stage pT0 after radical prostatectomy with previous positive biopsy sets: a multicenter study.

Purpose: We analyzed preoperative data, pathological results and followup of pT0 tumors after radical prostatectomy for prostate cancer diagnosed on previous positive biopsy.

Materials And Methods: At 6 centers a total of 30 of 7,693 radical prostatectomy specimens were classified as pT0 despite prior biopsy proven prostate cancer. No patients were diagnosed after transurethral prostate resection or received neoadjuvant hormonal treatment.

Fetal interlens distance: normal values during pregnancy.

Objectives: The aims of this study were to establish normal ranges of values for interlens distance (ILD) during gestation, and to assess the correlation between ILD and growth of the orbits and other fetal biometric parameters.

Methods: A cross-sectional study of morphologically normal, singleton fetuses was carried out in low-risk pregnant women. We measured the distance between the centers of the fetal lenses from 12 to 37 completed weeks of gestation.

Mallampati class changes during pregnancy, labour, and after delivery: can these be predicted?

Background: An increase in Mallampati class is associated with difficult laryngoscopy in obstetrics. The goal of our study was to determine the changes in Mallampati class before, during, and after labour, and to identify predictive factors of the changes.

Methods: Mallampati class was evaluated at four time intervals in 87 pregnant patients: during the 8th month of pregnancy (T(1)), placement of epidural catheter (T(2)), 20 min after delivery (T(3)), and 48 h after delivery (T(4)).

Pathological findings and prostate specific antigen outcomes after radical prostatectomy in men eligible for active surveillance--does the risk of misclassification vary according to biopsy criteria?

Purpose: We compared the pathological findings and prostate specific antigen outcome after radical prostatectomy in men eligible for active surveillance according to 3 biopsy inclusion criteria.

Materials And Methods: The study population included 177 men eligible for active surveillance who fulfilled clinicobiological criteria and biopsy criteria as group 1-less than 3 positive cores and less than 3 mm total tumor length, group 2-less than 3 positive cores with cancer involvement of less than 50% in any core and group 3-less than 33% of positive cores. Prostate specific antigen density cutoffs were also studied in these groups.

Efficacy of venlafaxine, medroxyprogesterone acetate, and cyproterone acetate for the treatment of vasomotor hot flushes in men taking gonadotropin-releasing hormone analogues for prostate cancer: a double-blind, randomised trial.

Background: Hot flushes are the most common complaints reported by men undergoing androgen suppression treatment for prostate cancer. We designed a randomised double-blind trial to compare the efficacy of three drugs, each of which has proven effective for preventing hot flushes in previous studies.

Methods: Men with prostate cancer with an indication for androgen suppression were enrolled in the study at 106 urology centres in France between April 14, 2004, and April 20, 2007.

Using Z-scores to compare biometry data obtained during prenatal ultrasound screening by midwives and physicians.

Objective: To compare retrospectively the distribution of foetal biometry data as measured by midwives and physicians during second and third trimester screening of an unselected population of pregnant women.

Methods: Standard measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were performed by four midwives and ten physicians at 20 to 24 weeks of gestation and at 30 to 34 weeks of gestation as part of routine ultrasound examinations over a 26-month period (Jan. 2005-Mar.