Higher perioperative morbidity and in-hospital mortality in patients with end-stage renal disease undergoing nephrectomy for non-metastatic kidney cancer: a population-based analysis.

Unlabelled: What's known on the subject? and What does the study add? Patients with renal failure more frequently harbour RCC due to predisposing factors such as cystic disease of the kidney. The benefit of nephrectomy might be outweighed by adverse perioperative events, however, which may be more prevalent in patients with end-stage renal disease (ESRD). In a population-based study focusing on patients after non-elective colorectal surgery, patients with ESRD had an increased risk of mortality and complications.

Venous thromboembolism after radical prostatectomy: the effect of surgical caseload.

Unlabelled: What's known on the subject? and What does the study add? Several risk factors increase VTE after RP: advanced age, comorbidities such as cardiopulmonary disease, rheumatologic diseases, prior history of VTE, more advanced prostate cancer, and simultaneous pelvic lymph node dissection. To date, the effect of annual surgical caseload (ASC), an established determinant of various RP outcomes, has not been tested. A previous study showed in adjusted analyses that patients operated for colorectal cancer by very high ASC surgeons were 60% less likely to suffer a VTE than those operated by low ASC surgeons.

Blood transfusions in radical prostatectomy: a contemporary population-based analysis.

Objective: To examine the homologous blood transfusion (HBT), autologous blood transfusion (ABT) and intraoperative blood conservation technique (IOBCT) rates and trends at open (ORP) and minimally invasive radical prostatectomy (MIRP).

Methods: The Nationwide Inpatient Sample was queried. Multivariable logistic regression models focused on all three transfusion types.

The effect of annual surgical caseload on the rates of in-hospital pneumonia and other in-hospital outcomes after radical prostatectomy.

Purpose: To examine the effect of annual surgical caseload (ASC) on contemporary in-hospital pneumonia (IHP) rates and three other in-hospital outcomes after radical prostatectomy (RP).

Methods: Between 1999 and 2008, 34,490 open RPs were performed in the state of Florida. First, logistic regression models predicting the rate of IHP were fitted.

A population-based analysis of temporal perioperative complication rates after minimally invasive radical prostatectomy.

Background: Existing population-based reports on complication rates after minimally invasive radical prostatectomy (MIRP) did not address temporal trends.

Objective: To examine contemporary temporal trends in perioperative MIRP outcomes.

Design, Setting, And Participants: Between 2001 and 2007, 4387 patients undergoing MIRP were identified using the Nationwide Inpatient Sample.

The novel nomogram of Gleason sum upgrade: possible application for the eligible criteria of low dose rate brachytherapy.

Objective: To examine the rate of Gleason sum upgrading (GSU) from a sum of 6 to a Gleason sum of ≥7 in patients undergoing radical prostatectomy (RP), who fulfilled the recommendations for low dose rate brachytherapy (Gleason sum 6, prostate-specific antigen ≤10 ng/mL, clinical stage ≤T2a and prostate volume ≤50 mL), and to test the performance of an existing nomogram for prediction of GSU in this specific cohort of patients.

Methods: The analysis focused on 414 patients, who fulfilled the European Society for Therapeutic Radiation and Oncology and American Brachytherapy Society criteria for low dose rate brachytherapy (LD-BT) and underwent a 10-core prostate biopsy followed by RP. The rate of GSU was tabulated and the ability of available clinical and pathological parameters for predicting GSU was tested.

Biochemical recurrence after radical prostatectomy: multiplicative interaction between surgical margin status and pathological stage.

Purpose: A positive surgical margin after radical prostatectomy is considered an adverse prognostic feature. However, few groups have explored the potential interaction between surgical margin status and other cancer characteristics, specifically pathological stage. We addressed the first degree of interaction between positive surgical margins and other established adverse predictors of biochemical recurrence after radical prostatectomy.

The presence of prostate cancer on saturation biopsy can be accurately predicted.

Objective: To improve the ability of our previously reported saturation biopsy nomogram quantifying the risk of prostate cancer, as the use of office-based saturation biopsy has increased.

Patients And Methods: Saturation biopsies of 540 men with one or more previously negative 6-12 core biopsies were used to develop a multivariable logistic regression model-based nomogram, predicting the probability of prostate cancer. Candidate predictors were used in their original or stratified format, and consisted of age, total prostate-specific antigen (PSA) level, percentage free PSA (%fPSA), gland volume, findings on a digital rectal examination, cumulative number of previous biopsy sessions, presence of high-grade prostatic intraepithelial neoplasia on any previous biopsy, and presence of atypical small acinar proliferation (ASAP) on any previous biopsy.

Unilateral prostate cancer cannot be accurately predicted in low-risk patients.

Purpose: Hemiablative therapy (HAT) is increasing in popularity for treatment of patients with low-risk prostate cancer (PCa). The validity of this therapeutic modality, which exclusively treats PCa within a single prostate lobe, rests on accurate staging. We tested the accuracy of unilaterally unremarkable biopsy findings in cases of low-risk PCa patients who are potential candidates for HAT.

External validation of a preoperative nomogram for prediction of the risk of recurrence after radical prostatectomy.

Purpose: To test the validity of an updated version of the preoperative Kattan nomogram for prediction of recurrence after radical prostatectomy (RP), published by Stephenson et al.

Methods And Materials: We relied on clinical and postoperative prostate-specific antigen follow-up data of 1978 patients treated with open RP at our institution between 1992 and 2006. The accuracy of the nomogram-derived recurrence-free survival predictions were separately tested at 1 to 10 years after RP.

Differences in histopathological and biochemical outcomes in patients with low Gleason score prostate cancer.

Study Type: Diagnosis (case series).

Level Of Evidence: 4.

Objective: To test whether the number or percentage of positive biopsy cores can be used to discriminate between patients with prostate cancer of a favourable and less favourable Gleason score (GS) < or =3 + 3, as prognostically, not all GS 3 + 3 prostate cancers are the same.

Testosterone and prostate cancer: revisiting old paradigms.

Context: Androgens are vital for growth and maintenance of the prostate; however, the notion that pathologic prostate growth, benign or malignant, can be stimulated by androgens is a commonly held belief without scientific basis. Therefore, the current prostatic guidelines for testosterone therapy (TT) appear to be overly restrictive and should be reexamined.

Objective: To review the literature addressing the possible relationship between testosterone and prostate cancer (PCa) and to summarize the main aspects of this issue.

Effect of body mass index on histopathologic parameters: results of large European contemporary consecutive open radical prostatectomy series.

Objectives: To determine whether an increased body mass index (BMI) is a predictor of advanced pathologic findings in European men undergoing radical prostatectomy (RP). The relationship between obesity and prostate cancer is controversial. Studies, predominantly derived from the United States, have suggested that an increased BMI is a significant predictor of adverse pathologic findings in patients treated with open RP.

Androgen deprivation therapy for the treatment of prostate cancer: consider both benefits and risks.

Context: Androgen deprivation therapy (ADT) is increasingly used for the treatment of prostate cancer (PCa), even in clinical settings in which there is no evidence-based proof of prolonged overall survival (OS). ADT, however, may be associated with numerous side effects, including an increased therapy-related cardiovascular mortality.

Objective: To discuss different clinical settings in which ADT is currently used and to critically weigh the benefits of ADT against its possible side effects.