Purpose Radical cystectomy is a surgical treatment for recurrent non-muscle invasive and muscle-invasive bladder cancer, however, many patients may not receive this treatment. Methods A total of 27,578 patients diagnosed with clinical stage I to IV bladder cancer from January 1, 2007 to December 31, 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry database. We used multivariable regression analyses to identify factors predicting use of radical cystectomy and pelvic lymph node dissection. Cox proportional hazards models were used to analyze survival outcomes. Results A total of 1,693 (6.1%) patients with bladder cancer underwent radical cystectomy. Most patients (92.4%) who underwent radical cystectomy also underwent pelvic lymph node dissection. When compared with white patients, non-Hispanic blacks were less likely to undergo a radical cystectomy (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.64–0.96, p = 0.019). Moreover, recent year of surgery 2013 vs. 2007 (OR 2.32, 95% CI 1.90–2.83, p < 0.001), greater percentage of college education ≥ 36.3% vs. <21.3% (OR 1.23, 95% CI 1.04–1.44, p =0.013), Midwest vs. West (OR 1.64, 95% CI 1.39–1.94, p<0.001) and more advanced clinical stage III vs. I (OR 29.1, 95% CI 23.9–35.3, p<0.001) was associated with increased use of radical cystectomy. Overall survival was improved for patients who underwent radical cystectomy compared with those who did not undergo a radical cystectomy (hazard ratio 0.88, 95% CI 0.80–0.97, p = 0.008). Conclusion There is significant underutilization of radical cystectomy in patients across all age groups diagnosed with bladder cancer, especially among older, non-Hispanic black patients.

Objective To compare overall survival of patients who underwent radical prostatectomy or radiotherapy versus non-cancer controls in order to discern if there is a survival advantage according to prostate cancer treatment and the impact of selection bias on these results. Patients and Methods A matched cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. We identified 34,473 patients age 66 to 75 years without significant comorbidity from who were diagnosed with localized prostate cancer treated with surgery or radiotherapy between 2004 and 2011. These patients were matched to a non-cancer control cohort. We compared the rates of all-cause mortality that occurred within the study period. We used Cox Proportional Hazards Regression analysis to identify determinants associated with overall survival. Results Of the total 34,473 patients who were included in the analysis, 21,740 (63%) received radiation therapy and 12,733 (37%) received surgery. There was improved survival in patients treated with surgery (hazard ratio [HR], 0.35; 95% CI, 0.32-0.38) as well as with radiotherapy (HR, 0.72; 95% CI, 0.68-0.75) when compared to non-cancer controls. There was significantly improved overall survival among both treatment groups with most benefit observed among patients who underwent surgery (log rank p<0.001). Conclusions Using population based data, treatment with either surgery or radiotherapy demonstrated improved overall survival when compared to a cohort of matched non-cancer controls. Treatment with surgery resulted in longer survival compared to those receiving radiation therapy. These results suggest inherent selection-bias due to unmeasured confounding variables.

Older, unmarried patients with increased comorbidities are less likely to undergo radical cystectomy. We developed and validated a generalizable instrument that has been converted into an online tool (Radical Cystectomy Survival Calculator), to provide a benefit-risk assessment for patients considering radical cystectomy.

Patients diagnosed with ASAP managed according to guideline recommendations are more likely diagnosed with benign pathology and indolent prostate cancer on repeat biopsy. These findings support prior studies suggesting refinement of guidelines in regard to the appropriateness and timeliness of repeat biopsy among patients diagnosed with ASAP.

These results demonstrate the promising potential of the first transperineal targeted prostate biopsy platform in the USA as an alternative diagnostic method for PCa.

Tumours of the paranasal sinuses are relatively uncommon in the horse. A collision tumour occurs when 2 separate tumour types arise in close proximity to each other and encroach on one another. This report describes the presence of neoplasia comprising glandular tissue and spindle cells growing concurrently in the frontal and caudal maxillary sinus of a geriatric donkey. As far as the authors are aware, this is the first description of a possible collision tumour in an equid.

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Symptomatic prostatic calculi are rare occurrences with several management options, the most popular of which is currently transurethral laser lithotripsy. This is a generally well-tolerated procedure with minimal complications. To date, no reported episodes of steinstrasse at the urethral level following prostatic calculi lithotripsy have been documented to our knowledge. We report a unique case of acute urinary retention secondary to obstructive calculi fragments following a transurethral laser lithotripsy of large prostatic calculi, further complicated by stricture at the fossa navicularis.