No abstract

The data represent the largest series of its kind and strongly suggest that RPN is a safe, effective, and feasible option for the minimally invasive approach to renal hilar tumors with no increased risk of adverse outcomes compared with nonhilar tumors in the hands of experienced robotic surgeons.

Fusion of T2WI and high b-value DWI resulted in significant improvements in sensitivity and accuracy for tumor detection on a sextant-basis, with similar specificity.

OBJECTIVES To assess patients who had radical prostatectomy (RP) and pelvic lymph node dissection (PLND) for pT2–4 N0M0 prostate cancer, to determine if LN yield affects the risk of biochemical failure (BCF), as the extent of PLND at the time of RP has become increasingly uncertain with the decreasing trend in tumour stage. PATIENTS AND METHODS We reviewed the Columbia University Urologic Oncology Database for patients with pT2–4 N0M0 prostate cancer treated with RP from 1990 to 2005. Exclusion criteria included <12 months of follow-up, incomplete clinical and pathological data, and neoadjuvant androgen-deprivation therapy (ADT) or immediate adjuvant ADT or external beam radiotherapy. Unadjusted and adjusted models were used to determine the ability of clinical and pathological variables to predict BCF. RESULTS The final dataset included 964 patients, with a mean age of 60.5 years and median preoperative prostate-specific antigen (PSA) level of 6.2 ng/mL. The median (range) LN yield was 7 (1–42) and the median follow-up 59 (12–190) months. In the unadjusted and adjusted models, preoperative PSA, pathological Gleason score, pathological stage, surgical margin status and year of surgery were significant predictors of BCF.The LN group was not a significant predictor of BCF in both the unadjusted and adjusted model ( P = 0.759 and 0.408, respectively). When patients were stratified into highand low-risk groups, LN yield remained an insignificant predictor of BCF. CONCLUSION A higher LN yield at the time of RP does not increase the chance of cure for patients with pT2–4N0M0 prostate cancer. This lack of a survival advantage holds true for patients with high-risk disease.

This study demonstrates that UPJO resolves at an equal rate after EP performed with or without ipsilateral renal calculi. Patients with UPJO and renal calculi should undergo stone extraction and EP in the same setting with the expectation of excellent results.

Given a greater proportion of tumors visible on the ADC map than trace DWI and greater contrast relative to benign PZ on the ADC map, we suggest that, when performing DWI of the prostate, careful attention be given to the ADC map for tumor identification.

No abstract

Tubeless PCNL with the Polaris stent results in decreased postoperative pain and narcotic use, and earlier hospital discharge. Our novel use of the Polaris Loop stent in tubeless PCNL redefines state-of-the-art for minimally invasive endoscopic surgery in patients with heavy stone burden.