Conduit urinary diversion is associated with a high overall complication rate but a low reoperation rate. Long-term followup of these patients is necessary to closely monitor for potential complications from the urinary diversion that can occur decades later.

This large retrospective analysis suggests a possible beneficial effect of regional anaesthetic techniques on oncological outcomes after prostate surgery for cancer; however, these findings need to be confirmed (or refuted) in randomized trials.

No abstract

RESULTS• Of the 2651 patients studied, 182 (6.9%) presented with M1 RCC. Tumour size was significantly greater in patients with M1 RCC than in patients with M0 RCC (a median size of 10 vs 4.5 cm; P < 0.001). Only 1 of the 629 patients (0.2%) with a tumour < 3 cm had M1 RCC and that tumour was 2.5 cm. The risk of M1 RCC increased from 1.1% for patients with tumours 3-3.9 cm to 16.5% for patients with tumours ≥ 7 cm.• Of the 2124 patients with M0 RCC, 430 developed distant metastases at a median (range) of 1.4 (0.1-16.2) years after surgery. Only 9 of the 498 patients (1.8%) with a tumour < 3 cm developed distant metastases after surgery.• Each 1-cm increase in tumour size increased the risk of death from RCC by 20% [hazard ratio (HR) 1.20; 95% confidence interval (CI) 1.18-1.22; P < 0.001] and death from any cause by 10% (HR 1.10; 95% CI 1.09-1.12; P < 0.001).• For the 1346 patients who were still alive at last follow-up, the median (range) duration of follow-up was 6.9 (0.1-19.7) years. CONCLUSIONS• Tumour size is significantly associated with metastases in patients with renal masses.• Patients with tumours < 3 cm have a low risk of synchronous metastatic disease. KEYWORDSkidney neoplasms, renal cell carcinoma, nephrectomy, recurrence, neoplasm staging, neoplasm metastasis Study Type -Prognosis (case series) Level of Evidence 4 OBJECTIVE• To determine the metastatic potential of renal masses based on original tumour size. MATERIALS AND METHODS• We identified 2651 patients who had undergone surgical resection for a unilateral, sporadic renal tumour between 1990 and 2006.• Associations of tumour size with synchronous metastasis at presentation [M1 renal cell carcinoma (RCC)] and development of metastases, death from RCC, and death from any cause after surgery were evaluated using logistic and Cox proportional hazards regression.

We conclude that UFP can be successfully managed with endoscopic techniques. Postoperative surveillance is recommended for potential early detection of ureteral stricture or recurrence.

7 0 9What ' s known on the subject? and What does the study add? Despite a lack of randomised controlled trials, most men with locally advanced prostate cancer are recommended to undergo external beam radiotherapy (EBRT), often combined with long-term androgen-deprivation therapy (ADT). Many of these men are not offered radical prostatectomy (RP) by their treating urologist. Additionally, it is know that EBRT with long-term ADT does provide good cancer control (88% at 10 years). We have previously published intermediate-term follow-up of a large series of men treatment with RP for cT3 prostate cancer.We report long-term follow-up of a large series of men treated with RP as primary treatment for cT3 prostate cancer. Our study shows that with long-term follow-up RP provides excellent oncological outcomes even at 20 years. While most men do require a multimodal treatment approach, many men can be managed successfully with RP alone. OBJECTIVE• To present long-term survival outcomes after radical prostatectomy (RP) for patients with cT3 prostate cancer, as the optimal treatment for patients with clinical T3 prostate cancer is debated. PATIENTS AND METHODS• We identifi ed 843 men who underwent RP for cT3 tumours between 1987 and 1997.• Survival was estimated using the Kaplan -Meier method.• Cox proportional hazards regression models were used to evaluate the association of clinicopathological features with outcome RESULTS• The median (range) postoperative follow-up was 14.3 (0.1 -23.5) years.• Down-staging to pT2 disease occurred in 26% (223/843) at surgery.• Local recurrence-free, systemic progression-free and cancer-specifi c survival for men with cT3 prostate cancer after RP was 76%, 72%, and 81%, respectively, at 20 years.• On multivariate analysis, increasing RP Gleason score (hazard ratio [ HR ] 1.8; P = 0.01), non-diploid chromatin content (HR 1.8; P = 0.01), positive surgical margins (HR 2.1; P = 0.007), and seminal vesicle invasion (HR 2.1; P = 0.005) were associated with a signifi cant risk of prostate cancer death, while a more recent year of surgery was associated with a decreased risk of cancer-specifi c mortality (HR 0.88; P = 0.01) CONCLUSIONS• RP affords accurate pathological staging and may be associated with durable cancer control for cT3 prostate cancer, with 20 years of follow-up presented here.• RP as part of a multimodal treatment strategy therefore remains a viable treatment option for patients with cT3 tumours. KEYWORDS

Autosomal dominant polycystic kidney disease increased operative complexity, the need for multiple percutaneous access tracts and the likelihood of repeat endoscopy. Despite the altered anatomy percutaneous nephrolithotomy was a safe, efficacious approach for autosomal dominant polycystic kidney disease. At last followup there was no stone recurrence and renal function was stable.

Scoring algorithms based on independent predictors of site-specific recurrence were presented. These models may be used to tailor postoperative surveillance to the individual patient based upon clinicopathologic features at the time of cystectomy.