Study Type – Therapy (case series) Level of Evidence 4
What’s known on the subject? and What does the study add?
Interim result of this study had shown promising efficacy, with response rate of 14.7% and median PFS of 7.4 months, and good tolerability in previously‐treated
Japanese metastatic RCC patients.
The final result of the study adds:
The median overall survival in Japanese metastatic RCC patients was 25.3 months, which is longer than that in the Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGET).
The response rate elevated from 14.7% to 19.4% because of 6 late responders achieved after 9.2 months or longer of SD period.
Neither unknown adverse events nor cumulative toxicity was observed in the long‐term use of sorafenib.
OBJECTIVE • To evaluate a novel technique to lower positive surgical margin rates while preserving as much of the neurovascular bundles as possible during nerve‐sparing robotic prostatectomy.
MATERIALS AND METHODS • In situ intraoperative frozen section (IFS) was performed during robotic‐assisted laparoscopic prostatectomy (RALP) when there was macroscopic concern for a positive margin or residual prostate tissue.
• When IFS was positive, additional sections were taken from the same area until the IFS was negative, similar to the procedure of Mohs micrographic surgery.
• Positive surgical margin and biochemical recurrence rates were compared between the patients who underwent IFS and those who did not.
RESULTS • Of 970 patients consecutively undergoing RALP at a single institution, IFS was performed on 177 (18%).
• Eleven patients (6%) had IFS positive for carcinoma, whereas another 25 (14%) had benign prostatic tissue in the IFS specimen.
• IFS and non‐IFS patients had similar pathological and nerve‐sparing characteristics.
• The IFS group had significantly lower rates of positive surgical margins, 7% vs 18% (P= 0.001) but similar rates of biochemical recurrence (5%) at a median follow‐up of 11 months.
CONCLUSIONS • In situ IFS is an effective way of reducing positive margins during RALP.
• Twenty percent of patients who underwent IFS, representing 4% of the overall RALP population, had either malignant or benign prostate tissue removed from their prostatic fossa.
• Although a reduction of biochemical recurrence was not demonstrated, the follow‐up is short and a difference may become apparent as the data mature.
This case series of GIP, the largest reported from a single center, highlights the high rate of Crohn's-like clinical and pathological manifestations of GIP and their potential to confound the accurate classification of patients with IBD. A diagnosis of UC should not be amended to CD based on the findings of the polyposis segment alone.
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