Indication to pelvic lymph nodes dissection for prostate cancer: the role of multiparametric magnetic resonance imaging when the risk of lymph nodes invasion according to Briganti updated nomogram is <5

Background: The Briganti updated nomogram (BN) is the most popular predictive model aiming to predict the presence of lymph node invasion (LNI) in patients with prostate cancer (PCa), but it lacks information obtained by preoperative imaging. The primary aim of the study was to evaluate the role of multiparametric prostate magnetic resonance imaging (mp-MRI) in the indication to perform pelvic lymph nodes dissection (PLND) or not in patients with risk of LNI according to BN below 5%. Methods: Since March 2012 and September 2016, 310 patients who underwent a preoperative mp-MRI for staging purpose and subsequent robot-assisted extended PLND (RAEPLND) were retrospectively evaluated. Mp-MRIs were prospectively analyzed by two experienced radiologists. The imaging parameters analyzed were the presence of extracapsular extension (ECE), seminal vesicles invasion (SVI) and predominant Gleason pattern 4 (pG4). All patients underwent RAEPLND by two experienced surgeons with a standardized technique. A dedicated uropathologist performed all pathological analysis. Univariate analysis and multivariate logistic regression analysis were used in order to identify the predictors of LNI in patients with PCa. Results: In the overall population, 57 (18.4%) patients had histologically proven pN1 disease. 48/250 patients (19.2%) with a risk of LNI â¥5% as calculated by the BN were staged pN1 at final histopathological analysis. 9/60 patients (15.0%) with a risk of LNI <5% as calculated by BN, who underwent RAEPLND anyway according to the findings at mp-MRI, were staged pN1 at final histopathological analysis. At multivariate logistic regression analysis, all the three mp-MRI parameters were significant independent predictors of LNI after RAEPLND. Conclusions: The role of mp-MRI seemed to be crucial in patients with a risk of LNI <5% as calculated by the BN. The presence of ECE, SVI, or pG4 at mp-MRI was found to be an independent predictor of LNI by itself

Prejudice in evidence in cases of economic crimes

Background. The Code of Criminal Procedure of the Russian Federation contains a number of exemptions for criminal proceedings on economic crimes. Evidence in this category of cases is no exception. In particular, the institution of prejudice in criminal proceedings has been repeatedly reformed. For many years, the legislator has been trying, taking into account the trends of the times and the priorities set in the state, to establish a balance in the use of court decisions taken in civil, arbitration, administrative proceedings in proving in criminal cases of economic crimes. The purpose of the study is to assess the changes made to Article No. 90 of the Code of Criminal Procedure of the Russian Federation since 2009, as well as the impact of such changes on the proof in “economic” cases. Materials and methods. The implementation of research tasks was achieved on the basis of an analysis of the norms of the Code of Criminal Procedure of the Russian Federation, the Decree of the Constitutional Court of the Russian Federation dated December 21, 2011 No. 30-P. In addition, the views on the institution of prejudice in relation to cases of economic crimes of Russian such process scientists as E.I. Zhidkova, S.A. Lopatin, L.V. Golovko, O.V. Khimicheva, N.V. Azaryonok have been studied. The methodological basis of this study is the dialectical method of scientific knowledge. In this work, general scientific methods of cognition are applied, such as: modeling, analysis, synthesis, analogy, abstraction, deduction, induction and comparison. Results. The institute of prejudice in the Russian criminal process before the reform of 2009 and after it is considered. Differences between sectoral and intersectoral, refutable and irrefutable prejudice are studied. The advantages and disadvantages of the current intersectoral irrefutable prejudice are revealed. Conclusions. Certain disadvantages of the current provision on prejudice in criminal proceedings are noted. Other types of legal proceedings do not provide such a set of guarantees as the criminal process, therefore, the institution of prejudice in its current form, including within the framework of the specifics of proceedings in cases of economic crimes, does not fully meet the goals and objectives of investigating and resolving criminal cases