Sense and Nonsense of an Extended Pelvic Lymph Node Dissection in Prostate Cancer

Lymph node metastases associated with prostate cancer (PCa) has been shown to be a poor prognostic factor. The role of pelvic lymph node dissection (PLND) itself in relation to survival remains unclear, however. A Medline search was conducted to address this issue. The following conclusions were drawn. Only recently, improved survival due to completion of radical prostatectomy (RP) (compared to abandoning RP) in known or presumed lymph-node-positive patients has been shown. Lymph node sampling can only be considered representative if an adequate number of nodes is removed. While several authors have suggested that a therapeutic benefit in patients undergoing RP is not provided by PLND, the reliability of these studies is uncertain. Contrary to this, several studies have indicated the possibility of long-term survival even in the presence of limited lymph node metastases. The role and timing of initiation of adjuvant androgen deprivation therapy (ADT) in patients who have node-positive disease after RP is controversial. Recent studies suggest that delaying ADT may not adversely impact survival

Grossesses extra utérines successives et bilharziose tubaire chez une touriste française

La bilharziose est la seconde endémie parasitaire mondiale et ses atteintes génito urinaires sont bien décrites. Les grossesses ectopiques (GEU) sur obstruction tubaire par les oeufs de bilharziose sont rapportées dans les populations africaines. La bilharziose affecte aussi les voyageurs mais l'atteinte de l’appareil génital féminin est plus rare. Nous rapportons un cas exceptionnel de deux GEU successives sur bilharziose tubaire chez une patiente d'origine Française, sept ans après un voyage touristique au Mali, la première découverte sur pièce de salpingectomie et la seconde ayant nécessité une salpingotomie controlatérale avec une injection de  méthotrexate, deux mois plus tard.Key words: Grossesse extra utérine, bilharziose tubaire, tromp

Consensus Statements on PSMA PET/CT Response Assessment Criteria in Prostate Cancer

Funding The one-day EAU / EANM PSMA PET/CT Response Assessment Criteria meeting received an unrestricted grant from Janssen, and no influences on the content of the meeting or on the publication. Acknowledgements The authors acknowledge John William Bean PhD (Bean Medical Writing, Halle, Belgium and funded by EAU Research Foundation) for providing medical writing services and Wim Witjes MD PhD (Scientific and Clinical Research Director EAU Research Foundation) and Emily Spieker (Management Assistant, European Association of Urology) for project management.Peer reviewedPublisher PD

Pain in IBD Patients: Very Frequent and Frequently Insufficiently Taken into Account.

Pain is a common symptom related to inflammatory bowel disease (IBD). In addition to abdominal pain, pain can also be an extraintestinal manifestation of IBD. Pain treatment is challenging and a substantial part of IBD patients are treated with opioids. Therefore, a better knowledge on pain symptoms is crucial for a better therapeutic approach to this clinical problem. Patients of the Swiss IBD Cohort Study (SIBDCS) (n = 2152) received a questionnaire regarding pain intensity, pain localization and impact of pain on daily life and social activities. Furthermore, the questionnaire investigated the use of pain-specific medication. A vast majority of patients (71%) experienced pain during the disease course. For a substantial part of patients (49% in UC and 55% in CD) pain is a longstanding problem (>5 years). Pain in UC was of shorter duration compared to CD (p < 0.01). Abdominal pain (59.5%) and back pain (38.3%) were the main pain localizations. 67% of patients took pain medication; 24% received no pain treatment. The general quality of life was significantly lower in patients suffering of pain compared to those without pain (38 vs. 77; (-100 very bad; 100 very good) p<0.0001). Prevalence of pain is high in patients of the SIBDCS. It is a longstanding problem for the majority of the patients affected. Pain was found to be undertreated in the SIBDCS and was significantly associated with health-related quality of life. Thus, an increased awareness is mandatory to address this frequent complication in the course of IBD

Effect of the Calcination Duration on the Electrochemical Properties of Na2Ti3O7 as Anode Material for Na-Ion Batteries

peer reviewedThe growing interest in Na-ion batteries as a “beyond lithium” technologies for energy storage drives the research for high-performance and environment-friendly materials. Na2Ti3O7 (NTO) as an eco-friendly, low-cost anode material shows a very low working potential of 0.3 V vs. Na+/Na but suffers from poor cycling stability, which properties can be significantly influenced by materials synthesis and treatment. Thus, in this work, the influence of the calcination time on the electrochemical performance and the reaction mechanism during cycling were investigated. NTO heat-treated for 48 h at 800 °C (NTO-48h) demonstrated enhanced cycling performance in comparison to NTO heat-treated for only 8 h (NTO-8h). The pristine material was thoroughly characterized by X-ray diffraction, laser granulometry, X-ray photoelectron spectroscopy, and specific surface area measurements. The reaction mechanisms induced by sodiation/desodiation and cycling were investigated by operando XRD. Electrochemical impedance spectroscopy was used to evidence the evolution of the solid electrolyte interface layer (SEI) and modification of charge transfer resistances as well as the influence of cycling on capacity decay. The evolution of the crystallographic structure of NTO-48h revealed a more ordered structure and lower surface contamination compared to NTO-8h. Moreover, the residual Na4Ti3O7 phase detected after the sodium extraction step in NTO-8h seems correlated to the lower electrochemical performance of NTO-8h compared to NTO-48h

A core outcome set for localised prostate cancer effectiveness trials

Objective: To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer. Background: Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio. This is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials. Subjects and methods: A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 prostate cancer patients. A two-stage consensus process involving 118 patients and 56 international healthcare professionals (HCPs) (cancer specialist nurses, urological surgeons and oncologists) was undertaken, consisting of a three-round Delphi survey followed by a face-to-face consensus panel meeting of 13 HCPs and 8 patients. Results: The final COS included 19 outcomes. Twelve apply to all interventions: death from prostate cancer, death from any cause, local disease recurrence, distant disease recurrence/metastases, disease progression, need for salvage therapy, overall quality of life, stress urinary incontinence, urinary function, bowel function, faecal incontinence, sexual function. Seven were intervention-specific: perioperative deaths (surgery), positive surgical margin (surgery), thromboembolic disease (surgery), bothersome or symptomatic urethral or anastomotic stricture (surgery), need for curative treatment (active surveillance), treatment failure (ablative therapy), and side effects of hormonal therapy (hormone therapy). The UK-centric participants may limit the generalisability to other countries, but trialists should reason why the COS would not be applicable. The default position should not be that a COS developed in one country will automatically not be applicable elsewhere. Conclusion: We have established a COS for trials of effectiveness in localised prostate cancer, applicable across all interventions which should be measured in all localised prostate cancer effectiveness trials

European Association of Urology Position Paper on the Prevention of Infectious Complications Following Prostate Biopsy

Funding support: This work is supported by the European Association of Urology Guidelines Office.Peer reviewedPostprin

Mapping European Association of Urology Guideline Practice Across Europe:An Audit of Androgen Deprivation Therapy Use Before Prostate Cancer Surgery in 6598 Cases in 187 Hospitals Across 31 European Countries

Open Access via the Elsevier Agreement We are grateful to the EAU Research Foundation for funding the project. The sponsor played a role in review of the manuscript.Peer reviewedPublisher PD

EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

Funding support and role of sponsor: The EAU/EANM PSMA-based imaging and therapy consensus meeting was supported by an unrestricted educational grant from Novartis; Novartis had no influence over the content of the meeting or the publication. Medical writing support was funded by the European Association of Urology Research Foundation. Acknowledgements: The authors acknowledge Emily Spieker (Management Assistant, European Association of Urology) for project management. Medical writing support was provided by Angela Corstorphine of Kstorfin Medical Communications (KMC) limited.Peer reviewedPublisher PD