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Renal fossa recurrence after nephrectomy for renal cell carcinoma

This paper is an analysis of 36 years of radical nephrectomy for renal cell carcinoma in the Mayo Clinic (1970-2006). In particular, it contains an analysis of the risk of renal fossa recurrence after nephrectomy (partial nephrectomies are not included)...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

Long-term oncologic outcomes of salvage cryoablation for rrPC

Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...

First and second-line treatments in metastatic renal cell carcinoma

Over the past two decades, the treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly, leading to a quadrupling of patient survival rates. Modern systemic treatments include combinations of anti-PD-1 antibodies with either anti-CTLA-4 antibodies or antiangiogenic tyrosine...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Overview of partial nephrectomy techniques: influence of technology

Traditionally, radical nephrectomy was the preferred operation for kidney cancer, while partial nephrectomy was reserved for specific circumstances and essential indications such as a tumour in a solitary kidney, bilateral kidney tumours, or severe chronic kidney disease (CKD). Given the...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

Frailty in urology – part 2

The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

Paediatric urology: what you need to know for FRCS (Urol)

Lianne Pickett, Urology ST5 at Great Ormond Street Hospital (GOSH), and Ms Neetu Kumar, Consultant Paediatric Urological Surgeon at GOSH, provide expert insights into the key aspects of paediatric urology. Curriculum Paediatric urology contributes one of the eight stations of...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...