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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...

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)...

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...

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...

ABU joins BCG in fight against NMIBC recurrence?

The authors test a hypothesis retrospectively in two cohorts of patients with non-muscle invasive bladder cancer (NMIBC), that endogenous bacteria in the bladder might exert antitumour effects, similar to live mycobacteria (BCG), through local immune-related or other mechanisms, on NMIBC...

Activity of enzalutamide in men with mCRPC is affected by prior treatment with abiraterone and / or docetaxel

This study reported on the real-world clinical outcomes of patients at seven academic institutions who were treated with enzalutamide, with the primary objective being to assess the effect of prior therapies (namely abireterone and docetaxel). Three hundred and ten patients...

BCG maintenance therapy not superior to induction alone

With the ongoing shortage of BCG remaining an issue for urologists in the UK and further afield, this topical paper presented the results of the CUETO study evaluating the outcome of a modified three-year BCG maintenance regimen versus induction therapy...

Performance status may alter outcomes in those treated with abiraterone

The drug therapies available for those with metastatic castrate-resistant prostate cancer have increased over the past few years. Abiraterone, a CYP17 inhibitor, has been proven effective in phase three trials, however those with poor performance status were largely under-represented in...

BCG strain differences have an impact on clinical outcome in bladder cancer immunotherapy

Bacillus Calmette-Guérin (BCG) has been part of the treatment algorithm for non-muscle invasive bladder cancer (NMIBC) for a number of years. In this single centre, prospective, randomised trial, two of the most commonly available strains, BCG Connaught and BCG Tice,...

Adjuvant radiotherapy versus wait-and-see after radical prostatectomy

Optimum treatment modalities in prostate cancer continue to evolve, with debates at each stage of the evolution process, from focal therapy to radical treatment. In this randomised study, Wiegel et al. investigated the role of adjuvant radiotherapy following open radical...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...