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Re: Lymph Node Management in Patients with Paratesticular Rhabdomyosarcoma: A Population-Based Analysis
UROLOGICAL ONCOLOGY: TESTIS CANCER AND ADVANCES IN ONCOLOGIC THERAPY
note that public health strategies to identify and treat diabetes and cardiovascular disease in men on ADT should be similar to those in the general population. Of course, this also needs to be done in the context of the overall medical condition of an individual, to include prostate cancer. Tomas L. Griebling, MD, MPH
Suggested Reading Oefelein MG: Time to normalization of serum testosterone after 3-month luteinizing hormone-releasing hormone agonist administered in the neoadjuvant setting: implications for dosing schedule and neoadjuvant study consideration. J Urol 1998; 160: 1685.
Re: Prostatic Biopsies in Selected Men Aged 75 Years and Older Guide Key Clinical Management Decisions A. L. Paterson, M. K. Sut, A. R. Khan and H. K. Sharma Department of Urology, Bedford Hospital, Bedford, United Kingdom Int Urol Nephrol 2013; 45: 1539e1544.
Abstract available at http://jurology.com/ Editorial Comment: Prostate cancer screening is generally not recommended in elderly men, variably defined as older than 70 to 75 years, or in those with an estimated remaining life expectancy of 10 years or less. However, there is less information about the usefulness of prostate biopsy and pathology outcomes in elderly men with prostate cancer. This study examined findings from clinical evaluation, including prostate biopsy for 138 men 75 years or older, and identified how this information influenced subsequent care. Overall prevalence of prostate cancer was 43%, and 92% of these cases were considered high or medium risk based on Gleason sum score and other pathological features. Half of the men diagnosed with prostate cancer underwent radiation therapy. In contrast, the calculated positive predictive value of prostate specific antigen and rectal examination was only 54%. These findings support the concept that targeted evaluation including prostate biopsy in select elderly men can help to guide therapeutic decisions and should be considered in the evaluation paradigm. Tomas L. Griebling, MD, MPH
Suggested Reading Scales CD Jr, Curtis LH, Norris RD et al: Prostate specific antigen testing in men older than 75 years in the United States. J Urol 2006; 176: 511.
Urological Oncology: Testis Cancer and Advances in Oncologic Therapy Re: Lymph Node Management in Patients with Paratesticular Rhabdomyosarcoma: A Population-Based Analysis N. D. Dang, P. T. Dang, J. Samuelian and A. C. Paulino Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas Cancer 2013; 119: 3228e3233.
Abstract available at http://jurology.com/ Editorial Comment: Paratesticular rhabdomyosarcoma is the most common paratesticular malignancy diagnosed in patients 7 to 36 years old (mean 10 years). There is an excellent overall prognosis
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1786
UROLOGICAL ONCOLOGY: TESTIS CANCER AND ADVANCES IN ONCOLOGIC THERAPY
for patients with this entity, with 3-year recurrence-free survival rates upwards of 90%. However, controversy exists regarding lymph node management in these cases. Staging ipsilateral retroperitoneal lymph node dissection is recommended for boys older than 10 years but is reserved for those younger than 10 with enlarged lymph nodes. The authors have used the SEER (Surveillance, Epidemiology and End Results) database during the last 30 years to identify 255 patients, of whom 173 were older than 10 years. Overall survival was better in patients older than 10 years if they underwent retroperitoneal lymph node dissection. Thus, the authors conclude that lymph node dissection should be recommended in patients older than 10 years. Jerome P. Richie, MD
note that public health strategies to identify and treat diabetes and cardiovascular disease in men on ADT should be similar to those in the general population. Of course, this also needs to be done in the context of the overall medical condition of an individual, to include prostate cancer. Tomas L. Griebling, MD, MPH
Suggested Reading Oefelein MG: Time to normalization of serum testosterone after 3-month luteinizing hormone-releasing hormone agonist administered in the neoadjuvant setting: implications for dosing schedule and neoadjuvant study consideration. J Urol 1998; 160: 1685.
Re: Prostatic Biopsies in Selected Men Aged 75 Years and Older Guide Key Clinical Management Decisions A. L. Paterson, M. K. Sut, A. R. Khan and H. K. Sharma Department of Urology, Bedford Hospital, Bedford, United Kingdom Int Urol Nephrol 2013; 45: 1539e1544.
Abstract available at http://jurology.com/ Editorial Comment: Prostate cancer screening is generally not recommended in elderly men, variably defined as older than 70 to 75 years, or in those with an estimated remaining life expectancy of 10 years or less. However, there is less information about the usefulness of prostate biopsy and pathology outcomes in elderly men with prostate cancer. This study examined findings from clinical evaluation, including prostate biopsy for 138 men 75 years or older, and identified how this information influenced subsequent care. Overall prevalence of prostate cancer was 43%, and 92% of these cases were considered high or medium risk based on Gleason sum score and other pathological features. Half of the men diagnosed with prostate cancer underwent radiation therapy. In contrast, the calculated positive predictive value of prostate specific antigen and rectal examination was only 54%. These findings support the concept that targeted evaluation including prostate biopsy in select elderly men can help to guide therapeutic decisions and should be considered in the evaluation paradigm. Tomas L. Griebling, MD, MPH
Suggested Reading Scales CD Jr, Curtis LH, Norris RD et al: Prostate specific antigen testing in men older than 75 years in the United States. J Urol 2006; 176: 511.
Urological Oncology: Testis Cancer and Advances in Oncologic Therapy Re: Lymph Node Management in Patients with Paratesticular Rhabdomyosarcoma: A Population-Based Analysis N. D. Dang, P. T. Dang, J. Samuelian and A. C. Paulino Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas Cancer 2013; 119: 3228e3233.
Abstract available at http://jurology.com/ Editorial Comment: Paratesticular rhabdomyosarcoma is the most common paratesticular malignancy diagnosed in patients 7 to 36 years old (mean 10 years). There is an excellent overall prognosis
1785
1786
UROLOGICAL ONCOLOGY: TESTIS CANCER AND ADVANCES IN ONCOLOGIC THERAPY
for patients with this entity, with 3-year recurrence-free survival rates upwards of 90%. However, controversy exists regarding lymph node management in these cases. Staging ipsilateral retroperitoneal lymph node dissection is recommended for boys older than 10 years but is reserved for those younger than 10 with enlarged lymph nodes. The authors have used the SEER (Surveillance, Epidemiology and End Results) database during the last 30 years to identify 255 patients, of whom 173 were older than 10 years. Overall survival was better in patients older than 10 years if they underwent retroperitoneal lymph node dissection. Thus, the authors conclude that lymph node dissection should be recommended in patients older than 10 years. Jerome P. Richie, MD