GU Cast | Urology Podcast

Pelvic lymph node dissection (PLND) - one of our perennial favourite and contentious topics on GU Cast. Today we have both Alberto Briganti (Milano, ITA), and Tobias Maurer (Hamburg, GER), in the studio. Two hugely experienced prostate cancer surgeons, both with huge expertise in PLND. Alberto's name synomous with PLND due to the eponymous nomograms he has deveoped over the years. And Tobias with his pioneering experience in PSMA radio-guided PLND. 
Your usual hosts are Renu Eapen and Declan Murphy

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Two great topics on the GU Cast Journal Club today. How should we image patients with haematuria (the DETECT trial, J Urol 2018), and what is the role of adjuvant vs salvage radiotherpay following radical prostatectomy (three great trials - RAVES, RADICALS and GETUG-AFU 17), see links below).
Plus we welcome new GU Cast co-Editor Gaetan Devos, who recently joined us on Fellowship at Peter Mac, replacing Carlos Delgado.
Usual GU Cast Hosts are Renu Eapen and Declan Murphy, and GU Cast Journal Club Editor, Elena Berg.

Links:
1. Can Renal and Bladder Ultrasound Replace Computerized Tomography Urogram in Patients Investigated for Microscopic Hematuria?

2. Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial

3. Timing of radiotherapy after radical prostatectomy (RADICALS-RT): a randomised, controlled phase 3 trial

4. Adjuvant radiotherapy versus early salvage radiotherapy plus short-term androgen deprivation therapy in men with localised prostate cancer after radical prostatectomy (GETUG-AFU 17): a randomised, phase 3 trial

The perennially thorny topic of prostate cancer screening has been very well addressed in the brand new Australian guidelines for the Early Detection of Prostate Cancer which we are delighted to highlight today.  Pragmatic, progressive and patient-focused,  are some of the comments we have read - great to hear! We have been very gratified to see the very positive reception which these guidelines have received, not just here in Australia, but also by other expert and patient groups around the world.

Today, GU Cast co-Host Declan Murphy (also a member of the Guideline Expert Advisory Group), chat with co-Chair of the Guideline committee, Prof Peter Heathcote (Urologist, ex-president of USANZ), and Dr. Jane Crowe (GP, co-Chair of the PSA Working Group along with Declan). What are the key messages for men in different age groups? Which men are considered higher risk? What are the major changes from the old guideline? All this and more in this episode of GU Cast.

See below for links to all the key documents, and huge congratulations to Guideline co-Chair Jeff Dunn and all at the Prostate Cancer Foundation of Australia for enabling this, and everyone involved in the process. Too many to mention!

Links:
https://www.pcfa.org.au/awareness/new-guidelines-for-the-early-detection-of-prostate-cancer/

Urologist Ben Lowentritt (Chesapeake Urology, Baltimore), pops into the studio today while passing through Melbourne. We chat about life in a large urology group practice (a huge part of urology service delivery in the USA), why there appears to be a drop in interest in Fellowship training, and his experience of managing advanced prostate cancer in a large urology group practice. Ben, who is also Secretary of the Large Urology Group Practice Association in the USA, has a lot of interest in gathering real world data from large urology group practices, and shares with us some data on the use of ARPIs in mHSPC which has recently been accepted for publication. 

This is a Themed Podcast supported by our Gold Partners, Johnson & Johnson.

Open vs partial nephrectomy, and open vs robotic prostatectomy - two large randomised trials that did not change surgical practice! Just as important to examine these in GU Cast Journal Club as to examine pivotal trials that did change practice. Today we discuss the EORTC Today we discuss the EORTC 30904 RCT looking at kidney cancer surgery (Eur Urol 2011), and the Brisbane randomised trial of open vs robotic prostatectomy conducted (Lancet 2016).

We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Mexico City, MEX), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. AN emotional one as Carlos is heading home to Mexico soon!

Links to papers below:
1. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma Eur Urol 2011

2. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study Lancet 2016

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About GU Cast Journal Club:
Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology
. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner
. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.