European urology
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The diagnostic performance of a genetic score based on single nucleotide polymorphisms (SNPs) is unknown in the prostate-specific antigen (PSA) range of 1-3 ng/ml. A substantial proportion of men in this PSA span have prostate cancer (PCa), but biomarkers to determine who should undergo a prostate biopsy are lacking. ⋯ A risk score based on SNPs predicts biopsy outcome in previously unbiopsied men with PSA 1-3 ng/ml. Introducing a genetic-based risk stratification tool can increase the proportion of men being classified in line with their true risk of PCa.
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Pilot studies have demonstrated the utility of indocyanine green (ICG) sentinel lymphadenectomy for prostate cancer. Prior work has used ICG with radiocontrast agents injected at a separate procedure and relied on assistant-controlled fluorescence systems, making the technique costly and cumbersome. ⋯ FERRP is safe, feasible, and allows for reliable prostate tissue marking and identification of sentinel lymphatic drainage in the majority of patients. ICG sentinel nodes are highly sensitive but relatively nonspecific for the detection of nodal metastasis.
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Editorial Comment
Improving outcome of surgical procedures is not possible without adequate quality measurement.
Outcome measurement allows for acknowledging differences in quality and must be used as a basis for quality assessment, regardless of what procedure is to be assessed and improved. As urologists, we should actively take the lead to guide this necessary and inevitable process.
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Editorial Comment
Moving beyond the headlines: improving the technical quality of radical prostatectomy.
Recent work from surgeons in Europe and the United States has provided both the motivation, and a blueprint, for implementing peer assessments of technical skill as a robust and practical strategy for evaluating and ultimately improving technical expertise with radical prostatectomy.