Christian P. Pavlovich, MD, examines the use of TULSA in prostate cancer treatment, highlighting its technique, outcomes, and future potential.
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Arthur L. Burnett II, MD, MBA, FACS, explores intraoperative neuromonitoring in radical prostatectomy.
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Arthur L. Burnett II, MD, MBA, FACS, reflects on over 30 years of research on priapism.
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Daniel Song, MD, explores the evolving role of metastasis-directed therapy (MDT) and androgen deprivation therapy (ADT) in oligometastatic prostate cancer. Initial studies, including SABR-COMET and STOMP, demonstrate that MDT, through approaches like stereotactic body radiotherapy (SBRT) or surgery, improves progression-free and ADT-free survival compared to observation alone. Recent trials also evaluate the combination of MDT and short-term ADT, such as the EXTEND trial, which shows significantly prolonged progression-free survival.
The 9-minute presentation highlights how advanced imaging, particularly PSMA PET scans, outperforms conventional imaging in detecting and targeting metastases, enhancing MDT’s efficacy. Comparisons of PSMA-guided versus choline-guided SBRT reveal superior outcomes in disease-free survival. Furthermore, ongoing research seeks to clarify whether systemic hormone therapy is necessary alongside MDT, with trials like DART exploring novel ADT strategies.
Dr. Song asserts that MDT improves survival metrics in oligometastatic prostate cancer, particularly when informed by advanced imaging. Combining MDT with prostate radiation or systemic ADT offers additional survival benefits.
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Arvin K. George, MD, delves into the nuances of prostate cancer biopsy techniques, focusing on the comparison between transperineal and transrectal approaches.
In this 14-minute presentation, Dr. George shares that transperineal and transrectal biopsies demonstrate equivalent cancer detection rates, particularly for clinically significant prostate cancer. However, some retrospective data suggest potential advantages of transperineal biopsy in specific anatomical areas, with notable studies emphasizing the reduced risk of infections with transperineal biopsy. Dr. George also discusses a decreased need for antibiotics and the use of local anesthesia in a transperineal approach.
Further, Dr. George reflects on the implications for clinical practice, antibiotic stewardship, and cost-effectiveness for transperineal and transrectal approaches. His talk provides a comprehensive synthesis of current evidence, encouraging a balanced and thoughtful approach to biopsy method selection.
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