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Seattle-The prognosis for patients with advanced hormone-refractory prostate cancer is improving. That is the ultimate result from the latest trial of sipuleucel-T (Provenge), published last month (J Clin Oncol 2006; 24:3089-94). The novel immunotherapy agent showed a statistically significant survival advantage and a solid safety profile. Consequently, the manufacturer plans to submit trial data later this year as the basis for a biologics license application to the FDA.

New data on outcomes of surgery, radiotherapy, and watchful waiting, along with studies of minimally invasive surgical approaches provided the core for the AUA meeting take-home messages on management of localized prostate cancer. Findings of research on outcomes of different disease management options are important in providing longer-term follow-up that generally corroborates results of previous studies, said Richard D. Williams, MD, Rubin H. Flocks professor and chairman, department of urology, University of Iowa, Iowa City.

An intravesical formulation of the chemotherapy agent docetaxel (Taxotere) appears to be safe for further investigation in patients with superficial bladder cancer that has recurred following standard therapies, according to findings from a phase I trial published in the Journal of Clinical Oncology (2006; 24:3075-80).

A three-question, noninvasive test appears to accurately classify stress and urge incontinence, according to a study in the Annals of Internal Medicine (2006; 144:715-23).

Mayo Clinic researchers say they have identified a molecule known as B7-H4 that blocks the immune system, thereby helping renal cell carcinoma grow and metastasize.

The FDA has granted approval to two devices indicated for the treatment of overactive bladder.

Heat sensitivity may make testicular cancer, and possibly other malignancies, more susceptible to standard treatments and die off more readily, according to a commentary in last week's JAMA (2006; 296:445-8).

If a protein known as BAD is inhibited, then prostate cancer cells survive, a finding that may lead to more effective drug treatments for the disease. Researchers from Wake Forest University Baptist Medical Center, Winston-Salem, NC, recently reported their findings about the BAD protein in the Journal of Biological Chemistry (2006; 281:20891-901).

When it comes to the business side of medicine, managers and physicians are irritated by the flow of paper in their office and the major investment of time and money required to manage it. So much for the paperless office!

Washington-Changes are coming in the way the Centers for Medicare and Medicaid Services calculates physician payments for Medicare services. The agency is putting the finishing touches on a new plan that would provide higher physician payments for cognitive services, while making corresponding reductions in practice expense payments.

Malvern, PA and Woodstock, GA-The new LithoGold spark gap shockwave lilthotripsy unit from Siemens Medical Solutions, USA, and Shockwave Technical Service, a division of Tissue Regeneration Technologies, LLC, is built into the housing of the Siemens Modularis system, ensuring compatibility with Siemens' C-arms and the Modularis table. The unit incorporates the STS SmartTrode intelligent electrode, which automatically adjusts to the specified energy level. FDA 510(k) review is pending.

AEterna Zentaris Inc. said it will file an investigational new drug application with the FDA for permission to proceed to phase III clinical trials of cetrorelix, a luteinizing hormone-releasing hormone antagonist product candidate for the treatment of BPH. The decision follows FDA review of safety and efficacy data from an extensive phase II program of the drug.

Atlanta-An approach to transvaginal total pelvic reconstruction that uses a single piece of polypropylene mesh with four-point fixation is proving to be safe and efficacious during long-term follow-up, according to an outcomes analysis undertaken by urologists at North Shore-Long Island Jewish Medical Center, New Hyde Park, NY.

Atlanta-A study of patients receiving a double-cuff artificial urinary sphincter (AUS) shows encouraging short-term outcomes, but a second, longer-term study comparing single-cuff and double-cuff AUS indicates comparable outcomes but a greater complication rate with the double-cuff version.

Atlanta-The transobturator approach for sling placement may result in decreased pad use and overall patient satisfaction in men with stress urinary incontinence, according to the preliminary findings of a small study presented by Peter Rehder, MD, a urologist at the University of Innsbruck, Austria. The data were reported at the AUA annual meeting here.

Atlanta-Sling procedures have long been touted as minimally invasive approaches to stress urinary incontinence, but new data from UCLA suggest that complications resulting from sling surgery may happen far more frequently than is reported in the literature.

Atlanta-A sling procedure for women with stress urinary incontinence known as the distal urethral polypropylene sling (DUPS) procedure results in minimal complications and produces long-lasting results, according to 5-year results presented here at the AUA annual meeting.

Atlanta-Results of a Medicare claims analysis of women undergoing a sling procedure for stress urinary incontinence have revealed a significant variation between gynecologists and urologists in their approach to patient evaluation and the outcomes after surgery. However, further study is needed to understand the factors underlying those differences, researchers from UCLA said at the AUA annual meeting here.

Atlanta-As radiofrequency ablation emerges as a minimally invasive treatment option for small-cell renal carcinoma, urologists should consider including biopsy as a normal component of patient follow-up, say researchers from the Cleveland Clinic.

Atlanta-Several groups have recently demonstrated the safety and efficacy of radiofrequency ablation in select patients ineligible for surgical excision of small renal tumors. Short-term data from these single-institution studies were presented at the AUA annual meeting here.

Endopelvic fascia and dorsal venous complex are left intact, one of the hallmarks of this technique.

Atlanta-An investigational vaccine directed against prostate cancer cells has been found to be well tolerated with minimal toxicity in patients with hormone-refractory prostate cancer. In patients receiving the agent, median survival appeared to be enhanced when compared with accepted nomograms, reported researchers from Virginia Mason Medical Center, Seattle. These results were from two phase II trials of the vaccine, known as GVAX, presented at the AUA annual meeting here.

Atlanta-Combining the endothelin A (ETA) receptor antagonist atrasentan (Xinlay) with taxane chemotherapy has a significant additive effect against prostate cancer, results of a preclinical investigation presented at the AUA annual meeting here have demonstrated.

Atlanta-The decision about when to intervene in patients with small, low-grade prostate tumors can be a tough one for both patient and physician. A study from The Johns Hopkins Hospital, Baltimore, suggests that these men may have 2 years or longer to make a decision without compromising effective treatment.

Atlanta-Laurence H. Klotz, MD, looks momentarily at the data generated by his study of the role that PSA kinetics might play in influencing intervention in men with low-risk prostate cancer and summarizes the findings in a single observation: "It is hard to argue with 99% disease-specific survival."

Atlanta-Phosphodiesterase-5 inhibitor therapy, which is commonly used to treat erectile dysfunction, may have a paradoxical benefit as a treatment for priapism in patients with sickle cell anemia, according to research presented at the AUA annual meeting here and at the American Society of Andrology annual meeting in Chicago.

Atlanta-Which procedure nets better results for patients with Peyronie's disease-corporeal plication or plaque incision with venous grafting? According to a long-term study from Kaiser Permanente Medical Center in Los Angeles, there is no difference between the two procedures in terms of patient satisfaction. The major difference between the two is time spent in the operating room.

Atlanta-Surgeons from Italy have developed a technique to take tissue from the underside of the tongue and transplant it to repair strictures in the urethra, giving surgeons an alternative to buccal mucosa for the procedure.