Andrew Stephenson

Excellent work. Transformative. – at Chicago, IL

Important point re: marker+/MRI-. If pretest probability very high, a negative test (i.e. MRI) may not alter post-test probability all that much. Still favor biopsy in high risk pts despite neg MRI - especially if one doesn’t have expert MRI reviewer. – at Chicago, IL

Great approach / philosophy. Off-ramps => repeat PSA, free:total, 4K, select MDX, mpMRI I do use PCPT risk calc in almost all pts - estimate risk of important cancer. If > 10%, MRI +/- biopsy warranted. – at Chicago, IL

Look at PROTECT and recent data from Ontario Canada => in the end, almost all GG1 get treated, sooner or later. I doubt the treatment rate among pts on AS is largely physician driven. Lots of progress to be made. @UroOncMD – at Chicago, IL

Single dose FQ with IM gent (or IM 3rd gen ceph). Negligible sepsis rate. – at Rosemont, IL

Honestly, I am amazed survival differences were observed among a cohort of low-risk pts who were treated compared to another cohort of whom 60% received treatment (albeit delayed). Maybe GG1 is actually a cancer! Fascinating and provocative. @uroegg @dr_coops

Equally relevant for surgical planning purposes. Perhaps this explains the conflicting data re: LND in RALRP. Important anatomical regions may be unaddressed surgically in many LN dissections. Exciting times for potential refinements in treatment. – at Greenville, WI

The initial challenge was convincing patients & clinicians to buy into AS. The challenge now is to identify reliable indicators for when AS should be abandoned. Much of this is also patient-driven anxiety and fatigue. Unfortunately, these data are similar to many others. – at Oshkosh, WI

Well-deserved. Congratulations 👏🏻 – at Rosemont, IL

A reliable BCR endpoint for focal therapy is likely to be elusive => so many confounders with intact and untreated prostate. – at Chicago, IL

The value of a test is based in part on the pre-test probability. We published a paper in EurUrol showing that 0.05 is adequate for pts with pT3b, pN1, GG4-5. A more rigorous and specific definition is needed (e.g. 0.2 and rising) for non-high risk. NOTE: All open RP pts. – at Michigan, USA

The AUA/ASCO GCT guidelines did not recognize RPLND as standard option until publication of the SEMS and German trials. Both of these P2 trials provide compelling evidence that it should be a consideration in non bulky CS II seminoma, as primary or CS I relapse. Stay tuned. – at Waterloo, Ontario

Agree 100%. Relapse does not equate to mortality in GCT as in other malignancies. It’s about preventing GCT deaths with the least long-term collateral damage. So many have been banging this drum for years. – at Waterloo, Ontario

Great work!

Saw this nice gesture on social media in light of the tragedy at Michigan State - the house united.

Agreed! – at King, Ontario

At the heart of this is universal access (public option or single-payer system). – at King, Ontario

In a way, this supports stepwise sequential treatment intensification for aggressive PC. – at King, Ontario

Huge.

Congratulations!