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\(\textit {Introduction:}\) To evaluate perioperative outcomes related to resident involvement (RI) in a large and prospectively collected multi-institutional database of patients undergoing orchiectomy for testicular cancer. \(\textit {Materials and Methods:}\) Using current procedural terminology and ICD-9 codes, information about patients with testicular cancer were abstracted from the American College of Surgeons National Surgical Quality Improvement Program database (2006–2013). Multivariable analyses evaluated the impact of RI on outcomes after orchiectomy. Prolonged operative time (pOT) and prolonged length of stay were defined by the 75th percentile (59 min) and postoperative inpatient stay ≥ 2 days, respectively. \(\textit {Results:}\) Overall, 267 patients underwent orchiectomy either with (38.6%) or without (61.4%) RI. In all, 89.1% of patients underwent an outpatient procedure. The median body mass index was 26.8 and baseline characteristics between the 2 groups were similar. Overall complications, re-intervention, and bleeding-related complication rates were 2.6, 0.7, and 0.4%, respectively. Although there was no difference in terms of overall complications between the groups (3.9 vs. 1.8%; p = 0.44), RI resulted in pOT (32 vs. 19.5%; p = 0.028). In multivariable analyses, RI predicted pOT (OR 1.89, 95% CI 1.06–3.37; p = 0.031), without association with prolonged length of stay and overall complications. \( \textit {Conclusions:}\) RI during orchiectomy for testicular cancer does not undermine patient safety at the cost of pOT.

We performed a systematic literature search to identify original articles and editorials about the Decipher(®) Prostate Cancer Test (GenomeDx Biosciences, San Diego, CA) to provide an overview of the current literature and its present role in urologic clinical practice. The Decipher test, which uses the expression of 22 selected RNA markers (from a total of over 1.4 million), showed a very high discrimination in predicting clinical metastasis (0.75-0.83) and cancer-specific mortality (0.78) in external validation studies, outperforming all routinely available clinicopathologic characteristics. Further, the timing of postoperative radiotherapy (adjuvant vs salvage) may be guided based on Decipher scores. The Decipher test was also the only independent predictor of clinical metastasis in patients with biochemical recurrence after surgery. The Decipher Genomic Resource Information Database (GRID) is a novel research tool that captures 1.4 million marker expressions per patient and may facilitate precision-guided, individualized care to patients with prostate cancer. In this era of precision medicine, Decipher, along with the Decipher GRID platform, is a promising genomic tool that may aid in managing prostate cancer patients throughout the continuum of care and delivering appropriate treatment at an individualized level.

2002 wurden 10 Kriterien vorgeschlagen, um den Vergleich von chirurgischen Eingriffen zu standardisieren. Problem: Für die offene retropubische radikale Prostatektomie existiert im deutschen Sprachraum keine Publikation, die alle Kriterien berücksichtigt. Standardisierte Einteilung der Komplikationen (bis 30 Tage postoperativ) nach der Clavien-Dindo Methode: Klassifikation und Berücksichtigung aller Martin-Kriterien bei der offenen retropubischen radikalen Prostatektomie. Es wurden 943 Komplikationen bei 801 von 2893 Patienten erfasst (Gesamtkomplikationsrate 27.7%). Von diesen Ergebnis: waren 779 Grad 1-2 (82.7%) und 161 Grad 3-5 (17.3%). Unabhängige Prädiktoren (p≤0,05) für Komplikationen ≥Grad 3 waren Alter, Prostatavolumen und eine pelvine Lymphadenektomie. Diskussion: Komplikationen sollten standardisiert erfasst und mit einer standardisierten Methode berichtet werden. Bei Verwendung der Clavien-Dindo Klassifikation beobachtet man eine akzeptable Gesamtkomplikationsrate.