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A clinical cT3 prostate cancer can mean so many different tumors, that no single approach can actually be proposed. Radical prostatectomy has become standard treatment for T1/T2 tumors, but the surgical treatment for the clinical T3 prostate cancer has always been and remains controversial, although some urologists felt that radical prostatectomy remained a treatment option for T3 prostatic cancer when poor prognosis patients were excluded. The clinical staging of locally confined or locally advanced prostate cancer is not reliable. More than 70% of the clinically T2-tumors are pT3. On the others hand clinically T3-tumors are sometimes overestimated and about 20% of the clinical T3 cancers were shown to be pT2.--At the Department of Urology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium--158 patients had radical prostatectomy for clinical stage T3N0M0 prostate cancer. 110 patients were surgically treated only. 30 patients had adjuvant hormone-therapy and were considered to be progressive at 1 month because PSA follow-up is unreliable. 18 other patients were irradiated postoperatively. PSA-free survival rate exceeds 70% at 24 months and the 5 years estimated PSA-free survival is more than 60%. Summarizing radical prostatectomy appears to be a justified treatment modality in pT3-prostate cancer, if PSA is < 10 ng/ml.

The case is reported of a 75-year-old man with bullous pemphigoid that was resistant to conventional treatment with prednisone and azathioprine. A hypernephroma was discovered and surgically excised, whereafter the skin lesions healed completely without any other therapeutic measures being taken.

The authors made a comparative study (intravenous urography, loopography and loopomanometry) between patients with inverted antireflux anastomosis, as proposed by Melchior, and 12 patients with classical uretero-ileostomy (Bricker bladder). Inverting the anastomosis results in greater incidence of obstruction, while less complications were seen using the classical technique. The importance of reflux in ileal loops and the validity of the classical and manometry loopogram is discussed. Antireflux procedure is only indicated in cases with dilated ureters.