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Introduction: The year 2015 brought a major shift in the national health care system in Poland - the diagnosis and treatment of patients with malignant diseases became a priority. Close multidisciplinary collaboration was facilitated to optimize patients' care. The aim of this study was to investigate temporal changes in neoadjuvant chemotherapy (NAC) utilization in patients who underwent radical cystectomy (RC) due to muscle invasive bladder cancer (MIBC) in a single academic center in Poland., Material and Methods: Patients who underwent planned curative RC with bilateral pelvic lymph node dissection between January 2013 and December 2018 in a tertiary care center were included in the study. To assess the response to chemotherapy, tumor regression grades (TRGs) were included into the standard pathological examination of RC specimens., Results: Out of 183 patients enrolled into the study, 105 (57.4%) underwent NAC before RC. Only 1 (4%) out of 25 patients underwent NAC prior to RC in 2013. The percentage of patients who received NAC in subsequent years were: 4% (1/25) in 2013, 36% (9/25) in 2014, 55.3% (21/38) in 2015, 62.9% (21/35) in 2016, 83.9% (26/31) in 2017 and 89.7% (26/29) in 2018 (p-value for trend <0.001). Thirty patients (28.6%) had complete pathological response to NAC (TRG1), 50 patients (47.6%) showed strong response (TRG2) and 25 patients (23.7%) had weak or no response (TRG3)., Conclusions: This study showed an increasing utilization of NAC amongst MIBC patients who underwent RC. Close multidisciplinary collaboration is the key to optimizing perioperative care of patients with MIBC., Competing Interests: The authors declare no conflicts of interest., (Copyright by Polish Urological Association.)

Introduction: The aim of this single centre retrospective study was to analyse the results of second resection (repeat transurethral resection of bladder tumour - reTURBT) after a macroscopically complete resection of T1 urothelial bladder tumour and to identify prognostic factors for absence of residual disease (T0) in the second resection of T1 bladder cancer., Material and Methods: Patients with T1 bladder cancer diagnosed in a macroscopically complete initial resection who underwent second resection within 12 weeks were included into the retrospective analysis. Based on the presence or absence of residual disease, patients were grouped for further analysis. Univariate and multivariable logistic regressions were performed to identify potential prognostic factors., Results: Among the 139 patients who met the inclusion criteria, 96 (69.1%) had no residual disease (T0) and 43 (30.9%) had residual disease in the second resection (including muscle invasive bladder cancer in 2.2%). Adjusted odds ratios (OR) of T0 status obtained from the final model were as follows: detrusor muscle presence in the first resection (OR 3.05; 95% CI 1.12-8.35, p = 0.03), immediate post-operative intravesical mitomycin C administration after the first TURBT (OR 2.52, 95% CI 1.12-5.68; p = 0.03) and primary bladder cancer setting (OR 2.45, 95% CI 1.10-5.47; p = 0.03)., Conclusions: Our results add evidence regarding the importance of detrusor muscle presence in the first TURBT. Identification of predictors of T0 status at second resection could help design prospective studies assessing the possibility to avoid re-resection in selected patients with T1 bladder cancer without compromising oncological outcomes., Competing Interests: The authors declare no conflicts of interest., (Copyright by Polish Urological Association.)

Background and Objective: Urological diseases represent a significant health issue worldwide. Presented study aimed at assessing current urological knowledge and confidence in performing urological diagnostic and therapeutic procedures among medical students at Jagiellonian University Medical College in Poland and compare it on different stages of the undergraduate medical education., Material and Methods: We designed an anonymous survey distributed among Polish students from 1st to 6th year of medical studies, before and after clinical urology course. Questions concerned general urological knowledge, prostate diseases, erectile dysfunction, and self-reported practical urological skills., Results: Overall, 437 respondents participated in the survey. Mean total test score in our study group was 50.08%, mean general urological knowledge score was 53.44%, mean prostate diseases knowledge score was 55.43%, mean erectile dysfunction score was 36% and mean practical skills score was 45.83%. Mean total test score increased with consecutive years of studies (R = 0.58; p <0.001). The risk of an above average total test score was significantly influenced by the urology course (OR = 7.95, 95%CI = 1.81-34.84, p = 0.006) and the year of medical studies (4th-6th vs. 1st-3rd) (OR = 5.16, 95%CI = 3.41-7.81, p <0.001). Practical skills score above average was significantly more frequent in the group after the urology course (OR = 6.75, 95%CI = 1.54-29.58, p = 0.011)., Conclusions: Results of this study reveal low mean scores obtained by students, even after completing the urology course, which implies that curriculum requires further development. Urological knowledge and self-assessed practical skills increased with years of medical education. The urology course improved the score obtained in our survey, both in terms of total test score and practical skills.

The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up.