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The article suggests the potential of machine learning in the form of radiomics to improve the assessment of preoperative imaging for patients with upper tract urothelial cell carcinoma (UTUC), with reference to a study which assessed preoperative radiologic variables and the pathologic outcomes of tumor. It calls for collaborative research, standardized radiologic reporting and further research into the role of genomics and circulating tumor DNA for patients with UTUC.

Introduction: The management of patients with a small renal mass (SRM) varies significantly. The objective of this study was to determine which initial management strategy resulted in the greatest quality- adjusted life months (QALM) for an index patient with a SRM. Methods: A Markov decision analysis was used to determine the effect of 1) treating patients with a partial nephrectomy (PN); 2) active surveillance (AS); and 3) renal mass biopsy on QALM over a 10-year horizon. All relevant health states were modelled. Biopsy sensitivity and specificity were modelled assuming an 80% prevalence of cancer using procedural pathology as the gold standard. Health state utilities were obtained from the Tufts Medical Centre Cost-Effective Analysis Registry. Deterministic sensitivity analyses were used to test key assumptions. Results: Over a 10-year time horizon for a 70-year-old male with a 2 cm SRM, the biopsy strategy resulted in 38.07 QALM, whereas treating all patients with PN resulted in 37.69 QALM and AS in 36.25 QALM. The model was most sensitive to the probability that a patient would remain alive at baseline. Biopsy was the preferred strategy when sensitivity was greater than 77%. As the underlying probability of cancer increased, the threshold of renal mass biopsy sensitivity to still favor biopsy increased. Conclusions: Renal mass biopsy is the preferred initial management strategy for an index patient with a SRM to optimize QALM. When the probability of cancer is high, centers should aim for a sensitivity of at least 77% in order to consider a biopsy as the first strategy. [ABSTRACT FROM AUTHOR]

The article offers information on consensus statement of Kidney Cancer Research Network of Canada (KCRNC) on the role of renal mass biopsy in the management of kidney cancer. Topics discussed include information on aim to provide guidance regarding the role of renal mass biopsy; low-to-moderate-quality of consensus statement; and evidence reported on renal mass biopsy which is predominantly comprised of retrospective cohort series of patients managed at high-volume center.

Introduction: Data from a randomized trial suggest transfusion rates are similar for robotic and open prostatectomy. The objective of this study was to compare perioperative outcomes of robotic and open prostatectomy at a Canadian academic centre. Methods: A retrospective review of all prostatectomies performed by all surgeons at The Ottawa Hospital between 2009 and 2016 was completed. Cases and outcomes were identified using an administrative data warehouse. Extracted data included patient factors (age, body mass index, American Society of Anesthesiologists score, Elixhauser comorbidity score), operative factors (length of operation, surgical approach, anesthesia type), and perioperative outcomes (length of recovery room and hospital stay, transfusion rate, hospital cost). Baseline characteristics and outcomes were compared between robotic and open surgical approaches. The primary outcome was transfusion during the index admission. Results: A total of 1606 prostatectomies were performed by 12 surgeons during the study period (840 robotic, 766 open). The rate of transfusion was lower in patients undergoing robotic compared to open surgery (0.6% vs. 11.2%; p<0.001). The robotic prostatectomy cohort had a shorter length of stay in the recovery room (155.7 vs. 231.1 minutes; p<0.001) and shorter length of hospital admission (1.4 vs. 2.8 days; p<0.001). Hospital costs per case were approximately $800 more for robotic prostatectomy ($11 475 vs. $10 656; p<0.001). Conclusions: This hospital-wide analysis revealed that robotic prostatectomy is associated with a lower transfusion rate compared to the open approach. Further studies emphasizing patient-reported outcomes are needed. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 36-year old man suffering from minor chest wall trauma sustained from accident at work. The patient underwent ultrasonic imaging and adrenalectomy wherein a substantial right upper quadrant (RUQ) mass indicating an adrenocortical carcinoma. He was also diagnosed with carcinomatosis.

Introduction: Given restrictions on electives outside of medical students' home institutions during the COVID-19 pandemic, the objective of this study was to create a novel recruitment strategy for the University of Ottawa's (uOttawa) urology residency program. Methods: A steering committee was formed and created a threepart recruitment strategy that included a new uOttawa urology website, a residency program social media campaign (Twitter and Instagram), and a virtual open house (VOH). Descriptive data from the website and Instagram and Twitter accounts were collected. Attendees of the VOH completed a mixed-methods survey, which collected quantitative and qualitive responses assessing aspects of the VOH and virtual resource use. Results: From August 1 to December 31, 2020, the uOttawa urology website had 1707 visits. The Twitter account had a total of 29 000 views with 1000-5000 views per tweet. Thirty-one candidates attended the VOH. Survey responders reported that the most frequently used resources to gain knowledge of the program were the website (81%) and Twitter account (71%). The most helpful and informative resources were the uOttawa urology website, the VOH, and direct conversations with residents arranged through the website. Despite not having completed an elective, 26 students (84%) felt they had an understanding of what it might feel like to train in the program. Suggestions by students for future initiatives included one-on-one virtual meetings, another VOH, and more information on selection processes. Conclusions: A multifaceted, virtual recruitment strategy can be implemented to improve candidate understanding and engagement with residency programs while visiting elective opportunities remain limited. [ABSTRACT FROM AUTHOR]

The article describes the case of a 58-year-old obese male who developed malakoplakia following living donor renal transplantation. Malakoplakia is a rare granulomatous condition that can arise in organ transplant patients. It notes that this disease is benign and responds to antibiotics, but it can cause significant morbidity and needs surgical intervention.