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Final results of the CALGB 90206 and AVOREN trials have failed to demonstrate an overall survival benefit for bevacizumab plus interferon compared to interferon monotherapy in patients with metastatic renal cell carcinoma. Progression-free survival or objective response rate might be more suitable primary end points in phase III trials.
The risk of suicide is increased among men diagnosed with prostate cancer, particularly those with metastatic disease. These results indicate a need to identify signs of depression and optimize treatment among newly diagnosed patients.
Improving the end-of-life care for patients and their families has become an increasingly high priority for the UK National Health Service over the past decade. This Review describes several government initiatives, such as the National End of Life Care Programme, and, using a case history of a patient with terminal prostate cancer, how they have been implemented at a local level.
Today's urologists require a broad skill set, and training must keep pace with scientific and technical advances in a number of fields. Here, Ahmed and colleagues discuss the issues surrounding competency in this specialty, focusing on the attributes required of a competent urologist, and the tools and frameworks used to evaluate and improve these skills.
Hydrocele in patients aged 13–18 years are mostly likely idiopathic in origin or caused by varicocelectomy. Cimador and colleagues describe the clinical presentation and diagnosis of hydrocele in adolescents, before discussing the possible treatment options for these individuals.
Management of urethral strictures can be challenging, given the heterogeneity of the disease and the myriad surgical techniques from which to choose. In this Review, Drs. Zimmerman and Santucci describe three urethroplasty procedures—anastomotic, buccal mucosal graft-onlay and the two-staged Johanson urethroplasty—that can accommodate the majority of patients and give good long-term results.
Achievement of urinary continence is an important developmental step, but debate continues as to the best age to begin toilet training. This Review by Professor Wu focuses on the achievement of urinary continence in children, discussing the optimum age for toilet training and providing an overview of bladder function and voiding mechanisms in the infant and young child. Medical disorders that may cause difficulty in achieving urinary continence are also overviewed.