Objectives To test the hypothesis that a randomised trial of extended pelvic lymph node dissection (ePLND) can recruit at a rate acceptable for a larger scale trial. To compare the following secondary endpoints between the 2 arms: the rate of protocol violations, the intraoperative and postoperative morbidity of ePLND, and complications, and to evaluate short-term oncological outcomes comparing biochemical recurrence, clinical recurrence, and survival between arms. Patients and Methods A pilot study will be undertaken at Chris O’Brien Lifehouse and Royal Prince Alfred Hospitals for the NODE trial. Twenty patients will be randomised 1:1 to radical prostatectomy with or withoutePLND. Eligible participants will have high-risk prostate cancer and will be scheduled for robotic radical prostatectomy. High-risk disease will be defined as in the 2019 NCCN guidelines (stage ≥ T3a, ISUP Grade Group ≥ 4 or PSA ≥ 20ng/mL). PSMA PET/CT staging not showing any extraprostatic disease will be required. Quality control measures to ensure consistent delivery of high-quality extended lymph node dissections are in place,and surgeons have been selected for their consistent ability to perform such procedures. Results The trial is currently underway. Conclusion On current available evidence, it is unclear if ePLND provides additional benefit over radicalprostatectomy.
Acute Lymphoblastic Leukemia (ALL) in infancy is a rare entity with reported incidence of 2.5-5% of total childhood ALL.1 It usually presents with organomegaly, hyperleukocytosis, central nervous system (CNS) involvement and B-cell phenotype. Acquired mixed lineage leukemia (MLL) gene rearrangement on chromosome 11q23 is the most observed cytogenetic abnormality in infantile ALL with an incidence of ~80%.2 The Philadelphia (Ph) chromosome positive B-lymphoblastic leukemia (B-ALL) is uncommon in childhood (<5%) and exceptionally rare in infants.3 Here, we report a case of infantile B-ALL with presence of Ph chromosome and absence of MLL gene rearrangement.An 11-month infant boy presented with complains of fever and irritability. On examination, he had cervical lymphadenopathy, and hepato-splenomegaly. Complete blood count (CBC) showed haemoglobin (Hb) 8.7gm/dl, total leucocyte count
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.