OBJECTIVE• To assess the patient and cancer characteristics as well as outcomes of a large cohort of Australian men who chose active surveillance (AS) as initial management of their low-risk prostate cancer. PATIENTS AND METHODS• Men treated by one surgeon who had chosen AS as the primary management for prostate cancer were identifi ed from the records.• The patient and cancer data recorded included: patient age, prostate-specifi c antigen (PSA) concentration at diagnosis, mode of prostate cancer detection.• For prostate cancer diagnosed at prostate biopsy, data were collected for the number of cores taken as well as positive core number, cancer burden, and Gleason grade.• Survival analysis was used to determine the duration of AS. RESULTS• In all, 154 men with low-risk prostate cancer with a median (range) age 63.0 (36 -81) years and a mean (range) PSA concentration of 6.5 (0.3 -22) ng/mL underwent AS.• The median (range) duration of AS was 1.9 (0.1 -16.6) years. AS was ceased in 29 patients (19%) after a mean (range) of 2.4 (0.2 -7.9) years. Of these, 26 were upstaged, one chose curative treatment despite stable disease, and two died from disease not related to prostate cancer.• Actuarial analysis on the probability of still being on AS after 5 years was 61.9% (95% confi dence interval [ CI ] 46.2 -74.2%) and after 10 years was 45.0% (95% CI 21.3 -66.2%).• While the period of follow-up is short, there were no biochemical recurrences in men who underwent curative treatment and no deaths from prostate cancer. CONCLUSION• AS is an acceptable mode of initial treatment in Australian men with low-risk prostate cancer.

ObjectiveTo investigate the incidence and mortality trends of upper tract urothelial cancers (UTUC) in Victoria over the last decade. Patients and MethodsAge-adjusted incidence and mortality rates were calculated for UTUC. These were identified using data from the Victorian Cancer Registry from 2001 until 2011 based on histological diagnoses. Age at diagnosis, sex and demographical location were compared. ResultsThe age-standardised incidence of UTUC remained stable from 2001 to 2011. There were 278 deaths from UTUC over this period with an overall 5-year survival rate of 32%. There was no significant difference in survival between 2001-06 and 2007-11 (30% vs 36%, respectively). Lower age at diagnosis was associated with a significant improvement in survival (P = 0.01). Sex and geographical location appeared to have no effect on survival. ConclusionThe 5-year survival rates for UTUC in Victoria are poor, particularly in comparison to worldwide data. In contrast to worldwide trends, the incidence of UTUC appears to be stable. No significant improvement in 5-year survival rates over the short study period was identified. These findings highlight the difficulties in managing this rare yet deadly malignancy.

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We describe a case of a partial unilateral duplex system and ureterocele containing a 4 cm stone in a 66-year-old woman who presented with renal colic. Cystoscopic stone removal and deroofing of the ureterocele were performed and a ureteral stent was placed for a total of 6 weeks. Our case is unique as it highlighted the diagnostic pitfalls of ureteroceles, especially when obscured by a large calculus. We also described the use of a Holmium laser to simultaneously incise the ureterocele and fragment the calculus.

This study concludes that patients with acute appendicitis presenting to a hospital with no acute surgical services had a greater waiting period prior to surgery. However, this did not translate into greater complication rates or length of stay for these patients. We propose a prospective study to further analyse the outcomes in such patients.