OBJECTIVES To review the long‐term outcome of prostatic involvement in patients with bladder cancer (BC) treated with radical cystectomy (RC), as urothelial carcinoma (UC) involving the prostate occurs in such patients, and prostatic invasion by UC is by transmural invasion (contiguous), or when UC develops from the epithelium of the prostatic urethra (not contiguous). PATIENTS AND METHODS Between 1992 and 2006, 351 men had RC for BC by one surgeon at our centre; they were stratified into those with contiguous or non‐contiguous disease, based on prostatic stromal involvement. Relevant clinical and pathological data were collected and the survival analysed. RESULTS In all, 24% (78/320) of the patients who had RC had prostatic involvement; 29 (9%) and 49 (15%) had contiguous and non‐contiguous involvement, respectively. In the non‐contiguous group, there was stromal and non‐stromal UC involvement in 18 (37%) and 31 (63%), respectively. The overall 5‐year survival of contiguous, non‐contiguous and no prostatic involvement was 6%, 57% and 66% (P < 0.001). The 5‐year overall survival of stromal and non‐stromal UC was 26% and 74% (P = 0.008). There was no statistical difference in survival between contiguous and non‐contiguous stromal involvement (P = 0.58). CONCLUSIONS Prostatic UC with no stromal involvement did not alter the survival predicted by the primary bladder stage. Stromal involvement of the prostate has a poor prognosis regardless of the mode of invasion.

Cytoreductive nephrectomy in the elderly population can be associated with the potential for significant morbidity and mortality. Despite this and as part of a multidisciplinary approach it may provide potential survival as well as other benefits, which may justify it in highly select and highly motivated patients who are 75 years or older. However, it must be performed carefully with realistic expectations on behalf of the patient and urologist.

Docetaxel followed by gefitinib demonstrated sequence specific efficacy against gefitinib sensitive bladder cancer compared with gefitinib followed by docetaxel or either drug alone. Accordingly gefitinib administration concurrently or after chemotherapy might be the sequence of choice and it should be considered for future clinical trials.

Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS). Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data. Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

Although, the presence of LVI in node-negative patients is an adverse prognostic factor on univariate analysis of disease-specific survival, it is not an independent prognostic factor on multivariate analysis. Pathological stage is the only independent prognostic factor for survival.