TCa D 17
Absence of Antegrade Ejaculation causes greatest Psycho- Social influence on testicular cancer survivors.
Maintaining Antegrade Ejaculation by Nerve- Sparing RPLND may help to overcome it in upto 95 %of patients.......

📢🔈And then on the other hand... just breaking this month - jamanetwork.com/journals/jama/… - 19 of 46 cancer drugs (41%) granted accelerated FDA approval from 2013-2017 did not improve overall survival in confirmatory trials; 🧐 #radonc

💙alison birtle Robert Huddart💙 That SUVmax will entail an approx 35pc risk of relapse.

2nd line chemo for those unfortunate to relapse not a cakewalk you will agree. 😊 And percentage of cure falls.

IMO the fear with 30 Gy IFRT is exaggerated and unfounded.

TCa D16

Interesting poll results here!

Ongoing RCT PROSEM is comparing top 2 options here, accrual 1/3rd complete 😇
Vedang Murthy gaganprakash
Amandeep Arora Amit Joshi Santosh Menon mahendra pal
#testicularcancer

😍Our NEW paper out in Clinical Oncology

Elective pelvic RT for high risk #ProstateCancer : Contour upper extent is Aortic Bifurcation, lower?? 🤔
*no recc nodes within 2cm of TOPS*
**Keep lower extent 1cm above TOPS**

Wonderful work Maneesh Singh👏🏼

doi.org/10.1016/j.clon…

Priyamvada Maitre gaganprakash mahendra pal Santosh Menon Amit Joshi YAU Working Group Penile & Testis Cancer DrBagrodia AFP+ in seminoma might indicate an occult yolk-sac tumor subpopulation, please see our publication on this issue, if you are interested...

onlinelibrary.wiley.com/doi/10.1111/hi…

Angela Jia Alison Tree 💙🇺🇦 Angela Jia

POPRT adding nodes Vedang Murthy

RTOG0534 QOL

Overall some added toxicity and QOL decline, but less than we say from 1990s trials.

TCa D12
Metastatic NSGCT, rx'd BEP ▶️ TIP chemo
Multiple stable lung mets
2 mets increase☠️☠️
In comes #SBRT 🤠🤠
Both mets responded, markers ⬇️
FU 3 yrs+, no acute/late tox, no progression🤞🏽🤞🏽

Is NSGCT *really* radioresistant, or just 2Gy-resistant?🤯
#TestisCancer

Did the Lap nephrectomy for the first Napster trial patient post SABR for high risk ccRCC at Monash Health. Planes were not too bad- just over an hour operative time. Thanks Peter Mac Cancer Centre Shankar Siva and Mohammed Ali for the collaboration!

TCa D9 : RA-RPLND in carefully selected patients and in hands with experience in open RPLND and Robotic surgery is an option worth considering for its distinct advantages in periop morbidity. gaganprakash Prasant Nayak 🇮🇳 Amandeep Arora mahendra pal Tata Memorial Hospital

TCa D10: Another way of reducing morbidity, especially ileus, is the EXTRA-PERITONEAL RPLND.

Minimal bowel handling

Usually for smaller masses

Again….Needs experience with the usual “transperitoneal” RPLND !

And no special retractor for the peritoneal sac ??

Sean Collins Prostate SBRT@Georgetown University This patient could have been included in PACE-B. With 5-year BCF without ADT around 96% modern SBRT doesnt leave much room for improvement with adding ADT

#testicularcancerawarenessmonth
Amit Joshi gaganprakash Amandeep Arora

Vedang Murthy Alexandros Papachristofilou Ryan Hutten, MD Igor Migowski (MD) silke gillessen Christian D. Fankhauser Here you go Vedang Murthy

TCa D8
Seminoma with a small RP node. Stage 2a-b
Classical Rx has been overkill.
Dog leg RT 😕
3x BEP 😭😭
The folks at SAKK have made it so elegant. Alexandros Papachristofilou
silke gillessen
Christian D. Fankhauser
1x Carboplatin and IFRT 😊
Very cool and very effective.

TCa D7 : here are our discordance rates .. Vidur garg Amit Joshi Vedang Murthy mahendra pal Ankit Misra Santosh Menon Priyamvada Maitre

TCa D7 When the disease is beyond the retro-peritoneum!!

Post-chemo disease in the RP + lungs/liver/supraclav LNs

Do you always resect extra-RP disease?

Does it depend on the RP pathology?

Do you do it simultaneously or staged?

Some answers from our data Tata Memorial Hospital

Yüksel Ürün Matt Sydes Amar Kishan Alberto Bossi Piet Ost Daniel E Spratt Thomas Zilli silke gillessen Dr. Brandon Mahal 🏁 Mutlay Sayan, MD Emre Yekedüz Gianluca Giannarini Agreed, delayed RT preferred for most cases

I prefer early RT for high or very high risk cases as these patients were not well represented on early v delayed trials

Ie GS 9-10, N+, positive margins, high initial postop PSA etc