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When we published our RCT showing lower mets with extended PLND, folks said "reduce mets but not BCR? impossible!". But existing data shows response to salvage at BCR related to extent of PLND. sciencedirect.com/science/articl…

mskcc.org/news/myths-abo…

"Expanding eligibility for AS and the uptake of AS in men with favourable GG2 PCa is crucial to address the stage shift resulting from the increased accuracy of MRI." bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bj…

This appeared high up in my feed. Can someone explain to me why serious medical researchers are still on this platform? Can we not just move to Bluesky?

#AUA25 kicks straight off with a thorny topic: do we really understand localised prostate cancer? Answer: clearly no! We can't even agree on our age-old risk strat criteria: •GG1, PSA 21, 150cc = High risk 🤔 •GG2 49% ≠ GG3 51% 😂 •GG4 2mm 100% 4 worse than GG2 12mm 40% 4🤦

Pattern 4 quantification is superior to biopsy Grade group for prediction of recurrence and metastases in #prostatecancer Andrew Vickers #aua25

Latest data from PBCG on MRI prostate biopsy: 2-fold variation in probability PI-RADS 4/5 across 13 sites after adjustment for case mix. Risk of GG ≥2 disease for PI-RADS 4/5 varied between 23%-68% / 49%-87%. Need better standardization sciencedirect.com/science/articl…

I think I did pretty well at AUA. However, my son *crushed*in the first game of the season, beating the team he grew up following youtube.com/watch?v=0bhu74…

Were there none pointing out that he is a fundamentally unserious person focused on generating outrage to promote his own personal brand?

Editorial - How To Write a Response to Reviewers by Andrew Vickers et al Read the full article here: buff.ly/fBvKg9m #UroSoMe #MedTwitter #Editorial #EurUrol

European Urology is recruiting associate statistical editors! A high impact journal with long track record of innovations in statistical peer review, this a fantastic opportunity for junior statisticians to gain experience at a top journal. Paid position. Email me if interested.

A tactic of the anti lymph node dissection crowd is to exaggerate risks. In this case, a 17% risk of lymphocele is claimed, with a citation to a systematic review. The review included several papers showing risks of 2-3% and one small abstract showing 17%. pdf.sciencedirectassets.com/272280/1-s2.0-…

The MAHA Report Cites Studies That Don’t Exist notus.org/health-science…

This is a great trial. But why are we ok with RCTs requiring 11 years at 17 hospitals to accrue n=173? That's less than 1 patient per center per year. TME not a rare procedure.

Can we stop calling non-randomized trials "Phase III"? pubmed.ncbi.nlm.nih.gov/40118738/

Major systematic review on PSMA PET in prostate cancer concludes "PSMA PET cannot be used alone to determine the need for lymph node dissection (LND)." Time to end the practice of negative PSMA PET = no LND sciencedirect.com/science/articl…

Kevin Ginsburg Andrew Vickers The headlong rush to do PSMA for all and change management - without the evidence it changes outcomes/survival reminds me of how MRI became gospel for everything from detection to prognosis without question- 2025 and no definitive data yet of impact on oncology outcomes

Have presented “Replace Gleason score with quantification of pattern 4 (after suitable research)” to > 30 different prostate cancer groups. Despite radical premise – change fundamental basis of treatment – remarkably little push back: it just seems kind of obvious to most folks.

What is the best evidence that presence of cribriform improves our ability to risk stratify prostate cancer? Please send citations to papers showing e.g. improvement in discrimination of a standard nomogram.

Current "informed consent" policies on PSA-screening lead to higher incidence of metastatic prostate cancer in socioeconomically deprived neighborhoods pmc.ncbi.nlm.nih.gov/articles/PMC11…