Pelvic lymph node dissection (PLND) - one of our perennial favourite and contentious topics on GU Cast. Today we have both Alberto Briganti (Milano, ITA), and Tobias Maurer (Hamburg, GER), in the studio. Two hugely experienced prostate cancer surgeons, both with huge expertise in PLND. Alberto's name synomous with PLND due to the eponymous nomograms he has deveoped over the years. And Tobias with his pioneering experience in PSMA radio-guided PLND. 
Your usual hosts are Renu Eapen and Declan Murphy

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Two great topics on the GU Cast Journal Club today. How should we image patients with haematuria (the DETECT trial, J Urol 2018), and what is the role of adjuvant vs salvage radiotherpay following radical prostatectomy (three great trials - RAVES, RADICALS and GETUG-AFU 17), see links below).
Plus we welcome new GU Cast co-Editor Gaetan Devos, who recently joined us on Fellowship at Peter Mac, replacing Carlos Delgado.
Usual GU Cast Hosts are Renu Eapen and Declan Murphy, and GU Cast Journal Club Editor, Elena Berg.

Links:
1. Can Renal and Bladder Ultrasound Replace Computerized Tomography Urogram in Patients Investigated for Microscopic Hematuria?

2. Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial

3. Timing of radiotherapy after radical prostatectomy (RADICALS-RT): a randomised, controlled phase 3 trial

4. Adjuvant radiotherapy versus early salvage radiotherapy plus short-term androgen deprivation therapy in men with localised prostate cancer after radical prostatectomy (GETUG-AFU 17): a randomised, phase 3 trial 

The perennially thorny topic of prostate cancer screening has been very well addressed in the brand new Australian guidelines for the Early Detection of Prostate Cancer which we are delighted to highlight today.  Pragmatic, progressive and patient-focused,  are some of the comments we have read - great to hear! We have been very gratified to see the very positive reception which these guidelines have received, not just here in Australia, but also by other expert and patient groups around the world.

Today, GU Cast co-Host Declan Murphy (also a member of the Guideline Expert Advisory Group), chat with co-Chair of the Guideline committee, Prof Peter Heathcote (Urologist, ex-president of USANZ), and Dr. Jane Crowe (GP, co-Chair of the PSA Working Group along with Declan). What are the key messages for men in different age groups? Which men are considered higher risk? What are the major changes from the old guideline? All this and more in this episode of GU Cast.

See below for links to all the key documents, and huge congratulations to Guideline co-Chair Jeff Dunn and all at the Prostate Cancer Foundation of Australia for enabling this, and everyone involved in the process. Too many to mention!

Links:
https://www.pcfa.org.au/awareness/new-guidelines-for-the-early-detection-of-prostate-cancer/

Urologist Ben Lowentritt (Chesapeake Urology, Baltimore), pops into the studio today while passing through Melbourne. We chat about life in a large urology group practice (a huge part of urology service delivery in the USA), why there appears to be a drop in interest in Fellowship training, and his experience of managing advanced prostate cancer in a large urology group practice. Ben, who is also Secretary of the Large Urology Group Practice Association in the USA, has a lot of interest in gathering real world data from large urology group practices, and shares with us some data on the use of ARPIs in mHSPC which has recently been accepted for publication. 

This is a Themed Podcast supported by our Gold Partners, Johnson & Johnson. 

Open vs partial nephrectomy, and open vs robotic prostatectomy - two large randomised trials that did not change surgical practice! Just as important to examine these in GU Cast Journal Club as to examine pivotal trials that did change practice. Today we discuss the EORTC Today we discuss the EORTC 30904 RCT looking at kidney cancer surgery (Eur Urol 2011), and the Brisbane randomised trial of open vs robotic prostatectomy conducted (Lancet 2016).

We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Mexico City, MEX), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. AN emotional one as Carlos is heading home to Mexico soon!

Links to papers below:
1. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma Eur Urol 2011

2. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study Lancet 2016

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About GU Cast Journal Club:
Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology
. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner
. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

Welcome back Rana McKay! Renu was on a flight to Europe this week so Rana jumped into her seat in the GU Cast studio this week to have a chat about the intriguing ARASEC trial which she presented at the AUA Annual Meeting recently. Plus her thoughts on the ARACOG data presented at ASCO last month. And then a great chat with our other studio guest, Professor Renea Taylor, translational scientist at Peter Mac and Monash University, about the very interesting Early Onset Prostate Cancer project, an international collaboration which herself and Rana are both very involved with, looking at the reasons behind why younger men are turning up with aggressive prostate cancer. 

This is a Themed Podcast supported by our Gold Partners, Bayer Pharmaceuticals. 

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Links:
ARASEC trial at AUA 2026
ARACOG trial at ASCO 2026 

Tips and tricks for nerve-sparing surgery, learned over 25 years of performing robotic radical prostatectomy. Today we are joined by Dr Ash Tewari, Chief of Urology at Mt Sinai (New York), to talk about his favourite topic - nerve-sparing surgery - and a little about his second favourite topic - cricket! Ash has been one of the world's foremost experts in robotic prostatectomy having been there at the very start when Mani Menon was developing the technique, and has studied the anatomy of nerve-sparing prostatectomy in fine detail.
Today we chat through his thoughts on the optimal approach to nerve-sparing prostatectomy to deliver the best outcomes for our patients. Some surgical footage included on the YouTube version.

This is a Themed Podcast supported by our Silver Partner, Device Technologies.

Links:
7th International Prostate Cancer Symposium December 2025 - Lecture on nerve-sparing surgery 
Mt Sinai Symposium at AUA, May 2026 - Lecture on nerve-sparing surgery 

Hot topics in a hot city!! Declan and Renu escaped from deep Winter in Melbourne and landed into the hottest day on record in Berlin!! We are here to help with the Astellas Global Prostate Cancer Masterclass, a wonderful two day meeting focussing on advanced prostate cancer. Delegates from all over the world and a top class local and International faculty. We catch up with great friends of GU Cast Stephen Freedland (Cedars-Sinai Medical Centre, Los Angeles) and Bertrand Tombal (UC Louvain, Brussels), to pick their brains on hot topics in this hot city.

This is a Themed Podcast supported by our Platinum Partner, Astellas.

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All you need to know about enfortumab vedotin (EV) & pembro in bladder cancer in 25 minutes! We are joined in studio by bladder cancer gurus Shilpa Gupta (Cleveland Clinic, USA) and Andrew Weickhardt (Austin Health, AUS) to get an update on the role of EV-pembro in both muscle-invasive localised bladder cancer, and metastatic bladder cancer. Shilpa led a very nice paper in this month's European Urology titled optimal management of muscle, invasive bladder, cancer, so we were very keen to pick her brains on this, especially the emerging role of peri-operative EV-pembro. We also picked herself and Andrew‘s brains for the optimal management of metastatic bladder cancer, as they were both involved in the historic EV 302 trial which has transformed the management of metastatic bladder cancer. Must know stuff! A great overview of where we stand today. Thanks so much to Shilpa for dropping into Gu Cast while on holidays in Australia! 

With your usual hosts are Declan Murphy and Reno Eapn

This is a Themed Podcast, supported by our Platinum Partners, Astellas

Disclaimer:

Enfortumab vedotin in combination with pembrolizumab is not registered for MIBC in Australia and a number of other countries. Please refer to the registration status in your country before prescribing

Links:

Eur Urol paper on optimal management of MIBC

Yep it's been a buzz word in testis cancer for a while now, but with the read-out of the CLIMATE and SWOG 1823 trials in the past six months, we thought we better get ourselves updated on this exciting biomarker.
We are joined in studio by testis cancer gurus Ben Tran (Medical Oncologist, Peter MacCallum Cancer Centre, Melbourne), and online by Aditya Bagrodia (Urologist, UCSD, San Diego), to give us a bluffers guide to miR-371.
Plus we hear about the fantastic MaGIC Consortium global testis cancer meeting which takes place in Melbourne 8-11 January 2027. See links below. A great excuse to come to Melbourne, especially to escape the Northern Hemisphere winter!

Links:
MaGIC Consortium Conference, January 2027
Some coverage of the ANZUP CLIMATE trial from ASCO GU 2026
Some coverage of the SWOG 1823 trial from ASCO 2026