The proportion of potential candidates for focal therapy in localized prostate cancer in a real-life cohort and their final pathologic results.

OBJECTIVES: To determine the proportion of patients who would have been eligible for focal therapy (FT) in a population of patients who underwent prostatectomies; additionally, to assess the risk of having underestimated disease on the surgical specimen by using consensus selection criteria. METHOD: We retrospectively analyzed data from 446 patients who underwent radical prostatectomy between 2016 and 2018. Patients suitable for FT had unifocal significant prostate cancer on MRI, as well as on pathological data from targeted and systematic biopsies. Inclusion criteria were defined by the 2014 consensus conference, PSA<15ng/mL, tumor stage T1c-T2a and Gleason score 3+3 or 3+4 on biopsies. Disease was considered to be underestimated on postoperative data in the presence of extraprostatic invasion, a high Gleason score (≥4+4) and significant multifocality defined by secondary foci of Gleason 6 (3+3)>5mm or Gleason 7 (3+4). RESULTS: In our cohort of 446 patients, 97 patients met the inclusion criteria, and 27 patients (27.8%) were eligible for focal therapy. Among the eligible patients, 4 patients (14.8%) had pT3, and no patient had significant multifocality or a Gleason score of 8 (4+4) on the surgical specimen. CONCLUSION: In the era of pre-biopsy MRI, there could be a significant proportion of patients who could benefit from focal therapy among patients currently undergoing radical prostatectomy. The 2014 consensus conference eligibility criteria could effectively predict the presence of extraprostatic invasion and safely select patients for FT.

COVID19 pandemic impacts on anxiety of French urologist in training: Outcomes from a national survey.

INTRODUCTION: The COVID-19 outbreak in France is disturbing our health system. Urologists in training who are already known to have burnout, are in the front line to face this disease. The aim of our study was to assess the psychological impact of COVID-19 pandemic on young French urologists in training. MATERIAL AND METHODS: A self-administered anonymous questionnaire evaluating the pandemic added stress, and its negative impact on work and training quality, was e-mailed to the members of the French Association of Urologists in Training (AFUF). The association includes all French junior and senior residents. The survey lasted 3 days. Multivariable analyses using logistic regression was performed to identify the predictive factors. RESULTS: Two hundred and seventy-five (55.5%) of the 495 AFUF members responded to the questionnaire. More than 90% of responders felt more stressed by the pandemic. Fellows and senior residents were more likely to feel that the crisis had an important impact on their work quality (OR=1.76, IC95=[1.01-3.13]), even more when COVID 19 patients were present in their department (OR=2.31, IC95=[1.20-4.65]). Past medical history of respiratory disease (OR=2.57, IC95=[1.31-5.98]) and taking in charge COVID19 patients (OR=1.85, IC95=[0.98-3.59]) were additional risk factors. CONCLUSION: COVID19 pandemic has a negative impact on young French urologists in training and on their work and training quality. Managing their psychosocial well-being during this time is as important as managing their physical health. LEVEL OF EVIDENCE: 3.