Introduction: Pancreatic neuroendocrine tumours (PNETs) are heterogenous entities with variable clinical outlook. The prevalence of PNETs is increasing in Australia. Despite this, data on peri‐operative management and post‐operative prognosis for Australian patients is scant in the literature.Methods: Patients from two tertiary hospitals in Victoria were recruited. Inclusion criteria included patients who underwent curative surgical resection for primary, non‐functioning, PNETs without metastases from January 2011 to December 2021. Patients were identified via histopathological reports, CMBS and ICD‐10 codes. Data were sourced from Electronic Medical Records, outpatient notes and letters.Results: Sixty‐three patients (34 Male, 29 Female) underwent surgical resection for PNETs. Fifty‐three patients (84.1%) had a post‐operative complication, and 21 (33.3%) had severe complications. Two patients had disease recurrence. Head PNETs had higher Ki‐67% (5.33 vs. 2.72, P = 0.29), and likelihood of nodal spread (9 (36%) vs. 4 (16%), P = 0.054). Pancreatic Head resections were also associated with more frequent ICU admissions (21 (84%) vs. 18 (54.5), P = 0.024), longer ICU stays (4.05 vs. 2.17 days, P = 0.10) and hospital stays (26.76 vs. 8.27 days, P = <0.001).Conclusion: Within the limitations of this study, it demonstrates that surgical resection of PNET carries a significant morbidity with a low rate of recurrence. Additionally, Pancreatic head NETs may be associated with higher grades and increased likelihood of nodal metastases. Considering this, careful patient selection is paramount.

Introduction and Objectives: Voiding dysfunction remains a common side effect postprostate biopsy leading to significant morbidity. Alpha blockers have emerged as a potential therapeutic option to mitigate this risk, with various centres already incorporating its use in practice. Despite this, the literature regarding its efficacy remains inconclusive. Hence, a systematic review was performed to quantify the effect of perioperative alpha blockers on prostate biopsy‐related voiding function.Methods: A systematic search in MEDLINE, Embase and PubMed between January 1989 and July 2023 was performed to identify relevant articles. Two independent reviewers independently screened abstracts, full texts and performed data extraction. Data including International Prostate Symptom Scores (IPSS), voiding flow rates (Qmax), postvoid residuals (PVR), rates of acute urinary retention (AUR) and quality of life (QoL) scores were extracted. Results were combined in an inverse variance random effects meta‐analysis.Results: A total 808 patients from six randomised controlled trials (RCTs) comparing alpha blockers to controls were included. All articles excluded patients with pre‐existing voiding dysfunction. Pooled outcomes demonstrated statistically significant differences favouring alpha blocker usage in all objective and subjective measures including IPSS (mean difference 4.21, 95% confidence interval [CI] 2.58–5.84, p < 0.00001), PVR (mean difference 20.41 mL, 95% CI 3.44–37.39, p = 0.02), Qmax (mean difference 3.07 mL/s, 95% CI 2.55–3.59, p < 0.00001), QoL (weighted‐mean difference 0.82, CI 0.17–1.48, p = 0.01) as well as overall risk of AUR (odds ratio 0.22, CI 0.09–0.55, p = 0.001). There was variable heterogeneity (I² = 0–86%) between outcomes.Conclusions: This review highlights the potential role of alpha blockers in improving urinary function and reducing adverse voiding outcomes postprostate biopsy. The standard practice of incorporating the usage of perioperative alpha blockers may be considered to reduce the morbidity of voiding complications secondary to prostate biopsy.

Objectives: To evaluate the effectiveness of a streamlined Prostate Cancer Care Pathway (PCCP) in reducing post‐biopsy waiting times and improving patient satisfaction in a high‐volume tertiary centre.Patients and Methods: Patients undergoing prostate biopsies were prospectively followed through PCCP for one year and were retrospectively compared to 150 patients who were treated at our centre either immediately prior to PCCP implementation (2022) or during Covid‐19 lockdowns (2020). Waiting times were compared using the Kruskal‐Wallis H‐test. Patient satisfaction was assessed using the modified PCa Questionnaire for Patients (PCQ‐P).Results: A total of 398 patients were included. 248 patients went through PCCP, compared with 75 patients pre‐PCCP implementation (2022) and 75 patients during the 2020 pandemic. The median time from biopsy to results post‐PCCP was 15.0 days (IQR 13.0–19.0). This was significantly shorter than pre‐PCCP introduction of 21.0 days (17.0–28.0) and during 2020 lockdowns, 18.0 days (14.0–21.0, p < 0.001). A total of 131 patients (52.8%) requiring treatment under PCCP were streamlined for multidisciplinary discussion following imaging at a median time of 38.0 (29.8–42.0) days and seen at Urology or Radiation Oncology Consultant clinic for treatment discussion at a median of 38.0 days (31.0–49.0), compared to 63.0 days (45.0–84.0) pre‐PCCP (2022) and 52.0 days in 2020 (38.0–75.0, p < 0.001). A total of 176 PCCP patients (70.1%) participated in PCQ‐P with 93.2% of participants reporting satisfaction with waiting time durations (n = 176).Conclusion: PCCP implementation reduced waiting times in all post‐biopsy care measures following significant Covid‐19 delays in PCa care delivery. Streamlining resources using similar pathways can reduce waiting times in cancer care and other conditions to alleviate anxiety during healthcare system strain.

Background and objective: Radical cystectomy (RC) is standard for muscle‐invasive disease (MIBC) and utilised frequently in high‐risk non‐muscle‐invasive bladder cancer (NMIBC). Pelvic lymph node dissection (PLND) is routinely performed during RC for MIBC, demonstrating a survival benefit. However, the oncologic value in NMIBC remains uncertain. As such, a systematic review was conducted to determine whether PLND confers an oncologic benefit in NMIBC patients undergoing RC. Materials and methods: A systematic search of MEDLINE, Embase and PubMed (January 1989–January 2025) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines (CRD42023443011). Eligible studies included NMIBC patients undergoing RC with or without PLND. Data extraction and quality assessment (ROBINS‐I, MINORS) were performed independently by two reviewers. Results: Twenty‐one retrospective studies ( n = 35 793) met inclusion criteria. Lymph node positivity ranged from 0% to 13%. Comparative studies consistently demonstrated improved overall survival and cancer‐specific survival with PLND, particularly among pT1 subgroups (pooled 5‐year OS = 71.8%, 95% CI 59.3–84.3). Several studies demonstrated a dose–response association between lymph node yield or dissection extent and improved outcomes. Benefits were inconsistent for Ta/Tis disease. Pathological upstaging occurred in 16%–36% of clinically staged cohorts. However, study quality was moderate, with heterogeneity in PLND definitions, staging methods and adjuvant treatment use. Conclusions: PLND appears to improve staging and survival in high‐risk NMIBC, especially pT1 disease. Routine PLND for low‐risk Ta/Tis disease is unsupported. Standardised definitions of PLND extent and prospective evaluation are needed to confirm its therapeutic role.