There is a growing body of literature supporting an inverse association between a history of diabetes and subsequent risk of prostate cancer. In addition, epidemiologic and pre-clinical studies have suggested metformin, an oral anti-hyperglycemic medication commonly used in the management of Type 2 diabetes, having a potential anti-cancer effect with respect to prostate cancer. The researchers looked at the relationship between metformin use in diabetics and outcomes after radical prostatectomy (RP) for clinically localized cancer. They found that, in contrast to data suggesting an antitumor activity associated with metformin use, there was no evidence that metformin improved outcomes. Conversely, diabetes regardless of metformin use was significantly associated with an increased likelihood of recurrence after RP.

Flexible CO2 Laser-Assisted Neurovascular Bundle Dissection for Robotic Prostatectomy

Dr. Ketan BadaniDirector of robotic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, and assistant professor of urology at Columbia University College of Physicians and Surgeons

Carbon dioxide (CO2) lasers are known to be effective at targeting tumors without damaging adjacent healthy tissue, and are widely used in head and neck oncology surgery and neurosurgery. Until recently, use of the CO2 laser as a surgical tool has been limited by the necessity for delivery through a rigid, rather than a fiber-based flexible, delivery system. Excess thermal spread during neurovascular bundle (NVB) dissection can affect potency in men following radical prostatectomy. Dr. Badani and his co-investigators report on a novel delivery of CO2 laser energy through a flexible fiber to enhance the accuracy of dissection of the NVB during robotic-assisted laparoscopic prostatectomy (RALP). They found that the flexible CO2 laser fiber was easily manipulated and identification of fascial layers during nerve sparing was facilitated with the fiber. Long-term follow-up is necessary to determine the efficacy of this technology versus conventional techniques on the NVB. Larger studies are currently in progress to determine if use of the flexible CO2 laser fiber results in improvements in functional outcomes with regards to return of sexual potency following robotic prostatectomy.

SOURCE Columbia University Medical Center

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