Prof. Hinev talks about SEEM and his lecture
Surgical margin positivity following radical prostatectomy
At the EAU 6th South Eastern European Meeting (SEEM) held on 1 and 2 October in Istanbul, Turkey, several top experts will present on subjects in their specific field of expertise. One of them is Associate Professor Alexander Hinev. He is head of the Urology & Vascular Surgery clinic of the Varna Medical University Hospital in Varna, Bulgaria. He will be giving a lecture on ‘Surgical margin positivity following radical retropubic prostatectomy'.
Q: Why do you feel it is important to participate in the SEEM meeting in Istanbul?
Hinev: “The SEEM meeting is in fact an annual Balkan Congress of Urology and increases in popularity among urologists in the Balkan every year. Urologists from neighbouring Balkan countries, who have much in common with respect to their countries’ history and the current economical and political situation, gather here to discuss the latest developments in urology. What is more, because the meeting is organised by the EAU this guarantees that it meets high European quality standards. Because no registration fee is charged at SEEM for poster presenters – unlike the situation at the Annual EAU Congress – more of my colleagues are motivated to participate in these presentations.
For young doctors and residents the significant awards that are being handed out for the best poster presentations during SEEM is an additional stimulus to participated. Plus the fact that the accepted abstracts are being published in European Urology Supplements.
For me personally it is an established tradition and a matter of honour to participate actively in the annual SEEM meetings of the EAU to represent Bulgaria and the Bulgarian urologists. As a matter of fact, I have not missed any of these meetings, starting from the very beginning; the first SEEM meeting in Belgrade in 2005! I am proud to be a Faculty member (for the second time) and an invited speaker at such an important international meeting.”
Q: Why did you choose the subject ‘Surgical margin positivity following radical prostatectomy‘ for your lecture?
Hinev: “I have been working in the field of uro-oncology since 1984 and have extensive personal experience in radical prostatectomy using different surgical approaches: the open retropubic, perineal and laparoscopic approach. I hope to share my expertises with the audience. Radical prostatectomy is always a great challenge, as there is a thin line between oncological safety (i.e. leaving no positive surgical margins (PSM) behind) and preservation of important anatomical structures, which leads to good functional results. One more reason to give this lecture is that I plan to defend a scientific thesis on radical prostatectomy and write a book on prostate cancer in the near future.“
Q: Can you inform us of the latest developments in the field?
Hinev: “PSM in radical prostatectomy specimens are uniformly considered an adverse pathological feature that may significantly affect final outcome. They are associated with an increased hazard of biochemical recurrence (BCR) and local disease recurrence as well as the need for secondary cancer treatment. A posterolateral PSM appears to give the greatest risk of recurrence, whereas the prognostic significance of positive apical margins remains controversial. The role of preoperative imaging and intraoperative frozen section analysis in reducing margin positivity rates is being investigated. Regardless of the surgical approach used (open, laparoscopic or robotic), attention to surgical details is essential to minimize PSM rates. There is evidence that adjuvant radiotherapy in men with PSM reduces BCR rates and clinical progression and may have impact on overall survival. Currently, it is the only established treatment with curative potential. However, prospective randomized trials comparing immediate versus salvage radiotherapy in patients with PSM are needed before definitive recommendations can be made.“
Q: Why is it important for the audience to attend your lecture?
Hinev: “I sincerely hope that discussing various technical points and paying attention to surgical details will help surgeons minimize positive margin rates in their patients. I believe that my information will help clinicians in counselling their patients with a PSM who are destined to experience a cancer recurrence; it will help them take the proper treatment decision by choosing the optimal method of treatment.“
Q: What results do you expect of the SEEM meeting?
Hinev: “I hope that the SEEM meeting enables us to put innovations into practice and learn from the tips & tricks of renowned experts and from the theoretical knowledge presented at the meeting. Furthermore participants may establish useful personal contacts with colleagues and friends from neighbouring countries and with distinguished speakers, established names worldwide.“