Re: Genomic Classifier Identifies Men with Adverse Pathology After Radical Prostatectomy Who Benefit from Adjuvant Radiation Therapy.

Experts’ summary: This study is a retrospective review of a series of 20 patients from 1974 to 2013. Most were primary patients. There were six deaths, two stillbirths, and four patients who died early after birth. The surviving group comprised nine male and five female patients. The authors describe a variety of associated gastrointestinal, urologic, genital, spinal, and skeletal malformations. All patients were born with an associated omphalocele and imperforate anus. Most of the patients required eventual gastrointestinal tract diversion with nine ileostomy patients and two colostomy patients. Only two patients are continent, with one having obtained continence through a flap in her urogenital sinus. Six patients required Bricker ileal conduit diversion. Prior to 1998, all male patients had been reassigned to the female sex with associated genitoplasty and orchiectomy. Only 11 patients had bilateral dorsal iliac osteotomies performed during their initial closure. One patient without osteotomies had recurrence of the pubic diastasis. The authors comment that this paper illustrates the need for centers of excellence to care for cloacal exstrophy patients.