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The 15th Meeting of the European Section of Oncological Urology (ESOU 2018) has completed the second day in vibrant Amsterdam. UroToday is pleased to provide highlights from comprehensive coverage from this excellent onco-urology scientific program. Today's report focuses on prostate and renal cancers.
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Treatment Modalities for Intermediate Risk Prostate Cancer - Active Surveillance
Patients with low risk prostate cancer (PC) are hardly likely to die from their disease. Instead the focus in these men should be on avoiding additional harm. In case of advanced disease, the focus is on prolonging survival with acceptable quality of life. In contrast, treatment choices are more crucial in men with intermediate risk PC (IRPC).
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Treatment Modalities for Intermediate Risk Prostate Cancer - Focal Therapy
The significant role of dose-escalation in the radiation treatment (RT) of localized prostate cancer (PC) is well established. Nevertheless, when delivered at conventional fractionation (CF, 1.8-2 Gy/fraction), the prolonged treatment time of high-dose RT (7-8 weeks) can lead to a high number of hospital visits.
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Treatment Modalities for Intermediate Risk Prostate Cancer - Hypofractionation Radiotherapy
The significant role of dose-escalation in the radiation treatment (RT) of localized prostate cancer (PC) is well established. Nevertheless, when delivered at conventional fractionation (CF, 1.8-2 Gy/fraction), the prolonged treatment time of high-dose RT (7-8 weeks) can lead to a high number of hospital visits.
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Treatment Modalities for Intermediate Risk Prostate Cancer - Surgery
Intermediate prostate cancer (IRPC) is defined according to the D’Amico risk classification system, as PSA 10-20, Gleason score (GS) 7 or clinical stage T2b. The risk of lymph node invasion in patients with IRPC ranges between 14.4%-20.1%. The SPCG-4 trial, comparing watchful waiting to radical prostatectomy, demonstrated that the benefit of surgery was the largest in men younger than 65 and in those with IRPC1.
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How Have Recommendations Against Prostate Cancer Screening Impacted the Incidence and Mortality of Prostate Cancer in the US?
The PSA biomarker has had a greater impact on cancer detection staging, prognosis, and monitoring for prostate cancer (PC) than any other biomarker has had on any other cancer! It is more accessible, ubiquitous, quantitative, reproducible, and accurate than any other cancer biomarker.
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Cognitive Prostate Biopsy
Dr. Rouviere presented on why cognitive prostate biopsies are still the best method to obtain a prostate biopsy. With cognitive guidance, the biopsy operator reviews the MR images and creates a mental three-dimensional representation of the prostate and of the lesion within it. Using this representation, the biopsy operator will guide the biopsy needle in to the lesion of interest in the prostate, even if it is not visible on ultrasound (US).
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The WHO ISUP Classification of Renal Tumors: What Has Changed?
The classification of renal tumors, particularly of renal cell neoplasms, has encountered numerous changes during the last thirty years. Two important consensus conferences held in Heidelberg and Rochester in 1996 and 1997, respectively have set the foundations for the subsequent WHO classification that was drawn up initially in 2002 in Lyon and later on edited in 2004.
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Alternative Approaches for Characterization of Renal Tumors - Liquid Biopsy
Circulating Tumor cell free DNA (cfDNA) was first reported in 1948. It is a non-invasive method for cancer biomarker detection, and presents a significant innovation in the field of personalized medicine. Liquid biopsy (LB) presents the genetic profile of all tumor subclones in one patient, in contrast to normal tissue biopsy, where only one specific tumor area can be analyzed.
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Alternative Approaches for Characterization of Renal Tumors - Conventional and Optical Renal Mass Biopsy
The European Association of Urology (EAU) guidelines recommend performing a renal biopsy only before ablative therapy and systemic therapy without previous pathology. The guidelines also state to consider a biopsy in select patients who are considered for active surveillance (AS).
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