Conferences

Advanced Prostate Cancer Consensus Conference (APCCC) 2024 Scientific Programme

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SESAUA 2024: Time Interval Between Radium-223 Therapy and 177Lu-PSMA Treatment for mCRPC and Outcomes in the RALU Study

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Alexander Chehrazi-Raffle discussing the time interval between Radium-223 therapy and 177Lu-PSMA treatment for mCRPC and outcomes in the RALU study. Radium-223 improves overall survival and quality of life with an acceptable profile in men with bone-predominant mCRPC.1 Additionally, 177Lu-PSMA is a beta-particle emitting therapy that has shown an acceptable safety profile and prolonged overall survival in patients with PSMA-positive mCRPC, previously treated with androgen receptor pathway inhibition and taxane-based chemotherapy.2 Data from a small retrospective study of patients with mCRPC who initiated 177Lu-PSMA therapy within 8 weeks of receiving Radium-223 suggested that the use of both radionuclides within a short time frame is feasible.3 The observational, retrospective study, RALU, investigated the safety and clinical outcomes of sequential Radium-223/177Lu-PSMA therapy in patients with mCRPC. This analysis evaluated the association of time between Radium-223 and 177Lu-PSMA treatments and safety and overall survival outcomes following 177Lu-PSMA.

SESAUA 2024: State of the Art Lecture: Management of Complications Following RPLND

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a State of Art Lecture by Dr. Charles Peyton discussing the management of complications following RPLND. Dr. Peyton started his presentation with a case of a 47 year old male with left neck swelling and medical history of stage IIIA NSGCT treated with left orchiectomy and BEP x 3 cycles in 1996. He was married, had several children, and worked as the lead PACU nurse.

SESAUA 2024: Addressing Racial Disparities in Prostate Cancer Prediction Models: External Validation and Comparison of Four Models of Pathological Outcome Prediction before Radical Prostatectomy

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Mahdi Mottaghi discussing racial disparities in prostate cancer prediction models, specifically the external validation and comparison of four models of pathological outcome prediction before radical prostatectomy. The development of widely used nomograms for predicting radical prostatectomy outcomes involved a relatively small proportion of Black men, potentially compromising the accuracy of predictions for this patient group. Additionally, most available models developed in tertiary care centers tend to overpredict outcomes in the general population. The Michigan Urological Surgery Improvement Collaborative (MUSIC) nomogram was developed based on the general urology patient population.1 This study by Dr. Mottaghi and colleagues presented at SESAUA 2024 aimed to implement the first external validation of the MUSIC model and compare the predictive performance of these models in Black men.

SESAUA 2024: Screening with PSA and MRI: Yearly Trends by PI-RADS and Race Shows Stable Diagnosis of NCCN Very Low Risk Disease

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Christine Lightfoot discussing screening with PSA and MRI. MRI incorporation into prostate cancer screening protocols has been associated with decreased rates of low-risk prostate cancer diagnosis.1,2 Whether this has changed characteristics of patients with newly diagnosed very low-risk or low-risk disease has not been fully described. The aim of this study presented at SESAUA 2024 was to evaluate the trend of newly diagnosed prostate cancer based on AUA and NCCN risk categories after screening with PSA and MRI at an equal access institution.

SESAUA 2024: Darolutamide in Combination with ADT and Docetaxel: Efficacy and Safety by Disease Volume and Risk in the Phase 3 ARASENS Trial

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Evan Goldfischer discussing efficacy and safety by disease volume and risk in the phase 3 ARASENS trial. In patients with metastatic hormone-sensitive prostate cancer (mHSPC), metastatic disease burden is a prognostic factor. Darolutamide + ADT + docetaxel was shown to significantly reduce the risk of death by 32.5% (HR 0.68; 95% CI: 0.57–0.80; p < 0.0001) versus placebo + ADT + docetaxel in patients with mHSPC in the ARASENS trial.1 Outcomes based on disease volume and risk provides additional information to clinicians when making decisions about treatment intensification for patients with mHSPC. At the 2024 SESAUA annual meeting, Dr. Goldfischer and colleagues compared the outcomes of patients stratified into high/low disease volume and high/low risk subgroups.

SESAUA 2024: Association of PSA Response and Overall Survival in Patients with mHSPC: Results from the Phase 3 ARASENS Trial

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Daniel George discussing the association of PSA response and overall survival in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the phase 3 ARASENS trial.1 Reductions in PSA level have been associated with improved overall survival in patients with mHSPC.2,3 At the 2024 SESAUA annual meeting, Dr. George and colleagues presented results for the association between PSA response and overall survival from the ARASENS trial.

SESAUA 2024: Should I Order a PET Scan? Integrating Molecular Imaging into Urologic Oncology Clinical Practice: Current Approaches and Future Opportunities

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured an AUA Course Lecture and a presentation by Dr. Marc Bjurlin discussing current approaches and future opportunities for integrating molecular imaging into urologic oncology clinical practice. As part of this AUA course, Dr. Bjurlin noted that, in addition to himself, there were several faculty involved including the following:

SESAUA 2024: Non-Narcotic Compliance and Clinical Outcomes in ERAS Cystectomy Patients

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Lila McGrath discussing non-narcotic compliance and clinical outcomes in Enhanced Recovery After Surgery (ERAS) cystectomy patients. Non-narcotic analgesia is a central component of ERAS protocols which have been shown to decrease narcotic utilization after radical cystectomy.

SESAUA 2024: Skeletal Muscle Changes in Upper Tract Urothelial Carcinoma Following Radical Nephroureterectomy

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a urothelial cancer session and a presentation by Dr. Edouard Nicaise discussing skeletal muscle changes in upper tract urothelial carcinoma following radical nephroureterectomy. Definitive local treatment for high-risk upper tract urothelial carcinoma includes radical nephroureterectomy. Importantly, baseline low muscle mass (ie. sarcopenia) is independently associated with overall survival in upper tract urothelial carcinoma patients following radical nephroureterectomy. At the 2024 SESAUA annual meeting, Dr. Nicaise and colleagues examined the relationship between preoperative (baseline) and postoperative changes in muscle quantity with overall survival following radical nephroureterectomy.

SESAUA 2024: Safety and Efficacy of Surgery in Metastatic and Non-Metastatic RCC with Supradiaphragmatic Tumor Thrombus Involving Cardiac Procedures

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a kidney cancer session and a presentation by Dr. Edouard Nicaise discussing the safety and efficacy of surgery in metastatic and non-metastatic renal cell carcinoma (RCC) with supradiaphragmatic tumor thrombus involving cardiac procedures. Invasion of the inferior vena cava (IVC) is a unique feature of RCC, and tumor thrombus extension into the supradiaphragmatic IVC carries high morbidity and mortality attributable to surgical complexity. However, it is unclear whether safety and efficacy have been shown to warrant cytoreductive surgery for metastatic RCC with concomitant thrombus. At SESAUA 2024, Dr. Nicaise and colleagues presented outcomes of cytoreductive and non-cytoreductive radical nephrectomy with supradiaphragmatic tumor thrombectomy involving cardiac surgery.

SESAUA 2024: Prognostic Significance of Pathologic Response to Neoadjuvant Chemotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder with Variant Histology

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Seth Teplitsky discussing the prognostic significance of pathologic response to neoadjuvant chemotherapy in muscle-invasive urothelial carcinoma of the bladder with variant histology. Bladder cancers with variant histology encompass ~25% of cases are largely treatment refractory and are associated with atypical metastases and higher rates of cancer-specific mortality compared to pure urothelial cancers. Additionally, patients with variant histology are often excluded or underrepresented in neoadjuvant chemotherapy clinical trials for muscle invasive bladder cancer. There exists conflicting data regarding inherent neoadjuvant chemotherapy sensitivity for individual histologic variants. The objective of this study presented at SESAUA was to assess prognostic significance of pathologic response to neoadjuvant chemotherapy in muscle invasive bladder cancer patients with variant histology and pure urothelial cancers.

SESAUA 2024: Determining the Genetic Causes of Bladder Cancer in a Family with Heritable Pattern of Bladder Cancer

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Aditya Sathe discussing the genetic causes of bladder cancer in a family with heritable pattern of bladder cancer.

SESAUA 2024: State of the Art Lecture: Digital Discounts for Urology Patients: Online Tools to Decrease Out-of-Pocket Prescription Costs

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a State of the Art Lecture by Dr. Ruchika Talwar discussing online tools to decrease out-of-pocket prescription costs for our urology patients. Dr. Talwar started by emphasizing that the objectives of this presentation are not to solve America’s problem of unaffordable prescription medication, nor is it to discuss why treatment prices are so high in America and figure out who is to blame, but rather to be able to provide guidance for when patients ask their provider “Doc, what will this prescription cost me?”

SESAUA 2024: Intravascular Heparinization During IVC Thrombectomy and Perioperative Complications

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a kidney cancer session and a presentation by Dr. Sol Moon discussing intravascular heparinization during IVC thrombectomy and perioperative complications. IVC tumor thrombectomy is a complex operation and frequently requires venous cross-clamping for reconstruction. Although the use of subcutaneous prophylactic heparin is standard for the prevention of thromboembolic events, the use of IV heparinization prior to IVC clamping is not. Dr. Moon and colleagues sought to evaluate and compare the characteristics and postoperative outcomes of patients undergoing radical nephrectomy with level I or higher IVC tumor thrombectomy who received IV heparinization versus those who did not. The hypothesis for this study was that for patients undergoing IVC tumor thrombectomy, IV heparinization at the time of IVC cross-clamping is safe and does not contribute to an increased risk of post-operative complications.

SESAUA 2024: Prevalence, Trends, and Costs of Office-Based and ASC-Based Diagnostic Cystoscopy in the United States

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Shreyas Joshi discussing the prevalence, trends, and costs of office-based and ASC-based diagnostic cystoscopy in the United States. Diagnostic cystoscopy is one of the most performed procedures in Urology with over one million procedures performed annually in the U.S. As a result, its cost and profitability have a global impact on urologists and patients. These procedures are usually performed in the outpatient setting including in-office and ambulatory surgical centers (ASC), and the cost depends on several factors, such as the type of facility used. In this study presented at SESAUA, Dr. Joshi and colleagues aimed to analyze trends in diagnostic cystoscopy procedures performed in office versus ASC and analyze factors and costs associated with use in each venue.

SESAUA 2024: Darolutamide, Enzalutamide, and Apalutamide for Non-Metastatic Castration-Resistance Prostate Cancer Patients in the United States (DEAR): Comparative Real-World Evidence

(UroToday.com) The 2024 American Urological Association (AUA) Southeastern Section annual meeting held in Austin, TX between March 20th and 23rd hosted a prostate cancer poster session. Dr. Zachary Klaassen presented the results of a real-world analysis (DEAR) comparing darolutamide, enzalutamide, and apalutamide for non-metastatic castrate-resistant prostate cancer (nmCRPC) patients in the United States.

SESAUA 2024: Investigating the Role of Access to Quality Care for Muscle-Invasive Bladder Cancer in the Disparate Outcomes Among Sociodemographically Disadvantaged Patients in the State of Kentucky

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Joon Kyung Kim discussing the role of access to quality care for muscle-invasive bladder cancer in the disparate outcomes among sociodemographically disadvantaged patients in Kentucky.

SESAUA 2024: Impact of Rural Location on Receipt of Standard of Care Treatment and Survival for Locally Advanced Bladder Cancer in Louisiana

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Ashley Foret discussing the impact of rural location on receipt of standard of care treatment and survival for locally advanced bladder cancer in Louisiana.

SESAUA 2024: Feasibility and Outcomes of Interventions to Reduce Cystoscopy Discomfort: A Quality Improvement Project

(UroToday.com) The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a Health Services Research and Socioeconomics session and a presentation by Avani Desai discussing the feasibility and outcomes of interventions to reduce cystoscopy discomfort. Each year, over a million individuals undergo office cystoscopy for bladder cancer diagnosis and surveillance.1