EAU 2018

EAU 2018: Local and Metastasis Imaging Targeted Treatments are Needed

Copenhagen, Denmark (UroToday.com) Dr. Briganti, as moderator of this session, introduced a case of oligometastatic prostate cancer. This is a 61 year old man with a family history of prostate cancer (father treated with radiotherapy for intermediate risk disease). Medically healthy (hypertension, well controlled on oral meds), IPSS 12/35 (moderate LUTS), IIEF-EF 12 (moderate ED). Elevated PSA 12.6 (8%), repeated 11.9. DRE with left lobe firmness, cT2b. 

EAU 2018: Early Surgical Safety Outcomes from PURE-01: Neoadjuvant Pembrolizumab before Radical Cystectomy For Muscle-Invasive Urothelial Bladder Carcinoma

Copenhagen, Denmark (UroToday.com) Briganti et al. presented a secondary analysis on the early surgical safety outcomes from PURE-01, a phase 2 open-label trial of neoadjuvant Pembrolizumab, an immune checkpoint inhibitor, prior to radical cystectomy for muscle-invasive bladder cancer (MIBC). Pembro is already approved for the treatment of metastatic urothelial carcinoma, and given the benefit of using neoadjuvant chemotherapy for MIBC, there is a great deal of excited anticipation to see how well checkpoint inhibitors may work in this space. Given the toxicity of chemotherapy regimens, using immune-oncologic agents would be a preferred choice, if clinically effective.

EAU 2018: Nomogram-Based Risk Prediction of Local and Distant Relapse After Radical Cystectomy and the Role of Perioperative Chemotherapy in Patients with Muscle-Invasive Bladder Cancer: A Multicenter Study

Copenhagen, Denmark (UroToday.com)  Necchi et al. presented data from 27 centers in Europe, U.S.A, Israel, and Canada, encompassing 1600 patients, on the development of a risk-prediction tool for the detection of local and distant relapse following radical cystectomy (RC) for patients with muscle-invasive bladder cancer (MIBC). The impetus for the study is the lack of knowledge of the relapse pattern for patients who have received perioperative chemotherapy compared to patients who do not receive chemotherapy. 

EAU 2018: Trends and Morbidity for Minimally Invasive vs Open Cytoreductive Nephrectomy in the Management of Metastatic Renal Cell Carcinoma

Copenhagen, Denmark (UroToday.com)  Cytoreductive nephrectomy (CN) prior to systemic therapy for metastatic renal cell carcinoma (RCC) is recommended in patients with a surgically resectable primary tumor. This is based on data from the IL-2 / IFN era but is continued to be recommended in the current guidelines. Many centers prioritize CN if the bulk of the cancer volume is still in the primary tumor.

EAU 2018: Case-based Debate: How to Treat Multi-focal Ta, HG Disease if BCG is Unavailable?

Copenhagen, Denmark (UroToday.com)  This is one of a series of case-based debates. Each is set up as follows: 2 min case-presentation, 5-min discussant presentation (two sides of the debate, discussion), summary 2 minutes. This was  series arranged by JA Witjes, M. Brausi, and P-U Malmstrom.

EAU 2018: mpMRI in Bladder Cancer: Development of VI-RADS ver 1.0

Copenhagen, Denmark (UroToday.com)  Dr. Valeria Panebianco from Italy presented their collaborative group’s development of the mpMRI VI-RADS 1.0 for bladder cancer. As Dr. Panebianco notes, there are clinical questions and imaging answers when it comes to staging bladder cancer and that a multimodal approach reduces the risk of error from one particular test, but may present a dilemma when results conflict. As clinicians that treat prostate cancer, we are all familiar with the PI-RADS system for mpMRI of the prostate, however there are other disease sites that also use a ‘RADS’ format, including breast (BI-RADS) and liver (LI-RADS). 

EAU 2018: Dividing Pathologically Upstaged T3a Renal Cell Carcinoma is Associated with Improved Alignment of Outcomes: A call for TMN Revision

Copenhagen, Denmark (UroToday.com) In this abstract, the authors propose updating the current TNM staging to account for pathologic upstaging. Specifically, they focus on patients identified on final pathology to represent pT3a disease (“Tumor extends into the renal vein or its segmental branches, or invades the pelvicalyceal system, or invades perirenal and/or renal sinus fat but not beyond Gerota’s fascia”). They correctly note that there is heterogeneity in outcomes in this patient population.