EAU 2018

EAU 2018: Multiparametric-MRI/Ultrasound Fusion Prostate Biopsy: Are Two Biopsy Cores Per MRI-Lesion Required?

Copenhagen, Denmark (UroToday.com) Dr. Hiester and colleagues from Germany presented results of their mpMRI/ultrasound fusion biopsy, specifically relating to the number of cores per MRI-lesion. Currently, the number of targeted biopsy cores per suspicious MRI lesion is arbitrarily established by urologists during mpMRI/ultrasound fusion prostate biopsy and a general consensus on the topic is lacking. The objective of the current study was to evaluate the accuracy of a single biopsy core per MRI-lesion to properly detect prostate cancer.

EAU 2018: Prostate Cancer Diagnosis by Three-Dimensional Contrast-Ultrasound Dispersion Imaging

Copenhagen, Denmark (UroToday.com) Dr. Mischi and colleagues presented results of their experience using 3-D contrast ultrasound dispersion imaging. Dynamic contrast-enhanced ultrasound (DCE-US) provides the opportunity to localize prostate cancer by detection of an associated angiogenic processes. As such, dedicated DCE-US methods have been proposed, however until now these methods have been validated in 2D only, requiring the injection of an ultrasound contrast agent bolus for the analysis of each imaging plane. The need for multiple injections hampers the value of these methods for routine clinical practice. A 3D approach would overcome this problem and the full prostate volume could be analyzed by injection of a single ultrasound contrast agent bolus. The objective of this study was to investigate the feasibility of 3D contrast-ultrasound dispersion imaging for prostate cancer localization.

EAU 2018: Pre-Operative Assessment in Elderly Bladder Cancer Patients

Copenhagen, Denmark (UroToday.com) Dr. Niegisch discussed the importance of a pre-operative assessment in elderly patients with bladder cancer. He started by highlighting that in the elderly oncologic and surgical outcomes are worse, and complications are more frequent. However, more than half of patients will be cured by radical cystectomy alone and that most of the patients (>90%) will not die during the perioperative period. These are important considerations as Dr. Niegisch notes that individuals that live until 80 years of age can be expected to live for an additional 9 (females) and 7 (males) years.

EAU 2018: The Best Local Palliative Treatment for Inoperable Bladder Cancer Patients

Copenhagen, Denmark (UroToday.com) Dr. Van Oort presentated a talk discussing the best local palliative treatment for inoperable bladder cancer patients. Dr. Van Oort started by highlighting that 19.2% of people in the European Union are older than 65 years of age and, people that live until 65 years of age can expect to live 21.2 (females) and 17.9 (males) additional years. 

EAU 2018: Oncological Outcome of Radical Salvage Prostatectomy in a Large Contemporary Series

Copenhagen, Denmark (UroToday.com) The use of salvage prostatectomy remains highly controversial due to the high incidence of surgical complications, poor functional outcomes, and questionable oncological results. Emerging data from small retrospective trials have suggested that salvage prostatectomy in highly selected patients can improve cancer-specific survival while maintaining a high safety profile. Dr. Heidenreich, from the University Hospital of Cologne, presents a multi-institutional (University Hospital of Cologne and Mayo Clinic) collaboration aim at assessing the oncological outcomes of patients treated with salvage radical prostatectomy (SRP) in a contemporary cohort. 

EAU 2018: Obese Patients Undergoing Robotic Radical Prostatectomy Have No Impaired Operative Outcome

Copenhagen, Denmark (UroToday.com) Outcome of obese patients after robotic assisted radical prostatectomy (RARP) is still controversially discussed. The authors evaluated the impact of obesity on operative- and perioperative outcome. In this study, obesity was defined as a Body Mass Index (BMI) of over 30.

EAU 2018: Is There an Age Limit for the Indication of Extended Pelvic Lymph Node Dissection During Radical Prostatectomy in Patients with Clinically Localized Prostate Cancer?

Copenhagen, Denmark (UroToday.com) Available recommendations for extended lymph node dissection (eLND) at radical prostatectomy (RP) do not consider patient age, but rely on cancer characteristics only. However, for patients with limited life-expectancy, eLND might be an overtreatment. The authors hypothesized that limited life-expectancy of older RP candidates might dilute any beneficial effect of eLND in terms of cancer staging and outcomes. Therefore, the authors aimed to assess the differential effect of age on the risk of lymph node invasion (LNI) and mortality resulting from non-prostate cancer causes, to define an age limit above which eLND might be avoided.