AUA 2018: Patient Reported Outcomes in SPARTAN, a Phase 3, Double-Blind, Randomized Study of Apalutamide plus ADT vs placebo plus ADT in Men with nmCRPC
San Francisco, CA (UroToday.com) There are no approved treatments for men with non-metastatic CRPC (nmCRPC), resulting in little data on health-related quality of life (HRQoL) for these patients. In the SPARTAN trial, treatment with Apalutamide (APA) vs placebo (PBO) improved metastasis-free survival (MFS) (median 40.5 vs 16.2 mo; HR=0.28; 95% CI, 0.23-0.35; P < 0.0001). The aim of this analysis was to assess HRQoL for men with nmCRPC receiving APA and ADT.
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AUA 2018: Outcomes of Synchronous and Metachronous Bilateral Small Renal Masses (4cm)
San Francisco, CA (UroToday.com) The authors presented a study reporting longitudinal outcomes of a population based cohort of patients diagnosed with bilateral small renal masses from a period of over 11 years. Consecutive patients diagnosed with bilateral small renal masses (synchronous or metachronous) of a defined geographical area were recorded in a large database (TUCAN database) between January 2005 and December 2016.
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AUA 2018: Long-Term Active Surveillance of Complex Cystic Renal Masses & the Heterogeneity of BOSNIAK 3 Lesions
San Francisco, CA (UroToday.com) The authors presented a study attempting to better characterize the frequency of Bosniak cyst class changes and determine the average growth rate of cysts, helping to validate the safety of active surveillance. Consecutive patients referred for management of complex cysts (>= Boniak 2f) at a single institution between January 1, 2003 - Aug 31, 2014 were included in the analysis.
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AUA 2018: MRI Imaging - AUA Statement on its Use for Diagnosis, Staging, and Management
San Francisco, CA (UroToday.com) Peter Pinto, MD gave an overview of prostate multiparametric MRI (mpMRI). He began his talk discussing transrectal US (TRUS). Few urologists use TRUS to look for areas suspicious for cancer. 60% of ultrasound morphologically suspicious lesions are not cancer. Data from the PROMIS study, comparing TRUS to mpMRI for prostate cancer diagnosis, show that the sensitivity and specificity of TRUS is 48% and 74%, respectively. In contrast, the sensitivity and specificity of MRI is 93% and 89%, respectively.
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AUA 2018: Prostate Cancer: What PET to GET?
San Francisco, CA (UroToday.com) Thomas Hope, MD presented the different PET radiotracers available today for prostate cancer. He began with the NaF PET/CT. This radiotracer has a good spatial resolution, high signal to the background with CT available for correlation, and has a short time from injection to imaging.
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AUA 2018: Controversies in Urology: Kidney Cancer – Treatment with Thermal Ablation – CON
San Francisco, CA (UroToday.com) Ketan Badani, MD gave a talk on the disadvantages of thermal ablations for small renal masses (SRM). The first issue discussed was the problem of incomplete ablation. He began by describing a systematic review and metanalysis of laparoscopic vs. percutaneous cryotherapy for renal tumors.
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AUA 2018: Controversies in Urology: Kidney Cancer – Treatment with Thermal Ablation – CON Rebuttal
San Francisco, CA (UroToday.com) Craig Rogers, MD gave a talk supporting Ketan Badani, MD in his opinion favoring partial nephrectomy (PN) over ablation for small renal masses (SRM). There is no doubt that PN is a more definitive therapy than ablation treatments. PN is the gold standard of treatment for clinical stage T1a disease. Robust data demonstrate excellent oncologic outcomes. PN allows complete pathological evaluation, and although it harbors the increased risk of urologic complications, it does not entail a higher risk of overall complications.
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