EAU 2018

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.

EAU 2018: Socioeconomic Status and Diagnosis, Treatment, and Mortality in Men with Prostate Cancer: A Nationwide Population-Based Study

Copenhagen, Denmark (UroToday.com)  Evidence from a variety of settings indicate that patients with higher socioeconomic status have better prostate cancer-specific outcomes. This has also been shown for several cancers in Sweden, a country with a tax-financed health care system aiming to provide care on equal terms to all residents. Dr. Ventimiglia and colleagues presented results of their nationwide population-based study examining the association between socioeconomic status and patterns of care and mortality in men with prostate cancer.

EAU 2018: Development of PSA Screening Nomograms for 15-Year Prediction of Prostate Cancer Diagnosis, Mortality, and All-Cause Mortality

Copenhagen, Denmark (UroToday.com)  Dr. Carlsson presented their group’s work developing PSA screening nomograms for 15-year prediction of prostate cancer diagnosis, mortality and all-cause mortality. Recommendations for PSA screening encourage shared decision making between patients and providers, rather than population-based screening. Nomograms provide individualized risk predictions potentially enhancing informed decisions to undergo screening.

EAU 2018: U-SMART: (UCSD small mass ALT RENAL score tumor diameter) A novel scoring system of preoperative predictors to stratify oncologic risk of small renal masses

Copenhagen, Denmark (UroToday.com) New international guidelines have now begun to incorporate active surveillance as a first-line treatment option for patients with small renal masses (SRMs), equivalent to surgery up front. However, just like surgery can be considered over-treatment in some patients, AS can be undertreatment in others – some aggressive renal cancers will ultimately need intervention.

EAU 2018: The German Risk-Adapted Prostate Cancer Screening Trial (PROBASE): First Results After Recruitment of 30,000 Men

Copenhagen, Denmark (UroToday.com) Dr. Arsov and colleagues presented the initial results of the German PROBASE trial.  Certainly, population-based screening is still controversially, and a risk-adapted approach using a baseline PSA value at age 45 may improve the number needed to screen and to treat. The German risk-adapted prostate cancer screening trial PROBASE is currently the largest ongoing screening trial and aims to accrue 50,000 men within 5 years in a prospective and randomized fashion. The trial opened in April 2014 and the objective of this study was to report results of the first 30,000 men recruited to the PROBASE study.

EAU 2018: Tumor-Associated Macrophages in Prostate Biopsy Determined by Automated Image Analysis - Independent Prognostic Marker for Biochemical Recurrence in Prostate Cancer Patients

Copenhagen, Denmark (UroToday.com)  It is known that the composition of different immune cell populations in the tumor microenvironment plays an important role for tumor progression in various cancer types. In particular, tumor-associated macrophages (TAM) are relevant factors. In this study, the authors systematically quantified TAM populations in prostate biopsies from prostate cancer (PCa) patients using a Tissue Phenomics approach. The objective of the study was to evaluate the prognostic relevance of TAM for PCa recurrence prediction, and to establish a biopsy-based risk stratification for PCa patients.