AUA 2018: Safety Lead-in of a Phase II Trial of Neo-Adjuvant SAbR for IVC tumor Thrombus in RCC
San Francisco, CA (UroToday.com) Patients with advanced renal cell carcinoma (RCC) may be present with extension into the renal vein or into the inferior vena cava (IVC). It is evident in up to 10% of patients presenting with advanced RCC, and necessitates more urgent management. Traditionally, the standard of care has been nephrectomy and tumor thrombectomy – though this can be an extensive operation depending on the extent of the thrombus. Poor long-term outcomes are expected in patients who present with tumor thrombus, as many often present with metastatic disease.
AUA 2018: Factors Driving Worse Survival Between Black and White Patients with Renal Cell Carcinoma
San Francisco, CA (UroToday.com) Many studies in multiple different malignancies have demonstrated a significant racial disparity between Caucasian (white) Americans and African-American (black) patients. This manifests sometimes as worse pathology and worse initial presentation, but in many cases, even accounting for the same initial presentation and pathology, outcomes are often worse in black patients. However, the underlying reasons for this disparity are not clear. This has often been attributed to lack of access to healthcare, relationship with the healthcare system, healthcare professionals acceptance of black patients, and socioeconomic differences.
AUA 2018: Self-Reported Quality of Life for Predicting Mortality in Renal Cell Carcinoma
San Francisco, CA (UroToday.com) Historically, the emphasis has been on pathology and clinical variables as the strongest predictors of clinical outcomes. Yet, more recent studies have begun to demonstrate that subjective measures, such as patient quality of life (QOL) and symptoms, may have an impact on outcomes as well. Renal cell carcinoma (RCC) is typically an asymptomatic disease, but in its more advanced stages, can become symptomatic, either due to direct mass effect or due to paraneoplastic syndromes.
AUA 2018: Novel Use of the EPIC Electronic Medical Record Platform to Identify Lost Ureteral Stents
San Francisco, CA USA (UroToday.com) Juan F. Javier-DesLoges, MD, a third-year resident from Yale University presented data on a ureteral stent tracking system with the use of EPIC, an electronic medical record (EMR). They also sought to identifying risk factors for patients lost to follow-up, and retrospectively studied patients to find out why they were being lost to follow-up.
AUA 2018: Chest Follow-Up Schedule of Surgically Resected Renal Cell Carcinoma Should Be Differentiated According to Histological Subtype
San Francisco, CA (UroToday.com) Renal cell carcinoma patients, following surgical resection of primary localized disease, usually end up on surveillance with routine imaging at least once a year. As the authors note, international guidelines (EAU, AUA, NCCN) provide follow-up guidelines for surgically treated renal cell carcinoma (RCC). However, these guidelines are not supported by good quality evidence.
AUA 2018: Validation of the Preoperative Nomogram Predicting 12-Year Probability of Metastatic Renal Cancer
San Francisco, CA (UroToday.com) Nomograms can help guide patient management and counsel patients. In 2008, Raj et al.1 (working in conjunction with Dr. Kattan, well-known for his prostate cancer nomograms) generated a nomogram to predict 12-year probably of developing metastases in patients with cM0 clear cell renal cell carcinoma using pooled institutional data. In that original study, their nomogram, which was based on pre-operative clinical factors such as size of the primary renal mass, patient gender, evidence of lymphadenopathy or necrosis on preoperative imaging and the mode of presentation (incidental, symptomatic, etc), had a concordance index of 0.80; this exceeded TNM staging, which had a concordance index of 0.71.
AUA 2018: The Impact of Common Urological Complications on the Risk of a Prosthetic Joint Infection
San Francisco, CA USA (UroToday.com) Nahid Punjani, MD, clinical urology resident from Western University, presented on the association between joint infections after total hip or knee arthroplasty (THA or TKA) and urologic complications such as urinary tract infections (UTI) or acute urinary retention (AUR). He began by establishing that PJIs can cause significant patient morbidity and healthcare costs.