ASCO GU 2018: Utilization and Outcomes of Chemoprophylaxis for the Prevention of Venous Thromboembolism Following Radical Cystectomy: A Population-Based Study

San Francisco, CA ( Venous thromboembolism (VTE), comprising deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major preventable source of postoperative complications. The risk of VTE in patients undergoing radical cystectomy (RC) for bladder cancer has been estimated at 6%, and the American Society of Clinical Oncology, American Urological Association, and National Comprehensive Cancer Network all recommend perioperative chemoprophylaxis to lower the risk of this complication. We performed a population-based analysis to determine the utilization of chemoprophylaxis against VTE in patients undergoing RC.

ASCO GU 2018: Utility Of Lymph Node Dissection for Clinical Node Negative Upper Tract Urothelial Cell Carcinoma: A Multicenter Study

San Francisco, CA ( Upper tract urothelial cell carcinoma (UTUC) is an uncommon aggressive malignancy with disparate outcomes. Although use of lymph node dissection (LND) for urothelial cell carcinoma of the bladder has demonstrated a survival benefit even in setting of negative nodal status, therapeutic benefit of LND in the setting of clinical node negative disease for UTUC is unclear. The authors evaluated survival outcomes for UTUC after LND.

ASCO GU 2018: Defining the DNA Damage Repair Genomic Landscape of Urothelial Carcinoma of the Bladder

San Francisco, CA ( Impaired DNA damage repair (DDR) genes is associated with response to platinum-based chemotherapy. Several genomically directed trials have been proposed using DDR alteration status for enrollment. In this study, the authors characterized the deleterious DDR alteration (DDRa) landscape of bladder urethral carcinoma (UCB) across various clinical states.

ASCO GU 2018: Perioperative Hypogonadism in Men Undergoing Radical Cystoprostatectomy for Bladder Cancer

San Francisco, CA ( Radical cystectomy (RC) is a procedure associated with significant morbidity, commonly accompanied by loss of body weight, even in patients without any significant nutritional deficiencies. Prior studies have demonstrated a high prevalence of hypogonadism (HG) in men with cancer and who undergo anesthesia/major surgery. The suppression of testosterone persists up to seven days following surgery. The authors hypothesized that HG is prevalent in male patients undergoing RC for bladder cancer (BC), with persistence in the post-operative period. 

ASCO GU 2018: A Decision-Support Tool to Assist Muscle-Invasive Bladder Cancer Patients Choosing Between Radical Cystectomy and Chemoradiotherapy

San Francisco, CA ( Patients with high-risk muscle-invasive bladder cancer (MIBC) who are borderline medically operable for radical cystectomy (RC) face a difficult decision between RC which has higher short-term treatment-related morbidity/mortality & chemoradiotherapy (CRT) which is better tolerated in the short-term but may have worse long-term cancer control outcomes. To date, there are no existing decision support tools to assist patients & providers in understanding these trade-offs. Therefore, the authors developed a visualization tool to inform patients & providers how the relative risks & benefits of RC & CRT vary over time with respect to overall survival (OS).

ASCO GU 2018: Is Radical Radiotherapy Effective for Elderly Patients with Muscle Invasive Bladder Cancer?

San Francisco, CA ( Radical radiotherapy (RT) is a curative option for muscle-invasive bladder cancer (MIBC), and offers the chance of bladder preservation. To date, RT and radical cystectomy have not been compared in a randomized controlled trial, however, previous studies assessing RT +/- concurrent systemic therapy have demonstrated outcomes comparable to surgery. In the clinical practice of the real world, patients are often older and considerably less fit, when compared to patients enrolled to trials, and consequently may not be fit for concurrent chemotherapy which may impact treatment outcomes.

ASCO GU 2018: Interim Results from PURE-01: A Phase 2, Open-Label Study of Neoadjuvant Pembrolizumab Before Radical Cystectomy for Muscle-Invasive Urothelial Bladder Carcinoma

San Francisco, CA ( invasive urothelial bladder cancer (MIUC) is an aggressive disease with more than 40% of patients developing recurrence after radical cystectomy (RC). Despite the fact that there is level 1 evidence demonstrating that cisplatin-based neoadjuvant chemotherapy confers an overall survival benefit1, it is administered in a minority of patients worldwide. Pembro is an EMA and FDA-approved standard therapy for metastatic urothelial carcinoma after platinum failure or for cisplatin-ineligible patients. The authors hypothesized that neoadjuvant pembro, could downstage MIUC and reduce recurrence.

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