ASCO GU 2018: Adrenal Cortical Carcinoma: Finding the Wolf in Sheep’s Clothing

San Francisco, CA (UroToday.com) Dr. Mayo-Smith from Boston’s Brigham and Women’s Hospital provided the Keynote Lecture for Adrenal Cortical Carcinoma (ACC). Dr. Mayo-Smith started by highlighting that when looking at the NCI website for ACC, it states several telling points: (i) NCI does not have evidence-based information about prevention of ACC, (ii) rare endocrine cancers have novel genetic alterations, and (iii) NCI does not have evidence-based information about screening for ACC. 

ASCO GU 2018: Thromboembolic Complications in Germ Cell Tumor Patients: Should Use of Peripherally Inserted Central Catheters be Pursued?

San Francisco, CA (UroToday.com) Dr. Louis Francois and his colleagues from France presented the results of thromboembolic complications among patients with germ cell tumors. Patients with germ cell tumors receiving cisplatin-based chemotherapy are at high risk of thromboembolic events. The objective of this study was to assess predictors of thromboembolic events in single institution setting.

ASCO GU 2018: Effect of Number of CT Scans During Follow-Up of Patients with Clinical Stage I Seminoma: A Trial-Level Meta-Analysis

San Francisco, CA (UroToday.com) Dr. Patrizia Giannatempo presented results of her team’s trial level-analysis assessing the effect of number of CT scans during follow-up of patients with clinical stage I (CSI) seminoma. Despite the overall high cure-rate for patients with CSI seminoma regardless of the intervention used, huge discrepancy exists in the number of CT scans that are proposed to patients during the follow-up period, mainly during active surveillance. The objective of this study was to assess the impact of such a discrepancy in diagnosing patients with a high-risk relapse using published literature and a meta-analysis.

ASCO GU 2018: Is Surveillance without Immediate Treatment an Option for Newly Diagnosed Testicular Germ-cell Cancer Patients with Borderline Size Retroperitoneal Lymph Nodes on CT Scan?

San Francisco, CA (UroToday.com) Dr. Nadav Milk and colleagues from Israel presented results of surveillance for patients with borderline size retroperitoneal nodes on CT scan. The AJCC TNM staging system for testicular cancer does not set a minimal diameter to define positive lymph nodes on CT scan. However, it is common to refer to lymph nodes ≥ 1 cm in diameter as positive, even though benign lymph nodes in the borderline size of 1-1.5cm are common. The objective of this study was to describe the outcome of testicular cancer patients with borderline size retroperitoneal lymph nodes of undetermined significance managed initially with surveillance.

ASCO GU 2018: High-Dose Chemotherapy and Stem-Cell Rescue - Salvage Treatment for Germ Cell Testicular Tumors in Second- and Third-Line, and Outside Clinical Trials

San Francisco, CA (UroToday.com) Dr. Fernanda Ronchi and colleagues from Brazil provided results of their experience with high-dose chemotherapy and stem-cell rescue as salvage treatment among men with germ cell testicular tumors. Testicular tumors are the most common cancer in young males, usually curable in early stages. Therefore, only 25% of relapsed patients are long-term survivors. Previous non-randomized studies showed promising results with high-dose chemotherapy, however, the only randomized trial did not support this approach [1]. The objective of this study was to report the real-world use of high-dose chemotherapy and stem cell rescue in the second- and third-line at a Brazilian institution. 

ASCO GU 2018: Current Practice Patterns Surrounding Fertility Concerns in Stage I Seminoma Patients: Survey of United States Radiation Oncologists

San Francisco, CA (UroToday.com) Carl Post and colleagues presented results of their survey of US radiation oncologists with regards to their current practice patterns surrounding fertility concerns for stage I seminoma patients. Indeed, patients with testicular seminoma may face fertility issues because of their underlying disease as well as treatments they undergo. The current patterns of practice among US radiation oncologists aimed at assessing and preserving fertility in patients with stage I seminoma are unknown, thus forming the objective of the current study. The author’s hypothesis was that US radiation oncologists have embraced observation as the first-choice option for stage I seminoma patients.

ASCO GU 2018: Diagnostic Radiation and Testicular Germ Cell Tumor Risk

San Francisco, CA (UroToday.com) Dr. Kevin Nead and colleagues presented their work assessing diagnostic radiation and testicular germ cell tumor risk. Dr. Nead notes that both the incidence of testicular germ cell tumors (TGCT) and use of diagnostic radiation have increased in recent decades. In a quarter of diagnostic scans in children, direct and indirect radiation dose to the testes exceeds 20 mSv, which surpasses thresholds associated with malignancy risk (~5 mSv). The objective of this study was to examine the association between exposure to diagnostic radiation and TGCT risk in a case-control study. 
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