AUA 2017: Big Renal Angiomyolipoma: The 4 cm size limit for conservative management should be revisited?

Boston, MA (UroToday.com) Recent publications have challenged the previous dogma that is unsafe to follow AML > 4 cm in size. Previous reports stated the risk of bleeding rose proportionally with AML size and the likelihood of a successful nephron-sparing procedure was less likely in larger masses.
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AUA 2017: A Multi-Institutional Propensity Score Matched Comparison of Transperitoneal vs. Retroperitoneal Robotic Partial Nephrectomy for Posterior Clinical T1 Renal Masses

Boston, MA (UroToday.com) Several single institutional series have reported improved surgical outcomes in patients with posterior renal masses managed with a retroperitoneal robotic partial nephrectomy. The reason for this improvement is the decrease need for renal mobilization, easier access to the renal artery, improved tumor visualization in patient with hilar posterior masses, and avoidance of the intraperitoneal cavity in patients with hostile abdomens.
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AUA 2017: Impact of Renal Vein Invasion on the Outcome in Patient with Renal Cell Carcinoma and Caval Thrombus

Boston, MA (UroToday.com) Renal vein wall invasion by the tumor thrombus has been associated with increased risk recurrence and survival. The data available remains conflicting given the low number of patients studied in several small institutional reports. Dr. Isharwal, from the CCF, presents the results of a large institutional data set of patients with vascular wall invasion in regards to risk of recurrence and survival.
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AUA 2017: Renal Mass Biopsy is Associated with increased Incidence of Pathological Upstaging to Perinephric Fat Invasion in Patient with Clinically Localized Renal Cell Carcinoma.

Boston, MA (UroToday.com) The popularity of renal mass biopsy has been rising over the last 10 years following reports on increased accuracy and safety. Early on there was significant concern of tumor seeding following the biopsy but this risk has been mitigated with the use of coaxial approach. Dr. Salmasi, from UCLA, discusses the potential risk of perinephric fat invasion following renal mass biopsy caused by capsular disruption at the time of biopsy. In order to answer this question Dr. Salmasi queried the National Cancer Data Base (NCDB) to assess the likelihood of renal mass upgrading following renal mass biopsy and its association with overall survival.
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AUA 2017: Quantitative Digital Image Analysis and Machine Learning Accurately Classifies Primary Prostate Tumors of Bone Metastatic Disease Based on Histomorphometric Features in Diagnostic Prostate Needle Biopsies

Boston, MA (UroToday.com) Biomarker development in prostate cancer (PC) is the subject of intensive research. Investigators from UCLA presented a novel and extraordinarily powerful platform that uses digital imaging analysis to classify tissue characteristics in ways that were previously unfathomable.
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AUA 2017: Androgen receptor splice variant 7 (AR-V7) in patients with locally advanced, metastatic, and metastatic castration-resistant prostate cancer: a novel capillary nano-immunoassay technique

Boston, MA (UroToday.com) In this session, Dr. Rodriguez and colleagues aimed to investigate the feasibility of a novel capillary nan-immunoassay in detecting AR-V7 variant in plasma from prostate cancer patients. The AR-V7 splice variant has been associated with differences in response of prostate cancer to systemic treatment.
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AUA 2017: Prostate Health Index Density Improves Detection of Clinically-Significant Prostate Cancer

Boston, MA (UroToday.com) There are a variety of nascent biomarkers in prostate cancer (PC), many of which were evaluated in development and validation studies presented this year at the AUA. Some well-known and widely used markers include PSA, free PSA, PSA density, 4k score, and prostate health index (PHI), just to name a few. PHI is calculated via a formula that integrates free PSA, total PSA, and one of the truncated pro-PSA isoforms easily detected in blood.
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