AUA 2018: Phase II Trial of Neoadjuvant Chemotherapy Followed by Extirpative Surgery for Patients with High Grade Upper Tract Urothelial Carcinoma: Results From ECOG-ACRIN 8141

San Francisco, CA ( Neoadjuvant chemotherapy (NAC) is a standard of care for urothelial carcinoma of the bladder. Though underutilized, there is Level 1 evidence supporting its utilization in all patients with muscle-invasive disease. However, while recent studies have demonstrated that upper tract urothelial carcinoma (UTUC) may be a distinct disease process from bladder cancer, it shares a lot of similarities with bladder cancer, and in some cases is secondary to bladder cancer.

AUA 2018: Variability in Partial Nephrectomy Outcomes: Does Your Surgeon Matter?

San Francisco, CA USA ( Recently, there have been many publications citing the difference amongst surgeon skill and technique in partial nephrectomy. Julien Dagenais, MD emphasized these articles in the beginning of his talk by mentioning fifteen articles surrounding this topic. Understanding discrepancies between surgeons is increasingly important in the pursuit of quality-based healthcare in the United States.

AUA 2018: Survival after Segmental Resection of Distal Ureter and Termino-Terminal Ureteral Anastomosis vs Bladder Cuff Removal and Ureteral Reimplantation for Urothelial Carcinoma of the Ureter

San Francisco, CA ( Kidney-sparing surgery (KSS) is an alternative to radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). However, segmental resection of iliac and lumbar ureter seems to be associated with greater failure than for distal pelvic ureter. The overall (OS) and cancer specific survival (CSS) of patients treated with segmental resection and termino-terminal anastomosis of iliac or lumbar ureter (TT) were compared to that of patients treated with segmental resection of the distal pelvic ureter with bladder cuff removal and ureteral reimplantation (RR). The secondary endpoint was evaluation and comparison of TT vs. RR impact on renal function. 

AUA 2018: The Impact of Blue-Light Cystoscopy on Response to Induction BCG in Patients with High-Grade Non-Muscle Invasive Bladder Cancer

San Francisco, CA USA ( Recent randomized clinical trials have demonstrated the superiority of blue light cystoscopy (BLC) during transurethral resection of bladder tumor (TURBT) over regular white light cystoscopy in regard to early recurrence rates. This improvement is likely related to the resection of smaller lesions which are often missed in white light cystoscopy. Animal studies have shown that BCG effectiveness is improved by the presence of bladder cancer tumor cells in the bladder.

AUA 2018: Debate: Molecular Subtypes: Not Ready for Prime Time

San Francisco, CA ( David McConkey, MD, provided a rebuttal to Peter Black, MD, suggesting that molecular subtyping is not yet ready for ‘prime-time’. The previous work done with basal and luminal subtypes suggests that there is potential clinical utility according to McConkey. Several important points regarding basal and luminal subtypes:

AUA 2018: Debate: Molecular Profiling Influences My Treatment Selection

San Francisco, CA ( Peter Black, MD, from the University of British Columbia provided his rationale for molecular profiling with regards to treatment selection for patients with muscle-invasive bladder cancer. Dr. Black started by highlighting the current landscape of neoadjuvant chemotherapy for MIBC:

AUA 2018: Treatment for MIBC for Cis-Platinum Ineligible Patients: Immediate Cystectomy

San Francisco, CA ( For the debate of treatment options for MIBC cisplatin ineligible patients, Jonathan Wright, MD from the University of Washington provided the argument for immediate cystectomy. Wright provided a nice summary figure displaying the recurrence free survival following radical cystectomy without neoadjuvant chemotherapy stratified by pathologic stage:

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