AUA 2018: ADT Increased the Risk of Pulmonary Embolism in Patients with Prostate Cancer - Taiwan National Health Insurance Research Database

San Francisco, CA (UroToday.com) Androgen deprivation therapy (ADT) is a standard treatment for men with metastatic prostate cancer. There are several known potential side-effects of ADT, such as weight gain, metabolic syndrome, hot flashes, and decreased bone density.  Jian-Hua Hong from National Taiwan University Hospital presented his group’s work looking at the association between ADT and pulmonary embolism (PE).

AUA 2018: Association of Dose Reduction of Abiraterone Acetate plus Prednisone or Enzalutamide and PSA Progression in Veterans with mCRPC

San Francisco, CA (UroToday.com) Abiraterone acetate and enzalutamide are oral agents which have both been shown to reduce PSA, delay time to PSA progression, and prolong overall survival in men with metastatic castrate-resistant prostate adenocarcinoma (mCRPC).  Stephen Freedland, MD,  from Cedars-Sinai Medical Center, presented his group’s data evaluating the association between the dose reduction of these agents, which can sometimes be necessary in order to minimize side-effects or toxicities, and PSA progression in men with mCRPC. 

AUA 2018: Impact of Lymph Node Count and Adjuvant Therapy on Oncologic Outcomes in Node Positive Patients with Prostate Cancer

San Francisco, CA (UroToday.com) In this abstract, Selma Masic, MD and colleagues evaluated the associations between oncologic outcomes and nodal count in patients with positive nodes at radical prostatectomy.  Additionally, they sought to determine if there was an association between adjuvant therapy in node positive patients that improved oncologic outcomes.  Pelvic lymph node dissection is the most definitive lymph node staging modality for prostate cancer.  While newer imaging methods are actively being investigated, previous studies have demonstrated that existing imaging with CT and MRI have low sensitivity.

AUA 2018: Prospective Evaluation of Effect on Intraocular Pressure and Visual Function in Patients Without and with Ophthalmic Diseases after Robotic Assisted Laparoscopic Prostatectomy

San Francisco, CA (UroToday.com) In this abstract Shigenori Kakutani, MD discussed ophthalmic changes from robotic-assisted laparoscopic prostatectomy.  Previous publications have demonstrated the increase in intraocular pressure from the steep Trendelenburg position with subsequent concerns over the potential postoperative visual loss.  Few data have investigated ophthalmic disease following prostatectomy specifically. 

AUA 2018: Which Patients with Low Risk Prostate Cancer Are Still Receiving Radical Prostatectomy? Impact of Patient Selection on Inverse Stage Migration

San Francisco, CA (UroToday.com) The increasing utilization of conservative approaches such as active surveillance in select patients with low risk prostate cancer substantially reduce the proportion of patients with favorable disease characteristics undergoing radical prostatectomy.  In this study, the authors sought to describe the stage migration towards more aggressive disease characteristics in patients treated by radical prostatectomy.

AUA 2018: High Intensity Focused Ultrasound Dose Escalation Leads to Fewer Recurrences in Following Focal HIFU in Prostate Cancer

San Francisco, CA (UroToday.com) Dr. Huber and colleagues evaluated retrospective data to analyze optimal techniques used for high intensity focused ultrasound (HIFU) in prostate cancer. Their database contained 190 men, 131 of whom were treated with 2 HIFU ablation zones, and 59 of whom were treated with 3 ablation zones. This led to 37 matched pairs that were compared with regard to prostate cancer recurrence. The pairs were matched for exact Gleason score and tumor volume as assessed via mpMRI.

AUA 2018: PSA 1.5 is the new 4.0

San Francisco, CA (UroToday.com) E. David Crawford gave a talk regarding the state of prostate cancer diagnostics and specifically focused on the role of PSA cutoff for evaluation.  First, most people, including in the auditorium, are unsatisfied with the current state of prostate cancer detection. In his interactions with practicing urologists and family practice/internal medicine physicians, most are concerned – for different reasons. Common areas of concern: screening parameters, informed decisions, risks and benefits of PCa screening. However, both fields feel there is value to PCa screening.
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