AUA 2018: Trends in Renal Surgery from the National Inpatient Sample: Implications for Resident Education
San Francisco, CA USA (UroToday.com) In accordance with the increased diagnosis of renal cancer in the past two decades, urologists have become more comfortable with minimally invasive surgery. However, there is yet no established impact of these observations on resident exposure and case mix. The objective of this study was to examine trends in utilization of open and minimally invasive approaches for radical and partial nephrectomies, in training and nonteaching institutions.
AUA 2018: Radical Nephrectomy for Recurrent Renal Cell Carcinoma: Patient Selection for Laparoscopic Approach
San Francisco, CA USA (UroToday.com) Zachary Kozel, MD of the Arthur Smith Institute for Urology at Northwell Health presented a moderated poster of their experience with laparoscopic completion nephrectomy following locoregional renal cell carcinoma (RCC) recurrence.
AUA 2018: ELOC-Mutated Renal Cell Carcinoma: A Distinct Clinical Entity with Unclear Disease Course
San Francisco, CA USA (UroToday.com) Renzo DiNatale, MD, a urology research fellow at Memorial Sloan Cancer Center, presented on hotspot mutations in ELOC and the hypothesis of how clear-cell renal cell carcinomas (RCC) with certain mutations in the ELOC gene may have an indolent disease course. He began by noting that RCC frequently has many of the same genomic mutations, but some cases of RCC, does not show the mutations typically associated with clear cell (ccRCC) or papillary RCC and instead have variations within the ELOC gene.
AUA 2018: Active Surveillance of T1a Renal Masses: Results from National Cancer Database
San Francisco, CA USA (UroToday.com) Dave Jiang, MD, currently a second year resident at Oregon Health and Science University, presented data comparing results on the active surveillance (AS) and other intervention of T1a renal masses based on the National Cancer Database (NCDB). He focused on determining the contemporary use and results of AS in SRMs in the United States. He introduced T1a kidney cancer as a small renal mass (SRMs, ≤ 4 cm) in which 20% are benign. Active surveillance (AS) has been a management strategy since 2010 because such tumors have a low rate of metastases in the first 3 years (<5%).
AUA 2018: State-of-the-Art Lecture - Disparities in Urology: Renal Transplant
San Francisco, CA USA (UroToday.com) Charles S. Modlin, MD, from the Cleveland Clinic provided a video presentation on the disparities of renal transplants, focusing on the African American (AA) population group. He indicated that the incidence of end-stage renal disease is 4 times higher in AAs compared to European Americans (EU). The causes behind kidney failure are primarily due to hypertension and diabetes. The AA group has worse renal transplant outcomes compared to EAs and the causes for this disparity tends to be multifactorial.
AUA 2018: Crossfire: Controversies in Urology: Kidney Cancer
San Francisco, CA USA (UroToday.com) Ralph V. Clayman, MD opened the debate by proposing the use of thermal ablation in the case of a 62 year-old healthy man with a 3 cm posterolateral renal mass. This is of relevance as the rising use of computed tomography has lead to the increased discovery of renal masses of 3 cm of less.
First up in the debate was Dr. Jaime Landman, who argued for the “Pro” side of thermal ablation. Dr. Landman began by showing data on the sensitivity, specificity, and complication rates for renal, breast, lung, pancreas, thyroid, liver, and prostate biopsies. He argued that renal biopsies have a more favorable sensitivity, specificity, and complications profile than most other biopsies. Furthermore, Dr. Landman emphasized how 70% of renal masses biopsies reveal benign disease, not requiring surgical intervention.
AUA 2018: Tips and Tricks: Dissection of the Renal Mass with Hilar Fat Invasion
San Francisco, CA USA (UroToday.com) Monish Aron, MD, presented on the “enucleo-resection” of pT3a renal masses. Dr. Aron explained that pT3a renal masses are difficult to predict on pre-operative imaging and have the potential to lead to tumor violation and/or positive surgical margins with subsequent implications for prognosis.