AUA 2018: Use of Surveillance vs Active Treatment for Renal Masses ≤7 Cm: Results from the MUSIC KIDNEY Regional Collaborative
San Francisco, CA (UroToday.com) Active surveillance has now become an established first-line therapeutic option for cT1a renal masses. However, uptake of active surveillance (AS) has not been universal. Quality control measures have been instituted internationally to help further evaluate its utilization and efficacy.
AUA 2018: Frozen Sections for Margins During Partial Nephrectomy Do Not Influence Recurrence Rates
San Francisco, CA (UroToday.com) Frozen sections, or intra-operative pathologic evaluations, are often sent during various oncologic operations to help assist in the decision for further intraoperative management. In cystectomies, frozen sections are often sent from the distal ureters and urethra; in prostatectomy, frozen sections are sometimes sent from concerning lymph nodes; in penectomies/partial penectomies, proximal margins are sent to confirm adequate distance from disease; in partial nephrectomy for renal cell carcinoma (RCC), frozen sections are sometimes sent from the base of the resection bed to confirm complete excision.
AUA 2018: “Pin the Tumor on the Kidney”: An Evaluation of How Surgeons Translate CT and MRI data to 3D Models
San Francisco, CA USA (UroToday.com) Ms Wake from New York University School of Medicine presents here research on patient-specific 3D models as tools for pre-operative surgical planning, virtual reality (VR) simulators, intra-operative guidance and patient education. These 3D models provide an intuitive understanding of the surgical anatomy, however there is limited data to quantify the added value of these models. Her research team sought out to identify the ability of surgeons to translate their CT or MRI understanding to a 3D model.
AUA 2018: Is There a Role for Nephron Sparing Cytoreductive Partial Nephrectomy in Metastatic Renal Cell Carcinoma?
San Francisco, CA (UroToday.com) Cytoreductive nephrectomy, or removal of the primary tumor, is a mainstay of therapy for patients with metastatic renal cell carcinoma (mRCC). However, in the era of targeted therapy, even the role of cytoreductive nephrectomy has been called into question – to the point that many clinicians generally justify a cytoreductive nephrectomy in patients whom the volume of disease in the kidney predominates the total volume of disease. In patients with a significant metastatic disease but a small primary, the role for cytoreductive nephrectomy is being questioned.
AUA 2018: Systematic Review and Meta-Analysis of Adjuvant Therapy After Nephrectomy for High-risk, Non-metastatic Renal Cell Carcinoma
San Francisco, CA USA (UroToday.com) The current treatment for non-metastatic renal cell carcinoma (nmRCC) is either a partial or radical nephrectomy. However, many adjuvant therapies have been examined such as radiotherapy, vaccines, immunotherapy, Vascular Endothelial Growth Factor (VEGF)-TKI, and checkpoint inhibitors. Five trials, ASSURE, S-TRAC, PROTECT, SORCE, ATLAS, have been designed to evaluate the effect of adjuvant VEGF-based therapy in patients with nmRCC, who underwent either partial or radical nephrectomy. The ASSURE, S-TRAC and the PROTECT trials published their results.
AUA 2018: Rapid Patient Derived Xenografts that Consider Tumor Heterogeneity for Prediction of Cancer Immunotherapy Responses in Metastatic Renal Cell Carcinoma
San Francisco, CA USA (UroToday.com) Metastatic renal cell carcinoma is one of the most lethal of all genitourinary cancers due to its resistant nature to both chemotherapy and radiotherapy. The currently available clinical treatment options for this patient population is a cytoreductive nephrectomy followed by either surgery, systemic anti-angiogenic agents or immunotherapy. This particular cancer subtype is a good candidate for personalized medicine as around 30% of patients are de novo resistant to their selective frontline anti-angiogenic and a long term durable response is only seen in a subpopulation of patients undergoing immunotherapy. Specifically, patient responses to cancer immunotherapy such as checkpoint inhibitor drugs (PD-1 and PD-L1) vary greatly between patients and between disease sites.
AUA 2018: Does Tumor Size at the Time of Cytoreductive Nephrectomy Influence Survival?
San Francisco, CA USA (UroToday.com) Renzo DiNatale, MD, from Memorial Sloan Kettering Cancer Center presented his groups multi-institutional research focusing on the management of metastatic renal cell carcinoma. Although the cancer has metastasized, patients often undergo a cytoreductive nephrectomy (CN) to improve their quality of life and survival outcomes. However, urologists struggle to select the appropriate patient for the procedure as there are no clear-cut guidelines.