AUA 2018: Renal Cell Carcinoma and Brain Metastasis: A SEER Analysis
San Francisco, CA USA (UroToday.com) Dr. Daugherty from SUNY Upstate Medical University presented his groups research focusing on metastatic renal cell carcinoma (RCC). He explained that management decisions are often driven by the site and number of metastases. Brain metastases are considered a poor prognostic factor which typically excludes patients from undergoing cytoreductive nephrectomy (CN). Using the SEER database, his team sought to investigate the outcomes of patients that had brain metastases and underwent CN.
AUA 2018: Radical Versus Partial Nephrectomy for cT1 Renal Cell Carcinoma: A Propensity-Score Based Analysis
San Francisco, CA USA (UroToday.com) Previous observational studies suggest reduced chronic kidney disease risk as well as all-cause mortality in using partial nephrectomy (PN) with respect to radical nephrectomy (RN). However, the only randomized trial comparing PN and RN reported no significant benefit to PN.
AUA 2018: Postoperative Outcomes of Elderly Patients Undergoing Partial Nephrectomy: A Multicentric-Study of the French Research Network On Kidney Cancer UroCCR
San Francisco, CA USA (UroToday.com) Dr. Sophie, from the University Hospital of Bordeaux presented on partial nephrectomy (PN) in the elderly population. She stressed the importance of preserving renal function as it is an independent predictor of cardiovascular function. Since there is limited data on the feasibility and morbidity of PN for patients over the age of 75 years old, Dr. Sophie sought to shed light on this issue by analyzing the clinical outcomes in this population group.
AUA 2018: Tumor Enucleation: Functional Comparison with Standard Partial Nephrectomy
San Francisco, CA USA (UroToday.com) Suk-Ouichai, from the Glickman Urological and Kidney Institute, Cleveland Clinic presented her research on two nephron-sparing techniques used to treat renal cancer, conventional partial nephrectomy (PN) and tumor enucleation (TE) (Figure 1). TE is like PN but it spares more of the normal parenchymal tissue by dissecting along the avascular pseudocapsule. Therefore, it is thought that TE better preserves renal function compared to PN, however this remains up for debate. Her team sought to shed some light on this issue by analyzing and comparing the functional outcomes of TE and PN.
AUA 2018: Renal Function Variability Can Identify Subclinical Kidney Disease Before Nephrectomy
San Francisco, CA USA (UroToday.com) Andrew Sun, MD and his team at Stanford University sought to determine the relationship between the variability in preoperative kidney function and the onset of chronic kidney disease (CKD) and survival rate after partial and radical nephrectomies. As past studies have shown, variability within kidney function has shown to be correlated with more detrimental renal outcomes for patients with CKD. This study further observed the relationship between preoperative variability and overall survival following partial and radical nephrectomies.
AUA 2018: Automated Digital Analysis of Renal Core Biopsy Specimens Using a Deep-Learning Artificial Intelligence Network
San Francisco, CA USA (UroToday.com) Michael Fenstermaker, MD, a urology specialist from Michigan Medicine, and his team have been developing a convolutional neural network (CNN) that can accurately and efficiently identify the presence of clear cell renal cell carcinoma (ccRCC) based on renal biopsies. Because of limited tissue sampling from patients, biopsies are not prominently reliable for various diagnoses. To combat this problem, a network has been studied to determine the efficiency and potential use for histologic analysis.
AUA 2018: Safety Lead-in of a Phase II Trial of Neo-Adjuvant SAbR for IVC tumor Thrombus in RCC
San Francisco, CA (UroToday.com) Patients with advanced renal cell carcinoma (RCC) may be present with extension into the renal vein or into the inferior vena cava (IVC). It is evident in up to 10% of patients presenting with advanced RCC, and necessitates more urgent management. Traditionally, the standard of care has been nephrectomy and tumor thrombectomy – though this can be an extensive operation depending on the extent of the thrombus. Poor long-term outcomes are expected in patients who present with tumor thrombus, as many often present with metastatic disease.