AUA 2018: Factors Driving Worse Survival Between Black and White Patients with Renal Cell Carcinoma
San Francisco, CA (UroToday.com) Many studies in multiple different malignancies have demonstrated a significant racial disparity between Caucasian (white) Americans and African-American (black) patients. This manifests sometimes as worse pathology and worse initial presentation, but in many cases, even accounting for the same initial presentation and pathology, outcomes are often worse in black patients. However, the underlying reasons for this disparity are not clear. This has often been attributed to lack of access to healthcare, relationship with the healthcare system, healthcare professionals acceptance of black patients, and socioeconomic differences.
AUA 2018: Self-Reported Quality of Life for Predicting Mortality in Renal Cell Carcinoma
San Francisco, CA (UroToday.com) Historically, the emphasis has been on pathology and clinical variables as the strongest predictors of clinical outcomes. Yet, more recent studies have begun to demonstrate that subjective measures, such as patient quality of life (QOL) and symptoms, may have an impact on outcomes as well. Renal cell carcinoma (RCC) is typically an asymptomatic disease, but in its more advanced stages, can become symptomatic, either due to direct mass effect or due to paraneoplastic syndromes.
AUA 2018: Chest Follow-Up Schedule of Surgically Resected Renal Cell Carcinoma Should Be Differentiated According to Histological Subtype
San Francisco, CA (UroToday.com) Renal cell carcinoma patients, following surgical resection of primary localized disease, usually end up on surveillance with routine imaging at least once a year. As the authors note, international guidelines (EAU, AUA, NCCN) provide follow-up guidelines for surgically treated renal cell carcinoma (RCC). However, these guidelines are not supported by good quality evidence.
AUA 2018: Validation of the Preoperative Nomogram Predicting 12-Year Probability of Metastatic Renal Cancer
San Francisco, CA (UroToday.com) Nomograms can help guide patient management and counsel patients. In 2008, Raj et al.1 (working in conjunction with Dr. Kattan, well-known for his prostate cancer nomograms) generated a nomogram to predict 12-year probably of developing metastases in patients with cM0 clear cell renal cell carcinoma using pooled institutional data. In that original study, their nomogram, which was based on pre-operative clinical factors such as size of the primary renal mass, patient gender, evidence of lymphadenopathy or necrosis on preoperative imaging and the mode of presentation (incidental, symptomatic, etc), had a concordance index of 0.80; this exceeded TNM staging, which had a concordance index of 0.71.
AUA 2018: Pretreatment Diagnosis of the Small Renal Mass: Status of Renal Biopsy in the US
San Francisco, CA (UroToday.com) Renal tumor biopsy is now recognized as a safe procedure with limited risks compared to historical series. The theoretical risk of seeding has not been seen in more recent series. Improved biopsy technique has improved yield. However, uptake has been limited by the general medical community and is often reserved for patients who active surveillance is considered, especially in patients who are not good surgical candidates.
AUA 2018: Evaluation of Bacterial Biofilms on Renal Calculi
San Francisco, CA USA (UroToday.com) Negar Motayagheni, MD, from the Wake Forest School of Medicine, presented data regarding the relevance of bacterial biofilms on and in renal calculi and urine culture to establish a cause for sepsis. He prefaced his research by stating bacterial biofilms have been found anchored on indwelling medical devices and in UTIs. Motayagheni hypothesized that the presence and aggregation of bacteria on uroliths can be a cause for sepsis.
AUA 2018: Diagnostic Value of 68GA-Labelled PSMA PET/CT Imaging for Renal Cell Carcinoma
San Francisco, CA (UroToday.com) PSMA (prostate specific membrane antigen) is a targetable receptor that has high specificity for prostate cancer, and as such, PSMA PET scans have been gaining significant traction in the management of recurrent prostate cancer to identify low-volume recurrent disease. Yet, despite its high specificity for prostate cancer, it is known to be expressed in other benign tissues – and occasionally other malignancies.