AUA 2018: Comparative Analysis of Minimally Invasive Radical and Partial Nephrectomy for Clinical T2 Renal Mass: Analysis of the Robotic Surgery for Large Renal Mass (ROSULA) Group
San Francisco, CA USA (UroToday.com) Over the last two decades, nephron-sparing surgery has continued to evolve as being standard of care for cT1a patients, as well as increasingly for patients with cT1b tumors, when feasible and in patients with solitary kidneys. With this advancement, feasibility of a partial nephrectomy for cT2 renal masses has been postulated. Given that the da Vinci platform for robotic surgery has allowed highly skilled robotic surgeons to perform many complex procedures minimally invasively, cT2 partial nephrectomy may be feasible.
AUA 2018: Complex Cases: Locally Advanced and Metastatic Kidney Cancer
San Francisco, CA (UroToday.com) Christopher Wood, MD from the University of Texas MD Anderson Cancer Center begins the session by presenting complex kidney cancer patients and discussing their management amongst the panelists. The first case is of a 62-year-old patient that presented with decreased appetite, weight loss and a central 6 cm right renal mass found on CT scan by her PCP.
AUA 2018: Outcomes of Synchronous and Metachronous Bilateral Small Renal Masses (4cm)
San Francisco, CA (UroToday.com) The authors presented a study reporting longitudinal outcomes of a population based cohort of patients diagnosed with bilateral small renal masses from a period of over 11 years. Consecutive patients diagnosed with bilateral small renal masses (synchronous or metachronous) of a defined geographical area were recorded in a large database (TUCAN database) between January 2005 and December 2016.
AUA 2018: Long-Term Active Surveillance of Complex Cystic Renal Masses & the Heterogeneity of BOSNIAK 3 Lesions
San Francisco, CA (UroToday.com) The authors presented a study attempting to better characterize the frequency of Bosniak cyst class changes and determine the average growth rate of cysts, helping to validate the safety of active surveillance. Consecutive patients referred for management of complex cysts (>= Boniak 2f) at a single institution between January 1, 2003 - Aug 31, 2014 were included in the analysis.
AUA 2018: Controversies in Urology: Kidney Cancer – Treatment with Thermal Ablation – CON
San Francisco, CA (UroToday.com) Ketan Badani, MD gave a talk on the disadvantages of thermal ablations for small renal masses (SRM). The first issue discussed was the problem of incomplete ablation. He began by describing a systematic review and metanalysis of laparoscopic vs. percutaneous cryotherapy for renal tumors.
AUA 2018: Controversies in Urology: Kidney Cancer – Treatment with Thermal Ablation – CON Rebuttal
San Francisco, CA (UroToday.com) Craig Rogers, MD gave a talk supporting Ketan Badani, MD in his opinion favoring partial nephrectomy (PN) over ablation for small renal masses (SRM). There is no doubt that PN is a more definitive therapy than ablation treatments. PN is the gold standard of treatment for clinical stage T1a disease. Robust data demonstrate excellent oncologic outcomes. PN allows complete pathological evaluation, and although it harbors the increased risk of urologic complications, it does not entail a higher risk of overall complications.
AUA 2018: Controversies in Urology: Kidney Cancer – Treatment with Thermal Ablation – PRO Rebuttal
San Francisco, CA (UroToday.com) Houston Thompson, MD gave a presentation supporting the role of ablative treatments for small renal masses (SRM). In 2015 a paper from Mayo clinic was published in European Urology comparing patients with clinical stage T1 treated with radiofrequency ablation or cryotherapy and partial nephrectomy.1 This paper received substantial criticism with the main points being: