AUA 2018: Complications following 1053 Percutaneous Core Renal Mass Biopsies: Risk Factors and Safety Assessment
San Francisco, CA (UroToday.com) Percutaneous renal mass biopsy (RMB) is an effective diagnostic tool. Although morbidity of RMB is generally minimal, few studies have investigated risk factors and safety, and complications. The purpose of this project was to evaluate patient, tumor, and technical factors associated with procedural complications following RMB. Consecutive patients treated with percutaneous core RMB from 2003-2017 were included in this analysis. According to the trial protocol, RMB was performed with an INR up to 2.0, platelets > 25,000 and continuation of aspirin (ASA) therapy. Complications within 30 days were graded using the Clavien-Dindo classification system.
AUA 2018: Comparative Analysis of Outcomes of Papillary Type 1 and Type 2 and clear Cell Renal Cell Carcinoma: A Multi-Institutional Study
San Francisco, CA (UroToday.com) Compared to Clear Cell Renal Cell Carcinoma (ccRCC), papillary RCC (pRCC) has been thought of as lower risk pathology associated with higher cancer specific survival (CSS). The impact of histophatological subtypes of pRCC on outcomes is controversial. In this study the authors divided the cohort into analytical subgroups based on histology (ccRCC vs. pRCC type I vs. pRCC type II). The primary end-point was overall (OS) and the secondary endpoint was Cancer specific survival (CSS). Kaplan-Meier survival (KMS) and multivariable regression model were used to estimate 5- and 10- year OS and CSS rates and the predictors associated with CSS.
AUA 2018: Tumor Board - Kidney Cancer: The Current State of Knowledge and Management Paradigms for Patients with Kidney Cancer
San Francisco, CA USA (UroToday.com) An all-star group of presenters were gathered at AUA 2018 to discuss the management of difficult kidney cancer cases. They discussed several clinical vignettes that shed important light on the current state of knowledge and management paradigms for patients with kidney cancer.
AUA 2018: Evaluation of the Risks and Benefits of CT Urography for Assessment of Gross Hematuria
San Francisco, CA USA (UroToday.com) Gross hematuria is a common presenting chief complaint to urology offices worldwide. Part of the evaluation of gross hematuria is evaluation of the upper tract. Guidelines have historically utilized CT Urography (aka tri-phasic CT or CT Urogram) to evaluate the kidneys and ureters, yet more recent guidelines have begun to consider the radiation risk of such imaging – especially as it may be repeated for future episodes. More recent guidelines have begun to consider alternative such as renal ultrasound as an initial diagnostic test.
AUA 2018: Long Term Outcomes for Patients with Von Hippel Lindau and Pheochromocytoma: Defining the Best Candidates for Active Surveillance
San Francisco, CA (UroToday.com) Von Hippel Lindau (VHL) is a germline mutation in 3p25-26 (the short arm of chromosome 3). While it has many clinical manifestations, including angiomatosis, hemangioblastomas, pancreatic cysts (pancreatic serous cystadenoma), endolymphatic sac tumor, and bilateral papillary cystadenomas of the epididymis (men) or broad ligament of the uterus (women), it is significant to urologists for 2 specific conditions: renal cell carcinoma (RCC) and pheochromocytoma. Patients with VHL associated RCC are known to have a more aggressive, often bilateral disease – aggressive management is warranted as recurrences are high.
AUA 2018: Primary Adrenal Malignancy: Insights into the Epidemiology of a Rare Histological Subset
San Francisco, CA (UroToday.com) Renal cell carcinoma (RCC) has traditionally been surgically managed. Extirpative surgery, either radical nephrectomy (RN) or partial nephrectomy (PNx), remains the standard of care for localized disease. Targeted therapies (TT), including tyrosine kinase inhibitors (TKIs) and mTOR inhibitors, have become a cornerstone of RCC therapy, specifically for metastatic RCC, demonstrating extended progression-free survival. While the efficacy of targeted therapies is well established for metastatic RCC, its role as an adjuvant therapy is less clear.