CUA 2018: Comparative Survival Following Initial Cytoreductive Nephrectomy versus Initial Targeted Therapy for Metastatic Renal Cell Carcinoma

Halifax, Nova Scotia ( Bimal Bhindi, MD presented a population level analysis assessing survival following upfront cytoreductive nephrectomy (CN) versus targeted therapy (TT) for patients with metastatic RCC. The optimal sequence of CN and TT for patients with mRCC remains to be established. The CARMENA study demonstrated that sunitinib was non-inferior to CN followed by sunitinib.1. Therefore, the authors aimed to compare overall survival (OS) between patients with mRCC receiving initial CN with or without subsequent TT versus initial TT with or without subsequent CN.

CUA 2018: Surveillance Post-Radio Frequency Ablation for Small Renal Masses: Recurrence and Follow-Up

Halifax, Nova Scotia ( The management of renal cell carcinoma (RCC) continues to evolve as we begin to develop a better understanding of its natural history. We now know that growth kinetics can vary significantly for renal masses, and those with slow growth kinetics can often be watched without losing the opportunity for cure. As such, there has been a shift from surgery (radical or partial nephrectomy for every renal mass) to more conservative options to help reduce morbidity, unnecessary treatment and to spare nephrons. Active surveillance for small renal masses has become more established and is now a front-line treatment option in many guidelines. Similarly, when masses are small but growing, an alternative to surgery is focal therapy – radiofrequency ablation (RFA) being one such energy source option. 

CUA 2018: An Educational Intervention for Androgen Deprivation Therapy Patients: Dyadic Adjustment and Intimacy Outcomes

Halifax, Nova Scotia ( Richard Wassersug, MD, presented their study assessing the impact of an educational intervention for patients treated with androgen deprivation therapy (ADT). It is known that adjustment to ADT can have a negative impact on patient’s quality of life and on couples’ relationships. A pilot of a couples-based intervention for patients on ADT demonstrated improved dyadic adjustment and relational intimacy for patients in the treatment group and declines for patients in the control group.  Despite the intervention, partners experiences attenuated declines in dyadic adjustment and declines in relational intimacy.

CUA 2018: Predictors of a Positive Genetic Test Result in Patients with a Suspected Hereditary Kidney Cancer Syndrome: Results from a Provincial Medical Genetics Unit

Halifax, Nova Scotia ( Andrea Kokorovic, MD, presented a study attempting to assess risk factors associated with a positive genetic test in a real-life cohort of patients referred to medical genetics for evaluation of hereditary renal cell carcinoma (RCC).

CUA 2018: Patterns of Bladder Cancer Recurrence after Open and Robotic Radical Cystectomy

Halifax, Nova Scotia ( Pierre-Alain Hueber, MD, presented a study comparing open and robotic radical cystectomy in a single center. The rate /patterns of recurrence after robotic-assisted radical cystectomy (RARC) for bladder cancer may be different compared to open radical cystectomy (ORC). RARC has been thought lead to atypical recurrences, including peritoneal carcinomatosis, extra-pelvic lymph node metastasis and port side metastasis. 

CUA 2018: Optimizing the Use of Neoadjuvant Chemotherapy in Micropapillary Bladder Cancer: Validation of Proposed Risk Classifiers

Halifax, Nova Scotia ( Jonathon Duplisea, MD, presented a study aiming to optimize the use of neoadjuvant chemotherapy (NAC) in micropapillary bladder cancer.

Micropapillary urothelial carcinoma (MPUC) is a known aggressive variant of bladder cancer. The role of NAC in the treatment of this histologic variant is not well defined. There are 3 proposed MPUC clinical risk groups:
  1. Lower risk – Clinical T1, no hydronephrosis
  2. High risk – >= clinical T2, no hydronephrosis
  3. Highest risk – any clinical T stage, hydronephrosis

CUA 2018: Does Prior Inguinoscrotal Surgery Alter Recurrence Patterns and Survival Outcome for Patients with Testicular Cancer? The Princess Margaret Cancer Centre Experience

Halifax, Nova Scotia ( Surgical dogma has long engrained in practicing urologists that prior scrotal or inguinal surgery violates the traditional lymphatic drainage patterns of testicular cancer, yet little evidence exists in the modern literature to support these concerns. This was primarily based on small historical single-institution series from the 1980’s and early 1990’s. While the management of the disease has not changed drastically in that time, systemic therapy has improved, radiographic technology has improved, and there is an increasing utilization of active surveillance for clinical stage 1 testicular cancer (CS1 TCa). As such, the authors of this study decided to utilize their large TCa database (as a major tertiary referral center for TCa in Canada) to help answer this question – an added benefit is that, as a major proponent of AS, the natural history of these patients can be better ascertained. 

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