CUA 2018: The Association Between Baseline Renal Function And Oncologic Outcomes After Radical Cystectomy

Halifax, Nova Scotia (UroToday.com) In recent literature, there has been speculation about the role of renal function in regard to cancer disease progression. According to some, decreased renal function has been identified as a potential risk factor in cancer recurrence and mortality due to malignancy. Though this was previously reviewed, there has not been a published account of whether decreased renal function is responsible for worsening outcomes among patients with urothelial carcinoma (UC). To expand on this issue, Ross Mason, MD, from the Mayo Clinic in Rochester, Minnesota attempted to examine the association between preoperative renal function and oncological outcomes after radical cystectomy (RC). 

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

Halifax, Nova Scotia (UroToday.com) 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 (UroToday.com) 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: Trends and Disparities in the Receipt of Definitive Treatment for Clinically Localized, Muscle-Invasive Urothelial Carcinoma

Halifax, Nova Scotia (UroToday.com) Muscle-invasive bladder cancer (MIBC), which represents about 30% of new bladder cancer diagnosis, is a difficult disease to manage. Metastatic bladder cancer has a poor prognosis, so the opportunity for cure exists – yet treatment options remain quite morbid and have significant impact on quality of life. Yet, to date, the standard of care for MIBC has remained radical cystectomy and urinary diversion (RC) – neoadjuvant chemotherapy (NAC) is recommended, though not always provided. 

CUA 2018: Predicting Perioperative Complications in Patients Receiving Radical Cystectomy Using Preoperative Computed Tomography-Measured Adipose Tissue Indices

Halifax, Nova Scotia (UroToday.com) Radical cystectomy (RC) remains the standard of care treatment for muscle-invasive bladder cancer (MIBC), but is also an operation with significant morbidity and peri-operative complications. There have been numerous studies looking at predictors of perioperative complications and outcomes; amongst those, body mass index (BMI) has been assessed, and it has had mixed results as a predictor of outcomes. 

CUA 2018: A High-Fidelity Transurethral Resection of Bladder Tumour Simulator: Validation as a Tool for Training

Halifax, Nova Scotia (UroToday.com) In modern clinical practice, the training of future urologists is paramount to delivering quality care. Jonathan Moore, MD, a urologic resident at the Dalhousie University, understood the need for advanced training for urologic students and advocated a novel tumor simulator: the Simbionix TURBT Mentor (Simbionix LTD, Israel).

CUA 2018: Integrating Immune-Oncology with the Current Treatment of Advanced Urothelial Carcinoma

Halifax, Nova Scotia (UroToday.com) As part of the CUA 2018 education forum, Bobby Shayegan, MD, served as moderator for the immunotherapy in urothelial carcinoma session. Shayegan started by noting that bladder cancer therapies have historically lagged behind other malignancies, until the advent of immunotherapy. Secondary to bladder cancer’s somatic mutational burden, immunotherapy is attractive for bladder cancer and has been one of the first significant advancements regarding systemic therapy in several decades.
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