EAU 2018: Precision Medicine in Renal Cell Cancer, Can We Select The Treatment?

Copenhagen, Denmark (UroToday.com) Dr. Alessandro Volpe provided a discussion on precision medicine for patients with renal cell cancer. Precision medicine is a medical model that proposes the customization of healthcare with medical decisions, treatment and practices tailored to the individual patient. Precision medicine, specifically in patients with high risk/advanced/metastatic RCC, includes (i) selection of the optimal targeted/immunotherapy, (ii) indications for adjuvant therapy after radical nephrectomy, and (iii) indications for cytoreductive nephrectomy in the setting of metastatic RCC. Precision medicine, specifically in patients with localized RCC, includes (i) indications for nephron-sparing surgery in larger tumors (T1b-T2), (ii) indications for lymph node dissection in high-risk disease, and (iii) indications for non-surgical management in select patients. 

EAU 2018: Molecular Heterogeneity Between Primary Tumors and Metastases in Renal Cell Cancer

Copenhagen, Denmark (UroToday.com) Dr. Kerstin Junker from Germany discussed the molecular heterogeneity between primary tumors and metastases. According to Dr. Junker there are three types of tumor heterogeneity, including (i) intertumor heterogeneity, (ii) intratumor heterogeneity, and (iii) heterogeneity between primary tumors and metastases. Understanding the heterogeneity of metastatic disease allows selection of therapy targets and prediction of therapy responses. 

EAU 2018: Results from the TRACERx Renal Study: Deterministic Routes to Tumor Progression in Clear Cell Renal Cell Carcinoma

Copenhagen, Denmark (UroToday.com) Dr. Samra Turajlic from the Francis Crick Institute in London provided initial results from the TRACERx Renal study. Dr. Turajlic opened by noting that there are a wide range of clinical phenotypes/outcomes among patients with advanced renal cell carcinoma, including (i) indolent disease – oligo metastatic progression among which patients may benefit from cytoreductive nephrectomy and oligo-metastasectomy, and (ii) aggressive disease – disseminated metastases and early death among which patients do not benefit from cytoreductive nephrectomy and have a poor response to therapy. There are three important clinical dilemmas according to Dr. Turajlic: (i) treatment of metastatic disease, which may include surgery to defer systemic therapy, (ii) adjuvant therapy for high-risk disease, (iii) active surveillance of small renal masses.

EAU 2018: Latest in Medical Treatment - Renal Cell Cancer

Copenhagen, Denmark (UroToday.com)  Dr. Bedke gave an overview of the latest advancements in renal cell carcinoma (RCC). He discussed on the topics of cytoreductive nephrectomy (CN), adjuvant therapy (AT) and changes in 1st line therapy for advanced metastatic RCC.

EAU 2018: Acute Obstructive Pyelonephritis Can Be Caused By E. coli at ≤104 Bacteriuria Level Experimental Model

Copenhagen, Denmark (UroToday.com) Bacteria in the urine, or bacteruria, can be symptomatic or asymptomatic in patients. In patients where it is symptomatic, it may cause development of upper urinary tract infections which can lead to acute obstructive pyelonephritis (AOP). Dr. M.I. Kogan the team sought to determine the rate of AOP in an animal experimental model.

EAU 2018: The Impact of Acute Kidney Injury on Prognosis in Patients With Urological Sepsis

Copenhagen, Denmark (UroToday.com) Acute kidney injury (AKI) is common in patients who have undergone urological procedures. AKI is increasing in incidence and is associated with longer hospitals stays for patients as well as considerable morbidity and mortality. Although common not much is known about the effect of AKI in patients with urological sepsis.

EAU 2018: PCNL SIRS Risk Increasing in Patients with Positive Stone Culture and Sub-optimal Renal Drainage

Copenhagen, Denmark (UroToday.com) Dr. S Bolomytis presented data that determined which preoperative risk factors and postoperative outcomes were associated with PCNL SIRS. As an introduction to his talk, Dr. Bolomytis stated the gold standard for the treatment and management of large renal stones is percutaneous nephrolithotomy. However, one of the most complications related to this procedure is systemic inflammatory response syndrome (SIRS).

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