EAU 2018: Variation in Pelvic Lymph Node Dissection Among Prostate Cancer Patients in The Netherlands: Are We Using a Double Standard for Radical Prostatectomy and Radiotherapy Patients?
Copenhagen, Denmark (UroToday.com) The Dutch guidelines advice to consider a pelvic node dissection (PLND) for all patients scheduled for curative intent intervention with a risk of node involvement. Apparently, this applies to both patients undergoing a radical prostatectomy and radiation therapy.
EAU 2018: The Importance of the Size of Nodal Metastases in Predicting Recurrence of Node-positive Prostate Cancer Patients Treated with Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: Implications For Post-operative Treatment Tailoring
Copenhagen, Denmark (UroToday.com) Patients found to have nodal involvement at the time of radical prostatectomy present a treatment quandary given the different prognostic pathways some of these patients may follow. It is then not surprising that the level one data reported by ECOG 3886 is seldomly followed, which advocated for early hormonal treatment in patients with node positive disease.
EAU 2018: Monitoring: Can we skip biopsies?
Copenhagen, Denmark (UroToday.com) Dr. Antti Rannikko summarized this morning’s debate on the utility of MRI-targeted fusion biopsies for men on active surveillance (AS).
EAU 2018: Point-counterpoint session Selection for active surveillance: Only Magnetic Resonance Imaging (MRI)-targeted lesions are relevant-Con
Copenhagen, Denmark (UroToday.com) Dr. Arsov presented the counterpoint to Dr. Moore regarding the appropriateness of relying on MRI-targeted lesions for men being selected for active surveillance (AS). He started by posing a question: Should we really let all men with negative MRIs get away without a biopsy? Indeed, evidence suggests that we should exercise caution; a negative MRI cannot completely rule out high grade disease.
EAU 2018: Point-counterpoint session Selection for active surveillance: Only Magnetic Resonance Imaging (MRI)-targeted lesions are relevant- Pro
Copenhagen, Denmark (UroToday.com) Dr. Moore presented a position on the utility of MRI-targeted fusion biopsies (Fbx) for patients considered for prostate cancer active surveillance (AS), arguing that MRI-targeted lesions are the most relevant variable when considering how to manage these men.
EAU 2018: Prostate Specific Membrane Antigen (PSMA) Expression in Transitional Cell Carcinoma (TCC) – Who Puts The S in PSMA?
Copenhagen, Denmark (UroToday.com) PSMA (prostate-specific membrane antigen) is a unique molecular specific to prostate tissue that has enabled novel imaging for prostate cancer, specifically in the setting of biochemical recurrence. PSMA-targeted PET scans, used for both diagnosis and potentially treatment, have been increasingly utilized in the setting of early biochemical recurrence, and in some cases, for staging purposes. As such, it has revolutionized prostate cancer management.
EAU 2018: What is the Optimal Field of Post-Prostatectomy Radiation Therapy? Long-Term Results from a Multi-Institutional
Copenhagen, Denmark (UroToday.com) Approximately 30% of patients will experience a PSA recurrence following a radical prostatectomy. Local management of a PSA recurrences remains ill-defined with some advocating for prostate fossa radiation while orders recommend additional whole pelvis coverage. Given the increased risk of radiation side effects with whole pelvic radiation, so have advocated its use for those with a high risk of nodal recurrence. Unfortunately, there is a paucity of prediction models to accurately select patients at high risk of nodal involvement at the time recurrence, PSA doubling time being the most accurate. Dr. Chiordia, from Urologic Research Institute at San Raffaele, presents a retrospective review of patients undergoing focal and whole pelvis radiation with the aim to find pathological prediction markers to better select patients for each.