SUO 2017: The Effect of Agent Orange Exposure on Treatment Choice

Washington, DC ( Agent Orange exposure in Vietnam veterans is associated with the detection of aggressive prostate cancer in men undergoing a biopsy [1]. Public awareness of this link creates anxiety about the risk of cancer development and progression and thus may affect the treatment choice. Dr. Ahmadi and colleagues presented their experience with Agent Orange exposure and prostate cancer. The objective of the study was to assess the impact of Agent Orange exposure on shared decision making at the time of prostate cancer diagnosis. 

SUO 2017: Inaccuracy of Clinical Staging After Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer

Washington, DC ( Dr. Meyer and colleagues presented their work assessing inaccuracy of clinical staging after neoadjuvant chemotherapy for muscle invasive bladder cancer (MIBC). Based on randomized clinical trial data1, the standard of care for patients with MIBC is radical cystectomy (RC) + neoadjuvant chemotherapy (NAC). The authors report that they routinely perform restaging workup post-NAC prior to RC including imaging and cystoscopy with resection/biopsy. The objective of the current study was to evaluate the accuracy of restaging after NAC by comparing post-NAC with final RC pathology.

SUO 2017: Testosterone Responders to Continuous Androgen Deprivation Therapy

Washington, DC ( Dr. Sayyid and colleagues presented their study assessing testosterone responders to continuous androgen deprivation therapy (ADT) and exhibit considerable variations in testosterone levels on follow-up including Implications for clinical practice.

SUO 2017: Contemporary Trends in Abiraterone and Enzalutamide Prescription by Provider Specialty

Washington, DC ( Dr. Pucheril and colleagues discussed trends in abiraterone and enzalutamide prescription by provider and analysis of Medicare Part D 2013-15. For more than 70 years, androgen deprivation therapy (ADT) with LHRH-agonists and anti-androgens, is established in the management of prostate cancer and is administered by urologists, medical oncologists, and radiation oncologists. However, newer agents for ADT, abiraterone acetate and enzalutamide, were approved by the FDA in 2011 and 2012, respectively, for the management of metastatic castrate resistant prostate cancer (mCRPC) after failing chemotherapy. The objective of this study was to evaluate the contemporary economic burden of abiraterone and enzalutamide and their utilization by provider specialty.

SUO 2017: Does Insurance Status Lead to a Delay in Therapy - Patient Presenting with Metastatic Prostate Cancer?

Washington, DC ( Dr. Schober and colleagues discussed the impact of insurance status on delay in therapy for men presenting with metastatic prostate cancer. Insurance status has been recently linked to the risk of metastatic disease at initial diagnosis of prostate cancer [1]. However, the association of insurance status on the receipt and timing of appropriate care remains under explored in this population. As such, the objective of this study was to determine if insurance type is associated with the receipt and timeliness of therapy in patients presenting with metastatic prostate cancer.

SUO 2017: Chemotherapy Prior to Radical Nephroureterectomy in Patients with Advanced Upper Tract Urothelial Carcinoma

Washington, DC ( Dr. Miest and colleagues presented their institutional experience of chemotherapy prior to radical nephroureterectomy for patients with advanced upper tract urothelial carcinoma (UTUC). Although chemotherapy improves survival in muscle-invasive urothelial carcinoma of the bladder, its use in the management of UTUC either before or after radical nephroureterectomy remains unclear. The objective of this study was to determine the outcomes of neoadjuvant chemotherapy in patients with UTUC. 

SUO 2017: Hospital Readmissions after Radical Cystectomy: The Impact of an Enhanced Recovery Pathway

Washington, DC ( Dr. Khanna and colleagues from the Cleveland Clinic presented their research assessing hospital readmissions after radical cystectomy, with a specific focus on the implementation of an enhanced recovery pathway. Because radical cystectomy is associated with greater morbidity and health service utilization than any other surgical procedure in urology, enhanced recovery pathways have been instituted [1], demonstrating decreased length of stay. Despite this, it has been suggested that earlier discharge may lead to increased readmission rates. The objective of this study was to assess return to hospital outcomes following implementation of a peri-operative optimization pathway for patients undergoing radical cystectomy at a high-volume tertiary care center.

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