SUO 2017: BMI is Not a Risk Factor for Active Surveillance Progression

Washington, DC (UroToday.com) The use of mpMRI has been increasingly used as an adjunct in the management of patients with prostate cancer on active surveillance (AS). Targeted fusion biopsy, especially in conjunction with systematic biopsy, has become an important component of the active surveillance algorithm.

SUO 2017: Determinants Of Active Surveillance In Patients With Small Renal Masses

Washington, DC (UroToday.com) Introduction: Active surveillance (AS) has been increasingly recognized as a viable management strategy for patients with small renal masses (SRM), that affords the delay or avoidance of definitive treatment. However, little is known about national utilization trends for AS, or the factors that influence initial expectant management.

SUO 2017: Small Renal Masses and New Guidelines in Management

Washington, DC (UroToday.com) Dr. Ithaar Derweesh from UC San Diego provided a comprehensive review of the new 2017 AUA Guidelines for small renal masses [1] at the 18th Annual Meeting of the Society of Urologic Oncology. The focus of this guideline was clinically localized renal masses suspicious for cancer in adults, including solid enhancing renal tumors and Bosniak 3 and 4 complex cystic renal masses. A main departure from the 2009 guidelines was that there were no index patients, considering there is great variance in patient/oncologic/functional characteristics, the panel recommends individualized counseling/management. 

SUO 2017: Prostate Cancer Treatment Variation in Accountable Care Organizations

Washington, DC (UroToday.com) Dr. Parth Modi presented on prostate cancer treatment variation in Accountable Care Organizations (ACOs). ACOs aim to improve outcomes and reduce costs of healthcare by improving care coordination and avoiding low-value care. Prostate cancer care, with its potential for overtreatment, represents an important area for potential improvement. However, ACOs are focused on primary care providers, and as such specialists may not benefit from ACO incentives. The objective of this study was to examine the impact of Medicare Shared Savings Program (MSSP) ACOs on the use of curative treatment and treatment cost for prostate cancer.           

SUO 2017: Ablative Technologies for Kidney Masses

Washington, DC (UroToday.com) Dr. Tom Atwell presented an update on the guidelines for ablative technologies for renal masses at the 2017 SUO winter meeting. Dr. Atwell started by noting that the European guidelines suggest that the “quality of the available data does not allow definitive conclusions regarding morbidity and oncological outcomes of cryoablation and radiofrequency ablation [1].” The most recent version of the ASCO guidelines [2] suggest percutaneous thermal ablation should be considered an option for those that possess tumors such that complete ablation will be achieved. 

SUO 2017: Safe And Effective Partial Nephrectomy Is Feasible In Appropriately Selected Patients With Complex (Renal Nephrometry Score 10-12) Renal Tumors: A Multi-institutional Analysis

Washington, DC (UroToday.com) Introduction: Current guidelines recommend partial nephrectomy (PN) for clinical T1a renal masses; however, the decision to perform PN or radical nephrectomy (RN) for localized, anatomically complex renal masses remains debated. This led the authors to examine differences in oncologic and perioperative outcomes between PN and RN for highly complex tumors.

SUO 2017: Point - Counterpoint: IVC Thrombectomy for Level 2 Tumor Thrombus Versus a Robotic Approach

Washington, DC (UroToday.com) Dr. Gill provided a spirited rebuttal to Dr. Leibovich’s argument for open IVC thrombectomy by arguing that we should be doing level II IVC thrombus cases via a robotic approach. Dr. Gill notes that for skilled robotic surgeons, level II thrombi can be confidently performed robotically; there are already series describing robotic IVC thrombectomy for level III cases1. Furthermore, according to Dr. Gill, we already have the skills necessary to perform these complex procedures robotically, as well as additional minimally invasive tools including intracaval balloon occlusion, patch grafting, and vena cavoscopy2.
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