SUO 2017: Comparing Effective Treatment Strategies for Squamous Cell Carcinoma of the Bladder

Washington, DC (UroToday.com) Dr. Stensland and colleagues presented their work assessing comparative effectiveness of treatment strategies for squamous cell carcinoma of the bladder. Because treatment recommendations for muscle invasive bladder cancer (MIBC) are primarily based on urothelial carcinoma histology, the effectiveness of treatment strategies for variant histologies has been understudied. The objective of this study was to assess the effectiveness of primary treatment strategies for squamous cell carcinoma. 

SUO 2017: Validation of The Preoperative Nomogram Predicting 12-Year Probability of Metastatic Renal Cancer

Washington, DC (UroToday.com) Dr. Ghanaat and colleagues presented their validation of a preoperative nomogram predicting 12-year probability of metastatic renal cancer. The authors previously published a predictive model to determine the preoperative risk of metastatic recurrence in localized renal cell carcinoma [1], as size of the primary renal mass, evidence of lymphadenopathy or necrosis on preoperative imaging and the mode of presentation were important predictors for the subsequent development of metastases. The objective of this study was to validate this initial nomogram and interrogate the additive value of somatic mutations in a subcohort with available genomic data. 

SUO 2017: Keynote-564: Phase 3, Double-blind, Placebo-controlled Trial Of Pembrolizumab As Adjuvant Treatment For Renal Cell Carcinoma

Washington, DC (UroToday.com) Dr. Zhang and colleagues presented their phase III trial design of adjuvant pembrolizumab for patients with renal cell carcinoma (RCC) at this afternoon’s SUO 2017 annual meeting poster session. Effective adjuvant therapies for patients with RCC at risk of recurrence after nephrectomy are lacking, and previous adjuvant therapy trials utilizing TKIs have proven disappointing [1-3]. Programmed death ligand 1 (PD-L1) and 2 (PD-L2) expression predicts poor prognosis in RCC. Programmed death 1 (PD-1) inhibitors have demonstrated activity in metastatic RCC [4], and PD-1 may represent a novel therapeutic target in the adjuvant setting. Pembrolizumab is a PD-1 inhibitor that directly blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2. The objective of this randomized, double-blind, placebo-controlled phase III trial is to evaluate the efficacy and tolerability of pembrolizumab as adjuvant therapy in patients with high-risk RCC following nephrectomy and/or metastasectomy.

SUO 2017: Sarcomatoid Differentiation in Renal Cell Carcinoma: Does Stage Make A Meaningful Difference On Survival?

Washington, DC (UroToday.com) Sarcomatoid differentiation is present in approximately 4% of patients with renal cell carcinoma (RCC) and is associated with poor clinical outcomes. Dr. Blum and colleagues presented their institutional analysis assessing the impact of stage on survival for this aggressive RCC histology. The objective of this study was to evaluate the impact of sarcomatoid differentiation, especially for patients with lower stage pT1-2 disease. 

SUO 2017: MRI Fusion Biopsy is Associated with a Higher Rate of Pathologic Downgrading at Radical Prostatectomy

Washington, DC (UroToday.com) MRI targeted fusion biopsy has higher sensitivity and specificity in predicting Gleason score compared with standard 12-core biopsy [1]. Dr. Beksac and co-authors presented results of their study assessing MRI fusion biopsy and pathologic staging at the time of radical prostatectomy. Gleason score discordance may still occur post radical prostatectomy, which can impact decision-making. The objective of this study was to analyze the patterns of Gleason downgrading after standard biopsy versus fusion biopsy.

SUO 2017: Outcomes of Serial MRI/Ultrasound Fusion Targeted Biopsy

Washington, DC (UroToday.com) Dr. Hsiang and colleagues presented their results of men undergoing serial magnetic resonance imaging (MRI)/ultrasound fusion targeted biopsies in men with very low-risk and low-risk prostate cancer managed with active surveillance (AS). The outcomes and utility of serial MRI/ultrasound fusion targeted prostate biopsy in men with prostate cancer on AS have not been clearly defined. The objective of this study was to assess the rate of Gleason upgrading both on sequential fusion targeted and systematic biopsies among these specific men with prostate cancer.

SUO 2017: The Role of Inguinal Lymph Node Dissection in Men with Urethral Squamous Cell Carcinoma

Washington, DC (UroToday.com) Urethral squamous cell carcinoma (SCC) is a rare disease with limited clinical recommendations. Dr. Werntz and colleagues presented their population-level analysis assessing the impact of inguinal lymph node dissection in men with urethral SCC. Despite the similarities to penile cancer in terms of histology and lymphatic drainage, no consensus exists on the role of inguinal lymph node dissection for men with high-risk tumors. The objective of this study was to define the rate of inguinal lymph node dissection performance and its impact on survival. 
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