SUO 2018: Debate: Enucleo-Resection vs. Wedge Resection for Partial Nephrectomy in 4 cm tumors - PRO

Phoenix, Arizona (UroToday.com) In this debate Dr. Gupta presented his opinion on why renal tumors of less than 4 cm should be enucleated rather than undergo standard partial nephrectomy. Tumor enucleation is a common procedure which is defined as tumor excision along the natural plane between the peritumoral pseudo-capsule and the renal parenchyma, without removing a visible rim of normal parenchyma.

SUO 2018: Debate: Enucleo-Resection vs. Wedge Resection for Partial Nephrectomy in 4 cm tumors - CON

Phoenix, Arizona (UroToday.com) Dr. Finelli summarized several key points on why enucleation should not be used as the standard of care for partial nephrectomy. He started his talk presenting a case of a 56 year old man with morbid obesity and no family history of cancer, who was found to have a left renal mass.

SUO 2018: Hereditary Kidney Cancer and Genetic Testing

Phoenix, Arizona (UroToday.com) Dr. Maria Carlo gave a brief overview of the more common and less common renal hereditary cancer syndromes and some guidelines on when should patients be referred for genetic testing. Figure 1 demonstrates the prevalence of germline mutations in renal cell carcinoma (RCC) cases in the cancer genome atlas (TCGA).

SUO 2018: Cytoreductive Nephrectomy Is No Longer Standard of Care in Patients with Metastatic Renal Cell Carcinoma

Phoenix, Arizona (UroToday.com) Dr. Tannir gave a discussion on why cytoreductive nephrectomy should not be the standard of care in metastatic renal cell carcinoma (RCC). Dr. Tannir believes that cytoreductive nephrectomy is for intermediate risk patients only. In the cytokine era cytoreductive nephrectomy was shown to prolong overall survival by 6-7 months (1,2). The benefit of cytoreductive nephrectomy is inversely associated with the efficacy of systemic therapies.

SUO 2018: Surgical Perspective on Management for Hereditary Kidney Cancer

Phoenix, Arizona (UroToday.com) Dr. Shuch gave a great talk on the surgical management of hereditary kidney cancer. Unfortunately, to date, there is no level 1 evidence regarding the treatment of hereditary renal cell carcinoma (RCC). A high volume of hereditary RCC cases treated with surgical management is a unique experience shared at several high-volume hospital centers. The data gathered on the surgical management of these cases is at best described in case reports, learnt through trial and error.

SUO 2018: A Phase 3, Randomized, Double Blind, Placebo Controlled Study of Enzalutamide in Men with Nonmetastatic Castration-Resistant Prostate Cancer: Post Hoc Analysis of PROSPER by Prior Definitive Surgery

Phoenix, Arizona (UroToday.com) The PROSPER trial, published in the New England Journal of Medicine in June 2018, demonstrated that in med with non-metastatic castrate resistant prostate cancer with a rising PSA, treatment with enzalutamide led to a 71% lower risk of metastasis or death than placebo.

SUO 2018: There Is Still a Role for Cytoreduction

Phoenix, Arizona (UroToday.com) Dr. Leibovich began the presentation explaining why there is still a role for cytoreduction in metastatic renal cell carcinoma (RCC). The benefit in overall survival of cytoreductive nephrectomy in the cytokine era is well known.1,2 These relatively older data demonstrated that cytoreductive nephrectomy entailed a 5 months survival advantage and that 19.6% of the patients were still alive at 5 years. 
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