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Highlights from the 2022 European Association of Urology Annual Meeting |
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Perioperative Treatment of Urothelial Cancer in 2022 Plenary Session
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| State-of-the-art Lecture Landscape of Current Trials with Intravesical Treatment in High Risk BCG naïve NMIBC |
| Ashish M. Kamat, MD, MBBS |
Ashish Kamat expertly discussed the landscape of current trials with intravesical treatment in high-risk BCG naïve non-muscle invasive bladder cancer (NMIBC). Dr. Kamat emphasized the importance of classifying all HG Ta tumors as high risk NMIBC for the purpose of clinical trials design and that any trial in the BCG naïve space must have a control arm. BCG remains an excellent treatment option in this disease space and remains the “one to beat” in 2022.
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New Insights in the Management of Upper Tract Urothelial Cancer
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| Detection of Individualized Mutation Using Plasma and Urinary Circulating Tumor DNA in Patients with Upper Tract Urothelial Carcinoma |
| Daichi Tamura, MD |
| Daichi Tamura presented his group’s work evaluating the utility of plasma and urinary circulating tumor DNA (ctDNA) in the detection of individualized mutations in patients with UTUC. This study showed changes in VAFs of case-specific mutations using plasma and urine samples before and after RNU VAFs of ctDNA could be related to tumor burden. Plasma and urinary ctDNA are useful biomarkers of UTUC. |
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| Elevated Hemoglobin: Creatinine Ratio Is a Novel Preoperative Marker for Worsened Survival Outcomes in Upper Tract Urothelial Carcinoma: Analysis from the ROBUUST Registry |
| Ithaar H. Derweesh, MD |
| Ithaar Derweesh presented results from the ROBUUST (ROBotic surgery for Upper Tract Urothelial Cancer study) registry evaluating creatinine to hemoglobin ration elevations as a novel preoperative marker for worsened survival outcomes in UTUC. |
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| Renal Function Variation After Nephroureterectomy for Upper Urinary Tract Carcinoma: Evaluation in a Large Multicenter Cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium) |
| Clara Cerrato, MD |
| Clara Cerrato presented results from the Radical Nephroureterectomy Outcomes (RaNeO) registry evaluating renal function variations after radical nephroureterectomy (RNU) for UTUC. The aim of this study was to evaluate the frequency and predictors of renal function variations after RNU for UTUC. Although elderly patients experience less pronounced post-operative eGFR declines, eGFR in younger patients recovers better during follow up. |
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| Benefit of Lymph Node Dissection in cN+ Patients in the Treatment of Upper Tract Urothelial Carcinoma: Analysis of NCDB Registry |
| Austin J. Piontkowski and Firas Abdollah, MD |
| Firas Abdollah and Austin Piontkowski presented results from the National Cancer Database (NCDB) evaluating the role of lymph node dissection (LND) in UTUC patients with cN+ disease. LND in patients with cN+ UTUC disease undergoing RNU was not associated with improvement in OS on both univariable and multivariable analyses, although most patients with cN+ disease receive a LND as per results from the NCDB. |
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| Clinical Significance of Tumor Location for Ureteroscopic Tumor Grading in Upper Tract Urothelial Carcinoma |
| Satoshi Katayama, MD |
| Satoshi Katayama evaluated the clinical significance of tumor location with regards to disease upgrading/downgrading at time of radical nephroureterectomy (RNU) in UTUC. The authors conducted a multi-institutional, retrospective analysis of UTUC patients who underwent a diagnostic ureteroscopy with biopsy followed by an RNU at 29 centers between 2005 and 2020. |
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| Eleven Years of Experience with UTUC: Survival and Renal Function After Kidney Sparing Surgery Versus Radical Nephroureterectomy
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| Nora Hendriks, MD, MS
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| Nora Hendriks presented the oncologic and renal function outcomes of UTUC patients undergoing kidney sparing surgery (KSS) versus radical nephroureterectomy (RNU) at a single center. Based on the proposed clinical composite risk stratification by the EAU guidelines, patients with high-risk disease should be offered treatment by RNU.
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| Contemporary Trends of Systemic Neoadjuvant and Adjuvant Intravesical Chemotherapy for UTUC Undergoing Minimally Invasive or Open Radical Nephroureterectomy: US Claims Analysis on Perioperative and Health Care Costs Outcomes |
| Francesco Del Giudice, Ph.D. |
| Francesco Del Giudice discussed contemporary trends of systemic neoadjuvant and adjuvant intravesical chemotherapy for upper tract urothelial carcinomas undergoing minimally invasive or open radical nephroureterectomy. |
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| The Impact of Adjuvant Chemotherapy on Overall Survival in Patients with Node-Positive Upper Tract Urothelial Carcinoma: Improving Precision in Medicine with a Risk-Stratified Approach |
| Shravan Morisetty |
| Shravan Morisetty discussed the impact of adjuvant chemotherapy on overall survival in patients with node-positive upper tract urothelial carcinoma. Previous studies reported a possible beneficial impact of adjuvant chemotherapy on overall survival in patients with node-positive upper tract urothelial carcinoma. Dr. Morisetty and colleagues hypothesized that in these individuals the impact of adjuvant chemotherapy on overall survival can vary based on patient demographics, and tumor characteristics. |
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| Biodegradable Device for Controlled Release of Cisplatin As Local Chemotherapy for Bladder Cancer |
| E. Gilad Amiel, MD |
| Gilad Amiel discussed a biodegradable device for controlled release of cisplatin as local chemotherapy for bladder cancer. Dr. Amiel and colleagues have developed a biodegradable device that gradually releases cisplatin into the urinary tract in order to eliminate cancer cells. The device is lodged in the renal pelvis, as an alternative strategy for injecting substances into the bladder. |
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| Implementing the Follow-up Schedule After Radical Nephroureterectomy for Low Risk Upper Tract Urothelial Carcinoma |
| Alberto Martini, MD |
| Alberto Martini discussed implementing the follow-up schedule after radical nephroureterectomy for low risk upper tract urothelial carcinoma. Based on the data, it was found that this scheme should not be applied to low risk upper tract urothelial carcinoma since a high risk of bladder recurrence persists even after 5 years and urologists should counsel patients on undergoing cystoscopy beyond this time point. |
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| Impact of Node Count on Survival Outcomes of Lymph Node Dissection in Non-Metastatic Upper Tract Urothelial Carcinoma: Analysis of the ROBUUST Registry |
| Kevin Hakimi |
| Kevin Hakimi discussing the impact of node count on survival outcomes of lymph node dissection in non-metastatic upper tract urothelial carcinoma. The utility of lymph node dissection in localized upper tract urothelial carcinoma is controversial, thus this study evaluated the impact of lymph node count on survival outcomes in patients with non-metastatic upper tract urothelial carcinoma using a multi-institutional database. |
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