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UroToday is excited to bring you written conference highlights, by uro-oncologists from the 2020 EAU Annual Meeting - Virtual Experience
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The European Association of Urology Virtual Meeting |
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Challenges Across the Spectrum of Bladder Cancer Plenary Session |
Definition of Very High-Risk and Refractory Non-Muscle Invasive Bladder Cancer |
Marek Babjuk, MD, Ph.D.
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According to the EAU guidelines, the treatment recommendations for high risk non-muscle invasive bladder cancer include full dose BCG instillations for 1-3 years or radical cystectomy. BCG reduces the risk of progression in NMIBC, but 30% of T1G3 will require deferred radical cystectomy. In T1G3, five-year disease-related death after BCG occurs in 11.3% of patients.
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Early Cystectomy in High-Risk Non-Muscle Invasive Bladder Cancer: A Standard
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Shahrokh Shariat, MD |
In bladder cancer, our goal is to eradicate existing bladder tumors and prevent or delay tumor recurrence and progression while preventing pan-urothelial disease. High grade non-muscle invasive bladder cancer is a very heterogeneous disease. BCG for NMIBC has an initial response rate of 70-80%, but some patients do not derive benefit, and over time, many tumors can relapse as well.
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Immunotherapy and Beyond: New Options for Non-Muscle Invasive Bladder Cancer
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Peter Black, MD, FACS, FRCSC
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Peter Black gave an overview of the current and future treatment options for nonmuscle-invasive bladder cancer patients. To date, there are generally three different options for intravesical treatment: Single-dose chemotherapy, BCG or chemotherapy induction therapy and maintenance, and Device assisted. Dr. Black divided NMIBC into three categories: BCG naïve, BCG “exposed.”, and BCG unresponsive.
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Urinary Markers in Low-Grade Non-Muscle Invasive Bladder Cancer: Ready to Stop Cystoscopies
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J. Alfred Witjes, MD, Ph.D.
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Fred Witjes began his talk explaining that he believes cystoscopy is still needed in the primary diagnosis of bladder tumors. Cystoscopy gives important information regarding multiplicity, size, stage, the grade of bladder tumors, and OR planning.
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Frailty and Cognitive Assessment in Patients Diagnosed with Muscle-Invasive Bladder Cancer
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Géraldine Pignot, MD
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Radical cystectomy with or without neoadjuvant chemotherapy is considered the standard treatment for localized muscle-invasive bladder cancer. Radical cystectomy is a major abdominal surgery that has a high morbidity rate, with perioperative complications being around 50% to 70%. Half of the patients diagnosed with muscle-invasive bladder cancer are older than 75 and have associated comorbidities with polypharmacy and potential cognitive difficulties.
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Treatment Options for Elderly Patients with Muscle-Invasive Bladder Cancer
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María José Ribal Caparrós, MD, Ph.D.
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The world is aging, and it is predicted that by the year 2050 the percentage of patients aged 65 and over will rise by 188%, and the percentage of patients 85 and over will rise by 351%. In bladder cancer, chronological age is of limited relevance. It is critical to assess the patient's comorbidities by validated scores of all elderly patients before deciding on the appropriate treatment of their muscle-invasive bladder cancer.
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Different Bladder Cancer Genotypes: New Treatment Options
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Roland Seiler, MD |
In bladder cancer, there are two pathways, the papillary and non-papillary pathways. Papillary tumors develop to low-grade tumors, which can later progress to high-grade tumors. The non-papillary tumors develop into high-grade invasive tumors. When discussing the classification of muscle-invasive bladder cancer, it is important to be aware of the equilibrium of the urothelium.
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The Future of Personalized Treatment: Test the Tumor for a Response |
Michael Shen, MD
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Michael Shen began his discussion on the use of organoid models for studying tumor evolution and drug response. The entire process or isolation and analysis of human bladder organoids was described next. The efficiency of orthotopic xenografting is 83%. |
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