1 BEST PAPERS OFF 2016 for Renal cancer & Bladder cancer ΙΩΑΝΝΗΣ ΒΑΡΚΑΡΑΚΗΣ ΑΝΑΠΛΗΡΩΤΗΣ ΚΑΘΗΓΗΤΗΣ ΟΥΡΟΛΟΓΙΑΣ ΕΘΝΙΚΟ & ΚΑΠΟΔΙΣΤΡΙΑΚΟ ΠΑΝΕΠΙΣΤΗΜΙΟ ΑΘΗΝΩΝ ΣΙΣΜΑΝΟΓΛΕΙΟ ΝΟΣΟΚΟΜΕΙΟ
2 ΔΕΝ ΕΧΩ ΣΥΓΚΡΟΥΣΗ ΣΥΜΦΕΡΟΝΤΩΝ
4 EAU guidelines recommend treatment in: large tumors women of child-bearing age follow-up or access to emergency care is inadequate A size threshold for treatment remains controversial, with previous recommendazons suggeszng 3 4 cm. The 4 cm threshold is based on a study by Oesterling et al based on 13 pt The true natural history may remain unknown because symptoma?c cases are more likely to be idenzfied and included in case series.
5 MATERIALS & METHODS Radiology record crawler system (Montage; Montage Healthcare Systems, Philadelphia, USA) 2741 pazents with renal AML. 447 pazents with 582 tumors with >3 abdominal imaging. FU: median 43 mo (range: mo)
6 RESULTS (10%) Tumors>4cm more likely Younger age TSC SymptomaZc intervenzon No difference in the average growth rate of lesions <4cm vs >4cm 91% did not grow or grew slowly (0.02cm/y) 9% grew with rate >0.25cm/y 93% were eleczve intervenzons 25/447(5.6%) had interven?on More frequently young age TSC SymptomaZc >4cm
7 RESULTS SYMPTOMS In 10% overall In 30% if AML>4cm Most common hematuria & pain Non TSC Pain > hematuria TSC Hematuria > Pain (p=0.16) Retroperitoneal bleeding Rare 0.4% Majority do not have prior Sx Can happen with RCC as well with same frequency Interven?on 5% SAE, RFA, mtor inhibitors, PNx
8 TAKE HOME MESSAGE Most sporadic AMLs are ASx do not grow or grow slowly regardless of inizal size. Pt with ASx or mildly Sx AMLs even if >4cm should be offered inizal AS Pt should be aware of small risk of progression especially in fast growing AMLs (>0.25cm/y)
9 Uniform temperatures >60C required my not be reached (heat sink) RFA outcomes associated with Tumor size Increased failure rates Clear cell histology Degree of tumor enhancement (change HU from non-contrast to contrast enhanced arterial phase ) FAILURE?
12 STUDY LIMITATIONS Retrospec?ve study. Limited number of pt. Standard protocol for contrast use in CT was used some varia?on is expected: Degree of enhancement within the tumor depends on 0ming amount of contrast used Part of tumor measured tumors are heterogeneous and degree of enhancement can vary.
13 TAKE HOME MESSAGE Tumors with contrast enhancement >60HU have higher incomplete abla?on a er RFA Contrast enhancement cannot predict DFS Tumor size >3cm remains a significant risk factor for DFS
14 Heterogeneous behavior of RCC lesions Low grade & stage indolent course High grade & stage risk of growth and systemic spread Residual tumor in the context of PSM mimics the primary lesion Lack of consensus for clinical relevance of a PSM acer PNx Variability in pathological characteriszcs in various studies Contemporary studies lack the sta?s?cal power High risk pazents with and without PSM PSM in high and low risk pazents
15 A retrospec?ve mul?-ins?tu?onal review 1240 pt PNx (O/L/R) Median FU 33mo +sm 7.8% (97) 2/3 in Low risk pt (71%) 1/3 in High risk pt (29%) Recurrence 5.6% (69) Median Zme 19mo MATERIALS & METHODS PSM was unrelated to tumor size, stage, grade, histology, focality (all p > 0.05).
16 univariable -sm RESULTS +sm 61% 39% A +margin was associated with an increased risk of relapse on mulzvariable analysis (HR 2.08, 95% CI 1.09e 3.97, p. 0.03) but not with site of recurrence. increased risk of local as well as metasta?c relapse.
17 RESULTS Subgroups in which PSM was a predictor of recurrence Median Zme to recurrence was 19 months for high risk cases.
18 RESULTS 45% in 5 years a posi?ve surgical margin was significantly associated with a higher risk of recurrence in cases considered high risk (p < 0.001) but not low risk (p ).
19 STUDY LIMITATIONS Retrospec?ve nature Heterogeneity Surgical technique Pt seleczon Follow up Incomplete informa?on Nephrometry score Intraopera?ve biopsy Management of intraopera?ve biopsy Depth and magnitude of PSM Not powered for analysis of recurrence loca?on
20 TAKE HOME MESSAGE PSM associated with local and metasta?c tumor recurrence a er PN This relazonship observed specifically for tumors with high risk features RFS was similar among low risk features regardless of margin status In complex ct2 maybe RNx beger?
21 Most common site of metastasis in pt with RCC is the lung (45-75%) Indeterminate pulmonary nodules (IPN): 1mm-2cm round pulmonary opacity that may be benign or malignant Determine predictors of progression of an IPN to pulmonary metastasis in pt with localized or locally advanced RCC treated with nephrectomy.
22 MATERIALS & METHODS 251 pt with IPM in prop CT FU at least 3years (Q3-6mt CT or CXR) IPM <2cm Considered Pulmonary M when Increase of size Increase of number Histological diagnosis RESULTS IPN developed in M+ 29% (FU 35.3mo) IPN not develop in M+ 71% (FU 38mo)
23 RESULTS T N G LVI Sarc IVC pt3a
25 RESULTS 3y 65%
26 RESULTS 79%
27 Nomogram for LMFS Calibra?on plot of the predicted probability of 3y vs actual % of pt who survived 3y without LM
28 STUDY LIMITATIONS RetrospecZve study Single insztuzon SelecZon bias NOT standard preoperazve and postoperazve imaging strategy Heterogeneous treatment strategy a er diagnosis of pulmonary M may change DSS
29 TAKE HOME MESSAGE IPN have a higher probability of becoming M+ in pt with high T stage high N stage high Grade thrombi Presence of fat invasion Presence of LVI Presence of more and larger nodules in preop CT Although this knowledge will not change clinical management Beger risk stra?fica?on will change FU?ming and influence adjuvant TX strategies.
30 Tumor in the IMPDU is unusual (finding of tumor in UO during TURBT) Complete TURBT (wide resec?on of the UO) PotenZally higher risk of Ureteral scarring/stricture UTUC recurrence (reflux?) Predic?ve factors for development of Ureteral scarring/stricture UTUC recurrence (reflux?)
31 MATERIALS & METHODS RetrospecZve analysis: 2,317 TURBT pt 112 pt with tumors of the IMPDU Complete TURBT with wide resec?on of UO Double-J catheter for 15d: extensive resec?on of the trigone macroscopic tumor remaining in the distal ureter All cases BCG FU U/S 1 mo a er. If hydro noted CTU 3 mt and Q6mt Stricture if intervenzon needed
32 RESULTS 4.83% (112pt) reseczon of UO Ta in 64% of cases T1 in 27.7% CIS in 17% 31% Double-J catheter (36 pt) Double J did not influence ureteral stenosis recurrent UTUC Distal ureteral stenosis in 11.6% at a median of 47 days UTUC developed in 15.2% (22mt FU) Distal ureter in 65.4% Invasive or high grade 59%-NUx
33 RESULTS Recurrent Tumor associa?on with Ureteral Stenosis and UTUC 42% were recurrent SS differences between primary and recurrent tumors with respect to the incidence of: ü symptoms at diagnosis (60% vs 26%, p <0.001), ü development of ureteral stenosis (4.6% vs 21.3%, p ) ü incidence of UTUC (4.6% vs 29.8%, p <0.001). Treatment of 13 pazents with ureteral stenosis: de-obstruczve TURBT in 6 (46%), ureteral reimplanta?on in 5 (38%) balloon dilazon in 2 (15%)
35 STUDY LIMITATIONS Retrospec?ve study Small number of pt with stenosis & UTUC recurrence Stent placement only when extended resec?on selec7on bias Not able to evaluate vesicoureteral reflux and therefore not possible to associate recurrent UTUC with reflux or primary mulzfocal disease
36 Tumor at the UO occurs with at 4.8% of TURBTs A er complete Resec?on of the UO a er a mean FU 56mo: Stenosis occurred at 11.6% UTUC occurred 15.2% On mul?variate analysis Tumor size >1.5cm and T1 stage were factors for stenosis T1 in the bladder and CIS in the IMPDU were factors for UTUC recurrence Double J stent did not influence the occurrence or not of stenosis TAKE HOME MESSAGE
37 Immediate RC is considered the gold standard a er BCG failure Salvage IVT in pazents who want to maintain their bladder Early RC a er BCG fails vs. delayed RC a er salvage IVT fails
38 MATERIALS & METHODS GROUP 1: Early RCx acer BCG failure GROUP 2: Late RCx acer salvage IVT T1 61 pt 56 pt cis Path report of last TURB before RCB
39 RESULTS Median?me from diagnosis prompzng for BCG to RCx 0.81years in group A 2.51 years in group B 1.7y retained their bladder more in group B Group B Underes?mated 37 pt NOT included Did not require RCx acer salvage IVT (for 5.7years)
40 RESULTS Predictors of upstaging LVI most strongly predicted muscle invasion 8 /10 pt with at least 1 TUR specimen with LVI progressed to pt2 or greater at RC
41 RESULTS OS 5y 80% CSS 5y 85% Median FU acer RCx Group A 4.68y Group B 5.14y A er RC bladder cancer recurred in 32 pazents, 15 in group 1 17 in group 2.
42 RESULTS Significant predictors of death
43 TAKE HOME MESSAGE Pa?ents that select to defer RCx and do further IVT a er they fail BCG, have similar OS and CSS while keeping their bladder for longer. Risk factors of poor prognosis in this popula?on include repezzve instances of ct1 and CIS, upstaging to ct1 prosta?c urethra involvement. LVI on any TUR specimen (very poor prognoszcator) (8/10 pt had MIBC at RC & 7/10 died of BC) 2 or more of these risk factors should prompt serious considerazon of abandoning further IVT in favor of RC..
44 Delay of RCx >12 weeks from diagnosis is associated with inferior survival (higher pt3-4, pn+) Determine the effect on survival of the?ming of radical cystectomy from the diagnosis of MIBC in pazents who received NAC
45 MATERIALS & METHODS CX + NAC JHH database Pa?ent Popula?on PaZent charts for 1) pretreatment characteris?cs (demographics, clinical stage, histology and previous IVT) 2) intervals between diagnosis of MIBC and the inizazon of NAC and RCx; 3) Post-treatment and treatment clinical and pathological characteriszcs. Study End Points Complete pathological response a er NAC (no tumor) Par?al pathological response a er NAC (no MIBC) Pathological response rate (%of pazents with CR & PR) Overall survival
47 RESULTS At cystectomy 22% complete pathological response (T0) 29% par?al pathological response (Tis/T1) 51% pathological response rate Median OS 43.2 mo Be er OS age < 62 years (p ) pure urothelial histology (p ) Worse OS < 3 cycles NAC extravesical /N+ disease (p ).
48 Dx 6wk NAC RESULTS 28wk 22wk 4GC-12wk 10wk RCx Associa?on of OS and Treatment Intervals P=0.36 P=0.8 P=0.38 None of the treatment intervals was significantly associated with OS
49 STUDY LIMITATIONS RetrospecZve Inherent selec?on bias (Young/caucasian pt) Small sample GC predominantly used in this study (safety profile) Short FU Pt treated with NAC who had progression or toxicity were not captured in this database
50 TAKE HOME MESSAGES There was a 51% pathological response rate (22% CR, 29% PR) NO associa?on between OS and?me between MIBC diagnosis and cystectomy in pazents with MIBC receiving NAC. Less than 3 cycles of NAC and extravesical and or pn+ Dx is associated with worse OS. However delays in treatment should not be legi?mized based on this study. In pa?ents not receiving NAC, prompt surgical intervenzon remains the standard of care.
51 166 T1 HG randomised Low dose 40mg 8wk Standard dose 80mg Complete response rates low dose 79% standard dose 85% Low dose less fever (p = 0.001) micturi?on pain (p = 0.047) higher quality of life scores. No differences recurrence, Progression Overall survival
52 Comparing the short-term outcomes and complica?ons of monopolar and bipolar transurethral resec?on of non-muscle invasive bladder cancers: a prospec?ve, randomized, controlled study. Bolat D 1, Gunlusoy B 1, Degirmenci T 1, Ceylan Y 1, Polat S 1, Aydin E 1, Aydogdu O 1, Kozacioglu Z 1. Bipolar TURBT had significantly lower obturator jerk and bladder perfora?on than monopolar. B- TURBT is a reasonable treatment modality in pazents with NMIBC.
54 5% improvement in OS with NAC included only 4% with cn1-3 disease. Thus, NAC results may not necessarily extend to cn1-3. Clinical outcomes in pt with BCa & cn1-3 treated with induc?on chemotherapy followed by radical cystectomy are limited. In this study we assess pathological and survival outcomes
55 PATIENTS & METHODS Mul?-ins?tu?onal retrospeczve analysis (19 centers) PaZents with ct1-4an1-n3 urothelial carcinoma who received NAC followed by RCB. Lymph node status based on imaging criteria Chemotherapy regimens: MVAC GC other (not cisplazn) End points pathological response rates complete (pt0n0) par?al (pt1n0 or less) overall survival. factors prediczng outcomes
56 Number of pa?ents 304/1618 (19%) had cn /304 (82%) had pn0-3 RESULTS Chemo regimens GC 43% MVAC 42% Other 15% (median 4 cycles) Pathological Complete and Par?al Response pcr (pt0n0) 14.5% ppr (pt1n0 or less) 27% (pcr was only seen in pa7ents with cn1-n2). On mulzvariable analysis none of the selected variables were independent predictors of pcr or ppr pcr & ppr was similar with all chemo regimens
57 RESULTS Pathological Nodal Response. pcnr (pn0) 48% 56% of cn1 39% of cn2 39% of cn3 (p.0.03) OS improved in cn2-3 cases that became pn0 vs those remained pn+. Of pt0 bladder status pa7ents 38% were found to have posi7ve lymph nodes (pt0n+)
58 RESULTS P< mo 107mo 45mo 14mo Median OS for the enzre cohort was 23 mo 55% local recurrence or M+ disease (151 pt) Overall 50% pt died during FU (median of 10 mo) 88% of them died of bladder cancer 28% with pt0 23% with pn0 18% with pcr
59 RESULTS OS longer for cn1 vs cn2-3 but NSS (p=0.23) Remained NSS a er controlling for age, gender, T stage (p=0.11) At the cutoff point of 15 lymph nodes removed OS was p=0.01 OS associated with pcr of nodes (pn0) Number of nodes removed (-)sm Cispla?n Tx (MVAC vs GC same)
60 RESULTS Pa?ents with Unknown Pathological Nodal status Median survival similar to the pn+ cohort worse than the pn0
61 RetrospecZve study No standardizazon of chemotherapy (dose, data on toxicity, morbidity and mortality) SelecZon bias in the choice of chemotherapy regimens. Some Pt with cn1-3 not proceed to RC (seleczon bias-favorable subset of cn1-3pt) Not centralized radiological and pathological review Not always biopsy confirmazon of nodal involvement Risk factors not included performance status medical comorbidizes, Hydronephrosis Cardiovascular status Renal funczon STUDY LIMITATIONS
62 Induc?on chemotherapy in N+ pazents associated with a clinically significant pathological response. Complete pathological nodal response can be achieved, even in pazents with cn2-3 disease, and this corresponds to improved survival. 48% of cn1-3 cases converted to pn0 down staging to pt0 occurred in 24% of cases 38% of pt0 had +N pcr (pt0no) only 14.5% In pazents with cn1-3 disease the best outcomes are seen in those Receiving cispla?n based chemo Same GC and MVAC Have nega?ve margins Complete nodal response at RC. TAKE HOME MESSAGES
63 Eur Urol Jan;69(1):60-9. doi: /j.eururo Epub 2015 Jul 23. EORTC Nomograms and Risk Groups for Predic?ng Recurrence, Progression, and Disease-specific and Overall Survival in Non-Muscle-invasive Stage Ta-T1 Urothelial Bladder Cancer Pa?ents Treated with 1-3 Years of Maintenance Bacillus Calmege- Guérin. Cambier S 1, Sylvester RJ 2, Colle e L 1, Gontero P 3, Brausi MA 4, van Andel G 5, Kirkels WJ 6, Silva FC 7, Oosterlinck W 8, Presco S 9, Kirkali Z 10, Powell PH 11, de Reijke TM 12, Turkeri L 13, Colle e S 1, Oddens J 14. Data for 1812 pazents were merged from two European OrganizaZon for Research and Treatment of Cancer randomized phase 3 trials in intermediate- and high-risk NMIBC. With a median follow-up of 7.4 yr, 762 pazents recurred; 173 progressed; and 520 died, 83 due to bladder cancer (BCa). StaZsZcally significant prognoszc factors idenzfied by mulzvariable analyses were prior recurrence rate and number of tumors for recurrence, and tumor stage and grade for progression and death due to BCa. T1G3 pazents do poorly, with 1- and 5-yr disease-progression rates of 11.4% and 19.8%, respeczvely, and 1- and 5-yr disease-specific death rates of 4.8% and 11.3%. LimitaZons include lack of repeat transurethral reseczon in high-risk pazents and exclusion of pazents with carcinoma in situ. NMIBC pazents treated with 1-3 yr of maintenance BCG have a heterogeneous prognosis. PaZents at high risk of recurrence and/or progression do poorly on currently recommended maintenance schedules. AlternaZve treatments are urgently required.
Reviewing Immunotherapy for Bladder Carcinoma In Situ Samir Bidnur Dept of Urologic Sciences, Grand Rounds March 1 st, 2017 Checkpoint Inhibition and Bladder Cancer, an evolving story with immunotherapy
Alicia K. Morgans, MD Assistant Professor of Medicine Division of Hematology/Oncology Vanderbilt University Medical Center January 24, 2015 Overview Background Perioperative chemotherapy in MIBC Neoadjuvant
NMIBC Piotr Jarzemski Department of Urology Jan Biziel University Hospital Bydgoszcz, Poland 71 year old male patient was admitted to the Department of Urology First TURBT - 2 months prior to the hospitalisation.
Treatment of Invasive Bladder Cancer in the Elderly and Frail Pa9ent Jehonathan H Pinthus MD, Ph.D, FRCSC Associate Professor Department of Surgery/Urology McMaster University Life expectancy Current age
Chemotherapy and Bladder Cancer Blayne Welk UBC Urology Grand Rounds June 4, 2008 Outline Review of Incidence and Impact of bladder cancer Neoadjuvant chemotherapy Adjuvant chemotherapy Bladder preservation
Current Findings on High Intensity Focused Ultrasound (HIFU) Thomas J Polascik, MD, FACS Professor of Surgery Outline Whole gland abla6on selec6on and outcomes Focal abla6on - Eligibility and pa6ent selec6on
Guidelines for the Management of Bladder Cancer West Midlands Expert Advisory Group for Urological Cancer West Midlands Clinical Networks and Clinical Senate Coversheet for Network Expert Advisory Group
Bladder Cancer Guidelines Agreed by Urology CSG: October 2011 Review Date: September 2013 Bladder Cancer 1. Referral Guidelines The following patients should be considered as potentially having bladder
Intravesical Therapy 2010-When, with What, When to Stop Friday, April 9, 2010 Ralph de VereWhite, MD Director, UC Davis Cancer Center Associate Dean for Cancer Programs Professor, Department of Urolgoy
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org Conservative Treatment of Invasive Bladder Cancer Luis Souhami, MD Professor Department of Radiation Oncology
WHAT IS THE ROLE OF ACTIVE SURVEILLANCE IN THE CONTEXT OF RENAL ABLATION AND PARTIAL NEPHRECTOMY? Alessandro Volpe University of Eastern Piedmont Novara, Italy RCC INCIDENCE SEER DATABASE (1975-2006) RCC
T1HG Bladder Cancer What is the Best Therapy? Ashish M. Kamat, MD, MBBS, FACS Professor of Urology Director, Urologic Oncology Fellowship Guidelines for T1HG Bladder Cancer AUA Recommendation: BCG induction
THE INTERNATIONAL CONFERENCE PROGRESS IN URO-ONCOLOGY 5th Edition September, 25th 26th 2014 CLUJ-NAPOCA Neoadjuvant chemotherapy for bladder cancer: fighting between evidence 1 level and real life. Dr.
CHEMO-RADIOTHERAPY FOR BLADDER CANCER Dr Darren Mitchell Consultant Clinical Oncologist Northern Ireland Cancer Centre AIMS Muscle invasive disease Current Gold-Standard Rationale behind Chemo-Radiotherapy
Collecting Cancer Data Bladder & Renal Pelvis NAACCR 2012 2013 Webinar Series Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching
Dr Anna Lawrence Urologist Auckland Dr Andrew Williams Urologist Auckland Madhu Koya Urologist Auckland Andrew Lienert Urologist Auckland Dr Louise Tomlinson Consultant Gynaecologist Auckland 16:30-18:30
BLADDER CANCER: PATIENT INFORMATION The bladder is the balloon like organ located in the pelvis that stores and empties urine. Urine is produced by the kidneys, is conducted to the bladder by the ureters,
Endoscopic Management of Upper Tract Urothelial Cell Carcinoma Michael Ferrandino, MD Associate Professor of Urology Director, Minimally Invasive Urologic Surgery Duke University Medical Center Epidemiology
Case Presentation 58 year old male with recent history of hematuria, for which he underwent cystoscopy. A 1.5 cm papillary tumor was found in the left lateral wall of the bladder. Pictures of case Case
Management options for high-risk, BCG-refractory NMIBC Alan M. Nieder, M.D. Columbia University Division of Urology Mount Sinai Medical Center Bladder Cancer in U.S. 4 th most common cancer in men 9 th
Debate: Adjuvant vs. Neoadjuvant Therapy for Urothelial Cancer Kala Sridhar, MD, MSc, FRCPC Medical Oncologist, Princess Margaret Hospital GU Medical Oncology Site Group Head Associate Professor, University
Urothelial Tumors of the Upper Tract: Diagnosis and Management Daniel Rapoport April 11, 2007 Urology Grand Rounds 1 Overview Background Epidemiology and risk factors Natural history and prognostic factors
Surgery of Renal Cell Carcinoma Axel Bex, MD, PhD The Netherlands Cancer Institute 23 March 2012, Sao Paulo, Brazil Surgery of RCC Locally confined (small) renal tumours Locally advanced disease Metastatic
Memorial Sloan-Kettering Cancer Center 1275 York Avenue, New York, NY 10065 10th International Congress on the Future of Breast Cancer Coronado, CA 6 August 2011 Implications of ACOSOG Z11 for Clinical
Indications For Partial Nephrectomy Christopher G. Wood, M. D., FACS Professor and Deputy Chairman Douglas E. Johnson, M. D. Endowed Professorship in Urology Department of Urology The University of Texas
Diagnosis & Treatment of Non- Muscle Invasive Bladder Cancer: AUA/SUO Guidelines Sam S. Chang, MD, MBA Patricia & Rodes Hart Chair Professor of Urologic Surgery & Oncology Vanderbilt University Medical
When PSA fails Urology Grand Rounds Alexandra Perks Rising PSA after Radical Prostatectomy Issues Natural History Local vs Metastatic Treatment options 1 10 000 men / year in Canada 4000 RRP 15-year PSA
Japanese Journal of Clinical Oncology, 2015, 45(10) 963 967 doi: 10.1093/jjco/hyv098 Advance Access Publication Date: 29 July 2015 Original Article Original Article Impact of adjuvant chemotherapy on patients
Bladder Cancer Role of Radiation in Bladder Sparing David C. Beyer M.D., FACR, FACRO, FASTRO Arizona Oncology Services Phoenix, Arizona Primary Radiation for Bladder Cancer No modern surgery / XRT randomized
DOI 10.1007/s00345-014-1383-5 Original Article Mixed low and high grade non muscle invasive bladder cancer: a histological subtype with favorable outcome Tina Schubert Matthew R. Danzig Srinath Kotamarti
Discovery and Validation of Prognostic Genomic Based Signatures in High Risk Bladder Cancer Following Cystectomy Anirban P. Mitra, M.D., Ph.D. Center for Personalized Medicine University of Southern California
Non-Muscle-Invasive Bladder Cancer Staging, Treatment and Assessment Featuring SWOG Trials S1602 & S1605 Peter C.V. Black, M.D. S1605 Study Chair University of British Columbia Vancouver Prostate Centre
Invasive Bladder Transitional Cell Carcinoma UBC Urology Grand Rounds 7 September 2005 John Morrell R5 OBJECTIVES Review role of lymphadenectomy Review role of chemotherapy Review results of bimodal bladder
Panel: A Case-based Approach to the Management of Bladder Cancer ~ Moderator: Robert Donohue, MD Panel: David C. Beyer, MD E. David Crawford, MD Donald L. Lamm, MD Paul D. Maroni, MD TCC Cases Robert E.
RITE Thermochemotherapy in the treatment of BCG refractory NMIBC Ben Ayres Consultant Urological Surgeon St George s Hospital London 1 Financial and Other Disclosures Off-label use of drugs, devices, or
Management of High Grade, T1 Bladder Cancer Douglas S. Scherr, M.D. Assistant Professor of Urology Clinical Director, Urologic Oncology Weill Medical College-Cornell University Estimated new cancer cases.
MUHAMMAD IDREES MD Indiana University School of Medicine Indianapolis, IN Updates in TNM Staging of Testicular Cancer International Society of Urologic Pathology Companion Meeting San Antonio, TX March
Upper Tract Urothelial Cancers Nephron Sparing Strategies Girish Kulkarni, MD, PhD, FRCSC Urologic surgeon, Division of Urology Princess Margaret Hospital, University Health Network Assistant Professor,
EUROPEAN UROLOGY 61 (2012) 1025 1030 available at www.sciencedirect.com journal homepage: www.europeanurology.com Bladder Cancer Lymph Node Positive Bladder Cancer Treated With Radical Cystectomy and Lymphadenectomy:
Original Article Effect of internal iliac artery chemotherapy after transurethral resection of bladder tumor for muscle invasive bladder cancer Jianxing Li 1, Qi Wang 2, Bo Xiao 1, Xin Zhang 1 1 Department
EU GUIDELINES ON NON-MUSLE INVSIVE (TaT1, IS) LDDER NER (Limited text update March 2017) M. abjuk (hair), M. urger (Vice-hair), E. ompérat, P. Gontero,.H. Mostafid, J. Palou,.W.G. van Rhijn, M. Rouprêt,
ISRN Urology Volume 2013, Article ID 405064, 5 pages http://dx.doi.org/10.1155/2013/405064 Research Article Radical Cystectomy after BCG Immunotherapy for High-Risk Nonmuscle-Invasive Bladder Cancer in
Prostate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017 Dr Puay Hoon Tan Division of Pathology Singapore General Hospital Prostate cancer (acinar adenocarcinoma) Invasive carcinoma composed
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
Update on staging colorectal carcinoma, the 8 th edition AJCC Dale C. Snover, MD November 3, 2017 General overview of staging Reason for uniform staging Requirements to use AJCC manual and/or CAP protocols
Best Papers UROLOGY F. Fusco Best papers - 2015 RP/RT Oncological outcomes RP/RT IN ct3 Utilization trends RP/RT Complications Evolving role of elnd /Salvage LND This cohort reflects the current clinical
Prognostic Effect of Carcinoma In Situ in Muscle-invasive Urothelial Carcinoma Patients Receiving Neoadjuvant Chemotherapy Derek E. Thomas 1, Hristos Z. Kaimakliotis 1,2, Kevin R. Rice 1,2, Jose A. Pereira
ORIGINAL ARTICLE Vol. 43 (x): 2017 August 8.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2017.0218 Ureteral orifice involvement by urothelial carcinoma: long term oncologic and functional outcomes Muammer
Treatment of muscle invasive bladder cancer ie: pt2 N. Mottet Disclosures Astellas BMS Pierre Fabre Sanofi MIBC: really undertreated 28 691 MIBC in the US (national database). Gray Eur Urol 2013 Patients
Clinical Outcomes of Patients with pt0 Bladder Cancer after Radical Cystectomy: A Single-institute Experience Fumimasa Fukuta, Naoya Masumori *, Ichiya Honma, Masatoshi Muto, Koji Ichihara, Hiroshi Kitamura
8th International ISIORT Conference September 25-27, 2014 Cologne/Germany Cologne Marriott Hotel IORT for genitourinary malignancies Marco Krengli Dept. of Radiotherapy University of Piemonte Orientale
Greater Manchester and Cheshire HPB Unit Guidelines for the Assessment & Management of Hepatobiliary and Pancreatic Disease Chapter 14 Contents 14. Neuroendocrine Tumours 161 14.1. Diagnostic algorithm
BLADDER CANCER Joseph H. Williams, MD Idaho Urologic Institute St. Alphonsus Regional Medical Center September 22, 2016 BLADDER CANCER = UROTHELIAL CANCER Antiquated term is Transitional Cell Carcinoma
Attachment #2 Overview of Follow-up Provided below is a general overview of follow-up and this may vary based on specific patient or cancer characteristics. Of note, Labs and imaging can be performed closer
Open clinical uro-oncology trials in Canada George Rodrigues, MD, Eric Winquist, MD London Health Sciences Centre, London, Ontario, Canada bladder cancer AN OPEN-LABEL, MULTICENTER, RANDOMIZED PHASE II
SFSPM Novembre 217 Valeur prédictive et pronostique de l infiltrat immunitaire dans les cancers du sein traités par chimiothérapie néoadjuvante Dr Fabien REYAL Service de Chirurgie INSERM U932 Immunity
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
CASE SCENARIO 1 9/10/13 HISTORY: Patient is a 67-year-old white male and presents with lesion located 4-5cm above his right ear. The lesion has been present for years. No lymphadenopathy. 9/10/13 anterior
Hello. My name is William Osai. I am a nurse practitioner in the GU Medical Oncology Department at The University of Texas MD Anderson Cancer Center in Houston. Today s presentation is Part 2 of the Overview
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
European ssociation of Urology Pocket Guidelines 2016 edition European ssociation of Urology Pocket Guidelines 2016 edition Introduction We are honoured to present the 2016 edition of the EU Pocket Guidelines.
E-Da Medical Journal 20;():-5 Original Article Rare Small Cell Carcinoma in Genitourinary Tract: Experience from E-Da Hospital Wei-Ting Kuo, I-Wei Chang2, Kevin Lu, Hua-Pin Wang, Tsan-Jung u, Victor C.
european urology 55 (2009) 911 921 available at www.sciencedirect.com journal homepage: www.europeanurology.com Bladder Cancer Bladder Preservation in Selected Patients with Muscle-Invasive Bladder Cancer
Multiple Primary and Histology Site Specific Coding Rules URINARY 1 Prerequisites 2 Completion of Multiple Primary and Histology General Coding Rules 3 There are many ways to view the Multiple l Primary/Histology
ACTIVE SURVEILLANCE FOR RENAL MASSES: Where are we in 2016? Phillip M. Pierorazio, MD Assistant Professor of Urology and Oncology Brady Urological Institute Sidney Kimmel Cancer Center Johns Hopkins Hospital
The Predictors of Local Recurrence after Radical Cystectomy in Patients with Invasive Bladder Cancer Hiroki Ide, Eiji Kikuchi, Akira Miyajima, Ken Nakagawa, Takashi Ohigashi, Jun Nakashima and Mototsugu
Case Discussions: Prostate Cancer Andrew J. Stephenson, MD FRCSC FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Elevated PSA 1 54 yo, healthy male, family Hx of
2885 Ivyspring International Publisher Research Paper Journal of Cancer 2017; 8(15): 2885-2891. doi: 10.7150/jca.20003 Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) After Initial TUR-BT:
Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Hagen Kennecke, MD, MHA, FRCPC Division Of Medical Oncology British Columbia Cancer Agency October 25, 2008 Objectives Review milestones
Management of Superficial Bladder Cancer Douglas S. Scherr, M.D. Assistant Professor of Urology Clinical Director, Urologic Oncology Weill Medical College-Cornell University Estimated new cancer cases.
Decipher Bladder Predicts Which Patients May Benefit from Neoadjuvant Chemotherapy Prior to Cystectomy Contact the GenomeDx Customer Support Team 1.888.792.1601 (toll-free) firstname.lastname@example.org
BCG Failure or BCG Unresponsive: Defining and Managing Difficult Patients Michael S. Cookson, MD, Professor and Chair Department of Urology University of Oklahoma Non-muscle Invasive Bladder Cancer Bladder
SEER Summary Stage Still Here! CCRA NORTHERN REGION STAGING SYMPOSIUM SEPTEMBER 20, 2017 SEER Summary Stage Timeframe: includes all information available through completion of surgery(ies) in the first
RADIOTHERAPY IN THE MANAGEMENT OF CANCERS OF THE URINARY BLADDER INTRODUCTION Incidence: Mortality: 20/100000/year (Europe) 8-9/100000/year Worldwide fourth most common cancer in men Incidence: 31.1 mortality: