Vincenzo Ficarra. Direttore Clinica di Urologia Azienda Ospedaliera Universitaria di Udine

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1 Best Papers on Kidney Cancer Vincenzo Ficarra Direttore Clinica di Urologia Azienda Ospedaliera Universitaria di Udine

2 Uro-oncological oncological topics Renal Tumor biopsy Positive Surgical Margins after PN Expanding indications for PN Relapses after nephrectomy Cytoreductive nephrectomy

3 Tsivian M. et al. BJU Inter 2014; doi: /bju.12470

4 Topics and discussed items Tsivian M. et al. BJU Inter 2014; doi: /bju.12470

5 RTB: indications Tsivian M. et al. BJU Inter 2014; doi: /bju.12470

6 RTB: technical aspects Tsivian M. et al. BJU Inter 2014; doi: /bju.12470

7 RTB: pathological interpretation Tsivian M. et al. BJU Inter 2014; doi: /bju.12470

8 Uro-oncological oncological topics Renal Tumor biopsy Positive Surgical Margins after PN Expanding indications for PN Relapses after nephrectomy Cytoreductive nephrectomy

9 Presence of cancer cells at the level of inked parenchymal excision surface

10 Ontario Cancer Registry Pathology reports on 664 were reviewed Partial nephrectomy for RCC between 1995 and 2004 Seventy-one patients with PSMs (10.7%) Ani I. et al. BJU Inter 2014; doi: /j x x

11 PSMs after PN: overall survival NSM: 91.9% PSM: 90.9% Ani I. et al. BJU Inter 2014; doi: /j x x

12 PSMs after PN: cancer-specific survival NSM: 88.6% PSM: 84.4% Ani I. et al. BJU Inter 2014; doi: /j x x

13 Prospective, multicenter study (5 US institutions) 943 RAPN 21 (2.2%) cases with positive surgical margins Khalifeh A. et al. J Urol 2013; 190:

14 Recurrence-free survival Metastasis-free survival HR %CI p <0.01) HR 78 95%CI ,967 p <0.0001) Khalifeh A. et al. J Urol 2013; 190:

15 PSMs after PN: management Management Radical Nephrectomy Repeat Partial Nephrectomy Ablative therapies Observation(watchful waiting) 1. Residual tumor present in 7-15% of the cases 2. Increased risk of CKD 1. Technically demanding procedure 2. Intraoperative bleeding 3. Complications 1. No tissueis retrieved for histologic evaluation 2. Follow-up is hampered by artificial tissue alterations 1. Intensive follow-up is needed 2. No validated follow-up scheme exists

16 Uro-oncological oncological topics Renal Tumor biopsy Positive Surgical Margins after PN Expanding indications for PN Relapses after nephrectomy Cytoreductive nephrectomy

17 Expanding indications for PN

18 Expanding indications for PN

19 Radical and Partial Nephrectomy for Clinical T2 Renal Tumors Kopp R. et al. BJU Inter 2014; (available online)

20 Radical and Partial Nephrectomy for Clinical T2 Renal Tumors Kopp R. et al. BJU Inter 2014; (available online)

21 Radical and Partial Nephrectomy for Clinical T2 Renal Tumors Kopp R. et al. BJU Inter 2014; (available online)

22 Retrospective analysis consecutive cohort of 33 patients with metastatic renal cell carcinoma partial nephrectomy at a single institution 1996 and 2011 Babaian K et al. J Urol 2014; 192: 1-7

23 Partial Nephrectomy for metastatic Renal Cell Carcinoma Babaian K et al. J Urol 2014; 192: 1-7

24 Partial Nephrectomy for metastatic Renal Cell Carcinoma Babaian K et al. J Urol 2014; 192: 1-7

25 Uro-oncological oncological topics Renal Tumor biopsy Positive Surgical Margins after PN Expanding indications for PN Relapses after nephrectomy Cytoreductive nephrectomy

26 Brookman S. et al. BJU Inter 2013; 112:

27 Time to recurrence and CSS Brookman S. et al. BJU Inter 2013; 112:

28 Time to recurrence and CSS Brookman S. et al. BJU Inter 2013; 112:

29 Brookman S. et al. Eur Urol 2013; 64:

30 Late relapses after Nephrectomy Evaluated period: Brookman S. et al. Eur Urol 2013; 64:

31 Late relapses after Nephrectomy Brookman S. et al. Eur Urol 2013; 64:

32 Late relapses after Nephrectomy Brookman S. et al. Eur Urol 2013; 64:

33 Kroeger N. et al. Eur Urol 2014; 65:

34

35 Treatment outcomes after late relapses Kroeger N. et al. Eur Urol 2014; 65:

36 Treatment outcomes after late relapses Kroeger N. et al. Eur Urol 2014; 65:

37 Treatment outcomes after late relapses Kroeger N. et al. Eur Urol 2014; 65:

38 Uro-oncological oncological topics Renal Tumor biopsy Positive Surgical Margins after PN Expanding indications for PN Relapses after nephrectomy Cytoreductive nephrectomy

39 SEER programme to identify a population-based sample of 4914 patients diagnosed with metastatic RCC between 2000 and had non-clear-cell histology. Median follow-up was 20 months. Primary outcome measure was RCC-specific mortality Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67 74

40 CN in non-clear-cell cell RCC Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67 74

41 CN in non-clear-cell cell RCC Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67 74

42 CN in non-clear-cell cell RCC Patients from the SEER programme with metastatic non-clear-cell RCC, including those treated in the targeted therapy era, appear to derive a survival benefit from CN, an association which remained significant regardless of histological subtype This observation suggests that CN should remain standard in patients with advanced RCC who are deemed to be surgical candidates Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67 74