Genitourinary Cancers

Three new clinical guidelines, potentially practice-changing advances in robotics and artificial intelligence, and research on hot-button public health issues such as opioid abuse were among many highlights of the AUA annual meeting in San Francisco.

Other key prostate cancer studies from AUA 2018 included updated survival data from the European Randomized Study of Screening for Prostate Cancer and a multicenter trial of MRI-targeted biopsy.

Despite improved patient awareness and established guidelines, compliance remains low.

Findings from a retrospective analysis of data collected at the National Institutes of Health provide insight on how multiparametric MRI/transrectal ultrasound-fusion biopsy (“fusion biopsy”) may be affecting management patterns and outcomes for men with prostate cancer.

Adding abiraterone acetate (ZYTIGA) to androgen deprivation therapy for the management of patients with metastatic castration-naïve prostate cancer does not increase medical resource utilization.

The treatment method may delay need for systemic therapy in men with oligometastatic prostate cancer.

Study findings bolster the idea that frequent repeat biopsies are unnecessary.

Learn about this and other products in the pipeline for prostate cancer and bladder cancer.

"Every effort should be made to reduce the cost of molecular testing and expand their access," writes Ashley Ross, MD, PhD.

A new study examining gene expression assays for stratifying prostate cancer risk is suggesting that it may be possible to develop lower-cost alternatives and expand access.

Recent data support the product’s use in protecting organs at risk for radiation exposure.

Active surveillance as an initial management strategy for men with low-risk prostate cancer results in cost savings compared with immediate treatment, regardless of the treatment chosen.

To help you sift the enormous scientific program and prioritize your schedule at the AUA annual meeting, the editors have called upon Urology Times’ editorial advisory board to identify the key research across multiple areas of the specialty.

In this video, Trinity J. Bivalacqua, MD, PhD, presents the case of a 63-year-old man with history of carcinoma in situ found to have low-grade Ta non-muscle invasive bladder cancer.

Based on recent developments with blue light cystoscopy, the use of white light cystoscopy alone is now considered suboptimal as a diagnostic tool.

More evidence is needed before blue light cystoscopy becomes the standard of care for diagnosis and treatment and renders white light cystoscopy obsolete.

Biopsy decreases overall uncertainty, is safe, fairly accurate, relatively inexpensive, and improves shared decision-making with patients.

Renal mass biopsy provides actionable information, but only under specific circumstances-yet it is an increasingly necessary part of the nuanced patient discussion.

An immunotherapy combination of nivolumab (Opdivo) and ipilimumab (Yervoy) extended overall survival compared with sunitinib (SUTENT) as first-line treatment of patients with advanced or metastatic renal cell carcinoma.

Agents for bladder cancer, prostate cancer, and stress urinary incontinence are also included in this round-up of pipeline developments.

Patients with bacillus Calmette-Guérin-unresponsive bladder cancer had worse clinical outcomes than patients who relapsed but did not meet BCG-unresponsive criteria, according to results of a retrospective analysis presented at the 2017 Society of Urologic Oncology annual meeting in Washington.

Fluorescent blue light cystoscopy improves 3-year recurrence-free survival rates in patients with recurrent bladder tumors compared to white light cystoscopy, and researchers believe its use should be expanded.

"Numerous clinical studies have exhibited significantly improved tumor detection rates with BLC," write Zachary L. Smith, MD, and Norm D. Smith, MD.

A look at Urology Times' most-read articles on bladder cancer reveals a variety of topics, ranging from radical cystectomy to the role of protein- and cell-based urinary biomarkers for bladder cancer detection and surveillance.

A 46-year-old male underwent a left laparoscopic radical nephrectomy for a cT1b renal cell carcinoma. Intra-operatively, a rent in the descending mesocolon was made during bowel mobilization but was not closed. Subsequently, the patient presented to the emergency room 4 days later with complaints of sudden onset sharp abdominal pain and nausea. A non-contrast computed tomography scan was obtained. What is the diagnosis?

"In the end, it is up to the surgeons who wish to continue to perform these robotic procedure to demonstrate their cost-effectiveness," writes Badar M. Mian, MD.

Other pipeline products discussed in this round-up include and advanced renal cell carcinoma agent, a bladder cancer detection agent, and a BPH treatment.

There’s a troubling disconnect between low-risk prostate cancer patients’ desire to preserve sexual function and the treatment choices they and their doctors often make.

A bladder-sparing approach for the treatment of muscle-invasive bladder cancer increases quality-adjusted life years compared with radical cystectomy in appropriately selected patients.