Role of cytoreductive surgery in the era of immunotherapy
Purpose of review
The benefit of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) was first called into question in the tyrosine kinase inhibitors (TKIs) era. It remains undefined in the context of the recent development and approval of immune checkpoint inhibitors (ICIs) and level one evidence supporting the rapid adoption of dual ICI and combination ICI + TKI therapeutic approaches for mRCC. Our objective is to synthesize the available contemporary data regarding the safety, feasibility, and oncologic outcomes with CN for mRCC in the age of immunotherapy as well as to highlight trials in progr...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: THE ROLE OF SURGERY FOR LOCO-REGIONAL AND ADVANCED UROLOGICAL CANCERS: Edited by Declan Murphy and Derya Tilki Source Type: research
The role of surgery for locally advanced urothelial cancers
Purpose of review
Extirpative surgery can play an important role in the management strategies for locally advanced urothelial carcinoma. The current review is intended to relay current information reported in the literature over the past 12 months regarding the usage of surgical resection in advanced urothelial cancers of the bladder and upper tracts, document operative outcomes, and oncologic efficacy.
Recent findings
Multimodal therapy is key to long-term overall survival for advanced urothelial carcinoma. Radical cystectomy with bilateral pelvic lymph node dissection can be performed after an observable res...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: THE ROLE OF SURGERY FOR LOCO-REGIONAL AND ADVANCED UROLOGICAL CANCERS: Edited by Declan Murphy and Derya Tilki Source Type: research
Extent of lymph node dissection and impact on survival in radical cystectomy for advanced bladder cancer
This study differed from the LEA study in several aspects but might also turn out to be a negative study.
Summary
There are still no firm data on the oncological benefit brought by more extended LND in patients with MIBC. Survival benefits seem limited, at least in the general population. Other factors could influence the impact of LND on survival, including the administration of adjuvant and neoadjuvant chemotherapies. (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: THE ROLE OF SURGERY FOR LOCO-REGIONAL AND ADVANCED UROLOGICAL CANCERS: Edited by Declan Murphy and Derya Tilki Source Type: research
Testosterone therapy in prostate cancer: is it still a controversy?
Purpose of review
The benefits of testosterone therapy (TTh) in the hypogonadal male can be dramatic. Historically, TTh has been contraindicated in prostate cancer (PCa). Current evidence has redefined our understanding of the influence serum testosterone has on prostatic androgen activity. Increasing numbers of hypogonadal men with coexisting PCa emphasizes the importance of describing those who may safely receive TTh. This review aims to present literature that evaluates the efficacy and safety of TTh in men with coexisting PCa.
Recent findings
Our study, a comprehensive review of published literature regardin...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: ENDOCRINE DISORDERS: Edited by Mesut Remzi and David Albala Source Type: research
Metabolic syndrome, obesity and cancer risk
Purpose of review
This review aims to report the latest discoveries regarding the relationship between BMI, obesity, and cancer development and treatment.
Recent findings
Obesity and metabolic syndrome relationships with cancer have been deeply investigated in the literature but their association is still debated. Currently, it has been recorded an association between BMI and endometrial, colorectal, gastric, liver, bladder, and prostate cancer. The mechanisms behind this association have also been investigated. It has been hypothesized that chronic inflammation determined by obesity may concur to the developmen...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: ENDOCRINE DISORDERS: Edited by Mesut Remzi and David Albala Source Type: research
Adrenal functional imaging – which marker for which indication?
Purpose of review
In recent years, a broad spectrum of molecular image biomarkers for assessment of adrenal functional imaging have penetrated the clinical arena. Those include positron emission tomography and single photon emission computed tomography radiotracers, which either target glucose transporter, CYP11B enzymes, C-X-C motif chemokine receptor 4, norepinephrine transporter or somatostatin receptors. We will provide an overview of key radiopharmaceuticals and determine their most relevant clinical applications, thereby providing a roadmap for the right image biomarker at the right time for the right patient.
...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: ENDOCRINE DISORDERS: Edited by Mesut Remzi and David Albala Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Device-assisted intravesical chemotherapy treatment for nonmuscle invasive bladder cancer: 2022 update
Purpose of review
To critically analyze the oncological outcomes and safety profile of device-assisted intravesical chemotherapy studies reported in 2021. Studies were considered eligible if they included patients with nonmuscle invasive blood cancer (NMIBC), had a prospective or retrospective design, included at least 10 patients, were published in 2021, and assessed the oncological impact of device-assisted intravesical chemotherapy and/or reported standardized adverse effects (AEs).
Recent findings
Eight new studies reported oncological outcomes after hyperthermic intravesical chemotherapy (HIVEC). In Bacillu...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?
Purpose of review
This review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).
Recent findings
A growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Molecular biomarkers to help select neoadjuvant systemic therapy for urothelial carcinoma of the bladder
Purpose of review
In this review, we aimed to summarize the available evidence on pretreatment molecular biomarkers that may help to predict oncologic and pathologic outcomes in patients treated with neoadjuvant systemic therapy (NAST) for urothelial carcinoma of the bladder (UCB).
Recent findings
Several readily available and easily measurable blood-based biomarkers (e.g., neutrophil to lymphocyte or platelet–lymphocyte ratios) seems to help improve the selection of UCB patients who are most likely to benefit from NAST. Recent evidence suggests liquid biopsy including circulating tumor DNA (ctDNA) to be a pro...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Comparative performance of the different orthotopic urinary diversions
Purpose of review
Majority of patients undergoing radical cystectomy are suitable for orthotopic urinary diversion. The effect of different techniques of neobladder reconstruction on early and long-term postoperative complications is still being determined. Additionally, it is unclear which type of neobladder provides the best patient satisfaction. The purpose of this article is to review the outcomes of different orthotopic urinary diversions following radical cystectomy.
Recent findings
Ileal neobladder is the preferred type of orthotopic urinary diversion following radical cystectomy. Hautmann and Studer, whi...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Radical cystectomy and women's sexual health – can we do better?
Purpose of review
Female sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.
Recent findings
Sexual function is important to women and there is a significant desire (and unmet need) for more perioperative counseling and discussion regarding sexual function changes...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
The use of MRI in urothelial carcinoma
Purpose of review
To conduct a nonsystematic review of the existing literature to investigate the role of Magnetic Resonance Imaging (MRI) in urothelial carcinomas (UCs).
Recent findings
Imaging is becoming progressively more crucial in local and distant staging of UCs, especially in cases of bladder cancer (BCa). The primary objective of imaging in patients with BCa is to detect lesions and distinguish T1 from T2 stages, since the treatment varies significantly.
Summary
The applicability of MRI in the management of UCs has been investigated, particularly focusing on the new evidence on multiparametric MR...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Drug instillation in the management of urinary tract urothelial carcinoma
This article aimed to investigate the efficacy of drug instillation therapy in preventing the recurrence of postsurgical upper urinary tract urothelial carcinoma (UTUC) by reviewing recently published research articles.
Recent findings
Several clinical trials have shown new potential forms of postsurgical intracavitary and intravesical drug instillation methodologies with better efficacy and less toxicity for use in UTUC. With the improvement of endoscopic imaging techniques and laser sciences, diverse attempts in drug instillation have shown an improved recurrence rate after kidney-sparing surgery in low-grade, low...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
RNA-based urinary assays for non-muscle invasive bladder cancer
This study evaluated Xpert Bladder and reported a sensitivity: 73%, specificity: 84%, NPV: 99%, and PPV: 12%. Ten studies assessed test performance during surveillance for NMIBC. For the detection of high-grade (HG) and high-risk (HR) NMIBC, sensitivity, specificity, NPV, and PPV varied between 78–100%, 64–89%, 97.0–99.7%, and 9.2–39%.
Summary
Multiple RNA-based urine assays have been investigated for the detection of urothelial cancer in the primary or surveillance setting. However, studies included within this review have important limitations, hampering the interpretation of study results. As such, perfor...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
