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

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Presentation on theme: "Best Papers on Kidney Cancer Vincenzo Ficarra Direttore Clinica di Urologia Azienda Ospedaliera Universitaria di Udine."— Presentation transcript:

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

2 Uro-oncological topics Renal Tumor biopsyRenal Tumor biopsy Positive Surgical Margins after PNPositive Surgical Margins after PN Expanding indications for PNExpanding indications for PN Relapses after nephrectomyRelapses after nephrectomy Cytoreductive nephrectomyCytoreductive nephrectomy

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

4 Topics and discussed items

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

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

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

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

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

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

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

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

15 PSMs after PN: management Management Radical Nephrectomy1. Residual tumor present in 7-15% of the cases 2. Increased risk of CKD Repeat Partial Nephrectomy1. Technically demanding procedure 2. Intraoperative bleeding 3. Complications Ablative therapies1. No tissue is retrieved for histologic evaluation 2. Follow-up is hampered by artificial tissue alterations Observation (watchful waiting)1. Intensive follow-up is needed 2. No validated follow-up scheme exists

16 Uro-oncological topics Renal Tumor biopsyRenal Tumor biopsy Positive Surgical Margins after PNPositive Surgical Margins after PN Expanding indications for PNExpanding indications for PN Relapses after nephrectomyRelapses after nephrectomy Cytoreductive nephrectomyCytoreductive nephrectomy

17 Expanding indications for PN

18

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

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

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

25 Uro-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

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

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

30 Late relapses after Nephrectomy Evaluated period:

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

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

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

34

35 Treatment outcomes after late relapses

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

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

38 Uro-oncological topics Renal Tumor biopsyRenal Tumor biopsy Positive Surgical Margins after PNPositive Surgical Margins after PN Expanding indications for PNExpanding indications for PN Relapses after nephrectomyRelapses after nephrectomy Cytoreductive nephrectomyCytoreductive nephrectomy

39 Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67–74 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

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

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

42 Aizer AA et al. BJU Inter 2014; BJU Int 2014; 113: 67–74 CN in non-clear-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


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