CUOS 2019: Biopsy of the Small Renal Mass - Still Controversial?

Toronto, Ontario (UroToday.com) Dr. Tony Finelli presented on the topic of biopsy of small renal masses. There are common arguments against the routine use of renal tumor biopsy, made by physicians and patients alike.  Dr. Finelli addressed each one of these comments during his talk.

CUOS 2019: Cytoreductive Nephrectomy: Is There Still a Role for Nephrectomy in Patients with Metastatic RCC?

Toronto, Ontario (UroToday.com) There were an estimated 6600 new cases of kidney cancer in Canada in 2018, with a 1/3 of them presenting with regional or distant metastases. According to the European Association of Urology (EAU) guidelines, there is a weak recommendation to perform cytoreductive nephrectomy in favorable and intermediate risk patients with metastatic renal cell carcinoma (RCC). For patients with oligometastatic disease, the guidelines recommend performing immediate cytoreductive nephrectomy if complete resection could be achieved. The recommendations of the National Comprehensive Cancer Network (NCCN) guidelines are quite similar.

CUOS 2019: Lymph Node Dissection at the Time of Nephrectomy - CON

Toronto, Ontario (UroToday.com) The concept of lymph node dissection (LND) in renal cell carcinoma (RCC) is controversial. Past studies have reported mixed results. Population-based studies demonstrate that LND rates during surgery are decreasing in the US.1 However, some of the larger more experienced centers report an increased rate of LND.2 Recent data from the national cancer database (NCDB) demonstrate an LND usage of 5%, 23%, 31%, 47%, of T1, T2, T3, T4, respectively receiving LND.3 The likelihood of lymph node metastases varies by stage and grade with 1.1-5.1% of T1 disease and up to 12.3-37.1% in T4 disease.4

CUOS 2019: Lymph Node Dissection at the Time of Nephrectomy - PRO

Toronto, Ontario (UroToday.com) Dr. Rendon presented on the role of lymph node dissection (LND) in renal cell carcinoma (RCC). The rationale for LND in RCC is due to several factors including improved staging, improved prognostication, and improved oncologic outcomes.