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- Sam Chang is joined by Phil Pierorazio for a broad discussion on upper tract disease. Dr. Pierorazio provides an overview to help understand the histology of upper tract urothelial cancer and recognize the importance of staging of UTUC disease. Biographies: Philip Pierorazio, MD, Chief of Urology, Penn Presbyterian Hospital, The University of Pennsylvania Philadelphia Sam S. Chang, M.D., M.B.A. Pa...
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- Sam Chang and Ryan Hsi, discuss percutaneous techniques and evaluation for upper tract tumors. Dr. Hsi begins this conversation with a background on antegrade approaches. He discusses the goals of these antegrade approaches to be obtaining tissues and cytologies, while also ablating, resecting, and treating the visible tumor. He also goes on to discuss his approach to using antegrade techniques, w...
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- In this patient case evaluation discussion, Sima Porten joins Sam Chang presenting a case of a 64-year-old man with high-risk urothelial carcinoma. He presented with gross hematuria. His workup initially was started with a cystoscopy that was done by a urologist close to home, which was normal. Biographies: Sima P. Porten, MD, MPH, Assistant Professor, Department of Urology, UCSF Medical Center Sa...
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- In a discussion hosted by Ashish Kamat, Evanguelos Xylinas delves into the complexities of systemic therapies for localized upper tract urothelial carcinoma. Dr. Xylinas critically examines the POUT trial, which has established platinum-based adjuvant chemotherapy as the new standard of care following radical nephroureterectomy. While acknowledging the trial's contributions, he points out its limi...
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- Sam Chang converses with Vitaly Margulis about the evaluation, treatment, and follow-up of patients with upper tract carcinoma. Focusing on low-risk disease, they delve into the complexities of diagnostic procedures like CT scans, cystoscopy, and ureteroscopy. Dr. Margulis emphasizes the importance of a thorough workup, including repeat biopsies, especially when considering organ preservation. The...
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- Sam Chang and Doug Scherr discuss risk stratification for patients with upper urinary tract cancer (UTUC). They discuss cancer recurrences and how it may be possible to predict the likelihood of these events. They evaluate tumor-specific factors and treatment-specific factors. Dr. Scherr discusses the future of prognostic genomic risk scores for upper tract urothelial carcinoma, similar to those a...
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- Eugene Pietzak details the molecular landscape of upper tract urothelial carcinoma and highlights practical clinical implications of recent findings of the molecular biology of upper tract urothelial cancer, with a particular focus on what is relevant to the urologist in this conversation with Sam Chang. Upper tract urothelial cancer comprises a very small proportion of all urothelial cancer. it h...
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- In this patient case evaluation discussion, Surena Matin joins Sam Change presenting a patient case of low grade, upper tract, urothelial cancer. This was a 71-year-old patient who presented with microhematuria and he was found to have a 7 mm lesion in the distal, right ureter. Drs. Matin and Chang discuss diagnosing and staging the patient, and Dr. Matin talks through his approach to treatment. G...
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- Upper tract urothelial (transitional cell) carcinoma (UTUC) is a rare malignant disease occurring in roughly two people per 100 000 population. UTUCs comprise 5–10% of urothelial carcinomas. Given limited high-level evidence, Dr. Chang brings together two experts to discuss their approaches in various clinical scenarios. Sam Chang, MD hosts experts Eugene Pietzak, urologist, and Arjun Balar, medic...
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- In April 2020, the US Food and Drug Administration approved Jelmyto (mitomycin gel) as the first therapy for low-grade UTUC. One year later, Jelmyto has become a valuable treatment that urologists can incorporate into their clinical armamentarium. In this conversation with Sam Chang, Karim Chamie provides a state-of-the-art lecture on UTUC and treatment in 2021. Dr. Chamie summarizes risk stratifi...
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