Urologic Oncology

Questions discussed in this category

Which patients with prostate cancer do you consider to be good candidates for salvage local treatment after radiation therapy?

How does time since radiation, original PSA and grade group/gleason score inform your decision?

2 Answers available

For a patient post-prostatectomy with a high PSA (>1), a negative MRI pelvis, and a negative PSMA PET scan, do you pursue any other imaging?

FDG PET, Axumin PET, Bone scan? Or just proceed with salvage ADT/RT?

4 Answers available

How do you decide between internal versus external decompression of malignant obstruction of the ureter (MUO)?

How do you decide between ureteral stent and percutaneous nephrostomy for decompression?

1 Answer available

How would you manage a patient with PSA persistence after RALP demonstrating metastasis in regional lymph nodes without further evidence of disease on bone or CT scans?

Does performance status, age, or urinary incontinence after surgery affect your recommendations?

1 Answer available

Is there evidence that prostatectomy improves overall survival in local recurrence of prostate cancer post-definitive radiation?

3 Answers available

How do you manage favorable intermediate risk prostate cancer patients that have a PIRADS 5 lesion that was most-likely missed in the template biopsy?

For example, a patient that received an MRI after biopsy that demonstrates a PIRADS 5 lesion in anterior TZ which likely was not sampled on biopsy. Wo...

4 Answers available

Do you still order mpMRI for staging of prostate cancer in addition to PET-PSMA?

Which patients specifically benefit from both mpMRI and PET-PSMA?

4 Answers available

Is it appropriate to offer definitive trimodality therapy, as an equivalent option to neoadjuvant chemotherapy followed by radical cystectomy, in patients with muscle-invasive bladder cancer regardless of fitness or platinum eligibility?

Has this recent retrospective analysis published in Lancet Oncology changed your practice?

1 Answer available

When will you recommend enfortumab vedotin plus pembrolizumab as first-line treatment of metastatic urothelial carcinoma for cisplatin-ineligible patients?

Will you use it rather than a carboplatin-containing regimen?

2 Answers available

In a patient with very high risk prostate cancer opting for prostatectomy, when, if ever, do you recommend neoadjuvant ADT?

4 Answers available

How would you treat a metastatic pure urethral adenocarinoma?

Based on GI regimen or urothelial carcinoma regimens?

1 Answer available

How would you approach a patient considered to be unfit for cystectomy with recurrent NMIBC refractory to BCG, failed pembrolizumab and unable to do more intravesical Rx?

2 Answers available

How would you approach treatment for a cT1N0M0 urothelial carcinoma of the ureter, high grade in a non-surgical candidate due to medical comorbidities?

2 Answers available

In a patient with otherwise low-risk prostate cancer, does presence of a small component of Grade Group 3 disease up-stage to unfavorable intermediate?

How would you treat such a patient?

3 Answers available

What chemotherapy do you use with radiation for urothelial carcinoma with squamous differentiation?

2 Answers available

How do you manage a Ta pure squamous cell carcinoma of the urinary bladder?

Confirmed no urothelial carcinoma and muscle in specimen without involvement.

1 Answer available

What could explain the contradictory results between CheckMate 274 and IMVIGOR 010?

Does this raise concerns about the efficacy of adjuvant immune checkpoint inhibition? Are any preliminary results from AMBASSADOR (adjuvant pembrolizu...

3 Answers available

Would you recommend adjuvant nivolumab for patients with upper tract urothelial cancer?

The forest plot from CheckMate 274 did not show a benefit for such patients? How would you select between adjuvant chemotherapy and adjuvant nivoluma...

1 Answer available

When is the ideal time to start adjuvant nivolumab after radical surgery in urothelial carcinoma?

Is a 3 month delay too long in someone who had postoperative complications?

2 Answers available

Is there an absolute PSA level above which you would not recommend a radical prostatectomy for newly diagnosed prostate cancer despite the absence of metastatic disease with advanced imaging?

Are there other high or very high risk features that would also contribute to your decision making?

1 Answer available

Would you offer cytoreductive nephrectomy to a young, healthy patient with widely metastatic renal medullary carcinoma with partial response to cisplatin based chemotherapy?

Is there a benefit to cytoreductive nephrectomy if residual metastases are not resected? Any benefit to extending surgery to other metastatic sites?

2 Answers available

Would you recommend surgery or radiation for newly diagnosed localized prostate cancer diagnosed on a urethral lesion biopsy?

GS 4+4. PSA low (1-2). CT and bone scan negative for lymphadenopathy or metastatic disease. Prostate MRI pending.

2 Answers available

Would you continue pembrolizumab in a patient with BCG-refractory NMIBC with CIS who has a negative surveillance cystoscopy (including random biopsies) but positive urine cytology?

1 Answer available

Would you use pembrolizumab to treat patients with BCG-refractory Ta or T1 NMIBC without CIS?

2 Answers available

For a patient who is cisplatin-eligible with localized, high-grade upper tract urothelial carcinoma, but no muscularis propria seen on biopsy, what is your approach?

What neoadjuvant or adjuvant therapy would you give?

1 Answer available

Is there any role for regional lymph node dissection with radical nephrectomy for patients with early stage RCC?

Wouldn't lymph node dissection improve sensitivity of staging and inform adjuvant treatment decisions?

1 Answer available

Do you offer bladder-sparing approaches as an alternative to cystectomy for surgery-eligible patients with muscle-invasive bladder cancer?

Should cystectomy remain standard of care? (Recently debated in JAMA Oncology: http://jamanetwork.com/journals/jamaoncology/article-abstract/2520055...

1 Answer available

How do you approach isolated recurrence in a para-aortic lymph node following definitive radiation for localized prostate cancer?

Is there a role for salvage LN dissection or salvage RT to the node? And is there a role for systemic therapy (ADT or chemotherapy) in addition? If yo...

1 Answer available