University of Texas Southwestern Medical Center

CAPTAIN: A Randomized Controlled Trial of MRI-Guided Transurethral Ultrasound Ablation of the Prostate versus Radical Prostatectomy

Xiaosong Meng, MD, PhD, explores the ongoing CAPTAIN trial, a multinational, randomized clinical study comparing transurethral ultrasound ablation (TULSA) with radical prostatectomy in patients with intermediate-risk prostate cancer. The CAPTAIN trial builds on the TACT study, which demonstrated the safety and efficacy of whole-gland ablation using TULSA.

In this 11-minute presentation, Dr. Meng outlines the eligibility criteria for the CAPTAIN trial participants and reviews the study schema. The trial aims to provide level 1 evidence of safety and efficacy, addressing the need for robust comparative studies to support guideline adoption of ablative technologies.

The trial evaluates outcomes including quality of life, urinary continence, erectile function, and long-term efficacy, with follow-up extending to 10 years. The study’s findings are anticipated to substantiate the use of TULSA as an effective and patient-preferred alternative to radical prostatectomy, potentially influencing clinical practice and reimbursement policies.

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Mutliparametric MRI for Solid Masses: Accurate Detection of Clear Cell Renal Cell Carcinoma to Direct Patient Care

Jeffrey A. Cadeddu, MD, Ralph C. Smith, MD, Distinguished Chair in Minimally Invasive Urologic Surgery, Director of The University of Texas (UT) Southwestern Clinical Center for Minimally Invasive Treatment of Urologic Cancer, and Professor of Urology and Radiology at UT Southwestern Medical Center in Dallas, Texas, discusses multiparametric magnetic resonance imaging (mpMRI) for small renal masses (SRM). Dr. Cadeddu emphasizes the use of mpMRI and a clear cell likelihood score (ccLS) as a promising, reliable, non-invasive, and cost-effective means of renal tumor characterization that can eliminate the need for biopsy in most patients.

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Kidney Tumor Ablation in 2022: Optimal Outcomes

Jeffrey A.Cadeddu, MD, discusses optimal outcomes in kidney tumor ablation. He reviews reliable and reproducible 5+ year data comparing ablation effectiveness and outcomes to that of surgery and emphasizes that for tumors of <3 cm, tumor ablation is indicated. Dr. Cadeddu explains that ablation is nephron-preserving and minimizes chronic kidney disease progression, is less expensive than conventional surgery, reduces risk of metastatic potential associated with AS, and in addition to tumor size, histologic subtype is an important consideration in treatment decision-making.

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