Guilherme Godoy, MD, MS

Guilherme Godoy, MD, MS

Baylor College of Medicine

Houston, Texas

Guilherme Godoy, MD, MS, serves as assistant professor of urology at the Baylor College of Medicine (BCM) in Houston, Texas. He joined the faculty of the Scott Department of Urology at BCM in 2012 and has been the chief of the urology service at Ben Taub General Hospital (Harris Health System), since 2017.

Dr. Godoy earned his medical degree from Fundacao Universitaria do ABC in Sao Paulo, Brazil. His training includes an internship and residency in urology at Santa Casa De Sao Paulo in Vila Buarque, Brazil, and a fellowship in urologic oncology at BCM. Dr. Godoy has also completed urologic oncology fellowship training at Vancouver General Hospital, New York University, and Memorial Sloan-Kettering Cancer Center. He earned his MS in clinical investigations at BCM and has remained active in clinical research, translational studies, and clinical trials, mostly focused on prostate, urothelial (upper and lower urinary tract), and testicular cancers.

Dr. Godoy’s expertise includes early diagnosis, minimally invasive approaches (endoscopic and robotic), utilization of molecular and genetic tools for personalized decision-making, management of hereditary cancers, and surgical management of complex/large genitourinary (GU) tumors. His clinical areas of interest include adrenal and kidney tumors, urothelial cancers (upper and lower urinary tract including ureter, renal pelvis, bladder, and urethra), prostate cancer, penile cancer, and testicular and paratesticular cancers. Dr. Godoy also specializes in the utilization of intestinal segments for urinary tract reconstructions, and coordination of multidisciplinary approaches to manage complex intra-abdominal, retroperitoneal, and pelvic tumors. Dr. Godoy is responsible for and moderates the GU Tumor Board Meetings at Baylor St. Luke’s Medical Center as well as the St. Luke’s International GU Tumor Board Meetings.


Talks by Guilherme Godoy, MD, MS

Surgical Training for Radical Prostatectomy – Should the Open Approach Still Be Taught? Which Patients? Retropubic, Perineal, Mini-Incision, etc.?

Guilherme Godoy, MD, MS, explores the question of whether or not to teach residents open radical prostatectomy, weighing multifunctional surgical skills with robotic advancements. He then explains that the open approach to radical prostatectomy is the gold standard in the medical community; however, the robotic approach is more commonly performed.

Dr. Godoy proceeds by questioning whether a sufficient number of open-approach radical prostatectomies are being conducted to warrant training residents in this method. Referring to a 2020 study, he finds that perhaps too few open-approach procedures are occurring to allow for resident proficiency.

Dr. Godoy then asks whether the open approach offers any benefits, exploring four situations in which the open approach is preferred over the robotic method. Dr. Godoy then cites a 2007 study to evaluate the learning curves of open-approach radical prostatectomy subtypes compared to the robotic approach, finding drastic differences in the climb to proficiency.

He completes his presentation by stressing that resident skill and comfort level should be considered in the debate between the open and robotic approaches. Following the presentation, audience members offer points of consideration regarding rural populations, new robots, and current robot malfunctions during radical prostatectomies.

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NMIBC Post-FDA Approval of New Drugs

Guilherme Godoy, MD, MS, explores recently FDA-approved treatments for NMIBC high-risk patients, with a focus on alternatives for BCG-unresponsive patients. He examines studies comparing the effectiveness of drug-based and gene-based therapies for the treatment of NMIBC against BCG, including:

Adstiladrin (Nadofaragene Firadenovec-vngc)

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When is Radical Cystectomy Indicated for NMIBC?

Guilherme Godoy, MD, MPH, Assistant Professor of Urology at Baylor College of Medicine, in Houston, Texas, discusses the role of cystectomy in non-muscle invasive bladder cancer (NMIBC). He begins by describing the management options for NMIBC, including transurethral resection of the bladder tumor (TURBT), intravesical treatment, systemic therapy, and radical cystectomy. Dr. Godoy then explains the importance of re-TURBT, stating that it is one of the most critical steps in management for reducing understaging and improving intravesical therapy response in patients. He summarizes the indicators for cystectomy, including failure to resect, adverse pathology, and treatment failures. Dr. Godoy reviews data from a large single-institution retrospective study showing a significant difference in recurrence-free survival, cancer-specific survival, and overall survival in favor of the primary muscle invasion at presentation group vs. the progressive MIBC group. He then discusses data from a systematic review and meta-analysis of 14 studies on oncological outcomes of primary and secondary MIBC, finding worse outcomes overall for secondary muscle invasive cystectomy. Dr. Godoy looks at the European and AUA risk stratification tables, focusing on how both support aggressive management of high risk disease. He shows data from a study of the impact of variant histology on outcomes with intravesical immunotherapy, finding 40% progression-free survival compared to 17.5% in conventional bladder cancer. He states that all of this data supports cystectomy as an important and integral tool in the management of NMIBC due to its excellent oncological outcomes and potential benefit of abbreviated management and follow-up for aggressive NMIBC despite its morbidity, though the treatment may not be appropriate for everyone.

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Decisional Tools to Determine Need for Biopsy and Re-Biopsy in Men with Elevated PSAs

Guilherme Godoy, MD, MPH, Assistant Professor of Urology and Urology Oncology at Baylor College of Medicine, in Houston, Texas, discusses how and when to use elevated PSA and other markers to determine whether a biopsy is needed. Dr. Godoy cautions that relying solely on an abnormal level for a sensitive biomarker like PSA can lead to false positives and overtreatment, noting that an elevated PSA is an indicator of the prostate but not necessarily of cancer. He reminds physicians to consider the PSA level related to the size of the prostate before jumping ahead to other steps. Dr. Godoy describes how oft-overlooked PSA derivatives in conjunction with family history and other risk factors can be used to individualize risk and personalize assessments for a patient. He then presents an array of current and emerging molecular, genetic, and imaging-based testing options. The 4Kscore assesses the probability of high-risk cancer (Gleason 7 or higher) in the biopsy and informs risk of metastatic disease in 20 years. This test can also indicate risk stratification for mortality. Urine-based tests such as SelectMDx and EPI ExoDx Prostate Intelliscore similarly provide risk stratification for biopsy-naïve men, while tissue-based tests such as ConfirmMDx are useful when a patient has had a previous negative prostate biopsy. He summarizes with a diagram of the clinical integration of MRI and molecular markers illustrating how these testing options should be used.

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