Oklahoma City Archives

Robotic Cystectomy and ICUD for Muscle Invasive Bladder Cancer

Posted by Sanjay G. Patel, MD | Mar 2020

Sanjay G. Patel, MD, Assistant Professor of Urology at the University of Oklahoma College of Medicine, evaluates oncologic evidence comparing open radical cystectomy to robotic cystectomy. This includes addressing morbidity rates detailed in a recent meta-analysis, and questioning whether open diversion could affect these results. Additionally, Dr. Patel analyzes the learning curve associated with performing a robotic cystectomy. Finally, he explains the cost differences between the two techniques, as well as why a more costly operation and/or hospital stay may still be more indirectly cost-effective down the road.

Retzius-Sparing Robotic-Assisted Laparoscopic Radical Prostatectomy (RARP): Rationale, Selection & Technique

Posted by Daniel C. Parker, MD | Mar 2020

Daniel C. Parker, MD, an assistant professor of urology at the University of Oklahoma, discusses the functional outcomes of the Retzius-sparing robotic-assisted laparoscopic prostatectomy (RARP) as compared to a traditional RARP. He goes on to describe the differences in postoperative continence and erectile disruption between the two approaches, how to select patients who may be candidates for a Retzius-sparing approach, as well as several randomized studies that describe any oncological and functional outcome differences between the two approaches.

New Approaches to Metastatic Hormone Sensitive Prostate Cancer

Posted by Michael S. Cookson, MD, MMHC | Mar 2020

Michael S. Cookson, MD, MMHC, Professor of Urology at the University of Oklahoma, reviews the current treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC). He goes on to discuss several aspects of the disease, including classifying patients into low or high risk, how to incorporate androgen axis inhibitors with ADT in managing newly diagnosed patients, and how to identify patients who may be candidates for chemotherapy plus ADT in patients with mHSPC.

Radiation Therapy: What’s New for Localized Disease

Posted by Christina E. Henson, MD | Mar 2020

Christina E. Henson, MD, describes how recent trial-based research has established new standards in prostate cancer radiotherapy. She discusses several modes of therapy, including hypofractionation, metastasis-directed therapy for treating oligometastatic disease, and pelvic nodal irradiation, noting that research has shown them to be effective treatments in a variety of disease states. Ultra-hypofractionation has been proven to have an increased therapeutic ratio compared to other methods, as well as a 5-year failure-free survival of 84% across all trials. Elective nodal radiation up to L4 or higher is now recommended to maximize treatment outcomes. Metastasis-directed therapy has been proven to help patients even with limited disease burden and should be viewed as an option in these cases, though it is not always successful.

Early Stage Testicular Cancer Update

Posted by Kelly L. Stratton, MD | Mar 2020

Kelly L. Stratton, MD, an assistant professor of Urologic Oncology in the University of Oklahoma Department of Urology, discusses newly released guidelines for early-stage testicular cancer. He goes on to describe how these guidelines, provided by the American Urological Association, were designed to provide doctors with guidance on the diagnosis and treatment of the disease. He then goes on to discuss how to identify patients who would benefit from treatment post-orchiectomy, as well as how to develop a follow-up strategy in those patients who are candidates for surveillance.