Topic: Kidney Cancer

Cytoreductive Surgery in the Era of Targeted Therapy for Kidney Cancer: If Yes, When?

Riccardo Autorino MD, PhD, FEBU, discusses the decline in using cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC) due to the shift toward targeted therapy in urological practice. He explains the rationale behind CN, its drawbacks, and individual scenarios in which it could provide a benefit, as opposed to targeted therapy and nephron-sparing surgery (NSS). Furthermore, he presents the current therapeutic algorithm for patient selection in these treatment options.

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MRI Fusion Biopsy

Peter Schulam, MD, PhD, reviews the controversy surrounding prostate cancer screening, explains the literature that led to the United States Preventive Services Task Force (USPSTF) coming out with a C recommendation for prostate cancer screening, and notes the limitations in the current standard of transrectal ultrasound (TRUS) biopsy. He then discusses how MRI fusion biopsy could address these limitations.

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Adverse Pathologic Characteristics in the Small Renal Mass

Peter Schulam MD, PhD, emphasizes the importance of staging renal tumors based on weighted risk, including risk of metastases, histologic subtypes, and adverse pathologic characteristics, and not simply mass size. This is essential when considering partial nephrectomy, radical nephrectomy, active surveillance, ablative techniques, or other management options for individual patients.  

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