073IC - Upper-Tract Urothelial Cancer Guidelines—An Interactive and Evidence-Based Course Highlighting the Full Spectrum of Disease via Case Discussion and Video Presentation

Monday, May 1, 2023

7:30 AM – 9:30 AM CST

Location: S102C

Instructional Course Director(s)

JC

Jonathan Coleman, MD

Memorial Sloan Kettering Cancer Center

Instructional Course Faculty(s)

Hong Truong, MD,MS

Penn State Health Milton S. Hershey Medical Center
JR

Jay Raman, MD, FACS

Professor and Chair
Penn State Health Milton S. Hershey Medical Center
JH

Jean Hoffman-Censits, MD (she/her/hers)

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins Greenberg Bladder Cancer Institute

Course Description: This course will walk through the newly developed AUA Guidelines for Upper Tract Urothelial Cancer (UTUC) using an interactive discussion of complex cases with attendee involvement to enhance their knowledge of this challenging disease and provide a basis for practice improvement. Aspects such as optimizing initial workup and risk stratification, endoscopic techniques for biopsy and treatment, multidisciplinary management (e.g., coordinating with medical oncology, nephrology, genetic counseling) and nuances of surgical approaches will be stressed. Presentations will include video demonstrations of surgical techniques for endoscopic, robotic and open approaches. Point and counterpoint discussions among panelists will highlight controversies in management. New/emerging therapies and technologies such as topical and laser-based treatments will be covered including management of complications and follow-up strategies

Learning Objectives:

Apply a standardized approach to optimally evaluate and diagnose patients with UTUC, including the interpretation of imaging features, appropriate use and documentation of endoscopic findings, and tissue sampling techniques to better standardize patient care and reliably allow for disease risk stratification while minimizing potential for patient harms.
Identify pre-surgical risk features shown to be associated with aggressive disease biology (e.g., progression, metastasis) and medical comorbidities (e.g., renal dysfunction, neuropathy, smoking, hereditary factors, etc.) to be addressed as part of comprehensive patient care, and how to incorporate these features when counseling patients on therapeutic options.
Describe the rationale, evidence and appropriate scenarios for recommending neoadjuvant or adjuvant therapy for patients with UTUC as well as the expected side effects and impact on surgical management.
Explain the scenarios for considering organ-sparing management, describing all available options including the indications and appropriate application of topical therapies, endoscopic treatment approaches and segmental resection as well as associated limitations, complications and how to mitigate these events.
Describe the data on the oncologic impact of lymph node dissection at the time of nephroureterectomy, patterns of lymph node metastasis associated with anatomical location of UTUC tumors and the implications for templates of staging lymphadenectomy as part of surgical management.
Articulate several of the new directions under development to address unmet needs not addressed by the guidelines including urine-based genomic biomarkers to predict for high-risk disease and novel therapeutics/devices being studied in clinical trials to offer better organ-sparing strategies.