CEM17 takes up onco-urology issues in Plzen

Onco-urological experts examined current issues during the first plenary session of the EAU 17th Central European Meeting (CEM17) held in conjunction with the 63rd Annual Conference of the Czech Urological Society (CUS) which opened today in Plzen, Czech Republic.

“We are glad to see the growth of urology in Central Europe and this current format of the CEM is proof of the dynamic work and collaboration among local and international urologists,” said Prof. Francesco Montorsi (IT), EAU Adjunct Secretary General for Science. Montorsi welcomed more than 700 registered participants during the opening plenary session, together with CUS Chairman Prof. Marko Babjuk (CZ), Prof. Jens Sønksen (DK), EAU Adjunct Secretary for Clinical Practice, and Prof. Milan Hora (CZ), CUS Vice Chairman and CEM17 president.

Babjuk also noted the steady growth of collaboration among Central European countries as he noted the rise in the number of young urologists in recent years. Eight countries are part of the Central European region with Poland and the Czech Republic accounting for the biggest numbers of urologists and residents. The region accounts for around 4,045 urologists and 990 residents.

The CEM is the longest-running regional meeting organized by the EAU or held in conjunction with the annual meetings of the local national societies. Held annually since 2001, the meeting is known for demonstrating the growing links among national and regional urology groups.

“With the international platform provided by the EAU and the readiness of local urologists to collaborate with their colleagues, we hope for more expanded support particularly for young urologists,” said Babjuk, who also heads the EAU Guidelines Working Panel for bladder cancer.

Hora also welcomed R. Prymulak, Ministry of Health representative and colleagues V. Simanek and B. Kreuzberg for joining the session which also highlighted the incidence of onco-urological malignancies, particularly prostate and bladder cancers, in the Czech Republic.

A range of key topics were presented and discussed by speakers A. Leminski (PL), Prof. Montorsi, A. Abdel-Karim (EG), M. Stanik (CZ), L. Dusek (CZ) and O. Hes (CZ). Leminski, winner of last year’s Young Urologist Cpmpetition, discussed the role of minimally invasive radical cystectomy. “The literature data on minimally invasive radical cystectomy (miRC) seem mature enough to recommend it as an alternative for selected patients with MIBC qualified for radical treatment,” he said. He added, however, that high initial stage or bulky tumors with extensive nodal involvement should probably still be managed with open radical cystectomy.

Montorsi provided a compact lecture on clinical relevant questions in the management of prostate cancer patients. He discussed tailoring the surgical approach based on pre-operative clinical characteristics, how to improve post-operative results after radical prostatectomy (RP), improving urinary continence recovery after RP and managing erectile and functional problems following RP.

Prof. Aly Abdel-Karim of Alexandria University in Egypt took up the laparoscopic repair of female genito-urinary fistulas and noted that conservative treatment often does not provide cure. “This remains a challenge to the surgeon and operative failure represents a burden, both for the patient and the surgeon,” he said.

Stanik gave a succinct lecture on the role of surgery in managing locally advanced and regionally metastatic bladder cancer, addressing issues such as lymph node dissection, neoadjuvant chemotherapy, unresectable disease (cT4b) and future prospects in imaging, molecular classification and emerging therapies. “Muscle-invasive bladder caner is frequently a systemic disease at the time of diagnosis and thus deserves a combination of local and systemic treatment,” he said. He also noted that patients with locally advanced and node-positive tumors “…should not be neglected as many of them are still potentially curable.”

Bio-statistician professor Ladislav Dusek (CZ) looked into the incidence and survival rates of onco-urology patients in Czech Republic and said that based on 2015 figures, there were 7,049 new prostate cancer patients in the country, which accounts for 8.2% of all new cancer cases. “There are 53,769 persons in prevalence and 9.9% of all persons have had a history of cancer. But the incidence is stable,” he added.

The first plenary session concluded with the overview lecture of Prof. Ondrej Hes (CZ), pathologist at the University Hospital in Plzen. Taking the WHO 2016 updated report, he listed the most lethal forms of renal tumors such as tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, and hereditary leiomyomatosis RCC and SDH deficient RCC.

Hes said that management of patients with these lethal tumors depends on genetic tests and disease progression. “In some patients a checkup of family history is recommended and in cases of mutation, a close follow-up of the patient is needed,” he said.