EMUC15: Challenges and developments in urological cancers

From diagnosis, systemic treatment to surgical management, experts and specialists in urological cancers assessed current practices and prospects while noting that the steady gains already achieved will hopefully lead to more optimal therapies.

“Since 2007 when we had our first meeting, and through the years, this conference with its focus on multidisciplinary collaboration has become better and more important. It is also important that we do not only speak to each other but also speak the same language,” said Prof. Cora Sternberg (IT) of the European Society of Medical Oncology (ESMO) at the end of the three-day 7th European Multidisciplinary Meeting on Urological Cancers (EMUC) held in Barcelona.

Together with European Association of Urology (EAU) Adjunct Sec. General Prof. Hein Van Poppel and Prof. Philip Poortmans of the European SocieTy for Radiotherapy & Oncology (ESTRO), Sternberg conveyed her thanks to the participants and faculty members. Nearly 1,300 participants from more than 60 countries have attended the event.

Some of the key take home messages from medical oncology, urology, pathology, radiation oncology and radiology were summarized by Profs. Susanne Osanto, Harriet Theony, Alberto Briganti, Berardino De Bari and Antonio Lopez-Beltran.

Theony summarized the key points for radiology noting the various imaging techniques and standard procedures for prostate, kidney, testis, bladder and renal cancers. She underlined the need for reducing radiation dosage by reducing the frequency of CT-scanning and limiting the length of follow-ups, particularly in testis cancer patients. Considering alternative imaging methods such as MRI may also provide benefits.

In urology, Briganti noted developments in genomics for PCa, the role of PSA for younger patients, the role of surgery in oligometastatic PCa, optimal treatment for muscle-invasive bladder cancer and risk stratification for urethelial carcinomas.

Osanto noted several developments particularly in the use of Radium 223 in prostate cancer, initial findings in a UK-based research on intratumoural heterogeneity in kidney cancer, the role of immune oncology in bladder cancer (BCa), progress in The Cancer Genome Atlas Project in BCa, and understanding the role of checkpoint inhibitors in kidney cancer, among other issues.

De Bari discussed the crucial role of multidisciplinary strategies and issues in survivorship. He also noted the importance of integrating new imaging techniques such as MRI in prostate delineation.

Lopez-Beltran noted the new grading system for prostate cancer as contained in the WHO 2016 recommendations. He said that although urologists and radiation oncologists have welcome and adapted the grading system there is still little interest and a cautionary stance from medical oncology. He also discussed the heterogeneity of kidney and prostate cancer tumours where precision imaging and further research are needed.