Скачать или смотреть Highlights of NCCN AUA Guidelines 2024 with Dr. Siamak Daneshmand, MD

Siamak Daneshmand, MD, covers recent updates in bladder cancer guidelines, focusing on the 2024 NCCN and AUA recommendations.

In this 26-minute presentation, Dr. Daneshmad emphasizes genetic testing, making germline testing and genetic counseling more routine. He prefers gemcitabine over mitomycin due to the latter's severe, idiosyncratic side effects, and most urologists have adopted it for intravesical therapy.

The experts enter the discussion to debate the classification of high-grade urothelial carcinoma. Histological subtypes are being redefined, with variant histology terminology being challenged by WHO's push for “subtypes,” leading to controversy among experts. Molecular genomic testing is increasingly recommended. The panel shares concerns about intravesical gemcitabine's systemic absorption, leading to unexpected hair loss and thrombocytopenia. The discussion touches on lymph node involvement in variant histology, showing urothelial rather than aggressive variants in metastases. Finally, adjuvant nivolumab is reinforced as the standard for high-risk post-cystectomy patients, with evolving strategies for bladder preservation.