2nd EAU Baltic Meeting: Showcasing young urology talents Baltic’s dynamic urology community attracts overseas participants By Joel Vega A relatively ‘young’ meeting annually organised by the Regional Office, the 2nd EAU Baltic Meeting held in Riga, Latvia, last May 29 to 30, drew not only the participation of urologists based in the Baltic region but also from across central Europe and countries such as Ireland, the United Kingdom, Nigeria, and Turkey. “We are proud to organise this meeting and see the impressive work that is being done in the region,”
Djavan also underscored that aside from promoting the synergies among the Baltic associations, the meeting also aims to identify promising talents. “The regional meetings have always emphasised the importance of recruiting urologists, which can only help our community to strengthen the core specialties of urology.” Treatment challenges The meetings scientific programme covered a wide range of issues in prostate, bladder and kidney cancers, male sexual function, medical and surgical
and costs, improving current treatments and the impact of new technologies. He concluded that the endoscopic approach promises higher stone-free rates, and the choice whether to use extracorporeal shock wave lithotripsy (ESWL), ureteroscopic lithotripsy (URS) and flexible ureterorenoscopy (FURS) is made based on the local situation and patient preference.
Prize Winners
The follow-up session tackled prostate cancer issues such as clinically insignificant PCa (Mihhail Žarkovski, EE), histological evaluation (Maris Sperga, LV), active surveillance (Robertas Adomaitis, LT) and focal therapy for PCa (Mark Emberton, GB). Noting that prostate cancers now account for a large number of newly diagnosed PCa cases, Žarkovski said doctors should exercise caution in using radical therapies that may only lead to complications. Regarding the use of nomograms, he noted their use as good prediction tools, but stressed that nomograms should be validated in unscreened populations. “Active surveillance (AS) is the only way to reduce overtreatment associated with PSA screening for prostate cancer,” he added.
First Prizes: Astellas Award: “Autoantibody responses elicited by prostate cancer-possible biomarkers for the aggressiveness of the disease,” Asbtract 34, Melne, V. et al., (Riga, LV)
R. Adomaitis (LT) examined challenges in active surveillance and underlined the importance of doctors carefully discussing the option with their patients. Saying that AS is safe, Adomaitis said using multiparametric-MRI would prove valuable in the selection and follow-up of patients. “When it comes to the issue of AS, urologists should take the initiative to go beyond current guidelines and publish our own data, ” he said.
2015 Baltic Meeting Opening session said Regional Office Chairman Prof. Bob Djavan in his opening remarks. He noted that even in the second year alone the event has already drawn the interest of many urologists from various countries.
treatment of stone disease and functional urology in lectures, workshops, hands-on training and poster sessions. Around 78 posters were presented during the two-day meeting in four sessions, with organisers selecting nine winners for the best abstract “If we look at the quality of the scientific work and the presentations. best practices in urology here, we are impressed with the progress you have already achieved,” added In the first plenary session, EAU Adjunct Sec. General Djavan. He said the increase in attendance since the for Science Prof. Francesco Montorsi (IT) gave the EAU first meeting in 2014 signals the advances made in the Lecture on contemporary management of high-risk region. Around 340 participants, including exhibitors prostate cancer (PCa). He said that 15% to 25% of and faculty members, attended this year’s meeting. today’s PCa patients who had radical prostatectomy for localised disease will suffer biochemical Co-organised with the national urological associations recurrence (BCR). “Patients with BCR have higher risk of Latvia, Lithuania and Estonia, the scientific of clinical progression and cancer-specific mortality,” programme covered a number of issues and topics in Montorsi said. He described his centre’s experience in urology such as onco-urology, stone disease, managing PCa patients and compared the pros and andrology, urological imaging and minimally invasive cons of robot-assisted radical prostatectomy versus procedures, among other topics. open radical prostatectomy. Assoc. Prof. Eglis Vjaters , local organiser and president of the Latvian Urological Association, expressed his appreciation for the EAU’s active support and stressed that collaboration with Estonia and Lithuania was invaluable in ensuring the meeting’s success. Profs. Mindaugas Jievaltas and Toomas Tamm, presidents of the Lithuanian and Estonian urological societies, respectively, also mentioned the vital role of close partnership among their organisations and the EAU’s sustained support.
“In G1-2 NMIBC, multi-marker panel or multiparameter analysis is necessary,” he said while underscoring that urologists should conduct prospective (randomized) trials in G1-2 tumours. Quality studies Several sponsored symposiums were presented with speakers discussing benign prostatatic hyperplasia (BPH), overactive bladder, metastatic castrationresistant prostate cancer (mCRPC) and lower urinary tract symptoms (LUTS). Among the highlighted key messages are: • B. Djavan on LUTS: “Watchful waiting is an option, but patient can profit from prevention of progression.”
“A comprehensive meeting full of insights”
• A. Mehik on mCRPC treatment: “Treatment with enzalutamide significantly reduces the risk of death and delays the progression of metastatic disease. Enzalutamide added to ADT at progression provides meaningful clinical benefit to men with mCPRC. ”
“I attended the meeting because I´d like to know more about the specialities of urology before I go for residency. This meeting is really an eye-opener for me and made me more enthusiastic to go into urology. The lectures were not only practical and comprehensive but also gave insights on daily clinical practice, challenges and issues in treatment. I learned much more than I expected. Given the chance, I will definitely attend another meeting. ”
European Urology Today
Dr. Nauman Nabi, practising urologist, from Galway (IE) “This is my second participation in this meeting and I can say that there is improvement. The lectures were all very informative, although it would have been more useful for me if there were more engaging discussions and direct exchange of views among expert panellists and speakers after the lectures. The abstract presentations were also very informative and gave me ideas what urologists and researchers are doing in other countries. Congratulations to the organisers for doing a good job.”
Berlin Chemie Award: “Lower ureteric stones treated by expulsive medical therapy: Selective a1-adrenergic blockers versus tadalafil plus selective a1-adrenergic blockers,” Abstract 75, Nabi, N. et al., (Galway, IE)
Prof. Bernd Schmitz-Dräger (DE) gave a state-ofthe-art lecture on bladder cancer, discussing the challenges in identifying better markers. In his closing remarks, Schmitz-Dräger pointed out that although better markers are desirable, the performance of current markers is sufficient. He recommended that doctors use markers before ultrasound cystoscopies (UC) in the follow-up of high-grade tumours.
Dr. Linards Redmanis (LV) discussed renal colic and examined both conservative and surgical management of stones in the upper urinary tract. Among the challenges he mentioned were the growing number of patients, treatment availability
Marisa Butnere, medical student, from Riga (LV)
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In his closing remarks, Montorsi mentioned that in a retrospective series, adjuvant radiotherapy “...showed impact on survival of certain patients with nodepositive prostate cancer.“
Emberton discussed the role of focal therapy in prostate cancer. “Focal therapy has emerged as a new class of therapy which now commands legitimacy,” he said while noting that focal therapy has prompted “an order of precision in terms of risk stratification that was hitherto missing.” Emberton: “Our treatments have, to date, been modifications of existing therapies. The next few years will see the emergence of treatments designed for the task.”
• M. Drake on OAB: “Mirabegron is well-tolerated and reduces frequency and incontinence episodes, regardless of prior drugs. ”
Four poster sessions were also organised covering topics such as functional urology, prostate cancer, kidney/urothelial malignancies and stone disease. The organisers said the quality of the submissions were very good and the jury had a tough time selecting the winners of the nine awards given by Astellas, Berlin Chemie and Karl Storz. The first prize winners tackled issues ranging from PCa biomarkers, lower ureteric stones to partial nephrectomy for small renal masses. Below is the list of winners.
Karl Storz Award: “Outcomes following partial nephrectomy for small renal masses,” Abstract 47, Cekauskas, A. et al., (Vilnius, LT) Second Prizes: Astellas Award: “Luminex detected antibodies are clinically relevant in pretransplant risk assessment,” Abstract 73, Veskimäe, P. et al., (Tartu, EE) Berlin Chemie Award: “Survival rates of hereditary and sporadic prostate cancer patients,” Abstract 28, Miculis, K. et al., (Riga, LV) Karl Storz Award: “Immediate results of surgical treatment of non-muscle invasive bladder cancer using the new en bloc TURBT,” Abstract 42, Masanski, I. et al., (Minsk, Belarus) Third Prizes: Astellas Award: “Is there a difference in number of interstitial cells, nuerons, presence of fibrosis and inflammation in UPL tissues of patients with UPJ obstruction with and without crossing-vessel and normal subjects in humans?” Abstract 16, Canda, A.E. et al., (Sakarya, TR) Berlin Chemie Award: “Evidence of bladder re-innervation following spinal cord injury via vagal nerve- fMRI study,” Abstract 5, Krhut, J. et al., (Prague, CZ) Karl Storz Award: “Renal colic: Emergency department diagnostic workout and treatment,” Abstract 76, Redmanis, L. et al., (Riga, LV)
June/July 2015