Episode 41

Teaming Up with Urology to Treat Renal Masses

with urologist Dr. Arthur Caire and interventional radiologist Dr. Shelby Bennett

Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more. Special thanks to our sponsor RADPAD® Radiation Protection.

Cite this podcast: BackTable, LLC (Producer). (2019, April 29). Ep 41 – IR and Urology Collaboration on Renal Masses [Audio podcast]. Retrieved from https://www.backtable.com/podcast

In this Episode

Podcast Participants

Dr. Arthur Caire is a practicing urologist with Christus St. Vincent Health System in Santa Fe, New Mexico.

Dr. Shelby Bennett is a practicing interventional radiologist with X-Ray Associates of New Mexico in Santa Fe.

Host Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.

Contents

Referral Patterns

  • For Urology, majority of referrals are driven by lesions detected on incidental imaging

  • For Interventional Radiology, majority of referrals from Urology with occasional referrals from Oncology

 

Renal Biopsy

  • Risks tend to outweigh benefits

  • Does not change treatment strategy in majority of cases

  • Can be inclusive

  • Risk of tract seeding


Staging system: TNM staging system

  • Page 479 of AJCC Cancer Staging Manual (link below)

 

Ideal IR Candidate

  • Less than 4 cm, lower/mid pole and peripheral

  • Nothing is off limits, but some lesions are more suited to percutaneous approach than others

  • Dr. Bennett prefers cryotherapy over microwave ablation


Urology tools for treating T1a lesions

  • Laparoscopic nephrectomy

  • Robotic-assisted partial nephrectomy

  • Cryotherapy: can do either laparoscopic vs robotically (if reconstruction needed)

  • Complex cystic lesions: cryoablation can be beneficial


Complications

  • Urology

    • Hemorrhage

    • Tumor recurrence

  • Interventional Radiology

    • Same as Urology

    • Hematuria is expected

Follow Up

  • Interventional Radiology

    • 1, 3, 9, 12 month scans and yearly thereafter

    • MRI preferred over CT

  • Urology

    • 1st follow up at 6 months. Depending on patient, 6 or 12 month thereafter

    • Will usually follow with CT

Collaborative practice patterns

  • Know resources available in the community

  • Open dialogue between physicians

  • Always keep patients first

2 simple ways to support the show

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  • Leave BackTable a short written review on iTunes

Resources

Protect yourself and your patients. Contact us to request a free RADPAD No Brainer® surgical cap and learn more about radiation protection at www.radpad.com.

BackTable Podcast Episode 15 - Renal Ablation Therapies
 

AJCC Cancer Staging Manual

Disclaimer: The Materials available on the BackTable Podcast are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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