EMUC prides itself on being a multidisciplinary meeting on genito-urinary cancers and one draw for the audience is the opportunity to ask experts from other disciplines for an honest view on shared problems in diagnosis and treatment.
Such was the case for Prof. Jonathan Epstein, expert pathologist from Baltimore (US) who structured his talk in the shape of “questions on PCa pathology you were afraid to ask”. The audience members certainly didn’t show their fear after his talk, as many took the opportunity to ask some very specific questions that they had been stewing on.
Epstein spoke on the second day of EMUC18, the 10th European Multidisciplinary Congress on Urological Cancers in Amsterdam.
“Some recommendations to routinely do adjuvant radiotherapy following radical prostatectomy with EPE is not supported by data, especially with lower grade cancer and those with focal EPE in the absence of a positive margin,” Epstein said on the implications for treatment.
Other topics covered by Epstein included high-grade prostatic intraepithelial neoplasia and ductal adenocarcinoma.
Prof. Alberto Briganti (Milan, IT) acted as discussant and asked some questions from the treating urologist’s perspective, specifically on how the clinician could help the pathologist achieve better results. Briganti asked for the most important biopsy quality indicators. Prof. Epstein noted that the total core length of the biopsy is very important but is too rarely reported.
The second speaker in the same session was radiation oncologist Prof. Philippe Lambin (Maastricht, NL), who gave the audience an overview of emerging radiomic technologies. Rather than investing in new hardware (9T MR) or developing new imaging biomarkers (PSMA), new smart software could already extract more information from existing imaging data.
Medical images hold more information than the human eye can identify. With machine learning and image analysis, current images can be converted into minable data and knowledge. This kind of image processing can extract diagnostic, theragnostic, prognostic and predictive radiomic signatures.