Page 9 - [Podium Sessions] CUA 2022 Annual Meeting Abstracts

2022 CUA ABSTRACTS

CUA 2022 Annual Meeting Abstracts – Podium Session 3:

Oncology – Prostate

Saturday, June 25, 2022 • 10:50–11:50

Cite as: Can Urol Assoc J 2022;16(6Suppl1):S13-8. http://dx.doi.org/10.5489/cuaj.7921

POD-3.1 POD-3.2
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The carbon footprint of travel to Canadian Urological Association Effect of F-DCFPyL prostate-specific membrane antigen-positron
conferences emission tomography/computed tomography on the management
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Nicolas Vanin Moreno , Naji Touma 1 of suspected limited residual/recurrent disease following radical
1 Department of Urology, Queen’s University, Kingston, ON, Canada prostatectomy: A prospective, multicenter registry trial in Ontario
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Introduction: Global warming has emerged as one of the greatest threats Joseph L.K. Chin , Ur Metser , Katherine Zukotynski , Victor Mak , Deanna
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to habitats and human health in the coming years. Exacerbations of uro- Langer , Pamela MacCrostie , Anil Kapoor , Luke T. Lavallée , Laurence Klotz ,
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logical conditions, such as urolithiasis and infertility, have been linked to Catherine Hildebrand , Marlon Hagerty , Antonio Finelli , Glenn Bauman 8
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this manmade problem. The significance of the challenge is forcing govern- 1 Department of Surgery (Urology), Western University, London, ON,
ments, organizations, and individuals to re-examine policies and habits that Canada; Department of Medical Imaging, University of Toronto, Toronto,
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address this issue. Pre-pandemic, Canadian Urological Association (CUA) ON, Canada; Department of Medical Radiology, McMaster University,
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conferences were held annually, alternating between an eastern, central, Hamilton, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada;
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or western location across Canada. The goal of this study is to examine 5 Department of Surgery (Urology), McMaster University, Hamilton, ON,
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the carbon footprint of travel to the CUA conference, and whether this is Canada; Department of Surgery (Urology), University of Ottawa, Ottawa,
impacted by location. ON, Canada; Department of Surgery (Urology), University of Toronto,
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Methods: Anonymized registrant information was obtained for the attendees Toronto, ON, Canada; Department of Oncology, Western University,
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of the 2016 (Vancouver), 2018 (Halifax), and 2019 (Quebec City) CUA London, ON, Canada; Department of Radiation Oncology, Northwest
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conferences. Registrant institution was used to estimate the distance that Regional Cancer Care, Thunder Bay, ON, Canada
attendees traveled. Industry attendees and registrants without institutional Support: Cancer Care Ontario, Ontario Ministry of Health & Long-Term
city of origin information were excluded from the analysis. It was assumed Care. NCT03718260
that attendees from institutions <3 hours from the conference traveled by Introduction: We aimed to assess disease detection rate of F-DCFPyL
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car (midrange vehicle, fuel efficiency: 8.42 L/100 km). All other registrants positron emission tomography/computed tomography (PET/CT) and man-
were assumed to have flown (round-trip, economy class, no layovers). agement changes directed by PET results in patients with suspected limited
Carbon footprint was calculated using an online calculator in tons of CO residual or recurrent disease following radical prostatectomy (RP).
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(tCO ). Total attendees, number of attendees driving, number of attendees Methods: A total of 1289 patients from six Ontario cancer centers were
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flying, mean distance traveled per attendee (km, round-trip), total carbon enrolled, including 487 post-RP. Cohort 1 (C1) (n=72) were node-positive
footprint, and average carbon footprint were calculated for each confer- or had prostate-specific antigen (PSA) >0.1 ng/ml post-RP. Cohort 2 (C2)
ence. Mean carbon footprint, and mean distance traveled were compared (n=415) had biochemical failure (BCF) post-RP, with 0–4 disease sites on CT
using one-way ANOVA, with a Tukey’s multiple comparisons test (α=0.05). and/or bone scan. Management intent (curative or palliative) was collected
Results: Vancouver had the largest number of attendees (n=473; 407 fly- both pre- and post-prostate-specific membrane antigen (PSMA) PET/CT.
ing, 66 driving), followed by Halifax (n=382; 331 flying, 51 driving), and Results: PSMA-PET detected disease in 39/72(54.2%) in C1 and
Quebec City (n=362; 265 flying, 97 driving). The mean distance traveled 188/415(45.3%) in C2. In C1 patients with node-positive disease post-
by attendees was greatest for the Vancouver CUA (6041 km/roundtrip) RP and PSA <0.1, the detection rate was 16.7% (1/6). For C1 on PET,
compared to Quebec City (3096 km/roundtrip, p<0.0001) and Halifax 22/72(30.6%) had locoregional failure, 11 (15.3%) were oligometastatic,
(2985 km/roundtrip, p<0.0001). There was no difference in mean distance and six (8.3%) had extensive disease. For C2, the respective data were
traveled between Halifax and Quebec City (p=0.95). The highest total car- 122/188 (29.4%), 51 (12.3%), and 15 (3.6%). Overall, management change
bon footprint was seen in Vancouver (tCO =447.76), followed by Quebec was recorded in 212/487 (43.5%). In 91/474 men (19.2%), there was a
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City (tCO =217.04), and Halifax (tCO =182.22). The average footprint per management intent change (“intent” data unavailable in 13). In C1, 13%
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attendee was significantly higher in Vancouver (mean tCO =1.08) compared changed from curative to palliative intent and 10.1% from palliative to
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to both Quebec City (mean tCO =0.62, p<0.0001) and Halifax (mean curative. For C2, 5.4% changed from curative to palliative and 13.1% from
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tCO =0.52, p<0.0001). There was no difference in the average footprint palliative to curative intent. The most common management changes for
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between Halifax and Quebec City (p=0.63). both cohorts were: 1) conversion from observation or systemic therapy to
Conclusions: The location of a CUA conference has a significant impact salvage radiation or surgery for locoregional disease (68/487,13.9%); and
on its carbon footprint. While engagement of the entire membership in a 2) addition of node-directed therapy (65/487, 13.3%).
large country is a worthy goal when considering the site of CUA confer- Conclusions: Compared with standard imaging, PSMA-PET detected
ences, we submit that the environmental impact of such meetings should additional disease sites in approximately 50% of patients with BCF and
also be a consideration. suspected low-volume metastatic disease, often resulting in management
change. Significantly, PSMA-PET led to therapeutic intent change in 20%
of men. Long-term followup will determine if PSMA-PET will impact even-
tual disease outcome in patients with suspected limited residual/recurrent
disease following RP.
CUAJ • June 2022 • Volume 16, Issue 6(Suppl1) S13
© 2022 Canadian Urological Association