My interest in caring for children, adolescents and young adults with urologic cancer has guided my training and career development. For that reason, after completing my residency in Urology and Urologic Surgery, I pursued fellowship training in both urologic oncology (cancer treatment) and pediatric urology. This allows me to provide care to children, adolescents, and adults with testicular cancer at both “adult” and “pediatric” hospitals.
I am involved with kidney and testicular cancer both as a clinician and as a researcher. My particular areas of focus include my work as the Surgical Discipline Lead for the Children’s Oncology Group Renal Tumor Committee, a Panel Member for the NCCN Testicular Cancer Guidelines, the Lead for our Hereditary Renal Cancer Program and our VHL Clinical Care Center, and the Co-Director of the Surgical Oncology Program at Children’s Hospital Colorado
Specifically, the cancers and tumors in children, adolescents, and adults that I treat include:
Kidney tumors (Wilms Tumor, Renal Cell Carcinoma (RCC), Angiomyolipomas(AML))
Testicular and Para-testicular tumors (Germ Cell Tumors, Rhabdomyosarcomas)
Pelvic Tumors (Bladder and Prostate Rhabdomyosarcomas)
Adrenal Tumors (Pheochromocytoma, Adrenal Cortical Carcinoma)
Tumor predisposition syndromes such as von Hippel Lindau, Tuberous Sclerosis, and Birt-Hogg-Dube.
I also am interested in the use of minimally invasive surgery (robotic-assisted laparoscopy, laparoscopy, single-site laparoscopy, and endoscopy) for all variety of urologic conditions.
I believe that by working in such a wonderful environment at the University of Colorado Anschutz Medical Campus, we can provide the most current therapy as well be involved in research to improve outcomes for patients with urologic cancer.
My clinical philosophy for patient care is to first listen to the patient's concerns and needs. Then, I assess the patient's condition and previous testing and labs in order to explain my evaluation and offer my recommendations. I believe it is important to make sure the patient and family understand their condition as well as possible to enable us all to make the plan of care together, as a team.
I am available to discuss your situation with you or your physician, so please feel free to contact me anytime at the e-mail address below. I look forward to the opportunity to work with you.
Nicholas Cost, MD
1. Geller JI, Cost NG, Chi YY, Tornwall B, Cajaiba M, Perlman EJ, Kim K, Mullen E, Glick RD, Khanna G, Daw NC, Ehrlich P, Fernandez CV and Dome JS. A Prospective Study of Pediatric and Adolescent Renal Cell Carcinoma: A Report from the Children’s Oncology Group (COG) Study AREN032. Cancer. 2020; 126(23):5156-5164.
2. Gilligan T, Lin DW, Aggarwal R, Chism D, Cost N, Derweesh IH, Emamekhoo H, Feldman DR, Geynisman DM, Hancock SL, LaGrange C, Levine EG, Longo T, Lowrance W, McGregor B, Monk P, Picus J, Pierorazio P, Rais-Bahrami S, Saylor P, Sircar K, Smith DC, Tzou K, Vaena D, Vaughn D, Yamoah K, Yamzon J, Johnson-Chilla A, Keller J, Pluchino LA. Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2019; 17(12):1529-1554.
3. Saltzman AF, Smith DE, Gao D and Cost NG. Lymph Node Yield in Pediatric, Adolescent and Young Adult Renal Cell Carcinoma - How Many Are Enough? Journal of Pediatric Surgery. 2020; 55(10):2030-2034.
4. Rodrigues Pessoa R, Maccini M, Caldwell BT, Maroni P and Cost NG. Optimal approach to small unilateral testicular nodules: can we reliably predict tumor histology based on size? Urology Practice. 2021; 8: 119-124,
5. Saltzman AF, Carrasco A, Amini A, and Cost NG. Patterns of Care and Survival Comparison of Adult and Pediatric Wilms Tumor in the United States: A Study of the National Cancer Database. Urology. 2020; 135: 50-56.
6. Walker JP, Johnson J, Eguchi M, Saltzman AF, Cockburn M, Cost NG. Factors affecting lymph node sampling patterns and the impact on survival of lymph node density in patients with Wilms tumor: A Surveillance, Epidemiology, and End Result (SEER) database review. Journal of Pediatric Urology. 2020; 16(1): 81-88.
7. Saltzman AF, Smith, DE, Gao D, Ghosh D, Amini A, Aldrink JH, Dasgupta R, Gow KW, Glick RD, Ehrlich PF and Cost NG. How Many Lymph Nodes Are Enough? Assessing the Adequacy of Lymph Node Yield for Staging in Favorable Histology Wilms Tumor. Journal of Pediatric Surgery. 2019; 54(11): 2331-2335.
8. Hecht SL, Walker JP, Treece AL, Cost NG. Isolated pure malignant rhabdoid tumor (MRT) of the bladder: case report and lessons learned. Urology. 2020; 137:164-167.
9. Iguchi N, Donmez MI, Carrasco A, Wilcox DT, Pineda RH, Malykhina AP, Cost NG. Doxorubicin induces detrusor smooth muscle impairments through myosin dysregulation, leading to a risk of lower urinary tract dysfunction. American Journal of Physiology-Renal Physiology. 2019; 317(1):F197-F206.
10. Saltzman AF, Carrasco A, Hecht S, Walker J, Caldwell BT, Bruny J and Cost NG. A Decision Tree to Guide Long Term Venous Access Placement in Children and Adolescents Undergoing Surgery for Renal Tumors. Journal of Pediatric Surgery. 2020; 55(7): 1334-1338.
11. Saltzman AF, Stokes W, Walker J, and Cost NG. Factors Related to Lymph Node Sampling at the Time of Surgery in Children, Adolescents and Young Adults with Unilateral Non-Metastatic Renal Cell Carcinoma. Journal of Pediatric Urology. 2019; 15(3): 259.e1-259.e7.
12. Caldwell BT, Saltzman AF, Maccini MA and Cost NG. Appropriateness for Testis Sparing Surgery Based on Testicular Tumor Size in a Pediatric and Adolescent Population. Journal of Pediatric Urology. 2019; 15(1): 70.e1-70.e6.
13. Walker JP, Meyers LM, Saltzman AF, Hecht SL, Cost NG. The Natural History of Wilms Tumor - A Case Comparison of Two Different Tumors. Urology. 2019; 130:151-154.
14. Walker JP, Saltzman AF, Kessler ER, and Cost NG. Adult Wilms Tumor During Pregnancy - Case Report and Literature Review. Urology. 2019; 129:200-205.
15. Warncke JC, Saltzman AF, Maroni PD, Danesmand S and Cost NG. Retroperitoneal Lymph Node Dissection (RPLND) as an alternative treatment strategy for low-volume, clinical stage II testicular seminoma: a survey of patients and providers. Urology Practice. 2019; 6: 249-255.
16. Aldrink JA, Cost NG, McLeod DJ, Bates G, Stanek JP, Smith EA and Ehrlich PF. Technical considerations for nephron-sparing surgery in children: what is needed to preserve renal units? Journal of Surgical Research. 2018; 232: 614-620.
17. Islam M, Saltzman AF, Amini A, Carrasco A, Cost NG. Factors Influencing Overall Survival of Children, Adolescents and Young Adults with High Risk Renal Tumors. Urology. 2018; 120: 222-230.
18. Cajaiba MM, Dyer LM, Geller JI, Jennings LJ, George D, Kirschmann D, Rohan SM, Cost NG, Khanna G, Mullen EA, Dome JS, Fernandez CV, Perlman EJ. The classification of pediatric and young adult renal cell carcinomas registered on the Children's Oncology Group (COG) protocol AREN03B2 after focused genetic testing. Cancer. 2018; 124(16): 3381-3389.
19. Saltzman AF, Warncke JC, Colvin AN, Carrasco A, Roach JP, Bruny JL and Cost NG. Development of a Post-Operative Care Pathway for Children with Renal Tumors. Journal of Pediatric Urology. 2018;14(4): 326.e1-326.e6.
20. Saltzman AF, Carrasco A, Colvin AN, Meyers ML and Cost NG. Can a Modified Bosniak Classification System Risk Stratify Pediatric Cystic Renal Masses? Journal of Urology. 2018; 200(2):434-439.
21. Saltzman AF, Carrasco Jr. A, Weinman J, Meyers M, Cost NG. Initial Imaging for Pediatric Renal Tumors: An Opportunity for Improvement. Journal of Urology. 2018; 199(5):1330-1336.
22. Stokes CL, Stokes WA, Kalapurakal JA, Paulino AC, Cost NG, Cost CR, Garrington TP, Greffe BS, Roach JP, Bruny JL, Liu AK. Timing of Radiation Therapy in Pediatric Wilms Tumor: A Report From the National Cancer Database. Int J Radiat Oncol Biol Phys. 2018: 101(2):453-461
23. Luckie TM, Danzig M, Zhou S, Wu H, Cost NG, Karaviti L, Venkatramani R. A Multicenter Retrospective Review of Pediatric Leydig Cell Tumor of the Testis. Journal of Pediatric Hematology Oncology. 2019; 41(1):74-76.
24. Cost NG, Aldrink JH, Saltzman AF, Dasgupta R, Gow KW, Glick R, Ehrlich PF. Current State of Renal Tumor Surgery among Pediatric Surgeons and Pediatric Urologists - A Survey of American Pediatric Surgery Association (APSA) and Society for Pediatric Urology (SPU) Members. Journal of Pediatric Urology. 2018; 14(2): 168.e1-168.e8.
25. Saltzman AF, Carrasco A, Amini A, Aldrink JH, Dasgupta R, Gow KW, Glick RD, Ehrlich PF and Cost NG. Patterns of Lymph Node Sampling and the Impact of Lymph Node Density in Favorable Histology Wilms Tumor: An Analysis of the National Cancer Database. Journal of Pediatric Urology. 2018; 14(2): 161.e1-161.e8.
26. Carrasco A, Caldwell BT, Cost CR, Greffe BS, Garrington TP, Bruny JL, Black JO, and Cost NG. Reliability of Intraoperative Frozen Section for the Diagnosis of Renal Tumors Suspicious for Malignancy in Children and Adolescents. Pediatric Blood and Cancer. 2017; 64(8): e26458.
27. Sandberg JK, Mullen EA, Cajaiba MM, Smith EA, Servaes S, Perlman EJ, Geller JI, Ehrlich PF, Cost NG, Dome JS, Fernandez CV, Khanna G. Imaging of renal medullary carcinoma in children and young adults: a report from the Children's Oncology Group. Pediatric Radiology, 2017; 47(12):1615-1621.
28. Cost NG, Ross JH, Ferrer FA, Lorenzo AJ, Shnorhavorian M, Routh JC, Kieran K, and Ritchey ML. Patterns of Performance of Surgical Oncology by North American Pediatric Urologists - a Report from the Pediatric Urologic Oncology Working Group (PUOWG) of the Society for Pediatric Urology (SPU). Journal of Urology. 2017; 197(5):1349-1354.
29. Stokes W, Amini A, Maroni PD, Kessler ER, Stokes C, Cost CR, Greffe BS, Garrington TP, Liu AK and Cost NG. Patterns of Care and Survival Outcomes for Adolescent and Young Adult Patients with Testicular Seminoma in the United States: A National Cancer Database Analysis. Journal of Pediatric Urology. 2017; 13(4):386.e1-386.e7.
30. Warncke JC, Brodie KE, Grantham EC, Catarinicchia SP, Tong S, Kondo KL, Cost NG. Pediatric Renal Angiomyolipomas in Tuberous Sclerosis Complex. Journal of Urology. 2017; 197(2):500-506.
31. Cost NG, Ferrer FA, Lorenzo AJ, Shnorhavorian M, Kieran K, Routh JC, Ritchey ML and Ross JH. A Society for Pediatric Urology (SPU) Workforce Survey on the Current Perceptions of Oncology Care by Pediatric Urologists - a Report from the Pediatric Urologic Oncology Working Group (PUOWG) of the SPU. Journal of Urology. 2017; 197(3 Pt 2):892-897.
32. Rove KO, Maroni PD, Cost CR, Fairclough DL, Giannarini G, Harris AK, Schultz KAP, Cost NG. Pathologic Risk Factors for Metastatic Disease in Post-pubertal Patients with Clinical Stage I Testicular Stromal Tumors. Urology. 2016; 97:138-144
33. Amini A, Waxweiler TV, Maroni PD, Kessler ER, Cost CR, Greffe BS, Garrington TP, Liu AK, and Cost NG. Survival Outcomes of Adolescent and Adult Patients with Non-Seminomatous Testicular Germ-Cell Tumors: A Population-Based Study. Journal of Pediatric Urology. 2016; 12(6):405.e1-405.e9
34. Cost NG, Caldwell BT, Adibi M, Raj GV, Sagalowsky AI and Margulis V. Do Referral Patterns in Adolescents and Young Adults with Testicular Cancer Impact Oncologic Outcomes? Journal of Adolescent and Young Adult Oncology. 2016; 5(3):248-53.
35. Rove KO, Maroni PD, Cost CR, Fairclough DL, Giannarini G, Harris AK, Schultz KA, Cost NG. Pathologic Risk Factors in Pediatric and Adolescent Patients with Clinical Stage I Testicular Stromal Tumors. Journal of Pediatric Hematology and Oncology. 2015; 37(8):e441-6..
36. Grantham EC, Caldwell BT, Cost NG. Current Urologic Care for Testicular Germ Cell Tumors in Pediatric and Adolescent Patients. Urologic Oncology: Seminars and Original Investigations. 2016; 34(2):65-75.
37. Geller JI, Ehrlich PF, Cost NG, Khanna G, Mullen EA, Gratias EJ, Naranjo A, Done JS, Perlman EJ. Characterization of Adolescent and Pediatric Renal Cell Carcinoma: a Report from the Children’s Oncology Group Study AREN03B2. Cancer. 2015; 121(14):2457-2464.
38. Hall D*, Cost NG*, Hedge S*, Kellner E, Mikhaylova O, Stratton Y, Ehmer B, Abplanalp WA, Pandey R, Biesiada J, Harteneck C, Plas DR, Meller J, Czyzyk-Krzeska MF. TRPM3 and miR-204 Establish a Regulatory Circuit that Controls Oncogenic Autophagy in Clear Cell Renal Cell Carcinoma. Cancer Cell. 2014; 26(5):738-53. * - indicates co-primary authors.
39. Cost NG, Lubahn JD, Adibi M, Romman A, Wickiser JE, Raj GV, Sagalowsky AI, and Margulis V. Risk Stratification for Pubertal Children and Post-pubertal Adolescents with Clinical Stage I Testicular Non-Seminomatous Germ Cell Tumors. Journal of Urology. 2014; 191(5 Suppl):1485-90.
40. Cost NG, Lubahn JD, Adibi M, Romman A, Wickiser JE, Raj GV, Sagalowsky AI, and Margulis V. A Comparison of Pediatric, Adolescent and Adult Testicular Germ Cell Malignancy. Pediatric Blood and Cancer. 2014; 61(3):446-51.
41. Cost NG, Maroni P and Flaig TW. Metastatic Relapse After Initial Clinical Stage I Testicular Leydig Cell Tumor. Oncology (Williston Park). 2014; 28(3):211-4.
42. Cost NG, DeFoor WR Jr, Crotty EJ and Geller JI. The Initial Experience with RENAL Nephrometry in Children, Adolescents, and Young Adults with Renal Tumors. Pediatric Blood and Cancer. 2014; 61(8):1434-9.
43. Wang HH, Abern MR, Cost NG, Chu DI, Ross SS, Wiener JS and Routh JC. Use of Nephron Sparing Surgery and Impact on Survival in Children with Wilms Tumor: A SEER Analysis. Journal of Urology. 2014; 192(4):1196-1202.
44. Cost NG, Sawicz-Birkowska K, Kajbafzadeh AM, Tourchi A, Parigi GB, Guillén G, DeFoor WR and Apoznanski W. A Comparison of Renal Function Outcomes after Nephron-Sparing Surgery and Radical Nephrectomy for non-Syndromic Unilateral Wilms Tumor. Urology. 2014; 83(6):1388-93.
45. Cost NG, Liss ZJ, Bean CM, Geller JI, Minevich EA and Noh PH. Pre-Chemotherapy Robotic-Assisted Laparoscopic Radical Nephrectomy for an Adolescent with Wilms Tumor. Journal of Pediatric Hematology and Oncology. 2015; 37(2):e125-e127.
46. Cost NG, Cost CR, Geller JI and DeFoor WR. Adolescent Urologic Oncology: Current Issues and Future Directions. Urologic Oncology: Seminars and Original Investigations. 2014; 32(2):59-69.
47. Cost NG, Geller JI, Le LD, Crombleholme TM, Keswani SG, Lim FY and Alam S. Urologic Co-Morbidities Associated with Sacrococcygeal Teratoma and a Rational Plan for Urologic Surveillance. Pediatric Blood and Cancer. 2013; 60(10):1626-9.
48. Walther A, Cost NG, Garrison AP, Geller JI, Alam S and Tiao GM. Renal Rhabdomyosarcoma in a Pancake Kidney. Urology. 2013; 82(2):458-60.
49. Cost NG, Granberg CF, Schlomer BJ, Wickiser J, Gargollo P, Baker LA and Rakheja D. Single Institution Experience with Tru-Cut Renal Mass Biopsy for Diagnosing Wilms Tumor. Urology Journal. 2013; 10(1):780-3.
50. Cost NG, Geller JI, DeFoor WR, Wagner LM and Noh PH. A Robotic-Assisted Laparoscopic Approach for Pediatric Renal Cell Carcinoma Allows for both Nephron-Sparing Surgery and Extended Lymph Node Dissection. Journal of Pediatric Surgery. 2012; 47(10):1946-50.
51. Cost NG, Lubahn JD, Granberg CF, Sagalowsky AI, Wickiser JE, Gargollo PC, Baker LA, Margulis V and Rakheja D. Pathologic Review of Wilms Tumor Nephrectomy Specimens and Potential Implications for Nephron Sparing Surgery In Wilms Tumor. Journal of Urology. 2012; 188(4 Suppl):1506-10.
52. Lubahn JD*, Cost NG*, Kwon J, Powell JA, Yang M, Granberg CF, Wickiser JE, Rakheja D, Gargollo PC, Baker LA and Margulis V. Correlation between pre-operative staging Computed Tomography and pathologic findings after nodal sampling in children with Wilms tumor. Journal of Urology. 2012; 188(4 Suppl):1500-5. * - indicates co-primary authors.
53. Cost NG, Adibi M, Lubahn JD, Romman A, Raj GV, Sagalowsky AI and Margulis V. Effect of Testicular Germ Cell Tumor Therapy on Renal Function. Urology. 2012; 80(3):641-8.
54. Rakheja D, Khokhar S, Mitui M and Cost N. Immunohistochemical expression of GLUT1 and its correlation with unfavorable histology and TP53 codon 72 polymorphism in Wilms tumors. Pediatric and Developmental Pathology. 2012; 15(4):286-92.
55. Cost NG, Mitui M, Khokhar S, Wickiser JE, Baker LA and Rakheja D. TP53 Codon 72 Polymorphisms in Favorable Histology Wilms Tumors. Pediatric Blood and Cancer. 2012; 59(2):326–8.
56. Cost NG, DaJusta DG, Granberg CF, Cooksey RM, Laborde CE, Wickiser JE and Gargollo PC. Robotic Assisted Laparoscopic Retroperitoneal Lymph Node Dissection in an Adolescent Population. Journal of Endourology. 2012; 26(6):635-40.
57. Cost NG, Lubahn JD, Granberg CF, Schlomer BJ, Wickiser JE, Rakheja D, Gargollo PC, Leonard D, Baker LA, Raj GV and Margulis V. Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms tumor. Pediatric Blood and Cancer. 2012; 58(6):898-904.
58. Cost NG, Lubahn JD, Granberg CF, Schlomer BJ, Wickiser JE, Rakheja D, Gargollo PC, Leonard D, Baker LA, Raj GV and Margulis V. Abstract 9561 - Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms tumor. Journal of Clinical Oncology. 2011; 29(15S):599s
59. Cost NG, Delacroix SE, Sleeper JP, Smith PJ, Youssef RF, Chapin BF, Karam JA, Culp S, Abel EJ, Brugarloas J, Raj GV, Sagalowsky AI, Wood CG and Margulis V. The Impact of Targeted Molecular Therapies on the Level of Renal Cell Carcinoma Vena Caval Tumor Thrombus. European Urology. 2011; 59(6):912-8.
Outside of work I enjoy spending time with my wife, my son, and family. We love to travel and experience foreign languages and cultures, specifically the time we spend in Italy. I enjoy being active and being in the wonderful Colorado outdoors (Golf, Skiing, Basketball, Soccer, Running), but also try to find time to relax and enjoy reading, both fiction and non-fiction.
Kidney Cancer; Testicular Cancer; Pediatric, Adolescent and Young Adult Urologic Oncology