ABSTRACTS of the 20Th ANNUAL MEETING of the ITALIAN SOCIETY of URO-ONCOLOGY (Siuro)
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ANTICANCER RESEARCH 30: 1375-1544 (2010) ABSTRACTS OF THE 20th ANNUAL MEETING OF THE ITALIAN SOCIETY OF URO-ONCOLOGY (SIUrO) Rome, June 23-25, 2010 Catholic University of the Sacred Heart Faculty of Medicine “A. Gemelli ” Centro Congressi Europa, Largo Francesco Vito, 1, Rome, Italy Chair: Gigliola Sica Honorary Chair: Pier Francesco Bassi Advisory Committee: Giorgio Arcangeli Cora Sternberg Giuseppe Vespasiani Organizing Secretariat Italian Society of Uro-Oncology (SIUrO) Emilia Viaggi Congressi & Meeting S.r.l. President: Giuseppe Martorana Via Porrettana, 76 40033 Casalecchio di Reno (BO) tel. + 39 051 6194911 – fax + 39 051 6194900 e-mail: [email protected] web: www.emiliaviaggi.it Scientific Secretariat Società Italiana di Urologia Oncologica (SIUrO) c/o Clinica Urologica, Alma Mater Studiorum Catholic University of the Sacred Heart Università di Bologna Permanent Training Office Policlinico S. Orsola Malpighi tel. + 39 06 30154886 – fax +39 06 3055397 Padiglione Palagi, via P. Palagi, 9 – 40138 Bologna e-mail: [email protected] tel. +39 051 6362421 – 051 302082 – fax +39 051 308037 web: www.rm.unicatt.it e-mail: [email protected] – web: www.siuro.it Abstracts of the 20th Annual Meeting of SIUrO, Rome, June 23-25, 2010 1 Objective: To evaluate the functional and oncological LAPAROSCOPIC VERSUS OPEN RADICAL outcomes of laparoscopic partial nephrectomy (LPN) in NEPHRO-URETERECTOMY FOR UPPER URINARY comparison with open partial nephrectomy (OPN) for renal TRACT UROTHELIAL CANCER: ONCOLOGICAL tumour. OUTCOMES AND 5-YEAR FOLLOW-UP Patients and Methods: Between July 1997 and January 2004, 125 LPN and 125 OPN were performed in our Clinic. Francesco Greco, Sigrid Wagner, Rashid M. Hoda, Amir Preoperatively, all the patients underwent intravenous Hamza and Paolo Fornara pyelography and computed tomography (CT) for detailed information on tumour size, location, extent of parenchymal Department of Urology and Kidney Transplantation, Martin infiltration, and proximity to the pelvicaliceal system. Luther University, Halle/Saale, Germany Demographic data (age, gender), perioperative and postoperative parameters, including operating time, estimated Laparoscopic surgery is increasingly accepted in the treatment blood loss, complications, length of hospital stay, renal of urological pathology. We compared the oncological function, histological tumour staging and grading, and outcomes of laparoscopic vs. open nephro-ureterectomy for metastasis rates were collected and analysed. upper urinary tract transitional cell carcinoma. Results: The mean operative time for LPN and OPN was Patients and Methods: Between July 1999 and January 135 min and 165 min, respectively. 2003, 70 laparoscopic nephro-ureterectomies (LNU) and 70 Mean warm ischemia time was 30 min (7-53 min) in the LPN open nephro-ureterectomies (ONU) for transitional cell and 28 min (6-50) in the OPN group. After 5 years from carcinoma of the upper urinary tract (TCC) were performed. operation, the biochemical markers of glomerular filtration The open procedure was reserved for patients with previous were completely normalized, demonstrating the absence of abdominal surgery or with severe cardiac and/or pulmonary renal injury. The definitive pathological results showed an problems. Demographic data, perioperative and postoperative incidence of 68% for renal clear-cell tumour, 13% for variables, tumour staging and histological grading and rates chromophobe tumour, 17% for angiomyolipoma and 2% for of metastasis were recorded and compared. benign complex cyst. The overall and cancer-specific survival Results: For LNU and ONU, respectively, mean operative rates at 5 years were 88% and 100%, respectively, in the LPN times were 240 min and 190 min; mean estimated blood loss group and 86% and 98% in the OPN group. was 70 ml in LNU and 120 ml in ONU. The definitive Conclusion: Laparoscopic partial nephrectomy, if pathology showed a high incidence of tumour stage pT2 G2 in performed by a skilled laparoscopist in expert centres, can both LNU and ONU groups. The median follow-up period was achieve oncological and functional outcomes that present no 60 months. In the LNU group, the 5-year disease-free survival relevant differences in comparison with the open procedure. was 75%: 100% for pTa, 88% for pT1, 78% for pT2, and 35% for pT3 (p<0.0001). In the ONU group, the 5-year disease-free survival was 73% (LNU-ONU; p=0.037): 100% for pTa, 89% 3 for pT1, 75% for pT2 and 31% for pT3 (p<0.0001). THE EXTENDED 14-CORE PROSTATE BIOPSY Conclusion: The results of our long-term controlled study SCHEME INCLUDING MIDLINE PERIPHERAL support the use of LNU as an effective alternative to an open SAMPLING IS MANDATORY IN PATIENTS WITH procedure in the therapy of upper urinary tract urothelial LOW PSA DENSITY cancer. Luigi Cormio, Fabrizio Lorusso, Oscar Selvaggio, Antonia Perrone, Giuseppe Di Fino, Mario De Siati, Pasquale 2 Annese, Francesca Sanguedolce, Pantaleo Bufo and LAPAROSCOPIC VERSUS OPEN PARTIAL Giuseppe Carrieri NEPHRECTOMY: ONCOLOGICAL AND FUNCTIONAL OUTCOMES OF A 5-YEAR Ospedali Riuniti di Foggia, Italy PROSPECTIVE STUDY IN 250 PATIENTS Aim: There is no general agreement on the ideal scheme for Francesco Greco, Sigrid Wagner, Raschid M Hoda, Felix transrectal prostate biopsy (TPB) and whether the scheme Kawan, Antonino Inferrera, Antonio Lupo and Paolo should be adjusted to patient clinical parameters. This study Fornara aimed to evaluate the diagnostic yield of an extended 14-core TPB scheme in detecting prostate cancer (PCa) and to Department of Urology and Kidney Transplantation, Martin identify those patients who would benefit most from such a Luther University, Halle/Saale, Germany scheme. 1377 ANTICANCER RESEARCH 30: 1375-1544 (2010) Patients and Methods: Between December 2005 and cores increases TPB diagnostic yield. The present study September 2009, 922 consecutive men underwent an aimed to determine whether duplication of lateral cores extended 14-core TPB because of serum PSA>4 ng/ml and/or sampling by another operator may improve the diagnostic abnormal digital rectal examination. The 14-core scheme yield of TPB. included sextant biopsies, 2 biopsies (one basal and one Patients and Methods: Between January 2008 and apical) in each lateral peripheral zone and 2 biopsies (one September 2009, 143 men scheduled by a single urologist for basal and one apical) in each midline peripheral zone. Each TPB because of serum PSA >4 ng/ml and/or abnormal digital core was numbered and analysed separately to determine the rectal examination underwent an extended 18-core biopsy overall detection rate of 6-, 10-, and 14-core biopsy schemes, scheme including our standard 14-core scheme (sextant as well as the detection rate according to serum PSA and biopsies + 2 biopsies, one basal and one apical, in each lateral prostate volume. Complications occurring up to 20 days after peripheral zone, + 2 biopsies, one basal and one apical, in the biopsy were also recorded. each midline peripheral zone) followed by duplication of Results: All procedures were carried out under local lateral peripheral zone sampling by another urologist. Each anaesthesia. PCa detection rate of 6-, 10-, and 14-core core was numbered and analysed separately to determine the schemes was 30.9% (285/922), 35.5% (328/922), and 37.2% overall detection rate of the 14- and 18-core biopsy schemes. (343/922), respectively, with an increase in diagnostic yield Complications occurring up to 20 days after the biopsy were of 14- vs. 6- and 10-core schemes of 10% and 4,5%, also recorded. respectively. When stratifying for clinical parameters, the Results: All procedures were carried out under local increase in diagnostic yield of the 14- vs. the 10-core scheme anaesthesia. While the addition of midline peripheral zone was greater in patients with low PSA levels (18.1%, 7.4%, sampling was found to be associated with a 4.9% increase in and 0% for serum PSA levels <4 ng/ml, 4 to 10 ng/ml, and diagnostic yield (44.7% vs. 42.6% for the 14- and the 10- >10 ng/ml, respectively), with large prostate volumes (6.7%, core scheme, respectively), duplication of lateral peripheral 4.1% and 3% for prostate volume >55 cc, 35 to 55 cc, and zone sampling did not change diagnostic yield at all. There <35 cc, respectively), and low PSA density (11% and 0.8% were no complications requiring hospitalization. for PSA density <0.15 and ≥0.15, respectively). There was no Conclusion: The present study shows that while the major complication requiring hospitalization. addition of midline peripheral sampling (the 14- vs. the 10- Conclusion: The present study confirms that the 10-core core scheme) increases the diagnostic yield of TPB by almost biopsy scheme provides better diagnostic yield than the 5%, the duplication of lateral peripheral sampling (the 18- vs. sextant scheme and should replace it as the standard protocol the 14- core scheme) even by a second operator does not for TPB. The extended 14-core scheme including midline increase the detection rate at all. peripheral sampling provides an overall increase in diagnostic yield of 4.5%; however, after stratifying for the evaluated clinical parameters (serum PSA, prostate volume and PSA 6 density) it becomes clear that it should be considered only in INTEGRATED STAGING SYSTEMS FOR patients with a serum PSA up to 10 ng/ml, and that it is most CONVENTIONAL RENAL CELL CARCINOMA: beneficial in patients with a low PSA density. A COMPARISON OF TWO PROGNOSTIC MODELS Martella Oreste 4 DUPLICATION OF LATERAL PERIPHERAL Division of Urology, Giuseppe Mazzini Hospital, Teramo, SAMPLING DOES NOT IMPROVE THE DETECTION Italy; Department of Health Sciences, L’Aquila University RATE OF THE EXTENDED 14-CORE TRANSRECTAL Medical School, L'Aquila, Italy PROSTATE BIOPSY SCHEME Objective: The objective of the current study was to compare, Luigi Cormio, Fabrizio Lorusso, Oscar Selvaggio, Antonia in a single centre experience, the discriminating accuracy of Perrone, Giuseppe Di Fino, Mario De Siati, Francesca two prognostic models to predict the outcome of patients Sanguedolce, Pantaleo Bufo and Giuseppe Carrieri surgically treated for conventional renal cell carcinoma (RCC).