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INTRODUCTION AND OBJECTIVE:Men with family history of prostate cancer (PCa) constitute a high-risk cohort for PCa. Unfortunately, in absence of level 1 data, specific guidelines regarding prostate-...

INTRODUCTION AND OBJECTIVE:The prognostic significance of a ‘second’ biochemical recurrence (sBCR) after salvage radiation therapy (sRT) with/without hormonal therapy following primary radical pros...

INTRODUCTION AND OBJECTIVE:Age adjusted Prostate-Specific Antigen (aaPSA) reference ranges are used to improve the specificity and sensitivity of PSA testing due to the inherent variability and pro...

INTRODUCTION AND OBJECTIVE:A significant proportion of men that experience biochemical recurrence after radical prostatectomy do not receive timely salvage radiation therapy (sRT). It is unknown wh...

INTRODUCTION AND OBJECTIVE:Men with family history of prostate cancer (PCa) constitute a high-risk cohort for PCa, as do Black men. Specific guidelines regarding prostate-specific antigen (PSA) scr...

INTRODUCTION AND OBJECTIVE:The efficacy of prostate specific antigen (PSA) screening is predicated on, amongst other factors, age and ethnicity of recipients. The goal of the current study was to c...

INTRODUCTION AND OBJECTIVE:There are five rare histological variants of prostate adenocarcinoma (PCa), namely, ductal, mucinous, signet ring cell (SRC), adenosquamous (ASC) and neuroendocrine (NEC)...

INTRODUCTION AND OBJECTIVE:Transrectal ultrasound guided (TRUS) prostate biopsies are the standard of care for the diagnosis of prostate cancer (PCa). However, magnetic resonance imaging (MRI) has ...

INTRODUCTION AND OBJECTIVE:The detrimental impact of lymphovascular invasion (LVI) in prostate cancer (PCa) on the risk of biochemical recurrence has been previously described. However, the impact ...

We report a 1-year update of functional urinary and sexual recovery, oncologic outcomes and postoperative complications in patients who completed a randomized controlled trial comparing posterior (Retzius sparing) with anterior robot-assisted radical prostatectomy.A total of 120 patients with clinically low-intermediate risk prostate cancer were randomized to undergo robot-assisted radical prostatectomy via the posterior and anterior approach in 60 each. Surgery was performed by a single surgical team at an academic institution. An independent third party ascertained urinary and sexual function outcomes preoperatively, and 3, 6 and 12 months after surgery. Oncologic outcomes consisted of positive surgical margins and biochemical recurrence-free survival. Biochemical recurrence was defined as 2 postoperative prostate specific antigen values of 0.2 ng/ml or greater.Median age of the cohort was 61 years and median followup was 12 months. At 12 months in the anterior vs posterior prostatectomy groups there were no statistically significant differences in the urinary continence rate (0 to 1 security pad per day in 93.3% vs 98.3%, p = 0.09), 24-hour pad weight (median 12 vs 7.5 gm, p = 0.3), erection sufficient for intercourse (69.2% vs 86.5%) or postoperative Sexual Health Inventory for Men score 17 or greater (44.6% vs 44.1%). In the posterior vs anterior prostatectomy groups a nonfocal positive surgical margin was found in 11.7% vs 8.3%, biochemical recurrence-free survival probability was 0.84 vs 0.93 and postoperative complications developed in 18.3% vs 11.7%.Among patients with clinically low-intermediate risk prostate cancer randomized to anterior (Menon) or posterior (Bocciardi) approach robot-assisted radical prostatectomy the differences in urinary continence seen at 3 months were muted at the 12-month followup. Sexual function recovery, postoperative complication and biochemical recurrence rates were comparable 1 year postoperatively.

INTRODUCTION AND OBJECTIVES:Clinical trials are currently examining the role of local therapy in metastatic prostate cancer (mPCa). While the safety of RP in localized disease is proven, few studies have looked at perioperative complications and cost of cytoreductive RP (cRP). We used the National Inpatient Sample (NIS) to study the inpatient morbidity, and cost of cRP in the United States (US).METHODS:Analyzing the NIS dataset from 2008-2014, we identified 90,662 patients (weighted estimate 449,025 in the US) who underwent RP for nonmetastatic disease, and 1,173 patients (weighted estimate 5,835) who underwent cRP for mPCa (see Fig. 1). Outcomes of interest were inpatient complications, individual complications, hospital stay, and total cost. Covariates included age, race, Charlson Comorbidity score, insurance status, rural/semi-urban/urban location, income, hospital location (rural/urban), teaching status, geographical location of hospital, and hospital volume. Multivariable logistic regression was used...

INTRODUCTION AND OBJECTIVES:The last decade witnessed an increasing adoption of active surveillance (AS) as a treatment option in low-risk prostate cancer (PCa) patients. However, low-risk patients...

INTRODUCTION AND OBJECTIVES:The CARMENA phase III randomized trial reported that overall survival with sunitinib alone is noninferior to the combination of nephrectomy followed by sunitinib in pati...

INTRODUCTION AND OBJECTIVES:American Joint Committee on Cancer (AJCC) recognizes five rare histological variants of PCa. Our aim was to describe the contemporary presentation and overall survival (...

INTRODUCTION AND OBJECTIVES:To evaluate rates and patterns of local and metastatic disease occurrence in patients with node-negative non-metastatic prostate cancer at radical prostatectomy (RP) tha...

Although black men represent a high risk population for prostate specific antigen screening for prostate cancer, recommendations in black men are unclear. To our knowledge the resultant effect of conflicting recommendations and disparities in access to care on prostate specific antigen screening in black men is unknown.We compared the rate of self-reported prostate specific antigen screening in black men relative to that in nonHispanic white men. The BRFSS (Behavioral Risk Factor Surveillance System) 2012 data set was used to identify asymptomatic men 40 to 99 years old who reported undergoing prostate specific antigen screening in the last 12 months. Age, education, income, residence location, marital status, health insurance, regular access to a health care provider and a health care provider recommendation to undergo screening were extracted. Subgroup analyses by race and age were performed using complex samples logistic regression models to assess the odds of undergoing prostate specific antigen screening.In 2012 there were 122,309 survey respondents (weighted estimate 54.5 million) in the study population, of whom 29% of black and 32% of nonHispanic white men reported undergoing prostate specific antigen screening. Younger black males had higher rates and odds of screening than nonHispanic white men of a similar age (ages 45 to 49, 50 to 54 and 55 to 59 years OR 1.66, 1.58 and 1.36, respectively). Among black men only a higher education level (graduates vs nongraduates OR 2.12), regular access to a health care provider (OR 2.05) and a health care provider recommendation for screening (OR 8.43) were independently associated with prostate specific antigen screening.Despite long-standing disparities in health care access black males 45 to 60 years old have a higher rate and probability of prostate specific antigen screening than nonHispanic white men. Among black men educational attainment had a more pronounced association. In contrast the association with health care provider recommendations was less pronounced relative to that in nonHispanic white men. Future research may shed more light on the gamut of factors that influence the decision making process for prostate specific antigen testing.

INTRODUCTION AND OBJECTIVES: To assess the oncological and functional outcome after prostate brachytherapy (PB), a “Quadrella” index, has been recently developed (Radiother Oncol, 2014: 110-113). We aimed to evaluate this “Quadrella”: survival, erectile function, urinary and rectal toxicity at 1 and 2 years. METHODS: From 08/2007 to 01/2013, 193 patients underwent 125I PB (loose seeds, realtime planning, prescribed dose 160 Gy), for a low-risk or favorable intermediate-risk adenocarcinoma (PC). Inclusion criteria were: low risk PC, with no incontinence (initial score ICS1⁄40), and good erectile function (IIEF5 score >16). One hundred patients met the criteria (mean age: 64y), including 10 patients who had neoadjuvant hormotherapy (to obtain reduction volume: 16), the absence of urinary toxicity (IPSS 15 with ?IPSS

INTRODUCTION AND OBJECTIVES: To describe the feasibility and early outcomes of a Modification to robot-assisted radical prostatectomy (RARP) that allows for mitigation of the lack of tactile feedback during RARP by allowing immediate Organ Retrieval for Examination and targeted frozen-section biopsies (MORE technique). METHODS: MORE consists of a GelPOINT device inserted periumbilically. Prostate is excised and retrieved through the GelPOINT without undocking the robot, and examined bimanually on-table by the surgeon. Lesions suspicious for positive surgical margin (PSM) are sent for frozen section analysis (Figure). Biopsies positive/suspicious for cancer resulted in more tissue excision from the corresponding pelvic bed site. 352 patients with a probability of extracapsular extension (EPE) >25% (Partin table) were selected to undergo MORE RARP. MORE RARP patients with pT3a at final pathology (n1⁄4103) were compared to a control group of 74 consecutive patients with pT3a after conventional RARP. RESULTS: Except a greater proportion of clinically palpable disease in the MORE RARP vs. control group (43.7 vs. 17.6%; p1⁄40.005), the two groups had comparable rates of nodal dissection, nerve sparing, pathological stage, grade and nodal status. The PSM rate in the MORE group was 17.5% (18/103) compared to 36.5% (27/74) in the control group (p1⁄40.004); the odds ratio was 0.37 (CI: 0.18-0.74; p1⁄40.005). 8 patients in each group had biochemical recurrence; short follow-up (median 16.6 and 15.4 months respectively) precluded detection of any significant difference. Frozen section biopsy site matched the EPE site at final pathology in 59/79 (73.4%) cases selected for frozen section analyses. CONCLUSIONS: Adoption of the MORE technique led to a significant reduction in the PSM rate following RARP in patients harboring locally advanced disease without increasing operative time. Its easy reproducibility may also allow potential utility in other robotassisted urologic oncologic procedures. Source of Funding: none