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INTRODUCTION AND OBJECTIVE:Lymph node (LN) status is a key prognostic factor in the decision-making process for prostate cancer (PC) management. Sectioning and haematoxylin-eosin (HE) staining tech...

INTRODUCTION AND OBJECTIVE:Posterior rhabdosphincter reconstruction (PRRS) following radical prostatectomy was designed to improve early urinary continence. We executed a randomized clinical trial ...

INTRODUCTION AND OBJECTIVES: Epitelial-to-mesenchymal transition (EMT) is a well characterised process linked to tumour progression and metastasis in a number of carcinomas. EMT enables carcinoma cells to lose cell to cell contacts and endows them with stem cell-like properties to invade and initiate metastasis. Recent reports have identified EMT as potentially playing a significant role in RCC disease recurrence, invasion and metastasis. Several signalling pathways like HIF/2 and IL-6/STAT, are well known inducers of the EMT phenotype. Protein kinase CK2 is a constitutively active serine/threonine kinase consisting of two catalytic subunits (CK2alpha/alpha’) and two regulatory subunits (CK2Beta) and is present in the nucleus and cytoplasm of all eukaryotic cells. The imbalance of CK2 catalytic and regularory subunits, due to underexpression of CK2Beta subunit, has been correlated with the expression of EMT markers. In clear cell renal cell carcinoma (ccRCC), the alterations in the ratios between CK2 subunits during the neoplasic process seems to participate at different stages of tumour progression METHODS: We analyzed the expression and distribution of CK2 subunits in samples of clear cell renal carcinomas (ccRCC) and renal healthy tissue from the same patients by immunohistochemistry on TMAs and Western-blot in a total of 98 patients. Tumour registry data and patient outcome were retrospectivelly collected and correlates with clinicopathological data (F€ urhman grade, pT stage and Risk group) and with IL-6/STAT inmunoexpression RESULTS: We observed an increase of CK2 in tumors. Regarding the subcellular distribution in normal tissue CK2alpha is predominantly cytoplasmic whereas tumors markedly increased in the core, with only a slight decrease in the cytoplasm, indicating nuclear overexpression CK2alpha tumors. CK2Beta changes are more discreet and its nuclear accumulation in tumors could be due to translocation from the cytoplasm, which is a marked decrease. Using 786-O cells, derived ccRCC pVHL deficient, and 786-O cells stably transfected with an expression vector pVHL, we have observed that the presence of VHL not decrease but it increases CK2alpha levels by altering the ratio between CK2alpha/CK2Beta. It was observed higher survival in the subset patients with underexpression of CK2sBeta although log-rank was not significant (0,301). The combination of overexpression of STAT3 and underexpression ok CK2Beta seems to provide a higher survival hazard ratio of 4,252 (95% IC, 1,182-18.413) CONCLUSIONS: The results indicate CK2alpha overexpression in clear cell renal cell carcinoma by a mechanism that does not appear due to inactivation of VHL. In patients with underexpression of IL-6/STAT3, CK2Beta was no able to discriminate any behaviour, but the patients defined as poor prognostic when STAT3 was overexpressed has similar survival than those that had underexpression of STAT3. The combination of overexpression of STAT3 and underexpression of CK2Beta provided a higher survival rate

INTRODUCTION AND OBJECTIVES: The number of discarded kidneys for transplantation approaches 25% in the Spanish transplant registry. The main cause(w50%) is the presence of advanced histological lesions in kidney pre-implantation biopsies. Transplants results with expanded criteria donors are poorer than results with standard donors and kidneys with advanced histological lesions are not used in many transplant centers. AIM: To analyze transplant results from deceased donors using pre-implantation biopsies to evaluate expanded donors in our renal transplant unit. METHODS: Since 2009 all kidneys offered to our transplant unit were accepted for clinical examination. A pre-implantation kidney biopsy is obtained in patients with expanded criteria. Pre-implantation biopsies are processed in paraffin and pathologists cathegorizes the biopsies according to the Banff criteria (from 0 to 3). Individual scores are added and a pre-implantation score ranging from 0 to 15 is obtained. In general, kidneys with a pre-implantation donor score > 7 are discarded. An old-for-old policy is applied for kidney allocation with a donor/recipient age difference lower than 15 years. Kidneys with a donor biopsy score >5 were only transplanted in recipients older than 60 years RESULTS: Between 2009 and 2013 we evaluated 404 kidneys and 41 (10%) were discarded. Only 20 kidneys (5%) were discarded due to a pre-implantation biopsy score >7. Thus, 362 transplants were performed and according to our protocol in 254 cases (70%) a pre-implantation biopsy was obtained. Donors with a pre-implantation biopsy were older (61 10 vs. 39 10 years, p 5, n1⁄479) have a similar renal function at 1 year (45 14 vs. 46 15 mL/min) and a similar 5-year graft survival (81.4% vs. 83.5%) than transplants from kidneys with lower scores (1 to 5). CONCLUSIONS: Careful evaluation and selection of deceased donors and renal transplant recipients allows to reduce the number of discarded kidneys (10% in our unit) and to maintain standard transplant results.

underwent PN, in 33.3% of which a MIT was adopted. Majority of RNs for T1 tumours were performed using a MIT (90.3%). Of the laparoscopic PNs, 30.5% were robot-assisted. No significant difference in intra operative complications was found between the RN and PN groups (4% vs 4.3% respectively; p1⁄40.79). However PN accounted for a higher postoperative complications rate (RN 11.3% vs PN 17.6%; p1⁄40.0002). Operative time between RN and PN was comparable (141min vs 145min; p1⁄40.25). Blood loss was less in the RN group (mean for RN 165mL vs PN 323mL; p

The aim of this study was to evaluate bone mass changes after 1 year of four different types of pharmacological intervention. Ninety-seven prostate cancer patients treated with androgen deprivation therapy, and severe osteopenia or osteoporosis were retrospectively studied. Patients were divided in four groups. Group 1: 28 patients treated with denosumab, Group 2: 24 patients treated with alendronate, Group 3: 24 patients with no antiresorptive treatment and Group 4: 21 patients previously treated with alendronate and switched to denosumab. Dual X-ray absorptiometry was performed at baseline and after 1 year. Bone mass changes at the L2–L4 lumbar spine, femoral neck and total hip were evaluated. No differences were found at baseline. After 1 year, men receiving denosumab or alendronate (Group 1 and 2) showed a significant bone mass increase at the lumbar spine (+2.4 and +5.0 %, respectively), while no significant changes were observed in Group 3 and 4. At the femoral neck, Group 1 and 2 patients showed a significant bone mass increase (+3.7 and +3.6 %, respectively), while no significant changes were observed in Group 3 and 4. At the total hip, we observed a significant bone mass increase in Group 1 (+2.9 %) and a significant bone mass loss in Group 3 patients (−1.9 %). No significant changes were observed in Group 2 and 4. Denosumab increased significantly bone mass in all three dual X-ray absorptiometry standard sites, while alendronate did not at total hip. No benefit was observed in men previously treated with alendronate who switched to denosumab treatment.

INTRODUCTION AND OBJECTIVES: Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function. The influence on erection and ejaculation of the new surgical procedures available to treat BPH has been poorly studied. Although testosterone levels correlate with sexual function, the effect of BPH surgery on these levels in unknown. OBJECTIVES: To assess the effect of HoLEP on sexual function in a group of patients with LUTS secondary to BPH. To assess whether HoLEP has any effect on serum testosterone levels. METHODS: Prospective study that analyzes changes in sexual function and urinary symptoms in a group of 100 consecutive patients that underwent HoLEP. To assess the changes on erection and ejaculation, urinary symptoms and their interference on quality of life, four validated questionnaires were used: IIEF-5, ICIQ-MLUTSsex, AUA questionnaire and QoL index of the ICC. Serum determinations of total, free and bioavailable testosterone were performed in half of patients. Patients were evaluated before surgery and 3 and 12 months after HoLEP. Patients under PDE5 or testosterone treatment were excluded. RESULTS: Mean age was 69 years. Half of patients were on 5ARI treatment before surgery. The table shows the changes in scores on the questionnaires employed. There was a significant and sustained improvement in the scores of questionnaires evaluating urinary symptoms and the interference of the symptoms in QoL. No significant differences were observed between the number of patients with erectile disfunction (mild/moderate/severe) before and after surgery. The percentage of patients with absence or severely decreased ejaculation increased with HoLEP from 33% to 80%. The degree of importance that patients gave to their ejaculatory problems decreased with surgery. No significant differences were found between testosterone levels with surgery. CONCLUSIONS: HoLEP causes an improvement in the scores of questionnaires that assess urinary symptoms and the interference of the symptoms in the quality of life of patients. Although surgery causes most of patients have retrograde ejaculation, its presence is not interpreted as a problem by patients. In contrast, the quality of erection does not change at all with surgery. HoLEP has not effect on serum testosterone levels.