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Introduction: The aim of this study is to assess the effectiveness of University of California San Francisco Cancer of Prostate Risk Assessment (UCSF-CAPRA) as a predictor of positive surgical margins (PSM) after robot-assisted radical prostatectomy (RARP). Materials and Methods: This is a two-center retrospective study. The dataset included patients who underwent RARP between January 2012 and January 2014. Patients were stratified in accordance with D'Amico and UCSFCAPRA criteria. PSMs were defined as cancer cells at the inked surface of the specimen. Surgical margin status (negative and positive) was compared with pre, intra, and postoperative characteristics using Mann-Whitney U test and Pearson 2 correlation. Wilcoxon signed log rank test was performed to evaluate the difference between clinical and pathological stage and biopsy and pathological Gleason score. Two regression models (one with preoperative characteristics and one with postoperative characteristics) were build to evaluate independent factors associated with PSM. Results: We reported a PSM rate of 23.1% (53 of 229) between two centers. In the logistic regression, pre-operative predictors of PSMs were UCSF-CAPRA class risk, UCSF-CAPRA coded as continuous variable, and biopsy Gleason score. Pathological stage and pathological Gleason score were postoperative independent factors related with PSM. Conclusion: This study shows that CAPRA score is a good and simple tool to stratify patients before surgery. The use of CAPRA score system can help the surgeons in planning the best treatment for patients to reduce PSM rate after RARP. [ABSTRACT FROM AUTHOR]

Introduction: Sunitinib therapy showed an improvement in survival of patients with metastatic renal cell carcinoma. Materials and Methods: A 51-year-old man, with Eastern Cooperative Oncology Group Score (ECOG) of 0, presented at our Institute in March 2012 for macrohematuria and urinary retention. A computed tomography (CT) scan of the abdomen showed a right renal lesion. The lesion had a diameter of 15 cm and was developing towards the liver, in the absence of cleavage planes between the liver and kidney. A 12 mm finding, suspected as secondary lesion, was detected at the level of the VII hepatic segment. Neoadjuvant chemotherapy with Sunitinib was proposed. Results: The patient underwent a ultrasound-guided biopsy, which confirmed the presence of Clear Cell Carcinoma. The patient began chemotherapy treatment in May 2012 according to the scheme SUNITINIB 50 mg daily for 4 weeks every 6 weeks. After four courses of treatment, according to RECIST criteria for solid tumors, 40% (9 cm vs 15 cm) regression of the primary tumor and 33% (8 mm vs 12 mm) regression of the secondary lesion were observed at a CT scan of the abdomen. In February 2013, Laparoscopic Adrenal-Sparing Radical Nephrectomy was performed. At a follow-up of 3 months, performed with a thorax and abdomen CT scans, there was a complete remission of hepatic secondary lesion and no areas of secondary localization of disease. Conclusions: This case report showed the effectiveness of neoadjuvant chemotherapy with Sunitinib. The use of this chemotherapy agent can change the approach to the management of cRCC. [ABSTRACT FROM AUTHOR]