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This study was conducted in order to review the outcomes regarding polygenic risk score (PRS) in prediction of prostate cancer (PCa). With the increasing proficiency of genetic analysis, assessment of PRS for prediction of PCa has been performed in numerous studies. Genetic risk prediction models for PCa that include hundreds to thousands of independent risk-associated variants are under development. For estimation of additive effect of multiple variants, the number of risk alleles carried by an individual is summed, and each variant is weighted according to its estimated effect size for generation of a PRS.Currently, regarding the accuracy of PRS alone, PCa detection rate ranged from 0.56 to 0.67. A higher rate of accuracy of 0.866-0.880 was observed for other models combining PRS with established clinical markers. The results of PRS from Asian populations showed a level of accuracy that is somewhat low compared with values from Western populations (0.63-0.67); however, recent results from Asian cohorts were similar to that of Western counterparts. Here, we review current PRS literature and examine the clinical utility of PRS for prediction of PCa.Emerging data from several studies regarding PRS in PCa could be the solution to adding predictive value to PCa risk estimation. Although commercial markers are available, development of a large-scale, well validated PRS model should be undertaken in the near future, in order to translate hypothetical scenarios to actual clinical practice.

INTRODUCTION AND OBJECTIVE:Renal function after partial nephrectomy (PN) depends on a complex of clinical conditions including preoperative parenchymal quality, postop parenchymal quantity, and the...

INTRODUCTION AND OBJECTIVE:We aimed to evaluate the prognostic value of seminal vesicle invasion (SVI) on preoperative multiparametric MRI (mpMRI) in pathological T3b prostate cancer (PCa).METHODS:...

INTRODUCTION AND OBJECTIVE:Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with upper tract urothelial carcinoma (UTUC). We evaluated the impact of preopera...

It has not been clearly proved in real practice whether early rehabilitation with phosphodiesterase type 5 inhibitors starting immediately after radical prostatectomy improves erectile function recovery more effectively than delayed treatment with the same regimen. We performed a prospective randomized trial to identify this.Patients with prostate cancer and an IIEF-5 (International Index of Erectile Function-5) preoperative score of 17 or greater were randomly assigned to receive sildenafil 100 mg regularly twice per week for 3 months immediately after urethral catheter removal as the early group or only 3 months after nerve sparing robot-assisted laparoscopic radical prostatectomy as the delayed group. The study primary end point was the full erectile function recovery rate, defined as an IIEF-5 score of 17 or greater, during the 12 months.Of the 120 randomized patients the proportion who achieved full recovery was significantly higher during the 12 months in the early group than in the delayed group (β = 0.356, p0.001, generalized estimating equation). After 9 months postoperatively the proportion of patients who achieved full recovery steadily increased to 41.4% at 12 months in the early group while patients in the delayed group showed no further improvement. Thus, full recovery was achieved in only 17.7% of patients at 12 months. Only early sildenafil treatment independently improved full recovery at 12 months (HR 2.943, p = 0.034).Our trial provides clinical data to suggest that earlier rehabilitation with phosphodiesterase type 5 inhibitors can contribute to the recovery of erectile function after radical prostatectomy in the clinical setting.

INTRODUCTION AND OBJECTIVE:To identify whether the concurrent systematic biopsy (SB) is still necessary in the magnetic resonance imaging fusion-targeted biopsy (MRIFTB) eraMETHODS:Total of 714 men...

INTRODUCTION AND OBJECTIVES:The effect of biofeedback for pelvic floor muscle training (PFMT) on the recovery of post-prostatectomy urinary incontinence (PPI) is still controversial. We performed a...

We examined the synergistic antitumor effects of cisplatin combined with triptolide in cisplatin resistant T24R2 bladder cancer cells and investigated possible molecular mechanisms.T24R2 cells were treated with cisplatin and/or triptolide. Tumor cell proliferation was determined using cell counting and clonogenic assays. The combination index of the synergism between cisplatin and triptolide was calculated. The cell cycle phase and apoptosis rate were determined by flow cytometry. Apoptosis and cell cycle related protein expression were analyzed by Western blot.The synergistic cytotoxicity effect of cisplatin and triptolide combination treatment was greater than the cytotoxic effect of cisplatin or triptolide alone. Combination treatment also induced cell cycle arrest via cyclin D1 and E1 expression. Apoptosis induced by combination treatment was accompanied by increased expression of caspase-3, 8 and 9, PARP and cytochrome c.Our results suggest that triptolide synergistically enhanced the antitumor effect of cisplatin in cisplatin resistant human bladder cancer cells. Cisplatin and triptolide combination treatment may be effective for advanced bladder cancer.

INTRODUCTION AND OBJECTIVES: Angiogenesis is known to play a major role in the pathogenesis of bladder cancer. Bosutinib is an orally bioavailable dual Src/Abl tyrosin kinase inhibitor (TKI). Nintedanib and vatalanib are TKI that inhibits the vascular endothelial growth factor receptor (VEGFR) and the platelet-derived growth factor receptor (PDGFR), has been demonstrated to exert anti-tumor effects. However, the molecular mechanisms underlying its effects on bladder cancer remain unknown. We examined anti-tumor effects of bosutinib, nintedanib, and vatalanib in human bladder cancer cells (T24, cisplatinresistant-T24R2). METHODS: Bladder cancer cells were treated with bosutinib, nintedanib, and vatalanib and cancer cell proliferation was determined using the cell counting kit-8 (CCK-8) assay and clonogenic assay. Cell cycle and apoptosis rate were measured by flow cytometry. Apoptosisand cell cycle-related protein expression was analyzed by Western blot assays. RESULTS: Bladder cancer cell proliferation and colony formation was significantly reduced by bosutinib and vatalanib treatment in a dose-dependent manner. Bosutinib, nintedanib, and vatalanib induced apoptosis and cell cycle arrest at G1 phase. Expression of apoptosis related proteins (caspase-3, -8, -9, PARP, cytochrome c, bad, and bax) was elevated by bosutinib, nintedanib, and vatalanib treatment. CONCLUSIONS: In conclusion, new TKI (bosutinib, nintedanib, and vatalanib) showed anticancer effect in bladder cancer cells through induce apoptosis and cell cycle arrest. These data suggest that bosutinib, nintedanib, and vatalanib may be a novel therapeutic approach in the bladder cancer.

Chi-Square, Fischer’s exact, student’s t or Mann Whitney U tests as appropriate. RESULTS: 151 participants were enrolled and randomized into the study. 31 participants did not return their 24 hour VAS and were excluded. There was no difference in age, sex, stent duration, largest stone size, stone location, stone number, or initial VAS between groups (all >0.05). 3 of 120 (2.5%) of participants had severe pain (VAS >70) at follow-up. Opiate use did not differ between groups (12.5% vs 7.8%, p1⁄40.39), but patients who used opiates (n 1⁄4 12) had higher 24 hour VAS scores that those who did not (mean 32.1 mm in those using opiates, 4.9 mm in those not using opiates p 20 (p1⁄40.20) or of patients with severe pain (p1⁄41.0). CONCLUSIONS: Though there was a statistically significant difference in 24 hour VAS between groups, it does not appear to be clinically relevant. Significant pain after ureteral stent removal appears to be a rare phenomenon not requiring prophylactic pain medication.

visualized. However, these lesions might not be easy to localize intraoperatively. Thus, the aim of this feasibility study was to evaluate intraoperative detection of metastatic lesions using a gamma probe after injection of a radiolabelled PSMA-ligand in correlation with postoperative histological findings. METHODS: 9 consecutive PCa patients with rising PSA after curative treatment (Median: 1.3ng/ml, range: 0.2 e 4.7ng/ml) and evidence of recurrent disease within the pelvis on 68Ga-HBEDPSMA PET hybrid imaging were included in this analysis. 24 hours before surgery patients received an intravenous injection of 111Inlabelled PSMA-I&T. Intraoperatively, metastatic lesions were detected by gamma probe with acoustic and visual feedback. Using the freehand SPECT technique optical tracking of the gamma probe allowed augmenting the live video stream of the field of surgery with reconstructed 3D image showing the position of positive lesions. Results of ex vivo radioactive rating (positive vs. negative) of resected tissue were compared to findings of postoperative histological analysis. RESULTS: In total, 32 separate histological specimens were evaluated (Median: 2, range: 2 e 7) and 15 specimens contained metastatic lesions at histological analysis. Lesions declared radioactive-positive intraoperatively and exhibiting a positive signal by the gamma probe ex vivo corresponded to metastatic PCa lesions with a sensitivity of 93.3% and a specificity of 100%. Detection of lesions as well as complete resection of even small metastatic lymph nodes was facilitated by the use of the gamma probe. Compared to preoperative 68Ga-HBED-PSMA PET hybrid imaging the intraoperative use of the gamma probe might even be more accurate as it detected all positive lesions and even additional lesions as small as 2mm. CONCLUSIONS: In this initial series, PSMA-radioguided surgery proved to be of high value for intraoperative detection of even small metastatic lesions in PCa patients. However, adequate patient selection for this individual treatment concept is crucial. Furthermore, greater patient numbers including follow-up data are needed to determine its possible role in clinical routine.

dations: 2 of 3 UA with 3 rbc/hpf. Upper tract imaging consisted of multiphase CT or IVP plus renal ultrasound. All patients underwent cystoscopy. Urologists reported: 1. Hx of gross hematuria in past 6 months; 2. Result of imaging; 3. Cystoscopy findings; 4. Cause of hematuria. UA results, stratified as 0-3, 4-10, 11-25, 26-50, 50 rbc/hpf. Smoking history, and patient demographics were abstracted. Statistical Analysis Multivariable logistic regression models were used to build a predictive risk model. Patient age, sex, degree of hematuria on UA, recent hx of gross hematuria and smoking history were included. The model’s predictive ability was assessed using the area under the receiver operating characteristic (ROC) curve. The resulting risk score was applied to an independent validation cohort and the area under the ROC curve was estimated. RESULTS: The overall CA detection rate was 2.1% in a cohort of 4414. Patients with a recent hx of gross hematuria and age over 50 were at greatest risk of being diagnosed with a urinary tract CA. Smoking hx and male sex were less predictive. Degree of hematuria ( 25rbc/hpf) was least predictive. The areas under the receiver operating characteristic curves were 0.849 and 0.842 for the original and validation cohorts, respectively. CONCLUSIONS: These data suggest that patients under age 50, with no hx of gross hematuria, approximately 1/3 of pts evaluated, may safely avoid unnecessary and potentially hazardous testing for AMH. Microscopic hematuria of any degree should not be the basis to determine diagnostic evaluation.

Objective: To investigate the prognostic significance of positive surgical margins (PSM)s among patients who underwent radical prostatectomy (RP) for pT2 and pT3a prostate cancer. Patients and methods: We reviewed the records of 658 patients who were revealed to have pT2 and pT3a prostate cancer after undergoing RP without neoadjuvant or adjuvant treatment. For our analysis, patients were subgrouped as the following: group 1: 406 (61.7%) with negative surgical margins (NSM)s and no extracapsular extension of tumor (ECE); group 2: 99 (15.0%) with PSMs and no ECE; group 3: 63 (9.6%) with NSMs and ECE; and group 4: 90 (13.7%) with PSMs and ECE. The effects of various variables on biochemical recurrence (BCR)-free survival were assessed via uni- and multivariate analyses. Results: During median follow-up of 36 months, group 1 had significantly higher BCR-free survival compared with the other 3 groups (P 0.001). However, no significant differences in BCR-free survivals were observed among the group 2, 3, and 4 (all P 0.05). In multivariate analysis, PSM (P 0.009) was observed to be significantly associated with BCR-free survival among groups 1 and 2 combined. Among groups 3 and 4, pathologic Gleason score (P 0.002), but not PSM (P 0.668), was the only significant predictor for BCR-free survival in multivariate analysis. Conclusions: According to our results, PSM is significantly associated with biochemical outcome after RP in pT2 prostate cancer. Meanwhile, patients with pT2 tumor and PSM appear to have comparable biochemical outcome compared with those with stage pT3a tumor

Objective We aimed to investigate significance of smoking regarding pathologic and biochemical outcomes following radical prostatectomy (RP).