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INTRODUCTION AND OBJECTIVES: Active surveillance (AS) is increasingly recognized as the recommended treatment option in prostate cancer (PCa) patients with clinically localized, low-risk disease. However, previous studies suggest that its utilization is uncommon.Weset to evaluate the nationwide utilization rate of AS in the contemporary era, identifying predictors of local treatment of the prostate in AS candidates. METHODS: We relied on the 2010e2011 Surveillance Epidemiology and End Results (SEER) database using all 18 SEER-based registries. We identified 9,049 patients that fulfilled the University of California, San Francisco (UCSF) AS criteria: prostate-specific antigen (PSA)

INTRODUCTION AND OBJECTIVES: We investigated the correlation between the expression of the vascular endothelial cell growth factor (VEGF), the platelet-derived growth factor(PDGF), their receptors (VEGFR2, PDGFR), and the pathologic stage or cell type in non-metastatic, renal cell carcinoma (RCC). METHODS: A prospective, observational study was conducted to assess the VEGF, VEGFR2, PDGF, and PDGFRprotein expression by immunohistochemical assay in tumor tissue samples obtained from surgical specimens after radical or partial nephrectomy performed at our center between January 2008 and March 2012. The intensity of these proteins were quantified by a single pathologist and rated on a scale of 0 to 3. We dichotomized the expression level as weak (scale 0-1) or strong (scale 2-3). The correlation between the expression of these proteins and the oncologic parameters, especially the pathologic classification according to the cell type of RCC, was analyzed. RESULTS: A total of 1,423 patients diagnosed with RCC underwent surgery during the study period. Excluding 292 patients with pathologically proven tumor other than RCC and 50 patients with metastasis, 1,091 patients with a mean age of 54 years were finally included in the analysis. Clear cell, papillary, chromophobe, and other types of RCC occurred in 962 (88.8%), 80 (7.4%), 31 (2.9%), and 10 (0.8%), respectively, of the 1,091 study patients (Table). PDGFRexpression was the highest in clear cell RCC, however VEGF and PDGFexpression was the highest in papillary RCC. VEGF staining showed higher expression with the increasing T or N stage. After adjusting the T stage and Furhman nuclear grade using multivariate logistic regression analysis, papillary RCC showed significantly stronger expression of VEGF (OR 3.57, 95% CI 1.74–7.32, p 0.001), VEGFR2 (OR 1.82, 95% CI 1.11–2.99, p 0.017), and PDGF(OR 2.46, 95% CI 1.49–4.06, p 0.019) compared to clear cell RCC. CONCLUSIONS: In this large series of immunohistochemical assay, we demonstrated different cytoplasmic expression of VEGF, VEGFR2, PDGF, and PDGFRin tumor cell according to the pathologic stage and the cell type of RCC. It is noteworthy that VEGF and PDGFexpression was the highest in papillary RCC, not in clear cell RCC.

comes of patients undergoing radical cystectomy with and without prior pelvic radiation. METHODS: A retrospective review of patients who underwent RC at our institution since 2000 was performed. Patients were stratified into two groups, those having received pelvic radiation prior to surgery (RPS) and an age/stage-matched control group without prior pelvic irradiation. Complications within 90 days of surgery were assigned a Clavien classification. RESULTS: 515 RCs were performed over the decade, of which 50 (9.7%) patients had received prior pelvic radiation. These 50 patients were compared to 50 age/stage-matched controls. There were no demographic differences between the two groups (Table 1). There was no significant difference in preoperative T stage, with the majority of each group having T2 disease (60.0% vs. 61.2%, p 0.274). The RPS group, however, had a significantly higher requirement for transfusion, at a rate of 79% compared with 45% in the controls (p 0.001). Postoperative complications as classified by the Clavien system did not differ between the groups, with a rate of 86% in the RPS group vs. 81.6% in the controls (p 0.777) (Table 2). Final pathology revealed a trend towards a higher rate of T4 lesions in the RPS group (31.3% vs 16.3%), but this value was not statistically significant (p 0.08). Rates of progression to metastatic disease were equivalent (57.1% vs. 55.8%, p 1). There was no significant difference in overall survival rates (1061 and 737 days, p 0.89) at a median follow up of 19.6 and 23.9 months. CONCLUSIONS: The majority of patients have a complication after RC using the Clavien system. Prior pelvic radiation did not appear to significantly increase intraoperative or postoperative complication rates using the Clavien classification system. Blood transfusion rate was higher in the radiated group.

INTRODUCTION AND OBJECTIVES: To determine the cancer control afforded by nephron-sparing surgery (NSS) in renal cell carcinomas (RCC) over 4 cm. METHODS: We performed a retrospective review of data for patients treated between 1980 and 2005. The following case characteristics were analyzed: age, surgical procedure, intraoperative parameters, complications, tumor size, Fuhrman grade, TNM stage, pathological data, and outcome. Kaplan-Meier survival curves were generated. RESULTS: The median age of the 61 patients included was 64 years (40-83). Mean intraoperative blood loss was 622 ml ± 691 (504800) and mean operative time was 155.7 ± 82 mins (52-360). Mean preoperative and immediate postoperative creatinine was 1.16 and 1.25 mg/dL, respectively. Mean RCC size was 56.3 ±18 mm (41-100). Margin status was positive in 11 cases (18%). Median follow-up time was 70.7 months. Five and ten-year cancer specific survival rates were 81% and 78%, respectively. Tumor-free survival rate was 92% at five years and 88% at ten years. By univariate analysis, tumor size >7 cm (p=0.002), pathological stage (p=0.001), and Fuhrman grade (p=0.004) were associated with survival. In the multivariate analysis, only pathological stage (p