678
LAPAROSCOPIC RADICAL PROSTATECTOMY FOR HIGHRISK PROSTATE CANCER
+XWWRQ&5RXVH3(GHQ* Royal Surrey County Hospital, Dept. of Urology, Broad Oak, United Kingdom, 2 Royal Surrey County Hospital, Dept. of Urology, Guildford, United Kingdom
1
Introduction & Objectives: +LJKULVN SURVWDWH FDQFHU +L53& 36$ ! QJPO *OHDVRQ F7ุF Gಬ$PLFR LV FKDUDFWHULVHG E\ LWV KLJKHU UDWH RI PHWDVWDVLV DQG FDQFHUUHODWHG GHDWK WKDQ RWKHU JURXSV DQG UHVSRQGV SRRUO\ WR WUHDWPHQW PRQRWKHUDS\ ZLWK \HDU VXUYLYDO UDWHV IRU * RI /X
679
RISDWLHQWV0HDQIROORZXSZDVP6' $JHุZDVQRWDSUHGLFWRU IRU&66S 16 :KLOHDJHZDVVLJQLᚏFDQWO\UHODWHGWRRYHUDOOVXUYLYDOS WKHPHGLDQRYHUDOOVXUYLYDORISDWLHQWVDJHGุZDVPDQGLQSDWLHQWVDJHG ุ Q PHGLDQ VXUYLYDO ZDV P ,Q WKH &R[ PXOWLYDULDWH DQDO\VLV DJHุQRWVLJQLᚏFDQWO\UHODWHGWR&66KRZHYHUDJHุZDVDQLQGHSHQGHQW SUHGLFWRU RI 26 S +5 &, EHVLGHV O\PSK QRGH LQYDVLRQVSHFLPHQ*OHDVRQVFRUHDQGVXUJLFDOPDUJLQVWDWXV Conclusions: 7KH RQFRORJLFDO RXWFRPH RI VHQLRU DGXOWV ZLWK KLJKULVN ORFDOL]HG SURVWDWH FDQFHU XQGHUJRLQJ VXUJHU\ DSSHDUV WR EH KLJKO\ VDWLVIDFWRU\ (YHQ WKRXJK DJH ุ ZDV VLJQLᚏFDQWO\ FRUUHODWHG WR RYHUDOO PRUWDOLW\ PHGLDQ RYHUDOO VXUYLYDO WLPH LQ WKLV DJH JURXS ZDV ZHOO RYHU \HDUV PLUURULQJ FRUUHFW SDWLHQW VHOHFWLRQ 6HQLRU DGXOWV ZKR KDYH IHZ FRPRUELGLWLHV PD\ VWLOO EH FDQGLGDWHV IRU VXUJLFDOPDQDJHPHQWRIKLJKULVNSURVWDWHFDQFHU
680
ELDERLY PATIENTS ARE AT A MORE ELEVATED RISK OF PT 3 PROSTATE CANCER: RESULTS OF A EUROPEAN SINGLE CENTER
%XG¦XV/6SHWKPDQQ-6DORPRQ*6DORPRQ*,VEDUQ+$XSULFK0 6WHXEHU7+DHVH$6FKORPP7+HLQ]HU++XODQG+.DUDNLHZLF]3, *UDHIHQ0 1 University Medical Centre Hamburg-Eppendorf, Dept. of Urology, Hamburg, Germany, 2University Medical Center Hamburg-Eppendorf, Martini-Clinic, Prostate Cancer Center, Hamburg, Germany, 3University of Montreal Health Center, Cancer Prognostics and Health Outcomes Unit, Montreal, Canada Introduction & Objectives: 6XUJLFDO PDQDJHPHQW RI SURVWDWH FDQFHU UHTXLUHV FDUHIXOFRQVLGHUDWLRQRISDWKRORJLFDOWXPRUH[WHQWWRDGMXVWWKHW\SHDQGH[WHQWRI UDGLFDOSURVWDWHFWRP\)RUH[DPSOHDKLJKHUULVNRIS7GLDJQRVLVPD\GLFWDWHWKH QHHGIRUZLGHUUHVHFWLRQDQGDPRUHH[WHQGHGO\PSKDGHQHFWRP\:HH[DPLQHG WKHWUHQGVRIS7SURVWDWHFDQFHULQWKHHOGHUO\DJHV\HDUVDQGROGHU HVSHFLDOO\ WKDWWKHVHPHQPD\DOVREHDᚎHFWHGE\EDVHOLQHHUHFWLOHG\VIXQFWLRQZKLFKPLJKW UHQGHUQHUYHVSDULQJQHHGOHVV Material & Methods: %HWZHHQDQGDWRWDORISDWLHQWVZHUH WUHDWHG ZLWK UDGLFDO SURVWDWHFWRP\ LQ VLQJOH (XURSHDQ FHQWHU E\ VXUJHRQV 2I WKRVH SDWLHQWV ZHUH DJHG \HDUV DQG ROGHU 3URSRUWLRQV WUHQGV DQG PXOWLYDULDEOHDQDO\VHVWHVWHGWKHVHDVVRFLDWLRQVEHWZHHQPRUHDGYDQFHGDJH \HDUVDQGROGHU DQGWKHUDWHRIS7DWᚏQDOSDWKRORJ\
IS SURGERY FOR HIGH-RISK LOCALIZED PROSTATE CANCER VALID IN THE ELDERLY POPULATION? AN ANALYSIS OF THE INFLUENCE OF AGE AN CANCERSPECIFIC AND OVERALL SURVIVAL
*RQWHUR36SDKQ0%ULJDQWL$0DUFKLRUR*7RPEDO%+VX&< 9DQGHU(HFNW.%DGHU3:DO]-)URKQHEHUJ'*UDHIHQ00RQWRUVL) 7L]]DQL$9DQ&DQJK39DQ3RSSHO+-RQLDX6 1 University of Turin, Dept. of Urology, Turin, Italy, 2Julius Maximilians University Würzburg, Dept. of Urology, Würzburg, Germany, 3San Raphael Hospital, Dept. of Urology, Milan, Italy, 4University of Piedmont Orientale, Dept. of Urology, Novarra, Italy, 5Université Catholique de Louvain, Dept. of Urology, Brussels, Belgium, 6 University Hospitals Leuven, Dept. of Urology, Leuven, Belgium, 7Community Hospital Karlsruhe, Dept. of Urology, Karlsruhe, Germany, 8University Medical Centre Eppendorf, Dept. of Urology, Hamburg, Germany Introduction & Objectives: $FFRUGLQJWRWKH($8SURVWDWHFDQFHUJXLGHOLQHVD UDGLFDOSURVWDWHFWRP\53 LVEHRSWLRQDOLQKLJKULVNORFDOL]HGGLVHDVHSURYLGHG WKDWWKHSDWLHQWKDVDOLIHH[SHFWDQF\RIDWOHDVW\HDUV6HQLRUDGXOWVDJHG RUDERYHDUHJHQHUDOO\QRWFRQVLGHUHGFDQGLGDWHVIRUVXUJHU\ZKHQWKH\SUHVHQW ZLWK ุF7D 25 36$! 25 *OHDVRQ VFRUH ุ 3&D 0RVW RI WKHP ZLOO UHFHLYH KRUPRQDOWUHDWPHQWUDGLRWKHUDS\RUDFRPELQDWLRQRIERWK:HDLPHGWRDQDO\VH WKHFDQFHUVSHFLᚏF&66 DQGRYHUDOOVXUYLYDO26 RISDWLHQWVDJHGRUKLJKHU LQD(XURSHDQPXOWLFHQWHU53GDWDEDVHRISDWLHQWVZLWKKLJKULVNORFDOL]HGSURVWDWH FDQFHU Material & Methods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esults: %HWZHHQ$SULODQG$SULOSDWLHQWVZLWKF72536$! QJPO25ELRSV\*OHDVRQVFRUHุXQGHUZHQWD53DWVHYHQ(XURSHDQLQVWLWXWLRQV 0HDQDJHZDV\HDUV6' 0HGLDQ36$ZDVQJPO,45 2IWKHSDWLHQWV SUHVHQWHGZLWKF7DQG ZLWKุ7 GLVDVH%LRSV\*OHDVRQVFRUHZDVLQ DQGุLQ 36$ ZDVืLQ DQG!LQ ,QWRWDO SDWLHQWV ZHUH ZHUHุ$GMXYDQWWUHDWPHQWZDVDGPLQLVWHUHGLQ
Results: 7KHUDWHRIS7GLDJQRVLVZDVQ LQWKHHOGHUO\YVQ LQ QRQHOGHUO\ SDWLHQWV S (YHQ DIWHU DGMXVWPHQW ZDV PDGH IRU 36$ FOLQLFDO VWDJH DQG SDWKRORJLF *OHDVRQ VFRUH HOGHUO\ SDWLHQWV ZHUH PRUH OLNHO\WRKDUERUS7SURVWDWHFDQFHU25S Conclusions: 'HVSLWHDGMXVWPHQWIRU36$FOLQLFDOVWDJHDQGSDWKRORJLFDO*OHDVRQ VFRUH HOGHUO\ SDWLHQWV ZHUH PRUH OLNHO\ WR KDUERU S7 SURVWDWH FDQFHU DW ᚏQDO SDWKRORJ\ ,Q FRQVHTXHQFH SDUWLFXODU PHQ VKRXOG EH JLYHQ WR WKH FRQVLGHUDWLRQ RIZLGHUHVHFWLRQHVSHFLDOO\LQWKHFRQWH[WRIKLJKHUUDWHVRISUHH[LVWLQJHUHFWLOH G\VIXQFWLRQLQWKHVHLQGLYLGXDOV
681
NERVE SPARING RADICAL PROSTATECTOMY IN PROPERLY SELECTED PATIENTS WITH PT3 PROSTATE CANCER DOES NOT UNDERMINE THE RATES OF POSITIVE SURGICAL MARGINS
%XG¦XV/6DORPRQ*6SHWKPDQQ-,VEDUQ+6WHXEHU7+DHVH$ /XJKH]]DQL*6XQ06FKORPP7&KXQ.+)+HLQ]HU++XODQG+ .DUDNLHZLF]3,*UDHIHQ0 1 Martini-Clinic, University Medical Centre Hamburg-Eppendorf, Prostate Cancer Centre, Hamburg, Germany, 2University Medical Centre Hamburg-Eppendorf, Dept. of Urology, Hamburg, Germany, 3University of Montreal Health Centre, Cancer Prognostics and Health Outcomes Unit, Montreal, Canada Introduction & Objectives: 1HUYHVSDULQJUDGLFDOSURVWDWHFWRP\KHOSVSUHVHUYH VH[XDO IXQFWLRQ LQ SDWLHQWV ZLWK ORFDOL]HG SURVWDWH FDQFHU EXW PD\ LQFUHDVH WKH SRVLWLYH VXUJLFDO PDUJLQ UDWH 360 :H H[DPLQHG WKH UDWHV RI SRVLWLYH VXUJLFDO PDUJLQV 360 DQG ELRFKHPLFDO UHFXUUHQFH UDWHV %&5 LQ SDWLHQWV ZLWK S7 SURVWDWH FDQFHU DFFRUGLQJ WR WKH W\SH RI QHUYHVSDULQJ 1RQH YV XQLODWHUDO YV ELODWHUDO Material & Methods: %HWZHHQ DQG SDWLHQWV ZLWK S7 Q S7EQ SURVWDWHFDQFHUXQGHUZHQWDQRQQHUYHVSDULQJQ
Eur Urol Suppl 2010;9(2):223