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An operative experience of nephrectomy following sunitinib treatment in patients with metastatic renal cell carcinoma
256 Conclusion: This study demonstrates proof of concept for multivariate algorithmic classifiers in the management of bladder cancer. Greater specificity may be attained following analysis of further biomarkers in serum.
Poster Abstracts 20 years of bladder cancer research in the West Midlands: A comparison of two large cohorts R.T. Bryan a,b,c , D. Bird a,b,c , N.D. James a,b,c , M.P. Zeegers a,b,c , K.K. Cheng a,b,c , D.M.A. Wallace a,b,c a Department
doi:10.1016/j.bjmsu.2009.09.011 An operative experience of nephrectomy following sunitinib treatment in patients with metastatic renal cell carcinoma J. Bycroft, C. Foley, S. Ndirika, T. Powles, J. Green, J. Peters Whipps Cross University Hospital NHS Trust, London, United Kingdom Introduction: Tyrosine-kinase inhibitors such as sunitinib are rapidly changing the management of patients with advanced and metastatic renal cell carcinoma. Sunitinib improves survival in such patients compared to traditional therapies such as interferon. The role of surgery in this group is currently unclear and is under investigation. We report our unique operative experience of nephrectomy in patients pre-treated with sunitinib. Patients: Ten patients underwent cytoreductive nephrectomy in our unit. All were enrolled in the SUMR (upfront sunitinib therapy followed by surgery in patients with metastatic renal cell carcinoma). Nine were male, and the mean age was 64 years. Six patients required thoracoabdominal nephrectomy. Results: Mean operative time was 195 min, and mean blood loss was 2200 ml. The mean inpatient stay was 8 days. One patient developed a lymphocele (drained radiologically), one patient had delayed wound healing and one patient (74-yearold male with extensive lung metastases) died of respiratory complications post-operatively. Conclusions: Cytoreductive nephrectomy postsunitinib is feasible but technically challenging, and specific complications should be anticipated. Patients are generally able to recommence sunitinib in the early post-operative period. Our experience paves the way for Phase III studies and promotes the early use of sunitinib in this patient group. doi:10.1016/j.bjmsu.2009.09.012
of Public Health, Epidemiology and Biostatistics, University of Birmingham, United Kingdom b School of Cancer Sciences, University of Birmingham, United Kingdom c The Queen Elizabeth Hospital, Birmingham, United Kingdom Introduction: We have established two large independent prospective cohorts of newly diagnosed bladder cancer patients in the West Midlands over the last 20 years: 1537 patients (1991—1992) and 1044 patients (2006—present). The objective of this study was to compare the simple baseline data of these two large cohorts. Patients and methods: Gender, age, smoking history, and tumour grade, stage, type, and multiplicity data from each cohort were compared, with Chi-squared used as the test statistic. Results: The two cohorts show no difference in gender distribution (p = 0.25), smoking history (p = 0.54) or tumour type (p = 0.36). There are significant differences in age distribution, and tumour grade, stage and multiplicity: the current cohort shows a higher proportion of patients in the 71—80 and >80 years categories (p < 0.001), a larger proportion of grade 3 tumours (p < 0.001), a larger proportion of Ta and T1 tumours (p < 0.005), and a higher frequency of multiple tumours (p < 0.001). Conclusion: These data provide insights to the changing pattern of bladder cancer in the West Midlands, and possibly the UK. The findings may result from changes in occupational and smoking habits between genders, changes in pathology reporting practices, and improvements in cystoscopic technology. Further analyses are currently ongoing. doi:10.1016/j.bjmsu.2009.09.013 Does holmium laser ablation of superficial bladder tumour recurrences under topical anaesthesia increase the risk of recurrence? W.J.G. Finch, M.R. Habib, G.K. Banerjee The Ipswich Hospital NHS Trust, Ipswich, United Kingdom Introduction: Holmium laser ablation of superficial bladder tumours under topical anaesthesia has been shown to be feasible, with high patient satis-
Poster Abstracts 20 years of bladder cancer research in the West Midlands: A comparison of two large cohorts R.T. Bryan a,b,c , D. Bird a,b,c , N.D. James a,b,c , M.P. Zeegers a,b,c , K.K. Cheng a,b,c , D.M.A. Wallace a,b,c a Department
doi:10.1016/j.bjmsu.2009.09.011 An operative experience of nephrectomy following sunitinib treatment in patients with metastatic renal cell carcinoma J. Bycroft, C. Foley, S. Ndirika, T. Powles, J. Green, J. Peters Whipps Cross University Hospital NHS Trust, London, United Kingdom Introduction: Tyrosine-kinase inhibitors such as sunitinib are rapidly changing the management of patients with advanced and metastatic renal cell carcinoma. Sunitinib improves survival in such patients compared to traditional therapies such as interferon. The role of surgery in this group is currently unclear and is under investigation. We report our unique operative experience of nephrectomy in patients pre-treated with sunitinib. Patients: Ten patients underwent cytoreductive nephrectomy in our unit. All were enrolled in the SUMR (upfront sunitinib therapy followed by surgery in patients with metastatic renal cell carcinoma). Nine were male, and the mean age was 64 years. Six patients required thoracoabdominal nephrectomy. Results: Mean operative time was 195 min, and mean blood loss was 2200 ml. The mean inpatient stay was 8 days. One patient developed a lymphocele (drained radiologically), one patient had delayed wound healing and one patient (74-yearold male with extensive lung metastases) died of respiratory complications post-operatively. Conclusions: Cytoreductive nephrectomy postsunitinib is feasible but technically challenging, and specific complications should be anticipated. Patients are generally able to recommence sunitinib in the early post-operative period. Our experience paves the way for Phase III studies and promotes the early use of sunitinib in this patient group. doi:10.1016/j.bjmsu.2009.09.012
of Public Health, Epidemiology and Biostatistics, University of Birmingham, United Kingdom b School of Cancer Sciences, University of Birmingham, United Kingdom c The Queen Elizabeth Hospital, Birmingham, United Kingdom Introduction: We have established two large independent prospective cohorts of newly diagnosed bladder cancer patients in the West Midlands over the last 20 years: 1537 patients (1991—1992) and 1044 patients (2006—present). The objective of this study was to compare the simple baseline data of these two large cohorts. Patients and methods: Gender, age, smoking history, and tumour grade, stage, type, and multiplicity data from each cohort were compared, with Chi-squared used as the test statistic. Results: The two cohorts show no difference in gender distribution (p = 0.25), smoking history (p = 0.54) or tumour type (p = 0.36). There are significant differences in age distribution, and tumour grade, stage and multiplicity: the current cohort shows a higher proportion of patients in the 71—80 and >80 years categories (p < 0.001), a larger proportion of grade 3 tumours (p < 0.001), a larger proportion of Ta and T1 tumours (p < 0.005), and a higher frequency of multiple tumours (p < 0.001). Conclusion: These data provide insights to the changing pattern of bladder cancer in the West Midlands, and possibly the UK. The findings may result from changes in occupational and smoking habits between genders, changes in pathology reporting practices, and improvements in cystoscopic technology. Further analyses are currently ongoing. doi:10.1016/j.bjmsu.2009.09.013 Does holmium laser ablation of superficial bladder tumour recurrences under topical anaesthesia increase the risk of recurrence? W.J.G. Finch, M.R. Habib, G.K. Banerjee The Ipswich Hospital NHS Trust, Ipswich, United Kingdom Introduction: Holmium laser ablation of superficial bladder tumours under topical anaesthesia has been shown to be feasible, with high patient satis-