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MP-20.01: Prediction of prostate volume in community dwelling men
MODERATED POSTER SESSIONS
(41-77) years. 75% (9 out of 12) patients had a history of bladder cancer. The number of tumors was 1.3 (1-3). The tumor size was 5.4 (4-10) mm. 61.1 % (11/18) were diagnosed as urothelial cancer (UC). All of UCs were Grade 1 or 2, pTa. Pathological diagnosis revealed complete resection without positive cancer margin. The whole procedures were finished within 20 minutes in all cases. No patient complained severe pain and gross hematuria. The follow-up 12.0 (1-19) months. In 45%, ( 5 out of 11) recurrent tumor was found. Conclusion: Our small series indicated this outpatient based TURBT with a flexible cystoscope could be performed safely and efficiently. MP-19.17 Prognostic factors for patients with lymph node metastases following radical cystectomy Osawa T1,2, Abe T1, Shinohara N1, Harabayashi T1, Sazawa A1, Shibata T2, Kamota S3, Kumagai A4, Mori T5, Nonomura K1 1 Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Urology, Otaru Municipal Hospital, Otaru, Japan; 3 Department of Urology, Obihiro Kousei General Hospital, Obihiro, Japan; 4Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan; 5Department of Urology, Asahikawa Kousei General Hospital, Asahikawa, Japan Introduction and Objective: Recent studies have shown that lymph node density (LND, the number of positive nodes/total number of nodes resected) is able to stratify patients with bladder cancer who have nodal metastasis. We assessed its relevance in our series of patients treated with radical cyctectomy and in the context of others clinical characteristics. Methods: A multi-institutional retrospective study evaluated 435 patients treated by radical cyctectomy for bladder cancer between 1990 and 2005. Of these patients 83 had nodal metastasis. Exclusion criteria were patients with (1) neoadjuvant chemotherapy, (2) past history of either previous or synchronous upper urinary tract cancer, (3) distant metastasis and (4) incomplete followup data. A total of 64 patients with a median follow-up of 18 months were included in the current study. The variables analyzed were age (68⬎ vs 68ⱕ), sex (male vs female), histology (pure urothelial cancer vs others), lymphovascular invasion (yes vs no), pathological
stage (pT2ⱖ vs pT3ⱕ), pathological grade (G2 vs G3), the total number of nodes excised (11⬎ vs 11ⱕ), lymph node density (24%⬎ vs 24%ⱕ), adjuvant chemotherapy (yes vs no). Overall-survival curves were estimated by KaplanMeier method and survival distributions were compared by log-rank test. Cox proportional hazards model was applied for multivariate analyses. P values ⬍ 0.05 were considered significant. Results: Five-year overall survival rate was 26.8%. Univariate analysis demonstrated that lower lymph node density, pure urothelial pathology and adjuvant chemotherapy were significant predictors of prolonged survival. Multivariate analysis showed that these three characteristics still remained significant factors. Pure urothelial pathology (v mixed; hazard ratio [HR], 0.456; p⫽0.024), and lymph node density (24%⬎) ( v 24%ⱕ; HR, 0.335; p⫽0.002), and adjuvant chemotherapy ( v no adjuvant chemotherapy; HR, 0.425; p⫽0.022). Conclusions: Our study supported the relevance of LND to the survival in patients with node positive bladder cancer. In addition, tumor histology and adjuvant chemotherapy were independent survival factors.
MP-20: BPO and LUTS Wednesday, September 5 10:15-12:15 MP-20.01 Prediction of prostate volume in community dwelling men Jacobsen SJ1, Jacobson DJ2, St. Sauver JL2, McGree ME2, Sarma AV3, Girman CJ4, Lieber MM2 1 Kaiser Permanente Southern California, Pasadena, CA, USA; 2Mayo Clinic College of Medicine, Rochester, MN, USA; 3University of Michigan, Ann Arbor, MI, USA; 4 Merck Research Laboratories, North Wales, PA, USA Introduction: While of potential use in research and clinical settings, there are no currently accepted methods to estimate prostate volume outside of a digital rectal examination or imaging studies. We sought to determine the ability to estimate prostate volume on the basis of easily obtained clinical variables. Methods: An estimation set was drawn from men participating in the baseline examination of the Olmsted County Study of Urinary Symptoms and Health Status
UROLOGY 70 (Supplment 3A), September 2007
among Men. The Olmsted County study cohort was randomly sampled from the local population of Caucasian men ages 40-79 years in 1990 (n⫽2115, 55% participation). A random sample of participants was invited for a clinical examination that included measurement of prostate volume by transrectal ultrasound, height, weight and serum PSA level. Followed biennially thereafter, men lost to follow-up were replaced with a similar procedure (n⫽149). An 80% random sample of the baseline cohort (n⫽366) was used to develop an equation to estimate prostate volume on the basis of age, serum PSA level, weight and height. The remaining baseline men (n⫽100) and replacement men represented two validation sets. A third validation set was obtained from the Flint Men’s Health Study, which recruited 345 African-American men (45% participation) following a similar protocol. The equation from the estimation set was used to estimate prostate volume in the three validation sets and the estimated results were compared with the measured values. Results: From the estimation set, the regression of log-prostate volume on age, log-serum PSA level, weight and height had a multiple correlation coefficient of (R) of 0.66. When applied to the validation samples, the predicted R values were 0.73, 0.69, and 0.60 for the baseline, replacement and Flint Study, respectively (all p⬍0.001). When sets were pooled, the average standard deviation from the predicted line (root mean square error) was 0.28. Conclusion: These data suggest that in men representing the spectrum of normal to enlarged prostates, prostate volume can be reliably estimated with easily-obtained clinical variables. This may help in settings where costs and practicality may preclude the use of imaging techniques. MP-20.02 The efficacy, duration of efficacy and safety of Ozarelix, a novel GnRH antagonist, in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) Denes B1, Bantchev AV2, Karanikolov SS3, Nikolovski M4, Pantchev P5, Petkova LD6, Debruyne F7 1 Spectrum Pharmaceuticals, Irvine, CA, USA; 2University Multiprofile Hospital, St. George, Plovdiv, Bulgaria; 3Oncology Dispenser, Shumen; 4Aleksandrovska Hospital, Sofi, Bulgaria; 5Aleksandrovska Hospital, Sofia, Bulgaria; 6Multiprofile Hospital St. Anna, Varna, Bulgaria; 7University Medical Center, Nijmegen, Netherlands
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(41-77) years. 75% (9 out of 12) patients had a history of bladder cancer. The number of tumors was 1.3 (1-3). The tumor size was 5.4 (4-10) mm. 61.1 % (11/18) were diagnosed as urothelial cancer (UC). All of UCs were Grade 1 or 2, pTa. Pathological diagnosis revealed complete resection without positive cancer margin. The whole procedures were finished within 20 minutes in all cases. No patient complained severe pain and gross hematuria. The follow-up 12.0 (1-19) months. In 45%, ( 5 out of 11) recurrent tumor was found. Conclusion: Our small series indicated this outpatient based TURBT with a flexible cystoscope could be performed safely and efficiently. MP-19.17 Prognostic factors for patients with lymph node metastases following radical cystectomy Osawa T1,2, Abe T1, Shinohara N1, Harabayashi T1, Sazawa A1, Shibata T2, Kamota S3, Kumagai A4, Mori T5, Nonomura K1 1 Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Urology, Otaru Municipal Hospital, Otaru, Japan; 3 Department of Urology, Obihiro Kousei General Hospital, Obihiro, Japan; 4Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan; 5Department of Urology, Asahikawa Kousei General Hospital, Asahikawa, Japan Introduction and Objective: Recent studies have shown that lymph node density (LND, the number of positive nodes/total number of nodes resected) is able to stratify patients with bladder cancer who have nodal metastasis. We assessed its relevance in our series of patients treated with radical cyctectomy and in the context of others clinical characteristics. Methods: A multi-institutional retrospective study evaluated 435 patients treated by radical cyctectomy for bladder cancer between 1990 and 2005. Of these patients 83 had nodal metastasis. Exclusion criteria were patients with (1) neoadjuvant chemotherapy, (2) past history of either previous or synchronous upper urinary tract cancer, (3) distant metastasis and (4) incomplete followup data. A total of 64 patients with a median follow-up of 18 months were included in the current study. The variables analyzed were age (68⬎ vs 68ⱕ), sex (male vs female), histology (pure urothelial cancer vs others), lymphovascular invasion (yes vs no), pathological
stage (pT2ⱖ vs pT3ⱕ), pathological grade (G2 vs G3), the total number of nodes excised (11⬎ vs 11ⱕ), lymph node density (24%⬎ vs 24%ⱕ), adjuvant chemotherapy (yes vs no). Overall-survival curves were estimated by KaplanMeier method and survival distributions were compared by log-rank test. Cox proportional hazards model was applied for multivariate analyses. P values ⬍ 0.05 were considered significant. Results: Five-year overall survival rate was 26.8%. Univariate analysis demonstrated that lower lymph node density, pure urothelial pathology and adjuvant chemotherapy were significant predictors of prolonged survival. Multivariate analysis showed that these three characteristics still remained significant factors. Pure urothelial pathology (v mixed; hazard ratio [HR], 0.456; p⫽0.024), and lymph node density (24%⬎) ( v 24%ⱕ; HR, 0.335; p⫽0.002), and adjuvant chemotherapy ( v no adjuvant chemotherapy; HR, 0.425; p⫽0.022). Conclusions: Our study supported the relevance of LND to the survival in patients with node positive bladder cancer. In addition, tumor histology and adjuvant chemotherapy were independent survival factors.
MP-20: BPO and LUTS Wednesday, September 5 10:15-12:15 MP-20.01 Prediction of prostate volume in community dwelling men Jacobsen SJ1, Jacobson DJ2, St. Sauver JL2, McGree ME2, Sarma AV3, Girman CJ4, Lieber MM2 1 Kaiser Permanente Southern California, Pasadena, CA, USA; 2Mayo Clinic College of Medicine, Rochester, MN, USA; 3University of Michigan, Ann Arbor, MI, USA; 4 Merck Research Laboratories, North Wales, PA, USA Introduction: While of potential use in research and clinical settings, there are no currently accepted methods to estimate prostate volume outside of a digital rectal examination or imaging studies. We sought to determine the ability to estimate prostate volume on the basis of easily obtained clinical variables. Methods: An estimation set was drawn from men participating in the baseline examination of the Olmsted County Study of Urinary Symptoms and Health Status
UROLOGY 70 (Supplment 3A), September 2007
among Men. The Olmsted County study cohort was randomly sampled from the local population of Caucasian men ages 40-79 years in 1990 (n⫽2115, 55% participation). A random sample of participants was invited for a clinical examination that included measurement of prostate volume by transrectal ultrasound, height, weight and serum PSA level. Followed biennially thereafter, men lost to follow-up were replaced with a similar procedure (n⫽149). An 80% random sample of the baseline cohort (n⫽366) was used to develop an equation to estimate prostate volume on the basis of age, serum PSA level, weight and height. The remaining baseline men (n⫽100) and replacement men represented two validation sets. A third validation set was obtained from the Flint Men’s Health Study, which recruited 345 African-American men (45% participation) following a similar protocol. The equation from the estimation set was used to estimate prostate volume in the three validation sets and the estimated results were compared with the measured values. Results: From the estimation set, the regression of log-prostate volume on age, log-serum PSA level, weight and height had a multiple correlation coefficient of (R) of 0.66. When applied to the validation samples, the predicted R values were 0.73, 0.69, and 0.60 for the baseline, replacement and Flint Study, respectively (all p⬍0.001). When sets were pooled, the average standard deviation from the predicted line (root mean square error) was 0.28. Conclusion: These data suggest that in men representing the spectrum of normal to enlarged prostates, prostate volume can be reliably estimated with easily-obtained clinical variables. This may help in settings where costs and practicality may preclude the use of imaging techniques. MP-20.02 The efficacy, duration of efficacy and safety of Ozarelix, a novel GnRH antagonist, in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) Denes B1, Bantchev AV2, Karanikolov SS3, Nikolovski M4, Pantchev P5, Petkova LD6, Debruyne F7 1 Spectrum Pharmaceuticals, Irvine, CA, USA; 2University Multiprofile Hospital, St. George, Plovdiv, Bulgaria; 3Oncology Dispenser, Shumen; 4Aleksandrovska Hospital, Sofi, Bulgaria; 5Aleksandrovska Hospital, Sofia, Bulgaria; 6Multiprofile Hospital St. Anna, Varna, Bulgaria; 7University Medical Center, Nijmegen, Netherlands
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