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P007 Clinical relevance of incidental prostate tumor on radical cystoprostatectomy's specimens. A retrospective review
A B S T R A C T S / E U R O P E A N U R O L O G Y S U P P L E M E N T S 12 (2013) 123–180
aclass Correlation Coefficients (ICCs) were used to assess interrater agreement and assessors’ learning curves. Results: The inter-rater agreement was adequate-high (ICC = 0.63–0.91) for all of the chairing elements. Agreement was higher in live MDT ratings (mean 0.79, SD 0.092) compared to video ratings (mean 0.72, SD 0.069). Conclusions: An observational assessment tool can be reliably used for assessing the chair person in cancer MDTs (both in live and video-recorded). Such robust assessment tools provide part of a toolkit for MDT leadership evaluation and enhancement. The ability to feed back their performance to MDT leads can enable promotion of good practice. P005 Antineoplastic activity of curcumin and new synthetic chalcone analog in human cancer cells of the urinary bladder B. Robev 1 , D. Batovska 2 . 1 Sofia Cancer Center, Dept. of Chemotherapy, Sofia, Bulgaria; 2 Bulgarian Academy of Sciences, Institut of Organic Chemistry With Centre of Phytochemistry, Sofia, Bulgaria Introduction & Objectives: Bladder cancer is the sixth most common malignancy and accounts for 7% of malgnant disease in men and 3% of women. Standard treatment include TUR in stage I/Ta and T1 and subsequent intravesical therapy with BCG, Mitomycin C and Epirubicin, and for advanced disease – radical cystectomy with adjuvant or neoadjuvant chemotherapy. In stage IV has proven the benefits of use of palliative chemotherapy. Material & Methods: The purpose of this study was to compare the effect of the applied standard cytotoxic agent with substance of plant and synthetic origin – curcumin and synthesized chalcone derivative. Curcumin is a polyphenolic pigment from the plant Curcuma longa. Antitumor potential of plant drug is known from ancient Indian medicine. Diferuloilmenanat (curcumin) having the status of a dietary supplement, but no clinical studies in multiple myeloma and cancer of the lung. Suspected mechanisms of action confined to inhibition of transcription factors such as NF-κB, such as enzymes of the inducible COX-2, a receptor tyrosine kinase and the like. Results: In our studies with cell lines of human bladder cancer detected data for concentration-dependent cytotoxic effect, which occurs independently of gp170 (IC50 approximately 30 μM). Research and pre-selected representative of chalcones on in vitro models of bladder cancer and found anticancer activity also independent of gp170. The application of in vivo chalcone showed IC50 of accessibility in mice without evidence of toxicity. Conclusions: Taken together, our data suggest that curcumin and chalcone are promising newly synthesized compounds have low intravesical applicability in noninvasive bladder cancer. P006 Effect of an increased water intake in DNA adducts formation and urinary mutagenicity in smokers: A randomised controlled trial I. Buendia Jimenez 1 , P. Richardot 2 , P. Picard 3 , G. Talaska 4 , M. De Meo 5 , G Friedlander 6 . 1 Danone Research, Hydration Department, Palaiseau, France; 2 Danone Research, Analytical Department, Palaiseau, France; 3 Danone Research, Statistical Department, Palaiseau, France; 4 University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, United States of America; 5 Université De La Méditerranée and IMBE, Laboratoire Mutagenèse Environnementale, Faculté De Pharmacie, Marseille, France; 6 Institute For European Expertise In Physiology, Science Department, Paris, France Introduction & Objectives: The association between fluid intake and bladder cancer risk remains controversial since epidemio-
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logical studies has produced mixed results. To date, very little is known about to which extent the amount of water intake influences the action of excreted toxics upon the urinary system. We performed a proof of concept trial to investigate the effect of water intake on mutagenesis in smokers, a high risk population for bladder cancer. Material & Methods: Monocentric randomized controlled trial. Inclusion criteria: Male subjects aged 20–45 y/o, smokers (at least 15 cigarettes per day) and small drinkers (≤1 L of fluid/day; ≤500 mL of water/day; urinary 24-hour urinary volume <1 L and osmolality >700 mOsmol/kg). Exclusion criteria: History of diseases which could affect the results of the study or under treatment which could modify measurements of the study.Primary outcome: 4-ABP DNA adducts formation in exfoliated bladder cells in 24-hour urine collection. Secondary outcome: urinary mutagenicity in 24-hour urine. Study design: Subjects were allocated in two groups: Test group: Subjects had to consume 1.5 L daily of the study product (EVIAN® ) on top of their usual water intake for 50 days. Control group: Subjects had to continue their usual lifestyle habits. Results: 65 subjects were randomized. Mean age was 30 y/o and mean cigarettes per day was 20. A slight decrease in adducts formation was observed between baseline and last visit but no statistically significant difference was demonstrated between the groups. Conversely, urinary mutagenicity significantly decreased in the intervention group compared to the control group. Conclusions: Our study shows that increasing water intake decreases urinary mutagenicity. However, it is not confirmed by urinary adducts formation. Further research with a larger sample size or longer intervention period would be necessary to address the impact on this parameter. P007 Clinical relevance of incidental prostate tumor on radical cystoprostatectomy’s specimens. A retrospective review V. Del Rosario Rodríguez, B.F. Amir Nicolau, C. Fumero Gorrín, A. Amador Robayna, O.B. Halawa González, S. Fumero Arteaga, J. Monllor Gisbert. Hospital Universitario Nuestra Señora De Candelaria, Servicio De Urología, Tenerife, Spain Introduction & Objectives: To determine the incidence and clinical relevance of incidental prostate tumor on specimens of cystoprostatectomy for muscle-invasive bladder cancer. Material & Methods: A retrospective review of 128 male patients submitted to radical cystoprostatectomy for muscle-invasive bladder cancer in our centre for the last 10 years (2002–2012). We determined the frequency of incidental prostate tumor on the surgical specimens. All patients with previous history of positive prostate biopsy for adenocarcinoma were excluded. The results obtained have been analysed using SPSS 15.0. Results: The mean age of the patients was 66.9 years old. Anatomopathological study showed on more than 64% of cases an extravesical extension (pT3a-pT4b). 14% of surgical specimens showed a localised prostate cancer (pT1a-pT2c) with a prevailing Gleason score 3+3. This rate is much lower than the reported in the literature (23–68%). 17% of patients with a confirmed prostate tumor had a personal history of negative transurethral prostate resection or prostate biopsy. Conclusions: Several studies advocate for the preservation of prostate’s apex on cystectomy to keep the urinary continence. However frequency and clinical relevance of incidental prostate tumor must be taken into account, through the enlargement of the study before the surgery with a PSA, rectal examination and prostate biopsy (mainly when we consider perform an orthotopic derivation).
aclass Correlation Coefficients (ICCs) were used to assess interrater agreement and assessors’ learning curves. Results: The inter-rater agreement was adequate-high (ICC = 0.63–0.91) for all of the chairing elements. Agreement was higher in live MDT ratings (mean 0.79, SD 0.092) compared to video ratings (mean 0.72, SD 0.069). Conclusions: An observational assessment tool can be reliably used for assessing the chair person in cancer MDTs (both in live and video-recorded). Such robust assessment tools provide part of a toolkit for MDT leadership evaluation and enhancement. The ability to feed back their performance to MDT leads can enable promotion of good practice. P005 Antineoplastic activity of curcumin and new synthetic chalcone analog in human cancer cells of the urinary bladder B. Robev 1 , D. Batovska 2 . 1 Sofia Cancer Center, Dept. of Chemotherapy, Sofia, Bulgaria; 2 Bulgarian Academy of Sciences, Institut of Organic Chemistry With Centre of Phytochemistry, Sofia, Bulgaria Introduction & Objectives: Bladder cancer is the sixth most common malignancy and accounts for 7% of malgnant disease in men and 3% of women. Standard treatment include TUR in stage I/Ta and T1 and subsequent intravesical therapy with BCG, Mitomycin C and Epirubicin, and for advanced disease – radical cystectomy with adjuvant or neoadjuvant chemotherapy. In stage IV has proven the benefits of use of palliative chemotherapy. Material & Methods: The purpose of this study was to compare the effect of the applied standard cytotoxic agent with substance of plant and synthetic origin – curcumin and synthesized chalcone derivative. Curcumin is a polyphenolic pigment from the plant Curcuma longa. Antitumor potential of plant drug is known from ancient Indian medicine. Diferuloilmenanat (curcumin) having the status of a dietary supplement, but no clinical studies in multiple myeloma and cancer of the lung. Suspected mechanisms of action confined to inhibition of transcription factors such as NF-κB, such as enzymes of the inducible COX-2, a receptor tyrosine kinase and the like. Results: In our studies with cell lines of human bladder cancer detected data for concentration-dependent cytotoxic effect, which occurs independently of gp170 (IC50 approximately 30 μM). Research and pre-selected representative of chalcones on in vitro models of bladder cancer and found anticancer activity also independent of gp170. The application of in vivo chalcone showed IC50 of accessibility in mice without evidence of toxicity. Conclusions: Taken together, our data suggest that curcumin and chalcone are promising newly synthesized compounds have low intravesical applicability in noninvasive bladder cancer. P006 Effect of an increased water intake in DNA adducts formation and urinary mutagenicity in smokers: A randomised controlled trial I. Buendia Jimenez 1 , P. Richardot 2 , P. Picard 3 , G. Talaska 4 , M. De Meo 5 , G Friedlander 6 . 1 Danone Research, Hydration Department, Palaiseau, France; 2 Danone Research, Analytical Department, Palaiseau, France; 3 Danone Research, Statistical Department, Palaiseau, France; 4 University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, United States of America; 5 Université De La Méditerranée and IMBE, Laboratoire Mutagenèse Environnementale, Faculté De Pharmacie, Marseille, France; 6 Institute For European Expertise In Physiology, Science Department, Paris, France Introduction & Objectives: The association between fluid intake and bladder cancer risk remains controversial since epidemio-
133
logical studies has produced mixed results. To date, very little is known about to which extent the amount of water intake influences the action of excreted toxics upon the urinary system. We performed a proof of concept trial to investigate the effect of water intake on mutagenesis in smokers, a high risk population for bladder cancer. Material & Methods: Monocentric randomized controlled trial. Inclusion criteria: Male subjects aged 20–45 y/o, smokers (at least 15 cigarettes per day) and small drinkers (≤1 L of fluid/day; ≤500 mL of water/day; urinary 24-hour urinary volume <1 L and osmolality >700 mOsmol/kg). Exclusion criteria: History of diseases which could affect the results of the study or under treatment which could modify measurements of the study.Primary outcome: 4-ABP DNA adducts formation in exfoliated bladder cells in 24-hour urine collection. Secondary outcome: urinary mutagenicity in 24-hour urine. Study design: Subjects were allocated in two groups: Test group: Subjects had to consume 1.5 L daily of the study product (EVIAN® ) on top of their usual water intake for 50 days. Control group: Subjects had to continue their usual lifestyle habits. Results: 65 subjects were randomized. Mean age was 30 y/o and mean cigarettes per day was 20. A slight decrease in adducts formation was observed between baseline and last visit but no statistically significant difference was demonstrated between the groups. Conversely, urinary mutagenicity significantly decreased in the intervention group compared to the control group. Conclusions: Our study shows that increasing water intake decreases urinary mutagenicity. However, it is not confirmed by urinary adducts formation. Further research with a larger sample size or longer intervention period would be necessary to address the impact on this parameter. P007 Clinical relevance of incidental prostate tumor on radical cystoprostatectomy’s specimens. A retrospective review V. Del Rosario Rodríguez, B.F. Amir Nicolau, C. Fumero Gorrín, A. Amador Robayna, O.B. Halawa González, S. Fumero Arteaga, J. Monllor Gisbert. Hospital Universitario Nuestra Señora De Candelaria, Servicio De Urología, Tenerife, Spain Introduction & Objectives: To determine the incidence and clinical relevance of incidental prostate tumor on specimens of cystoprostatectomy for muscle-invasive bladder cancer. Material & Methods: A retrospective review of 128 male patients submitted to radical cystoprostatectomy for muscle-invasive bladder cancer in our centre for the last 10 years (2002–2012). We determined the frequency of incidental prostate tumor on the surgical specimens. All patients with previous history of positive prostate biopsy for adenocarcinoma were excluded. The results obtained have been analysed using SPSS 15.0. Results: The mean age of the patients was 66.9 years old. Anatomopathological study showed on more than 64% of cases an extravesical extension (pT3a-pT4b). 14% of surgical specimens showed a localised prostate cancer (pT1a-pT2c) with a prevailing Gleason score 3+3. This rate is much lower than the reported in the literature (23–68%). 17% of patients with a confirmed prostate tumor had a personal history of negative transurethral prostate resection or prostate biopsy. Conclusions: Several studies advocate for the preservation of prostate’s apex on cystectomy to keep the urinary continence. However frequency and clinical relevance of incidental prostate tumor must be taken into account, through the enlargement of the study before the surgery with a PSA, rectal examination and prostate biopsy (mainly when we consider perform an orthotopic derivation).