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P088 Barriers to decision making in cancer multidisciplinary teams. Analysis of cancer decision-making in two surgical specialities
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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
cal stage (R= −0.5, p=0.03), probability of LN invasion (R= −0.6, p=0.02) and number of LN metastases (R= −0.6, p=0.01). Conclusions: Levels of PLA2 in serum and prostate tumor tissue could have a predictive role in assessing of tumor aggressiveness. High levels of PLA2 in serum combined with decreased levels in tumor tissue are associated with higher probability and number of LN metastases reveled. P087 Average rates of chromogranin A in patients with various prostate diseases Apolikhin 1 ,
Sivkov 2 ,
Keshishev 2 ,
Kovchenko 2 ,
A.V. N.G. G.A. O.I. G.D. Efremov 2 , D.G. Sokov 2 , L.M. Nikonova 2 , E.Z. Rabinovich 2 , S.A. Prohorov 2 . 1 Federal State Budget Research Institute of Urology, Innovative, Moscow, Russia; 2 Federal State Institute of Urology, Innovative, Moscow, Russia Introduction & Objectives: It is considered that neuroendocrine cells (NEC) are always present in prostate cancer (PCa) in various amounts. NEC markers are: chromogranin A (ChA), serotonin, secretogranin, thyroid stimulating hormone, calcitonin, katacalcin, parathyroid hormone etc. Most sensitive marker of blood in the identification of neuroendocrine differentiation (NED) of prostate cancer is ChA. The aim of the epidoemiological study was to determine the average values of the ChA for various prostate diseases. Material & Methods: The study included 233 patients with prostate diseases: benign prostatic hyperplasia (BPH) – 10, chronic prostatitis (ChP) – 13, BPH and low-grade prostatic intraepithelial neoplasia, (BPH + LPIN) – 49, BPH and high-grade prostatic intraepithelial neoplasia (BPH + HPIN) – 33, localized prostate cancer (LPC) – 76, locally advanced prostate cancer (LAPC) – 20, castration-resistant prostate cancer (CRPC) – 32. ChA was determined in all these patients by ELISA on automated analyzer “Gemini” (ELISA kit EuroDiagnostica). The reference values of ChA were up to 3 nmol/L. Results: Number of patients with ChA level more than 3 nmol/l was higher in patients with CRP comparing to patients with LAPC and LPC: 33%, 28% and 9% correspondingly (p<0.05). ChA level in patients with CRPC was statistically higher than in patients with LAPC and LPC: 3.38, 2.89 and 1.74 nmol/l correspondingly (p<0.05).Comparative analysis of the 4 groups of patients (BPH, ChP, BPH + LPIN, BPH + HPIN) has not revealed any statistical difference (p>0.05), however average rates of ChA statistically differed in patients with LPC and LAPC: 1.74 and 2.82 nmol/l correspondingly (p<0.05) (Table 1). Table 1. Average rates of chromogranin A in patients with various prostate diseases Diagnosis
Number of patients
Average rates of chromogranin A (nmol/l)
BPH ChP BPH + LPIN BPH + HPIN
10 13 49 33
1.04±0.56 1.14±0.46 1.24 ±0.29 1.91± 0.45
LPC LAPC CRPC
76 20 32
1.74 ±0.35 2.89 ±1.06 3.38 ±0.51
Total number of patients
233
p>0.05 p>0.05 p<0.05
p>0.05
p<0.05
Conclusions: ChA is a valuable marker for prostate cancer. Significant correlation of ChA is observed in prostate diseases, particularly depending on prostate cancer stages.
P088 Barriers to decision making in cancer multidisciplinary teams. Analysis of cancer decision-making in two surgical specialities R.T. Jalil 1 , M. Vasquez Rios 2 , N. Sevdalis 1 , J.S.A. Green 3 . 1 Imperial College London, Dept. of Surgery and Cancer, London, United Kingdom; 2 BartsHealth NHS Trust, Dept. of Surgery, London, United Kingdom; 3 BartsHealth NHS Trust, Dept. of Urology, London, United Kingdom Introduction & Objectives: Multidisciplinary Team meetings are becoming the standard practice in managing cancer patients in the world. In the UK, there is a quality assurance program for the function and structure of the MDTs; however there no agreed way to assess the efficacy of such teams. This study investigated the factors hampering decision-making in cancer MDT meetings. Material & Methods: All available MDT decision outcomes of cancer patients discussed between February to December 2012 of both Urology and colorectal surgery were reviewed. MDT decisions and reasons for cases with no decision reached were analysed. Results: MDT discussion outcome of 2035 cancer cases were reviewed (19 Urology MDMs, n=1126, 50 Colorectal MDMs, n=909). 9.5% (n=107) of Urology and 6.4% (n=58) of colorectal cases had no decision reached. Main reasons were: unavailability of histopathological results (47.7% (n=51) of urology and 24.1% (n=14) of Colorectal cases); unavailability of radiological investigation results (43.9% (n=47) of Urology and 43.1% (n=25) of Colorectal cases); unavailability of an Oncologist in the meeting (3.7% (n=4) of Urology and 5.2% (n=3) of Colorectal cases). Conclusions: This study uncovers the main barriers that MDTs face in decision-making. Assessing the efficacy of a MDT could be made by its capability to formulate a decision plan for all the cases discussed. Tackling these barriers would result in a more cost-effective process, enhance decision-making and thus enhance cancer care. P089 Volatile organic compounds as an alternative to other biomarkers in the diagnosis and monitoring of prostate cancer A. Jimenez Pacheco 1 , A. Lopez Luque 1 , M.C. Iribar Ibabe 2 , J.L. Mijan Ortiz 3 , J. Alonso Garcia 4 , A. Zuluaga Gomez 3 , J.M. Peinado Herreros 2 . 1 Santa Ana Hospital, Dept. of Urology, Granada, Spain; 2 Medicine Faculty, Granada University, Dept. of Biochemistry and Molecular Biology III and Immunology, Granada, Spain; 3 San Cecilio University Hospital, Dept. of Urology, Granada, Spain; 4 San Cecilio University Hospital, Dept. of Biochemistry, Granada, Spain Introduction & Objectives: Prostate cancer (PCa) tumor is the most common non-cutaneous malignancy in men and is the second cause of cancer death in men in the U.S.A.The PSA is considered the most important biomarker for the detection and monitoring of prostate cancer, although it lacks specificity. This has led to search for alternative biomarkers.Volatile organic compounds (VOCs) are gases produced by cellular metabolism, which appear in breath, urine and other body fluids have been detected in different types of cancers such as lung, breast, ovarian, colorectal and prostate.The aim of this study is to review the literature of the VOCs identified in patients with PCa. Material & Methods: We conducted a search of the PubMed database by using the keywords “urine volatile organic compounds”. We identified 173 studies published before June 2013. We then selected of studies that were published in English or Spanish; and that analyzed the relationship between VOCs and prostate cancer.
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
cal stage (R= −0.5, p=0.03), probability of LN invasion (R= −0.6, p=0.02) and number of LN metastases (R= −0.6, p=0.01). Conclusions: Levels of PLA2 in serum and prostate tumor tissue could have a predictive role in assessing of tumor aggressiveness. High levels of PLA2 in serum combined with decreased levels in tumor tissue are associated with higher probability and number of LN metastases reveled. P087 Average rates of chromogranin A in patients with various prostate diseases Apolikhin 1 ,
Sivkov 2 ,
Keshishev 2 ,
Kovchenko 2 ,
A.V. N.G. G.A. O.I. G.D. Efremov 2 , D.G. Sokov 2 , L.M. Nikonova 2 , E.Z. Rabinovich 2 , S.A. Prohorov 2 . 1 Federal State Budget Research Institute of Urology, Innovative, Moscow, Russia; 2 Federal State Institute of Urology, Innovative, Moscow, Russia Introduction & Objectives: It is considered that neuroendocrine cells (NEC) are always present in prostate cancer (PCa) in various amounts. NEC markers are: chromogranin A (ChA), serotonin, secretogranin, thyroid stimulating hormone, calcitonin, katacalcin, parathyroid hormone etc. Most sensitive marker of blood in the identification of neuroendocrine differentiation (NED) of prostate cancer is ChA. The aim of the epidoemiological study was to determine the average values of the ChA for various prostate diseases. Material & Methods: The study included 233 patients with prostate diseases: benign prostatic hyperplasia (BPH) – 10, chronic prostatitis (ChP) – 13, BPH and low-grade prostatic intraepithelial neoplasia, (BPH + LPIN) – 49, BPH and high-grade prostatic intraepithelial neoplasia (BPH + HPIN) – 33, localized prostate cancer (LPC) – 76, locally advanced prostate cancer (LAPC) – 20, castration-resistant prostate cancer (CRPC) – 32. ChA was determined in all these patients by ELISA on automated analyzer “Gemini” (ELISA kit EuroDiagnostica). The reference values of ChA were up to 3 nmol/L. Results: Number of patients with ChA level more than 3 nmol/l was higher in patients with CRP comparing to patients with LAPC and LPC: 33%, 28% and 9% correspondingly (p<0.05). ChA level in patients with CRPC was statistically higher than in patients with LAPC and LPC: 3.38, 2.89 and 1.74 nmol/l correspondingly (p<0.05).Comparative analysis of the 4 groups of patients (BPH, ChP, BPH + LPIN, BPH + HPIN) has not revealed any statistical difference (p>0.05), however average rates of ChA statistically differed in patients with LPC and LAPC: 1.74 and 2.82 nmol/l correspondingly (p<0.05) (Table 1). Table 1. Average rates of chromogranin A in patients with various prostate diseases Diagnosis
Number of patients
Average rates of chromogranin A (nmol/l)
BPH ChP BPH + LPIN BPH + HPIN
10 13 49 33
1.04±0.56 1.14±0.46 1.24 ±0.29 1.91± 0.45
LPC LAPC CRPC
76 20 32
1.74 ±0.35 2.89 ±1.06 3.38 ±0.51
Total number of patients
233
p>0.05 p>0.05 p<0.05
p>0.05
p<0.05
Conclusions: ChA is a valuable marker for prostate cancer. Significant correlation of ChA is observed in prostate diseases, particularly depending on prostate cancer stages.
P088 Barriers to decision making in cancer multidisciplinary teams. Analysis of cancer decision-making in two surgical specialities R.T. Jalil 1 , M. Vasquez Rios 2 , N. Sevdalis 1 , J.S.A. Green 3 . 1 Imperial College London, Dept. of Surgery and Cancer, London, United Kingdom; 2 BartsHealth NHS Trust, Dept. of Surgery, London, United Kingdom; 3 BartsHealth NHS Trust, Dept. of Urology, London, United Kingdom Introduction & Objectives: Multidisciplinary Team meetings are becoming the standard practice in managing cancer patients in the world. In the UK, there is a quality assurance program for the function and structure of the MDTs; however there no agreed way to assess the efficacy of such teams. This study investigated the factors hampering decision-making in cancer MDT meetings. Material & Methods: All available MDT decision outcomes of cancer patients discussed between February to December 2012 of both Urology and colorectal surgery were reviewed. MDT decisions and reasons for cases with no decision reached were analysed. Results: MDT discussion outcome of 2035 cancer cases were reviewed (19 Urology MDMs, n=1126, 50 Colorectal MDMs, n=909). 9.5% (n=107) of Urology and 6.4% (n=58) of colorectal cases had no decision reached. Main reasons were: unavailability of histopathological results (47.7% (n=51) of urology and 24.1% (n=14) of Colorectal cases); unavailability of radiological investigation results (43.9% (n=47) of Urology and 43.1% (n=25) of Colorectal cases); unavailability of an Oncologist in the meeting (3.7% (n=4) of Urology and 5.2% (n=3) of Colorectal cases). Conclusions: This study uncovers the main barriers that MDTs face in decision-making. Assessing the efficacy of a MDT could be made by its capability to formulate a decision plan for all the cases discussed. Tackling these barriers would result in a more cost-effective process, enhance decision-making and thus enhance cancer care. P089 Volatile organic compounds as an alternative to other biomarkers in the diagnosis and monitoring of prostate cancer A. Jimenez Pacheco 1 , A. Lopez Luque 1 , M.C. Iribar Ibabe 2 , J.L. Mijan Ortiz 3 , J. Alonso Garcia 4 , A. Zuluaga Gomez 3 , J.M. Peinado Herreros 2 . 1 Santa Ana Hospital, Dept. of Urology, Granada, Spain; 2 Medicine Faculty, Granada University, Dept. of Biochemistry and Molecular Biology III and Immunology, Granada, Spain; 3 San Cecilio University Hospital, Dept. of Urology, Granada, Spain; 4 San Cecilio University Hospital, Dept. of Biochemistry, Granada, Spain Introduction & Objectives: Prostate cancer (PCa) tumor is the most common non-cutaneous malignancy in men and is the second cause of cancer death in men in the U.S.A.The PSA is considered the most important biomarker for the detection and monitoring of prostate cancer, although it lacks specificity. This has led to search for alternative biomarkers.Volatile organic compounds (VOCs) are gases produced by cellular metabolism, which appear in breath, urine and other body fluids have been detected in different types of cancers such as lung, breast, ovarian, colorectal and prostate.The aim of this study is to review the literature of the VOCs identified in patients with PCa. Material & Methods: We conducted a search of the PubMed database by using the keywords “urine volatile organic compounds”. We identified 173 studies published before June 2013. We then selected of studies that were published in English or Spanish; and that analyzed the relationship between VOCs and prostate cancer.