Balaji Reddy

PD59-09 MANAGEMENT OF SMALL RENAL MASSES IN RENAL TRANSPLANT RECIPIENT CANDIDATES: A MULTI-INSTITUTIONAL SURVEY ANALYSIS

validate a criterion for AS eligibility based on tumour clinical size and age on a cohort of patients treated with surgery. METHODS: 1922 patients diagnosed with a cT1cN0cM0 renal mass elected for surgical treatment and collected into a prospective database were assessed. Under the assumption that older patients with smaller tumours are optimal candidates for AS relative to younger patients with larger tumours, we relied on the ratio [R] between tumour clinical size and age in order to differentiate patients suitable for AS (R<5) from patients unsuitable for AS (R 5). X2 test was used to compare the rate of malignant histology, stage pT3-pT4 and grade G3G4 at final pathology in patients suitable vs. unsuitable for AS. Smoothed Poisson’s incidence plots were used to examine the rate of cancer specific [CSM] and other cause mortality [OCM] in patients suitable vs. unsuitable for AS. RESULTS: According to the proposed definition, the rate of patients suitable for AS was 34%. Patient suitable for AS had a lower rate of malignant histology (78 vs. 87%; p<0.001), pT3-pT4 (4 vs. 10% p1⁄40.001) and grade G3-G4 (7 vs. 17% p<0.001) relative to patients unsuitable for AS. In patients suitable for AS, the 10-year rates of CSM and OCM were 1.7 and 19%, respectively (Fig. 1A). In patients unsuitable for AS, the 10-year rates of CSM and OCM were 6.7 and 11% (Fig. 1B), respectively. CONCLUSIONS: When validated in a cohort of surgically treated patients, the ratio between tumour clinical size and age is a useful parameter to differentiate patients with adverse pathologic outcomes from patients with more favourable pathologic outcomes. These differences translate into critically different relative rates of CSM and OCM. These findings suggest that the proposed strategy criterion deserve further examination as a potential criterion for AS.

MP53-09 THE NUMBER OF LYMPH NODES SAMPLED DURING RADICAL PROSTATECTOMY DOES NOT IMPACT THE RISK OF BIOCHEMICAL RECURRENCE IN PATIENTS WITH SEMINAL VESICLE INVASION

p<0.001. The median OS was 7.1, 9.1 and 7.4 y respectively (p<0.001). Multivariable Cox proportional hazards analysis assessing for predictors of OS showed improved survival in diabetics on metformin (HR 0.77, 95% CI 0.74-0.81; p<0.001) vs. diabetics not on metformin (HR 0.99, 95% CI 0.95-1.03; p1⁄40.5) with non-diabetics as referent group while controlling for age, co-morbidity, and Gleason score. Assessing for predictors of SRE revealed no association between metformin use (HR 0.99, 95% CI 0.92-1.07; p1⁄40.8) and SRE. Lastly, PC-specific survival was improved in diabetics on metformin (HR 0.72, 95% CI 0.67-0.78; p<0.001) and to a lesser extent diabetics not on metformin (HR 0.87, 95% CI 0.810.93; p<0.001) with non-diabetics as referent group. CONCLUSIONS: Metformin use in Veterans with advanced PC receiving ADT is associated with improved OS and cancer-specific survival. Improved outcomes for PC patients receiving metformin should be evaluated in a prospective clinical trial.

MP80-02 INCREASED URINARY CALCIUM EXCRETION IS MORE COMMON IN YOUNGER STONE FORMERS.

INTRODUCTION AND OBJECTIVES: Ureteral colic due to an obstructing stone is a common presentation to the emergency department. We sought to evaluate how often serum and urine studies were unremarkable in patienst with this presentation. METHODS: Two hundred thirty-two consecutive patients evaluated in an urban tertiary care emergency department and who were diagnosed with an obstructing ureteral stone on computerized tomography (CT) were evaluated. Inclusion criteria were as follows: ureteral stone diagnosed on CT, urine dipstick and serum WBC checked. Studies were considered “normal” if urine dipstick showed 0 RBC, 0 WBC, and was nitrite negative AND if serum WBC was < 12.0. RESULTS: Mean patient age was 46.9 years (SD 15.4), gender prevalence was 35.8% female:64.2% male, mean axial stone diameter was 4.0 mm (SD 2.0), and mean serum WBC was 10.1 (SD 3.7). Stone position was proximal ureter e 24.6%, distal ureter e 27.1%, and ureterovesical junction e 48.3%. Completely normal urine dipstick and serum WBC was seen in 47 patients (20.2%), whereas 185 patients (79.7%) demonstrated at least a single abnormality of urine dipstick or WBC. On mulvariate logistic regression, neither age, gender, stone location, or stone size were significant predictors of the presence or absence of laboratory abnormalities. CONCLUSIONS: Up to 20% of patients presenting with ureteral colic and ureteral stones will not demonstrate abnormalities of urine dipstick or serum WBC. These data may be helpful in selecting which patients may benefit from additional imaging or workup in cases when the diagnosis is not obvious.