C. Kuk

Prevalence of Inflammation and Benign Prostatic Hyperplasia on Autopsy in Asian and Caucasian Men

UNLABELLEDnInflammation has been suggested to be involved in the pathogenesis of benign prostatic hyperplasia (BPH). We studied the prevalence of inflammation and BPH in Asian and Caucasian men on prostate glands (n=320) obtained during autopsy in Moscow, Russia (Caucasian men, n=220), and Tokyo, Japan (Asian men, n=100). We correlated the presence and grade of acute inflammation (AI) or chronic inflammation (CI) and BPH. AI, CI, and histologic BPH were analyzed in a blinded fashion using a grading system (0-3). We used the Cochran-Armitage test for associations between the degree of BPH and clinical variables and proportional odds logistic regression models in multivariable analysis. Histologic BPH was observed in a similar proportion of Asian and Caucasian men (p=0.94). CI was found in>70% of men in both the Asian and Caucasian groups (p>0.05). Higher BPH scores were associated with more CI (p<0.001). In multivariate analyses, individuals with CI were 6.8 times more likely to have a higher BPH score than individuals without (p<0.0001). Men included in this study presented at the hospital and their symptomatic status was not known. The prevalence of CI and BPH on autopsy is similar in Asian and Caucasian men despite very different diet and lifestyle. CI is strongly associated in both groups with BPH.nnnPATIENT SUMMARYnIn this study, we looked at the prevalence of inflammation and benign prostatic hyperplasia (BPH) on autopsy in Asian and Caucasian men. We found chronic inflammation in>70% of men on autopsy. More chronic inflammation was associated with more BPH.

Positive surgical margins: race or surgeon?

The present study by Jalloh et al. published in this month’s issue of European Urology aimed to investigate the influence of racial variations on pathologic outcome after radical prostatectomy (RP) for low-risk prostate cancer (PCa) patients. The positive surgical margin (PSM) rate was significantly higher in the African American group (31%) than in the Caucasian group (21%) [1]. This well-known and respected group of authors concluded, after adjusting for appropriate confounders, that the rate of upstaging and upgrading is not influenced by race. They found that the rate of PSMs was significantly higher in African American men. The exact reasons are still unclear, but this observation is certainly hypothesis generating. Given that a disproportionate number of African American men are diagnosed with PCa each year and are likely to die from the disease, the authors should be commended for having addressed this important question. Their patient cohort had major limitations that included having only a very small percentage of African American men available for analysis, 6.5% of the entire cohort [1]. In addition, race was associated with PSMs among men who were treated at community-based clinics but not in the subset treated at academic centers. Of note, PSM rates were also strikingly lower at academic sites (15%) versus community-based sites (24%) (p < 0.01), and the authors were unable to adjust the analyses by surgeon, given the large number of participating operators. Several other reasons for a PSM can be proposed, like extensive nervepreservation attempts, wide differences in surgeon experience, and surgical technique. Using retrospectively gathered margins data from 14 institutions worldwide on 9778 open RPs, positive

625 A non-invasive urine-based epigenetic urinary biomarker panel for the detection of bladder cancer and the discrimination of high-grade and low-grade disease

1Princess Margaret Cancer Centre, Dept. of Surgical Oncology, Division of Urology, University of Toronto, Toronto, Canada, 2Mount Sinai Hospital, Samuel Lunenfeld Research Institute, Toronto, Canada, 3University Health Network, Dept. of Surgery, Division of Urology, University of Toronto, Toronto, Canada, 4Mount Sinai Hospital, Dept. of Surgery, Division of Urology, Toronto, Canada, 5Dalhousie University, Dept. of Urology, Halifax, Canada, 6University of Liege, Dept. of Urology, Liege, Belgium, 7University Health Network, Dept. of Pathology, University of Toronto, Toronto, Canada