Ja Yoon Ku

Malignant Inflammatory Myofibroblastic Tumor of the Bladder with Rapid Progression

A 71-year-old man was referred for painless hematuria and a bladder tumor. Cystoscopy and computed tomography revealed a 3-cm oval nodular mass on the left lateral side of the bladder. The patient underwent a complete transurethral resection of the lesion and histology showed a proliferation of atypical spindle cells with inflammation consistent with a myofibroblastic tumor. After 4 and 7 months, follow-up cystoscopy demonstrated nodular mass lesions and transurethral resection of bladder tumor was done, which showed chronic cystitis and a recurred myofibroblastic tumor, respectively. Five months later, multiple lymph node, bone, and soft tissue metastases were found by positron emission tomography. The patient was treated first with palliative chemotherapy, including doxorubicin and cisplatin. After that, radiologic studies showed disease progression but the patient refused further treatment and died 6 months later.

Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data

To evaluate the clinical application of computed tomography‐based measurement of renal cortical volume and split renal volume as a single tool to assess the anatomy and renal function in patients with renal tumors before and after partial nephrectomy, and to compare the findings with technetium‐99m dimercaptosuccinic acid renal scan.

Long-term oncologic outcomes of postoperative adjuvant versus salvage radiotherapy in prostate cancer: Systemic review and meta-analysis of 5-year and 10-year follow-up data

Purpose To evaluate the oncologic outcomes between adjuvant radiotherapy (ART) and salvage radiotherapy (SRT) in patients with locally advanced prostate cancer or with adverse pathologic factors including positive surgical margin and high Gleason score. Materials and Methods We searched the literature published from January 2000 until December 2014 at MEDLINE, PubMed, Web of Science, Embase, ProQuest, and Cochrane Library. To be specific, included were studies comparing ART and SRT settings if they followed up oncologic outcomes more than 5 years. Results Overall, 3 retrospective, nonrandomized, observational studies, 1 matched control analysis, and 3 prospective randomized controlled studies met our inclusion criteria including a total of 2,380 patients (1,192 ART vs. 1,188 SRT). Higher favorable results were found in ART than in SRT was seen in the 5-year and 10-year biochemical recurrence (BCR)-free survival (risk ratio [RR], 0.61 and 0.70; 95% confidence interval [CI], 0.54-0.69 and 0.63-0.76). ART had a significantly higher 5-year progression-free survival rate than that in SRT (RR, 0.64; 95% CI, 0.51-0.80), but this was not the same for the 10-year progression-free survival rate (RR, 0.88; 95% CI, 0.72-1.08). There was no significant difference for the 5-year and 10-year overall survival rates between ART and SRT (RR, 0.80 and 0.94; 95% CI, 0.59-1.07 and 0.80-1.11). Conclusions ART showed favorable results in BCR-free survival during the 5-year follow-up period. However, the 10-year progression-free survival and overall survival did not show any difference between ART and SRT.

Evaluation of holmium laser for transurethral deroofing of severe and multiloculated prostatic abscesses

Purpose Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses. Materials and Methods From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed. Results Multiloculated or multifocal abscess cavities were found on the preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient. Conclusions Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage.

Predictors for Intravesical Recurrence Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A National Multicenter Analysis

Micro‐Abstract We evaluated the clinicopathologic factors on intravesical recurrence (IVR), using 760 patients who had undergone radical nephroureterectomy. The 5‐year cancer‐specific and overall survival curves, stratified by the occurrence of IVR, showed no significant difference between the 2 groups. Multivariate Cox analysis also showed that positive hydronephrosis, larger tumor size, positive preoperative urinary cytology, and ureterorenoscopy before radical nephroureterectomy were independent predictors of IVR. Introduction: The purpose of this study was to identify the prognostic impact of intravesical recurrence (IVR) on oncologic outcomes and the clinicopathologic factors that predict IVR in patients who undergo radical nephroureterectomy (RNU) for upper tract urothelial carcinoma. Patients and Methods: Between January 2000 and December 2015, 760 patients with upper tract urothelial carcinoma underwent RNU at 5 institutions in Korea, and patient data were retrospectively collected. Clinicopathologic factors were analyzed for intravesical recurrence‐free survival, cancer‐specific survival (CSS), and overall survival (OS). Univariate and multivariate Cox proportional hazards regression models were used to test the clinicopathologic factors on IVR. Results: Of the 760 patients, 231 (30.3%) patients experienced IVR within 10 months of the median interval between RNU and the first IVR. The overall estimated probabilities of 5‐year CSS, intravesical recurrence‐free survival, and OS were 84.2%, 63.8%, and 79.2%, respectively. No difference was noted in terms of CSS and OS between the patients who did or did not experience IVR. The multivariate Cox analysis showed an association between IVR and positive hydronephrosis, tumor size, positive preoperative urinary cytology, and ureterorenoscopy before RNU (all P < .05). However, a significantly decreased risk of IVR was associated with female gender, laparoscopic RNU, and receipt of adjuvant systemic chemotherapy (all P < .05). Conclusion: The occurrence of IVR following RNU did not affect CSS and OS. Patients with larger tumor size, preoperative hydronephrosis, positive preoperative urinary cytology, and ureterorenoscopy before RNU had a higher risk of IVR following RNU.

Comparison of the accuracy of multiparametric magnetic resonance imaging (mpMRI) results with the final pathology findings for radical prostatectomy specimens in the detection of prostate cancer

To assess the accuracy of multiparametric magnetic resonance imaging (mpMRI), used in conjunction with the Prostrate Imaging Reporting and Data System (PI‐RADS), version 2, in the detection of prostate cancer (PCa), and to determine the extent of the efficacy of mpMRI as a screening test in biopsy‐naïve patients.

Transcript Levels of Androgen Receptor Variant 7 and Ubiquitin-Conjugating Enzyme 2C in Hormone Sensitive Prostate Cancer and Castration-Resistant Prostate Cancer.

This study is designed to identify the androgen receptor variant 7 (AR‐V7) status, clinical significance of AR‐V7 in hormone sensitive prostate cancer (HSPC). Then, we evaluated AR‐V7 and changes of its target gene, ubiquitin‐conjugating enzyme E2C (UBE2C) which is an anaphase‐promoting complex/cyclosome (APC/C)‐specific ubiquitin‐conjugating enzyme, in castration‐resistant prostate cancer (CRPC) in serial tumor biopsies from patients receiving androgen deprivation therapy.

MP59-11 CLINICAL APPLICATION OF CALCULATED SPLIT RENAL VOLUME USING COMPUTED TOMOGRAPHY-BASED RENAL VOLUMETRY AFTER PARTIAL NEPHRECTOMY: CORRELATION WITH 99MTC-DMSA RENAL SCAN DATA

INTRODUCTION AND OBJECTIVES: Partial nephrectomy aims to maintain renal function by nephron sparing. However, the functional change of contralateral kidney remains to be known. We evaluated the functional change in contralateral kidney using DTPA renal scan and determined the predicting factors of contralateral kidney function after partial nephrectomy. METHODS: From 2001 to 2012, 699 patients underwent partial nephrectomy and we performed DTPA renal scan before and after surgery in all patients to assess the exact renal function of each kidney. Patients were divided into 3 groups according to initial contralateral glomerular filtration rate (GFR) (group 1: <30ml/min/1.73m2, group 2: 30~45ml/min/1.73m2, and group 3: 45ml/min/1.73m2). We evaluated separate renal functions using DTPA up to 5 year after surgery. Logistic regression analysis was used to identify the factors associated with increased GFR of contralateral kidney. Kaplan-Meier method was used for overall survival. Median follow-up period was 45.1 month. RESULTS: Patients of group 1 were older age (64.2 9.8 vs 55.0 11.0 vs 48.0 9.5, p<0.001), more hypertension history (59.5% vs 39.3% vs 20.9%, p<0.001), worse American society of anesthesiologists (ASA) score ( 2; 94.0% vs 89.5% vs 80.2%, p<0.001), and shorter ischemic time (19.9 8.0 vs 22.3 8.7 vs 22.8 8.9, p1⁄40.025) among three groups (respectively). Tumor size, resected weight, RENAL nephrometry score and ischemic type were not different among three groups (p1⁄40.293, p1⁄40.255, p1⁄40.582 and p1⁄40.967, respectively). The mean ipsilateral GFR changes were -7.5%, -1.6%, and -21.2% in group 1, 2, and 3, respectively and contralateral GFR changes were 33.9%, 19.9%, and 7.3% in group 1, 2, and 3, respectively at 5 year after partial nephrectomy. On multivariable analysis, ASA score (OR 0.54, 95% confidence interval [CI] 0.31-0.92 p1⁄40.0277) and preoperative contralateral GFR (OR 0.97, 95% CI 0.95-0.99 p1⁄40.0011) were the significant predictive factors for increased GFR of contralateral kidney within 5 years. 5 year overall survival rates were 86.1%, 93.1% and 97.4% in group 1, 2, 3, respectively. CONCLUSIONS: Contralateral kidney compensated for the functional loss of ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in healthy patients with decreased contralateral renal function.

MP67-08 PREOPERATIVE SYSTEMIC INFLAMMATORY MARKERS IN UPPER TRACT UROTHELIAL CELL CARCINOMA: WHICH IS BETTER AS A PROGNOSTIC FACTOR?

Eu Chang Hwang*, Yang Hyun Cho, Ho Seok Chung, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Gwangju, Korea, Republic of; Myung Ki Kim, Jeonju, Korea, Republic of; Sung Gu Kang, Seok Ho Kang, Jun Cheon, Seoul, Korea, Republic of; Ja Yoon Ku, Hong Koo Ha, Busan, Korea, Republic of; Chang Wook Jeong, Ja Hyeon Ku, Cheol Kwak, Seoul, Korea, Republic of; Tae Gyun Kwon, Tae-Hwan Kim, Seock Hwan Choi, Daegu, Korea, Republic of; Ill Young Seo, Iksan, Korea, Republic of

MP67-04 EVALUATION OF THE DE RITIS (ASPARTATE TRANSAMINASE/ALANINE TRANSAMINASE) RATIO AS A PREDICTOR OF ONCOLOGICAL OUTCOMES IN PATIENTS WITH UPPER URINARY TRACT UROTHELIAL CARCINOMA AFTER SURGERY

Eu Chang Hwang*, Yang Hyun Cho, Ho Seok Chung, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Gwangju, Korea, Republic of; Myung Ki Kim, Jeonju, Korea, Republic of; Sung Gu Kang, Jun Cheon, Seoul, Korea, Republic of; Ja Yoon Ku, Hong Koo Ha, Busan, Korea, Republic of; Chang Wook Jeong, Ja Hyeon Ku, Cheol Kwak, Seoul, Korea, Republic of; Tae Gyun Kwon, Tae-Hwan Kim, Seock Hwan Choi, Daegu, Korea, Republic of