Noriya Yamaguchi

Robot-assisted radical cystectomy is a promising alternative to open surgery in the Japanese population with a high rate of octogenarians

BackgroundJapanese patients who undergo radical cystectomy have a unique feature, i.e., the ratio of octogenarians is higher than in Western patients because of the aging Japanese population. The purpose of this study was to compare perioperative outcomes, complications, and oncologic outcomes between robot-assisted radical cystectomy and open radical cystectomy.MethodsFrom 2010−2015, 20 (of which 8 were octogenarians) and 40 (of which 11 were octogenarians) patients underwent robot-assisted radical cystectomy and open radical cystectomy, respectively.ResultsThere was no significant difference in terms of patient demographics between the two surgical cohorts, regardless of patient age. In the octogenarian patient cohort, the rates of previous abdominal surgery and the median age-adjusted Charlson comorbidity index were higher. The median estimated blood loss, transfusion rate and the days to resumption of a regular diet were significantly lower in the robot-assisted radical cystectomy cohort, regardless of patient age. Robot-assisted radical cystectomy significantly decreased grade II or higher complications, but there were no significant differences in terms of decreasing grade III or higher complications, regardless of patient age. Positive surgical margin and the mean number of lymph nodes removed were similar between the two surgical cohorts, regardless of patient age.ConclusionAlthough robot-assisted radical cystectomy has a short history in Japan, the outcomes were generally comparable to those of previous studies. In a country that is aging rapidly like Japan, robot-assisted radical cystectomy could be a valid option for the management of muscle-invasive and high-risk superficial bladder cancer.

Influence of multinerve-sparing, robot-assisted radical prostatectomy on the recovery of erection in Japanese patients

To evaluate in Japanese patients their sexual function after robot‐assisted radical prostatectomy (RARP) and to investigate the influence of the multinerve‐sparing (NS) grade on their sexual function.

MP60-20 IDENTIFICATION OF MICRORNA REGULATING SUNITINIB RESISTANCE IN RENAL CELL CARCINOMA CELLS

patients have distal metastasis at the time of diagnosis. Despite great improvement in therapeutic treatment including molecular targeted therapy, the prognosis of patients with distant metastases remains unfavorable. HOX transcript antisense RNA (HOTAIR) is one of the long non-coding RNAs (lncRNAs). Accumulating evidence demonstrates that HOTAIR plays essential roles in cancer development and metastasis in several types of cancer such as lung cancer and gastric cancer. However, the precise mechanism by which HOTAIR enhances cancer malignancy is still unknown, especially in RCC. The object of this study is to elucidate the function of HOTAIR in RCC. METHODS: The tumor and adjacent normal renal tissues were obtained with informed consent from 64 patients who underwent radical or partial nephrectomy in Miyagi Cancer Center. All tumor tissues were diagnosed pathologically as clear cell renal cell carcinoma. We evaluated the clinical correlates of HOTAIR expression determined by realtime PCR using RNA extracted from the tumor and normal tissues. The functional role of HOTAIR was examined using HOTAIR-overexpressing or knockdown human renal cell carcinoma cell lines (ACHN, A498 and Caki-1). RESULTS: The expression of HOTAIR was significantly correlated with tumor nuclear grade, lymph node metastasis, lung metastasis, and AJCC stage. Migration capacity was enhanced in a HOTAIR-depending manner in vitro. Overexpression of HOTAIR in human renal cell carcinoma accelerated tumorigenicity in immunodeficient mice. Microarray analysis revealed that Insulin Growth Factor Binding Protein 2 (IGFBP2) gene was up-regulated in HOTAIR-overexpressing cells, which was validated by real-time PCR and Western blotting. Co-expression of IGFBP2 and HOTAIR was observed in clinical samples (P 1⁄4 0.04, Fisher0s exact test). Enhanced migration activity in HOTAIR-expressing cells was attenuated by IGFBP2knockdown. CONCLUSIONS: We newly identified IGFBP2 as a downstream molecule of HOTAIR, which is involved in migration capacity. Our findings suggest that a HOTAIR-IGFBP2 axis plays critical roles in RCC progression, and serves as a novel therapeutic target for advanced RCC treatment.

MP97-18 LONGITUDINAL HEALTH-RELATED QUALITY OF LIFE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

The IH recurrence rate was lower in the IPOM group by a clinically relevant but not statistically significant difference (4% vs. 9%; p1⁄40.58) CONCLUSIONS: In patients undergoing RALP and IH repair, IPOM repair is feasible, and may be associated with better perioperative outcomes and safety profile than suture repair. The effectiveness of IPOM repair was superior but not significantly. A prospective comparison against the gold-standard technique is warranted.

Lysosome‑associated membrane protein 2 (LAMP‑2) expression induced by miR‑194‑5p downregulation contributes to sunitinib resistance in human renal cell carcinoma cells

Sunitinib is a tyrosine kinase inhibitor that is used as the primary treatment in metastatic renal cell carcinoma (RCC). The main difficulty associated with its use is the development of drug resistance. In the present study, ACHN cells, a human renal cell carcinoma cell line, were used to establish sunitinib-resistant (SR) cells. Microarray analysis and reverse transcription-quantitative polymerase chain reaction revealed that miR-194-5p expression was significantly decreased in SR-ACHN cells when compared with that observed in ACHN cells (P<0.05). Transfection of miR-194-5p, though not with negative control miR, in SR-ACHN cells could significantly inhibit cell proliferation following sunitinib treatment (2.5–40 µM; P<0.05). Western blotting demonstrated that the expression of lysosome-associated membrane protein-2 (LAMP-2), which attenuates the anti-proliferative effect of sunitinib, was significantly higher in SR-ACHN than in ACHN cells (P<0.01). In addition, LAMP-2 expression was suppressed by miR-194-5p transfection in SR-ACHN cells. These data suggested that miR-194-5p downregulation may be associated with sunitinib resistance via the induction of LAMP-2 expression in human RCC.

OP2-11 THE UTILITY OF THE REMNANT KIDNEY VOLUME / BODY SURFACE AREA RATIO AND TUMOR DIAMETER AS PREDICTORS OF BOTH MILD AND SEVERE POST-OPERATIVE RENAL INSUFFICIENCY IN PATIENTS WITH RENAL CELL CARCINOMA TREATED BY RADICAL NEPHRECTOMY

(p1⁄40.001). Collectively, the overall FIRST (r 1⁄4 0.829, p <0.001) and dVSS (r 1⁄4 0.742, p1⁄40.001) simulation scores highly correlated with total GEARS performance scores. Further analysis of the individual FIRST and dVSS tasks demonstrated statistically significant correlation of task score to intraoperative performance with the exception of Energy Switcher 1 (p1⁄40.078) (Table 1). CONCLUSIONS: This is the first study to demonstrate a significant correlation between baseline simulated robotic performance and robotic clinical performance (concurrent validity). Of note, the strongest correlation was observed between inanimate task scores and clinical performance, highlighting the current potential limitations of virtual simulation. These findings support the implementation of these specific inanimate and virtual reality robotic training tools in a standardized robotic training curriculum.