Riu Hamada

The powerful impact of double-layered posterior rhabdosphincter reconstruction on early recovery of urinary continence after robot-assisted radical prostatectomy

BACKGROUND AND PURPOSE The usefulness of posterior rhabdosphincter reconstruction (PR) during robot-assisted radical prostatectomy (RARP) has still been controversial. We investigated the association of several factors, including the Rocco original double-layered PR, with early recovery of urinary continence after RARP. PATIENTS AND METHODS Between August 2006 and April 2011, a single surgeon at Tokyo Medical University Hospital performed 206 RARPs. Of these 206 patients, 199 eligible patients were enrolled in this study. We retrospectively analyzed the correlation of several perioperative factors, including surgical techniques, with early recovery of urinary continence 1 month after catheter removal. Continence was defined as no use or the use of only one safety pad. RESULTS Univariate analysis showed that surgeon experience, lateral approach of bladder neck preservation, bladder neck reconstruction, anterior reconstruction, and the Rocco double-layered PR were significantly associated with early recovery of urinary continence 1 month after catheter removal. Preoperative prostate-specific antigen level, body mass index, and attempted nerve-sparing (NS) procedures, however, were not significantly associated with early recovery of urinary continence. Multivariate logistic regression analysis showed that the Rocco PR and attempted NS were the only independent predictive factors of urinary continence recovery 1 month after catheter removal (odds ratio [OR], 15.01; 95% confidence interval [CI], 3.413-66.67; P=0.0003 and OR, 2.248; 95% CI, 1.048-4.975; P=0.0402, respectively). When we applied NS as well as the Rocco PR, the recovery rates of continence at 1 month after catheter removal was 85.3%. CONCLUSIONS The Rocco double-layered PR and attempted NS and not surgeon experience were the significant independent predictive factors of early recovery of urinary continence after RARP. NS procedures positively influenced early recovery of urinary continence only when they were applied with the PR technique.

Safety and efficacy of docetaxel, estramustine phosphate and hydrocortisone in hormone-refractory prostate cancer patients

Objective:  To assess the combination of docetaxel (DTX), estramustine phosphate (EMP) and hydrocortisone for patients with hormone‐refractory prostate cancer (HRPC).

Radical retropubic prostatectomy with running vesicourethral anastomosis and early catheter removal: Our experience

Objectives:  To assess the outcomes of patients undergoing radical retropubic prostatectomy (RRP) with a running vesicourethral anastomosis and catheter removal on postoperative day 3 or 5.

A Case of Primary Small-Cell Carcinoma of the Bladder.

Primary small-cell carcinoma arising from the bladder (SmCCB) is uncommon. It differs from urothelial carcinoma (UC), the most common type of bladder cancer, with respect to its cell of origin, biology, and prognosis. Biologically, prostatic SmCCB is much more aggressive than UC, and the prognosis for cases with distant metastasis is especially poor. We report here a case of primary SmCCB (cT3bN1M0) treated with radical cystectomy.

MP45-17 SIGNIFICANT ASSOCIATION BETWEEN ABO BLOOD GROUP AND BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

INTRODUCTION AND OBJECTIVES: Recent studies have demonstrated associations among the ABO blood group, risk, and prognosis in various diseases. However, to date, few studies have investigated the prognostic significance of the ABO blood group in prostate cancer. The aim of this study was to investigate the association of the ABO blood group with biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS: We reviewed 719 patients who underwent RP for clinical T1e3N0M0 prostate cancer at our institution between 2000 and 2010. Patients who had neoadjuvant and/or adjuvant therapy were excluded from this study. As a result, a total of 592 patients were included for analysis in the present study. The associations among the ABO blood group, clinicopathologic factors, and BCR were analyzed using univariate and multivariate analyses. RESULTS: With a mean follow-up period of 67.3 months, 183 patients (30.9%) experienced BCR, with a 5-year BCR-free rate of 66.1%. Among the clinicopathologic characteristics, only surgical margin status was observed to significantly differ between patients with different ABO blood groups (A vs. B, P 1⁄4 0.005; AB vs. B, P 1⁄4 0.007). In univariate analyses, a higher serum prostate-specific antigen (PSA) level at diagnosis, extracapsular extension, a positive surgical margin, seminal vesicle invasion, lymphovascular invasion, and a higher Gleason score (GS 8) in the RP specimen were significantly associated with BCR. Although not a significant factor in univariate analysis (P 1⁄4 0.131), the ABO blood group, in addition to the serum PSA level, extracapuslar extension, positive surgical margin, seminal vesicle invasion, and Gleason score, was an independent predictor of BCR in multivariate analysis. Hazard ratio and 95% confidence intervals for BCR according to the ABO blood group were shown in the Figure. Blood type O patients demonstrated a significantly lower risk of BCR than type A patients (HR, 0.624; 95%CI, 0.432e8211;0.901; P 1⁄4 0.012). CONCLUSIONS: The ABO blood group was significantly associated with BCR in prostate cancer patients who underwent RP. In particular, blood type O is significantly associated with a decreased risk of BCR after RP. Further studies are needed to clarify the nature of this association.