Page 18 - CUA 2020_Endourology

2020 CUA Abstracts

pre-/post-SC prostate-specific antigen time from radiation to biochemical (p<0.001). Among the 40 and 39 GAs closest to Saskatoon and Regina,
recurrence, time to SC failure, and overall survival. respectively, 37 (93%) and 35 (90%) GAs had Saskatoon and Regina as
Conclusions: Prostate DC following SC appears to be under-reported. their respective observed center. The sensitivity analysis showed 36 (90%),
Our long followup has revealed this AE, which appears to have delayed 35 (88%), and 30 (75%) GAs had Saskatoon and 35 (90%), 30 (77%),
onset (>8 years). Proposed etiology includes dystrophic calcium deposi- and 26 (67%) GAs had Regina as the observed center at the 60%, 80%,
tion following chronic inflammation superimposed on radiated tissues. and 100% cutoffs, respectively. Three GAs with no observed values were
This previously unappreciated AE can significantly impact quality of life excluded from the analysis.
(requiring long-term catheter drainage) and should be part of preopera- Conclusions: This analysis shows that PC patients in south and central
tive counselling. SK undergo RT at a PC assessment center closest to them in distance.
References Closest treatment center can be a proxy for where a patient undergoes
1. Williams AK, Martínez CH, Lu C, et al. Disease-free survival fol- PC treatment.
lowing salvage cryotherapy for biopsy-proven radio-recurrent pros-
tate cancer. Eur Urol 2011;60:405-10. https://doi.org/10.1016/j. UP-1.29
eururo.2010.12.012
2. Touma NJ, Izawa JI, Chin JL. Current status of local salvage therapies Robotic-assisted radical prostatectomy as salvage procedure
following radiation failure for prostate cancer. J Urol 2005;173:373- after abandoned open radical prostatectomy 3
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9. https://doi.org/10.1097/01.ju.0000150627.68410.4d Ellen O’Connor , Samantha S. Koschel , Niranjan N. Sathianathen ,
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3. Dru C, Bender L. Dystrophic calcification of the prostate Isaac I. Thangasamy , Daniel D. Moon , Declan D. Murphy
1
after cryotherapy. Case Rep Urol 2014;2014:1-4. https://doi. Department of Surgery, University of Melbourne, Austin Hospital,
2
org/10.1155/2014/471385 Heidelberg, Australia; Young Urology Research Organization, (YURO),
3
4. Zumstein V, Betschart P, Müllhaupt G, et al. Recurrent dystrophic Melbourne, Australia; Division of Cancer Surgery, Peter MacCallum
4
calcification of the prostatic resection cavity after transurethral resec- Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department
tion of the prostate: Clinical presentation and endoscopic manage- of Oncology, University of Melbourne, Parkville, Australia
ment. J Endourol Case Reports 2017;3:81-3. https://doi.org/10.1089/ Introduction: Robotic-assisted radical prostatectomy (RARP) has largely
cren.2017.0058 replaced open radical prostatectomy (ORP) where robotic facilities are
available, with functional and oncological outcomes reported as equiva-
lent in studies published thus far. To the best of our knowledge, no series
UP-1.28 examining abandoned ORP where subsequent salvage RARP has then
Does distance to prostate cancer assessment center predict been successfully performed, has been published. We aim to evaluate the
location for radiation therapy treatment center? reasons for abandoning ORP and technical aspects of performing salvage
Mustafa Andkhoie , Michael Szafron 1 RARP in our series of five patients.
1
1 School of Public Health, University of Saskatchewan, Saskatoon, SK, Methods: A retrospective review of five patients who had ORP abandoned
Canada and were then referred for RARP was performed. Analysis of patient and
Support: Telus Ride For Dad. Prostate Cancer Fight Foundation operative characteristics, and oncological outcomes were performed and
Introduction: In Saskatchewan (SK), prostate cancer (PC) assessment cen- reasons for abandonment of ORP were described.
ters are in the cities of Regina and Saskatoon, respectively located in the Results: Five patients were included for analysis. Mean age was 60 years,
southern and central portions of SK with approximately 250 km between mean presenting prostate-specific antigen (PSA) was 6.6 ng/ml, and mean
them. We hypothesize that patients undergo treatment in the city with body mass index (BMI) was 32.26 kg/m . All patients had intermediate-risk
2
the closest (by distance) PC assessment center. prostate cancer. Small prostate and deep pelvis was given as the reason for
Methods: PC patient data (2010–2014) from the SK Cancer Registry abandoning ORP in 80% of cases, with 3/4 of these also citing increased
included the treatment location for patients (n=888) living in south and BMI as a factor. Extensive mesh from previous bilateral inguinal hernia
central SK who underwent radiation therapy (RT). The study region was repair was cited as the reason in the final patient. Mean operating time
subdivided into 82 geographical areas (GAs) and patients were catego- was 157 minutes (range 135–190) and mean estimated blood loss was
rized per the GAs in which they lived at the time of diagnosis. For each 200 ml (range 100–300). Extensive adhesions were noted at RARP in all
patient, we identified the “closest” center to be Regina or Saskatoon five patients, with small bladder lacerations encountered in the patient
using the Euclidean distance between the centroids of the GAs and the with mesh hernia repairs.
two cities. The proportions of patients undergoing RT in each center were Conclusions: Abandoning ORP is rare, but this case series demonstrates
calculated for each GA. The “observed” center for a GA was then the that subsequent RARP, while more technically difficult, can be safely
center with more than 50% of the RT treatments. Odds ratios were used performed. Increased BMI with a small prostate in a deep pelvis and
to determine if any associations exist between the closest and observed previous mesh hernia repair appear to be catalysts for abandonment of
centers. We conducted a sensitivity analysis on our observed center defi- open surgery in this cohort. Identifying these patients early at time of
nition using 60%, 80%, and 100%. prostate cancer diagnosis and potentially referring on to a center with
Results: PC patients have 108 (95% confidence interval [CI] 22.5–517) robotic expertise may be preferential.
times the odds of undergoing RT in their corresponding closest center

S56 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)