Background:Lower urinary tract symptoms (LUTS) and pain are clinically relevant problems after transurethral resection (TURBT) of nonmuscle-invasive bladder cancer. Although intravesical instillation of hyaluronic acid has already been proven to be a valid treatment for storage LUTS and pain in patients with inflammatory bladder syndrome, its efficacy in patients who undergo TURBT is unknown. This study aimed to present the results of a prospective, randomized, controlled, clinical pilot study on the safety and clinical performance of HydealCyst (Fidia Farmaceutici S.p.A., Italy), a device formulated to provide progressive, long-lasting intravesical release of hyaluronic acid. Materials and methods:Adults diagnosed with nonmuscle-invasive bladder cancer and scheduled for TURBT were included and underwent 4 visits up to 25 days after TURBT. Of the 47 patients who completed the investigation, 25 participants received 2 postoperative intravesical instillations with HydealCyst. The efficacy of HydealCyst on storage LUTS, pain, urinary symptoms, and patients' quality of life was evaluated using validated questionnaires. Results:Although the overall LUTS were similar in the 2 experimental groups, lower micturition frequency and fewer daytime micturitions were observed in patients treated with HydealCyst. These patients also showed a significant reduction in pain (p = 0.03) 3 days after catheter removal and better quality of life at the end of the study. The device was well tolerated, with no treatment-emergent adverse events of severe intensity. Conclusion:The results from this pilot study indicate a clinically meaningful improvement of symptoms after 2 instillations of HydealCyst, supporting this intervention as a potentially effective treatment for LUTS and pain after TURBT.

This prospective imaging trial was designed to compare [68Ga]PSMA-11 PET/CT with multiparametric MRI (mpMRI) in parallel in men with suspicion of prostate cancer (PCa) after at least one previous negative biopsy (ClinicalTrials.gov: NCT05297162; GR-2018-12366240). Between April 2022 and June 2025, we enrolled 130 patients who met the inclusion criteria and completed protocol investigations. Target lesions were defined based on PI-RADS v2.1 for mpMRI and PRIMARY Score, SUVmax and SUVratio for [68Ga]PSMA-11 PET/CT. Findings were statistically correlated with pathology results. Subsequently, we developed a nomogram to predict clinically significant PCa (csPCa), defined as International Society of Urological Pathology [ISUP] grade ≥ 2, using Boruta’s algorithm for variable selection. Median age in our cohort was 65.5 years (range, 50.5–82.2) and median PSA 9.7 ng/ml (range, 4–35). According to pathology, 20 patients (15.4

Abstract Background and Objective Prostate cancer (PCa) is a significant global health concern, ranking as the second most prevalent cancer among men worldwide. Genetic factors, particularly germline pathogenic variants (PVs) in DNA repair genes (DRGs), play a crucial role in PCa predisposition. Our study aimed to assess patients' adherence to a targeted PCa screening program targeting high‐risk individuals with DRG PVs and evaluate the potential reduction in biopsy and MRI rates by employing our screening protocol. Methods We conducted a prospective ongoing trial evaluating targeted PCa screening in men with documented PVs in DRGs. Screening involved annual assessment of medical history, physical examination, prostate‐specific antigen (PSA) testing, Prostate Health Index (PHI), and multiparametric magnetic resonance imaging (mpMRI) when indicated. Descriptive statistics were used to analyse patient characteristics, and adherence to screening was evaluated at three time points: baseline (T0), one year (T1), and two years (T2) from enrolment. Key Findings and Limitations A total of 101 high‐risk individuals were enrolled, with a median age of 52 years. Adherence to screening was high, with 72.3% of patients attending the first annual follow‐up (T1) and 100% attending the second follow‐up (T2). Despite elevated PSA levels in some patients, no PCa was detected during the study period. However, our screening protocol demonstrated the potential in reducing unnecessary biopsies and MRIs, particularly in patients with elevated PSA but low PHI values. Limitations include the ongoing nature of the study, small sample size, and lack of non‐carrier controls. Conclusions and Clinical Implications Our findings described a new PCa screening strategy integrated with genetic risk factors. The incorporation of PHI shows promise in improving the efficiency of diagnostic procedures while minimizing unnecessary interventions. High adherence among high‐risk individuals underscores the potential effectiveness of targeted screening programs.

Objective:The contribution of germline DNA repair gene (gDRG) variants to bladder cancer (BC) susceptibility and progression is still poorly defined, particularly in European populations. This study aims to evaluate the prevalence and clinical implications of germline homologous recombination repair (HRR) gene variants in BC patients of European ancestry. Methods:In this prospective case-control study, 75 BC patients attending follow-up at a single tertiary centre were screened for germline variants in 20 gDRGs. Patients were included regardless of disease stage and classified by pathogenicity (Class 3-5). Clinical characteristics and outcomes were compared between variant-positive and variant-negative patients. Results:Among 75 eligible patients, 72 underwent successful germline sequencing. A total of 23 patients (30.6%) harboured at least one pathogenic, likely pathogenic, or VUS variant. The most frequently altered genes included ATM (n = 6), ATR (n = 4), BARD1 (n = 4), CHEK2 (n = 3) and PMS2 (n = 3). Eight patients (34.7%) had multiple variants, and one carried three variants. Notably, 25.8% of NMIBC and 50% of MIBC patients had gDRG variants. Moreover, 30% of patients with low-grade G1 disease harboured at least one variant. Patients with gDRG variants had a higher rate of histopathological variants (34.8% vs. 13.5%) and underwent radical cystectomy at a younger age (60 vs. 75 years, p < 0.05). Conclusions:Germline HRR variants are prevalent in BC patients and may influence disease aggressiveness and treatment decisions. These findings support broader implementation of germline testing in BC and warrant further validation in larger cohorts.

288 Background: The current study is designed to evaluate the role of PSMA PET/CT for response prediction in prostate cancer (PCa) patients who are candidates for High-Intensity Focused Ultrasound (HIFU) focal therapy (FT). Methods: BetweenOctober 2020 and June 2023, overall 65 patients have been enrolled in our prospective, single-center study. Inclusion criteria were: PSA<20ng/mL, radiological stage ≤T2bN0M0, ISUP grade 1-3, PSMA PET/CT at baseline and at response evaluation 6-12 months post-treatment. Follow up included: PSA at 3, 6 and 12 months. Post-treatment biopsies were scheduled per-protocol at 12 months or earlier if imaging suspicious. Biochemical response and treatment failure were correlated to mpMRI and PSMA PET data, comprising PI-RADS, Primary score, SUVmax, SUVratio, and their variations after HIFU FT. Results: Median age was 67 years (range 53-80), initial PSA (iPSA) was 6.56ng/mL (range 2.25-13.25) and prostate volume was 45mL (range 20-160). The majority of the patients presented with ISUP 1 (66%). mpMRI results were: 14 patients with PI-RADS 1-2 (21.5%) and 51 with PI-RADS 3-4. Baseline Primary scores were: 30 score 1-2 (45%), and 35 score 3-5. Median baseline SUVmax and SUVratio resulted 5.4 (range 1.5-33.2) and 1.43 (range 0.86-9.39), respectively. At 3 months post-HIFU, 23% of the patients obtained a PSA response ≥50%; whereas at 6 months and 12 months, PSA responses were 26% and 45%, respectively. Post-treatment PSMA PET/CT was available in 40 patients. Median SUVmax and SUVratio post-treatment resulted 3.4 (range 1.4-28.4) and 1.1 (range 0.64-10), respectively, with a median ΔSUVmax of 39% and ΔSUVratio of 42%. There was a moderate negative correlation between post-treatment SUVmax and SUVratio with PSA response at 12 months (rho=-0.504, p=0.0280, and rho=-0.521, p=0.0231, respectively), while a positive moderate correlation was confirmed for ΔSUVmax (rho=0.475, p=0.0383). PET parameters were also statistically significantly correlated to treatment failure at 12months (p=0.020, p=0.048 and p=0,04, respectively for SUVmax, SUVratio and Primary), with Primary scores confirmed as predictive on logistic regression (OR=10.5; 95%CI 1.12-98.9). Conclusions: PSMA PET/CT provides useful information for treatment monitoring in PCa patients undergoing HIFU FT. Baseline and post-treatment SUV parameters and Primary score can predict biochemical response and treatment failure at 12 months post-completion.

328 Background: Although one of the most important risk factors for prostate cancer (PCa) is a family history of the disease, there is a poor awareness of genetic risk. The aim of the current study is to investigate the awareness of genetic risk for PCa in men belonging to female families with germline variants in DNA-repair genes (DRGs). Methods: Data were extracted by a prospective observational study designed to select men with germline pathogenic variants (PVs) and offer them a dedicated PCa screening. The selection of probands was performed by genetic counseling and testing of male grade I relatives of female patients with a PVs. Male candidates were identified after reviewing the genealogical trees of all women who had received the diagnosis of breast and/or ovarian cancer and tested positive for a PVs. All the probands, 35-69 yrs old, who resulted positive for PVs were offered to participate to a specific PCa screening based on annually digital rectal examination (DRE), detection of PHI, which is a blood test including total PSA, free PSA, free/total PSA and -2proPSA, and multiparametric MRI. The primary outcome was the “willing to be tested”, defined as a proxy for male awareness of PCa risk. The secondary endpoint was the acceptance rate to be screened. Results: We reviewed the genealogical trees of breast/ovarian cancer female patients from January 2017 to December 2021 and we identified, over 1256 families, 139 positive cases for PVs in DRGs. Among 139 families, we identified 378 “healthy” 35-69 yrs old men, who were offered a genetic counseling, and if they agree a genetic testing. Overall 117/378 (31%) healthy males declared to be interested to be tested. Out of the 51 new tests (66 men already tested out of the study), we found 30 (58.8%) positive men. All the new positive tested men accepted to attend the PCa screening. Living in Northern Italy, having at least one child and higher (degree) level of education were the strongest predictors of willing for testing (p<0.01). Conclusions: Our data reveals a limited will to be tested, but all men tested positive for PVs accepted to participate to the PCa screening. These findings strongly support the urgent need to implement awareness of genetic risk for PCa.

Abstract Abstract Objective The aim of this study is to evaluate male awareness of developing prostate cancer (PCa) in families with germline DNA‐repair genes (DRG) variants. Materials and methods Data were collected from a prospective, monocentric cohort study. The study was conducted in a university hospital with a multidisciplinary approach to the patient (collaboration of the Departments of Oncology, Urology, Pathology, Radiology, and Medical Genetics Laboratory). We recruited healthy males, relatives of families of women with breast or ovarian cancer who tested positive for pathogenic variants (PVs) or likely pathogenic variants (LPVs) in DRGs. A dedicated PCa screening was designed and offered to men aged 35 to 69 years, based on early visits with digital rectal examination (DRE), prostate health index (PHI) measurement, multiparametric magnetic resonance imaging (mpMRI) and, if necessary, targeted/systematic prostate biopsies. The primary endpoint was to evaluate the willingness of healthy men from families with a DRG variants detected in female relatives affected with breast and/or ovarian cancer to be tested for the presence of familial PVs. The secondary endpoints were the acceptance to participate if resulted positive and compliance with the screening programme. Results Over 1256 families, of which 139 resulted positive for PVs in DRGs, we identified 378 ‘healthy’ men aged between 35 and 69 years old. Two hundred sixty‐one (69.0%) refused to be tested for DRG variants, 66 (17.5%) declared to have been previously tested, and 51 (13.5%) males were interested to be tested. Between those previously tested and those who accepted to be tested, 62 (53.0%) were positive for a DRG variant, and all of them accepted to participate in the subsequent surveillance steps. The main limitation is that is a single‐centre study and a short follow‐up. Conclusions All men tested positive for a DRG variants agreed to go under the surveillance scheme. However, only 31% of ‘men at risk’ (i.e., relative of a DRG variant carrier) expressed their willingness to be tested for the familial DRG variant. This observation strongly supports the urgent need to implement awareness of genetic risk for PCa within the male population.

Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa. The overall SF collection yield was 18.2% (39% when considering only compliant patients), with about a half of the patients (53.15%) not consenting to SF donation. Independent favorable predictors for SF collection were younger age and lower prostate volume. We implemented a protocol to enrich prostate-derived cells by multi-color flow cytometry and applied it on SF and urine samples from 100 patients. The number of prostate-enriched cells (SYTO-16+ PSMA+ CD45-) was variable, with higher numbers of cells isolated from SF than urine (p value < 0.001). Putative cancer cells (EpCAMhigh) were 2% of isolated cells in both specimens. The fraction of EpCAMhigh cells over prostate-enriched cells (PSMA+) significantly correlated with patient age in both semen and urine, but not with other clinical parameters, such as Gleason Score, ISUP, or TNM stage. Hence, enumeration of prostate-derived cells is not sufficient to guide PCa diagnosis; additional molecular analyses to detect patient-specific cancer lesions will be needed.

You have accessJournal of UrologyCME1 Apr 2023MP73-16 SUV VARIATION ON PSMA PET/CT CORRELATES WITH BIOCHEMICAL RESPONSE IN PATIENTS WITH PROSTATE CANCER UNDERGOING HIGH-INTENSITY FOCUSED ULTRASOUND (HIFU) FOCAL THERAPY Egesta Lopci, Giovanni Lughezzani, Vittorio Fasulo, Davide Maffei, Emmanuella Nana Yaa Dede Adjaye, Alberto Saita, Piergiuseppe Colombo, Rodolfo Hurle, Marzo Katia, Roberto Peschechera, Alessio Benetti, Silvia Zandegiacono, Luisa Pasini, Paolo Casale, Luca Balzarini, Arturo Chiti, Giorgio Guazzoni, Nicolò Maria Buffi, and Massimo Lazzeri Egesta LopciEgesta Lopci More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Vittorio FasuloVittorio Fasulo More articles by this author , Davide MaffeiDavide Maffei More articles by this author , Emmanuella Nana Yaa Dede AdjayeEmmanuella Nana Yaa Dede Adjaye More articles by this author , Alberto SaitaAlberto Saita More articles by this author , Piergiuseppe ColomboPiergiuseppe Colombo More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Marzo KatiaMarzo Katia More articles by this author , Roberto PeschecheraRoberto Peschechera More articles by this author , Alessio BenettiAlessio Benetti More articles by this author , Silvia ZandegiaconoSilvia Zandegiacono More articles by this author , Luisa PasiniLuisa Pasini More articles by this author , Paolo CasalePaolo Casale More articles by this author , Luca BalzariniLuca Balzarini More articles by this author , Arturo ChitiArturo Chiti More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , and Massimo LazzeriMassimo Lazzeri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy (FT) for localized prostate cancer (PCa) offers minimally invasive localized ablative treatment while minimizing treatment-related toxicity compared to standard radical options. Recent advances in PCa imaging with PSMA PET/CT offer new opportunities to detect PCa foci and monitor response to treatment. The current study is designed to evaluate the role of PSMA PET/CT for response assessment in PCa patients candidate to High-Intensity Focused Ultrasound (HIFU) focal therapy. METHODS: The present analyses was conducted in patients enrolled in an ongoing, prospective, single-center cohort study of patients treated with HIFU FT for localized PCa. Inclusion criteria: PSA<20 ng/mL, radiological stage≤T2bN0M0, ISUP grade 1-3, PSMA PET/CT at baseline and at response evaluation. Follow up included: PSA at 3, 6 and 12 months; PSMA PET/CT between 6-12 months post treatment. Biochemical response and PET response were statistically correlated: SUVmax and SUVratio to background of the target lesions were used as semi-quantitative parameters for PSMA PET/CT, together with their variations before and after HIFU FT (i.e. ΔSUVmax and ΔSUVratio). RESULTS: Overall, 23 patients met inclusion criteria for the analysis. Median age was 67 years (IQR 63-72), initial PSA (iPSA) was 5.9 ng/mL (IQR 5.2-8.7) and prostate volume was 40 mL (IQR 35.8-50.8). ISUP score was 1 in 16 (70%) patients and 2 in the remaining 7 (30%). Median SUVmax and SUVratio before treatment resulted 3.4 (IQR 2.6-6.3) and 1.4 (IQR 1.1-1.8), respectively. At 3 months post-HIFU, 35% of the patients obtained a PSA response≥50%; whereas at 6 months and 12 months, PSA responses were 35% and 36%, respectively. Median SUVmax and SUVratio post-treatment resulted 2.5 (IQR 1.7-3.4) and 0.9 (IQR 0.7-1.0), respectively, proving a statistically significant reduction compared to baseline values (p=0.048 and 0.0051, respectively). Median ΔSUVmax -22% and ΔSUVratio resulted-30%. There was a statistically significant correlation of ΔSUVmax and PSA response at 12 months post-HIFU (p=0.021) (Figure). CONCLUSIONS: PSMA-PET may be a useful tool for monitoring response in PCa patients undergoing HIFU FT. Moreover, the SUV variation can predict biochemical response at 12 months post-treatment completion. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1041 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Egesta Lopci More articles by this author Giovanni Lughezzani More articles by this author Vittorio Fasulo More articles by this author Davide Maffei More articles by this author Emmanuella Nana Yaa Dede Adjaye More articles by this author Alberto Saita More articles by this author Piergiuseppe Colombo More articles by this author Rodolfo Hurle More articles by this author Marzo Katia More articles by this author Roberto Peschechera More articles by this author Alessio Benetti More articles by this author Silvia Zandegiacono More articles by this author Luisa Pasini More articles by this author Paolo Casale More articles by this author Luca Balzarini More articles by this author Arturo Chiti More articles by this author Giorgio Guazzoni More articles by this author Nicolò Maria Buffi More articles by this author Massimo Lazzeri More articles by this author Expand All Advertisement PDF downloadLoading ...

Objectives:To test the hypothesis of a relationship between a specific genetic lesion (T2:ERG) and imaging scores, such as PI-RADS and PRI-MUS, and to test the effectiveness of these parameters for the diagnosis of prostate cancer (PCa) and clinically significant PCa (csPCa).Materials and methods:This is a prospective study of men with suspected PCa enrolled between 2016 and 2019 at a high-volume tertiary hospital. Patients underwent systematic US-guided biopsy, plus targeted biopsy if they were presenting with >=1 suspicious lesion (PI-RADS>2) at mpMRI or PR-IMUS >2 at micro-ultrasound assessment. For each patient, one core from the highest PI-RADS or PRI-MUS lesion was collected for T2:ERG analysis. Multivariable logistic regression models (LRMs) were fitted for csPCa with a clinical model (age, total PSA, previous biopsy, family history for PCa), a clinical plus PI-RADS, clinical plus T2:ERG, clinical plus PI-RADS plus T2:ERG, and T2:ERG plus PI-RADS alone.Results:The cohort consists of 158 patients: 83.5% and 66.2% had respectively a diagnosis of PCa and csPCa after biopsy. A T2:ERG fusion was found in 37 men and 97.3% of these patients harbored PCa, while 81.1% were diagnosed with csPCa. SE of T2:ERG assay for csPCa was 28.8%, SP 87.0%, NPV 38.8%, and PPV 81.1%. Of 105 patients who performed mpMRI 93.% had PIRADS ≥3. SE of mpMRI for csPCa was 98.5%, SP was 12.8%, NPV was 83.3%, and PPV was 65.7%. Among 67 patients who were subjected to micro-US, 90% had a PRI-MUS ≥3. SE of micro-US for csPCa was 89.1%, SP was 9.52%, NPV was 28.6%, and PPV was 68.3%. At univariable LRM T2:ERG was confirmed as independent of mpMRI and micro-US result (OR 1.49, p=0.133 and OR 1.82, p=0.592, respectively). At multivariable LRM the clinical model alone had an AUC for csPCa of 0.74 while the clinical model including PI-RADS and T2:ERG achieved an AUC of 0.83.Conclusions:T2:ERG translocation and imaging results are independent of each other, but both are related csPCa. To evaluate the best diagnostic work-up for PCa and csPCa detection, all available tools (T2:ERG detection and imaging techniques) should be employed together as they appear to have a complementary role.

You have accessJournal of UrologyCME1 May 2022MP59-20 [18F]-FDG PET/CT FOR BLADDER CANCER STAGING AND DECISION-MAKING IN PATIENTS WITH HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER (HR-NMIBC) Rodolfo Hurle, Paolo Casale, Alberto Saita, NicolòMaria Buffi, Giovanni Lughezzani, Roberto Contieri, Vittorio Fasulo, Nicola Frego, Alessio Benetti, Arturo Chiti, Marcello Rodari, Martini Sollini, Cristiano Pini, Fabrizia Gelardi, Giorgio Guazzoni, and Massimo Lazzeri Rodolfo HurleRodolfo Hurle , Paolo CasalePaolo Casale , Alberto SaitaAlberto Saita , NicolòMaria BuffiNicolòMaria Buffi , Giovanni LughezzaniGiovanni Lughezzani , Roberto ContieriRoberto Contieri , Vittorio FasuloVittorio Fasulo , Nicola FregoNicola Frego , Alessio BenettiAlessio Benetti , Arturo ChitiArturo Chiti , Marcello RodariMarcello Rodari , Martini SolliniMartini Sollini , Cristiano PiniCristiano Pini , Fabrizia GelardiFabrizia Gelardi , Giorgio GuazzoniGiorgio Guazzoni , and Massimo LazzeriMassimo Lazzeri View All Author Informationhttps://doi.org/10.1097/JU.0000000000002642.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Standard imaging as CT and MRI have been failed in detecting lymph node metastasis (LNM) in muscle invasive bladder cancer (MIBC). Recently [18F]-FDG PET/CT has been reported to be more sensitive than CT and MR in staging MIBC, but no data has been reported about its role in non-muscle invasive bladder cancer (NMIBC). We investigated the potential clinical performance of [18F]-FDG PET/CT in staging and decision-making (bladder sparing) in patients with high-risk (HR-NMIBC). METHODS: This is prospective, exploratory study, in patients with MIBC and HR or very HR (VHR) NMIBC, according to EAU guideline, who were candidate to radical cystectomy at our tertiary University Hospital. Patients were enrolled if they had primary T2 or higher, T1 HG/G3 with or without CIS or BCG failure NMIBC. We compare pre-operative diagnostic performance of [18F]-FDG PET/CT with diuretic administration and delayed acquisition with pathological data in patients who underwent radical cystectomy (RC) and concomitant pelvic lymph node dissection (LND). We defined the capacity of avoiding over-/under-treatment by local staging and LNM detection in patients with HR- VHR-NMIBC by sensitivity, specificity, NPV and PPV. RESULTS: From September 2020 to July 2021, 47 patients were enrolled. Overall [18F]FDG-PET/CT correctly identified 13/19 true positive and 23/28 true negative LNM (sensitivity 68.4%, specificity 82.1%, PPV 72.2%, NPV 79.3%; AUC 75.3% [95% CI 62.3%-88.2%]). In the 34 patients with definitive MIBC, [18F]FDG-PET/CT correctly identified 10/16 true positive and 16/18 true negative lymph nodes (sensitivity 62.5%, specificity 88.9%, PPV 83.3%, NPV 72.7%; AUC =75.7% [95% CI 61.3%-98.6%]), In 13 NMIBC patients the sensitivity was 100%, specificity 70%, with a PPV of 50% and a NPV of 100%. The AUC was higher in NMIBC than MIBC: 85% [95% CI 70%-100%]. Figure1 showed a patient with NMIBC and negative lymph node (a), and a patient with a VHR-NMIBC with multiple positive pelvic lymph node (b; arrows). CONCLUSIONS: These preliminary findings showed that [18F]FDG-PET/CT, with diuretic administration and delayed acquisition, may detect LNM in NMIBC and it could be an accurate tool for decision making (bladder sparing or not) in HR- or VHR-NMIBC. Larger and multi-institutional series remain mandatory to confirm our data. Source of Funding: NONE © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1010 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rodolfo Hurle More articles by this author Paolo Casale More articles by this author Alberto Saita More articles by this author NicolòMaria Buffi More articles by this author Giovanni Lughezzani More articles by this author Roberto Contieri More articles by this author Vittorio Fasulo More articles by this author Nicola Frego More articles by this author Alessio Benetti More articles by this author Arturo Chiti More articles by this author Marcello Rodari More articles by this author Martini Sollini More articles by this author Cristiano Pini More articles by this author Fabrizia Gelardi More articles by this author Giorgio Guazzoni More articles by this author Massimo Lazzeri More articles by this author Expand All Advertisement PDF downloadLoading ...

Objective: Many individuals with bladder cancer have undergone a surgical urostomy and often complain of being self-conscious of the unpleasant smell of their own urine. The focus of this study was to test the efficacy of a pouch cover made of a carbon and zeolite containing polyester material to inhibit the smell of urine by comparing two trained dogs’ response time in detecting volatile organic compounds (VOCs) in urine, with and without the fabric covering the samples. Methods: This study used a randomized, blinded experimental design to evaluate the efficacy of a fabric to interfere with two highly trained dogs’ ability to detect specific VOCs present in the urine of prostate cancer patient. Ninety urine samples were analyzed in this study. Results: Prior to the experiment, both dogs accurately detected VOCs in the uncovered test urine samples of men with prostate cancer with a sensitivity and specificity of nearly 100%. Both dogs recognized the “uncovered” urine samples of men with prostate cancer within two seconds. When the test sample was covered with the study fabric, the test urine samples were detected within 30-40 seconds and in some instances the dogs were not able to identify the covered samples, whatsoever. Conclusion: The findings of this study demonstrate that the carbon and zeolite containing polyester fabric did significantly interfere with the ability of the dogs to detect VOCs in urine of men with prostate cancer. The fabric may show promise as a pouch cover in controlling offensive urine odor which many ostomates experience.

INTRODUCTION AND OBJECTIVE:Although “en-bloc” resection of bladder tumors (eb-TURBT) has been widely used for decades, its long-term oncological outcomes have not been completely examined yet. Here...

BACKGROUND:The aim of this study was to identify the predictive factors for progression defined as any event that shifted the management of the disease from a bladder sparing approach, by comparing patients with pure versus non-pure carcinoma in situ (CIS) of the bladder.METHODS:A retrospective analysis was carried out in consecutive patients affected by newly-diagnosed pure CIS and non-pure CIS (excluding cases with concomitant muscle invasive cancer). All patients were enrolled a in our institution from 1998 to 2010. Data was prospectively collected. Main end point was progression-free survival.RESULTS:Overall, 149 patients with CIS were identified for the analysis. A total of 98 patients had pure CIS (66%). Median follow-up was 103 months (range: 40-206 months). Progression occurred in 29 patients (19%). A total of 30 patients died during the follow-up (20%). In 13 cases (9%), the death was cancer specific. Progression-free survival estimate was 181 months (95% CI: 169-193 months) and 154 months (95% CI: 133-176 months) respectively for pure and non-pure CIS population (P=0.03). Among examined variables (age, gender, symptoms, smoking habit, ASA score, number of bacillus Calmette-Guérin [BCG] instillations), multivariate analysis disclosed that only CIS type was an independent predictor of progression (P=0.03) with a relative risk of 0.37 in favor of pure CIS.CONCLUSIONS:Pure and non-pure CIS are efficiently treated by BCG therapy combined with trans-urethral resection and/or radical cystectomy, with relatively low rate of progression. CIS type was the only significant predictor of progression.

Background: Positron emission tomography (PET)/computed tomography (CT) with Ga-68-labeled prostate-specific membrane antigen ligand (Ga-68-PSMA) may represent the most promising alternative to multiparametric magnetic resonance imaging (mpMRI) for prostate cancer (PCa) diagnosis. Objective: To test the diagnostic performance of Ga-68-PSMA PET/CT in this clinical context. Design, setting, and participants: From January 2017 to December 2018 we prospectively enrolled 97 patients with persistently elevated prostate-specific antigen and/or Prostate Health Index score, negative digital rectal examination, and previous negative biopsy. We also included patients with either negative mpMRI or contraindications to or positive mpMRI but previous negative biopsy. Intervention: Patients underwent 68Ga-PSMA PET/CT with additional pelvic reconstruction. Outcome measurements and statistical analysis: The primary endpoint of the study was the diagnostic performance of Ga-68-PSMA PET/CT in detecting malignant lesions and clinically significant PCa (Gleason score [GS] >= 7). Results and limitations: Ga-68-PSMA PET/transrectal ultrasound fusion biopsy was performed in 64 of 97 patients (66%) for 114 regions of interest (ROIs). Forty patients (41%) had already undergone mpMRI with either a negative result for PCa (n = 15; 22 ROIs) or a positive mpMRI result but a previous negative biopsy. According to pathology, 23 patients (36%) had evidence of PCa: eight (16 ROIs) with GS 6. 13 (21 ROIs) with GS 7 (3 + 4 or 4+ 3), one (2 ROIs) with GS 8, and one (2 ROIs) with GS 10. Clinically significant PCa was identified in four patients with previous negative mpMRI (25%). PET/CT demonstrated PCa in seven patients (14 ROls) with previous positive mpMRI and negative biopsy. The median maximum standardized uptake value (SUVmax) and median SUV ratio were significantly higher for PCa lesions than for benign lesions (p < 0.001). Optimal cutoff points obtained for SUVmax (>5.4) and SUV ratio (>2.2) could identify clinically significant PCa with accuracy of 81% and 90%, respectively. Conclusions: In our cohort of patients with high suspicion of cancer, Ga-68-PSMA PET/CT was capable of detecting malignancy and accurately identifying clinically relevant PCa. Patient summary: Positron emission tomography/computed tomography with a Ga-68-labeled ligand for prostate-specific membrane antigen is capable of detecting prostate cancer in patients with a high suspicion of cancer and a previous negative biopsy. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.