ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

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Jean Marc Lobaccaro 2 , Antonio Alberto Sinisi 1 , Domenico Prezioso 3 , Fabrizio Iacono 3 , Ester Illiano 3 and Gennaro Iapicca 3 1 Endocrinologia, Dipartimento di Scienze Cardiotoraciche, Seconda Università di Napoli, Napoli, Italy; 2 Endocrinology, Clermont University, Aubiere, France; 3 Clinica Urologica Universitá Federico II Napoli, Napoli, Italy Aim: Oxysterols may exert antiproliferative effects on several cancer cells, including prostate cells (PC), acting on liver X receptors alpha and beta (LXRalpha and LXRbeta). Here, we evaluated the presence of LXRs and the effects of a synthetic oxysterol (T09) using the androgen-dependent cell lines EPN and a stabilized line, derived from prostate cancer (CPEC). Materials and Methods: Starved cultures were treated with T09 (3 or 10 μM) or DMSO and harvested 72 h after treatment, stained with propidium iodide for flow cytometry of cell cycle distribution by FACSCalibur or recovered for protein extraction for Western blot analysis or for mRNA extraction for quantitative real-time PCR. Cells grown on slides were also treated and harvested after 72 h for TUNEL assay. Results: LXRalpha and beta transcripts were found in both EPN and CPEC with higher LXRalpha levels in CEPC (p
Abstracts of the <strong>21st</strong> Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 22-24 June, 2011, Naples, Italy renal parenchyma. With respect to open enucleation, warm ischemia time affected laparoscopic rather than open access. The reported personal technique, saving time usually used for parenchymal hemostatic sutures, shortened the operative ischemia time, which in our series was found to be within the safe limits for the preservation of renal function, achieving good peri- and postoperative haemostasis. Our sutureless technique during elective laparoscopic enucleation for cT1a exophytic renal tumors was feasible and effective in reducing the complexity of laparoscopic maneuvers and warm ischemia time, without major bleeding complications. 73 MALIGNANCY IN HORSESHOE KIDNEYS: REVIEW AND OUR EXPERIENCE Remigio Pernetti, Fabiano Palmieri, Michele Malizia, Giorgio Bruno, Enza Lamanna, Calogero Di Stefano and Salvatore Voce Santa Maria delle Croci Hospital, Ravenna, Italy Background: Horseshoe kidney is one of the most common congenital anomalies of renal structure. The incidence of renal carcinoma in these abnormal kidneys is similar to that with normal anatomy and 85% of them are adenocarcinomas. Surgical treatment is difficult with regard to the anatomy of the isthmus and vascular malformations. We report a case of renal cell carcinoma in a horseshoe kidney and our experience in its management. Case Report: In October 2010, a 75-yearold man was referred to our institution and underwent abdomino-pelvic ultrasound, computed tomography and magnetic resonance imaging examinations. These examinations showed a 15-mm solid mass in the parenchymatous isthmus of a horseshoe kidney. The patient was without symptoms; the abdominal exploration was normal and there was no evidence of metastases. A partial nephrectomy was performed with an anterior bilateral intercostal Chevron-type incision. The pathological evaluation of the lesion gave evidence of chromophobe renal cell carcinoma of Fuhrman grade III. The immunohistochemical tests showed that the tumor tissue was positive for CK7. The follow-up was negative. Discussion: A horseshoe kidney is a rare, developmental anomaly that occurs in about 0.25% of the population, arising during the fourth week of embryonic development. There are two theories about the embryological development of a horseshoe kidney. The first is the classical mechanical theory according to which fusion of the inferior poles occurs, while the second theory is that of abnormal migration of the posterior nephrogenic area, which is now considered to be a more common causative factor. Recently reported data suggest that the theory of mechanical fusion is valid only for horseshoe kidneys with a fibrous isthmus, while the abnormal migration of the posterior nephrogenic area causes the majority of horseshoe kidneys, where the isthmus consists of parenchyma. Development of the isthmus through abnormal migration could predispose this location to renal cell carcinoma. Conclusion: The anatomical particularities of horseshoe kidneys should be taken into account during surgery because they render the treatment difficult and, thus, the presence of a horseshoe kidney should be determined before surgery. The key to successful surgery lies in careful and good preoperative planning. A computed tomographic scan with contrast agent is essential in the diagnosis and management of these cases. 74 CRANBERRY EXTRACTS REDUCE URINARY TRACT INFECTIONS DURING RADIO<strong>THE</strong>RAPY FOR PROSTATE ADENOCARCINOMA Alberto Bonetta1 , Roberto Derelli1 and Francesco Di Pierro2 1Radioterapia Oncologica, Istituti Ospitalieri Di Cremona, Cremona, Italy; 2Velleja Research Pontenure, Piacenza, Italy Introduction: Cranberry (Vaccinium macrocarpon) has been suggested to reduce the attachment of bacteria to uroepithelial cells, thus preventing urinary tract infections (UTI). Although the mechanism of action is not completely clear, flavonoids and proanthocyanidin oligomers are known to prevent bacterial attachment to host bladder mucosa. Because UTI is one of the most frequent adverse events during external beam radiotherapy (EBRT) of prostate carcinoma (PCa), with an incidence rate of about 20%, we have tested a cranberry extract (V. macrocarpon fruit titrated and highly standardized at 30% in proanthocyanidins), 200 mg/day/p.o., to prevent cystitis in extreme conditions, such as partial bladder irradiation. Patients and Methods: From June 2007 to June 2009, 244 consecutive patients were enrolled in this study. All patients received hypofractionated intensity-modulated radiotherapy with simultaneous integrated boost to the prostate bed (with/without pelvis considering lymph nodal risk). A total of 120 patients were treated with cranberry extract and 124 were enrolled in the control group. Risk factors (diabetes, previous surgery, age, performance status, median dose to the bladder, V50 and V60) had a similar distribution between the two groups. Cranberry extract therapy started on the simulation day, when a bladder catheterization was performed. During EBRT (over 6-7 weeks), all patients underwent a weekly examination, recording urinary tract symptoms. Urine cultures were performed at 20 and 40 Gy and, eventually, when intense dysuria occurred. Results: All treated patients regularly took cranberry extract. No adverse effects due to the extract were observed, while two patients with chronic 1849
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Nucciotti R, 35 Oderda M, 37, 38, 1
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