Hung, Sheng-Chun

Ou, Yen-Chuan

Yang, Cheng-Kuang

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The influence of intravesical prostatic protrusion and post operative continence after patients received robotic assisted laparoscopic radical prostatectomy 

Sheng-Chun Hung

Yen-Chuan Ou, PhD

Cheng-Kuang Yang

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Urological Science

The influence of intravesical prostatic protrusion and post operative continence after patients received robotic assisted laparoscopic radical prostatectomy

Abstracts / Urological Science 26 (2015) S36eS49S4625mg/m2, IV, every three to four weeks. Thirty patients ever received prior
docetaxel treatments. The PSA response, pain response, time to progres-
sion duration and adverse events were recorded.
Results: The median age of the thirty-two patients was 65.7 years (range
45e84) and the median PSA when started Cabazitaxel was 65.5 ng/ml
(range 3.82e5239). The mean treatment courses of the patient were 5.9
(range 3e17). PSA declined in twenty-two patients (69%, 22/32) and
eighteen of them (56%, 18/32) got more than 50% declination (PSA
response). The median progression free survival was 6 months. The most
common subjective adverse effects were leukopenia (84%). Ten (31%) pa-
tients had grade 3-4 neutropenia and 4 (12.5%) patients had more than
grade 2 anemia. Liver function impairment was also found in three (9%)
patients.
Conclusions: Cabazitaxel 20-25mg/m2, IV, every three to four weeks were
tolerated and revealed good PSA response in castration resistant prostate
cancer patients. However, high risk of neutropenia should be kept in mind.
MP4-8.
ANDROGEN RECEPTOR EXPANDS THE POPULATION OF CANCER STEM
CELLS IN UPPER URINARY TRACT UROTHELIAL CARCINOMA CELLS
Chi-Cheng Chen 1,2, Teng-Fu Hsieh 1,2, Chi-Ping Huang 1, Chih-Rong
Shyr 1. 1 Sex Hormone Research Center, Departments of Urology/Surgery
and Medical, Technology, Graduate Institute of Clinical Medical Science,
China Medical, University/Hospital, Taichung, Taiwan; 2Department of
Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical, Foundation,
Taichung, Taiwan
Purpose: Androgen receptor (AR) plays a role in the development and
progression of upper urinary tract urothelial cell carcinoma (UUTUC). Here
we investigated whether AR stimulates UUTUC development and pro-
gression, possibly by expanding the population of cancer stem cells (CSCs),
which are a particular population of cells within cancer cells responsible
for tumor initiation, drug resistance and metastasis.
Materials and methods: We compared BFTC 909 cells with or without the
addition of AR on their CSC population with ﬂow cytometry, colony for-
mation and sphere formation assay to determine the effects of AR on CSC
activity. To observe the effects of AR on BFTC 909 cells, quantitative real-
time PCR was used to detect the expression stemness genes and miRNAs
and western blotting was also performed to examine EMT (epithelial-
mesenchymal transition) related proteins. In vivo tumor formation was
also evaluated with the implantation of cancer cells in nude mice and IHC
was used to detect OCT4 and MMP9 expression on the tumor samples.
Results: We found that the addition of AR in UUTUC cells, (BFTC 909 cell
line) signiﬁcantly increased the population of CSC, clonogenicity, sphere
formation and the expression of stemness genes (Oct4, Bmi1 and Nanog)
and CSC-related miRNA proﬁle as well as EMT related proteins. Further-
more, in an immune-deﬁcient mouse model, the addition of AR in UUTUC
cells also increased the tumor formation.
Conclusions: This study will help us better understand the extent to
which AR contributes to UUTUC by expanding their CSC population and
capacity and could explain high incidence of UUTUC observed in males.
These ﬁndings may lead AR to serve as a potential therapeutic target for
urothelial carcinomas in the future.
MP4-9.
RENAL CLASSIC AND EPITHELIOID ANGIOMYOLIPOMA e EXPERIENCE
OF CHI MEI HOSPITAL AND LITERATURES REVIEW
Ming-Hsiang Kuo, Steven Kuan-Hua Huan. Division of Urology, Department
of Surgery, Division of Uro-Oncology, Chi-Mei Medical Center, Tainan, Taiwan
Introduction: Renal angiomyolipoma (AML) is a benign neoplasm. There
are two major histologic types of AMLs: classic and epithelioid. Recently
malignant epithelioid variant of angiomyolipoma has been further
described. We would like to compare these two histologic types receiving
surgical treatment of our own experience
Material: We collected 53 cases of renal angiomyolipoma from our hos-
pital receiving surgical intervention from September 2010 to August 2014.
Results: Among these cases, 38 (71.7%) was female with medium age 56.9
year-old. 15 male (28.3%) with medium age 58.7 year-old. 21 of 53 (39.6%)had right side AML with left 30 of 53 (56.6%) and bilateral 1 of 53 (1.9%). 3
of 53 (5.7%) received nephrectomy and 50/53 (94.3%) received partial
nephrectomy. Classic angiomyolipoma accouted for 92.5% (49/53) of all
cases with epithelioid variant 7.5% (4/53). No recurrence was noticed
among classic type with average follow-up length 32.6 months. Recur-
rence was noted in one of epithelioid variant in 31 months follow-up.
Conclusion: Renal angiomyolipoma is a benign neoplasm consisting of
thick-walled aneurysmal vessels, smooth muscle, and varying levels of
mature adipose tissue. Recently malignant epithelioid variant of angio-
myolipoma has been further described since it was presented on 1997 by
Eble and colleagues. Here, We compared these two histologic types
receiving surgical treatment of our own experience and we would like to
compared it with data of other institute to see of there’s any differences
and the cause leading to it.
MP4-10.
RETROPERITONEAL LIPOSARCOMA: EXPERIENCE OF CHI-MEI
HOSPITAL
Hsuan-Ying Ho, Kuan-Hua Huang. Division of Urology, Department of
Surgery, Division of Uro-Oncology, Chi Mei Medical Center, Taiwan
Purpose: Retroperitoneal liposarcomas are rare malignant tumor with an
aggressive disease course and high recurrent rate. In this article, we will
share our experience in treating retroperitoneal liposarcoma and describe
the tumor behavior we observed.
Materials and methods: During January 2010 to December 2014, 11 pa-
tient are treated in our hospital for retroperitoneal liposarcomas. We re-
view the treatments (surgical or non-surgical), clinical presentation, tumor
behavior, pathological subtype, and the characteristics of recurrent tumor.
Results: There are 11 patients of retroperitoneal liposarcoma enrolled in
this analysis. 9 patients are female, and 2 are male. 7 patients are well-
differentiated liposarcoma, and 4 are de-differentiated liposarcoma. One
patient died one month after surgical excision of tumor because of
pneumonia. One patient has no recurrence in 3 years of follow-up. One has
bone metastasis at the time of diagnosis. 8 patients are found recurrent
and receive repeated surgical excision of tumor, and 3 of them experience
second recurrence. One patient experience third recurrence, and one has
forth recurrence. The mean time to recurrence is 40 months. 4 patients
have surgical margin involved with tumor, and the mean recurrence time
in this subgroup is 5 months.
Conclusions: During the past 4 years, 11 patients with retroperitoneal
liposarcoma receiving surgical excision of tumor have been followed at our
hospital. There is no obvious difference in tumor recurrence between pa-
thology subtypes. Patients with positive surgical margin experience
shorter time to recurrence.Moderated Poster-5Oncology
MP5-1.
THE INFLUENCE OF INTRAVESICAL PROSTATIC PROTRUSION AND POST
OPERATIVE CONTINENCE AFTER PATIENTS RECEIVED ROBOTIC
ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY
Sheng-Chun Hung, Yen-Chuan Ou PhD, Cheng-Kuang Yang. Divisions of
Urology, Department of Surgery, Taichung Veterans General Hospital, Taiwan
Purpose: We try to evaluate the inﬂuence of intravesical prostatic pro-
trusion (IPP) in the postoperative continence of patient who received ro-
botic assisted laparoscopic radical prostatectomy.
Materials and methods: A total 600 patients who underwent robotic
assisted laparoscopic radical prostatectomy were included in the study.
Preoperative MRI was performed in all patients and the vertical distance
from the tip of the protruding prostate to the base of the urinary bladder
was measured in all sagittal plane. The degree of intravesical prostatic
protrusion were divided into three groups ( IPP<5mm, 5mm<IPP<10mm,
Abstracts / Urological Science 26 (2015) S36eS49 S4710mm<IPP). All patients underwent surgical intervention with anterior
approach of prostatectomy and the continence component such as pubo-
prostatic ligament and arcus tendineus were preserved. Posterior recon-
struction of the rhabdomyosphincter was also performed. Continence was
deﬁned as no pad use or only one safety pad per day and assessed at 1, 3
and 12 months postoperatively. The correlation between the intravesical
prostatic protruding and postoperative continence was examed.
Results: The overall continence rate at 1, 3 and 12month was 69.2%, 91.33%
and 95.5%. Among the three groups, there is signiﬁcant difference in 1
month, 3 month and 12 month continence rate (IPP < 5mm: 82.5%, 96.3%,
97.7%; 5mm < IPP < 10mm: 61.9%, 89.4%, 94.4%; 10mm < IPP: 30%, 75.6%,
88.9%, p < 0.001). At one month, 415 patients achieved continence but 195
patients still incontinence and the length of IPP among the two groups
were 4.43 ± 3.74 mm and 8.69 ± 6.63mm, p < 0.001. Respectively, at the 3
month and 12 month, 548 and 573 patients achieved continence and the
IPP length among continence and incontinence groupwere 5.29 ± 4.56mm
vs. 10.50 ± 8.32mm and 5.55 ± 4.93 vs. 9.88 ± 8.37, there is also statistical
signiﬁcance.
Conclusions: To our result, the intravesical prostatic protrusion have
negative inﬂuence in continence of patients received robotic assisted
radical prostatectomy. The patient with less protruding prostate may
achieve early continence after operation and the postoperative inconti-
nence rate was markedly higher in patient with more protruding prostate.
MP5-2.
INHIBITION OF CELL GROWTH AND INDUCTION OF APOPTOSIS ON
HUMAN BLADDER CANCER CELLS WITH THE ANTIFUNGAL DRUG
MICONAZOLE
Sheau-Yun Yuan 1,3, Shian-Shiang Wang 1, Kan-Jen Tsai 2, Ming-Yuh
Shiau 3, Yen-Chuan Ou 1. 1Department of Surgery, Taichung Veterans
General Hospital; 2Department of Medical Technology, Chung Shan Medical
University, Taichung, Taiwan; 3Department of Nursing, HungKung
University, Taichung, Taiwan
Purpose: Miconazole (MIC) is an imidazole antifungal agent that is
commonly applied topically to the skin or mucous membranes to improve
fungal infections. Recent studies have demonstrated that MIC exhibits
anti-tumor effects on human colon cancers and leukemia. The aim of this
study was to determine the effects of MIC on the growth inhibition and
apoptosis of human bladder cancer cells.
Materials and methods: Human bladder cancer cell lines (T24 and TSGH-
8301) were used in this study. The T24 and TSGH-8301 cells were treated
with various concentrations (6, 12, 25, 50 and 100 mM) of MIC for 24 h each.
Cell viability was determined by MTT assay. The apoptosis mechanismwas
detected by sub-G1 population, DNA fragmentation and reactive oxygen
species (ROS) generation, and the mitochondrial membrane potentials
were evaluated by ﬂow cytometry. SDS-PAGE/Western blot assay was used
to detect apoptotic proteins (PARP, caspase-3/-8/-9), Bcl-2 family proteins
and cell-cycle-regulated proteins.
Results: The study showed that MIC elicited cytotoxic effects on human
T24 and TSGH-8301 bladder cancer cells in a dose- and time-dependent
manner with IC50 ~48.3 ± 0.35 mM and 47.8 ± 0.27 mM, respectively, as
determined by MTT assay. MIC increased the sub-G1 population, DNA
fragmentation formation, activation of caspase-3/-8/-9 and cleavage of
poly (ADPribose) polymerase (PARP), and provoked apoptosis in both
bladder cancer cell lines. Western blot analysis revealed increases of p21
and p27 protein levels, along with decreases of Cyclin E1, CDK2 and CDK4
expressed in MIC-treated T24 and TSGH-8301 cells, which is related to the
G0/G1 phase of the cell cycle. Meanwhile, there was an induced increase of
cleaved Bax proteins and a decrease of Bcl-2 proteins, up-regulation of the
DR5 death receptor and ROS generation subsequent to reduced mito-
chondrial membrane potential at higher concentrations (>50 mM) of MIC
for 24 h, in both the T24 and the TSGH-8301 bladder cancer cells.
Conclusions: These results indicate that MIC triggered apoptosis via G0/
G1 arrest, leading to the activation of the TRAIL death receptor, then
activation of caspase-3/-8/-9 and the ROS-dependent mitochondrial
pathway in human bladder cancer cells. This suggests that MIC may be a
potential anti-bladder cancer agent in humans.MP5-3.
SIGNIFICANCE OF HER2 EXPRESSION IN UPPER TRACT UROTHELIAL
CARCINOMA: A META-ANALYSIS
Chia-Horng Chen 1, Yuh-Shyan Tsai 2, Tzong-Shin Tzai 2. 1Department of
Urology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation,
Chia-yi County, Taiwan; 2Department of Urology, College of Medicine and
Hospital, National Cheng Kung University, Tainan, Taiwan
Purpose: Several studies explored the prognostic values of HER2 expres-
sion in upper tract urothelial carcinoma (UTUC), but the results remain not
consistent.
Materials andmethods: Using published evidence, we performed ameta-
analysis to examine its clinical values in patients with UTUC. Thirty-ﬁve
articles from 679 references related to EGFR family expression assessment
in UTUC were reviewed and there were 7 papers ﬁt for analyses. The es-
timates included the odds ratio (OR), distribution related to stage and
grade, hazard ratios (HR), and 95% conﬁdence intervals (CI) from survival
analyses of intravesical recurrence, progression and overall survival.
Results: The pooled results showed that HER2 expression is signiﬁcantly
associated with higher stage, but not with tumor grade in patients with
UTUC (OR, 2.05; 95% CI, 1.15-3.68; p ¼ 0.016 and OR, 4.73; 95% CI,
0.80e27.8; p ¼ 0.086, respectively). Also, the pooled survival analyses
demonstrated that HER2 expression yielded a worse recurrence-free sur-
vival in UTUC patients (HR, 4.32; 95% CI, 2.17e8.60; p < 0.0001). However,
there is lack of statistical signiﬁcance in term of progression-free survival
an overall survival (HR, 2.08; 95%CI, 0.46e9.32; p ¼ 0.339 and HR, 1.06;
95% CI, 0.48e2.37; p ¼ 0.879, respectively).
Conclusion: The relevant studies existed heterogeneous and were limited.
Our analysis suggests that HER2 expression plays an important role in
subsequent recurrence in the urinary bladder after primary treatment for
UTUC.
MP5-4.
DEVELOPMENT OF 3-HYDROXYANTHRANILIC ACID-BASED INTEGRATED
NON-INVASIVE BIOSENSOR FOR BLADDER CANCER DETECTION
Yuh-Shyan Tsai 1, Yeong-Chin Jou 2, Yen-Ping Tsai 1, Bin-Da Liu 3, Hung-In
Lin 4, Chia-Lin Wei 3, Syue-Yi Chen 5, Hsin-Tzu Tsai 1, Chien-Hui
Ou 1, Wen-Horng Yang 1, Tzong-Shin Tzai 1. 1Department of Urology,
National Cheng Kung University Hospital, College of Medicine, National
Cheng Kung University, Tainan, Taiwan; 2Department of Urology, Chia-Yi
Christian Hospital, Chia-Yi, Taiwan; 3Department of Electric Engineering,
College of Medicine and Hospital, National Cheng Kung University, Tainan,
Taiwan; 4Department of Chemical and Material Engineering, National
Kaohsiung University, Kaohsiung, Taiwan; 5Department of Medical
Research, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
Purpose: Bladder cancer is a common human malignancy and exhibits a
life-long risk of disease recurrence and progression. It is continuing to
search some simple, innovative biomarker to monitor the disease status
in order to diminish the suffering during cystoscopic follow-up. The
metabolite of tryptophan after indoleamine 2,3-dioxygenase (IDO)
digestion, 3-Hydroxyanthranilic acid (3-HAA) is conventionally thought
to be a potential biomarker for bladder cancer occurrence. The aim to
study is to investigate the diagnostic potential of an integrated a 3-HAA-
based biosensor for urothelial carcinoma of the upper tract and urinary
bladder.
Materials and methods: Human urothelial cancer cell lines and human
urothelial carcinoma tissues as well as adjacent benign tissues were
available for exploring IDO expression, including western blotting and
immunohistochemical staining. Patients who received urological surgery
were enrolled for urine 3-HAA testing using an integrating biosensor for 3-
HAA. Some of urine specimens were investigated with high performance
liquid chromatography (HPLC) assay.
Results: From western blotting assays, eight human urothelial carcinoma
cell lines exhibited more IDO expression than the immortalized cell SV-
HUC. Both of urothelial carcinoma of urinary bladder and upper urinary
tract exhibited more IDO immunoreactivity than those of the adjacent


The influence of intravesical prostatic protrusion and post operative continence after patients received robotic assisted laparoscopic radical prostatectomy

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