A. Di Domenico

A. Volpe

C. Terrone

E. De Lorenzis

I. Mittino

L. Zegna

M. Billia

P. De Angelis

P. Mondino

English

AIR Universita degli studi di Milano

characteristics mentioned above. Results: Among our 60
patients, 58 had organ confined disease (8 pT2a: 13%, 6
pT2b:10 %, 41 pT2c: 68%) while 2 patients had extracapsular
invasion (pT3a: 3%), though no seminal vescicle involvement
(pT3b) was detected in this cohort. In 50 cases (83%) the
resection margins were free from cancer (R0), while 10 cases
(17%) showed positive margins (R1). The pathological Gs was
6 in 18 cases (30%), 3+4 in 27 (45%), 4+3 in 14 (23%) and 8-
10 in 1 (2%). According to the risk based analysis, 45 patients
(75%) were at low risk of aggressive disease, while the
percentage of intermediate risk patients was about 23%, and
only 1 patient (2%) harboured a high risk prostate cancer.
Conclusion: According to our study, the inclusion criteria of
Prostate Cancer Research International Active Survelliance
(P.R.I.A.S.) have high accuracy in the prediction of organ
confined and low-intermediate risk prostate cancer. Our results
seem to be consistently better than those of the actual literature,
maybe thanks to the anatomopathological review performed by
a single experienced uropathologist, which allowed us to
exclude 53 patients who would have compromised the accuracy
of our results. Thus, according to our experience, the actual
Active Surveillance parameters can be safely adopted, only if
the review is performed by a single uropathologist of proven
experience.
78
TRENDS IN PARTIAL NEPHRECTOMY 
USE IN ITALY: DATA FROM PIEDMONT 
REGION IN THE LAST DECADE
Alessandro Volpe, Paolo De Angelis, Michele Billia, 
Antonia Di Domenico, Luisa Zegna, Paolo Mondino, 
Irene Mittino, Elisa De Lorenzis, Carlo Terrone 
Clinica Urologica Università del Piemonte Orientale -
Ospedale Maggiore della Carità, Novara, Italy
Introduction: Recent studies have shown that partial
nephrectomy (PN) has equivalent oncologic outcomes with
radical nephrectomy (RN) for localized renal tumors. The
most recent international guidelines for renal cell carcinoma
(RCC) recommend the use of nephron sparing surgery (NSS)
for renal lesions up to 7 cm in size whenever technically
feasible. Despite this, PN remains underused in North
America. Aim of this study was to evaluate trends in PN use
during the last decade in a north-western Italian region.
Patients and Methods: The regional archives of hospital
discharge records in Piedmont region from January 2000 to
December 2010 were retrospectively analysed. All procedures
recorded with the ICD-9 codes 55.3, 55.4 (PN) and 55.5 (RN)
performed for a primary diagnosis of renal tumor (189.0) were
included in the analysis (n=6180). The surgeries were
performed in 43 different urological institutions, that were
stratified according to academic status and hospital
nephrectomy volume (high >300, intermediate 100-300, low
<100 nephrectomies in the study period). Trends in the use of
PN were assessed overall and according to institution type.
Results: The overall number of surgical procedures for renal
tumors performed in Piedmont region increased significantly
from 2000 to 2010 (+27%). RN is the preferred surgical
treatment, but an increasing use of PN was observed over the
study period. This trend is more significant in centres with
high renal surgical volume (+ 19.9%) and in non academic
centres (+13.7%). Discussion and Conclusion: PN is
increasingly performed in the last decade in Piedmont region.
The most significant increase in the indications to NSS was
observed in institutions with high renal surgical volume.
However, PN remains relatively underused and strategies to
enhance conservative treatments of renal tumors should be
implemented. 
79
FLUORESCENT CYSTOSCOPY WITH
HEXAMINOLEVULINATE: DIAGNOSTIC
ACCURACY FOR NON MUSCLE 
INVASIVE BLADDER CANCER
Alessandro Volpe, Davide Giraudo, Paolo De Angelis,
Elisa De Lorenzis, Monica Zacchero, Paolo Mondino,
Francesco Varvello, Filippo Sogni, Carlo Terrone
Clinica Urologica, Università del Piemonte Orientale,
Ospedale Maggiore della Carità, Novara, Italy
Introduction: The sensitivity of white light cystoscopy (WLC)
can be improved especially for the detection of flat urothelial
neoplasms. Fluorescent or blue light cystoscopy (BLC) has the
potential to overcome the limitations of WLC. Aim of this
study was to compare the diagnostic accuracy of WLC and
BLC in the diagnosis of urothelial cancer and to identify the
conditions where BLC can provide the highest diagnostic
advantage over WLC. Patients and Methods: 71 patients with
a suspicious primary or recurrent bladder tumor were enrolled
in the study. Patients who had intravesical instillations in the 3
months before the procedure were not eligible. After
intravescical instillation of Hexaminolevulinate 85 mg one
hour before the procedure, the patients underwent WLC
followed by BLC. All observed lesions were reported in a
diagram, biopsied or resected. Detection rate and false
detection rate of the two techniques were compared. Data
were stratified according to pathology of bladder lesions and
bladder site where the lesions were observed. A subset
analysis was also performed to assess the diagnostic accuracy
of WLC and BLC in patients who had (n=36) or had not
(n=35) undergone previous intravesical treatments to prevent
recurrence and progression. Results: Overall 270 bladder
Abstracts of the 22nd Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 13-15 June, 2012, Bologna, Italy
1897


TRENDS IN PARTIAL NEPHRECTOMY USE IN ITALY: DATA FROM PIEDMONT REGION IN THE LAST DECADE

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TRENDS IN PARTIAL NEPHRECTOMY USE IN ITALY: DATA FROM PIEDMONT REGION IN THE LAST DECADE

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