Relationship between Gleason's grade and Testicular atrophy in patients with advanced prostate cancer

s 113 In a logistic regression analysis, the only significant associations with blood transfusion in open prostatectomy were the duration of surgery (.042), comorbidity (.006) and the pre-operative haemoglobin level (.000). Conclusion: The intra-operative blood transfusion rate in open prostatectomy for BPH in this series was 21.5%. Blood transfusion rate was associated with and significantly higher in emergency surgeries, in the absence of co-morbidities and with procedures done under general anaesthesia. Using logistic regression analysis, the main determinants of transfusion were the duration of surgery, comorbidity and the pre-operative haemoglobin level. http://dx.doi.org/10.1016/j.afju.2014.03.009 Relationship between Gleason’s grade and Testicular atrophy in patients with advanced prostate cancer A.O. Anegbe 1,∗, E.O. Olapade-Olaopa 1,2,3, O.B. Shittu 1,2,3, L.I. Okeke 1,2,3, A.O. Takure 1,2, S.A. Adebayo 1,2 1 University College Hospital, Ibadan, Nigeria 2 College of Medicine, University of Ibadan, Nigeria 3 Ibadan PIUTA Center, Department of Surgery, University College Hospital, Ibadan, Nigeria ∗Corresponding author at: Department of Surgery, University College Hospital, Ibadan, Nigeria. E-mail address: ambroseanegbe@yahoo.com (A.O. Anegbe) Introduction: Testicular atrophy in patients with prostate cancer (CaP) has been associated with poor outcome. We have previously reported that 65% of our newly diagnosed CaP patients treated with bilateral orchidectomy had testicular atrophy. This is a pilot retrospective study evaluating the relationship between histologic grade and severity of testicular atrophy in these patients. Methods: Data was collated from records of patients who had therapeutic bilateral orchidectomy for prostate cancer between 2002 and 2012. The Histology was reported by a Consultant Pathologist. Testicular atrophy was graded as none (normal), mild, moderate or severe based on the degree of testicular tubular sclerosis found at histology. CaP specimens were graded using the Gleason scoring systems. Analysis was done using SPSS version 18. Results: The histology of 164 prostate biopsies and 113 orchidectomy specimens from prostate cancer patients were analyzed. The age range was 36-91 years; mean age was 69.23 years (SD 9.446 years). The Gleason’s score ranged 4–10, mean 6.95 (SD 1.44). 64 patients (39%) had GS of 4–6, 87 (53%) had GS of 7–8 and 13 (8%) had GS 9–10. 21 (18.6%) had normal testis, 39 (34.5%) had mild, 16 (14.2%) had moderate and 37 (32.7%) had severe testicular atrophy. There was no statistically significant difference in GS among the four groups; F = 1.555; Sig. 0.221. Conclusion: Most patients in our environment with advanced prostate cancer have testicular atrophy, the degree of which is unrelated to histology grade of the tumour. http://dx.doi.org/10.1016/j.afju.2014.03.010 Prostate cancer (PC)-management of 669 cases in Ghana West Africa E.D. Yeboah 1,3, A.W. Hsing 4, R.B. Biritwum 1, Y. Tettey 1, S. Mante 2, J.E. Mensah 1, Y.M. Kyei 1, J. Yarney 1, V. Vanderpuije 1, K. Beechem 1, K. Asante 1, K. Ampadu 1, B. Adusei 2, S.G. Attee 1, G.O. Klufio 1, E. Lamptey 1, C. Owoo 1, A. Marzo 4, G. Netto 4, K. Yu 4, V. Li 4, A. Chokkalingham 4, D. Chia 4, S. Jaddalah 4, A. Partin 4, I.M. Thompson 4, S.M. Quaraishi 4, G. Addo-Ayensu 4, S. Niwa 4, R. Tarone 5, R.N. Hoover 4 1 Department of Surgery, Pathology, Radiooncology, University of Ghana Medical School, and Korle-Bu Teaching Hospital, Ghana 2 37 Military Hospital, Accra, Ghana 3 Nyaho Medical Centre, Accra, Ghana 4 NCI/NIH Bethesda, USA 5 Cancer Protection Institute, CA, Ghana Objectives: To study clinical incidence of histologically proven PC, TNM stage and management outcomes Methods: Case expansion study of PC managed in Accra, abstracted records 2004–2012. Diagnosis by history, Hogh PSA, physical and abnormal DRE and histologically confirmed by biopsy. With gleason scores (GS) and TNM staged and managed by approved protocols. Organ confined PC by radical prostatectomy (RP), brachytherapy (BRCHY), external beam radiotherapy (EBRT), Hormonal/Chemotherapy, or surveillance if life expectancy less than 15 years. T3-4M0 treated by hormonal/chemotherapy±Total androgen blockade (TAB), BRCHY/EBRT. Metastatic T1-4-M1 is treated by hormonal/chemotherapy±TAB. Significant LUTO is treated by alpha blockers, TUIP/TURP. Results: There were 669 cases median age 70 years, median GS 7,organ confined PC 415 (62%), T3-4 M0 167 (25%), METASTATIC CASES 87 (13%). The report on 669 cases were followed for 1–7 years is as follows. A. Organ Confined T1-2 N0 M0 PC – n = 415 presentation is asymptomatic. Symptomatic cases 1–20% treatment regimes i) Radical Prostatectomy – n = 92. Open retropubic/prior median PSA 16.1 ng/ml, post PSA 0.23 ng/ml. RP specimen BPH = 3, organ confined 76, positive margins 13. Complications rate (COMP) 3–22%. ii) Brachytherapy – n = 70.145 GY, median prior PSA 14.6 ng/ml, post PSA 0.59 ng/ml. COMP 3–10%. iii) EBRT no = 155. 70/74GY. Median prior PSA 15.7 ng/ml post PSA 0.54 ng/ml. COMP 2–6%. iv) Hormonal Chemotherapy + TAB – n = 98 prior median PSA 48.5 ng/ml, post PSA 0.6 ng/ml. METHODS LHRH analogue /Chemotherapy 41%, stilboesterol 29%, BTO 30%. COMP 4–30%. v) Surveillance GS 6.prior PSA < 8 ng/ml. Presentation symptomatic 60%. All had neoadjuvant hormonal/chemotherapy + TAB, LHRH 52%, stilboesterol 12%, BTO36% then i) Bachytherapy – T3N3, prior PSA 14.6 ng/ml, post PSA 0.11 ng/ml. ii) EBRT. no-64. Prior PSA T3 (34%) 32.4 ng/ml, T4 (2%) 64.6 ng/ml, Post PSA T3 0.6 ng/ml, T4 0.4 ng/ml, COMP = 2–70%. iii) Hormonal chemotherapyn = 103 (T3 24%, T4 38%), LHRH 28% stilboesterol 4%, BTO 30%, COMP 4–35%, Hospitalmortality 26.3%.