Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Moderated Poster Session 4: Kidney/Bladder/Penile/Testicular/ Adrenal Cancer MP4-09 UrologicalManagement of Incarcerated PersonswithTesticularMalignancy at a Single Institution W. Visser 1 , T. Cisu 1 , N. Feld 2 , T. Jacobs 2 , L. Terasaki 2 , S. Zhang 2 , R. Foster 1 , S. Krzastek 1,3 1 Virginia Commonwealth University Health System, Richmond, VA, USA; 2 Virginia Commonwealth University School of Medicine, Richmond, VA, USA; 3 Richmond VA Medical Center, Richmond, VA, USA Introduction and Objective: Incarcerated patients face many barriers to healthcare. There is sparse literature on Urologic care in this patient population specifically regarding genitourinary malignancies. Due to the rapid progression of testicular cancer, early diagnosis and treatment is essential. We hypothesize that barriers to care result in delays in diagnosis and treatment of testicular cancer in the inmate population. The aim of this studywas to define the timeframe from evaluation to intervention for inmates presenting for testicular masses at our institution to identify and improve upon barriers to care in this vulnerable patient population. Methods: A retrospective chart review was performed on incarcerated patients seen between 2014 and 2020 for germ cell testicular tumors (GCT). Data was collected on the time from suspicion of disease to time of radical orchiectomy, clinical stage at presentation, post-operative TNMS staging, and need for additional therapy. Results: Ten patients were evaluated for GCT between 2014 and 2020 (White, N=7; Black, N=3). Mean patient age was 40.1 (25-62) years. Time from scrotal ultrasound to date of surgery was 49 ± 79.4 days. Two patients were lost to follow up and underwent radical orchiectomy 107 and 256 days after the initial ultrasound was performed. One of these patients required adjuvant radiation. Overall, 50% of patients underwent adjuvant treatment (RPLND, N=3; chemotherapy, N=4; radiation, N=2) and 30% underwent multi-modal treatments. Seven patients (70%) were diagnosed as stage 1, three patients (30%) were diagnosed as stage 2 post-orchiectomy. Conclusions: Our results suggest that incarcerated patients may face significant delays in management of testicular cancer, which could result in the need for adjuvant therapy. Disease stage at orchiectomy was higher in our population than what is reported in the general literature. Further work is needed to identify and reduce barriers to care for Urological malignancies in the incarcerated patient population. Rising Rates of Newly Diagnosed Testicular Cancer: 27-Year Trends from a Statewide Registry A. Alzubaidi 1,2 , J. Fuletra 1,2 , J. Pham 1 , V. Walter 1 , M. Kaag 1,2 , S. Merrill 1,2 , J. Raman 1,2 1 Penn State College of Medicine, Hershey, PA, USA; 2 Penn State Health Medical Center, Hershey, PA, USA Introduction and Objective: Testicular cancer (TC) remains one of the most curable genitourinary malignancies particularly when identified at an early stage. We reviewed >27-years of newly diagnosed TC across a statewide cancer registry to better define incidence, geographic distribution, and trends over time. Methods: Using the Pennsylvania Cancer Registry from 1990 to 2017, county and statewide age-adjusted-TC incidence rates and stage distribution were determined. JoinPoint TrendAnalysis Software and R-4.0.2 software modeled annual percent changes (APCs) in age-adjusted rates and mapped county- level incidence rates over five-year time intervals, respectively. Results: Atotal of 9,933 cases were identified. Over two-thirds of patients were <40 years of age and 95%werewhite.Age-adjusted annual rates increased from 4.8 to 7.2 patients per 100,000 with an APC of 0.94 (95%CI 0.59-1.29, p<0.01) over the study interval. (Figure-1) Stage distribution using the SEER staging system included (68.1%)local, (19.1%)regional, (11.0%)distant, and (1.8%) unknown. Annual rates of local disease increased from 3.2 to 5.0 patients per 100,000 with an APC of 1.07 (95%CI- 0.67-1.46, p < 0.01). Distant disease rates remained stable ranging from 0.5 to 0.8 patients per 100,000 with an APC of 0.69 (95%CI- 0.02-1.40, p=0.06). Geospatial investigation of disease distribution noted “hot-spots” in the southeastern and southwestern parts of the state that persisted over time(Figure-2) Conclusions: Rates of TC have risen by 50% in Pennsylvania over the past two decades. Fortunately, this trend is predominantly attributable to increases in local and regional disease. Geospatialmapping implicates “hot-spots” of TC incidence although investigation is necessary to delineate the underlying etiologies. MP4-08 28