UROFAIR Virtual 2020

UROFAIR Virtual 2020 Abstracts Time on Dialysis and Prevalence of RCC in ADPKD Patients Undergoing Native Nephrectomy Margaret Mansbridge (1) (1) Princess Alexandra Hospital Introduction and Objectives: Multiple enlarging bilateral renal cysts in ADPKD can lead to ESRD necessitating renal replacement therapy (RRT). It has been suggested that ESRD and time on RRT may be associated with RCC of native kidneys in ADPKD patients. In this contemporary review, we assessed the prevalence of RCC in nephrectomy specimens, and whether it is associated with duration on RRT. Methods: Data was collected on patients with ADPKD who underwent nephrectomy from 1/10/10-30/11/18. Retrospective chart review collected data on patient demographics, perioperative details, time on RRT, and formal histological diagnosis. Results: 29 nephrectomies were performed in 27 patients. Average age at nephrectomy was 56.8+/-9.3 years, and average age of patients with RCC was 66.8 years. RCC was found in 13.8% (n=4) of nephrectomy specimens. One patient was dialysis naive and commenced dialysis on day one postoperatively.Average time on RRT for all patients was 24.8+/-27.2months. Average time on RRT in RCC confirmed patients and non-RCC patients was 35+/-46.8 and 23.2+/-24 months respectively. There was not a statistically significant difference between time on RRT between the non-RCC and RCC groups (p=0.21). Conclusions: We report contemporary findings on ADPKD patients who underwent native nephrectomy. There was a wide range in time on RRT, and although patients with RCC were found to have longer mean dialysis exposure, our sample size was too small to draw conclusions. Nevertheless, given the trend of increasing risk of RCC inADPKDpatients who are dialysed, it would be reasonable to suggest imaging of native kidneys especially prior to proceeding with transplantation. Breast Cancer Metastasis to the Urinary Bladder and the Role of Immunohistochemistry Profiling Joshua Chek Hao Foo (1) (1) Lee Kong Chian school of Medicine Introduction and Objectives: Breast cancer is a one of the commonest malignancies affecting women. It is known to metastasize to multiple sites such as the lymph nodes, lung, liver, and bones. The urinary bladder is an uncommonmetastatic site and its incidencemay be under-reported, requiring a high level of clinical suspicion to diagnose them. At times, due to the poorly differentiated nature of the metastatic cells, ascertaining the primary origin of the metastases can be challenging to pathologists. Immunohistochemistry is the molecular technique to detect protein expression and changes in nucleic acids in various tissue samples. They can be a very useful adjunct for pathologists and knowing some of its basic principles may be useful to the practising urologist. Methods: We present a 42 year old female patient that initially underwent radical mastectomy and axillary lymph node dissection for high grade invasive ductal breast carcinoma (pT3N3cM0). Results: Despite adjuvant radiotherapy, chemotherapy and hormonal therapy, the patient developed interval liver metastasis 6 years later which required further palliative chemotherapy. Unfortunately while on anticoagulation therapy for a lower limb deep vein thrombosis, the patient developed visible haematuria. CT abdomen/pelvis showed no urological abnormalities. A flexible cystoscopy revealed extensive sessile tumour at the bladder trigone. Histology of the biopsy specimen revealed poorly differentiated adenocarcinoma. Immunohistochemistry profile supported that it was breast cancer in origin. Conclusions: In this case report we present a literature review on metastatic breast cancer to the urinary bladder as well as an overview of immunohistochemistry profile relevant to the practising urologist. C-10111 C-10106 C-10107 Contemporary Management of Prostate Cancer in Renal Transplant Recipients Margaret Mansbridge (1) (1) Princess Alexandra Hospital Introduction andObjectives: Prostate cancer is a ubiquitous disease affecting a significant proportion of the male population including renal transplant patients. Management has been complicated by the presence of a pelvic allograft and uretero-neovesicostomy at the bladder dome. We assess our current trend in management of prostate cancer in renal transplant recipients and outcomes. Methods: Retrospective review of all renal transplant recipients managed for prostate cancer between 2010 to 2018 was performed. Medical records, pathology and radiology were reviewed to determine outcomes. Results: Mean age of patients diagnosed with prostate cancer was 68.57+/- 7.98 years in this unique population. PSA on referral ranged from 1.1-1260 ng/mL (mean 98.48+/-279.26 ng/mL). Average time to diagnosis from time of renal transplantation was 6.35+/-4.65 years. 50% (n=13) of patients had localised disease; 61.5% (n=8) underwent intensity modulated radiation therapy (IMRT), and 38.5% (n=5) underwent radical prostatectomy (RP), 4 of whichwere robot assisted laparoscopic prostatectomy (RALP). 11.5% (n=3) of patients ultimately died from cancer related deaths during the reviewperiod. There were no graft-related adverse events. Conclusions: While traditionally thought to be associated with high risk to the allograft, a contemporary review from our tertiary transplant unit found no graft related adverse events associated with any treatment modality. There was a trend for RALP in this cohort as well as tailored IMRT for radiotherapy including virtual high dose brachytherapy with stereotactic radiotherapy. With advancing age of renal transplant recipients and increased life expectancy, it is important to recognise the ongoing need for prostate cancer assessment and treatment in these males. Outcomes of Polyomavirus Positive Micropapillary Urothelial Cancer Margaret Mansbridge (1) (1) Princess Alexandra Hospital Introduction and Objectives: Polyomavirus has been associated with rare bladder histopathological subtypes such as micropapillary urothelial cell carcinoma (UCC). The virus is more prevalent in the transplant population and associated with poorer cancer outcomes due to immunosuppression. In this study, we review micropapillary UCC associated with polyomavirus in transplant recipients at our tertiary transplant centre. Methods: We performed a retrospective review fromApril 2010 toApril 2019 of micropapillary variant UCC. SV40 staining was assessed for positivity and retrospective chart review was performed on patient demographics, comorbidities, histology, treatment, and outcomes. Results: We identified four cases of SV40 positive micropapillary variant UCC in our 9 year study period. All patients were male, and average age at diagnosis was 62+/-9.5 years. Patients had received kidney-pancreas (n=2), kidney (n=1), and bilateral lung (n=1) transplants. Average time since transplant was 10+/-2.9 years. 50% (n=2) of patients were found to have HGT1 at initial TURBT, and 50% (n=2) were diagnosed with HGT2. All patients were managed with radical cystoprostatectomy. Concurrent CIS and prostate cancer were identified in three and three patients respectively, with two patients found to have synchronous CIS and prostate cancer. Average time of follow-up was 17.8 months (range 6-36). Average cancer specific time to death in two patients was 9 months. Conclusions: Although a recent meta-analysis reports seemingly more favourable outcomes for micropapillary variant UCC than expected, there is scant data on polyomavirus associated micropapillary UCC in transplant patients. We identified four cases of this rare entity in our institution, and despite radical cystoprostatectomy, found that these patients experienced a clinically aggressive disease course. C-10105 11