UROFAIR Virtual 2020

UROFAIR Virtual 2020 Abstracts C-10018 Real World Experience with Lenvatinib inMetastatic Renal Cell Carcinoma (mRCC) Patients in an Asian Comprehensive Cancer Centre Joshua Zhi-Chien Tan (1) , RavindranKanesvaran (1) , Wan-Ling Tan (1) , Gillianne Geet-Yi Lai (1) , Tanujaa Rajasekaran (1) , Chee-Keong Toh (1) , Quan-Sing Ng (1) , Johan Chan (1) (1) National Cancer Centre Introduction and Objectives: Lenvatinib is a tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor (VEGFR1-3), fibroblast growth factor receptor (FGFR1-4), platelet-derived growth factor receptor (PDGFR), stem cell factor receptor (KIT), and rearranged during transfection (RET). However data on lenvatinib use in an Asian mRCC population is limited. Methods: In this single centre retrospective study, we examined data on lenvatinib use in 27 patients withmetastatic renal cell carcinomawho had been treated with lenvatinib alone, or in combination with other systemic agents. Results: 88% were male patients (n=24), median age was 57 years at diagnosis and histology was clear cell renal cell carcinoma in 88.9% (n=24). 70.4% (n=19) of patients had prior nephrectomies and average prior lines of treatment was 2 (range 0-5). Partial response was observed in 55.6% of patients (n=15), stable disease in 33.3% (n=9) and progressive disease in 7.4% (n=2). Median progression free survival was 5.9 months. Discontinuationwas due to progressive disease in 57.8% (n=12) and toxicity in 26.3% of patients (n=5). Grade 3 toxicities occurred in 59.3% (n=16) patients of which the most frequent were hypertension (25.9%, n=7) and gastrointestinal toxicity (14.8%, n=4). Cutaneous toxicities while common (55.6%, n=15) were only grade 3 in 7.4% (n=2) of patients. Conclusions: This data suggests that lenvatinib in an Asian population produces response rates similar to that seen in the pivotal trial with a tolerable toxicity profile. Pre Treatment Neutrophil Lymphocyte Ratio as Oncological Prognostic in Bladder Cancer Patients : A Meta-analysis Fauzan Kurniawan Dhani (2) , Taufiq Nur Budaya (1) (1) Department of Urology, Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia, (2) Medika Utama Hospital, Blitar, Indonesia Introduction and Objectives: A meta-analysis to evaluate the evidence of pretreatment NLR as Oncological Prognostic of survival in Non-Muscle Invasive Bladder Cancer (NMIBC) and Muscle Invasive Bladder Cancer (MIBC). Methods: Author was using a meta-analysis were searched by PUBMED, EMBASE, and the Cochrane Controlled Trials Register and were carried out hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarise the correlations between NLR and both Cancer Specific Survival (CSS) and Recurrence-Free Survival (RFS). The data was evaluated and statistically analysed by using RevMan version 5.3.0. Results: The meta-analysis included 14 studies with a total of 10184 patients assessed the prognostic value of NLR in NMIBC andMIBC patients. Overall, high pre-treatment NLR was correlated to poorer CSS (pooled HR = 1.49, 95% CI 1.261.75, p = 0.00001) and RFS (pooled HR = 1.39, 95% CI 1.201.63, p = 0.0001). Conclusions: In this meta-analysis demonstrated a significant correlation between elevated NLR and poorer prognosis in cancer specific survival and also increase risk of disease recurrence. The prognostic role of NLR may become valuable indicator in bladder cancer patients. C-10021 C-10020 Treatment and Outcomes of Prostate Abscess: A Cohort of 74 Adult Cases Lim Tze Ying Benjamin (1) , Sey Kiat Lim (1) , Joon-Jae Park (1) , Foo Cheong Ng (1) , Li-Tsa Koh (1) (1) Changi General Hospital Introduction andObjectives: Prostate abscesses are rare, difficult to diagnose and lack guidelines for treatment. We present a case series of 74 patients with prostate abscess at our institution reporting on demographic, clinical findings and treatment outcomes. Methods: We retrospectively examined the records of 74 patients who were diagnosed with prostate abscess in a tertiary hospital from April 2005 to December 2016. Therapy and intervention for individual patients were dictated by the treating physician;conservative, transrectal aspiration or transurethral deroofing of abscess. All patients received 4 to 6 weeks of antibiotics. Results: Mean age of patients is 60 years. Mean duration of hospitalisation is 19 days. Thirty-four patients have multiple abscesses within the prostate (46%). Forty six percent of patients were managed conservatively with intravenous antibiotics , 50%underwent TRUS aspiration and 4%underwent transurethral deroofing. Mean abscess size in patients undergoing TRUS aspiration was significantly higher at 4cm as compared to 2 cm in the conservative group (p=0.000). For patients who underwent TRUS aspiration, 61.5% have negative urine culture, 53.8% have negative blood culture, and 48.7% have both negative blood and urine cultures. Two patients needed rehospitalisation; one had concomitant renal abscess, and the other had genitourinary tuberculosis. There were no reported complications after TRUS guided aspiration Conclusions: Rates of negative blood and urine cultures in prostate abscess patients are high. Conservative treatment with antibiotics alone may not be effective in large prostate abscess and negative cultures. TRUS aspiration and drainage is safe, effective and assist in obtaining tissue culture to guide appropriate antimicrobial therapy. Expanding the Feasibility of Low-Intensity Extracorporeal Shockwave Therapy as a Promising Modality for Chronic Pelvic Pain Syndrome: A Meta-analysis of Randomized Controlled Trial Niwanda Yogiswara (1) , Anton Hermawan (1) , Ryan Akhmad (1) (1) Dr. Iskak General Hospital, Tulungagung, East Java Introduction and Objectives: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological discomfort inmen. Various oral and complementary therapies have failed to show a consistent improvement in CP/CPPS. Recent studies have found that the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) could improve various chronic diseases, including CP/CPPS. This study aims to evaluate the feasibility of Li-ESWT for reducing symptoms in CP/CPPS patients. Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2019 following the PRISMA guideline. We screened RCTs with our inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), subgroup analysis for triple therapy users was conducted to improve interpretability.The analysis was performed using RevMan 5.3. Results: A total of 6 RCTs, comprising of 311 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the control group, Li- ESWT had a significant decrease in NIH-CPSI total score at the endpoint of the treatment (MD -5.61 95% CI -7.4 to -3.82, p < 0.001) and during 12-week follow-up (MD -9.14 95%CI -12 to -6.27, p < 0.001). Subgroup analysis showed that Li-ESWT improved 12-week NIH-CPSI total score in triple therapy users (MD -7.46 95% CI -9.85 to -5.07, p < 0.001). Conclusions: This study revealed that Li-ESWT has great feasibility in improving CP/CPPS symptoms, as demonstrated by a significant decrease in NIH-CPSI total score at the endpoint and 12-week follow-up of the treatment. C-10014 3