but not exempt of complications, andhigher difficulty to adjust dose and treat-ment area. Low dose-rate prostatic brachy-therapy is actually an alternative optionfor patients with localized prostate can-cer. We present our experience with lowdose-rate brachytherapy for local prostatecancer relapse after RP.Material & Methods: Nineteen patientswere treated for local prostate cancer re-lapse from April 2004 to November 2006.Medium age is 67.8 years (54-74). All pa-tients were treated initially by RP with57.9% pT2a, 26.3% pT3a and 15.8% pT3b.Gleason ranged from 6-9. All of them under-went anastomosis area biopsy and confirmlocal relapse. Medium PSA before rescuetreatment was 2.2 ng/mL. (0.6-6.8). Realtime implant was realized using Vareseed�

7.2 and Rapid Strand� seeds were used.Treatment dose planning was for 140 Gy.Results: There were no major periopera-tive complications. Hospital stay was 21hin all of them. Continence worsened in 2(11%). Mild previous incontinence im-proved in 3 patients (15.8%). Two pa-tients had light gastrointestinal toxicity(grade 1). None of them had seed voidingin follow up after implant. Medium followup is 15.7 months (2-34). Medium PSAafter 1, 6 and 24 months is 2.2, 1.4 and0.34 ng/mL respectively. One patient (5%)had progression after 9 months, withoutevidence of metastasis.Conclusions: A longer follow up isneeded, but preliminary results with mini-mal morbidity and good biochemical re-sponse, make us think it is a valid optionfor patients with local relapse after radicalprostatectomy.

MP-08.16Docetaxel and oral estramustinephosphate in patients with hormonerefractory prostate cancerSegawa T, Masuda N, Shiraishi Y, NegoroH, Oka H, Iwamura H, Moroi S, Okubo K,Okada T, Kawakita M,Department of Urology, Kobe City Medi-cal Center General Hospital, Kobe, Japan

Introduction: Recently, Docetaxel hasbeen highlighted for the treatment of hor-mone refractory prostate cancer (HRPC),while Estramustine phosphate is an estab-lished oral drug for HRPC. To evaluate thesafety and efficacy of the combination, wehave conducted a clinical trial of Do-cetaxel and oral Estramustine phosphatein patients with HRPC.Methods: Patients with prostate cancer,which was progressing despite androgenablation therapy, were treated with i.v. Do-cetaxel, 35 mg/m2, on Day 2 with oral Es-

tramustine phosphate, 1260 mg, 840 mg,and 840 mg on Day 1, 2 and 3, respectively.Treatment cycles were adjusted for the pa-tients’ condition, with the basis of two cy-cles a month. Patients were evaluated forresponse every cycle, and the treatmentwas continued until the cancer progressed.Results: From April 2003, Twenty-sevenprogressive HRPC patients, with the me-dian age of 72.4 years (Range 55 to 82years) were treated for a median of 7 cy-cles (Range 1 to 46 cycles). Of 291 cycles,235 cycles (81%) were on an outpatientbasis. Median pretreatment PSA valueswere 37.6ng/ml (Range 1.8 to 1760ng/ml). Post-therapy decreases in serum PSAlevels of 50%, and 75% were seen in 52%,and 33% of the patients, respectively. Ofthe 16 patients with measurable disease,none (0%) had a complete response or apartial response. The overall median timeto PSA progression was 4 months (Range0 to 24 months. Major grade 3 or 4 ad-verse effects were anemia (11%), leukocy-topenia (33%). Mild anorexia / nauseawere observed in 56% of the patients.Conclusion: Docetaxel with oral Estra-mustine phosphate has significant anti-tumor activity and is well tolerated in pa-tients with progressive HRPC.

MP-08.17Correlation of clinical andpathological staging in patientsundergoing radical prostatectomyArumainayagam N1, McPhail S2, AyresB1, MacGrath J1, Fowler S3, Cottier B4,Verne J2, Gillatt DA3

1Bristol Urological Institute; 2South WestPublic Health Observatory; 3British Asso-ciation of Urological Surgeons; 4NationalCancer Surveillance and Analysis Team,Clatterbridge Centre for Oncology

Introduction: The aim of this retro-spective study was to compare the pre-operative clinical stage of patients un-dergoing radical prostatectomy (RP)with subsequent pathological stage.Methods: Patients undergoing radical pros-tatectomy from 1999 to 2005 were identi-fied using cancer registry databases and theclinical database of the British UrologicalSurgeons. This covers approximately 50% of

all RP’s performed in the UK in this periodwithin the NHS. The clinical T stage wascompared at the time of diagnosis with sub-sequent pathological stage after surgery.Results: The total number of patients was5339. Tumours were grouped as organ con-fined (T1 / T2), or locally advanced (T3).This was applied to both clinical and patho-logical staging.Conclusion: There is a significant dis-crepancy between clinical and actualpathological staging. Identifying risk fac-tors for up or down staging of tumoursmay aid clinical decision-making.

MP-08.18Robot-assisted laparoscopic radicalprostatectomy in locally advancedprostate cancer: results of a singlesurgeon experience in KoreaPark SY, Park SJ, Lee YH, Kim HJ, Lee SW,Han WK, Kim JH, Choi YD, Rha KH,Yang SCDepartment of Urology, College of Medi-cine, Urological Science Institute andBrain Korea 21 Project for Medical Sci-ence, Yonsei University, Seoul, Korea

Introduction: Radical prostatectomy stillremains controversial in the managementof locally advanced prostate cancer (LAP).The perception of an increased technicaldifficulty and a higher morbidity rate hasbeen a major cause of concern in propos-ing surgery for LAP. The purpose of thisstudy is to assess the feasibility and theoncologic outcome of robot-assisted lapa-roscopic radical prostatectomy (RLRP) inLAP.Methods: Between July 2005 and March2007, 29 RLRPs were performed by singlesurgeon in clinically LAP. LAPs were com-pared with 73 RLRPs performed duringthe same period by the same surgeon inclinically localized disease (LP).Results: The preoperative parameterswere comparable for both groups. Thetwo groups did not differ significantly insurgical morbidity except for estimatedblood loss and operative time, whichshowed a higher rate in patients withLAP. The mean estimated blood loss was367 mL for LAP and 320 mL for LP(P�0.03). The mean operating time was

Table 1. MP-08.17

CLINICAL STAGE T1 / T2 n � 5109 T3 n � 230

Pathological stage pT1-2 pT3 pT1-2 pT3Number 3915 1194 69 161Percentage 77 23 30 70

23 % of clinical T1-2 tumours are subsequently upstaged to pathological stage T3, and 30% of clinical T3 tumoursare subsequently downstaged to organ confined pathological stage T1-2.

MODERATED POSTER SESSIONS

82 UROLOGY 70 (Supplment 3A), September 2007