Results: Demographic. Preoperative, op-erative and pathologic details are given intable 1. Mean hospital stay was 1 day andmean catheter duration was 9.8 days(range 6-21 days). Only one patient re-quired blood transfusion (0.01%). At amean follow up of 78 weeks, 6 patients(4.8%) had biochemical recurrence com-pared to 14 (3.6%) in the non obese(P�0.15). Three patients (2%) were using2 pads per day compared to similar per-centage among the non obese.Conclusions: Robotic surgery is feasiblein the morbidly obese and can achievegood operative, post operative outcomesand oncologic control despite havinglarger prostates and a bad disease.

MP-3.10Perioperative and PathologicalOutcomes in Obese Men: An Analysisof Robotic Assisted LaparoscopicRadical ProstatectomyFerreira M1,2,3, Sawh S1, Korkes F4,Berry A1, Hu J1

1Section of Robotics and Minimally Inva-sive Surgery, Division of Urologic Sur-gery, Brigham and Women’s Hospital,Harvard Medical School, Boston, USA;2Servico Ambulatorio Medico da CamaraMunicipal de Porto Alegre, Porto Alegre,Brazil; 3Division of Urology, Hospital deClinicas de Porto Alegre, Federal Univer-sity of the Rio Grande do Sul, RioGrande do Sul, Brazil; 4Division of Urol-ogy, Hospital Israelita Albert Einstein,Sao Paulo, Brazil

Introduction and Objectives: The uniquechallenges of operating on obese menshould come under scrutiny as obesity prev-alence increases in developed countries. Weevaluate the effect of obesity on periopera-tive outcomes in obese vs. non-obese menundergoing robotic assisted laparoscopicradical prostatectomy (RALP).Materials and Methods: We prospec-tively examined 234 consecutive men un-

dergoing RALP and classified them into 2groups based on body mass index (BMI):obese (BMI higher or equal to 30 Kg/m2),and non-obese (BMI � 30Kg/m2). Dataconcerning perioperative outcomes andstandardized quality of life instrumentswere prospectively examined and ana-lyzed using Statistical Package for the So-cial Sciences version 12.0.Results: We identified 88 (37.6%) obesevs. 146 (62.4%) non-obese men from ourseries. There were no statistical differ-ences in age or biopsy tumor characteris-tics; however, obese men were morelikely to have hypertension (p�0.01) andhypercholesterolemia (p�0.03). Mean op-erative time was increased for obese men(215 vs. 194 min, p�0.01). Estimatedblood loss, intraoperative complications,transfusions, length of stay (LOS) andcatheterization were similar betweengroups, although obese men were morelikely to experience postoperative compli-cations (17% vs. 8.2%, p�0.02).Conclusions: RALP in the obese male isa feasible procedure with acceptable peri-operative outcomes. In our series, obesitywas associated with an increased rate ofpostoperative complications and longeroperative times. Surgeons early in their ro-botic experience should exercise discretionin patient selection to optimize outcomes.

MP-3.11Pathological Gleason Score Trends inPatients Undergoing RadicalProstatectomyOrvieto M, Shikanov S, Zagaja G,Brendler C, Shalhav A, Zorn KUniversity of Chicago, Chicago, IL, USA

Introduction and Objectives: Large radi-cal prostatectomy ((RP) series have dem-onstrated a trend for lower incidence ofGleason score (GS) �5 and high GS�8along with a trend for higher incidence ofGS 6-7. It is unclear whether thesechanges are due to differences in patho-

logical interpretation or reflect actualchange of tumor aggressiveness over time.In the present study, we sought to evalu-ate the trends in prevalence of pathologi-cal Gleason scores over the last 14 yearsfor RP patients at the University of Chi-cago.Materials and Methods: Data includingage, race, BMI, preoperative PSA, clinicalstage, pathological GS and pathologicalstage were collected for all patients whounderwent RP at our institution between1994 and 2007. Patients were divided intotwo groups: treated before (Group1) andafter (Group2) January 2000. Patientswere stratified by pathological GS�6, 7and �8. The GS7 cohort was substratifiedinto 3�4 and 4�3 subcategories. Parame-ters were compared using analysis of vari-ance, p�0.05 was considered statisticallysignificant.Results: A total of 2067 consecutive RPswere performed at our institution be-tween March 1994 and September 2007.Nine hundred and ninety-six patients un-derwent open RP and 1071 robotic RP.Group 1 and Group 2 consisted of 545(23.4%) and 1522 (76.6%) patients, re-spectively. Mean age (p�0.6) and race(p�0.9) did not differ significantly be-tween groups. Group 2 patients had sig-nificantly higher BMI (p�0.0001), lowerPSA (p�0.0001) and higher rate of nonpalpable (cT1c) tumors (p�0.0001). Or-gan confined (pT2) disease was moreprevalent in Group 2 patients(p�0.0001).The rate of pathological GS�6 was found to be significantly lower(p�0.008) in Group 2 (54.8% vs. 62.4%),while GS7 and GS�8 significantly higher.Among GS7 cases, Group 2 patients hadsignificantly lower rate of GS 3�4 tumors(74.0%) compared to Group1 (82.6%)(p�0.02).Conclusions: Based on the findings ofthe present analysis, it may be assumedthat the previously found trend for GS 6-7upward migration continues and extendsinto the range of GS�7 prostate cancers.Further longitudinal large populationbased studies are needed to evaluate theGS upward migration, including differentcancer treatment modalities to address thepossibility of patients shifting.

MP-3.12Brachytherapy After 12 Years: OurExperience with 412 Cases with aMinimum Follow-Up of 12 MonthsCobreros C, Borghi M, Montes de Oca L,Becher E, Chernovilsky V, Momesso A,Iturralde UCentro de Urologia, Buenos Aires, Argen-tina

Table, MP-3.09

Parameters BMI 25 or Less BMI 35 or More P-valueAge (mean) 60.1 59.9 0.20BMI (mean) 23.9 36.9 �0.0001Pre-op PSA(mean) 5.83 (0.4-56ng/ml) 6.21 (0.7-44ng/ml) 0.44Prostate weight (mean) 46.9 Gms (13-220) 53.4 Gms (20-148) 0.008Mean OP and console time 154 min

116 min183 min139 min

0.03

Blood loss (mean) 157 ml 203 ml 0.10Path. Gl. Sum 6.6 7 0.01Extracapsular disease 22% 41% 0.001Biochemical recurrence 14 (3.6%) 6 (4.8%) 0.15Continence 98% 98% N.S.

MODERATED POSTER SESSIONS

UROLOGY 72 (Supplement 5A), November 2008 S79