Variable N (%)Gender

Male 69 (75.8)

Female 22 (24.2)

RCC histologic subtype

Clear Cell 80 (87.9)

Papillary 3 (3.3)

Sarcomatoid 7 (7.7)

Chromophobe 1 (1.1)

Primary tumor stage

T2 38 (42.8)

T3a 27 (29.7)

T3b/c 25 (27.5)

T4 1 (1.1)

Node Status

Nx 21 (23.0)

N0 53 (58.2)

N1 6 (6.6)

N2 11 (12.1)

Metastatic Disease Status

Mx/M0 69 (75.8)

M1 22 (24.1)

TABLE 1: Clinicopathological demographics

Source of Funding: Kidney Cancer Keystone Program

27LAPAROSCOPIC ADRENALECTOMY FOR ADRENALMETASTASIS OF LUNG CANCER: RESULTS OF APROSPECTIVE STUDY

Francesco Porpiglia*, Cristian Fiori, Riccardo Bertolo, GiovanniSelvaggi, Giorgio Scagliotti, Roberto Mario Scarpa, Orbassano(Torino), Italy

INTRODUCTION AND OBJECTIVES: Aim of this prospectivestudy is to evaluate the results of laparoscopic adrenalectomy (LA) formetachronous lung cancer metastasis in patients with advanced lungcancer (LC) treated with radio-chemotherapy.

METHODS: From July 2002 to February 2009, patients af-fected by lung cancer (both Small Cell LC and Non Small Cell LC),previously treated with radio-chemotherapy in which metachronoussolitary adrenal metastasis was demonstrated at follow up, were sub-mitted to LA. In all cases LC was considered locally stable. Thefollowing parameters were registered: age, gender, side of lesion,pathology, size, operative time, blood loss, conversion, hospital stay,complications, pre- and 1 month post-operative Karnofsky Perfor-mance Status Score (KPSS) and oncological outcomes. Moreover, inorder to better define the safety of the procedure, patients werestratified according to lesion size (�5 cm Group A vs �5 cm Group B)and the two subgroups were compared using the same variables.Statistical analyses were performed using Kaplan-Meyer method, Stu-dent t test and chi square test, a p-value � 0.05 was consideredsignificant

RESULTS: Twenty-seven patients were enrolled in this study:median age was 62.3 (40-79), median lesions size was 5.1 (1.2-13.0),operative time was 120.0 minutes (75.0-180), blood losses were 247.4cc (50.0-400.0). Two conversions to open surgery were recorded dueto infiltration of surrounding tissue; hospital stay was 4.1 (3.0-5.0) days,preoperative and postoperative KPSS was 56.8 and 63.1 respectively(p�0.05). Pathological analyses revealed a LC metastases in all cases,whilst in 4 cases (14.5%) positive surgical margins was registered.Eighteen patients died (66.6%), 16 due to systemic progression andcachexy, one for acute embolism and one for local recurrence. Medianfollow-up was 10.2 months whilst median overall survival (OS) was 9months. A comparison between subgroups B was performed: 17 and10 patients were assigned to subgroup A and B respectively: mediansize was 3.3 and 8.4 cm respectively (p�0.0001). No statistical differ-

ence was registered in terms of perioperative and pathological vari-ables; nevertheless, all cases of positive surgical margins (four cases)and conversions to open surgery (two cases) were recorded in group B.No significant difference was recorded in terms of disease specificsurvival time and OS.(p�0.05);

CONCLUSIONS: LA for metastasis in patient with advanced LCseems to improve performance status of patients, whilst overall survivalis still low. The safety of the procedure seems to be higher when thelesion size is � 5 cm.

Source of Funding: None

28PRELIMINARY ONCOLOGIC OUTCOME OF LAPAROSCOPICADRENALECTOMY FOR ISOLATED ADRENAL METASTASIS

Rocco Papalia*, Giuseppe Simone, Salvatore Guaglianone, AlfredoBove, Ester Forastiere, Michele Gallucci, Rome, Italy

INTRODUCTION AND OBJECTIVES: We report the oncologi-cal outcome of laparoscopic treatment of adrenal metastases.

METHODS: Between October 2002 and May 2009 128 laparo-scopic adrenalectomies (LA) were performed. We retrospectively re-viewed a prospectively maintained database to evaluate the outcomeof 16 patients undergone LA for adrenal metastasis. Preoperative data,perioperative results and follow-up were evaluated.

RESULTS: Nineteen LAs were performed in 16 patients. Themean operative time was 48 minutes (range 35-63) for unilateralprocedures and 115 minutes (range 75 to 160) for single settingbilateral procedures. The mean blood loss was 60 ml (range 30-150ml)for unilateral adrenalectomies and 80 ml (50-300ml) for bilateral ones.No major complication occurred. The median time to discharge was 3days (range 2 to 6). The median tumor size was 5,5 cm (range 3.5 to10). The pathologic analysis revealed renal cell carcinoma metastasesin 10 patients and transitional cell carcinoma metastases in two menwho underwent bilateral laparoscopic adrenalectomy. Metastasis frompapillary renal cell carcinoma, poorly differentiate lung carcinoma,colorectal carcinoma and melanoma were respectively detected in theother four patients. Surgical margins were negative in all patients andlocal recurrence occurred in one patient. At a median follow-up of 21months 75% of patients were alive and 31,25% were disease free. Themean time to recurrence was 13 months (range 4-50). When analyzedfor primary tumor histology, recurrence free survival rate in the group ofpatients with renal cell carcinoma metastasis was 46% and cancerspecific survival rate was 91%. No patients with primary tumor histologydifferent by renal cell carcinoma was recurrence free and 4 out of 5 fivepatients died of disease.

CONCLUSIONS: Laparoscopic removal of adrenal metastasisis minimally invasive and oncologically effective. The final outcome ofpatients mainly depends on the primary tumor histology and on thechances of treatment of metastases subsequently developed.

Source of Funding: None

29DETERMINATION OF THE BEST BIOCHEMICAL EVALUATIONFOR THE DIAGNOSIS OF PHEOCHROMOCYTOMA

Eric Huyghe*, Ali Salloum, Julien Berbe, Boris Delaunay, AntoineBennet, Philippe Caron, Michel Soulie, Pierre Plante, Toulouse,France

INTRODUCTION AND OBJECTIVES: To compare the perfor-mances of the various combinations of urinary biochemical dosagesused for the diagnosis of pheochromcytoma.

METHODS: One center cohort study of patients tested forsuspicion of pheochromocytoma between 1998 and 2007. The analysisincluded 51 patients in whom we had at least one preoperative urinedosage of catecholamines and their metabolites prior to surgery. Wedivided the population into 2 groups, group 1 (n�38) with patients whohad histopathological confirmation of pheochromocytoma and group 2

e12 THE JOURNAL OF UROLOGY� Vol. 183, No. 4, Supplement, Saturday, May 29, 2010