Eur Urol Suppl 2010;9(6):536 N6 VITAMIN D INTAKE AND DEFICIENCY IN MEN AT RISK OF PROSTATE CANCER Meija L. 1 , Šitova A. 2 , Zeltīte R. 3 , Erdmane D. 1 , Rafaels R. 4 , Teibe U. 5 , Lietuvietis V. 6 , Lejnieks A. 7 1 Pauls Stradins Clinical University Hospital, Riga, Dept. of Nutrition, Riga, Latvia, 2 Riga Stradins University, Faculty of Rehabilitation, Riga, Latvia, 3 NMS- Laboratory, Biochemistry, Riga, Latvia, 4 Animal Health and Environment „BIOR”, Biochemistry, Riga, Latvia, 5 Riga Stradins University, Statistics, Riga, Latvia, 6 Riga Eastern Clinical University Hospital, Dept. of Urology, Riga, Latvia, 7 Riga Eastern Clinical University Hospital, Internal Diseases, Riga, Latvia Introduction & Objectives: Prostate cancer (PC) is the second cancer as the cause of cancer-related death in men both in western countries and in Latvia. There is evidence that vitamin D has anticarcinogenic activity Epidemiological studies show that vitamin D deficiency increases the risk of prostate cancer, but the findings are inconsistent. Objective ± To examine whether vitamin D intake were associated with vitamin D serum concentrations, age and body mass index (BMI) and to investigate vitamin D status in men at risk of prostate cancer and without findings of PC. Material & Methods: The study included 92 men of age 45 till 79, prostate-specific antigen (PSA) 1.0-10.0 µg/L, no PC family history, no vitamin D supplement use. Men with prostate biopsy detected PC were excluded from the study. Serum concentration of 25-hydroxyvitamin D (25(OH)D) was measured. The BMI of men was determined. Usual dietary intake during the 12 month was assessed using 147-item country-specific food frequency questionnaire (FFQ). Subjects were interviewed using picture folder for the assessment of portion size. Nutritional data were processed on the originally developed software, using data base of the German Nutrient Data Base (BLS). Descriptive statistics and appropriate parametric and nonparametric tests, linear correlations and regression analysis were used for data analysis. Results: 95% of men had vitamin D deficiency or insufficiency. 31.3% had deficiency, 45.2% had severe insufficiency 19.1% moderate insufficiency, and 4.3% had 25(OH)D in serum above 30.0 ng/mL. 74% of men had insufficient intake of vitamin D (<400 IU). The mean data: serum 25(OH)D 15.7 ng/mL, vitamin D intake 311.3 IU/d, age 56.5 years, BMI 28.4 kg/m². There were significant positive association between vitamin D intake and serum concentration (r=0.215; p=0.039). No significant association was found between vitamin D intake at either age, or BMI (p>0.05). Conclusions: Our findings show that insufficient Vitamin D intake and deficiency and insufficiency in serum could be prevalent among men at risk of prostate cancer. Vitamin D intake is associated with circulating concentration of 25(OH)D but neither age nor BMI. N7 PROSTATECTOMY PATHOLOGIC EVALUATION OF PATIENTS WITH PROSTATE CANCER CANDIDATES TO LOCAL ABLATION THERAPY Lucio R., Campos Pinheiro L., Rommel Rangel A.J., Rocha Mendes J. Hospital Curry Cabral, Dept. of Urology, Lisbon, Portugal Introduction & Objectives: Examine risk pathologic factors in prostate cancer patients amenable to local ablation therapy. Material & Methods: We investigated 60 patients in which 12 core needle biopsy predicted limited disease (Gleason score 6 or less, less than 3 positive cores, 50% or less involvement of any positive core and all positive cores unilateral), by reviewing the radical prostatectomy specimens pathology report. Results: There were 1, 2 or 3 positive cores in 32, 20 and 8 patients, respectively. On average, 14% of each positive core was involved with tumor. In 41 radical prostatectomy specimens there was some tumor contralateral to the positive biopsy side, but without reference to tumor volume. Gleason score 7 or more was found in 50% of the specimens studied. Extraprostatic extension was detected in 21 patients (35%), 15 of them positive for contralateral tumor. There were 32% of overall positive margins. Conclusions: The 12 core biopsy has the main goal of diagnosing, rather than mapping, prostate cancer as 68% of specimens were positive for contralateral tumor. The exact pathologic characteristics of contralateral tumor were not determined (volume and grade). Due to the high percentages of many risk factors for aggressive prostate cancer (upgrading, positive margins and extraprostatic extension), many cases may not be good candidates for focal therapy. N4 THE D’AMICO AND EPSTEIN CRITERIA PREDICT ORGAN CONFINED BUT NOT CLINICALLY INSIGNIFICANT PROSTATE CANCER Milonas D., Baltrimavicius R., Grybas A., Jievaltas M. University of Medicine, Dept. of Urology, Kaunas, Lithuania Introduction & Objectives: The D’Amico and Epstein criteria represent mostly used models for prediction of low risk prostate cancer. We evaluate the rate of potentially clinically significant prostate cancer (Gleason score ≥7 and/or extra prostatic extension (EPE)) and prostate specific antigen (PSA) free survival in men who fulfilled the D’Amico and Epstein criteria before radical prostatectomy. Material & Methods: Between 2004 and 2007, 690 men underwent prostate biopsy and open radical retropubic prostatectomy at a single department of university hospital. Of those the 314 patients have met the D’Amico criteria and 64 among them – the Epstein criteria. The study end point was detection of potentially clinically significant prostate cancer in the groups using different criteria models. The secondary end point was detection of PSA free survival in the each group. Results: EPE was found in 39 (12.4%) of the “D’Amico group” and in 4 (6.3%) of the “Epstein group” patients (Chi Square test p=0.156, Fisher Exact test p=0.197). Gleason score ≥7 after radical prostatectomy was found in 94 (29.9%) and 12 (18.8%) respectively of study groups men (Chi Square test p=0.069, Fisher Exact test p=0.092). Clinically significant prostate cancer (EPE and/or upgrading) was detected in 109 (34.7%) and 14 (23.4%) those groups patients (Chi Square test p=0.08, Fisher Exact test p=0.102) respectively. At median 24 months follow up the overall PSA free survival in the “D’Amico group” was 91.8% (for insignificant PCa 94% and for clinically significant – 87.5%, long rank test p=0.048). According Epstein criteria the overall PSA free survival was 93.5% (for insignificant PCa 93.8% and for clinically significant – 92.9%, long rank test p=0.942). There was no different overall PSA free survival in study groups (Log rank test p=0.691). Conclusions: Using the D’Amico or Epstein criteria we can predict the organ confided disease at 87.6 and 93.7% but potentially clinically insignificant prostate cancer only at 65.3 and 76.6% respectively. For underestimated significant prostate cancer biochemical relapse within two years can be suspected in 13.5 and 7.1% of study groups patients. No priority for better selection of patients for surgery using D’Amico or Epstein models was detected. N5 CORRELATION OF MINUTE FOCUS OF PROSTATE ADENOCARCINOMA ON RANDOM MULTIFOCAL NEEDLE BIOPSY WITH RADICAL PROSTATECTOMY SPECIMEN Urbansky A.I. Russian Research Centre For Radiology and Surgical Technologies, Dept. of Pathology, St. Petersburg, Russia Introduction & Objectives: The incidence of minute carcinoma of the prostate has increased from 0,5 % in 1988 to 5,2 % in the current study. This paper attempts to determine the importance of small foci of prostatic cancer in random multifocal needle biopsy specimens. Material & Methods: 64 (5,3 %) patients with a microscopic focus confined to a single core specimen (which defined as tumor less than 1 mm in greatest dimension or as cancer involving less than 5 % of needle core tissue with a Gleason score of 6 or less) were identified from a retrospective review of 1206 needle biopsies of the prostate. Twelve of these 64 subsequently underwent radical retropubic prostatectomy at our centre. The average number of prostate cores per biopsy was 14,5. Clinically significant tumors were defined as those with volume greater than 0,5 cc. Results: Average tumor volume was 0,9 ± 0,6 cc (range 0,068 to 2,9 cc). In 66,6 % (8) of the cases mean tumor volume were less 1,0 cc. In 41,66 % (5) of the cases were less 0,5 cc (range 0,068 to 0,458 cc, mean volume – 0,22 ± 0,15 cc). In 91,6 % (11) of the cases tumors were multifocal. In 10 (83,33%) of the cases tumoral knots were only in a peripheral zone. In 1 (8,4%) of the case the basic tumoral knot was in a peripheral zone and the second (little) tumoral knot was in a transitional zone. In 1 (8,4%) of the case the basic tumoral knot was in a transitional zone and the second (little) tumoral knot was in a peripheral zone. In 11 (75,0 %) of the cases the tumoral knots were in both doles prostate. In 1 (8,4%) of the case tumoral knot was in one. There was 1 (8,4 %) of patient with extraprostatic extension. Conclusions: Our data have shown high frequency of revealing insignificant tumours (mean 42 ± 28 % ; Р=0,95); in investigated group of 64 persons with a minute focus of prostate adenocarcinoma the average expected number of cases potentially insignificant tumours should be equal 27 (the confidential interval will make 95 % from 9 to 45 cases insignificant cancers). However, about 60 % of patients had clinically significant tumors warranting definitive therapy. The smallest focus of cancer on needle biopsy is not a guarantee of a clinically insignificant tumor.