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Aim: Darolutamide significantly prolonged metastasis-free survival (MFS) versus placebo in the Phase III ARAMIS study. We analyzed outcomes in Spanish participants in ARAMIS. Patients & methods: Patients with high-risk nonmetastatic castration-resistant prostate cancer were randomized 2:1 to darolutamide 600 mg twice daily or placebo, plus androgen-deprivation therapy. The primary end point was MFS. Descriptive statistics are reported for this post hoc analysis. Results: In Spanish participants, darolutamide (n = 75) prolonged MFS versus placebo (n = 42): hazard ratio 0.345, 95% confidence interval 0.175–0.681. The incidence and type of treatment-emergent adverse events were comparable between treatment arms. Conclusion: For Spanish participants in ARAMIS, efficacy outcomes favored darolutamide versus placebo, with a similar safety profile, consistent with the overall ARAMIS population. Clinical Trials Registration: NCT02200614 ( ClinicalTrials.gov )

Resumen Introduccion El varicocele es la causa mas frecuente de infertilidad masculina corregible y el tratamiento estandar es la varicocelectomia. En nuestro centro incorporamos recientemente el abordaje microquirurgico del varicocele y el objetivo del presente estudio es determinar las diferencias en resultados clinicos y analiticos entre la varicocelectomia microquirurgica (VMI) y la macroquirurgica (VMA) convencional. Material y metodos Se realiza un estudio comparativo entre la VMA y la VMI en el periodo comprendido entre enero del 2013 y diciembre del 2016. Incluimos a pacientes con varicocele clinico y alteracion en parametros seminales. Analizamos datos correspondientes a la edad, la lateralidad y el grado del varicocele, el volumen testicular, la tecnica quirurgica, los parametros seminales pre y postratamiento y la recidiva. Resultados Entre enero del 2013 y diciembre del 2016 se realizaron en nuestro centro 46 varicocelectomias, excluyendose del estudio a 12 pacientes por falta de seguimiento. De los restantes 34, 19 (55,9%) se intervinieron de VMA y 15 (44,1%) de VMI subinguinal. No hubo diferencias significativas en las caracteristicas basales de ambos grupos. La concentracion espermatica preoperatoria en VMI 30,1 ± 35,6 106/ml vs. VMA 25,6 ± 19,9 106/ml (p = 0,64) y la movilidad progresiva a + b en VMI 17,7 ± 13,6% vs. VMA 16,5 ± 10,1% (p = 0,77). La concentracion posvaricocelectomia fue en VMI 29,16 ± 33 106/ml vs. VMA 45,6 ± 55,5 106/ml (p = 0,32) y la movilidad progresiva a + b fue en VMI 26,4 ± 20,1% vs. VMA 27,7 ± 20,4% (p = 0,85). Objetivamos una tendencia no significativa a la mayor presencia de recidiva en la VMA (26,3%) vs. la VMI (6,7%) (p = 0,15). Conclusiones Asumiendo la curva de aprendizaje de la VMI, objetivamos resultados en mejoria de los parametros seminales comparables con la VMA clasica. Aunque no significativa, existe una tendencia a la menor presencia de recidiva en la VMI, consistente con lo descrito en la literatura.

INTRODUCTION AND OBJECTIVE:Orthotopic kidney transplant is a good alternative for patients with an end-stage renal disease non-suitable for a heterotopic kidney transplant (KT) due to severe iliac ...

Introduction & Objectives: in Spain kidneys after controlled cardiac death (cDCD) has increased over the years. This group present a high incidence of DGF. Graft quality optimization has been the major interest over the last decade. The aim of this study is to evaluate de benefit of hypothermic machine perfusion (HMP) in reducing de delayed graft function (DGF) and primary non-function (PNF) compared to cold storage in cDCD. Other parameters are evaluated: 99mTc-MAG-3 scintigraphy TFS (tubular function slope) and ultrasound (US) resistive index (RI) 24-48 hours after surgery, rejection rate, duration of DGF. Materials & Methods: We are conducting a randomized prospective study since April 2017. We select all cDCD from one single institution, Hospital Universitari de Bellvitge, and we randomize 1:1 to cold storage and HMP. Data from donors, surgery, HMP, and post-operatory are collected; and analysed.

Introduction & Objectives: during the past decade, kidneys obtained after controlled circulatory death (cDCD) have significantlyincreased, in order to increase the number of donors. It achieved 24% of total Kidneys transplant during the last year in Spain. However, it implies warm ischemia times, resulting ina greater risk for organs. Focusing on graft quality optimization, abdominal Normothermic Extracorporeal Membrane Oxygenation (NECMO) has been implemented in order to restore blood flow before organ recovery. NECMO perfusion provides promising results for the use of liver grafts for cDCD. The aim of this study is to evaluate cDCD kidneys, obtained from NECMO technique compared with cDCD ultra-rapid retrieval.

Varicocele is the most common cause of male infertility and the standard treatment is varicocelectomy. Having recently started performing microsurgical varicocelectomy (MV) in our centre, the objective of this study is to determine the differences in clinical outcomes and laboratory findings between MV and the conventional varicocelectomy (CV).This is a comparative study between MV and CV in our centre between 01/2013 and 12/2016. We included patients with clinical varicocele and altered seminal parameters. We analyzed the following variables: age, laterality, grade of varicocele, testicular volume, surgical technique used, seminogram parameters prior to and after surgery and recurrence.Between 01/2013 and 12/2016 46 varicocelectomies were performed in our centre, excluding from the study 12 patients due to lack of follow-up. Of the remaining 34, 19 (55.9%) underwent CV and 15 (44.1%) MV. There were no significant differences between the baseline characteristics of both groups. The preoperative sperm count was 30.1±35.6 10Despite the learning curve with MV, we obtained improvements in seminal analysis similar to those with CV. Even though not statistically significant, there was a tendency to less recurrence in the MV group, consistent with what is already described in medical literature.

BACKGROUND: Novel predictors of prognosis and treatment response for prostate cancer (PCa) are required to better individualize treatment. Single-nucleotide polymorphisms (SNPs) in four genes directly (XRCC5 (X-ray repair complementing defective repair in Chinese hamster cells 5) and XRCC6 (X-ray repair complementing defective repair in Chinese hamster cells 6)) or indirectly (PARP1 and major vault protein (MVP)) involved in non-homologous end joining were examined in 494 Spanish PCa patients. METHODS: A total of 22 SNPs were genotyped in a Biotrove OpenArray NT Cycler. Clinical tumor stage, diagnostic PSA serum levels and Gleason score at diagnosis were obtained for all participants. Genotypic and allelic frequencies were determined using the web-based environment SNPator. RESULTS: (XRCC6) rs2267437 appeared as a risk factor for developing more aggressive PCa tumors. Those patients carrying the GG genotype were at higher risk of developing bigger tumors (odds ratio (OR)=2.04, 95% confidence interval (CI) 1.26-3.29, P=0.004), present higher diagnostic PSA levels (OR=2.12, 95% CI 1.19-3.78, P=0.011), higher Gleason score (OR=1.65, 95% CI 1.01-2.68, P=0.044) and D'Amico higher risk tumors (OR=2.38, 95% CI 1.24-4.58, P=0.009) than those patients carrying the CC/CG genotypes. Those patients carrying the (MVP) rs3815824 TT genotype were at higher risk of presenting higher diagnostic PSA levels (OR=4.74, 95% CI 1.40-16.07, P=0.013) than those patients carrying the CC genotype. When both SNPs were analyzed in combination, those patients carrying the risk genotypes were at higher risk of developing D'Amico higher risk tumors (OR=3.33, 95% CI 1.56-7.17, P=0.002). CONCLUSIONS: We believe that for the first time, genetic variants at XRCC6 and MVP genes are associated with risk of more aggressive disease, and would be taken into account when assessing the malignancy of PCa. This work was subsidized by grants from the Instituto de Salud Carlos III (Ministerio de. Economía y Competitividad from Spain), ID: PI12/01867 and PI13/00412; and Instituto Canario de Investigación del Cáncer (ICIC-GR-F-14/11). Almudena Valenciano has a grant from the Instituto Canario de Investigación del Cáncer (ICIC).

BACKGROUND: Prostate cancer (PCa) is an androgen-dependent disease. Nonetheless, the role of single nucleotide polymorphisms (SNPs) in genes encoding androgen metabolism remains an unexplored area. PURPOSE: To investigate the role of germline variations in cytochrome P450 17A1 (CYP17A1) and steroid-5α-reductase, α-polypeptides 1 and 2 (SRD5A1 and SRD5A2) genes in PCa. PATIENTS AND METHODS: In total, 494 consecutive Spanish patients diagnosed with nonmetastatic localized PCa were included in this multicenter study and were genotyped for 32 SNPs in SRD5A1, SRD5A2, and CYP17A1 genes using a Biotrove OpenArray NT Cycler. Clinical data were available. Genotypic and allelic frequencies, as well as haplotype analyses, were determined using the web-based environment SNPator. All additional statistical analyses comparing clinical data and SNPs were performed using PASW Statistics 15. RESULTS: The call rate obtained (determined as the percentage of successful determinations) was 97.3% of detection. A total of 2 SNPs in SRD5A1-rs3822430 and rs1691053-were associated with prostate-specific antigen level at diagnosis. Moreover, G carriers for both SNPs were at higher risk of presenting initial prostate-specific antigen levels>20ng/ml (Exp(B) = 2.812, 95% CI: 1.397-5.657, P = 0.004) than those who are AA-AA carriers. Haplotype analyses showed that patients with PCa nonhomozygous for the haplotype GCTTGTAGTA were at an elevated risk of presenting bigger clinical tumor size (Exp(B) = 3.823, 95% CI: 1.280-11.416, P = 0.016), and higher Gleason score (Exp(B) = 2.808, 95% CI: 1.134-6.953, P = 0.026). CONCLUSIONS: SNPs in SRD5A1 seem to affect the clinical characteristics of Spanish patients with PCa. Copyright © 2015 Elsevier Inc. All rights reserved. This work was subsidized by Grants from the Instituto de Salud Carlos III, Madrid, Spain (Ministerio de Economía y Competitividad, Spain), ID: PI12/01867 and/nPI13/00412; and Instituto Canario de Investigación del Cáncer, Canary Islands, Spain (ID: ICIC-GR-F-14/11). Almudena Valenciano received a Grant from the/nInstituto Canario de Investigación del Cáncer (ICIC).

Background Besides serum levels of PSA, there is a lack of prostate cancer specific biomarkers. It is need to develop new biological markers associated with the tumor behavior which would be valuable to better individualize treatment. The aim of this study was to elucidate the relationship between single nucleotide polymorphisms (SNPs) in genes involved in DNA repair and prostate cancer progression., Methods A total of 494 prostate cancer patients from a Spanish multicenter study were genotyped for 10 SNPs in XRCC1, ERCC2, ERCC1, LIG4, ATM and TP53 genes. The SNP genotyping was made in a Biotrove OpenArray® NT Cycler. Clinical tumor stage, diagnostic PSA serum levels, and Gleason score at diagnosis were obtained for all participants. Genotypic and allelic frequencies were determined using the web-based environment SNPator., Results SNPs rs11615 (ERCC1) and rs17503908 (ATM) appeared as risk factors for prostate cancer aggressiveness. Patients wild homozygous for these SNPs (AA and TT, respectively) were at higher risk for developing cT2b – cT4 (OR = 2.21 (confidence interval (CI) 95% 1.47 – 3.31), p, Conclusions Genetic variants at DNA repair genes are associated with prostate cancer progression, and would be taken into account when assessing the malignancy of prostate cancer., This work was subsidized by a grant from the Instituto de Salud Carlos III (Ministerio de Economía y Competitividad from Spain), ID: PI12/01867. Almudena Valenciano has a grant from the Instituto Canario de Investigación del Cáncer (ICIC).

[Background] Differences in the distribution of genotypes between individuals of the same ethnicity are an important confounder factor commonly undervalued in typical association studies conducted in radiogenomics. [Objective] To evaluate the genotypic distribution of SNPs in a wide set of Spanish prostate cancer patients for determine the homogeneity of the population and to disclose potential bias. [Design, Setting, and Participants] A total of 601 prostate cancer patients from Andalusia, Basque Country, Canary and Catalonia were genotyped for 10 SNPs located in 6 different genes associated to DNA repair: XRCC1 (rs25487, rs25489, rs1799782), ERCC2 (rs13181), ERCC1 (rs11615), LIG4 (rs1805388, rs1805386), ATM (rs17503908, rs1800057) and P53 (rs1042522). The SNP genotyping was made in a Biotrove OpenArray® NT Cycler. [Outcome Measurements and Statistical Analysis] Comparisons of genotypic and allelic frequencies among populations, as well as haplotype analyses were determined using the web-based environment SNPator. Principal component analysis was made using the SnpMatrix and XSnpMatrix classes and methods implemented as an R package. Non-supervised hierarchical cluster of SNP was made using MultiExperiment Viewer. [Results and Limitations] We observed that genotype distribution of 4 out 10 SNPs was statistically different among the studied populations, showing the greatest differences between Andalusia and Catalonia. These observations were confirmed in cluster analysis, principal component analysis and in the differential distribution of haplotypes among the populations. Because tumor characteristics have not been taken into account, it is possible that some polymorphisms may influence tumor characteristics in the same way that it may pose a risk factor for other disease characteristics. [Conclusion] Differences in distribution of genotypes within different populations of the same ethnicity could be an important confounding factor responsible for the lack of validation of SNPs associated with radiation-induced toxicity, especially when extensive meta-analysis with subjects from different countries are carried out., This work was subsidized by a grant from the Instituto de Salud Carlos III (Ministerio de Economía y Competitividad from Spain), ID: PI12/01867. Almudena Valenciano has a grant from the Instituto Canario de Investigación del Cáncer (ICIC).