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Purpose: To evaluate if the density of interstitial cells of Cajal (ICC) in the ureteropelvic junction (UPJ) influences the outcomes of pyeloplasty in adults. Methods: Twenty-three patients with the diagnosis of ureteropelvic junction obstruction (UPJO) that underwent laparoscopic dismembered pyeloplasty were included. ICC density was measured using immunohistochemistry reaction for c-KIT expression in the resected UPJ segment. Pyeloplasty outcome was evaluated by patient self-report pain, urinary outflow using DTPA renogram and hydronephrosis assessment using ultrasound (US) at 12 months of follow-up. A logistic regression analysis was performed to assess the association of pyeloplasty outcomes and ICC density. Results: Low, moderate, and high ICC density were present in 17.4%, 30.4%, and 52.2% of the patients, respectively. Complete pain resolution was observed in 100%, 85.7%, and 75% of patients with low, moderate and high ICC density, respectively ( p = 0.791). DTPA renogram improved in 75%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( p = 0.739). Hydronephrosis improved in 25%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( p = 0.032). Conclusions: Patients with high ICC density have a significant amelioration of hydronephrosis after pyeloplasty. However, ICC density is not associated with functional outcomes.

Telomere dysfunction is one of the hallmarks of cancer, which puts telomere-associated genes in a prominent position in oncology. The CTC1-STN1-TEN1 (CST) complex is vital for telomere maintenance and participates in several steps of DNA metabolism, such as repair and replication, essential functions for malignant cells. Despite this, little is known about these genes in cancer biology. Here, using bioinformatics tools, we performed a study in 33 cancer types and over 10,000 TCGA samples analyzing the role of the CST complex in cancer. We obtained the somatic landscape and gene expression patterns of each of the subunits of the complex studied. Furthermore, we show that CST is important for genetic stability and nucleic acid metabolism in cancer. We identify possible interactors, transcription factors, and microRNAs associated with CST and two drugs that may disrupt their pathways. In addition, we show that CST gene expression is associated with cancer survival and recurrence in several tumor types. Finally, we show negative and positive correlations between immune checkpoint genes and CST in different types of cancer. With this work, we corroborate the importance of these genes in cancer biology and open perspectives for their use in other works in the field.

Introduction: specialists have an urge for biomarkers that can discriminate indolent prostate cancer from aggressive tumors. Ki67 is a proliferation marker, and its expression is associated with the aggressiveness of several cancers. Objective: analyze the expression of Ki67 in prostate cancer samples correlating with the aggressiveness of the disease. Methods: Ki67 mRNA levels were determined utilizing data from a TCGA cohort (Tumor(n)=492 and control(n)=52). The protein expression was determined on 94 biopsies from patients by immunohistochemical assay. Results: in mRNA, the Ki67 upregulation is associated with cancer tissue (p

The new identified protein telomeric zinc-finger associated protein (TZAP) is a negative regulator of telomere length. Since telomere length and telomere maintenance mechanisms are essential to cancer progression, TZAP is considered a new player in cancer biology. Here we aimed to analyze TZAP using the Cancer Genome Atlas data in a Pan-Cancer approach. We gathering data from TCGA Pan-Cancer studies utilizing cBioPortal, GEPIA and UALCAN. In total we analyzed 33 types of cancer (n=9664) and their respective controls (n=711). TZAP is transcribed in all cancers but less than 5% of all tumors show any somatic changes. TZAP was downregulated in kidney chromophobe carcinoma, and upregulated in esophageal cancer, head and neck squamous cell carcinomas, kidney renal clear cell carcinoma and in liver hepatocellular carcinoma. Globally, TZAP expression is related to favorable prognosis, associated to better overall and disease-free survival. Looking to specific tumors, TZAP expression has a dual behavior. Its downregulation is associated with poor prognosis in cervical squamous cell carcinoma, in kidney renal clear cell carcinoma, kidney papillary cell carcinoma, lung adenocarcinoma and pancreas adenocarcinoma. On the contrary, in adrenocortical carcinoma, colon and rectal cancer, brain lower grade glioma and prostate adenocarcinoma the upregulation of TZAP is related with poor prognosis. TZAP expression has a positive correlation with TRF1 and TRF2 in normal tissue but not in cancer. Our analyses indicate that TZAP has an important role in oncology and may be considered as a potential biomarker.

5085 Background: Patients (pts) with high-risk localized prostate cancer (HRLPC) have a significant risk of disease recurrence and metastasis after radical prostatectomy (RP). Neoadjuvant therapy remains investigational but there may be a role for the next-generation androgen signaling inhibitors. We sought to evaluate pathologic and imaging response after the intense neoadjuvant approach. Methods: This is a phase II investigator-initiated randomized trial of 3-month neoadjuvant therapy with goserelin (androgen deprivation therapy, ADT) + abiraterone acetate and prednisone (AAP arm) or AAP + apalutamide (A-APA arm) before RP for pts with HRLPC (Gleason ≥ 8 and/or cT3N0-1 and/or PSA ≥ 20 ng/mL). The primary endpoint was the rate of pathologic complete response (pCR) or minimal residual disease (MRD, tumor ≤ 0.5 cm). The secondary endpoints were safety, rate of residual cancer burden ≤0.25 cm3 (RCB = tumor volume x cellularity), Gallium 68 prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance correlates and rate of biochemical relapse (BR). Results: Sixty-two pts were randomized to A-APA (N = 31) or AAP (N = 31). Median age was 65 (range 47-77) years. NCCN risk groups included high-risk disease in 19%, very high-risk in 76% and regional (N1) disease in 5% (79% cT3, 65% Gleason 8-10, 57% PSA ≥ 20 ng/mL). Outcomes after intense neoadjuvant ADT are described in the Table. There was no statistically significant difference between study arms regarding pCR/MRD or RCB ≤ 0.25 cm3 rates. Patients with complete PSMA-PET response (psmaCR) demonstrated a RCB ≤ 0.25 cm3 rate of 50% compared to 7.5% in pts without a psmaCR ( P= 0.001). The rate of BR was 14% for pts with RCB ≤ 0.25 cm3 versus 38% in pts with RCB > 0.25 cm3 ( P= 0.118). At current median follow-up of 2.6 years, all patients with both psmaCR and RCB ≤ 0.25cm3 (N = 11, 18%) are free of BR. There were 2 grade (G) 5 adverse events (AEs) in the AAP arm (pulmonary embolism and sudden death, both after surgery). Nine (14.5%) pts (6 in A-APA; 3 in AAP) experienced G3-4 treatment-related AEs. The most common G3-4 AEs were hypertension (11.3%), AST/ALT elevations (3.2%) and skin rash (1.6%). Conclusions: No difference in pCR or MRD was observed between arms. Although pCR or MRD after intense neoadjuvant ADT was infrequent, a significant proportion of pts achieved a favorable pathologic response with RCB ≤ 0.25 cm3. PSMA-PET response is a potential surrogate for pathologic response. Clinical trial information: NCT02789878. [Table: see text]

Background Scaffolds have shown considerable progress in recent years. In orthopaedic surgery, scaffolds have been used as grafts in procedures involving tendon and ligament reconstruction. This paper aims to produce and evaluate decellularized tendon scaffolds from biomechanical, microscopic, macroscopic and in vivo perspectives.Methods Bilateral gastrocnemius muscle tendons from 18 (eighteen) adult New Zealand rabbits were collected. Of these 36 (thirty-six) tendons, 11 (eleven) were used as controls (Group A), and 25 (twenty-five) were used in the decellularization protocol (Group B). The groups were subjected to histological, biomechanical and macroscopic analyseis, and group B was subjected to an additional in vivo evaluation. Regarding the decellularization protocol, we used a combination of aprotinin, EDTA (ethylenediamine tetraacetic acid, 0,1% w/v), SDS (sodium dodecyl sulfate) and Triton X-100 (t-octyl-phenoxypolyethoxyethanol) for six days. During the six days, the scaffold was kept at room temperature on a shaker with constant rotation.Results The decellularized tendon scaffold showed an increased cross-sectional area and inter-fascicular distance, without changing parallelism or matrix organization. The nuclear material was not organized in the decellularized tendon scaffolds, as it was in the control. In the biomechanical analysis, a significant difference was not found between the groups after analysis of ultimate tensile load, stiffness, and elongation at the ultimate tensile load. During the in vivo evaluation, infiltration of mononuclear cells was noted.Conclusions The evaluated decellularization protocol efficiently made a decellularized tendon scaffold, maintained the most important biomechanical characteristics and permitted cell infiltration.

Functioning primarily in the rearrangement of identical pre-mRNA into different molecules, the alternative splicing (AS) contributes to the organism proteomic diversity. There are still unknown AS events, especially the aberrant splicing events that are associated to nonfunctional final products or tumorigenesis. For instance, hallmarks, such as apoptosis, metastasis, and angiogenesis, of certain types of cancer are known to be affected by some kind of aberrant splicing event. As examples, for BCLX gene, antiapoptotic and proapoptotic isoforms have been discovered, and, for the VEGFA gene, changes between proangiogenic and antiangiogenic isoforms expression have been detected in tumors and normal-matched samples, as well as among several distinct tissues. We hypothesize that AS events can also be associated and contribute to the origin and maintenance of specific tumor types and sub-types. We characterized the AS events in 35 samples of primary bladder tumors, classified as 20 high-grade (cells poorly differentiated, invasive and metastatic tumor), 11 low-grade (cell differentiated, noninvasive tumor), and 5 normal tissues. To access the AS events, we generated in total 2.5 billion of reads using RNAseq. The next step was mapping these reads against the human reference genome, using a set of in-house and publicly available pipelines to detect AS events in high-/low-grade bladder samples and normal tissues. As result, we observed 992 significant splicing events on high-grade tumors as compared to normal samples, 796 significant events on low-grade versus normal samples, and 871 significant events on low-grade versus high-grade tumors. After looking for some of these events in combinations of tumor grades and control, we found a tumor-specific isoform for RPS24 gene and five splicing events of genes RPL13A, RPL3, RPL37A, RPS27A, and RPL34 that are unique to high-grade tumors. We believe that these low-/high-grade AS specific events should be further studied in order to contribute to the understanding and to the development of new drugs for bladder tumors presenting low- or high-grade. Citation Format: André Luiz Ventura Sávio, Ricardo Piuco, Katia Ramos Moreira Leite, Daisy Maria Favero Salvadori, Pedro Alexandre Favoretto Galante, Luiz Otavio Ferraz Penalva. Analysis of alternative splicing events in high- and low-grade bladder tumors [abstract]. In: Proceedings of the AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; São Paulo, Brazil. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(1_Suppl):Abstract nr A26.

Primary lymphoma of the liver is an extremely rare entity. A case of anaplastic large B-cell (both CD-20 and lambda positive) non-Hodgkin's lymphoma that was confined to the liver in a 33-year-old man is reported. The patient was treated with an extended right hepatectomy and combination chemotherapy: cyclophosphamide, adriamycin, vincristine, and prednisone. The patient was disease free 24 months after the procedure.O linfoma primário do fígado é uma entidade extremamente rara. Os autores relatam um caso de linfoma não-Hodgkin de células B grandes anaplásicas (positivo para CD-20 e Lambda) em um paciente do sexo masculino de 33 anos. O tumor estava localizado no lobo hepático direito e foi tratado por hepatectomia direita ampliada e quimioterapia pós-operatória com ciclofosfamida, adriamicina, vincristina e prednisone. Vinte quatro meses de seguimento o paciente encontra-se sem recidiva tumoral.

INTRODUÇÂO:O Câncer de Próstata (CaP), possui alta prevalência e representa um importante problema de saúde, com forte impacto econômico se considerarmos o rastreamento, diagnóstico, tratamento e a mortalidade pela doença. Com o avanço da metodologia do CRISPR, novas possibilidades se abriram para o entendimento e controle dos mecanismos de resistência celular. A edição gênica pela técnica de CRISPR-Cas9 é efetiva na correção de mutações celulares que promovem resistência. O microRNA-21, que atua sobre o gene supressor tumoral RECK e o oncogene MMP-9, apresenta um papel importante no processo de migração e invasão das células tumorais para outros tecidos, gerando metástases. Devido à importância destas moléculas na carcinogênese, são necessárias maiores investigações sobre o seu papel no CaP. OBJETIVO:Avaliar o papel da MMP-9 e seu regulador indireto miR-21 no CaP, com a edição gênica pela técnica de CRISPR-Cas9. MÉTODOS: Inicialmente foi feita a inserção das sequências de RNAs guia (sgRNA) da MMP9 e miR-21 no plasmídeo PX-330. Em seguida, os plasmídeos com os insertos para MMP-9 foram transfectados em linhagens celulares de CaP DU145 e PC-3M-luc-C6. Foi feita a análise da expressão gênica e proteica da MMP9 por qPCR e Western Blotting, e a imunofluorescência. Os genes alvo do miR-21, incluindo RECK, MARKS, BTG2, PDCD4, as integrinas ITGB1 e ITGB3, CDH1, BAX e mTOR, foram avaliados por qPCR. Foi feita a citometria de fluxo para validar a expressão proteica relacionada à apoptose e proliferação celular, em células editadas para MMP9 e miR-21, utilizando os marcadores Annexin5 e 7-AAD, eKi67 respectivamente. Foi feito o ensaio de invasão com matrigel, e as células foram analisadas 48 horas após, com microscopia ótica. O grupo controle consistiu em células transfectadas com plasmídeo PX-330 sem as inserções de sgRNA(Scramble). O crescimento tumoral foi avaliado por um sistema de bioluminescência in vivo, após a injeção de 300 mil células, divididas em grupos, Scramble, editadas para MMP9 e miR-21 com CRISPR-Cas9 em camundongos Balb/c Nude. Esses animais foram acompanhados por 14 dias.RESULTADOS: Foi realizada a padronização das técnicas de digestão e inserção dos sgRNAs da MMP9 e miR-21 no plasmídeo PX-330, validadas por sequenciamento. Após essa etapa, observamos que as linhagens celulares transfectadas com o plasmídeo com sgRNA1 e 2 para MMP9 apresentaram GFP positivo, o que mostra a eficácia da transfecção. As células editadas para miR-21 com CRISPR-Cas9 apresentaram expressão gênica de RECK, MARKS, BTG2, e PDCD4 aumentadas em relação ao grupo Scramble. CDH1 e integrinas ITGB3 e ITGB1 foram aumentadas em células editadas para MMP9 e miR-21 com CRISPR-Cas9 quando comparado ao Scramble.O aumento do BAX e a diminuição da expressão de mTOR foram observados nas células editadas para MMP9 e miR-21 com CRISPR-Cas9 comparação ao grupo Scramble. Estes resultados foram validados por citometria de fluxo, mostrando a redução da proliferação e aumento da apoptose em células editadas para MMP9 e miR-21 com CRISPR-Cas9 quando comparados ao Scramble. No ensaio de invasão celular, observamos que as células editadas para MMP9 e miR-21 apresentam taxas de invasão inferiores às do grupo Scramble. Nos experimentos in vivo, o crescimento tumoral foi significativamente reduzido nos animais que receberam células editadas com CRISPR-Cas9 para MMP9, quando comparadas ao Scramble. Não encontramos diferença nos animais que receberam células editadas para miR-21. CONCLUSÃO: A edição gênica por CRISPR-Cas9 de MMP9 e miR-21 em linhagens celulares de CaP metastáticas modula fatores moleculares que atenuam a proliferação e invasão celular e estimulam a apoptose, possivelmente impedindo a evolução do tumor INTRODUCTION: Prostate Cancer (PCa) has a high prevalence and represents an important health problem, with a strong economic impact if we consider screening, diagnosis, treatment, and mortality from the disease. With the advance of CRISPR methodology, new possibilities have opened for the understanding and control of cellular resistance mechanisms. Gene editing by the CRISPR-Cas9 technique is effective in correcting cellular mutations that promote resistance. The microRNA-21, which acts on the tumor suppressor gene RECK and the oncogene MMP-9, has an important role in the process of migration and invasion of tumor cells into other tissues, generating metastases. Due to the importance of these molecules in carcinogenesis, further investigations of their role in PCa are needed. OBJECTIVE: To evaluate the role of MMP-9 and the indirect regulator miR-21 in PCa, with gene editing by CRISPR-Cas9 technique. METHODS: Initially, insertion of the MMP9 and miR-21 guide RNAs (sgRNA) sequences into the PX-330 plasmid was performed. Then, the plasmids with the inserts for MMP-9 were transfected into PCa DU145 and PC-3M-luc-C6 cell lines. MMP9 gene and protein expression analysis was performed by qPCR, Western Blotting, and immunofluorescence. The target genes of miR-21, including RECK, MARKS, BTG2, PDCD4, the integrins ITGB1 and ITGB3, CDH1, BAX and mTOR, were evaluated by qPCR. Flow cytometry was performed to validate protein expression related to apoptosis and cell proliferation, in cells edited for MMP9 and miR-21, using the markers Annexin5, 7-AAD andKi67 respectively. Matrigel invasion assays were performed, and cells were analyzed after 48 hours, with light microscopy. The control group consisted of cells transfected with plasmid PX-330 without the sgRNA insertions(Scramble). Tumor growth was assessed by an in vivo bioluminescence system in mice Balb/c Nude. After injection of 300.000 cells, divided into groups, Scramble, edited for MMP9 and miR-21 with CRISPR-Cas9 These animals were followed up for 14 days. RESULTS: We standardized the techniques of digestion and insertion of the sgRNAs of MMP9 and miR-21 into the plasmid PX-330, validated by sequencing. After this step, we observed that the cell lines transfected with the plasmid with sgRNA1 and 2 for MMP9 showed positive GFP, which shows the efficiency of the transfection. Cells edited for miR-21 with CRISPR-Cas9 showed increased gene expression of RECK, MARKS, BTG2, and PDCD4 compared to the Scramble group. CDH1 and integrins ITGB3 and ITGB1 were increased in cells edited for MMP9 and miR-21 with CRISPR-Cas9 when compared to Scramble. Increased BAX and decreased mTOR gene expression were observed in cells edited for MMP9 and miR-21 with CRISPR-Cas9 compared to the Scramble group. These results were validated by flow cytometry, showing reduced proliferation and increased apoptosis in cells edited for MMP9 and miR-21 with CRISPR-Cas9 compared to Scramble. In the cell invasion assay, we observed that cells edited for MMP9 and miR-21 have lower invasion rates than the Scramble group. In the in vivo experiments, tumor growth was significantly reduced in animals that received cells edited with CRISPR-Cas9 for MMP9 compared to Scramble. We found no difference in animals that received cells edited for miR-21. CONCLUSION: Gene editing by CRISPR-Cas9 for MMP9 and miR-21 in metastatic PCa cell lines modulates molecular factors that attenuate cell proliferation and invasion and stimulate cell apoptosis, possibly preventing PCa tumor evolution

INTRODUÇÃO: O câncer de próstata (CaP) é um tipo de tumor que apresenta alta dependência de andrógenos para a sua progressão. Em média, 35% dos casos diagnosticados evoluem para a resistência à castração, conferindo pior prognóstico e diminuição da taxa de sobrevida. Na tentativa de bloquear essa condição, comumente se faz o uso de terapias de privação androgênica. Entretanto, quando a doença adquire um fenótipo resistente, essas terapias deixam de ser eficazes. Alguns coativadores de andrógeno, como os que constituem a família p160 (SRC-1, SRC-2 e SRC-3), influenciam na transativação do receptor de andrógeno e frequentemente são identificados desregulados, nos casos com fenótipo resistente à castração. OBJETIVOS: Avaliar os níveis de expressão gênica dos coativadores p160 (SRC-1, SRC-2 e SRC-3) nos espécimes clínicos de CaP. Correlacionar os níveis de expressão gênica com os dados clínico patológicos dos pacientes. MATERIAIS E MÉTODOS: De forma retrospectiva, selecionamos 44 amostras de tecido prostático de pacientes com carcinoma prostático clinicamente localizados, submetidos à prostatectomia radical. Todos apresentaram recidiva bioquímica e realizaram tratamento hormonal. Nove desses pacientes evoluíram com boa resposta à terapia e 35 progrediram para resistência ao hormônio, com elevação dos níveis de antígeno prostático especifico (PSA). Para o grupo controle foram utilizadas amostras teciduais de cinco pacientes sem diagnóstico de câncer, provenientes de zona periférica da próstata. Para análise dos níveis de expressão gênica dos coativadores, obtivemos o RNA total das amostras através de métodos convencionais de extração. Em seguida realizamos a análise de qPCR, utilizando primers específicos para os genes selecionados. RESULTADOS: Encontramos uma superexpressão dos genes SRC-1 (p = 0,0482), SRC-2 (p = 0,0028), SRC-3 (p = 0,0330) e RA (p

INTRODUÇÃO E OBJETIVOS: O câncer de pênis (CaPe) é uma doença rara com alta morbidade e mortalidade. A carcinogênese não é totalmente compreendida e, embora alguns biomarcadores relacionados a prognóstico tenham sido descritos, até o momento nenhum foi adotado na prática clínica. Nosso objetivo foi identificar, através de varredura por microarray, os miRNAs diferencialmente expressos (DEmiR) entre tecido tumoral (TT) versus não neoplásico (TNN) e pacientes com doença metastática versus localizada, bem como identificar os genes diferencialmente expressos (DEG) entre estes grupos e realizar análise integrativa miRNA-mRNA propondo assim elucidar a via de tumorigênese e a descoberta de novos biomarcadores para o CaPe. MÉTODOS: Foram coletadas prospectivamente amostras frescas de TT e TNN adjacente de 24 pacientes com carcinoma espinocelular (CEC) de pênis operados em nossa instituição entre julho de 2015 a janeiro de 2018. Inicialmente, foram selecionados 5 pacientes com doença localizada e 6 com doença metastática linfonodal para realização do microarray. O RNA foi purificado e a análise de varredura com o microarray utilizou o miRNA 4.0 Genechip (Affymetrix). Foram identificados os DEmiRs entre TT e TNN utilizando-se o programa TAC (Affymetrix) com fold change (FC)>2,0, p1,5 e p0,78 (IL1A, MCM2, MMP1, MMP12, SFN e VEGFA). Na análise integrativa, encontramos 8 pares de miRNA-mRNA que mudaram significativamente sua relação, sendo a maior alteração observada para o par miR-432- 5p-TP53. Entre os DEGs da comparação entre os pacientes metastáticos e localizados encontramos 7 DEGs (CCND1, EGFR, ENTPD5, HOXA10, IGF1R, MYC, SNAI2), todos com boa acurácia (AUC>0,74) na distinção entre os grupos. Observamos correlações significativas entre maior expressão do MMP1 com tamanho tumoral (p=0,042), grau (p=0,045), estádio T patológico (p=0,018) e invasão perineural (p=0,007). O gene MMP1 é regulado pelo miR-145-5p que está subexpresso na amostra tumoral. Observamos também correlação entre maior expressão do CCND1 (p=0,006) e EGFR (p=0,001) com grau tumoral; e menor expressão de MMP9 com invasão microvascular (p=0,044). Nas curvas de sobrevida, a maior expressão dos genes CCND1, EGFR, GADD45A, MYC, SNAI2 e SRC e menor dos CDH1, CDKN1A, KLF4 e TP63 estavam associados a mortalidade por CaPe. A maior expressão dos genes FGF2, GADD45A, IL6, MYC, NES e NRP1 e a subexpressão do CDH1 foram correlacionadas a menor sobrevida global. CONCLUSÕES: Descrevemos uma assinatura molecular relacionada à carcinogênese do pênis baseada nas expressões dos miR-432-5p, miR-478b-3p, miR-145-5p, miR-30a-5p, miR-200a-5p, miR-224-5p, miR-31-3p e miR-31-5p e dos genes IL1A, MCM2, MMP1, MMP12, SFN e VEGFA. Identificamos um painel de potenciais biomarcadores de prognóstico no CaPe baseada na expressão dos miR-421, miR-744-5p, miR31-3p e dos genes CCND1, CDH1, CDKN1A, EGFR, ENTPD5, FGF2, GADD45A, HOXA10, IGF1R, KLF4, MMP1, MYC, NES, NRP1, SNAI2, SRC e TP63 INTRODUCTION AND OBJECTIVES: Penile cancer (PeCa) is a rare disease with high morbidity and mortality. Its carcinogenesis is not fully understood and, although some prognostic-related biomarkers have been described, none have been adopted in clinical practice to date. Our objective was to identify, through microarray scanning, the differentially expressed miRNAs (DEmiR) between tumor tissue (TT) versus nonneoplastic tissue (NNT) and patients with metastatic versus localized disease, as well as to identify the differentially expressed genes (DEG) between these groups and perform integrative miRNA-mRNA analysis thus proposing to elucidate the tumorigenesis pathway and the discovery of new biomarkers for PeCa. METHODS: Fresh samples of TT and adjacent NNT were prospectively collected from 24 patients with squamous cell carcinoma (SCC) of the penis operated on at our institution between July 2015 and January 2018. Initially, 5 patients with localized disease and 6 with metastatic disease were selected for microarray performance. The RNA was purified and microarray scanning analysis used the miRNA 4.0 Genechip (Affymetrix). The DEmiRs between TT and NNT were identified using the TAC program (Affymetrix) with fold change (FC)>2.0, p1.5 and p0.78 (IL1A, MCM2, MMP1, MMP12, SFN and VEGFA). In the integrative analysis, we found 8 pairs of miRNA-mRNA that significantly changed their relationship, with the greatest change being observed for the pair miR-432-5p-TP53. Among the DEGs in the comparison between metastatic and localized patients, we found 7 DEGs (CCND1, EGFR, ENTPD5, HOXA10, IGF1R, MYC, SNAI2), all with good accuracy (AUC>0.74) in the distinction between groups. We observed significant correlations between increased MMP1 expression and tumor size (p=0.042), grade (p=0.045), pathological T stage (p=0.018) and perineural invasion (p=0.007). The MMP1 gene is regulated by miR-145-5p which is under expressed in the tumor sample. We also observed a correlation between higher expression of CCND1 (p=0.006) and EGFR (p=0.001) with tumor grade; and lower MMP9 expression with microvascular invasion (p=0.044). In the survival curves, higher expression of genes CCND1, EGFR, GADD45A, MYC, SNAI2 and SRC and lower expression of CDH1, CDKN1A, KLF4 and TP63 were associated with mortality from PeCa. Higher expression of FGF2, GADD45A, IL6, MYC, NES and NRP1 genes and under expression of CDH1 were correlated with lower overall survival. CONCLUSIONS: We described a molecular signature related to penile carcinogenesis based on the expressions of miR-432-5p, miR-478b-3p, miR-145-5p, miR-30a-5p, miR-200a-5p, miR-224-5p, miR-31-3p and miR-31-5p and IL1A, MCM2, MMP1, MMP12, SFN and VEGFA genes. We identified a panel of potential prognostic biomarkers in PeCa based on the expression of miR-421, miR-744-5p, miR31-3p and the genes CCND1, CDH1, CDKN1A, EGFR, ENTPD5, FGF2, GADD45A, HOXA10, IGF1R, KLF4, MMP1, MYC, NES, NRP1, SNAI2, SRC and TP63

Introdução: As vias inflamatórias estão relacionadas aos mais diversos tipos de cânceres, onde os seus mediadores desempenham um papel fundamental na sobrevivência e crescimento das células tumorais. As prostaglandinas e leucotrienos são produzidos a partir do ácido araquidônico (AA) por meio das enzimas cicloxigenases (COX) e lipoxigenases (LOX) e estão presentes em grande quantidade nos tumores. Sabe-se que os eicosanoides contribuem com a progressão do câncer de próstata (CaP), promovendo a proliferação, motilidade celular, invasão e angiogênese. Para que ocorra este processo é necessário que o AA seja hidrolisado pela Fosfolipase A2 (PLA2). As enzimas PLA2 são uma grande família de proteínas subdivididas em seis classes com base na sua sequência de aminoácidos cuja expressão e atividade tem sido descrita em inúmeras neoplasias. Os estudos das PLA2 no CaP sugerem um papel dessas enzimas no seu comportamento, podendo representar um novo biomarcador. Nenhum estudo abordou de forma completa o perfil de expressão das PLA2 no CaP correlacionando-as com os principais fatores prognósticos e com o comportamento do CaP. Objetivo: Avaliar a expressão das PLA2 e identificar seu papel como marcador diagnóstico e prognóstico do CaP em espécimes de Prostatectomia Radical (PR). Materiais e métodos: Realizamos a análise de expressão das PLA2 por reação em cadeia da polimerase em tempo real quantitativa (qRT-PCR) em espécimes de PR de 108 pacientes. Correlacionamos os níveis de expressão com os fatores prognósticos clássicos do CaP e sobrevida livre de recidiva bioquímica e desenvolvimento de metástases. Resultados: Todas as PLA2 estudas se mostraram superexpressas no CaP em relação aos controles. A superexpressão das cPLA2 foram relacionadas com fatores de bom prognóstico, com maior destaque para a PLA2G4B mais expressa nos pacientes que não sofreram recidiva bioquímica (p = 0,016) (HR: 0,356). PLA2G4A foi mais expressa nos pacientes com doença órgão-confinada (p = 0,036). PLA2G4C relacionou-se com menor porcentagem de fragmentos positivos da biópsia (FR+) (p = 0,039) e a PLA2G4D apresentou maior expressão em pacientes com PSA < 10 ng/mL (p = 0,010). Considerando outras classes de PLA2, a PL2G16 se relacionou tanto com menor FR+ (p = 0,029) como também com ausência de metástases linfonodais (p = 0,039). Das sPLA2 a PLA1G1B associou-se a ausência metástases linfonodais (p = 0,029), a PLA2G2A se relacionou com PSA < 10 ng/mL (p = 0,046). Apenas PLA2G2D relacionou-se com pior grau de diferenciação histológica (ISUP) (p = 0,037). Conclusão: As PLA2 estão superexpressas no CaP e a análise individual de diferentes PLA2 demonstra uma relação maior com fatores prognósticos favoráveis, e maior sobrevida livre de recidiva bioquímica Introduction: The inflammatory pathways are related to the most diverse types of cancers, playing a fundamental role in tumor cell growth and survival. Arachidonic acids (AA) are transformed in prostaglandins and leukotrienes through the action of enzymes cyclooxygenases (COX) and lipoxygenases (LOX) and are present in large quantities in tumors. Eicosanoids are known to contribute to the progression of prostate cancer (PCa), promoting proliferation, cell motility, invasion and angiogenesis. For this process to occur, AA must be hydrolyzed by Phospholipase A2 (PLA2). PLA2 are a large family of enzymes divided into six classes based on the sequence of amino acids whose expression and activity has been searched in neoplasms. Characterization of PLA2 profile in PCa are important and may reveal new diagnosis and prognosis biomarkers. No study has addressed the complete expression profile of PLA2 in PCa correlating with the main prognostic factors and tumor behavior. Objective: to evaluate the expression of PLA2 in surgical specimens of radical prostatectomy (RP), correlating with the main prognostic factors and to biochemical free and metastasis free survival rates. Materials and method: PLA2 expression was searched by quantitative real-time polymerase chain reaction (qRT-PCR) in RP specimens from 108 patients. The expression levels of PLA2 were correlated with classical PCa prognostic factors and biochemical recurrence-free and metastasis-free survival rates. Results: All PLA2 were overexpressed in the PCa comparing to the controls. Overexpression of cPLA2 was associated with favorable prognostic factors, mainly PLA2G4B that was overexpressed in patients who did not suffer biochemical recurrence (p = 0.010) (HR: 0.356). PLA2G4A was overexpressed by organ-confined tumors (p = 0.036). PLA2G4C was related to lower percentage of positive biopsy fragments (FR+) (p = 0.039) and PLA2G4D was overexpressed by patients with PSA < 10 ng/mL (p = 0.010). PL2G16 was related to lower FR+ (p = 0.029) and also to lymph nodes free of tumor (LF+) (p = 0.039). From sPLA2 to PLA1G1B was associated with the absence of LF+ (p = 0.029), PLA2G2A was associated with PSA < 10 ng/mL (p = 0.046). PLA2G2D was associated with unfavorable ISUP histological grading (p = 0.037). Conclusion: PLA2 are overexpressed in the PCa and are associated with favorable prognostic factors and better tumor behavior

O tratamento para o Carcinoma urotelial da Bexiga (CaUB) com invasão da camada muscular própria envolve a Cistectomia Radical (CR) e a linfadenectomia regional. A quimioterapia (QT) neoadjuvante baseada em Cisplatina apresenta melhora na sobrevida em 5 anos de 5 a 10%. Ao se estratificar os pacientes de acordo com o grau de resposta à QT observa-se sobrevida aos 5 anos de 80-90% para os quimiossensíveis, 30-40% para os quimiorresistentes e 50% para aqueles tratados com CR isolada. Neste contexto é importante selecionar os pacientes sensíveis à QT, que obteriam melhora da sobrevida com o tratamento combinado. Sabe-se que o CaUB é bastante heterogêneo em termos de alterações genéticas, expressão de RNA e proteínas. Neste estudo foram avaliados os marcadores imuno-histoquímicos (IHQ) que potencialmente confeririam resposta à QT neoadjuvante em CaUB invasivos submetidos a CR. Entre 2009 e 2016, 384 pacientes foram operados no Instituto do Câncer do Estado de São Paulo (ICESP), sendo que 52 receberam QT neoadjuvante e 25 tinham os espécimes cirúrgicos disponíveis, tanto da primeira intervenção cirúrgica (Ressecção Transuretral - RTU) quanto da CR para avaliação. Este material foi objeto do estudo da expressão das proteínas, relacionando os achados à presença de resposta patológica à QT e à sobrevida. O intervalo médio entre o fim da QT e a cirurgia foi de 58,7 (+21) dias. Dezesseis (64%) pacientes vieram a óbito ao longo do tratamento com um tempo médio de 49,3 (+52,7) dias. Dez (40%) pacientes apresentaram resposta à QT. Foram identificadas Variantes Histológicas do CaUB em 36% dos casos e nenhum desses pacientes respondeu à QT neoadjuvante (p=0,002). O biomarcador Anidrase Carbônica 9 (CAIX) foi expresso por 53% dos não-respondedores sendo negativo em todos os pacientes que responderam à QT. Nossos resultados mostram que expressão de CAIX (p=0,005) e a presença de variantes histológicas no CaUB são potenciais biomarcadores de não-resposta à QT neoadjuvante e podem ser facilmente usados na prática clínica Treatment for muscle-invasive urothelial bladder cancer (MIBC) involves radical cystectomy (RC) and regional lymphadenectomy. Neo-adjuvant chemotherapy (NAC) based on platinum improves 5-year survival from 5 to 10%. A 5-year survival rate of 80-90% for chemosensitive patients, 30-40% for chemoresistant patients, and 50% for those treated with isolated RC were observed when patients were stratified. It is crucial to select patients sensitive to QT who have better survival outcomes using combined treatment. It is known that MIBC is quite heterogeneous in terms of genetic alterations, RNA, and protein expression. In this study, immunohistochemical markers that could potentially confer response to neoadjuvant QT in MIBC treated with RC were evaluated. Between 2009 and 2016, 384 patients underwent surgery at the Cancer Institute of the State of São Paulo (ICESP). Of those, 52 received neoadjuvant chemotherapy, and surgical specimens were available from 25 patients, both from the first surgical intervention (Transurethral Resection) and RC. The protein expression of the surgical specimens was evaluated to relate the presence of pathological response to QT and survival. The average interval between the end of chemotherapy and surgery was 58.7+ 21 days. Sixteen (64%) patients died during treatment (mean 49.3+ 52.7 days). Ten (40%) patients responded to the QT. MIBC histological variants were identified in 36% of the cases, and none of these patients responded to neoadjuvant chemotherapy (p=0.002). The biomarker Carbonic Anhydrase IX (CAIX) was expressed by 53% of non-responders and was negative in all patients responding to QT. Our results show that CAIX expression (p=0.005) and the presence of histological variants in MIBC are potential biomarkers for non-responders to neoadjuvant QT and can be used in clinical practice

INTRODUÇÃO: O câncer de próstata (CP) apresenta desafios importantes tanto no momento do diagnóstico quanto no momento do tratamento. A ressonância nuclear magnética da próstata (RNMp) é um método de avaliação com crescente utilização em diversas fases do diagnóstico e a prostatectomia radical assistida por robô (PRAR) consolidou-se como opção no tratamento do CP devido à sua menor agressividade. Entretanto, a possibilidade de ocorrência de resultados funcionais e oncológicos desfavoráveis ainda são grandes preocupações. Dessa forma, surge a necessidade de busca por preditores de disfunção erétil (DE), incontinência urinária (IU) e recorrência bioquímica (RB) pós-PRAR. Este trabalho tem o objetivo de avaliar se determinados parâmetros de RNMp têm a capacidade de predizer RB, IU e DE em pacientes submetidos à PRAR. Outro objetivo do trabalho é avaliar se um novo parâmetro denominado densidade de antígeno prostático específico da lesão neoplásica (DLN) tem a capacidade de predizer RB em pacientes submetidos à PRAR. MÉTODOS: Trata-se de um estudo longitudinal, retrospectivo e quantitativo analítico. Para análise dos parâmetros de RNMp foram incluídos 53 pacientes e, para análise da DLN, 219 pacientes. As imagens de RNMp foram resgatadas do banco de dados das clínicas de radiologia nas quais os pacientes realizaram os exames. As séries de imagens foram revisadas por dois radiologistas com experiência em RNMp e os parâmetros foram testados como preditores de DE e RB. De posse das informações presentes no estudo anatomopatológico como peso da próstata e volume da próstata ocupada pelo tumor, foi estabelecido um cálculo para avaliar a DLN. Este parâmetro foi testado como preditor de recorrência bioquímica. RESULTADOS: O único parâmetro de RNMp que apresentou correlação estatisticamente significante (p=0,01) com a variável RB foi a presença de contato significativo do tumor com a cápsula prostática (CSC). Em relação ao desfecho DE, houve correlação com significância estatística (p=0,02) nas análises relativas às áreas máximas dos feixes vasculonervosos no meio (AMXM) e na base prostática (AMXB). Notou-se, também, correlação estatisticamente significativa entre DE e acometimento de vesículas seminais (AVS) na RNMp pré-operatória(p=0,03). A respeito da variável DLN, a média dos pacientes que não evoluíram com RB foi de 0,54. Já a média dos pacientes recidivados foi de 0,68 (p=0,03). CONCLUSÕES: A presença de CSC na RNMp pré-operatória e a DLN têm a capacidade de predizer RB. A AMXB, a AMXM e a presença de sinais de AVS na RNMp têm a capacidade de predizer a ocorrência de DE em pacientes submetidos à PRAR. INTRODUCTION: The prostate cancer (PC) presents important challenges both at the time of diagnosis and at the time of treatment. Prostate magnetic resonance imaging (pMRI) is an evaluation method with increasing use in several stages of diagnosis. Robot-assisted radical prostatectomy (RARP) has consolidated as an option in the treatment of PC due to its low aggressiveness. However, the possibility of unfavorable functional and oncological outcomes are still major concerns. Thus, it is necessary to search for predictors of erectile dysfunction (ED), urinary incontinence (UI) and biochemical recurrence (BR) after RARP. This study aims to assess whether certain parameters of pMRI have the ability to predict BR, UI and ED in patients undergoing RARP. Another purpose of the work is to evaluate whether a new parameter called density of neoplastic lesion-specific prostatic antigen (DLN) has the ability to predict BR in patients undergoing RARP. METHODS: This is a longitudinal, retrospective, quantitative analytical study. For analysis of the parameters of pMRI, 53 patients were included and for analysis of the DLN, 219 patients. The pMRI images were retrieved from the database of radiologic centers in which patients underwent examinations. The series of images were reviewed by two radiologists with experience in pMRI and the parameters were tested as predictors of ED and BR. With the information present in the anatomopathological study such as weight of the prostate and volume of the prostate occupied by the tumor, a calculation was established to assess the DLN. This parameter was tested as a predictor of biochemical recurrence. RESULTS: The only parameter of pMRI that showed a statistically significant correlation (p = 0.01) with the BR variable was the presence of significant contact between the tumor and the prostatic capsule (CSC). Regarding the ED outcome, there was a statistically significant correlation (p = 0.02) in the analyzes related to the maximum areas of the neurovascular bundles in the medium (AMXM) and in the prostatic base (AMXB). There was also a statistically significant correlation between ED and seminal vesicles invasion (SVI) in preoperative MRI (p = 0.03). Regarding the DLN variable, the mean number of patients who did not progress with BR was 0.54. The mean number of recurrent patients was 0.68 (p = 0.03). CONCLUSION: The presence of CSC in preoperative pMRI and DLN have the ability to predict BR. The AMXB, the AMXM and the presence of signs of SVI in pMRI have the ability to predict the occurrence of ED in patients undergoing RARP.

Introdução: O Câncer de Próstata (CaP) metastático é uma doença incurável cujo tratamento tradicional e mais eficiente é o bloqueio androgênico. Essa modalidade, entretanto, tem papel limitado e após período médio de cinco anos os tumores adquirem o status resistente à castração, sendo nessa fase as opções terapêuticas muito limitadas. O conhecimento de vias moleculares vem propiciando o desenvolvimento de moléculas ou anticorpos para serem utilizados como terapia alvo em diversos tipos de câncer. Os microRNAs (miRNAs) são pequenas moléculas, fundamentais para o controle da expressão de genes e a alteração de sua expressão tem sido descrita no processo de carcinogênese do CaP. Neste estudo avaliamos um possível papel dos miRNAs 100 e 145 em modelo in vivo de CaP metastático, no controle de seus genes alvo, KRAS, cMYC e SMARCA5. Objetivo: Analisar a atividade dos miRNAs 100 e 145 no tratamento do CaP metastático em camundongos atímicos e estudar os efeitos desse tratamento nos níveis de expressão de seus genes alvo cMYC, KRAS, mTOR e SMARCA5 no tecido tumoral. Métodos: Para a indução do CaP metastático, os camundongos machos Balb/c nude foram inoculados com células PC-3M-luc-C6 (linhagem bioluminescente) intra venticular esquerdo. Após a o estabelecimento da doença metastática, no dia 21, os animais foram separados em grupos de tratamentos com o miR-100, anti-miR-100 e miR-145 e seus respectivos controles negativos, associados ao atelocolágeno através de três injeções por via sistêmica com intervalos de 3 dias. As imagens do crescimento tumoral foram obtidas no equipamento IVIS (Spectrum). Três dias pós a última dose de tratamento (dia 30), os animais foram eutanasiados e o tecido tumoral foi avaliado por PCR quantitativo em tempo real (qRT-PCR) para determinação do nível de expressão dos miRNAs 100 e 145 e de seus genes alvo cMYC, KRAS, mTOR e SMARCA5. Resultados: O grupo de animais tratado com miR-145 apresentou a menor velocidade de crescimento tumoral. O grupo tratado com miR-100 mostrou maior expressão intratumoral de miR-100 e subexpressão de mTOR. SMARCA5 esteve superexpresso neste grupo. Os animais tratados com anti-miR-100 mostraram redução na expressão de miR-100 intratumoral, subexpressão de mTOR e ausência de alterações em SMARCA5. No grupo tratado com miR-145 houve aumento dos níveis de expressão de miR-145 e redução dos níveis de KRAS e cMYC. Conclusão: Demonstramos em modelo in vivo o efeito dos miRNAs 100 e 145 sobre o crescimento tumoral e no controle de expressão de seus genes alvo mTOR, cMYC e KRAS Introduction: Metastatic prostate cancer (PC) is an incurable disease which treatment is based on the androgen deprivation. Although efficient at the beginning, after a mean period of 5 years, tumor acquires a castration-resistant status, when therapies have less efficacy. The knowledge of molecular pathways involved with progression of PC have been responsible for the development of molecules and antibodies, improving the survival in many types of cancer. microRNAs are small molecules related to gene expression control, and alterations in their expression profile have been described in PC. In this study we evaluated the expression levels of target genes of miR-100 and 145, KRAS, cMYC, mTOR and SMARCA5 and their effects in an in vivo model of metastatic PC. Objective: To analyze the activity of miRNAs 100 and 145 in the treatment of metastatic PC in nude mice, and to study the effects of the miRNAs over their target genes KRAS, cMYC, mTOR and SMARCA5 in tumor tissue. Methods: Male Balb/c nude mice were inoculated with bioluminescent PC-3M-luc-C6 cell line. After the development of metastatic disease, on day 21, the animals were treated with miR-100, anti-miR-100 and miR-145, and their respective controls systemically with 3 days interval between them. In vivo images were obtained using the IVIS (Spectrum) equipment. Three days after the last dose (day 30), animals were sacrificed, and tumor tissues were stocked for molecular analysis. Expression levels of miR-100, miR-145 and their target controls, KRAS, cMYC, mTOR and SMARCA5 were detected by quantitative, real-time PCR (qRT-PCR). Results: Animals treated with miR-145 presented the lowest tumor growth among the groups. The examination of tumor tissue showed that miR-100 treated animals had high levels of miR-100 and lower expression of mTOR. SMARCA5 was underexpressed in this group. Animals treated with miR-145 showed higher expression of miR-145, and reduction in the levels of KRAS and cMYC compared to controls. Conclusion: We showed the effects of miR-100 and miR-145 over tumor growth and over the expression levels of their target genes mTOR, cMYC and KRAS in an in vivo model of metastatic PC

Introdução: O século XXI trouxe novos paradigmas na tecnologia da informação, com repercussões nos mais diversos aspectos da vida cotidiana. Aplicativos móveis, sites, softwares desenvolvidos para smartphones e tablets são cada vez mais utilizados na área da saúde, permitindo o suporte remoto ao paciente ou a autopromoção dos cuidados com a saúde. O rastreio do câncer de próstata (CP) permitiu o diagnóstico de CP em fases iniciais, resultando em procedimentos mais curativos, como a prostatectomia radical. Entre as principais complicações após a cirurgia estão a incontinência urinária e a disfunção erétil. No entanto, os números exatos relacionados a essas morbidades estão sempre escassos devido à breve entrevista durante a consulta no consultório médico. Portanto, o objetivo do estudo foi construir um aplicativo para coletar dados de pacientes sobre a recuperação após o tratamento em um ambiente informal e mais confortável. Métodos: O aplicativo foi construído usando o sistema IONIC Framework e aplicado aos pacientes através de um estudo prospectivo randomizado. Foram incluídos 100 pacientes divididos em dois grupos 1. Pacientes que usaram o aplicativo (n = 50) 2. Pacientes que responderam através de questionários impressos validados (grupo controle) (n = 50). Todos os pacientes receberam aconselhamento de alta para responder aos questionários 1, 3, 6 e 12 meses após o procedimento. O grupo de aplicativos após orientações verbais sobre como o monitoramento ocorreria recebeu um SMS com um nome de usuário e senha permitindo o acesso ao sistema e enviou alertas aos usuários para responder aos questionários. Resultados: O aplicativo desenvolvido é chamado UroHealth e está disponível para download na loja da Apple ou no site www.urohealth.com.br. A média de idade dos pacientes foi de 64,45 anos (± 8,33). Idade, PSA, volume da próstata, grau ISUP e estadiamento patológico foram semelhantes entre os grupos. Quando avaliamos as taxas de resposta, encontramos que 43,8% dos pacientes responderam ao questionário pré-operatório no grupo app, enquanto 16,3% responderam no grupo controle (p = 0,003). O acompanhamento em um, três, seis e 12 meses manteve taxas de resposta mais altas no grupo app, mas não houve significância estatística para nenhum deles (p > 0,05). Conclusão: O desenvolvimento de aplicativos, como o UroHealth, pode ser de grande valor no acompanhamento de pacientes após procedimentos cirúrgicos, permitindo informações de boa qualidade quanto à recuperação e morbidade relacionada ao tratamento. Nossos resultados iniciais indicam que pode se tornar uma ferramenta útil na obtenção de respostas mais frequentes e realistas, auxiliando na melhora das técnicas cirúrgica Introduction: The 21st century brought new paradigms in information technology, with repercussions in the most diverse aspects of daily life. Mobile applications, websites, softwares developed for smartphones and tablets are increasingly used in healthcare, allowing remote patient support or self-promotion of health care. The prostate cancer (PC) screening allowed PC diagnosis in early stages resulting in more curative procedures as radical prostatectomy. Among the main complications following surgery are urinary incontinence and erectile dysfunction. However, the exact numbers related to these morbidities are often missing due to the brief interview during consultation in the medical office. Therefore, the objective of the study was to build an app to collect data of patients regarding recovery after treatment in an informal and more comfortable environment. Methods:The app was built using the IONIC Framework system and applied to patients through a prospective randomized study. We included 100 patients divided into two groups 1. Patients who used the app (n = 50) 2. Patients who responded via validated printed questionnaires (control group) (n = 50). All patients received discharge counseling to respond to questionnaires 1, 3, 6 and 12 months after the procedure. The app group after verbal guidance on how the monitoring would occur received an SMS with a user name and password allowing access to the system and sent alerts to users to respond the questionnaires. Results: The app developed is called UroHealth and is available for download in the Apple store or at www.urohealth.com.br. The mean age of patients was 64.45 years-old (± 8.33). Age, PSA, prostate volume, ISUP grade and pathological staging were similar between groups. When we evaluated response rates, we found that 43.8% of the patients answered the preoperative questionnaire in the app group while 16.3% responded in the control group (p = 0.003). The follow up in one, three, six and 12 months maintained higher response rates in the app group, but there was no statistical significance for any of them (p > 0.05). Conclusion: The app development, such as UroHealth may be of great value in monitoring patients after surgical procedures, allowing information of good quality regarding recovery and morbidity related to treatment. Our initial results indicate that it may become a useful tool in obtaining more frequent and realistic answers, helping the improvement of surgical techniques