5069 Background: We previously reported that African American (AA) men have a higher recurrence rate than Caucasian (CA) men treated with radical prostatectomy at the New York Veteran Administration Medical Center (NY-VAMC), an equal access to care facility (J Urol. 2006). In the current study, we attempted to examine the differences in survival of AA and CA prostate cancer (PC) patients with clinically detected localized disease treated with non curative intent. We hypothesized that comparing patients whose PC was not altered by primary treatment might give a better idea about the difference, if any, of the natural history of PC in AA compared to CA patients. Methods: Men diagnosed with PC at NY-VAMC during 1990–2005 were identified. Inclusion criteria were: 1) biopsy confirmed PC; 2) no evidence of metastatic disease within 6 months after diagnosis; 3) no curative intent treatment. Results: The study included 530 men (288 AA and 242 CA) with median follow-up of 8.1 years (range: 0.6–17.6 years). AA men presented with significantly higher PSA compared to CA patients (median 18.5 versus 11.4 respectively, p = 0.004), however, there were no differences in age at presentation (median 73 versus 74, p = 0.98) or Gleason score (23% of AA and CA had Gleason >7, p = 0.92). Of the 530 patients, 198 (37%) are alive with disease, 67 (13%) died of prostate cancer, 206 (39%) died of other causes, and 59 (11%) died of unknown causes. AA patients had shorter median overall survival compared to CA patients (8 versus 9 years, respectively), however, the difference was not significant (p = 0.29). Factors most predictive of mortality by Cox regression multivariable analysis were PSA at diagnosis (p = 0.001), Gleason score (p = 0.04), and age of patient at diagnosis (p < 0.0001). Race was not an independent predictor of mortality in this model (p = 0.37). Competing risk analysis distinguishing the types of death is underway. Conclusions: The extended follow up available for our study cohort points to non PC related mortality as the major cause of death in patients treated with non-curative intent. No significant financial relationships to disclose.

MBCs) of CPC against diverse uropathogenic bacteria to design an optimal CPC instillation strategy for women with rUTI.METHODS: Following IRB approval, uropathogenic Escherichia coli (UPEC), Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa were isolated from urine collected from postmenopausal women with active rUTI. Serial two-fold dilutions of CPC were placed into a microtiter plate. Overnight cultures grown in Mueller Hinton (MH) broth were normalized to an OD 600 of 0.05 and were inoculated into each well. Following overnight static incubation at 37 C, growth was measured. The MIC was recorded as the lowest concentration of CPC for which no growth was visible. 10 mL from wells with no growth was spotted onto MH Agar (MHA). The concentration for which no growth occurred on MHA was recorded as the MBC.RESULTS: The MIC and MBC of CPC ranged from 0.0008% to 0.0016% for UPEC and from 0.0016% to 0.0063% for K. pneumoniae. P. mirabilis had an MIC of 0.0063% and MBC of 0.0125%. The MIC and MBC of CPC for P. aeruginosa were both 0.0125%. A CPC concentration as low as 0.0125% exhibited bactericidal activity against all tested uropathogens.CONCLUSIONS: This study determined that 0.0125% CPC shows bactericidal activity against diverse uropathogens. Future bladder instillation trials using 0.0125% CPC could potentially alleviate reported symptoms of bladder irritation. Continued work will focus on studying the cytotoxic effects of CPC against bladder epithelial cells and the pharmacodynamics of CPC through a time-kill kinetic assay.

INTRODUCTION AND OBJECTIVE:The research process is often conducted without the meaningful input of the patients it affects. To conduct truly patient-centered research, it is essential to engage patients through the entirety of the research process. There have been limited prior studies on patient-centered research prioritization in patients with bladder cancer (BCa), making it unclear what research topics are important. To address this, we established the Wisconsin Bladder Cancer Network (WiBCaN). This project aims to discover what research topics are important to BCa patients and their caregivers in the state of Wisconsin and to get them engaged in the research process.METHODS: Using prioritized research questions identified in previous research, we created a survey to identify important research topics via REDCap. This initial survey was designed to evaluate two domains: the patient experience and decision-making at the time of diagnosis. Beginning in December 2020, we engaged patients with BCa across the state of Wisconsin to complete the survey and join WiBCaN. Recruitment was conducted by email, telephone, mail, and in-person primarily from the senior author's panel of patients (KAR). The data from the first 105 respondents was analyzed.RESULTS: In the first three months of recruitment, 102 patients and three caregivers completed the survey. Patients' mean age was 70 (range 48-92) and the mean age of BCa diagnosis was 66 (range 40-88). 59% of patients had non-muscle invasive bladder cancer and 48% had undergone cystectomy. While it is clear that patients had a diverse range of experiences, many echoed similar priorities in their responses. In the domain of patient experience, further research on treatment/intervention was found to be the highest-ranked priority with 66% of respondents saying that stopping the disease from progressing is the most important aspect to them in their patient experience. Regarding decision-making at the time of diagnosis, the highest-ranked priority was the appropriate time for cystectomy when needed with 61% of respondents reporting it was the most important aspect for them in the decision-making process.CONCLUSIONS: WiBCaN successfully identified patient-reported research priorities and has laid the foundation for an engaged network of patients with BCa in the state of Wisconsin. While patients have reported a diverse range of experiences thus far, topics such as decisionmaking regarding timely cystectomy are clear priorities for study participants.

INTRODUCTION AND OBJECTIVE: Environmental exposures are potential risk factors for bladder cancer (BCa). Agent Orange (AO) was an herbicide used during the Vietnam War and has subsequently been labeled as a probable human carcinogen with potential links to BCa. In this study, we explore the effect of AO exposure on BCa outcomes in patients receiving Bacille-Calmette Guerin (BCG) for nonmuscle invasive BCa (NMIBC).METHODS: We retrospectively examined the association between AO exposure in patients with NMIBC in national VA databases who were being treated with BCG. We chose to include only patients receiving BCG to focus on a more homogeneous patient population. Patients were diagnosed with NMIBC from 2000-2010 with follow-up through 2018. Clinical, pathological, and demographic variables were compared by AO exposure. Associations of AO exposure with overall survival, cancer-specific survival, and progression-free survival were performed using Cox proportional hazard models after inverse propensity score weighted (IPSW) and competing risks adjustments.RESULTS: Overall, 7,651 patients were identified of which 753 (9.8%) were exposed to AO. The median follow-up time was > 10 years in both groups. The AO exposed patients were younger (age 61 vs 71 years, p <0.001), but had similar Charlson comorbidity scores and stage/grade distribution as the non-AO exposed patients. After IPSW adjustment in our Cox multivariable analyses, AO exposure was not associated with worse overall survival (HR 1.07, 95% CI 0.91-1.27, p[0.41), cancer-specific survival (HR 1.31, p[0.13), or progression-free survival (HR 1.08, 95% CI 0.86-1.36, p[0.51).CONCLUSIONS: AO exposure was not associated with worse oncologic outcomes in patients receiving BCG for NMIBC. While this is reassuring, additional research is needed in other patient populations and disease states to determine if the effect is consistent.

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