Incontinence after robot-assisted radical prostatectomy (RARP) is feared by most patients with prostate cancer. Many risk factors for incontinence after RARP are known, but a paucity of data integrates them. Prospectively acquired data from 680 men who underwent RARP January 2008–December 2015 and met inclusion/exclusion criteria were queried retrospectively and then divided into model development (80%) and validation (20%) cohorts. The UCLA-PCI-Short Form-v2 Urinary Function questionnaire was used to categorize perfect continence (0 pads), social continence (1–2 pads), or incontinence (≥3 pads). The observed incontinence rates were 26% at 6 months, 7% at 12 months, and 3% at 24 months. Logistic regression was used for model development, with variables identified using a backward selection process. Variables found predictive included age, race, body mass index, and preoperative erectile function. Internal validation and calibration were performed using standard bootstrap methodology. Calibration plots and receiver operating curves were used to evaluate model performance. The initial model had 6-, 12-, and 24-month areas under the curves (AUCs) of 0.64, 0.66, and 0.80, respectively. The recalibrated model had 6-, 12-, and 24-month AUCs of 0.52, 0.52, and 0.76, respectively. The final model was superior to any single clinical variable for predicting the risk of incontinence after RARP.

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106 Background: Using previously developed prostatectomy incontinence nomogram (PIN) we sought to externally validate the nomogram that predicts probability of incontinence at 6-, 12-, and 24-months after robot assisted radical prostatectomy (RARP). Methods: Prospective data from 663 men with prostate cancer that underwent RARP from 2010 to 2014 at two comprehensive cancer centers and three large group practices was queried. The performance of the previously developed model was evaluated using calibration plots (predicted continence rates versus observed continence rates with 95% CI obtained using Jeffrey’s prior method) and receiver operating curves (ROC). Using Expanded Prostate Cancer Index Composite (EPIC-50) Urinary Function questionnaire, perfect continence was defined as 0 pads, social continence was defined as 1 or 2 pads, and incontinence was defined as ≥ 3 pads used after RARP. Results: The 6-, 12-, and 24- month social continence rates were 77%, 88%, and 93%, respectively. Similar to the 6- and 12-month model development cohort, the external validation cohort has modest predictability with a 6- and 12- month AUC of 0.61, and 0.62, respectively. The 24-month AUC of 0.62 in the external validation cohort is worse than what was reported in the development cohort (AUC 0.80). Conclusions: The externally validated prostatectomy incontinence nomogram is generalizable but has modest 6-, 12-, and 12-month predictability in risk of incontinence after RARP.

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INTRODUCTION AND OBJECTIVES: Racial disparities among black and white men have been established in several urological malignancies including prostate and renal cancer. The purpose of this study is to compare socio-demographic factors and survival outcomes among black and white men with testicular cancer.METHODS: The National Cancer Database was queried to identify black and white men with testicular cancer diagnosed between 2004 and 2015. Baseline demographic characteristics included age at diagnosis, Charlson Comorbidity Index (CCI), insurance status, median household income by residence, education level, distance to facility, facility type, and stage at diagnosis. Frequencies and relative frequencies were compared using Chi-squared test. Kaplan-Meier method and Cox proportional hazards modeling were used to analyze survival and comparisons, respectively.RESULTS: A total of 62,705 men were included in our analysis, of which 60,566 (96.6%) were white and 2,139 (3.4%) were black. When compared to whites, blacks had significantly higher CCI (8.4% vs 6.2%; p<0.001), were less likely to be insured (17.6% vs 10.8%; p<0.001), and more likely to have stage III disease (16.6% vs 12.6%; p<0.001). Blacks had a lower median household income and education level. Blacks were more likely to be treated at an Academic/Research/ Integrated Network center (20.0% vs 13.9%; p<0.001), whereas whites were more likely to be treated at Community/Comprehensive Community centers (19.0% vs 14.6%; p<0.001). Blacks were more likely to live within a 10-mile radius of their treatment facility (62.3% vs 51.2%; p<0.001). Black men had a twofold increase in 30-day mortality (0.6% vs 0.3%; p<0.001) and 90-day mortality (1.3% vs 0.6%; p<0.001) when compared to white men. When compared to whites, blacks have a significantly lower 10-year overall survival (p<0.001). After controlling for insurance status, income, CCI, and stage, race continued to be a predictor of mortality (HR 1.122, p<0.001).CONCLUSIONS: Our analysis reinforces previously identified conclusions on racial disparities in testicular cancer using a larger and more current data set. After surveying the largest cohort of cancer patients nationwide to date, race continues to be an independent predictor of mortality in testis cancer.