VEP (25.4% vs. 20.7%, p<0.04). Laparoscopic approach was more frequent in the VEP (43.2% vs. 37%, p<0.04). Partial nephrectomy and lymphadenectomy were performed less frequently in the older group (p<0.01, and p<0.02, respectively); there were no differences in surgical time, surgical margins, estimated blood loss (EBL), blood transfusions or complication rates. Length of stay was slightly longer in the VEP (4AE4 vs. 4AE3 days, p<0.01). On multivariate regression analysis, EBL!500cc (OR 2.06, CI 95% 1.36-3.11, p<0.00) was independently associated with perioperative complications.CONCLUSIONS: Despite VEP having more comorbidities, worse performance status and more pT3-4 tumors, surgical resection of RCC is a safe and successful intervention in this subgroup. Perioperative outcomes are similar to their younger counterparts. Age alone should not guide decision making in these patients and treatment must be tailored according to performance status and severity of other comorbidities.

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We report a case of a 69-years-old man who presented with a solitary 1 cm nodule in the lower lobe of the left lung almost 3 years after radical prostatectomy for pT3aN0M0, Gleason score 4+3 disease, without evidence of osseous or lymphatic spread. Surgical resection of the pulmonary lobe confirmed the metastatic nature of the lesion, with subsequent reduction of serum PSA to undetectable levels. After 2 years from the metastasis resection, serum PSA is still undetectable, without the necessity of additional treatments. Solitary pulmonary metastases from prostate cancer (Pca) are rare in clinical practice, with only 29 previous cases described besides the one that we present.KEY WORDS: Prostate cancer; Recurrence; PSA. of the left lung, strongly suggesting a tumor. The patient was suspected to have a secondary lung metastasis. Since there was no evidence of metastatic disease in the remaining workup, the patient elected to undergo a thoracoscopic segmental resection with lymph node dissection. Histopathological examination revealed Pca metastasis with negative lymph nodes (Figure 1). Subsequently, PSA serum level dropped to undetectable levels (less than 0.05 ng/ml) and remained undetectable for more than 36 months. DISCUSSIONThe incidence of lung metastases from Pca is reported from 5% to 27%; however, it is a very rare condition in the absence of gross osseous or lymphatic involvement (1). Wallis and colleagues, in their recent literature review, found a total of only 18 cases of solitary metastatic Pca to lung and 15 cases of multiple metastases without osseous or lymphatic involvement (2). Until now, androgen deprivation therapy (ADT) is the cornerstone of treatment for PCa patients diagnosed with metastatic progression following primary treatment, although the optimal timing and schedule of ADT is still under debate in this setting (3).

Introduction and objectives: Impending erosion is an unusual complication of inflatable penile prosthesis that can strongly impact on patient’s morbidity and quality of life. In this case report we present a salvage surgery technique for impending erosion performed in a 57-year-old man. Materials and methods: We present our surgical technique for cylinder reimplantation in an impending erosion of a three-component inflatable prosthesis with a peno-scrotal access and extracapsular reseating of the cylinder. Results: No post-operative complication occurred, and the patient regained full function of the prosthesis after recovery. The surgical site healed well with no signs of infections. Conclusions: Impending erosion is a problematic complication of penile prosthesis; however, can be administered with a salvage technique avoiding the explant of the IPP.

The molecular mechanisms of muscle invasion in bladder cancer (BC) are still unknown. Based on the microRNA (miRNA) signature of BC by deep sequencing, we recently found that several double-stranded mature miRNAs derived from the same pre-miRNAs acted as tumor suppressors by regulating common target genes. In this study, we focused on miR-199 family members (miR-199a-3p/-5p and miR-199b-3p/-5p) that were downregulated in the signature. The aim of this study was to investigate the functional role of miR-199 family members and to identify molecular targets that contribute to tumor invasion in BC.METHODS: Expression levels of these miRNAs in 32 BC clinical samples and 12 normal bladder epithelia (NBE) and cell lines (T24 and BOY) were evaluated by qRT-PCR. Cell proliferation, migration, and invasion assays were performed in these miRNAs transfected BC cells. In silico analysis by using TargetScan and GEO database were applied to identify candidate target genes of these miRNAs. Luciferase reporter assays were carried out to determine whether these miRNAs directly bind to the target gene. We performed loss-of-function studies by using si-RNA transfectants to evaluate the functional role of target gene. We confirmed the target gene expression and the correlations between miR-199 family and the target gene expression by The Cancer Genome Atlas (TCGA) database (408 BCs and 19 NBE).RESULTS: The expression levels of these miRNAs were significantly reduced in clinical BCs (P < 0.005). Restoration of these miRNAs significantly inhibited cell migration and invasion in BC cells (P < 0.0001). Luciferase reporter assays identified integrin a3 (ITGA3) as a target gene directly regulated by these miRNAs. TCGA database showed that ITGA3 expression was significantly upregulated in BC compared with NBE (P ¼ 0.0063) and there were significant negative correlations between ITGA3 and miR-199 family expression (P < 0.05). Immunohistochemistry demonstrated ITGA3 expression was significantly upregulated in BCs compared with NBE (P ¼ 0.0038) and highly expressed in patients with advanced tumor stage (T2 or more) (P ¼ 0.048). Loss-of-function study showed that cell migration and invasion were significantly inhibited in si-ITGA3 transfectans (P < 0.0001).CONCLUSIONS: Recent studies showed that ITGA3 functions as extracellular matrix (ECM) receptor and contributes to cancer cell migration and invasion. Our data suggested that ITGA3 was directly regulated by miR-199 family and could be a novel therapeutic target in BC.