Introduction: The R.E.N.A.L Nephrometry Score (RNS) was developed to standardise the reporting of anatomical information of a renal mass. This study aimed to identify the association of preoperative clinical and tumor features assessed by the RNS with pathological upstaging of clinical T1 renal cell carcinomas (RCCs) in complete en bloc radical nephrectomy (RN) specimens. Materials and Methods: A review was performed for 65 consecutive RN patients (2005RN patients ( -2013, performed for a unilateral clinical T1N0M0 RCC. The RNS was measured in all patients based on preoperative computer-tomographic scans. Pathological review was performed to identify patients with final pathological upstaging. Associations were assessed with Fisher's exact test, student t test and Wilcoxon rank-sum test. Results: Of the 65 patients (41 male, mean age 59 years), 4 (6%) patients were upstaged to pT2 and 16 (25%) were upstaged to pT3a and above in the final histology. Upstaged patients were not significantly different from those without in terms of age, gender, race, surgical approach, side, grade and cell type. Independent tumor features associated with pathological upstaging were (R) tumor diameter (p = 0.021), and (L) central location within polar lines (p = 0.010). Tumors which were upstaged had a higher median total RNS than those without (9 vs. 10, p = 0.010). Complex tumors, with RNS ≥10, were associated with significantly increased risk of upstaging compared with low and intermediate complexity categories (RNS < 10) (RR = 2.56, 95% CI 1.22-5.37, p = 0.014). Conclusions: A higher RNS was associated with an increased risk of upstaging in clinical T1 cancers, predominantly from perinephric or sinus fat invasion in RN pathological specimens. This may have implications on the selection of surgical option for the clinical T1 renal mass. COP-02Long term results of a double-blind randomised controlled trial of interferon alpha-2b and low dose BCG in patients with high risk nonmuscle-invasive bladder cancer Introduction: Bacillus Calmette-Gu erin (BCG) immunotherapy, at full-dose in a maintenance schedule of 36 months, reduces recurrence and progression of high risk non-muscle-invasive bladder cancer (NMIBC). However, many patients do not complete the full course due to its toxicity or non-compliance. We report long-term results of a trial to evaluate the efficacy and toxicity of reduced dose Connaught-strain BCG with interferon alpha-2b (IFNa-2b). Material and Methods: This was a prospective, randomised, double-blinded, controlled, multi-institution clinical trial in which 140 patients with Stage Ta or T1 bladder cancer and/or CIS were assigned to one of three therapies following transurethral resection. Patients received 6weekly intravesical instillations of full-dose BCG (81 mg) or low-dose BCG (27 mg) or low-dose BCG plus IFNa-2b (10 MU) followed by 3 weekly booster instillations 6 weeks after the 6th instillation. They underwent close surveillance with regular cystoscopy and urine cytology. End points were time to local rec...