Report of the forth Asian Prostate Cancer (A-CaP) study meeting.

The Asian Prostate Cancer (A-CaP) Study is an Asia-wide prospective registry study for surveying the treatment outcome of prostate cancer patients who have received a histopathological diagnosis. The study aims to clarify the clinical situation for prostate cancer in Asia and use the outcomes for the purposes of international comparison. Following the first meeting in Tokyo on December 2015, the second meeting in Seoul, Korea 2016, the third meeting in Chiang Mai, Thailand, on October 2017, the fourth meeting was held in Seoul, again on August 2018 with the participation of members and collaborators from 13 countries and regions. In the meeting, participating countries and regions presented the current status of data collection and the A-CaP office presented a preliminary analysis of the registered cases received from each country and region. Participants discussed ongoing challenges relating to data cleaning and data up-dating which is the next step of the A-CaP study following the data collection phase between 2016 and 2018. There was specific difference in term of the patient characteristics, and initial treatment pattern among East Asia, Southeast Asia and Turkey, and Jordan. Finally, a close relationship between prevalence of PSA test and disease stage of the patients at diagnosis in Japan and Malaysia was discussed.

Advantage of the right lateral position compared with the lithotomy position during the perineal procedure in abdominoperineal resection.

BACKGROUND/AIMS: Abdominoperineal resection (APR) is generally performed in the lithotomy position (LT-APR). The aim of this retrospective study was to evaluate the advantage of the right lateral (RL) position during the perineal phase of APR, in extended APR (ext-APR) that needed additional excision of the pelvic organs and sacrococcyx, and in total pelvic exenteration (TPE). METHODS: The present study is based on 50 patients observed from January 1993 to December 2004 (43 with primary rectal malignancy, 7 with recurrent cancer), who had undergone the following surgeries: LT-APR was carried out in 20 patients, RL-APR in 13, LT-ext-APR in 5, RL-ext-APR in 8, LT-TPE in 2 and RL-TPE in 2. Perioperative factors were compared between the LT and RL position in each operative procedure. RESULTS: When RL-APR was compared with LT-APR, operative time (including the time to change the position) and the amount of operative blood loss were significantly less in RL-APR (mean +/- SE = 314 +/- 16 vs. 381 +/- 18 min, p = 0.0156 and 598 +/- 78 vs. 1,160 +/- 171 g, p = 0.0168, respectively). The blood loss and operative time were also significantly less in RL-ext-APR than in LT-ext-APR (1,060 +/- 170 vs. 3,590 +/- 1,270 g, p = 0.0277 and 353 +/- 31 vs. 488 +/- 41 min, p = 0.0219, respectively). The average blood loss and operative time were 4,190 g and 650 min in LT-TPE, and 1,450 g and 609 min in RL-TPE, respectively. CONCLUSION: The RL position during the perineal phase following the abdominal phase in the LT position significantly decreases blood loss and operative time in APR and ext-APR.