μ m bare-ended fibre. The results of the recently introduced 120-W Tm-YAG were compared to the established 70-W device. Kidney tissue was embedded for histological evaluation. After staining (haematoxylin and eosin, H&E; and NADH) of the specimen, the coagulation zone and depth of the necrotic tissue layer were measured. RESULTSWith increased power output, the mean ( SD ) rate of vaporization of tissue increased, from 9.80 (3.03) g/10 min at 70 W to 16.41 (5.2) g/ 10 min at 120 W using the 550 μ m fibre. The total amount of ablated tissue using the 800 μ m fibre was lower than with the 550 μ m fibre. With increasing power output the bleeding rate remained stable in either group. Tissue penetration remained shallow, even with increasing power output. In contrast to H&E staining, where the coagulation zone was measured, NADH staining showed an inner zone of necrotic tissue, again with no difference between the 70-and the 120-W Tm-YAG. CONCLUSIONThe 120-W Tm-YAG offers significantly higher ablation rates than the 70-W device, and despite the increased rate of ablation with the 120-W Tm-YAG, the bleeding rate and depth of tissue penetration were comparable to those using the 70-W device. KEYWORDSbenign prostatic enlargement, tissue ablation, coagulation, thulium : YAG, laser Study Type -Aetiology (case series) Level of Evidence 4 OBJECTIVETo evaluate the ablative and haemostatic properties of the recently introduced 120-W thulium:yttrium-aluminium-garnet (Tm-YAG) laser and to assess these results against those of the previously introduced 70-W Tm-YAG laser. MATERIALS AND METHODSThe ex-vivo model of the isolated bloodperfused porcine kidney was used to determine the ablation capacity, haemostatic properties and coagulation depth of a 2 μ m continuous-wave Tm-YAG laser. The energy was delivered using a 550-μ m and an 800-

FG is a strong prognostic factor for CSS in papRCC patients. In addition, patients older than 75 have worse CSM than patients younger than 50 years. These findings should be considered for clinical decision making.

The aim of this study was to analyze the impact of metabolic syndrome (MetS) on outcome of patients with localized renal cell carcinoma (RCC). A retrospective database was compiled consisting of 646 patients who underwent surgery for localized RCC between 2005 and 2014. A total of 439 patients were eligible for final analysis. For diagnosis of MetS, the WHO criteria of 1998 were used. Median follow-up was 32 months (ranging from 2 to 119). Kaplan-Meier and log-rank analyses were performed to compare patients with and without MetS or its components. Univariate and multivariate logistic regression identified prognostic factors for progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). In our cohort, 9.8% (n = 43) of patients were diagnosed with MetS. There were no differences between patients with and without MetS regarding clinicopathological parameters with the exception of patients' age (p = 0.002). Kaplan-Meier and log-rank analyses revealed a shorter PFS for patients with MetS (p = 0.018), whereas no differences were found for each of the single components of MetS, namely, diabetes mellitus (DM) (p = 0.332), BMI >30 kg/m (p = 0.753), hypertension (p = 0.451), and hypertriglyceridemia (p = 0.891). Logistic regression identified age (HR = 1.92, p = 0.03), tumor stage (HR = 4.37, p < 0.001), grading (HR = 4.57, p < 0.001), nodal status (HR = 3.73, p = 0.04), surgical margin (HR = 1.96, p = 0.04), concomitant sarcomatoid differentiation (HR = 5.06, p < 0.001), and MetS (HR = 1.98, p = 0.04) as independent factors for PFS. For CSS, only age (HR = 2.62, p = 0.035), tumor stage (HR = 3.06, p < 0.02), and grading (HR = 6.83, p < 0.001) were significant. In conclusion, patients with localized RCC and MetS show significantly reduced PFS and might profit from specific consultation and follow-up.