100 results on '"Gontero P."'
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2. Lymphovaskuläre Invasion als prognostischer Faktor bei PatientInnen mit high grade T1 nicht-muskelinvasivem Urothelkarzinom der Harnblase
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Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, Shariat, SF, Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, and Shariat, SF
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- 2024
3. Die Auswirkungen von T1-Substaging auf das onkologische Überleben bei PatientInnen mit high grade nicht-muskelinvasivem Urothelkarzinom der Harnblase
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Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, Shariat, SF, Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, and Shariat, SF
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- 2024
4. Starkes Rauchen führt zu schlechteren Ergebnissen bei PatientInnen mit high grade T1 nicht-muskelinvasivem Urothelkarzinom der Harnblase
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Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, Shariat, SF, Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, and Shariat, SF
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- 2024
5. Starkes Rauchen führt zu schlechteren Ergebnissen bei PatientInnen mit high grade T1 nicht-muskelinvasivem Urothelkarzinom der Harnblase
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Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, Shariat, SF, Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, and Shariat, SF
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- 2024
6. Die Auswirkungen von T1-Substaging auf das onkologische Überleben bei PatientInnen mit high grade nicht-muskelinvasivem Urothelkarzinom der Harnblase
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Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, Shariat, SF, Laukhtina, E, Klemm, J, Fazekas, T, Matsukawa, A, Gontero, P, Soria, F, Babjuk, M, Teoh, JYC, Moschini, M, Karakiewicz, PI, Abufaraj, M, Compérat, E, and Shariat, SF
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- 2024
7. Vergleich der Energiequellen bei der En-bloc-Resektion von Blasentumoren: Post-hoc-Analyse der multizentrischen, prospektiven, randomisierten kontrollierten eBLOC-Studie
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Mancon, S, Ofner, H, Soria, F, Tsuboi, I, Hurle, R, Enikeev, D, Xylinas, E, Lusuardi, L, Heidenreich, A, Matsukawa, A, Gontero, P, Compérat, E, Shariat, SF, D'Andrea, D, Mancon, S, Ofner, H, Soria, F, Tsuboi, I, Hurle, R, Enikeev, D, Xylinas, E, Lusuardi, L, Heidenreich, A, Matsukawa, A, Gontero, P, Compérat, E, Shariat, SF, and D'Andrea, D
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- 2024
8. Is There an Impact of Transperineal Versus Transrectal Magnetic Resonance Imaging-targeted Biopsy on the Risk of Upgrading in Final Pathology in Prostate Cancer Patients Undergoing Radical Prostatectomy? An European Association of Urology-Young Academic Urologists Prostate Cancer Working Group Multi- institutional Study
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Zattoni, F, Marra, G, Martini, A, Kasivisvanathan, V, Grummet, J, Harkin, T, Ploussard, G, Olivier, J, Chiu, PK, Valerio, M, Marquis, A, Gontero, P, Guo, H, Zhuang, J, Frydenberg, M, Moon, D, Morlacco, A, Kretschmer, A, Barletta, F, Heidegger, I, Tilki, D, van den Bergh, R, Dal Moro, F, Briganti, A, Montorsi, F, Novara, G, Gandaglia, G, Zattoni, F, Marra, G, Martini, A, Kasivisvanathan, V, Grummet, J, Harkin, T, Ploussard, G, Olivier, J, Chiu, PK, Valerio, M, Marquis, A, Gontero, P, Guo, H, Zhuang, J, Frydenberg, M, Moon, D, Morlacco, A, Kretschmer, A, Barletta, F, Heidegger, I, Tilki, D, van den Bergh, R, Dal Moro, F, Briganti, A, Montorsi, F, Novara, G, and Gandaglia, G
- Abstract
BACKGROUND: The concordance rates of transperineal (TP) versus transrectal (TR) prostate biopsies with radical prostatectomy (RP) specimen have been assessed poorly in men diagnosed with magnetic resonance imaging (MRI)-targeted biopsy (TBx). OBJECTIVE: To evaluate International Society of Urological Pathology (ISUP) concordance rates between the final pathology at RP and MRI-TBx or MRI-TBx + random biopsy (RB) according to the biopsy approach. DESIGN, SETTING, AND PARTICIPANTS: A multi-institutional database included patients diagnosed with TP or TR treated with RP. INTERVENTION: TP-TBx or TR-TBx of the prostate. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The ISUP grade at biopsy was compared with the final pathology. A multivariable logistic regression analysis (MVA) was performed to assess the association between the biopsy approach (TP-TBx vs TR-TBx) and ISUP upgrading, downgrading, concordance, and clinically relevant increase (CRI). RESULTS AND LIMITATIONS: Overall, 752 (59%) versus 530 (41%) patients underwent TR versus TP. At the MVA, TP-TBx was an independent predictor of upgrading (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4-0.9, p < 0.01) and improved concordance relative to the final pathology (OR 1.7, 95% CI 1.2-2.5, p < 0.01) after adjusting for age, cT stage, Prostate Imaging Reporting and Data System, number of targeted cores, prostate-specific antigen, and prostate volume. Moreover, TP-TBx was associated with a lower risk of CRI than TR-TBx (OR 0.7, p < 0.01). This held true when considering patients who underwent MRI-TBx + RB (OR 0.6, p < 0.01). The inclusion of men who had RP represents a potential selection bias. CONCLUSIONS: The adoption of TP-TBx compared with TR-TBx may reduce the risk of upgrading and improve the concordance of biopsy grade with the final pathology. The TP approach decreases the odds of CRI with improved patient selection for the correct active treatment. PATIENT SUMMARY: In this report, we evaluated whether tra
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- 2023
9. High-quality Transurethral Resection of Bladder Tumour Needs Additional Forms of Tumour Delineation.
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Stenzl, A., Rouprêt, M., Witjes, J.A., Gontero, P., Stenzl, A., Rouprêt, M., Witjes, J.A., and Gontero, P.
- Abstract
Item does not contain fulltext, Good-quality transurethral resection of non-muscle-invasive bladder cancer may change the course of the disease. Multiple prospective trials have confirmed the efficacy of photodynamic diagnosis in detecting tumours and thus facilitating adequate resection.
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- 2023
10. High-quality Transurethral Resection of Bladder Tumour Needs Additional Forms of Tumour Delineation.
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Stenzl, A., Rouprêt, M., Witjes, J.A., Gontero, P., Stenzl, A., Rouprêt, M., Witjes, J.A., and Gontero, P.
- Abstract
Item does not contain fulltext, Good-quality transurethral resection of non-muscle-invasive bladder cancer may change the course of the disease. Multiple prospective trials have confirmed the efficacy of photodynamic diagnosis in detecting tumours and thus facilitating adequate resection.
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- 2023
11. Prognosis of Primary Papillary Ta Grade 3 Bladder Cancer in the Non-muscle-invasive Spectrum
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Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Subiela Henríquez, J.D., Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Claps, F., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, T.H. van der, Babjuk, M., Sylvester, R.J., Rhijn, B.W.G. van, Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Subiela Henríquez, J.D., Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Claps, F., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, T.H. van der, Babjuk, M., Sylvester, R.J., and Rhijn, B.W.G. van
- Abstract
Contains fulltext : 294430.pdf (Publisher’s version ) (Open Access), BACKGROUND: Ta grade 3 (G3) non-muscle-invasive bladder cancer (NMIBC) is a relatively rare diagnosis with an ambiguous character owing to the presence of an aggressive G3 component together with the lower malignant potential of the Ta component. The European Association of Urology (EAU) NMIBC guidelines recently changed the risk stratification for Ta G3 from high risk to intermediate, high, or very high risk. However, prognostic studies on Ta G3 carcinomas are limited and inconclusive. OBJECTIVE: To evaluate the prognostic value of categorizing Ta G3 compared to Ta G2 and T1 G3 carcinomas. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5170 primary Ta-T1 bladder tumors from 17 hospitals were analyzed. Transurethral resection of the tumor was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Time to recurrence and time to progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox-regression models with interaction terms stratified by institution. RESULTS AND LIMITATIONS: Ta G3 represented 7.5% (387/5170) of Ta-T1 carcinomas of which 42% were classified as intermediate risk. Time to recurrence did not differ between Ta G3 and Ta G2 (p = 0.9) or T1 G3 (p = 0.4). Progression at 5 yr occurred for 3.6% (95% confidence interval [CI] 2.7-4.8%) of Ta G2, 13% (95% CI 9.3-17%) of Ta G3, and 20% (95% CI 17-23%) of T1 G3 carcinomas. Time to progression for Ta G3 was shorter than for Ta G2 (p < 0.001) and longer than for T1 G3 (p = 0.002). Patients with Ta G3 NMIBC with concomitant carcinoma in situ (CIS) had worse prognosis and a similar time to progression as for patients with T1 G3 NMIBC with CIS (p = 0.5). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS: The prognosis of Ta G3 tumors in terms of progression appears to be in between that of Ta G2 and T1 G3. However, patients with Ta G3 NMIBC with concomitant CIS have worse prognosis that is compar
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- 2023
12. Perioperative Outcomes of Open, Laparoscopic, and Robotic Partial Nephrectomy: A Prospective Multicenter Observational Study (The RECORd 2 Project)
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Bravi, C, Larcher, A, Capitanio, U, Mari, A, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Bove, P, Brunocilla, E, Da Pozzo, L, Di Maida, F, Fiori, C, Gontero, P, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Porpiglia, F, Schiavina, R, Schips, L, Simeone, C, Siracusano, S, Terrone, C, Trombetta, C, Volpe, A, Montorsi, F, Ficarra, V, Carini, M, Minervini, A, Bravi C. A., Larcher A., Capitanio U., Mari A., Antonelli A., Artibani W., Barale M., Bertini R., Bove P., Brunocilla E., Da Pozzo L., Di Maida F., Fiori C., Gontero P., Li Marzi V., Longo N., Mirone V., Montanari E., Porpiglia F., Schiavina R., Schips L., Simeone C., Siracusano S., Terrone C., Trombetta C., Volpe A., Montorsi F., Ficarra V., Carini M., Minervini A., Bravi, C, Larcher, A, Capitanio, U, Mari, A, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Bove, P, Brunocilla, E, Da Pozzo, L, Di Maida, F, Fiori, C, Gontero, P, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Porpiglia, F, Schiavina, R, Schips, L, Simeone, C, Siracusano, S, Terrone, C, Trombetta, C, Volpe, A, Montorsi, F, Ficarra, V, Carini, M, Minervini, A, Bravi C. A., Larcher A., Capitanio U., Mari A., Antonelli A., Artibani W., Barale M., Bertini R., Bove P., Brunocilla E., Da Pozzo L., Di Maida F., Fiori C., Gontero P., Li Marzi V., Longo N., Mirone V., Montanari E., Porpiglia F., Schiavina R., Schips L., Simeone C., Siracusano S., Terrone C., Trombetta C., Volpe A., Montorsi F., Ficarra V., Carini M., and Minervini A.
- Abstract
Background: Partial nephrectomy (PN) has a non-negligible perioperative morbidity. Comparative evidence of the available surgical techniques is limited. Objective: To compare the perioperative outcomes of open, laparoscopic, and robotic PN. Methods: Data of 2331 patients treated with PN for cT1 renal tumors were extracted from the RECORd2 database, a prospective multicenter project. Multivariable regression models assessed the relationship between surgical technique and surgical margins, warm ischemia time, postoperative complications, and acute kidney injury (AKI). The probability of achieving a modified trifecta (negative margins, warm ischemia time <25 min, and no Clavien–Dindo ≥2 complications) was examined for each surgical approach. Results: Minimally invasive techniques had lower rate of Clavien–Dindo ≥2 complications than that of open surgery (odds ratio [OR] for robotic surgery: 0.27; 95% confidence interval [95% CI]: 0.15–0.47, p < 0.0001; OR for laparoscopy: 0.52; 95% CI: 0.34–0.78; p = 0.002). The probability of receiving ischemia was highest for robotic PN (p < 0.001). Among on-clamp PN, laparoscopy had longer ischemia than open (estimate: 1.09; 95% CI: –0.00 to 2.18; p = 0.050) and robotic (estimate: 1.36; 95% CI: 0.31–2.40; p = 0.011) surgery. When compared with open PN, the risk of AKI was roughly halved for patients treated by robotic and laparoscopic surgery (both p < 0.0001). Positive margins rate did not differ between the groups (all p ≥ 0.1). The likelihood to achieve a modified trifecta was not affected by surgical technique in the overall population (all p ≥ 0.075). In Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score < 10 lesions, robotic surgery had higher probability of achieving a modified trifecta than open PN (OR: 1.66; 95% CI: 1.09–2.53; p = 0.018) and laparoscopy (OR: 1.34; 95% CI: 0.94–1.90; p = 0.11). Conclusions: In PADUA < 10 renal tumors, robotic PN allows for higher rates of trifecta than
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- 2021
13. Overview of potential determinants of radical prostatectomy versus radiation therapy in management of clinically localized prostate cancer: results from an Italian, prospective, observational study (the Pros-IT CNR study)
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Antonelli, A, Palumbo, C, Noale, M, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Bruni, A, Corvò, R, Gacci, M, Magrini, S, Montironi, R, Porreca, A, Tubaro, A, Zagonel, V, Maggi, S, Alitto, A, Ambrosi, E, Aristei, C, Barbieri, M, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Berruti, A, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruno, G, Brunocilla, E, Buffoli, A, Buglione, M, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini Francolini, D, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, De Nunzio, C, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Andrea, D, Dandrea, M, De Angelis, M, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli Esposti, C, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Fabiano, M, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari, P, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico, G, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi, A, Martillotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mazzeo, E, Mearini, L, Medoro, S, Molè, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone, D, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliotti, G, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Serni, S, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simeone, C, Simone, V, Spagnoletti, G, Spinelli, M, Squillace, L, Tombolini, V, Toninelli, M, Triggiani, L, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzì, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Zaramella, S, Zeccolini, G, Zini, G, Antonelli A, Palumbo C, Noale M, Artibani W, Bassi P, Bertoni F, Bracarda S, Bruni A, Corvò R, Gacci M, Magrini SM, Montironi R, Porreca A, Tubaro A, Zagonel V, Alitto AR, Ambrosi E, Aristei C, Barbieri M, Bardari F, Bardoscia L, Barra S, Bartoncini S, Basso U, Becherini C, Bellavita R, Bergamaschi F, Berlingheri S, Berruti A, Borghesi M, Bortolus R, Borzillo V, Bosetti D, Bove G, Bove P, Brausi M, Bruno G, Brunocilla E, Buffoli A, Buglione M, Buttigliero C, Cacciamani G, Caldiroli M, Cardo G, Carmignani G, Carrieri G, Castelli E, Castrezzati E, Catalano G, Cattarino S, Catucci F, Cavallini Francolini D, Ceccarini O, Celia A, Chiancone F, Chini T, Cianci C, Cisternino A, Collura D, Corbella F, Corinti M, Corsi P, Cortese F, Corti L, De Nunzio C, Cristiano O, D'angelillo R, Da Pozzo L, D'agostino D, D'andrea D, Dandrea M, De Angelis M, De Cobelli O, De Concilio B, De Lisa A, De Luca S, De Stefani A, Deantoni CL, Degli Esposti C, Destito A, Detti B, Di Muzio N, Di Stasio A, Di Stefano C, Di Trapani D, Difino G, Fabiano M, Falivene S, Farullo G, Fedelini P, Ferrari I, Ferrau F, Ferro M, Fodor A, Fontana F, Francesca F, Francolini G, Frata P, Frezza G, Gabriele P, Galeandro M, Garibaldi E, Gennari PG, Gentilucci A, Giacobbe A, Giussani L, Giusti G, Gontero P, Guarneri A, Guida C, Gurioli A, Huqi D, Imbimbo C, Ingrosso G, Iotti C, Italia C, La Mattina P, Lamanna E, Lastrucci L, Lazzari G, Liberale F, Liguori G, Lisi R, Lohr F, Lombardo R, Lovisolo J, Ludovico GM, Macchione N, Maggio F, Malizia M, Manasse G, Mandoliti G, Mantini G, Marafioti L, Marciello L, Marconi AM, Martillotta A, Marzano S, Masciullo S, Maso G, Massenzo A, Mazzeo E, Mearini L, Medoro S, Molè R, Monesi G, Montanari E, Montefiore F, Montesi G, Morgia G, Moro G, Muscas G, Musio D, Muto P, Muzzonigro G, Napodano G, Negro CL, Nidini M, Ntreta M, Orsatti M, Palazzolo C, Palumbo I, Parisi A, Parma P, Pavan N, Pericolini M, Pinto F, Pistone A, Pizzuti V, Platania A, Polli C, Pomara G, Ponti E, Porcaro AB, Porpiglia F, Pugliese D, Pycha A, Raguso G, Rampini A, Randone DF, Roboldi V, Roscigno M, Ruggieri MP, Ruoppo G, Sanseverino R, Santacaterina A, Santarsieri M, Santoni R, Scagliotti GV, Scanzi M, Scarcia M, Schiavina R, Sciarra A, Sciorio C, Scolaro T, Scuzzarella S, Selvaggio O, Serao A, Serni S, Signor MA, Silvani M, Silvano G, Silvestris F, Simeone C, Simone V, Spagnoletti G, Spinelli MG, Squillace L, Tombolini V, Toninelli M, Triggiani L, Trinchieri A, Trodella LE, Trodella L, Trombetta C, Tronnolone L, Tucci M, Urzì D, Valdagni R, Valeriani M, Vanoli M, Vitali E, Zaramella S, Zeccolini G, Zini G., Antonelli, A, Palumbo, C, Noale, M, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Bruni, A, Corvò, R, Gacci, M, Magrini, S, Montironi, R, Porreca, A, Tubaro, A, Zagonel, V, Maggi, S, Alitto, A, Ambrosi, E, Aristei, C, Barbieri, M, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Berruti, A, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruno, G, Brunocilla, E, Buffoli, A, Buglione, M, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini Francolini, D, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, De Nunzio, C, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Andrea, D, Dandrea, M, De Angelis, M, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli Esposti, C, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Fabiano, M, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari, P, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico, G, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi, A, Martillotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mazzeo, E, Mearini, L, Medoro, S, Molè, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone, D, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliotti, G, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Serni, S, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simeone, C, Simone, V, Spagnoletti, G, Spinelli, M, Squillace, L, Tombolini, V, Toninelli, M, Triggiani, L, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzì, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Zaramella, S, Zeccolini, G, Zini, G, Antonelli A, Palumbo C, Noale M, Artibani W, Bassi P, Bertoni F, Bracarda S, Bruni A, Corvò R, Gacci M, Magrini SM, Montironi R, Porreca A, Tubaro A, Zagonel V, Alitto AR, Ambrosi E, Aristei C, Barbieri M, Bardari F, Bardoscia L, Barra S, Bartoncini S, Basso U, Becherini C, Bellavita R, Bergamaschi F, Berlingheri S, Berruti A, Borghesi M, Bortolus R, Borzillo V, Bosetti D, Bove G, Bove P, Brausi M, Bruno G, Brunocilla E, Buffoli A, Buglione M, Buttigliero C, Cacciamani G, Caldiroli M, Cardo G, Carmignani G, Carrieri G, Castelli E, Castrezzati E, Catalano G, Cattarino S, Catucci F, Cavallini Francolini D, Ceccarini O, Celia A, Chiancone F, Chini T, Cianci C, Cisternino A, Collura D, Corbella F, Corinti M, Corsi P, Cortese F, Corti L, De Nunzio C, Cristiano O, D'angelillo R, Da Pozzo L, D'agostino D, D'andrea D, Dandrea M, De Angelis M, De Cobelli O, De Concilio B, De Lisa A, De Luca S, De Stefani A, Deantoni CL, Degli Esposti C, Destito A, Detti B, Di Muzio N, Di Stasio A, Di Stefano C, Di Trapani D, Difino G, Fabiano M, Falivene S, Farullo G, Fedelini P, Ferrari I, Ferrau F, Ferro M, Fodor A, Fontana F, Francesca F, Francolini G, Frata P, Frezza G, Gabriele P, Galeandro M, Garibaldi E, Gennari PG, Gentilucci A, Giacobbe A, Giussani L, Giusti G, Gontero P, Guarneri A, Guida C, Gurioli A, Huqi D, Imbimbo C, Ingrosso G, Iotti C, Italia C, La Mattina P, Lamanna E, Lastrucci L, Lazzari G, Liberale F, Liguori G, Lisi R, Lohr F, Lombardo R, Lovisolo J, Ludovico GM, Macchione N, Maggio F, Malizia M, Manasse G, Mandoliti G, Mantini G, Marafioti L, Marciello L, Marconi AM, Martillotta A, Marzano S, Masciullo S, Maso G, Massenzo A, Mazzeo E, Mearini L, Medoro S, Molè R, Monesi G, Montanari E, Montefiore F, Montesi G, Morgia G, Moro G, Muscas G, Musio D, Muto P, Muzzonigro G, Napodano G, Negro CL, Nidini M, Ntreta M, Orsatti M, Palazzolo C, Palumbo I, Parisi A, Parma P, Pavan N, Pericolini M, Pinto F, Pistone A, Pizzuti V, Platania A, Polli C, Pomara G, Ponti E, Porcaro AB, Porpiglia F, Pugliese D, Pycha A, Raguso G, Rampini A, Randone DF, Roboldi V, Roscigno M, Ruggieri MP, Ruoppo G, Sanseverino R, Santacaterina A, Santarsieri M, Santoni R, Scagliotti GV, Scanzi M, Scarcia M, Schiavina R, Sciarra A, Sciorio C, Scolaro T, Scuzzarella S, Selvaggio O, Serao A, Serni S, Signor MA, Silvani M, Silvano G, Silvestris F, Simeone C, Simone V, Spagnoletti G, Spinelli MG, Squillace L, Tombolini V, Toninelli M, Triggiani L, Trinchieri A, Trodella LE, Trodella L, Trombetta C, Tronnolone L, Tucci M, Urzì D, Valdagni R, Valeriani M, Vanoli M, Vitali E, Zaramella S, Zeccolini G, and Zini G.
- Abstract
BACKGROUND: We assessed patients and tumor characteristics, as well as health-related quality of life (HRQoL) items, associated with curative intent treatment decision-making in clinically localized prostate cancer (PCa) patients. METHODS: Clinically localized PCa treated with either radical prostatectomy (RP) or radiation therapy (RT) within 12 months from diagnosis were abstracted from The PROState cancer monitoring in ITaly, from the National Research Council (Pros-IT CNR) database. Multivariable logistic regression (MLR) models predicting RT vs. RP were fitted, after adjustment for HRQoL items, patients and tumor characteristics. RESULTS: Of 1041 patients, 631 (60.2%) were treated with RP and 410 (39.8%) with RT. Relative to RT, RP patients were younger age (mean age 64.5±6.6 vs. 71.4±4.9, P<0.001) and had higher rates of D’Amico low-intermediate risk groups (31.8 vs. 21.9% low, 46.3% vs. 43.5% intermediate and 21.9% vs. 34.6% high risk, P<0.001). Overall, 93.2% of RP patients were enrolled by urologists and 82.7% of RT patients by radiation oncologists. RP patients had generally higher means values of HRQoL items. In MLR models, higher RT rates were independently associated with more advanced age (odds ratio [OR] 6.14, P<0.001) and BMI≥30 kg/m2 (OR 1.78, P<0.001). Conversely, lower rates of RT were independently associated with married (OR 0.55, P=0.01) and worker status (OR 0.52, P=0.004), enrollment in academic centers (OR 0.59, P=0.005) and higher physical composite score (OR 0.88, P=0.03) and baseline sexual function items (OR 0.92, P<0.001). CONCLUSIONS: Most patients with clinically localized prostate cancer undergoing definitive treatment at Italian institutions receive RP instead of RT. Moreover, those who are younger, married, working, as well as those with better physical and sexual function are more likely to undergo surgery.
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- 2020
14. Reducing the Frequency of Follow-up Cystoscopy in Low-grade pTa Non-muscle-invasive Bladder Cancer Using the ADXBLADDER Biomarker
- Author
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Rouprêt, M., Gontero, P., McCracken, S.R.C., Dudderidge, T., Stockley, J., Kennedy, A., Rodriguez, O., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Colombel, M., Longo, F., Montanari, E., Palou, J., Sylvester, R.J., Rouprêt, M., Gontero, P., McCracken, S.R.C., Dudderidge, T., Stockley, J., Kennedy, A., Rodriguez, O., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Colombel, M., Longo, F., Montanari, E., Palou, J., and Sylvester, R.J.
- Abstract
Item does not contain fulltext, BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is one of the most expensive cancers owing to frequent follow-up cystoscopies for detection of recurrence. OBJECTIVE: To assess if the noninvasive ADXBLADDER urine test could permit a less intensive surveillance schedule for patients with low-grade (LG) pTa tumor without carcinoma in situ (CIS) at the previous diagnosis. DESIGN, SETTING, AND PARTICIPANTS: In a prospective, double-blind, multicenter study, 629 patients underwent follow-up cystoscopy, transurethral resection of bladder tumor/biopsy of suspect lesions, and ADXBLADDER testing. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Diagnostic test accuracy and decision curve analysis were used to evaluate the impact of ADXBLADDER on decision-making on whether to perform follow-up cystoscopy. The primary endpoint was the negative predictive value (NPV) of ADXBLADDER for detection of high-grade and/or CIS (HG/CIS) recurrence and its impact on reducing unnecessary cystoscopies. RESULTS AND LIMITATIONS: ADXBLADDER had sensitivity of 66.7% (95% confidence interval [CI] 34.9-90.1%) and an NPV of 99.15% (95% CI 97.8-99.8%) for detection of HG/CIS recurrence. The probability of HG/CIS recurrence was 5.0% for ADXBLADDER-positive patients and 0.85% for ADXBLADDER-negative patients. For HG/CIS recurrence threshold probabilities between 0.85% and 5.0%, ADXBLADDER yields a net benefit with omission of cystoscopy for ADXBLADDER-negative patients. The corresponding net reduction in unnecessary cystoscopies ranges from 11 to 62 per 100 patients. CONCLUSIONS: Patients with LG pTa tumor at the previous diagnosis, for which the risk of HG/CIS recurrence is low and the ADXBLADDER NPV for ruling out HG/CIS recurrence is 99.15%, are ideally suited for a less intensive, personalized follow-up surveillance strategy using ADXBLADDER, with omission of cystoscopy for ADXBLADDER-negative patients. PATIENT SUMMARY: ADXBLADDER is a urine test that can predict the probability of recurrenc
- Published
- 2022
15. T1G1 Bladder Cancer: Prognosis for this Rare Pathological Diagnosis Within the Non-muscle-invasive Bladder Cancer Spectrum
- Author
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Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Henríquez, J.D. Subiela, Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, Theodorus H. van der, Babjuk, M., Sylvester, R.J., Rhijn, B.W. van, Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Henríquez, J.D. Subiela, Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, Theodorus H. van der, Babjuk, M., Sylvester, R.J., and Rhijn, B.W. van
- Abstract
Item does not contain fulltext, BACKGROUND: The pathological existence and clinical consequence of stage T1 grade 1 (T1G1) bladder cancer are the subject of debate. Even though the diagnosis of T1G1 is controversial, several reports have consistently found a prevalence of 2-6% G1 in their T1 series. However, it remains unclear if T1G1 carcinomas have added value as a separate category to predict prognosis within the non-muscle-invasive bladder cancer (NMIBC) spectrum. OBJECTIVE: To evaluate the prognostic value of T1G1 carcinomas compared to TaG1 and T1G2 carcinomas within the NMIBC spectrum. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5170 primary Ta and T1 bladder tumors from 17 hospitals in Europe and Canada were analyzed. Transurethral resection (TUR) was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Time to recurrence and progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox regression models stratified by institution. RESULTS AND LIMITATIONS: T1G1 represented 1.9% (99/5170) of all carcinomas and 5.3% (99/1859) of T1 carcinomas. According to primary TUR dates, the proportion of T1G1 varied between 0.9% and 3.5% per year, with similar percentages in the early and later calendar years. We found no difference in time to recurrence between T1G1 and TaG1 (p = 0.91) or between T1G1 and T1G2 (p = 0.30). Time to progression significantly differed between TaG1 and T1G1 (p < 0.001) but not between T1G1 and T1G2 (p = 0.30). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS: The relative prevalence of T1G1 diagnosis was low and remained constant over the past three decades. Time to recurrence of T1G1 NMIBC was comparable to that for other stage/grade NMIBC combinations. Time to progression of T1G1 NMIBC was comparable to that for T1G2 but not for TaG1, suggesting that treatment and surveillance of T1G1 carcinomas should be more like the approaches for T1G2 NMIBC in
- Published
- 2022
16. Reducing the Frequency of Follow-up Cystoscopy in Low-grade pTa Non-muscle-invasive Bladder Cancer Using the ADXBLADDER Biomarker
- Author
-
Rouprêt, M., Gontero, P., McCracken, S.R.C., Dudderidge, T., Stockley, J., Kennedy, A., Rodriguez, O., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Colombel, M., Longo, F., Montanari, E., Palou, J., Sylvester, R.J., Rouprêt, M., Gontero, P., McCracken, S.R.C., Dudderidge, T., Stockley, J., Kennedy, A., Rodriguez, O., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Colombel, M., Longo, F., Montanari, E., Palou, J., and Sylvester, R.J.
- Abstract
Contains fulltext : 287583.pdf (Publisher’s version ) (Open Access), BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is one of the most expensive cancers owing to frequent follow-up cystoscopies for detection of recurrence. OBJECTIVE: To assess if the noninvasive ADXBLADDER urine test could permit a less intensive surveillance schedule for patients with low-grade (LG) pTa tumor without carcinoma in situ (CIS) at the previous diagnosis. DESIGN, SETTING, AND PARTICIPANTS: In a prospective, double-blind, multicenter study, 629 patients underwent follow-up cystoscopy, transurethral resection of bladder tumor/biopsy of suspect lesions, and ADXBLADDER testing. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Diagnostic test accuracy and decision curve analysis were used to evaluate the impact of ADXBLADDER on decision-making on whether to perform follow-up cystoscopy. The primary endpoint was the negative predictive value (NPV) of ADXBLADDER for detection of high-grade and/or CIS (HG/CIS) recurrence and its impact on reducing unnecessary cystoscopies. RESULTS AND LIMITATIONS: ADXBLADDER had sensitivity of 66.7% (95% confidence interval [CI] 34.9-90.1%) and an NPV of 99.15% (95% CI 97.8-99.8%) for detection of HG/CIS recurrence. The probability of HG/CIS recurrence was 5.0% for ADXBLADDER-positive patients and 0.85% for ADXBLADDER-negative patients. For HG/CIS recurrence threshold probabilities between 0.85% and 5.0%, ADXBLADDER yields a net benefit with omission of cystoscopy for ADXBLADDER-negative patients. The corresponding net reduction in unnecessary cystoscopies ranges from 11 to 62 per 100 patients. CONCLUSIONS: Patients with LG pTa tumor at the previous diagnosis, for which the risk of HG/CIS recurrence is low and the ADXBLADDER NPV for ruling out HG/CIS recurrence is 99.15%, are ideally suited for a less intensive, personalized follow-up surveillance strategy using ADXBLADDER, with omission of cystoscopy for ADXBLADDER-negative patients. PATIENT SUMMARY: ADXBLADDER is a urine test that can predict the probability of recurrenc
- Published
- 2022
17. T1G1 Bladder Cancer: Prognosis for this Rare Pathological Diagnosis Within the Non-muscle-invasive Bladder Cancer Spectrum
- Author
-
Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Henríquez, J.D. Subiela, Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, Theodorus H. van der, Babjuk, M., Sylvester, R.J., Rhijn, B.W. van, Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M., Plass, K., Rodríguez, O., Henríquez, J.D. Subiela, Hernández, V., Peña, E. de la, Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S., Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., Sheikh, S., Volanis, D., Côté, J.F., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen-van de Kaa, C.A., Heijden, A.G. van der, Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N'Dow, J., Ribal, M.J., Kwast, Theodorus H. van der, Babjuk, M., Sylvester, R.J., and Rhijn, B.W. van
- Abstract
Item does not contain fulltext, BACKGROUND: The pathological existence and clinical consequence of stage T1 grade 1 (T1G1) bladder cancer are the subject of debate. Even though the diagnosis of T1G1 is controversial, several reports have consistently found a prevalence of 2-6% G1 in their T1 series. However, it remains unclear if T1G1 carcinomas have added value as a separate category to predict prognosis within the non-muscle-invasive bladder cancer (NMIBC) spectrum. OBJECTIVE: To evaluate the prognostic value of T1G1 carcinomas compared to TaG1 and T1G2 carcinomas within the NMIBC spectrum. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5170 primary Ta and T1 bladder tumors from 17 hospitals in Europe and Canada were analyzed. Transurethral resection (TUR) was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Time to recurrence and progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox regression models stratified by institution. RESULTS AND LIMITATIONS: T1G1 represented 1.9% (99/5170) of all carcinomas and 5.3% (99/1859) of T1 carcinomas. According to primary TUR dates, the proportion of T1G1 varied between 0.9% and 3.5% per year, with similar percentages in the early and later calendar years. We found no difference in time to recurrence between T1G1 and TaG1 (p = 0.91) or between T1G1 and T1G2 (p = 0.30). Time to progression significantly differed between TaG1 and T1G1 (p < 0.001) but not between T1G1 and T1G2 (p = 0.30). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS: The relative prevalence of T1G1 diagnosis was low and remained constant over the past three decades. Time to recurrence of T1G1 NMIBC was comparable to that for other stage/grade NMIBC combinations. Time to progression of T1G1 NMIBC was comparable to that for T1G2 but not for TaG1, suggesting that treatment and surveillance of T1G1 carcinomas should be more like the approaches for T1G2 NMIBC in
- Published
- 2022
18. The current role of precision surgery in oligometastatic prostate cancer
- Author
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von Deimling, M., Rajwa, P., Tilki, D., Heidenreich, A., Pallauf, M., Bianchi, A., Yanagisawa, T., Kawada, T., Karakiewicz, P., I, Gontero, P., Pradere, B., Ploussard, G., Rink, M., Shariat, S. F., von Deimling, M., Rajwa, P., Tilki, D., Heidenreich, A., Pallauf, M., Bianchi, A., Yanagisawa, T., Kawada, T., Karakiewicz, P., I, Gontero, P., Pradere, B., Ploussard, G., Rink, M., and Shariat, S. F.
- Abstract
Oligometastatic prostate cancer (omPCa) is a novel intermediate disease state characterized by a limited volume of metastatic cells and specific locations. Accurate staging is paramount to unmask oligometastatic disease, as provided by prostate-specific membrane antigen-positron emission tomography. Driven by the results of prospective trials employing conventional and/or modern staging modalities, the treatment landscape of omPCa has rapidly evolved over the last years. Several treatment-related questions comprising the concept of precision strikes are under development. For example, beyond systemic therapy, cohort studies have found that cytoreductive radical prostatectomy (CRP) can confer a survival benefit in select patients with omPCa. More importantly, CRP has been consistently shown to improve long-term local symptoms when the tumor progresses across disease states due to resistance to systemic therapies. Metastasis-directed treatments have also emerged as a promising treatment option due to the visibility of oligometastatic disease and new technologies as well as treatment strategies to target the novel PCa colonies. Whether metastases are present at primary cancer diagnosis or detected upon biochemical recurrence after treatment with curative intent, targeted yet decisive elimination of disseminated tumor cell hotspots is thought to improve survival outcomes. One such strategy is salvage lymph node dissection in oligorecurrent PCa which can alter the natural history of progressive PCa. In this review, we will highlight how refinements in modern staging modalities change the classification and treatment of (oligo-)metastatic PCa. Further, we will also discuss the current role and future directions of precision surgery in omPCa.
- Published
- 2022
19. Treatment paths for localised prostate cancer in Italy: The results of a multidisciplinary, observational, prospective study (Pros-IT CNR)
- Author
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Buglione, M, Noale, M, Bruni, A, Antonelli, A, Bertoni, F, Corvo, R, Ricardi, U, Borghetti, P, Maddalo, M, Simeone, C, Mazzeo, E, Porreca, A, Serni, S, Bassi, P, Gacci, M, Mirone, V, Montironi, R, Tubaro, A, Berruti, A, Conti, G, Maggi, S, Magrini, S, Triggiani, L, Crepaldi, G, Artibani, W, Bracarda, S, Graziotti, P, Russi, E, Muto, G, Pecoraro, S, Zagonel, V, Alitto, A, Ambrosi, E, Aristei, C, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruno, G, Brunocilla, E, Buffoli, A, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini, F, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, de Nunzio, C, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Elia, C, Dandrea, M, De Angelis, M, De Angelis, P, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli, E, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari, P, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, La Rocca, R, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico, G, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi, A, Martilotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mearini, L, Medoro, S, Mole, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone, D, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliarini, S, Scagliotti, G, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simone, V, Spagnoletti, G, Spinelli, M, Squillace, L, Tombolini, V, Toninelli, M, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzi, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Volpe, A, Zaramella, S, Zeccolini, G, Zini, G, Buglione M., Noale M., Bruni A., Antonelli A., Bertoni F., Corvo R., Ricardi U., Borghetti P., Maddalo M., Simeone C., Mazzeo E., Porreca A., Serni S., Bassi P., Gacci M., Mirone V., Montironi R., Tubaro A., Berruti A., Conti G. N., Maggi S., Magrini S. M., Triggiani L., Crepaldi G., Artibani W., Bracarda S., Graziotti P., Russi E., Muto G., Pecoraro S., Zagonel V., Alitto A. R., Ambrosi E., Aristei C., Bardari F., Bardoscia L., Barra S., Bartoncini S., Basso U., Becherini C., Bellavita R., Bergamaschi F., Berlingheri S., Borghesi M., Bortolus R., Borzillo V., Bosetti D., Bove G., Bove P., Brausi M., Bruno G., Brunocilla E., Buffoli A., Buttigliero C., Cacciamani G., Caldiroli M., Cardo G., Carmignani G., Carrieri G., Castelli E., Castrezzati E., Catalano G., Cattarino S., Catucci F., Cavallini F. D., Ceccarini O., Celia A., Chiancone F., Chini T., Cianci C., Cisternino A., Collura D., Corbella F., Corinti M., Corsi P., Cortese F., Corti L., de Nunzio C., Cristiano O., D'angelillo R. M., Da Pozzo L., D'agostino D., D'elia C., Dandrea M., De Angelis M., De Angelis P., De Cobelli O., De Concilio B., De Lisa A., De Luca S., De Stefani A., Deantoni C. L., Degli E. C., Destito A., Detti B., Di Muzio N., Di Stasio A., Di Stefano C., Di Trapani D., Difino G., Falivene S., Farullo G., Fedelini P., Ferrari I., Ferrau F., Ferro M., Fodor A., Fontana F., Francesca F., Francolini G., Frata P., Frezza G., Gabriele P., Galeandro M., Garibaldi E., Gennari P. G., Gentilucci A., Giacobbe A., Giussani L., Giusti G., Gontero P., Guarneri A., Guida C., Gurioli A., Huqi D., Imbimbo C., Ingrosso G., Iotti C., Italia C., La Mattina P., La Rocca R., Lamanna E., Lastrucci L., Lazzari G., Liberale F., Liguori G., Lisi R., Lohr F., Lombardo R., Lovisolo J. A. J., Ludovico G. M., Macchione N., Maggio F., Malizia M., Manasse G., Mandoliti G., Mantini G., Marafioti L., Marciello L., Marconi A. M., Martilotta A., Marzano S., Masciullo S., Maso G., Massenzo A., Mearini L., Medoro S., Mole R., Monesi G., Montanari E., Montefiore F., Montesi G., Morgia G., Moro G., Muscas G., Musio D., Muto P., Muzzonigro G., Napodano G., Negro C. L. A., Nidini M., Ntreta M., Orsatti M., Palazzolo C., Palumbo I., Parisi A., Parma P., Pavan N., Pericolini M., Pinto F., Pistone A., Pizzuti V., Platania A., Polli C., Pomara G., Ponti E., Porcaro A. B., Porpiglia F., Pugliese D., Pycha A., Raguso G., Rampini A., Randone D. F., Roboldi V., Roscigno M., Ruggieri M. P., Ruoppo G., Sanseverino R., Santacaterina A., Santarsieri M., Santoni R., Scagliarini S., Scagliotti G. V., Scanzi M., Scarcia M., Schiavina R., Sciarra A., Sciorio C., Scolaro T., Scuzzarella S., Selvaggio O., Serao A., Signor M. A., Silvani M., Silvano G., Silvestris F., Simone V., Spagnoletti G., Spinelli M. G., Squillace L., Tombolini V., Toninelli M., Trinchieri A., Trodella L. E., Trodella L., Trombetta C., Tronnolone L., Tucci M., Urzi D., Valdagni R., Valeriani M., Vanoli M., Vitali E., Volpe A., Zaramella S., Zeccolini G., Zini G., Buglione, M, Noale, M, Bruni, A, Antonelli, A, Bertoni, F, Corvo, R, Ricardi, U, Borghetti, P, Maddalo, M, Simeone, C, Mazzeo, E, Porreca, A, Serni, S, Bassi, P, Gacci, M, Mirone, V, Montironi, R, Tubaro, A, Berruti, A, Conti, G, Maggi, S, Magrini, S, Triggiani, L, Crepaldi, G, Artibani, W, Bracarda, S, Graziotti, P, Russi, E, Muto, G, Pecoraro, S, Zagonel, V, Alitto, A, Ambrosi, E, Aristei, C, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruno, G, Brunocilla, E, Buffoli, A, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini, F, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, de Nunzio, C, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Elia, C, Dandrea, M, De Angelis, M, De Angelis, P, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli, E, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari, P, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, La Rocca, R, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico, G, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi, A, Martilotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mearini, L, Medoro, S, Mole, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone, D, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliarini, S, Scagliotti, G, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simone, V, Spagnoletti, G, Spinelli, M, Squillace, L, Tombolini, V, Toninelli, M, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzi, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Volpe, A, Zaramella, S, Zeccolini, G, Zini, G, Buglione M., Noale M., Bruni A., Antonelli A., Bertoni F., Corvo R., Ricardi U., Borghetti P., Maddalo M., Simeone C., Mazzeo E., Porreca A., Serni S., Bassi P., Gacci M., Mirone V., Montironi R., Tubaro A., Berruti A., Conti G. N., Maggi S., Magrini S. M., Triggiani L., Crepaldi G., Artibani W., Bracarda S., Graziotti P., Russi E., Muto G., Pecoraro S., Zagonel V., Alitto A. R., Ambrosi E., Aristei C., Bardari F., Bardoscia L., Barra S., Bartoncini S., Basso U., Becherini C., Bellavita R., Bergamaschi F., Berlingheri S., Borghesi M., Bortolus R., Borzillo V., Bosetti D., Bove G., Bove P., Brausi M., Bruno G., Brunocilla E., Buffoli A., Buttigliero C., Cacciamani G., Caldiroli M., Cardo G., Carmignani G., Carrieri G., Castelli E., Castrezzati E., Catalano G., Cattarino S., Catucci F., Cavallini F. D., Ceccarini O., Celia A., Chiancone F., Chini T., Cianci C., Cisternino A., Collura D., Corbella F., Corinti M., Corsi P., Cortese F., Corti L., de Nunzio C., Cristiano O., D'angelillo R. M., Da Pozzo L., D'agostino D., D'elia C., Dandrea M., De Angelis M., De Angelis P., De Cobelli O., De Concilio B., De Lisa A., De Luca S., De Stefani A., Deantoni C. L., Degli E. C., Destito A., Detti B., Di Muzio N., Di Stasio A., Di Stefano C., Di Trapani D., Difino G., Falivene S., Farullo G., Fedelini P., Ferrari I., Ferrau F., Ferro M., Fodor A., Fontana F., Francesca F., Francolini G., Frata P., Frezza G., Gabriele P., Galeandro M., Garibaldi E., Gennari P. G., Gentilucci A., Giacobbe A., Giussani L., Giusti G., Gontero P., Guarneri A., Guida C., Gurioli A., Huqi D., Imbimbo C., Ingrosso G., Iotti C., Italia C., La Mattina P., La Rocca R., Lamanna E., Lastrucci L., Lazzari G., Liberale F., Liguori G., Lisi R., Lohr F., Lombardo R., Lovisolo J. A. J., Ludovico G. M., Macchione N., Maggio F., Malizia M., Manasse G., Mandoliti G., Mantini G., Marafioti L., Marciello L., Marconi A. M., Martilotta A., Marzano S., Masciullo S., Maso G., Massenzo A., Mearini L., Medoro S., Mole R., Monesi G., Montanari E., Montefiore F., Montesi G., Morgia G., Moro G., Muscas G., Musio D., Muto P., Muzzonigro G., Napodano G., Negro C. L. A., Nidini M., Ntreta M., Orsatti M., Palazzolo C., Palumbo I., Parisi A., Parma P., Pavan N., Pericolini M., Pinto F., Pistone A., Pizzuti V., Platania A., Polli C., Pomara G., Ponti E., Porcaro A. B., Porpiglia F., Pugliese D., Pycha A., Raguso G., Rampini A., Randone D. F., Roboldi V., Roscigno M., Ruggieri M. P., Ruoppo G., Sanseverino R., Santacaterina A., Santarsieri M., Santoni R., Scagliarini S., Scagliotti G. V., Scanzi M., Scarcia M., Schiavina R., Sciarra A., Sciorio C., Scolaro T., Scuzzarella S., Selvaggio O., Serao A., Signor M. A., Silvani M., Silvano G., Silvestris F., Simone V., Spagnoletti G., Spinelli M. G., Squillace L., Tombolini V., Toninelli M., Trinchieri A., Trodella L. E., Trodella L., Trombetta C., Tronnolone L., Tucci M., Urzi D., Valdagni R., Valeriani M., Vanoli M., Vitali E., Volpe A., Zaramella S., Zeccolini G., and Zini G.
- Abstract
Background There are several treatments available to newly diagnosed prostate cancer (PCA) patients. Although surgery and radiotherapy (RT) with or without androgen deprivation therapy (ADT) are widely adopted treatment options for localized PCA together with active surveillance (AS), there is no consensus nor randomised trials on treatment selection, prospective quality of life (QOL), along with toxicity outcomes and according to treatment modality in the Italian population. The current study aimed to describe clinical-therapeutic features and QOL at PCA diagnosis, according to different treatment patterns in a large prospective, Italian population, enrolled in the Pros-IT CNR study. Methods The Pros-IT CNR is an on-going national, multicenter, observational, prospective study on patients affected by PCA who have been referred by 97 Italian Urology, Radiation Oncology and Medical Oncology facilities participating in the project. The possible relationships between the treatment patterns reported in the 6 month follow-up case report form and patients’ features at diagnosis were evaluated using exploratory multiple correspondence analysis (MCA) and other data analysis method. Results At diagnosis, surgery and AS patients were significantly younger, had fewer comorbidities, lower PSA levels and Gleason Score (GS) values; they were also diagnosed at an earlier stage of disease with respect to the RT or ADT patients who showed significantly worse QoL scores at the time of diagnosis. Conclusions An analysis of the data collected at baseline and 6 months later uncovered substantial differences in ages, comorbidities, clinical and QOL features in the various treatment groups. These findings do not fully reflect the current PCA treatment guidelines and suggest the need for a multidisciplinary consensus guideline to ameliorate both the counselling and treatments of PCA patients.
- Published
- 2019
20. Impact of Surgical Approach on Patient-Reported Outcomes after Radical Prostatectomy: A Propensity Score-Weighted Analysis from a Multicenter, Prospective, Observational Study (The Pros-IT CNR Study)
- Author
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Antonelli, A, Palumbo, C, Noale, M, Porreca, A, Maggi, S, Simeone, C, Bassi, P, Bertoni, F, Bracarda, S, Buglione, M, Conti, G, Corvo, R, Gacci, M, Mirone, V, Montironi, R, Triggiani, L, Tubaro, A, Artibani, W, Crepaldi, G, Graziotti, P, Russi, E, Magrini Stefano, M, Muto, G, Pecoraro, S, Ricardi, U, Zagonel, V, Alitto Anna, R, Ambrosi, E, Aristei, C, Barbieri, M, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Berruti, A, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruni, A, Bruno, G, Brunocilla, E, Buffoli, A, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini, F, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, de Cosimo, N, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Elia, C, Dandrea, M, De Angelis, M, De Angelis, P, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli Esposti, C, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari Pietro, G, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico Giuseppe, M, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi Alberto, M, Martilotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mazzeo, E, Mearini, L, Medoro, S, Mole, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone Donato, F, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliarini, S, Scagliotti Giorgio, V, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Serni, S, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simone, V, Spagnoletti, G, Spinelli Matteo, G, Squillace, L, Tombolini, V, Toninelli, M, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzi, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Volpe, A, Zaramella, S, Zeccolini, G, Zini, G, Antonelli A., Palumbo C., Noale M., Porreca A., Maggi S., Simeone C., Bassi P., Bertoni F., Bracarda S., Buglione M., Conti G. N., Corvo R., Gacci M., Mirone V., Montironi R., Triggiani L., Tubaro A., Artibani W., Crepaldi G., Graziotti P., Russi E., Magrini Stefano M., Muto G., Pecoraro S., Ricardi U., Zagonel V., Alitto Anna R., Ambrosi E., Aristei C., Barbieri M., Bardari F., Bardoscia L., Barra S., Bartoncini S., Basso U., Becherini C., Bellavita R., Bergamaschi F., Berlingheri S., Berruti A., Borghesi M., Bortolus R., Borzillo V., Bosetti D., Bove G., Bove P., Brausi M., Bruni A., Bruno G., Brunocilla E., Buffoli A., Buttigliero C., Cacciamani G., Caldiroli M., Cardo G., Carmignani G., Carrieri G., Castelli E., Castrezzati E., Catalano G., Cattarino S., Catucci F., Cavallini F. D., Ceccarini O., Celia A., Chiancone F., Chini T., Cianci C., Cisternino A., Collura D., Corbella F., Corinti M., Corsi P., Cortese F., Corti L., de Cosimo N., Cristiano O., D'Angelillo R., Da Pozzo L., D'agostino D., D'Elia C., Dandrea M., De Angelis M., De Angelis P., De Cobelli O., De Concilio B., De Lisa A., De Luca S., De Stefani A., Deantoni C. L., Degli Esposti C., Destito A., Detti B., Di Muzio N., Di Stasio A., Di Stefano C., Di Trapani D., Difino G., Falivene S., Farullo G., Fedelini P., Ferrari I., Ferrau F., Ferro M., Fodor A., Fontana F., Francesca F., Francolini G., Frata P., Frezza G., Gabriele P., Galeandro M., Garibaldi E., Gennari Pietro G., Gentilucci A., Giacobbe A., Giussani L., Giusti G., Gontero P., Guarneri A., Guida C., Gurioli A., Huqi D., Imbimbo C., Ingrosso G., Iotti C., Italia C., La Mattina P., Lamanna E., Lastrucci L., Lazzari G., Liberale F., Liguori G., Lisi R., Lohr F., Lombardo R., Lovisolo J. A. J., Ludovico Giuseppe M., Macchione N., Maggio F., Malizia M., Manasse G., Mandoliti G., Mantini G., Marafioti L., Marciello L., Marconi Alberto M., Martilotta A., Marzano S., Masciullo S., Maso G., Massenzo A., Mazzeo E., Mearini L., Medoro S., Mole R., Monesi G., Montanari E., Montefiore F., Montesi G., Morgia G., Moro G., Muscas G., Musio D., Muto P., Muzzonigro G., Napodano G., Negro C. L. A., Nidini M., Ntreta M., Orsatti M., Palazzolo C., Palumbo I., Parisi A., Parma P., Pavan N., Pericolini M., Pinto F., Pistone A., Pizzuti V., Platania A., Polli C., Pomara G., Ponti E., Porcaro A. B., Porpiglia F., Pugliese D., Pycha A., Raguso G., Rampini A., Randone Donato F., Roboldi V., Roscigno M., Ruggieri M. P., Ruoppo G., Sanseverino R., Santacaterina A., Santarsieri M., Santoni R., Scagliarini S., Scagliotti Giorgio V., Scanzi M., Scarcia M., Schiavina R., Sciarra A., Sciorio C., Scolaro T., Scuzzarella S., Selvaggio O., Serao A., Serni S., Signor M. A., Silvani M., Silvano G., Silvestris F., Simone V., Spagnoletti G., Spinelli Matteo G., Squillace L., Tombolini V., Toninelli M., Trinchieri A., Trodella L. E., Trodella L., Trombetta C., Tronnolone L., Tucci M., Urzi D., Valdagni R., Valeriani M., Vanoli M., Vitali E., Volpe A., Zaramella S., Zeccolini G., Zini G., Antonelli, A, Palumbo, C, Noale, M, Porreca, A, Maggi, S, Simeone, C, Bassi, P, Bertoni, F, Bracarda, S, Buglione, M, Conti, G, Corvo, R, Gacci, M, Mirone, V, Montironi, R, Triggiani, L, Tubaro, A, Artibani, W, Crepaldi, G, Graziotti, P, Russi, E, Magrini Stefano, M, Muto, G, Pecoraro, S, Ricardi, U, Zagonel, V, Alitto Anna, R, Ambrosi, E, Aristei, C, Barbieri, M, Bardari, F, Bardoscia, L, Barra, S, Bartoncini, S, Basso, U, Becherini, C, Bellavita, R, Bergamaschi, F, Berlingheri, S, Berruti, A, Borghesi, M, Bortolus, R, Borzillo, V, Bosetti, D, Bove, G, Bove, P, Brausi, M, Bruni, A, Bruno, G, Brunocilla, E, Buffoli, A, Buttigliero, C, Cacciamani, G, Caldiroli, M, Cardo, G, Carmignani, G, Carrieri, G, Castelli, E, Castrezzati, E, Catalano, G, Cattarino, S, Catucci, F, Cavallini, F, Ceccarini, O, Celia, A, Chiancone, F, Chini, T, Cianci, C, Cisternino, A, Collura, D, Corbella, F, Corinti, M, Corsi, P, Cortese, F, Corti, L, de Cosimo, N, Cristiano, O, D'Angelillo, R, Da Pozzo, L, D'Agostino, D, D'Elia, C, Dandrea, M, De Angelis, M, De Angelis, P, De Cobelli, O, De Concilio, B, De Lisa, A, De Luca, S, De Stefani, A, Deantoni, C, Degli Esposti, C, Destito, A, Detti, B, Di Muzio, N, Di Stasio, A, Di Stefano, C, Di Trapani, D, Difino, G, Falivene, S, Farullo, G, Fedelini, P, Ferrari, I, Ferrau, F, Ferro, M, Fodor, A, Fontana, F, Francesca, F, Francolini, G, Frata, P, Frezza, G, Gabriele, P, Galeandro, M, Garibaldi, E, Gennari Pietro, G, Gentilucci, A, Giacobbe, A, Giussani, L, Giusti, G, Gontero, P, Guarneri, A, Guida, C, Gurioli, A, Huqi, D, Imbimbo, C, Ingrosso, G, Iotti, C, Italia, C, La Mattina, P, Lamanna, E, Lastrucci, L, Lazzari, G, Liberale, F, Liguori, G, Lisi, R, Lohr, F, Lombardo, R, Lovisolo, J, Ludovico Giuseppe, M, Macchione, N, Maggio, F, Malizia, M, Manasse, G, Mandoliti, G, Mantini, G, Marafioti, L, Marciello, L, Marconi Alberto, M, Martilotta, A, Marzano, S, Masciullo, S, Maso, G, Massenzo, A, Mazzeo, E, Mearini, L, Medoro, S, Mole, R, Monesi, G, Montanari, E, Montefiore, F, Montesi, G, Morgia, G, Moro, G, Muscas, G, Musio, D, Muto, P, Muzzonigro, G, Napodano, G, Negro, C, Nidini, M, Ntreta, M, Orsatti, M, Palazzolo, C, Palumbo, I, Parisi, A, Parma, P, Pavan, N, Pericolini, M, Pinto, F, Pistone, A, Pizzuti, V, Platania, A, Polli, C, Pomara, G, Ponti, E, Porcaro, A, Porpiglia, F, Pugliese, D, Pycha, A, Raguso, G, Rampini, A, Randone Donato, F, Roboldi, V, Roscigno, M, Ruggieri, M, Ruoppo, G, Sanseverino, R, Santacaterina, A, Santarsieri, M, Santoni, R, Scagliarini, S, Scagliotti Giorgio, V, Scanzi, M, Scarcia, M, Schiavina, R, Sciarra, A, Sciorio, C, Scolaro, T, Scuzzarella, S, Selvaggio, O, Serao, A, Serni, S, Signor, M, Silvani, M, Silvano, G, Silvestris, F, Simone, V, Spagnoletti, G, Spinelli Matteo, G, Squillace, L, Tombolini, V, Toninelli, M, Trinchieri, A, Trodella, L, Trombetta, C, Tronnolone, L, Tucci, M, Urzi, D, Valdagni, R, Valeriani, M, Vanoli, M, Vitali, E, Volpe, A, Zaramella, S, Zeccolini, G, Zini, G, Antonelli A., Palumbo C., Noale M., Porreca A., Maggi S., Simeone C., Bassi P., Bertoni F., Bracarda S., Buglione M., Conti G. N., Corvo R., Gacci M., Mirone V., Montironi R., Triggiani L., Tubaro A., Artibani W., Crepaldi G., Graziotti P., Russi E., Magrini Stefano M., Muto G., Pecoraro S., Ricardi U., Zagonel V., Alitto Anna R., Ambrosi E., Aristei C., Barbieri M., Bardari F., Bardoscia L., Barra S., Bartoncini S., Basso U., Becherini C., Bellavita R., Bergamaschi F., Berlingheri S., Berruti A., Borghesi M., Bortolus R., Borzillo V., Bosetti D., Bove G., Bove P., Brausi M., Bruni A., Bruno G., Brunocilla E., Buffoli A., Buttigliero C., Cacciamani G., Caldiroli M., Cardo G., Carmignani G., Carrieri G., Castelli E., Castrezzati E., Catalano G., Cattarino S., Catucci F., Cavallini F. D., Ceccarini O., Celia A., Chiancone F., Chini T., Cianci C., Cisternino A., Collura D., Corbella F., Corinti M., Corsi P., Cortese F., Corti L., de Cosimo N., Cristiano O., D'Angelillo R., Da Pozzo L., D'agostino D., D'Elia C., Dandrea M., De Angelis M., De Angelis P., De Cobelli O., De Concilio B., De Lisa A., De Luca S., De Stefani A., Deantoni C. L., Degli Esposti C., Destito A., Detti B., Di Muzio N., Di Stasio A., Di Stefano C., Di Trapani D., Difino G., Falivene S., Farullo G., Fedelini P., Ferrari I., Ferrau F., Ferro M., Fodor A., Fontana F., Francesca F., Francolini G., Frata P., Frezza G., Gabriele P., Galeandro M., Garibaldi E., Gennari Pietro G., Gentilucci A., Giacobbe A., Giussani L., Giusti G., Gontero P., Guarneri A., Guida C., Gurioli A., Huqi D., Imbimbo C., Ingrosso G., Iotti C., Italia C., La Mattina P., Lamanna E., Lastrucci L., Lazzari G., Liberale F., Liguori G., Lisi R., Lohr F., Lombardo R., Lovisolo J. A. J., Ludovico Giuseppe M., Macchione N., Maggio F., Malizia M., Manasse G., Mandoliti G., Mantini G., Marafioti L., Marciello L., Marconi Alberto M., Martilotta A., Marzano S., Masciullo S., Maso G., Massenzo A., Mazzeo E., Mearini L., Medoro S., Mole R., Monesi G., Montanari E., Montefiore F., Montesi G., Morgia G., Moro G., Muscas G., Musio D., Muto P., Muzzonigro G., Napodano G., Negro C. L. A., Nidini M., Ntreta M., Orsatti M., Palazzolo C., Palumbo I., Parisi A., Parma P., Pavan N., Pericolini M., Pinto F., Pistone A., Pizzuti V., Platania A., Polli C., Pomara G., Ponti E., Porcaro A. B., Porpiglia F., Pugliese D., Pycha A., Raguso G., Rampini A., Randone Donato F., Roboldi V., Roscigno M., Ruggieri M. P., Ruoppo G., Sanseverino R., Santacaterina A., Santarsieri M., Santoni R., Scagliarini S., Scagliotti Giorgio V., Scanzi M., Scarcia M., Schiavina R., Sciarra A., Sciorio C., Scolaro T., Scuzzarella S., Selvaggio O., Serao A., Serni S., Signor M. A., Silvani M., Silvano G., Silvestris F., Simone V., Spagnoletti G., Spinelli Matteo G., Squillace L., Tombolini V., Toninelli M., Trinchieri A., Trodella L. E., Trodella L., Trombetta C., Tronnolone L., Tucci M., Urzi D., Valdagni R., Valeriani M., Vanoli M., Vitali E., Volpe A., Zaramella S., Zeccolini G., and Zini G.
- Abstract
Background: To report health-related quality of life outcomes as assessed by validated patient-reported outcome measures (PROMs) after radical prostatectomy (RP).-Methods: This study analyzed patients treated with RP within The PROState cancer monitoring in Italy, from the National Research Council (Pros-IT CNR). Italian versions of Short-Form Heath Survey and university of California los Angeles-prostate cancer index questionnaires were administered. PROMs were physical composite scores, mental composite scores and urinary, bowel, sexual functions and bothers (UF/B, BF/B, SF/B). Baseline unbalances were controlled with propensity scores and stabilized inverse weights; differences in PROMs between different RP approaches were estimated by mixed models. Results: Of 541 patients treated with RP, 115 (21%) received open RP (ORP), 90 (17%) laparoscopic RP (LRP) and 336 (61%) robot-assisted RP (RARP). At head-to-head-comparisons, RARP showed higher 12-month UF vs. LRP (interaction treatment ∗ time p = 0.03) and 6-month SF vs. ORP (p < 0.001). At 12-month from surgery, 67, 73 and 79% of patients used no pad for urinary loss in ORP, LRP and RARP respectively (no differences for each comparison). Conversely, 16, 27 and 40% of patients declared erections firm enough for sexual intercourse in ORP, LRP and RARP respectively (only significant difference for ORP vs. RARP, p = 0.0004). Conclusions: Different RP approaches lead to significant variations in urinary and sexual PROMs, with a general trend in favour of RARP. However, their clinical significance seems limited.
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- 2019
21. Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)
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Mari, A, Campi, R, Schiavina, R, Amparore, D, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Borghesi, M, Bove, P, Brunocilla, E, Capitanio, U, Da Pozzo, L, Daja, J, Gontero, P, Larcher, A, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Pisano, F, Porpiglia, F, Simeone, C, Siracusano, S, Tellini, R, Trombetta, C, Volpe, A, Ficarra, V, Carini, M, Minervini, A, Altieri, V, Berardinelli, F, Celia, A, Costantini, E, Di Maida, F, Falsaperla, M, Fiori, C, Furlan, M, Marson, F, Montorsi, F, Morgia, G, Porreca, A, Roscigno, M, Schips, L, Selli, C, Simonato, A, Terrone, C, Vespasiani, G, Villari, D, Mari A., Campi R., Schiavina R., Amparore D., Antonelli A., Artibani W., Barale M., Bertini R., Borghesi M., Bove P., Brunocilla E., Capitanio U., Da Pozzo L., Daja J., Gontero P., Larcher A., Li Marzi V., Longo N., Mirone V., Montanari E., Pisano F., Porpiglia F., Simeone C., Siracusano S., Tellini R., Trombetta C., Volpe A., Ficarra V., Carini M., Minervini A., Altieri V., Berardinelli F., Celia A., Costantini E., Di Maida F., Falsaperla M., Fiori C., Furlan M., Marson F., Montorsi F., Morgia G., Porreca A., Roscigno M., Schips L., Selli C., Simonato A., Terrone C., Vespasiani G., Villari D., Mari, A, Campi, R, Schiavina, R, Amparore, D, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Borghesi, M, Bove, P, Brunocilla, E, Capitanio, U, Da Pozzo, L, Daja, J, Gontero, P, Larcher, A, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Pisano, F, Porpiglia, F, Simeone, C, Siracusano, S, Tellini, R, Trombetta, C, Volpe, A, Ficarra, V, Carini, M, Minervini, A, Altieri, V, Berardinelli, F, Celia, A, Costantini, E, Di Maida, F, Falsaperla, M, Fiori, C, Furlan, M, Marson, F, Montorsi, F, Morgia, G, Porreca, A, Roscigno, M, Schips, L, Selli, C, Simonato, A, Terrone, C, Vespasiani, G, Villari, D, Mari A., Campi R., Schiavina R., Amparore D., Antonelli A., Artibani W., Barale M., Bertini R., Borghesi M., Bove P., Brunocilla E., Capitanio U., Da Pozzo L., Daja J., Gontero P., Larcher A., Li Marzi V., Longo N., Mirone V., Montanari E., Pisano F., Porpiglia F., Simeone C., Siracusano S., Tellini R., Trombetta C., Volpe A., Ficarra V., Carini M., Minervini A., Altieri V., Berardinelli F., Celia A., Costantini E., Di Maida F., Falsaperla M., Fiori C., Furlan M., Marson F., Montorsi F., Morgia G., Porreca A., Roscigno M., Schips L., Selli C., Simonato A., Terrone C., Vespasiani G., and Villari D.
- Abstract
Objective: To identify meaningful predictors and to develop a nomogram of postoperative surgical complications in patients treated with partial nephrectomy (PN). Patients and Methods: We prospectively evaluated 4308 consecutive patients who had surgical treatment for renal tumours, between 2013 and 2016, at 26 Italian urological centres (RECORd 2 project). A multivariable logistic regression for surgical complications was performed. A nomogram was created from the multivariable model. Internal validation processes were performed using bootstrapping with 1000 repetitions. Results: Overall, 2584 patients who underwent PN were evaluated for the final analyses. The median (interquartile [IQR]) American Society of Anesthesiologists (ASA) score was 2 (2–3). In all, 72.4% of patients had clinical T1a (cT1a) stage tumours. The median (IQR) Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score was 7 (6–8). Overall, 34.3%, 27.7%, 38% of patients underwent open PN (OPN), laparoscopic PN (LPN), and robot-assisted PN (RAPN). Overall and major postoperative surgical complications were recorded in 10.2% and 2.5% of patients, respectively. At multivariable analysis, age, ASA score, cT2 vs cT1a stage, PADUA score, preoperative anaemia, OPN and LPN vs RAPN, were significant predictive factors of postoperative surgical complications. We used these variables to construct a nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. Conclusion: Several clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.
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- 2019
22. Diagnostic Accuracy of Novel Urinary Biomarker Tests in Non-muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis
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Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., Pradere, B., Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., and Pradere, B.
- Abstract
Item does not contain fulltext, CONTEXT: During the past decade, several urinary biomarker tests (UBTs) for bladder cancer have been developed and made commercially available. However, none of these is recommended by international guidelines so far. OBJECTIVE: To assess the diagnostic estimates of novel commercially available UBTs for diagnosis and surveillance of non-muscle-invasive bladder cancer (NMIBC) using diagnostic test accuracy (DTA) and network meta-analysis (NMA). EVIDENCE ACQUISITION: PubMed, Web of Science, and Scopus were searched up to April 2021 to identify studies addressing the diagnostic values of UBTs: Xpert bladder cancer, Adxbladder, Bladder EpiCheck, Uromonitor and Cxbladder Monitor, and Triage and Detect. The primary endpoint was to assess the pooled diagnostic values for disease recurrence in NMIBC patients using a DTA meta-analysis and to compare them with cytology using an NMA. The secondary endpoints were the diagnostic values for high-grade (HG) recurrence as well as for the initial detection of bladder cancer. EVIDENCE SYNTHESIS: Twenty-one studies, comprising 7330 patients, were included in the quantitative synthesis. In most of the studies, there was an unclear risk of bias. For NMIBC surveillance, novel UBTs demonstrated promising pooled diagnostic values with sensitivities up to 93%, specificities up to 84%, positive predictive values up to 67%, and negative predictive value up to 99%. Pooled estimates for the diagnosis of HG recurrence were similar to those for the diagnosis of any-grade recurrence. The analysis of the number of cystoscopies potentially avoided during the follow-up of 1000 patients showed that UBTs might be efficient in reducing the number of avoidable interventions with up to 740 cystoscopies. The NMA revealed that diagnostic values (except specificity) of the novel UBTs were significantly higher than those of cytology for the detection of NMIBC recurrence. There were too little data on UBTs in the primary diagnosis setting to allow a statistica
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- 2021
23. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
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Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., Palou, J., Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., and Palou, J.
- Abstract
Item does not contain fulltext, Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. Material and methods: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. Results: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors >= 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The
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- 2021
24. Comparison of the performances of the ADXBLADDER test and urinary cytology in the follow-up of non-muscle-invasive bladder cancer: a blinded prospective multicentric study
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Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., Palou, J., Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., and Palou, J.
- Abstract
Contains fulltext : 245022.pdf (Publisher’s version ) (Open Access), OBJECTIVE: To compare directly the performance of the ADXBLADDER test with that of cytology in the detection of non-muscle-invasive bladder cancer (NMIBC) recurrences. BACKGROUND: ADXBLADDER is a urine test based on the detection of MCM5, a DNA licensing factor expressed in all cells capable of dividing. Expression is usually restricted to the basal stem cell compartment; however, in malignancy, MCM5-expressing cells can be found throughout the epithelium. Detection of MCM5 in urine sediment can be indicative of the presence of a bladder tumour. PATIENTS AND METHODS: A multicentre prospective, blinded study was carried out from August 2017 and July 2019 at 21 European Union centres, 14 of which collected matching cytology data. Urine was collected from patients prior to cystoscopy. Urine cytology and ADXBLADDER were performed and compared to the diagnosis obtained by cystoscopy. The performance of cytology and ADXBLADDER were then compared. RESULTS: The overall performance of ADXBLADDER demonstrated a sensitivity of 51.9%, a specificity of 66.4%, and a negative predictive value (NPV) of 92%. The sensitivity of ADXBLADDER for low- and high-grade recurrences was 44.1% and 58.8%, respectively. By contrast, cytology sensitivity was 16.7%, specificity was 98% and NPV was 90.7%. Cytology sensitivity for both low- and high-grade disease was 17.6%. CONCLUSIONS: ADXBLADDER detection of both low- and high-grade NMIBC recurrence is superior to that of cytology, with ADXBLADDER able to exclude the presence of high-grade recurrence in 97.8% of cases compared to 97.1% with cytology. These results show that ADXBLADDER has promise as a more reliable alternative to urine cytology in the follow-up of NMIBC.
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- 2021
25. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non-muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel Study
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Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., Sylvester, R.J., Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., and Sylvester, R.J.
- Abstract
Item does not contain fulltext, BACKGROUND: In the current European Association of Urology (EAU) non-muscle-invasive bladder cancer (NMIBC) guideline, two classification systems for grade are advocated: WHO1973 and WHO2004/2016. OBJECTIVE: To compare the prognostic value of these WHO systems. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5145 primary Ta/T1 NMIBC patients from 17 centers were collected between 1990 and 2019. The median follow-up was 3.9 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariate and multivariable analyses of WHO1973 and WHO2004/2016 stratified by center were performed for time to recurrence, progression (primary endpoint), cystectomy, and duration of survival, taking into account age, concomitant carcinoma in situ, gender, multiplicity, tumor size, initial treatment, and tumor stage. Harrell's concordance (C-index) was used for prognostic accuracy of classification systems. RESULTS AND LIMITATIONS: The median age was 68 yr; 3292 (64%) patients had Ta tumors. Neither classification system was prognostic for recurrence. For a four-tier combination of both WHO systems, progression at 5-yr follow-up was 1.4% in low-grade (LG)/G1, 3.8% in LG/G2, 7.7% in high grade (HG)/G2, and 18.8% in HG/G3 (log-rank, p < 0.001). In multivariable analyses with WHO1973 and WHO2004/2016 as independent variables, WHO1973 was a significant prognosticator of progression (p < 0.001), whereas WHO2004/2016 was not anymore (p = 0.067). C-indices for WHO1973, WHO2004, and the WHO systems combined for progression were 0.71, 0.67, and 0.73, respectively. Prognostic analyses for cystectomy and survival showed results similar to those for progression. CONCLUSIONS: In this large prognostic factor study, both classification systems were prognostic for progression but not for recurrence. For progression, the prognostic value of WHO1973 was higher than that of WHO 2004/2016. The four-tier combination (LG/G1, LG/G2, HG/G2, and HG/G3) of both WHO systems proved to be superior, as it d
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- 2021
26. European Association of Urology (EAU) Prognostic Factor Risk Groups for Non-muscle-invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel
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Sylvester, R.J., Rodríguez, O., Hernández, V., Turturica, D., Bauerová, L., Bruins, H.M., Bründl, J., Kwast, Theodorus H. van der, Brisuda, A., Rubio-Briones, J., Seles, M., Hentschel, A.E., Kusuma, V.R.M., Huebner, N., Cotte, J., Mertens, L.S., Volanis, D., Cussenot, O., Henríquez, J.D. Subiela, Peña, E. de la, Pisano, F., Pešl, M., Heijden, A.G. van der, Herdegen, S., Zlotta, A.R., Hacek, J., Calatrava, A., Mannweiler, S., Bosschieter, J., Ashabere, D., Haitel, A., Côté, J.F., Sheikh, S., Lunelli, L., Algaba, F., Alemany, I., Soria, F., Runneboom, W., Breyer, J., Nieuwenhuijzen, J.A., Llorente, C., Molinaro, L., Hulsbergen-van de Kaa, C.A., Evert, M., Kiemeney, L.A., N'Dow, J., Plass, K., Čapoun, O., Soukup, V., Dominguez-Escrig, J.L., Cohen, D., Palou, J., Gontero, P., Burger, M., Zigeuner, R., Mostafid, A.H., Shariat, S.F., Rouprêt, M., Compérat, E.M., Babjuk, M., Rhijn, B.W. van, Sylvester, R.J., Rodríguez, O., Hernández, V., Turturica, D., Bauerová, L., Bruins, H.M., Bründl, J., Kwast, Theodorus H. van der, Brisuda, A., Rubio-Briones, J., Seles, M., Hentschel, A.E., Kusuma, V.R.M., Huebner, N., Cotte, J., Mertens, L.S., Volanis, D., Cussenot, O., Henríquez, J.D. Subiela, Peña, E. de la, Pisano, F., Pešl, M., Heijden, A.G. van der, Herdegen, S., Zlotta, A.R., Hacek, J., Calatrava, A., Mannweiler, S., Bosschieter, J., Ashabere, D., Haitel, A., Côté, J.F., Sheikh, S., Lunelli, L., Algaba, F., Alemany, I., Soria, F., Runneboom, W., Breyer, J., Nieuwenhuijzen, J.A., Llorente, C., Molinaro, L., Hulsbergen-van de Kaa, C.A., Evert, M., Kiemeney, L.A., N'Dow, J., Plass, K., Čapoun, O., Soukup, V., Dominguez-Escrig, J.L., Cohen, D., Palou, J., Gontero, P., Burger, M., Zigeuner, R., Mostafid, A.H., Shariat, S.F., Rouprêt, M., Compérat, E.M., Babjuk, M., and Rhijn, B.W. van
- Abstract
Item does not contain fulltext, BACKGROUND: The European Association of Urology (EAU) prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC) are used to provide recommendations for patient treatment after transurethral resection of bladder tumor (TURBT). They do not, however, take into account the widely used World Health Organization (WHO) 2004/2016 grading classification and are based on patients treated in the 1980s. OBJECTIVE: To update EAU prognostic factor risk groups using the WHO 1973 and 2004/2016 grading classifications and identify patients with the lowest and highest probabilities of progression. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for primary NMIBC patients were collected from the institutions of the members of the EAU NMIBC guidelines panel. INTERVENTION: Patients underwent TURBT followed by intravesical instillations at the physician's discretion. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable Cox proportional-hazards regression models were fitted to the primary endpoint, the time to progression to muscle-invasive disease or distant metastases. Patients were divided into four risk groups: low-, intermediate-, high-, and a new, very high-risk group. The probabilities of progression were estimated using Kaplan-Meier curves. RESULTS AND LIMITATIONS: A total of 3401 patients treated with TURBT ± intravesical chemotherapy were included. From the multivariable analyses, tumor stage, WHO 1973/2004-2016 grade, concomitant carcinoma in situ, number of tumors, tumor size, and age were used to form four risk groups for which the probability of progression at 5 yr varied from <1% to >40%. Limitations include the retrospective collection of data and the lack of central pathology review. CONCLUSIONS: This study provides updated EAU prognostic factor risk groups that can be used to inform patient treatment and follow-up. Incorporating the WHO 2004/2016 and 1973 grading classifications, a new, very high-risk group has been identified for wh
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- 2021
27. Total phallic construction techniques in transgender men: An updated narrative review.
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Falcone M., Preto M., Blecher G., Timpano M., Gontero P., Falcone M., Preto M., Blecher G., Timpano M., and Gontero P.
- Abstract
From 2012, the World Professional Association Transgender Health defined a structured therapeutic path and standards of care for transgender patients undergoing genital gender affirming surgery (GGAS). The main goal of GGAS in transgender males is to provide patients with an aesthetically appealing appearance of the neophallus that should allow standing micturition and enabling penetrative intercourse along with erogenous and tactile sensitivity. The optimal procedure should be safe, reproducible and performed in the fewest number of surgical stages. The ideal technique for total phallic construction (TPC) has not yet been demonstrated; TPC remains challenging and, from a functional point of view, it is also make more demanding as yet there are no perfect replacement materials for erectile and urethral tissues. Several procedures and different type of flaps (pedicled and free-flaps) have been proposed and investigated over time to address TPC with significant advances over the years especially after microsurgical procedures introduction. Due to its high complexity TPC is not free from complications. Local tissue ischaemic complications, complete and partial flap loss, donor site morbidity and urethral complications (fistulae and strictures) are reported. This narrative review aims to provide the readers with a contemporary overview of surgical procedures for TPC in transgender males focusing on key surgical steps, as well as surgical and functional outcomes.Copyright © Translational Andrology and Urology. All rights reserved.
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- 2021
28. A Novel Artificial Urinary Sphincter (VICTO) for the Management of Postprostatectomy Urinary Incontinence: Description of the Surgical Technique and Preliminary Results from a Multicenter Series.
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Giammo A., Falcone M., Blecher G., Ammirati E., Geretto P., Manassero A., Bottero D., Lorusso V., Signorello D., Gontero P., Carone R., Giammo A., Falcone M., Blecher G., Ammirati E., Geretto P., Manassero A., Bottero D., Lorusso V., Signorello D., Gontero P., and Carone R.
- Abstract
Aims: The objective of the study was to analyze short-term outcomes and safety profile of the newly designed artificial urinary sphincters (AUSs) VICTO and VICTOplus. Method(s): Data from the implant of VICTO or VICTOplus AUSs on a series of consecutive male patients with stress urinary incontinence (SUI) following radical prostatectomy (RP) were retrospectively collected in 3 tertiary referral centers between May 2017 and December 2019. Patients were affected by moderate-severe genuine SUI (200-400 or >400 g urine leakage in 24-h pad test) refractory to conservative treatment. Outcomes were evaluated through the 24-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Follow-up was scheduled after 3, 6, and 12 months and then when clinically needed. Nonparametric tests were applied in subgroup analyses. Result(s): Seventeen patients were enrolled: 8 were implanted with the VICTO device and 9 with VICTOplus. The median age at surgery was 69 (interquartile range (IQR) 60-75) years. The median follow-up was 15 (IQR 12-18) months. At 12 months, the dry rate was 76.4% and the social continence rate was 94%. The postoperative complication rate was 17.6%. All complications were classified as Clavien-Dindo I. No difference in terms of outcomes was observed between the VICTO and the VICTOplus subgroups. Conclusion(s): Preliminary outcomes of the VICTO and VICTOplus implantation are satisfactory. These devices may represent a safe and realistic solution for patients with moderate-severe SUI following RP.Copyright © 2021 S. Karger AG, Basel.
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- 2021
29. Total phallic construction techniques in transgender men: An updated narrative review.
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Falcone M., Preto M., Blecher G., Timpano M., Gontero P., Falcone M., Preto M., Blecher G., Timpano M., and Gontero P.
- Abstract
From 2012, the World Professional Association Transgender Health defined a structured therapeutic path and standards of care for transgender patients undergoing genital gender affirming surgery (GGAS). The main goal of GGAS in transgender males is to provide patients with an aesthetically appealing appearance of the neophallus that should allow standing micturition and enabling penetrative intercourse along with erogenous and tactile sensitivity. The optimal procedure should be safe, reproducible and performed in the fewest number of surgical stages. The ideal technique for total phallic construction (TPC) has not yet been demonstrated; TPC remains challenging and, from a functional point of view, it is also make more demanding as yet there are no perfect replacement materials for erectile and urethral tissues. Several procedures and different type of flaps (pedicled and free-flaps) have been proposed and investigated over time to address TPC with significant advances over the years especially after microsurgical procedures introduction. Due to its high complexity TPC is not free from complications. Local tissue ischaemic complications, complete and partial flap loss, donor site morbidity and urethral complications (fistulae and strictures) are reported. This narrative review aims to provide the readers with a contemporary overview of surgical procedures for TPC in transgender males focusing on key surgical steps, as well as surgical and functional outcomes.Copyright © Translational Andrology and Urology. All rights reserved.
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- 2021
30. A Novel Artificial Urinary Sphincter (VICTO) for the Management of Postprostatectomy Urinary Incontinence: Description of the Surgical Technique and Preliminary Results from a Multicenter Series.
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Giammo A., Falcone M., Blecher, Gideon, Ammirati E., Geretto P., Manassero A., Bottero D., Lorusso V., Signorello D., Gontero P., Carone R., Giammo A., Falcone M., Blecher, Gideon, Ammirati E., Geretto P., Manassero A., Bottero D., Lorusso V., Signorello D., Gontero P., and Carone R.
- Abstract
Aims: The objective of the study was to analyze short-term outcomes and safety profile of the newly designed artificial urinary sphincters (AUSs) VICTO and VICTOplus. Method(s): Data from the implant of VICTO or VICTOplus AUSs on a series of consecutive male patients with stress urinary incontinence (SUI) following radical prostatectomy (RP) were retrospectively collected in 3 tertiary referral centers between May 2017 and December 2019. Patients were affected by moderate-severe genuine SUI (200-400 or >400 g urine leakage in 24-h pad test) refractory to conservative treatment. Outcomes were evaluated through the 24-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Follow-up was scheduled after 3, 6, and 12 months and then when clinically needed. Nonparametric tests were applied in subgroup analyses. Result(s): Seventeen patients were enrolled: 8 were implanted with the VICTO device and 9 with VICTOplus. The median age at surgery was 69 (interquartile range (IQR) 60-75) years. The median follow-up was 15 (IQR 12-18) months. At 12 months, the dry rate was 76.4% and the social continence rate was 94%. The postoperative complication rate was 17.6%. All complications were classified as Clavien-Dindo I. No difference in terms of outcomes was observed between the VICTO and the VICTOplus subgroups. Conclusion(s): Preliminary outcomes of the VICTO and VICTOplus implantation are satisfactory. These devices may represent a safe and realistic solution for patients with moderate-severe SUI following RP.Copyright © 2021 S. Karger AG, Basel.
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- 2021
31. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients.
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Pisano, F, Gontero, P, Sylvester, R, Joniau, S, Serretta, V, Larré, S, Di Stasi, S, van Rhijn, B, Witjes, A, Grotenhuis, A, Colombo, R, Briganti, A, Babjuk, M, Soukup, V, Malmström, Per-Uno, Irani, J, Malats, N, Baniel, J, Mano, R, Cai, T, Cha, E, Ardelt, P, Varkarakis, J, Bartoletti, R, Dalbagni, G, Shariat, S F, Xylinas, E, Karnes, R J, Palou, J, Pisano, F, Gontero, P, Sylvester, R, Joniau, S, Serretta, V, Larré, S, Di Stasi, S, van Rhijn, B, Witjes, A, Grotenhuis, A, Colombo, R, Briganti, A, Babjuk, M, Soukup, V, Malmström, Per-Uno, Irani, J, Malats, N, Baniel, J, Mano, R, Cai, T, Cha, E, Ardelt, P, Varkarakis, J, Bartoletti, R, Dalbagni, G, Shariat, S F, Xylinas, E, Karnes, R J, and Palou, J
- Abstract
INTRODUCTION AND OBJECTIVES: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. MATERIAL AND METHODS: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. RESULTS: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors > 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001.
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- 2021
- Full Text
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32. Diagnostic Accuracy of Novel Urinary Biomarker Tests in Non-muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis
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Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., Pradere, B., Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., and Pradere, B.
- Abstract
Contains fulltext : 244217.pdf (Publisher’s version ) (Open Access), CONTEXT: During the past decade, several urinary biomarker tests (UBTs) for bladder cancer have been developed and made commercially available. However, none of these is recommended by international guidelines so far. OBJECTIVE: To assess the diagnostic estimates of novel commercially available UBTs for diagnosis and surveillance of non-muscle-invasive bladder cancer (NMIBC) using diagnostic test accuracy (DTA) and network meta-analysis (NMA). EVIDENCE ACQUISITION: PubMed, Web of Science, and Scopus were searched up to April 2021 to identify studies addressing the diagnostic values of UBTs: Xpert bladder cancer, Adxbladder, Bladder EpiCheck, Uromonitor and Cxbladder Monitor, and Triage and Detect. The primary endpoint was to assess the pooled diagnostic values for disease recurrence in NMIBC patients using a DTA meta-analysis and to compare them with cytology using an NMA. The secondary endpoints were the diagnostic values for high-grade (HG) recurrence as well as for the initial detection of bladder cancer. EVIDENCE SYNTHESIS: Twenty-one studies, comprising 7330 patients, were included in the quantitative synthesis. In most of the studies, there was an unclear risk of bias. For NMIBC surveillance, novel UBTs demonstrated promising pooled diagnostic values with sensitivities up to 93%, specificities up to 84%, positive predictive values up to 67%, and negative predictive value up to 99%. Pooled estimates for the diagnosis of HG recurrence were similar to those for the diagnosis of any-grade recurrence. The analysis of the number of cystoscopies potentially avoided during the follow-up of 1000 patients showed that UBTs might be efficient in reducing the number of avoidable interventions with up to 740 cystoscopies. The NMA revealed that diagnostic values (except specificity) of the novel UBTs were significantly higher than those of cytology for the detection of NMIBC recurrence. There were too little data on UBTs in the primary diagnosis setting to allow a statistica
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- 2021
33. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
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Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, J.A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., Palou, J., Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, J.A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., and Palou, J.
- Abstract
Item does not contain fulltext, Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. Material and methods: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. Results: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors >= 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The
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- 2021
34. Comparison of the performances of the ADXBLADDER test and urinary cytology in the follow-up of non-muscle-invasive bladder cancer: a blinded prospective multicentric study
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Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., Palou, J., Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., and Palou, J.
- Abstract
Contains fulltext : 245022.pdf (Publisher’s version ) (Open Access), OBJECTIVE: To compare directly the performance of the ADXBLADDER test with that of cytology in the detection of non-muscle-invasive bladder cancer (NMIBC) recurrences. BACKGROUND: ADXBLADDER is a urine test based on the detection of MCM5, a DNA licensing factor expressed in all cells capable of dividing. Expression is usually restricted to the basal stem cell compartment; however, in malignancy, MCM5-expressing cells can be found throughout the epithelium. Detection of MCM5 in urine sediment can be indicative of the presence of a bladder tumour. PATIENTS AND METHODS: A multicentre prospective, blinded study was carried out from August 2017 and July 2019 at 21 European Union centres, 14 of which collected matching cytology data. Urine was collected from patients prior to cystoscopy. Urine cytology and ADXBLADDER were performed and compared to the diagnosis obtained by cystoscopy. The performance of cytology and ADXBLADDER were then compared. RESULTS: The overall performance of ADXBLADDER demonstrated a sensitivity of 51.9%, a specificity of 66.4%, and a negative predictive value (NPV) of 92%. The sensitivity of ADXBLADDER for low- and high-grade recurrences was 44.1% and 58.8%, respectively. By contrast, cytology sensitivity was 16.7%, specificity was 98% and NPV was 90.7%. Cytology sensitivity for both low- and high-grade disease was 17.6%. CONCLUSIONS: ADXBLADDER detection of both low- and high-grade NMIBC recurrence is superior to that of cytology, with ADXBLADDER able to exclude the presence of high-grade recurrence in 97.8% of cases compared to 97.1% with cytology. These results show that ADXBLADDER has promise as a more reliable alternative to urine cytology in the follow-up of NMIBC.
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- 2021
35. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non-muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel Study
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Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., Sylvester, R.J., Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., and Sylvester, R.J.
- Abstract
Item does not contain fulltext, BACKGROUND: In the current European Association of Urology (EAU) non-muscle-invasive bladder cancer (NMIBC) guideline, two classification systems for grade are advocated: WHO1973 and WHO2004/2016. OBJECTIVE: To compare the prognostic value of these WHO systems. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5145 primary Ta/T1 NMIBC patients from 17 centers were collected between 1990 and 2019. The median follow-up was 3.9 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariate and multivariable analyses of WHO1973 and WHO2004/2016 stratified by center were performed for time to recurrence, progression (primary endpoint), cystectomy, and duration of survival, taking into account age, concomitant carcinoma in situ, gender, multiplicity, tumor size, initial treatment, and tumor stage. Harrell's concordance (C-index) was used for prognostic accuracy of classification systems. RESULTS AND LIMITATIONS: The median age was 68 yr; 3292 (64%) patients had Ta tumors. Neither classification system was prognostic for recurrence. For a four-tier combination of both WHO systems, progression at 5-yr follow-up was 1.4% in low-grade (LG)/G1, 3.8% in LG/G2, 7.7% in high grade (HG)/G2, and 18.8% in HG/G3 (log-rank, p < 0.001). In multivariable analyses with WHO1973 and WHO2004/2016 as independent variables, WHO1973 was a significant prognosticator of progression (p < 0.001), whereas WHO2004/2016 was not anymore (p = 0.067). C-indices for WHO1973, WHO2004, and the WHO systems combined for progression were 0.71, 0.67, and 0.73, respectively. Prognostic analyses for cystectomy and survival showed results similar to those for progression. CONCLUSIONS: In this large prognostic factor study, both classification systems were prognostic for progression but not for recurrence. For progression, the prognostic value of WHO1973 was higher than that of WHO 2004/2016. The four-tier combination (LG/G1, LG/G2, HG/G2, and HG/G3) of both WHO systems proved to be superior, as it d
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- 2021
36. European Association of Urology (EAU) Prognostic Factor Risk Groups for Non-muscle-invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel
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Sylvester, R.J., Rodríguez, O., Hernández, V., Turturica, D., Bauerová, L., Bruins, H.M., Bründl, J., Kwast, Theodorus H. van der, Brisuda, A., Rubio-Briones, J., Seles, M., Hentschel, A.E., Kusuma, V.R.M., Huebner, N., Cotte, J., Mertens, L.S., Volanis, D., Cussenot, O., Henríquez, J.D. Subiela, Peña, E. de la, Pisano, F., Pešl, M., Heijden, A.G. van der, Herdegen, S., Zlotta, A.R., Hacek, J., Calatrava, A., Mannweiler, S., Bosschieter, J., Ashabere, D., Haitel, A., Côté, J.F., Sheikh, S., Lunelli, L., Algaba, F., Alemany, I., Soria, F., Runneboom, W., Breyer, J., Nieuwenhuijzen, J.A., Llorente, C., Molinaro, L., Hulsbergen-van de Kaa, C.A., Evert, M., Kiemeney, L.A., N'Dow, J., Plass, K., Čapoun, O., Soukup, V., Dominguez-Escrig, J.L., Cohen, D., Palou, J., Gontero, P., Burger, M., Zigeuner, R., Mostafid, A.H., Shariat, S.F., Rouprêt, M., Compérat, E.M., Babjuk, M., Rhijn, B.W. van, Sylvester, R.J., Rodríguez, O., Hernández, V., Turturica, D., Bauerová, L., Bruins, H.M., Bründl, J., Kwast, Theodorus H. van der, Brisuda, A., Rubio-Briones, J., Seles, M., Hentschel, A.E., Kusuma, V.R.M., Huebner, N., Cotte, J., Mertens, L.S., Volanis, D., Cussenot, O., Henríquez, J.D. Subiela, Peña, E. de la, Pisano, F., Pešl, M., Heijden, A.G. van der, Herdegen, S., Zlotta, A.R., Hacek, J., Calatrava, A., Mannweiler, S., Bosschieter, J., Ashabere, D., Haitel, A., Côté, J.F., Sheikh, S., Lunelli, L., Algaba, F., Alemany, I., Soria, F., Runneboom, W., Breyer, J., Nieuwenhuijzen, J.A., Llorente, C., Molinaro, L., Hulsbergen-van de Kaa, C.A., Evert, M., Kiemeney, L.A., N'Dow, J., Plass, K., Čapoun, O., Soukup, V., Dominguez-Escrig, J.L., Cohen, D., Palou, J., Gontero, P., Burger, M., Zigeuner, R., Mostafid, A.H., Shariat, S.F., Rouprêt, M., Compérat, E.M., Babjuk, M., and Rhijn, B.W. van
- Abstract
Item does not contain fulltext, BACKGROUND: The European Association of Urology (EAU) prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC) are used to provide recommendations for patient treatment after transurethral resection of bladder tumor (TURBT). They do not, however, take into account the widely used World Health Organization (WHO) 2004/2016 grading classification and are based on patients treated in the 1980s. OBJECTIVE: To update EAU prognostic factor risk groups using the WHO 1973 and 2004/2016 grading classifications and identify patients with the lowest and highest probabilities of progression. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for primary NMIBC patients were collected from the institutions of the members of the EAU NMIBC guidelines panel. INTERVENTION: Patients underwent TURBT followed by intravesical instillations at the physician's discretion. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable Cox proportional-hazards regression models were fitted to the primary endpoint, the time to progression to muscle-invasive disease or distant metastases. Patients were divided into four risk groups: low-, intermediate-, high-, and a new, very high-risk group. The probabilities of progression were estimated using Kaplan-Meier curves. RESULTS AND LIMITATIONS: A total of 3401 patients treated with TURBT ± intravesical chemotherapy were included. From the multivariable analyses, tumor stage, WHO 1973/2004-2016 grade, concomitant carcinoma in situ, number of tumors, tumor size, and age were used to form four risk groups for which the probability of progression at 5 yr varied from <1% to >40%. Limitations include the retrospective collection of data and the lack of central pathology review. CONCLUSIONS: This study provides updated EAU prognostic factor risk groups that can be used to inform patient treatment and follow-up. Incorporating the WHO 2004/2016 and 1973 grading classifications, a new, very high-risk group has been identified for wh
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- 2021
37. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
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Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, J.A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., Palou, J., Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V., Larre, S., Stasi, S. Di, Rhijn, B. Van, Witjes, J.A., Grotenhuis, J.A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V., Malmstrom, P.U., Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S.F., Xylinas, E., Karnes, R.J., and Palou, J.
- Abstract
Item does not contain fulltext, Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. Material and methods: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. Results: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors >= 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The
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- 2021
38. Comparison of the performances of the ADXBLADDER test and urinary cytology in the follow-up of non-muscle-invasive bladder cancer: a blinded prospective multicentric study
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Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., Palou, J., Gontero, P., Montanari, E., Roupret, M., Longo, F., Stockley, J., Kennedy, A., Rodriguez, O., McCracken, S.R.C., Dudderidge, T., Sieverink, C.A., Vanié, F., Allasia, M., Witjes, J.A., Sylvester, R., Colombel, M., and Palou, J.
- Abstract
Contains fulltext : 245022.pdf (Publisher’s version ) (Open Access), OBJECTIVE: To compare directly the performance of the ADXBLADDER test with that of cytology in the detection of non-muscle-invasive bladder cancer (NMIBC) recurrences. BACKGROUND: ADXBLADDER is a urine test based on the detection of MCM5, a DNA licensing factor expressed in all cells capable of dividing. Expression is usually restricted to the basal stem cell compartment; however, in malignancy, MCM5-expressing cells can be found throughout the epithelium. Detection of MCM5 in urine sediment can be indicative of the presence of a bladder tumour. PATIENTS AND METHODS: A multicentre prospective, blinded study was carried out from August 2017 and July 2019 at 21 European Union centres, 14 of which collected matching cytology data. Urine was collected from patients prior to cystoscopy. Urine cytology and ADXBLADDER were performed and compared to the diagnosis obtained by cystoscopy. The performance of cytology and ADXBLADDER were then compared. RESULTS: The overall performance of ADXBLADDER demonstrated a sensitivity of 51.9%, a specificity of 66.4%, and a negative predictive value (NPV) of 92%. The sensitivity of ADXBLADDER for low- and high-grade recurrences was 44.1% and 58.8%, respectively. By contrast, cytology sensitivity was 16.7%, specificity was 98% and NPV was 90.7%. Cytology sensitivity for both low- and high-grade disease was 17.6%. CONCLUSIONS: ADXBLADDER detection of both low- and high-grade NMIBC recurrence is superior to that of cytology, with ADXBLADDER able to exclude the presence of high-grade recurrence in 97.8% of cases compared to 97.1% with cytology. These results show that ADXBLADDER has promise as a more reliable alternative to urine cytology in the follow-up of NMIBC.
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- 2021
39. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non-muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel Study
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Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., Sylvester, R.J., Rhijn, B.W. van, Hentschel, A.E., Bründl, J., Compérat, E.M., Hernández, V., Čapoun, O., Bruins, H.M., Cohen, D., Rouprêt, M., Shariat, S.F., Mostafid, A.H., Zigeuner, R., Dominguez-Escrig, J.L., Burger, M., Soukup, V., Gontero, P., Palou, J., Kwast, Theodorus H. van der, Heijden, A.G. van der, Kiemeney, L.A., Babjuk, M., and Sylvester, R.J.
- Abstract
Item does not contain fulltext, BACKGROUND: In the current European Association of Urology (EAU) non-muscle-invasive bladder cancer (NMIBC) guideline, two classification systems for grade are advocated: WHO1973 and WHO2004/2016. OBJECTIVE: To compare the prognostic value of these WHO systems. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5145 primary Ta/T1 NMIBC patients from 17 centers were collected between 1990 and 2019. The median follow-up was 3.9 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariate and multivariable analyses of WHO1973 and WHO2004/2016 stratified by center were performed for time to recurrence, progression (primary endpoint), cystectomy, and duration of survival, taking into account age, concomitant carcinoma in situ, gender, multiplicity, tumor size, initial treatment, and tumor stage. Harrell's concordance (C-index) was used for prognostic accuracy of classification systems. RESULTS AND LIMITATIONS: The median age was 68 yr; 3292 (64%) patients had Ta tumors. Neither classification system was prognostic for recurrence. For a four-tier combination of both WHO systems, progression at 5-yr follow-up was 1.4% in low-grade (LG)/G1, 3.8% in LG/G2, 7.7% in high grade (HG)/G2, and 18.8% in HG/G3 (log-rank, p < 0.001). In multivariable analyses with WHO1973 and WHO2004/2016 as independent variables, WHO1973 was a significant prognosticator of progression (p < 0.001), whereas WHO2004/2016 was not anymore (p = 0.067). C-indices for WHO1973, WHO2004, and the WHO systems combined for progression were 0.71, 0.67, and 0.73, respectively. Prognostic analyses for cystectomy and survival showed results similar to those for progression. CONCLUSIONS: In this large prognostic factor study, both classification systems were prognostic for progression but not for recurrence. For progression, the prognostic value of WHO1973 was higher than that of WHO 2004/2016. The four-tier combination (LG/G1, LG/G2, HG/G2, and HG/G3) of both WHO systems proved to be superior, as it d
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- 2021
40. Diagnostic Accuracy of Novel Urinary Biomarker Tests in Non-muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis
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Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., Pradere, B., Laukhtina, E., Shim, S.R., Mori, K., D'Andrea, D., Soria, F., Rajwa, P., Mostafaei, H., Compérat, E., Cimadamore, A., Moschini, M., Teoh, J.Y., Enikeev, D., Xylinas, E., Lotan, Y., Palou, J., Gontero, P., Babjuk, M., Witjes, J.A., Kamat, A.M., Roupret, M., Shariat, S.F., and Pradere, B.
- Abstract
Contains fulltext : 244217.pdf (Publisher’s version ) (Open Access), CONTEXT: During the past decade, several urinary biomarker tests (UBTs) for bladder cancer have been developed and made commercially available. However, none of these is recommended by international guidelines so far. OBJECTIVE: To assess the diagnostic estimates of novel commercially available UBTs for diagnosis and surveillance of non-muscle-invasive bladder cancer (NMIBC) using diagnostic test accuracy (DTA) and network meta-analysis (NMA). EVIDENCE ACQUISITION: PubMed, Web of Science, and Scopus were searched up to April 2021 to identify studies addressing the diagnostic values of UBTs: Xpert bladder cancer, Adxbladder, Bladder EpiCheck, Uromonitor and Cxbladder Monitor, and Triage and Detect. The primary endpoint was to assess the pooled diagnostic values for disease recurrence in NMIBC patients using a DTA meta-analysis and to compare them with cytology using an NMA. The secondary endpoints were the diagnostic values for high-grade (HG) recurrence as well as for the initial detection of bladder cancer. EVIDENCE SYNTHESIS: Twenty-one studies, comprising 7330 patients, were included in the quantitative synthesis. In most of the studies, there was an unclear risk of bias. For NMIBC surveillance, novel UBTs demonstrated promising pooled diagnostic values with sensitivities up to 93%, specificities up to 84%, positive predictive values up to 67%, and negative predictive value up to 99%. Pooled estimates for the diagnosis of HG recurrence were similar to those for the diagnosis of any-grade recurrence. The analysis of the number of cystoscopies potentially avoided during the follow-up of 1000 patients showed that UBTs might be efficient in reducing the number of avoidable interventions with up to 740 cystoscopies. The NMA revealed that diagnostic values (except specificity) of the novel UBTs were significantly higher than those of cytology for the detection of NMIBC recurrence. There were too little data on UBTs in the primary diagnosis setting to allow a statistica
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- 2021
41. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
- Author
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Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V, Larre, S., Di Stasi, S., van Rhijn, B., Witjes, A., Grotenhuis, A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V, Malmström, Per-Uno, Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S. F., Xylinas, E., Karnes, R. J., Palou, J., Pisano, F., Gontero, P., Sylvester, R., Joniau, S., Serretta, V, Larre, S., Di Stasi, S., van Rhijn, B., Witjes, A., Grotenhuis, A., Colombo, R., Briganti, A., Babjuk, M., Soukup, V, Malmström, Per-Uno, Irani, J., Malats, N., Baniel, J., Mano, R., Cai, T., Cha, E., Ardelt, P., Varkarakis, J., Bartoletti, R., Dalbagni, G., Shariat, S. F., Xylinas, E., Karnes, R. J., and Palou, J.
- Abstract
Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. Material and methods: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. Results: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors >= 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001
- Published
- 2021
- Full Text
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42. Comparison of the performances of the ADXBLADDER test and urinary cytology in the follow-up of non-muscle-invasive bladder cancer: a blinded prospective multicentric study.
- Author
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Gontero, P. and Gontero, P.
- Subjects
- Radboudumc 15: Urological cancers RIMLS: Radboud Institute for Molecular Life Sciences.
- Published
- 2021
43. Dual implantation of penile prosthesis and ATOMS system for post-prostatectomy erectile dysfunction and urinary incontinence: a feasibility study.
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Blecher G., Falcone M., Preto M., Ammirati E., Carone R., Gontero P., Giammo A., Blecher G., Falcone M., Preto M., Ammirati E., Carone R., Gontero P., and Giammo A.
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- 2020
44. Dual implantation of penile prosthesis and ATOMS system for post-prostatectomy erectile dysfunction and urinary incontinence: a feasibility study.
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Blecher G., Falcone M., Preto M., Ammirati E., Carone R., Gontero P., Giammo A., Blecher G., Falcone M., Preto M., Ammirati E., Carone R., Gontero P., and Giammo A.
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- 2020
45. Transurethral Resection of Bladder Tumour: The Neglected Procedure in the Technology Race in Bladder Cancer
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Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., Kamat, A.M., Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., and Kamat, A.M.
- Abstract
Contains fulltext : 220581.pdf (Publisher’s version ) (Closed access), Transurethral resection of bladder tumour is the initial, most critical step in the management of bladder cancer; as such, this is a call to arms for the urological community to it the due diligence it deserves regarding technology and training.
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- 2020
46. EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort Under the Auspices of the EAU-ESMO Guidelines Committees
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Witjes, JA, Babjuk, M, Bellmunt, J, Bruins, HM, De Reijke, TM, De Santis, M, Gillessen, S, James, N, Maclennan, S, Palou, J, Powles, T, Ribal, MJ, Shariat, SF, Van der Kwast, T, Xylinas, E, Agarwal, N, Arends, T, Bamias, A, Birtle, A, Black, PC, Bochner, BH, Bolla, M, Boormans, JL, Bossi, A, Briganti, A, Brummelhuis, I, Burger, M, Castellano, D, Cathomas, R, Chiti, A, Choudhury, A, Comperat, E, Crabb, S, Culine, S, De Bari, B, De Blok, W, De Visschere, PJL, Decaestecker, K, Dimitropoulos, K, Dominguez-Escrig, JL, Fanti, S, Fonteyne, V, Frydenberg, M, Futterer, JJ, Gakis, G, Geavlete, B, Gontero, P, Grubmueller, B, Hafeez, S, Hansel, DE, Hartmann, A, Hayne, D, Henry, AM, Hernandez, V, Herr, H, Herrmann, K, Hoskin, P, Huguet, J, Jereczek-Fossa, BA, Jones, R, Kamat, AM, Khoo, V, Kiltie, AE, Krege, S, Ladoire, S, Lara, PC, Leliveld, A, Linares-Espinos, E, Logager, V, Lorch, A, Loriot, Y, Meijer, R, Mir, MC, Moschini, M, Mostafid, H, Mueller, A-C, Mueller, CR, N'Dow, J, Necchi, A, Neuzillet, Y, Oddens, JR, Oldenburg, J, Osanto, S, Oyen, WJG, Pacheco-Figueiredo, L, Pappot, H, Patel, M, Pieters, BR, Plass, K, Remzi, M, Retz, M, Richenberg, J, Rink, M, Roghmann, F, Rosenberg, JE, Roupret, M, Rouviere, O, Salembier, C, Salminen, A, Sargos, P, Sengupta, S, Sherif, A, Smeenk, RJ, Smits, A, Stenzl, A, Thalmann, GN, Tombal, B, Turkbey, B, Lauridsen, SV, Valdagni, R, Van der Heijden, AG, Van Poppel, H, Vartolomei, MD, Veskimae, E, Vilaseca, A, Rivera, FAV, Wiegel, T, Wiklund, P, Williams, A, Zigeuner, R, Horwich, A, Witjes, JA, Babjuk, M, Bellmunt, J, Bruins, HM, De Reijke, TM, De Santis, M, Gillessen, S, James, N, Maclennan, S, Palou, J, Powles, T, Ribal, MJ, Shariat, SF, Van der Kwast, T, Xylinas, E, Agarwal, N, Arends, T, Bamias, A, Birtle, A, Black, PC, Bochner, BH, Bolla, M, Boormans, JL, Bossi, A, Briganti, A, Brummelhuis, I, Burger, M, Castellano, D, Cathomas, R, Chiti, A, Choudhury, A, Comperat, E, Crabb, S, Culine, S, De Bari, B, De Blok, W, De Visschere, PJL, Decaestecker, K, Dimitropoulos, K, Dominguez-Escrig, JL, Fanti, S, Fonteyne, V, Frydenberg, M, Futterer, JJ, Gakis, G, Geavlete, B, Gontero, P, Grubmueller, B, Hafeez, S, Hansel, DE, Hartmann, A, Hayne, D, Henry, AM, Hernandez, V, Herr, H, Herrmann, K, Hoskin, P, Huguet, J, Jereczek-Fossa, BA, Jones, R, Kamat, AM, Khoo, V, Kiltie, AE, Krege, S, Ladoire, S, Lara, PC, Leliveld, A, Linares-Espinos, E, Logager, V, Lorch, A, Loriot, Y, Meijer, R, Mir, MC, Moschini, M, Mostafid, H, Mueller, A-C, Mueller, CR, N'Dow, J, Necchi, A, Neuzillet, Y, Oddens, JR, Oldenburg, J, Osanto, S, Oyen, WJG, Pacheco-Figueiredo, L, Pappot, H, Patel, M, Pieters, BR, Plass, K, Remzi, M, Retz, M, Richenberg, J, Rink, M, Roghmann, F, Rosenberg, JE, Roupret, M, Rouviere, O, Salembier, C, Salminen, A, Sargos, P, Sengupta, S, Sherif, A, Smeenk, RJ, Smits, A, Stenzl, A, Thalmann, GN, Tombal, B, Turkbey, B, Lauridsen, SV, Valdagni, R, Van der Heijden, AG, Van Poppel, H, Vartolomei, MD, Veskimae, E, Vilaseca, A, Rivera, FAV, Wiegel, T, Wiklund, P, Williams, A, Zigeuner, R, and Horwich, A
- Abstract
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus stateme
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- 2020
47. Transurethral Resection of Bladder Tumour: The Neglected Procedure in the Technology Race in Bladder Cancer
- Author
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Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., Kamat, A.M., Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., and Kamat, A.M.
- Abstract
Contains fulltext : 220581.pdf (Publisher’s version ) (Closed access), Transurethral resection of bladder tumour is the initial, most critical step in the management of bladder cancer; as such, this is a call to arms for the urological community to it the due diligence it deserves regarding technology and training.
- Published
- 2020
48. Transurethral Resection of Bladder Tumour: The Neglected Procedure in the Technology Race in Bladder Cancer
- Author
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Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., Kamat, A.M., Mostafid, H, Babjuk, M., Bochner, B., Lerner, S.P., Witjes, F., Palou, J., Roupret, M., Shariat, S., Gontero, P., van Rhijn, B., Zigeuner, R., Sylvester, R., Comperat, E., Burger, M., Malavaud, B., Soloway, M., Williams, S., Black, P., Daneshmand, S., Steinberg, G., Brausi, M., Catto, J., and Kamat, A.M.
- Abstract
Contains fulltext : 220581.pdf (Publisher’s version ) (Closed access), Transurethral resection of bladder tumour is the initial, most critical step in the management of bladder cancer; as such, this is a call to arms for the urological community to it the due diligence it deserves regarding technology and training.
- Published
- 2020
49. EAU–ESMO consensus statements on the management of advanced and variant bladder cancer - an international collaborative multi-stakeholder effort : under the auspices of the EAU and ESMO Guidelines Committees
- Author
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Horwich, A, Babjuk, M, Bellmunt, J, Bruins, H M, Reijke, T M De, Santis, M De, Gillessen, S, James, N, Maclennan, S, Palou, J, Powles, T, Ribal, M J, Shariat, S F, Kwast, T Van Der, Xylinas, E, Agarwal, N, Arends, T, Bamias, A, Birtle, A, Black, P C, Bochner, B H, Bolla, M, Boormans, J L, Bossi, A, Briganti, A, Brummelhuis, I, Burger, M, Castellano, D, Cathomas, R, Chiti, A, Choudhury, A, Compérat, E, Crabb, S, Culine, S, Bari, B De, Blok, W De, De Visschere, P J L, Decaestecker, K, Dimitropoulos, K, Dominguez-Escrig, J L, Fanti, S, Fonteyne, V, Frydenberg, M, Futterer, J J, Gakis, G, Geavlete, B, Gontero, P, Grubmüller, B, Hafeez, S, Hansel, D E, Hartmann, A, Hayne, D, Henry, A M, Hernandez, V, Herr, H, Herrmann, K, Hoskin, P, Huguet, J, Jereczek-Fossa, B A, Jones, R, Kamat, A M, Khoo, V, Kiltie, A E, Krege, S, Ladoire, S, Lara, P C, Leliveld, A, Linares-Espinós, E, Løgager, V, Lorch, A, Loriot, Y, Meijer, R, Mir, M Carmen, Moschini, M, Mostafid, H, Müller, A-C, Müller, C R, N'Dow, J, Necchi, A, Neuzillet, Y, Oddens, J R, Oldenburg, J, Osanto, S, Oyen, W J G, Pacheco-Figueiredo, L, Pappot, H, Patel, M I, Pieters, B R, Plass, K, Remzi, M, Retz, M, Richenberg, J, Rink, M, Roghmann, F, Rosenberg, J E, Rouprêt, M, Rouvière, O, Salembier, C, Salminen, A, Sargos, P, Sengupta, S, Sherif, Amir, Smeenk, R J, Smits, A, Stenzl, A, Thalmann, G N, Tombal, B, Turkbey, B, Lauridsen, S Vahr, Valdagni, R, Van Der Heijden, A G, Van Poppel, H, Vartolomei, M D, Veskimäe, E, Vilaseca, A, Rivera, F A Vives, Wiegel, T, Wiklund, P, Williams, A, Zigeuner, R, Witjes, J A, Horwich, A, Babjuk, M, Bellmunt, J, Bruins, H M, Reijke, T M De, Santis, M De, Gillessen, S, James, N, Maclennan, S, Palou, J, Powles, T, Ribal, M J, Shariat, S F, Kwast, T Van Der, Xylinas, E, Agarwal, N, Arends, T, Bamias, A, Birtle, A, Black, P C, Bochner, B H, Bolla, M, Boormans, J L, Bossi, A, Briganti, A, Brummelhuis, I, Burger, M, Castellano, D, Cathomas, R, Chiti, A, Choudhury, A, Compérat, E, Crabb, S, Culine, S, Bari, B De, Blok, W De, De Visschere, P J L, Decaestecker, K, Dimitropoulos, K, Dominguez-Escrig, J L, Fanti, S, Fonteyne, V, Frydenberg, M, Futterer, J J, Gakis, G, Geavlete, B, Gontero, P, Grubmüller, B, Hafeez, S, Hansel, D E, Hartmann, A, Hayne, D, Henry, A M, Hernandez, V, Herr, H, Herrmann, K, Hoskin, P, Huguet, J, Jereczek-Fossa, B A, Jones, R, Kamat, A M, Khoo, V, Kiltie, A E, Krege, S, Ladoire, S, Lara, P C, Leliveld, A, Linares-Espinós, E, Løgager, V, Lorch, A, Loriot, Y, Meijer, R, Mir, M Carmen, Moschini, M, Mostafid, H, Müller, A-C, Müller, C R, N'Dow, J, Necchi, A, Neuzillet, Y, Oddens, J R, Oldenburg, J, Osanto, S, Oyen, W J G, Pacheco-Figueiredo, L, Pappot, H, Patel, M I, Pieters, B R, Plass, K, Remzi, M, Retz, M, Richenberg, J, Rink, M, Roghmann, F, Rosenberg, J E, Rouprêt, M, Rouvière, O, Salembier, C, Salminen, A, Sargos, P, Sengupta, S, Sherif, Amir, Smeenk, R J, Smits, A, Stenzl, A, Thalmann, G N, Tombal, B, Turkbey, B, Lauridsen, S Vahr, Valdagni, R, Van Der Heijden, A G, Van Poppel, H, Vartolomei, M D, Veskimäe, E, Vilaseca, A, Rivera, F A Vives, Wiegel, T, Wiklund, P, Williams, A, Zigeuner, R, and Witjes, J A
- Abstract
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus sta
- Published
- 2019
- Full Text
- View/download PDF
50. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committeesdagger
- Author
-
Horwich, A., Babjuk, M., Bellmunt, J., Bruins, H.M., Reijke, T.M. de, Santis, M. de, Gillessen, S., James, N., MacLennan, S., Palou, J., Powles, T., Ribal, M.J., Shariat, S.F., Kwast, T.V., Xylinas, E., Agarwal, N., Arends, T.J., Bamias, A., Birtle, A., Black, P.C., Bochner, B.H., Bolla, M., Boormans, J.L., Bossi, A., Briganti, A., Brummelhuis, I., Burger, M., Castellano, D., Cathomas, R., Chiti, A., Choudhury, A., Comperat, E., Crabb, S., Culine, S., Bari, B. De, Blok, W., Visschere, P.J. De, Decaestecker, K., Dimitropoulos, K., Dominguez-Escrig, J.L., Fanti, S., Fonteyne, V., Frydenberg, M., Fütterer, J.J., Gakis, G., Geavlete, B., Gontero, P., Grubmuller, B., Hafeez, S., Hansel, D.E., Hartmann, A., Hayne, D., Henry, A.M., Hernandez, V., Herr, H., Herrmann, K., Hoskin, P., Huguet, J., Jereczek-Fossa, B.A., Jones, R., Kamat, A.M., Khoo, V., Kiltie, A.E., Krege, S., Ladoire, S., Lara, P.C., Leliveld, A., Linares-Espinos, E., Logager, V., Lorch, A., Loriot, Y., Meijer, R., Mir, M.C., Moschini, M., Mostafid, H, Muller, A.C., Muller, C.R., N'Dow, J., Necchi, A., Neuzillet, Y., Oddens, J.R., Oldenburg, J., Osanto, S., Oyen, W.J., Pacheco-Figueiredo, L., Pappot, H., Patel, M.I., Pieters, B.R., Plass, K., Remzi, M., Retz, M., Richenberg, J., Rink, M., Roghmann, F., Rosenberg, J.E., Roupret, M., Rouviere, O., Salembier, C., Salminen, A., Sargos, P., Smeenk, R.J., Heijden, A.G. van der, Witjes, J.A., Horwich, A., Babjuk, M., Bellmunt, J., Bruins, H.M., Reijke, T.M. de, Santis, M. de, Gillessen, S., James, N., MacLennan, S., Palou, J., Powles, T., Ribal, M.J., Shariat, S.F., Kwast, T.V., Xylinas, E., Agarwal, N., Arends, T.J., Bamias, A., Birtle, A., Black, P.C., Bochner, B.H., Bolla, M., Boormans, J.L., Bossi, A., Briganti, A., Brummelhuis, I., Burger, M., Castellano, D., Cathomas, R., Chiti, A., Choudhury, A., Comperat, E., Crabb, S., Culine, S., Bari, B. De, Blok, W., Visschere, P.J. De, Decaestecker, K., Dimitropoulos, K., Dominguez-Escrig, J.L., Fanti, S., Fonteyne, V., Frydenberg, M., Fütterer, J.J., Gakis, G., Geavlete, B., Gontero, P., Grubmuller, B., Hafeez, S., Hansel, D.E., Hartmann, A., Hayne, D., Henry, A.M., Hernandez, V., Herr, H., Herrmann, K., Hoskin, P., Huguet, J., Jereczek-Fossa, B.A., Jones, R., Kamat, A.M., Khoo, V., Kiltie, A.E., Krege, S., Ladoire, S., Lara, P.C., Leliveld, A., Linares-Espinos, E., Logager, V., Lorch, A., Loriot, Y., Meijer, R., Mir, M.C., Moschini, M., Mostafid, H, Muller, A.C., Muller, C.R., N'Dow, J., Necchi, A., Neuzillet, Y., Oddens, J.R., Oldenburg, J., Osanto, S., Oyen, W.J., Pacheco-Figueiredo, L., Pappot, H., Patel, M.I., Pieters, B.R., Plass, K., Remzi, M., Retz, M., Richenberg, J., Rink, M., Roghmann, F., Rosenberg, J.E., Roupret, M., Rouviere, O., Salembier, C., Salminen, A., Sargos, P., Smeenk, R.J., Heijden, A.G. van der, and Witjes, J.A.
- Abstract
Contains fulltext : 215784.pdf (publisher's version ) (Closed access), BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as >/=70% agreement and
- Published
- 2019
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