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Start Over Author "Gozzo, A." Publisher elsevier b.v.
219 results on '"Gozzo, A."'

20. Impairment in Activities of Daily Living Assessed by the Barthel Index Predicts Adverse Oncological Outcomes After Radical Cystectomy for Bladder Cancer.

Author

Panunzio, Andrea, Gozzo, Alessandra, Mazzucato, Giovanni, Ornaghi, Paola Irene, Di Filippo, Giacomo, Soldano, Antonio, De Maria, Nicola, Cianflone, Francesco, Orlando, Rossella, Boldini, Michele, Pettenuzzo, Greta, Montanaro, Francesca, Artibani, Walter, Porcaro, Antonio Benito, Pagliarulo, Vincenzo, Cerruto, Maria Angela, Antonelli, Alessandro, and Tafuri, Alessandro

Subjects
*BARTHEL Index, *ONCOLOGY, *CYSTECTOMY, *BLADDER cancer, *DISEASES
Abstract

The Barthel Index is a widely used tool to assess functional health status. This study tested its role in predicting disease recurrence and survival in patients diagnosed with bladder cancer treated with radical cystectomy. Our results demonstrated that a moderate, severe, or total functional impairment, indicated by a Barthel Index ≤ 90, associated with worse prognosis, even after considering patient and tumor characteristics. Its use in daily clinical practice may improve the risk assessment of patients candidates to radical cystectomy. Introduction: We tested the association between functional impairment in activities of daily living (ADL) assessed through the Barthel Index (BI), and oncological outcomes following radical cystectomy (RC) for bladder cancer (BCa). Patients and Methods: We retrospectively analyzed data of 262 clinically nonmetastatic BCa patients, who underwent RC between 2015 and 2022, with available follow-up. According to preoperative BI, patients were divided in 2 groups: BI =90 (moderate/severe/total dependency in ADL) versus BI 95 to 100 (slight dependency/independency in ADL). Kaplan-Meier plots compared disease recurrence (DR)-, cancer-specific mortality (CSM)-, and overall mortality (OM)- free survival according to established categor ies. Multivar iable Cox regression models tested the BI as an independent predictor of oncological outcomes. Results: According to the BI, the patient cohort was distributed as follows: 19% (n = 50) BI =90 versus 81% (n = 212) BI 95-100. Compared to patients with BI 95 to 100, patients with BI =90 were less likely to receive intravesical immuno- or chemotherapy (18% vs. 34%, p = .028), and more frequently underwent less complex urinary diversion as ureterocutaneostomy (36% vs. 9%, p < .001), or harbored muscle-invasive BCa at final pathology (72% vs. 56%, p = .043). In multivariable Cox regression models adjusted for age, ASA physical status score, pathological T and N stage, and surgical margins status, BI =90 independently predicted higher DR (HR [hazard ratio]:2.00, 95%CI [confidence interval]:1.21-3.30, p = .007), CSM (HR:2.70, 95%CI:1.48-4.90, p = .001), and OM (HR:2.09, 95%CI:1.28-3.43, p = .003). Conclusion: Preoperative impairment in ADL was associated with adverse oncological outcomes following RC for BCa. The integration of the BI into clinical practice may improve the risk assessment of BCa patients candidates to RC. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Surgery for tuberous sclerosis complex-related epilepsy: Risk factors for an unfavorable seizure outcome.

Author

d'Orio, Piergiorgio, Pelliccia, Veronica, Biondi, Diana, Scarpa, Pina, Gozzo, Francesca, Revay, Martina, Cardinale, Francesco, Tassi, Laura, and Cossu, Massimo

Abstract

Purpose: This study aimed to identify risk factors of postoperative seizure outcome in a consecutive cohort of patients operated on for TSC-related focal epilepsy, by evaluating several presurgical and surgical variables, including also MRI-visible brain abnormalities other than cortical tubers.Methods: This retrospective study included 51 patients surgically treated for drug-resistant focal epilepsy with a histological diagnosis of cortical tuber and followed for at least 12 months postoperatively. We investigated the association between several potentially explanatory variables and seizure outcome by univariate and multivariate analysis in the whole cohort and in the subgroups of patients with single and multiple tubers, respectively.Results: The median postoperative follow-up was 115 months (IQR 63-168) and 54.9% of patients were in Engel's class I at final control. In the whole cohort, variables independently associated with an unfavorable seizure outcome (Engel's classes II-IV) were: preoperative non-focal interictal EEG (RR 5, CI 2.46-6.39), presence of sub-ependymal nodules (SEN) (RR 3.53, CI 1.71-4.56) and seizure onset before the first year of age (RR 3.56, CI 0.91-6.89). Non-focal interictal EEG was independently associated with an unfavorable outcome also in the subgroup of patients with multiple tubers (RR 4.34, CI 2.23-5.37), while the presence of SEN (p=0.0221) and of extra-central nervous system lesions (p= 0.0152) predicted an unfavorable seizure outcome in patients with a single tuber.Conclusion: Surgery represents an effective option for seizure control in patients with TSC-related epilepsy. The identification of preoperative risk factors for seizure outcome could be helpful for optimizing patients' selection for surgery and pre-surgical counseling. [ABSTRACT FROM AUTHOR]

Published
2022
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