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23. Validation of the 2009 TNM Version in a Large Multi-Institutional Cohort of Patients Treated for Renal Cell Carcinoma: Are Further Improvements Needed?

Author

Novara, G, Ficarra, V, Antonelli, A, Artibani, W, Bertini, R, Carini, M, Cosciani Cunico, S, Imbimbo, C, Longo, N, Martignoni, G, Martorana, G, Minervini, A, Mirone, V, Montorsi, F, Schiavina, R, Simeone, C, Serni, S, Simonato, A, Siracusano, S, Volpe, A, Carmignani, G, De Cobelli O, SATURN Project LUNA F. o. u. n. d. a. t. i. o. n., Corti, S, Castelli, M, Cimino, S, Favilla, V, Morgia, G, Billia, M, Terrone, C, Masieri, L, Oneto, F, Varca, V, Rocco, F, Costantini, E, Porena, M, Zucchi, A, Ciciliato, S, Lampropoulou, N, Fontana, D, Gontero, Paolo, Tizzani, Alessandro, Brunelli, M, Valotto, C, Zattoni, F., Novara, G, Ficarra, V, Antonelli, A, Artibani, W, Bertini, R, Carini, M, Cosciani Cunico, S, Imbimbo, Ciro, Longo, Nicola, Martignoni, G, Martorana, G, Minervini, A, Mirone, Vincenzo, Montorsi, F, Schiavina, R, Simeone, C, Serni, S, Simonato, A, Siracusano, S, Volpe, A, Carmignani, G., Novara, Giacomo, Ficarra, Vincenzo, Antonelli, Alessandro, Artibani, Walter, Bertini, Roberto, Carini, Marco, Cunico Sergio, Cosciani, Martignoni, Guido, Martorana, Giuseppe, Minervini, Andrea, Montorsi, Francesco, Schiavina, Roberto, Simeone, Claudio, Serni, Sergio, Simonato, Alchiede, Siracusano, Salvatore, Volpe, Alessandro, Carmignani, Giorgio, G., Novara, V., Ficarra, A., Antonelli, W., Artibani, R., Bertini, M., Carini, S. C., Cunico, N., Longo, G., Martignoni, G., Martorana, A., Minervini, F., Montorsi, R., Schiavina, C., Simeone, S., Serni, A., Simonato, S., Siracusano, A., Volpe, G., Carmignani, Novara G., Ficarra V., Antonelli A., Artibani W., Bertini R., Carini M., Cosciani Cunico S., Imbimbo C., Longo N., Martignoni G., Martorana G., Minervini A., Mirone V., Montorsi F., Schiavina R., Simeone C., Serni S., Simonato A., Siracusano S., Volpe A., Carmignani G., De Cobelli O., Corti S., Castelli M., Cimino S., Favilla V., Morgia G., Billia M., Terrone C., Masieri L., Oneto F., Varca V., Rocco F., Costantini E., Porena M., Zucchi A., Ciciliato S., Lampropoulou N., Fontana D., Gontero P., Tizzani A., Brunelli M., Valotto C., Zattoni F., Petralia G., Roscigno M., Strada E., NOVARA G, FICARRA V, ANTONELLI A, ARTIBANI W, BERTINI R, CARINI M, COSCIANI CUNICO S, IMBIMBO C, LONGO N, MARTIGNONI G, MARTORANA G, MINERVINI A, MIRONE V, MONTORSI F, SCHIAVINA R., SIMEONE C, SERNI S, SIMONATO A, SIRACUSANO S, VOLPE A, CARMIGNANI G, SATURN PROJECT-LUNA FOUNDATION., ERRATUM IN: EUR UROL. 2011 JAN, 59(1):182. SCHIAVINA, ROBERTO [CORRECTED TO SCHIAVINA, RICCARDO]., Imbimbo, C, Longo, N, Mirone, V, Carmignani, G, and SATURN Project LUNA, Foundation

Subjects
Male, Nephrology, Oncology, IMPACT, medicine.medical_treatment, Validation of the 2009 TNM version in a large multi-institutional cohort of patients treated for renal cell carcinoma: are further improvements needed?, Kidney neoplasm, Nephrectomy, Renal cell carcinoma, TNM, Urology, Cohort Studies, renal cell carcinoma, staging system, PROPOSAL, PRIMARY TUMOR CLASSIFICATION, NEPHRECTOMY, RECLASSIFICATION, kidney cancer, RADICAL NEPHRECTOMY, Middle Aged, Primary tumor, Kidney Neoplasms, REVISION, classification, Cohort, CUTOFF, Aged, Carcinoma, Renal Cell, Female, Humans, Neoplasm Staging, Retrospective Studies, kidney neoplasm, Human, medicine.medical_specialty, TNM staging system, STRATIFICATION, Internal medicine, medicine, business.industry, Carcinoma, Renal Cell, Retrospective cohort study, medicine.disease, Surgery, SIZE, Cohort Studie, business, Kidney cancer, Kidney disease
Abstract

Background: A new edition of the TNM was recently released that includes modifications for the staging system of kidney cancers. Specifically, T2 cancers were subclassified into T2a and T2b ( 10 cm), tumors with renal vein involvement or perinephric fat involvement were classified as T3a cancers, and those with adrenal involvement were classified as T4 cancers. Objective: Our aim was to validate the recently released edition of the TNM staging system for primary tumor classification in kidney cancer. Design, setting, and participants: Our multicenter retrospective study consisted of 5339 patients treated in 16 academic Italian centers. Intervention: Patients underwent either radical or partial nephrectomy. Measurements: Univariable and multivariable Cox regression models addressed cancer-specific survival (CSS) after surgery. Results and limitations: In the study, 1897 patients (35.5%) were classified as pT1a, 1453 (27%) as pT1b, 437 (8%) as pT2a, 153 (3%) as pT2b, 1059 (20%) as pT3a, 117 (2%) as pT3b, 26 (0.5%) as pT3c, and 197 (4%) as pT4. At a median follow-up of 42 mo, 786 (15%) had died of disease. In univariable analysis, patients with pT2b and pT3a tumors had similar CSS, as did patients with pT3c and pT4 tumors. Moreover, both pT3a and pT3b stages included patients with heterogeneous outcomes. In multivariable analysis, the novel classification of the primary tumor was a powerful independent predictor of CSS (p for trend < 0.0001). However, the substratification of pT1 tumors did not retain an independent predictive role. The major limitations of the study are retrospective design, lack of central pathologic review, and the small number of patients included in some substages. Conclusions: The recently released seventh edition of the primary tumor staging system for kidney tumors is a powerful predictor of CSS. However, some of the substages identified by the classification have overlapping prognoses, and other substages include patients with heterogeneous outcomes. The few modifications included in this edition may have not resolved the most critical issues in the previous version. (C) 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Published
2010

27. Evaluation of intralesional injection of hyaluronic acid compared with verapamil in Peyronie's disease: preliminary results from a prospective, double-blinded, randomized study

Author

Favilla, V., primary, Russo, G. I., additional, Zucchi, A., additional, Siracusa, G., additional, Privitera, S., additional, Cimino, S., additional, Madonia, M., additional, Cai, T., additional, Cavallini, G., additional, Liguori, G., additional, D'Achille, G., additional, Silvani, M., additional, Franco, G., additional, Verze, P., additional, Palmieri, A., additional, Torrisi, B., additional, Mirone, V., additional, and Morgia, G., additional

Published
2017
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28. Intralesional verapamil versus ialuronic acid for the treatment of Peyronie’s disease: A randomized single-blinded study

Author

Favilla, V., primary, Russo, G.I., additional, Zucchi, A., additional, Siracusa, G., additional, Privitera, S., additional, Cimino, S., additional, Madonia, M., additional, Cai, T., additional, Cavallini, G., additional, Liguori, G., additional, Silvani, M., additional, Dachille, G., additional, Franco, G., additional, Verze, P., additional, Palmieri, A., additional, Mirone, V., additional, and Morgia, G., additional

Published
2017
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31. Chromophobe renal cell carcinoma (RCC): oncological outcomes and prognostic factors in a large multicentre series

Author

Volpe, A., Novara, G., Antonelli, A., Bertini, R., Billia, M., Carmignani, G., Cosciani Cunico, S., Longo, N., Martignoni, G., Minervini, A., Mirone, V., Simonato, A., Terrone, C., Zattoni, F., Ficarra, V., De Cobelli, O., Martorana, G., Schiavina, R., Corti, S., Simeone, C., Castelli, M., Cimino, Sebastiano, Favilla, V., Morgia, Giuseppe Maria, Imbimbo, C., Carini, M., Masieri, L., Serni, S., Oneto, F., Varca, V., Rocco, F., Valotto, C., Costantini, E., Porena, M., Zucchi, A., Ciciliato, S., Lampropoulou, N., Siracusano, S., Fontana, D., Gontero, P., Tizzani, A., Artibani, W., Brunelli, M., Montorsi, F., Petralia, G., Roscigno, M., Strada, E., Alessandro Volpe, Giacomo Novara, Alessandro Antonelli, Roberto Bertini, Michele Billia, Giorgio Carmignani, Sergio Cosciani Cunico, Nicola Longo, Guido Martignoni, Andrea Minervini, Vincenzo Mirone, Alchiede Simonato, Carlo Terrone, Filiberto Zattoni, Vincenzo Ficarra, members of the Surveillance and Treatment Update on Renal Neoplasms (SATURN) Project – Leading Urological No-Profit Foundation for Advanced Research (LUNA) Foundation [.., Riccardo Schiavina, ], Volpe, A., Novara, G., Antonelli, A., Bertini, R., Billia, M., Carmignani, G., Cosciani Cunico, S., Longo, N., Martignoni, G., Minervini, A., Mirone, V., Simonato, A., Terrone, C., Zattoni, F., Ficarra, V., De Cobelli, O., Martorana, G., Schiavina, R., Corti, S., Simeone, C., Castelli, M., Cimino, S., Favilla, V., Morgia, G., Imbimbo, C., Carini, M., Masieri, L., Serni, S., Oneto, F., Varca, V., Rocco, F., Valotto, C., Costantini, E., Porena, M., Zucchi, A., Ciciliato, Stefano, Lampropoulou, N., Siracusano, Salvatore, Fontana, D., Gontero, P., Tizzani, A., Artibani, W., Brunelli, M., Montorsi, F., Petralia, G., Roscigno, M., Strada, E., Volpe, Alessandro, Novara, Giacomo, Antonelli, Alessandro, Bertini, Roberto, Billia, Michele, Carmignani, Giorgio, Cunico, Sergio Cosciani, Longo, Nicola, Martignoni, Guido, Minervini, Andrea, Mirone, Vincenzo, Simonato, Alchiede, Terrone, Carlo, Zattoni, Filiberto, Ficarra, Vincenzo, Volpe, A, Novara, G, Antonelli, A, Bertini, R, Billia, M, Carmignani, G, Cunico, Sc, Martignoni, G, Minervini, A, Simonato, A, Terrone, C, Zattoni, F, Imbimbo, Ciro, Ciciliato, S., and Siracusano, S.

Subjects
Male, renal cell carcinoma, chromophobe RCC, prognostic factors, Carcinoma, Nephrectomy, Prognosis, Renal cell, Kaplan-Meier Estimate, Chromophobe renal cell carcinoma, Chromophobe, Humans, Carcinoma, Renal Cell, carcinoma, renal cell, chromophobe, prognosis, nephrectomy, Kidney Neoplasm, Middle Aged, Kidney Neoplasms, oncological outcames, oncological outcomes and prognostic factors, Female, prognosi, Human
Abstract

Study Type - Outcomes (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? About 80% of RCCs have clear cell histology, and consistent data are available about the clinical and histological characteristics of this histological subtype. Conversely, less attention has been dedicated to the study of non-clear cell renal tumours Specifically, published data show that chromophobe RCC (ChRCC) have often favourable pathological stages and better nuclear grades as well as a lower risk of metastasizing compared with clear cell RCC (ccRCC). Patients with ChRCC were shown to have significantly higher cancer-specific survival (CSS) probabilities compared with ccRCC. However, an independent prognostic role of RCC histotype was not confirmed in some large multicenter series and only a few studies have focused on the oncological outcomes of ChRCC. The present study is one of the few to evaluate cancer-related outcomes of ChRCC and represents to our knowledge the largest series of ChRCCs. Consequently, the present findings may assist in elucidating the natural history of surgically treated ChRCC. The present study confirms that ChRCCs have good prognosis and a low tendency to progress and metastasize. Only 1.3% of patients presented with distant metastases at diagnosis, and the 5- and 10-year CSS were 93% and 88.9%, respectively. However, although ChRCCs are generally characterised by an excellent prognosis, we observed that patients with locally advanced or metastatic cancers as well as those with sarcomatoid differentiation have a poor outcome. The study also investigated prognostic factors for recurrence-free survival (RFS) and CSS for this RCC histotype. The definition of outcome predictors can be useful for patient counselling, planning of follow-up strategies, and patient selection for clinical trials. In the present study, gender, clinical T stage, pathological T stage, and presence of sarcomatoid differentiation were significantly associated with RFS and CSS at multivariable analysis. We also identified N/M stage as an independent predictor of CSS. Notably, as Fuhrman grade was not an independent predictor of cancer-related outcomes, the present study confirms that this histological variable is not a reliable prognostic factor for ChRCC. OBJECTIVES: To investigate cancer-related outcomes of chromophobe renal cell carcinoma (ChRCC) in a large multicentre dataset. To determine prognostic factors for recurrence-free survival (RFS) and cancer-specific survival (CSS) for this RCC histological type. PATIENTS AND METHODS: In all, 291 patients with ChRCC were identified from a multi-institutional retrospective database including 5463 patients who were surgically treated for RCC at 16 Italian academic centres between 1995 and 2007. Univariable and multivariable Cox regression models were used to identify prognostic factors predictive of RFS and CSS after surgery for ChRCC. RESULTS: At a median follow-up of 44 months, 25 patients (8.6%) had disease recurrence and 18 patients (6.2%) died from disease. The 5-year RFS and CSS rates were 89.3% and 93%, respectively. Gender (P= 0.014), clinical T stage (P= 0.017), pathological T stage (P= 0.003), and sarcomatoid differentiation (P= 0.032) were independent predictors of RFS at multivariable analysis. For CSS, there was an independent prognostic role for gender (P= 0.032) and T stage (P= 0.019) among the clinical variables and for T stage (P= 0.016), N/M stage (P= 0.023), and sarcomatoid differentiation (P= 0.015) among the pathological variables. CONCLUSIONS: Patients with ChRCC have a low risk of tumour progression, metastasis, and cancer-specific death. Patient gender, clinical and pathological tumour stage, and sarcomatoid differentiation are significant predictors of RFS and CSS for ChRCC.

Published
2011

32. 'LUTS E DE NELLA PRATICA CLINICA ANDROLOGICA IN SICILIA: ANALISI EPIDEMIOLOGICA SU CONDIZIONI DI FAMILIARITA' (PATOLOGIE URO-GENITALI), COMORBIDITA', ALTERAZIONI' (C33) ALL'ESAME OBIETTIVO

Author

DE GRANDE, G, MORGIA, M, LAPIRA, G, MASTROENI, F, LAMARTINA, M, MILITO, V, FAVILLA, V, LA VIGNERA, S, VICARI, ES, PAVONE, Carlo, ABBADESSA, Daniela, OXENIUS, Irina, ALLEGRO, Rosalinda, DE GRANDE, G, PAVONE, C, MORGIA, M, LAPIRA, G, MASTROENI, F, LAMARTINA, M, MILITO, V, FAVILLA, V, ABBADESSA, D, OXENIUS, I, ALLEGRO, R, LA VIGNERA, S, and VICARI, ES

Subjects
EPIDEMIOLOGIA, PATOLOGIE URO-GENITALI, Settore MED/24 - Urologia
Published
2009

38. Arterial erectile dysfunction: Different severities of endothelial apoptosis between diabetic patients 'responders' and 'non responders' to sildenafil

Author

Condorelli, R.A. Calogero, A.E. Favilla, V. Morgia, G. Johnson, E.O. Castiglione, R. Salemi, M. Mongioi', L. Nicoletti, C. Duca, Y. Di Mauro, M. Vicari, E. La Vignera, S.

Abstract

Background: The low pharmacological response to phosphodiesterase type 5 inhibitors represents an expression of higher endothelial damage in certain categories of patients with erectile dysfunction and high cardiovascular risk. The present study evaluated this objective in type 2 diabetic patients with erectile dysfunction, classified as "non responders" to Sildenafil. Methods: Eighteen "responder" and twelve "non responder" type 2 diabetic patients were evaluated, relatively to different levels of endothelial damage, through the diagnostic use of a new immunophenotype of circulating endothelial progenitor cells (CD45neg/CD34pos/CD144pos) and endothelial microparticles (CD45neg/CD144pos/Annexin Vpos), recently developed and published by our group. Results "Non responder" patients showed a significant higher severity [8.0 ± 3.0 (International Index of Erectile Function-abbreviated version with 5 questions) vs 14.0 ± 3.0] and duration (10.0 ± 2.0 vs 7.0 ± 2.0 years) of erectile dysfunction, higher level of penile arterial insufficiency (peak systolic velocity = 13.0 ± 16.0 vs 28.0 ± 26.0 cm/s; acceleration time = 153 ± 148 vs 125 ± 128 mm/s) and finally a significant higher level of endothelial apoptosis [0.15 ± 0.13 vs 0.05 ±.0.03% (serum concentrations of endothelial microparticles)] associated with higher serum concentrations of circulating late immunophenotype of endothelial progenitor cells (0.40 ± 0.35 vs 0.12 ±.0.10%). Conclusions: The results of this study corroborate the clinical value of the low clinical response to phosphodiesterase type 5 inhibitors in the treatment of erectile dysfunction in the patients with high cardiovascular risk profile, such as diabetics. In addition, the markers used in this study confirm their potential application in clinical practice as useful indicators of endothelial alteration. However, in the future we will have to assess a larger number of patients and for a longer period of observation in order to better understand the causal and temporal relations. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Published
2013

41. Prognostic role of tumour multifocality in renal cell carcinoma

Author

Siracusano, S1, Novara, G, Antonelli, A, Artibani, W, Bertini, R, Carini, M, Carmignani, G, Ciciliato, S, Cunico, Sc, Lampropoulou, N, Longo, N, Martorana, G, Minervini, A, Mirone, V, Simeone, C, Simonato, A, Valotto, C, Zattoni, F, Ficarra, V, Collaborators De Cobelli O, members of the SATURN Project LUNA F. o. u. n. d. a. t. i. o. n., Schiavina, R, Corti, S, Cunico, S, Castelli, M, Cimino, Sebastiano, Favilla, V, Morgia, Giuseppe Maria, Billia, M, Terrone, C, Volpe, A, Imbimbo, C, Masieri, L, Serni, S, Oneto, F, Varca, V, Rocco, F, Costantini, E, Porena, M, Zucchi, A, Siracusano, S, Fontana, D, Gontero, P, Tizzani, A, Brunelli, M, Martignoni, G, Montorsi, F, Petralia, G, Roscigno, M, and Strada, E.

Published
2012

42. Chromophobe renal cell carcinoma (RCC): oncological outcomes and prognostic factors in a large multicentre series

Author

Volpe, A, Novara, G, Antonelli, A, Bertini, R, Billia, M, Carmignani, G, Cunico, Sc, Longo, N, Martignoni, G, Minervini, A, Mirone, V, Simonato, A, Terrone, C, Zattoni, F, Ficarra, V, De Cobelli, O, Martorana, G, Schiavina, R, Corti, S, Simeone, C, Castelli, M, Cimino, S, Favilla, V, Morgia, G, Imbimbo, C, Carini, M, Masieri, L, Serni, S, Oneto, F, Varca, V, Rocco, F, Valotto, C, Costantini, E, Porena, M, Zucchi, A, Ciciliato, S, Lampropoulou, N, Siracusano, S, Fontana, Dario, Gontero, P, Tizzani, A, Artibani, W, Brunelli, M, Montorsi, F, Petralia, G, Roscigno, M, and Strada, E

Published
2012

43. Dietary patterns and prostatic diseases

Author

Cimino, Sebastiano, Favilla, V, Castelli, T, Marchese, F, Sortino, G, Russo, M, Russo, Gi, Cali, C, Salamone, C, Madonia, M, and Morgia, G.

Published
2012

47. Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: results of a nonrandomized, retrospective, comparative study

Author

Minervini, A, Ficarra, V, Rocco, F, Antonelli, A, Bertini, R, Carmignani, G, Cosciani Cunico, S, Fontana, D, Longo, N, Martorana, G, Mirone, V, Morgia, Giuseppe Maria, Novara, G, Roscigno, M, Schiavina, R, Serni, S, Simeone, C, Simonato, A, Siracusano, S, Volpe, A, Zattoni, F, Zucchi, A, Carini, M, De Cobelli O, SATURN Project LUNA F. o. u. n. d. a. t. i. o. n., Corti, S, Castelli, M, Cimino, Sebastiano, Favilla, V, Morgia, G, Billia, M, Terrone, C, Imbimbo, C, Masieri, L, Oneto, F, Varca, V, Valotto, C, Costantini, E, Porena, M, Ciciliato, S, Lampropoulou, N, Gontero, P, Tizzani, A, Artibani, W, Brunelli, M, Martignoni, G, Montorsi, F, Petralia, G, and Strada, E.

Published
2011

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