2,422 results on '"Gontero P."'
Search Results
2. Development and validation of a clinical decision support system based on PSA, microRNAs, and MRI for the detection of prostate cancer
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Mazzetti, Simone, Defeudis, Arianna, Nicoletti, Giulia, Chiorino, Giovanna, De Luca, Stefano, Faletti, Riccardo, Gatti, Marco, Gontero, Paolo, Manfredi, Matteo, Mello-Grand, Maurizia, Peraldo-Neia, Caterina, Zitella, Andrea, Porpiglia, Francesco, Regge, Daniele, and Giannini, Valentina
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- 2024
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3. Risk of Cancer-related Death for Men with Biopsy Grade Group 1 Prostate Cancer and High-risk Features: A European Multi-institutional Study
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Daimantas Milonas, Alexander Giesen, Tim Muilwijk, Charlotte Soenens, Gaëtan Devos, Zilvinas Venclovas, Alberto Briganti, Paolo Gontero, R. Jeffrey Karnes, Piotr Chlosta, Frank Claessens, Gert De Meerleer, Wouter Everaerts, Markus Graefen, Giansilvio Marchioro, Rafael Sanchez-Salas, Bertrand Tombal, Henk Van Der Poel, Hendrik Van Poppel, Martin Spahn, and Steven Joniau
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High-risk prostate cancer ,Gleason grading ,Radical prostatectomy ,Outcomes ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
International Society of Urological Pathology grade group 1 (GG 1) prostate cancer (PCa) is generally considered insignificant, with recent suggestions that it should even be considered as “noncancerous”. We evaluated outcomes for patients with GG 1 PCa on biopsy (bGG 1) and high-risk features (prostate-specific antigen [PSA] >20 ng/ml and/or cT3–4 stage) to challenge the hypothesis that every case of bGG 1 PCa has a benign disease course. We used the multi-institutional EMPaCT database, which includes data for 9508 patients with high-risk PCa undergoing surgery. We included patients with bGG 1 PCa (n = 848) in our analysis and divided them into three groups according to PSA >20 ng/ml, cT3–4 stage, or both. The estimated 10-yr cancer-specific survival (CSS) rate was 96% in the overall population, 88% in the group with both PSA >20 ng/ml and cT3–4 stage, 97% in the group with PSA >20 ng/ml alone, and 98% in the group with cT3–4 stage alone. Similar CSS outcomes were found in subgroups with GG 1 PCa on pathology (n = 502) and with GG 1 on biopsy diagnosed after 2005 (n = 253). Study limitations include the lack of magnetic resonance imaging (MRI) staging and MRI-targeted biopsies. In conclusion, patients with GG 1 and either PSA >20 ng/ml or cT3–4 stage have a low risk of dying from their cancer after surgery. However, patients with GG 1 PCa and both PSA >20 ng/ml and cT3–4 stage are at higher risk of cancer-specific mortality and active treatment should be discussed for this subgroup. Patient summary: We assessed outcomes for patients diagnosed with low-grade prostate cancer on biopsy who also had one or two factors associated with high risk disease. Men with both of those risk factors had a higher risk of dying from their prostate cancer. Active treatment should be discussed for this subgroup of patients.
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- 2024
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4. MRI-Targeted Prostate Fusion Biopsy: What Are We Missing outside the Target? Implications for Treatment Planning
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Marco Oderda, Alessandro Dematteis, Giorgio Calleris, Romain Diamand, Marco Gatti, Giancarlo Marra, Gilles Adans-Dester, Yazan Al Salhi, Antonio Pastore, Riccardo Faletti, and Paolo Gontero
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prostate biopsy ,fusion ,out-field ,outside ,MRI ,accuracy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: This study aimed to evaluate the added diagnostic value of systematic biopsies (SBx) after magnetic resonance imaging (MRI)-targeted biopsies (TBx) and the presence of prostate cancer (PCa) outside MRI targets, in a prospective, contemporary, multicentric series of fusion biopsy patients. Methods: We collected data on 962 consecutive patients who underwent fusion biopsy between 2022 and 2024. Prostate cancer was considered clinically significant (csPCa) in the case of grade ≥ 2. Median test and Fisher exact chi-square tests were used. To identify predictors of out-field positivity, univariate and multivariable logistic regression analyses were performed. Results: Prostate cancer and csPCa were detected by TBx only in 56% and 50%, respectively, and by SBx only in 55% and 45%, respectively (p < 0.001). Prostate cancer and csPCa were diagnosed by TBx in 100 (10%) and 82 (8%) SBx-negative cases and by SBx in 86 (9%) and 54 (6%) TBx-negative cases (p < 0.001). Tumors outside MRI targets were found in 213 (33%) cases in the same lobe and 208 (32%) in the contralateral lobe, most of them being csPCa. Predictors of out-field contralateral PCa were positive DRE (HR 1.50, p 0.03), PSA density ≥ 0.15 (HR 2.20, p < 0.001), and PI-RADS score 5 (HR 2.04, p 0.01). Conclusions: Both TBx and SBx identify a non-negligible proportion of csPCa when the other modality is negative. SBx after TBx should always be considered given the risk of missing other csPCa foci within the prostate, especially in patients with positive DRE, PSA density ≥ 0.15, and PIRADS 5 lesions.
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- 2024
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5. Observation With or Without Subsequent Salvage Therapy for Pathologically Node-positive Prostate Cancer With Negative Conventional Imaging: Results From a Large Multicenter Cohort
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Giancarlo Marra, Federico Lesma, Gabriele Montefusco, Claudia Filippini, Jonathan Olivier, Andres Affentranger, Josias Bastian Grogg, Thomas Hermanns, Luca Afferi, Christian D. Fankhauser, Agostino Mattei, Bartosz Malkiewicz, Simone Scuderi, Francesco Barletta, Sebastian Gallina, Alessandro Antonelli, Fabio Zattoni, Fabrizio Dal Moro, Wever Lieke, Timo Soeterik, Roderick C.N. van den Bergh, Pawel Rajwa, Shahrokh F. Shariat, Lara Rodriguez-Sanchez, Rossella Nicoletti, Riccardo Campi, Mohamed Ahmed, R. Jeffrey Karnes, Michael Ladurner, Isabel Heidegger, Alberto Briganti, Paolo Gontero, Giorgio Gandaglia, William Berchiche, Guillaume Ploussard, Peter Chiu, Charles Dariane, Ignacio Puche-Sanz, Kamil Kowalczyk, Alberto Bianchi, Alessandro Magli, Fabrizio Tonetto, and Matteo Facco
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Prostate cancer ,Negative conventional imaging ,Positive lymph nodes ,Observation ,Salvage therapies ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and objective: More than 10% of patients with negative clinical metastatic status (cN0M0) on conventional imaging for prostate cancer (PCa) harbor lymph node involvement (pN+) at final pathology following radical prostatectomy (RP) and lymphadenectomy. Our aim was to assess outcomes of initial observation for cN0M0 pN+ PCa and identify prognostic factors that may help in clinical decision-making. Methods: We performed a retrospective multicenter study of patients with cN0M0 PCa on conventional imaging (computed tomography and/or magnetic resonance imaging, and a bone scan) who were found to have pN+ disease at RP between 2000 and 2021. Biochemical recurrence (BCR) and systemic progression/recurrence were the primary outcomes. Kaplan-Meier curves and Cox proportional hazards model were used for survival and multivariate analysis. Key findings and limitations: A total of 469 men were included in this retrospective multicenter trial. Median prostate-specific antigen (PSA) was 10.1 ng/ml (interquartile range [IQR] 6.6–18.0). Among these patients, 56% had grade group ≥4, 53.7% had stage ≥pT3b, 42.6% had positive margins, and 19.6% had PSA persistence. The median number of positive nodes and of nodes removed were 1 (IQR 1–3) and 20 (14–28), respectively. At median follow-up of 41 mo, 48.5% experienced BCR. The 5-yr BCR-free survival rate was 31.7% (95% confidence interval [CI] 26.33–37.1%). Salvage treatments were needed in 211 patients and included radiotherapy (RT; n = 53), RT + androgen deprivation therapy (ADT; n = 88), ADT alone (n = 68), and salvage lymphadenectomy (n = 2). The 5-yr estimated survival rates were 66.3% (95% CI 60.4–72.1) for metastasis-free survival, 97.7% (95% CI 95.5–99.8%) for cancer-specific survival, and 95.3% (95% CI 92.4–98.1%) for overall survival. On multivariable analysis, PSA persistence was an independent predictor of BCR (odds ratio [OR] 51.8, 95% CI 12.2–219.2), exit from observation (OR 8.5, 95% CI 4.4–16.5), and systemic progression (OR 3.0, 95% CI 1.771–4.971). Conclusions: Initial observation in the management of pN+ cN0M0 PCa is feasible and has excellent survival rates in the intermediate term. Patients with worse disease features, especially PSA persistence, have a higher likelihood of recurrence and progression and may be candidates for more aggressive upfront management. Patient summary: We investigated the value of initial observation for men with prostate cancer with negative scan findings for metastasis who were then found to have positive lymph nodes after surgery to remove the prostate. Our results show that initial observation is a good option for patients with less aggressive prostate cancer features.
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- 2024
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6. Differential effect of surgical technique on intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial cancer: a systematic review and Meta-analysis
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Tsuboi, Ichiro, Matsukawa, Akihiro, Kardoust Parizi, Mehdi, Klemm, Jakob, Schulz, Robert J, Cadenar, Anna, Mancon, Stefano, Chiujdea, Sever, Fazekas, Tamás, Miszczyk, Marcin, Laukhtina, Ekaterina, Kawada, Tatsushi, Katayama, Satoshi, Iwata, Takehiro, Bekku, Kensuke, Wada, Koichiro, Gontero, Paolo, Rouprêt, Morgan, Teoh, Jeremy, Singla, Nirmish, Araki, Motoo, and Shariat, Shahrokh F.
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- 2024
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7. Reply to YuHsiang Lin, ChenPang Hou, and ChunTe Wu’s letter to the editor beyond traditional stenting: evaluating pigtail suture stents for reduced ureterorenoscopy symptoms
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Bosio, Andrea, Alessandria, Eugenio, and Gontero, Paolo
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- 2024
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8. External validation and comparison of magnetic resonance imaging-based risk prediction models for prostate biopsy stratification
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Diamand, Romain, Guenzel, Karsten, Jabbour, Teddy, Baudewyns, Arthur, Bourgeno, Henri-Alexandre, Lefebvre, Yolène, Ferriero, Mariaconsiglia, Simone, Giuseppe, Fourcade, Alexandre, Fournier, Georges, Bui, Alexandre Patrick, Taha, Fayek, Oderda, Marco, Gontero, Paolo, Rysankova, Katerina, Bernal-Gomez, Adrian, Mastrorosa, Alessandro, Roche, Jean-Baptiste, Fiard, Gaelle, Abou Zahr, Rawad, Ploussard, Guillaume, Windisch, Olivier, Novello, Quentin, Benamran, Daniel, Delavar, Gina, Anract, Julien, Barry Delongchamps, Nicolas, Halinski, Adam, Dariane, Charles, Vlahopoulos, Léonidas, Assenmacher, Gregoire, Roumeguère, Thierry, and Peltier, Alexandre
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- 2024
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9. The impact of prostate volume estimation on the risk‐adapted biopsy decision based on prostate-specific antigen density and magnetic resonance imaging score
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Baudewyns, Arthur, Guenzel, Karsten, Halinski, Adam, Dariane, Charles, Delavar, Gina, Anract, Julien, Barry Delongchamps, Nicolas, Jabbour, Teddy, Bourgeno, Henri-Alexandre, Lefebvre, Yolène, Ferriero, Mariaconsiglia, Simone, Giuseppe, Fourcade, Alexandre, Fournier, Georges, Oderda, Marco, Gontero, Paolo, Bernal-Gomez, Adrian, Mastrorosa, Alessandro, Roche, Jean-Baptiste, Zahr, Rawad Abou, Ploussard, Guillaume, Fiard, Gaelle, Rysankova, Katerina, Bui, Alexandre Patrick, Taha, Fayek, Windisch, Olivier, Benamran, Daniel, Vlahopoulos, Léonidas, Assenmacher, Gregoire, Roumeguère, Thierry, Peltier, Alexandre, and Diamand, Romain
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- 2024
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10. The impact of mpMRI-targeted vs systematic biopsy on the risk of prostate cancer downgrading at final pathology
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Sorce, G., Stabile, A., Pellegrino, F., Mazzone, E., Mattei, A., Afferi, L., Serni, S., Minervini, A., Roumiguiè, M., Malavaud, B., Valerio, M., Rakauskas, A., Marra, G., Gontero, P., Porpiglia, F., Guo, H., Zhuang, J., Gandaglia, G., Montorsi, F., and Briganti, A.
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- 2024
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11. Patients undergoing double J substitution with a pigtail suture stent report a significant decrease of stent-related symptoms. Results from a prospective multicenter longitudinal trial
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Bosio, Andrea, Ferretti, Stefania, Alessandria, Eugenio, Vitiello, Federico, Vercelli, Eugenia, Campobasso, Davide, Micai, Luca, Gozzo, Claudia, Bertello, Glauco, Guarino, Giulio Gaetano, Alice, Claudia, Bisconti, Alessandro, Fop, Fabrizio, and Gontero, Paolo
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- 2024
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12. A Bosniak III Cyst Unmasking Tubulocystic Renal Cell Carcinoma in an Adolescent: Management with Selective Arterial Clamping and Robotic Enucleation
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Marcello Della Corte, Elisa Cerchia, Marco Allasia, Alessandro Marquis, Alessandra Linari, Martina Mandaletti, Elena Ruggiero, Andrea Sterrantino, Paola Quarello, Massimo Catti, Franca Fagioli, Paolo Gontero, and Simona Gerocarni Nappo
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Bosniak III cyst ,renal cyst ,pediatric ,tubulocystic renal cell carcinoma ,cystic neoplasm of kidney ,renal cell carcinoma ,Surgery ,RD1-811 - Abstract
The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with some adjustments made with the aim of accommodating magnetic resonance imaging (MRI) and ultrasonography (US). Bosniak IV lesions are rare in adolescents, indicating localized renal cell carcinoma and requiring surgical intervention. In contrast, Bosniak III lesions can be treated conservatively, although there is a lack of specific guidelines on their management. We present a case of a 14-year-old boy with a Bosniak III lesion, which was incidentally detected during the US evaluation of a left varicocele. After a 12-month follow-up, MRI revealed progression to a Bosniak IV cyst. Robot-assisted tumor enucleation was performed with selective artery clamping when the patient was 15. Histopathology showed tubulocystic renal cell carcinoma without adverse features. Immunocytochemistry supported a favorable prognosis of this rare tumor (
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- 2024
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13. Inguinal Lymphadenectomy for Penile Cancer: An Interim Report from a Trial Comparing Open Versus Videoendoscopic Surgery Using a Within-patient Design
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Marco Falcone, Murat Gül, Federica Peretti, Mirko Preto, Lorenzo Cirigliano, Martina Scavone, Omid Sedigh, Marco Oderda, and Paolo Gontero
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Penile cancer ,Inguinal lymphadenectomy ,Open surgery ,Video laparoscopic surgery ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and objective: Nodal metastasis is a major survival and prognostic factor in penile cancer (PeCa). Thus, accurate staging, prognosis, and treatment selection require adequate inguinal lymphadenectomy (ILND). ILND surgery should balance oncologic rigor with morbidity and postoperative complications. Our aim was to compare the feasibility and safety of open ILND (OILND) and videoendoscopic ILND (VEILND) in patients with PeCa. Methods: We conducted a single-center randomized trial with a within-patient design between October 2019 and April 2023. Patients who were undergoing either staging or radical ILND for PeCa were included and randomized to receive either OILND or VEILND on one side, with the other technique then used on the contralateral side. The trial was approved by the local ethics committee and was registered on ClinicalTrials.gov (NCT05887921). The primary outcome was the safety of VEILND. Secondary outcomes included intraoperative and postoperative morbidity rates and surgical outcomes for the two procedures, as well as oncological outcomes according to survival estimates. Key findings and limitations: We included 14 patients in the study. Median follow-up was 12 mo (interquartile range [IQR] 12–17). There were no significant differences in operative time and the number of lymph nodes removed between OILND and VEILND. However, the median time to drain removal was significantly shorter in the VEILND group (15 d, IQR 13–17, 95% confidence interval [CI] 12–17) than in the OILND group (27 d, IQR 20–41, 95% CI 24–31; p = 0.025). No intraoperative complications were observed, but postoperative complications occurred in three cases (21.4%, 95% CI 8.4–37.8%) in the VEILND group and eight (57.1%, 95% CI 18.6–54.3%) in the OILND group (p = 0.032). Conclusions and clinical implications: VEILND represents a safe technique to consider for either staging or curative intent in PeCa and seems to have an advantage over OILND in terms of morbidity. Further high-powered studies are warranted to confirm these preliminary results. Patient summary: We compared the outcomes of two different surgical techniques to remove lymph nodes in patients with penile cancer. We found that a video-assisted keyhole surgery approach seems to result in a lower rate of complications than after open surgery.
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- 2024
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14. Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project
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Andrea Cocci, Marta Pezzoli, Fernando Bianco, Franco Blefari, Pierluigi Bove, Francois Cornud, Gaetano De Rienzo, Paolo Destefanis, Danilo Di Trapani, Alessandro Giacobbe, Luca Giovanessi, Antonino Laganà, Giovanni Lughezzani, Guglielmo Manenti, Gianluca Muto, Gianluigi Patelli, Novello Pinzi, Stefano Regusci, Giorgio I. Russo, Juan I.M. Salamanca, Matteo Salvi, Luigi Silvestri, Fabrizio Verweij, Eric Walser, Riccardo G. Bertolo, Valerio Iacovelli, Alessandro Bertaccini, Debora Marchiori, Hugo Davila, Pasquale Ditonno, Paolo Gontero, Gennaro Iapicca, Theo M De Reijke, Vito Ricapito, Pierluca Pellegrini, Andrea Minervini, Sergio Serni, and Francesco Sessa
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Transperineal laser ablation ,Prostate cancer ,Benign prostatic hyperplasia ,Delphi consensus ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method. Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized. Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations. Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.
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- 2024
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15. The outcomes of surgical management options for adult acquired buried penis
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Falcone, Marco, Preto, Mirko, Timpano, Massimiliano, Oderda, Marco, Plamadeala, Natalia, Cirigliano, Lorenzo, Blecher, Gideon, Peretti, Federica, Ferro, Ilaria, and Gontero, Paolo
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- 2023
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16. Impact of operator expertise on transperineal free-hand mpMRI-fusion-targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicenter prospective learning curve
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Calleris, Giorgio, Marquis, Alessandro, Zhuang, Junlong, Beltrami, Mattia, Zhao, Xiaozhi, Kan, Yansheng, Oderda, Marco, Huang, Haifeng, Faletti, Riccardo, Zhang, Qing, Molinaro, Luca, Wang, Wei, Guo, Hongqian, Gontero, Paolo, and Marra, Giancarlo
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- 2023
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17. Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?
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Beijert, Irene J., Hentschel, Anouk E., Bründl, Johannes, Compérat, Eva M., Plass, Karin, Rodríguez, Oscar, Subiela Henríquez, Jose D., Hernández, Virginia, de la Peña, Enrique, Alemany, Isabel, Turturica, Diana, Pisano, Francesca, Soria, Francesco, Čapoun, Otakar, Bauerová, Lenka, Pešl, Michael, Bruins, H. Maxim, Runneboom, Willemien, Herdegen, Sonja, Breyer, Johannes, Brisuda, Antonin, Calatrava, Ana, Rubio-Briones, José, Seles, Maximilian, Mannweiler, Sebastian, Bosschieter, Judith, Kusuma, Venkata R. M., Ashabere, David, Huebner, Nicolai, Cotte, Juliette, Contieri, Roberto, Mertens, Laura S., Claps, Francesco, Masson-Lecomte, Alexandra, Liedberg, Fredrik, Cohen, Daniel, Lunelli, Luca, Cussenot, Olivier, El Sheikh, Soha, Volanis, Dimitrios, Côté, Jean-François, Rouprêt, Morgan, Haitel, Andrea, Shariat, Shahrokh F., Mostafid, A. Hugh, Nieuwenhuijzen, Jakko A., Zigeuner, Richard, Dominguez-Escrig, Jose L., Hacek, Jaromir, Zlotta, Alexandre R., Burger, Maximilian, Evert, Matthias, Hulsbergen-van de Kaa, Christina A., van der Heijden, Antoine G., Kiemeney, Lambertus A. L. M., Soukup, Viktor, Molinaro, Luca, Gontero, Paolo, Llorente, Carlos, Algaba, Ferran, Palou, Joan, N’Dow, James, Ribal, Maria J., van der Kwast, Theo H., Babjuk, Marko, Sylvester, Richard J., and van Rhijn, Bas W. G.
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- 2024
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18. Diagnosis of prostate cancer with magnetic resonance imaging in men treated with 5-alpha-reductase inhibitors
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Falagario, Ugo G., Lantz, Anna, Jambor, Ivan, Busetto, Gian Maria, Bettocchi, Carlo, Finati, Marco, Ricapito, Anna, Luzzago, Stefano, Ferro, Matteo, Musi, Gennaro, Totaro, Angelo, Racioppi, Marco, Carbonara, Umberto, Checcucci, Enrico, Manfredi, Matteo, D’Aietti, Damiano, Porcaro, Antonio Benito, Nordström, Tobias, Björnebo, Lars, Oderda, Marco, Soria, Francesco, Taimen, Pekka, Aronen, Hannu J., Perez, Ileana Montoya, Ettala, Otto, Marchioni, Michele, Simone, Giuseppe, Ferriero, Mariaconsiglia, Brassetti, Aldo, Napolitano, Luigi, Carmignani, Luca, Signorini, Claudia, Conti, Andrea, Ludovico, Giuseppe, Scarcia, Marcello, Trombetta, Carlo, Claps, Francesco, Traunero, Fabio, Montanari, Emanuele, Boeri, Luca, Maggi, Martina, Del Giudice, Francesco, Bove, Pierluigi, Forte, Valerio, Ficarra, Vincenzo, Rossanese, Marta, Mucciardi, Giuseppe, Pagliarulo, Vincenzo, Tafuri, Alessandro, Mirone, Vincenzo, Schips, Luigi, Antonelli, Alessandro, Gontero, Paolo, Cormio, Luigi, Sciarra, Alessandro, Porpiglia, Francesco, Bassi, PierFrancesco, Ditonno, Pasquale, Boström, Peter J., Messina, Emanuele, Panebianco, Valeria, De Cobelli, Ottavio, and Carrieri, Giuseppe
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- 2023
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19. Single-use digital flexible cystoscope for double J removal versus reusable instruments: a prospective, comparative study of functionality, risk of infection, and costs
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Oderda, Marco, Asimakopoulos, Anastasios, Batetta, Valerio, Bosio, Andrea, Dalmasso, Ettore, Morra, Ivano, Vercelli, Eugenia, and Gontero, Paolo
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- 2023
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20. The role of perioperative chemotherapy for upper tract urothelial carcinoma patients treated with radical nephroureterectomy
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Pinar, Ugo, Calleris, Giorgio, Grobet-Jeandin, Elisabeth, Grande, Pietro, Benamran, Daniel, Thibault, Constance, Gontero, Paolo, Rouprêt, Morgan, and Seisen, Thomas
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- 2023
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21. En bloc resection of bladder tumour: the rebirth of past through reminiscence
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Teoh, Jeremy Yuen-Chun, D’Andrea, David, Gallioli, Andrea, Yanagisawa, Takafumi, MacLennan, Steven, Nicoletti, Rossella, Fai, Ng Chi, Maffei, Davide, Hurle, Rodolfo, Lusuardi, Lukas, Malavaud, Bernard, Miki, Jun, Kramer, Mario, Mostafid, Hugh, Enikeev, Dmitry, Babjuk, Marek, Breda, Alberto, Shariat, Shahrokh, Gontero, Paolo, and Herrmann, Thomas
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- 2023
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22. 6 - Bladder instillations of Adelmidrol+ Sodium Hyaluronate in patients with symptomatic actinic cystitis: Efficacy of the treatment
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Francesco Maria Bracco, Enrico Ammirati, Paolo Geretto, Marco Falcone, Alberto Manassero, Stefania Chierchia, Marco Agnello, Alessandro Giammò, and Paolo Gontero
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Diseases of the genitourinary system. Urology ,RC870-923 - Published
- 2024
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23. Different profiles of acute graft pyelonephritis among kidney recipients from standard or elderly donors
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Rita Tarragoni, Giovanni Congiu, Alberto Mella, Giovanni Augelli, Fabrizio Fop, Caterina Dolla, Ester Gallo, Maria Cristina Di Vico, Riccardo Faletti, Andrea Bosio, Paolo Gontero, Cristina Costa, Rossana Cavallo, Filippo Mariano, Silvia Corcione, Francesco Giuseppe De Rosa, Paolo Fonio, and Luigi Biancone
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acute pyelonephritis ,kidney transplantation ,urinary tract infections ,multidrug resistant pathogens ,ureteral stenosis ,Medicine (General) ,R5-920 - Abstract
BackgroundAcute graft pyelonephritis (AGPN) is a relatively common complication in kidney transplants (KTs); however, the effects on allograft function, diagnostic criteria, and risk factors are not well established.MethodsRetrospective analysis of all consecutive adult KTs was performed between 01 January 2011 and 31 December 2018 (follow-up ended on 31 December 2019) to examine the association between the diagnosis of AGPN (confirmed with magnetic resonance imaging [MRI]) during the first post-transplantation year and graft outcomes.ResultsAmong the 939 consecutive KTs (≈50% with donors ≥60 years), we identified 130 MRI-confirmed AGPN episodes, with a documented association with recurrent and multidrug-resistant bacterial urinary tract infections (UTIs) (p
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- 2024
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24. Ejaculation physiology and dysfunction after BPH surgery: the role of the new MISTs
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Sibona, Mattia, Destefanis, Paolo, Vercelli, Eugenia, Secco, Silvia, Gontero, Paolo, and Cindolo, Luca
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- 2023
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25. The Use of Vacuum Devices as Adjuvant Therapy before and after Penile Curvature Surgery in Patients Affected by La Peyronie’s Disease: Results from a Comparative Study
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Tommaso Cai, Marco Capece, Carlo Ceruti, Daniele Tiscione, Marco Puglisi, Paolo Verze, Paolo Gontero, and Alessandro Palmieri
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Peyronie’s disease ,vacuum erection devices ,penile curvature ,surgery ,quality of life ,Medicine (General) ,R5-920 - Abstract
Background: Peyronie’s disease (PD) represents a challenging urological disease, due to not optimal post-operative surgical outcomes. We aim to retrospectively evaluate if vacuum erection device (VED) treatment before penile curvature surgery is able to improve post-operative surgical outcomes. Methods: All enrolled patients were assigned to the following groups: (a) the treatment group: VED treatment (three times per week) starting 3 months before surgery and (three times per week) one month after surgery; and (b) the control group: VED treatment (three times per week) one month after surgery. Follow-up urologic visits were scheduled for 3 and 6 months after surgery, and the two groups were compared. Results: A total of 38 patients were enrolled (median age 67 years, 57–74, IQR): 20 in the treatment group and 18 in the control group. At the follow-up visits, the two groups were different in terms of IIEF-5 (26 vs. 24; p = 0.02), “yes” to SEP2 and 3 (85% vs. 55%; p < 0.001, 85% vs. 50%; p < 0.001, respectively), and PDQ (−16 vs. −11; p = 0.03). Complete correction of penile curvature was achieved in 36 patients (94.7%). In the treatment group, no hourglass deformity was reported, whereas one patient reported a mild hourglass deformity in the control group. In the treatment group, we obtained a longer total penile length (median +1.5 cm). The overall satisfaction rate was 98% in the treatment group and 96% in the control group. Conclusions: The VED treatment before penile curvature surgery in patients affected by PD was able to improve surgical outcomes.
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- 2023
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26. Comparative Performance of 68Ga-PSMA-11 PET/CT and Conventional Imaging in the Primary Staging of High-Risk Prostate Cancer Patients Who Are Candidates for Radical Prostatectomy
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Guido Rovera, Serena Grimaldi, Marco Oderda, Giancarlo Marra, Giorgio Calleris, Giuseppe Carlo Iorio, Marta Falco, Cristiano Grossi, Roberto Passera, Giuseppe Campidonico, Maria Luce Mangia, Désirée Deandreis, Riccardo Faletti, Umberto Ricardi, Paolo Gontero, and Silvia Morbelli
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prostate cancer ,hormone-sensitive prostate cancer ,positron emission tomography ,PSMA PET ,primary staging ,conventional imaging ,Medicine (General) ,R5-920 - Abstract
This prospective study aimed to (1) compare the diagnostic performance of 68Ga-PSMA-11 PET/CT with respect to conventional imaging (computed tomography (CT) and bone scintigraphy (BS)) in the primary staging of high-risk prostate cancer (PCa) patients and (2) validate PSMA-PET/CT accuracy in pelvic nodal staging in comparison with postoperative histopathology and assess PSMA-PET/CT’s impact on patient management. Sixty castration-sensitive high-risk (ISUP 4–5 and/or PSA > 20 ng/mL and/or cT3) PCa patients eligible for radical prostatectomy were enrolled (median PSA 10.10 [IQR: 6.22–17.95] ng/mL). PSMA-PET/CT, compared with CT, identified nodal (N) and/or distant metastases (M1) in 56.7% (34/60) vs. 13.3% (8/60) (p < 0.001) of patients: N + 45% vs. 13.3% (p < 0.001), M1a 11.7% vs. 1.7% (p = 0.03), M1b 23.3% vs. 1.7% (p < 0.001). Compared with BS, PSMA-PET/CT localized unknown skeletal metastases in 15% (9/60) of cases, with no false negative findings. Overall, PSMA-PET/CT led to a TNM upstaging in 45.0% (27/60) of cases, with no evidence of downstaging, resulting in a change in management in up to 28.8% (17/59) of patients. Compared with histopathology data (n = 32 patients), the per-patient accuracy of PSMA-PET/TC for detecting pelvic nodal metastases was 90.6%. Overall, the above evidence supports the use of PSMA-PET/CT in the diagnostic workup of high-risk prostate cancer staging.
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- 2024
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27. Prechemotherapy Transperitoneal Robotic-Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four-Year-Old Patient
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Marcello Della Corte, Elisa Cerchia, Marco Oderda, Paola Quarello, Franca Fagioli, Paolo Gontero, and Simona Gerocarni Nappo
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Wilms tumor ,nephron-sparing surgery ,robotic surgery ,partial nephrectomy ,3D reconstruction ,DaVinci ,Medicine ,Pediatrics ,RJ1-570 - Abstract
Background: Wilms tumor (WT) is the most frequent renal tumor in children. The SIOP-UMBRELLA Guidelines allow for nephron-sparing surgery (NSS) in syndromic patients, as well as in cases of small (
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- 2023
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28. Prognostic significance of PI-RADS 5 lesions in patients treated by radical prostatectomy
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Fiard, G., Seigneurin, A., Roumiguié, M., Albisinni, S., Anract, J., Assenmacher, G., Barry Delongchamps, N., Dariane, C., Feyaerts, A., Fourcade, A., Fournier, G., Gontero, P., Mastroianni, R., Oderda, M., Peltier, A., Roumeguère, T., Saussez, T., Simone, G., Van Damme, J., Descotes, J. L., Ploussard, G., and Diamand, R.
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- 2023
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29. Efficacy and safety profile of GreenLight laser photoselective vaporization of the prostate in ≥ 75 years old patients: results from the Italian GreenLight Laser Study Group
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Campobasso, Davide, Morselli, Simone, Greco, Francesco, De Nunzio, Cosimo, Destefanis, Paolo, Fasolis, Giuseppe, Varvello, Francesco, Voce, Salvatore, Reale, Giulio, Cai, Tommaso, Oriti, Rino, Tuccio, Agostino, Ruggera, Lorenzo, Laganà, Antonino, Dadone, Claudio, Gontero, Paolo, De Rienzo, Gaetano, Pucci, Luigi, Carrino, Maurizio, Montefiore, Franco, Rabito, Salvatore, Miano, Roberto, Schips, Luigi, Frattini, Antonio, Micali, Salvatore, Ferrari, Giovanni, and Cindolo, Luca
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- 2023
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30. Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus
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Tan, Wei Phin, Rastinehad, Ardeshir R, Klotz, Laurence, Carroll, Peter R, Emberton, Mark, Feller, John F, George, Arvin K, Gill, Inderbir S, Gupta, Rajan T, Katz, Aaron E, Lebastchi, Amir H, Marks, Leonard S, Marra, Giancarlo, Pinto, Peter A, Song, Daniel Y, Sidana, Abhinav, Ward, John F, Sanchez-Salas, Rafael, de la Rosette, Jean, Polascik, Thomas J, Authors, Focal Therapy Group, Katz, Aaron, Aminsharifi, Alireza, Lebastchi, Amir, Abreu, Andre, Villers, Arnauld, Schulman, Ariel, Rastinehad, Ardeshir, George, Arvin, Oto, Aytekin, Turkbey, Baris, Malavaud, Bernard, Muller, Berrend, Moore, Caroline, Eberli, Daniel, Margolis, Daniel, Song, Daniel, Lomas, Derek, Orabi, Hazem, Lepor, Herbert, Tan, Hui Meng, Jambor, Ivan, Grummet, Jeremy, Feller, John, Ward, John, Colemen, Jonathan, Gregg, Justin, Tay, Kae Jack, Marks, Leonard, Deane, Leslie, Laguna, M Pilar, Kimura, Masaki, Tsivian, Matvey, Gorin, Michael, Siddiqui, Minhaj, Ukimura, Osamu, Gontero, Paolo, Carroll, Peter, Pinto, Peter, Mozer, Pierre, Arcot, Ro, Taneja, Samir, Ghai, Sangeet, Crouzet, Sebastian, Mehralivand, Sherif, Joniau, Steven, Shoji, Sunao, Shiraishi, Takumi, Polascik, Thomas, Shin, Toshitaka, Lindnet, Uri, Tammisetti, Varaha, van den Bos, Willemien, and Matsuoka, Yoh
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Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Urologic Diseases ,Prostate Cancer ,Clinical Research ,Ablation Techniques ,Aged ,Aged ,80 and over ,Consensus ,Delphi Technique ,Humans ,Male ,Middle Aged ,Prostatic Neoplasms ,Watchful Waiting ,Localized prostate cancer ,Focal therapy ,Partial gland ablation ,Active surveillance ,Focal Therapy Group Authors ,Urology & Nephrology ,Clinical sciences ,Oncology and carcinogenesis - Abstract
BackgroundWith the advancement of imaging technology, focal therapy (FT) has been gaining acceptance for the treatment of select patients with localized prostate cancer (CaP). We aim to provide details of a formal physician consensus on the utilization of FT for patients with CaP who are discontinuing active surveillance (AS).MethodsA 3-stage Delphi consensus on CaP and FT was conducted. Consensus was defined as agreement by ≥80% of physicians. An in-person meeting was attended by 17 panelists to formulate the consensus statement.ResultsFifty-six respondents participated in this interdisciplinary consensus study (82% urologist, 16% radiologist, 2% radiation oncology). The participants confirmed that there is a role for FT in men discontinuing AS (48% strongly agree, 39% agree). The benefit of FT over radical therapy for men coming off AS is: less invasive (91%), has a greater likelihood to preserve erectile function (91%), has a greater likelihood to preserve urinary continence (91%), has fewer side effects (86%), and has early recovery post-treatment (80%). Patients will need to undergo mpMRI of the prostate and/or a saturation biopsy to determine if they are potential candidates for FT. Our limitations include respondent's biases and that the participants of this consensus may not represent the larger medical community.ConclusionsFT can be offered to men coming off AS between the age of 60 to 80 with grade group 2 localized cancer. This consensus from a multidisciplinary, multi-institutional, international expert panel provides a contemporary insight utilizing FT for CaP in select patients who are discontinuing AS.
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- 2021
31. European Association for Endoscopic Surgery (EAES) consensus on Indocyanine Green (ICG) fluorescence-guided surgery
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Cassinotti, E., Al-Taher, M., Antoniou, S. A., Arezzo, A., Baldari, L., Boni, L., Bonino, M. A., Bouvy, N. D., Brodie, R., Carus, T., Chand, M., Diana, M., Eussen, M. M. M., Francis, N., Guida, A., Gontero, P., Haney, C. M., Jansen, M., Mintz, Y., Morales-Conde, S., Muller-Stich, B. P., Nakajima, K., Nickel, F., Oderda, M., Parise, P., Rosati, R., Schijven, M. P., Silecchia, G., Soares, A. S., Urakawa, S., and Vettoretto, N.
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- 2023
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32. Active surveillance in renal transplant patients with prostate cancer: a multicentre analysis
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Soeterik, Timo F. W., van den Bergh, Roderick C. N., van Melick, Harm H. E., Kelder, Hans, Peretti, Federica, Dariane, Charles, Timsit, Marc-Olivier, Branchereau, Julien, Mesnard, Benoit, Tilki, Derya, Olsburgh, Jonathon, Kulkarni, Meghana, Kasivisvanathan, Veeru, Breda, Alberto, Biancone, Luigi, Gontero, Paolo, Gandaglia, Giorgio, and Marra, Giancarlo
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- 2023
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33. Feasibility of therapeutic music listening in fibromyalgia: a randomised controlled pilot study
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Raglio, Alfredo, Bettaglio, Raffaella, Manera, Marina R., Aiello, Edoardo N., Gontero, Giulia, Imbriani, Chiara, Brischigiaro, Luca, Bonezzi, Cesare, and Demartini, Laura
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- 2023
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34. Urethral Sheath to Evacuate Blood Clots through Mitrofanoff Appendicovesicostomy
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Marcello Della Corte, Erica Clemente, Mattia Sibona, Elisa Cerchia, Berenice Tulelli, Paolo Gontero, and Simona Gerocarni Nappo
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Mitrofanoff ,appendicovesicostomy ,clots ,hematuria ,augmented bladder ,urethral sheath ,Surgery ,RD1-811 - Abstract
Background: the Mitrofanoff appendicovesicostomy provides a catheterizable submucosal tunnel between umbilicus and bladder (or neobladder). In patients with a closed bladder neck, the Mitrofanoff channel is the only way to access the bladder. We describe our case of a 17 year-old girl with a Mitrofanoff appendicovesicostomy and a previous surgical closure of the bladder neck and who developed a large bladder clot due to hematuria after a surgical cystolithotomy in an augmented bladder; Methods: after an unsuccessful trans-appendicovesicostomy bladder washing, the endoscopic evaluation was performed using a 14 Ch rigid cystoscope and surrounded by its own urethral sheath. The clot was progressively fragmented through the cystoscope under direct vision. Clot fragments were aspirated to obtain a complete evacuation; Results: the urethral sheath prevented damages to the appendicovesicostomy, allowing at the same time repeated accesses of the cystoscope into the neobladder and ensuring the procedural success. The postoperative period was uneventful, and the neobladder catheter was removed after two days. Neither channel stenosis nor anastomosis dehiscence nor incontinence were reported after five months; Conclusions: the use of urethral sheath 14 Ch through an appendicovesicostomy preserves both the stoma and the channel, making possible endoscopic procedures such as blood clot evacuation into the neobladder.
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- 2023
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35. International Opinions on Grading of Urothelial Carcinoma: A Survey Among European Association of Urology and International Society of Urological Pathology Members
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Irene J. Beijert, Liang Cheng, Fredrik Liedberg, Karin Plass, Sean R. Williamson, Paolo Gontero, Maria J. Ribal, Marko Babjuk, Peter C. Black, Ashish M. Kamat, Ferran Algaba, David M. Berman, Arndt Hartmann, Alexandra Masson-Lecomte, Morgan Rouprêt, Antonio Lopez-Beltran, Hemamali Samaratunga, Shahrokh F. Shariat, A. Hugh Mostafid, Murali Varma, Steven Shen, Maximilian Burger, Toyonori Tsuzuki, Joan Palou, Eva M. Compérat, Richard J. Sylvester, Theo H. van der Kwast, Bas W.G. van Rhijn, and Michelle R. Downes
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Bladder ,Cancer ,Grading ,Survey ,European Association of Urology ,International Society of Urological Pathology ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Grade of non–muscle-invasive bladder cancer (NMIBC) is an important prognostic factor for progression. Currently, two World Health Organization (WHO) classification systems (WHO1973, categories: grade 1–3, and WHO2004 categories: papillary urothelial neoplasm of low malignant potential [PUNLMP], low-grade [LG], high-grade [HG] carcinoma) are used. Objective: To ask the European Association of Urology (EAU) and International Society of Urological Pathology (ISUP) members regarding their current practice and preferences of grading systems. Design, setting, and participants: A web-based, anonymous questionnaire with ten questions on grading of NMIBC was created. The members of EAU and ISUP were invited to complete an online survey by the end of 2021. Thirteen experts had previously answered the same questions. Outcome measurements and statistical analysis: The submitted answers from 214 ISUP members, 191 EAU members, and 13 experts were analyzed. Results and limitations: Currently, 53% use only the WHO2004 system and 40% use both systems. According to most respondents, PUNLMP is a rare diagnosis with management similar to Ta-LG carcinoma. The majority (72%) would consider reverting back to WHO1973 if grading criteria were more detailed. Separate reporting of WHO1973-G3 within WHO2004-HG would influence clinical decisions for Ta and/or T1 tumors according the majority (55%). Most respondents preferred a two-tier (41%) or a three-tier (41%) grading system. The current WHO2004 grading system is supported by a minority (20%), whereas nearly half (48%) supported a hybrid three- or four-tier grading system composed of both WHO1973 and WHO2004. The survey results of the experts were comparable with ISUP and EAU respondents. Conclusions: Both the WHO1973 and the WHO2004 grading system are still widely used. Even though opinions on the future of bladder cancer grading were strongly divided, there was limited support for WHO1973 and WHO2004 in their current formats, while the hybrid (three-tier) grading system with LG, HG-G2, and HG-G3 as categories could be considered the most promising alternative. Patient summary: Grading of non–muscle-invasive bladder cancer (NMIBC) is a matter of ongoing debate and lacks international consensus. We surveyed urologists and pathologists of European Association of Urology and International Society of Urological Pathology on their preferences regarding NMIBC grading to generate a multidisciplinary dialogue. Both the “old” World Health Organization (WHO) 1973 and the “new” WHO2004 grading schemes are still used widely. However, continuation of both the WHO1973 and the WHO2004 system showed limited support, while a hybrid grading system composed of both the WHO1973 and the WHO2004 classification system may be considered a promising alternative.
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- 2023
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36. Predictors of Prostate Cancer at Fusion Biopsy: The Role of Positive Family History, Hypertension, Diabetes, and Body Mass Index
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Marco Oderda, Alessandro Dematteis, Giorgio Calleris, Adriana Conti, Daniele D’Agate, Marco Falcone, Alessandro Marquis, Gabriele Montefusco, Giancarlo Marra, and Paolo Gontero
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fusion biopsy ,prostate cancer ,risk factors ,family history ,hypertension ,diabetes ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: PSA density and an elevated PI-RADS score are among the strongest predictors of prostate cancer (PCa) in a fusion biopsy. Positive family history, hypertension, diabetes, and obesity have also been associated with the risk of developing PCa. We aim to identify predictors of the prostate cancer detection rate (CDR) in a series of patients undergoing a fusion biopsy. Methods: We retrospectively evaluated 736 consecutive patients who underwent an elastic fusion biopsy from 2020 to 2022. Targeted biopsies (2–4 cores per MRI target) were followed by systematic mapping (10–12 cores). Clinically significant PCa (csPCa) was defined as ISUP score ≥ 2. Uni- and multi-variable logistic regression analyses were performed to identify predictors of CDR among age, body mass index (BMI), hypertension, diabetes, positive family history, PSA, a positive digital rectal examination (DRE), PSA density ≥ 0.15, previous negative biopsy status, PI-RADS score, and size of MRI lesion. Results: The median patients’ age was 71 years, and median PSA was 6.6 ng/mL. A total of 20% of patients had a positive digital rectal examination. Suspicious lesions in mpMRI were scored as 3, 4, and 5 in 14.9%, 55.0%, and 17.5% of cases, respectively. The CDR was 63.2% for all cancers and 58.7% for csPCa. Only age (OR 1.04, p < 0.001), a positive DRE (OR 1.75, p = 0.04), PSA density (OR 2.68, p < 0.001), and elevated PI-RADS score (OR 4.02, p = 0.003) were significant predictors of the CDR in the multivariable analysis for overall PCa. The same associations were found for csPCa. The size of an MRI lesion was associated with the CDR only in uni-variable analysis (OR 1.07, p < 0.001). BMI, hypertension, diabetes, and a positive family history were not predictors of PCa. Conclusions: In a series of patients selected for a fusion biopsy, positive family history, hypertension, diabetes, or BMI are not predictors of PCa detection. PSA-density and PI-RADS score are confirmed to be strong predictors of the CDR.
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- 2023
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37. Carboplatin Induction Chemotherapy in Clinically Lymph Node–positive Bladder Cancer
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Markus von Deimling, Laura S. Mertens, Bas W.G. van Rhijn, Yair Lotan, Philippe E. Spiess, Siamak Daneshmand, Peter C. Black, Maximilian Pallauf, David D'Andrea, Marco Moschini, Francesco Soria, Francesco Del Giudice, Luca Afferi, Ekaterina Laukhtina, Takafumi Yanagisawa, Tatsushi Kawada, Jeremy Y.-C. Teoh, Mohammad Abufaraj, Guillaume Ploussard, Mathieu Roumiguié, Pierre I. Karakiewicz, Marko Babjuk, Paolo Gontero, Evanguelos Xylinas, Michael Rink, Shahrokh F. Shariat, and Benjamin Pradere
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Carboplatin ,Induction chemotherapy ,Oligometastatic ,Survival ,Urinary bladder neoplasms ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: There are currently no guideline recommendations regarding the treatment of cisplatin-ineligible, clinically lymph node–positive (cN+) bladder cancer (BCa). Objective: To investigate the oncological efficacy of gemcitabine/carboplatin induction chemotherapy (IC) in comparison to cisplatin-based regimens in cN+ BCa. Design, setting, and participants: This was an observational study of 369 patients with cT2–4 N1–3 M0 BCa. Intervention: IC followed by consolidative radical cystectomy (RC). Outcome measurements and statistical analysis: The primary endpoints were the pathological objective response (pOR; ypT0/Ta/Tis/T1 N0) rate and the pathological complete response (pCR; ypT0N0) rate. We applied 3:1 propensity score matching (PSM) to reduce selection bias. Overall survival (OS) and cancer-specific survival (CSS) were compared across groups using the Kaplan-Meier method. Associations between the treatment regimen and survival endpoints were tested in multivariable Cox regression analyses. Results and limitations: After PSM, a cohort of 216 patients was available for analysis, of whom 162 received cisplatin-based IC and 54 gemcitabine/carboplatin IC. At RC, 54 patients (25%) had a pOR and 36 (17%) had a pCR. The 2-yr CSS was 59.8% (95% confidence interval [CI] 51.9–69%) for patients who received cisplatin-based IC versus 38.8% (95% CI 26–57.9%) for those who received gemcitabine/carboplatin. For the pOR (p = 0.8), ypN0 status at RC (p = 0.5), and cN1 BCa subgroups (p = 0.7), there was no difference in CSS between cisplatin-based IC and gemcitabine/carboplatin. In the cN1 subgroup, treatment with gemcitabine/carboplatin was not associated with shorter OS (p = 0.2) or CSS (p = 0.1) on multivariable Cox regression analysis. Conclusions: Cisplatin-based IC seems to be superior to gemcitabine/carboplatin and should be the standard for cisplatin-eligible patients with cN+ BCa. Gemcitabine/carboplatin may be an alternative treatment for selected cisplatin-ineligible patients with cN+ BCa. In particular, selected cisplatin-ineligible patients with cN1 disease may benefit from gemcitabine/carboplatin IC. Patient summary: In this multicenter study, we found that selected patients with bladder cancer and clinical evidence of lymph node metastasis who cannot receive standard cisplatin-based chemotherapy before surgery to remove their bladder may benefit from chemotherapy with gemcitabine/carboplatin. Patients with a single lymph node metastasis may benefit the most.
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- 2023
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38. Sarcopenia Predicts Disease Progression in Patients with T1 High-grade Non–muscle-invasive Bladder Cancer Treated with Adjuvant Intravesical Bacillus Calmette-Guérin: Implications for Decision-making?
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Francesco Soria, David D'Andrea, Maurizio Barale, Kilian M. Gust, Francesca Pisano, Simone Mazzoli, Matteo De Bellis, Matteo Rosazza, Simone Livoti, Daniele Dutto, Beatrice Lillaz, Benjamin Pradere, Marco Moschini, Dietmar Tamandl, Shahrokh F. Shariat, and Paolo Gontero
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Sarcopenia ,T1 high-grade non–muscle-invasive bladder cancer ,Bacillus Calmette-Guérin ,Recurrence ,Progression ,Prediction ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Skeletal muscle loss (sarcopenia) has been linked to cancer cachexia and can predict survival in several tumors, including advanced genitourinary malignancies. Objective: To investigate the predictive and prognostic role of sarcopenia in patients with T1 high grade (HG) non-muscle invasive bladder cancer (NMIBC) treated with adjuvant intravesical Bacillus Calmette-Guerin (BCG). Design, setting, and participants: Oncological outcomes were evaluated for 185 patients with T1 HG NMIBC treated with BCG at two European referral centers. Sarcopenia, identified from computed tomography scans performed within 2 mo after surgery, was defined as a skeletal muscle index of
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- 2023
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39. Cohort profile: the Turin prostate cancer prognostication (TPCP) cohort
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Nicolas Destefanis, Valentina Fiano, Lorenzo Milani, Paolo Vasapolli, Michelangelo Fiorentino, Francesca Giunchi, Luca Lianas, Mauro Del Rio, Francesca Frexia, Luca Pireddu, Luca Molinaro, Paola Cassoni, Mauro Giulio Papotti, Paolo Gontero, Giorgio Calleris, Marco Oderda, Umberto Ricardi, Giuseppe Carlo Iorio, Piero Fariselli, Elena Isaevska, Olof Akre, Renata Zelic, Andreas Pettersson, Daniela Zugna, and Lorenzo Richiardi
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prostate cancer ,prognosis ,prognostic modelling ,digital pathology ,DNA methylation ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
IntroductionProstate cancer (PCa) is the most frequent tumor among men in Europe and has both indolent and aggressive forms. There are several treatment options, the choice of which depends on multiple factors. To further improve current prognostication models, we established the Turin Prostate Cancer Prognostication (TPCP) cohort, an Italian retrospective biopsy cohort of patients with PCa and long-term follow-up. This work presents this new cohort with its main characteristics and the distributions of some of its core variables, along with its potential contributions to PCa research.MethodsThe TPCP cohort includes consecutive non-metastatic patients with first positive biopsy for PCa performed between 2008 and 2013 at the main hospital in Turin, Italy. The follow-up ended on December 31st 2021. The primary outcome is the occurrence of metastasis; death from PCa and overall mortality are the secondary outcomes. In addition to numerous clinical variables, the study’s prognostic variables include histopathologic information assigned by a centralized uropathology review using a digital pathology software system specialized for the study of PCa, tumor DNA methylation in candidate genes, and features extracted from digitized slide images via Deep Neural Networks.ResultsThe cohort includes 891 patients followed-up for a median time of 10 years. During this period, 97 patients had progression to metastatic disease and 301 died; of these, 56 died from PCa. In total, 65.3% of the cohort has a Gleason score less than or equal to 3 + 4, and 44.5% has a clinical stage cT1. Consistent with previous studies, age and clinical stage at diagnosis are important prognostic factors: the crude cumulative incidence of metastatic disease during the 14-years of follow-up increases from 9.1% among patients younger than 64 to 16.2% for patients in the age group of 75-84, and from 6.1% for cT1 stage to 27.9% in cT3 stage.DiscussionThis study stands to be an important resource for updating existing prognostic models for PCa on an Italian cohort. In addition, the integrated collection of multi-modal data will allow development and/or validation of new models including new histopathological, digital, and molecular markers, with the goal of better directing clinical decisions to manage patients with PCa.
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- 2023
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40. Topography of Prostate Cancer Recurrence: A Single-centre Analysis of Salvage Radical Prostatectomy Specimens and Implications for Focal Salvage Treatments
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Giancarlo Marra, Giorgio Calleris, Emilia Massari, Elena Vissio, Luca Molinaro, Paola Cassoni, Daniele D'Agate, Marco Oderda, Massimo Valerio, Yannick Raskin, Steven Joniau, Mauro Papotti, and Paolo Gontero
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Salvage radical prostatectomy ,Recurrent prostate cancer ,Focal therapy ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Most prostate cancer (PCa) recurrences after nonsurgical first-line treatment are managed with androgen deprivation therapy (ADT). When local treatment is indicated, salvage focal treatment (FT) may achieve outcomes similar to those after salvage radical prostatectomy (sRP), with lower morbidity. However, descriptions of the topography of PCa recurrence are scarce. Objective: To describe the characteristics and topography of recurrent PCa at sRP. Design, setting, and participants: We performed a review of the final pathology for consecutive men undergoing sRP at a single centre between 2007 and 2021. Outcome measurements and statistical analysis: Clinical and pathological outcomes and recurrence localisation (standardised map) were recorded. Suitability for salvage FT was evaluated using criteria defined a priori. Results and limitations: We included 41 men who underwent sRP after whole-gland treatment (82.9% primary radiotherapy). Of these, 68.3% had grade group ≥3 and 46.3% had pT3 disease, including nine men (22%) with seminal vesicle involvement >1 cm. The pN+ rate was 29.3%. Surgical margins were positive in 39% (mostly at the apex, 21.9%). PCa was located at
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- 2023
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41. Correction to: The outcomes of surgical management options for adult acquired buried penis
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Falcone, Marco, Preto, Mirko, Timpano, Massimiliano, Oderda, Marco, Plamadeala, Natalia, Cirigliano, Lorenzo, Blecher, Gideon, Peretti, Federica, Ferro, Ilaria, and Gontero, Paolo
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- 2023
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42. Correction to: Overdiagnosis and stage migration of ISUP 2 disease due to mpMRI-targeted biopsy: facts or fictions
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Martini, Alberto, Touzani, Alae, Mazzone, Elio, Roumiguié, Mathieu, Marra, Giancarlo, Valerio, Massimo, Beauval, Jean Baptiste, Campi, Riccardo, Minervini, Andrea, van den Berg, Roderick C. N., Soeterik, Timo F. W., Zhuang, Junlong, Guo, Hongqian, Gontero, Paolo, Montorsi, Francesco, Briganti, Alberto, Gandaglia, Giorgio, and Ploussard, Guillame
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- 2023
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43. Outcomes and predictive factors of successful salvage microdissection testicular sperm extraction (mTESE) after failed classic TESE: results from a multicenter cross-sectional study
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Boeri, Luca, Bebi, Carolina, Dente, Donato, Greco, Ermanno, Turetti, Matteo, Capece, Marco, Cocci, Andrea, Cito, Gianmartin, Preto, Mirko, Pescatori, Edoardo, Ciampaglia, Walter, Scroppo, Fabrizio Ildefonso, Falcone, Marco, Ceruti, Carlo, Gadda, Franco, Franco, Giorgio, Dehò, Federico, Palmieri, Alessandro, Rolle, Luigi, Gontero, Paolo, Montorsi, Francesco, Montanari, Emanuele, and Salonia, Andrea
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- 2022
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44. Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium)
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Tafuri, Alessandro, Marchioni, Michele, Cerrato, Clara, Mari, Andrea, Tellini, Riccardo, Odorizzi, Katia, Veccia, Alessandro, Amparore, Daniele, Shakir, Aliasger, Carbonara, Umberto, Panunzio, Andrea, Trovato, Federica, Catellani, Michele, Janello, Letizia M. I., Bianchi, Lorenzo, Novara, Giacomo, Dal Moro, Fabrizio, Schiavina, Riccardo, De Lorenzis, Elisa, Parma, Paolo, Cimino, Sebastiano, De Cobelli, Ottavio, Maiorino, Francesco, Bove, Pierluigi, Crocerossa, Fabio, Cantiello, Francesco, D’Andrea, David, Di Cosmo, Federica, Porpiglia, Francesco, Ditonno, Pasquale, Montanari, Emanuele, Soria, Francesco, Gontero, Paolo, Liguori, Giovanni, Trombetta, Carlo, Mantica, Guglielmo, Borghesi, Marco, Terrone, Carlo, Del Giudice, Francesco, Sciarra, Alessandro, Galosi, Andrea, Moschini, Marco, Shariat, Shahrokh F., Di Nicola, Marta, Minervini, Andrea, Ferro, Matteo, Cerruto, Maria Angela, Schips, Luigi, Pagliarulo, Vincenzo, and Antonelli, Alessandro
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- 2022
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45. The outcomes of penile prosthesis in neurologic patients: a multicentric retrospective series
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Marco Falcone, Paolo Capogrosso, Lorenzo Cirigliano, Paolo Geretto, Mirko Preto, Massimiliano Timpano, Carlo Ceruti, Federica Peretti, Ilaria Ferro, Natalia Plamadeala, Federico Dehò, Carlo Bettocchi, Celeste Manfredi, Lorenzo Spirito, Alessandro Palmieri, Alberto Manassero, Gideon Blecher, and Paolo Gontero
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Introduction: Neurological disease is a known entity for causing erectile dysfunction (ED). Pharmacological therapies are not always effective these patients – penile prosthesis implant (PPI) is an established surgical treatment option. For a variety of reasons, neurological patients may experience differing outcomes of PPI compared to those whose ED arises from other causes. We investigated outcomes of PPI in neurological patients using the Italian multi-institutional national registry of penile prostheses [Italian Nationwide Systematic Inventarization of Surgical Treatment for ED (INSIST-ED)]. Methods: Patients undergoing PPI were investigated via the INSIST-ED registry, from 2014 to 2021. Data were prospectively recorded by 45 surgeons on a dedicated website ( www.registro.andrologiaitaliana.it ) and reviewed by a data manager. We subselected patients with neurological disease undergoing PPI for ED, and these patients were reviewed at 3, 6, and 12 months, and annually thereafter. Postoperative complications and functional outcomes were evaluated through validated questionnaires [International Index of Erectile Function-5 (IIEF-5), Sexual Encounter Profile 2–3, and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS)]. A nonvalidated questionnaire was administered to assess patient satisfaction. Results: A total of 33 patients were included with a median age of 49 [interquartile range (IQR) 41–55]. Median follow-up was 83 months (IQR 67–99.5). A penoscrotal approach for PPI was performed in most cases (90.9%), while infrapubic was used in three cases (9.1%). Inflatable and malleable devices were implanted in 30 (90.9%) and 3 cases (9.1%), respectively. Intraoperative complications occurred in one case (3%). Early postoperative complications (
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- 2023
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46. Association of an organ transplant-based approach with a dramatic reduction in postoperative complications following radical nephrectomy and tumor thrombectomy in renal cell carcinoma
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González, Javier, Gaynor, Jeffrey J, Martínez-Salamanca, Juan I, Capitanio, Umberto, Tilki, Derya, Carballido, Joaquín A, Chantada, Venancio, Daneshmand, Siamak, Evans, Christopher P, Gasch, Claudia, Gontero, Paolo, Haferkamp, Axel, Huang, William C, Espinós, Estefania Linares, Master, Viraj A, McKiernan, James M, Montorsi, Francesco, Pahernik, Sascha, Palou, Juan, Pruthi, Raj S, Rodriguez-Faba, Oscar, Russo, Paul, Scherr, Douglas S, Shariat, Shahrokh F, Spahn, Martin, Terrone, Carlo, Vera-Donoso, Cesar, Zigeuner, Richard, Hohenfellner, Markus, Libertino, John A, and Ciancio, Gaetano
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Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Rare Diseases ,Kidney Disease ,Evaluation of treatments and therapeutic interventions ,6.4 Surgery ,Blood Transfusion ,Carcinoma ,Renal Cell ,Female ,Follow-Up Studies ,Humans ,Kidney Neoplasms ,Male ,Middle Aged ,Nephrectomy ,Postoperative Complications ,Retrospective Studies ,Thrombectomy ,Thrombosis ,Vena Cava ,Inferior ,Renal cell carcinoma ,Inferior vena cava ,Tumor thrombus ,Surgical technique ,Postoperative complications ,Oncology & Carcinogenesis ,Clinical sciences ,Oncology and carcinogenesis - Abstract
ObjectivesOur aim was to determine whether using an organ transplant-based(TB) approach reduces postoperative complications(PCs) following radical nephrectomy(RN) and tumor thrombectomy(TT) in renal cell carcinoma(RCC) patients with level II-IV thrombi.MethodsA total of 390(292 non-TB/98 TB) IRCC-VT Consortium patients who received no preoperative embolization/IVC filter were included. Stepwise linear/logistic regression analyses were performed to determine significant multivariable predictors of intraoperative estimated blood loss(IEBL), number blood transfusions received, and overall/major PC development within 30days following surgery. Propensity to receive the TB approach was controlled.ResultsThe TB approach was clearly superior in limiting IEBL, blood transfusions, and PC development, even after controlling for other significant prognosticators/propensity score(P
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- 2019
47. Intraoperative 3D-US-mpMRI Elastic Fusion Imaging-Guided Robotic Radical Prostatectomy: A Pilot Study
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Marco Oderda, Giorgio Calleris, Daniele D’Agate, Marco Falcone, Riccardo Faletti, Marco Gatti, Giancarlo Marra, Alessandro Marquis, and Paolo Gontero
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elastic fusion ,intraoperative ,robotic radical prostatectomy ,3D ,ultrasound ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: When performing a nerve-sparing (NS) robotic radical prostatectomy (RARP), cancer location based on multiparametric MRI (mpMRI) is essential, as well as the location of positive biopsy cores outside mpMRI targets. The aim of this pilot study was to assess the feasibility of intraoperative 3D-TRUS-mpMRI elastic fusion imaging to guide RARP and to evaluate its impact on the surgical strategy. Methods: We prospectively enrolled 11 patients with organ-confined mpMRI-visible prostate cancer (PCa), histologically confirmed at transperineal fusion biopsy using Koelis Trinity. Before surgery, the 3D model of the prostate generated at biopsy was updated, showing both mpMRI lesions and positive biopsy cores, and was displayed on the Da Vinci robotic console using TilePro™ function. Results: Intraoperative 3D modeling was feasible in all patients (median of 6 min). The use of 3D models led to a major change in surgical strategy in six cases (54%), allowing bilateral instead of monolateral NS, or monolateral NS instead of non-NS, to be performed. At pathologic examination, no positive surgical margins (PSMs) were reported. Bilateral PCa presence was detected in one (9%), four (36%), and nine (81%) patients after mpMRI, biopsy, and RARP, respectively. Extracapsular extension was found in two patients (18%) even if it was not suspected at MRI. Conclusions: Intraoperative 3D-TRUS-mpMRI modeling with Koelis Trinity is feasible and reliable, helping the surgeon to maximize functional outcomes without increasing the risk of positive surgical margins. The location of positive biopsy cores must be registered in 3D models, given the rates of bilateral involvement not seen at mpMRI.
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- 2022
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48. Safety and Feasibility of Transperineal Targeted Microwave Ablation for Low- to Intermediate-risk Prostate Cancer
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Marco Oderda, Alessandro Marquis, Giorgio Calleris, Daniele D'Agate, Riccardo Faletti, Marco Gatti, Giancarlo Marra, and Paolo Gontero
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Focal therapy ,Prostate cancer ,Microwave ,Koelis ,Image fusion ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Focal therapy has emerged as an interesting option for localized low- to intermediate-risk prostate cancer (PCa). Targeted microwave ablation (TMA) is a novel FT modality involving targeted delivery of microwave energy under multiparametric magnetic resonance imaging (MRI)/ultrasound guidance. Objective: To describe the step-by-step procedure for TMA and report early functional outcomes. Design, setting, and participants: This was an experimental phase 1–2 trial in 11 patients diagnosed with a single, MRI-visible PCa lesion of up to 12 mm, scored as International Society of Urological Pathology grade group (GG) 1 or 2. Surgical procedure: Transperineal TMA under MRI/ultrasound image fusion guidance. Measurements: We recorded patient and PCa features; intraoperative and postoperative parameters; pain (Visual Analog Scale [VAS]) and adverse events (Common Terminology Criteria for Adverse Events v5.0); and prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) scores at 1 wk and 1, 3, and 6 mo. Results and limitations: The median patient age was 67 yr (interquartile range [IQR] 18). Median PSA was 5.4 ng/ml (IQR 1.8), median prostate volume was 51 cm3 (IQR 35), and median lesion size on MRI was 10 mm (IQR 4). Ten patients had GG 2 PCa and one had GG 1 disease. The median procedure time was 40 min (IQR 30). No intraoperative complications were reported. All treatments were performed on a day-case basis and no patients were discharged with a urinary catheter. Postoperatively, no grade ≥2 complications were reported. No significant changes in PSA (p = 0.46), IPSS (p = 0.39), or IIEF-5 scores (p = 0.18) scores were reported. The postoperative VAS score at 24 h was 0 for all patients. Conclusions: TMA is safe, feasible, and well tolerated in patients with low- to intermediate-risk PCa. Oncological outcomes are still awaited. Patient summary: Targeted microwave therapy is safe and feasible for selected patients with low- to intermediate-risk prostate cancer. The procedure is well tolerated and does not require a urinary catheter after the procedure. Cancer control outcomes are still awaited.
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- 2022
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49. mEPE-score: a comprehensive grading system for predicting pathologic extraprostatic extension of prostate cancer at multiparametric magnetic resonance imaging
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Gatti, Marco, Faletti, Riccardo, Gentile, Francesco, Soncin, Enrico, Calleris, Giorgio, Fornari, Alberto, Oderda, Marco, Serafini, Alessandro, Strazzarino, Giulio Antonino, Vissio, Elena, Bergamasco, Laura, Cirillo, Stefano, Papotti, Mauro Giulio, Gontero, Paolo, and Fonio, Paolo
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- 2022
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50. Event-free survival after 68 Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC) patients eligible for salvage therapy
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Ceci, Francesco, Rovera, Guido, Iorio, Giuseppe Carlo, Guarneri, Alessia, Chiofalo, Valeria, Passera, Roberto, Oderda, Marco, Dall’Armellina, Sara, Liberini, Virginia, Grimaldi, Serena, Bellò, Marilena, Gontero, Paolo, Ricardi, Umberto, and Deandreis, Désirée
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- 2022
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