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1. Prognosis of patients with pelvic lymph node (LN) metastasis after radical prostatectomy: value of extranodal extension and size of the largest LN metastasis

Author

Passoni NM, Fajkovic H, Xylinas E, Kluth L, Seitz C, Robinson BD, Rouprêt M, Chun FK, Lotan Y, Roehrborn CG, Crivelli JJ, Karakiewicz PI, Scherr DS, Rink M, Graefen M, Schramek P, Briganti A, MONTORSI , FRANCESCO, Tewari A, Shariat SF, Passoni, Nm, Fajkovic, H, Xylinas, E, Kluth, L, Seitz, C, Robinson, Bd, Rouprêt, M, Chun, Fk, Lotan, Y, Roehrborn, Cg, Crivelli, Jj, Karakiewicz, Pi, Scherr, D, Rink, M, Graefen, M, Schramek, P, Briganti, A, Montorsi, Francesco, Tewari, A, and Shariat, Sf

Subjects
Male, Prostatectomy, recurrence, Pelvi, Prognosi, Urology, extranodal extension, Lymph Node, Lymphatic Metastasi, staging, lymph node metastasi, Middle Aged, prostate cancer, Disease-Free Survival, Follow-Up Studie, Treatment Outcome, Prostatic Neoplasm, Lymph Node Excision, Aged, Human, Neoplasm Staging
Abstract

Objective To assess the prognostic role of extranodal extension (ENE) and the size of the largest lymph node (LN) metastasis in predicting early biochemical relapse (eBCR) in patients with LN metastasis after radical prostatectomy (RP). Patients and Methods We evaluated BCR-free survival in men with LN metastases after RP and pelvic LN dissection performed in six high-volume centres. Multivariable Cox regression tested the role of ENE and diameter of largest LN metastasis in predicting eBCR after adjusting for clinicopathological variables. We compared the discrimination of multivariable models including ENE, the size of largest LN metastasis and the number of positive LNs. Results Overall, 484 patients were included. The median (interquartile range, IQR) follow-up was 16.1 (6-27.5) months. The median (IQR) number of removed LNs was 10 (4-14), and the median (IQR) number of positive LNs was 1 (1-2). ENE was present in 280 (58%) patients, and 211 (44%) had their largest metastasis >10 mm. Patients with ENE and/or largest metastasis of >10 mm had significantly worse eBCR-free survival (all P < 0.01). On multivariable analysis, number of positive LNs (≤2 vs >2) and the diameter of LN metastasis (≤10 vs >10 mm), but not ENE, were significant predictors of eBCR (all P < 0.003). ENE and diameter of LN metastasis increased the area under the curve of a baseline multivariable model (0.663) by 0.016 points. Conclusions The diameter of the largest LN metastasis and the number of positive LNs are independent predictors of eBCR. Considered together, ENE and the diameter of the largest LN metastasis have less discrimination than the number of positive LNs.

Published
2014

2. Selecting the optimal candidate for adjuvant radiotherapy after radical prostatectomy for prostate cancer: a long-term survival analysis

Author

Abdollah F, Suardi N, Cozzarini C, Gallina A, Capitanio U, Bianchi M, Sun M, Fossati N, Passoni NM, Fiorino C, Di Muzio N, Karakiewicz PI, Rigatti P, MONTORSI , FRANCESCO, BRIGANTI , ALBERTO, DI MUZIO, NADIA GISELLA, Abdollah, F, Suardi, N, Cozzarini, C, Gallina, A, Capitanio, U, Bianchi, M, Sun, M, Fossati, N, Passoni, Nm, Fiorino, C, Di Muzio, N, Karakiewicz, Pi, Rigatti, P, Montorsi, Francesco, Briganti, Alberto, and DI MUZIO, NADIA GISELLA

Subjects
Oncology, Male, medicine.medical_treatment, Prostatic neoplasms/surgery, Cohort Studies, Prostate cancer, Retrospective Studie, Multivariate Analysi, Adjuvant, Aged, 80 and over, Prostatectomy, Medicine (all), Middle Aged, Combined Modality Therapy, Prostatic neoplasms/mortality, Treatment Outcome, Survival Analysi, Prostatic neoplasms/pathology, Human, Neoplasm recurrence, Adult, medicine.medical_specialty, Pelvi, Urology, Risk Assessment, Disease-Free Survival, Pelvis, Internal medicine, medicine, Humans, Survival analysis, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Radiotherapy, Proportional hazards model, business.industry, Patient Selection, Prostatic Neoplasms, Retrospective cohort study, medicine.disease, Survival Analysis, Radiation therapy, Prostatic Neoplasm, Multivariate Analysis, Proportional Hazards Model, Lymph Node Excision, Radiotherapy, Adjuvant, Risk factor, Cohort Studie, Neoplasm Grading, business
Abstract

Background: The role of adjuvant radiotherapy (ART) after radical prostatectomy (RP) on survival of patients with prostate cancer (PCa) is still controversial. Objective: We tested the impact of ART on cancer-specific mortality (CSM) and overall mortality (OM) in PCa patients according to pathologic PCa features. Design, setting, and participants: We evaluated 1049 PCa patients treated with RP and extended pelvic lymph node dissection alone or in combination with adjuvant treatments between 1998 and 2008. All patients had positive surgical margins and/or pT3/pT4 disease with or without positive lymph nodes. Outcome measurements and statistical analysis: Cox regression analyses tested the relationship between pathologic characteristics and CSM rates. Independent predictors of survival were used to develop a novel risk score based on the number of risk factors. Finally, Cox regression models tested the relationship between ART and survival according to the number of risk factors. Results and limitations: On multivariable analyses, only pathologic Gleason score >= 8, pT3b/T4 stage, and presence of positive lymph nodes represented independent predictors of CSM (all p = 0.4). Conversely, in patients with a risk score >= 2, ART was associated with lower CSM and OM rates (all p = 0.006). The observational nature of the cohort represents a limitation of the study. Conclusions: ART significantly improved survival only in patients with at least two of the following pathologic features at RP: Gleason score >= 8, pT3/pT4 disease, and positive lymph nodes. These patients represent the ideal candidates for ART after RP. (c) 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Published
2012

3. Is [11C]choline PET/CT recommended for restaging prostate cancer patients after radical prostatectomy when PSA is lower than 1 ng/ml?

Author

Tutolo M, Briganti A, Suardi N, Gallina A, Abdollah F, Parra RG, Picchio M, Giovacchini G, Gianolli L, Messa MC, Di Trapani E, Zanni G, Passoni NM, Fossati N, Guazzoni G, Rigatti P, Montorsi F., Tutolo, M, Briganti, A, Suardi, N, Gallina, A, Abdollah, F, Parra, Rg, Picchio, M, Giovacchini, G, Gianolli, L, Messa, Mc, Di Trapani, E, Zanni, G, Passoni, Nm, Fossati, N, Guazzoni, G, Rigatti, P, and Montorsi, F.

Published
2012

5. [11C]CHOLINE PET/CT SCAN PREDICTS SURVIVAL IN PROSTATE CANCER PATIENTS WITH BIOCHEMICAL FAILURE AFTER RADICAL PROSTATECTOMY

Author

Suardi N, Gallina A, Abdollah F, Di Muzio NG, Passoni NM, Fossati N, Gianolli L, Messa MC, Giovacchini G, Scattoni V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Suardi, N, Briganti, Alberto, Gallina, A, Abdollah, F, DI MUZIO, NADIA GISELLA, Passoni, Nm, Fossati, N, Gianolli, L, Messa, Mc, Giovacchini, G, Scattoni, V, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2012

6. LYMPH NODE DENSITY PREDICTS SURVIVAL OF PATIENTS WITH NODAL METASTASES AND PROSTATE CANCER ONLY IN PRESENCE OF MORE EXTENSIVE NODAL DISSECTION. IMPORTANCE OF ACCURATE STAGING

Author

Passoni NM, Suardi N, Gallina A, Capitanio U, Abdollah F, Bianchi M, Tutolo M, Di Trapani A, Di Trapani D, Freschi M, Colombo R, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Passoni, Nm, Briganti, Alberto, Suardi, N, Gallina, A, Capitanio, U, Abdollah, F, Bianchi, M, Tutolo, M, Di Trapani, A, Di Trapani, D, Freschi, M, Colombo, R, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2011

7. DOES BIOCHEMICAL PROGRESSION AFTER RADICAL PROSTATECTOMY AND ADJUVANT RADIOTHERAPY FOR LOCALLY ADVANCED PROSTATE CANCER INVARIABLY IMPACT CANCER-SPECIFIC MORTALITY?

Author

BRIGANTI , ALBERTO, Suardi N, Cozzarini C, Gallina A, Capitanio U, Tutolo M, Bianchi M, Passoni NM, Fossati N, Di Muzio N, Martinez Salamanca GI, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Suardi, N, Cozzarini, C, Gallina, A, Capitanio, U, Tutolo, M, Bianchi, M, Passoni, Nm, Fossati, N, Di Muzio, N, Martinez Salamanca, Gi, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2011

8. MORE EXTENSIVE PELVIC LYMPH NODE DISSECTION IS ASSOCIATED WITH REDUCED RISK OF CANCER PROGRESSION IN NODE NEGATIVE ORGAN CONFINED PROSTATE CANCER PATIENTS

Author

BRIGANTI , ALBERTO, Gallina A, Tutolo M, Suardi N, Capitanio U, Matloob R, SALONIA, ANDREA, Bianchi M, Fossati N, Passoni NM, Di Girolamo V, MONTORSI, FRANCESCO, Briganti, Alberto, Gallina, A, Tutolo, M, Suardi, N, Capitanio, U, Matloob, R, Salonia, Andrea, Bianchi, M, Fossati, N, Passoni, Nm, Di Girolamo, V, and Montorsi, Francesco

Published
2011

9. ADJUVANT RADIOTHERAPY REDUCES THE RATE OF URINARY CONTINENCE RECOVERY AFTER RADICAL PROSTATECTOMY IN INTERMEDIATE AND HIGH RISK PROSTATE CANCER PATIENTS

Author

Gallina A, Suardi N, Capitanio U, Di Trapani E, Bianchi M, La Croce G, Tutolo M, Passoni NM, Cozzarini C, Di Muzio N, Di Girolamo V, Colombo R, Rigatti P, Guazzoni G, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Capitanio, U, Di Trapani, E, Bianchi, M, La Croce, G, Tutolo, M, Passoni, Nm, Cozzarini, C, Di Muzio, N, Di Girolamo, V, Colombo, R, Rigatti, P, Guazzoni, G, and Montorsi, Francesco

Published
2011

10. CHARLSON COMORBIDITY INDEX IS NOT AN INDEPENDENT PREDICTOR OF OVERALL SURVIVAL IN PATIENTS WITH INTERMEDIATE AND HIGH RISK PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY

Author

Suardi N, Gallina A, Capitanio U, Tutolo M, Bianchi M, Fossati N, Passoni NM, Scattoni V, SALONIA, ANDREA, Colombo R, Di Girolamo V, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Suardi, N, Briganti, Alberto, Gallina, A, Capitanio, U, Tutolo, M, Bianchi, M, Fossati, N, Passoni, Nm, Scattoni, V, Salonia, Andrea, Colombo, R, Di Girolamo, V, Rigatti, P, and Montorsi, Francesco

Published
2011

13. SOPRAVVIVENZA CANCRO-SPECIFICA DEI PAZIENTI CON RIPRESA BIOCHIMICA DI MALATTIA DOPO PROSTATECTOMIA RADICALE E RADIOTERAPIA ADIUVANTE PER TUMORE PROSTATICO LOCALMENTE AVANZATO

Author

Passoni NM, Cozzarini C, BRIGANTI , ALBERTO, Suardi N, Gallina A, Capitanio U, Angiolilli D, Tutolo M, Di Muzio N, Bolognesi A, Pasetti M, Scattoni V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Roscigno M, Da Pozzo L., Passoni, Nm, Cozzarini, C, Briganti, Alberto, Suardi, N, Gallina, A, Capitanio, U, Angiolilli, D, Tutolo, M, Di Muzio, N, Bolognesi, A, Pasetti, M, Scattoni, V, Guazzoni, G, Rigatti, P, Montorsi, Francesco, Roscigno, M, and Da Pozzo, L.

Published
2010

14. QUAL È LA MIGLIORE DEFINIZIONE DI RECUPERO DELLA FUNZIONE ERETTILE DOPO PROSTATECTOMIA RADICALE NERVE-SPARING BILATERALE? ANALISI DELLA SODDISFAZIONE DEI PAZIENTI

Author

Gallina A, Suardi N, Capitanio U, Bianchi M, Tutolo M, Passoni NM, Fossati N, Villa L, Zanni G, Colombo R, SALONIA, ANDREA, Di Girolamo V, Guazzoni G, MONTORSI, FRANCESCO, Rigatti P., BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Capitanio, U, Bianchi, M, Tutolo, M, Passoni, Nm, Fossati, N, Villa, L, Zanni, G, Colombo, R, Salonia, Andrea, Di Girolamo, V, Guazzoni, G, Montorsi, Francesco, and Rigatti, P.

Published
2010

15. L’APPROCCIO FARMACOLOGICO PRO ERETTILE DOPO PROSTATECTOMIA RADICALE NERVE SPARING BILATERALE DEVE ESSERE INIZIATO PRECOCEMENTE DOPO L'INTERVENTO. RISULTATI DI UNO STUDIO RETROSPETTIVO

Author

Gallina A, Suardi N, Capitanio U, Tutolo M, Bianchi M, Bua L, Ghezzi M, Di Trapani D, Matloob R, Passoni NM, Cestari A, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Capitanio, U, Tutolo, M, Bianchi, M, Bua, L, Ghezzi, M, Di Trapani, D, Matloob, R, Passoni, Nm, Cestari, A, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2010

16. Assessing the risk of lymph node invasion in patients with intermediate risk prostate cancer. A novel prediction tool

Author

Passoni NM, Gallina A, Suardi N, Capitanio U, Bianchi M, Tutolo M, Fossati N, SALONIA, ANDREA, Colombo R, Scattoni V, Zanni G, Ghezzi M, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Passoni, Nm, Briganti, Alberto, Gallina, A, Suardi, N, Capitanio, U, Bianchi, M, Tutolo, M, Fossati, N, Salonia, Andrea, Colombo, R, Scattoni, V, Zanni, G, Ghezzi, M, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2010

19. SVILUPPO E VALIDAZIONE INTERNA DI UN NOMOGRAMMA PER DETERMINARE L'IMPATTO DELLO SCHEMA BIOPTICO SULLA INDIVIDUAZIONE DI TUMORE IN UOMINI SOTTOPOSTI AD UNA PRIMA BIOPSIA PROSTATICA

Author

Scattoni V, Abdollah F, Roscigno M, Angiolilli D, Suardi N, Bianchi M, Tutolo M, Passoni NM, Di Girolamo V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Scattoni, V, Abdollah, F, Roscigno, M, Angiolilli, D, Briganti, Alberto, Suardi, N, Bianchi, M, Tutolo, M, Passoni, Nm, Di Girolamo, V, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

20. IMPACT OF STAGE MIGRATION ON THE PREVALENCE OF PELVIC LYMPH NODE METASTASES IN PATIENTS UNDERGOING EXTENDED PELVIC LYMPH NODE DISSECTION FOR PROSTATE CANCER: A 23-YEAR SINGLE INSTITUTION EXPERIENCE

Author

BRIGANTI , ALBERTO, Suardi N, Gallina A, SALONIA, ANDREA, Zanni G, Bianchi M, Passoni NM, Capitanio U, Da Pozzo LF, Freschi M, Doglioni C, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Suardi, N, Gallina, A, Salonia, Andrea, Zanni, G, Bianchi, M, Passoni, Nm, Capitanio, U, Da Pozzo, Lf, Freschi, M, Doglioni, C, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

24. I PAZIENTI CON NEOPLASIA PROSTATICA ORGANO-CONFINATA E MARGINI CHIRURGICI POSITIVI HANNO TASSI DI RIPRESA DI MALATTIA SIMILI AI PAZIENTI CON ESTENSIONE EXTRA-CAPSULARE DI MALATTIA E MARGINI CHIRURGICI NEGATIVI. PROPOSTA DI RICLASSIFICAZIONE

Author

BRIGANTI , ALBERTO, Gallina A, Suardi N, Capitanio U, Passoni NM, Bianchi M, Tutolo M, Fossati N, Zanni G, Di Girolamo V, Bertini R, Da Pozzo L, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Gallina, A, Suardi, N, Capitanio, U, Passoni, Nm, Bianchi, M, Tutolo, M, Fossati, N, Zanni, G, Di Girolamo, V, Bertini, R, Da Pozzo, L, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

25. QUALI PAZIENTI HANNO UN REALE RISCHIO DI MORIRE PER CARCINOMA PROSTATICO? FOLLOW UP A LUNGO TERMINE DI PAZIENTI CON TUMORE PROSTATICO AD ALTO RISCHIO TRATTATI NELL'ERA DEL PSA

Author

BRIGANTI , ALBERTO, Gallina A, Suardi N, Bianchi M, Tutolo M, Passoni NM, Capitanio U, Di Girolamo V, Vincenzo S, Da Pozzo L, SALONIA, ANDREA, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Gallina, A, Suardi, N, Bianchi, M, Tutolo, M, Passoni, Nm, Capitanio, U, Di Girolamo, V, Vincenzo, S, Da Pozzo, L, Salonia, Andrea, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

26. MIGLIORARE LA PREDIZIONE DEL RECUPERO DELLA FUNZIONE ERETTILE DOPO PROSTATECTOMIA RADICALE CON TECNICA NERVE-SPARING BILATERALE. IMPORTANZA DELLA VALUTAZIONE DELLA FUNZIONE ERETTILE PRECOCE POST-OPERATORIA

Author

Gallina A, Suardi N, SALONIA, ANDREA, Dehò F, Saccà A, Rocchini L, Passoni NM, Bianchi M, Tutolo M, Rigatti P., BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Salonia, Andrea, Dehò, F, Saccà, A, Rocchini, L, Passoni, Nm, Bianchi, M, Tutolo, M, and Rigatti, P.

Published
2009

29. NON TUTTI I PAZIENTI CON NEOPLASIA PROSTATICA AD ALTO RISCHIO HANNO LA MEDESIMA PROBABILITA' DI RECIDIVA BIOCHIMICA DI MALATTIA DOPO PROSTATECTOMIA RADICALE. ANALISI MULTI - ISTITUZIONALE DEI FATTORI PREDITTIVI DI OUTCOME

Author

BRIGANTI , ALBERTO, Suardi N, Gallina A, Tutolo M, Bianchi M, Passoni NM, Capitanio U, SALONIA, ANDREA, Da Pozzo L, Scattoni V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Bastian PJ, Chun FKH, Graefen M, Stief CG, Huland H., Briganti, Alberto, Suardi, N, Gallina, A, Tutolo, M, Bianchi, M, Passoni, Nm, Capitanio, U, Salonia, Andrea, Da Pozzo, L, Scattoni, V, Guazzoni, G, Rigatti, P, Montorsi, Francesco, Bastian, Pj, Chun, Fkh, Graefen, M, Stief, Cg, and Huland, H.

Published
2009

30. PERCENTAGE OF POSITIVE CORES STRONGLY INFLUENCES THE RATE OF GLEASON SUM AGREEMENT BETWEEN PROSTATE BIOPSY AND RADICAL PROSTATECTOMY

Author

Abdollah F, Gallina A, Suardi N, Scattoni V, Dehò F, Bianchi M, Passoni NM, Maccagnano C, Matloob R, Capitanio U, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Abdollah, F, Briganti, Alberto, Gallina, A, Suardi, N, Scattoni, V, Dehò, F, Bianchi, M, Passoni, Nm, Maccagnano, C, Matloob, R, Capitanio, U, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

31. QUAL È IL TEMPO IDEALE PER VALUTARE LA FUNZIONE ERETTILE DOPO PROSTATECTOMIA RADICALE NERVE-SPARING BILATERALE?RISULTATI DI UN'ANALISI PROSPETTICA

Author

BRIGANTI , ALBERTO, Gallina A, Suardi N, SALONIA, ANDREA, Bianchi M, Tutolo M, Passoni NM, Fossati N, Colombo R, Salonia A, Cestari A, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Gallina, A, Suardi, N, Salonia, Andrea, Bianchi, M, Tutolo, M, Passoni, Nm, Fossati, N, Colombo, R, Salonia, A, Cestari, A, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

33. QUANDO ESEGUIRE UNA SCINTIGRAFIA OSSEA IN PAZIENTI CON CARCINOMA PROSTATICO DI NUOVA DIAGNOSI.VALIDAZIONE ESTERNA DELLE ATTUALI LINEE GUIDA E PROPOSTA DI UNA NUOVA STRATIFICAZIONE DEL RISCHIO

Author

BRIGANTI , ALBERTO, Capitanio U, Da Pozzo L, Gallina A, Suardi N, Ferrari M, SALONIA, ANDREA, Passoni NM, Tutolo M, Bianchi M, Cestari A, Zanni G, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Capitanio, U, Da Pozzo, L, Gallina, A, Suardi, N, Ferrari, M, Salonia, Andrea, Passoni, Nm, Tutolo, M, Bianchi, M, Cestari, A, Zanni, G, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

34. PROSTATECTOMIA RADICALE CON APPROCCIO NERVE SPARING INTRAFASCIALE SENZA COMPROMETTERE LA SICUREZZA ONCOLOGICA. RISULTATI DI UN SINGOLO CHIRURGO AD ALTO VOLUME

Author

Gallina A, Suardi N, SALONIA, ANDREA, Bianchi M, Passoni NM, Tutolo M, Capitanio U, Cestari A, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Salonia, Andrea, Bianchi, M, Passoni, Nm, Tutolo, M, Capitanio, U, Cestari, A, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

35. LA PERCENTUALE DI PRELIEVI POSITIVI INFLUENZA FORTEMENTE LA CORRISPONDENZA TRA IL PUNTEGGIO DI GLEASON ALLA BIOPSIA E QUELLO ALLA PROSTATECTOMIA RADICALE

Author

Tutolo M, Abdollah F, Suardi N, Gallina A, Bianchi M, Passoni NM, Capitanio U, Fossati N, Scattoni V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Tutolo, M, Abdollah, F, Briganti, Alberto, Suardi, N, Gallina, A, Bianchi, M, Passoni, Nm, Capitanio, U, Fossati, N, Scattoni, V, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

37. LA RADIOTERAPIA ADIUVANTE MIGLIORA LA SOPRAVVIVENZA CANCRO SPECIFICA DEI PAZIENTI AFFETTI DA NEOPLASIA PROSTATICA E METASTASI LINFONODALI. RISULTATI DI UNA MATCHED ANALYSIS DI 703 PAZIENTI CON INVASIONE LINFONODALE

Author

BRIGANTI , ALBERTO, Da Pozzo L, Suardi N, Gallina A, Cozzarini C, Freschi M, Tutolo M, Bianchi M, Passoni NM, SALONIA, ANDREA, Scattoni V, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Kernes J, Blute M., Briganti, Alberto, Da Pozzo, L, Suardi, N, Gallina, A, Cozzarini, C, Freschi, M, Tutolo, M, Bianchi, M, Passoni, Nm, Salonia, Andrea, Scattoni, V, Guazzoni, G, Rigatti, P, Montorsi, Francesco, Kernes, J, and Blute, M.

Published
2009

38. LA RADIOTERAPIA ADIUVANTE NON MIGLIORA L'OUTCOME ONCOLOGICO DEI PAZIENTI CON NEOPLASIA PROSTATICA IN STADIO PATOLOGICO T2 E MARGINI CHIRURGICI POSITIVI. RISULTATI DI UN SINGOLO CENTRO

Author

BRIGANTI , ALBERTO, Suardi N, Gallina A, Passoni NM, Tutolo M, Bianchi M, Capitanio U, Fossati N, Colombo R, Cozzarini C, Da Pozzo L, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Suardi, N, Gallina, A, Passoni, Nm, Tutolo, M, Bianchi, M, Capitanio, U, Fossati, N, Colombo, R, Cozzarini, C, Da Pozzo, L, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

39. LA LINFOADENECTOMIA PELVICA NON MIGLIORA L'OUTCOME ONCOLOGICO DEI PAZIENTI CON NEOPLASIA PROSTATICA A BASSO RISCHIO. RISULTATI DI UNA MATCHED ANALYSIS

Author

BRIGANTI , ALBERTO, Gallina A, Suardi N, Capitanio U, Bianchi M, Passoni NM, Tutolo M, SALONIA, ANDREA, Da Pozzo L, Colombo R, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Haese A, Chun FKH, Graefen M, Huland H., Briganti, Alberto, Gallina, A, Suardi, N, Capitanio, U, Bianchi, M, Passoni, Nm, Tutolo, M, Salonia, Andrea, Da Pozzo, L, Colombo, R, Guazzoni, G, Rigatti, P, Montorsi, Francesco, Haese, A, Chun, Fkh, Graefen, M, and Huland, H.

Published
2009

40. IMPATTO DELLO STAGE MIGRATION SULLA PREVALENZA DI METASTASI LINFONODALI IN PAZIENTI SOTTOPOSTI A LINFOADENECTOMIA PELVICA ESTESA PER NEOPLASIA PROSTATICA: 23 ANNI DI ESPERIENZA DI UN SINGOLO ISTITUTO

Author

BRIGANTI , ALBERTO, Suardi N, Gallina A, SALONIA, ANDREA, Capitanio U, Tutolo M, Bianchi M, Zanni G, Passoni NM, Freschi M, Doglioni C, Di Girolamo V, Da Pozzo L, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Suardi, N, Gallina, A, Salonia, Andrea, Capitanio, U, Tutolo, M, Bianchi, M, Zanni, G, Passoni, Nm, Freschi, M, Doglioni, C, Di Girolamo, V, Da Pozzo, L, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

42. OUTCOME ONCOLOGICO DEI PAZIENTI CON GLEASON 8-10 ALLA PROSTATECTOMIA RADICALE. RISULTATI A LUNGO TERMINE DI UN SINGOLO CENTRO

Author

BRIGANTI , ALBERTO, Gallina A, Suardi N, Passoni NM, Bianchi M, Tutolo M, Capitanio U, Da Pozzo L, Freschi M, Doglioni C, SALONIA, ANDREA, Zanni G, Abdollah F, Guazzoni G, Rigatti P, MONTORSI, FRANCESCO, Briganti, Alberto, Gallina, A, Suardi, N, Passoni, Nm, Bianchi, M, Tutolo, M, Capitanio, U, Da Pozzo, L, Freschi, M, Doglioni, C, Salonia, Andrea, Zanni, G, Abdollah, F, Guazzoni, G, Rigatti, P, and Montorsi, Francesco

Published
2009

44. LA CURVA DI APPRENDIMENTO E' INFINITA: IL TASSO DI RECIDIVA BIOCHIMICA CONTINUA A VARIARE ANCHE TRA CHIRURGHI AD ALTO VOLUME DI PROSTATECTOMIA RADICALE RETROPUBICA

Author

Gallina A, Suardi N, SALONIA, ANDREA, Passoni NM, Bianchi M, Colombo R, Da Pozzo L, Di Girolamo V, Rigatti P, MONTORSI, FRANCESCO, BRIGANTI , ALBERTO, Gallina, A, Briganti, Alberto, Suardi, N, Salonia, Andrea, Passoni, Nm, Bianchi, M, Colombo, R, Da Pozzo, L, Di Girolamo, V, Rigatti, P, and Montorsi, Francesco

Published
2009

45. Assessing the most accurate formula to predict the risk of lymph node metastases from prostate cancer in contemporary patients treated with radical prostatectomy and extended pelvic lymph node dissection

Author

Andrea Gallina, Paolo Dell'Oglio, Cesare Cozzarini, Manuela Tutolo, Maxine Sun, Firas Abdollah, Andrea Salonia, Marco Bianchi, Niccolo Passoni, Alberto Briganti, Pierre I. Karakiewicz, Alessandro Nini, Nazareno Suardi, Francesco Montorsi, Nicola Fossati, Abdollah, F, Cozzarini, C, Sun, M, Suardi, N, Gallina, A, Passoni, Nm, Bianchi, M, Tutolo, M, Fossati, N, Nini, A, Dell'Oglio, P, Salonia, Andrea, Karakiewicz, P, Montorsi, Francesco, and Briganti, A.

Subjects
Adult, Male, Risk, Radiology, Nuclear Medicine and Imaging, Lymphatic metastasis, medicine.medical_specialty, Pelvi, medicine.medical_treatment, Urology, Single Center, Pelvis, Prostate cancer, Prediction model, Humans, Extended pelvic lymph node dissection, Medicine, Neoplasm Invasiveness, Radiology, Nuclear Medicine and imaging, Lymph node, Aged, Aged, 80 and over, Neoplasm Invasivene, Prostatectomy, business.industry, Medicine (all), Prostatic Neoplasms, Lymphatic Metastasi, Hematology, Middle Aged, medicine.disease, Surgery, Dissection, medicine.anatomical_structure, Oncology, Decision curve analysis, Lymphatic Metastasis, Area Under Curve, Prostatic Neoplasm, Lymph Node Excision, Roach formula, business, Lymph node invasion, Human
Abstract

Background and purpose: The aim of this study was to perform a head-to-head comparison of the Roach formula vs. two other newly developed prediction tools for lymph node invasion (LNI) in prostate cancer, namely the Nguyen and the Yu formulas. Material and methods: We included 3115 patients treated with radical prostatectomy and extended pelvic lymph node dissection (ePLND), between 2000 and 2010 at a single center. The predictive accuracy of the three formulas was assessed and compared using the area-under-curve (AUC) and calibration methods. Moreover, decision curve analysis compared the net-benefit of the three formulas in a head-to-head fashion. Results: Overall, 10.8% of patients had LNI. The LNI-predicted risk was >15% in 25.5%, 3.4%, and 10.2% of patients according to the Roach, Nguyen and Yu formula, respectively. The AUC was 80.5%, 80.5% and 79%, respectively (all p > 0.05). However, the Roach formula demonstrated more favorable calibration and generated the highest net-benefit relative to the other examined formulas in decision curve analysis. Conclusions: All formulas demonstrated high and comparable discrimination accuracy in predicting LNI, when externally validated on ePLND treated patients. However, the Roach formula. showed the most favorable characteristics. Therefore, its use should be preferred over the two other tools. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Published
2013

46. Incidence, survival and mortality rates of stage-specific bladder cancer in United States: A trend analysis

Author

Alberto Briganti, Zhe Tian, Pierre I. Karakiewicz, Rodolphe Thuret, Firas Abdollah, Niccolo Passoni, Maxine Sun, Jan Schmitges, Francesco Montorsi, Claudio Jeldres, Shahrokh F. Shariat, Giorgio Gandaglia, Paul Perrotte, Abdollah, F, Gandaglia, G, Thuret, R, Schmitges, J, Tian, Z, Jeldres, C, Passoni, Nm, Briganti, Alberto, Shariat, Sf, Perrotte, P, Montorsi, Francesco, Karakiewicz, Pi, and Sun, M.

Subjects
United State, Male, Cancer Research, medicine.medical_specialty, Urinary bladder neoplasms/mortality, Epidemiology, Survival analysi, medicine, Humans, Age Factor, Stage (cooking), Survival rate, Survival analysis, Aged, Neoplasm Staging, Aged, 80 and over, Bladder cancer, business.industry, Incidence, Incidence (epidemiology), Mortality rate, Age Factors, numerical data, medicine.disease, SEER program/statistics &amp, United States, Survival Rate, Trend analysis, Urinary Bladder Neoplasms, Oncology, Urinary Bladder Neoplasm, Neoplasm staging, Female, business, Human, SEER Program, Demography
Abstract

Purpose: To examine the overall and stage-specific age-adjusted incidence, 5-year survival and mortality rates of bladder cancer (BCa) in the United States, between 1973 and 2009. Materials and methods: A total of 148,315 BCa patients were identified in the Surveillance, Epidemiology and End Results database, between years 1973 and 2009. Incidence, mortality, and 5-year cancer-specific survival rates were calculated. Temporal trends were quantified using the estimated annual percentage change (EAPC) and linear regression models. All analyses were stratified according to disease stage, and further examined according to sex, race, and age groups. Results: Incidence rate of BCa increased from 21.0 to 25.5/100,000 person-years between 1973 and 2009. Stage-specific analyses revealed an increase incidence for localized stage: 15.4-20.2 (EAPC: +0.5%, p < 0.001) and distant stage: 0.5-0.8 (EAPC: +0.7%, p = 0.001). Stage-specific 5-year survival rates increased for all stages, except for distant disease. No significant changes in mortality were recorded among localized (EAPC: -0.2%, p = 0.1) and regional stage (EAPC: -0.1%, p = 0.5). An increase in mortality rates was observed among distant stage (EAPC: +1.0%, p = 0.005). Significant variations in incidence and mortality were recorded when estimates were stratified according to sex, race, and age groups. Discussion: Albeit statistically significant, virtually all changes in incidence and mortality were minor, and hardly of any clinical importance. Little or no change in BCa cancer control outcomes has been achieved during the study period. (C) 2013 Elsevier Ltd. All rights reserved.

Published
2013

47. Identifying the Best Candidate for Radical Prostatectomy Among Patients with High-Risk Prostate Cancer

Author

Hendrik Van Poppel, Bruno Frea, Burkhard Kneitz, Jochen Walz, Bertrand Tombal, R. Jeffrey Karnes, Giansilvio Marchioro, Niccolo Passoni, Paolo Gontero, Steven Joniau, Francesco Montorsi, Firas Abdollah, Alberto Briganti, Detlef Frohneberg, Markus Graefen, Chris H. Bangma, Martin Spahn, Alessandro Tizzani, Urology, Briganti, Alberto, Joniau, S, Gontero, P, Abdollah, F, Passoni, Nm, Tombal, B, Marchioro, G, Kneitz, B, Walz, J, Frohneberg, D, Bangma, Ch, Graefen, M, Tizzani, A, Frea, B, Karnes, Rj, Montorsi, Francesco, Van Poppel, H, and Spahn, M.

Subjects
Male, Oncology, medicine.medical_specialty, Urology, medicine.medical_treatment, Disease, urologic and male genital diseases, Androgen deprivation therapy, Prostate cancer, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Humans, Medicine, In patient, Aged, Retrospective Studies, Prostatectomy, business.industry, Patient Selection, Prostatic Neoplasms, Retrospective cohort study, Middle Aged, Prostate-Specific Antigen, Nomogram, medicine.disease, Nomograms, Prostate-specific antigen, Treatment Outcome, Lymph Node Excision, Neoplasm Grading, business
Abstract

Background: The current role of radical prostatectomy (RP) in patients with high-risk disease remains controversial. Objective: To identify which high-risk prostate cancer (PCa) patients might have favorable pathologic outcomes when surgically treated. Design, setting, and participants: We evaluated 1366 patients with high-risk PCa (ie, at least one of the following risk factors: prostate-specific antigen [PSA] > 20 ng/ml, cT3, biopsy Gleason 8-10) treated with RP and pelvic lymph node dissection (PLND) at eight European centers between 1987 and 2009. A favorable pathologic outcome was defined as specimen-confined (SC) disease-namely, pT2-pT3a, node negative PCa with negative surgical margins. Intervention: All patients underwent radical retropubic prostatectomy and PLND. Measurements: Univariable and multivariable logistic regression models tested the association between predictors and SC disease. A logistic regression coefficient-based nomogram was developed and internally validated using 200 bootstrap resamples. The Kaplan-Meier method was used to depict biochemical recurrence (BCR) and cancer-specific survival (CSS) rates. Results and limitations: Overall, 505 of 1366 patients (37%) had SC disease at RP. All preoperative variables (ie, age and PSA at surgery, clinical stage, and biopsy Gleason sum) were independent predictors of SC PCa at RP (all p

Published
2012

48. Impact of the Site of Metastases on Survival in Patients with Metastatic Prostate Cancer

Author

Alberto Briganti, Pierre I. Karakiewicz, Markus Graefen, Niccolo Passoni, Maxine Sun, Jonas Schiffmann, Francesco Montorsi, Giorgio Gandaglia, Vincent Trudeau, Gandaglia, G, Karakiewicz, Pi, Briganti, Alberto, Passoni, Nm, Schiffmann, J, Trudeau, V, Graefen, M, Montorsi, Francesco, and Sun, M.

Subjects
Oncology, Male, Time Factors, Kaplan-Meier Estimate, Androgen deprivation therapy, Metastatic prostate cancer, Prostate cancer, Retrospective Studie, Risk Factors, Overall survival, Multivariate Analysi, Lymph node, Aged, 80 and over, Site of metastase, education.field_of_study, Medicine (all), medicine.anatomical_structure, Lymphatic Metastasis, Disease Progression, Human, United State, medicine.medical_specialty, Time Factor, Urology, Population, Bone Neoplasms, Bone Neoplasm, Risk Assessment, Disease-Free Survival, Internal medicine, medicine, Humans, education, Aged, Proportional Hazards Models, Retrospective Studies, Chi-Square Distribution, business.industry, Proportional hazards model, Risk Factor, Prostatic Neoplasms, Lymphatic Metastasi, Retrospective cohort study, medicine.disease, United States, Clinical trial, Viscera, Number of metastase, Prostatic Neoplasm, Multivariate Analysis, Proportional Hazards Model, business, Chi-squared distribution, SEER Program
Abstract

Background Limited data exist on the impact of the site of metastases on survival in patients with stage IV prostate cancer (PCa). Objective To investigate the role of metastatic phenotype at presentation on mortality in stage IV PCa. Design, setting, and participants Overall, 3857 patients presenting with metastatic PCa between 1991 and 2009, included in the Surveillance Epidemiology and End Results-Medicare database were evaluated. Outcome measurements and statistic analyses Overall and cancer-specific survival rates were estimated in the overall population and after stratifying patients according to the metastatic site (lymph node [LN] alone, bone, visceral, or bone plus visceral). Multivariable Cox regression analyses tested the relationship between the site of metastases and survival. All analyses were repeated in a subcohort of patients with a single metastatic site involved. Results and limitations Respectively, 2.8%, 80.2%, 6.1%, and 10.9% of patients presented with LN, bone, visceral, and bone plus visceral metastases at diagnosis. Respective median overall survival and cancer-specific survival were 43 mo and 61 mo for LN metastases, 24 mo and 32 mo for bone metastases, 16 mo and 26 mo for visceral metastases, and 14 mo and 19 mo for bone plus visceral metastases (p < 0.001). In multivariable analyses, patients with visceral metastases had a significantly higher risk of overall and cancer-specific mortality versus those with exclusively LN metastases (p < 0.001). The unfavorable impact of visceral metastases persisted in the oligometastatic subgroup. Our study is limited by its retrospective design. Conclusions Visceral involvement represents a negative prognostic factor and should be considered as a proxy of more aggressive disease in patients presenting with metastatic PCa. This parameter might indicate the need for additional systemic therapies in these individuals. Patient summary Patients with visceral metastases should be considered as affected by more aggressive disease and might benefit from the inclusion in clinical trials evaluating novel molecules.

Published
2014

49. Treatment of lymph node-positive prostate cancer: teaching old dogmas new tricks

Author

Firas Abdollah, Francesco Montorsi, Alessandro Nini, R. Jeffrey Karnes, Niccolo Passoni, Alberto Briganti, Briganti, A, Passoni, Nm, Abdollah, F, Nini, A, Montorsi, Francesco, and Karnes, Rj

Subjects
Oncology, Male, Prostatectomy, medicine.medical_specialty, Pathology, business.industry, Urology, Lymph duct, Cancer, Prostatic Neoplasms, medicine.disease, Metastasis, Prostate cancer, medicine.anatomical_structure, Breast cancer, Lymphatic system, Internal medicine, Prostatic Neoplasm, medicine, Humans, Lymph, business, Lymph node, Human
Abstract

The optimal treatment of men with positive lymph nodes after radical prostatectomy (RP) is an active debate in the urologic community. In addition, this topic has seemed to gain scientific attention in recent years because of the shift to offering RP to higher risk patients. However, patients with positive lymph nodes represent a paradigmatic group for which indications for and typesof treatmenthavebeenbased mainly on eminence-based rather than on evidence-based medicine. In the past, these patients were generally not considered suitable for radical treatment because of the assumption that cure was neither possible nor helpful. For several years, any definitive therapy attempt was denied because of undisputed dogma: Patients with lymph node metastasis are affected by a systemic disease. This assumption led to threemisguided concepts in clinical practice. First, maximizing local control was considered either useless or of limited therapeutic value. Second, extending the template of pelvic lymph node dissection (PLND) was not justified because, according to opponents of such an extensive approach, these patients would progress anyway, regardless of the extent of PLND. Third, patients with positive lymph nodes needed lifelong adjuvant androgen-deprivation therapy because of the presence of disseminated disease. Such statements can certainly be challenged today. We should still understand whether the presence of pelvic lymph node metastases indicates systemic dissemination. The etymology of the term metastasis shows that it comes from the Greek terms meta-, meaning across, and histanai, meaning to place. Therefore, the terms indicate a tumor spread outside of the organ of origin. For this reason, strictly speaking, patients with lymph node invasion have metastatic disease. However, such statement should be balanced by several key and still unknown aspects of the metastasizing process of prostate cancer (PCa). Cancer cells that spread to the lymph nodes have acquired certain phenotypic changes that confer to them the ability to invade lymphatic vessels and access lymph nodes; however, we still do not know what happens next. Lymph nodes can represent the door to hematogenous dissemination to other organs [1]. Tumor cells could spread from lymph nodes to distant organs via blood vessels associated with the nodes or by entering the venous system via the major lymphatic ducts and then spreading via blood vessels. In mice with metastatic lymph nodes, the expression of lymphangiogenesis signals the increased probability of metastasization to additional organs [2]. However, in some cases, these draining lymph nodes may also represent dead ends rather than temporary stopping points from which more distant metastases are launched [3]. Moreover, as demonstrated in breast cancer, these cells may have specific epigenetic modifications that predispose to selective metastasization to the lymph nodes instead of visceral organs [4]. Therefore, the routes of systemic and nodal metastasization may also be different and separated. Cancer metastasized to the lymph nodes can also enter a quiescent state. This status is well known as tumor dormancy [5]. Tumor dormancy ensues when cancer cell proliferation is counteracted by other mechanisms such as apoptosis because of impaired vascularization or immunosurveillance, and cellular dormancy ensues when growth of the cancer cells is arrested. Several mechanisms can explain tumor dormancy, including disruption of crosstalk between EURO P E AN URO L OG Y 6 5 ( 2 0 1 4 ) 2 6 – 2 9

Published
2013

50. Clinical and diagnostic assessment for therapeutic decisions in prostate cancer

Author

Passoni, N. M., Di Trapani, E., Suardi, N., Gallina, A., Abdollah, F., Bianchi, M., Maria Picchio, Giovacchini, G., Messa, C., Rigatti, P., Montorsi, F., Briganti, A., Passoni, Nm, Di Trapani, E, Suardi, N, Gallina, A, Abdollah, F, Bianchi, M, Picchio, M, Giovacchini, G, Messa, C, Rigatti, P, Montorsi, Francesco, Briganti, Alberto, Passoni, N, Messa, M, Montorsi, F, and Briganti, A

Subjects
Male, Radiology, Nuclear Medicine and Imaging, diagnostic imaging, Humans, Prostatic Neoplasms, staging, Prostatic neoplasm, Prognosis, Decision Support Techniques
Abstract

Due to the heterogeneity of prostate cancer (PCa) outcomes, there is a need for individualized treatment plans based on clinical and cancer characteristics. Recent advances in sophisticated imaging modalities have improved the ability to stratify patients according to their risk of PCa diagnosis and progression. This, in turn, has positively influenced the clinical decision making process. However, there is also an overuse of diagnostic imaging in the evaluation of PCa patients. Baseline diagnostic and re-staging evaluations need to be indeed personalized, in order to maximize the results and reduce unnecessary, lengthy and costly procedures. The aim of this review was to critically evaluate current international guidelines in order to identify clinical and diagnostic markers that might help clinicians in the selection of the most appropriate imaging approach. For this aim, different imaging modalities were analyzed in patients with newly diagnosed PCa, focusing on local, nodal and distant staging. Every step of staging was taken into consideration based on patient individualized risk, as defined by routinely available clinical variables. Second, different imaging techniques were also reviewed in the context of relapse after primary treatment, highlighting their utility and impact in the clinical decision making process. This review focuses mainly on conventional established imaging techniques, with an eye also to novel approaches that still need to be validated on large patient series.

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