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1. Follow-up on patients with initial negative mpMRI target and systematic biopsy for PI-RADS ≥ 3 lesions – an EAU-YAU study enhancing prostate cancer detection

Author

Zattoni, Fabio, Gandaglia, Giorgio, van den Bergh, Roderick C. N., Marra, Giancarlo, Valerio, Massimo, Martini, Alberto, Olivier, Jonathan, Puche – SanzI, Ignacio, Rajwa, Pawel, Maggi, Martina, Campi, Riccardo, Nicoletti, Rossella, Amparore, Daniele, De Cillis, Sabrina, Zhuang, Junlong, Guo, Hongqian, Fuschi, Andrea, Veccia, Alessandro, Ditonno, Francesco, Paulino Pereira, Leonor J., Marquis, Alessandro, Barletta, Francesco, Leni, Riccardo, Kasivisvanathan, Veeru, Antonelli, Alessandro, Rivas, Juan Gomez, Remmers, Sebastiaan, Roobol, Monique J., Briganti, Alberto, Dal Moro, Fabrizio, and Novara, Giacomo

Published
2024
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2. The Impact of Baseline Endogenous Testosterone Levels on Risk Stratification in Pathological Organ-Confined Prostate Cancer: Results in 460 Patients Treated with Robot-Assisted Radical Prostatectomy

Author

Porcaro, Antonio Benito, Panunzio, Andrea, Bianchi, Alberto, Gallina, Sebastian, Serafin, Emanuele, Rizzetto, Riccardo, Mazzucato, Giovanni, Vidiri, Stefano, D’Aietti, Damiano, Fassio, Giulia, Orlando, Rossella, Ditonno, Francesco, Baielli, Alberto, Artoni, Francesco, Montanaro, Francesca, Marafioti Patuzzo, Giulia, Migliorini, Filippo, Veccia, Alessandro, Brunelli, Matteo, Siracusano, Salvatore, Cerruto, Maria Angela, Tafuri, Alessandro, and Antonelli, Alessandro

Published
2024
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3. Metaverse in surgery — origins and future potential

Author

Checcucci, Enrico, Veccia, Alessandro, Puliatti, Stefano, De Backer, Pieter, Piazza, Pietro, Kowalewski, Karl-Friedrich, Rodler, Severin, Taratkin, Mark, Belenchon, Ines Rivero, Baekelandt, Loic, De Cillis, Sabrina, Piana, Alberto, Eissa, Ahmed, Rivas, Juan Gomez, Cacciamani, Giovanni, and Porpiglia, Francesco

Published
2024
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4. Tumor upgrading among very favorable intermediate-risk prostate cancer patients treated with robot-assisted radical prostatectomy: how can it impact the clinical course?

Author

Porcaro, Antonio Benito, Bianchi, Alberto, Panunzio, Andrea, Gallina, Sebastian, Serafin, Emanuele, Tafuri, Alessandro, Trabacchin, Nicolò, Orlando, Rossella, Ornaghi, Paola Irene, Mazzucato, Giovanni, Vidiri, Stefano, D’Aietti, Damiano, Montanaro, Francesca, Brusa, Davide, Patuzzo, Giulia Marafioti, Artoni, Francesco, Baielli, Alberto, Migliorini, Filippo, De Marco, Vincenzo, Veccia, Alessandro, Brunelli, Matteo, Siracusano, Salvatore, Cerruto, Maria Angela, and Antonelli, Alessandro

Published
2024
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5. Briganti’s 2012 nomogram is an independent predictor of prostate cancer progression in EAU intermediate-risk class: results from 527 patients treated with robotic surgery

Author

Antonio Benito Porcaro, Francesca Montanaro, Alberto Baielli, Francesco Artoni, Claudio Brancelli, Sonia Costantino, Andrea Franceschini, Sebastian Gallina, Alberto Bianchi, Emanuele Serafin, Alessandro Veccia, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Salvatore Siracusano, Maria Angela Cerruto, Riccardo Giuseppe Bertolo, and Alessandro Antonelli

Subjects
biochemical recurrence, briganti’s 2012 nomogram, intermediate-risk prostate cancer, pelvic lymph node invasion, prostate cancer progression, robot-assisted radical prostatectomy, Diseases of the genitourinary system. Urology, RC870-923
Abstract

The study aimed to test if Briganti’s 2012 nomogram could be associated with the risk of prostate cancer (PCa) progression in European Association of Urology (EAU) intermediate-risk patients treated with robotic surgery. From January 2013 to December 2021, 527 consecutive patients belonging to the EAU intermediate-risk class were selected. Briganti’s 2012 nomogram, which predicts the risk of pelvic lymph node invasion (PLNI), was assessed as a continuous and dichotomous variable that categorized up to the median of 3.0%. Disease progression defined as biochemical recurrence and/or metastatic progression was evaluated by Cox proportional hazards (univariate and multivariate analysis). After a median follow-up of 95.0 months (95% confidence interval [CI]: 78.5–111.4), PCa progression occurred in 108 (20.5%) patients who were more likely to present with an unfavorable nomogram risk score, independently by the occurrence of unfavorable pathology including tumor upgrading and upstaging as well as PLNI. Accordingly, as Briganti’s 2012 risk score increased, patients were more likely to experience disease progression (hazard ratio [HR] = 1.060; 95% CI: 1.021–1.100; P = 0.002); moreover, it also remained significant when dichotomized above a risk score of 3.0% (HR = 2.052; 95% CI: 1.298–3.243; P < 0.0001) after adjustment for clinical factors. In the studied risk population, PCa progression was independently predicted by Briganti’s 2012 nomogram. Specifically, we found that patients were more likely to experience disease progression as their risk score increased. Because of the significant association between risk score and tumor behavior, the nomogram can further stratify intermediate-risk PCa patients, who represent a heterogeneous risk category for which different treatment paradigms exist.

Published
2024
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6. Pelvic Lymph Node Dissection: A Comparison Among Extraperitoneal Single-port and Transperitoneal Multiport Radical Prostatectomy—A Single-center Experience

Author

Greta Pettenuzzo, Francesco Ditonno, Donato Cannoletta, Matteo Pacini, Luca Morgantini, Ruben Calvo Sauer, Juan R. Torres-Anguiano, Francesco Montorsi, Alberto Briganti, Riccardo Bartoletti, Alessandro Veccia, Riccardo Bertolo, Alessandro Antonelli, and Simone Crivellaro

Subjects
Lymph node dissection, Robotic surgical procedures, Prostatectomy, Extraperitoneal, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background and objective: The role of pelvic lymph node dissection (PLND) for prostate cancer is still controversial. This study aims to compare the outcomes of PLND between extraperitoneal single-port (SP eRARP) and transperitoneal multiport (MP tRARP) robotic-assisted radical prostatectomy. Methods: This was a retrospective analysis from our single-center database for patients who underwent SP eRARP or MP tRARP with PLND between 2015 and 2023. The primary endpoint was to analyze and compare specific data related to PLND between the two populations by the detection of pN+ patients, the total number of lymph nodes removed, and the number of positive lymph nodes removed. The secondary endpoints included comparing major complications, lymphoceles, and biochemical recurrence between the two cohorts of the study. Key findings and limitations: A total of 293 patients were included, with 85 (29%) undergoing SP eRARP and 208 (71%) undergoing MP tRARP. SP eRARP showed significant differences in PLND extension from MP tRARP, while MP tRARP yielded more lymph nodes (p

Published
2024
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10. The 2012 Briganti nomogram predicts disease progression in surgically treated intermediate-risk prostate cancer patients with favorable tumor grade group eventually associated with some adverse factors

Author

Porcaro, Antonio Benito, Orlando, Rossella, Panunzio, Andrea, Tafuri, Alessandro, Baielli, Alberto, Artoni, Francesco, Montanaro, Francesca, Gallina, Sebastian, Bianchi, Alberto, Mazzucato, Giovanni, Serafin, Emanuele, Veccia, Alessandro, Boldini, Michele, Treccani, Lorenzo Pierangelo, Rizzetto, Riccardo, Brunelli, Matteo, Migliorini, Filippo, Bertolo, Riccardo, Cerruto, Maria Angela, and Antonelli, Alessandro

Published
2024
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14. The 2012 Briganti nomogram not only predicts lymph node involvement but also disease progression in surgically treated intermediate-risk prostate cancer patients with PSA

Author

Antonio Benito Porcaro, Andrea Panunzio, Rossella Orlando, Francesca Montanaro, Alberto Baielli, Francesco Artoni, Sebastian Gallina, Alberto Bianchi, Giovanni Mazzucato, Emanuele Serafin, Giulia Marafioti Patuzzo, Alessandro Veccia, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Riccardo Bertolo, Alessandro Tafuri, Maria Angela Cerruto, and Alessandro Antonelli

Subjects
Prostatic Neoplasms, Minimally Invasive Surgical Procedures, Lymph Node Excision, Diseases of the genitourinary system. Urology, RC870-923
Abstract

ABSTRACT Purpose We assessed the prognostic impact of the 2012 Briganti nomogram on prostate cancer (PCa) progression in intermediate-risk (IR) patients presenting with PSA

Published
2024
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16. Intraoperative Performance of DaVinci Versus Hugo RAS During Radical Prostatectomy: Focus on Timing, Malfunctioning, Complications, and User Satisfaction in 100 Consecutive Cases (the COMPAR-P Trial)

Author

Alessandro Antonelli, Alessandro Veccia, Sarah Malandra, Riccardo Rizzetto, Vincenzo De Marco, Alberto Baielli, Andrea Franceschini, Francesca Fumanelli, Francesca Montanaro, Iolanda Palumbo, Greta Pettenuzzo, Luca Roggero, Maria Angela Cerruto, Riccardo Bertolo, Michele Aloe, Francesco Artoni, Paolo Bianchi, Claudio Brancelli, Sonia Costantino, Peres Fokana Pongmoni, Piero Fracasso, Giulia Marafioti Patuzzo, Antonio Raiti, Endri Toska, and Vincenzo Vetro

Subjects
DaVinci, Hugo RAS, Robotic surgery, Radical prostatectomy, Surgical outcomes, Performance, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background and objective: The Hugo RAS and DaVinci Xi systems are used for performing robot-assisted radical prostatectomy (RARP). This study aims to compare these two platforms providing granular and comprehensive data on their intraoperative performance. Methods: The Comparison of Outcomes of Multiple Platforms for Assisted Robotic surgery—Prostate (COMPAR-P) trial is a prospective post-market study (clinicaltrials.org NCT05766163). Enrollment began in March 2023, allocating patients to DaVinci or Hugo RAS for RARP, without selection criteria, for up to 50 consecutive cases. Two experienced console surgeons performed the procedures, following the same technique. Evaluation focused on timing, learning curves, malfunctioning events, complications, and users’ satisfaction, using standard statistical methods, including the cumulative summation analysis (CUSUM) for the learning curve assessment. Key findings and limitations: Fifty patients each were enrolled for DaVinci (DV-RARP) and Hugo RAS (H-RARP) RARP. Baseline features were balanced. DV-RARP showed significantly shorter “setup” and “console” phase durations than H-RARP (37 vs 55 min and 97 vs 126 min, respectively, p

Published
2024
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17. Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy

Author

Francesco Ditonno, Riccardo Bertolo, Alessandro Veccia, Sonia Costantino, Francesca Montanaro, Francesco Artoni, Alberto Baielli, Michele Boldini, Davide Brusa, Vincenzo De Marco, Filippo Migliorini, Antonio Benito Porcaro, Riccardo Rizzetto, Maria Angela Cerruto, Riccardo Autorino, and Alessandro Antonelli

Subjects
Renal neoplasm, Robotic, Nephrectomy, Drain, Complications, Medicine, Science
Abstract

Abstract The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate. After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and “major” complications. 342 patients were included: 192 patients in the “drain group” versus 150 patients in the “no-drain” group. Renal masses were larger (p

Published
2024
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18. Tissue- and liquid-biopsy based NGS profiling in advanced non-small-cell lung cancer in a real-world setting: the IMMINENT study

Author

Marco Sposito, Lorenzo Belluomini, Riccardo Nocini, Jessica Insolda, Ilaria Mariangela Scaglione, Jessica Menis, Michele Simbolo, Antonio Lugini, Federica Buzzacchino, Francesco Verderame, Francesca Spinnato, Giuseppe Aprile, Lorenzo Calvetti, Mario Occhipinti, Daniele Marinelli, Antonello Veccia, Fiorella Lombardo, Hector José Soto Parra, Francesco Ferraù, Clementina Savastano, Camilla Porta, Lorenzo Pradelli, Emilia Sicari, Silvia Castellani, Umberto Malapelle, Silvia Novello, Emilio Bria, Sara Pilotto, and Michele Milella

Subjects
next generation sequencing, non-small cell lung cancer, precision medicine, liquid biopsy, target therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

IntroductionTo date, for all non-small cell lung cancer (NSCLC) cases, it is recommended to test for driver alterations to identify actionable therapeutic targets. In this light, comprehensive genomic profiling (CGP) with next generation sequencing (NGS) has progressively gained increasing importance in clinical practice. Here, with the aim of assessing the distribution and the real-world frequency of gene alterations and their correlation with patient characteristics, we present the outcomes obtained using FoundationOne (F1CDx) and FoundationLiquid CDx (F1L/F1LCDx) NGS-based profiling in a nationwide initiative for advanced NSCLC patients.MethodsF1CDx (324 genes) was used for tissue samples, and F1L (70 genes) or F1LCDx (324 genes) for liquid biopsy, aiming to explore the real-world occurrence of molecular alterations in aNSCLC and their relationship with patients’ characteristics.ResultsOverall, 232 advanced NSCLC patients from 11 Institutions were gathered [median age 63 years; never/former or current smokers 29.3/65.9%; adenocarcinoma/squamous 79.3/12.5%; F1CDx/F1L+F1LCDx 59.5/40.5%]. Alterations were found in 170 different genes. Median number of mutated genes per sample was 4 (IQR 3–6) and 2 (IQR 1–3) in the F1CDx and F1L/F1LCDx cohorts, respectively. TP53 (58%), KRAS (22%), CDKN2A/B (19%), and STK11 (17%) alterations were the most frequently detected. Actionability rates (tier I and II) were comparable: 36.2% F1CDx vs. 34% ctDNA NGS assays (29.5% and 40.9% F1L and F1LCDx, respectively). Alterations in KEAP1 were significantly associated with STK11 and KRAS, so as TP53 with RB1. Median tumor mutational burden was 6 (IQR 3–10) and was significantly higher in smokers. Median OS from metastatic diagnosis was 23 months (IQR 18.5–19.5) and significantly lower in patients harboring ≥3 gene mutations. Conditional three-year survival probabilities increased over time for patients profiled at initial diagnosis and exceeded those of individuals tested later in their clinical history after 12 months.ConclusionThis study confirms that NGS-based molecular profiling of aNSCLC on tissue or blood samples offers valuable predictive and prognostic insights.

Published
2024
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22. Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates

Author

Michele Marchioni, Giulia Primiceri, Alessandro Veccia, Marta Di Nicola, Umberto Carbonara, Fabio Crocerossa, Ugo Falagario, Ambra Rizzoli, Riccardo Autorino, and Luigi Schips

Subjects
Prostate cancer, Transurethral surgery of the prostate, Prostate surgery, Population-based analysis, Benign prostatic hyperplasia, Laser surgery, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Objective: Prostate cancer (PCa) patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia (BPH). Some of them might be treated for their lower urinary tract symptoms instead of PCa. We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery, namely complication and mortality rates. Methods: Within the American College of Surgeons National Surgical Quality Improvement Program database (2011–2016), we identified patients who underwent transurethral resection of the prostate, photoselective vaporization, or laser enucleation. Patients were stratified according to postoperative diagnosis (PCa vs. BPH). Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality. A formal test of interaction between diagnosis and surgical technique used was performed. Results: Overall, 34 542 patients were included. Of all, 2008 (5.8%) had a diagnosis of PCa. The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients (odds ratio: 0.9, 95% confidence interval: 0.7–1.1; p=0.252). Moreover, similar rates of perioperative mortality (p=0.255), major acute cardiovascular events (p=0.581), transfusions (p=0.933), and length of stay of more than or equal to 30 days (p=0.174) were found. Additionally, all tests failed to show an interaction between post-operative diagnosis and surgical technique used. Conclusion: Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts. Moreover, the diagnosis seems to not influence surgical technique outcomes.

Published
2024
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23. THE INTEGRATIVE APPROACH TO THE PSYCHO- PHYSICAL REHABILITATION ISSUES OF BREAST CANCER SURVIVORS

Author

Cristina Accetta, Daniela Belella, Annalisa Di Micco, Alessio Filippone, Cristina Rossi, Maria Maddalena Rossi, Claudia Maggiore, Luana Forcina, Maria Natale, Francesca Veccia, Daniela Pia Rosaria Chieffo, Riccardo Masetti, and Stefano Magno

Subjects
integrative oncology, unmet needs, breast cancer, rehabilitation, personalized medicine, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background Survival rates for breast cancer are increasing, but many clinical needs in a larger and larger population of survivors are not properly met. During and beyond cancer treatments, patients tend to reduce their physical activity levels, gain weight and may complain about chronic pain, lymphedema, fatigue, cognitive problems, depression and anxiety, reduced social contacts and difficulties in resuming daily activities. In addition, younger women must also face fertility issues and early menopause, higher levels of distress regarding body image, sexual health, childcare and career management. Beside this, all the survivors may feel a fear for disease recurrence and many of them are not educated to identify and express their needs. Materials and Methods Tailored supportive strategies, including physical and psychological interventions, should be offered since the time of diagnosis and along the entire cancer journey and the follow up period. They should be aimed not only to the prevention and control of psychological and physical impairments (such as anxiety, stress, depression, lymphedema, genitourinary symptoms and sexual dysfunctions), but also to encourage remodulation of personal lifestyles for tertiary prevention and nurture patient’s resources that can promote a personal growth after the traumatic experience of cancer. Conclusions Toward this goal, many cancer centres worldwide including ours offer dedicated programs of psycho-oncological support, nutritional and physical activity counselling and evidence based complementary treatments (such as acupuncture, mindfulness, meditation, reflexology, herbal medicine, music therapy and more).

Published
2024
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24. The impact of a second MRI and re-biopsy in patients with initial negative mpMRI-targeted and systematic biopsy for PIRADS ≥ 3 lesions

Author

Zattoni, Fabio, Pereira, Leonor J. Paulino, Marra, Giancarlo, Valerio, Massimo, Olivier, Jonathan, Puche-Sanz, Ignacio, Rajwa, Pawel, Maggi, Martina, Campi, Riccardo, Amparore, Daniele, De Cillis, Sabrina, Junlong, Zhuang, Guo, Hongqian, La Bombarda, Giulia, Fuschi, Andrea, Veccia, Alessandro, Ditonno, Francesco, Marquis, Alessandro, Barletta, Francesco, Leni, Riccardo, Serni, Sergio, Kasivisvanathan, Veeru, Antonelli, Alessandro, Dal Moro, Fabrizio, Rivas, Juan Gomez, van den Bergh, Roderick C. N., Briganti, Alberto, Gandaglia, Giorgio, and Novara, Giacomo

Published
2023
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25. Advanced age is an independent prognostic factor of disease progression in high-risk prostate cancer: results in 180 patients treated with robot-assisted radical prostatectomy and extended pelvic lymph node dissection in a tertiary referral center

Author

Porcaro, Antonio Benito, Bianchi, Alberto, Gallina, Sebastian, Panunzio, Andrea, Serafin, Emanuele, Mazzucato, Giovanni, Orlando, Rossella, Montanaro, Francesca, Patuzzo, Giulia Marafioti, Baielli, Alberto, Artoni, Francesco, Ditonno, Francesco, Vidiri, Stefano, D’Aietti, Damiano, Migliorini, Filippo, Rizzetto, Riccardo, Veccia, Alessandro, Gozzo, Alessandra, Brunelli, Matteo, Tafuri, Alessandro, Cerruto, Maria Angela, and Antonelli, Alessandro

Published
2023
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28. Robot-assisted staged bilateral reno-lymphatic disconnection for massive idiopathic chyluria: A case report

Author

Sonia Costantino, Francesca Montanaro, Alberto Bianchi, Greta Pettenuzzo, Riccardo Bertolo, Maria Angela Cerruto, Alessandro Veccia, and Alessandro Antonelli

Subjects
Case report, Chyluria, Pediatric, Milky urine, Robotic surgery, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Chyluria, an abnormal lymphatic disorder, results in excessive abdominal lymph drainage into the urinary system, causing protein loss, nutritional deficiencies, and immune issues. Mainly linked to parasitic infections in developed countries, non-parasitic causes like trauma or tumors are rare. Typically appearing in adults with bilateral involvement, management options include conservative or surgical approaches. We present the case of a 13-year-old with congenital chyluria, treated with robot-assisted staged reno-lymphatic disconnection after failed interventional radiology. Bilateral scleroangiography followed, leading to persistently milky urine for a month. Finally, urine clarity improved, correlating with better urinalysis, emphasizing the need for a comprehensive, multi-disciplinary approach.

Published
2024
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29. Robot-assisted excision of hemangioma of the right renal vein

Author

Francesca Montanaro, Riccardo Bertolo, Sonia Costantino, Nicola De Maria, Alessandro Veccia, Filippo Migliorini, Anna Caliò, Matteo Brunelli, Stefania Montemezzi, Maria Angela Cerruto, and Alessandro Antonelli

Subjects
Robotic, Hemangioma, Renal neoplasm, Nephron-sparing, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Hemangiomas, benign vascular masses, occasionally occur in the kidneys, presenting as rare, small, unilateral, and solitary growths. Venous hemangiomas, a renal subtype, are atypical. While clinically nonspecific, they are typically asymptomatic and may be incidentally discovered during unrelated clinical workups. Diagnosing renal hemangioma preoperatively is challenging due to rarity, lacking standard radiographic criteria, and poor differentiation from aggressive renal neoplasms on contrast-enhanced imaging. These tumors commonly follow a benign course, with no documented recurrence. This video article showcases the robot-assisted excision of a renal vein hemangioma, addressing the expertise needed in managing this uncommon condition robotically.

Published
2024
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30. Digital Therapeutics in Urology: An Innovative Approach to Patient Care and Management

Author

Severin Rodler, Karl-Friedrich Kowalewski, Henriette Scheibert, Moritz Bensel, Leo Federico Stadelmeier, Amelie Styn, Ines Rivero Belenchon, Mark Taratkin, Stefano Puliatti, Juan Gomez Rivas, Alessandro Veccia, Pietro Piazza, Enrico Checcucci, Maurice S. Michel, Christian G. Stief, and Giovanni Cacciamani

Subjects
Digital therapeutics, Patient perspective, Urology, App, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Digital therapeutics (DTx) are a new class of intervention involving evidence-based software applications and have been used in neurology and psychiatry. To assess the potential of DTx in urology, we conducted a survey to assess the current prevalence of the digital infrastructure required for DTx, areas of support expected by patients, and requirements for uptake. Between November 2022 and January 2023, we conducted an anonymized survey at two German academic centers among patients with urologic conditions. We found that among patients aged

Published
2023
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32. Intraoperative Performance of DaVinci Versus Hugo RAS During Radical Prostatectomy: Focus on Timing, Malfunctioning, Complications, and User Satisfaction in 100 Consecutive Cases (the COMPAR-P Trial)

Author

Aloe, Michele, Artoni, Francesco, Bianchi, Paolo, Brancelli, Claudio, Costantino, Sonia, Pongmoni, Peres Fokana, Fracasso, Piero, Patuzzo, Giulia Marafioti, Raiti, Antonio, Toska, Endri, Vetro, Vincenzo, Antonelli, Alessandro, Veccia, Alessandro, Malandra, Sarah, Rizzetto, Riccardo, De Marco, Vincenzo, Baielli, Alberto, Franceschini, Andrea, Fumanelli, Francesca, Montanaro, Francesca, Palumbo, Iolanda, Pettenuzzo, Greta, Roggero, Luca, Angela Cerruto, Maria, and Bertolo, Riccardo

Published
2024
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34. Advanced Age Impacts Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma

Author

Ferro, Matteo, Chiujdea, Sever, Vartolomei, Mihai Dorin, Bove, Pierluigi, Porreca, Angelo, Busetto, Gian Maria, del Giudice, Francesco, Antonelli, Alessandro, Foschi, Nazario, Racioppi, Marco, Autorino, Riccardo, Chiancone, Francesco, Longo, Nicola, Barone, Biagio, Crocetto, Felice, Musi, Gennaro, Luzzago, Stefano, Piccinelli, Mattia Luca, Mistretta, Francesco Alessandro, de Cobelli, Ottavio, Tataru, Octavian Sabin, Hurle, Rodolfo, Liguori, Giovanni, Borghesi, Marco, Veccia, Alessandro, Greco, Francesco, Schips, Luigi, Marchioni, Michele, Lucarelli, Giuseppe, Dutto, Daniele, Colucci, Fulvia, Russo, Giorgio Ivan, Giudice, Arturo Lo, Montanari, Emanuele, Boeri, Luca, Simone, Giuseppe, Rosazza, Matteo, Livoti, Simone, Gontero, Paolo, and Soria, Francesco

Published
2024
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35. Characteristics and outcomes of immunotherapy-related liver injury in patients with hepatocellular carcinoma versus other advanced solid tumours

Author

Celsa, Ciro, Cabibbo, Giuseppe, Fulgenzi, Claudia A.M., Scheiner, Bernhard, D’Alessio, Antonio, Manfredi, Giulia F., Nishida, Naoshi, Ang, Celina, Marron, Thomas U., Saeed, Anwaar, Wietharn, Brooke, Pinter, Matthias, Cheon, Jaekyung, Huang, Yi-Hsiang, Lee, Pei-Chang, Phen, Samuel, Gampa, Anuhya, Pillai, Anjana, Vivaldi, Caterina, Salani, Francesca, Masi, Gianluca, Roehlen, Natascha, Thimme, Robert, Vogel, Arndt, Schönlein, Martin, von Felden, Johann, Schulze, Kornelius, Wege, Henning, Galle, Peter R., Kudo, Masatoshi, Rimassa, Lorenza, Singal, Amit G., El Tomb, Paul, Ulahannan, Susanna, Parisi, Alessandro, Chon, Hong Jae, Hsu, Wei-Fan, Stefanini, Bernardo, Verzoni, Elena, Giusti, Raffaele, Veccia, Antonello, Catino, Annamaria, Aprile, Giuseppe, Guglielmini, Pamela Francesca, Di Napoli, Marilena, Ermacora, Paola, Antonuzzo, Lorenzo, Rossi, Ernesto, Verderame, Francesco, Zustovich, Fable, Ficorella, Corrado, Di Pietro, Francesca Romana, Battelli, Nicola, Negrini, Giorgia, Grossi, Francesco, Bordonaro, Roberto, Pipitone, Stefania, Banzi, Maria, Ricciardi, Serena, Laera, Letizia, Russo, Antonio, De Giorgi, Ugo, Cavanna, Luigi, Sorarù, Mariella, Montesarchio, Vincenzo, Bordi, Paola, Brunetti, Leonardo, Pinto, Carmine, Bersanelli, Melissa, Cammà, Calogero, Cortellini, Alessio, and Pinato, David J.

Published
2024
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36. Awareness and Use of ChatGPT and Large Language Models: A Prospective Cross-sectional Global Survey in Urology

Author

Eppler, Michael, Ganjavi, Conner, Ramacciotti, Lorenzo Storino, Piazza, Pietro, Rodler, Severin, Checcucci, Enrico, Gomez Rivas, Juan, Kowalewski, Karl F., Belenchón, Ines Rivero, Puliatti, Stefano, Taratkin, Mark, Veccia, Alessandro, Baekelandt, Loïc, Teoh, Jeremy Y.-C., Somani, Bhaskar K., Wroclawski, Marcelo, Abreu, Andre, Porpiglia, Francesco, Gill, Inderbir S., Murphy, Declan G., Canes, David, and Cacciamani, Giovanni E.

Published
2024
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37. Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution

Author

Bertolo, Riccardo, Ditonno, Francesco, Veccia, Alessandro, Montanaro, Francesca, Artoni, Francesco, Baielli, Alberto, Boldini, Michele, Brusa, Davide, Costantino, Sonia, Sibani, Marcella, De Marco, Vincenzo, Migliorini, Filippo, Porcaro, Antonio Benito, Rizzetto, Riccardo, Cerruto, Maria Angela, Autorino, Riccardo, and Antonelli, Alessandro

Published
2024
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39. The role of warm ischemia time on functional outcomes after robotic partial nephrectomy: a radionuclide renal scan study from the clock randomized trial

Author

Antonelli, Alessan dro, Cindolo, Luca, Sandri, Marco, Veccia, Alessandro, Annino, Filippo, Bertagna, Francesco, Di Maida, Fabrizio, Celia, Antonio, D’Orta, Carlo, De Concilio, Bernardino, Furlan, Maria, Giommoni, Valentina, Ingrosso, Manuela, Mari, Andrea, Nucciotti, Roberto, Olianti, Catia, Porreca, Angelo, Primiceri, Giulia, Schips, Luigi, Sessa, Francesco, Bove, Pierluigi, Simeone, Claudio, and Minervini, Andrea

Published
2023
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40. The impact of prognostic group classification on prostate cancer progression in intermediate-risk patients according to the European Association of Urology system: results in 479 patients treated with robot-assisted radical prostatectomy at a single tertiary referral center

Author

Antonio Benito Porcaro, Alberto Bianchi, Andrea Panunzio, Sebastian Gallina, Alessandro Tafuri, Emanuele Serafin, Rossella Orlando, Giovanni Mazzucato, Stefano Vidiri, Damiano D’Aietti, Francesca Montanaro, Giulia Marafioti Patuzzo, Francesco Artoni, Alberto Baielli, Francesco Ditonno, Riccardo Rizzetto, Alessandro Veccia, Alessandra Gozzo, Vincenzo De Marco, Matteo Brunelli, Maria Angela Cerruto, and Alessandro Antonelli

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Background: Treatment outcomes in intermediate-risk prostate cancer (PCa) may be impaired by adverse pathology misclassification including tumor upgrading and upstaging. Clinical predictors of disease progression need to be improved in this category of patients. Objectives: To identify PCa prognostic factors to define prognostic groups in intermediate-risk patients treated with robot-assisted radical prostatectomy (RARP). Design: Data from 1143 patients undergoing RARP from January 2013 to October 2020 were collected: 901 subjects had available follow-up, of whom 479 were at intermediate risk. Methods: PCa progression was defined as biochemical recurrence and/or local recurrence and/or distant metastases. Study endpoints were evaluated by statistical methods including Cox’s proportional hazards, Kaplan–Meyer survival curves, and binomial and multinomial logistic regression models. Results: After a median (interquartile range) of 35 months (15–57 months), 84 patients (17.5%) had disease progression, which was independently predicted by the percentage of biopsy-positive cores ⩾ 50% and the International Society of Urological Pathology (ISUP) grade group 3 for clinical factors and by ISUP > 2, positive surgical margins and pelvic lymph node invasion for pathological features. Patients were classified into clinical and pathological groups as favorable, unfavorable (one prognostic factor), and adverse (more than one prognostic factor). The risk of PCa progression increased with worsening prognosis through groups. A significant positive association was found between the two groups; consequently, as clinical prognosis worsened, the risk of detecting unfavorable and adverse pathological prognostic clusters increased in both unadjusted and adjusted models. Conclusion: The study identified factors predicting disease progression that allowed the computation of highly correlated prognostic groups. As the prognosis worsened, the risk of PCa progression increased. Intermediate-risk PCa needs more prognostic stratification for appropriate management.

Published
2024
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41. Risk of cardiovascular toxicity with combination of immune-checkpoint inhibitors and angiogenesis inhibitors: a meta-analysis

Author

Alessandro Inno, Antonello Veccia, Giorgio Madonia, Alvise Berti, Roberto Bortolotti, Lorena Incorvaia, Antonio Russo, Orazio Caffo, and Stefania Gori

Subjects
immune checkpoint inhibitors, angiogenesis inhibitors, multikinase inhibitors, cardiovascular toxicity, hypertension, stroke, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

IntroductionCombinations of immune checkpoint inhibitors (ICIs) and angiogenesis inhibitors (AIs) have been investigated for the treatment of several tumor types. Both ICIs and AIs may lead to cardiovascular adverse events, and their combination may potentially increase the risk for cardiovascular toxicity. In the present meta-analysis, we aim to assess the cardiovascular toxicity of ICIs plus AIs vs. AIs alone. Secondary objectives are non-cardiovascular adverse events and efficacy.MethodsSystematic review was performed according to PRISMA statement. Phase II and III randomized clinical trials were identified by searching the MEDLINE/PubMed, Cochrane Library and ASCO Meeting abstracts, from inception to June 2022. The pooled risks for overall response rate (ORR), 1-year progression-free survival (PFS), adverse events (AEs), immune-related AEs, (irAEs), hypertension, and vascular events defined as stroke, myocardial infarction and pulmonary embolisms, were calculated.ResultsIn terms of cardiovascular toxicity, we found higher risk for severe hypertension among patients treated with ICIs plus AIs as compared with those receiving AIs (OR 1.24, 95% CI: 1.01–1.53), but no significant difference was found for any-grade hypertension, and for vascular events. There was also no difference in terms of overall AEs, whereas the incidence of irAEs was increased in the ICIs plus AIs arm, as expected. In terms of efficacy, ICIs plus AIs achieved better ORR (OR 2.25, 95% CI: 1.70–2.97) and PFS (HR 0.49, 95% CI: 0.39–0.63) as compared to AIs alone.ConclusionThe addition of ICIs to AIs significantly increased the risk of high-grade hypertension, but not that of acute vascular events.

Published
2024
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42. Using peripheral immune-inflammatory blood markers in tumors treated with immune checkpoint inhibitors: An INVIDIa-2 study sub-analysis

Author

Anpalakhan, Shobana, Signori, Alessio, Cortellini, Alessio, Verzoni, Elena, Giusti, Raffaele, Aprile, Giuseppe, Ermacora, Paola, Catino, Annamaria, Pipitone, Stefania, Di Napoli, Marilena, Scotti, Vieri, Mazzoni, Francesca, Guglielmini, Pamela F., Veccia, Antonello, Maruzzo, Marco, Schinzari, Giovanni, Casadei, Chiara, Grossi, Francesco, Rizzo, Mimma, Montesarchio, Vincenzo, Verderame, Francesco, Mencoboni, Manlio, Zustovich, Fable, Fratino, Lucia, Accettura, Caterina, Cinieri, Saverio, Tondini, Carlo Alberto, Camerini, Andrea, Banzi, Maria Chiara, Sorarù, Mariella, Zucali, Paolo Andrea, Vignani, Francesca, Ricciardi, Serena, Russo, Antonio, Cosenza, Agnese, Di Maio, Massimo, De Giorgi, Ugo, Pignata, Sandro, Giannarelli, Diana, Pinto, Carmine, Buti, Sebastiano, Fornarini, Giuseppe, Rebuzzi, Sara Elena, Rescigno, Pasquale, Addeo, Alfredo, Banna, Giuseppe L., and Bersanelli, Melissa

Published
2023
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43. Predictors of Efficacy of Immune Checkpoint Inhibitors in Patients With Advanced Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Author

Ferro, Matteo, Crocetto, Felice, Tataru, Sabin, Barone, Biagio, Dolce, Pasquale, Lucarelli, Giuseppe, Sonpavde, Guru, Musi, Gennaro, Antonelli, Alessandro, Veccia, Alessandro, Terracciano, Daniela, Busetto, Gian Maria, Del Giudice, Francesco, Marchioni, Michele, Schips, Luigi, Porpiglia, Francesco, Fiori, Cristian, Carrieri, Giuseppe, Lasorsa, Francesco, Verde, Antonio, Scafuri, Luca, Buonerba, Carlo, and Di Lorenzo, Giuseppe

Published
2023
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45. Using peripheral immune-inflammatory blood markers in tumors treated with immune checkpoint inhibitors: An INVIDIa-2 study sub-analysis

Author

Shobana Anpalakhan, Alessio Signori, Alessio Cortellini, Elena Verzoni, Raffaele Giusti, Giuseppe Aprile, Paola Ermacora, Annamaria Catino, Stefania Pipitone, Marilena Di Napoli, Vieri Scotti, Francesca Mazzoni, Pamela F. Guglielmini, Antonello Veccia, Marco Maruzzo, Giovanni Schinzari, Chiara Casadei, Francesco Grossi, Mimma Rizzo, Vincenzo Montesarchio, Francesco Verderame, Manlio Mencoboni, Fable Zustovich, Lucia Fratino, Caterina Accettura, Saverio Cinieri, Carlo Alberto Tondini, Andrea Camerini, Maria Chiara Banzi, Mariella Sorarù, Paolo Andrea Zucali, Francesca Vignani, Serena Ricciardi, Antonio Russo, Agnese Cosenza, Massimo Di Maio, Ugo De Giorgi, Sandro Pignata, Diana Giannarelli, Carmine Pinto, Sebastiano Buti, Giuseppe Fornarini, Sara Elena Rebuzzi, Pasquale Rescigno, Alfredo Addeo, Giuseppe L. Banna, and Melissa Bersanelli

Subjects
Immune response, Immunity, Immunology, Science
Abstract

Summary: The neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII) have been reported as prognosticators in non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), and melanoma. This analysis of the INVIDIa-2 study on influenza vaccination in patients with cancer treated with immune checkpoint inhibitors (ICIs) assessed NLR and SII on overall survival (OS) by literature-reported (LR), receiver operating characteristic curve (ROC)-derived (ROC) cutoffs or as continuous variable (CV). NLR and SII with ROC cutoffs of

Published
2023
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46. Impact of influenza vaccination on survival of patients with advanced cancer receiving immune checkpoint inhibitors (INVIDIa-2): final results of the multicentre, prospective, observational study

Author

Bersanelli, Melissa, Verzoni, Elena, Cortellini, Alessio, Giusti, Raffaele, Calvetti, Lorenzo, Ermacora, Paola, Di Napoli, Marilena, Catino, Annamaria, Guadalupi, Valentina, Guaitoli, Giorgia, Scotti, Vieri, Mazzoni, Francesca, Veccia, Antonello, Guglielmini, Pamela Francesca, Perrone, Fabiana, Maruzzo, Marco, Rossi, Ernesto, Casadei, Chiara, Montesarchio, Vincenzo, Grossi, Francesco, Rizzo, Mimma, Travagliato Liboria, Maria Grazia, Mencoboni, Manlio, Zustovich, Fable, Fratino, Lucia, Accettura, Caterina, Cinieri, Saverio, Camerini, Andrea, Sorarù, Mariella, Zucali, Paolo Andrea, Ricciardi, Serena, Russo, Antonio, Negrini, Giorgia, Banzi, Maria Chiara, Lacidogna, Gaetano, Fornarini, Giuseppe, Laera, Letizia, Mucciarini, Claudia, Santoni, Matteo, Mosillo, Claudia, Bonetti, Andrea, Longo, Lucia, Sartori, Donata, Baldini, Editta, Guida, Michele, Iannopollo, Mauro, Bordonaro, Roberto, Morelli, Maria Francesca, Tagliaferri, Pierosandro, Spada, Massimiliano, Ceribelli, Anna, Silva, Rosa Rita, Nolè, Franco, Beretta, Giordano, Giovanis, Petros, Santini, Daniele, Luzi Fedeli, Stefano, Nanni, Oriana, Maiello, Evaristo, Labianca, Roberto, Pinto, Carmine, Clemente, Alberto, Tognetto, Michele, De Giorgi, Ugo, Pignata, Sandro, Di Maio, Massimo, Buti, Sebastiano, and Giannarelli, Diana

Published
2023
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47. Randomized Clinical Trial Comparing On-clamp Versus Off-clamp Laparoscopic Partial Nephrectomy for Small Renal Masses (CLOCK II Laparoscopic Study): A Intention-to-treat Analysis of Perioperative Outcomes

Author

Riccardo Bertolo, Pierluigi Bove, Marco Sandri, Antonio Celia, Luca Cindolo, Chiara Cipriani, Mario Falsaperla, Costantino Leonardo, Andrea Mari, Paolo Parma, Alessandro Veccia, Domenico Veneziano, Andrea Minervini, and Alessandro Antonelli

Subjects
Partial nephrectomy, Renal neoplasm, Laparoscopy, Off-clamp, Clampless, Ischemia, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: Recent randomized trials (RCTs) in the field of robotic partial nephrectomy (PN) showed no significant differences in perioperative outcomes between the off- and on-clamp approaches. Objective: To compare the perioperative outcomes of on- versus off-clamp pure laparoscopic PN (LPN). Design, setting, and participants: A multi-institutional analysis of the on- versus off-clamp approach during LPN in the setting of an RCT (CLOCK II trial; ClinicalTrials.gov NCT02287987) was performed. Intervention: Off- versus on-clamp LPN. Outcome measurements and statistical analysis: Baseline patient and tumor variables, and peri- and postoperative data were collected. Randomized allocation with a 1:1 ratio was assigned. Surgical strategy for managing the renal pedicle was dictated by the study protocol. In the off-clamp arm, the renal artery had to remain unclamped for the duration of the whole procedure. Reporting the intention-to-treat analysis is the purpose of the study. Results and limitations: The study recruited 249 patients. Of them, 123 and 126 were randomized and allocated into the on- and off-clamp treatment groups, respectively. Treatment groups were comparable at baseline after randomization with respect to patients’ demographics, comorbidities, renal function, and tumor size and complexity. A univariable analysis found no differences in the perioperative outcomes between the groups, including median (interquartile range) estimated blood loss (150 [100–200] vs 150 [100–250] ml, p = 0.2), grade ≥2 complication rate as classified according to the Clavien-Dindo system (5.7% vs 4.8%, p = 0.6), and positive surgical margin rate (8.2% vs 3.5% for the on- vs off-clamp group, p = 0.1). No differences were found in terms of the 1st (81.3 [66.7–94.3] vs 85.3 [71.0–97.7] ml/min, p = 0.2) and 5th postoperative days estimated glomerular filtration rate (83.3 [70.5–93.7] vs 83.4 [68.6–139.3] ml/min, p = 0.2). A multivariable analysis found each +1 increase in RENAL score corresponded to an increase in the protection from the occurrence of complications (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.54–0.97, p = 0.034), while each +1 cm increase in tumor size corresponded to an increase in the risk of blood transfusion (OR 1.39, 95% CI 1.14–1.70, p = 0.001). Conclusions: In the setting of an RCT, no differences were found in the perioperative and early functional outcomes between on- and off-clamp LPN. Patient summary: In this study, we investigated, by means of a randomized trial, whether avoiding the clamping of renal artery during laparoscopic resection of renal mass is able to translate into benefits. We found no differences in terms of safety, efficacy, and renal function from the standard approach, which includes arterial clamping.

Published
2022
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48. Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium)

Author

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

Published
2022
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49. Addition of Niraparib to Best Supportive Care as Maintenance Treatment in Patients with Advanced Urothelial Carcinoma Whose Disease Did Not Progress After First-line Platinum-based Chemotherapy: The Meet-URO12 Randomized Phase 2 Trial

Author

Vignani, Francesca, Tambaro, Rosa, De Giorgi, Ugo, Giannatempo, Patrizia, Bimbatti, Davide, Carella, Claudia, Stellato, Marco, Atzori, Francesco, Aieta, Michele, Masini, Cristina, Hamzaj, Alketa, Ermacora, Paola, Veccia, Antonello, Scandurra, Giuseppa, Gamba, Teresa, Ignazzi, Gianluca, Pignata, Sandro, Di Napoli, Marilena, Lolli, Cristian, Procopio, Giuseppe, Pierantoni, Francesco, Zonno, Antonia, Santini, Daniele, and Di Maio, Massimo

Published
2023
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50. Decisional and prognostic impact of diagnostic ureteroscopy in high-risk upper tract urothelial carcinoma: A multi-institutional collaborative analysis (ROBUUST collaborative group)

Author

Ditonno, Francesco, Franco, Antonio, Veccia, Alessandro, Bertolo, Riccardo, Wu, Zhenjie, Wang, Linhui, Abdollah, Firas, Finati, Marco, Simone, Giuseppe, Tuderti, Gabriele, Helstrom, Emma, Correa, Andres, De Cobelli, Ottavio, Ferro, Matteo, Porpiglia, Francesco, Amparore, Daniele, Tufano, Antonio, Perdonà, Sisto, Bhanvadia, Raj, Margulis, Vitaly, Brönimann, Stephan, Singla, Nirmish, Puri, Dhruv, Derweesh, Ithaar H., Mendiola, Dinno F., Gonzalgo, Mark L., Ben-David, Reuben, Mehrazin, Reza, Moon, Sol C., Rais-Bahrami, Soroush, Yong, Courtney, Sundaram, Chandru P., Moghaddam, Farshad Sheybaee, Ghoreifi, Alireza, Djaladat, Hooman, Autorino, Riccardo, and Antonelli, Alessandro

Published
2024
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