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Beatrici E, Contieri R, Frego N, Fasulo V, Diana P, Paciotti M, Saitta C, Chiarelli G, Arena P, Gobbo A, Avolio P, Uleri A, Buffi N, Lazzeri M, Casale P, Saita A, Guazzoni G, Lughezzani G, Hurle R. The update from Bladder Cancer Italian Active Surveillance (BIAS) project for low-grade bladder tumors: Long-term oncological outcomes of patients under active surveillance. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00313-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hurle R, Gobbo A, Casale P, Saita A, Buffi N, Lughezzani G, Sollini M, Rodari M, Pini C, Gelardi F, Contieri R, Guazzoni G, Chiti A, Lazzeri M. [18F]-FDG PET/CT for bladder cancer staging and decision-making in patients with High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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78
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Uleri A, Diana P, Beatrici E, Lughezzani G, Poretti D, D'Antuono F, Lazzeri M, Hurle R, Saita A, Casale P, Contieri R, Fasulo V, Pedicini V, Buffi N. Developing of a novel nephrometry score to predict the outcomes of percutaneous ablation of renal masses: The PCT score. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00301-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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79
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Avolio P, Fasulo V, Paciotti M, Frego N, Diana P, Maffei D, Contieri R, Uleri A, Beatrici E, Saitta C, Saita A, Lazzeri M, Hurle R, Casale P, Buffi N, Lughezzani G. Assessing the role of high-resolution micro-ultrasound among patients with a negative multiparametric MRI and a persistent suspicion of prostate cancer. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00831-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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80
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Contieri R, Gobbo A, Paciotti M, Avolio P, Fasulo V, Saitta C, Uleri A, Valeri M, Colombo P, Saita A, Lazzeri M, Casale P, Lughezzani G, Buffi N, Guazzoni G, Hurle R. Accuracy of AUA and EAU risk stratification groups in predicting early recurrence in Hg Ta non-muscle invasive bladder cancer: A comparison analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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81
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Diana P, Lughezzani G, Saita A, Uleri A, Frego N, Contieri R, Buffi N, Balzarini L, D’Orazio F, Piergiuseppe C, Elefante MG, Lazzeri M, Guazzoni G, Casale P, Hurle R. Head-to-Head Comparison between High-Resolution Microultrasound Imaging and Multiparametric MRI in Detecting and Local Staging of Bladder Cancer: The BUS-MISS Protocol. Bladder Cancer 2022. [DOI: 10.3233/blc-211611] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND: MRI has been proposed as a new staging tool for bladder cancer (BC), but use is limited by its high costs and low availability. 29-MHz high-resolution micro-ultrasound (mUS) technology has been suggested as an alternative to detect BC and distinguish between muscle-invasive and non-muscle invasive BC. OBJECTIVE: The aim was to compare the diagnostic accuracy of mUS vs. magnetic resonance imaging (MRI) in differentiating NMIBC and MIBC at definitive pathological examination. METHODS: This is a prospective study of patients with a primary diagnosis of BC with either positive urine cytology (UC) or negative UC and a tumor size > 25 mm from a tertiary care high volume center. mUS, with the ExactVu system with an EV29L 29 MHz side-fire transducer, and a 3-Tesla MRI were performed before transurethral resection of bladder tumor (TURBT) in every patient before undergoing TURBT. We compared the imaging results with pathological reports. RESULTS: The analyzed population consisted of 58 individuals. The reported mUS and MRI sensitivity, specificity, positive, and negative predictive values were 85.0%, 76.3%, 65.4%, and 90.6%, versus 85.0%, 50.0%, 47.2%, and 86.4%, respectively. In accuracy analysis, the AUC for mUS and MRI were respectively 0.807 and 0.675. CONCLUSIONS: In our population mUS seems to have a better performance in distinguishing NMIBC from MIBC. The main limitation of mUS is the probe shape that makes its use problematic in cases with a large prostate and inadequate rectal preparation. Further studies with a larger population are ongoing to compare and validate these techniques in this setting.
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Fasulo V, Buffi NM, Regis F, Paciotti M, Persico F, Maffei D, Uleri A, Saita A, Casale P, Hurle R, Lazzeri M, Guazzoni G, Lughezzani G. Use of high-resolution micro-ultrasound to predict extraprostatic extension of prostate cancer prior to surgery: a prospective single-institutional study. World J Urol 2022; 40:435-442. [PMID: 35001161 DOI: 10.1007/s00345-021-03890-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/13/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We aim to evaluate the accuracy of micro-ultrasound (microUS) in predicting extraprostatic extension (EPE) of Prostate Cancer (PCa) prior to surgery. METHODS Patients with biopsy-proven PCa scheduled for robot-assisted radical prostatectomy (RARP) were prospectively recruited. The following MRI-derived microUS features were evaluated: capsular bulging, visible breach of the prostate capsule (visible extracapsular extension; ECE), presence of hypoechoic halo, and obliteration of the vesicle-prostatic angle. The ability of each feature to predict EPE was determined. RESULTS Overall, data from 140 patients were examined. All predictors were associated with non-organ-confined disease (p < 0.001). Final pathology showed that 79 patients (56.4%) had a pT2 disease and 61 (43.3%) ≥ pT3. Rate of non-organ-confined disease increased from 44% in those individuals with only 1 predictor (OR 7.71) to 92.3% in those where 4 predictors (OR 72.00) were simultaneously observed. The multivariate logistic regression model including clinical parameters showed an area under the curve (AUC) of 82.3% as compared to an AUC of 87.6% for the model including both clinical and microUS parameters. Presence of ECE at microUS predicted EPE with a sensitivity of 72.1% and a specificity of 88%, a negative predictive value of 80.5% and positive predictive value of 83.0%, with an AUC of 80.4%. CONCLUSIONS MicroUS can accurately predict EPE at the final pathology report in patients scheduled for RARP.
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Maffei D, Paciotti M, Avolio P, Frego N, Diana P, Fasulo V, Uleri A, Contieri R, Hurle R, Lazzeri M, Saita A, Casale P, Guazzoni G, Buffi N, Lughezzani G. Prostate biopsies by micro-ultrasound for clinically significant cancer detection: Results from a high-volume center. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03095-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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84
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Paciotti M, Fasulo V, Lazzeri M, Contieri R, Casale P, Avolio P, Saita A, Lughezzani G, Diana P, Frego N, Saitta C, Guazzoni G, Buffi N, Hurle R. Xpert bladder monitor may avoid cystoscopies in patients under “active surveillance” for recurrent bladder cancer (BIAS project): longitudinal cohort study. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00936-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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85
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Contieri R, Frego N, Paciotti M, Diana P, Beatrici E, Avolio P, Uleri A, Fasulo V, Saita A, Casale P, Buffi N, Lughezzani G, Lazzeri M, Guazzoni G, Hurle R. Active surveillance in low-grade non-muscle-invasive bladder cancers. Results after 8 years of bladder cancer Italian Active Surveillance (BIAS) project. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00703-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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86
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Arena P, Paciotti M, Maffei D, Matassa G, Jandric J, Fasulo V, Gobbo A, Frego N, Beatrici E, Hurle R, Saita A, Casale P, Lazzeri M, Lughezzani G, Guazzoni G, Chiti A, Buffi N. Additional value of 68GA-PSMA PET in patients who underwent choline-pet for biochemical recurrence after radical treatment for prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00970-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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87
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Contieri R, Paciotti M, Frego N, Maffei D, Avolio P, Diana P, Uleri A, Fasulo V, Domanico L, Gobbo A, Lazzeri M, Saita A, Taverna G, Greco F, Muto G, Barra S, Casale P, Lughezzani G, Buffi N, Guazzoni G, Hurle R. Is it safe to replace retur in T1 high grade non-muscle invasive bladder cancer patients with urine cytology and in-office cystoscopy? Preliminary results from the ongoing prospective multicenter trial “hunire”. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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88
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Frego N, Avolio P, Paciotti M, Diana P, Contieri R, Uleri A, Maffei D, Fasulo V, Saita A, Buffi N, Casale P, Lughezzani G. One-year follow-up results following transperineal laser ablation for the treatment of benign prostatic hyperplasia: a single institutional experience. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00712-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Taverna G, Thiel LM, Miller DL, Tidu L, Sardella P, Camp P, Zanoni ML, Vota P, Mazzieri C, Toia G, Fasulo V, Avolio P, Benetti A, Buffi N, Lughezzani G, Lazzeri M, Casale P, Guazzoni G, Grizzi F, Stork B. Hope for Ostomates: A Carbon and Zeolite Impregnated Polyester Fabric Inhibits Urine Odor in Cancer Patients: A Randomized Experimental Study. Asian Pac J Cancer Prev 2021; 22:2917-2921. [PMID: 34582662 PMCID: PMC8850874 DOI: 10.31557/apjcp.2021.22.9.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Many individuals with bladder cancer have undergone a surgical urostomy and often complain of being self-conscious of the unpleasant smell of their own urine. The focus of this study was to test the efficacy of a pouch cover made of a carbon and zeolite containing polyester material to inhibit the smell of urine by comparing two trained dogs' response time in detecting volatile organic compounds (VOCs) in urine, with and without the fabric covering the samples. METHODS This study used a randomized, blinded experimental design to evaluate the efficacy of a fabric to interfere with two highly trained dogs' ability to detect specific VOCs present in the urine of prostate cancer patient. Ninety urine samples were analyzed in this study. RESULTS Prior to the experiment, both dogs accurately detected VOCs in the uncovered test urine samples of men with prostate cancer with a sensitivity and specificity of nearly 100%. Both dogs recognized the "uncovered" urine samples of men with prostate cancer within two seconds. When the test sample was covered with the study fabric, the test urine samples were detected within 30-40 seconds and in some instances the dogs were not able to identify the covered samples, whatsoever. CONCLUSION The findings of this study demonstrate that the carbon and zeolite containing polyester fabric did significantly interfere with the ability of the dogs to detect VOCs in urine of men with prostate cancer. The fabric may show promise as a pouch cover in controlling offensive urine odor which many ostomates experience.
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Uleri A, Hurle R, Contieri R, Diana P, Buffi N, Lazzeri M, Saita A, Casale P, Guazzoni G, Lughezzani G. Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series. Urologia 2021; 89:363-370. [PMID: 34346247 DOI: 10.1177/03915603211035191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. OBJECTIVE To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). METHODS We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. RESULTS A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282-11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027-1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312-6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374-6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12-6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95-5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623-0.795). Limitations include the retrospective nature of the study and the relatively small sample size.
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Paciotti M, Contieri R, Fasulo V, Casale P, Saita A, Buffi NM, Lughezzani G, Diana P, Frego N, Guazzoni G, Lazzeri M, Hurle R. Active surveillance for recurrent Non-Muscle Invasive Bladder Cancer (NMIBC): which lessons have we learned during COVID-19 pandemia? Minerva Urol Nephrol 2021; 74:1-4. [PMID: 34338493 DOI: 10.23736/s2724-6051.21.04613-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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92
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Uleri A, Diana P, Lughezzani G, Lazzeri M, Casale P, Porpiglia F, Amparore D, Verri P, Rosiello G, Mottrie A, De Naeyerd G, De Grooted R, Porter J, Buffi N. Robot-assisted partial nephrectomy for ruptured angiomyolipomas: A multi institutional series. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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93
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Paciotti M, Yim K, Nguyen D, Marchese M, Häuser L, Modonutti D, Kölker M, Lughezzani G, Buffi N, Mossanen M, Trinh QD, Cole A. Propensity score based comparison of nephroureterectomy versus segmental ureterectomy for ureteral tumors. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01178-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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94
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Maffei D, Paciotti M, Avolio P, Frego N, Fasulo V, Diana P, Contieri R, Uleri A, Lazzeri M, Hurle R, Saita A, Casale P, Guazzoni G, Buffi N, Lughezzani G. Diagnostic accuracy of mpMRI-US fusion and micro-ultrasound guided biopsies for clinically significant prostate cancer detection. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01300-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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95
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Diana P, Uleri A, Frego N, Contieri R, Maffei D, Avolio P, Balzarini L, D’Orazio F, Colombo P, Lughezzani G, Buffi N, Saita A, Casale P, Lazzeri M, Hurle R. Head-to-head comparison between high-resolution microultrasound imaging and multiparametric MRI in detecting and local staging of bladder cancer: The bus-miss protocol. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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96
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Fasulo V, Lazzeri M, Paciotti M, Frego N, Roberto C, Avolio P, Uleri A, Casale P, Saita A, Lughezzani G, Buffi N, Guazzoni G, Hurle R. Xpert bladder monitor: Longitudinal clinical performance for avoiding un-necessary cystoscopies in patients under active surveillance for recurrent bladder cancer (BIAS project). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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97
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Avolio P, Maffei D, Paciotti M, Frego N, Diana P, Fasulo V, Uleri A, Contieri R, Casale P, Hurle R, Lazzeri M, Buffi N, Saita A, Lughezzani G. Assessing the relationship between micro-ultrasound results and pathology at radical prostatectomy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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98
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Contieri R, Hurle R, Saita A, Casale P, Lughezzani G, Lazzeri M, Taverna G, Greco F, Barra S, Muto G, Paciotti M, Avolio P, Frego N, Diana P, Uleri A, Maffei D, Fasulo V, Domanico L, Buffi N, Guazzoni G. Is it safe to replace ReTUR in high grade T1 non-muscle invasive bladder cancer patients with urine cytology and in-office cystoscopy? Preliminary results from an ongoing prospective multicenter trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01138-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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99
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Zanoni M, Vota P, Toia G, Mazzieri C, Sangalli M, Mandressi A, Grizzi F, Frego N, Buffi N, Lughezzani G, Lazzeri M, Guazzoni G, Taverna G. Thulium Laser Enucleation (ThuLEP) versus Transurethral Bipolar Prostate Resection (TURP): Prospective randomized study: Early intra- and postoperative results. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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100
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Diana P, Uleri A, Lughezzani G, Frego N, Contieri R, Paciotti M, Fasulo V, Colombo P, Buffi N, Saita A, Casale P, Hurle R, Lazzeri M. Potential role of micro-ultrasound in the differentiation between muscle-invasive and non-muscle invasive bladder cancer: A prospective analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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