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Saita A, Casale P, Lazzeri M, Buffi N, Hurle R, Peschechera R, Lughezzani G, Benetti A, Pasini L, Zandegiacomo S, Lista G, Cardone P, Guazzoni G. MP55-17 NEW CONCEPTION FOR FLEXOR VUE DEFLECTING ENDOSCOPIC SYSTEM USE, IN ORDER TO IMPROVE STONE FREE RATE (SFR) AFTER RIRS: PRELIMINARY RESULTS FROM A SINGLE CENTRE STAGE 2A STUDY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Torelli T, Lughezzani G, Catanzaro M, Nicolai N, Colecchia M, Biasoni D, Piva L, Maffezzini M, Stagni S, Necchi A, Giannatempo P, Farè E, Salvioni R. Prostatic Metastases from Testicular Nonseminomatous Germ Cell Cancer: Two Case Reports and a Review of the Literature. TUMORI JOURNAL 2018; 99:e203-7. [DOI: 10.1177/030089161309900513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Prostatic metastases from testicular germ cell tumors (TGCTs) are extremely uncommon. To the best of our knowledge, only five cases of prostatic metastases from seminoma have been reported in the literature. Conversely, no cases of metastases to the prostate from nonseminomatous germ cell tumors (NSGCT) have been previously reported. Case presentation We present two patients who developed prostatic metastases 5 and 21 years after the initial diagnosis. The first case concerned a 28-year-old Caucasian man who underwent a right orchiectomy and right retroperitoneal lymph node dissection (RPLND) for a stage I NSGCT in 1999 and five years later was diagnosed with prostatic metastases. The second case concerned a 30-year-old man treated with a right orchiectomy and right RPLND for stage I NSGCT in 1985 who was diagnosed with prostatic metastases in 2006, 21 years after primary surgery. We reviewed the available literature on the topic. Conclusion Prostatic metastases from TCGTs are highly unusual. Lower urinary tract symptoms in patients treated for previous testicular cancer require immediate clinical attention. However, because of their extreme rarity, specific clinical investigations to screen for possible prostatic involvement from TGCT should not be recommended.
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Lazzeri M, Lopci E, Lughezzani G, Colombo P, Casale P, Hurle R, Saita A, Leonardi L, Lista G, Peschechera R, Pasini L, Rodari M, Zandegiacomo S, Benetti A, Cardone P, Mrakic F, Balzarini L, Chiti A, Guazzoni G, Buffi NM. Targeted 11C-choline PET-CT/TRUS software fusion-guided prostate biopsy in men with persistently elevated PSA and negative mpMRI after previous negative biopsy. Eur J Hybrid Imaging 2017; 1:9. [PMID: 29782590 PMCID: PMC5954704 DOI: 10.1186/s41824-017-0011-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/18/2017] [Indexed: 12/22/2022] Open
Abstract
Background We evaluated the feasibility and accuracy of 11C–choline PET-CT/TRUS fusion-guided prostate biopsy in men with persistently elevated PSA and negative mpMRI or contraindication to MRI, after previous negative biopsy. Clinical data were part of a prospective on-going observational clinical study: “Diagnostic accuracy of target mpMRI/US fusion biopsy in patients with suspected prostate cancer after initial negative biopsy”. Patients with a negative biopsy and negative mpMRI (PI-RADS v.2 < 3) or absolute contraindications to MRI and persistently elevated PSA, were included. All patients underwent 11C–choline PET with dedicated acquisition of the pelvis and PET-CT/TRUS-guided prostate biopsy by Bio-Jet™ fusion system (D&K Technologies, Germany). The primary endpoint was to assess the accuracy of 11C–choline PET-CT to determine the presence and the topographical distribution of PCa. Results Overall, 15 patients (median age 71 yrs. ± 8.89; tPSA 13.5 ng/ml ± 4.3) were analysed. Fourteen had a positive PET scan, which revealed 30 lesions. PCa was detected in 7/15 patients (46.7%) and four patients presented a clinically significant PCa: GS > 6. Over 58 cores, 25 (43.1%) were positive. No statistically significant difference in terms of mean and median values for SUVmax and SUVratio between benign and malignant lesions was found. PCa lesions with GS 3 + 3 (n = 3) showed a median SUVmax and SUVratio of 4.01 and 1.46, compared to 5.45 and 1.57, respectively for lesions with GS >6 (n = 4). Conclusion Software PET-CT/TRUS fusion-guided target biopsy could be a diagnostic alternative in patients with a suspected primary PCa and negative mpMRI, but its specificity appeared low.
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Hurle R, Lazzeri M, Lughezzani G, Buffi N, Saita A, Pasini L, Zandegiacomo S, Benetti A, Forni G, Colombo P, Peschechera R, Casale P, Lista G, Cardone P, Guazzoni G. PD19-01 ACTIVE SURVEILLANCE FOR NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC): RESULT FROM BLADDER CANCER ITALIAN ACTIVE SURVEILLANCE (BIAS) PROJECT. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lughezzani G, Buffi N, Lista G, Maffei D, Forni G, Fossati N, Larcher A, Lazzeri M, Saita A, Casale P, Guazzoni G, Porter J, Mottrie A. MP72-17 ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR COMPLEX CASES (PADUA SCORE = 10): RESULTS FROM A MULTICENTER EXPERIENCE AT THREE HIGH-VOLUME CENTERS. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2253] [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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181
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Taverna G, Tidu L, Grizzi F, Stork B, Mandressi A, Seveso M, Bozzini G, Sardella P, Latorre G, Lughezzani G, Buffi N, Casale P, Fiorini G, Lazzeri M, Guazzoni G. Highly-trained dogs' olfactory system for detecting biochemical recurrence following radical prostatectomy. Clin Chem Lab Med 2017; 54:e67-70. [PMID: 26402886 DOI: 10.1515/cclm-2015-0717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 08/26/2015] [Indexed: 11/15/2022]
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Capelli L, Taverna G, Bellini A, Eusebio L, Buffi N, Lazzeri M, Guazzoni G, Bozzini G, Seveso M, Mandressi A, Tidu L, Grizzi F, Sardella P, Latorre G, Hurle R, Lughezzani G, Casale P, Meregali S, Sironi S. Application and Uses of Electronic Noses for Clinical Diagnosis on Urine Samples: A Review. SENSORS 2016; 16:s16101708. [PMID: 27754437 PMCID: PMC5087496 DOI: 10.3390/s16101708] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/15/2016] [Accepted: 09/29/2016] [Indexed: 01/01/2023]
Abstract
The electronic nose is able to provide useful information through the analysis of the volatile organic compounds in body fluids, such as exhaled breath, urine and blood. This paper focuses on the review of electronic nose studies and applications in the specific field of medical diagnostics based on the analysis of the gaseous headspace of human urine, in order to provide a broad overview of the state of the art and thus enhance future developments in this field. The research in this field is rather recent and still in progress, and there are several aspects that need to be investigated more into depth, not only to develop and improve specific electronic noses for different diseases, but also with the aim to discover and analyse the connections between specific diseases and the body fluids odour. Further research is needed to improve the results obtained up to now; the development of new sensors and data processing methods should lead to greater diagnostic accuracy thus making the electronic nose an effective tool for early detection of different kinds of diseases, ranging from infections to tumours or exposure to toxic agents.
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Buffi NM, Lughezzani G, Hurle R, Lazzeri M, Taverna G, Bozzini G, Bertolo R, Checcucci E, Porpiglia F, Fossati N, Gandaglia G, Larcher A, Suardi N, Montorsi F, Lista G, Guazzoni G, Mottrie A. Reply to Marc A. Bjurlin, Lee C. Zhao, and Michael D. Stifelman's Letter to the Editor Re: Nicolò Maria Buffi, Giovanni Lughezzani, Rodolfo Hurle, et al. Robot-assisted Surgery for Benign Ureteral Strictures: Experience and Outcomes from Four Tertiary Care Institutions. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2016.07.022. Eur Urol 2016; 71:e92-e93. [PMID: 27641789 DOI: 10.1016/j.eururo.2016.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/02/2016] [Indexed: 10/21/2022]
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Benincasa A, Nicolosi F, Lughezzani G, Buffi NM, Casale P, Hurle R, Lazzeri M, Cardone P, Guazzoni G, Saita A. Safety and Feasibility of Salvage Endoscopic Combined Intrarenal Surgery in Embolized Kidney. J Endourol Case Rep 2016; 2:127-30. [PMID: 27579440 PMCID: PMC4996616 DOI: 10.1089/cren.2016.0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Although endoscopic combined intrarenal surgery (ECIRS) is well established as primary approach to complex lithiasis, no evidences are still available on its use in salvage context. Case Presentation: A male patient, of 55 years of age, underwent many unsuccessful surgical procedures to treat large and multiple right kidney stones, including percutaneous nephrolithotomy (PCNL). The latter was complicated by severe postoperative hemorrhage, managed with super-selective renal artery embolization (SRAE). Therefore he came to our institution to achieve a complete resolution of the urolithiasis. Preoperative evaluation included CT scan and renal scintigraphy to establish kidney and stone morphologic features and residual renal function. Salvage ECIRS was performed and postoperative assessment showed a complete resolution of lithiasis and absence of renal function impairment. Conclusion: To our knowledge, this is the first case of salvage ECIRS reported in literature after previous failed PCNL. Even after SRAE, this procedure appears as safe and as efficacious as standard salvage PCNL when performed by experienced hands.
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Nielsen TK, Lagerveld BW, Keeley F, Lughezzani G, Sriprasad S, Barber NJ, Hansen LU, Buffi NM, Guazzoni G, van der Zee JA, Ismail M, Farrag K, Emara AM, Lund L, Østraat Ø, Borre M. Oncological outcomes and complication rates after laparoscopic-assisted cryoablation: a European Registry for Renal Cryoablation (EuRECA) multi-institutional study. BJU Int 2016; 119:390-395. [PMID: 27488479 DOI: 10.1111/bju.13615] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess complication rates and intermediate oncological outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRMs). PATIENTS AND METHODS A retrospective review of 808 patients treated with LCA for T1a SRMs from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification. Kaplan-Meier analyses were used to estimate 5- and 10-year disease-free survival (DFS) and overall survival (OS). RESULTS The median [interquartile (IQR)] age was 67 (58-74) years. The median (IQR) tumour size was 25 (19-30) mm. The transperitoneal approach was used in 77.7% of the patients. The median postoperative hospital stay was 2 days. In all, 514 patients with a biopsy-confirmed renal cell carcinoma (RCC) were available for survival analyses. The median (IQR) follow-up for the RCC-cohort was 36 (14-56) months. A total of 32 patients (6.2%) were diagnosed with treatment failure. The 5-/10-year DFS was 90.4%/80.0% and 5-/10-year OS was 83.2%/64.4%, respectively. A total of 134 postoperative complications (16.6%) were reported, with severe complications (grade ≥III) in 26 patients (3.2%). An American Society of Anesthesiologists score of 3 was associated with an increased risk of overall complications (odds ratio 2.85, 95% confidence interval 1.32-6.20; P = 0.005). CONCLUSIONS This large series of LCA demonstrates satisfactory long-term oncological outcomes for SRMs. However, although LCA is considered a minimally invasive procedure, risk of complications should be considered when counselling patients.
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Buffi NM, Lughezzani G, Hurle R, Lazzeri M, Taverna G, Bozzini G, Bertolo R, Checcucci E, Porpiglia F, Fossati N, Gandaglia G, Larcher A, Suardi N, Montorsi F, Lista G, Guazzoni G, Mottrie A. Robot-assisted Surgery for Benign Ureteral Strictures: Experience and Outcomes from Four Tertiary Care Institutions. Eur Urol 2016; 71:945-951. [PMID: 27473298 DOI: 10.1016/j.eururo.2016.07.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. OBJECTIVE To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. DESIGN, SETTING, AND PARTICIPANTS This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014. SURGICAL PROCEDURE Robotic PYP and robot-assisted UUY were performed according to previously reported surgical techniques. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS No robot-assisted UUY cases required surgical conversion, while 2.8% of PYP cases were not completed robotically. The median operative time was 120 and 150min for robot-assisted PYP and robot-assisted UUY, respectively. No intraoperative complications were reported. The overall complication rate for all procedures was 11% (n=20) and complications were mostly of low grade. The high-grade complication rate was 2.2% (n=4). At median follow-up of 24 mo, the overall success rate was >90% for both procedures. The study limitations include its retrospective nature and the heterogeneity of the study population. CONCLUSIONS Robotic surgery for benign US is safe and effective, with limited risk of high-grade complications and good intermediate-term results. PATIENT SUMMARY In this study we review the use of robotic surgery at four different tertiary care centres in the treatment of patients affected by benign ureteral strictures. Our results demonstrate that robotic surgery is a safe alternative to the standard open approach in the treatment of ureteral strictures.
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Hurle R, Peschechera R, Buffi NM, Lughezzani G, Morenghi E, Saita A, Pasini L, Casale P, Seveso M, Zandegiacomo S, Taverna G, Benetti A, Vavassori I, Colombo P, Lazzeri M, Guazzoni G. Impact of a teaching program on outcome quality of white light transurethral resection for bladder tumor: A cohort study. ACTA ACUST UNITED AC 2016. [DOI: 10.5430/jst.v6n2p56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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188
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Hurle R, Pasini L, Lazzeri M, Colombo P, Buffi N, Lughezzani G, Casale P, Morenghi E, Peschechera R, Zandegiacomo S, Benetti A, Saita A, Cardone P, Guazzoni G. Active surveillance for low-risk non-muscle-invasive bladder cancer: mid-term results from the Bladder cancer Italian Active Surveillance (BIAS) project. BJU Int 2016; 118:935-939. [DOI: 10.1111/bju.13536] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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189
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Bozzini G, Provenzano M, Buffi N, Seveso M, Lughezzani G, Guazzoni G, Mandressi A, Taverna G. An observational study of the use of beclomethasone dipropionate suppositories in the treatment of lower urinary tract inflammation in men. BMC Urol 2016; 16:25. [PMID: 27267961 PMCID: PMC4897870 DOI: 10.1186/s12894-016-0144-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 05/31/2016] [Indexed: 12/30/2022] Open
Abstract
Background Nonbacterial prostatitis, together with chronic pelvic pain syndrome, accounts for 90–95 % of prostatitis cases. Anti-inflammatory medications are commonly used to reduce storage/inflammatory symptoms that can deteriorate quality of life. The purpose of this study was to observe the efficacy and safety of beclomethasone dipropionate rectal suppositories (Topster®) in inflammations of the lower urinary tract in men. Methods Patients underwent diagnostic and therapeutic protocols according to current evidence-based practice. Efficacy assessments: voiding parameters, perineal pain, International Prostate Symptom Score (IPSS), digital rectal examination (DRE). Adverse events and patient compliance were recorded throughout the study. Results One hundred eighty patients were enrolled, mean age 52 ± 14.97. Most frequent diagnosis: nonbacterial prostatitis (85 %). All patients completed visits 1 and 2. All patients were treated with beclomethasone dipropionate (BDP) suppositories, 136/180 also with Serenoa repens (SR) extract. Antibiotics were rarely required. 162/180 patients presented clinically significant improvements and terminated treatment. Mean change vs. baseline in voiding frequency: −3.55 ± 2.70 n/day in patients taking only BDP and −3.68 ± 2.81 n/day in those taking both BDP and SR (P<.0001 in both groups). Uroflowmetry improved significantly; change from baseline 3.26 ± 5.35 ml/s in BDP only group and 5.61 ± 7.32 ml/s in BDP + SR group (P = 0.0002 for BDP, P<.0001 for BDP + SR). Urine stream normal in 35 % of patients at visit 1 and 57.22 % of patients at visit 2. Mean change in perineal pain, on 0–10 VAS, −0.66 ± 2.24 for BDP only group (P = 0.0699) and −1.37 ± 2.40 for BDP + SR group (P<.0001). IPSS increased at visit 2. No adverse events were reported. For all parameters, none of the comparisons between groups was found to be statistically significant. Conclusion This study confirmed the drug’s good safety profile. We also observed an improvement in the main storage symptoms and clinical findings associated with lower urinary tract inflammation in patients treated with beclomethasone dipropionate suppositories.
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Fossati N, Barbagli G, Larcher A, Dell’Oglio P, Sansalone S, Lughezzani G, Guazzoni G, Montorsi F, Lazzeri M. The Surgical Learning Curve for One-stage Anterior Urethroplasty: A Prospective Single-surgeon Study. Eur Urol 2016; 69:686-690. [DOI: 10.1016/j.eururo.2015.09.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 09/14/2015] [Indexed: 11/25/2022]
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191
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Lazzeri M, Hurle R, Casale P, Buffi N, Lughezzani G, Fiorini G, Peschechera R, Pasini L, Zandegiacomo S, Benetti A, Taverna G, Guazzoni G, Barbagli G. Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence. Ther Adv Urol 2016; 8:91-9. [PMID: 27034722 PMCID: PMC4772357 DOI: 10.1177/1756287215621234] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although the pathophysiology of acute chronic cystitis and other 'sensory' disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A 'cascade' of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminary experiences with GAG replenishment for different pathological conditions involving the lower urinary tract have been reported. There is a range of commercially available intravesical formulations of these components, alone or in combination. Literature evidence shows that exogenous intravesical hyaluronic acid markedly reduces recurrences of urinary tract infections (UTIs). Patients treated with exogenous GAGs have fewer UTI recurrences, a longer time to recurrence and a greater improvement in quality of life. Exogenous intravesical GAGs have been used for the treatment of PBS/IC. Despite the limitations of most of the studies, findings confirmed the role of combination therapy with hyaluronic acid and chondroitin sulfate as a safe and effective option for the treatment of PBS/IC. To prevent and/or treat radiotherapy and chemotherapy induced cystitis, GAG replenishment therapy has been used showing preliminary encouraging results. The safety profile of exogenous GAGs has been reported to be very favourable, without adverse events of particular significance.
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Lughezzani G, Lazzeri M, Hurle R, Buffi N, Casale P, Fiorini G, Peschechera R, Pasini L, Zandegiacomo S, Bini V, Benetti A, Haese A, Palou Redorta J, McNicholas T, de la Taille A, Guazzoni G. MP02-01 CLINICAL UTILITY OF PHI (PROSTATE HEALTH INDEX) IN MEN WITH TPSA > 10 NG/ML. RESULTS FROM A MULTICENTRIC EUROPEAN STUDY. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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193
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Lopci E, Lazzeri M, Lughezzani G, Pasini L, Hurle R, Leonardi L, Casale P, Buffi N, Peschechera R, Rodari M, Zandegiacomo S, Benetti A, Fiorini G, Chiti A, Guazzoni G. 505 Targeted PET/TRUS software fusion-guided biopsy in men with persistently elevated PSA and negative mpMRI after previous negative biopsy: A feasibility study and preliminary results. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60507-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Suardi N, Dell׳Oglio P, Gallina A, Gandaglia G, Buffi N, Moschini M, Fossati N, Lughezzani G, Karakiewicz PI, Freschi M, Lucianò R, Shariat SF, Guazzoni G, Gaboardi F, Montorsi F, Briganti A. Evaluation of positive surgical margins in patients undergoing robot-assisted and open radical prostatectomy according to preoperative risk groups. Urol Oncol 2016; 34:57.e1-7. [DOI: 10.1016/j.urolonc.2015.08.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/27/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
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Taverna G, Bozzini G, Grizzi F, Seveso M, Mandressi A, Balzarini L, Mrakic F, Bono P, De Franceco O, Buffi N, Lughezzani G, Lazzeri M, Casale P, Guazzoni GF. Endorectal multiparametric 3-tesla magnetic resonance imaging associated with systematic cognitive biopsies does not increase prostate cancer detection rate: a randomized prospective trial. World J Urol 2015; 34:797-803. [PMID: 26481226 DOI: 10.1007/s00345-015-1711-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/09/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate prostate cancer (PC) detection rate, employing endorectal multiparametric 3-tesla magnetic resonance imaging (MRI) driving subsequent cognitive systematic prostatic biopsy (CSPB) versus a homogenous group of patients who did not undergo endorectal MRI. MATERIALS AND METHODS A series of patients with a first negative biopsy were enrolled in the study. Patients were randomized into two groups: Group A: patients underwent MRI and subsequent CSPB; Group B: patients that did not undergo MRI. Each patient underwent a 13-core sampling. Patients from Group A had four cores more for each MRI suspected lesion. The cancer detection rate was calculated for each group with regard to possible matches or mismatches between MRI evidence and pathological reports. RESULTS Two hundred consecutive patients were investigated. Fifty out of 200 (25 %) patients had a diagnosis of PC, 24 in Group A and 26 in Group B. In Group A, 67 patients (67 %) were positive for suspected lesions at the MRI. The mismatch between MRI findings and the CSPB outcome was 61 % with an MRI-driven detection rate of 15 %. Group B detection rate was 26 % with no significant differences versus Group A (P = NS). Patient discomfort was higher in Group A (82 %). The accuracy of CSPB was 41 % with a positive predictive value of 22.3 %. This rate is lower in high-grade cancers (11.9 %). The cost-effectiveness was higher in Group A. CONCLUSIONS Prostate cancer detection rate does not improve by CSPB. The accuracy of CSPB was lower in high-grade PC, and a higher cost was found with CSPB.
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Lughezzani G, Buffi NM, Guazzoni G. Predicting Cancer-specific Mortality After Radical Prostatectomy: Still a Long Way To Go. Eur Urol 2015; 69:1044-5. [PMID: 26320379 DOI: 10.1016/j.eururo.2015.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/16/2015] [Indexed: 11/28/2022]
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Lazzeri M, Lughezzani G, Guazzoni G. Re: comparative analysis of transperineal template saturation prostate biopsy versus magnetic resonance imaging targeted biopsy with magnetic resonance imaging-ultrasound fusion guidance. Eur Urol 2015; 68:535-6. [PMID: 26282352 DOI: 10.1016/j.eururo.2015.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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198
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Fossati N, Larcher A, Gadda GM, Sjoberg DD, Mistretta FA, Dell'Oglio P, Lista G, Carenzi C, Lughezzani G, Lazzeri M, Montorsi F, Vickers AJ, Guazzoni G, Buffi NM. Minimally Invasive Partial Nephrectomy Versus Laparoscopic Cryoablation for Patients Newly Diagnosed with a Single Small Renal Mass. Eur Urol Focus 2015; 1:66-72. [PMID: 28723359 DOI: 10.1016/j.euf.2015.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 01/19/2015] [Accepted: 02/04/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Minimally invasive partial nephrectomy (MIPN) and laparoscopic renal cryoablation (LRC) are two treatment options increasingly used for small renal masses. OBJECTIVE To compare perioperative, oncologic, and functional outcomes after MIPN and LRC. DESIGN, SETTING, AND PARTICIPANTS We included 372 consecutive patients newly diagnosed with a single small renal mass and treated with either MIPN or LRC at a single institution. INTERVENTION MIPN and LRC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Regression models were used to evaluate the impact of surgical treatment (MIPN vs LRC) on perioperative, oncologic, and functional outcomes. RESULTS AND LIMITATIONS Overall, 206 patients (55%) underwent MIPN and 166 (45%) were treated with LRC. In multivariate analysis, the rate of postoperative complications was significantly lower in the MIPN compared to the LRC group (20% vs 28%; adjusted difference -11%; p=0.02) after adjusting for age at surgery, American Society of Anesthesiologists score (1 vs 2 vs 3), and tumor size. The median follow-up was similar in the two groups (43 and 39 mo for MIPN and LRC, respectively). In univariate Cox regression analysis, treatment type was not significantly associated with disease-free survival (hazard ratio 1.06, 95% confidence interval [CI] 0.45-2.52; p=0.9). The disease-free survival rate at 5 yr was 92% in MIPN and 93% in LRC patients. In multivariate linear regression analysis, LRC was significantly associated with a higher estimated glomerular filtration rate (eGFR) at 6 mo compared to MIPN (coefficient 4.68, 95% CI 0.06-9.30; p=0.047) after adjusting for age at surgery, tumor size, and preoperative eGFR. There was no significant association between surgical treatment and postoperative eGFR at 3 yr after surgery (coefficient -2.36, 95% CI -7.55 to 2.83; p=0.4). Limitations include the retrospective study design and selection bias. CONCLUSIONS MIPN and LRC provided similar cancer control and comparable renal function at intermediate-term follow-up. Both surgical techniques emerged as viable treatment options for patient newly diagnosed with a single small renal mass. Further multi-institutional studies with longer follow-up and nephrometry scores are needed to corroborate our findings. PATIENT SUMMARY In patients newly diagnosed with a single small renal mass, minimally invasive partial nephrectomy and laparoscopic renal cryoablation provided similar cancer control and comparable renal function at intermediate-term follow-up.
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Lughezzani G, Catanzaro M, Torelli T, Piva L, Biasoni D, Stagni S, Necchi A, Giannatempo P, Raggi D, Fare' E, Colecchia M, Pizzocaro G, Salvioni R, Nicolai N. Relationship between lymph node ratio and cancer-specific survival in a contemporary series of patients with penile cancer and lymph node metastases. BJU Int 2015; 116:727-33. [DOI: 10.1111/bju.12510] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Buffi N, Lughezzani G, Spinoglio G, Guazzoni G. Is Robotic Surgery Unnecessary for Adrenalectomy? Weighting the Pros and Cons of the Robotic Approach. Eur Urol Focus 2015; 1:263-264. [PMID: 28723396 DOI: 10.1016/j.euf.2015.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022]
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